Method for bone reattachment

• US 9,005,287 B2
• Filed: 11/04/2013
• Issued: 04/14/2015
• 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: Stone, Kevin T.
• Primary Examiner(s): STEWART, JASON-DENNIS NEILKEN
• Application Number:
  US14/071,295
• Publication Number:
  US 20140067081A1
• Time in Patent Office: 526 Days
• Field of Search: 623/16.11, 623/18.11, 623/22.11, 623 1911- 1914, 606 69- 75
• US Class Current: 623/16.11
• 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 17/82 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 2017/06185 hollow or tubular
• CPC Class Codes: A61F 2/30739 Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter proximal parts of endoprosthetic femoral shafts A61F2/367; non-prosthetic trochanteric devices A61B17/74
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/4607 of hip femoral endoprostheses
• CPC Class Codes: A61F 2002/30462 retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30578 having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30785 parallel

Abstract

A method for trochanteric reattachment can include positioning a femoral prosthesis relative to a proximal portion of a femur. A first portion of a self-locking adjustable flexible member construct can be coupled to a first attachment region of the prosthesis, and a second portion of the self-locking adjustable flexible member construct can be coupled to a second attachment region of the femoral prosthesis, where the second portion can be opposite the first portion. A trochanter can be positioned relative to the femur and a trochanteric engaging region of the prosthesis, and the self-locking adjustable flexible member construct can be positioned around an outer surface of the trochanter. Free ends of the self-locking adjustable flexible member construct can be tensioned to draw the trochanter into secure engagement with the prosthesis and the femur via the self-locking adjustable flexible member construct in an absence of a knot.

Claims

1. A method for reattachment of a bone, comprising:

positioning a prosthesis relative to a proximal portion of a first bone;

coupling a first portion of a self-locking adjustable flexible member construct to a first attachment region of the prosthesis;

positioning a second bone portion relative to the proximal portion of the first bone and a second bone engaging region of the prosthesis;

coupling a second portion of the self-locking adjustable flexible member construct to the second bone portion; and

tensioning free ends of the self-locking adjustable flexible member construct having a body that forms a passage, wherein tensioning free ends includes at least moving the free ends extending from the passage to cause the passage to constrict about portions of the self-locking adjustable flexible member construct due to caused tension, wherein tensioning further draws the second bone portion into secure engagement with the prosthesis and the first bone via the self-locking adjustable flexible member construct in an absence of a knot.

2. The method of claim 1, wherein the first bone includes a femur and the second bone portion includes a greater trochanter of the femur.

3. The method of claim 1, wherein the first bone includes a humerus and the second bone portion includes a greater trochanter of the humerus.

4. A method for reattachment of a bone, comprising:

positioning a prosthesis relative to a proximal portion of a first bone;

coupling a first portion of a self-locking adjustable flexible member construct to a first attachment region of the prosthesis;

positioning a second bone portion relative to the proximal portion of the first bone and a second bone engaging region of the prosthesis;

coupling a second portion of the self-locking adjustable flexible member construct to the second bone portion;

tensioning free ends of the self-locking adjustable flexible member construct to draw the second bone portion into secure engagement with the prosthesis and the first bone via the self-locking adjustable flexible member construct in an absence of a knot; and

forming a bore through the second bone portion that has been at least partially separated from the first bone;

wherein coupling the first portion of the self-locking adjustable flexible member construct to the first attachment region of the prosthesis includes coupling the first portion of the self-locking adjustable flexible member construct to a plug member.

5. The method of claim 4, wherein coupling the first portion of the self-locking adjustable flexible member construct to the first attachment region of the prosthesis includes passing the first portion through the bore formed in the second bone portion and through a through bore in the first prosthesis, the medial plug configured to be at least partially received in the through bore of the prosthesis.

6. The method of claim 5, wherein coupling a second portion of the self-locking adjustable flexible member construct to the second bone portion includes positioning a flexible anchor slidably coupled to the flexible member construct on an outer surface of the second bone portion adjacent the bore;

and

wherein tensioning free ends of the self-locking adjustable flexible member construct to draw the second bone portion into secure engagement with the prosthesis and the first bone includes tensioning the free ends to draw the medial plug into fixed engagement with a side of the through bore opposite a side facing the second bone.

7. A method for reattachment of a bone, comprising:

positioning a prosthesis relative to a first bone portion;

coupling a first portion of a first self-locking adjustable flexible member construct to a first attachment region of the prosthesis;

positioning a second bone portion relative to the first bone portion and a second bone engaging region of the prosthesis;

coupling a second portion of the first self-locking adjustable flexible member construct to the second bone portion; and

tensioning free ends of the first self-locking adjustable flexible member construct having a body that forms a passage, wherein tensioning free ends causes the passage to constrict about portions of the self-locking adjustable flexible member construct and draws the second bone portion into secure engagement with the prosthesis and the first bone via the first self-locking adjustable flexible member construct.

8. The method of claim 7, wherein the first self-locking adjustable flexible member construct is a braided flexible suture.

9. The method of claim 8, wherein tensioning the free ends of the first self-locking adjustable flexible member construct includes pulling on at least a first end of and a second end of the first self-locking adjustable flexible member construct that have both passed through a passage portion formed by the first self-locking adjustable flexible member construct.

10. The method of claim 7, further comprising:

forming a bore through the second bone portion that has been at least partially separated from the first bone; and

wherein coupling the first portion of the first self-locking adjustable flexible member construct to the first attachment region of the prosthesis includes coupling the first portion of the first self-locking adjustable flexible member construct to a plug member.

11. The method of claim 10, wherein coupling the first portion of the first self-locking adjustable flexible member construct to the first attachment region of the prosthesis includes passing the first portion through the bore formed in the second bone portion and through a through bore in the first prosthesis, the medial plug configured to be at least partially received in the through bore of the prosthesis.

12. The method of claim 11, wherein coupling a second portion of the first self-locking adjustable flexible member construct to the second bone portion includes positioning a flexible anchor slidably coupled to the first self-locking adjustable flexible member construct on an outer surface of the second bone portion adjacent the bore;

and

wherein tensioning free ends of the first self-locking adjustable flexible member construct to draw the second bone portion into secure engagement with the prosthesis and the first bone includes tensioning the free ends to draw the medial plug into fixed engagement with a side of the through bore opposite a side facing the second bone.

13. The method of claim 7, wherein the first bone includes a femur and the second bone portion includes a greater trochanter of the femur.

14. The method of claim 7, further comprising:

positioning at least the first self-locking adjustable flexible member construct around an outer surface of the second bone portion.

15. The method of claim 7, further comprising:

forming a bore in the second bone portion;

wherein coupling the first portion of the first self-locking adjustable flexible member construct to the first attachment region of the prosthesis includes positioning a flexible anchor slidably coupled to the first self-locking adjustable flexible member adjacent an aperture define by the prosthesis; and

wherein coupling a second portion of the first self-locking adjustable flexible member construct to the second bone portion includes positioning a flexible anchor slidably coupled to the first self-locking adjustable flexible member construct on an outer surface of the second bone portion adjacent a bore in the second bone portion.

16. A method for reattachment of a bone, comprising:

positioning a prosthesis relative to a first bone portion;

coupling a first portion of a first self-locking adjustable flexible member construct to a first attachment region of the prosthesis;

positioning a second bone portion relative to the first bone portion and a second bone engaging region of the prosthesis;

coupling a second portion of the first self-locking adjustable flexible member construct to the second bone portion;

tensioning free ends of the first self-locking adjustable flexible member construct to draw the second bone portion into secure engagement with the prosthesis and the first bone via the first self-locking adjustable flexible member construct;

coupling a second self-locking adjustable flexible member construct to a third attachment region of the prosthesis; and

positioning at least the first self-locking adjustable flexible member construct and the second self-locking adjustable flexible member construct around an outer surface of the second bone portion in an overlapping manner so as to form an X-shaped pattern with the first self-locking adjustable flexible member construct and the second self-locking adjustable flexible member construct.

17. A method for reattachment of a bone, comprising:

positioning a prosthesis relative to a first bone portion;

coupling a first portion of a first self-locking adjustable flexible member construct to a first attachment region of the prosthesis;

positioning a second bone portion relative to the first bone portion and a second bone engaging region of the prosthesis;

coupling a second portion of the first self-locking adjustable flexible member construct to the second bone portion; and

tensioning free ends of the first self-locking adjustable flexible member construct to draw the second bone portion into secure engagement with the prosthesis and the first bone via the first self-locking adjustable flexible member construct;

wherein tensioning the free ends of the first self-locking adjustable flexible member construct includes pulling on at least a first end of and a second end of the first self-locking adjustable flexible member construct that have both passed through a passage portion formed by the first self-locking adjustable flexible member construct;

wherein coupling the first portion of the first self-locking adjustable flexible member construct to the first attachment region of the prosthesis includes passing at least a portion of the first portion of the first self-locking adjustable flexible member construct through an aperture formed through the prosthesis and positioning a flexible anchor slidably coupled to the first self-locking relative to the prosthesis.

18. The method of claim 17, further comprising:

forming a bore through at least the second bone portion;

wherein coupling the second portion of the first self-locking adjustable flexible member construct to the second bone portion including passing at least a portion of the second portion of the first self-locking adjustable flexible member construct through the formed bore.

19. A method for reattachment of a bone, comprising:

positioning a prosthesis relative to a first bone portion;

coupling a first portion of a first self-locking adjustable flexible member construct to a first attachment region of the prosthesis;

positioning a second bone portion relative to the first bone portion and a second bone engaging region of the prosthesis;

coupling a second portion of the first self-locking adjustable flexible member construct to the second bone portion; and

tensioning free ends of the first self-locking adjustable flexible member construct to draw the second bone portion into secure engagement with the prosthesis and the first bone via the first self-locking adjustable flexible member construct;

wherein tensioning the free ends of the first self-locking adjustable flexible member construct includes pulling on at least a first end of and a second end of the first self-locking adjustable flexible member construct that have both passed through a passage portion formed by the first self-locking adjustable flexible member construct;

wherein coupling the first portion of the first self-locking adjustable flexible member construct to the first attachment region of the prosthesis includes positioning the first portion of the first self-locking adjustable flexible member construct over at least one tab extending from the prosthesis.