Transosseous suture anchor method

• US 10,143,462 B2
• Filed: 07/29/2016
• Issued: 12/04/2018
• Est. Priority Date: 08/04/2015
• Status: Active Grant

• Current Assignee: Crossroads Extremity Systems, Llc (Johnson & Johnson)
• Original Assignee: kator, LLC
• Inventors: Fallin, T. Wade, Helgerson, Joel
• Primary Examiner(s): NGUYEN, TUAN VAN
• Application Number:
  US15/224,284
• Publication Number:
  US 20170035552A1
• Time in Patent Office: 858 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 17/06133 of parallelepipedal shape, e.g. made of rectangular or slightly oval panels
• CPC Class Codes: A61B 2017/0053 Loading magazines or sutures into applying tools
• 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 2017/0412 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 lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0425 the anchor or the separate member comprising threads, e.g. a set screw in the anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 2090/0807 Indication means
• CPC Class Codes: A61B 90/92 coded with colour
• 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 2002/0882 Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone

Abstract

Methods are disclosed for attaching a suture to a bone. One exemplary method includes passing a portion of a suture through a bone so that a first portion of the suture extends from a first opening in the bone and a second portion of the suture extends from a second opening in the bone, passing the second portion of the suture through a portion of a suture anchor body in a proximal to distal direction, the suture anchor body having a proximal end and a distal end, passing the second portion of the suture alongside an outer surface of the suture anchor body in a distal to proximal direction, and then inserting the suture anchor into the bone through one of the first and second openings, the distal end being inserted first through the opening.

Claims

1. A method of attaching a suture to a bone, comprising:

passing a portion of a suture through a bone so that a first portion of the suture extends from a first opening in the bone and a second portion of the suture extends from a second opening in the bone;

passing the second portion of the suture through a portion of a suture anchor body in a proximal to distal direction, the suture anchor body having a proximal end and a distal end;

passing the second portion of the suture alongside an outer surface of the suture anchor body in a distal to proximal direction; and

then inserting the suture anchor into the bone through one of the first and second openings, the distal end being inserted first through the opening.

2. The method of claim 1 wherein the step of passing the second portion of the suture longitudinally through a portion of a suture anchor body in a proximal to distal direction comprises engaging the second portion of the suture with a first suture threader and pulling the suture threader through the anchor, the first suture threader being preloaded on the suture anchor.

3. The method of claim 1 further comprising passing the first portion of the suture longitudinally through a portion of the suture anchor body in a distal to proximal direction.

4. The method of claim 3 wherein the step of passing the first portion of the suture longitudinally through a portion of the suture anchor body in a distal to proximal direction comprises engaging the second portion of the suture with a second suture threader and pulling the suture threader through the anchor, the second suture threader being preloaded on the suture anchor.

5. The method of claim 1 further comprising after inserting the suture anchor into a hole in the bone, advancing a locking member into the suture anchor to lock the suture to the anchor.

6. The method of claim 4 further comprising before advancing the locking member, tensioning the suture.

7. The method of claim 4 wherein a proximal member is joined to the proximal end of the anchor by a frangible connection, the method further comprising after advancing the locking member, separating the proximal member and anchor at the frangible connection.

8. The method of claim 7 wherein the proximal member includes a hole through a sidewall adjacent the frangible portion and the suture extends through the hole, further wherein separating the proximal member and anchor transforms the hole into a distally opening slot and releases the suture distally from the slot.

9. A method of attaching a suture to a bone, comprising:

disengaging a first portion of a suture extending from a distal end of a suture anchor from a suture keeper, a second portion of the suture extending from a proximal end of the suture anchor being joined to the suture keeper;

then passing the first suture portion through a patient'"'"'s body tissue;

then inserting the suture anchor body into a hole in a bone; and

then separating the suture keeper from the second portion of the suture.

10. The method of claim 9 wherein the second portion includes at least first and second strands of suture, the first strand being joined to a first portion of the suture keeper and the second strand being joined to a second portion of the suture keeper, the method further comprising independently tensioning the first and second strands.

11. The method of claim 9 further comprising sliding the suture anchor over the first portion of suture away from the suture keeper while the second portion remains joined to the suture keeper.

12. A method of attaching soft tissue to bone, comprising:

passing a tube through a portal in a patient'"'"'s skin, the tube having a suture passing through it;

passing the suture through a soft tissue;

splitting the tube to free the suture from the tube; and

anchoring the suture to a bone.

13. A method of attaching a suture to a bone, comprising:

providing a suture anchor having a proximal end, a distal end, a longitudinal passage extending within the suture anchor in a proximal to distal direction, a first opening communicating with the longitudinal passage nearer the proximal end than the distal end, a second opening through the sidewall of the suture anchor nearer the distal end than the proximal end, and a third opening through the sidewall of the suture anchor nearer the distal end than the proximal end, a first suture threader extending within the longitudinal passage between the first and third openings, the first suture threader extending through the first opening to a grip portion outside of the longitudinal passage, the first suture threader extending through the third opening to a suture engaging portion outside of the longitudinal passage, a second suture threader extending within the longitudinal passage between the first and second openings, the second suture threader extending through the first opening to a suture engaging portion outside of the longitudinal passage, the second suture threader extending through the second opening to a grip portion outside of the longitudinal passage;

passing a portion of a suture through a bone so that a first portion of the suture extends from a first opening in the bone and a second portion of the suture extends from a second opening in the bone;

engaging the first portion of the suture with the first suture threader;

pulling on the grip portion of the first suture threader to pass the first portion of the suture through the longitudinal passage in a distal to proximal direction;

engaging the second portion of the suture with the second suture threader;

pulling on the grip portion of the second suture threader to pass the second portion of the suture through the longitudinal passage in a proximal to distal direction; and

then inserting the suture anchor into the bone through one of the first and second openings, the distal end being inserted first through the opening.

14. The method of claim 13 further comprising:

passing the second portion of the suture through soft tissue;

tying a knot in the second portion of the suture outside of a patient'"'"'s body; and

pulling on the first portion of the suture to move the knot nearer to the soft tissue.

15. The method of claim 13 further comprising:

passing the first portion of the suture through a tube;

placing the tube and first portion of the suture through a portal in the patient'"'"'s body;

splitting the tube to free the suture laterally from the tube.

16. The method of claim 13 further comprising passing the second portion alongside an outer surface of the anchor in a distal to proximal direction.

17. The method of claim 13 further comprising advancing a locking member in the longitudinal passage to secure the suture within the longitudinal passage.

18. The method of claim 17 wherein a proximal member is joined to the proximal end of the anchor by a frangible connection, the proximal member housing the locking member, the step of advancing the locking member comprising pressing the locking member from the proximal member into the longitudinal passage, the method further comprising after advancing the locking member, separating the proximal member and anchor at the frangible connection.

19. The method of claim 18 wherein advancing the locking member comprises actuating an inserter to press the locking member in a first direction while applying a counterforce to the proximal member in a second direction opposite the first direction, and wherein separating the proximal member and anchor comprises further actuating the inserter to break the frangible connection.