Method and apparatus for coupling soft tissue to a bone

• US 8,118,836 B2
• Filed: 08/22/2008
• Issued: 02/21/2012
• Est. Priority Date: 11/05/2004
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Denham, Gregory J., Stone, Kevin T.
• Primary Examiner(s): Erezo, Darwin
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US12/196,410
• Publication Number:
  US 20080312689A1
• Time in Patent Office: 1,278 Days
• Field of Search: 623/13.14, 623/23.72, 606/228, 606/232, 606/139, 606/148
• US Class Current: 606/232
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/00845 of moving parts with respect to each other
• CPC Class Codes: A61B 2017/00858 high friction or non-slip
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• 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
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 : with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/0618 : elastic, e.g. stretchable
• CPC Class Codes: A61B 2017/06185 : hollow or tubular
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0805 : Implements for inserting tendons or ligaments
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0823 : Modular anchors comprising a plurality of separate parts
• 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 2002/0864 : Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• CPC Class Codes: A61F 2002/087 : Anchor integrated into tendons, e.g. bone blocks, integrated rings
• 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
• CPC Class Codes: D04C 1/06 : Braid or lace serving particular purposes
• CPC Class Codes: D04C 1/12 : Cords, lines, or tows
• CPC Class Codes: D10B 2509/00 : Medical; Hygiene
• CPC Class Codes: D10B 2509/04 : Sutures

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. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

Claims

1. A method of surgically implanting a suture comprising:

forming a bore in a bone;

said suture having a passage portion defining a through passage;

passing a first end of the suture through a first aperture defined by the suture into the through passage of the 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 suture loop;

passing a second end of the suture through a third aperture into the through passage of the passage portion and out a fourth aperture so as to place the second end outside of the passage portion and form a second suture loop, and applying tension to the first and second ends;

coupling a collapsible tube to the suture;

passing the collapsible tube through a first opening of the bore such that the collapsible tube is positioned at an outer surface of the bone adjacent to a second opposite opening of the bore; and

applying a tensile load to a portion of the suture to form an anchoring mass with the collapsible tube having a locking profile engaging the outer surface of the bone, wherein applying the tensile load collapses the collapsible tube from a first profile to a second profile having a larger diameter to form the anchoring mass.

2. The method of surgically implanting a suture according to claim 1 wherein forming a bore in a bone includes forming a femoral tunnel in a femur and forming a tibial tunnel in a tibia.

3. The method according to claim 2 further comprising:

threading the collapsible tube through at least the femoral tunnel;

threading a soft tissue through the first suture loop; and

applying tension onto the suture to apply a load to the soft tissue.

4. The method according to claim 3 wherein applying tension onto the suture includes drawing the soft tissue into one of the femoral or tibial tunnel.

5. The method according to claim 3, wherein applying a tensile load to a portion of the suture to form an anchoring mass with the collapsible tube having a locking profile includes applying tension to the suture to reduce a size of the first suture loop and collapse the collapsible tube about the second surface adjacent the femoral tunnel to secure the suture relative to the femoral tunnel.

6. The method according to claim 5, further comprising coupling a second fastener to the soft tissue to secure the soft tissue relative to the tibial tunnel.

7. The method according to claim 6, wherein applying tension onto the suture to apply the load to the soft tissue includes applying tension onto the suture to reduce a size of the first adjustable suture loop and apply a tensile load to the soft tissue relative to the femur and the tibia.

8. The method according to claim 1 wherein applying tension onto the suture applies a compressive load onto the collapsible tube.

9. The method according to claim 1 further comprising sliding the suture with respect to the collapsible tube.

10. The method according to claim 1 wherein applying tension onto the first and second ends to constrict at least one of the first and second loops collapses the collapsible tube.

11. The method according to claim 1, wherein the first and fourth apertures are positioned about one end of the passage portion and the second and third apertures are positioned about another opposite end of the passage portion.

12. A method of surgically implanting a suture comprising:

forming a first tunnel in a first bone;

forming a second tunnel in a second bone;

positioning a first anchor together with an adjustable suture construct attached thereto into the first tunnel, wherein the adjustable suture construct has a body defining a longitudinal internal bore and a first end of the suture passes through a first aperture defined by the suture body and into the longitudinal internal bore and out a second aperture defined by the suture body to form a first adjustable loop, and wherein a second end of the suture passes through a third aperture defined by the suture body into the longitudinal internal bore and out a fourth aperture defined by the suture body to form a second adjustable loop;

coupling soft tissue to the adjustable suture construct;

positioning a second anchor relative to the second tunnel; and

tensioning at least one end of the adjustable suture construct to apply tension to the soft tissue relative to the first and second bones.

13. The method according to claim 12, wherein forming a first tunnel in a first bone includes forming a femoral tunnel in a femur, and wherein forming a second tunnel in a second bone includes forming a tibial tunnel in a tibia.

14. The method according to claim 12, wherein positioning the first anchor relative to the first tunnel includes:

passing the first anchor in a first profile through the first tunnel; and

engaging the first anchor in a second profile to a positive locking surface of the first bone adjacent the first tunnel.

15. The method according to claim 14, wherein tensioning at least one end of the adjustable suture construct to apply tension to the soft tissue relative to the first and second bones includes collapsing the first anchor from the first profile to the second profile, the second profile forming an anchoring mass.

16. The method according to claim 14, wherein the first anchor includes a collapsible tube collapsible from the first profile to the second profile to form the anchoring mass.

17. The method according to claim 12, wherein coupling soft tissue to the adjustable suture construct includes coupling the soft tissue to the first and second adjustable loops extending from the adjustable suture construct.

18. The method according to claim 17, wherein the adjustable suture construct includes a passage portion, the passage portion being coupled to the first anchor and allowing portions of the first and second loops to slide relative to the passage portion to adjust a size of the first and second loops.

19. The method according to claim 17, wherein positioning a second anchor relative to the second tunnel includes coupling the second anchor to the soft tissue to secure the soft tissue relative to the second tunnel.

20. The method according to claim 19, wherein tensioning at least one end of the adjustable suture construct to apply tension to the soft tissue relative to the first and second bones includes tensioning at least one end of the adjustable suture construct to reduce a size of the first and second adjustable loops to apply tension to the soft tissue relative to the first and second bones.

21. A method of surgically implanting a suture comprising:

forming a femoral tunnel in a femur;

forming a tibial tunnel in a tibia;

positioning a first anchor relative to the femoral tunnel, the first anchor including an adjustable suture construct extending therefrom, the adjustable suture construct including first and second adjustable loops, wherein the adjustable suture construct has a body defining a longitudinal internal bore and a first end of the suture passes through a first aperture defined by the suture body and into the longitudinal internal bore and out a second aperture defined by the suture body to form the first adjustable loop, and wherein a second end of the suture passes through a third aperture defined by the suture body into the longitudinal internal bore and out a fourth aperture defined by the suture body to form the second adjustable loop;

passing soft tissue into and around the first and second adjustable loops;

positioning a second anchor relative to the tibial tunnel;

positioning the adjustable suture construct between at least a portion of the femur and the tibia; and

tensioning at least one end of the adjustable suture construct to apply tension to the soft tissue relative to the femur and the tibia.

22. The method according to claim 21, wherein positioning a first anchor relative to the femoral tunnel includes:

passing the first anchor in a first profile through the femoral tunnel; and

engaging the first anchor in a second profile to a positive locking surface of the femur adjacent the femoral tunnel.

23. The method according to claim 22, wherein tensioning at least one end of the adjustable suture construct to apply tension to the soft tissue relative to the femur and the tibia includes tensioning at least one end of the adjustable suture construct to reduce a size of the first and second loops and collapse the first anchor from the first profile to the second profile, the second profile forming an anchoring mass relative to the femur.

24. The method according to claim 21, wherein the first anchor includes a collapsible tube collapsible from the first profile to the second profile under tension to form the anchoring mass.

25. The method according to claim 21, wherein the adjustable suture construct includes a passage portion, the passage portion being coupled to the first anchor and allowing portions of the first and second loops to slide relative to the passage portion to adjust a size of the first and second loops.

26. The method according to claim 21, wherein positioning a second anchor relative to the tibial tunnel includes coupling the second anchor to the soft tissue to secure the soft tissue to the tibial tunnel;

and

wherein tensioning at least one end of the adjustable suture construct to apply tension to the soft tissue relative to the femur and the tibia includes tensioning first and second ends of the adjustable suture construct to reduce a size of the first and second adjustable loops to apply tension to the soft tissue relative to the femur and the tibia via the respective first and second anchors.

27. The method according to claim 21, wherein tensioning at least one end of the adjustable suture construct to apply tension to the soft tissue relative to the femur and the tibia includes tensioning first and second ends of the adjustable suture construct to reduce a size of the first and second adjustable loops, which includes sliding the first and second loops relative to the soft tissue coupled thereto.

28. A method of surgically implanting a suture comprising:

forming a femoral bore in a femur and a tibial bore in a tibia;

passing a graft over at least a portion of first and second adjustable loops of an adjustable suture construct, wherein the adjustable suture construct has a body defining a longitudinal internal bore and a first end of the suture passes through a first aperture defined by the suture body and into the longitudinal internal bore and out a second aperture defined by the suture body to form the first adjustable loop, and wherein a second end of the suture passes through a third aperture defined by the suture body into the longitudinal internal bore and out a fourth aperture defined by the suture body to form the second adjustable loop;

passing a first anchor member into the femoral bore, the first anchor member coupled to the adjustable suture construct carrying the graft;

positioning a second anchor member relative to the tibial tunnel; and

tensioning at least one end of the adjustable suture construct to apply tension to the graft relative to the femoral and tibial bores.

29. The method according to claim 28, wherein passing a first anchor member into the femoral bore includes:

passing the first anchor member in a first profile through the femoral bore; and

engaging the first anchor member in a second profile to a positive locking surface of the femur adjacent the femoral bore.