EP1993449A1 - Système d'ancrage de suture canulé - Google Patents
Système d'ancrage de suture canuléInfo
- Publication number
- EP1993449A1 EP1993449A1 EP06737699A EP06737699A EP1993449A1 EP 1993449 A1 EP1993449 A1 EP 1993449A1 EP 06737699 A EP06737699 A EP 06737699A EP 06737699 A EP06737699 A EP 06737699A EP 1993449 A1 EP1993449 A1 EP 1993449A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- anchor
- suture
- head
- installation tool
- guide wire
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0445—Suture 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
Definitions
- the present disclosure relates to orthopedic surgery and, more particularly, relates to a system and method for performing arthroscopy shoulder repair.
- Shoulder arthroscopy involves the repair of tissue inside or around the shoulder joint.
- the procedure is typically performed under endoscopic visualization with, e.g., an arthroscope, which is introduced within a small incision in the skin.
- Various narrow diameter instruments are positioned within the tissue to perform the desired surgical procedure.
- a saline solution may be pumped into the shoulder to expand the joint to enhance visualization and facilitate manipulation of the instruments during the procedure.
- a suture anchor system includes a suture anchor, preferably, a screw anchor, and an installation tool for installing the suture anchor in tissue.
- the suture anchor defines a longitudinal axis and has a longitudinal cannulation for reception and passage of a guide wire.
- the suture anchor has trailing and leading ends, and an anchor head adjacent the trailing end thereof.
- the anchor head includes at least one eyelet for reception of a suture and an internal bore therein.
- the installation tool includes a main body and a driver head extending from the main body.
- the main body includes an outer surface having a longitudinal recess therein to accommodate the suture.
- the driver head is correspondingly dimensioned to be received within the internal bore of the anchor head of the suture anchor whereby movement of the installation tool about a longitudinal axis, e.g., rotational movement, thereof causes corresponding movement, e.g., rotational, of the suture anchor.
- the installation tool may also define a longitudinal cannulation for reception and passage of the guide wire.
- the anchor head preferably includes first and second eyelets for reception of respective sutures.
- the outer surface of the installation tool includes first and second longitudinal recesses for receiving respective sutures extending from the respective first and second eyelets of the anchor head.
- the first and second longitudinal recesses of the installation tool are in general aligmnent with the first and second eyelets of the anchor head when the suture anchor is mounted to the installation tool.
- the driver head of the installation tool may be dimensioned to define first and second clearances between respective outer surfaces of the driver head and internal surfaces of the internal bore of the anchor head when the driver head is mounted within the anchor head. The clearances accommodate suture portions of the sutures and are in general alignment with respective longitudinal recesses in the outer surface of the installation tool.
- the arrangement of the eyelets, longitudinal recesses of the installation tool and sutures within the recesses significantly reduces the profile of the system to thereby facilitate maneuvering of the system within the restricted surgical area.
- the sutures accommodated within the recesses the potential of entanglement of the sutures during manipulation and/or rotation of the insertion tool is greatly minimized.
- a method for attaching soft tissue to bone tissue within a bone area of a patient includes the steps of: accessing an internal target of a bone area of a patient, preferably, the shoulder area; positioning a guide wire in relation to the internal target of the shoulder area; mounting a cannulated anchor, preferably, a screw anchor onto the guide wire, the cannulated anchor having at least one suture connected thereto; advancing the cannulated anchor along the guide wire to the internal target; securing the cannulated anchor within bone tissue of the internal target; and securing soft tissue to the cannulated anchor with the at least one suture.
- FIGS. 1-3 are perspective views of the suture anchor system of the present disclosure
- FIG. 4 is a cross-sectional view taken along the lines 4-4 of FIG. 1 illustrating the arrangement of the insertion tool within the screw head of the screw anchor;
- FIGS. 5-6 illustrate a preferred method of use of the suture anchor system in shoulder repair.
- the suture anchor system of the present disclosure is intended for use in arthrosopic procedures and has particular application in securing soft tissue including tendons, ligaments etc. to hard cortical bone.
- the system may be used in conjunction with surgery performed on the knee, back, ankle, elbow etc. and has particular application in shoulder repair, particularly, arthroscopic shoulder repair.
- shoulder repair operations are inclusive, but, not limited to, reattachment of a torn or damaged cartilage ring (labrum) or ligaments, reattachment of a torn rotator cuff or reattachment of a torn or damaged biceps tendon.
- Other procedures are also envisioned.
- FIGS. 1-3 illustrate, each in perspective view, the novel suture anchor system in accordance with the principles of the present disclosure.
- Suture anchor system 10 generally includes three components, namely screw anchor 12, insertion tool 14 for mounting the screw anchor 12 into bone and a pair of sutures 16 connected to the screw anchor 12 for securing the soft tissue to the screw anchor 12.
- Screw anchor 12 includes anchor body 18 defining longitudinal axis "a" and having leading and trailing ends 20, 22.
- Anchor body 18 includes longitudinal cannulation 24 which extends the length of the anchor body 18.
- Cannulation 24 is dimensioned to receive a guide wire.
- Anchor body 18 further includes screw head 26 adjacent leading end 20.
- Screw head 26 includes inner wall portions 28 defining internal bore 30 which communicates with cannulation 24 (FIG. 4).
- Screw head 26 further has first and second diametrically opposed eyelets 32 which extend through the outer wall of the screw head 26.
- Internal bore 30 is dimensioned to cooperate with insertion tool 14.
- internal bore 30 may take various geometrical shapes including, e.g., square, rectangular, triangular or any other polygonal arrangement, in a preferred embodiment, the internal bore 30 is generally of hexagonal configuration.
- First and second eyelets 32 are adapted to receive sutures 16.
- anchor body 18 has an external thread 34 commencing adjacent screw head 26 and terminating in leading end 22.
- External thread 34 may be continuous along the length of anchor body 18 or alternatively be interrupted to define a plurality of thread segments.
- External thread 34 is preferably self-tapping although it is envisioned that the external thread may be configured for advancement within a pre- tapped bore in bone.
- External thread 34 further includes a plurality of flutes or cut-outs 36 in the thread. Flutes 36 collect bone tissue during the initial self-tapping advancement of the anchor body to facilitate the anchoring process.
- Sutures 16 may be fabricated from any biocompatible material.
- the preferred materials for sutures 16 include synthetic bioabsorbable materials such as polymers or copolymers of glycolide, lactide, trimethylene carbonate, dioxanone, caprolactone or blends thereof.
- Other suitable materials for the components of sutures 16 include nonabsorbable materials such as polycarbonate, polyester, polyethylene, polyamide, polypropylene, polytetrofluoroethylene (PTFE), polysulfone and acrylic.
- Insertion tool 14 includes main body 38 defining longitudinal axis "b" and having driver head 40 at the end of the main body 38. It is noted that in the Figures only the distal end portion of main body 38 is illustrated. Main body 38 includes a pair of longitudinal recesses 42 within the outer surface of the main body 38 and extending from driver head 40 along at least a portion of the length preferably, the entire length of the main body 38. Longitudinal recesses 42 define an arc section removed from the outer surface of main body 38. The radius of the arc section preferably at least approximates the diameter of the sutures 16 to ensure that the sutures are fully accommodated within the longitudinal recesses during use of the system 10. Preferably, longitudinal recesses 42 are arranged in diametrical opposed relation as shown and are in alignment with eyelets 32 of anchor screw 14 when the anchor screw 12 is mounted to insertion tool 14 as depicted in FIG. 1.
- driver head 40 defines a general rectangular cross-section having first and second cross-sectional dimensions "dl, d2" each being transverse to longitudinal axis "b". Second cross-sectional dimension "d2"is greater than first cross-sectional dimension "dl”.
- Driver head 40 includes opposed outer surfaces 44 and opposed outer surfaces 46, and chamfered surfaces 48 interconnecting the surfaces 44, 46.
- a clearance or gap 50 is defined between outer surfaces 44 and inner surface portions 30 of the screw head 26. (FIG. 4)
- the clearances 50 are in general longitudinal alignment with respective eyelets 32 of screw head 26 and respective longitudinal recesses 42 of insertion tool 14.
- the distances between inner surface portions 30 and surfaces 44 within clearances 50 are each preferably dimensioned to at least be equal to, preferably, slightly greater than, the diameters of sutures 16. With this arrangement, the sutures 16 may slide within the clearance area 50 during manipulation of the system 10. Furthermore, the overall axial profile of system 10 is reduced by virtue of longitudinal recesses 42 to facilitate use during a minimally invasive or laparoscopic procedure.
- Insertion tool 14 further defines longitudinal cannulation 52 extending along the length of the insertion tool 14. Longitudinal cannulation 52 is dimensioned for receiving a guide wire.
- an internal target area is accessed through a small incision in the tissue adjacent the shoulder.
- An arthroscope may be utilized and introduced through a cannula as is conventional in the art to visualize the target area.
- Saline solution may then be pumped within the shoulder joint to expand the joint to provide more room to perform the procedure.
- a guide wire 100 is advanced through the shoulder joint to contact the cortical bone 150.
- the guide wire 100 may be at least partially embedded within the cortical bone 150 to positively fix the guide wire 100 to facilitate advancement of the remaining instruments.
- the guide wire 100 may be driven into the cortical bone 100 or alternatively, a drill may be introduced through a cannula to drill a bore for reception of the distal end of the guide wire.
- the guide wire 100 may optionally be driven through the tendon/ligament to be reattached and then secured to the cortical bone as discussed hereinabove.
- a cannulated drill (not shown) may be advanced along the guide wire 100 to core a hole in the targeted cortical bone 150 for subsequent positioning of screw anchor 12.
- the hole within the cortical bone may be tapped if desired with a tapping instrument.
- the screw anchor 12 with mounted insertion tool 14 are positioned over the guide wire 100 with the guide wire 100 being accommodated within cannulations 24, 52 of the screw anchor 12 and the insertion tool 14, respectively.
- the screw anchor 12 is positioned within the hole in the cortical bone 150 by rotating the insertion tool 14 to cause corresponding rotational movement of the screw anchor 12 to advance the screw anchor 12 within the cortical bone 150.
- the guide wire 100 is removed.
- Sutures 16 are then passed through the tendon/ligament 200 and tied off (by knotting) to secure the ligament 200 to the screw anchor 12 and cortical bone 150. It is appreciated that sutures 16 may be passed through the tendon/ligament 200 and then loaded onto suture anchor 16 followed by placement of the screw anchor 12 in the cortical bone if desired.
- the screw anchor 12 with mounted sutures 16 may be punched through the tendon/ligament 200 and advanced within the cortical bone 150 followed by subsequent tying-off of the sutures 16. Over time, sufficient tissue growth/regrowth occurs to affix the natural tendon/ligament 200 to the cortical bone.
- sutures 16 are accommodated within longitudinal recesses 42 of the insertion tool 14.
- the overall profile of the system is reduced.
- the potential of entanglement of the sutures 16 is significantly reduced during rotational movement of the insertion tool 14.
- the system and method for shoulder repair may incorporate a screwless anchor, i.e., an anchor devoid of an external screw thread.
- Anchors suitable for this purpose are disclosed in commonly assigned U.S. Patent Nos. 5,720,753 to Sander et al. and 5,948,000 to Larsen et al., the contents of each being incorporated herein by reference.
- the anchors disclosed in the '753 and OOO patents incorporate expandable legs with anchoring means to engage the bone and may be deployed through non rotational longitudinal movement of a drive element.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Rheumatology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/US2006/008546 WO2007102829A1 (fr) | 2006-03-09 | 2006-03-09 | Système d'ancrage de suture canulé |
Publications (2)
Publication Number | Publication Date |
---|---|
EP1993449A1 true EP1993449A1 (fr) | 2008-11-26 |
EP1993449A4 EP1993449A4 (fr) | 2012-03-07 |
Family
ID=38475168
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP06737699A Withdrawn EP1993449A4 (fr) | 2006-03-09 | 2006-03-09 | Système d'ancrage de suture canulé |
Country Status (5)
Country | Link |
---|---|
EP (1) | EP1993449A4 (fr) |
JP (1) | JP4922316B2 (fr) |
AU (1) | AU2006339575B2 (fr) |
CA (1) | CA2641105C (fr) |
WO (1) | WO2007102829A1 (fr) |
Families Citing this family (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2493393B1 (fr) * | 2009-10-28 | 2019-12-11 | Smith & Nephew, Inc. | Ancrage de suture fileté |
US10426459B2 (en) | 2016-07-05 | 2019-10-01 | Mortise Medical, LLC | Extra joint stabilization construct |
KR101797861B1 (ko) * | 2016-07-01 | 2017-11-14 | 인제대학교 산학협력단 | 인체의 뼈 치료 유닛 |
JP7250789B2 (ja) * | 2017-12-01 | 2023-04-03 | クロスローズ エクストリミティ システムズ リミテッド ライアビリティ カンパニー | 付加的な関節安定化の構造体 |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20020032466A1 (en) * | 1996-08-05 | 2002-03-14 | Arthrex, Inc. | Headed bioabsorbable tissue anchor |
US20030144696A1 (en) * | 2002-01-25 | 2003-07-31 | Medicinelodge, Inc. | Threaded suture anchor and method of use |
WO2004062507A2 (fr) * | 2003-01-09 | 2004-07-29 | Xiros Plc | Dispositif de fixation a utiliser en chirurgie |
Family Cites Families (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5258016A (en) * | 1990-07-13 | 1993-11-02 | American Cyanamid Company | Suture anchor and driver assembly |
JPH0824281A (ja) * | 1994-07-12 | 1996-01-30 | Ikufumi Yamada | 先の溶けるスクリュー |
JPH0866410A (ja) * | 1994-08-26 | 1996-03-12 | Ikufumi Yamada | 分離可能なスクリュー |
JP3766709B2 (ja) * | 1995-05-08 | 2006-04-19 | 郁史 山田 | 骨の固定連結具 |
US5944724A (en) * | 1997-10-30 | 1999-08-31 | Mitek Surgical Products, Inc. | Suture anchor insertion system |
US6045573A (en) * | 1999-01-21 | 2000-04-04 | Ethicon, Inc. | Suture anchor having multiple sutures |
US6517542B1 (en) * | 1999-08-04 | 2003-02-11 | The Cleveland Clinic Foundation | Bone anchoring system |
US20020173822A1 (en) * | 2001-05-17 | 2002-11-21 | Justin Daniel F. | Threaded suture anchor |
WO2006009910A2 (fr) * | 2004-06-17 | 2006-01-26 | The Regents Of The University Of California | Dispositif optometrique non invasif a resolution temporelle pour diagnostic medical |
ATE411784T1 (de) * | 2004-06-18 | 2008-11-15 | Arthrex Inc | Knotenloser knochenanker |
US7914538B2 (en) * | 2004-06-28 | 2011-03-29 | Depuy Mitek, Inc. | Suture anchor inserter |
-
2006
- 2006-03-09 WO PCT/US2006/008546 patent/WO2007102829A1/fr active Application Filing
- 2006-03-09 CA CA2641105A patent/CA2641105C/fr not_active Expired - Fee Related
- 2006-03-09 EP EP06737699A patent/EP1993449A4/fr not_active Withdrawn
- 2006-03-09 JP JP2008558244A patent/JP4922316B2/ja not_active Expired - Fee Related
- 2006-03-09 AU AU2006339575A patent/AU2006339575B2/en not_active Ceased
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20020032466A1 (en) * | 1996-08-05 | 2002-03-14 | Arthrex, Inc. | Headed bioabsorbable tissue anchor |
US20030144696A1 (en) * | 2002-01-25 | 2003-07-31 | Medicinelodge, Inc. | Threaded suture anchor and method of use |
WO2004062507A2 (fr) * | 2003-01-09 | 2004-07-29 | Xiros Plc | Dispositif de fixation a utiliser en chirurgie |
Non-Patent Citations (1)
Title |
---|
See also references of WO2007102829A1 * |
Also Published As
Publication number | Publication date |
---|---|
JP2009529368A (ja) | 2009-08-20 |
AU2006339575A1 (en) | 2007-09-13 |
CA2641105A1 (fr) | 2007-09-13 |
AU2006339575B2 (en) | 2013-07-18 |
CA2641105C (fr) | 2013-11-19 |
EP1993449A4 (fr) | 2012-03-07 |
JP4922316B2 (ja) | 2012-04-25 |
WO2007102829A1 (fr) | 2007-09-13 |
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Legal Events
Date | Code | Title | Description |
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PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
Free format text: ORIGINAL CODE: 0009012 |
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17P | Request for examination filed |
Effective date: 20080930 |
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AK | Designated contracting states |
Kind code of ref document: A1 Designated state(s): DE ES FR GB IE IT |
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RIN1 | Information on inventor provided before grant (corrected) |
Inventor name: MARTINEK, JONATHAN Inventor name: LEHMAN, RICHARD, C. |
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RBV | Designated contracting states (corrected) |
Designated state(s): DE ES FR GB IE IT |
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A4 | Supplementary search report drawn up and despatched |
Effective date: 20120202 |
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RIC1 | Information provided on ipc code assigned before grant |
Ipc: A61B 17/04 20060101AFI20120127BHEP |
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DAX | Request for extension of the european patent (deleted) | ||
RAP1 | Party data changed (applicant data changed or rights of an application transferred) |
Owner name: COVIDIEN LP |
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STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE APPLICATION HAS BEEN WITHDRAWN |
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18W | Application withdrawn |
Effective date: 20150303 |