Internal brace for tissue repairs and reinforcements

Abstract

A reconstruction system and associated techniques for soft tissue repairs and repair augmentation. The reconstruction system is an internal soft tissue brace formed of at least one fixation device (for example, anchors or screws) and a replacement/reinforcement construct (for example, a suture construct in the form of a suture tape such as FiberTape® or a collagen tape or a suture with biological material or a collagen coated material, or a collagen patch, or a biological construct such as Arthroflex). The reinforcement construct and fixation devices may be used as a suture repair alone (to replace the ligament or tendon), or in conjunction with other traditional soft tissue repair procedures, acting as a reinforcement system for the repaired soft tissue.

What is claimed is: 
     
         1 . A method of surgical repair, comprising:
 inserting a first fixation device into a first bone at a first location that is adjacent to a first attachment point of a ligament;   shuttling a suture construct that is connected to the first fixation device from the first location to a second location that is adjacent to a second attachment point of the ligament,   wherein shuttling the suture construct includes passing the suture construct between the ligament and a tissue overlying the ligament;   connecting the suture construct to a second fixation device; and   inserting the second fixation device into a second bone at the second location,   wherein, after inserting the first and second fixation devices, the suture construct extends over the ligament to reinforce the ligament.   
     
     
         2 . The method as recited in  claim 1 , comprising establishing a tunnel that extends from the first location to the second location prior to shuttling the suture construct. 
     
     
         3 . The method as recited in  claim 2 , wherein the tunnel is a soft tissue tunnel. 
     
     
         4 . The method as recited in  claim 2 , wherein establishing the tunnel includes inserting a curved tip of a suture passer between the ligament and the tissue. 
     
     
         5 . The method as recited in  claim 1 , wherein the tissue includes skin, muscle, and fascia. 
     
     
         6 . The method as recited in  claim 1 , wherein the ligament is a knee ligament. 
     
     
         7 . The method as recited in  claim 6 , wherein the knee ligament is a medial collateral ligament (MCL). 
     
     
         8 . The method as recited in  claim 1 , comprising repairing the ligament prior to inserting the first fixation device. 
     
     
         9 . The method as recited in  claim 1 , comprising replacing the ligament prior to inserting the first fixation device. 
     
     
         10 . The method as recited in  claim 1 , comprising delivering a biological material to the ligament. 
     
     
         11 . The method as recited in  claim 10 , wherein the biological material includes bone marrow aspirate, bone marrow stem cells, platelet rich plasma, growth factors, or combinations thereof. 
     
     
         12 . The method as recited in  claim 1 , wherein the suture construct includes a suture tape. 
     
     
         13 . The method as recited in  claim 1 , wherein the suture construct includes a collagen tape. 
     
     
         14 . The method as recited in  claim 1 , wherein at least one of the first fixation device or the second fixation device is a knotless fixation device. 
     
     
         15 . The method as recited in  claim 1 , wherein at least one of the first fixation device or the second fixation device is an interference screw. 
     
     
         16 . The method as recited in  claim 1 , comprising testing a range of motion of the ligament prior to inserting the second fixation device into the second bone. 
     
     
         17 . The method as recited in  claim 1 , comprising positioning a joint comprised of the first bone and the second bone in flexion prior to inserting the first fixation device into the first bone. 
     
     
         18 . A method of surgical repair, comprising:
 inserting a first fixation device into a first bone at a first location that is adjacent to a first attachment point of a knee ligament;   shuttling a suture construct that is connected to the first fixation device from the first location to a second location that is adjacent to a second attachment point of the knee ligament,   wherein shuttling the suture construct includes passing the suture construct between the knee ligament and a tissue overlying the knee ligament;   connecting the suture construct to a second fixation device; and   inserting the second fixation device into a second bone at the second location,   wherein, after inserting the first and second fixation devices, the suture construct extends over the knee ligament to reinforce the knee ligament.