Abstract:
A bone anchor is provided having has a body with a proximal end and a distal end, a first section starting from the proximal end, with an outside thread and also a thread-free second section adjoining to it. The first section has a length that is adjusted to the thickness of the corticalis. The bone anchor has a device at the proximal end, the device extending from the proximal end into the body and serves to hold a holding thread.

Description:
BACKGROUND OF THE INVENTION  
       [0001]     The invention concerns a device for attaching soft tissues to a human or animal bone.  
         [0002]     In various human and veterinary surgical processes, soft tissues, for example, tendons and ligaments, must be attached to a bone. The attachment can become necessary when, for example, due to an accident or a degenerative process, a tendon becomes separated from the bone and then the tendon will have to be attached to it again. In surgery various devices are used for this, which are frequently called bone anchors, as in the description below. The bone anchor is attached to an exposed bone in a preparatory step. With a suture material (for example, holding thread) attached to or guided into the bone anchor, for example, the tendon is attached to the bone anchor and thus to the bone.  
         [0003]     A known bone anchor is the Statak® bone anchor made by the company Zimmer, Inc. This bone anchor has a cylindrical screw body with an outside thread, a distal wedge-shaped anchor tip and a proximal head part. The outside thread extends essentially between the anchor tip and the head part. The head part has a loop for holding the suture material perpendicular to the longitudinal axis of the screw body. Moreover, the head part has a multi-edged outer surface for placement of a tool. Therefore, the head part does not have any outside thread.  
         [0004]     Another bone anchor is known from EP 829 233 A1. This bone anchor has a cylindrical screw body, which then goes to a distal part ending in a tip. An outside thread extends along the screw body between the distal part and the proximal end. Perpendicular to the longitudinal axis and within the part going to the tip, the bone anchor has a through bore to hold the suture material. In another example, instead of the through bore, the bone anchor has a notch starting from the distal part to hold the suture material. In both examples the screw body has two grooves opposite to one another, which extend parallel to the longitudinal axis and guide the suture material from the through bore or the notch to the proximal end. At the proximal end the screw body has an insertion slit for attaching a tool.  
         [0005]     The above bone anchors are screw anchors, which are screwed into the bone. In addition to these screw anchors, striking anchors are used, which are driven into the bone with a special setting instrument. Wings or barbs extend from the cylindrical body of the bone anchor and these wedge themselves under the cortical bone and thus are supposed to keep the bone anchor safely in the bone. At the proximal end, the bone anchor, transversely to its longitudinal axis, has a lead-through to hold a holding thread. An example of such a bone anchor is the GII® anchor of DePuy Mitek, Inc.  
         [0006]     Physicians, above all surgeons, expect that the bone anchors can be implanted reliably and be handled in a practical manner, for example, that the holding thread, if not already made available by the manufacturer, can be threaded easily, will not tear off accidentally, and will not become fouled. Moreover, the bone anchor must be held securely in the bone.  
         [0007]     In the Statak® bone anchor, the head part has a double function, namely it serves both for holding the suture material and as a support for the tool. Due to the relatively small cross-section of the head part, there is a danger that the head part and thus the thread holder, will be screwed off during the setting of the bone anchor. Although in the bone anchor known from EP 829 233 A1 the insertion slit in the screw body is sunk so that the danger of it becoming screwed off no longer exists, the need to thread the thread into the groove from the tip to the proximal end seems not very practicable. Since the GII® anchor is not screwed in, in this anchor the problem of screwing the insertion slit off does not exist. However, in the case of this anchor the disadvantage is that the set anchor cannot be removed again or is difficult to remove because of the wedging of the barbs.  
       SUMMARY OF THE INVENTION  
       [0008]     Therefore, there is a need for a bone anchor of the type described at the outset with improved properties regarding reliability, ease of handling and secure anchoring in the bone.  
         [0009]     Accordingly, a device for securing of soft tissues onto a bone that has a corticalis of a predetermined thickness, in a practical example, has a body with a proximal end and a distal end, which has a first section with an outside thread starting from the proximal end and then a second section following it which does not have any thread. The first section has a length that is adapted to the thickness of the corticalis of the bone. Moreover, this device has at the proximal end a device that extends from the proximal end into the body and serves to carry a holding thread.  
         [0010]     As it will be evident from the description which follows and the drawings, the bone anchor described here can be conceived to be a striking anchor, which has an outside thread near the proximal end. As a result of this, the bone anchor can be set into the bone very rapidly. The outside thread fixes the bone anchor in the corticalis. In spite of that, if needed, it can be removed again relatively easily.  
         [0011]     The device which is at the proximal end is designed so that it makes easier threading of the holding thread possible and that no edges are present at which the holding thread may tear. The device ends with the proximal end of the bone anchor, as a result of which the implanted bone anchor ends essentially at the outside surface of the bone. In this way, guiding of the holding thread over an edge of the bone and breaking of the thread there can be avoided. 
     
    
     BRIEF DESCRIPTION OF THE FIGURES  
       [0012]     Further embodiments, advantages, new properties and applications of the invention follow from the detailed description given below, with reference to the drawings. In the drawings, the same elements have the same reference numbers. The following are shown in the drawings:  
         [0013]      FIG. 1  is a schematic side view of a practical example of a bone anchor;  
         [0014]      FIG. 2  is a schematic cross-section through the bone anchor shown in  FIG. 1  along a longitudinal axis;  
         [0015]      FIG. 3  is a top view onto the bone anchor shown in  FIG. 1 ; and  
         [0016]      FIGS. 4 and 5  are schematic side views of other practical examples of a bone anchor. 
     
    
     DETAILED DESCRIPTION  
       [0017]      FIG. 1  shows a practical example of a bone anchor  1 , which serves to secure soft tissues on a bone. The bone anchor  1  has a body  6  which extends symmetrically around a longitudinal axis A from a proximal end  2  to a distal end  4 . Body  6  has a section S 1  of a length L 1 , which, starting from proximal end  2  extends in the direction of the distal end  4 . Section S 1  has an outside thread  8 . The body  6  also has a section S 2  of a length L 2 , which is attached to section S 1  and extends to the distal end  4 . Section S 2  does not have a thread.  
         [0018]     As further explained below, the length L 1  of section S 1  is chosen so that the outside thread  8  screws into the corticalis of the bone. In a practical example, the length L 1  is about 3 mm and the length L 2  about 6 mm. The values for the length L 1  may vary, but they correspond to the thicknesses that typically exist in humans in the corticalis. The total length of the bone anchor  1  can be about 5 to about 10 mm.  
         [0019]     In the practical example shown in  FIG. 1 , the body  6  narrows from the proximal end  2  in the direction of the distal end  4 . The body  6  can, for example, be cone-shaped or have the shape of a truncated cone. A narrowing or conical shape can be advantageous for impacting into the bone. However, it is understood that the bone anchor  1  in another practical example may have a different shape, for example, it may be cylindrical.  
         [0020]     At distal end  4 , the bone anchor  1  has a tip  12 , which is joined to body  6 . The tip  12  and body  6  in one practical example are made of one piece of material. The material is biocompatible and can be, for example, stainless steel, titanium, a titanium alloy or a resorbable material (for example polylactide or polyglyconate).  
         [0021]     Moreover, the bone anchor  1  has a device  10 , which extends from the proximal end  2  into body  6  and serves for holding the holding thread. In  FIG. 1 , for illustration, the device  10  is indicated by dashed lines, since it is not visible when viewing the bone anchor  1  from the side. In the case of the bone anchor  1  shown, in the area of the proximal end  2 , the device  10  forms a cavity, which is delineated by a wall surface  16  and is open at the proximal end  2 . The wall surface  16  has a concave shape in  FIG. 1 . In addition, the device  10  has a bridge  14  with a circular cross-sectional surface that extends into the cavity.  
         [0022]      FIG. 2  shows a schematic cross-section through the bone anchor  1  shown in  FIG. 1  along longitudinal axis A. In the practical example shown in  FIG. 2  the wall surface  16  has curved surface section  16   c  and two side surfaces  16   a,    16   b,  which extend parallel to the longitudinal axis A and go into the flat section  16   c.  The wall surface  16  forms the hollow cavity in the practical example shown so that a disk-shaped hollow cavity is produced. It is understood that in other practical examples the cavity may have another shape, for example, the shape of a half-oval or a half-sphere.  
         [0023]     The bridge  14  extends essentially transversely to the longitudinal axis A between side parts  16   a,    16   b.  Hereby in a practical example, bridge  14  is located on the level of the plane of the proximal end  2  as shown, for example, in  FIGS. 4 and 5 . In the representation shown in  FIG. 2 , the bridge  14  is set back from the plane of the proximal end  2  in the direction of the cavity. In a practical example, the bridge  14  is set back less than about 1 mm from the proximal end  2 . The transition from the plane of the proximal end  2  into the cavity is rounded or inclined in a region  18  in order to avoid edges at which the holding thread could be separated.  
         [0024]      FIG. 3  shows a top view onto the bone anchor  1  shown in  FIG. 1 . One can see the proximal end  2 , the cavity formed by wall surface  16  and the bridge  14  extending into the cavity. In the top view, the cavity has an elongated oval opening, which is formed by side surfaces  16   a,    16   b  and flat section  16   c.  The bridge  14  divides the oval opening into two approximately equally-sized partial openings. For example, a surgeon can guide an attaching thread through one partial opening into the cavity, guide it around the bridge  4  and then remove it through the other partial opening.  
         [0025]     At the proximal end  2  the surgeon can also set a tool in order to screw the bone anchor  1  into the bone. In a practical example, the tool is designed in such a way that it extends into the cavity. The tool can have a recess corresponding to the diameter of bridge  14  in order to guide the tool through bridge  14  into the cavity, so that the torque can grip in the inside of body  6 . The danger of damaging the bone anchor  1  is thereby significantly reduced.  
         [0026]      FIGS. 4 and 5  show schematic side views of other practical examples of a bone anchor  1 . In these practical examples, in one or several areas of section S 1  there is no anchor material and thus no outside thread  8  present. For example, from the bone anchor  1  shown in  FIGS. 1-3 , the anchor material can be removed over a length of several thread turns (can be ground off). As a result of this, near the proximal end  2  less anchor material is present that would displace bone material. As a result of this, the stress can be removed from the bone material in this area.  
         [0027]     In the practical example of bone anchor  1  shown in  FIG. 4 , in an area  20 , the anchor material has been removed starting from the proximal end  2  over approximately two thread turns, so that a side opening is produced through which the bridge  14  and a part of the cavity formed by side surface  16  are visible. On an opposite side of the opening, the anchor material can also be removed in the same way, as a result of which another side opening is produced.  
         [0028]     In the practical example of bone anchor  1  shown in  FIG. 5 , on the other hand, in an area  20   a  the anchor material was removed over the entire length of section S 1 . The bridge  14  and a part of the cavity formed by wall area  16  are also thereby visible through a side opening formed. In this practical example too, the anchor material can be removed in the same way on the opposite side of the opening, as a result of which another side opening is formed.  
         [0029]     The bone anchor  1  that is described above with the aid of practical examples, makes handling possible in a practical and reliable way, since the device which holds and guides the holding thread at the proximal end  2  is easily accessible to the surgeon and in the implanted state it essentially ends at the bone surface. In this practical example the threaded holding thread is not guided over a bone edge where it could tear. The concave wall area  16  supports the surgeon during threading of the holding thread. The side openings shown in  FIGS. 4 and 5  additionally facilitate the threading of the holding thread. The device  10  and especially bridge  14  are designed in such a way that they do not have any sharp edges on which the holding thread could tear.  
         [0030]     In addition, bone anchor  1  ensures secure holding in the bone. This is achieved above all by the fact that the outside thread  8  extends in the region of the proximal end  2  along section S 1 . Thus the outside thread  8  finds good holding in the corticalis of the bone and not in the region of the bone marrow, where the section S 2 , that has no threads, sits. In the case of patients in whom little structure is present in the region of the bone marrow, for example, in elderly patients, as a result of this, secure holding in the bone can be achieved.  
         [0031]     The bone anchor  1  described above with the aid of practical examples can be struck directly into the bone. Only then is the bone anchor  1  pushed further into the bone by screwing it in, whereby the section S 1  comes to lie essentially in the corticalis.  
         [0032]     Depending on the practical example, the outside thread  8  does not have to extend to the outermost edge of the proximal end  2 , although this is preferred; however, it extends so close to the proximal end  2  that the function of the anchoring can be fulfilled by the outside thread  8  in the corticalis.  
       REFERENCE LIST  
       [0000]    
       
          A Axis  
          S 1  Section (length L 1 )  
          S 2  Section (length L 2 )  
           1  Bone anchor  
           2  Proximal end  
           4  Distal end  
           6  Body  
           8  Outside thread  
           10  Device  
           12  Tip  
           14  Bridge  
           16  Wall surface  
           16   a  Side surface  
           16   b  Side surface  
           16   c  Surface section  
           18  Region  
           20  Region  
           20   a  Region