MENISCUS REPAIR

• US 20120283750A1
• Filed: 09/28/2011
• Published: 11/08/2012
• Est. Priority Date: 05/06/2011
• Status: Active Grant

• Current Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Original Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Inventors: Saliman, Justin D., Culbert, Brad S., Jasso, Alexander, Hendricksen, Michael J., McCutcheon, John G., Bender, Chris P., Murillo, Michael
• Granted Patent: US 9,861,354 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• 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 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06009 having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
• CPC Class Codes: A61B 2017/06014 spring-loaded
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft

Abstract

Methods for repairing a meniscus, and particularly a torn meniscus. A method of repairing a meniscus may include using a suture passer to pass a suturing element from the region between the superior surface of the meniscus and the femoral condyle, through the meniscus tissue, into the region between the inferior surface of the meniscus and the tibial plateau, across the inferior surface of the meniscus, and back to the superior surface of the meniscus, without deeply penetrating the posterior capsular region of the knee. Equivalently, the suture element may be passed from the inferior surface of the meniscus to the superior surface and back to the inferior surface.

Claims

1. A method of arthroscopically placing a suture around a tear in a meniscus without penetrating a meniscocapsular region of the meniscus, the method comprising using a suture passer to pass a suture across a superior meniscus surface between the superior surface and a femur, through the meniscus on a first side of the tear, across an inferior meniscus surface between the inferior surface and a tibia, and through the meniscus on a second side of the tear.

2. The method of claim 1 comprising entirely arthroscopically placing the suture.

3. The method of claim 1, wherein placing the suture comprises extending a tissue penetrating element in an arcuate pathway through the meniscus.

4. The method of claim 1, further comprising approaching the meniscus tear from an apex of the meniscus.

25. The method of claim 1 further comprising:

extending a first arm of the suture passer into a space between the superior surface of the meniscus and the femur;

extending a second arm of the suture passer into a space between the inferior surface of the meniscus and the tibia; and

passing a suturing element between the first arm and second arm of the suture passer.

5. A method of repairing a meniscus in a knee joint, the meniscus having an apex, a superior surface adjacent a femur, and an inferior surface adjacent a tibia, the method comprising:

using a suture passer to pass a suturing element from a region between the superior surface of the meniscus and the femur, through the meniscus to a region between the inferior surface of the meniscus and the tibia, across the inferior surface of the meniscus, and back through the meniscus to the superior surface of the meniscus.

6. The method of claim 5, further comprising minimally invasively positioning a distal end of the suture passer near the apex of the meniscus before passing the suturing element.

7. The method of claim 5, further comprising minimally invasively entering the knee joint with the suture passer from an anterior approach.

8. The method of claim 5, further comprising extending a first arm of the suture passer between the superior surface of the meniscus and the femur and extending a second arm of the suture passer between the inferior surface of the meniscus and the tibia.

9. The method of claim 5, further comprising approaching the meniscus from the apex of the meniscus.

10. The method of claim 5, wherein the suturing element comprises a suture.

11. The method of claim 5, wherein using the suture passer to pass the suturing element across the inferior surface of the meniscus comprises passing the suturing element radially across the inferior surface of the meniscus, to form a vertical loop around the meniscus.

12. The method of claim 5, wherein using the suture passer to pass the suturing element across the inferior surface of the meniscus comprises passing the suturing element laterally across the inferior surface of the meniscus, to form a lateral loop around the meniscus.

26. The method of claim 5 further comprising:

extending a first arm of the suture passer into a space between the superior surface of the meniscus and the femur;

extending a second arm of the suture passer into a space between the inferior surface of the meniscus and the tibia; and

passing a suturing element between the first arm and second arm of the suture passer.

13. A method of repairing a meniscus in a knee joint, the meniscus having an apex, a superior surface adjacent a femur, and an inferior surface adjacent a tibia, the method comprising:

using a suture passer to pass a suturing element from a region between the inferior surface of the meniscus and the tibia, through the meniscus, to a region between the superior surface of the meniscus and the femur, across the superior surface of the meniscus, and back through the meniscus to the inferior surface of the meniscus.

14. The method of claim 13, further comprising minimally invasively positioning a distal end of the suture passer near the apex of the meniscus before passing the suturing element.

15. The method of claim 13, further comprising minimally invasively entering the knee joint with the suture passer from an anterior approach.

16. The method of claim 13, further comprising extending a first arm of the suture passer between the superior surface of the meniscus and the femur and extending a second arm of the suture passer between the inferior surface of the meniscus and the tibia.

17. The method of claim 13, wherein the suturing element comprises a suture.

18. The method of claim 13, wherein using the suture passer to pass the suturing element across the superior surface of the meniscus comprises passing the suturing element radially across the superior surface of the meniscus, to form a vertical loop around the meniscus.

19. The method of claim 13, wherein using the suture passer to pass the suturing element across the superior surface of the meniscus comprises passing the suturing element laterally across the superior surface of the meniscus, to form a lateral loop around the meniscus.

27. The method of claim 13 further comprising:

extending a first arm of the suture passer into a space between the superior surface of the meniscus and the femur;

extending a second arm of the suture passer into a space between the inferior surface of the meniscus and the tibia; and

passing a suturing element between the first arm and second arm of the suture passer.

20. A meniscus repair device configured to aid in repair of a meniscus of a knee, the device comprising:

an elongate body extending distally and proximally;

a first arm extending distally in parallel or in line with the elongate body; and

a second arm extendable distally at an acute angle from the elongate body, wherein either or both the first and second arms are slideably coupled to move distally and proximally relative to each other such that the device has a first configuration in which the first and second arms form an acute-angled distal-facing opening, and a second configuration wherein the first arm is proximal to the second arm.

21. The device of claim 20, further comprising a handle at the proximal end.

22. The device of claim 20, further comprising a tissue penetrator configured to extend between the first and second arms when the device is in the first configuration.

23. The device of claim 20, further comprising at least one dock the second arm configured to receive a tissue penetrator extending from the first arm when the device is in the first configuration.

24. The device of claim 20, further comprising a tissue penetrator configured to extend from the first arm.