Devices, systems and methods for meniscus repair

• US 8,449,533 B2
• Filed: 05/02/2012
• Issued: 05/28/2013
• Est. Priority Date: 11/09/2009
• Status: Active Grant

• Current Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Original Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Inventors: Saliman, Justin D., Jasso, Alexander, Anastas, George V.
• Primary Examiner(s): Tyson, Melanie
• Assistant Examiner(s): DANG, PHONG SON H
• Application Number:
  US13/462,728
• Publication Number:
  US 20120265221A1
• Time in Patent Office: 391 Days
• Field of Search: None
• US Class Current: 606/1
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06009 having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
• CPC Class Codes: A61B 2017/06042 located close to needle tip

Abstract

Described herein are meniscus suture passers for repair of the meniscus of the knee. These devices are typically suture passers that may include an elongate body having a pair of arms. One or more of the arms may be angled or bent at the distal end region relative to the long axis of the device, forming a distal-facing opening that is configured to fit meniscus tissue. One or both arms may be movable in the axial direction (e.g., the direction of the long axis of the device). The devices typically include a tissue penetrating element housed within one of the arms but configured to extend across the distal opening between the arms. Thus, a suture may be passed from a first side of the tissue to a second side.

Claims

1. A suture passer device for passing a suture through the meniscus, the device comprising:

an elongate body extending distally and proximally along a long axis;

a first arm that is connected to the elongate body and axially slideable distally and proximally relative to the elongate body along the long axis,

a second arm extending distally from the elongate body, wherein the distal region of the second arm bends away from the long axis to form a distal opening between the distal region of the second arm and the distal region of the first arm when the first arm is extended distally; and

a tissue penetrator configured to extend across the distal opening from the first arm to the second arm to pass a suture there between, wherein the first arm is configured to retract proximally independently relative to the second arm so that it does not form the distal opening with the second arm.

2. The device of claim 1, wherein the distal end of the second arm is bendable to form an angle relative to the long axis.

3. The device of claim 1, wherein the distal end of the second arm is bendable to form an acute angle of between about 1 and 90 degrees relative to the long axis.

4. The device of claim 1, wherein the distal end of the second arm is bendable to form an acute angle of between about 20 and 50 degrees.

5. The device of claim 1, wherein the tissue penetrator is configured to releasably couple to the suture to carry the suture through a tissue.

6. The device of claim 1, wherein the distal opening is an acute-angled distal-facing opening configured to fit a meniscus therein.

7. The device of claim 1, wherein the distal opening is a v-shaped distal-facing opening configured to receive a meniscus between the second and first arms when the first arm is extended distally relative to the elongate body.

8. The device of claim 1, wherein the tissue penetrator is configured to be housed within the first arm.

9. The device of claim 1, wherein the tips of the distal ends of the second and first arms are rounded and atraumatic.

10. The device of claim 1 further comprising a proximal handle having a first control for axially moving at least the distal region of the first arm relative to the elongate body.

11. The device of claim 1 further comprising a proximal handle having a tissue penetrator control for controlling the extension and retraction of the tissue penetrator across the distal opening.

12. The device of claim 1 further comprising a dock at the distal region of the second arm configured to retain a suture, permitting the tissue penetrator to pass the suture between the first arm to the second arm.

13. The device of claim 1, wherein the tissue penetrator is configured to extend across the distal opening in a curved path.

14. The device of claim 1, further comprising a first stop to limit the movement of the first arm distally along the long axis of the device.

15. The device of claim 1, further comprising a plurality of stops at different axial positions of the first arm along the long axis.

23. The device of claim 1, wherein the tissue penetrator is further configured to bend from a straightened configuration as it extends across the distal opening.

24. The device of claim 1, wherein the tissue penetrator comprises a shape memory alloy.

25. The device of claim 1, wherein the tissue penetrator extends from a position completely within the first arm as it extends across the distal opening from the first arm to the second arm.

16. A suture passer device for passing a suture through the meniscus, the device comprising:

an elongate shaft extending distally and proximally along a long axis;

a first arm that is connected to the elongate body having a distal region that is slideable distally and proximally relative to the long axis;

a second arm having a distal region configured to bend away from the long axis of the shaft at an angle to form a distal-facing opening with the first arm when the first arm is extended distally;

wherein the first arm is moveable distally and proximally relative to the second arm and wherein the first arm is configured to retract proximally independently relative to the second arm so that it does not form the distal-facing opening with the second arm;

a tissue penetrator configured to extend across the distal-facing opening from the first arm to the second arm to pass a suture there between; and

a suture dock on the second arm configured to exchange the suture with the tissue penetrator.

17. The device of claim 16, wherein the second arm is bendable from a straight configuration relative to the long axis.

18. The device of claim 16, wherein the tissue penetrator is housed within the first arm and configured to extend therefrom.

19. The device of claim 16 further comprising a proximal handle having a control for axially moving at least the distal region of the first arm relative to the shaft.

20. The device of claim 16 further comprising a proximal handle having a tissue penetrator control for controlling the extension and retraction of the tissue penetrator across the distal-facing opening.

21. The device of claim 16, further comprising a first arm stop limiting the movement of the first arm along the long axis of the device.

22. A suture passer device for passing a suture through the meniscus, the device comprising:

an elongate body extending distally and proximally along a long axis;

a first arm that is connected to the elongate body and axially movable distally and proximally relative to the elongate body along the long axis,

a second arm extending distally from the elongate body, wherein the distal region of the second arm is pre-bent or bendable at an angle relative to the long axis to form an angular distal-facing opening between the distal region of the second arm and the distal region of the first arm when the first arm is extended distally;

wherein the first arm is moveable distally and proximally relative to the second arm and further wherein the first arm is configured to retract proximally independently relative to the second arm so that it does not form the distal-facing opening with the second arm; and

a tissue penetrator housed within the first arm that is configured to extend across the distal-facing opening to pass a suture there between.