Method and apparatus for coupling anatomical features

• US 8,721,684 B2
• Filed: 03/05/2012
• Issued: 05/13/2014
• 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: Denham, Gregory J., Stone, Kevin T.
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US13/412,127
• Publication Number:
  US 20120165867A1
• Time in Patent Office: 799 Days
• Field of Search: 606/139, 606/142, 606/144, 606/148, 606/228, 606/232, 623/13.14
• US Class Current: 606/232
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/0487 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 2017/0404 Buttons
• 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 2017/0419 H-fasteners
• 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 2017/045 snug fit 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
• CPC Class Codes: A61B 2017/0641 : having at least three legs as part of one single body
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0829 : without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
• 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
• 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: Y10T 29/49826 : Assembling or joining

Abstract

An assembly for coupling a first portion of an anatomy to a second portion of the anatomy includes an anchor having an anchor body and a first and second bores through the anchor body. A first adjustable suture construct having a body portion passes through the first bore of the anchor and includes first and second adjustable loops slidable relative to a passage portion defined in the body portion of the first adjustable suture construct. A similar second adjustable suture construct passes through the second bore of the anchor.

Claims

1. A method of coupling a first portion of an anatomy to a second portion of the anatomy comprising:

forming a first bore in a first bone of the anatomy;

forming a second bore in a second bone of the anatomy;

positioning a first anchor relative to the first bore;

positioning a second anchor relative to the second bore, the second anchor having first and second adjustable suture constructs extending from the second anchor, each of the first and second adjustable suture constructs defining corresponding body portions;

positioning the first and second adjustable suture constructs between the first and second bones;

coupling the first and second adjustable suture constructs with corresponding first and second ligament replacements;

tensioning at least one end of the first adjustable suture construct to tension the first ligament replacement, wherein tensioning at least one end of the first adjustable suture construct includes adjusting a size of first and second adjustable loops slidably passing through a longitudinal interior bore defined in a passage portion of the body portion of the first adjustable suture construct; and

tensioning at least one end of the second adjustable suture construct to tension the second ligament replacement, wherein tensioning at least one end of the second adjustable suture construct includes adjusting a size of first and second adjustable loops slidably passing through a longitudinal interior bore defined in a passage portion of the body portion of the second adjustable suture construct.

2. The method of claim 1, wherein the first adjustable suture construct passes through a first through bore of the second anchor and wherein the second adjustable suture construct passes through a second through bore of the second anchor.

3. The method of claim 2, wherein the first and second adjustable loops of the first adjustable suture construct are coupled to a portion of the first ligament replacement positioned in the second bore of the second bone, and wherein the first and second adjustable loops of the second adjustable suture construct are coupled to a portion of the second ligament replacement positioned in the second bore of the second bone.

4. The method of claim 3, wherein the first anchor is coupled to portions of the first and second ligament replacement in the first bore of the first bone.

5. The method of claim 3, wherein first and second adjustable loops of the first adjustable suture construct are coupled to the first ligament replacement with a first fastener formed by a suture loop.

6. The method of claim 3, wherein first and second adjustable loops of the second adjustable suture construct are coupled to the second ligament replacement with a second fastener.

7. The method of claim 1, wherein the second anchor is a toggle anchor.

8. The method of claim 7, further comprising:

passing the toggle anchor through the first bore of the first bone and through and outside the second bore of the second bone in a first orientation aligned with the corresponding first and second bores; and

rotating the toggle anchor to a second orientation transverse to the first orientation outside the second bore of the second bone.

9. The method of claim 1, wherein the first adjustable suture construct has first and second ends, and the first end passes through a first aperture defined by the body portion and into the longitudinal internal bore of the passage portion and out a second aperture defined by the body portion to form the first adjustable loop of the first adjustable suture construct, and wherein the second end of the suture passes through a third aperture defined by the body portion and into the longitudinal internal bore and out a fourth aperture defined by the body portion to form the second adjustable loop of the first adjustable suture construct.

10. The method of claim 9, wherein the first aperture coincides with the fourth aperture and the second aperture coincides with the third aperture.

11. The method of claim 9, wherein the second adjustable suture construct has first and second ends, and the first end passes through a first aperture defined by the body portion and into the longitudinal internal bore of the passage portion and out a second aperture defined by the body portion to form the first adjustable loop of the second adjustable suture construct, and wherein the second end of the suture passes through a third aperture defined by the body portion and into the longitudinal internal bore and out a fourth aperture defined by the body portion to form the second adjustable loop of the second adjustable suture construct.

12. The method of claim 11, wherein the first aperture coincides with the fourth aperture and the second aperture coincides with the third aperture.

13. A method of coupling a first portion of an anatomy to a second portion of the anatomy comprising:

forming a first bore in a first bone of the anatomy;

forming a second bore in a second bone of the anatomy;

positioning a first anchor relative to the first bore;

positioning a second anchor relative to the second bore, wherein the second anchor has a first adjustable suture construct defining a body portion passing through a first transverse bore of the second anchor, and a second adjustable suture construct defining a body portion passing through a second transverse bore of the second anchor;

positioning the first and second adjustable suture constructs between the first and second bones;

coupling first and second adjustable suture loops of the first adjustable suture construct with a first ligament replacement, wherein the first and second adjustable suture loops slidably pass through a longitudinal interior bore defined in a passage portion of the body portion of the first adjustable suture construct;

coupling first and second adjustable suture loops of the second adjustable suture construct with a second ligament replacement, wherein the first and second adjustable suture loops slidably pass through a longitudinal interior bore defined in a passage portion of the body portion of the second adjustable suture construct;

tensioning at least one end of first and second ends of the first adjustable suture construct to adjust a size of the first and second adjustable loops and tension the first replacement ligament; and

tensioning at least one end of first and second ends of the second adjustable suture construct to adjust a size of the first and second adjustable loops and tension the second ligament replacement.

14. The method of claim 13, wherein the first end of the first adjustable suture construct passes through a first aperture defined by the body portion and into the longitudinal internal bore of the passage portion and out a second aperture defined by the body portion to form the first adjustable loop of the first adjustable suture construct, and wherein the second end of the of the first adjustable suture construct passes through a third aperture defined by the body portion and into the longitudinal internal bore and out a fourth aperture defined by the body portion to form the second adjustable loop of the first adjustable suture construct.

15. The method of claim 14, wherein the first and second adjustable loops of the first adjustable suture construct extend outside the first and second bores, and wherein the first ligament replacement passes through the first and second adjustable loops of the first adjustable suture construct outside the first and second bores, and wherein the first and second adjustable loops of the second adjustable suture construct extend outside the first and second bores, and wherein the second replacement ligament passes through the first and second adjustable loops of the second adjustable suture construct outside the first and second bores.

16. A method of coupling a first portion of an anatomy to a second portion of the anatomy comprising:

forming a first bore in a first bone of the anatomy;

forming a second bore in a second bone of the anatomy;

positioning a first anchor relative to the first bore;

positioning a second anchor relative to the second bore, the second anchor having a first adjustable suture construct passing through a first transverse bore of the second anchor and extending from the second anchor and a second adjustable suture construct passing through a second transverse bore of the second anchor and extending from the second anchor, each of the first and second adjustable suture constructs defining corresponding body portions;

positioning the first and second adjustable suture constructs between the first and second anchors;

tensioning at least one end of the first adjustable suture construct, wherein tensioning at least one end of the first adjustable suture construct includes adjusting a size of first and second adjustable loops slidably passing through a longitudinal passage portion defined in the body portion of the first adjustable suture construct; and

tensioning at least one end of the second adjustable suture construct, wherein tensioning at least one end of the second adjustable suture construct includes adjusting a size of first and second adjustable loops slidably passing through a longitudinal passage portion defined in the body portion of the second adjustable suture construct.

17. The method of claim 16, wherein the first end of the first adjustable suture construct passes through a first aperture defined by the body portion and into the longitudinal passage portion and out a second aperture defined by the body portion to form the first adjustable loop of the first adjustable suture construct, and wherein the second end of the of the first adjustable suture construct passes through a third aperture defined by the body portion and into the longitudinal passage portion and out a fourth aperture defined by the body portion to form the second adjustable loop of the first adjustable suture construct.

18. The method of claim 16, further comprising coupling the first and second adjustable suture loops of the first adjustable suture construct with a first ligament replacement and coupling first and second adjustable suture loops of the second adjustable suture construct with a second ligament replacement.

19. The method of claim 18, wherein tensioning at least one end of first and second ends of the first adjustable suture construct tensions the first replacement ligament and tensioning at least one end of first and second ends of the second adjustable suture construct tensions the second ligament replacement.

20. The method of claim 19, wherein the first and second adjustable loops of the first adjustable suture construct extend outside the first and second bores, and wherein the first ligament replacement passes through the first and second adjustable loops of the first adjustable suture construct outside the first and second bores, and wherein the first and second adjustable loops of the second adjustable suture construct extend outside the first and second bores, and wherein the second replacement ligament passes through the first and second adjustable loops of the second adjustable suture construct outside the first and second bores.