Implant and method for repair of the anterior cruciate ligament
Described herein are methods and devices for use in repair of a patient's anterior cruciate ligament (ACL). These methods (and devices for performing them) allow the repair, rather than merely replacement, of the ACL. For example, described herein are anchoring devices that may be inserted into a bone and may anchor a scaffolding/support (e.g., graft) material within the bone so that the torn or damaged end of the ACL may be secured to the scaffolding/support material within the femoral notch. These anchoring devices and method of using them are particularly well suited for use with the continuous suture passers described herein, since these suture passers may allow access to previously inaccessible regions of the knee (or other body regions).
1. A method for repairing a torn anterior cruciate ligament (ACL) within the femoral notch, the method comprising:
forming a tunnel through a femur extending from a first side of the femur to a second side of the femur that is within the femoral notch;
anchoring a graft within the femoral notch by securing a suture anchor coupled to the graft within the tunnel near the second side of the femur;
securing a torn end of the ACL to a suture; and
anchoring the suture in the suture anchor by pulling the suture through the anchor from the second side of the femur and out of the first side of the femur, wherein the anchor is configured to prevent the suture from pulling out of the anchor toward the second side of the femur; and
suturing a torn end of the ACL to the graft within the femoral notch.
2. A method for repairing a torn anterior cruciate ligament (ACL) within the femoral notch, the method comprising:
forming a tunnel through a femur extending from a first side of the femur to a second side of the femur that is within the femoral notch;
securing a suture anchor within the tunnel near the second side of the femur;
securing a torn end of the ACL to a suture; and
anchoring the suture in the suture anchor by pulling the suture through the anchor from the second side of the femur and out of the first side of the femur, wherein the anchor is configured to prevent the suture from pulling out of the anchor toward the second side of the femur.
3. The method of claim 2 , wherein forming the tunnel comprises driving a pin through the femur.
4. The method of claim 2 , further comprising securing the ACL to a graft connected to the suture anchor.
5. The method of claim 2 , wherein securing the torn end of the ACL comprises pulling the suture through the tunnel and anchor to position the torn end of the ACL adjacent to a graft and suturing the torn end of the ACL to the graft.
6. The method of claim 2 , wherein securing a suture anchor comprises securing the anchor to which a graft has been coupled within the femur so that a proximal end of the graft extends from the second side of the femur.
7. The method of claim 2 , wherein forming a tunnel through a femur comprises driving a guidewire through the femur and drilling an opening to hold the suture anchor.
8. The method of claim 2 , wherein the suture anchor is secured by screwing the anchor into the femur.
9. The method of claim 2 , wherein suturing the torn end of the ACL comprises passing the suture through the ACL multiple times with a continuous suture passer without removing the suture passer from the tissue.
10. The method of claim 2 , further comprising tensioning the ACL by pulling the suture from the first side of the femur.
11. The method of claim 2 , further comprising knotting and securing the suture from the first side of the femur.
12. A method for repairing a torn ligament within the femoral notch, the method comprising:
forming a tunnel through a femur extending from a first side of the femur facing away from the femoral notch to a second side of the femur that is within the femoral notch;
securing a suture anchor within the tunnel near the second side of the femur;
percutaneously securing a torn end of the ligament to a suture using a suture passer from within the femoral notch; and
pulling the suture through the anchor from the second side of the femur and out of the first side of the femur, wherein the anchor is configured to prevent the suture from pulling out of the anchor toward the second side of the femur.
13. The method of claim 12 , further comprising securing the ligament to a graft connected to the suture anchor.
14. The method of claim 12 , wherein securing the torn end of the ligament comprises pulling the suture through the tunnel and anchor to position the torn end of the ligament adjacent to a graft and suturing the torn end of the ligament to the graft.
15. The method of claim 12 , wherein securing a suture anchor comprises securing the anchor to which a graft has been coupled within the femur so that a proximal end of the graft extends from the second side of the femur.
16. The method of claim 12 , wherein forming a tunnel through a femur comprises driving a guidewire through the femur and drilling an opening to hold the suture anchor.
17. The method of claim 12 , wherein the suture anchor is secured by screwing the anchor into the femur.
18. The method of claim 12 , wherein suturing the torn end of the ligament comprises passing the suture through the ligament multiple times with a continuous suture passer without removing the suture passer from the tissue.
19. The method of claim 12 , further comprising tensioning the ligament by pulling the suture from the first side of the femur.
20. The method of claim 12 , further comprising knotting and securing the suture from the first side of the femur.