Flipping-type graft fixation device and method
A buckle useful for cortical fixation has a graft retention loop slidably affixed thereto for movement from a first position adjacent a first end of the buckle to a second position at about the midpoint of the buckle. The buckle, with a graft over the loop, is drawn up lengthwise through a bone tunnel through a tibia and then flipped sideways to rest against the surface of the bone with the loop and graft depending back into the tunnel. The sliding attachment of the loop permits flipping of the buckle minimizes the flipping distance, which is the excess amount of the loop which must be pulled free of the tunnel to allow the buckle to be flipped sideways.
1. A method for fixing a graft ligament into a bone tunnel, the method comprising the steps of:
a) forming a graft construct by draping the graft ligament over a loop depending from a fixation buckle, the buckle having a length along a longitudinal axis which is at least twice a maximum lateral dimension, the tunnel having an exit where it exits the bone and the length also being larger than a maximum width of exit;
b) pulling the graft construct up through the bone tunnel with the buckle traveling lengthwise through the tunnel with the loop depending from the buckle from a first position located below a midpoint of the length of the buckle;
c) pulling the buckle out of the tunnel through the exit and rotating it so that its longitudinal axis is sufficiently out of alignment with the tunnel to prevent the buckle from passing back into the tunnel;
d) moving the loop from the first position to a second position along the buckle, the second position being at about the midpoint of the buckle; and
e) engaging the buckle against the bone at the exit with the loop depending into the tunnel from the second position on the buckle;
wherein the loop slides along a surface of the buckle between the first position and the second position and wherein the surface slopes downwardly as it approaches the midnight of the buckle;
wherein aster step e) the loop depends into the tunnel by a first length and during step c) the loop depends into the tunnel by a second length that is less than the first length and during the performance of step c) the second length is never less than the first length by more than 3.5.
2. The method according to claim 1 wherein the loop is received through at least one elongated slot on the buckle and moves from the first position to the second position by sliding along the at least one elongated slot.
3. The method according to claim 2 wherein the at least one slot has an end at about the midpoint of the buckle and wherein the loop is engaged with the end of the slot as it is moved into the second position.
4. The method according to claim 1 wherein the graft ligament is an ACL replacement and the bone tunnel is formed through a tibia.