Method and apparatus for coupling soft tissue to bone

• US 8,128,658 B2
• Filed: 08/22/2008
• Issued: 03/06/2012
• 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: Kaiser, Ryan A., Denham, Gregory J., Stone, Kevin T., Bonnarens, Frank O.
• Primary Examiner(s): Erezo, Darwin
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US12/196,405
• Publication Number:
  US 20090062854A1
• Time in Patent Office: 1,292 Days
• Field of Search: 606/232, 606/228, 606/139, 606/148, 623/13.14, 623/23.72
• 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 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 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 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• 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 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0835 with deformation of anchor parts, e.g. expansion of dowel by set screw
• CPC Class Codes: A61F 2002/0852 Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0864 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

Abstract

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction.

Claims

1. A method of coupling soft tissue to bone comprising:

passing a first end of a suture 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 define a first adjustable loop;

passing a second end of the suture through the second aperture into the passage portion of the suture and out the first aperture so as to place the second end outside of the passage portion and define a second adjustable loop;

coupling a first fastener to the suture so as to place the passage portion within a bore defined by the first fastener;

coupling a second fastener to the bone;

coupling the first loop to the soft tissue; and

coupling the first fastener to the second fastener.

2. The method according to claim 1 further comprising coupling the first loop to the second loop.

3. The method according to claim 1 wherein the second fastener defines an aperture.

4. The method according to claim 3 wherein the first fastener is coupled to the aperture.

5. The method according to claim 3 wherein the first fastener is disposed within the aperture.

6. The method according to claim 1 further comprising coupling a third fastener to the bone;

and

coupling the second loop to the third fastener.

7. The method according to claim 6 further comprising passing the soft tissue through the second loop.

8. The method according to claim 1 further comprising forming a locking hook in the second fastener.

9. The method according to claim 8 further comprising coupling at least one of the first and second loops to the locking hook.

10. The method according to claim 1 further comprising the first and second adjustable loops being separate by the passage portion.

11. The method according to claim 10 further comprising the first and second adjustable loops extending from opposite ends of the passage portion.

12. The method according to claim 1 further comprising passing the first fastener through the soft tissue.

13. A method of coupling soft tissue to a bone comprising:

coupling a bone engaging fastener to bone, said bone engaging fastener defining a bore;

coupling a suture bearing fastener having an adjustable suture construct extending therefrom to the bore of the bone engaging fastener, the adjustable suture construct having a first end of a suture that extends 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 that the first end is outside of the passage portion and defines a first adjustable loop, and having a second end of the suture that extends through the second aperture into the passage portion and out the first aperture so that the second end is outside of the passage portion and defines a second adjustable loop, where the first and second adjustable loops are separated by the passage portion such that they extend from opposed ends of the passage portion; and

coupling the first adjustable loop to a patient.

14. The method according to claim 13 further comprising coupling the first loop to soft tissue.

15. The method according to claim 13 further comprising passing the first loop through soft tissue.

16. The method according to claim 13 wherein coupling the suture bearing fastener having the adjustable suture construct extending therefrom to the bore of the bone engaging fastener includes the passage portion of the adjustable suture construct being positioned in a bore defined by the suture bearing fastener.

17. The method according to claim 13 further comprising passing the suture bearing fastener through the soft tissue.

18. A method of coupling soft tissue to a bone, the method comprising:

coupling at least one adjustable suture construct extending from a first fastener to bone, the adjustable suture construct having a first end of a suture that extends 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 that the first end is outside of the passage portion and defines a first adjustable loop, and having a second end of the suture that extends through the second aperture into the passage portion and out the first aperture so that the second end is outside of the passage portion and defines a second adjustable loop, where the first and second adjustable loops are separated by the passage portion and the passage portion is positioned within a bore defined by the first fastener;

attaching the adjustable suture construct to soft tissue; and

applying tension to at least one of the first and second ends of the adjustable suture construct.

19. The method according to claim 18 further comprising coupling a second fastener to the bone and coupling the adjustable suture construct to the bone through the second fastener.

20. The method according to claim 19 further comprising applying tension onto at least one end of the adjustable suture construct to constrict the adjustable suture construct about the soft tissue.

21. The method according to claim 19 wherein applying tension onto at least one end of the adjustable suture construct includes drawing the soft tissue to the second fastener.

22. The method according to claim 19 wherein applying tension onto at least one end of the adjustable suture construct applies compression to the passage portion.

23. The method according to claim 19 further comprising passing the soft tissue through the first and second adjustable loops.

24. The method according to claim 19 wherein coupling a second fastener to the bone and coupling the adjustable suture construct to the bone through the second fastener includes passing the first fastener through the soft tissue and into a bore defined by the second fastener.

25. The method according to claim 18 wherein attaching the adjustable suture construct to soft tissue includes threading the adjustable suture construct through the soft tissue.

26. A method of coupling soft tissue to bone comprising:

coupling a first fastener to bone, the first fastener defining a bore;

coupling a second fastener having an adjustable suture construct extending therefrom to the bore of the first fastener, the adjustable suture construct having a first end of a suture that extends 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 that the first end is outside of the passage portion and defines a first adjustable loop and having a second end of the suture that extends through the second aperture into the passage portion and out the first aperture so that the second end is outside of the passage portion and defines a second adjustable loop;

attaching the first adjustable loop to the soft tissue;

coupling the second adjustable loop to a locking recess formed in an exterior of the second fastener; and

applying tension to the first and second ends of the adjustable suture construct to reduce a size of the adjustable loops and draw the soft tissue toward the first and second fasteners.

27. The method according to claim 26, wherein attaching the first adjustable loop to the soft tissue includes looping the first adjustable loop around the soft tissue.

28. The method according to claim 26, wherein coupling the second fastener having the adjustable suture construct extending therefrom to the bore of the first fastener includes coupling the second fastener having the adjustable suture construct extending from a bore defined in the second fastener to the bore of the first fastener.

29. The method according to claim 26, wherein coupling the second fastener having the adjustable suture construct extending therefrom to the bore of the first fastener includes coupling the second fastener to the bore of the first fastener that extends along an entire longitudinal length of the first fastener such that a tissue piercing proximal end of the second fastener extends beyond a corresponding proximal end of the first fastener.

30. The method according to claim 29, further comprising positioning the first fastener in the bore of the second fastener such that the locking recess with the second adjustable loop coupled thereto is positioned within the bore of the first fastener.