METHODS AND DEVICES FOR REPAIRING AND ANCHORING DAMAGED TISSUE

• US 20110022083A1
• Filed: 07/24/2009
• Published: 01/27/2011
• Est. Priority Date: 07/24/2009
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: Whittaker, Gregory R., DiMatteo, Kristian, Fifolt, Douglas Allen, Capobianco, Mark A., Sengun, Mehmet Ziya, Story, Brooks J.
• Granted Patent: US 8,828,053 B2
• Time in Patent Office: Days
• US Class Current: 606/228
• 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 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• 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 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• 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
• CPC Class Codes: A61B 2017/2901 Details of shaft

Abstract

Methods and devices are provided for anchoring suture to tissue, incorporating anchoring devices constructed substantially from suture. The anchoring devices are constructed as longitudinally extended, preformed knot configurations that upon deployment are reconfigured to form anchoring knots having an increased cross-section relative to the preformed knot configuration, for secure lodging in tissue. The anchoring devices are suitable for single and multi-anchor surgical procedures in soft tissue or bone, and multiple anchors can be delivered using a single delivery device.

Claims

1. A method for anchoring a suture length to a material internal to a human or another animal, the method comprising the steps of:

providing

positioning into an opening in a portion of the material a preformed knot configuration which is located on a first portion of a suture length, the preformed knot configuration having a first length and first cross-sectional area along the first portion of the suture length; and

reconfiguring the preformed knot configuration into an anchoring knot by reducing the first length and increasing the cross-sectional area, thereby engaging the anchoring knot against the material.

2. A method according to claim 1 wherein the material is a body tissue of the human or other animal.

3. The method of claim 2 wherein the body tissue is a humerus in a shoulder, and the preformed knot configuration is passed through substantially overlying soft tissue before the positioning into the opening.

4. A method according to claim 1 wherein the material is an implant anchored to a body tissue of the living organism.

5. The method of claim 4 wherein the implant is a cannulated, externally threaded screw.

6. A method according to claim 1 wherein the step of reconfiguring the preformed knot configuration comprises tensioning a second portion of the suture length with respect to the preformed knot configuration.

7. A method according to claim 6 wherein the material comprises a first face and an opposite second face, the opening penetrating the first face and through the second face and wherein the step of moving the suture length relative to the abutment comprises pushing the preformed knot configuration through the opening to form the expanded configuration abutting the second face.

8. A method according to claim 1 wherein the step of reconfiguring the preformed knot configuration comprises placing an abutment against the preformed knot configuration and moving the suture length relative to the abutment to cause the preformed knot configuration to bunch up and increase in cross sectional area.

9. The method according to claim 8 wherein the material comprises meniscal tissue in a knee.

10. A method according to claim 1 wherein the step of positioning the preformed knot configuration into the opening comprises penetrating the material with a needle having a longitudinal cannulation, the preformed knot configuration being disposed within the cannulation.

11. A method according to claim 1 wherein the anchoring knot has a cross-sectional area at least ten times the first cross-sectional area.

12. A method according to claim 1 wherein the preformed knot configuration is reconfigured to the anchoring knot within the material.

13. A method according to claim 1 wherein the preformed knot configuration is reconfigured to the anchoring knot after passing through the material.

14. A method according to claim 1 wherein the preformed knot configuration and the suture length are formed from a single line of suture.

15. A method according to claim 1 wherein the portion of the line of suture forming the knot configuration has the same structure and material as the portion of the line of suture forming the suture length.

16. A method according to claim 1 wherein the portion of the line of suture forming the preformed knot configuration differs in at least one of structure and material from the portion of the line of suture forming the suture length.

17. A method for anchoring a suture length to tissue, the method comprising the steps of:

fixing an implant body to the tissue, the implant body having an external surface, and at least one fixation member extending from the external surface to fix the implant body to the tissue;

fixing the implant body to the tissue with the at least one fixation member;

positioning a preformed knot configuration into the opening, the preformed knot configuration having a first cross-sectional area; and

reconfiguring the preformed knot configuration to form an anchoring knot having a second cross-sectional area greater than the first cross-sectional area, thereby engaging the anchoring knot against the implant body.

18. A suture unit for anchoring in human tissue, the suture unit comprising:

a suture length;

a first preformed knot configuration along a portion of the suture length,

wherein the first preformed knot configuration has a maximum diameter along the suture length and is reconfigurable into a first anchoring knot having a minimum diameter that is at least three times larger than the maximum diameter.

19. A suture unit according to claim 18 wherein the first preformed knot configuration and the suture length are formed from a single line of suture.

20. A suture unit according to claim 18 wherein the portion of the line of suture forming the first preformed knot configuration has the same structure and material as the portion of the line of suture forming the suture length.

21. A suture unit according to claim 18 wherein the portion of the line of suture forming the first preformed knot configuration differs in at least one of structure and material from the portion of the line of suture forming the suture length.

22. A suture unit according to claim 18 wherein the first preformed knot configuration comprises a separate piece of suture intertwined with a portion of the suture length.

23. A suture unit according to claim 18 and wherein at least a portion of the suture length is formed into a loop closed with a sliding knot along the suture length.

24. A suture unit according to claim 18 wherein the sliding knot is positioned within the first preformed knot configuration.

25. A suture unit according to claim 18 and further comprising a second preformed knot configuration reconfigurable into a second anchoring knot having a minimum diameter which is at least three times larger than the second preformed knot configuration maximum diameter.

26. An assembly for repairing tissue, the assembly comprising:

a length of suture, a first preformed knot configuration formed along a portion of the length, the preformed knot configuration having a proximal end, a distal end, a head length therebetween, and a head diameter along the head length, the preformed knot configuration being reconfigurable to an anchoring knot having a knot diameter at least three times greater than the head diameter;

a delivery needle having a proximal end, a distal end and a cannulation therebetween, the first preformed knot configuration being slidably disposed within the cannulation;

a piston slidably disposed within the cannulation proximal of the preformed knot configuration, the piston being adapted for pushing the preformed knot configuration distally from the cannulation.