Method for soft tissue repair with free floating suture locking member

• US 9,023,083 B2
• Filed: 01/27/2012
• Issued: 05/05/2015
• Est. Priority Date: 01/27/2012
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Foerster, Seth A., Wolf, Steven, Karapetian, Emil, White, George W., Gregoire, David, Catania, Pablo, Rodriguez, Christopher
• Primary Examiner(s): HOLWERDA, KATHLEEN SONNETT
• Application Number:
  US13/359,891
• Publication Number:
  US 20130197579A1
• Time in Patent Office: 1,194 Days
• Field of Search: 606/139, 606144-148, 606/232
• 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 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/043 by insertion of a separate spreading member into the anchor
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0464 for soft tissue
• 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 2002/0864 Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon

Abstract

A suture anchor device and method for attaching soft tissue to bone includes an anchor body and a suture locking wedge movably disposed within the anchor body. The suture locking wedge includes lateral portions which engage slots or windows in the anchor body. Tension applied to one limb of a suture causes the suture locking wedge to translate and rotate to a position which compresses the suture, thereby locking the suture in the anchor.

Claims

1. A method for securing soft tissue to bone comprising:

(a) securing a first limb of a length of suture to the soft tissue to be attached to the bone;

(b) extending the length of suture into an anchor body and looping the length of suture around a suture locking member movably disposed within the anchor body and such that a second limb of the suture extends from the anchor body, the suture locking member being cooperatively engaged with the anchor body to move between an unlocked position in which the length of suture slides around the suture locking member, and a locked position in which the length of suture is compressed between a first contact surface of the suture locking member and the anchor body, wherein the suture locking member has an elongate cross section, angled towards a more parallel orientation relative to an elongate axis of the anchor body while in the unlocked position so as to provide a larger gap between the first contact surface and the anchor body and ease the steps of extending and looping;

(c) fixing the anchor body within the bone;

(d) applying a first tension on the second limb of the length of suture such that the length of suture slides around the suture locking member so as to move the first limb of the suture and the soft tissue towards the anchor body and until a second tension on the first limb of the suture arises from the soft tissue; and

(e) releasing the second limb, thereby halting the application of the first tension on the second limb such that the second tension on the first limb of the suture causes the suture locking member to rotate and translate from the unlocked position to the locked position, thereby compressing the length of suture between the suture locking member and the anchor body.

2. The method of claim 1 further comprising manually drawing on the first limb to increase an amount of compression on the length of suture between the suture locking member and the anchor body.

3. The method of claim 1 further comprising releasing the suture from being compressed.

4. The method of claim 3 wherein the step of releasing the suture is performed by applying a third tension to the second limb of the suture thereby causing the suture locking member to rotate and translate from the locked position to the unlocked position.

5. The method of claim 3 further comprising re-tensioning the suture by drawing on the second limb of the suture to reposition the soft tissue relative to the anchor body.

6. The method of claim 4 further comprising moving the suture locking member to the locked position by manually applying a fourth tension on the first limb of the suture.

7. A method for repairing soft connective tissue with a suture comprising:

(a) providing an anchor device, said anchor device comprising an anchor body and a movable suture locking member at least partially disposed within the anchor body, the suture locking member cooperatively engaged within the anchor body to move between a locked position in which a length of the suture is compressed between a first contact surface of the suture locking member and the anchor body, and an unlocked position in which a gap is defined between the first contact surface of the suture locking member and the anchor body such that the length of suture is not substantially compressed between the suture locking member and the anchor body;

wherein the suture locking member has an elongate cross section defining an elongate width that is approximately uniform and a suture locking member long axis,

(b) securing a first limb of the suture to a first tissue section;

(c) extending the length of suture in the anchor body and around the suture locking member such that a second limb of the suture extends therefrom;

(d) embedding the anchor body in a second tissue section;

(e) approximating the first tissue section towards the second tissue section by applying a first tension force to the second limb of the suture so as to slide the length of suture around the suture locking member thereby creating a second tension force on the first limb; and

(f) adjusting the first tension to be less than the second tension thereby causing the suture locking member to rotate and translate until the suture locking member is seated in the suture locked position, thereby compressing the length of suture;

wherein the suture locking member long axis moves from a more parallel orientation towards a more perpendicular orientation relative to an elongate axis of the anchor body when moving to the locked position.

8. The method of claim 7 wherein the step of embedding the anchor body in a second tissue section is performed by embedding the anchor body in a bone.

9. The method of claim 7 wherein step (f) is performed by applying the second tension force to the first limb of the suture.

10. The method of claim 9 wherein applying the second tension force is effectuated by hand.

11. The method of claim 7 wherein adjusting the first tension to be less than the second tension is effectuated by halting the applying a first tension force to the second limb during the approximating step.

12. A method for repairing tissue with a suture anchor and a suture, comprising:

(a) securing a tissue limb of the suture to a first tissue section;

(b) inserting a length of the suture into a lumen of the suture anchor, and looping the length of the suture about a suture locking member movably disposed within the lumen of the suture anchor such that a free limb of the suture exits the lumen proximal end;

wherein the step of looping the length of suture about a suture locking member comprises extending the length of suture along a first elongate surface of the suture locking member, around a distally disposed first contact surface and returning the length of suture along a second elongate surface, wherein the first and second elongate surfaces define an elongate cross section with an approximately uniform width;

(c) inserting the suture anchor into a second tissue section;

(d) applying a first tension on the free limb of the suture such that the length of suture slides around the suture locking member, drawing the first tissue section towards the suture anchor until a second tension is applied on the tissue limb of the suture from the first tissue section; and

(e) halting the applying a first tension on the free limb while the second tension is applied on the tissue limb of the suture to cause the suture locking member to rotate and translate from a suture unlocked position to a suture locked position, compressing the suture between the suture locking member and the suture anchor.

13. The method of claim 12 wherein the step of inserting the suture anchor in the second tissue section is performed by embedding the suture anchor in a bone.

14. The method of claim 12 further comprising re-applying tension on the tissue limb.

15. The method of claim 12 wherein rotating and translating the suture locking member seats the suture locking member in complimentary engagement with the lumen of the suture anchor to compress the suture in the suture locked position.

16. The method of claim 14 wherein the re-applying step comprises applying a third tension greater or equal to the second tension, thereby unseating the suture locking member from the suture locked position, allowing the suture to slide.

17. A method for repairing soft tissue with a suture anchor and a suture, said suture anchor comprising a lumen and a movable suture locking member disposed therein, and the suture having a length extending through the lumen proximal end, around the suture locking member, and returning through the lumen proximal end comprising a free first limb of suture and a second limb of suture secured to the soft tissue, said method comprising the steps:

(a) fixing the suture anchor in a bone;

(b) applying a first tension on the free first limb of the suture such that the length of suture slides around the suture locking member, drawing the soft tissue towards the suture anchor until a second tension is applied on the second limb of the suture from the soft tissue; and

(c) moving in two degrees of freedom the suture locking member from a suture unlocked position to a suture locked position, thereby compressing the suture between the suture locking member and the suture anchor;

wherein the suture locking member has an elongate cross section defining an approximately uniform width and an elongate cross section axis that is angled towards a more perpendicular orientation to an elongate axis of the suture anchor while moving to the suture locked position.

18. The method of claim 17 wherein the moving is effectuated by pausing the applying the first tension on the first limb of the suture while the second tension is applied on the second limb of the suture.

19. The method of claim 18 wherein the moving comprises rotation.

20. The method of claim 19 wherein the moving comprises moving in a direction comprising a translational dimension and an angular dimension.

21. The method of claim 17 wherein the moving comprises moving in a translational, angular, and non-linear direction.

22. The method of claim 17 wherein the step of applying a first tension on the free first limb of the suture is carried out until the soft tissue is moved within a threshold distance from the anchor body, such that the second tension arises on the second limb from the soft tissue.

23. he method of claim 22 wherein the step of moving the suture locking member is carried out by halting applying the first tension on the free first limb, thereby causing the second tension on the second limb of the suture to move the suture locking member.

24. The method of claim 23 wherein the threshold distance is between 3 and 6 mm.

25. The method of claim 18 further comprising releasing the suture from being compressed.

26. The method of claim 25 wherein the releasing the suture from being compressed is performed by applying a third tension to the first limb of the suture thereby causing the suture locking member to rotate and translate from the locked position to the unlocked position.

27. The method of claim 26 further comprising re-tensioning the suture by drawing on the first limb of the suture to reposition the soft tissue relative to the suture anchor.

28. A method for repairing a soft tissue comprising a first tissue section and a second tissue section separated by a region, said method comprising:

(a) providing a plurality of anchor bodies each comprising a suture locking wedge movably disposed therein, said plurality of anchor bodies including a first anchor body and a last anchor body;

(b) securing a first limb of a length of suture to the first tissue section;

(c) threading the length of suture through each anchor body of said plurality of anchor bodies until the suture is looped around the suture locking wedge of the last anchor body providing an intermediate limb extending into the last anchor body, and a free suture limb extending from the last anchor body, and such that a sequence of anchor bodies is defined with the suture extending from the first anchor body to the last anchor body wherein each of the suture locking wedges have an elongate cross section defining an approximately uniform width and a long axis that is angled towards a more parallel orientation to an elongate axis of each respective anchor body during the threading and looping step, the elongate cross section adapted to ease loading of the length of suture with the anchor bodies;

(d) fixing the plurality of anchor bodies in the soft tissue such that the suture length extending between two sequential anchor bodies spans the region;

(e) decreasing a size of the region by applying a first tension to the free limb of the suture so as to move at least one of the first tissue section and second tissue section of soft tissue towards the other tissue section; and

(f) locking the suture in the last anchor body by translating and rotating the suture locking wedge to a suture locking position wherein the translating and rotating is effectuated at least in part by a second tension on the intermediate limb of the suture.

29. The method of claim 28 wherein the region comprises a tear, and decreasing the size of the region comprises closing the tear.

30. The method of claim 29 wherein the soft tissue comprises meniscus.

31. The method of claim 30 wherein the step of providing a plurality of anchor bodies comprises providing at least 5 anchor bodies.

32. The method of claim 28 wherein the soft tissue is capsular tissue.

33. The method of claim 28 wherein the second tension is created by manual manipulation of the suture.

34. The method of claim 28 wherein translating and rotating the suture locking wedge is effectuated by halting applying the first tension to the free limb.

35. The method of claim 28 wherein translating and rotating the suture locking wedge comprises rotating the elongate cross section of the suture locking wedge to compress the length of suture between a first contact location of the suture locking wedge and the last anchor body.

36. The method of claim 28 wherein translating and rotating the suture locking wedge comprises loading the suture locking wedge in the first suture locking position with a biasing member in the last anchor body.