Suture anchor

• US 5,522,846 A
• Filed: 03/10/1995
• Issued: 06/04/1996
• Est. Priority Date: 05/14/1993
• Status: Expired due to Term

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: Peter M. Bonutti
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/402,352
• Time in Patent Office: 452 Days
• Field of Search: 606/139, 606/144, 606/220, 606/232, 606/72, 606/74
• 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 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0411 Instruments for removing suture anchors for removing suture clamps, clips or locks A61B2017/049
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0459 Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2090/062 penetration depth

Abstract

The present invention is an anchor for securing a suture in the body. The anchor includes a tubular wall having a central axis. The tubular wall has a proximal end and a distal end each free of axially inwardly extending slots. The tubular wall has an inner surface extending for the entire length of the tube and defining in the anchor a central opening extending between the proximal end and the distal end. The anchor has a width less than its length. A suture may extend through the anchor within the central opening. First and second end portions of the suture extend out of opposite ends of the anchor and are sufficiently long to project out of the body when the suture is secured in the body by the anchor. The anchor has an anchoring orientation in the body achieved by manipulation of the distal end of the anchor by pulling on the second end portion of the suture. The anchor has a removal orientation in the body achieved by manipulation of the proximal end of the anchor by pulling on the first end portion of the suture. The present invention also relates to a method of anchoring to a bone a suture having .first and second end portions.

Claims

1. A method of anchoring a suture, said method comprising the steps of:

moving a pusher member to a position in which the pusher member projects outward from a base member with an end surface on the pusher member spaced a predetermined distance from an end surface on the base member,

inserting a suture through a passage in the pusher member, through a passage in the base member, and through a passage in an anchor,

engaging a first end surface on the anchor with the end surface on the pusher member,

pushing the anchor into body tissue with a second end surface on the anchor leading, said step of pushing the anchor into body tissue including pressing the end surface on the pusher member against the first end surface on the anchor and moving a portion of the pusher member which extends outwardly from the end surface on the base member into the body tissue, and

terminating said step of pushing the anchor into the body tissue when the end surface on the base member engages the body tissue.

2. A method as set forth in claim 1 wherein said step of pushing the anchor into body tissue is at least partially performed with a portion of the suture extending from the passage in the anchor, across the second end surface on the anchor, along an outer side surface on the anchor, and along an outer side surface on the pusher member to a location outside of the body tissue.

3. A method as set forth in claim 2 further including the steps of at least partially removing the pusher member from the body tissue, thereafter, applying force against a portion of the anchor by pulling on the suture and transmitting force through the portion of the suture which extends along the outer side surface on the anchor to the second end surface on the anchor, and moving the second end surface on the anchor in a direction opposite to a direction in which the anchor is pushed into the body tissue under the influence of the force transmitted through the portion of the suture which extends along the outer side surface of the anchor.

4. A method as set forth in claim 1 further including the step of inserting a thin elongated member into the body tissue and inserting the thin elongated member through the passage in the anchor and through the passages in the pusher and base members prior to performance of said step of pushing the anchor into body tissue.

5. A method as set forth in claim 4 further including the step of removing the thin elongated member from the body tissue, from the passage in the anchor, and from the passages in the pusher and base members, and, thereafter, changing the orientation of the anchor relative to the body tissue by pulling on the suture.

6. A method of anchoring a suture, said method comprising the steps of providing an anchor having an outer side surface which extends between first and second end surfaces and having a passage which extends through the anchor, providing a depth measurement device having a first surface spaced from a second surface, inserting a suture through the passage extending through the anchor, and moving the anchor into body tissue with the first end surface of the anchor leading and the second end surface of the anchor trailing and with the suture extending through the passage in the anchor, said step of moving the anchor into body tissue including engaging the second end surface on the anchor with the first surface on the depth measurement device and moving the anchor relative to the body tissue until the second surface on the depth measurement device engages a surface of the body tissue.

7. A method as set forth in claim 6 wherein one of said first and second surfaces on said depth measurement device is movable relative to the other of said first and second surfaces on said depth measurement device, said method further including the steps of determining a desired distance of movement of the anchor into the body tissue and moving said one of said first and second surfaces relative to said other of said first and second surfaces until said first and second surfaces are spaced apart by a distance which is a function of the desired distance of movement of the anchor into the body tissue.

8. A method as set forth in claim 6 wherein said step of moving the anchor into the body tissue further includes transmitting force from the first surface on the depth measurement device to the second end surface on the anchor to move the anchor into the body tissue.

9. A method as set forth in claim 6 further including the step of inserting a thin elongated member through the passage in the anchor and inserting the thin elongated member into the body tissue, said step of moving the anchor into body tissue includes moving the anchor along the thin elongated member.

10. A method of anchoring a suture, said method comprising the steps of providing an anchor having a passage which extends through the anchor, determining a desired distance of insertion of the anchor into body tissue, inserting a suture through the passage extending through the anchor, moving the anchor into body tissue with the suture extending through the passage in the anchor, measuring the distance which the anchor moves into the body tissue, and interrupting said step of moving the anchor into body tissue when the measured distance which the anchor extends into the body tissue is the same as the desired distance of insertion of the anchor into the body tissue.

11. A method of anchoring a suture, said method comprising the steps of providing an anchor having a passage which extends through the anchor, providing first and second members, inserting a suture through the passage in the anchor, inserting the anchor and at least a portion of the first member into the second member, moving the anchor out of the passage in the second member and into body tissue with a portion of the suture extending through the passage in the anchor and with a portion of the suture extending from the passage in the anchor along a path which is at least partially disposed between the first and second members, and, thereafter, transmitting force to the anchor through the portion of the suture which is at least partially disposed between the first and second members.

12. A method as set forth in claim 11 further including the step of inserting a thin elongated member through the passage in the anchor and through a passage in the first member, said step of moving the anchor into body tissue includes moving the anchor along the thin elongated member with the thin elongated member extending through the passage in the first member.

13. A method as set forth in claim 11 wherein said step of inserting the anchor and at least a portion of the first member into the second member is performed with a portion of the suture extending along an outer side of the first member.

14. A method as set forth in claim 11 wherein said step of transmitting force to the anchor through the portion of the suture which is at least partially disposed between the first and second members is performed with the anchor disposed in the body tissue.

15. A method as set forth in claim 11 wherein said step of moving the anchor into body tissue includes engaging a trailing end of the anchor with an end of the first member, said method further including applying force against the trailing end of the anchor with the first member simultaneously with performance of said step of transmitting force to the anchor through the portion of the suture which is at least partially disposed between the first and second members.

16. A method as set forth in claim 15 wherein said step of applying force against the trailing end of the anchor includes applying force against only a portion of a surface on the trailing end of the anchor with the first member to concentrate the force at a relatively small area on the trailing end of the anchor.

17. A method as set forth in claim 11 wherein said step of moving the anchor into body tissue includes transmitting force through the suture to press a trailing end of the anchor against an end of the first member.

18. A method as set forth in claim 11 further including engaging a portion of the anchor with the first member and pivoting the anchor about an area of engagement between the first member and the anchor while transmitting force to the anchor through the portion of the suture which is at least partially disposed between the first and second members.

19. A method as set forth in claim 11 wherein said method further includes moving the anchor along a path extending transverse to the passage in the second member simultaneously with performance of said step of transmitting force to the anchor through the portion of the suture which is at least partially disposed between the first and second members.

20. A method as set forth in claim 11 further including pressing an outer side of the anchor against body tissue and displacing body tissue under the influence of force applied against the body tissue by the outer side of the anchor during performance of said step of transmitting force to the anchor through the portion of the suture which is at least partially disposed between the first and second members.

21. A method as set forth in claim 11 wherein said step of providing an anchor includes providing a tubular anchor having a passage which extends between first and second ends of the anchor, said step of moving the anchor into body tissue being performed with the first end of the anchor leading and with the suture extending across at least a portion of the first end of the anchor.

22. An apparatus for use in anchoring a suture in body tissue, said apparatus comprising a first member having inner and outer sides, said inner side of said first member at least partially defines a passage extending through said first member, a second member having an inner side which at least partially defines a passage extending through said second member, said first member being at least partially disposed in said passage in said second member, an anchor having a passage which extends through said anchor, and a suture having a first portion which extends through said passage in said first member, a second portion which extends through said passage in said anchor, and a third portion which extends along a path which is at least partially disposed between said outer side of said first member and said inner side of said second member.

23. An apparatus as set forth in claim 22 wherein said third portion of said suture is disposed in engagement with a first end of said anchor and extends along an outer side of said anchor.

24. An apparatus as set forth in claim 23 wherein a second end of said anchor is disposed in engagement with an end portion of said first member.

25. An apparatus as set forth in claim 22 wherein said first member has an end portion which engages only a portion of one end of said anchor, said third portion of said suture being disposed in engagement with an end of said anchor opposite from said one end.

26. A method of anchoring a suture, said method comprising the steps of providing an anchor having a passage which extends through the anchor, providing first and second members, inserting a suture through the passage in the anchor and through a passage in the first member, enclosing at least a portion of the first member with the second member, moving the anchor into body tissue with a first portion of the suture extending from a location disposed to one side of the body tissue through the passage in the first member, with a second portion of the suture extending through the passage in the anchor, and with a third portion of the suture extending along an outer side surface of the anchor and to the location disposed to one side of the body tissue, at least partially enclosing the third portion of the sture with the second member during performance of said step of moving the anchor into the body tissue, and engaging one end of the anchor with an end of the first member during performance of at least a portion of said step of moving the anchor into body tissue.

27. A method as set forth in claim 26 wherein said step of moving the anchor into body tissue includes moving the first member, anchor, and first and third portions of said suture relative to said second member.

28. A method as set forth in claim 26 wherein said step of moving the anchor into body tissue includes engaging a surface on the second member with the third portion of the suture and sliding the third portion of the suture along the engaged surface on the second member while at least partially enclosing the third portion of the suture with the second member.

29. A method as set forth in claim 26 wherein at least a portion of said step of moving the anchor into body tissue includes sliding an outer side surface of the first member along an inner side surface of the second member.

30. A method as set forth in claim 26 wherein said step of moving the anchor into the body tissue includes moving the anchor and first member together relative to the second member while the second member is in engagement with the body tissue and at least partially encloses the anchor and the first member.

31. A method as set forth in claim 26 wherein said step of providing an anchor includes providing an anchor having a passage which extends between first and second ends of the anchor, said step of moving the anchor into body tissue being performed with the first end of the anchor leading and with the third portion of the suture extending across at least a portion of the first end of the anchor.

32. A method as set forth in claim 26 further including the steps of pressing an outer side of the anchor against body tissue and displacing body tissue under the influence of force applied against the body tissue by the outer side of the anchor.

33. A method as set forth in claim 26 further including engaging a portion of the anchor with the first member and pivoting the anchor about an axis extending through an area of engagement between the first member and the anchor.

34. A method as set forth in claim 26 wherein said step of moving the anchor into body tissue includes transmitting force through the first and third portions of the suture to press a trailing end of the anchor against an end of the first member.

35. A method as set forth in claim 26 further including the step of inserting a thin elongated member through the passage in the anchor and through the second member, said step of moving the anchor into body tissue includes moving the anchor along the thin elongated member with the thin elongated member extending through the second member.

36. A method of anchoring a suture, said method comprising the steps of providing an anchor having a passage which extends through the anchor, providing first and second members, inserting a suture through the passage in the anchor, positioning at least a portion of the anchor in a passage in the second member along with at least a portion of the first member, pressing an end portion of the second member against a surface area on the body tissue, and moving the anchor out of the passage in the second member and through the surface area on the body tissue while continuing to press the end portion of the second member against the surface area on the body tissue, said step of moving the anchor out of the passage in the second member and through the surface area on the body tissue includes pressing the anchor against body tissue under the influence of force transmitted from the first member to the anchor and with the suture extending through the passage in the anchor.

37. A method as set forth in claim 36 further including the step of inserting a thin elongated member through the surface area on the body tissue prior to performance of said step of moving the anchor out of the passage in the second member and through the surface area on the body tissue, said step of moving the anchor out of the passage in the second member and through the surface area on the body tissue includes moving the anchor along the thin elongated member with the thin elongated member and the suture extending through the passage in the anchor.

38. A method as set forth in claim 36 wherein said step of moving the anchor out of the passage in the second member and through the surface area on the body tissue is performed with a portion of the suture extending from the passage in the anchor along a path which is at least partially disposed between the first and second members.

39. A method as set forth in claim 36 wherein said step of moving the anchor out of the passage in the second member and through the surface area on the body tissue includes moving the first member and anchor along the passage in the second member while maintaining the end portion of the second member stationary relative to the surface area on the body tissue.

40. A method as set forth in claim 36 wherein said step of moving the anchor out of the passage in the second member and through the surface area on the body tissue includes moving an end portion of the first member out of the passage in the second member and through the surface area on the body tissue while continuing to press the end portion of the second member against the surface area on the body tissue.

41. A method as set forth in claim 40 further including the step of changing the orientation of the anchor relative to the first member while continuing to press the end portion of the second member against the surface area on the body tissue and after having performed said step of moving the end portion of the first member out of the passage in the second member and through the surface area on the body tissue, said step of changing the orientation of the anchor includes transmitting force between one end portion of the anchor and the end portion of the first member while transmitting force between the suture and an end portion of the anchor opposite from the one end portion by tensioning the suture.

42. A method as set forth in claim 40 further including the step of changing the orientation of the anchor relative to the first member while continuing to press the end portion of the second member against the surface area on the body tissue and after having performed said step of moving the end portion of the first member out of the passage in the second member and through the surface area on the body tissue, said step of changing the orientation of the anchor includes transmitting force between an axially tapering end portion of the first member and an end surface of the anchor while tensioning the suture to pivot the anchor relative to the axially tapering end portion of the first member.

43. A method of anchoring a suture, said method comprising the steps of providing an anchor having a passage which extends through the anchor, providing first and second members, inserting a suture through the passage in the anchor, positioning at least a portion of the anchor in a passage in the second member along with at least a portion of the first member, moving the first member along the passage in the second member from a first position in which an end portion of the first member and the anchor are at least partially enclosed by the second member to a second position in which the end portion of the first member projects outward from the second member and the anchor is spaced from the second member, and, thereafter, pivoting the anchor relative to the end portion of the first member while the end portion of the first member is projecting outward from the second member and the anchor is spaced from the end portion of the second member.

44. A method as set forth in claim 43 wherein said step of pivoting the anchor relative to the end portion of the first member includes applying to the anchor a force having a component which extends transverse to a central axis of the first member by tensioning the suture.

45. A method as set forth in claim 44 wherein said step of pivoting the anchor relative to the end portion of the first member by applying to the anchor a force having a component transverse to a central axis of the first member by tensioning the suture includes applying to the anchor a force having a component which extends along the central axis of the first member by tensioning the suture to thereby urge the anchor toward the end portion of the first member.

46. A method as set forth in claim 45 further including the step of inserting the suture through the passage in the first member prior to performance of said step of moving the first member along the passage in the second member.

47. A method as set forth in claim 45 wherein said step of moving the first member along the passage in the second member from a first position in which an end portion of the first member and the anchor are enclosed by said second member to a second position in which an end portion of the first member projects outward from the second member and the anchor is spaced from the second member is performed with a portion of the suture extending from the passage in the anchor along a path which is at least partially disposed between the first and second members.

48. A method as set forth in claim 45 further including the step of moving the first member along the passage in the second member from a first position to a second position is performed while pressing an end portion of the second member against a surface area on the body tissue, said step of moving the first member from a first position to a second position includes moving the end portion of the first member through the surface area on the body tissue.

49. A method of anchoring a suture, said method comprising the steps of providing an anchor having a passage which extends between first and second end portions of the anchor, providing first member having a passage which extends between first and second end portions of said first member, providing a second member having a passage extending between first and second end portions of the second member, inserting the first member into the passage in the second member, inserting a suture through the passage in the anchor and through the passage in the first member, moving the anchor and the first end portion of the first member into engagement with body tissue by moving the first member relative to the second member, said step of moving the anchor and the first end portion of the first member into engagement with body tissue being performed with the first end portion of the anchor leading and the second end portion of the anchor trailing, said step of moving the anchor and the first end portion of the first member into engagement with body tissue being performed with a first portion of the suture extending from a location disposed to one side of the body tissue through the passage in the first member, a second portion of the suture extending through the passage in the anchor and a third portion of the suture extending across the first end portion of the anchor to the location disposed to one side of the body tissue, thereafter, applying to the first end portion of the anchor a force having a component which extends transverse to a central axis of the first member and a component which extends along the central axis of the first member by tensioning the third portion of the suture.

50. A method as set forth in claim 49 further including the step of pressing the second end portion of the anchor against the first end portion of the first member while the force is applied to the first end portion of the anchor by tensioning the third portion of the suture.

51. A method as set forth in claim 49 further including the step of pressing an end portion of the second member against a surface area on the body tissue, said step of moving the anchor and the first end portion of the first member into engagement with body tissue by moving the first member relative to the second member includes moving the anchor and the first end portion of the first member through the surface area on the body tissue while pressing the end portion of the second member against the surface area on the body tissue.

52. A method as set forth in claim 51 further including the step of pressing the second end portion of the anchor against the first end portion of the first member under the influence of the force applied to the first end portion of the anchor by tensioning the third portion of the suture.