Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1999-07-09
2001-02-06
Philogene, Pedro (Department: 3732)
Surgery
Instruments
Orthopedic instrumentation
C606S075000, C606S232000
Reexamination Certificate
active
06183479
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates generally to installation of suture anchors and, more particularly, to a tool for installing suture anchors.
BACKGROUND OF THE INVENTION
Suture anchors are widely used in surgery, particularly for attaching sutures to bones in orthopedic surgical procedures. The suture anchor connects a portion of a suture to a bone, while the remainder of the suture (typically, two segments extending from the suture anchor) is used for various applications, e.g., for securing loosened connective tissue, such as ligament, to the bone. The suture anchor is typically driven into a hole made in the bone, e.g., into a pre-drilled hole. Suture anchors are particularly useful for firmly attaching sutures to bones during and after orthopedic surgery.
Suture anchors and tools for installing suture anchors are described in U.S. Pat. Nos. 5,207,679, 5,411,523 and 5,217,486, and in PCT publication WO 96/28100.
U.S. Pat. No. 5,411,523 describes a suture anchor and installation tool combination. The suture is threaded through a ring attached to a removable link member which is connected to an installation end of the installation tool. The threaded suture is folded into two free-ended segments which are guided together through a single bore formed in the installation tool. By applying a driving force to the installation tool, the suture anchor is driven into a pre-drilled hole in the bone together with a portion of the suture.
PCT publication WO 96/28100 also describes a suture anchor installation tool, wherein the suture is attached to the suture anchor and two free-ended segments of the suture are guided together through the installation tool. The suture anchor is driven into the bone by a force which is transmitted thereto by the installation tool.
Likewise, both U.S. Pat. Nos. 5,207,679 and 5,217,486 describe an installation tool for a suture anchor. In the devices described in these patents, the suture is threaded through a loop which is attached to the suture anchor and the installation tool drives the suture anchor into a pre-drilled hole, but the free ended segments of the suture are not guided through the installation tool.
Each of the prior art devices described above is susceptible to the effect of lateral forces which may act on the suture anchor and/or on the installation tool during installation. In response to such lateral forces, the installation tool may skew with respect to the suture anchor and/or the suture anchor may skew in the pre-drilled hole. Consequently, the suture anchor and/or the installation tool may be damaged and the suture anchor may be improperly installed in the bone.
Further, in prior art devices, a certain degree of freedom between the suture anchor and the installation tool may result in lateral movement of the suture anchor upon installation. Such lateral movement makes it difficult to align the suture anchor with respect to the pre-drilled hole. Thus, installation of a suture anchor is generally difficult and requires very high precision. Additionally, there is often insufficient space for maneuvering the installation tool at the installation site to compensate for lateral movement of the suture anchor.
SUMMARY OF THE INVENTION
Accordingly, it is an object of the present invention to overcome the drawbacks of prior art tools for installing suture anchors. More specifically, the present invention provides a suture anchor installation tool which makes the installation of suture anchors simpler and more reliable, reducing the risk of damaging the suture anchors or the installation tool.
In the present invention, a suture anchor supporting first and second suture segments is mounted on an installation end of an installation tool. The installation end includes an arrangement for transmitting mechanical power to the suture anchor to drive the suture anchor into a bone. The installation tool further includes a guiding arrangement which guides and supports the first and second suture segments near the installation end in a non-parallel configuration, wherein the distance between the first and second suture segments changes near the installation end. For example, in some embodiments of the invention, the paths of the first and second suture segments are crossed near the installation end.
The non-parallel configuration of the suture segments near the installation end of the present invention enables, inter alia, compensation for lateral forces which may act on the suture anchor and/or the installation end during installation. When the suture segments are tensioned, e.g., by pulling their free ends, the forces applied to the installation end by the first and second suture segments have opposite lateral components. However, the longitudinal components of the forces applied by the first and second suture segments are both operative to pull the suture anchor against the installation end. Thus, by controlling the relative tensions of the suture segments in the present invention, it is possible to counteract lateral forces acting on the suture anchor and/or the installation end, while maintaining the suture anchor securely mounted on the installation end. For example, when a lateral force tilts the suture anchor in the direction of the first suture segment, the tension in the second suture segment is increased relative to the first suture segment and, thus, the suture anchor is urged back to its original position. Similarly, when a lateral force tilts the suture anchor in the direction of the second suture segment, the tension in the first suture segment is increased relative to the second suture segment and, thus, the suture anchor is urged back to its original position.
In one embodiment of the present invention, the guiding arrangement includes a suture guide which supports the first and second suture segments, respectively, at least at a first and a second support points which are laterally spaced with respect to a direction of installation of the suture anchor. Thus, at the suture guide, the first and second suture segments are separated laterally by a predetermined distance. A non-parallel configuration of the suture segments near the installation end is obtained by guiding the suture segments closer together downstream of the suture guide.
In another embodiment of the present invention, the guiding arrangement includes a first and a second, longitudinally spaced, suture guides having a predetermined gap therebetween. The first suture guide supports the first and second suture segments, respectively, at least at a first and second support points which are laterally spaced with respect to the direction of installation of the suture anchor. The second suture guide supports the first and second suture segments, respectively, at least at a third and a fourth support points which are laterally spaced with respect to the direction of installation of the suture anchor. A non-parallel configuration of the suture segments is obtained by crossing the suture segments at a region between the first and second suture guides, such that the paths of the first and second suture guides are inverted. To position the suture segments in such a crossed configuration, the suture segments can be simply inserted through the gap between the first and second suture guides. This obviates the need for difficult and precision-demanding procedures for positioning the suture, such as threading through eyes or the like, which are utilized in prior art devices.
The installation tool of the present invention may be provided with a position guide which ensures correct positioning of the suture anchor on the installation end. The position guide may include a protrusion on the installation end adapted to fit into a notch on the suture anchor, or vice versa.
The suture anchor of the present invention may be formed with a peripheral, longitudinal groove which extends along two opposite sides of the suture anchor. A middle portion of the suture is placed in the peripheral groove such that it does not protrude from the surface of the suture anchor, thereby avoiding
Pirhonen Eija
Tormala Pertti
Bionx Implants Oy
Kenyon & Kenyon
Philogene Pedro
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