CA2448406A1 - Method and apparatus for attaching connective tissues to bone using a cortical bone anchoring device - Google Patents

Method and apparatus for attaching connective tissues to bone using a cortical bone anchoring device Download PDF

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Publication number
CA2448406A1
CA2448406A1 CA002448406A CA2448406A CA2448406A1 CA 2448406 A1 CA2448406 A1 CA 2448406A1 CA 002448406 A CA002448406 A CA 002448406A CA 2448406 A CA2448406 A CA 2448406A CA 2448406 A1 CA2448406 A1 CA 2448406A1
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CA
Canada
Prior art keywords
disk
bone anchor
recited
tube
bone
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002448406A
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French (fr)
Other versions
CA2448406C (en
Inventor
Seth A. Foerster
Norman S. Gordon
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Arthrocare Corp
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Individual
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Publication of CA2448406A1 publication Critical patent/CA2448406A1/en
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Publication of CA2448406C publication Critical patent/CA2448406C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0409—Instruments for applying suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0458—Longitudinal through hole, e.g. suture blocked by a distal suture knot
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0805—Implements for inserting tendons or ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0817—Structure of the anchor
    • A61F2002/0823—Modular anchors comprising a plurality of separate parts
    • A61F2002/0835—Modular anchors comprising a plurality of separate parts with deformation of anchor parts, e.g. expansion of dowel by set screw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0847—Mode of fixation of anchor to tendon or ligament
    • A61F2002/0864—Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0876—Position of anchor in respect to the bone
    • A61F2002/0888—Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A bone anchor device for attaching connective tissue to bone comprises a disk (12) adapted for insertion into a portion of bone to which the connective tissue is to be attached. The disk is movable between a bent orientation for presenting a smaller cross-section and an expanded orientation for presenting a larger cross-section. The bent orientation is utilized for inserting the disk through a small hole into a region of cancellous bone beneath the cortical bone layer, after which the disk is actuated to its expanded orientation so that it will be permanently anchored in the canellous bone, as it will be too large to return proximally through the hole in the cortical bone layer. Two embodiments are disclosed. In a first embodiment, the disk is initially formed in the expanded orientation, of spring steel. In a second embodiment, the disk is initially formed in the bent orientation, and spring steel is not required.

Claims (40)

1. A bone anchor device for attaching connective tissue to bone, comprising a disk which is adapted for insertion into a portion of bone, said disk being movable between a bent orientation for presenting a smaller cross-section and an expanded orientation for presenting a larger cross-section, said disk being substantially planar in said expanded orientation.
2. The bone anchor device as recited in Claim 1, wherein said disk is annular, comprising an annular sidewall and a center aperture.
3. The bone anchor device as recited in Claim 2, and further comprising two axial suture receiving grooves disposed on an inner surface of said annular sidewall, said grooves being spaced from one another approximately 180 degrees.
4. The bone anchor device as recited in Claim 1, wherein said disk is substantially solid, having two small apertures adjacent to one another in a center portion thereof for receiving suturing material therethrough.
5. The bone anchor device as recited in Claim 1, and further comprising a slit disposed in the disk for facilitating the movement of said disk between the bent orientation and the expanded orientation.
6. The bone anchor device as recited in Claim 5, wherein said disk has a longitudinal axis extending between a first end and a second end thereof, said disk bending about an axis which lies transversely to said longitudinal axis, and forming a generally "V" shape in said bent orientation.
7. The bone anchor device as recited in Claim 6, wherein said slit comprises an axial portion extending from the first end of the disk, and a circumferential portion extending about a portion of an outer sidewall of said disk, said circumferential portion being in communication with said axial portion so that the two slit portions together form a generally "T" shaped slit.
8. The bone anchor device as recited in Claim 7, and further comprising a thin axial length of said sidewall extending between the second end of the disk and said circumferential slit portion.
9. The bone anchor device as recited in Claim 8, wherein said disk has a thickness of approximately .031 inches and said thin axial length of said sidewall is approximately .006 inches long.
10. The bone anchor device as recited in Claim 8, wherein said disk bends about said transverse axis in a region including said thin axial length.
11. The bone anchor device as recited in Claim 6, wherein tension applied to opposing edges of said disk causes said bending to occur.
12. The bone anchor device as recited in Claim 6, wherein an axial compressive force applied to said disk causes said bending to occur.
13. The bone anchor device as recited in Claim 5, and further comprising a second slit disposed approximately 180 degrees from the first slit.
14. The bone anchor device as recited in Claim 1, wherein said disk comprises spring stainless steel, and is biased by said spring stainless steel to assume said expanded orientation unless otherwise constrained.
15. The bone anchor device as recited in Claim 1, wherein said disk is initially formed in said bent orientation.
16. The bone anchor device as recited in Claim 1, and further comprising a plurality of said disks, arranged in a stacked array, for providing a higher pull-out force resistance than is possible using a single disk.
17. The bone anchor device as recited in Claim 1, wherein said disk is generally elliptical when in said expanded orientation, and presents a generally circular footprint when in said bent orientation and viewed from a proximal position.
18. A bone anchor apparatus, comprising:
a first tube;
a second tube coaxially and slidably disposed within said first tube; and a disk which is movable between a bent orientation for presenting a smaller cross-section and an expanded orientation for presenting a larger cross-section;
wherein said disk is disposed within said first tube distally of said second tube, in said bent orientation, a distal end of the second tube engaging said disk.
19. The bone anchor apparatus as recited in Claim 18, wherein said first tube comprises a proximal end portion having a first diameter and a distal end portion having a second diameter which is reduced relative to said first diameter, an axial length of said distal end portion being approximately equal to a thickness of cortical bone in a portion of bone into which said disk is to be disposed to function as a bone anchor, wherein a transition region on said tube between said proximal and distal end portions is adapted to function as a stop when said first tube is inserted into a hole in said bone portion, thereby ensuring that a distal end of the first tube is disposed in cancellous bone beneath said cortical bone thickness.
20. The bone anchor apparatus as recited in Claim 19, and further comprising a slit in an outer wall of said first tube, said slit extending proximally from the distal end of said first tube proximally of said transition region.
21. The bone anchor apparatus as recited in Claim 18, and further comprising a slit in an outer wall of said first tube, extending proximally from a distal end of the first tube.
22. The bone anchor apparatus as recited in Claim 21, and further comprising a slit in an outer wall of said second tube, the first and second tubes being rotationally oriented relative to one another, when the second tube is disposed within the first tube, so that the slits in each of said first and second tubes are substantially coincident with one another.
23. The bone anchor apparatus as recited in Claim 18, and further comprising a suture retaining device disposed distally of said disk.
24. The bone anchor apparatus as recited in Claim 18, and further comprising a center aperture in said disk for receiving suture material therethrough.
25. The bone anchor apparatus as recited in Claim 18, and further comprising a slit disposed in the disk for facilitating the movement of said disk between the bent orientation and the expanded orientation.
26. The bone anchor apparatus as recited in Claim 25, wherein said apparatus has a longitudinal axis which extends between a proximal end and a distal end of said disk, said disk bending about an axis which lies transversely to said longitudinal axis, and forming a generally "V" shape in said bent orientation.
27. The bone anchor device as recited in Claim 26, wherein said slit comprises an axial portion extending from said distal end of the disk, and a circumferential portion extending about a portion of an outer sidewall of said disk, said circumferential portion being in communication with said axial portion so that the two slit portions together form a generally "T" shaped slit.
28. The bone anchor device as recited in Claim 27, and further comprising a thin axial length of said sidewall extending between the proximal end of the disk and said circumferential slit portion.
29. The bone anchor device as recited in Claim 28, wherein said disk bends about said transverse axis in a region including said thin axial length.
30 30. The bone anchor device as recited in Claim 26, wherein tension applied to opposing edges of said disk by an inner wall of said first tube cause said bending to occur.
31. The bone anchor device as recited in Claim 25, and further comprising a second slit disposed approximately 180 degrees from the first slit.
32. The bone anchor device as recited in Claim 18, and further comprising a plurality of said disks, arranged in a stacked array within said first tube.
33. The bone anchor device as recited in Claim 18, wherein said disk is generally elliptical when in said expanded orientation, and presents a generally circular footprint when in said bent orientation and viewed from a proximal position.
34. A bone anchor apparatus, comprising:
an anchor body having a first displaceable portion and a second displaceable portion; and a connecting portion which joins said first and second displaceable portions;
wherein said first and second displaceable portions are each moveable from a first orientation wherein portions of each of the first and second displaceable portions are disposed proximally of the connecting portion, and a second orientation wherein the first and second displaceable portions and the connecting portion all lie in substantially the same plane.
35. The bone anchor apparatus as recited in Claim 34, and further comprising a suture receiving groove in each of the first and second displaceable portions.
36. The bone anchor apparatus as recited in Claim 34, wherein the first and second displaceable portions in combination with the connecting portion comprise a disk.
37. The bone anchor apparatus as recited in Claim 34 wherein the anchor body is initially disposed in said first orientation.
38. A method for securing connective tissue to bone, comprising:
securing a first end of a length of suture to a portion of soft tissue to be attached to a portion of bone;
threading a second end of the length of suture through an aperture in a body of a bone anchor disk;
disposing said bone anchor disk within a lumen of a tube, the disk being disposed in a bent orientation having a reduced cross-section;
inserting a distal end of said tube into a hole within said portion of bone;
and deploying said disk from the distal end of said tube.
39. The method as recited in Claim 38, and further comprising a step of moving said disk to an expanded orientation after deployment from said tube, so that the disk becomes anchored within said portion of bone.
40. A method of fabricating a bone anchor device, comprising:

providing a tube of biocompatible material;
forming a bone anchor device by making a series of cuts on a first end of the tube; and separating the bone anchor device from a remaining portion of the tube by making a further cut through said tube.
CA2448406A 2001-06-06 2002-06-04 Method and apparatus for attaching connective tissues to bone using a cortical bone anchoring device Expired - Fee Related CA2448406C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/876,260 US6547800B2 (en) 2001-06-06 2001-06-06 Method and apparatus for attaching connective tissues to bone using a cortical bone anchoring device
US09/876,260 2001-06-06
PCT/US2002/017493 WO2002098279A2 (en) 2001-06-06 2002-06-04 Method and apparatus for attaching connective tissues to bone using a cortical bone anchoring device

Publications (2)

Publication Number Publication Date
CA2448406A1 true CA2448406A1 (en) 2002-12-12
CA2448406C CA2448406C (en) 2010-08-10

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Family Applications (1)

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CA2448406A Expired - Fee Related CA2448406C (en) 2001-06-06 2002-06-04 Method and apparatus for attaching connective tissues to bone using a cortical bone anchoring device

Country Status (6)

Country Link
US (2) US6547800B2 (en)
EP (1) EP1392187A4 (en)
JP (1) JP4299120B2 (en)
KR (1) KR20040016874A (en)
CA (1) CA2448406C (en)
WO (1) WO2002098279A2 (en)

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