U.S. patent application number 14/185449 was filed with the patent office on 2014-06-19 for tissue graft anchor assembly and instrumentation for use therewith.
The applicant listed for this patent is Smith & Nephew, Inc.. Invention is credited to Alfred R. Berube, Ben K. Graf, Gary M. McCarthy.
Application Number | 20140171983 14/185449 |
Document ID | / |
Family ID | 42829453 |
Filed Date | 2014-06-19 |
United States Patent
Application |
20140171983 |
Kind Code |
A1 |
Graf; Ben K. ; et
al. |
June 19, 2014 |
TISSUE GRAFT ANCHOR ASSEMBLY AND INSTRUMENTATION FOR USE
THEREWITH
Abstract
The present disclosure relates to a soft tissue graft anchor.
The anchor includes a plurality of prongs, each prong including a
distal end and a proximal end, wherein the prongs are coupled at
their distal ends to form an inner cavity having an opening, at
least one of the prongs including a fin, the fin extending
perpendicular to a longitudinal axis of the prong and including a
pointed end. A tissue graft anchor assembly, a method for tissue
repair, and instrumentation for use therewith are also
disclosed.
Inventors: |
Graf; Ben K.; (Madison,
WI) ; Berube; Alfred R.; (North Attleboro, MA)
; McCarthy; Gary M.; (East Bridgewater, MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Smith & Nephew, Inc. |
Memphis |
TN |
US |
|
|
Family ID: |
42829453 |
Appl. No.: |
14/185449 |
Filed: |
February 20, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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12832616 |
Jul 8, 2010 |
8663325 |
|
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14185449 |
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|
61224123 |
Jul 9, 2009 |
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61225240 |
Jul 14, 2009 |
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61312508 |
Mar 10, 2010 |
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61315521 |
Mar 19, 2010 |
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61332998 |
May 10, 2010 |
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Current U.S.
Class: |
606/151 |
Current CPC
Class: |
A61F 2/0811 20130101;
A61B 17/1659 20130101; A61F 2220/0016 20130101; A61B 2017/0456
20130101; A61B 17/0401 20130101; A61B 17/1675 20130101; A61F
2002/0888 20130101; A61F 2002/0852 20130101; A61F 2002/0835
20130101 |
Class at
Publication: |
606/151 |
International
Class: |
A61F 2/08 20060101
A61F002/08 |
Claims
1. A broach comprising: a handle; and a shaft coupled to the
handle, the shaft including a member located at an end of the
shaft, the member including prongs, grooves located between the
prongs, and a fin on at least one of the prongs, the fin extending
perpendicular to a longitudinal axis of the of the prong.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Patent
Application No. 61/224,123, filed Jul. 9, 2009; U.S. Patent
Application No. 61/225,240, filed Jul. 14, 2009; U.S. Patent
Application No. 61/312,506, filed Mar. 10, 2010; U.S. Patent
Application No. 61/315,521, filed Mar. 19, 2010; and U.S. Patent
Application No. 61/332,998, filed May 10, 2010, the disclosures of
which are incorporated by reference in their entireties.
BACKGROUND
[0002] 1. Field of Technology
[0003] The present disclosure relates to the fixation of soft
tissue to bone.
[0004] 2. Related Art
[0005] In many aspects of orthopedic surgery it is necessary to fix
a soft tissue to bone. In one example, a ligament, such as an
anterior cruciate ligament (ACL), that has ruptured and is
non-repairable, may be replaced by a soft tissue graft. The tissue
graft can be harvested from various sites including, without
limitation, the patellar tendon, quadriceps tendon, semitendonosis
tendon, gracilis tendon, or a combination thereof. Alternatively,
the graft may be formed from synthetic materials or from a
combination of synthetic and natural materials.
[0006] The replacement tissue graft is implanted by securing one
end of the tissue graft through a passage formed in the femur, and
the other end of the graft through a passage formed in the tibia.
Generally, an anchor (e.g., an interference screw or a post) is
used to affix each end of the tissue graft to the bone.
[0007] In another example, a soft tissue may be anchored to
passages in the femur and patella to reconstruct the medial
patellofemoral ligament. Other examples of ligament reconstructions
include, but are not limited to, elbow and ankle ligament
reconstructions. Tendons not part of a ligament reconstruction may
also be anchored into bone passages. An example is fixation of the
proximal biceps tendon to the proximal humerus.
[0008] There remains a need for a soft tissue anchor and
instrumentation for use with the anchor which is simple, easy to
install, and inexpensive to manufacture, while providing secure,
trouble-free anchoring of a soft tissue graft.
SUMMARY
[0009] In an aspect, the present disclosure relates to a soft
tissue graft anchor. The anchor includes a plurality of prongs,
each prong including a distal end and a proximal end, wherein the
prongs are coupled at their distal ends to form an inner cavity
having an opening, at least one of the prongs including a fin, the
fin extending perpendicular to a longitudinal axis of the prong and
including a pointed end. In an embodiment, at least one of the
prongs includes at least one barb on at least one side surface of
the prong. In another embodiment, the anchor includes a through
hole, wherein the cavity extends into the through hole. In yet
another embodiment, at least one of the prongs includes at least
one groove.
[0010] In another aspect, the present disclosure relates to tissue
graft anchor assembly. The anchor assembly includes a tissue graft
anchor including a plurality of prongs, each prong including a
distal end and a proximal end, wherein the prongs are coupled at
their distal ends to form an inner cavity having an opening, at
least one of the prongs including a fin, the fin extending
perpendicular to a longitudinal axis of the prong and including a
pointed end; and a fixation member configured to be disposed within
the cavity.
[0011] In yet another aspect, the present disclosure relates to a
method of tissue repair. The method includes creating a tunnel in
bone; inserting a soft tissue graft within the tunnel; inserting a
tissue graft anchor within the tunnel, the tissue graft anchor
comprising a plurality of prongs, each prong including a distal end
and a proximal end, wherein the prongs are coupled at their distal
ends to form an inner cavity having an opening, at least one of the
prongs including a fin, the fin extending perpendicular to a
longitudinal axis of the prong and including a pointed end; and
inserting a fixation member within the cavity of the tissue graft
anchor, whereby inserting the fixation member into the cavity
causes the prongs to twist and expand, thereby causing ends of the
grafts to engage a wall of the tunnel and fixate the grafts to the
bone.
[0012] In a further aspect, the present disclosure relates to a
tension device. The tension device includes a body including two
sides, wherein each side includes one wheel and two guides, wherein
the wheel is configured for longitudinal movement relative to the
body and the guides are stationary; a shoulder assembly coupled to
the body; and a shaft assembly coupled to the shoulder assembly,
the shaft assembly comprising a shaft and a handle coupled to the
shaft, the handle including a window.
[0013] In yet a further aspect, the present disclosure relates to a
broach. The broach includes a handle; and a shaft coupled to the
handle, the shaft including a member located at an end of the
shaft, the member including prongs, grooves located between the
prongs, and a fin on at least one of the prongs, the fin extending
perpendicular to a longitudinal axis of the of the prong.
[0014] In an aspect, the present disclosure relates to a delivery
device. The delivery device includes a handle; a shaft coupled to
the handle; and a movable member coupled to the shaft, the member
including a track, a nipple coupled to the shaft located within the
track, wherein the nipple is located in a first area of the track
when the movable member is located in a first position and the
nipple is located in a second area of the track when the movable
member is located in a second position.
[0015] In another aspect, the present disclosure relates to a kit.
The kit includes a tissue graft anchor including a plurality of
prongs, each prong including a distal end and a proximal end,
wherein the prongs are coupled at their distal ends to form an
inner cavity having an opening, at least one of the prongs
including a fin, the fin extending perpendicular to a longitudinal
axis of the prong and including a pointed end; and a fixation
member configured to be disposed within the cavity.
[0016] Further areas of applicability of the present disclosure
will become apparent from the detailed description provided
hereinafter. It should be understood that the detailed description
and specific examples, while indicating the preferred embodiment of
the disclosure, are intended for purposes of illustration only and
are not intended to limit the scope of the disclosure.
BRIEF DESCRIPTION OF THE DRAWINGS
[0017] The accompanying drawings, which are incorporated in and
form a part of the specification, illustrate the embodiments of the
present disclosure and together with the written description serve
to explain the principles, characteristics, and features of the
disclosure. In the drawings:
[0018] FIGS. 1 and 2 show side elevation views of the tissue graft
anchor of the present disclosure.
[0019] FIG. 3 shows an isometric view of the tissue graft anchor of
the present disclosure.
[0020] FIG. 4 shows an isometric view of the tissue graft anchor of
the present disclosure.
[0021] FIG. 5 shows a side elevation view of the tissue anchor
assembly of the present disclosure.
[0022] FIG. 6 shows the tissue graft anchor assembly of the present
disclosure after insertion of the assembly into a bone tunnel.
[0023] FIG. 7 shows an isometric view of an alternative embodiment
of the tissue graft anchor of the present disclosure.
[0024] FIGS. 8-11 show the tension device of the present disclosure
and its components.
[0025] FIG. 12 shows an isometric view of the broach of the present
disclosure.
[0026] FIGS. 13-15 show the delivery device of the present
disclosure.
[0027] FIGS. 16-19 show soft tissue reconstruction surgery via use
of the tissue graft anchors of the present disclosure.
[0028] FIG. 20 shows an isometric view of another alternative
embodiment of the tissue graft anchor of the present
disclosure.
DETAILED DESCRIPTION OF THE EMBODIMENTS
[0029] The following description of the preferred embodiment(s) is
merely exemplary in nature and is in no way intended to limit the
disclosure, its application, or uses.
[0030] FIGS. 1-4 show the soft tissue graft anchor 10 of the
present disclosure. The anchor 10 includes prongs 10a, wherein each
prong 10a has a distal end 10b and a proximal end 10c. The prongs
10a are coupled at their distal ends 10b to form an inner cavity
10d having an opening 10e and at least one prong 10a includes at
least one barb 10i on at least one side surface 10j of the prong
10a. As shown in FIGS. 1-4, the number of prongs 10a having barbs
10i and the number of barbs 10i may vary. It is also within the
scope of this disclosure for the prongs 10a to not have any barbs
10i. In addition, at least one of the prongs 10a includes a fin
10f. The fin 10f extends perpendicular to a longitudinal axis L of
prong 10a and includes a pointed end 10g. An anchor 10 having
prongs 10a wherein more than one prong 10a has a fin 10f and an
anchor 10 without a fin 10f are also within the scope of this
disclosure. For the purposes of the present disclosure, the tissue
graft anchor 10 includes a plurality of prongs 10a, with the word
plurality meaning at least two prongs 10a. Additionally, the anchor
10 includes a through hole 10k. However, it is within the scope of
this disclosure for the anchor 10 to not include a through hole
10k. As shown in FIGS. 3 and 4, the inner cavity 10d extends into
the through hole 10k.
[0031] FIG. 5 shows the tissue graft anchor assembly 20 of the
present disclosure. The assembly 20 includes the tissue graft
anchor 10 and a fixation member 11, which is configured to be
disposed within the cavity 10d of the anchor 10. The fixation
member 11 includes a distal end 11a, a proximal end 11b, and an
outer surface 11c including threads 11d. The proximal end 11b
includes a hole (not shown) that is configured for engagement with
a delivery device (not shown) during surgery, as will be further
described below. The hole may extend a partial length or a full
length of the member 11. At least one of the prongs 10a also
includes an inner surface 10h having at least one groove 10L that
is configured for engagement with the threads 11d of the fixation
member 11 upon insertion of the fixation member 11 into the inner
cavity 10d, as will be further described below. As shown in FIGS.
1-4, the number of prongs 10a having grooves 10L and the number of
grooves 10L may vary. For the purposes of this disclosure, the
grooves 10L are located at the proximal ends 10c of the prongs 10a
and extend a partial length of the prongs 10a, but may be located
any where along the inner surface 10h, including along the entire
inner surface 10h of the prongs 10a. It is also within the scope of
this disclosure for the prongs 10a to not have any grooves 10L.
Also, the inner surfaces 10h of proximal ends 10c of the prongs 10a
are tapered along partial lengths of the inner surfaces 10h.
[0032] As mentioned above, during ligament reconstruction surgery,
tunnels are created in the femur and tibia and the replacement
tissue graft is implanted by securing one end of the tissue graft
in the tunnel formed within the femur and the other end of the
graft in the tunnel formed within the tibia. One or more
replacement tissue grafts may be used. FIG. 6 illustrates use of
the assembly 20 to secure the ends 31,41 of the replacement grafts
30,40 within the tibial tunnel 50. Once the ends 31,41 are passed
through the tunnel 50, the tissue anchor 10 is inserted into the
tunnel 50 such that the ends 31,41 are located between the prongs
10a. The anchor 10 is seated within the tunnel 50 such that the
prong 10a with the fin 10f is not completely inserted into the
tunnel 50. Rather, as shown in FIG. 6, the fin 10f engages a
portion of the tibia (outer surface of the tibia) outside of the
tunnel and acts as a depth stop to substantially reduce over
insertion of the anchor 10 into the tunnel 50. In addition to
acting as a depth stop, the fin 10f engages the bone and allows for
cortical fixation of the anchor 10.
[0033] The fixation member 11 is then inserted within the cavity
10d of the anchor 10 in a rotary manner. As mentioned above, the
grooves 10i are configured for engagement with the threads 11d of
the fixation member 11 to facilitate insertion of the fixation
member 11 into the inner cavity 10d. In addition, the tapered inner
surfaces 10h at the proximal ends 10c of the prongs 10a cooperate
with the tapered distal portion 11a of the fixation member 11 to
allow for easier insertion of the fixation member 11. During
insertion of the fixation member 11 into the cavity 10d, the prongs
10a are caused to twist and expand, as shown in FIG. 6, thereby
forcing the ends 31,41 of the grafts 30,40 against a wall 51 of the
bone tunnel 50 and fixating the grafts 30,40 to the tibia.
Additionally, upon insertion of the anchor 10 into the bone tunnel
50, the barbs 10i engage the ends 31,41 of the grafts 30,40 and
apply compression to the ends 31,41 when the fixation member 11 is
inserted into the inner cavity 10d so as to further fixate the
grafts 30,40 to the tibia.
[0034] For the purposes of this disclosure, the fixation member 11
is not shown in FIG. 6. However, the illustration in FIG. 6 and the
following corresponding description describes insertion of the
fixation member 11 into the inner cavity 10d and subsequent
fixation of the grafts 30,40 to bone as if the member 11 was shown
in FIG. 6. The anchor 10 is made from a non-metal material,
including, but not limited to a polymer material. However, it may
be made from a metal material. Also, the anchor 10 is made via an
injection molding process, but may be made via another process
known to one of skill in the art. The fixation member 11 is made
from a non-metal material, including, but not limited to a polymer
material and is made via an injection molding process. However,
other materials and processes known to one of skill in the art are
also possible.
[0035] For the purposes of this disclosure, the assembly 20 is used
to fixate soft tissue within the tibial tunnel. However, the
assembly 20 may be used to fixate soft tissue within the femoral
tunnel or to bone in other parts of the body, such as described
above in other types of ligament reconstructions and procedures. In
addition, the assembly may be used to fixate soft tissue to bone in
other areas of the body. The method described above may further
include locating a guide wire within the femoral and tibial tunnels
either before or after the tunnels are drilled for guiding the
drill and/or guiding placement of the anchor 10 and/or the fixation
member 11 within the tunnel.
[0036] FIG. 7 shows an alternative embodiment of the tissue graft
anchor 60 of the present disclosure. Anchor 60 is similar to anchor
10. However, anchor 60 differs from anchor 10 such that the distal
ends 60b of the prongs 60a are substantially rounded, rather than
tapered; the barbs 60i are wider and straight compared to barbs
10i, and only two of the prongs 60a have grooves 60L, rather than
four, as in anchor 10.
[0037] FIGS. 8-15 show instrumentation for use with anchors 10,60
during ligament reconstruction surgery. FIGS. 8-11 show a tension
device 70 for applying tension to a soft tissue graft prior to
fixating the soft tissue graft to bone via use of one of anchors
10,60. The device 70 includes a body 71 having suture wheels 71a
and guides 71b. For the purposes of this disclosure, each side of
the body 71 includes one wheel 71a and two guides 71b. However, the
number of wheels 71a and guides 71b may vary. The guides 71b are
stationary, but the wheels 71a are capable of being rotated and
moved longitudinally relative to the body 71. Each wheel 71a has a
central opening 71a' through which is disposed a bearing pin 72. A
first end 72a of each bearing pin 72 is coupled to a movable insert
73, which is housed within a slot 74.
[0038] Springs 74a are also located within slots 74 to allow for
longitudinal movement of the inserts 73, and thus the wheels 71a,
when tension is applied via use of the tension device 70, as will
be further described later. The wheels 71a are located on second
ends 72b of the bearing pins 72 such that first snap rings 75 are
located between the wheels 71a and the second ends 72b of the
bearing pins 72. The snap rings 75 may be coupled to outer surfaces
72c of the bearing pins 72 or inner surfaces 71a'' of the wheel
openings 71a'.
[0039] The device 70 also includes a central opening 71c to which a
shoulder assembly 76 is coupled. The assembly 76 includes a
shoulder 76a disposed within the opening 71c and a bearing 76b
coupled to the shoulder 76a. The shoulder 76a has a central opening
76a', in which the bearing 76b is disposed, and the bearing 76b has
a central opening 76b'. A shaft assembly 77 is coupled to the
shoulder assembly 76. The shaft assembly 77 includes a shaft 77a
and a handle 77b coupled to the shaft 77a. The shaft 77a includes a
first end 77a' and a second end 77a''. The first end 77a' is
coupled to the shoulder assembly 76 such that the first end 77a' is
disposed within the bearing central opening 76b'. The second end
77a'' of the shaft 77a includes a flange 77a''', the purposes of
which will be described later.
[0040] Located on the shaft 77a is a cannulated handle 77b. Also
disposed on the shaft 77a is a spring 78 located between an end
77b' of the handle 77b and the flange 77a'''. The handle 77b
includes pull members 77c, grooves 77d, a first window 77e on a
first side 77f of the handle 77b, and a second window (not shown)
on a second side 77g of the handle 77b. Sets of reference numbers
77h are located next to each window and a hash mark 77i corresponds
with each reference number. The reference numbers 77h refer to the
amount of tension applied by the user in Newtons (first side) or
pounds (second side). During reconstruction surgery, force is
applied to the handle 77b by pulling the handle 77b toward the user
until a hash mark 77j, located on the second end 77a'' and visible
through the window 77e, is in line with a hash mark 771 that
represents the amount of tension required by the user, as shown in
FIG. 11 and as will be further described below. During this time,
when the user is pulling on the handle 77b, the spring 78 is in a
compressed state.
[0041] For the purposes of this disclosure, the shoulder 76a is
press-fit into the opening 71c, the bearing 76b is press-fit into
the opening 76a' of the shoulder 76a, the shaft 77a is press-fit
and welded into the opening 76b' of the bearing 76b, and the first
end 72a of the bearing pin 72 is press-fit into the insert 73.
However, other method of coupling may also be used.
[0042] FIG. 12 shows a cannulated broach 80 for use during
reconstruction surgery. The broach 80 is used to divide the ends of
the tissue grafts and create a seat for the anchor 10,60, as will
be further described below. The broach 80 includes a handle 81 and
a shaft 82 coupled to the handle 81. The handle 81 includes a
removal tab 81a extending perpendicular to a longitudinal axis L of
the handle 81. The shaft 82 includes a member 84 located at an end
83 of the shaft 82. The member 84 is similar to the anchors 10,60
in that the member 84 has prongs 84a and grooves 84b located
between the prongs 84a. Similarly, at least one of the prongs 84a
includes a fin 85 extending perpendicular to a longitudinal axis L'
of the prong 84a.
[0043] FIGS. 13-15 show a cannulated delivery device 90 for use in
delivering the anchors 10,60. The device 90 includes a handle 91, a
shaft 92 coupled to the handle 91, and a movable member 93 coupled
to the shaft 92. Also coupled to the shaft 92 and located between
the movable member 93 and the shaft 92 are a fixed spring stop 94
and a spring 95. The shaft 92 includes a proximal end 92a and a
distal end 92b. The distal end 92b includes a plurality of
longitudinal grooves 92c that extend a partial length of the shaft
92. The movable member 93 includes a track 93a through which a
nipple 92d, coupled to the shaft 92, rides in. In a first position,
the nipple 92d is located, in a first area 93a' of the track 93a,
as shown in FIG. 13, and in a second, retracted position the nipple
92d is located in a second area 93a'' of the track 93a. The movable
member 93 also includes a distal portion 93b and a proximal portion
93c. The distal portion 93b includes a fin 93d and an opening 93e.
When the anchor 10,60 is located on the distal end 92b of the shaft
92, fin 10f,60f is disposed within the opening 93e and aligned with
fin 93d. In the first and second positions, as described above, the
spring 95 is in a relaxed position and a compressed position,
respectively. When the movable member is in the second position,
the spring 95 is compressed between the proximal portion 93c and
the spring stop 94.
[0044] As shown in FIG. 16, once the replacement tissue grafts
101,102 are secured in the femur (not shown) and the ends
101a-b,102a-b of the grafts 101,102 are located in the tibial
tunnel 301, suture 401-404 coupled to the ends 101a-b,102a-b are
formed into two loops 405,406. For the purposes of this disclosure,
two grafts 101,102 are used. However, the use of more or less than
two grafts is also within the scope of this disclosure. Each graft
101,102 has two ends 101a-b,102a-b and a suture 401-404 extends
from each end 101a-b,102a-b, such that two suture ends 401,403 are
tied together to form a first loop 405 and the other two suture
ends 402,404 are tied together to form a second loop 406.
Subsequently, the first loop 405 is placed around a wheel 71a and
two suture guides 71b on one side of the tension device 70 and the
second loop 406 is placed around a wheel 71a and two suture guides
71b on the other side of the tension device 70. The handle 77b is
then pulled towards the user until the proper amount of tension is
shown in the window 77e, as shown in FIG. 16A.
[0045] A guide wire (500, FIG. 19) is then placed in the tunnel
301. As shown in FIG. 17, the shaft 82 of the broach 80 is then
placed over the guide wire 500, through the tension device 70, via
the cannulated handle 77b and shaft 77a, and the end 83 is placed
within the tibial tunnel 301 such that the prongs 84a are inserted
between the ends 101a-b,102a-b of the soft tissue grafts 101,102 to
divide the grafts 101,102, as shown in FIG. 17A. As the prongs 84a
extend between the grafts 101,102, they also extend into the wall
of the tibial tunnel 301 to create a seat for the prongs 10a,60a of
the anchor 10,60 when the anchor 10,60 is inserted into the tunnel
301. The fin 85 of the broach 80 engages a portion of the tibia 300
outside of the tunnel 301 and acts as a depth stop to substantially
reduce over insertion of the end 83 of the broach 80 into the
tunnel 301, as also shown in FIG. 17A.
[0046] The anchor 10,60 is then loaded on the distal end 92b of the
delivery device 90, while the delivery device is in the first
position, as described above, by placing the distal end 92b of the
delivery device 90 into the cavity 10d,60d of the anchor 10,60 such
that the prongs 10a,60a engage the grooves 92c and the fin 10f,60f
of the anchor 10,60 aligns with the fin 93d of the movable member
93 and is secured in the opening 93e. The shaft 92 of the delivery
device 90 is inserted over the guide wire 500, through the tension
device 70, via the cannulated handle 77b and shaft 77a, and the
distal end 92b, and therefore the anchor 10,60, is placed into the
tunnel 301 until the fin 10f,60f engages a portion of the tunnel
301, as described above and shown in FIGS. 18 and 18A. The delivery
device 90 is then removed and the movable member 93 is retracted to
place the movable member 93 in the second position, as described
above. The fixation member 600 is then loaded onto the distal end
92b of the delivery device 90 and the device 90 is inserted through
the tension device 70 and into the cavity 10d,60d of the anchor
10,60. The member 600 is inserted into the cavity 10d,60d as
described and shown above in FIG. 6 and as also shown in FIGS. 19
and 19A. After the delivery device 90 is removed from the tunnel
301, the suture loops 405,406 are removed from the tension device
70 and the ends 101a-b,102a-b of the grafts 101,102 are cut.
[0047] FIG. 20 shows another alternative embodiment of the anchor
700. Anchor 700 is similar to anchor 10. However, anchor 700
differs from anchor 10 such that the distal ends 700b of the prongs
700a are extended, rather than tapered, and spaces 700m exist
between the extended portions. During use of the anchor 700 in
surgery, one or more grafts may be extended over the anchor 700
such that the grafts are located within the grooves 700m and the
ends of the grafts are located between the prongs 700a.
[0048] For the purposes of this disclosure, a guide wire is used
during surgery. The guide wire is inserted into the tunnel and the
instruments are inserted over the guide wire. However, it is
possible for the guide wire to be inserted into the tunnel in other
manners. It is also within the scope of this disclosure for the
guide wire to not be used. In this instance, the anchor, fixation
member, and instrumentation may be non-cannulated. Furthermore, it
is within the scope of this disclosure for a tension device to not
be used during surgery.
[0049] Additionally, it is within the scope of this disclosure for
the anchors to have a varying number of prongs. Also, for the
purposes of this disclosure the prongs are symmetric. However, the
prongs may be asymmetric.
[0050] As various modifications could be made to the exemplary
embodiments, as described above with reference to the corresponding
illustrations, without departing from the scope of the disclosure,
it is intended that all matter contained in the foregoing
description and shown in the accompanying drawings shall be
interpreted as illustrative rather than limiting. Thus, the breadth
and scope of the present disclosure should not be limited by any of
the above-described exemplary embodiments, but should be defined
only in accordance with the following claims appended hereto and
their equivalents.
* * * * *