364 results about "Bone tunnel" patented technology

A radially expandable sheath is provided having a substantially closed distal end with at least two sidewalls extending proximally therefrom and defining a central lumen. Each sidewall can have a substantially concave outer surface adapted to seat a graft member, and each side wall is at least partially separated by a longitudinally oriented slot that extends from a proximal end along a substantial length of each sidewall. The slot preferably terminates at a position just proximal to the distal end. The device can also include a sheath expander that is adapted to be disposed in the central lumen of the radially expandable sheath and that is configured to flex the sidewalls to radially expand the sheath so as to fix a graft member within a bone tunnel.

A bioabsorbable interference screw having a tapered profile which extends along substantially the entire length of the screw. The tapered profile makes the screw easy to insert while providing superior fixation resulting from a progressively increasing diameter. Upon insertion, the screw engages cortical bone at the back end of the bone tunnel and fills all but 5-10 mm. of the tunnel, thereby providing increased fixation strength while also promoting fast healing. The screw includes a head provided with a specially designed drive socket with radially extending slots at its outer end for receiving corresponding protrusions on the shaft of screwdriver. The drive socket optimizes the torque capacity of the screw. To maintain wall thickness, the socket has a taper corresponding to the tapered outer profile of the screw. The taper of the socket also permits easy insertion of the tip and shaft of the driver into the screw.

The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

The present invention comprises the provision and use of a novel retainer which is slidably advanced to a desired fixation position within a bone tunnel, fixed in position within the bone tunnel (preferably by wedging and / or pinning) while applying a lateral force against the graft ligament so as to compressively hold the graft ligament against the sidewall of the bone tunnel, and which then, optionally, has the graft ligament secured thereto with a cap, whereby to secure the graft ligament to the retainer and hence additionally to the host bone. The present invention also comprises the provision and use of a novel retainer which is slidably advanced to a desired fixation position within a bone tunnel so as to apply a lateral force against the graft ligament so as to compressively hold the graft ligament against the sidewall of the bone tunnel, and which is then locked to the host bone as the graft ligament is simultaneously secured to the retainer, whereby to secure the graft ligament to the retainer and hence additionally to the host bone.

A method for reconstructing a knee ligament and for performing a tibial osteotomy on the knee in a single procedure, the method comprising:forming a bone tunnel through the tibia at a location appropriate for the ligament reconstruction, disposing a graft ligament in the bone tunnel, and securing the graft ligament in the bone tunnel, and forming a wedge-like opening in the bone at a location appropriate for the tibial osteotomy, positioning an osteotomy implant in the wedge-like opening in the bone, and securing the osteotomy implant in the wedge-like opening in the bone;wherein the osteotomy implant is secured in the wedge-like opening in the bone with a fastener which extends through the implant and into the bone tunnel.

A jamming retainer for fixing a ligament in a bone tunnel without excessive sideways pressure on the ligament that may result in tissue necrosis the jamming retainer including a substantially rigid body with a bore or loop for receiving a ligament or tendon and a bore or ring for receiving a suture for towing the jamming retainer and ligament or tendon through a bone tunnel. Once positioned, the jamming retainer is fixed in the bone tunnel with an interference screw.

Devices, systems and methods for fixation of tendon to bone are described. An exemplary surgical implant is a modified bone anchor that is able to grasp the tendon and hold it firmly in a bone tunnel. Once deployed, the anchor delivers lateral compression to the tendon, providing direct tendon to bone compression to facilitate healing. The anchor has different versions which allow it to be attached to the tendon prior to insertion into the bone tunnel, or be inserted between tendon arms when the surgical procedure dictates. The resulting tendon to bone compression allows for the firm fixation in a manner markedly simpler than traditional techniques. A modification of this anchor can also allow the anchor to grasp and hold suture. This variation facilitates the technique for knotless rotator cuff repair.

A method for reconstructing a knee ligament and for performing a tibial osteotomy on the knee in a single procedure, the method comprising:forming a bone tunnel through the tibia at a location appropriate for the ligament reconstruction, disposing a graft ligament in the bone tunnel, and securing the graft ligament in the bone tunnel, and forming a wedge-like opening in the bone at a location appropriate for the tibial osteotomy, positioning an osteotomy implant in the wedge-like opening in the bone, and securing the osteotomy implant in the wedge-like opening in the bone;wherein the osteotomy implant is secured in the wedge-like opening in the bone with a fastener which extends through the implant and into the bone tunnel.

The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

A radially expandable sheath is provided having a substantially closed distal end with at least two sidewalls extending proximally therefrom and defining a central lumen. Each sidewall can have a substantially concave outer surface adapted to seat a graft member, and each side wall is at least partially separated by a longitudinally oriented slot that extends from a proximal end along a substantial length of each sidewall. The slot preferably terminates at a position just proximal to the distal end. The device can also include a sheath expander that is adapted to be disposed in the central lumen of the radially expandable sheath and that is configured to flex the sidewalls to radially expand the sheath so as to fix a graft member within a bone tunnel.

A method and construct for joint repair in which attachment of a double bundle graft ligament approximates anatomic orientation using interference fixation in a single bone tunnel. The double bundle graft features separable strands. A threaded screw is inserted between the separable strands and provides interference fixation of the graft against radially opposing walls defining the bone tunnel. Attachment of the graft using separated strands more closely approximate the configuration of the native ligament. The resulting reconstruction exhibits mechanical functionality that more accurately mimics that of the intact joint, with a minimum of associated tissue morbidity.

A method and apparatus for bunion repair using a suture passing K-wire configured to easily pass through bone tunnels with suture trailing. The suture passing K-wire includes a tapered guide pin with a multi-diameter shaft (i.e., comprising at least two regions or sections that have different diameters) and a loop which is securely attached to an end of the guide pin (i.e., to the smaller diameter section of the guide pin). The reconstruction system may be formed of a pair of buttons connected by a flexible strand. The procedure offers indirect placement of buttons and a minimally invasive approach.

Various embodiments described herein provide methods and apparatus for achieving the secure and stable fixation of a graft ligament within a bone tunnel using a screw that includes a cylindrical wall having a leading end and a trailing end, threads arranged on an outside surface of the cylindrical wall, and a plurality of portals arranged in the cylindrical wall and adapted to receive a plurality of prongs of a screwdriver.

A graft fixation device, system and method are disclosed for reconstruction or replacement of a ligament or tendon preferably wherein a soft tissue graft or a bone-tendon-bone graft is received and implanted in a bone tunnel. The graft fixation system includes a fixation device comprising a threaded body which is rotatably connected to a graft interface member. One embodiment of the implant / graft interface member includes an enclosed loop for holding a soft tissue graft. Another embodiment of the interface member includes a bone cage comprising a cage bottom and removable cage top to hold a bone block at one end of a bone-tendon-bone (BTB) graft. An additional embodiment of the interface member includes a one-piece bone cage which may be crimped or stapled to a bone block. The fixation device holds a graft in centered axial alignment in a bone tunnel. The body portion of the fixation device may be turned without imparting substantial twist to a graft attached to the device, due to the rotatable coupling between the threaded body and the interface member. The fixation device may be installed using a driver tool that has a shaft and an outer sleeve, wherein the driver may be used to twist the fixation device and independently exert a pushing or pulling force thereto. The graft fixation method may be used to install a fixation device by pulling or pushing it into a prepared bone tunnel while minimizing the possibility of abrasion or other damage to a graft attached to the fixation device.

A fixation screw, graft ligament anchor assembly, and method for fastening a graft ligament in a bone tunnel. The screw comprises an elongated shank having a distal end and a proximal end, and a central axis extending from the distal end to the proximal end. Screw threads are disposed on the shank and extend from the distal end to the proximal end. The proximal end defines an end plane disposed transversely to the axis and at an angle thereto other than a normal angle.

The subject invention is a fixation device or anchor intended to secure a graft ligament or other soft tissue repair. The device is designed to be attached to a graft ligament and to secure the graft within a bone tunnel by extending transversely across the opening of the tunnel. In certain procedures the device is intended to pass through a bone tunnel in an orientation generally aligned with the tunnel and then turn transversely. The device has an inherent tendency to rotate upon exiting the tunnel to thereby become automatically transversely aligned with the tunnel and the graft ligament. The rotation is due to a moment automatically created as a resultant of forces applied to the anchor by a pulling-suture via a laterally offset aperture joining the pulling-suture to the anchor.

In a first embodiment, the present invention includes an instrumentation system for preparing a bone for soft tissue repair, the instrumentation system including a flexible drill pin capable of bending along a curved path; an aimer capable of engaging the flexible pin to bend the flexible pin; and a flexible reamer having a flexible portion along at least a portion of its length, the flexible portion comprising a plurality of laser cuts. In an alternate embodiment, the present invention may also include a method for preparing a bone tunnel in a femur adjacent a knee joint, the method including introducing a flexible drill pin into the knee joint; guiding the flexible drill pin towards a surface of the femur with an instrument introduced into the knee joint; drilling the flexible drill pin into the femur; removing the instrument from the knee joint; introducing a cannulated flexible reamer into the knee joint by placing the flexible pin within the cannulation of the flexible reamer; and reaming the bone tunnel in the femur along the path of the flexible pin.

Devices, systems and methods for fixation of tendon to bone are described. An exemplary surgical implant is a modified bone anchor that is able to grasp the tendon and hold it firmly in a bone tunnel. Once deployed, the anchor delivers lateral compression to the tendon, providing direct tendon to bone compression to facilitate healing. The anchor has different versions which allow it to be attached to the tendon prior to insertion into the bone tunnel, or be inserted between tendon arms when the surgical procedure dictates. The resulting tendon to bone compression allows for the firm fixation in a manner markedly simpler than traditional techniques. A modification of this anchor can also allow the anchor to grasp and hold suture. This variation facilitates the technique for knotless rotator cuff repair.

A two piece graft fixation arrangement includes a graft block engageable with a graft and a transverse member engageable with the graft block to fix the graft block in a bone tunnel. Instruments and methods are presented for installing a graft in a bone tunnel and anchoring the graft with a transverse member placed through a transverse bore intersecting the bone tunnel.

A graft ligament is looped through a graft hole in a graft ligament support block, and the graft ligament support block is mounted to an installation tool. Then the installation tool is used to advance the graft ligament support block into a bone tunnel, with the two free ends of the looped graft ligament extending back out the bone tunnel. Next, a transverse tunnel is formed in the host bone, with the transverse tunnel being aligned with a transverse fixation pin hole in the graft ligament support block. Then the graft ligament support block is secured in place by pinning the graft ligament support block within the tunnel, i.e., by advancing a transverse fixation pin along the transverse tunnel and into the transverse fixation pin hole in the graft ligament support block. Then the installation tool is detached from the graft ligament support block and withdrawn from the surgical site.

A system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.

A graft fixation device comprising a sheath having a body that defines an inner longitudinal bore and a member for insertion within the bore. The sheath includes at least two projections movably connected to the sheath body by a distal hinge. The distal hinge causes the projection to pivot inwardly as the sheath is placed in a bone tunnel, and to be displaceable radially outwardly of the sheath body upon insertion of the member within the bore.

A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

A two piece graft fixation arrangement includes a graft block engageable with a graft and a transverse member engageable with the graft block to fix the graft block in a bone tunnel. Instruments and methods are presented for installing a graft in a bone tunnel and anchoring the graft with a transverse member placed through a transverse bore intersecting the bone tunnel.

A femoral guide for precisely positioning a guide wire on a bone surface of the femur includes a body having a lumen for receiving a guide wire and a tongue protruding from the body for engaging an edge or reference point on the bone surface with the tongue being spaced a predetermined distance from a longitudinal axis of the lumen. The lumen includes an opening allowing a guide wire extending through the lumen to contact the bone surface at a location spaced from the edge substantially the predetermined distance with the tongue engaging the edge. A stylus on the body can be driven into the bone to secure and stabilize the femoral guide prior to driving the guide wire into the bone through the lumen. With the guide wire driven into the bone, a bone tunnel can be formed substantially concentrically or coaxially along the guide wire such that a longitudinal axis of the bone tunnel will be disposed from the edge substantially the predetermined distance. Methods of precisely forming bone tunnels include the steps of engaging an edge of a bone surface with a tongue of the femoral guide, inserting a guide wire through a lumen of the femoral guide, driving the guide wire into the bone through the lumen and forming a bone tunnel in the bone along the guide wire such that a longitudinal axis of the bone tunnel will be disposed from the edge engaged by the tongue a distance substantially equal to the distance that the tongue is disposed from a longitudinal axis of the lumen.

A new approach for reconstructing a ligament, the new approach comprising: creating a bone tunnel within a host bone, the bone tunnel having a proximal end and a distal end, and defining a central axis extending from the proximal end to the distal end; creating an intervening layer of bone between the central axis of the bone tunnel and a rigid portion of the host bone, the intervening layer having a first side and a second side in opposition to one another, the first side of the intervening layer facing toward the central axis of the bone tunnel and the second side of the intervening layer facing toward the rigid portion of the surrounding host bone; and compressing the intervening layer of bone against a graft ligament positioned within the bone tunnel.

A method and apparatus for reconstructing a ligament using a graft ligament support block which comprises a body, and a graft hole and a transverse fixation pin hole extending through the body, with both the graft hole and the fixation pin hole preferably extending substantially perpendicular to the longitudinal axis of the body. A graft ligament is looped through the graft hole, and the support block is advanced into the bone tunnel, with the two free ends of the looped graft ligament extending back out the bone tunnel. Next, a transverse tunnel is formed in the host bone, with the transverse tunnel being aligned with the fixation pin hole. Then the support block is secured in place by pinning the support block within the tunnel, i.e., by advancing a fixation pin along the transverse tunnel in the host bone and into the fixation pin hole in the support block.

Method and apparatus for reconstructing a ligament. A graft ligament support block comprises a body, a graft hole, and a transverse fixation pin hole extending through the body. An installation tool is provided for inserting the support block into a bone tunnel and forming a transverse tunnel aligned with the pin hole. In use, a graft ligament is looped through the graft hole, and the support block is mounted to the tool. The tool is used to advance the support block into the bone tunnel, with two free ends of the graft ligament extending out the bone tunnel. A transverse tunnel is formed aligned with the pin hole. The support block is secured in place by pinning the support block within the tunnel by advancing a fixation pin along the transverse tunnel and into the pin hole in the support block.