Biceps Tenodesis Implants and Delivery Tools

Patent metadata

Field	Value
Publication number	US-2016113756-A1
Application number	US-201514610602-A
Country	US
Kind code	A1
Filing date	Jan 30, 2015
Priority date	Oct 23, 2014
Publication date	Apr 28, 2016
Grant date	—

Abstract

Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a surgical implant is provided having a sheath and an expander that is received within the sheath. Various delivery tools, including a sheath inserter and a driver, are also provided. In use, the sheath inserter can be used to position a tendon within a prepared bone hole, and it can be used to deliver the sheath with a guidewire coupled thereto into the bone hole. The driver can be provided for delivering the expander into the sheath. A loader can optionally be used to load the driver and expander onto the guidewire coupled to the implanted sheath.

First claim

What is claimed is:

1 . An anchor assembly for anchoring a tendon to bone, comprising:
a sheath having a substantially solid distal end with at least two sidewalls extending proximally therefrom and separated by at least first and second slots, the sidewalls defining an inner lumen therebetween, and the solid distal end of the sheath having a mating feature; a guidewire having a distal tip configured to releasably mate with the mating feature in the sheath, the guidewire extending proximally from the sheath when mated thereto; and an expander having a generally elongate cylindrical configuration and configured to be received within the inner lumen of the sheath, the expander having a lumen extending therethrough for receiving the guidewire.

2 . The anchor assembly of claim 1 , wherein the mating feature comprises a threaded bore formed in the sheath and the distal tip on the guidewire is threaded for threadably engaging the threaded bore.

3 . The anchor assembly of claim 1 , wherein the sheath includes at least one anti-collapse tab formed on at least one of the sidewalls adjacent to one of the first and second slots, the at least one anti-collapse tab being configured to limit movement of the sidewalls toward one another.

4 . The anchor assembly of claim 1 , wherein the sheath includes at least one anti-plunge tab extending radially outward from a proximal-most end thereof and configured to limit an insertion depth of the sheath into a bone hole.

5 . The anchor assembly of claim 4 , wherein the sheath includes at least one retaining tab extending radially outward from the sheath at a predetermined distance from the at least one anti-plunge tab, the distance being configured such that the at least one anti-plunge tab can be positioned on a proximal surface of cortical bone and the at least one retaining tab can be positioned on a distal surface of the cortical bone.

6 . The anchor assembly of claim 1 , wherein a distal-facing end of the sheath is concave for seating a tendon.

7 . The anchor assembly of claim 1 , wherein a proximal-facing end of the sheath is convex.

8 . The anchor assembly of claim 1 , wherein the sidewalls have an increased thickness at a mid-portion thereof as compared to proximal and distal portions thereof.

9 . The anchor assembly of claim 1 , wherein the sidewalls include ribs extending radially therearound.

10 . The anchor assembly of claim 9 , wherein the ribs on a first sidewall of the anchor are angled distally and the ribs on a second opposite sidewall of the anchor are angled proximally.

11 . The anchor assembly of claim 1 , wherein the sidewalls of the anchor have threads formed on an internal surface thereof, and the expander includes threads formed on an external surface thereof for threadably mating with the threads formed on the internal surface of the at least two sidewalls.

12 . The anchor assembly of claim 1 , wherein the first and second slots each have a proximal portion, a distal portion, and a transition region extending between the proximal and distal portions, the proximal and distal portions each having a constant width, and the transition region having a width that tapers inward in a distal direction.

13 . The anchor assembly of claim 12 , wherein a length of transition region is substantially equally to a width of the proximal portion.

14 . A method for anchoring a tendon to bone, comprising:
positioning a distal end of a sheath over a tendon extending across a bone hole, the sheath having a guidewire mated thereto and extending proximally therefrom; advancing the sheath with the guidewire mated thereto into the bone hole such that the tendon is advanced into the bone hole and extends between the sheath and the bone hole; and advancing a cannulated expander along the guidewire and into the sheath, the expander causing the sheath to expand outward to anchor the tendon within the bone hole.

15 . The method of claim 14 , wherein the sheath is advanced into the bone hole using an inserter tool having the guidewire extending therethrough.

16 . The method of claim 15 , further comprising, after advancing the sheath, manipulating the inserter tool to release the guidewire from a guidewire grasper in the inserter tool, and removing the inserter tool from the guidewire.

17 . The method of claim 14 , wherein the expander is advanced along the guidewire using a driver tool, and wherein the driver tool includes an outer shaft having opposed prongs on a distal end thereof that are positioned within opposed slots formed in the sheath, and an inner shaft extending through the outer shaft and engaged with the expander, the inner shaft being rotated to advance the expander into the sheath while the prongs on the outer shaft hold the sheath substantially stationary.

18 . The method of claim 17 , further comprising removing the driver tool from the guidewire, and removing the guidewire from the sheath leaving the sheath and the expander implanted in bone.

19 . The method of claim 17 , wherein, when the expander is fully inserted into the sheath, the expander and the sheath are in full circumferential contact along a majority of a length thereof.

20 . The method of claim 17 , wherein the expander is non-rotatably advanced into the sheath.

21 . The method of claim 17 , wherein a distal portion of the expander is non-rotatably advanced into the sheath, and a proximal portion of the expander is rotatably threaded into the sheath.

22 . An anchor assembly for anchoring a tendon to bone, comprising:
a sheath having a body with at least two sidewalls extending proximally therefrom, the sidewalls being separated by at least two slots, the sidewalls defining an inner lumen therebetween, and the sidewalls having threads formed on an internal surface thereof; and a threaded expander configured to be received between the at least two sidewalls and to threadably mate with the threads formed on the internal surface of the sidewalls; wherein the sheath and the threaded expander are configured such that, when the expander is fully threaded into the sheath, a mid-portion of the sidewalls expands radially outward by a distance that is greater than a distance that proximal and distal portions of the sidewalls expand radially outward such that the mid-portion defines a maximum outer dimension of the sheath to anchor the sheath within a bone hole.

23 . The anchor assembly of claim 22 , wherein the mid-portion of the at least two sidewalls has a thickness that is greater than a thickness of the proximal and distal portions of the at least two sidewalls.

24 . The anchor assembly of claim 22 , wherein the expander has a minor diameter and the threads on the expander define a major diameter, and wherein a minor diameter of the expander causes the at least two sidewalls of the sheath to expand outward.

25 . The anchor assembly of claim 22 , wherein the expander includes a cylindrical proximal portion having a substantially constant diameter, and a tapering distal portion having a diameter that decreases distally.

26 . A method for anchoring a tendon to bone, comprising:
positioning a distal end of a sheath over a tendon extending across a bone hole; advancing the sheath into the bone hole such that the tendon is advanced into the bone hole; and inserting an expander into an inner lumen of the sheath such that the expander causes proximal, middle,

Assignees

• Depuy Synthes Products Inc

Inventors

• Diduch David R
• Getelman Mark H
• Marks Jacob A
• Miller Gerome
• Ravenscroft Matthew J
• Sengun Mehmet Z
• Tang Howard C
• Weitzel Paul P
• Whittaker Gregory R

Classifications

• A61F2002/0882

  Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone · CPC title

• A61B17/0642 Primary

  for bones, e.g. for osteosynthesis or connecting tendon to bone · CPC title

• A61F2002/0858

  Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges · CPC title

• A61B2017/0648

  threaded, e.g. tacks with a screw thread · CPC title

• A61F2/0805 Primary

  Implements for inserting tendons or ligaments · CPC title