Surgical implant assembly

Abstract

The surgical implant assembly comprises first and second anchor bodies configured to engage with the respective metacarpal surfaces of the first and second metacarpal bones, a main suture having a suture length extending between the first and second ends of the main suture, and a secondary suture having a suture length extending between the first and second ends of the secondary suture, wherein the suture length of the main suture comprises a first suture portion passing through the first anchor body and an extension between the first and second suture portions of the main suture. The first suture includes a bridging portion of the main suture and a second suture portion that passes through the second anchor body, wherein the first suture portion is located between the bridging portion and the first end, the second suture portion is located between the bridging portion and the second end, the auxiliary suture includes an auxiliary suture portion that passes through the first anchor body, the auxiliary suture portion is located between the first end and the second end of the auxiliary suture, and no portion of the auxiliary suture passes through the second anchor body.

Description

Detailed Description of the Invention

[0001] 〔Technical Field〕 The present invention relates to an implantable sling and anchor assembly in combination with a suture, and is particularly suitable for surgical repair and reconstruction of joints, preferably hand joints, particularly the thumb joint. 〔Background〕

[0002] Any reference to prior art methods, devices or documents should not be regarded as evidence or recognition that they formed, or were part of, common general knowledge.

[0003] Degenerative arthritis of the first carpometacarpal joint (CMC joint) of the thumb is a disease that causes general functional impairment. This disease occurs due to wear of the cartilage of the carpometacarpal (CMC) joint. As the arthritis progresses, the patient suffers from pain associated with loading, which affects pinching and gripping movements. Furthermore, the patient experiences muscle weakness, severe functional impairment, reduced range of motion, and loss of function. Trapeziectomy is a common surgical procedure that completely removes the trapezium bone. Some surgeons fill the void created by the removed bone with a part of the tendon of the hand joint. To fill the remaining space, artificial metal and plastic joints, or silicone rubber spacers may be used. This method basically involves removing the trapezium bone, excising the arthritic joint portion, and temporarily stabilizing the joint by traction fixation. This treatment brings pain relief, but may be accompanied by persistent collapse deformation, proximal migration, and muscle weakness.

[0004] The key principles for successful proximal phalangeal arthroplasty include trapezium resection, which is necessary for pain relief, and some form of ligament reconstruction to restore the function of the important palmar stabilizing ligaments. This reconstructs the proper balance, alignment, longitudinal length, and function of the thumb. Ligament reconstruction not only reduces pain but also restores strength, alignment, and stability. Trabezium resection is one of the representative methods for treating such arthritis, but it is desirable to provide a method and implantable assembly that simplifies the actual surgical procedure and further shortens the postoperative recovery and rehabilitation period. Long-term results of existing trapezium resections, while excellent in terms of pain relief, have been reported to involve a prolonged healing process, extensive and multiple incisions, sinking with loss of arthroplasty space, and complications at the pin insertion site. Furthermore, this procedure is technically complex and time-consuming and requires the sacrifice of the normally functioning carpal flexor tendons. This invention aims to address some of these problems without compromising the excellent pain relief results. [Summary of the Invention]

[0005] In one embodiment, the present invention comprises first and second anchor bodies configured to engage with the respective metacarpal surfaces of the first and second metacarpal bones, a main suture having a suture length extending between a first end and a second end of the main suture, and a secondary suture having a suture length extending between a first end and a second end of the secondary suture, wherein the suture length of the main suture includes a first suture portion passing through the first anchor body and a bridging portion of the main suture extending between the first suture portion and the second suture portion of the main suture. The present invention provides a surgical implant assembly comprising a second suture portion having a portion and passing through the second anchor body, wherein the first suture portion is located between the bridging portion and the first end, the second suture portion is located between the bridging portion and the second end, the auxiliary suture includes an auxiliary suture portion passing through the first anchor body, the auxiliary suture portion is located between the first end and the second end of the auxiliary suture, and no portion of the auxiliary suture passes through the second anchor body.

[0006] In one embodiment, the first and second anchor bodies are sufficiently deformable to pass through the respective bone tunnels drilled in the first and second metacarpal bones.

[0007] In one embodiment, the first suture portion passes through a plurality of openings in the first anchor body, and the second suture portion passes through a plurality of openings in the second anchor body.

[0008] In one embodiment, the surgical implant assembly further comprises a main suture sleeve for receiving the main suture and passing it toward the first anchor body, wherein the first suture portion forms a first main loop that engages with the first anchor body by returning the main suture through the main suture sleeve after it has passed through the first anchor body.

[0009] In one embodiment, the main suture sleeve is elongated and extends between a first end and a second end so that the main suture can be received at the first end of the main suture sleeve. The main suture is then pulled out from the second end of the main suture sleeve, the main suture portion is passed through the first anchor body, and then the main suture is returned to the second end of the main suture sleeve and pulled out from the first end of the main suture sleeve.

[0010] In one embodiment, at least a portion of the bridging portion passes through the main suture sleeve and extends out of the main suture sleeve, and then extends toward the second anchor body.

[0011] In another or additional embodiment, a portion of the main suture located between the first suture portion and the first end can optionally be passed through the second anchor body.

[0012] In one embodiment, the surgical implant assembly further comprises a secondary suture sleeve for receiving the secondary suture and passing it toward the first anchor body, and after passing the secondary suture portion toward the first anchor body, the secondary suture passing through the secondary suture sleeve is returned to form a secondary loop that engages with the first anchor body.

[0013] In one embodiment, the auxiliary suture sleeve is elongated and extends between the first and second ends of the auxiliary suture sleeve so that the auxiliary suture is received at the first end of the auxiliary suture sleeve. The auxiliary suture is then pulled out from the second end of the auxiliary suture sleeve, the auxiliary suture portion is passed through the first anchor body, and then the auxiliary suture is returned to the second end of the auxiliary suture sleeve and exits from the first end of the auxiliary suture sleeve so that both ends of the auxiliary suture extend out from the second end of the auxiliary suture sleeve.

[0014] Preferably, the main sleeve portion and the sub-sleeve portion are joined at one or more joining positions. More preferably, the main sleeve portion and the sub-sleeve portion may be provided as part of an integrated sleeve body. This allows the main sleeve portion and the sub-sleeve portion to be movable relative to each other with respect to the one or more joining positions, while still providing two independent passages for the main sleeve portion and the sub-sleeve portion. The main sleeve portion and the sub-sleeve portion are movable to form a flexible V-shaped structure, thereby enabling the integrated sleeve body to function as a sling.

[0015] In one embodiment, the main sleeve portion and the sub-sleeve portion are joined or adjacent to each other at the second end.

[0016] In one embodiment, each of the main sleeve portion and the sub-sleeve portion is formed from a fibrous material that defines a longitudinal lumen for each sleeve portion extending between the open ends.

[0017] In one embodiment, the first anchor body comprises an elongated and deformable structure having the main suture and the secondary suture, and the main suture and the secondary suture penetrate the elongated and deformable structure along a plurality of penetration positions, thereby applying tension to the main suture and / or the secondary suture, which increases the radial dimension of the first anchor, causing the first anchor to engage with the bone surface of the first metacarpal bone and preventing the anchor from passing through the bone tunnel of the first metacarpal bone.

[0018] In one embodiment, the main suture and the secondary suture penetrate the first anchor body at a plurality of penetration points spaced apart from the end of the elongated structure of the first anchor body.

[0019] In one embodiment, the second anchor body comprises an elongated and deformable structure having the main suture, and the main suture passes through the elongated and deformable structure at multiple penetration points, thereby applying tension to the main suture, which increases the radial dimension of the second anchor, causing the second anchor to engage with the bone surface of the second metacarpal bone and preventing the second anchor from passing through the bone tunnel of the second metacarpal bone.

[0020] In one embodiment, the main suture thread penetrates the second anchor body at a plurality of penetration points spaced apart from the end of the elongated structure of the second anchor body.

[0021] In one embodiment, each of the first anchor body and the second anchor body comprises a flat, fibrous structure.

[0022] In one embodiment, the end of the auxiliary suture is equipped with a needle for penetrating the tissue and passing the end through the tissue.

[0023] In one embodiment, the present invention provides an inserter having first and second elongated shafts. Each of the first and second shafts has a pair of claws located at the distal end of the shaft for defining bone tunnel engagement portions that are pressed into bone to form the respective bone tunnels, the claws being spaced apart and defining a slot between them, the slot forming an anchor holding portion located immediately adjacent to the passage forming portion, so that after the bone tunnel is formed, the anchor placed in the anchor holding portion advances into the bone tunnel.

[0024] Preferably, the first and second elongated shafts are perpendicular to each other, and preferably perpendicular to each other.

[0025] In one embodiment, the first anchor is attached to the anchor holding portion of the first shaft, and the second anchor is attached to the anchor holding portion of the second shaft.

[0026] In one embodiment, the inserter further comprises first and second inserter housings for receiving the proximal ends of the first and second elongated shafts, respectively.

[0027] In one embodiment, the first and second housing portions are provided with a plurality of suture receiving channels for winding and storing the main suture and the secondary suture.

[0028] In one embodiment, the present invention provides a method of performing a thumb metacarpophalangeal arthroplasty. The method includes providing an implantable assembly, the implantable assembly including first and second anchor bodies configured to engage respective metacarpal surfaces of the first and second metacarpals, a main suture having a suture length extending between a first end and a second end of the main suture, and a secondary suture having a suture length extending between a first end and a second end of the secondary suture, wherein the suture length of the main suture includes a first suture portion passing through the first anchor body, a bridging portion of the main suture extending between the first suture portion and a second suture portion of the main suture, and a second suture portion passing through the second anchor body, the first suture portion being located between the bridging portion and the first end, the second suture portion being located between the bridging portion and the second end, the secondary suture including a secondary suture portion passing through the first anchor body, the secondary suture portion being located between the first end and the second end of the secondary suture and no portion of the secondary suture passing through the second anchor body, the method including performing a greater rhomboid osteotomy to create an arthroplasty space, inserting the first anchor body through a first hole drilled transversely through the index metacarpal, and then applying tension to the main suture such that the first hole extends between two openings in the outer surface of the index metacarpal and the first anchor body engages and is fixed to the index metacarpal surface, inserting the second anchor body through a second hole drilled transversely through the thumb metacarpal, and then applying tension to the secondary suture such that the second hole extends between two openings in the outer surface of the thumb metacarpal and the second anchor body engages and is fixed to the thumb metacarpal surface, and applying tension to the main suture and the secondary suture within the arthroplasty space along the joint base of the thumb metacarpal to position at least a portion of the bridging portion of the main suture and the secondary suture portion of the secondary suture.

[0029] In one embodiment, the implant assembly further comprises a main suture sleeve for receiving the main suture and passing it toward the first anchor body, and a secondary suture sleeve for receiving the secondary suture and passing it toward the first anchor body. After the first suture portion passes through the first anchor body, it forms a first main loop engaging the first anchor body by returning the main suture passing through the main suture sleeve. After passing the secondary suture portion through the first anchor body, tension is applied to the main suture and the secondary suture that form a secondary loop engaging the first anchor body by returning the secondary suture passing through the secondary suture sleeve, so that the main suture sleeve and the secondary suture sleeve are disposed below the joint base of the metacarpal bone of the thumb, forming a sling to support the joint base of the metacarpal bone of the thumb. Brief Description of the Drawings

[0030] Preferred features, embodiments, and variations of the present invention can be understood from the following detailed description. This detailed description provides sufficient information for those skilled in the art to implement the present invention. The detailed description does not limit the scope of the foregoing summary of the invention in any way. In the detailed description, reference is made to the multiple drawings shown below. FIG. 1 is a top perspective view of a surgical implant assembly 1000 according to a first embodiment. FIG. 2A is an enlarged view of the first anchor body 100A. FIG. 2B is an enlarged view of the second anchor body 100B. FIG. 2C is an enlarged view of a sleeve member 500 having a first sleeve portion 520 and a second sleeve portion 540. FIGS. 3A to 3D show perspective views from the palmar side (front) of the right hand. The thumb is on the right side (referred to as the radial side or the radial edge), and the index finger and other fingers are on the left side (referred to as the ulnar side or the ulnar edge). FIGS. 3A to 3D sequentially illustrate the insertion and deployment of the implant assembly 1000 according to an embodiment of the method. FIG. 4 is a perspective view of an inserter 2000 according to a preferred embodiment. Figure 5 is an exploded view of the Inserter 2000. Figures 6 and 7 show the top and bottom views of the inserter 2000. [Detailed description of preferred embodiments]

[0031] Figures 1 to 3 illustrate the surgically implantable sling assembly 1000. The sling assembly 1000 is particularly suitable for performing trapezium resection and spondyloplasty, which involve removing the trapezium, one of the carpal bones that form part of the thumb joint, to manage the symptoms of thumb arthritis. Thumb arthritis is also known as carpometacarpal (CM) joint osteoarthritis. The procedure for performing spondyloplasty is explained step-by-step in Figures 3A to 3D, and will be described in detail in the preceding chapters after the explanation of the surgical implant assembly 1000 and its various main components.

[0032] Figure 1 shows the assembled state of the surgical implant assembly 1000. The surgical implant assembly 1000 consists of first and second flexible suture anchor bodies 100A and 100B having substantially identical configurations. The anchor bodies 100A and 100B are preferably made from flexible and biocompatible materials. However, in other embodiments, the anchor bodies 100A and 100B may be made from non-flexible materials, including but not limited to biocompatible alloys or hard polymer buttons.

[0033] Each of the anchor bodies, generally denoted as 100, has a deformable and elongated shape and is preferably made of a fibrous material. The anchor body 100 is deformable enough to allow the deformed anchor body to be pushed into a bone tunnel drilled in the metacarpal bone, as described in the preceding chapters. The flat and fibrous structure of the anchor body 100 not only allows the anchor body 100 to be deformable but also allows one or more sutures to pass through the fibrous body of the anchor body 100 through multiple openings. These openings are formed by drilling the flat fibrous structure of the anchor body 100 at multiple locations.

[0034] The flat and elongated shape of the anchor body 100 allows it to be bent along its central region. This brings the ends of the anchor body closer together, creating a U-shaped or V-shaped configuration with a vertex from which anchor limbs extend. This configuration allows the vertex of the anchor body 100 to be inserted into a drilled bone tunnel. As a result, the anchor limbs move toward each other as the anchor body 100 passes through the bone tunnel, creating a radially narrow configuration.

[0035] As most clearly shown in Figures 2A and 2B, each anchor body 100 and 200 has a flat, elongated shape, with two limbs of the anchor extending from the apex of the anchor body. Each anchor body 100 has an outer surface 112 and an inner surface 114. One or more sutures penetrate the inner surface 114 at a first position spaced apart from one end of the anchor body 100 and pass through the thickness of the anchor body 100. This effectively weaves the sutures over the length of the anchor body 100, and then extends out from a second position spaced apart from the other end of the anchor body 100. With this configuration of the anchor body 100, when the sutures passing through the anchor body 100 are subjected to tension, the anchor body 100 undergoes radial expansion of the deformable anchor body 100. As a result, anchor body 100A or 100B engages with bone tissue and becomes too narrow to pass through their respective bone tunnels. Other anchor body configurations can also be understood in which a flexible and deformable anchor body like 100 expands radially after passing through a narrow bone tunnel when the suture passing through the anchor body 100 is subjected to tension. As mentioned above, the deformable anchor bodies 100A and 100B are not limiting, and in other alternative embodiments, a non-deformable anchor body may also be used to achieve the intended function of the anchor body 100.

[0036] The first anchor body 100A and the second anchor body 100B are connected to each other by a main suture 200. The implant assembly 1000 also includes a secondary suture 300 that passes through the first anchor body 100A but not through the second anchor body 100B. The secondary suture 300 has a length (secondary suture length) that extends between its two ends. Both ends of the second suture 300 are provided with needles 305 that allow the suture to pass through the tissue, as described in the preceding chapters.

[0037] The main suture thread 200 has a main suture length extending between the ends 205 of the main suture thread 200. The main suture thread 200 includes a first suture section 201. The main suture thread 200 passes from the first end of the first anchor body 100A and exits from the second end of the first anchor body 100A in the manner described in the preceding chapters, so that when the main suture thread 200 is subjected to tension, the first anchor body 100A undergoes radial expansion. The main suture thread 200 further includes a second suture section 202 that passes again from the first end to the second end of the second anchor body 100B in the manner described in the preceding chapters. This allows the first anchor body 100A to undergo radial expansion when the main suture thread 200 is subjected to tension. The bridging portion 203 extends from the second end of the first anchor body 100A to the first end of the second anchor body 100B, so that the main suture passes through both the first anchor body 100A and the second anchor body 100B. The first suture portion 201 is located between the bridging portion 203 and the first end 205A, and the second suture portion 202 is located between the bridging portion 203 and the second end 205B. In another embodiment, it is also possible to optionally allow a portion of the main suture 200 located between the first suture portion 201 and the first end 205A to pass through the second anchor body 100B.

[0038] Unlike the main suture 200, the auxiliary suture 300 passes only through the first anchor body 100A. In a preferred embodiment, the auxiliary suture 300 also has an end 305, and the auxiliary suture portion 301 (extending between the end 305s) passes through the main anchor body 100A. Specifically, the second suture portion 301 extends into the first anchor body 100A at its first end, and then follows a similar path to the first suture portion 201 of the main suture 200 by being drawn out from the second end of the first anchor body 100A through a plurality of openings in the anchor body 100A. This allows the first anchor body 100A to undergo radial expansion when the main and auxiliary sutures 300 are subjected to tension.

[0039] As is evident from Figures 1 and 2, the implant assembly 100 employs a novel combination of two deformable anchors 100A and 100B and a main suture 200 (connecting anchors 100A and 100B). On the other hand, the secondary suture 300 is connected only to the first anchor body 100B so that the tension of the secondary suture 300 does not directly affect the deformation or unfolding of the second anchor body 100B. The operation of the implant assembly 1000 will be described in detail in the preceding chapters.

[0040] Furthermore, a main suture sleeve portion 520 is provided to receive and pass the first sleeve engagement portion of the main suture 200. The main suture 200 extends from the first end 205A toward the first end of the first anchor body 100A. The main suture sleeve portion 520 also receives and passes the second sleeve engagement portion (which is part of the bridging portion 203) of the main suture 200, which is returned from the second end of the anchor body 100A and extends toward the second anchor body 100B as described above. Therefore, the first sleeve portion 520 assists in the formation of the first loop of the main suture 200 that engages with the first anchor body 100A. The main suture sleeve portion 520 is elongated and extends between the first and second ends of the main suture sleeve 520 so that the main suture 200 is received at the first end of the main suture sleeve 520. Subsequently, the main suture thread 200 is pulled out from the second end of the main suture sleeve 520, and the main suture portion 201 passes through the first end of the anchor body 100A. Then, the main suture thread 200 is returned from the second end of the first anchor body 100A towards the second end of the main suture sleeve 520, passes through the main suture sleeve, exits from the second end of the main suture sleeve 520, and extends towards the first end of the second anchor body 100B. As a result, the first end 205A extends out from the first end of the main sleeve portion 520, and the second end 205B extends out from the second end of the second anchor body 100B.

[0041] The auxiliary suture sleeve portion 540 is also provided to receive and pass through the first sleeve engagement portion of the auxiliary suture thread 300, which extends from the first end toward the first end of the first anchor body 100A. The auxiliary sleeve portion 540 also receives the second sleeve engagement portion that is returned from the second end of the second anchor body 100B. As a result, the end portion 305 extends out from the first open end of the auxiliary suture thread sleeve portion 540.

[0042] In a preferred embodiment, the main sleeve portion 520 and the sub-sleeve portion 540 are joined at a joining position along their second ends, as is most clearly shown in Figure 2C. The main sleeve portion 520 and the sub-sleeve portion 540 can be formed by dividing a one-piece hollow sleeve body, made of a flexible woven material, into the main sleeve portion 520 and the sub-sleeve portion 540 by forming a large slit along the center, and joining them at the joint position in the center. As a result, the main sleeve portion 520 and the sub-sleeve portion 540 are movably positioned around the joint position, defining a V-shape configuration and enabling their use as a support sling.

[0043] Figures 3A to 3D show a perspective view of the right hand from the palmar side (front). The thumb is located on the right side (referred to as the radial side or radial border), and the index finger and other fingers are located on the left side (referred to as the ulnar side or ulnar border). The implant assembly 100, comprising the anchor body 100 and the sling 500, exhibits rotational symmetry and can be implanted in either the right or left hand. All figures show that the trapezium bone has been removed and the articular space S remains.

[0044] In the arthroplasty procedure, the sling 500 is fixed or anchored to a predetermined position at the joint base of the thumb metacarpal bone using suture anchor bodies 100A and 100B and auxiliary sutures 300. The first anchor body 100A forms a pre-anchor that is inserted through a hole B2 drilled in the index finger metacarpal bone (M2). The first hole B2 drilled in the index finger metacarpal bone extends between two openings located on the index finger metacarpal bone. The pre-anchor suture anchor 100A is inserted through hole B2 as shown in Figure 3C, fixing the pre-anchor suture anchor 100A to the metacarpal surface of the index finger metacarpal bone M2. A second hole B1 is drilled in the thumb metacarpal bone M1. The second hole B1 also extends between two openings within the thumb metacarpal bone, so that the second anchor body 100B forms a posterior anchor, which is positioned to be fixed to the metacarpal surface of the thumb metacarpal bone M1. By fixing the suture anchor 100A, the main suture 200 and the secondary suture 300 extend through the first hole B2 of the index finger metacarpal bone M2. By inserting the second anchor body 100B into the second hole B1 of the thumb metacarpal bone M1, the second anchor body 100B is fixed to the metacarpal surface of the thumb metacarpal bone M1. By fixing the second anchor body 100B, the main suture 200 also passes through the second hole B1, as shown in Figure 3D.

[0045] A needle located at the end 305 of the auxiliary suture 300 is used to penetrate the abductor pollicis tendon and fix the auxiliary suture 300 to the tendon. In this process, tension is applied to the auxiliary suture 300, causing the first anchor body 100A to expand radially. This fixes the first anchor body 100A to the bone surface of the index finger metacarpal bone M2, and the sleeve 500, particularly the sleeve portions 520 and 540, are positioned along the articular base of the thumb metacarpal bone. Specifically, the second anchor body 100B is positioned and fixed to the metacarpal bone surface of the thumb metacarpal bone M1 so that the sleeve portions 520 and 540 function as a sling supporting the articular base of the thumb metacarpal bone. After the main suture 200 is sufficiently pulled to fix the second anchor body 100B, the ends 205 can be joined together to form a knot. By fully pulling the main suture 200, the sleeve 500, having the sleeve portions 520 and 540, functions as a proximal joint stabilizer anchored or fixed by the anchor bodies 100A and 100B. By pulling the end 250 to apply tension to the main suture 200, the shape of the sleeve portions 520 and 540 also conforms to the complex shape of the joint base of the thumb metacarpal bone M1.

[0046] Figures 4 to 6 show an inserter 2000 particularly (but not limited to) suitable for deploying the implant assembly 1000 described in the preceding chapters. While the features of the inserter 200 have been described with reference to the implant assembly 1000, the scope of the inserter 2000 is not limited to the specific configuration of the implant assembly 1000, and other implant assemblies having multiple anchor bodies (e.g., anchor bodies 100A and 100B) can also be used without departing from the intent and scope of the inserter 2000. The inserter 2000 comprises first and second elongated shafts 2100 and 2200 that are orthogonal to each other. In a preferred embodiment, each of the shafts 2100 and 2200 is identical to each other. Each shaft (2100 or 2200) has a pair of spaced-apart claws located at the distal end of the shaft, defining a bone tunnel engagement portion for being pressed into the metacarpal bone M1 or M2 to form the respective bone tunnel. The claws of each shaft (2100 and 2200) are spaced apart, defining a slot between them, which forms an anchor holding portion located immediately adjacent to the bone tunnel formation portion.

[0047] The elongated shaft 2200 is used for inserting and loading the first anchor body 100A. Specifically, the first anchor body 100A is positioned at the spaced-apart claw anchor holding portion located at the distal end of the first elongated shaft 2200. Parts of the main suture 200 and secondary suture 300 extend from the proximal end of the first elongated shaft 2200 toward the anchor holding portion, and then return from the distal end toward the proximal end of the elongated shaft 2200. The second anchor body 100B is positioned at the spaced-apart claw anchor holding portion located at the distal end of the second elongated shaft 2100. Parts of the main suture 200 extend from the proximal end of the second elongated shaft 2100 toward the anchor holding portion, and then return from the distal end toward the proximal end of the second elongated shaft 2100. The proximal portions of shafts 2100 and 2200 are coupled to an inserter body having housing portions 2150 (2150A and 2150B) and 2250 (2250A and 2250B), respectively, which are orthogonal to each other. Each of the housing portions 2150 and 2250 is substantially hollow and provides a channel for winding the main suture 200 and secondary suture 300 inside. The inserter allows each shaft 2100 and 2200 to be inserted into bone tunnels B2 and B1 in order to position the anchor bodies 100A and 100B on the metacarpal surfaces of the index finger metacarpal bone M1 and the thumb metacarpal bone M2. Advantageously, the distal or tip portions of each shaft 2100 and 2200, where the respective anchor bodies 100A and 100B are positioned, have an overall thickness that is thinner than the thickness of the posterior end of the shaft (2100 or 2200). As a result, when the anchor bodies 100A and 100B are attached to the anchor receiving ends of the shafts (2100 or 2200), the tip of the shaft achieves a similar overall thickness compared to the rear ends of each shaft 2100 and 2200. This configuration makes it even easier to insert the anchor bodies 100A and 100B into the bone tunnels B1 and B2.

[0048] The first housing portion 2150 is provided with a first visual indicator, such as the letter "I", indicating that the first shaft 2100 should be inserted into the metacarpal bone M1 of the index finger. The second housing portion 2250 is also provided with a second visual indicator, such as the letter "T", indicating that the second shaft 2100 should be inserted into the metacarpal bone M2 of the thumb.

[0049] As most clearly shown in Figure 5, the housing body 2150 may include a cover portion 2152A for easy use of the main suture 200 and secondary suture 300 wound along a winding channel provided in the holding portion 2154 of the housing body 2150. Similarly, the housing body 2250 may also be equipped with a removable cover portion 2252A so that it can be easily used for the main suture thread 200 wound along the winding channel provided in the holding portion 2254 of the housing body 2250.

[0050] In accordance with the law, the structural or methodological features of this invention are described in more or less specific language. The term "(comprises)" and its variations (such as "comprising," "comprised of," etc.) are used throughout in a comprehensive sense and do not preclude additional features.

[0051] Since the means described herein constitute a preferred embodiment for carrying out the present invention, it should be understood that the present invention is not limited to the specific features shown or described.

[0052] Accordingly, the present invention claims its rights in any form or modification within the appropriate scope of the appended claims as appropriately interpreted by those skilled in the art. [Brief explanation of the drawing]

[0053] [Figure 1] This is a top perspective view of a surgical implant assembly 1000 according to the first embodiment. [Figure 2A] This is an enlarged view of the first anchor body 100A. [Figure 2B] This is an enlarged view of the second anchor body 100B. [Figure 2C] This is an enlarged view of a sleeve member 500 having a first sleeve portion 520 and a second sleeve portion 540. [Figure 3A] A perspective view from the palm side (front) of the right hand is shown. The insertion and deployment of the implant assembly 1000 according to the embodiment of the method will be described sequentially. [Figure 3B] A perspective view from the palm side (front) of the right hand is shown. The insertion and deployment of the implant assembly 1000 according to the embodiment of the method will be described sequentially. [Figure 3C] A perspective view from the palm side (front) of the right hand is shown. The insertion and deployment of the implant assembly 1000 according to the embodiment of the method will be described sequentially. [Figure 3D] A perspective view from the palm side (front) of the right hand is shown. The insertion and deployment of the implant assembly 1000 according to the embodiment of the method will be described sequentially. [Figure 4] This is a perspective view of inserter 2000 according to a preferred embodiment. [Figure 5] This is an exploded view of the Inserter 2000. [Figure 6] This shows a top view of the Inserter 2000. [Figure 7] This shows the bottom view of the Inserter 2000.

Claims

1. First and second anchor bodies configured to engage with the respective metacarpal surfaces of the first and second metacarpal bones, A main suture having a suture length extending between the first and second ends of the main suture, A secondary suture having a suture length extending between the first and second ends of the secondary suture, The length of the main suture includes a first suture portion that passes through the first anchor body, and a second suture portion that passes through the second anchor body and has a bridging portion of the main suture that extends between the first suture portion and the second suture portion of the main suture. The first suture portion is located between the bridging portion and the first end, and the second suture portion is located between the bridging portion and the second end. The auxiliary suture includes an auxiliary suture portion that passes through the first anchor body, The auxiliary suture portion is located between the first end and the second end of the auxiliary suture, and no portion of the auxiliary suture passes through the second anchor body. The main suture is received and passed toward the first anchor body, and the first suture portion forms a first main loop that engages with the first anchor body by returning the main suture after passing through the first anchor body. The auxiliary suture is received, passed toward the first anchor body, and after the auxiliary suture portion is passed through the first anchor body, the auxiliary suture is returned to form an auxiliary loop that engages with the first anchor body, and A surgical implant assembly in which the main loop and the secondary loop overlap along the bridging portion of the main suture.

2. The surgical implant assembly according to claim 1, wherein the first and second anchor bodies are sufficiently deformable to pass through the respective bone tunnels drilled in the first and second metacarpal bones.

3. The first suture portion passes through multiple openings in the first anchor body, and The surgical implant body according to claim 1 or claim 2, wherein the second suture portion passes through a plurality of openings in the second anchor body.

4. The device further comprises a main suture sleeve for receiving the main suture and passing it toward the first anchor body, The surgical implant assembly according to any one of claims 1 to 3, wherein the first suture portion, after passing through the first anchor body, returns the main suture that passes through the main suture sleeve to form a first main loop that engages with the first anchor body.

5. The main suture sleeve is elongated and extends between the first and second ends of the main suture sleeve so that the main suture can be received at the first end of the main suture sleeve. Subsequently, the main suture thread is pulled out from the second end of the main suture thread sleeve, and the main suture thread portion is passed through the first anchor body. The surgical implant assembly according to claim 4, wherein the main suture is then returned to the second end of the main suture sleeve and pulled out from the first end of the main suture sleeve.

6. The surgical implant assembly according to claim 4 or 5, wherein at least a portion of the bridging portion passes through the main suture sleeve, extends out of the main suture sleeve, and then extends toward the second anchor body.

7. The system further comprises a secondary suture sleeve for receiving the secondary suture and passing it toward the first anchor body, The surgical implant assembly according to any one of claims 1 to 6, wherein after passing the auxiliary suture portion through the first anchor body, the auxiliary suture passing through the auxiliary suture sleeve is returned to form an auxiliary loop that engages with the first anchor body.

8. The auxiliary suture sleeve is elongated and extends between the first and second ends of the auxiliary suture sleeve so that the auxiliary suture is received at the first end of the auxiliary suture sleeve. Subsequently, the auxiliary suture is pulled out from the second end of the auxiliary suture sleeve, and the auxiliary suture portion is passed through the first anchor body. The surgical implant assembly according to claim 7, wherein the auxiliary suture is then returned to the second end of the auxiliary suture sleeve and exits from the first end of the auxiliary suture sleeve, so that both ends of the auxiliary suture extend from the second end of the auxiliary suture sleeve.

9. The surgical implant assembly according to claim 7, which is dependent on any one of claims 4 to 6, wherein the main sleeve portion and the sub-sleeve portion are joined at one or more joining positions.

10. The surgical implant assembly according to claim 8, dependent on claim 3, wherein the main sleeve portion and the sub-sleeve portion are joined or adjacent at the second end, respectively.

11. The surgical implant assembly according to claim 9 or 10, wherein each of the main sleeve portion and the sub-sleeve portion is formed from a fibrous material that defines a longitudinal lumen for each sleeve portion extending between the open ends.

12. The first anchor body has the main suture and the secondary suture, and comprises an elongated and deformable structure, The main suture and the secondary suture penetrate the elongated and deformable structure along multiple penetration points, The surgical implant assembly according to any one of claims 1 to 11, wherein tension is applied to the main suture and / or the secondary suture, thereby increasing the radial dimension of the first anchor, causing the first anchor to engage with the bone surface of the first metacarpal bone and preventing the anchor from passing through the bone tunnel of the first metacarpal bone.

13. The surgical implant assembly according to claim 12, wherein the main suture and the secondary suture penetrate the first anchor body at the plurality of penetration positions spaced apart from the end of the elongated structure of the first anchor body.

14. The second anchor body has the main suture thread and comprises an elongated and deformable structure, and the main suture thread penetrates the elongated and deformable structure at multiple penetration points, The surgical implant assembly according to any one of claims 1 to 13, wherein tension is applied to the main suture, increasing the radial dimension of the second anchor, causing the second anchor to engage with the bone surface of the second metacarpal bone and preventing the second anchor from passing through the bone tunnel of the second metacarpal bone.

15. The surgical implant assembly according to claim 14, wherein the main suture penetrates the second anchor body at a plurality of penetration positions spaced apart from the end of the elongated structure of the second anchor body.

16. The surgical implant assembly according to any one of claims 1 to 15, wherein each of the first anchor body and the second anchor body comprises a flat fibrous structure.

17. The surgical implant assembly according to any one of claims 1 to 16, wherein the end of the auxiliary suture is provided with a needle for penetrating tissue and passing the end through the tissue.

18. The inserter further comprises first and second elongated shafts, Each of the first and second shafts has a pair of claws positioned at the distal end of the shaft for defining a bone tunnel forming portion that is pressed into the bone to form the respective bone tunnel, The aforementioned claws are spaced apart, defining a slot between them, The surgical implant assembly according to any one of claims 1 to 17, wherein the slot forms an anchor holding portion located immediately adjacent to the passage forming portion, so that after the bone tunnel is formed, the anchor placed in the anchor holding portion advances into the bone tunnel.

19. The surgical implant assembly according to claim 18, wherein the first and second elongated shafts are perpendicular to each other.

20. The surgical implant assembly according to claim 18 or 19, wherein, when in use, the first anchor is attached to the anchor holding portion of the first shaft, and the second anchor is attached to the anchor holding portion of the second shaft.

21. The surgical implant assembly according to any one of claims 18 to 20, further comprising first and second inserter housings for receiving the proximal ends of the first and second elongated shafts, respectively.

22. The surgical implant assembly according to claim 21, wherein the first and second housing portions are provided with a plurality of suture receiving channels for winding and storing the main suture and the secondary suture.

23. A method for performing proximal phalangeal joint arthroplasty of the thumb, The aforementioned method, The process includes providing an implantable assembly, The aforementioned implantable assembly is First and second anchor bodies configured to engage with the respective metacarpal surfaces of the first and second metacarpal bones, A main suture having a suture length extending between the first and second ends of the main suture, A secondary suture having a suture length extending between the first and second ends of the secondary suture, The length of the main suture includes a first suture portion that passes through the first anchor body, and a second suture portion that passes through the second anchor body and has a bridging portion of the main suture that extends between the first suture portion and the second suture portion of the main suture. The first suture portion is located between the bridging portion and the first end, and the second suture portion is located between the bridging portion and the second end. The auxiliary suture includes an auxiliary suture portion that passes through the first anchor body, The auxiliary suture portion is located between the first end and the second end of the auxiliary suture, and no portion of the auxiliary suture passes through the second anchor body. The main suture is received and passed toward the first anchor body, and the first suture portion forms a first main loop that engages with the first anchor body by returning the main suture after passing through the first anchor body. The auxiliary suture is received, passed toward the first anchor body, and after the auxiliary suture portion is passed through the first anchor body, the auxiliary suture is returned to form an auxiliary loop that engages with the first anchor body, and The main loop and the sub-loop overlap along the bridging portion of the main suture, This includes the process of performing trapezium resection to create arthroplasty space, The process includes inserting the first anchor body through a first hole drilled transversely through the metacarpal bone of the index finger, and subsequently applying tension to the main suture, thereby causing the first hole to extend between two openings on the outer surface of the metacarpal bone of the index finger, and the first anchor body to engage with and be fixed to the surface of the metacarpal bone of the index finger, The process includes inserting the second anchor body through a second hole drilled transversely through the metacarpal bone of the thumb, and subsequently applying tension to the auxiliary suture, thereby causing the second hole to extend between two openings on the outer surface of the metacarpal bone of the thumb, and the second anchor body to engage with and be fixed to the surface of the metacarpal bone of the thumb. A method comprising the step of applying tension to the main suture and the auxiliary suture within the articular space along the articular base of the thumb metacarpal bone in order to position at least a portion of the bridging portion, the main loop of the main suture, and the auxiliary loop of the auxiliary suture portion.

24. The aforementioned implant assembly is A main suture sleeve for receiving the main suture and passing it toward the first anchor body, The system further comprises a secondary suture sleeve for receiving the secondary suture and passing it toward the first anchor body, After the first suture portion passes through the first anchor body, the main suture that passes through the main suture sleeve is returned to form a first main loop that engages with the first anchor body. After passing the secondary suture portion through the first anchor body, the secondary suture passing through the secondary suture sleeve is returned to form a secondary loop that engages with the first anchor body. The method according to claim 21, wherein tension is applied to the main suture and the secondary suture so that the main suture sleeve and the secondary suture sleeve are positioned below the joint base of the thumb metacarpal bone, forming a sling to support the joint base of the thumb metacarpal bone.

Images