Apparatus for discrete tissue anchoring for soft tissue repair and method of use

• US 8,597,336 B2
• Filed: 12/28/2007
• Issued: 12/03/2013
• Est. Priority Date: 12/28/2007
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Inventors: van der Burg, Erik, Cohen, Nathaniel
• Primary Examiner(s): Schaper, Michael T
• Assistant Examiner(s): BECCIA, CHRISTOPHER J
• Application Number:
  US11/966,137
• Publication Number:
  US 20090171400A1
• Time in Patent Office: 2,167 Days
• Field of Search: 606/77, 606/232, 606/76, 606300-331, 606139-145, 606/213, 606/215
• US Class Current: 606/300
• 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 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 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• 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

Disclosed herein are devices and methods for securing soft tissue to a rigid structure such as bone. Various directional anchors that allow for increasing the stability the attachment of soft tissue to bone are described. Also described is a delivery system for use with the directional anchors that allows for open surgical or arthroscopic application of one embodiment of the device. A method for repairing rotator cuff tears is also described.

Claims

1. A method for reattaching a soft tissue to bone at a natural footprint of the soft tissue on the bone, comprising:

providing at least one directional anchor having a soft tissue anchoring section and a bone anchoring section;

inserting the at least one directional anchor into the surface of bone so that the bone anchoring section penetrates the bone surface and the soft tissue anchoring section extends away from the bone;

placing soft tissue over the soft tissue anchoring section so that the soft tissue anchoring section penetrates only one surface of the soft tissue; and

applying force onto the soft tissue so that the soft tissue anchoring section extends into the soft tissue and enhances the mating engagement of the soft tissue to the bone, wherein the mating engagement is at the natural footprint of the soft tissue on the bone.

2. The method of claim 1, wherein the at least one directional anchor has a longitudinal axis and the at least one directional anchor is inserted into the bone at an angle, which is the angle between the surface of the bone and the longitudinal axis.

3. The method of claim 2, wherein the at least one directional anchor is inserted into the bone at an angle θ

relative to a surface of the bone in a range of about 15°

to about 87°

.

4. The method of claim 3, wherein the tissue experiences at least one directional forces F tending to pull the tissue away from the bone, and wherein the directional anchor is angled in a direction substantially away from directional forces F on the tissue, thereby pulling the tissue onto the bone.

5. The method of claim 4, wherein a plurality of directional anchors are inserted into bone in a pattern corresponding to the surface of the tissue through which the tissue anchoring sections penetrate.

6. The method of claim 5, wherein the tissue anchoring sections have a length L, and the tissue has a thickness T, wherein L is less than T.

7. The method of claim 5, wherein the plurality of directional anchors are not connected to each other.

8. The method of claim 1, wherein the at least one directional anchor has an aperture for receiving a suture thread, and wherein a suture thread passes through the tissue on the side opposite the tissue anchoring section.

9. The method of claim 1, wherein the tissue engaging section does not engage the surface of the bone.

10. The method of claim 1, wherein the tissue being reattached to bone is the rotator cuff tendon, and wherein a plurality of directional anchors are inserted into bone in substantial alignment along the length of the rotator cuff tendon.

11. The method of claim 1, wherein a suture is passed along the tissue on the side of the tissue opposite the tissue engaging section to stabilize the tissue to the tissue engaging section.

12. The method of claim 1, wherein the tissue is the rotator cuff tendon which defines a footprint where the tendon mates with bone, further comprising inserting a plurality of directional anchors into the area of the footprint.

13. A method for reattaching a tissue to bone, comprising:

providing a first directional anchor, a second directional anchor, up to an Nth directional anchor, the directional anchors having a tissue anchoring section and a bone anchoring section;

preparing the surface of the bone by abrading a cortical surface of the bone;

inserting the directional anchors into the prepared cortical surface of bone so that the bone anchoring sections penetrate the prepared cortical bone surface and the tissue anchoring sections extend away from the bone;

placing tissue over the tissue anchoring sections so that the tissue anchoring sections penetrate only one surface of the tissue; and

applying force onto the tissue so that the tissue anchoring sections extend into the tissue thereby enhancing the mating engagement of the tissue to the bone.

14. The method of claim 13, wherein the directional anchors have a longitudinal axis and the directional anchors are inserted into the bone at an angle θ

which is the angle between the surface of the bone and the longitudinal axis.

15. The method of claim 14, wherein the directional anchors are inserted into the bone at an angle θ

relative to a surface of the bone in a range of about 15°

to about 87°

.

16. The method of claim 13, wherein the tissue experiences at least one directional force F tending to pull the tissue away from the bone, and wherein the directional anchors are angled in a direction substantially away from directional forces F on the tissue, thereby pulling the tissue onto the bone.

17. The method of claim 13, wherein the tissue anchoring sections have a length L, and the tissue has a thickness T, wherein L is less than T.

18. The method of claim 13, wherein the directional anchors are spaced apart.

19. The method of claim 13, wherein the at least one directional anchor has an aperture for receiving a suture thread, and wherein a suture thread passes through the tissue on the side opposite the tissue anchoring section.

20. The method of claim 13, wherein the directional anchors are inserted into the bone a predetermined distance so that the tissue engaging sections do not contact the surface of the bone.

21. A method for attaching tissue to bone, comprising:

providing a plurality of directional anchors each having a tissue anchoring section and a bone anchoring section;

preparing the surface of the bone by abrading a cortical surface of the bone;

inserting the directional anchors into the prepared cortical surface of bone so that the bone anchoring sections penetrate the prepared cortical surface of the bone and the tissue anchoring sections penetrate tissue;

placing tissue over the tissue anchoring sections so that the tissue anchoring sections penetrate only one surface of the tissue;

one of the directional anchors having an aperture for receiving a suture; and

inserting a suture thread into the tissue and through the aperture and tensioning the suture thread to secure the tissue onto the directional anchors.

22. The method of claim 21, wherein the suture is inserted into the side of the tissue opposite of the tissue engaging sections.

23. The method of claim 22, wherein the tissue is the rotator cuff tendon which defines a footprint where the tendon mates with bone, further comprising inserting the directional anchors into the area of the footprint and inserting the suture anchor into bone outside the area of the footprint.