Arthroscopic Method and Apparatus for Rotator Cuff Repair

Abstract

An arthroscopic method for reattaching a rotator cuff tendon to a humeral head may include creating a trough in the top of the humeral head, creating a cavity in the lateral portion of the humeral head, creating one or more tunnels between the cavity and the trough, retrieving sutures affixed to a loose end of the tendon through the trough, at least one tunnel, and the cavity; and passing the sutures through a tensioning and securing device, which is then implanted in the cavity, and the sutures are variously pulled or released to pull, tension, or release the sutures until the tendon is secured in the trough. The trough is preferably created using a unique extendable, angled surgical burr.

What is claimed is: 
     
         1 . A combined awl and suture retriever for arthroscopically creating a transosseous tunnel in a humeral head between a cavity extending laterally into the humeral head and a trough in the footprint of the greater tuberosity, the combined awl and suture retriever comprising:
 an awl;   a suture retriever;   a body, the body having a distal end and an opening near the distal end;   wherein the combined awl and suture retriever includes a storage configuration   wherein the awl and the suture retriever are housed within the body, and a deployed configuration where a portion of the awl or the suture retriever is extended from the opening.   
     
     
         2 . The combined awl and suture retriever of  claim 1 , wherein operating a trigger moves the combined awl and suture retriever between the storage configuration and the deployed configuration. 
     
     
         3 . The combined awl and suture retriever of  claim 1 , further including an electric motor to move the combined awl and suture retriever between the storage configuration and the deployed configuration. 
     
     
         4 . A method of arthroscopically creating a transosseous tunnel in a humeral head between a cavity extending laterally into the humeral head and a trough on top of the humeral head and routing sutures through the tunnel using a combined awl and suture retriever, the method comprising:
 arthroscopically inserting a distal end of a combined awl and suture retriever into a cavity extending laterally into the humeral head;   deploying an awl from a storage position within the combined awl and suture retriever into the humeral head and the trough from an opening in the combined awl and suture retriever located near an upper and distal end of the combined awl and suture retriever;   retracting the awl back into the combined awl and suture retriever to form a transosseous tunnel;   deploying a suture retriever from within the combined awl and suture retriever through the tunnel and into the trough;   routing sutures through an end of the suture retriever;   retracting the suture retriever back into the combined awl and suture retriever.