Suture button

• US 5,306,290 A
• Filed: 02/12/1993
• Issued: 04/26/1994
• Est. Priority Date: 02/12/1993
• Status: Expired due to Term

• Current Assignee: Mitek Surgical Products, Inc. (Johnson & Johnson)
• Original Assignee: Mitek Surgical Products, Inc. (Johnson & Johnson)
• Inventors: Martins, Harold M., Snyder, Stephen J.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Jackson, Gary
• Application Number:
  US08/017,145
• Time in Patent Office: 438 Days
• Field of Search: 606/232, 215/307, 215/309, 215/355
• 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 2017/0404 Buttons
• 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 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61F 2002/3021 frustoconical
• CPC Class Codes: A61F 2230/0067 conical

Abstract

A suture retaining device in the form of a frusto-conical button having parallel upper and lower planar surfaces which are connected together by a conical surface. The button is provided with a recessed chamber for substantially completely accommodating one or more suture knots. At least one hole is formed in the button leading from the recessed chamber to the lower planar surface, and at least one hole is formed in said button leading from the recessed chamber to the conical surface.

Claims

1. A suture retention means for use in approximating an object to an anatomical structure by at least one length of suture extending outwardly from said anatomical structure and through said object, said suture retention means comprising:

a substantially frusto-conical body having a longitudinal axis, a top surface, a bottom surface, a side surface and a longitudinally-centered cavity extending into said top surface;

said top and bottom surfaces each (a) being substantially planar, (b) being oriented in spaced, parallel relation to one another, and (c) defining a substantially circular periphery centered about said longitudinal axis, said periphery of said bottom surface being smaller than said periphery of said top surface;

said side surface extending in a substantially frusto-conical monomer between said periphery of said top surface and said periphery of said bottom surface;

said longitudinally-centered cavity including a base surface, a sidewall surface and an open end; and

said body further defining at least one opening extending from said bottom surface to said base surface, each said opening being sized so as to allow at least one free end of at least one length of suture to be threaded therethrough from said bottom surface into said longitudinally-centered cavity, and so as to prevent a knot formed by said at least one free end of suture from passing therethrough.

2. The suture retention means of claim 1 wherein said body further defines at least one side opening extending from said side surface to said sidewall surface, each said side opening being sized so as to allow at least one free end of at least one second length of suture to be threaded therethrough from said side surface into said longitudinally-centered cavity, and so as to prevent a knot formed by said free end of said at least one second length of suture from passing therethrough.

3. The suture retention means of claim 1 wherein said longitudinally-centered cavity is sized so as to substantially completely contain said knot formed by said at least one free end of said at least one length of suture when said knot abuts said base surface adjacent the opening through which its associated at least one length of suture extends.

4. The suture retention means of claim 2 wherein said longitudinally-centered cavity is sized so as to substantially completely contain said knots formed (a) in said at least one free end of said at least one suture, and (b) in said at least one free end of said at least one second length of suture when said knots abut said base surface and said sidewall surface, respectively, adjacent the openings through which their associated at least one length of suture or at least one second length of suture extend.

11. The suture retention means of claim 1 wherein said object comprises bone.

12. The suture retention means of claim 1 wherein said object comprises soft tissue.

13. The suture retention means of claim 1 wherein said anatomical structure comprises bone.

14. The suture retention means of claim 1 wherein said anatomical structure comprises soft tissue.

15. The suture retention means of claim 14 wherein said soft tissue comprises a length of ligament material.

16. The suture retention means of claim 15 wherein said length of ligament material extends outwardly from a piece of bone.

17. The suture retention means of claim 16 wherein said anatomical structure further comprises a bone plug attached to one end of said length of ligament material.

18. The suture retention means of claim 1 wherein said object defines a hole extending therethrough, and said anatomical structure has a portion adapted to extend into said hole.

5. A suture retention means for use in approximating an object to an anatomical structure by at least one length of suture extending outwardly from said anatomical structure and through said object, said suture retention means comprising:

a substantially frusto-conical body having a longitudinal axis, a top surface, a bottom surface, a side surface and a longitudinally-centered cavity extending into said top surface;

said top and bottom surfaces each (a) being substantially planar, (b) being oriented in spaced, parallel relation to one another, and (c) defining a substantially circular periphery centered about said longitudinal axis, said periphery of said bottom surface being smaller than said periphery of said top surface;

said side surface extending between said periphery of said top surface and said periphery of said bottom surface;

said longitudinally-centered cavity including a base surface, a sidewall surface and an open end; and

said body further defining at least one opening extending from said side surface to said sidewall surface, each said opening being sized so as to allow at least one free end of at least one length of suture to be threaded therethrough from said side surface into said longitudinally-centered cavity, and so as to prevent a knot formed by said at least one free end of suture from passing therethrough.

6. The suture retention means of claim 5 wherein said longitudinally-centered cavity is sized so as to substantially completely contain said knot formed by said at least one free end of said at least one length of suture when said knot abuts said sidewall surface adjacent the opening through which its associated at least one length of suture extends.

7. A method for approximating an object to an anatomical structure by at least one length of suture extending outwardly from a surface of said anatomical structure, wherein said object has a first surface and a second surface, said method comprising the steps of:

(a) providing suture retention means comprising;

a substantially frusto-conical body having a longitudinal axis, a top surface, a bottom surface, a side surface and a longitudinally-centered cavity extending into said top surface;

said top and bottom surfaces each (a) being substantially planar, (b) being oriented in spaced, parallel relation to one another, and (c) defining a substantially circular periphery centered about said longitudinal axis, said periphery of said bottom surface being smaller than said periphery of said top surface;

said side surface extending between said periphery of said top surface and said periphery of said bottom surface;

said longitudinally-centered cavity including a base surface, a sidewall surface and an open end; and

said body further defining at least one opening extending from said bottom surface to said base surface, each said opening being sized so as to allow at least one free end of at least one length of suture to be threaded therethrough from said bottom surface into said longitudinally-centered cavity, and so as to prevent a knot formed by said at least one free end of suture from passing therethrough;

(b) forming an opening in said object extending from said first surface to said second surface;

(c) countersinking said opening in said object adjacent said first surface so as to form an inclined surface, with the countersunk region being sized so as to substantially completely accommodate said body when said side surface of said body is in engagement with said inclined surface;

(d) locating said object and said anatomical structure in a predetermined position relative to one another, and passing said at least one free end of said at least one length of suture through at least a portion of said opening in said object so as to extend outwardly from said countersunk region;

(e) locating said body in said countersunk region of said opening, with said at least one free end of said at least one length of suture extending through said at least one opening in said body, and tensioning said at least one length of suture; and

(f) forming a knot in said at least one free end of said at least one length of suture such that said at least one length of suture is maintained under tension when said knot abuts the portion of said base of said cavity adjacent the opening with which said at least one free end of said at least one length of suture is associated.

8. The method of claim 7 wherein said body further defines at least one side opening extending from said side surface to said sidewall surface, each said side opening being sized so as to allow at least one free end of at least one second length of suture to be threaded therethrough from said side surface into said cavity, and so as to prevent a knot formed by said free end of said at least one second length of suture from passing therethrough, and said method includes the additional steps of:

(i) forming a second opening in said object extending from a surface thereof to said countersunk region;

(ii) locating a second anatomical structure having at least one free end of at least one second length of suture extending outwardly from a surface thereof in a predetermined position relative to said object such that said at least one free end of said at least one second length of suture extends outwardly from said inclined surface of said countersunk region;

(iii) locating said body in said countersunk region of said opening, with said at least one free end of said at least one second length of suture extending through said at least one side opening in said body, and tensioning said at least one second length of suture; and

(iv) forming a knot in said at least one free end of said at least one second length of suture such that said at least one second length of suture is maintained under tension when said knot abuts the portion of said sidewall surface of said cavity adjacent the second opening with which said at least one free end of said at least one second length of suture is associated.

9. The method of claim 8 wherein said object is bone and said second opening in said object comprises the intramedullary canal of said bone.

19. The method of claim 7 wherein said object comprises bone.

20. The method of claim 7 wherein said object comprises soft tissue.

21. The method of claim 7 wherein said anatomical structure comprises bone.

22. The method of claim 7 wherein said anatomical structure comprises soft tissue.

23. The method of claim 22 wherein said soft tissue comprises a length of ligament material.

24. The method of claim 23 wherein said length of ligament material extends outwardly from a piece of bone.

25. The method of claim 24 wherein said anatomical structure further comprises a bone plug attached to one end of said length of ligament material.

26. The method of claim 7 wherein said object defines a hole extending therethrough, and said anatomical structure has a portion adapted to extend into said hole.

10. A method for approximating an object to an anatomical structure by at least one length of suture extending outwardly from a surface of said anatomical structure, wherein said object has a first surface and a second surface, said method comprising the steps of:

(a) providing suture retention means comprising;

a substantially frusto-conical body having a longitudinal axis, a top surface, a bottom surface, a side surface and a longitudinally-centered cavity extending into said top surface;

said top and bottom surfaces each (a) being substantially planar, (b) being oriented in spaced, parallel relation to one another, and (c) defining a substantially circular periphery centered about said longitudinal axis, said periphery of said bottom surface being smaller than said periphery of said top surface;

said side surface extending between said periphery of said top surface and said periphery of said bottom surface;

said longitudinally-centered cavity including a base surface, a sidewall surface and an open end; and

said body further defining at least one opening extending from said side surface to said sidewall surface, each said opening being sized so as to allow at least one free end of at least one length of suture to be threaded therethrough from said side surface into said longitudinally-centered cavity, and so as to prevent a knot formed by said at least one free end of suture from passing therethrough.

(b) forming an opening in said object extending inwardly from said first surface;

(c) countersinking said opening in said object adjacent said first surface so as to form an inclined surface, with the countersunk region being sized so as to substantially completely accommodate said body when said side surface of said body is in engagement with said inclined surface;

(d) forming a second opening in said object extending from said second surface to said inclined surface of said countersunk region;

(e) locating said object and said anatomical structure in a predetermined position relative to one another, and passing said at least one free end of said at least one length of suture through at least a portion of said second opening in said object so as to extend outwardly from said countersunk region;

(f) locating said body in said countersunk region of said opening, with said at least one free end of said at least one length of suture extending through said at least one opening in said body, and tensioning said at least one length of suture; and

(g) forming a knot in said at least one free end of said at least one length of suture such that said at least one length of suture is maintained under tension when said knot abuts the sidewall surface of said longitudinally-centered cavity adjacent the opening with which said at least one free end of said at least one length of suture is associated.