Knotless suture and tissue securing method

• US 9,706,986 B2
• Filed: 11/09/2015
• Issued: 07/18/2017
• Est. Priority Date: 06/22/2000
• Status: Expired due to Term

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Burkhart, Stephen S., ElAttrache, Neal S., Dreyfuss, Peter J.
• Primary Examiner(s): BUI, VY Q
• Application Number:
  US14/935,778
• Publication Number:
  US 20160058551A1
• Time in Patent Office: 617 Days
• Field of Search: 606 73, 606 75, 606139, 606144, 606232
• 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 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8645 Headless screws, e.g. ligament interference screws
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2017/0403 Dowels
• 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 2017/044 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 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• 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 2002/0835 with deformation of anchor parts, e.g. expansion of dowel by set screw
• 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 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

An illustrative example suture securing method includes moving a first member in an insertion direction into bone. The first member includes an eyelet and suture threaded through the eyelet transverse to the insertion direction. The method includes moving a second member relative to the first member in the insertion direction into a suture securing position where the second member traps the suture.

Claims

1. A knotless suture and tissue securing method, comprising:

placing a first member in a bone, the first member being situated near a distal end of an inserter, the inserter having a proximal end and a longitudinal axis between the distal end and the proximal end, the first member including an eyelet and having a suture threaded through the eyelet across the longitudinal axis;

manipulating the suture including moving the suture relative to the eyelet to bring soft tissue into a selected position near the bone; and

moving a second member relative to the first member in a distal direction toward the eyelet until the second member pins the suture against the second member in the bone to thereby securely hold the soft tissue in the selected position without tying knots in the suture.

2. The method of claim 1, wherein

the second member comprises a screw and moving the second member in the distal direction comprises rotating the screw to advance the screw in the distal direction.

3. The method of claim 1, wherein

the second member comprises a plug and moving the second member in the distal direction comprises using an impact force to advance the plug in the distal direction.

4. The method of claim 1, wherein

the inserter comprises a handle near the proximal end;

the inserter comprises a first shaft and a second shaft;

and the method comprises

using at least the first shaft for placing the first member in the bone; and

using at least the second shaft for moving the second member in the distal direction.

5. The method of claim 1, wherein

manipulating the suture comprises

grasping two ends of the suture extending away from one side of the eyelet;

and

moving the two ends of the suture in an at least partially proximal direction to draw the soft tissue into the selected position;

and

wherein

moving the second member in the distal direction includes moving the second member into engagement with two portions of the suture between the two ends and the soft tissue; and

the two portions of the suture are respectively pinned against a surface on the second member.

6. The method of claim 5, wherein the two portions of suture are respectively pinned between an outer surface of the second member and the bone.

7. The method of claim 5, wherein

the second member holds the two portions of suture in a fixed position relative to the bone to thereby securely fasten the soft tissue in the selected position without tying knots in the suture.

8. The method of claim 1, comprising

threading the suture through the soft tissue so that two free ends of the suture are situated away from the soft tissue;

passing the two free ends of the suture through the eyelet to thread the suture through the eyelet across the longitudinal axis.

9. The method of claim 1, wherein

the first member comprises a loop of suture.

10. The method of claim 1, wherein moving the second member at least partially covers the eyelet of the first member.

11. A surgical method, comprising:

capturing a portion of soft tissue with a suture;

threading two free ends of the suture through an eyelet of a first member;

moving the first member in an insertion direction into bone, wherein the suture is threaded through the eyelet transverse to the insertion direction;

moving the two free ends of the suture relative to the first member to thereby position the soft tissue near the bone in a selected position; and

moving a second member relative to the first member in the insertion direction until the second member contacts the suture to securely fasten the soft tissue in place near the bone in the selected position without tying knots in the suture.

12. The method of claim 11, wherein

the second member comprises a screw and moving the second member in the insertion direction comprises rotating the screw to advance the screw in the insertion direction.

13. The method of claim 11, wherein

the second member comprises a plug and moving the second member in the insertion direction comprises using an impact force to advance the plug in the insertion direction.

14. The method of claim 11, comprising

using a driver for moving the first member and moving the second member;

and

wherein

the driver has a length and a width,

the length is greater than the width,

the length is parallel to the insertion direction,

the first member is supported by the driver,

the eyelet is transverse to the length,

the second member is supported by the driver,

the driver has a distal end and a proximal end,

the insertion direction corresponds to a direction from the proximal end toward the distal end, and

the first member is situated at least partially beyond the distal end of the driver,

the driver comprises a handle and a rod extending from the handle;

the rod includes a first shaft and a second shaft;

the first shaft facilitates inserting the first member in the bone;

the second shaft facilitates moving the second member in the insertion direction; and

the handle is at least partially moveable relative to at least the first shaft for moving the second shaft to cause the second member to move in the insertion direction.

15. The method of claim 14, wherein

the second shaft is moveable relative to the first shaft for moving the second member in the insertion direction.

16. The method of claim 11, wherein

moving the suture comprises

grasping the two free ends of the suture;

and

pulling on the two free ends of the suture in an at least partially proximal direction to draw the soft tissue into the selected position.

17. The method of claim 16, wherein

moving the second member into the suture securing position moves the second member into engagement with portions of the suture between the two free ends and the soft tissue;

and

the portions of the suture are respectively pinned against a surface on the second member.

18. The method of claim 16, wherein the portions of suture are respectively pinned between the surface of the second member and the bone.

19. The method of claim 16, wherein

the second member holds the portions of suture in a fixed position relative to the bone to thereby securely fasten the soft tissue in the selected position relative to the bone without tying knots in the suture.

20. The method of claim 11, wherein

the first member comprises a loop of suture.

21. The method of claim 11, wherein moving the second member at least partially covers the eyelet of the first member.