Method and Apparatus for Coupling Soft Tissue to Bone

• US 20110270306A1
• Filed: 07/13/2011
• Published: 11/03/2011
• Est. Priority Date: 11/05/2004
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Bonnarens, Frank O., Denham, Gregory J., Stone, Kevin T.
• Granted Patent: US 8,551,140 B2
• Time in Patent Office: Days
• US Class Current: 606/228
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• 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
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• 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 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular
• CPC Class Codes: A61B 2017/0641 : having at least three legs as part of one single body
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0829 : without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
• CPC Class Codes: A61F 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0864 : Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• CPC Class Codes: A61F 2002/087 : Anchor integrated into tendons, e.g. bone blocks, integrated rings
• CPC Class Codes: A61F 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• CPC Class Codes: A61F 2002/0888 : Anchor in or on a blind hole or on the bone surface without formation of a tunnel
• CPC Class Codes: Y10T 29/49826 : Assembling or joining

Abstract

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction.

Claims

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

determining an area of the bone to couple a first anchor and a second anchor, wherein;

(i) the first anchor includes a first bone engaging feature, a first aperture, and a first suture member, the first suture member including a braided body disposed in the first aperture and defining a longitudinally extending passage, and a first end extending from the braided body and passing through the passage and the first aperture so as to place the first end outside of the passage, and define an adjustable first loop, and (ii) the second anchor includes a second bone engaging feature and a first coupling feature;

forming a first hole in the area;

forming a second hole in the area adjacent to the first hole;

positioning the first anchor in the first hole;

positioning the second anchor in the second hole;

coupling the first loop to the soft tissue; and

coupling the first loop to the first coupling feature.

2. The method according to claim 1, further comprising passing the first loop through the soft tissue.

3. The method according to claim 2, further comprising passing the first loop through the soft tissue prior to coupling the first loop to the first coupling feature.

4. The method according to claim 3, further comprising:

passing the first end through the first loop; and

passing the first end through the soft tissue.

5. The method according to claim 1, further comprising looping the first loop around the soft tissue.

6. The method according to claim 5, further comprising looping the first loop around the soft tissue prior to coupling the first loop to the first coupling feature.

7. The method according to claim 1, wherein the first coupling feature includes a hook configured to receive the first loop, and wherein coupling the first loop to the first coupling feature includes coupling the first loop to the hook.

8. The method according to claim 1, further comprising adjusting a size of the first loop to compress the soft tissue against the bone by pulling on the first end of the first suture member.

9. The method according to claim 1 further comprising tensioning the first loop to compress the soft tissue against the bone by pulling on the first end of the first suture member.

10. The method according to claim 1, wherein the first suture member further includes a second end extending from the braided body and passing through the passage and the first aperture so as to place the second end outside of the passage, and define an adjustable second loop, the method further comprising:

passing the soft tissue through the second loop; and

adjusting a size of the second loop to compress the soft tissue against the bone by pulling on the second end.

11. The method according to claim 1, wherein the first anchor further includes a second coupling feature and a second end extending from the braided body and passing through the passage and the first aperture so as to place the second end outside of the passage, and define a self-locking, adjustable second loop, the method further comprising:

coupling the second loop to the soft tissue; and

coupling the second loop to one of the first coupling feature or the second coupling feature.

12. The method according to claim 1, wherein the first suture member further includes a second end extending from the braided body and passing through the passage and the first aperture so as to place the second end outside of the passage, and define an adjustable second loop, the method further comprising:

coupling the second loop to a third anchor in the bone adjacent to the first anchor.

13. A method of coupling a soft tissue to a bone, comprising:

determining an area of the bone to couple a first anchor, a second anchor, and a third anchor, wherein;

(i) the first anchor includes a first bone engaging feature and a first suture member coupled to the first anchor and forming an adjustable first loop, (ii) the second anchor includes a second bone engaging feature, a first coupling feature, and a second suture member coupled to the second anchor and forming an adjustable second loop; and

(iii) the third anchor includes a third bone engaging feature and a second coupling feature;

positioning the first anchor, the second anchor, and the third anchor in the bone adjacent to each other in the area;

coupling the first loop to the soft tissue and to the first coupling feature of the second anchor; and

coupling the second loop to the soft tissue and to the second coupling feature of the third anchor.

14. The method according to claim 13, further comprising passing the second loop through the first loop.

15. The method according to claim 13, further comprising passing at least one of the first loop or the second loop through the soft tissue.

16. The method according to claim 13, further comprising looping at least one of the first loop or the second loop around the soft tissue.

17. The method according to claim 13, further comprising:

adjusting a first size of the first loop to compress the soft tissue against the bone by pulling on a first end of the first suture member; and

adjusting a second size of the second loop to compress the soft tissue against the bone by pulling on a second end of the second suture member.

18. The method according to claim 13, further comprising passing the soft tissue through the first loop and the second loop.

19. The method according to claim 13, wherein:

the first suture member includes;

(i) a first aperture, (ii) a first braided body disposed in the first aperture and defining a longitudinally extending first passage, and (iii) a first end extending from the first braided body and passing through the first passage and the first aperture so as to place the first end outside of the first passage, and define the first loop; and

the second suture member includes;

(i) a second aperture, (ii) a second braided body disposed in the second aperture and defining a longitudinally extending second passage, and (iii) a second end extending from the second braided body and passing through the second passage and the second aperture so as to place the second end outside of the second passage, and define the second loop.

20. A method of coupling a soft tissue to a bone, comprising:

determining an area of the bone to couple a first anchor, a second anchor, and a third anchor wherein;

(i) the first anchor includes a first bone engaging feature, a first aperture, and a first suture member, the first suture member including a first braided body disposed in the first aperture and defining a longitudinally extending first passage, and a first end extending from the first braided body and passing through the first passage and the first aperture so as to place the first end outside of the first passage, and define a self-locking, adjustable first loop, (ii) the second anchor includes a second bone engaging feature, a second aperture, a first hook feature, and a second suture member, the second suture member including a second braided body disposed in the second aperture and defining a longitudinally extending second passage, and a second end extending from the second braided body and passing through the second passage and the second aperture so as to place a second end outside of the second passage, and define a self-locking, adjustable second loop, and (iii) the third anchor includes a third bone engaging feature and a second hook feature;

forming a first hole, a second hole, and a third hole adjacent to each other in the area;

positioning the first anchor, the second anchor, and the third anchor in the first hole, the second hole, and the third hole, respectively;

coupling the first loop and the second loop to the soft tissue;

coupling the first loop to the first hook feature;

passing the second loop through the first loop; and

coupling the second loop to the second hook feature.

21. The method of claim 20, wherein the bone is a shoulder bone and the soft tissue is a rotator cuff, and wherein coupling the first loop and the second loop to the soft tissue includes coupling the first loop and the second loop to the rotator cuff.