Biceps tenodesis implants and delivery tools
Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a surgical implant is provided having a sheath and an expander that is received within the sheath. Various delivery tools, including a sheath inserter and a driver, are also provided. In use, the sheath inserter can be used to position a tendon within a prepared bone hole, and it can be used to deliver the sheath with a guidewire coupled thereto into the bone hole. The driver can be provided for delivering the expander into the sheath. A loader can optionally be used to load the driver and expander onto the guidewire coupled to the implanted sheath.
1. An anchor assembly for anchoring a tendon to bone, comprising:
a sheath having a substantially solid distal end with only two sidewalls extending proximally therefrom and separated by first and second slots, a width between the slots decreasing toward the substantially solid distal end, the sidewalls defining an inner lumen therebetween, and the solid distal end of the sheath having a mating feature, wherein the sheath includes at least one anti-collapse tab formed on at least one of the sidewalls adjacent to one of the first and second slots, the at least one anti-collapse tab being configured to limit movement of the sidewalls toward one another;
a guidewire having a distal tip configured to releasably mate with the mating feature in the sheath, the guidewire extending proximally from the sheath when mated thereto; and
an expander having a generally elongate cylindrical configuration, tapered distally along a distal portion, and configured to be received within the inner lumen of the sheath, the expander having a lumen extending therethrough for receiving the guidewire.
2. The anchor assembly of claim 1 , wherein the mating feature comprises a threaded bore formed in the sheath and the distal tip on the guidewire is threaded for threadably engaging the threaded bore.
3. The anchor assembly of claim 1 , wherein the sheath includes at least one anti-plunge tab extending radially outward from a proximal-most end thereof and configured to limit an insertion depth of the sheath into a bone hole.
4. The anchor assembly of claim 3 , wherein the sheath includes at least one retaining tab extending radially outward from the sheath at a predetermined distance from the at least one anti-plunge tab, the distance being configured such that the at least one anti-plunge tab can be positioned on a proximal surface of cortical bone and the at least one retaining tab can be positioned on a distal surface of the cortical bone.
5. The anchor assembly of claim 1 , wherein a distal-facing end of the sheath is concave for seating a tendon.
6. The anchor assembly of claim 1 , wherein a proximal-facing end of the sheath is convex.
7. The anchor assembly of claim 1 , wherein the sidewalls have an increased thickness at a mid-portion thereof as compared to proximal and distal portions thereof.
8. The anchor assembly of claim 1 , wherein the sidewalls include ribs extending radially therearound.
9. The anchor assembly of claim 8 , wherein the ribs on a first sidewall of the anchor are angled distally and the ribs on a second opposite sidewall of the anchor are angled proximally.
10. The anchor assembly of claim 1 , wherein the sidewalls of the anchor have threads formed on an internal surface thereof, and the expander includes threads formed on an external surface thereof for threadably mating with the threads formed on the internal surface of the at least two sidewalls.
11. The anchor assembly of claim 1 , wherein the first and second slots each have a proximal portion, a distal portion, and a transition region extending between the proximal and distal portions, the proximal and distal portions each having a constant width, and the transition region having a width that tapers inward in a distal direction.
12. The anchor assembly of claim 11 , wherein a length of transition region is substantially equally to a width of the proximal portion.
13. An anchor assembly for anchoring a tendon to bone, comprising:
a sheath having
a substantially solid end,
two sidewalls extending proximally from the distal end, the sidewalls being separated by at least two slots, a width between the slots decreasing toward the substantially solid distal end, and the sidewalls defining an inner lumen therebetween,
at least one anti-plunge tab extending from a proximal-most end of the sheath adjacent to at least one of the slots, the at least one anti-plunge tab preventing over-insertion of the sheath into a bone hole,
at least one retaining tab extending from the sheath at a location distal to the at least one anti-plunge tab, the at least one retaining tab being positioned a distance apart from the at least one anti-plunge tab, the distance being configured such that when the at least one anti-plunge tab is positioned on a proximal surface of a cortical bone, the at least one retaining tab will extend beneath a distal surface of the cortical bone,
at least one anti-collapse tab formed on at least one of the sidewalls adjacent to one of the first and second slots, the at least one anti-collapse tab being configured to limit movement of the sidewalls toward one another; and
an expander configured to be received between the at least two sidewalls on the sheath to cause the sheath to expand and engage bone.
14. The anchor assembly of claim 13 , wherein the at least one anti-plunge tab comprises a pair of anti-plunge tabs, and the at least one retaining tab comprises a pair of retaining tabs.
15. The anchor assembly of claim 13 , wherein the distance is greater than about 0.5 mm.
16. The anchor assembly of claim 13 , wherein the at least one anti-plunge tab extends radially outward by a distance that is greater than a distance that the at least one retaining tab extends outward.
17. The anchor assembly of claim 13 , wherein the at least one anti-plunge tab is co-planar with the at least one retaining tab.