Evan D. Collins of Houston received U.S. Patent 8,110,000 for “Ligament Reconstruction System.”

Texas Business Patent Of The Day:  A Texas man devised a better way to rebuild your elbow.

Evan D. Collins of Houston received U.S. Patent 8,110,000 for “Ligament Reconstruction System.”

Collins filed for the patent on March 6, 2008.

Collins’ invention relates to ligament reconstruction. More particularly, the present invention involves systems of ligament reconstruction of a joint using a tendon graft.

More particularly still, his invention involves systems for ligament reconstruction of an elbow, according to the patent document.  

The human body is comprised of many joints including the ankle, the knee, the shoulder, and the elbow. At each of these joints, there are two bones connected by a ligament. Over time, a ligament can become stretched or torn because of over-stressed movement or an injury. When this happens, ligament reconstruction is needed. 

Ligament reconstruction typically reestablishes joint stability through a bone-tendon connection.

A tendon is taken from another part of the body and is woven through bone tunnels that have been drilled in each of the bones of the joint. The tendon is appropriately tensioned between the two bones of the joint, and then the tendons are usually secured to the bones of the joint. 

Surgical methods for reconstructing ligaments of a joint have existed for years. For example, a method for reconstruction of a ligament of an elbow, called "Tommy John surgery", has been a common procedure since its inception in 1974. "Tommy John surgery" is most commonly performed on pitchers in the sport of baseball.

Because pitching overhand is a particularly stressful motion, pitching at high speeds puts a substantial strain on a pitcher's elbow joint and is commonly injurious. Injuries resulting from the stressful motion of pitching can range from a sprain to a tear of the ligament of the elbow. Regardless of the severity of the injury, a "Tommy John surgery" is usually needed to restore a pitchers arm to full velocity. 

Tommy John surgery is much like other methods of ligament reconstruction for other joints. Ligament reconstruction has historically entailed individual assessment of a patient's anatomy so as to determine the correct placement for a graphed tendon. The individual assessment also determines the location of the bone tunnels utilized for a reconstruction surgery. In every patient, bone tunnels through which the ligaments are threaded are created with every effort to ensure the best placement, equal size, and symmetry. Likewise, appropriate tendon length and tension is also individually assessed and applied.

The process of ligament reconstruction is recreated with each individual patient and each surgeon, with inevitable variations due more to human error rather than any error attributable to a device or apparatus. Moreover, there is usually no standard navigation device or uniform system for a ligament reconstruction procedure. Even slight variations in tunnel location, size or symmetry of the tunnels, as well as tendon length and tension, can impact the outcome and recovery of the patient. Thus, there is a need for a more uniform system and procedure for ligament reconstruction, especially for that of the elbow. 

Collins’ objective is to provide a system for ligament reconstruction of the joints of the human body that standardizes ligament reconstruction of a joint with precise measurements while minimizing variations in ligament reconstruction from patient to patient. 

 His method includes placing a first jig having a first plurality of drill guide holes on a first bone of the joint, forming two intersecting holes in the first bone using the first plurality of drill guide holes of the first jig, placing a second jig having a second plurality of drill guide holes on a second bone of the joint, forming a tunnel and a first branch hole and a second branch hole in the second bone using the second plurality of drill guide holes, placing a tendon through a passageway formed by the two intersecting holes in the first bone such that a first end and a second end of the tendon extend outwardly of the passageway, attaching first and second sutures to the first and second ends of the tendon, respectively, extending the first and second sutures through the tunnel and respectively through the first and second branch holes such that the first and second ends of the tendon are positioned within the tunnel and the first and second sutures extend outwardly respectively of the first and second branch holes, and affixing the first and second ends of the tendon within the tunnel. The joint contemplated by the present invention is an elbow. The first bone of the elbow is the ulna, and the second bone of the elbow is the humerus. 

The method of the present invention further includes securing the first jig to the first bone prior to the step of forming two intersecting holes, securing the second jig to the second bone prior to the step of forming the tunnel and the first branch hole and the second branch hole, removing the first jig from the first bone after the step of forming two intersecting holes, and removing the second jig from the second bone after the step of affixing the tendon. The method of the present invention also further includes adjusting a length of the tendon by securing the first suture to the second jig, clamping the second suture to a handle affixed to the second jig, adjusting the first bone and the second bone of the joint to a desired position, and adjusting the handle so as to fix the length of the tendon. 

The step of securing the first jig includes inserting a first securing pin through a pin guide hole into the first bone adjacent to a joint line, and inserting a second securing pin through a cannulated handle removably affixed to the first body into the first bone. The step of clamping includes pulling a second suture in through a slot in a the handle, the slot being centered at a proximal end of the tunnel. 

The step of forming two intersecting holes includes attaching drill sleeves to each of the plurality of drill guide holes, inserting a drill bit into each of the drill sleeves, drilling the intersecting holes with the drill bit in the first bone, and reaming the intersecting holes. The drill sleeves have axes intersecting a short distance from the first jig inside the first bone. 

The step of forming a tunnel includes attaching a first drill guide to a first drill guide hole of the second plurality of drill guide holes, inserting a drill bit into the first drill guide, and drilling the tunnel to a desired depth. The step of forming the first and second branch holes includes attaching a second drill guide to a second drill guide hole of the second plurality of drill guide holes, inserting the drill bit into the second drill guide, drilling the first branch hole, removing the second drill guide from the second drill guide hole, attaching a third drill guide to a third drill guide hole of the second plurality of drill guide holes, inserting the drill bit into the third drill guide, drilling second branch hole, and removing the third drill guide from the third drill guide hole. The first and second branch holes have a smaller diameter than a diameter of the tunnel. 

The step of affixing the first and second ends of the tendon can include tying the first and second sutures together. The step of affixing the first and second ends of the tendon can also include placing locking plugs in the tunnel through the first and second branch holes. 

The present invention is also an apparatus for ligament reconstruction. The apparatus has a first jig and a second jig. The first jig has a body formed so as to fit over a first bone. The second jig is arranged in spaced relation to the first jig and has a body formed so as to fit over a second bone of a joint. A plurality of openings and at least one pin guide hole are formed in the body of the first jig. A handle is placed on the body of the first jig. The plurality of openings are located on the body of the first jig so as to have axes intersecting a desired distance from one side of the first jig. The second jig has a first drill guide hole, a second drill guide hole, a third drill guide hole, and at least one fixing hole formed in the body of the second jig. The second and third drill guide holes have axes intersecting at a desired distance from one side of the second jig. These axes also intersect a longitudinal axis of the first dill guide hole. The second jig also has a second handle affixed to the body thereof. 

In particular, the first jig has a surface formed so as to fit over a portion of an ulna of an elbow. The second jig has a surface formed so as to fit over a portion of a humerus of an elbow. The plurality of openings have a diameter of between 10 to 15 millimeters. The first drill guide hole has a diameter of approximately 8 millimeters. The second and third drill guide holes have a diameter smaller than the diameter of the first drill guide hole.