Anatomic soft tissue repair

• US 9,955,980 B2
• Filed: 02/24/2015
• Issued: 05/01/2018
• Est. Priority Date: 02/24/2015
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Norton, Daniel, Stone, Kevin T.
• Primary Examiner(s): BOLES, SAMEH RAAFAT
• Application Number:
  US14/630,031
• Publication Number:
  US 20160242793A1
• Time in Patent Office: 1,162 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 17/06061 Holders for needles or sutures, e.g. racks, stands hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1714 for applying tendons or ligaments implements for applying tendons or ligaments A61F2/0805
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/0608 J-shaped
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2090/0801 Prevention of accidental cutting or pricking

Abstract

A method for repairing soft tissue. The method includes: forming a first bone hole; forming a second bone hole; connecting a first portion of the first bone hole to a second portion of the second bone hole to form a single bone bore; positioning at least a first anchor of a first suture construct at a distal end of the first bone hole, and positioning a second anchor of a second suture construct at a distal end of the second bone hole; connecting the first and the second suture constructs to the soft tissue; and drawing the soft tissue into the single bone bore with the first and the second suture constructs.

Claims

1. A method for repairing soft tissue comprising:

forming a first bone hole;

forming a second bone hole;

connecting a first portion of the first bone hole to a second portion of the second bone hole to form a single bone bore;

positioning at least a first anchor of a first suture construct at a distal end of the first bone hole, and positioning a second anchor of a second suture construct at a distal end of the second bone hole;

connecting the first and the second suture constructs to the soft tissue; and

drawing the soft tissue into the single bone bore with the first and the second suture constructs.

2. The method of claim 1, further comprising guiding a first guide wire to the bone with a drill guide to form the first bone hold, and guiding a second guide wire to the bone with a bore defined by a chisel to form the second bone hole.

3. The method of claim 2, further comprising:

forming a third bone hole between, and laterally spaced apart from, the first and the second bone holes;

inserting a third guide wire in the third bone hole; and

mounting the chisel to the third guide wire.

4. The method of claim 1, further comprising guiding a first guide wire to the bone with a first bore of a chisel to form the first bone hole;

and guiding a second guide wire to the bone with a second bore of the chisel to form the second bone hole.

5. The method of claim 4, further comprising:

moving a first insertion rod of a first inserter, with the first anchor at a distal tip of the first insertion rod, through the first bore of the chisel and through the first bone hole to position the first anchor at the distal end of the first bone hole; and

moving a second insertion rod of a second inserter, with the second anchor at a distal tip of the second insertion rod, through the second bore of the chisel and through the second bone hole to position the second anchor at the distal end of the second bone hole.

6. The method of claim 1, further comprising shaping the first and second portions of the first and the second bone holes with a chisel to approximate a shape of the soft tissue.

7. The method of claim 1, wherein the soft tissue includes:

an anterior cruciate ligament (ACL);

medial patellofemoral ligament (MPFL);

flexor halluces longus tendon;

biceps tendon;

anterior tibial fibular ligament;

calcaneal fibular ligament;

spring ligament;

or flexor and extensor tendons of the hand and foot.

8. A method for repairing soft tissue comprising:

inserting a first guide wire in a bone to define a first bone hole;

inserting a second guide wire in the bone proximate to the first guide wire to define a second bone hole proximate to the first bone hole;

enlarging a proximal portion of each of the first bone hole and the second bone hole such that the proximal portions of the first and the second bone holes are connected;

positioning a first anchor of a first suture construct at a distal end of the first bone hole, and positioning a second anchor of a second suture construct at a distal end of the second bone hole;

connecting a first suture of the first suture construct to a first portion of soft tissue, and connecting a second suture of the second suture construct to a second portion of soft tissue; and

drawing the first and second portions of soft tissue into the proximal portions of each of the first and second bone holes by pulling a first end of the first suture construct to close a first loop of the first suture construct, and by pulling a second end of the second suture construct to close a second loop of the second suture construct;

wherein the first and the second portions of soft tissue are portions of separate pieces of tissue or portions of a single piece of tissue.

9. The method of claim 8, further comprising enlarging the proximal portion of each of the first bone hole and the second bone hole with a reamer.

10. The method of claim 8, further comprising shaping the proximal portion of each of the first bone hole and the second bone hole with a chisel.

11. The method of claim 8, wherein the proximal portions of the first and the second bone holes are directly connected.

12. The method of claim 8, further comprising inserting a third guide wire in the bone to define a third bone hole;

and

enlarging a proximal portion of the third bone hole to connect the third bone hole to the proximal portions of each of the first and the second bone holes such that the proximal portions of each of the first and the second bone holes are connected by way of the proximal portion of the third bone hole.

13. The method of claim 8, further comprising:

guiding the first guide wire to the bone by inserting the first guide wire through a first bore defined by a chisel;

guiding the second guide wire to the bone by inserting the second guide wire through a second bore defined by the chisel; and

shaping the proximal portion of each of the first bone hole and the second bone hole with the chisel to correspond to a shape of the soft tissue.

14. The method of claim 13, further comprising supporting the chisel at the bone with a preliminary guide wire inserted into the bone prior to inserting the first guide wire and the second guide wire into the bone.

15. The method of claim 8, further comprising inserting the first and the second guide wires such that they extend through a first cortical bone layer, a cancellous bone layer, and a second cortical bone layer.

16. The method of claim 15, further comprising implanting the first anchor and the second anchor at the second cortical bone layer.

17. A method for repairing soft tissue comprising:

forming a bone hole extending through a first cortical bone layer, a cancellous bone layer, and a second cortical bone layer on a side of the cancellous bone layer opposite to the first cortical bone layer;

expanding a diameter of the formed bone hole at the first cortical bone layer and the cancellous bone layer only;

positioning a first anchor of a first suture construct at a distal end of the bone hole beyond the second cortical bone layer;

positioning a second anchor of a second suture construct at a distal end of the bone hole beyond the second cortical bone layer;

connecting the first and the second suture constructs to soft tissue;

drawing the soft tissue into the bone hole by pulling a first end of the first suture construct and by pulling a second end of the second suture construct.

18. The method of claim 17, wherein connecting the first and the second suture constructs to soft tissue includes connecting the first suture construct to a first soft tissue and connecting the second suture construct to a second soft tissue that is separate from the first soft tissue.

19. The method of claim 17, wherein connecting the first and the second suture constructs to soft tissue includes connecting both the first suture construct and the second suture construct to a single tissue.

20. The method of claim 17, wherein the soft tissue includes:

an anterior cruciate ligament (ACL);

medial patellofemoral ligament (MPFL);

flexor hallucis long us tendon;

biceps tendon;

anterior tibial fibular ligament;

calcaneal fibular ligament;

spring ligament;

or flexor and extensor tendons of the hand and foot.

21. The method of claim 17, wherein pulling the first end of the first suture construct includes pulling a portion of the first suture construct through the first anchor, and pulling the second end of the second suture construct includes pulling a portion of the second suture construct through the second anchor.

22. The method of claim 17, wherein pulling the first end of the first suture construct closes a first loop and a second loop of the first suture construct;

and pulling the second end of the second suture construct closes a first loop and a second loop of the second suture construct.