Method and apparatus for coupling soft tissue to bone

• US 8,551,140 B2
• Filed: 07/13/2011
• Issued: 10/08/2013
• Est. Priority Date: 11/05/2004
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Denham, Gregory J., Stone, Kevin T., Bonnarens, Frank O.
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US13/181,729
• Publication Number:
  US 20110270306A1
• Time in Patent Office: 818 Days
• Field of Search: 606/232, 606/228, 623/13.14
• US Class Current: 606/232
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/0469 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 17/06166 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 2017/0419 H-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 2017/0448 Additional elements on or within the anchor
• 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 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular
• CPC Class Codes: A61B 2017/0641 : having at least three legs as part of one single body
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• 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 2002/0864 : Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• CPC Class Codes: A61F 2002/087 : Anchor integrated into tendons, e.g. bone blocks, integrated rings
• 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
• CPC Class Codes: Y10T 29/49826 : Assembling or joining

Abstract

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction.

Claims

1. A method of coupling a soft tissue to a bone, comprising:

determining an area of the bone to couple a first anchor and a second anchor, wherein;

(i) the first anchor includes a first bone engaging feature, a first aperture, and a first suture member, the first suture member including a braided body disposed in the first aperture and defining a longitudinally extending passage having a plurality of passage apertures, and a first end extending from the braided body and passing through a passage aperture, through the passage and out another passage aperture, so as to place the first end outside of the passage, and define an adjustable first loop, and a second end extending from the braided body and passing through a passage aperture, through the passage and out another passage aperture, so as to place the second end outside of the passage, and define an adjustable second loop, and (ii) the second anchor includes a second bone engaging feature and a first coupling feature;

forming a first hole in the area;

forming a second hole in the area adjacent to the first hole;

positioning the first anchor in the first hole;

positioning the second anchor in the second hole;

coupling the first loop to the soft tissue;

coupling the first loop to the first coupling feature; and

adjusting a size and tensioning the first loop to compress the soft tissue against the bone by pulling on the first end of the first suture member, after the first anchor is positioned in the first hole and after the second anchor is positioned in the second hole.

2. The method according to claim 1, further comprising passing the first loop through the soft tissue.

3. The method according to claim 2, further comprising passing the first loop through the soft tissue prior to coupling the first loop to the first coupling feature.

4. The method according to claim 3, further comprising:

passing the first end through the first loop; and

passing the first end through the soft tissue.

5. The method according to claim 1, further comprising looping the first loop around the soft tissue.

6. The method according to claim 5, further comprising looping the first loop around the soft tissue prior to coupling the first loop to the first coupling feature.

7. The method according to claim 1, wherein the first coupling feature includes a hook configured to receive the first loop, and wherein coupling the first loop to the first coupling feature includes coupling the first loop to the hook after the second anchor is positioned in the second hole.

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

passing the soft tissue through the second loop; and

adjusting a size of the second loop to compress the soft tissue against the bone by pulling on the second end after the first anchor is positioned in the first hole and after the second anchor is positioned in the second hole.

9. The method according to claim 1, the method further comprising:

coupling the second loop to the soft tissue; and

coupling the second loop to one of the first coupling feature or the second coupling feature.

10. The method according to claim 1, the method further comprising:

coupling the second loop to a third anchor in the bone adjacent to the first anchor.

11. A method of coupling a soft tissue to a bone, comprising:

determining an area of the bone to couple a first anchor, a second anchor, and a third anchor, wherein;

(i) the first anchor includes a first bone engaging feature and a first suture member coupled to the first anchor and forming an adjustable first loop, where the first suture member includes;

(a) a first braided body defining a longitudinally extending first passage, and a first end extending from the first braided body and passing through a first aperture in the braided body and along the first passage and out a second aperture in the braided body so as to place the first end outside of the first passage, and define the first loop; and

(b) a second end extending from the braided body and passing through the second aperture in the braided body and along the first passage and out the first aperture in the braided body so as to place the second end outside of the first passage, and define a second loop, (ii) the second anchor includes a second bone engaging feature, a first coupling feature, and a second suture member coupled to the second anchor and forming an adjustable third loop; and

(iii) the third anchor includes a third bone engaging feature and a second coupling feature;

positioning the first anchor, the second anchor, and the third anchor in the bone adjacent to each other in the area;

coupling the first loop to the soft tissue and to the first coupling feature of the second anchor, wherein the first loop is coupled to the second anchor after the first anchor and the second anchor have been positioned in the bone; and

coupling the third loop to the soft tissue and to the second coupling feature of the third anchor, wherein the third loop is coupled to the third anchor after the second anchor and third anchor have been positioned in the bone.

12. The method according to claim 11, further comprising passing the third loop through the first loop.

13. The method according to claim 11, further comprising passing at least one of the first loop or the third loop through the soft tissue.

14. The method according to claim 13, further comprising looping at least one of the first loop or the third loop around the soft tissue.

15. The method according to claim 11, further comprising:

adjusting a first size of the first loop to compress the soft tissue against the bone by pulling on a first end of the first suture member after the first anchor and the second anchor are positioned in the bone; and

adjusting a second size of the third loop to compress the soft tissue against the bone by pulling on a third end of the second suture member after the second anchor and the third anchor are positioned in the bone.

16. The method according to claim 11, further comprising passing the soft tissue through the first loop and the third loop.

17. The method according to claim 11, wherein:

the second suture member includes;

a second braided body coupled to the second anchor defining a longitudinally extending second passage, and a third end extending from the second braided body and passing through a first aperture in the second braided body and along the second passage and out a second aperture in the second braided body so as to place the third end outside of the second passage, and define the third loop.

18. The method of claim 11, further comprising:

passing the soft tissue through the third loop; and

adjusting a size of the third loop to compress the soft tissue against the bone by pulling on a third end.

19. The method of claim 11, wherein the first anchor further includes a third coupling feature, the method further comprising:

coupling the second loop to the soft tissue; and

coupling the second loop to the third coupling feature.

20. A method of coupling a soft tissue to a bone, comprising:

determining an area of the bone to couple a first anchor, a second anchor, and a third anchor wherein;

(i) the first anchor includes a first bone engaging feature, a first aperture, and a first suture member, the first suture member including a first braided body disposed in the first aperture and defining a longitudinally extending first passage, and a first end extending from the first braided body and passing into the first passage and and out the first passage so as to place the first end outside of the first passage, and define a self-locking, adjustable first loop, and a second end extending from the first braided body and passing into the first passage and out the first passage so as to place the second end outside of the first passage, and define a self-locking, adjustable second loop, (ii) the second anchor includes a second bone engaging feature, a second aperture, a first hook feature, and a second suture member, the second suture member including a second braided body disposed in the second aperture and defining a longitudinally extending second passage, and a third end extending from the second braided body and passing into the second passage and out the second passage so as to place the third end outside of the second passage, and define a self-locking, adjustable third loop, and a fourth end extending from the second braided body and passing into the second passage and out the second passage so as to place the fourth end outside of the second passage, and define a self-locking, adjustable fourth loop, and (iii) the third anchor includes a third bone engaging feature and a second hook feature;

forming a first hole, a second hole, and a third hole adjacent to each other in the area;

positioning the first anchor, the second anchor, and the third anchor in the first hole, the second hole, and the third hole, respectively;

coupling the first loop and the third loop to the soft tissue;

coupling the first loop to the first hook feature;

passing the third loop through the first loop;

coupling the third loop to the second hook feature; and

tensioning the first loop and the third loop to compress the soft tissue against the bone by pulling on the first end of the first suture member and the third end of the second suture member after the first anchor is positioned in the first hole, after the second anchor is positioned in the second hole, and after the third anchor is positioned in the third hole.

21. The method of claim 20, wherein the bone is a shoulder bone and the soft tissue is a rotator cuff, and wherein coupling the first loop and the third loop to the soft tissue includes coupling the first loop and the third loop to the rotator cuff.