U.S. patent application number 15/486530 was filed with the patent office on 2017-08-03 for knotless anchor.
This patent application is currently assigned to Smith & Nephew, Inc.. The applicant listed for this patent is Smith & Nephew, Inc.. Invention is credited to Tatsuya Arai, Matthew E. Koski.
Application Number | 20170215867 15/486530 |
Document ID | / |
Family ID | 49620283 |
Filed Date | 2017-08-03 |
United States Patent
Application |
20170215867 |
Kind Code |
A1 |
Arai; Tatsuya ; et
al. |
August 3, 2017 |
KNOTLESS ANCHOR
Abstract
A knotless anchor (100) includes an elongate body (102), a
plurality of wings (104) extending outward from the body, a
plurality of grooves (106) corresponding to the wings formed in the
body, and a transverse bore (110) in communication with the
grooves. The wings may be pivotably attached to the body, allowing
movement between an open position, where the wings do not engage
the grooves, and a closed position, where at least a portion of
each wing engages its corresponding groove. A suture (122) routed
through the grooves and the transverse bore is frictionally secured
to the suture when the wings are urged in the closed position. In
use, the wings may be urged into the closed position when inserted
into a recess smaller than the cross-section of the anchor, such as
a hole formed in a bone.
Inventors: |
Arai; Tatsuya; (Houston,
TX) ; Koski; Matthew E.; (Westford, MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Smith & Nephew, Inc. |
Memphis |
TN |
US |
|
|
Assignee: |
Smith & Nephew, Inc.
Memphis
TN
|
Family ID: |
49620283 |
Appl. No.: |
15/486530 |
Filed: |
April 13, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14435036 |
Apr 10, 2015 |
9649103 |
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PCT/US13/67858 |
Oct 31, 2013 |
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15486530 |
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61721614 |
Nov 2, 2012 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61F 2002/0823 20130101;
A61B 2017/0412 20130101; A61B 2017/0414 20130101; A61B 17/0485
20130101; A61B 2017/0403 20130101; A61B 2017/0454 20130101; A61B
2017/0427 20130101; A61B 2017/0409 20130101; A61B 2017/0437
20130101; A61B 2017/0443 20130101; A61F 2002/0835 20130101; A61F
2/0811 20130101; A61B 2017/0456 20130101; A61F 2002/0817 20130101;
A61B 17/0401 20130101 |
International
Class: |
A61B 17/04 20060101
A61B017/04 |
Claims
1. A suture anchor comprising: an elongated body defining a
transverse bore extending through the body; and a first wing
hingedly attached to the body at a distal end of the first
wing.
2. The suture anchor according to claim 1, further comprising a
first groove in the outer surface of the body and extending along
at least a portion of the length of the body, wherein the distal
end of the first wing is hingedly attached to a distal end of the
first groove.
3. A suture anchor according to claim 2, further comprising a
second groove and a second wing, wherein a distal end of the second
wing is hingedly attached to a distal end of the second groove.
4. A suture anchor according to claim 3, wherein the second groove
and the second wing are positioned at diametrically opposed
surfaces of the body to the first groove and the first wing.
5. A suture anchor according to claim 3, wherein each hinge is
formed integrally with the body.
6. A suture anchor according to claim 5, wherein each hinge is a
living hinge.
7. A suture anchor according to claim 3, wherein the transverse
bore connects the first groove and the second groove.
8. A suture anchor according to claim 3, wherein each wing further
comprises at least one protrusion on an inner surface.
9. A suture anchor according to claim 8, wherein the at least one
protrusion is positioned adjacent the transverse bore, such that at
least a portion of the protrusion extends into the transverse bore,
in use.
10. A suture anchor according to claim 3, wherein the anchor body
further comprises a first plurality of circumferential ribs.
11. A suture anchor according to claim 10, wherein an outer surface
of each wing comprises a second plurality of ribs, the second
plurality of ribs corresponding to the first plurality of
circumferential ribs.
12. A suture anchor according to claim 7, wherein the anchor body
further comprises a longitudinal bore extending through at least a
portion of the anchor body.
13. A suture anchor according to claim 12, wherein the longitudinal
bore extends into the transverse bore.
14. A suture anchor according to claim 1, further comprising a
plurality of ribs mounted on an outer surface of the first
wing.
15. A suture anchor according to claim 3, wherein each wing further
comprises one or more notches, the one or more notches positioned
on at least one of an outer surface and an inner surface of each
wing.
16. A suture anchor comprising: an elongated anchor body; at least
one longitudinally extending groove formed along at least a portion
of an outer surface of the anchor body; a transverse bore extending
through the anchor body and in communication with the at least one
groove; at least one wing extending from the at least one groove,
wherein the at least one groove is dimensioned to receive the at
least one wing; and a hinge attaching the at least one wing with
the anchor body and permitting motion of the at least one wing
between a first position, where the at least one wing extends
outside of the at least one groove, and a second position, where at
least a portion of the at least one wing is positioned within the
at least one groove.
17-20. (canceled)
Description
BACKGROUND
[0001] The labral tissue, or labrum, is a type of soft tissue or
cartilage that surrounds the socket of ball-and-socket joints, such
as the shoulder and the hip joints. The labrum forms a ring around
the edge of the bony socket of the joint and helps to provide
stability to the joint by deepening the socket. The labrum may
further assist in containing lubricating fluids within the joint,
promoting flexibility and motion.
[0002] Ball-and-socket joints may become damaged when experiencing
high stresses. Often, joint damage may involve tearing of the
labral tissue away from the underlying bone. This labral tearing
may cause a patient to experience severe pain and give rise to
abnormal motion of the ball-and-socket joint. Over time, such
abnormal motion may lead to excessive cartilage wear within the
joint and arthritis.
[0003] In most cases, once the labrum is torn from the bone,
surgery is required to repair the damaged labrum. This surgery may
involve reattachment of the torn labrum to the bone or attachment
of a tissue graft to the damaged portion of the labrum. In either
case, it is desirable to reduce the number of surgical implants
and/or the number of steps required during surgical repair.
SUMMARY
[0004] Reconstructive surgery often employs surgical attachment
techniques using a suture secured to a rigid skeletal member such
as a bone. For example, labral reconstructive surgery often
involves sutured reattachment of the labrum or tissue grafts to the
circumference of a socket joint. Embodiments of the present
disclosure relate to knotless suture anchors for use in surgical
techniques, such as labral reconstructive repair.
[0005] For example, in an embodiment, a knotless suture anchor may
include a generally elongated body having proximal and distal ends.
In certain embodiments, the body includes a distal tapered tip and
a uniform cross-section extending proximally from the distal tip.
In alternative embodiments, the anchor body is tapered along its
length, with the body cross-section becoming smaller towards the
distal end. In further embodiments, the cross-sectional shape of
the body is circular, In alternative embodiments, the
cross-sectional shape of the body is ovoid.
[0006] The suture anchor may further include one or more wings that
extend outward and proximally from the anchor body. In certain
embodiments, the suture anchor may include a pair of wings,
positioned on opposing faces of the suture anchor. In alternative
embodiments, the suture anchor may include three, four or five
wings.
[0007] The distal end of each wing may be secured to the anchor
body at a distal end, while the proximal end of each wing may be
free. The junction between the distal end of each wing and the
anchor body may further include a hinge. The hinge allows the wings
to pivot between an open position, where the proximal ends of the
wings are distanced from the anchor body and a closed position,
where at least a portion of the wings abut the anchor body. In
certain embodiments, the wings may be biased in an open
position.
[0008] A transverse bore may be further formed within the anchor
body, extending through the suture anchor. The transverse bore may
be dimensioned to receive a suture. When embodiments of the anchor
are in use, a suture is passed through the transverse bore and the
anchor may be positioned within a hole or recess formed in bone. So
positioned, the one or more wings are urged from the open position
into the closed position by contact with the sidewalls of the hole.
Concurrently, at least a portion of the suture is compressed
between the anchor body and the wings (e.g., the inner surface of
the wings). Furthermore, the wings exert a compressive force upon
the suture that inhibits sliding of the suture with respect to the
anchor body.
[0009] In additional embodiments, grooves may be formed in the
outer surface of the anchor body, corresponding to each wing, to
further promote retention of the suture within the suture anchor.
When positioned within the suture anchor, the suture may be routed
within one or more of the grooves and the transverse bore. When the
one or more wings are urged in the closed position, the inner
surface of the wings may abut the suture along at least a portion
of the length of the grooves. This configuration further increases
the area of contact over which the suture is compressed between the
anchor body (e.g., the grooves) and the wings (e.g., the inner
surface of the wings) and further inhibits sliding of the suture
with respect to the anchor body.
[0010] In an embodiment, each of the components of the anchor is
formed from the same or different materials. In further
embodiments, each of the components of the anchor is independently
formed from biocompatible materials or a material with a
biocompatible coating. Examples of biocompatible materials include,
but are not limited to, biocompatible polymers, biocompatible
metals, metal alloys, and metal oxides, and biocompatible ceramics
and glass-ceramics. Examples of biocompatible polymers include, but
are not limited to, thermoplastic polyurethanes (e.g.,
polyester-based polyurethanes, polyether-based urethanes, and
polycarbonate-based polyurethanes, in aromatic or aliphatic
grades), polyamides, fluoropolymers, polyolefins, and polyimides.
Specific examples of biocompatible polymers may include polyether
ether ketone (PEEK), polytetrafluoroethylene (PTFE), polyvinyl
chloride (PVC), and nylons. Examples of biocompatible metals
include, but are not limited to, titanium, titanium alloys (e.g.,
Ti.sub.6Al.sub.4, Ti.sub.6Al.sub.4V, Ti.sub.6Al.sub.7Nb), CoCrMo,
stainless steel (e.g., 316L). Examples of biocompatible ceramics
include, but are not limited to, diamond-like carbon (DLC),
aluminum oxide, calcium phosphates, zirconium oxide. In a preferred
embodiment, the anchor is formed from one or more of PEEK,
titanium, and a biocomposite material (e.g., Regensorb, Smith &
Nephew, PLC, London, UK).
[0011] In an embodiment, the distal tip of the anchor is formed
from a different material than the body of the anchor. For example,
the tip may be formed from titanium, while the anchor body is
formed from a biocompatible polymer or ceramic.
[0012] In an embodiment, a suture anchor is provided. The suture
anchor includes an elongated body and a transverse bore through the
body. The suture anchor further includes a wing hingedly attached
to the body at one end in the distal region of the anchor body.
[0013] Additional embodiments of the suture anchor include one or
more of the following, alone or in combination. For example, the
suture anchor includes at least one longitudinally extending groove
formed in the outer surface of the body and extending along at
least a portion of the length of the body, where the distal end of
the wing is hingedly attached to a distal end of the groove. The
suture anchor includes a second groove and a second wing, where a
distal end of the second wing is hingedly attached to a distal end
of the second groove. Optionally, the second groove and the second
wing are positioned at diametrically opposed surfaces of the body
to the first groove and wing. The hinge of the suture anchor is
formed integrally with the anchor body, optionally a living hinge.
Optionally, the transverse bore connects the at least one groove.
Each wing further includes at least one protrusion on an inner
surface. Optionally, the at least one protrusion is positioned
adjacent the transverse bore, such that at least a portion of the
protrusion extends into the transverse bore, in use. This
arrangement helps to provide enhance fixation of the suture within
the anchor. The suture anchor includes an anchor body including a
first plurality of circumferential ribs. Optionally, the outer
surface of each wing includes a second plurality of ribs
corresponding to the first plurality of ribs. The suture anchor
includes an anchor body including a longitudinal bore extending
through at least a portion of the anchor body. Optionally, the
longitudinal bore extends into the transverse bore. In further
embodiments, the longitudinal bore extends fully through the anchor
body.
[0014] In an embodiment, the groove is dimensioned to mate with its
corresponding wing. For example, the width, length, and depth of
the mating groove is about equal to the width, length, and
thickness of its corresponding wing and the wing is fully seated
within the groove when urged into contact with the anchor body. In
a further embodiment, when the wing is positioned within its mating
groove, the second plurality of ribs abut the first plurality of
ribs and forms a plurality of ribs extending continuously about the
outer surface of the anchor.
[0015] In an additional embodiment, the groove is dimensioned to
mate with its corresponding wing along only a portion of the length
of the anchor body. For example, the width and depth of the wing
and its mating groove are equal, while the length of the groove is
less than the length of the wing.
[0016] In an alternative embodiment, the groove is dimensioned to
fully receive its corresponding wing along only a portion of the
length of the anchor body. For example, the width of the wing and
its mating groove are equal, while the depth of the groove is
different than the length of the wing along a selected portion of
the length of the anchor. The divergence between the depth of the
groove and the thickness of the wing may begin at the distal end of
the wing or at a location proximal to the distal end of the wing.
The divergence between the depth of the groove and the thickness of
the wing may be accomplished by decreasing the groove depth with
respect to the wing thickness or increasing the wing thickness with
respect to the groove depth. In either case, the divergence between
the depth of the groove and the thickness of the wing causes the
outer surface of the wing extends outside the groove.
[0017] In a further embodiment, a suture anchor is provided. The
suture anchor includes an elongated anchor body. The suture anchor
also includes at least one longitudinally extending groove formed
along at least a portion of the outer surface of the anchor body.
The suture anchor additionally includes a transverse bore extending
through the anchor body and in communication with the at least one
groove. The suture anchor also includes a wing extending from the
at least one groove, where the at least one groove is dimensioned
to receive the wing. The suture anchor further includes a hinge
attaching the wing with the anchor body and permitting motion of
the wing between a first position, where the wing extends outside
of its corresponding groove, and a second position, where at least
a portion of the wing is positioned within its corresponding
groove.
[0018] In an embodiment, a segmented suture anchor is provided. The
segmented suture anchor includes an elongate body formed in two
pieces, a distal anchor body and a proximal anchor body. A
longitudinal bore extends through each of the proximal and distal
anchor bodies. The proximal anchor body further includes a
transverse bore extending through the proximal anchor body and
positioned adjacent a distal end of the proximal anchor body. The
distal anchor body further includes one or more wings extending
from an outer surface thereof, the one or more wings being
positioned adjacent to the transverse bore of the proximal anchor
body in an assembled configuration of the anchor.
[0019] In an additional embodiment, a method of inserting a suture
anchor in a structure is provided. The method includes providing a
suture anchor having an elongate body. The elongate body is formed
from two pieces, including a distal anchor body and a proximal
anchor body separate from one another. A longitudinal bore extends
through each of the proximal and distal anchor bodies, such that
the assembled elongate anchor body is cannulated. The proximal
anchor body further includes a transverse bore which is located in
a distal region of, and extends through, the proximal anchor body.
The distal anchor body includes one or more wings extending from an
outer surface thereof, the one or more wings being positioned
adjacent to the transverse bore of the proximal anchor body in an
assembled configuration. The method further includes inserting one
or more wire loops through the longitudinal bore at a proximal end
of the proximal anchor body, where the one or more wire loops are
dimensioned to receive a suture. The method also includes advancing
the wire loops through the longitudinal bore until at least a
portion of the wire loops exit the distal end of the distal anchor
body. The method further includes inserting a suture through at
least one of the wire loops. The method also includes retracting
the wire loops through the longitudinal bore of the distal anchor
body and at least one end of the transverse bore of the proximal
anchor body, where the ends of the suture exit the anchor body
through at least one end of the transverse bore. The method
additionally includes advancing the suture anchor into a recess,
the recess having a diameter smaller than the one or more wings,
where the recess urges the wings into frictional engagement with
the suture by compression of the wings against the recess.
[0020] Additional embodiments of the method include one or more of
the following. For example, inserting a suture through at least one
of the wire loops includes inserting a first end of the suture
through a first wire loop and inserting a second end of the suture
through a second wire loop. After retracting the wire loops, the
first end of the suture exits the anchor body through a first end
of the transverse bore and the second end of the suture exits the
anchor body through a second end of the transverse bore. Inserting
a suture through at least one of the wire loops includes inserting
each end of the suture through a single wire loop. After retracting
the wire loops, each end of the suture exits the anchor body
through a single end of the transverse bore. Inserting a suture
through at least one of the wire loops includes inserting each end
of the suture through a first and a second wire loop. After
retracting the wire loops, each end of the suture enters the anchor
body through a first end of the transverse bore and each end of the
suture exits the anchor body through a second end of the transverse
bore.
BRIEF DESCRIPTION OF THE DRAWINGS
[0021] The foregoing and other objects, features and advantages
will be apparent from the following more particular description of
the embodiments, as illustrated in the accompanying drawings in
which like reference characters refer to the same parts throughout
the different views. The drawings are not necessarily to scale,
emphasis instead being placed upon illustrating the principles of
the embodiments.
[0022] FIGS. 1A-1D are schematic illustrations of an embodiment of
the knotless suture anchor of the present disclosure; (A)
perspective view; (B) cutaway view; (C) open configuration; (D)
closed configuration;
[0023] FIGS. 2A-2D are schematic illustrations of an embodiment of
a knotless suture anchor including an inner wing protrusion; (A)
perspective view; (B) cutaway view); (C) open configuration; (D)
closed configuration;
[0024] FIGS. 3A-3B are schematic illustration of an embodiment of a
knotless suture anchor including a proud surface on an inner wing
for securing a suture;
[0025] FIG. 4A is a schematic illustration of an embodiment of a
knotless suture anchor including a longitudinal bore for insertion
or communication with a transverse bore;
[0026] FIG. 4B is a schematic illustration of an embodiment of a
knotless suture anchor including a wing-on-wing configuration;
[0027] FIGS. 4C-4D are schematic illustrations of embodiments of
knotless suture anchors including stress relieving features
[0028] FIG. 4E is a schematic illustration of an embodiment of a
knotless suture anchor including a wing insert;
[0029] FIGS. 5A-5C are schematic illustrations of a segmented
knotless suture anchor and an insertion tool for use in conjunction
with embodiments of the segmented knotless suture anchor; and
[0030] FIGS. 6A-6C are schematic illustrations of suture routing
pathways through embodiments of the knotless suture anchor.
DETAILED DESCRIPTION
[0031] Specific embodiments of a suture anchor will now be
described with reference to the Figures. According to FIGS. 1A-1D,
there is illustrated a first embodiment of a knotless suture anchor
100. The suture anchor 100 includes a body 102, one or more wings
104, and a transverse bore 110. The suture anchor 100 further
includes grooves 106. In alternate embodiments, not shown, the
anchor body does not include grooves in its outer surface.
[0032] The body 102 is generally elongate and includes distal and
proximal ends 102A, 102B, respectively, and a tip 112 positioned at
about the distal end 102A (e.g., a tapered tip). In the illustrated
embodiments, the cross-section of the body 102 from the proximal
end 102B to the distal end 102A, through the distal tip 112, is
generally circular in shape and tapered, where the cross-sectional
area decreases from the proximal end 102B to the distal end 102A.
In an alternative embodiment, the body includes a tapered distal
tip and the cross-section of the body, extending proximally from
the distal tip, is approximately uniform in dimension. In further
embodiments, the cross-sectional shape of the body is ovoid.
[0033] The suture anchor 100 further includes a transverse bore 110
extending laterally through the anchor body 100. The ends of the
transverse bore 110 allow entry of the suture into the transverse
bore 110. In certain embodiments, the transverse bore 110 is
positioned along the length of the anchor body such that it
intersects one or more of the grooves 106. With the suture anchor
100 so configured, a suture 122 may be routed through the
transverse bore 110 and one or more of the grooves 106 (e.g., two
grooves), as illustrated in FIG. 1D.
[0034] The one or more wings 104 are generally elongate and
attached to the anchor body 102 at a distal end 104A. The wings 104
are each offset from the terminus of the distal end 102B (e.g., by
the distal tip 112) and extend proximally from their point of
attachment with the anchor body 102. In certain embodiments, the
length of each wing may be dimensioned so as to extend to the
proximal end of the anchor body. In other embodiments, the length
of each wing may extend a shorter distance, terminating prior to
the proximal end of the anchor body.
[0035] In the illustrated embodiments, the suture anchor 100
includes a pair of wings 104 and corresponding grooves 106. The
pair of wings 104 and grooves 106 are positioned on opposing
surfaces of the anchor body 102. However, it may be understood that
the number of wings and grooves may be increased or decreased, as
necessary. In an alternative embodiment, the anchor may include a
single wing. In further embodiments, not shown, the anchor may
include more than two wings (e.g., three, four, five, etc.).
Furthermore, the wings may be positioned at any positions about the
periphery of the anchor body, without limit.
[0036] A hinge 114 attaches each of the wings 104 to the body 102.
In the illustrated embodiment, the hinge 114 is a live hinge,
integrally formed with the anchor body 102 and its respective wing
104. Each hinge 114 allows its respective wing 104 to pivot between
an open position, where the wing 104 extends outward from the
anchor body 102 (FIG. 1C), and a closed position, where at least a
portion of the wing 104 proximal to the anchor 114 abuts the anchor
body 102 (FIG. 1D).
[0037] In alternative embodiments, not shown, the wings and anchor
body are formed separately. For example, the distal end of a wing
is attached to the anchor body, where the distal end of the wing
attached to the anchor body forms the hinge. In another example,
the hinge may be formed separately from each of the wings and the
anchor body and attached to each wing and the anchor body (e.g., an
elastic material). In either case, such attachment may be formed by
use of an adhesive or mechanical fixation device (e.g., rivets,
screws, and the like).
[0038] The one or more grooves 106 are formed in the outer surface
of the anchor body 102, in a region adjacent to and corresponding
with the wings 104. That is to say, a groove 106 is formed for each
wing 104 present in the anchor 100. In the embodiments illustrated
in FIGS. 1A-4B, each of the one or more grooves 106 extend
proximally from the hinge 114 and possesses a length approximately
equal to the length of its corresponding wing 104. For example,
each of the grooves 106 extends from a corresponding hinge 114 to
the proximal end of the anchor body 102B. In alternative
embodiments, the length of each groove may be greater than or
shorter than the length of its corresponding wing. In further
alternative embodiments, not shown, the grooves may be omitted.
[0039] The grooves 106 are dimensioned such that an outer surface
of a corresponding wing is substantially flush with the outer
surface of the anchor body 102 when the wing is in the closed
position. That is to say, the depth of each of the grooves 106 is
approximately equal to the thickness of its respective wing 104. In
further embodiments, the width of each of the grooves may be
approximately equal to the thickness of its respective wing. As
discussed in greater detail below, dimensioning the grooves to
complement the shape of the wings facilitates frictional retention
of sutures within embodiments of the suture anchor. In alternative
embodiments, the depth of each of the grooves is independently
selected to be greater than or less than its corresponding
wing.
[0040] In an alternative embodiment, discussed with respect to FIG.
5A-5C, the suture anchor 100 is formed in two pieces, a distal
anchor body 506 and a proximal body 510. The distal body 510
includes a distal tip 112 and wings 104. The proximal body 506
includes a transverse bore 110. The segmented configuration of the
anchor 100 helps to facilitate loading the anchor 100 with a
suture, as discussed in greater detail below.
[0041] In a surgical application employing the suture anchor 100, a
surgical recess is drilled in a body (e.g., a bone) such that the
recess has a diameter smaller than the anchor. Accordingly,
insertion of the suture anchor 100 into the recess urges the wings
104 into frictional engagement with the suture 122 by compression
of the wings 104 against the recess, inhibiting removal of the
suture 116 from the anchor 100. Typically a drilled hole provides a
circular recess of a consistent diameter that is well suited for
retaining the anchor 100. However other types of surgical recesses
may be employed. Pivoting of the wings 104 about the hinge 114 from
the open position to the closed position therefore brings the wings
104 into alignment with the anchor body 102 as the wings 104 are
received into their respective grooves 106.
[0042] To facilitate retention of the anchor 104 within the bone,
the anchor body 102 may further include a plurality of ribs 120
extending about the periphery of the anchor body 102. The ribs 120
are generally spaced apart from one another along the length of the
anchor body 102, between the distal and proximal ends 102A, 102B,
as illustrated in FIGS. 1A-1D. Alternatively, the ribs may be
formed in a helical configuration, extending continuously between
the distal and proximal ends. When the anchor 100 is placed within
a surgical recess, such as a hole drilled through bone, the ribs
120 encounter greater compressive force from the surrounding
recess, and the resilient nature of the anchor material allows a
slight deformation for conforming the ribs in the recess, and may
be continuous with the outer surface of the wings 104.
[0043] FIGS. 2A-4E present schematic illustrations of alternative
embodiments of a knotless suture anchor. With respect to FIGS.
2A-2D and 3A-3B, the suture anchor of FIG. 1 has been modified to
include protrusions 200 on inner surfaces of one or more of the
wings 104. The protrusions 200 are positioned to align with and
enter the transverse bore 110 when the wings 104 are in the closed
position. So configured, the wings provide additional frictional
engagement with suture 122 positioned within the transverse bore
110, further inhibiting removal of the suture 122 from the suture
anchor 100.
[0044] The protrusions may adopt any shape, provided that it fits
within the transverse bore 110. For example, the protrusions may
adopt a hemispherical shape, as illustrated in the embodiments of
FIGS. 2A-2D or a rectangular shape, as illustrated in the
embodiments of FIGS. 3A-3B.
[0045] In a further alternative embodiment, not illustrated, at
least one inner surface of the one or more wings may be patterned
or textured. Such feature may further increase the frictional
sliding resistance of a suture with respect to the inner surface of
the wing and enhance fixation of the suture with respect to the
anchor.
[0046] FIG. 4A illustrates an embodiment of the suture anchor 100
which includes a longitudinal bore 400. In an embodiment, the
longitudinal bore 400 extends through the anchor body to intersect
the transverse bore. In alternative embodiments, the longitudinal
bore may terminate at a position proximal to the transverse bore.
In further embodiments, the longitudinal bore extends fully through
the anchor body. As shown, the longitudinal bore 400 is concentric
with a longitudinal axis of the suture anchor 100 and possesses a
circular cross-section. In further embodiments, the cross-sectional
shape of the longitudinal bore may be non-circular. Examples may
include, but are not limited to, ovoid and closed-sided, faceted
surfaces (e.g., triangle, square, polygon, etc.). As discussed in
greater detail below, the longitudinal bore may facilitate
engagement of the anchor with an inserter tool. For example, the
longitudinal bore may receive a portion of a delivery tool,
allowing the anchor to be positioned by manipulation of the
tool.
[0047] FIG. 4B illustrates an embodiment of a suture anchor which
includes secondary wings 402 mounted on wings 104. The secondary
wings 402 provide increased fixation between the anchor 100 and the
bone hole into which the anchor 100 is inserted.
[0048] FIG. 4C illustrates an embodiment of a suture anchor which
has been modified with respect to the suture anchor 100 of FIG.
1A-1D to remove possible stress concentrating features which can
result in crack growth and fracture. In general, when two surfaces
come together at vertex (e.g., a crack-like shape), a remotely
applied stress is magnified near the sharp tip. In contrast, two
surfaces joined at a curved surface do not concentrate stress to
the same degree. To help mitigate potential stress concentrations,
the illustrated hinge 114 is formed with a curved junction between
the anchor body 102 and the wings 104 (e.g., a circular junction),
rather than a sharp or crack-like junction.
[0049] FIG. 4D illustrates an embodiment of a suture anchor which
includes a plurality of notches 406 along the length of the wings
104. The notches 406 are positioned along the surface of the wings
104 and abut the anchor body 102 when the wings 104 are compressed
(e.g., when the anchor 100 is positioned in a bone recess).
Alternatively, the notches may be formed in the outer surface of
the wings or a combination of the inner and outer surfaces. The
notches act to relieve bending stresses which arise in the wings,
inhibiting crack growth, fracture, and ultimate failure of the
wing.
[0050] FIG. 4E illustrates an alternative embodiment of a suture
anchor which includes wings 104' that are inserted within the
transverse bore 110, rather than mounted to the outer surface of
the anchor body 102. The wings 104' may be combined with
embodiments of the suture anchor 100 that include mating grooves
106, as discussed above, or with embodiments of suture anchor 100
that do not include grooves 106.
[0051] The discussion will now turn to FIGS. 5A-5E, which
illustrates embodiments of an insertion tool 500 for use in loading
a suture 122 within the suture anchor 100 and delivering the suture
anchor 100 to a desired location. The inserter 500 includes a
handle 502 and a shaft 504. The shaft 504 extends distally from the
handle 502 and engages the anchor 100 by insertion through its
longitudinal bore 400. In alternative embodiments, not shown, the
tool and anchor may be modified such that the anchor is inserted
within the shaft.
[0052] In further embodiments, the longitudinal bore can extend
through the entire length of the anchor body. Also, the anchor can
be segmented into a distal portion and a proximal portion. The
distal portion may include the distal tip and the one or more
wings, while the proximal portion may include the transverse bore
and grooves, if present.
[0053] With reference to FIG. 5A, the inserter tool 500 includes
wire loops 512 for retaining the suture 122. The wire loops 512
include a distal loop portion 514 and a proximal extension portion
516. The wire loops 512 are attached to the shaft 504, where the
loop portion 514 extends outward from the shaft 504 distally, while
the extension portion 516 extends outward from the shaft 504
proximally, with respect to an attachment point 518. In certain
embodiments, the wire loops 512 may be provided in the same number
and relative position as the wings 104. For example, as illustrated
in FIGS. 5A-5C, the inserter tool 500 includes two opposed wire
loops 512.
[0054] In use of the tool 500, the wire loops 512 are inserted
through the longitudinal bore 400 of the anchor 100. The distal
loop portion 514 is formed from a flexible material capable of
reversibly deforming for travel through the bore 400. Suitable
materials include, but are not limited to, nickel-titanium alloys
(i.e., nitinol) and stainless steel. When the distal loop portion
512 is advanced through the longitudinal bore 400, the distal loop
portion 514 extends out from a distal end of the distal anchor
portion 506, while the proximal extension portion 516 extends
outwards from the proximal anchor portion 510 through ends 520 of
the transverse bore 110.
[0055] Subsequently, wire loops 512 are withdrawn from the anchor
100 to draw the suture 122 into engagement with the transverse bore
110. The extension portions 514 are drawn proximally through the
ends 520 of the transverse bore 110 of the proximal anchor body
510. This motion also urges the distal loop portion 512 and the
ends of the suture 122 through the distal anchor body 506 and ends
520 of the transverse bore 110. The manner in which the suture 122
is positioned within the wire loops 512 will determine how the
suture is routed through the anchor body 100 as discussed in
greater detail below.
[0056] So configured, the suture anchor 100 is ready for disposal
along the shaft 504 and into a recess, such as a drilled bone 602
(see, e.g., recess 600 of FIGS. 6A-6C). The recess 600 will
generally possess a diameter smaller than the wings 104 such that
insertion of the anchor 100 into the recess 602 draws the wings 104
into frictional engagement with the suture 122 by compression of
the wings 104 against the recess.
[0057] An alternative embodiment of a suture anchor is illustrated
in FIG. 5C. In this embodiment, the suture anchor 100 is segmented,
as discussed above with respect to FIGS. 5A, 5B. The anchor 100
includes grooves 106 that extend along the length of the proximal
anchor portion 510 and are dimensioned to mate with the wings 104,
as discussed above.
[0058] FIGS. 6A-6C illustrate embodiments of suture routing through
the anchor 100 in use with the inserter tool 500. In the embodiment
of FIG. 6A, each end of the suture 122 (e.g., 122A, 122B) is routed
through a different end of the transverse bore 110 (e.g., 520A,
520B). This routing may be accomplished by using a tool having two
opposed wire loops and inserting each end the suture 122 through
opposing wire loops prior to retraction of the wire loops from the
anchor. As a result, when the wire loops are retracted from the
anchor, the ends of the suture 122A, 122B will be drawn through
opposing ends of the transverse bore 110 (e.g., 520A, 520B).
[0059] In the embodiment of FIG. 6B, both ends of the suture 122
are routed through a single end 520 of the transverse bore 110.
This routing may be accomplished by using a tool having at least
one wire loop and inserting each end of the suture 122 through a
single wire loop prior to retraction of the one or more wire loops
from the anchor 100. As a result, when the one or more wire loops
are retracted from the anchor, each end of the suture 122 will be
drawn through the same end 520 of the transverse bore 110.
[0060] In the embodiment of FIG. 6C, both ends of the suture 122
(e.g., 122A, 122B) enter the anchor body through a first end 520A
of the transverse bore 110 and exit a second end 520B. This routing
may be accomplished by using a tool having two opposed wire loops
and inserting the suture ends 122A, 122B through each of the
opposing wire loops 514 prior to retraction of the wire loops from
the anchor. In such a suture loading, each of the suture ends 122A,
122B extend out from a single wire loop. As a result, when the wire
loops are retracted from the anchor 100, the ends of the suture
122A, 122B will be drawn through a single ends of the transverse
bore 110 (e.g., end 520B).
[0061] The terms comprise, include, and/or plural forms of each are
open ended and include the listed parts and can include additional
parts that are not listed. And/or is open ended and includes one or
more of the listed parts and combinations of the listed parts.
[0062] One skilled in the art will realize the invention may be
embodied in other specific forms without departing from the spirit
or essential characteristics thereof. The foregoing embodiments are
therefore to be considered in all respects illustrative rather than
limiting of the invention described herein. Scope of the invention
is thus indicated by the appended claims, rather than by the
foregoing description, and all changes that come within the meaning
and range of equivalency of the claims are therefore intended to be
embraced therein.
* * * * *