Method and apparatus for securing tissue
First Claim
1. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, wherein said step of forming an opening in the bone includes enclosing the anchor with a sleeve and applying force against a trailing end portion of the anchor while the anchor is enclosed by the sleeve.
8 Assignments
0 Petitions
Accused Products
Abstract
An anchor has a pointed end portion may be utilized to form an opening in a bone in a patient'"'"'s body. The anchor is moved into the opening formed in the bone in the patient'"'"'s body with a suture connected to the anchor. The suture may then be utilized to retain body tissue in a desired position relative to the bone. The body tissue may be either hard or soft body tissue. If desired the anchor may be utilized in conjunction with layers of soft body tissue. When a suture is used it may be secured by connecting a retainer with the suture. Alternatively, sections of the suture may be interconnected. It is believed that it may be preferred to secure the suture in place after at least a predetermined tension has been established in the suture and/or a predetermined force has been transmitted to the body tissue. The suture may be secured in place by exposing a retainer to ultrasonic vibratory energy or by applying the ultrasonic vibratory energy directly to sections of the suture.
586 Citations
162 Claims
- 1. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, wherein said step of forming an opening in the bone includes enclosing the anchor with a sleeve and applying force against a trailing end portion of the anchor while the anchor is enclosed by the sleeve.
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13. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone and first and second sections of the suture extending from the anchor, moving the anchor through soft body tissue with the first and second sections of the suture extending from the anchor, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, and tensioning the first and second sections of the suture and gripping the first and second sections of the suture with a suture retainer while tensioning the first and second sections of the suture, wherein said step of moving the anchor into the opening in the bone being completed with the anchor spaced from the soft body tissue and with at least one of the first and second sections of the suture extending through the soft body tissue and wherein said step of gripping the first and second sections of the suture with the suture retainer includes pressing material of the suture retainer against the first and second sections of the suture.
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14. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone and first and second sections of the suture extending from the anchor, moving the anchor through soft body tissue with the first and second sections of the suture extending from the anchor, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, and tensioning the first and second sections of the suture and gripping the first and second sections of the suture with a suture retainer while tensioning the first and second sections of the suture, wherein said step of moving the anchor into the opening in the bone being completed with the anchor spaced from the soft body tissue and with at least one of the first and second sections of the suture extending through the soft body tissue and wherein said step of gripping the first and second sections of the suture with the suture retainer includes applying force against the suture retainer and cold flowing material of the suture retainer under the influence of the force applied against the suture retainer.
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15. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone and first and second sections of the suture extending from the anchor, moving the anchor through soft body tissue with the first and second sections of the suture extending from the anchor, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, and tensioning the first and second sections of the suture and gripping the first and second sections of the suture with a suture retainer while tensioning the first and second sections of the suture, wherein said step of moving the anchor into the opening in the bone being completed with the anchor spaced from the soft body tissue and with at least one of the first and second sections of the suture extending through the soft body tissue and wherein the step of gripping the first and second sections of the suture with the suture retainer includes transmitting ultrasonic vibratory energy to the suture retainer.
- 16. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone and first and second sections of the suture extending from the anchor, moving the anchor through soft body tissue with the first and second sections of the suture extending from the anchor, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, tensioning the first and second sections of the suture, and bonding the first and second sections of the suture together, wherein said step of moving the anchor into the opening in the bone being completed with the anchor spaced from the soft body tissue and with at least one of the first and second sections of the suture extending through the soft body tissue.
- 18. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, and moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, wherein the method further includes the steps of securing a portion of body tissue disposed in the patient'"'"'s body against movement relative to the bone in the patient'"'"'s body, said step of securing body tissue includes tensioning the suture with the anchor disposed in the opening formed in the bone in the patient'"'"'s body, positioning a suture retainer relative to the suture, and securing the suture retainer against movement relative to the suture while continuing to tension the suture.
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24. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, positioning a suture retainer relative to the suture, increasing the tension in the suture to a predetermined tension, and transmitting ultrasonic vibratory energy to the suture retainer in response to an increase in the tension in the suture to a predetermined tension.
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25. A method of securing a suture relative to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion formed of bone, pressing a surface on bone forming the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an initial opening in the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the bone forming the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body with the suture connected with the anchor, wherein said step of forming an opening in the bone includes enlarging the initial opening in the bone in the patient'"'"'s body.
- 26. A method of securing tissue to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion, pressing a surface on the pointed end portion of the anchor against the tissue, forming an opening in the tissue under the influence of force applied against the tissue by the surface on the pointed end portion of the anchor, moving the anchor into the opening formed in the tissue, pressing the surface on the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body, and securing the tissue against movement relative to the bone, said step of securing tissue includes tensioning a suture connected with the anchor and partially disposed in the opening formed in the bone in the patient'"'"'s body and with a portion of the suture extending from the bone in the patient'"'"'s body into engagement with the tissue, positioning a suture retainer relative to the suture, and securing the suture retainer against movement relative to the suture while continuing to tension the suture.
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42. A method of securing tissue to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion, pressing a surface on the pointed end portion of the anchor against the tissue, forming an opening in the tissue under the influence of force applied against the tissue by the surface on the pointed end portion of the anchor, moving the anchor into the opening formed in the tissue, pressing the surface on the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body, positioning a suture retainer relative to a suture connected with the anchor, increasing tension in the suture to a predetermined tension, and transmitting ultrasonic vibratory energy to the suture retainer in response to an increase in the tension in the suture to a predetermined tension.
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43. A method of securing tissue to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion, pressing a surface on the pointed end portion of the anchor against the tissue, forming an initial opening in the bone in the patient'"'"'s body, forming an opening in the tissue under the influence of force applied against the tissue by the surface on the pointed end portion of the anchor, moving the anchor into the opening formed in the tissue, pressing the surface on the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the pointed end portion of the anchor, and moving the anchor into the opening formed in the bone in the patient'"'"'s body, wherein said step of forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the pointed end portion of the anchor includes enlarging the initial opening in the bone in the patient'"'"'s body.
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44. A method of securing tissue to a bone in a patient'"'"'s body, said method comprising the steps of providing an anchor having a pointed end portion, pressing a surface on the pointed end portion of the anchor against the tissue, forming an opening in the tissue under the influence of force applied against the tissue by the surface on the pointed end portion of the anchor, moving the anchor into the opening formed in the tissue, pressing the surface on the pointed end portion of the anchor against the bone in the patient'"'"'s body, forming an opening in the bone in the patient'"'"'s body under the influence of force applied against the bone in the patient'"'"'s body by the surface on the pointed end portion of the anchor, moving the anchor into the opening formed in the bone in the patient'"'"'s body, wherein the anchor is formed by a single piece of bone, said step of forming an opening in the bone in the patient'"'"'s body includes enclosing the anchor with a sleeve and applying force against a trailing end portion of the anchor while the anchor is enclosed by the sleeve.
- 45. A method of securing first tissue in a patient'"'"'s body to second tissue in the patient'"'"'s body, said method comprising the steps of positioning an anchor relative to the second tissue with a suture connected with the anchor and extending from the second tissue, positioning a retainer relative to the suture, transmitting force from the retainer to the first tissue to urge the first tissue toward the second tissue, tensioning the suture, said step of tensioning the suture includes detecting when at least a predetermined tension is present in the suture, and connecting the retainer with the suture in response to detection of at least the predetermined tension in the suture.
- 60. A method of securing first tissue in a patient'"'"'s body to second tissue in the patient'"'"'s body, said method comprising the steps of positioning an anchor relative to the second tissue with a suture connected with the anchor and extending from the second tissue, positioning a retainer relative to the suture, transmitting force from the retainer to the first tissue to urge the first tissue toward the second tissue, said step of transmitting force from the retainer to the first tissue includes detecting when at least a predetermined force is transmitted to the first tissue, tensioning the suture, and connecting the retainer with the suture in response to detection of transmission of at least the predetermined force to the first tissue.
- 75. A method of securing first tissue in a patient'"'"'s body to second tissue in the patient'"'"'s body, said method comprising the steps of positioning an anchor relative to the second tissue with a suture connected with the anchor and extending from the second tissue, positioning a retainer relative to the suture, transmitting force from the retainer to the first tissue to urge the first tissue toward the second tissue, said step of transmitting force from the retainer to the first tissue includes detecting when at least a predetermined force is transmitted to the first tissue, tensioning the suture, said step of tensioning the suture includes detecting when at least a predetermined tension is present in the suture, and connecting the retainer with the suture in response to detection of both the predetermined tension in the suture and the transmission of the predetermined force to the first tissue.
- 90. A method of securing first tissue in a patient'"'"'s body to second tissue in the patient'"'"'s body, said method comprising the steps of positioning an anchor relative to the second tissue with first and second sections of a suture connected with the anchor and extending from the second tissue, positioning the first and second sections of the suture relative to the first tissue, tensioning the first and second sections of the suture, and connecting the first and second sections of the suture together, said step of connecting the first and second sections of the suture together includes transmitting ultrasonic vibratory energy to at least one of the first and second sections of the suture and pressing the first section of the suture against the second section of the suture.
- 99. A method of securing a suture relative to body tissue, said method comprises the steps of positioning the suture relative to the body tissue, connecting the suture to a first member, establishing at least a predetermined tension in the suture by urging the first member in a direction away from the body tissue, positioning a retainer relative to the suture, establishing the transmission of at least a predetermined force from the retainer to the body tissue by urging the retainer toward the body tissue, and connecting the retainer with the suture while at least the predetermined tension is present in the suture and while at least the predetermined force is being transmitted from the retainer to the body tissue, said step of connecting the retainer with the suture includes transmitting ultrasonic vibratory energy to the retainer.
- 107. A method of securing a suture relative to body tissue, said method comprises the steps of positioning the suture relative to body tissue, connecting first and second sections of the suture to a first member, establishing at least a predetermined tension in the first and second sections of the suture by urging the first member in a direction away from the body tissue, establishing the transmission of at least a predetermined force from a second member to the body tissue by urging the second member in a direction toward the body tissue, and connecting the first and second sections of the suture together while at least the predetermined tension is present in the suture and while at least the predetermined force is being transmitted from the second member to the body tissue, said step of connecting the first and second sections of the suture together includes transmitting ultrasonic vibratory energy to at least one of the sections of the suture and pressing the first section of the suture against the second section of the suture.
- 115. An apparatus for use in securing a suture relative to body tissue, said apparatus comprising means for tensioning the suture with at least a predetermined tension, means for applying at least a predetermined force to a retainer to urge the retainer toward the body tissue, means for detecting when at least the predetermined tension is present in the suture, and means for connecting the retainer with the suture, said means for connecting the retainer with the suture being operable to connect the retainer with the suture in response to detection that at least the predetermined tension is present in the suture.
- 119. An apparatus for use in securing a suture relative to body tissue, said apparatus comprising means for tensioning the suture with at least a predetermined tension, means for applying a predetermined force to a retainer to urge the retainer toward the body tissue, means for detecting when at least a predetermined force is applied to the retainer, and means for connecting the retainer with the suture, said means for connecting the retainer with the suture being operable to connect the retainer with the suture in response to detection that at least the predetermined force is being applied to the retainer.
- 123. An apparatus for use in securing first and second sections of a suture relative to body tissue, said apparatus comprising means for tensioning the first and second sections of the suture with at least a predetermined tension, means for applying at least a predetermined force which is transmitted to the body tissue and is effective to urge the body tissue in a direction away from said means for tensioning the first and second sections of the suture with at least the predetermined tension, means for detecting when at least the predetermined tension is present in the first and second sections of the suture, and means for interconnecting the first and second sections of the suture, said means for interconnecting the first and second sections of the suture being operable to interconnect the first and second sections of the suture in response to detection that at least the predetermined tension is present in the first and second sections of the suture.
- 128. An apparatus for use in securing first and second sections of a suture relative to body tissue, said apparatus comprising means for tensioning the first and second sections of the suture with at least a predetermined tension, means for applying at least a predetermined force which is transmitted to the body tissue and is effective to urge the body tissue in a direction away from said means for tensioning the first and second sections of the suture with at least a predetermined tension, means for detecting when at least the predetermined force is transmitted to the body tissue, and means for interconnecting the first and second sections of the suture, said means for interconnecting the first and second sections of the suture being operable to interconnect the first and second sections of the suture in response to detection that at least the predetermined force is being transmitted to the body tissue.
- 133. An apparatus for use in securing a suture relative to body tissue, said apparatus comprising a base, a first member connected with said base and connectable with the suture, said first member being urged in a direction toward the body tissue under the influence of tension force transmitted to said first member through the suture, a second member connected with said base and engageable with a retainer which is disposed adjacent to the suture, said second member being effective to transmit force to the retainer to urge the retainer toward the body tissue, and a connector assembly which is connected with said base and is operable to connect the retainer with the suture upon application of a predetermined force to at least one of said first and second members.
- 138. An apparatus for use in securing a suture relative to body tissue, said apparatus comprising a base, a first member connected with said base and connectable with the suture, said first member being urged in a direction toward the body tissue under the influence of tension force transmitted to the first member through first and second sections of the suture, a second member connected with said base, said second member being urged toward said first member under the influence of force transmitted between said second member and the body tissue, and a connector assembly which is connected with said base and is operable to connect the first and second sections of the suture together upon application of a predetermined force to at least one of said first and second members.
- 145. An apparatus for use in securing a suture relative to body tissue, said apparatus comprising a base, a first member connected with said base and connectable with the suture, said first member being urged in a direction toward the body tissue under the influence of tension force transmitted to the first member through the suture, a second member connected with said base and engageable with a retainer which is disposed adjacent to the suture, said second member being effective to transmit force to the retainer urging the retainer toward the body tissue, and a connector assembly which is connected with said base and is operable to connect the retainer to the suture when there is both the transmission of a first predetermined force from the suture to the first member and the transmission of a second predetermined force from the second member to the retainer.
- 150. An apparatus for use in securing first and second sections of a suture relative to body tissue, said apparatus comprising a base, a first member connected with said base and connectable with the first and second sections of the suture, said first member being urged in a direction toward the body tissue under the influence of tension force transmitted through the suture, a second member connected with said base, said second member being urged toward said first member under the influence of force transmitted between said second member and the body tissue, and a connector assembly which is connected with said base and is operable to connect the first and second sections of the suture together when there is both the transmission of a first predetermined force to the first member and the transmission of a second predetermined force between said second member and the body tissue.
- 156. An apparatus for use in securing a suture relative to a bone in a patient'"'"'s body, said apparatus comprising an anchor formed of a single piece of bone, said anchor including a cylindrical body portion having a longitudinal central axis and a pointed end portion having a central axis which is coincident with the longitudinal central axis of said body portion, said body portion including first and second openings which extend through said body portion in a direction transverse to the longitudinal central axis of said body portion and which receive the suture, said second opening having a central axis which extends parallel to a central axis of said first opening and said pointed end portion having surface means for forming an opening in the bone in the patient'"'"'s body under the influence of force applied against a trailing end of said body portion in a direction extending along the longitudinal central axis of said body portion.
Specification