Methods and apparatus for preventing migration of sutures through transosseous tunnels

• US 6,830,572 B2
• Filed: 10/16/2001
• Issued: 12/14/2004
• Est. Priority Date: 09/24/1990
• Status: Expired due to Term

• Current Assignee: DePuy Mitek Incorporated (Johnson & Johnson)
• Original Assignee: DePuy Mitek Incorporated (Johnson & Johnson)
• Inventors: Nicholson, James, McDevitt, Dennis
• Primary Examiner(s): BROWN, MICHAEL A
• Application Number:
  US09/981,623
• Publication Number:
  US 20020133179A1
• Time in Patent Office: 1,155 Days
• Field of Search: 606/72, 606/73, 606/80, 606/86, 606/87, 606/88, 606/232, 623/13, 623/14, 623/16, 411/54, 411/55, 411/57, 411/60
• US Class Current: 606/232
• CPC Class Codes: A01B 1/222 Adjustable blades
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/686 Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
• 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 2017/0403 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: 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 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0425 the anchor or the separate member comprising threads, e.g. a set screw in the anchor
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter
• 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 2002/0835 : with deformation of anchor parts, e.g. expansion of dowel by set screw
• CPC Class Codes: A61F 2002/0841 : Longitudinal channel for insertion tool running through the whole tendon anchor, e.g. for accommodating bone drill, guidewire
• 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 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• CPC Class Codes: Y10S 623/902 : Method of implanting

Abstract

An improved method for attaching soft tissue to bone by passing a suture through an opening in the bone, e.g., a transosseous tunnel, and affixing the soft tissue with the suture. The improvement, for preventing the suture from migrating through the bone at the end of the opening, includes placing a eyelet into an end of the bone opening and passing the suture through the eyelet, as well as through the opening in the bone, in order to affix the soft tissue to the bone with the suture.

Claims

1. A method for attaching soft tissue to bone, comprising:

preparing a transosseous tunnel in the bone;

placing an eyelet having an channel extending therethrough into an end of the tunnel, the eyelet being adapted to reinforce an opening at the end of the tunnel to prevent migration of a suture through an edge of the opening;

passing the suture through the channel of the eyelet, as well as through the transosseous tunnel; and

affixing the soft tissue to the bone with the suture.

2. The method of claim 1, wherein the soft tissue comprises the spinatus tendon, and the bone comprises the humerus.

3. The method of claim 1, wherein the eyelet is screwed into bone at the end of the tunnel.

4. The method of claim 3, wherein the body of the eyelet is threaded for screwing the eyelet into the opening of the transosseous tunnel.

5. The method of claim 1, wherein the eyelet is affixed into bone at the end of the tunnel by an interference fit.

6. The method of claim 1, further comprising the step of expanding the opening at the end of the tunnel prior to placing the eyelet therein.

7. The method of claim 1, wherein the eyelet includes a flanged head portion.

8. A device for reinforcing a transosseous tunnel in bone, comprising:

an eyelet expandable member having a channel extending therethrough for receiving a suture, the eyelet including a head with a flange formed thereon that is adapted to prevent migration of a suture through bone at an edge of the opening of the tunnel; and

an insertion element including a channel extending therethrough, at least a portion of the insertion element including an outer diameter greater than an inner diameter of the channel in the expandable member such that, upon insertion of the insertion element into the expandable member, the expandable member expands to obtain a pressure fit with the opening of the transosseous tunnel.

9. The device of claim 8, wherein an outer surface of the eyelet is threaded for screwing the eyelet into the opening of the transosseous tunnel.

10. The device according to claim 8, wherein the eyelet is adapted for interference fit within the opening of the transosseous tunnel.

11. A method for attaching soft tissue to bone, comprising:

preparing a transosseous tunnel in the bone;

placing an expandable member having an channel extending therethrough into an end of the tunnel, the expandable member being adapted to reinforce an opening at the end of the tunnel;

inserting an insertion element having a channel extending therethrough into the channel of the expandable member, at least a portion of the insertion element including an outer diameter greater than an inner diameter of the channel of at least a portion of the expandable member such that the insertion element is adapted to expand the expandable member to obtain a pressure fit with the bone opening;

passing a suture through the channel of the insertion element, as well as through the transosseous tunnel; and

affixing the soft tissue to the bone with the suture.

12. The method of claim 11, wherein the expandable member is substantially cylindrical and the channel comprises an axial channel extending between its proximal and distal ends, and wherein the insertion element comprises an elongate insertion element.

13. The method of claim 11, wherein the method is adapted for rotator cuff repair, and the expandable member is placed into an end of a transosseous tunnel in the humerus.

14. The method of claim 11, wherein the step of placing an expandable member into an end of the tunnel comprises placing the expandable member into the end of the tunnel using an emplacement element.

15. The method of claim 14, wherein the expandable member is frangibly attached to the emplacement element.

16. The method of claim 15, wherein the inserting step includes applying a force to the insertion element, and the method further comprises breaking the frangible attachment between the expandable member and the emplacement element by applying force to the insertion element subsequent to expansion of the expandable member in the bone opening.

17. A method for attaching soft tissue to bone, comprising:

preparing a transosseous tunnel in the bone;

placing an expandable member having an channel extending therethrough into an end of the tunnel using an emplacement element frangibly attached to the expandable member, the expandable member being adapted to reinforce an opening at the end of the tunnel;

applying a compressive force to said expandable member to expand its channel so that an outer surface of said expandable member engages with the bone;

breaking the frangible attachment between the expandable member and the emplacement element, and removing the emplacement element;

passing a suture through the channel of the insertion element, as well as through the transosseous tunnel; and

affixing the soft tissue to the bone with the suture.

18. The method of claim 17, wherein the step of applying a compressive force comprises inserting an insertion element into the channel of the expandable member, the insertion element including an outer diameter greater than an inner diameter of at least a portion of the channel of the expandable member for expansion thereof upon engagement therewith.

19. The method of claim 17, wherein the method is adapted for rotator cuff repair, and the emplacement element is used to place the expandable member into an end of a transosseous tunnel in the humerus.