Surgical constructs with collapsing suture loop and methods for securing tissue

• US 9,737,293 B2
• Filed: 12/31/2013
• Issued: 08/22/2017
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Medos International Sarl (Johnson & Johnson)
• Original Assignee: Medos International Sarl (Johnson & Johnson)
• Inventors: Sengun, Mehmet Ziya, Tang, Howard C., Whittaker, Gregory R.
• Primary Examiner(s): LOUIS, RICHARD G
• Application Number:
  US14/145,486
• Publication Number:
  US 20140277132A1
• Time in Patent Office: 1,330 Days
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061

Abstract

Surgical constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct is formed from a suture filament and includes two terminal ends of filament and an intermediate portion disposed along at least a portion of a length extending between the terminal ends. The construct can have a first terminal end that is the first terminal end of the filament, and a second terminal end that includes a loop. The loop can be formed by disposing the second terminal end of the filament within a volume of a portion of the intermediate portion of the filament. In some disclosed methods, both terminal ends of the filament can be passed through tissue when performing soft tissue repairs. Various other embodiments of constructs and methods are provided, including constructs having two or more filaments associated with an anchor and methods of using such constructs.

Claims

1. A surgical repair method, comprising:

inserting an anchor having surgical filament associated therewith in bone in proximity to detached soft tissue, the surgical filament having a first portion with a loop formed therefrom, the loop including a snare formed from a portion thereof, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume;

passing the terminal end of the second portion of the filament through a portion of the detached soft tissue;

passing the terminal end of the second portion through the snare;

collapsing the snare to engage the soft tissue;

advancing the collapsed snare distally to bring the tissue into proximity with the bone; and

deconstructing the coaxial region by moving, relative to the volume of filament in which it is disposed, the portion of the filament disposed in its own volume out from the volume of the filament in which it was disposed.

2. The method of claim 1, further comprising tying at least one locking knot with the filament at a location that is proximate to the collapsed snare to secure a location of the filament with respect to the tissue.

3. The method of claim 1, further comprising forming the snare from the loop after the anchor has been inserted in bone in proximity to detached soft tissue.

4. The method of claim 1, further comprising passing the loop through a portion of the detached soft tissue before forming the snare in the loop.

5. The method of claim 4, wherein the anchor has a second surgical filament associated therewith, the second surgical filament having a first portion with a snare formed therein, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume, the method further comprising:

passing the terminal end of the second portion of the second filament through a portion of the detached soft tissue;

passing the terminal end of the second portion of the second filament through the snare of the second filament;

collapsing the snare of the second filament to engage the soft tissue; and

advancing the collapsed snare of the second filament distally to bring the tissue into proximity with the bone, the first filament being disposed between the collapsed snare of the second filament and the soft tissue.

6. The method of claim 4, wherein the anchor has a second surgical filament associated therewith, the second surgical filament having a first portion with a loop formed therefrom, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume, the method further comprising:

passing the terminal end of the second portion of the second filament through a portion of the detached soft tissue;

passing the loop of the second filament through a portion of the detached soft tissue;

after passing the loop of the second filament through a portion of the detached soft tissue, forming a snare in the loop of the first portion of the second filament;

passing the terminal end of the second portion of the second filament through the snare of the second filament;

collapsing the snare of the second filament to engage the soft tissue;

advancing the collapsed snare of the second filament distally to bring the tissue into proximity with the bone;

deconstructing the coaxial region of the second filament by removing the portion of the second filament from the volume of the second filament in which it was disposed,

wherein deconstructing the coaxial region of the first filament results in a first limb and a second limb extending from the collapsed snare of the first filament, and deconstructing the coaxial region of the second filament results in a first limb and a second limb extending from the collapsed snare of the second filament;

attaching the first and second limbs of the first filament and the first and second limbs of the second filament to a second anchor; and

applying tension to the first and second limbs of the first and second filaments to secure a location of the limbs with respect to the second anchor.

7. The method of claim 6, wherein applying tension to the first and second limbs of the first and second filaments to secure a location of the limbs with respect to the second anchor further comprises inserting the second anchor into bone with the first and second limbs of the first and second filaments being disposed between an outer wall of the anchor and the bone.

8. The method of claim 6, wherein the locations of the first and second limbs of the first and second filaments with respect to the second anchor are secured without tying a knot in either of the first or second filaments.

9. A surgical repair method, comprising:

inserting an anchor having surgical filament associated therewith in bone, the surgical filament having a first portion with a loop formed therefrom, the loop including a snare formed from a portion thereof, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume;

passing the terminal end of the second portion of the surgical filament through the snare;

collapsing the snare;

advancing the collapsed snare into proximity with the bone;

deconstructing the coaxial region by removing the portion of the filament from the volume of the filament in which it was disposed such that a first limb and a second limb extend from the collapsed snare; and

performing at least one additional surgical repair step with at least one of the first and second limbs.

10. The method of claim 9, wherein the anchor has a second surgical filament associated therewith, the second surgical filament having a first portion with a loop formed therefrom, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume, the method further comprising:

passing the terminal end of the second portion of second filament through the snare of the second filament;

collapsing the snare of the second filament;

advancing the collapsed snare of the second filament distally into proximity with the bone;

deconstructing the coaxial region of the second filament by removing the portion of the second filament from the volume of the second filament in which it was disposed such that a first limb and a second limb extend from the collapsed snare;

attaching the first and second limbs of the first filament and the first and second limbs of the second filament to a second anchor; and

applying tension to the first and second limbs of the first and second filaments to secure a location of the limbs with respect to the second anchor.

11. The method of claim 10, wherein applying tension to the first and second limbs of the first and second filaments to secure a location of the limbs with respect to the second anchor further comprises inserting the second anchor into bone with the first and second limbs of the first and second filaments being disposed between an outer wall of the anchor and the hone.

12. The method of claim 10, wherein the locations of the first and second limbs of the first and second filaments with respect to the second anchor are secured without tying a knot in either of the first or second filaments.

13. The method of claim 9, wherein the anchor has a second surgical filament associated therewith, the second surgical filament having a first portion with a snare formed therein, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume, the method further comprising:

passing the terminal end of the second portion of the second filament through the snare of the second filament;

collapsing the snare of the second filament to engage the soft tissue; and

advancing the collapsed snare of the second filament distally into proximity with the bone.

14. The method of claim 9, wherein performing at least one additional surgical repair step further comprises tying the first and second limbs together to further secure the collapsed snare.

15. The method of claim 9, wherein performing at least one additional surgical repair step further comprises associating at least one of the first and second limbs with a second anchor to form a dual row repair.