System and method for all-inside suture fixation for implant attachment and soft tissue repair

• US 20060178680A1
• Filed: 02/07/2006
• Published: 08/10/2006
• Est. Priority Date: 02/07/2005
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: ReGen Biologics Incorporated
• Inventors: Harris, Stephen Vaughan, Nelson, Nadine Beverly
• Granted Patent: US 8,808,309 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• 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 2017/0474 Knot pushers
• 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 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061

Abstract

A system for repairing a meniscus includes a suture including a first anchor, a second anchor, and a flexible portion connecting the first anchor and the second anchor. The flexible portion includes a self-locking slide knot between the first anchor and the second anchor. The system also includes a needle having a longitudinal extending bore and an open end. The bore is configured to receive the first anchor and the second anchor. The system further includes a pusher configured to be movable within the bore of the needle. The pusher is configured to (1) discharge the first anchor and the second anchor, and (2) push the self-locking slide knot after the discharge of the second anchor.

Claims

1. A system for repairing a meniscus comprising:

a suture including a first anchor, a second anchor, and a flexible portion connecting the first anchor and the second anchor, the flexible portion including a self-locking slide knot between the first anchor and the second anchor;

a needle having a longitudinal extending bore and an open end, the bore being configured to receive the first anchor and the second anchor; and

a pusher configured to be movable within the bore of the needle, the pusher being configured to (1) discharge the first anchor and the second anchor, and (2) push the self-locking slide knot after the discharge of the second anchor.

2. The system according to claim 1, further comprising a cutting surface for cutting the flexible portion of the suture.

3. The system according to claim 2, wherein the needle comprises the cutting surface at the open end, and wherein the pusher is configured to align the flexible portion of the suture with the cutting surface and move relative to the cutting surface so as to cut the flexible portion of the suture.

4. The system according to claim 2, wherein the cutting surface is disposed on a cutting sheath that at least partially surrounds the needle, and wherein the cutting sheath is configured to move relative to the needle so as to cut the flexible portion of the suture.

5. The system according to claim 2, wherein the pusher comprises a hollow rod with a pair of slots, the slots being configured to expose a portion of the flexible portion of the suture so that the exposed portion is cut against the cutting surface.

6. The system according to claim 1, wherein the needle includes a dimple adjacent to the open end, the dimple being configured to locate the first anchor and the second anchor prior to discharge from the needle.

7. The system according to claim 1, further comprising a spacer for positioning the pusher relative to the needle, the spacer being configured to limit movement of the pusher when the first anchor is being discharged.

8. A method for repairing a meniscus comprising:

providing a system for repairing a meniscus, the system comprising;

(i) a suture including a first anchor, a second anchor, and a flexible portion connecting the first anchor and the second anchor, the flexible portion including a self-locking slide knot between the first anchor and the second anchor;

(ii) a needle having a longitudinal extending bore and an open end, the bore being configured to receive the first anchor and the second anchor; and

(iii) a pusher configured to be movable within the bore of the needle, the pusher being configured to (1) discharge the first anchor and the second anchor, and (2) push the self-locking slide knot after the discharge of the second anchor;

providing an implant;

passing the needle of said system through the implant and the meniscus at a first location to deliver the first anchor to an opposite side of the meniscus;

retracting the needle from the meniscus and the implant;

passing the needle of said system through the implant and the meniscus at a second location to deliver the second anchor to the opposite side of the meniscus; and

pushing the self-locking slide knot to a surface of the implant.

9. The method according to claim 8, wherein said opposite side of the meniscus is the meniscus rim.

10. The method according to claim 9, wherein the delivered first anchor sits against the meniscus rim and is not embedded in said meniscus, and wherein the delivered second anchor sits against the meniscus rim and is not embedded in said meniscus.

11. The method according to claim 10, wherein the length of the flexible portion is minimized so that the second anchor sits against the meniscus rim.

12. The method according to claim 8, wherein said pushing includes advancing a distal end of the pusher beyond the open end of the needle.

13. The method according to claim 8, wherein the implant comprises collagen.

14. The method according to claim 8, wherein the implant comprises a collagen-based meniscus implant.

15. The method according to claim 8, wherein said system further comprises a cutting surface, and wherein said method further comprises cutting the flexible portion of the suture against the cutting surface.

16. The method according to claim 15, wherein the needle comprises the cutting surface and the pusher is configured to align the flexible portion of the suture with the cutting surface, and wherein said cutting comprises moving the pusher relative to the cutting surface so as to shear the flexible portion of the suture against the cutting surface.

17. The method according to claim 15, wherein the system further comprises a cutting sheath comprising the cutting surface that at least partially surrounds the needle, and wherein said cutting comprises moving the cutting sheath relative to needle so as to shear the flexible portion of the suture against the cutting surface.

18. The method according to claim 15, wherein said pushing and said cutting are completed without removing the needle or the pusher from the body in between said pushing and said cutting.

19. A method for repairing a meniscus in a body with an implant and a suture, the method comprising:

inserting a needle through the implant and the meniscus at a first location;

delivering a first anchor of the suture to an opposite side of the meniscus;

retracting the needle from the meniscus and the implant;

inserting the needle through the implant and the meniscus at a second location;

delivering a second anchor of the suture to the opposite side of the meniscus, the second anchor being connected to the first anchor with a flexible portion of the suture; and

pushing a self-locking slide knot located along the flexible portion between the first anchor and the second anchor to a surface of the implant,

wherein said delivering the second anchor and said pushing the self-locking knot are completed without removing the needle from the body.

20. The method according to claim 19, further comprising

cutting the flexible portion of the suture at a location adjacent the self-locking slide knot.

21. The method according to claim 20, wherein said pushing and said cutting are completed without removing the needle from the body in between said pushing and said cutting.

22. The method according to claim 20, wherein said cutting comprises shearing the flexible portion of the suture against a cutting surface disposed on the needle.

23. The method according to claim 20, wherein said cutting comprises moving a cutting sheath that at least partially surrounds the needle and shearing the flexible portion of the suture against a cutting surface disposed on the cutting sheath.

24. A method for repairing a tear in a meniscus in a body with a suture, the method comprising:

inserting a needle through the meniscus at a first location;

delivering a first anchor of the suture to an opposite side of the meniscus;

retracting the needle from the meniscus;

inserting the needle through the meniscus at a second location on an opposite side of the tear as the first location;

delivering a second anchor of the suture to the opposite side of the meniscus, the second anchor being connected to the first anchor with a flexible portion of the suture; and

pushing a self-locking slide knot located along the flexible portion between the first anchor and the second anchor to a surface of the meniscus,

wherein said delivering the second anchor and said pushing the self-locking knot are completed without removing the needle from the body.

25. The method according to claim 24, further comprising

cutting the flexible portion of the suture at a location adjacent the self-locking slide knot.

26. The method according to claim 25, wherein said pushing and said cutting are completed without removing the needle from the body in between said pushing and said cutting.

27. The method according to claim 25, wherein said cutting comprises shearing the flexible portion of the suture against a cutting surface disposed on the needle.

28. The method according to claim 25, wherein said cutting comprises moving a cutting sheath that at least partially surrounds the needle and shearing the flexible portion of the suture against a cutting surface disposed on the cutting sheath.

29. An applicator for delivering a suture for repairing a meniscus in a body, the suture comprising a first anchor, a second anchor, and a flexible portion that connects the first anchor to the second anchor, the applicator comprising:

a needle having a longitudinal bore, the longitudinal bore being configured to receive the first anchor and the second anchor;

a pusher for pushing the first anchor and the second anchor out of the longitudinal bore of the needle, the pusher being configured to receive the flexible portion therein and expose a portion of the flexible portion of the suture; and

a cutting surface configured to cut the suture.

30. An applicator according to claim 29, wherein the applicator is configured to shear the exposed portion of the suture against the cutting surface.

31. An applicator according to claim 30, wherein the cutting surface is located on the needle and the pusher is configured to shear the exposed portion of the suture against the cutting surface.

32. An applicator according to claim 30, further comprising a cutting sheath at least partially surrounding the needle, wherein the cutting surface is located on the cutting sheath and the cutting sheath is configured to shear the exposed portion of the suture against the cutting surface.