U.S. patent application number 15/659689 was filed with the patent office on 2017-11-09 for visual aid for identifying suture limbs arthroscopically.
The applicant listed for this patent is Biomet Sports Medicine, LLC. Invention is credited to Brian K. Berelsman, Gregory J. Denham, Benjamin P. Heilman, Daniel R. Norton, Christopher M. Palese, Kevin T. Stone, Nathan A. Winslow.
Application Number | 20170319204 15/659689 |
Document ID | / |
Family ID | 51488752 |
Filed Date | 2017-11-09 |
United States Patent
Application |
20170319204 |
Kind Code |
A1 |
Norton; Daniel R. ; et
al. |
November 9, 2017 |
VISUAL AID FOR IDENTIFYING SUTURE LIMBS ARTHROSCOPICALLY
Abstract
A flexible suture for coupling tissue includes a first suture
portion extending to a first end and a second suture portion
extending to a second end. A plurality of braided strands form the
first and second suture portions. An identifier characteristic is
formed into the plurality of braided strands. The identifier
characteristic extends from the first end of the first suture
portion to the second end of the second suture portion, and the
identifier characteristic distinguishes the first suture portion
from the second suture portion.
Inventors: |
Norton; Daniel R.; (Warsaw,
IN) ; Denham; Gregory J.; (Warsaw, IN) ;
Heilman; Benjamin P.; (Warsaw, IN) ; Winslow; Nathan
A.; (Warsaw, IN) ; Stone; Kevin T.; (Winona
Lake, IN) ; Palese; Christopher M.; (Warsaw, IN)
; Berelsman; Brian K.; (Warsaw, IN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Biomet Sports Medicine, LLC |
Warsaw |
IN |
US |
|
|
Family ID: |
51488752 |
Appl. No.: |
15/659689 |
Filed: |
July 26, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
13791014 |
Mar 8, 2013 |
9757119 |
|
|
15659689 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 90/92 20160201;
A61B 17/06166 20130101; A61B 17/0485 20130101; A61B 2017/044
20130101; A61B 17/0401 20130101; A61B 2017/06185 20130101; A61B
2017/0414 20130101 |
International
Class: |
A61B 17/06 20060101
A61B017/06; A61B 90/92 20060101 A61B090/92; A61B 17/04 20060101
A61B017/04 |
Claims
1. (canceled)
2. A flexible suture construct, comprising: a first suture limb and
a second suture limb, the first and second suture limbs each
including a braided suture portion that is composed of a plurality
of suture strands braided together to define an outer suture wall
and a hollow core, wherein the first suture limb includes a first
aperture extending through its outer suture wall and into its
hollow core, and the second suture limb includes a second aperture
extending through its outer suture wall and into its hollow core,
and wherein a first section of the first suture limb extends
through the second aperture and into the hollow core of the second
suture limb, and a first section of the second suture limb extends
through the first aperture and into the hollow core of the first
suture limb.
3. The flexible suture construct of claim 2, wherein the first
suture limb is locked within the hollow core of the second suture
limb, and the second suture limb is locked within the hollow core
of the first suture limb.
4. The flexible suture construct of claim 2, wherein the first
and/or second suture limb includes a visual identifier
characteristic configured to allow a medical professional to
visually distinguish between the first and second suture limbs.
5. The flexible suture construct of claim 4, wherein the visual
identifier characteristic is selected from the group consisting of
a tracer strand on a portion of the flexible suture construct, a
diameter of the first suture limb being different than a diameter
of the second suture limb, a color of the first suture limb being
different than a color of the second suture limb, and a size of the
first suture limb being different than a size of the second suture
limb.
6. The flexible suture construct of claim 2, wherein the first
suture limb includes a terminal end and the second suture limb
includes a terminal end, and wherein the terminal end of the first
suture limb is disposed within the hollow core of the second suture
limb, and the terminal end of the second suture limb is disposed
within the hollow core of the first suture limb.
7. The flexible suture construct of claim 2, wherein the first
aperture is formed as loose portions between pairs of strands
defining the first suture limb.
8. The flexible suture construct of claim 7, wherein the second
aperture is formed as loose portions between pairs of strands
defining the second suture limb.
9. The flexible suture construct of claim 2, wherein the first
suture limb comprises a plurality of apertures extending through
its outer suture wall and into its hollow core, and the second
suture limb comprises a plurality of apertures extending through
its outer suture wall and into its hollow core.
10. The flexible suture construct of claim 9, wherein the first
suture limb extends through the plurality of apertures of the
second suture limb, and the second suture limb extends through the
plurality of apertures in the first suture limb.
11. A flexible suture construct, comprising: a first suture limb
and a second suture limb, the first and second suture limbs each
including a braided suture portion that is composed of a plurality
of suture strands braided together to define an outer suture wall
and a hollow core, wherein the first suture limb is locked within
the hollow core of the second suture limb, and the second suture
limb is locked within the hollow core of the first suture limb.
12. The flexible suture construct of claim 11, wherein the first
suture limb includes a first aperture extending through its outer
suture wall and into its hollow core, and the second suture limb
includes a second aperture extending through its outer suture wall
and into its hollow core, and wherein a first section of the first
suture limb extends through the second aperture and into the hollow
core of the second suture limb, and a first section of the second
suture limb extends through the first aperture and into the hollow
core of the first suture limb.
13. The flexible suture construct of claim 11, wherein the first
suture limb includes a terminal end and the second suture limb
includes a terminal end, and wherein the terminal end of the first
suture limb is disposed within the hollow core of the second suture
limb, and the terminal end of the second suture limb is disposed
within the hollow core of the first suture limb.
14. The flexible suture construct of claim 13, wherein the terminal
end of the first suture limb is configured to resist reverse
movement inside the hollow core of the second suture limb when the
first and second suture limbs are placed in tension.
15. The flexible suture construct of claim 14, wherein the terminal
end of the second suture limb is configured to resist reverse
movement inside the hollow core of the first suture limb when the
first and second suture limbs are placed in tension.
16. The flexible suture construct of claim 12, wherein the first
aperture is formed as loose portions between pairs of strands
defining the first suture limb.
17. The flexible suture construct of claim 16, wherein the second
aperture is formed as loose portions between pairs of strands
defining the second suture limb.
18. A flexible suture construct, comprising: a first suture limb
and a second suture limb, the first and second suture limbs each
including a braided suture portion that is composed of a plurality
of suture strands braided together to define an outer suture wall
and a hollow core, wherein the first suture limb is locked within
the hollow core of the second suture limb, and the second suture
limb is locked within the hollow core of the first suture limb, and
wherein the first and/or second suture limb includes a visual
identifier characteristic configured to allow a medical
professional to visually distinguish between the first and second
suture limbs.
19. The flexible suture construct of claim 18, wherein the visual
identifier characteristic is selected from the group consisting of
a tracer strand on a portion of the flexible suture construct, a
diameter of the first suture limb being different than a diameter
of the second suture limb, a color of the first suture limb being
different than a color of the second suture limb, and a size of the
first suture limb being different than a size of the second suture
limb.
20. The flexible suture construct of claim 18, wherein the first
suture limb includes a first aperture extending through its outer
suture wall and into its hollow core, and the second suture limb
includes a second aperture extending through its outer suture wall
and into its hollow core, and wherein a first section of the first
suture limb extends through the second aperture and into the hollow
core of the second suture limb, and a first section of the second
suture limb extends through the first aperture and into the hollow
core of the first suture limb.
21. The flexible suture construct of claim 20, wherein the first
aperture is formed as loose portions between pairs of strands
defining the first suture limb, and the second aperture is formed
as loose portions between pairs of strands defining the second
suture limb.
Description
FIELD
[0001] The present disclosure relates to suture constructions and,
more particularly, to suture loop constructions containing visual
aids for identifying suture limbs arthroscopically.
BACKGROUND
[0002] This section provides background information related to the
present disclosure which is not necessarily prior art.
[0003] Arthroscopic surgery is performed using an arthroscope, a
type of endoscope that is inserted into the joint through a small
incision. The surgery is performed through portals (or cannulas) in
the body through which the endoscope and tools are inserted. Often
the surgeon is working in small, tight areas.
[0004] It is common for surgeons to use sutures to secure soft
tissues to bone, bone to bone, and tissue to tissue. Often when
working in the small tight area, the surgeon may have difficulty
distinguishing the suture limbs or tying the suture limbs without
moving the tissue or bone.
SUMMARY
[0005] This section provides a general summary of the disclosure,
and is not a comprehensive disclosure of its full scope or all of
its features.
[0006] The present teachings provide for a flexible suture for
coupling tissue. The flexible suture includes a first suture
portion extending to a first end and a second suture portion
extending to a second end. A plurality of braided strands that form
the first and second suture portions. An identifier characteristic
is formed into the plurality of braided strands. The identifier
characteristic extends from the first end of the first suture
portion to the second end of the second suture portion, and the
identifier characteristic distinguishes the first suture portion
from the second suture portion.
[0007] The present teachings also provide for a flexible suture for
coupling tissue that includes a first suture limb extending to a
first end and a second suture limb extending to a second end. A
plurality of braided strands that form the first and second suture
limbs. A first structural identifier characteristic is formed into
the plurality of braided strands of the first suture limb. A second
structural identifier characteristic is formed into the plurality
of braided strands of the second suture limb. The first and second
structural identifiers differentiate the structure of the first
suture limb from the structure of the second suture limb.
[0008] The present teachings also provide for a flexible suture for
coupling tissue that includes a first suture limb extending to a
first end and a second suture limb extending to a second end. A
plurality of braided strands that form the first and second suture
limbs. One of the first and second suture limbs includes a dyed
portion.
[0009] The present teachings also provide for flexible suture for
coupling tissue that includes a first suture limb extending to a
first end and a second suture limb extending to a second end. A
plurality of braided strands that form the first and second suture
limbs. The first suture limb forms a braided cylinder, and the
second suture limb forms a braided flat ribbon.
[0010] A flexible suture for coupling tissue that includes a first
suture section that extends from a first end to a second end. A
second suture section that extends from a third end to a fourth
end. A plurality of braided strands that form the first and second
suture sections. An identifier characteristic that is formed into
the plurality of braided strands. The identifier characteristic
extends from the first end to the second end of the first suture
section and from the third end to the fourth end of the second
suture section, and the identifier characteristic distinguishes the
first suture limb from the second suture limb. A coupler attaches
the first suture section to the second suture section.
[0011] Further areas of applicability will become apparent from the
description provided herein. The description and specific examples
in this summary are intended for purposes of illustration only and
are not intended to limit the scope of the present disclosure.
DRAWINGS
[0012] The drawings described herein are for illustrative purposes
only of selected embodiments and not all possible implementations,
and are not intended to limit the scope of the present
disclosure.
[0013] FIG. 1A is a side view of a suture construct according to
the present disclosure;
[0014] FIG. 1B is a perspective view of the suture construct of
FIG. 1A arranged in an anchor device;
[0015] FIG. 2 is a cross-sectional view taken along line 2-2 of
FIG. 1A;
[0016] FIG. 3 is an environmental view of the suture securing a
portion of soft tissue to a portion of bone according to the
present disclosure;
[0017] FIGS. 4A-C are environmental views of the suture repairing a
tear in soft tissue according to the present disclosure;
[0018] FIG. 5A is a side view of a second embodiment of a suture
construct according to the present disclosure;
[0019] FIG. 5B is a perspective view of the suture construct of
FIG. 5A arranged in the anchor device;
[0020] FIG. 5C is a second side view of the suture construct of
FIG. 5A;
[0021] FIG. 5D is a perspective view of the suture construct of
FIG. 5C arranged in the anchor device;
[0022] FIGS. 6A-B are side views of a third embodiment of a suture
construct according to the present disclosure;
[0023] FIG. 7 is a side view of a fourth embodiment of a suture
construct according to the present disclosure;
[0024] FIG. 8 is a side view of a fifth embodiment of a suture
construct according to the present disclosure;
[0025] FIG. 9 is a perspective view of a sixth embodiment of a
suture construct arranged in the anchor device according to the
present disclosure;
[0026] FIGS. 10A-B are side views of a seventh embodiment of a
suture construct according to the present disclosure;
[0027] FIG. 11 is a side view of an eighth embodiment of a suture
construct according to the present disclosure;
[0028] FIGS. 12A-C are side views of a ninth embodiment of a suture
construct arranged in the anchor device according to the present
disclosure;
[0029] FIG. 13 is a perspective view of a tenth embodiment of a
suture construct according to the present disclosure; and
[0030] FIGS. 14-22 illustrate formation of a tail of a knotless
suture anchor device according to the present teachings.
[0031] Corresponding reference numerals indicate corresponding
parts throughout the several views of the drawings.
DETAILED DESCRIPTION
[0032] Example embodiments will now be described more fully with
reference to the accompanying drawings.
[0033] With initial reference to FIG. 1A, a suture construct is
generally illustrated at reference numeral 10. The suture construct
10 generally includes a first terminal end 14 and a second terminal
end 18 and may include an identification characteristic such as a
tracer 22 to identify the suture 10. The tracer 22 may extend from
the first terminal end 14 to the second terminal end 18 of the
suture construct 10. As shown in more detail in FIG. 2, the suture
construct 10 may include an outer wall 26 formed from a plurality
of strands 30 braided together. Each strand 30 may further include
a plurality of fibers 34 braided together to form the strand 30.
The tracer 22 may be one or more of the plurality of strands 30 or
fibers 34.
[0034] When the tracer 22 extends from the first terminal end 14 to
the second terminal end 18 of the suture construct 10, the suture
construct 10 is easier to form because it can be manufactured in a
single continuous step. There is no need to stop the machine during
manufacturing to add or subtract any of the strands that are
braided into the suture.
[0035] The suture construct 10 and tracer 22 may be made of any
suitable flexible material or member, and need not be made of a
suture. The suture construct 10 may also be made of a variety of
different materials. When the suture construct 10 and tracer 22 are
made of sutures, any suitable suture can be used.
[0036] For example, the braided suture may be a 16-strand
hollow-core suture (see FIG. 2). In this example, 16 strands are
braided together to form the outer wall 26, leaving a hollow
passage 28 through the center extending from the first terminal end
14 to the second terminal end 18. Each strand 30 is formed from the
plurality of fibers 34 that are braided together. The tracer 22 may
be at least one strand or a plurality of strands in the suture
construct 10. Any suitable braided suture can be used.
[0037] The suture construct 10 and tracer 22 may be of a variety of
different materials. For example, the strands 30 of suture
construct 10 may be of a polyethylene material that is
substantially translucent or colorless. The tracer 22 may be of a
polyester or nylon material that is either white or dyed a
contrasting color to identify the tracer 22 in the suture construct
10. The tracer 22 assists the surgeon in differentiating between
suture strands with the trace and suture strands without the trace.
The tracer 22 may be modified from the first terminal end 14 to the
second terminal end 18 of the suture construct 10 to assist the
surgeon in distinguishing the first end 14 from the second 18.
[0038] With additional reference to FIG. 1B, sutures generally are
manufactured in a spool and then cut to a specific length (for
example only, 38 inches) to form the suture construct 10. Once cut
to length, the suture construct 10 may be attached to an exemplary
anchor 38. While a rigid anchor is illustrated, the surgeon can use
any known anchor including a flexible anchor. The suture construct
10 may further include a first suture limb 42 adjacent to the first
terminal end 14 and a second suture limb 46 adjacent to the second
terminal end 18. The length of the first suture limb 42 may be
equivalent to half the length of the suture construct 10 (for
example only, 19 inches), equivalent to a portion that is less than
half the length of the suture construct 10, or equivalent to a
portion that is more than half the length of the suture construct
10. To help distinguish between the first suture limb 42 and the
second suture limb 46, which can be particularly helpful for a
surgeon during surgery, the first suture limb 42 and the second
suture limb 46 can be provided with different colors, patterns, or
designs, for example. Accordingly, when the suture is threaded
through the eyelet of the anchor 38, the two limbs 42 and 46 may be
distinguished, helping to identify their direction of travel.
[0039] In the embodiment of FIGS. 1A and B, the first suture limb
42 is distinguished from the second suture limb 46 in the number of
picks per inch (PPI), or tightness, of the tracer 22 braided into
the suture. The PPI is the number of traces visible per inch along
the suture. For example, the PPI of the tracer 22 in the first
suture limb 42 may be 30 PPI; whereas, the PPI of the tracer 22 in
the second suture limb 46 may be 60 PPI, or twice as tight as the
first suture limb 42. This difference is apparent by visual
inspection because the colored tracer 22 will appear twice as often
on the second suture limb 46 as it does on the first suture limb
42.
[0040] Now referring to FIG. 3, the suture construct 10 can be used
to attach a portion of soft tissue 50 to bone 54. The suture
construct 10 is threaded through the anchor 38. The anchor 38 is
secured to the bone 54 by engaging a plurality of threads 58 on the
anchor 38 into the bone 54 using an anchor implant or driving tool
(not pictured). The first suture limb 42 may be passed through the
soft tissue 50, becoming a post. The second suture limb 46 is
passed around the outside of the soft tissue 50 and is knotted to
the post 42. The suture limb 42 passing through the soft tissue 50
is used as the post when securing the first and second suture limbs
42, 46, because it is desirable for there to be minimal movement of
the suture limb in the soft tissue 50. By knowing which end of the
suture is the post and which end is to be knotted to the post, via
the tracer 22, the surgeon can perform the procedure more quickly
and efficiently during arthroscopic surgery.
[0041] Now referring to FIGS. 4A-C, the suture construct 10 may be
used to repair a tear 62 in soft tissue 66. The suture construct 10
is threaded through the soft tissue, the first suture limb 42 on a
first side of the tear 62 and the second suture limb 46 on an
opposite, second side of the tear 62 (FIG. 4A). One of the suture
limbs, for example only, the first suture limb 42, is determined to
function as the post. The other suture limb, for example only, the
second suture limb 46, is knotted around the post 42 (FIG. 4B). The
knot is then pulled tight closing the tear 62 in the soft tissue 66
(FIG. 4C). Again, by knowing which end of the suture is the post
and which end is to be knotted to the post, via the tracer 22, the
surgeon can perform the procedure more quickly and efficiently
during arthroscopic surgery.
[0042] Now referring to FIGS. 5A-D, a second embodiment of a suture
construct 100 is illustrated. The suture construct 100 generally
includes a first terminal end 104 and a second terminal end 108 and
may include an identifier characteristic such as a color coating
112 on only a portion of the suture 100. The suture construct 100
may include the outer wall 26 formed from the plurality of strands
30 braided together (FIG. 2). Each strand 30 may further include
the plurality of fibers 34 braided together to form the strand 30.
Further, the suture construct 100 may also be of a monofilament
construct (not shown). The suture construct 100 may be divided into
two portions, a first suture limb 116 adjacent to the first
terminal end 104 and a second suture limb 120 adjacent to the
second terminal end 108, that may be distinguished by the color
coating 112.
[0043] The plurality of fibers 34 may be of an all-white
polyethylene material that is braided to form the plurality of
strands 30. The second suture limb 120 may be coated with a dye or
other material that is known to adhere to the polyethylene
material. The dye or other material may be of a contrasting color
to the all-white polyethylene and therefore may provide the color
coating 112 on a portion of the suture construct 100. The color
coating 112 may be applied to the entire second suture limb 120
(FIG. 5A) or may be applied in specific locations of the second
suture limb 120 (FIG. 5C), distinguishing the second suture limb
120 from the first suture limb 116. The differences between the
first suture limb 116 and the second suture limb 120 become more
apparent when the suture construct 100 is threaded through the
anchor 38. The differences in appearance help to identify the
direction of travel and corresponding ends of each suture limb 116,
120.
[0044] The plurality of fibers 34 may also contain a material known
to be radiopaque, for example barium sulfate, that is braided to
form the plurality of strands 30. A radiopaque material is known in
the art to be visible in x-ray images and to the naked eye. The
second suture limb 120 may be coated with a radiopaque material
such as barium sulfate. The radiopaque material may be of a
contrasting color to the plurality of strands 30 and therefore may
provide the color coating 112 on a portion of the suture construct
100. The color coating 112 may be applied to the entire second
suture limb 120 (FIG. 5A) or may be applied in specific locations
of the second suture limb 120 (FIG. 5C), distinguishing the second
suture limb 120 from the first suture limb 116.
[0045] Now referring to FIGS. 6A-B, a third embodiment of a suture
construct 200 is illustrated. The suture construct 200 generally
includes a first suture limb 204 and a second suture limb 208 and
may include an identifier characteristic such as a tracer 210 on a
portion of the suture 200. The tracer 210 may extend the entire
length of the suture limb 204. The suture construct 200 may include
the outer wall 26 formed from the plurality of strands 30 braided
together (FIG. 2). Each strand 30 may further include the plurality
of fibers 34 braided together to form the strand 30.
[0046] The first suture limb 204 may be connected to the second
suture limb 208 to form a continuous suture construct 200. The
first suture limb 204 may include a first terminal end 212 and a
second terminal end 216, and the second suture limb 208 may include
a first terminal end 220 and a second terminal end 224. The first
and second suture limbs 204, 208 may be tied together with a knot,
adhered or epoxied together, locked together by passing each strand
through the opposite strand, or fixed together by any means known
in the art. When passing the strands through opposite ends, the
suture from one end is passed between the braided strands, along
the hollow core, and out through the braided strand or retained in
the hollow core.
[0047] The second end 216 of the first suture limb 204 may be
locked within the second suture limb 208, and the second end 224 of
the second suture limb 208 may be locked within the first suture
limb 204 (FIG. 6B). The first suture limb 204 may include a first
aperture 228, and the second suture limb 208 may include a second
aperture 232. The first and second apertures 228, 232 are formed
during the braiding process as loose portions between pairs of
strands defining the suture. The second terminal end 216 is passed
through the second aperture 232 and into the hollow passage 28 of
the 16-strand hollow-core suture. The second terminal end 224 is
passed through the first aperture 228 and into the hollow passage
28 of the 16-strand hollow-core suture. When tightened, the second
terminal end 216 of the first suture limb 204 and the second
terminal end 224 of the second suture limb 208 resist the reverse
movement. It is envisioned that the second terminal end 216 of the
first suture limb 204 and the second terminal end 224 of the second
suture limb 208 may be passed through the hollow passage 28 several
times through multiple apertures in the first and second suture
limbs 204, 208. Further, the second terminal end 216 of the first
suture limb 204 and the second terminal end 224 of the second
suture limb 208 may be retained in the hollow passage 28 or passed
out through the braided strand.
[0048] The first and second suture limbs 204, 208 may be of
different colors or sizes to assist the surgeon in differentiating
between the different limbs 204, 208. For example, the first suture
limb 204 may include the tracer 22 extending from the first end 212
to the second end 216 and being of a polyethylene or nylon material
that has been dyed black. The second suture limb 208 may not
include the tracer 22 or may include the tracer 22 being of a
contrasting color such as red. The first and second suture limbs
204, 208 may also be of different sizes or diameters. For example,
the first suture limb 204 may be braided tighter than the second
suture limb 208, or vice versa. The second suture limb 208 may have
a larger diameter than the first suture limb 204, and the first
suture limb 204 may have a higher stiffness than the second suture
limb 208, or vice versa.
[0049] Now referring to FIG. 7, a fourth embodiment of a suture
construct 300 is illustrated. The suture construct 300 generally
includes a first suture limb 304 adjacent to a first terminal end
308 and a second suture limb 312 adjacent to a second terminal end
316. The suture construct 300 may further include an identifier
characteristic such as a tracer 320 on a portion of the suture 300.
The tracer 320 may extend from the first terminal end 308 to the
second terminal end 316. The suture construct 300 may include the
outer wall 26 formed from the plurality of strands 30 braided
together (FIG. 2). Each strand 30 may further include the plurality
of fibers 34 braided together to form the strand 30.
[0050] The tracer 320 may be one or more of the plurality of
strands 30 or fibers 34 braided into the suture construct 300
similar to that of the embodiment illustrated in FIGS. 1a-b. The
suture construct 300 and tracer 320 can be made of any suitable
flexible material or member, and need not be made of a suture. When
the suture construct 300 and tracer 320 are made of sutures, any
suitable suture can be used.
[0051] The suture construct 300 and tracer 320 may be of a variety
of different materials. For example, the strands 30 of suture
construct 300 may be of a polyethylene material that is
substantially translucent or colorless and may also include a
polyester or nylon material that is white in color. The tracer 320
may be of a polyester or nylon material that is either white or
dyed a contrasting color to identify the tracer 320 in the suture
construct 300. The tracer 320 assists the surgeon in
differentiating between suture strands with the trace and suture
strands without the trace.
[0052] The tracer 320 may be braided so that it is visual to an
observer for a first portion 324 of the suture construct 300. The
first portion 324 may be the same length as, and correspond to, the
first suture limb 304. The tracer 320 then may be braided in the
hollow passage 28 so that it is not visible to the observer for a
second portion 328 of the suture construct 300. The second portion
328 may be the same length as, and correspond to, the second suture
limb 312. After the second portion 328 the tracer 320 may be
braided so that it is visual to the observer again. This pattern
may be followed for the length of several suture constructs 300
during manufacturing and then cut to specified suture construct 300
lengths (for example only, 38 inches) at a later time.
[0053] Now referring to FIG. 8, a fifth embodiment of a suture
construct 400 is illustrated. The suture construct 400 generally
includes a first suture limb 404 adjacent to a first terminal end
408 and a second suture limb 412 adjacent to a second terminal end
416. The suture construct may further include an identifier
characteristic such as a tracer 420 on a portion of the suture 400.
The tracer 420 may extend from the first terminal end 408 to the
second terminal end 416 of the suture construct 400. The suture
construct 400 may include the outer wall 26 formed from the
plurality of strands 30 braided together (FIG. 2). Each strand 30
may further include the plurality of fibers 34 braided together to
form the strand 30.
[0054] The tracer 420 may be one or more of the plurality of
strands 30 or fibers 34 braided into the suture construct 400
similar to that of the embodiment illustrated in FIGS. 1A-B. The
suture construct 400 and tracer 420 can be made of any suitable
flexible material or member, and need not be made of a suture. When
the suture construct 400 and tracer 420 are made of sutures, any
suitable suture can be used.
[0055] The suture construct 400 and tracer 420 may be of a variety
of different materials. For example, the strands 30 of suture
construct 400 may be of a polyethylene material that is
substantially translucent or colorless or white in color. The
tracer 420 may be of a polyester or nylon material that is white in
color. The tracer 420 assists the surgeon in differentiating
between suture strands with the trace and suture strands without
the trace.
[0056] The tracer 420 may be braided into the suture construct 400
such that it is visible to the observer. After manufacturing of the
suture construct 400 is complete, a first portion 424 of the suture
construct 400 may be dipped in a dye solution of a contrasting
color to dye the tracer 420 braided into the first portion 424. The
first portion 424 may be the same length as the first suture limb
404. The dye adheres to the polyester or nylon material of the
tracer 420 and does not adhere to the polyethylene fibers in the
suture construct 420. Only the first portion 424 of the suture
construct 400 is dyed a contrasting color so that the first suture
limb 404 is differentiated from the second suture limb 412. By
braiding a white tracer 420 into the suture construct 400 during
manufacturing and dying the tracer 420 at a later time, a plurality
of suture constructs 400 can be manufactured at one time and later
be dyed different colors.
[0057] Now referring to FIG. 9, a sixth embodiment of a suture
construct 500 is illustrated. The suture construct 500 generally
includes a first suture limb 504 and a second suture limb 508. The
suture construct 500 may include an identifier characteristic such
as a tracer (not pictured) extending the entire length of the
suture construct 500 as discussed in previous embodiments, but
inclusion of the tracer in the suture construct 500 is not
necessary for the sixth embodiment. The suture construct 500 may be
the 16-strand hollow-core suture and may include the outer wall 26
formed from the plurality of strands 30 braided together (FIG. 2).
Each strand 30 may further include the plurality of fibers 34
braided together to form the strand 30. The suture construct 500
may further be threaded through an eyelet of an anchor 512.
[0058] The suture construct 500 may be braided similar to that of
the embodiment illustrated in FIGS. 1A-B. The suture construct 500
can be made of any suitable flexible material or member, and need
not be made of a suture. When the suture construct 500 is made of
sutures, any suitable suture can be used. For example, the fibers
34 forming the strands 30 of suture construct 500 may be of a
polyethylene material that is substantially translucent or
colorless or white in color.
[0059] The suture construct 500 may include a structural identifier
characteristic, such as knots, extending the entire length of the
suture construct 500. One of the first and second suture limbs 504,
508 may include knots 516 in specific locations along the suture
limb, for example the second suture limb 508, as illustrated. The
knots 516 along the second suture limb 508 may assist the surgeon
in differentiating between the first suture limb 504 and the second
suture limb 508 and may help to identify the direction of travel of
each suture limb 504, 508.
[0060] Once the suture construct 500 is braided as discussed in
previous embodiments, the suture construct 500 may be cut to
length. The suture construct 500 may be threaded through the eyelet
of the anchor 512. Preformed knots 516 may be placed in specific
locations along either the first suture limb 504 or the second
suture limb 508 (for example only, the second suture limb 508). The
anchor 512 is secured in the bone 54, and the first suture limb 504
without the knots 516 is threaded through the soft tissue 50 (see
also FIG. 3). The first suture limb 504 becomes the post. The
second suture limb 508 is passed around the outside of the soft
tissue 50 and is knotted to the post 504. The first suture limb 504
passing through the soft tissue 50 is used as the post when
securing the first and second suture limbs 504,508, because it is
desirable for there to be minimal movement of the suture limb in
the soft tissue 50. Further, the first suture limb 504 is desirable
to pass through the soft tissue 50 because the first suture limb
504 does not contain knots 516 that may become caught or do more
damage or tearing to the soft tissue 50.
[0061] Now referring to FIGS. 10A-B, a seventh embodiment of a
suture construct 600 is illustrated. The suture construct 600
generally includes a first suture limb 604 adjacent to a first
terminal end 608 and a second suture limb 612 adjacent to a second
terminal end 616. The suture construct 600 may further include an
identifier characteristic such as a tracer 620 on a portion of the
suture 600. The tracer 620 may extend from the first terminal end
608 to the second terminal end 616. The suture construct 600 may be
the 16-strand hollow-core suture and may include the outer wall 26
formed from the plurality of strands 30 braided together (FIG. 2).
Each strand 30 may further include the plurality of fibers 34
braided together to form the strand 30.
[0062] The tracer 620 may be one or more of the plurality of
strands 30 or fibers 34 braided into the suture construct 600. The
suture construct 600 and tracer 620 can be made of any suitable
flexible material or member, and need not be made of a suture. When
the suture construct 600 and tracer 620 are made of sutures, any
suitable suture can be used.
[0063] The suture construct 600 and tracer 620 may be of a variety
of different materials. For example, the strands 30 of suture
construct 600 may be of a polyethylene material that is
substantially translucent or colorless or white in color. The
tracer 620 may be of a polyester or nylon material that is a
contrasting color. The tracer 620 assists the surgeon in
differentiating between suture strands with the trace and suture
strands without the trace.
[0064] Each suture construct 600 may be cut from a suture group
624. The suture group 624 may be manufactured by braiding 16
strands 30 (of the plurality of fibers 34) together for a specific
length (for example only, 1 inch) and then splitting the strands 30
into a first group 628 and a second group 632 of 8 strands each.
One of the first group 628 and the second group 632 contains the
plurality of strands 30 of the tracer 620. Each group of strands
628, 632 is individually braided for a specific length (for example
only, 38 inches). The 16 strands 30 are then braided together. This
pattern is repeated several times to form the suture group 624. The
resulting suture group 624 is cut at a first portion 636 where the
16 strands 30 are braided together and at a second portion 640
along the first group 628 and the second group 632 a specific
length (for example only, 19 inches) from where the 16 strands
split into two groups of 8 strands each. Once cut, each suture
construct 600 is in a condition ready for use.
[0065] Now referring to FIG. 11, an eighth embodiment of a suture
construct 700 is illustrated. The suture construct 700 generally
includes a first suture limb 704 adjacent to a first terminal end
708 and a second suture limb 712 adjacent to a second terminal end
716. The suture construct 700 may further include an identification
characteristic such as a tracer 720 on a portion of the suture 700.
The tracer 720 may extend from the first terminal end 708 to the
second terminal end 716. The suture construct 700 may be the
16-strand hollow-core suture and may include the outer wall 26
formed from the plurality of strands 30 braided together (FIG. 2).
Each strand 30 may further include the plurality of fibers 34
braided together to form the strand 30.
[0066] The suture construct 700 and tracer 720 can be made of any
suitable flexible material or member, and need not be made of a
suture. When the suture construct 700 and tracer 720 are made of
sutures, any suitable suture can be used. For example, the strands
30 of suture construct 700 may be of a polyethylene material that
is substantially translucent or colorless or white in color. The
tracer 720 may be of a polyester or nylon material that is a
contrasting color. The tracer 720 assists the surgeon in
differentiating between suture strands with the trace and suture
strands without the trace.
[0067] The tracer 720 may be sewn in to the suture construct 700
after the suture construct 700 has been braided into the 16-strand
hollow-core suture as described above. The tracer 720 may only be
sewn into a portion of the suture construct 700 corresponding to
the second suture limb 712 to differentiate the second suture limb
712 from the first suture limb 704. The tracer may also be sewn
into the portion of the suture construct 700 corresponding to the
second suture limb 712 so that it is visible on the second suture
limb 712 and may be sewn into the hollow passage 28 of the suture
construct 700 over a portion corresponding to the first suture limb
704 so that it is not visible but extends the entire length of the
suture construct 10.
[0068] Now referring to FIGS. 12A-C, a ninth embodiment of a suture
construct 800 is illustrated. The suture construct 800 generally
includes a first suture limb 804 and a second suture limb 808. The
suture construct 800 may include an identifier characteristic such
as a tracer (not pictured) extending the entire length of the
suture construct 800 as discussed in previous embodiments, but
inclusion of the tracer in the suture construct 800 is not
necessary for the ninth embodiment. The suture construct 800 may be
the 16-strand hollow-core suture and may include the outer wall 26
formed from the plurality of strands 30 braided together (FIG. 2).
Each strand 30 may further include the plurality of fibers 34
braided together to form the strand 30. One of the first suture
limb 804 and the second suture limb 808 may include a structural
identifier, such as a loop or a bifurcation, to assist the surgeon
in differentiating between the first and second suture limbs 804,
808. Further, the suture construct 800 may include a structural
identification characteristic extending the entire length of the
suture 800 that differentiates a first suture limb 804 from a
second suture limb 808.
[0069] Referring specifically to FIG. 12A, once the suture
construct 800 is braided according to previous embodiments, the
suture construct 800 may be cut to length. The suture construct 800
may then be threaded through the eyelet of an anchor 812. The
second suture limb 808 may be looped back to the eyelet of the
anchor 812 and secured in order to form a loop for identification
and ability to manipulate. The anchor 812 is secured in the bone
54, and the second suture limb 808 with the loop is passed through
the soft tissue 50 (see also FIG. 3). The second suture limb 808
becomes the post. The first suture limb 804 is passed around the
outside of the soft tissue 50 and is knotted to the post 808. The
second suture limb 808 passing through the soft tissue 50 is used
as the post when securing the first and second suture limbs 804,
808, because it is desirable for there to be minimal movement of
the suture limb in the soft tissue 50 and the loop in the second
suture limb 808 is easy to grab with a tool arthroscopically.
[0070] Referring specifically to FIG. 12B, once the suture
construct 800 is braided according to previous embodiments, the
suture construct 800 may be cut to length. The suture construct 800
may be threaded through the eyelet of the anchor 812. A loop 816
may be secured along the length of the second suture limb 808 for
identification and manipulation. The loop 816 may be secured to the
suture limb 808 similarly to the locking method discussed in the
third embodiment 200. The second suture limb 808 may include a
first aperture 820 and a second aperture 824. The first and second
apertures 820, 824 are formed during the braiding process as loose
portions between pairs of fibers defining the suture. A first end
828 of the loop 816 is passed through the first aperture 820 and
into the hollow passage 28 of the 16-strand hollow-core suture. A
second end 832 is passed through the second aperture 824 and into
the hollow passage 28 of the 16-strand hollow-core suture. When
tightened, the first end 828 and the second end 832 resist reverse
movement and the loop 816 remains secured to the second suture limb
808.
[0071] The anchor 812 is secured in the bone 54, and the second
suture limb 808 with the loop 816 is passed through the soft tissue
50 arthroscopically (see also FIG. 3). The second suture limb 808
becomes the post. The first suture limb 804 is passed around the
outside of the soft tissue 50 and is knotted to the loop 816 on the
post 808. The second suture limb 808 passing through the soft
tissue 50 is used as the post when securing the first and second
suture limbs 804, 808, because it is desirable for there to be
minimal movement of the suture limb in the soft tissue 50 and the
loop in the second suture limb 808 is easy to grab with a tool
arthroscopically.
[0072] Referring specifically to FIG. 12C, once the suture
construct 800 is braided according to previous embodiments, the
suture construct 800 may be cut to length. The suture construct 800
may be threaded through the eyelet of the anchor 812. A bifurcation
836 may be formed along the length of the second suture limb 808
for identification and manipulation. The bifurcation 836 may be
formed during the braiding process as a loose portion between pairs
of fibers defining the suture.
[0073] The anchor 812 is secured in the bone 54, and the second
suture limb 808 with the bifurcation 836 is passed through the soft
tissue 50 arthroscopically (see also FIG. 3). The second suture
limb 808 becomes the post. The first suture limb 804 is passed
around the outside of the soft tissue 50 and is knotted to the
bifurcation 836 on the post 808. The second suture limb 808 passing
through the soft tissue 50 is used as the post when securing the
first and second suture limbs 804, 808, because it is desirable for
there to be minimal movement of the suture limb in the soft tissue
50, and the bifurcation 836 in the second suture limb 808 is easy
to grab with a tool arthroscopically.
[0074] During the process to secure the first suture limb 804 to
the second suture limb 808, the first suture limb 804 is passed
through the bifurcation 836 in the second suture limb 808. The
strands 30 of fibers 34 in the second suture limb 808 may be
tightened applying pressure to the first suture limb 804. When
tightened, the first suture limb 804 resists reverse movement and
may be knotted around the second suture limb 808.
[0075] Now referring to FIG. 13, a tenth embodiment of a suture
construct 900 is illustrated. The suture construct 900 generally
includes a first suture limb 904 adjacent to a first terminal end
908 and a second suture limb 912 adjacent to a second terminal end
916. The suture construct 900 may include an identifier
characteristic such as a tracer (not pictured) extending the entire
length of the suture construct 900 as discussed in previous
embodiments, but inclusion of the tracer in the suture construct
900 is not necessary for the tenth embodiment. The suture construct
900 can be made of any suitable flexible material or member, and
need not be made of a suture. When the suture construct 900 is made
of sutures, any suitable suture can be used. For example, the
strands 30 of suture construct 900 may be of a polyethylene
material that is substantially translucent, colorless, or white in
color.
[0076] The suture construct 900 may include an identification
characteristic on a plurality of portions to assist the surgeon in
identifying the first terminal end 908 and the second terminal end
916. A first portion 920 that may correspond to the first suture
limb 904 may be the 16-strand hollow-core suture discussed
previously and may include the outer wall 26 formed from the
plurality of strands 30 braided together (FIG. 2). Each strand 30
may further include the plurality of fibers 34 braided together to
form the strand 30. A second portion 924 that may correspond to the
second suture limb 912 may be a 16-strand flat braided ribbon
construct formed from the plurality of strands 30 braided together.
Each strand 30 may further include the plurality of fibers 34
braided together to form the strand 30. The round or cylindrical
shape of the first portion 920 is distinguished from the flat shape
of the second portion 924 both by touch and sight to assist the
surgeon in distinguishing the first suture limb 904 from the second
suture limb 912.
[0077] During manufacture of the first portion 920 of the suture
construct 900, each of the 16 strands 30 is braided around the
remainder of the strands 30 to form the cylindrical shape. During
manufacture of the second portion 924 of the suture construct 900,
the strands 30 are braided horizontally back and forth to create a
flat braid. While manufacturing the suture construct 900, the
different braid patterns are alternated to form a single long
suture group that can then be cut to appropriate suture lengths
(for example only, 38 inches).
[0078] With additional reference to FIGS. 14-22, a method for
forming a suture tail 12', or any other suture strand in which it
would be advantageous to distinguish between two different suture
portions, will now be described. With initial reference to FIG. 14,
a second portion 68' of the suture tail 12' is illustrated. The
second portion 68' includes a first end 68A' and a second end 68B'.
Second end 18' of the suture tail 12' is at the second end 68B' of
the second portion 68'. As illustrated in FIG. 15, a threader, such
as the threader 92' or any suitable threading device, is inserted
through a first area of the second portion 68' of the suture tail
12' to define a first tail sleeve 68C'. The threader 92' is also
inserted through a second area to define a second tail sleeve 68D'.
The second tail sleeve 68D' is closer to the first end 68A' than
the first tail sleeve 68C'.
[0079] With the threader 92' extending through each of the first
tail sleeve 68C' and the second tail sleeve 68D', the first end
68A' is inserted into the threader 92' and grasped by the threader
92'. The threader 92' is then withdrawn through the second tail
sleeve 68D' and the first tail sleeve 68C' in order to draw the
first end 68A' through the second tail sleeve 68D' and into the
first tail sleeve 68C', as illustrated in FIG. 16. Therefore, the
second portion 68' defines a loop 68E'. Again, since the tail 16'
is made from braided fibers, the first tail sleeve 68C' and the
second tail sleeve 68D' are formed by a passage formed by the
braided fibers that extends from the first end 66A' to the second
end 66B'. Ends of each of the first tail sleeve 68C' and the second
tail sleeve 68D' are formed by openings in the braided fibers.
[0080] With additional reference to FIG. 17, the first portion 66'
of the suture tail 12' includes a first end 66A' that is opposite
to a second end 66B'. The threader 92' is inserted through the
first portion 66' at or proximate to the second end 66B' to define
a third tail sleeve 66C' in the first portion 66'. The second end
68B' of the second portion 68' is inserted through the threader
92', and the threader 92' is withdrawn through the third tail
sleeve 66C' in order to draw the second portion 68' into the third
tail sleeve 66C', as illustrated in FIG. 18.
[0081] With additional reference to FIG. 19, the first end 66A' of
the first portion 66' is inserted through the loop 68E' of the
second portion 68', and the first end 66A' is pulled, which pulls
the third tail sleeve 66C' over and past the first tail sleeve 68C'
and onto the second tail sleeve 68D', as illustrated in FIG. 20.
With additional reference to FIG. 21, an excess area of the second
portion 68' proximate to the first end 68A' is cut from a remainder
of the second portion 68'. As illustrated in FIG. 22, the first
portion 66' and the second portion 68' are then pulled apart to
strengthen the connection between the first portion 66' and the
second portion 68', and thereby form the suture tail 12' of the
knotless suture anchor device 10'.
[0082] To make it easier for a surgeon to distinguish between the
first portion 66' and the second portion 68' of the suture tail
12', the first portion 66' and the second portion 68' can be
configured in any suitable manner to facilitate distinction
therebetween, such as visual distinction therebetween. For example,
the first portion 66' and the second portion 68' can include or
consist of different colors, and/or different design patterns,
and/or any of the tracers 22, 210, 320, 420, 620, 720 described
herein configured in any suitable manner to distinguish the first
and second portions 66' and 68' from one another. The first and
second portions 66' and 68' can also have different thicknesses or
weights. The foregoing description of the embodiments has been
provided for purposes of illustration and description. It is not
intended to be exhaustive or to limit the disclosure. Individual
elements or features of a particular embodiment are generally not
limited to that particular embodiment, but, where applicable, are
interchangeable and can be used in a selected embodiment, even if
not specifically shown or described. The same may also be varied in
many ways. Such variations are not to be regarded as a departure
from the disclosure, and all such modifications are intended to be
included within the scope of the disclosure.
* * * * *