Patent Description:
The present invention is directed generally to suture anchors and, more particularly, to a knotless suture anchor construct for securing a tissue in a desired position relative to a bone hole.

Surgical procedures often call for suture anchors to provide a reliable attachment location for sutures in and/or against a substrate. The attached sutures are then used to capture and retain other objects including soft tissue. The substrate may be bone or honey material or soft tissue. For bone and like honey material, suture anchors can be inserted into a pre-formed hole in the bone so that the attached suture extends from the suture anchor out of the pre-formed hole. Where the substrate is soft tissue, suture anchors can reside on a side of the soft tissue so that the suture extends from the suture anchor, through a hole in the tissue, and further beyond the soft tissue on a side opposite the soft anchor.

In conventional practice, suture anchors can incorporate at least one feature to generate a retention capacity to retain the suture anchor in the pre-formed hole. In some anchors, the feature embodies a ridged member that can deform to create an interference fit with the substrate. Other suture anchors utilize an external feature (e.g., a barb, screw threads(s), etc.). These external features can interact with the substrate to create the retention capacity, often by piercing, cutting, and/or deforming the substrate. In still other suture anchors, the feature may be moveable (e.g., a deployable barb) that translates to create the retention capacity. A suture anchor from which the pre-characterising part of claim <NUM> starts out is disclosed in <CIT>.

Many factors can have a direct effect on the actual retention capacity achieved by any suture anchor. For example, the quality of tissue, bony or soft, may increase or decrease the retention capacity by a large degree depending on the design of a particular suture anchor. Thus, some suture anchors perform well in certain circumstances while other anchors perform better in other circumstances. Similarly, the quality of installation affects the retention capacity.

Therefore, there is a need for a suture material interleaved into a soft, malleable substrate to form a loop configuration to pull repair sutures into a pre-formed hole and to deform the substrate.

Description of the Related Art Section Disclaimer: To the extent that specific patents/publications/products are discussed above in this Description of the Related Art Section or elsewhere in this disclosure, these discussions should not be taken as an admission that the discussed patents/publications/products are prior art for patent law purposes. For example, some or all of the discussed patents/publications/products may not be sufficiently early in time, may not reflect subject matter developed early enough in time and/or may not be sufficiently enabling so as to amount to prior art for patent law purposes. To the extent that specific patents/publications/products are discussed above in this Description of the Related Art Section and/or throughout the application, the descriptions/disclosures of which are all hereby incorporated by reference into this document in their respective entirety(ies).

The discussion below describes embodiments of a suture anchor that is configured to pull repair sutures into a pre-formed hole in bone or honey tissue. These configurations can have a filament (e.g., a suture) interwoven into a soft, malleable substrate (e.g., suture ribbon). The interwoven filament can form loops to receive free-ends of the repair suture that originates from a fixation site adjacent the pre-formed hole. In use, tension on free-ends of the interwoven filament can translate the loops to engage the repair suture, effectively pulling the free-ends into the pre-formed hole and interleaving the repair suture with the substrate in a manner that allows the filament to freely translate through the substrate and relative to the repair suture.

The accompanying drawings show embodiments of the invention and those not of the present invention, <FIG> showing embodiments of the invention. The foregoing and other objects, features, and advantages of the invention are apparent from the following description taken in conjunction with the accompanying drawings in which:.

Aspects of the present invention and certain features, advantages, and details thereof, are explained more fully below with reference to the non-limiting examples illustrated in the accompanying drawings. Descriptions of well-known structures are omitted so as not to unnecessarily obscure the invention in detail. It should be understood, however, that the detailed description and the specific non-limiting examples, while indicating aspects of the invention, are given by way of illustration only, and are not by way of limitation. The following description relates to embodiments of the invention and those not of the present invention, <FIG> showing embodiments of the invention.

Referring now to the figures, wherein like reference numerals refer to like parts throughout, <FIG> shows a top view schematic representation of a knotless suture anchor construct <NUM> in a planar configuration, according to an embodiment. The knotless suture anchor construct <NUM> comprises a substrate <NUM> having and extending between a first end <NUM> and a second end <NUM> along a central longitudinal y-y axis. The substrate <NUM> can be any suture material, such as the Y-Knot® suture tape. In the depicted embodiment, the substrate <NUM> is rectangular, although other shapes and configurations can be used.

The knotless suture anchor <NUM> additionally comprises a first filament <NUM> woven through substrate <NUM>. The filament <NUM> can be composed of any suture material. In the preferred embodiment, the filament <NUM> is composed of hollow suture braid, which flattens and does not flip as much as round suture (but can be round, flat, and/or include or not include a core). In the first configuration, the filament <NUM> is folded at a central section <NUM> ("central section" herein is interpreted as any folded area of the filament <NUM>, not necessarily the middle of the filament <NUM>), creating a passing limb <NUM> and a reducing limb <NUM>. The filament <NUM> is woven through the substrate <NUM>, from a first surface <NUM> to a second surface (not shown), at a plurality of passing locations <NUM>. In the depicted embodiment, the filament <NUM> is woven such that the central section <NUM> extends from a first terminal passing location 118A on the first end <NUM> of the substrate <NUM>, creating a first loop <NUM> (with a first diameter) in the filament <NUM>.

As also shown in <FIG>, the passing limb <NUM> and reducing limb <NUM> are woven through additional passing locations <NUM> along the substrate <NUM> toward the second end <NUM>. The passing limb <NUM> and reducing limb <NUM> extend from a second terminal passing location 118B at the second end <NUM> of the substrate <NUM>. Thus, in the planar configuration, as shown in <FIG>, the first loop <NUM> of the filament <NUM> extends from the first end <NUM> of the substrate <NUM> and the passing limb <NUM> and reducing limb <NUM> extend from the second end <NUM> of the substrate <NUM>.

Turning now to <FIG>, there is shown a top view schematic representation of the knotless suture anchor construct <NUM> with a second loop <NUM>, according to an embodiment. With the knotless suture anchor construct <NUM> in the planar configuration, a passing portion <NUM> of the reducing limb <NUM> between two adjacent central passing locations 118C, 118D is pulled from the substrate <NUM>, away from the central longitudinal y-y axis. As the passing portion <NUM> is pulled away from the substrate <NUM>, a second loop <NUM> (with a first diameter) is created in the reducing limb <NUM>, as shown.

Referring now to <FIG> and <FIG>, there are shown top views schematic representations of the knotless suture anchor construct <NUM> with the second loop <NUM> passed through the first loop <NUM>, according to an embodiment. After the second loop <NUM> is created in the reducing limb <NUM> (<FIG>), the second loop <NUM> is passed through the first loop <NUM> at the first end <NUM> of the substrate <NUM>, as shown in <FIG>. Thereafter, the first loop <NUM> is tensioned by pulling the passing limb <NUM> in a direction away from the second end <NUM> of the substrate <NUM>. Tensioning the passing limb <NUM> causes the first loop <NUM> to decrease in size to a second diameter smaller than the first diameter. As shown in <FIG>, when the first loop <NUM> decreases in size, it surrounds or constricts around the second loop <NUM>, moving the knotless suture anchor construct <NUM> to a pre-deployment configuration.

Turning now to <FIG> and <FIG>, there are shown perspective and side views schematic representations of the knotless suture anchor construct <NUM> in use around an object <NUM>, according to an embodiment. In the pre-deployment configuration, as shown in <FIG>, the knotless suture anchor construct <NUM> is inserted into a bone hole <NUM> (<FIG>). As shown in <FIG>, the knotless suture anchor construct <NUM> is positioned in a bone hole <NUM> (<FIG>) adjacent an object <NUM>, such as a tissue. Although the object <NUM> may be any other biological material, exemplary embodiments wherein the object <NUM> is a tissue are discussed below. The knotless suture anchor construct <NUM> is positioned such that the first end <NUM> of the substrate <NUM> is proximal and the second end <NUM> of the substrate <NUM> is distal relative to the tissue <NUM>, as shown in <FIG>. Alternatively, as depicted in <FIG>, the knotless suture anchor construct <NUM> can be placed within a bone hole <NUM> beneath the tissue <NUM> such that the first end <NUM> of the substrate <NUM> extends toward one side of the tissue <NUM> and the second end <NUM> of the substrate <NUM> extends toward an opposing side of the tissue.

With the second loop <NUM> positioned next to the tissue <NUM>, the knotless suture anchor construct <NUM> can be deployed. To deploy the knotless suture anchor construct <NUM>, the passing limb <NUM> is first passed through the second loop <NUM> and then passed through or around the tissue <NUM>, as shown in <FIG> and <FIG>. Thus, the passing limb <NUM> and the second loop <NUM> encircle or otherwise grab the tissue <NUM>. After the passing limb <NUM> is wrapped around (or passed through) the tissue <NUM>, the passing limb <NUM> is threaded back through the second loop <NUM>, as shown in <FIG> and <FIG>.

Referring now to <FIG>, there are shown perspective and side views schematic representations of the knotless suture anchor construct <NUM> in use around a tissue <NUM>, according to an embodiment. After the passing limb <NUM> is threaded back through the second loop <NUM>, the reducing limb <NUM> is tensioned. By pulling the reducing limb <NUM> in a direction away from the substrate <NUM>, the first diameter of the second loop <NUM> is reduced to a second diameter. In other words, as the reducing limb <NUM> is tensioned, the second loop <NUM> begins to tighten around the passing limb <NUM>, as shown in <FIG>.

Referring now to <FIG>, there is shown perspective and side views schematic representations of the knotless suture anchor construct <NUM> in a deployed configuration, according to an embodiment. In the deployed configuration, the reducing limb <NUM> has been tensioned such that the second loop <NUM> is tightened around the passing limb <NUM> extending therethrough. As a result of the reduced size of the second loop <NUM>, the tissue <NUM> is drawn close to or next to the substrate <NUM> (and the bone hole <NUM>, as shown in <FIG>), placing the knotless suture anchor construct <NUM> in a desired position relative to the tissue <NUM>.

Turning now to <FIG> and <FIG>, there are shown top and bottom views schematic representations of knotless suture anchor construct <NUM> with a second filament <NUM> (hereinafter "locking filament"), according to an alternative embodiment. In <FIG>, the knotless suture anchor construct <NUM> is in the pre-deployment configuration (as shown in <FIG>). With the knotless suture anchor construct <NUM> in the pre-deployment configuration, the locking filament <NUM> is woven through the passing and reducing limbs <NUM>, <NUM> extending from the second surface <NUM> of the substrate <NUM>, as shown in <FIG>. The locking filament <NUM> prevents the passing limb <NUM> and reducing limb <NUM> from tearing through the substrate <NUM>. The locking filament <NUM> also prevents the second loop <NUM> from pulling through the substrate <NUM>. The locking filament <NUM> can be composed of any type of suture, such as monofilament, braided, or suture tape, for example.

Still referring to <FIG>, the locking filament <NUM> passes through the passing and reducing limbs <NUM>, <NUM> between two adjacent passing locations <NUM>. Stated differently, the locking filament <NUM> can pass through one or more exposed portions of the passing and reducing limbs <NUM>, <NUM> on the second surface <NUM> of the substrate <NUM>. In the embodiment shown in <FIG>, the locking filament <NUM> is woven through the passing and reducing limbs <NUM>, <NUM> between three pairs of adjacent passing locations <NUM>, crossing under the passing and reducing limbs <NUM>, <NUM> once per pair of adjacent passing locations <NUM>. In another embodiment, the locking filament can pass through exposed portions of the passing and reducing limbs <NUM>, <NUM> on the first surface of the substrate <NUM>.

Referring now to <FIG> and <FIG>, there is shown perspective and side view schematic representations of a knotless suture anchor construct <NUM> in a pre-deployment configuration and a deployed configuration, respectively, according to an alternative embodiment. The knotless suture anchor construct <NUM> in <FIG> comprises a substrate <NUM> and a filament <NUM>. The filament <NUM> comprises a first end <NUM> and a second end <NUM> with an eye splice <NUM> therebetween. The portion of the filament <NUM> between the first end <NUM> and the eye splice <NUM> comprises a passing limb <NUM> and the portion of the filament <NUM> between the second end <NUM> and the eye splice <NUM> comprises a reducing limb <NUM>.

To achieve the first configuration shown in <FIG>, the passing limb <NUM> is first passed through the eye splice <NUM>, creating a first loop <NUM>. The passing limb <NUM> is then woven through at least one passing location <NUM> at a first end <NUM> of the substrate <NUM>. The passing limb <NUM> is woven such that it extends from the first end <NUM> of the substrate <NUM>. The reducing limb <NUM> is woven through the substrate <NUM> toward a second end <NUM> of the substrate <NUM>. Specifically, the reducing limb <NUM> is woven through a passing location <NUM> adjacent the passing location <NUM> of the passing limb <NUM>. In the depicted embodiment, the reducing limb <NUM> is woven through at least two passing locations <NUM> along the substrate <NUM> and extends from the second end <NUM> of the substrate <NUM>, as shown.

Still referring to <FIG>, a passing portion <NUM> of the reducing limb <NUM> between two adjacent passing locations <NUM> is pulled from the substrate <NUM>. As the passing portion <NUM> is pulled away from the substrate <NUM>, a second loop <NUM> is created in the reducing limb <NUM>. To achieve the pre-deployment configuration, the second loop <NUM> is passed through the first loop <NUM>, as shown. As shown in <FIG>, for deployment, the knotless suture anchor construct <NUM> is placed within a bone hole <NUM> (<FIG>) in a desired location relative to an object <NUM>, such as a tissue.

In <FIG>, the knotless suture anchor construct <NUM> is positioned such that the passing limb <NUM> and the first end <NUM> of the substrate <NUM> are proximal relative to the tissue <NUM>. As shown in <FIG>, the passing limb <NUM> is then wrapped around or passed through the tissue <NUM>. Thereafter, the passing limb <NUM> is passed through the second loop <NUM>. To reduce the size of the second loop <NUM> (from a first diameter to a second diameter), the reducing limb <NUM> is pulled in a direction away from the bone hole <NUM>. As the reducing limb <NUM> is tensioned, the second loop <NUM> decreases in size and tightens around the passing limb <NUM>, pulling the tissue <NUM> into apposition with the bone hole <NUM>. When the tissue <NUM> is in the desired location, the passing and reducing limbs <NUM>, <NUM> can be trimmed.

Turning now to <FIG>, there is shown a side view schematic representation of the knotless suture anchor construct <NUM> on a driver <NUM>, according to an embodiment. In the depicted embodiment, the substrate <NUM> is placed within the forked end <NUM> of the driver <NUM>. As shown, the first end <NUM> of the substrate <NUM> (and the second loop <NUM>) are on a first side <NUM> of the driver <NUM>. The second end <NUM> of the substrate <NUM> is on a second side <NUM> of the driver <NUM>. As shown in <FIG>, the passing limb <NUM> and reducing limb <NUM> extend from the second end <NUM> of the substrate <NUM> along the second side <NUM> of the driver <NUM>. In the depicted embodiment, a third filament <NUM> is passed through the second loop <NUM>. The third filament <NUM> can be pulled to elongate the second loop <NUM>, while pulling the reducing limb <NUM> minimizes the second loop <NUM>. Thus, the third filament <NUM> and the reducing limb <NUM> can be used to both stabilize the second loop <NUM> as the knotless suture anchor construct <NUM> is placed in a bone hole and facilitate deployment of the knotless suture anchor construct <NUM>.

Referring now to <FIG>, there are shown various views schematic representations of the knotless suture anchor construct <NUM> of alternative embodiments. In the embodiment shown in <FIG>, the knotless suture anchor construct <NUM> comprises a passing portion <NUM> in the reducing limb <NUM> that wraps around the first loop <NUM> in a clockwise fashion, instead of through the first loop <NUM> in the embodiment of <FIG>. The knotless suture anchor construct <NUM> of <FIG> also has a passing portion <NUM> wrapping around the first loop <NUM>, but it wraps around the first loop <NUM> in the opposite direction (in a counterclockwise fashion) of that shown in <FIG>.

In the embodiment shown in <FIG>, the passing portion <NUM> extends through the first loop <NUM>; however, the passing portion <NUM> is passed through the first loop <NUM> from below (i.e., from a direction opposite that shown in <FIG>). In <FIG>, an embodiment of the knotless suture anchor construct <NUM> is shown wherein the filament <NUM> is woven through the substrate <NUM> in a first direction, a second direction, and back in the first direction again. The filament <NUM> is passed through the substrate <NUM> such that a first loop <NUM> is created and the passing limb <NUM> and reducing limb <NUM> extend from opposing sides of the substrate <NUM>.

In <FIG>, the knotless suture anchor construct <NUM> comprises an eye splice <NUM> in the first loop <NUM>. The passing portion <NUM> of the reducing limb <NUM> is wrapped around the first loop <NUM>. Thereafter, the reducing limb <NUM> is passed through the eye splice <NUM>, as shown. In <FIG>, the passing limb (not shown) and the reducing limb <NUM> extend from opposing sides of the substrate <NUM>. Further, the knotless suture anchor construct <NUM> comprises a "finger trap" <NUM> on the reducing limb <NUM>. A third filament <NUM> is threaded through the finger trap <NUM> and the first loop <NUM> and grabs the reducing limb <NUM>. The third filament <NUM> is used to pull the reducing limb <NUM> and the first loop <NUM> through the finger trap <NUM>.

In <FIG>, the knotless suture anchor construct <NUM> comprises a finger trap <NUM> wherein the passing limb <NUM> and the reducing limb <NUM> are threaded therethrough. The passing limb <NUM> and reducing limb <NUM> extend from the finger trap <NUM> in the pre-deployment configuration, as shown in <FIG>. The knotless suture anchor construct <NUM> also comprises an eye splice <NUM> in the passing limb <NUM>. The passing limb <NUM> is threaded through the eye splice <NUM> to form a second loop <NUM>. To deploy the knotless suture anchor construct <NUM>, the passing limb <NUM> is threaded through the first loop <NUM>, around the object <NUM>, and through the second loop <NUM>, as shown in <FIG>. Tensioning the reducing limb <NUM>, decreases the size of the first loop <NUM> and move the object <NUM> into toward the finger trap <NUM>.

Other configurations of the knotless suture anchor construct <NUM> are contemplated and may include a variation of elements, such as the finger trap or eye splice.

While various embodiments have been described and illustrated herein, those of ordinary skill in the art will readily envision a variety of other means and/or structures for performing the function and/or obtaining the results and/or one or more of the advantages described herein, and each of such variations and/or modifications is deemed to be within the scope of the embodiments described herein. More generally, those skilled in the art will readily appreciate that all parameters, dimensions, materials, and configurations described herein are meant to be exemplary and that the actual parameters, dimensions, materials, and/or configurations will depend upon the specific application or applications for which the teachings is/are used. Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments described herein. It is, therefore, to be understood that the foregoing embodiments are presented by way of example only and that, within the scope of the appended claims and equivalents thereto, embodiments may be practiced otherwise than as specifically described and claimed. Embodiments of the present disclosure are directed to each individual feature, system, article, material, kit, and/or method described herein. In addition, any combination of two or more such features, systems, articles, materials, kits, and/or methods, if such features, systems, articles, materials, kits, and/or methods are not mutually inconsistent, is included within the scope of the present disclosure.

It will be further understood that the terms "comprise" (and any form of comprise, such as "comprises" and "comprising"), "have" (and any form of have, such as, "has" and "having"), "include" (and any form of include, such as "includes" and "including"), and "contain" (any form of contain, such as "contains" and "containing") are open-ended linking verbs. As a result, a method or device that "comprises", "has", "includes" or "contains" one or more steps or elements. Likewise, a step of method or an element of a device that "comprises", "has", "includes" or "contains" one or more features possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way, but may also be configured in ways that are not listed.

Claim 1:
A knotless suture anchor construct, comprising:
a substrate (<NUM>) having a first end (<NUM>) and a second end (<NUM>); and
a filament (<NUM>) woven through a plurality of passing locations (<NUM>) along the substrate, the filament forming a first loop (<NUM>) extending to a passing limb (<NUM>) and to a reducing limb (<NUM>);
wherein a passing portion (<NUM>) in the reducing limb (<NUM>) between two adjacent passing locations of the plurality of passing locations (<NUM>) forms a second loop;
characterised in that
the first loop (<NUM>) of the filament extends from a first surface on the first end (<NUM>) of the substrate (<NUM>) and the passing limb (<NUM>) and the reducing limb (<NUM>) extend from the first surface or a second surface on the second end (<NUM>) of the substrate; and
said passing portion (<NUM>) wraps around the first loop (<NUM>).