Knotless suture or tissue fixation using an implant having a pointed tip

• US 10,052,091 B2
• Filed: 02/12/2013
• Issued: 08/21/2018
• Est. Priority Date: 06/22/2000
• Status: Expired due to Fees

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Dreyfuss, Peter J., Burkhart, Stephen S., ElAttrache, Neil S.
• Primary Examiner(s): BUI, VY Q
• Application Number:
  US13/765,218
• Publication Number:
  US 20130150885A1
• Time in Patent Office: 2,016 Days
• Field of Search: 606 73, 606 75, 606104, 606139, 606144, 606232
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8645 Headless screws, e.g. ligament interference screws
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61F 2/0805 Implements for inserting tendons or ligaments
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0835 with deformation of anchor parts, e.g. expansion of dowel by set screw
• CPC Class Codes: A61F 2002/0852 Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A method for securing soft tissue to bone which does not require the surgeon to tie suture knots to secure the tissue to the bone. Suture is passed through the tissue at desired points. A cannulated plug or screw is pre-loaded onto the distal end of a driver provided with an eyelet implant at its distal end. Suture attached to the tissue is passed through the eyelet of the implant located at the distal end of the driver. The distal end of the driver together with the eyelet implant is inserted into the bone. Tension is applied to the suture to position the tissue at the desired location relative to the bone. The screw or plug is advanced into the pilot hole by turning the interference screw or tapping the plug until the cannulated screw or plug securely engages and locks in the eyelet implant, so that the cannulated plug or screw with the engaged eyelet implant is flush with the bone. Once the screw or plug is fully inserted and the suture is secured in the bone, the driver is removed and any loose ends of the sutures protruding from the anchor site are then clipped short.

Claims

1. A system for interference fixation of a suture in bone, comprising:

a driver including a shaft having a proximal end and a distal end;

an interference device situated on the shaft, the interference device having a length and an outer surface configured to engage bone; and

an implant releasably attached near the distal end of the shaft with a spacing between the implant and the interference device, the spacing corresponding to the length of the interference device, a portion of the shaft being co-extensive with the spacing and exposed along the spacing, the implant having a suture-accommodating aperture for receiving a suture, the suture-accommodating aperture being aligned generally perpendicular to an axis between the proximal end and the distal end, the implant having a conical portion terminating in a pointed tip at its most distal end configured to establish a hole in bone for receiving the interference device;

wherein the driver includes a handle near the proximal end of the shaft, a portion of the handle being configured to be malleted to advance the implant in an insertion direction into bone without predrilling a hole in the bone and wherein the handle is manipulatable to advance the interference device in the insertion direction toward the implant into a suture securing position where the interference device secures the suture in the bone.

2. The system of claim 1, wherein the interference device is a screw.

3. The system of claim 1, wherein the interference device is a plug.

4. The system of claim 1, wherein the aperture of the implant has an eyelet configuration.

5. The system of claim 1, wherein

the shaft comprises an inner shaft at least partially received within an outer shaft;

and

the implant is releasably attached to the inner shaft by a connector portion of the implant that fits within the distal end of the inner shaft.

6. The system of claim 1, wherein

the shaft includes an outer shaft disposed around an inner shaft and movable between a proximal position and a distal position along the inner shaft;

the interference device is loaded onto the inner shaft by inserting the inner shaft through a cannula of the interference device with the outer shaft retracted to the proximal position so that the proximal end of the loaded interference device abuts the distal end of the outer shaft; and

the handle is manipulatable to cause the outer shaft to advance from the proximal position to the distal position to advance the interference device toward the implant.

7. The system of claim 1, wherein the driver is useable in a first mode for urging the implant into bone and in a second mode for urging the interference device into bone.

8. The system of claim 1, wherein the interference device wedges suture between the interference device and bone.

9. The system of claim 1, wherein the interference device wedges suture in place to secure the suture without tying any knots.

10. The system of claim 1, wherein

the conical portion of the implant has a proximal end;

the proximal end of the conical portion defines a largest outside diameter of the implant; and

the spacing is determined between the proximal end of the conical portion and the interference device.

11. A surgical device, comprising:

a driver including a shaft having a proximal end and a distal end, the driver including a handle near the proximal end of the shaft;

a suture anchor situated at least partially on the driver, the suture anchor having a length; and

an implant releasably attached near the distal end of the shaft with a spacing between the implant and the suture anchor, the spacing corresponding to the length of the suture anchor, a portion of the shaft being co-extensive with the spacing and exposed along the spacing, the implant having a suture-accommodating aperture for receiving a suture, the suture-accommodating aperture being transverse to an insertion direction, the implant having a conical portion terminating in a pointed tip at its most distal end configured to establish a hole in bone for receiving the suture anchor;

wherein a portion of the handle is configured to be malleted to advance the implant in the insertion direction into bone without predrilling a hole in the bone and the handle is manipulatable to advance the suture anchor in the insertion direction toward the implant into a suture securing position where the suture anchor secures the suture in the bone.

12. The surgical device of claim 11, wherein

the suture anchor wedges suture in place relative to bone resulting from the driver causing the suture anchor to move away from the proximal end toward the aperture of the implant.

13. The surgical device of claim 11, wherein the suture anchor wedges suture between the suture anchor and bone.

14. The surgical device of claim 11, wherein the suture anchor comprises a screw.

15. The surgical device of claim 11, wherein the suture anchor comprises a plug.

16. The surgical device of claim 11, wherein the aperture of the implant has an eyelet configuration.

17. The surgical device of claim 11, wherein

the shaft comprises an inner shaft at least partially received within an outer shaft;

and

the implant is releasably attached to the inner shaft by a connector portion of the implant that fits within a tubing near the distal end of the inner shaft.

18. The surgical device of claim 11, wherein the shaft includes an outer shaft disposed around an inner shaft and movable between a proximal position and a distal position along the inner shaft, and wherein the suture anchor is loaded onto the inner shaft by inserting the inner shaft through a cannula of the suture anchor with the outer shaft retracted to the proximal position so that the proximal end of the loaded suture anchor abuts a distal end of the outer shaft.

19. The surgical device of claim 11, wherein the driver is useable in a first mode for urging the implant into bone and in a second mode for urging the suture anchor into bone.

20. The surgical device of claim 11, wherein

the generally conical portion of the implant has a proximal end;

the proximal end of the conical portion defines a largest outside diameter of the implant; and

the spacing is determined between the proximal end of the generally conical portion and the suture anchor.