Method and Apparatus for Securing Soft Tissue to Bone

• US 20110098727A1
• Filed: 10/29/2010
• Published: 04/28/2011
• Est. Priority Date: 09/29/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Denham, Gregory J., Stone, Kevin T., Kaiser, Ryan A.
• Granted Patent: US 8,562,647 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 2017/00792 Plastic surgery
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061

Abstract

A method and apparatus for securing soft tissue to bone can include forming a bore in the bone and carrying a flexible suture anchor into the bore. The flexible anchor can include a passage and can be coupled to a suture construct. The suture construct can include at least one self-locking adjustable loop, and the flexible anchor can include a first profile while being carried into the bore. A shape of the flexible anchor can be changed from the first profile to a second profile forming an anchoring mass to retain the flexible anchor in the bore. Tension can be applied to a portion of the suture construct to reduce a size of the self-locking adjustable loop and secure the soft tissue relative to the flexible anchor and the bone.

Claims

1. A method for securing soft tissue to bone, comprising:

forming a bore in the bone;

carrying a flexible anchor into the bore, the flexible anchor including a passage and being coupled to a suture construct, the suture construct including at least one self-locking adjustable loop, the flexible anchor including a first profile while being carried into the bore;

changing a shape of the flexible anchor from the first profile to a second profile forming an anchoring mass to retain the flexible anchor in the bore; and

applying tension to a portion of the suture construct to reduce a size of the self-locking adjustable loop and secure the soft tissue relative to the flexible anchor and the bone.

2. The method of claim 1, wherein changing a shape of the flexible anchor includes collapsing the flexible anchor from the first profile to the anchoring mass of the second profile, wherein the anchoring mass includes a width in a direction perpendicular to a longitudinal axis of the bore greater than the first profile.

3. The method of claim 1, wherein carrying a flexible anchor into the bore includes carrying a tubular flexible anchor into the bore, wherein the flexible anchor is formed from a woven or braided suture material.

4. The method of claim 1, wherein applying tension to a portion of the suture construct to reduce a size of the self-locking adjustable loop and secure the soft tissue relative to the flexible anchor and the bone includes sliding the suture construct relative to the flexible anchor in the formed anchor mass of the second profile.

5. The method of claim 2, wherein forming a bore in bone includes forming a bore through a cortical layer of the bone and into a cancellous layer of the bone;

and

wherein changing a shape of the flexible anchor includes seating the anchoring mass against the cortical layer of the bone.

6. The method of claim 5, wherein changing a shape of the flexible anchor includes forming the anchoring mass where the width is greater than a width of the bore through the cortical layer of the bone.

7. The method of claim 1, wherein carrying a flexible anchor into the bore includes coupling the flexible anchor to a distal tip of an inserter instrument.

8. The method of claim 7, further comprising:

positioning a cannulated guide member relative to the bore; and

inserting the inserter instrument having the flexible anchor coupled thereto into the guide member to guide the distal tip of the inserter instrument into the bore.

9. The method of claim 7, further comprising routing a portion of the suture construct through a recess in a handle of the inserter instrument and through a protrusion in the handle having a removable securing member configured to removable secure the suture construct to the protrusion and facilitate retaining the flexible anchor relative to the distal tip.

10. The method of claim 1, wherein forming a bore in the bone includes forming a bore in a portion of glenoid bone.

11. The method of claim 10, wherein applying tension to a portion of the suture construct to reduce a size of the self-locking adjustable loop and secure the soft tissue relative to the flexible anchor and the bone includes securing a portion of a labrum to the glenoid bone.

12. The method of claim 1, further comprising coupling the flexible anchor to the suture construct by inserting a free end of the suture construct through an intermediate portion of the passage spaced apart from respective ends of the flexible anchor such that the flexible anchor is coupled to the at least one self-locking adjustable loop and is slidable relative thereto;

wherein portions of the flexible anchor between the intermediate portion and each end define anchoring leg portions.

13. The method of claim 12, further comprising forming the suture construct, including:

providing a suture having first and second free ends and a body defining a passage portion;

passing the first end into and through the passage portion to form a first self-locking adjustable loop; and

passing the second free end into and through the passage portion in an opposite direction as the first end to form a second self-locking adjustable loop.

14. The method of claim 13, wherein applying tension to a portion of the suture construct to reduce a size of the self-locking adjustable loop includes applying tension to the free ends to pull first and second portions of the suture construct passing through the passage portion in opposite directions relative to the passage portion to reduce a size of the first and second loops and secure the soft tissue to the bone.

15. The method of claim 13, wherein the flexible anchor includes first and second flexible anchors coupled to the respective first and second self-locking adjustable loops.

16. The method of claim 15, wherein forming a bore in the bone includes forming a first bore and a second bore in the bone;

wherein carrying a flexible anchor into the bore includes carrying the first flexible anchor into the first bore and carrying the second flexible anchor into the second bore to position the suture construct relative to the soft tissue; and

wherein applying tension to a portion of the suture construct includes applying tension to the first and second ends to reduce a size of the first and second loops thereby changing the shape of the first and second flexible anchors to the anchoring mass of the second profile and securing the soft tissue to the bone.

17. The method of claim 13, wherein the flexible anchor includes first and second flexible anchors, the first flexible anchor being coupled to the first and second self-locking adjustable loops and the second flexible anchor being coupled to the passage portion.

18. The method of claim 17, wherein carrying a flexible anchor into the bore includes inserting the second flexible anchor through the soft tissue and into the bore such that the passage portion is in the bore while the second flexible anchor remains outside of the soft tissue;

and

wherein applying tension to a portion of the suture construct includes applying tension to the first and second ends to reduce a size of the first and second loops to secure the first flexible anchor in the bone and engage the second flexible anchor with a surface of the soft tissue to tightly secure the soft tissue relative to the first flexible anchor and the bone.

19. The method of claim 13, wherein forming a bore in the bone includes forming a bore in a skull of a patient, and wherein the flexible anchor is coupled to the first self-locking adjustable loop.

20. The method of claim 19, further comprising:

attaching the second self-locking adjustable loop to facial skin of the patient;

wherein applying tension to a portion of the suture construct includes applying tension to the first and second ends to reduce a size of the first and second loops to secure the flexible anchor in the bore in the skull and stretch the facial skin relative to and toward the bore in the skull.

21. The method of claim 20, wherein attaching the second self-locking adjustable loop to facial skin of the patient includes attaching the second self-locking adjustable loop to forehead skin of the patient.

22. A method for securing soft tissue to bone, comprising:

forming a bore in the bone;

forming a suture construct, including;

providing a suture having first and second free ends and a body defining a passage portion;

providing first and second flexible suture anchors each having a passage;

coupling the first and second flexible anchors to the suture by passing a portion of the suture through a portion of the passage of each flexible anchor;

passing the first and second free ends of the suture into and through the passage portion in opposite directions to form first and second self-locking adjustable loops;

carrying the first flexible suture anchor into the bore, the first flexible anchor including a first profile while being carried into the bore;

changing a shape of the first flexible anchor from the first profile to a second profile forming an anchoring mass to retain the first flexible anchor in the bore; and

applying tension to the first and second ends of the suture construct to reduce a size of the first and second self-locking adjustable loops and secure the soft tissue relative to the first flexible anchor and the bone.

23. The method of claim 22, wherein coupling the first and second flexible anchors to the suture includes coupling the first flexible anchor to the passage portion of the suture construct and coupling the second flexible anchor to the first and second self-locking adjustable loops.

24. The method of claim 22, wherein coupling the first and second flexible anchors to the suture includes coupling the first flexible anchor to the first self-locking adjustable loop and coupling the second flexible anchor to the second self-locking adjustable loop.

25. The method of claim 22, wherein applying tension to the first and second ends of the suture construct to reduce a size of the first and second self-locking adjustable loops and secure the soft tissue relative to the first flexible anchor and the bone includes sliding the first loop relative to the first flexible anchor in the second profile and the second loop relative to the second flexible anchor.

26. The method of claim 22, wherein forming a bore in the bone includes forming first and second bores in the bone;

wherein carrying the first flexible suture anchor into the bore includes carrying the first flexible anchor into the first bore and carrying the second flexible anchor into the second bore to position the suture construct relative to the soft tissue; and

wherein applying tension to the first and second ends of the suture construct to reduce a size of the first and second self-locking adjustable loops includes applying tension to the first and second ends of the suture construct to reduce a size of the first and second self-locking adjustable loops and secure the soft tissue relative to the first and second flexible anchors secured in the respective first and second bores.

27. The method of claim 26, further comprising providing an inserter instrument having first and second inserters removably coupled to each other for carrying the respective first and second flexible anchors;

wherein carrying the first flexible anchor into the first bore and carrying the second flexible anchor into the second bore to position the suture construct relative to the soft tissue includes;

carrying the first flexible anchor into the first bore with the first inserter while the second inserter is removably attached thereto;

removing the second inserter from the first inserter; and

carrying the second flexible anchor into the second bore with the second inserter that is detached from the first inserter.

28. An assembly for securing soft tissue to bone, comprising:

a flexible tubular anchor having a passage; and

a flexible member construct having a body defining a passage portion between first and second ends, the first end being passed though a portion of the passage of the flexible tubular anchor spaced apart from respective ends of the flexible anchor, and the first end being passed into and through the passage portion via first and second openings associated with the passage portion to form at least one adjustable, self-locking loop;

wherein the flexible tubular anchor is slidably coupled to the flexible member construct and is configured to be collapsible upon engagement with bone to form an anchoring mass having a locking profile.

29. The assembly of claim 28, wherein the flexible member construct further comprises the first end being passed into the passage portion via the first opening and exiting the passage portion via the second opening to form a first adjustable, self-locking loop, and the second end being passed into and through the passage portion in a direction opposite the first end via entering through the second opening and exiting through the first opening to form a second adjustable self-locking loop.

30. The assembly of claim 29, further comprising passing the second end through a portion of a passage of a second flexible tubular anchor to slidably couple the second flexible anchor to the flexible member construct.

31. The assembly of claim 29, further comprising an inserter instrument having first and second elongate members extending from respective first and second handles, the flexible anchor coupled to a distal tip of the first elongate member and the second flexible anchor coupled to a distal tip of the second elongate member, the first and second handles being removable coupled to each other such that the first elongate member extends distally beyond the distal tip of the second elongate member.

32. The assembly of claim 31, wherein each handle includes a proximal end and a distal end, the elongate members extending from the distal ends of the respective handles, wherein the first and second handles are removable coupled to each other such that the handles are substantially axially aligned with the distal end of the second handle removably engaging the proximal end of the first handle.

33. The assembly of claim 32, wherein the proximal end of the first handle includes one of a male or female coupling member and the distal end of the second handle includes the other of the male or female coupling member.

34. The assembly of claim 28, wherein the flexible member construct further comprises the first end being passed into the passage portion via the second opening and exiting the passage portion via the first opening to form a first adjustable, self-locking loop, and the second end being passed into and through the passage portion in a direction opposite the first end via entering through the first opening and exiting through the second opening to form a second adjustable, self-locking loop.

35. The assembly of claim 34, further comprising passing the first and second ends through a portion of a passage of a second flexible tubular anchor to slidably couple the second flexible anchor to the first and second loops;

and

wherein the flexible tubular anchor is slidably coupled to the passage portion of the flexible member construct.

36. The assembly of claim 28, wherein the flexible tubular anchor is formed from woven or braided suture and includes first and second openings intermediate respective first and second ends, the first end of the flexible member construct being passed through the passage via the flexible anchor first and second openings;

and

wherein portions of the flexible tubular anchor between the first and second ends and the respective first and second openings define anchoring leg portions.

37. The assembly of claim 28, further comprising an inserter instrument having an elongate member extending from a handle, the flexible anchor being coupled to a distal tip of the elongate member and the flexible member construct being secured to a protrusion extending from the handle via a securing member removably coupled to the protrusion.