Devices and methods for stabilizing tissue and implants

• US 9,271,766 B2
• Filed: 11/11/2013
• Issued: 03/01/2016
• Est. Priority Date: 10/26/2004
• Status: Expired due to Fees

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US14/076,812
• Publication Number:
  US 20140067063A1
• Time in Patent Office: 841 Days
• Field of Search: 606/279, 623 1711- 1716, 623 1311- 132
• US Class Current: 1/1
• 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 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7067 Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00951 adhesive
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• 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 2/30749 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2/4405 for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/30462 retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/4435 Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61L 27/58 Materials at least partially resorbable by the body

Abstract

An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

Claims

1. A sheath for reinforcement of a ligament extending between a first bone and a second bone, the sheath comprising:

a tubular sleeve defining a longitudinal axis and configured for placement in a predetermined implantation site within body tissue to reinforce the ligament, the tubular sleeve including an interior surface, an exterior surface, a tubular wall, a first end, a second end and an axially extending interior space defining an interior diameter, the exterior surface has a gripping feature thereon, the gripping feature comprises threads, the tubular sleeve being substantially solid between the first end and the second end, the tubular sleeve constructed of a flexible, reinforcement graft material, a first slit through the tubular wall extending continuously from the first end to the second end, a first fastening hole proximate the first end and a second fastening hole proximate the second end;

a first fastener configured for securing to the first end and the first bone by interaction with the first fastening hole; and

a second fastener configured for securing to the second end and the second bone by interaction with the second fastening hole.

2. The sheath of claim 1, wherein the tubular sleeve includes a therapeutic substance coated thereon.

3. The sheath of claim 1, further comprising:

a therapeutic substance packed into the tubular sleeve.

4. The sheath of claim 3, wherein the therapeutic substance is selected from the group consisting of an autogenic material, an allogeneic material, a xenogeneic material and a synthetic material.

5. The sheath of claim 1, wherein the internal space is comprised of a lumen.

6. The sheath of claim 1, wherein the tubular sleeve encapsulates the ligament between the first end and the second end and is secured to the ligament between the first end and the second end by a suture.

7. A sheath for reinforcement of a ligament extending between a first bone and a second bone, the sheath comprising:

a tubular sleeve defining a longitudinal axis and configured for placement in a predetermined implantation site within body tissue to reinforce the ligament, the tubular sleeve including an interior surface, an exterior surface, a tubular wall, a first end, a second end and an axially extending interior space defining an interior diameter, the exterior surface has a gripping feature thereon, the gripping feature comprises a plurality of raised regions, the tubular sleeve being substantially solid between the first end and the second end, the tubular sleeve constructed of a flexible, reinforcement graft material, a first slit through the tubular wall extending continuously from the first end to the second end, a first fastening hole proximate the first end and a second fastening hole proximate the second end;

a first fastener configured for securing to the first end and the first bone by interaction with the first fastening hole; and

a second fastener configured for securing to the second end and the second bone by interaction with the second fastening hole.

8. The sheath of claim 7, wherein the plurality of raised regions comprises raised bumps.

9. A sheath for reinforcement of a ligament extending between a first bone and a second bone, the sheath comprising:

a tubular sleeve defining a longitudinal axis and configured for placement in a predetermined implantation site within body tissue to reinforce the ligament, the tubular sleeve including an interior surface, an exterior surface, a tubular wall, a first end, a second end and an axially extending interior space defining an interior diameter, the exterior surface has a gripping feature thereon, the gripping feature comprises a plurality of circumferentially elevated areas for holding the sleeve within the tissue, the tubular sleeve being substantially solid between the first end and the second end, the tubular sleeve constructed of a flexible, reinforcement graft material, a first slit through the tubular wall extending continuously from the first end to the second end, a first fastening hole proximate the first end and a second fastening hole proximate the second end;

a first fastener configured for securing to the first end and the first bone by interaction with the first fastening hole; and

a second fastener configured for securing to the second end and the second bone by interaction with the second fastening hole.

10. The sheath of claim 9, wherein the plurality of circumferentially elevated areas comprises circumferentially raised ridges.

11. A sheath for reinforcement of a ligament extending between a first bone and a second bone, the sheath comprising:

a tubular sleeve defining a longitudinal axis and configured for placement in a predetermined implantation site within body tissue to reinforce the ligament, the tubular sleeve including an interior surface, an exterior surface, a tubular wall, a first end, a second end and an axially extending interior space defining an interior diameter, the tubular sleeve includes a second slit through the tubular wall extending continuously from the first end to the second end, the second slit positioned on an opposite side of the tubular sleeve relative to the first slit, the tubular sleeve being substantially solid between the first end and the second end, the tubular sleeve constructed of a flexible, reinforcement graft material, a first slit through the tubular wall extending continuously from the first end to the second end, a first fastening hole proximate the first end and a second fastening hole proximate the second end;

a first fastener configured for securing to the first end and the first bone by interaction with the first fastening hole; and

a second fastener configured for securing to the second end and the second bone by interaction with the second fastening hole.

12. A sheath for reinforcement of a ligament extending between a first bone and a second bone utilizing a minimally invasive technique, the sheath comprising:

a tubular sleeve defining a longitudinal axis and configured for placement in a predetermined implantation site within body tissue to reinforce the ligament, the tubular sleeve including an interior surface, an exterior surface, a tubular wall, a first end, a second end, a first anchoring point proximate the first end, a second anchoring point proximate the second end and an axially extending interior space defining an interior diameter, the exterior surface has a gripping feature thereon, the tubular sleeve being constructed of a flexible material and being configured to enable the tubular member to be inserted into a nonlinear passage into a patient'"'"'s body, a first slit through the tubular wall extending continuously from the first end to the second end, the tubular sleeve including openings through the tubular wall configured to promote tissue growth through the tubular wall;

a first fastener configured for securing to the first end and the first bone at the first anchoring point; and

a second fastener configured for securing to the second end and the second bone at the second anchoring point, the tubular sleeve being tensioned between the first fastener and the second fastener in an implanted configuration.

13. The sheath of claim 12, wherein the tubular sleeve is braided.

14. The sheath of claim 12, wherein the tubular sleeve is constructed of a composite material including a therapeutic substance.

15. The sheath of claim 12, wherein the tubular sleeve is coated with a therapeutic substance.

16. The sheath of claim 12, further comprising:

a first suture configured for securing the first end to the first bone.

17. The sheath of claim 16, further comprising:

a second suture configured for securing the second end to the second bone.

18. A sheath for reinforcement of one of an anterior cruciate, posterior cruciate, tibial collateral, fibular collateral, posterior meniscofemoral, and transverse ligament extending between a first bone and a second bone utilizing a minimally invasive technique, the sheath comprising:

a tubular sleeve defining a longitudinal axis and configured for placement in a predetermined implantation site within body tissue to reinforce the ligament, the tubular sleeve including an interior surface, an exterior surface, a tubular wall, a first end, a second end, a first fastening structure proximate the first end, a second fastening structure proximate the second end and an axially extending interior space defining an interior diameter, the exterior surface has a gripping feature thereon, the tubular sleeve being constructed of a flexible material and being configured to enable the tubular member to be inserted into a nonlinear passage into a patient'"'"'s body, a first slit through the tubular wall extending continuously from the first end to the second end;

a first fastener configured for securing to the first end and the first bone at the first fastening structure; and

a second fastener configured for securing to the second end and the second bone at the second fastening structure, the tubular sleeve being secured to the ligament between the first and second ends by a suture and encapsulating the ligament in an implanted configuration.

19. The sheath of claim 18, wherein the tubular sleeve is substantially solid between the first end and the second end.