# US 8,784,426 B2 · Double-loop endobutton, ovoid tunnel guide, and method of ACL re-construction using the ovoid tunnel guide and the double-loop endobutton > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 8,784,426 B2 - Document ID: US8784426B2 - Status: Granted - Kind: B2 - Application number: 13/251,932 - Filed: 2011-10-03 - Published: 2013-04-04 - Granted: 2014-07-22 - Earliest claimed: 2011-10-03 - Assignees: Smith & Nephew, Inc. - Applicants: Graham Smith; Anastasios Dimitrios Georgoulis - Inventors: Graham Smith; Anastasios Dimitrios Georgoulis - Web page: https://patentgrep.com/patent/US8784426B2 ## CPC - A61F 2/0811: {Fixation devices for tendons or ligaments} - A61B 17/1714: {for applying tendons or ligaments (implements for applying tendons or ligaments A61F2/0805)} - A61B 17/1764: {for the knee} - A61B 17/06166: {Sutures (suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M)} - A61B 2017/0404: {Buttons} - A61F 2002/0852: {Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes} - A61F 2002/0882: {Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone} - A61F 2210/0004: bioabsorbable - 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) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A graft attachment apparatus including at least two separately formed filament loops, and a fixation member comprising at least one opening configured to receive the at least two separately formed filament loops. The at least two separately formed filament loops are coupled to the fixation member. Further, each of the at least two separately formed filament loops are continuous loops. ## Claims ### Claim 1 A method for ligament construction comprising the step(s) of: providing a guide configured to guide at least one guide pin into a bone and a fixation device having at least two separately-formed suture loops, separately coupling a first graft directly to one of the at least two separately-formed suture loops and a second graft directly to another of the at least two separately-formed suture loops; forming an oval-shaped socket within a bone; drawing the fixation device through the oval-shaped socket; orienting the first graft and the second graft within the oval-shaped socket; wherein said forming an oval-shaped socket includes forming an oval-shaped socket within the bone so as to have a first portion and a second portion; and wherein said orienting includes orienting the first graft so as to be disposed in the first portion of the oval-shaped socket and orienting the second graft so as to be disposed in the second portion of the oval-shaped socket; securing the fixation device on an exterior surface of the bone. ### Claim 2 (depends on 1) The method of claim 1, wherein forming an oval-shaped socket within a bone comprises: forming a first tunnel within the bone; forming a second tunnel within the bone; and dilating each of the first tunnel and the second tunnel with a dilator to form the oval-shaped socket. ### Claim 3 (depends on 2) The method of claim 2, wherein forming a first tunnel and a second tunnel within the bone comprises: disposing a first guide pin, at least partially, within the bone; disposing the guide over the first guide pin, wherein the first guide pin is received by a first hole of the guide; disposing a second guide pin, at least partially, within the bone, wherein the second guide pin is received by a second hole of the guide. ### Claim 4 (depends on 3) The method of claim 3, wherein the first guide pin is substantially parallel to the second guide pin. ### Claim 5 (depends on 3) The method of claim 3, further comprising: removing the first guide pin from the bone, and then forming the first tunnel; and removing the second guide pin from the bone, and then forming the second tunnel. ### Claim 6 (depends on 3) The method of claim 3, further comprising: drilling the first tunnel over the first guide pin; drilling the second tunnel over the second guide pin; and removing each of the first guide pin and the second guide pin from the bone. ### Claim 7 (depends on 2) The method of claim 2, wherein a depth of the first tunnel is different from a depth of the second tunnel. ### Claim 8 (depends on 4) The method of claim 4, wherein a lead suture is coupled to the fixation device. ### Claim 9 (depends on 8) The method of claim 8, wherein drawing the fixation device through the oval-shaped socket comprises drawing the fixation device through the oval-shaped socket with the lead suture. ### Claim 10 (depends on 4) The method of claim 4, further comprising orienting the fixation device within the oval-shaped socket, wherein orienting the fixation device within the oval-shaped socket comprises substantially aligning a longitudinal axis of the fixation device with a longitudinal axis of the oval-shaped socket. ### Claim 11 (depends on 4) The method of claim 4, wherein securing the fixation device on an exterior surface of the bone comprises re-orienting the fixation device such that the longitudinal axis of the fixation device is substantially perpendicular to the longitudinal axis of the oval-shaped socket. ### Claim 12 (depends on 4) The method of claim 4, wherein each of the at least two separately-formed suture loops of the fixation device are different in length. ### Claim 13 (depends on 4) The method of claim 4, wherein the oval shaped-socket comprises a keyhole-like tunnel. ### Claim 14 (depends on 2) The method of claim 2, wherein said forming the first tunnel includes drilling the first tunnel to a first depth; said forming the second tunnel includes drilling the second tunnel to a second depth; and the first depth is different from the second depth. ### Claim 15 (depends on 14) The method of claim 14, wherein each of the at least two separately-formed suture loops of the fixation device are different in length. ### Claim 16 (depends on 7) The method of claim 7, wherein each of the at least two separately-formed suture loops of the fixation device are different in length. ### Claim 17 (depends on 1) The method of claim 1, wherein said orienting the first graft and second grafts includes re-orienting the fixation device such that the first graft and the second graft are oriented in a predetermined orientation within the oval-shaped socket. ### Claim 18 (depends on 17) The method of claim 17, wherein the first graft is oriented so as to be near an anterior region, medially in the tibia and close to the over the top position in the femur. ### Claim 19 (depends on 1) The method of claim 1, wherein the method is used in connection with an anterior cruciate ligament construction/re-construction technique, where the first graft forms an anteromedial (AM) fiber bundle and the second graft forms a posterolateral (PL) fiber bundle; and wherein the method further includes: re-orienting the fixation device such that the first graft and the second graft are oriented in a predetermined orientation within the oval-shaped socket. ### Claim 20 (depends on 19) The method of claim 19, wherein the first graft is oriented so as to be near an anterior region, medially in a tibia and close to the over the top position in a femur. ### Claim 21 (depends on 7) The method of claim 7, wherein the provided guide is configured and arranged so as to include a first hole and a second hole for receiving the guide pins and wherein the method further includes configuring the guide so that the first and second holes are spaced from each other one of 1 mm to 11 mm or larger or 7 mm. ### Claim 22 (depends on 1) The method of claim 1, further including positioning one end of the guide at a desired location of the bone such that the oval-shaped socket is formed at a desired location within the bone. ### Claim 23 A method for ligament construction comprising the steps of: providing a guide having a first and a second hole for receiving at least two guide pins and providing a fixation device having at least two separately-formed suture loops and at least one opening, each of the at least two separately-formed suture loops being received in the at least one opening; directly coupling a first graft to one of the at least two separately-formed suture loops and a second graft to another of the at least two separately-formed suture loops; forming an oval-shaped socket within a bone using the guide pins; drawing the fixation device through the oval-shaped socket; orienting the first graft and the second graft within the oval-shaped socket so as to be in a desired orientation; wherein said forming an oval-shaped socket includes forming an oval-shaped socket within the bone so as to have a first portion and a second portion; and wherein said orienting includes orienting the first graft so as to be disposed in the first portion of the oval-shaped socket and orienting the second graft so as to be disposed in the second portion of the oval-shaped socket; securing the fixation device on an exterior surface of the bone. ### Claim 24 (depends on 23) The method of claim 23, wherein the method is used in connection with an anterior cruciate ligament construction/re-construction technique, where the first graft forms an anteromedial (AM) fiber bundle and the second graft forms a posterolateral (PL) fiber bundle; and wherein the method further includes: re-orienting the fixation device such that the first graft and the second graft are oriented in a predetermined orientation within the oval-shaped socket. ### Claim 25 (depends on 24) The method of claim 24, wherein the first graft is oriented so as to be near an anterior region, medially in a tibia and close to the over the top position in a femur.