GB2537592A - Suture anchor delivery tool - Google Patents

Abstract

A suture anchor delivery device comprising a handle 1 attached to a shaft 2 for engaging a suture anchor 5, wherein the handle comprises bobbin means 9 around which a suture 6, extending, in use, from the anchor 5 attached to the shaft, is wound to secure and hold, under tension, the suture 6. The device further includes, in the handle, a locking means (11 fig.5) for locking the bobbin 9 against rotation and release means for releasing the bobbin to allow rotation. The shaft 2 may be hollow and the suture 6 may extend along the shaft 2 within the hollow body. The may further include means for retaining one or more curved suture needles, this means may be within the bobbin means 9.

Description

53.123353 Suture Anchor Delivery Tool The present invention is concerned with a tool or device to delivering a suture anchor to a bone site.

Suture anchors are used in various situations for anchoring surgical suture to bone. For example, if soft tissue tears away from hone, reattachment becomes necessary. One way of treating this is to provide a suture anchor that is anchored into the bone site and provides a secure attachment for suture that is then threaded through the tissue, or other material to be reattached to the bone site.

Various types of suture anchors are known, and the most commonly used suture anchors have an external thread to allow the anchor to be screwed into and secured in the bone. Alternatively, the anchor may be provided with an interference fit similar to a rawpiug or may be provided with other anchoring mechanisms such as tines, protrusions or the like. Various materials are suitable for hone anchors, inciuding metal, PEEK or a biodegradable material which dissolves in the body over time.

Most commonly used anchors comprise the anchor itself provided with the external thread or other securing means, and preferably provided with a tapered or pointed end to simplify insertion into the hone. The anchor is also provided with soma sort Of eyelet or securing means for attachment of the suture to the anchor. The eyelet can be, for example, a hole or a loop in the anchor through which the suture passes or to which the suture is attached.

Various suture materials are known and common sutures can be made of non-absorbable material or absorbable material. In use, generally, an insertion tool is used to drive the anchor into the bone at the insertion site, either by screwing or applying some other force, and the anchor engages with arid is secured in place in the bone by means of the thread or other securing means, The suture may be pre-attached to the anchor on insertion or may be threaded through the eyelet once the anchor has been fixed in the bone.

The open ends of the suture are then sewn or otherwise attached to the tissue. usually by means of a needle, thus fixing the tendon or tissue to the bone.

There are two main types of procedure for secunn,g the tissue or tendon to thebone using the anchodsuture arrangement.

In an open surgery approach, the suture is provided with pre-atttached need:es. The needles are curved and are used stitch through the soft tissue, e.g the rotator cuff, that needs reattaching to the bone. This is done once the anchor and suture are inserted into and anchored within the bone. Hand stitching is possible due to the open wound site.

An alternative to open surgery is arthroscopic or keyhole surgery. Here, the sutures are not provided with pre-attached needles. Instead, a secondary device is used to pass the suture through the tissue or tendon, e.g. the rotator cuff. Again, this is done after the anchor and suture have been inserted into and secured in the bone.

As mentioned above, delivery devices are available to deliver and insert the n to the bone. Conventional delivery devices comprise an elongate shaft attached to a handle, similar, in appearance, to a conventional screwdriver. The distal end of the shaft engages with the anchor. The handle is attached to the other end of the shaft and force is applied (either axially or a rotational force) to push or screw the anchor into the bone.

For anchors frith pre-attached suture, deliver/ devices are available which retain the suture to extend away from the implant site; along the shaft, to keep the suture out of the way, whilst the anchor is being inserted into the bone. The free ends of the suture can be attached to or inside the handle of the delivery device so as to keep the suture under tension; which prevents the suture becoming tangled or snagged and also secures the anchor under tension to the distal end of the delivery device shaft. Once the anchor is located; the sutures can be released to attach the tissue/tendons etc. Most existing devices comprise an elongate metallic shaft attached to a plastic handle. 'Hie delivery device is generally a single-use, disposable device, although devices with disposable shafts and reusable handles are also available, Delivery devices e available rhors with pre -attached sutures: Sher with or without pre-attach d needles.

As mentioned above, for open surgery, the anchor and suture usually come with pre-attached curved needles. Delivery devices are available that allow the anchor to be received at the distal end of the shaft, with the sutures extending along the outside of the shaft to the handle, where the sutures and, if provided, the pre-attached needles are secured whilst the anchor is inserted, and then released, fof use (e.g. Fig. 1).

re the needles are not pre-attached, for example for arthroscopic surgery, the sutures can be retained along the inside of the hollow metal shaft of a deliv device, which retains the sutures better, prior to release (e.g. Fig. 2). The use of a hollow shaft of a delivery device, within which the sutures can pass, avoids the problem of 'tenting', that can arise with deliver/ devices were the sutures extend along the outside of the shaft to the handle, as discussed below.

Generally speaking, the handle of the delivery device has a greater diameter than that of the metal shaft, as this is the most practical and user-friendly construction.

This means, however, that the sutures, extending along the outside of the from a narrow point where the shaft engages with the anchor, and then extend radially outwards as they engace with and are secured to or within the handle. This gives rise to a region towards the joint between the handle and the metal shaft where the sutures are spaced from the shaft, and this is known as'tenting'. This ag can mean that the sutures are in the way during anchor insertion, as they can catch on surrounding wound site soft tissue.

For handles with pre ached needles, the needles also need to be securely stowed, to avoid, for example, tearing the gloves of the surgeon or causing injury.

to one known delivery device, the ends of the sutures and the pre-attached needle are securely stowed within the body of the handle. To release the suture and needles, after the anchor has been implanted, the handle is opened, by means of a skiable lid, and the suture and needles can then be removed and released.

A disadvantage oi such systems is that the surgeon needs two hands to cols open the lid which can be difficult and time consuming during surgery.

An alternative delivery device has been designed having a handle construction tT securing the sutures and stowing the pre-attached needles more securely and which is configured to allow an easier release of the sutures and the needles. The deliver/ device comes pre-loaded with the anchor, sutures and needles. The:anchor is mounted to the distal end of the shaft and the sutures extend along the shaft into the handle. running externally to the shaft but within recessed slots. A transitional portion between the shaft and the handle, of an intermediate diameter, ensures that the sutures are kept close to the body of the shaft to avoid tenting. The sutures are gripped and compressed to the handle and are locked in place which secures the suture and also holds the anchor securely to the distal end or the shaft. After the anchor has been inserted, the needles and suture are released by rotation of the handle which allows single-handed release. The needles drop cut of cavities inside the handle: on rotation.

Whilst this handle allows for secure stowing of the sutures and needles during implantation of the anchor and allows for single-handed release of the needles, one problem is that the needles merely drop out of the handle once the cavity is opened which could be considered dangerous The aim of the nt invention is to provide a Jr delivery device that securely holds the anchor and suture and, if provided, needles, in place whilst the anchor is being implanted into the bone and which enables simple and safe release of the suture and needles after implantation.

In accordance with one aspect, the present invention provides a suture delivery device comprising a handle configured to be attached to a shaft for engaging a suture anchor, wherein the handle comprises bobbin means around which a suture, extending, in use, from the anchor attached to the shaft is wound to secure and hold, under tension, the suture; the device further including, in the handle, locking means for locking the bobbing against rotation and release means for releasing the bobbin to allow rotation so as to allow the suture to unwind from around the bobbin.

In accordance with a second aspect, the present invention provides a suture anchor delivery device comprising an elongate shaft having, at one end, means for receiving a suture anchor to which a length of suture is attached; and a handle attached to the other end of the shaft, wherein the handle comprises bobbin means around which a suture, extending, in use, from the anchor attached to the shaft, is wound to secure and hold, under tension, the suture; the device further including, in the handle, locking means for locking the bobbing against rotation and release means for releasing the bobbin to allow rotation so as to allow the suture to unwind from around the bobbin.

In a third aspect of the invention, the present invention e a kit comprising a suture anchor delivery device as described in rela aspect, as well as an anchor mounted to the first end of the shaft, and a length of suture attached to the anchor and extending along the length of the shaft into the handle the free ends of the suture being wound around the bobbin means and held, under tension, by means of the locking means locking the bobbin.

In some embodiments the shaltislow body and the suture extends along the shaft within the hollow body.

In some embodiments. the handle lud retaining one or more curved needles attached to the uture. In the most preferred embodiment, the retaining are provided within the bobbin means.

Preferred embodiments of the invention will now be described, by way example only, with reference to the drawings.

Fig. 1 is a side schematic view of a known delivery device; Fig. 2 is a sectional view of an alternative known device; Fig. 3 is a perspective view of a delivery tool according to an embodiment Of the invention; Fig. 4 is a perspective view of a delivery tool according to an embodiment of the invention; Fig. 5 is a side sect onai view of an embodiment of the invention with the bobbin locked; Fig, 6 is a view as in Fig. 5 but with the bobbin released; Fig. 7 is a detailed section of the bobbin Of one embodiment; Fig. 8 is a side sectional view of an alternative embodiment; Fig. 95.3 detailed section of the bobbin of an alternative embodiment; Fig. 10 is a detailed perspective view of the handle of one embodiment Fig. 3 is a perspective view of a delivery device according to one aspect of the invention. The device comprises a handle 1 which, in preferred embodiments, is made of plastic or a similar light material That can be easily held in the hand of the user. The handle can be disposable or re-usable.

The distal end of the handle is configured to receive an elongate shaft 2. This shaft may be made of metal or some other suitable material for insertion into the body.

The shaft is preferably disposable but could, in theory, be re-usable provided the necessary standards of hygiene are retained.

The distal end 4 of the shaft, furthest from the handle, is arranged to receive the anchor to be positioned in the bone site.

When the anchor 5 is mounted on the distal end of the shaft, the suture 6 attached to the anchor is extended along the length of the shaft and is secured in the handle. In some embodiments the suture length can be provided within the metal shaft, in which case the shall is a hollow body, as shown in Fig. 8 and described further below.

The exterior of the handle is preferably formed to be easily and comfortably held in one hand but, of course, the actual shape of the handle can be any design and shape and the shape of the handle is not part of the invention. :35

In the embodiment shown, the end of the handle to which the shaft is attached has two openings to receive the free ends of the sutures and these extend into the body of the handle. In this embodiment, a handle lid 7, which is preferably removable, is provided and a button 8, movable between two positions, is mounted on the handle. The example of the button is for locking and releasing the bobbins, as described below. Any button or other mechanism that can be orierated by the user, to cause the locking and releasing, can be used.

Hg. 4 shows the delivery device of Fig. 3, with the handle lid 7 removed !aside the handle is provided the bobbin means 9,for receiving arid securing the free ends of the suture 6. In the embodiment shown, two bobbins are provided, one for each free end, of the length of suture. It is conceivably, however, that a single, bobbin could be used.

While the delivery device is provided pre with the anchor and sutures, the anchor is mounted to the distal end of the shaft and the sutures are pulled into the handle and wound tightly around the bobbins and then secured in place by locking the bobbins.

For delivery devices where the suture ends are provided with a curveed needle, the handle is configured to stow the needles in the pre-leaded configuration, as will be described further below.

The handle is provided With:Meana:fel locking the bobbin against rotation, to prevent unwinding of the suture and means for releasing the bobbin to allow rotation to allow unwinding of the suture for use. Preferred embodiments are shown in Figs. 5.iand 6, In the preferred embodiment, the bobbin comprises a number of teeth 10 arranged around the bobbin. The handle is provided with a movable lug 11 that can be moved, for example by means of the button, or other slider or configuration to engage with the teeth, in the locked position, thus preventing the bobbin from rotating. To release the bobbin, the button or other release means moves the lug 11 out of engagement with the teeth as shown in Fig. 6, thus allowing the bobbin to rotate and to release h re and, if provided, the needles. Other means can be used to lock and release the bobbin, e.g. by means of friction or other forms of engagement.

is a detail section of the bobbin in bodiment having means for stowing pre-attached needles 12. The bobbin is provided with a slot 13 within which the needle(S) fitS. As the bobbin rotates to release, the suture will unwind and draw the needle out of the slot, In some embodiments, as mentioned above, but not those having pre-attached needles, the shaft may be a hollow shaft and the sutures can be retained within and along the length of the hollow shaft as shown in Fig. 8, Other asf acts cf the att achment,within the handle, are as ' ibed b As shown in Fig. 9, in one emb ple a b triangular tab 14, can be provided at the entrance to the bobbin, along the sides of which the sutures are fed and are iocked to either side of the tab as can be seen in Fig. 9. Other means can be provided, of course, for securing the sutures within the bobbin.

In embodiments ere the suture exttends along the outside of the tab, means may also be provided avoid the problems of tenting described above. The handle may include, preferably close to the point where the shaft meets the handle, a retaining means 15 for retaining the suture close to the shaft. In the embodiment shown in Fig. 10, this may be in the form of a L-shaped peg 15 that provides a retaining, force on the suture.

The handle arrangement of the vention ensures that the bobbins an therefore. the sutures and, where available, needles, unwind in a controlled manner, and that the release of the sutures can be performed easily, by the surgeon, with one hand, simply by sliding the button or other release mechanism on the handle and pulling the handle in a direction away from the patient.

Claims (6)

1. CLAiMS.1. A suture anchor delivery device comprising a handle configured to be attached to a shaft for engaging a suture anchor, wherein the handle comprises bobbin means around which a suture, extending, in use, from the anchor attached to the shaft, is wound to secure and hold, under tension, the suture; the device further including, in the handle, locking means for locking the bobbing against rotation and release means for releasing the bobbin to allow rotation so as to allow the suture to unwind from around the bobbin.
2. 2 A suture anchor delivery device comprising an elongate shaft having, end, means for receiving a suture anchor to which a length of suture is attach and a handle attached to the other end of the shaft, wherein the handle comprises bobbin means around which a suture, extending, in use, from the anchor attached to the shaft, is wound to secure and hold, under tension, the suture; the device further including, in the handle, locking means for locking the bobbing against rotation and release means for releasing the bobbin to allow rotation so as to allow the suture to unwind from around the bobbin.
3. CO 20 3, A kit comprising a suture anchor delivery device as described in relation to C\I the second aspect, as well as an anchor mounted to the first end of the shaft, and a length of suture attached to the anchor and extending along the length of the shaft into the handle, the free ends of the suture being wound around the bobbin means and held, under tension, by means of the locking means locking the bobbin.
4. 4. The device of claim or 2 or the kit of claim 3, wherein the shaft is a hollow body and the suture extends along the shaft within the hollow body.
5. 5. The device of claim 1, 2 or 4 or the kit of claim 3 or 4, wherein the handle includes means for retaining one or more curved needles attached to the suture.
6. 6. The device or kit of claim 5, wherein the retaining means areprovided within the bobbin means Cr) O