Source: https://patents.google.com/patent/US9579188
Timestamp: 2018-07-20 14:15:50
Document Index: 31206966

Matched Legal Cases: ['Application No. 2011', 'Application No. 2013', 'Application No. 201280022627', 'Application No: 200980155954', 'Application No. 2012', 'Application No: 2011', 'Application No. 2015147534120', 'Application No. 14712930', 'Application No. 2013144961']

US9579188B2 - Anchor having a controlled driver orientation - Google Patents
Anchor having a controlled driver orientation Download PDF
US9579188B2
US9579188B2 US14085295 US201314085295A US9579188B2 US 9579188 B2 US9579188 B2 US 9579188B2 US 14085295 US14085295 US 14085295 US 201314085295 A US201314085295 A US 201314085295A US 9579188 B2 US9579188 B2 US 9579188B2
US14085295
US20140081339A1 (en )
Steve Mark Bowman
The present disclosure relates to an interference screw having a body with a proximal end, distal end, and longitudinal axis extending between thereinbetween. The screw further includes threads for fixing the screw into bone. The screw further includes a through bore defined by the body. The through bore extends between the proximal and distal ends along the longitudinal axis, and has a surface. The screw further includes a controlling member formed by the through bore surface. To install the screw into bone, a surgeon turns the screw with a driver that engages with the controlling member. The driver only engages the controlling member when it is in a driving orientation with respect to the controlling member. Advantageously, with this “one-way” engagement the surgeon can control and confirm the orientation of the driver without seeing the driver and/or screw.
Interference screws have proven to be an effective means for securing a graft ligament in a bone tunnel in a number of applications, such as ACL reconstruction surgery and biceps tenodesis. However, the interference screw itself generally takes up a substantial amount of space within the bone tunnel, which can limit the surface area contact established between the graft ligament and the side wall of the bone tunnel. This in turn limits the region of bone-to-ligament in-growth, and hence can affect the strength of the joinder. By way of example but not limitation, it has been estimated that the typical interference screw obstructs about 50% of the potential bone-to-ligament integration region.
In one aspect, the present disclosure relates to an interference screw. The screw includes a body having a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end. The screw further includes threads extending in an open helical form between the proximal end and distal end of the body. The screw further includes a through bore defined by the body extending between the proximal end and distal end of the body along the longitudinal axis. The through bore has a surface from which a controlling member is formed. The controlling member being engaged by a driver when the driver is in a driving orientation with respect to the controlling member. The controlling member being not engaged by the driver when the driver is in an orientation different than the driving orientation.
In another aspect, the present disclosure relates to a method for installing an interference screw into bone. The method includes removing a driver from a body of an interference screw inserted into bone. The body has a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end. The body defines a through bore extending between the proximal end and distal end along the longitudinal axis. The through bore has a surface. The method further includes engaging a controlling member formed by the surface of the through bore with the driver. The controlling member being engaged by the driver when the driver is in a driving orientation with respect to the controlling member. The controlling member not being engaged by the driver when the driver is in an orientation different than the driving orientation. The method further includes confirming the orientation of the driver in the body of the screw based on the engagement of the controlling member with the driver.
In yet another aspect, the present disclosure relates to another method for installing an interference screw into bone. The method includes inserting, initially, a driver into a through bore defined by a body of an screw inserted into bone. The through bore extends between a proximal end and a distal end of the body along a longitudinal axis extending between the proximal end and distal end of the body. The through bore has a surface. The method further includes rotating the driver within the through bore, about the longitudinal axis of the body, until the driver engages a controlling member formed by the surface of the through bore. The engagement confirms a driving orientation of the driver with respect to the controlling member. The method further includes driving the screw further into the bone with the driver in the driving orientation.
FIG. 27 shows a side view of an interference screw the entire length of which is supported by a driver.
FIG. 28 shows a side view of an interference screw the entire length of which is not supported by a driver.
FIG. 29 shows a side view of an interference screw that has failed, structurally.
FIGS. 30A-30C show an example of an interference screw with a controlling member being inserted further into bone.
FIG. 31 shows a side view of an example of the interference screw with the controlling member.
FIG. 32 shows an end view of an example of the interference screw with the controlling member.
FIG. 33A shows a top view of a cross section of a driver in a driving orientation with respect to the interference screw.
FIG. 33B shows a top view of a cross section of a driver in an orientation different then the driving orientation of FIG. 33A.
FIGS. 34A and 34B show examples of the controlling member.
With some interference screw designs, it is necessary to support the entire length of an screw (or a substantial portion thereof) with a driver, as shown in FIG. 27, in order to insert the screw into bone properly. The need is especially great when the screw is made from a weak and/or brittle material, such as an osteoconductive material. This is also prevalent when the screw has fenestrations or openings that reduce the flexural (torsional) strength of the screw. Inserting the screw into bone when it is not fully supported, as shown in FIG. 28, may result in the screw failing, as shown in FIG. 29. With some screw designs, the orientation of the driver with respect to the screw determines whether the screw is fully supported or not. Accordingly, in these designs, there is a need to control the orientation of the driver with respect to the screw.
It may not be possible or it may be difficult for a surgeon to see the screw and/or driver and confirm the orientation of the driver with respect to the screw. For example, a surgeon's view may be obstructed when the screw is partly installed in bone. Accordingly, there is a further need to confirm the orientation of the driver with respect to the screw blindly.
FIGS. 30A-C show the surgeon driving an example of an screw 400 with a controlling member into bone 401. As shown, the screw 400 sits proud of the surface of the bone 401. The surgeon drives the screw 400 further into the bone 401, so that it sits flush with the bone surface, by inserting a driver 450 into the screw 400. The surgeon then rotates of the driver 450 within the screw 400 until it engages the controlling member of the screw 400. Engagement of the driver 450 with the controlling member confirms that the driver 450 is in the proper “driving” orientation and provides the surgeon with the confidence that the screw 400 is fully supported by the driver 450. The surgeon can then drive the screw 400 into the bone 401 without worry of the screw 400 failing.
FIG. 31 shows an example of the screw 400 having a body 405. The body 405 includes a proximal end 410, distal end 415, and longitudinal axis 420 extending between the proximal and distal ends 410, 415. The body 405 may be made from a bioabsorbable, non-bioabsorbable, osteoconductive or composite material. Examples of a non-bioabsorbable material include polyether ether ketone (PEEK), titanium, and surgical stainless steel. The screw 400 further includes threads 425 extending in an open helical form between the proximal end 410 and distal end 415 of the body 405. In some examples of the screw 400, the threads 425 are similar to the threads 63 described above with reference FIGS. 5-7.
FIG. 32 shows the body 405 defining a through bore 430. The through bore 430 extends between the proximal and distal ends 410, 415 of the body along the longitudinal axis 420. The through bore 430 has a surface 435. The screw 400 includes a controlling member 440 formed by the through bore surface 435. The driver 450 engages the controlling member 440 when the driver 450 is in a driving orientation with respect to the screw 400. The driver 450 does not engage the controlling member 440 when the driver 450 is in an orientation different than the driving orientation.
One example of the controlling member 440 shown in FIG. 32 includes a plurality of runners 445 extending between the proximal and distal ends 410, 415 of the body 405 along the longitudinal axis 420. Three runners (445 a, 445 b, 445 c) are shown but other multiples of runners are possible (e.g., two and four). The plurality of runners 445 is spaced equally around the circumference of the through bore 430. There is an equal distance (d) between each of the runners (445 a, 445 b, 445 c) (the distance (d) being measured, for example, from centerline to centerline of each of the runners). The runners (445 a, 445 b, 445 c) can be described as being arranged in a radial manner about the longitudinal axis 420 (coming out of the page of the figure). As such, the position of each of the runners (445 a, 445 b, 445 c) can be described as being at 0° (12 o'clock), at 120° (4 o'clock), and at 240° (8 o'clock), respectively.
One of the plurality of runners is of different shape and/or size than the other runners. A convenient example of the controlling member 440 includes one runner (445 a) having a cross sectional shape based on a rectangle and the other runners (445 b, 445 c) having a cross sectional shape based on a semi-circle. Other cross sectional shapes are possible. In another example of the controlling member 440, the dimension(s) of one or more of the runners (445 a, 445 b, 445 c), for example the width and/or height, varies with the overall size of the screw 400. For example, a first anchor is larger in size than a second anchor. In the first anchor, the height of runners is taller than the height of runners associated with the second anchor.
Turning now to FIGS. 33A-33B, which are views looking down at cross sections of the driver 450. The driver 450 used by the surgeon to turn the screw 400 into bone 401 includes grooves 455. The grooves 455 have an inverse geometry of the plurality of runners 445. When the driver 450 is in the driving orientation shown in FIG. 33A, the corresponding driver grooves 455 house the plurality of runners 445, thus, enabling the surgeon to turn the screw 400 using the driver 450. When the driver 450 is not in the driving orientation, as shown in FIG. 33B, the corresponding driver grooves 455 do not house the plurality of runners 445 (represented in the figure as hidden lines) and surgeon cannot turn the screw 400 using the driver 450. In the example shown in FIG. 33B, in order for the driver grooves 455 to house the plurality of runners 445, the driver is turned counterclockwise (in the direction of the drawn arrow), from the 10 o'clock to 9 o'clock position.
The foregoing arrangement provides a “one-way” engagement that is advantageous because the surgeon can control and confirm the orientation of the driver 450 without seeing the driver 450 and/or screw 400 i.e., the procedure can be done blindly. If the surgeon inserts the driver 450 into the screw 400 and is able to rotate it freely (i.e., without resistance) or is not able to insert the driver 450 into the screw 400 at all, then the surgeon knows that the driver 450 is not in the driving orientation. The surgeon can then rotate the driver 450 until it engages the controlling member 440 of the screw 400. Engaging the controlling member 440 causes the screw 400 to be driven into the bone and consequently, the surgeon must turn the driver 450 harder. As such, advantageously some examples of the screw 400 provide tactile feedback that enables the surgeon to seek the proper driver orientation.
FIG. 34A shows another example of the controlling member 440 that includes a plurality of runners 445′ extending between the proximal and distal ends 410, 415 of the body 405 along the longitudinal axis 420. The plurality of runners 445′ is spaced unequally around the circumference of the through bore 430. There is a different distance (d, d′, d″) between each of the runners 445′ (the distances (d, d′, d″) being measured, for example, from centerline to centerline of each of the runners). Described in the terms of radial arrangement, the positions of the runners 445′ are such that the number degrees separating positions are not equal.
FIG. 34B shows yet another example of the controlling member 445 that includes a plurality of runners 445″ extending between the proximal and distal ends 410, 415 of the body 405 along the longitudinal axis 420. The plurality of runners 445″ is spaced equally around the circumference of the through bore 430. The example controlling member 440 further includes a tab 460 spaced between an adjacent pair of runners (445 a″ and 445 b″). Another example of the controlling member 440 includes a plurality of runners spaced unequally around the circumference of the through bore with a tab spaced between an adjacent pair of runners. In some examples, the tab 460 extends part of the length of the screw 400 and is different than a runner. While the one way or “keyed” feature of the screw 400 is described with reference to the example arrangements above, those skilled in the art will readily recognize that other arrangements are possible.
Other examples of the screw 400 include a depth stop, such as the open depth stop 25 described above with reference FIG. 5 and the closed depth stop 65 described above with reference FIG. 18. The depths stop engages a depth stop of the driver 450 such that a distal end of the driver extends beyond the distal end of the body. In still other examples of the screw 400, the proximal end 410 of the body 405 aligns with a hash mark on a distal end of the driver and a number associated with the hash mark identifies the length of the body 405 of the screw 400.
In an example procedure to install the screw 400 into bone 401, the surgeon may remove the driver 450 from the body 405 of the screw 400 that has been partly inserted into bone 401. The surgeon reinserts the driver 450 into the body 405 of the screw 400 and engages the controlling member 440. The surgeon confirms the orientation of the driver 450 based on the engagement of the controlling member 440 with the driver 450. Engaging the controlling member 440 tells the surgeon that the driver 450 is in the driving orientation. The lack of engagement tells the surgeon that the driver 450 is in an orientation different than the driving orientation. In the event the driver 450 does not engage the controlling member 440 (e.g., the surgeon turns driver 450 but the screw 400 does not turn), the surgeon rotates the driver 450 within the through bore 430 until the driver 450 engages the controlling member 440 (e.g., the surgeon turns driver and the screw turns).
In the example procedure, each time the surgeon removes and reinserts the driver 450 into the screw, the surgeon controls and confirms the orientation of the driver 450 using the controlling member 440. This is advantageous because the surgeon may have to remove and reinsert the driver 450 several times during the procedure in order to install the screw 400 into bone 401, completely.
Some examples of the screw 400 may be a part of an screwing system that includes the above-described driver 450. In an example system, the screw 400 maybe “preloaded” and disposed on at a distal end of the driver 450.
removing a driver from a body of an interference screw inserted into bone, the body having a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end, the body defining a through bore extending between the proximal end and distal end along the longitudinal axis, the through bore having a surface;
engaging a controlling member formed by the surface of the through bore with the driver, the controlling member being engaged by the driver when the driver is in a driving orientation with respect to the controlling member and not being engaged by the driver when the driver is in an orientation different than the driving orientation;
confirming the orientation of the driver in the body of the interference screw based on the engagement of the controlling member with the driver; and
rotating the driver within the through bore with respect to the controlling member, about the longitudinal axis of the body, until the driver engages the controlling member.
2. The method of claim 1 further comprising inserting the driver into the through bore until a depth stop of the driver engages a depth stop extending, longitudinally, a partial length of the body such that a distal end of the driver extends beyond the distal end of the body.
3. The method of claim 1 wherein the controlling member includes a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced equally around the circumference of the through bore, and one of the plurality of runners is of different shape and/or size than other runners.
4. The method of claim 1 wherein the controlling member includes a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced unequally around the circumference of the through bore.
inserting, initially, a driver into a through bore defined by a body of an interference screw inserted into bone, the through bore extending between a proximal end and a distal end of the body along a longitudinal axis extending between the proximal end and distal end of the body, the through bore having a surface;
rotating the driver within the through bore, about the longitudinal axis of the body, until the driver engages a controlling member formed by the surface of the through bore, the engagement confirming a driving orientation of the driver with respect to the controlling member; and
driving the interference screw further into the bone with the driver in the driving orientation.
6. The method of claim 5 further comprising inserting the driver further into the through bore until a depth stop of the driver engages a depth stop extending, longitudinally, a partial length of the body such that a distal end of the driver extends beyond the distal end of the body.
7. The method of claim 5 wherein the controlling member includes a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced equally around the circumference of the through bore, and one of the plurality of runners is of different shape and/or size than other runners.
8. The method of claim 5 wherein the controlling member includes a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced unequally around the circumference of the through bore.
US14085295 2010-03-10 2013-11-20 Anchor having a controlled driver orientation Active 2032-10-11 US9579188B2 (en)
US31229110 true 2010-03-10 2010-03-10
US33480810 true 2010-05-14 2010-05-14
US35908010 true 2010-06-28 2010-06-28
US13044777 US8979865B2 (en) 2010-03-10 2011-03-10 Composite interference screws and drivers
US14085295 US9579188B2 (en) 2010-03-10 2013-11-20 Anchor having a controlled driver orientation
KR20167013396A KR20160088314A (en) 2013-11-20 2014-11-19 Anchor having a controlled driver orientation
PCT/US2014/066389 WO2015077327A1 (en) 2013-11-20 2014-11-19 Anchor having a controlled driver orientation
JP2016532562A JP2016537120A (en) 2013-11-20 2014-11-19 Anchor with controlled driver orientation
EP20140808788 EP3071146A1 (en) 2013-11-20 2014-11-19 Anchor having a controlled driver orientation
CN 201480073698 CN105916469A (en) 2013-11-20 2014-11-19 Anchor having a controlled driver orientation
US15284689 US20170020589A1 (en) 2010-03-10 2016-10-04 Anchor having a controlled driver orientation
US13044777 Continuation-In-Part US8979865B2 (en) 2010-03-10 2011-03-10 Composite interference screws and drivers
US15284689 Continuation US20170020589A1 (en) 2010-03-10 2016-10-04 Anchor having a controlled driver orientation
US20140081339A1 true US20140081339A1 (en) 2014-03-20
US9579188B2 true US9579188B2 (en) 2017-02-28
ID=50275240
US14085295 Active 2032-10-11 US9579188B2 (en) 2010-03-10 2013-11-20 Anchor having a controlled driver orientation
US15284689 Abandoned US20170020589A1 (en) 2010-03-10 2016-10-04 Anchor having a controlled driver orientation
US (2) US9579188B2 (en)
US2288864A (en) * 1940-12-03 1942-07-07 Whitehead Walter John Means for holding parts together
US3320783A (en) * 1966-12-09 1967-05-23 Chicago Lock Co Key for an axial tumbler type lock
USD288777S (en) * 1983-11-22 1987-03-17 Vehicle wheel locking nut
CN1701775A (en) 2005-06-15 2005-11-30 林志春 Flexible contraception device and setting and taking-out device
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Decision of Rejection from related Japanese Application No. 2013-558094 issued Sep. 5, 2016.
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US20140081339A1 (en) 2014-03-20 application
US20170020589A1 (en) 2017-01-26 application
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BOWMAN, STEVEN MARK;BERUBE, ALFRED R;BOURQUE, BERNARD JOSEPH;AND OTHERS;SIGNING DATES FROM 20161013 TO 20161101;REEL/FRAME:040186/0260