Soft tissue repair device and associated methods
A soft tissue repair device. The device includes an inserter having a distal portion, a first anchor carried externally onto the distal portion, a second anchor carried externally onto the distal portion, and a flexible strand coupling the first and second anchors and forming an adjustable knotless loop.
1. A meniscal tissue repair device, comprising:
an outer tube, the outer tube comprising an open distal end and a longitudinal bore that extends through the outer tube to the open distal end;
an inserter received in the longitudinal bore of the outer tube, the inserter including a distal portion with an inclined sharp edge for piercing through meniscal tissue, the inserter further including a longitudinal channel that extends to the distal portion of the inserter;
a first flexible tubular anchor deployable from the inserter at a first location along an outer surface of a meniscus;
a second flexible tubular anchor deployable from the inserter at a second location along the outer surface of the meniscus, wherein, prior to deployment of the first flexible tubular anchor from the inserter along the outer surface of the meniscus, the second flexible tubular anchor is located proximal of the first flexible tubular anchor along the inserter;
a suture coupling the first flexible tubular anchor to the second flexible tubular anchor; and
a deploying member, the deploying member including a proximal shaft portion and a projection that projects from a side of the deploying member at a distal end of the deploying member, the deploying member having a first width at the proximal shaft portion and a second width at the projection that is greater than the first width, the deploying member slidably received in the longitudinal channel of the inserter, wherein, prior to deployment of the first flexible tubular anchor from the inserter along the outer surface of the meniscus, the deploying member extends to the first flexible tubular anchor through the second flexible tubular anchor along the longitudinal channel of the inserter, wherein the projection is configured to:
engage the first flexible tubular anchor prior to deployment of the first flexible tubular anchor from the inserter along the outer surface of the meniscus;
be advanced distally along the inserter while so engaging the first flexible tubular anchor so as to force the first flexible tubular anchor from the inserter at the first location along the outer surface of the meniscus;
be retracted proximally along the inserter and into engagement with the second flexible tubular anchor; and
be advanced distally along the inserter while so engaging the second flexible tubular anchor so as to force the second flexible tubular anchor from the inserter at the second location along the outer surface of the meniscus.
2. The meniscal tissue repair device of claim 1 further comprising a hollow shaft received in the longitudinal bore of the outer tube, the hollow shaft received over the deploying member with a distal end of the hollow shaft contacting the second flexible tubular anchor to provide a stop for the second flexible tubular anchor.
3. The meniscal tissue repair device of claim 1 , wherein the projection is configured to engage an intermediate portion of the first flexible tubular anchor prior to deployment of the first flexible tubular anchor from the inserter along the outer surface of the meniscus, the intermediate portion located between a first end and a second end of the first flexible tubular anchor.
4. The meniscal tissue repair device of claim 1 , wherein the suture comprises an adjustable loop.
5. The meniscal tissue repair device of claim 4 , wherein the adjustable loop is a knotless adjustable loop.
6. A meniscal tissue repair device, comprising:
an outer tube, the outer tube comprising an open distal end and a longitudinal bore that extends through the outer tube to the open distal end;
an inserter received in the longitudinal bore of the outer tube, the inserter including a distal portion with an inclined sharp edge for piercing through meniscal tissue, the inserter further including a longitudinal channel that extends to the distal portion of the inserter;
a first flexible tubular anchor deployable from the inserter at a first location along an outer surface of a meniscus;
a second flexible tubular anchor deployable from the inserter at a second location along the outer surface of the meniscus, wherein, prior to deployment of the first flexible tubular anchor from the inserter along the outer surface of the meniscus, the second flexible tubular anchor is located proximal of the first flexible tubular anchor along the inserter;
a suture coupling the first flexible tubular anchor to the second flexible tubular anchor; and
a deploying member received in the longitudinal channel of the inserter and including a projection that projects from a side of the deploying member, the deploying member longitudinally slidable in the longitudinal channel of the inserter from a first deployment position to additional deployment positions for deploying the first flexible tubular anchor and the second flexible tubular anchor from the inserter along the outer surface of the meniscus,
wherein, in the first deployment position, the deploying member, while received in the longitudinal channel of the inserter, extends through the second flexible tubular anchor such that the projection is located distally of the second flexible tubular anchor and engages an intermediate portion of the first flexible tubular anchor, the intermediate portion located between a first end and a second end of the first flexible tubular anchor,
wherein the deploying member is movable distally in the longitudinal channel of the inserter from the first deployment position to a second deployment position to thereby force the first flexible tubular anchor to move distally relative to the inserter, wherein, in the second deployment position, the deploying member remains extending through the second flexible tubular anchor and the projection engages the first flexible tubular anchor distally of the inclined sharp edge of the distal portion of the inserter for deploying the first flexible tubular anchor from the inserter,
wherein the deploying member is movable proximally in the longitudinal channel of the inserter from the second deployment position to a third deployment position, wherein, in the third deployment position, the projection: (i) no longer engages the first flexible tubular anchor; and (ii) has been pulled back through at least part of the second flexible tubular anchor, and
wherein the deploying member is movable distally in the longitudinal channel of the inserter from the third deployment position to a fourth deployment position to thereby force the second flexible tubular anchor to move distally relative to the inserter, wherein, in the fourth deployment position, the projection engages the second flexible tubular anchor distally of the inclined sharp edge of the distal portion of the inserter for deploying the second flexible tubular anchor from the inserter.
7. The meniscal tissue repair device of claim 6 further comprising a hollow shaft received in the longitudinal bore of the outer tube, the hollow shaft received over the deploying member with a distal end of the hollow shaft contacting the second flexible tubular anchor to provide a stop for the second flexible tubular anchor.
8. The meniscal tissue repair device of claim 6 , wherein the deploying member includes a proximal shaft portion, and wherein the projection is located at a distal end of the deploying member, the deploying member having a first width at the proximal shaft portion and a second width at the projection that is greater than the first width.
9. The meniscal tissue repair device of claim 6 , wherein the suture comprises an adjustable loop.
10. The meniscal tissue repair device of claim 9 , wherein the adjustable loop is a knotless adjustable loop.
11. The meniscal tissue repair device of claim 6 , wherein the projection is an elastically deformable projection.
12. A meniscal tissue repair device, comprising:
an outer tube, the outer tube comprising an open distal end and a longitudinal bore that extends through the outer tube to the open distal end;
an inserter received in the longitudinal bore of the outer tube, the inserter including a distal portion with an inclined sharp edge for piercing through meniscal tissue, the inserter further including a longitudinal channel that extends to the distal portion of the inserter;
a first flexible tubular anchor deployable from the inserter at a first location along an outer surface of a meniscus;
a second anchor coupled to the first anchor with a suture and deployable from the inserter at a second location along the outer surface of the meniscus, wherein, prior to deployment of the first flexible tubular anchor from the inserter along the outer surface of the meniscus, the second flexible tubular anchor is located proximal of the first flexible tubular anchor along the inserter; and
a deploying member movable back and forth in the longitudinal channel of the inserter for deploying the first flexible tubular anchor and the second flexible tubular anchor from the inserter, the deploying member including a projection that projects from a side of the deploying member, the projection positioned distal of the second flexible tubular anchor along the inserter while the deploying member is extending through the second flexible tubular anchor and while the projection is engaging an intermediate portion of the first flexible tubular anchor so that, via engagement of the intermediate portion with the projection, the first flexible tubular anchor can be forced from the inserter when the deploying member is moved distally in the longitudinal channel, the intermediate portion located between a first end and a second end of the first flexible tubular anchor.
13. The meniscal tissue repair device of claim 12 , wherein the deploying member is movable back through the longitudinal channel of the inserter in a proximal direction following deployment of the first flexible tubular anchor from the inserter such that the projection passes through at least part of the second flexible tubular anchor and into engagement with the second flexible tubular anchor so that, via engagement of the second flexible tubular anchor with the projection, the second flexible tubular anchor can be forced from the inserter when the deploying member is again moved distally in the longitudinal channel.
14. The meniscal tissue repair device of claim 12 , wherein the deploying member includes a proximal shaft portion, and wherein the projection is located at a distal end of the deploying member, the deploying member having a first width at the proximal shaft portion and a second width at the projection that is greater than the first width.
15. The meniscal tissue repair device of claim 12 , wherein the longitudinal channel of the inserter includes a channel opening on a side of the inserter, and wherein a portion of the suture coupling the first flexible tubular anchor to the second flexible tubular anchor extends through the channel opening so as to reside outside of the inserter.
16. The meniscal tissue repair device of claim 12 , wherein the suture comprises an adjustable loop.
17. The meniscal tissue repair device of claim 16 , wherein the adjustable loop is a knotless adjustable loop.
18. The meniscal tissue repair device of claim 12 , wherein the first flexible tubular anchor and the second flexible tubular anchor each comprise a braided suture material.
19. A meniscal tissue repair device, comprising:
an outer tube, the outer tube comprising an open distal end and a longitudinal bore that extends through the outer tube to the open distal end;
an inserter received in the longitudinal bore of the outer tube, the inserter including a distal portion with an inclined sharp edge for piercing through meniscal tissue, the inserter further including a longitudinal channel that extends to the distal portion of the inserter;
a first flexible tubular anchor deployable from the inserter at a first location along an outer surface of a meniscus;
a second flexible tubular anchor deployable from the inserter at a second location along the outer surface of the meniscus, wherein, prior to deployment of the first flexible tubular anchor from the inserter along the outer surface of the meniscus, the second flexible tubular anchor is located proximal of the first flexible tubular anchor along the inserter; a suture coupling the first flexible tubular anchor to the second flexible tubular anchor; and
a deploying member received in the longitudinal channel of the inserter, the deploying member including a proximal shaft portion and a projection that projects from a side of the deploying member at a distal end of the deploying member, the deploying member having a first width at the proximal shaft portion and a second width at the projection that is greater than the first width, the deploying member longitudinally slidable in the longitudinal channel of the inserter from a first deployment position to additional deployment positions for deploying the first flexible tubular anchor and the second flexible tubular anchor from the inserter along the outer surface of the meniscus,
wherein, in the first deployment position, the deploying member, while received in the longitudinal channel of the inserter, extends through the second flexible tubular anchor and into engagement with the first flexible tubular anchor,
wherein the deploying member is movable distally in the longitudinal channel of the inserter from the first deployment position to a second deployment position to thereby force the first flexible tubular anchor from the inserter at the first location along the outer surface of the meniscus, wherein, in the second deployment position, the deploying member remains extending through the second flexible tubular anchor,
wherein the deploying member is movable proximally in the longitudinal channel of the inserter from the second deployment position to a third deployment position to thereby retract the projection relative to the inserter and move the projection proximally through at least part of the second flexible tubular anchor, and
wherein the deploying member is movable distally in the longitudinal channel of the inserter from the third deployment position to a fourth deployment position to thereby force the second flexible tubular anchor from the inserter at the second location along the outer surface of the meniscus.
20. The meniscal tissue repair device of claim 19 further comprising a stop member contacting the second flexible tubular anchor for preventing the second flexible tubular anchor from sliding backwards relative to the inserter.
21. The meniscal tissue repair device of claim 19 , wherein the longitudinal channel of the inserter includes a channel opening on a side of the inserter, and wherein, in the first deployment position, a portion of the suture coupling the first flexible tubular anchor to the second flexible tubular anchor extends through the channel opening so as to reside outside of the inserter.
22. The meniscal tissue repair device of claim 19 , wherein the suture comprises an adjustable knotless loop.
23. The meniscal tissue repair device of claim 19 , wherein, in the first deployment position, the projection engages an intermediate portion of the first flexible tubular anchor, the intermediate portion located between a first end and a second end of the first flexible tubular anchor.