Method and apparatus for attaching tissue to bone, including the provision and use of a novel knotless suture anchor system

• US 9,826,973 B2
• Filed: 12/12/2014
• Issued: 11/28/2017
• Est. Priority Date: 07/17/2009
• Status: Active Grant

• Current Assignee: Stryker Puerto Rico Holdings BV (Stryker Corporation)
• Original Assignee: Pivot Medical, Inc. (Stryker Corporation)
• Inventors: Graul, Jeremy, Burley, J. Brook
• Primary Examiner(s): LYNCH, ROBERT A
• Application Number:
  US14/568,805
• Publication Number:
  US 20150100087A1
• Time in Patent Office: 1,082 Days
• 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 17/0485 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 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 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 lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/0425 the anchor or the separate member comprising threads, e.g. a set screw in the anchor
• 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: A61B 2017/0453 threaded elements, e.g. set screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 90/57 Accessory clamps

Abstract

Apparatus for securing an object to bone, the apparatus comprising: an anchor, the anchor comprising: a body comprising an opening for receiving a filament therein; and a locking element movably mounted to the body for selectively locking the filament to the body; and an inserter for deploying the anchor in bone, the inserter comprising: a handle; an overtube extending distally from the handle; a carriage movably mounted to the handle; a shaft movably mounted within the overtube and connected to the carriage and releasably connected to the body of the anchor, the shaft being hollow; and a rod movably mounted within the shaft and connected to the locking element.

Claims

1. Apparatus for securing an object to bone, said apparatus comprising:

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element, at least a portion of which is movably disposed within said body, for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle, said overtube comprising a proximal end and a distal end, wherein the proximal end is fixedly attached to the handle, and wherein the distal end is configured to engage the bone and to receive at least a portion of the anchor;

a hollow shaft comprising a proximal end and a distal end, wherein at least a portion of said hollow shaft is movably disposed within said overtube, and wherein said body of said anchor is releasably mechanically connected to the distal end of the hollow shaft; and

an elongated member comprising a proximal end a distal end, wherein at least a portion of said elongated member is movably disposed within said hollow shaft, wherein the distal end of said elongated member is connected to said locking element.

2. Apparatus according to claim 1 wherein the distal end of said overtube is curved.

3. Apparatus according to claim 2 wherein the distal end of said hollow shaft is flexible.

4. Apparatus according to claim 3 wherein said hollow shaft is formed out of a shape memory alloy.

5. Apparatus according to claim 2 wherein at least a portion of said elongated member is flexible.

6. Apparatus according to claim 1 wherein said hollow shaft comprises a plurality of slits formed therein.

7. Apparatus according to claim 6 wherein each of said plurality of slits extends substantially perpendicular to the longitudinal axis of said hollow shaft.

8. Apparatus according to claim 1 wherein said handle comprises a carriage movably mounted to said handle, and further wherein said hollow shaft is mounted to said carriage.

9. Apparatus according to claim 8 wherein said carriage comprises a drive head extending out of said handle, such that applying a force to said drive head moves said carriage relative to said handle.

10. Apparatus according to claim 9 further comprising a mechanism for creating a force which must be overcome in order to enable distal movement of said carriage relative to said handle.

11. Apparatus according to claim 8 further comprising a removable stop for selectively locking said carriage relative to said handle.

12. Apparatus according to claim 8 further comprising a mechanism for limiting movement of said carriage relative to said handle to substantially one-way movement.

13. Apparatus according to claim 8 wherein the carriage is configured to move the elongated member to lock the filament to the body of the anchor.

14. Apparatus according to claim 1 wherein proximal movement of said elongated member moves said locking element proximally to lock the filament to said body.

15. Apparatus according to claim 1 wherein the elongated member comprises a rod.

16. Apparatus according to claim 15 wherein the rod is releasably connected to the locking element.

17. Apparatus for securing an object to bone, said apparatus comprising:

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element, at least a portion of which is movably disposed within said body, for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle, said overtube comprising a proximal end and a distal end, wherein the proximal end is fixedly attached to the handle, and wherein the distal end is configured to engage the bone and to receive at least a portion of the anchor;

a carriage movably mounted to said handle;

a hollow shaft comprising a proximal end and a distal end, wherein at least a portion of said hollow shaft is movably disposed within said overtube, wherein the proximal end of the hollow shaft is connected to said carriage, and wherein said body of said anchor is releasably mechanically connected to the distal end of the hollow shaft; and

an elongated member comprising a proximal end a distal end, wherein at least a portion of said elongated member is movably disposed within said hollow shaft, wherein the distal end of said elongated member is connected to said locking element.

18. Apparatus according to claim 17 wherein said carriage comprises a drive head extending out of said handle, such that applying a force to said drive head moves said carriage.

19. Apparatus according to claim 18 further comprising a mechanism for creating a force which must be overcome in order to enable distal movement of said carriage relative to said handle.

20. Apparatus according to claim 17 further comprising a removable stop for selectively locking said carriage relative to said handle.

21. Apparatus according to claim 17 further comprising a mechanism for limiting movement of said carriage relative to said handle to substantially one-way movement.

22. Apparatus according to claim 17 wherein at least a portion of said hollow shaft is flexible.

23. Apparatus according to claim 22 wherein the distal end of said overtube is curved.

24. Apparatus according to claim 22 wherein said hollow shaft is formed out of a shape memory alloy.

25. Apparatus according to claim 22 wherein said hollow shaft comprises a plurality of slits formed therein.

26. Apparatus according to claim 25 wherein each of said plurality of slits extends substantially perpendicular to the longitudinal axis of said hollow shaft.

27. Apparatus for securing an object to bone, said apparatus comprising:

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle, said overtube comprising a proximal end and a distal end, wherein the proximal end is fixedly attached to the handle, and wherein the distal end is configured to engage the bone and to receive at least a portion of the anchor;

a carriage movably mounted to said handle; and

a hollow shaft comprising a proximal end and a distal end, wherein at least a portion of said hollow shaft is movably disposed within said overtube, wherein the proximal end of the hollow shaft is connected to said carriage, wherein said body of said anchor is releasably mechanically connected to the distal end of the hollow shaft, and further wherein movement of said carriage moves said hollow shaft and hence said anchor.

28. A method for securing an object to bone, said method comprising:

providing apparatus comprising;

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element, at least a portion of which is movably disposed within said body, for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle, said overtube comprising a proximal end and a distal end, wherein the proximal end is fixedly attached to the handle, and wherein the distal end is configured to engage the bone and to receive at least a portion of the anchor;

a hollow shaft comprising a proximal end and a distal end, wherein at least a portion of said hollow shaft is movably disposed within said overtube, and wherein said body of said anchor is releasably mechanically connected to the distal end of the hollow shaft; and

an elongated member comprising a proximal end a distal end, wherein at least a portion of said elongated member is movably disposed within said hollow shaft, wherein the distal end of said elongated member is connected to said locking element;

forming a hole in the bone; and

using the inserter to insert the anchor into the hole formed in the bone.

29. A method for securing an object to bone, said method comprising:

providing apparatus comprising;

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element, at least a portion of which is movably disposed within said body, for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle, said overtube comprising a proximal end and a distal end, wherein the proximal end is fixedly attached to the handle, and wherein the distal end is configured to engage the bone and to receive at least a portion of the anchor;

a carriage movably mounted to said handle;

a hollow shaft comprising a proximal end and a distal end, wherein at least a portion of said hollow shaft is movably disposed within said overtube, wherein the proximal end of the hollow shaft is connected to said carriage, and wherein said body of said anchor is releasably mechanically connected to the distal end of the hollow shaft; and

an elongated member comprising a proximal end a distal end, wherein at least a portion of said elongated member is movably disposed within said hollow shaft, wherein the distal end of said elongated member is connected to said locking element;

forming a hole in the bone; and

using the inserter to insert the anchor into the hole formed in the bone.

30. A method for securing an object to bone, said method comprising:

providing apparatus comprising;

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle, said overtube comprising a proximal end and a distal end, wherein the proximal end is fixedly attached to the handle, and wherein the distal end is configured to engage the bone and to receive at least a portion of the anchor;

a carriage movably mounted to said handle; and

a hollow shaft comprising a proximal end and a distal end, wherein at least a portion of said hollow shaft is movably disposed within said overtube, wherein the proximal end of the hollow shaft is connected to said carriage, wherein said body of said anchor is releasably mechanically connected to the distal end of the hollow shaft, and further wherein movement of said carriage moves said hollow shaft and hence said anchor;

forming a hole in the bone; and

using the inserter to insert the anchor into the hole formed in the bone.

31. Apparatus for securing an object to bone, said apparatus comprising:

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element movably mounted to said body for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle;

a shaft movably mounted within said overtube and releasably connected to said body of said anchor, said shaft being hollow; and

a rod movably mounted within said shaft and connected to said locking element;

wherein at least a portion of said shaft is flexible;

wherein said handle comprises a carriage movably mounted to said handle, wherein said shaft is mounted to said carriage, and further wherein the apparatus comprises a mechanism for limiting movement of said carriage relative to said handle to substantially one-way movement.

32. Apparatus for securing an object to bone, said apparatus comprising:

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element movably mounted to said body for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle;

a shaft movably mounted within said overtube and releasably connected to said body of said anchor, said shaft being hollow; and

a rod movably mounted within said shaft and connected to said locking element;

wherein at least a portion of said shaft is flexible;

wherein said handle comprises a carriage movably mounted to said handle, wherein said shaft is mounted to said carriage, wherein said carriage comprises a drive head extending out of said handle, such that applying a force to said drive head moves said carriage relative to said handle, and further wherein the apparatus comprises a mechanism for creating a force which must be overcome in order to enable distal movement of said carriage relative to said handle.

33. Apparatus for securing an object to bone, said apparatus comprising:

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element movably mounted to said body for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle;

a carriage movably mounted to said handle;

a shaft movably mounted within said overtube and connected to said carriage and releasably connected to said body of said anchor, said shaft being hollow;

a rod movably mounted within said shaft and connected to said locking element; and

a mechanism for limiting movement of said carriage relative to said handle to substantially one-way movement.

34. Apparatus for securing an object to bone, said apparatus comprising:

an anchor, said anchor comprising;

a body comprising an opening for receiving a filament therein; and

a locking element movably mounted to said body for selectively locking said filament to said body; and

an inserter for deploying said anchor in bone, said inserter comprising;

a handle;

an overtube extending distally from said handle;

a carriage movably mounted to said handle, wherein said carriage comprises a drive head extending out of said handle, such that applying a force to said drive head moves said carriage;

a shaft movably mounted within said overtube and connected to said carriage and releasably connected to said body of said anchor, said shaft being hollow;

a rod movably mounted within said shaft and connected to said locking element; and

a mechanism for creating a force which must be overcome in order to enable distal movement of said carriage relative to said handle.