U.S. patent application number 12/690697 was filed with the patent office on 2010-05-13 for suture anchoring system and method.
This patent application is currently assigned to WARSAW ORTHOPEDIC, INC.. Invention is credited to Lehmann K. Li.
Application Number | 20100121376 12/690697 |
Document ID | / |
Family ID | 34963311 |
Filed Date | 2010-05-13 |
United States Patent
Application |
20100121376 |
Kind Code |
A1 |
Li; Lehmann K. |
May 13, 2010 |
Suture Anchoring System and Method
Abstract
A suture anchoring system and method includes a plurality of
anchor members interconnected to form an anchor assembly with a
suture extending therefrom. The anchor assembly has an insertion
configuration wherein the anchor members are aligned in a
substantially linear arrangement for delivery through an aperture
in bodily tissue and an expanded configuration wherein the anchor
members are transitioned to a non-linear arrangement to prevent
passage of the anchor assembly back through the aperture.
Inventors: |
Li; Lehmann K.; (Milford,
CT) |
Correspondence
Address: |
MEDTRONIC;Attn: Noreen Johnson - IP Legal Department
2600 Sofamor Danek Drive
MEMPHIS
TN
38132
US
|
Assignee: |
WARSAW ORTHOPEDIC, INC.
Warsaw
IN
|
Family ID: |
34963311 |
Appl. No.: |
12/690697 |
Filed: |
January 20, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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10803440 |
Mar 18, 2004 |
7658750 |
|
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12690697 |
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Current U.S.
Class: |
606/232 |
Current CPC
Class: |
A61B 17/0401 20130101;
A61B 2017/0409 20130101; A61B 2017/0458 20130101; A61B 2017/0496
20130101; A61B 2017/0417 20130101; A61B 2017/0454 20130101; A61B
2017/0408 20130101 |
Class at
Publication: |
606/232 |
International
Class: |
A61B 17/04 20060101
A61B017/04 |
Claims
1. A suture anchoring system, comprising: a suture; and at least
three anchor members interconnected to form an anchor assembly with
said suture extending therefrom, said anchor assembly having an
insertion configuration wherein said at least three anchor members
are aligned in a substantially linear arrangement sized for
delivery through an aperture in bodily tissue and being
transitionable to an expanded configuration wherein said at least
three anchor members are positioned in a non-linear arrangement
sized to prevent passage of said anchor assembly back through the
aperture, said non-linear arrangement selected from the group
consisting of a triangular-shaped arrangement of said at least
three anchor members and a side-by-side arrangement of said at
least three anchor members.
2. The system of claim 1, wherein said non-linear arrangement
comprises said triangular-shaped arrangement of said at least three
anchor members.
3. The system of claim 1, wherein said non-linear arrangement
comprises said side-by-side arrangement of said at least three
anchor members.
4. The system of claim 3, wherein said side-by-side arrangement of
said at least three anchor members comprises an alignment of said
at least three anchor members in a substantially parallel
relationship relative to one another.
5. The system of claim 3, wherein each of said at least three
anchor members includes opposite first and second end portions; and
wherein said side-by-side arrangement of said at least three anchor
members comprises an alignment wherein said first end portions of
said at least three anchor members are positioned adjacent one
another and wherein said second end portions of said at least three
anchor members are positioned adjacent one another.
6. The system of claim 1, wherein said at least three anchor
members are interconnected in series to form said anchor
assembly.
7. The system of claim 1, wherein said at least three anchor
members include first and second outer anchor members and at least
one intermediate anchor member.
8. The system of claim 7, wherein said at least one intermediate
anchor member is positioned transversely between said first and
second outer anchor members to at least partially define said
non-linear arrangement of said at least three anchor members.
9. The system of claim 7, wherein said first and second outer
anchor members are drawn toward one another to at least partially
define said non-linear arrangement of said at least three anchor
members.
10. The system of claim 9, wherein said non-linear arrangement
comprises said triangular-shaped arrangement of said at least three
anchor members with said at least one intermediate anchor member
extending transversely between said first and second outer anchor
members.
11. The system of claim 10, wherein each of said first and second
outer anchor members includes first and second end portions, said
at least one intermediate anchor member extending laterally between
said first end portions of said outer anchor members, said second
end portions of said outer anchor members being drawn toward one
another to provide said triangular-shaped arrangement of said at
least three anchor members.
12. The system of claim 9, wherein said non-linear arrangement
comprises said side-by-side arrangement of said at least three
anchor members with said at least one intermediate anchor member
positioned laterally between said first and second outer anchor
members.
13. The system of claim 12, wherein said anchor assembly comprises
two of said intermediate anchor members positioned laterally
between said first and second outer anchor members in a
side-by-side relationship to define said expanded configuration of
said anchor assembly.
14. The system of claim 12, further comprising: a first actuating
element extending through a first loop structure associated with
said first outer anchor member and through a second loop structure
associated with said second outer anchor member; and a second
actuating element secured to said anchor assembly adjacent said at
least one intermediate anchor member; and wherein said first and
second outer anchor members are drawn toward one another by pulling
said first actuating element in a direction away from said anchor
assembly to at least partially transition said anchor assembly
toward said expanded configuration; and wherein said at least one
intermediate anchor member is positioned laterally between said
first and second outer anchor members by pulling said second
actuating element in a direction away from said anchor assembly to
further transition said anchor assembly toward said expanded
configuration
15. The system of claim 7, further comprising an actuating element
extending through a first loop structure associated with said first
outer anchor member and through a second loop structure associated
with said second outer anchor member; and wherein said first and
second outer anchor members are drawn toward one another by pulling
said actuating element in a direction away from said anchor
assembly to at least partially transition said anchor assembly
toward said expanded configuration.
16. The system of claim 15, wherein each of said at least three
anchor members has a tubular configuration defining an axial
passage extending therethrough, said at least three anchor members
being serially interconnected by a linking element extending
through said axial passage in each of said at least three anchor
members to form said anchor assembly, looped end portions of said
linking element defining said first and second loop structures
associated with said first and second outer anchor members.
17. The system of claim 16, wherein each of said linking element
and said actuating element comprises a suture.
18. The system of claim 7, wherein each of said at least three
anchor members has a tubular configuration defining an axial
passage extending therethrough, said at least three anchor members
being serially interconnected by a linking element extending
through said axial passage in each of said at least three anchor
members to form said anchor assembly.
19. The system of claim 18, further comprising an actuating element
extending through a first looped end portion of said linking
element adjacent said first outer anchor member and through a
second looped end portion of said linking element adjacent said
second outer anchor member; and wherein said first and second outer
anchor members are drawn toward one another by pulling said
actuating element in a direction away from said anchor assembly to
at least partially transition said anchor assembly toward said
expanded configuration.
20.-55. (canceled)
56. A suture anchoring system, comprising: a suture; and at least
three anchor members interconnected to form an anchor assembly with
said suture extending therefrom, said anchor assembly having an
insertion configuration wherein said at least three anchor members
are aligned in a substantially linear arrangement sized for
delivery through an aperture in bodily tissue and being
transitionable to an expanded configuration wherein said at least
three anchor members are positioned in a triangular-shaped
arrangement sized to prevent passage of said anchor assembly back
through the aperture; and wherein said at least three anchor
members include outer anchor members and at least one intermediate
anchor member, each of said outer anchor members including first
and second end portions, said at least one intermediate anchor
member extending laterally between said first end portions of said
outer anchor members, said second end portions of said outer anchor
members positioned adjacent one another to provide said
triangular-shaped arrangement of said at least three anchor
members.
57. A suture anchoring system, comprising: a suture; and at least
three anchor members interconnected to form an anchor assembly with
said suture extending therefrom, said anchor assembly having an
insertion configuration wherein said at least three anchor members
are aligned in a substantially linear arrangement sized for
delivery through an aperture in bodily tissue and being
transitionable to an expanded configuration wherein said at least
three anchor members are positioned in a side-by-side arrangement
sized to prevent passage of said anchor assembly back through the
aperture; and wherein said at least three anchor members include
outer anchor members and at least one intermediate anchor member,
each of said at least three anchor members including opposite first
and second end portions, said first end portions of said at least
three anchor members positioned adjacent one another and said
second end portions of said at least three anchor members
positioned adjacent one another to provide said side-by-side
arrangement of said at least three anchor members.
58. The system of claim 57, wherein said side-by-side arrangement
of said at least three anchor members comprises an alignment of
said at least three anchor members in a substantially parallel
relationship relative to one another.
59. The system of claim 57, wherein said anchor assembly comprises
two of said intermediate anchor members positioned between said
outer anchor members in a side-by-side relationship to define said
side-by-side arrangement of said at least three anchor members.
Description
BACKGROUND
[0001] The complete or partial detachment of ligaments, tendons or
other soft tissues from their associated bones within the body is a
relatively common place injury, particularly among athletes and
physically active individuals. These types of injuries generally
result from excessive stresses being applied to the soft tissues.
For example, a tissue detaching injury may occur as the result of a
fall, overexertion during a work-related activity, during the
course of an athletic event, and/or in association with other
situations or physical activities.
[0002] In the case of a partial detachment injury, which is
commonly referred to under the general term "sprain", the injury
will frequently heal itself if given sufficient time and if care is
taken not to expose the injury to any undue or extraordinary stress
during the healing process. If, however, the ligament or tendon is
completely detached from its associated bone or bones, or if it is
severed as a result of a traumatic injury, partial or permanent
disability may result. Fortunately, a number of surgical techniques
exist for reattaching detached tissues and/or completely replacing
severely damaged tissues. One such technique involves reattachment
of detached tissue using traditional attachment devices such as
metal staples, sutures over buttons and/or cancellous bone screws.
These types of traditional attachment techniques and devices may
also be used to attach tendon or ligament substitutes (sometimes
formed of autogenous tissue harvested from other locations in the
body) to the desired bone or bones.
[0003] Although attempts have been made to provide techniques and
devices for forming an attachment to bone or other tissue, there is
a general need in the industry to provide an improved suture
anchoring system and method. The present invention satisfies this
need and provides other benefits and advantages in a novel and
unobvious manner.
SUMMARY
[0004] The present invention relates generally to an improved
suture anchoring system and method. While the actual nature of the
invention covered herein can only be determined with reference to
the claims appended hereto, certain forms of the invention that are
characteristic of the preferred embodiments disclosed herein are
described briefly as follows.
[0005] In one form of the present invention, a suture anchoring
system is provided including at least three anchor members
interconnected to form an anchor assembly with a suture extending
therefrom. The anchor assembly has an insertion configuration sized
for delivery through an aperture in bodily tissue and is
transitionable to an expanded configuration sized to prevent
passage of the anchor assembly back through the aperture.
[0006] In another form of the present invention, a suture anchoring
system is provided including at least three anchor members
interconnected to form an anchor assembly with a suture extending
therefrom. The anchor assembly has an insertion configuration
wherein the anchor members are aligned in a substantially linear
arrangement for delivery through an aperture in bodily tissue and
an expanded configuration wherein the anchor members are
transitioned to a non-linear arrangement to prevent passage of the
anchor assembly back through the aperture.
[0007] In another form of the present invention, a suture anchoring
system is provided including at least three anchor members
interconnected to form an anchor assembly with a suture extending
therefrom. The anchor assembly includes first and second outer
anchor members and at least one intermediate anchor member, and has
an insertion configuration wherein the anchor members are aligned
in a substantially linear arrangement for delivery through an
aperture in bodily tissue and an expanded configuration wherein the
outer anchor members are drawn toward one another to define a
non-linear arrangement to prevent passage of the anchor assembly
back through the aperture.
[0008] In another form of the present invention, a suture anchoring
system is provided including at least three anchor members, means
for interconnecting the anchor members to form an anchor assembly
with a suture extending therefrom and having an insertion
configuration wherein the anchor members are aligned in a
substantially linear arrangement for delivery through an aperture
in bodily tissue, and means for transitioning the anchor assembly
from the insertion configuration to an expanded configuration
wherein the anchor members are transitioned to a non-linear
arrangement to prevent passage of the anchor assembly back through
the aperture.
[0009] In another form of the present invention, a suture anchoring
system is provided including a plurality of anchor members
interconnected to form an anchor assembly with a suture extending
therefrom. The anchor assembly has an insertion configuration
wherein the anchor members are aligned in a substantially linear
arrangement for delivery through an aperture in bodily tissue and
an expanded configuration wherein first and second ones of the
anchor members are drawn toward one another to define a non-linear
arrangement to prevent passage of the anchor assembly back through
the aperture. The system further includes an actuating element
extending through a first loop structure associated with the first
anchor member and through a second loop structure associated with
the second anchor member, and wherein the first and second anchor
members are drawn toward one another by pulling the actuating
element in a direction away from the anchor assembly to at least
partially transition the anchor assembly toward the expanded
configuration.
[0010] In another form of the present invention, a method for
anchoring a suture to bodily tissue is provided including providing
at least three anchor members interconnected to form an anchor
assembly with a suture extending from the anchor assembly, aligning
the anchor members in a substantially linear configuration,
inserting the anchor members through an aperture in the bodily
tissue while in the linear configuration, and transitioning the
anchor members from the linear configuration to a non-linear
configuration to prevent passage of the anchor assembly back
through the aperture.
[0011] It is one object of the present invention to provide an
improved suture anchoring system and method. Further objects,
features, advantages, benefits, and aspects of the present
invention will become apparent from the drawings and description
contained herein.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] FIG. 1 is a perspective view of a suture anchoring system
according to one form of the present invention.
[0013] FIG. 2 is an illustration of the suture anchoring system
shown in FIG. 1, as loaded within a cannula tube in an insertion
configuration for delivery through an aperture in body tissue.
[0014] FIG. 3 is an illustration of the suture anchoring system
shown in FIG. 2, with the anchor members delivered through the
aperture in the body tissue.
[0015] FIG. 4 is an illustration of the suture anchoring system
shown in FIG. 3, with the anchor members transitioned to a first
anchoring configuration.
[0016] FIG. 5 is an illustration of the suture anchoring system
shown in FIG. 4, with the anchor members transitioned to a second
anchoring configuration.
[0017] FIG. 6 is a perspective view of a suture anchoring system
according to another form of the present invention.
[0018] FIG. 7 is an illustration of the suture anchoring system
shown in FIG. 6, as loaded within a cannula tube in an insertion
configuration for delivery through an aperture in body tissue.
[0019] FIG. 8 is an illustration of the suture anchoring system
shown in FIG. 7, with the anchor members delivered through the
aperture in the body tissue.
[0020] FIG. 9 is an illustration of the suture anchoring system
shown in FIG. 8, with the anchor members transitioned to an
anchoring configuration.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0021] For the purposes of promoting an understanding of the
principles of the invention, reference will now be made to the
embodiments illustrated in the drawings and specific language will
be used to describe the same. It will nevertheless be understood
that no limitation of the scope of the invention is hereby
intended, and that alterations and further modifications to the
illustrated devices and/or further applications of the principles
of the invention as illustrated herein are contemplated as would
normally occur to one skilled in the art to which the invention
relates.
[0022] Referring to FIG. 1, shown therein is a suture anchoring
system 10 according to one form of the present invention. The
anchoring system 10 is generally comprised of a plurality of anchor
members 12 and a number of suture elements 14. As will be discussed
in greater detail below, in one embodiment of the invention, the
anchoring system 10 is configured for anchoring to either hard or
soft biological tissue, with the suture elements 14 serving to
attach another element or structure (either biological or
non-biological) to the biological tissue. As used herein, the term
"suture" is broadly defined to include any type of longitudinal
element suitable for attachment to biological tissue including, for
example, thread, wire, gut or any other type of suture material
known to those of skill in the art.
[0023] In the illustrated embodiment of the invention, the anchor
members 12 each have a generally tubular configuration including a
cylindrical wall 20 and defining an axial passage or channel 22
extending therethrough. However, it should be understood that other
shapes and configurations of the anchor members 12 are also
contemplated as falling within the scope of the present invention
including, for example, a rectangular, triangular, polygonal or
spherical configuration, or any other suitable shape or
configuration. The anchor members 12 are preferably formed of a
bio-compatible material. In one embodiment, the anchor members 12
are formed of metallic material such as stainless steel or a
stainless steel alloy, titanium or a titanium alloy, a shape-memory
alloy, or any other suitable metallic material. However, the use of
other materials is also contemplated, including polymeric or
ceramic materials, resorbable materials, bioabsorbable materials,
or bone or bone substitute materials.
[0024] In the illustrated embodiment of the invention, the suture
anchoring system 10 includes four anchor members 12a, 12b, 12c and
12d that are coupled together or interconnected to form an anchor
assembly. However, it should be understood that the anchoring
system 10 may include any number of anchor members 12, including
two, three or five or more anchor members. In one embodiment, the
anchor members 12a-12d are coupled or interconnected to one another
via a linking element 30. In the illustrated embodiment, the
linking element 30 comprises a suture extending through the axial
passages 22 in each of the anchor members 12a-12d to link the
anchor members 12a-12d together in series. The linking element 30
provides structural integrity to the anchoring system 10 by
controlling the position and/or orientation of the anchor members
12a-12d relative to one another, the details of which will be
discussed below. Additionally, the linking element 30 has a
length/such that the anchor members 12a-12d may be axially
separated or spaced from one another in a non-abutting manner, the
purpose of which will also become apparent below.
[0025] In the illustrated embodiment of the invention, the ends
30a, 30b of the linking element 30 are attached to one another so
to define a continuous suture loop having a first end loop 32
extending from the outer anchor member 12a and a second end loop 34
extending from the outer anchor member 12d. In the illustrated
embodiment of the invention, the ends 30a, 30b are tied or knotted
together to form the suture loop 30. However, it should be
understood that the ends 30a, 30b of the suture loop 30 may be
attached to one another using other techniques such as, for
example, via the use of a crimp or another type of coupling device,
by fusing or splicing the ends 30a, 30b together, or by any other
suitable method of attachment. It should also be understood that
the linking element 30 need necessarily be configured as a loop,
but may alternatively define a non-looped, single strand
configuration. It should further be understood that the anchor
members 12a-12d need not necessarily be coupled together or
interconnected via a single suture element, but may alternatively
be individually coupled together via a number of discrete suture
elements. Additionally, it should be understood that the anchor
members 12a-12d need not necessarily be coupled together by suture
material, but may alternatively be coupled together using other
elements and techniques such as, for example, via a number of pins,
hinges, fittings, eyelets or any other suitable coupling
device.
[0026] In the illustrated embodiment of the invention, the
anchoring system 10 also includes an actuating element 40 that
cooperates with the linking element 30 to selectively manipulate
the position and/or orientation of one or more of the anchor
members 12a-12d. In the illustrated embodiment, the actuating
element 40 comprises a suture that engages the end portions of the
linking element 30 to selectively manipulate the position and/or
orientation of one or more of the anchor members 12a-12d. In a
specific embodiment, the actuating element 40 extends through the
end loops 32, 34 of the linking element 30 such that pulling the
ends 40a, 40b of the actuating element 40 draws the outer anchor
members 12a, 12d toward one another and transitions one or more of
the anchor members 12a-12d to a different position and/or
orientation, the details of which will be discussed below. Although
the actuating element 40 is illustrated and described as being
engaged with the end loops 32, 34 of the linking element 30, it
should be understood that the actuating element 40 may
alternatively be coupled to the outer anchor members 12a, 12d via
other suitable techniques for drawing the outer anchor members 12a,
12d toward one another and for selectively transitioning one or
more of the anchor members 12a-12d to a different position and/or
orientation. For example, a full or partial loop element may be
attached directly to the outer anchor members 12a, 12d through
which the actuating element 40 extends.
[0027] In the illustrated embodiment of the invention, the
anchoring system 10 further includes a second actuating element 50
that cooperates with the linking element 30 to selectively
manipulate the position and/or orientation of one or more of the
anchor members 12a-12d. In the illustrated embodiment, the
actuating element 50 comprises a suture that engages the linking
element 30 at a location between the inner anchor member 12b, 12c
to selectively manipulate the position and/or orientation of one or
more of the anchor members 12a-12d. In one embodiment, the
actuating element 50 is looped about the linking element 30 such
that pulling the ends 50a, 50b of the actuating element 50 draws
the inner anchor members 12b, 12c to a location between the outer
anchor members 12a, 12d. In a specific embodiment, the actuating
element 50 is threaded between the strands of the suture loop
linking element 30. Although the actuating element 50 is
illustrated and described as being looped about the linking element
30, it should be understood that the actuating element 50 may be
coupled to the linking element 30 via other techniques suitable for
drawing the inner anchor members 12b, 12c between the outer anchor
members 12a, 12d. For example, instead of looping the actuating
element 50 about the linking element 30, an end portion of the
actuating element 50 may by tied or otherwise secured to the
linking element 30.
[0028] Having illustrated and described the various elements and
features associated with the suture anchoring system 10, reference
will now be made to a technique for engaging the anchoring system
10 to human body tissue. As indicated above, the anchoring system
10 is used to anchor a suture in either hard or soft biological
tissue. In the illustrated embodiment of the invention, the
anchoring system 10 is used to anchor a suture to bone in a human
body. In a specific embodiment, the anchoring system 10 is used to
anchor a suture to a portion of one or more vertebrae in the spinal
column. However, it should be understood that other applications of
the anchoring system 10 are also contemplated, including anchoring
to other bones or anatomic structures within the human body.
Additionally, it should be understood that use of the anchoring
system 10 in other animals is also contemplated as falling within
the scope of the present invention.
[0029] Referring to FIG. 2, the anchoring system 10 is illustrated
as being used in association with a bone B having a relatively hard
and compact outer cortical layer L surrounding a softer and more
porous inner cancellous region C. In one embodiment of the
invention, an axial tunnel or aperture A having a maximum
transverse dimension d may be preformed through the cortical layer
L and into the cancellous region C for receiving the anchoring
system 10. However, in an alternative embodiment, the anchoring
system 10 may be inserted directly into the body tissue without
creating a preformed tunnel or aperture, particularly in
applications involving relatively soft body tissue.
[0030] In the illustrated embodiment of the invention, the
anchoring system 10 is delivered to the surgical site via a
delivery instrument 200 extending along a longitudinal axis 201 and
generally comprising an outer sleeve or cannula member 202 and an
inner rod member 204. The cannula member 202 defines an axial
passageway 206 extending therethrough and having an inner cross
section sized somewhat larger than the outer transverse cross
section of the individual anchor members 12. The inner rod member
204 is sized and configured to be slidably positioned within the
axial passageway 206 of the cannula member 202. In one embodiment,
the inner rod member 204 has a circular outer cross section that
corresponds to the inner cross section of the cannula member 202.
However, other configurations of the cannula member 202 and/or the
inner rod member 204 are also contemplated as falling within the
scope of the present invention.
[0031] The outer transverse cross section of the individual anchor
members 12 is sized somewhat smaller than the inner cross section
of the axial passageway 206 in the cannula member 202 to allow the
anchor members 12 to freely slide along the axial passageway 206.
Additionally, sufficient clearance exists between the anchor
members 12 and the cannula member 202 to provide spacing for the
passage of the suture elements 40 and 50. In the illustrated
embodiment, the axial passageway 206 has a circular inner cross
section corresponding to the circular outer cross section of the
anchor members 12. However, it should be understood that the axial
passageway 206 may be configured to have a different inner cross
section such as, for example, a rectangular, triangular or
polygonal inner cross section, or any other inner cross section
suitable for receiving and conveying the anchor members 12
therethrough. Additionally, in an alternative embodiment of the
invention, the outer transverse cross section of the anchor members
12 and the inner cross section of the axial passageway 206 can be
configured different from one another to provide a predetermined
spacing therebetween for passage of the suture elements 40 and 50.
For example, in one alternative embodiment, the axial passageway
206 can be configured to have a circular inner cross section
whereas the anchor members 12 can be configured to have a generally
triangular or rectangular outer cross section.
[0032] The anchor members 12a-12d are initially positioned within
the distal end portion of the cannula member 202 in an
axially-aligned or linear configuration, with the axes of the
anchor members 12a-12d generally aligned along the longitudinal
axis 201. The end portions 40a, 40b and 50a, 50b of the suture
elements 40 and 50 extend from the proximal end (not shown) of the
cannula member 202 for subsequent manipulation by the surgeon. The
distal end portion 202a of the cannula member 202 is positioned
proximally adjacent the bone B, with the axial passageway 206
generally aligned with the aperture A. However, in an alternative
embodiment of the invention, the distal end portion 202a of the
cannula member 202 may be positioned within the aperture A formed
through the outer cortical layer L and possibly extending partially
into the cancellous region C of the bone B.
[0033] Referring to FIG. 3, once the cannula member 202 is properly
positioned relative to the aperture A, the inner rod member 204 is
axially displaced in the direction of arrow 210 with the distal end
204a engaging the anchor member 12d, which in turn displaces the
anchor members 12a-12d through the axial passageway 206. The inner
rod member 204 is axially advanced in the direction of arrow 210
until the anchor members 12a-12d are deployed from the cannula
member 202 and into the aperture A in the cancellous region C of
the bone B. As illustrated in FIG. 3, the depth of the aperture A
in the cancellous region C is preferably sized to entirely receive
the anchor members 12a-12d therein in the axially-aligned
configuration. The rod member 204 may then be removed from the
cannula member 202 or can remain in position until the anchoring
process is completed to prevent the anchor members 12a-12d from
passing back through the cortical layer L of the bone B.
[0034] Referring to FIG. 4, once the anchor members 12a-12d are
deployed from the cannula member 202 and properly positioned within
the aperture A in the cancellous region C of the bone B, the anchor
members 12a-12d are selectively transitioned to a non-linear or
expanded configuration. As should be appreciated, transitioning of
the anchor members 12a-12d to the non-linear configuration results
in outward compression against the relatively soft cancellous bone
tissue, thereby resulting in enlargement of the aperture A in the
bone B. However, as should also be appreciated, for applications
involving anchoring to denser or harder bone tissue, an enlarged
portion of the aperture A may have to be preformed in the bone B to
allow for transitioning of the anchor members 12a-12d to the
expanded, non-linear configuration.
[0035] Transitioning of the anchor members 12a-12d is effectuated
by pulling the ends 40a, 40b of the actuating suture element 40 in
a proximal direction so as to reconfigure the anchor members
12a-12d from the axially-aligned configuration illustrated in FIG.
3 to the expanded configuration illustrated in FIG. 4. More
specifically, since the suture element 40 extends through the end
loops 32, 34 of the linking element 30, pulling the suture element
40 in a proximal direction draws the outer anchor members 12a, 12d
toward one another. As a result, the anchor members 12a-12d are
repositioned/reoriented so as to define a generally U-shaped
configuration, with the anchor members 12a, 12b being arranged
generally laterally opposite the anchor members 12c, 12d.
[0036] Once transitioned to the non-linear configuration
illustrated in FIG. 4, the anchor members 12a-12d are further
transitioned to the expanded configuration illustrated in FIG. 5 by
pulling the ends 50a, 50b of the actuating suture element 50 in a
proximal direction. As should be appreciated, pulling the suture
element 50 in a proximal direction reconfigures the anchor members
12a-12d from the U-shaped expanded configuration illustrated in
FIG. 4 to the denser configuration illustrated in FIG. 5. Pulling
the actuating element 50 in a proximal direction draws the inner
anchor members 12b, 12c between the outer anchor members 12a, 12d.
More specifically, the inner anchor members 12b, 12c are
repositioned and reoriented relative to the outer anchor members
12a, 12d so as to position the inner anchor members 12b-12c in a
laterally adjacent or side-by-side relationship relative to the
outer anchor members 12a, 12d. As should be appreciated, the
expanded configuration of the anchor members 12a-12d illustrated in
FIG. 5 is somewhat larger than the inner cross section of the
aperture A extending through the outer cortical layer L of the bone
B. Accordingly, the expanded configuration of the anchor members
12a-12d will not pass through the aperture A in the cortical bone
layer L, thereby securely anchoring the anchor members 12a-12d and
the suture elements 40 and 50 to the bone B. The suture elements 40
and 50 may then be attached to other elements/structures so as to
secure such elements/structures to the bone B, examples of which
will be set forth below.
[0037] Referring to FIG. 6, shown therein is a suture anchoring
system 100 according to another form of the present invention. The
anchoring system 100 is generally comprised of a plurality of
anchor members 112 and a number of suture elements 114. As will be
discussed in greater detail below, in one embodiment of the
invention, the anchoring system 100 is configured for anchoring to
either hard or soft biological tissue, with the suture elements 114
serving to attach another element or structure (either biological
or non-biological) to the biological tissue.
[0038] In the illustrated embodiment of the invention, the anchor
members 112 are configured identical to the anchor members 12
illustrated and described above with regard to the anchoring system
10, with each anchor member 112 having a generally tubular
configuration including a cylindrical wall 120 and defining an
axial passage or channel 122 extending therethrough. However, it
should be understood that other shapes and configurations of the
anchor members 112 are also contemplated as falling within the
scope of the present invention including, for example, a
rectangular, triangular, polygonal or spherical configuration, or
any other suitable shape or configuration. The anchor members 112
are preferably formed of a bio-compatible material. In one
embodiment, the anchor members 112 are formed of metallic material
such as stainless steel or a stainless steel alloy, titanium or a
titanium alloy, a shape-memory alloy, or any other suitable
metallic material. However, the use of other materials is also
contemplated, including polymeric or ceramic materials, resorbable
materials, bioabsorbable materials, or bone or bone substitute
materials.
[0039] In the illustrated embodiment of the invention, the suture
anchoring system 100 includes three anchor members 112a, 112b and
112c that are coupled together or interconnected to form an anchor
assembly. However, it should be understood that the anchoring
system 100 may include any number of anchor members 112, including
two or four or more anchor members. In one embodiment, the anchor
members 112a-112c are coupled or interconnected to one another via
a linking element 130. In the illustrated embodiment, the linking
element 130 comprises a suture extending through the axial passages
122 in each of the anchor members 112a-112c to link the anchor
members 112a-112c together in series. The linking element 130
provides structural integrity to the anchoring system 100 by
controlling the position and/or orientation of the anchor members
112a-112c relative to one another, the details of which will be
discussed below. Additionally, the linking element 130 has a length
l' such that the anchor members 112a-112c may be axially separated
or spaced from one another in a non-abutting manner, the purpose of
which will become apparent below.
[0040] In the illustrated embodiment of the invention, the ends
130a, 130b of the linking element 130 are attached to one another
so to define a continuous suture loop having a first end loop 132
extending from the outer anchor member 112a and a second end loop
134 extending from the outer anchor member 112c. In the illustrated
embodiment of the invention, the ends 130a, 130b are tied or
knotted together to form the suture loop 130. However, it should be
understood that the ends 130a, 130b of the suture loop 130 may be
attached to one another using other techniques such as, for
example, via the use of a crimp or another type of coupling device,
by fusing or splicing the ends 130a, 130b together, or by any other
suitable method of attachment. It should also be understood that
the linking element 130 need necessarily be configured as a loop,
but may alternatively define a non-looped, single strand
configuration. It should further be understood that the anchor
members 112a-112c need not necessarily be coupled together or
interconnected via a single suture element, but may alternatively
be individually coupled together via a number of discrete suture
elements. Additionally, it should be understood that the anchor
members 112a-112c need not necessarily be coupled together by
suture material, but may alternatively be coupled together using
other elements and techniques such as, for example, via a number of
pins, hinges, fittings, eyelets or any other suitable coupling
device.
[0041] In the illustrated embodiment of the invention, the
anchoring system 100 also includes an actuating element 140 that
cooperates with the linking element 130 to selectively manipulate
the position and/or orientation of one or more of the anchor
members 112a-112c. In the illustrated embodiment, the actuating
element 140 comprises a suture that engages the end portions of the
linking element 130 to selectively manipulate the position and/or
orientation of one or more of the anchor members 112a-112c. In a
specific embodiment, the actuating element 140 extends through the
end loops 132, 134 of the linking element 130 such that pulling the
ends 140a, 140b of the actuating element 140 draws the outer anchor
members 112a, 112c toward one another and transitions one or more
of the anchor members 112a-112c to a different position and/or
orientation, the details of which will be discussed below. Although
the actuating element 140 is illustrated and described as being
connected to the end loops of the linking element 130, it should be
understood that the actuating element 140 may be coupled to the
outer anchor members 112a, 112c via other suitable techniques for
drawing the outer anchor members 112a, 112c toward one another and
for selectively transitioning one or more of the anchor members
112a-112c to a different position and/or orientation. For example,
a full or partial loop element may be attached directly to the
outer anchor members 112a, 112c through which the actuating element
140 extends.
[0042] Having illustrated and described the various elements and
features associated with the suture anchoring system 100, reference
will now be made to a technique for engaging the anchoring system
100 to biological tissue such as, for example, to the bone B.
However, as discussed above with regard to the anchoring system 10,
it should be understood that other applications of the anchoring
system 100 are also contemplated, including anchoring to other
bones or anatomic structures. Referring to FIG. 7, in one
embodiment of the invention, the anchoring system 100 is delivered
to the surgical site via the delivery instrument 200 illustrated
and described above. The anchor members 112a-112c are initially
positioned within the distal end portion of the cannula member 202
in an axially-aligned or linear configuration, with the axes of the
anchor members 112a-112c generally aligned along the longitudinal
axis 201. The end portions 140a, 140b of the suture element 40
extend from the proximal end (not shown) of the cannula member 202
for subsequent manipulation by the surgeon. The distal end portion
202a of the cannula member 202 is positioned proximally adjacent
the bone B, with the axial passageway 206 generally aligned with
the aperture A extending into the cortical layer L.
[0043] Referring to FIG. 8, once the cannula member 202 is properly
positioned relative to the aperture A, the inner rod member 204 is
axially displaced in the direction of arrow 210 with the distal end
204a engaging the anchor member 112c, which in turn displaces the
anchor members 112a-112c through the axial passageway 206. The
inner rod member 204 is axially advanced in the direction of arrow
210 until the anchor members 112a-112c are deployed from the distal
end 202a of cannula member 202 and into the cancellous region C of
the bone B. As illustrated in FIG. 8, the depth of the aperture A
in the cancellous region C is preferably sized so as to receive the
axially-aligned anchor members 112a-112c therein. The rod member
204 may then be removed from the cannula member 202 or can remain
in position until the anchoring process is completed to prevent the
anchor members 112a-112c from passing back through the cortical
layer L of the bone B.
[0044] Referring to FIG. 9, once the anchor members 112a-112c are
deployed from the distal end of the cannula member 202 and properly
positioned within the aperture A in the cancellous region C of the
bone B, the anchor members 112a-112c are transitioned to a
non-linear or expanded configuration. Such transitioning is
effectuated by pulling the ends 140a, 140b of the actuating suture
element 140 in a proximal direction to reconfigure the anchor
members 112a-112c from the axially-aligned configuration
illustrated in FIG. 8 to the expanded configuration illustrated in
FIG. 9. More specifically, since the suture element 140 extends
through the end loops 132, 134 of the linking element 130, pulling
the suture element 140 in a proximal direction draws the outer
anchor members 112a, 112c toward one another. As a result, the
anchor members 112a-112c are repositioned/reoriented so as to
define a generally triangular-shaped configuration, with the outer
anchor members 112a, 112c being angled toward one another and with
the inner anchor member 112b extending laterally between the outer
anchor members 112a, 112c.
[0045] As should be appreciated, the expanded configuration of the
anchor members 112a-112c illustrated in FIG. 9 is larger than the
inner cross section of the aperture A extending through the outer
cortical bone layer L. Accordingly, the expanded configuration of
the anchor members 112a-112c will not pass through the aperture A
in the cortical bone layer L, thereby securely anchoring the anchor
members 112a-112c and the suture element 140 to the bone B. The
suture element 140 may be attached to other elements/structures so
as to secure such elements/structures to the bone B.
[0046] As should now be appreciated, the anchoring systems 10, 100
illustrated and described above may be anchored to either hard or
soft biological tissue, with the suture elements 40, 50 and 140
being used to attach another element or structure to the biological
tissue. In one embodiment of the invention, the anchoring systems
10, 100 may be used to provide a surgical anchor useful in the
repair and/or replacement of ligaments, tendons or other types of
tissues. In another embodiment of the invention, the anchoring
systems 10, 100 may be used to provide a surgical anchor for
holding a bone block in place in a tunnel formed in bone such that
a piece of soft tissue attached to the bone block can be connected
to the bone under tension. In yet another embodiment of the
invention, the anchoring systems 10, 100 may be used to provide a
surgical anchor that avoids or reduces the risks associated with
severing, twisting or otherwise damaging material associated with
soft tissue repair or replacement. In still another embodiment of
the invention, the anchoring systems 10, 100 may be used to provide
a surgical anchor that may be inserted into a tunnel formed in bone
that avoids or reduces the likelihood of seriously damaging the
surrounding bone material. In a further embodiment of the
invention, the anchoring systems 10, 100 may be used to provide a
surgical anchor that is adapted to secure material used in
association with tissue repair or replacement in close proximity to
bone in such a manner as to promote the formation or growth of a
permanent attachment therebetween. In another embodiment of the
invention, the anchoring systems 10, 100 may be used in association
with a method for repairing and/or replacing ligaments, tendons or
other types of tissues by coupling an end portion of such tissue
(or its replacement) to a tunnel extending into or through a bone
or a bone-like structure.
[0047] While the invention has been illustrated and described in
detail in the drawings and foregoing description, the same is to be
considered as illustrative and not restrictive in character, it
being understood that only the preferred embodiments have been
shown and described and that all changes and modifications that
come within the spirit of the invention are desired to be
protected.
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