Knotless suture constructs for rigid body anchors and all-over suture anchors

Abstract

To provide a suture construct that can be used to secure tissue to bone at a bone anchor location without requiring knot stacking. The suture construct has an anchoring limb including a body having a first end and a second end. A loop is formed at the first end of the body and interconnected to a tail extending from the other end of the body. A suture shuttle having a shuttle loop and a shuttle tail extends through the body of the anchoring limb such that the shuttle loop is disposed adjacent to the loop and the shuttle tail exits the body from a splice formed at an intermediate position of the body. The suture construct may be coupled to a rigid body anchor or all of the suture anchors. The suture shuttle is used to capture the anchoring limb, pull it onto the tissue to be anchored, and return it through the body of the construct to form a unidirectional fastening loop.

Description

[Technical Field]

[0001] The present invention relates to orthopedic bonded anchors, and more particularly to knotless suture constructs that can be used to secure tissue to hard or soft bone anchors. [Background technology]

[0002] During orthopedic surgery, tissue may need to be attached to a specific location on a bone. Tying the tissue toward the bone is suboptimal because it leaves a knot stack at that location in the process, which may interfere with other anatomical structures over time. Conventional knotless anchoring techniques can avoid knot stacking, but require the anchor inserter to remain in place while the tissue is being secured, making it impossible to secure tissue directly above the anchor insertion point. Therefore, there is a need in the art for a technique that can secure tissue to bone at the location of a bone anchor without leaving a knot stack. Summary of the Invention

[0003] The present invention provides a suture construct that can be used to secure tissue to bone at a bone anchor location without the need for knot stacking. The suture construct has a fixation limb including a body having a first end and a second end. A loop is formed at the first end of the body and is interconnected to a tail extending from the other end of the body. A suture shuttle having a shuttle loop and a shuttle tail is provided, with the shuttle loop positioned adjacent to the loop and the shuttle tail extending from the body. The suture construct extends through the body of the fixation limb so as to exit the body from a splice formed at an intermediate position of the suture construct. The suture construct may be coupled to the rigid-body anchor, such as by forming a Larks knot or a luggage tag knot at the loop of the suture construct and the eyelet of the rigid-body bone anchor. The fixation limb of the suture construct extends through the longitudinal hole of the anchor so that the shuttle loop and shuttle tail extend from the longitudinal hole of the anchor. The splice of the suture construct is positioned so that it is just outside of the longitudinal hole of the anchor.

[0004] In another embodiment of the present invention, a suture construct may be coupled to a whole suture anchor having a suture body configured to be compressed from an expanded configuration to a compressed configuration. In this embodiment, the suture construct and suture shuttle may be woven through the suture body of the whole suture anchor such that the loop of the suture construct is disposed at a first end of the suture body and the tail, shuttle loop, and shuttle tail of the suture construct are disposed at a second end of the suture body. A splice is disposed between the first and second ends of the suture body when the suture body is in the expanded configuration. [Brief explanation of the drawings]

[0005] The present invention will be more fully understood and appreciated from the following detailed description read in conjunction with the accompanying drawings.

[0006] [Figure 1] 1 is a schematic diagram of a suture construct in accordance with the present invention.

[0007] [Figure 2] FIG. 1 is a schematic diagram of a suture construct according to the present invention loaded into a hard-bodied anchor.

[0008] [Figure 3] 10A-10C are a series of schematic diagrams illustrating the operation of a suture construct in accordance with the present invention.

[0009] [Figure 4]1 is a schematic diagram of a first step of a suture construct according to the present invention securing tissue to bone with an anchor loaded with the suture construct. FIG.

[0010] [Figure 5] 10A-10C are schematic diagrams of another step of a suture construct according to the present invention securing tissue to bone with an anchor loaded with the suture construct.

[0011] [Figure 6] 1A-1C are schematic diagrams of a first approach for loading a suture construct into a hard-bodied anchor in accordance with the present invention.

[0012] [Figure 7] FIG. 10 is another schematic representation of a first approach for loading a suture construct into a hard-bodied anchor in accordance with the present invention.

[0013] [Figure 8] 10A-10C are further schematic illustrations of a first approach for loading a suture construct into a hard-bodied anchor in accordance with the present invention.

[0014] [Figure 9] 10A-10C are additional schematic views of a first approach for loading a suture construct into a hard-bodied anchor in accordance with the present invention.

[0015] [Figure 10] 10 is a schematic representation of a second approach for loading a suture construct into a hard-bodied anchor in accordance with the present invention. FIG.

[0016] [Figure 11] 10 is a further schematic illustration of a second approach for loading a suture construct into a hard-bodied anchor in accordance with the present invention. FIG.

[0017] [Figure 12] 10A-10C are additional schematic illustrations of a second approach for loading a suture construct into a hard-bodied anchor in accordance with the present invention.

[0018] [Figure 13] 10A-10C are schematic illustrations of another approach for loading a suture construct in accordance with the present invention.

[0019] [Figure 14] FIG. 14 is a schematic diagram of the procedure of FIG. 13 after the fixation limbs have been shuttled through the anchors.

[0020] [Figure 15] 1A-1C are schematic diagrams of a technique for loading a suture construct into a full suture anchor according to the present invention.

[0021] [Figure 16] 10 is another schematic illustration of a technique for loading a suture construct into a full suture anchor in accordance with the present invention. FIG.

[0022] [Figure 17] 1 is a schematic diagram of a technique for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0023] [Figure 18] FIG. 10 is another schematic illustration of a technique for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor.

[0024] [Figure 19] 10 is a schematic diagram of another approach for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0025] [Figure 20] 10 is a schematic diagram of another approach for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0026] [Figure 21] 10 is a schematic diagram of another approach for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0027] [Figure 22] 10 is a schematic diagram of another approach for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0028] [Figure 23] 10 is a schematic diagram of another approach for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0029] [Figure 24] 10 is a schematic diagram of another approach for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0030] [Figure 25] 1 is a schematic diagram of a second embodiment of a suture construct according to the present invention. FIG.

[0031] [Figure 26] 10 is a schematic diagram of another approach for fastening tissue to bone using a suture construct according to the present invention having a full suture anchor. FIG.

[0032] [Figure 27] 10 is a schematic illustration of the use of a second embodiment of a suture construct according to the present invention to secure tissue to bone. FIG.

[0033] [Figure 28] 10 is another schematic illustration of the use of a second embodiment of a suture construct according to the present invention to secure tissue to bone. FIG. [Figure 29] FIG. 10 is a schematic diagram showing fixation limbs formed from a single suture braided as a unitary structure. DETAILED DESCRIPTION OF THE INVENTION

[0034] Detailed Description of the Invention Referring to the drawings, wherein like numerals refer to like parts throughout, FIG. 1 illustrates a suture construct 10 in accordance with the present invention. The suture construct 10 comprises an anchoring limb 12 having a body 14, with a loop 16 formed at a first end 18 of the body 14 extending rearwardly through the body 14 as an embedded portion to emerge at a second end 20 as a tail 22. The anchoring limb 12 may be formed from a single length of suture that is spliced ​​at one end to define the first end 18 of the body 14, and then the spliced ​​end is embedded back through the body 14 to form a loop 16 at the first end 18 having a predetermined diameter with an embedded portion extending through the body 14 to emerge at the second end 20 as the tail 22. The tail 22 may be pulled further through the body 14 to reduce the diameter of the loop 16. The tail 22 is used to trap tissue that is secured to bone, as described herein.

[0035] Suture construct 10 further comprises a suture shuttle 30 having a shuttle loop 32 and a shuttle tail 34 that extends through the center of fixation limb 12 and exits at a splice 36 within body 14 such that shuttle loop 32 is disposed at a first end 18 proximate loop 16. The positioning of splice 36 is configured to position the emergence of fixation limb 12 proximate the surface of the bone on which suture construct 10 is being used, and thus depends on the nature and dimensions of the hard body anchor or all-suture anchor used with suture construct 10, as described in further detail below.

[0036] 2, the suture construct 10 may be used in association with a rigid-body anchor 40 having a longitudinal bore 42 and a transverse opening 44 therebetween that combines with a post 46 to form an eyelet 48. In this embodiment, the suture construct 10 may be secured to the post 46 of the anchor 40 by forming a Larks Head knot (also known as a luggage tag knot), with the loop 16 passing around the post 46 and the remainder of the suture construct 10 passing through the loop 16 and extending longitudinally through the bore 42 of the rigid-body anchor 40, such that the fixation limb 12, as well as the shuttle loop 32 and shuttle tail 34, extend from the rigid-body anchor 40. The shuttle loop 32 also extends externally of the rigid-body anchor 40 but into the body 14 adjacent the post 46. The suture shuttle 30 is positioned within the rigid-body anchor 40 so that the shuttle tail 24 exits the splice 36 outside of the hole 42, and therefore outside of the rigid-body anchor 40. The location of the splice 36 within the fixation limb 12 is therefore determined according to the dimensions of the post 46 and longitudinal hole 42 of the rigid-body anchor 40. For example, for a rigid-body anchor 40 with an outer diameter of 2.5 or 3.0 millimeters and a length of 9.8 or 10.6 millimeters, the body 14 may have a length of approximately 178 millimeters, and the splice 36 would be positioned 7 millimeters (+ / - 1 mm) from the first end 18.

[0037] 3 , once the fixation limb 12 and the shuttle loop 32 and shuttle tail 34 are positioned to extend from the rigid body anchor 40, the fixation limb 12 can be passed through the shuttle loop 32. The shuttle tail 34 is then pulled away from the rigid body anchor 40 until the shuttle loop 32 is retracted through the splice 36 and through the body 14, and then withdrawn from the suture construct 10. Movement of the shuttle loop 32 through the splice 36 and body 14 retracts the fixation limb 12 through the splice 36 and body 14, such that the fixation limb 12 is pulled back through the splice 36 and body 14 until the tail 22 is released, thereby forming a one-way tightening loop 60 that can be pulled closed by pulling on the tail 22.

[0038] 4 and 5, operation of the suture construct 10 shown in FIG. 3 may be performed after the hard-body anchor 40 has been placed in a drilled hole 52 in a bone 54 in a conventional manner for seating the hard-body anchor 40. As described above, the splice 36 is positioned along the fixation limb 12 so that it is positioned just outside of the hard-body anchor 40, e.g., between 1 and 2 millimeters, and thus slightly above the hole 52 in the bone 54. The fixation limb 12 may then be passed over tissue 50 and secured to the bone 54, and loaded through the shuttle loop 32. The shuttle tail 24 may then be pulled to retract the shuttle loop 32 and captured fixation limb 12 into the longitudinal hole 42, allowing the fixation limb 12 to be shuttled through the body 14 and from the splice 36. Thus, forces applied to the suture construct by the tissue, which tend to loosen the fixation limbs 14, further tighten the body 14 around the fixation limbs 12, so that the fixation limbs 12 form a one-way tightening loop 60 around the tissue 50. The fixation limbs 12 may be pulled further to tighten the loop 60 and then trimmed to leave the tissue 50 fixed to the bone 54 adjacent the rigid body anchor 40 without the use of a knot.

[0039] Referring to FIG. 6 , the suture construct 10 may be coupled to the rigid-body anchor 40 by passing the fixation limb 12 around the post 46 of the eyelet 48. As seen in FIG. 7 , the tail 22 of the fixation limb 12 may be passed through the loop 16 to form a Larks knot (or luggage tag knot) around the post 46. The tail 22 is then pulled to tightly close the loop 16 around the post 56 of the eyelet 58. As seen in FIG. 8 , the suture shuttle 30 may then be spliced ​​to the body 14 as described above, such that the splice 36 is located proximate to the anchor 40 when fully deployed. As seen in FIG. 9 , the fixation limb 12 and suture shuttle 30 (including the shuttle loop 32 and shuttle tail 34) may then be passed through the hole 42 of the rigid-body anchor 40, such that the tail 22 along with the suture shuttle 30 extends from the rigid-body anchor 40 and the splice 36 is just outside the hole 42.

[0040] 10, suture construct 10 may also be coupled to rigid body anchor 40 by passing suture construct 10 through longitudinal hole 42 of rigid body anchor 40, around post 46 of eyelet 48, back through longitudinal hole 42 of rigid body anchor 40, and then through rigid body anchor 40, so that loop 16, as well as tail 22, shuttle loop 32, and shuttle tail 34 extend from rigid body anchor 40. Tail 22, shuttle loop 32, and shuttle tail 34 may then be passed through loop 16 under tension, as shown in FIG. 11, and a Larks knot (or luggage tag knot) may be formed around post 46, as shown in FIG. 12.

[0041] 13, the suture construct 10 may be coupled to a rigid body anchor 10 such that the shuttle loop 32 and shuttle tail 34 extend through the loop 16 to form a Larks knot (or luggage tag knot). As seen in FIG. 14, when the fixation limb 12 is closed, the fixation limb is pulled through the loop 16 of the Larks knot (or luggage tag knot) as it returns through the anchor 10, causing the loop 16 to contract to the point where it holds, resulting in a maximum amount of material in the splice, as shown by the thick-to-thin transition on the right side of FIG. 14 through the splice.

[0042] 15, the suture construct 10 may also be used in connection with an entire suture anchor 70 including a suture body 72 formed from a braided construct extending from a first end 74 to a second end 76 and compressible from an expanded position to a compressed position, the suture body 72 forming a spheroid that is secured within a hole 52 in a bone 54. In this embodiment, the suture construct 10 includes a tail 22, a shuttle loop 32, and a shuttle tail 34 extending from the first end 74. 16 , the tail 22, shuttle loop 32, and shuttle tail 34 are passed through the loop 16 before the entire suture anchor 70 is inserted into the hole 52 in the bone 54, and the splice 36 is disposed between the first end 74 and the second end 76 of the suture body 72. Thus, the loop 16 forms a Larks knot or a luggage tag knot with the suture body 72, but remains loose at this point so that the suture body 72 remains in its expanded position.

[0043] 17 , the entire suture anchor 70 including the suture construct 10 may be inserted into the hole 52 in the bone 54 so that the suture body 72, including the splice 36 and loop 16, is positioned within the hole 52 and the tail 22, shuttle loop 32, and shuttle tail 34 extend from the hole 52 in the bone 54. The tail 22, shuttle loop 32, and shuttle tail 34 are pulled to deploy the entire suture anchor 70, thereby compressing the suture body 72 into its spheroid configuration. Now, the body 14 of the fixation limb 12 is positioned completely outside the entire suture anchor 70, with only the loop 16 forming a Larks knot or luggage tag knot with the suture body 72. The tail 22 may then be secured and extended onto the tissue 50 so that it passes through the shuttle loop 32. The shuttle tail 34 may then be pulled to pull the fixation limb 12 through the body 14 and out of the splice 36, as shown in FIG. 18, thereby forming a unidirectional tightening loop 60 around the tissue 50 in the same manner as described above with respect to the rigid body anchor 40.

[0044] 19-26 illustrate various ways in which the loop 16, fixation limb 12, tail 22, shuttle loop 32, and shuttle tail 34 may be positioned relative to the suture body 72 for deployment within the hole 52 in the bone 54 as described above.

[0045] 27, another embodiment of a suture construct 100 in accordance with the present invention comprises a body 114 that is folded back and spliced ​​through a portion of the body 114 to form a tissue fixation loop 116, an anchoring limb 112 having a loop reduction end 122 proximate the loop 116, and an anchoring end 118 at the other end of the body 114. Thus, tension on the loop reduction end 122 reduces the diameter of the loop 116, while splicing back through the body 114 resists opening of the loop 116, thereby allowing only the tissue fixation loop 116 to close. Suture construct 100 may be secured to rigid-body anchor 40 by securing fixation end 118 back to body 114, or by passing fixation end 118 through itself to form anchor loop 120, such as by forming a Larks knot or a luggage tag knot using anchor loop 120, which can be used to secure suture construct 100 to rigid-body anchor 40. Thus, as shown in FIG. 28 , tissue securement loop 116 can be used to capture and secure tissue directly onto rigid-body anchor 40 after the anchor driver has been removed from the site.

[0046] 29, the fixation limb 12 may be formed from a single suture braided as a unitary structure, with the loop 16 formed as a round braided section of 17 fibers, the body 14 formed from a flat braided section of 17 fibers, and the tail 22 formed from a round braided section with a gradually decreasing number of fibers down to 11 or fewer. The loop 16 may have a diameter (d) of approximately 0.092 inches (2.33 mm), the body 14 may have a length (L1) of approximately 6.0 + / - 0.5 inches (152 mm + / - 12.7), and the tail 22 may have a length (L2), such that the total length of the fixation limb 12 has a length (L3) of approximately 26 inches + / - 1 inch (660 mm + / - 25.4 mm).

Claims

1. 1. A system for securing a quantity of tissue to bone, comprising: a suture construct formed by fixation limbs having a body having a first end and a second end, a loop formed at the first end of the body, and a tail extending from the loop through the body; a suture shuttle having a shuttle loop and a shuttle tail extending within and through the body of the fixation limb, the shuttle loop being disposed adjacent to the loop and the shuttle tail being present in the body from an exit splice location; 1. A system for fixing a quantity of tissue to bone, comprising:

2. The system of claim 1 , further comprising a hard body anchor coupled to the suture construct.

3. The system of claim 2 , wherein the rigid body anchor is coupled to the suture construct by the loop and an eyelet on the rigid body anchor.

4. The system of claim 3 , wherein the loop is formed into a luggage tag knot at the eyelet.

5. The system of claim 4 , wherein the fixation limbs of the suture construct extend through longitudinal holes in the hard body anchor.

6. The system of claim 5 , wherein the shuttle loop and the shuttle tail extend through the longitudinal hole of the hard body anchor.

7. The system of claim 6 , wherein the exit splice location is located outside of the longitudinal bore of the rigid body anchor.

8. The system of claim 1 , further comprising all suture anchors coupled to the suture construct.

9. The system of claim 8 , wherein all of the suture anchors include a suture body configured to be compressed from an expanded configuration to a compressed configuration.

10. 10. The system of claim 9, wherein the suture construct and the suture shuttle are woven through the suture bodies of all of the suture anchors, the loop of the suture construct is disposed at a first end of the suture body, and one or more of the tail, the shuttle loop, and the shuttle tail of the suture construct are disposed at a second end of the suture body.

11. The system of claim 10, wherein one or more of the tail, the shuttle loop, and the shuttle tail of the suture construct extend through the loop of the suture construct.

12. The system of claim 11 , wherein the tail and the shuttle tail of the suture construct extend through the loop of the suture construct.

13. The entirety of the tail, the shuttle loop, and the shuttle tail of the suture construct The system of claim 12 , wherein a guidewire extends through the loop of the suture construct.

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