Scaffold for spring ligament repair

• US 9,918,826 B2
• Filed: 12/03/2013
• Issued: 03/20/2018
• Est. Priority Date: 09/29/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Berelsman, Brian K., Myerson, Mark S., Stone, Kevin T.
• Primary Examiner(s): Dornbusch, Dianne
• Application Number:
  US14/095,614
• Publication Number:
  US 20140094913A1
• Time in Patent Office: 1,568 Days
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 2017/00858 high friction, non-slip on handles A61B2017/00429
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0477 with pre-tied 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 2002/0852 Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• 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 construct is disclosed that may be used to repair or replace a natural ligament. The construct may be formed of materials for biocompatibility and/or resorbtion. The construct may be provided or connected to a soft anchor for connection to a bone portion.

Claims

1. A method of augmenting a ligament, comprising:

forming a first bore in a first bone, wherein forming the first bore in the first bone includes forming the first bore in a navicular bone;

forming a second bore in a second bone, wherein forming the second bore in the second bone includes forming the second bore in a calcaneus bone, wherein the second bone is separate from the first bone and naturally connected with a natural ligament;

positioning a first anchoring mass relative to the first bone via the first bore;

positioning a second anchoring mass relative to the second bone via the second bore; and

tensioning a ligament construct between the first anchoring mass and the second anchoring mass anchor.

2. The method of claim 1, wherein positioning the first anchoring mass relative to the first bone via the first bore includes passing a first anchor through the first bone and positioning the first anchor on an exterior surface of the first bone opposite an insertion position of the ligament construct.

3. The method of claim 2, further comprising:

applying a tensile load to the first anchor after passing the first anchor through the first bore, including applying the tensile load to a portion of a suture construct to form the first anchoring mass with the first anchor having a locking profile engaging the exterior surface of the first bone, wherein applying the tensile load collapses the first anchor from a first profile to a second profile having a larger diameter to form the anchoring mass.

4. The method of claim 1, wherein positioning the first anchoring mass relative to the first bone via the first bore includes passing a first anchor into the first bore and into the first bone and positioning the first anchor on an exterior surface of the first bone away from an insertion position of the ligament construct.

5. The method of claim 4, further comprising:

applying a tensile load to the first anchor after passing the first anchor into the first bore, including applying the tensile load to a portion of a suture construct to form the first anchoring mass with the first anchor having a locking profile engaging the interior of the first bone, wherein applying the tensile load collapses the first anchor from a first profile to a second profile having a larger diameter to form the first anchoring mass.

6. The method of claim 1, wherein tensioning the ligament construct includes applying tension to a first and a second end of a suture portion;

wherein the suture portion is interconnected with the ligament construct and at least one of a first anchor and a second anchor;

wherein the suture portion has a passage portion that defines a through-passage and the suture portion is a continuous loop, wherein the first end is passed through a first aperture defined by the suture into the through-passage of the 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 form a first suture loop and the second end of the suture is passed through a third aperture into the through-passage of the passage portion and out a fourth aperture so as to place the second end outside of the passage portion to form a second suture loop.

7. The method of claim 1, wherein forming the first bore in the first bone and forming the second bore in the second bone includes, separately:

drilling a first through bore through a proximal cortical bone layer and a distal cortical bone layer with a first diameter drill;

over drilling a second bore through the proximal cortical bone layer and short of the distal cortical bone layer;

wherein each of the first bore and the second bore define an internal shoulder.

8. The method of claim 1, further comprising:

connecting the ligament construct with at least a portion of the ligament configured to interconnect the first bone and the second bone.

9. The method of claim 1, further comprising:

positioning a third anchoring relative to a third bone; and

tensioning the ligament construct relative to each of the first bone, the second bone, and the third bone;

wherein all of the first bone, the second bone, and the third bone are within a foot.

10. The method of claim 1, further comprising:

positioning a fourth anchoring relative to the third bone or a fourth bone; and

tensioning the ligament construct relative to each of the first bone, the second bone, the third bone, and the fourth bone;

wherein all of the first bone, the second bone, the third bone, and the fourth bone are within a foot or articulate with the foot;

wherein positioning the fourth anchoring may be in the third bone.

11. The method of claim 1, forming the first bore in the first bone and forming the second bore in the second bone includes, separately:

forming each of the first bore and the second bore to define an internal shoulder.

12. A method of augmenting a ligament, comprising:

forming a first bore in a tibia bone;

forming a second bore in a calcaneus bone, wherein the calcaneus bone is separate from the tibia bone;

providing a ligament construct connected to a first suture construct and a second suture construct, each of the first suture and the second suture having a passage portion that defines a through-passage and at least one suture loop relative to the passage portion and a first end and a second end;

providing a first collapsible soft anchor connected to the first suture construct;

providing a second collapsible soft anchor connected to second suture construct;

positioning the first collapsible soft anchor tube relative to the tibia bone via the first bore;

positioning a second collapsible soft anchor relative to the calcaneus bone via the second bore;

applying a first force to the first collapsible soft anchor with the first suture construct to form a first anchoring mass with the first collapsible soft anchor;

applying a second force to the second collapsible soft anchor with the second suture construct to form a second anchoring mass with the second collapsible soft anchor; and

tensioning the ligament construct between the first anchoring mass and the second anchoring mass.

13. The method of claim 12, wherein positioning the first collapsible soft anchor relative to the tibia bone via the first bore and positioning the second collapsible soft anchor relative to the calcaneus bone via the second bore includes passing the respective first collapsible soft anchor and the second collapsible soft anchor through the respective first bore and second bore to place the first collapsible soft anchor on an exterior surface of the tibia and to place the second collapsible soft anchor on an exterior surface of the calcaneus.

14. The method of claim 12, wherein tensioning the ligament includes applying a force to the first end and the second end of the first suture construct after the first anchoring mass is formed to at least draw the ligament construct towards the tibia bone.

15. The method of claim 12, wherein tensioning the ligament includes applying a force to the first end and the second end of the second suture construct after the second anchoring mass is formed to at least draw the ligament construct towards the calcaneus bone.

16. The method of claim 12, wherein providing a ligament construct connected to a first suture construct and a second suture construct includes providing an elongated construct having a first terminal end folded and attached centrally of the first terminal end to form a first eyelet through which the first suture construct is positioned and a second terminal end folded and attached centrally of the second terminal end to form a second eyelet through which the second suture construct is positioned.

17. The method of claim 16, further comprising:

providing the ligament construct formed of a woven polymer material.

18. The method of claim 12, wherein providing a ligament construct connected to a first suture construct and a second suture construct includes providing an elongated construct having a first bore formed through a first end through which the first suture construct is positioned and a second bore formed through a second end through which the second suture construct is positioned.

19. The method of claim 12, further comprising:

forming a third bore in a calcaneous;

forming a fourth bore in the calcaneous;

positioning a third collapsible soft anchor relative to the calcaneous bone via the third bore; and

positioning a fourth collapsible soft anchor relative to the calcaneous bone via the fourth bore.

20. A method of augmenting a ligament, comprising:

forming a ligament construct extending from a first terminal end to a second terminal end;

forming a first passage near the first terminal end of the ligament construct;

forming a second passage near the second terminal end of the ligament construct;

connecting a first suture construct to the ligament construct through the first passage;

connecting a second suture construct to the ligament construct through the second passage;

providing each of the first suture construct and the second suture construct having a passage portion that defines a through-passage, where a first end of each suture is passed into the through-passage through a first aperture to form a first loop and exits the through-passage through a second aperture and a second end of each suture is passed into the through-passage through a third aperture to form a second loop and exits the through-passage through a fourth aperture; and

coupling a first soft anchor to the first suture construct and a second soil anchor to the second suture construct.

21. The method of claim 20, wherein forming the first passage near the first terminal end of the ligament construct includes folding the first terminal end inwards to a first position towards a center of the ligament construct and fixing the first terminal end at the first position;

and

wherein forming the second passage near the second terminal end of the ligament construct includes folding the second terminal end inwards to a second position towards the center of the ligament construct and fixing the second terminal end at the second position.

22. The method of claim 20, wherein forming the first passage near the first terminal end of the ligament construct and forming the second passage near the second terminal end of the ligament construct includes forming a through-bore through the ligament construct from a first side to a second side.

23. The method of claim 20, where coupling the first soil anchor to the first suture construct includes coupling a first collapsible tube about the first suture construct and the second soft anchor to the second suture construct includes coupling a second collapsible tube about the second suture construct.

24. The method of claim 23, further comprising:

providing the first collapsible tube to collapse and the second collapsible tube to collapse when a tensile force is applied by the respective first suture or second suture.

25. The method of claim 20, wherein forming the ligament construct extending from the first terminal end to the second terminal end includes forming a first arm and a second atm to extend near the second end transverse to a longitudinal axis of the ligament construct defined between the first terminal end to the second terminal end.