Method for the treatment of tissue

• US 9,192,372 B2
• Filed: 06/03/2013
• Issued: 11/24/2015
• Est. Priority Date: 10/14/2008
• Status: Expired due to Fees

• Current Assignee: KRT Investors, Inc.
• Original Assignee: KRT Investors, Inc.
• Inventors: Bentley, Ishmael, Burns, Matthew M., Cauthen, Joseph C. III, Dukart, Brian L., Houfburg, Rodney L., Wales, Lawrence W., Wessman, Bradley J.
• Primary Examiner(s): Hammond, Ellen C
• Application Number:
  US13/908,677
• Publication Number:
  US 20130268002A1
• Time in Patent Office: 904 Days
• Field of Search: 623 1711- 1716, 606/279
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 17/0466 Suture bridges
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/0023 disposable
• CPC Class Codes: A61B 2017/0065 the implement being an adhesive
• CPC Class Codes: A61B 2017/00659 located only on one side of the opening
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/0406 Pledgets
• 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 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0472 : Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 : Knot pushers
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 : with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/0646 : for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2090/036 : abutting on tissue or skin
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/30907 : Nets or sleeves applied to surface of prostheses or in cement
• 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 2/4603 : for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4611 : of spinal prostheses
• 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 2002/3008 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30092 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30158 : trapezoidal
• CPC Class Codes: A61F 2002/30299 : umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30448 : using adhesives
• CPC Class Codes: A61F 2002/30451 : soldered or brazed or welded
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30784 : Plurality of holes
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• 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 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4662 : for measuring penetration depth
• CPC Class Codes: A61F 2210/0019 : operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation
• CPC Class Codes: A61F 2220/005 : using adhesives
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0026 : trapezoidal
• CPC Class Codes: A61F 2230/0093 : Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers

Abstract

This disclosure presents methods for treating a defect in soft tissue of a patient. The methods employ fixation delivery apparatuses and fixation apparatuses positioned, at least in part, in or on the soft tissue to be repaired. In some aspects, these techniques include the use of this includes a fixation apparatus that includes at least one bone anchor connected to at least one tissue anchor by a shortenable elongate member.

Claims

1. An orthopedic repair method for re-approximating a defect in tissue of a patient, the method comprising:

inserting a bone anchor into a bone that is contiguous to tissue having a defect to be repaired, wherein the bone anchor is coupled to a shortenable elongate member;

disposing a portion of the elongate member proximate to the defect in the tissue;

providing a fixation device having a first member, a second member, and a connecting element therebetween;

placing the first member of the fixation device into the tissue on a first side of the portion of the elongate member disposed proximate to the defect in the tissue;

placing the second member of the fixation device into the tissue on a second side of the portion of the elongate member disposed proximate to the defect in the tissue so that the connecting element between the first member and the second member extends across the portion of the elongate member disposed proximate to the defect in the tissue;

after the second member is placed, shortening a length of the connecting element between the first member and second member; and

shortening the elongate member to an extent sufficient to cause the connecting element between the first member and the second member to be drawn in tension to pull, wholly or partially, the tissue toward the bone anchor positioned within the bone.

2. The method of claim 1, wherein the placing steps occur simultaneously.

3. The method of claim 1, wherein the bone anchor comprises a bone screw, a T-anchor, a barb, an expandable element or an adhesive.

4. A method for repair of a defect in patient tissue, the method comprising:

inserting a bone anchor having a shortenable elongate member attached thereto into a bone that is contiguous to tissue having a defect to be repaired;

aligning a portion of the elongate member proximate to the defect;

inserting a first anchor member having a first elongate element attached thereto into the tissue on a first side of the portion of the elongate member;

inserting a second anchor member having a second elongate element attached thereto into the tissue on a second side of the portion of the elongate member opposite the first side;

providing an adjustable coupling that extends over the portion of the elongate member between the first elongate element of the first anchor member and the second elongate element of the second anchor member;

applying tension to the coupling between the first and second elongate elements thereby shortening a length of the coupling; and

shortening a length of the elongate member between the bone anchor and the coupling.

5. The method of claim 4, and further comprising

inserting a third anchor member having a third elongate element attached thereto into the tissue at a location spaced from the insertion locations of the first and second anchor members, wherein the adjustable coupling also extends to the third elongate element;

and

prior to the step of shortening the length of the elongate member, applying tension to the coupling between the first, second and third elongate elements.

6. The method of claim 4, wherein the step of inserting the first anchor member further comprises disposing the first anchor member proximate to the defect in the tissue.

7. The method of claim 6, wherein the step of inserting the second anchor member further comprises disposing the second anchor member proximate to the defect in the tissue.

8. The method of claim 4, wherein the first anchor and second anchor inserting steps occur simultaneously.

9. The method of claim 4, wherein the bone anchor comprises a bone screw, a T-anchor, a barb, an expandable element or an adhesive.

10. A method for repair of a defect in patient tissue, the method comprising:

inserting a bone anchor having a shortenable elongate member attached thereto into a bone that is contiguous to tissue having a defect to be repaired;

aligning a portion of the elongate member proximate to the defect;

inserting a first anchor member having a first elongate element attached thereto into the tissue on one side of the portion of the elongate member;

inserting a second anchor member having a second elongate element attached thereto into the tissue on the other side of the portion of the elongate member;

providing a coupling that extends over the portion of the elongate member between the first elongate element of the first anchor member and the second elongate element of the second anchor member, wherein the coupling comprises a loop; and

shortening a length of the elongate member between the bone anchor and the coupling.

11. The method of claim 10, and further comprising shortening a length of the coupling that extends over the portion of the elongate member between the first anchor member and second anchor member.

12. The method of claim 10, and further comprising inserting a third anchor member having a third elongate element attached thereto into the tissue at a location spaced from the insertion locations of the first and second anchor members, wherein the coupling also extends to the third elongate element.

13. The method of claim 12, and further comprising shortening a length of the coupling that extends over the portion of the elongate member, after the first, second and third anchor inserting steps.

14. The method of claim 10, wherein the step of inserting the first anchor member further comprises disposing the first anchor member proximate to the defect in the tissue.

15. The method of claim 14, wherein the step of inserting the second anchor member further comprises disposing the second anchor member proximate to the defect in the tissue.

16. The method of claim 10, wherein the first anchor member is inserted before the second anchor member.

17. The method of claim 10, wherein the first anchor and second anchor inserting steps occur simultaneously.

18. The method of claim 10, wherein the bone anchor comprises a bone screw, a T-anchor, a barb, an expandable element or an adhesive.