Method and apparatus for attaching connective tissues to bone using a knotless suture anchoring device

• US 20020128684A1
• Filed: 06/07/2001
• Published: 09/12/2002
• Est. Priority Date: 02/12/2001
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: Opus Medical, Inc. (Smith & Nephew PLC)
• Inventors: Foerster, Seth A.
• Granted Patent: US 6,770,076 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• 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 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 2017/042 plastically deformed during insertion
• 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: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0864 Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• CPC Class Codes: A61F 2002/0882 Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• 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 device for attaching connective tissue to bone has a longitudinal axis and comprises an annular toggle member and a body member disposed distally of the toggle member, such that there is an axial space between the toggle member and the body member. The toggle member is movable between an undeployed position wherein the toggle member has a smaller profile in a direction transverse to the axis and a deployed position wherein the toggle member has a larger profile in the direction transverse to the axis. When installed in a desired procedural site, in suitable bone, suturing material extends axially through a center aperture in the annular toggle member, without being secured to or contacting the toggle member. This approach permits a suture attachment which lies entirely beneath the cortical bone surface, and which further permit the attachment of suture to the bone anchor without the necessity for tying knots, which is particularly arduous and technically demanding in the case of arthroscopic procedures.

Claims

1. A bone anchor device for attaching connective tissue to bone, said device having a longitudinal axis and comprising:

a toggle member;

a body member disposed distally of the toggle member, such that there is an axial space between said toggle member and said body member; and

a connecting portion disposed in said axial space and joining said toggle member to said body member;

said toggle member being movable between an undeployed position wherein said toggle member has a smaller profile in a direction transverse to said axis and a deployed position wherein said toggle member has a larger profile in said direction transverse to said axis;

said connecting portion deforming when said toggle member is moved from said undeployed position to said deployed position such that said axial space is reduced in length.

2. The bone anchor device as recited in claim 1, wherein said body member is tubular.

3. The bone anchor device as recited in claim 1, wherein said connecting portion comprises a strut having a proximal end joined to said toggle member and a distal end joined to said body member.

4. The bone anchor device as recited in claim 3, wherein said connecting portion comprises a pair of struts.

5. The bone anchor device as recited in claim 1, wherein said toggle member comprises a ring.

6. The bone anchor device as recited in claim 5, wherein said ring is elliptical.

7. The bone anchor device as recited in claim 1, wherein said toggle member is disposed at an acute angle relative to said axis in said undeployed position, and is disposed in a substantially transverse orientation relative to said axis in said deployed position.

8. The bone anchor device as recited in claim 1, wherein said connecting portion is formed of a biocompatible relatively ductile material.

9. The bone anchor device as recited in claim 8, wherein said biocompatible relatively ductile material comprises annealed metal.

10. The bone anchor device as recited in claim 1, wherein a transverse dimension of said toggle member in the undeployed position is substantially the same or less than a transverse dimension of said body member.

11. The bone anchor device as recited in claim 10, wherein said transverse dimension of said toggle member in the deployed position is substantially greater than the transverse dimension of said body member.

12. The bone anchor device as recited in claim 1, and further comprising a mandrel disposed proximally of said toggle member.

13. The bone anchor device as recited in claim 1, and further comprising a casing extending axially through said toggle member.

14. The bone anchor device as recited in claim 13, wherein said casing has a distal end disposed distally of said toggle member which is attached to said body member.

16. The bone anchor device as recited in claim 15, and further comprising a body member disposed distally of said toggle member, such that there is an axial space between said toggle member and said body member, and a connecting portion disposed in said axial space and joining said toggle member to said body member.

17. The bone anchor device as recited in claim 16, wherein said connecting portion deforms when said toggle member is rotated from said undeployed position to said deployed position, such that said axial space is reduced in length.

18. The bone anchor device as recited in claim 16, wherein said connecting portion comprises a strut having a proximal end joined to said toggle member and a distal end joined to said body member.

20. The apparatus as recited in claim 19, and further comprising a connecting portion disposed in said axial space and joining said toggle member to said body member, said connecting portion deforming when said toggle member is moved from said undeployed position to said deployed position, such that said axial space is reduced in length.

21. The apparatus as recited in claim 19, and further comprising a mandrel disposed proximally of said toggle member.

22. The apparatus as recited in claim 19, and further comprising suturing material extending axially through a center aperture in said annular toggle member.

23. The apparatus as recited in claim 22, wherein said suturing material is not secured in any way to said annular toggle member.

24. The apparatus as recited in claim 22, wherein said suturing material does not contact said annular toggle member.

27. The apparatus as recited in claim 26, wherein said suture return member comprises a fixed shaft.

28. The apparatus as recited in claim 26, wherein said suture return member comprises a rotatable shaft.

29. The apparatus as recited in claim 26, wherein said bone anchoring member comprises a toggle member.

30. The apparatus as recited in claim 29, wherein in said undeployed position said toggle member has a smaller profile in a direction transverse to said axis and in said deployed position the toggle member has a larger profile in said direction transverse to said axis.

31. The apparatus as recited in claim 30, said toggle member being disposed proximally of said anchor body such that there is an axial space between the toggle member and the anchor body.

32. The apparatus as recited in claim 31, wherein when said toggle member is moved from said undeployed position to said deployed position the axial space is reduced in length.

33. The apparatus as recited in claim 31, and further comprising a connecting portion disposed in said axial space and joining said toggle member to said anchor body.

34. The apparatus as recited in claim 33, wherein said connecting portion comprises a strut having a proximal end joined to said toggle member and a distal end joined to said anchor body.

35. The apparatus as recited in claim 34, wherein said connecting portion comprises a pair of struts.

37. The method as recited in claim 36, and further comprising a step of fastening the two free ends of the length of suture with respect to the anchor body without knots.

38. The method as recited in claim 36, wherein the soft tissue is a tendon, and the body cavity is formed in a bone.

39. The method as recited in claim 36, wherein the step of fixing the anchor body with respect to the body cavity comprises forming the body cavity, passing the anchor body into the body cavity, and radially expanding anchoring structure on the anchor body.

40. The method as recited in claim 39, wherein the body cavity is formed in bone and the anchoring structure is provided on a proximal end of the anchor body so as to engage the cortical layer of the bone and to prevent proximal removal of the anchor body from the cylindrical tunnel.

41. The method as recited in claim 40, wherein the anchoring structure comprises a deployable toggle member.

15. A bone anchor device for attaching soft tissue to bone, said device having a longitudinal axis and comprising a toggle member being rotatable from an undeployed position wherein said toggle member has a smaller profile in a direction transverse to said axis and a deployed position wherein said toggle member has a larger profile in said direction transverse to said axis, said toggle member having no structure for attaching suture material thereto.

19. Apparatus for attaching connective tissue to bone, said apparatus having a longitudinal axis and comprising:

an annular toggle member; and

a body member disposed distally of the toggle member, such that there is an axial space between said toggle member and said body member;

said toggle member being movable between an undeployed position wherein said toggle member has a smaller profile in a direction transverse to said axis and a deployed position wherein said toggle member has a larger profile in said direction transverse to said axis.

25. Apparatus for attaching connective tissue to bone, said apparatus having a longitudinal axis and comprising:

a toggle member;

a body member disposed distally of the toggle member, such that there is an axial space between said toggle member and said body member;

said toggle member being movable between an undeployed position wherein said toggle member has a smaller profile in a direction transverse to said axis and a deployed position wherein said toggle member has a larger profile in said direction transverse to said axis; and

a connecting portion disposed in said axial space and joining said toggle member to said body member.

26. Apparatus for attaching connective tissue to bone, comprising:

an anchor body having a longitudinal axis and having an anchoring structure for fixing the anchor body within a body cavity, the anchor body having a proximal end, a distal end, and a lumen opening at the proximal end, the anchor body further including a suture return member disposed therein such that a length of suture may be introduced into the lumen from the proximal end, looped around the suture return member, and passed out of the lumen through the proximal end;

a suture locking plug movable within the lumen from a first position to a second position; and

a bone anchoring member attached to said anchor body and movable between an undeployed position and a deployed position.

36. A method of using suture to secure soft tissue with respect to a body cavity, comprising:

passing a length of suture material through soft tissue so that a loop of suture material is disposed in the soft tissue, resulting in two free ends;

providing an anchor body having an open proximal end and a lumen, and a suture return member disposed in the anchor body;

passing the two free ends of the length of suture into the lumen of the anchor body through the open proximal end, and looping them about the suture return member such that the two free ends of the suture extend proximally from the lumen through said open proximal end;

fixing the anchor body with respect to the body cavity; and

tensioning the loop of suture material by pulling on one or both of the two free ends of the length of suture, to approximate the soft tissue with respect to the body cavity as desired.

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

disposing an anchor body having a longitudinal axis and having a length of suture secured therein within a bore disposed in a portion of bone; and

deploying a toggle member attached to a proximal end of the anchor body from an undeployed position wherein said toggle member has a smaller profile in a direction transverse to said axis to a deployed position wherein said toggle member has a larger profile transverse to said axis, such that the toggle member fixes the anchor body axially relative to the portion of bone.

43. The method as recited in claim 42, wherein a connecting portion joins said toggle member to said anchor body, and is disposed in an axial space between said toggle member and said anchor body, said deploying step including deforming said connecting portion as said toggle member is moved from said undeployed position to said deployed position.

44. The method as recited in claim 42, and further comprising the steps of:

tensioning the loop of suture material by pulling on one or both of the two free ends of the length of suture, to approximate the soft tissue with respect to the body cavity as desired; and

fastening the two free ends of the length of suture with respect to the anchor body without knots.