US20170020589A1 - Anchor having a controlled driver orientation - Google Patents
Anchor having a controlled driver orientation Download PDFInfo
- Publication number
- US20170020589A1 US20170020589A1 US15/284,689 US201615284689A US2017020589A1 US 20170020589 A1 US20170020589 A1 US 20170020589A1 US 201615284689 A US201615284689 A US 201615284689A US 2017020589 A1 US2017020589 A1 US 2017020589A1
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- Prior art keywords
- screw
- runners
- distal end
- driver
- interference screw
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- Abandoned
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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- A61B17/869—Pins or screws or threaded wires; nuts therefor characterised by an open form, e.g. wire helix
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- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8877—Screwdrivers, spanners or wrenches characterised by the cross-section of the driver bit
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- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8886—Screwdrivers, spanners or wrenches holding the screw head
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- 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
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- 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
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
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- 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
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0458—Longitudinal through hole, e.g. suture blocked by a distal suture knot
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0841—Longitudinal channel for insertion tool running through the whole tendon anchor, e.g. for accommodating bone drill, guidewire
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- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0858—Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
- A61F2250/0097—Visible markings, e.g. indicia
Definitions
- the present disclosure relates to medical apparatuses and procedures in general, and more particularly to medical apparatuses and procedures for reconstructing a ligament.
- ligaments are torn or ruptured as the result of an accident. Accordingly, various procedures have been developed to repair or replace such damaged ligaments.
- the anterior and posterior cruciate ligaments i.e., the “ACL” and “PCL”
- ACL anterior and posterior cruciate ligaments
- PCL posterior cruciate ligaments
- the anterior cruciate ligament i.e., the ACL
- various surgical procedures have been developed for reconstructing the ACL so as to restore substantially normal function to the knee.
- the ACL may be reconstructed by replacing the ruptured ACL with a graft ligament.
- bone tunnels are generally formed in both the top of the tibia and the bottom of the femur, with one end of the graft ligament being positioned in the femoral tunnel and the other end of the graft ligament being positioned in the tibial tunnel, and with the intermediate portion of the graft ligament spanning the distance between the bottom of the femur and the top of the tibia.
- the two ends of the graft ligament are anchored in their respective bone tunnels in various ways well known in the art so that the graft ligament extends between the bottom end of the femur and the top end of the tibia in substantially the same way, and with substantially the same function, as the original ACL.
- This graft ligament then cooperates with the surrounding anatomical structures so as to restore substantially normal function to the knee.
- the graft ligament may be a ligament or tendon which is harvested from elsewhere within the patient's body, e.g., a patella tendon with or without bone blocks attached, a semitendinosus tendon and/or a gracilis tendon.
- the end of the graft ligament is placed in the bone tunnel, and then the graft ligament is fixed in place using a headless orthopedic screw, generally known in the art as an “interference” screw. More particularly, with this approach, the end of the graft ligament is placed in the bone tunnel and then the interference screw is advanced into the bone tunnel so that the interference screw extends parallel to the bone tunnel and simultaneously engages both the graft ligament and the side wall of the bone tunnel.
- the interference screw essentially drives the graft ligament laterally, into engagement with the opposing side wall of the bone tunnel, whereby to secure the graft ligament to the host bone with a so-called “interference fit”. Thereafter, over time (e.g., several months), the graft ligament and the host bone grow together at their points of contact so as to provide a strong, natural joinder between the ligament and the bone.
- Interference screws have proven to be an effective means for securing a graft ligament in a bone tunnel in a number of applications, such as ACL reconstruction surgery and biceps tenodesis.
- the interference screw itself generally takes up a substantial amount of space within the bone tunnel, which can limit the surface area contact established between the graft ligament and the side wall of the bone tunnel. This in turn limits the region of bone-to-ligament in-growth, and hence can affect the strength of the joinder.
- interference screws fabricated from absorbable materials, so that the interference screw can eventually disappear over time and bone-to-ligament in-growth can take place about the entire perimeter of the bone tunnel.
- various absorbable interference screws have been developed which are made from biocompatible, bioabsorbable polymers, e.g., polylactic acid (PLA), polyglycolic acid (PGA), etc. These polymers generally provide the substantial mechanical strength needed to advance the interference screw into position, and to thereafter hold the graft ligament in position while bone-to-ligament in-growth occurs, without remaining in position on a permanent basis.
- PLA polylactic acid
- PGA polyglycolic acid
- interference screws made from such biocompatible, bioabsorbable polymers have proven clinically successful.
- these absorbable interference screws still suffer from several disadvantages.
- clinical evidence suggests that the quality of the bone-to-ligament in-growth is somewhat different than natural bone-to-ligament in-growth, in the sense that the aforementioned bioabsorbable polymers tend to be replaced by a fibrous mass rather than a well-ordered tissue matrix.
- Second, clinical evidence suggests that absorption generally takes a substantial period of time, e.g., on the order of three years or so. Thus, during this absorption time, the bone-to-ligament in-growth is still significantly limited by the presence of the interference screw.
- absorbable interference screws generally tend to be fairly large in order to provide them with adequate strength, e.g., it is common for an interference screw to have a diameter (i.e., an outer diameter) of 8-12 mm and a length of 20-25 mm.
- the present disclosure relates to an interference screw.
- the screw includes a body having a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end.
- the screw further includes threads extending in an open helical form between the proximal end and distal end of the body.
- the screw further includes a through bore defined by the body extending between the proximal end and distal end of the body along the longitudinal axis.
- the through bore has a surface from which a controlling member is formed. The controlling member being engaged by a driver when the driver is in a driving orientation with respect to the controlling member. The controlling member being not engaged by the driver when the driver is in an orientation different than the driving orientation.
- the present disclosure relates to a method for installing an interference screw into bone.
- the method includes removing a driver from a body of an interference screw inserted into bone.
- the body has a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end.
- the body defines a through bore extending between the proximal end and distal end along the longitudinal axis.
- the through bore has a surface.
- the method further includes engaging a controlling member formed by the surface of the through bore with the driver.
- the controlling member being engaged by the driver when the driver is in a driving orientation with respect to the controlling member.
- the controlling member not being engaged by the driver when the driver is in an orientation different than the driving orientation.
- the method further includes confirming the orientation of the driver in the body of the screw based on the engagement of the controlling member with the driver.
- the present disclosure relates to another method for installing an interference screw into bone.
- the method includes inserting, initially, a driver into a through bore defined by a body of a screw inserted into bone.
- the through bore extends between a proximal end and a distal end of the body along a longitudinal axis extending between the proximal end and distal end of the body.
- the through bore has a surface.
- the method further includes rotating the driver within the through bore, about the longitudinal axis of the body, until the driver engages a controlling member formed by the surface of the through bore.
- the engagement confirms a driving orientation of the driver with respect to the controlling member.
- the method further includes driving the screw further into the bone with the driver in the driving orientation.
- FIG. 1 shows a first embodiment of the delivery device of the present disclosure.
- FIG. 2 shows a side view of the shaft of the delivery device of FIG. 1 .
- FIG. 2A shows an exploded view of the distal end of the shaft of FIG. 2 .
- FIG. 3 shows a cross-sectional view of the shaft of FIG. 2 .
- FIG. 4 shows a front view of the distal end of the shaft of FIG. 2 .
- FIG. 5 shows an isometric view of the screw for use with the shaft of FIG. 2 .
- FIG. 6 shows a side view of the screw of FIG. 5 .
- FIG. 7 shows a cross-sectional view of the screw of FIG. 6 .
- FIG. 8 shows a second embodiment of a shaft of the present disclosure.
- FIG. 9 shows a side view of the inner member of the shaft of FIG. 8 .
- FIG. 9A shows an exploded view of the distal end of the inner member of FIG. 9 .
- FIG. 10 shows a cross-sectional view of the inner member of the shaft of FIG. 9 .
- FIG. 11 shows a front view of the distal end of the inner member of FIG. 9 .
- FIG. 12 shows an isometric view of the outer member of the shaft of FIG. 8 .
- FIG. 13 shows a cross-sectional view of the outer member of FIG. 12 .
- FIGS. 14 and 15 show side views of the shaft of FIG. 8 with the outer member in different positions.
- FIG. 16 shows an isometric view of a third embodiment of a shaft of the present disclosure and a screw for use with the shaft.
- FIG. 17 shows an isometric view of the shaft of FIG. 16 .
- FIG. 18 shows an isometric view of the screw of FIG. 16 .
- FIG. 19 shows a side view of the screw of FIG. 16 .
- FIG. 20 shows a cross-sectional view of the screw of FIG. 19 .
- FIG. 21 shows an isometric view of a fourth embodiment of a shaft of the present disclosure and a screw for use with the shaft.
- FIG. 22 shows an isometric view of the screw of FIG. 21 .
- FIG. 23 shows an isometric view of the shaft of FIG. 21 .
- FIG. 24 shows an isometric view of the shaft of FIG. 21 and an alternative screw for use with the shaft.
- FIG. 25 shows a side view of the screw of FIG. 24 .
- FIG. 26 shows a cross-sectional view of the screw of FIG. 24 .
- FIG. 27 shows a side view of an interference screw the entire length of which is supported by a driver.
- FIG. 28 shows a side view of an interference screw the entire length of which is not supported by a driver.
- FIG. 29 shows a side view of an interference screw that has failed, structurally.
- FIGS. 30A-30C show an example of an interference screw with a controlling member being inserted further into bone.
- FIG. 31 shows a side view of an example of the interference screw with the controlling member.
- FIG. 32 shows an end view of an example of the interference screw with the controlling member.
- FIG. 33A shows a top view of a cross section of a driver in a driving orientation with respect to the interference screw.
- FIG. 33B shows a top view of a cross section of a driver in an orientation different then the driving orientation of FIG. 33A .
- FIGS. 34A and 34B show examples of the controlling member.
- FIG. 1 shows a first embodiment of the delivery device 10 of the present disclosure.
- the device 10 includes a handle assembly 11 and a shaft 12 coupled to the handle assembly 11 .
- the handle assembly 11 includes a handle 11 a and a connector 11 b coupled to the handle 11 a .
- the connector 11 b has a channel 11 b ′ and an opening 11 b ′′ to the channel 11 b ′.
- the opening 11 b ′′ is in the shape of a “D”.
- a proximal end 12 a of the shaft 12 is disposed within the channel 11 b′.
- FIGS. 2, 2A, and 3-4 show the shaft 12 .
- the shaft 12 includes a proximal end 12 a and a distal end 12 b .
- the proximal end 12 a is in the shape of a “D” to match the shape of the opening 11 b ′′.
- the distal end 12 b includes threads 12 c , grooves 12 d , and a depth stop 12 e .
- the grooves 12 d extend a partial length of the shaft 12 and intersect the threads 12 c .
- the depth stop 12 e is for use with a depth stop on a screw that the device 10 is used to implant into a bone tunnel during ligament reconstruction surgery.
- FIGS. 5-7 show the screw 20 for use with the delivery device 10 of the present disclosure.
- the screw 20 includes a proximal end 21 and a distal end 22 .
- a majority of the screw 20 includes screw threads 23 in the form of an open helical coil, i.e. a connected series of continuous regularly spaced turns extending in a helical or spiral form substantially from the proximal end 21 to the distal end 22 with apertures 24 being defined by the space between the turns of the coil.
- interference screw 20 may include an open helical coil defining an internal volume, with the internal volume communicating with the region exterior to the open helical coil through the spacing between the turns of the open helical coil.
- the distal end 22 also includes a depth stop 25 that extends a partial length of the screw 20 .
- the depth stop 25 includes a proximal end 25 a and a distal end 25 b . Additionally, a plurality of longitudinally-extending runners 26 extend along the interior of the screw threads 23 .
- the distal end 12 b of the shaft 12 is placed within the interior of the screw 20 , via the opening 27 , until the proximal end 25 a of the depth stop 25 engages the depth stop 12 e of the shaft 12 .
- the runners 26 engage the grooves 12 d and become housed within the grooves 12 d .
- the distal end 12 b of the shaft 12 also includes hash marks 12 f , each of which is associated with a number 12 g .
- FIGS. 8, 9-9A, and 10-15 show an alternative shaft 30 of the present disclosure.
- the shaft 30 includes an inner member 31 and an outer member 32 disposed over the inner member 31 .
- the proximal end 31 a of the inner member 31 is similar in shape to the proximal end 12 a of the shaft 12 .
- the distal end 31 b of the inner member 31 includes threads 31 c .
- Grooves 31 d extend along the member 31 and intersect the threads 31 c .
- threads 31 e are located between the proximal and distal ends 31 a , 31 b of the member 31 .
- the outer member 32 includes a first section 32 a and a second section 32 b .
- the first section 32 a has a larger diameter than the second section 32 b .
- the first section 32 a also includes threads 32 c on an inner wall 32 d of the outer member 32 .
- the distal end 31 b of inner member 31 includes hash marks/numbers (not shown) that align with an end 32 b ′ of the second section 32 b , thereby indicating a length of screw 40 that will be disposed on the distal end 31 b of the inner member 31 .
- the outer member 32 is located at different positions along the length of the inner member 31 to allow for screws 40 of different lengths to be loaded on the distal end 31 b of the inner member 31 .
- a handle assembly is coupled to the proximal end 31 a of the inner member 31 .
- screw 40 includes a proximal end 41 and a distal end 42 .
- the screw 40 includes screw threads 43 in the form of an open helical coil having an interior and a plurality of longitudinally-extending runners 45 extending along the interior of the screw threads 43 .
- Screw 40 is more fully described in United States Patent Application Publication No. 20080154314, the disclosure of which is incorporated herein by reference in its entirety.
- the screw 40 is loaded onto the distal end 31 b , such that a proximal end 41 of the screw 40 engages the end 32 b ′ and the runners 45 engage the grooves 31 d and become housed within the grooves 31 d.
- FIGS. 16-20 show another alternative embodiment of the shaft 50 and screw 60 of the present disclosure.
- the shaft 50 includes a first portion 51 including a proximal end 51 a and a distal end 51 b and a second portion 52 including a first area 52 a and a second area 52 b .
- the proximal end 51 a is configured to be coupled to a handle assembly, similar to the handle assembly 11 . However, other handle assemblies may be used.
- the first area 52 a has a smaller diameter than the first portion 51 , such that a first depth stop 51 b ′ exists at the distal end 51 b of the first portion 51 .
- the second area 52 b has a smaller diameter than the first area 52 a such that a second depth stop 52 c exists between the first area 52 a and the second area 52 b .
- An end 52 b ′ of the second area 52 b is tapered to allow for easier insertion of the anchor 60 into a bone during ligament reconstruction surgery, as will be further described below.
- the second portion 52 also includes grooves 53 extending between the first and second areas 52 a , 52 b . For the purposes of this disclosure, there are three grooves 53 . However, the second portion 52 may include a higher or lower number of grooves 53 .
- screw 60 includes a proximal end 61 and a distal end 62 .
- a majority of the screw 60 includes screw threads 63 in the form of an open helical coil, i.e. a connected series of continuous regularly spaced turns extending in a helical or spiral form substantially from the proximal end 61 to the distal end 62 with apertures 64 being defined by the space between the turns of the coil.
- interference screw 60 may include an open helical coil defining an internal volume, with the internal volume communicating with the region exterior to the open helical coil through the spacing between the turns of the open helical coil.
- the distal end 62 also includes a depth stop 65 that extends a partial length of the screw 60 .
- the depth stop 65 includes a proximal end 65 a and a distal end 65 b .
- the depth stop 65 of screw 60 is a closed depth stop, most clearly shown in FIG. 18 .
- a plurality of longitudinally-extending runners 66 extend along the interior of the screw threads 63 .
- the second portion 52 of the shaft 50 is placed within the interior of the screw 60 , via the opening 67 , until the proximal end 65 a of the depth stop 65 engages the second depth stop 52 c of the shaft 50 .
- the runners 66 engage the grooves 53 and become housed within the grooves 53 .
- the screws 60 may be of a variety of lengths. For example, a screw 60 may be of such length that its proximal end 61 would engage the first depth stop 51 b′.
- the end of the graft ligament is placed in the bone tunnel and then the interference screw 20 , 40 , 60 is advanced into the bone tunnel via the use of shafts 12 , 30 , 50 so that the interference screw 20 , 40 , 60 extends parallel to the bone tunnel and simultaneously engages both the graft ligament and the side wall of the bone tunnel.
- the screws 20 , 40 , 60 may be used in either the femoral or tibial tunnels. Methods of ligament reconstruction via use of the screws 20 , 40 , 60 is further shown in the '314 publication shown above.
- FIGS. 21-23 show yet another alternative embodiment of the screw 100 and the delivery device 200 of the present disclosure.
- the screw 100 includes a proximal end 101 and a distal end 102 .
- a majority of the screw 100 includes screw threads 103 in the form of an open helical coil, i.e. a connected series of continuous regularly spaced turns extending in a helical or spiral form substantially from the proximal end 101 to the distal end 102 with apertures 104 being defined by the space between the turns of the coil.
- interference screw 100 may include an open helical coil defining an internal volume, with the internal volume communicating with the region exterior to the open helical coil through the spacing between the turns of the open helical coil.
- the distal end 102 also includes a suture bridge 105 that extends a partial length of the screw 100 .
- the suture bridge 105 includes a proximal end 105 a and a distal end 105 b .
- the distal end 105 b includes a concave shape.
- a flexible member 110 such as a suture, is housed within the screw 100 , such that the suture 110 extends around the distal end 105 b of the bridge 105 .
- longitudinally-extending runners 106 extend from the suture bridge 105 and along the interior of the screw threads 103 . For the purposes of this disclosure, there are two longitudinally extending runners 106 . However, more or less than two runners are within the scope of this disclosure.
- the delivery device 200 includes a distal end 201 having a slot 202 and grooves 203 extending from the slot 202 on each side of the device 200 .
- the screw 100 is located on the distal end 201 such that the suture bridge 105 is housed within the slot 202 and the runners 106 are housed within the grooves 203 .
- the delivery device 200 is cannulated, such that when the screw 100 is located on the device 200 , the suture ends 110 a , 110 b extend through the cannulation 204 .
- FIGS. 24-26 show a screw 300 similar to screw 100 .
- screw 300 additionally includes a pointed tip 311 located on the distal end 302 .
- the tip 311 includes a through hole 312 .
- the hole 312 helps in locating the suture 110 within the interior of the screw 300 .
- the screw 300 is located on the distal end 201 of delivery device 200 such that the suture bridge 305 is housed within the slot 202 and the runners 306 are housed within the grooves 203 .
- the delivery device 200 is cannulated, such that when the screw 300 is located on the device 200 , the suture ends 110 a , 110 b extend through the cannulation 204 , as shown in FIG. 24 .
- the device 200 would include a proximal end, similar to the devices above, which may be coupled to a handle assembly, similar to handle assembly 11 above.
- the screws 100 , 300 are used in the repair of soft tissue, specifically to re-attach tissue to bone.
- This repair is when the screw 100 , 300 is delivered into bone via the use of device 200 , the device 200 is removed from screw 100 , 300 , the tissue is placed on the bone to be adjacent the screw 100 , 300 , the suture ends 110 a , 110 b are pulled through the tissue, and then the suture ends 110 a , 110 b are tied.
- a hole may be made in the bone prior to insertion of the screw 100 , 300 into the bone.
- screw 300 may be inserted into bone without first making a hole in the bone.
- the pointed tip 311 is used to start insertion of the screw 300 into the bone and then rotary motion may be used to complete insertion of the screw 300 into the bone.
- Other methods of tissue repair via use of these screws and delivery device may also be used.
- the handle 11 a of handle assembly 11 is made from plastic, however, other non-metal and metal materials may also be used.
- the shape and size of handle 11 a may be any shape and size necessary to help facilitate insertion of the screw 20 into bone.
- the coupler 11 b is made from a metal material, such as stainless steel or titanium, but may be made from other metal and non-metal materials that are strong enough to withstand the forces applied during surgery.
- the coupler 11 b is press-fit to the handle 11 a , but may be coupled to the handle 11 a in any other manner known to those of skill in the art.
- the size and shape of the coupler 11 b may be any size and shape necessary to help facilitate insertion of the screw 20 into bone.
- the channel 11 b ′ may be any length necessary and the opening 11 b ′′ may be any shape necessary to facilitate coupling of the shaft 12 to the coupler 11 b.
- the shaft 12 is made from a metal material, such as stainless steel and titanium, however, other metal and non-metal materials that would withstand the forces applied during surgery may be used.
- the diameter of the shaft 12 may vary.
- the proximal end 12 a of the shaft 12 may be any shape necessary to facilitate insertion of the end 12 a through opening 11 b ′′ and into channel 11 b ′.
- the number of threads 12 c and grooves 12 d may vary and the lengths of the grooves 12 d may also vary.
- the location of depth stop 12 e may also vary based on the diameter of the shaft 12 and the diameter of the screw 20 that is used.
- the grooves 12 d , depth stop 12 e , and threads 12 c may be formed by any method known to one of skill in the art.
- the screw 20 is made from a polymer material via a molding method. However, other material, which would allow the screw 20 to withstand forces applied during surgery, and other methods of making may be used.
- the depth stop 25 is open ended and doesn't extend the entire inner diameter of the screw 20 . The amount of screw inner diameter that the depth stop 25 covers may vary and the length of the depth stop 25 may vary based on the diameter of the screw. The number and length of the runners 26 may also vary.
- the threads 12 c create threads in the bone, thereby creating a seat for the screw threads 23 , as described more fully in the '314 publication.
- the amount of the distal end 12 b of the shaft 12 that extends from the distal end 22 of the screw 20 may vary.
- the diameters of the first and second sections 32 a , 32 b of outer member 32 may vary and the number of threads 32 c may also vary.
- the number of threads 31 c , 31 e and grooves 31 d may vary and the lengths of the grooves 31 d may also vary.
- the inner and outer members 31 , 32 are made from a metal material, such as stainless steel and titanium, and via a method known to one of skill in the art. However, other materials may also be used.
- the screw 40 is made from a polymer material via a molding method. However, other material and methods of making may be used.
- the number and length of the runners 45 may also vary.
- the distal end 31 b of the shaft 30 extends from the distal end 42 of the screw 40 .
- the threads 31 c create threads in the bone, thereby creating a seat for the screw threads 43 , as described more fully in the '314 publication.
- the amount of the distal end 31 b of the shaft 30 extending from the screw 40 may vary.
- the shaft 50 is made from a metal material, such as stainless steel or titanium, but may be made from another metal material or a non-metal material that is strong enough to withstand the force applied to the shaft 50 during surgery.
- the shaft 50 may be made via a method known to one of skill in the art.
- the diameters of the first and second portions 51 , 52 may vary along with the number and lengths of the grooves 53 and the locations of the depth stops 52 c , 51 b ′ may vary based on the diameter of the screw 60 or other factors. Rather than being tapered, the end 52 b ′ may be designed in another manner to allow easier insertion of the screw 60 into bone.
- the screw 60 is made from a polymer material via a molding method.
- the number and length of the runners 66 may also vary. Once the screw 60 is located on the shaft 50 , the second portion 52 of the shaft 50 extends from the distal end 62 of the screw 60 . The amount of the second portion 52 extending from the screw 60 may vary. Additionally, the length of the depth stop 65 may also vary based on the diameter of the screw 60 or other factors.
- the delivery device 200 is made from a metal material, such as stainless steel or titanium, but may be made from a non-metal material that is strong enough to withstand the forces applied to the device 200 during surgery.
- the delivery device 200 is made via a method known to one of skill in the art.
- the screws 100 , 300 are made from a polymer material and via a molding process, however, other material, which would allow the screw to withstand the forces applied during surgery, and other processes known to one of skill in the art may be used.
- the suture bridge 105 may have a distal end 105 b having a shape other than concave and the length of the suture bridge 105 , the slot 202 , and the grooves 203 may vary.
- the size and the shape of the hole 312 may vary.
- FIGS. 30A-C show the surgeon driving an example of an screw 400 with a controlling member into bone 401 .
- the screw 400 sits proud of the surface of the bone 401 .
- the surgeon drives the screw 400 further into the bone 401 , so that it sits flush with the bone surface, by inserting a driver 450 into the screw 400 .
- the surgeon then rotates of the driver 450 within the screw 400 until it engages the controlling member of the screw 400 .
- Engagement of the driver 450 with the controlling member confirms that the driver 450 is in the proper “driving” orientation and provides the surgeon with the confidence that the screw 400 is fully supported by the driver 450 .
- the surgeon can then drive the screw 400 into the bone 401 without worry of the screw 400 failing.
- FIG. 31 shows an example of the screw 400 having a body 405 .
- the body 405 includes a proximal end 410 , distal end 415 , and longitudinal axis 420 extending between the proximal and distal ends 410 , 415 .
- the body 405 may be made from a bioabsorbable, non-bioabsorbable, osteoconductive or composite material. Examples of a non-bioabsorbable material include polyether ether ketone (PEEK), titanium, and surgical stainless steel.
- the screw 400 further includes threads 425 extending in an open helical form between the proximal end 410 and distal end 415 of the body 405 . In some examples of the screw 400 , the threads 425 are similar to the threads 63 described above with reference FIGS. 5-7 .
- FIG. 32 shows the body 405 defining a through bore 430 .
- the through bore 430 extends between the proximal and distal ends 410 , 415 of the body along the longitudinal axis 420 .
- the through bore 430 has a surface 435 .
- the screw 400 includes a controlling member 440 formed by the through bore surface 435 .
- the driver 450 engages the controlling member 440 when the driver 450 is in a driving orientation with respect to the screw 400 .
- the driver 450 does not engage the controlling member 440 when the driver 450 is in an orientation different than the driving orientation.
- One example of the controlling member 440 shown in FIG. 32 includes a plurality of runners 445 extending between the proximal and distal ends 410 , 415 of the body 405 along the longitudinal axis 420 .
- Three runners ( 445 a , 445 b , 445 c ) are shown but other multiples of runners are possible (e.g., two and four).
- the plurality of runners 445 is spaced equally around the circumference of the through bore 430 . There is an equal distance (d) between each of the runners ( 445 a , 445 b , 445 c ) (the distance (d) being measured, for example, from centerline to centerline of each of the runners).
- the runners ( 445 a , 445 b , 445 c ) can be described as being arranged in a radial manner about the longitudinal axis 420 (coming out of the page of the figure). As such, the position of each of the runners ( 445 a , 445 b , 445 c ) can be described as being at 0° (12 o'clock), at 120° (4 o'clock), and at 240° (8 o'clock), respectively.
- One of the plurality of runners is of different shape and/or size than the other runners.
- a convenient example of the controlling member 440 includes one runner ( 445 a ) having a cross sectional shape based on a rectangle and the other runners ( 445 b , 445 c ) having a cross sectional shape based on a semi-circle. Other cross sectional shapes are possible.
- the dimension(s) of one or more of the runners ( 445 a , 445 b , 445 c ), for example the width and/or height varies with the overall size of the screw 400 .
- a first anchor is larger in size than a second anchor. In the first anchor, the height of runners is taller than the height of runners associated with the second anchor.
- FIGS. 33A-33B are views looking down at cross sections of the driver 450 .
- the driver 450 used by the surgeon to turn the screw 400 into bone 401 includes grooves 455 .
- the grooves 455 have an inverse geometry of the plurality of runners 445 .
- the corresponding driver grooves 455 house the plurality of runners 445 , thus, enabling the surgeon to turn the screw 400 using the driver 450 .
- the driver 450 is not in the driving orientation, as shown in FIG. 33B
- the corresponding driver grooves 455 do not house the plurality of runners 445 (represented in the figure as hidden lines) and surgeon cannot turn the screw 400 using the driver 450 .
- the driver is turned counterclockwise (in the direction of the drawn arrow), from the 10 o'clock to 9 o'clock position.
- the foregoing arrangement provides a “one-way” engagement that is advantageous because the surgeon can control and confirm the orientation of the driver 450 without seeing the driver 450 and/or screw 400 i.e., the procedure can be done blindly. If the surgeon inserts the driver 450 into the screw 400 and is able to rotate it freely (i.e., without resistance) or is not able to insert the driver 450 into the screw 400 at all, then the surgeon knows that the driver 450 is not in the driving orientation. The surgeon can then rotate the driver 450 until it engages the controlling member 440 of the screw 400 . Engaging the controlling member 440 causes the screw 400 to be driven into the bone and consequently, the surgeon must turn the driver 450 harder. As such, advantageously some examples of the screw 400 provide tactile feedback that enables the surgeon to seek the proper driver orientation.
- FIG. 34A shows another example of the controlling member 440 that includes a plurality of runners 445 ′ extending between the proximal and distal ends 410 , 415 of the body 405 along the longitudinal axis 420 .
- the plurality of runners 445 ′ is spaced unequally around the circumference of the through bore 430 .
- There is a different distance (d, d′, d′′) between each of the runners 445 ′ (the distances (d, d′, d′′) being measured, for example, from centerline to centerline of each of the runners).
- the positions of the runners 445 ′ are such that the number degrees separating positions are not equal.
- FIG. 34B shows yet another example of the controlling member 445 that includes a plurality of runners 445 ′′ extending between the proximal and distal ends 410 , 415 of the body 405 along the longitudinal axis 420 .
- the plurality of runners 445 ′′ is spaced equally around the circumference of the through bore 430 .
- the example controlling member 440 further includes a tab 460 spaced between an adjacent pair of runners ( 445 a ′′ and 445 b ′′).
- Another example of the controlling member 440 includes a plurality of runners spaced unequally around the circumference of the through bore with a tab spaced between an adjacent pair of runners.
- the tab 460 extends part of the length of the screw 400 and is different than a runner. While the one way or “keyed” feature of the screw 400 is described with reference to the example arrangements above, those skilled in the art will readily recognize that other arrangements are possible.
- the screw 400 include a depth stop, such as the open depth stop 25 described above with reference FIG. 5 and the closed depth stop 65 described above with reference FIG. 18 .
- the depths stop engages a depth stop of the driver 450 such that a distal end of the driver extends beyond the distal end of the body.
- the proximal end 410 of the body 405 aligns with a hash mark on a distal end of the driver and a number associated with the hash mark identifies the length of the body 405 of the screw 400 .
- the surgeon may remove the driver 450 from the body 405 of the screw 400 that has been partly inserted into bone 401 .
- the surgeon reinserts the driver 450 into the body 405 of the screw 400 and engages the controlling member 440 .
- the surgeon confirms the orientation of the driver 450 based on the engagement of the controlling member 440 with the driver 450 .
- Engaging the controlling member 440 tells the surgeon that the driver 450 is in the driving orientation.
- the lack of engagement tells the surgeon that the driver 450 is in an orientation different than the driving orientation.
- the surgeon rotates the driver 450 within the through bore 430 until the driver 450 engages the controlling member 440 (e.g., the surgeon turns driver and the screw turns).
- the screw 400 may be a part of an screwing system that includes the above-described driver 450 .
- the screw 400 maybe “preloaded” and disposed on at a distal end of the driver 450 .
Abstract
The present disclosure relates to an interference screw having a body with a proximal end, distal end, and longitudinal axis extending between thereinbetween. The screw further includes threads for fixing the screw into bone. The screw further includes a through bore defined by the body. The through bore extends between the proximal and distal ends along the longitudinal axis, and has a surface. The screw further includes a controlling member formed by the through bore surface. To install the screw into bone, a surgeon turns the screw with a driver that engages with the controlling member. The driver only engages the controlling member when it is in a driving orientation with respect to the controlling member. Advantageously, with this “one-way” engagement the surgeon can control and confirm the orientation of the driver without seeing the driver and/or screw.
Description
- This application is a continuation of co-pending U.S. patent application Ser. No. 14/085,295, filed Nov. 20, 2013, which in turn is a continuation-in-part application of U.S. patent application Ser. No. 13/044,777, filed Mar. 10, 2011, now U.S. Pat. No. 8,979,865, which in turn claims priority to U.S. Patent Application Ser. No. 61/312,291, filed Mar. 10, 2010, U.S. Patent Application Ser. No. 61/334,808, filed May 14, 2010, and U.S. Patent Application Ser. No. 61/359,080, filed Jun. 28, 2010 the disclosures of which are incorporated herein by reference in their entireties for all purposes.
- Field of Technology
- The present disclosure relates to medical apparatuses and procedures in general, and more particularly to medical apparatuses and procedures for reconstructing a ligament.
- Related Art
- In many cases, ligaments are torn or ruptured as the result of an accident. Accordingly, various procedures have been developed to repair or replace such damaged ligaments.
- For example, in the human knee, the anterior and posterior cruciate ligaments (i.e., the “ACL” and “PCL”) extend between the top end of the tibia and the bottom end of the femur. Often, the anterior cruciate ligament (i.e., the ACL) is ruptured or torn as the result of, for example, a sports-related injury. Consequently, various surgical procedures have been developed for reconstructing the ACL so as to restore substantially normal function to the knee.
- In many instances, the ACL may be reconstructed by replacing the ruptured ACL with a graft ligament. More particularly, in such a procedure, bone tunnels are generally formed in both the top of the tibia and the bottom of the femur, with one end of the graft ligament being positioned in the femoral tunnel and the other end of the graft ligament being positioned in the tibial tunnel, and with the intermediate portion of the graft ligament spanning the distance between the bottom of the femur and the top of the tibia. The two ends of the graft ligament are anchored in their respective bone tunnels in various ways well known in the art so that the graft ligament extends between the bottom end of the femur and the top end of the tibia in substantially the same way, and with substantially the same function, as the original ACL. This graft ligament then cooperates with the surrounding anatomical structures so as to restore substantially normal function to the knee.
- In some circumstances, the graft ligament may be a ligament or tendon which is harvested from elsewhere within the patient's body, e.g., a patella tendon with or without bone blocks attached, a semitendinosus tendon and/or a gracilis tendon.
- As noted above, various approaches are well known in the art for anchoring the two ends of the graft ligament in the femoral and tibial bone tunnels.
- In one well-known procedure, which may be applied to femoral fixation, tibial fixation, or both, the end of the graft ligament is placed in the bone tunnel, and then the graft ligament is fixed in place using a headless orthopedic screw, generally known in the art as an “interference” screw. More particularly, with this approach, the end of the graft ligament is placed in the bone tunnel and then the interference screw is advanced into the bone tunnel so that the interference screw extends parallel to the bone tunnel and simultaneously engages both the graft ligament and the side wall of the bone tunnel. In this arrangement, the interference screw essentially drives the graft ligament laterally, into engagement with the opposing side wall of the bone tunnel, whereby to secure the graft ligament to the host bone with a so-called “interference fit”. Thereafter, over time (e.g., several months), the graft ligament and the host bone grow together at their points of contact so as to provide a strong, natural joinder between the ligament and the bone.
- Interference screws have proven to be an effective means for securing a graft ligament in a bone tunnel in a number of applications, such as ACL reconstruction surgery and biceps tenodesis. However, the interference screw itself generally takes up a substantial amount of space within the bone tunnel, which can limit the surface area contact established between the graft ligament and the side wall of the bone tunnel. This in turn limits the region of bone-to-ligament in-growth, and hence can affect the strength of the joinder. By way of example but not limitation, it has been estimated that the typical interference screw obstructs about 50% of the potential bone-to-ligament integration region.
- For this reason, substantial efforts have been made to provide interference screws fabricated from absorbable materials, so that the interference screw can eventually disappear over time and bone-to-ligament in-growth can take place about the entire perimeter of the bone tunnel. To this end, various absorbable interference screws have been developed which are made from biocompatible, bioabsorbable polymers, e.g., polylactic acid (PLA), polyglycolic acid (PGA), etc. These polymers generally provide the substantial mechanical strength needed to advance the interference screw into position, and to thereafter hold the graft ligament in position while bone-to-ligament in-growth occurs, without remaining in position on a permanent basis.
- In general, interference screws made from such biocompatible, bioabsorbable polymers have proven clinically successful. However, these absorbable interference screws still suffer from several disadvantages. First, clinical evidence suggests that the quality of the bone-to-ligament in-growth is somewhat different than natural bone-to-ligament in-growth, in the sense that the aforementioned bioabsorbable polymers tend to be replaced by a fibrous mass rather than a well-ordered tissue matrix. Second, clinical evidence suggests that absorption generally takes a substantial period of time, e.g., on the order of three years or so. Thus, during this absorption time, the bone-to-ligament in-growth is still significantly limited by the presence of the interference screw. Third, clinical evidence suggests that, for many patients, absorption is never complete, leaving a substantial foreign mass remaining within the body. This problem is exacerbated somewhat by the fact that absorbable interference screws generally tend to be fairly large in order to provide them with adequate strength, e.g., it is common for an interference screw to have a diameter (i.e., an outer diameter) of 8-12 mm and a length of 20-25 mm.
- Thus, there is a need for a new and improved interference fixation system which (i) has the strength needed to hold the graft ligament in position while bone-to-ligament in-growth occurs, and (ii) promotes superior bone-to-ligament in-growth.
- In one aspect, the present disclosure relates to an interference screw. The screw includes a body having a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end. The screw further includes threads extending in an open helical form between the proximal end and distal end of the body. The screw further includes a through bore defined by the body extending between the proximal end and distal end of the body along the longitudinal axis. The through bore has a surface from which a controlling member is formed. The controlling member being engaged by a driver when the driver is in a driving orientation with respect to the controlling member. The controlling member being not engaged by the driver when the driver is in an orientation different than the driving orientation.
- In another aspect, the present disclosure relates to a method for installing an interference screw into bone. The method includes removing a driver from a body of an interference screw inserted into bone. The body has a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end. The body defines a through bore extending between the proximal end and distal end along the longitudinal axis. The through bore has a surface. The method further includes engaging a controlling member formed by the surface of the through bore with the driver. The controlling member being engaged by the driver when the driver is in a driving orientation with respect to the controlling member. The controlling member not being engaged by the driver when the driver is in an orientation different than the driving orientation. The method further includes confirming the orientation of the driver in the body of the screw based on the engagement of the controlling member with the driver.
- In yet another aspect, the present disclosure relates to another method for installing an interference screw into bone. The method includes inserting, initially, a driver into a through bore defined by a body of a screw inserted into bone. The through bore extends between a proximal end and a distal end of the body along a longitudinal axis extending between the proximal end and distal end of the body. The through bore has a surface. The method further includes rotating the driver within the through bore, about the longitudinal axis of the body, until the driver engages a controlling member formed by the surface of the through bore. The engagement confirms a driving orientation of the driver with respect to the controlling member. The method further includes driving the screw further into the bone with the driver in the driving orientation.
- Further areas of applicability of the present disclosure will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating the preferred embodiment of the disclosure, are intended for purposes of illustration only and are not intended to limit the scope of the disclosure.
- The accompanying drawings, which are incorporated in and form a part of the specification, illustrate the embodiments of the present disclosure and together with the written description serve to explain the principles, characteristics, and features of the disclosure. In the drawings:
-
FIG. 1 shows a first embodiment of the delivery device of the present disclosure. -
FIG. 2 shows a side view of the shaft of the delivery device ofFIG. 1 . -
FIG. 2A shows an exploded view of the distal end of the shaft ofFIG. 2 . -
FIG. 3 shows a cross-sectional view of the shaft ofFIG. 2 . -
FIG. 4 shows a front view of the distal end of the shaft ofFIG. 2 . -
FIG. 5 shows an isometric view of the screw for use with the shaft ofFIG. 2 . -
FIG. 6 shows a side view of the screw ofFIG. 5 . -
FIG. 7 shows a cross-sectional view of the screw ofFIG. 6 . -
FIG. 8 shows a second embodiment of a shaft of the present disclosure. -
FIG. 9 shows a side view of the inner member of the shaft ofFIG. 8 . -
FIG. 9A shows an exploded view of the distal end of the inner member ofFIG. 9 . -
FIG. 10 shows a cross-sectional view of the inner member of the shaft ofFIG. 9 . -
FIG. 11 shows a front view of the distal end of the inner member ofFIG. 9 . -
FIG. 12 shows an isometric view of the outer member of the shaft ofFIG. 8 . -
FIG. 13 shows a cross-sectional view of the outer member ofFIG. 12 . -
FIGS. 14 and 15 show side views of the shaft ofFIG. 8 with the outer member in different positions. -
FIG. 16 shows an isometric view of a third embodiment of a shaft of the present disclosure and a screw for use with the shaft. -
FIG. 17 shows an isometric view of the shaft ofFIG. 16 . -
FIG. 18 shows an isometric view of the screw ofFIG. 16 . -
FIG. 19 shows a side view of the screw ofFIG. 16 . -
FIG. 20 shows a cross-sectional view of the screw ofFIG. 19 . -
FIG. 21 shows an isometric view of a fourth embodiment of a shaft of the present disclosure and a screw for use with the shaft. -
FIG. 22 shows an isometric view of the screw ofFIG. 21 . -
FIG. 23 shows an isometric view of the shaft ofFIG. 21 . -
FIG. 24 shows an isometric view of the shaft ofFIG. 21 and an alternative screw for use with the shaft. -
FIG. 25 shows a side view of the screw ofFIG. 24 . -
FIG. 26 shows a cross-sectional view of the screw ofFIG. 24 . -
FIG. 27 shows a side view of an interference screw the entire length of which is supported by a driver. -
FIG. 28 shows a side view of an interference screw the entire length of which is not supported by a driver. -
FIG. 29 shows a side view of an interference screw that has failed, structurally. -
FIGS. 30A-30C show an example of an interference screw with a controlling member being inserted further into bone. -
FIG. 31 shows a side view of an example of the interference screw with the controlling member. -
FIG. 32 shows an end view of an example of the interference screw with the controlling member. -
FIG. 33A shows a top view of a cross section of a driver in a driving orientation with respect to the interference screw. -
FIG. 33B shows a top view of a cross section of a driver in an orientation different then the driving orientation ofFIG. 33A . -
FIGS. 34A and 34B show examples of the controlling member. - The following description of the preferred embodiment(s) is merely exemplary in nature and is in no way intended to limit the disclosure, its application, or uses.
-
FIG. 1 shows a first embodiment of thedelivery device 10 of the present disclosure. Thedevice 10 includes ahandle assembly 11 and ashaft 12 coupled to thehandle assembly 11. Thehandle assembly 11 includes ahandle 11 a and aconnector 11 b coupled to the handle 11 a. Theconnector 11 b has achannel 11 b′ and anopening 11 b″ to thechannel 11 b′. Theopening 11 b″ is in the shape of a “D”. Aproximal end 12 a of theshaft 12 is disposed within thechannel 11 b′. -
FIGS. 2, 2A, and 3-4 show theshaft 12. Theshaft 12 includes aproximal end 12 a and adistal end 12 b. Theproximal end 12 a is in the shape of a “D” to match the shape of theopening 11 b″. Thedistal end 12 b includesthreads 12 c,grooves 12 d, and adepth stop 12 e. Thegrooves 12 d extend a partial length of theshaft 12 and intersect thethreads 12 c. Thedepth stop 12 e is for use with a depth stop on a screw that thedevice 10 is used to implant into a bone tunnel during ligament reconstruction surgery. -
FIGS. 5-7 show thescrew 20 for use with thedelivery device 10 of the present disclosure. Thescrew 20 includes aproximal end 21 and adistal end 22. A majority of thescrew 20 includesscrew threads 23 in the form of an open helical coil, i.e. a connected series of continuous regularly spaced turns extending in a helical or spiral form substantially from theproximal end 21 to thedistal end 22 withapertures 24 being defined by the space between the turns of the coil. In other words,interference screw 20 may include an open helical coil defining an internal volume, with the internal volume communicating with the region exterior to the open helical coil through the spacing between the turns of the open helical coil. Thedistal end 22 also includes adepth stop 25 that extends a partial length of thescrew 20. Thedepth stop 25 includes aproximal end 25 a and adistal end 25 b. Additionally, a plurality of longitudinally-extendingrunners 26 extend along the interior of thescrew threads 23. - The
distal end 12 b of theshaft 12 is placed within the interior of thescrew 20, via theopening 27, until theproximal end 25 a of thedepth stop 25 engages thedepth stop 12 e of theshaft 12. During insertion of theshaft 12 into thescrew 20, therunners 26 engage thegrooves 12 d and become housed within thegrooves 12 d. As shown inFIG. 1 , thedistal end 12 b of theshaft 12 also includes hash marks 12 f, each of which is associated with a number 12 g. Once thescrew 20 is placed on theshaft 12, theproximal end 21 of thescrew 20 aligns with one of the hash marks/numbers 12 f, thereby indicating the length of thescrew 20. -
FIGS. 8, 9-9A, and 10-15 show analternative shaft 30 of the present disclosure. Theshaft 30 includes aninner member 31 and anouter member 32 disposed over theinner member 31. Theproximal end 31 a of theinner member 31 is similar in shape to theproximal end 12 a of theshaft 12. Thedistal end 31 b of theinner member 31 includesthreads 31 c.Grooves 31 d extend along themember 31 and intersect thethreads 31 c. Additionally,threads 31 e are located between the proximal and distal ends 31 a,31 b of themember 31. Theouter member 32 includes afirst section 32 a and asecond section 32 b. Thefirst section 32 a has a larger diameter than thesecond section 32 b. Thefirst section 32 a also includesthreads 32 c on an inner wall 32 d of theouter member 32. - Once the
outer member 32 is disposed over theinner member 31,threads 32 c engagethreads 31 e to move theouter member 32 relative to theinner member 31. Moving theouter member 32 relative to theinner member 31 allows for more or less of thedistal end 31 b of theinner member 31 to be shown. Similar to thedistal end 12 b of theshaft 12, thedistal end 31 b ofinner member 31 includes hash marks/numbers (not shown) that align with anend 32 b′ of thesecond section 32 b, thereby indicating a length ofscrew 40 that will be disposed on thedistal end 31 b of theinner member 31. As shown inFIGS. 14 and 15 , theouter member 32 is located at different positions along the length of theinner member 31 to allow forscrews 40 of different lengths to be loaded on thedistal end 31 b of theinner member 31. - A handle assembly, similar to the
handle assembly 11, is coupled to theproximal end 31 a of theinner member 31. Similar to screw 20,screw 40 includes aproximal end 41 and adistal end 42. Thescrew 40 includesscrew threads 43 in the form of an open helical coil having an interior and a plurality of longitudinally-extendingrunners 45 extending along the interior of thescrew threads 43.Screw 40 is more fully described in United States Patent Application Publication No. 20080154314, the disclosure of which is incorporated herein by reference in its entirety. Once theouter member 32 has been moved to indicate the screw length, thescrew 40 is loaded onto thedistal end 31 b, such that aproximal end 41 of thescrew 40 engages theend 32 b′ and therunners 45 engage thegrooves 31 d and become housed within thegrooves 31 d. -
FIGS. 16-20 show another alternative embodiment of theshaft 50 and screw 60 of the present disclosure. Theshaft 50 includes afirst portion 51 including aproximal end 51 a and adistal end 51 b and asecond portion 52 including afirst area 52 a and asecond area 52 b. Theproximal end 51 a is configured to be coupled to a handle assembly, similar to thehandle assembly 11. However, other handle assemblies may be used. Thefirst area 52 a has a smaller diameter than thefirst portion 51, such that afirst depth stop 51 b′ exists at thedistal end 51 b of thefirst portion 51. Thesecond area 52 b has a smaller diameter than thefirst area 52 a such that asecond depth stop 52 c exists between thefirst area 52 a and thesecond area 52 b. Anend 52 b′ of thesecond area 52 b is tapered to allow for easier insertion of theanchor 60 into a bone during ligament reconstruction surgery, as will be further described below. Thesecond portion 52 also includesgrooves 53 extending between the first andsecond areas grooves 53. However, thesecond portion 52 may include a higher or lower number ofgrooves 53. - Similar to screw 20 shown in
FIGS. 5-7 , screw 60 includes aproximal end 61 and adistal end 62. A majority of thescrew 60 includesscrew threads 63 in the form of an open helical coil, i.e. a connected series of continuous regularly spaced turns extending in a helical or spiral form substantially from theproximal end 61 to thedistal end 62 withapertures 64 being defined by the space between the turns of the coil. In other words,interference screw 60 may include an open helical coil defining an internal volume, with the internal volume communicating with the region exterior to the open helical coil through the spacing between the turns of the open helical coil. Thedistal end 62 also includes adepth stop 65 that extends a partial length of thescrew 60. Thedepth stop 65 includes aproximal end 65 a and adistal end 65 b. Unlike theopen depth stop 25 ofscrew 20 most clearly shown inFIG. 5 , the depth stop 65 ofscrew 60 is a closed depth stop, most clearly shown inFIG. 18 . Additionally, a plurality of longitudinally-extendingrunners 66 extend along the interior of thescrew threads 63. - The
second portion 52 of theshaft 50 is placed within the interior of thescrew 60, via theopening 67, until theproximal end 65 a of thedepth stop 65 engages thesecond depth stop 52 c of theshaft 50. During insertion of theshaft 50 into thescrew 60, therunners 66 engage thegrooves 53 and become housed within thegrooves 53. Thescrews 60 may be of a variety of lengths. For example, ascrew 60 may be of such length that itsproximal end 61 would engage thefirst depth stop 51 b′. - As described above, during ligament reconstruction surgery, the end of the graft ligament is placed in the bone tunnel and then the
interference screw shafts interference screw screws screws -
FIGS. 21-23 show yet another alternative embodiment of thescrew 100 and thedelivery device 200 of the present disclosure. Thescrew 100 includes aproximal end 101 and adistal end 102. A majority of thescrew 100 includesscrew threads 103 in the form of an open helical coil, i.e. a connected series of continuous regularly spaced turns extending in a helical or spiral form substantially from theproximal end 101 to thedistal end 102 withapertures 104 being defined by the space between the turns of the coil. In other words,interference screw 100 may include an open helical coil defining an internal volume, with the internal volume communicating with the region exterior to the open helical coil through the spacing between the turns of the open helical coil. Thedistal end 102 also includes asuture bridge 105 that extends a partial length of thescrew 100. Thesuture bridge 105 includes aproximal end 105 a and adistal end 105 b. Thedistal end 105 b includes a concave shape. Aflexible member 110, such as a suture, is housed within thescrew 100, such that thesuture 110 extends around thedistal end 105 b of thebridge 105. Additionally, longitudinally-extendingrunners 106 extend from thesuture bridge 105 and along the interior of thescrew threads 103. For the purposes of this disclosure, there are two longitudinally extendingrunners 106. However, more or less than two runners are within the scope of this disclosure. - The
delivery device 200 includes adistal end 201 having aslot 202 andgrooves 203 extending from theslot 202 on each side of thedevice 200. As shown inFIG. 21 , thescrew 100 is located on thedistal end 201 such that thesuture bridge 105 is housed within theslot 202 and therunners 106 are housed within thegrooves 203. Thedelivery device 200 is cannulated, such that when thescrew 100 is located on thedevice 200, the suture ends 110 a, 110 b extend through thecannulation 204. -
FIGS. 24-26 show ascrew 300 similar to screw 100. However, screw 300 additionally includes apointed tip 311 located on thedistal end 302. Thetip 311 includes a throughhole 312. Thehole 312 helps in locating thesuture 110 within the interior of thescrew 300. As shown inFIG. 24 , thescrew 300 is located on thedistal end 201 ofdelivery device 200 such that thesuture bridge 305 is housed within theslot 202 and therunners 306 are housed within thegrooves 203. As stated above, thedelivery device 200 is cannulated, such that when thescrew 300 is located on thedevice 200, the suture ends 110 a,110 b extend through thecannulation 204, as shown inFIG. 24 . - For clarity purposes, only the
distal end 201 of thedevice 200 is shown. However, thedevice 200 would include a proximal end, similar to the devices above, which may be coupled to a handle assembly, similar to handleassembly 11 above. Thescrews screw device 200, thedevice 200 is removed fromscrew screw screw pointed tip 311 is used to start insertion of thescrew 300 into the bone and then rotary motion may be used to complete insertion of thescrew 300 into the bone. Other methods of tissue repair via use of these screws and delivery device may also be used. - The
handle 11 a ofhandle assembly 11 is made from plastic, however, other non-metal and metal materials may also be used. The shape and size ofhandle 11 a may be any shape and size necessary to help facilitate insertion of thescrew 20 into bone. Thecoupler 11 b is made from a metal material, such as stainless steel or titanium, but may be made from other metal and non-metal materials that are strong enough to withstand the forces applied during surgery. Thecoupler 11 b is press-fit to the handle 11 a, but may be coupled to the handle 11 a in any other manner known to those of skill in the art. The size and shape of thecoupler 11 b may be any size and shape necessary to help facilitate insertion of thescrew 20 into bone. Thechannel 11 b′ may be any length necessary and theopening 11 b″ may be any shape necessary to facilitate coupling of theshaft 12 to thecoupler 11 b. - The
shaft 12 is made from a metal material, such as stainless steel and titanium, however, other metal and non-metal materials that would withstand the forces applied during surgery may be used. The diameter of theshaft 12 may vary. Theproximal end 12 a of theshaft 12 may be any shape necessary to facilitate insertion of theend 12 a throughopening 11 b″ and intochannel 11 b′. The number ofthreads 12 c andgrooves 12 d may vary and the lengths of thegrooves 12 d may also vary. The location ofdepth stop 12 e may also vary based on the diameter of theshaft 12 and the diameter of thescrew 20 that is used. Thegrooves 12 d, depth stop 12 e, andthreads 12 c may be formed by any method known to one of skill in the art. - The
screw 20 is made from a polymer material via a molding method. However, other material, which would allow thescrew 20 to withstand forces applied during surgery, and other methods of making may be used. Thedepth stop 25 is open ended and doesn't extend the entire inner diameter of thescrew 20. The amount of screw inner diameter that thedepth stop 25 covers may vary and the length of thedepth stop 25 may vary based on the diameter of the screw. The number and length of therunners 26 may also vary. Once thescrew 20 is located on theshaft 12, thedistal end 12 b of theshaft 12 extends from thedistal end 22 of thescrew 20. During insertion of thescrew 20 into bone, thethreads 12 c create threads in the bone, thereby creating a seat for thescrew threads 23, as described more fully in the '314 publication. The amount of thedistal end 12 b of theshaft 12 that extends from thedistal end 22 of thescrew 20 may vary. - The diameters of the first and
second sections outer member 32 may vary and the number ofthreads 32 c may also vary. The number ofthreads grooves 31 d may vary and the lengths of thegrooves 31 d may also vary. The inner andouter members screw 40 is made from a polymer material via a molding method. However, other material and methods of making may be used. The number and length of therunners 45 may also vary. Once thescrew 40 is located on theshaft 30, thedistal end 31 b of theshaft 30 extends from thedistal end 42 of thescrew 40. During insertion of thescrew 40 into bone, thethreads 31 c create threads in the bone, thereby creating a seat for thescrew threads 43, as described more fully in the '314 publication. The amount of thedistal end 31 b of theshaft 30 extending from thescrew 40 may vary. - The
shaft 50 is made from a metal material, such as stainless steel or titanium, but may be made from another metal material or a non-metal material that is strong enough to withstand the force applied to theshaft 50 during surgery. Theshaft 50 may be made via a method known to one of skill in the art. The diameters of the first andsecond portions grooves 53 and the locations of the depth stops 52 c,51 b′ may vary based on the diameter of thescrew 60 or other factors. Rather than being tapered, theend 52 b′ may be designed in another manner to allow easier insertion of thescrew 60 into bone. Thescrew 60 is made from a polymer material via a molding method. However, other material, which would allow the screw to withstand the forces applied during surgery, and other methods of making may be used. The number and length of therunners 66 may also vary. Once thescrew 60 is located on theshaft 50, thesecond portion 52 of theshaft 50 extends from thedistal end 62 of thescrew 60. The amount of thesecond portion 52 extending from thescrew 60 may vary. Additionally, the length of thedepth stop 65 may also vary based on the diameter of thescrew 60 or other factors. - The
delivery device 200 is made from a metal material, such as stainless steel or titanium, but may be made from a non-metal material that is strong enough to withstand the forces applied to thedevice 200 during surgery. Thedelivery device 200 is made via a method known to one of skill in the art. Thescrews suture bridge 105 may have adistal end 105 b having a shape other than concave and the length of thesuture bridge 105, theslot 202, and thegrooves 203 may vary. The size and the shape of thehole 312 may vary. - With some interference screw designs, it is necessary to support the entire length of an screw (or a substantial portion thereof) with a driver, as shown in
FIG. 27 , in order to insert the screw into bone properly. The need is especially great when the screw is made from a weak and/or brittle material, such as an osteoconductive material. This is also prevalent when the screw has fenestrations or openings that reduce the flexural (torsional) strength of the screw. Inserting the screw into bone when it is not fully supported, as shown inFIG. 28 , may result in the screw failing, as shown inFIG. 29 . With some screw designs, the orientation of the driver with respect to the screw determines whether the screw is fully supported or not. Accordingly, in these designs, there is a need to control the orientation of the driver with respect to the screw. - It may not be possible or it may be difficult for a surgeon to see the screw and/or driver and confirm the orientation of the driver with respect to the screw. For example, a surgeon's view may be obstructed when the screw is partly installed in bone. Accordingly, there is a further need to confirm the orientation of the driver with respect to the screw blindly.
-
FIGS. 30A-C show the surgeon driving an example of anscrew 400 with a controlling member intobone 401. As shown, thescrew 400 sits proud of the surface of thebone 401. The surgeon drives thescrew 400 further into thebone 401, so that it sits flush with the bone surface, by inserting adriver 450 into thescrew 400. The surgeon then rotates of thedriver 450 within thescrew 400 until it engages the controlling member of thescrew 400. Engagement of thedriver 450 with the controlling member confirms that thedriver 450 is in the proper “driving” orientation and provides the surgeon with the confidence that thescrew 400 is fully supported by thedriver 450. The surgeon can then drive thescrew 400 into thebone 401 without worry of thescrew 400 failing. -
FIG. 31 shows an example of thescrew 400 having abody 405. Thebody 405 includes aproximal end 410,distal end 415, andlongitudinal axis 420 extending between the proximal anddistal ends body 405 may be made from a bioabsorbable, non-bioabsorbable, osteoconductive or composite material. Examples of a non-bioabsorbable material include polyether ether ketone (PEEK), titanium, and surgical stainless steel. Thescrew 400 further includes threads 425 extending in an open helical form between theproximal end 410 anddistal end 415 of thebody 405. In some examples of thescrew 400, the threads 425 are similar to thethreads 63 described above with referenceFIGS. 5-7 . -
FIG. 32 shows thebody 405 defining a throughbore 430. The throughbore 430 extends between the proximal anddistal ends longitudinal axis 420. The throughbore 430 has asurface 435. Thescrew 400 includes a controllingmember 440 formed by the throughbore surface 435. Thedriver 450 engages the controllingmember 440 when thedriver 450 is in a driving orientation with respect to thescrew 400. Thedriver 450 does not engage the controllingmember 440 when thedriver 450 is in an orientation different than the driving orientation. - One example of the controlling
member 440 shown inFIG. 32 includes a plurality of runners 445 extending between the proximal anddistal ends body 405 along thelongitudinal axis 420. Three runners (445 a, 445 b, 445 c) are shown but other multiples of runners are possible (e.g., two and four). The plurality of runners 445 is spaced equally around the circumference of the throughbore 430. There is an equal distance (d) between each of the runners (445 a, 445 b, 445 c) (the distance (d) being measured, for example, from centerline to centerline of each of the runners). The runners (445 a, 445 b, 445 c) can be described as being arranged in a radial manner about the longitudinal axis 420 (coming out of the page of the figure). As such, the position of each of the runners (445 a, 445 b, 445 c) can be described as being at 0° (12 o'clock), at 120° (4 o'clock), and at 240° (8 o'clock), respectively. - One of the plurality of runners is of different shape and/or size than the other runners. A convenient example of the controlling
member 440 includes one runner (445 a) having a cross sectional shape based on a rectangle and the other runners (445 b, 445 c) having a cross sectional shape based on a semi-circle. Other cross sectional shapes are possible. In another example of the controllingmember 440, the dimension(s) of one or more of the runners (445 a, 445 b, 445 c), for example the width and/or height, varies with the overall size of thescrew 400. For example, a first anchor is larger in size than a second anchor. In the first anchor, the height of runners is taller than the height of runners associated with the second anchor. - Turning now to
FIGS. 33A-33B , which are views looking down at cross sections of thedriver 450. Thedriver 450 used by the surgeon to turn thescrew 400 intobone 401 includes grooves 455. The grooves 455 have an inverse geometry of the plurality of runners 445. When thedriver 450 is in the driving orientation shown inFIG. 33A , the corresponding driver grooves 455 house the plurality of runners 445, thus, enabling the surgeon to turn thescrew 400 using thedriver 450. When thedriver 450 is not in the driving orientation, as shown inFIG. 33B , the corresponding driver grooves 455 do not house the plurality of runners 445 (represented in the figure as hidden lines) and surgeon cannot turn thescrew 400 using thedriver 450. In the example shown inFIG. 33B , in order for the driver grooves 455 to house the plurality of runners 445, the driver is turned counterclockwise (in the direction of the drawn arrow), from the 10 o'clock to 9 o'clock position. - The foregoing arrangement provides a “one-way” engagement that is advantageous because the surgeon can control and confirm the orientation of the
driver 450 without seeing thedriver 450 and/or screw 400 i.e., the procedure can be done blindly. If the surgeon inserts thedriver 450 into thescrew 400 and is able to rotate it freely (i.e., without resistance) or is not able to insert thedriver 450 into thescrew 400 at all, then the surgeon knows that thedriver 450 is not in the driving orientation. The surgeon can then rotate thedriver 450 until it engages the controllingmember 440 of thescrew 400. Engaging the controllingmember 440 causes thescrew 400 to be driven into the bone and consequently, the surgeon must turn thedriver 450 harder. As such, advantageously some examples of thescrew 400 provide tactile feedback that enables the surgeon to seek the proper driver orientation. -
FIG. 34A shows another example of the controllingmember 440 that includes a plurality of runners 445′ extending between the proximal anddistal ends body 405 along thelongitudinal axis 420. The plurality of runners 445′ is spaced unequally around the circumference of the throughbore 430. There is a different distance (d, d′, d″) between each of the runners 445′ (the distances (d, d′, d″) being measured, for example, from centerline to centerline of each of the runners). Described in the terms of radial arrangement, the positions of the runners 445′ are such that the number degrees separating positions are not equal. -
FIG. 34B shows yet another example of the controlling member 445 that includes a plurality of runners 445″ extending between the proximal anddistal ends body 405 along thelongitudinal axis 420. The plurality of runners 445″ is spaced equally around the circumference of the throughbore 430. Theexample controlling member 440 further includes atab 460 spaced between an adjacent pair of runners (445 a″ and 445 b″). Another example of the controllingmember 440 includes a plurality of runners spaced unequally around the circumference of the through bore with a tab spaced between an adjacent pair of runners. In some examples, thetab 460 extends part of the length of thescrew 400 and is different than a runner. While the one way or “keyed” feature of thescrew 400 is described with reference to the example arrangements above, those skilled in the art will readily recognize that other arrangements are possible. - Other examples of the
screw 400 include a depth stop, such as theopen depth stop 25 described above with referenceFIG. 5 and theclosed depth stop 65 described above with referenceFIG. 18 . The depths stop engages a depth stop of thedriver 450 such that a distal end of the driver extends beyond the distal end of the body. In still other examples of thescrew 400, theproximal end 410 of thebody 405 aligns with a hash mark on a distal end of the driver and a number associated with the hash mark identifies the length of thebody 405 of thescrew 400. - In an example procedure to install the
screw 400 intobone 401, the surgeon may remove thedriver 450 from thebody 405 of thescrew 400 that has been partly inserted intobone 401. The surgeon reinserts thedriver 450 into thebody 405 of thescrew 400 and engages the controllingmember 440. The surgeon confirms the orientation of thedriver 450 based on the engagement of the controllingmember 440 with thedriver 450. Engaging the controllingmember 440 tells the surgeon that thedriver 450 is in the driving orientation. The lack of engagement tells the surgeon that thedriver 450 is in an orientation different than the driving orientation. In the event thedriver 450 does not engage the controlling member 440 (e.g., the surgeon turnsdriver 450 but thescrew 400 does not turn), the surgeon rotates thedriver 450 within the throughbore 430 until thedriver 450 engages the controlling member 440 (e.g., the surgeon turns driver and the screw turns). - In the example procedure, each time the surgeon removes and reinserts the
driver 450 into the screw, the surgeon controls and confirms the orientation of thedriver 450 using the controllingmember 440. This is advantageous because the surgeon may have to remove and reinsert thedriver 450 several times during the procedure in order to install thescrew 400 intobone 401, completely. - Some examples of the
screw 400 may be a part of an screwing system that includes the above-describeddriver 450. In an example system, thescrew 400 maybe “preloaded” and disposed on at a distal end of thedriver 450. - As various modifications could be made to the exemplary embodiments, as described above with reference to the corresponding illustrations, without departing from the scope of the disclosure, it is intended that all matter contained in the foregoing description and shown in the accompanying drawings shall be interpreted as illustrative rather than limiting. Thus, the breadth and scope of the present disclosure should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims appended hereto and their equivalents.
Claims (15)
1. An interference screw comprising:
a body having a proximal end, a distal end, and a longitudinal axis extending between the proximal end and distal end;
threads extending in an open helical form between the proximal end and distal end of the body;
a through bore defined by the body extending between the proximal end and distal end of the body along the longitudinal axis, the through bore having a surface; and
a controlling member formed by the surface of the through bore, the controlling member configured to be engaged by a driver when the driver is in a driving orientation with respect to the controlling member and configured to not be engaged by the driver when the driver is in an orientation different than the driving orientation.
2. The interference screw of claim 1 wherein the controlling member includes a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced equally around the circumference of the through bore, and one of the plurality of runners is of different shape and/or size than other runners.
3. The interference screw of claim 2 wherein the one runner has a cross sectional shape based on a rectangle and the other runners have a cross sectional shape based on a semi-circle.
4. The interference screw of claim 1 wherein the controlling member includes a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced unequally around the circumference of the through bore.
5. The interference screw of claim 4 wherein one of the plurality of runners has a cross sectional shape based on a rectangle and other runners have a cross sectional shape based on a semi-circle.
6. The interference screw of claim 1 wherein the controlling member includes:
a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced equally around the circumference of the through bore; and
a tab spaced between an adjacent pair of runners.
7. The interference screw of claim 1 wherein the controlling member includes:
a plurality of runners extending between the proximal end and distal end of the body along the longitudinal axis, the plurality of runners spaced unequally around the circumference of the through bore; and
a tab spaced between an adjacent pair of runners.
8. The interference screw of claim 1 wherein the body is made from a bioabsorbable, non-bioabsorbable, osteoconductive or composite material.
9. The interference screw of claim 8 wherein the non-bioabsorbable material includes polyether ether ketone (PEEK), titanium, and surgical stainless steel.
10. The interference screw of claim 1 further comprising an ingrowth core received within the through bore.
11. The interference screw of claim 10 wherein the ingrowth core is doped with bone growth factors so as to enhance bone ingrowth.
12. The interference screw of claim 1 further comprising a depth stop extending, longitudinally, a partial length of the body, the depth stop engages a depth stop of the driver such that a distal end of the driver extends beyond the distal end of the body.
13. The interference screw of claim 12 wherein the depth stop is an open depth stop encircling part of the distal end of the body.
14. The interference screw of claim 12 wherein the depth stop is a closed depth stop encircling the distal end of the body.
15. The interference screw of claim 1 wherein the proximal end of the body aligns with a hash mark on a distal end of the driver and a number associated with the hash mark identifies the length of the body of the interference screw.
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US15/284,689 US20170020589A1 (en) | 2010-03-10 | 2016-10-04 | Anchor having a controlled driver orientation |
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US35908010P | 2010-06-28 | 2010-06-28 | |
US13/044,777 US8979865B2 (en) | 2010-03-10 | 2011-03-10 | Composite interference screws and drivers |
US14/085,295 US9579188B2 (en) | 2010-03-10 | 2013-11-20 | Anchor having a controlled driver orientation |
US15/284,689 US20170020589A1 (en) | 2010-03-10 | 2016-10-04 | Anchor having a controlled driver orientation |
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US15/284,689 Abandoned US20170020589A1 (en) | 2010-03-10 | 2016-10-04 | Anchor having a controlled driver orientation |
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Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20160120534A1 (en) * | 2013-03-15 | 2016-05-05 | Smith & Nephew, Inc. | Miniaturized dual drive open architecture suture anchor |
US9775702B2 (en) | 2010-03-10 | 2017-10-03 | Smith & Nephew, Inc. | Composite interference screws and drivers |
US9808337B2 (en) | 2010-03-10 | 2017-11-07 | Smith & Nephew, Inc. | Composite interference screws and drivers |
US9808298B2 (en) | 2013-04-09 | 2017-11-07 | Smith & Nephew, Inc. | Open-architecture interference screw |
US9901355B2 (en) | 2011-03-11 | 2018-02-27 | Smith & Nephew, Inc. | Trephine |
US9924934B2 (en) | 2011-06-07 | 2018-03-27 | Smith & Nephew, Inc. | Surgical anchor delivery system |
USD868967S1 (en) * | 2017-10-13 | 2019-12-03 | Karl Storz Se & Co. Kg | Interference screw |
Families Citing this family (6)
Publication number | Priority date | Publication date | Assignee | Title |
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US10582925B2 (en) * | 2017-02-06 | 2020-03-10 | Medos International Sarl | Devices, systems, and methods for knotless suture anchors |
FR3063005B1 (en) * | 2017-02-22 | 2021-11-12 | Novastep | SCREW FOR OSTEOSYNTHESIS WITH ANGULAR INDEX TO THE SCREWDRIVER |
WO2018209177A1 (en) * | 2017-05-12 | 2018-11-15 | Cutting Edge Spine Llc | Implants for tissue fixation and fusion |
US11376050B2 (en) | 2017-06-27 | 2022-07-05 | Medos International Sarl | Bone screw |
US10772667B2 (en) * | 2017-12-22 | 2020-09-15 | Medos International Sarl | Bone screw with cutting tip |
US11141262B2 (en) * | 2018-12-21 | 2021-10-12 | Industrial Technology Research Institute | Bone implant |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
USRE33114E (en) * | 1983-03-17 | 1989-11-21 | Tamper-proof threaded fastenings | |
US20080154314A1 (en) * | 2006-08-16 | 2008-06-26 | Mcdevitt Dennis M | Composite interference screw for attaching a graft ligament to a bone, and other apparatus for making attachments to bone |
US20090187216A1 (en) * | 2006-05-18 | 2009-07-23 | Arthrex, Inc. | Fenestrated swivel anchor for knotless fixation of tissue |
US20160081727A1 (en) * | 2014-09-19 | 2016-03-24 | Agent Medical, Llc | Intramedullary compression screw system |
Family Cites Families (210)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2288864A (en) * | 1940-12-03 | 1942-07-07 | Whitehead Walter John | Means for holding parts together |
US3499222A (en) | 1965-08-17 | 1970-03-10 | Leonard I Linkow | Intra-osseous pins and posts and their use and techniques thereof |
US3320783A (en) * | 1966-12-09 | 1967-05-23 | Chicago Lock Co | Key for an axial tumbler type lock |
US3716058A (en) | 1970-07-17 | 1973-02-13 | Atlanta Res Inst | Barbed suture |
US3821975A (en) * | 1972-11-16 | 1974-07-02 | L Haker | Automotive wheel lock means |
US3874258A (en) * | 1973-05-21 | 1975-04-01 | Stallion Enterprises Inc | Keyed attachment device for vehicle wheels |
US3869942A (en) | 1974-02-04 | 1975-03-11 | Textron Inc | Driving tool |
US4027572A (en) * | 1974-05-13 | 1977-06-07 | Burge William G | Theft-prevention screw fastenings |
US4177797A (en) | 1977-03-04 | 1979-12-11 | Shelby M. Baylis | Rotary biopsy device and method of using same |
USD288777S (en) * | 1983-11-22 | 1987-03-17 | Kwon Kee J | Vehicle wheel locking nut |
CA1227902A (en) | 1984-04-02 | 1987-10-13 | Raymond G. Tronzo | Fenestrated hip screw and method of augmented internal fixation |
US4854311A (en) | 1986-01-09 | 1989-08-08 | Acro Med Corporation | Bone screw |
US4738255A (en) | 1986-04-07 | 1988-04-19 | Biotron Labs, Inc. | Suture anchor system |
US4741651A (en) | 1986-04-25 | 1988-05-03 | Despres Roger J | Hole saw |
US4913143A (en) | 1986-05-28 | 1990-04-03 | The United States Of America As Represented By The Secretary Of The Air Force | Trephine assembly |
CH672058A5 (en) | 1986-08-05 | 1989-10-31 | Synthes Ag | |
US4834757A (en) | 1987-01-22 | 1989-05-30 | Brantigan John W | Prosthetic implant |
US5593409A (en) | 1988-06-13 | 1997-01-14 | Sofamor Danek Group, Inc. | Interbody spinal fusion implants |
US5609635A (en) | 1988-06-28 | 1997-03-11 | Michelson; Gary K. | Lordotic interbody spinal fusion implants |
US4961740B1 (en) | 1988-10-17 | 1997-01-14 | Surgical Dynamics Inc | V-thread fusion cage and method of fusing a bone joint |
US4988351A (en) | 1989-01-06 | 1991-01-29 | Concept, Inc. | Washer for use with cancellous screw for attaching soft tissue to bone |
US5129906A (en) | 1989-09-08 | 1992-07-14 | Linvatec Corporation | Bioabsorbable tack for joining bodily tissue and in vivo method and apparatus for deploying same |
US5055104A (en) | 1989-11-06 | 1991-10-08 | Surgical Dynamics, Inc. | Surgically implanting threaded fusion cages between adjacent low-back vertebrae by an anterior approach |
US5139520A (en) | 1990-01-31 | 1992-08-18 | American Cyanamid Company | Method for acl reconstruction |
US5258016A (en) | 1990-07-13 | 1993-11-02 | American Cyanamid Company | Suture anchor and driver assembly |
DK0547134T3 (en) | 1990-09-04 | 1997-12-22 | Smith & Nephew Inc | Surgical screw |
CA2062012C (en) | 1991-03-05 | 2003-04-29 | Randall D. Ross | Bioabsorbable interference bone fixation screw |
US5197967A (en) | 1991-04-02 | 1993-03-30 | Synthes (U.S.A.) | Trephine instrument and method for cutting annular holes |
US5116337A (en) | 1991-06-27 | 1992-05-26 | Johnson Lanny L | Fixation screw and method for ligament reconstruction |
US5236431A (en) | 1991-07-22 | 1993-08-17 | Synthes | Resorbable fixation device with controlled stiffness for treating bodily material in vivo and introducer therefor |
DE4135310A1 (en) | 1991-10-25 | 1993-04-29 | Habermeyer Peter | CEMENT-FREE ENDOPROTHESIS |
US5242447A (en) | 1992-02-06 | 1993-09-07 | Howmedica Inc. | Pin with tapered root diameter |
ATE172091T1 (en) | 1992-02-14 | 1998-10-15 | Smith & Nephew Inc | POLYMERIC SCREWS AND COATINGS FOR SURGICAL USE |
US5407427A (en) | 1992-06-16 | 1995-04-18 | Loma Linda University Medical Center | Trocar facilitator for endoscopic surgery |
US5447533A (en) | 1992-09-03 | 1995-09-05 | Pacesetter, Inc. | Implantable stimulation lead having an advanceable therapeutic drug delivery system |
US5354299A (en) | 1992-12-07 | 1994-10-11 | Linvatec Corporation | Method of revising a screw in a tunnel |
US5814073A (en) | 1996-12-13 | 1998-09-29 | Bonutti; Peter M. | Method and apparatus for positioning a suture anchor |
US5423823A (en) | 1993-02-18 | 1995-06-13 | Arthrex Inc. | Coring reamer |
US5370662A (en) | 1993-06-23 | 1994-12-06 | Kevin R. Stone | Suture anchor assembly |
AU7404994A (en) | 1993-07-30 | 1995-02-28 | Regents Of The University Of California, The | Endocardial infusion catheter |
US5921982A (en) | 1993-07-30 | 1999-07-13 | Lesh; Michael D. | Systems and methods for ablating body tissue |
US5456685A (en) | 1994-02-14 | 1995-10-10 | Smith & Nephew Dyonics, Inc. | Interference screw having a tapered back root |
AU689846B2 (en) | 1994-03-29 | 1998-04-09 | Zimmer Gmbh | Screw made of biodegradable material for bone surgery purposes, and screwdriver suitable therefor |
US5411523A (en) | 1994-04-11 | 1995-05-02 | Mitek Surgical Products, Inc. | Suture anchor and driver combination |
US5411506A (en) | 1994-04-11 | 1995-05-02 | Mitek Surgical Products, Inc. | Anchor driver |
EP0682917B1 (en) | 1994-04-22 | 1998-08-12 | Institut Straumann Ag | Screwdriver for a screw consisting of a bolt and a nut adapted to be screwed thereon |
US5573548A (en) | 1994-06-09 | 1996-11-12 | Zimmer, Inc. | Suture anchor |
US6604945B1 (en) | 1994-08-15 | 2003-08-12 | Shedrick D. Jones | Method and apparatus for implantation |
US5676545A (en) | 1994-08-15 | 1997-10-14 | Jones; Shedrick D. | Method and apparatus for implantation |
DE69526094T2 (en) | 1994-09-15 | 2002-11-21 | Surgical Dynamics Inc | CONICAL FUSION CAGE |
US5464427A (en) | 1994-10-04 | 1995-11-07 | Synthes (U.S.A.) | Expanding suture anchor |
FR2726171B1 (en) | 1994-10-28 | 1997-01-24 | Jbs Sa | REHABITABLE CONNECTING SCREW DEVICE FOR BONE JOINT, IN PARTICULAR FOR STABILIZING AT LEAST TWO VERTEBRES |
AR000417A1 (en) | 1994-12-23 | 1997-06-18 | Inst Straumann A G | An improved implant for oral-dental application |
US6235057B1 (en) | 1995-01-24 | 2001-05-22 | Smith & Nephew, Inc. | Method for soft tissue reconstruction |
US5632747A (en) | 1995-03-15 | 1997-05-27 | Osteotech, Inc. | Bone dowel cutter |
US5782919A (en) | 1995-03-27 | 1998-07-21 | Sdgi Holdings, Inc. | Interbody fusion device and method for restoration of normal spinal anatomy |
US5626613A (en) | 1995-05-04 | 1997-05-06 | Arthrex, Inc. | Corkscrew suture anchor and driver |
US5571139A (en) | 1995-05-19 | 1996-11-05 | Jenkins, Jr.; Joseph R. | Bidirectional suture anchor |
US6039762A (en) | 1995-06-07 | 2000-03-21 | Sdgi Holdings, Inc. | Reinforced bone graft substitutes |
US5662683A (en) | 1995-08-22 | 1997-09-02 | Ortho Helix Limited | Open helical organic tissue anchor and method of facilitating healing |
KR100415064B1 (en) | 1995-10-20 | 2005-04-06 | 신테스 아게 츄어 | Intervertebral implant |
US5709683A (en) | 1995-12-19 | 1998-01-20 | Spine-Tech, Inc. | Interbody bone implant having conjoining stabilization features for bony fusion |
US5702397A (en) | 1996-02-20 | 1997-12-30 | Medicinelodge, Inc. | Ligament bone anchor and method for its use |
US5681352A (en) | 1996-03-06 | 1997-10-28 | Kinetikos Medical Incorporated | Method and apparatus for anchoring surgical ties to bone |
CA2199462C (en) | 1996-03-14 | 2006-01-03 | Charles J. Winslow | Method and instrumentation for implant insertion |
US5868749A (en) | 1996-04-05 | 1999-02-09 | Reed; Thomas M. | Fixation devices |
DE19628473C1 (en) | 1996-07-15 | 1998-04-23 | Aesculap Ag & Co Kg | Implant to fuse vertebrae |
US6117162A (en) | 1996-08-05 | 2000-09-12 | Arthrex, Inc. | Corkscrew suture anchor |
US6569188B2 (en) | 1996-08-05 | 2003-05-27 | Arthrex, Inc. | Hex drive bioabsorbable tissue anchor |
ES2225915T3 (en) | 1996-08-26 | 2005-03-16 | Shedrick D. Jones | DEVICE FOR FIXING AN IMPLANT IN OSEO FABRIC. |
US5968098A (en) | 1996-10-22 | 1999-10-19 | Surgical Dynamics, Inc. | Apparatus for fusing adjacent bone structures |
US7083647B1 (en) | 1996-11-27 | 2006-08-01 | Sklar Joseph H | Fixation screw, graft ligament anchor assembly, and method for securing a graft ligament in a bone tunnel |
FI111802B (en) | 1996-12-19 | 2003-09-30 | Biocon Oy | Suture anchors |
FR2760355B1 (en) | 1997-03-07 | 2000-02-25 | Serge Schrayer | INTERSOMATIC CAGE FORMING DEVICE WITH INTERNAL PROVISIONAL SOLIDARIZATION OF A TIGHTENING TOOL |
KR100553297B1 (en) | 1997-04-25 | 2006-02-20 | 스뜨리케르 프랑스 | Two-Part Intersomatic Implant |
US5802794A (en) | 1997-05-05 | 1998-09-08 | Jayne Industries Inc. | Ceramic fiber securing device |
US5876405A (en) | 1997-09-17 | 1999-03-02 | The Anspach Effort, Inc. | Perforator |
US5891146A (en) | 1997-10-15 | 1999-04-06 | Applied Biological Concepts, Inc. | Wedge orthopedic screw |
US5964783A (en) | 1997-11-07 | 1999-10-12 | Arthrex, Inc. | Suture anchor with insert-molded suture |
US6097986A (en) | 1997-12-17 | 2000-08-01 | Cardiac Pacemakers, Inc. | Retractable lead with mesh screen |
JP3930960B2 (en) | 1998-01-26 | 2007-06-13 | 若井産業株式会社 | Threaded anchor |
US5961524A (en) | 1998-03-11 | 1999-10-05 | Stryker Technologies Corporation | Screw and method of attachment to a substrate |
US6008433A (en) | 1998-04-23 | 1999-12-28 | Stone; Kevin R. | Osteotomy wedge device, kit and methods for realignment of a varus angulated knee |
US6086593A (en) | 1998-06-30 | 2000-07-11 | Bonutti; Peter M. | Method and apparatus for use in operating on a bone |
US6648903B1 (en) | 1998-09-08 | 2003-11-18 | Pierson, Iii Raymond H. | Medical tensioning system |
US6302632B1 (en) * | 1998-11-17 | 2001-10-16 | Chao-Wei Lin | Screw with compound recesses |
US6283973B1 (en) | 1998-12-30 | 2001-09-04 | Depuy Orthopaedics, Inc. | Strength fixation device |
US8343186B2 (en) | 2004-04-06 | 2013-01-01 | Arthrex, Inc. | Fully threaded suture anchor with transverse anchor pin |
US7226469B2 (en) | 1999-02-02 | 2007-06-05 | Arthrex, Inc. | Insert molded suture anchor |
US6096060A (en) | 1999-05-20 | 2000-08-01 | Linvatec Corporation | Bioabsorbable threaded soft tissue anchor system |
US6517542B1 (en) | 1999-08-04 | 2003-02-11 | The Cleveland Clinic Foundation | Bone anchoring system |
US7033372B1 (en) | 1999-08-04 | 2006-04-25 | Percardia, Inc. | Corkscrew reinforced left ventricle to coronary artery channel |
US20040122424A1 (en) | 2000-01-15 | 2004-06-24 | Ferree Bret A. | Enhanced surface area spinal fusion devices and alignment apparatus therefor |
EP1093774B1 (en) | 1999-10-21 | 2002-06-19 | Karl Storz GmbH & Co. KG | Interference screw |
DE59900298D1 (en) | 1999-10-21 | 2001-11-08 | Storz Karl Gmbh & Co Kg | Biodegradable fixation body |
AU1233301A (en) | 1999-10-26 | 2001-05-08 | H. Randall Craig | Helical suture instrument |
EP1101459B1 (en) | 1999-11-15 | 2006-02-22 | Arthrex, Inc. | Tapered bioabsorbable interference screw for endosteal fixation of ligaments |
US6360129B1 (en) | 1999-12-13 | 2002-03-19 | Cardiac Pacemakers, Inc. | Mannitol/hydrogel cap for tissue-insertable connections |
FR2803739B1 (en) | 2000-01-13 | 2002-02-15 | Denis Bertin | THREADED IMPLANT FOR MEDICAL USE |
US6554830B1 (en) | 2000-04-10 | 2003-04-29 | Sdgi Holdings, Inc. | Fenestrated surgical anchor and method |
US6610067B2 (en) | 2000-05-01 | 2003-08-26 | Arthrosurface, Incorporated | System and method for joint resurface repair |
US6823871B2 (en) | 2000-06-01 | 2004-11-30 | Arthrex, Inc. | Allograft bone or synthetic wedges for osteotomy |
US6447545B1 (en) | 2000-07-01 | 2002-09-10 | George W. Bagby | Self-aligning bone implant |
US9387094B2 (en) | 2000-07-19 | 2016-07-12 | Warsaw Orthopedic, Inc. | Osteoimplant and method of making same |
US6923824B2 (en) | 2000-09-12 | 2005-08-02 | Axya Medical, Inc. | Apparatus and method for securing suture to bone |
US6953462B2 (en) | 2000-10-05 | 2005-10-11 | The Cleveland Clinic Foundation | Apparatus for implantation into bone |
US20040073216A1 (en) | 2000-10-05 | 2004-04-15 | The Cleveland Clinic Foundation | Apparatus and method for attaching adjacent bones |
US6551322B1 (en) | 2000-10-05 | 2003-04-22 | The Cleveland Clinic Foundation | Apparatus for implantation into bone |
US6551320B2 (en) | 2000-11-08 | 2003-04-22 | The Cleveland Clinic Foundation | Method and apparatus for correcting spinal deformity |
US6488683B2 (en) | 2000-11-08 | 2002-12-03 | Cleveland Clinic Foundation | Method and apparatus for correcting spinal deformity |
US6551319B2 (en) | 2000-11-08 | 2003-04-22 | The Cleveland Clinic Foundation | Apparatus for implantation into bone |
US6544265B2 (en) | 2000-11-08 | 2003-04-08 | The Cleveland Clinic Foundation | Apparatus for implantation into bone related applications |
US6527774B2 (en) | 2000-11-08 | 2003-03-04 | The Cleveland Clinic Foundation | Apparatus for attaching fractured sections of bone |
FR2816824B1 (en) | 2000-11-23 | 2003-05-23 | Michel Kurc | BONE RECOVERY BIT AND DRILLING DEVICE COMPRISING SUCH A BIT |
US6443989B1 (en) | 2000-12-04 | 2002-09-03 | Roger P. Jackson | Posterior expandable fusion cage |
US6451023B1 (en) | 2001-01-25 | 2002-09-17 | Linvatec Corporation | Guide bushing for coring reamer, storage package for reamer assembly, and method of use |
US7083638B2 (en) | 2001-02-12 | 2006-08-01 | Arthrocare Corporation | Method and apparatus for attaching connective tissues to bone using a knotless suture anchoring device |
US6663656B2 (en) | 2001-02-26 | 2003-12-16 | Arthrex, Inc. | Torque driver for interference screw |
US6511481B2 (en) | 2001-03-30 | 2003-01-28 | Triage Medical, Inc. | Method and apparatus for fixation of proximal femoral fractures |
US6620195B2 (en) | 2001-04-18 | 2003-09-16 | Medicinelodge, Inc. | Apparatus and method for attaching a graft ligament to a bone |
US20050234458A1 (en) | 2004-04-19 | 2005-10-20 | Huebner Randall J | Expanded stabilization of bones |
US7235079B2 (en) | 2004-11-18 | 2007-06-26 | Acumed Llc | Composite bone fasteners |
ITBO20010263A1 (en) | 2001-05-02 | 2002-11-02 | Citieffe Srl | DEVICE FOR ANCHORING AN ELEMENT TENSILE AND FLEXIBLE ELEMENT FOR THE RECONSTRUCTION OF A TEARED LIGAMENT |
US7018412B2 (en) | 2001-08-20 | 2006-03-28 | Ebi, L.P. | Allograft spinal implant |
US20030055431A1 (en) | 2001-09-19 | 2003-03-20 | James Kevin Brannon | Bone cutting assembly |
US20030065374A1 (en) | 2001-10-01 | 2003-04-03 | Medtronic, Inc. | Active fixation lead with helix extension indicator |
US6652563B2 (en) | 2001-10-02 | 2003-11-25 | Arthrex, Inc. | Suture anchor with internal suture loop |
US6656183B2 (en) | 2001-11-08 | 2003-12-02 | Smith & Nephew, Inc. | Tissue repair system |
US20030125749A1 (en) | 2001-12-27 | 2003-07-03 | Ethicon, Inc. | Cannulated screw and associated driver system |
US6685728B2 (en) | 2002-01-25 | 2004-02-03 | Stryker Endoscopy | Threaded suture anchor and method of use |
JP3890589B2 (en) | 2002-04-15 | 2007-03-07 | ニプロ株式会社 | Intracardiac suture device |
JP4319980B2 (en) | 2002-06-11 | 2009-08-26 | タイコ ヘルスケア グループ エルピー | Hernia mesh tack |
WO2003105673A2 (en) | 2002-06-17 | 2003-12-24 | Trimedyne, Inc. | Devices and methods for minimally invasive treatment of degenerated spinal discs |
US7442202B2 (en) | 2002-08-26 | 2008-10-28 | Arthrex, Inc. | Suture anchor attached to tissue-fixation disk without top knot |
FR2846867B1 (en) | 2002-11-08 | 2005-09-09 | Textile Hi Tec | ANCHOR INSERTED INTO A BONE CAVITY AND TOOL FOR INSERTING SUCH ANCHOR |
US7090690B2 (en) | 2002-11-19 | 2006-08-15 | Arthrocare Corporation | Devices and methods for repairing soft tissue |
FR2847456B1 (en) | 2002-11-21 | 2005-01-28 | Michel Collette | SCREWS FOR FIXING A LIGAMENT GRAFT |
US6887194B2 (en) | 2003-01-17 | 2005-05-03 | Applied Medical Resources Corporation | Surgical access apparatus and method |
US7070586B2 (en) | 2003-01-17 | 2006-07-04 | Applied Medical Resources Corporation | Surgical access apparatus and method |
US7141051B2 (en) | 2003-02-05 | 2006-11-28 | Pioneer Laboratories, Inc. | Low profile spinal fixation system |
US9314235B2 (en) | 2003-02-05 | 2016-04-19 | Smith & Nephew, Inc. | Tissue anchor and insertion tool |
DK1628702T3 (en) | 2003-04-28 | 2013-08-05 | Winter Erwin De | ANCHORAGE SCREW INTERIOR |
US7608097B2 (en) | 2003-04-29 | 2009-10-27 | Millennium Medical Technologies | Bone screw with fluid delivery structure |
IL156033A0 (en) | 2003-05-21 | 2004-03-28 | Ophir Fromovich Ophir Fromovic | Dental implant |
EP1635723B1 (en) | 2003-06-13 | 2011-08-10 | Tyco Healthcare Group LP | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US20050203513A1 (en) | 2003-09-24 | 2005-09-15 | Tae-Ahn Jahng | Spinal stabilization device |
US8016865B2 (en) | 2003-09-29 | 2011-09-13 | Depuy Mitek, Inc. | Method of performing anterior cruciate ligament reconstruction using biodegradable interference screw |
US7217279B2 (en) | 2003-11-14 | 2007-05-15 | Ethicon, Inc. | Suture loop anchor |
US20090042951A1 (en) | 2004-02-20 | 2009-02-12 | Robert Danziger | Blood Pressure Reduction in Salt-Sensitive Hypertension |
US20050250988A1 (en) | 2004-05-07 | 2005-11-10 | Usgi Medical Inc. | Removable apparatus for manipulating and securing tissue within a treatment space |
US20050250987A1 (en) | 2004-05-07 | 2005-11-10 | Usgi Medical Inc. | Removable apparatus and methods for manipulating and securing tissue |
US20050250985A1 (en) | 2004-05-07 | 2005-11-10 | Usgi Medical Inc. | Self-locking removable apparatus and methods for manipulating and securing tissue |
US7322978B2 (en) | 2004-06-22 | 2008-01-29 | Hs West Investments, Llc | Bone anchors for use in attaching soft tissue to a bone |
WO2006015302A1 (en) | 2004-07-29 | 2006-02-09 | X-Sten, Corp. | Spinal ligament modification devices |
US20060058788A1 (en) | 2004-08-27 | 2006-03-16 | Hammer Michael A | Multi-axial connection system |
US20060079895A1 (en) | 2004-09-30 | 2006-04-13 | Mcleer Thomas J | Methods and devices for improved bonding of devices to bone |
US7909851B2 (en) | 2006-02-03 | 2011-03-22 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US7857830B2 (en) | 2006-02-03 | 2010-12-28 | Biomet Sports Medicine, Llc | Soft tissue repair and conduit device |
US7658751B2 (en) | 2006-09-29 | 2010-02-09 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US7905904B2 (en) | 2006-02-03 | 2011-03-15 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US7905903B2 (en) | 2006-02-03 | 2011-03-15 | Biomet Sports Medicine, Llc | Method for tissue fixation |
US7749250B2 (en) | 2006-02-03 | 2010-07-06 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US7914539B2 (en) | 2004-11-09 | 2011-03-29 | Biomet Sports Medicine, Llc | Tissue fixation device |
US8034090B2 (en) | 2004-11-09 | 2011-10-11 | Biomet Sports Medicine, Llc | Tissue fixation device |
US7608098B1 (en) | 2004-11-09 | 2009-10-27 | Biomet Sports Medicine, Llc | Bone fixation device |
AU2005306603B2 (en) | 2004-11-15 | 2011-12-01 | Covidien Lp | Method and apparatus for the repair of a rotator cuff (RTC) tendon or ligament |
US20060149266A1 (en) | 2004-12-10 | 2006-07-06 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Anchor for screw fixation of soft tissue to bone |
FR2879915B1 (en) | 2004-12-24 | 2008-02-15 | Advanced Biomaterials Soc Par | INTERFERENCE SCREW AND ADJUSTABLE SCREWDRIVER |
JP2008529607A (en) | 2005-02-08 | 2008-08-07 | アイバランス・メディカル・インコーポレーテッド | Method and apparatus for forming a wedge-shaped opening in a bone for wedge osteotomy |
AU2006223357A1 (en) | 2005-03-10 | 2006-09-21 | Tyco Healthcare Group Lp | Suture anchors |
CN1701775A (en) | 2005-06-15 | 2005-11-30 | 林志春 | Flexible contraception device and setting and taking-out device |
US8252006B2 (en) | 2005-08-05 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Single pass gastric restriction with a corkscrew style wall anchor |
DE602006020094D1 (en) | 2005-09-12 | 2011-03-31 | Arthrex Inc | Ösennahtanker |
US20070122764A1 (en) | 2005-11-28 | 2007-05-31 | Ace Surgical Supply Co., Inc. | Orthodontic bone screw |
US20070142849A1 (en) | 2005-12-16 | 2007-06-21 | Usgi Medical, Inc. | Helical tissue manipulation instruments and methods of use |
US8251998B2 (en) | 2006-08-16 | 2012-08-28 | Biomet Sports Medicine, Llc | Chondral defect repair |
US20090228012A1 (en) | 2006-02-16 | 2009-09-10 | Universite Libre De Bruxelles | Surgical boring tool set |
US8118312B2 (en) | 2006-06-14 | 2012-02-21 | American Torch Tip Co. | Quick change centering tool holder |
US8894661B2 (en) | 2007-08-16 | 2014-11-25 | Smith & Nephew, Inc. | Helicoil interference fixation system for attaching a graft ligament to a bone |
US8167906B2 (en) | 2006-11-01 | 2012-05-01 | Depuy Mitek, Inc. | Suture anchor with pulley |
US20110319933A1 (en) | 2007-04-21 | 2011-12-29 | Slobodan Tepic | Suture bone anchor |
US8845685B2 (en) | 2007-05-03 | 2014-09-30 | Biomet Sports Medicine, Llc | Anchor assembly and method of use |
US20090024174A1 (en) | 2007-07-17 | 2009-01-22 | Stark John G | Bone screws and particular applications to sacroiliac joint fusion |
US8882801B2 (en) | 2007-09-14 | 2014-11-11 | Depuy Mitek, Llc | Dual thread cannulated suture anchor |
US8388654B2 (en) | 2007-09-26 | 2013-03-05 | Redyns Medical Llc | Method and apparatus for attaching soft tissue to bone |
US8814935B2 (en) | 2008-03-31 | 2014-08-26 | The Lonnie and Shannon Paulos Trust | Interference screw driver assembly and method of use |
EP2656797A3 (en) | 2008-07-17 | 2014-02-12 | Smith & Nephew, Inc. | Anchor |
CA2733783A1 (en) | 2008-08-15 | 2010-02-18 | Kinetic Spine Technologies Inc. | Dynamic pedicle screw |
US8262675B2 (en) | 2008-10-29 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Methods and devices for applying multiple suture anchors |
CN201436022U (en) | 2009-04-20 | 2010-04-07 | 李光磊 | Directional wire extending device |
US8672967B2 (en) | 2009-10-30 | 2014-03-18 | Depuy Mitek, Llc | Partial thickness rotator cuff repair system and method |
US9936939B2 (en) | 2009-11-10 | 2018-04-10 | Smith & Nephew, Inc. | Tissue repair devices |
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CN102068305B (en) | 2009-11-20 | 2016-01-20 | 上海微创骨科医疗科技有限公司 | Bone screw |
US9308080B2 (en) | 2010-03-10 | 2016-04-12 | Smith & Nephew Inc. | Composite interference screws and drivers |
US8979865B2 (en) | 2010-03-10 | 2015-03-17 | Smith & Nephew, Inc. | Composite interference screws and drivers |
AU2011256194A1 (en) | 2010-05-19 | 2013-01-10 | Depuy Spine, Inc. | Bone anchors |
US8469998B2 (en) | 2010-08-30 | 2013-06-25 | Depuy Mitek, Llc | Knotless suture anchor |
US8460340B2 (en) | 2010-08-30 | 2013-06-11 | Depuy Mitek, Llc | Knotless suture anchor |
US8821543B2 (en) | 2010-12-23 | 2014-09-02 | Depuy Mitek, Llc | Adjustable anchor systems and methods |
WO2012171011A1 (en) | 2011-06-09 | 2012-12-13 | Zyga Technology, Inc. | Bone screw |
EP2596758A1 (en) | 2011-11-24 | 2013-05-29 | Sysorb GmbH | Bone screw |
US9615821B2 (en) | 2011-12-09 | 2017-04-11 | Arthrex, Inc. | Tensionable knotless anchor systems and methods of tissue repair |
US9408613B2 (en) | 2011-12-13 | 2016-08-09 | Biomet Manufacturing, Llc | Glenoid reamer |
US9788844B2 (en) | 2011-12-16 | 2017-10-17 | Medos International Sarl | Methods and systems for attaching tissue to bone |
US20130158610A1 (en) | 2011-12-16 | 2013-06-20 | Depuy Mitek, Inc. | Bone graft fixation systems and methods |
US9138220B2 (en) | 2011-12-19 | 2015-09-22 | Medos International Sarl | Knotless suture anchor |
US9439644B2 (en) | 2011-12-20 | 2016-09-13 | Medos International Sàrl | Systems and methods for repairing tissue |
US9265494B2 (en) | 2011-12-20 | 2016-02-23 | Medos International Sarl | Knotless instability anchor |
US9155531B2 (en) | 2013-03-15 | 2015-10-13 | Smith & Nephew, Inc. | Miniaturized dual drive open architecture suture anchor |
-
2013
- 2013-11-20 US US14/085,295 patent/US9579188B2/en active Active
-
2016
- 2016-10-04 US US15/284,689 patent/US20170020589A1/en not_active Abandoned
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
USRE33114E (en) * | 1983-03-17 | 1989-11-21 | Tamper-proof threaded fastenings | |
US20090187216A1 (en) * | 2006-05-18 | 2009-07-23 | Arthrex, Inc. | Fenestrated swivel anchor for knotless fixation of tissue |
US20080154314A1 (en) * | 2006-08-16 | 2008-06-26 | Mcdevitt Dennis M | Composite interference screw for attaching a graft ligament to a bone, and other apparatus for making attachments to bone |
US20160081727A1 (en) * | 2014-09-19 | 2016-03-24 | Agent Medical, Llc | Intramedullary compression screw system |
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US20160120534A1 (en) * | 2013-03-15 | 2016-05-05 | Smith & Nephew, Inc. | Miniaturized dual drive open architecture suture anchor |
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US9579188B2 (en) | 2017-02-28 |
US20140081339A1 (en) | 2014-03-20 |
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