Method and apparatus for treating a hip joint, including the provision and use of a novel suture passer

1. A suture passer comprising:

a shaft having an axis;

a first jaw mounted to a distal end of the shaft in alignment with the axis, the first jaw being configured to releasably support a length of suture thereon;

a second jaw movably mounted to the shaft; and

a needle movably mounted to the shaft, the needle having a hook and being configured to reciprocate in alignment with the axis of the shaft so that the hook can selectively pass out of the second jaw and then engage suture releasably supported on the first jaw;

wherein the first jaw comprises a movable element for selectively preventing movement of the suture along the axis of the shaft, wherein the movable element is biased to inhibit movement of the suture along the axis of the shaft, wherein the movable element comprises a pathway for receiving the needle.

2. A suture passer according to claim 1 wherein the movable element comprises an inclined surface.

3. A suture passer according to claim 1 wherein the first jaw comprises a slot sized to receive the suture therein.

4. A suture passer according to claim 3 wherein the slot comprises a first portion opening on a proximal portion of the first jaw and extending distally.

5. A suture passer according to claim 4 wherein the slot comprises a second portion extending transverse to the first portion.

6. The suture passer according to claim 3 wherein the movable element pushes the suture in a direction transverse to the direction of the axis of the shaft.

7. A suture passer according to claim 1 wherein the second jaw is configured to reciprocate in alignment with the axis so as to advance toward, and retract from, the first jaw.

8. A suture passer according to claim 1 wherein the movable element comprises a spring.

9. A suture passer according to claim 1 wherein the first jaw comprises a passage for the needle.

10. A suture passer according to claim 1 wherein the needle comprises a bevel, and further wherein the bevel is configured so that when a suture is disposed on the first jaw and the bevel engages the suture, the bevel causes the suture to move away from the axis of the shaft, and when the bevel disengages from the suture, the suture moves back toward the axis of the shaft.

11. A suture passer according to claim 10 wherein the needle has a longitudinal axis, and further wherein the distalmost point of the needle is disposed laterally of the longitudinal axis of the needle.

12. A suture passer according to claim 1 wherein the movable element comprises a proximal rise, a distal rise and a trough formed between the proximal rise and the distal rise for accommodating the suture in the trough between the proximal rise and the distal rise.

13. The suture passer according to claim 1 wherein the hook comprises a proximally-facing hooking surface.

14. A suture passer comprising:

a shaft having an axis;

a first jaw mounted to the shaft in alignment with the axis, the first jaw being configured to releasably support a length of suture thereon;

an element movably mounted to the first jaw, wherein the element is configured to move between a first position wherein the element inhibits a suture from moving axially past the element and a second position in which the element does not inhibit the suture from moving axially past the element;

a spring for yieldably biasing the element toward the first position from the second position;

a second jaw movably mounted to the shaft for reciprocal movement towards and away from the first jaw; and

a needle movably mounted to the shaft, the needle having a hook and being configured to reciprocate in alignment with the axis of the shaft so that the hook can snare a suture releasably supported on the first jaw, wherein the element comprises a pathway for receiving the needle.

15. A suture passer according to claim 14 wherein the element comprises a spring.

16. A suture passer according to claim 14 wherein the element comprises an inclined surface.

17. A suture passer according to claim 14 wherein the needle comprises a bevel, and further wherein the bevel is configured so that when a suture is disposed on the first jaw and the bevel engages the suture, the bevel causes the suture to move away from the axis of the shaft, and when the bevel disengages from the suture, the suture moves back toward the axis of the shaft.

18. A suture passer according to claim 17 wherein the needle has a longitudinal axis, and further wherein the distalmost point of the needle is disposed laterally of the longitudinal axis of the needle.

19. A suture passer according to claim 14 wherein the first jaw comprises a slot sized to receive the suture therein.

20. A suture passer according to claim 19 wherein the slot comprises a first portion opening on a proximal portion of the first jaw and extending distally.

21. A suture passer according to claim 20 wherein the slot comprises a second portion extending transverse to the first portion.

22. The suture passer according to claim 19 wherein the element pushes the suture in a direction transverse to the direction of the axis of the shaft.

23. A suture passer according to claim 14 wherein the first jaw comprises a passage for the needle.

24. A suture passer according to claim 14 wherein the second jaw is configured to reciprocate in alignment with the axis so as to advance toward, and retract from, the first jaw.

25. A suture passer according to claim 14 wherein the element comprises a proximal rise, a distal rise and a trough formed between the proximal rise and the distal rise for accommodating the suture in the trough between the proximal rise and the distal rise.

26. The suture passer according to claim 14 wherein the hook comprises a proximally-facing hooking surface.

27. A suture passer comprising:

a shaft having a distal end, a proximal end and an axis extending between the distal end and the proximal end;

a jaw mounted to the shaft in alignment with the axis, the jaw comprising a suture slot sized to receive a length of suture therein, wherein the suture slot opens on a proximal portion of the jaw and extends distally; and

a needle movably mounted to the shaft, the needle being configured to reciprocate in alignment with the axis of the shaft so that the needle can selectively engage suture received in the suture slot;

wherein the jaw comprises a spring and a member biased by the spring, the spring being configured to (i) project the member to inhibit proximal movement of the suture out of the suture slot, and (ii) allow retraction of the member to allow proximal movement of the suture out of the suture slot and out of engagement with the jaw, wherein the member comprises a pathway for receiving the needle.

28. A suture passer according to claim 27 wherein the member comprises an inclined surface.

29. A suture passer according to claim 27 wherein the jaw comprises a passage for the needle.

30. A suture passer according to claim 27 wherein the suture slot comprises a portion extending transverse to the axis of the shaft.

31. A suture passer according to claim 27 wherein the needle comprises a bevel, and further wherein the bevel is configured so that when a suture is disposed on the jaw and the bevel engages the suture, the bevel causes the suture to move away from the axis of the shaft, and when the bevel disengages from the suture, the suture moves back toward the axis of the shaft.

32. A suture passer according to claim 31 wherein the needle has a longitudinal axis, and further wherein the distalmost point of the needle is disposed laterally of the longitudinal axis of the needle.

33. A suture passer according to claim 27 wherein the member comprises a proximal rise, a distal rise and a trough formed between the proximal rise and the distal rise for accommodating the suture in the trough between the proximal rise and the distal rise.

34. The suture passer according to claim 27 wherein the needle comprises a hook, wherein the hook comprises a proximally-facing hooking surface.

35. The suture passer according to claim 27 wherein the spring pushes the suture in a direction transverse to the direction of the axis of the shaft.

36. The suture passer according to claim 27 wherein the suture passer comprises a second jaw.

37. The suture passer according to claim 36 wherein the second jaw is configured to reciprocate in alignment with the axis so as to advance toward, and retract from, the jaw.

38. A suture passer comprising:

a shaft having a distal end, a proximal end and an axis extending between the distal end and the proximal end;

a jaw mounted to the distal end of the shaft in alignment with the axis, the jaw being configured to releasably support a length of suture thereon, wherein the jaw comprises a proximal end and a distal end, a first lateral outside surface and a second lateral outside surface, wherein the jaw further comprises a suture slot, wherein the suture slot opens on the proximal end of the jaw and extends distally, and further wherein the suture slot extends from the first lateral outside surface of the jaw to the second lateral outside surface of the jaw;

a needle movably mounted to the shaft, the needle being configured to reciprocate in alignment with the axis of the shaft so that the needle can selectively engage suture releasably supported on the jaw; a member; and

a spring for biasing the member for selectively restraining the suture from exiting the proximal end of the suture slot, wherein the member comprises a pathway for receiving the needle.

39. A suture passer according to claim 38 wherein the member comprises an inclined surface.

40. A suture passer according to claim 38 wherein the jaw comprises a passage for the needle.

41. A suture passer according to claim 38 wherein the suture slot comprises a portion extending transverse to the axis of the shaft.

42. A suture passer according to claim 38 wherein the needle comprises a bevel, and further wherein the bevel is configured so that when a suture is disposed on the jaw and the bevel engages the suture, the bevel causes the suture to move away from the axis of the shaft, and when the bevel disengages from the suture, the suture moves back toward the axis of the shaft.

43. A suture passer according to claim 42 wherein the needle has a longitudinal axis, and further wherein the distalmost point of the needle is disposed laterally of the longitudinal axis of the needle.

44. A suture passer according to claim 38 wherein the member comprises a proximal rise, a distal rise and a trough formed between the proximal rise and the distal rise for accommodating the suture in the trough between the proximal rise and the distal rise.

45. The suture passer according to claim 38 wherein the needle comprises a hook, wherein the hook comprises a proximally-facing hooking surface.

46. The suture passer according to claim 38 wherein the spring pushes the suture in a direction transverse to the direction of the axis of the shaft.

47. The suture passer according to claim 38 wherein the suture passer comprises a second jaw.

48. The suture passer according to claim 47 wherein the second jaw is configured to reciprocate in alignment with the axis so as to advance toward, and retract from, the jaw.

49. A suture passer comprising:

a shaft having an axis;

a jaw mounted to a distal end of the shaft in alignment with the axis, the jaw being configured to releasably support a length of suture thereon; and

a needle movably mounted to the shaft, the needle being configured to reciprocate in alignment with the axis of the shaft so that the needle can engage suture releasably supported on the jaw;

wherein the jaw comprises a movable element, wherein the movable element comprises a pair of proximal rises and a pair of distal rises, and further wherein an axial pathway for receiving the needle is disposed between the pair of proximal rises and between the pair of distal rises, wherein the movable element comprises a pathway for receiving the needle.