SUTURE METHODS FOR FORMING LOCKING LOOPS STITCHES

• US 20140276987A1
• Filed: 05/30/2014
• Published: 09/18/2014
• Est. Priority Date: 01/10/2011
• Status: Active Grant

• Current Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Original Assignee: Justin D. Saliman
• Inventors: SALIMAN, Justin D.
• Granted Patent: US 9,848,868 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 2017/0412 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 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06095 pliable

Abstract

Methods for suturing tissue by forming a locking loop of suture material. In particular, method of using a suture passer to arthroscopically create a locking loop of suture in difficult to access tissues. As used herein a locking loop of suture is a loop of suture that is passed through a tissue from a first side to a second side of the tissue; one or more of the legs of the loop extending from the first side are passed through the tissue to the second side of the tissue and are then passed through the loop, and the loop is cinched to tighten closed over the one or more legs. The resulting locking loops stitches are extremely strong and distribute the stresses across the tissue in a desirable manner.

Claims

1. A method of arthroscopically repairing a knee tissue with a length of suture having a distal limb region, a proximal limb region and a central loop region there between, the method comprising:

arthroscopically passing a first loop of the loop region of the suture through the tissue with a suture passer, from a first side of the tissue to a second side of the tissue;

moving the distal limb region of the suture from the first side of the tissue to the second side of the tissue;

moving the distal limb region though the first loop; and

cinching the first loop region closed.

2. The method of claim 1, further comprising forming a passage through either the tibia or the femur;

and pulling the first and second limb regions through the passage after cinching the first loop region closed.

3. The method of claim 1, wherein arthroscopically passing the first loop comprises passing the first loop of the loop region of the suture from an inferior to a superior surface of a meniscus with the suture passer.

4. The method of claim 1, wherein arthroscopically passing the first loop comprises passing the first loop of the loop region of the suture from a first side of an anterior cruciate ligament to a second side of the anterior cruciate ligament.

5. The method of claim 1, further comprising arthroscopically positioning the suture passer with a first jaw on one side of the tissue and a second jaw on an opposite side of the tissue.

6. The method of claim 1, further comprising arthroscopically positioning the suture passer with a first jaw between a superior surface of a meniscus and a femur and a second jaw between the inferior surface and a tibia.

7. The method of claim 1, wherein moving the distal limb region of the suture comprises passing the distal limb region of the suture with the suture passer through the tissue.

8. The method of claim 1, further comprising moving the proximal limb region of the suture from the first side of the tissue to the second side of the tissue.

9. The method of claim 1, further comprising moving the proximal limb region though the first loop.

10. The method of claim 1, wherein arthroscopically passing the first loop is performed before moving the distal limb region of the suture from the first side of the tissue to the second side of the tissue.

11. A method of arthroscopically repairing a knee tissue with a length of suture having a distal limb region, a proximal limb region and a central loop region therebetween, the method comprising:

passing a first loop of the loop region of the suture from an inferior to a superior surface of a meniscus with a suture passer;

passing the distal limb region of the suture from the inferior to the superior surface of the meniscus with the suture passer;

passing the distal limb region though the first loop; and

cinching the first loop region closed.

12. The method of claim 11, further comprising passing the proximal limb region of the suture from the inferior to the superior surface of the meniscus with the suture passer;

13. The method of claim 12, further comprising passing the proximal limb region though the first loop.

14. The method of claim 11, wherein passing the first loop is performed before passing the distal limb region of the suture from the inferior to the superior surface of the meniscus with the suture passer.

15. The method of claim 11, wherein passing the distal limb region of the suture from the inferior to the superior surface of the meniscus with the suture passer is performed before passing the first loop.

16. The method of claim 11, further comprising arthroscopically positioning the suture passer with a first jaw between the superior surface of the meniscus and the femur and a second jaw between the inferior surface and the tibia.

17. A method of arthroscopically repairing a knee tissue with a length of suture having a distal limb region, a proximal limb region and a central loop region therebetween, the method comprising:

passing a first loop of the loop region of the suture from an inferior to a superior surface of a meniscus with a suture passer;

passing the proximal limb region of the suture from the inferior to the superior surface of the meniscus with the suture passer;

passing the distal limb region of the suture from the inferior to the superior surface of the meniscus with the suture passer;

passing the distal limb region though the first loop; and

cinching the first loop region closed.

18. The method of claim 17, further comprising anchoring the distal limb region and the proximal limb region to the tibia.

19. The method of claim 17, further comprising passing a second loop of the loop region of the suture from an inferior to a superior surface of the meniscus with the suture passer;

and passing the proximal limb region through the second loop; and

cinching the second loop region closed.

20. The method of claim 17, further comprising forming a channel in the tibia to anchor the suture.

21. The method of claim 17, wherein passing the first loop is performed before passing the distal limb region or the proximal limb region.

22. The method of claim 17, wherein passing the distal limb region is performed before passing the first loop.

23. A method of arthroscopically repairing a knee tissue with a length of suture having a distal limb region, a proximal limb region and a central loop region therebetween, the method comprising:

passing a first loop of the loop region of suture from an inferior to a superior surface of a meniscus having a radially tear using a suture passer, so that the first loop is on a first side of the radial tear;

passing the distal limb region of the suture from the inferior to the superior surface of the meniscus using the suture passer, so that the distal limb region is on the first side of the radial tear;

passing the distal limb region though the first loop;

cinching the first loop region closed;

passing a second loop of the loop region of suture from the inferior to the superior surface of the meniscus using the suture passer, so that the second loop is on a second side of the radial tear;

passing the proximal limb region of the suture from the inferior to the superior surface of the meniscus using the suture passer, so that the proximal limb region is on the second side of the radial tear;

cinching the second loop region closed; and

knotting the proximal limb region and the distal limb region of the suture together to close the radial tear.

24. A method of repairing a tissue by arthroscopically forming a locking loop of suture through the tissue, the suture formed of a length of suture material having a distal limb region, a proximal limb region and a central loop region therebetween, the method comprising:

passing a loop of the central loop region of the suture from a first side of the tissue to a second side of the tissue;

passing the a distal limb region through the tissue from the first side to the second side of the tissue;

passing the distal limb region through the loop; and

cinching the loop over the distal limb.

25. A method of repairing a knee tissue by arthroscopically forming a locking loop of suture through the ACL, the suture formed of a length of suture material having a distal limb region, a proximal limb region and a central loop region therebetween, the method comprising:

passing a loop of the central loop region of the suture from a first side of a torn Anterior Cruciate Ligament (ACL) to a second side of the ACL;

passing the a distal limb region through the ACL from the first side to the second side of the ACL;

passing the proximal limb region through the ACL from the first side to the second side of the ACL;

passing the distal and proximal limb regions through the loop; and

cinching the loop over the distal and proximal limbs.

26. A method of repairing a torn rotator cuff by arthroscopically forming a locking loop of suture through the supraspinus tendon, the suture formed of a length of suture material having a distal limb region, a proximal limb region and a central loop region therebetween, the method comprising:

passing a loop of the central loop region of the suture from a first side of the supraspinus tendon to a second side of the supraspinus tendon;

passing the a distal limb region through the supraspinus tendon to the second side of the supraspinus tendon;

passing the proximal limb region through the supraspinus tendon to the second side of the supraspinus tendon;

passing the distal and proximal limb regions through the loop; and

cinching the loop over the distal and proximal limbs.