DELIVERY DEVICE AND ANCHOR COMBINATION
FIELD
The present disclosure relates generally to surgical devices and procedures and, more particularly, to surgical devices and procedures for soft tissue repair.
BACKGROUND
Current standard of care for reattaching soft tissue (e g., ligaments or tendon) to bone typically uses suture anchors and suture to reattach the soft tissue to bone. Suture anchors that can support multiple sutures or suture tapes are clinically desirable because they allow for more points of fixation, which in turn allows for more potential locations for tissue-to-bone healing to occur. In addition, smaller screw-in anchors (i.e., those having a diameter of 5.5 mm or less) are desirable because they can be applied to currently underserved procedures, such as in the extremities. Smaller screw-in anchors also allow the surgeon to place more anchors and thus provide more points of fixation, potentially enhancing patient heahng. Therefore, it would be desirable to provide a smaller, screw-in anchor that can also support multiple sutures and/or tapes to be used in a soft tissue repair.
SUMMARY
The disclosure describes a delivery device and anchor combination that uses sutures having a spliced transfer loop at one end. Each transfer loop is loaded with two or more suture tapes or repair sutures. The surgeon inserts the anchor loaded with the transfer loops into bone and then removes the delivery device from the anchor, leaving the anchor and the transfer loops behind in the bone. Removing the delivery’ device frees up more space within the internal volume of the anchor. Then, using the free end of the suture, the surgeon pulls the transfer loop through the anchor, thereby loading the two or more tapes or repair sutures into the free internal volume of the anchor. In this way, multiple suture tapes or repair sutures can be used with the smaller anchor in the repair of soft tissue.
Further examples of the delivery device and anchor combination of this disclosure may include one or more of the following, in any suitable combination.
In examples, a delivery’ device and anchor combination of this disclosure includes a delivery device having a handle and a shaft coupled to the handle. The shaft includes a proximal end. a distal end, and a longitudinal axis extending therebetween. The shaft and the handle define a cannulation extending along the longitudinal axis. An anchor is coupled to the distal end of the shaft. The anchor has a proximal end, a distal end, and threads extending in an open helical form from the proximal to the distal end. A plurality of ribs extends longitudinally along an interior of the anchor. The plurality of ribs are housed within a corresponding plurality of grooves defined in the distal end of the shaft. A suture bridge connects to and extends transverse to the longitudinal axis between the plurality of ribs. At least one transfer suture is disposed around the suture bridge with first and second ends of the transfer suture extending through the cannulation and exiting a proximal end of the handle. The first end of the transfer suture is a non-looped end and the second end has a loop.
In further examples, the at least one transfer suture is a cannulated suture. In examples, the loop is formed by splicing a size 2-0 suture through the cannulation of the at least one transfer suture. In examples, the at least one transfer suture is a size No. 2 suture. In examples, the combination further includes a plurality of repair sutures or suture tapes extending around the loop. In examples, the plurality of repair sutures or suture tapes is two or three repair sutures or suture tapes. In examples, the at least one transfer suture is three transfer sutures.
Examples of a method of tissue repair of this disclosure include delivering a delivery' device and anchor combination to an area in need of repair. The delivery' device and anchor combination includes a delivery device having a handle and a shaft coupled to the handle. The shaft includes a proximal end, a distal end, and a longitudinal axis extending therebetween. The shaft and the handle define a cannulation extending along the longitudinal axis. An anchor is coupled to the distal end of the shaft. The anchor has a proximal end, a distal end, and threads extending in an open helical form from the proximal to the distal end. A plurality of ribs extends longitudinally along an interior of the anchor. The plurality of ribs are housed within a corresponding plurality of grooves defined in the distal end of the shaft. A suture bridge connects to and extends transverse to the longitudinal axis between the plurality of ribs. At least one transfer suture is disposed around the suture bridge with first and second ends of the transfer suture extending through the cannulation and exiting a proximal end of the handle. The first end of the transfer suture is a non-looped end and the second end has a loop. The anchor is inserted into bone using the delivery device. The delivery' device is then removed from the anchor, such that the first non-looped end and the second looped end of the transfer suture extend from the bone.
In further examples, the method includes passing a plurality of repair sutures or suture tapes around the loop. Using the non-looped end of the transfer suture, the plurality of repair sutures or suture tapes are pulled into the internal volume of the anchor. In examples, the plurality of repair sutures or suture tapes is two or three repair sutures or suture tapes. In examples, the at least one transfer suture is a cannulated suture. In examples, the loop is formed by splicing a size 2-0 suture through the cannulation of the at least one transfer suture. In examples, the at least one transfer suture is a No. 2 suture. In examples, the at least one transfer suture is three transfer sutures. In examples, inserting the anchor into the bone includes inserting the anchor into a preformed hole in the bone.
A reading of the following detailed description and a review of the associated drawings will make apparent the advantages of these and other features. Both the foregoing general description and the following detailed description sen e as an explanation only and do not restrict aspects of the disclosure as claimed.
BRIEF DESCRIPTION OF THE DRAWINGS
Reference to the detailed description, combined with the following figures, will make the disclosure more fully understood, wherein:
FIG. 1 illustrates a delivery device and anchor combination according to an embodiment of this disclosure;
FIG. 2 is a detailed view of the anchor of FIG. 1 , according to an embodiment of this disclosure;
FIG. 3 is a detailed view of the distal end of the shaft of the delivery device of FIG. 1, according to an embodiment of this disclosure;
FIG. 4 is a detailed view of the anchor disposed on the distal end of the shaft of FIG. 3, according to an embodiment of this disclosure; and
FIGS. 5A-5E illustrate a method of inserting the anchor into bone using the delivery device and anchor combination of FIG. 1. according to an embodiment of this disclosure.
DETAILED DESCRIPTION
In the following description, like components have the same reference numerals, regardless of different illustrated examples. To illustrate examples clearly and concisely. the drawings may not necessarily reflect appropriate scale and may have certain features shown in somewhat schematic form. The disclosure may describe and/or illustrate features in one example, and in the same way or in a similar way in one or more other examples, and/or combined with or instead of the features of the other examples.
In the specification and claims, for the purposes of describing and defining the invention, the terms "about" and "‘substantially” represent the inherent degree of uncertainty attributed to any quantitative comparison, value, measurement, or other representation. The terms “about” and “substantially” moreover represent the degree by which a quantitative representation may vary from a stated reference without resulting in a change in the basic function of the subject matter at issue. Open-ended terms, such as “comprise,” “include.” and/or plural forms of each, include the listed parts and can include additional parts not listed, while terms such as “and/or” include one or more of the listed parts and combinations of the listed parts.
FIG. 1 illustrates a delivery device and anchor combination 10 according to an embodiment of this disclosure. As shown in FIG. 1, the delivery device and anchor combination 10 generally includes an anchor 100 and a delivery device 200. The delivery device 200 may include a handle 210 and a shaft 212 extending from the handle 210 along a longitudinal axis A. In examples, various components of the handle 210 may be made from plastic. However, other non-metal and metal materials may also be used to construct the handle 210. The handle 210 may have any shape and size necessary to help facilitate insertion of the anchor 100 into bone. Examples of the shaft 212 may be made from a metal material, such as stainless steel and titanium. How ever, other metal and non-metal materials that could withstand the forces applied during surgery may also be used to construct the shaft 212.
Still referring to FIG. 1, the anchor 100 may be disposed on a distal end 213 of the shaft 212. In examples, a diameter of the anchor 100 may be about 5.5 mm. However, the disclosure also contemplates both larger and smaller diameters of the anchor 100. The anchor 100 may be made from a polymer material via a molding process. However, other materials that would allow the anchor 100 to withstand the forces applied during surgery, and other processes known to one of skill in the art, may be used to construct the anchor 100. At least one transfer suture 110 assembled to the anchor 100 may extend through an interior of the anchor 100 and through a cannulation 204 (FIG. 3) defined by the shaft 212 and the handle 210 to exit a proximal end 201 of the handle 210. Each transfer suture 110 may comprise a transfer loop 112 at a first end 110a of the transfer suture 110, while the second end 110b of the transfer suture 110 is non-looped. In examples, the transfer suture 110 is a cannulated No. 2 suture. In other examples, the transfer loops 112 maybe formed by splicing a smaller size 2-0 suture into the cannulation of the transfer suture 1 10, forming the transfer loop 112. However, the disclosure contemplates other suitable methods of forming the transfer loops 112. In further examples, the at least one transfer suture 110 is three transfer sutures 110. as shown. However, the disclosure contemplates more or fewer than three transfer sutures 110.
FIG. 2 is a detailed view of the anchor 100 according to an embodiment of this disclosure. As shown in FIG. 2, the anchor 100 may include a proximal end 101 and a distal end 102. A majority of the anchor 100 includes screw threads 103 in the form of an open helical coil - that is, a connected series of continuous, regularly spaced turns of the screw threads 103 extending in a helical or spiral form substantially from the proximal end 101 to the distal end 102 of the anchor 100. Apertures 104 may be defined by the spaces betw een the turns of the screw7 threads 103. The anchor 100 may also define an internal volume 107, with the internal volume 107 communicating with the region exterior to the anchor 100 through the apertures 104. The distal end 102 of the anchor 100 may also include a suture bridge 105 that extends a partial length of the interior volume 107 of the anchor 100. The suture bridge 105 may include a proximal end 105a and a distal end 105b. The distal end 105b of the suture bridge 105 may have a concave shape, as shown. However, the disclosure contemplates that the distal end 105b may have a shape other than concave, such as a flat, convex, or bulbous shape. The transfer suture 110 may extend within the internal volume 107 and around the distal end 105b of the suture bridge 105 such that the first and second ends 110a, b extend through the interior volume 107 and exit the proximal end 101. Additionally, longitudinally-extending ribs 106 may extend from the suture bridge 105 and along the interior of the screw threads 103 to the proximal end 101 of the anchor 100. In examples, the anchor 100 includes two ribs 106, as shown. How ever, the disclosure contemplates more or fewer than tw o ribs 106.
FIG. 3 is a detailed view of the distal end 212a of the shaft 212 of the delivery device 200 according to an embodiment of this disclosure. The distal end 212a may include a slot 202 and grooves 203 extending from the slot 202 on each side of the shaft 212. The shaft 212 may define a cannulation 204, such that when the anchor 100 is located on the shaft 212, the first and second ends 110a, 110b of the transfer suture 110 extend through the cannulation 204. Moreover, as shown in FIG. 4, the anchor 100 may be located on the distal end 213 of the shaft 212 such that the suture bridge 105 is housed within the slot 202 and the ribs 106 are housed within the grooves 203. Further nonlimiting examples of the anchor 100 and the delivery device 200 are described in U.S. Patent No. 9,308,080 to Smith & Nephew, Inc. (Memphis, TN), the contents of which are incorporated herein by reference.
FIGS. 5A-5E illustrate a method of inserting the anchor 100 into bone 20 using the delivery device and anchor combination 10, according to an embodiment of this disclosure. As shown in FIG. 5 A. the user initially inserts the anchor 100 into a hole 30 in bone 20 - for example, by rotating the delivery device 200. The hole 30 may be made in the bone 20 prior to insertion of the anchor 100. Alternatively, the distal end 213 of the shaft 212 may be adapted to create the hole 30 as the anchor 100 is being rotated into the hole 30. As shown in FIG. 5B, the user then removes the delivery device 200 from the anchor 100, leaving the transfer suture 110 and the transfer loops 112 extending from the bone 20. As shown in FIG. 5C, each transfer loop 112 may then be loaded with a plurality of suture tapes or repair sutures 300, by folding an end portion of the suture tape or repair suture 300 over the transfer loop 112. In examples, the plurality of suture tapes or repair sutures 300 is two or three suture tapes or repair sutures 300. However, the disclosure contemplates more or fewer than two or three suture tapes or repair sutures 300. The user may then pull the second end 110b of the transfer suture 110 to pull the transfer loop 112 through the interior volume 107, around the suture bridge 105. and back out of the interior volume 107 of the anchor 100, thereby pulling the suture tapes or repair sutures 300 into the interior volume 107. The transfer loop 112 may then be disengaged from the folded- over end portion of the suture tape or repair suture 300. As shown in FIG. 5D, by repeatedly using a single transfer loop 112 to pull the plurality of repair sutures or suture tapes 300 into the anchor 100, the anchor 100 can be loaded with substantially more sutures and tapes 300 than can be loaded into an anchor 100 that contains both the delivery device 200 and the transfer suture 110. FIG. 5E shows an isolated view of the anchor 100 loaded with the repair sutures or suture tapes 300 and with the transfer sutures 110 removed. The ends of the suture tapes or repair sutures 300 can then be used to attach to soft tissue to complete the repair.
While the disclosure particularly shows and describes preferred examples, those skilled in the art will understand that various changes in form and details may exist without departing from the spirit and scope of the present application as defined by the appended claims. The scope of this present application intends to cover such variations. As such, the foregoing description of examples of the present application does not intend to limit the full scope conveyed by the appended claims.