Patent ID: 12185936

Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate exemplary embodiments of the disclosure, and such exemplifications are not to be construed as limiting the scope of the disclosure in any manner.

DETAILED DESCRIPTION

As disclosed herein, fixed sutures within an anchor can eliminate the need for a surgeon to tie knots for fixation. The free ends of the fixed sutures can be passed through soft tissue to a knotless anchor for a faster procedure. The suture constructs disclosed herein can include a fixed suture configuration where at least one suture is fixed to an anchor without a surgeon having to tie a knot or otherwise secure the suture to the anchor. As a result, the free ends of a suture can be passed through soft tissue and directly passed to a knotless anchor resulting in decreased time for a procedure. For example, the free ends of a fixed suture can be passed through the supraspinatus tendon, the subscapularis tendon, or the infraspinatus tendon during a rotator cuff repair procedure and then secured to each other using knots.

As used herein proximal refers to a location on a bone anchor that is closer to the physician. Distal refers to a location on a bone anchor that is away from the physician. Leading end refers to a tip or distal portion of a bone anchor. Trailing end refers to a tail or proximal portion of a bone anchor.

Turning now to the figures,FIG.1shows a surgical site100in accordance with at least one example of the present disclosure. As shown inFIG.1, surgical site100can include a bone102in which one or more suture anchor constructs104may be implanted. Each of suture anchor constructs104can include an anchor106, a first suture108, and a second suture110. Suture anchor constructs104can be used to secure tissue112to bone102as disclosed herein. Surgical site100can represent any surgical procedure where tissue can be attached to or otherwise anchored to bone.

FIG.2shows a method200for securing tissue to bone and will be described with reference toFIG.1. During surgery, a surgeon can drill one or more holes114in bone102(202). Drilling holes114can include using a drill guide or other surgical instruments to locate holes114and/or sturdy the drilling equipment used to drill holes114.

After holes114are drilled anchors106can be implanted into bone102(204). Implanting anchors106can include using an inserter to screw anchors106, which can include a threaded exterior surface, into bone102. Anchors106can also include barbs, a porous metal coating, and/or other features to secure anchors106within holes104. Thus, anchors106can be pressed into bone102as well as screwed into bone102.

With anchors106securely implanted into bone102, any combination of first and second sutures108and110can be passed thought tissue112(206). Any one of second sutures110, which are fixedly secured to a respective anchor106, can be passed through tissue112. As disclosed herein, the fixed nature of second suture110can allow the surgeon to secure tissue112to bone102without the need to first secure second suture110to anchors106. First sutures108can also be passed through tissue112in preparation for securing tissue112to bone102.

After passing at least one of first sutures108or second sutures110through tissue112, tissue112can be secured to bone102(208). For example, using second sutures110, which are now secured to bone102in an immovable manner, the surgeon can pull free ends of second sutures110to apply tension to tissue112and manipulate tissue112into a desired position. Once tissue112is in a desired position, the surgeon can tie the free ends of first and second sutures108and110together or to other sutures and/or anchors.

By having second sutures110secured to anchors106, time can be saved in the operating room because the surgeon or other medical staff can pass seconds suture110through the tissue and have it anchored down with a knotless anchor, such as anchors106, before inserting anchors106. In addition, second sutures110being secured to anchors106can aid the surgeon in positioning tissue112due to the fixed nature of a portion of second suture110.

FIG.3shows a suture anchor construct300, such as suture anchor construct100, in accordance with at least one example of the present disclosure. Suture anchor construct300can include an anchor302, a first suture304, and a second suture306. Anchor302can include a body308that defines a central hole310and a radial hole312. Anchor302can include a post314that extends from a first portion of radial hole312to a second portion of radial hole312. Stated another way, post314can span from one side of anchor302to another side of anchor302within radial hole312. Radial hole312and post314can be located proximate to the leading end of anchor302.

First suture304can include a first tail316, a second tail318, and a first intermediate portion320located in between first tail316and second tail318. Second suture306can include a third tail322, a fourth tail324, and a second intermediate portion326located in between third tail322and fourth tail324.

Consistent with embodiments disclosed herein, first suture304can be free to move about post314. By having first suture304being free to move, a surgeon can reposition first suture304as need. By repositioning first suture304the surgeon can adjust the lengths of first tail316and second tail318without having to cut first suture304. The surgeon also has the option to tie knots if they want, or they can remove first suture304if they want.

Second suture306can be secured to post314. As shown inFIG.3, second intermediate portion326can be wrapped around post314. A knot328can be tied in second intermediate portion326to fixedly secure second suture306to post314. For example, knot328can be sliding or fixed hitch knot. Knot328can also be tied first first and anchor302can then be overmolded to form post314and secure second suture306to post314.

By having second suture306secured to post314, the surgeon can initially secure tissue to a bone, such as bone102, in which anchor302can be implanted. The secured nature of second suture306can allow the surgeon to initially secure tissue, such as tissue112, to a bone. For example, using second suture306, the surgeon can pass fourth tail324through the tissue and manipulate fourth tail324to position the tissue. Fourth tail324can then be tied to third tail322, first suture304, bone, and/or other anatomical or implanted structures within the patient.

Tails316,318,322, and324can be used to secure the tissue. For example, once the tissue is secured using fourth tail324, the surgeon can then use first tail316and second tail318to further secure the tissue.

FIG.3shows first suture304located in between second suture306and an interior surface330. This configuration can allow first suture304to move relative to post314and second suture306.

FIG.4shows a suture anchor construct400in accordance with at least one example of the present disclosure. Suture anchor construct400can include an anchor402, a first suture404, and a second suture406. Anchor402can include a body408that defines a central hole410and a radial hole412. Anchor402can include a post414that extends from a first portion of radial hole412to a second portion of radial hole412. Post414can define a through-hole432. Radial hole412and post414can be located proximate to a leading end of anchor402.

First suture404can include a first tail416, a second tail418, and a first intermediate portion420located in between first tail416and second tail418. Second suture406can include a third tail422, a fourth tail424, and a second intermediate portion426located in between third tail422and fourth tail424. As shown inFIG.4, first suture404can pass around post414. In addition, first tail416and/or second tail418can pass through through-hole432.

Consistent with embodiments disclosed herein, first suture404can be free to move about post414as disclosed above with respect toFIG.4.

Second suture406can be secured to post414. As shown inFIG.4, second intermediate portion426can be tied into a knot428. Knot428can be tied at a midpoint of second suture406or at any point along second suture406.

The diameter of through-hole432can be smaller than the knot428. As a result, knot428cannot pass back through through-hole432. In other words, tension on third and fourth tails,422and424, can cause knot428to become wedged in through-hole432. WhileFIG.4shows through-hole432having a cylindrical profile, through-hole432can have a conical profile. Thus, as tension in third and fourth tails,422and424, is increased, the force applied to knot428by the walls of through-hole432can increase.

By having second suture406secured to post414, the surgeon can initially secure tissue to a bone, such as bone102, in which anchor402can be implanted. The secured nature of second suture406can allow the surgeon to initially secure tissue, such as tissue112, to a bone as disclosed above with respect toFIG.3.

FIG.4shows first suture404located in between second suture406and an interior surface430. This configuration can allow first suture404to move relative to post414and second suture406as disclosed above with respect toFIG.3. Still consistent with embodiments disclosed herein, first suture404can be fixed to post414. In addition, first suture404can pass through knot428.

FIG.5shows a suture anchor construct500in accordance with at least one example of the present disclosure. Suture anchor construct500can include an anchor502, a first suture504, and a second suture506. Anchor502can include a body508that defines a central hole510and a radial hole512. Anchor502can include a post514that extends from a first portion of radial hole512to a second portion of radial hole512. Radial hole512and post514can be located proximate to a leading end of anchor502.

First suture504can include a first tail516, a second tail518, and a first intermediate portion520located in between first tail516and second tail518. Second suture506can include a third tail522, a fourth tail524, and a second intermediate portion526located in between third tail522and fourth tail524.

Consistent with embodiments disclosed herein, first suture504can be free to move about post514as disclosed above with respect toFIG.3.

Second suture506can be secured to post514. As shown inFIG.5, second intermediate portion526can be wrapped around post514. A pin536can pass through second intermediate portion526to fixedly secure second suture506to post514.

By having second suture506secured to post514, the surgeon can initially secure tissue to a bone, such as bone102, in which anchor502can be implanted. The secured nature of second suture506can allow the surgeon to initially secure tissue, such as tissue112, as disclosed above with respect toFIG.3.

FIG.5shows first suture504located in between second suture506and an interior surface530. This configuration can allow first suture504to move relative to post514and second suture506as disclosed above with respect toFIG.3. Still consistent with embodiments disclosed herein, first suture504can be fixed to post514. For example, pin536can pass through first suture504just as with second suture506. In addition, a second pin (not shown) can pass through first suture504to second suture506.

FIG.6shows a suture anchor construct600in accordance with at least one example of the present disclosure. Suture anchor construct600can include an anchor602, a first suture604, and a second suture606. Anchor602can include a body608that defines a central hole610and a radial hole612. Anchor602can include a post614that extends from a first portion of radial hole612to a second portion of radial hole612. Radial hole612and post614can be located proximate to a leading end of anchor602.

First suture604can include a first tail616, a second tail618, and a first intermediate portion620located in between first tail616and second tail618. Second suture606can include a third tail622, a fourth tail624, and a second intermediate portion626located in between third tail622and fourth tail624.

Consistent with embodiments disclosed herein, first suture604can be free to move about post614as disclosed above with respect toFIG.3.

Second suture606can be secured to post614. As shown inFIG.6, post614can include a protrusion or barb640. Barb640can extend from a distal side of post614. Barb640can include a point that can allow barb640to pierce and pass through second suture606. Still consistent with embodiments disclosed herein, second suture606can be tied to barb640instead of or in addition to being punctured by barb640.

By having second suture606secured to post614, the surgeon can initially secure tissue to a bone, such as bone102, in which anchor602can be implanted. The secured nature of second suture606can allow the surgeon to initially secure tissue, such as tissue112, as disclosed above with respect toFIG.3.

First suture604can move relative to post614and second suture606as disclosed above with respect toFIG.3. Still consistent with embodiments disclosed herein, first suture604can be fixed to post614. For example, barb640can pass through first suture604or first suture604can be tied to barb640just as with second suture606.

FIG.7shows a suture anchor construct700in accordance with at least one example of the present disclosure. Suture anchor construct700can include an anchor702, a first suture704, and a second suture706. Anchor702can include a body708that defines a central hole710and a radial hole712. Anchor702can include a post714that extends from a first portion of radial hole712to a second portion of radial hole712. Radial hole712and post714can be located proximate to a leading end of anchor702.

First suture704can include a first tail716, a second tail718, and a first intermediate portion720located in between first tail716and second tail718. Second suture706can include a third tail722, a fourth tail724, and a second intermediate portion726located in between third tail722and fourth tail724.

First suture704and second suture706can be secured to post714. As shown inFIG.7, post714can define a hole738which can divide post714into two portions. Tails716,718,722, and724can be passed through hole738and wrapped around a distal portion of post714. As shown inFIG.7, first suture704and second suture706can be woven together to further secure first suture and second suture706to the distal portion of post714.

By having first suture704and second suture706secured to post714, the surgeon can initially secure tissue to a bone, such as bone102, in which anchor702can be implanted. The secured nature of first suture704and second suture706can allow the surgeon to initially secure tissue, such as tissue112, to a bone as disclosed above with respect toFIG.3.

FIG.8shows a suture anchor construct800in accordance with at least one example of the present disclosure. Suture anchor construct800can include an anchor802and a first suture804. Anchor802can include a body808that defines a central hole810and a radial hole812. Anchor802can include a post814that extends from a first portion of radial hole812to a second portion of radial hole812. Radial hole812and post814can be located proximate to a leading end of anchor802.

First suture804can include a first tail816, a second tail818, and a first intermediate portion820located in between first tail816and second tail818. While not shown, suture construct800can include a second suture as with other suture constructs disclosed herein.

First suture804can be secured to post814. As shown inFIG.8, post814can define a hole838which can divide post814into two portions. Tails816and818can be passed through hole838and wrapped around a proximal portion of post814. In leu of a knot, a plug840can be inserted into central hole810. Upon insertion of plug840, plug840can become wedged into central hole810. Friction between body808, first suture804and plug840can secure first suture to anchor802.

As disclosed herein, by having first suture804secured to post814the surgeon can initially secure tissue to a bone as disclosed above with respect toFIG.3.

FIG.9shows a suture anchor construct900in accordance with at least one example of the present disclosure. Suture anchor construct900can include an anchor902and a first suture904. Anchor902can include a body908that defines a central hole910and a radial hole912. Anchor902can include a post914that extends from a first portion of radial hole912to a second portion of radial hole912. Radial hole912and post914can be located proximate to a leading end of anchor902.

First suture904can include a first tail916, a second tail918, and a first intermediate portion920located in between first tail916and second tail918. Second suture906can include a third tail922, a fourth tail924, and a second intermediate portion926located in between third tail922and fourth tail924.

First suture904can be secured to second suture906. As shown inFIG.9, first intermediate portion920and second intermediate portion926can be tied together. A knot928formed by tying first suture904and second suture906together can be located at a distal end of post914. The configuration shown inFIG.9allows first suture904and second suture906to move relative to anchor902, but not relative to one another.

FIG.10shows a suture anchor construct1000in accordance with at least one example of the present disclosure. Suture anchor construct1000can include an anchor1002and a first suture1004. Anchor1002can include a body1008that defines a central hole1010and a radial hole1012. Radial hole1012and central hole1010can form an eyelet. The eyelet can be used to secure first suture1004to anchor1002.

First suture1004can include a first tail1016, a second tail1018, and a first intermediate portion1020located in between first tail1016and second tail1018. While not shown, suture construct1000can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture1004can be secured to anchor1002. As shown inFIG.10, first intermediate portion1020can be wrapped around a distal portion of body1008to form a loop that can be located outside of anchor1002. First tail1016and second tail1018can travel back through central hole1010and exit anchor1002. When anchor1002is inserted into bone, first intermediate portion1020can be pinched in between body1008and the bone, thus locking first suture1004in a fixed portion.

FIG.11shows a suture anchor construct1100in accordance with at least one example of the present disclosure. Suture anchor construct1100can include an anchor having a post1114(the anchor body is not shown) and a first suture1104. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture1104can include a first tail1116, a second tail1118, and a first intermediate portion1120located in between first tail1116and second tail1118. While not shown, suture construct1100can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture1104can be secured to the anchor. As shown inFIG.11, first intermediate portion1120can be wrapped around post1114and sewn together. For example, first intermediate portion1120can be wrapped around post1114and another short section of suture1142can pierced through both first tail1116and second tail1118. After piercing first intermediate portion1120, suture1142can be tied into a knot1144to secure first suture1104to post1114.

The number of short sections of sutures1142can equal the number of regular sutures, such as first suture1104, or be different. For example, a single short section of suture1142can pierce any number of regular sutures. In addition, each regular suture or groups of regular sutures can have their own respective short section of suture1142.

FIG.12shows a suture anchor construct1200in accordance with at least one example of the present disclosure. Suture anchor construct1200can include an anchor having a post1214(the anchor body is not shown) and a first suture1204. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture1204can include a first tail1216, a second tail1218, and a first intermediate portion1220located in between first tail1216and second tail1218. While not shown, suture construct1200can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture1204can be secured to the anchor. As shown inFIG.12, first intermediate portion1220can be wrapped around post1214and a tube1250can be used to secure first suture1204to post1214. For example, first intermediate portion1220can be wrapped around post1214and both first tail1216and second tail1218can be fed through tube1250. Tube1250can be tight fitting so as to maintain a position on first tail1216and second tail1218once placed thereon. To secure first suture1204to post1214tube1250can be pushed until it meets post1214.

The number of tubes1250can equal the number of regular sutures, such as first suture1204or be different. For example, a tube1250can be located on any number of regular sutures. In addition, each regular suture or groups of regular sutures can have their own respective tube1250.

Tube1250can be a rubber band type device. The rubber band type device can be attached to both first tail1216and second tail1218. The rubber band type device can pull first tail1216and second tail1218together to prevent them from sliding.

FIG.13shows a suture anchor construct1300in accordance with at least one example of the present disclosure. Suture anchor construct1300can include an anchor1302having a body1308that defines a radial hole1312and a first suture1304.

First suture1304can include a first tail1316, a second tail1318, and a first intermediate portion1320located in between first tail1316and second tail1318. While not shown, suture construct1300can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture1304can be secured to anchor1304. As shown inFIG.13, first suture1304can be passed through radial hole1312. Once anchor1304is implanted into bone, first suture1304can be compressed in between body1308and the bone. The compression of first suture1304can secure first suture1304into a fixed state.

FIG.14shows a suture anchor construct1400in accordance with at least one example of the present disclosure. Suture anchor construct1400can include an anchor having a post1414(the anchor body is not shown) and a first suture1404. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture1404can include a first tail1416, a second tail1418, and a first intermediate portion1420located in between first tail1416and second tail1418. While not shown, suture construct1400can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture1404can be secured to post1414. As shown inFIG.14, first intermediate portion1420can be wrapped around post1414and itself to secure first suture1404to post1414. For example, first intermediate portion1420can be wrapped around post1214and both first tail1216and second tail1218can be fed through loop1452formed by first intermediate portion1420. For instance, first suture1404can be folded in half to create loop1452. Loop1452can then be wrapped around post1414. First tail1416and second tail1418can then be passed through loop1452.

The number of loops1452can equal the number of regular sutures, such as first suture1404. For example, a loop1452can be formed for each regular suture. In addition, one or more regular sutures can be passed through a loop1452formed by a different suture. As a result, a single loop1452can be used to secure one or more sutures to post1414.

FIG.15shows a suture anchor construct1500in accordance with at least one example of the present disclosure. Suture anchor construct1500can include an anchor having a post1514(the anchor body is not shown), a first suture1504, and a second suture1506. Post1514can include a barb1540that protrudes from a distal portion of post1514. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture1504can include a first tail1516, a second tail1518, and a first intermediate portion1520located in between first tail1516and second tail1518. Second suture1506can include a third tail1522, a fourth tail1524, and a second intermediate portion1526located in between third tail1522and fourth tail1544.

First suture1504and second suture1506can be secured to post1514. As shown inFIG.15, first intermediate portion1520can be folded to form a loop1554and a knot1556tied in first suture1504. Second intermediate portion1526can be folded to form a loop1558and a knot1560tied in second suture1506. Loops1554and1558can be placed around barb1540thus, securing first suture1504and second suture1506to the anchor. Knots1556and1560can be hitch knots or slip nots that allow loops1554and1558to collapse onto barb1540to prevent first suture1504and second suture1506from slipping off of barb1540.

FIG.16shows a suture anchor construct1600in accordance with at least one example of the present disclosure. Suture anchor construct1600can include an anchor having a post1614(the anchor body is not shown) and a first suture1604. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture1604can include a first tail1616, a second tail1618, and a first intermediate portion1620located in between first tail1616and second tail1618. While not shown, suture construct1400can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture1604can be secured to post1614. As shown inFIG.16, first intermediate portion1620can wrapped around post1614. After wrapping first intermediate portion1620around post1614, first tail1616can piece second tail1618one or more times to secure first suture1604to post1614. WhileFIG.16shows a single suture, the number of sutures can be greater than one. Each of the sutures can be twisted together to both secure the sutures together and to post1614. In addition, each suture can be twisted separately or in combination with a sub grouping of sutures.

FIG.17shows a suture anchor construct1700in accordance with at least one example of the present disclosure. Suture anchor construct1700can include an anchor1702having a body1708and a post1714and a first suture1704. The anchor can define a central hole1710and a first radial hole1714and a second radial hole1762.

First suture1704can include a first tail1716, a second tail1718, and a first intermediate portion1720located in between first tail1716and second tail1718. While not shown, suture construct1700can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture1704and can be secured to post1714. As shown inFIG.17, first intermediate portion1720can wrap partially around a distal end of post1714and through first radial opening1712. First tail1716and second tail1718can then re-enter central hole1710via second radial passage1762and exit anchor1702. Once anchor1702is implanted in bone1764, first suture1704can be compressed between bone1764and anchor1702.

FIG.18shows a suture anchor construct1800in accordance with at least one example of the present disclosure. Suture anchor construct1800can include an anchor having a post1814(the anchor body is not shown), a first suture1804, and a second suture1806. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture1804can include a first tail1816and a second tail1818tied into a knot1866. Second suture1806can include a third tail1822and a fourth tail1824tied into a knot1868. The size of knots1866and1868are such that they will not fit through a through hole1832. WhileFIG.18shows first suture1804and second suture1806tied individually, first suture1804and second suture1806can be tied together.

FIG.19Ashows a suture anchor construct1900in accordance with at least one example of the present disclosure. Suture anchor construct1900can include an anchor1902, a first suture1904, and a second suture1906. First suture1904can include a first tail1916, a second tail1918, and a first intermediate portion1920located in between first tail1916and second tail1918. Second suture1906can include a third tail1922, a fourth tail1924, and a second intermediate portion1926located in between third tail1922and fourth tail1924.

Anchor1902can be formed from a braided material, such as suture materials. As shownFIG.19B, the braided material can be formed from a plurality of strands1956. Also as shown inFIG.19B, first suture1904and second suture1906can pass in between various strands1954to penetrate anchor1902. To pass first suture1904and second suture1906in between the various strands1954, a snare (not shown) can be used. The snare can include a wire that forms a loop or hook that can first be passed through anchor1902. First suture1904and second suture1906can then be passed through the loop or hook of the snare and pulled through anchor1902.

As shown inFIG.19A, second intermediate portion1926can be tied into a knot1928. Knot1928can secure second suture1906to anchor1902. Knot1928can be bigger than the space between the various strands1954used to form anchor1902. The larger size of knot1928can hinder movement of second suture1906upon implanting anchor1902.

Suture anchor construct1900by passing first suture1904and second suture1906through anchor1902as described herein and forming knot1928to secure second suture1906to anchor1902. Suture anchor construct1900can also be prepared by the manufacturer and delivered with first suture1904and second suture1906already connected to anchor1902with knot1928already formed to secure second suture1906to anchor1902.

During surgery, the surgeon can use an inserter to press anchor1902into a hole drilled into bone. Upon extracting the inserter, anchor1902can remain in the hole and expand, thereby securing anchor1902in the hole. First tail1916, a second tail1918, third tail1922, and a fourth tail1924can extend from the hole for use by the surgeon in securing tissue to the bone.

The various knots disclosed herein can be tied in a variety of fashions. The inserter used to install the anchors can be used to pull the knots tight. For example, a suture can be wrapped around the end of the inserter and pushed through a gap such as the central passage in the trailing end the anchor. The suture can include a pre-tied, but loose, knot located at the end of the inserter that is tightened using the inserter. Tightening the knot can create a suture anchor construct that is larger than the central passage in the anchor that the suture and inserter shaft are pushed through. The inserter can then be removed and the suture tied inside the anchor, unable to slide.

It will be readily understood to those skilled in the art that various other changes in the details, material, and arrangements of the parts and method stages which have been described and illustrated in order to explain the nature of the inventive subject matter can be made without departing from the principles and scope of the inventive subject matter as expressed in the subjoined claims.