Method and apparatus for forming a self-locking adjustable loop

• US 8,936,621 B2
• Filed: 11/03/2011
• Issued: 01/20/2015
• 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., Wagner, Zachary
• Primary Examiner(s): Woo, Julian W
• Assistant Examiner(s): PAEZ, LUCAS M
• Application Number:
  US13/288,463
• Publication Number:
  US 20120046693A1
• Time in Patent Office: 1,174 Days
• Field of Search: 606/103, 606/213, 606/228, 606/232, 606/233, 606/300, 606/74, 623 1311- 1315
• 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 17/06004 Means for attaching suture to needle tipping A61B17/06195; connecting wire to other metallic objects B21F15/00
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/82 for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• 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 2002/0852 Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• 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

An apparatus can include a first flexible member having first and second ends and a first body extending therebetween, where the first body defines a first passage portion. A second flexible member can have first and second ends and a second body extending therebetween, where the second body defines second and third passage portions. The first end of the first flexible member passes into and through the second passage portion such that the first end extends outside of the second passage portion, and the second end of the first flexible member passes into and through the third passage portion such that the second end extends outside of the third passage portion. The first and second ends of the second flexible member pass into and through the first passage portion to form a self-locking adjustable flexible member construct.

Claims

1. A method of using an adjustable flexible member construct in a surgical procedure, comprising:

passing a first end of a self-locking adjustable flexible member construct through soft tissue, the flexible member construct having an adjustable portion formed from first and second flexible members coupled to each other and selectively movable relative to each other;

forming a bore in a bone;

passing an anchor member coupled to a second opposite end of the flexible member construct into the bore; and

applying tension to first ends of the first and second flexible members slidably extending from the anchor member to reduce a size of the adjustable portion of the flexible member construct and draw the soft tissue toward the anchor member.

2. The method of claim 1, wherein passing the first end of the self-locking adjustable flexible member construct through soft tissue includes passing second ends of the first and second flexible members opposite the first ends through the soft tissue, where the flexible member construct includes the first and second ends of the second flexible member passed into and though a first passage portion defined by the first flexible member between the first and second ends thereof and the first and second ends of the first flexible member passed into and through a second and passage portion defined by the second flexible member, the adjustable portion extending between the first and second passage portions.

3. The method of claim 2, wherein passing an anchor member coupled to a second opposite end of the flexible member construct into the bore includes passing the anchor member into the bore with the first passage portion being positioned in a passage of the anchor member.

4. The method of claim 3, wherein passing the first end of the self-locking adjustable flexible member through soft tissue includes passing second ends of the first and second flexible members through the soft tissue at least two times.

5. The method of claim 4, further comprising passing an end of the soft tissue and the anchor member through a portion of the flexible member construct between the soft tissue and the first end of the flexible member construct such that a fixed portion of the second flexible member extends over the soft tissue.

6. The method of claim 5, wherein applying tension to first ends of the first and second flexible members slidably extending from the anchor member includes:

moving the first ends of the first and second flexible members relative to portions of the first and second flexible members coupled to the anchor member; and

moving the fixed portion of the second flexible member relative to the tensioned first flexible member and the soft tissue to draw the fixed portion into engagement with the soft tissue.

7. The method of claim 6, wherein moving the fixed portion of the second flexible member relative to the tensioned first flexible member and the soft tissue includes sliding the second portion of the second flexible member relative to the first flexible member passing therethrough.

8. The method of claim 5, wherein applying tension to first ends of the first and second flexible members slidably extending from the anchor member to reduce the size of the adjustable portion includes applying tension to first ends of the first and second flexible members extending from the bore to reduce a length of a first portion of the first flexible member extending between the first passage portion and the second passage portion and a second portion of the second flexible member extending between the first passage portion and the second passage portion.

9. The method of claim 8, wherein applying tension to the first ends of the first and second flexible members includes automatically maintaining the reduced size of the self-locking adjustable flexible member construct under tension by self-locking the first and second passage portions under tension to maintain the reduced length of the first and second portions of the flexible member construct.

10. The method of claim 1, wherein forming the bore in the bone includes forming the bore in a radius bone, and wherein passing the first end of the self-locking adjustable flexible member construct through soft tissue includes passing the first end of the self-locking adjustable flexible member construct through a distal bicep.

11. The method of claim 1, wherein applying tension to the first ends of the first and second flexible members includes automatically maintaining the reduced size of the self-locking adjustable flexible member construct under tension in an absence of a knot.

12. The method of claim 1, wherein applying tension to the first ends of the first and second flexible members includes automatically maintaining the reduced size of the self-locking adjustable flexible member construct under tension via only the first and second flexible members.

13. The method of claim 1, wherein passing the first end of the self-locking adjustable flexible member construct through soft tissue includes passing second ends of the first and second flexible members through the soft tissue.

21. The method of claim 1, wherein applying tension to the first and second flexible members to reduce the size of the adjustable portion includes applying tension to first ends of the first and second flexible members.

22. The method of claim 21, wherein passing a first end of the flexible member construct through soft tissue includes passing second ends of the first and second flexible members through the soft tissue.

23. The method of claim 22, wherein passing a first end of the flexible member construct through soft tissue includes passing the second ends of the first and second flexible members through the soft tissue multiple times.

24. The method of claim 22, wherein piercing members are coupled to the second ends of the first and second flexible members.

25. The method of claim 24, further comprising:

removing the piercing members from the second ends of the first and second flexible members after passing the second ends through the soft tissue; and

coupling the second ends of the first and second flexible members to each other.

14. A method of using an adjustable flexible member construct in a surgical procedure, comprising:

passing a self-locking adjustable suture construct through soft tissue, the suture construct having a first suture defining a first passage portion between first and second ends and a second suture defining second and third passage portions between third and fourth ends, the first and second ends passing through the respective second and third passage portions at a first end of the suture construct and the third and fourth ends passing through the first passage portion at a second opposite end of the suture construct, the suture construct having an adjustable length portion extending between the first passage portion and the second and third passage portions, the first end of the suture construct being passed though the soft tissue;

positioning a fixed length portion of the second suture extending between the second and third passage portions over a portion of the soft tissue;

forming a bore in a bone;

passing an anchor member slidably coupled to the first passage portion into the bore;

applying tension to the first and second ends of the first suture extending from the soft tissue; and

applying tension to the third and fourth ends of the second suture slidably extending from the anchor member while maintaining tension in the first suture to reduce a size of the adjustable portion and draw the soft tissue along and relative to the first suture toward the anchor member to automatically maintain the reduced size of the suture construct under tension via the first, second and third passage portions.

15. The method of claim 14, applying tension to the first and second ends of the first suture extending from the soft tissue includes:

applying tension to the first and second ends of the first suture extending from the second and third passage portions positioned about the soft tissue so as to provide tension in the first suture extending from the soft tissue and the anchor member positioned in the bore; and

providing a guide path for the soft tissue via the tensioned first suture.

16. The method of claim 15, wherein applying tension to the third and fourth ends of the second suture includes:

applying tension to the third and fourth ends of the second suture extending from the bore to reduce a length of a first portion of the first and second sutures extending between one end of the first passage portion and the second passage portion and a second portion of the first and second sutures extending between an opposite end of the first passage portion and the third passage portion.

17. The method of claim 16, wherein applying tension to the third and fourth ends of the second suture slidably extending from the anchor member while maintaining tension in the first suture to reduce a size of the adjustable portion and draw the soft tissue along and relative to the first suture toward the anchor member to automatically maintain the reduced size of the suture construct under tension via the first, second and third passage portions includes supporting the soft tissue under tensile load via the first and second portions of the first and second sutures extending between the anchor member and the second and third passage portions coupled to the soft tissue.

18. The method of claim 14, wherein forming a bore in the bone includes forming a bore in a radius bone, and wherein passing the self-locking adjustable suture construct through soft tissue includes passing the self-locking adjustable suture construct through a distal bicep.

19. A method of securing soft tissue to bone, comprising:

passing a first end of an adjustable flexible member construct through soft tissue, the flexible member construct including an adjustable portion and first and second flexible members directly coupled to each other;

inserting an anchor member coupled to the flexible member construct into bone; and

applying tension to the first and second flexible members to reduce the size of the adjustable portion of the flexible member construct and draw the soft tissue toward the anchor member.

20. The method of claim 19, wherein the adjustable portion of the flexible member construct is formed from the first and second flexible members.

26. The method of claim 19, further comprising forming a bore in the bone before inserting the anchor member into the bone, wherein inserting the anchor member into the bone includes passing the anchor member into the bore.

27. The method of claim 19, wherein the flexible member construct maintains the reduced size of the adjustable portion without using a knot.

28. The method of claim 19, wherein:

the first flexible member includes a first passage portion;

the second flexible member includes a second passage portion; and

the adjustable portion is formed by passing the first end of the first flexible member through the second passage portion of the second flexible member and passing the first end of the second flexible member through the first passage portion of the first flexible member.

29. The method of claim 28, wherein the anchor member is coupled to portions of the first and second flexible members extending between the first and second passage portions.