Surgical fixation assembly and method of use

Abstract

A surgical fixation assembly includes a screw-in anchor, wherein a suture structure is attached to and extends through an interior of the anchor. The suture structure has two finger trap-type couplings to trap suture that has passed through the finger trap-type couplings when the structure is under tension. A transfer suture containing a loop is preloaded through the finger trap engagement and is used to pull an end of a repair suture through the finger trap engagement to form a reduced loop around or through the captured tissue.

Description

Technical Field

[0001] The present disclosure relates to surgical repair of tissue, and more particularly to devices and methods for inserting suture anchors for use in such repairs. Background Art

[0002] During joint repair, surgeons often use suture anchors to attach soft tissue grafts to bones. Typically, the surgeon uses an inserter tool to implant the suture anchor into a drilled hole in the bone. The surgeon then attaches one or more sutures or suture bands to the suture anchor. The surgeon places the suture around or through the tissue and then ties a knot on the suture to secure the tissue to the bone. However, surgeons often prefer knotless suture repairs that avoid knots that interfere with the repair. Summary of the invention

[0003] The surgical fixation assembly described herein includes a screw-in anchor with a suture structure attached to and extending through the interior of the anchor. The suture structure has two finger trap joints to capture the suture that has passed through the finger trap joints when the structure is placed under tension. A transfer suture containing a loop is preloaded through the finger trap joints and is used to pull the end of the repair suture through the finger trap joints to form a reduced loop around or through the captured tissue. Advantageously, this allows the surgeon to complete the repair without tying a knot in the suture.

[0004] Additional examples of the presently disclosed surgical fixation assemblies and methods may include one or more of the following in any suitable combination.

[0005] An example of a surgical fixation assembly disclosed herein includes an anchor having a proximal end, a distal end, and a thread extending from the proximal end to the distal end in an open spiral form. At least one rib extends through the interior of the anchor. A suture bridge extends at least partially through the interior of the anchor. The assembly also includes a suture structure, which includes a repair suture having a first repair leg and a second repair leg. A first transfer suture is coupled to the first repair leg via a first contraction element. The first end of the first transfer suture is a first free end, and the second end of the first transfer suture includes a first transfer loop. The second transfer suture is coupled to the second repair leg via a second contraction element. The first end of the second transfer suture is a second free end, and the second end of the second transfer suture includes a second transfer loop. The suture structure is coupled to the suture bridge so that the first repair leg, the second repair leg, the first transfer suture, and the second transfer suture extend through the interior of the anchor.

[0006] In another example, the distal end of the suture bridge has a concave shape. In an example, at least one rib is two ribs, and the suture bridge is connected to the two ribs and extends between the two ribs. In an example, the first transfer ring is configured to pull the end of the first repair leg through the first contraction element to form a first reducible loop. In an example, the first contraction element is configured to allow the first reducible loop to be tightened without loosening. In an example, the second transfer ring is configured to pull the end of the second repair leg through the second contraction element to form a second reducible loop. In an example, the second contraction element is configured to allow the second reducible loop to be tightened without loosening. In an example, the suture structure is connected to the suture bridge through the connection area of ​​the repair leg, and the connection area extends between the first repair leg and the second repair leg. In an example, the first contraction element and the second contraction element are adjacent to the connection area. In an example, the connection area is attached to the suture bridge by one of the luggage tag connection or knot. In an example, the anchor is arranged on the distal end of the delivery device so that the first repair leg and the second repair leg and the first transfer suture and the second transfer suture extend through the cannula of the delivery device. In an example, the suture bridge is received within the groove and at least one rib is received within at least one corresponding groove of the delivery device.

[0007] An example of a tissue repair method disclosed herein includes inserting an anchor of a surgical fixation assembly into a first tissue. The surgical fixation assembly includes an anchor having a proximal end, a distal end, and a thread extending from the proximal end to the distal end in an open spiral form. At least one rib extends through the interior of the anchor. A suture bridge extends at least partially through the interior of the anchor. The surgical fixation assembly also includes a suture structure including a repair suture having a first repair leg and a second repair leg. A first transfer suture is coupled to the first repair leg via a first contraction element. The first end of the first transfer suture is a first free end and the second end of the first transfer suture includes a first transfer loop. The second transfer suture is coupled to the second repair leg via a second contraction element. The first end of the second transfer suture is a second free end and the second end of the second transfer suture includes a second transfer loop. The method also includes causing the first repair end to surround or pass through the second tissue and pass through the first transfer loop. The method also includes using the first free end of the first transfer suture to pull the first repair end through the first contraction element to form a first reducible loop around or through the second tissue. The first constriction element is configured to allow the first reducible loop to be tightened around or through the second tissue without loosening.

[0008] In another example, the method also includes causing the second repair end to surround or pass through a third tissue and pass through a second transfer loop. The method also includes using the first free end of the second transfer suture to pull the second repair end through a second contraction element to form a second reducible loop around or through the third tissue. The second contraction element is configured to allow the second reducible loop to be tightened around or through the third tissue without loosening. In an example, the method also includes inserting an anchor into the first tissue using a delivery device. The anchor is disposed on the distal end of the delivery device so that the first and second repair legs and the first transfer suture and the second transfer suture extend through the cannula of the delivery device. In an example, the method also includes attaching a connection area of ​​the repair leg to a suture bridge. The connection area extends between the first repair leg and the second repair leg. In an example, the first tissue is bone. In an example, the second tissue is a soft tissue graft.

[0009] Advantages of these and other features will become apparent upon reading the following detailed description and examining the associated drawings.Both the foregoing general description and the following detailed description are intended to be explanatory only and are not restrictive of the various aspects of the present disclosure as claimed. BRIEF DESCRIPTION OF THE DRAWINGS

[0010] The present disclosure will be more fully understood by reference to the detailed description taken in conjunction with the following drawings, in which:

[0011] FIG. 1 illustrates an example of an anchor for use with the surgical fixation assembly of the present disclosure;

[0012] Figure 2 An example of a surgical fixation assembly of the present disclosure is shown in a disassembled state;

[0013] Figure 3 An example of a suture structure of the present disclosure assembled to an anchor is shown;

[0014] Figure 4A and 4B An example of a method of coupling a repair suture to an anchor is shown;

[0015] FIG. 5A illustrates an example of a delivery device for delivering a surgical fixation assembly of the present disclosure to a repair site;

[0016] Figure 5B An example of an anchor located on the distal end of a delivery device is shown; and

[0017] Fig. 6A -C shows an example of a method of using the surgical fixation assembly of the present disclosure in surgical repair. DETAILED DESCRIPTION

[0018] In the following description, similar parts have the same reference numerals regardless of whether the examples shown are different or not. In order to clearly and concisely illustrate the examples, the drawings may not necessarily reflect proper scale and may have certain features shown in some schematic form. The present disclosure may describe and / or illustrate features in one example and describe and / or illustrate features in the same manner or in a similar manner in one or more other examples, and / or describe and / or illustrate features in combination with or in place of features of other examples.

[0019] In the specification and claims, for the purposes of describing and defining the invention, the terms "about" and "substantially" represent the inherent degree of uncertainty attributed to any quantitative comparison, value, measurement, or other representation. The terms "about" and "substantially" also represent the degree to which a quantitative representation may vary from a stated reference without resulting in a change in the basic function of the subject matter at issue. Open-ended terms such as "comprising," "including," and / or the plural form of each term include the listed parts and may include additional parts that are not listed, while terms such as "and / or" include one or more of the listed parts and combinations of the listed parts.

[0020] FIG. 1 shows an example of an anchor 100 for use with a surgical fixation assembly 10 of the present disclosure. As shown in FIG. 1 , the anchor 100 may include a proximal end 101 and a distal end 102. A majority of the anchor 100 may include a thread 103 in the form of an open helical coil (i.e., a series of continuous, regularly spaced turns connected in a spiral or helical form), extending substantially from the proximal end 101 to the distal end 102, wherein an orifice 104 is defined by the space between the turns of the coil. The open helical coil may define an internal volume 114, which is communicated with an area outside the open helical coil through the orifice 104 between the turns of the open helical coil. The distal end 102 may also include a suture bridge 105 extending a portion of the length of the anchor 100. The suture bridge 105 may include a proximal end 105a and a distal end 105b. In an example, the distal end 105b may have a concave shape. However, the present disclosure also contemplates other suitable shapes of the distal end 105b, such as flat, convex or spherical. The anchor 100 is configured such that a flexible member 110, such as a suture, can be housed within the anchor 100, wherein the suture 110 extends around the distal end 105b of the suture bridge 105. Additionally, at least one rib 106 can extend through the interior volume 114 along the interior of the threads 103. For purposes of the present disclosure, two ribs 106 extend through the interior volume 114. However, the present disclosure contemplates more or less than two ribs 106. Other non-limiting examples of anchors 100 configured for use with the surgical fixation assembly 10 of the present disclosure are shown and described in U.S. Pat. No. 9,949,820 to Smith & Nephew, Inc. (Memphis, TN), which is incorporated herein by reference.

[0021] Figure 2 An example of a surgical fixation assembly 10 of the present disclosure is shown in a disassembled state. Figure 2 As shown in , the surgical fixation assembly 10 can generally include an anchor, such as the anchor 100 of FIG. 1 , and a suture structure 200 that can be attached to the anchor 100. The suture structure 200 can include a repair suture 202 having a first repair leg 202a and a second repair leg 202b. As further described below, a coupling region 202c extends between the first repair leg 202a and the second repair leg 202b and is configured to be attached to a suture bridge 105. The first repair leg 202a can be coupled to a first transfer suture 204 via a first contraction element 206 positioned adjacent to the coupling region 202c. In an example, the first contraction element 206 can include an engagement section that operates in a "finger trap" manner. Similarly, the second repair leg 202b can be coupled to a second transfer suture 208 via a second contraction element 210, which is positioned adjacent to the coupling region 202c and operates in a similar manner to the first contraction element 206.

[0022] Figure 3 An example of a suture structure 200 of the present disclosure is shown with a suture bridge 105 attached to an anchor 100. Figure 3 As shown in , when the suture structure 200 is attached to the suture bridge 105, the first contraction element 206 and the second contraction element 210 can be located within the interior volume 114 of the anchor 100, while the first and second repair legs 202a, b and the first and second transfer sutures 204, 208 extend from the proximal end 101 of the anchor 100. The first transfer end 204a of the first transfer suture 204 can include a first free end, and the second transfer end 204b of the first transfer suture 204 can include a first transfer loop 212. Similarly, the first transfer end 208a of the second transfer suture 208 can include a second free end, and the second transfer end 208b of the second transfer suture 208 can include a second transfer loop 214, the purpose of which will be further described below.

[0023] Figure 4A and 4B An example of a method for attaching a repair suture 202 to the suture bridge 105 of the anchor 100 is shown. For ease of illustration, Figure 4A and 4B The repair legs 202a, b are shown extending distally from the suture bridge 105. However, during normal operation, the repair legs 202a, b will instead extend proximally from the suture bridge 105 and through the interior volume 114 of the anchor 100. Figure 4AIn the example of FIG. 1 , the coupling region 202c can extend around the suture bridge 105, and any type of knot 216 known in the art can be formed by the repair legs 202a, b within the interior volume 114 of the anchor 100. Figure 4B In the alternative example shown in , the repair legs 202a, b can pass between the coupling region 202c and the suture bridge 105 in a "luggage tag" manner. The present disclosure also contemplates any other suitable method of rigidly connecting the repair suture 202 to the anchor 100, such as overmolding, ultrasonic welding, or adhesives.

[0024] FIG. 5A shows an example of a delivery device 300 for delivering the surgical fixation assembly 10 of the present disclosure to a repair site. For clarity, FIG. 5A shows only the distal end 301 of the delivery device 300. However, the delivery device 300 will include a proximal end that can be coupled to a handle assembly 306 ( Figure 5B ). The distal end 301 may have a slot 302 and at least one groove 303 extending from the slot 302. The cannula 304 may extend through the delivery device 300. In use, the anchor 100 may be positioned on the distal end 301 of the delivery device 300 such that the suture bridge 105 is received within the slot 302 and the rib 106 is received within the groove 303. Other non-limiting examples of delivery devices 300 configured for use with the surgical fixation assembly 10 of the present disclosure are shown and described in U.S. Pat. No. 9,949,820 to Smith & Nephew, Inc. (Memphis, TN), which is incorporated herein by reference.

[0025] Figure 5B An example of an anchor 100 positioned on a distal end 301 of a delivery device 300 is shown. Figure 5B 5A ), and exit the proximal end of the handle assembly 306. The examples of the repair suture 202 and transfer sutures 204, 208 may have different colors to allow a user to distinguish between the two types of sutures.

[0026] Fig. 6A -C shows an example of a method of using the surgical fixation assembly 10 of the present disclosure. Fig. 6AAs shown in , the user can rotate the handle assembly 306 to screw the anchor 100 into tissue 20, such as bone. Once the anchor 100 has been fully inserted, the user can then separate the delivery device 300 from the anchor 100 by pulling the delivery device 300 in the proximal direction, thereby embedding the anchor 100 and the suture structure 200 into the tissue 20. The user can pass the first repair leg 202a through the first transfer ring 212, and use the transfer end 204a to pull the first repair leg 202a through the first contraction element 206, so that the first repair leg 202a forms a first reducible loop. Similarly, the user can pass the second repair leg 202b through the second transfer ring 214, and use the transfer end 208a to pull the second repair leg 202b through the second contraction element 210, so that the second repair leg 202b forms a second reducible loop. As shown in FIG. Figure 6B , the reducible loops 218, 220 can extend around or through tissue such as soft tissue grafts 30, 32. As shown, the transfer end 204a can pull the first transfer loop 212 completely through the first contraction element 206 so that the first transfer suture 204 can be removed from the repair. Similarly, the transfer end 208a can pull the second transfer loop 214 completely through the second contraction element 210 so that the second transfer suture 208 can be removed from the repair. This leaves only the reducible loops 218, 220 and the repair suture ends 202a, b extending from the anchor 100. Figure 6C A detailed view of the reducible loops 218, 220 and the repair suture ends 202a, b is shown with the tissue grafts 30, 32 removed for ease of illustration. Once the reducible loops 218, 220 have been fully tensioned around or through the tissue, the contraction elements 206, 210 prevent the reducible loops 218, 220 from loosening, thereby advantageously forming a knotless tissue attachment to the bone 20. As a final step, the user can trim the repair suture ends 202a, b from the repair.

[0027] Although the present disclosure particularly shows and describes preferred embodiments, it will be understood by those skilled in the art that various changes in form and detail may be made without departing from the spirit and scope of the present application as defined by the appended claims. The scope of the present application is intended to encompass these changes. Thus, the foregoing description of the examples of the present application is not intended to limit the full scope conveyed by the appended claims.

Claims

1. A surgical fixation assembly, comprising: An anchor, the anchor comprising: a proximal end, a distal end, and threads extending in an open spiral from the proximal end to the distal end; at least one rib extending through an interior of the anchor; and a suture bridge extending at least partially through an interior of the anchor; and A suture structure, the suture structure comprising: a repair suture having a first repair leg and a second repair leg; a first transfer suture coupled to the first repair leg via a first constricting element, the first end of the first transfer suture comprising a first free end, and the second end of the first transfer suture comprising a first transfer loop; and a second transfer suture coupled to the second repair leg via a second constricting element, the first end of the second transfer suture comprising a second free end, and the second end of the second transfer suture comprising a second transfer loop; Wherein the suture structure is coupled to the suture bridge such that the first repair leg, the second repair leg, the first transfer suture, and the second transfer suture extend through an interior of the anchor.

2. The surgical fixation assembly of claim 1, wherein the distal end of the suture bridge has a concave shape.

3. The surgical fixation assembly of claim 1, wherein the at least one rib is two ribs.

4. The surgical fixation assembly of claim 3, wherein the suture bridge is connected to and extends between the two ribs.

5. The surgical fixation assembly of claim 1, wherein the first transfer ring is configured to draw an end of the first repair leg through the first constriction element to form a first reducible ring.

6. The surgical fixation assembly of claim 5, wherein the first constriction element is configured to allow the first reducible loop to be tightened without loosening.

7. The surgical fixation assembly of claim 1, wherein the second transfer ring is configured to draw an end of the second repair leg through the second constriction element to form a second reducible ring.

8. The surgical fixation assembly of claim 7, wherein the second constriction element is configured to allow the second reducible loop to be tightened without loosening.

9. The surgical fixation assembly of claim 1, wherein the suture structure is coupled to the suture bridge via a coupling region of the repair leg, the coupling region extending between the first repair leg and the second repair leg.

10. The surgical fixation assembly of claim 9, wherein the first retraction element is adjacent to the coupling region.

11. The surgical fixation assembly of claim 9, wherein the second retraction element is adjacent to the coupling region.

12. The surgical fixation assembly of claim 9, wherein the coupling region is attached to the suture bridge by one of a luggage tag coupling or a knot.

13. The surgical fixation assembly of claim 1, wherein the anchor is disposed on a distal end of a delivery device such that the first and second repair legs and the first and second transfer sutures extend through a cannula of the delivery device.

14. The surgical fixation assembly of claim 13, wherein the suture bridge is received within a groove and the at least one rib is received within at least one corresponding groove of the delivery device.

15. A method of tissue repair, comprising: Inserting an anchor of a surgical fixation assembly into a first tissue, the surgical fixation assembly comprising: The anchor comprises: a proximal end, a distal end, and threads extending in an open spiral from the proximal end to the distal end; at least one rib extending through an interior of the anchor; and a suture bridge extending at least partially through an interior of the anchor; and A suture structure, the suture structure comprising: a repair suture having a first repair leg and a second repair leg; a first transfer suture coupled to the first repair leg via a first constricting element, the first end of the first transfer suture comprising a first free end, and the second end of the first transfer suture comprising a first transfer loop; and a second transfer suture coupled to the second repair leg via a second constricting element, the first end of the second transfer suture comprising a second free end, and the second end of the second transfer suture comprising a second transfer loop; passing the first repair end around or through a second tissue and through the first transfer ring; and using the first free end of the first transfer suture, pulling the first repair end through the first constricting element to form a first reducible loop around or through the second tissue; Wherein the first constriction element is configured to allow the first reducible loop to be tightened around or through the second tissue without loosening.

16. The method according to claim 15, further comprising: Allowing the second repair end to wrap around or pass through a third tissue and pass through the second transfer ring; as well as using the first free end of the second transfer suture, pulling the second repair end through the second constricting element to form a second reducible loop around or through the third tissue; Wherein the second constriction element is configured to allow the second reducible loop to be tightened around or through the third tissue without loosening.

17. The method according to claim 15, further comprising: The anchor is inserted into the first tissue using a delivery device disposed on a distal end of the delivery device such that the first and second repair legs and the first and second transfer sutures extend through a cannula of the delivery device.

18. The method according to claim 15, further comprising: A coupling region of the repair leg is attached to the suture bridge, the coupling region extending between the first repair leg and the second repair leg.

19. The method of claim 15, wherein the first tissue is bone.

20. The method of claim 15, wherein the second tissue is a soft tissue graft.

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