Methods and devices for forming bone tunnels
View Patent ↗Methods and devices are provided for forming bone tunnels. In general, the methods and devices allow multiple converging tunnels to be formed in bone, such as in an arthroscopic surgical procedure, e.g., a rotator cuff repair surgical procedure. One or more sutures can be advanced through the converging tunnels, and the suture(s) can be coupled to tissue. The suture(s) with the tissue coupled thereto can be tensioned, thereby helping to maximize an amount of the tissue in contact with the bone. In an exemplary embodiment, a guide device is provided that can be configured to allow a first tunnel to be formed in bone and to allow a plurality of additional tunnels to be formed in the bone at predetermined angular positions relative to the first tunnel such that each of the additional tunnels can extend transverse to the first tunnel and intersect the first tunnel.
1. A surgical device, comprising: a frame having a base portion and an arm portion extending transversely from the base portion, the base portion having an opening formed therethrough, and the arm portion having a plurality of holes formed therethrough, the opening formed through the base portion being configured to receive a surgical instrument therethrough, each of the plurality of holes being configured to receive a suture therethrough, a longitudinal axis of the opening formed through the base portion being substantially perpendicular to longitudinal axes of each of the plurality of holes, and the longitudinal axes of the plurality of holes being substantially parallel to one another; a shaft having a cannulated interior and being configured to be slidably seated in the opening, wherein when the shaft is slidably seated in the opening, the longitudinal axis of each of the plurality of holes intersects the cannulated interior of the shaft; a first suture configured to, when the shaft is slidably seated in the opening, extend through a first one of the plurality of holes, into the cannulated interior of the shaft, and through the opening formed through the base portion of the frame; and a second suture configured to, when the shaft is slidably seated in the opening, extend through a second one of the plurality of holes, into the cannulated interior of the shaft, and through the opening formed through the base portion of the frame.
2. The device of claim 1 , further comprising a suture capture device having at least one suture capture feature, the suture capture device being configured to be advanced through the opening such that at least one suture capture feature is aligned with at least one of the holes.
3. The device of claim 1 , further comprising a suture capture device configured to be advanced through the opening formed through the base portion to capture at least one suture extending through at least one of the plurality of holes, and retracted through the opening formed through the base portion with the at least one suture captured thereto.
4. The device of claim 1 , wherein the shaft is configured to be inserted into bone.
5. The device of claim 4 , wherein when the shaft is slidably seated in the opening and the shaft is positioned within the bone, an intermediate portion of the shaft extending between a first end of the shaft and a second end of the shaft is positioned within the bone and is positioned relative to the arm portion of the frame such that respective longitudinal axes of the plurality of holes intersect a longitudinal axis of the intermediate portion of the shaft.
6. The device of claim 5 , wherein the shaft has a plurality of openings formed in the intermediate portion thereof, and, when the shaft is slidably seated in the opening, each of the plurality of openings is coaxially aligned with one of the plurality of holes.
7. The device of claim 1 , wherein the shaft includes an alignment feature configured to align the shaft in a predetermined orientation relative to the holes.
8. The device of claim 7 , wherein the frame include a surface feature configured to align with the alignment feature when the shaft is slidably seated in the opening so as to align the shaft in the predetermined orientation relative to the holes.
9. The device of claim 1 , wherein the cannulated interior is configured to receive therein the suture that is received by each of the plurality of holes.
10. A surgical device, comprising: a guide device having first and second terminal ends with an intermediate portion extending between the first and second terminal ends, a first plurality of holes being formed in the intermediate portion, and the first terminal end including an opening therein; a shaft having one or more holes formed therein, the shaft having an inner lumen extending therethrough that is in communication with the one or more holes, the shaft being configured to be releasably received in the opening such that longitudinal axes of each of the first plurality of holes pass through the one or more holes, and the shaft being configured to be advanced into a bone of a patient; wherein when the shaft is positioned within the bone and is releasably received in the opening, the guide device is positioned entirely external to the patient; a first suture configured to, when the shaft is releasably received in the opening, extend through a first one of the first plurality of holes, into the inner lumen of the shaft, and through the opening; and a second suture configured to, when the shaft is releasably received in the opening, extend through a second one of the first plurality of holes, into the inner lumen of the shaft, and through the opening.
11. The device of claim 10 , wherein the one or more holes include a second plurality of holes, and when the shaft is releasably received in the opening, each one of the first plurality of holes is coaxially aligned with one of the second plurality of holes.
12. The device of claim 10 , wherein the one or more holes include a single hole.
13. The device of claim 10 , wherein the longitudinal axes of the first plurality of holes are substantially parallel to one another.
14. The device of claim 10 , further comprising a suture capture device configured to be
slidably moved in the opening in a first direction and then capture at least one suture extending through at least one of the first plurality of holes, and
slidably moved in the opening in a second direction so as to slidably retract the captured at least one suture through the opening, the second direction being opposite to the first direction.
15. The device of claim 10 , wherein the guide device includes a feature configured to position the shaft releasably received in the opening in a predetermined orientation relative to the guide device, the longitudinal axes of each of the first plurality of holes passing through the one or more holes when the shaft is in the predetermined orientation relative to the guide device.
16. The device of claim 15 , wherein the feature includes at least one of a cut-out formed in the guide device, a visual mark on the guide device, and a tactile mark on the guide device.
17. A surgical device, comprising:
a frame having a base portion and an arm portion extending transversely from the base portion, the base portion having an opening formed therethrough, and the arm portion having a plurality of holes formed therethrough, the opening formed through the base portion being configured to receive a surgical instrument therethrough, each of the plurality of holes being configured to receive a suture therethrough, a longitudinal axis of the opening formed through the base portion being substantially perpendicular to longitudinal axes of each of the plurality of holes, and the longitudinal axes of the plurality of holes being substantially parallel to one another;
a first suture configured to, when a shaft is slidably seated in the opening, extend through a first one of the plurality of holes, into an inner lumen of the shaft, and through the opening formed through the base portion of the frame; and
a second suture configured to, when the shaft is slidably seated in the opening, extend through a second one of the plurality of holes, into the inner lumen of the shaft, and through the opening formed through the base portion of the frame.