Surgical filament snare assemblies

• US 10,292,695 B2
• Filed: 09/14/2016
• Issued: 05/21/2019
• Est. Priority Date: 11/23/2010
• Status: Active Grant

• Current Assignee: Medos International Sarl (Johnson & Johnson)
• Original Assignee: Medos International Sarl (Johnson & Johnson)
• Inventors: Sengun, Mehmet Ziya, Tang, Howard C., Spenciner, David B., Whittaker, Gregory R., Miller, Gerome
• Primary Examiner(s): Bui, Vy
• Application Number:
  US15/264,645
• Publication Number:
  US 20170000479A1
• Time in Patent Office: 979 Days
• Field of Search: 606232, 606139, 606144, 606145, 606148, 606223, 606224, 606225, 606228, 606230
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• 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 2017/06185 hollow or tubular hollow suture needles A61B2017/061

Abstract

A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose on a first portion of at least a first limb and has a second portion connected to the filament engagement feature of the anchor. Preferably, at least one free filament limb, which in some embodiments is a length of the first filament and in other embodiments is a second filament, is capable of being passed through tissue to be repaired and has at least one end passable through the noose to enable incremental tensioning of the tissue after the anchor is fixated in bone. The noose strangulates the free filament limb when tension is applied to at least one of the free filament limb and the noose.

Claims

1. A surgical tissue repair method, the method comprising:

fixing an anchor in bone in proximity to detached soft tissue, the anchor having at least one passage extending from a proximal end of the anchor and toward a filament engagement feature located at a distal end of the anchor, and at least a first filament engaged therewith, the first filament having a noose on a first portion of at least a first limb at the time the first filament is first engaged with the anchor and a second portion extending into the passage to engage the filament engagement feature of the anchor, the noose forming a closed loop in which an entire inner perimeter of the closed loop is remote from the filament engagement feature, such that the inner perimeter of the closed loop does not contact the filament engagement feature;

passing a first free filament limb through the noose;

tensioning the noose around the first free filament limb to strangulate the first free filament limb;

passing the first free filament limb through the detached soft tissue; and

tensioning the tissue as desired after the anchor is fixated in bone.

2. The method of claim 1, further comprising advancing the noose toward the anchor.

3. The method of claim 1, wherein the noose is formed by at least one half hitch.

4. The method of claim 1, wherein the noose is formed by a hangman'"'"'s type knot.

5. The method of claim 1, further comprising inserting at least one tube into the noose to provide a passage for the first free filament limb.

6. The method of claim 5, further comprising passing the first free filament limb through a slot formed in the tube to remove the first free filament limb from the tube.

7. The method of claim 1, wherein the noose is formed from a knot having at least three openings.

8. The method of claim 7, further comprising,

passing a second free filament limb through a hole in the noose,

wherein, the first free filament limb and the second free filament limb are passed through different openings in the knot.

9. A surgical tissue repair method, the method comprising:

fixing an anchor in bone in proximity to detached soft tissue, the anchor having at least one passage extending from a proximal end of the anchor and toward a filament engagement feature located at a distal end of the anchor, and at least a first filament associated therewith, the first filament having a noose on a first portion of at least a first limb and a second portion extending into the passage to engage the filament engagement feature of the anchor, the noose forming a closed loop in which an entire inner perimeter of the closed loop is remote from the filament engagement feature, such that the inner perimeter of the closed loop does not contact the filament engagement feature;

passing a first free filament limb through the noose;

passing a second free filament limb through the noose;

tensioning at least one of the first and second free filament limbs to collapse the noose and advance the noose towards the anchor;

passing the first free filament limb through the detached soft tissue; and

tensioning the tissue as desired after the anchor is fixated in bone.

10. The method of claim 9, further comprising advancing the noose toward the anchor.

11. The method of claim 9, wherein the noose is formed by at least one half hitch.

12. The method of claim 9, wherein the noose is formed by a hangman'"'"'s type knot.

13. The method of claim 9, further comprising inserting at least one tube into the noose to provide a passage for the first free filament limb.

14. The method of claim 13, further comprising passing the first free filament limb through a slot formed in the tube to remove the first free filament limb from the tube.

15. The method of claim 9, wherein the noose is formed from a knot having at least three openings.

16. The method of claim 15, wherein the first free filament limb and the second free filament limb are passed through different openings in the knot.

17. A surgical tissue repair method, the method comprising:

fixing an anchor in bone in proximity to detached soft tissue, the anchor having at least one passage extending from a proximal end of the anchor and toward a filament engagement feature located at a distal end of the anchor, and at least a first filament associated therewith, the first filament having a noose on a first portion of at least a first limb and a second portion extending into the passage to engage the filament engagement feature of the anchor, the noose forming a closed loop in which an entire inner perimeter of the closed loop is remote from the filament engagement feature, such that the inner perimeter of the closed loop does not contact the filament engagement feature;

passing a first free filament limb through the noose after the anchor is fixated in bone in proximity to detached soft tissue; and

tensioning the first free filament limb to collapse the noose and advance the noose towards the anchor.

18. The method of claim 17, further comprising:

passing the first free filament limb through the detached soft tissue; and

tensioning the tissue as desired after the anchor is fixated in bone.

19. The method of claim 17, further comprising advancing the noose toward the anchor.

20. The method of claim 17, further comprising inserting at least one tube into the noose to provide a passage for the first free filament limb.

21. The method of claim 20, further comprising passing the first free filament limb through a slot formed in the tube to remove the first free filament limb from the tube.

22. The method of claim 17, wherein the noose is formed from a knot having at least three openings.

23. The method of claim 22, further comprising:

passing a second free filament limb through the noose,

wherein, the first free filament limb and the second free filament limb are passed through different openings in the knot.

24. A surgical tissue repair method, the method comprising:

fixing an anchor in bone in proximity to detached soft tissue, the anchor having at least one passage extending from a proximal end of the anchor and toward a filament engagement feature located at a distal end of the anchor, and at least a first filament associated therewith, the first filament having a noose on a first portion of at least a first limb and a second portion extending into the passage to engage the filament engagement feature of the anchor, the noose forming a closed loop in which an entire inner perimeter of the closed loop is remote from the filament engagement feature, such that the inner perimeter of the closed loop does not contact the filament engagement feature;

passing a distal terminal end of a first free filament limb through the noose such that the distal terminal end of the first free filament limb is a first, leading portion of the first free filament limb that passes through the noose; and

tensioning the first free filament limb to collapse the noose and advance the noose towards the anchor.

25. The method of claim 24, further comprising:

passing the first free filament limb through the detached soft tissue; and

tensioning the tissue as desired after the anchor is fixated in bone.

26. The method of claim 24, further comprising advancing the noose toward the anchor.

27. The method of claim 24, further comprising inserting at least one tube into the noose to provide a passage for the first free filament limb.

28. The method of claim 27, further comprising passing the first free filament limb through a slot formed in the tube to remove the first free filament limb from the tube.

29. The method of claim 24, wherein the noose is formed from a knot having at least three openings.

30. The method of claim 29, further comprising:

passing a second free filament limb through the noose,

wherein, the first free filament limb and the second free filament limb are passed through different openings in the knot.