Source: https://patents.justia.com/patent/10390817
Timestamp: 2019-10-17 20:06:19
Document Index: 355975334

Matched Legal Cases: ['arty\n5234443', 'artz\n5618314', 'art\n5681351', 'art\n5690676', 'artz\n5741282', 'art\n5851185', 'artz\n6340365', 'artz\n20010056287']

US Patent for Tissue fixation system and method Patent (Patent # 10,390,817 issued August 27, 2019) - Justia Patents Search
Justia Patents Screw Or Pin Placement Or Removal MeansUS Patent for Tissue fixation system and method Patent (Patent # 10,390,817)
Jun 30, 2016 - P Tech, LLC
Latest P Tech, LLC Patents:
FIG. 6 shows a fastener and elongate fastening member with the fastener in a first orientation with respect to the elongate fastening member.
As shown in FIG. 13, a distal fastener 112a is inserted into sleeve 142. Distal fastener 112a is inserted in the first orientation with respect to elongate fastening member 130 with first end 120 as the leading end. In this configuration, tissue contacting surface 116 will be in contact with fracture portion 102 when distal fastener 112a is pivoted into the second orientation. This is best seen in FIGS. 14 and 15, in which a pushrod 144 is used to advance distal fastener 112a and elongate fastening member 130 through sleeve 142. Pushrod 144 also facilitates the pivoting of distal fastener 112a from the first orientation to the second orientation. This pivoting is not possible until distal fastener 112a has exited through sleeve 142. Also, because the length of distal fastener 112a is larger than the passage created in bone 104, pulling back on elongate fastening member 130 helps to ensure distal fastener 112a is in the second orientation and flush against fracture portion 102.
As illustrated in FIG. 16, sleeve 142 is removed from bone 104. Fastener 112a is located on the distal side of bone 104. Elongate fastening member 130 extends from fastener 112a through the bone passage and out the proximal opening of the bone or tissue passage. Any suitable means can be used to keep distal fastener 112a against fracture portion 102 with tension, where the tension can be measure and controlled in accordance with use. For example, elongate fastening member 130 can be deformed at the proximal end of the passage such that the deformed section rests against bone 104. The deformation would depend on the nature of elongate fastening member 130. If elongate fastening member 130 is a relatively flexible element, such as a suture, cable, or wire, then simply tying a knot in fastening member 130 could be sufficient to maintain the tension. If elongate fastening member 130 does not allow a knot, such as would be the case with a rod or tube, then mechanical deformation of elongate fastening member 130 to create an enlarged head could be sufficient to maintain the tension. U.S. Patent Application Publication No. US 2002/0016593, the contents of which are incorporated herein by reference, discloses mechanisms to mechanically deform an extension member and could be used to deform elongate fastening member 130.
In an exemplary embodiment, a proximal fastener 112b is used to secure distal fastener 112a and elongate fastening member 130. In this embodiment, proximal fastener 112b is identical to distal fastener 112a. If not already pre-loaded, proximal fastener 112b is loaded onto elongate fastening member 130. Proximal fastener 112b is loaded as shown in FIGS. 7 and 8, i.e. with second end 122 as the leading end so that after proximal fastener 112b is slid down against bone 104 and pivoted into the second orientation, tissue contacting surface 116 is in contact with bone 104.
Elongate fastening member 130 is tensioned, and proximal fastener 112b is secured to elongate fastening member 130 to thereby approximate the fracture and stabilize bone 104. The tension of elongate fastening member 130 pulls on distal and proximal fasteners 112a, 112b generally toward each other, thereby applying pressure to the fractured bone or tissue. In this regard, a bushing 146 can be used to secure proximal fastener 112b with the desired tension. Single or multiple elongated members 130 can be used to secure the fractured bone or tissue.
With additional reference to FIG. 18, tensioning mechanism 204 includes collet holder 208 defining a longitudinal passage along a central longitudinal axis A-A. Collet holder 208 is fixedly positioned through top portion 212 of handle portion 202, secured by collet holder pin 214. A cable tensioner 216 is positioned proximal to a first end 218 of the collet holder 208. Cable tensioner 216 includes rotatable shaft 220 aligned with the longitudinal passage of the collet holder 208. Rotatable shaft 220 includes a cable aperture 222 (visible in FIGS. 20, 21) for threading the cable therethrough, wherein cable 132 is wrapped about rotatable shaft 220 to thereby prevent relative movement between cable 132 and cable tensioner 216.
Referring to FIG. 26, cover plate 297 can be positioned over and affixed to compression plate 276, cover plate 297 can include limit stop 298, for limiting maximum allowable tension on cable. Thumb cap 300 can be attached to the head of adjustment bolt 288 to facilitate adjustment. Thumb cap 300 is designed to engage limit stop 298, thus preventing an over adjust of adjustment bolt 288.
Referring to FIGS. 18 and 27, collet 310 is affixed to second end portion 312 of collet holder 208, opposite cable tensioner 216. Collet 310 defines a collet passage longitudinally aligned with the longitudinal passage of collet holder 208, along central longitudinal axis A-A. An end portion of collet 310 is bisected, forming first and second collet arms 314 and 316. Gap portion 318 is provided between first and second collet arms 314 and 316. Each of first and second collet arms 314 and 316 include force application end portions 320 and 322, force application end portions 320 and 322, combine to form bushing aperture 324 configured to received bushing 146 therein. Collet 310 is made of a semi-rigid material, such that first and second collet arms 314 and 316 can be moved from an open to closed position, closing gap 318 and bushing aperture 324 between force application end portions 320 and 322.
Referring to FIG. 35, a cutting mechanism in accordance with an embodiment of the invention further includes a stroke limiter to prevent overdriving of the cut of cams 352. The stroke limiter includes set screw 380 threadably positioned in threaded hole 382 through lower portion of rocker 360, set screw 380 is positioned such that back end of set screw 380 extends from rocker 360. When rocker 360 is actuated, the back end 384 of set screw contacts contacting surface 386 in handle 20, thus limiting travel of rocker 360 and wedges 354, to thereby limit compression of cutting edges 353. Set screw 380 can be adjusted to adjust maximal compression of cutting edges 353, thereby prevent overdriving of cut off cams 352.
In a method of use in accordance with the invention, cable 132 is passed through bone 104 and fracture 102, where first fastener 112a secures cable 132 on first side (fracture side) of bone and second fastener 112b is positioned about cable on second side of bone, opposite first fastener 112a. Bushing 146 is positioned onto cable 132 to secure second fastener 112a against second side of bone 104.
The components of the medical device 200 of the present invention are rigid members made of, for example, aluminum, stainless steel, polymeric, composite materials, or combinations thereof. The components are sufficiently rigid to transmit the necessary forces. It should be understood that any material of sufficient rigidity might be used. For example, some components can be made by injection molding. Generally, for injection molding, tool and die metal molds of the components am prepared. Hot, melted plastic material is injected into the molds. The plastic is allowed to cool, forming components. The components are removed from the molds and assembled.
Furthermore, it is contemplated that the methods of the present invention may be performed under indirect visualization, such as endoscopic guidance, computer assisted navigation, magnetic resonance imaging. CT scan, ultrasound, fluoroscopy, X-ray, or other suitable visualization technique. The implants, fasteners, fastener assemblies, and sutures of the present invention may include a radiopaque material for enhancing indirect visualization. The use of these visualization means along with minimally invasive surgery techniques permits physicians to accurately and rapidly repair, reconstruct, augment, and secure tissue or an implant within the body. U.S. Pat. Nos. 5,329,924; 5,349,956; and 5,542,423 disclose apparatus and methods for use in medical imaging. Also, the present invention may be performed using robotics, such as haptic arms or similar apparatus. The above-mentioned patents are hereby incorporated by reference.
1. A system for securing body tissue, comprising:
an elongate member, wherein the elongate member is configured to secure at least one of a tissue, bone, and implant; and
a medical device configured to tension the elongate member, the medical device comprised of: a handle; an outer tube, fixed in position relative to the handle, including first and second ends and defining a longitudinal passage along a central longitudinal axis, wherein the second end of the outer tube is disposed in the handle, and wherein the elongate member is configured to enter the first end of the longitudinal passage of the outer tube, and pass at least partially through the longitudinal passage in the outer tube; and a tensioning mechanism disposed on the handle of the medical device, the tensioning mechanism comprising: a rotation assembly; at least one biasing member configured to apply a tension force to the elongate member; and a rotatable shaft positioned along an axis perpendicular to and intersecting the axis defined by the longitudinal passage of the outer tube, the rotatable shaft having an open end slotted aperture through which the elongate member is configured to be captured and secured, wherein rotational actuation of the rotation assembly of the tensioning mechanism applies tension to the elongate member as the rotation assembly wraps the elongate member around the rotatable shaft.
2. A system for securing body tissue as set forth in claim 1, further comprising the tensioning mechanism having a locking assembly, wherein the locking assembly of the tensioning mechanism is configured to at least one of maintain tension in the elongate member and prevent reversing of the rotation assembly.
3. A system for securing body tissue as set forth in claim 1, wherein the elongate member is at least one of a suture, thread, and cable.
4. A system for securing body tissue as set forth in claim 3, wherein the elongate member is at least one of threadlike, multifilament, braided, and interlaced and comprised at least in part of polyethylene.
5. A system for securing body tissue as set forth in claim 1, further comprising a surgical robotic mechanism configured to operate the system.
6. A system for securing body tissue as set forth in claim 1, wherein the implant is at least one of a plate, anchor, and button.
7. A system for securing body tissue as set forth in claim 1, further comprising a tension limiting mechanism configured to restrict tensioning of the elongate member beyond a desired tension limit.
8. A system for securing body tissue as set forth in claim 1, wherein the system is configured to secure body tissue in anterior cruciate ligament surgery.
9. A system for securing body tissue as set forth in claim 1, wherein the tensioning mechanism further includes a torque controller.
10. A system for securing body tissue as set forth in claim 1, wherein the rotation assembly includes a knob.
11. A system for securing body tissue as set forth in claim 1, wherein the tissue is at least one of a graft, bone, cartilage, ligament and tendon.
12. A system for securing body tissue as set forth in claim 1, further comprising a mechanism configured to measure the tension applied to the elongate member.
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Patent number: 10390817
Patent Publication Number: 20160310133
Assignee: P Tech, LLC (Effingham, IL)
Inventors: Peter M. Bonutti (Manalapan, FL), Hank Bonutti (Bloomfield Hills, MI), Kevin Ruholl (Teutopolis, IL), Glen A. Phillips (Effingham, IL)
Application Number: 15/198,151
International Classification: A61B 17/04 (20060101); A61B 17/68 (20060101); A61B 17/88 (20060101); A61B 17/82 (20060101); A61B 17/00 (20060101); A61B 90/00 (20160101); A61F 2/08 (20060101);