Expandable Surgical Anchor

Abstract

A method of tissue repair using expandable surgical anchors and knotless fixation. The method includes coupling repair strands to tissue to be fixed and inserting an implant with the repair strands captured by the implant into a pre-drilled bone hole in an insertion direction. After the implant is inserted into the bone hole, an expandable cannulated fixation device is placed within the bone hole such that the repair strands are disposed outside the fixation device. After the fixation device is placed within the bone hole, the fixation device is expanded by pulling the implant into the fixation device in an actuation direction while the fixation device remains stationary, thereby compressing the fixation device against the bone hole with the repair strands disposed between the outer surface of the fixation device and the bone hole, and fixating the tissue without creating knots.

Description

[Technical Field]

[0001] The present disclosure relates generally to surgical anchors, and more particularly to an expandable suture anchor and a method of tissue repair using same in conjunction with knotless fixation. [Background technology]

[0002] When soft tissue is detached from bone, it requires reattachment. Reattachment of soft tissue to bone typically requires a surgeon to implant a suture anchor into the bone so that the suture anchor and the repair suture connected to the tissue are secured and do not come loose from the bone. Current suture anchors secure the suture to the bone by threading or an interference fit between the anchor and the bone. These anchors mostly achieve suture fixation in the dense cortical region of bone, at the expense of suture fixation in the less dense cancellous bone. Summary of the Invention

[0003] The present disclosure provides a method of tissue repair using knotless fixation, the method comprising the steps of coupling at least one flexible repair strand to tissue to be fixated; inserting the implant into a pre-drilled bone hole with the at least one flexible repair strand captured by the implant in an insertion direction toward the bottom of the bone hole; after inserting the implant into the bone hole, placing an expandable cannulated fixation device within the bone hole such that the flexible repair strands are disposed outside of the fixation device; and after placing the fixation device in the bone hole, while the fixation device remains stationary, expanding the fixation device by pulling the implant into the fixation device in an actuation direction opposite the insertion direction, thereby compressing the fixation device against the bone hole with the flexible repair strands disposed between an outer surface of the fixation device and the bone hole, and fixating the tissue without creating knots.

[0004] In one embodiment of the method, the implant is pulled in the actuation direction by pulling a flexible actuation strand threaded through an eyelet in the proximal end section of the implant facing the top of the bone tunnel, and the flexible repair strand is captured by threading the flexible repair strand through an eyelet in the distal end section of the implant facing the bottom of the bone tunnel.

[0005] In some embodiments of the method, when the implant is pulled in the actuation direction, the fixation device expands and an outermost diameter of the implant engages and pushes out one or more expandable portions of the fixation device, the expandable portions of the fixation device are formed by one or more longitudinal slots in the body of the fixation device, and / or the outermost diameter is between a proximal end section and a distal end section of the implant, each of the proximal end section and the distal end section having an eyelet. The method can further include threading another flexible repair strand through the eyelet in the proximal end section of the implant and / or locking another flexible repair strand to the proximal end section of the implant and / or pre-loading the fixation device onto the shaft of the inserter and releasably attaching the implant to the distal end of the inserter.

[0006] In other embodiments, another flexible repair strand is locked by threading its free end through a splice of another flexible repair strand, so that the implant and fixation device are axially aligned when the implant is pulled in the actuation direction, and / or at least one flexible repair strand is captured by threading at least one flexible repair strand through an eyelet on the implant, so that the eyelet on the implant remains outside the fixation device when the fixation device is expanded by pulling the implant into the fixation device.

[0007] In one embodiment, the implant is a soft anchor, at least one flexible actuating strand is threaded through the soft anchor, and the soft anchor bunches when the actuating strand is pulled in an actuating direction, and the soft anchor is a sleeve, the actuating strand extends through the inside of the sleeve, and the flexible repair strand engages the outside of the sleeve.

[0008] Another aspect of the present disclosure is a surgical anchor comprising an implant having a proximal end section configured to engage an end of an inserter, a distal end section configured to engage one or more flexible repair strands, and an expander section between the proximal and distal end sections. The proximal end section of the implant is configured to capture the one or more flexible actuation strands, and the expander section of the implant has a substantially frustoconical shape that tapers outward toward the distal end section and defines an outermost diameter of the implant. An expandable cannulated fixation device is loaded onto the inserter and configured to engage the implant, the fixation device having one or more expandable portions configured to allow the fixation device to expand outward when the implant is received within the fixation device and the expander section of the implant pushes the one or more expandable portions outward.

[0009] In certain embodiments, the proximal end section of the implant includes eyelets for capturing one or more flexible actuation strands, the distal end section of the implant includes eyelets for capturing one or more flexible repair strands, the size of the eyelets in the distal end section of the implant is at least about twice the size of the eyelets in the proximal end section, the expandable portion is formed by one or more longitudinal slots in the body of the fixation device, the one or more flexible repair strands are threaded through the eyelets of the implant and positioned outside the body of the fixation device, the outer surface of the fixation device has bone-gripping features, and / or the one or more flexible repair strands are sutures or suture tape.

[0010] In one embodiment, a method of attaching soft tissue to bone with knotless fixation includes installing a first plurality of anchors in a first medial row and installing a second plurality of anchors in a second lateral row, wherein at least one of the first or second plurality of anchors is a surgical anchor of the present disclosure.

[0011] In another embodiment, a method for attaching soft tissue to bone with knotless fixation using a surgical anchor of the present disclosure includes inserting the anchor having a length of suture attached thereto into a first hole in the bone, threading the suture attached to the first anchor up through the soft tissue, positioning an implant with the free end of the suture threaded through an eyelet of the implant over a second hole in the bone, inserting the implant into the second hole in the bone, and placing a fixation device over the implant and into the second hole in the bone to secure the suture in the second hole without making a knot, such that fixation of the suture in the second hole is knotless. The method may further include retrieving the suture through a cannula after it has been threaded up through the soft tissue, and inserting the end of the suture through a distal eyelet of the implant after retrieving the suture through the cannula. The method may also include tensioning the suture.

[0012] This summary is not intended to identify essential features of the claimed subject matter, nor is it intended for use in determining the scope of the claimed subject matter. It is to be understood that both the foregoing general description and the following detailed description are exemplary and intended to provide an overview or framework for understanding the nature and character of the present disclosure. [Brief explanation of the drawings]

[0013] The accompanying drawings are incorporated into and constitute a part of this specification. It should be understood that the drawings illustrate only some embodiments of the present disclosure, and that other embodiments or combinations of various embodiments not specifically shown in the figures may still fall within the scope of the present disclosure. The embodiments will now be described in additional detail using the drawings. [Figure 1] FIG. 1 is an elevational view of an exemplary surgical anchor according to one embodiment, showing an expandable suture anchor loaded into an inserter. [Figure 2] 2 is a perspective view from the proximal end of an exemplary implant of the surgical anchor of FIG. 1. FIG. [Figure 3] 2 is another perspective view of the implant of the surgical anchor shown in FIG. 1. [Figure 4] 2 is a side view of an exemplary fixation device of the surgical anchor shown in FIG. 1. [Figure 5] FIG. 5 is a cross-sectional view of the fixation device shown in FIG. 4. [Figure 6a] 5 is a cross-sectional view of an alternative embodiment of the body of the fixation device shown in FIG. 4. [Figure 6b] 5 is a cross-sectional view of an alternative embodiment of the body of the fixation device shown in FIG. 4. [Figure 7a] 2 illustrates steps in an exemplary method of tissue repair using the surgical anchor shown in FIG. 1. [Figure 7b] 2 illustrates steps in an exemplary method of tissue repair using the surgical anchor shown in FIG. 1. [Figure 7c] 2 illustrates steps in an exemplary method of tissue repair using the surgical anchor shown in FIG. 1. [Figure 7d] 2 illustrates steps in an exemplary method of tissue repair using the surgical anchor shown in FIG. 1. [Figure 7e] 2 illustrates steps in an exemplary method of tissue repair using the surgical anchor shown in FIG. 1. [Figure 8a] FIG. 1 is an elevational view of an exemplary surgical anchor according to another embodiment. [Figure 8b] FIG. 1 is an elevational view of an exemplary surgical anchor according to another embodiment. [Figure 9a] 8a and 8b illustrate steps of another exemplary method of tissue repair using the surgical anchor shown in FIGS. 8a and 8b. [Figure 9b] 8a and 8b illustrate steps of another exemplary method of tissue repair using the surgical anchor shown in FIGS. 8a and 8b. [Figure 9c] 8a and 8b illustrate steps of another exemplary method of tissue repair using the surgical anchor shown in FIGS. 8a and 8b. DETAILED DESCRIPTION OF THE INVENTION

[0014] The presently disclosed expandable surgical anchors and methods of tissue repair incorporate additional fixation beyond that of traditional suture anchors after the anchor is implanted in bone. The presently disclosed anchors are designed to maintain fixation in cortical bone, but utilize expansion and locking into cancellous bone for additional fixation. The presently disclosed surgical anchors and methods of repair anchor repair strands, such as sutures, in the cortical region of the bone, but expand the anchor within the cancellous region of the bone to compress the bone and increase fixation of the suture in the compressed bone.

[0015] Referring to the figures, a surgical anchor 100 according to an exemplary embodiment of the present disclosure generally includes an implant 102 capturing one or more flexible repair strands 30 (also referred to as “primary repair strands”) and a fixation device 104. The implant 102 is configured to be received within and expand the fixation device 104, such that the one or more primary repair strands 30 (coupled to the soft tissue 70) are secured within the bone 90 between an outer surface 106 of the fixation device 104 and an inner surface 98 of a pre-drilled hole 96 in the bone 90. The surgical anchor 100 is adapted for positive tissue or bone contact, securing to the bone 90 and both the cortical region 92 and cancellous region of the bone 90, as seen in FIG. 7e.

[0016] In one embodiment, the anchor 100 includes a cannulated, slotted, expandable anchor body 130, into which the expander / implant 102 can be retracted to expand the anchor 100 after placement in the bone hole. The implant 102 includes a proximal eyelet 120 at its proximal end that receives one or more flexible actuation strands 40 for retracting the implant 102 through the body of the anchor. The anchor body 130 may include an outer ridge 132 for engaging bone within the bone hole. The anchor body 130 may also have internal teeth at its distal end for engaging corresponding teeth on an angled proximal ledge of the implant. To secure the anchor to the bone, the rim 42 of the actuation strand 40 (connected to the proximal eyelet 120 at the proximal end of the implant) is pulled back in line or coaxially with the anchor body 130, causing the implant 102 to retract into the anchor body 130, thereby expanding the distal end of the implant 102 into the cancellous bone 94.

[0017] As seen in FIGS. 1-3 , the implant 102 has a proximal end section 112, a distal end section 114, and a dilator section 116 therebetween. The proximal end section 112 is configured to releasably engage the end or tip 14 of the inserter 10. For example, the proximal end section 112 can have a reduced diameter portion 113 that allows the proximal end section 112 to be slidably inserted into the tip 14 of the cannulated rod 12 of the inserter 10, as seen in FIG. 7 a. Any releasable engagement can be used to couple the proximal end section 112 of the implant 102 with the tip 14 of the inserter 10. The proximal end section 116 of the implant 102 can also be configured to capture one or more flexible actuation strands 40 (also referred to as “actuation strands”). For example, an opening, notch, or eyelet 120 (also referred to as a “proximal eyelet”) can be incorporated into the proximal end section 112 of the implant 102. The proximal eyelet 120 is sized to receive the actuation strand 40. When the implant 102 is loaded onto the inserter 10, the rim 42 of the actuation strand 40 can extend through the cannulated rod 14 of the inserter 10. The proximal eyelet 120 can also receive, in addition to the primary repair strand 30, one or more secondary flexible repair strands 32 (also referred to as “secondary repair strands”) that can be used to secure the tissue 70 to the bone 90.

[0018] The distal end section 114 of the implant 102 is configured to engage one or more primary repair strands 30. For example, an aperture, notch, or eyelet 122 (also referred to as a "distal eyelet") can be incorporated into the distal end section 114 of the implant 102. The distal eyelet 122 is sized to receive one or more primary repair strands 30. The proximal and distal eyelets 120 of the implant 102 may be different sizes and / or shapes, or may be substantially the same size and / or substantially the same shape. In one example, as seen in FIG. 7c, the distal eyelet 122 is circular and is at least about twice the size of the circular proximal eyelet 120.

[0019] The expander section 116 of the implant 102 can have a substantially frustoconical shape that tapers outwardly toward the distal end section 114 and defines an outermost diameter 118 of the implant 102, as seen, for example, in Figures 2 and 3. The outermost diameter 118 is sized to engage and expand the fixation device 104. The outer surface 124 of the expander section 116 may be textured or grooved with ribs, teeth, indentations, or the like.

[0020] The distal eyelet 122 of the implant 102 is configured to receive one or more primary repair strands 30. The primary repair strands 30 may be any known flexible strand suitable for use in surgical repair procedures, such as, for example, sutures or suture tape. One or more secondary repair strands 32 may be provided at the proximal end section 112 of the implant 102. A second repair strand 32 may be threaded through the same proximal eyelet 102 as the actuation strand 40 at the proximal end section 112 of the implant 102. This secondary repair strand 32 may be secured to the proximal eyelet 120 through the locking splice 36 by threading the secondary repair strand 32 over itself at the splice 36 using a passing device or shuttle 50, as seen in FIG. 3 , thereby securing the secondary repair strand 32 in place. When repairing tissue, the surgeon can use either or both primary repair strands 30 and secondary repair strands 32, and strands 30 and 32 can be used for the same or different repair purposes.

[0021] The fixation device 104 includes an anchor body 130 that is cannulated for loading the fixation device 104 into the inserter 10. The outer surface 106 of the anchor body 130 may have bone-gripping features 132, such as threads, barbs, ribs, teeth, or the like, for engaging the inner surface 98 of the bone hole 96. The fixation device 104 is configured to expand when the implant 102 is drawn into the cannulated portion 131 of the anchor body 130. The fixation device 104 can be designed to be expandable by including slots, notches, recesses, grooves, or the like in the anchor body 130. In one example, the fixation device 104 has one or more expandable portions 134 configured to allow the fixation device 104 to expand outward when the implant 102 is received within the anchor body 130 of the fixation device 104, with the outermost diameter 118 of the implant engaging the inner surface 133 of the fixation device 104, as seen in FIG. 7c. The expandable portion 134 may be formed by one or more longitudinal slots 136 in the anchor body 130, which open at a distal end 138 of the anchor body 130. A proximal end 139 of the anchor body 130 opposite the distal end 138 is adapted to engage or abut the outer shaft 16 of the inserter 10, as seen in FIG.

[0022] In one embodiment, anchor body 130 is fully cannulated, and outer surface 106 can be either threaded or barbed for fixation within bone. Also, there are at least two longitudinal slots 136 that can extend from a distal end 138 of anchor body 130 to allow anchor expansion through portion 134 at distal end 138. In one example, longitudinal slots 136 can extend approximately three-quarters of the length of anchor body 130.

[0023] The top or closed end of each longitudinal slot 136 can be radiused or curved, as seen in FIG. 4 , to prevent the expanding slot from propagating through the anchor body 130 and avoid snagging of the repair strands. The bottom of the slots 136 at the distal end 138 of the anchor body 130 can be rounded or chamfered to allow the repair strands to slide freely past the anchor body 130 during anchor expansion. FIG. 5 shows a cross section of the anchor body 130 of the fixation device 104, showing the cannulation portion 131 and one of the slots 136. The inner surface 133 of the anchor body 130 can optionally include internal texture or teeth at or near the distal end 138 of the anchor body 130.

[0024] Each longitudinal slot 136 can also be perpendicular or offset at an angle, as seen in Figures 6a and 6b, respectively. As seen in Figure 6a, the slots 136 are oriented perpendicular or straight across the length of the anchor body 130. The longitudinal slots 136 can extend generally parallel to the central longitudinal axis of the fixation device 104.

[0025] As seen in FIG. 6b, the longitudinal slots 136' can be cut at an angle to aid in closing the slot while rotating the fixation device 104 into the bone. This helps prevent any sharp edges of the anchor body 130 from catching on the bone and damaging the fixation device 104 when the device 104 is installed. Additionally, by angling the slots 136', the sharp or acute corner 135' of each slot 136' will pivot away from the repair strand 30 during insertion of the fixation device 104 and will not engage the repair strand 30, and the blunt or obtuse corner 137' on the opposite side of each slot 136' will pivot the anchor body 130 toward the repair strand 30 and will not engage the repair strand 30 during insertion of the fixation device 104.

[0026] The method of tissue repair using surgical anchor 100 can be for a single attachment, or a single row attachment (anchor to tissue), or a double row (e.g., inner and outer rows) attachment (anchor to anchor).

[0027] To load the surgical anchor 100 onto the inserter 10, the cannulated body 130 of the fixation device 104 is first inserted onto the cannulated rod 12 of the inserter 10 and then seated onto the shaft end of the inserter 10, similar to the disclosure of U.S. Pat. No. 8,012,174, the subject matter of which is incorporated herein by reference. The rim 42 of the actuation strand 40 extending from the proximal eyelet of the implant 102 is threaded through the cannulated portion of the rod 12 of the inserter 10. The implant 102 is then seated onto the distal tip 14 of the inserter 10.

[0028] An exemplary method of tissue repair of the present disclosure can be achieved with knotless fixation and includes coupling a flexible repair strand 30 to the tissue 70 to be fixed and inserting the implant 102 into a pre-drilled bone hole 96 in an insertion direction toward the bottom of the hole, with the flexible repair strand 30 captured within the distal eyelet 122 of the implant 102. As seen in FIG. 7a, the primary repair strand 30 is fed through the distal eyelet 122 of the implant 102. In one embodiment of the present disclosure, the primary repair strand 30 is threaded through the tissue or graft at a desired point. The cannulated anchor body 130 of the fixation device 104 is pre-loaded onto the inserter 10 with the implant 102 at its distal end or tip 14. The repair strand 30, attached to the tissue or graft, is threaded through the distal eyelet 122 of the implant 102. The distal end of the inserter 10, along with the implant 102, can be inserted directly into the pre-drilled hole 96 in the bone 90. The inserter 10 can be rotated (e.g., clockwise) to advance the fixation device 104 over the proximal end section 112 of the implant 102. The eyelet 122 is then placed at the bottom of the prepared or pre-drilled bone hole 96. The surgeon has the option of adjusting the tension of the repair strand at this point.

[0029] After inserting the implant 102 into the bone tunnel 96, the expandable cannulated fixation device 104 is placed into the bone tunnel 96 so that the flexible repair strands 30 are positioned outside of the fixation device 104. As seen in FIG. 7b, the anchor body 130 is inserted until it is flush with the cortical bone 92. The primary repair strands 30 are secured between the anchor body 130 and the cortical bone 92. They are secured in part by interference with the cancellous bone. The inserter 10 can then be removed, leaving the repair strands 30 connected to the distal eyelets 122 of the implant 102.

[0030] After the fixation device 104 is placed in the bone hole 96, the fixation device 104 is expanded by pulling the implant 102 in an actuation direction opposite the insertion direction of the fixation device 104 into the cannulation portion 131 while the fixation device 104 remains stationary, as seen in FIG. 7c. The rim 42 of the actuation strand 40 connecting to the proximal eyelet 120 of the implant 102 is pulled back into alignment with the anchor body 130, as seen in FIGS. 7c and 7d. The implant 102 is pulled in the actuation direction by pulling the actuation strand through the proximal eyelet 120 of the implant 102 facing the top of the bone hole 96, and the repair strand 30 is captured by threading the repair strand 30 through the distal eyelet 122 of the implant 102 facing the bottom of the bone hole 96.

[0031] As the implant 102 is pulled into the anchor body 130 in the actuation direction, the outermost diameter 118 of the implant 102 pushes the expandable portion 134 of the fixation device 104 out, compressing it against the inner surface 98 of the bone hole 96, and the one or more repair strands 30 are disposed between the outer surface 106 of the fixation device 104 and the bone hole 96, thereby securing the tissue without creating a knot. When the fixation device 104 is expanded by pulling the implant 102 into the fixation device, the distal eyelet 122 of the implant 102 can remain outside the fixation device 104. A knot pusher or stout device can be placed against the proximal end 139 of the anchor body 130 to prevent the anchor body 130 from pulling out of the bone while tensioning the repair strands 30. As seen in FIG. 7e, once the anchor 100 is secured in place, the actuation strand 40 can be removed and the remaining limbs of the repair suture can be pulled and cut, thereby completing the repair.

[0032] Another method of tissue repair of the present disclosure involves inserting a first anchor, which can be any type of known anchor, with a length of one or more repair strands 30 attached thereto into a first pre-drilled hole in bone in a manner similar to that disclosed in U.S. Patent No. 8,012,174, and then threading the repair strands 30 attached to the first anchor up through soft tissue. A second anchor implant 102, which is a surgical anchor 100, is loaded onto the inserter 10 and positioned over a second pre-drilled hole in the bone with the repair strands 30 threaded through a distal eyelet 122 of the implant 102. The implant 102 is inserted into the second hole in the bone, and a fixation device 104 is placed over the implant 102 and into the second hole in the bone to secure the one or more repair strands 30 in the second hole in the bone without creating a knot in the same manner as described above. The method may also include retrieving the repair strand 30 through the cannula after the repair strand 30 has been passed upward through the soft tissue 70, and inserting an end of the repair strand 30 through the distal eyelet 122 of the implant 102 after retrieving the repair strand 30 through the cannula.

[0033] Another exemplary method of the present disclosure may include installing a first plurality of anchors in a first medial row and installing a second plurality of anchors in a second lateral row, similar to the method disclosed in U.S. Pat. No. 8,012,174, wherein one or more of the first or second plurality of anchors are surgical anchors 100.

[0034] 8a, 8b, and 9a-9c illustrate a surgical anchor 100' according to an alternative embodiment of the present disclosure. The surgical anchor 100' includes an implant 102', which is a soft anchor such as a sleeve or sheath formed from a bunched material. A flexible actuation strand 40 is threaded inside the implant 102' such that the implant 102' bunches when the actuation strand 40 is pulled in an actuation direction, as seen in FIG. 9c. The bunching of the implant 102' inside the anchor body 130 causes the expandable portion 134 of the anchor body 130 to expand outward and engage the bone. The repair strand 30 engages the outside of the sleeve implant 102'. For example, the repair strand 30 can be threaded through an eyelet 122' formed by looping or folding the implant 102', as seen in FIG. 9a.

[0035] Sutures or suture tape may be flexible repair strands used with the anchor to secure tissue to bone. However, the anchors of the present disclosure may be used with any type of flexible material or suture. Alternatively, allograft or biological elements may be used in place of sutures or tape. The allograft or biological elements may be composed of tendon or pericardium, for example, to promote tissue repair. Any combination of sutures, suture tape, and allograft or biological elements may be used depending on the characteristics of the particular surgical repair and / or as desired.

[0036] The presently disclosed surgical anchors are knotless fixation devices, advantageously minimizing or eliminating the need to tie knots to complete the repair. Use of the disclosed surgical anchors also securely fixates flexible repair strands by forcing the strands into the bone hole and holding them firmly between the outside of the fixation device and the bone hole.

[0037] It will be apparent to one skilled in the art having the benefit of the teachings presented in the foregoing description and the associated drawings that modifications, combinations, subcombinations, and variations can be made without departing from the spirit or scope of the present disclosure. Similarly, the various embodiments described may be used individually or in combination with other embodiments. Those skilled in the art will recognize various combinations of embodiments not specifically described or shown herein that are still within the scope of the present disclosure. In this regard, it should be understood that the present disclosure is not limited to the particular embodiments described, and that the embodiments of the present disclosure are intended to be illustrative and not limiting.

[0038] As used in this specification and the appended claims, the singular forms "a," "an," and "the" include the plural forms unless the context clearly dictates otherwise. Similarly, the adjective "another," when used to introduce an element, is intended to mean one or more elements. The terms "comprising," "including," "having," and similar terms are intended to be inclusive so that there may be additional elements other than the listed elements.

[0039] Furthermore, where the method above or a method claim below does not explicitly require an order for its steps to be followed, or where no order is required based on the language of the description or claims, no particular order is intended to be inferred. Similarly, if a method claim below does not explicitly recite a step referenced in the description above, it should not be assumed that the step is required by that claim.

[0040] It should be noted that geometric or relational terms such as proximal, distal, vertical, horizontal, right, left, upper, lower, top, bottom, linear, arcuate, elongated, parallel, perpendicular, etc. may be used in the description and claims. These terms are not intended to limit the disclosure and are generally used for convenience and to facilitate description based on examples shown in the figures. Furthermore, the geometric or relational terms may not be precise. For example, walls may not be exactly perpendicular or parallel to one another due to, for example, surface roughness, tolerances allowed in manufacturing, etc., yet may still be considered perpendicular or parallel. [Explanation of symbols]

[0041] 100 Surgical Anchors 102 Implants 104 Expandable Cannulated Fixation Device

Claims

1. 1. An implant having a proximal end section configured to engage an end of an inserter, a distal end section configured to engage one or more flexible repair strands, and a dilator section between the proximal end section and the distal end section, an implant, the proximal end section of the implant being configured to capture one or more flexible actuation strands, the dilator section of the implant having a substantially frustoconical shape that tapers outwardly toward the distal end section and defines an outermost diameter of the implant; an expandable cannulated fixation device loaded onto the inserter and configured to engage the implant, the expandable cannulated fixation device having one or more expandable portions configured to allow the expandable cannulated fixation device to expand outward when the implant is received within the expandable cannulated fixation device and the expander section of the implant pushes the one or more expandable portions outward; and A surgical anchor comprising:

2. The anchor assembly of claim 1 , wherein the proximal end section of the implant includes an eyelet for capturing the one or more flexible actuation strands.

3. The anchor assembly of claim 2 , wherein the distal end section of the implant includes an eyelet for capturing the one or more flexible repair strands.

4. The anchor assembly of claim 3 , wherein the size of the eyelet at the distal end section of the implant is at least about twice the size of the eyelet at the proximal end section.

5. The anchor assembly of claim 1 , wherein the expandable portion is formed by one or more longitudinal slots in a body of the expandable cannulated fixation device.

6. The anchor assembly of claim 1 , wherein the one or more flexible repair strands are threaded through eyelets of the implant and disposed outside a body of the expandable cannulated fixation device.

7. The anchor assembly of claim 1 , wherein an outer surface of the expandable cannulated fixation device has bone-gripping features.

8. The anchor assembly of claim 1 , wherein the one or more flexible repair strands are sutures or suture tape.

9. The anchor assembly of claim 1 , wherein the expander section of the implant is textured and has an outer surface configured to engage a textured inner surface of the expandable cannulated fixation device.

10. The anchor assembly of claim 1 , wherein an outermost diameter of the implant is between the proximal and distal end sections of the implant, and each of the proximal and distal end sections has an eyelet.

11. providing an implant loaded with at least one flexible repair strand, said implant having a proximal end section and a distal end section; providing an expandable cannulated fixation device to receive the implant, the expandable cannulated fixation device having a proximal end and a distal end; expanding the expandable cannulated fixation device by pulling the implant in an actuation direction toward the proximal end of the expandable cannulated fixation device; Including, the implant is configured to be pulled in the actuation direction by pulling a flexible actuation strand threaded through an eyelet in the proximal end section of the implant; The method of actuating a surgical anchor, wherein the at least one flexible repair strand is positioned outside the expandable cannulated fixation device.

12. The method of claim 11 , wherein the at least one flexible repair strand is loaded into the implant by threading the at least one flexible repair strand through an eyelet in the distal end section of the implant.

13. The method of claim 11 , wherein the expandable cannulated fixation device includes an expandable portion formed by one or more longitudinal slots in a body of the expandable cannulated fixation device.

14. The method of claim 11, wherein another flexible repair strand is threaded through the eyelet in the proximal end section of the implant, and the other flexible repair strand is locked by threading its free end through the splice of the other flexible repair strand.

15. 12. The method of claim 11, wherein teeth on an outer surface of the implant engage teeth on an inner surface of the expandable cannulated fixation device when the implant is pulled in the actuation direction.

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