Surgery – Instruments – Suture retaining means
Reexamination Certificate
2000-05-03
2003-07-15
Jackson, Gary (Department: 3731)
Surgery
Instruments
Suture retaining means
Reexamination Certificate
active
06592609
ABSTRACT:
BACKGROUND OF THE INVENTION
The present invention relates to a new and improved method and apparatus for securing tissue in a patient's body. The method and apparatus may be utilized to secure hard tissue and/or soft tissue in a patient's body.
Anchors have previously been utilized to retain sutures in a patient's body. The anchors have previously been formed of metal, such as stainless steel or titanium. In addition, anchors have been formed of biodegradable materials. Anchors have also been formed of bone. It has previously been suggested to construct anchors in the manner disclosed in U.S. Pat. Nos. 5,527,343; 5,534,012; 5,928,267; and 5,989,282. The disclosures in the aforementioned patents are hereby incorporated herein in their entirety by this reference thereto.
It has previously been suggested that ultrasonic vibratory energy be utilized to interconnect sections of a suture in the manner disclosed in U.S. Pat. No. 3,513,848. This patent suggests that the suture is initially tensioned by a surgeon or his assistant by gripping free ends of the suture and applying the requisite force. While the requisite force is maintained, ultrasonic energy is applied to the segments of the suture. The high frequency mechanical vibrations applied to the suture result in bonding of overlapping areas on segments of the suture. It has also been suggested that ultrasonic energy could be utilized in connecting an elongated element with a fusible receptacle in the manner disclosed in U.S. Pat. No. 5,964,765.
When tissue is to be secured against movement relative to a portion of a bone, it is necessary to interconnect the bone and the tissue. In this situation, it has been a common practice to drill a hole which extends into or through the bone. A retaining member, such as a pin, screw or suture anchor is positioned in the hole after it has been drilled in the bone. The concept of utilizing a retainer member formed of bone to anchor a suture is disclosed in U.S. Pat. No. 5,626,612. It has also been suggested that screws, pins, anchors and plates could be fabricated from bone in the manner disclosed in U.S. Pat. No. 5,968,047.
SUMMARY OF THE INVENTION
The present invention relates to a method and apparatus for use in securing soft tissue, hard tissue, or hard and soft tissue in a patient's body. The hard tissue may be any one of the many bones in a patient's body. The soft tissue may be any one of the tissues in a patient's body other than the hard tissue.
The tissue may be secured by using a suture. The suture may be connected with an anchor. When an anchor is utilized in association with a suture, the anchor may be formed of any one of many different materials including bone or other body tissue, biodegradable materials, or non-biodegradable materials. The anchor may be formed of two or more different materials.
When a suture is utilized to secure body tissue, a retainer may be connected with the suture. Alternatively, sections of the suture may be connected with each other.
If a suture is utilized to secure body tissue, an apparatus may advantageously be provided to tension the suture with a predetermined force. If a retainer is utilized in association with the suture, the apparatus may urge the retainer toward the body tissue with a predetermined force. The retainer may be connected with the suture in response to detection of at least a predetermined tension in the suture and/or the transmission of a predetermined force to the body tissue. When the retainer is to be eliminated, sections of the suture may be interconnected in response to detection of a predetermined tension in the suture and/or detection of the transmission of a predetermined force to the body tissue.
The anchor, for some uses at least, may be formed of a single piece of bone. A pointed end portion of the anchor may have a surface which forms an opening in a bone or other tissue in a patient's body. The anchor may be moved into the opening formed in the tissue by the pointed leading end portion of the anchor.
It should be understood that in certain situations, it may be desired to use just a suture, without an anchor, to secure the body tissue. In these situations, a retainer may be connected with the suture. Alternatively, sections of the suture may be directly connected with each other. In other situations, it may be desired to use an anchor, without a suture, to secure body tissue.
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Article entitled “The Search for the; Holy Grail: a Century of Anterior Cruciate Ligament Reconstruction”, R. John Naranja, Jr., MD, Jeffrey R. Kuhlman, MD, and Joseph S. Torg, MD, Published by the American Journal of Orthopaedics, Nov. 1997, pp. 743-752.
Article under the heading Technical Note, entitled “Femoral Bone Plug Recession in Endoscopic Anterior Cruciate Ligament Reconstruction”, By David E. Taylor, M.D., F.R.A.C.S., Gregory C. R. Keene, M.D., F.R.A.C.S., published by Arthroscopy: The Journal of Arthroscopic and Related Surgery, vol. 12, No. 4 (Aug.), 1996: 513-515.
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Bianco Paul D.
Bonutti 2003 Trust-A
Fleit Martin
Fleit Kain Gibbons Gutman & Bongini P.L.
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