Method and apparatus for attaching tissue to bone, including the provision and use of a novel knotless suture anchor system, including a novel locking element

• US 10,058,319 B2
• Filed: 10/13/2015
• Issued: 08/28/2018
• Est. Priority Date: 07/17/2009
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: Pivot Medical, Inc. (Stryker Corporation)
• Inventors: Konrath, Michael, Kaiser, William, Pandya, Sudip, Graul, Jeremy, Burley, J. Brook
• Primary Examiner(s): LYNCH, ROBERT A
• Application Number:
  US14/881,270
• Publication Number:
  US 20160128682A1
• Time in Patent Office: 1,050 Days
• 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 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0042 with special provisions for gripping
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/0403 Dowels
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0453 threaded elements, e.g. set screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/06185 hollow or tubular
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

Apparatus for securing a first object to a second object, the apparatus including an elongated body having a distal end, a proximal end, and a lumen extending between the distal and proximal end; a window extending through the side wall of the elongated body and communicating with the lumen; an elongated element extending through the lumen; and a locking element mounted to the distal end of the elongated element and disposed in the lumen; whereby, when the elongated body is disposed in a second object, and the first object extends through the window, proximal movement of the locking element causes the locking element to capture the first object to the elongated body, whereby to secure the first object to the second object; wherein the elongated element comprises a pull line terminating in a loop; and wherein the locking element comprises at least one filament extending through the loop.

Claims

1. Apparatus for securing a suture to a bone, the apparatus comprising:

an elongated body having a distal end, a proximal end, and a lumen extending between the distal end and the proximal end, the lumen comprising a distal section and a proximal section, the distal section of the lumen having a wider diameter than the proximal section of the lumen;

a window extending through the side wall of the elongated body and communicating with the lumen, the window being disposed in the vicinity of an intersection between the distal section of the lumen and the proximal section of the lumen and being sized to receive a suture therein;

an elongated element extending through the lumen of the elongated body, the elongated element comprising a proximal end and a distal end, wherein the elongated element comprises a pull line terminating in a loop; and

a locking element mounted to the distal end of the elongated element and disposed in the distal section of the lumen, wherein the locking element comprises at least one filament extending through the loop of the pull line;

whereby, when the elongated body is disposed in a bone, and the suture extends through the window and into the lumen, and the pull line is thereafter moved proximally so as to move the at least one filament proximally, proximal movement of the at least one filament causes the at least one filament to capture the suture extending through the window and into the lumen to the elongated body, whereby to secure the suture to the bone.

2. Apparatus according to claim 1 wherein the suture is configured to be attached to tissue.

3. Apparatus according to claim 1 wherein the elongated body comprises a shoulder at the intersection of the distal section of the lumen and the proximal section of the lumen, and further wherein the window is disposed distal to the shoulder.

4. Apparatus according to claim 3 wherein the elongated body comprises a second shoulder within the proximal section of the lumen, with the window being disposed proximal to the second shoulder.

5. Apparatus according to claim 1 wherein the pull line comprises a pull wire.

6. Apparatus according to claim 1 wherein the loop of the pull wire comprises a weakened section configured to break upon the application of a selected force.

7. Apparatus according to claim 6 wherein the force required to break the loop of the pull wire is greater than the force required to pull the at least one filament proximally to capture the suture to the elongated body.

8. Apparatus according to claim 6 wherein the force required to break the loop of the pull wire is less than the force required to pull the at least one filament completely through the proximal section of the lumen.

9. Apparatus according to claim 1 wherein the locking element has a diameter that is larger than the diameter of the proximal section of the lumen when the locking element is in an uncompressed state.

10. Apparatus according to claim 1 wherein the locking element is diametrically compressible.

11. Apparatus according to claim 1 wherein the at least one filament comprises a plurality of filaments.

12. Apparatus according to claim 11 wherein the size and composition of each of the plurality of filaments are selected so that the locking element formed from the plurality of filaments has the desired size, stiffness, coefficient of friction and strength for capturing the suture to the elongated body.

13. Apparatus according to claim 1 wherein the locking element comprises at least one eyelet formed in the at least one filament.

14. Apparatus according to claim 1 wherein the locking element comprises at least one knot formed in the at least one filament.

15. Apparatus according to claim 1 wherein the locking element comprises at least one relatively hard component attached to the at least one filament.

16. Apparatus according to claim 1 wherein the at least one filament comprises suture.

17. Apparatus according to claim 1 further comprising an inserter for manipulating the elongated body.

18. A method for securing a first object to a second object, the method comprising:

providing apparatus comprising;

an elongated body having a distal end, a proximal end, and a lumen extending between the distal end and the proximal end, the lumen comprising a distal section and a proximal section, the distal section of the lumen having a wider diameter than the proximal section of the lumen;

a window extending through the side wall of the elongated body and communicating with the lumen, the window being disposed in the vicinity of an intersection between the distal section of the lumen and the proximal section of the lumen and being sized to receive a first object therein;

an elongated element extending through the lumen of the elongated body, the elongated element comprising a proximal end and a distal end; and

a locking element mounted to the distal end of the elongated element and disposed in the distal section of the lumen;

wherein the elongated element comprises a pull line terminating in a loop; and

wherein the locking element comprises at least one filament extending through the loop;

extending the first object through the window;

positioning the elongated body in the second object; and

moving the locking element proximally, such that proximal movement of the locking element causes the locking element to capture the first object to the elongated body, whereby to secure the first object to the second object.

19. Apparatus for securing a suture to a bone, the apparatus comprising:

an elongated body having a distal end, a proximal end, and a lumen extending between the distal end and the proximal end;

an elongated element extending through the lumen of the elongated body, the elongated element comprising a proximal end and a distal end, wherein the elongated element comprises a pull line; and

a locking element mounted to the distal end of the elongated element and disposed in the lumen of the elongated body, wherein the locking element comprises at least one fiber, wherein the at least one fiber is coupled to the pull line;

whereby, when the elongated body is disposed in a bone, and a suture extends at least partially through the lumen of the elongated body, and the pull line is thereafter moved proximally so as to move the at least one fiber proximally, proximal movement of the at least one fiber causes the at least one fiber to capture the suture to the elongated body, whereby to secure the suture to the bone.

20. Apparatus according to claim 19 wherein the at least one fiber is formed by one from the group consisting of braiding, weaving, twisting, knitting or extruding.

21. Apparatus according to claim 19 wherein the at least one fiber is absorbable.

22. A method for securing a suture to a bone, the method comprising:

providing apparatus comprising;

an elongated body having a distal end, a proximal end, and a lumen extending between the distal end and the proximal end;

an elongated element extending through the lumen of the elongated body, the elongated element comprising a proximal end and a distal end, wherein the elongated element comprises a pull line; and

a locking element mounted to the distal end of the elongated element and disposed in the lumen of the elongated body, wherein the locking element comprises at least one fiber, wherein the at least one fiber is coupled to the pull line;

extending the suture at least partially through the lumen of the elongated body;

positioning the elongated body in the bone; and

moving the pull line proximally so as to move the at least one fiber proximally, such that proximal movement of the at least one fiber causes the at least one fiber to capture the suture to the elongated body, whereby to secure the suture to the bone.

23. A method according to claim 22 wherein the at least one fiber is formed by one from the group consisting of braiding, weaving, twisting, knitting or extruding.

24. A method according to claim 22 wherein the at least one fiber is absorbable.