Tissue fastening system

• US 9,867,706 B2
• Filed: 04/30/2013
• Issued: 01/16/2018
• Est. Priority Date: 10/26/2004
• Status: Active Grant

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US13/873,389
• Publication Number:
  US 20130238039A1
• Time in Patent Office: 1,722 Days
• Field of Search: 623 1711- 1716, 606246-278
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/56 Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/7022 Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables A61B17/702 takes precedence
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/8869 Tensioning devices
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/30749 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/2817 Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30677 Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/4435 Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2002/444 for replacing the nucleus pulposus
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00359 : Bone or bony tissue
• CPC Class Codes: A61L 2430/38 : for reconstruction of the spine, vertebrae or intervertebral discs
• CPC Class Codes: A61L 27/12 : Phosphorus-containing materials, e.g. apatite
• CPC Class Codes: A61L 27/225 : Fibrin; Fibrinogen
• CPC Class Codes: A61L 27/24 : Collagen
• CPC Class Codes: A61L 27/3834 : Cells able to produce different cell types, e.g. hematopoietic stem cells, mesenchymal stem cells, marrow stromal cells, embryonic stem cells
• CPC Class Codes: A61L 27/54 : Biologically active materials, e.g. therapeutic substances A61L27/227 takes precedence
• CPC Class Codes: A61L 27/58 : Materials at least partially resorbable by the body

Abstract

A stabilization implant, such as a rod or plate, may be positioned adjacent spinous processes. Fasteners and sutures may be used to secure the rod or plate to the spine. A plurality of fasteners may be positioned against the rod or plate proximate to each spinous process. A second plurality of fasteners may be placed within or against the spinous processes. Sutures may extend between the fasteners and may be tensioned. The plate or rod may be positioned within or against the fractured bone. A fastener may be driven across the bone and locked onto the plate, rod, or another fastener.

Claims

1. A tissue fastening system comprising:

a stabilization implant, wherein the stabilization implant is one of a plate or rod, and wherein the stabilization implant has at least two apertures;

a suture, the suture having two legs;

a toggling suture anchor having two slots for receiving the two legs of the suture, the toggling suture anchor configured to contact with a first tissue portion and configured to provide an anchor against the first tissue portion to enable tensioning of the two legs of suture;

a first fastener, having at least two slots, configured to at least partially contact the stabilization implant at a first position and secure the stabilization implant against a second tissue portion, wherein the first fastener is configured to allow passage of the two legs of suture, and

wherein the suture is configured to pass through a first aperture in the stabilization implant and through the first fastener, be tensioned, and fastened by the first fastener to limit relative motion between the first and second tissue portions; and

a second fastener configured to secure the stabilization implant against a third tissue portion, wherein the second fastener is positioned against the stabilization implant at a second position.

2. The system of claim 1, wherein the first fastener is one of an anchor and a button.

3. The system of claim 1, wherein the second fastener is one of an anchor, a button, and a screw.

4. The system of claim 1, wherein the second and third tissue portions are portions of the same bone.

5. The system of claim 1, wherein the first and second tissue portions are portions of different bones.

6. The system of claim 1, wherein the first or second tissue portion includes at least a portion of a knee, ankle, elbow, wrist, foot, hand, hip, shoulder, and jaw.

7. The system of claim 1, wherein at least one of the first, second, and third tissue portions include a portion of a spine.

8. The system of claim 1, wherein at least one of the first, second, and third tissue portions include a portion of a bone.

9. The system of claim 1, wherein at least one of the first, second, and third tissue portions include a portion of soft tissue.

10. The system of claim 9, wherein the soft tissue includes at least a portion of a muscle, ligament, tendon, and skin.

11. The system of claim 1, wherein at least one of the first, second, and third tissue portions include at least one of a portion of collagen, cartilage, and tissue graft.

12. The system of claim 1, wherein the first or second tissue portions include a portion of a spinous process.

13. The system of claim 1, wherein at least one of the first, second, and third tissue portions include at least a portion of a tibia and fibula.

14. A tissue fastening system comprising:

a plate configured to be positionable against a first tissue portion;

a suture, the suture having two legs;

a suture anchor having two slots for receiving the two legs of the suture, the suture anchor configured to provide an anchor against a second tissue portion to enable tensioning of the two legs of suture;

a first fastener, having at least two slots, configured to at least partially contact the plate at a first position, position the plate against the first tissue portion, and secure the two legs of suture relative to the plate,

wherein the suture is configured to pass through the plate and through the first fastener and be tensioned relative to the plate to limit relative motion between the first and second tissue portions; and

a second fastener configured to secure the plate against a third tissue portion, wherein the second fastener is positioned against the plate at a second position.

15. The system of claim 14, wherein the first fastener is one of an anchor and a button.

16. The system of claim 14, wherein the first or second tissue portion includes at least a portion of a knee, ankle, elbow, wrist, foot, hand, hip, shoulder, and jaw.

17. The system of claim 14, wherein at least one of the first, second, and third tissue portions include a portion of a bone.

18. The system of claim 14, wherein the first and third tissue portions are portions of the same bone.

19. The system of claim 14, wherein at least one of the first, second, and third tissue portions include a portion of soft tissue.

20. The system of claim 19, wherein the soft tissue includes at least a portion of a muscle, ligament, tendon, and skin.

21. The system of claim 14, wherein at least one of the first, second, and third tissue portions include at least one of a portion of collagen, cartilage, and tissue graft.

22. The system of claim 14, wherein the first and second tissue portions are portions of different bones.

23. The system of claim 14, wherein at least one of the first, second, and third tissue portions include at least a portion of a tibia and fibula.

24. The system of claim 14, wherein the second fastener is one of an anchor, a button, and a screw.

25. A tissue fastening system comprising:

a stabilization plate, wherein the stabilization plate has at least two apertures;

a suture, the suture having two legs;

a toggling suture anchor configured to have the two legs of the suture extend from at least one passage through the toggling suture anchor, the toggling suture anchor positionable against a portion of a tibia to provide an anchor and enable tensioning of the two legs of suture;

a first fastener, having at least two slots through the first fastener, configured to at least partially contact the stabilization implant at a first position and secure the stabilization plate against a first portion of a fibula and relative to the two legs of suture,

wherein the suture is configured to pass through a first aperture in the stabilization plate and through the first fastener, be tensioned, and fastened by the first fastener to limit relative motion between the tibia and fibula portions; and

a second fastener configured to further secure the stabilization plate against a second portion of the fibula, wherein the second fastener is positioned against the stabilization plate at a second position.

26. The system of claim 25, wherein the first fastener is one of an anchor and a button.

27. The system of claim 25, wherein the second fastener is one of an anchor, a button, and a screw.