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1. Field of Invention
A cancellous externally threaded pulley anchor for transporting an anterior cruciate ligament graft into the distal femur from the intra-articular surface during a surgical repair of the anterior cruciate ligament. A method using this device eliminates the need to pierce the lateral femoral skin during the surgery and also prevent interference with other surgical instruments and the knee and thigh holder, the anchor providing a pulley for the force insertion of the ligament graft into a femoral bone tunnel after the anchor is installed within the femoral bone tunnel by pulling the unattached end of the suture while the other end of the suture is secured to the ligament graft.
2. Description of Prior Art
The following United States patents were discovered and are disclosed within this application for utility patent. All relate to internally affixed surgical anchors. In U.S. Pat. No. 7,083,647 to Sklar, a screw and shank assembly are used to anchor a graft ligament in a bone tunnel, with the shank deployed in the bone tunnel and the screw affixed to the graft installed within the shank. A sleeve and insert are also disclosed in U.S. Pat. No. 5,871,504 to Eaton, wherein the sleeve is inserted into a drilled bone tunnel in the femur and an insert adapted to be threaded within the sleeve is attached to the ligament or graft, which is then installed within the sleeve. U.S. Pat. No. 7,063,717 to St. Pierre discloses an interference fixation device which allows for the passage of a suture attached to a graft to be drawn through the device, the device preventing withdrawal of the suture once installed, retaining the ligament in place.
In U.S. Pat. No. 6,994,725 to Goble, a similar bone tunnel is drilled within the tibial and femur of the knee, but a more narrow passage is drilled in the anterior portion of the femur. Using a C-shaped frame. An externally threaded screw anchor device is placed in the narrow portion with a suture passed through the installed device with the knee appearing to be in a flat orientation during installation. The suture is pulled downward from the bone canal to be attached to a bone graft prepared with what appears to be two plugs, which is then drawn upwards into the bone tunnel.
Other graft anchors are disclosed in U.S. Pat. No. 6,599,289 to Bojarski and U.S. Pat. No. 6,554,553 to Freedland, but do not bear similar elements or installation methods as the current anchor device disclosed herein.
One of the most common sports injury to the knee involves a tearing of the anterior cruciate ligament in the knee. Over the years, surgery has evolved from open reduction surgical procedures on the knee to reattach the ligament, or what is left of it, between the femur and the tibia. More recently, the surgical procedures have become less intrusive and causing less trauma to the surrounding tissue, resulting in more complete and faster recovery. In the prior art, the most common method involves retaining the knee in a right angle bent position, drilling a hole from the anterior proximal end of the tibia, through the distal anterior portion of the femur, and attaching the ligament or tendon graft to a surgical anchor and installing the surgical anchor within the bone tunnel or just outside the exit hole of the bone tunnel on the anterior surface of the femur. The anchor insertion is terminated when the graft is stretched to its fullest extent, hopefully with a portion inserted within the bone tunnel of the femur.
The present externally threaded anchor device is a cancellous pulley device which is intended to gain purchase or attachment with rotational insertion and allow a pre-placed suture to pull the ACL graft up into a bone tunnel in the distal femur. The intra-articular, femoral sided bone tunnel is drilled through and anterior portion of the proximal tibia or through a puncture hole in the joint capsule, and fully inserted into the bone tunnel of the femur using a tool adapted to a socket in a bottom portion of the device. One end of the suture is sewn or tied into the end of the ACL graft. The opposite end of the suture is then pulled, allowing the device to act as a pulley around which the suture makes a 180 degree turn, wherein the graft end of the suture pulls the ACL graft up into the bone tunnel in the femur into an intended place.
Use of this device prevents the need to puncture the skin of the lateral femur with an extended delivery device, reducing the chance of contamination or infection during and after surgery as well as eliminating an extra puncture wound. It also eliminates the potential of interference with the tourniquet and thigh-holder used during the surgical procedure during installation of the device.
The primary objective of the invention is to provide an anchor utilized in a surgical ACL repair procedure which is pre-threaded with a suture loop attached within a bone tunnel through the tibia into the femur which will act as a pulley for the suture, attaching one end of the suture to a ligament graft and pulling on the other end of the suture to draw the ligament graft into the bone tunnel and subsequently tying off the free end of the suture when the ligament graft is at the appropriate location and tension chosen by the surgeon. A second objective is to reduce the potential of infection, contamination or interference with other surgical instruments and appliances during the ACL surgical procedure by eliminating unnecessary puncture wounds in the skin, especially the outer skin over the distal end of the femur.
The following drawings are submitted with this utility patent application.
An externally threaded pulley anchor device 40a, 40b, shown in
A second embodiment of the device 40b, shown in
Although having the potential for reattachment of any ligament in a joint, the device as utilized in an ACL surgical repair would require surgical preparation of the knee 10, including the placement of the knee 10 at a ninety degree angle with the leg retained in a thigh-holder. A tourniquet is applied above the knee. After the skin is properly cleaned and sterilized, an incision is made in the skin covering the upper anterior portion 12 of the tibia 11, and a bone tunnel 16 is drilled from the upper anterior portion 12 of the tibia 11 into the distal end 15 of the femur 14 through the knee capsule 13,
While the invention has been particularly shown and described with reference to a preferred embodiment thereof, it will be understood by those skilled in the art that changes in form and detail may be made therein without departing from the spirit and scope of the invention.