Bone anchor installer and method of use

• US 9,539,001 B2
• Filed: 04/30/2014
• Issued: 01/10/2017
• Est. Priority Date: 03/22/2006
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Tornier Incorporated
• Inventors: Fanton, Gary S., Krumme, John
• Primary Examiner(s): SEVILLA, CHRISTIAN ANTHONY
• Application Number:
  US14/266,577
• Publication Number:
  US 20140296911A1
• Time in Patent Office: 986 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 17/0483 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 17/0487 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 17/062 Needle manipulators
• 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 2017/0427 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 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• 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 2017/0453 threaded elements, e.g. set screws
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0459 Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied

Abstract

Systems, apparatuses and methods for securing tissue to bone using a bone anchoring system are described. Methods and apparatuses may allow transformation between locked and unlocked states, thereby allowing adjustment of the tension in the suture. The apparatus and/or methods may allow unidirectional movement of a suture, while preventing slippage or movement of the suture and tissue in the opposite direction. Ends of a suture may be individually tensioned to adjust positioning of a tissue with respect to a bone.

Claims

1. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion;

removably coupling at least a first portion of an anchor holder to the distal end of the loading portion;

removably coupling a second portion of the anchor holder to the first portion, wherein the first and second portions are separable halves of the anchor holder;

threading a suture through the bone anchor and the anchor holder; and

removing the anchor holder from the distal end of the loading portion.

6. The method of claim 1, comprising delivering the bone anchor and the loading portion to a surgical site through a cannula.

11. The method of claim 1, wherein the first and second portions completely encircle the bone anchor.

2. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion, wherein releasably attaching comprises retaining the bone anchor to the loading portion with a tether;

removably coupling at least a first portion of an anchor holder to the distal end of the loading portion;

removably coupling a second portion of the anchor holder to the first portion;

threading a suture through the bone anchor and the anchor holder; and

removing the anchor holder from the distal end of the loading portion.

3. The method of claim 2, wherein the tether extends from the bone anchor to a proximal end of the loading portion.

4. The method of claim 2, comprising varying a tension on the tether.

5. The method of claim 2, comprising releasing the tether from near a proximal end of the loading portion.

7. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion;

removably coupling at least a first portion of an anchor holder to the distal end of the loading portion;

removably coupling a second portion of the anchor holder to the first portion;

threading a suture through the bone anchor and the anchor holder, wherein threading the suture comprises coupling a suture puller to the anchor holder and the bone anchor;

coupling the suture to a distal end of the suture puller; and

pulling the suture puller through the anchor holder and the bone anchor to couple the suture to the bone anchor; and

removing the anchor holder from the distal end of the loading portion.

8. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion;

removably coupling at least a first portion of an anchor holder to the distal end of the loading portion;

removably coupling a second portion of the anchor holder to the first portion;

threading a suture through the bone anchor and the anchor holder, wherein threading the suture comprises threading the suture through a two bar locking mechanism of the bone anchor; and

removing the anchor holder from the distal end of the loading portion.

9. The method of claim 8, comprising the steps of:

threading the suture between a first locking bar and the bone anchor from a side opposite a second locking bar;

threading the suture around the second locking bar; and

threading the suture back through a space between the first and second locking.

10. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion;

removably coupling at least a first portion of an anchor holder to the distal end of the loading portion;

removably coupling a second portion of the anchor holder to the first portion, wherein the first and second portions completely encircle the distal end of the loading portion;

threading a suture through the bone anchor and the anchor holder; and

removing the anchor holder from the distal end of the loading portion.

12. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion;

removably coupling at least a first portion of an anchor holder to the distal end of the loading portion;

removably coupling a second portion of the anchor holder to the first portion;

threading a suture through the bone anchor and the anchor holder, wherein threading the suture comprises coupling the suture to a first end of a suture puller; and

pulling a second end of the suture puller through the anchor holder and the bone anchor; and

removing the anchor holder from the distal end of the loading portion.

13. The method of claim 12, wherein the first end and the second end both protrude laterally from the anchor holder.

14. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion;

removably coupling an anchor holder with a cavity to the distal end of the loading portion and the bone anchor;

threading a suture through the bone anchor and the anchor holder, wherein threading the suture comprises threading the suture through a two bar locking mechanism of the bone anchor;

uncoupling the anchor holder from the loading portion while the distal end of the loading portion and the bone anchor are within the cavity; and

removing the anchor holder from the distal end of the loading portion.

15. The method of claim 14, further comprising:

threading the suture between a first locking bar and the bone anchor from a side opposite a second locking bar;

threading the suture around the second locking bar; and

threading the suture back through a space between the first and second locking bars.

16. A method comprising:

releasably attaching a bone anchor to a distal end of a loading portion;

removably coupling at least a first portion of an anchor holder to the distal end of the loading portion, wherein the first portion defines a first inner surface of a cavity, wherein the first inner surface is on one side of the bone anchor;

removably coupling a second portion of the anchor holder to the first portion, wherein the second portion defines a second inner surface of the cavity, wherein the second inner surface is on another side of the bone anchor;

threading a suture through the bone anchor and the anchor holder, wherein threading the suture comprises threading the suture through a two bar locking mechanism of the bone anchor; and

removing the anchor holder from the distal end of the loading portion.

17. The method of claim 16, further comprising:

threading the suture between a first locking bar and the bone anchor from a side opposite a second locking bar;

threading the suture around the second locking bar; and

threading the suture back through a space between the first and second locking bars.