METHODS AND DEVICES FOR REPAIRING AND ANCHORING DAMAGED TISSUE

• US 20110022084A1
• 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 LLC (Johnson & Johnson)
• Inventors: DiMatteo, Kristian, Fifolt, Douglas Allen, Whittaker, Gregory R., Capobianco, Mark A., Sengun, Mehmet Ziya, Story, Brooks J.
• Granted Patent: US 8,814,903 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 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 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• 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
• CPC Class Codes: A61B 2017/2901 Details of shaft

Abstract

Methods and devices are provided for repairing a tear in a meniscus. A pair of fixation member each entailing a preformed knot configuration coupled together by a suture length. The fixation members are placed on the meniscal tissue with the suture length spanning the tear, the knot configurations are expanded to form anchoring knots and the suture length is shortened to close the tear.

Claims

1. A meniscal repair apparatus comprising:

a first fixation member and a second fixation member;

a suture length coupled to the first and second fixation members;

means associated with the suture length for shortening the suture length between the first fixation member and the second fixation member;

wherein the first fixation member comprises a first preformed knot configuration along a portion of the suture length and the second fixation member comprises a second preformed knot configuration along another portion of the suture length; and

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

2. The meniscal repair apparatus of claim 1 wherein the meniscal repair apparatus is sterile and packaged in a bacterial proof enclosure.

3. The meniscal repair apparatus of claim 1 wherein the meniscal repair apparatus is formed of biologically compatible materials.

4. The meniscal repair apparatus of claim 1 wherein at least one of the first fixation member and the second fixation member are formed of the suture length.

5. The meniscal repair apparatus of claim 1 wherein at least one of the first fixation member and the second fixation member comprise a separate piece of suture intertwined with the suture length.

6. The meniscal repair apparatus of claim 1 wherein the means associated with the suture length for shortening the suture length comprises a slip knot.

7. The meniscal repair apparatus of claim 5 wherein one of the first fixation member and the second fixation member is positioned on a loop of the suture length and wherein the slip knot is configured to allow the loop to be shortened.

8. The meniscal repair apparatus of claim 7 wherein the slip knot is located at one of the first fixation member and second fixation member.

9. The meniscal repair apparatus of claim 8 wherein the slip knot is formed by passing a portion of the suture length through of the first preformed knot configuration and second preformed knot configuration.

10. The meniscal repair apparatus of claim 1 wherein the first minimum diameter is at least five times larger than the first maximum diameter.

11. The meniscal repair apparatus of claim 1 wherein the first minimum diameter is at least ten times larger than the first maximum diameter.

12. The meniscal repair apparatus of claim 1 and further comprising instructions for use which include the steps of placing the first fixation member at a first location on a meniscus adjacent to a tear in the meniscus, placing the second fixation member at a second location on the meniscus adjacent to the tear, passing the suture length across the tear and shortening the suture length to close the tear.

13. A method of repairing a tear in a meniscus comprising the steps of:

placing a first fixation member, which comprises a first preformed knot configuration and which is coupled to a suture length, at a first location adjacent the tear in the meniscus;

placing a second fixation member, which comprises a second preformed knot configuration which is coupled to the suture length spaced apart from the first fixation member, at a second location adjacent the tear in the meniscus with the suture length passing through the meniscus and across the tear;

expanding the first preformed knot configuration into a first anchoring knot;

expanding the second preformed knot configuration into a second anchoring knot; and

shortening the length of suture between the first fixation member and the second fixation member to close the tear.

14. The method of claim 13 wherein a portion of the length of suture between the fist fixation member and the second fixation member comprises a loop having a slip knot and wherein the step of shortening the length of suture between the first fixation member and the second fixation member comprising sliding the slip knot so as to at least partially close the loop.

15. The method of claim 14 wherein the slip knot is located at one of the first fixation member or second fixation member and does not move from that location during the step of sliding the slip knot.

16. The method of claim 13 wherein the meniscus has a first surface facing a femur and a second surface facing laterally or medially and away from the femur and wherein the first location and the second location are chosen on the second surface.

17. The method of claim 16 wherein the length of suture is passed over a portion of the first surface.

18. The method of claim 17 wherein the step of placing the first fixation member at a first location member comprises passing a cannulated needle through the meniscus from the first surface to the second surface and ejecting the first fixation member at the first location.

19. The method of claim 18 wherein the step of expanding the first preformed knot configuration comprises tensioning a suture tail extending therefrom with respect to the first preformed knot.

20. The method of claim 19 and further comprising placing an abutment associated with the cannulated needle against the first preformed knot while tensioning the suture tail.

21. The method of claim 19 wherein the suture tail comprises the suture length.