Surgery – Instruments – Sutureless closure
Reexamination Certificate
1999-09-21
2001-10-23
Reip, David O. (Department: 3731)
Surgery
Instruments
Sutureless closure
C606S220000, C606S232000, C606S144000
Reexamination Certificate
active
06306156
ABSTRACT:
BACKGROUND OF THE INVENTION
1. The Field of the Invention
The present invention relates generally to surgical fasteners. More particularly, it concerns an implant for repairing meniscal tearing in the knee.
2. The Background Art
Intracorporeal tearing in body tissue occurs most often at bone joint regions. Certain body tissues act as a cushion for absorbing the forces of joint movement, preventing friction in the joint, and channeling the mechanical stress and strain associated with such movement. Like any shock-absorbing material, such body tissues experience failure when applied forces exceed the strength of the material, including failure in shear and tension.
Human joints include a type of shock-absorbing body tissue known as a “meniscus.” Such body tissue comprises a fibrous cartilage. In each human knee there are two generally crescent-shaped menisci on opposite sides of the knee (see FIG.
1
), referred to in the medical field as a medial meniscus and a lateral meniscus. Different types of tearing occur in the knee menisci, perhaps twenty percent of which are repairable by mechanical connecting apparatus. Most of these repairable tears occur in the outer two thirds of the knee meniscus, since the knee meniscus is generally triangular in cross section (see FIG.
2
), tapering inwardly to a small inner edge that is sometimes not conducive to mechanical repair.
Untreated meniscal tearing may deteriorate and cause further complications. It is known in the surgical field to repair tears in the meniscus by holding the sides of the tear together, usually for at least six weeks, to allow the body to regenerate the tissue needed to hold the tear together.
Several different techniques have been developed for repairing meniscus tears. Many of the presently known techniques for repairing meniscal tearing in the knee have proven to be a significant benefit in the relief of knee injury, pain and discomfort. Four major techniques are known in the field of meniscus repair: “open” technique, “inside-out” technique, “outside-in” technique and “all inside” technique. These techniques generally involve suturing the sides of a meniscus tear together. Such techniques, while useful, are laborious to perform and sometimes fail to provide adequate holding strength during the healing period, since the sutures rely only upon fixation points on the exterior edges of the meniscus.
Attempts have been made to provide additional fixation points within the meniscus itself, to increase the holding strength of the repair. U.S. Pat. No. 4,873,976 (granted Oct. 17, 1989 to Schreiber) discloses a rigid implant that resembles a sharp-tipped tack, and has barbs along its length. The rigid implant is pressed into a torn meniscus to approximate the tear, and the barbs of the implant function as internal fixation points. U.S. Pat. No. 5,059,206 (granted Oct. 22, 1991 to Winters) discloses a similar tack-like meniscus repair implant, and a flexible-tipped delivery device for deploying the implant.
These prior art apparatus and methods, while useful, are nevertheless characterized by several disadvantages. The rigid implants of Schreiber and Winters appear to require a fixation point against the inner edge of the meniscus and fail to provide a fixation point against the outer edge. Further, their methods of deploying the implant are to force the implant and its sharp barbs directly into the tissue, causing the barbs to tear into the meniscus before coming to rest at the proper position, thereby risking a reduction in strength and fixation of the internal fixation points.
OBJECTS AND SUMMARY OF THE INVENTION
It is therefore an object of the present invention to provide a surgical fastener that is simple in design and manufacture.
It is another object of the present invention, in accordance with one aspect thereof, to provide such a surgical fastener having an external fixation point against the outer edge of the knee meniscus.
It a is further object of the present invention, in accordance with one aspect thereof, to provide such a surgical fastener capable of advancing its barbs within body tissue without contacting the tissue with the barbs until said barbs are properly positioned.
It is an additional object of the invention to provide such a surgical fastener that can provide increased pressure resistance and holding strength during the healing period.
It is still another object of the invention to provide such a surgical fastener as part of a system capable of holding the sides of a tear in compression during insertion of the fastener.
The above objects and others not specifically recited are realized in a specific illustrative embodiment of a meniscus repair anchor. The anchor includes an anchor body and a retaining head intercoupled by a flexible member. The anchor is lodged within a hollow needle. The needle is advanced into the meniscus and across the tear in an inner-to-outer direction, thereby preventing contact between the anchor body and meniscal tissue during deployment. Once the needle tip has penetrated the outer edge of the meniscus and protrudes therefrom, a stylus is used to deploy the flexibly tethered retaining head against the outer edge. The hollow needle is then retracted, causing the barbs along the anchor body to deploy internally within the meniscus. Excess length of the anchor body is cut off at the inner edge entry point of the meniscus.
Additional objects and advantages of the invention will be set forth in the description which follows, and in part will be apparent from the description, or may be learned by the practice of the invention. The objects and advantages of the invention may be realized and obtained by means of the instruments and combinations particularly pointed out in the appended claims.
REFERENCES:
patent: 3166072 (1965-01-01), Sullivan, Jr.
patent: 3946740 (1976-03-01), Bassett
patent: 3981051 (1976-09-01), Brumlik
patent: 4006747 (1977-02-01), Kronenthal et al.
patent: 4060089 (1977-11-01), Noiles
patent: 4259959 (1981-04-01), Walker
patent: 4316469 (1982-02-01), Kapitanov
patent: 4502161 (1985-03-01), Wall
patent: 4653486 (1987-03-01), Coker
patent: 4741330 (1988-05-01), Hayhurst
patent: 4759765 (1988-07-01), Van Kampen
patent: 4776329 (1988-10-01), Treharne
patent: 4796612 (1989-01-01), Reese
patent: 4873976 (1989-10-01), Schreiber
patent: 4884572 (1989-12-01), Bays et al.
patent: 4895148 (1990-01-01), Bays et al.
patent: 4924865 (1990-05-01), Bays et al.
patent: 4944742 (1990-07-01), Clemow et al.
patent: 4968317 (1990-11-01), Töomälä et al.
patent: 4973333 (1990-11-01), Treharne
patent: 4976715 (1990-12-01), Bays et al.
patent: 5041129 (1991-08-01), Hayhurst et al.
patent: 5059206 (1991-10-01), Winters
patent: 5062843 (1991-11-01), Mahoney, III
patent: 5129906 (1992-07-01), Ross et al.
patent: 5261914 (1993-11-01), Warren
patent: 5269809 (1993-12-01), Hayhurst et al.
patent: 5352463 (1994-10-01), Badylak et al.
patent: 5562704 (1996-10-01), Tamminmäki et al.
patent: 5569252 (1996-10-01), Justin et al.
patent: 5730744 (1998-03-01), Justin et al.
patent: 5827298 (1998-10-01), Hart et al.
patent: 5843087 (1998-12-01), Jensen et al.
patent: 5851219 (1998-12-01), Goble et al.
Gene R. Barrett, MD, Stephen H. Treacy, MD, Cynthia G. Ruff, MS; The T-Fix Technique for Endoscopic Meniscus Repair (Technique, Complications, and Preliminary Results); pp. 151-155; The American Journal of Knee Surgery; Summer 1996/vol. 9 No. 3.
Graeme C. Brown, FRACS, Thomas D. Rosenberg, MD, Kathleen T. Deffner; Inside-Out Meniscal Repair Using Zone-Specific Instruments; pp. 144-150; The American Journal of Knee Surgery; Summer 1996/vol. 9 No. 3.
W. Dilworth Cannon, Jr. MD;Arthroscopic Meniscal Repair;pp. 137-143; The American Journal of Knee Surgery; Summer 1996/vol. 9 No. 3.
Clayton Howarth & Cannon, P.C.
Reip David O.
LandOfFree
Meniscus repair anchor system does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Meniscus repair anchor system, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Meniscus repair anchor system will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2607207