Suture-locking washer for use with a bone anchor, and method for supporting the thumb of a patient after basal joint arthroplasty, and other novel orthopedic apparatus and other novel orthopedic procedures
The invention provides surgical methods, devices, apparatus, and systems for supporting the thumb of a patient after basal joint arthroplasty. The embodiments of the invention comprise at least one index metacarpal anchor, at least one thumb metacarpal anchor, at least one sling for positioning the thumb metacarpal anchor relative to the index metacarpal anchor, and at least one anchor washer for tightening and securing the sling(s) without the need to tie the suture(s) components of the sling(s) into knots. Index and thumb metacarpal anchors comprise at least one bone-engaging element for engaging the respective metacarpal. The anchor washer may incorporate one or more sling-engagement mechanisms. Increasing the number of sling-engagement mechanisms associated with the anchor washer increases the surface area of the sling(s) and provides multiple sling elements to provide redundancy and increase the pull force of the sling(s) attachment(s) used to affix the thumb and index metacarpal anchors into a position relative to each other.
1 . Apparatus for securing a first anatomical object to a second anatomical object, said apparatus comprising:
a washer body comprising:
a central bore extending through the washer body, wherein the central bore is configured to receive an anchor, wherein a portion of the washer body comprises a passageway opening into the central bore of the washer body;
a first opening extending through the washer body on one side of the passageway; and
a second opening extending through the washer body on an opposite side of the passageway; and
a first tubular structure disposed in the first opening of the washer body and a second tubular structure disposed in the second opening of the washer body, wherein the first tubular structure and the second tubular structure each comprise a side wall defining a filament passageway, a portion of the side wall of the tubular structure projecting into the filament passageway so as to provide one-way movement of a filament extending through the filament passageway, wherein the first tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the first opening to secure the first tubular structure in the first opening in the washer body, and further wherein the second tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the second opening to secure the second tubular structure in the second opening in the washer body.
2 . Apparatus according to claim 1 wherein the end projections are configured to extend out of the first and second openings in said washer body to secure the first and second tubular structures in the first and second openings in said washer body.
3 . Apparatus according to claim 1 wherein the first and second openings each comprise a stepped bore defining a shoulder, and further wherein the first and second tubular structures engage said shoulder.
4 . Apparatus according to claim 1 wherein the washer body is a bone anchor.
5 . Apparatus according to claim 1 wherein said apparatus further comprises the filament extending through the filament passageway.
6 . A method for securing a first anatomical object to a second anatomical object, said method comprising:
providing apparatus for securing the first anatomical object to the second anatomical object, said apparatus comprising:
a washer body comprising:
a central bore extending through the washer body, wherein the central bore is configured to receive an anchor, wherein a portion of the washer body comprises a passageway opening into the central bore of the washer body;
a first opening extending through the washer body on one side of the passageway; and
a second opening extending through the washer body on an opposite side of the passageway; and
a first tubular structure disposed in the first opening of the washer body and a second tubular structure disposed in the second opening of the washer body, wherein the first tubular structure and the second tubular structure each comprise a side wall defining a filament passageway, a portion of the side wall of the tubular structure projecting into the filament passageway, wherein the first tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the first opening to secure the first tubular structure in the first opening in the washer body, and further wherein the second tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the second opening to secure the second tubular structure in the second opening in the washer body;
passing a filament through said filament passageway;
associating one end of said filament with the second anatomical object and associating said washer body with the first anatomical object; and
moving said filament through said filament passageway so as to shorten the length of said filament extending between the first anatomical object and the second anatomical object so as to fixedly connect the first anatomical object to the second anatomical object, wherein the portion of the sidewall of the tubular structure projecting into the filament passageway provides one-way movement of the filament.
7 . A method according to claim 6 wherein said washer body is secured to the first anatomical object using a bone anchor.
8 . A method according to claim 6 wherein said washer body is secured to the first anatomical object by positioning said washer body against a far surface of the first anatomical object.
9 . A method according to claim 8 wherein said filament extends to the far surface of the first anatomical object by passing said filament through a through-hole formed in the first anatomical object.
10 . A method according to claim 6 wherein said filament is secured to the second anatomical object using a bone anchor.
11 . A method according to claim 6 wherein said filament is secured to the second anatomical object by positioning a second washer body against a far surface of the second anatomical object.
12 . A method according to claim 11 wherein said filament extends to the far surface of the second anatomical object by passing said filament through a through-hole formed in the second anatomical object.
13 . Apparatus for securing a first anatomical object to a second anatomical object, the apparatus comprising:
a bone anchor comprising an elongated shaft having a distal end, a proximal end and an enlarged head at the proximal end of the elongated shaft;
a washer body comprising:
a central bore extending through the washer body, wherein the central bore is configured to receive the elongated shaft of the bone anchor, wherein a portion of the washer body comprises a passageway opening into the central bore of the washer body;
a first opening extending through the washer body on one side of the passageway; and
a second opening extending through the washer body on an opposite side of the passageway; and
a first tubular structure disposed in the first opening of the washer body and a second tubular structure disposed in the second opening of the washer body, wherein the first tubular structure and the second tubular structure each comprise a side wall defining a filament passageway, a portion of the side wall of the tubular structure projecting into the filament passageway so as to secure a filament extending through the filament passageway, wherein the first tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the first opening to secure the first tubular structure in the first opening in the washer body, and further wherein the second tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the second opening to secure the second tubular structure in the second opening in the washer body.
14 . A method for securing a first anatomical object to a second anatomical object, the method comprising:
providing apparatus for securing the first anatomical object to the second anatomical object, the apparatus comprising:
a bone anchor comprising an elongated shaft having a distal end, a proximal end and an enlarged head at the proximal end of the elongated shaft;
a washer body comprising:
a central bore extending through the washer body, wherein the central bore is configured to receive the elongated shaft of the bone anchor, wherein a portion of the washer body comprises a passageway opening into the central bore of the washer body;
a first opening extending through the washer body on one side of the passageway; and
a second opening extending through the washer body on an opposite side of the passageway; and
a first tubular structure disposed in the first opening of the washer body and a second tubular structure disposed in the second opening of the washer body, wherein the first tubular structure and the second tubular structure each comprise a side wall defining a filament passageway, a portion of the side wall of the tubular structure projecting into the filament passageway, wherein the first tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the first opening to secure the first tubular structure in the first opening in the washer body, and further wherein the second tubular structure comprises at least one end projection configured to be bent into engagement with a portion of the washer body adjacent to the second opening to secure the second tubular structure in the second opening in the washer body;
passing a filament through the filament passageway;
mounting the washer body to the bone anchor;
connecting one end of the filament with the first anatomical object and inserting the apparatus into the second anatomical object; and
moving the filament through the filament passageway so as to shorten the length of the filament extending between the first anatomical object and the second anatomical object so as to fixedly connect the first anatomical object to the second anatomical object, wherein the portion of the sidewall of the tubular structure projecting into the passageway secures the filament extending through the filament passageway.