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Publication numberUS20060015108 A1
Publication typeApplication
Application numberUS 11/230,020
Publication date19 Jan 2006
Filing date19 Sep 2005
Priority date19 Aug 1996
Also published asUS5718717, US5980559, US6152949, US6572635, US6955683, US8845687, US20030195565, US20140018852, US20140018853
Publication number11230020, 230020, US 2006/0015108 A1, US 2006/015108 A1, US 20060015108 A1, US 20060015108A1, US 2006015108 A1, US 2006015108A1, US-A1-20060015108, US-A1-2006015108, US2006/0015108A1, US2006/015108A1, US20060015108 A1, US20060015108A1, US2006015108 A1, US2006015108A1
InventorsPeter Bonutti
Original AssigneeBonutti Peter M
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Tissue fixation device
US 20060015108 A1
Abstract
A suture anchor is formed of a material which absorbs body liquid when exposed to body liquid. The anchor may be at least partially formed of a material having a strong affinity for body liquids. This enables the anchor to absorb body liquid and expand upon being inserted into a patient's body. At least one embodiment of the suture anchor has portions formed of a relatively hard material which does not absorb body liquids and is pressed against body tissue by the material which absorbs body liquid to mechanically interlock the suture anchor and the body tissue. The anchor may be at least partially formed of a cellular material. The cells expand to absorb body liquid. At least one embodiment of the anchor has a pointed leading end portion to form an opening in an imperforate surface on body tissue. The configuration of the anchor may be changed by tensioning the suture while the anchor is disposed in body tissue.
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Claims(18)
1. A method of securing a suture comprising:
providing a suture anchor having a generally tubular configuration and a passage extending axially therethrough;
positioning a portion of a suture within the passage of the anchor;
inserting the anchor into body tissue with the suture extending from the anchor;
expanding a portion of the suture anchor radially outward to lock the anchor within the body tissue; and
tensioning the suture.
2. The method of claim 1, further including creating a recess in the body tissue and wherein inserting the anchor includes inserting the anchor within the recess.
3. The method of claim 2, wherein the body tissue is bone.
4. The method of claim 3, wherein the recess is created by drilling the bone.
5. The method of claim 4, wherein the anchor has an initial orientation during the insertion step and maintains the initial orientation during the expansion step.
6. The method of claim 5, further including the step of securing soft tissue relative to the bone.
7. The method of claim 1, wherein the suture anchor has first and second configurations, the anchor having the first configuration prior to expansion and the second configuration after expansion.
8. The method of claim 7, wherein the first configuration of the anchor is smaller in diameter than the second configuration.
9. The method of claim 8, wherein the second configuration of the suture anchor locks the anchor into the body tissue.
10. The method of claim 1, wherein expanding the anchor includes increasing a cross sectional area of the anchor as viewed in a plane extending perpendicular to the longitudinal axis of the anchor.
11. The method of claim 10, wherein the increased cross sectional area of the suture anchor locks the anchor into the body tissue.
12. The method of claim 1, wherein the anchor is made of a polymeric material.
13. The method of claim 1, wherein the anchor includes both polymeric and ceramic materials.
14. The method of claim 13, wherein the polymeric material is a resorbable polymer.
15. A method of securing a suture comprising:
providing a suture anchor having a generally tubular configuration and a passage extending axially therethrough;
positioning a portion of a suture within the passage of the anchor;
creating a recess in bone;
inserting the anchor into the recess with the suture extending from the anchor;
increasing an cross sectional diameter of a portion of the suture anchor to lock the anchor within the bone; and
tensioning the suture.
16. The method of claim 15, wherein the recess has a substantially cylindrical shape.
17. The method of claim 16, wherein the anchor has an initial orientation during the insertion step and maintains the initial orientation thereafter.
18. The method of claim 17, further including the step of securing soft tissue relative to the bone with the suture.
Description
    CROSS REFERENCE TO RELATED APPLICATIONS
  • [0001]
    This application is a continuation of application Ser. No. 10/442,353 filed May 21, 2003. The aforementioned '353 application is itself a continuation of application Ser. No. 09/703,058 filed Oct. 31, 2000 (now U.S. Pat. No. 6,572,635). The aforementioned '058 application is itself a continuation of application Ser. No. 09/378,190 filed Aug. 20, 1999 (now U.S. Pat. No. 6,152,949). The aforementioned '190 application is itself a continuation of application Ser. No. 08/964,167 filed Nov. 4, 1997 (now U.S. Pat. No. 5,980,559). The aforementioned '167 application is itself a divisional of application Ser. No. 08/699,553 filed Aug. 19, 1996 (now U.S. Pat. No. 5,718,717). The benefit of the earlier filing dates of the aforementioned applications is hereby claimed.
  • BACKGROUND OF THE INVENTION
  • [0002]
    The present invention relates to new and improved suture anchor and more specifically to a suture anchor which is capable of expanding in a patient's body to enable the anchor to withstand relatively large pull-out forces.
  • [0003]
    Anchors are commonly utilized to retain sutures in a patient's body. The anchors have previously been formed of metal, such as stainless steel or titanium. In addition, anchors have been formed of biodegradable materials. These known anchors have relied upon mechanical interlocks between the body tissue and the anchor to retain the anchor in place against the influence of force transmitted through the suture to the anchor. It has previously been suggested to construct anchors in the manner disclosed in U.S. Pat. Nos. 5,405,359; 5,403,348; 5,203,787; 5,046,513; and 5,041,129. In addition, an anchor formed of body tissue is disclosed in co-pending application Ser. No. 08/626,393 filed Mar. 29, 1996 filed by Peter M. Bonutti and entitled “Suture Anchor”.
  • SUMMARY OF THE INVENTION
  • [0004]
    The present invention relates to a new and improved suture anchor which absorbs body liquid. A suture extends from the anchor. The anchor and the suture are inserted into a patient's body. When the anchor is disposed in the patient's body, the anchor expands. The anchor expands by absorbing body liquid and/or by its own natural resilience. As the anchor expands, an improved interlock is obtained between the anchor and the body tissue to enable the anchor to resist relatively large tension forces transmitted through the suture.
  • [0005]
    The anchor may be formed of a material which absorbs body liquid. Alternatively, the anchor may contain cells which are expanded to absorb body liquid.
  • [0006]
    The anchor may have a leading end portion which forms an opening in an imperforate body surface. Alternatively, the anchor may be inserted into body tissue through an opening formed in the body tissue by a member other than the anchor. The configuration of the anchor may be changed while the anchor is in the body tissue.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0007]
    The foregoing and other features of the invention will become more apparent upon a consideration of the following description taken in connection with the accompanying drawings, wherein:
  • [0008]
    FIG. 1 is a schematic illustration depicting the manner in which an anchor is inserted into a patient's body with a suture extending into the anchor;
  • [0009]
    FIG. 2 is a schematic illustration depicting the manner in which the anchor of FIG. 1 is pivoted in the patient's body;
  • [0010]
    FIG. 3 is a schematic illustration depicting the manner in which the patient's body tissue is secured with the anchor immediately after the anchor has been inserted into the patient's body;
  • [0011]
    FIG. 4 is a schematic illustration, generally similar to FIG. 3, illustrating the manner in which the anchor expands by absorbing body liquid after the anchor has been inserted into the patient's body;
  • [0012]
    FIG. 5 is a schematic illustration depicting another manner in which the anchor of FIG. 1 may be inserted into a patient's body;
  • [0013]
    FIG. 6 is a schematic illustration depicting the manner in which the anchor of FIG. 5 expands in the patient's body by absorbing body liquid;
  • [0014]
    FIG. 7 is a schematic illustration, generally similar to FIG. 1, illustrating the manner in which a second embodiment of the anchor may be inserted into a patient's body through an imperforate surface on body tissue;
  • [0015]
    FIG. 8 is a schematic pictorial illustration of a third embodiment of the anchor having a portion which absorbs body liquid and a portion which does not absorb body liquid and has projections to engage body tissue;
  • [0016]
    FIG. 9 is a schematic pictorial illustration of a fourth embodiment of the anchor having a core which absorbs body liquid and a casing formed of an elastic material which does not absorb body liquid;
  • [0017]
    FIG. 10 is a pictorial schematic illustration of a suture receiving opening formed in material which does not absorb body liquid and is connected with a main portion which absorbs body liquid;
  • [0018]
    FIG. 11 is a schematic illustration of a an apparatus for inserting an anchor having cells which are collapsed before the anchor is moved into a patient's body;
  • [0019]
    FIG. 12 is a schematic illustration of another apparatus for inserting the anchor of FIG. 11 into body tissue;
  • [0020]
    FIG. 13 is a schematic illustration of the manner in which the configuration of an anchor is changed while the anchor is in the patient's body tissue; and
  • [0021]
    FIG. 14 is a schematic illustration of another manner in which the configuration of an anchor is changed while the anchor is in a patient's body tissue.
  • DESCRIPTION OF SPECIFIC PREFERRED EMBODIMENTS OF THE INVENTION
  • [0000]
    General Description
  • [0022]
    Suture anchors have previously been utilized to retain sutures in either hard or soft tissue in a human patient's body. The suture anchors have previously been formed of metal, biodegradable materials, and other materials. These known suture anchors have been retained in the patient's body by changing the orientation of the anchor relative to the patient's body once it has been inserted into the patient's body. Alternatively, known anchors have been retained in the patient's body by a mechanical interlock formed with the material of the patient's body by barbs or other projections.
  • [0023]
    In accordance with one of the features of the present invention, sutures may be retained in a patient's body by anchors which are at least partially formed of material which absorbs body liquid when exposed to the body liquid. The material expands as it absorbs the liquid in the patient's body. As the anchor expands, an improved interlock is formed between the anchor and body tissue of the patient's body. The improved interlock enables relatively large forces to be transmitted through a suture to the anchor.
  • [0024]
    In accordance with another of the features of the present invention, sutures may be retained in a patient's body by anchors which are formed of material which expands under the influence of its own natural resilience. As the material expands, cells are expanded from a collapsed condition. As the cells expand, the anchor absorbs body liquid by at least partially filling the cells with body liquid. As the anchor expands, an improved interlock is formed between the anchor and tissue of the patient's body. If desired, the material which forms the cells could also absorb body liquid.
  • [0025]
    In accordance with another feature of the invention, the anchor could be inserted into a patient's body through an imperforate surface on body tissue. This may be done by forming an opening in the body tissue with a leading end portion of the anchor. Alternatively, the opening could be formed by one or more members other than the anchor. Once the anchor has entered the patient's body the configuration of the anchor may be changed under the combined influence of force transmitted to the anchor through the suture and force applied against the outer surface of the anchor by body tissue.
  • [0000]
    Suture Anchor Formed of Material which Absorbs Body Liquid
  • [0026]
    A suture anchor 20 (FIG. 1) is formed of a material which absorbs body liquid when the anchor is exposed to body liquid. As the material of the anchor 20 absorbs body liquid, the anchor expands from the initial volume of FIGS. 1-3 to the expanded volume of FIG. 4. As the material of the anchor 20 absorbs body liquid and expands, the volume of the anchor increases and an improved mechanical interlock is formed between the anchor and body tissue in which the anchor has been inserted. The improved interlock enables the anchor 20 to resist large tension forces in a suture 32 without pulling out of body tissue 22.
  • [0027]
    It is contemplated that the anchor 20 could be completely formed of material which absorbs body liquid. Alternatively, the anchor could be partially formed of material which absorbs body liquid and partially formed of material which does not absorb body liquid. The material which does not absorb body liquid may be provided with projections which are forced into the body upon expansion of the material which absorbs body liquid. This would result in at least two different interlocks being obtained between the anchor and the body tissue, that is, an interlock due to expansion of the material which absorbs body liquid and an interlock due to engagement of projections on the material which does not absorb body liquid with the body tissue.
  • [0028]
    The suture anchor 20 is entirely formed of material which absorbs body liquid. In one specific instance, the suture anchor 20 was formed of a polymeric material which absorbs body liquid. The polymeric material may be either a copolymer or a dipolymer. The polymeric material may be hydrophilic. The polymeric material may be cellulose, petroylglutamic acid, high purity carboxymethylcellulose, a collagen, or polylactide. It is believed that a ceramic as found in hydroxyapatite composites with polyethylene, polylactide or polyhydroxybutyrate may be utilized to form the anchor 20. Of course, the suture anchor 20 could be formed of other known materials which absorb body liquid.
  • [0029]
    It is theorized that the hydrophilic material forming the anchor 20 attracts body liquid under the influence of molecular attraction and establishes molecular linkages with the body liquid. The material forming the anchor 20 is body liquid permeable. The body liquid enters minute cavities in the porous material forming the anchor 20 under the influence of capillary action. The attractive forces between molecules of the body liquid and molecules of the material forming the anchor 20 holds the body liquid in the minute cavities in the material forming the anchor.
  • [0030]
    In the embodiment of the invention illustrated in FIGS. 1-3, the suture anchor 20 has a tubular cylindrical configuration. The suture anchor 20 has a tubular wall 24 formed of material which absorbs body liquid. The tubular wall 24 has a cylindrical outer side surface 26 which is coaxial with a cylindrical inner side surface 28. The cylindrical inner side surface 28 forms a cylindrical passage 30 which extends axially through the center of the suture anchor 20.
  • [0031]
    The wall 24 of the suture anchor 20 is formed as one piece of a porous hydrophilic polymer which absorbs body liquid. Although it is preferred to form the anchor 20 with a cylindrical configuration, the anchor may be shaped or ground to any one of many different axially tapering or flaring configurations, such as those disclosed in U.S. Pat. No. 5,403,348. It is believed that it may be preferred to form the anchor 20 with either a cylindrical configuration or a polygonal configuration.
  • [0032]
    Although it is contemplated that the tubular cylindrical suture anchor 20 could be of many different sizes, it is believed that the suture anchor may preferably have a length or axial extent of between 2 and 4 millimeters. The cylindrical outer side surface 26 of the suture anchor 20 may have a diameter of between 1 and 2 millimeters. The cylindrical inner side surface 28 of the passage 30 in the anchor 20 may have a diameter of 1 to 1 millimeter. Of course, the suture anchor 20 could be formed with many different dimensions and/or shapes if desired.
  • [0033]
    A suture 32 is inserted into the passage 30 in the suture anchor 20. The suture 32 includes a portion or leg 34 which extends away from a flat annular trailing end surface 36 of the anchor 20. In addition, the suture 32 has a second portion or leg 38 which extends across a flat annular leading end surface 40 of the anchor 20. The leg 38 of the suture 32 extends along the cylindrical outer side surface 26 of the anchor 20 to a location adjacent to and spaced from the leg portion 34 of the suture 32. A relatively short portion 44 of the suture 32 interconnects the leg portions 34 and 38 and is disposed in the passage 30 in the suture anchor 20.
  • [0034]
    An inserter assembly 60 is used to position the suture anchor 20 and a portion of the suture 32 in a patient's body tissue 22. The inserter assembly 60 includes a cylindrical tubular outer sleeve 66 having a cylindrical central passage 68 in which the anchor 20 is disposed. The inserter 60 also includes a cylindrical tubular inner sleeve 72 which is telescopically received in the outer sleeve 66. The tubular inner sleeve 72 has a conical tapered leading end portion 74 which engages an annular trailing end surface 36 of the anchor 20.
  • [0035]
    The leg or portion 34 of the suture 32 extends through a cylindrical passage 76 in the inner sleeve 72. The leg or portion 38 of the suture 32 extends through the central passage 68 in the outer sleeve 66 along a path which extends between the inner and outer sleeves. The leg or portion 38 of the suture 32 could extend along the outside of the outer sleeve 66. If desired, one of the legs or portions 34 or 38 of the suture could be omitted. If this was done, the suture 32 could be tied or otherwise secured to the anchor 20.
  • [0036]
    It is contemplated that the anchor 20 may be inserted into a human patient's body at many different locations. The anchor 20 may be inserted into either hard or soft tissue. In the situation illustrated schematically in FIG. 1, the anchor 20 is being inserted into bone tissue 22 in a patient's body. A cylindrical recess 80 is formed in the bone tissue 22 of the patient's body by drilling or other methods. The recess 80 extends through a hard compact outer layer 82 of the patient's bone tissue 22 into the relatively porous inner or cancellous tissue 84.
  • [0037]
    To insert the anchor 20 in the patient's body tissue 22, the cylindrical inner sleeve 72 is moved axially downward (as viewed in FIG. 1) to apply force against a relatively small area on the annular trailing end surface 36 of the anchor 20. Once the anchor 20 has been pushed into the recess 80 by axial movement of the inner sleeve 72 relative to the outer sleeve 66, the leg 38 of the suture 32 is tensioned to apply force against an annular leading end surface 40 of the anchor 20. At the same time, the bevelled leading end 74 of the inner sleeve 72 is pressed against the trailing end surface 36 of the anchor.
  • [0038]
    This results in the application of a counterclockwise (as viewed in FIGS. 1 and 2) torque to the anchor 20. This torque causes the anchor 20 to pivot through the orientation shown in FIG. 2 to the orientation shown in FIG. 3. Once the anchor 20 has been pivoted to the orientation shown in FIG. 3, by tensioning the suture 32 and applying force against the anchor with the leading end portion 74 of the inner sleeve 72, the anchor 20 engages the hard compact outer layer 82 of the patient's bone tissue to hold the anchor in the recess 80. Thus, a solid initial interlock is obtained between the anchor 20 and body tissue 22.
  • [0039]
    The suture 32 is then tensioned to secure a member, such as body tissue 90, in place. The member or body tissue 90 may be soft tissue, or a ligament, or a tendon, or other body tissue. If desired, the suture 32 may be used to secure other members, such as an implant or splint, in place relative to the patient's body tissue 22. The suture is tensioned to transmit force between the anchor 20 and a member to be held in place.
  • [0040]
    One specific known inserter assembly 60 and method of inserting a suture anchor 20 into a patient's body tissue has been illustrated in FIGS. 1-3. This specific inserter assembly and the method of inserting the anchor 20 are the same as is disclosed in U.S. Pat. No. 5,403,348 issued Apr. 4, 1995 and entitled “Suture Anchor”. However, it is contemplated that many different known types of inserter assemblies could be utilized to install the suture anchor 20 with many different methods in a patient's body tissue. For example, the inserter assembly and method disclosed in U.S. Pat. No. 5,464,426 issued Nov. 7, 1995 and entitled “Method of Closing Discontinuity in Tissue” could be utilized if desired. Of course, other known apparatus and methods could also be utilized if desired.
  • [0041]
    In accordance with a feature of the invention, the suture anchor 20 absorbs body liquid and expands once the suture anchor has been inserted into the body tissue 22. The expansion of the suture anchor 20 improves the initial interlock between the anchor and body tissue 22. The initial interlock between the anchor 20 and body tissue 22 is obtained by pivoting the anchor in the body tissue to the orientation shown in FIG. 3. The improved interlock is obtained by expanding the anchor 20, as shown in FIG. 4. The improved interlock allows relatively large tension forces to be transmitted through the suture 32 between the anchor 20 and a member to be held in place by the suture.
  • [0042]
    The suture anchor 20 expands in all directions, from the initial size illustrated in FIG. 3 to a relatively large expanded size illustrated in FIG. 4, shortly after the suture anchor has been inserted into the body tissue 22. After the suture anchor 20 has been inserted into the body tissue 22, the suture anchor is exposed to body liquids, indicated schematically at 98 in FIG. 4. The body liquids 98 are drawn into the suture anchor 20 due to the affinity of the polymeric material forming the suture anchor 20 for body liquids.
  • [0043]
    As the body liquids 98 are drawn into the suture anchor 20, the anchor expands in a substantially uniform manner in all directions. Thus, the anchor 20 swells both radially and axially. Substantially uniform expansion of the entire outer side surface area of the suture anchor 20 occurs as body liquids 98 are absorbed by the anchor. The extent of expansion of the suture anchor 20 will depend upon the specific characteristics of the material from which the suture anchor is formed and may vary between 10 and 50 percent by volume. Of course, the extent of expansion of the anchor 20 will be a function of the force applied against the outer side surface of the anchor by the body tissue 22.
  • [0044]
    As the suture anchor 20 swells, the size of the anchor 20 increases. As the size of the anchor 20 increases, the outer side surface of the anchor presses both axially and radially outward against the body tissue 22. As the anchor 20 expands and presses against the body tissue, the body tissue is displaced by the anchor. Thus, the outer side surface of the anchor 20 applies force against the body tissue 22 and moves the body tissue to make room for the anchor as the anchor expands. If the anchor 20 encounters a localized area of high resistance to expansion in the body tissue, the anchor will expand around the localized area and may even shift in the body tissue 22.
  • [0045]
    The expansion of the anchor 20 as it absorbs the body liquids 98 results in an increasing mechanical interlocking action between the anchor 20 and the body tissue 22. There is an initial mechanical interlock between the anchor 20 and the body tissue 22 when the anchor has its original or initial size (FIG. 3). As body liquids 98 are absorbed by the suture anchor 20 and the volume of the anchor increases, the anchor expands to improve the mechanical interlock between the anchor and the body tissue 22. The improved interlock between the anchor 20 and body tissue 22 allows relatively large tension forces to be transmitted through the suture 32 without pulling the anchor out of the body tissue.
  • [0000]
    Installation—Second Procedure
  • [0046]
    In the embodiment of the invention illustrated in FIGS. 1-4, the anchor 20 was pivoted from the orientation shown in FIG. 1 through the orientation shown in FIG. 2 to the orientation shown in FIG. 3 to obtain an initial mechanical interlock between the anchor and body tissue 22. In the embodiment of the invention illustrated in FIGS. 5 and 6, the anchor is not pivoted from its initial orientation to obtain an initial mechanical interlock. The anchor is merely positioned in the body tissue and expanded in all directions by absorbing body liquid. The expansion of the anchor results in the formation of an interlock between the anchor and the body tissue. Since the embodiment of the invention illustrated in FIGS. 5 and 6 is generally similar to the embodiment of the invention illustrated in FIGS. 1-4, similar numerals will be utilized to designate similar components, the suffix letter “a” being associated with the numerals of FIGS. 5 and 6 in order to avoid confusion.
  • [0047]
    The suture anchor 20 a has the same construction and is formed of the same hydrophilic polymeric material as the suture anchor 20 of FIGS. 1-3. The suture anchor 20 a (FIG. 5) has a cylindrical tubular configuration. The suture anchor 20 a has a cylindrical outer side surface 26 a. A cylindrical central passage 30 a extends through the suture anchor 20 a between opposite annular end surfaces 36 a and 40 a of the suture anchor 20 a.
  • [0048]
    A suture 32 a has a leg 34 a which extends through a passage 76 a formed in an inner sleeve 72 a; A second leg 38 a of the suture 32 a extends through a central passage 68 a and a tubular outer sleeve 66 a. The leg 38 a of the suture 32 a extends between a cylindrical inner side surface 68 a of the inner sleeve 72 a and a cylindrical inner side surface of the outer sleeve 66 a.
  • [0049]
    It is contemplated that the anchor 20 a may be inserted into a patient's body at many different locations. The anchor 20 a may be inserted into either hard or soft tissue. In the situation illustrated schematically in FIG. 5, the anchor is being inserted into bone tissue 22 a in a patient's body with the inserter assembly 60 a. A recess 80 a is formed in the bone tissue 20 a of the human patient's body by drilling or other methods. The cylindrical recess 80 a extends through the hard compact outer layer 82 a of the patient's bone tissue 20 a into the relatively porous inner or cancellous tissue 84 a.
  • [0050]
    To insert the anchor 20 a in the patient's body tissue 22 a, the inner sleeve 72 a is moved axially downward (as viewed in FIG. 5) to apply force against the trailing end surface 36 a of the anchor 20 a. In this embodiment of the inserter assembly 60 a, the inner sleeve 72 a has a cylindrical leading end portion 74 a which applies a substantially uniform force over substantially the entire flat annular trailing end surface 36 a of the anchor 20 a. Therefore, the anchor 20 a is not pivoted but is merely moved straight into the recess 80 a.
  • [0051]
    Once the anchor 20 a has been positioned in the recess 80 a, the anchor absorbs body liquid 98 a and increases in volume as the liquid is absorbed. This results in the anchor expanding in all directions from the initial size of FIG. 5 to a relatively large expanded size illustrated in FIG. 6. As the anchor 20 a expands, its size increases by 10 to 50 percent by volume.
  • [0052]
    The anchor 20 a is porous and is formed of a hydrophilic material. The body liquid 98 a is drawn into openings in the porous material of the anchor 20 a by the affinity of the porous material forming the anchor for the body liquid. The attractive forces between the material forming the anchor 20 a and the body liquid holds the body liquid in the anchor.
  • [0053]
    As the anchor 20 a expands from the initial size, the outer surfaces on the anchor press radially and axially against the body tissue 22 a. Substantially uniform expansion of the anchor 20 a forms a secure mechanical interlock with the body tissue. This interlock enables tension forces to be transmitted through the suture 32 a between the anchor 20 a and a member, such as the body tissue 90 a.
  • [0054]
    As the anchor 20 a expands radially outward, the cancellous tissue 84 a is compressed and the size of the portion of the recess 80 a in the cancellous tissue 84 a is increased. As this happens, the diameter of the cylindrical anchor 20 a increases from a diameter which is just slightly less than the size of the portion of the recess 80 a which extends through the hard compact outer layer 82 a of the bone tissue 22 a to a diameter which is greater than the diameter of the portion of the recess 80 a extending through the hard compact outer layer 82 a of bone tissue. This results in the anchor 20 a being locked in place in the body tissue 22 a.
  • [0055]
    The suture 32 a can then be used to secure a member 90 a in place in the manner illustrated schematically in FIG. 6. The member 90 a may be soft body tissue, or a ligament, or a tendon, or other body tissue. If desired, the suture 32 a may be used to secure an implant or splint in place relative to the patient's body 22 a. The interlock between the anchor 20 a and body tissue 22 a enables substantial tension force to be transmitted through the suture 32 a without pulling the anchor out of the body tissue.
  • [0056]
    The expansion of the anchor 20 a has been schematically illustrated in FIG. 6 as being uniform in all directions. This will be the case when the body tissue 22 a applies uniform forces against all sides of the anchor 20 a. However, the body tissue 22 a may provide nonuniform resistance to expansion of the anchor 20 a. When this occurs, the anchor 20 a may shift in the body tissue 22 a under the influence of forces applied against the body tissue as the anchor expands. In addition or alternatively, the anchor 20 a may expand in a nonuniform manner.
  • Anchor—Second Embodiment
  • [0057]
    In the embodiment of the invention illustrated in FIGS. 1-4, the anchor 20 has a generally cylindrical configuration and is formed entirely of a hydrophilic polymeric material which absorbs body liquid. The anchor illustrated in FIGS. 1-4, due to its relatively blunt leading end portion, is particularly well adapted for positioning in preformed recesses in body tissue. In the embodiment of the anchor illustrated in FIG. 7, the anchor has a sharp or pointed leading end portion to facilitate forming an opening in imperforate body tissue. Since the embodiment of the invention illustrated in FIG. 7 is generally similar to the embodiment of the invention illustrated in FIGS. 1-4, similar numerals will be utilized to designate similar components, the suffix letter “b” being associated with the numerals of FIG. 7 to avoid confusion.
  • [0058]
    The tubular cylindrical suture anchor 20 b has a generally cylindrical outer side surface 26 b which is coaxial with a cylindrical inner side surface 28 b. The cylindrical inner side surface 28 b forms a portion of a passage 30 b which extends through the anchor 20 b. In addition to the main portion of the passage 30 b formed by the cylindrical side surface 28 b, a second cylindrical side surface 110 has a central axis which extends perpendicular to the central axis of the cylindrical side surface 28 b. The cylindrical side surface 110 intersects the cylindrical side surface 28 b and extends radially outward from the cylindrical side surface 28 b. The cylindrical side surfaces 28 b and 110 cooperate to form the passage 30 b with a generally L-shaped configuration.
  • [0059]
    A suture 32 b is inserted into the passage 30 b in the suture anchor 20 b. The suture 32 b includes a portion or leg 34 b which extends away from a flat annular trailing end surface 36 b of the anchor 20 b. In addition, the suture 32 b has a second portion or leg 38 b which extends along the cylindrical outer side surface 26 b of the anchor 20 b and along the cylindrical inner side surface 68 b of the outer sleeve 66 b. A relatively short portion 44 b of the suture 32 b interconnects the leg portions 34 b and 38 b and is disposed in the passage 30 b in the suture anchor 20 b.
  • [0060]
    An inserter assembly 60 b is used to position the suture anchor 20 b and a portion of the suture 32 b in a patient's body tissue 22 b. The inserter assembly 60 b includes a generally cylindrical tubular outer sleeve 66 b having a central passage 68 b in which the anchor 20 b is disposed. The inserter 60 b also includes a tubular inner sleeve 72 b which is telescopically received in the outer sleeve 66 b. The tubular inner sleeve 72 b has a conical tapered leading end portion 74 b which engages the trailing end surface 36 b of the anchor 20 b.
  • [0061]
    In accordance with a feature of the embodiment of the invention illustrated in FIG. 7, the anchor 20 b has a leading end portion 112 with a generally conical configuration. The leading end portion 112 of the anchor 20 b is adapted to form an opening in an imperforate outer side surface 114 of the patient's body tissue 22 b. In addition, the leading end portion 112 of the anchor 20 b facilitates moving the anchor into the body tissue 22 b under the influence of force applied against the trailing end surface 36 b of the anchor 20 b by the tubular inner sleeve 72 b. The conical leading end portion 112 of the anchor 20 b is formed by a conical layer of a relatively hard polymeric material. The polymeric material forming the leading end portion 112 may be biodegradable if desired.
  • [0062]
    In addition, the anchor 20 b has a cylindrical body portion or wall 116 which is disposed in a coaxial relationship with the leading end portion 112. The cylindrical body portion 116 is formed of a hydrophilic polymeric material which absorbs body liquid when exposed to the body liquid. The cylindrical body portion 116 is formed of the same material as the anchor 20 of FIGS. 1-4. As the body portion 116 of the anchor 20 b absorbs body liquid, the body portion of the anchor expands radially and axially to interlock with the body tissue 22 b. The leading end portion 112 is formed of a rigid polymeric material which does not absorb body liquid.
  • [0063]
    The leading end portion 74 b of the tubular inner sleeve 72 b is tapered so that it applies force against the trailing end surface 36 b of the anchor 20 b at a relatively small area on the trailing end surface. The concentrated application of force to the trailing end surface 36 b of the anchor 20 b facilitates pivoting movement of the anchor in the body tissue 22 b upon tensioning of the leg 38 b of the suture 32 b.
  • [0064]
    Assuming the anchor 20 b is to be moved into body tissue 22 b disposed beneath a layer 120 of skin, force is applied against the tubular inner sleeve 72 b to force the pointed leading end portion 112 of the anchor against the imperforate outer side surface 114 of the skin 120. This force causes the anchor 20 b to pierce the skin 120 and enter soft body tissue 122 disposed beneath the skin. Once the anchor 20 b has been moved completely beneath the skin 120 into the soft body tissue 122, the leg 38 b of the suture 32 b is tensioned. This results in the application of torque to the anchor 20 b tending to rotate or pivot the anchor in a counterclockwise direction from the orientation shown in FIG. 7 to a generally horizontal orientation, corresponding to the orientation of the anchor illustrated in FIG. 3. At this time, the longitudinal central axis of the anchor will be generally parallel to the skin 120.
  • [0065]
    Once the anchor 20 b has been moved into the body tissue 122 and pivoted in the manner previously explained, the body portion 116 of the anchor will absorb body liquid such as blood or other fluids. As the hydrophilic body portion 116 of the anchor 20 b absorbs body liquids, the body portion expands in all directions and presses against the body tissue 122. As the anchor expands, body tissue is displaced and the mechanical interlock with the anchor 20 b is enhanced.
  • [0066]
    Thus, the anchor 20 b is mechanically interlocked with the body tissue 122 by both pivotal movement of the anchor to a sidewise orientation and expansion of the anchor as it absorbs body liquids. The improved interlock obtained by expanding the anchor 20 b enables relatively large tension forces to be transmitted between a member (not shown) and the anchor 20 b through the suture 32 b.
  • Anchor—Third Embodiment
  • [0067]
    In the embodiment of the anchor illustrated in FIGS. 1-4, the anchor is formed entirely of material which absorbs body liquid when it is exposed to the body liquid. In the embodiment of the anchor illustrated in FIG. 8, a portion of the anchor is formed of material which absorbs body liquid and another portion of the anchor is formed of material which does not absorb body liquid. The material which does not absorb body liquid has projections which engage body tissue to enhance an interlock between the anchor and the body tissue. Since the embodiment of the invention illustrated in FIG. 8 is generally similar to the embodiment of the invention illustrated in FIGS. 1-4, similar numerals will be utilized to designate similar components, the suffix letter “c” being associated with the numerals of FIG. 8 in order to avoid confusion.
  • [0068]
    An anchor 20 c (FIG. 8) has a tubular cylindrical configuration. A suture (not shown) extends through a central passage 30 c in the anchor 20 c in the same manner as illustrated in FIG. 1 for the anchor 20.
  • [0069]
    In accordance with a feature of this embodiment of the invention, the anchor 20 c (FIG. 8) has a body portion 116 c which is formed of a hydrophilic polymeric material which absorbs body liquid when exposed to the body liquid. In addition, the anchor 20 c includes a plurality of identical retaining portions 130, 132 and 134. The retaining portions 130, 132 and 134 are formed of a relatively hard polymeric material which does not absorb body liquid. The retaining portions 130, 132 and 134 may be biodegradable if desired.
  • [0070]
    In the illustrated embodiment of the invention, the retaining portions 130, 132 and 134 and a plurality of ribs or projections 138 which extend outward from the retaining portion. When the anchor 20 c is positioned in body tissue in the manner previously explained in conjunction with the embodiments of the invention illustrated in FIGS. 1-4, the body portion 116 c absorbs body liquid. When this occurs, the body portion 116 c of the anchor 20 c expands radially and axially outward to enhance the mechanical interlock with the body tissue.
  • [0071]
    As the body portion 116 c of the anchor 20 c expands, the retaining portions 130, 132 and 134 are moved radially outward away from the central axis of the anchor 20 c. This presses the ribs 138 on the retaining portions 130, 132 and 134 into the body tissue to further enhance the mechanical interlock between the anchor and the body tissue. Although the ribs 138 have been shown in FIG. 8 as having a generally arcuate configuration and a generally smooth outer side surface, it is contemplated that the ribs could have barbs or other projections which would impale the body tissue as the body portion 116 c of the anchor 20 c absorbs body liquid and expands. Of course, this would further enhance the mechanical interlock between the anchor 20 c and the body tissue.
  • [0072]
    In the embodiment of the anchor 20 c illustrated in FIG. 8, the anchor has a generally flat annular leading end portion. However, it is contemplated that the anchor 20 c could be provided with a conical leading end portion, similar to the conical leading end portion 112 on the anchor 20 b of FIG. 7. If the anchor 20 c were to be provided with a conical leading end portion, it is contemplated that the retaining portions 130, 132 and 134 could be extended in an axial direction to form the conical leading end portion as three separate segments. As the body portion 116 c of the anchor 20 c absorbs body liquid and expands, the retaining portions 130, 132 and 134 would move radially outward away from each other and the leading end portion of the anchor would expand.
  • [0073]
    A relatively strong interlock is obtained between the anchor 20 c and body tissue. This interlock is obtained by changing the orientation of the anchor 20 c relative to the body tissue, in the manner illustrated for the anchor 20 in FIG. 2. In addition, the interlock is obtained by expansion of the anchor 20 c as the body portion 116 c absorbs body liquid. The interlock is also obtained by engagement of the ribs 138 with body tissue. The result is a strong interlock which enables the anchor 20 c to resist very large tension forces transmitted to the anchor through a suture.
  • Anchor—Fourth Embodiment
  • [0074]
    In the embodiment of the anchor 20 illustrated in FIGS. 1-4, the anchor is formed entirely of material which expands when it is exposed to body liquid. In the embodiment of the invention illustrated in FIG. 9, the anchor is formed by a core of material which expands upon being exposed to body liquid and an elastic jacket which encloses the core. Since the embodiment of the invention illustrated in FIG. 9 is generally similar to the embodiment of the invention illustrated in FIGS. 1-4, similar numerals will be utilized to designate similar components, the suffix letter “d” being associated with the numerals of FIG. 9 in order to avoid confusion.
  • [0075]
    An anchor 20 d (FIG. 9) has a cylindrical configuration. The anchor 20 d includes a cylindrical core 144 which is enclosed by a tubular cylindrical jacket 146. A passage 30 d extends through both the core 144 and the jacket 146. The passage 30 d extends diametrically through the core 144 and the jacket 146 and has a cylindrical configuration. A suture (not shown) is positioned in the passage 30 d. The suture may be tied off at one end of the passage or may extend through the passage so that legs of the suture extend along opposite sides of the jacket 146.
  • [0076]
    The jacket 146 is provided with a plurality of circular openings 150 which extend through the jacket. The openings 150 enable body liquid to pass through the jacket into the core 144. The jacket 146 is formed of an elastic polymeric material which is easily stretched. The core 144 is formed of a material which absorbs body liquid upon being exposed to the body liquid. In one specific embodiment of the suture anchor 20 d, the core 144 was formed of a hydrophilic polymeric material which is the same as the material forming the anchor 20 of FIGS. 1-4.
  • [0077]
    When the anchor 20 d is inserted into body tissue, in the manner illustrated schematically in either FIGS. 1-3 or 5 and 6, the entire anchor 20 d is exposed to body liquid. The body liquid passes through the openings 150 and is absorbed by the core 144. As the core 144 absorbs body liquid, the core expands and stretches the jacket 146.
  • [0078]
    Although the anchor 20 d has been shown as having a generally cylindrical configuration with flat annular end surfaces, it is contemplated that the anchor could be provided with a conical leading end portion, similar to the conical leading end portion 112 of the anchor 20 b of FIG. 7. The conical leading end portion could be formed either as a portion of the jacket 46 or separately from the jacket. It is believed that it may be preferred to form a conical leading end portion for the anchor 20 d separately from the jacket 146 to enable the leading end portion to be formed of a hard material which is not readily stretched and which is capable of piercing an imperforate surface of body tissue.
  • [0079]
    In the illustrated embodiment of the invention, the jacket 146 is formed of a material which is resiliently stretched when the core 144 absorbs body liquid and expands. It is contemplated that the size of the jacket 146 could be increased in other ways to accommodate expansion of the core. For example, releasable tucks could be formed in the jacket. Upon expansion of the core, stitches or other devices holding the tucks would be released under the influence of force applied against the jacket by the core.
  • Anchor—Fifth Embodiment
  • [0080]
    The anchors illustrated in FIGS. 1-9 all have passages through which the suture extends. In the embodiment of the invention illustrated in FIG. 10, the anchor has an eyelet through which the suture extends. Since the embodiment of the invention illustrated in FIG. 10 is generally similar to the embodiment of the invention illustrated in FIGS. 1-9, similar numerals will be utilized to designate similar components, the suffix letter “e” being associated with the embodiment of the invention illustrated in FIG. 10 to avoid confusion.
  • [0081]
    An anchor 20 e has a solid cylindrical body portion 116 e. The body portion 116 e of the anchor 20 e is formed of a hydrophilic polymeric material which absorbs body liquid when exposed to the body liquid. The material forming the body portion of the anchor 20 e is the same as the material forming the anchor 20 of FIGS. 1-4. Upon absorbing body liquid, a portion 116 e of the anchor 20 e expands.
  • [0082]
    In accordance with a feature of the embodiment of the invention illustrated in FIG. 10, the anchor 20 e is provided with a trailing end portion 160 which is connected with a suture. The trailing end portion 160 of the anchor 20 e has a circular wall 162 which is fixedly connected with the body portion 116 e of the anchor 20 e. A passage 30 e is formed in a projection 164 which extends axially outward from the end wall 162. The passage 30 e receives a suture. The suture may be tied off on the projection 164 or may extend through the projection and have a pair of legs, corresponding to the legs 34 and 38 of the suture 32 of FIG. 1.
  • [0083]
    When the anchor 20 e is inserted into body tissue, using an inserter assembly similar to the inserter assembly 60 of FIGS. 1 and 2, the body portion 116 e is exposed to body liquid. This results in the body portion 116 e of the anchor 20 e expanding radially and axially outward from the trailing end portion 160 to form a mechanical interlock with the body tissue.
  • Anchor—Sixth Embodiment
  • [0084]
    In the embodiments of the invention illustrated in FIGS. 1-10, at least portions of the anchors are formed of a hydrophilic polymeric material which absorbs body liquid. In the embodiment of the invention illustrated in FIG. 11, the anchor is formed of cellular material which absorbs body liquid. Since the embodiment of the invention illustrated in FIG. 11 is generally similar to the embodiments of the invention illustrated in FIGS. 1-10, similar numerals will be utilized to designate similar components, the suffix letter “f” being associated with the numerals of FIG. 11 to avoid confusion.
  • [0085]
    A suture anchor 20 f has a tubular cylindrical configuration when the anchor is in an unrestrained condition. When the suture anchor 20 f is in an unrestrained condition, the anchor has a tubular wall 24 f which has a cylindrical outer side surface 26 f which is coaxial with a cylindrical inner side surface 28 f of the anchor. The cylindrical inner side surface 28 f forms a passage 30 f which extends axially through the center of the suture anchor 20 f when the anchor is in an unrestrained condition.
  • [0086]
    The wall 24 f of the suture anchor 20 f is formed as one piece of resilient material containing a large number of cells which are expandable to absorb body liquid. The cellular material which forms the suture anchor 20 f may be a hydrophilic polymeric cellular material which absorbs body liquid. Although it is preferred to form the anchor 20 f with a cylindrical configuration, the anchor may be shaped to any one of many different axially tapering or flaring configurations or may have a polygonal configuration.
  • [0087]
    A suture 32 f is inserted into the passage 30 f in the suture anchor 20 f. The suture 32 f includes a leg portion 34 f which extends away from a flat annular trailing end surface 36 f of the anchor 20 f. In addition, the suture 32 f has a second portion or leg 38 f which extends across a flat annular leading end surface 40 f of the anchor 20 f. The leg 38 f of the suture 32 f extends along the cylindrical outer side surface 26 f. A relatively short portion 44 f of the suture 32 f interconnects the leg portion 34 f and 38 f and is disposed in the passage 30 f in the anchor 20 f.
  • [0088]
    An inserter assembly 60 f is used to position the anchor 20 f and a portion of the suture 32 f in a patient's body tissue 22 f. The inserter assembly 60 f includes a cylindrical tubular outer sleeve 66 f having a cylindrical passage 68 f in which the anchor 20 f is disposed. The inserter 60 f also includes a cylindrical tubular inner sleeve 72 f which is telescopically received in the outer sleeve 66 f. The tubular inner sleeve 72 f has a cylindrical leading end portion 74 f which engages the trailing end surface 36 f of the anchor 20 f.
  • [0089]
    The leading end portion 74 f of the tubular inner sleeve 72 f has an end wall 168 with a flat end surface which abuttingly engages the flat annular trailing end surface 36 f on the anchor 20 f. The two legs 34 f and 36 f of the suture 32 f extend through a central opening formed in the end wall 168 at the leading end portion 74 f of the inner sleeve 72 f. The legs 34 f and 38 f of the suture 32 f extend through the tubular inner sleeve 72 f to a location remote from the inserter assembly 60 f. If desired, one of the legs 34 f or 38 f of the suture could be omitted. If this was done, the suture 32 f could be tied or otherwise secured to the anchor 20 f.
  • [0090]
    It is contemplated that the anchor 20 f may be inserted into a human patient's body at many different locations. The anchor 20 f may be inserted into either hard or soft tissue. In the situation illustrated schematically in FIG. 11, the anchor 20 f is being inserted into soft body tissue in a patient's body.
  • [0091]
    To facilitate insertion of the anchor 20 f into soft body tissue, a leading end portion 170 of the outer sleeve 60 f has an axially tapered or configuration. The pointed configuration of the leading end portion 170 of the outer sleeve 60 f enables the leading end portion of the outer sleeve to form an opening in an imperforate outer side surface 114 f of the patient's body tissue 22 f. In addition, the pointed leading end portion 170 of the outer sleeve 60 f facilitates moving the outer sleeve 60 f into the body tissue 22 f under the influence of force manually applied against an outer end portion of the outer sleeve 60 f.
  • [0092]
    To insert the anchor 20 f into the patient's body tissue 22 f, the pointed leading end portion 170 of the outer sleeve 66 f is pressed against the imperforate outer side surface 114 f of skin or other tissue 120 f. The pointed leading end portion of the outer sleeve 66 f pierces the imperforate outer surface 114 f of the skin 120 f and enters soft body tissue 122 f disposed beneath the skin. The outer sleeve 66 f is forced into the soft body tissue 22 f for a desired distance corresponding to the distance which the suture anchor 20 f is to be inserted into the body tissue.
  • [0093]
    The inner sleeve 72 f is then pressed downward (as viewed in FIG. 11) to move the suture anchor 20 f to the leading end portion 170 of the outer tubular member 66 f. The inner side surface 68 f of the tubular outer member 66 f applies force against the outer side surface 26 f of the anchor 20 f to maintain the anchor in the compressed condition shown in FIG. 11. The outer tubular member 66 f is then moved axially upward (as viewed in FIG. 11) relative to the stationary inner tubular member 72 f. This results in the anchor 20 f being ejected from the outer tubular member 66 f into the body tissue 22 f. Once the anchor 20 f has moved from the outer sleeve 66 f into the body tissue 22 f, both the inner and outer sleeves 66 f and 72 f are withdrawn from the body tissue.
  • [0094]
    If desired, a pointed member, such as a trocar, could be inserted through the outer sleeve 66 f to pierce the surface 114 f and body tissue 22 f. If this was done, the inner sleeve 72 f and anchor 20 f would be removed from the outer sleeve 66 f to provide room for the pointed member. After the body tissue has been pierced by the pointed member, the pointed member would be withdrawn from the outer sleeve 66 f and the inner sleeve 72 f and compressed anchor 20 f inserted into the outer sleeve.
  • [0095]
    In accordance with a feature of the present invention, the anchor 20 f is formed of a resilient cellular material. Prior to insertion of the anchor 20 f into the outer sleeve 66 f, the cellular material of the anchor 20 f is resiliently compressed from a relatively large unrestrained size to a compacted size illustrated in FIG. 11. The unrestrained size of the suture anchor 20 f may be 2 to 20 times as large as the size illustrated in FIG. 11.
  • [0096]
    As the resilient cellular material of the anchor 20 f is compressed, the passage 30 f which extends through the anchor 20 f when the anchor is in its unrestrained condition, is collapsed tightly inward against the portion 44 f of the suture 32 f. In addition, as the anchor 20 f is resiliently compressed from its unrestrained condition, the cells in the anchor are collapsed. Thus, the anchor 20 f is resiliently compressed from an unrestrained condition to the compacted or compressed condition of FIG. 11 in much the same manner as in which a sponge may be compressed.
  • [0097]
    The compressed anchor 20 f, with the suture 32 f extending through the anchor and the inner sleeve 72 f, is inserted into the outer sleeve 66 f. The inner sleeve 72 f then pushes the compressed anchor axially downward (as viewed in FIG. 11) into the outer sleeve as the telescopic relationship between the inner and outer sleeves is increased.
  • [0098]
    When the anchor 20 f is in the outer sleeve 66 f, the inner side surface 68 f of the outer sleeve applies force against the outer side surface 26 f of the anchor to hold the anchor in its compressed condition. Upon movement of the anchor 20 f out of the outer sleeve 66 f into the body tissue 22 f, the force holding the anchor 20 f in a compressed condition is removed from the outer side surface 26 f of the anchor. As this occurs, the natural resilience of the cellular material forming the anchor 20 f causes the anchor to expand.
  • [0099]
    As the anchor 20 f expands, the anchor applies force against the soft body tissue 122 f and increases the size of the cavity which was originally formed by the outer sleeve 66 f of the inserter assembly 60 f. As the anchor 20 f expands, it applies force against the soft body tissue 122 f and displaces the soft body tissue. Thus, the outer side surface 26 f of the anchor 20 f is pressed against the soft body tissue 122 f and moves the soft body tissue as the anchor expands radially outward.
  • [0100]
    As the anchor 20 f expands, the cells in the anchor are expanded from a collapsed condition to an expanded condition. As the size of the cells in the anchor 20 f increases, body liquids are drawn into the cells. Thus, the anchor 20 f absorbs body liquid as it expands.
  • [0101]
    The anchor 20 f is formed of a resilient polymeric material having an open cell, sponge-like construction. When the anchor 20 f is in the compressed condition illustrated in FIG. 11, the cells are collapsed. As the anchor 20 f expands in the body tissue 22 f, the cells expand. Since the anchor 20 f has an open cellular construction, body liquid can flow into the cells as the anchor expands.
  • [0102]
    Once the anchor 20 f has expanded in the body tissue 22 f, the expanded anchor is substantially larger than the opening which was formed in the body tissue by insertion of the outer sleeve 66 f into the body tissue. However, it should be understood that due to force applied against the anchor 20 f by the body tissue 22 f, the anchor may not expand fully back to its unrestrained size. As the outer sleeve 66 f is withdrawn from the body tissue, the visco-elastic nature of the body tissue causes the body tissue to come together and close off the passage which was formed by the insertion of the outer sleeve 66 f into the body tissue. Thus, the body tissue will move inward and grip the legs or portions 34 f and 38 f of the suture 32 f. The anchor 20 f will fill a cavity formed in the body tissue 22 f by expansion of the anchor.
  • [0103]
    The expansion of the anchor 20 f in the body tissue results in the formation of an interlock between the anchor and the body tissue to prevent the anchor from being pulled out of the body tissue under the influence of tension applied to the suture 32 f. The suture 32 f may be used to position a member which is body tissue, in the manner similar to that illustrated in FIGS. 3 and 4, or may be used to position a splint or implant member relative to the body tissue. Since the expanded anchor 20 f has a firm interlock with the body tissue 122 f, tension forces transmitted through the suture 32 f between the anchor 20 f and a member held in place by the suture will not pull the anchor 20 f out of the body tissue.
  • [0104]
    In FIG. 11, the compressed suture anchor 20 f is being inserted into a solid mass of soft body tissue 122 f. However, it is contemplated that the suture anchor 20 f could be inserted into either a natural or artificial body cavity. If this was done the suture anchor 20 f would expand to at least partially fill the body cavity.
  • [0000]
    Alternative Anchor Insertion Apparatus
  • [0105]
    In the embodiment of the invention illustrated in FIG. 11, the anchor 20 f moves through the open end portion 170 of the outer sleeve 66 f into the body tissue 22 f. In the embodiment of the invention illustrated in FIG. 12, the outer sleeve has a closed pointed end portion and the anchor is moved from the outer sleeve at a location immediately behind the pointed end portion of the outer sleeve. Since the embodiment of the invention illustrated in FIG. 12 is generally similar to the embodiment of the invention illustrated in FIG. 11, similar numerals will be utilized to designate similar components, the suffix letter “g” being associated with the numerals of FIG. 12 to avoid confusion.
  • [0106]
    An anchor 20 g has the same construction and is formed of the same resilient open cell material as the anchor 20 f of FIG. 11. A suture 32 g has a leg or portion 34 g which extends from a flat annular trailing end surface 36 g of the cylindrical anchor 20 g. A second leg or portion 38 g of the suture 32 g extends from a flat annular leading end surface 40 g of the anchor 20 g. A portion 44 g of the suture 32 g extends through the anchor and interconnects the legs or portions 34 g and 38 g.
  • [0107]
    The two legs or portions 34 g and 38 g of the suture 32 g extend through a cylindrical central passage in an outer sleeve 72 g of an inserter assembly 60 g. The inner sleeve 72 g is disposed in a telescopic relationship with a cylindrical outer sleeve 66 g of the inserter assembly 60 g. The inner sleeve 72 g cooperates with the outer sleeve 66 g in the same manner as previously explained in conjunction with the inserter assembly of FIG. 11.
  • [0108]
    In accordance with a feature of this embodiment of the invention, the outer sleeve 66 g has a solid pointed end portion 170 g with a generally conical configuration. The pointed end portion 170 g is utilized to pierce an imperforate surface of body tissue in much the same manner as in which the end portion 170 of the outer sleeve 66 f of the inserter assembly 60 f (FIG. 11) is used to pierce an imperforate surface 114 f of the body tissue 22 f.
  • [0109]
    In accordance with one of the features of the present invention, the outer sleeve 66 g has a generally oval opening 180 in a cylindrical outer side surface 182 of the outer sleeve 66 g. The opening 180 is connected with a central passage 68 g. The passage 68 g extends from an open upper (as viewed in FIG. 12) end portion of the outer sleeve 66 g to the solid pointed leading end portion 170 g.
  • [0110]
    When the outer sleeve 66 g has been inserted to the desired depth in body tissue, the inner sleeve 72 g is moved axially downward (as viewed in FIG. 12) and the anchor 20 g is forced along an arcuate cam surface 184 leading to the opening 180. This results in the anchor 20 g being forced from the passage 68 g in the outer sleeve 66 g into the soft body tissue. As this occurs, the leading end 40 g of the anchor 20 g applies force against the body tissue to displace the body tissue and provide space for the anchor.
  • [0111]
    As the anchor 20 g moves along the passage 68 g and through the opening 180, the orientation of the anchor relative to the body tissue changes. Thus, the orientation of the anchor 20 g changes from the orientation shown in FIG. 12 to an orientation similar to the orientation of the anchor 20 in FIG. 3. This pivotal movement of the anchor 20 g results in the anchor moving from an initial orientation in which a central axis of the anchor extends parallel to and is coincident with a central axis of the outer sleeve 66 g to an orientation in which the central axis of the anchor 20 g extends perpendicular to the central axis of the outer sleeve 66 g.
  • [0112]
    As the anchor 20 g exits from the passage 68 g in the outer sleeve 66 g, the anchor 20 g expands under the influence of its own natural resilience and further displaces body tissue. Once the inner sleeve 72 g has been moved downward to the maximum extent possible, that is, to a position in which the leading end of the inner sleeve 72 g engages the cam surface 184, the inner and outer sleeves are withdrawn together from the body tissue. As this occurs, engagement of the anchor 20 g with the body tissue causes the trailing end portion of the anchor to move out of the passage 68 g in the outer sleeve 66 g.
  • [0113]
    As the outer sleeve 66 g continues to be withdrawn, the pointed leading portion 170 of the outer sleeve moves upward (as viewed in FIG. 12), past the anchor 20 g. As this occurs, the anchor 20 g expands into the space previously occupied by the leading end portion 170 g of the outer sleeve 66 g. As the outer sleeve 66 g and inner sleeve 72 g are withdrawn from the body tissue, the visco-elastic body tissue closes around the anchor 20 g and the legs 34 g and 38 g of the suture 32 g.
  • [0114]
    As the anchor 20 g is forced from the outer sleeve 66 g into the body tissue and expands, cells in the anchor 20 g also expand. As the cells in the anchor 20 g expand, body liquid is drawn into and at least partially fills the cells in the anchor. The anchor 20 g has an open cellular construction, similar to the construction of a sponge. The anchor 20 g is resiliently compressed prior to insertion into the outer sleeve 66 g so that the cells in the anchor 20 g are resiliently collapsed until the anchor is allowed to expand as it is forced out of the side opening 180 in the outer sleeve 66 g.
  • [0000]
    Changing Configuration of Anchor
  • [0115]
    In the embodiment of the invention illustrated in FIGS. 1-3, the general configuration of the anchor 20 is illustrated as being maintained constant. Thus, the anchor 20 has a cylindrical tubular configuration with a linear central axis. In the embodiment of the invention illustrated in FIG. 13, the configuration of the anchor is changed while the anchor is in a patient's body tissue. Since the embodiment of the invention illustrated in FIG. 13 is generally similar to the embodiment of the invention illustrated in FIGS. 1-4, similar numerals will be utilized to designate similar components, the suffix letter “h” being associated with the numerals of FIG. 13 to avoid confusion.
  • [0116]
    A suture anchor 20 h has the same construction and is formed of the same hydrophilic polymeric material as the suture anchor 20 of FIGS. 1-3. The suture anchor 20 h (FIG. 13) has a cylindrical tubular configuration. The suture anchor 20 h has a cylindrical outer side surface 26 h. A cylindrical central passage (not shown) extends through the suture anchor 20 h between opposite annular end surfaces 36 h and 40 h of the suture anchor 20 h.
  • [0117]
    A suture 32 h has a leg 34 h which extends from an annular end surface 36 h of the anchor 20 h. A second leg 38 h of the suture 32 h extends from the opposite end surface 40 h of the anchor 20 h. The anchor 20 h is inserted into body tissue 20 h in the same manner as in which the anchor 20 f of FIG. 11 is inserted into the body tissue 22 f. Thus, an inserter assembly, similar to the inserter assembly 60 f of FIG. 11, is used to position the anchor 20 h in the body tissue 22 h. The inserter assembly may include a tubular outer sleeve, corresponding to the sleeve 66 f of FIG. 11 and a tubular inner sleeve, corresponding to the inner sleeve 72 f of FIG. 11. However, the inner sleeve 72 f is provided with a conical leading end portion having a configuration corresponding to the configuration of the leading end portion 74 (FIG. 1) of the inner sleeve 72. This enables the inserter assembly to pivot the suture anchor 20 h to the position shown in FIG. 13.
  • [0118]
    The outer sleeve of the inserter assembly which is used to position the anchor 20 h in the body tissue 22 h has a pointed leading end portion, corresponding to the pointed leading end 170 of the outer sleeve 66 f of the inserter assembly 60 f of FIG. 11. The pointed leading end of the outer sleeve of the inserter assembly was used to pierce the imperforate outer side surface 114 h of skin 120 h and to enter soft body tissue 122 h.
  • [0119]
    As the anchor 20 h was positioned in the soft body tissue 122 h, the opposite legs 34 h and 38 h of the suture 32 h were tensioned. This resulted in the suture 32 h applying force against the opposite flat annular end surfaces 36 h and 40 h of the anchor 20 h. The force applied to opposite ends of the anchor 20 h by the suture 32 h pulled the outer side surface 26 h of the anchor against the body tissue 122 h. In addition, the force applied against opposite ends of the anchor 20 h by the suture 32 h caused the suture to bend from an initial configuration to the deflected configuration shown in FIG. 13.
  • [0120]
    When the anchor 20 h was in the initial configuration, the anchor 20 h had a straight longitudinal central axis, the same as the anchor 20 of FIGS. 1-3. However, tensioning the suture 32 h caused the legs 34 h and 38 h of the suture to apply force against opposite ends of the anchor 20 h and pull the anchor against the body tissue 122 h. As this occurred, the anchor was deflected to the arcuate configuration illustrated in FIG. 13. Since the anchor 20 h is formed of the same hydrophilic polymeric material as the anchor 20 of FIGS. 1-3, the anchor 20 h absorbs body fluid and expands in the body tissue 122 h while the anchor has the deflected configuration illustrated in FIG. 13.
  • Deflection of Anchor—Second Embodiment
  • [0121]
    In the embodiment of the invention illustrated in FIG. 13, the configuration of the anchor 20 h is changed from an initial configuration in which the anchor has a straight longitudinal central axis to a configuration in which the anchor has an arcuate longitudinal central axis by tensioning the suture 32 h to apply force against opposite ends of the anchor. In the embodiment of the invention illustrated in FIG. 14, the configuration of the anchor is changed from an initial configuration to a deflected configuration by tensioning a suture which is connected with a central portion of the anchor. Since the embodiment of the invention illustrated in FIG. 14 is generally similar to the embodiment of the invention illustrated in FIG. 13, similar numerals will be utilized to designate similar components, the suffix letter “j” being associated with the numerals of FIG. 14 to avoid confusion.
  • [0122]
    An anchor 20 j has an outer side surface 26 j. The outer side surface 26 j extends between opposite end surfaces 36 j and 40 j of the anchor.
  • [0123]
    A suture 32 j is connected with a central portion of the anchor 20 j disposed between the opposite end surfaces 36 j and 40 j. The anchor 20 j is formed of the same hydrophilic polymeric material as the anchor 20 of FIGS. 1-3. The anchor 20 j is inserted into body tissue 22 j in the same manner as described in connection with the embodiment of the invention illustrated FIG. 13.
  • [0124]
    Prior to insertion of the anchor 20 j into the body tissue 22 j, the anchor 20 j has a solid cylindrical configuration with a straight longitudinal central axis. As the anchor 20 j is inserted into the body tissue 22 j and moved to the orientation shown in FIG. 14, the suture 32 j is tensioned. Tensioning of the suture 32 j presses the outer side surface 26 j of the anchor 20 j against the body tissue 22 j. As this occurs, the anchor 20 j is deflected from its initial configuration to the deflected configuration illustrated in FIG. 14. When the anchor 20 j is in the deflected orientation, the longitudinal central axis of the anchor has an arcuate configuration.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US1213005 *22 Dec 191416 Jan 1917Victor CzesklebaObstetrical instrument.
US2187852 *18 Aug 193623 Jan 1940Friddle William DFracture nail and fracture nail driver
US2270188 *12 Jul 194013 Jan 1942Harry Herschel LeiterSurgical threaded nail and method of applying same
US3229006 *5 Apr 196211 Jan 1966Friedrich HobigerProcess for the production of tubes of synthetic plastics or the like
US3554192 *23 Jul 196812 Jan 1971Orthopedic Equipment CoMedullary space drill
US3557794 *30 Jul 196826 Jan 1971Us Air ForceArterial dilation device
US3635223 *2 Dec 196918 Jan 1972Us Catheter & Instr CorpEmbolectomy catheter
US3709218 *24 Apr 19709 Jan 1973Halloran WCombination intramedullary fixation and external bone compression apparatus
US3711347 *7 Jul 197116 Jan 1973D WagnerMethod of sealing and locking a fastener
US3788318 *12 Jun 197229 Jan 1974Dusseau AExpandable cannular, especially for medical purposes
US4000525 *21 Aug 19754 Jan 1977The United States Of America As Represented By The Secretary Of The NavyCeramic prosthetic implant suitable for a knee joint plateau
US4183102 *8 Sep 197715 Jan 1980Jacques GuisetInflatable prosthetic device for lining a body duct
US4243048 *21 Sep 19766 Jan 1981Jim ZegeerBiopsy device
US4244370 *20 Nov 197813 Jan 1981American Medical Systems, Inc.Tool for positioning implantable medical prosthetic device _and method of using same
US4309488 *21 Jun 19795 Jan 1982Battelle-Institut E.V.Implantable bone replacement materials based on calcium phosphate ceramic material in a matrix and process for the production thereof
US4311145 *16 Jul 197919 Jan 1982Neomed, Inc.Disposable electrosurgical instrument
US4312353 *9 May 198026 Jan 1982Mayfield Education And Research FundMethod of creating and enlarging an opening in the brain
US4369768 *30 Jul 198025 Jan 1983Marko VukovicArthroscope
US4493317 *16 Nov 198115 Jan 1985Synthes Ltd. (U.S.A.)Surgical compression plate and drill guide
US4495664 *28 Jul 198229 Jan 1985CeraverTitanium or titanium alloy pin for cement-free fixing in a long bone to form a prosthesis
US4562598 *1 Apr 19827 Jan 1986Mecron Medizinische Produkte GmbhJoint prosthesis
US4565192 *12 Apr 198421 Jan 1986Shapiro James ADevice for cutting a patella and method therefor
US4566138 *24 Apr 198528 Jan 1986Zimmer, Inc.Prosthetic device with spacers
US4716893 *23 Dec 19855 Jan 1988Artur FischerBone fastener
US4716901 *25 Sep 19855 Jan 1988Pratt Burnerd International LimitedSurgical appliance for forming an opening through the skin
US4718909 *16 Jul 198512 Jan 1988Brown Byron LMethod and apparatus for cementing a femoral stem prosthesis within a femoral canal
US4718916 *3 Jun 198612 Jan 1988Sulzer Brothers Ltd.Femur head prosthesis
US4719908 *15 Aug 198619 Jan 1988Osteonics Corp.Method and apparatus for implanting a prosthetic device
US4721096 *3 Apr 198726 Jan 1988Marrow-Tech IncorporatedProcess for replicating bone marrow in vitro and using the same
US4721103 *18 Aug 198626 Jan 1988Yosef FreedlandOrthopedic device
US4721104 *2 Dec 198526 Jan 1988Dow Corning Wright CorporationFemoral surface shaping apparatus for posterior-stabilized knee implants
US4794854 *27 Nov 19873 Jan 1989Hall Swaim CFood press with separating bowl sections for cleaning
US4795467 *4 Apr 19863 Jan 1989Collagen CorporationXenogeneic collagen/mineral preparations in bone repair
US4796629 *3 Jun 198710 Jan 1989Joseph GrayzelStiffened dilation balloon catheter device
US4798205 *23 Oct 198717 Jan 1989Cox-Uphoff InternationalMethod of using a subperiosteal tissue expander
US4798213 *9 Sep 198717 Jan 1989Doppelt Samuel HBone biopsy apparatus
US4800901 *9 Sep 198731 Jan 1989Lior RosenbergBalloon-type Tissue expansion device
US4801299 *22 Feb 198431 Jan 1989University Patents, Inc.Body implants of extracellular matrix and means and methods of making and using such implants
US4890612 *16 May 19882 Jan 1990Kensey Nash CorporationDevice for sealing percutaneous puncture in a vessel
US4892552 *8 Sep 19869 Jan 1990Ainsworth Robert DOrthopedic device
US4895148 *22 Mar 198923 Jan 1990Concept, Inc.Method of joining torn parts of bodily tissue in vivo with a biodegradable tack member
US4983179 *8 Mar 19898 Jan 1991Smith & Nephew Dyonics Inc.Arthroscopic surgical instrument
US4984563 *27 Jun 198815 Jan 1991Croisy RenaudMultiple function observation and treatment endoscope and preparation process
US4985038 *5 Jun 199015 Jan 1991Lyell Mark SNeedle stop surgical instrument
US5078731 *5 Jun 19907 Jan 1992Hayhurst John OSuture clip
US5078744 *22 Sep 19897 Jan 1992Bio-Products, Inc.Method of using tendon/ligament substitutes composed of long, parallel, non-antigenic tendon/ligament fibers
US5078745 *22 Dec 19887 Jan 1992Rhenter Jean LucSynthetic ligament for the knee
US5082670 *15 Dec 198821 Jan 1992The Regents Of The University Of CaliforniaMethod of grafting genetically modified cells to treat defects, disease or damage or the central nervous system
US5084050 *2 Oct 198928 Jan 1992Klaus DraenertImplant for bone reinforcement and for anchoring bone screws, implants and implant parts
US5084051 *3 Nov 198728 Jan 1992Toermaelae PerttiLayered surgical biocomposite material
US5176682 *1 Jun 19925 Jan 1993Chow James C YSurgical implement
US5176684 *20 Feb 19925 Jan 1993Dow Corning WrightModular shaping and trial reduction guide for implantation of posterior-stabilized femoral prosthesis and method of using same
US5176702 *7 Feb 19925 Jan 1993Symbiosis CorporationRatchet locking mechanism for surgical instruments
US5178622 *1 Nov 199112 Jan 1993Lehner Ii Robert HInstrument for implanting a soft intraocular lens
US5179964 *30 Aug 199119 Jan 1993Cook Melvin SSurgical stapling method
US5180388 *28 Jun 199019 Jan 1993American Cyanamid CompanyBone pinning system
US5275166 *16 Nov 19924 Jan 1994Ethicon, Inc.Method and apparatus for performing ultrasonic assisted surgical procedures
US5281235 *21 Feb 199225 Jan 1994Habley Medical Technology CorporationNeedle manipulator
US5379759 *21 Jul 199310 Jan 1995Sewell, Jr.; Frank K.Retractor for endoscopic surgery
US5382254 *30 Oct 199217 Jan 1995United States Surgical CorporationActuating handle for surgical instruments
US5383883 *7 Jun 199224 Jan 1995Wilk; Peter J.Method for ultrasonically applying a surgical device
US5383905 *9 Oct 199224 Jan 1995United States Surgical CorporationSuture loop locking device
US5383937 *26 Feb 199324 Jan 1995Mikhail; W. E. MichaelRecessed patellar prosthesis
US5464427 *4 Oct 19947 Nov 1995Synthes (U.S.A.)Expanding suture anchor
US5480403 *28 Oct 19942 Jan 1996United States Surgical CorporationSuture anchoring device and method
US5484437 *10 Jun 199316 Jan 1996Michelson; Gary K.Apparatus and method of inserting spinal implants
US5486197 *24 Mar 199423 Jan 1996Ethicon, Inc.Two-piece suture anchor with barbs
US5487844 *17 Jan 199530 Jan 1996Fujita; SanaiFlocculating agent for the purification of fluids
US5591206 *30 Sep 19937 Jan 1997Moufarr+E,Gra E+Ee Ge; RichardMethod and device for closing wounds
US5593422 *6 Jan 199514 Jan 1997Muijs Van De Moer; Wouter M.Occlusion assembly for sealing openings in blood vessels and a method for sealing openings in blood vessels
US5593425 *30 May 199514 Jan 1997Peter M. BonuttiSurgical devices assembled using heat bonable materials
US5593625 *10 Jun 199414 Jan 1997Phenix Biocomposites, Inc.Biocomposite material and method of making
US5707390 *5 Jun 199513 Jan 1998General Surgical Innovations, Inc.Arthroscopic retractors
US5707395 *16 Jan 199713 Jan 1998Li Medical Technologies, Inc.Surgical fastener and method and apparatus for ligament repair
US5860997 *5 Jun 199519 Jan 1999General Surgical Innovations, Inc.Method of dissecting tissue layers
US5961538 *10 Apr 19965 Oct 1999Mitek Surgical Products, Inc.Wedge shaped suture anchor and method of implantation
US5968044 *2 Feb 199619 Oct 1999Innovasive Devices, Inc.Bone fastener
US6010525 *1 Aug 19974 Jan 2000Peter M. BonuttiMethod and apparatus for securing a suture
US6013853 *15 Feb 199411 Jan 2000The University Of Texas SystemContinuous release polymeric implant carrier
US6017305 *29 Jan 199625 Jan 2000General Surgical Innovations, Inc.Method of retracting bones
US6017321 *30 May 199625 Jan 2000Boone; Jeffrey S.Tampon reminder
US6171236 *26 Apr 19999 Jan 2001General Surgical Innovations, Inc.Method of retracting soft tissue from a bone
US6171299 *5 Jun 19959 Jan 2001General Surgical Innovations, Inc.Method of providing surgical access through an incision
US6174313 *1 Jun 199916 Jan 2001Peter M. BonuttiApparatus and method for tissue removal
US6338730 *6 Jun 199515 Jan 2002Peter M. BonuttiMethod of using expandable cannula
US6503267 *15 Dec 20007 Jan 2003Peter M. BonuttiSurgical devices assembled using heat bondable materials
US6503277 *1 Mar 20017 Jan 2003Peter M. BonuttiMethod of transplanting human body tissue
US6989029 *21 Feb 200324 Jan 2006Bonutti Ip, LlcTissue cage
US6990982 *12 Mar 200331 Jan 2006Bonutti Ip, LlcMethod for harvesting and processing cells from tissue fragments
US7481825 *14 Oct 200327 Jan 2009Marctec, Llc.Apparatus and method for treating a fracture of a bone
US7481831 *22 Apr 200527 Jan 2009Marctec, Llc.Method of securing tissue
US20030009147 *3 Sep 20029 Jan 2003Bonutti Peter M.Biodegradable sac and method of using same
US20030023260 *17 Sep 200230 Jan 2003Bonutti Peter M.Method and apparatus for dissecting tissue layers
US20040010287 *7 Jul 200315 Jan 2004Bonutti Peter M.Method and apparatus for securing tissue
US20080021474 *22 Mar 200724 Jan 2008Bonutti Peter MMethods and devices for intracorporeal bonding of implants with thermal energy
US20120010623 *30 Aug 201112 Jan 2012Bonutti Peter MCannulated systems
US20140018852 *16 Sep 201316 Jan 2014Bonutti Skeletal Innovations LlcAnchor for securing a suture
US20140018853 *17 Sep 201316 Jan 2014Bonutti Skeletal Innovations LlcAnchor for securing a suture
US20140018854 *19 Sep 201316 Jan 2014Bonutti Skeletal Innovations LlcDevice and method for securing a suture
US20140025110 *18 Sep 201323 Jan 2014Bonutti Skeletal Innovations LlcApparatus and method for securing a suture
US20140025111 *20 Sep 201323 Jan 2014Bonutti Skeletal Innovations LlcAnchor for securing a suture
US20140025112 *24 Sep 201323 Jan 2014Bonutti Skeletal Innovations LlcAnchor and method for securing a suture
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US801686529 Sep 200313 Sep 2011Depuy Mitek, Inc.Method of performing anterior cruciate ligament reconstruction using biodegradable interference screw
US8241324 *3 Mar 200814 Aug 2012Eilaz BabaevUltrasonic vascular closure device
US849665729 Aug 200830 Jul 2013P Tech, Llc.Methods for utilizing vibratory energy to weld, stake and/or remove implants
US861718513 Feb 200831 Dec 2013P Tech, Llc.Fixation device
US874743910 Jul 200610 Jun 2014P Tech, LlcMethod of using ultrasonic vibration to secure body tissue with fastening element
US877131428 Sep 20078 Jul 2014Ethicon, Inc.Surgical anchor device
US88083293 Apr 201219 Aug 2014Bonutti Skeletal Innovations LlcApparatus and method for securing a portion of a body
US881490231 Jul 200626 Aug 2014Bonutti Skeletal Innovations LlcMethod of securing body tissue
US882149417 Aug 20122 Sep 2014Howmedica Osteonics Corp.Surgical instruments and methods of use
US883453826 Jul 201116 Sep 2014Depuy Mitek, LlcMethod of performing anterior cruciate ligament reconstruction using biodegradable interference screw
US884568717 Sep 201330 Sep 2014Bonutti Skeletal Innovations LlcAnchor for securing a suture
US88456996 Mar 201230 Sep 2014Bonutti Skeletal Innovations LlcMethod of securing tissue
US90607672 Mar 200923 Jun 2015P Tech, LlcTissue fastener and methods for using same
US906736231 Oct 200730 Jun 2015P Tech, LlcMethod of using ultrasonic vibration to secure body tissue with fastening element
US908932321 Feb 200628 Jul 2015P Tech, LlcDevice and method for securing body tissue
US913822217 Feb 200422 Sep 2015P Tech, LlcMethod and device for securing body tissue
US91492817 Jun 20136 Oct 2015P Tech, LlcRobotic system for engaging a fastener with body tissue
US915554420 Mar 200213 Oct 2015P Tech, LlcRobotic systems and methods
US917364721 Feb 20063 Nov 2015P Tech, LlcTissue fixation system
US917365031 May 20113 Nov 2015P Tech, LlcMethods and devices for trauma welding
US91923957 May 201324 Nov 2015P Tech, LlcRobotic fastening system
US922674423 Jul 20145 Jan 2016Howmedica Osteonics Corp.Surgical instruments and methods of use
US922681612 Sep 20145 Jan 2016Depuy Mitek, LlcMethod of performing anterior cruciate ligament reconstruction using biodegradable interference screw
US922682820 Sep 20135 Jan 2016P Tech, LlcDevices and methods for stabilizing tissue and implants
US92717418 Aug 20131 Mar 2016P Tech, LlcRobotic ultrasonic energy system
US927176611 Nov 20131 Mar 2016P Tech, LlcDevices and methods for stabilizing tissue and implants
US927177913 Aug 20131 Mar 2016P Tech, LlcMethods of using a robotic spine system
US94026204 Mar 20132 Aug 2016Howmedica Osteonics Corp.Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use
US94026684 Dec 20132 Aug 2016P Tech, LlcTissue fixation system and method
US94210056 Feb 200723 Aug 2016P Tech, LlcMethods and devices for intracorporeal bonding of implants with thermal energy
US943964224 Feb 201013 Sep 2016P Tech, LlcMethods and devices for utilizing bondable materials
US944580323 Nov 201120 Sep 2016Howmedica Osteonics Corp.Filamentary suture anchor
US94630125 Oct 200511 Oct 2016P Tech, LlcApparatus for guiding and positioning an implant
US946301313 Mar 201311 Oct 2016Stryker CorporationAdjustable continuous filament structure and method of manufacture and use
US948047514 Mar 20131 Nov 2016DePuy Synthes Products, Inc.Bone plate suture anchor
US948622725 Jul 20138 Nov 2016P Tech, LlcRobotic retractor system
US954526812 Mar 201417 Jan 2017P Tech, LlcDevices and methods for stabilizing tissue and implants
US957912911 Mar 201428 Feb 2017P Tech, LlcDevices and methods for stabilizing tissue and implants
US958572521 Jun 20137 Mar 2017P Tech, LlcRobotic arthroplasty system
US961007322 Mar 20074 Apr 2017P Tech, LlcMethods and devices for intracorporeal bonding of implants with thermal energy
US962968712 Aug 201625 Apr 2017P Tech, LlcRobotic arthroplasty system
US974396328 Sep 201529 Aug 2017P Tech, LlcMethods and devices for trauma welding
US975049624 Apr 20125 Sep 2017P Tech, LlcSystem for securing a portion of a body
US976371917 Aug 201119 Sep 2017Redyns Medical LlcMethod and apparatus for attaching soft tissue to bone
US977023823 Feb 200426 Sep 2017P Tech, LlcMagnetic positioning apparatus
US978882611 Mar 201317 Oct 2017Howmedica Osteonics Corp.Filamentary fixation device and assembly and method of assembly, manufacture and use
US980831815 Jun 20177 Nov 2017P Tech, LlcRobotic arthroplasty system
US20050070905 *29 Sep 200331 Mar 2005Lisa DonnellyMethod of performing anterior cruciate ligament reconstruction using biodegradable interference screw
US20060089646 *26 Oct 200527 Apr 2006Bonutti Peter MDevices and methods for stabilizing tissue and implants
US20070093895 *27 Nov 200626 Apr 2007Lisa DonnellyMethod of performing anterior cruciate ligament reconstruction using biodegradable interference screw
US20080108916 *31 Oct 20078 May 2008Bonutti Peter MMethod of using ultrasonic vibration to secure body tissue with fastening element
US20080195145 *13 Feb 200814 Aug 2008Bonutti Peter MTissue fixation system and method
US20090088797 *28 Sep 20072 Apr 2009Ethicon, Inc.Surgical anchor device
US20090222037 *3 Mar 20083 Sep 2009Bacoustics, LlcUltrasonic vascular closure device
Classifications
U.S. Classification606/232, 606/908, 606/323, 606/331, 606/910, 606/327
International ClassificationA61B17/04, A61B17/56
Cooperative ClassificationA61B17/0401, A61B2017/0458, A61B2017/0417, A61B2017/0414, A61B2017/047, A61B2017/0445, A61B2017/0403, A61B2017/0409, A61B2017/0427, A61B2017/0412
European ClassificationA61B17/04A
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