Systems and methods for preparing reinforced graft constructs
Systems and methods for preparing a tissue repair construct for a ligament reconstruction procedure using a reinforced whip-stitching are provided. The described techniques include passing a needle having suture tails attached thereto through a first surface of a graft at an origin point so that a portion of the suture tails exits on a second, opposite surface of the graft while a terminal length of the suture tails is maintained on the first surface of the graft. Multiple suture loops are formed by repeatedly passing the needle with the suture tails around opposite sides of the graft and through the first surface of the graft at subsequent entry points spaced apart along a length of the graft. Each loop is formed so that the construct is reinforced by having a terminal length of each of the suture tails disposed between the first surface of the graft and the loop.
1. A method of graft preparation, comprising:
passing a needle and a suture attached thereto and having first and second suture tails through a first surface of a graft at a first entry point remote from a first end of the graft so that the needle and a portion of the attached suture are passed to a second, opposite surface of the graft while maintaining a terminal length of each of the first and second suture tails on the first surface of the graft such that the terminal length of the suture tails extends in a first direction from the first entry point towards the first end of the graft;
passing the needle and the attached suture through the first surface at a second entry point longitudinally spaced apart from the first entry point in the first direction to the second surface with the suture tails disposed on opposite sides of the graft so that the suture forms a loop defined by the suture tails extending from the second entry point, to an exit point on the second surface of the graft and around opposite sides of the graft, the loop surrounding the terminal length of the first and second suture tails such that the terminal length of the suture tails is disposed between the first surface of the graft and the loop;
repeatedly passing the needle and the attached suture through the first surface at subsequent entry points longitudinally spaced apart from the first and second entry points in the first direction to the second surface to form multiple loops, each of the multiple loops spaced apart from adjacent loops in the first direction and each loop surrounding the terminal length of the first and second suture tails such that the terminal length of the suture tails is disposed between the first surface of the graft and the loop; and
continuing the act of repeatedly passing until reaching a final entry point in proximity to the first end of the graft.
2. The method of claim 1 , wherein passing the needle and the attached suture through the first surface at the second entry point comprises passing the needle and the attached suture through the terminal length of at least one of the suture tails.
3. The method of claim 1 , wherein the needle is substantially a mid-point of the suture and the first and second suture tails attached to the needle have approximately the same length.
4. The method of claim 1 , wherein a length of the suture tails is approximately equal to a length of a portion of the graft between the first entry point and the first end of the graft.
5. The method of claim 1 , wherein the suture tails extend beyond the first end of the graft.
6. The method of claim 1 , wherein passing the needle and the attached suture through the first surface at the second and subsequent entry points comprises passing the needle and the attached suture between the first and second suture tails.
7. The method of claim 1 , wherein the suture comprises a continuous, uninterrupted suture.
8. The method of claim 1 , wherein the suture is attached to the needle via an intermediate feature.
9. The method of claim 1 , further comprising:
passing a second needle and a second suture attached thereto and having third and fourth suture tails through the first surface of the graft at a third entry point remote from the second end of the graft so that the second needle and a portion of the attached second suture are passed to the second surface of the graft while maintaining a second terminal length of each of the third and fourth suture tails on the first surface of the graft such that the terminal length of the third and fourth suture tails extends in a second direction from the third entry point towards the second end of the graft;
passing the second needle and the second attached suture through the first surface at a fourth entry point longitudinally spaced apart from the third entry point in the second direction to the second surface with the third and fourth suture tails disposed on opposite sides of the graft so that the second suture forms a second loop defined by the third and fourth suture tails extending from the fourth entry point, to an exit point on the second surface of the graft and around opposite sides of the graft, the second loop surrounding the terminal length of the third and fourth suture tails such that the terminal length of the third and fourth suture tails is disposed between the first surface of the graft and the second loop;
repeatedly passing the second needle and the attached second suture through the first surface at second subsequent entry points longitudinally spaced apart from the third and fourth entry points in the second direction to the second surface to form second multiple loops, each of the second multiple loops spaced apart from adjacent second loops in the second direction and each loop surrounding the terminal length of the third and fourth suture tails such that the terminal length of the third and fourth suture tails is disposed between the second surface of the graft and the loop; and
continuing the act of repeatedly passing until reaching a second final entry point in proximity to the second end of the graft.