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

• US 20070027476A1
• Filed: 08/09/2006
• Published: 02/01/2007
• Est. Priority Date: 02/07/2005
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: ReGen Biologics Incorporated
• Inventors: Harris, Stephen, Nelson, Nadine
• Granted Patent: US 8,128,640 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 17/0467 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 2017/0417 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 that includes 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 body portion operatively connected to the needle at a distal end of the body portion. The body portion has a lumen. The system also includes a pusher configured to rotate and slide within the lumen of the body portion and the longitudinal extending bore of the needle. The pusher has first and second stop surfaces, each of which is constructed and arranged to engage a proximal end of the body portion.

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;

a body portion operatively connected to the needle at a distal end of the body portion, the body portion having a lumen;

a pusher configured to rotate and slide within the lumen of the body portion and the longitudinal extending bore of the needle, the pusher having a first stop surface and a second stop surface,

the first stop surface of the pusher being constructed and arranged to engage a proximal end of the body portion after the first anchor has been discharged from the needle by the pusher to prevent the pusher from discharging the second anchor, and

the second stop surface of the pusher being constructed and arranged to engage the proximal end of the body portion after the second anchor has been discharged from the needle by the pusher.

2. The system according to claim 1, wherein the needle comprises a cutting surface at the open end for cutting the flexible portion of the suture, 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.

3. The system according to claim 2, wherein the flexible portion of the suture is aligned with the cutting surface when the second stop surface engages the second end of the body portion.

4. 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 when the pusher is moved relative to the cutting surface.

5. The system according to claim 1, wherein the pusher further comprises a third stop surface, the third stop surface being constructed and arranged to engage the proximal end of the body portion and to prevent the first anchor from being discharged from the needle by the pusher.

6. The system according to claim 5, wherein the pusher comprises a stopper, a hollow rod connected to the stopper, a first projection projecting from the rod, and a second projection projecting from the rod, the first and second projections being spaced from each other, and wherein the first projection defines the first stop surface, the stopper defines the second stop surface, and the second projection defines the third stop surface.

7. The system according to claim 6, wherein the proximal end of the body portion comprises an opening constructed and arranged to receive the first projection when the first projection is aligned with the opening so as to allow the first projection to be received by the bore in the body portion.

8. The system according to claim 7, wherein the opening is also constructed and arranged to receive the second projection after the first projection has been received by the bore in the body portion so as to allow the second projection to be received by the bore in the body portion.

9. The system according to claim 7, wherein the opening is shaped as a keyhole.

10. The system according to claim 6, wherein the first projection is axially spaced from the second projection.

11. The system according to claim 10, wherein the first projection is radially spaced from the second projection at an angle.

12. The system according to claim 11, wherein the angle is about 90°

.

13. 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;

pushing a pusher in a first orientation to a first position relative to the needle to deliver 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;

rotating the pusher from the first orientation to a second orientation relative to the needle;

pushing the pusher in the second orientation to a second position relative to the needle to deliver 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;

retracting the needle from the meniscus and the implant;

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 with the pusher; and

rotating the pusher from the second orientation relative to the needle to cut the flexible portion of the suture at a location adjacent the self-locking slide knot.

14. The method according to claim 13, wherein said pushing the pusher the self-locking slide knot and said rotating the pusher from the second orientation are completed without removing the needle from the body.

15. The method according to claim 13, further comprising rotating the pusher from a third orientation to the first orientation before said pushing the pusher to the first position.

16. The method according to claim 13, wherein the method is completed without removing the needle from the body.

17. 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 extending bore and an open end, the bore being configured to receive the first anchor and the second anchor;

a body portion operatively connected to the needle at a distal end of the body portion, the body portion having a lumen;

a pusher configured to slide and rotate within the lumen of the body portion and the longitudinal bore of the needle, the pusher having a first stop surface and a second stop surface,

the first stop surface of the pusher being constructed and arranged to engage a proximal end of the body portion after the first anchor has been discharged from the needle by the pusher to prevent the pusher from discharging the second anchor, and

the second stop surface of the pusher being constructed and arranged to engage the proximal end of the body portion after the second anchor has been discharged from the needle by the pusher.

18. The applicator according to claim 17, wherein the needle comprises a cutting surface at the open end for cutting the flexible portion of the suture, 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.

19. The applicator according to claim 18, wherein the flexible portion of the suture is aligned with the cutting surface when the second stop surface engages the second end of the body portion.

20. The applicator according to claim 18, 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 when the pusher is moved relative to the cutting surface.

21. The applicator according to claim 17, wherein the pusher further comprises a third stop surface, the third stop surface being constructed and arranged to engage the proximal end of the body portion and to prevent the first anchor from being discharged from the needle by the pusher.

22. The applicator according to claim 21, wherein the pusher comprises a stopper, a hollow rod connected to the stopper, a first projection projecting from the rod, and a second projection projecting from the rod, the first and second projections being spaced from each other, and wherein the first projection defines the first stop surface, the stopper defines the second stop surface, and the second projection defines the third stop surface.

23. The applicator according to claim 22, wherein the proximal end of the body portion comprises an opening constructed and arranged to receive the first projection when the first projection is aligned with the opening so as to allow the first projection to be received by the bore in the body portion.

24. The applicator according to claim 23, wherein the opening is also constructed and arranged to receive the second projection after the first projection has been received by the bore in the body portion so as to allow the second projection to be received by the bore in the body portion.

25. The applicator according to claim 23, wherein the opening is shaped as a keyhole.

26. The applicator according to claim 22, wherein the first projection is axially spaced from the second projection.

27. The applicator according to claim 26, wherein the first projection is radially spaced from the second projection at an angle.

28. The applicator according to claim 27, wherein the angle is about 90°

.