Adjustable suture-button constructs for ligament reconstruction
An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.
1. A method of ligament fixation at a site, comprising the steps of:
providing at least one adjustable, knotless, flexible loop construct having an adjustable length, two splices that are interconnected, and tractable suture ends, and at least one button that is adapted for engagement with the adjustable, knotless, flexible loop construct;
engaging the at least one adjustable, knotless, flexible loop construct with a ligament;
positioning the at least one adjustable, knotless, flexible loop construct and engaged ligament into a bone tunnel;
assembling the at least one button to the at least one adjustable, knotless, flexible loop construct, the at least one button being configured to removably attach to and detach from the adjustable, knotless, flexible loop construct; and
adjusting the length of the at least one adjustable, knotless, flexible loop construct to secure the ligament and engage the at least one button at the site.
2. The method of claim 1 , wherein the ligament is a PCL graft configured to engage the tibial cortex.
3. The method of claim 1 , wherein the button that is adapted for engagement is non-securely attached to the adjustable, knotless, flexible loop construct, the button having an elongate body with attachment features that permit attachment to and removal from the adjustable, knotless, flexible loop construct.
4. The method of claim 3 , wherein the attachment features include lateral, symmetrical slots disposed on a circumference of the elongate body.
5. The method of claim 1 , wherein the step of engaging the at least one adjustable, knotless, flexible loop construct with a ligament further includes providing the at least one adjustable, knotless, flexible loop construct with a second button that is sutured to the ligament.
6. The method of claim 1 , wherein providing at least one adjustable, knotless, flexible loop construct having an adjustable length, two splices that are interconnected, and tractable suture ends, and at least one button that is adapted for engagement with the adjustable, knotless, flexible loop construct includes providing a second adjustable, knotless, flexible loop construct having an adjustable length, two splices that are interconnected, and tractable suture ends, wherein the second adjustable, knotless, flexible loop construct also engages a ligament.