Method and device for securing body tissue

• US 8,932,330 B2
• Filed: 02/17/2004
• Issued: 01/13/2015
• Est. Priority Date: 03/13/2000
• Status: Active Grant

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M., Cremens, Matthew J.
• Primary Examiner(s): McEvoy, Thomas
• Assistant Examiner(s): SZPIRA, JULIE ANN
• Application Number:
  US10/780,444
• Publication Number:
  US 20040220616A1
• Time in Patent Office: 3,983 Days
• Field of Search: 206/63.3, 206/363, 206/701, 606/232, 606/144, 606/148, 606/153, 534/29, 534/30, 604/180
• US Class Current: 606/232
• 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 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0459 Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0619 thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it suture cutters A61B17/0467; ultrasonic cutters A61B17/320068; electrically heated instruments A61B18/08

Abstract

A suture and a suture retainer are positioned relative to body tissue. Energy is utilized to heat the suture retainer and effect a securing of portions of the suture retainer to each other and/or to the suture. Portions of the body tissue may be pressed into linear apposition with each other and held in place by cooperation between the suture and the suture retainer. The suture retainer may include one or more portions between which the suture extends. The suture retainer may include sections which have surface areas which are bonded together. If desired, the suture may be wrapped around one of the sections of the suture retainer. The suture retainer may be formed with a recess in which the suture is received. If desired, the suture retainer may be omitted and the sections of the suture bonded to each other.

Claims

1. An implantable fastener for securing an object relative to a body tissue within the body, comprising:

a first section including a first surface and an extension member projection extending from said first surface, and

a second section including a second surface with a recess and a projection configured to contact the first surface and resist movement of the first surface toward the second surface, the second surface opposing the first surface and being configured to receive at least a portion of the extension member in the recess, and the extension member projection and a surface of the recess configured to be bondable together with the application of energy,

wherein the extension member projection is configured to shorten in length when the first and second sections are bonded together.

2. The fastener according to claim 1, wherein the first section includes a pair of parallel channels for carrying a first portion of the object in a first of the pair of the parallel channels and for carrying a second portion of the object in a second of the pair of the parallel channels.

3. The fastener according to claim 2, wherein the extension member projection is interposed between the pair of parallel channels.

4. The fastener according to claim 1, wherein the recess in the second section is a channel configured for receiving the extension member projection.

5. The fastener according to claim 4, wherein the extension member projection is positioned within the channel, such that the object is interposed between the first and second sections.

6. The fastener according to claim 1, wherein the first section comprises a pair of parallel extension members.

7. The fastener according to claim 6, wherein the second section includes a pair of parallel channels configured for receiving the parallel extension members.

8. The fastener according to claim 7, wherein the object is interposed between the parallel extension members.

9. The fastener according to claim 1, wherein the extension member is a center post.

10. The fastener according to claim 9, wherein the second section includes a flange defining a passage configured for receiving the center post.

11. The fastener according to claim 10, wherein an exterior surface of the center post and an interior surface of the passage are textured.

12. The fastener according to claim 11, wherein the object is wrapped around the center post.

13. The fastener according to claim 12, wherein the center post is positioned within the passage, such that the object is interposed between the center post and an interior surface of the passage.

14. The fastener according to claim 1, wherein at least a portion of at least one of the first and second sections contacting the other of the first and second sections is textured.

15. The fastener according to claim 1, wherein the first and second sections are interconnected.

16. The fastener according to claim 1, wherein the fastener is made of a biodegradable material.

17. The fastener according to claim 1, wherein the fastener is made of a heat shrink material.

18. The fastener according to claim 1, wherein the fastener includes viable cells.

19. The fastener according to claim 1, wherein the fastener includes at least one pharmaceutical agent.

20. The fastener according to claim 1, wherein the energy source is selected from the group consisting of radio frequency energy, laser energy, microwave energy, ultrasound energy, contact heating energy, and combinations thereof.

21. The fastener according to claim 1, wherein said first surface and said second surface are configured to sandwich the object.

22. The fastener according to claim 1, wherein:

said first section has two channels formed therein, said channels being disposed opposingly about and immediately adjacent to said extension member projection; and

said second section is configured to seat within said channels of said first section.

23. The fastener according to claim 1, wherein:

said extension member projection divides said first surface into two first subsurfaces,

a channel divides said second surface into two second subsurfaces,

one of said first subsurfaces is configured to align with one of said second subsurfaces when said first section is bonded to said second section; and

the other of said first subsurfaces is configured to align with the other of said second subsurfaces when said first section is bonded to said second section.

24. The fastener according to claim 23, further comprising a suture being disposed between at least one of said first subsurfaces and at least one of said second subsurfaces.

25. The fastener according to claim 1, wherein said object is elongated.

26. The fastener according to claim 1, wherein said object is a suture.

27. The fastener according to claim 1, wherein said object is body tissue.

28. The fastener according to claim 27, wherein said body tissue is selected from the group consisting of soft tissue, tendon, ligament, and bone.

29. The fastener according to claim 1, wherein said object is metallic.

30. The fastener according to claim 1, wherein said extension member projection plastically deforms during the application of the energy source to move said first surface and said second surface closer to each other.

31. The fastener according to claim 1, wherein said extension member projection plastically deforms with the application of the energy source to a height about equal to a thickness of the object to be secured.

32. The fastener according to claim 1, wherein said extension member projection is bonded to said second surface and has been compressed to a height about equal to a thickness of the object to be secured.

33. The fastener according to claim 1, wherein said fastener is made of a biocompatible material.

34. The fastener according to claim 1, wherein said fastener is rigid when the energy source is not being applied.

35. The fastener according to claim 34, wherein the object secured relative to body tissue is a rigid object.

36. The fastener according to claim 1, wherein said first section has a top surface opposing said first surface, said top surface being configured to contact the energy source.

37. The fastener according to claim 1, wherein the energy source is an ultrasonic end effector.

38. The fastener according to claim 36, wherein said second section has a bottom surface opposing said second surface, said bottom surface being configured to contact an anvil when said top surface is contacting the energy source.

39. The fastener according to claim 1, wherein said extension member projection is fin shaped.

40. The fastener according to claim 1, wherein said object secured relative to body tissue is a metallic object.

41. The fastener according to claim 1, wherein the object extends through the fastener in a substantially linear fashion.

42. The fastener according to claim 1, wherein the fastener includes an osteoinductive agent.

43. The fastener of claim 1, wherein the recess includes a side surface configured to be substantially parallel to a side surface of the extension member projection.

44. The fastener of claim 1, wherein the recess includes a side surface configured to be substantially orthogonal to the second surface.

45. An implantable fastener for securing an object relative to body tissue inside the body, comprising:

a first section including a first surface and an extension member projection extending from the first surface; and

a second section including a second surface with a recess and a projection configured to contact the first surface and resist movement of the first surface toward the second surface, the second surface opposing the first surface and configured for receiving at least a portion of the extension member projection in the recess, the extension member projection and a surface of the recess configured to be bondable together with the application of energy,

wherein the extension member projection is configured to shorten in length when the first and second sections are bonded together,

wherein the first surface and the second surface move closer to each other with the application of energy to thereby secure the object to the fastener.

46. The fastener according to claim 45, wherein ultrasonic energy bonds the first and second surfaces together to thereby secure the object to the fastener.

47. The fastener of claim 45, wherein the second surface changes shape as energy is applied to the fastener.

48. The fastener of claim 45, wherein the recess includes a side surface configured to be substantially parallel to a side surface of the extension member projection.

49. The fastener of claim 45, wherein the recess includes a side surface configured to be substantially orthogonal to the second surface.

50. A fastener implantable in a body for securing an object to body tissue within the body, comprising:

a first section including a first surface and further including an extension member projection extending from said first surface, and

a second section including a second surface with a recess and a projection configured to contact the first surface and resist movement of the first surface toward the second surface, said second surface opposing said first surface and being configured for receiving at least a portion of the extension member projection in the recess, the extension member projection and a surface of the recess configured to be bondable together by the application of ultrasonic energy and pressure to the fastener, whereby said extension member projection is configured to shorten in the direction of force applying pressure to the fastener,

wherein said first and second surfaces are configured to compress the object thereby securing the object with respect to the fastener.

51. The fastener of claim 50, wherein the recess includes a side surface configured to be substantially parallel to a side surface of the extension member projection.

52. The fastener of claim 50, wherein the recess includes a side surface configured to be substantially orthogonal to the second surface.