SELF-REINFORCING TISSUE FIXATION

• US 20080262544A1
• Filed: 04/23/2008
• Published: 10/23/2008
• Est. Priority Date: 03/30/2005
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Burkhart, Stephen S.
• Granted Patent: US 8,465,522 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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

Abstract

Self-reinforcing mechanical systems with application to biological fixation of a first tissue (for example, soft tissue) to a second tissue (for example, bone). As a repair construct is stressed, there is a feedback mechanism (self-reinforcing) against failure that is initially triggered by early failure. The construct “detects” its early/impending failure and utilizes the potentially destructive force to reinforce itself.

Claims

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

providing a first medial row constructed with a first plurality of fixation devices, wherein 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 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;

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

forming multiple passes of the suture chain over the soft tissue; and

elastically compressing the soft tissue with the suture chain, to increase the frictional force of the suture chain relative to the soft tissue.

2. The method of claim 1, wherein the multiple passes of the suture chain have a rectangular configuration.

3. 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.

4. 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.

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

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

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

passing a flexible member through the soft tissue and over a lateral portion of the soft tissue, the flexible member being attached at one end in a hole in bone by the knotless fixation device without tying a knot; and

elastically compressing the soft tissue with the flexible member, to increase the frictional force of the flexible member relative to the soft tissue.

7. The method of claim 6, further comprising the formation of a structure of multiple passes of said flexible member over the soft tissue, wherein the structure is held in place by the fixation devices in the first and second rows.

8. The method of claim 7, wherein the flexible member of the structure is comprised of suture.

9. The method of claim 7, wherein the flexible member of the structure is comprised of suture tape.

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

passing respective strands of suture tape through respective apertures of the swivel tip of a plurality of first knotless fixation anchors;

providing a first medial row constructed with the plurality of first knotless fixation anchors with suture tape passed through the apertures of the swivel tips of the anchors, and securing the suture anchors in respective holes in bone in the first medial row;

passing a tail of the suture tape from each of the anchors of the medial row over a lateral portion of the soft tissue and loading each tail of the suture tape into an aperture in a swivel tip of a respective plurality of knotless fixation anchor in a second lateral row, and securing the respective tails of the suture tape in holes in bone in the lateral row by the knotless fixation devices without tying a knot; and

rotating the swivel tip of the suture anchors to elastically compressing the soft tissue with the suture tape, to increase the frictional force of the flexible member relative to the soft tissue.

11. The method of claim 10, further comprising the formation of a structure of multiple passes of said flexible member over the soft tissue, wherein the structure is held in place by the anchors in the first and second rows.