Method and apparatus for coupling soft tissue to a bone

• US 8,361,113 B2
• Filed: 06/22/2009
• Issued: 01/29/2013
• Est. Priority Date: 02/03/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Stone, Kevin T., Denham, Gregory J., Harper, Ryan
• Primary Examiner(s): Dornbusch, Dianne
• Application Number:
  US12/489,168
• Publication Number:
  US 20090318961A1
• Time in Patent Office: 1,317 Days
• Field of Search: 606/139, 606/151, 606/232, 606/60, 606/300, 606/301, 606/313, 128/898, 623/13.11, 623/13.14, 623 1317- 132, 623/14.12
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00858 high friction, non-slip on handles A61B2017/00429
• CPC Class Codes: A61B 2017/0404 Buttons
• 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 2017/0417 T-fasteners
• 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 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• 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 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone

Abstract

A method and apparatus for surgically repairing a tear in soft tissue is disclosed. A plurality of collapsible tubes are positioned about the suture. The collapsible tubes are pushed through soft tissue and orthopedic mesh on opposite sides of a tear in soft tissue. When tension is applied to the suture, the tubes are compressed to fix the suture to the soft tissue and draw the soft tissue portions together.

Claims

1. A method of surgically repairing a tear in soft tissue comprising:

forming a first aperture in a first soft tissue;

forming a second aperture in a second soft tissue;

passing an end of a suture through passages defined by first and second collapsible tubes;

positioning the first collapsible tube through the first aperture;

positioning the second collapsible tube through the second aperture, wherein first and second ends of the respective first and second collapsible tubes are passed through the respective first and second apertures; and

applying a tensile load to a portion of the suture to compress the first and second collapsible tubes to form a pair of anchoring masses about an outer surface of the respective first and second soft tissue, the anchoring masses having locking profiles and pulling the first and second soft tissue together at the location of the tear, the locking profiles operative to prevent the anchoring masses from being drawn into the apertures upon applying the tensile load.

2. The method of surgically repairing a tear in soft tissue according to claim 1 further comprising passing the first collapsible tube through at least one of an orthopedic mesh, allograft, skin, tendon, xenograft, and autograft.

3. The method of surgically repairing a tear in soft tissue according to claim 2 further comprising threading the second collapsible tube through the orthopedic mesh.

4. The method of surgically repairing a tear in soft tissue according to claim 3 wherein applying tension onto the suture applies a compressive load between the first and second soft tissues.

5. The method of surgically repairing a tear in soft tissue according to claim 3 wherein applying tension onto the suture includes applying a compressive load to the second collapsible tube.

6. The method of surgically repairing a tear in soft tissue according to claim 1 comprising sliding the suture with respect to the first and second collapsible tubes.

7. The method of surgically repairing a tear in soft tissue according to claim 1 wherein the first and second tissue are portions of a rotator cuff.

8. The method according to claim 1, further comprising:

coupling a second suture to the first and second collapsible tubes; and

applying tension to the second suture to draw the first and second collapsible tubes toward each other relative to the tear thereby applying compression to the tear.

9. A method of surgically repairing a tear between first and second soft tissues in a rotator cuff comprising:

passing a suture having at least first and second collapsible tubes threaded therethrough relative to the tear between the first and second soft tissue such that the first collapsible tube is passed through a first passage formed in the first soft tissue and the second collapsible tube is passed through a second passage formed in the second soft tissue, wherein first and second ends of the respective first and second collapsible tubes are passed through the respective first and second passages;

positioning an orthopedic mesh relative to the tear and an outer surface of the first and second tissue;

connecting the first collapsible tube to a first portion of the orthopedic mesh;

connecting the second collapsible tube to a second portion of the orthopedic mesh;

applying tension to a portion of the first suture so as to collapse the first and second collapsible tubes into respective first and second anchoring masses such that the collapsible tubes in the form of the anchoring masses are prevented from being drawn into the respective passages;

coupling the first and second anchoring masses to a patient.

10. The method according to claim 9, wherein applying tension to the portion of the suture to collapse the first and second collapsible tubes includes applying compression to the tear between the first and second tissues.

11. The method according to claim 10, wherein applying tension to the portion of the suture to collapse the first and second collapsible tubes includes applying tension to the portion of the suture to collapse the first and second collapsible tubes outside of the first and second passages and relative to the orthopedic mesh and an outer surface of the first and second soft tissues.

12. The method according to claim 9, further comprising:

coupling a second suture to the first and second collapsible tubes; and

applying tension to the second suture to draw the first and second collapsible tubes toward each other relative to the tear thereby applying compression to the tear.

13. A method of surgically repairing a rotator cuff comprising:

forming a first tunnel in a first portion of soft tissue on a first side of a soft tissue tear;

forming a second tunnel in a second portion of soft tissue on a second side of the soft tissue tear;

positioning a suture having first and second collapsible tubes threaded therethrough relative to the soft tissue tear, the first and second collapsible tubes having a first profile which allows insertion of the first collapsible tube into the first tunnel and a second profile different than the first profile which allows engagement with a first positive locking surface upon the collapsing of the first collapsible tube, and further allows insertion of the second collapsible tube into the second tunnel and a second profile which allows engagement with a positive locking surface upon the collapsing of the second collapsible tube;

threading the first collapsible tube through the first tunnel such that first and second ends of the first collapsible tube are passed through the first tunnel;

threading the second collapsible tube through the second tunnel such that first and second ends of the second collapsible tube are passed through the second tunnel;

threading the first and second collapsible tubes through an orthopedic mesh;

collapsing the first and second collapsible tubes from the first profile to the second profile; and

drawing the first and second sides of the soft tissue tear together.

14. The method of surgically repairing a tear in soft tissue according to claim 13 further including collapsing the first collapsible tube outside of the first tunnel relative to an outer surface of the soft tissue and the orthopedic mesh.

15. The method according to claim 13 further comprising applying tension onto the suture to engage the orthopedic mesh with the positive locking surface of the first and second collapsible tubes.

16. The method according to claim 15 wherein applying tension onto the suture includes drawing the soft tissue to the orthopedic mesh.

17. The method according to claim 15 wherein applying tension onto the suture applies compression to the first collapsible tube and the second collapsible tube.

18. The method according to claim 13 further comprising a second suture between the first and second collapsible tubes, wherein applying tension to the second suture draws the first and second collapsible tubes toward each other thereby applying compression to the soft tissue tear.