US-20260124031-A1 - SUTURE FIXATION SYSTEMS FOR LIGAMENT RECONSTRUCTION

US20260124031A1US 20260124031 A1US20260124031 A1US 20260124031A1US-20260124031-A1

Abstract

A suture fixation system for ligament reconstruction may include a suture lock, which may include a proximal end including a first portion, a distal end including a second portion that may be smaller than the first portion and configured to be received in a bone tunnel, a ledge portion configured to inhibit the first portion from entering the bone tunnel, and suture apertures extending from the distal end to the proximal end and configured to allow the sutures to pass through the suture lock. The system may further include a fastener including a fastener head and configured to engage the suture lock. With the sutures applying tension to the ligament graft, the fastener may be configured to securably pinch the sutures between the fastener head and the suture lock to inhibit sliding of the sutures relative to the suture lock to maintain the tension of the ligament graft.

Inventors

Amir Jamali

Assignees

Amir Jamali

Dates

Publication Date: 20260507
Application Date: 20241105

Claims (20)

1 . A suture fixation system for ligament reconstruction configured to tension and secure a ligament graft to a bone using one or more sutures, the system comprising: a suture lock comprising: a proximal end comprising a first portion; a distal end comprising a second portion that is smaller than the first portion and configured to be received in a bone tunnel; a ledge portion configured to inhibit the first portion from entering the bone tunnel; and one or more suture apertures extending from the distal end to the proximal end and configured to allow the one or more sutures to pass through the suture lock; and a fastener comprising a fastener head and configured to engage the suture lock; wherein, with the one or more sutures applying tension to the ligament graft, the fastener is configured to securably pinch the one or more sutures between the fastener head and the suture lock to inhibit sliding of the one or more sutures relative to the suture lock to maintain the tension of the ligament graft.
2 . The system of claim 1 , further comprising a washer comprising a central aperture configured to receive the fastener and a locking portion, wherein the suture lock further comprises a proximal recess, and, with the locking portion engaged in the proximal recess, the washer is configured to inhibit loosening of the fastener relative to the suture lock.
3 . The system of claim 1 , wherein the system further comprises a suture lock holder comprising a second distal end, wherein the second distal end is configured to receive the suture lock and the sutures, and wherein the first portion comprises a plurality of notches and the second distal end comprises a plurality of protrusions configured to be received in the plurality of notches, and the suture lock holder is configured to removably retain the suture lock and facilitate placement of the suture lock within the bone tunnel.
4 . The system of claim 3 , wherein the suture lock holder further comprises an inside portion configured to allow the one or more sutures to pass through the inside portion with the suture lock retained in the suture lock holder.
5 . The system of claim 1 , wherein the suture lock further comprises a first threaded portion and the fastener further comprises a second threaded portion, wherein the second threaded portion is configured to threadably engage the first threaded portion.
6 . The system of claim 1 , wherein the second portion is angularly offset from the first portion so that the second portion aligns with the bone tunnel and the ledge portion aligns with a bone surface proximate the bone tunnel.
7 . The system of claim 6 , further comprising a tensioning block comprising a first surface configured to engage the proximal end of the suture lock and a second surface angularly offset from the first surface, wherein, with the tensioning block engaged with the suture lock, a first longitudinal axis of the tensioning block is parallel with a second longitudinal axis of the second portion.
8 . A suture fixation system for ligament reconstruction configured to tension and secure a ligament graft to a bone using one or more sutures, the system comprising: a suture lock comprising: a proximal end comprising a first portion; a distal end opposite the proximal end comprising a second portion; and one or more suture apertures extending from the distal end to the proximal end and configured to allow the one or more sutures to pass through the suture lock; a fastener comprising a fastener head, wherein the fastener is configured to engage the suture lock; and a suture lock holder comprising a second distal end, wherein the second distal end is configured to receive the suture lock and the sutures; wherein: the first portion comprises a plurality of notches; the second distal end comprises a plurality of protrusions configured to be received in the plurality of notches; the suture lock holder is configured to removably retain the suture lock and facilitate placement of the suture lock within a bone tunnel; and with the one or more sutures applying tension to the ligament graft, the fastener is configured to securably pinch the sutures between the fastener and the suture lock to inhibit sliding of the one or more sutures relative to the suture lock and maintain the tension of the ligament graft.
9 . The system of claim 8 , further comprising a washer comprising a central aperture configured to receive the fastener and a locking portion, and, wherein the washer is configured to inhibit loosening of the fastener relative to the suture lock and securably pinch the sutures between the locking portion and the suture lock.
10 . The system of claim 9 , wherein the suture lock holder further comprises an inside portion configured to allow the one or more sutures to pass through the inside portion with the suture lock retained in the suture lock holder.
11 . The system of claim 8 , wherein the second portion is angularly offset from the first portion so that the second portion aligns with the bone tunnel and the first portion aligns with a bone surface proximate the bone tunnel.
12 . The system of claim 11 , further comprising a tensioning block comprising a first surface configured to engage the proximal end of the suture lock and a second surface angularly offset from the first surface, wherein, with the tensioning block engaged with the suture lock, a first longitudinal axis of the tensioning block is parallel with a second longitudinal axis of the second portion.
13 . The system of claim 12 , wherein the first surface of the tensioning block comprises a plurality of locating bosses, the first portion of the suture lock further comprises a plurality of locating apertures, and with the tensioning block engaged with the suture lock, the plurality of locating bosses and the plurality of locating apertures inhibit rotation and translation of the tensioning block relative to the suture lock.
14 . A suture fixation system for ligament reconstruction configured to tension and secure a ligament graft to a bone using one or more sutures, the system comprising: a suture lock comprising: a first portion comprising a proximal recess and a first longitudinal axis; a second portion that is smaller than the first portion and configured to be received in a bone tunnel and comprising a second longitudinal axis that is not parallel to the first longitudinal axis; a ledge portion configured to inhibit the first portion from entering the bone tunnel; and one or more suture apertures extending through the second portion to the proximal recess and configured to allow the one or more sutures to pass through the suture lock; a fastener comprising a fastener head, wherein the fastener is configured to engage the suture lock; and a washer configured to be received in the proximal recess and comprising a central aperture configured to receive the fastener; wherein: with the one or more sutures applying tension to the ligament graft, the fastener securably pinches the one or more sutures between the washer and the suture lock to inhibit sliding of the one or more sutures relative to the suture lock and maintain the tension of the ligament graft.
15 . The system of claim 14 , wherein the suture lock comprises an axis angle between the first longitudinal axis and the second longitudinal axis and the axis angle is between 30 degrees and 70 degrees.
16 . The system of claim 14 , wherein the washer comprises an outside portion comprising a locking portion, wherein the locking portion is configured to securably pinch the one or more sutures between the washer and the suture lock to inhibit the sliding of the one or more sutures relative to the suture lock and maintain the tension of the ligament graft.
17 . The system of claim 14 , wherein the suture lock further comprises a first threaded portion and the fastener further comprises a second threaded portion, wherein the second threaded portion is configured to threadably engage the first threaded portion.
18 . The system of claim 14 , further comprising a tensioning block comprising a first surface configured to engage the first portion of the suture lock and a second surface angularly offset from the first surface, wherein, with the tensioning block engaged with the suture lock, a third longitudinal axis of the tensioning block is parallel with the second longitudinal axis.
19 . The system of claim 18 , wherein the first surface of the tensioning block comprises a plurality of locating bosses, the first portion of the suture lock further comprises a plurality of locating apertures, and, with the tensioning block engaged with the suture lock, the plurality of locating bosses and the plurality of locating apertures inhibit rotation and translation of the tensioning block relative to the suture lock.
20 . The system of claim 18 , wherein the tensioning block further comprises a second central aperture, the fastener head comprises a drive feature, and, with the tensioning block engaged with the suture lock, a fastener driver may engage the drive feature through the second central aperture to secure the fastener to the suture lock.

Description

TECHNICAL FIELD The present disclosure relates to systems and methods for use in orthopedic surgery. More specifically, the present disclosure relates to suture fixation systems for ligament reconstruction. BACKGROUND Ligaments in the knee are typically divided into those that are on the outside of the joint (extraarticular) such as the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) or on the inside of the joint (intraarticular) such as the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL). The extraarticular ligaments typically can heal with nonsurgical treatment occasionally requiring a brace. This is due to the nature of their anatomy being superimposed on the joint capsule. The joint capsule provides a template for the ligament to heal from its origin to its insertion through the elaboration of scar tissue. The situation is more complex in the case of intraarticular ligaments. These typically do not heal without surgical intervention since the two ends have no soft tissue connection upon which scar tissue can be laid. As a result, the intraarticular ligaments usually require reconstruction with a separate source of tissue. The tissue used for reconstruction of ligaments can be either from the patient's own body, termed an autograft, from a donor individual, termed an allograft, or from a synthetic source such as a collagen bundle or a polymer such as Teflon made in a laboratory setting. Regardless, the ligament has to span two points of the native ligament to function. One of the challenges faced by orthopedic surgeons is how to fix these ligaments securely so that they can function durably and withstand the stresses posed by the patient's activities. The ligament grafts thus have to have extra length at each end so that they can be placed in bone tunnels and secured. The fixation of the graft ends in the bone tunnels can be performed with a variety of techniques including interference fasteners, where a large fastener is used to push the graft up against the bone to facilitate attachment and healing of the graft to the bone. Another technique is to sew the end of the graft to a metal button that is on the outside of the bone. By tying a knot on the button or using a button with an internal cinching mechanism, the sutures coming from the ligament can be kept taut at all times. The difficulty with the use of buttons is that they require a cortical bridge and are most amenable to a surgical technique where there is only a small aperture in the bone on which the button will rest. The buttons are also problematic in cases of weak cortical bone or in the revision setting where there is a large hole in the cortex of the bone. SUMMARY The various systems and methods of the present disclosure have been developed in response to the present state of the art, and in particular, in response to the problems and needs in the art that have not yet been fully solved by currently available suture fixation systems for ligament reconstruction. In some embodiments, a suture fixation system for ligament reconstruction configured to tension and secure a ligament graft to a bone using one or more sutures may include a suture lock. The suture lock may include a proximal end including a first portion, a distal end including a second portion that may be smaller than the first portion and configured to be received in a bone tunnel, a ledge portion configured to inhibit the first portion from entering the bone tunnel, and one or more suture apertures extending from the distal end to the proximal end and configured to allow the one or more sutures to pass through the suture lock. The system may further include a fastener including a fastener head and configured to engage the suture lock. With the one or more sutures applying tension to the ligament graft, the fastener may be configured to securably pinch the one or more sutures between the fastener head and the suture lock to inhibit sliding of the one or more sutures relative to the suture lock to maintain the tension of the ligament graft. In the system of any preceding paragraph, the system may further include a washer including a central aperture configured to receive the fastener and a locking portion. The suture lock may further include a proximal recess, and, with the locking portion engaged in the proximal recess, the washer may be configured to inhibit loosening of the fastener relative to the suture lock. In the system of any preceding paragraph, the system may further include a suture lock holder having a second distal end, wherein the second distal end may be configured to receive the suture lock and the sutures. The first portion may include a plurality of notches and the second distal end may include a plurality of protrusions configured to be received in the plurality of notches, and the suture lock holder may be configured to removably retain the suture lock and facilitate placement of the suture lock within the bone t