Soft tissue attachment and repair

• US 7,887,551 B2
• Filed: 10/23/2002
• Issued: 02/15/2011
• Est. Priority Date: 12/02/1999
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Sikora, George, Ek, Steven, Torrie, Paul Alexander, Bojarski, Ray
• Primary Examiner(s): Nguyen; Anhtuan T
• Assistant Examiner(s): NGUYEN, TUAN VAN
• Application Number:
  US10/278,474
• Publication Number:
  US 20030130694A1
• Time in Patent Office: 3,037 Days
• Field of Search: 606/72, 606/73, 606139-141, 606222-232, 606144-157, 606/215, 606/216, 606/233
• US Class Current: 606/139
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• 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 2017/0458 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 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/061 : hollow or tubular
• CPC Class Codes: A61B 2017/0646 : for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0648 : threaded, e.g. tacks with a screw thread
• 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 2002/0829 : without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
• CPC Class Codes: A61F 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 : Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• 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: A61F 2002/0888 : Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A surgical assembly includes a fastener, a retainer, and a flexible member. The fastener is configured to be secured within bone tissue. The flexible member connects the fastener to the retainer and is movably attached to the retainer such that pulling on a free end of the flexible member shortens a length of the flexible member between the fastener and the retainer. A method includes positioning a fastener within bone tissue, positioning a retainer against soft tissue to be attached to the bone tissue, and pulling a free end of a flexible member. The fastener and the retainer are connected by the flexible member, the flexible member is movably attached to the retainer, and pulling on the free end of the flexible member shortens a length of the flexible member between the fastener and the retainer.

Claims

1. A delivery device for repairing a meniscal tear comprising:

a needle having a wall defining a lumen with a longitudinal channel, the needle having a beveled tip and the wall defining a longitudinal slot therethrough;

a handle coupled to the needle;

a pusher positioned within the lumen and actuatable at the handle; and

an implant including

an elongate first retainer positioned within the longitudinal channel and including a protrusion extending through the longitudinal slot in the wall of the needle such that pulling on the handle of the delivery device after advancement of a portion of the needle having the first retainer through meniscal tissue causes the first retainer to be deployed from the needle by interaction of the protrusion and the meniscal tissue, the first retainer having a beveled distal end and defining a through hole; and

an elongate second retainer positioned within the longitudinal channel proximally of the first retainer and including a protrusion extending through the longitudinal slot in the wall of the needle such that pulling on the handle of the delivery device after advancement of a portion of the needle having the second retainer through the meniscal tissue causes the second retainer to be deployed from the needle by the interaction of the protrusion and the meniscal tissue, the second retainer having a beveled distal end and defining a through hole, the pusher being arranged to advance the second retainer distally toward the needle tip; and

suture extending through the first and second retainer holes to connect the first and second retainers and having a slip knot formed therein between the first and second retainers prior to advancement of the needle tip into the tissue, the slip knot including a portion defining a loop, only one of the first and second retainers being slidably attached to the loop such that the slidably-attached retainer is adapted to limit the loop from passing through the slip knot and untying the slip knot, a portion of the suture capable of sliding through the slip knot so as to either shorten the loop or close a distance between the two retainers as a result of pulling on only a free limb of the suture to compress the meniscal tear.

2. The delivery device of claim 1, wherein at least one of the first and second retainers comprises a body with an outwardly extending formation configured for attachment to bone tissue.

3. The delivery device of claim 1, wherein no portion of the suture extends substantially from either retainer to the other retainer and back to the original retainer.

4. The delivery device of claim 1, wherein the first and second retainers comprise a cylindrical portion.

5. The delivery device of claim 1, wherein one of the first and second retainers comprises a T shape.

6. The delivery device of claim 1, wherein the slip knot is positioned within the longitudinal channel.

7. The delivery device of claim 1, wherein the slip knot is positioned outside of the longitudinal channel.

8. The delivery device of claim 1 being preassembled for use in a surgical procedure.

9. The delivery device of claim 1, wherein the slip knot is spaced from the first and second retainers.

10. A delivery device for repairing a meniscal tear comprising:

a needle having a wall defining a lumen with a longitudinal channel, the needle having a beveled tip and the wall defining a longitudinal slot therethrough;

a handle coupled to the needle;

a pusher positioned within the lumen and actuatable at the handle; and

an implant including

an elongate first retainer positioned within the longitudinal channel and including a protrusion extending through the longitudinal slot in the wall of the needle such that pulling on the handle of the delivery device after advancement of a portion of the needle having the first retainer through meniscal tissue causes the first retainer to be deployed from the needle by interaction of the protrusion and the meniscal tissue, the first retainer having a beveled distal end and defining a through hole; and

an elongate second retainer positioned within the longitudinal channel proximally of the first retainer and including a protrusion extending through the longitudinal slot in the wall of the needle such that pulling on the handle of the delivery device after advancement of a portion of the needle having the second retainer through the meniscal tissue causes the second retainer to be deployed from the needle by the interaction of the protrusion and the meniscal tissue, the second retainer having a beveled distal end and defining a through hole, the pusher being arranged to advance the second retainer distally toward the needle tip; and

suture extending through the first and second retainer holes to connect the first and second retainers and having a slip knot formed therein prior to advancement of the needle tip into the tissue, the slip knot including a portion defining a loop, only one of the first and second retainers being slidably attached to the loop such that the slidably-attached retainer is adapted to limit the loop from passing through the slip knot and untying the slip knot, a portion of the suture capable of sliding through the slip not so as to either shorten the loop or close a distance between the two retainers as a result of pulling on only a free limb of the suture to compress the meniscal tear, wherein no portion of the suture extends substantially from either retainer to the other retainer and back to the original retainer.

11. The delivery device of claim 10, wherein at least one of the first and second retainers comprises a body with an outwardly extending formation configured for attachment to bone tissue.

12. The delivery device of claim 10, wherein the slip knot is formed in the suture between the first and second retainers.

13. The delivery device of claim 10, wherein the first and second retainers comprise a cylindrical portion.

14. The delivery device of claim 10, wherein one of the first and second retainers comprises a T shape.

15. The delivery device of claim 10, wherein the slip knot is positioned within the longitudinal channel.

16. The delivery device of claim 10, wherein the slip knot is positioned outside of the longitudinal channel.

17. The delivery device of claim 10 being preassemble for use in a surgical procedure.

18. The delivery device of claim 10, wherein the slip knot is spaced from the first and second retainers.