Method and Device for Stabilizing Joints With Limited Axial Movement

Abstract

An apparatus for stabilizing a joint with low relative motion during orthopedic surgery. The apparatus includes a press-fit fastener body and a coupler. The press-fit fastener body has a proximal end and a distal end and is configured to be press-fit into a tunnel in a first bone member. The coupler is located on or is part of the press-fit fastener body and is configured to receive at least one flexible element trailing from at least one suture anchor. At least a portion of the suture anchors are located within a second bone member.

Description

PRIORITY[0001]This patent application is a continuation in part of utility patent application Ser. No. 12 / 109,825 entitled “Method and Device for Stabilizing Joints With Limited Axial Movement” filed Apr. 25, 2008, assigned attorney docket number 2878 / 105, and naming Michael G. McNamara and Avery B. Munoz as inventors the disclosure of which is incorporated herein, in its entirety, by reference.[0002]Utility patent application Ser. No. 12 / 109,825, in turn, claims priority from provisional United States patent applications:[0003]Application No. 60 / 913,975, filed Apr. 25, 2007, entitled, “Method and Device for Securing Suture Anchors in Tension,” assigned attorney docket number 2878 / 103, and naming Michael G. McNamara and Avery B. Munoz as inventors, the disclosure of which is incorporated herein, in its entirety, by reference.[0004]Application No. 60 / 984,895, filed Nov. 2, 2007, entitled, “Method and Device for Securing Suture Anchors in Tension,” assigned attorney docket number 2878...

AI Technical Summary

Benefits of technology

[0018]The suture anchor can be inserted such that the suture anchor is beneath the surface of the first bone member. Likewise, the fastener can be inserted such that it is beneath the surface of the second bone member. By inserting the suture anchor and fastener in this manner, abrasion of and by adjacent bone and soft tissue is avoided.

[0025]The method may also include drilling a hole through at least the first bone member, the second bone member, and the intermediate bone member. Additionally, inserting the fastener into the hole in the second bone member may create a press-fit. The suture anchor and the fastener may be inserted such that they are beneath the surface of the first and second bone members in order to avoid abrasion of soft tissue and / or abrasion injury to cartilage. The flexible element may be secured to the fastener before inserting the fastener and adjusting the tension. Alternatively, the fastener may be inserted before securing and adjusting the flexible element. Moreover, in other embodiments, the flexible member may be adjusted before the flexible element is secured and the fastener is inserted.

[0028]In accordance with additional embodiments, a method for stabilizing a joint with limited axial movement may include making an incision on a first incision site (e.g., proximate to a first bone member), drilling a guidewire through the first bone member, a second bone member, and a third bone member, and making a second incision on a second incision site (e.g., proximate to the third bone member). Once the incisions are made, the method may create a bone tunnel through the first, second, and third bone members, and pass a flexible element through the bone tunnel (e.g., by affixing the flexible element to an eyelet located on the guidewire, and drawing the flexible element through the bone tunnel using the guidewire). The flexible element may extend from the first incision to the second incision and pass through the first, second, and third bone members.

[0032]This invention greatly broadens applications of suture anchors in orthopedics, extending the focus to fixture of bone to bone, rather than just soft tissue to bone.

Problems solved by technology

Scapho-lunate dissociation typically causes wrist pain, swelling, clicking, progressive radiocarpal arthritis, and decreased motion and grip strength.

However, all of these treatments have some undesirable results (e.g., loss of range of motion, long periods of immobilization and / or high rates of failure).

Additionally, the bone-tissue-bone grafts and the RASL procedure discussed below have only limited clinical results.

Currently available results indicate that dorsal capsulodesis is associated with long term weakening and provides only limited motion recovery.

Although long-term results are unavailable, the RASL procedure offers only limited motion recovery and relatively high potential for failure.

During failure, screws inserted into the bone during the procedure may back out and protrude into the scapho-lunate interval.

In addition, the screws wear and weaken the bone as the bone rotates about the screw during motion.

Once a RASL procedure fails the patient is left with very limited treatment options because the damage to the bone can be very severe.

Chronic instances of scapholunate instability extending towards degenerative arthritis typically require more extreme surgical procedures with highly compromising results.

As one would expect, fusion of the bones greatly reduces the patient's range of motion.

Additionally, there are high complication and failure rates associated with the intercarpal fusion procedure.

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