Medical apparatus and method for attaching a suture to a bone

Abstract

A method of forming a channel in a bone, the method comprising: providing a first bore in the bone; and forming, a second bore in the bone at a predefined angle from said first bore, using said first bore as a reference point for defining the location of the second bore in the bone, wherein the first and second bores intersect in the bone.

What is claimed is: 
     
         1 . A medical implement for attaching a suture to a bone, comprising:
 a handle having a proximal end for manual grasping and a distal end for engagement with a bone to which a suture is to be attached, said bone being pre-formed with at least one first bore, said handle extending longitudinally from said proximal end to said distal end;   a hook carried at said distal end of the handle, spaced from an outer surface at said distal end of the handle, and configured for reception in said first bore of the bone;   a movable member resiliently coupled with a spring to said handle and urged to extend longitudinally from said distal end of the handle to an extended position responsive to said resilient coupling,   wherein said movable member is movable between said extended position and a retracted position, wherein in said retracted position said movable member is retracted away from said hook to facilitate reception of said hook into said first bore, and in said extended position said movable member is extended toward said hook to engage said bone for clamping said handle to said bone at a predetermined angle with respect to said first bore while said hook is in said first bore; and   a manually manipulatable member coupled to said movable member for moving said movable member between said extended and retracted positions;   said handle being formed with a passageway extending longitudinally therethrough from its proximal end to its distal end, said passageway being positioned with respect to said hook for receiving a drill, for drilling a second bore through said bone at said predetermined angle with respect to said first bore and for passing through the passageway one end of a suture to traverse, and to extend past, said first bore such that said one end of the suture is accessible through said first bore for being pulled out therefrom, while the opposite end of the suture is accessible through said second bore for pulling out therefrom in order to attach the suture to said bone.   
     
     
         2 . The implement according to  claim 1 , wherein said hook includes a loop movable to an extended position with respect to the hook for facilitating entry of a first end of the suture through said loop, and to a retracted position towards said hook for clamping said first end of the suture to enable pulling-out said first end of the suture through said first bore of the bone; and
 wherein said handle includes a second manually manipulatable member coupled to said loop for moving the loop to its extended and retracted positions.   
     
     
         3 . The implement according to  claim 2 , wherein said second manipulatable member includes a knob coupled to a stem slideable through a slot in said handle and coupled to said loop. 
     
     
         4 . The implement according to  claim 3 , wherein said stem is coupled to said loop by a cable extending through a sleeve in said handle coupled to said hook. 
     
     
         5 . The implement according to  claim 3 , wherein said knob is slideable along an axis parallel to the longitudinal axis of the handle. 
     
     
         6 . The implement according to  claim 3 , wherein said knob is pivot along a pivot axis perpendicular to the longitudinal axis of the handle. 
     
     
         7 . The implement according to  claim 1 , wherein said predetermined angle is about 70°. 
     
     
         8 . The implement according to  claim 1 , wherein said manually manipulatable member is a slideable member slideably received on the proximal end of said handle. 
     
     
         9 . The implement according to  claim 8 , wherein said proximal end of the handle includes a threaded section, and further includes a nut threaded on said threaded section to lock said slideable member in position. 
     
     
         10 . A medical kit useful for attaching a suture to a bone in an arthroscopic surgical procedure, comprising:
 a medical implement according to  claim 1 ; and   a drill receivable within said passageway of the handle for drilling said second bore in the bone;   said drill including a stop engageable with said proximal end of the handle to fix the length of the second bore to extend for a slight distance past said first bore, to thereby permit the first end of the suture to traverse and extend past said first bore in order to facilitate its access and extraction via said first bore.   
     
     
         11 . The kit according to  claim 10 , wherein said drill has a diameter of 2.5 mm. 
     
     
         12 . The kit according to  claim 10 , wherein said kit further includes a suture loader sized and configured for reception in said passageway of the handle and for passing said suture through said second bore past said first bore in the bone. 
     
     
         13 . The kit according to  claim 12 , wherein said suture loader includes a distal end formed with a slot for receiving said suture, and a proximal end formed with a handle having flat opposed sides parallel to said slot for orienting the suture loader with respect to the suture to be received within said slot. 
     
     
         14 . The kit according to  claim 10 , wherein said kit further includes:
 a drill guide having a distal end engageable with said bone at the location of the first bore to be formed therein; and a proximal end opposite to said distal end; and   a second drill receivable within said drill guide, said second drill including a distal end formed with cutting edges to drill said first bore in the bone, and a proximal end formed with a shoulder engageable with the proximal end of the drill guide for defining the depth of the first bore to be drilled by said second drill.   
     
     
         15 . The kit according to  claim 14 , wherein said second drill has a diameter of 2.9 mm. 
     
     
         16 . The kit according to  claim 10 , wherein said kit further includes a suture hook sized and configured for reception in said first bore and for extracting the first end of the suture therethrough.