Soft tissue repair device and associated methods

• US 9,510,819 B2
• Filed: 03/15/2013
• Issued: 12/06/2016
• Est. Priority Date: 02/03/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Stone, Kevin T., Kaiser, Ryan A., Sautter, Nathan M., Holst, Andrew
• Primary Examiner(s): Dornbusch, Dianne
• Application Number:
  US13/838,755
• Publication Number:
  US 20130211452A1
• Time in Patent Office: 1,362 Days
• Field of Search: 606213-216, 606/232, 623/13.11, 623/14.12
• US Class Current: 1/1
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/0469 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 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0493 Protective devices for suturing, i.e. for protecting the patient's organs or the operator
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0406 Pledgets
• 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 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• 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
• CPC Class Codes: A61B 2017/06185 hollow or tubular
• CPC Class Codes: A61B 2017/0646 for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2090/036 : abutting on tissue or skin

Abstract

A fibrous tissue repair device includes first and second tubular anchors having corresponding longitudinal passages. The tissue repair device includes corresponding first and second inserters. Each inserter has a shaft with a distal portion received in the longitudinal passage of the corresponding tubular anchor. A flexible strand couples the first and second anchors.

Claims

1. A method for repairing a meniscal tear in meniscal tissue, comprising:

positioning a first inserter carrying a first anchor on a distal outer surface of the first inserter adjacent to the meniscal tear;

passing a distal end of the first inserter through the meniscal tear and deploying the first anchor at a first location on an outer surface of the meniscal tissue, wherein said deploying the first anchor at the first location includes retracting the first inserter relative to the meniscal tissue;

retracting the first inserter relative to a second inserter;

positioning the second inserter carrying a second anchor on a distal outer surface of the second inserter adjacent to the meniscal tear;

passing a distal end of the second inserter through the meniscal tear and deploying the second anchor at a second location on the outer surface of the meniscal tissue; and

reducing the tear by tightening a flexible strand coupling the first and second anchors.

2. The method of claim 1, wherein said carrying the first anchor on the distal outer surface of the first inserter includes the first anchor in a folded configuration on the distal outer surface of the first inserter.

3. The method of claim 1, further comprising passing the distal end of the first inserter through a cannula.

4. The method of claim 3, further comprising passing the distal end of the second inserter through the cannula.

5. The method of claim 4, further comprising positioning a distal end of the cannula adjacent to the meniscal tear.

6. The method of claim 1, further comprising using the flexible strand to rotate the first anchor on the outer surface of the meniscal tissue.

7. The method of claim 6, further comprising using the flexible strand to rotate the second anchor on the outer surface of the meniscal tissue.

8. The method of claim 1, wherein said retracting the first inserter relative to the second inserter includes the first inserter sliding substantially parallel to the second inserter inside a cannula in which both the first inserter and the second inserter are positioned.

9. The method of claim 1, further comprising passing the first anchor through the meniscal tear in a first orientation and rotating the first anchor to a second orientation outside the meniscal tissue.

10. The method of claim 9, further comprising passing the second anchor through the meniscal tear in a first orientation and rotating the second anchor to a second orientation outside the meniscal tissue.

11. The method of claim 1, further comprising abutting a buttress of the first inserter against a corresponding surface of the first anchor.

12. The method of claim 11, further comprising keying a surface of the first inserter to a corresponding surface of the first anchor.

13. The method of claim 11, wherein said first inserter is a unitary one-piece inserter.

14. The method of claim 11, wherein said carrying the first anchor on the distal outer surface of the first inserter includes the first anchor positioned proximal of the distal end of the first inserter, and wherein the buttress of the first inserter and the distal end of the first inserter are provided by a single shaft body.

15. The method of claim 1, further comprising abutting a buttress of the second inserter against a corresponding surface of the second anchor.

16. The method of claim 1, further comprising sliding the first inserter substantially parallel to the second inserter.

17. The method of claim 1, wherein the first anchor is carried on the distal outer surface of the first inserter without the first inserter penetrating the first anchor.

18. The method of claim 1, wherein passing the distal end of the first inserter through the meniscal tear further includes piercing the meniscal tissue with the distal end of the first inserter that is carrying the first anchor on an exterior of the first inserter.

19. The method of claim 18, wherein the first anchor includes a first end and a second end, the first and second ends of the first anchor being proximal to the distal end of the first inserter, where the distal end of the first inserter forms a passage through the meniscal tissue to carry the first anchor.

20. A method for repairing a meniscal tear in meniscal tissue comprising:

positioning a distal end of a cannula adjacent to a first side of the meniscal tear at a first location;

passing and positioning a distal portion of a first elongated shaft carrying a first anchor through the cannula to the first location;

piercing the meniscus with a distal end of the distal portion of the first elongated shaft, where the first anchor is positioned proximal the distal end to carry the first anchor from the first side of the meniscal tear to a second side of the meniscal tear at a second location on an outer surface of the meniscal tissue;

retracting the first elongated shaft to deploy the first anchor at the second location;

positioning the distal end of the cannula adjacent to the first side of the meniscal tear at a third location;

passing and positioning a distal portion of a second elongated shaft carrying a second anchor through the cannula to the third location;

piercing the meniscal tissue with a distal end of the distal portion of the second elongated shaft, where the second anchor is proximal the distal end to carry the second anchor from the first side of the meniscal tear to the second side of the meniscal tear at a fourth location on an outer surface of the meniscal tissue;

retracting the second elongated shaft to deploy the second anchor at the fourth location; and

reducing the meniscal tear by tightening a flexible strand coupling the first and second anchors.

21. The method of claim 20, further comprising passing the first anchor through the meniscal tear in a first orientation and rotating the first anchor to a second orientation outside the meniscal tissue.

22. The method of claim 20, further comprising passing the second anchor through the meniscal tear in a first orientation and rotating the second anchor to a second orientation outside the meniscal tissue.

23. The method of claim 20, further comprising completely removing the first elongated shaft from the cannula after deploying the first anchor.

24. The method of claim 20, further comprising sliding the first elongated shaft relative to the second elongated shaft.

25. The method of claim 20, further comprising using the flexible strand to rotate the first and second anchors on the outer surface of the meniscal tissue.

26. The method of claim 20, further comprising using a first buttress surface of the first elongated shaft to drive the first anchor through the meniscal tissue and utilizing a second buttress surface of the second elongated shaft to drive the second anchor through the meniscal tissue.

27. The method of claim 26, wherein piercing the meniscal tissue with the distal end of the distal portion of the first elongated shaft includes piercing the meniscal tissue with a sharp edge of the distal end defined by a slanted surface.

28. The method of claim 27, wherein the first anchor includes a first blunt end and a second blunt end and the first anchor is positioned on an exterior surface of the first elongated shaft where the first anchor is carried through the meniscal tissue as the sharp edge of the slanted surface of the distal end pierces the meniscal tissue and the first buttress drives the first anchor through the meniscal tissue.

29. The method of claim 27, wherein the first anchor includes a first blunt end and a second blunt end and the first anchor is positioned on an exterior surface of the first elongated shaft, where the first anchor is carried through the meniscal tissue as the sharp edge of the slanted surface of the distal end pierces the meniscal tissue and the first buttress drives the first anchor through the meniscal tissue.

30. The method of claim 20, wherein reducing the tear further comprises sliding a slip knot of the flexible strand to reduce the tear.

31. A method for repairing a meniscal tear in meniscal tissue comprising:

positioning a distal end of a cannula adjacent to a first side of the meniscal tear at a first location;

passing and positioning a distal portion of a first elongated shaft carrying a first anchor through the cannula to the first location;

piercing the meniscal tissue with a sharp edge of a distal end of the distal portion of the first elongated shaft defined by a slanted surface, where the first anchor is positioned proximal the distal end to carry the first anchor from the first side of the meniscal tear to a second side of the meniscal tear at a second location on an outer surface of the meniscal tissue by driving the first anchor through the meniscal tissue using a first buttress surface of the first elongated shaft that engages the first anchor;

retracting the first elongated shaft to deploy the first anchor at the second location;

positioning the distal end of the cannula to the first side of the meniscal tear at a third location;

passing and positioning a distal portion of a second elongated shaft carrying a second anchor through the cannula to the third location;

piercing the meniscal tissue with a sharp edge of a distal end of the distal portion of the second elongated shaft defined by a slanted surface, where the second anchor is positioned proximal the distal end to carry the second anchor from the first side of the meniscal tear to the second side of the meniscal tear at a fourth location on an outer surface of the meniscal tissue by driving the second anchor through the meniscal tissue using a second buttress surface of the second elongated shaft that engages the second anchor;

retracting the second elongated shaft to deploy the second anchor at the fourth location; and

reducing the meniscal tear by tightening a flexible strand coupling the first and second anchors.

32. The method of claim 31, further comprising passing the first anchor through the meniscal tear in a first orientation and rotating the first anchor to a second orientation outside the meniscal tissue.

33. The method of claim 31, further comprising completely removing the first elongated shaft from the cannula after deploying the first anchor.

34. The method of claim 31, further comprising sliding the first elongated shaft relative to the second elongated shaft.

35. The method of claim 31, wherein reducing the tear further comprises sliding a slip knot of the flexible strand to reduce the tear.