Abstract:
The present disclosure relates to an anchor assembly. The anchor assembly includes an anchor defining a cavity and an opening to the cavity and an insertion member configured for arrangement within the anchor cavity. The insertion member may include a body having a proximal end portion and a flat distal end portion. A method of tissue repair and other anchor assemblies are also disclosed.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation of U.S. patent application Ser. No. 12/259,106 filed on Oct. 27, 2008 which claims the benefit of U.S. patent application Ser. No. 60/982,521 filed on Oct. 25, 2007 and U.S. patent application Ser. No. 60/986,342 filed on Nov. 8, 2007, all of the disclosures of which are incorporated herein by reference in their entirety. 
     
    
     BACKGROUND 
       [0002]    1. Field of Technology 
         [0003]    The present disclosure relates to tissue repair, and more specifically, to an anchor assembly for securing tissue to bone. 
         [0004]    2. Related Art 
         [0005]    Arthroscopic procedures often require soft tissue to be reattached to bone. To achieve this, anchors are placed in the bone and sutures attached to the anchor are passed through the tissue to securely retain the tissue in place. When making a repair of soft tissue to bone, it is advantageous to have as large an area of contact between the bone and tissue as possible. Anchor points spaced from one another in rows result in a repair having a broader area of contact. A procedure, and components for use in such procedure, that securely attaches tissue to bone using a plurality of attachment points over a large area of contact is needed. Such procedure must be able to be done in a quick and efficient manner with a minimum of recovery time for the patient. 
       SUMMARY 
       [0006]    In one aspect, the present disclosure relates to an anchor assembly. The anchor assembly includes an anchor defining a cavity and an opening to the cavity and an insertion member configured for arrangement within the anchor cavity. The insertion member includes a body having a proximal end portion and a flat distal end portion, and a head coupled to the proximal end portion of the body. The anchor includes protrusions located on an outer surface of the anchor, wherein the protrusions are configured to facilitate loading of a flexible member into the anchor. In an embodiment, the anchor assembly further includes a transverse through hole extending through the anchor. In another embodiment, the anchor assembly further includes at least two slots on an outer surface of the anchor, wherein the slots extend from the transverse through hole to a proximal portion of the anchor. In yet another embodiment, the anchor includes barbs on an outer surface of the body, wherein the barbs are intersected by the slots. 
         [0007]    In a further embodiment, at least one flexible member, which may be a suture, is disposed within the through hole. In yet a further embodiment, a plurality of flexible members are disposed within the through hole. In yet an even further embodiment, the cavity includes threads. In an embodiment, the insertion member body includes threads, wherein the threads are configured for engagement with the threads of the cavity when the insertion member is arranged within the cavity. In another embodiment, the cavity extends into the through hole. In yet another embodiment, the head is configured for engagement with a delivery device. In a further embodiment, the insertion member is arranged within the anchor cavity such that the insertion member secures the flexible member in the through hole. 
         [0008]    In another aspect, the present disclosure relates to a method of tissue repair. The method includes inserting a first anchor into bone, the first anchor having a flexible member coupled thereto; passing ends of the flexible member through the tissue; providing a second anchor defining a cavity and an opening to the cavity and a transverse through hole extending through the anchor; passing at least one end of the flexible member through the through hole of the second anchor; placing the second anchor into bone; providing an insertion member including a body having a proximal end portion and a flat distal end portion, and a head coupled to the proximal end portion of the body; and placing the insertion member within the anchor cavity of the second anchor to secure the flexible member in the through hole and the tissue to the bone. 
         [0009]    In an embodiment, the method further includes tensioning the flexible member before placing the insertion member within the anchor cavity. In another embodiment, the method further includes moving the insertion member away from the through hole, tensioning the flexible member, and moving the insertion member back toward the through hole to resecure the flexible member in the through hole. In yet another embodiment, the second anchor includes protrusions, wherein the protrusions create paths in a wall of the bone when the second anchor is inserted into the bone. The paths allow the flexible member to slide through the second anchor when the second anchor is located in the bone. 
         [0010]    In yet another aspect, the present disclosure relates to an anchor assembly. The anchor assembly includes an anchor defining a proximal portion, a distal portion, and an inner cavity; and an insertion member configured for arrangement within the inner cavity. The anchor includes barbs located on the proximal portion and protrusions located on the distal portion, wherein the protrusions are configured to facilitate loading of a flexible member into the anchor. In an embodiment, the insertion member includes a proximal end portion and a flat distal end portion. 
         [0011]    In still another aspect, an anchoring system includes an anchor with a longitudinal axis extending along a length of the anchor and a delivery device. The anchor may include an anchor body and an insertion member. The anchor body may more specifically include a proximal end positioned along the longitudinal axis, a distal end positioned along the longitudinal axis and opposite from the proximal end, a cavity positioned along the longitudinal axis between the proximal end and the distal end, an opening to the cavity at the proximal end of the anchor body, a transverse hole into the cavity, wherein the transverse hole includes a proximal edge and a distal edge, and wherein the cavity extends distal of the distal edge of the transverse hole and proximal of the proximal edge of the transverse hole. The insertion member may include an end having a substantially flat profile sized and configured to be moved within the cavity such that the insertion member, as measured from the substantially flat profile to another point along the insertion member, covers the transverse hole from a point proximal of the proximal edge of the transverse hole to a point distal of the distal edge of the transverse hole. The delivery device may be configured to couple with the anchor and move the insertion member relative to the anchor body along the longitudinal axis. 
         [0012]    In an aspect, an anchoring system includes an anchor with a longitudinal axis extending along a length of the anchor and a delivery device. The anchor may include an anchor body and an insertion member. The anchor body may include a proximal end positioned along the longitudinal axis, a distal end positioned along the longitudinal axis and opposite from the proximal end, a cavity positioned along the longitudinal axis between the proximal end and the distal end, an opening to the cavity at the proximal end of the anchor body, a transverse hole into the cavity, wherein the transverse hole includes a proximal edge and a distal edge, and wherein the cavity has a working diameter that extends distal of the distal edge of the transverse hole and proximal of the proximal edge of the transverse hole. The insertion member may have a minimum diameter along a length of the insertion member sized to substantially fill the working diameter of the cavity from a point proximal of the proximal edge of the transverse hole to a point distal of the distal edge of the transverse hole. The delivery device may be configured to couple with the anchor and move the insertion member relative to the anchor body along the longitudinal axis. 
         [0013]    Embodiments include an anchoring system having an anchor with a longitudinal axis extending along a length of the anchor and a delivery device. The anchor may include an anchor body and an insertion member. The anchor body may include a proximal end positioned along the longitudinal axis, a distal end positioned along the longitudinal axis and opposite from the proximal end, a cavity positioned along the longitudinal axis between the proximal end and the distal end, an opening to the cavity at the proximal end of the anchor body, a transverse hole into the cavity, wherein the transverse hole includes a proximal edge and a distal edge, and wherein the cavity extends distal of the distal edge of the transverse hole and proximal of the proximal edge of the transverse hole. The insertion member may be sized and configured to be moved within the cavity to cover the transverse hole, wherein the insertion member includes a typical outer body diameter, wherein the typical outer body diameter is smaller than a diameter of any threads on the insertion member and smaller than a diameter of any head of the insertion member and larger than a dimension of the transverse hole into the cavity that is substantially perpendicular to the longitudinal axis of the anchor, and wherein the anchor is sized and configured such that the typical body diameter of the insertion member fits within the cavity from a point proximal of the proximal edge of the transverse hole to a point distal of the distal edge of the transverse hole. The delivery device may be configured to couple with the anchor and move the insertion member relative to he anchor body along the longitudinal axis. 
         [0014]    Further areas of applicability of the present disclosure will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating the preferred embodiment of the disclosure, are intended for purposes of illustration only and are not intended to limit the scope of the disclosure. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0015]    The accompanying drawings, which are incorporated in and form a part of the specification, illustrate the embodiments of the present disclosure and together with the written description serve to explain the principles, characteristics, and features of the disclosure. In the drawings: 
           [0016]      FIG. 1  shows an exploded view of the anchor assembly of the present disclosure. 
           [0017]      FIG. 2  shows a cross-sectional view of the anchor assembly of the present disclosure. 
           [0018]      FIG. 3  shows a front view of the anchor assembly of the present disclosure. 
           [0019]      FIGS. 4A-4D  show use of the anchor assembly of the present disclosure in repairing tissue. 
       
    
    
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
       [0020]    The following description of the preferred embodiment(s) is merely exemplary in nature and is in no way intended to limit the disclosure, its application, or uses. 
         [0021]      FIGS. 1-3  show the anchor assembly  10  of the present disclosure. The assembly  10  includes the anchor  20  and the insertion member  30 , The anchor  20  includes a proximal portion  21 , a distal portion  22 , and an inner cavity  23 . An opening  24  to the cavity  23  is located at the proximal portion  21  of the anchor  20 . A transverse through hole  25  is located between the proximal and distal portions  21 ,  22  and extends through the anchor  20 . Openings  25   a, b  are located at each end of the through hole  25 . Located below each opening  25   a, b  is a protrusion  26 . The protrusions  26  facilitate loading of a flexible member, such as a suture, through the through hole  25 , and allow for the creation of a path in the wall of a bone hole when the anchor  20  is inserted into bone hole, as will be further described below, The outer surface  27  of the proximal portion  21  also includes barbs  28  for substantially reducing the possibility of removal of the anchor  20  when inserted into bone, as will be further described below. The outer surface  27  also includes slots  29  extending from the openings  25   a, b  of the through hole  25  to the proximal portion  21  of the anchor  20 . The slots  29  intersect the barbs  28  and are configured for housing of the suture after positioning of the anchor  20  in bone, as further described below. As shown in  FIG. 2 , the cavity  23  extends into the through hole  25  and includes a proximal portion  23   a  and a threaded distal portion  23   b  for receipt of the insertion member  30 , as will be further described below. 
         [0022]    The insertion member  30  includes a body  31 , having a proximal end portion  31   a  and a flat distal end portion  31   b,  and a head  32  coupled to the proximal end portion  31   a.  The head  32  is configured for engagement with a delivery tool and the body  31  includes threads  31   c  that are configured for engagement with the threads  23   c  of the cavity  23  when the insertion member is arranged within the cavity  23 , as shown in  FIG. 2 . 
         [0023]    The anchor  10  of the present disclosure may be used in conjunction with another anchor to repair soft tissue.  FIGS. 4A-4D  show the anchor assembly  10  in use during arthroscopic repair of the rotator cuff. However, the anchor assembly  10  may be used in the repair of soft tissue in other parts of the body.  FIG. 4A  shows a first anchor  40  that has been inserted into the lateral aspect of a bone  50 , such as a humeral bone. The anchor  40 , which has a flexible member  60 , such as a suture, coupled thereto is inserted into the bone  50 , a soft tissue  70 , such as a rotator cuff tendon, is placed on the bone  50  to be located adjacent to the anchor  40 , and the ends  61  of the flexible member  60  are placed through the soft tissue  70 . 
         [0024]    Next, at least one end  61  of the flexible member  60  is passed through the transverse through hole  25  of a second anchor, such as the anchor  20  of the present disclosure, and the anchor  20  is subsequently placed into a previously drilled hole  51  in the medial aspect of the bone  50 , as shown in  FIG. 4B , such that the flexible member  60  is housed within the transverse through hole  25  and both slots  29  of the anchor  20  and the ends  61  extend out of the hole  51 . The anchor  20  is advanced into the hole  50  in an axially-oriented manner by tapping on the end of a delivery tool (not shown) that is used to deliver the anchor  20  into the hole  51 .  FIGS. 4B-4D  show spaces between the outer surface  27  of the anchor  20  and the walls  52  of the hole  51 . However, the diameter of the hole  51  will be sized such that the barbs  28  of the anchor  20  will abut the walls  52 , and most likely extend through the walls  52  and into the bone  50 , in order to substantially reduce the possibility of anchor removal. In addition, due to the hole diameter, the protrusions  26  located below the openings  25   a, b  create a path (not shown) in the wall of the bone hole  51  when the anchor  20  is inserted into hole  51 . This path allows the suture  60  to slide when through the anchor  20  when the anchor  20  is located within the hole  51 . 
         [0025]    After placement of the anchor  20  into the hole  51 , the ends  61  of the flexible member  60  may be pulled to provide a preferred amount of tension on the flexible member  60  and the soft tissue  70 . This tension on the flexible member  60  can be seen in  FIGS. 4C-D , especially when comparing these figures to  FIG. 4B . The insertion member  30  is subsequently placed in the anchor cavity  23  in a rotary manner, via a delivery tool  80 , to secure the flexible member  60  in the through hole  25  and the tissue  70  to the bone  50 . The insertion member  30  may be removed from the cavity  23  to re-tension the flexible member  60  and then replaced. within the cavity  23  to re-secure the flexible member  60  in the through hole  25 . 
         [0026]    The components of the anchor assembly  10  and the first anchor  40  are made from a bioabsorbable polymer material via an injection molding process. However, other materials and processes may be used. In addition, the suture material is made from a bioabsorbable polymer material, but other material may be used. Also, the initial anchor, such as the first anchor  40  shown above, may include more than one suture and the sutures may be secured together at one attachment point, such as within the second anchor  20  shown above, or independently at more than one attachment point. Furthermore, the outer surface  27  of the anchor  20  may include features other than barbs  28  to reduce the possibility of removal of the anchor  20  and the barbs  28  may extend the entire length or a partial length of the anchor  20 . Similarly, the body  31  of the insertion member  30  and the cavity  23  of the anchor  20  may include features other than threads to facilitate insertion and removal of the insertion member  30  and the threads may extend the entire length or a partial length of the body  31  and cavity  23 . Also, for the purposes of this disclosure, the through hole  25  is located between the proximal  21 . and distal  22  portions, but may be located anywhere along the length of the anchor  20 . 
         [0027]    The anchor assembly  10  of the present disclosure allows a surgeon to load a suture from a previously placed anchor and secure the suture in the assembly  10  at a preferred tension. In addition, the assembly  10  allows the tension on the suture to be adjusted with tactile feedback. Furthermore, the assembly allows for one or more sutures to be secured together at one attachment point, such as described above with the second anchor  20 , or independently at several attachment points. This allows for a large area of contact between the tissue and the bone and results in a better repair. 
         [0028]    As various modifications could be made to the exemplary embodiments, as described above with reference to the corresponding illustrations, without departing from the scope of the disclosure, it is intended that all matter contained in the foregoing description and shown in the accompanying drawings shall be interpreted as illustrative rather than limiting. Thus, the breadth and scope of the present disclosure should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims appended hereto and their equivalents.