Method and apparatus for anchoring a suture

• US 5,534,012 A
• Filed: 05/26/1995
• Issued: 07/09/1996
• 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:
  US08/451,865
• Time in Patent Office: 410 Days
• Field of Search: 606/72-74, 606/139, 606/144, 606/151, 606/220, 606/232, 24/115 H, 24/122.6
• 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 2090/062 penetration depth

Abstract

A tubular anchor may have a polygonal cross-sectional configuration with flat outer side surfaces areas connected by a plurality of outer corner portions. A passage through the anchor may be formed by flat inner side surfaces interconnected by inner corner portions. A suture is inserted through the passage. A concentrated force may be applied against a limited area on a trailing end of the anchor to rotate the anchor to move an outer corner portion of the anchor into engagement with body tissue. The suture may engage an inner corner portion of the anchor. The suture may be inserted through a plurality of anchors and the anchors moved through a tubular member into the body tissue under the influence of force transmitted from a trailing anchor to a leading anchor. When the leading anchor is moved into the body tissue, it is rotated under the influence of force applied against a trailing end of the leading anchor. If desired, two anchors may be interconnected. A groove may advantageously be provided along the leading end and side of an anchor to receive the suture.

Claims

1. An apparatus which is at least partially received in body tissue, said apparatus comprising a first anchor section, a second anchor section, a connector integrally formed as one piece with and extending between said first and second anchor sections, said connector having a cross sectional area which is substantially less than a cross sectional area of said first anchor section and a cross sectional area of said second anchor section, and a suture adapted to extend into the body tissue and at least part way through said first and second anchor sections, said suture being tensionable with said first and second anchor sections at least partially in the body tissue to deform said connector section and move said first anchor section relative to said second anchor section from a first position in which a central axis of said first anchor section is disposed in a first orientation relative to a central axis of said second anchor section to a second position in which the central axis of said first anchor section is disposed in a second orientation relative to a central axis of said second anchor section.

2. An apparatus as set forth in claim 1 wherein said first anchor section is tubular and has a polygonal cross-sectional configuration and said second anchor section is tubular and has a polygonal cross-sectional configuration.

3. An apparatus as set forth in claim 1 wherein said first anchor section includes a first plurality of flat outer side surface areas which are interconnected by a first plurality of longitudinally extending corner portions, said first plurality of longitudinally extending outer corner portions and said first plurality of flat outer side surface areas being engageable with body tissue to retain said first anchor section in the body tissue, said second anchor section including a second plurality of flat outer side surface areas which are interconnected by a second plurality of longitudinally extending corner portions, said second plurality of longitudinally extending corner portions and said second plurality of flat outer side surface areas being engageable with body tissue to retain said second anchor section in the body tissue.

4. An apparatus as set forth in claim 1 wherein said first anchor section has a central passage which extends axially through said first anchor section, said second anchor section having a central passage which extends axially through said second anchor section.

5. An apparatus as set forth in claim 4 wherein said central passage through said first anchor section has a first inner corner portion, said central passage through said second anchor section having a second inner corner portion, said suture being engageable with said first and second inner corner portions to urge said first and second anchor sections into engagement with body tissue.

6. An apparatus as set forth in claim 5 wherein said first anchor section has first and second flat outer side surface areas which are interconnected by a first outer corner portion which is disposed adjacent to said first inner corner portion, said second anchor section having third and fourth flat outer side surface areas which are interconnected by a second outer corner portion which is disposed adjacent to said second inner corner portion.

7. An apparatus as set forth in claim 1 wherein said central axis of said first anchor section is parallel to said central axis of said second anchor section when said first anchor section is in the first position, said central axis of said first anchor section being transverse to said central axis of said second anchor section when said first anchor section is in the second position.

8. A method of anchoring a suture, said method comprising the steps of providing an anchor device having a first anchor section with a first passage, a second anchor section with a second passage and a connector interconnecting said first and second anchor sections, inserting a suture into the passages in the first and second anchor sections, moving at least the first anchor section into body tissue with the suture in the passages in the first and second anchor sections, said step of moving the first anchor section into body tissue including transmitting force from the second anchor section to the first anchor section through the connector to move the first and second anchor sections in a first direction, and deforming the connector with the first anchor section in the body tissue by moving the first anchor section in a second direction transverse to the first direction.

9. A method as set forth in claim 8 wherein said step of deforming the connector with the first anchor section in the body tissue includes tensioning the suture.

10. A method as set forth in claim 8 wherein said step of deforming the connector includes bending the connector and maintaining the first anchor section connected with the second anchor section by the connector during movement of the first anchor section in the second direction.

11. A method as set forth in claim 8 further including moving the first and second anchor sections transverse to the first direction after having performed said step of deforming the connector.

12. A method as set forth in claim 8 wherein a central axis of said first anchor section is parallel to a central axis of said second anchor section during movement of the first and second anchor sections together in the first direction, the central axis of the first anchor section being skewed relative to the central axis of the second anchor section after deformation of the connector.

13. A method of anchoring a suture in body tissue, said method comprising the steps of inserting a tubular member into the body tissue, providing an anchor having first and second sections interconnected by a connector and having passages extending through the first and second sections of the anchor, inserting a suture through the passages in the first and second sections of the anchor, inserting the anchor into the tubular member with the first section of the anchor leading and with the suture extending from a location outside of the tubular member, through the passages in the first and second sections of the anchor, and into engagement with an end of the first section of the anchor, applying force against the second section of the anchor, moving the first section of the anchor and the connector through an open end of the tubular member to a location disposed in the body tissue with the suture in engagement with the end of the first section of the anchor, and deforming the connector to move the first section of the anchor and the portion of the suture which engages the end of the first section of the anchor to a location offset to a first side of the tubular member, said step of deforming the connector includes tensioning the suture to apply force against the end of the first section of the anchor.

14. A method as set forth in claim 13 further including the step of pressing an outer side of the first section of the anchor against body tissue adjacent to a first side of the tubular member and pressing an outer side of the second section of the anchor against body tissue adjacent to a second side of the tubular member after having performed said step of deforming the connector.

15. A method as set forth in claim 13 wherein a portion of an outer side of the first section of the anchor is spaced from an inner side of the tubular member and a portion of the outer side of the second section of the anchor is spaced from the inner side of the tubular member when the anchor is inserted in the tubular member to at least partially form a channel between the inner side of the tubular member and the anchor, said method further including maintaining a portion of the suture in the channel during movement of the anchor in the tubular member.

16. A method of anchoring a suture, said method comprising the steps of providing an anchor having first and second sections interconnected by a connector, inserting a suture through a passage in the anchor, moving at least the first section of the anchor into body tissue with the suture extending through the passage in the anchor, and changing the orientation of the first section of the anchor relative to the second section of the anchor by deforming the connector with the first section of the anchor in the body tissue.

17. A method as set forth in claim 16 wherein said step of deforming the connector includes tensioning the suture to transmit force from the suture to at least one of the first and second sections of the anchor and moving the first section of the anchor relative to the second section of the anchor.

18. A method as set forth in claim 16 wherein each of the first and second sections of the anchor has a polygonal cross-sectional configuration with a plurality of flat outer side surfaces and a plurality of corner portions which interconnect the outer side surfaces, said method further including urging a first corner portion on the first section of the anchor and a first corner portion on the second section of the anchor into engagement with the body tissue by tensioning the suture, urging flat outer side surfaces interconnected by the first corner portion of the first section of the anchor into engagement with body tissue by tensioning the suture, and urging flat outer side surfaces interconnected by the first corner portion of the second section of the anchor into engagement with body tissue by tensioning the suture.

19. A method as set forth in claim 18 wherein the passage in the anchor has an inner corner portion, said steps of urging the corner portions and flat outer side surfaces on the first and second sections of the anchor into engagement with body tissue include transmitting force from the suture to the inner corner portion of the passage in the anchor.

20. A method as set forth in claim 16 wherein said step of changing the orientation of the first section of the anchor relative to the second section of the anchor includes applying torque to the first section of the anchor to induce rotation of the first section of the anchor about an axis which extends transversely to a central axis of the first section of the anchor during deforming of the connector.

21. A method as set forth in claim 16 wherein said step of moving at least the first section of the anchor into body tissue includes moving the first and second sections of the anchor along a first path length, said step of changing the orientation of the first section of the anchor relative to the second section of the anchor includes moving the first section of the anchor along a path length which extends transversely to the first path length while deforming the connector.

22. A method as set forth in claim 16 wherein said step of moving at least the first section of the anchor into body tissue includes transmitting force to the suture from the first section of the anchor to pull the suture into the body tissue with a first portion of the suture extending from a leading end portion of the first section of the anchor through the passage in the anchor and with a second portion of the suture extending from the leading end portion of the first section of the anchor along an outer side of the first section of the anchor.

23. A method as set forth in claim 16 wherein said step of changing the orientation of the first section of the anchor relative to the second section of the anchor includes moving the first section of the anchor from an orientation in which a central axis of the first section of the anchor is parallel to a central axis of the second section of the anchor to an orientation in which the central axis of the first section of the anchor is skewed relative to the central axis of the second section of the anchor while deforming the connector.

24. A method as set forth in claim 16 wherein said step of providing an anchor having first and second sections interconnected by a connector includes providing an anchor having first and second sections each of which has an outer side with flat outer side surface areas interconnected by an outer corner portion, the passage in the anchor having an inner surface having flat inner side surface areas interconnected by an inner corner portion, said method further including moving the suture into engagement with the inner corner portion of the passage in the anchor, urging the outer corner portion and flat outer side surface areas of the first section of the anchor into engagement with body tissue under the influence of force transmitted from the suture, and urging the outer corner portion and flat outer side surface areas of the second section of the anchor into engagement with body tissue under the influence of force transmitted from the suture.

25. A method of anchoring a suture, said method comprising the steps of providing an anchor having a first section with first and second end portions, a second section with first and second end portions, and a connector which connects the second end portion of the first section with the first end portion of the second section, said first section of the anchor having a passage which extends between the first and second end portions of the first section of the anchor, said second section of the anchor having a passage which extends between the first and second end portions of the second section, inserting a suture through the passages in the first and second sections of the anchor, said step of inserting a suture through the passages in the first and second sections of the anchor includes positioning the suture across the connector, thereafter, moving the first and second sections of the anchor through an opening in body tissue with the first end portion of the first section of the anchor leading and with the second end portion of the second section of the anchor trailing, and deforming the connector by tensioning the suture, said step of deforming the connector includes moving the first section of the anchor relative to the second section of the anchor and the body tissue to press the anchor against the body tissue.

26. A method as set forth in claim 25 wherein outer sides of each of the first and second sections of the anchor include flat outer side surface areas interconnected by an outer corner portion, each of the first and second sections of the anchor having flat inner side surface areas which are interconnected by an inner corner portion and at least partially define the passages through the first and second sections of the anchor, said step of deforming the connector includes transmitting force from the suture to the inner corner portion of the first section of the anchor to urge the outer corner portion of the first section of the anchor into engagement with the body tissue and transmitting force from the suture to the inner corner portion of the second section of the anchor to urge the outer corner portion of the second section of the anchor into engagement with the body tissue.

27. A method as set forth in claim 25 further including the step of changing the orientation of the first and second sections of the anchor relative to the body tissue during performance of said step of deforming the connector.

28. A method as set forth in claim 25 further including the steps of inserting a tubular member through the opening in the body tissue, inserting the anchor into the tubular member with the first end portion of the first section of the anchor leading, said step of moving the first and second sections of the anchor through the opening in body tissue includes moving the anchor along the tubular member through the opening in the body tissue, effecting relative movement between the first section of the anchor and the tubular member to move the first section of the anchor from the tubular member, effecting relative movement between the second section of the anchor and the tubular member to move the second section of the anchor from the tubular member, said step of deforming the connector being at least partially performed after having moved the first and second sections of the anchor from the tubular member.

29. A method as set forth in claim 28 wherein said step of effecting relative movement between the first section of the anchor and the tubular member to move the first section of the anchor from the tubular member includes transmitting force from the first end portion of the second section of the anchor through the connector section of the anchor to the second end portion of the first section of the anchor.

30. A method as set forth in claim 28 further including the step of retaining the first and second sections of the anchor against rotational movement about a longitudinal central axis of the tubular member by engaging the first and second sections of the anchor with a locating surface.

31. A method comprising the steps of providing an anchor having first and second sections interconnected by a connector, a first end of the anchor being disposed on the first section of the anchor and a second end of the anchor being disposed on the second section of the anchor, the anchor having a first passage which extends through the first section of the anchor and a second passage which extends through the second section of the anchor, inserting a suture through the first and second passages in the first and second sections of the anchor, moving at least a portion of the anchor into body tissue with the suture extending through the first and second passages in the first and second sections of the anchor and with the first end of the anchor leading and the second end of the anchor trailing, and thereafter, changing the orientation of at least the first section of the anchor relative to the body tissue by simultaneously applying force against the second end of the anchor and tensioning at least a portion of the suture to apply force against the first end of the anchor, said step of changing the orientation of at least the first section of the anchor relative to the body tissue includes deforming the connector under the influence of the force applied against the first and second ends of the anchor.

32. A method as set forth in claim 31 wherein said step of changing the orientation of at least the first section of the anchor relative to the body tissue includes pressing a rigid member against the second end of the anchor while pulling on the suture to apply force against the first end of the anchor.

33. A method as set forth in claim 31 wherein said step of deforming the connector includes rotating the first section of the anchor relative to the second section of the anchor about an axis which is disposed adjacent to the connector.