# US 11,992,205 B2 · Devices and methods for stabilizing tissue and implants

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- Number: US 11,992,205 B2
- Document ID: US11992205B2
- Status: Granted
- Kind: B2
- Application number: 18/495,593
- Filed: 2023-10-26
- Published: 2024-02-15
- Granted: 2024-05-28
- Earliest claimed: 2004-10-26
- Assignees: P Tech, LLC
- Applicants: P Tech, LLC
- Inventors: Peter M. Bonutti
- Web page: https://patentgrep.com/patent/US11992205B2

## CPC

- 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)}
- A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)}
- A61B 17/0483: {Hand-held instruments for holding sutures (A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30)}
- A61B 17/0487: {Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122)}
- A61B 17/1637: {Hollow drills or saws producing a curved cut, e.g. cylindrical (A61B10/025, A61B17/1695 take precedence)}
- A61B 17/1671: {for the spine}
- A61B 17/1675: {for the knee}
- A61B 17/17: Guides {or aligning means} for drills {, mills, pins or wires}
- A61B 17/683: {comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut}
- A61B 17/7053: {with parts attached to bones or to each other by flexible wires, straps, sutures or cables}
- A61B 17/7064: {Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor}
- A61B 17/7067: {Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor}
- A61B 17/82: for bone cerclage {(apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842)}
- A61B 17/842: {Flexible wires, bands or straps (A61B17/72, A61B17/82, A61B17/86 take precedence)}
- A61B 17/844: {with expandable anchors or anchors having movable parts}
- A61B 17/8861: {Apparatus for manipulating flexible wires or straps (devices for inserting Kirschner wires A61B17/1697)}
- A61B 17/8863: {Apparatus for shaping or cutting osteosynthesis equipment by medical personnel}
- A61B 17/8869: {Tensioning devices}
- A61F 2/0811: {Fixation devices for tendons or ligaments}
- A61F 2/30749: {Fixation appliances for connecting prostheses to the body}
- A61F 2/4405: {for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes (devices implanted between spinous or transverse processes A61B17/7062)}
- A61F 2/441: {made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel}
- A61L 27/58: Materials at least partially resorbable by the body
- A61B 17/00491: {Surgical glue applicators}
- A61B 17/0467: {Instruments for cutting sutures (surgical cutting instruments A61B17/32)}
- A61B 17/0485: {Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet}
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/1757: {for the spine}
- A61B 17/685: {Elements to be fitted on the end of screws or wires, e.g. protective caps}
- A61B 2017/00004: {(bio)absorbable, (bio)resorbable or resorptive}
- A61B 2017/00398: {using powered actuators, e.g. stepper motors, solenoids}
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00818: {Treatment of the gastro-intestinal system}
- A61B 2017/00876: {magnetic}
- A61B 2017/00893: {pharmaceutically effective}
- A61B 2017/00898: {expandable upon contact with fluid}
- A61B 2017/00951: {adhesive}
- A61B 2017/0404: {Buttons}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0458: {Longitudinal through hole, e.g. suture blocked by a distal suture knot}
- A61B 2017/0464: {for soft tissue}
- A61B 2017/0488: {Instruments for applying suture clamps, clips or locks}
- A61B 2017/0496: {for tensioning sutures}
- A61B 2017/06176: {with protrusions, e.g. barbs}
- A61B 2017/2926: {Details of heads or jaws}
- A61B 2090/035: {preventing further rotation}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61F 2/0063: {Implantable repair or support meshes, e.g. hernia meshes}
- A61F 2/08: Muscles; Tendons; Ligaments
- A61F 2/28: Bones
- A61F 2/442: {Intervertebral or spinal discs, e.g. resilient (non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455)}
- A61F 2002/2817: {Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]}
- A61F 2002/30062: {(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive}
- A61F 2002/30462: {retained or tied with a rope, string, thread, wire or cable}
- A61F 2002/30677: {Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body}
- A61F 2002/4435: {Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes}
- A61F 2002/444: {for replacing the nucleus pulposus}
- A61F 2210/0004: bioabsorbable
- A61F 2310/00293: containing a phosphorus-containing compound, e.g. apatite
- A61F 2310/00359: Bone or bony tissue
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61L: METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES (preservation of bodies or disinfecting characterised by the agents employed A01N; preserving, e.g. sterilising, food or foodstuffs A23; preparations for medical, dental or toiletry purposes A61K)

## Abstract

An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

## Claims

### Claim 1

A surgical method for augmenting a ligament of a joint in a body of a subject, the surgical method comprising:
implanting a reinforcing suture including
securing the reinforcing suture, using a first fastener, to a first bone of the joint adjacent a first end of the ligament;
securing the reinforcing suture, using a second fastener, to a second bone of the joint adjacent an attachment of a second end of the ligament; and
tensioning the reinforcing suture between the first and second fasteners,
wherein simultaneously with completion of the surgical method and continuing thereafter: i) the reinforcing suture extends between the first and second fasteners and parallel to the ligament; ii) the reinforcing suture is free from acting on the joint if the joint is within a normal range of motion of the joint; and iii) the reinforcing suture acts on the joint to provide a sudden stopping action of the joint if the joint is outside the normal range of motion of the joint to prevent injury to the joint.

### Claim 2 (depends on 1)

The surgical method set forth in claim 1, wherein the reinforcing suture is non-elastic.

### Claim 3 (depends on 1)

The surgical method set forth in claim 1, wherein the reinforcing suture comprises a polymer.

### Claim 4 (depends on 1)

The surgical method set forth in claim 1, wherein the reinforcing suture is non-biodegradable in the body.

### Claim 5 (depends on 4)

The surgical method set forth in claim 4, wherein the first and second fasteners are non-biodegradable in the body.

### Claim 6 (depends on 1)

The surgical method set forth in claim 1, further comprising repairing the ligament before completing said implanting the reinforcing suture.

### Claim 7 (depends on 1)

The surgical method set forth in claim 1, further comprising reconstructing the ligament before completing said implanting the reinforcing suture.

### Claim 8 (depends on 1)

The surgical method set forth in claim 1, wherein the ligament is a ligament in a hand of the subject.

### Claim 9 (depends on 1)

The surgical method set forth in claim 1, wherein ligament is a ligament in the ankle of the subject.

### Claim 10 (depends on 1)

The surgical method set forth in claim 1, wherein the ligament is a ligament in a foot of the subject.

### Claim 11 (depends on 1)

The surgical method set forth in claim 1, wherein the ligament is a ligament in a knee of the subject.

### Claim 12 (depends on 1)

The surgical method set forth in claim 1, wherein the ligament is a ligament in a wrist of the subject.

### Claim 13 (depends on 1)

The surgical method set forth in claim 1, further wherein simultaneously with completion of the surgical method and continuing thereafter: iv) the ligament acts on the joint if the joint is within a normal range of motion of the joint.

### Claim 14 (depends on 13)

The surgical method set forth in claim 13, wherein the reinforcing suture is non-elastic.

### Claim 15 (depends on 13)

The surgical method set forth in claim 13, wherein the reinforcing suture comprises a polymer.

### Claim 16 (depends on 13)

The surgical method set forth in claim 13, wherein the reinforcing suture and the first and second fasteners are non-biodegradable in the body.

### Claim 17 (depends on 13)

The surgical method set forth in claim 13, further comprising repairing the ligament before completing said implanting the reinforcing suture.

### Claim 18 (depends on 13)

The surgical method set forth in claim 13, further comprising reconstructing the ligament before completing said implanting the reinforcing suture.