Soft button assembly and procedure
A suture construct having a soft button, defining a multiplicity of first apertures and a set of second apertures. Also, a suture loop assembly has a suture defining a lumen and forming a double loop, formed by a double trap having a first end and a second end, formed in a trap region of the suture, and in which a first portion of the suture is threaded through the trap region lumen from the first end to the second end and the first portion extends out from the second end, and a second portion of the suture is threaded through the trap region lumen from the second end to the first end, and the second portion extends out from the first end. Finally, the double loop passes through the set of second apertures of the soft button.
1. A method for affixing a suture loop to a bone structure, comprising:
a) providing a suture construct, including:
i. a soft button, comprising a sheet of flexible material defining a multiplicity of first apertures and a set of second apertures; and
ii. a suture loop assembly, a suture defining a lumen and forming a double loop, formed by a double trap having a first end and a second end, formed in a double trap region of said suture, and in which a first portion of said suture is threaded through said double trap region of said lumen from said first end to said second end and said first portion extends out from said second end, and a second portion of said suture is threaded through said trap region lumen from said second end to said first end, and said second portion extends out from said first end to a second end; and
iii. wherein said double loop is threaded through said set of second apertures in said soft button;
b) drilling through said bone structure, thereby creating a passageway, having a first and a second rim;
c) pulling said soft button through said passageway, from said first rim through said second rim, together with said first portion and said second portion, with the remainder of said loop extending through said passageway;
d) anchoring said loop at a position opposed to said soft button; and
e) pulling on said first and second portions to bring said suture loop into tension, with said soft button resting against said second rim.
2. The method of claim 1 , wherein said first and second apertures are interstices of a weave of biocompatible fibers, comprising said sheet of flexible material.
3. The method of claim 1 , wherein said first and second apertures are laser-drilled apertures in a sheet of polymeric material, comprising said sheet of flexible material.
4. The method of claim 1 , wherein said soft button is a first soft button and said suture loop assembly further comprises a second soft button, opposed to said first soft button and further wherein said step of anchoring said suture loop at a position opposed to said first soft button is performed by said second soft button being positioned so that it braces against said first rim.
5. The method of claim 4 , wherein said bone structure is a lower calf structure of said patient, including a tibia and fibula, and wherein said drilling is performed through said tibia and fibula, and wherein said loop holds said tibia and fibula together, after implantation, with said first.
6. The method of claim 1 , further comprising leaving said soft button in said patient and thereby permitting tissue ingrowth into said first apertures and creating a part tissue part button-material button that resists being pulled back through said passageway.
7. The method of claim 1 , wherein set of second apertures consists of at least six apertures, and wherein said soft button is formed into at least three folds by said double loop passing through said six apertures.