System for suture anchor placement

• US 5,948,001 A
• Filed: 10/23/1997
• Issued: 09/07/1999
• Est. Priority Date: 10/03/1996
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Larsen, Scott
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/959,277
• Time in Patent Office: 684 Days
• Field of Search: 606/104, 606/139, 606/232
• US Class Current: 606/232
• 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 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0424 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/06142 having needle- or suture- retaining members, e.g. holding tabs or needle parks
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments

Abstract

A system for suture anchor placement includes an apparatus having a handle portion and an operating portion. The handle portion includes a spring, a needle park, and a member for releasably holding a length of the suture. The operating portion includes a sheath tube and a plunger rod slidably disposed within the bore of the sheath tube. The plunger rod is fixedly mounted at its proximal end to the handle. The suture anchor is releasably engaged to the distal end portion of the plunger rod. The sheath tube is mounted to the handle and movable with respect to the handle between a distal position and a proximal position, the sheath tube being resiliently biased to the distal position by the spring and movable to the proximal position in response to proximally directed force of sufficient magnitude applied to the distal end of the sheath tube. The sheath tube has a portion with an outer diameter greater than the diameter of the hole in the bone such that when the installation tool is pressed toward the bone, the sheath tube retracts into the handle and the suture anchor is advanced into a hole previously made in the bone. The suture, initially held in a taut configuration, is released in response to movement of the sheath tube to its proximal position.

Claims

1. An apparatus for installing a suture anchor, which comprises:

a) a handle portion having at least one pinch means for releasably holding a suture; and

b) an elongated portion attached to said handle portion, and including a sheath tube having an axial bore and distal and proximal ends, and an inner rod disposed within the bore of the sheath tube, the inner rod being fixedly mounted to the handle.

2. The apparatus of claim 1 wherein the inner rod has a distal end portion having an opening to releasably hold a suture anchor.

3. The apparatus of claim 1 wherein the handle includes at least one needle park.

4. The apparatus of claim 1 wherein the pinch means includes a pair of spaced apart arms each being movable between an outward position into close proximity to a respective one of a corresponding pair of plates for frictionally holding a suture therebetween and an inner position wherein the suture is released.

5. The apparatus of claim 1 further including a plate disposed within the handle portion and at least one leg in opposing relation to the plate, the leg being biased toward the plate to hold a suture therebetween.

6. The apparatus of claim 5 further including a suture anchor with a suture connected thereto wherein the suture is disposed longitudinally along an outside surface of the sheath tube in an initially taut configuration, a portion of the suture being disposed between the plate and the at least one leg.

7. The apparatus of claim 1 further including a suture anchor which includes an elongated setting pin at least partially mounted within a longitudinal bore of a socket and slidably movable between a distal first position wherein at least a portion of the setting pin is distal to the socket and a proximal second position, the socket having at least two proximally pointing legs which are radially expandable in response to movement of the setting pin to said proximal second position, and the setting pin having a suture connected thereto.

8. A system for installing a suture anchor, which comprises:

a) means for drilling a hole of predetermined diameter into bone tissue;

b) a suture anchor having a length of suture attached thereto;

c) a suture anchor installation tool which includes

i) a handle portion; and

ii) an elongated portion attached to said handle portion, and including a sheath tube having an axial bore and distal and proximal ends, and an inner rod disposed within the bore of the sheath tube, the inner rod being fixedly mounted to the handle, and the sheath tube being mounted to the handle and having a portion with an outer diameter greater than the diameter of the hole in the bone.

9. The system of claim 8 wherein the suture anchor is releasably mounted to a distal end portion of the rod.

10. The system of claim 8 wherein the sheath tube includes at least one longitudinal slot and the inner rod includes a pin extending into the longitudinal slot of the sheath tube.

11. The system of claim 8 wherein the handle includes at least one needle park.

12. The system of claim 8 wherein the means for drilling a hole in bone includes a guide tube and a drill bit movably disposed with the guide tube.

13. The system of claim 8 further including an obturator.

14. The system of claim 8 wherein the suture anchor includes an elongated-setting pin at least partially mounted within a longitudinal bore of a socket and slidably movable between a distal first position wherein at least a portion of the setting pin is distal to the socket and a proximal second position, the socket having at least two proximally pointing legs which are radially expandable in response to movement of the setting pin to said proximal second position.

15. A method for applying a suture anchor to bone, comprising:

a) drilling a hole of predetermined size into a mass of bone tissue;

b) providing a suture anchor having a length of suture connected thereto;

c) providing a suture anchor installation tool which includes;

i) a handle portion; and

ii) an elongated portion attached to said handle portion, and including an sheath tube having an axial bore, and distal and proximal ends, and an inner rod disposed within the bore of the sheath tube, the inner rod being fixedly mounted to the handle and having a distal end portion to which the suture anchor is releasably engaged, and the sheath tube being mounted to the handle and having a portion with an outer diameter greater than the diameter of the hole in the bone;

d) positioning the distal end of the sheath tube in conjunction with the hole in the bone such that the suture anchor is aligned with the hole in the bone;

e) applying distally directed force to the installation tool, thereby advancing the suture anchor into the hole in the bone.

16. The method of claim 15 further comprising the step of deploying the suture anchor in the hole.

17. The method of claim 16 wherein the suture anchor includes a setting pin connected at least partially mounted within a longitudinal bore of a socket and slidably movable between a distal first position wherein at least a portion of the setting pin is distal to the socket and a proximal second position, the socket having at least two legs which are radially expandable in response to movement of the setting pin to said proximal second position, the step of actuating the suture anchor comprising moving the setting pin to its proximal second position.

18. The method of claim 17 wherein the setting pin is moved to its proximal position by applying a proximally directed pulling force to the suture sufficient to move the setting pin to the proximal second position.

19. The method of claim 15 further including the steps of providing an obturator and forming an opening in soft body tissue in the vicinity of the bone mass prior to drilling a hole in the bone and inserting a cannula into the opening in the soft tissue.

20. The method of claim 19 wherein the step of drilling a hole of predetermined size into a mass of bone tissue comprises:

placing a drill guide tube through the opening in the soft tissue formed by the obturator,

positioning the drill guide tube with respect to the bone,

inserting a drill bit through the drill guide tube into contact with the bone tissue, and

drilling the bone tissue with the drill bit.