Abstract:
A device for setting and removing a deformable implant from bone wherein the device includes a body on which is mounted a movable handle which is operatively connected to activating elements for displacing a rod relative to the body for deforming and/or removing an implant from the bone. The device further includes a rod locking and disengaging assembly which is movable from a first position to prevent movement of the rod to a second position to permit movement of the rod relative to the body.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a device, or instrument, for positioning or the withdrawal of an implant and, in particular, for a suture anchor for attaching soft tissues, such as ligaments or tendons, to bone to repair rotator cuffs and Bankart lesions. 
     2. Description of the Related Art 
     Patent EP 0 599 772 discloses a device allowing the positioning of a suture anchor in bone, which device is in the form of a gun. This gun, provided with a grip that can be manually operated, comprises a driving mechanism and a stop that activates the mechanism. The gun comprises a cylinder and a guide that contains a clip or a suture anchor designed to hold a suture thread. The gun ejects the clip, holding the suture thread, from the cylinder in order to anchor in the bone for various surgical interventions. 
     It must be noted that the removal of the suture anchors provided with deformable fixation means is effected by drilling a hole into the cortical bone; the diameter of such a hole is slightly greater than that of the fixation means. Under such conditions, the surgeon causes considerable damage to the cortical portion of the bone, preventing any possibility to remove or position a suture anchor. 
     The present invention has the particular aim to remedy these disadvantages. 
     SUMMARY OF THE INVENTION 
     The ancillary device of the present invention has as an object in particular the positioning or the removal of suture anchors of reversible expansion allowing the deformation of the expansion elements and the fastening of suture threads, or the deformation of the elements for fixation at the time of ligamentous or tendinous reinsertion operations under arthroscopies or on the surface. 
     The ancillary device for the positioning or the withdrawal of an elastically deformable implant into or from a bone of a patient according to the present invention includes a body onto which is affixed a mobile grip, tractive or activating elements that move a traction rod for the deformation of the implant, and a locking and disengaging device that allows the rod to move or not to move freely in a rotational and translational manner with respect to the body. 
     The positioning ancillary device according to the present invention also includes control means for the tractive force applied to the rod for the deformation of the implant. 
     The positioning ancillary device according to the present invention has a body that is provided with a first chamber that houses the tractive means or activating elements and a second chamber that houses the locking and disengaging device. 
     The tractive or activating means includes two plates between which is compressed a spring, and at least one of these plates interacts with a curved return mechanism actuated by the mobile grip to press the plate against the traction rod to have it return with respect to the body. 
     The locking and disengaging device is provided with a lever that is susceptible to be blocked by a catch elastically affixed to a fixed grip of the body. A plate is connected to a spring with adjustable tension so that the plate can press against the traction rod under a stress of the lever to pass from a disengaged vertical position to an engaged or locked tilted position. 
     The control means includes a nose affixed to the body in which is provided, around the rod that displaces freely, a plate affixed to a traction tube in which the rod slides. 
     The withdrawal ancillary device according to the present invention makes possible the opening of the fixation elements of the suture anchors inside of the spongy bone in order to remove them without having to bore a hole that would damage the surface of the cortical bone. 
     The withdrawal ancillary device according to the present invention includes a body to which is coupled a mobile grip, compression or activating means moving a compression rod for the deformation of the implant, and a locking or disengaging device that allows to have the compression rod move freely or not in a rotational and translational manner with respect to the body in order to adjust the travel of the rod. 
     The withdrawal ancillary device according to the present invention also includes anchoring means affixed to the body and rotating around the rod, that are designed to fasten inside of the implant to be removed. 
     The withdrawal ancillary device according to the invention includes a body provided with a first chamber in which are mounted the compression or activating means and a second chamber in which is housed the locking and disengaging device. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The below description, taking into account the accompanying drawings, given as not limiting examples, allows a better understanding of the invention, of its characteristics and the advantages it may offer: 
     FIG. 1 is a sectional drawing illustrating the ancillary device according to the present invention; 
     FIG. 2 is a sectional drawing illustrating the ancillary device in a position actuated for the deformation of the implant; 
     FIG. 3 is a horizontal projection illustrating the ancillary device according to the present invention; 
     FIGS. 4 a  and  4   b  are views illustrating in detail the ferrules to be affixed to the ancillary device in order to adapt the implants; 
     FIGS. 5 a  to  5   c  are views illustrating the deformation of an implant by means of the ancillary device according to the present invention for, on the one hand, its fixation into the bone and, on the other hand, the fastening of the suture thread; 
     FIGS. 6 a  to  6   c  are views illustrating a variant of the ancillary device for the shaping of a head of an implant for the fixation of soft tissues to the bone of a patient; 
     FIG. 7 is a sectional drawing illustrating the ancillary device according to the present invention; 
     FIG. 8 is a horizontal projection illustrating the ancillary device according to the present invention; 
     FIG. 9 is a sectional drawing illustrating the ancillary device in a compressed position for the deformation of the implant to be removed from the bone; 
     FIGS. 10 a  to  10   c  are views illustrating in detail the stages for the removal of the implant by means of the ancillary device according to the present invention; and 
    
    
     FIGS. 1 to  3  show an ancillary device  1  enabling, in particular, but not in a limiting manner the positioning of implants. 
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
     The ancillary device  1  allows the positioning and fixation of reversible expansion suture anchors  2  and  3  in the bone of a patient. 
     The ancillary device  1  does also facilitate, at the moment of the fixation of the suture anchors  2  and  3  to the bone, the deformation of expansion elements, of fastening means for the suture treads or the deformation of the fixation elements of the anchor  3 , at the time of the ligamentous or tendinous reinsertion effectuated by arthroscopy or open cut. 
     The ancillary device  1  comprises a body  4  in the shape of a gun on which is pivotally mounted a grip  5  that can be moved by manual force. The grip  5  is mounted opposite from another fixed grip  10  molded in the body  4  of the ancillary device  1 . 
     The body  4  is provided with a first chamber  6  into which extends the grip  5  by means of a curved counter-shaft  7 . The travel of the grip  5  is limited by the dimensions of an oblong opening  70  provided in the curved counter-shaft  7 . The chamber  6  is horizontally traversed by a traction rod  8 , also opening on both sides of the body  4 . The chamber  6  has an oblong shape provided with an opening  16  on the upper part of the body. 
     The chamber  6  houses a traction or activating assembly  12  that is constituted by two opposite plates  13 ,  14  between which is compressed a spring  15 . The traction means  12  and particularly the plates  13  and  14  are traversed by the traction rod  8  while the spring  15  is coaxially wound around the rod to come into contact with each of the plates. 
     The plates  13  and  14  are positioned perpendicular to the longitudinal axis of the traction rod  8 , so that the plate  14  is in contact with the curved counter-shaft  7  of the mobile grip  5 . It can also be seen that the plates  13  and  14  protrude to the outside of the body  4  of the ancillary device  1  through the opening  16  of the chamber  6 . 
     The mobile grip  5 , actuated manually, causes the curved counter-shaft  7  to move the plate  14  so that it presses against the traction rod  8  due to the compression force of the spring  15 , while the other plate  13  remains always perpendicular to the rod and against the vertical wall  17  of the body  4 , separating the two chambers  6  and  9 . 
     The body  4  includes a second chamber  9  provided in an extension of the body and on the side of the fixed grip  10 . The traction rod  8  traverses the chamber  9  in such a manner that an upper end of the rod interacts with a movable head  11 . The chamber  9  has a lower opening  18  that is turned to the side of the fixed grip  10  for the passage of a hinged lever  19 . The lever  19  interacts with a blocking catch  20  actuated by a torsional spring  21  that is housed in the fixed grip  10 . 
     The lever  19  is in contact with a plate  22  that is located around the traction rod  8  and in the second chamber  9 . The extremity of the plate  22 , located opposite from the one interacting with the lever  19 , is movable in an aperture  23  provided in the body  4  and opposite the opening  18 . The insertion of the plate  22  into the aperture  23  allows a pivoting of the plate when it is subjected to a rocking force generated by the lever  19 . 
     The chamber  9  is affixed to a ferrule  24  that is screwed into a vertical wall  25  opposite to the wall  17  of the body  4 . The ferrule  24  is traversed by the traction rod  8  for the positioning of a spring  26  that is wound around the rod and compressed between the ferrule and the plate  22 . The ferrule  24  allows the adjustment of the tension of the spring  26 . 
     The above described device mounted in the chamber  9  of the ancillary device constitutes a system of locking and disengagement allowing engagement and retention of the rod or a disengagement allowing a free rotating and translational movement of the traction rod  8  with respect to the body  4 . 
     In fact, the disengaged position of the ancillary device  1  (dotted line in FIG. 1) is obtained by pressing upon the lever  19  until it becomes blocked by the catch  20  pushed by the tensional spring  21 . The rocking of the lever  19  allows the displacement of the plate  22  in a vertical direction so that it binds the plate in its aperture  23 . 
     In this disengaged position, the traction rod  8  is attached to the plate  14  which allows, when one presses the mobile grip  5 , to move the rod towards the back or rear of the body  4 . When one releases the grip  5 , the spring  15 , compressed between the plates  13  and  14 , allows the traction rod to move towards the front of the body to its original position. 
     The disengaged position of the ancillary device  1  allows the surgeon to introduce the suture anchor  2 ,  3  into the bone either by screwing it in or by striking the movable head  11  affixed to the end of the traction rod  8 . When the suture anchor  2 ,  3  is introduced into the bone by screwing it in, the head  11  is first removed to allow the surgeon to directly act upon the traction rod  8  to bring it into rotation. The rotary movement of the traction rod  8  can be effected manually by means of a handle or a drill, not illustrated herein, that is attached to the rod. 
     The engaged or locked position of the ancillary device  1  (solid line in FIG. 1) is obtained by pressing on the catch  20  to release the lever  19  for the plate  22  to press the plate against the traction rod  8  under the force of the spring  15 . In this engaged position, the traction rod  8  is no longer free to move either in rotation or in translation with respect to the body  4  of the ancillary device  1 . Thus, the traction rod  8  is held firmly against the plate  14  which, when one presses on the mobile grip  5 , allows the rod to be moved towards the back of the body  4 . When one releases the grip  5 , the traction rod  8  remains locked in this position. 
     The engaged position of the ancillary device  1  allows the surgeon, when the suture anchor  2 ,  3  has been previously inserted into the bone, to deform the fixation elements of the anchor to fix it into the bone and to shape it to attach the soft tissues to be secured to the bone. 
     A nose  27  is affixed as an extension of the chamber  6  opposite from the second chamber  9 . The nose  27  is traversed by the traction rod  8 . Inside the nose  27 , around the rod  8 , is provided a compression spring  28  that is in contact with the vertical wall of the nose, on the one side, and with a vertical plate  29 , on the other side. 
     The plate  29  is firmly attached to a tube  30  which is movable in translational and within which slides the traction rod  8  when it is subjected to a tractive force. Opposite the plate  29 , the tube  30  is firmly attached to a guide  31  provided with an internal threaded section intended for the lodging of either a ferrule  32  or a ferrule  33 , allowing the positioning of the suture anchor  2  and  3 , respectively. 
     The plate  29  interacts with an aperture  36  provided in an upper portion of the nose  27 , in the proximity of which are etched reference marks  37  that allow monitoring of the force applied to the suture anchor  2 ,  3  for its deformation. 
     The nose  27  is affixed to a fixed sleeve  39 , mounted coaxially to the tube  30  on which screwed an implement for the deformation of the suture anchor  3  for the fixation of soft tissues to the bone. 
     The sleeve  39  is constituted by a tube  40 , coaxial to the one  30 , whose free end, disposed around the ferrule  33  corresponding to the positioning of the suture anchor  3 , has a curved edge  41  in order to bend the fixation elements of the suture anchor. 
     The traction rod  8  is provided at the guide  31  with an end  34  that is of less diameter than the remainder of the rod and that traverses either the ferrule  32  or the ferrule  33  depending on which suture anchor  2 ,  3  is to be fixed. The section of the end  34  of the traction rod  8  outside of the ferrule  32 ,  33  includes a threaded section  35  to be screwed into the suture anchor  2 ,  3 . 
     FIG. 4 a  illustrates the ferrule  32  for the positioning of the suture anchor  2 , that includes a cylindrical body  42  of which one section is screwed into the inside of the guide  31  while another section presses against the suture anchor. The section pressing against the suture anchor is attached in proximity of the traction rod  8  to a thread guide  43 . Inside of the body  42  is a spring  44  that presses against thread guide  43  and the inside of the guide  31  is affixed to the tube  30 . 
     FIG. 4 b  illustrates the ferrule  33  for the positioning of the suture anchor  3 , that includes a cylindrical body  45  of which one section is screwed into the guide  31  while another section has a conical side  46  that presses against the suture anchor  3 . 
     FIGS. 5 a  to  5   c  illustrate the positioning of the suture anchor  2  by means of the ancillary device  1  into a patient&#39;s bone  47 , that consists of the spongy bone  48  and the cortical bone  49 . The suture anchor  2  includes an elongated, hollow cylindrical body  50  susceptible to plastically deform and that can be positioned at the surgical location by means of arthroscopy. 
     The body  50  comprises a head  51  enabling the fixation of soft tissues  52  to the bone of a patient by means of one or several suture threads  53  that are fastened to the head. The head  51  includes a cylindrical support face  54  that extends by means of two tongues  55 ,  56 , opposite and parallel to the longitudinal axis XX′ of the body  50 , prior to their deformation. The tongues  55  and  56  delimit an oblong clearance  57  that allows the surgeon to pass at least one suture thread  53  therethrough when operating. 
     The tongues  55  and  56  are connected opposite from the face  54  to a cylindrical section  58  that extends by at least two fixation prongs  59 ,  60  that, prior to deformation, run parallel to the longitudinal axis XX′ of the body  50 . The prongs  59  and  60  are extended parallel to the axis XX′ by a conical point  61  that facilitates the positioning of the suture anchor in the bone  47 . The cylindrical section  58  includes an internal threaded borehole  62  on the axis XX′, which bore opens, on the one hand, between the tongues  55 ,  56  and, on the other hand, between the fixation prongs  59 ,  60 . 
     The conical point  61  is provided on its inside with a threaded blind hole  63  that opens between the fixation prongs  59 ,  60  and is bored into the same longitudinal axis XX′ as the borehole  62 . Further, the diameter of the borehole  62  is greater than that of the threaded hole  63 . 
     The prongs  59  and  60  are attached to the cylindrical section  58  and to the point  61  by bending fasteners  64  in a direction toward the center of the body  50  and that allow the prongs to deform by means of a tensile force applied by the rod  8  of the ancillary device  1 . 
     The prongs  59  and  60  are also provided in their middle with a bending fastener  65 , opposite to each other and in reverse direction to constitute two identical segments and of the same length. 
     Between each prong  59  and  60  is provided a stop  66  affixed to the cylindrical section  50  oriented in direction to the conical point  61 . Each stop extends parallel to the longitudinal axis XX′ of the body  50  and has a length that depends on the deformation one wishes to obtain from the prongs  59  and  60 . In fact, the deformation of the prongs  59  and  60  is limited by the stops  66  that press against a face of the conical point  61 . The face  67  is on a plane perpendicular to one bearing the axis XX′ of the body  50 . 
     In support face  54 , on which meet the tongues  55 ,  56  opposite from the cylindrical section  58 , is drilled a borehole  68 , coaxial to the threaded borehole  62  but with greater diameter. The borehole  68  opens between the tongues  55 ,  56  and inside the oblong clearance  57 . 
     FIG. 5 a  illustrates, after the positioning of the suture anchor  2  in the bone  47 , the traction rod  8  screwed in the blind hole  63  of the conical point  61 . Into the guide  21 , affixed to the tube  30 , is screwed the ferrule  32  in such a manner that the thread guide  43  penetrates through the borehole  68  inside the oblong clearance delimited by the tongues  55 ,  56  of the anchor  2 . In this position, the face  54  of the suture anchor  2  is pressed against the ferrule  32  of the ancillary device and the surgeon may place, in the oblong clearance  57 , the suture threads  53 . 
     The surgeon then places the ancillary device  1 , by means of the lever  19 , in its engaged or locked position so that the traction rod  8  cannot effectuate a translational nor rotational movement. 
     In FIG. 5 b  is illustrated the deformation of the suture anchor  2  and, more specifically, the prongs  59  and  60  inside of the spongy bone  48  when a tensile force T is applied to the rod  8 . The tensile force T is generated by successive compressions of the mobile grip  5  by the surgeon in order to displace horizontally, by means of the plate  14 , the traction rod  8  according to the axis XX′ with respect to the body  4 . It should be noted that, when the rod  8  is displaced into the body  4 , the ferrule  32  is pressed against the face  54  of the suture anchor  2 . 
     The deformation of the prongs  59  and  60  is limited until the conical point  61  presses against the herein not illustrated stops of the body  50 . As soon as the face of the conical point  61  comes to press against the stops  66  by means of its face  67 . As soon as the face  67  presses against the stops  66 , the surgeon releases the grip  5 . The force T applied to the suture anchor  2  is controlled by the displacement of the plate  29  with respect to the reference marks  37  etched into the nose  27 . 
     The prongs  59  and  60  deform under the effects of a compression force due to the traction force T applied to the rod  8  of the ancillary device  1  according to the shape of the fasteners  64  and  65 , so that segments of the prongs are oriented towards the outside of the body  50  and in a direction essentially perpendicular to the axis XX′. 
     It is thus noted that the fixation of the suture anchor  2  to the spongy bone  48  is effected by the deformation of the prongs  59  and  60  until one of the segments comes into contact with the internal face of the cortical bone  49 . 
     In FIG. 5 c  is illustrated the fastening of the suture threads to the head  51  of the anchor  2  through the deformation of the tongues  55 ,  56 . 
     Bringing the conical point  61  in contact with the stops  66 , the surgeon can press anew the grip  5  to apply a tensile force T 1 , greater than that of T, to the traction rod  8 , without risking damage to the prongs  59  and  60 , to deform the tongues  55  and  56 . 
     The deformation of the tongues  55  and  56  reduces the oblong clearance  57  in order to block, in a taut position, the suture threads  53  on the head  51  of the suture anchor  2 . 
     At the time of the deformation of the tongues  55 ,  56 , the thread guide  43  allows the suture threads  53  to be removed from the traction rod  8  so as not to damage them. The thread guide  43  is kept in contact with the inside of the suture anchor  2  by the spring  44  that is independent of the operation of the ancillary device  1 . The suture threads  53  allow the surgeon to ligature the soft tissues  52  to the suture anchor  2 . After the fastening of the suture threads  53 , the surgeon disengages the ancillary device  1  and unscrews the traction rod  8  to withdraw it from the suture anchor  2 . 
     FIGS. 6 a  to  6   c  illustrate the positioning of the suture anchor  3  by means of the ancillary device  1  in the bone  47  of a patient, which bone is constituted by the spongy bone  48  and the cortical bone  49 . 
     The suture anchor  3  is similar to the anchor  2  but the head  51  is not provided with the tongues  55  and  56  for the fastening of the suture threads  53 . The head  51  includes the cylindrical section  58 , longer than the one described above, and into which is drilled the internal threaded borehole  62 . This bore opens, on the one hand, between the prongs  59  and  60  and, on the other hand, to the outside of the body  50  by a coaxial borehole  25  of greater diameter. The head  51  is provided at the end of the cylindrical section  58 , and opposite from the prongs  59  and  60 , with a disk  69  that can be adapted to allow the holding of the soft tissues  52  to the bone  47 . 
     The steps for the insertion and the fixing of the suture anchor  3  into the bone  47  are the same as those described above in FIGS. 5 a  and  5   b  for the suture anchor  2 . It should be noted that for the positioning of the suture anchor  3  in the bone  47 , the ancillary device  1  is provided with a ferrule  33  that is screwed on to the guide  31 , and shaping implement  39  is also screwed on to the nose  27 . 
     When the suture anchor  3  is affixed to the bone  47  and, more specifically, to the spongy bone  48 , as the prongs  59  and  60  are deformed by means of the traction rod  8  of the ancillary device  1 , the surgeon thereafter disengages the rod  8  by pressing on the lever  190  to bring the plate  22  to a vertical position (dotted line in FIG.  1 ). This disengaged position allows the surgeon to draw back the ancillary device  1  and the ferrule  33  but leaves the traction rod  8  screwed into the suture anchor  3  (FIG. 6 c ). 
     The surgeon engages anew the ancillary device  1  by means of the lever  190  to lock the translational and rotational movement of the traction rod  8  with respect to the body  4 . The surgeon brings the shaping implement  39  against the disk  69  of the head  51  by unscrewing it slightly from the nose  27  (FIG. 6 c ). Lastly, the surgeon presses successively the grip  5  in order to subject the shaping implement  39  to a sufficient force for the deformation of the disk  69  in order to fasten the soft tissues against the cortical bone  49 . 
     The shape or the bending of the disk  69  is effectuated in several phases by successive rotations of the implement  39  around its axis to present the curved shape  41  in another position. The surgeon proceeds in the same manner as above to reshape the disk  69 . 
     After the deformation of the disk  69 , the surgeon disengages the ancillary device  1  to unscrew the traction rod  8  to withdraw it from the suture anchor  3 . 
     FIGS. 7 to  9  illustrate an ancillary device  1  allowing in particular, but not in a limiting manner, the withdrawal of implants, such as suture anchors  2 ,  3 . 
     The ancillary device  1  allows the withdrawal of the reversible expansion suture anchor  2 ,  3  from the bone of a patient by a deformation of the fixation means of the anchor, in order to return them to a position essentially identical to their original one. 
     The body  4  has the shape of a gun on which is hinged the grip  5  that can be manually displaced. The grip  5  is located opposite another fixed grip  10  formed within the body  4  of the ancillary device  1 . The body  4  is provided with a first chamber  6  into which opens the grip  5  by way of a curved counter-shaft  7 . The chamber  6  is traversed horizontally by a rod  8  that also comes out on both ends of the body  4 . The chamber  6  is of oblong shape provided with an aperture  16  on the upper part of the body  4 . 
     The chamber  6  houses the compression or activating means  100  for the rod  8  that are constituted by two opposite plates  110 ,  120  between which is compressed a spring  130 . The compression means  100  and, more specifically, the plates  110  and  120 , are traversed by the rod  8 , while the spring  130  is coaxially wound around the rod to come into contact with each of the plates. The plates  110  and  120  are affixed to the rod  8  in such a manner that the plate  110  is in contact with the curved end  7  of the mobile grip  5  in an inclined direction with respect to the longitudinal axis of the rod. It should also be noted that the plates  110  and  120  protrude outside the body  4  of the ancillary device  1  through the aperture  16  of the chamber  6 . 
     The mobile grip  5 , manually actuated, causes the plate  110  to press against the rod  8  by compressing the spring  130  while the other plate  120  remains perpendicular to the rod and against the vertical wall  140  of the body  4 , delimiting the chamber  6 . 
     The body  4  is provided with a second chamber  9  on the extension of the first chamber  6  and on the opposite side of the vertical wall  140 . The chamber  9  is separated from chamber  6  by a vertical wall  160  that is located in the extension of the fixed grip  10  of the body  4 . The chamber  9  is horizontally traversed by the rod  8  in such a manner that the end of the latter, being outside of the body  4  and behind the fixed grip  10 , interacts with a knurled head  170 . 
     The knurled head is provided with notches  270  of different dimensions that interact with a stop  280  on an upper part of the chamber  9  and outside of it, to allow the rod  8  to effect more or less travel or movement depending on the model of the implant or the suture anchor  2 ,  3  to be withdrawn. 
     The chamber  9  is provided with an aperture  180  on its underside that is turned to the side of the fixed handle for the passing of a plate member  190 . At one of its extremities, the plate member  190  interacts with a blocking catch  200  pushed by a torsional spring  210  that is housed in the fixed grip  10 . 
     The plate  190  is arranged around the rod  8  and in the second chamber  9  in such a manner that the other extremity, opposite from the one interacting with the catch  200 , is housed inside an aperture  220  provided in the body  4 . By means of a spring  230 , wound around the rod  8 , the plate  190  is connected to another plate member  240  that presses against the vertical wall  160 . The plate member  240  extends into another upper aperture  250  provided in the body  4  of the ancillary device  1 . The apertures  220  and  250  are separated by a partition  260  against which abuts the plate  190  in a tilted direction with respect to the longitudinal axis of the rod  8 . 
     The above-described device mounted in the chamber  9  of the ancillary device  1  constitutes a locking and disengaging system allowing the rod  8  to effect or not a rotary and translational movement with respect to the body  4 . In fact, the disengaged position of the ancillary device  1  (solid line in FIG. 9) is obtained by pressing against the plate  190  until it engages in the catch  200 , pushed by the torsional spring  210 . It should be noted that, in this position, the plate  190  is in an essentially vertical position under the effect of the thrust of the spring  230 , thus abutting the partition  260  and the plate  190  is blocked by the catch  200 . 
     In this disengaged position, the rod  8  is free to move rotationally and translationally with respect to the body  4 , so that it can be handled independently of the ancillary device  1 . 
     The engaged or locked position of the ancillary device  1  (solid line in FIG. 7) is obtained by pressing against the catch  200  to release the plate  190  so that it presses against the rod  8  under the effect of the spring  230 . In this engaged position, the rod  8  is no longer free to move either in rotation or translation with respect to the body  4  of the ancillary device  1 . Thus, the rod  8  remains secured to the plate  110  which, when pressing the mobile grip  5 , allows the rod to move towards the front of the body  4 . When one releases the grip  5 , the rod  8  remains blocked in this position. 
     The engaged position allows the surgeon to withdraw the suture anchor  2 ,  3  by applying a sufficiently strong force to deform the fixation elements of the anchor, so that they return to a position essentially equivalent to their original one. 
     In the extension of the chamber  6  and opposite from the chamber  9 , a knurled element  290  is affixed to the body  4 , to which element is affixed a sleeve  300  in which slides the rod  8 . To the free end of sleeve  300  is affixed a threaded ferrule  310  that is longitudinally traversed by a chambered section  320  constituting a thruster for the rod  8 . The knurled element  290  is partially shielded by a housing  330  that is affixed to the body  4  on the extension of the chamber  6 . 
     It can also be noted that a mobile head  340  is adapted to the outside of the sleeve  300  to enable the surgeon to withdraw the suture anchor  2  by knocking against the housing  330 . 
     In FIGS. 10 a  to  10   c  are illustrated the various steps to use the ancillary device to withdraw the suture anchor  2  from the bone  47 , that has been previously described. It allows the withdrawal of the suture anchor assembly having reversible fixation means. 
     In FIG. 10 a  is illustrated the insertion of the ancillary device  1  on the surgical location by arthroscopy. Prior to the positioning of the ancillary device  1 , the surgeon checks the model of the suture anchor  2  to be withdrawn in order to be able to index, by rotating the rod  8 , the notch  270  corresponding to the knurled head  170  so that it is opposite the stop  280  of the body  4 . The adjustment of the notch  270  limits the travel of the rod  8  in order to prevent that the suture anchor to be withdrawn without breaking inside of the bone. 
     Then, the surgeon screws the ferrule  310  of the ancillary device  1  into a disengaged locked position by means of the knurled element  290  inside of the suture anchor  2  and, more specifically, in the threaded borehole  62 . The surgeon brings the thruster  320  of the rod  8  to the bottom of the blind hole  63  provided in the conical point  61 . 
     In FIG. 10 b  the surgeon engages the ancillary device  1  by means of the plate  190  to be able to act upon the rod  8  by pressing the mobile grip  5 . The rod  8 , through its thruster  320 , applies a thrust force P on the conical point  61  in order to swing open the prongs  59 ,  60  and to bring them into a position essentially parallel to the axis XX′ of the body  50  of the suture anchor  2 . When the suture anchor  2  has returned to an essentially elongated position, by means of the head  340 , the surgeon can strike gently on the sleeve  330  of the ancillary device  1  in order to withdraw the anchor from the bone  47  (FIG. 10 c ). 
     The ancillary device  1  allows the withdrawal of the suture anchor  2 , or analogous ones, without having to drill a hole whose diameter would be almost that of the hole required for the deformed prongs  59 ,  60 . 
     It can be noted that for the withdrawal, the ancillary device  1  allows the withdrawal of the suture anchors  2  as well as  3 , illustrated and described above for the positioning ancillary device.