Method and apparatus for positioning a suture anchor

• US 6,364,897 B1
• Filed: 03/22/2000
• Issued: 04/02/2002
• Est. Priority Date: 02/04/1993
• Status: Expired due to Fees

• 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:
  US09/533,076
• Time in Patent Office: 741 Days
• Field of Search: 606/232, 606/72, 606/73, 606/74, 606/104, 606/102, 606/139
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61M 2025/0024 Expandable catheters or sheaths
• CPC Class Codes: A61M 2025/0089 Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
• CPC Class Codes: A61M 2025/0095 being one or more needles protruding from the distal tip and which are not used for injection nor for electro-stimulation, e.g. for fixation purposes
• CPC Class Codes: A61M 25/0084 being one or more injection needles
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/06 Body-piercing guide needles or the like
• CPC Class Codes: A61M 25/0662 Guide tubes

Abstract

An inserter assembly is operable between a closed condition blocking movement of a suture anchor through the inserter assembly and an open condition in which the inserter assembly is ineffective to block movement of the anchor. The inserter assembly may have an end portion which pierces body tissue. In one embodiment, a tubular member has a plurality of segments which are moved from a closed condition to an open condition. In another embodiment, a plurality of wires extend along an inner side of a passage in a sheath. As the suture anchor slides along the wires, force is transmitted to the sheath to expand the sheath and operate the inserter assembly from the closed condition to the open condition. If desired, the wires may be omitted and the sheath resiliently expanded by a member which encloses the suture anchor. Indicia may be provided to indicate the depth to which the inserter assembly is inserted into body tissue.

Claims

1. A method of positioning an anchor member relative to body tissue, said method comprising the steps of providing a tubular member, said step of providing a tubular member includes providing a tubular member having a plurality of wires which extend along a passage in the tubular member, inserting the tubular member into body tissue by piercing the body tissue with an end portion of the tubular member and moving at least a portion of the tubular member through an opening formed in the body tissue by piercing the body tissue with the end portion of the tubular member, moving the anchor member along a passage in the tubular member, said step of moving the anchor member along the passage in the tubular member includes sliding the anchor member along the wires, and moving the anchor member out of the passage in the tubular member into the body tissue.

2. A method as set forth in claim 1 further including the step of expanding at least a portion of the passage in the tubular member by transmitting force from a leading end portion of the anchor member to the tubular member while moving the anchor member along the passage in the tubular member.

3. A method as set forth in claim 1 wherein said step of piercing the body tissue includes forming an opening in the body tissue at a location which is free of naturally occurring openings.

4. A method as set forth in claim 1 further including the step of expanding at least a portion of the passage in the tubular member by resiliently stretching material which forms at least a portion of the tubular member.

5. A method as set forth in claim 1 further including the step of moving segments of the end portion of tubular member which pierced the body tissue from an initial position in which portions of the segments of the end portion of the tubular member are disposed in engagement with each other to an extended position in which the portions of the segments of the end portion of the tubular member are spaced apart from each other.

6. A method as set forth in claim 1 further including the step of expanding at least a portion of the passage in the tubular member under the influence of force applied against the wires by the anchor member while sliding the anchor member along the wires.

7. A method as set forth in claim 1 wherein said step of moving the anchor member along a passage in the tubular member is performed with at least a portion of the anchor member enclosed by an expansion member, said method further includes the step of expanding at least a portion of the passage in the tubular member by transmitting force from the expansion member to the tubular member while moving the expansion member and the anchor member together along the passage in the tubular member.

8. A method as set forth in claim 1 further including the steps of covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue.

9. A method of positioning an anchor member relative to body tissue, said method comprising the steps of providing a tubular member, said step of providing a tubular member includes providing a tubular member which at least partially encloses a plurality of wires which extend along at least a portion of the passage in said tubular member, inserting the tubular member into body tissue by piercing the body tissue with an end portion of the tubular member and moving at least a portion of the tubular member through an opening formed in the body tissue by piercing the body tissue with the end portion of the tubular member, moving the anchor member along a passage in the tubular member, said step of moving the anchor member along a passage in the tubular member includes applying force against the anchor member with a pusher member and sliding the pusher member along the wires, and moving the anchor member out of the passage in the tubular member into the body tissue.

10. A method as set forth in claim 9 further including the step of expanding at least a portion of the passage in the tubular member by transmitting force from a leading end portion of the anchor member to the tubular member while moving the anchor member along the passage in the tubular member.

11. A method as set forth in claim 9 wherein said step of piercing the body tissue includes forming an opening in the body tissue at a location which is free of naturally occurring openings.

12. A method as set forth in claim 9 further including the step of expanding at least a portion of the passage in the tubular member by resiliently stretching material which forms at least a portion of the tubular member.

13. A method as set forth in claim 9 further including the step of moving segments of the end portion of tubular member which pierced the body tissue from an initial position in which portions of the segments of the end portion of the tubular member are disposed in engagement with each other to an extended position in which the portions of the segments of the end portion of the tubular member are spaced apart from each other.

14. A method as set forth in claim 9 further including the step of expanding at least a portion of the passage in the tubular member under the influence of force applied against the wires by the anchor member while sliding the anchor member along the wires.

15. A method as set forth in claim 9 wherein said step of moving the anchor member along a passage in the tubular member is performed with at least a portion of the anchor member enclosed by an expansion member, said method further includes the step of expanding at least a portion of the passage in the tubular member by transmitting force from the expansion member to the tubular member while moving the expansion member and the anchor member together along the passage in the tubular member.

16. A method as set forth in claim 9 further including the steps of covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue.

17. A method of positioning an anchor member relative to body tissue, said method comprising the steps of providing a tubular member, inserting the tubular member into body tissue by piercing the body tissue with an end portion of the tubular member and moving at least a portion of the tubular member through an opening formed in the body tissue by piercing the body tissue with the end portion of the tubular member, moving the anchor member along a passage in the tubular member, said step of moving the anchor member along a passage in the tubular member is performed with at least a portion of the anchor member enclosed by an expansion member, expanding at least a portion of the passage in the tubular member by transmitting force from the expansion member to the tubular member while moving the expansion member and the anchor member together along the passage in the tubular member, and moving the anchor member out of the passage in the tubular member into the body tissue.

18. A method as set forth in claim 17 further including the step of expanding at least a portion of the passage in the tubular member by transmitting force from a leading end portion of the anchor member to the tubular member while moving the anchor member along the passage in the tubular member.

19. A method as set forth in claim 17 wherein said step of piercing the body tissue includes forming an opening in the body tissue at a location which is free of naturally occurring openings.

20. A method as set forth in claim 17 further including the step of expanding at least a portion of the passage in the tubular member by resiliently stretching material which forms at least a portion of the tubular member.

21. A method as set forth in claim 17 further including the step of moving segments of the end portion of tubular member which pierced the body tissue from an initial position in which portions of the segments of the end portion of the tubular member are disposed in engagement with each other to an extended position in which the portions of the segments of the end portion of the tubular member are spaced apart from each other.

22. A method as set forth in claim 17 further including the steps of covering indicia on the tubular member with body tissue as the tubular member is inserted into the body tissue, and interrupting said step of inserting the tubular member into body tissue in response to covering of indicia corresponding to a desired depth of insertion of the tubular member into body tissue.