CA1336756C

CA1336756C - Channel ligament clamp and system

Info

Publication number: CA1336756C
Application number: CA000608989A
Authority: CA
Inventors: Marlowe E. Goble; W. Karl Somers
Original assignee: Individual
Current assignee: Individual
Priority date: 1988-08-23
Filing date: 1989-08-22
Publication date: 1995-08-22
Anticipated expiration: 2012-08-22
Also published as: EP0358372A1; AU4012789A; AU612097B2; US4960420A; JPH0288049A

Abstract

A ligament fixation device and system for its use that includes a channel ligament clamp (10) fabricated for human implantation and consisting of a channel section having a web (13) between parallel sides wherefrom sections have been removed leaving spaced apart pointed spikes (11) that extend outwardly from walls (12), the channel web including a group of pointed pins (15) that extend therefrom parallel and alongside the spikes (11), and at least one screw-type fastener hole (14) formed therethrough. The system of the invention includes tooling for locating a ligament on a bone surface and scoringthat surface for drilling. After drilling, a right angle post (22) of a drilling guide (21) is fitted into that drilled hole (20) and the drill guide longitudinal axis is aligned with the ligament location on the bone surface, which drilling guide hasan array of spike and pin holes formed therethrough for receiving a drill turnedindividually therethrough into the bone surface. In practice, the clamp (10) is positioned over the drilled holes, with a ligament under tension therebetween and the pointed pins (15) are driven through the ligament and into the prepared pin holes, preferably utilizing a seating tool (30), and a screw (40) is turned through the web hole (19) and the ligament into the prepared hole (20), to sandwich the ligament that is contained between the clamp spikes (12) against the bone surface.

Description

1 336~56 CHANNEL LIGAMENT CLAMP AND SYSTEM

BACKGROUND OF THE INVENTION

Field of the Invention The present invention relates to devices used in ligament repair and replacement surgery for securing under tension a ligament end to a bone surface.

Prior Art In the area of ligament repair and replacement surgery it has been common to utilize a staple arrangement to attach a ligament end to a bone surface.
An example of such staple device and its use is shown in a patent to Shapiro, U.S. Patent No. 4,414,967. The Shapiro patent illustrates an arrangement where, with tension applied to the ligament end and staple legs positioned to straddle the ligament, the staple legs are driven into the bone with the staple web sandwiching and binding the ligament against the bone.
Examples of other devices for connecting ligament ends to a bone surface or to within a bone are shown in a patent of the present inventors, U.S. Patent No.
4,632,100, and in U.S. Patent No. 4,772,286 of September 20, 1988, as well as in a patent to one of the present inventors, E. Marlowe Goble, U.S. Patent No. 4,738,255.
Additionally, another example of a ligament anchor system is shown in a United States Patent to Hunt, et al., U.S.
Patent No. 4,590,928.

~1. r fi ~
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~ h~ above cited llgament anahor devlces an~ ~y~tems all provid~ ~or fixing a l~gament to a ~one ~ur~ace or to within a bone during heallng where the bone and llgament bond together.
Thie 1 also the ~unction performe~ by the channel llgamen~
clamp o~ the pre~en~ invention. The pr~6ent invention, howev~r, pro~ide~ a 6uperior pull out etr~ngt~ to ~u~h earller d~vice~, partlcularly staple-~ype arrange~nt6.
The ~hannel clamp o~ the preeent inventlon provide~ a number Or pol~ted ~pikes and plns a~ ~ell as at lea~t on~
~crew-type coupllng. W~ioh pin~ and screw-type ~oupllngs are pa~ed through th~ ligament and into t~e bone with the 6pikes containLng th~ llgament. Thi6 arr~ngement pro~ide~ a number of point~ o~ rlgid ~upport through the ligament for clamplng lt 3ecurQly to the bone ~urface. Hereto~ore, ce~tain fixatlon d~ice~ that have been ~mployed for holding a ligament end onto a bone ~ur~ace ha~e lnol~dea A dlBk or plate to r~ce~ve a screw the~ethrough ~or Beating in the bone. Such ~evice~ have lncorporate~ spike~ that extend from a li~ament engaging gurfAce ~or penetrat$ng to grip the llgament surf~ce but do not pa68 through the ~igament, So arranged, ~s the screw i~
turned lnto the ~one, ~he llgament engaglng ~ur~a~e aandwiche~
~h~ ligament agaln6t the bone. Examples of such f~xa~lon dev~ ce~ a~e manufactured ~y Synthe~ Canada, ~td., o~
Misal~s~uga, Ontarlo, Canada. ~hese fixation devlce~, however, by thel~ arrangemen~ o~ splke6 ~or grlpplng the ligament sur~aqe, do not pro~ide the coupl~ng strength of the ~h~nnel clamp ~ ~he pr~ent in~ention, 133675~

B~IEF S~MZ~RY OF THF: ~NvENTIoN
~ a princ~pHl ob~ec~ or the pre~ent lnventlon in a channel ligament olamp an~ ey~tem to provlde a device for securely flxlng a llgament to a bone su~face 80 as to promote healln~, Another ob~ ect of the pr~sent invention ~g to p~ovide a ey~tem ~or optimally looa~ing an end of a ligament ~nder tens~on to a bone ~urface, ~nd prep~rlng that bone location to recel~e ~pike~ and pln~ of ~ channel clamp and at lea~t one screw-type faetener $itted through the we~ of that channel clamp, ~hlch fas~Rner ifi turned through the llgament and lnto the bone, th~ pin~ paesing through the ligament and into the holes drilled lnto the bone, for containlng the ligament between the 6plke~ and clamplng it again~t the ~one surf~ce, Ano~her ob~ct of the present ln~ention is to provlde a channel llgament clamp w~e~e the channel parallel ~de~ arQ
formed into space~ apart parallel splkee an~ the channel web inclu~e6 ~t least one ho~e formed thereth~ou~h alon~ with a grouping Or a plura~lty o~ polnted p~n~ extending alongside and parallel to the spike~.
Stlll another ob~ct of the pr~6ent lnventlon ~ to provlde a 6yetem of toollng for: pier~1ng an end of the ligament under t~n~ion to score a bonR surfao~; drllling, at that ecored locatio~, a ~ole in th~ bone to ~eoeive a sc~ew-type fa~tenPr; an~ lo~ating and drill~ng into the bone su~$ace hole~ to ac~omm~date the ~pikeg and pin~ of a channel clamp.

4 ~33675~
gtill another ob~ec~ Or the pr~ent lnv~ntion ~ to provl~e a ~hannel ligament clamp that iB ea~ily and reliably posltloned to a bone sur~ace to ~ecure a ligament end thereto and to prohlblt llgament separation fro~ that bon~ curfa~ at nignifl~antly greater than antloipated ten~ion load~.
In accord~n~e with the sbove ob~ects, the present inventlon in a channel ligament clamp is ~ormed from a me~al ~uch a~ titanium that i~ co~pat~ble for human lmplantat~on and io of a ~ize such ~hat the chann~l we~ wlll ~ust span an ~nd of a lig~ment that is to ~ attached to a ~one surface. The channel ligament clamp parallel sldeQ ar~ each formed into ~paçed apa~ parall~l ~pike~, And the channel web inolude~ a grouplng of pins exten~ng t~er~from and parallel to and alongslde of the 8pi~8. Whlch web 1~ al60 C~ntrally hole~ to receive a B¢~eW-type fa~tener fitted therethrough for turning through the liga~ont and into a bone so a~ to clamp the ligament to ~he bone eurface. In su~h clamp$ng, the ~crew-type ~astener and polnted ende o~ the pins ~ill pas~ through the 1igAment an~ into t~e bone, provid~ng a number of anchor po~nt~ for the ligamQnt and t~ the bo~e, with the ~pikes, also seated in the bone, con~a$ning the ligament therebetween.
The ~ystem of the present inven~ion provldes tool$ng for iirBt hollng the end of a ligamen~ unaer tenslon tha~ is po~l~ione~ appropriately on a bone ~urface. Durlng the hol~ ng ~ that bone surface~ i~ scrlbed by a tool pa~sed th~ough the ligament for drilllng a hole in ~hat bonQ surfao~ to reoeive th~ screw-type coupling. For ~ur~her preparing thls bone, a pOB~ portlon o~ a template or drLll guide ie fitted into that drilled hole and the longitudinal axis of a body 1 336~ 56 portlon of that arlll guide 1B aligned over where the ligamen~
longitudlnal center axis will be position~d. The drill gulde body iB appropriately holed to recQive a drill turned therethrough that pasce~ $nt~ the bone surface, ~orming hole~
thereln to a depth that 1~ sultable to receive the pointed ende o~ the channel clamp spike~ and pin~. T~ bone 6u~face is thereby prepare~ to recelv~ the channel clamp ~ltt~d thereto.
In prHctice, a lig~ment ~nder a de6ired tenQlon iB
optlmally posltionQd on a bon~ ~ur~ac~ and a pointed end of a 6ha~t 1B urged through ~ lateral midpoint of that ligament, scoring the bone ~urface. The bone i~ then drilled At th~
scored point forming a hole to re~ive a screw-type ~astener to be turned thereln. Following the drilling, a pin end of a template or drill guide i5 fitted therein with the longitu~l~al axi~ of which ~ill guid~ body to approximately align with a line on ~he b~ne ~ur~ace whereover the llgament longitudinal axis i~ to ~e pos~tioned. The bone ~u~face ie then d~illed throug~ hole~ ln the drill guide to an ~pprop~i~te depth to recelve the pointed ends o~ the channel clamp pin~ and ~ike~.
To attaoh th~ ligament to the bone s~r~ace the ch~nnel ligament clamp iB posit~onsd to ~traddle ~he 1 ~gament ~uch that the hole through ~h~ channel llgamen~ olamp w~b i~
~llgn~d with th~ ~ole ~ormed through the ligament and th~
~crew-type raetener hol~ drilled into the bone. ~n this po~ltioning the pln~ ~nd ~plk~ of the channel ligam~nt clamp will be ~ligned with the holes that have been fo~med into th~
bone ~ur~ce utlli~lng the drill guld~. A eeating tool le (336~56 then overlai~ ths c~annel llga~nt clamp, which ~eating tool i~ hol~d to recelve a tapered 5haft that has a pointed end, The ~eatlng tool hol~ to be al$gned with and pasG the tapered sha~t pointe~ end through the channel ligament clamp web hole, the hole ~hrou~h the llqam~nt, and in~o the ~¢rew-type f~6tener hole ~ormed lnto the bon~. The tapered Rh~ft opposite end 1~ th~n ~truck or otherwi~e u~ged to ~ove the 6haft p~ln~ed end into the bone. In which travel the tapered ~lde of the shaft picks up the ~eating tool, driving th~ pin~
o~ the channel ligament clamp t~rough ~he ligament and in~o the hole~ forme~ in the bone ~ur f a¢R ~ The ~ating tool and ~haft are then removed and a ~crew-type coupllng ~8 turned into the bon~, locki~g the ch~nnel ligament clamp wlth the ligamen~ containe~ between the Fpikes, ~andwiched to the bone 6ur~ace, A second ¢hannel llga~nt clamp ~mbodiment can include two ~p~oed apart laterally centered hole~ formed through the web ther~o~. Each hole for receiving a screw-~ype ~agtener ~lt~ed therethrough th~t i5 turned into holes prepared in the bone, a8 ~et out above.
DF~SCRIPTION OF THE D~INGS
The~e and other ob~ect6 and features of the p~esent inventlon will become ~ore fully apparent from the ollowing de~cription ~n conjunction wi~h the ac~ompanying ~rawings.
~ lg. 1 i~ 8 pro~ile persp~ctiYe v~w of a fir~t e~odimRnt o~ a channe~ l~g~ment ~lamp of th~ present lnvention:
Fig. 2 i~ a ~lde elevation ~ectlonal view tak~n Along ~he line 2-2 of Fig. 1;

Fig. 3 1~ a profile per~p~c~lve view Or a bone whereto a ligament i~ ~how~ aligned to ~e ~ecured with a polnted en~ of a ~haft pa~ed ther~through to ~r~b~ the ~one ~ur~acë:
Fig. 4 ~ ide elevation enlar~ed 6ectional view o~
the bone o~ Fig. 3 after a hole ha~ b~en formed into that bon~
at the ~rlbe point and showing a roun~ed end of a post of a te~plate or drill guide ~itted the~ein;
Fig. 5 1B A profile per6pective ~lew o~ the template or drill gul~e of F~g. 4, ~howing ~ latRral sectlon removed t~er~from;
Fig. 6 is an end ~l~vatlon ~w of ~he ~ection of bone of Fig. 4 nhowing the channel ligament ¢l~mp of Fig. 1 allgned thereover with hole~ formed in the bone to receive channel llg~en~ clamp p~n~ ~nd spikes, with a eectio~ of a ligament sandwiched ~herebetween, and with a ~eating tool ~how~
posltloned thereabove;
Flg. 7 ie a proflle perspectlv~ view of the sea~lng tool of Fig. ~ showing it as lncluding a tapered polnted ~haft aligne~ for ~tting through ~ vertical stepped holQ o~ the ~e~ing tool;
~ lg. 8 iQ A ~lde elevat~on view of the ~ectlon of bone of Fig. 4, ~howlng the cha~nsl ligament clamp mounted thereto, to ~andwich the llgamen~ sectlo~ of Fig. 6 to the bone sur~ace and ahow~ a 6crew-type fastener turn~d through the channel llgament clamp we~, ligame~ an~ intc th~ bon~; and Fig. 9 i~ a profile per~pective view of a second embodiment of a channel llgament clamp o~ the present inventlon;

l 336156 DETA:tLED ~ES~;:RIPTION
Ligament repalr and replaoe~ent surgery that lnvolves either biologlc graft~ or prosthetic ligamen~s generally re~uire, a~ part of ~h~ procedure, a capabll~t~ for exactly ma~ntainln~ t~e ligament end po~ltioni~g and ten6ion to a bone sur~ace. The pre~ent lnv~ntion, ~8 ~hown ln Fig~. 1 and 2~ ~ B
in a channel ligament olamp 10, hereina~ter refer~d to a~
clamp 10, that ls for fixing a llgamen~ under ten~i~n ~o a b~ne ~urf~ce, Additlonal to cla~p 10 the pre~ent ln~ention alao lncludes tooling and a ey~tem ~or it~ u~e for mounting clamp 10 to a bone ~ The tooling 1~ u~ed for both po~tioning the ligament and cla~p lo on a bone surface and forming, prefe~ably by dr~ ng, holes into that bon~ ~o recelve pln8 and eplk~s Or t~e cl~mp w$th at least one ~crew-type fastener for ma~ntaining the clamp 10 to the bone, pa~6ing through a ho~e in the olamp web and through the ligament.
F~g~. 1 an~ 2 ehow clamp ~ a~ a channel ~ection having parallel ~de6 that have b~n ~ormed ln~o 6paced apart and parallel polnted ~pikes 11. ~pike~ 11 extend outwardly ~ro~ a top o~ She channel ~lde walls 12 that are curved ~h~ough nlnety (90) ~egree~ into a we~ 13 that extend~ ther~between.
Prox$mat~ to one en~ of Which web 13, along its longitudlnal axi~, a hole 14 i6 ~ormed for reoeiving a ~rew-type ~a~tener ~ittod therethroug~ ~r turning ln~o a bone, a~ will be discu~e~ ln detail later he~ein, particularly wl~h reference to F~gs. 6 and 9.
Shown be~t in Figs. 1 and 2, the clamp web 13 further lnclude~ a grouping o~ pine 15. Each pin 15 i~ ~hown as havlng ~ ~harp polnted en~, the pine extendlng parallel to one 1 33675~

another, at right angle~ from that web 13, ~nd are arrang~d alon~ e an~ parallel to ~plkea 11. Pref~rably, the pins 15 are 61 ightly l~nger than the spikes 11 to fir~t contac~ a ligament surface, ag wlll ~e ee~ out ln detail later herein.
In practice, as the clamp 10 i8 urged onto the ligamen~, the pln~ 15 ~lr~t penetrate an~ pass through ~he ligament to travel ln~o holes formed in the bone ~ur~ace, a~ will be sQt out hereinbelow. The clamp ~plke~ 12 to follow the pin~ 15 into the b~ne ~urface for contain~ng the ligament therebetween, a~ ~et out in detail hereinbelow.
Flg. 2 ~hows the clamp 10 a~ pre~erably con~tru~ted of metal. In pra~tic~, titanium metal hav~ng a thickne6~ of approximately .040 lnche~ has bsRn u~ed 6ucce~s~ully in practlce, whi~h metal 1~ ~uitablo for huma~ lmplan~ation.
Where Flgs. 1 and 2 show a ~lr~t embodiment o~ clamp 10 a~ ln¢luding four pins 15 that are a~anged in a ~qua~e, ea~h pro~ectlng alongel~e and parallel from the olamp web 13, i~
~oul~ be under~tood that other numbQr~ and arrangement~ o~
plns 15 could be employed wlthln the ~cope o thlG di~cloaure.
An example of another pin arrangemen~ i6 ~hown as a second ohannel llgament clamp e~bodim~nt in ~i~. g, as will be ussed hereinbelow.
In formlng the ohannel 10, a8 shown ln Flg~ nd 2, the unit, le88 the pine lS, ~ay ~e ~ormed from a ~ingle ~ection o~ t~e prefe~re~ ~ltanium, or ot~er mater~al aB i5 appxopri~te ~cr human impl~ntation. Such rabrication may lnvolve formlng, a~ by bending t~e ~hannel sld~s ~ach t~rough approxlmately an . 08 lnch radial bend, whereafter sections o~
tho~e slde~ are r~moved, a~ by grinding, to leave a5 l 336?~6 rem~lhder~ the 6pike~ 11. So arranged, the ~plke~ ex~end co-planar from wallB 12, and ths end~ o~ ~h$ch ~pike~ 11 are ~harpened. Further, hole 14 an~ a grouping o~ pin 15 head hole6 are rOrme~ through the web 13. Of cour~e, ~he ~ection~
of the chann~l ~ide~ and web hole~ can be removed a6 by stamping and the 8pike~ nd wall6 lZ then bent to the configuration ~hown, or the entire clamp 10 can be caBt a~ a 5 ~ n~le unlt, wlthln the ecope o~ this dl~closure.
~ he clamp web 13 with pin head hol~s ~ormed tberethr~ugh, a~ set out hereinabove, ls ~o receive pinB 15 ~ounted the~eto. Preferably, ~or that mounting, ea¢h pin 15 wlll have a flat ~ead end w1th a ~cum~erentlal groove formed around the neck thereof ~u~t below the head. The pln 15 i~
mounted to the we~ 13 by a creat$on o~ a ~low o~ the web ~etal around the ~ole lnto th~ pin neck ~lr~um~erentla~ groove.
This mounting le pre~erably ac~ompli~hed utilizing a Btaking tool, not shown, whexe the clamp web 13 i6 po~itloned thereon with a pln 15 fltted t~ro~gh that web into a reces~ ln the st~kiny tool- The llp o~ the ~taklng tool re~Qss i~
preferably roun~e~ to ~oncentrate a force applied thereto.
Thereby, when a compre~sive pr~s~ure ie applied to the pln head ~nd, the ~taklng tool lip wlll t~nd to urge the metal aro~n~ t~e w~b hole lnto the pin neck clrcum~erential groo~e.
Thls m~tal flow provlde6 a tight pær~a~n~nt ~oupling of the pin 15 ln tbe clamp web 13. of: course, the clamp lo could be fabrl~ated by 2nol~ing m~thods, ~rom the above net out or other metal, or a hard plastlc wl~hln the ~cope of ~hl~ disclosure.

Al~o, lt ehould be under6tood, the clamp 10 can be ~ormed in different sizes ~or accommodating dlf~eren~ wldth~ of ligaments.
Ae set out above, the clamp 10 ie ~or eecuring a ligament to a ~one eurface whereby the ex~ot po~lt$oning and tenelle 6tate of ~he llgament to ~he bon~ ~e m~intained during healing. ~coordlngly, the present inventlon al~o lnoludes tooling and a procedure for itB use ~or: locating a connect~on point for the llgament on a bone ~urfac~; drilling hole~ into the bone ~urfaçe for receiving the eplke~ and pln~
of the ~lamp 10 and ~or receivlng at lea~t one screw-type ~astener7 urging the cla~p pin~ 15 through the ligament into the appropriate prepared holee, the splke~ 11 ¢ontaining the ligament therebetween al~o pa~51ng into the Appropriate prepare~ holes; and ~urning the ecrew-type fa~tQn~r in the hole formed in the bone to permanen~ly ma~ntain the ligamen~
ag~ln~t the bone sur~a4e.
Fig. 3 6hows a bone 1~ that coul~ b~ the eide of a tlbla havln~ a surface 17 whereto a l~gament 18 1~ ~hown positioned ~or attachment to that bone ~urface with the clamp 10 o~ the pre~en~ ln~ention. Ligament 18, it 6houl~ be understood, can be a natural or biologlc graft (allogra~t or autograft) l~gament or a pro~the~i¢ ligament.
Shown in Fig. 3, ligament 18 i~ po~l~ioned, ae by a eurgeon per~ormlng the pro~edur~r ~n ~he bone sur~ace 17, an~
a de~ired te~ e ~r~es ie applied thereto. So arrange~, a po~nted end o~ a eplke 19, or llke pointed tool, le manually urge~ through the ligament to ~core the bone ~urfaoe 17.
Therea~ter, A~ llluctrated ln Fig. 4, the ~one eurface 17 1 drilled at that ~cored polnt to form a 6crew-type ~a~tener hol~ therein, hereinafter referred to a~ ecrew hole. The screw hole 20 i~ for receiving a ~crew or like fa~tener turned therein, a~ s~own in Flg. 8. A1BO~ aB llluctrate~ ln Flg. 4, ~crew hole 20 recelves a post 22 fitted thereln of a te~plate or ~rill guide 21, ~er~inafter referred to as drlll guide.
The post 22 1~ fo~ use in aligning that drill gulae on the bonè su~face to overlay where the l~gament will be poQitloned and i6 ~or formlng aplke and pin holes the~eln, a~ ~et out immediately ~elow.
The drill gu$d~ 21, A~ ~hown in ~lg. 5, preferably ha~ a rectangular body 23, ehown aB being preferably formed of metal, and ~a6 a ~enter la~er~l ~lo~ 24 re~ove~ from the undersurf ace or ~ace thereo~ as a hand en~aging or gripping ~urface. The rectan~ular body i8 ehown broken a~ros~ an end thereof that i8 opposite to pont 22, illustrating that the b~dy 23 can be forme~ to have a convenient length to f~cllitate lt~ b~ing held by a ~urgeon pRrfonmlng the procedure.
The ~rlll gulde rectangular body has ~ormed therethrough, parallel rows of ~pl~e hole~ 25, an~ ~ clu~ter of four pin hole~ 26, ~hown ~ormed as a square. The respectiv~ spik~ and pin hole~, 25 an~ ZÇ, are to reaeive, a~
~hown ln Flg. 4, ~ drlll 27 turned therethrough that travel6 into bone 15. A~cordtnglyt ~ ~urgeon hol~lng the rectangular bo~y 23, wl~h the po~t 22 thereo~ in~talled, as ~hown ln F~g.
4, ln ~he ~arew hole 20, can align the longitudlnal axl~ of the rectangul~r body ~he~e the longltu~lnal axls o~ the llgame~t Wlll be po~ltioned, which line will b~ mArked on the 13 ~ 33615~
surface 17 of bone 16. Drill 27 1B turned to form Gpike hole~
28 and pin hole~ 2~ that ar~ at an appropri~te ~epth into the bone surface 17, aB shown in Flg. ~, 80 as to recelve ths channel spikes 11 and pln~ 15 poin~ en~ fltte~ therein, Shown in Flg. ~, the clamp 10 i~ po~itione~ over bone ~ur~ac~ 17 wherethrough spike and pln holes 28 and 29, re~pectively, have been drille~. Po6i~ioned between the clamp 10 and bone surface 17 iB shown an end of llgament 18 wlth a seating tool 30 ~hown po~itioned a~ove the clamp. Which ~e~tin~ tool con~ist6 of a body 31 and A eeparate tapered sha~t 32. The ~eating tool bo~y 31, a~ nhown in Fig. ~, h~ a depre~ion 33 ~orm~ in the und~rcurface thereof to ~ust accommodate the clamp 10 we~ 13 seated ther~in. Which depres~ion 33 i~ further ~tepp~d ~ nto the bo~y 31 to rOrm a r~ces~ 34. The depre6~l0n 33 exactly accommoda~e~, a~ ~hown in Fig. 6, the top surface of ~he ~lamp web 13, with ~he head end~ of pln~ 15 to fit into reces~ 34, pro~ldlng ~hereby h close and constant contact o~ the ~eat~ng tool over the ent~r~
~lamp we~
8hown in bro~en line~ ln Fig. 6 and ln a ~roken away port$on of Fig. 7, thQ seatlng tool body 31 ~ B ~rllle~
therethrough W~th a hole 35 thA~ 1~ counter ~unk to hav~ a grea~er dlameter upper hole portion 36, above a ~eck 37. The shaft 32, as Ehown be~t in ~iq. 6, i5 for flttlng through thR
upper hole 36 to extend thro~gh and ~ust beyond the end of hole 35, whereat the tApered ~ur~ac~ of the ~haft engages the neck 37. So arranged, ~ha~t 32 pointed end will exten~
through the clamp web hole 14 and li~amen~ 18 hol~, ~orm~d by tool 19 aq shown ln Flg . 3, and travel lnto ~crew hole 20.

14 1~36756 shown ln F~g. 7, the ~hart 32 include~ a fla~ upper or top erl~l 39 for striki~g, a~ with a hammer, not ~hown. Str$k~ng the 6haft top end 39 cause~ the ehaft 3Z to travel through the upp~r hole 3~ and hole 35 to where the 6haft t~pere~ ~ur~ace ~lameter i~ equal to the diam~t~r a~ neck 37. Therea~t~r the body 31 Will travel with the ~haft ~uch that a ~orce applied to the ~ha~t 32 head end iB tran~mi~ed through the body 31 and d$rectly into clamp 10.
Sho~n in Fig. 6, appli¢ation of a force on th~ shaf~ 3~
head ~nd wtll be di~tributed through the bo~y unlformly onto clamp 10. Guided by the ~haft point end 38 tha~ ~ravel~
through the l~gamen~ 18 and lnto screw hole 20, the clamp pln~
15 w$11 flr~t psss through th~ l~gament and then t~avel lnto t~e pin hol~6 29 forme~ ln the bone cur~ace. Th~ clamp ~plk~s 11, ln turn, are to contaln the l~g~ment there~etween, with their end~ pa~lng into the ~pike h~lee 28 ~ormed ln ~he bone ~ur~ace, to the at~ltude shown in Fig. 8. Fig. 8 additionAlly ehows a ~crew 40 a~ having been fitt~d through cla~p hole 14 ana llgament 18 and turned $nto ~crew hole 20 of bone 16, sandwichin~ the llgament ~8 agalnst bone ~ur~ace 17.
~ ig. 8 show~ scr~ ~0 as being a ~hort ~crew.
Accordingly, the ~crew 40 will pas~ through only the one bone surface 17 or cortex. In practl~e, the number o~ ~one ~ur~ace~ or cor~eX pa~ed through i~ a m~asure of fa~tener hold~ng strength. F~;r th~ arrangement of ~lg. 8, t~e clamp 10 6trength iB judged a~ a "purcha~e o~ one cor~ex". S~ould longer ecrew 40 ~e uned w~er~ it wlll t~rn through the bone 16 and exit the oppo~$te bone eur~ace, then th~ coup~ ~ng woul~
~uall~y as A "purcha6e of two cortex", lndlcating a ~tronger coupllng.
Fig. 9 sh~w~ another embo~lment o~ a ¢hannel ligament clamp 50, herelna~ter referred to a~ clamp. Clamp 50 i8 like the above-dencribed ~lamp 10 in that it i8 pre~erably forme~
~rom a ~eotion o~ channel of titanium wherefrom sections of the paral~l channel ~idee have been removed lea~ng polnted ~pikes 51 that extend outwardly ~rom walls S2, th~ walls having a web 53 therebetw~n. Like clamp 10, the web S3 also includes a group~ng of point~d pln~ 54 that ext~nd parallel and along~lde npik~e 51, whlch pins 5~, in thl~ embodlment, are ~hown arxanged in a ~rlangular grouping. Di~tino~ from clamp 10, cla~p 50 lncluden A palr of hole~ S5 that are epaced Qguidi~tantly ~rom the web oppocite ~nde, and are each centered laterally along the w~b longitudinal axis. Each hole 55 ls to receive a ~crew-type fastener ~itted therethrough and through tbe bone surface or cortex. Accord~ngly, cla~p 50 allowR the ~urgeon, utilizing ehor~ ~o~ew~ to "purchase two cort~x," providing a hol~ trength that ~ equlvalent to use o~ clamp 10 with a long s~rew ~hat i~ pas~e~ through the bone to ~xit the oppoeite bone ~urface, or cor~ex. ~urther, ~oX added holding strength, long ~crQw~ can be ueed with clamp 50 to travel through the bone, exiting the opposlte bone urf~ce~ to provid~ for a "purcha~e Or ~our oortex".
It shoul~ be unde~etoo~ that the inetallat~on of clamp 50 i~ es~entially llke the procedure d~eorlbed ~or in~talling clamp 10 and acoordlngly the d~scusslon of the inet~llatlon of clamp ~0 ehould ~e taken a~ being ~s~en~ially the same ~or 1 336~56 clamp 50. Except, of course, th~t after locating the clamp SO
on the Pons 6urface, over th~ llgament, a first ~crew i8 turned through one hole 55, follow~d ~y the turning of a ~econd ncrew through the second hol~ 55.
While preferred embodiment~ of t~e invention ln a channel liga~ent clamp and ~y~tem have been shown and de~c~ibed herein, lt ~hould be under~too~ t~at tho present di6closure 16 made by way of example only and that var~ations to the 6tructure of t~e channel ligament clamp, tooling, ~nd procens are pos~i~le w~thin the ~cope of this di~clo6ure without departing from the ~u~ ec~ matter coming within the scope of t~e followlng claims, which ¢lal~ we regard a~ our inve~tlon.

Claims

1. A channel ligament clamp comprising, a section of channel constructed from a material suitable for human implantation having upstanding parallel spaced apart parallel spikes as the channel sides with a web therebetween, said web to fit over a ligament for attachment to a bone surface, said ligament contained between said spikes; pin means extending from said web alongside and parallel to said spikes; and at least one laterally centered hole formed through said web for receiving a screw-type fastener fitted therethrough .

2. A channel ligament clamp as recited in Claim 1, wherein the spikes and pins each have pointed ends and the pins are slightly longer than the spikes.

3. A channel ligament clamp as recited in Claim 1, wherein the pins are arranged equidistant from and along opposite sides of the web longitudinal axis in a grouping that is proximate to one web end, with the laterally centeredhole formed through said web proximate to the other web end.

4. A channel ligament clamp as recited in Claim 1, wherein the pins are arranged in a triangular pattern at approximately the web center, one pin onand the other pins straddling the web longitudinal axis; and a pair of laterallycentered holes are formed through said web, each proximate to a web end.

5. A channel ligament clamp as recited in Claim 1, wherein the channel section and pins are formed out of titanium.

6. A ligament clamp system for attaching a ligament, that is either a biologic graft or prosthetic, to a bone surface comprising, a pointed instrument for piercing a ligament that is maintained at a desired tension and location on a bone surface to score that bone surface therebelow; means for forming a right angle hole into that bone surface at that scored point; a channel ligament clamp formed for human implantation that includes parallel spikes arranged as the channel sides with a web therebetween, which web includes a plurality of pins that extend therefrom that are alongside and parallel to said spikes, and at least one laterally centered hole formed therethrough; drill guide means that includes a body with a right angle post extending therefrom, which body includes holes formed therethrough in the pattern of the channel ligament clamp pins and spikes, said drill guide means post for fitting into said hole formed in said bone, said pin and spike holes each to receive a drill turned therethrough into said bone surface; seating tool means arranged for locating said channel ligament clamp web hole over the hole through said ligament and the hole formed in the bone, and for urging, when a force is applied thereon, said channel ligament clamp pins through said ligament contained between said spikes, said pins and spike ends to enter the pin and spike holes formed in saidbone surface; and a screw-type fastener means for turning through said aligned web and ligament holes and into the hole formed in said bone, sandwiching said ligament against said bone surface.

7. A ligament clamp system as recited in Claim 6, wherein the pins are arranged in a group that is located proximate to one web end, with each pin equidistant from the web longitudinal axis.

8. A ligament clamp system as recited in Claim 7, wherein the pin grouping is a square.

9. A ligament clamp system as recited in Claim 6, wherein the channel ligament clamp web has two longitudinally aligned laterally centered holes formed therethrough separated by a grouping of pins extending therefrom .

10. A ligament clamp system as recited in Claim 9, wherein the pins are arranged in a triangle configuration with one pin located on the web longitudinal axis and the remaining pins that form the triangle are spaced equidistantly from that axis.

11. A ligament clamp system as recited in Claim 6, wherein the channel ligament clamp is fabricated out of titanium.

12. A ligament clamp system as recited in Claim 6, wherein the drill guide body means includes means for aligning its longitudinal axis with the position on the bone surface whereon the ligament will rest.

13. A ligament clamp system as recited in Claim 6, wherein the seating tool means consist of a rectangular block that includes on a lower surface, a depression formed therein that is of a shape to accommodate the channel ligament clamp nesting therein, and includes a vertical hole formed therethrough that will align with the hole formed through the web of said channel ligament clamp, which vertical hole is stepped outwardly from the lesser diameter adjacent to the depression to a greater diameter thereabove; and a shaft means that is tapered outwardly from a pointed end to where the shaft means has a diameter that is greater than lesser diameter portion of said vertical hole, and which shaft means has a flat upper end surface.

14. A ligament clamp system as recited in Claim 6, wherein the screw-type fastener is a short screw to be turned through only one bone surface.

15. A ligament clamp system as recited in Claim 6, wherein the screw-type fastener is a long screw that is to be turned through the entire bone.