Patent ID: 12185935

DETAILED DESCRIPTION OF THE INVENTION

Referring now to the drawings, wherein like reference numerals refer to like parts throughout, there is seen inFIG.1an illustrative embodiment of the locking suture construct10with a slidably attached suture anchor2. A purpose of the locking suture construct10in the illustrative embodiment discussed herein is to secure the suture anchor2in relative position to a tissue18via a fixation loop30with a fixed size and tension, as shown for example inFIG.14(described further below), where the suture anchor2can represent a first body (B) and the tissue18can represent a second body (A) (see, e.g.,FIG.15).

In accordance with multiple embodiments, the first body (B) can be a suture anchor as shown inFIGS.1and2, a surgical button (for use in, e.g., ACL repair), or a bone such as the coracoid process (for use in, e.g., bone to bone or bone to soft tissue fixation), as long as the locking suture construct10can be attached in an adjustable (e.g., slidable) manner to the first body (B). In the depicted embodiment ofFIG.1, for example, the suture anchor2can be an all-suture anchor, such as a Y-Knot® anchor (as should be understood and appreciated by those of ordinary skill in the art in conjunction with a review of this disclosure). In an alternative embodiment shown inFIG.2, the suture anchor2can be a rigid suture anchor, such as the Revo® anchor or CrossFT® anchor (as should be understood and appreciated by those of ordinary skill in the art in conjunction with a review of this disclosure). Similarly, the second body (A) can be soft tissue as shown for example inFIG.14, or a tendon, a bone block, or a bone such as a clavicle (as should be understood and appreciated by those of ordinary skill in the art in conjunction with a review of this disclosure). Notwithstanding these examples, the structure, configuration, use and functionality of the embodiments of the locking suture construct10described herein are not dependent on the particulars of the first body (B) and the second body (A). Stated differently, the first body (B) and the second body (A) can be any two objects, and the locking suture construct10can generally be structured, constructed and function in the same manner as described herein.

Referring back toFIG.1, the locking suture construct10can include a length of suture material6having a first end or strand12and a second end or strand13. As shown, the suture material6can be threaded through a loop8in a control line11and then through the suture anchor2(from right to left inFIG.1) such that the first end12and the second end13of the suture material6are preferably relatively equal in length and parallel. Alternatively, any similar instrument (or no instrument at all, e.g., a user's finger), can be used in place of control line11and perform all of the functions of control line11as described herein and below (such as a gripper, a device with a hook, or any other grabbing or gripping device as should be understood by those of skill in the art in conjunction with a review of this disclosure) by grabbing or catching bight7formed in suture material6(see, e.g., bight7shown inFIGS.1,2,4,5,6,7,8,9,10,11,17,18,19,21).

The locking suture construct10can also include a constricting member, which can be fixed or adjustable. As described further below and illustrated in the Figures, each of the embodiments of the constricting member is formed as part of a structural intersection construct through which other portions of the suture6and a control line11or a threader21pass. Each constricting member embodiment is configured to move along/rotate around fixation loop30to an optimal position as determined by a user, i.e., medical professional (compare, for example, the positioning of the constricting member inFIG.12withFIG.14, and the positioning of the constricting member inFIG.13withFIG.15), while the fixation loop30preferably maintains a fixed size and tension about first body (B) and second body (A). The constricting member can be formed as an adjustable locking splice/constricting member20as shown inFIGS.3A-3B, an alternative adjustable constricting member20′ as shown inFIGS.3C-3D, a fixed constricting member20″ as shown inFIG.3E, another alternative adjustable constricting member20′″ as shown inFIGS.3F-3G, or any other similar enclosed boundary component (as should be understood and appreciated by those of ordinary skill in the art in conjunction with a review of this disclosure).

Turning toFIGS.3A-3B, schematic representations of an adjustable constricting member20are shown. Adjustable constricting member20is formed of a loop created by the second end13of the suture material6(or portion4) being passed through itself in one direction or the other. The embodiment shown inFIG.3Ais configured such that second end13moves to the right (is pulled) to shrink the size of the hole formed by adjustable constricting member20. The embodiment shown inFIG.3Bis configured such that portion4′ moves to the right to shrink the size of the hole formed by adjustable constricting member20. The adjustable constricting member20is the embodiment of the constricting member used in certain example figures illustrating the use and functionality of the constricting member, which is further detailed below.

Turning toFIGS.3C-3D, schematic representations of a locking splice20′ are shown. Locking splice20′ is a fixed constricting member, and is formed of a segment of hollow round suture23between voids25in the wall of a length of hollow round suture.

Turning toFIG.3E, a schematic representation of another fixed constricting member20″ is shown. The fixed constricting member20″ is formed of a section of hollow round braided suture material23between sections of flat braided suture material24.

Turning toFIGS.3F-3G, schematic representations of another adjustable constricting member20′″ are shown. The adjustable constricting member20′ is formed of a loop created by the second end13of suture material6being passed through a section of round suture material23between sections of flat suture material24. As with the adjustable constricting member20′, the perimeter of the adjustable constricting member20′″ is reduced when the threaded piece of suture material, either the threaded limb4or second end13, is pulled.

Referring now toFIG.4, there is shown an illustrative embodiment of the locking suture construct10loaded on a suture anchor inserter14. The suture anchor2is loaded onto the inserter14, such as a Y-Knot® inserter (as should be understood and appreciated by those of ordinary skill in the art in conjunction with a review of this disclosure) such that the first end12is on a first side of the inserter14and the second end13is on a second side of the inserter14. In the depicted embodiment, the inserter14, suture anchor2, and the locking suture construct10are shown in a pre-bone installation position and configuration, and both the control line11and the first end12are on the first side of the inserter14. However, in this position and configuration, the control line11may alternatively be on the second side of the inserter14with the second end13.

Once the locking suture construct10is loaded onto the inserter14, the inserter14can be used to implant the suture anchor2within a bone hole26formed in bone16, as shown inFIG.5. In the illustrative embodiment, the suture anchor2is placed within the bone hole26such that the first end12of suture material6and the control line11are on a first side of a tissue18. As similarly stated above, the control line11may alternatively be on the second side of the tissue18with the second end13of the suture material6.

FIGS.6-16depict the steps to alter and fix the relative distance between the suture anchor2and the tissue18using the locking suture construct10. First, inFIG.6, the control line11is threaded through the constricting member20. As shown in the depicted embodiment, the control line11is fed through the constricting member20formed on the second end13positioned above the tissue18. Then, as shown inFIG.7, the control line11and loop8and a portion of suture material6are fully pulled through the constricting member20, creating a locking loop15with portion of the suture material6that was pulled through constricting member20. As the perimeter of locking loop15grows per the continued pulling of the control line11, the constricting member20is configured to move toward the tissue18.

Although shown expanded for clarity, the constricting member20inFIG.7is preferably actually tight around the locking loop15, as shown inFIG.8, pursuant to pulling on second end13(in the upward direction as shown inFIG.8). Next, referring now toFIG.9, the first end12and the second end13of the suture material6are passed through the locking loop15.FIG.10depicts the first end12and the second end13pulled through the locking loop15, where the constricting member20is shown in an expanded configuration for clarity of the positioning of each of the reference components.

Referring now toFIG.11, the first end12and the second end13are shown passed through the locking loop15, which had previously been enlarged, moving the constricting member20against the tissue18as described above. With the constricting member20in close proximity to the tissue18, the first end12is pulled to reduce the perimeter of the locking loop15to a minimum perimeter, as shown in the views ofFIGS.12and13. When the locking loop15is reduced, the locking loop15squeezes, pinches or “strangles” the first end12and the second end13to obtain a minimum working perimeter (where, for example, the inner surface of the locking loop15preferably fully contacts and applies pressure to the first end12and the second end13; and/or where the inner surface of the locking loop15squeezes down to a point where if1′ and2′ are pulled separately/individually, they do not freely or easily move/slide through constricting member20—see, e.g.,FIG.3D—as should be understood by a person of ordinary skill in the art in conjunction with a review of this disclosure). Tension is preferably maintained on the control line11while reducing the locking loop15(per the pulling of first end12) until the locking loop15has a minimum working perimeter. Once locking loop15reaches the minimum working perimeter, fixation loop30is configured to maintain its size and tension about first body (B) and second body (A).

With reference toFIGS.14-15, if the first end12is continuously pulled after the locking loop15has reached a minimum perimeter, the constricting member20is configured to and begins to move/rotate toward the suture anchor2(while fixation loop30preferably still is configured to maintain its size and tension). As shown inFIGS.14-15, as compared toFIGS.12and13, respectively, the first end12can be pulled such that the constricting member20moves/rotates around the tissue18(from the position shown inFIGS.12and13) until it is in close proximity to the suture anchor2or other optimal location as may be decided by the user. While first end12is pulled, positioning loop40becomes smaller (compareFIG.13withFIG.15). Constricting member20can be a relatively bulky construct, and a user may prefer to move constricting member20towards first body (B) (within a bone hole26) in a less irritating position to the patient. Finally, excess suture material6from the first end12and the second end13can be excised near the bone16to produce the end result of the locking suture construct10surrounding the tissue18(second body (A)) and the suture anchor2(first body (B)) in a post-bone installation position and configuration as shown inFIG.16. Thus, the tissue18is held in a position relative to the suture anchor2by the locking suture construct10. The relative position is ultimately secured with two loops, the fixation loop30and the positioning loop40. The fixation loop30holds the tissue18(second body (A)) in relative position to the suture anchor2(first body (B)), while the positioning loop40holds the constricting member20in a desirable position such that irritation and trauma is reduced.

However, if the constricting member20moves or is rotated to an undesirable or non-optimal position with respect to the tissue18and the suture anchor2, the locking suture construct10can be repositioned as long as the first end12and second end13have not been cut. To reposition the locking suture construct10, the control line11is pulled and the constricting member20moves/rotates away from the suture anchor2and back toward the tissue18. As the constricting member20moves/rotates, the perimeter of the locking loop15grows (essentially performing the above referenced steps in reverse order). This allows the locking suture construct10to be repositioned in a desirable area, for example, an area where the constricting member20will cause less irritation or trauma to the surrounding tissue or bone. In accordance with an alternative embodiment, second end13can be pulled instead of control line11to obtain the same results as discussed in this paragraph.

In an alternative embodiment shown inFIGS.17-20, the illustrated constricting member of the locking suture construct10′ is not adjustable and is instead a fixed constricting member (e.g., fixed constricting member20″ shown inFIG.3E) to be used in conjunction with a threader21.

Referring next toFIG.18, the threader21is shown inserted through the hollow section23of the fixed constricting member20″. The eyelet22of the threader21extends through the fixed constricting member20. As shown in the depicted embodiment, the control line11is being pulled through the eyelet22of the threader21. Thereafter, with reference toFIG.19, the threader21is pulled away from the fixed constricting member20, such that the eyelet22holding the control line11is fully pulled through the fixed constricting member20. Just as shown in and described with respect toFIG.8,FIG.20depicts the control line11pulled through the constricting member20to create the locking loop15. The steps shown and described with respect toFIGS.8-16apply equally to the fixed constricting member20″ alternative embodiment.

Referring back toFIGS.3C-3D, an alternative embodiment regarding the locking splice20′ constricting member construct is shown.FIG.21shows a top perspective view schematic representation of the locking suture construct10″ using the locking splice20′ according to this alternative embodiment. In the depicted embodiment, the second body (A) is in a first position relative to the first body (B). As shown, both the first end12and the second end13have been pulled through the locking loop15.

Referring back toFIG.3C, there is shown a magnified view of the locking splice construct20′. In the depicted embodiment, the locking splice construct20′ is formed in a fourth limb4′, which is in the second end13of the suture material6, similar to that shown inFIG.1and also shown inFIG.21. The locking loop15has a first limb1′ and a second limb2′, which extend through the locking splice construct20′. In addition, the first end12of the suture material6which has been passed through the locking loop15, extends through the locking splice construct20′ as a third limb3′ on the same side of the second body (A) as the first limb1′ and the second limb2′. The fourth limb4′ is the only portion of suture material6shown on the opposing side of the second body (A). Ultimately, when the perimeter of the locking loop15is reduced to the minimum working perimeter, the first limb1′ and the second limb2′ are pulled through the locking splice construct20until the locking loop15is tightly wrapped around the third limb3′ and the fourth limb4′, as shown inFIG.3D. The steps shown and described with respect toFIGS.8-16apply equally to the locking splice20′ alternative embodiment.

While embodiments of the present invention has been particularly shown and described with reference to certain exemplary embodiments, it will be understood by one skilled in the art that various changes in detail may be effected therein without departing from the spirit and scope of the invention as defined by claims that can be supported by the written description and drawings. Further, where exemplary embodiments are described with reference to a certain number of elements it will be understood that the exemplary embodiments can be practiced utilizing either less than or more than the certain number of elements.