Method and apparatus for re-attaching the labrum to the acetabulum, including the provision and use of a novel suture anchor system

• US 9,101,355 B2
• Filed: 06/29/2012
• Issued: 08/11/2015
• Est. Priority Date: 07/17/2009
• Status: Active Grant

• Current Assignee: Stryker Puerto Rico Holdings BV (Stryker Corporation)
• Original Assignee: Pivot Medical, Inc. (Stryker Corporation)
• Inventors: Lantz, Andrew, Burley, J. Brook, Graul, Jeremy, Flom, James
• Primary Examiner(s): Dornbusch, Dianne
• Assistant Examiner(s): LYNCH, ROBERT A
• Application Number:
  US13/538,378
• Publication Number:
  US 20130006276A1
• Time in Patent Office: 1,138 Days
• Field of Search: 606/53, 606/60, 606/86.R, 606/104, 606/139, 606/144, 606/148, 606/151, 606/232, 606/300, 606/326, 606/327, 606/916, 411/34, 411/35, 411/38, 411/44, 411/45, 411/54, 411/54.1, 411/56, 411/57.1, 411/58, 411/59, 411/60.1, 411/390, 411/490, 411/498, 623/13.14, 244/53
• US Class Current: 1/1
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• 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 lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• 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: A61B 2090/037 with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 90/03 Automatic limiting or abutting means, e.g. for safety

Abstract

Apparatus for securing an object to bone, the apparatus including an anchor assembly including an anchor and an actuation element extending from the anchor, wherein applying a force to the actuation element when the anchor is disposed in a hole formed in a bone secures the anchor to the bone; and an inserter for deploying the anchor assembly in a hole formed in a bone, the inserter including a shaft for releasably engaging the anchor; and a force delivery mechanism mounted to the shaft and connected to the actuation element, the force delivery mechanism being constructed so as to receive an input force from an external source and to selectively apply an output force to the actuation element, with the force delivery mechanism being constructed so that the magnitude of the output force is limited regardless of the magnitude of the input force.

Claims

1. A method for securing an object to bone, the method comprising:

using an inserter to position an expandable anchor in a hole formed in a bone; and

applying an input force to the inserter from an external source so as to selectively apply an output force to the expandable anchor, whereby to expand the expandable anchor and thereby secure the expandable anchor to the bone;

wherein the inserter comprises a force delivery mechanism comprising an input element for receiving the input force from the external source, an output element for selectively applying the output force to the expandable anchor so as to expand the expandable anchor, and a spring-biased connection element for transferring force from the input element to the output element provided that the magnitude of the input force is less than a threshold level, wherein the spring-biased connection element is releasably connected to the input element and secured to the output element, and further wherein the spring-biased connection element is configured to remain connected to the input element when the magnitude of the input force is below the threshold level so as to transfer force from the input element to the output element and to disconnect from the input element when the magnitude of the input force reaches the threshold level so as to not transfer force from the input element to the output element, so that the magnitude of the output force applied to the expandable anchor is limited regardless of the magnitude of the input force applied to the input element.

2. The method according to claim 1 wherein the expandable anchor comprises:

an actuation element extending from the expandable anchor, and further wherein the inserter comprises a shaft for releasably engaging the expandable anchor.

3. An inserter according to claim 2 wherein the force delivery mechanism is constructed so that the magnitude of the output force becomes substantially zero when the magnitude of the input force reaches a threshold level.

4. An inserter according to claim 3 wherein the output element selectively applies the output force to the actuation element.

5. An inserter according to claim 4 wherein the input element comprises one from the group consisting of a finger pull, a rotary knob, a lever, a trigger and a pull tab.

6. An inserter according to claim 4 wherein the connection element comprises a releasable grip between the input element and the output element.

7. An inserter according to claim 6 wherein the releasable grip comprises an outwardly biased element releasably retained in a recess.

8. An inserter according to claim 6 wherein the releasable grip comprises at least one inwardly biased element for releasably engaging a recess.

9. An inserter according to claim 8 wherein the actuation element comprises a suture, the input element comprises a user interface element movably mounted to the shaft, and the output element comprises a suture cleat and pair of grippers longitudinally and laterally movable relative to the user interface element, and further wherein the grippers connect the suture cleat to the user interface element when the magnitude of the input force is less than a threshold level, and the grippers do not connect the suture cleat to the user interface element when the magnitude of the input force reaches the threshold level.

10. The method according to claim 1 wherein the spring-biased connection element comprises a wishbone connection.

11. The method according to claim 2 wherein the actuation element comprises a suture, the input element comprises a user interface element movably mounted to the shaft, and the output element comprises a suture cleat, wherein the spring-biased connection element comprises a wishbone connection, wherein the wishbone connection comprises a recess formed in the user interface element and a wishbone releasably retained in the recess, the suture being mounted to the suture cleat so that movement of the user interface element applies the output force to the suture so long as the wishbone is releasably retained in the recess, and wherein the wishbone is releasably retained in the recess when the magnitude of the input force is less than the threshold level and wherein the wishbone is released from the recess when the magnitude of the input force reaches the threshold level.

12. The method according to claim 11 wherein the suture cleat is secured to the shaft, and further wherein a portion of the wishbone slidingly engages the suture so as to apply tension to the suture when the input force is applied to the input element and the magnitude of the input force is less than the threshold level.

13. The method according to claim 11 wherein the wishbone comprises a pair of bifurcated arms which are biased apart.

14. The method according to claim 13 wherein a spring is disposed between the pair of bifurcated arms so as to bias the arms apart.

15. The method according to claim 13 wherein the pair of bifurcated arms are formed out of resilient material.

16. The method according to claim 13 wherein the pair of bifurcated arms comprise outboard projections, the recess comprises inward narrowings, and further wherein the outboard projections engage the inward narrowings when the wishbone is engaged in the recess.

17. The method according to claim 2 wherein the expandable anchor comprises a passageway extending therethrough, and further wherein the actuation element comprises an enlargement for expanding the expandable anchor when the enlargement is moved through the passageway.

18. The method according to claim 17 wherein the enlargement expands the expandable anchor when the enlargement is moved proximally through the passageway.

19. The method according to claim 17 wherein the actuation element further comprises a suture connected to the enlargement for moving the enlargement through the passageway.

20. A method according to claim 1 wherein the output element is attached to the expandable anchor.

21. A method according to claim 20 wherein the output element comprises a suture.

22. A method according to claim 1 wherein the input element comprises one from the group consisting of a finger pull, a rotary knob, a lever, a trigger and a pull tab.

23. A method according to claim 1 wherein the connection element comprises a releasable grip between the input element and the output element.

24. A method according to claim 23 wherein the releasable grip comprises an outwardly biased element releasably retained in a recess.

25. A method for securing an object to bone, the method comprising:

providing (i) an anchor assembly comprising an expandable anchor and an actuation element extending from the expandable anchor, and (ii) an inserter comprising a shaft for releasably engaging the expandable anchor and a force delivery mechanism mounted to the shaft and connected to the actuation element, the force delivery mechanism comprising an input element for receiving an input force from an external source, an output element for selectively applying an output force to the actuation element so as to expand the expandable anchor, and a spring-biased connection element for transferring force from the input element to the output element provided that the magnitude of the input force is less than a threshold level, wherein the spring-biased connection element is releasably connected to the input element and secured to the output element, and further wherein the spring-biased connection element is configured to remain connected to the input element when the magnitude of the input force is below the threshold level so as to transfer force from the input element to the output element and to disconnect from the input element when the magnitude of the input force reaches the threshold level so as to not transfer force from the input element to the output element so that the magnitude of the output force applied to the expandable anchor is limited regardless of the magnitude of the input force applied to the input element;

using the inserter to position the expandable anchor inside a hole formed in a bone; and

using the force delivery mechanism to apply an output force to the actuation element, whereby to expand the expandable anchor, and thereby secure the expandable anchor to the bone.

26. A method according to claim 25 wherein the output element is attached to the expandable anchor.

27. A method according to claim 26 wherein the output element comprises a suture.

28. A method according to claim 25 wherein the input element comprises one from the group consisting of a finger pull, a rotary knob, a lever, a trigger and a pull tab.

29. A method according to claim 25 wherein the spring-biased connection element comprises a releasable grip between the input element and the output element.

30. A method according to claim 29 wherein the releasable grip comprises an outwardly biased element releasably retained in a recess.