RATCHETING INSERTER DEVICE AND SUTURE ANCHOR ARRANGEMENT

• US 20140277128A1
• Filed: 03/15/2013
• Published: 09/18/2014
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Tony Napolitano
• Inventors: MOORE, Kurt Hamilton, NAPOLITANO, Tony
• Granted Patent: US 9,451,954 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 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• 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 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0425 the anchor or the separate member comprising threads, e.g. a set screw in the anchor
• 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 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0453 threaded elements, e.g. set screws

Abstract

A ratcheting inserter device for tensioning a knotless suture anchor includes an outer inserter shaft and an inner inserter shaft having a common longitudinal axis. A ratcheting mechanism provided between the inner inserter shaft and the outer inserter permits rotation of the inner inserter shaft in one direction relative to the outer inserter shaft. The outer inserter shaft has a protrusion at a distal end that is received by an anchor outer sleeve of a suture anchor to prevent relative rotation thereof, and the inner inserter shaft has a projection at the distal end that is received by an inner core of the anchor for rotational movement therewith. The ratcheting inserter device rotates the inner core of the suture anchor to spool and tension suture thread. Thereafter, the ratcheting mechanism is disengaged and the inner inserter shaft is forced axially into the anchor outer sleeve.

Claims

1. A ratcheting inserter device, comprising:

a hollow outer inserter shaft having a distal end and a proximal end, including an outer shaft handle disposed at the proximal end and a protrusion projecting from the outer shaft distal end;

an inner inserter shaft having a distal end and a proximal end, including an inner shaft control at the proximal end and a projection at the inner shaft distal end; and

a ratcheting mechanism permitting rotation of the inner inserter shaft in one direction relative to the outer inserter shaft and preventing rotation of the inner inserter shaft in the opposing direction relative to the outer inserter shaft,

wherein at least a portion of the inner shaft is positioned within the outer inserter shaft and the inner inserter shaft is rotatable relative to the outer inserter shaft in the one direction.

2. The ratcheting inserter device of claim 1, wherein the ratcheting mechanism comprises at least one pawl formed in one of an outer surface of the inner inserter shaft and an inner surface of the outer inserter shaft.

3. The ratcheting inserter device of claim 2, wherein the ratcheting mechanism further comprises teeth formed in the other of the outer surface of the inner inserter shaft and the inner surface of the outer inserter shaft for engaging the at least one pawl to prevent rotation of the inner inserter shaft in the one direction.

4. The ratcheting inserter device of claim 3, wherein the teeth and the at least one pawl are aligned radially toward each other along a portion of the respective inner inserter shaft and the outer inserter shaft.

5. The ratcheting inserter device of claim 1, wherein the protrusion comprises a flange and the inner shaft control comprises an inner shaft knob.

6. The ratcheting inserter device of claim 1, including a spacer disposed between the outer shaft handle and the inner shaft control.

7. The ratcheting inserter device of claim 6, wherein the inserter device is configured so that removal of the spacer enables force applied to the inner shaft control toward a distal end of the inserter device, to axially move the distal end of the inner inserter shaft outwardly beyond the distal end of the outer inserter shaft for driving an anchor inner core of a suture anchor into an anchor outer sleeve of the suture anchor.

8. The ratcheting inserter device of claim 7, wherein the inner shaft control includes a projecting screw shaft oriented along a common longitudinal axis of the outer inserter shaft and the inner inserter shaft, and the outer shaft handle includes an open bore with matching screw threads for receiving the projecting screw shaft, and wherein axial movement of the inner inserter shaft disengages the ratcheting mechanism, whereby the inner shaft control is capable of rotating in an opposite direction to the one direction.

9. The ratcheting inserter device of claim 8, wherein the anchor outer sleeve includes an inner threaded region at a proximal end and the inner core includes core threads at the proximal end, and wherein during movement of the inner shaft control rotatably and axially into the outer shaft handle and toward the suture anchor, the distal end of the inner inserter shaft rotatably and axially drives the core threads of the inner core into the threaded region of the outer sleeve.

10. The ratcheting inserter device of claim 9, wherein the inner shaft control rotates in a range from about a one quarter rotation and about a three quarter rotation to axially advance a distance that corresponds to the width of the spacer.

11. The ratcheting inserter device of claim 7, wherein the ratcheting mechanism comprises a first ratcheting mechanism and the axial movement of the inner inserter shaft disengages the first ratcheting mechanism, and wherein a second ratcheting mechanism axially spaced from the first ratcheting mechanism engages the inner inserter shaft to limit rotation thereof.

12. The ratcheting inserter device of claim 1, wherein the projection fits into a bore hole of an inner core of a suture anchor and the projection is configured to rotate the inner core of the suture anchor for tensioning suture threads coacting with the suture anchor.

13. The ratcheting inserter device according to claim 1, wherein the inner shaft control is movable axially away from the outer shaft handle to disengage the ratcheting mechanism and to enable rotation of the inner inserter shaft in each direction relative to the outer inserter shaft.

14. A knotless suture anchor, comprising:

an anchor inner core having a proximal end with an inner bore hole and an aperture oriented transversely to a longitudinal axis of the anchor inner core for receiving an end of a suture thread;

an anchor outer sleeve having an open bore hole at a proximal end for receiving the anchor inner core and including apertures oriented transversely to a longitudinal axis of the anchor outer sleeve for receiving an end of a suture thread, the anchor outer sleeve receiving and enclosing a first portion of the anchor inner core, with a second portion at the proximal end of the anchor inner core extending away from the proximal end of the anchor outer sleeve; and

an anchor tip,

wherein the anchor inner core is rotatable relative to the anchor outer sleeve.

15. The suture anchor of claim 14, wherein the anchor inner core includes core threads at the proximal end thereof, and wherein the anchor outer sleeve includes an inner threaded region in the open bore hole at the proximal end thereof.

16. The suture anchor of claim 14, wherein the anchor inner core has a finned region at the proximal end thereof, and wherein the anchor inner core is capable of cutting the anchor outer sleeve during insertion therein.

17. A method for securing a suture anchor into a bone comprising:

providing a suture anchor comprising an anchor inner core and an anchor outer sleeve having an open bore hole at a proximal end for receiving and enclosing a first portion of the anchor inner core with a second portion of the anchor inner core extending away from the proximal end of the anchor outer sleeve;

driving the suture anchor into bone with an inserter device to dispose the proximal end of the anchor outer sleeve adjacent a bone surface;

tensioning suture threads coacting with the suture anchor; and

driving the anchor inner core into the anchor outer sleeve.

18. The method of claim 17, wherein the anchor inner core includes core threads at the proximal end thereof, and wherein the anchor outer sleeve includes an inner threaded region in the open bore hole at the proximal end thereof, and the step of driving the anchor inner core into the anchor outer sleeve comprises simultaneously applying an axial force and a rotating force, for rotating the anchor inner core into the anchor outer sleeve.

19. The method of claim 17, wherein the inserter device comprises a ratcheting inserter device and the step of tensioning suture threads comprises operating the ratcheting inserter device to rotate the anchor inner core relative to the anchor outer sleeve.

20. The method of claim 17, including the step of moving a portion of an inserter device away from the suture anchor to release tension of the suture threads.