Apparatus and methods for independently conditioning and pre-tensioning a plurality of ligament grafts during joint repair surgery
First Claim
1. A tensioning system for use in joint repair surgery involving independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning system comprising:
- a plurality of breakaway guide pins adapted for attachment to a patient'"'"'s bone, each breakaway guide pin including one or more notches or grooves that facilitate preferential breakage of the guide pin at or near the one or more notches or grooves, the one or more notches or grooves being spaced apart from a tip of the guide pin so that, after insertion of the guide pin into a patient'"'"'s bone and breaking off a first portion of the guide pin, a remaining portion of the guide pin will extend from a patient'"'"'s leg; and
a tensioning device that provides for independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning device comprising;
an attachment portion comprising a plurality of attachment posts, each configured to slidably attach to one of said breakaway guide pins when positioned in a bone so as to extend from a patient'"'"'s leg; and
a tensioning portion configured to independently apply a desired tensile load to each of at least two separate strands of a soft tissue graft, the tensioning portion comprising;
a tensioning block;
a first adjustable tensioning apparatus attached to the tensioning block and configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft in communication with the first adjustable tensioning apparatus; and
a second adjustable tensioning apparatus attached to the tensioning block in a spaced-apart relationship wit the first adjustable tensioning apparatus and configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft in communication wit the second adjustable tensioning apparatus independently of the first tensile load applied by the first adjustable tensioning apparatus,the tensioning block maintaining a sufficient space between the first and second adjustable tensioning apparatus as to permit an interference screw to pass between the first and second adjustable tensioning apparatus while securing a soft tissue graft to the bone tunnel.
1 Assignment
0 Petitions
Accused Products
Abstract
Apparatus and methods for conditioning and pre-tensioning soft tissue grafts during joint repair surgery, such as during repair of the anterior cruciate ligament (ACL). The inventive apparatus is advantageously adapted and configured so as to enable a surgeon to independently apply a desired tensile load to individual graft strands or graft bundles of a multi-strand tissue graft. The inventive methods enable each graft strand or bundle to be properly tensioned so as to both “condition” the graft to prevent subsequent stretching, relaxation or elongation following surgery, which can destabilize the joint, and to pre-tension each graft strand or bundle to a predetermined amount so that each contributes to the strength and stability of the joint, thus resulting in a stronger and more durable joint. The tensioning device is advantageously equipped with structure for attachment to a patient'"'"'s limb during the conditioning and pre-tensioning procedure. It has multiple adjustable tension applicators that can be independently manipulated so as to apply a separate tensile load to one or more ends of a tissue graft strand attached to each adjustable tension applicator.
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Citations
24 Claims
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1. A tensioning system for use in joint repair surgery involving independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning system comprising:
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a plurality of breakaway guide pins adapted for attachment to a patient'"'"'s bone, each breakaway guide pin including one or more notches or grooves that facilitate preferential breakage of the guide pin at or near the one or more notches or grooves, the one or more notches or grooves being spaced apart from a tip of the guide pin so that, after insertion of the guide pin into a patient'"'"'s bone and breaking off a first portion of the guide pin, a remaining portion of the guide pin will extend from a patient'"'"'s leg; and a tensioning device that provides for independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning device comprising; an attachment portion comprising a plurality of attachment posts, each configured to slidably attach to one of said breakaway guide pins when positioned in a bone so as to extend from a patient'"'"'s leg; and a tensioning portion configured to independently apply a desired tensile load to each of at least two separate strands of a soft tissue graft, the tensioning portion comprising; a tensioning block; a first adjustable tensioning apparatus attached to the tensioning block and configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft in communication with the first adjustable tensioning apparatus; and a second adjustable tensioning apparatus attached to the tensioning block in a spaced-apart relationship wit the first adjustable tensioning apparatus and configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft in communication wit the second adjustable tensioning apparatus independently of the first tensile load applied by the first adjustable tensioning apparatus, the tensioning block maintaining a sufficient space between the first and second adjustable tensioning apparatus as to permit an interference screw to pass between the first and second adjustable tensioning apparatus while securing a soft tissue graft to the bone tunnel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A tensioning system for use in joint repair surgery involving independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning system comprising:
a tensioning device that provides for independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning device comprising; an attachment portion configured to removably attach the tensioning device to a person'"'"'s limb; and a tensioning portion configured to independently apply a desired tensile load to each of at least two separate stands of a soft tissue graft, the tensioning portion comprising; a tensioning block; a first adjustable tensioning apparatus attached to the tensioning block and configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft in communication with the first adjustable tensioning apparatus; and a second adjustable tensioning apparatus attached to the tensioning block in a spaced-apart relationship with the first adjustable tensioning appratus and configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft in communication with the second adjustable tensioning apparatus independently or the first tensile load applied by the first adjustable tensioning apparatus, the tensioning block maintaining a sufficient space between the first and second adjustable tensioning apparatus as to permit an interference screw to pass between the first and second adjustable tensioning apparatus while securing a soft tissue graft to the bone tunnel; and at least one suture strand separator configured for removable attachment to the tensioning device and adapted to maintain at least two suture strands attached to different ends of a multi-strand tissue graft in a desired space-apart relationship. - View Dependent Claims (12, 13, 14, 15, 16, 17)
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18. A tensioning system for use in joint repair surgery involving independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning system comprising:
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a tensioning device that provides for independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning device comprising; an attachment portion configured to removably attach the tensioning device to a person'"'"'s limb; and a tensioning portion configured to independently apply a desired tensile load to each of at least two separate strands of a soft tissue graft, the tensioning portion comprising; a first adjustable tensioning apparatus configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft in communication with the first adjustable tensioning apparatus; and a second adjustable tensioning apparatus configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft in communication with the second adjustable tensioning apparatus independently of the first tensile load applied by the first adjustable tensioning apparatus; and a tension calculator adapted for determining what portion of a total tensile load to be applied to a composite tissue graft is to be applied to each tissue graft strand individually. - View Dependent Claims (19, 20, 21, 22)
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23. A tensioning system for use in joint repair surgery involving independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning system comprising:
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a plurality of breakaway guide pins adapted for attachment to a patient'"'"'s bone, each breakaway guide pin including one or more notches or grooves that facilitate preferential breakage of the guide pin at or near the one or more notches or grooves and a protrusion positioned between a tip and the one or more notches or grooves that limits how far the guide pin can be inserted into a bone; and a tensioning device that provides for independent tensioning of multiple tissue graft strands attached to a bone tunnel, the tensioning device comprising; an attachment portion comprising a plurality of attachment posts, each configured to slidably attach to one of said breakaway guide pins when positioned in a bone so as to extend from a patient'"'"'s leg; and a tensioning portion configured to independently apply a desired tensile load to each of at least two separate strands of a soft tissue graft, the tensioning portion comprising; a tensioning block; a first adjustable tensioning apparatus attached to the tensioning block and configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft in communication with the first adjustable tensioning apparatus; a second adjustable tensioning apparatus attached to the tensioning block in a spaced-apart relationship with the first adjustable tensioning appratus and configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft in communication with the second adjustable tensioning apparatus independently of the first tensile load applied by the first adjustable tensioning apparatus; and the tensioning block maintaining a sufficient space between the first and second adjustable tensioning apparatus as to permit an interference screw to pass between the first and second adjustable tensioning apparatus while securing a soft tissue graft to the bone tunnel. - View Dependent Claims (24)
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Specification