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 . An adjustable tensioning and securing device for tensioning and securing a rotator cuff tendon to a humeral head, the tensioning and securing device comprising:
 a body, the body having an outer diameter, a lateral end and a distal end, body steps, and a suture opening distal of the body steps, the body sized to fit in a cavity created in a lateral section of a humeral head;   a face member attached to the lateral end, the face member extending beyond the outer diameter of the body;   a tensioning wheel, the tensioning wheel rotatably mounted on a shaft attached to the body;   a securing wheel, the securing wheel configured to move along the body steps, the movement of the securing wheel in a proximal direction limited by at least one retention member, the movement of the securing wheel in a distal direction limited by the tensioning wheel and the body steps;   wherein the tensioning and securing device is configured to prevent the distal movement of a suture passing through the tensioning and securing device by trapping the suture between the tensioning wheel and the securing wheel.   
     
     
         2 . The adjustable tensioning and securing device of  claim 1 , wherein the body is circular in cross section. 
     
     
         3 . The adjustable tensioning and securing device of  claim 1 , wherein the body is comprised of medical grade stainless steel. 
     
     
         4 . The adjustable tensioning and securing device of  claim 1 , wherein the body is comprised of medical grade plastic. 
     
     
         5 . The adjustable tensioning and securing device of  claim 1 , wherein the tensioning wheel and the shaft are comprised of medical grade stainless steel. 
     
     
         6 . The adjustable tensioning and securing device of  claim 1 , further comprising a cap configured to be arthroscopically affixed to an exposed end of the body when adjustable tensioning and securing device is implanted. 
     
     
         7 . The adjustable tensioning and securing device of  claim 1 , wherein the adjustable tensioning and securing device further comprises a cap. 
     
     
         8 . The adjustable tensioning and securing device of  claim 7 , wherein the cap is further configured to secure the suture or sutures.