Method and apparatus for re-attaching the labrum of a hip joint

1. A method for treating pincer-type femoroacetabular impingement (FAI), the method comprising:

detaching the labrum from the overgrown acetabular portion which is to be removed in order to alleviate the impingement;

removing the overgrown acetabular portion in order to alleviate the impingement, thereby providing a newly-trimmed acetabular rim surface;

grasping the detached labrum with a grasper;

while holding the detached labrum over the newly-trimmed acetabular rim surface with the grasper, extending a guide pin through the grasper, through the detached labrum and into the acetabulum at the newly-trimmed acetabular rim surface;

advancing an anchor, having a length of suture trailing therefrom, down the guide pin, through the grasper, through the labrum, through the newly-trimmed acetabular rim surface and into the acetabulum beneath the newly-trimmed acetabular rim surface, so that a first portion of the suture extends out of the acetabulum at the newly-trimmed acetabular rim surface and through the labrum at a first location; and

securing a second portion of the suture to the acetabulum at the newly-trimmed acetabular rim surface, such that a loop of suture extends from the newly-trimmed acetabular rim surface, through the labrum and back to the newly-trimmed acetabular rim surface, whereby to secure the labrum to the newly-trimmed acetabular rim surface.

2. A method according to claim 1 wherein securing the second portion of the suture to the acetabulum at the newly-trimmed acetabular rim surface comprises advancing a fixation member into the anchor so as to secure the second portion of the suture to the anchor and hence to the newly-trimmed acetabular rim surface.

3. A method according to claim 2 wherein the fixation member comprises a collet.

4. A method according to claim 3 wherein the collet comprises an opening, and further wherein the second portion of the suture passes through the opening of the collet.

5. A method according to claim 4 wherein the opening is closed down when the collet is advanced into the anchor.

6. A method according to claim 1 wherein the first location is the location at which the anchor passes through the labrum.

7. A method according to claim 1 wherein the second portion of the suture extends alongside an outer edge of the labrum.

8. A method according to claim 1 wherein the second portion of the suture passes through the labrum at a second location, and further wherein the second location is offset from the first location.

9. A method for treating pincer-type femoroacetabular impingement (FAI), the method comprising:

removing the overgrown acetabular portion in order to alleviate the impingement, thereby providing a newly-trimmed acetabular rim surface and a free portion of the labrum;

grasping the free portion of the labrum with a grasper;

while holding the free portion of the labrum over the newly-trimmed acetabular rim surface with the grasper, extending a guide pin through the grasper, through the free portion of the labrum and into the acetabulum at the newly-trimmed acetabular rim surface; advancing a trans-labral dart; having a length of suture trailing therefrom, down the guide pin, through the grasper, through the labrum, through the newly-trimmed acetabular rim surface and into the acetabulum beneath the newly-trimmed acetabular rim surface, so that a first portion of the suture extends out of the acetabulum at the newly-trimmed acetabular rim surface and through the labrum at a first location; and

securing a second portion of the suture to the acetabulum at the newly-trimmed acetabular rim surface, such that a loop of suture extends from the newly-trimmed acetabular rim surface, through the labrum and back to the newly-trimmed acetabular rim surface, whereby to secure the labrum to the newly-trimmed acetabular rim surface.

10. A method according to claim 9 wherein a hole is drilled in the newly-trimmed acetabular rim surface.

11. A method according to claim 10 wherein the hole is drilled in the newly-trimmed acetabular rim surface while the free portion of the labrum is being grasped by the grasper.

12. A method according to claim 10 wherein the hole is drilled with a drill bit.

13. A method according to claim 12 wherein the drill bit is passed down the guide pin, through the labrum, through the acetabular rim surface and into the acetabulum at the newly-trimmed acetabular rim surface.

14. A method according to claim 9 wherein the free portion of the labrum is grasped with the grasper while advancing the trans-labral dart down the guide pin, through the grasper, through the labrum, through the newly-trimmed acetabular rim surface and into the acetabulum beneath the newly-trimmed acetabular rim surface.

15. A method according to claim 9 , wherein

the trans-labral dart comprises:

a body having a recess and a distal tip configured for passing down the guide pin, through the grasper, through the free portion of the labrum, through the newly-trimmed acetabular rim surface and into the acetabulum beneath the newly-trimmed acetabular rim surface, the first end of the suture being fixedly secured to the body of the trans-labral dart; and

a compressible collet having a bore therethrough and being selectively receivable within the recess of the body of the trans-labral dart, wherein the collet is configured to slidably receive the suture therethrough when the collet is outside the recess of the body of the trans-labral dart, and further wherein the collet is configured to compress the bore and grip the suture when the collet is within the recess of the body of the trans-labral dart.

16. A method according to claim 15 wherein securing the free portion of the labrum to the newly-trimmed acetabular rim surface comprises:

passing the body of the trans-labral dart down the guide pin, through the grasper, through the free portion of the labrum, through the newly-trimmed acetabular rim surface and into the acetabulum beneath the newly-trimmed acetabular rim surface; and

passing the collet over the second end of the suture, down the length of the suture and into the recess so as to create a cinched loop of suture securing the labrum to the trans-labral dart and hence to the acetabular rim surface.

17. A method according to claim 9 wherein securing the second portion of the suture to the acetabulum at the newly-trimmed acetabular rim surface comprises advancing a fixation member into the trans-labral dart so as to secure a second portion of the suture to the trans-labral dart and hence to the newly-trimmed acetabular rim surface.

18. A method according to claim 17 wherein the fixation member comprises a collet.

19. A method according to claim 18 wherein the collet comprises an opening, and further wherein the second portion of the suture passes through the opening of the collet.

20. A method according to claim 19 wherein the opening is closed down when the collet is advanced into the trans-labral dart.

21. A method according to claim 9 wherein the first location is the location at which the trans-labral dart passes through the labrum.

22. A method according to claim 9 wherein the second portion of the suture extends alongside an outer edge of the labrum.

23. A method according to claim 9 wherein the second portion of the suture passes through the labrum at a second location, and further wherein the second location is offset from the first location.