Knotless suture anchoring device having deforming section to accommodate sutures of various diameters

• US 8,657,854 B2
• Filed: 06/01/2006
• Issued: 02/25/2014
• Est. Priority Date: 02/12/2001
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Foerster, Seth A., Vijay, Francis, Woloszko, Jean
• Primary Examiner(s): ANDERSON, GREGORY A
• Application Number:
  US11/916,135
• Publication Number:
  US 20100191283A1
• Time in Patent Office: 2,826 Days
• Field of Search: 606/213, 606/215, 606/232, 623/13.11
• 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 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 2017/0417 T-fasteners
• 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 2017/0496 for tensioning sutures
• 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 2002/0835 with deformation of anchor parts, e.g. expansion of dowel by set screw
• 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 2002/0882 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

An innovative bone anchor and methods for securing soft tissue, such as tendons, to bone, which permit a suture attachment that lies entirely beneath the cortical bone surface. The suturing material between the soft tissue and the bone anchor may be secured without the need for tying a knot. The suture attachment to the bone anchor involves the looping of a length of suture around a suture return member or path within the bone anchor, tightening the suture and attached soft tissue, and compressing the suture against the bone anchor. The bone anchor may be a tubular body having a lumen with a locking plug that compresses the suture therein. One of the components of the locking structure may include a deformable or flexible section, member, or surface. The locking plug may include a shaft and an enlarged head that interferes with the tubular body to provide a positive stop. An actuation rod attached at a frangible section to the shaft may be manipulated by an external handle during locking of the suture within the bone anchor. The bone anchor further may include locking structure for securing itself within a bone cavity.

Claims

1. A knotless suture anchor apparatus for anchoring a length of suture with respect thereto, comprising:

an anchor body having a proximal end, a distal end, and a lumen opening at the proximal end, the anchor body further including a suture return path such that a length of suture may be introduced into a lumen from the proximal end, and passed out of the lumen through the proximal end; and

a suture locking plug movable within the lumen from a first position which does not interfere with axial movement of the length of suture to a second position that compresses the length of suture against the anchor body and interferes with axial movement of the length of suture, wherein the lumen is sized to be larger than the locking plug and wherein at least one of said plug or the anchor body comprises a selectively deformable section, and wherein the deformable section is sized to deform only by the presence of both the length of suture and the suture locking plug within the lumen to accommodate and secure said suture as it is compressed.

2. The apparatus of claim 1, wherein the anchor body is generally tubular and the lumen opens at the distal end as well as at the proximal end.

3. The apparatus of claim 1, wherein the suture locking plug comprises a shaft axially displaceable within the lumen and a distal stop larger in cross-sectional dimension than the lumen diameter that interferes with the anchor body and limits proximal movement of the shaft with respect thereto.

4. The apparatus of claim 1, further comprising an anchoring structure for fixing the anchor body within a body cavity.

5. The apparatus of claim 4 wherein said anchoring structure comprises a first deflecting member and a second deflecting member attached to the proximal end of the body member, and wherein each of the first deflecting member and the second deflecting member comprises a low profile undeployed position and a larger profile deployed position.

6. The apparatus of claim 1, where the fixed suture path comprises a pulley disposed at a distal end of the anchor body.

7. The apparatus of claim 1 wherein said deformable section comprises at least one slit or opening.

8. The apparatus of claim 1 wherein the anchor body deformable section flexes outwardly in response to the pressure from the plug member in cooperation with the length of suture disposed within the lumen.

9. The apparatus of claim 1 wherein the deformable section is expandable to accommodate sutures of varying diameters.

10. The apparatus of claim 1 wherein the suture return path comprises a suture return member, wherein the suture return member is a pulley member or pin.

11. The apparatus of claim 1 wherein the suture return path comprises a surface that directs the suture in a direction.

12. The apparatus of claim 1 wherein said deformable section comprises at least one rib.

13. The apparatus of claim 1 wherein said deformable section comprises a wall thickness less than that of another portion of said lumen.

14. The apparatus of claim 1, wherein said deforming section is adapted to provide elastic deformation.

15. The apparatus of claim 1, wherein said deforming section is adapted to provide plastic or inelastic deformation.

24. A kit comprising:

a first suture having a first diameter;

a second suture having a second diameter different than said first diameter; and

a knotless suture anchor apparatus as recited in claim 1 to accommodate both of said first suture or said second suture and prevent said suture from axial movement when said plug is in said second position.

25. The kit of claim 24 wherein said first suture is a No. 2 suture.

26. The kit of claim 24 further comprising an insertion instrument to deploy said apparatus and tension said suture.

16. A knotless suture anchor apparatus for anchoring a length of suture with respect to a body cavity, comprising:

an anchor body having an anchoring structure for fixing the anchor body within a body cavity, the anchor body having a proximal end, a distal end, a lumen and a lumen opening at both the proximal and distal ends, the lumen having a diameter that permits a length of suture to be passed therethrough; and

a suture locking plug comprising a shaft axially displaceable within the lumen, wherein the suture locking plug is movable within the lumen from a first position which does not interfere with axial movement of the length of suture to a second position that interferes with axial movement of the length of suture, wherein the plug is sized to be smaller than the lumen and wherein said plug and said body are adapted to have a difference in rigidity such that at least one of the plug or the body shall selectively deform, and wherein the at least one of the plug or the body is sized to deform only by the presence of both the length of suture and the suture locking plug within the lumen to accommodate and secure the suture.

17. The apparatus of claim 16, further including an actuation rod removably attached to the proximal end of the shaft and projecting out of the proximal end of the anchor body, the actuation rod usable to displace the shaft axially within the lumen.

18. The apparatus of claim 17, further including a point of tensile weakness along the actuation rod permitting the rod to be detached from the shaft upon application of a predetermined tensile force on the actuation rod in the proximal direction after the stop engages.

19. The apparatus of claim 16, wherein the anchor body further comprises a suture pulley such that the length of suture may be passed into lumen from the proximal end, looped around the pulley, and passed out of the lumen through the proximal end.

20. The apparatus of claim 19, wherein the fixed suture pulley is formed in a sidewall of the lumen.

21. The apparatus of claim 19, wherein the anchor body comprises a generally tubular body defining the lumen therein, and the fixed suture pulley is defined by a rod disposed transversely around a portion of the body and distal to an opening in the body.

22. The apparatus of claim 19, wherein the anchor body comprises a generally tubular body defining the lumen therein, and the fixed suture pulley is defined by a bridge between two spaced apertures at the distal end of the body.

23. The apparatus of claim 19, wherein the suture locking plug interferes with axial movement of the length of suture in the second position by compressing the length of suture against the anchor body.

27. A suture-locking apparatus for anchoring a suture within a body cavity, comprising:

a body member having a proximal end, a distal end, and an axial lumen in between said proximal and distal ends, said proximal end adapted for passing a portion of a suture into said lumen; and

a plug member movable from a first position to a second position in said lumen, wherein said lumen is sized to be larger than said plug member, said plug member comprising a radial protrusion adapted for compressing said suture against said body member on moving to said second position; and

wherein at least one of said plug member or the body member comprises a selectively deformable section, and wherein the deformable section is sized to deform only by the presence of both the suture and the plug member within the lumen to accommodate and secure said suture as it is compressed.

28. The suture-locking apparatus of claim 27, wherein said radial protrusion is also adapted for stopping said plug member at said second position.

29. The suture-locking apparatus of claim 27, wherein said radial protrusion is adapted for compressing said suture and stopping proximal axial movement of said plug member in said lumen.

30. The suture-locking apparatus of claim 27, wherein said body member further comprises an aperture defined in said body member for inserting said plug member into said lumen.

31. The suture-locking apparatus of claim 27, wherein said body member further comprises a suture pulley member fixed with respect to said lumen for turning around and exiting said suture through said lumen at said proximal end.

32. The suture-locking apparatus of claim 27, wherein said body member comprises a tubular body, and said suture pulley member comprises a portion of said tubular body defined between said aperture and said distal end.

33. The suture-locking apparatus of claim 27, wherein said suture is movable in said lumen while said plug member is located at said first position.

34. The suture-locking apparatus of claim 27, wherein said plug member is movable from said first position to said second position while said suture is attached to a body tissue.

35. The suture-locking apparatus of claim 27, wherein said lumen is characterized by a larger internal wall cross-section within said first position, and a smaller internal wall cross-section at said second position, said larger cross-section transitioning to said smaller cross-section at a zigzag wall section therein.

36. The suture-locking apparatus of claim 35, wherein said zigzag wall section is adapted for limiting said movement of said plug member at said second position.

37. The suture-locking apparatus of claim 27, wherein said body member is dimensioned for anchoring a body tissue in a body cavity.

38. The suture-locking apparatus of claim 27, wherein said radial protrusion comprises a step portion formed thereon between a larger tail-section and a smaller nose-section of said plug member.

39. The suture-locking apparatus of claim 27, wherein said radial protrusion comprises a radial ridge formed thereon between a larger tail-section and a smaller nose-section of said plug member.

40. The suture-locking apparatus of claim 27, wherein said radial protrusion comprises a circumferential stop formed thereon between a larger tail-section and a smaller nose-section of said plug member.

41. The suture-locking apparatus of claim 27, wherein said plug member further comprises an actuator member attached thereto for moving said plug member within said lumen.

42. The suture-locking apparatus of claim 41, wherein said actuator includes a built-in failure-point for detaching said actuator from said plug member upon application of a threshold tensile force on said plug member.

43. The suture-locking apparatus of claim 41, wherein said plug member comprises a lumen for attaching said actuator to said plug member.

44. The suture-locking apparatus of claim 27, further comprising

a toggle member disposed proximally and axially with said body member;

and

a strut member connecting said toggle member to said body member,

wherein said toggle member when disposed at an undeployed position projects a smaller profile transverse to said body member, and at a deployed position projects a larger profile transverse to said body member, said strut member adapted for collapsing to translate said toggle member from said undeployed position to said deployed position.

45. A knotless suture-locking apparatus for anchoring a suture within a body cavity, comprising:

a body member for fixing said suture-locking apparatus within a body cavity, said body member having a proximal end, a distal end, and a lumen, the lumen comprising an opening at said proximal end to receive a length of suture therein; and

a suture-locking plug member comprising a radial protrusion for positively interfering with proximal movement of said suture-locking plug with respect to said body member, wherein

said suture-locking plug member is movable within said lumen from a first position that does not interfere with axial movement of said length of suture, to a second position that interferes with axial movement of said length of suture; and

wherein at least one of the suture-locking plug or the body member comprises a selectively deformable section, and wherein the deformable section is sized to deform only by the presence of both the suture and the suture-locking plug within the lumen to accommodate and secure the suture as it is compressed.

46. The suture-locking apparatus of claim 45, wherein said suture-locking plug further includes a detachable actuation rod member removably attached thereto and projecting out of said proximal end of said anchor body, said actuation rod for moving said suture-locking plug axially within said lumen.

47. The suture-locking apparatus of claim 46, wherein said actuation rod comprises a built-in point of tensile weakness along said actuation rod for permitting said rod to be detached from said suture-locking plug upon application of a threshold tensile force on said actuation rod in said proximal direction while said radial protrusion is compressing said suture in said lumen.

48. The suture-locking apparatus of claim 46, wherein said plug member comprises a lumen for attaching said actuation rod to said plug member.

49. The suture-locking apparatus of claim 45, wherein said body member further includes a suture pulley member fixed with respect to said lumen such that said length of suture may be passed into said lumen from said proximal end, looped around said pulley, and passed out of said lumen through said proximal end.

50. The suture-locking apparatus of claim 49, wherein said body member comprises a tubular body, and said suture pulley member comprises a portion of said tubular body between an aperture and said distal end.

51. The apparatus of claim 49, wherein said suture pulley member is deployed transversely across said lumen.

52. The apparatus of claim 49, wherein said suture pulley member comprises a rod.

53. The apparatus of claim 49, wherein the pulley comprises a bridge between two spaced apertures at the distal end of the tubular body.

54. The suture-locking apparatus of claim 45, wherein a portion of said suture is attached to a body tissue.

55. The suture-locking apparatus of claim 45, wherein said lumen is characterized by a larger wall cross-section at said first position, and a smaller wall cross-section at said second section, said larger cross-section transitioning to said smaller cross-section at a zigzag wall section therein.

56. The suture-locking apparatus of claim 55, wherein said zigzag wall section is adapted for limiting the movement of said plug member at said second position in said lumen.

57. The apparatus of claim 45, wherein said body member comprises a material selected from the group consisting of a plastic, a polyaryletheketone and a stainless steel.

58. The suture-locking apparatus of claim 45, wherein said radial protrusion comprises a zigzag shoulder portion formed at a transition between a larger tail-section and a smaller nose-section on said plug member.

59. The suture-locking apparatus of claim 45, wherein said radial protrusion comprises a radial ridge or step formed between a larger tail-section and a smaller nose-section on said plug member.

60. The suture-locking apparatus claim 45, wherein said plug member comprises a material selected from the group consisting of a plastic, a polyaryletheketone and a stainless steel.

61. The suture-locking apparatus of claim 45, further comprising

a toggle member disposed proximally to and axially with said body member;

and

a collapsible strut member connecting said toggle member to said body member,

wherein said toggle member while located at an undeployed position projects a smaller profile transverse to said body member, and at a deployed position projects a larger profile transverse to said body member, said strut member adapted for collapsing and translating said toggle member from said undeployed position to said deployed position.