Tenodesis Anchoring Systems and Tools

• US 20170290656A1
• Filed: 04/08/2016
• Published: 10/12/2017
• Est. Priority Date: 04/08/2016
• Status: Active Grant

• Current Assignee: Medos International Sarl (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Piccirillo, Justin M., Miller, Gerome, Sa, Sherri
• Granted Patent: US 10,231,824 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/8645 Headless screws, e.g. ligament interference screws
• CPC Class Codes: A61B 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61F 2/0805 Implements for inserting tendons or ligaments
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0823 Modular anchors comprising a plurality of separate parts
• CPC Class Codes: A61F 2002/0835 with deformation of anchor parts, e.g. expansion of dowel by set screw
• CPC Class Codes: A61F 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• 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 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

Systems and tools are provided for anchoring a ligament or tendon to bone. In one embodiment, a sheath is provided having a first sidewall with proximal and distal ends and a second sidewall with proximal and distal ends. The distal ends of the first and second sidewalls can be coupled to one another by a hinge pin such that the first and second sidewalls pivot relative to one another about the hinge pin. A sheath inserter tool is also provided and it can be configured to couple to the sheath and to advance the expandable sheath, with a tendon disposed therearound, into a bone hole. An expander is also provided for expanding the sheath. In this way, a tendon or ligament is delivered into the bone hole and the sheath and tendon are locked within the bone hole.

Claims

1. A bone anchoring system, comprising:

a sheath having a first sidewall with proximal and distal ends and a second sidewall with proximal and distal ends, the distal ends of the first and second sidewalls being coupled to one another by a hinge pin such that the first and second sidewalls pivot relative to one another about the hinge pin;

an elongate shaft having a distal end with a distally-extending central protrusion that extends into the sheath between the first and second sidewalls, and the distal end having at least first and second distally-extending side protrusions positioned on opposite sides of the central protrusion and extending along opposite outer sides of the first and second sidewalls such that the first and second distally-extending side protrusions prevent rotation of the first and second sidewalls about the hinge pin.

2. The bone anchoring system of claim 1, wherein the distally-extending central protrusion extends a distance beyond the first and second distally-extending side protrusions.

3. The bone anchoring system of claim 1, wherein the distally-extending central protrusion and the first and second distally-extending side protrusions define a radially extending slot therebetween that seats a proximal-most end of the first and second sidewalls.

4. The bone anchoring system of claim 1, wherein the distally-extending central protrusion has an oblong cross-sectional shape such that the distally-extending central protrusion is prevented from rotating within the first and second sidewalls.

5. The bone anchoring system of claim 1, further comprising third and fourth distally-extending side protrusions positioned on opposite sides of the central protrusion and extending along opposite outer sides of the first and second sidewalls.

6. The bone anchoring system of claim 5, wherein the first and second outer sidewalls each have a plurality of teeth formed thereon, and wherein the first and third distally-extending side protrusions are positioned on opposite sides of a tooth formed on an outer surface of the first sidewall, and the second and fourth distally-extending side protrusions are positioned on opposite sides of a tooth formed on an outer surface of the second sidewall.

7. The bone anchoring system of claim 1, further comprising a handle slidably coupled to a proximal end of the elongate shaft.

8. The bone anchoring system of claim 1, wherein the elongate shaft comprises proximal and distal components that are rotatably coupled to one another, the proximal component being mated to a handle.

9. A bone anchor inserter tool, comprising:

an outer shaft having proximal and distal ends and an inner lumen extending at least partially therethrough, the distal end having first and second prongs extending distally therefrom; and

an inner shaft extending through the inner lumen of the outer shaft, at least a portion of the inner shaft being non-rotatably and freely slidably coupled to the outer shaft, the inner shaft having a distal end with a distally-extending central protrusion and at least first and second distally-extending side protrusions positioned on opposite sides of the central protrusion.

10. The bone anchor inserter tool of claim 9, wherein the inner shaft comprises a distal component that is non-rotatable relative to the outer shaft, and a proximal component that is rotatably coupled to the distal component.

11. The bone anchor inserter tool of claim 10, wherein the proximal and distal components of the inner shaft are mated by a snap-fit connection.

12. The bone anchor inserter tool of claim 10, further comprising a handle coupled to the proximal end of the outer shaft and coupled to the proximal component of the inner shaft.

13. The bone anchor inserter tool of claim 9, wherein the inner shaft includes third and fourth distally-extending side protrusions positioned on opposite sides of the central protrusion.

14. A tendon anchoring system, comprising:

an anchor assembly having a sheath with first and second sidewalls that are coupled at a distal end by a hinge pin such that the first and second sidewalls are configured to pivot about the hinge pin relative to one another;

an inserter tool including

an outer shaft having an inner lumen extending therethrough between proximal and distal ends thereof, the distal end having first and second prongs extending distally therefrom, and

an inner shaft extending through the inner lumen of the outer shaft and having a distal end configured to engage the first and second sidewalls of the sheath to prevent pivotal movement of the first and second sidewalls about the hinge pin.

15. The tendon anchoring system of claim 14, wherein the anchor assembly further comprises an expander configured to be received within the sheath to cause the first and second sidewalls to pivot away from one another.

16. The tendon anchoring system of claim 15, wherein the first and second sidewalls each have at least one retention boss formed thereon and configured to engage a proximal end of the expander when the expander is seated between the first and second sidewalls.

17. The tendon anchoring system of claim 15, wherein the expander has an inner lumen extending therethrough with a cross-bar extending across the inner lumen for receiving a suture therearound.

18. The tendon anchoring system of claim 14, wherein the first and second sidewalls each include at least one anti-rotation boss formed thereon and configured to engage at least one of the first and second prongs therebetween to prevent rotation of the sheath relative to the outer shaft.

19. The tendon anchoring system of claim 14, wherein the first and second prongs include proximal slots formed therein that receives tabs formed on the proximal ends of the first and second sidewalls of the sheath, and wherein the tabs move out of the slots when the first and second sidewalls of the sheath pivotally move away from one another.

20. A surgical method, comprising:

advancing a sheath into a bone hole;

advancing an expander into the sheath, the expander causing first and second sidewalls of the sheath to pivot relative to one another about a hinge pin coupling distal ends of the first and second sidewalls.

21. The method of claim 20, wherein advancing the sheath comprising manipulating an inserter tool having the sheath mounted on a distal end thereof to advance the sheath into a bone hole.

22. The method of claim 21, wherein the inserter tool has first and second prongs that extend between the first and second sidewalls of the sheath, and wherein the first and second prongs include anti-rotation bosses thereon that prevent rotation of the sheath relative to the first and second prongs during advancement of the sheath into the bone hole.

23. The method of claim 21, wherein the inserter tool includes an outer shaft and an inner shaft, the inner shaft having a distally-extending central protrusion that extends into the sheath between the first and second sidewalls, and having at least first and second distally-extending side protrusions positioned on opposite sides of the central protrusion and extending along opposite outer sides of the first and second sidewalls such that the first and second distally-extending side protrusions prevent rotation of the first and second sidewalls of the sheath about the hinge pin.