Arthroscopic instruments for labral repair procedures and their use.

Abstract

Arthroscopic instrument for labral repair, comprising: a cannula-shaped working channel having a proximal and distal end; and a retaining element located at the proximal end of the working channel, wherein the proximal end of the working channel has a terminal edge and a terminal opening passing through the proximal end of the working channel, the entire terminal edge being located proximal to the working channel; the working channel having a longitudinal axis along at least the distal portion of the working channel; the proximal end of the working channel being positioned at a non-zero angle with respect to the longitudinal axis; and the retaining element having at least one support surface for simultaneously supporting the labrum during arthroscopic labral repair and allowing a drill to pass through both the labrum and the bone adjacent to the labrum.

Description

Technical Field

[0001] Related applications This application is a continuation of U.S. Patent Application No. 16 / 275,415, filed on February 14, 2019, and claims the benefit of priority of U.S. Provisional Patent Application No. 62 / 631,571, filed on February 16, 2018. The entire contents of each of the above applications are hereby incorporated by reference in their entirety as if fully set forth herein.

[0002] Technical field The present invention generally relates to instruments for labral repair techniques, such as arthroscopic instruments for hip reconstruction techniques.

Background Art

[0003] The treatment of musculoskeletal diseases usually involves reattaching ligaments, tendons, or other tissues to bone. This requires placing an anchor within the bone. After inserting the anchor, the tissue to be repaired is grasped with a suture, and after pre-attaching the suture to the anchor, a knot is often made in the suture to adjust the tension and fix the tissue at the desired position.

[0004] In particular, various structural abnormalities of the hip joint require hip reconstruction techniques, which involve detachment of the labral tissue. Subsequently, it is necessary to reattach the labrum to the bone using an anchor. Also, the treatment of the hip joint is particularly difficult because the hip joint is deep, and it may be difficult to insert surgical instruments into the joint while operating the surgical instruments from outside the patient's body. Moreover, the working space in the hip joint is minimal, and there is little room for joint repair such as reattaching a torn labrum to the acetabular rim.

Summary of the Invention

[0005] An object of the present invention is to provide an arthroscopic instrument and method for improved labral repair techniques.

[0006] Example 1. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, The work channel comprises a retaining element located at the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element is used during arthroscopic labral repair procedures. To support the labrum, and, To allow the drill to pass through both the labrum and the bone adjacent to the labrum, Having at least one support surface for performing the same action simultaneously, Arthroscopic instruments for labral repair procedures.

[0007] Example 2. The system further comprises an anchor cassette adapted to be attached to the aforementioned work channel. Arthroscopic instruments for the labral repair procedure described in Example 1.

[0008] Example 3. The anchor cassette has at least two anchors connected by surgical sutures. Arthroscopic instruments for the labral repair procedure described in Example 2.

[0009] Example 4. The retaining element has a distal end that is adapted to be securely attached to the proximal end of the work channel. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-3.

[0010] Example 5. The proximal end of the work channel defines an inclined edge. An arthroscopic instrument for the arthroscopic labral repair technique according to any one of Examples 1 to 4.

[0011] Example 6. The holding element is adapted to be attached to the proximal end of the working channel at the inclined edge. An arthroscopic instrument for the arthroscopic labral repair technique according to Example 5.

[0012] Example 7. The holding element includes an upwardly projecting portion adapted to support the tissue to be treated during the arthroscopic labral repair technique. An arthroscopic instrument for the arthroscopic labral repair technique according to any one of Examples 1 to 6.

[0013] Example 8. The holding element has a concave surface on the distal side of the upwardly projecting portion, and the concave surface is adapted to support the tissue to be treated during the arthroscopic labral repair technique. An arthroscopic instrument for the arthroscopic labral repair technique according to Example 7.

[0014] Example 9. The holding element is selectively positionable at various angles with respect to the working channel. An arthroscopic instrument for the arthroscopic labral repair technique according to any one of Examples 1 to 8.

[0015] Example 10. The working channel is adapted such that at least one surgical drill can pass through the working channel. An arthroscopic instrument for the arthroscopic labral repair technique according to any one of Examples 1 to 9.

[0016] Example 11. The holding element is positionable with respect to the working channel such that the surgical drill passing through the working channel passes through a part of the labrum supported by the at least one support surface. An arthroscopic instrument for the arthroscopic labral repair technique according to Example 10.

[0017] Example 12. The working channel has a longitudinal axis along at least a distal portion of the working channel, and the anchor cassette is disposed along the longitudinal axis of the working channel. An arthroscopic instrument for the labral repair technique according to Example 2 or 3.

[0018] Example 13. The anchor cassette is mounted in the working channel. An arthroscopic instrument for the labral repair technique according to any one of Examples 2 to 3 and 12.

[0019] Example 14. It has a guide part attached to a part of the working channel and adapted to guide the insertion of at least one anchor into the part of the working channel. An arthroscopic instrument for the labral repair technique according to any one of Examples 1 to 13.

[0020] Example 15. The guide part has a closing direction, and the working channel has a size and shape that positions the surgical drill within the working channel when the guide part is in the closing direction. An arthroscopic instrument for the labral repair technique according to Example 14.

[0021] Example 16. When the guide part is in the closing direction, the at least one anchor is prevented from being released into the working channel. An arthroscopic instrument for the labral repair technique according to Example 14 or 15.

[0022] Example 17. The working channel has a size and shape that allows a pusher to be inserted into the working channel, and the pusher is displaceable proximally to fix at least one anchor in bone. An arthroscopic instrument for the labral repair technique according to any one of Examples 1 to 16.

[0023] Example 18. The terminal opening has a shape corresponding to the cross-section of the work channel, and the cross-section passes through the longitudinal axis of the work channel and is taken at an angle to the proximal end of the work channel. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-17.

[0024] Example 19. The most proximal end of the work channel defines a plane, and the terminal opening defines a plane parallel to the plane. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-18.

[0025] Example 20. The retaining element enables alignment of the labrum and the bone adjacent to the labrum. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-19.

[0026] Example 21. The holding element is rotatable about the longitudinal axis of the work channel. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-20.

[0027] Example 22. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, The work channel comprises a retaining element located at the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element has at least one support surface that supports the labrum during arthroscopic labral repair procedures. The retaining element includes an upward-facing ridge adapted to support the tissue being treated during the labral repair procedure, The retaining element has a concave surface distal to the upward-facing protrusion, and the concave surface is adapted to support the tissue to be treated during the labral repair procedure. Arthroscopic instruments for labral repair procedures.

[0028] Example 23. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, The work channel comprises a retaining element located at the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element is used during arthroscopic labral repair procedures. To support the labrum, and, To allow the drill to pass through both the labrum and the bone adjacent to the labrum, Having at least one support surface for performing the same action simultaneously, The arthroscopic instrument further comprises an anchor cassette adapted to be attached to the working channel, the anchor cassette having at least two anchors. Arthroscopic instruments for labral repair procedures.

[0029] Example 24. The at least two anchors are connected by surgical sutures. Arthroscopic instruments for the labral repair procedure described in Example 23.

[0030] Example 25. The support surface allows the drill to pass through the labrum and one of the acetabulum and the glenoid bone. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-21 and 23-24.

[0031] Example 26. The arthroscopic instrument is used as a working channel for at least one of the drill, pusher, suture threader, and suture cutter. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-16.

[0032] Example 27. The arthroscopic instrument has a distal tube portion and an attached proximal tube portion, and the working channel extends through the distal tube portion and the proximal tube portion. Arthroscopic instruments for labral repair procedures as described in any one of Examples 1-26.

[0033] Example 28. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal portion with a proximal end and a distal portion, The work channel comprises a retaining element located at the proximal end of the work channel, The communication hole extends through the proximal and distal portions of the work channel, and the proximal end of the work channel has a terminal edge and a terminal opening that passes through the proximal end of the work channel, the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along the distal portion of the work channel, and the communication hole includes a distal hole formed through the distal portion of the work channel and a proximal hole formed through the proximal portion of the work channel, wherein the proximal hole is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element has at least one support surface for supporting the labrum during arthroscopic labral repair procedures. Arthroscopic instruments for labral repair procedures.

[0034] Example 29. The retaining element includes an upward-facing protrusion adapted to support the tissue to be treated during the labral repair procedure, the retaining element having a concave surface distal to the upward-facing protrusion, the concave surface adapted to support the tissue to be treated during the labral repair procedure. Arthroscopic instruments for labral repair procedures as described in any one of Examples 23-28.

[0035] Example 30. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, A retaining element adapted to be attached to the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element has at least one support surface for supporting the labrum during arthroscopic labral repair procedures. Arthroscopic instruments for labral repair procedures.

[0036] Example 31. Arthroscopic instruments for tissue repair procedures, It comprises a cannula-shaped working channel having a proximal portion with a proximal end and a distal portion, The communication hole extends through the proximal and distal portions of the work channel, and the proximal end of the work channel has a terminal edge and a terminal opening that passes through the proximal end of the work channel, the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along the distal portion of the work channel, and the communication hole includes a distal hole formed through the distal portion of the work channel and a proximal hole formed through the proximal portion of the work channel, wherein the proximal hole is positioned at a non-zero angle with respect to the longitudinal axis. The working channel has a size and shape for inserting a pusher through the working channel, the pusher is displaceable proximally to fix multiple anchors in the bone, and the multiple anchors are connected by surgical sutures. Arthroscopic instruments for tissue repair procedures.

[0037] Example 32. The aforementioned tissue repair procedure is a labral repair procedure. The arthroscopic instrument has a retaining element located at the proximal end of the working channel, and the retaining element is used during arthroscopic labral repair procedures. To support the labrum, and, To allow the drill to pass through both the labrum and the bone adjacent to the labrum, Having at least one support surface for performing the same action simultaneously, Arthroscopic instruments for tissue repair procedures as described in Example 31.

[0038] Example 33. The support surface of the device supports the labrum, The drill is passed through the working channel of the instrument such that it passes through both the labrum and the bone adjacent to the labrum. Methods for repairing the labrum, including those mentioned above.

[0039] Unless otherwise defined, all technical and / or scientific terms described herein have the meaning commonly understood in the art relating to the present invention. While methods and materials similar to or equivalent to those described above may be used in carrying out or verifying embodiments of the present invention, the following describes exemplary methods and / or materials. In the event of any inconsistency, the patent specification, including definitions, shall prevail. Furthermore, the above materials, methods, and examples are merely illustrative and should not be construed as limiting. [Brief explanation of the drawing]

[0040] The present invention can be more fully understood and appreciated by referring to the following detailed description and drawings.

[0041] [Figure 1] Figures 1A to 1D are simplified diagrams of the typical anatomical structure of the hip joint. [Figure 2] This is a simplified flowchart illustrating the surgical process for labral repair. [Figure 3] Figures 3A and 3B are simplified exploded perspective and cross-sectional exploded perspective views of an instrument for a labral repair procedure, which is configured and operated according to one embodiment of the present invention. [Figure 4] Figures 4A and 4B are simplified side and cross-sectional views of the distal tube portion of the labral repair instrument shown in Figures 3A and 3B. [Figure 5] Figures 5A and 5B are simplified side and cross-sectional views of the proximal tubing portion of the labral repair instrument shown in Figures 3A and 3B. [Figure 6] Figures 3A and 3B are schematic side views of the holding member of the instrument used for labral repair procedures. [Figure 7] Figures 3A and 3B show simplified partial cross-sections of an anchor cassette adapted for the attachment of labral repair instruments. [Figure 8A] Figures 3A and 3B are simplified side views of the assembly device used for labral repair procedures. [Figure 8B]Figures 3A and 3B are simplified cross-sectional views of the assembled instruments used in labral repair procedures. [Figure 9] Figures 3A and 3B show a magnified, simplified side view of the labral repair instrument, which has a drill, placed inside the bone of a patient. [Figure 10] Figures 3A and 3B show a simplified side view of the labral repair instrument with a drill, located within the bone of a patient, magnified by the drill. [Modes for carrying out the invention]

[0042] This specification discloses an instrument for labral repair procedures. This instrument is particularly useful for fixing soft tissue to bone and is applicable, for example, when fixing the labrum to the acetabulum or to the glenoid bone.

[0043] Here, we refer to Figures 1A to 1D, which show the typical anatomical structure of the hip joint. Figure 1A depicts a normal hip joint structure, where the femur is partially inserted into the acetabulum. Figure 1B shows a pathological structure of the hip joint, where the femur is enlarged and unable to perform normal function. Figure 1C shows a pathological structure of the hip joint, where the acetabulum is enlarged, impairing the normal function of the hip joint. Figure 1D shows an even more pathological hip joint structure. Both the femur and acetabulum are enlarged, which prevents the hip joint from functioning normally.

[0044] Currently known surgical procedures involve partially separating the labrum, located between the hip and acetabulum, from the bone, repairing the pathological bone structure, and then reattaching the labrum to the bone using sutures that surround it. The sutures placed around the labrum are known to be traumatic for the patient and can hinder joint healing and cause wear.

[0045] One embodiment of the present invention is characterized by the fact that, instead of encircling the labrum with the suture, the suture passes through the labrum, thereby facilitating healing and ensuring proper function of the hip joint.

[0046] It should be noted that similar surgery may also be performed on the labrum, which is located between the clavicular fossa and the humeral head of the shoulder joint.

[0047] Here, we refer to Figure 2, a simplified flowchart illustrating the procedure for labral repair.

[0048] As shown in Figure 2, an instrument 100 having the configuration and function according to one embodiment of the present invention is inserted into the patient's body and adapted to support the labrum. For example, a perforation element such as a K-wire is used to perforate the bone through the labrum via the instrument 100.

[0049] A specific feature of one embodiment of the present invention is that the instrument 100 is used as a working channel for various surgical instruments such as drills, pushers, suture threaders, and suture cutters.

[0050] Furthermore, Figure 2 shows that the first anchor is inserted into the patient's bone via the labrum through the instrument 100. Additional holes are drilled in the patient's bone at other locations. Subsequently, a second anchor is inserted through the labrum via the instrument 100 into the additional holes in the patient's bone. It is understood that any desired number of anchors may be inserted to securely attach the labrum to the patient's bone. It is also understood that sutures are attached to each anchor.

[0051] Since at least four anchors will be used in a single procedure, please understand that steps 2-7 of the procedure will be repeated as needed.

[0052] After inserting the desired number of anchors, the anchor sutures are tightened and any remaining suture material is removed.

[0053] One embodiment of the present invention is characterized in that the surgeon can perform all of these procedures without removing the instrument 100 from the initial insertion site, the surgeon can perform all of the procedures through a single working channel, and the repositioning of the treatment site after each step of the procedure is not required. Preferably, the instrument 100 is operatively engaged with the labrum at each stage of the surgery.

[0054] Refer to Figures 3A and 3B, which are simplified exploded and cross-sectional exploded views, respectively, of the labral repair instrument 100 configured and operated according to an embodiment of the present invention.

[0055] As shown in Figures 3A and 3B, the hollow distal tube section 102 is adapted to be attached to the proximal tube section 104, both positioned along the longitudinal axis 105. A guide 103 is adapted to be attached to the distal tube section 102 to guide the insertion of the anchor into the distal tube section 102. A retaining member 106 is adapted to be attached to the proximal tube section 104 to support tissue, such as the labrum, while manipulating various surgical instruments at the treatment site.

[0056] Furthermore, it can be seen that the proximal tube portion 104 and the distal tube portion 102 are composed of a single, integrally manufactured element, arranged alternately.

[0057] The anchor cassette 110 is fitted to attach to the distal tubing 102 and is typically secured by two retention elements 112. The distal end of the anchor cassette 110 is fitted to partially insert a cover 114 for centering a surgical instrument fitted for passing through the labral repair instrument 100.

[0058] Here, refer to the simplified side view and cross-sectional view of the distal tube portion 102 of the labral repair instrument 100 shown in Figures 3A and 3B, respectively, as shown in Figures 4A and 4B.

[0059] In Figures 4A and 4B, it can be seen that the distal tube portion 102 is preferably a single-piecely fabricated element arranged along the longitudinal axis 105 and having a longitudinal hole 120 through which it passes. Furthermore, an opening 122 is formed on the circumference of the distal tube portion 102 for inserting a surgical anchor into the longitudinal hole 120.

[0060] Here, refer to the simplified side view and cross-sectional view of the proximal tube portion 102 of the labral repair instrument 100 shown in Figures 3A and 3B, respectively, as shown in Figures 5A and 5B.

[0061] In Figures 5A and 5B, it can be seen that the proximal tube portion 104 is preferably an integrally formed element partially arranged along the longitudinal axis 105. The proximal end 126 is preferably positioned at an angle to the main portion 128 of the proximal tube portion 104. A longitudinal hole 130 is formed through the main portion 128, and a hole 132 is formed through the proximal end 126. The proximal end 126 defines an inclined edge portion 134.

[0062] Here, we refer to Figure 6, which is a simplified side view of the holding member 106 of the labral repair instrument 100 shown in Figures 3A and 3B.

[0063] The retaining element 106 is preferably a single-piece element, as shown in Figure 6. The retaining element 106 has a concave surface 140 and an upward-facing protrusion 142 positioned adjacent thereto, and is preferably used to support the tissue to be treated. The distal end 144 of the retaining element 106 is fitted to be fixed to the proximal tube portion 104 of the labral repair instrument 100.

[0064] It should be noted that the retaining element 106 may be rotatably attached to the proximal tube portion 104 of the labral repair instrument 100.

[0065] Here, we refer to Figure 7, a simplified partial cross-sectional view of an anchor cassette 110 adapted to be attached to the labral repair instrument 100 shown in Figures 3A and 3B.

[0066] The anchor cassette is positioned along the longitudinal axis 105 and has a longitudinal hole 148 adapted for mounting the anchor cassette to the distal tube portion 102.

[0067] In this specific example shown in Figure 7, anchors 150, 152, and 154 are arranged within the anchor cassette, but any other number of anchors can be arranged within the anchor cassette, and at least two anchors are attached by surgical sutures (not shown). Anchors 150, 152, and 154 are preferably supported by springs (not shown).

[0068] A specific feature of one embodiment of the present invention is that, typically, two anchors 150 and 152 are arranged in a connected manner within the anchor cassette, and the anchors 150 and 152 are attached to each other by sutures. Alternatively, the anchors are arranged individually and separately within the anchor cassette 110.

[0069] Please note that the anchor cassette is disposable, and once an anchor has been removed, a new anchor cassette 110 should be attached to the labral repair instrument 110.

[0070] Here, we refer to the simplified side view and cross-sectional view of the labral repair procedure assembly device 100 shown in Figures 3A and 3B, respectively, as shown in Figures 8A and 8B.

[0071] Figures 8A and 8B show that the distal tube portion 102 is attached to or integrally formed with the proximal tube portion 104, and that the retaining elements 106 are sequentially attached to the proximal tube portion 104. The retaining elements 106 are held in a rotatably adjustable manner relative to the proximal tube portion 104, and the retaining elements 106 can be positioned at various angles relative to the proximal tube portion 104.

[0072] The cover 114 is fixed to the distal end of the distal tube portion 102 to center a surgical instrument that is fitted to be inserted into the instrument 100.

[0073] A specific feature of one embodiment of the present invention is that the longitudinal holes 120, holes 130 and 132 form working channels through which surgical instruments can be passed, and a retaining element 106 is integrally formed therein, so that soft tissue can be maintained and supported by the concave surface 140 and the raised portion 142.

[0074] The anchor cassette 110 is preferably fixed around the distal tube portion 102, such that the anchors 150, 152, and 154 are positioned adjacent to and slightly distal to the guide 103. The guide 103 closes when a surgical instrument is inserted into the working channel, and when the surgical instrument is removed from the working channel, the guide 103 becomes open, releasing at least one of the anchors 150, 152, and 154 and guiding it into the working channel defined by the holes 120, 130, and 132.

[0075] Here, see Figure 9, which is a simplified side view of the drill-equipped labral repair instrument 100 shown in Figures 3A and 3B, and an enlarged view of it shown within the patient's bone.

[0076] Figure 9 shows that a drill 202, such as a K-wire, is passed through the working channel of the labral repair instrument 100. The proximal tip of the drill 202 penetrates the labrum, which is supported by the retaining element 106, and extends into the patient's bone 200.

[0077] Furthermore, as long as the drill 202 is located within the work channel, the guide 103 remains closed, preventing the anchor from being released into the work channel.

[0078] Here, refer to Figure 10, which is a simplified side view and an enlarged view of the labral repair instrument 100 shown in Figures 3A and 3B, equipped with a pusher positioned within the patient's bone.

[0079] As shown in Figure 10, after the guide 103 releases one or more anchors, such as anchors 150, 152, and 154, into the working channel, the pusher 204 is inserted into the working channel and pushed proximal to fix the anchors to the patient's bone 200 while passing through the labrum.

[0080] It should be understood that each anchor can be inserted individually into its respective borehole. Alternatively, by connecting two or more anchors with sutures, one suture can be passed through the first hole and the other through the second hole, and then the sutures can be tightened to provide a contact surface (footprint) and apply greater pressure to the labrum, thereby attaching the labrum to the edge of the acetabulum or glenoid bone.

[0081] Those skilled in the art will understand from the above specific illustrations and descriptions that the present invention is not limited. Rather, the scope of the present invention includes combinations and partial combinations of the various features described above, as well as non-prior art variations and modifications relating thereto. Furthermore, any priority document in any of the patent documents of this application is incorporated herein by reference in whole.

Claims

1. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, The work channel comprises a retaining element located at the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element is used during arthroscopic labral repair procedures. To support the labrum, and, To allow the drill to pass through both the labrum and the bone adjacent to the labrum, Having at least one support surface for performing the same action simultaneously, Arthroscopic instruments for labral repair procedures.

2. The system further comprises an anchor cassette adapted to be attached to the aforementioned work channel. Arthroscopic instrument for labral repair procedures as described in claim 1.

3. The anchor cassette has at least two anchors connected by surgical sutures. Arthroscopic instrument for labral repair procedures as described in claim 2.

4. The retaining element has a distal end that is adapted to be securely attached to the proximal end of the work channel. An arthroscopic instrument for a labral repair procedure according to any one of claims 1 to 3.

5. The proximal end of the work channel defines an inclined edge. Arthroscopic instrument for labral repair procedures as described in claim 1.

6. The retaining element is adapted to be attached to the proximal end of the work channel at the inclined edge. Arthroscopic instrument for labral repair procedures as described in claim 5.

7. The retaining element includes an upward-facing ridge adapted to support the tissue being treated during the labral repair procedure, Arthroscopic instrument for labral repair procedures as described in claim 1.

8. The retaining element has a concave surface distal to the upward-facing protrusion, and the concave surface is adapted to support the tissue to be treated during the labral repair procedure. Arthroscopic instrument for labral repair procedures as described in claim 7.

9. The holding element can be selectively positioned at various angles relative to the work channel. Arthroscopic instrument for labral repair procedures as described in claim 1.

10. The work channel is adapted so that at least one surgical drill passes through the work channel. Arthroscopic instrument for labral repair procedures as described in claim 1.

11. The retaining element is positioned relative to the working channel so that the surgical drill passing through the working channel passes through a portion of the labrum supported by at least one support surface. Arthroscopic instrument for labral repair procedures according to claim 10.

12. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the anchor cassette is arranged along the longitudinal axis of the work channel. Arthroscopic instrument for a labral repair procedure according to claim 2 or 3.

13. The anchor cassette is mounted in the work channel. Arthroscopic instrument for a labral repair procedure according to claim 2 or 3.

14. A guide portion is attached to a portion of the work channel and is adapted to guide the insertion of at least one anchor into the portion of the work channel, Arthroscopic instrument for labral repair procedures as described in claim 1.

15. The guide portion has a closing direction, and the work channel has a size and shape that positions the drill within the work channel when the guide portion is in the closing direction. Arthroscopic instrument for labral repair procedures as described in claim 14.

16. When the guide is in the closing direction, the at least one anchor is prevented from being released into the work channel. Arthroscopic instrument for labral repair procedures according to claim 14 or 15.

17. The working channel has a size and shape that allows a pusher to be inserted into the working channel, and the pusher is displaceable proximally to fix at least one anchor in the bone. Arthroscopic instrument for labral repair procedures as described in claim 1.

18. The terminal opening has a shape corresponding to the cross-section of the work channel, and the cross-section passes through the longitudinal axis of the work channel and is taken at an angle to the proximal end of the work channel. Arthroscopic instrument for labral repair procedures as described in claim 1.

19. The most proximal end of the work channel defines a plane, and the terminal opening defines a plane parallel to the plane. Arthroscopic instrument for labral repair procedures as described in claim 1.

20. The retaining element enables alignment of the labrum and the bone adjacent to the labrum. Arthroscopic instrument for labral repair procedures as described in claim 1.

21. The holding element is rotatable about the longitudinal axis of the work channel. Arthroscopic instrument for labral repair procedures as described in claim 1.

22. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, The work channel comprises a retaining element located at the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element has at least one support surface that supports the labrum during arthroscopic labral repair procedures. The retaining element includes an upward-facing ridge adapted to support the tissue being treated during the labral repair procedure, The retaining element has a concave surface distal to the upward-facing protrusion, and the concave surface is adapted to support the tissue to be treated during the labral repair procedure. Arthroscopic instruments for labral repair procedures.

23. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, The work channel comprises a retaining element located at the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element is used during arthroscopic labral repair procedures. To support the labrum, and, To allow the drill to pass through both the labrum and the bone adjacent to the labrum, Having at least one support surface for performing the same action simultaneously, The arthroscopic instrument further comprises an anchor cassette adapted to be attached to the working channel, the anchor cassette having at least two anchors. Arthroscopic instruments for labral repair procedures.

24. The at least two anchors are connected by surgical sutures. Arthroscopic instrument for labral repair procedures as described in claim 23.

25. The aforementioned support surface is The aforementioned labrum, The acetabulum and one of the glenoid bones, Allowing the drill to pass through, An arthroscopic instrument for a labral repair procedure according to any one of claims 1 to 3 and 22 to 24.

26. The arthroscopic instrument is used as a working channel for at least one of the drill, pusher, suture threader, and suture cutter. An arthroscopic instrument for a labral repair procedure according to any one of claims 1 to 3 and 22 to 24.

27. The arthroscopic instrument has a distal tube portion and an attached proximal tube portion, and the working channel extends through the distal tube portion and the proximal tube portion. An arthroscopic instrument for a labral repair procedure according to any one of claims 1 to 3 and 22 to 24.

28. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal portion with a proximal end and a distal portion, The work channel comprises a retaining element located at the proximal end of the work channel, The communication hole extends through the proximal and distal portions of the work channel, and the proximal end of the work channel has a terminal edge and a terminal opening that passes through the proximal end of the work channel, the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along the distal portion of the work channel, and the communication hole includes a distal hole formed through the distal portion of the work channel and a proximal hole formed through the proximal portion of the work channel, wherein the proximal hole is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element has at least one support surface for supporting the labrum during arthroscopic labral repair procedures. Arthroscopic instruments for labral repair procedures.

29. The retaining element includes an upward-facing protrusion adapted to support the tissue to be treated during the labral repair procedure, the retaining element having a concave surface distal to the upward-facing protrusion, the concave surface adapted to support the tissue to be treated during the labral repair procedure. Arthroscopic instrument for a labral repair procedure according to claim 23 or 24.

30. Arthroscopic instruments for labral repair procedures, A cannula-shaped working channel having a proximal end and a distal end, A retaining element adapted to be attached to the proximal end of the work channel, The proximal end of the work channel has a terminal edge and a terminal opening passing through the proximal end of the work channel, and the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along at least the distal portion of the work channel, and the proximal end of the work channel is positioned at a non-zero angle with respect to the longitudinal axis. The retaining element has at least one support surface for supporting the labrum during arthroscopic labral repair procedures. Arthroscopic instruments for labral repair procedures.

31. Arthroscopic instruments for tissue repair procedures, It comprises a cannula-shaped working channel having a proximal portion with a proximal end and a distal portion, The communication hole extends through the proximal and distal portions of the work channel, and the proximal end of the work channel has a terminal edge and a terminal opening that passes through the proximal end of the work channel, the entire terminal edge is located proximal to the work channel. The work channel has a longitudinal axis along the distal portion of the work channel, and the communication hole includes a distal hole formed through the distal portion of the work channel and a proximal hole formed through the proximal portion of the work channel, wherein the proximal hole is positioned at a non-zero angle with respect to the longitudinal axis. The working channel has a size and shape for inserting a pusher through the working channel, the pusher is displaceable proximally to fix multiple anchors in the bone, and the multiple anchors are connected by surgical sutures. Arthroscopic instruments for tissue repair procedures.

32. The aforementioned tissue repair procedure is a labral repair procedure. The arthroscopic instrument has a retaining element located at the proximal end of the working channel, and the retaining element is used during arthroscopic labral repair procedures. To support the labrum, and, To allow the drill to pass through both the labrum and the bone adjacent to the labrum, Having at least one support surface for performing the same action simultaneously, The arthroscopic instrument for tissue repair procedures according to claim 31.

33. The support surface of the device supports the labrum, The drill is passed through the working channel of the instrument such that it passes through both the labrum and the bone adjacent to the labrum. Methods for repairing the labrum, including those mentioned above.

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