WO2001034036A1 - Toggle anchor and tool for insertion thereof - Google Patents
Toggle anchor and tool for insertion thereof Download PDFInfo
- Publication number
- WO2001034036A1 WO2001034036A1 PCT/US2000/030745 US0030745W WO0134036A1 WO 2001034036 A1 WO2001034036 A1 WO 2001034036A1 US 0030745 W US0030745 W US 0030745W WO 0134036 A1 WO0134036 A1 WO 0134036A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- anchor
- anchor member
- insertion tool
- site
- longitudinal axis
- Prior art date
Links
- 238000003780 insertion Methods 0.000 title claims abstract description 66
- 230000037431 insertion Effects 0.000 title claims abstract description 66
- 238000000034 method Methods 0.000 claims abstract description 39
- 230000033001 locomotion Effects 0.000 claims abstract description 35
- 230000003247 decreasing effect Effects 0.000 claims description 5
- 230000001154 acute effect Effects 0.000 claims 6
- 210000000988 bone and bone Anatomy 0.000 description 29
- 210000001519 tissue Anatomy 0.000 description 7
- 230000008901 benefit Effects 0.000 description 4
- 210000003041 ligament Anatomy 0.000 description 4
- 230000008439 repair process Effects 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 3
- 208000014674 injury Diseases 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 210000000513 rotator cuff Anatomy 0.000 description 2
- 210000004872 soft tissue Anatomy 0.000 description 2
- 230000008733 trauma Effects 0.000 description 2
- 206010061223 Ligament injury Diseases 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 239000012620 biological material Substances 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
- 230000007812 deficiency Effects 0.000 description 1
- 230000000881 depressing effect Effects 0.000 description 1
- 230000002708 enhancing effect Effects 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 210000003734 kidney Anatomy 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 230000000750 progressive effect Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- 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
- A61B2017/0406—Pledgets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- 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
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- 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
- A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- 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
- A61B2017/0417—T-fasteners
Definitions
- the present invention is relates to fixation devices or anchors and tools and methods for emplacing the same.
- the present invention in particular, relates to medical anchors, for example, suture anchors or prosthesis anchors.
- the invention further relates to a method and apparatus for implanting such devices in biological materials, for example bone.
- the present invention relates to a medical anchor which can be inserted through a longitudinally or even curved extending bore hole so that the anchor is initially substantially aligned with the bore hole, and then, the emplacement tool manipulated so that the anchor pivots to form an undercut in the bore hole.
- the present invention is particularly suitable for the emplacement of anchors adapted to repair ligaments, for example rotator cuff ligaments, interior cruciate ligaments (ACL's) and other ligaments.
- the anchor is also suitable for prosthesis fixation.
- U.S. Patent No. 6,117,161 a medical anchor is disclosed which can be emplaced in a groove which extends substantially parallel to the surface of the bone and then rotated along an axis defined by an employment tool and which axis is perpendicular to the extent of the groove to form an undercut in the walls of the groove to secure the anchor.
- a medical anchor which can be emplaced in a borehole so that the anchor is initially substantially aligned with the borehole and then, via an emplacement tool, manipulated so the anchor pivots in two axes to form an undercut in the borehole.
- a medical anchor which can be emplaced in a bore hole so that the anchor is initially substantially aligned with the bore hole and then, using an emplacement tool, rotated about the axis of the tool.
- a deploy spring causes the anchor to deploy and rotate about an axis perpendicular to the axis of the tool to initially engage the borehole. Further rotation of the tool causes the anchor to cut into the borehole. The rotation by the user and action of the spring causes the anchor to screw into the borehole as it turns on two axes.
- a further object of the invention is provide a method and apparatus for emplacing an anchor into a borehole in substantial alignment with the bore hole and once inserted, activated simply so that it engages with the walls of the borehole by moving to a position substantially at an angle (up to a perpendicular angle) to the borehole.
- Such an anchor would be suitable, for example, to repair rotator cuff and other ligament injuries such that the appropriate attachment strength is provided.
- the present invention comprises an apparatus and method for delivering an anchor member which sets in biological tissue.
- the apparatus and method for delivering the anchor member into biological tissue comprises the following basic steps:
- Steps (a)-(c) may be performed through open or minimally invasive surgical techniques.
- the anchor is caused to rotate by a simple, non-rotational motion of the emplacement tool.
- the insertion hole may e a pre-made borehole or may be an aperture formed by the anchor member or the emplacement tool during the step of inserting.
- Figs. 1A, B, C, D and E show steps in the insertion of an anchor according to a first embodiment of the invention
- Figs. 2A and B shows steps in insertion of a second embodiment of an anchor according to the present invention
- FIG. 3 A, B, C, D and E show steps in the insertion of a third embodiment of an anchor according to the invention
- Fig. 4 is an isometric view of the anchor according to the third embodiment
- Fig. 5 is a side view of the anchor according to the third embodiment.
- Fig. 6 is a top view of the anchor according to the third embodiment prior to deployment
- Fig. 7 is a top view of the anchor according to the third embodiment during deployment ;
- Fig. 8 A, B, C, D and E are progressive views of the anchor viewed proximally along the bone hole axis showing the anchor during different stages of deployment;
- Figs. 9, 10 and 11 shows details of the distal end of a tool for installing the anchor according to the third embodiment in a pre-deploy, mid-deploy and full deploy positions, respectively.
- FIGS. 1 A, B, C, D and E show an apparatus comprising the distal end 10 of an insertion tool 10', either disposable or reusable, with an anchor 20 attached thereon and inserted into a predrilled bone hole
- the anchor 20 is flipped outwardly by the biasing force of a push member 22 (Fig. IB) until the anchor reaches an approximately perpendicular position relative to the bone hole, as shown in Figs. ID and IE.
- Push member 22 can be driven by another member that is actuated at a proximally located handle of the tool 10'.
- the push member 22 may be a spring-like member.
- the member 22 has a spring characteristic, as shown in Fig. ID, allowing the member to deflect when the tool is withdrawn.
- the tool 22 can also be a spring member whose spring provided biasing force causes the initial outward rotation of the anchor 20.
- the tool 10' is thereafter removed, as shown in Fig. IE, leaving the anchor 20 in position, as shown, approximately aligned perpendicular to the axis of the tool 10' and borehole, with suture 24 looped around an internal passage or passages of the anchor.
- the anchor has been set initially by the force of the pusher member 22.
- the pusher member is released by a suitable actuating force (e.g. depressing a button on tool 10'). No rotation of the tool was required to set the anchor. See Figs. 1 A, B, C and D.
- the pusher member 22 is activated to flip the proximal end 23 of the anchor outwardly into the wall of the bone hole.
- Distal end 23 A likewise penetrates into the bone hole as the anchor 20 rotates about axle 26.
- Edges 28 and 29 of the anchor 20 are provided with sharp edges to facilitate penetration into the bone hole.
- the anchor is separated from the insertion tool, leaving a secured anchor and suture 24 with which to reattach soft tissue. See Fig. IE.
- the anchor 20 can be separated from the tool by causing forked distal end
- axle 26 can be made of two spring biased sections that move oppositely horizontally in the pivot holes under bias of a tension spring, allowing the tool to be removed.
- the tool and anchor can be caused to separate automatically upon exertion of a predefined withdrawal force, such as by providing a frangible or breakable connection between tool and anchor that ruptures upon application of a predefined withdrawal force.
- Figs. 2A and B show a multi-piece anchor 30 in a bone hole in a predeployed state (Fig. 2A) and post deployed state (Fig. 2B).
- the anchor 30 is positioned in the bone hole and then actively deployed such that the proximal tips 32 and 33 of the anchor 30 are pushed outwardly and penetrate into the bone as the anchor is pulled proximally.
- the anchor 30 has two elements 30A and 30B disposed on a common shaft 34. The two elements are pushed by a pusher member (not shown) or by a spring like member (not shown) to cause the elements to pivot about the shaft and cut into the bore hole. Each member has a sharp edge 32', 33' to allow it to cut into the borehole.
- the anchor is made from multiple parts as shown.
- This anchor 30 is intended to be attached to the distal end of an insertion tool which is not shown in the figures.
- a distally directed force is applied to the proximal ends of the anchor to bias the sharp edges 32' and 33' to engage into the wall of the bone hole.
- the edges of the proximal ends 32 and 33 of the anchor will penetrate the bone walls and move the anchor members to an angle distinct from the axis of the bore hole. See Fig. 2B.
- Suture strands are connected to the anchor at or near the pivot point 34 of the anchor with which soft tissue can be attached to the bone.
- Figs. 3 A, B, C, D and E show stages of deployment of another embodiment of the anchor of the invention.
- the anchor itself is shown in Figs. 4to 7 and is formed approximately by slicing a cylinder in two parallel planes which are set at an angle to the long axis of the cylinder.
- this anchor 50 is formed approximately by slicing a portion of a cylinder along two parallel planes at an angle to the axis 51 of the cylinder, thereby forming surfaces having sharp edges 52 and 53.
- the cylinder section thus formed is provided with a center hub portion 55 having openings 57 and 58 surrounding the central hub portion.
- a suture 24 is threaded through the openings and around the hub portion 55.
- Figs. 4to 7 shows stages of deployment of another embodiment of the anchor of the invention.
- the anchor itself is shown in Figs. 4to 7 and is formed approximately by slicing a cylinder in two parallel planes which are set at an angle to the long axis of the cylinder
- a pusher member 60 is disposed in a cylinder 70 of the insertion tool 10; shown only schematically.
- the anchor is initially disposed at the distal end of the cylinder 70, inside a portion 74 of cylinder 70 of decreased wall thickness.
- Sutures 24 are wrapped around the center hub 55 of the anchor as shown.
- the pusher member 60 pushes the anchor 50 out of the cylinder 70 into the bore hole.
- the pusher member 60 causes the anchor to pivot about its center.
- the pusher member 60 may have a rounded end 62.
- the anchor Upon further movement of the pusher member, the anchor attains the position shown in Fig. 3C, which is adequate deployment.
- the insertion tool 10' is removed as shown in Fig. 3D, and an upward tug can optionally be provided to the sutures to ensure that the anchor is secured as shown in Fig. 3E.
- Such tugging is only optional and is a good check to ensure that the anchor is secure. It may further cause some additional rotation of the anchor, as shown in Fig. 3E, although such further rotation is not required.
- the anchor is adequately set in the position shown in Fig. 3D.
- An advantage of this design is that the anchor 50 is not attached to the tool, so that separation occurs simply upon withdrawal of the tool.
- Figs. 4, 5, 6 and 7 shows various views of the anchor.
- Fig. 4 shows an isometric view.
- Fig. 5 shows a side view.
- Fig. 6 shows a top view of the anchor as it is disposed in the cylinder prior to deployment and
- Fig. 7 shows the anchor in a top view after full deployment.
- Figs. 8A, B, C, D and E correspond to Figs. 3 A, B, C, D and E and show the anchor in the various stages of deployment, viewed from a proximal location.
- Fig. 9 shows the anchor 50 according to the third embodiment and the preferred embodiment of the distal end of a tool for deploying the anchor 50.
- the distal end of the tool includes an outer tube 70' and an inner tube 60'.
- Tube 60' functions as a pusher member.
- the inner tube 60' has an end 64 which is formed at an angle to conform to the angled surface of the anchor 50.
- the suture 24 is looped around the center hub 55 of the anchor 50.
- the outer tube 70' has a stop shoulder 72 and at the distal end having a reduced diameter portion 74.
- the stop shoulder 72 functions as a stop for limiting movement of the outer tube 70' into the borehole in the bone surface indicated at 90. Once the stop shoulder 72 is seated on the bone surface 90, as shown in Fig.
- the pusher member 60' is moved in the direction of arrow 68 and the anchor is pushed into the borehole, shown at 40.
- the anchor 50 is still maintained in the same orientation due to its abutting against the reduced diameter portion 74 and the angled end 64 of pusher member 60'.
- the anchor member of the embodiments shown may be shaped as a disk, oval, blade, kidney, be pointed, polygonal, or have any symmetrical or asymmetrical geometrical shape or be a solid or have fenestrations.
- the anchor member may have sha ⁇ edges, points, protrusions, cut outs, curves or other defining features.
- the anchor member may be two dimensional or three dimensional.
- the anchor member may be made from metal, a polymer, a bioabsorbable material, bone, or any other biocompatible material. To insert the anchor, a hole in the bone may or may not need to be pre-made or pre-drilled, depending on the sha ⁇ ness of the leading point of the anchor or tool, or whether there may be cutting surfaces, such as threads, on the anchor.
- the insertion tool may be designed for a single use, i.e., disposable, or as a reusable instrument. Also, the insertion tool may be designed for open or minimally invasive surgery.
- the activation element to initiate the outward bias of the anchor may be a spring, lever, rod or any other suitable design element. Near the distal end of the insertion tool may be a shoulder stop to indicate the maximum depth of anchor insertion into biological tissue for more precise and reliable engagement of the anchor.
- the anchor and insertion tool assembly may be provided as a single use device, in which case, it can be made with simplicity and provides convenience.
- the anchor is set by simple motions, i.e., vertical insertion of the tool, depression of a button or other member to activate the biasing spring 22 and/or withdrawal of the tool. Rotation of the tool is not necessary to set the anchor.
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002389063A CA2389063C (en) | 1999-11-11 | 2000-11-10 | Toggle anchor and tool for insertion thereof |
JP2001536049A JP2003513695A (en) | 1999-11-11 | 2000-11-10 | Toggle anchor and tool to insert it |
AU15903/01A AU781140B2 (en) | 1999-11-11 | 2000-11-10 | Toggle anchor and tool for insertion thereof |
EP00978438A EP1229840A4 (en) | 1999-11-11 | 2000-11-10 | Toggle anchor and tool for insertion thereof |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US16489899P | 1999-11-11 | 1999-11-11 | |
US60/164,898 | 1999-11-11 | ||
US18889400P | 2000-03-14 | 2000-03-14 | |
US60/188,894 | 2000-03-14 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2001034036A1 true WO2001034036A1 (en) | 2001-05-17 |
Family
ID=26860963
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2000/030745 WO2001034036A1 (en) | 1999-11-11 | 2000-11-10 | Toggle anchor and tool for insertion thereof |
Country Status (6)
Country | Link |
---|---|
EP (1) | EP1229840A4 (en) |
JP (1) | JP2003513695A (en) |
AU (1) | AU781140B2 (en) |
CA (1) | CA2389063C (en) |
TW (1) | TW477686B (en) |
WO (1) | WO2001034036A1 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2003061530A1 (en) * | 2002-01-16 | 2003-07-31 | Smith & Nephew | Tissue anchor insertion tool |
US20140257380A1 (en) * | 1999-08-09 | 2014-09-11 | Bonutti Skeletal Innovations Llc | Method of connecting body tissue to a bone |
US8845687B2 (en) | 1996-08-19 | 2014-09-30 | Bonutti Skeletal Innovations Llc | Anchor for securing a suture |
US8845699B2 (en) | 1999-08-09 | 2014-09-30 | Bonutti Skeletal Innovations Llc | Method of securing tissue |
WO2024076686A1 (en) * | 2022-10-06 | 2024-04-11 | INTERNATIONAL LIFE SCIENCES, LLC d/b/a ARTELON | Surgical anchors, instrumentation, and methods of use |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2620104A3 (en) * | 2003-07-16 | 2014-05-14 | Covidien LP | Surgical stapling device with tissue tensioner |
JP6829847B2 (en) * | 2019-06-06 | 2021-02-17 | 株式会社プロメット | anchor |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5269809A (en) * | 1990-07-02 | 1993-12-14 | American Cyanamid Company | Locking mechanism for use with a slotted suture anchor |
US5522846A (en) * | 1993-05-14 | 1996-06-04 | Bonutti; Peter M. | Suture anchor |
US5845645A (en) * | 1993-05-14 | 1998-12-08 | Bonutti; Peter M. | Method of anchoring a suture |
US6102934A (en) * | 1998-06-02 | 2000-08-15 | Li; Lehmann K. | Anchor tool and method and apparatus for emplacing anchor in a borehole |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5203787A (en) * | 1990-11-19 | 1993-04-20 | Biomet, Inc. | Suture retaining arrangement |
US6660022B1 (en) * | 1999-06-01 | 2003-12-09 | Smith & Nephew, Inc. | Rotor blade anchor and tool for installing same |
-
2000
- 2000-11-10 WO PCT/US2000/030745 patent/WO2001034036A1/en active IP Right Grant
- 2000-11-10 AU AU15903/01A patent/AU781140B2/en not_active Expired
- 2000-11-10 EP EP00978438A patent/EP1229840A4/en not_active Withdrawn
- 2000-11-10 JP JP2001536049A patent/JP2003513695A/en active Pending
- 2000-11-10 CA CA002389063A patent/CA2389063C/en not_active Expired - Lifetime
- 2000-11-13 TW TW89123943A patent/TW477686B/en active
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5269809A (en) * | 1990-07-02 | 1993-12-14 | American Cyanamid Company | Locking mechanism for use with a slotted suture anchor |
US5522846A (en) * | 1993-05-14 | 1996-06-04 | Bonutti; Peter M. | Suture anchor |
US5845645A (en) * | 1993-05-14 | 1998-12-08 | Bonutti; Peter M. | Method of anchoring a suture |
US6102934A (en) * | 1998-06-02 | 2000-08-15 | Li; Lehmann K. | Anchor tool and method and apparatus for emplacing anchor in a borehole |
Non-Patent Citations (1)
Title |
---|
See also references of EP1229840A4 * |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8845687B2 (en) | 1996-08-19 | 2014-09-30 | Bonutti Skeletal Innovations Llc | Anchor for securing a suture |
US20140257380A1 (en) * | 1999-08-09 | 2014-09-11 | Bonutti Skeletal Innovations Llc | Method of connecting body tissue to a bone |
US8845699B2 (en) | 1999-08-09 | 2014-09-30 | Bonutti Skeletal Innovations Llc | Method of securing tissue |
WO2003061530A1 (en) * | 2002-01-16 | 2003-07-31 | Smith & Nephew | Tissue anchor insertion tool |
WO2024076686A1 (en) * | 2022-10-06 | 2024-04-11 | INTERNATIONAL LIFE SCIENCES, LLC d/b/a ARTELON | Surgical anchors, instrumentation, and methods of use |
Also Published As
Publication number | Publication date |
---|---|
JP2003513695A (en) | 2003-04-15 |
AU781140B2 (en) | 2005-05-05 |
TW477686B (en) | 2002-03-01 |
EP1229840A1 (en) | 2002-08-14 |
AU1590301A (en) | 2001-06-06 |
EP1229840A4 (en) | 2009-03-25 |
CA2389063C (en) | 2008-01-29 |
CA2389063A1 (en) | 2001-05-17 |
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