Method and apparatus for mechanical attachment of soft tissue to bone tissue

A rivet for attaching soft tissue to bone tissue, comprising:

• a) an elongated unitary body symmetrical about a longitudinal axis and including a shank portion adapted to be anchored in said bone tissue and a clamp portion adapted to impale said soft tissue;
• b) means on said shank portion for retaining said rivet anchored in said bone tissue;
• c) means on said clamp portion selectively permanently reformable in situ to extend radially in relation to said longitudinal axis to overlie said soft tissue whereby to clamp said impaled soft tissue to said bone tissue;
• d) said means on said clamp portion selectively reformable in situ to extend radially in relation to said longitudinal axis comprises a plurality of circumferentially spaced initially longitudinally extending lugs;
• e) said lugs and the spaces therebetween being generally triangular, and the proximal ends of the lugs remote from said shank portion are flared radially outwardly to form surfaces inclined to the longitudinal axis of the unitary body.

A rivet for attaching soft tissue to bone tissue, comprising:

• a) an elongated unitary body symmetrical about a longitudinal axis and including a shank portion adapted to be anchored in said bone tissue and a clamp portion adapted to impale said soft tissue;
• b) means on said shank portion for retaining said rivet anchored in said bone tissue;
• c) means on said clamp portion selectively permanently reformable in situ to extend radially in relation to said longitudinal axis to overlie said soft tissue whereby to clamp said impaled soft tissue to said bone tissue;
• d) said means on said clamp portion selectively reformable in situ to extend radially in relation to said longitudinal axis comprises a plurality of circumferentially spaced initially longitudinally extending lugs;
• e) said shank portion being provided with an integral head having an outer cylindrical periphery, and said lugs are integral with said head and extend axially therefrom in a circular array;
• and
• f) each said lug being configured generally as an isosceles triangular member having its base integral to said head and its apex end flared radially outwardly to form a surface inclined to the longitudinal axis of the unitary body, said apexes of the generally triangular lugs being arranged in a circular array spaced axially from said head, the arcuate spacing between said apexes substantially corresponding to the arcuate length of the base integral with the head.

A rivet for attaching soft tissue to bone tissue, comprising:

• a) an elongated unitary body symmetrical about a longitudinal axis and including a shank portion adapted to be anchored in said bone tissue and a clamp portion adapted to impale said soft tissue;
• b) means on said shank portion for retaining said rivet anchored in said bone tissue;
• c) means on said clamp portion selectively permanently reformable in situ to extend radially in relation to said longitudinal axis to overlie said soft tissue whereby to clamp said impaled soft tissue to said bone tissue;
• d) said means on said clamp portion selectively reformable in situ to extend radially in relation to said longitudinal axis comprises a plurality of circumferentially spaced initially longitudinally extending lugs;
• e) said shank portion being provided with an integral head having an outer cylindrical periphery, and said lugs are integral with said head and extend axially therefrom in a circular array;
• and
• f) each said lug being configured generally as an isosceles triangle having its apex integral to said head and its base flared radially outwardly to form a surface inclined to the longitudinal axis of the unitary body, said bases of the triangular lugs being arranged in a circular array spaced axially from said head, the arcuate spacing between said bases substantially corresponding to the arcuate length of the apex integral with the head.

The method of attaching soft tissue to bone tissue through use of surgical procedures, comprising the steps of:

• a) exposing to view the area of the bone tissue to which the soft tissue is to be attached;
• b) securing anchor means having a reformable head portion to the exposed bone tissue in the area of the bone tissue to which the soft tissue is to be attached;
• c) impaling on said reformable head portion of the anchor means the soft tissue to be attached to the bone tissue;
• d) reforming in situ the head portion of the anchor means to clamp and retain the soft tissue in intimate contact with the area of the bone tissue surrounding the anchor means whereby said soft tissue may attach itself to the associated bone tissue through natural regenerative healing processes;
• e) said head portion of the anchor means over which said soft tissue is impaled initially comprising a plurality of circumferentially spaced parallel lugs integral with said anchor means and symmetrical about a central longitudinal axis, and subsequent to impalement of said soft tissue over said head portion, said lugs are reformed to lie perpendicular to said central longitudinal axis distally from the surface of the bone tissue and in clamping association with the soft tissue.

The method of attaching soft tissue to bone tissue through use of surgical procedures, comprising the steps of:

• a) exposing to view the area of the bone tissue to which the soft tissue is to be attached;
• b) securing anchor means having a reformable head portion to the exposed bone tissue in the area of the bone tissue to which the soft tissue is to be attached;
• c) impaling on said reformable head portion of the anchor means the soft tissue to be attached to the bone tissue;
• d) reforming in situ the head portion of the anchor means to clamp and retain the soft tissue in intimate contact with the area of the bone tissue surrounding the anchor means whereby said soft tissue may attach itself to the associated bone tissue through natural regenerative healing processes;
• e) said anchor means including an elongated tubular structure having inner and outer peripheral surfaces, said inner peripheral surface constituting a guide portion and said outer peripheral surface constituting a bone tissue engaging surface, and said head portion of the anchor means over which said soft tissue is impaled initially comprises a plurality of circumferentially spaced parallel lugs integral with said anchor means and symmetrical about a central longitudinal axis and subsequent to impalement of said soft tissue over said head portion said lugs are reformed to lie substantially perpendicular to said central longitudinal axis distally from the surface of the bone tissue and in clamping association with the soft tissue.

The method of attaching soft tissue to bone tissue through use of surgical procedures, comprising the steps of:

• a) exposing to view the area of the bone tissue to which the soft tissue is to be attached;
• b) securing anchor means having a reformable head portion to the exposed bone tissue in the area of the bone tissue to which the soft tissue is to be attached;
• c) impaling on said reformable head portion of the anchor means the soft tissue to be attached to the bone tissue;
• d) reforming in situ the head portion of the anchor means to clamp and retain the soft tissue in intimate contact with the area of the bone tissue surrounding the anchor means whereby said soft tissue may attach itself to the associated bone tissue through natural regenerative healing processes;
• e) The surface area of the exposed bone from which soft tissue avulsion has occurred being decorticated to expose raw cancellous bone, thereafter mobilizing the soft tissue to contiguously overlie the exposed raw cancellous bone, driving a K-wire through the soft tissue that has been mobilized and into the underlying raw cancellous bone to retain the soft tissue in position, inserting a soft tissue positioning instrument over the K-wire and into penetrating engagement with the soft tissue and manipulating the soft tissue positioning instrument to adjust the position of the soft tissue to place it where it is to be permanently reattached, thereafter attaching a sterile anchor means in the form of a cannulated rivet to a rivet insertion instruments threading the rivet and rivet insertion instrument over the K-wire and telescopically into the soft tissue positioning instrument to impale the soft tissue with the rivet and place the distal end thereof into contact with the raw cancellous bone, rotating the rivet through rotation of the rivet insertion instrument until the rivet is maximally embedded in the bone, withdrawing the rivet insertion instrument from the K-wire and the soft tissue positioning instrument, withdrawing the soft tissue positioning instrument while retaining the K-wire embedded in the bone, inserting a first forming instrument over the K-wire into contact with parallel lugs forming the reformable head of the rivet, thereafter delivering impacts as necessary to the first forming instrument to partially radially displace the lugs, thereafter withdrawing the first forming instrument and inserting a second forming instrument into contact with the partially reformed lugs and delivering impacts as necessary to further radially displace the lugs into a common plane wherein the radially displaced lugs clamp the soft tissue to the raw cancellous bone area, thereafter withdrawing the second reforming instrument, and thereafter withdrawing the K-wire and closing the incision.