Graft ligament strand tensioner

Abstract

A graft ligament strand tensioner includes a frame member for slidingly retaining loops of sutures extending from graft ligament strands. The tensioner further includes a collar portion, and is provided with a handle having a core portion on which the collar portion is disposed for axial movement, and a grip portion. The tensioner still further includes a spherical member connected to the handle and having rounded surfaces facing the collar portion. The collar portion is tiltingly movable on the spherical member rounded surfaces when manipulation of the handle, to pull sutures on the frame member taut, causes the collar portion to engage the spherical member rounded surfaces. The sliding retention of the sutures and the tilting movement of the collar portion provide substantial equalization of tension in the sutures and thereby the graft ligament strands.

1 . A ligament strand tensioner comprising: 
 a frame member for slidingly retaining loops of suture strands extending from ligament strands, and having a collar portion;    a cylindrically-shaped tube on which the collar portion is mounted;    a base member fixed on said tube; and    a handle connected to said tube;    the collar portion being tiltingly movable on said base member when manipulation of said handle, to pull the suture strands on said frame member taut, causes said base member to engage the collar portion; wherein    proximal axial movement of said frame member effects application of the tension on the strands; and    the sliding retention of the suture strands and the tilting movement of the collar portion provide substantial equalization of tension in the ligament strands.    
     
     
         2 . A ligament strand tensioner in accordance with  claim 1  wherein said base member extends outwardly from the tube and is provided with rounded surfaces thereon.  
     
     
         3 . A ligament strand tensioner in accordance with  claim 2  wherein said frame member collar portion is provided with an inner surface complementary to the base member rounded surfaces.  
     
     
         4 . A ligament strand tensioner in accordance with  claim 3  wherein the frame member collar inner surface and the base member rounded surface are spherically configured.  
     
     
         5 . A ligament strand tensioner in accordance with  claim 1  wherein a tubular core portion of said handle is slidingly disposed on the tube.  
     
     
         6 . A ligament strand tensioner in accordance with  claim 5  wherein said tensioner further comprises a spring, biasing said handle against proximal movement of said handle, on the tube.  
     
     
         7 . A ligament strand tensioner in accordance with  claim 6  wherein the handle core portion is provided with an inwardly-extending ledge, the spherical tube is provided with a stop member on a proximal end thereof, and said spring comprises a coil spring extending from the ledge to the stop member.  
     
     
         8 . A ligament strand tensioner in accordance with  claim 7  wherein the tube proximal end is provided with external threads and the stop member is provided with internal threads, and the stop member is threadedly connected to the tube proximal end.  
     
     
         9 . A ligament strand tensioner in accordance with  claim 1  wherein said frame member is provided with first and second rails fixed to the collar portion, each of the rails having a groove therein for the sliding retention of one of the loops of suture strands.  
     
     
         10 . A ligament strand tensioner in accordance with  claim 1  wherein said ligament strand tensioner further comprises an opening for passing instruments through the ligament strand tensioner to engage the ligament strands.  
     
     
         11 . A ligament strand tensioner comprising: 
 a cylindrically-shaped tube;    a base member extending from the tube and having rounded surfaces;    a handle having a tubular core portion and a grip portion, said core portion being mounted on said tube and having an internal protrusion;    a stop member fixed to a proximal end of said tube;    a spring mounted in said core portion and extending from said internal protrusion to said stop member; and    a frame member disposed on said core portion and having suture strand rails thereon for retaining suture strands extending from ligament graft strands, said tube being movable axially relative to said frame member whereby said frame member may be engaged by said base member, with said frame member being tiltingly movable along the rounded surfaces, to provide equalization of tension in the suture strands retained on the rails, and thereby in the ligament strands.    
     
     
         12 . A ligament strand tensioner in accordance with  claim 11  wherein said base member comprises opposed first and second outwardly-extending stop portions, each of said stop portions having the rounded surfaces thereon.  
     
     
         13 . A ligament strand tensioner in accordance with  claim 12  wherein said frame member comprises a collar portion movably disposed on the handle core portion, the rails being fixed to said collar portion.  
     
     
         14 . A ligament strand tensioner in accordance with  claim 13  wherein said collar portion is provided with rounded internal surfaces complementary to the base portion rounded surfaces.  
     
     
         15 . A ligament strand tensioner in accordance with  claim 11  wherein said handle core portion is movable axially along the tube portion against a bias of said spring.  
     
     
         16 . A ligament strand tensioner in accordance with  claim 15  wherein the tube is provided with indicia progressively revealed by the movement of the handle core portion, relative to the tube, against the bias of said spring.  
     
     
         17 . A ligament graft strand tensioner comprising: 
 a cylindrically-shaped tube;    a base member extending from a distal end of the tube and having proximally-facing surfaces of spherical configuration;    a handle having a tubular core portion and an annularly-shaped flange portion extending outwardly from a proximal end of the core portion, the core portion being mounted on the tube and having an internal ledge;    a spring mounted in the core portion and abutting the ledge at a distal end of said spring;    a stop member fixed to a proximal end of the tube, a proximal end of said spring abutting said stop member; and    a collar disposed on the handle core portion between the handle flange and the base member, said collar having grooved rails fixed thereto and adapted to retain sutures extending from strands of ligament grafts, said tube being movable axially relative to said collar, whereby said collar may be engaged by said base member, with said collar being movable tiltingly along the spherical surfaces, to provide equalization of tension in ligament graft strands attached to the sutures retained on the grooved rails.    
     
     
         18 . A ligament strand tensioner in accordance with  claim 17  wherein said collar is provided with spherical internal surfaces for the tilting movement of said collar on the spherical surfaces of the base member.  
     
     
         19 . A ligament strand tensioner in accordance with  claim 17  wherein the handle tubular core portion is movable axially along the tube against a bias exerted by said spring.  
     
     
         20 . A ligament strand tensioner in accordance with  claim 19  wherein the tube is provided with indicia thereon, and axial movement of the handle tubular core portion along the tube, against the bias of said spring, serves to progressively reveal portions of the indicia.  
     
     
         21 . A ligament strand tensioner in accordance with  claim 20  wherein said spring is a coil spring and the indicia progressively revealed are correlated with compression of said spring.  
     
     
         22 . A ligament strand tensioner in accordance with  claim 10  wherein a central axis of the opening is adapted to be off-set from a central opening of a bone tunnel in which the ligament strands are disposed, and wherein the opening is sufficiently large to permit passage of the instruments colinearly from the opening and into the bone tunnel opening.  
     
     
         23 . A ligament strand tensioner comprising: 
 a frame member for slidingly retaining loops of suture strands extending from ligament strands; and    a handle connected to said frame for manipulation of said frame to apply tension to the suture strands and thereby to the ligament strands;    said frame member being pivotally mounted on the tensioner, such that sliding movement of the sutures on said frame member, and pivotal movement of said frame member provide substantial equalization of tension in the ligament strands.    
     
     
         24 . The ligament strand tensioner in accordance with  claim 23  wherein said tensioner is provided with a central opening extending therethrough for alignment with a bone tunnel opening, for passage of instruments through the tensioner and into the bone tunnel.  
     
     
         25 . A ligament strand tensioner comprising: 
 a frame member for slidingly retaining loops of suture stands extending from ligament strands, and having a collar portion;    a handle having a core portion on which the collar portion is mounted for axial movement, and a grip portion; and    an abutment member connected to said handle and having rounded surfaces facing the collar portion;    the collar portion being tiltingly movable on the abutment member rounded surfaces when manipulation of said handle, to pull suture strands on said frame member taut, causes the abutment member to engage said collar portion;    wherein the sliding retention of the suture strands and the tilting movement of the collar portion provide substantial equalization of tension in the ligament strands.    
     
     
         26 . A method for reconstructing a ligament, comprising: 
 attaching sutures S 1  and S 2  to ligament grafts G 1  and G 2 , attaching sutures S 3  and S 4  to ligament grafts G 3  and G 4 , fixing portions of ligament grafts G 1 , G 2 , G 3  and G 4  to a first bone in the body, and drawing sutures S 1 , S 2 , S 3  and S 4  through a hole in a second bone in a body;    providing a ligament strand tensioner comprising: a frame member for slidingly retaining loops of suture strands extending from ligament strands, and having a collar portion, a handle having a core portion on which the collar portion is disposed for axial movement, and a grip portion, and a base member connected to said handle and having rounded surfaces facing the collar portion, the collar portion being tiltingly movable on the base member rounded surfaces when manipulation of said handle, to pull suture strands on said frame member taut, causes the base member rounded surfaces to engage said collar portion, wherein the sliding retention of the suture strands and the tilting movement of the collar portion provide substantial equalization of tension in the ligament strands;    tying together sutures S 1  and S 2 , and tying together sutures S 3  and S 4 , and positioning said sutures on said rounded surfaces;    pulling said handle axially so as to pull said sutures taught; and    securing said ligament grafts G 1 , G 2 , G 3  and G 4  to said second bone.