Other

W Karl Somers

E Marlowe Goble

David A McGuire

Richard B Caspari

Marlowe E Goble

An apparatus for use in positioning a ligament or a graft within a joint during surgery. The apparatus includes a tensioning assembly which is operable to adjustably apply tension to the ligament or graft during surgery. The apparatus further includes support assembly which is operable to secure the tensioning assembly to the extremity associated with the joint. Alternatively, the tensioning assembly may be secured directly to the bone forming the joint.

Method and apparatus for tensioning grafts or ligaments

The improved channel ligament clamp of the invention is for human implantation in a surgical procedure for securing a ligament, that is either natural or prosthetic, onto a bone cortex and includes, as a clamp body, a rectangular section of a thin, flat metal material, such as titanium, with identical equal opposite edge portions of which material bent at approximately right angles forming upstanding parallel side walls. Edges of which upstanding parallel side walls are for contacting a bone surface whereto the clamp is secured to closely contain a ligament section therebetween without crushing it, and which parallel side walls are the side walls of a channel section with the flat material therebetween constituting the channel section web. Which channel section web includes a plurality of pointed end parallel pins secured thereto that extend at right angles and are parallel to clamp the side walls. Preferably four pins are employed with each arranged as a corner of a square pattern, and a hole that is preferably threaded, is formed through the web in the center of which formed square for passing a screw type connector therethrough.

Channel ligament clamp

The invention is in a double guide sleeve drill guide for use in an arthroscopic surgical procedure for replacement of a cruciate ligament in a straight ligament tunnel procedure that involves forming intersecting tunnels to the femoral and tibial sections of which straight ligament tunnel. The drill guide of the invention includes straight parallel reference and guide rods that are in the extend from a web member at right angles and are in the same plane, forming a U-shaped device, with the reference rod arranged for fitting into which straight ligament tunnel. The connection of which reference rod to the web member is adjustable along the web member for setting a spacing distance between which reference and guide rods, and equidistant markings are scribed along the reference rod as a scale. The guide rod mounts a pair of blocks, one fixed and one movable, with threaded holes formed through each for receiving a guide sleeve wherethrough a drill is turned, guiding drilling of holes that intersect which femoral and tibial tunnel sections. The fixed block is slightly movable to spread apart the threaded guide sleeve hole that is formed as two segments, to allow for passage of a drill sleeve slid therein. The two threaded guide sleeve hole sections are closed together to mesh with a guide sleeve threaded body portion, and a slot is formed in the guide rod that intersects the fixed block threaded guide sleeve hole to allow a drill or K-wire to pass therethrough.

Mutliple guide sleeve drill guide

A harpoon suture anchor and driver, which suture anchor includes a pointed forward harpoon end that is for driving into a bone, the driver for mounting the suture anchor onto one end and is configured to receive a hammer force on its other end, and transmit that force into so as to drive the suture anchor harpoon end into which bone. An end of a suture connects into a cavity of a suture anchor cylindrical body, which cylindrical body fits into a suture anchor mount of the driver that includes a collar for contacting the bone surface limiting suture anchor penetration. Which suture anchor mount is open therethrough as is a driver rod connected thereto, the openings for maintaining the suture fitted therein until the driver and suture anchor mount are pulled therefrom. The invention includes three embodiments of suture anchor harpoon ends: a first embodiment of which is a regular cone that is inturned at a skirt into a wall that extends to the cylindrical body, sloping towards the pointed end, the skirt to flex inwardly as the suture anchor is hammered into a bone; a second embodiment of which is like the first embodiment except spaced arcuate flutes are removed from the regular cone body, leaving spaced body sections in a cross configuration, skirt sections of which body sections to flex inwardly during installation; and a third embodiment of which that is like the second embodiment except that the removed flutes are identically twisted or angled to the longitudinal axis, with the body sections likewise twisted, which twist imparts a rotation to the suture anchor around its longitudinal axes as it is hammered into a bone.

Harpoon suture anchor

For knee reconstruction surgery involving replacement of an anterior or posterior cruciate ligament the present invention is in a process for verifying isometric ligament positioning at the femoral and tibial points of origin that includes, as apparatus, an arrangement of a stud (19) with attached suture (24) to serve as a mock ligament for testing isometry. In practice, as for an anterior cruciate ligament replacement procedure, a surgeon, observing on a fluoroscopic monitor (17), forms a tibial tunnel (18) from a point medial to the tibial tuberosity that exits a test or proposed tibial point of ligament origin. The stud (19) is arranged for turning on a driver (20) that is then passed through that formed tunnel and the stud is turned into the test or proposed femoral point of ligament origin. The driver (20) is then pulled out of engagement with the stud (19) exposing the suture (24) that extends from that stud, which suture (24) is attached under tension to a tension isometer (25) and the knee (10) is flexed through its full range of motion. With an isometrically correct selection of the femoral and tibial ligament points of origin, the tension isometer (25) will show no more than a three (3) pound change in force and no more than a two (2) mm change in ligament length or distance between the two points of origin over a full range of knee (10) flexure.

Procedure for verifying isometric ligament positioning

A soft tissue anchor involving a footing stud that includes a drill end followed by self tapping threads, the footing stud arranged for turning and tapping into a bone mass. The footing stud for endosteal seating at a ligament attachment site on that bone mass. A center longitudinal hole is arranged in that footing stud rear end that receives and locks to a pointed cone base end edge of a tack that is fitted therein. The tack includes a tack shaft whereto is axially attached, on one end, the pointed cone base with a broad head secured to the other shaft end. The tack broad head is disk shaped and includes spikes that project at spaced radial intervals from the undersurface thereof, parallel to the shaft, and includes a center axial threaded post that extends outwardly from a top surface thereof. Which threaded post is for turning into a threaded end of a tack driver. The tack pointed cone is for passing through a ligament, or the like, and locking in the footing stud, in which configuration the spikes that extend from the undersurface of the broad head spikes have penetrated the ligament and the ligament is held and compressed tightly against the bone surface.

Soft tissue anchor system

An endosteal fixation for mounting a prosthetic or soft tissue graft or combination thereof, under tension at a cortex end of a bone tunnel and process for its use. The endosteal fixation stud includes a cylindrical body that is preferably manufactured from a somewhat resilient material, and is suitable for implantation in a human body. The cylindrical body is stepped outwardly, proximate to a rear end, into a bridge that has spaced rearwardly extending arms wherebetween the graft is secured. The cylindrical body forward end is split into equal parallel sections that can be flexed together, one of which sections includes a hook that extends and rearwardly, that will align with the cylindrical body surface when the two cylindrical body sections are compressed together. The endosteal fixation stud can be arranged to be pushed or pulled through a bone tunnel. A single endosteal fixation stud is utilized to mount a graft and to the cortex at a bone tunnel end, the graft extending therefrom through the tunnel and out the opposite bone tunnel end, whereat it is bent and secured under tension, as with a staple, to the cortex surface adjacent to that bone tunnel end.

Endosteal fixation stud and system

A ligament fixation device and system for its use that includes a channel ligament clamp (10) fabricated for human implantation and consisting of a channel section having a web (13) between parallel sides wherefrom sections have been removed leaving spaced apart pointed spikes (11) that extend outwardly from walls (12), the channel web including a group of pointed pins (15) that extend therefrom parallel and alongside the spikes (11), and at least one screw-type fastener hole (14) formed therethrough. The system of the invention includes tooling for locating a ligament on a bone surface and scoring that surface for drilling. After drilling, a right angle post (22) of a drilling guide (21) is fitted into that drilled hole (20) and the drill guide longitudinal axis is aligned with the ligament location on the bone surface, which drilling guide has an array of spike and pin holes formed therethrough for receiving a drill turned individually therethrough into the bone surface. In practice, the clamp (10) is positioned over the drilled holes, with a ligament under tension therebetween and the pointed pins (15) are driven through the ligament and into the prepared pin holes, preferably utilizing a seating tool (30), and a screw (40) is turned through the web hole (19) and the ligament into the prepared hole (20), to sandwich the ligament that is contained between the clamp spikes (12) against the bone surface.

Channel ligament clamp and system

A cannulated interference screw (10) and process for human implantation in an arthroscopic surgical procedure for replacement of a ligament, or the like. The interference screw is provided with a drill end (11) that extends longitudinally from an end of a cylindrical body (14), which drill end includes equally spaced flutes (12) therearound. The flutes extend into first and second cutting threads (15a) and (15b), respectively which cutting threads and threads (15) are formed around the cylindrical body. A center longitudinal passage (16) is formed through the interference screw drill end and cylindrical body, which passage is stepped outwardly within the cylindrical body into a hexagonal sided section (18) that is for receiving a sided end (20) of a driver (19) that is fitted therein. In practice, the cannulated interference screw is installed by sliding it along a guide rod (25) that is fitted in a prepared ligament tunnel (22) through a bone mass, alongside a bone block portion of a ligament (23) within the bone endosteum, which ligament is maintained in that tunnel under tension. The driver is also holed longitudinally to travel along the guide rod to fit into and turn the interference screw, providing fixation of the ligament in that tunnel.

Process of endosteal fixation of a ligament

The present invention is in a drill guide (20) that is for use with and for mounting to a 'K' wire (13) that has been fitted through an anterior or posterior cruciate ligament tunnel. The drill guide (20) includes identical parallel rails (21) that are mounted to a stationary bracket (22), essentially at right angles, and are journaled to a traveling bracket (25), the traveling bracket further including set screws (28) to releasably lock it to the rails. The stationary and traveling brackets (22) and (25), respectively, are each isosceles triangular in shape, and each mounts a guide cylinder (23) and (26), respectively, at right angles through their apexes such that longitudinal openings through which guide cylinders are aligned to receive the 'K' wire fitted therethrough. A trolley (30) is arranged for travel on rails (21) between the stationary and traveling brackets (22) and (25), and can be releasably locked in place. The trolley mounts a replaceable drill sleeve (36) with a barrel (40) that includes a longitudinal hole (41) formed therethrough wherethrough a drill (44) is turned.

Drill guide

An anchor system that is preferably for use in an arthoscopic cruciate ligament replacement procedure for securing a ligament (37) or (50), or ligament type device, with or without a stint (38), within a prepared ligament tunnel (33). The system includes a pair of threaded footings (11) for turning in opposite tapped ligament tunnel cortex ends (34) and (35) and studs (10), each having an eyelet end (18) or, for a prosthetic ligament (50) is secured to the ligament end, the studs each having a cylindrical body (17) and flared end (12). The stud flared end terminates in a lip (15) wherefrom a lock wall (16) extends at an angle to the vertical to the cylindrical body, which flared end is cross-cut at (19) and (20), forming sections. The stud flared end (12) sections to close together to fit through the threaded footing (11) and flex outwardly beyond that footing end (24), the lip lock wall (16) to flex over that footing end locking the stud therein. In practice, the ligament (37) with or without the stint (38) is formed into a loop for sliding along the stud (10), slot (20) into the eyelet (18), or the studs are attached to a prosthetic ligament ends in its manufacture, the pair of studs and connected ligament and stint for manipulation through an arthoscopic port (36) formed into the patient's knee, each stud for seating into a threaded footing, the studs each locking therein with the ligament stretched across the knee intra articular joint. Whereafter, tension on the ligament can be adjusted by individually turning the threaded footings appropriately into or out of the cortex threads.

Ligament anchor system

The invention provides a system for surgically implanting an allograft or prosthetic ligament as a replacement for a patient's cruciate ligaments. In a practice of the system, as a replacement for an anterior cruciate ligament, the patient's leg is bent and maintained at approximately a ninety degree (90.degree.) angle, a single incision is made medial to the tibial tuberosity. From this incision, under fluoroscopic and arthroscopic contol, a guidewire is driven through the tibia and across the cruciate ligament junctions with the proximal tibia and distal femur ends and into the femur cortex. Succesively larger drills are then turned along the guidewire to form a ligament tunnel, with, as a last step in the tunnel formation process, the preparation of the femur cortex end of the tunnel to receive a femoral connector of the implanted ligament, which connector is arranged in one embodiment to be outwardly flared and in another embodiment to be turned into the appropriately prepared femur end of the ligament tunnel to lock therein. The invention, in addition to the embodiments of the ligament femur end connectors, further includes a tibial surface ligament tibial end connector for both securing the ligament end to the bone and for setting ligament tensioning, of which ligament connectors can be manufactured from a biodegradable material for absorption by the body.

Ligament attachment method and apparatus

A cylindrical suture anchor having a drill formed on one end thereof and flights of threads formed on the other whereto at least one section of suture is permanently secured, the anchor to be turned through a driver maintained and turned by a separate drilling device operated by an orthopedic surgeon. In practice, the surge on positions the suture anchor drill end on a point on a bone mass in a human body and, by turning the driver, turns the suture anchor to drill into the bone mass, until a first thread flight engages the drilled hole wall and is turned therein, tapping that hole, to receive each following thread flight, until the anchor is seated therein, during which seating the driver is telescoped out of a splined coupling to the anchor and a suture secured in a longtudinal opening in the anchor that is folded into the driver is pulled from that driver for use by the orthopedic surgeon in securing a ligament to that point on the bone mass.

Growing community of inventors

Logan, UT, United States of America

W Karl Somers