Methods and systems for attaching tissue to bone

Patent metadata

Field	Value
Publication number	US-9788844-B2
Application number	US-201113328656-A
Country	US
Kind code	B2
Filing date	Dec 16, 2011
Priority date	Dec 16, 2011
Publication date	Oct 17, 2017
Grant date	Oct 17, 2017

Abstract

A system and method for attaching tissue to bone are provided. In one embodiment, a system for attaching tissue to bone includes a suture, suture anchor, inserter tool, drill, and drill guide having an outer guide and an inner guide. A method for attaching tissue to bone includes attaching a suture to tissue, nesting the suture in a notch on the distal end of the outer guide, passing the suture through a lumen formed in the outer guide, and inserting an inner guide in a lumen formed in the outer guide. The drill guide protects the suture from rotational movement of the drill and allows a user to maintain alignment between the drill guide and the drilled hole. As a result, a suture anchor can be more easily positioned within the drilled hole.

First claim

What is claimed is:

1. A system for attaching soft tissue to bone, comprising:
a suture having proximal and distal ends;
a suture anchor having at least one aperture for receiving the suture;
a tubular outer drill guide having a lumen extending therethrough from a proximal end to a distal end thereof, the outer drill guide having at least one slot formed in a sidewall thereof extending proximally from the distal end of the outer drill guide along a partial longitudinal length of the outer drill guide so as to terminate distal to the proximal end of the outer drill guide; and
a tubular inner drill guide having an inner lumen extending therethrough from a proximal end to a distal end thereof, the inner drill guide being configured to be removably and replaceably positioned within the lumen of the outer drill guide;
wherein when the inner drill guide is inserted into the lumen of the outer drill guide and a first mating feature at the proximal end of the inner drill guide is mated with a second mating feature at the proximal end of the outer drill guide, the distal end of the inner drill guide terminates distal to a proximal end of the at least one slot and proximal to the distal end of the outer drill guide, and the inner and outer drill guides are configured to retain at least a portion of the suture therebetween such that the suture is able to slide relative to the inner and outer drill guides.

2. The system of claim 1 , further comprising a drill tool configured to be removably and replaceably positioned within the inner lumen of the inner drill guide, and a distal end of the drill tool having a bone cutting tip disposed thereon.

3. The system of claim 1 , wherein the outer guide further includes at least one viewing window positioned adjacent to the at least one slot.

4. The system of claim 1 , wherein the distal end of the outer guide has a plurality of surface features for engaging bone.

5. The system of claim 1 , further comprising a threading tool configured to thread terminal ends of the suture through a lumen formed in the suture anchor.

6. The system of claim 1 , further comprising a cannula having a central lumen configured to receive the outer guide therein.

7. The system of claim 1 , wherein at least one bone engaging feature is disposed on an outer surface of the suture anchor.

8. The system of claim 1 , wherein the second mating feature is on a handle of the outer guide.

9. The system of claim 1 , wherein the at least one slot includes first and second slots formed in the sidewall of the outer drill guide, the first and second slots defining first and second distally-extending arms therebetween.

10. The system of claim 1 , wherein one of the first and second mating features includes a recess and the other of the first and second mating features includes a protrusion, the first and second mating features being mated when the protrusion is seated in the recess.

11. A method of attaching soft tissue to bone, comprising:
passing a suture through tissue at a desired location within a patient's body such that the suture extends through the tissue and first and second terminal ends of the suture are positioned outside of the patient's body;
positioning an outer guide within the patient such that a distal end of the outer guide is located adjacent to bone at a location that will receive a suture anchor and such that a portion of the suture extends through a central lumen of the outer guide, the outer guide having a notch formed through a sidewall thereof, the notch extending proximally from the distal end of the outer guide;
attaching the suture to a suture anchor while terminal ends of the suture remain positioned outside of the patient's body;
inserting an inner guide through the central lumen of the outer guide to be in a position as distally far as possible in the central lumen such that with the inner guide at the position, a portion of the suture is positioned between an outer wall of the inner guide and an inner wall of the outer guide and such that with the inner guide at the position, a distal end of the inner guide is at a location that is proximal to the distal end of the outer guide and that is between proximal and distal terminal ends of the notch;
after the inserting of the inner guide through the central lumen of the outer guide, inserting a bone drill through a central lumen in the inner guide and forming a hole at a desired location in the bone and subsequently removing the bone drill and the inner guide; and
while maintaining the outer guide in position surrounding the hole and in contact with bone, passing the suture anchor through the outer guide and implanting the suture anchor within the hole.

12. The method of claim 11 , wherein when the outer guide is positioned within the patient, a portion of the suture adjacent to the distal end of the outer guide is slidably nested in the notch that extends proximally from the distal end of the outer guide.

13. The method of claim 11 , further comprising tensioning the suture to draw the tissue into a desired position with respect to the bone.

14. The method of claim 11 , further comprising trimming the suture adjacent to a proximal end of the suture anchor.

15. The method of claim 11 , wherein attaching the suture to the suture anchor is accomplished by passing the suture from a position outside of the suture anchor, through an opening at a distal end of the suture anchor, and up through a central lumen within the suture anchor.

16. The method of claim 11 , wherein attaching the suture to the suture anchor is performed prior to inserting the bone drill through the central lumen in the inner guide.

17. The method of claim 11 , wherein positioning the outer guide within the patient includes passing the suture through the central lumen of the outer guide until the terminal ends of the suture are positioned outside of the outer guide.

18. The method of claim 11 , wherein when the suture anchor is passed through the outer guide, a longitudinal axis of the suture anchor is substantially aligned with a longitudinal axis of the hole.

19. The method of claim 11 , wherein positioning the outer guide within the patient includes positioning the outer guide through a cannula inserted in the patient.

20. The method of claim 11 , wherein the outer guide has a length that is greater than a length of the inner guide.

21. A method of attaching soft tissue to bone, comprising:
passing a suture through tissue at a desired location within a patient's body such that the suture extends through the tissue and first and second terminal ends of the suture are positioned outside of the patient's body;
positioning an outer guide within the patient such that a distal end of the outer guide is located adjacent to bone at a location that will receive a suture anchor and such that a portion of the suture extends through a central lumen of the outer guide;
attaching the suture to a suture anchor while terminal ends of the suture remain positioned outside of the patient's body;
inserting an inner guide through the central lumen of the outer guide such that a portion of the suture is positioned between an outer wall of the inner guide and an inner wall of the outer guide, the insertion of the inner guide stopping when a distal-most end of the inner guide is contained within the central lumen and is viewable through an opening formed through a sidewall of the outer guide and extending proximally along a partial longitudinal length of the outer guide;
with the

Assignees

• Miller Gerome O
• Mckenney Kevin B
• Whittaker Gregory R
• Medos Int Sarl

Inventors

• Miller Gerome O
• Mckenney Kevin B
• Whittaker Gregory R

Classifications

• A61B2017/0445

  cannulated, e.g. with a longitudinal through-hole for passage of an instrument · CPC title

• A61B17/0401

  Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811) · CPC title

• A61B2017/0409

  Instruments for applying suture anchors · CPC title

• A61B2017/0414

  having a suture-receiving opening, e.g. lateral opening · CPC title

• A61B2017/044

  with a threaded shaft, e.g. screws · CPC title