System and method for attaching soft tissue to bone

• US 20060004364A1
• Filed: 06/01/2005
• Published: 01/05/2006
• Est. Priority Date: 06/02/2004
• Status: Active Grant

• Current Assignee: Scott W. Tate
• Original Assignee: KFX Medical Corporation
• Inventors: Green, Michael L., Bojanowski, Bart, Tauro, Joseph C.
• Granted Patent: US 7,585,311 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• 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 2017/0408 Rivets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0422 by insertion of a separate member into the body of the anchor
• 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 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0817 Structure of the anchor

Abstract

Disclosed herein are methods and devices for securing soft tissue to a rigid material such as bone. A bone anchor is described that comprises a base and a top such that suture material may be compressed between surfaces on the base and top to secure the suture to the anchor. Also described is an inserter that can be used to insert the bone anchor into bone and move the anchor top relative to the anchor base to clamp suture material there between. Also described is a soft-tissue and bone piercing anchor and associated inserter. Methods are described that allow use of the bone anchors to provide multiple lengths of suture material to compress a large area of soft tissue against bone.

Claims

1. An anchor for securing a suture to bone, comprising:

an anchor base adapted to be securely fixed into the bone; and

a suture securing mechanism coupled to said anchor base and positioned proximally relative to said anchor base, the mechanism adapted to receive and secure a suture moved laterally into the mechanism.

2. The anchor of claim 1, wherein the anchor base comprises lateral protrusions adapted to resist removal of the anchor base from bone.

3. The anchor of claim 2, wherein the lateral protrusions include threads adapted to allow the anchor base to be screwed into bone.

4. The anchor of claim 1, wherein the suture securing mechanisms comprises at least two surfaces adapted to secure a suture by clamping the two surfaces together.

5. The anchor of claim 4, wherein the two surfaces are adapted to be positioned such that the suture can be freely moved laterally between the surfaces prior to clamping.

6. An anchor for securing a suture to bone, comprising:

an anchor base adapted to be securely fixed into the bone;

a first surface coupled to said anchor base and positioned proximally relative to said anchor base; and

a second surface coupled to said anchor base and positioned proximally relative to said anchor base, wherein the first and second surfaces are adapted to be relatively positioned in at least two configurations, one of said configurations such that a gap is present between the first and second surfaces so that the suture can be positioned between the first and second surfaces by moving the suture laterally into the gap, and the other of said configurations such that the first and second surfaces are in close proximity so that the suture can be securely clamped between the first and second surfaces.

7. The anchor of claim 6, wherein the first surface is even with or below the bone'"'"'s surface when the anchor base is securely fixed into the bone.

8. The anchor of claim 6, wherein the first surface comprises indentations and the second surface comprises protrusions adapted to fit within the first surface'"'"'s indentations.

9. The anchor of claim 6, wherein the first surface is generally proximally facing and the second surface is generally distally facing when the anchor base is securely fixed into the bone.

10. The anchor of claim 9, wherein the first surface is a proximal surface on the anchor base and the second surface is a distal surface on an anchor top adapted to couple to the anchor base.

11. The anchor of claim 6, further comprising:

a third surface; and

a fourth surface facing the third surface, wherein the third and fourth surfaces are adapted to be relatively positioned in at least two configurations, one of said relative configurations such that the fourth surface is above the bone'"'"'s surface when the anchor base is securely fixed into the bone and a gap is present between the third and fourth surfaces so that a suture can be freely passed between the third and fourth surfaces above the bone'"'"'s surface, and the other of said relative configurations such that the third and fourth surfaces are in close proximity so that a suture can be securely clamped between the third and fourth surfaces.

12. The anchor of claim 6, wherein said second surface as adapted to be positioned above the bone'"'"'s surface when the anchor base is securely fixed into the bone and when a gap is present between the first and second surfaces such that the suture can be positioned between the first and second surfaces above the bone'"'"'s surface.

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

passing a length of suture over the soft tissue;

inserting an anchor into the bone; and

securing the length of suture to the anchor after said inserting without passing an end of the length of suture through any aperture in the anchor and without tying any knots.

14. The method of claim 13, wherein said securing comprises moving the length of suture laterally into a suture securing mechanism.

15. The method of claim 13, wherein after said securing, the anchor is not inserted further into the bone.

16. The method of claim 13, wherein said inserting comprises screwing the anchor into the bone.

17. The method of claim 13, wherein said securing comprises clamping the suture between at least two surfaces on the anchor.

18. The method of claim 13, wherein said passing occurs prior to said securing.

19. The method of claim 13, wherein said passing, inserting, and securing are done arthroscopically.

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

inserting a first anchor through the soft tissue, wherein the first anchor comprises a length of suture fixedly secured to the first anchor prior to insertion;

inserting the first anchor into the bone;

passing the length of suture over the soft tissue; and

fixedly securing, after said passing, the length of suture to a second anchor.

21. The method of claim 20, further comprising, after inserting the first anchor through the soft tissue and before inserting the first anchor into the bone, moving the first anchor laterally relative to the bone so as to move the soft tissue laterally relative to the bone.

22. The method of claim 20, wherein inserting the first anchor through the soft tissue comprises directly piercing the soft tissue with the first anchor.

23. The method of claim 20, wherein inserting the first anchor into the bone comprises directly piercing the bone with the first anchor without drilling any holes.

24. The method of claim 20, wherein inserting the first anchor into the bone comprises deploying lateral protrusions on the first anchor, wherein the lateral protrusions are adapted to prevent the first anchor from being removed.

25. The method of claim 20, wherein the passing step comprises passing the length of suture over the soft tissue without the suture being coupled to the second anchor.

26. The method of claim 20, wherein said fixedly securing comprises, in order:

inserting the second anchor with the length of suture coupled thereto into the bone;

tensioning the length of suture; and

fixedly securing the length of suture to the second anchor.

27. The method of claim 26, wherein the step of inserting the second anchor comprises inserting the anchor directly into the bone without the anchor passing through the soft tissue.

28. The method of claim 20, wherein said fixedly securing comprises, in order:

inserting the second anchor with no suture coupled thereto into the bone;

tensioning the length of suture; and

fixedly securing the length of suture to the second anchor.

29. The method of claim 20, wherein the step of fixedly securing is performed without tying any knots.

30. The method of claim 20, wherein the step of fixedly securing is performed without passing the suture through any apertures in the second anchor.

31. The method of claim 20, wherein said inserting steps, passing step, and fixedly securing step are conducted arthroscopically.

32. A method of attaching soft tissue to bone, the soft tissue comprising a first surface adjacent to the bone'"'"'s surface and a second surface opposite the first surface, the method comprising:

inserting a first portion of a length of suture into the second surface of the soft tissue;

passing a second portion of the length of suture over the second surface of the soft tissue;

inserting a first anchor with no suture coupled thereto into the bone; and

fixedly securing the length of suture to the inserted first anchor, with the proviso that no part of the first portion of the length of suture is passed out of the second surface of the soft tissue.

33. The method of claim 32, wherein said first portion of the length of suture is fixedly secured to a second anchor and said step of inserting the first portion into the second surface comprises inserting the second anchor into the second surface.

34. The method of claim 33, further comprising after inserting the second anchor into the second surface, moving the second anchor laterally relative to the bone so as to move the soft tissue laterally relative to the bone and then inserting the second anchor into the bone.

35. The method of claim 32, wherein the step of fixedly securing is performed without tying any knots.

36. The method of claim 32, further comprising, prior to the fixedly securing step, tensioning the length of suture.

37. The method of claim 36, wherein the tensioning comprises a user grasping the suture and pulling.

38. The method of claim 37, wherein while pulling, the suture is contacting the first anchor.

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

inserting a first anchor with a length of suture pre-coupled thereto through the soft tissue;

inserting the first anchor into the bone;

inserting a second anchor with no suture coupled thereto into bone;

passing the length of suture over the soft tissue; and

fixedly securing the length of suture to the inserted second anchor.

40. The method of claim 39, further comprising, after inserting the first anchor through the soft tissue and before inserting the first anchor into the bone, moving the first anchor laterally relative to the bone so as to move the soft tissue laterally relative to the bone.

41. The method of claim 39, further comprising, after inserting the first anchor into the bone, fixedly securing the pre-coupled length of suture to the first anchor.

42. The method of claim 39, wherein inserting the first anchor into the bone comprises deploying lateral protrusions on the first anchor, wherein the lateral protrusions are adapted to prevent the first anchor from being removed.

43. The method of claim 39, wherein the step of fixedly securing is performed without tying any knots.

44. The method of claim 39, further comprising prior to the fixedly securing step, tensioning the length of suture.

45. The method of claim 44, wherein the tensioning comprises a user grasping the length of suture and pulling.

46. The method of claim 45, wherein while pulling, the suture is contacting the second anchor.

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

inserting a first, second, and third anchor into the bone;

fixedly securing a first length of suture over the soft tissue to the first and second anchors; and

fixedly securing a second length of suture over the soft tissue to the first and third anchors.

48. The method of claim 47, wherein the first anchor is positioned beneath the soft tissue and the second and third anchors are positioned laterally to the soft tissue.

49. The method of claim 48, wherein the first and second lengths of sutures are fixedly secured to the first anchor prior to insertion into the bone.

50. The method of claim 48, wherein inserting the first anchor comprises directly piercing the soft tissue with the first anchor, moving the first anchor laterally relative to the bone so as to move the soft tissue laterally relative to the bone, and directly piercing the bone with the first anchor without drilling any holes.

51. The method of claim 48, wherein inserting the first anchor comprises deploying lateral protrusions on the first anchor, wherein the lateral protrusions are adapted to prevent the first anchor from being removed.

52. The method of claim 48, wherein while inserting the first anchor, the first and second lengths of suture are not coupled to the second or third anchors.

53. The method of claim 47, wherein the first anchor is positioned laterally to the soft tissue and the second and third anchors are positioned beneath the soft tissue.

54. The method of claim 53, wherein the first and second lengths of suture are fixedly secured to the second and third anchors prior to insertion into the bone.

55. The method of claim 53, wherein inserting the second and third anchors comprises directly piercing the soft tissue with the second and third anchors, moving the second and third anchors laterally relative to the bone so as to move the soft tissue laterally relative to the bone, and directly piercing the bone with the second and third anchors without drilling any holes.

56. The method of claim 53, wherein inserting the second and third anchors comprises deploying lateral protrusions on the second and third anchors, wherein the lateral protrusions are adapted to prevent the second and third anchors from being removed.

57. The method of claim 53, wherein while inserting the second and third anchors, the first and second lengths of suture are not coupled to the first anchor.

58. The method of claim 47, further comprising:

tensioning the first length of suture prior to fixedly securing the first length of suture; and

separately tensioning the second length of suture prior to fixedly securing the second length of suture.

59. An anchor for securing a suture to bone, said anchor comprising:

an anchor base adapted to be securely fixed into the bone, said anchor base comprising a first proximal surface; and

an anchor top, said anchor top comprising a distal member coupled to said anchor base and a first proximal member comprising a first distal surface, wherein said anchor top is adapted to couple to said anchor base in at least two configurations, one of said configurations such that said first distal surface is above the bone'"'"'s surface when said anchor base is securely fixed into the bone, such that a suture can be freely passed between said first proximal and first distal surfaces above the bone'"'"'s surface, and the other of said configurations such that said first distal surface is in close proximity to said first proximal surface, such that a suture can be securely clamped between said first proximal and first distal surfaces.

60. The anchor of claim 59, wherein the anchor base comprises an axial bore adapted to receive the distal member of the anchor top.

61. The anchor of claim 60, wherein the axial bore comprises lateral protrusions and the distal member of the anchor top comprises indentations adapted to engage the lateral protrusions for inhibiting proximal movement of the distal member relative to the axial bore.

62. The anchor of claim 59, wherein the first proximal surface comprises indentations and the first distal surface comprises protrusions adapted to fit within the first proximal surface'"'"'s indentations.

63. The anchor of claim 59, wherein the anchor top further comprises a second proximal member comprising a second distal surface and wherein the first proximal member comprises a second proximal surface, wherein the first and second proximal members are adapted to be positioned relative to each other in at least two configurations, one of said relative configurations such that a gap is present between the second proximal and second distal surfaces so that a suture can be freely passed between the second proximal and second distal surfaces above the bone'"'"'s surface, and the other of said relative configurations such that the second proximal and second distal surfaces are in close proximity so that a suture can be securely clamped between the second proximal and second distal surfaces.

64. An anchor for securing a suture to bone, said anchor comprising:

a substantially hollow cylinder comprising an open end and comprising a portion of its walls cut in such a manner so as to allow the cylinder to deform under stress and form lateral protrusions;

a substantially pointed tip coupled to the cylinder opposite the open end, wherein the pointed tip is adapted to pierce the bone; and

a suture receiver coupled to said pointed tip and positioned within the substantially hollow cylinder so that a suture may be attached to the suture receiver and extend through the cylinder and out of the open end.

65. The anchor of claim 64, wherein the lateral protrusions consist of two protrusions opposite each other.

66. The anchor of claim 64, further comprising a stress inducing member coupled to the tip and extending through the cylinder and out of the open end, wherein the cylinder is adapted to deform when force is applied to pull the stress inducing member proximally out of the cylinder.

67. The anchor of claim 66, wherein after the cylinder has deformed, the stress inducing member is adapted to break free from the tip upon continued application of force.

68. The anchor of claim 66, wherein the stress inducing member is a wire.

69. The anchor of claim 64, wherein the suture receiver comprises an eyelet.

70. The anchor of claim 69, wherein the suture receiver is dimensioned such that when the suture passes through the eyelet, the suture is securely clamped between the suture receiver and the hollow cylinder.