Method and apparatus for coupling soft tissue to bone

• US 10,603,029 B2
• Filed: 09/13/2017
• Issued: 03/31/2020
• Est. Priority Date: 02/03/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Kaiser, Ryan A., Denham, Gregory J., Stone, Kevin T., Bonnarens, Frank O.
• Primary Examiner(s): Orkin, Alexander J
• Application Number:
  US15/703,727
• Publication Number:
  US 20180000477A1
• Time in Patent Office: 930 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/0404 Buttons
• 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 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• 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 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• 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 2002/0864 Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• CPC Class Codes: A61F 2002/087 Anchor integrated into tendons, e.g. bone blocks, integrated rings
• 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

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction.

Claims

1. A method of securing soft tissue to bone, comprising:

locating a first anchor in a bone at a first location and a second anchor in the bone at a second location that is spaced from the first location with an adjustable suture construct extending between the first anchor and the second anchor to couple the first anchor to the second anchor with a segment of soft tissue positioned under the adjustable suture construct and over the bone between the first anchor and the second anchor, the adjustable suture construct including a suture with a first free end and a second free end, the first free end extending longitudinally through a first longitudinal passage in the suture to form a first adjustable loop, the second free end extending longitudinally through a second longitudinal passage in the suture to form a second adjustable loop, wherein, with the first free end extending longitudinally through the first longitudinal passage in the suture to form the first adjustable loop and with the second free end extending longitudinally through the second longitudinal passage in the suture to form the second adjustable loop, the first free end can be pulled through the first longitudinal passage to decrease a size of the first adjustable loop without decreasing a size of the second adjustable loop and the second free end can be pulled through the second longitudinal passage to decrease a size of the second adjustable loop without decreasing a size of the first adjustable loop; and

pulling on the first free end of the suture to reduce a size of the first adjustable loop, wherein said pulling forces the segment of soft tissue against the bone.

2. The method of claim 1 further comprising pulling on the second free end of the suture to reduce a size of the second adjustable loop and force the segment of soft tissue against the bone.

3. The method of claim 1, wherein the first free end extends through the first longitudinal passage without extending through the second longitudinal passage, and wherein the second free end extends through the second longitudinal passage without extending through the first longitudinal passage.

4. The method of claim 1, wherein the first free end passes into the suture through a first aperture in the suture, extends longitudinally along the first longitudinal passage in the suture, and passes out of the suture through a fourth aperture in the suture to form the first adjustable loop, and wherein the second free end passes into the suture through a second aperture in the suture, extends longitudinally along the second longitudinal passage in the suture, and passes out of the suture through a third aperture in the suture to form the second adjustable loop, wherein the first aperture, the second aperture, the third aperture, and the fourth aperture are all separate apertures in the suture.

5. The method of claim 1, wherein the first longitudinal passage is separate from the second longitudinal passage in the suture.

6. The method of claim 1, wherein the first adjustable loop extends all the way from the first anchor to the second anchor during said pulling.

7. The method of claim 1, wherein the segment of soft tissue includes a rotator cuff.

8. A method of securing soft tissue to bone, comprising:

locating a first anchor in a bone at a first location, the first anchor having an adjustable suture construct coupled to the first anchor, the adjustable suture construct including a suture with a first free end and a second free end, the first free end passing into the suture through a first aperture in the suture, extending longitudinally along a first longitudinal passage in the suture, and passing out of the suture through a fourth aperture in the suture to form a first adjustable loop, the second free end passing into the suture through a second aperture in the suture, extending longitudinally along a second longitudinal passage in the suture, and passing out of the suture through a third aperture in the suture to form a second adjustable loop, wherein the first aperture, the second aperture, the third aperture, and the fourth aperture are all separate apertures in the suture;

locating a second anchor in the bone at a second location that is spaced from the first location;

coupling the adjustable suture construct to the second anchor; and

pulling on the first free end of the suture with the first anchor located at the first location and coupled to the adjustable suture construct and with the second anchor located at the second location and coupled to the adjustable suture construct so as to reduce a size of the first adjustable loop and force a segment of soft tissue that is positioned under the adjustable suture construct and over the bone between the first anchor and the second anchor against the bone.

9. The method of claim 8 further comprising pulling on the second free end of the suture to reduce a size of the second adjustable loop and force the segment of soft tissue against the bone.

10. The method of claim 8, wherein coupling the adjustable suture construct to the second anchor includes coupling the first adjustable loop to the second anchor.

11. The method of claim 8, wherein the first adjustable loops extends all the way from the first anchor to the second anchor during said pulling.

12. The method of claim 8, wherein the adjustable suture construct is coupled to the second anchor after the second anchor is located in the bone at the second location.

13. The method of claim 8, wherein the first longitudinal passage is separate from the second longitudinal passage in the suture.

14. The method of claim 8, wherein, with the first free end extending through the first longitudinal passage in the suture to form the first adjustable loop and with the second free end extending through the second longitudinal passage in the suture to form the second adjustable loop, the first free end can be pulled through the first longitudinal passage to decrease a size of the first adjustable loop without decreasing a size of the second adjustable loop and the second free end can be pulled through the second longitudinal passage to decrease the size of the second adjustable loop without decreasing the size of the first adjustable loop.

15. The method of claim 8, wherein the first free end extends through the first longitudinal passage without extending through the second longitudinal passage, and wherein the second free end extends through the second longitudinal passage without extending through the first longitudinal passage.

16. The method of claim 8, wherein the segment of soft tissue includes a rotator cuff.

17. The method of claim 8, wherein in bone is in the ankle.

18. A method of securing soft tissue to bone, comprising:

locating a first anchor in a bone at a first location with an adjustable suture construct that is coupled to the first anchor extending from the first anchor and through a soft tissue that is positioned over the bone so that at least part of the adjustable suture construct is positioned along an outer surface of the soft tissue, the adjustable suture construct including a suture with a first free end and a second free end, the first free end extending longitudinally through a first longitudinal passage in the suture to form a first adjustable loop, the second free end extending longitudinally through a second longitudinal passage in the suture to form a second adjustable loop, the first free end extending through the first longitudinal passage without extending through the second longitudinal passage, the second free end extending through the second longitudinal passage without extending through the first longitudinal passage;

locating a second anchor in the bone at a second location that is spaced from the first location;

coupling the adjustable suture construct to the second anchor; and

pulling on the first free end of the suture with the first anchor located at the first location and coupled to the adjustable suture construct and with the second anchor located at the second location and coupled to the adjustable suture construct so as to reduce a size of the first adjustable loop, wherein said pulling forces a segment of the soft tissue that is positioned under the adjustable suture construct and over the bone between the first anchor and the second anchor against the bone.

19. The method of claim 18 further comprising pulling on the second free end of the suture to reduce a size of the second adjustable loop and force the segment of soft tissue against the bone.

20. The method of claim 18, wherein the adjustable suture construct is coupled to the second anchor after the second anchor is located in the bone at the second location.

21. The method of claim 18, wherein, with the first free end extending longitudinally through the first longitudinal passage in the suture to form the first adjustable loop and with the second free end extending longitudinally through the second longitudinal passage in the suture to form the second adjustable loop, the first free end can be pulled through the first longitudinal passage to decrease a size of the first adjustable loop without decreasing a size of the second adjustable loop and the second free end can be pulled through the second longitudinal passage to decrease the size of the second adjustable loop without decreasing the size of the first adjustable loop.

22. The method of claim 18, wherein the first free end passes into the suture through a first aperture in the suture, extends longitudinally along the first longitudinal passage in the suture, and passes out of the suture through a fourth aperture in the suture to form the first adjustable loop, and wherein the second free end passes into the suture through a second aperture in the suture, extends longitudinally along the second longitudinal passage in the suture, and passes out of the suture through a third aperture in the suture to form the second adjustable loop, wherein the first aperture, the second aperture, the third aperture, and the fourth aperture are all separate apertures in the suture.