Soft tissue anchor and method

• US 5,643,320 A
• Filed: 03/13/1995
• Issued: 07/01/1997
• Est. Priority Date: 03/13/1995
• Status: Expired due to Term

• Current Assignee: DePuy Orthopaedics Incorporated (Johnson & Johnson)
• Original Assignee: DePuy Incorporated (Johnson & Johnson)
• Inventors: Goble, E. Marlowe, Lower, Jerry L.
• Primary Examiner(s): Tucker, Guy V.
• Assistant Examiner(s): RASCHE, PATRICK WILLIAM
• Application Number:
  US08/403,070
• Time in Patent Office: 841 Days
• Field of Search: 606/72, 606/73, 606/232, 606/75, 606/104, 606/65, 606/187, 606/139, 606/144, 411/388, 411/389, 411/393, 411/402
• 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 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• 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 2002/0829 without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
• CPC Class Codes: A61F 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel
• CPC Class Codes: Y10S 606/916 Tool for installing or removing orthopedic fastener

Abstract

A preassembled disposable driver and suture anchor are provided for threaded engagement into a bone to provide an attachment point for soft tissue. The anchor is formed to have an externally threaded body portion for engaging the bone, a distal end portion, and a proximal end portion. When the anchor is threaded into an opening in a bone, the distal end portion is adjacent a bottom of the opening and the proximal end portion is adjacent a mouth of the opening. A suture is attached to said anchor having free ends extending outwardly from the bone opening. The driver is elongated and has a distal end which engages the proximal end of the anchor and a proximal end for gripping by the surgeon. The driver also has a slot for receiving the suture which extends away from the anchor. The distal end portion of the driver is radially enlarged relative to the body portion of the anchor to engage the bone surrounding the mouth of the opening to limit the internal advancement of the driver such that further rotation and threading of the anchor into the bone by the driver will separate the anchor from the driver.

Claims

1. A preassembled disposable driver and suture anchor for threaded engagement into a bone to provide an attachment point for soft tissue, comprising:

an anchor being formed to have an externally threaded body portion for engaging the bone, a distal end portion, and a proximal end portion such that, when the anchor is threaded into an opening in a bone, the distal end portion is adjacent a bottom of the opening and the proximal end portion is adjacent a mouth of the opening, a suture attached to said anchor having free ends extending outwardly from the bone opening, said driver being elongated and having a distal end means for engaging the proximal end of said anchor and a proximal end for gripping by the surgeon, said driver also having means for receiving the suture which extends away from said anchor, at least a portion of the distal end means of said driver at the proximal end of the anchor when the anchor and the driver are assembled being radially enlarged relative to the body portion of the anchor to engage the bone surrounding the mouth of the opening to limit the internal advancement of the driver such that rotation of the driver causes no axial movement between the driver and anchor until the distal end means engages the bone surrounding the mouth of the opening whereupon continued rotation of the driver produces relative axial movement between the driver and anchor to provide continued threading of the anchor into the bone by the driver and subsequently separation of the anchor from the driver.

2. The apparatus of claim 1, wherein the proximal end of the anchor is configured to form a male head, and the distal end means of the driver is formed to include a female socket opening configured to receive the male head to provide the means for engaging the proximal end of said anchor.

3. The apparatus of claim 2, wherein the male head and the female socket opening have a square shape.

4. The apparatus of claim 3, wherein the male head includes four corners which are each threaded.

5. The apparatus of claim 2, wherein the threaded body portion of the anchor includes threads having a major diameter and a minor diameter, the head of the anchor having a diameter larger than the minor diameter of the threads.

6. The apparatus of claim 1, wherein the driver includes means for holding the free ends of the suture in tension to hold the anchor on the driver.

7. The apparatus of claim 1, wherein the anchor is formed to include first and second passageways extending longitudinally from the distal end of the anchor to the proximal end of the anchor to provide a web therebetween at the distal end of said anchor, and wherein the suture is threaded through the first passageway of the anchor over the web and back through the second passageway so that the free ends of the suture extend away from the distal end of the anchor.

8. The apparatus of claim 7, wherein the suture is movable in the first and second passageways to equalize a load on the anchor.

9. The apparatus of claim 1, wherein the anchor is made from a plastic material.

10. The apparatus of claim 1, wherein the anchor is made from an absorbable plastic material.

11. The apparatus of claim 1, wherein the anchor is absorbable.

12. The apparatus of claim 1, wherein the suture, when tensioned, applies a compressing force along a longitudinal axis of the anchor to expand the anchor radially outwardly within the opening of the bone to increase a retention force of the anchor in the bone.

13. The apparatus of claim 1 for use with a bone having a countersink surrounding the opening, and wherein the driver includes a conically shaped distal end located adjacent the anchor, the conically shaped distal end being configured to engage the countersink to separate the driver from the anchor.

14. The apparatus of claim 1, wherein the longitudinally extending means for receiving the suture includes a longitudinally extending slot for receiving the free ends of the suture.

15. A preassembled disposable driver and suture anchor for threaded engagement into a drilled and threaded opening in a bone to provide an attachment point for soft tissue to the bone with the opening deeper than the axial length of said anchor, comprising:

an anchor being formed to have an externally threaded body portion for engaging the bone, distal end portion, and a proximal end portion such that, when the anchor is threaded into the threaded opening in the bone, the distal end portion is adjacent and spaced apart from the bottom of the opening leaving an internal cavity and the proximal end portion is adjacent a mouth of the opening, said anchor also having a pair of suture openings extending longitudinally from the proximal end to the distal end, a suture extending into one of said pair of openings into the internal cavity and back out through the other of said pair of openings to have opposite free ends extending outwardly away from the proximal end of the anchor and movable within the pair of openings to equalize the tension in the suture when a soft tissue load is placed on the suture, an elongated driver having a distal end including means for drivingly engaging the proximal end of said anchor and a proximal end for gripping by the surgeon and wherein the driver has an enlarged distal end at the proximal end of the anchor when the anchor and the driver are connected wherein the driving connection causes the insert to automatically move into the bone away from the driver as the driver rotates the insert toward the bottom of the opening in the bone.

16. The apparatus of claim 15, wherein the driver is formed to include a longitudinally extending opening for receiving the free ends of the suture therein, the distal end portion of said driver being radially enlarged relative to the anchor to engage the bone surrounding the mouth of the opening to limit the internal advancement of the driver such that further rotation and threading of the anchor into the bone by the driver will separate the anchor from the driver.

17. The apparatus of claim 15, wherein the proximal end of the anchor is configured to form a male head, and the distal end of the driver is formed to include a female socket opening configured to receive the male head to provide the means for engaging the proximal end of said anchor.

18. The apparatus of claim 17, wherein the male head and the female socket opening have a square shape.

19. The apparatus of claim 15, wherein the driver includes means for holding the free ends of the suture in tension to hold the anchor on the driver.

20. The apparatus of claim 15, wherein the anchor is made from a plastic material.

21. The apparatus of claim 15, wherein the anchor is made from an absorbable plastic material.

22. The apparatus of claim 15, wherein the anchor is absorbable.

23. The apparatus of claim 15, wherein the suture, when tensioned, applies a compressing force along a longitudinal axis of the anchor to expand the anchor radially outwardly within the opening of the bone to increase a retention force of the anchor in the bone.

24. A driver suture anchor for threaded engagement into an opening in a bone to provide an attachment point for soft tissue to the bone and the driver therefor, comprising:

an anchor with an externally threaded body portion for engaging the bone, the body portion having a distal end, a proximal end, first and second passageways extending longitudinally from the distal end of the anchor to the proximal end of the anchor to provide a web therebetween at the distal end of the anchor;

a suture extending through the first passageway of the anchor over the web and back through the second passageway so that free ends of the suture extend away from the proximal end of the anchor, the suture being movable in the passageways; and

an elongated driver having a distal end formed to include means for engaging the proximal end of the anchor and a proximal end for gripping by the surgeon to rotate the driver and the anchor to thread the anchor into the bone and wherein the driver has an enlarged distal end at the proximal end of the anchor when the anchor and driver are connected wherein rotation of the driver by the surgeon causes concurrent rotation of driver and anchor into the bone without axial movement therebetween and wherein continued rotation of the driver and anchor causes relative axial movement of the anchor with respect to the driver when the driver engages the bone, with the relative axial movement continuing with conjoint rotation until the anchor is separated from the driver at a location completely within the bone.

25. The apparatus of claim 24 wherein the driver is formed to include a longitudinally extending slot for receiving the free ends of the suture therein.

26. The apparatus of claim 24 wherein the distal end of the driver has a larger diameter than a diameter of the body portion of the anchor so that the driver engages the bone surrounding a mouth of the opening to block internal advancement of the driver so that further rotation and threading of the anchor into the bone by the driver will automatically separate the driver from the inserted anchor.

27. The apparatus of claim 24 wherein the proximal end of the anchor is configured to form a male head, and the distal end of the driver is formed to include a female socket opening configured to receive the male head to provide the means for engaging the proximal end of said anchor.

28. The apparatus of claim 24 wherein the driver includes means for holding the free ends of the suture in tension to hold the anchor on the driver.

29. The apparatus of claim 24, wherein the suture is movable in the first and second passageways to equalize a load on the anchor.

30. The apparatus of claim 24, wherein the anchor is made from a plastic material.

31. The apparatus of claim 24, wherein the anchor is made from an absorbable plastic material.

32. The apparatus of claim 24, wherein the anchor is absorbable.

33. A method for attaching soft tissue to a bone using an anchor having an externally-threaded body portion, the method comprising the steps of:

(a) drilling a hole into the bone to a first predetermined depth with a spot faced, dressed area cut in the bone about an outer periphery of the hole;

(b) tapping the hole to provide internal threads to a second predetermined depth less than the first predetermined depth;

(c) inserting the externally threaded anchor, having an axial length less than the first predetermined depth and a threaded length less than the second predetermined depth, into the hole so that a distal end of the anchor is spaced apart from a bottom of the hole to provide an internal cavity and a proximal end of the anchor is disposed adjacent a mouth of the hole, the anchor carrying means for engaging the soft tissue to position the soft tissue against the spot faced, dressed area around the hole; and

wherein the inserting step uses a driver to rotate the anchor, the driver having a larger diameter than the anchor so that the driver engages the countersink to block internal advancement of the driver and so that further rotation and threading of the anchor into the bone by the driver automatically separates the driver from the inserted anchor.

34. The method of claim 33, wherein the drilling step forms a countersink surrounding a mouth of the hole and the dressed area is cut around the countersink so that the proximal end of the anchor is disposed generally within the countersink.

35. The method of claim 34, wherein the engaging means includes a spike formed on the proximal end of the anchor to extend outwardly from the hole and penetrate the soft tissue.

36. The method of claim 34, wherein the engaging means includes a suture coupled to the anchor.

37. The method of claim 34, wherein the anchor is absorbable.

38. The method of claim 34, wherein the anchor is made from a plastic material.

39. A method for attaching soft tissue to a bone using a suture anchor having an externally threaded body portion for engaging the bone, the body portion having a distal end, a proximal end, first and second passageways extending longitudinally from the distal end of the anchor to the proximal end of the anchor, the method comprising the steps of:

(a) drilling a hole into the bone to a first predetermined depth with a dressed area cut in the bone about an outer periphery of the hole to provide a contact surface for the soft tissue;

(b) tapping the hole to provide internal threads;

(c) providing a suture loosely threaded through the first passageway formed in the anchor, over a web of material at the distal end of the anchor between the first and second passageways, and back through the second passageway formed in the anchor so that free ends of the suture extend away from the proximal end of the anchor;

(d) inserting the anchor into the hole so that the distal end of the anchor is adjacent a bottom of the hole, the proximal end of the anchor is adjacent an opening of the hole and the free ends of the suture extend outwardly from the hole;

(e) attaching the free ends of the suture to the soft tissue to position the soft tissue against the dressed area around the hole; and

wherein the inserting step uses a driver to rotate the anchor, the driver having a larger diameter than the anchor so that the driver engages the countersink to block internal advancement of the driver and so that further rotation and threading of the anchor into the bone by the driver automatically separates the driver from the inserted anchor.

40. The method of claim 39, wherein the drilling step forms a countersink surrounding a mouth of the hole and the dressed area is cut around the countersink so that the proximal end of the anchor is disposed generally within the countersink.

41. The method of claim 39, wherein the anchor is absorbable.

42. The method of claim 39, wherein the anchor is made from a plastic material.