Suture anchor structures and deployment devices

Abstract

A soft suture anchor construct is provided for placement within or against tissue or bone. The anchor (20) includes a full suture anchor having two ends (22, 24) positioned in a first direction in a pre-deployed configuration. In the deployed configuration, the two ends are positioned in a second direction different from the first direction. The suture anchor construct (10) also includes a filament (30) passing through the anchor at a plurality of pass locations, the filament changing direction at least once along the longitudinal axis of the anchor to form at least one slack line. In the pre-deployed configuration, the filament extends a first length between adjacent pass locations, and the filament extends a second length between adjacent pass locations. The second length is shorter than the first length. The suture anchor construct can be placed into a bone hole using an inserter, anchor driver, or other deployment device.

Description

Technical Field

[0001] Cross - reference to Related Applications This application claims the priority and benefit of U.S. Patent Application No. 15 / 687,040, filed Aug. 25, 2017; U.S. Provisional Patent Application No. 62 / 515,023, filed Jun. 5, 2017; and U.S. Provisional Patent Application No. 62 / 517,395, filed Jun. 9, 2017.

[0002] The present invention relates to a soft suture anchor construct for internal body fixation including within a tip portion, and more particularly to a soft suture anchor construct having a full suture anchor that can be fixed within a narrow and shallow bone hole.

Background Art

[0003] Description of Related Art Anchors are commonly used during surgery to capture and hold an object, such as bone or soft tissue, at a desired attachment location. In particular, conventional full suture anchors are often used to repair soft tissue to bone due to certain benefits of the soft material including the full suture anchor (as understood by those skilled in the art). To deploy a conventional full suture anchor, the anchor is inserted into a pre - formed hole in the bone. A suture or other filament is sewn through the anchor, secured around it, and extends out of the bone hole from the anchor. Next, the suture or other filament is used to loop or otherwise attach to (or already be attached to) the soft tissue through it. Thus, when the suture or other filament is under tension, the soft tissue and the anchor are pulled relative to each other to a desired position.

[0004] Many surgical procedures, including soft tissue fixation at the tip of a suture, require anchors that can be used in shallow holes with a narrow diameter, for example, due to the nature of the surgical site. For shallow bone holes, the anchor needs to have excellent retention capabilities, as movement away from the shallow bone hole could potentially release the anchor completely from the bone hole. Many factors can affect the retention capacity of a suture anchor. For example, external factors such as the type and size of the bone hole tissue affect the retention capacity of the suture anchor. Other factors related to the anchor's design, such as size, shape, and material composition, also affect the retention capacity. Furthermore, the method of deployment of the suture anchor can also affect its retention capacity.

[0005] Conventional soft suture anchors for bone holes are often too large and can extend outward from the shallow, narrow bone hole at the tip. Inappropriate suture anchors increase instability and can cause inflammation or damage to the surrounding tissue where the anchor is exposed. Attempts to address this problem include reducing the size of conventional suture anchors to fit into shallow, narrow bone holes. However, reducing the size of conventional suture anchors causes them to lose their holding capacity and are therefore unstable within the bone hole.

[0006] In light of the foregoing, the inventors have identified and recognized the continuing need for suture anchors that provide reliable retention when installed in shallow, narrow bone holes.

[0007] Explanation of the Disclaimer in the Related Technical Section: To the extent that specific patents / publications / products are discussed in this Explanation in the Related Technical Section or elsewhere in this disclosure, these discussions should not be taken as permission for the patents / publications / products discussed to be prior art for the purposes of patent law. For example, some or all of the patents / publications / products considered are prior art for the purposes of patent law. It does not have to be minute early, it does not have to reflect subject matter that developed sufficiently early in time, and / or it does not have to be sufficiently effective to constitute prior art for the purposes of patent law. To the extent that a particular patent / publication / product is discussed above in the description of this relevant technical section and / or throughout the application, its description / disclosure is incorporated herein by reference. [Overview of the project]

[0008] Embodiments of the present invention recognize that there are potential problems and / or drawbacks with conventional suture anchors (as discussed above in this specification). For example, when conventional suture anchors are scaled down to fit into narrow bone holes, the scaled-down suture anchors lose their retention capacity and are therefore more likely to be pulled out of the bone hole. Thus, there is a need for an easily usable soft suture anchor construct having an anchor that is optimally positioned in shallow, narrow holes in the bone without compromising retention capacity. Various embodiments of the present invention may be advantageous in that they can solve or reduce one or more of the potential problems and / or drawbacks described herein.

[0009] This disclosure relates to the configuration, structure, and consequent function of the invention of a flexible suture anchor construct. The flexible suture anchor construct is provided for deployment in, through, or in contact with tissue or bone. The anchor may include a full suture anchor having two ends positioned in a first direction / facing a first direction in a pre-deployed configuration. In the deployed configuration, the two ends are positioned in a second direction / facing a second direction different from the first direction.

[0010] According to another embodiment, the flexible suture anchor structure system further includes a filament having a first end and a second end. The filament passes through the anchor, passing through a passage position between the two ends of the anchor. Preferably, the filament passes through the anchor at at least two central passage positions and two longitudinal passage positions. The system may also include anchor deployment devices such as inserters, anchor drivers, and other deployment devices having fork-shaped or other similarly shaped tips configured to capture and effectively deploy the anchor (further described below). Preferably, the anchor is positioned within the fork-shaped tip between the two central passage positions for balanced deployment.

[0011] In another embodiment, a method for deploying a flexible suture anchor structure is provided. The method comprises providing a flexible suture anchor and a filament having a first end and a second end. The filament passes through the anchor at passing positions between the two ends within the anchor. Specifically, the filament can pass through at least two central passing positions and two longitudinal passing positions. After a borehole is prepared, the anchor is passed through the hole by an anchor deployment device. The anchor is in a pre-deployed configuration in which the filament extends by a first length between adjacent passing positions, and the ends of the anchor face the first direction. Thereafter, while the filament is over the tip of the anchor driver in the borehole, the filament can be subjected to tension by pulling at least one end of the filament. As a result of the tension, the filament is stretched by a second length between adjacent passing positions, and the ends of the anchor face the second direction, which is different from the first direction. The second length is shorter than the first length so that the anchor is modified into a deployed configuration.

[0012] When the term is used and described herein, filaments, suture materials, or sutures include single-filament and braided (i.e., multi-filament) sutures, as well as any other metallic or non-metallic filament or wire-like material suitable for performing the function of sutures. This material includes both bioabsorbable and non-absorbable materials. It may include.

[0013] Suture anchors, as the term is used herein, may include soft suture anchors formed from filaments of suture material that are retained within a pre-formed bone hole by deforming to have a diameter larger than the size of the bone hole, thereby being present within the cancellous bone and subcortically. Some embodiments of such suture anchors and their inherent functionality when deployed in bone holes are disclosed in U.S. Patent Publication 2012 / 0290004, which is assigned to the assignee and incorporated herein by reference in its entirety. Soft anchors are usually made entirely of suture material and are therefore sometimes called “full suture” anchors, and generally include a fixed body portion of a fibrous structure (or a fibrous, braided or woven type structure such as a flexible web, as described in U.S. Patent No. 9,173,652) and a suture or filament portion. [Brief explanation of the drawing]

[0014] The present invention will be more fully understood and recognized by reading the following detailed description in conjunction with the accompanying drawings. The accompanying drawings illustrate only general embodiments of the disclosed subject matter and do not limit the scope of the disclosed subject matter, and other equally valid embodiments may be permitted.

[0015] Here's a brief look at the attached diagram.

[0016] [Figure 1] Figure 1 is a side view of a flexible suture anchor structure in a pre-configured configuration according to an embodiment. [Figure 2]Figure 2 is a side view of a flexible suture anchor structure loaded onto an inserter according to an embodiment. [Figure 3] Figure 3 is a side view of a flexible suture anchor structure loaded into a fully assembled deployment device according to an embodiment. [Figure 4] Figure 4 is a side view of the tensioning mechanism of the deployment device with the outer housing removed, according to an embodiment. [Figure 5] Figure 5 is a side view of the filaments of a flexible suture anchor structure loaded into the tension mechanism of the deployment device according to an embodiment. [Figure 6] Figure 6 is a schematic perspective view of the gears of a fully assembled deployment device tensioning mechanism according to an embodiment. [Figure 7] Figure 7 is a side view of a soft suture anchor structure, according to an embodiment, which is loaded onto an inserter and placed in a bone hole. [Figure 8] Figure 8 is a side view of a flexible suture anchor structure between pre-deployed and deployed components according to an embodiment. [Figure 9] Figure 9 is another side view of a flexible suture anchor structure between pre-deployed and deployed configurations according to an embodiment. [Figure 10] Figure 10 is a final side view of a flexible suture anchor structure between pre-deployed and deployed components according to an embodiment. [Figure 11] Figure 11 is a side view of a flexible suture anchor structure in a deployed configuration according to an embodiment. [Figure 12] Figure 12 is a side view of a flexible suture anchor structure in a fully deployed configuration according to an embodiment. [Figure 13] Figure 13 is an enlarged perspective schematic of a flexible suture anchor structure in a fully deployed configuration according to an embodiment. [Figure 14A] Figure 14A is a side view of a flexible suture anchor structure in a pre-configured configuration according to an embodiment. [Figure 14B]FIG. 14B is a side view of the soft suture anchor construct of FIG. 14A in the deployed configuration according to an embodiment. [Figure 14C] FIG. 14C is a side view of the soft suture anchor construct in the pre-deployed configuration according to an embodiment. [Figure 14D] FIG. 14D is a side view of the soft suture anchor construct of FIG. 14C in the deployed configuration according to an embodiment. DETAILED DESCRIPTION

[0017] Referring now to the drawings, like reference numerals refer to like parts throughout, and in FIG. 1, a side view of a soft suture anchor construct 10 according to an embodiment is shown. In the illustrated embodiment, the suture anchor construct 10 includes an anchor 20 having a first end 22 and a second end 24, with a proximal side 26 and a distal side 28 extending therebetween. The anchor 20 shown in FIG. 1 is a full suture anchor and can be composed of tubular or non-tubular strands of suture. The anchor 20 may also be cylindrical and solid, or may have a hollow core, and may be flat or non-planar (to be understood by those skilled in the art in conjunction with a review of the present disclosure). The full suture anchor 20 is soft with respect to fixation to soft tissue and is configured and ultimately positioned to minimize damage to surrounding tissue and bone (to be understood by those skilled in the art in conjunction with a review of the present disclosure).

[0018] The anchor 20 is preferably made from polyester suture No. 5 because the anchor is ideally relatively large and rigid during deployment. The polyester suture No. 5 anchor is, for example, sewn more highly and densely than a typical Y-Knot® anchor. As an additional advantage, the polyester suture No. 5 anchor 20 is less than 50% the length of a typical Y-Knot® anchor, having a length of 18 mm to 40 mm. Thus, while a Y-Knot® anchor is typically used in a 20 mm to 24 mm bone hole, the anchor 20 shown in FIG. 1 is preferably deployed in a narrow bone hole of about 10 mm.

[0019] Referring further to Figure 1, the soft suture anchor structure 10 includes a through filament 30 with a first end 32 and a second end 34 sutured through an anchor 20 in a T-shape in a pre-positioned configuration. Different combinations of body sizes of the filament 30 and anchor 20 are possible, as long as the anchor 20 is thicker than the filament 30. In the embodiment shown in Figure 1, the anchor 20 is a No. 5 suture and the filament 30 is a No. 0 suture. The holding force of the No. 5 suture anchor 20 is greater than the tensile strength of the No. 0 suture filament 30 sutured through it. Therefore, it is preferable that the No. 0 suture filament 30 breaks before the proximal movement of the No. 5 suture anchor 20 when the No. 5 suture anchor 20 is positioned and fixed in the correct position in the bone hole and the filament 30 is pulled. This characteristic of the positioned anchor 20 minimizes creep toward the upper / proximal end of the bone hole. Since the bone hole is relatively small and shallow when formed at the tip, proximal movement of the deployed anchor 20 in the bone hole is undesirable. Therefore, even slight movement of the anchor 20 can completely remove it from the bone hole. When more tension is applied to the No. 0 suture filament 30, the No. 5 suture anchor 20 is configured at the bottom of the bone hole to lock into place, expanding and wedge-shaped (based on the specific arrangement of the filaments through the anchor, the force and position applied by the deployment device on the anchor, and the properties of the anchor itself). The properties of specific whole suture anchors are described, for example, in U.S. Patent Application Publication No. 2012 / 0290004. As described in U.S. Patent Application Publication No. 2012 / 0290004 (for example, shown in paragraph 0060 and Figures 5 to 6, and generally shown and described in U.S. Patent 9173652), embodiments of the flexible anchor (or “full suture” anchor) described herein may include two sections: at least one filamentous and fibrous structure (fixed body) which, as part of the deployment, has increased width, thickness, and / or diameter and reduced length It may be small. When deployed, it is the fibrous structure (anchor) whose width, thickness, and / or diameter increase, but it should be understood that the filaments also play a role in the deployment of the anchor. The filaments can slide freely (in some embodiments) and, in other embodiments, are not slidable in relation to the fibrous structure (at least at a specific position or point in use). Briefly, the filaments help position, align, and support the fibrous structure (anchor). Other examples of combinations of anchors 20 with combinations of filaments 30 may include, but are not limited to, No. 5 anchors with No. 2 sutures and No. 2 anchors with No. 2-0 sutures.

[0020] In the embodiment shown in Figure 1a, the passing filament 30 enters and exits the proximal 26 and distal 28 of the anchor 20 at a plurality of passing positions 36, 38. In particular, the filament 30 sews through the anchor 20 at two central passing positions 36 and a plurality of longitudinal passing positions 38, with the first and second ends 32, 34 of the filament 30 extending from the central passing position 36 on the distal 26 of the anchor 20. In the embodiment shown in Figure 1, the filament 30 sews through the anchor 20 at a total of six passing positions 36, 38, which have longitudinal passing positions 38 between the central passing position 36 of the anchor 20 and the first and second ends 22, 24. However, in other embodiments, the number of passing positions 36, 38 may vary, as long as both the first and second ends 32, 34 of the filament 30 extend from the central passing position 36, and the passing position 38 in the longitudinal direction is between the central passing position 36 of the anchor 20 and the first and second ends 22, 24.

[0021] Referring to Figure 2, a side view of a flexible suture anchor structure 10 loaded onto a deployment device / inserter 40 according to an embodiment is shown. As shown, the inserter 40 includes a fork-shaped distal tip 42 having a pair of corners 44. The suture anchor structure 10 is loaded onto the inserter 40 such that the anchor 20 is positioned between the pair of corners 44 on the fork-shaped tip 42. In the configuration shown in Figure 2, the suture anchor structure 10 is loaded onto the inserter 40 such that the distal end 28 of the anchor 20 is positioned distally when it is placed within the fork-shaped tip 42. However, in an alternative embodiment, the anchor 20 may be loaded between the pair of corners 44 such that the distal end 28 of the anchor 20 is positioned proximal when it is placed within the fork-shaped tip 42. Importantly, the anchor 20 is positioned within a fork-shaped tip 42 such that the first end 32 of the filament 30 extends along the first side 46 of the inserter 40 and the second end 34 of the filament extends along the second side 48 of the inserter 40.

[0022] Referring here to Figures 3 to 6, side views of the suture anchor structure 10 loaded onto the deployment device 50 according to the embodiment are shown. Briefly, Figure 3 shows a fully assembled deployment device 50 having a body extending along the longitudinal axis y--y and including a distal tip having a suture anchor structure 10 positioned on the distal end of the distal tip. Figure 4 shows the deployment device 50 with the outer housing removed to expose the tension mechanism 56. Figure 5 shows the deployment device with the outer housing removed to expose the tension mechanism 56 and shows the first and second ends 32, 34 of the filament 30 wound around the tension mechanism 56. Figure 6 shows the fully assembled deployment device 50 and the axial rotation of a gear 58 configured to move the tension mechanism 56 proximal (indicated by an arrow around the gear 58).

[0023] In some embodiments, an anchor driver or other deployment device 50 is used as a substitute for the inserter 40. Such an anchor driver or other deployment device 50 may also have a fork-shaped tip 52 with a pair of angles 54 for loading the sutured anchor structure 10. The tensioning mechanism 56 holds the first end 32 and the second end 34 of the filament 30 in tension and partially holds them at an angle from the y-axis in the longitudinal direction (Figure (See Figure 5). The first end 32 and second end 34 of the filament 30, which are stably wound around the tension mechanism 56, maintain the suture anchor structure 10 in a pre-positioned configuration (shown in Figures 1 to 3) so that it can be inserted into the bone hole. After the distal end is inserted (preferably completely) into the bone hole, the suture anchor structure 10 may be deployed by applying tension to the first end 32 and second end 34 of the filament 30 (by pulling the first and second ends proximal away from the distal end) to fully expand and set / secure the suture anchor structure 10 within the bone hole (preferably to the bottom of the hole). The tension mechanism 56 may be used to implement this tension. In particular, a knob, crank, or other gear 58 may be rotated or otherwise actuated (see Figure 6) to pull the first and second ends 32, 34 of the filament 30 proximal, as discussed herein, and deploy the suture anchor structure 10. The first and second ends 32, 34 of the filament 30 may then be released from the deployment device 50, and the deployment device may be removed from the surgical site. The first end 32 and the second end 34 of the filament 30 can be further manually pulled distally from the anchor 20 by the user / medical professional to further pull the filament 30 and, if necessary, fully expand and set / deploy the anchor 20 in the bone hole and complete the surgery (as should be understood by those skilled in the art in conjunction with a review of this disclosure).

[0024] The deployment of the soft suture anchor structure 10 is further described and illustrated with reference to Figures 7 to 13. Referring here to Figure 7, a side view of the soft suture anchor structure 10, implanted by an inserter 40 into a pre-formed bone hole 60 according to an embodiment, is shown. Once the suture anchor structure 10 is loaded into the inserter 40 (or other deployment device 50), the inserter 40 is used to push the suture anchor structure 10 into a narrow, pre-formed bone hole 60 (e.g., 10 mm deep). Such narrow bone holes 60 are often formed in smaller bones as needed, such as in the tip of a bone. The bone holes 60 can be formed by known methods and instruments, such as the use of a punch or perforation.

[0025] As the suture anchor structure 10 enters the narrow bone hole 60, the first end 22 and the second end 24 of the anchor 20 begin to fold or bend proximally toward the surface of the bone 62 due to the narrow width of the bone hole 60. As shown in Figure 7, the first end 22 of the anchor 20 folds toward the first end 32 of the filament 30 and the first side surface 46 of the inserter 40, while the second end 24 of the anchor 20 folds toward the second end 34 of the filament 30 and the second side surface 48 of the inserter 40.

[0026] After the suture anchor structure 10 is inserted into the pre-formed bone hole 60, the suture anchor structure 10 can be deployed. Referring to Figure 8, a side view of the soft suture anchor structure 10 in the pre-formed bone hole 60 during deployment is shown. To deploy the suture anchor structure 10, the inserter 40 is held in place and fully inserted into the bone hole 60, while the first and second ends 32, 34 of the filament 30 are subjected to tension and pulled proximal away from the anchor 20. When the first and second ends 32, 34 of the filament 30 are pulled, the length of the anchor 20 between the respective passing positions 36, 38 is pulled together toward the same length when the slack of the filament 30 between the passing positions 36, 38 is minimized. As a result, the first end 22 and the second end 24 of the anchor 20 begin to rotate so that they face distally toward the bottom 64 of the bone hole 60.

[0027] Referring to Figure 9, another side view is shown of the soft suture anchor structure 10 in a pre-formed bone hole 60 during deployment. To continue the deployment of the suture anchor structure 10, the first and second ends 32, 34 of the filament 30 are further pulled in a proximal direction away from the anchor 20. The additional slack of the filament 30 between the passing positions 36, 38 of the anchor 20 decreases as the first and second ends 32, 34 are pulled. As a result, The first and second ends 22, 24 of the anchor 20 continue to fold or bend in any other way until the ends 22, 24 of the anchor 20 face the bottom 64 of the bone hole 60. As the first and second ends 22, 24 of the anchor 20 fold, pleats 21 begin to form between adjacent passing positions 36, 38.

[0028] Referring to Figure 10, an additional side view of the soft suture anchor structure 10 in a pre-formed bone hole 60 during deployment is shown. As the first and second ends 22, 24 of the anchor 20 rotate to face the bottom 64 of the bone hole 60, the first and second ends 32, 34 of the filament 30 are further pulled distally away from the anchor 20. The added tension again shortens the filament 30 between adjacent passing positions 36, 38 of the anchor 20. As a result, the first and second ends 22, 24 of the anchor 20 are pulled together closer together through the anchor 20 toward the central longitudinal y-axis. As an additional result, the pleat 21 between adjacent passing positions 36, 38 is further defined.

[0029] Subsequently, as shown in Figure 11, the first and second ends 32, 34 of the filament 30 are pulled until there is no remaining slack between the passing positions 36, 38 adjacent to the anchor 20. In the illustrated embodiment, the ends 22, 24 of the anchor 20 face the bottom 64 of the bone hole 60 and are near the y-axis in the direction of the central long axis of the anchor 20. As shown, the anchor 20 having six passing positions 36, 38 has four defined pleats 21. The anchor 20 is reinforced by applying additional tension to the ends 32, 34 of the filament 30, forcing the anchor 20 to spread or expand inward into the bone hole 60 until it reaches the fully deployed configuration shown in Figure 12. In particular, in the depicted embodiment, as the anchor 20 is compressed or shortened, the anchor 20 expands in a direction perpendicular to its length (i.e., width or thickness) to set or secure the anchor in place in the bone hole (preferably, or near the bottom of the bone hole). When the pleats are measured along the filament 30 from a first distance 31 (Figure 1) to a second distance 33 which is relatively shorter than the first distance 31, the distance between adjacent passing positions 36, 38 is reduced.

[0030] The pleats 21 form a stack of mattress thickness that increases the diameter (measured relative to the y-axis of anchor 20 and the y-axis of bone hole 60). This relative increase in size with respect to the distance from the y-axis of bone hole 60 creates a holding force on anchor 20, including the aforementioned expansion of width and / or thickness. In other words, the Poisson's ratio of the increase in width and / or mattress thickness during the decrease in length provides an increase in deployment size in addition to the increase due to the force of the pleats 21 on anchor 20. Poisson's ratio defines the cause-and-effect relationship of expansion of a material in a direction perpendicular to the compression direction, and conversely, an expanding material tends to contract in a direction transverse to the expansion direction. The ratio defines a proportional decrease in the measurement in the length direction for a proportional increase in the length of a sample of stretchably expanded material. Thus, for example, if a material is compressed in the x direction, the material will expand in the y and / or z directions. An example of the use of Poisson's ratio is shown by comparing Figure 7 (showing the suture anchor structure 10 in a pre-deployed configuration, but inserted into a bone hole) and Figure 12 (showing the suture anchor structure 10 in a deployed configuration). Thus, increasing the number of passing positions 36, 38 from six to seven or more is likely to increase the number of pleats 21 and therefore likely to increase the size of the anchor 20 after deployment. However, the limiting factor is the amount of friction increased by the additional passing positions 36, 38. Furthermore, the size of the bone hole 60 is an additional limiting factor.

[0031] Referring to Figure 12, the suture anchor structure 10 is in a fully deployed configuration with the inserter 40 removed from the suture anchor structure 10 and the bone hole 60. Figure 13 shows a close-up view of the suture anchor structure 10 outside the bone hole in the deployed configuration with the filament 30 extending from the anchor 20. Referring again to Figure 12, the filament 30 is removed from the bone hole 60 by either the first end 32 or the second end The filaments 30 can be removed from the anchor 20 by pulling on either of the 34. Once the anchor 20 is set in the bone hole 60 and secured thereto, the final form of the anchor 20 in the deployed state allows the filaments 30 to slide easily. That is, the tensile strength of the anchor 20 in this configuration is sufficient to keep the anchor 20 in place while allowing the filaments 30 to be easily removed.

[0032] One particular flexible suture anchor structure 10 is shown and further described with respect to Figures 1 to 13, but other embodiments of the flexible suture anchor structures 10' and 10'' are shown and described with respect to Figures 14A to 14D. The anchor 20 can “ball up” or enter a deployed configuration when the filament 30 is subjected to tension, partly by at least one change / shift in the direction of the filament 30 along the longitudinal axis x--x of the anchor 20. The ends 32 / 34 of the filament 30 do not necessarily have to pass close to / adjacent to the center of the anchor and / or its ends 22 / 24 so as to be configured to form such deployed configuration structures. (In addition to the embodiments described above) In these described embodiments, in addition to the pressure applied between the two filament ends 32 / 34, is preferably required to be at least one change in the direction of the filament along the longitudinal axis x--x of the anchor 20 (for example, as shown in the comparison of Figure 2 and Figure 11, the inserter 40 is positioned on the anchor between the filament ends 32 / 34 to capture the portion of the filament and the anchor together and maintain pressure / force in the opposite direction to the force pulling / tensioning the ends 32 / 34 of the suture to deploy the anchor).

[0033] For example, referring to Figure 14A, it is shown that the filament 30 begins at a first filament end 32 and passes through the anchor 20 at a passing position 35 near the first anchor end 22, from the proximal side 26 to the distal side 28 of the anchor 20. The filament 30 extends in a first direction 43 along an axis parallel to axis x--x toward a second end 24. Next, the filament 30 passes through the anchor 20 near the second end 24, from the distal side 28 to the proximal side 26 at a passing position 39, and continues to extend in a second direction 45 (opposite to the first direction). The filament 30 passes through the anchor 20 two more times at a passing position 41 (from the proximal side 26 to the distal side 28) and at a passing position 37 (from the distal side 28 to the proximal side 26), and terminates at the second end 34. No matter how many degrees the filament 30 passes through the anchor 30 (at an angle with respect to the longitudinal axis x--x of the anchor 20), there will still be one change / shift in the direction of the filament 30 in Figure 14A with respect to the longitudinal axis x--x of the anchor 20 measured from the first end 32 to the second end 34. This change / shift in direction creates at least one sag line 47 (it begins at the first directional starting point on the outside of the anchor on the anchor surface and ends at the first directional end on the outside of the anchor on the same anchor surface, i.e., from position 49 on the distal / surface 28 to position 51 on the distal / surface 28). By the reaction force of the inserter positioned between the filament ends 32 / 34 relative to the anchor 20, the filament ends 32 / 34 are pulled away from the anchor (as described above), causing the anchor ends 22 and 24 to bend in the direction toward the maximum sag line (here toward the sag line 47), as shown in Figure 14B. In any embodiment, the “largest sag line” is the sag line that is greatest in length on one side 26 / 28 of the anchor 20 (single – see Figure 14A, or additional / combined – see Figure 14C). For example, the largest and only suitable sag line in Figure 14A is sag line 47, which is created by a filament end 32 that extends through passing position 35, exits the distal end 28 at point 49, extends away from the nearest anchor end 22, and terminates at point 51 at the starting point of passing position 39.

[0034] Referring to Figure 14C, two variations of the orientation embodiment are shown (two variations of the orientation embodiment are also shown in Figures 1 to 13). Briefly, the filament 30 starts at the first filament end 32 and extends from the proximal side 26 to the distal side 28 of the anchor 20. Up to this point, it is shown that the filament passes the anchor 20 at passing position 35 near the first anchor end 22. The filament 30 extends in the first direction 43 along an axis parallel to axis x--x toward the second end 24. The filament 30 then passes the anchor 20 from the distal end 28 to the proximal end 26 at passing position 39' and continues to extend in the second direction 45 (opposite to the first direction). The filament 30 then passes the anchor 20 at passing position 41 (from the proximal end 26 to the distal end 28) and extends back toward the second anchor end 24. The filament 30 continues to extend in the first direction 43 along an axis parallel to axis x--x toward the second end 24. The filament 30 then passes the anchor 20 from the distal end 28 to the proximal end 26 at passing position 39' and continues to extend in the proximal direction to form the second filament end 34. No matter how many degrees the filament 30 passes through the anchor 30 (at a certain angle with respect to the longitudinal axis x--x of the anchor 20), there will still be two changes / shifts in the direction of the filament 30 in Figure 14C with respect to the longitudinal axis x--x of the anchor 20 measured from the first end 32 to the second end 34. These changes / shifts in direction are created by the two sag lines 47 and 51 (sag line 47 is maximum when it contains a combination of two loops). By the reaction force of the inserter positioned between the filament ends 32 / 34 relative to the anchor 20, the filament ends 32 / 34 are pulled away from the anchor (as described above), causing the anchor ends 22 and 24 to bend in the direction toward the maximum sag line (here toward the combined sag line 47), as shown in Figure 14D.

[0035] While embodiments of the present invention have been specifically shown and described with reference to certain exemplary embodiments, it will be understood by those skilled in the art that various modifications in detail can be made without departing from the spirit and scope of the invention as defined by the claims as supported by the description and drawings. Furthermore, where exemplary embodiments are described with reference to a certain number of elements, it will be understood that exemplary embodiments can be carried out using any of the following certain number of elements.

Claims

[Claim 1] A soft suture anchor structure placed inside a hole, A fully sutured anchor, formed in a longitudinal shape before being placed in the aforementioned hole, The aforementioned sutured anchor includes a single filament that is sewn through a plurality of passing positions arranged at intervals from one another in the longitudinal direction of the sutured anchor, in the short direction, The single filament is sewn so that it passes through one side of the entire suture anchor from one side to the other at a point where it passes through one end in the longitudinal direction of the entire suture anchor, then passes through from the other side to the one side at a point where it passes through from the other side to the one side at a point where it passes through a predetermined distance from the point where it passes through the other end closer to the center of the entire suture anchor, and further passes through from the other side to the one side at a point where it passes through a predetermined distance from the point where it passes through the one end closer to the center of the entire suture anchor. A flexible suture anchor structure in which, when both ends of the filament are pulled while positioned in the hole, the suture anchor folds in the width direction of the hole, becoming two halves and locking into the hole, such that the other side of the other end in the longitudinal direction of the suture anchor approaches the other side of the one end in the longitudinal direction of the suture anchor.

Images