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US5584862: Method and apparatus for anchoring a suture

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Filing Information

Inventor(s) Peter M. Bonutti ·
Assignee(s) None listed in document.
Attorney/Agent(s) Tarolli, Sundheim, Covell, Tummino & Szabo ·
Primary Examiner Gary Jackson ·
Application Number US8452310
Filing date 05/26/1995
Issue date 12/17/1996
Predicted expiration date 05/14/2013
U.S. Classifications 606/232  ·
International Classifications A61B 1704  ·
Kind CodeA
International Classifications 606139;232 ·
Related U.S. Application DataRELATED APPLICATIONS
This application is a divisional of U.S. patent application Ser. No. 08/291,970 filed Aug. 17, 1994 by Peter M. Bonutti and entitled "Method and Apparatus for Anchoring a Suture," now U.S. Pat. No. 5,549,630. The aforesaid application Ser. No. 08/291,970 is itself a continuation-in-part of U.S. patent application Ser. No. 08/062,295 filed May 14, 1993 by Peter M. Bonutti and entitled "Suture Anchor" (now U.S. Pat. No. 5,403,348) and of application Ser. No. 08/207,297 filed Mar. 7, 1994 by Peter M. Bonutti and entitled "Method of Closing discontinuity in Tissue" (now U.S. Pat. No. 5,464,426). The benefit, under Title 35, United States Code, .sctn.120, of the aforementioned applications is hereby claimed.
64 Claims, No Drawings


Abstract

A tubular anchor may have a polygonal cross-sectional configuration with flat outer side surfaces areas connected by a plurality of outer corner portions. A passage through the anchor may be formed by flat inner side surfaces interconnected by inner corner portions. A suture is inserted through the passage. A concentrated force may be applied against a limited area on a trailing end of the anchor to rotate the anchor to move an outer corner portion of the anchor into engagement with body tissue. The suture may engage an inner corner portion of the anchor. The suture may be inserted through a plurality of anchors and the anchors moved through a tubular member into the body tissue under the influence of force transmitted from a trailing anchor to a leading anchor. When the leading anchor is moved into the body tissue, it is rotated under the influence of force applied against a trailing end of the leading anchor. If desired, two anchors may be interconnected. A groove may advantageously be provided along the leading end and side of an anchor to receive the suture.

Independent Claims | See all claims (64)

  1. 1. A method of anchoring a suture, said method comprising the steps of providing an anchor, inserting a tubular member through an opening in body tissue, inserting a suture through a passage in the anchor, inserting the anchor and a portion of the suture into the tubular member, retaining the anchor against rotational movement about a longitudinal central axis of the tubular member by engaging the anchor with a locating surface in the tubular member, moving the anchor along the tubular member and through the opening in the body tissue, engaging the anchor with the locating surface in the tubular member during movement of the anchor along the tubular member, and moving the anchor from the tubular member into the body tissue.
  2. 10. A method of anchoring a suture, said method comprising the steps of providing at least one anchor having an outer side with flat outer side surface areas interconnected by an outer corner portion, the flat outer side surface areas and the corner portion of the one anchor extending axially along the one anchor between first and second end portions at axially opposite ends of the anchor, the one anchor has a passage with an inner surface having flat inner side surface areas interconnected by an inner corner portion which extend axially through the one anchor between the first and second end portions, inserting a suture through the passage extending between the first and second end portions of the one anchor, moving the one anchor through an opening in body tissue with the first end portion of the one anchor leading and with the suture extending through the passage in the one anchor and along the outer side of the one anchor moving the suture into engagement with the inner corner portion of the one anchor, and, urging the outer corner portion and flat outer surface areas of the one anchor into engagement with the body tissue by tensioning the suture and transmitting force from the suture to the inner corner portion of the one anchor.
  3. 29. A method of anchoring a suture, said method comprising the steps of providing first and second anchors, each of the anchors having an outer side which extends axially along the anchor between first and second end portions of the anchor and a passage which extends axially through the anchor between the first and second end portions of the anchor, inserting a suture through the passages extending through the first and second anchors, moving the first and second anchors through an opening in body tissue with the first end portion of the first anchor leading and with the second end portion of the first anchor trailing and with the first end portion of the second anchor leading and disposed adjacent to the second end portion of the first anchor and with the second end portion of the second anchor trailing, said step of moving the first and second anchors through the opening in body tissue being performed with the suture extending through the passages in the first and second anchors and along the outer sides of the first and second anchors, and, thereafter, urging the outer sides of the first and second anchors into engagement with the body tissue by tensioning the suture and transmitting force from the suture to the first and second anchors, said step of tensioning the suture includes pressing the second end portion of the first anchor and the first end portion of the second anchor together under the influence of force transmitted from the suture to the first end portion of the first anchor and to the second end portion of the second anchor.
  4. 42. A method of anchoring a suture, said method comprising the steps of providing at least one anchor having a polygonal cross-sectional configuration, the one anchor being formed by a plurality of side portions which extend axially along the one anchor and a plurality of corner portions which extend axially along the one anchor and interconnect the side portions, inserting a suture through a passage formed in and extending axially through the one anchor, moving the one anchor along a first path length into body tissue by applying force against a trailing end of the one anchor, pressing a leading end portion of the one corner portion of the one anchor against body tissue under the influence of force applied against the trailing end of the one anchor, moving the one anchor along a second path length which extends transversely to the first path length under the influence of force applied against the trailing end of the one anchor, and pressing-side portions of the one anchor interconnected by the one corner portion and the one corner portion of the anchor against the body tissue under the influence of force transmitted from the suture to the anchor.
  5. 51. A method of anchoring a suture in body tissue, said method comprising the steps of inserting a tubular member into the body tissue, providing an anchor having a central passage extending between first and second end portions of the anchor, inserting a suture through the central passage in the anchor, inserting the anchor into the tubular member with the first end portion of the anchor leading and with the suture extending from a location outside of the tubular member, across the first end portion of the anchor, along an outer side of the anchor a d back to a location outside of the tubular member, applying force against the second end portion of the anchor with the force concentrated in an area which is offset to one side of a central axis of the anchor, moving the anchor and a portion of the suture through an open end of the tubular member at a location disposed in the body tissue, moving the first end portion of the anchor and the portion of the suture which extends across the first end portion of the anchor to a location offset to a first side of the tubular member under the influence of the force which is applied against the first end portion of the anchor and is concentrated in an area which is offset to one side of a central axis of the anchor, and, thereafter, moving the second end portion of the anchor transversely to a longitudinal central axis of the tubular member by tensioning the suture to apply force against the first end portion of the anchor with the portion of the suture which extends across the first end portion of the anchor.
  6. 55. A method of anchoring a suture in body tissue, said method comprising the steps of inserting a tubular member into the body tissue, providing first and second anchors each of which has a central passage extending between opposite end portions of the anchor, inserting a suture through the central passages in the first and second anchors, inserting the first and second anchors into the tubular member with the first anchor leading and with the suture extending from a location outside of the tubular member through the central passages in the first and second anchors, along outer sides of the first and second anchors and back to a location outside of the tubular member, applying force against an end portion of the second anchor and transmitting force from the second anchor to the first anchor, moving the first anchor and a portion of the suture through an open end of the tubular member at a location disposed in the body tissue, moving at least a portion of the first anchor to a location offset to a first side of the tubular member under the influence of force which is applied to the second anchor and transmitted from the second anchor to the first anchor, thereafter, moving the second anchor through the open end of the tubular member at a location disposed in the body tissue, and moving at least a portion of the second anchor to a location offset to a second side of the tubular member by tensioning the suture.
  7. 61. A method of anchoring a suture, said method comprising the steps of providing a first anchor having first and second ends and a passage which extends through the first anchor, providing a second anchor having first and second ends and a passage which extends through the second anchor, inserting a suture through the passage extending through the first anchor and through the passage extending through the second anchor, moving the first and second anchors through an opening in body tissue with the first end of the first anchor leading, with the first end of the second anchor engaging the second end of the first anchor and with the second end of the second anchor trailing, said step of moving the first and second anchors through an opening in body tissue being performed with a first portion of the suture extending from a location disposed to one side of the body tissue through the opening in the body tissue to the second end of the second anchor, a second portion of the suture extending through the passages in the first and second anchors, and a third portion of the suture extending from the first end of the first anchor through the opening in the body tissue to the location disposed to one side of the body tissue, said step of moving the first and second anchors through an opening in body tissue includes moving the first and second anchors and a rigid member along at least a portion of a first path length with a first end of the rigid member in engagement with the second end of the second anchor and with the first end of the second anchor in engagement with the second end of the first anchor, and, thereafter, changing the orientation of the first and second anchors relative to the body tissue by tensioning the third portion of the suture to apply force to the first end of the first anchor and pivoting the second end of the second anchor about a location where the first end of the rigid member engages the second end of the second anchor under the influence of force transmitted to the first end of the first anchor by tensioning the third portion of the suture.
  8. 64.64. A method of anchoring a suture, said method comprising the steps of:providing a first anchor having first and second end portions, an outer side surface which extends between the first and second end portions of the first anchor, and a passage which extends through the first anchor;providing a second anchor having first and second end portions, an outer side surface which extends between the first and second end portions of the second anchor, and a passage which extends through the second anchor;inserting a suture through the passages in the first and second anchors;moving the first and second anchors through an opening in body tissue with the first end portion of the first anchor leading, with the first end portion of the second anchor engaging the second end portion of the second anchor, and with the second end portion of the first anchor trailing, said step of moving the first and second anchors through an opening in body tissue being at least partially performed with a first portion of the suture extending through the passages in the first and second anchors, a second portion of the suture extending across and disposed in engagement with the first end portion of the first anchor, and a third portion of the suture extending along and disposed in engagement with the outer side surface on the first anchor and extending to a location disposed to one side of the body tissue, said step of moving the first and second anchors through an opening in body tissue includes engaging the second end portion of the second anchor with a first end of a rigid member, and,thereafter, changing the orientation of the first and second anchors relative to body tissue by simultaneously applying force to the first and second end portions of the first and second anchors by tensioning the third portion of the suture and pressing the first end of the rigid member and the second end portion of the second anchor against each other.

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Patent Family

Document NumberAssigneeInventorsIssue/Pub Date
US5534012 Peter M. Bonutti Jul 1996
US5569305 Peter M. Bonutti Oct 1996
US5584862 Peter M. Bonutti Dec 1996