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US20110022061: APPARATUS AND METHOD FOR REPAIRING TISSUE

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Filing Information

Inventor(s) Stephen J. Orphanos · William Arthur Roosa · Marc R. Helmick · Stuart E. Fromm ·
Assignee(s) DePuy Mitek, Inc. ·
Correspondent PHILIP S. JOHNSON;JOHNSON & JOHNSON ·
Application Number US12609448
Filing date 10/30/2009
Publication date 01/27/2011
Predicted expiration date 10/30/2029
U.S. Classifications 606/139  · 606/232  ·
International Classifications A61B1704  · A61B1710  ·
Kind CodeA1
47 Claims, 9 Drawings


Abstract

Assemblies and methods suitable for knotless arthroscopic repair of tissue defects include two fixation members coupled by two limbs of suture comprising a continuous loop. A unidirectional restriction element that can be a preformed locking, sliding suture knot proximate to one of the fixation members, provides tensioning of the repair.

Independent Claims | See all claims (47)

  1. 1. An apparatus comprising: first and second fixation members, each of the first and the second fixation members having a first surface, an opposing second surface, first and second through openings defined between the first surface and the second surface; a flexible element coupling the first and the second fixation members, the flexible element having a first end, a second end and a length therebetween, the length extending from the first end, in order, along a first end section of suture, through the first opening in the first fixation member from the respective first surface to the respective second surface, through the first opening in the second fixation member from the respective second surface to the respective first surface, through the second opening in the second fixation member from the respective first surface to the respective second surface, through the second opening in the first fixation member from the respective second surface to the respective first surface, and along a second end section of suture; the first fixation member further comprising a third through opening defined between the respective first and second surface; a sliding, locking knot formed between the first end section and the second end section, the first end section positioned slidably through the knot, the first end section extending from the knot and through the third opening from the first surface to the second surface.
  2. 17. An apparatus comprising: first and second fixation members, each of the first and the second fixation members having a first surface and an opposing second surface, first, second and third through openings defined between the first surface and the second surface of the first fixation device, and one or more through opening defined between the first surface and the second surface of the second fixation device; a flexible element coupling the first and the second fixation members, the flexible element having a first end, a second end and a length therebetween, the length extending from the first end, in order, along a first end section of suture, through the first opening in the first fixation member from the respective first surface to the respective second surface, through at least one of the one or more opening in the second fixation member from the respective second surface to the respective first surface, through the second opening in the first fixation member from the respective second surface to the respective first surface, and along a second end section of suture; a sliding, locking knot formed between the first end section and the second end section, the second end section extending from the knot and through the third opening from the first surface to the second surface.
  3. 27. An apparatus comprising: first and second fixation members, the first fixation member having a first surface and an opposing second surface, the first and the second fixation member coupled by two continuous sections of suture extending therebetween, the two continuous sections being continuous with one another and slidable through an opening through the second fixation member, each of the two sections of suture extending through respective first and second through openings in the first fixation member from the second surface to the first surface, a sliding, locking knot joining the two continuous sections of suture adjacent to the first surface, a third through opening between the first surface and the second surface, one of the two continuous sections of suture extending from the knot and through the third opening from the first surface to the second surface.
  4. 28. An apparatus for repairing a defect in a body tissue, the apparatus comprising: a first fixation member having a first surface and an opposing second surface, first, second and third through openings between the first and the second surface, a second fixation member having one or more through openings, the first and the second fixation members coupled by a continuous length of suture defining a loop joined by a sliding, locking knot positioned substantially adjacent to the first side of the first fixation member, the loop extending from the knot and slidably through, in order, the first opening in the first fixation member, at least one of the one or more openings in the second fixation member, the second opening in the first fixation member, and returning to the knot, an end section of the continuous length of suture extending from the knot and through the third opening from the first side to the second side; and wherein the knot is configured so that tensioning the end section with respect to the first fixation member is effective to shorten the loop.
  5. 31. A method for repairing a defect in a body tissue, the method comprising: passing a first fixation member along a first delivery path through the tissue to a first location on a first surface area of the tissue, the first fixation member having opposing first and second surfaces, a sliding and locking suture knot adjacent to the first surface, the suture knot comprising suture, three limbs of suture extending from the second surface along the delivery path, the three limbs of suture each continuous with the suture comprising the knot, a first two of the three limbs together comprising a continuous loop of suture slidingly connected to a second fixation member, the loop having a loop length; tensioning at least one of the three sections of suture to deploy the second surface against the tissue at the first location; passing the second fixation member along a second delivery path through the tissue to a second location on a second surface area of the tissue; and tensioning the third limb of suture to reduce the loop length between the first fixation member and the second fixation member.
  6. 38. An apparatus comprising: a first fixation member having opposing first and second surfaces, a sliding and locking suture knot adjacent to the first surface, the suture knot comprising suture, three limbs of suture extending from the second surface, each of the three limbs of suture continuous with the suture comprising the knot, each of the three limbs positioned through a respective through opening between the first surface and the second surface, a first two of the three limbs together comprising a continuous loop of suture slidingly connected to a second fixation member, the loop having a loop length, and wherein the knot is configured such that tension applied to the third limb with respect to the first fixation member is effective to reduce the loop length
  7. 39. An apparatus comprising: a first fixation member having opposing first and second surfaces, first, second and third through openings between the first and the second surface; respective first, second and third limbs of suture positioned through the respective first, second and third openings, the first and the third limbs being positioned slidably through the respective first and third opening, and the first and the second limbs being continuous with one another to form a suture loop extending from the second surface; a second fixation member having one or more openings therethrough, the loop being positioned slidably through at least one of the one or more openings through the second fixation member; a restriction element associated with the first fixation member, the restriction member adapted to slidably pass suture therethrough in a first direction, but not in a second, opposite direction, and the first and the third limbs being continuous with one of them passing through the restriction member adjacent the first surface; and wherein tension applied to the third limb with respect to the first fixation member is effective to reduce the loop length by sliding the third and the first limb through the respective third and first opening.
  8. 40. An apparatus comprising: a first fixation member and a second fixation member, at least one opening through the second fixation member, two limbs of suture comprising a continuous loop of suture extending from the first fixation member, a portion of the loop positioned slidably through the at least one opening through the second fixation member, the first fixation member comprising a restriction element through which an extension of one of the two limbs is positioned to pass slidingly in a first longitudinal direction, but is restricted from sliding in a second, opposite longitudinal direction, and the two limbs and the extension extending from a common surface of the first fixation member.
  9. 41. An apparatus for repairing a body tissue having a surface, the apparatus comprising: first and second fixation members, each of the first and the second fixation members having a respective contact surface adapted to be positioned in contact with the tissue surface; a continuous loop of suture extending between respective contact surfaces of the first and the second fixation member, the loop having a length, and being slidably positioned through one or more opening through the second fixation member; a tensioning limb of suture extending from the contact surface of the first fixation member; and wherein tension applied to the tensioning limb with respect to the first fixation member is effective to reduce the length of the loop.
  10. 46. A method of repairing a defect in meniscus, the meniscus having a first surface facing an associated femur and a second, opposing surface away from the femur and away from a tibia, the method comprising the steps of: placing a first fixation member against the second surface at a first location adjacent the defect; placing a second fixation member against the second surface at a second location adjacent the defect; arranging a flexible member between the first fixation member and the second fixation member across the defect, the flexible member passing through the meniscus and comprising a loop upon which the second fixation member is slidably affixed and which comprises a slip knot affixed to the flexible member adjacent the first fixation member beyond the second surface; and tensioning a portion of the flexible member through the slip knot to shorten the loop and close the defect.

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