Filamentary fixation device
In one embodiment of the present invention, a fixation device including a sleeve member including an interior and an exterior surface along a length defined between a first end and a second end, and at least two openings positioned along the length and extending from the interior and through the exterior surface; and a filament including a first free end and a second free end and a length therebetween, the filament positioned relative to the sleeve member such that the free ends extend from the sleeve member at the first and second ends of the sleeve member, the filament being disposed inside the interior from the first end to a first opening, outside the sleeve member from the first opening to a second opening, and inside the interior from the second opening to the second end of the sleeve member.
1 . A filamentary fixation system, comprising:
a sleeve formed of filamentary material having a length and a lumen defined therethrough, the sleeve defining, in order along the length of the sleeve, first, second, third, and fourth openings, and a bottom portion configured to engage an inserter for inserting the sleeve into a bone hole through a cortical bone layer and into cancellous bone, the bottom portion being located between the second and third openings; and
a filament formed of filamentary material including a first free end and a second free end, the filament being disposed entirely outside the sleeve from the first opening to the second opening, entirely inside the lumen of the sleeve from the second opening to the third opening, and entirely outside the sleeve from the third opening to the fourth opening,
wherein the filament does not overlap itself along the length of the sleeve and the first free end and second free end are configured to be tensioned in a direction away from the bone hole to compress the bottom portion in a direction towards the cortical bone layer.
2 . The filamentary fixation system of claim 1 , wherein a diameter of the lumen is larger than a diameter of the filament such that the filament is slidable within the lumen.
3 . The filamentary fixation system of claim 1 , wherein the sleeve includes an inner surface defining the lumen and an exterior surface, and the first, second, third, and fourth openings extend entirely through the sleeve from the exterior surface to the lumen.
4 . The filamentary fixation system of claim 3 , wherein the filament exits the lumen through the first opening, enters the lumen through the second opening, exits the lumen through the third opening, and enters the lumen through the fourth opening.
5 . The filamentary fixation system of claim 1 , wherein the filament is positioned entirely within the lumen of the sleeve within the bottom portion.
6 . The filamentary fixation system of claim 1 , wherein the first free end and second free end are configured to be tensioned to pinch the second opening and the third opening together and compresses the bottom portion upwards such that at least a portion of the sleeve forms a W-shape.
7 . The filamentary fixation system of claim 1 , wherein the filament includes at least one indicating marker along a length of the filament.
8 . The filamentary fixation system of claim 1 , further comprising the inserter having a distal end provided with a forked tip.
9 . The filamentary fixation system of claim 8 , wherein the forked tip is positioned at a distal-most end of the inserter, wherein the bottom portion of the sleeve is configured to engage the forked tip.
10 . A filamentary fixation kit, comprising:
a sleeve formed of filamentary material having a length, an exterior surface and an interior surface defining a lumen extending through the sleeve, the sleeve defining, in order along the length of the sleeve, first, second, third, and fourth openings, and a bottom portion configured to engage an inserter for inserting the sleeve into a bone hole through a cortical bone layer and into cancellous bone, the bottom portion being located between the second and third openings; and
a filament formed of filamentary material including a first free end and a second free end, the filament being disposed entirely outside the sleeve from the first opening to the second opening, entirely inside the lumen of the sleeve from the second opening to the third opening, and entirely outside the sleeve from the third opening to the fourth opening such that the filament does not overlap itself along the length of the sleeve, wherein the first free end and second free end are configured to be tensioned in a direction away from the bone hole to compress the bottom portion in a direction towards the cortical bone layer; and
the inserter having a distal end for engaging the bottom portion of the sleeve.
11 . The filamentary fixation kit of claim 10 , wherein the distal end of the inserter comprises a forked tip.
12 . A surgical method, comprising the steps of:
accessing bone and preparing a bone hole through a cortical bone layer and into cancellous bone;
obtaining a fixation device, the fixation device, including:
a sleeve formed of filamentary material having a lumen defined therethrough, the sleeve defining, in order along the length of the sleeve, first, second, third, and fourth openings, and a bottom portion located between the second and third openings;
a filament formed of filamentary material including a first free end and a second free end, the filament being disposed entirely outside the sleeve from the first opening to the second opening, entirely inside the lumen of the sleeve from the second opening to the third opening, and entirely outside the sleeve from the third opening to the fourth opening such that the filament does not overlap itself along the length of the sleeve;
an inserter positioned against the bottom portion of the sleeve in between the second opening and the third opening;
inserting the fixation device into the bone hole using the inserter; and tensioning the first free end and the second free end in a direction away from the bone hole to compress the bottom portion in a direction towards the cortical bone layer.
13 . The surgical method of claim 12 , wherein the tensioning step comprises sliding the filament though the sleeve.
14 . The surgical method of claim 12 , wherein the tensioning step comprises tensioning the first and second free ends of the filament such that the second and third openings are pinched, and the bottom portion moves upwards.
15 . The surgical method of claim 12 , wherein the filament further comprises at least one indicating marker, and during the tensioning step, at least a portion of the at least one indicating marker slides relative to the sleeve from a position beneath a surface of the bone hole to a position above the surface of the bone hole.
16 . The surgical method of claim 12 , wherein the preparing the bone hole step comprises drilling the bone hole to a diameter of between about 1.2 mm and 1.8 mm.
17 . The surgical method of claim 12 , wherein the obtaining step comprises a forked end of the inserter adapted to be engaged against the bottom portion of the sleeve.
18 . The surgical method of claim 12 , wherein the inserting step comprises engaging the bottom portion of the sleeve against a floor of the bone hole.
19 . The surgical method of claim 12 , wherein the tensioning step comprises tensioning the first and second free ends of the filament to compress at least a portion of the sleeve into a W-shape.
20 . The surgical method of claim 12 , wherein the surgical method comprises repairing soft tissue of a rotator cuff, a shoulder labrum, or a hip labrum.