Apparatus for tissue repair

• US 9,833,231 B2
• Filed: 01/08/2010
• Issued: 12/05/2017
• Est. Priority Date: 12/02/1999
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Bojarski, Ray, Sikora, George, Torrie, Paul Alexander, Ek, Steven
• Primary Examiner(s): HOLWERDA, KATHLEEN SONNETT
• Application Number:
  US12/684,722
• Publication Number:
  US 20100114161A1
• Time in Patent Office: 2,888 Days
• Field of Search: 606139, 606144-148, 606228-232, 606224, 606225, 606213-217, 112222, 223102
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0404 Buttons
• 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 2017/0417 T-fasteners
• 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 2017/044 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 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/061 : hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/0646 : for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0648 : threaded, e.g. tacks with a screw thread
• 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 2002/0829 : without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
• 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 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• 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 apparatus includes first and second fixation members, a flexible member coupled to the first and second fixation members, and a limiting element coupled to the flexible member. The limiting element is movable relative to the second fixation member and acts to limit loosening of the flexible member relative to the second fixation member. The limiting element can be slidably received by the flexible member. The flexible member can be coupled to the fixation members such that pulling on a free end of the flexible member shortens a length of the flexible member between the fixation members.

Claims

1. An apparatus for tissue repair, comprising:

first and second fixation members, the first fixation member comprising a cylindrical body having a proximal end, a distal end and a longitudinal axis extending therebetween; and

a flexible member forming a knot, the flexible member including;

a first loop, having a portion less than the entire first loop that passes through the knot;

a first section threaded around and through the first loop and coiled around the first loop; and

a second section passing through a second loop at least partially formed by the first section and terminating at a free end of the flexible member;

wherein the first fixation member further comprises first and second parallel through holes for receiving the flexible member, each of the first and second through holes extending through a first surface and through a second surface opposite the first surface transverse to the longitudinal axis;

wherein the second fixation member is slidably attached to the first loop and is trapped on the first loop by the knot and the first fixation member is substantially immovably attached to the free end of the flexible member; and

wherein the first and second fixation members are the same.

2. The apparatus of claim 1, wherein the flexible member comprises a suture.

3. The apparatus of claim 1 being preassembled for use in a surgical procedure.

4. The apparatus of claim 1, wherein the flexible member is routed through the first through hole of the first fixation member from the first surface to the second surface, across the second surface, and then through the second through hole from the second surface to the first surface.

5. An apparatus for use in a surgical procedure, comprising:

first and second fixation members, the first fixation member comprising a cylindrical body having a proximal end, a distal end and a longitudinal axis extending therebetween; and

a flexible member coupling the first and second fixation members, the flexible member having two terminal ends, one of the terminal ends terminating at the first fixation member, the flexible member forming a slip knot, the slip knot including a pair of loops surrounding the flexible member that passes through the slip knot, such slip knot being between the fixation members and being preformed prior to use of the apparatus in a form for use, a first loop having a portion that is less than the entire first loop which passes through the slip knot;

wherein the first fixation member further comprises first and second parallel through holes for passage of the flexible member, each of the first and second through holes extending through a first surface and through a second surface opposite the first surface transverse to the longitudinal axis;

wherein the second fixation member is trapped on the first loop by the slip knot, the slip knot acting to limit slipping of the first loop; and

wherein the first and second fixation members are the same.

6. The apparatus of claim 5, wherein the flexible member comprises a suture.

7. The apparatus of claim 5, wherein the flexible member is routed through the first through hole of the first fixation member from the first surface to the second surface, across the second surface, and then through the second through hole from the second surface to the first surface.

8. The apparatus of claim 5, wherein the flexible member is movably coupled to the second fixation member.

9. The apparatus of claim 5, wherein the flexible member extends substantially from the second fixation member to the first fixation member and terminates prior to extending back to the second fixation member and the flexible member is substantially immovably secured to the first fixation member and movably coupled to the second fixation member.

10. The apparatus of claim 5, wherein the knot is spaced from the first and second fixation members.

11. An apparatus for use in a surgical procedure, comprising:

first and second fixation members, the first fixation member comprising a cylindrical body having a proximal end, a distal end and a longitudinal axis extending therebetween; and

a flexible member coupling the first and second fixation members, the flexible member forming a slip knot, the slip knot including a pair of loops surrounding the flexible member that passes through the slip knot, such slip knot being between the first and second fixation members and being preformed prior to use of the apparatus in a form for use, a first loop having a portion that is less than the entire first loop which passes through the slip knot;

wherein the first fixation member further comprises first and second parallel through holes for passage of the flexible member, each of the first and second through holes extending through a first surface and through a second surface opposite the first surface transverse to the longitudinal axis;

wherein the second fixation member is trapped on the first loop by the slip knot, the slip knot acting to limit slipping of the first loop;

wherein the flexible member extends substantially from the second fixation member to the first fixation member and terminates prior to extending back to the second fixation member; and

wherein the first and second fixation members are the same.

12. The apparatus of claim 11, wherein the flexible member comprises a suture.

13. The apparatus of claim 11, wherein the flexible member is routed through the first through hole of the first fixation member from the first surface to the second surface, across the second surface, and then through the second through hole from the second surface to the first surface.

14. The apparatus of claim 11, wherein the flexible member is movably coupled to the second fixation member.

15. The apparatus of claim 11, wherein the flexible member is substantially immovably secured to the first fixation member and movably coupled to the second fixation member.

16. The apparatus of claim 11, wherein the knot is spaced from the first and second fixation members.