System, devices and methods for anatomically correct reconstruction of ligaments

Abstract

A method, system and devices for the reconstruction of ribbon shaped ligaments following the anatomical native insertion sites of the ligaments in the corresponding bones is described. The reconstruction of the anterior cruciate ligament of the human knee is depicted. The system includes means for positioning and creating bone-tunnels, the preparation of grafts and the fixation thereof. The devices intended for bone tunnel creation take into account the ribbon-shaped nature of the ligament and can be adjusted to patient specific anatomy and take into consideration the various typologies of the ligament insertion sites. The method and devices for graft preparation are construed to reflect the anatomy of ligaments under consideration as close as possible to native ligaments by imitating the ribbon-like nature of native ligaments. The presented fixation methods follow this principle and are intended to support the ribbon-like nature of the grafts and are intended to support in-growth of the grafts. Furthermore, accessories supporting preparation of the grafts are presented.

1 .- 19 . (canceled) 
     
     
         20 . A system for creating a graft for ACL reconstruction, the system comprising a device for making the graft for ACL reconstruction, the graft comprising a first portion which is shaped and dimensioned to substantially conform to a slit shaped bone entrance point, a second portion that is shaped and dimensioned to be substantially ribbon like, and a third portion which is shaped and dimensioned to substantially conform to a half-moon shaped aperture. 
     
     
         21 . A method of preparing the graft of  claim 20  for a ligament reconstruction procedure, comprising the steps of:
 harvesting a tendon; 
 cleaning the tendon; 
 arranging individual tendon strands in a substantially ribbon-like, flat manner to mount and fixate the tendon; and, 
 preparing the individual tendon strands in a linear arrangement. 
 
     
     
         22 . A method of preparing the graft of  claim 20  for a ligament reconstruction procedure, comprising the steps of:
 harvesting a tendon to obtain a round tendon structure; cleaning 
 the round tendon structure; 
 preparing a substantially flat, ribbon-like structure from the round tendon structure along a longitudinal axis of the round tendon structure following tendon fibers, the substantially flat, ribbon-like structure having a first side and a second side; 
 spanning the first side of the substantially flat, ribbon-like structure substantially orthogonally to the longitudinal axis of the substantially flat, ribbon-like structure by attaching the substantially flat, ribbon-like to an attachment structure; and, 
 spanning the second side of the substantially flat, ribbon-like structure substantially orthogonally to the longitudinal axis by attaching the substantially flat, ribbon-like to an    
 
     
     
         23 . A method of preparing the graft of  claim 20  for a reconstruction procedure, comprising the steps of:
 harvesting a tendon having a plurality of tendon strands; 
 cleaning the tendon; 
 providing a split-button device having a lower partition and an upper partition; 
 introducing the tendon into the lower partition; 
 introducing the tendon into the upper partition; 
 providing a fiber-pod having separate fields and loops; 
 laying each tendon strand in a separate field; 
 weaving the plurality of tendon strands through the loops with a plurality of pull chords; 
 tightening the tendon strands by pulling the pull chords; and, 
 optionally securing the tendon strands with sutures. 
 
     
     
         24 . A method of preparing the graft of  claim 20  for a procedure, comprising the steps of:
 harvesting a flat, ribbon-like portion of a tendon (e.g. patella or quadriceps tendon); 
 cleaning the tendon portion; preparing a substantially flat tendon structure; and, 
 attaching said structure to fixation means allowing the upholding of a flat appearance and structure of the graft.