Suture buttress system

• US 6,620,166 B1
• Filed: 01/09/1998
• Issued: 09/16/2003
• 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: Wenstrom, Richard F. Jr., Craig, Edward V.
• Primary Examiner(s): Brown, Michael A.
• Application Number:
  US09/004,989
• Time in Patent Office: 2,076 Days
• Field of Search: 606/72, 606/73, 606/74, 606/75, 606/144, 606/148, 606/232, 606/233, 606/220
• 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 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 system has a suture retriever and a suture buttress. The suture retriever includes a handle portion with an elongate member extending therefrom and having an outer surface and a distal end that includes a suture retaining element. The suture buttress comprises a resilient hollow tube having an outer surface and opposed ends. The suture buttress is removably and replaceably disposed on the elongate member. The suture buttress may further include an external fastening element suitable to retain the suture buttress within a bone tunnel. A suture buttress deployment tool may also be provided.

Claims

1. A suture buttress system, comprising:

a suture retriever including a handle portion with an elongate member extending therefrom, the elongate member having an outer surface and a distal end that includes a suture retaining element; and

a suture buttress comprising a resilient hollow tube having an outer surface and opposed proximal and distal ends, the suture buttress being removably and replaceably disposed on the elongate member such that when the suture retaining element extends beyond the distal end of the suture buttress, the sutress buttress retaining element is operable through the distal end of the hollow tube.

2. The system of claim 1, wherein the suture buttress further comprises an external fastening element extending from the outer surface thereof.

3. The system of claim 2, wherein the elongate member has a curved portion in proximity to its distal end.

4. The system of claim 3, wherein the suture buttress is removably and replaceably disposed on the outer surface of the curved portion of the elongate member.

5. The system of claim 4, wherein the external fastening element comprises at least one slit formed in at least a portion of the outer surface of the tube, the at least one slit being formed at an angle to a plane transverse to a longitudinal axis of the tube such that when the tube is flexed, a raised edge extends outward from the outer surface of the suture buttress.

6. The system of claim 5, wherein a plurality of slits are formed in the tube and each slit is angled in the same direction.

7. The system of claim 5, wherein the external fastening element is formed so as to allow the suture buttress to slide into a bone tunnel in a first direction when urged into the tunnel by insertion of the suture retriever into the tunnel, but the external fastening element engages the tunnel to prevent the suture buttress from sliding out of the tunnel in a second direction, substantially opposed to the first direction, when the suture retriever is removed form the tunnel.

8. The system of claim 2, wherein the external fastening element comprises at least one resilient flange located on the outer surface of the suture buttress.

9. The system of claim 8, wherein the external fastening element comprises two resilient flanges disposed on the outer surface of the suture buttress, wherein one flange is in proximity to each of the opposed ends of the suture buttress.

10. The system of claim 2, wherein the external fastening element comprises a portion of the resilient tube of the suture buttress adjacent one of the opposed ends, the portion being folded over onto the outer surface of the resilient tube.

11. The system of claim 10, wherein the external fastening element comprises a portion of the resilient tube from each of the opposed ends, each portion being folded over onto the outer surface of the resilient tube.

12. The system of claim 1, wherein the suture buttress is constructed from a resorbable material.

13. The system of claim 1, wherein the suture buttress has a length of between about 0.75 and 1.50 inches.

14. The system of claim 1, wherein the suture buttress has an inner diameter of between about 0.060 and 0.085 and a wall thickness of between about 0.014 and 0.018 inches.

15. The system of claim 1, further comprising a suture buttress deployment tool having a handle and a deployment element attached to a distal end of the handle, the deployment element being removably and replaceably disposed on the outer surface of the elongate member of the suture retriever proximal to the suture buttress.

16. The system of claim 15, wherein the deployment element is effective to deploy the suture buttress away from the outer surface of the elongate member within a bone tunnel.

17. The system of claim 15, wherein the deployment element comprises a circular member disposed around the elongate member of the suture retriever.

18. A bone tunnel buttress system, comprising:

a suture retriever including a handle portion with an elongate member extending therefrom, the elongate member having an outer surface and a distal end that includes a suture retaining element; and

a bone tunnel buttress comprising a resilient hollow tube with an outer surface and opposed proximal and distal ends, the bone tunnel buttress being removably and replaceably disposed on the elongate member such that the suture retaining element is operable through the distal end of the hollow tube, the bone tunnel buttress further including at least one external fastening element on the outer surface, the external fastening element 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.

19. The system of claim 18, wherein the external fastening element comprises at least one slit formed in at least a portion of the outer surface of the tube at an angle to a plane transverse to a longitudinal axis of the tube such that when the tube is flexed, a raised edge extends outward from the outer surface of the bone tunnel buttress.

20. The system of claim 19, wherein a plurality of slits are formed in the tube and each slit is angled in the same direction.

21. The system of claim 18, wherein the external fastening element comprises at least one resilient flange located on the outer surface of the bone tunnel buttress.

22. The system of claim 18, wherein the external fastening element comprises a portion of the resilient tube of the bone tunnel buttress adjacent one of the opposed ends, the portion being folded over onto the outer surface of the resilient tube.

23. The system of claim 18, wherein the bone tunnel buttress is constructed from a resorbable material.

24. The system of claim 18, wherein the bone tunnel buttress has a length of between about 0.75 and 1.50 inches.

25. The system of claim 18, wherein the bone tunnel buttress has an inner diameter of between about 0.060 and 0.085 inches and a wall thickness of between about 0.014 and 0.018 inches.

26. A bone tunnel buttress, comprising:

a bioimplantable elongate hollow tube having an outer surface and opposed proximal and distal ends;

at least one external fastening member formed on the outer surface of the tube, the bone tunnel buttress being effective for deployment within a bone tunnel such that the external fastening member prevents removal of the bone tunnel buttress from the bone tunnel in a direction opposite to a direction of insertion of the bone tunnel buttress within the bone tunnel; and

wherein the external fastening element comprises at least one slit formed in at least a portion of the outer surface of the tube, the at least one slit being formed at an angle other than 90 degrees to a plane transverse to a longitudinal axis of the tube such that when the tube is flexed, a raised edge extends outward from the outer surface of the bone tunnel buttress.

27. The bone tunnel buttress of claim 26, wherein a plurality of slits are formed in the tube and each slit is angled in the same direction.

28. The bone tunnel buttress of claim 26, wherein the external fastening element is formed so as to allow the bone tunnel buttress to slide into a bone tunnel in a first direction when urged into the tunnel by insertion of the suture retriever into the tunnel, but the external fastening element engages the tunnel to prevent the bone tunnel buttress from sliding out of the tunnel in a second direction, substantially opposed to the first direction, when the suture retriever is removed form the tunnel.

29. The bone tunnel buttress of claim 26, wherein the external fastening element comprises at least one resilient flange located on the outer surface of the bone tunnel buttress.

30. The bone tunnel buttress of claim 29, wherein the external fastening element comprises two resilient flanges disposed on the outer surface of the bone tunnel buttress, one flange in proximity to each of the opposed ends of the bone tunnel buttress.

31. The bone tunnel buttress of claim 26, wherein the external fastening element comprises a portion of the resilient tube of the bone tunnel buttress adjacent one of the opposed ends, the portion being folded over onto the outer surface of the resilient tube.

32. The bone tunnel buttress of claim 31, wherein the external fastening element comprises a portion of the resilient tube from each of the opposed ends, each portion being folded over onto the outer surface of the resilient tube.

33. The bone tunnel buttress of claim 26, wherein the bone tunnel buttress is constructed from a resorbable material.

34. The bone tunnel buttress of claim 26, wherein the bone tunnel buttress has a length of between about 0.75 and 1.50 inches.

35. The bone tunnel buttress of claim 26, wherein the bone tunnel buttress has an inner diameter of between about 0.060 and 0.085 inches and a wall thickness of between about 0.014 and 0.018 inches.

36. 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;

attaching a suture thread to the soft tissue to be attached;

providing a suture buttress system comprising;

a suture retriever including a handle portion with an elongate member extending therefrom, the elongate member having an outer surface and a distal end that includes a suture retaining element; and

a suture buttress comprising a resilient hollow tube having an outer surface and opposed ends, the suture buttress being removably and replaceably disposed on the elongate member;

inserting the distal end of the elongate member of the suture buttress system into the second hole at least until the distal end of the elongate member reaches the first hole;

engaging a suture attached to the soft tissue with the suture retaining element; and

removing the suture retriever from the bone tunnel so as to draw the suture through the bone tunnel and the suture buttress while leaving the suture buttress within the tunnel.

37. The method of claim 36, wherein the first hole and the second hole are formed using a drill.

38. The method of claim 36, wherein the suture buttress further comprises at least one external fastening member formed on the outer surface of the tube, the bone tunnel buttress being effective for deployment within a bone tunnel such that the external fastening member prevents removal of the bone tunnel buttress from the bone tunnel in a direction opposite to a direction of insertion of the bone tunnel buttress within the bone tunnel.

39. The method of claim 38, wherein the bone tunnel is formed using a circular bone rasp.

40. The method of claim 39, wherein the external fastening element comprises at least one slit formed in at least a portion of the outer surface of the tube, the at least one slit being formed at an angle to a plane transverse to a longitudinal axis of the tube such that when the tube is flexed, a raised edge extends outward from the outer surface of the bone tunnel buttress.