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.

1 - 19 . (canceled) 
     
     
         20 . A device for securing a rotator cuff tendon to a humeral head, the device comprising:
 a body having an at least partially continuous outer side wall with an outer perimeter, an interior region, a proximal end, a distal end, and a suture opening in the side wall between the proximal end and distal end that extends into the interior region, the body being configured to fit in a cavity created in a lateral section of a humeral head such that the suture opening is aligned with a tunnel created in the humeral head to intersect the cavity and through which a suture extends;   a face member attached to the proximal end of the body, the face member extending beyond the outer perimeter of the body and overlapping a portion of the lateral cortex of the humeral head to limit the depth of insertion of the body into the cavity in the humeral head; and   a tensioning mechanism in the interior region that is configured to receive a suture through the suture opening and releasably hold the suture in place, wherein when the tensioning mechanism holds the suture in place, the face member distributes at least some of the force created by the tensioning mechanism holding the suture in place to the lateral cortex of the humeral head.   
     
     
         21 . The device of  claim 20 , wherein the face member is a flange. 
     
     
         22 . The device of  claim 20 , wherein the face member is at least one arm. 
     
     
         23 . The device of  claim 20 , wherein the body is cylindrical in shape. 
     
     
         24 . The device of  claim 20 , further comprising a mounting section in the interior region that is proximate to the suture opening, wherein the tensioning mechanism is mounted to the mounting section. 
     
     
         25 . The device of  claim 20 , further comprising a cap configured to be arthroscopically affixed to an exposed end of the body when the device is implanted. 
     
     
         26 . The device of  claim 25 , wherein the cap is further configured to secure the suture. 
     
     
         27 . The device of  claim 20 , wherein the face member includes a first portion that is located closer to the distal end of the body than another second portion of the face member to accommodate a non-planar surface of the lateral cortex of the humeral head. 
     
     
         28 . The device of  claim 20 , wherein the body has a first inner diameter and the face member has a second inner diameter, wherein the first and second inner diameters are approximately the same. 
     
     
         29 . A device for securing a rotator cuff tendon to a humeral head, the device comprising:
 a cylindrical body having an at least partially continuous outer side wall with an outer perimeter, an interior region, a proximal end, a distal end, and a suture opening in the side wall between the proximal end and distal end that extends into the interior region, the body being configured to fit in a cavity created in a lateral section of a humeral head such that the suture opening is aligned with a tunnel created in the humeral head to intersect the cavity and through which a suture extends;   a flange attached to the proximal end of the body, the flange extending beyond the outer perimeter of the body and overlapping a portion of the lateral cortex of the humeral head to limit the depth of insertion of the body into the cavity in the humeral head; and   a tensioning mechanism in the interior region that is configured to receive a suture through the suture opening and releasably hold the suture in place, wherein when the tensioning mechanism holds the suture in place, the flange distributes at least some of the force created by the tensioning mechanism holding the suture in place to the lateral cortex of the humeral head.   
     
     
         30 . The device of  claim 29 , further comprising a mounting section that is proximate to the suture opening, wherein the tensioning mechanism is mounted to the mounting section. 
     
     
         31 . The device of  claim 29 , further comprising a cap configured to be arthroscopically affixed to an exposed end of the body when the device is implanted. 
     
     
         32 . The device of  claim 31 , wherein the cap is further configured to secure the suture. 
     
     
         33 . The device of  claim 29 , wherein the flange includes a first portion that is located closer to the distal end of the body than another second portion of the face member to accommodate a non-planar surface of the lateral cortex of the humeral head. 
     
     
         34 . The device of  claim 29 , wherein the body has a first inner diameter and the face member has a second inner diameter, wherein the first and second inner diameters are approximately the same. 
     
     
         35 . A device for securing a rotator cuff tendon to a humeral head, the device comprising:
 body having an outer perimeter, an interior region, a proximal end, a distal end, and a suture opening in the side wall that extends into the interior region, the body being configured to fit in a cavity created in a lateral section of a humeral head;   a face member attached to the proximal end of the body, the face member extending beyond the outer perimeter of the body and overlapping a portion of the lateral cortex of the humeral head; and   a tensioning means in the interior region for receiving a suture and releasably holding the suture in place, wherein when the tensioning means holds the suture in place, the face member distributes at least some of the force created by tensioning the suture to the lateral cortex of the humeral head.   
     
     
         36 . The device of  claim 35 , wherein the face member is a flange. 
     
     
         37 . The device of  claim 35 , wherein the body is cylindrical in shape. 
     
     
         38 . The device of  claim 35 , wherein the face member includes a first portion that is located closer to the distal end of the body than another second portion of the face member to accommodate a non-planar surface of the lateral cortex of the humeral head 
     
     
         39 . The device of  claim 35 , wherein the body has a first inner diameter and the face member has a second inner diameter, wherein the first and second inner diameters are approximately the same.