Suture buttress

Details Suture buttress Suture buttress

1998-07-10

2001-06-12

Brown, Michael A. (Department: 3764)

Surgery

Instruments

Suture, ligature, elastic band or clip applier

C606S232000, C606S233000

Reexamination Certificate

active

06245081

ABSTRACT:

FIELD OF THE INVENTION
The invention relates to a suture buttress, and more particularly to a suture buttress having a securing element which retains the suture buttress within a bone tunnel.
BACKGROUND OF THE INVENTION
Open repair of the rotator cuff tendon is the most common open surgical procedure performed on the shoulder. It has been estimated that the incidence of rotator cuff tearing in the population at large runs between 15 and 25%, with approximately half of these being full thickness tears of the tendon. A smaller percentage of these become sufficiently symptomatic to warrant surgical repair.
Generally, techniques for repairing rotator cuff tears involve reattaching the torn tendon back to the bone from which it is avulsed. Typically, suture material is used to tie the tendon directly back to bone to facilitate healing of the tendon. Common technical problems with this repair often result from the fact that rotator cuff tears frequently occur in patients who are in an older age group. These patients often have poor quality bone, osteopenic bone, or bone that has been weakened by disuse due to pain. When the tendon is brought back to the bone, attempts to hold the tendon securely to the bone can be frustrated by the poor quality bone.
One method for reattaching the rotator cuff tendon to bone is to make a hole or tunnel in the bone of the greater tuberosity, to pass suture thread that has been secured to the tendon through these bone tunnels, and to reattach the rotator cuff tendon directly to the bone by tying these sutures. Using this method, the suture material can be frayed and weakened, or possibly severed, by contact with sharp edges of subcortical bone inside the bone tunnel or at the openings of the bone tunnel.
Poor bone quality also affects this method of repair adversely as the suture material may cut directly through the bone, frustrating the attempts at secure repair. Even where the suture does not cut completely through the bone, any amount of carving into bone by the suture material may result in a loosening of the suture and a corresponding loosening of the attachment of the rotator cuff tendon to bone.
SUMMARY OF THE INVENTION
The present invention provides a suture buttress having a hollow tube including an external securing element made up of at least one tab disposed on an outer surface of the suture buttress. The tabs are formed at an angle to a longitudinal axis of the suture buttress so that the tabs extend outward from the outer surface of the suture buttress. The tabs are resiliently deformable and may be recessable within cut-outs formed in the outer surface of the suture buttress, allowing the tabs to deform as the suture buttress slides into a bone tunnel in a first direction when inserted into a bone tunnel. After insertion of the suture buttress in the bone tunnel, the tabs engage the tunnel to prevent the suture buttress from sliding out of the tunnel. In one embodiment, a resilient flange is also disposed on the outer surface of the buttress. The resilient tube may also be constructed of a porous material or have pores formed thereon to promote bone ingrowth in a bone tunnel.
BRIEF DESCRIPTION OF THE DRAWINGS
The invention will be more fully understood by reference to the following detailed description when considered in conjunction with the accompanying drawings, in which:
FIG. 1
is an elevated view of a suture buttress system showing a distal portion of a suture retriever, a suture buttress disposed on the retriever and a suture retaining element extending from the retriever;
FIG. 2
is an elevated view of the suture buttress of
FIG. 1
in an unflexed position;
FIG. 3
is an elevated view of the suture buttress of
FIG. 1
in a flexed position;
FIG. 4
is a cross-sectional view of a suture buttress having flanges;
FIG. 5
is a cross-sectional view of a suture buttress having opposed ends folded over onto an outer surface of the buttress; and
FIG. 6
is an elevated view of a suture buttress system including a suture buttress deployment tool;
FIG. 7
is an elevated view, with a partial cut-away, of the suture retriever of
FIG. 1
, with the suture retaining element in a retracted position;
FIG. 8
is an elevated view, with a partial cut-away, of the suture retriever of
FIG. 1
, with the suture retaining element in an extended position;
FIG. 9
is an elevated view, with a partial cut-away, of the suture retriever of
FIG. 1
, with the suture retaining element in a partially retracted, intermediate position;
FIG. 10
is an elevated view of the suture retaining element of
FIG. 1
in an extended position;
FIG. 11
is an elevated view, with a partial cut-away, of the suture retaining element of
FIG. 1
in an intermediate position;
FIG. 12
is an elevated view of a suture tunnel buttress system having an internal tube delivery scheme;
FIG. 13
is a perspective view of an additional suture buttress in accordance with the teachings of the present invention;
FIG. 14
is a right side view of the suture buttress of
FIG. 13
;
FIG. 15
is a cross sectional view of the suture buttress taken along line
15
—
15
in
FIG. 14
;
FIG. 16
is a bottom view of the suture buttress of
FIG. 13
;
FIG. 17
is a detailed view of portion A of the suture buttress of
FIG. 13
;
FIG. 18
is a rear view of the suture buttress of
FIG. 13
;
FIG. 19
is a side view of the suture buttress of
FIG. 13
in a flexed position;
FIG. 20
is a side view of the suture buttress of
FIG. 13
in conjunction with a suture retriever;
FIG. 21
is a perspective view of a suture buttress bone rasp tool; and
FIG. 22
is a top view of the bone rasp tool of FIG.
21
.


REFERENCES:
patent: 3845772 (1974-11-01), Smith
patent: 4009719 (1977-03-01), Kletschka et al.
patent: 4045825 (1977-09-01), Stroot
patent: 4549545 (1985-10-01), Levy
patent: 5366480 (1994-11-01), Corriveau et al.
patent: 5423763 (1995-06-01), Helland et al.
patent: 5575801 (1996-11-01), Habermeyer et al.
patent: 5632748 (1997-05-01), Beck, Jr. et al.
patent: 5681333 (1997-10-01), Burkhart et al.
patent: WO9806344 (1998-02-01), None
The Rotator Cuff Repair System Surgical Technique, Surgical technique as described by Stephen J. Snyder, M.D., Southern California Orthopedic Institute, Van Nuys, California.
“Avoid suture migration following rotator cuff repair”Cuff Link™, Bone Tunnel Augmentation Device, Innovasive Devices, Inc., Copyright 1997.
Innovasive Cuff Link™, Bone Tunnel Augmentation Device, Instructions for Use, pp. 1-3.

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