Suture passer with radiused upper jaw

• US 10,004,492 B2
• Filed: 02/25/2016
• Issued: 06/26/2018
• Est. Priority Date: 11/09/2009
• Status: Active Grant

• Current Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Original Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Inventors: Hendricksen, Michael J., Murillo, Michael, Bender, Christopher P., Hirotsuka, Mark Y., Saliman, Justin D., McCutcheon, John G., Jasso, Alexander, Anastas, George V., Mina, Thomas D.
• Primary Examiner(s): Dang, Son
• Application Number:
  US15/054,072
• Publication Number:
  US 20160192926A1
• Time in Patent Office: 852 Days
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06009 having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06047 located at the middle of the needle
• CPC Class Codes: A61B 2017/2945 Curved jaws

Abstract

Described herein are suture passers that may be used for repair of the meniscus of the knee. These suture passers typically include an elongate body having a pair of arms. One or more of the arms may be radiused at the distal end region relative to the long axis of the device, to better fit between a target tissue and a body non-target tissue (e.g., the curvature of the femoral condyle). The arms may form a distal-facing opening that is configured to fit the target tissue. One arm may be movable in the axial direction (e.g., the direction of the long axis of the device), while the other arm may be bendable. A tissue penetrator may be housed within one of the arms to extend across the distal opening between the arms. Thus, a suture may be passed from a first side of the tissue to a second side.

Claims

1. A method of arthroscopically placing a suture around a tear in a meniscus from a superior surface of the meniscus to an inferior surface of the meniscus without penetrating laterally through a capsule region of the meniscus, the method comprising:

using a suture passer to pass a suture across the superior meniscus surface between the superior surface and a femur, through the meniscus on a first side of the tear, across the inferior meniscus surface between the inferior surface and a tibia, and through the meniscus on a second side of the tear; and

securing a knot in the suture.

2. The method of claim 1 wherein using the suture comprises:

extending a first arm of the suture passer into a space between the superior surface of the meniscus and the femur;

extending a second arm of the suture passer into a space between the inferior surface of the meniscus and the tibia; and

passing the suture between the first arm and second arm of the suture passer.

3. The method of claim 1 comprising entirely arthroscopically placing the suture.

4. The method of claim 1, wherein placing the suture comprises extending a tissue penetrating element in an arcuate pathway through the meniscus.

5. The method of claim 1, further comprising approaching the meniscus tear with the suture passer from an apex of the meniscus.

6. The method of claim 1, wherein securing the knot comprises securing a pre-tied knot in the suture.

7. A method of repairing a meniscus in a knee joint by arthroscopically passing a suture from a superior surface of the meniscus to an inferior surface of the meniscus, the meniscus having an apex, the superior surface adjacent a femur, and the inferior surface adjacent a tibia, the method comprising:

using a suture passer to pass a suture from a region between the superior surface of the meniscus and the femur, through the meniscus to a region between the inferior surface of the meniscus and the tibia, across the inferior surface of the meniscus, and back through the meniscus to the superior surface of the meniscus; and

securing a knot in the suture to form a loop extending through the meniscus between the inferior and superior surfaces.

8. The method of claim 7, further comprising minimally invasively positioning a distal end of the suture passer near the apex of the meniscus before passing the suture.

9. The method of claim 7, further comprising minimally invasively entering the knee joint with the suture passer from an anterior approach.

10. The method of claim 7, further comprising extending a first arm of the suture passer between the superior surface of the meniscus and the femur and extending a second arm of the suture passer between the inferior surface of the meniscus and the tibia.

11. The method of claim 7, further comprising approaching the meniscus from the apex of the meniscus.

12. The method of claim 7, wherein using the suture passer to pass the suture across the inferior surface of the meniscus comprises passing the suture radially across the inferior surface of the meniscus, to form a vertical loop around the meniscus.

13. The method of claim 7, wherein using the suture passer to pass the suture across the inferior surface of the meniscus comprises passing the suture laterally across the inferior surface of the meniscus, to form a lateral loop around the meniscus.

14. The method of claim 7, wherein using the suture comprises:

extending a first arm of the suture passer into a space between the superior surface of the meniscus and the femur;

extending a second arm of the suture passer into a space between the inferior surface of the meniscus and the tibia; and

passing the suture between the first arm and second arm of the suture passer.

15. The method of claim 7, wherein securing the knot comprises securing a pre-tied knot in the suture.

16. A method of repairing a meniscus in a knee joint by arthroscopically passing a suture from a superior surface of the meniscus to an inferior surface of the meniscus, the meniscus having an apex, the superior surface adjacent a femur, and the inferior surface adjacent a tibia, the method comprising:

using a suture passer to pass a suture from a region between the inferior surface of the meniscus and the tibia, through the meniscus, to a region between the superior surface of the meniscus and the femur, across the superior surface of the meniscus, and back through the meniscus to the inferior surface of the meniscus by extending a first arm of the suture passer into a space between the superior surface of the meniscus and the femur, extending a second arm of the suture passer into a space between the inferior surface of the meniscus and the tibia, and passing the suture between the first arm and second arm of the suture passer; and

securing a knot in the suture to form a loop extending through the meniscus between the inferior and superior surfaces.

17. The method of claim 16, wherein the suture comprises a suture.

18. The method of claim 16, wherein using the suture passer to pass the suture across the superior surface of the meniscus comprises passing the suture radially across the superior surface of the meniscus, to form a vertical loop around the meniscus.

19. The method of claim 16, wherein using the suture passer to pass the suture across the superior surface of the meniscus comprises passing the suture laterally across the superior surface of the meniscus, to form a lateral loop around the meniscus.

20. The method of claim 16, wherein securing the knot comprises securing a pre-tied knot in the suture.