US20090281581A1 - Method and device for securing sutures to bones - Google Patents

Method and device for securing sutures to bones Download PDF

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Publication number
US20090281581A1
US20090281581A1 US12/453,290 US45329009A US2009281581A1 US 20090281581 A1 US20090281581 A1 US 20090281581A1 US 45329009 A US45329009 A US 45329009A US 2009281581 A1 US2009281581 A1 US 2009281581A1
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Prior art keywords
anchor
screw
bone
hole
suture
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Abandoned
Application number
US12/453,290
Inventor
Jeffery H. Berg
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LUMACA ORTHOPAEDICS Pty Ltd
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Berg Jeffery H
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Application filed by Berg Jeffery H filed Critical Berg Jeffery H
Priority to US12/453,290 priority Critical patent/US20090281581A1/en
Publication of US20090281581A1 publication Critical patent/US20090281581A1/en
Priority to US13/252,494 priority patent/US20120022588A1/en
Assigned to LUMACA ORTHOPAEDICS PTY LTD reassignment LUMACA ORTHOPAEDICS PTY LTD ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BERG, JEFFREY H., MR.
Priority to US14/730,167 priority patent/US10159476B2/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/864Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
    • AHUMAN NECESSITIES
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    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8645Headless screws, e.g. ligament interference screws
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    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8685Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • AHUMAN NECESSITIES
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    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8872Instruments for putting said fixation devices against or away from the bone
    • AHUMAN NECESSITIES
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    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875Screwdrivers, spanners or wrenches
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8897Guide wires or guide pins
    • AHUMAN NECESSITIES
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    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
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    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0409Instruments for applying suture anchors
    • AHUMAN NECESSITIES
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    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0412Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from suture anchor body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0414Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/044Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0445Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors cannulated, e.g. with a longitudinal through-hole for passage of an instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0448Additional elements on or within the anchor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/062Measuring instruments not otherwise provided for penetration depth
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00General characteristics of surgical instruments

Definitions

  • FIGS. 5 a - 5 i depict the system and method in a double row rotator cuff repair.

Abstract

A method, system and device for securing a repair, such as a rotator cuff repair and includes an anchor placed within a hole formed in bone and a cannulated screw inserted into the hole after the anchor has been inserted to effectuate a firm and secure connection of tissue to bone, particularly when the quality of the bone does not permit optimal fixation. The method, system and device allows superior tissue fixation to bone with the ease of knotless suture anchor application.

Description

    CROSS-REFERENCE TO RELATED APPLICATION
  • The present application claims the benefit of U.S. Provisional Patent Application Ser. No. 61/071,568, filed On May 6, 2008. The subject matter of the provisional patent application is incorporated by reference herewith.
  • BACKGROUND OF THE INVENTION
  • During surgery, anchors have been used with sutures to reattach tissue to bone. The anchors have been inserted into holes that have been pre-drilled. Difficulties arise when the anchor has been inserted and is not flush with the top of the bone mass. Additionally, the anchor has been known to move or adjust thereby jeopardizing a secure repair.
  • SUMMARY OF THE INVENTION
  • Part of a successful surgery to reconnect tissue to bone requires that sutures firmly secure the tissue to the bone. It is important that the repair have long term stability. The disclosed method, system and device for securing the repair includes an anchor placed within a pre-drilled hole formed in bone and a cannulated screw inserted into the hole after the anchor, and holding same in place, to effectuate a firm and secure connection of tissue to bone, particularly when the quality of the bone does not permit optimal fixation. The method, system and device allows superior screw in fixation with the ease of knotless suture anchor application.
  • BRIEF DESCRIPTION OF DRAWINGS
  • FIG. 1 a is a view of a cannulated screw used with the system and method;
  • FIGS. 1 b-1 f depict steps of the repair;
  • FIGS. 2 a and 2 b show different types of anchors used with a multirow repair;
  • FIG. 3 is a view of the inserter rod, screw and anchor;
  • FIGS. 4 a-4 h depict the method in a single row rotator cuff repair; and
  • FIGS. 5 a-5 i depict the system and method in a double row rotator cuff repair.
  • DETAILED DESCRIPTION OF THE INVENTION
  • FIG. 1 a shows the cannulated fastener, such as a cannulated bone screw 10 having a central bore 12 extending the entire length of the screw, allowing the screw to move along a bone anchor inserter rod. The fastener may be made of any suitable material, including bioabsorbable material, and may be a barbed fastener which is driven into a bone hole, rather than screwed. The fastener that is inserted need only have a flattened distal aspect to block the fixation anchor from migrating. In FIG. 1 b, an anchor 14 has been inserted within a hole 16 in a bone 18. The anchor has a suture loop 20, either fixed or adjustable in length, passing through tissue 22, such as a rotator cuff, to secure the tissue 22 to the bone 18. The anchor has captured the loop, allowing for fixation without needing to tie a knot. As can be seen, there is a distance between the top of the anchor and the top of the opening in the bone. This distance can be measured by markings 25 along the inserter rod 24 seen in FIG. 1 c. In FIG. 1 d, the cannulated screw 10 is movable along the inserter rod 24, as is the cannulated screw driver 26. The screw driver 26 allows the screw 10 to be driven into the bone hole 16 as the end of the screw driver engages the head of the screw to rotate the screw. FIG. 1 e shows the screw 10 having been successfully driven into the hole and now on top of the bone anchor 14 to prevent the anchor's movement. Having been successfully accomplished, the inserter rod 24 is removed as seen in FIG. 1 f. The standard knotless anchor inserter rod is modified to have a reverse threaded tab 27. This enables the tab to be removed without removing the inserter rod from the anchor.
  • FIGS. 2 a and 2 b depict just one of the many types of bone anchors 30 that may be used with a double row repair. The bone anchor may accommodate one or multiple suture loops 32 which may be either of fixed or adjustable length. Utility sutures 34 extend from the suture loops. FIG. 3 shows the entire assembly of the inserter rod 24, a bone anchor 14 such as a knotless bone anchor and a cannulated screw 10 and screw driver 26 placed over and movable along the inserter rod.
  • FIGS. 4 a-4 h depict a single row rotator cuff repair. A lateral hole 16 is made, by either drilling, or is produced with an awl-like device 36, in the bone 18, as shown in FIG. 4 a and a suture 20 is passed through the tissue 22. The suture 20 is captured by the bone anchor 14, as seen in FIGS. 4 b and 4 c. The anchor 14 is inserted to the appropriate depth 16 and the suture loop is tightened in order to approximate the tissue to the repair site. The loop need not be tightened when the loop is of a fixed length. Once the anchor 14 is successfully seated within the hole, the screw 10 is advanced along the inserter rod 24 and driven into the hole by the cannulated screw driver 26 as seen in FIG. 4 f. Once successfully inserted, the inserter rod 24 is removed and the repair is complete as seen in FIG. 4 g. FIG. 4 h shows a completed two anchor repair.
  • FIGS. 5 a-5 i depict a double row repair with a spiral bone anchor 30 with attached suture loop(s) 32, such as the anchors seen in FIGS. 2 a and 2 b, driven into a first hole 38. The suture passes through tissue 22 and is captured by the bone anchor 14 as seen in FIG. 5 d. At this point, the anchor 14 is set within the second hole 16, followed by the setting of the bone screw 10 in a manner described earlier with reference to the single row repair. The completed multiple row repair is depicted in FIG. 5 i.
  • The method can be applied to any repair requiring tissue to be reattached to bone. Further, the bone anchor, or cannulated bone screw can be made of any desirable material and may be of bioabsorbable or bioreplaceable material. Either implanted device may change over time.

Claims (13)

1. A cannulated bone screw comprising a central bore extending an entire length of the screw and having a flat distal end for engaging a fixation anchor and preventing movement thereof.
2. The cannulated bone screw of claim 1, further comprising a screw pattern on its exterior for secure engagement with a bone mass.
3. The cannulated bone screw of claim 1, wherein the bone screw is made of a bioabsorbable or bioreplaceable material.
4. A method of firmly securing tissue to a bone mass comprising the steps of:
a) drilling or punching a hole in the bone mass;
b) inserting a fixation anchor, having at least one suture element attached thereto, into the hole, thereby drawing tissue that has been secured by the at least one suture, into secure attachment with the bone mass; and
c) inserting a cannulated bone screw into the hole to prevent movement of the anchor.
5. The method of claim 5, wherein the cannulated bone screw is screwed into the hole for secure engagement.
6. The method of claim 4, wherein the anchor and the screw are both inserted by an inserter rod which passes through the cannulated bone screw and inserts the anchor into the hole drilled in the bone mass.
7. The method of claim 4, wherein the suture element is captured by the anchor during the anchor's insertion into the hole.
8. The method of claim 6, wherein the inserter rod has markings to measure the distance the anchor has been inserted into the bone mass and allow for correctly sizing of a length of the screw.
9. The method of claim 6, wherein the inserter rod is removed once the screw has been placed into secure engagement with the anchor.
10. The method of claim 4, wherein the suture element is first inserted via a screw anchor into the bone mass; the suture is passed through the tissue element and then captured by an anchor for insertion into the hole.
11. The method of claim 10, wherein the screw anchor has one or more suture loops attached thereto.
12. The method of claim 4, wherein the anchor has at least one adjustable length suture loop attached thereto.
13. The method of claim 12, wherein the at least one adjustable length suture loop is adjustable using a sliding, self-locking knot.
US12/453,290 2008-05-06 2009-05-06 Method and device for securing sutures to bones Abandoned US20090281581A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US12/453,290 US20090281581A1 (en) 2008-05-06 2009-05-06 Method and device for securing sutures to bones
US13/252,494 US20120022588A1 (en) 2008-05-06 2011-10-04 Method for securing sutures to bones
US14/730,167 US10159476B2 (en) 2008-05-06 2015-06-03 Method for securing sutures to bones

Applications Claiming Priority (2)

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US7156808P 2008-05-06 2008-05-06
US12/453,290 US20090281581A1 (en) 2008-05-06 2009-05-06 Method and device for securing sutures to bones

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US14/730,167 Active US10159476B2 (en) 2008-05-06 2015-06-03 Method for securing sutures to bones

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Cited By (41)

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US20100145395A1 (en) * 2008-12-09 2010-06-10 Graf Ben K Tissue Repair Assembly
US20100298888A1 (en) * 2008-12-09 2010-11-25 Graf Ben K Tissue Repair Assembly
US20110106253A1 (en) * 2009-04-17 2011-05-05 Shane Barwood Tenodesis fixation method
US20120158051A1 (en) * 2010-12-17 2012-06-21 Foerster Seth A Re-tensionable knotless suture system
EP2574284A1 (en) * 2011-09-30 2013-04-03 DePuy Mitek, Inc. Knotless suture anchor
US8435264B2 (en) 2010-08-30 2013-05-07 Depuy Mitek, Llc Knotless suture anchor and driver
US8460340B2 (en) 2010-08-30 2013-06-11 Depuy Mitek, Llc Knotless suture anchor
US20130158598A1 (en) * 2011-12-20 2013-06-20 Depuy Mitek, Inc. Systems and methods for repairing tissue
US8469998B2 (en) 2010-08-30 2013-06-25 Depuy Mitek, Llc Knotless suture anchor
US8790370B2 (en) 2012-03-30 2014-07-29 Depuy Mitek, Llc Surgical filament assemblies
US8814905B2 (en) 2010-11-23 2014-08-26 Depuy Mitek, Llc Surgical filament snare assemblies
US8821543B2 (en) 2010-12-23 2014-09-02 Depuy Mitek, Llc Adjustable anchor systems and methods
US8821544B2 (en) 2010-11-23 2014-09-02 Depuy Mitek, Llc Surgical filament snare assemblies
US8894684B2 (en) 2012-05-07 2014-11-25 Medos International Sàrl Systems, devices, and methods for securing tissue using a suture having one or more protrusions
US9060763B2 (en) 2012-05-07 2015-06-23 Medos International Sàrl Systems, devices, and methods for securing tissue
US9060764B2 (en) 2012-05-07 2015-06-23 Medos International Sàrl Systems, devices, and methods for securing tissue
US9095331B2 (en) 2010-12-23 2015-08-04 Medos International Sàrl Adjustable anchor systems and methods
US20150313586A1 (en) * 2005-03-30 2015-11-05 Arthrex, Inc. Swivel anchor for knotless fixation of tissue
US9192373B2 (en) 2012-12-27 2015-11-24 Medos International Sàrl Surgical constructs and methods for securing tissue
CN105193484A (en) * 2015-11-06 2015-12-30 上海凯利泰医疗科技股份有限公司 Integrated fixing device for olecranal fracture
US9241783B2 (en) 2008-05-14 2016-01-26 Smith & Nephew, Inc. Arthroscopic biceps tenodesis repair
US9345567B2 (en) 2012-05-07 2016-05-24 Medos International Sàrl Systems, devices, and methods for securing tissue using snare assemblies and soft anchors
WO2016172508A1 (en) * 2015-04-24 2016-10-27 Biomet Sports Medicine, Llc Anchoring system and method for securing a suture to a pre-drilled bore
US9737293B2 (en) 2013-03-15 2017-08-22 Medos International Sàrl Surgical constructs with collapsing suture loop and methods for securing tissue
US9763655B2 (en) 2012-09-20 2017-09-19 Medos International Sarl Systems, devices, and methods for securing tissue using hard anchors
CN108392237A (en) * 2017-02-06 2018-08-14 美多斯国际有限公司 Devices, systems, and methods for unknotted type suture anchor
US10159476B2 (en) 2008-05-06 2018-12-25 Lumaca Orthopaedics Pty Ltd Method for securing sutures to bones
US10383618B2 (en) 2017-03-13 2019-08-20 Medos International Sarl Methods and devices for knotless suture anchoring
US10463357B2 (en) 2017-03-13 2019-11-05 Medos International Sarl Methods and devices for knotless suture anchoring
US10537318B2 (en) 2006-05-18 2020-01-21 Arthrex, Inc. Method for knotless fixation of tissue
US10639026B2 (en) 2017-07-27 2020-05-05 Medos International Sarl Knotless suture anchoring using two awl shafts
US10709488B2 (en) 2014-10-23 2020-07-14 Medos International Sárl Biceps tenodesis delivery tools
US10709436B2 (en) 2000-06-22 2020-07-14 Arthrex, Inc. Graft fixation using a plug against suture
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