Method and apparatus for tying suture to bone

• US 5,250,055 A
• Filed: 06/08/1992
• Issued: 10/05/1993
• Est. Priority Date: 06/08/1992
• Status: Expired

• Current Assignee: Orthopedic Systems, Inc.
• Original Assignee: Orthopedic Systems, Inc.
• Inventors: Moore, Robert R., Cohn, Arnold K.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US07/895,604
• Time in Patent Office: 484 Days
• Field of Search: 606/1, 606/53, 606/60, 606/72, 606/80, 606/86, 606/96, 606/99, 606/103, 606/139, 606/148, 606/170, 606/171, 606/180, 606/222, 606/223, 606/232, 128/898, 128/772, 604/28, 623/13
• US Class Current: 606/148
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/1714 for applying tendons or ligaments implements for applying tendons or ligaments A61F2/0805
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61B 17/1796 for holes for sutures or flexible wires
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes 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 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2210/0019 operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation

Abstract

A method and apparatus for arthroscopic attachment of a suture to bone by drilling parallel holes in the bone with a cannula and drill guide and passing a suture down one hole through soft bone into the other hole and retrieving the suture through the second hole.

Claims

1. Apparatus for attaching a suture to bone under soft tissue comprising in combination:

a cannula having an inner bore,

a drill guide telescopically received in the cannula and having at least two generally parallel bores, and

a suture pusher comprising a tool having a straight section telescopically received in one of the bores of the drill guide, a laterally extending handle on one end and on the other end a suture holding section movable in response to manipulation of the handle to push a suture loop through soft bone material between two parallel holes in bone aligned with two of the bores in the drill guide.

2. A suture pusher comprising a strand of resiliently deformable wire having a straight section, a laterally extending handle on one end and on the other end an appertured and naturally curved suture pushing section which in unstressed condition extends laterally from the straight section and a sleeve telescopically surrounding the strand of wire and supporting the naturally curved suture pushing section aligned with the straight section whereby the suture pushing section deforms to said unstressed laterally extending condition responsive to manipulation of the handle to move the wire telescopically from the sleeve.

3. The method of attaching a suture to bone under soft tissue which comprises:

inserting a cannula through soft tissue substantially to the bone,

inserting into the cannula a drill guide having at least two generally parallel spaced apart bores,

drilling two non-intersecting holes aligned with the bores of the drill guide into the bone through the hard surface of the bone into softer inner bone material,

inserting through one of the bores and holes a suture pusher having a suture carrying end and pushing the suture carrying end, with a suture loop thereon, through the inner bone material from the one hole to the other hole,

retrieving one strand of the suture loop through the other bone hole and bore,

removing the pusher and the drill guide,

tying a knot in the suture and passing it down the suture through the cannula, and

removing the cannula leaving the suture tied to the bone with the suture encircling a bridge of hard surface bone material between the two holes.

4. The method of claim 3 in which the suture pusher is a strand of a resiliently flexible TiNi alloy having a straight section, a laterally extending handle on one end and on the other end a curved suture pushing section extending laterally from the straight section and resiliently deformable to pass through a bore in a generally straightened condition.

5. The method of claim 4 in which a tube is inserted through the one bore and into the one hole in the bone before inserting the suture pusher so that the tube guides the suture pusher down into the bone before pushing the suture from the one hole to the other hole.