Methods for tissue repair

• US 9,220,494 B2
• Filed: 01/08/2010
• Issued: 12/29/2015
• Est. Priority Date: 12/02/1999
• Status: Expired due to Term

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Bojarski, Ray, Sikora, George, Torrie, Paul Alexander, Ek, Steven
• Primary Examiner(s): HOLWERDA, KATHLEEN SONNETT
• Application Number:
  US12/684,752
• Publication Number:
  US 20100114162A1
• Time in Patent Office: 2,181 Days
• Field of Search: 606/139, 606144-148, 606151-158, 606213-217, 606/232, 606/233
• 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 17/0469 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• 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
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• 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 2017/061 : hollow or tubular
• 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 2017/0648 : threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61F 2/0805 : Implements for inserting tendons or ligaments
• 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 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 : Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• CPC Class Codes: A61F 2002/0888 : Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A method of closing a tissue wound includes providing a wound closure device having a first fastener, a second fastener, and a flexible member extending between the first and second fasteners and movably attached to the second fastener by a one-way knot formed in the flexible member between the first and second fastener, positioning the first fastener against tissue, passing the flexible member across the wound, positioning the second fastener against tissue, and pulling on a free end of the flexible member to shorten a length of the flexible member between the first and second fasteners, thereby closing the wound.

Claims

1. A surgical method for repairing a meniscal tear comprising:

positioning a delivery device against a first position on soft tissue comprising a meniscus, the delivery device comprising a needle, a first fixation member positioned within a longitudinal channel of a lumen of the needle and including a protrusion extending from the first fixation member through a longitudinal slot in the needle, and a second fixation member positioned within the longitudinal channel of the lumen and including a protrusion extending from the second fixation member through the longitudinal slot in the needle;

advancing the needle through the soft tissue to a distal outer surface;

withdrawing the needle from the soft tissue such that the first fixation member is pulled from the needle by the interaction of the protrusion of the first fixation member and the soft tissue and such that the entirety of the first fixation member is positioned at one side of the meniscal tear along the external surface of the meniscus;

positioning the delivery device against a second position on the soft tissue;

advancing the needle through the soft tissue to a distal outer surface; and

withdrawing the needle from the soft tissue such that the second fixation member is pulled from the needle by the interaction of the protrusion of the second fixation member and the soft tissue and such that the entirety of the second fixation member is positioned at one side of the meniscal tear along the external surface of the meniscus.

2. The method of claim 1, wherein positioning the delivery device against the first position on soft tissue and positioning the delivery device against the second position on the soft tissue comprises positioning the first fixation member and the second fixation member on opposite sides of a meniscal tear.

3. The method of claim 1, wherein positioning the delivery device against the first position on soft tissue and positioning the delivery device against the second position on the soft tissue comprises positioning the first fixation member and the second fixation member on a same side of a meniscal tear.

4. The method of claim 1, further comprising:

pulling on a free end of a flexible member coupling the first and second fixation members to shorten a length of the flexible member between the first and second fixation members, thereby closing the meniscal tear.

5. The method of claim 4, wherein pulling on the free end of the flexible member moves a slip knot formed in the flexible member along a length of the flexible member to allow the length of the flexible member between the first and second fixation members to be shortened, but not lengthened.

6. The method of claim 1, wherein the slip knot is spaced from the first and second fixation members.

7. The method of claim 4, wherein the flexible member comprises a suture.

8. A surgical method for repairing a meniscal tear comprising:

positioning a delivery device against a first position on soft tissue comprising a meniscus, the delivery device comprising a needle, a first fixation member positioned within a longitudinal channel of a lumen of the needle and including a protrusion extending from the first fixation member through a longitudinal slot in the needle, and a second fixation member positioned within the longitudinal channel of the lumen and including a protrusion extending from the second fixation member through the longitudinal slot in the needle;

advancing the needle through the soft tissue until a tip of the needle and the first fixation member extend through a distal surface of the meniscal tissue;

withdrawing the needle from the soft tissue such that the first fixation member is pulled from the needle by the interaction of the protrusion of the first fixation member and the soft tissue and such that the entirety of the first fixation member is positioned at one side of the meniscal tear along the external surface of the meniscus;

positioning the delivery device against a second position on the soft tissue;

advancing the needle through the soft tissue until a tip of the needle and the second fixation member extend through a distal surface of the meniscal tissue; and

withdrawing the needle from the soft tissue such that the second fixation member is pulled from the needle by the interaction of the protrusion of the second fixation member and the soft tissue and such that the entirety of the second fixation member is positioned at one side of the meniscal tear along the external surface of the meniscus.

9. The method of claim 8, wherein the first fixation member and the second fixation member are positioned on opposite sides of the meniscal tear.

10. The method of claim 8, wherein the first fixation member and the second fixation member are positioned on a same side of the meniscal tear.

11. The method of claim 8, further comprising:

pulling on a free end of a flexible member coupling the first and second fixation members to shorten a length of the flexible member between the first and second fixation members, thereby closing the meniscal tear.

12. The method of claim 11, wherein pulling on the free end of the flexible member moves a slip knot formed in the flexible member along a length of the flexible member to allow the length of the flexible member between the first and second fixation members to be shortened, but not lengthened.

13. The method of claim 12, wherein the slip knot is spaced from the first and second fixation members.

14. The method of claim 8, wherein the flexible member comprises a suture.