Surgical fastening
Methods of joint repair employing sutures and attached fixation devices are discussed. For example, a bone block graft procedure (e.g., Latarjet) is discussed which employs fixation devices to secure contact between graft surfaces of two bones. A suture construct, including a continuous suture loop routed through a first fastener, is secured to a first bone. Looped ends of the suture loop are passed through passageways formed in the two bones. The looped suture ends are further routed through a second fastener. The second fastener is mounted to the second bone and a sliding knot, formed in the looped suture ends, is advanced into contact with the second fastener. The suture is further tensioned using a tensioner device to secure the two bones together.
1. A method for repairing an area of glenoid bone loss, the method comprising:
preparing a first grafting surface on a glenoid, the first grafting surface positioned adjacent an area of bone loss within the glenoid;
preparing a second grafting surface on an inferior surface of a coracoid process, drilling at least one first passage through the glenoid;
drilling at least one second passage through the coracoid process;
passing a guiding device through the at least one first passage in the glenoid;
passing the guiding device through the at least one second passage in the coracoid process;
resecting a tip of the coracoid process,
maneuvering the resected coracoid process along the guiding device such that at least a portion of the first and second grafting surfaces are in contact; and
securing the resected coracoid process to the glenoid with a suture construct;
wherein the suture construct comprises a first surgical fastener coupled to a continuous suture loop.
2. The method of claim 1 , wherein the guiding device is a looped guidewire.
3. The method of claim 1 , wherein the first surgical fastener comprises:
a generally circular body having a convex first surface, a concave second surface opposite the first surface, and a pair of first through holes extending through the body from the first surface to the second surface, the pair of first through holes being symmetrically offset from a center of the first surface;
a generally cylindrical post defining an outer curved surface, the post comprising:
a first end, a second end, and a longitudinal axis extending between the first and second ends, the longitudinal axis being perpendicular to the second surface of the body, the first end of the post being coupled to a center of the second surface; and
a second through hole formed in the post transverse to the longitudinal axis;
wherein the continuous suture loop is routed through either the pair of first through holes of the body or the second through hole of the post, such that two free ends of the continuous suture loop extend from the second surface of the body.
4. The method of claim 3 , wherein securing the resected coracoid process to the glenoid with the suture construct comprises passing the two free ends of the continuous suture loop through the at least one second passage of the coracoid process and the at least one first passage of the glenoid such that the body of the first surgical fastener rests on a superior surface of the coracoid process and the post of the first surgical first fastener is drawn into the at least one second passage of the coracoid process.
5. The method of claim 3 , wherein securing the resected coracoid process to the glenoid with the suture construct comprises routing the two free ends of the continuous suture loop through a second surgical fastener.
6. The method of claim 5 , wherein the second surgical fastener is the same as the first surgical fastener.
7. The method of claim 5 , further comprising advancing the second surgical fastener towards the glenoid such that a body of the second surgical fastener rests on an anterior surface of the glenoid and a post of the second surgical first fastener is drawn into the at least one first passage of the glenoid.