Methods for tissue repair

• US 9,295,461 B2
• Filed: 11/10/2014
• Issued: 03/29/2016
• Est. Priority Date: 12/02/1999
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Bojarski, Raymond A., Sikora, George, Torrie, Paul Alexander, Ek, Steven W.
• Primary Examiner(s): HOLWERDA, KATHLEEN SONNETT
• Application Number:
  US14/537,794
• Publication Number:
  US 20150066060A1
• Time in Patent Office: 505 Days
• Field of Search: 606/139, 606144-148, 606228-232
• 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 method of closing a tissue wound comprising:

positioning a first fastener of a wound closure device against tissue, the wound closure device having a second fastener, 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, and a needle having an open tip and defining a bore that connects to the open tip, the first and second fasteners being at least partially disposed within the bore;

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;

wherein the needle further defines a slit that connects to the bore and to the open tip, the first fastener including a projection that protrudes through the slit, and

wherein positioning the first fastener of the wound closure device against tissue includes engaging the projection with tissue to remove the first fastener from the bore.

2. The method of claim 1, wherein the flexible member is slidably attached to the second fastener by the one-way knot such that, after pulling on the free end of the flexible member, the length of the flexible member between the first and second fasteners remains shortened.

3. The method of claim 2, wherein the second fastener defines a partially enclosed region, the partially enclosed region housing at least a portion of the one-way knot, and the partially enclosed region being located such that, during pulling on the free end of the flexible member, the portion of the one-way knot disposed within the partially enclosed region avoids contact with tissue.

4. The method of claim 1, wherein positioning the first fastener of the wound closure device against tissue includes positioning the first fastener on a first side of the wound, passing the flexible member across the wound includes passing the flexible member from the first side to a second side of the wound, engaging tissue on the second side, and returning the flexible member to the first side, and positioning the second fastener against tissue includes positioning the second fastener on the first side of the wound.

5. The method of claim 1, wherein the flexible member passes through a through-hole in the second fastener, and a second flexible member also passes through the through-hole in the second fastener, the second flexible member having a thickened portion that is wider than the through-hole, the method further comprising pulling the second flexible member until the thickened portion wedges into the through-hole.

6. A method of closing a tissue wound comprising:

passing a first fastener of a wound closure device through tissue, the wound closure device having a second fastener, a flexible member including a slip knot between the first and second fasteners, the flexible member coupling the first and second fasteners and being movably attached to the second fastener, and a needle having an open tip and defining a bore that connects to the open tip, the first and second fasteners being at least partially disposed within the bore;

passing the flexible member across the wound;

passing the second fastener through 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, the slip knot allowing the length of the flexible member to be shortened, but not lengthened;

wherein the needle further defines a slit that connects to the bore and to the open tip, the first fastener including a projection that protrudes through the slit; and

wherein positioning the first fastener of the wound closure device against tissue includes engaging the projection with tissue to remove the first fastener from the bore.

7. The method of claim 6, wherein the flexible member comprises a suture.

8. The method of claim 6, wherein the slip knot is spaced from the first and second fasteners.