Flexible implant with adjustable coils
Devices and methods for securing a graft with respect to bone are provided. One exemplary embodiment of a surgical implant includes a flexible filament body and a suture filament or repair construct that extends through the filament body at multiple locations. The repair construct is formed into one or more coils, which can receive a graft. The flexible filament body can be configured to be actuated between unstressed and anchoring configurations, the latter of which sets a location of the suture filament, and associated graft, in a bone tunnel. More particularly, the flexible filament body can ball up, or become denser, to a size that cannot pass into the bone tunnel in which the suture filament holding the graft is disposed. The present disclosure also provides for feedback units to assist a surgeon in knowing a location of the implant. Further, other exemplary devices and methods are provided.
1 . A surgical method, comprising:
forming an implant-passing tunnel in a bone by inserting a guidewire through a thickness of the bone;
passing a drilling tool into the implant-passing tunnel of the bone to increase a portion of the implant-passing tunnel to form a distal graft tunnel, the distal graft tunnel being positioned distal to the implant-passing tunnel and terminating proximally within the thickness of the bone;
loading a graft onto one or more coils of a suture filament that is coupled to a filament body, the filament body having the suture filament extending therethrough at two or more separate locations to form the one or more coils with each coil of the one or more coils defining an opening that is configured to engage the graft, the suture filament having a slidable portion formed therefrom such that movement of the slidable portion towards and away from the filament body causes a size of at least one opening of the one or more coils to change, and a tensioning tail extending from the slidable portion that is configured to move the slidable portion to change the size of the at least one opening of the one or more coils;
pulling the suture filament, the filament body, and the graft proximally into the distal graft tunnel, and at least the suture filament and the filament body into the implant-passing tunnel until the filament body is disposed outside of the implant-passing tunnel such that at least a portion of the suture filament is disposed in the implant-passing tunnel, and at least a portion of the graft is disposed in the distal graft tunnel; and
actuating the filament body that is disposed external to the implant-passing tunnel and the distal graft tunnel,
wherein the suture filament includes a hollow portion, and the slidable portion comprises a portion of the suture filament being disposed within the hollow portion, the portion of the suture filament disposed within the hollow portion being adjustable by applying tension to the tensioning tail.
2 . The method of claim 1 , wherein the suture filament includes a second hollow portion and a second sliding portion, the second sliding portion comprising a portion of the suture filament being disposed within the second hollow portion, the portion of the suture filament disposed within the second hollow portion being adjustable by applying tension to a second tensioning tail formed from the suture filament, the second tensioning tail extending from the second sliding portion and being configured to move the second slidable portion to change the size of at least one opening of the one or more coils.
3 . The method of claim 1 , wherein pulling the suture filament, the filament body, and the graft through the implant-passing tunnel and the distal graft tunnel further comprises applying tension to a leading end of the suture filament in a proximal direction to move the filament body into its anchoring configuration when passing through the distal graft tunnel and to move the filament body into its unstressed configuration when it passes out of the implant-passing tunnel.
4 . The method of claim 3 , wherein moving the filament body into the unstressed configuration when it passes out of the implant-passing tunnel further comprises actuating the filament body by applying tension to the coils in a direction away from the filament body to actuate the filament body into the anchoring configuration.
5 . The method of claim 3 , further comprising reconfiguring one or more of the suture filament or the filament body from the unstressed configuration, having a first length extending between terminal ends of the filament body, to an anchoring configuration by applying of tension to the one or more coils in a direction away from the filament body, the filament body, in the anchoring configuration, having a second length extending between opposed terminal ends of the reconfigured filament body with the first and second lengths being measured along a longitudinal axis of the filament body and the first length being greater than the second length.
6 . The method of claim 1 , wherein the two or more separate locations comprise a plurality of openings, with the suture filament pass through each opening to form the one or more coils.
7 . The method of claim 1 , wherein the graft is disposed in the distal graft tunnel and a portion of the suture filament extends through the implant-passing tunnel when the filament body is disposed outside of the implant-passing tunnel.
8 . The method of claim 1 , wherein the guidewire comprises a Beath pin.
9 . The method of claim 8 , maintaining a location of the Beath pin during each of passing the drilling tool, loading the graft onto one or more coils, pulling the suture filament, and actuating the filament body.
10 . The method of claim 8 , further comprising positioning additional tools within the implant-passing tunnel using the Beath pin while the Beath pin remains disposed within the implant-passing tunnel.
11 . The method of claim 8 , wherein the drilling tool passes over the Beath pin to form the distal graft tunnel.
12 . The method of claim 1 , wherein the distal graft tunnel terminates distal to a proximal-most end of the bone.
13 . The method of claim 1 , wherein the implant-passing tunnel is a femoral tunnel.
14 . The method of claim 1 , wherein a diameter of the implant-passing tunnel is smaller than a diameter of the distal graft tunnel.
15 . The method of claim 1 , further comprising cutting a portion of the filament body proximal to the implant-passing tunnel when the filament body is secured.
16 . The method of claim 1 , wherein the drilling tool passes proximally into the bone from a distal end of the bone.