Tensionable and lockable micro suture anchors and anchor arrays for anatomical attachment of soft tissue to bone
A toggle-type suture anchor that incorporates individual suture tensioning and locking without knot tying. The anchor includes several exemplary designs of toggle bodies having a working suture pre-threaded through one or more passages therethrough. A locking suture loop is pre-threaded relative to the working suture and includes a collapsible loop that encircles a portion of the length of suture running longitudinally adjacent the side of the anchor. With the loop open, the working suture can slide through the anchor, however, when the loop is closed the working suture is locked in position to retain tension on the working suture. Alternatively, the locking suture loop can be replaced with a mechanical locking member that moves from a first unlocked to a second locked position. The exemplary anchors can be utilized in a pre-strung connected array of anchors.
1 . A pre-strung array of toggle-type suture anchors comprising:
a plurality of elongated toggle bodies, each having at least a first hole through the toggle body extending from a first longitudinal surface to a second longitudinal surface;
a single suture serially disposed through each of the plurality of toggle bodies, wherein for each toggle body, the suture passing into the first hole at the first longitudinal surface and out the first hole at the second longitudinal surface, wherein the suture is adapted to slide through the first hole of each of the plurality of toggle bodies when a force is applied thereto; and
a separate locking loop for each of the plurality of toggle bodies, each locking loop formed from a separate cord having a free distal end and a free proximal end, the separate cord encircling the suture proximate the second longitudinal surface adjacent one of the elongated toggle bodies, the free distal end of each locking loop forming a slidable knot being adjustable between a first position allowing the suture to slide through the locking loop and a second position that closes the locking loop onto the suture, thereby preventing sliding within the locking loop and preventing sliding of the suture through the first hole in one direction, each locking loop having a point of weakness configured to break and allow removal of the free proximal end of the separate cord.
2 . The pre-strung array of toggle-type suture anchors of claim 1 , further comprising a second hole through each of the plurality of elongated toggle bodies extending from the first longitudinal surface to the second longitudinal surface at a spaced interval along the elongated toggle body relative to the first hole, wherein for each of the plurality of toggle bodies, the suture exiting the first hole at the second longitudinal surface extends into the second hole on the second longitudinal surface and exits the second hole at the first longitudinal surface with a length of suture extending adjacent the toggle body between the first hole and the second hole near the second longitudinal surface with the locking loop encircling this length of suture.
3 . The pre-strung array of toggle-type suture anchors of claim 2 , further comprising a third hole through each of the plurality of toggle bodies extending from the first longitudinal surface to the second longitudinal surface and located between the first and second holes, wherein each locking loop extends from the third hole at the second longitudinal surface after passing through the toggle body.
4 . The pre-strung array of toggle-type suture anchors of claim 3 , wherein the free proximal end of the separate cord extends through the third hole and beyond the first longitudinal surface, to allow collapsing of the locking loop from the first position to the second position when the free proximal end is tensioned.
5 . The pre-strung array of toggle-type suture anchors of claim 1 , further comprising a second hole through each of the plurality of elongated toggle bodies extending from the first longitudinal surface to the second longitudinal surface at a spaced interval along the elongated toggle body relative to the first hole wherein the suture exiting the first hole at the second longitudinal surface wraps around the elongated toggle body over the top of the suture extending from the first hole, first longitudinal surface then into the second hole through the first longitudinal surface and out the second longitudinal surface to form a one-way locking knot preventing the suture from sliding in one direction but allowing sliding in the other direction.
6 . The pre-strung array of toggle-type suture anchors of claim 5 , wherein the locking loop encircles at least one of the overlapping sutures proximate their intersection.
7 . The pre-strung array of toggle-type suture anchors of claim 6 , wherein the locking loop encircles both of the overlapping sutures proximate their intersection.
8 . The pre-strung array of toggle-type suture anchors of claim 1 , wherein each locking loop compresses the suture adjacent the second longitudinal surface of one of the plurality of elongated toggle bodies when in the second position to thereby prevent the suture sliding through the locking loop.
9 . A pre-strung array of toggle-type suture anchors comprising:
a plurality of elongated toggle bodies, each having at least a first hole through the toggle body extending from a first longitudinal surface to a second longitudinal surface;
a single suture serially disposed through each of the plurality of toggle bodies, wherein for each toggle body, the suture passing into the first hole at the first longitudinal surface and out the first hole at the second longitudinal surface, wherein the suture is adapted to slide through the first hole of each of the plurality of toggle bodies when a force is applied thereto; and
a separate locking member for each of the plurality of toggle bodies, each locking member being separate from the suture, each locking member having a free distal end and a free proximal end, each locking member at least partially encircling the suture proximate the second longitudinal surface adjacent one of the plurality of elongated toggle bodies, the free distal end of each locking member forming a slidable knot which is moveable between a first position allowing the suture to slide through the locking member and a second position collapsing the locking member onto the suture and thereby preventing the suture from sliding through the locking member in at least one direction, each locking member having a point of weakness configured to break and allow removal of the free proximal end of the locking member.
10 . The pre-strung array of toggle-type suture anchors of claim 8 , wherein each locking member is slidably received in a chamber formed in one of the elongated toggle bodies and in the first position has a portion spaced radially from the longitudinal surface to allow suture movement while in the second position locking member is locked deeper within the chamber and creates a pinched tortuous pathway for the suture to prevent suture movement.
11 . The pre-strung array of toggle-type suture anchors of claim 9 , further comprising a second hole through each of the plurality of elongated toggle bodies extending from the first longitudinal surface to the second longitudinal surface at a spaced interval along the elongated toggle body relative to the first hole, wherein for each of the plurality of toggle bodies, the suture exiting the first hole at the second longitudinal surface extends into the second hole on the second longitudinal surface and exits the second hole at the first longitudinal surface with a length of suture extending adjacent the toggle body between the first hole and the second hole near the second longitudinal surface, the length of suture being encircled by the locking member near the second longitudinal surface.
12 . The pre-strung array of toggle-type suture anchors of claim 11 , wherein each locking member is slidably disposed in a chamber formed into the elongated body wherein it is movable between the first and second position.
13 . The pre-strung array of toggle-type suture anchors of claim 12 , wherein in the first position each locking member is positioned adjacent one of the elongated bodies' longitudinal surface to allow suture movement and in the second position pulls the locking member into the chamber sufficient to create a pinched or tortuous path that prevents movement of the suture in at least one direction.
14 . The pre-strung array of toggle-type suture anchors of claim 11 , further comprising a third hole through each of the plurality of toggle bodies extending from the first longitudinal surface to the second longitudinal surface and located between the first and second holes, wherein each locking member further comprises a pull suture extending from the locking member through the third hole at the first longitudinal surface after passing through the toggle body.
15 . The pre-strung array of toggle-type suture anchors of claim 9 , wherein each locking member compresses the suture adjacent the second longitudinal surface of one of the plurality of elongated toggle bodies when in the second position to thereby prevent the suture sliding through the locking member.
16 . A pre-strung array of toggle-type suture anchors comprising:
a plurality of elongated toggle bodies, each having at least a first hole through the toggle body extending from a first longitudinal surface to a second longitudinal surface;
a single suture serially disposed through each of the plurality of toggle bodies, wherein for each toggle body, the suture passing into the first hole at the first longitudinal surface and out the first hole at the second longitudinal surface, wherein the suture is adapted to slide through the first hole of each of the plurality of toggle bodies when a force is applied thereto; and
a separate suture lock for each of the plurality of toggle bodies, each suture lock adjacent a portion of the suture, each suture lock formed from a separate cord having a free distal end and a free proximal end, the separate cord encircling the suture and having a slidable knot formed from the free distal end and moveable from a first position allowing sliding movement of the suture relative to the toggle body and the suture lock, to a second position that closes the suture lock onto the suture to thereby prevent movement of the suture relative to the toggle body and the suture lock in at least one direction, the suture lock having a point of weakness configured to break and allow removal of the free proximal end of the suture lock.
17 . The pre-strung array of toggle-type suture anchors of claim 16 , wherein each of the plurality of elongate toggle bodies comprises a generally flat top and bottom surfaces and rounded side surfaces, the rounded side surfaces defining a maximum diameter of the elongate body and each of a proximal, a middle and a distal passage extending from the top surface to the bottom surface, each passage located at spaced intervals along the elongate body with the middle passage between the proximal and distal passages with the suture passing into the proximal passage at the top surface and out at the bottom surface, then back up through the distal passage at the bottom surface out at the top surface leaving a length of suture extending past the middle passage along the bottom surface wherein the cord has a tightening leg extending through the middle passage at the bottom surface and the suture lock encircles a portion of the length of the suture extending past the middle passage along the bottom surface.
18 . The pre-strung array of toggle-type suture anchors of claim 17 , wherein each suture lock is configured to collapse onto the suture when the tightening leg through the middle passage is tensioned.
19 . The pre-strung array of toggle-type suture anchors of claim 18 , wherein the middle passage has an upper portion for receiving the slidable knot at least partially therein from the top surface that terminates in a platform within the middle passage that does not allow passage of the slidable knot.
20 . The pre-strung array of toggle-type suture anchors of claim 16 , wherein each suture lock compresses the suture adjacent the second longitudinal surface of one of the plurality of elongated toggle bodies when in the second position to thereby prevent the suture sliding through the suture lock.