Locking suture construction

Abstract

A locking suture construction comprises: a fixing ring for fixing a first body in position relative to a second body; wherein the fixing ring comprises a fourth branch and a first branch having a constraining member; a positioning ring for fixing the constraining member in a first position relative to the first body; wherein the positioning ring comprises a second branch and a third branch; the first branch and the second branch pass through the constraining member and form a locking ring; and wherein the size of the positioning ring is configured to be reduced, and the constraining member is configured to move toward the first body by pulling the third branch in a direction away from the positioning ring and the constraining member.

Description

[0001] This application is a divisional application of the invention application with the application date of June 7, 2018, application number 201880052666.8, and name “Locking Suture Structure”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims priority to and the benefit of U.S. non-provisional patent application No. 15 / 630,215, filed June 22, 2017, which claims priority to and the benefit of provisional patent application No. 62 / 518749, filed June 13, 2017. Technical Field

[0004] The present invention relates to an adjustable locking structure for fixing two bodies at a surgical / repair site, and more particularly, to an adjustable suture loop structure for fixing the relative positions of two bodies at a surgical / repair site. Background Art

[0005] In orthopedic surgery, sutures with either traditional knotted or unstructured constructions are often used to reduce and secure two bodies. Once the suture is tied around the two bodies, the ends of the suture are either formed into a traditional knot or held in place by an unstructured construction to maintain the suture at a fixed length around the two bodies and capable of supporting loads. Traditional knots rely on a tight, tortuous path formed by pulling on the branches of the suture material to prevent the suture loop from growing under load. However, once the knot is constructed, it cannot be repositioned using the two available suture ends. The construction is often positioned so that other bodies can contact the knot, which can cause it to come loose. Furthermore, if other bodies contact the knot, the knot may irritate surrounding tissue.

[0006] Structureless constructions are used to improve knots, offering the ability to be quickly constructed and reduced in size. The reduced size of structureless constructions can limit any risk of potential irritation to the subject while maintaining strength. Structureless constructions typically rely on another clamping body separate from the suture, such as a "finger clamp" mechanism, or tension between the two bodies to provide pressure on the suture, or a combination of these factors to prevent the suture loop from growing under load. The clamping body increases the complexity of the construction and adds another point of failure. The "finger clamp" mechanism requires tension along the entire axis of the "finger clamp", and if tension is not maintained along the entire axis, it may slip. The load changes between the two bodies may fluctuate, or significant tension between the two bodies may be undesirable and make pressure on the suture ineffective in preventing the suture from slipping. Although smaller in size than traditional knots, structureless constructions often have a larger surface area, which may cause irritation.

[0007] Related Art Section Disclaimer Description: With respect to specific patents / publications / products discussed above in the Related Art Section or elsewhere in this disclosure, such discussion should not be considered 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 that was developed early enough in time, and / or may not be sufficient to achieve prior art equivalents for patent law purposes. With respect to specific patents / publications / products discussed above in the Related Art Section and / or throughout this application, their descriptions / disclosures are incorporated herein by reference in their respective entireties. Summary of the Invention

[0008] Embodiments of the present invention recognize that conventional knotted or knotless suture configurations present potential problems and / or disadvantages. For example, knotted and knotless configurations may be large enough to cause irritation without requiring a means for repositioning. Therefore, there is a need for a simple, easy-to-use locking suture configuration having a means for repositioning, tightening, and loosening the configuration without releasing its tension. Various embodiments of the present invention may be advantageous because they may address or reduce one or more of the potential problems and / or disadvantages discussed herein.

[0009] The present disclosure relates to the inventive configuration, structure, and resulting functionality of an adjustable locking suture construction comprising: a suture material having a first end and a second end, each of the first end and the second end being slidably attached to a first body; a constraining member formed in the second end of the suture material; and a loop between the first and second ends of the suture material. A locking loop in the suture material is formed when the loop passes through the constraining member around the second body.

[0010] When using the locking suture configuration, a retaining ring secures the first body in position relative to the second body. The retaining ring includes a fourth branch and a first branch. A positioning ring secures the restraining member in a first position relative to the first body. The positioning ring includes a second branch and a third branch. The fourth branch includes the restraining member. The first and second branches pass through the restraining member and form a locking ring.

[0011] According to another aspect, a method for securing a first body in position relative to a second body includes (but is not limited to) the following steps: providing a locking suture structure having: a suture material having a first end and a second end, the first end and the second end both being slidably attached to the first body; a restraining member formed in the second end of the suture material; and a loop between the first end and the second end of the suture material; pulling the loop through the restraining member around the second body to form a locking loop; passing the first and second ends of the suture material through the locking loop; pulling the locking loop while maintaining the first end of the suture material in a fixed position to increase the circumference of the locking loop to a first predetermined size; pulling the first end to reduce the circumference of the locking loop to a second predetermined size that is smaller than the first predetermined size; and after the locking loop reaches the second predetermined size, moving or rotating the restraining member through the second body toward the first body to a first position after the locking loop reaches the second predetermined size.

[0012] As used and described herein, the term "suture material" or "suture" includes monofilament or multifilament suture and any other metallic or non-metallic filamentous or thread-like material suitable for performing a suturing function. Such materials may include bioabsorbable and nonabsorbable materials. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] A more complete understanding and appreciation of the invention will be gained from the following detailed description read in conjunction with the accompanying drawings, which illustrate only typical embodiments of the disclosed subject matter and are therefore not to be considered limiting of its scope, for the disclosed subject matter may admit to other equally effective embodiments.

[0014] Reference will now be made briefly to the accompanying drawings, in which:

[0015] Figure 1 is a perspective schematic illustration of a locking suture construction with an anchor according to one embodiment;

[0016] Figure 2 is a perspective schematic illustration of a locking suture construction with an anchor according to an alternative embodiment;

[0017] Figure 3A is an enlarged perspective schematic diagram of a restraining member configuration of an adjustable restraining member according to one embodiment;

[0018] Figure 3B is an enlarged perspective schematic diagram of a restraining member configuration of an adjustable restraining member according to one embodiment;

[0019] Figure 3C is an enlarged perspective schematic diagram of a locking joint restraint member configuration according to one embodiment;

[0020] Figure 3D is a device according to one embodiment having a reduced locking ring Figure 3C An enlarged perspective schematic diagram of a locking joint restraint member structure;

[0021] Figure 3E According to an embodiment Figure 17 An enlarged perspective schematic diagram of a fixed restraining member;

[0022] Figure 3F is an enlarged perspective schematic diagram of the configuration of an adjustable restraining member according to one embodiment;

[0023] Figure 3G is an enlarged perspective schematic diagram of the configuration of an adjustable restraining member according to one embodiment;

[0024] Figure 4 According to an embodiment Figure 1 A schematic side view of a locking suture configuration shown loaded onto an insert;

[0025] Figure 5 According to one embodiment, an anchor is implanted in a bone hole. Figure 1 A schematic side view of the locking suture construction is shown;

[0026] Figure 6 According to one embodiment, the Figure 5 A perspective schematic diagram of the control lines of the constraining members of the tissue shown;

[0027] Figure 7 is a perspective schematic diagram of a locking loop formed in a suture material according to one embodiment;

[0028] Figure 8 is a device according to one embodiment having a reduced restraining member Figure 7 A perspective diagram of the locking suture structure;

[0029] Figure 9 According to one embodiment, Figure 7 a perspective schematic diagram of a first end and a second end of a locking loop of suture material;

[0030] Figure 10 is according to one embodiment similar to Figure 9 An expanded perspective diagram of the locking suture structure;

[0031] Figure 11 is a perspective schematic illustration of a reduced constraining member in close proximity to tissue according to one embodiment;

[0032] Figure 12 is a device according to one embodiment having a reduced locking ring Figure 11 An expanded perspective diagram of the locking suture structure;

[0033] Figure 13 According to an embodiment Figure 12 A top perspective diagram of a locking suture structure;

[0034] Figure 14 is a perspective schematic diagram of a constraining member and a locking ring rotated toward an anchor according to one embodiment;

[0035] Figure 15 According to an embodiment Figure 14 A top perspective diagram of a locking suture structure;

[0036] Figure 16 According to one embodiment, the redundant portions of the first and second ends are cut off. Figure 14 A perspective diagram of the locking suture structure;

[0037] Figure 17 is a perspective schematic diagram of a locking suture construction having a threader passing through a fixed constraining member according to an alternative embodiment;

[0038] Figure 18 is a perspective schematic diagram of a control wire being pulled through an eyelet of a threader according to an alternative embodiment;

[0039] Figure 19 is a perspective schematic diagram of a wire threader for pulling a control wire through a fixed restraining member according to an alternative embodiment;

[0040] Figure 20 is a perspective schematic illustration of a locking loop formed by pulling a control wire through a fixed restraining member according to an alternative embodiment; and

[0041] Figure 21 is a top perspective schematic illustration of a locking suture construction having a locking tab construction as a constraining member according to an alternative embodiment. DETAILED DESCRIPTION

[0042] Referring now to the drawings, wherein like numerals refer to like parts throughout, Figure 1 An illustrative embodiment of a locking suture construction 10 having a slidably attached suture anchor 2 is seen in FIG. In the illustrative embodiment discussed herein, the purpose of the locking suture construction 10 is to secure the suture anchor 2 in place relative to the tissue 18 by means of a securing ring 30 having a fixed size and tension, such as, for example, Figure 14 (described further below), where the suture anchor 2 can represent a first body (B) and the tissue 18 can represent a second body (A) (see, e.g., Figure 15 ).

[0043] According to various embodiments, the first body (B) may be Figure 1 and Figure 2 The suture anchor shown, a surgical button (for example, ACL repair), or a bone such as the coracoid process (for example, bone-to-bone or bone-to-soft tissue fixation), provided that the locking suture construct 10 can be attached to the first body (B) in an adjustable (e.g., slidable) manner. Figure 1 In the depicted embodiment, for example, the suture anchor 2 can be a full suture anchor, such as Anchor (as one of ordinary skill in the art would understand and appreciate upon review of this disclosure). Figure 2 In the alternative embodiment shown, the suture anchor 2 can be a rigid suture anchor such as Anchor or Anchor (as will be understood and appreciated by one of ordinary skill in the art in conjunction with a review of this disclosure). Similarly, the second body (A) may be, for example Figure 14 , or tendons, bone blocks, or bones such as the clavicle (as will be understood and appreciated by one of ordinary skill in the art in conjunction with a review of this disclosure). Despite these examples, the structure, configuration, use, and function of the embodiments of the locking suture construction 10 described herein are not dependent on the details of the first body (B) and the second body (A). In other words, the first body (B) and the second body (A) can be any two objects, and the locking suture construction 10 can generally be constructed, configured, and function in the same manner as described herein.

[0044] Re-reference Figure 1 , the locking suture construction 10 may include a length of suture material 6 having a first end or first strand 12 and a second end or second strand 13. As shown, the suture material 6 may be passed through the loop 8 in the control line 11 and then through the suture anchor 2 (at Figure 1 The first and second ends 12, 13 of the suture material 6 are preferably relatively equal in length and parallel. Alternatively, any similar instrument (or no instrument at all, for example, the user's fingers) can be used in place of the control line 11 and the loop 7 formed in the suture material 6 can be grasped or gripped (see, for example, FIG. Figure 1 、 Figure 2 、 Figure 4 、 Figure 5 、 Figure 6 、 Figure 7 、 Figure 8 、 Figure 9 、 Figure 10 、 Figure 11 、 Figure 17 、 Figure 18 、 Figure 19 、 Figure 21The wire loop 7 shown in FIG. 1 is used to perform all the functions of the control wire 11 described herein and below (such as a clamp, a hooked device, or any other grasping or clamping device that a person skilled in the art would understand upon review of this disclosure).

[0045] The locking suture construction 10 may also include a constraining member, which may be fixed or adjustable. As further described below and shown in the accompanying drawings, each embodiment of the constraining member is formed as part of a structural intersection through which the other portions of the suture 6 and the control line 11 or threader 21 pass. Each constraining member embodiment is configured to move along / rotate around the securing ring 30 to an optimal position determined by the user, i.e., the medical professional (e.g., comparing Figure 12 and Figure 14 The positioning of the constrained components in Figure 13 and Figure 15 The constraining member may be formed as follows: Figures 3A to 3B The adjustable locking joint / constraint member 20 shown, as Figures 3C to 3D The alternative adjustable restraining member 20 ' shown, Figure 3E The fixed restraining member 20" shown in FIG. Figures 3F to 3G Another alternative adjustable restraining member 20'' is shown, or any other similar closed boundary component (as will be understood and appreciated by one of ordinary skill in the art in conjunction with a review of this disclosure).

[0046] Steering Figures 3A to 3B , shows a schematic diagram of an adjustable constraining member 20. The adjustable constraining member 20 is formed by a loop formed by the second end 13 (or portion 4) of the suture material 6 passing through itself in one direction or the other. Figure 3A The illustrated embodiment is configured so that the second end 13 is moved (pulled) to the right to reduce the size of the aperture formed by the adjustable restraining member 20 . Figure 3B The embodiment shown is configured so that portion 4' moves to the right to reduce the size of the aperture formed by the adjustable restraining member 20. The adjustable restraining member 20 is an embodiment of a restraining member used in certain example figures illustrating the use and function of the restraining member, which will be described in further detail below.

[0047] Steering Figures 3C to 3D , shows a schematic diagram of a locking joint 20 ′. The locking joint 20 ′ is a fixed constraining member and is formed by a length of hollow circular suture 23 between voids 25 in the wall of a length of the hollow circular suture.

[0048] Go to Figure 3E, a schematic diagram of another fixed constraining member 20 ″ is shown. The fixed constraining member 20 ″ is formed by portions of hollow circular interwoven suture material 23 between portions of flat interwoven suture material 24 .

[0049] Steering Figures 3F to 3G , a schematic diagram of another adjustable constraining member 20'' is shown. The adjustable constraining member 20'' is formed by a loop formed by the second end 13 of the suture material 6 passing through a portion of the circular suture material 23 between portions of the flat suture material 24. As with the adjustable constraining member 20', the circumference of the adjustable constraining member 20'' decreases when the threaded suture material segment (the threaded branch 4 or the second end 13) is pulled.

[0050] Now refer to Figure 4 , shows an illustrative embodiment of a locking suture structure 10 loaded on a suture anchor insert 14. The suture anchor 2 is loaded on an insert 14 such as 14 and the locking suture construct 10 are shown in an anterior bone mounting position and configuration with the control wire 11 and the first end 12 both on the first side of the insert 14. However, in this position and configuration, the control wire 11 and the second end 13 may alternatively be on the second side of the insert 14.

[0051] Once the locking suture structure 10 is loaded onto the inserter 14, the inserter 14 can be used to implant the suture anchor 2 into a bone hole 26 formed in the bone 16, as shown in FIG. Figure 5 In the illustrated embodiment, the suture anchor 2 is placed within the bone hole 26 such that the first end 12 of the suture material 6 and the control line 11 are on a first side of the tissue 18. As similarly described above, the control line 11 and the second end 13 of the suture material 6 may alternatively be on a second side of the tissue 18.

[0052] Figures 6 to 16 The steps of using the locking suture structure 10 to change and fix the relative distance between the suture anchor 2 and the tissue 18 are depicted. Figure 6 In the embodiment depicted, the control wire 11 is fed through the restraining member 20. As shown in the depicted embodiment, the control wire 11 is fed through the restraining member 20 formed on the second end 13 located above the tissue 18. Then, as shown in FIG. Figure 7As shown, control wire 11 and loop 8, along with a portion of suture material 6, are pulled completely through constraining member 20, thereby forming locking loop 15 with the portion of suture material 6 pulled through constraining member 20. As the circumference of locking loop 15 increases by continued pulling of control wire 11, constraining member 20 is configured to move toward tissue 18.

[0053] Although shown expanded for clarity, upon pulling on the second end 13 (e.g. Figure 8 upward direction as shown), Figure 7 The restraining member 20 in the embodiment preferably substantially surrounds the locking ring 15, as Figure 8 Next, now refer to Figure 9 , the first end 12 and the second end 13 of the suture material 6 pass through the locking ring 15. Figure 10 The first and second ends 12, 13 of the locking ring 15 are depicted being pulled through, with the restraining member 20 shown in a deployed configuration for clarity in illustrating the position of each referenced component.

[0054] Now refer to Figure 11 , the first end 12 and the second end 13 are shown as being passed through the locking ring 15, which has been previously enlarged, thereby moving the restraining member 20 against the tissue 18 as described above. With the restraining member 20 very close to the tissue 18, the first end 12 is pulled to reduce the circumference of the locking ring 15 to a minimum circumference, as shown. Figure 12 and Figure 13 As the locking ring 15 is reduced, the locking ring 15 squeezes, clamps, or "tightens" the first end 12 and the second end 13 to obtain a minimum working perimeter (in this case, for example, the inner surface of the locking ring 15 preferably fully contacts and applies pressure to the first end 12 and the second end 13; and / or in this case, the inner surface of the locking ring 15 squeezes downward to a point where, if 1' and 2' are pulled individually / separately, they will not freely or easily move / slide through the restraining member 20 (see, for example, FIG. Figure 3D ), as will be understood by one of ordinary skill in the art upon review of this disclosure. Preferably, tension on control line 11 is maintained while locking ring 15 is reduced (by pulling on first end 12) until locking ring 15 has a minimum working circumference. Once locking ring 15 reaches the minimum working circumference, retaining ring 30 is configured to maintain its size and tension around first body (B) and second body (A).

[0055] refer to Figures 14 and 15 If the first end 12 is continuously pulled after the locking ring 15 has reached its minimum circumference, the constraining member 20 is configured to begin to move / rotate toward the suture anchor 2 (while the retaining ring 30 is preferably still configured to maintain its size and tension). Figures 14 and 15 As shown, respectively Figure 12 and Figure 13 In contrast, the first end 12 can be pulled to move / rotate the constraining member 20 about the tissue 18 (from Figure 12 and Figure 13 As the first end 12 is pulled, the positioning loop 40 becomes smaller ( Figure 13 and Figure 15 The restraining member 20 may be of relatively bulky construction, and the user may prefer to move the restraining member 20 toward the first body (B) (within the bone hole 26) in a position that is less irritating to the patient. Finally, excess suture material 6 from the first end 12 and the second end 13 may be cut away near the bone 16 to produce a Figure 16 The final result of the locking suture construction 10 around tissue 18 (second body (A)) and suture anchor 2 (first body (B)) in a retrobone mounted position and configuration is shown. Thus, the tissue 18 is held in position relative to the suture anchor 2 by the locking suture construction 10. The relative position is ultimately secured by two rings: a securing ring 30 and a positioning ring 40. The securing ring 30 holds the tissue 18 (second body (A)) in position relative to the suture anchor 2 (first body (B)), while the positioning ring 40 holds the constraining member 20 in the desired position, thereby reducing irritation and trauma.

[0056] However, if the constraining member 20 moves or rotates to an undesirable or non-optimal position relative to the tissue 18 and the suture anchor 2, the locking suture construction 10 can be repositioned as long as the first end 12 and the second end 13 have not been cut. To reposition the locking suture construction 10, the control wire 11 is pulled, and the constraining member 20 moves / rotates away from the suture anchor 2 and back toward the tissue 18. As the constraining member 20 moves / rotates, the circumference of the locking ring 15 increases (essentially performing the above-referenced steps in reverse order). This allows the locking suture construction 10 to be repositioned in a desired area, for example, in an area where the constraining member 20 will cause less irritation or trauma to the surrounding tissue or bone. According to an alternative embodiment, the second end 13 can be pulled instead of the control wire 11 to achieve the same result as discussed in this paragraph.

[0057] exist Figures 17 to 20 In the illustrated alternative embodiment, the illustrated constraining member of the locking suture construction 10' is not adjustable, but rather is a fixed constraining member used in conjunction with the threader 21 (e.g., Figure 3E The fixed restraining member 20" is shown).

[0058] Next reference Figure 18, the threader 21 is shown inserted through the hollow portion 23 of the fixed constraint member 20". The eyelet 22 of the threader 21 extends through the fixed constraint member 20. As shown in the depicted embodiment, the control line 11 is pulled through the eyelet 22 of the threader 21. Thereafter, with reference to Figure 19 , the threader 21 is pulled away from the fixed constraint member 20 so that the eyelet 22 holding the control line 11 is completely pulled through the fixed constraint member 20. Figure 8 As shown and described, Figure 20 Depicted is the control wire 11 being pulled through the restraining member 20 to form the locking loop 15. Figures 8 to 16 The steps shown and described are equally applicable to the alternative embodiment of the fixed restraint member 20".

[0059] Re-reference Figures 3C to 3D , showing an alternative embodiment of the restraining member configuration for the locking joint 20 ′. Figure 21 A top schematic view of a locking suture construction 10 ″ using a locking tab 20 ′ according to this alternative embodiment is shown. In the depicted embodiment, the second body (A) is in a first position relative to the first body (B). As shown, both the first end 12 and the second end 13 are pulled through the locking loop 15 .

[0060] Re-reference Figure 3C , shows an enlarged view of the locking joint structure 20 '. In the depicted embodiment, the locking joint structure 20 'is formed in the fourth branch 4 ', which is in the second end 13 of the suture material 6, similar to Figure 1 As shown and also as Figure 21 as shown. The locking loop 15 has a first branch 1' and a second branch 2', which extend through the locking joint structure 20'. In addition, the first end 12 of the suture material 6 that has passed through the locking loop 15 extends through the locking joint structure 20' as a third branch 3' on the same side of the second body (A) as the first branch 1' and the second branch 2'. The fourth branch 4' is the only portion of the suture material 6 shown on the opposite side of the second body (A). Ultimately, when the circumference of the locking loop 15 is reduced to the minimum working circumference, the first branch 1' and the second branch 2' are pulled through the locking joint structure 20 until the locking loop 15 is tightly wrapped around the third branch 3' and the fourth branch 4', as shown Figure 3D As shown. About Figures 8 to 16 The steps shown and described are equally applicable to the alternative embodiment of the locking connector 20'.

[0061] While embodiments of the present invention have been particularly shown and described with reference to certain exemplary embodiments, it will be understood by those skilled in the art that various changes of detail may be made therein without departing from the spirit and scope of the invention as defined by the claims as supported by the written description and the accompanying drawings. In addition, where exemplary embodiments are described with reference to a certain number of elements, it will be understood that the exemplary embodiments may be practiced with fewer or greater than the certain number of elements.

Claims

1. A locking suture construction comprising: a retaining ring for securing the first body in position relative to the second body; wherein the fixing ring comprises a fourth branch having a restraining member and the first branch; a retaining ring for securing the restraining member in a first position relative to the first body; The positioning ring includes a second branch and a third branch; The first branch and the second branch pass through the constraining member and form a locking loop; and The size of the positioning ring is configured to be reduced, and the restraining member is configured to be moved toward the first body by pulling the third branch in a direction away from the positioning ring and the restraining member.

2. The locking suture construction of claim 1 , further comprising: Secure the control wire around the locking ring.

3. The locking suture construction of claim 2, wherein: The positioning loop is configured to increase in size, and the constraining member is configured to move toward the second body by pulling the second end of the control line or suture material attached to the first body in a direction away from the positioning loop and the constraining member.

4. The locking suture construction of claim 1 , wherein: The restraining member is selected from the group consisting of an adjustable restraining member and a fixed restraining member.

5. A locking suture construction comprising: a retaining ring for securing the first body in position relative to the second body; wherein the fixing ring comprises a fourth branch having a restraining member and the first branch; a retaining ring for securing the restraining member in a first position relative to the first body; The positioning ring includes a second branch and a third branch; The first branch and the second branch pass through the restraining member and form a locking ring; a control wire secured around the locking ring; and The positioning loop is configured to increase in size, and the constraining member is configured to move toward the second body by pulling the second end of the control line or suture material attached to the first body in a direction away from the positioning loop and the constraining member.

6. The locking suture construction of claim 5, wherein: The size of the positioning ring is configured to be reduced, and the restraining member is configured to be moved toward the first body by pulling the third branch in a direction away from the positioning ring and the restraining member.

7. The locking suture construction of claim 5, wherein: The restraining member is selected from the group consisting of an adjustable restraining member and a fixed restraining member.

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