Arthoscopic method and apparatus for tissue attachment to bone

Abstract

Bone constructs of a patient are used to arthroscopically attach sutures to torn or dysfunctional tissue. Suture is passed through intersecting tunnels formed in the bone. An end of the suture extends from each of the tunnels, and the ends are used to secure the tissue to the bone, such as by arthroscopic tying of the ends, and pulling the tissue against the bone. Devices for achieving the process are also described.

1 . A method of attachment of tissue to bone, comprising the steps of: 
 a) arthroscopically forming a first tunnel in a bone;    b) arthroscopically forming a second tunnel in said bone, wherein said first tunnel intersects said second tunnel;    c) passing a suture though said first tunnel and said second tunnel, wherein an end of said suture extends from an opening to said first tunnel and an opposite end of said suture extends from an opening to said second tunnel; and    d) securing said first end of said suture and said second end of said suture over tissue to pull said tissue against said bone.    
     
     
         2 . A method of attachment of tissue to bone as described in  claim 1 , wherein at least a portion of said first tunnel is not parallel to said second tunnel.  
     
     
         3 . A method of attachment of tissue to bone as described in  claim 1 , wherein said first tunnel is not linear.  
     
     
         4 . A method of attachment of tissue to bone as described in  claim 1 , wherein said first tunnel does not pass through to an opposite side of said bone from a side of entry into said bone.  
     
     
         5 . A method of attachment of tissue to bone as described in  claim 1 , wherein said first tunnel does not pass through to an opposite side of said bone from a side of entry into said bone, and said second tunnel does not pass through to an opposite side of said bone from said side of entry into said bone.  
     
     
         6 . A method of attachment of tissue to bone as described in  claim 1 , wherein said first tunnel and said second tunnel intersect within said bone.  
     
     
         7 . A method of attachment of tissue to bone as described in  claim 1 , wherein a portion of said first tunnel is not parallel to said second tunnel at a point of intersection of said first tunnel and said second tunnel.  
     
     
         8 . A method of attachment of tissue to bone, comprising the steps of: 
 a) arthroscopically forming a first tunnel in a bone using a first drill guide;    b) arthroscopically forming a second tunnel in said bone using a second drill guide, wherein said first tunnel intersects said second tunnel;    c) passing a suture though said first tunnel and said second tunnel, wherein an end of said suture extends from an opening to said first tunnel and an opposite end of said suture extends from an opening to said second tunnel; and    d) securing said first end of said suture and said second end of said suture over tissue to pull said tissue against said bone.    
     
     
         9 . A method of attachment of tissue to bone as described in  claim 8 , wherein said first tunnel is formed using an arcuate drill guide having a lumen therein.  
     
     
         10 . A method of attachment of tissue to bone as described in  claim 9 , wherein said second tunnel is formed using a drill guide having a lumen therein.  
     
     
         11 . A method of attachment of tissue to bone as described in  claim 8 , wherein said first tunnel is formed by a flexible stylus that is inserted through said drill guide.  
     
     
         12 . A method of attachment of tissue to bone as described in  claim 8 , wherein said second tunnel is formed by a stylus that is inserted through said drill guide.  
     
     
         13 . A method of attachment of tissue to bone as described in  claim 8 , wherein said second tunnel is formed by a trephine that is inserted through said drill guide.  
     
     
         14 . A method of attachment of tissue to bone as described in  claim 11 , wherein said flexible stylus has a cutter formed on an end thereof.  
     
     
         15 . A method of attachment of tissue to bone as described in  claim 13 , wherein said suture is passed through a lumen in said trephine.  
     
     
         16 . A method of attachment of tissue to bone as described in  claim 15 , wherein, after said trephine is fully advanced to form said second tunnel, and prior to passing said suture through said lumen in said trephine, said trephine is partially retracted.