# US 12,178,426 B2 · Surgical fastening

> Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt

- Number: US 12,178,426 B2
- Document ID: US12178426B2
- Status: Granted
- Kind: B2
- Application number: 18/242,679
- Filed: 2023-09-06
- Published: 2023-12-21
- Granted: 2024-12-31
- Earliest claimed: 2013-03-15
- Assignees: Smith & Nephew, Inc.
- Applicants: Smith & Nephew, Inc.
- Inventors: Pascal Boileau; Mason James Bettenga; Christoph Haessig; Dirk Wunderle; Alexander Iwan Seidl; Oliver Streit; Stephen Anthony Santangelo
- Web page: https://patentgrep.com/patent/US12178426B2

## 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 17/02: for holding wounds open, e.g. retractors; Tractors
- A61B 17/0206: {with antagonistic arms as supports for retractor elements}
- A61B 17/025: {Joint distractors}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/144: {with cutting edges at the side of the saw blades}
- A61B 17/16: Instruments for performing osteoclasis; Drills or chisels for bones; Trepans {(arthroscopic bone cutters A61B17/320016)}
- A61B 17/1659: {Surgical rasps, files, planes, or scrapers}
- A61B 17/1739: {specially adapted for particular parts of the body}
- A61B 17/56: Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B 17/683: {comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut}
- A61B 17/88: {Osteosynthesis instruments;} Methods or means for implanting or extracting internal {or external} fixation devices {(A61B17/7074 takes precedence)}
- A61B 17/8888: {at its central region}
- A61F 2/0811: {Fixation devices for tendons or ligaments}
- A61B 17/1778: {for the shoulder}
- A61B 17/8869: {Tensioning devices}
- A61B 17/8877: {characterised by the cross-section of the driver bit}
- A61B 2017/0404: {Buttons}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0496: {for tensioning sutures}
- A61B 2017/564: {Methods for bone or joint treatment}
- 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)

## Abstract

Methods of joint repair employing sutures and attached fixation devices are discussed. For example, a bone block graft procedure (e.g., Latarjet) is discussed which employs fixation devices to secure contact between graft surfaces of two bones. A suture construct, including a continuous suture loop routed through a first fastener, is secured to a first bone. Looped ends of the suture loop are passed through passageways formed in the two bones. The looped suture ends are further routed through a second fastener. The second fastener is mounted to the second bone and a sliding knot, formed in the looped suture ends, is advanced into contact with the second fastener. The suture is further tensioned using a tensioner device to secure the two bones together.

## Claims

### Claim 1

A method of tensioning a flexible member, the method comprising:
coupling a free end of a flexible member to a barrel portion of a tensioning device, the tensioning device comprising:
an elongated shaft including a distal end, a proximal end, and a longitudinal axis extending therebetween; and
a tensioning assembly coupled to a proximal end of the shaft, the tensioning assembly including a rotatable member operatively coupled to the barrel portion; and
rotating the rotatable member of the tensioning assembly to cause movement of the barrel portion;
wherein the movement of the barrel portion exerts a force on the free end of the flexible member in a direction away from the distal end of the shaft, thereby increasing tension on the flexible member;
wherein the method is a surgical method.

### Claim 2 (depends on 1)

The method of claim 1, wherein the barrel portion extends perpendicular to the longitudinal axis of the shaft.

### Claim 3 (depends on 1)

The method of claim 1, further comprising coupling a first fastener to a first portion of the flexible member.

### Claim 4 (depends on 3)

The method of claim 3, further comprising coupling a second fastener to a second portion of the flexible member.

### Claim 5 (depends on 4)

The method of claim 4, wherein the exerting the force on the free end of the flexible member increases the tension on the flexible member between the first fastener and the second fastener.

### Claim 6 (depends on 4)

The method of claim 4, wherein at least one of the first and second fasteners comprises a rigid anchor.

### Claim 7 (depends on 4)

The method of claim 4, wherein at least one of the first and second fasteners comprises a suture-based anchor.

### Claim 8 (depends on 1)

The method of claim 1, further comprising using a ratchet system of the tensioning assembly to incrementally exert the force on the flexible member.

### Claim 9 (depends on 1)

The method of claim 1, wherein coupling the free end of a flexible member to the barrel portion comprises wrapping the free end of the flexible member around a circumference of the barrel portion.

### Claim 10 (depends on 1)

The method of claim 1, wherein the tensioning device further comprises a handle coupled to the proximal end of the shaft.