Methods and devices to treat diseased or injured musculoskeletal tissue

• US 9,463,010 B2
• Filed: 01/24/2013
• Issued: 10/11/2016
• Est. Priority Date: 05/12/2009
• Status: Active Grant

• Current Assignee: The Foundry Inc.
• Original Assignee: The Foundry Inc.
• Inventors: Gittings, Darin C., Deem, Mark, Hendricksen, Michael, Shenoy, Vivek, Gifford, Hanson S. III, Boyd, Stephen
• Primary Examiner(s): Woo, Julian W
• Assistant Examiner(s): David, Shaun L
• Application Number:
  US13/749,038
• Publication Number:
  US 20140031863A1
• Time in Patent Office: 1,356 Days
• 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 17/0466 Suture bridges
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 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 2017/0422 by insertion of a separate member into the body of the anchor
• CPC Class Codes: A61B 2017/0429 the barbs being expanded by a mechanical mechanism which also locks them in the expanded state
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0459 Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0496 for tensioning sutures

Abstract

A knotless suture anchoring system includes an outer anchor having a central channel and a distal tip adapted to penetrate tissue. An inner anchor is positionable in the central channel of the outer anchor and a locking feature on one or both of the inner and outer anchors retains the inner anchor within the central channel. A continuous length of suture is coupled with the inner and outer suture anchors and has a free end. At least one of the inner and the outer anchors also has a cinching mechanism that allows the suture to be tensioned by passage of the suture through the cinching mechanism in a first direction while movement of the suture through the cinching mechanism in a second direction opposite the first direction is constrained.

Claims

1. A method of knotless suturing comprising:

providing a delivery instrument carrying a first anchor and a second anchor, wherein a continuous length of suture is coupled directly with the first anchor and directly with the second anchor;

advancing the delivery instrument to a treatment region comprising treatment tissue;

placing the first anchor into a first region of the tissue;

coupling the suture to a portion of the treatment tissue;

attaching the second anchor to the first anchor;

tensioning the suture; and

securing the suture without knotting the suture by moving the suture through a cinching mechanism in the first or the second anchor, wherein the cinching mechanism is adapted to allow the suture to move through the cinching mechanism in a first direction while movement of the suture through the cinching mechanism in a second direction opposite the first direction is constrained independently of the position of the second anchor relative to the first anchor.

2. The method of claim 1, wherein the second anchor is stationary relative to the first anchor during the entire step of securing the suture.

3. The method of claim 1, wherein the tissue comprises bone and placing the first anchor comprises drilling a pilot hole into the bone, the pilot hole sized to receive the first or the second anchor.

4. The method of claim 1, further comprising deflecting a distal portion of the delivery instrument.

5. The method of claim 1, wherein the first region of tissue comprises the acetabulum and the treatment tissue comprises an acetabular labrum.

6. The method of claim 1, wherein attaching the second anchor to the first anchor comprises inserting the second anchor into a central channel of the first anchor and locking the two anchors together to prevent axial movement of the first anchor relative to the second anchor.

7. The method of claim 1, wherein the delivery instrument further comprises an actuator mechanism near a proximal end of the instrument and placing the first anchor comprises actuating the actuator mechanism to expose the first or the second anchor from the delivery instrument.

8. The method of claim 1, wherein securing comprises clamping the suture between a deflectable arm and an inner wall of the first or the second anchor.

9. The method of claim 8, wherein the arm is integral with either the first or the second anchor.

10. The method of claim 1, wherein attaching comprises placing the second anchor in a central channel within the first anchor.

11. The method of claim 10, wherein the cinching mechanism is disposed in an inner channel of the second anchor.

12. The method of claim 1, wherein the delivery instrument has a longitudinal axis, and wherein placing the first anchor comprises placing the first anchor into the first region at an angle transverse to the longitudinal axis of the delivery instrument.

13. The method of claim 1, wherein attaching the second anchor to the first anchor comprises actuating a jaw disposed on the delivery instrument.