MULTI-SUTURE KNOTLESS ANCHOR FOR ATTACHING TISSUE TO BONE AND RELATED METHOD

• US 20130267998A1
• Filed: 04/06/2012
• Published: 10/10/2013
• Est. Priority Date: 04/06/2012
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Vijay, Francis, White, George W.
• Granted Patent: US 9,855,028 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 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor

Abstract

A multi-suture knotless anchor and related method for securing soft tissue, such as tendons, to bone are described. The suture anchor includes a body, a sleeve, and an outer deformable bone locking structure. The bone locking structure has a first low profile configuration for insertion into the bone, and a second larger profile configuration for engaging the bone when actuated. The bone anchor and methods permit a suture attachment that lies beneath the cortical bone surface and does not require tying of knots in the suture.

Claims

1. A suture anchor for securing a soft tissue to a bone with at least one suture, wherein the suture anchor comprises a first undeployed configuration in which tissue may be drawn towards the suture anchor by applying tension to a free limb of the suture, and a second deployed configuration in which the suture anchor is fixed in the bone and the suture is locked in the suture anchor thereby securing the tissue to the bone, said suture anchor comprising:

an anchor body having a proximal section, an elongate intermediate section, and a distal section;

a bone locking member at least partially disposed about the elongate intermediate section and forming a cavity between an inner surface of the bone locking member and an outer surface of the elongate intermediate section; and

a sleeve member which moveably cooperates with the anchor body and the bone locking member to slide into the cavity along the elongate intermediate section thereby expanding the bone locking member and compressing the at least one suture between the outer surface of the elongate intermediate section and an inner surface of the sleeve member.

2. The suture anchor of claim 1 wherein the bone locking member is expandable to a plurality of different sizes.

3. The suture anchor of claim 1 wherein the bone locking member comprises a plurality of deflecting sections which deflect outwardly from the anchor body when the sleeve member is urged into said cavity.

4. The suture anchor of claim 3 wherein the plurality of deflecting sections comprises at least three discrete wings.

5. The suture anchor of claim 1 wherein distal section comprises a bone piercing tip.

6. The suture anchor of claim 5 wherein the bone piercing tip tapers from a proximal base to a distal end, wherein said base has an outer diameter of at least 4 mm.

7. The suture anchor of claim 1 wherein the anchor body is a biocompatible polymer.

8. The suture anchor of claim 1 wherein at least one of the bone locking member and sleeve comprises exterior ridges.

9. The suture anchor of claim 8 wherein the distal section of the anchor body comprises ridges.

10. The suture anchor of claim 1 wherein the distal section of the anchor body comprises a suture guide which guides the suture from one side of the anchor body to the other side of the anchor body.

11. The suture anchor of claim 10 wherein the suture guide is an aperture extending through the distal section of the anchor body.

12. The suture anchor of claim 1 wherein the cavity is an annular space.

13. A knotless suture anchoring system for anchoring a length of suture with respect to a bone, comprising:

an anchor insertion instrument comprising a handle, and an elongate rigid shaft extending distally from the handle, said shaft comprising a distal end section;

an anchor body detachably connected to the distal end section of the elongate rigid shaft, said anchor body comprising a proximal end section, an elongate intermediate section, and a distal end section, the distal end section comprising a suture carrying portion allowing the suture to pass from a first side of the anchor body to an opposite side of the anchor body;

a bone locking member disposed on the anchor body, the bone locking member comprising;

a base which cooperates with said distal end section of the anchor body to hold the base to the anchor body; and

a bone anchoring structure extending from the base and radially spaced from the intermediate section of the anchor body such that a cavity is defined between an outer surface of the anchor body and the inner surface of the bone anchoring structure, and wherein the cavity is sufficient in size to allow the length of suture to be drawn through the cavity and to the suture carrying portion; and

a sleeve member slidably disposed on the shaft distal end section of the instrument and proximal to the anchor body, the sleeve member having an outer diameter sufficient in size and shape to radially expand the anchoring structure when pushed along the shaft distal end section and into the cavity, and the sleeve member having an inner diameter sufficient in size and shape to compress a length of suture between the anchor body and an inner surface of the sleeve.

14. The system of claim 13 further comprising a snare extending through at least a portion of the insertion instrument and the suture carrying portion of the anchor body such that when a distal portion of the snare is affixed to the suture, withdrawal of the snare pulls the suture through the suture carrying portion of the anchor body and the distal portion of the insertion instrument.

15. The system of claim 13 wherein the distal end section of the anchor comprises a pointed tip.

16. The system of claim 13 further including a section of tensile weakness along the instrument shaft permitting the shaft to be detached from the anchor body proximal end upon application of a predetermined tensile force on the shaft in the proximal direction.

17. The system of claim 13 wherein the bone anchoring structure has a plurality of deflectable wings, and each wing comprises a plurality of exterior ridges.

18. The system of claim 13 wherein the cavity is an annular space.

19. A method for knotless securing of soft tissue to bone, the method comprising:

stitching tissue with at least one suture;

loading an anchor assembly with the at least one suture, the anchor assembly being detachably connected to the end of an insertion instrument;

manipulating the anchor assembly into the bone;

tensioning a free end of the suture to approximate the tissue to the anchor assembly;

moving a sleeve member into the anchor assembly to deploy a bone locking structure of the anchor assembly and to compress the suture; and

retracting the insertion instrument leaving the anchor assembly embedded in the bone, and the tissue secured to the bone.

20. The method of claim 19 wherein loading the anchor assembly with the at least one suture comprises loading the anchor assembly with a plurality of sutures.

21. The method of claim 20 wherein loading the anchor assembly is performed by snaring the sutures.

22. The method of claim 21 wherein snaring is performed by inserting the lengths of the sutures in a wire loop of a snare device detachably affixed to the distal section of the shaft, and pulling on a snare grip to draw the sutures through the anchor assembly and the instrument.

23. The method of claim 19 wherein the manipulating the anchor and suture into the bone comprises hammering the proximal end of the insertion instrument.

24. The method of claim 19 wherein the tensioning is performed prior to the manipulating step.

25. The method of claim 19 wherein the tissue is a rotator cuff tendon and the bone is the humeral head.

26. The method of claim 19 wherein the moving step comprises compressing a first section of suture between the anchor body and the sleeve member and a second section of the suture between a bone surface and an exterior of the bone locking structure.

27. The method of claim 19 wherein the moving step comprises pushing the sleeve into the cavity until a stop on the anchor body prevents further movement.

28. The method of claim 19, wherein said tensioning is performed semi-automatically.

29. The method of claim 19 further comprising toggling the anchor assembly.

30. The method of claim 29 wherein the toggling creates a tilt angle ranging from 5 to 10 degrees.

31. The method of claim 29 wherein the toggling is performed by applying tension on the tissue side of the suture.