METHOD AND SYSTEM FOR MENISCAL REPAIR USING SUTURE IMPLANT CINCH CONSTRUCT

• US 20090228042A1
• Filed: 03/03/2009
• Published: 09/10/2009
• Est. Priority Date: 03/04/2008
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Koogle,, David C. JR., Goradia, Vipool K., Jolly, Jacob A., Albertorio, Ricardo
• Granted Patent: US 8,961,538 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0496 for tensioning sutures

Abstract

Systems and methods for repairing tears in soft tissue, e.g., meniscal tissue, by employing cinch stitching. More specifically, the present invention provides apparatus and methods for meniscal repair using a suture implant construct. The suture implant construct includes a first and second implant which are connected to each other via a length of suture. The implants are designed to be loaded on external surfaces of the first and second trocars.

Claims

1. A system for repairing tears in soft tissue, comprising:

a first anchoring member connected to a second anchoring member by a flexible strand; and

a driver assembly for inserting the first and second anchoring members within soft tissue to be repaired.

2. The system of claim 1, wherein the driver assembly comprises:

an actuating mechanism comprising a body having a proximal end and a distal end, a handle attached to the proximal end, and an elongated shaft extending from the distal end of the body; and

a pair of substantially parallel first push rod and second push rod positioned within the longitudinal pathway of the body of the actuating mechanism, wherein the first anchoring device is configured to be mounted on an exterior surface of the first push rod, and wherein the second anchoring device is configured to be mounted on an exterior surface of the second push rod.

3. The system of claim 2, wherein the first anchoring device is configured to be deployed into the soft tissue to be repaired, from the exterior surface of the first push rod, and in response to operation of the actuating mechanism.

4. The system of claim 2, wherein the second anchoring device is configured to be deployed into the soft tissue to be repaired, from the exterior surface of the second push rod, and in response to operation of the actuating mechanism.

5. The system of claim 2, wherein the elongated shaft of the actuating mechanism is provided with a bent section at its most distal end.

6. The system of claim 1, wherein each of the first and second anchoring members is an implant having an elongated cylindrical body with a cannulation having a diameter about equal to the diameter of each of the first and second push rods, to allow mounting of the cylindrical body on the first and second push rods.

7. The system of claim 1, wherein the flexible strand passes through a cannulation of each of the first and second anchoring members.

8. The system of claim 1, wherein the flexible strand connects the first and second anchoring members by a sliding knot.

9. The system of claim 1, wherein the flexible strand is a suture strand.

10. The system of claim 1, wherein the flexible strand is FiberWire.

11. The system of claim 1, wherein the tear in the soft tissue is a meniscal tear or a tear in labral tissue.

12. A suture implant construct for meniscal repairs, comprising:

a first implant configured to be mounted on an external surface of a first trocar; and

a second implant mounted on an external surface of a second trocar,

wherein each of the first and second implants is provided with a through hole extending in a direction about parallel to the longitudinal axis of the first and second implants, to allow a strand of suture to be inserted therethrough,

and wherein the first implant is connected to the second implant by the strand of suture.

13. The suture implant construct of claim 12, wherein, when released from the first trocar, the first implant is configured to flip about 90 degrees to become secured on the exterior surface of the meniscus.

14. The suture implant construct of claim 12, wherein, when released from the second trocar, the second implant is configured to flip about 90 degrees to become secured on the exterior surface of the meniscus.

15. A surgical fastener apparatus, comprising:

a first implant mounted on an end of a first trocar;

a second implant mounted on an end of a second trocar;

a depth stop provided with a first and second openings configured to allow each of the first and second trocars to be received therein; and

a delivery mechanism comprising a body having a proximal end and a distal end, a handle attached to the proximal end, and an elongated shaft extending from the distal end of the body, the elongated shaft being configured to receive the first and second trocars and to allow sequential deployment of the first and second implants within tissue to be repaired.

16. The apparatus of claim 15, wherein the first implant is mounted on an exterior surface of the first trocar, and the second implant is mounted on an exterior surface of the second trocar.

17. The apparatus of claim 15, wherein the first implant is connected to the second implant by at least one strand of flexible material.

18. The apparatus of claim 15, wherein the first implant is connected to the second implant by at least one knot of a strand of flexible material.

19. A method of repairing a tear of a meniscus in a joint, comprising:

providing a pair of substantially parallel first push rod and second push rod in the vicinity of the tear, the first push rod having mounted thereon a first implant and the second push rod having mounted thereon a second implant, the first implant being attached to the second implant by at least a strand of flexible material;

deploying the first implant across the meniscal tear and inserting the first implant in a first location distal to the meniscal tear; and

subsequently, deploying the second implant across the meniscal tear and inserting the second implant in a second location distal to the meniscal tear, the second location being adjacent the first location.

20. The method of claim 19, wherein the first and second implant are positioned about parallel to a longitudinal axis of the meniscal tear.

21. The method of claim 19, wherein the first and second implant are positioned about perpendicular to a longitudinal axis of the meniscal tear.

22. The method of claim 19, wherein the step of inserting the first implant in the first location further comprises flipping of the first implant for about 90 degree at the first location.

23. The method of claim 19, wherein the step of inserting the second implant in the second location further comprises flipping of the second implant for about 90 degree at the second location.

24. A method of approximating tissue, comprising:

providing a first anchoring member at a first location in the tissue, and a second anchoring member at a second location in the tissue, the first location being adjacent the second location, wherein the first anchoring member is connected to the second anchoring member by a strand of flexible material and a sliding knot.

25. The method of claim 24, wherein the step of providing the first anchoring member at the first location, and the second anchoring member at the second location further comprises:

mounting the first and second anchoring members on a pair of substantially parallel first push rod and second push rod; and

sequentially deploying of the first and second anchoring members within the tissue.

26. The method of claim 25, wherein the first and second anchoring members are deployed within the tissue in a vertical orientation relative to the tissue.

27. The method of claim 25, wherein the first and second anchoring members are deployed within the tissue in a horizontal orientation relative to the tissue.