System and method for anchoring suture to bone

• US 7,572,275 B2
• Filed: 12/08/2004
• Issued: 08/11/2009
• Est. Priority Date: 12/08/2004
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: Stryker Endoscopy (Stryker Corporation)
• Inventors: Sinnott, M. Mary, Fallin, T. Wade
• Primary Examiner(s): Ho; (Jackie) Tan-Uyen T.
• Assistant Examiner(s): Anderson; Gregory A
• Application Number:
  US11/008,006
• Publication Number:
  US 20060122608A1
• Time in Patent Office: 1,707 Days
• Field of Search: 606/232, 623/13.11, 623 1312- 1314
• 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 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0459 Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A system for attaching soft tissue to bone includes an anchor, a suture, and a tissue retainer. The anchor may have a threaded tip that engages the bone, and a suture retention portion with passageways arranged such that each of first and second anchor portions of the suture can be drawn through the passageways along only a single direction. The tissue retainer has passageways through which the suture can freely move in either direction. Thus, the anchor and the tissue retainer may be attached to bone and tissue, respectively, and the suture may be drawn to substantially irreversibly draw the bone and tissue together. In alternative embodiments, an anchor may receive only one portion of suture and/or one suture end may be affixed to the anchor. The anchor may alternatively permit free motion of the suture, while the tissue retainer permits passage of the suture along only one direction.

Claims

1. A system for attaching a bone and a tissue together via a suture, the system comprising:

a suture;

an anchor comprising;

a bone retention portion shaped to engage the bone to attach the anchor to the bone; and

a first suture retention portion attached to the bone retention portion, wherein the first suture retention portion is configured to retain a first anchor portion of the suture; and

a tissue retainer comprising a second suture retention portion configured to retain a retainer portion of the suture;

wherein at least one of the first suture retention portion and the second suture retention portion comprises a plurality of passageways arranged to define a first pathway;

wherein the suture is routed through the passageways such that the first anchor portion of the suture is able to be drawn along the first pathway substantially along only a first direction;

wherein the first anchor portion is further routed along the first pathway such that a first compression section of the first anchor portion presses another part of the first anchor portion against the first suture retention portion of the anchor in response to tension urging the first anchor portion to move along the first pathway opposite to the first direction.

2. The system of claim 1, wherein the bone retention portion comprises a substantially rigid structure shaped to engage the bone to rigidly attach the anchor to the bone.

3. The system of claim 2, wherein the bone retention portion comprises a threaded tip comprising a plurality of threads shaped to engage the bone to attach the anchor to the bone.

4. The system of claim 1, wherein the suture further comprises a second anchor portion, wherein the suture is further routed through the passageways such that the second anchor portion of the suture is able to be drawn through at least some of the passageways substantially along only a second direction, wherein the second anchor portion is spaced apart from the first anchor portion, wherein the second anchor portion comprises a second compression section that presses another part of the second anchor portion against the first suture retention portion in response to tension urging the second anchor portion to move through the passageways opposite to the second direction, wherein the first suture retention portion is configured to retain the first and second anchor portions.

5. The system of claim 4, wherein the first suture retention portion comprises the plurality of passageways, wherein the passageways further define a second pathway along which the second anchor portion of the suture can be advanced only along a direction that draws the anchor and the tissue retainer closer together.

6. The system of claim 5, wherein the second suture retention portion comprises one or more passageways through which the retainer portion is relatively freely movable along either direction.

7. The system of claim 5, wherein the first and second anchor portions are able to be independently drawn along the first and second pathways, respectively.

8. The system of claim 5, wherein the passageways comprise a primary passageway, a first secondary passageway, and a second secondary passageway, wherein the first pathway passes through the primary passageway and the first secondary passageway, and the second pathway passes through the primary passageway and the second secondary passageway.

9. The system of claim 1, wherein the first suture retention portion comprises the plurality of passageways, wherein the plurality of passageways comprises two passageways symmetrically displaced from each other across a long axis of the anchor.

10. The system of claim 1, wherein at least one of the first suture retention portion and the second suture retention portion comprises a notch positioned adjacent to the passageways to receive a first compressed section of the suture such that the first compressed section is compressed against the notch by the first compression section of the suture to substantially prevent motion of the suture through the passageways in a manner that permits the tissue retainer to move apart from the anchor.

11. The system of claim 1, wherein the anchor is formed of a metal.

12. The system of claim 1, wherein the anchor is formed of a bioabsorbable material.

13. The system of claim 1, wherein the anchor is formed of a non-bioabsorbable polymer.

14. A system for attaching a bone and a tissue together via a suture, the system comprising:

a suture; and

an anchor comprising;

a bone retention portion comprising a substantially rigid structure shaped to engage the bone to rigidly attach the anchor to the bone; and

a suture retention portion attached to the bone retention portion, the suture retention portion comprising a plurality of passageways arranged to define a first pathway;

wherein the suture is routed through the passageways such that a first anchor portion of the suture is able to be drawn along the first pathway substantially along only a first direction;

wherein the first anchor portion is further routed along the first pathway such that a first compression section of the first anchor portion presses another part of the first anchor portion against the first suture retention portion in response to tension urging the first anchor portion to move along the first pathway opposite to the first direction.

15. The system of claim 14, wherein the bone retention portion comprises a threaded tip having a plurality of threads shaped to engage the bone to attach the anchor to the bone.

16. The system of claim 15, wherein the threaded tip comprises a sharpened shape selected to permit the bone anchor to penetrate the bone in response to pressure of the threaded tip against the bone.

17. The system of claim 14, wherein the suture further comprises a second anchor portions, wherein the second anchor portion extends along a second pathway along which the second anchor portion under tension can only be advanced in a second direction, wherein the second anchor portion comprises a second compression section that presses another part of the second anchor portion against the first suture retention portion in response to tension urging the second anchor portion to move along the second pathway opposite to the second direction.

18. The system of claim 17, wherein the first and second anchor portions are able to be independently drawn along the first and second pathways, respectively.

19. The system of claim 17, wherein the passageways comprise a primary passageway, a first secondary passageway, and a second secondary passageway, wherein the first pathway passes through the primary passageway and the first secondary passageway, and the second pathway passes through the primary passageway and the second secondary passageway.

20. The system of claim 14, wherein the plurality of passageways comprises two passageways symmetrically displaced from each other across a long axis of the anchor.

21. The system of claim 14, wherein the suture retention portion comprises a notch positioned adjacent to the passageways to receive a first compressed section of the suture such that the first compressed section is compressed against the notch by the first compression section of the suture to substantially prevent motion of the suture through the passageways in a manner that permits the tissue retainer to move apart from the anchor.

22. A system for attaching a bone and a tissue together via a suture, the system comprising:

a suture; and

an anchor comprising;

a bone retention portion configured to engage the bone to attach the anchor to the bone; and

a suture retention portion attached to the bone retention portion, the suture retention portion comprising a plurality of passageways arranged to receive the suture, and a first notch;

wherein the suture is routed through the passageways such that a first anchor portion of the suture is able to be drawn through at least some of the passageways. substantially along only a first direction;

wherein the first anchor portion is further routed through the passageways such that a first compression section of the first anchor portion presses a compressed section of the first anchor portion against the first suture retention portion in response to tension urging the first anchor portion to move through the passageways opposite to the first direction.

23. The system of claim 22, wherein the bone retention portion comprises a threaded tip having a plurality of threads shaped to engage the bone to attach the anchor to the bone.

24. The system of claim 22, wherein the suture comprises first and second anchor portions, wherein the first anchor portion extends along a first pathway through the passageways and the second anchor portion extends along a second pathway through the passageways, wherein the first and second anchor portions under tension can only be advanced in a single direction along the first and second pathways, respectively.

25. The system of claim 24, wherein the first and second anchor portions are able to be independently drawn along the first and second pathways, respectively.

26. The system of claim 24, wherein the first anchor portion comprises the compression section and the compressed section, wherein the suture retention portion further comprises a second notch positioned to receive a compressed section of the second anchor portion such that the compressed section of the second anchor portion is compressed against the second notch by a compression section of the second anchor portion.

27. The system of claim 22, wherein the first notch is oriented substantially perpendicular to at least one passageway of the plurality of passageways.

28. A system for attaching a bone and a tissue together via a suture comprising first and second anchor portions, the system comprising:

a suture; and

an anchor comprising;

a bone retention portion configured to engage the bone to attach the anchor to the bone; and

a first suture retention portion attached to the bone retention portion, the first suture retention portion comprising a plurality of passageways arranged to define first and second pathways;

wherein the suture is routed through the passageways such that a first anchor portion of the suture is able to be drawn along the first pathway substantially along only a first direction and a second anchor portion of the suture is able to be drawn along the second pathway substantially only along a second direction independently of advancement of the first anchor portion along the first pathway;

wherein the first anchor portion is routed along the first pathway such that a first compression section of the first anchor portion presses another part of the first anchor portion against the first suture retention portion in response to tension urging the first anchor portion to move along the first pathway opposite to the first direction.

29. The system of claim 28, wherein the passageways comprise a primary passageway, a first secondary passageway, and a second secondary passageway, wherein the first pathway passes through the primary passageway and the first secondary passageway, and the second pathway passes through the primary passageway and the second secondary passageway.

30. The system of claim 28, wherein the first and second pathways are substantially symmetrical to each other across a long axis of the anchor.

31. The system of claim 30, wherein the plurality of passageways comprises two passageways symmetrically displaced from each other across a long axis of the anchor.

32. The system of claim 28, further comprising a tissue retainer comprising a second suture retention portion configured to retain a retainer portion of the suture.

33. The system of claim 32, wherein the second suture retention portion comprises one or more passageways through which the retainer portion is relatively freely movable along a retainer pathway, along either direction.

34. A method for attaching a bone and a tissue together via a suture through the use of a system comprising an anchor and a tissue retainer, the method comprising:

retaining a first anchor portion of the suture with a first suture retention portion of the anchor;

retaining a retainer portion of the suture with a second suture retention portion of the tissue retainer; and

engaging the bone with a bone retention portion of the anchor to attach the anchor to the bone;

wherein one of retaining the first anchor portion and retaining the retainer portion comprises inserting the suture along a first pathway through a plurality of passageways of the corresponding suture retention portion of the first and second suture retention portions such that the suture is able to be drawn only along a direction that draws the anchor and the tissue retainer closer together;

wherein the suture is routed such that a first compression section of the first anchor portion presses another part of the first anchor portion against the first suture retention portion in response to tension urging anchor and the tissue retainer to move apart.

35. The method of claim 34, wherein the bone retention portion comprises a threaded tip, wherein engaging the bone comprises engaging the bone with a plurality of threads of the threaded tip in response to rotation of the anchor.

36. The method of claim 34, wherein the suture further comprises a second anchor portion, the method further comprising retaining the second anchor portion with the first suture retention portion.

37. The method of claim 36, wherein the first suture retention portion comprises the plurality of passageways, wherein retaining the second anchor portion comprises inserting the second anchor portion along a second pathway through the plurality of passageways such that the second anchor portion is able to be drawn only along a direction that draws the anchor and the tissue retainer closer together.

38. The method of claim 37, wherein the second suture retention portion comprises one or more passageways, the method further comprising inserting the retainer portion through the one or more passageways of the tissue retainer such that the retainer portion is relatively freely movable through the one or more passageways of the tissue retainer along either direction.

39. The method of claim 37, further comprising drawing one of the first and second anchor portions along the corresponding pathway of the first and second pathways independently of motion of the other of the first and second anchor portions.

40. The method of claim 37, wherein the passageways comprise a primary passageway, a first secondary passageway, and a second secondary passageway, wherein inserting the first anchor portion along the first pathway comprises moving the first anchor portion through the primary passageway and the first secondary passageway, wherein inserting the second anchor portion along the second pathway comprises moving the second anchor portion through the primary passageway and the second secondary passageway.

41. The method of claim 34, wherein at least one of the first suture retention portion and the second suture retention portion comprises a notch positioned adjacent to the passageways, wherein retaining the first anchor portion comprises receiving a first compressed section of the suture such that the first compressed section is compressed against the notch by the first compression section of the suture to substantially prevent motion of the suture through the passageways in a manner that permits the tissue retainer to move apart from the anchor.

42. The method of claim 34, further comprising positioning the tissue retainer to abut the tissue.

43. The method of claim 42, further comprising moving the first anchor portion along the pathway to draw the bone and the tissue closer together.

44. A method for coupling a suture to a bone through the use of an anchor, the method comprising:

inserting a suture along a first pathway through a plurality of passageways of a suture retention portion of the anchor, such that the suture under tension can only be advanced in a single direction along the first pathway, wherein the first anchor portion is routed such that a first compression section of the first anchor portion presses another part of the first anchor portion against the suture retention portion in response to tension urging the suture to move through the passageways opposite to the first direction; and

rotating the anchor about an axis to induce engagement the anchor with the bone, thereby attaching the anchor to the bone.

45. The method of claim 44, wherein the bone retention portion comprises a threaded tip having a plurality of threads, wherein inducing engagement of the anchor with the bone comprises engaging the bone with the threads in response to rotation of the anchor to attach the anchor to the bone.

46. The method of claim 45, wherein the threaded tip comprises a sharpened shape, the method further comprising:

positioning the threaded tip against the bone; and

pressing the tip against the bone along the axis to induce penetration of the bone by the threaded tip.

47. The method of claim 44, wherein the suture comprises first and second anchor portions, wherein inserting the suture along the first pathway comprises inserting the first anchor portion along the first pathway and inserting the second anchor portion along the second pathway such that the second anchor portion under tension can only be advanced in a single direction along the second pathway.

48. The method of claim 47, further comprising drawing one of the first and second anchor portions along the corresponding pathway of the first and second pathways independently of motion of the other of the first and second anchor portions.

49. The method of claim 47, wherein the passageways comprise a primary passageway, a first secondary passageway, and a second secondary passageway, wherein inserting the first anchor portion along the first pathway comprises inserting the first anchor portion through the primary passageway and the first secondary passageway, wherein inserting the second anchor portion along the second pathway comprises inserting the second anchor portion through the primary passageway and the second secondary passageway.

50. The method of claim 44, wherein the suture retention portion comprises a notch positioned adjacent to the passageways, wherein retaining the first anchor portion comprises receiving a first compressed section of the suture such that the first compressed section is compressed against the notch by the first compression section of the suture to substantially prevent motion of the suture through the passageways in a manner that permits the tissue retainer to move apart from the anchor.

51. A method for coupling a suture to a bone through the use of an anchor, the method comprising:

inserting the suture through a plurality of passageways of a suture retention portion of the anchor;

receiving a compressed section of the suture in a first notch of the suture retention portion such that the compressed section is compressed against the first notch by a compression section of the suture; and

receiving a bone retention portion of the anchor in the bone to retain the anchor.

52. The method of claim 51, wherein the bone retention portion comprises a threaded tip having a plurality of threads, wherein receiving the bone retention portion of the anchor into the bone comprises engaging the bone with the threads to attach the anchor to the bone.

53. The system of claim 51, wherein the suture comprises first and second anchor portions, wherein inserting the suture through the plurality of passageways comprises inserting the first anchor portion along a first pathway through the passageways and inserting the second anchor portion along an second pathway through the passageways, such that the first and second anchor portions under tension can only be advanced in a single direction along the first and second pathways, respectively.

54. The method of claim 53, further comprising drawing one of the first and second anchor portions along the corresponding pathway of the first and second pathways independently of motion of the other of the first and second anchor portions.

55. The method of claim 53, wherein the first anchor portion comprises the compression section and the compressed section, wherein the suture retention portion further comprises a second notch, the method further comprising receiving a compressed section of the second anchor portion in the second notch such that the compressed section of the second anchor portion is compressed against the second notch by a compression section of the second anchor portion.

56. A method for coupling a suture to a bone through the use of an anchor, the suture comprising a first anchor portion and a second anchor portion, the method comprising:

inserting the first and second anchor portions along first and second pathways, respectively, through a plurality of passageways of a suture retention portion of the anchor such that either of the first and second anchor portions under tension can only be advanced along the corresponding pathway in a single direction, wherein the first anchor portion is routed through the passageways such that a first compression section of the first anchor portion presses another part of the first anchor portion against the first suture retention portion in response to tension urging the first anchor portion to move through the passageways opposite to the single direction;

receiving a bone retention portion of the anchor in the bone to retain the anchor; and

further advancing only one of the first and second anchor portions along the corresponding pathway.

57. The method of claim 56, wherein the passageways comprise a primary passageway, a first secondary passageway, and a second secondary passageway, wherein inserting the first and second anchor portions along the first and second pathways comprises inserting the first anchor portion through the primary passageway and the first secondary passageway, and inserting the second anchor portion through the primary passageway and the second secondary passageway.

58. The method of claim 56, wherein inserting the first and second anchor portions along the first and second pathways comprises positioning the first and second anchor portions substantially symmetrically to each other across a long axis of the anchor.

59. The method of claim 56, further comprising inserting a retainer portion of the suture through one or more passageways of a tissue retainer such that advancing only one of the first and second anchor portions along the corresponding pathway draws the tissue retainer closer to the anchor.

60. The method of claim 56, wherein the second anchor portion is routed through the passageways such that a second compression section of the second anchor portion presses another part of the second anchor portion against the first suture retention portion in response to tension urging the second anchor portion to move through the passageways opposite to the single direction.