Locking ferrules with side wall eyelets for performing tensionable knotless surgical procedures

Abstract

Systems and methods are provided for performing tensionable knotless tissue repairs. A locking ferrule that includes a one-way locking mechanism may be utilized as part of the tensionable knotless tissue repairs for tensioning and locking one or more strands of suture. The one-way locking mechanism may be established by one or more locking barbs of the locking ferrule. The locking ferrule may further include one or more eyelets for accommodating the suture.

Description

LOCKING FERRULES WITH SIDE WALL EYELETS FOR PERFORMING TENSIONABLE KNOTLESS SURGICAL PROCEDURESInventors:Andrew Christian Petry Philipp MoroderTodd W. BarrettCarlson, Gaskey & Olds 400 W. Maple Road, Suite 350Birmingham, MI 48009(248) 988-8360LOCKING FERRULES WITH SIDE WALL EYELETS FOR PERFORMING TENSIONABLE KNOTLESS SURGICAL PROCEDURESCROSS-REFERENCE TO RELATED APPLICATIONS[oooi] This application claims priority to United States Patent Application No. 18 / 421,589, filed January 24, 2024, which claims the benefit of United States Provisional Application No. 63 / 623,006, filed January 19, 2024, the disclosures of which are incorporated herein by reference in their entirety.BACKGROUND

[0002] This disclosure relates to the field of surgery, and more particularly to a locking ferrule that includes an integrated side wall eyelet for accommodating suture. The locking ferrule is configured for locking the suture when performing a variety of tensionable knotless tissue repairs.

[0003] Repetitive trauma to a joint, such as a knee, ankle, hip, or shoulder joint, for example, may result in the development of tissue defects (e.g., soft tissue tears, cartilage defects, etc.). If not treated, tissue defects could further deteriorate, thereby causing joint instability and discomfort.SUMMARY

[0004] This disclosure relates to systems and methods for performing tensionable knotless tissue repairs. A locking ferrule that includes a one-way locking mechanism may be utilized during the tensionable knotless tissue repairs for tensioning and locking one or more strands of suture.[ooos] An exemplary locking ferrule for performing tissue repairs may include, inter alia, a body extending between a first end and a second end and including an outer diameter wall, an inner diameter wall, and a cannulation that is circumscribed by the inner diameter wall. An eyelet is connected to the body. A plurality of locking barbs extend into the cannulation and are configured to lock a suture that is received through the eyelet and the cannulation relative to the body.

[0006] An exemplary surgical method may include, inter alia, loading a suture through an eyelet of a locking ferrule, passing the suture through or around a tissue, and locking the suture relative to the locking ferrule after passing the suture through or around the tissue.

[0007] The embodiments, examples, and alternatives of the preceding paragraphs, the claims, or the following description and drawings, including any of their various aspects or respective individual features, may be taken independently or in any combination. Features described in connection with one embodiment are applicable to all embodiments, unless such features are incompatible.

[0008] The various features and advantages of this disclosure will become apparent to those skilled in the art from the following detailed description. The drawings that accompany the detailed description can be briefly described as follows.BRIEF DESCRIPTION OF THE DRAWINGS

[0009] Figure 1 illustrates a locking ferrule that can be used for performing various tensionable knotless tissue repairs.[oooio] Figure 2 is an end view of the locking ferrule of Figure 1.[oooii] Figure 3 is a cross-sectional view through section 3-3 of Figure 2.

[0012] Figure 4 schematically illustrates loading a suture through a locking ferrule.[oooi3j Figure 5 schematically illustrates locking a suture relative to a locking ferrule.

[0014] Figure 6 illustrates another exemplary locking ferrule.[ooois] Figure 7 schematically illustrates a surgical method for performing a tissue repair.

[0001] Figure 8 schematically illustrates another surgical method for performing a tissue repair.DETAILED DESCRIPTION

[0017] This disclosure relates to systems and methods for performing tensionable knotless tissue repairs. A locking ferrule that includes a one-way locking mechanism may be utilized during the tensionable knotless tissue repairs for tensioning and locking one or more strands of suture. These and other features of this disclosure are described in further detail below.[ooois] An exemplary locking ferrule for performing tissue repairs may include, inter alia, a body extending between a first end and a second end and including an outer diameter wall, aninner diameter wall, and a cannulation that is circumscribed by the inner diameter wall. An eyelet is connected to the body. A plurality of locking barbs extend into the cannulation and are configured to lock a suture that is received through the eyelet and the cannulation relative to the body.

[0019] In any further embodiment, the eyelet is integrally formed with the body.

[0020] In any further embodiment, the body is made of a first material, and the eyelet is made of a second material that is different from the first material.

[0021] In any further embodiment, the second material includes suture.

[0022] In any further embodiment, the eyelet is connected to the outer diameter wall of the body.

[0023] In any further embodiment, the eyelet includes a band that connects to the outer diameter wall and a suture passage that extends between the band and the outer diameter wall.

[0024] In any further embodiment, the suture is looped around the band.

[0025] In any further embodiment, the plurality of locking barbs are angled in a direction toward the second end.

[0026] In any further embodiment, the suture includes a varying thickness.

[0027] In any further embodiment, the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

[0028] In any further embodiment, the plurality of locking barbs each protrude inwardly from the inner diameter wall.

[0029] In any further embodiment, the plurality of locking barbs are arranged in at least a first row and a second row.

[0030] In any further embodiment, a first portion of the plurality of locking barbs of the first row are staggered relative to a second portion of the plurality of locking barbs of the second row.

[0031] An exemplary surgical method may include, inter alia, loading a suture through an eyelet of a locking ferrule, passing the suture through or around a tissue, and locking the suture relative to the locking ferrule after passing the suture through or around the tissue.

[0032] In any further embodiment, locking the suture relative to the locking ferrule includes passing the suture through a cannulation of the locking ferrule, tensioning the suture in afirst direction, and locking the suture within the cannulation to prevent movement of the suture in a second direction.

[0033] In any further embodiment, the suture is passed through or around the tissue prior to passing the suture through the cannulation of the locking ferrule.

[0034] In any further embodiment, loading the suture through the eyelet includes passing the suture through a suture passage that extends between a band of the eyelet and an outer diameter wall of the locking ferrule.

[0035] In any further embodiment, loading the suture through the eyelet includes arranging the suture around the eyelet and a second eyelet of the locking ferrule.

[0036] Figures 1-5 illustrate an exemplary locking ferrule 10 that can be used when performing various tensionable knotless tissue repairs. For example, the locking ferrule 10 could be utilized during surgical methods for attaching tissue (e.g., ligament, tendon, graft, etc.) to bone, for repairing bone fractures as part of a cerclage technique, for performing tissue reconstruction procedures (e.g., ACL / PCL reconstructions), or for repairing any other type of tissue effect.

[0037] The locking ferrule 10 may include a body 12 that extends along a longitudinal axis A between a first end 14 and a second end 16. The body 12 may be tubular shaped and may be constructed from either metallic materials or plastic materials. However, the specific size, shape, and material make-up of the body 12 are not intended to limit this disclosure.[ooo38j A cannulation 18 may extend through the body 12 and may establish an internal passageway for accommodating one or more strands of suture (see, for example, suture 20 shown in Figures 4 and 5). The cannulation 18 may extend across an entire length of the body 12 and thus extends from the first end 14 to the second end 16. The longitudinal axis A may bisect the cannulation 18.

[0039] The body 12 may include an outer diameter wall 22 and an inner diameter wall 24. The outer diameter wall 22 may be smooth or could alternatively include threads, barbs, or other features for facilitating bone fixation. The inner diameter wall 24 may circumscribe the cannulation 18. In some embodiments, the cannulation 18 may taper in a direction toward either the first end 14 or the second end 16.

[0040] A plurality of locking barbs 26 may protrude inwardly from the inner diameter wall 24. The locking barbs 26 may therefore occupy at least a portion of the open space of the cannulation 18. In an embodiment, the locking barbs 26 are integrally formed (e.g., molded)features of the body 12 of the locking ferrule 10. The locking barbs 26 may be provided along an entire length of the cannulation 18 or at only select portions thereof. The locking barbs 26 may be either rigid or flexible structures.

[0041] The locking barbs 26 may be arranged in multiple rows along the length of the cannulation 18. For example, the locking barbs 26 may be arranged in a least a first row R1 and a second row R2 (see Figure 3). In an embodiment, the locking barbs 26 of the second row R2 are staggered relative to the locking barbs 26 of the first row R1 (see Figure 3).

[0042] Each locking barb 26 may include a sharp or pointed tip 28, and, in this implementation, each locking barb 26 may be angled in a direction toward the second end 16. The locking barbs 26 may therefore establish a one-way locking mechanism that permits one or more sutures 20 to pass through the cannulation in a first direction DI while preventing the suture(s) 20 from being tensioned or otherwise moved in a second direction D2. The staggered relationship of the rows of locking barbs 26 may provide for maximum engagement with the suture 20 once it is passed through the cannulation 18.

[0043] The locking ferrule 10 may additionally include one or more eyelets 30. hi an embodiment, the locking ferrule 10 includes a pair of eyelets 30 that are provided on diametrically opposite sides of the body 12 (see Figures 1-5). In another embodiment, the locking ferrule 10 includes a single eyelet 30 (see Figure 6). Other configurations, including configurations with greater than two eyelets, are contemplated within the scope of this disclosure.

[0044] Each eyelet 30 may include a band 32 that is attached or integrally formed with the body 12 of the locking ferrule 10. The band 32 may be made of the same material or a different material (e.g., suture) as / from the body 12. In an embodiment, the band 32 is connected directly to the outer diameter wall 22 of the body 12 and therefore provides a side wall eyelet of the locking ferrule 10. An open space extending between the band 32 and the second end 16 of the body 12 may establish a suture passage 34 of the eyelet 30.

[0045] Referring now primarily to Figures 4 and 5, with continued reference to Figures 1- 3, one or more sutures 20 may be loaded through the eyelets 30 and then passed through the cannulation 18 of the locking ferrule 10. The suture 20 may be FiberWire®, FiberTape®, or any other suitable suture product. FiberWire® and FiberTape® are suture products marketed and sold by Arthrex, Inc. However, other suture products could be utilized for the suture 20 within the scopeof this disclosure. The size and type of suture utilized in conjunction with the locking ferrule 10 are not intended to limit this disclosure.

[0046] The suture 20 may include a varying thickness. The suture 20 may therefore include one or more tapered regions 50 where the suture 20 transitions between a thickened section 52 and a thinned section 54. In an embodiment, the thickened sections 52 are about twice as thick as the thinned sections 54. However, other ratios (e.g., 1.5:1, 3:1, etc.) between the relative thicknesses (e.g., outer diameters) of the thickened section 52 and the thinned section 54 are contemplated within the scope of this disclosure.

[0047] The one or more sutures 20 may be accommodated within the suture passages 34 such that the suture 20 is looped around the bands 32 of the eyelets 30. The suture 20 may then be inserted into the cannulation 18 at the first end 14 of the body 12 and be passed through the cannulation 18. The suture 20 may be passed through the cannulation 18 of the locking ferrule 10 using a suture loader 56. An eyelet 58 of the suture loader 56 may be passed through the cannulation 18 (e.g., by inserting the eyelet 58 at the second end 16 of the body 12 and then moving the suture loader 56 in the second direction D2). One or more thinned sections 54 of the suture 20 may then be loaded through the eyelet 58. The suture loader 56 may then be pulled, via a handle 60, in the first direction DI to shuttle the suture 20 through the cannulation 18.

[0048] Once the suture 20 has been passed through the cannulation 18, the suture 20 may be further tensioned in the first direction DI to tension and lock the thickened sections 52 of the suture 20 in place relative to the locking ferrule 10. The locking barbs 26 prevent the suture 20 from backing up or otherwise moving in the second direction D2. The pointed tips 28 of the locking barbs 26 may interdigitate with the suture 20 to lock the suture 20 and prevent it from moving in the second direction D2.

[0049] Although shown as locking a single folded suture 20 in the above implementations, the locking ferrule 10 could be configured to receive and lock single strands of unfolded suture, multiple strands of suture, and / or sutures of varying shapes and sizes.[oooso] The locking ferrules 10 described above and shown in Figures 1-6 may be utilized to tension and knotlessly fixate one or more sutures 20 as part of various surgical methods. Figure 7 schematically illustrates one such surgical method for repairing a fractured bone 70 as part of a cerclage technique. For example, the suture 20 may first be accommodated through the eyelet(s) 30 of the locking ferrule 10 and may then be wrapped around the fractured bone 70. The suture 20may then be inserted into the first end 14, passed through the cannulation 18 in a direction toward the second end 16, and then tensioned to lock the suture 20 in place, thereby creating a cerclage for allowing the fractured bone 70 to properly heal.[ooosi] Figure 8 schematically illustrates another exemplary surgical method that could benefit from the use of the locking ferrule 10. For example, the locking ferrule 10 may be used to perform a side-to-side repair within a tissue 72, such as when repairing a tom tissue or closing a wound. For example, the suture 20 may be accommodated through the eyelet(s) 30 and then be passed through or around the tissue 72 one or more times. The suture 20 may then be passed through the cannulation 18 in a direction that extends from the first end 14 toward the second end 16 and then tensioned to lock the suture 20 in place and thereby complete the side-to-side repair.

[0052] The locking ferrules of this disclosure may be utilized for performing various tensionable knotless tissue repairs. The locking ferrules provide for tensioning and retensioning suture(s) at various points of the tissue repair, including subsequent to implantation of the ferrule, thus providing numerous advantages over prior tissue repair techniques.

[0053] Although the different non-limiting embodiments are illustrated as having specific components or steps, the embodiments of this disclosure are not limited to those particular combinations. It is possible to use some of the components or features from any of the non-limiting embodiments in combination with features or components from any of the other non-limiting embodiments.

[0054] It should be understood that like reference numerals identify corresponding or similar elements throughout the several drawings. It should further be understood that although a particular component arrangement is disclosed and illustrated in these exemplary embodiments, other arrangements could also benefit from the teachings of this disclosure.

[0055] The foregoing description shall be interpreted as illustrative and not in any limiting sense. A worker of ordinary skill in the art would understand that certain modifications could come within the scope of this disclosure. For these reasons, the following claims should be studied to determine the true scope and content of this disclosure.

Claims

CLAIMSWhat is claimed is:

1. A locking ferrule for performing tissue repairs, comprising: a body extending between a first end and a second end and including an outer diameter wall, an inner diameter wall, and a cannulation that is circumscribed by the inner diameter wall; an eyelet connected to the body; and a plurality of locking barbs extending into the cannulation and configured to lock a suture relative to the body when the suture is received through the cannulation.

2. The locking ferrule as recited in claim 1, wherein the eyelet is integrally formed with the body.

3. The locking ferrule as recited in claim 1 or 2, wherein the body is comprised of a first material, and the eyelet is comprised of a second material that is different from the first material.

4. The locking ferrule as recited in claim 3, wherein the second material includes suture.

5. The locking ferrule as recited in any preceding claim, wherein the eyelet is connected to the outer diameter wall of the body.

6. The locking ferrule as recited in claim 5, wherein the eyelet includes a band that connects to the outer diameter wall and a suture passage that extends between the band and the outer diameter wall.

7. The locking ferrule as recited in claim 6, wherein the suture is looped around the band.

8. The locking ferrule as recited in claim 5, comprising a second eyelet connected to the outer diameter wall of the body.

9. The locking ferrule as recited in claim 8, wherein the eyelet and the second eyelet are located at diametrically opposite portions of the body.

10. The locking ferrule as recited in any preceding claim, wherein the plurality of locking barbs are angled in a direction toward the second end.

11. The locking ferrule as recited in any preceding claim, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

12. The locking ferrule as recited in any preceding claim, wherein the plurality of locking barbs each protrude inwardly from the inner diameter wall.

13. The locking ferrule as recited in claim 12, wherein the plurality of locking barbs are arranged in at least a first row and a second row.

14. The locking ferrule as recited in claim 13, wherein a first portion of the plurality of locking barbs of the first row are staggered relative to a second portion of the plurality of locking barbs of the second row.

15. A surgical method, comprising: loading the suture through the eyelet of the locking ferrule of claim 1 ; passing the suture through or around a tissue; and locking the suture relative to the locking ferrule after passing the suture through or around the tissue.

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