US6235057B1
Expired / Lapsed
US
⏱️ 0.0 years remaining
Method for soft tissue reconstruction
Assignee: Smith and Nephew Inc
•
Filing: 1997-02-19
•
Granted: 2001-05-22
•
Expires: 2017-02-19
Abstract
Abstract A method for the reconstruction of the anterior cruciate ligament of a patient is described. The process comprises the steps of: 1) harvesting from the patient semitendonosus and gracilis tendons, or other suitable tendons of adequate length, to form a tendon graft; 2) forming a hole through the patient's femur from the intercondylar notch therein anteriorly and laterally; 3) enlarging the cross-sectional area of that femoral hole adjacent the notch sufficiently to receive one end of the tendon graft and a suitable screw; 4) forming a suitably positioned hole through the patient's tibia opening at one end adjacent the medial tibial spine and having a cross-sectional area sufficient to receive the other end of the tendon graft and a suitable screw; 5) drawing the one end of the tendon graft through the tibial hole and the joint into the femoral hole while leaving the other end of the tendon graft in the tibial hole; 6) inserting a suitable screw into the femoral hole from its intercondylar notch end until the head of the screw is just within that end of the hole and the screw is pressing the tendon graft directly and firmly against a sidewall of the femoral hole; and 7) after tensioning the tendon graft, inserting a suitable screw into the hole in the tibia externally until the head of the screw is within the exterior end of the tibial hole and the screw is pressing the tendon graft directly and firmly against a sidewall of the tibial hole.
Inventors
- 👤 Gregory James Roger
- 👤 Leo Arieh Pinczewski
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-11-03 16:02
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/16; A61B17/1662; A61B17/1675; A61F; A61F2/00; A61F2/02; A61F2/08; A61F2/0811; A61B17/1604; A61B17/1613; A61B17/1615; A61F2002/0847; A61F2002/0858; A61F2002/087; A61F2002/0876; A61F2002/0882; A61F2002/0888; Y; Y10; Y10S; Y10S606/00; Y10S606/916
Claims Analysis
Total Claims: 43
Claim 1
Independent Claim
251 words
A method for the reconstruction of an anterior cruciate ligament of a patient comprising the steps of: a) forming a graft of soft material from tendon, other soft tissue or artificial tendon or ligament; b) forming a first hole through a femur of the patient from a suitable point in an intercondylar notch therein anteriorly and laterally, wherein a cross-sectional area of at least an end portion of the first hole through the femur adjacent: the intercondylar notch is sufficient to receive a first end of the graft and a fixation screw device having a leading end and a trailing end; c) forming a suitably positioned second hole through a tibia of the patient, said second hole opening at one end adjacent to a medial spine of the tibia, and said second hole having a cross-sectional area sufficient to receive a second end of the graft; d) drawing the first end of the graft into the end portion of the first hole in the femur and drawing the second end of the graft into the second hole in the tibia; e) inserting the leading end of the fixation screw device into the first hole in the femur from said end portion of said first hole so that the fixation screw device engages the soft material of the graft and presses the soft material of the graft directly and firmly against a sidewall of the first hole in the femur; and f) securing the second end of the graft to the tibia.
Claim 2
Independent Claim
251 words
A method for the reconstruction of an anterior cruciate ligament of a patient comprising the steps of: a) forming a graft of soft material from tendon, other soft tissue or artificial tendon or ligament; b) forming a first hole through a femur of the patient from a suitable point in an intercondylar notch therein anteriorly and laterally, wherein a cross-sectional area of at least an end portion of the first hole through the femur adjacent: the intercondylar notch is sufficient to receive a first end of the graft and a fixation screw device having a leading end and a trailing end; c) forming a suitably positioned second hole through a tibia of the patient, said second hole opening at one end adjacent to a medial spine of the tibia, and said second hole having a cross-sectional area sufficient to receive a second end of the graft; d) drawing the first end of the graft into the end portion of the first hole in the femur and drawing the second end of the graft into the second hole in the tibia; e) inserting the leading end of the fixation screw device into the first hole in the femur from said end portion of said first hole so that the fixation screw device engages the soft material of the graft and presses the soft material of the graft directly and firmly against a sidewall of the first hole in the femur; and f) securing the second end of the graft to the tibia.
Claim 3
Dependent Claim
37 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 1 further comprising forming the graft from a tendon or tendons harvested from the patient or from a third party.
Claim 4
Dependent Claim
34 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 2 , further comprising forming the graft from a tendon derived from hamstring tendons of the patient.
Claim 5
Dependent Claim
45 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 3 , further comprising forming the graft from gracilis and semitendinosus tendons of the patient derived from a leg of the patient that contains said anterior cruciate ligament.
Claim 6
Dependent Claim
37 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 4 , further comprising doubling over the tendon or tendons and trimming the tendon or tendons to a desired length.
Claim 7
Dependent Claim
64 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 1 , in which the graft includes two free ends, and further comprising binding together each of the free ends of the graft over a length approximately equal to the length that the respective free ends of the graft will extend through the first and second holes.
Claim 8
Dependent Claim
77 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 1 , further comprising forming the first hole in the femur and/or the second hole in the tibia by drilling a guide hole, inserting a guide wire into the guide hole and passing a cannulated rotary awl down the guide wire to enlarge the guide hole to the desired cross-sectional size by compressing or compacting bone surrounding the guide hole.
Claim 9
Dependent Claim
61 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 7 , further comprising causing the rotary awl to form adjacent one end of the first hole and/or the second hole a short region of further increased cross-sectional area adapted to receive a head formed at the trailing end of the fixation screw device.
Claim 10
Dependent Claim
82 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 1 , wherein said anterior cruciate ligament is associated with a leg having a knee joint and a thigh, further comprising drawing the first end of the graft into the first hole and the second hole by a suture that is connected to the first end of the graft and extends through the second hole, the knee joint, the first hole and out the thigh.
Claim 11
Dependent Claim
103 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 1 , further comprising securing the second end of the graft to the tibia using a second fixation screw device having a leading end and a trailing end in accordance with the step of: inserting the leading end of the second fixation screw device into an end of the second hole so that the second fixation screw device engages the soft material of the graft and presses the soft material of the graft directly and firmly against a sidewall of the second hole in the tibia.
Claim 12
Dependent Claim
28 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 10 , in which the second fixation screw device is cannulated.
Claim 13
Dependent Claim
38 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 11 , in which the second fixation screw device has a screw thread which is devoid of an outermost cutting line.
Claim 14
Dependent Claim
33 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 12 , in which the screw thread of the second fixation screw device is substantially nontapered.
Claim 15
Dependent Claim
35 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 11 , in which the second fixation screw device has a hemispherical head at the trailing end thereof.
Claim 16
Dependent Claim
40 words
A method for the reconstruction of an anterior cruciate ligament of a patient as claimed in claim 10 , further comprising inserting the second fixation screw device until the trailing end thereof is adjacent the end of the second hole.
Claim 17
Dependent Claim
60 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 15 , wherein the step of inserting the second fixation screw device into the second hole includes driving the second fixation screw device into said second hole until the trailing end of said second fixation screw device is just within said second hole.
Claim 18
Dependent Claim
39 words
A method for the reconstruction of an anterior cruciate ligament of a patient as claimed in claim 1 , further comprising inserting the fixation screw device until the trailing end thereof is adjacent the end of the first hole.
Claim 19
Dependent Claim
56 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 17 , wherein the step of inserting the fixation screw device into the first hole includes driving the fixation screw device into the hole until the trailing end of said fixation screw device is just within said first hole.
Claim 20
Dependent Claim
27 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 1 , in which the fixation screw device is cannulated.
Claim 21
Dependent Claim
37 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 19 , in which the fixation screw device has a screw thread which is devoid of an outermost cutting line.
Claim 22
Dependent Claim
34 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 20 , in which the fixation screw device has a hemispherical head at the trailing end thereof.
Claim 23
Dependent Claim
32 words
A method for the reconstruction of the anterior cruciate ligament of a patient as claimed in claim 20 , in which the screw thread of the fixation screw device is substantially nontapered.
Claim 24
Independent Claim
164 words
A method for the attachment of a graft of soft material to a bone of a patient at a joint between the bone and a second bone, wherein the soft material consists of a tendon or ligament or an artificial tendon or ligament, comprising the steps of: a) forming a hole in said bone wherein a cross-sectional area of an end portion of the hole adjacent to the joint with the second bone is large enough to receive an end of the graft and a fixation screw device having a leading end and a trailing end; b) drawing one end of the graft into the end portion of said hole; and c) inserting the leading end of the fixation screw device into the end portion of said hole from the joint so that the fixation screw device engages the soft material of the graft and presses the soft material of the graft directly and firmly against a sidewall of said hole in said bone.
Claim 25
Independent Claim
164 words
A method for the attachment of a graft of soft material to a bone of a patient at a joint between the bone and a second bone, wherein the soft material consists of a tendon or ligament or an artificial tendon or ligament, comprising the steps of: a) forming a hole in said bone wherein a cross-sectional area of an end portion of the hole adjacent to the joint with the second bone is large enough to receive an end of the graft and a fixation screw device having a leading end and a trailing end; b) drawing one end of the graft into the end portion of said hole; and c) inserting the leading end of the fixation screw device into the end portion of said hole from the joint so that the fixation screw device engages the soft material of the graft and presses the soft material of the graft directly and firmly against a sidewall of said hole in said bone.
Claim 26
Dependent Claim
137 words
The method set forth in claim 23 , wherein a second bone is adjacent to said bone, and further including the steps of: a) forming a second hole in said second bone wherein a cross-sectional area of an end portion of the second hole is large enough to receive an opposite end of the graft and a second fixation screw device having a leading end and a trailing end; b) drawing the opposite end of the graft into the end portion of said second hole; and c) inserting the leading end of the second fixation screw device into said second hole so that the second fixation screw device engages the soft material of the graft and presses the soft material of the craft directly and firmly against a sidewall of said second hole in said second bone.
Claim 27
Dependent Claim
35 words
A method for the attachment of soft tissue associated with two adjacent bones of a patient as claimed in claim 24 wherein said first bone is a femur, said second bone is an adjacent tibia.
Claim 28
Dependent Claim
74 words
A method for the attachment of soft tissue as claimed in claim 24 , further comprising forming said first hole in said first bone and/or said second hole in said second bone by drilling a guide hole, inserting a guide wire into the guide hole and passing a cannulated rotary awl down the guide wire to enlarge the guide hole to the desired cross-sectional size by compressing or compacting bone surrounding the guide hole.
Claim 29
Dependent Claim
64 words
A method for the attachment of soft tissue as claimed in claim 26 , further comprising causing the rotary awl to form adjacent one end of said first hole in said first bone and/or said second hole in said second bone a short region of further increased cross-sectional area adopted to receive a head formed at the trailing end of the fixation screw device.
Claim 30
Dependent Claim
71 words
A method for the attachment of soft tissue as claimed in claim 24 , in which the graft of soft material includes two free ends, and further comprising binding together each of the free ends of the soft material over a length approximately equal to the length that the respective free ends will extend into or through said hole in the first-mentioned bone and said second hole in the second bone.
Claim 31
Dependent Claim
82 words
The method set forth in claim 24 wherein said method is used for the reconstruction of an anterior cruciate ligament of a patient and said bone is a femur in the patient, and said second bone is a tibia in the patient; and further comprising forming said hole from a suitable point in an intercondylar notch in said femur anteriorly and laterally, and forming said second hole through the tibia and open at one end adjacent a medial spine of the tibia.
Claim 32
Dependent Claim
52 words
The method set forth in claim 23 wherein said method is used for the reconstruction of an anterior cruciate ligament of a patient and said bone is a femur in the patient, and further comprising forming said hole from a suitable point in an intercondylar notch in said femur anteriorly and laterally.
Claim 33
Dependent Claim
21 words
A method for the attachment of soft tissue as claimed in claim 23 , wherein said fixation screw device is cannulated.
Claim 34
Dependent Claim
35 words
A method for the attachment of soft tissue as claimed in claim 23 further comprising forming the graft of soft material from a tendon or tendons harvested from a patient or from a third party.
Claim 35
Dependent Claim
32 words
A method for the attachment of soft tissue as claimed in claim 32 , further comprising doubling over the tendon or tendons and trimming the tendon or tendons to a desired length.
Claim 36
Dependent Claim
16 words
The method set forth in claim 23 , in which the fixation screw device is cannulated.
Claim 37
Dependent Claim
26 words
The method set forth in claim 34 , in which the fixation screw device has a screw thread which is devoid of an outermost cutting line.
Claim 38
Dependent Claim
23 words
The method set forth in claim 35 , in which the fixation screw device has a hemispherical head at the trailing end thereof.
Claim 39
Dependent Claim
21 words
The method set forth in claim 35 , in which the screw thread of the fixation screw device is substantially nontapered.
Claim 40
Dependent Claim
17 words
The method set forth in claim 24 , in which the second fixation screw device is cannulated.
Claim 41
Dependent Claim
27 words
The method set forth in claim 38 , in which the second fixation screw device has a screw thread which is devoid of an outermost cutting line.
Claim 42
Dependent Claim
24 words
The method set forth in claim 39 , in which the second fixation screw device has a hemispherical head at the trailing end thereof.
Claim 43
Dependent Claim
22 words
The method set forth in claim 39 , in which the screw thread of the second fixation screw device is substantially nontapered.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 2004-05-21 | 2004-11-20 | 2005-05-22 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2008-05-21 | 2008-11-20 | 2009-05-22 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2012-05-21 | 2012-11-20 | 2013-05-22 | $7700.00 | Window Closed / Lapsed |