US20180035998A1 - Filamentary fixation device and assembly and method of assembly, manufacture and use - Google Patents
Filamentary fixation device and assembly and method of assembly, manufacture and use Download PDFInfo
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- US20180035998A1 US20180035998A1 US15/784,350 US201715784350A US2018035998A1 US 20180035998 A1 US20180035998 A1 US 20180035998A1 US 201715784350 A US201715784350 A US 201715784350A US 2018035998 A1 US2018035998 A1 US 2018035998A1
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- Prior art keywords
- filamentary
- retriever
- sleeve
- working
- loop
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- 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
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- 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
- A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
-
- 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
- A61B2017/0406—Pledgets
-
- 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
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0458—Longitudinal through hole, e.g. suture blocked by a distal suture knot
-
- 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
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0475—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery using sutures having a slip knot
Definitions
- Suture anchors are devices useful for fixing damaged soft tissue, such as tendons and ligaments, to bone.
- these devices may be secured to bone either through a solid-body anchor having threaded mechanism or interference fit.
- these devices are constructed from metal, polymer, or bioresorbable material. Consequently, these suture anchor devices tend to be rigid structures that require a minimum amount of material to provide the strength needed to prevent catastrophic failure. This minimum amount of material dictates the volume of bone that must be removed for implantation to occur, which may be significant.
- suture anchors typically include an eyelet at one end containing the suture designated for anchoring. This configuration commonly requires the suture anchor to be inserted into bone first, at which point the suture is passed through the target tissue where it is tensioned and tied-off with a surgical knot. Unfortunately, these knots may loosen or come undone compromising the procedure. Additionally, setting the proper tension may prove difficult as the operator may not be aware of the final tension of the suture until the surgical knot is set.
- the present invention includes devices, assemblies, systems, kits and methods of manufacture, assembly and use for the repair of soft tissue.
- the present invention includes a filamentary fixation device having a filamentary sleeve, loading member, and retriever member.
- the filamentary fixation device may have the filamentary sleeve, loading member, and a working suture. The filamentary fixation device can be used to anchor damaged soft tissue to bone.
- a method of assembling a filamentary fixation assembly including obtaining a filamentary sleeve having a pathway therethrough, a loading member positioned through at least a portion of the pathway, and a retriever member positioned through at least a portion of the pathway.
- the method also includes engaging a working suture with the retriever member. Additionally, the method includes positioning at least a portion of the working suture in the pathway using the retriever member. Further included in the method is the step of engaging the working suture with the loading member.
- the positioning step may include tensioning the retriever member such that at least a portion of the working suture may be disposed within the pathway and the working tails may pass through the pathway.
- the step of engaging the working suture with the loading member may include tying the working tails into a sliding knot around the loading member. Further, the method may thus include the additional step of tensioning the loading member such that the sliding knot passes into the pathway.
- the retriever member may include a first end and a second end with the first end including a first loop configuration.
- the loading member may also include a first end and a second end, with the first end including a second loop configuration.
- the filamentary sleeve may include a first end and a second end. The retriever member may be positioned through the pathway of the filamentary sleeve such that the first loop configuration may extend from the first end of the filamentary sleeve and the second end may extend from the second end of the filamentary sleeve.
- a filamentary fixation assembly in another embodiment, includes a filamentary sleeve constructed entirely of filamentary material and having a pathway extending therethrough. Further included in the assembly is a loading member, which includes a first loop and at least one loading tail that is at least partially disposed within the pathway. Additionally, a working suture, which includes at least a first working tail, is included in the assembly.
- the assembly can further include a retriever member.
- the retriever member may be at least partially disposed within the pathway and include a second loop and at least one retriever tail.
- the second loop may be positioned opposite the first loop, and the at least one retriever tail may be positioned adjacent the first loop.
- the loading member may be constructed from a single line of filament.
- the first loop may be formed by folding the single line of filament along its length, and the at least one loading tail may be two loading tails.
- the first loop may be a pre-formed loop, and the at least one loading tail may extend from the first loop.
- the retriever member may be constructed from a single line of filament.
- the second loop may be formed by folding the single line of filament along its length, and the at least one retriever tail may be two retriever tails.
- the second loop may be a pre-formed loop, and the at least one retriever tail may extend from the second loop.
- the retriever member may be constructed from memory metal.
- the filamentary sleeve may have a sidewall defined by the pathway, the sidewall having a plurality of pass-throughs disposed along one side of the filamentary sleeve.
- a method of anchoring tissue to bone using a filamentary sleeve is disclosed herein.
- the filamentary sleeve includes a pathway therethrough and a retriever member and loading member at least partially disposed within the pathway.
- the method includes engaging the retriever member with working tails of a working suture connected to the tissue, tensioning the retriever member such that at least a portion of the working suture is disposed within the pathway and the working tails pass through the pathway, inserting the filamentary sleeve into a bore hole in bone such that the loading member and working suture extend from the bore hole, tying the working tails into a sliding knot around the loading member and tensioning the loading member such that the sliding knot passes into the pathway, thereby fixedly securing the filamentary sleeve within the bore hole.
- the sliding knot may be a half-hitch knot.
- the step inserting of the sleeve into the bore hole may occur prior to the tying step.
- the step inserting of the sleeve into the bore hole may occur prior to the step of engaging the retriever member with the working tails.
- the retriever member may include a first end and a second end.
- the first end may include a first loop configuration.
- the loading member may also include a first end and a second end where this first end may have a second loop configuration.
- the filamentary sleeve may include a first end and a second end.
- the retriever member may be positioned through the pathway of the filamentary sleeve such that the first loop configuration extends from the first end of the filamentary sleeve and the second end may extend from the second end of the filamentary sleeve.
- the loading member may be positioned through the pathway of the filamentary sleeve such that the second loop configuration may extend from the second end of the filamentary sleeve and the first end may extend from the first end of the filamentary sleeve.
- the step of engaging may include passing the working tails through the loop configuration
- the step of tensioning of the retriever member may include pulling on the second end of the retriever member to pull the working suture into the pathway.
- the step of tying may include tying the working tails through the second loop configuration of the loading member, and the step of tensioning of the loading member may include pulling the second end of the loading member to pull the sliding knot into the pathway.
- FIG. 1A shows a perspective view of an embodiment of a filamentary fixation device having a first embodiment of a filamentary sleeve.
- FIG. 1B shows a perspective view of the filamentary fixation device of FIG. 1A having a second embodiment of the filamentary sleeve.
- FIGS. 2-8 show subsequent steps of an exemplary method of use and assembly illustrated using the filamentary fixation device of FIG. 1A .
- FIG. 1A depicts an embodiment of a filamentary fixation assembly 10 , which includes a filamentary sleeve 30 , a retriever member 40 , and a loading member 20 .
- the filamentary sleeve 30 may be cylindrical in shape and include a pathway 33 extending therethrough and a wall thickness 36 defined between the pathway 33 and an outer surface of the sleeve 30 .
- the filamentary sleeve 30 may be provided with an alternative configuration as illustrated in FIG. 1B .
- the filamentary sleeve 30 ′ may be generally cylindrical with a plurality of pass-throughs 31 .
- a set of these pass-throughs 31 may provide filamentary material positioned within pathway 33 , such as retriever member 40 , loading member 20 , and working suture 50 , to instead have an alternative configuration relative to sleeve 30 ′.
- the filamentary material extends through a portion of the pathway, exits the pathway 33 by traversing wall thickness 36 at a pass-through 31 , where it travels externally along apportion of the length of the filamentary sleeve 30 ′, then re-enters the pathway 33 at another pass-through 31 where it continues through another portion of the pathway 33 .
- These pass-throughs 31 may be symmetrically disposed along one side of the filamentary sleeve 30 ′. The symmetrical arrangement is such that when the filamentary sleeve 30 ′ is folded in half at least one pass-through 31 will face an opposing pass-through 31 .
- pass-throughs 31 may also facilitate folding and compressing of the filamentary sleeve 30 ′ by drawing together discrete portions of the filamentary sleeve that are disposed between the pass-throughs as the filamentary material disposed within and through the pass-throughs are tensioned.). Moreover, such pass-throughs may result in greater fixation strength with a bore hole to be prepared in the bone (if used in this manner, as described further below). Further, these pass-throughs 31 may facilitate a solid anchoring position where the filamentary sleeve 30 ′ is folded and inserted into a bore hole 81 in bone 80 .
- a pulling force typically originating from the filamentary material passing through the filamentary sleeve 30 ′, creates a deploying friction between the filamentary sleeve 30 ′ and bore hole 81 (if present, as in FIGS. 4 and 5 ).
- This friction buckles the filamentary sleeve 30 ′ material between the pass-throughs 30 ′ causing them to expand outwardly against the bore hole 81 , thereby significantly increasing the friction against the bone, which provides for a very strong anchor.
- the filamentary sleeve 31 ′ can be the Iconix® all suture anchor system (Howmedica Osteonics, Mahwah, N.J.). Additional example are disclosed in U.S. Provisional Application No.
- the sleeve could include a set of pass-throughs in the middle of the sleeve, along or in addition to one or more other sets of pass-throughs.
- Such a set of pass-through in the middle of the sleeve could also make folding the sleeve over an insertion instrument (not shown) easier, and thus also result in a more condensed structure on such an instrument, which thereby could necessitate a smaller bore hole in bone. While any of these sleeves (including sleeves 30 and 30 ′) could be used in the present invention, sleeve 30 is illustrated throughout the various disclosed embodiments for reasons of clarity and simplicity.
- the retriever member 40 may include a retriever loop 41 that is a pre-formed loop and one retriever tail 42 extending therefrom, as illustrated in FIGS. 1A and 1B .
- the retriever member 40 could have a plurality of retriever tails (not shown) extending from the retriever loop 41 .
- the retriever member 40 may be constructed from a single line of filament wherein the retriever loop 41 and tail 42 are formed by a locking Brummel splice, as is known in the art.
- the locking Brummel splice is merely an example of the various approaches known in the art for forming a retriever loop 41 and a single retriever tail 42 or a plurality of retriever tails (not shown) extending therefrom.
- Another example of the above mentioned configuration is a suture shuttle constructed from memory metal materials, such as nitinol, an example of which is disclosed in U.S. Provisional Application No. 61/755,654, filed Jan. 1, 2013 the entirety of which is incorporated by reference herein as if fully set forth herein and which is assigned to the same entity as the present application.
- Other alternative examples are illustrated in the above applications incorporated by reference, specifically the '336, '586 and '592 applications.
- the retriever member 40 may be a single line of filament (not shown).
- the single line of filament may be folded along its length forming a retriever loop and a pair of retriever tails (not shown).
- the loading member 20 may be similarly configured to that of the retriever member 40 , and thus may have any of the above arrangements as described above as to the retriever member 40 .
- the loading member 20 may be constructed from a single line of filament that may be folded along its length to form a loading loop 22 and a pair of loading tails 21 .
- the loading member 20 may include a loading loop that is a pre-formed loop and one loading tail, or a plurality of loading tails, extending from the loading loop.
- the loading member 20 may be constructed from a single line of filament wherein the loading loop and tail are formed by a locking Brummel splice, as is known in the art.
- the locking Brummel splice configuration is merely an example of the various approaches known in the art for forming a single loop with a tail extending therefrom, any of which may be utilized.
- FIGS. 1A and 1B illustrate a preferred embodiment of both the loading loop 20 and retriever member 40 , they may instead be present in a variety of other configurations, and may have similar or different configurations from one another as desired.
- the retriever member 20 may be partially disposed within a pathway 33 of the filamentary sleeve 30 such that the retriever loop 41 extends out of one side 34 of the filamentary sleeve 30 and the retriever tail 42 extends from the from the other side 35 of the filamentary sleeve 30 .
- the loading loop 40 may also be partially disposed within the pathway 33 such that the loading loop 22 extends out of one side 35 of the filamentary sleeve 30 and the loading tails 21 extend out of the other side 34 .
- the loading loop 22 is positioned on the opposite side 35 of filamentary sleeve 30 as the retriever loop 41 , but on the same side 35 and adjacent to the retriever tail 42 .
- FIG. 3 depicts another embodiment of the filamentary fixation assembly 10 ′, which may include the filamentary sleeve 30 , the loading member 20 , and a working suture 50 .
- the filamentary sleeve 30 and loading member 20 may be of any of the embodiments and configurations as described in the above embodiment of the filamentary fixation assembly 10 .
- the working suture 50 may be constructed from a single line of filament that may be folded along its length to form a pair of working tails 51 .
- the working suture 50 may include a pre-formed loop and at least one working tail extending from the pre-formed loop (not shown).
- the working suture 50 may be constructed from a single line of filament wherein the pre-formed loop and working tail are formed by a locking Brummel splice, as is known in the art.
- the locking Brummel splice configuration is merely an example of the various approaches known in the art for forming a single loop with a tail extending therefrom, any of which may be utilized.
- An example of such a working suture can be found in the above, incorporated by reference, '804 application, as well as U.S. application Ser. No. 13/441,290, filed Apr.
- Such working sutures may be secured to the tissue 60 by, for example, passing a free end around or through the tissue, and then through the pre-formed loop. The free end may then be tensioned to pull the loop against the tissue, similar to a “luggage tag” configuration.
- the filamentary sleeve 30 , retriever member 40 , loading member 20 and working suture 50 may be constructed from filamentary material, such as homogenous or heterogeneous materials including, but not limited to, polyester, polyethylene (including ultra-high molecular weight polyethylene (UHMWPE)), polytetrafluorethylene (including expanded polytetrafluorethylene), nylon, polypropylene, aramids (such as Kevlar-based materials), polydioxanone, polygycolic acid, and organic material (silk, animal tendon, or the like).
- the retriever member 40 may be constructed from memory metal material such as nitinol, and the filamentary sleeve 30 may be entirely constructed from filamentary material. Therefore, the filamentary fixation device 10 , 10 ′ may be, and is preferably, constructed entirely from filamentary material.
- the filamentary fixation device 10 , 10 ′ may be provided to the user in any number of arrangements.
- the end user may be provided the embodiment of the filamentary fixation assembly 10 that includes the loading member 20 and retriever member 40 disposed within the pathway 33 of the filamentary sleeve 30 .
- the user may be provided this embodiment of the filamentary fixation device 10 along with the working suture 50 disassembled from the filamentary fixation device 10 .
- the user may convert this embodiment into the other embodiment of the filamentary fixation device 10 ′ that includes the loading loop 20 and working suture 50 disposed within the pathway 33 of the filamentary sleeve 30 .
- the user may only be provided the filamentary fixation assembly 10 ′.
- a kit may be provided with a filamentary sleeve 30 , loading member 20 , retriever member 40 , and working suture 50 either in assembled form or unassembled leaving it to the user to arrange the device as he or she desires for a particular application. If the device comes to the user unassembled, the kit may further include a suture passing device, such as any of the variations of retriever member 40 and loading member 20 described above. Preferably, if included, such a suture passer would be manufactured from metal wire to provide adequate rigidity in passing the various filaments through the sleeve 30 .
- the working suture 50 , retriever member, and/or loading member may be provided affixed to a needle (not shown) to provide the adequate rigidity for passing through sleeve 30 .
- Any kit of the present invention may include a plurality of any or all of the sleeve 30 , member 20 , member 40 and/or suture 50 .
- the present invention also includes a method of assembly of one embodiment of the filamentary fixation device 10 , including a filamentary sleeve 30 , loading member 20 , and retriever member 40 , is now described.
- the filamentary sleeve 30 , retriever member 40 , and loading member 20 may be obtained unassembled and preferably constructed from filamentary material.
- the loading member 20 is positioned into the pathway 33 of the filamentary sleeve 30 such that the loading loop 22 and loading tails 21 extend from the filamentary sleeve 30 at opposing sides as shown in FIG. 1 .
- the retriever member 40 is then tensioned at the retriever tail 42 such that a portion of the working suture 50 enters into the pathway 33 of filamentary sleeve 30 , and preferably such that the working tails 51 extend from the same side 35 of the filamentary sleeve 30 as the loading loop 22 .
- the working tails 51 may then be tied to the loading loop 22 in a sliding knot configuration, preferably a half-hitch knot 52 , as shown in FIG. 5 .
- Tension may then be applied to the working tails 51 and a working loop 52 located opposite the working tails 51 in an opposite direction. Simultaneously, tension may be applied to the loading tails 21 such that the half-hitch knot 52 enters into the pathway 33 of the filamentary sleeve 30 . In this fashion, the working suture 50 may be fixedly secured to the sleeve 30 .
- This “luggage-tag” configuration may also be utilized where the working suture 50 includes the pre-formed loop and single working tail extending from the pre-formed loop as described above, or where the working suture 50 is provided pre-assembled with the filamentary sleeve 30 , also described above, in which case the entire filamentary fixation assembly 10 ′ would be passed through the looped end (not shown). It is noted that where the working suture 50 is provided already assembled to the filamentary sleeve 30 in conjunction with the loading loop 20 , the following steps utilizing the retriever loop 40 may be skipped.
- the filamentary sleeve 30 may be folded and inserted into a bore hole 81 that has been formed in bone 80 such that both ends of the loading member 20 and working suture 50 extend from the bore hole 81 as shown in FIG. 4A .
- the bore hole 81 is generally formed in cancelleous bone 82 through cortical bone 83 , and the filamentary sleeve 30 is generally inserted into the cancellous region of the bore hole 81 , as shown.
- the filamentary sleeve 30 may be folded and inserted into the bore hole 81 prior to engaging the working tails 51 with the retriever loop 41 .
- the configuration as in FIG. 4B would instead be achieved by first inserting and deploying sleeve 30 in bore hole 81 , followed by passing the tails 51 through retriever loop 41 .
- the working tails would be passed through the pathway 33 , as detailed above, while the filamentary sleeve 30 is folded and deployed within the bore hole 81 .
- tension on the tails 51 can allow the half-hitch 52 to slide along the working suture 50 , while suture 50 and tissue 60 are tensioned and drawn towards bone hole 81 , while preventing the working tails 51 , and half-hitch 52 , to prematurely move into the bore hole 81 and sleeve 30 .
- the tension on the working tails 51 may contract the half-hitch knot 52 and allow the user to maintain appropriate tension on the working suture 50 and the tissue 60 while the half-hitch 52 is slid into the filamentary sleeve 30 , as seen in FIG. 7 .
- the knot 52 may become trapped by the fold 32 (or other material of sleeve 30 ), at which point further tension on the working tails 51 and loading tails 21 further contracts the half-hitch knot 52 , until the working suture 50 and sleeve 30 are fixedly secured with one another and the engagement is so tight that it is no longer capable of sliding, thereby effectively securing the tissue 60 . Further, as the half-hitch 52 contracts and tightens, the material forming the knot 52 may become localized at a point, which further expands the filamentary sleeve 30 against the bore hole 81 , providing added anchoring support.
- This mechanism may provide the user the ability to maintain the desired tension of the working suture 50 up until the half-hitch 52 is locked into position, thereby setting the desired tension into the working suture 50 and tissue 60 .
- the working tails 51 and loading member 20 are trimmed close to the surface of the bone 80 resulting in a configuration as shown in FIG. 8 where the filamentary sleeve 30 is fixedly secured in the bore hole 81 and the half-hitch 52 fixedly secures the working suture 50 , sleeve 30 and tissue 60 to one another and to the bore hole 81 .
- a portion of the loading member 20 can remain within the filamentary sleeve 30 .
- the present invention includes a method of providing instructions or information to practice any of the various methods of performing soft tissue repair described herein.
- the method may include supplying a surgical protocol, or like document, to provide step-by-step instructions for performing any of the method embodiments of the present invention.
Abstract
The present invention, in one embodiment, includes a method of assembling a filamentary fixation device including obtaining a filamentary sleeve having a pathway therethrough, and a loading member and retriever member each positioned through at least a portion of the pathway, engaging a working suture with the retriever member, positioning at least a portion of the working suture in the pathway using the retriever member, and engaging the working suture with the loading member.
Description
- The present application is a continuation of U.S. patent application Ser. No. 13/792,982, filed on Mar. 11, 2013, the disclosure of which is incorporated herein by reference
- Suture anchors are devices useful for fixing damaged soft tissue, such as tendons and ligaments, to bone. Presently, certain of these devices may be secured to bone either through a solid-body anchor having threaded mechanism or interference fit. Generally, these devices are constructed from metal, polymer, or bioresorbable material. Consequently, these suture anchor devices tend to be rigid structures that require a minimum amount of material to provide the strength needed to prevent catastrophic failure. This minimum amount of material dictates the volume of bone that must be removed for implantation to occur, which may be significant.
- Further, current suture anchors typically include an eyelet at one end containing the suture designated for anchoring. This configuration commonly requires the suture anchor to be inserted into bone first, at which point the suture is passed through the target tissue where it is tensioned and tied-off with a surgical knot. Unfortunately, these knots may loosen or come undone compromising the procedure. Additionally, setting the proper tension may prove difficult as the operator may not be aware of the final tension of the suture until the surgical knot is set.
- Thus, there is a need for an all filament anchor that provides for less bone removal during pilot hole creation without compromising pullout strength and provides flexibility in setting the optimum suture tension without the need for a complex surgical knot.
- Generally, the present invention includes devices, assemblies, systems, kits and methods of manufacture, assembly and use for the repair of soft tissue. Specifically, in one embodiment, the present invention includes a filamentary fixation device having a filamentary sleeve, loading member, and retriever member. In another embodiment of the present invention, the filamentary fixation device may have the filamentary sleeve, loading member, and a working suture. The filamentary fixation device can be used to anchor damaged soft tissue to bone.
- According to a first embodiment of the present invention, a method of assembling a filamentary fixation assembly, including obtaining a filamentary sleeve having a pathway therethrough, a loading member positioned through at least a portion of the pathway, and a retriever member positioned through at least a portion of the pathway. The method also includes engaging a working suture with the retriever member. Additionally, the method includes positioning at least a portion of the working suture in the pathway using the retriever member. Further included in the method is the step of engaging the working suture with the loading member.
- Further, the positioning step may include tensioning the retriever member such that at least a portion of the working suture may be disposed within the pathway and the working tails may pass through the pathway. Additionally, the step of engaging the working suture with the loading member may include tying the working tails into a sliding knot around the loading member. Further, the method may thus include the additional step of tensioning the loading member such that the sliding knot passes into the pathway.
- Continuing with this embodiment, the retriever member may include a first end and a second end with the first end including a first loop configuration. The loading member may also include a first end and a second end, with the first end including a second loop configuration. Further, the filamentary sleeve may include a first end and a second end. The retriever member may be positioned through the pathway of the filamentary sleeve such that the first loop configuration may extend from the first end of the filamentary sleeve and the second end may extend from the second end of the filamentary sleeve. Similarly, the loading member may be positioned through the pathway of the filamentary sleeve such that the second loop configuration may extend from the second end of the filamentary sleeve and the first end may extend from the first end of the filamentary sleeve. As such, the engaging the retriever member with the working suture may include passing the working tails through the loop configuration. Further, the step of positioning at least a portion of the working suture in the pathway using the retriever member can include tensioning of the retriever member by pulling on the second end of the retriever member to pull the working suture into the pathway. Additionally, the aforementioned tying step may include tying the working tails through the second loop configuration of the loading member. Further, tensioning of the loading member may include pulling the second end of the loading member to pull the sliding knot into the pathway.
- In another embodiment of the present invention, a filamentary fixation assembly includes a filamentary sleeve constructed entirely of filamentary material and having a pathway extending therethrough. Further included in the assembly is a loading member, which includes a first loop and at least one loading tail that is at least partially disposed within the pathway. Additionally, a working suture, which includes at least a first working tail, is included in the assembly.
- The assembly can further include a retriever member. The retriever member may be at least partially disposed within the pathway and include a second loop and at least one retriever tail. The second loop may be positioned opposite the first loop, and the at least one retriever tail may be positioned adjacent the first loop.
- Further, the loading member may be constructed from a single line of filament. Further, the first loop may be formed by folding the single line of filament along its length, and the at least one loading tail may be two loading tails. Alternatively, the first loop may be a pre-formed loop, and the at least one loading tail may extend from the first loop.
- Moreover, the retriever member may be constructed from a single line of filament. Further, the second loop may be formed by folding the single line of filament along its length, and the at least one retriever tail may be two retriever tails. Alternatively, the second loop may be a pre-formed loop, and the at least one retriever tail may extend from the second loop. Optionally, the retriever member may be constructed from memory metal. In another alternative, the filamentary sleeve may have a sidewall defined by the pathway, the sidewall having a plurality of pass-throughs disposed along one side of the filamentary sleeve.
- In a further embodiment of the present invention, a method of anchoring tissue to bone using a filamentary sleeve is disclosed herein. The filamentary sleeve includes a pathway therethrough and a retriever member and loading member at least partially disposed within the pathway. The method includes engaging the retriever member with working tails of a working suture connected to the tissue, tensioning the retriever member such that at least a portion of the working suture is disposed within the pathway and the working tails pass through the pathway, inserting the filamentary sleeve into a bore hole in bone such that the loading member and working suture extend from the bore hole, tying the working tails into a sliding knot around the loading member and tensioning the loading member such that the sliding knot passes into the pathway, thereby fixedly securing the filamentary sleeve within the bore hole.
- Optionally, the sliding knot may be a half-hitch knot. Further, the step inserting of the sleeve into the bore hole may occur prior to the tying step. Optionally, the step inserting of the sleeve into the bore hole may occur prior to the step of engaging the retriever member with the working tails.
- Continuing with this embodiment, the method may further include the step of pulling on either or both the loading member and working suture to deploy the filamentary sleeve within the bore hole. Additionally, the filamentary sleeve can be constructed entirely of filamentary material and includes a sidewall defined by the pathway. The sidewall may optionally include a plurality of pass-throughs disposed along one side of the filamentary sleeve.
- Continuing with this embodiment, the retriever member may include a first end and a second end. The first end may include a first loop configuration. The loading member may also include a first end and a second end where this first end may have a second loop configuration. Also, the filamentary sleeve may include a first end and a second end. The retriever member may be positioned through the pathway of the filamentary sleeve such that the first loop configuration extends from the first end of the filamentary sleeve and the second end may extend from the second end of the filamentary sleeve. Also, the loading member may be positioned through the pathway of the filamentary sleeve such that the second loop configuration may extend from the second end of the filamentary sleeve and the first end may extend from the first end of the filamentary sleeve.
- Further, the step of engaging may include passing the working tails through the loop configuration, and the step of tensioning of the retriever member may include pulling on the second end of the retriever member to pull the working suture into the pathway.
- Moreover, continuing with this embodiment, the step of tying may include tying the working tails through the second loop configuration of the loading member, and the step of tensioning of the loading member may include pulling the second end of the loading member to pull the sliding knot into the pathway.
- These and other features, aspects, and advantages of the present invention will become better understood with regard to the following description, appended claims, and accompanying drawings where:
-
FIG. 1A shows a perspective view of an embodiment of a filamentary fixation device having a first embodiment of a filamentary sleeve. -
FIG. 1B shows a perspective view of the filamentary fixation device ofFIG. 1A having a second embodiment of the filamentary sleeve. -
FIGS. 2-8 show subsequent steps of an exemplary method of use and assembly illustrated using the filamentary fixation device ofFIG. 1A . -
FIG. 1A depicts an embodiment of afilamentary fixation assembly 10, which includes afilamentary sleeve 30, aretriever member 40, and aloading member 20. Thefilamentary sleeve 30 may be cylindrical in shape and include apathway 33 extending therethrough and awall thickness 36 defined between thepathway 33 and an outer surface of thesleeve 30. - In a substitute embodiment of the
filamentary sleeve 30, thefilamentary sleeve 30 may be provided with an alternative configuration as illustrated inFIG. 1B . In such embodiment, thefilamentary sleeve 30′ may be generally cylindrical with a plurality of pass-throughs 31. A set of these pass-throughs 31 may provide filamentary material positioned withinpathway 33, such asretriever member 40,loading member 20, and workingsuture 50, to instead have an alternative configuration relative tosleeve 30′. For example, the filamentary material (e.g.,member 40,member 20, suture 50) extends through a portion of the pathway, exits thepathway 33 by traversingwall thickness 36 at a pass-through 31, where it travels externally along apportion of the length of thefilamentary sleeve 30′, then re-enters thepathway 33 at another pass-through 31 where it continues through another portion of thepathway 33. These pass-throughs 31 may be symmetrically disposed along one side of thefilamentary sleeve 30′. The symmetrical arrangement is such that when thefilamentary sleeve 30′ is folded in half at least one pass-through 31 will face an opposing pass-through 31. These pass-throughs 31 may also facilitate folding and compressing of thefilamentary sleeve 30′ by drawing together discrete portions of the filamentary sleeve that are disposed between the pass-throughs as the filamentary material disposed within and through the pass-throughs are tensioned.). Moreover, such pass-throughs may result in greater fixation strength with a bore hole to be prepared in the bone (if used in this manner, as described further below). Further, these pass-throughs 31 may facilitate a solid anchoring position where thefilamentary sleeve 30′ is folded and inserted into abore hole 81 inbone 80. As such, a pulling force, typically originating from the filamentary material passing through thefilamentary sleeve 30′, creates a deploying friction between thefilamentary sleeve 30′ and bore hole 81 (if present, as inFIGS. 4 and 5 ). This friction buckles thefilamentary sleeve 30′ material between the pass-throughs 30′ causing them to expand outwardly against thebore hole 81, thereby significantly increasing the friction against the bone, which provides for a very strong anchor. In one example, thefilamentary sleeve 31′ can be the Iconix® all suture anchor system (Howmedica Osteonics, Mahwah, N.J.). Additional example are disclosed in U.S. Provisional Application No. 61/679,336, filed Aug. 3, 2012, U.S. application Ser. No. 13/303,849, filed Nov. 23, 2011, Ser. No. 13/588,586, filed Aug. 17, 2012, and Ser. No. 13/588,592, filed Aug. 17, 2012, and U.S. Pat. Nos. 5,989,252 and 6,511,498, the entireties of which are incorporated by reference herein as if fully set forth herein and all of which are assigned to the same entity as the present application. As described in certain of these references, the pass-throughs can alternatively be positioned elsewhere on the sleeve such that they may or may not be symmetrical. Moreover, in another alternative, the sleeve could include a set of pass-throughs in the middle of the sleeve, along or in addition to one or more other sets of pass-throughs. Such a set of pass-through in the middle of the sleeve could also make folding the sleeve over an insertion instrument (not shown) easier, and thus also result in a more condensed structure on such an instrument, which thereby could necessitate a smaller bore hole in bone. While any of these sleeves (includingsleeves sleeve 30 is illustrated throughout the various disclosed embodiments for reasons of clarity and simplicity. - In one embodiment of the
retriever member 40, theretriever member 40 may include aretriever loop 41 that is a pre-formed loop and oneretriever tail 42 extending therefrom, as illustrated inFIGS. 1A and 1B . Alternatively, theretriever member 40 could have a plurality of retriever tails (not shown) extending from theretriever loop 41. In one such configuration, theretriever member 40 may be constructed from a single line of filament wherein theretriever loop 41 andtail 42 are formed by a locking Brummel splice, as is known in the art. However, the locking Brummel splice is merely an example of the various approaches known in the art for forming aretriever loop 41 and asingle retriever tail 42 or a plurality of retriever tails (not shown) extending therefrom. Another example of the above mentioned configuration is a suture shuttle constructed from memory metal materials, such as nitinol, an example of which is disclosed in U.S. Provisional Application No. 61/755,654, filed Jan. 1, 2013 the entirety of which is incorporated by reference herein as if fully set forth herein and which is assigned to the same entity as the present application. Other alternative examples are illustrated in the above applications incorporated by reference, specifically the '336, '586 and '592 applications. - In an alternative embodiment of the
retriever member 40 theretriever member 40 may be a single line of filament (not shown). In such an embodiment, the single line of filament may be folded along its length forming a retriever loop and a pair of retriever tails (not shown). An example of such an alternative is illustrated in U.S. application Ser. No. 13/783,804, filed Mar. 4, 2013, the entirety of which is incorporated by reference herein as if fully set forth herein and which is assigned to the same entity as the present application. - The loading
member 20 may be similarly configured to that of theretriever member 40, and thus may have any of the above arrangements as described above as to theretriever member 40. In one embodiment, as illustrated inFIGS. 1A and 1B , the loadingmember 20 may be constructed from a single line of filament that may be folded along its length to form aloading loop 22 and a pair ofloading tails 21. - In an alternate embodiment (not shown), the loading
member 20 may include a loading loop that is a pre-formed loop and one loading tail, or a plurality of loading tails, extending from the loading loop. In one such configuration, the loadingmember 20 may be constructed from a single line of filament wherein the loading loop and tail are formed by a locking Brummel splice, as is known in the art. However, the locking Brummel splice configuration is merely an example of the various approaches known in the art for forming a single loop with a tail extending therefrom, any of which may be utilized. Thus, whileFIGS. 1A and 1B (and throughoutFIGS. 2-8 ) illustrate a preferred embodiment of both theloading loop 20 andretriever member 40, they may instead be present in a variety of other configurations, and may have similar or different configurations from one another as desired. - Continuing with the embodiment of the
filamentary fixation assembly 10 as illustrated inFIG. 1A , theretriever member 20 may be partially disposed within apathway 33 of thefilamentary sleeve 30 such that theretriever loop 41 extends out of oneside 34 of thefilamentary sleeve 30 and theretriever tail 42 extends from the from theother side 35 of thefilamentary sleeve 30. Theloading loop 40 may also be partially disposed within thepathway 33 such that theloading loop 22 extends out of oneside 35 of thefilamentary sleeve 30 and theloading tails 21 extend out of theother side 34. Generally, theloading loop 22 is positioned on theopposite side 35 offilamentary sleeve 30 as theretriever loop 41, but on thesame side 35 and adjacent to theretriever tail 42. -
FIG. 3 depicts another embodiment of thefilamentary fixation assembly 10′, which may include thefilamentary sleeve 30, the loadingmember 20, and a workingsuture 50. Thefilamentary sleeve 30 and loadingmember 20 may be of any of the embodiments and configurations as described in the above embodiment of thefilamentary fixation assembly 10. - In one embodiment of the working
suture 50, the working suture may be constructed from a single line of filament that may be folded along its length to form a pair of workingtails 51. - In an alternate embodiment of the working
suture 50, the workingsuture 50 may include a pre-formed loop and at least one working tail extending from the pre-formed loop (not shown). In one such configuration, the workingsuture 50 may be constructed from a single line of filament wherein the pre-formed loop and working tail are formed by a locking Brummel splice, as is known in the art. However, the locking Brummel splice configuration is merely an example of the various approaches known in the art for forming a single loop with a tail extending therefrom, any of which may be utilized. An example of such a working suture can be found in the above, incorporated by reference, '804 application, as well as U.S. application Ser. No. 13/441,290, filed Apr. 6, 2012, the entirety of which is incorporated by reference herein as if fully set forth herein and which is assigned to the same entity as the present application. Such working sutures may be secured to thetissue 60 by, for example, passing a free end around or through the tissue, and then through the pre-formed loop. The free end may then be tensioned to pull the loop against the tissue, similar to a “luggage tag” configuration. - As has been described in the prior embodiment of the
filamentary fixation assembly 10, the loadingmember 20 is partially disposed within thepathway 33 of thefilamentary sleeve 30 such that theloading loop 22 extends out of oneside 35 of thefilamentary sleeve 30 and theloading tails 21 extend from theother side 34. The workingsuture 50 also may be partially disposed within thepathway 33 such that the workingtails 51 extend from thefilamentary sleeve 30 on thesame side 35 as and adjacent to theloading loop 22. In some embodiments, the workingtails 51 may be tied around theloading loop 22 in a sliding knot configuration, such as a half-hitch knot, as discussed further below. - As will be described in greater detail below,
assembly 10′ can be assembled fromassembly 10 usingretriever member 40, or a similar device suitable to pass thetails 51 of workingsuture 50 throughsleeve 30. - The
filamentary sleeve 30,retriever member 40,loading member 20 and workingsuture 50 may be constructed from filamentary material, such as homogenous or heterogeneous materials including, but not limited to, polyester, polyethylene (including ultra-high molecular weight polyethylene (UHMWPE)), polytetrafluorethylene (including expanded polytetrafluorethylene), nylon, polypropylene, aramids (such as Kevlar-based materials), polydioxanone, polygycolic acid, and organic material (silk, animal tendon, or the like). Further, theretriever member 40 may be constructed from memory metal material such as nitinol, and thefilamentary sleeve 30 may be entirely constructed from filamentary material. Therefore, thefilamentary fixation device - The
filamentary fixation device filamentary fixation assembly 10 that includes theloading member 20 andretriever member 40 disposed within thepathway 33 of thefilamentary sleeve 30. However, in another arrangement, the user may be provided this embodiment of thefilamentary fixation device 10 along with the workingsuture 50 disassembled from thefilamentary fixation device 10. In such a circumstance, the user may convert this embodiment into the other embodiment of thefilamentary fixation device 10′ that includes theloading loop 20 and workingsuture 50 disposed within thepathway 33 of thefilamentary sleeve 30. However, in another arrangement, the user may only be provided thefilamentary fixation assembly 10′. - In another arrangement, a kit may be provided with a
filamentary sleeve 30,loading member 20,retriever member 40, and workingsuture 50 either in assembled form or unassembled leaving it to the user to arrange the device as he or she desires for a particular application. If the device comes to the user unassembled, the kit may further include a suture passing device, such as any of the variations ofretriever member 40 and loadingmember 20 described above. Preferably, if included, such a suture passer would be manufactured from metal wire to provide adequate rigidity in passing the various filaments through thesleeve 30. Alternatively, the workingsuture 50, retriever member, and/or loading member may be provided affixed to a needle (not shown) to provide the adequate rigidity for passing throughsleeve 30. Any kit of the present invention may include a plurality of any or all of thesleeve 30,member 20,member 40 and/orsuture 50. - The present invention also includes a method of assembly of one embodiment of the
filamentary fixation device 10, including afilamentary sleeve 30,loading member 20, andretriever member 40, is now described. In this embodiment, thefilamentary sleeve 30,retriever member 40, and loadingmember 20 may be obtained unassembled and preferably constructed from filamentary material. The loadingmember 20 is positioned into thepathway 33 of thefilamentary sleeve 30 such that theloading loop 22 andloading tails 21 extend from thefilamentary sleeve 30 at opposing sides as shown inFIG. 1 . Theretriever member 40 may then be positioned within thepathway 33 such that theretriever loop 41 extends from thesame side 34 of thefilamentary sleeve 30 as that of theloading tails 21, and theretriever tail 42 extends from thesame side 35 as theloading loop 22. While the loadingmember 20 is described herein as being positioned within thepathway 33 prior to theretriever member 40, theretriever member 40 may be positioned within thepathway 33 first. It is envisioned that a method may also entail the use of a suture passer, as described above. - In another embodiment of the
filamentary fixation device 10′, the workingsuture 50 andfilamentary sleeve 30 may be obtained, wherein thefilamentary sleeve 30 includes theloading member 20 andretriever member 40 disposed within thepathway 33 of thefilamentary sleeve 30, such that theloading loop 20 andretriever tails 42 extend from one side of thefilamentary sleeve 30 and theretriever loop 41 andloading tails 21 extend from the other. The workingsuture 50 may be placed into an engagement configuration with theretriever member 40. This engagement configuration could include simply passing the workingtails 42 through theretriever loop 41 or tying the workingtails 42 to theretriever loop 41. Theretriever member 40 is then tensioned at theretriever tail 42 such that a portion of the workingsuture 50 enters into thepathway 33 offilamentary sleeve 30, and preferably such that the workingtails 51 extend from thesame side 35 of thefilamentary sleeve 30 as theloading loop 22. The workingtails 51 may then be tied to theloading loop 22 in a sliding knot configuration, preferably a half-hitch knot 52, as shown inFIG. 5 . Tension may then be applied to the workingtails 51 and a workingloop 52 located opposite the workingtails 51 in an opposite direction. Simultaneously, tension may be applied to theloading tails 21 such that the half-hitch knot 52 enters into thepathway 33 of thefilamentary sleeve 30. In this fashion, the workingsuture 50 may be fixedly secured to thesleeve 30. - The
filamentary fixation assembly FIGS. 2-8 , for example. Such soft tissue repair can be performed in any soft tissue, include such tissue in the foot, ankle, hand, wrist, elbow, hip and shoulder, and in particular soft tissue repair of the rotator cuff and labrum in the hip and shoulder.FIGS. 2-8 illustrate one embodiment of such a method of repair, as performed specifically in the reattachment of the labrum to the glenoid, though this method may be useful and be performed in other soft tissues of the body. - Initially in this embodiment, as illustrated in
FIG. 2 , the workingsuture 50 may be passed around or through thetissue 60 designated for repair. Where the workingsuture 50 is a single line of filament, one end of the filament may be passed through thetissue 60, as seen inFIG. 2 , using a suture passer, as is known in the art, or other techniques that are known in the art. In other instances, the single line of filament many be folded along its length forming a looped-end 52 and a pair of workingtails 51, in which case the looped-end 52 is passed through the tissue and the workingtails 51 are passed through the looped-end 52 around a portion of the tissue in a “luggage-tag” configuration (not shown). This “luggage-tag” configuration may also be utilized where the workingsuture 50 includes the pre-formed loop and single working tail extending from the pre-formed loop as described above, or where the workingsuture 50 is provided pre-assembled with thefilamentary sleeve 30, also described above, in which case the entirefilamentary fixation assembly 10′ would be passed through the looped end (not shown). It is noted that where the workingsuture 50 is provided already assembled to thefilamentary sleeve 30 in conjunction with theloading loop 20, the following steps utilizing theretriever loop 40 may be skipped. - Continuing with this embodiment, and with reference to
FIG. 2 , thefilamentary fixation assembly 10 may be introduced to the surgical repair site where the workingtails 51 engage theretriever loop 41 of theretriever member 40. This engagement can be as simple as threading the workingtails 51 through theretriever loop 41. Theretriever member 40 is then tensioned at theretriever tail 42 as demonstrated byarrow 30. This tension passes theretriever loop 41 through thepathway 33 of the filamentary sleeve such that the workingsuture 50 is partially disposed within thefilamentary sleeve 30 and the workingtails 51 extend from thepathway 33 and reside adjacent theloading loop 22, as shown inFIG. 3 . - With the
loading member 20 and workingsuture 50 now disposed within thefilamentary sleeve 30 as shown inFIG. 3 , thefilamentary sleeve 30 may be folded and inserted into abore hole 81 that has been formed inbone 80 such that both ends of theloading member 20 and workingsuture 50 extend from thebore hole 81 as shown inFIG. 4A . Thebore hole 81 is generally formed incancelleous bone 82 throughcortical bone 83, and thefilamentary sleeve 30 is generally inserted into the cancellous region of thebore hole 81, as shown. Once thefilamentary sleeve 30 is inserted in thebore hole 81, either or both theloading member 20 and workingsuture 50 may be tensioned to deploysleeve 30 and firmly seat thesleeve 30 within thebore hole 81. Such deployment is described in many of the above-incorporated applications. Due to the relatively thin nature of thefilamentary sleeve 30 and filamentary material located therein, thebore hole 81 may generally be very small as compared to thebore hole 81 necessary to accommodate a current rigid suture anchor, thereby preserving native bone. For example, thesleeve 30 may be constructed of #5 suture, and workingsuture 50 and loadingmember 20 may both be constructed of #2 suture. Thus, in a preferred embodiment, borehole 81 may have a diameter of about 2.3 mm. - While the engagement of the working
tails 51 to theretriever loop 41 is described as occurring prior to folding and inserting thefilamentary sleeve 30 into thebore hole 81, this is merely an illustrative order of performance, and indeed, has been presented in this manner for the sake of clarity of illustration. In a preferred embodiment, thefilamentary sleeve 30 may be folded and inserted into thebore hole 81 prior to engaging the workingtails 51 with theretriever loop 41. As such, the configuration as inFIG. 4B would instead be achieved by first inserting and deployingsleeve 30 inbore hole 81, followed by passing thetails 51 throughretriever loop 41. Then, in such an alternative, the working tails would be passed through thepathway 33, as detailed above, while thefilamentary sleeve 30 is folded and deployed within thebore hole 81. - Referring to
FIG. 5 , the workingtails 51 are then engaged withloading loop 22. For example, as illustrated, thetails 51 may be tied through theloading loop 22 preferably in a simple half-hitch knot 52. While a half-hitch knot 52 is shown, any sliding knot that can be locked from further sliding that is known in the art may be utilized. Further, the tying of the half-hitch knot 52 may be performed prior to inserting thefilamentary sleeve 30 in thebore hole 81 or after. - Referring to
FIGS. 6 and 7 , with the half-hitch knot 52 tied through theloading loop 22, theloading tails 21 are tensioned as demonstrated byarrow 71. Contemporaneous with the tensioning of theloading tails 21, the workingtails 51 are tensioned as demonstrated byarrow 72. The tension on theloading tails 21 pulls the half-hitch knot 52 resulting in the sliding of half-hitch 52 toward thebore hole 81 andfilamentary sleeve 30 as illustrated byFIG. 6 , while the tension on the workingtails 51 allows the workingsuture 50, and thustissue 60, to be tensioned. Further, tension on thetails 51 can allow the half-hitch 52 to slide along the workingsuture 50, whilesuture 50 andtissue 60 are tensioned and drawn towardsbone hole 81, while preventing the workingtails 51, and half-hitch 52, to prematurely move into thebore hole 81 andsleeve 30. Further, the tension on the workingtails 51 may contract the half-hitch knot 52 and allow the user to maintain appropriate tension on the workingsuture 50 and thetissue 60 while the half-hitch 52 is slid into thefilamentary sleeve 30, as seen inFIG. 7 . - As the
knot 52 enters into thepathway 33, theknot 52 may become trapped by the fold 32 (or other material of sleeve 30), at which point further tension on the workingtails 51 andloading tails 21 further contracts the half-hitch knot 52, until the workingsuture 50 andsleeve 30 are fixedly secured with one another and the engagement is so tight that it is no longer capable of sliding, thereby effectively securing thetissue 60. Further, as the half-hitch 52 contracts and tightens, the material forming theknot 52 may become localized at a point, which further expands thefilamentary sleeve 30 against thebore hole 81, providing added anchoring support. This mechanism may provide the user the ability to maintain the desired tension of the workingsuture 50 up until the half-hitch 52 is locked into position, thereby setting the desired tension into the workingsuture 50 andtissue 60. The workingtails 51 and loadingmember 20 are trimmed close to the surface of thebone 80 resulting in a configuration as shown inFIG. 8 where thefilamentary sleeve 30 is fixedly secured in thebore hole 81 and the half-hitch 52 fixedly secures the workingsuture 50,sleeve 30 andtissue 60 to one another and to thebore hole 81. Thus, as illustrated, a portion of theloading member 20 can remain within thefilamentary sleeve 30. - In another embodiment, the present invention includes a system for the repair of soft tissue including at least one filamentary fixation assembly (including or in addition to a working suture 50), at least one instrument for insertion of the filamentary fixation assembly, and a surgical procedure. The surgical procedure may include instructions or protocol for using the filamentary fixation assembly and instrument to repair soft tissue. The protocol may include aspects of any of the above-discussed embodiments, though other variations are also envisioned within the scope of the present invention.
- In an associated embodiment, the present invention includes a method of providing instructions or information to practice any of the various methods of performing soft tissue repair described herein. For example, the method may include supplying a surgical protocol, or like document, to provide step-by-step instructions for performing any of the method embodiments of the present invention.
- Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims.
Claims (1)
1. A method of assembling a filamentary fixation assembly, comprising the steps of:
obtaining a filamentary sleeve having a pathway therethrough, a loading member positioned through at least a portion of the pathway, and a retriever member positioned through at least a portion of the pathway;
engaging a working suture with the retriever member;
positioning at least a portion of the working suture in the pathway using the retriever member; and
engaging the working suture with the loading member.
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-
2013
- 2013-03-11 US US13/792,982 patent/US9788826B2/en active Active
-
2014
- 2014-02-25 AU AU2014200973A patent/AU2014200973A1/en not_active Abandoned
- 2014-03-04 CA CA2844876A patent/CA2844876A1/en not_active Abandoned
- 2014-03-05 EP EP14157877.3A patent/EP2777511A3/en not_active Withdrawn
-
2017
- 2017-10-16 US US15/784,350 patent/US20180035998A1/en not_active Abandoned
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US9788826B2 (en) | 2017-10-17 |
AU2014200973A1 (en) | 2014-09-25 |
EP2777511A3 (en) | 2016-08-03 |
EP2777511A2 (en) | 2014-09-17 |
US20140257382A1 (en) | 2014-09-11 |
CA2844876A1 (en) | 2014-09-11 |
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AS | Assignment |
Owner name: HOWMEDICA OSTEONICS CORP., NEW JERSEY Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MCCARTNEY, CHARLES;REEL/FRAME:043872/0471 Effective date: 20131216 |
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STCB | Information on status: application discontinuation |
Free format text: EXPRESSLY ABANDONED -- DURING EXAMINATION |