62 results about "Tibial tunnel" patented technology

A material fixation system is particularly adapted to improve the tendon-to-bone fixation of hamstring autografts, as well as other soft tissue ACL reconstruction techniques. The system is easy to use, requires no additional accessories, uses only a single drill hole, and can be implanted by one person. Additionally, it replicates the native ACL by compressing the tendons against the aperture of the tibial tunnel, which leads to a shorter graft and increased graft stiffness. It is adapted to accommodate single or double tendon bundle autografts or allografts. It also provides pull out strength measured to be greater than 1000 N.

A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A filamentary loop is threaded through the femoral tunnel and tibial tunnel and partially through the transverse tunnel. A replacement graft is formed into a loop and moved into the tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

A system is disclosed for repairing and reconstructing an injured anterior cruciate ligament (ACL); This system may be used irrespective of the type of patient or the ACL graft selected. Means for performing single or multiple bundle reconstruction, primary ACL repair and physeal-sparing ACL reconstruction are disclosed. A guide for inside-out creation of a femoral tunnel independent of the tibial tunnel is also disclosed, as well as a series of implant options for tibial and femoral fixation of any bone-soft-tissue composite or soft-tissue-only graft.

The equal tension applying device is used to apply equal tension to a group of tendons. The device comprises a 3 to 9 inch elongate flexible member and a hook at each end of the flexible member. Typically a torn ACL is replaced with two loops of tendons defining 4 tendon strands. The ends of each strand have sutures therein. The tendon loops are fixed in a femoral tunnel with a fixation pin and extend into and through a tibial tunnel. The method includes the steps of: tying the ends of the sutures together to form a loop, placing a hook of the elongate tensioning device over the suture loop, applying tension on the device, followed by anchoring the ends of the tendon strands to the tibia.

An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Endosteal fixation of a ligament graft with an interference fixation device installed in a retrograde manner in ACL reconstruction is disclosed. The interference fixation device may be a screw or a ribbed implant fitted with a length of reinforced suture or wire for pulling the interference fixation device through the tibial tunnel. The suture extends beyond the leading tip of the interference fixation device a sufficient length to allow the interference fixation device to be passed into the joint by pulling on the suture or wire exiting the tibial tunnel. A driver or an impaction device, such as a slap hammer, is employed to advance and insert the interference fixation device in a retrograde manner into the tibial tunnel. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

Techniques and reconstruction systems for ACL repair by providing cross-pin fixation of a graft within a tibial tunnel. The invention provides tibial fixation techniques according to which cross-pin fixation of a graft (for example, an Anterior Tibialis allograft) is achieved on the tibial side, close to the jointline, by a single incision and with cortical fixation.

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.

An anterior cruciate ligament (ACL) surgical repair technique involves the use of a single femoral and tibial tunnel and an implant that separates and positions two distinct bundles. This allows for the surgeon to create a more anatomic reconstruction with a procedure that is less technically demanding, can be performed using a transtibial or anteromedial approach, minimizes tunnel widening, and decreases operative time. The result is a strong fixation option for soft tissue grafts, with circumferential graft compression at the aperture, high pull-out strength, and ease of use. The graft bundles are positioned in a more anatomic orientation through the above noted single femoral and tibial tunnel.

The present invention provides a method of performing posterior cruciate ligament replacement. Specifically, a graft tissue is harvested from a patient and single tunnels are prepared in each of the tibia and the femur of the patient. The graft is secured in the femoral tunnel and separated into a posterior cruciate medial bundle and a posterior lateral bundle. The bundles are inserted through the tibial tunnel. During insertion the posterior lateral bundle is positioned in a posterior lateral position in the tibial tunnel while the posterior cruciate medial bundle is positioned in a posterior cruciate medial position in the tibial tunnel. The posterior cruciate medial bundle is then tensioned while the patient's knee is in approximately 90 degrees of flexion, and the posterior lateral bundle is tensioned while the patient's knee is approximately in full extension. Each of the bundles is then secured in the tibial tunnel.

The present invention provides a method of performing anterior cruciate ligament replacement. Specifically, a graft tissue is harvested from a patient and single tunnels are prepared in each of the tibia and the femur of the patient. The graft is secured in the femoral tunnel and separated into an anterior cruciate medial bundle and a anterior cruciate posterior lateral bundle. The bundles are inserted through the tibial tunnel. During insertion the posterior lateral bundle is positioned in a posterior lateral position in the tibial tunnel while the anterior cruciate medial bundle is positioned in an anterior cruciate medial position in the tibial tunnel. The anterior cruciate medial bundle is then tensioned while the patient's knee is in approximately 90 degrees of flexion, and the posterior lateral bundle is tensioned while the patient's knee is approximately in full extension. Each of the bundles is then secured in the tibial tunnel.

A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A filamentary loop is threaded through the femoral tunnel and tibial tunnel and partially through the transverse tunnel. A replacement graft is formed into a loop and moved into the tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

Anterior cruciate ligament reconstruction methods and devices are designed to achieve an anatomically accurate double bundle anterior cruciate ligament reconstruction by using a single femoral and tibial tunnel. The method and devices reconstruct the two bundles of the anterior cruciate ligament in a single femoral and tibial tunnel using a bone-patellar tendon-bone graft. The methods and devices enable an accurate anatomical reconstruction of the anteromedial and posterolateral bundles by creating a single femoral and tibial tunnel as opposed to creating two tunnels in the tibia and femur.

A device for positioning a tibial tunnel during ACL reconstruction, the device that includes an elongated body having proximal and distal ends; and a distal arm extending from the distal end of the elongated body, a distal portion of the distal arm being configured for insertion into a pre-formed opening in a femur. The distal arm and the body are not aligned relative to each other when viewed from above. A pair of such devices, providing tunnel positioning for right and left knee surgeries, maybe provided in a set.

A device for positioning a tibial tunnel during ACL reconstruction, the device comprising: a distal portion including a body and a distal arm extending from the distal end of the body, and an outrigger configured to be held by a user. The outrigger and the distal portion are selectively rotatable relative to each other such that the distal portion and the outrigger may be selectively moved out of alignment relative to each other when viewed from above.

Techniques and reconstruction systems for ACL repair by providing cross-pin fixation of a graft within a tibial tunnel. The invention provides tibial fixation techniques according to which cross-pin fixation of a graft (for example, an Anterior Tibialis allograft) is achieved on the tibial side, close to the jointline, by a single incision and with cortical fixation.

A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A replacement graft is formed into a loop and moved into the femoral and tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

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.

Endosteal fixation of a ligament graft with a bioabsorbable interference screw installed in a retrograde manner in ACL reconstruction. The bioabsorbable interference screw is insert-molded with a length of suture extending from the distal tip of the screw for pulling the interference screw into the joint and into position for retrograde insertion at the top of the tibial tunnel. The interference screw has a cannulation extending partially through the screw from the leading tip. The cannulation is shaped to receive a correspondingly shaped driver. The driver is inserted into the tibial tunnel to engage the screw. By turning the driver, the interference screw is turned into the tibial tunnel in a retrograde manner. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A replacement graft is formed into a loop and moved into the femoral and tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. A pin passing member maintains one end of the filamentary wire in the transverse tunnel as the graft is being moved into place in the femoral and tibial tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A replacement graft is formed into a loop and moved into the femoral and tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. A pin passing member maintains one end of the filamentary wire in the transverse tunnel as the graft is being moved into place in the femoral and tibial tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

A method of providing a replacement anterior cruciate ligament (ACL) provides a tibial tunnel and at least one femoral tunnel for receiving the replacement ligament, the femoral and tibial tunnels not being colinear but rather in an orientation that more closely mimics the natural ACL. The femoral tunnel is formed through the anterior medial portal. A cross pinning guide having a femoral rod for insertion into the femoral tunnel, a spaced apart arc shaped track and a guide block having one or more bores aligned with the femoral rod whereby an instrument inserted through one of the bores creates a pilot hole for the cross pin which intersects the femoral tunnel and an appropriate angle thereof which avoids ligaments and other sensitive tissue can be selected by adjusting the guide block along the track.

A device for positioning a tibial tunnel during ACL reconstruction is provided. The device includes a portion insertable into a pre-formed opening in the femur. Also provided is a method for positioning a tibial tunnel during ACL reconstruction. The method includes the steps of forming an opening in a femur bone, inserting a portion of a device into the opening, and using the device to position an opening in a tibia bone.

A technique and reconstruction system for ligament repair by determining the exact length of the graft to be secured within a first tunnel or socket (for example, a tibial tunnel) and a second tunnel or socket (for example, a femoral tunnel) for improved graft fixation. The exact length of the graft (soft tissue graft or BTB graft, for example) is determined with a measuring device, by measuring the length of a first socket in a first bone region (for example, a tibial socket), the length of a second socket in a second bone region (for example, a femoral socket), and the length of the intraarticular joint space between the two sockets in the two bone regions (for example, tibia and femur). The measuring device may consist of at least one flexible member (for example, suture) with at least one fixation device attached to the flexible member, the fixation device being either a sliding knot, a washer or a button.

A method of securing a graft in a bone tunnel, in which graft is secured within the tunnel at both the entrance and the exit ends of the tunnel to provide bicortical fixation of the graft in the bone. Interference screws or other fixation devices are used to secure the graft within the tunnel. For tibial tunnel fixation using an interference screw, the back end of the distal screw is angled so that it closely approximates the angle of the outer tibial tunnel rim. The distal screw is non-cannulated to prevent hematomas from being formed by blood flowing from the tibial tunnel into the surrounding soft tissue. The proximal screw has a restricted cannula to minimize the flow of synovial fluid entering the tibial tunnel. Advantageously, the space between the two screws fills with blood to promote faster healing and incorporation of the graft in the tibial tunnel.

The invention discloses a method for virtually building an anterior cruciate ligament on femur and tibia tunnels. The method comprises the following steps of firstly, carrying out straightening part nuclear magnetic resonance scanning and flexed part CT (computerized tomography) scanning on two keen joints of a patient with damaged anterior cruciate ligament, then importing the scanning data of the two keen joints into medical image reconstruction software to carry out three-dimensional reconstruction, then importing the three-dimensional data into reverse project software to further finish and beautify, then sorting and calculating various types of data of the femur, the tibia and the anterior cruciate ligament by using a computer, and virtually forming the entrance and exit of the anterior cruciate ligament on the femur and the tibia, and marking points on the surfaces of the femur and the tibia. The method is suitable for realizing the ACL (anterior cruciate ligament) accurate positioning and implanting of individuals, and is an effective new path for improving the ACL restoration and reconstruction therapeutic effects, and a junior surgeon can carry out pre-operation planning, operation simulation and exercising, operation teaching, and instruction of practical operation and post-operation rehabilitation through the information in the virtual environment.

A suture needle construct and method for extracapsular ligament reconstruction in mammals. The joint is first is first explored, and the damaged ligament and meniscus are debrided. The joint capsule is closed and a tunnel is created at the appropriate location in the proximal tibia for tibial fixation. Subsequent to the formation of the tibial tunnel, a suture having a substantially curved needle at one end and a substantially straight needle at the other end is brought in the proximity of the joint. The suture is passed around the lateral fabella using the substantially curved needle, then deep to the patellar ligament using the substantially straight needle, and through the tibial tunnel using the straight needle. The needles are cut off, and the sutures are tensioned over repair site.