Tissue repair devices and methods of use
Tissue repair devices described herein allow for meniscal root repair with sutures and anchors delivered by a needle. The needle houses two deployable anchors, each connected to a separate suture. The device also includes a push mechanism that allows for reliable anchor deployment through the needle. The needle can have various degrees of curvature to access the superior or inferior surfaces of the meniscal roots. Each advancement of the push mechanism by the surgeon expels an individual suture/anchor construct from the distal tip of the needle at the desired location.
1 . A tissue repair device, comprising:
a handle;
an elongated needle defining a bore extending from the handle, the elongated needle including a proximal end and a distal end;
a first anchor disposed at least partially within the bore of the elongated needle, the first anchor defining a U-shaped suture pathway beginning and ending at a top surface of the first anchor;
a second anchor disposed at least partially within the bore of the elongated needle proximal to the first anchor;
a first flexible member, a distal end of the first flexible member comprising a round distal portion coupled to only the first anchor by routing a first free end thereof through the U-shaped suture pathway of the first anchor; and
a second flexible member separate from the first flexible member, a distal end of the second flexible member comprising a looped portion coupled to only the second anchor;
wherein, after routing through the U-shaped suture pathway of the first anchor, the first free end of the round distal portion of the first flexible member is further routed through a center of the round distal portion outside of the U-shaped suture pathway, creating a finger trap above the top surface of the first anchor, the first flexible member transitioning from the round distal portion at a first side of the finger trap to a flat proximal portion on a second side of the finger trap opposite the first side.
2 . The tissue repair device of claim 1 , further comprising:
a knob at least partially disposed within the handle; and
a hub coupled to the knob, the hub including a flange for manually advancing the knob over the hub.
3 . The tissue repair device of claim 2 , wherein the elongated needle extends from the handle through an outer tube extending through the hub.
4 . The tissue repair device of claim 1 , wherein a distal portion of the elongated needle is curved relative to a proximal portion of the elongated needle.
5 . The tissue repair device of claim 1 , wherein an outer surface of the elongated needle defines a slot extending from the outer surface to the bore, and wherein an upper surface of the first and second anchors projects above the slot.
6 . The tissue repair device of claim 5 , wherein a curvature of the elongated needle extends in-line with the slot.
7 . The tissue repair device of claim 1 , wherein the elongated needle further comprises a beveled, tissue piercing tip.
8 . The tissue repair device of claim 1 , wherein at least one of the first and second flexible members comprises suture or suture tape.
9 . The tissue repair device of claim 1 , wherein at least one of the first and second anchors comprises an elongate, generally cylindrical body and a rail extending from a top surface of the body.
10 . The tissue repair device of claim 9 , wherein at least one end of the rail includes a beveled end sloped toward the top surface of the body.
11 . The tissue repair device of claim 1 , wherein at least one of the first and second anchors has a symmetrical cross-section along both a length and width of the anchor.
12 . A method of tissue repair comprising:
creating at least one bone tunnel through a bone extending toward a tear in tissue;
inserting an elongated needle of a tissue repair device through the at least one bone tunnel, the tissue repair device comprising:
a handle;
the elongated needle defining a bore extending from the handle, the elongated needle including a proximal end and a distal end;
a first anchor disposed at least partially within the bore of the elongated needle, the first anchor defining a U-shaped suture pathway beginning and ending at a top surface of the first anchor;
a second anchor disposed at least partially within the bore of the elongated needle proximal to the first anchor;
a first flexible member, a distal end of the first flexible member comprising a round distal portion coupled to only the first anchor by routing a first free end thereof through the U-shaped suture pathway of the first anchor; and
a second flexible member separate from the first flexible member, a distal end of the second flexible member comprising a looped portion coupled to only the second anchor;
wherein, after routing through the U-shaped suture pathway of the first anchor, a first free end of the round distal portion of the first flexible member is further routed through a center of the round distal portion outside of the U-shaped suture pathway, creating a finger trap above the top surface of the first anchor, the first flexible member transitioning from the round distal portion at a first side of the finger trap to a flat proximal portion on a second side of the finger trap opposite the first side; and
deploying the first anchor from the bore of the elongated needle on a first side of the tear such that the first flexible member extends through the at least one bone tunnel to an outside surface of the bone.
13 . The method of claim 12 , further comprising deploying the second anchor from the bore of the elongated needle on a second side of the tear such that the second flexible member extends through the at least one bone tunnel to an outside surface of the bone.
14 . The method of claim 13 , further comprising securing second free ends of the first and second flexible members to the outside surface of the bone with a fixation device.