Methods and devices for accessing and retracting a capsule of a joint
Devices and methods are disclosed herein for accessing the hip joint. A first device can be securely attached to the capsule of a joint. The first device can tent the capsule to increase the volume of the peripheral compartment. A second device can be biased against the first device to pierce the tented capsule and create a portal. Devices and methods are also disclosed herein for distending the capsule of a joint. A distention device may access a portal established within the capsule. The distention device can expand the capsule by applying an expansive force within the peripheral compartment. The distention device can maintain distention of the peripheral compartment while other devices access the joint.
1. A method of closing a capsule of a joint, the method comprising:
forming a cut in the capsule of the joint so as to create a first flap of the capsule and a second flap of the capsule;
providing a first length of suture having a first anchor attached to one end of the first length of suture;
providing a second length of suture having a second anchor attached to one end of the second length of suture;
passing the first length of suture through the first flap of the capsule of the joint so that the first anchor is positioned against an exterior surface of the first flap of the capsule of the joint and the first length of suture extends out of the joint;
passing the second length of suture through the second flap of the capsule of the joint so that the second anchor is positioned against an exterior surface of the second flap of the capsule of the joint and the second length of suture extends out of the joint;
tying the first length of suture and the second length of suture together so as to close the capsule of the joint.
2. The method according to claim 1 wherein the method further comprises:
prior to tying the first length of suture and the second length of suture together, pulling at least one of the first and second lengths of suture so as to retract at least one of the first and second flaps of the capsule of the joint; and
performing an arthroscopic procedure in the joint while the capsule is retracted.
3. The method according to claim 1 wherein at least one of the first and second anchors comprises a T-bar anchor.
4. The method according to claim 1 wherein at least one of the first and second anchors comprises a body which is configured to assume (i) a first, folded configuration when the body is in a stressed condition, and (ii) a second, straight configuration when the body is in an unstressed condition.
5. The method according to claim 1 wherein passing the first length of suture through the first flap of the capsule of the joint comprises loading the first length of suture through a needle and passing the needle through the first flap of the capsule.
6. The method according to claim 1 wherein passing the second length of suture through the second flap of the capsule of the joint comprises loading the second length of suture through a needle and passing the needle through the second flap of the capsule.
7. The method according to claim 1 wherein the first anchor is positioned against the exterior surface of the first flap of the capsule by passing the first length of suture through the first flap of the capsule and pulling the first length of suture until the first anchor is positioned against the exterior surface of the first flap of the capsule.
8. The method according to claim 1 wherein the second anchor is positioned against the exterior surface of the second flap of the capsule by passing the second length of suture through the second flap of the capsule and pulling the second length of suture until the second anchor is positioned against the exterior surface of the second flap of the capsule.
9. The method according to claim 1 wherein the cut is formed in the capsule of the joint before positioning the first anchor and the second anchor against the exterior surface of the first flap and the exterior surface of the second flap, respectively.
10. The method according to claim 1 wherein the cut is formed in the capsule of the joint after positioning the first anchor and the second anchor against the exterior surface of the first flap and the exterior surface of the second flap, respectively.
11. A method of retracting a capsule of a joint, the method comprising:
forming a cut in the capsule of the joint so as to create a first flap of the capsule and a second flap of the capsule;
providing a first length of suture having a first anchor attached to one end of the first length of suture;
providing a second length of suture having a second anchor attached to one end of the second length of suture;
passing the first length of suture through the first flap of the capsule of the joint so that the first anchor is positioned against a surface of the first flap of the capsule of the joint and the first length of suture extends out of the joint;
passing the second length of suture through the second flap of the capsule of the joint so that the second anchor is positioned against a surface of the second flap of the capsule of the joint and the second length of suture extends out of the joint;
pulling at least one of the first and second lengths of suture so as to retract at least one of the first and second flaps of the capsule of the joint; and
performing an arthroscopic procedure in the joint while the capsule is retracted.
12. The method of claim 11 wherein the method further comprises tying the first length of suture and the second length of suture together so as to close the capsule of the joint.
13. The method according to claim 11 wherein the first and second anchors are positioned against the exterior surface of the first and second flaps, respectively, of the capsule of the joint.
14. The method according to claim 11 wherein the first and second anchors are positioned against the interior surface of the first and second flaps, respectively, of the capsule of the joint.
15. The method according to claim 11 wherein at least one of the first and second anchors comprises a T-bar anchor.
16. The method according to claim 11 wherein at least one of the first and second anchors comprises a body which is configured to assume (i) a first, folded configuration when the body is in a stressed condition, and (ii) a second, straight configuration when the body is in an unstressed condition.
17. The method according to claim 11 wherein passing the first length of suture through the first flap of the capsule of the joint comprises loading the first length of suture through a needle and passing the needle through the first flap of the capsule.
18. The method according to claim 11 wherein passing the second length of suture through the second flap of the capsule of the joint comprises loading the second length of suture through a needle and passing the needle through the second flap of the capsule.
19. The method according to claim 13 wherein the first anchor is positioned against the exterior surface of the first flap of the capsule by passing the first length of suture through the first flap of the capsule and pulling the first length of suture until the first anchor is positioned against the exterior surface of the first flap of the capsule.
20. The method according to claim 13 wherein the second anchor is positioned against the exterior surface of the second flap of the capsule by passing the second length of suture through the second flap of the capsule and pulling the second length of suture until the second anchor is positioned against the exterior surface of the second flap of the capsule.
21. The method according to claim 14 wherein the first anchor is positioned against the interior surface of the first flap of the capsule by passing the first length of suture and the first anchor through the first flap of the capsule and pulling the first length of suture until the first anchor is positioned against the interior surface of the first flap of the capsule.
22. The method according to claim 14 wherein the second anchor is positioned against the interior surface of the second flap of the capsule by passing the second length of suture and the second anchor through the second flap of the capsule and pulling the second length of suture until the second anchor is positioned against the interior surface of the second flap of the capsule.
23. The method according to claim 11 wherein the cut is formed in the capsule of the joint before positioning the first anchor and the second anchor against the surface of the first flap and the surface of the second flap, respectively.
24. The method according to claim 11 wherein the cut is formed in the capsule of the joint after positioning the first anchor and the second anchor against the surface of the first flap and the surface of the second flap, respectively.
25. A method for manipulating a capsule of a joint, the method comprising:
forming a cut in the capsule of the joint so as to create a first flap of the capsule and a second flap of the capsule;
providing a first length of suture having a first anchor attached to one end of the first length of suture;
providing a second length of suture having a second anchor attached to one end of the second length of suture;
passing the first length of suture through the first flap of the capsule of the joint so that the first anchor is positioned against an exterior surface of the first flap of the capsule of the joint and the first length of suture extends out of the joint;
passing the second length of suture through the second flap of the capsule of the joint so that the second anchor is positioned against an interior surface of the second flap of the capsule of the joint and the second length of suture extends out of the joint;
tying the first length of suture and the second length of suture together so as to close the capsule of the joint.
26. The method according to claim 25 wherein the method further comprises:
prior to tying the first length of suture and the second length of suture together, pulling at least one of the first and second lengths of suture so as to retract at least one of the first and second flaps of the capsule of the joint; and
performing an arthroscopic procedure in the joint while the capsule is retracted.
27. The method according to claim 25 wherein at least one of the first and second anchors comprises a T-bar anchor.