Suture buttress

• US 6,156,056 A
• Filed: 12/07/1998
• Issued: 12/05/2000
• Est. Priority Date: 01/09/1998
• Status: Expired due to Term

• Current Assignee: DePuy Mitek Holding Corporation, Depuy Synthes Products Incorporated (Johnson & Johnson), DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Kearns, Bryan K., Wenstrom, Richard F. Jr., Bowman, Steven M., Steckel, Mark, Craig, Edward V.
• Primary Examiner(s): Brown, Michael A.
• Application Number:
  US09/206,522
• Time in Patent Office: 729 Days
• Field of Search: 606/72, 606/73, 606/148, 606/230, 606/231, 606/232
• US Class Current: 606/232
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/1796 for holes for sutures or flexible wires
• CPC Class Codes: A61B 17/82 for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments

Abstract

A suture buttress comprises a hollow tube having an outer wall, a central channel, a center line extending through the channel, leading end for insertion into a bone tunnel and a trailing end. The hollow tube is bendable into a curved tube having an outer radius and an outer radial surface, the outer radial surface defining a plurality of slits formed in the outer wall. The suture buttress further includes at least one projecting member integral with and extending outward from the outer wall. The at least one projecting member is sufficiently strong to form a friction fit within a bone tunnel. A method for using the suture buttress to attach soft tissue to bone by inserting the suture buttress into a tunnel formed in bone, passing a suture through the tunnel and suture buttress and using the suture to attach soft tissue to the bone.

Claims

1. A suture buttress, comprising:

a hollow tube having an outer wall, a central channel, a center line extending through the channel, a leading end for insertion into a bone tunnel and a trailing end;

the hollow tube being bendable into a curved tube having an outer radius and an outer radial surface, the outer radial surface defining a plurality of slits formed in the outer wall, the slits having a leading edge and a trailing edge corresponding to the leading end and trailing end of the tube;

at least one projecting member integral with and extending outward from the outer wall, the at least one projecting member being sufficiently strong to form a friction fit within a bone tunnel.

2. The suture buttress of claim 1, wherein the projecting member is a pyramidal projection having a highest point adjacent to a leading edge of a slit formed in the outer radial surface.

3. The suture buttress of claim 1, wherein a plurality of projecting members are provided, each projecting member being larger than the adjacent projecting member in the trailing direction.

4. The suture buttress of claim 1, wherein the at least one slit is substantially perpendicular to the center line and extends past the center line.

5. The suture buttress of claim 1, wherein at least one secondary slit is defined on a surface of the hollow tube opposite the outer radial surface.

6. The suture buttress of claim 5, wherein the at least one secondary slit extends beyond the center line.

7. The suture buttress of claim 5, wherein the at least one secondary slit is substantially perpendicular to the center line.

8. The suture buttress of claim 5, wherein at least one secondary slit is provided between each adjacent slit in the outer radial surface.

9. The suture buttress of claim 1, wherein a circumferential flange is provided on the trailing end of the hollow tube.

10. The suture buttress of claim 1, wherein the suture buttress further comprises at least one resiliently deformable tab disposed on the outer surface of the tube, the at least one tab being formed at an angle to a longitudinal axis of the tube and extending outward from the outer surface of the bone tunnel buttress.

11. The suture buttress of claim 10, wherein the at least one tab is disposed on the tube in proximity to the trailing end.

12. The suture buttress of claim 1, wherein the suture buttress is adapted to be removably and replaceably disposed on a suture retriever.

13. The suture buttress of claim 1, wherein the tube is dimensioned to extend substantially through the bone tunnel.

14. The suture buttress of claim 13, wherein the tube has a length of about 0.75 to 1.50 inches.

15. The suture buttress of claim 1, wherein the hollow tube has bone ingrowth pores formed on the outer wall thereof.

16. The suture buttress of claim 1, further comprising a suture retriever, wherein the hollow tube is adapted to be removably and replaceably disposed on the suture retriever, the projecting member of the bone tunnel buttress being effective to allow the bone tunnel buttress to slide into a bone tunnel in a first direction when urged into the bone tunnel by the suture retriever while preventing the bone tunnel buttress from sliding out of the bone tunnel in a second direction that is substantially opposed to the first direction upon removal of the suture retriever from the bone tunnel.

17. A method for attaching soft tissue to a bone comprising the steps of:

forming a first hole at least through cortical bone tissue of the bone proximate to the soft tissue attachment site;

forming a second hole at least through cortical bone tissue of the bone spaced a predetermined distance apart from the first hole;

connecting the first hole and the second hole though subcortical bone tissue to form a tunnel in the bone;

providing a suture buttress system comprising;

a hollow tube having an outer wall, a central channel, a center line extending through the channel, a leading end for insertion into a bone tunnel and a trailing end;

the hollow tube being bendable into a curved tube having an outer radius and an outer radial surface, the outer radial surface defining a plurality of slits formed in the outer wall and extending past the center line, the slits having a leading edge and a trailing edge corresponding to the leading end and trailing end of the tube;

at least one projecting member extending outward from the outer wall, the at least one projecting member being sufficiently strong to form a friction fit within a bone tunnel;

inserting the leading end of the suture buttress system into the bone tunnel and securing the buttress within the tunnel;

attaching a suture to the soft tissue and passing the suture through the bone tunnel and through the channel in the buttress; and

securing the suture to secure the soft tissue to the bone.

18. The method of claim 17, wherein the projecting member is a pyramidal projection having a highest point adjacent to a leading edge of a slit formed in the outer radial surface.

19. The method of claim 17, wherein a plurality of projecting members are provided, each projecting member being larger than the adjacent projecting member in the trailing direction.

20. The method of claim 17, wherein the at least one slit is substantially perpendicular to the center line.

21. The method of claim 17, wherein at least one secondary slit is defined on a surface of the bendable tube opposite the outer radial surface.

22. The method of claim 21, wherein the at least one secondary slit extends beyond the center line.

23. The method of claim 21, wherein the at least one secondary slit is substantially perpendicular to the center line.

24. The method of claim 21, wherein at least one secondary slit is provided between each adjacent slit in the outer radial surface.

25. The method of claim 17, wherein a circumferential flange is provided on the trailing end of the hollow tube.

26. The method of claim 17, wherein the suture buttress system further comprises at least one resiliently deformable tab disposed on the outer surface of the tube, the at least one tab being formed at an angle to a longitudinal axis of the tube and extending outward from the outer surface of the bone tunnel buttress.

27. The method of claim 26, wherein the at least one tab is disposed on the tube in proximity to the trailing end.

28. The method of claim 17, wherein the tube is dimensioned to extend substantially through the bone tunnel.

29. The method of claim 28, wherein the tube has a length of about 0.75 to 1.50 inches.

30. The method of claim 17, wherein the hollow tube has bone ingrowth pores formed on the outer wall thereof.

31. The method of claim 17, wherein the suture buttress system further comprises a suture retriever, wherein the hollow tube is adapted to be removably and replaceably disposed on the suture retriever, the projecting member of the bone tunnel buttress being effective to allow the bone tunnel buttress to slide into a bone tunnel in a first direction when urged into the bone tunnel by the suture retriever while preventing the bone tunnel buttress from sliding out of the bone tunnel in a second direction that is substantially opposed to the first direction upon removal of the suture retriever from the bone tunnel.

32. The method of claim 17 for repairing a rotator cuff injury wherein the soft tissue is a rotator cuff tendon and the bone is a humerus.