Methods and devices for tissue graft fixation
Methods and devices for tissue graft fixation include fixation devices attached to an adjustable fixation loop of suture without compromising the graft or requiring additional material to complete the repair. Other fixation devices are attachable to an independent adjustable suture system. Adjustable fixation loops minimize slip/creep of the suture within the loop.
1 . A graft suspension device comprising:
an adjustable suture loop construct having a first loop and a second loop; and
an elongate body having a first end, a second end, and a longitudinal axis extending therebetween, a first sidewall extending between the first and second ends along the longitudinal axis, and a second sidewall opposite the first sidewall extending between the first and second ends along the longitudinal axis; wherein the elongate body further comprises:
at least a first and a second aperture defined through the body adjacent a midpoint of the body defined by the first and second ends;
a first slot extending though the body and also through one of the first or second sidewalls such that the first slot is adjacent the first aperture;
a second slot formed through the body and also through one of the first side or second sidewalls such that the second slot is adjacent the second aperture;
wherein the at least first and second apertures are configured to assemble to the first loop of the adjustable suture loop construct;
wherein the first and second slots are configured to assemble with the second loop of the adjustable suture loop construct, independently from the first loop and after the second loop has been threaded through a graft, and wherein the adjustable suture loop construct includes a cradle comprising a longitudinal passage, through which a limb end of the adjustable suture loop construct extends, the cradle spacing first loop from the second loop.
2 . The graft suspension device of claim 1 wherein the second loop is provided as a continuous loop, free from the elongate body, and wherein the second loop is configured to draw the cradle through graft tissue and then loop over the elongate body and into the first and second slots to assemble the second loop and thereby the graft tissue to the elongate body.
3 . The graft suspension device of claim 1 wherein the elongate body further comprises a third and fourth hole, disposed adjacent the first and second end respectively, the third and fourth holes configured to receive the first and second limbs therethrough.
4 . The graft suspension device of claim 1 wherein the first and second aperture and the first and second slots define four separate openings, each having an equivalent maximum opening width to each other.
5 . The graft suspension device of claim 1 wherein the first and second apertures are closed apertures and disposed directly opposite each other, on either side of the longitudinal axis.
6 . The graft suspension device of claim 1 wherein the first and second slots are disposed directly opposite each other, on either side of the longitudinal axis.
7 . The graft suspension device of claim 1 wherein the second loop is pre-assembled to a double loop needle system, the double loop needle system formed of a suture separately formed from the adjustable loop construct and configured to stage threading of a free end of the adjustable suture loop construct and the second loop through the graft.
8 . The graft suspension device of claim 7 wherein the double loop needle system includes a first continuous loop and a second continuous loop, the first continuous loop configured to couple directly to the second loop of the adjustable suture loop construct, and the second continuous loop is configured to couple directly to the second free end of the adjustable suture loop construct.
9 . A graft suspension device comprising:
an elongate body defining a length, a thickness and a transverse width shorter than the length and having a first end, a second end, and a longitudinal axis extending along the length from the first end to the second end, a first sidewall extending from the first to the second end along the longitudinal axis, and a second sidewall opposite the first sidewall extending from the first end to the second ends end along the longitudinal axis; wherein the elongate body further comprises:
a pair of holes extending through the entire thickness of the elongate body and disposed adjacent the first end, on opposing sides of the longitudinal axis to each other;
a pair of slotted holes disposed adjacent the second end, on opposing sides of the longitudinal axis to each other; and
an adjustable fixation loop construct having a first side and a second side, separated by a cradle, the first side including a first adjustable suture loop and first free end and the second side including a second adjustable suture loop and second free end;
wherein the first adjustable suture loop is pre-assembled to the pair of holes and wherein the second adjustable loop is pre-assembled to a needle loop, the needle loop including a suture and a needle, the suture formed separately from the adjustable fixation loop and wherein the needle loop is configured to couple the cradle to tissue while the first adjustable loop remains assembled to the pair of holes.
10 . The graft suspension device of claim 9 wherein the pair of holes and pair of slotted holes, each define a maximum opening width that are equivalent to each other.
11 . The graft suspension device of claim 9 wherein the cradle comprises a longitudinal passage portion through which the first free end and the second free end extend.
12 . The graft suspension device of claim 9 wherein the elongate body further comprises a third and a fourth hole, disposed adjacent the first and second end respectively, the third and fourth holes configured to receive one each of the first and second free ends therethrough.
13 . The graft suspension device of claim 9 wherein the pair of holes are disposed directly opposite each other.
14 . The graft suspension device of claim 9 wherein the pair of slotted holes are disposed directly opposite each other.
15 . The graft suspension device of claim 9 wherein the needle loop includes two continuous loops, configured to sequentially pass the second free end followed by the second adjustable suture loop through tissue.
16 . The graft suspension device of claim 15 wherein the two continuous loops have different perimeter sizes to each other.
17 . The graft suspension device of claim 15 wherein the two continuous loops define a first continuous loop configured to couple directly to the second adjustable loop and hold the second adjustable loop a first distance from the needle, and a second continuous loop, configured to couple directly to the second free end and hold to-the second free end a second, shorter distance from the needle.
18 . A graft suspension device comprising:
an adjustable suture loop construct including a first loop end, a second loop end, a first free limb and a second free limb and a cradle separating the first and second loop ends, the cradle formed of suture and including a longitudinal passage portion though which the first and second free limbs extend; and
an elongate body having a first end, a second end, and a longitudinal axis extending therebetween, a first sidewall extending between the first and second ends along the longitudinal axis, and a second sidewall opposite the first sidewall extending between the first and second ends along the longitudinal axis; wherein the elongate body further comprises:
at least a first and a second aperture defined through the body adjacent a midpoint of the body defined by the first and second ends;
a first slot extending though the body and also through one of the first or second sidewalls such that the first slot is adjacent the first aperture;
a second slot formed through the body and also through one of the first side or second sidewalls such that the second slot is adjacent the second aperture;
wherein the at least first and second apertures are preassembled to the first loop of the adjustable suture loop construct; and
wherein the first and second slots are configured to assemble with the second loop of the adjustable suture loop, after the second loop has been threaded through a graft.
19 . The graft suspension device of claim 18 wherein the second loop end is pre-assembled to a separately formed suture loop, and wherein the separately formed suture loop is configured to pass only the second loop end and second free limb through the graft.