Tenodesis implant and inserter and methods for using same
The present invention provides a novel split barbed fixation device for tenodesis, soft tissue reattachment of tendons and ligaments to bones. The insertion device is adapted for an entirely arthroscopic approach while achieving fixation strength with ultimate pullout resistance comparable to interference screws. The device includes an integrated tendon grasper that provides for easy manipulation of the tendon arthroscopically while eliminating the need for external whip stitching of the tendon, thereby reducing preparation time. The device further includes elements that prevent the fixation implant from being destabilized or rotating during deployment and manipulation, including: a depth limiting sheath, a first implant retainer, a first implant retaining step, a tendon grasping needle tube, and an implant keyway for mating the implant to the tube. The implant itself comprises two separate portions mating along a diagonal and having barbed surface features in opposite directions, only one of which contacts the tendon.
1. A method for arthroscopic tenodesis repair, comprising:
creating an opening in bone at a desired fixation site;
piercing a free end of a graft tendon with a distal end of an insertion device;
capturing said free end of said graft tendon by outwardly extending a tendon grasper;
actuating a mallet knob to move the insertion device distally, thereby introducing said free end of said graft tendon and a first implant disposed on said insertion device into said bone opening;
actuating said mallet knob an additional time to move a second implant distally until it mates with the first implant within the bone opening, removing a retaining pin from the mallet knob, wherein the step of removing the retaining pin permits the mallet knob to move axially relative to the insertion device when the mallet knob is actuated the additional time;
releasing said free end of said graft tendon; and
removing said insertion device from said bone opening.
2. The method as recited in claim 1 , and further comprising a step of extending a first implant retainer from the insertion device to engage the first implant, so that when the first mallet knob is actuated to introduce said first implant within said bone opening, said first implant does not move axially relative to the insertion device.
3. The method as recited in claim 2 , wherein the step of releasing the free end of the graft tendon also releases the first implant, so that when the insertion device removal step is performed, the tendon, first implant, and second implant remain in the bone opening.
4. The method as recited in claim 1 wherein only the first implant contacts the tendon.
5. The method as recited in claim 1 , wherein the mallet knob actuating steps are performed by pounding the mallet knob with a mallet.