Method and apparatus for coupling soft tissue to a bone

• US 8,840,645 B2
• Filed: 02/17/2012
• Issued: 09/23/2014
• 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.
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US13/399,125
• Publication Number:
  US 20120150297A1
• Time in Patent Office: 949 Days
• Field of Search: 606/139, 606/142, 606/144, 606/148, 606/232, 623/13.14, 623/23.72
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• 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
• 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 2017/044 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 2017/0458 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: 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 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 : Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• 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

Abstract

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

Claims

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

forming a tunnel in the bone;

positioning a flexible anchor having a suture construct coupled thereto into the tunnel, the flexible anchor having an elongated tubular body extending from a first end to a second opposed end, the tubular body defining a longitudinal bore extending from the first end to the second end of the tubular body, the suture construct being in the form of a closed loop of suture having a first looped section and a second looped section opposite the first looped section, the first looped section remaining outside the bore near the first end of the tubular body, the second looped section passing through the bore and exiting the bore at a position intermediate the first and second ends of the tubular body such that a remaining portion of the bore of the tubular body extending from the intermediate position to the second end of the tubular body includes an absence of the suture construct;

coupling the soft tissue to the suture construct;

pulling the flexible anchor with the soft tissue coupled thereto through the tunnel via the remaining portion of the tubular body; and

applying tension to the suture construct to collapse the flexible anchor relative to a positive locking surface of the bone from a first undeformed profile configured for passing the flexible anchor through the tunnel to a second deformed profile forming an anchoring mass relative to the positive locking surface.

2. The method of claim 1, wherein coupling soft tissue to the suture construct includes passing the soft tissue through the first looped section and the second looped section of the suture construct extending from the flexible anchor proximate the first end of the flexible anchor.

3. The method of claim 1, wherein forming the tunnel in the bone includes forming the tunnel in a femur.

4. The method of claim 3, wherein applying tension to the suture construct to collapse the flexible anchor relative to the positive locking surface of the bone includes applying tension to the suture construct to collapse the flexible anchor relative to an outer surface of the femur adjacent the tunnel from the first profile configured for passing the flexible anchor through the tunnel to the second profile forming the anchoring mass relative to the outer surface of the femur.

5. The method of claim 4, wherein pulling the flexible anchor with the soft tissue coupled thereto through the tunnel via the remaining portion of the body includes pulling the flexible anchor with the soft tissue coupled thereto in the first profile through the tunnel via the remaining portion of the body, the first profile configured to facilitate passing the flexible anchor through the tunnel and includes the flexible anchor extending substantially along a longitudinal axis of the flexible anchor.

6. The method of claim 1, wherein applying tension to the suture construct to collapse the flexible anchor relative to the positive locking surface of the bone includes drawing the first end of the body and the position intermediate the first and second ends of the body toward each other via the loop of suture to form the anchoring mass.

7. The method of claim 6, wherein applying tension to the suture construct to form the anchoring mass includes positioning the remaining portion of the body relative to the positive locking surface.

8. The method of claim 1, wherein forming the tunnel in the bone includes forming a first tunnel in a tibia and forming a second tunnel in a femur;

and

wherein pulling the flexible anchor with the soft tissue coupled thereto through the tunnel via the remaining portion of the body includes pulling the flexible anchor with the soft tissue coupled thereto through the first and second tunnels via the remaining portion of the body and a suture coupled thereto.

9. The method of claim 8, wherein pulling the flexible anchor with the soft tissue coupled thereto through the second tunnel includes pulling the flexible anchor with the soft tissue coupled thereto through the second tunnel such that the flexible anchor is positioned outside the second tunnel adjacent an outer surface of the femur and at least a portion of the suture construct with the soft tissue extending therefrom is positioned within the second tunnel.

10. The method of claim 9, wherein pulling the flexible anchor with the soft tissue coupled thereto through the first and second tunnels includes pulling the flexible anchor with the soft tissue coupled thereto through the first and second tunnels such that a portion of the soft tissue extends from an opening of the first tunnel remote from the femur.

11. The method of claim 10, wherein coupling soft tissue to the suture construct includes looping the soft tissue over the first looped section end and the second opposed looped section end of the suture construct extending from the body such that first and second ends of the looped soft tissue extend from the opening of the first tunnel upon positioning the flexible anchor relative to the outer surface of the femur, and wherein the loop of suture is a closed loop of suture.

12. The method of claim 11, wherein applying tension to the suture construct includes applying tension to the suture construct via the first and second ends of the soft tissue extending from the opening of the first tunnel.

13. The method of claim 12, further comprising positioning a second anchor relative to the first tunnel to secure the tensioned soft tissue relative to the first tunnel.

14. The method of claim 1, wherein the body is formed from a deformable material.

15. A method for coupling soft tissue to bone, comprising:

forming a first tunnel in a first bone;

forming a second tunnel in a second bone;

positioning a flexible anchor having a suture construct coupled thereto into the second tunnel, the flexible anchor having a body extending along a longitudinal axis from a first end to a second opposed end thereof, the body defining a hollow interior that extends from the first end to the second end along the longitudinal axis, the suture construct being in the form of a closed loop of suture having a first looped end section outside the first end of the body and a second looped section opposite the first looped section passing through the hollow interior and exiting the hollow interior at a position intermediate the first and second ends of the body such that a remaining portion of the body extending from the intermediate position to the second end of the body along the longitudinal axis includes an absence of the suture construct;

coupling soft tissue to the suture construct;

pulling the flexible anchor with the soft tissue coupled thereto through the second tunnel via the body such that the flexible anchor is positioned outside the first tunnel and the soft tissue extends at least into the second tunnel; and

applying tension to the suture construct to collapse the flexible anchor relative to an outer surface of the second bone from a first profile configured for passing the flexible anchor through at least the second tunnel to a second profile forming an anchoring mass relative to the outer surface of the second bone.

16. The method of claim 15, wherein pulling the flexible anchor with the soft tissue coupled thereto includes pulling the flexible anchor with the soft tissue coupled thereto through the second tunnel via the remaining portion of the body such that the flexible anchor is positioned outside the first tunnel and the soft tissue extends at least into the second tunnel.

17. The method of claim 16, wherein coupling soft tissue to the suture construct includes looping the soft tissue into and over the first looped section and the second looped section of the suture construct extending from the flexible anchor.

18. The method of claim 17, wherein applying tension to the suture construct to collapse the flexible anchor relative to an outer surface of the second bone includes applying tension to the suture construct via first and second ends of the soft tissue extending from the first tunnel.

19. The method of claim 18, further comprising positioning a second anchor relative to the first tunnel to secure the first and second ends of the soft tissue in a tensioned state relative to the first tunnel.

20. The method of claim 16, wherein forming the first tunnel includes forming the first tunnel in a tibia and wherein forming the second tunnel includes forming the second tunnel in a femur.

21. The method of claim 16, wherein applying tension to the suture construct to collapse the flexible anchor relative to the outer surface of the second bone from the first profile configured for passing the flexible anchor through at least the second tunnel to the second profile includes drawing the first end of the body and the position intermediate the first and second ends of the body toward each other via the loop of suture to form the anchoring mass, the anchoring mass including the remaining portion of the body.

22. The method of claim 15, wherein the body is formed from a deformable material.

23. A method for coupling soft tissue to bone, comprising:

forming a tunnel in a femur;

positioning a flexible anchor having a suture construct coupled thereto into at least the tunnel, the flexible anchor having a deformable body extending from a first end to a second opposed end thereof along a longitudinal axis, the body defining a hollow interior that extends from the first end to the second end, the suture construct being in the form of a closed loop of suture having a first looped section and a second looped section, the second looped section opposite the first looped section, the closed loop passing from the first end through the hollow interior and the second looped section exiting the hollow interior at a position intermediate the first and second ends of the body;

looping soft tissue into and over the first looped section and a second opposed looped section of the closed loop of suture to couple the soft tissue to the suture construct;

pulling the flexible anchor with the soft tissue coupled thereto through the tunnel via the remaining portion of the body such that the flexible anchor is positioned outside the tunnel and the soft tissue extends at least into the tunnel; and

applying tension to the suture construct to collapse the flexible anchor relative to an outer surface of the femur from a first elongated profile configured for passing the flexible anchor through at least the tunnel to a second curved profile forming an anchoring mass relative to the outer surface of the femur.