Knotless fixation of tissue to bone with suture chain

• US 20070135843A1
• Filed: 02/06/2007
• Published: 06/14/2007
• Est. Priority Date: 03/30/2005
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Burkhart, Stephen
• Granted Patent: US 7,981,140 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• 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 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61L 17/04 Non-resorbable materials
• CPC Class Codes: D04C 1/12 Cords, lines, or tows
• CPC Class Codes: D10B 2509/04 Sutures

Abstract

A chain of loops of braided high strength suture for soft tissue to bone fixation. The suture chain is advantageous for use in knotless fixation of soft tissue to bone, and can be used for knotless side-to-side suturing of U-shaped defects, such as rotator cuff tears. The soft tissue to bone fixation includes: (i) providing a first medial row constructed with a first plurality of fixation devices, at least one of the first plurality of fixation devices being an anchor; (ii) providing a second lateral row constructed with a second plurality of fixation devices, at least one of the second plurality of fixation devices being a knotless fixation device, (iii) providing a suture loop construct that includes at least two loops formed of and connected by suture; and (iv) fixating the suture loop construct so that it extends over the soft tissue and is secured in place by at least one of the fixation devices or anchors.

Claims

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

providing a first medial row constructed with a first plurality of fixation devices, wherein the at least one of the first plurality of fixation devices is an anchor;

providing a second lateral row constructed with a second plurality of fixation devices, wherein the at least one of the second plurality of fixation devices is a knotless fixation device;

providing a suture chain comprising a plurality of suture loops, the suture chain being attached to the anchor of the first medial row; and

securing the suture chain at an opposite end in a hole in bone by the knotless fixation device of the second lateral row.

2. The method of claim 1, further comprising the step of forming multiple passes of the suture chain over the soft tissue.

3. The method of claim 1, wherein the multiple passes have a criss-cross configuration, an X-shaped configuration, a rectangular configuration, a trapezoidal configuration, a regular polygonal configuration or an irregular polygonal configuration.

4. The method of claim 1, further comprising the step of capturing a loop of the suture chain prior to the step of securing the suture chain in the hole in bone.

5. The method of claim 1, wherein at least one of the plurality of suture loops is formed by lacing an end of the suture through itself to form the loop.

6. The method of claim 1, wherein at least one of the plurality of suture loops has a perimeter which is approximately equal to that of another of the plurality of suture loops.

7. The method of claim 2, further comprising the step of providing an implant material adjacent to the multiple passes of suture chain.

8. The method of claim 7, wherein the step of providing an implant material further comprises:

providing aspirate bone marrow;

providing a material to be implanted in the vicinity of a repair site defined by at least the multiple passes of suture chain;

hydrating the material with aspirate bone marrow to form the implant material; and

securing the implant material at the repair site.

9. The method of claim 8, wherein the implant material is collagen or allograft.

10. The method of claim 9, wherein the implant material is porous collagen impregnated with autogenous bone marrow.

11. The method of claim 9, wherein the implant material is tendon allograft impregnated with autogenous bone marrow.

12. The method of claim 1, wherein the soft tissue is rotator cuff tendon or shoulder ligament.

13. 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 a suture chain with a plurality of suture loops, the suture chain being secured to the first anchor prior to insertion through the soft tissue;

subsequently inserting the first anchor with the attached suture chain into the bone;

passing the length of the suture chain over at least a portion of the soft tissue;

capturing a loop of the suture chain with a second anchor and inserting the second anchor with the suture chain coupled thereto into the bone;

tensioning the suture chain; and

securing the suture chain to the second anchor.

14. The method of claim 13, wherein the step of inserting the second anchor comprises inserting the anchor directly into the bone without the anchor passing through the soft tissue.

15. The method of claim 13, wherein the step of securing the suture chain to the second anchor is performed without tying any knots.

16. The method of claim 13 further comprising the step of passing the length of the suture chain over at least a portion of a material comprising collagen or allograft, the material being adjacent the at least a portion of the soft tissue.

17. The method of claim 16, wherein the material is porous collagen impregnated with bone marrow.

18. The method of claim 16, wherein the material is tendon allograft impregnated with bone marrow.

19. The method of claim 13, wherein at least one of the first and second anchors is selected from the group consisting of a forked anchor, a notched anchor, a shouldered anchor and a swivel anchor.

20. A suture assembly comprising:

a suture chain comprising a suture strand with a plurality of suture loops;

a first fixation device fixedly attached to the suture chain; and

a second fixation device un-fixedly coupled to at least one of the plurality of suture loops.

21. The suture assembly of claim 20, wherein the first fixation device is a suture anchor selected from the group consisting of a forked suture anchor, a notched suture anchor, a shouldered suture anchor and a swivel suture anchor.

22. The suture assembly of claim 20, wherein the second fixation device is a suture anchor selected from the group consisting of a forked suture anchor, a notched suture anchor, a shouldered suture anchor and a swivel suture anchor.

23. The suture assembly of claim 20, wherein the suture chain is formed of a suture material comprising ultrahigh molecular weight polyethylene.

24. A method of positioning tissue within a body, comprising the steps of:

passing a length of a suture chain through at least a portion of the soft tissue, the suture chain comprising a plurality of suture loops;

attaching the suture chain to a fixation device; and

fixating the fixation device with the attached suture chain into bone.

25. The method of claim 24, wherein the step of attaching the suture chain to the fixation device further comprises capturing a loop of the suture chain with the fixation device.

26. The method of claim 24, further comprising the step of tensioning the suture chain.

27. The method of claim 24, wherein the fixation device is a suture anchor selected from the group consisting of a forked suture anchor, a notched suture anchor, a shouldered suture anchor and a swivel suture anchor.

28. The method of claim 24, wherein at least one of the plurality of suture loops is formed by lacing an end of the suture through itself to form the loop.

29. The method of claim 24, further comprising the step of providing an implant material adjacent to the suture chain and the fixation device.

30. The method of claim 29, wherein the step of providing an implant material further comprises:

providing aspirate bone marrow;

providing a material to be implanted in the vicinity of a repair site defined by at least the suture chain and the fixation device;

hydrating the material with aspirate bone marrow to form the implant material; and

securing the implant material at the repair site.

31. The method of claim 30, wherein the implant material is collagen or allograft.

32. The method of claim 24, wherein the soft tissue is rotator cuff ligament.