Methods and systems related to joint repair
AssigneesSmith & Nephew Orthopaedics AG, Smith & Nephew Asia Pacific Pte. Limited
InventorsNehal Patel, Mark Housman, Marc Balboa, Benjamin Hall, Jon-Paul Rogers, Matthew Koski, Pascal Boileau
Life of this patent
Estimating the term…
Abstract
Various embodiments and methods for improved joint repair are disclosed. At least some of the embodiments may include an adjustable loop construct with at least one anchor. At least some of the embodiments may include an all-suture anchor. At least some of the embodiments may include an adjustable loop construct with a locking passage. Embodiments may implement a method that reduces or avoids material removal from the bones of the joint. Embodiments may include means to reduce elongation of the repair over time.
Claims85
A tissue repair construct including:
- an adjustable loop construct formed of a flexible member, the adjustable loop construct including;
- a first loop end and a second loop end opposite the first loop end;
- a first locking passage and a second locking passage, each passage defining a first passage end and a second passage end, and wherein both first passage ends are closer to the first loop end than the second loop end;
- two adjustable loops, each extending from both passage first ends and defining the first loop end;
- and
- a saddle length of the flexible member, extending directly from both passage second ends and defining the adjustable loop second end, the saddle length fixed in length;
- a first reduction end of the flexible member extending from the second passage end of the first locking passage and a second reduction end of the flexible member extending from the second passage end of the second locking passage, wherein both first and second reduction ends extend towards the second loop end;
- and
- a bone anchor slidingly coupled to the first loop end.
A tissue repair construct, comprising:
- a first cortical button having a plurality of apertures therethrough;
- an adjustable loop construct formed with a flexible member, the adjustable loop construct including;
- two adjustable loops coupled to the first cortical button via the plurality of apertures;
- a first and a second locking passage separated from each other along the flexible member by a saddle length of the flexible member, the saddle length fixed in length;
- wherein a first of the two adjustable loops are formed by threading a first end of the flexible member that extends from the first locking passage through two of the plurality of apertures and then through the second locking passage, the second of the two adjustable loops formed by threading a second end of the flexible member that extends from the second locking passage through two of the plurality of apertures and then through the first locking passage;
- and
- a second cortical button configured to couple to the saddle length.
A method of forming a tissue repair construct with a cortical button having a plurality of apertures therethrough and a length of flexible member having a first and second end and a lumen therealong, the method comprising
- drawing the first end through two of the plurality of apertures and then introducing the first end into the lumen at a first location along the length of the flexible member and then out of the lumen at a second location, defining a first adjustable loop coupled to the cortical button with the first end extending away from the cortical button;
- drawing the second end through two of the plurality of apertures and then introducing the second end into the lumen at a third location along the length of the flexible member and then out of the lumen at a fourth location, defining a second adjustable loop coupled to the cortical button and the second end extending away from the cortical button;
- wherein the second and fourth locations are spaced away from each other a fixed distance, defining a saddle length.
A repair construct for holding two bones of a joint in a repaired configuration comprising;
- a flexible member construct having a first end and a second end defining an axial length;
- a first anchor configured to couple the flexible member to a first bone of the two bones, the first anchor having a first end and a second end, and a first anchor flexible member pulley disposed through the first end, the first anchor flexible member pulley configured to operatively couple to the flexible member first end;
- a second anchor configured to couple the flexible member to a second bone of the two bones, the second anchor having a first end and a second end, and a flexible member pulley disposed through the second anchor second end, the flexible member pulley of the second anchor configured to operatively couple to the second end of the flexible member construct;
- wherein the repair construct defines a total axial length, and when in the repaired configuration, the first and second anchor flexible member pulleys are positioned axially adjacent each other, configured to limit the axial length of the flexible member, and thereby limiting elongation of the repair construct during physiological loading on the repair construct.
A repair construct for placing a flexible linking construct between two bones of a joint comprising;
- a first bone anchor having a pulley at a first end of the first bone anchor configured to couple to a first end of the flexible linking construct;
- a second bone anchor defining a pulley at a first end of the second bone anchor, configured to couple to a second, opposing end of the flexible linking construct;
- wherein the first and second bone anchors are configured to engage, one each with a first and second bone of the two bones respectively and place the flexible linking construct between facing surfaces of the two bones with the pulleys of each bone anchor adjacent the facing surfaces, to define a limited length of the flexible linking construct, the limited length having a lower limit configured to provide sufficient flexibility to the joint upon repair, the limited length defining an upper limit configured to limit elongation of the repair construct due to physiological loading on the joint over time.
A method of fixing a first and a second bone of a joint in a repaired configuration with a repair construct, the repair construct including a flexible member construct, the method comprising;
- fixing a first loop end of the flexible member construct with the first bone, the first loop end disposed within a passage through the first bone and terminating directly adjacent an external surface of the first bone;
- fixing a second loop end of the flexible member construct with the second bone, the second loop end disposed within a passage through the second bone and terminating directly adjacent an external surface of the first bone;
- both external surfaces of each bone facing each other.
A repair construct for holding two bones of a joint in a repaired arrangement, the repair construct anchoring with a first of the two bones at a first anchoring end of the repair construct, and anchoring with a second of the two bones at a second anchoring end of the repair construct, the repair construct comprising:
- a flexible member coupled to a first and second bone anchor at the first anchoring end of the repair construct, the flexible member configured to operatively couple to a third bone anchor at the second anchoring end;
- wherein the first and second bone anchors are configured to anchor the first anchoring end of the repair construct at a single passage exit of a passage through the first bone.
The repair construct of claim wherein the first and second bone anchors are sized to pass sequentially through the passage through the first bone.
The repair construct of claim wherein the flexible member defines an adjustable loop construct, such that tension on at least one limb of the flexible member is configured to reduce a distance between the first and second anchoring end.
A repair system for repairing two bones of a joint comprising:
- a repair construct including;
- a flexible member having a first anchoring end for anchoring with a first of the two bones and a second anchoring end for anchoring with a second of the two bones;
- a first and second anchor coupled to the first anchoring end;
- and
- a third anchor configured to couple the second anchoring end to the first of the two bones;
- and
- an insertion instrument having a handle and a shaft extending distally therefrom, the shaft having a distal end configured to house the first and the second anchor therein and the handle configured to retain the first anchoring end.
A method of repairing a joint with a system including a first anchor and a second anchor coupled to a flexible member, the method comprising;
- placing the first and second anchors through a passage through a first bone of the joint;
- deploying both the first and second anchor at a single exit opening of the first bone passage and thereby coupling the repair construct to the first bone.
A method of holding a clavicle and a coracoid of an AC joint in a repaired configuration with a repair construct, the repair construct including an adjustable suture loop having a first loop end preassembled to a cortical anchor and also a second loop end, free of the cortical bone anchor, the method comprising:
- placing the second loop end through a clavicle passage, around an inferior surface of the coracoid and then through the clavicle passage again;
- placing the second loop end through a first and a second slot of the cortical anchor and thereby assembling the second loop end to the cortical anchor with the second loop end wrapped around the coracoid;
- and with the second loop assembled;
- and
- reducing the adjustable suture loop to hold the clavicle and coracoid in the repaired configuration.
A method of holding a clavicle and a coracoid of an AC joint in a repaired configuration with a repair construct, the repair construct including an adjustable suture loop construct having a first adjustable loop preassembled to a cortical anchor, a second adjustable loop, free of the cortical bone anchor, and a locking passage between the two adjustable loops the method comprising:
- passing the second adjustable loop and the locking passage through a clavicle passage and around an inferior surface of the coracoid and then through the clavicle passage a second time;
- coupling the second adjustable loop end to the cortical anchor after passing the second loop a second time;
- and
- with the second loop coupled, reducing the adjustable suture loop construct to reduce both the first and second adjustable loops.
A method of holding a clavicle and a coracoid of an AC joint in a repaired configuration with a repair construct, the repair construct including an adjustable suture loop construct having a first adjustable loop preassembled to a cortical anchor, a second adjustable loop, free of the cortical bone anchor, and a locking passage between the two loop ends the method comprising:
- passing the second adjustable loop and the locking passage through a clavicle passage, around an inferior surface of the coracoid and through another passage through the clavicle;
- coupling the second adjustable loop to the cortical anchor after passing the second adjustable loop through the another passage;
- and
- with the second adjustable loop coupled, reducing the adjustable suture loop construct to draw the cortical anchor to engage a superior clavicle surface.
Dependencies are inferred from the claim text.