Systems, devices, and methods for securing tissue using snare assemblies and soft anchors

• US 10,271,833 B2
• Filed: 04/29/2016
• Issued: 04/30/2019
• Est. Priority Date: 05/07/2012
• Status: Active Grant

• Current Assignee: Medos International Sarl (Johnson & Johnson)
• Original Assignee: Medos International Sarl (Johnson & Johnson)
• Inventors: Sengun, Mehmet Ziya
• Primary Examiner(s): Lynch, Robert A
• Application Number:
  US15/143,496
• Publication Number:
  US 20160296222A1
• Time in Patent Office: 1,096 Days
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/844 with expandable anchors or anchors having movable parts
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00845 of moving parts with respect to each other
• CPC Class Codes: A61B 2017/00849 with respect to tissue, e.g. hollow organs
• CPC Class Codes: A61B 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0406 Pledgets
• 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 2017/042 plastically deformed during insertion
• 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
• 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 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0618 elastic, e.g. stretchable for prostheses A61F2210/0057
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• CPC Class Codes: A61B 90/90 : Identification means for patients or instruments, e.g. tags
• CPC Class Codes: A61B 90/92 : coded with colour
• 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 2002/0888 : Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical soft tissue repair device includes a snare assembly coupled to a soft anchor in which the soft anchor has a first, unstressed configuration that can be used to insert the anchor into bone and a second, anchoring configuration that can be used to fixate the anchor in the bone. The snare assembly can be configured to actuate the anchor from the first configuration to the second configuration, and it can also be used to engage and approximate tissue by drawing the tissue closer to the anchor fixated in the bone. The snare assembly can be used in conjunction with a number of different anchor configurations, and other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Claims

1. A surgical soft tissue repair device, comprising:

a soft anchor configured to be fixated in bone and formed of a flexible construct with a plurality of openings formed therein, the soft anchor having an unstressed configuration with a first length and a first diameter; and

a snare assembly having a collapsible snare at one end thereof and at least one elongate filament extending therefrom, the elongate filament having a terminal end opposite the collapsible snare, the snare assembly being coupled to the soft anchor by the filament passing through the plurality of openings such that the soft anchor is at an intermediate location on the elongate filament between the collapsible snare and the terminal end,

wherein the soft anchor and snare are configured such that the soft anchor is reconfigurable from the unstressed configuration to an anchoring configuration by the application of tension to the filament when the soft anchor is disposed a distance away from the collapsible snare, the soft anchor and snare being further configured such that the snare remains a distance away from the soft anchor when no object is disposed therebetween for the duration of tension application to reconfigure the soft anchor to the anchoring configuration, and any soft anchor coupled to the snare assembly is disposed separate from the collapsible snare, the soft anchor having in the anchoring configuration a second length that is less than the first length and a second diameter that is greater than the first diameter.

2. The device of claim 1, wherein the soft anchor is a cannulated suture with a central lumen.

3. The device of claim 2, wherein the plurality of openings include a first opening on a distal portion of the soft anchor and a second opening on a proximal portion of the soft anchor, the first and second openings communicating with the central lumen.

4. The device of claim 3, wherein the filament passes into the second opening, through the lumen, and out of the first opening.

5. The device of claim 3, wherein the first and second openings are on the same side of the soft anchor.

6. The device of claim 1, wherein the soft anchor includes a plurality of transverse bores extending therethrough along the length of the soft anchor, and the plurality of openings include opposed paired openings with each opposed paired opening communicating with one of the transverse bores.

7. The device of claim 6, wherein the soft anchor includes at least four transverse bores and the filament passes into and out of each transverse bore through the opposed paired openings.

8. The device of claim 1, wherein the soft anchor is a crocheted suture anchor and the filament extends through openings defined between filament limbs of the crocheted suture anchor along the length thereof.

9. The device of claim 1, wherein the second diameter is at least about 20% greater than the first diameter.

10. The device of claim 1, wherein the snare assembly is formed of a double filament loop such that the filament has first and second filament limbs.

11. The assembly of claim 1, further comprising a flexible sleeve removably encapsulating at least a portion of the filament.

12. A surgical soft tissue repair device, comprising:

a soft anchor configured to be fixated in bone and formed of a flexible construct with a plurality of openings formed therein, the soft anchor having an unstressed configuration with a first length and a first diameter; and

a snare assembly formed by an elongate filament, the snare assembly having a first terminal end at which a collapsible snare is disposed and a second terminal end, opposed to the first terminal end, at which the elongate filament terminates, the collapsible snare being formed by a first portion of the elongate filament passing into a second portion of the elongate filament such that a leading end of the first portion does not pass out of the second portion, and the snare assembly being coupled to the soft anchor by the elongate filament passing through the plurality of openings such that the soft anchor is at an intermediate location on the elongate filament between the collapsible snare and the second terminal end,

wherein the soft anchor and snare are configured such that the soft anchor is reconfigurable from the unstressed configuration to an anchoring configuration by the application of tension to the filament, the soft anchor having in the anchoring configuration a second length that is less than the first length and a second diameter that is greater than the first diameter.

13. The device of claim 12, wherein the second portion of the elongate filament further comprises a cannulated portion configured to receive the first portion of the elongate filament therein.

14. The device of claim 13, wherein the cannulated portion is formed by a tubular section of the second portion of the elongate filament having a core removed therefrom.

15. The device of claim 12, wherein the soft anchor is a cannulated suture with a central lumen.

16. The device of claim 15, wherein the plurality of openings include a first opening on a distal portion of the soft anchor and a second opening on a proximal portion of the soft anchor, the first and second openings communicating with the central lumen.

17. The device of claim 16, wherein the filament passes into the second opening, through the lumen, and out of the first opening.

18. The device of claim 16, wherein the first and second openings are on the same side of the soft anchor.

19. The device of claim 12, wherein the soft anchor includes a plurality of transverse bores extending therethrough along a length of the soft anchor, and the plurality of openings includes opposed paired openings with each opposed paired opening communicating with one of the transverse bores.

20. The device of claim 19, wherein the soft anchor includes at least four transverse bores and the elongate filament passes into and out of each transverse bore through the opposed paired openings.

21. The device of claim 12, wherein the soft anchor is a crocheted suture anchor and the filament extends through openings defined between filament limbs of the crocheted suture anchor along the length thereof.

22. The device of claim 12, wherein the snare assembly is formed of a double filament loop such that the elongate filament has first and second filament limbs.

23. The device of claim 12, further comprising a flexible sleeve removably encapsulating at least a portion of the elongate filament.

24. A surgical soft tissue repair device, comprising:

a soft anchor configured to be fixated in bone and formed of a flexible construct with a plurality of openings formed therein, the soft anchor having an unstressed configuration with a first length and a first diameter; and

a snare assembly formed by an elongate filament, the snare assembly having a first terminal end at which a collapsible snare is disposed and a second terminal end, opposed to the first terminal end, at which the elongate filament terminates, the collapsible snare being formed by a first portion of the elongate filament passing into a second portion of the elongate filament, and the snare assembly being coupled to the soft anchor by the elongate filament passing through the plurality of openings such that the soft anchor is at an intermediate location on the elongate filament between the collapsible snare and the second terminal end, the elongate filament between the intermediate location and the second terminal end being disposed outside of the elongate filament,

wherein the soft anchor and snare are configured such that the soft anchor is reconfigurable from the unstressed configuration to an anchoring configuration by the application of tension to the filament, the soft anchor having in the anchoring configuration a second length that is less than the first length and a second diameter that is greater than the first diameter.

25. The device of claim 24, wherein the second portion of the elongate filament further comprises a cannulated portion configured to receive the first portion of the elongate filament therein.

26. The device of claim 24, wherein the soft anchor is a cannulated suture with a central lumen.

27. The device of claim 26, wherein the plurality of openings include a first opening on a distal portion of the soft anchor and a second opening on a proximal portion of the soft anchor, the first and second openings communicating with the central lumen.

28. The device of claim 27, wherein the filament passes into the second opening, through the lumen, and out of the first opening.

29. The device of claim 24, wherein the soft anchor is a crocheted suture anchor and the filament extends through openings defined between filament limbs of the crocheted suture anchor along the length thereof.

30. The device of claim 24, further comprising a flexible sleeve removably encapsulating at least a portion of the elongate filament.