Adjustable button cinch anchor orthopedic fastener

• US 6,162,234 A
• Filed: 02/14/1996
• Issued: 12/19/2000
• Est. Priority Date: 03/23/1993
• Status: Expired due to Fees

• Current Assignee: Yosef Freedland
• Original Assignee: Yosef Freedland
• Inventors: Freedland, Yosef, Ganaja, Scot
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): GOLDBERG, JONATHAN D
• Application Number:
  US08/601,177
• Time in Patent Office: 1,770 Days
• Field of Search: 606/232, 606/61, 606/73, 606/72, 411/344, 411/352, 411/353, 411/516-517, 411/519, 411/935, 411/947
• US Class Current: 606/151
• 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 17/7216 for bone lengthening or compression A61B17/7258 takes precedence
• CPC Class Codes: A61B 17/7225 for bone compression
• CPC Class Codes: A61B 17/7266 with fingers moving radially outwardly
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0411 Instruments for removing suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0433 the anchor or the separate member comprising threads, e.g. a set screw or a worm gear for moving spreading members
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• 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 2002/0835 with deformation of anchor parts, e.g. expansion of dowel by set screw
• CPC Class Codes: A61F 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 : Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0864 : Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• CPC Class Codes: A61F 2002/087 : Anchor integrated into tendons, e.g. bone blocks, integrated rings
• CPC Class Codes: A61F 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• 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: A61F 2250/0007 : for adjusting length
• CPC Class Codes: A61F 2250/0071 : breakable or frangible
• CPC Class Codes: Y10S 411/947 : Elastic-gripping action
• CPC Class Codes: Y10S 606/916 : Tool for installing or removing orthopedic fastener

Abstract

An orthopedic fastener device is based on a strong central shaft that is threaded in a one end region and that, in one embodiment, presents a ramp surface in the other end region. The ramp end is inserted down-hole a bore in bone while an expandable first collet having bendable circumferential flukes is snug to the shaft, presenting a diameter less than the bore. Partial axial withdrawal of the shaft from the bore forces the first collet into and against the shaft'"'"'s ramp region, causing the collet'"'"'s flukes to splay and strongly compressively engage the bone, thereby permanently anchoring the fastener'"'"'s first end. Soft tissue, normally a ligament, is slipped over the shaft region extending beyond the bone, and is optionally grasped by a toothed washer. Another, second, split collet--initially expanded in its internal diameter that has and presents threads--slides along the shaft so as to compress the ligament in position against the bone. A sleeve is forcibly slid over the second split collet by use of a tool so as to contract the second split collet against the shaft, locking tight the ligament against the bone at the position of the bore. The second collet may thereafter be rotated on the shaft in the manner of a button or screw so as to variably compress the ligament. In another embodiment a ring, attached to the threaded shaft, slips and attaches a tendon or ligament, attached to a first bone, that is pulled through a hole in a second bone. Rotation of the split collet as slid upon the shaft and lodged against the second bone'"'"'s surface serves to tension the ligament between the ring and the first bone. Any and all parts may be made from bio-absorbable materials.

Claims

1. An orthopedic fastening system for fastening one tissue to another tissue, the system comprising:

a first elongate fastener that is affixable at one end thereof down-hole a bore present within a first tissue, the elongate fastener having and presenting when so affixed a threaded extension region that extends beyond the bore;

a split collet that has threaded internal aperture that spreads to a diameter wholly larger that is an outer diameter of the extension region of the first elongate fastener and which collet, when so spread, (i) slides along the fastener region that extends beyond the bore so as to force a second tissue that has been slipped over the fastener'"'"'s extension region along this region and compressively into position against the first tissue, and that, when contracted, (ii) screws upon the threaded extension region of the first elongate fastener so as to variably adjust this compression;

a sleeve forcibly sliding over the split collet in its position upon the fastener'"'"'s extension region so as to contract the split collet against the fastener, thereafter locking the split collet into position holding tight the second tissue against the first tissue in compression at the position of the bore.

2. The orthopedic fastening system according to claim 1 wherein the first elongate fastener comprises:

a shaft;

wherein the threaded fastener extension region that extends beyond the bore is a threaded length of the shaft.

3. The orthopedic fastening system according to claim 2 wherein the shaft has and presents a ramp surface in a region that extends within the bore;

and wherein the first elongate fastener further comprises;

an apertured split collet having (i) a central aperture fitting snugly around the shaft in the region thereof that extends within the bore, and (ii) flukes, the split collet having and presenting a first diameter less than the diameter of the bore until the shaft is forcibly moved transversely in the aperture of the split collet so as to force the collet'"'"'s flukes to splay outward in greater separation from the central shaft, causing the flukes to expand in diameter and to forcibly compress against the first tissue that surrounds the bore.

4. The orthopedic fastening system according to claim 3

wherein the flukes of the split collet splay outward so that their tips are towards the entrance to the bore;

wherein the collet with its splayed flukes strongly resists extraction from the bore by pulling.

5. The orthopedic fastening system according to claim 1

wherein the first elongate fastener is suitably sized and shaped so as to be affixable at one end thereof down-hole a bore present within bone;

and

wherein the split collet is suitably sized and shaped, in its sliding along the fastener region that extends beyond the bore, so as to force a soft tissue that has been slipped over the fastener'"'"'s extension region along this region and into position against the bone.

6. An orthopedic fastening system comprising:

a first elongate shaft that is affixable at one end thereof down-hole a bore present within a first tissue, the elongate shaft having and presenting when so affixed an extension region that extends beyond the bore and a ramp surface in a region that extends within the bore;

a split collet sliding along the shaft region that extends beyond the bore so as to force a second tissue that has been slipped over the shaft'"'"'s extension region along this region and compressively into position against the first tissue;

a sleeve forcibly sliding over the split collet in its position upon the shaft'"'"'s extension region so as to contract the split collet against the shaft, thereafter locking the split collet into position holding tight the second tissue against the first tissue in compression at the position of the bore; and

an apertured split collet having (i) a central aperture fitting snugly around the shaft in the region thereof that extends within the bore, and (ii) flukes, the split collet having and presenting a first diameter less than the diameter of the bore until the shaft is forcibly moved transversely in the aperture of the split collet so as to force the collet'"'"'s flukes to splay outward in greater separation from the central shaft, causing the flukes to expand in diameter and to forcibly compress against the first tissue that surrounds the bore.

7. An orthopedic fastener for fastening a first tissue in which is present a bore to a second tissue in which is present a hole, the fastener comprising:

a shaft having and defining from a first end to a second end (i) a first circumferential surface region, (ii) a second circumferential surface region, and (iii) a third circumferential surface region with engagement features;

a first split collet initially encircling the shaft at its second circumferential surface region;

a deployment sleeve temporarily fitting over the shaft to force the first split collet from the second to the first circumferential surface region of the shaft while the first end of the shaft remains inserted in the bore within the first tissue, the split collet expanding during sliding from the second to the first circumferential surface region so as to become affixed within the bore;

a second split collet for sliding when split in distension along the shaft from the second end towards the first end that is affixed within the bore so that the second tissue that has its hole slipped over the shaft is forced along the shaft and compressively into position against the first tissue, the second split collet then being in the third circumferential surface region of the shaft;

a sleeve forcibly sliding over the second split collet in its position upon the shaft in the shaft'"'"'s third circumferential surface region so as to contract the second split collet to the shaft, locking the second split collet into position holding tight in compression the second tissue against the first tissue at the position of the bore;

wherein the first split collet expands while the second split collet contracts in order that each performs a holding function.

8. An orthopedic fastener comprising:

an elongate shaft having and defining circumferential engagement features, the shaft mountable at one end region thereof to a first tissue of the body so that a remaining portion of the shaft with its circumferential engagement features extends beyond this first tissue;

a split collet having and defining (i) an interior bore of a larger diameter than is the shaft with its circumferential engagement features, by which bore the split collet may slip the extending portion of the shaft, (ii) a plurality of deformable flukes at a split end of the collet, (iii) engagement features, complimentary to the engagement features of the shaft, located internally circumferentially on the collet'"'"'s plurality of flukes, and (iv) a ramp surface located externally circumferentially on the collet'"'"'s plurality of flukes; and

a sleeve in the shape of a hollow truncated frustaconical body, the sleeve having and defining an internal bore of larger diameter than is an external diameter of the split collet elsewhere from the collet'"'"'s plurality of flukes, and also an internally circumferential ramp surface to the bore which ramp surface is complimentary in shape and in diameter to the ramp surface of the collet'"'"'s plurality of flukes;

wherein when the split collet is slid upon the extended portion of the elongate shaft, and the sleeve is then slid forcibly over the split collet until its interior ramp surface forcibly engages the exterior ramp surface of the collet'"'"'s plurality of flukes, then the plurality of flukes are deformed until their internal circumferential engagement features engage the complimentary engagement features of the extended shaft portion, affixing the split collet to the shaft.

9. The fastener according to claim 8 wherein the elongate shaft'"'"'s circumferential engagement features comprise:

threads;

and wherein the engagement features located internally circumferentially on the collet'"'"'s plurality of flukes comprise;

threads;

wherein the split collet is affixable for threading the shaft.

10. The fastener according to claim 8

wherein the split collet further has and defines an exterior circumferential engagement feature;

wherein the sleeve further has and defines an interior circumferential engagement feature complimentary to the engagement feature of the collet; and

wherein when the sleeve is slid forcibly over the split collet then, by engagement of the complimentary engagement features of collet and of sleeve, the sleeve becomes engaged to the collet concurrently that the collet becomes affixed to the shaft.

11. A method of variably selectively compressing in vivo a free end of a soft tissue comprising:

engaging in vivo the free end of a first, soft, tissue (i) about a first-end extension region of an elongate fastener that is affixed at a second-end region down-hole a bore which is present and defined within another, second, tissue, and (ii) between, on the one hand, a sliding lock that both slides and screws in position along the fastener'"'"'s second-end extension region extending beyond the bore and that also locks and unlocks so as to so slide and screw in position upon this extension region, and, on the other hand, the second tissue;

first sliding in vivo the sliding lock in a first direction along the fastener'"'"'s second-end extension region that extends beyond the bore so as to assume a selectable first position wherein the soft tissue, which soft tissue has been engaged about the fastener'"'"'s extension region and between the sliding lock and the second tissue, is compressed;

first screwing in vivo the sliding lock in selectable first position so as to compress the soft tissue engaged about the fastener'"'"'s extension region and between the sliding lock and the second tissue to a variably predetermined first extent so as to selectively apply tension or compression to the soft tissue along the length of the first-end extension region of the elongate fastener; and

locking the sliding lock means in its assumed first position, therein to compress the soft tissue against the second tissue to the variably predetermined first extent.

12. A method of variably selectively compressing and variably selectively re-compressing in vivo a free end of a soft tissue, the method comprising:

affixing an elongate fastener at a first-end region thereof down-hole a bore which is present and defined within a first tissue, leaving extending outside the bore a second-end extension region;

mounting a lock that slides in position along the fastener'"'"'s second-end extension region extending beyond the bore to lock and to unlock upon this extension region;

engaging in vivo a second, soft, tissue about the second-end extension region of the elongate fastener and between the sliding lock and the first tissue;

first sliding the sliding lock in a first direction along the fastener'"'"'s second-end extension region that extends beyond the bore so as to assume a selectable first position where the soft tissue, which soft tissue has been engaged in vivo around the fastener'"'"'s second-end extension region and between the sliding lock and the first tissue, is compressed along a lengthwise direction of the elongate fastener to a variably predetermined first extent;

locking the sliding lock means in its assumed first position, therein to compress the soft tissue against the second tissue along the lengthwise direction of the elongate fastener and to the variably predetermined first extent; and

later

unlocking in vivo, at a time after the locking, the locked sliding lock in its first position along the fastener'"'"'s second-end extension region;

second sliding in vivo the sliding lock along the fastener'"'"'s second-end extension region that extends beyond the bore to a selectable second position so as to compress said soft tissue that has been engaged about the fastener'"'"'s second-end extension region into position against the first tissue to a variably predetermined second extent that is different from the variably predetermined first extent; and

re-locking the sliding lock at it'"'"'s selectable second position, therein re-compressing the soft tissue against the second tissue along the lengthwise direction of the elongate fastener and to the variably predetermined second extent.

13. The expanded and extended method according to claim 12 wherein the engaging in vivo comprises:

forming an aperture in the free end of the soft tissue; and

slipping the aperture of the free end of the soft tissue over an end of the second, extension, region of the elongate fastener.

14. The expanded and extended method according to claim 12

wherein the engaging is of the free end of a tendon.

15. The expanded and extended method according to claim 12

wherein the engaging is of the free end of a ligament.

16. The expanded and extended method according to claim 12

wherein the engaging is of the free end of a joint capsule.

17. The expanded and extended method according to claim 12

wherein the engaging is of the free end of the soft tissue about a first elongate fastener that is affixed at a one end thereof down-hole a bore present within bone.

18. A method of variably selectively tensioning in vivo a soft tissue to another, second, tissue, the method comprising:

engaging in vivo a soft tissue (i) about an elongate fastener that is affixed at one end thereof down-hole a bore present within another, second tissue, the elongate fastener having and presenting when so affixed a threaded extension region that extends beyond the bore, and (ii) between, on the one hand, a sliding lock that both slides and screws along the fastener region that extends beyond the bore and that locks and unlocks so as to both slide and screw in this its position upon the fastener'"'"'s extension region, and, on the other hand, the second tissue;

first sliding in vivo the sliding lock to a selectable first position along the fastener region that extends beyond the bore so as to compress said soft tissue, which soft tissue has been engaged about the fastener'"'"'s extension region and between the sliding lock and the second tissue, into, and into position proximate to, the first tissue;

first screwing in vivo the sliding lock in its selectable first position so as to compress the soft tissue engaged about the fastener'"'"'s extension region and between the sliding lock and the second tissue to a variably predetermined first extent so as to selectively apply tension or compression to the soft tissue along the length of the threaded extension region of the elongate fastener; and

locking the sliding lock in its selectable first position, therein fixing the extent of compression of the soft tissue towards the second tissue.

19. A method of variably selectively tensioning and later variably selectively re-tensioning in vivo a soft tissue, the method comprising:

engaging in vivo a soft tissue (i) around an elongate fastener that is affixed at one end thereof down-hole a bore present within another, second tissue, the elongate fastener having and presenting when so affixed an extension region that extends beyond the bore, and (ii) between, on the one hand, a sliding lock that both slides along the fastener region that extends beyond the bore, and that locks and unlocks in its position upon the fastener'"'"'s extension region, and, on the other hand, the second tissue;

first sliding in vivo the sliding lock to a selectable first position along the fastener region that extends beyond the bore so as to compress to a variably selectable first extent said soft tissue, which soft tissue has been engaged about the fastener'"'"'s extension region and between the sliding lock and the second tissue, into, and into position proximate to, the first tissue;

locking the sliding lock in its selectable first position, therein fixing the extent of compression of the soft tissue towards the second tissue along the length of the elongate fastener; and

later

unlocking in vivo, at a time after the locking, the locked sliding lock in its first selectable position along the fastener region;

second sliding in vivo the sliding lock along the fastener region that extends beyond the bore to a selectable new, second, position so as to compress the soft tissue that has been engaged about the fastener'"'"'s extension region into position against the first tissue to a variably selectable second extent that is different from the variably selectable first extent; and

re-locking the sliding lock means at it'"'"'s selectable second position, therein re-fixing the extent of compression of the soft tissue towards the second tissue along the length of the elongate fastener.

20. An orthopedic fastening system for fastening one tissue to another tissue, the system comprising:

a first elongate fastener having a first end region that is passable through a bore present within a first tissue and that is then affixable to a second tissue, the elongate fastener having and presenting when so passed and so affixed a threaded second end extension region that extends beyond the bore;

a split collet distending at times to a larger interior diameter than is an exterior diameter of the fastener'"'"'s second end extension region so as to slide along the fastener'"'"'s second end extension region that extends beyond the bore, and contracting at other times so as to threadingly engage the fastener'"'"'s threaded second end extension region; and

a sleeve forcibly sliding over the split collet in its position upon the fastener'"'"'s second end extension region so as to contract the split collet against the fastener at its second end extension region, locking the split collet into position where it may subsequently be screwed in fine positional adjustment.

21. The orthopedic fastening system according to claim 20 wherein the first elongate fastener comprises:

a shaft fitting within the bore of the first tissue;

wherein the fastener region that extends beyond the bore is a partial length of the shaft.

22. An orthopedic fastener comprising:

an elongate shaft having and defining a first end portion that is passable through a bore present within a first tissue and that is then affixable to a second tissue, while a remaining, second end, portion of the shaft having and defining threads extends beyond the first tissue'"'"'s bore;

a split collet having and defining (i) an interior bore of a larger diameter than is the shaft'"'"'s second end portion with its threads, by which bore the split collet may slip the extending second end portion of the shaft, (ii) a plurality of deformable flukes at a split end of the collet, (iii) threads complimentary to the threads of the shaft'"'"'s second end portion, located internally circumferentially on the collet'"'"'s plurality of flukes, and (iv) a ramp surface located externally circumferentially on the collet'"'"'s plurality of flukes; and

a sleeve in the shape of a hollow truncated frustaconical body, the sleeve having and defining an internal bore of larger diameter than is an external diameter of the split collet in positions elsewhere from the collet'"'"'s plurality of flukes, and also having and defining an internally circumferential ramp surface to the bore which ramp surface is complimentary in shape and in diameter to the ramp surface of the collet'"'"'s plurality of flukes;

wherein when the split collet is slid upon the extended portion of the elongate shaft, and the sleeve is then slid forcibly over the split collet until its interior ramp surface forcibly engages the exterior ramp surface of the collet'"'"'s plurality of flukes, then the plurality of flukes are deformed until their internal threads engage the complimentary threads of the shaft'"'"'s second end portion, affixing the split collet to the shaft so that it may thereafter screw upon the shaft.

23. The fastener according to claim 22 wherein the elongate shaft'"'"'s second end portion circumferential engagement features comprise:

threads;

and wherein the engagement features located internally circumferentially on the collet'"'"'s plurality of flukes comprise;

threads;

wherein the split collet is affixable for threading the shaft.

24. The fastener according to claim 22

wherein the split collet further has and defines an exterior circumferential engagement feature;

wherein the sleeve further has and defines an interior circumferential engagement feature complimentary to the engagement feature of the collet; and

wherein when the sleeve is slid forcibly over the split collet then, by engagement of the complimentary engagement features of collet and of sleeve, the sleeve becomes engaged to the collet concurrently that the collet becomes affixed to the shaft.

25. An orthopedic fastening system for fastening one tissue to another tissue, the system comprising:

a first elongate member that is affixable at one end thereof down-hole a bore present within a first tissue, the elongate member having and presenting when so affixed a threaded extension region that extends beyond the bore;

a screwing slider means first (i) distending to greater internal diameter than is the external diameter of the elongate fastener'"'"'s threaded extension region so as to slide along the extension region of the elongate member that extends beyond the bore to a variable extent so as to force a second tissue that has been slipped over the elongate member'"'"'s extension region along this region along the extension region and compressively into position against the first tissue, and then (ii) screwing upon the same threaded extension regions so as to adjust the compression along an axis of the extension region to a variably selected degree; and

a retention means for locking the screwing slider means in its position upon the elongate member'"'"'s extension region to the elongate member, thereafter holding tight the second tissue against the first tissue at the position of the bore while permitting the screwing slider means to screw into the selected degree of compression.