Reinforcement insert for tissue graft

Abstract

Devices and methods for reinforcing tissue grafts are described herein. In one embodiment, an implant is described that includes a proximal end portion having a through-hole formed therein, a distal end portion, and a reinforcing insert disposed in the through-hole. The insert includes a proximal face, a distal face opposed to the proximal face, a first upper surface extending between the proximal and distal faces and having a generally convex shape that abuts against at least a portion of a sidewall of the through-hole, and a second lower surface extending between the proximal and distal faces and having a generally concave shape. The second lower surface and portions of the sidewall of the through-hole not abutted by the first upper surface form a reinforced through-hole of the implant.

What is claimed is: 
     
         1 . An implant, comprising:
 a proximal end portion having a through-hole formed therein;   a distal end portion; and   a reinforcing insert disposed in the through-hole, the insert comprising:
 a proximal face; 
 a distal face opposed to the proximal face; 
 a first upper surface extending between the proximal and distal faces, the upper surface having a generally convex shape that abuts against at least a portion of a sidewall of the through-hole; and 
 a second lower surface extending between the proximal and distal faces, the lower surface being opposed to and disposed below the first upper surface, the lower surface having a generally concave shape, and the second lower surface and portions of the sidewall of the through-hole not abutted by the first upper surface forming a reinforced through-hole of the implant. 
   
     
     
         2 . The implant of  claim 1 , wherein a radius of curvature of the first upper surface of the reinforcing insert associated with the generally convex shape is approximately equal to a radius of curvature of the portion of the sidewall of the through-hole against which the first upper surface abuts. 
     
     
         3 . The implant of  claim 1 , wherein a radius of curvature of the second lower surface of the reinforcing insert associated with the generally concave shape is approximately equal to a radius of the through-hole. 
     
     
         4 . The implant of  claim 1 , wherein the distance between a midpoint of the convex surface and a midpoint of the concave surface is about 1 millimeter. 
     
     
         5 . The implant of  claim 1 , wherein at least one of the proximal and distal faces has a cavity formed therein for receiving an insertion tool. 
     
     
         6 . The implant of  claim 1 , further comprising a suture disposed in the reinforced through-hole. 
     
     
         7 . The implant of  claim 1 , wherein the implant is a bone plug. 
     
     
         8 . The implant of  claim 7 , wherein the bone plug is a bone-tendon-bone graft, with a first bone portion of the implant being part of the proximal end portion of the implant, a second bone portion of the implant being part of the distal end portion of the implant, and a tendon extends between the first and second bone portions. 
     
     
         9 . The implant of  claim 1 , wherein a cross-section of the reinforced through-hole has a circular shape. 
     
     
         10 . The implant of  claim 1 , wherein a cross-section of the through-hole has a non-circular shape. 
     
     
         11 . The implant of  claim 10 , wherein a cross-section of the reinforced through-hole has a circular shape. 
     
     
         12 . A reinforced bone plug, comprising:
 a bone plug having a substantially cylindrical shape and a through-hole extending transversely across a longitudinal axis of the bone plug; and   an insert positioned within the through-hole such that a convex surface of the insert abuts against at least a portion of a sidewall of the through-hole and an opposing concave surface of the insert intersects at least a second portion of the sidewall of the through-hole to define a reinforced through-hole in the bone plug.   
     
     
         13 . The reinforced bone plug of  claim 12 , wherein a cross-section of the through-hole is oblong and a cross-section of the reinforced through-hole is substantially circular. 
     
     
         14 . The reinforced bone plug of  claim 12 , wherein a radius of curvature of the convex surface is substantially equal to a radius of curvature of the portion of the sidewall of the through-hole against which it abuts. 
     
     
         15 . The reinforced bone plug of  claim 12 , wherein the radius of curvature of the concave surface is substantially equal to a radius of curvature of the second portion of the sidewall of the through-hole. 
     
     
         16 . The reinforced bone plug of  claim 15 , further comprising a suture disposed in the reinforced through-hole. 
     
     
         17 . A method for soft tissue surgical reconstruction, comprising:
 forming a through-hole in a proximal end portion of an implant;   positioning an insert having a convex surface opposed to a concave surface within the through-hole such that the convex surface abuts against at least a portion of a sidewall of the through-hole to form a reinforced through-hole;   threading a suture through the reinforced through-hole; and   drawing the implant into a bone tunnel by pulling on the suture threaded through the reinforced through-hole.   
     
     
         18 . The method of  claim 17 , wherein the through-hole has an oblong shape. 
     
     
         19 . The method of  claim 17 , wherein the suture abuts against the concave surface of the insert when pulled to draw the implant into the bone tunnel. 
     
     
         20 . The method of  claim 17 , wherein the implant includes a bone plug having a tendon coupled thereto, the through-hole is formed in the bone plug, and the portion of the sidewall of the through-hole against which the convex surface abuts is a proximal end portion of the sidewall disposed at a location that is opposite to the tendon coupled to the bone plug.