Suture anchor and method
Suture anchors and associated methods are disclosed having suture securing features able to lock suture ends extending from a body tissue, such as from a bone tunnel.
1. A method of repairing soft tissue comprising:
forming a bone tunnel through a bone adjacent to the soft tissue to be repaired, the bone tunnel having at least first and second spaced apart openings at a surface of the bone;
positioning a suture and an anchor proximate the bone tunnel, the anchor having a one-piece implant body, a first portion of the suture being attached to and/or routed through the one-piece implant body and a second portion of the suture being free;
placing the second portion of the suture through the bone tunnel and the soft tissue;
passing the second portion of the suture through a transverse aperture in the one-piece implant body, the transverse aperture extending to an outer surface of the one-piece implant body; and
connecting the second portion of the suture to the anchor; wherein the one-piece implant body further comprises an elongated body having a proximal end and a distal end, the first portion of the suture being attached to the distal end of the elongated body; and wherein a longitudinal passage extends into the elongated body.
2. The method of claim 1 further comprising, after placing the anchor into one of the bone tunnel openings, tensioning the suture.
3. The method of claim 2 wherein connecting the second portion of the suture to the anchor further comprises, after tensioning the suture:
provisionally engaging the second portion of the suture to the anchor such that the tension on the suture is maintained while the provisional engagement is easily reversed; and
evaluating the soft tissue repair.
4. The method of claim 3 further comprising, after provisionally engaging the second portion of the suture to the anchor and evaluating the soft tissue repair, adjusting the suture.
5. The method of claim 1 wherein placing the anchor into one of the bone tunnel openings comprises pulling on the second portion of the suture to advance the anchor into the bone tunnel.
6. The method of claim 1 wherein the suture comprises at least one suture strand having a first end and a second end, one end of the suture strand being attached to the anchor and the other end being free.
7. The method of claim 1 wherein the suture comprises at least one closed loop with a first portion of the loop being attached to the anchor and a second portion of the loop being free.
8. The method of claim 1 wherein the first portion of the suture is attached to the anchor by at least one of the methods consisting of tying, molding, crimping, and adhering.
9. The method of claim 1 wherein the bone tunnel is formed through the bone as a single continuous path from the first opening on the surface of the bone to the second opening on the surface of the bone.
10. The method of claim 9 wherein the bone tunnel is straight.
11. The method of claim 9 wherein the bone tunnel is curved.
12. The method of claim 1 wherein the bone tunnel is formed through the bone by first and second intersecting bores into the bone.
13. The method of claim 1 wherein the anchor further comprises an insert receivable in the longitudinal passage, the insert being operable to attach the second portion of the suture to the elongated body, wherein connecting the second portion of the suture to the anchor comprising advancing the insert into the longitudinal passage.
14. The method of claim 13 further comprising, after placing the anchor into one of the bone tunnel openings, tensioning the suture and advancing the insert in the longitudinal passage to a provisional locking position in which tension on the suture is maintained while the insert is still easily retractable to allow for suture adjustment.
15. The method of claim 14 further comprising, after advancing the insert to the provisional locking position, evaluating the soft tissue repair.
16. The method of claim 15 further comprising, after evaluating the soft tissue repair, retracting the insert, adjusting the suture, and advancing the suture to the provisional locking position.
17. The method of claim 16 further comprising advancing the insert to a final locking position in which it is difficult to retract the insert.
18. The method of claim 13 wherein the second portion of the suture extends distally away from the anchor, a step of placing the anchor into one of the bone tunnel openings comprising pulling on the second portion of the suture to advance the anchor into the bone tunnel opening.
19. The method of claim 13 wherein the insert includes a proximal end and a distal end and an insert aperture formed transversely at least part way through the insert between the proximal and distal ends of the invert for receiving the second portion of the suture, a step of connecting the second portion of the suture to the anchor comprising inserting the second portion of the suture into the insert aperture.
20. The method of claim 1 further comprising: after placing the second portion of the suture through the bone tunnel and the soft tissue, and after passing the second portion of the suture through the transverse aperture and pulling it proximally so that the second portion of the suture lies alongside the anchor; then placing the anchor into one of the bone tunnel openings such that the second portion of the suture is between a tunnel wall and the anchor; pulling on the second portion of the suture to provisionally tension the soft tissue repair, tension being temporarily maintained by a pressure on the second portion of the suture from the tunnel wall and anchor; and connecting the second portion of the suture to the anchor by advancing an insert into the longitudinal passage.
21. The method of claim 1 wherein forming the bone tunnel through the bone adjacent to the soft tissue to be repaired comprises forming the bone tunnel through a proximal humeral bone adjacent to a rotator cuff.
22. A method of repairing soft tissue adjacent a shoulder joint comprising a proximal humeral bone and a rotator cuff, the method comprising:
forming a bone tunnel through the proximal humeral bone adjacent to the rotator cuff, the bone tunnel having at least first and second spaced apart openings at a surface of the bone;
providing a suture and an anchor with a one-piece implant body, a first portion of the suture being attached to and/or routed through the one-piece implant body and a second portion of the suture being free;
placing the second portion of the suture through the bone tunnel and the soft tissue;
passing the second portion of the suture through a transverse aperture in the one-piece implant body and directly from the transverse aperture to a location outside the one-piece implant body; and
placing the implant body into one of the bone tunnel openings; wherein the one-piece implant body further comprises an elongated body having a proximal end and a distal end, the first portion of the suture being attached to the distal end of the elongated body; and wherein a longitudinal passage extends into the elongated body.
23. The method of claim 22 wherein the anchor further comprises an insert receivable in the longitudinal passage, the insert being operable to attach the second portion of the suture to the elongated body, wherein connecting the second portion of the suture to the anchor comprising advancing the insert into the longitudinal passage.
24. A method of repairing soft tissue comprising:
forming a bone tunnel through a bone adjacent to the soft tissue to be repaired, the bone tunnel having at least first and second spaced apart openings at a surface of the bone;
positioning a suture and an anchor proximate the bone tunnel, the anchor having a one-piece implant body, a first portion of the suture being attached to and/or routed through the implant body at a location offset from a longitudinal axis of the anchor and extending initially from the location generally parallel to the longitudinal axis, and a second portion of the suture being free;
placing the second portion of the suture through the bone tunnel and the soft tissue;
placing the anchor into one of the bone tunnel openings;
engaging the second portion of the suture with the one-piece implant body in such a manner that the second portion is oriented generally perpendicular to the first portion of the suture; and
after engaging the second portion of the suture with the one-piece implant body, securing the second portion to the one-piece implant body to prevent disengagement of the second portion from the one-piece implant body.
25. The method of claim 24 wherein the anchor has a transverse aperture; and wherein engaging the second portion of the suture with the anchor further comprises: passing the second portion of the suture through the transverse aperture in the anchor.