Method and apparatus for coupling soft tissue to a bone

• US 8,088,130 B2
• Filed: 05/29/2009
• Issued: 01/03/2012
• Est. Priority Date: 02/03/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Kaiser, Ryan A., Denham, Gregory J., Stone, Kevin T.
• Primary Examiner(s): Erezo, Darwin
• Assistant Examiner(s): DANG, PHONG SON H
• Application Number:
  US12/474,802
• Publication Number:
  US 20090312776A1
• Time in Patent Office: 949 Days
• Field of Search: 606/74, 606/103, 606/139, 606223-225, 606/228, 606/232, 600 29- 30, 600/37, 52/22, 241/15.H
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00858 high friction, non-slip on handles A61B2017/00429
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0432 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 : Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• CPC Class Codes: A61F 2002/0888 : Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

Claims

1. A method for use in surgically implanting a flexible strand comprising:

passing the flexible strand through a bore defined by a first construct;

passing a first end of the flexible strand through a first aperture defined by the flexible strand into a passage portion defined by the flexible strand and out a second aperture defined by the flexible strand so as to place the first end outside of the passage portion and form a first loop;

coupling the first construct to a patient;

forming a hole in soft tissue;

passing the first loop through the hole; and

applying tension to at least one end to constrict the first loop pulling soft tissue toward the first construct.

2. The method according to claim 1 further comprising passing the first end through the hole.

3. The method according to claim 1 wherein the first loop is coupled to a fastening member.

4. The method according to claim 3 wherein a second loop is coupled to the construct.

5. The method according to claim 1 further comprising passing a second end of the flexible strand through a third aperture into the passage portion and out a fourth aperture so as to place the second end outside of the passage portion and form a second loop;

and positioning the passage portion within the bore.

6. The method according to claim 5 further comprising coupling a collapsible fabric member disposed about one of the first or second loops.

7. The method according to claim 5 wherein the flexible strand comprises a collapsible fabric tube disposed about the first and second loops.

8. The method according to claim 1 wherein the flexible strand is a suture.

12. The method according to claim 5 wherein the third aperture is the second aperture and the fourth aperture is the first aperture.

13. The method according to claim 5, wherein passing a first end of the flexible strand through a first aperture defined by the flexible strand into a passage portion defined by the flexible strand and out a second aperture defined by the flexible strand so as to place the first end outside of the passage portion and form a first loop includes forming the first loop about a first end of the passage portion;

and

wherein passing a second end of the flexible strand through a third aperture into the passage portion and then out a fourth aperture so as to place the second end outside the passage portion and form a second loop includes forming the second loop about a second opposite end of the passage portion.

14. The method according to claim 13, wherein applying tension to at least one end to constrict the first loop pulling soft tissue toward the first construct includes applying tension to first and second ends of the flexible strand to reduce a size of the first and second loops and draw the soft tissue to the first construct.

9. A method for use in surgically implanting a suture comprising:

passing the suture through an aperture defined by a first bone engaging member, where a first end of the suture is passed through a first aperture defined by the suture into a passage portion defined by the suture and out a second aperture defined by the suture so as to place the first end outside of the passage portion and form a first loop, and where a first collapsible tube is threaded onto the first loop;

coupling the first bone engaging member to a patient; and

applying tension on at least one of the first end or a second end to constrict the first loop against patient soft tissue.

10. The method according to claim 9 further comprising forming a hole through the soft tissue and passing a portion of the suture through the hole.

11. The method according to claim 9 further comprising passing the first collapsible tube through the first hole.

15. A method for use in surgically implanting a suture comprising:

forming a first hole in soft tissue;

forming a second hole in soft tissue spaced apart from the first hole;

forming a bore in a bone of a patient;

positioning a fixation member in the bore of the bone, the fixation member having an adjustable flexible member construct extending therefrom;

positioning a first adjustable loop of the flexible member construct through the first hole in the soft tissue, where the first loop includes a first collapsible tube coupled thereto;

positioning a second adjustable loop of the flexible member construct through the second hole in the soft tissue, where the second loop includes a second collapsible tube coupled thereto; and

applying tension to first and second ends of the flexible member construct to reduce a size of the first and second loops and couple the soft tissue to the bone.

16. The method according to claim 15, wherein positioning a first adjustable loop of the flexible member construct through the first hole in the soft tissue, where the first loop includes a first collapsible tube coupled thereto includes positioning the first collapsible tube through the first hole;

and

positioning a second adjustable loop of the flexible member construct through the second hole in the soft tissue, where the second loop includes a second collapsible tube coupled thereto includes positioning the second collapsible tube through the second hole.

17. The method according to claim 15, wherein applying tension to first and second ends of the flexible member construct to reduce a size of the first and second loops and couple the soft tissue to the bone includes applying tension to the first and second ends to constrict the first and second collapsible tubes against the soft tissue.

18. A method for use in surgically implanting a flexible strand comprising:

passing the flexible strand through an aperture defined by a first bone engaging member;

passing a first end of the flexible strand through a first aperture defined by the flexible strand into a passage portion defined by the flexible strand and out a second aperture defined by the flexible strand so as to place the first end outside of the passage portion and form a first adjustable loop;

passing a second end of the flexible strand through the second aperture into the passage portion and then out the first aperture so as to place the second end outside the passage portion and form a second adjustable loop;

coupling a first collapsible tube to the first loop; and

coupling a second collapsible tube to the second loop.

19. The method according to claim 18 further comprising coupling a first cinch loop between the first collapsible tube and the first adjustable loop;

and coupling a second cinch loop between the second collapsible tube and the second adjustable loop.

20. The method according to claim 18, wherein coupling a first collapsible tube to the first loop and a second collapsible tube to the second loop includes threading a pair of first collapsible tubes through the first loop and threading a pair of second collapsible tubes through the second loop.

21. The method according to claim 18, wherein forming a first hole through the soft tissue and passing the first collapsible tube though the first hole includes forming a first pair of holes spaced apart from each other through the soft tissue and passing the pair of first collapsible tubes through the respective first pair of holes;

and

wherein forming a second hole through the soft tissue spaced apart from the first hole and passing the second collapsible tube through the second hole includes forming a second pair of holes spaced apart from each other and the first pair of holes through the soft tissue and passing the pair of second collapsible tubes through the respective second pair of holes.

22. The method according to claim 18, wherein passing the flexible strand through an aperture defined by a first bone engaging member includes positioning the passage portion within the aperture defined by the first bone engaging member.

23. The method according to claim 18, further comprising:

coupling the first bone engaging member to a bone of a patient;

forming a first hole through soft tissue and passing the first collapsible tube though the first hole;

forming a second hole through the soft tissue spaced apart from the first hole and passing the second collapsible tube through the second hole; and

applying tension on the first and second ends to constrict the first and second loops against the soft tissue.