Expandable suture anchor

• US 5,957,953 A
• Filed: 02/16/1996
• Issued: 09/28/1999
• Est. Priority Date: 02/16/1996
• Status: Expired due to Term

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Warren, Russell, Fitzpatrick, Denise D., Cerier, Jeffrey, DiPoto, Gene P., Lizardi, Jose E.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Shai, Daphna
• Application Number:
  US08/602,977
• Time in Patent Office: 1,320 Days
• Field of Search: 606/72, 606/73, 606/232
• 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 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0425 the anchor or the separate member comprising threads, e.g. a set screw in the anchor
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: Y10S 606/916 Tool for installing or removing orthopedic fastener

Abstract

An adjustably expandable suture anchor is provided. The suture anchor includes a pair of members, one of which includes a suture mount, which are configured to be secured together in a selected one of a plurality of positions to cause one of the members to expand by an amount that corresponds to the selected position. In one embodiment, the expandable member is an outer member, and the other member is an inner member which is progressively insertable into an opening in a body of the outer member and securable in the selected position therein. For example, the inner member is threaded into the outer member body or is inserted into the body in ratchet-like fashion. As the inner member is inserted distally into the outer member, an exterior enlargement on the inner member engages a plurality of arms which extend proximally from body, and causes the arms to progressively expand radially outwardly. Because the amount of expansion is adjustable, the suture anchor can be customized to provide the proper amount of fixation for the quality of the bone in which the anchor is installed. For example, when used in relatively soft bone tissue, the suture anchor can be expanded to a greater degree than might be required in harder bone tissue to obtain secure fixation.

Claims

1. A suture anchor comprising

a pair of members constructed to dwell within tissue, one of said members including a suture mount,

said members each including a locking element for securing the members together in a selected one of a plurality of positions, each of the plurality of positions causing an expansion of a first one of said member by a differing amount such that when secured together the first one of said members expands by an amount that corresponds to the selected position.

2. The suture anchor of claim 1 wherein said first one of said members comprises an outer member having an opening therein, a second one of said members comprising an inner member progressively insertable into said opening to be secured to said outer member in said selected one of said plurality of positions.

3. The suture anchor of claim 2 wherein said outer member includes a body configured to be secured to said inner member and an expandable portion configured to be expanded by said inner member, said opening being disposed through said expandable portion and said body along a longitudinal axis of said outer member.

4. The suture anchor of claim 3 wherein said expandable portion includes a plurality of arms which extend axially from said body to a proximal end of said outer member.

5. The suture anchor of claim 4 wherein said inner member is configured for insertion into said opening at said proximal end of said outer member and includes an enlargement for engaging said arms and causing said arms to progressively expand radially outwardly as said inner member is inserted distally into said opening.

6. The suture anchor of claim 5 wherein said enlargement is disposed on a portion of an exterior surface of said inner member and tapers in size axially along said inner member.

7. The suture anchor of claim 6 wherein said enlargement comprises a conically shaped proximal end of said inner member.

8. The suture anchor of claim 5 wherein said enlargement comprises a rib disposed on a portion of an exterior surface of said inner member.

9. The suture anchor of claim 4 wherein said arms are arranged around a periphery of said outer member and are circumferentially spaced by axially extending slots.

10. The suture anchor of claim 9 wherein each of said slots includes an enlarged portion adjacent to a junction between said arms and said body.

11. The suture anchor of claim 4 further comprising a ridge disposed on an exterior surface of said arms and oriented transversely to said axis.

12. The suture anchor of claim 4 further comprising a ridge disposed on an exterior surface of said body and oriented along said axis.

13. The suture anchor of claim 3 wherein said outer member locking element comprises threads in said opening in said body, and said inner member locking element comprises threads at a distal region of said inner member for threadably engaging said body to secure said inner member to said outer member in said selected one of said plurality of positions.

14. The suture anchor of claim 3 wherein said inner member and said outer member locking elements are configured for ratchet-like engagement therebetween as said inner member is axially inserted into said opening.

15. The suture anchor of claim 14 wherein said inner member locking element comprises circumferential grooves arranged axially along an exterior surface of said inner member, and said outer member locking element comprises a projection in said body opening to progressively engage said grooves as said inner member is axially inserted into said opening.

16. The suture anchor of claim 3 wherein said opening terminates in a closed distal end of said body.

17. The suture anchor of claim 16 wherein said closed distal end forms a tapered tip.

18. The suture anchor of claim 16 wherein said suture mount includes a suture receiving passage in said closed distal end oriented transversely to a longitudinal axis of said outer member.

19. The suture anchor of claim 18 wherein said passage includes a pair of open ends in an exterior surface of said distal end, and further comprising a pair of axially oriented channels in said exterior surface adjacent to said open ends.

20. The suture anchor of claim 18 wherein said expandable portion includes a plurality of arms which extend axially from said body to a proximal end of said outer member, said arms being arranged around a periphery of said outer member and being circumferentially spaced by axially extending slots that are aligned with said channels.

21. The suture anchor of claim 2 wherein said outer member is configured for insertion into a pre-drilled bone hole.

22. The suture anchor of claim 2 wherein said outer member includes threads on an exterior surface thereof.

23. The suture anchor of claim 2 wherein said suture mount comprises a suture receiving passage in said inner member and arranged along a longitudinal axis of said inner member.

24. The suture anchor of claim 23 wherein said suture receiving passage has an enlarged portion at a distal end of said inner member.

25. The suture anchor of claim 24 wherein said enlarged portion tapers in width proximally along said longitudinal axis.

26. The suture anchor of claim 2 wherein said suture mount includes suture receiving passage in said inner member and disposed transversely to a longitudinal axis of said inner member.

27. The suture anchor of claim 26 wherein said passage includes a pair of open ends in an exterior surface of said inner member, and further comprising a pair of axially oriented channels in said exterior surface adjacent to said open ends.

28. The suture anchor of claim 2 wherein said suture mount is disposed on said outer member.

29. A suture anchor comprising

an outer member which includes a body with an axially extending, threaded opening therein which terminates at a closed distal end of said body, and a plurality of arms arranged about the periphery of said body and extending axially from said body to a proximal end of said outer member,

a suture mount including a suture receiving passage in said closed distal end oriented transversely to a longitudinal axis of said outer member, and

an inner member having a threaded distal end configured to be inserted into said opening and threadably engage said body, and an enlargement on a proximal region thereof configured to engage said arms and cause said arms to be expanded radially by a selected amount that corresponds to an amount by which said distal end is inserted into said opening.

30. The suture anchor of claim 29 wherein said enlargement comprises a conically shaped proximal end of said inner member.

31. The suture anchor of claim 29 wherein said enlargement comprises a rib disposed on a portion of an exterior surface of said inner member.

32. The suture anchor of claim 29 wherein said suture receiving passage has a pair of open ends in an exterior surface of said distal end, and further comprising a pair of axially oriented channels in said exterior surface adjacent to said open ends of said passage.

33. The suture anchor of claim 29 wherein said arms are circumferentially spaced by axially extending slots that are aligned with said channels, each of said slots having an enlarged portion adjacent to a junction between said arms and said body.

34. The suture anchor of claim 29 further comprising a plurality of axially spaced ridges disposed on an exterior surface of said arms and oriented transversely to a longitudinal axis of said outer member.

35. The suture anchor of claim 29 further comprising a plurality of circumferentially spaced ridges disposed on an exterior surface of said body and oriented along a longitudinal axis of said outer member.

36. Apparatus comprising

a suture anchor that includes

an outer member and an inner member, one of which has a suture mount,

said outer member having an opening therein and said members each including a locking element for securing said inner member to said outer member in a selected one of a plurality of positions in said opening, each of the plurality of positions causing an expansion of said outer member by a differing amount such that when secured together said outer member expands by an amount that corresponds to the selected position;

and

a driver configured to engage said inner member and insert said inner member into said opening and secure said inner member at said selected position.

37. The apparatus of claim 36 wherein

said an outer member includes a body having an axially extending opening therein, and a plurality of arms which extend axially from said body to a proximal end of said outer member, said arms being arranged around a periphery of said body, and said inner member has a distal end including said locking element for securing said inner member to said outer member within said opening in said selected one of said plurality of positions, and an enlargement on a proximal region thereof configured to engage said arms,

said driver and said proximal region of said inner member being configured to engage each other so that said driver can transmit force to said inner member to progressively insert said distal region into said opening and cause said enlargement to engage and radially expand said arms by a selected amount that corresponds to an amount by which said distal end is inserted into said opening.

38. The apparatus of claim 37 wherein said outer member locking element comprises threads in said opening of said outer member and said inner member locking element comprises threads, said proximal region of said inner member and said driver being configured to enable said driver to rotate said inner member to progressively insert said inner member into said outer member.

39. The apparatus of claim 38 wherein said proximal region includes a socket and said driver includes a post configured to be received by said socket.

40. The apparatus of claim 39 wherein said suture mount includes a suture receiving passage disposed in said inner member along a longitudinal axis thereof, said passage having an open end disposed in said socket, said driver having an passage disposed therein and arranged to communicate with said suture receiving passage when said post is received in said socket.

41. The apparatus of claim 38 wherein

said outer member of said suture anchor includes a plurality of axially extending slots between said arms, and

said driver includes an outer sleeve with a distal end configured to be received by said slots, and a rotatable inner shaft disposed within an outer sleeve and configured to engage said proximal region of said inner member of said suture anchor.

42. The apparatus of claim 41 further comprising an exterior shoulder positioned on said outer sleeve at a selected distance proximally of said distal end thereof.

43. A method of inserting a suture anchor into bone, comprising

providing a suture anchor that includes a pair of members constructed to dwell within tissue, one of said members including a suture mount, said members each including a locking element for securing the members together in a selected one of a plurality of positions,

implanting a first one of said members into the bone, and

securing a second one of the members to said first member in a selected one of a plurality of positions, each of the plurality of positions causing an expansion of said first member by a differing amount such that when secured together said first member expands by an amount that corresponds to the selected position.

44. The method of claim 43 wherein said securing step includes progressively inserting said second member into an opening in said first member and securing said second member in said selected one of said plurality of positions in said opening.

45. The method of claim 44 wherein each of said locking elements comprises threads and said step of progressively inserting includes threading said second member into said opening.

46. The method of claim 45 further comprising preselecting a threshold amount of force to be exerted on said second member during said inserting, measuring said force during said inserting of said second member, and stopping said inserting member when said threshold is reached.

47. The method of claim 43 wherein said step of implanting includes forming a hole in the bone and then installing said first member into said hole.

48. The method of claim 43 wherein said step of implanting includes threadably inserting said first member into the bone.

49. The method of claim 43 wherein said step of implanting includes preassembling said first member and said second member and inserting them as a unit into the bone.

50. A suture anchor comprising

a pair of members one of which includes a suture mount,

said members being configured to be secured together in a selected one of a plurality of relative axial positions to cause a first one of said members to expand by an amount that corresponds to the selected axial position,

said first one of said members comprising an outer member having an opening therein, a second one of said members comprising an inner member progressively axially insertable into said opening to be secured to said outer member in said selected one of said plurality of relative axial positions,

said outer member including a body configured to be secured to said inner member and an expandable portion configured to be expanded by said inner member, said expandable portion including a plurality of arms which extend axially from said body to a proximal end of said outer member.

51. The suture anchor of claim 50 wherein said inner member is insertable into said opening at said proximal end of said outer member and includes an enlargement which engages said arms and causes said arms to progressively expand radially outwardly as said inner member is inserted distally into said opening.

52. A suture anchor comprising

a pair of members one of which includes a suture mount,

said members being configured to be secured together in a selected one of a plurality of positions to cause a first one of said members to expand by an amount that corresponds to the selected position,

said first one of said members including an outer member having an opening therein, a second one of said members including an inner member progressively insertable into said opening to be secured to said outer member in said selected one of said plurality of positions,

said outer member including a body configured to be secured to said inner member and an expandable portion configured to be expanded by said inner member, said opening being disposed through said expandable portion and said body along a longitudinal axis of said outer member, said expandable portion including a plurality of arms which extend axially from said body to a proximal end of said outer member, said arms being arranged around a periphery of said outer member and circumferentially spaced by axially extending slots, each of said slots including an enlarged portion adjacent to a junction between said arms and said body.

53. A suture anchor comprising

a pair of members one of which includes a suture mount,

said members being configured to be secured together in a selected one of a plurality of positions to cause a first one of said members to expand by an amount that corresponds to the selected position,

said first one of said members including an outer member having an opening therein, a second one of said members including an inner member progressively insertable into said opening to be secured to said outer member in said selected one of said plurality of positions,

said outer member including a body configured to be secured to said inner member and an expandable portion configured to be expanded by said inner member, said opening being disposed through said expandable portion and said body along a longitudinal axis of said outer member, said expandable portion including a plurality of arms which extend axially from said body to a proximal end of said outer member, said body including a ridge disposed on an exterior surface of said body and oriented along said axis.

54. A suture anchor comprising

an outer member which includes a body with an axially extending, threaded opening therein which terminates at a closed distal end of said body, a plurality of arms arranged about the periphery of said body and extending axially from said body to a proximal end of said outer member, and a plurality of circumferentially spaced ridges disposed on an exterior surface of said body and oriented along a longitudinal axis of said outer member,

a suture mount including a suture receiving passage in said closed distal end oriented transversely to a longitudinal axis of said outer member, and

an inner member having a threaded distal end configured to be inserted into said opening and threadably engage said body, and an enlargement on a proximal region thereof configured to engage said arms and cause said arms to be expanded radially by a selected amount that corresponds to an amount by which said distal end is inserted into said opening.

55. A method of inserting a suture anchor into bone, comprising

providing a suture anchor that includes a pair of members one of which includes a suture mount,

disposing a first one of said members into the bone, and

progressively inserting a second one of the members into an opening in said first member and securing said second member by threading said second member into said opening,

preselecting a threshold amount of force to be exerted on said second member during said inserting,

measuring said threshold during said inserting of said second member, said inserting stopping when said threshold is reached, and

securing said second member to said first member in a selected one of a plurality of positions to cause said first member to expand by an amount that corresponds to the selected position.

56. A suture anchor comprising:

a pair of members one of which includes a suture mount,

said members each including a locking element for securing the members together in a selected one of a plurality of relative axial positions, each of the plurality of relative axial positions causing an expansion of a first one of said member by a differing amount such that when secured together the first one of said members expands by an amount that corresponds to the selected axial position.

57. The suture anchor of claim 56, wherein said first one of said members comprises an outer member including a body, said outer member locking element comprising a threaded region of said body, a second one of said members comprising an inner member, said inner member locking element comprising a threaded region to threadably engage said body to secure said inner member to said outer member in said selected one of said plurality of axial positions.

58. A method of inserting a suture anchor into bone, comprising

providing a suture anchor that includes a pair of members one of which includes a suture mount, said members each including a locking element for securing the members together in a selected one of a plurality of positions,

implanting a first one of said members into the bone,

securing a second one of the members to said first member in a selected one of a plurality of relative axial positions, each of the plurality of relative axial positions causing an expansion of said first member by a differing amount such that when secured together said first member expands by an amount that corresponds to the selected axial position.

59. The method of claim 58, wherein each said locking element comprises threads and said securing step includes threading said second member into an opening in said first member.