Tissue fixation system

• US 9,173,647 B2
• Filed: 02/21/2006
• Issued: 11/03/2015
• Est. Priority Date: 10/26/2004
• Status: Expired due to Fees

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M., Phillips, Glen A., Crainich, Larry
• Primary Examiner(s): BOLES, SAMEH RAAFAT
• Application Number:
  US11/358,311
• Publication Number:
  US 20060229623A1
• Time in Patent Office: 3,542 Days
• Field of Search: 606/72, 606/69, 606/74, 606/916, 606/103, 606/60, 606/86.R, 606/99, 606/232
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/685 Elements to be fitted on the end of screws or wires, e.g. protective caps
• CPC Class Codes: A61B 17/7053 with parts attached to bones or to each other by flexible wires, straps, sutures or cables
• CPC Class Codes: A61B 17/82 for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/844 with expandable anchors or anchors having movable parts
• CPC Class Codes: A61B 17/8861 Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 17/8863 Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
• CPC Class Codes: A61B 17/8869 Tensioning devices
• 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 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/2926 : Details of heads or jaws
• CPC Class Codes: A61B 2090/035 : preventing further rotation
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 90/40 : Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/28 : Bones joints A61F2/30
• CPC Class Codes: A61F 2/442 : Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/4435 : Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2002/444 : for replacing the nucleus pulposus
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite

Abstract

A tissue fixation system is provided for dynamic and rigid fixation of tissue. A fastener connected with an elongate fastening member, such as a cable, wire, suture, rod, or tube, is moved through a passage between opposite sides of tissue. The fastener is provided with a groove that accommodates at least a portion of the fastening member to reduce the profile during the movement through the passage. The fastener is then pivoted to change its orientation. A second fastener can then be connected with the fastening member. While tension is maintained in the fastening member, the fasteners are secured against relative movement. This may be done by deforming the fastening member, either the first or second fasteners, or a bushing placed against the second fastener.

Claims

1. A tissue fixation system comprising:

an elongate flexible member; and

a fastener configured for implantation in the body, the fastener configured to be positionable on the flexible member and movable from a first orientation to a second orientation without disconnecting from the flexible member, the fastener having a body with a first surface and a tapered portion defined by a leading end surface and the first surface and a second surface parallel to the first surface and defined between the leading end surface and a trailing end surface, the first surface including a substantially flat portion configured to be positionable against a tissue section, and the fastener body including a bore extending from the first surface to the second surface and configured to receive a portion of the flexible member at an angle with respect to the flat portion,

wherein said flat portion is positionable against the tissue section in the second orientation by tensioning the flexible member.

2. The tissue fixation system of claim 1 wherein the second surface includes a channel configured to receive a portion of the flexible member in the first orientation.

3. The tissue fixation system of claim 1 wherein the fastener body includes a groove configured to receive a portion of the flexible member to reduce a profile of the fastener in at least the first or second orientation.

4. The tissue fixation system of claim 3 wherein the groove extends toward the leading end surface.

5. The tissue fixation system of claim 3 further comprising a biasing means for maintaining the fastener in the first orientation.

6. The tissue fixation system of claim 5 wherein the biasing means comprises an adhesive between a groove on the first surface and the portion of the flexible member received in the groove.

7. The tissue fixation system of claim 5 wherein the biasing means comprises a frangible connection between a groove on the first surface and the portion of the flexible member received in the groove.

8. The tissue fixation system of claim 1 wherein the fastener includes a taper.

9. The tissue fixation system of claim 1 wherein the second surface of the fastener body includes a well surrounding the bore.

10. The tissue fixation system of claim 1 wherein a distal end of the flexible member includes a stop larger than the bore.

11. The tissue fixation system of claim 10 wherein the well is configured and dimensioned to receive at least a portion of the stop.

12. The tissue fixation system as set forth in claim 1 further comprising a second fastener that includes a first surface having a substantially flat portion configured to be positionable adjacent the second tissue section and a bore extending from the first surface through a second surface.

13. The tissue fixation system of claim 1 wherein the fastener is pivotable from the first orientation to the second orientation and the first surface is configured to contact a tissue section in the second orientation.

14. The tissue fixation system of claim 1 wherein the first and second surfaces are substantially parallel.

15. The tissue fixation system of claim 1 wherein the bore is substantially perpendicular to the first or second surface.

16. The tissue fixation system of claim 1 wherein the fastener includes at least a deformable portion.

17. The tissue fixation system of claim 1 wherein the fastener includes at least a rounded portion.

18. The tissue fixation system of claim 1 wherein the leading or trailing end surface of the fastener is narrower than a majority of the fastener body.

19. A tissue fixation system to secure a first tissue section relative to a second tissue section, comprising:

an flexible member positionable in at least a portion of the first and second tissue sections;

a first fastener configured for implantation in the body, the first fastener configured to be movable from a first orientation to a second orientation and positionable on the flexible member, the first fastener having a body with a first surface and a tapered portion defined by a leading end surface and the first surface and a second surface parallel to the first surface and defined between the leading end surface and a trailing end surface, the first surface including a substantially flat portion configured to be positionable adjacent the first tissue section, and the first fastener body including a bore extending from the first surface to the second surface and configured to receive a portion of the flexible member at an angle with respect to the flat portion, wherein a first end of the flexible member includes a stop larger than the bore; and

a second fastener configured for implantation in the body, the second fastener configured to be positionable on the flexible member at a distance from the first fastener and adjacent to the second tissue section,

wherein the flexible member is tensionable between the first and second fasteners.

20. The tissue fixation system of claim 19 wherein the first fastener is an anchor.

21. A tissue fixation system as set forth in claim 19 wherein the first fastener is moveable with respect to the flexible member from a first orientation to a second orientation without disconnecting from the flexible member.

22. The tissue fixation system as set forth in claim 21 further comprising a biasing means maintaining the first fastener in the first orientation.

23. The tissue fixation system as set forth in claim 22 wherein the biasing means comprises an adhesive between a groove on the first surface and the portion of the flexible member received in the groove.

24. The tissue fixation system as set forth in claim 22 wherein the biasing means comprises a frangible connection between a groove on the first surface and the portion of the flexible member received in the groove.

25. The tissue fixation system as set forth in claim 21 further comprising a bushing member positionable on the second end of the flexible member, adjacent to the second fastener, wherein the bushing member is affixable about the second end of the flexible member.

26. The tissue fixation system as set forth in claim 21 wherein the first fastener is pivoted from a first orientation to a second orientation in which the first surface contacts the first tissue section and the second fastener is pivoted from a first orientation to a second orientation and the first surface is configured to contact the second tissue section.

27. The tissue fixation system as set forth in claim 19 wherein the first fastener body includes a channel.

28. The tissue fixation system as set forth in claim 27 wherein the second surface of the first fastener body includes a well surrounding the bore.

29. The tissue fixation system as set forth in claim 28 wherein the first fastener is an anchor.

30. The tissue fixation system as set forth in claim 29 wherein the well is configured and dimensioned to receive at least a portion of the stop.

31. The tissue fixation system as set forth in claim 30 wherein the first fastener body includes a taper.

32. The tissue fixation system as set forth in claim 19 wherein the leading or trailing end surface includes an edge.

33. The tissue fixation system as set forth in claim 19 wherein the first surface includes a groove.

34. The tissue fixation system as set forth in claim 19 wherein the second fastener includes a first surface having a substantially flat portion configured to be positionable adjacent the second tissue section and a bore extending from the first surface through a second surface.

35. The tissue fixation system as set forth in claim 19 wherein the second fastener has a body with a first surface that includes a groove configured and dimensioned to receive a portion of the flexible member in a first orientation and a second surface opposite the first surface that includes a channel configured and dimensioned to receive a portion of the flexible member in the first orientation.

36. The tissue fixation system of claim 19 wherein the first and second surfaces are substantially parallel.

37. The tissue fixation system of claim 19 wherein the bore is substantially perpendicular to the first or second surface.

38. The tissue fixation system of claim 19 wherein the first or second fastener includes at least a deformable portion.

39. The tissue fixation system of claim 19 wherein the fastener includes at least a rounded portion.

40. The tissue fixation system of claim 19 wherein the leading or trailing end surface of the first fastener is narrower than a majority of the first fastener body.

41. A tissue fixation system comprising:

an elongate flexible member;

a fastener configured for implantation in the body, the fastener configured to be positionable on the flexible member and movable from a first orientation to a second orientation with respect to the flexible member, the fastener having a body with a first surface and a tapered portion defined by a leading end surface and the first surface, a second surface parallel to the first surface and defined by the leading end surface and a trailing end surface, and a longitudinal axis between the leading and trailing end surfaces, the first surface including a substantially flat portion configured to be positionable against a tissue section, and the fastener body including a bore extending between the first and second surfaces at an angle with respect to the longitudinal axis.

42. The tissue fixation system of claim 41 wherein the fastener includes a groove configured to reduce a profile of the fastener in the first orientation.

43. The tissue fixation system of claim 41 wherein the fastener is an anchor.

44. The tissue fixation system of claim 41 wherein the first and second surfaces are substantially parallel.

45. The tissue fixation system of claim 41 wherein the bore is substantially perpendicular to the first or second surface.

46. The tissue fixation system of claim 41 wherein the fastener includes at least a deformable portion.

47. The tissue fixation system of claim 41 wherein the leading or trailing end surface of the fastener is rounded.

48. The tissue fixation system of claim 41 wherein the leading or trailing end surface of the fastener is narrower than a majority of the fastener body.