Biceps Tenodesis Implants and Delivery Tools

Patent metadata

Field	Value
Publication number	US-2016113757-A1
Application number	US-201514610609-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 inserter tool, comprising:
a first elongate body having first and second prongs extending distally from a distal end thereof and configured to extend along opposed slots formed in a sheath of an anchor assembly; a second elongate body slidably disposed relative to the first elongate body; a handle assembly coupled to a proximal end of each of the first and second elongate bodies, the handle assembly being configured such that the first elongate body has first and second ranges of motion, the first elongate body in the first range of motion being movable between a first position in which the first and second prongs extend distally beyond the second elongate body and a second position in which the first and second prongs are retained within the second elongate body, and the first elongate body in the second range of motion being movable from the second position to a third position in which the first elongate body is configured to cause a guidewire extending through the first elongate body and mated to the handle assembly to be disengaged and released from the handle assembly.

2 . The anchor inserter tool of claim 1 , wherein the first elongate body comprises an inner shaft and the second elongate body comprises an outer shaft disposed around the inner shaft.

3 . The anchor inserter tool of claim 1 , wherein the handle assembly includes a guidewire grasping element configured to engage a proximal end of a guidewire coupled to a sheath of an anchor assembly and extending through the first elongate body.

4 . The anchor inserter tool of claim 1 , wherein the handle assembly includes an actuator coupled to the first elongate body and configured to move the first elongate body through the first and second ranges of motion.

5 . The anchor inserter tool of claim 4 , wherein the actuator is in a distal-most position relative to the handle assembly in the first position, and the actuator is in a proximal-most position relative to the handle assembly in the third position.

6 . The anchor inserter tool of claim 1 , wherein the handle assembly includes a first biasing element that applies a first biasing force that must be overcome to move the first elongate body from the first position to the second position, and the handle assembly includes a second biasing element that applies a second biasing force that must be overcome to move the first elongate body from the second position to the third position, the second biasing force being greater than the first biasing force.

7 . The anchor inserter tool of claim 1 , wherein the handle assembly includes
a first handle mated to the second elongate body and having an engagement element formed therein for engaging a guidewire, and a second handle mated to the first elongate body for moving the first elongate body relative to the second elongate body.

8 . The anchor inserter tool of claim 1 , wherein the second elongate body includes a closed distal end having a central bore formed therein for receiving a guidewire and having first and second slots formed therein and extending radially outward from the central bore for receiving the prongs.

9 . The anchor inserter tool of claim 1 , wherein a distal portion of the second elongate body includes first and second concavities formed in opposite outer sidewalls thereof.

10 . The anchor inserter tool of claim 1 , wherein the first and second elongate bodies are configured to be releasably locked relative to one another such that movement of the first and second elongate bodies relative to one another is prevented.

11 . A tendon anchoring system, comprising:
an anchor assembly having
a sheath with at least two sidewalls at least partially separated by at least first and second slots, the sidewalls defining an inner lumen therebetween, and
an expander configured to be received within the inner lumen of the sheath; and
an inserter tool having
an outer shaft with an inner lumen extending therethrough,
an inner shaft having first and second prongs formed on a distal end thereof, the prongs being sized and dimensioned to extend along the first and second slots in the sheath and to extend distally beyond a distal end of the sheath, and
a handle assembly coupled to a proximal end of the inner and outer shafts, the handle assembly having an actuator configured to axially move the inner shaft relative to the outer shaft to thereby move the prongs between an extended position in which the prongs extend distally beyond a distal end of the outer shaft, and a retracted position in which the prongs are retracted into the distal end of the outer shaft.

12 . The tendon anchoring system of claim 11 , wherein the outer shaft has a closed distal end having a central bore formed therein for receiving a guidewire and having first and second slots formed therein and extending radially outward from the central bore for receiving the first and second prongs.

13 . The tendon anchoring system of claim 11 , wherein the actuator is movable between a distal position on the handle assembly in which the prongs extend distally beyond the distal end of the outer shaft, and a proximal position on the handle assembly in which the prongs are retracted into the distal end of the outer shaft.

14 . The tendon anchoring system of claim 13 , wherein the actuator is biased to the distal position.

15 . The tendon anchoring system of claim 11 , further comprising a guidewire mated to the sheath, and a guidewire grasping element in the handle assembly configured to engage the guidewire.

16 . The tendon anchoring system of claim 11 , wherein the first and second prongs include a connector extending therebetween along a proximal portion of the prongs, the connector having a central lumen extending therethrough.

17 . The tendon anchoring system of claim 11 , wherein the sheath includes at least one anti-plunge tab extending radially outward from a proximal-most end thereof, and wherein a distal facing surface of the outer shaft includes at least one recess formed therein for seating the at least one anti-plunge tab.

18 . A method for anchoring a tendon to bone, comprising:
attaching a sheath to an inserter tool such that a pair of prongs on a distal end of an inner shaft of the inserter tool extend along opposed slots formed in the sheath; manipulating an actuator on a handle assembly of the inserter tool to retract the pair of prongs into an outer shaft of the inserter tool, and with the prongs retracted, manipulating the handle assembly to advance the sheath through tissue; manipulating the actuator, after the sheath is advanced through tissue, such that the prongs extend along the opposed slots formed in the sheath and extend distally beyond a distal end of the sheath; positioning a tendon between the pair of prongs, and manipulating the handle assembly to advance the prongs, with the tendon therebetween, and the sheath into a bone hole; and removing the inserter tool such that the sheath and tendon remain in the bone hole.

19 . The method of claim 18 , further comprising, prior to attaching the sheath, measuring a size of a tendon to be anchored to bone by positioning the tendon between the pair of prongs on the distal end of the inner shaft of the inserter tool.

20 . The method of claim 19 , wherein measuring a size of a tendon comprises measuring a tendon using a first inserter tool having a pair of prongs spaced a first distance apart, and measuring the tendon using a second inserter tool having a pair of

Assignees

• Depuy Synthes Products Inc

Inventors

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

Classifications

• A61B2017/0438

  slotted, i.e. having a longitudinal slot for enhancing their elasticity · CPC title

• A61F2002/087

  Anchor integrated into tendons, e.g. bone blocks, integrated rings · CPC title

• A61B17/8872

  Instruments for putting said fixation devices against or away from the bone (A61B17/7074, A61B17/808 take precedence) · 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