KNOTLESS SUTURE ANCHORS
A readily implantable knotless suture anchor that de-couples the angle of insertion of the anchor from the tissue passage step and other steps of conventional procedures. An anchor provides an internal locking mechanism configured such that: suture knots do not have to be tied; suture and tissue tension can be easily adjusted intraoperatively; and suture passage and tensioning can be done at a variety of positions and angles. A method includes: passing a first suture through a patient's tissue and then through a loop of a shuttle suture; pulling the open end of the shuttle suture until the first suture passes through an internal suture locking mechanism; applying tension in the first suture until adequate tension is achieved with respect to the tissue; automatically engaging an internal locking member; and securing the first suture against further relative movement with respect to the anchor.
1 . An anchor for implantation in tissue, the anchor comprising:
a shell defining at least one passage;
a first suture in the at least one passage attached to the shell;
a longitudinally extending suture entwinement in the at least one passage; and
a shuttle suture having a first end and a second end; the first end being configured to engage the first suture,
wherein:
the shuttle suture passes in a first direction in the at least one passage and loops to pass in a second direction generally opposite to the first direction into and through the longitudinally extending suture entwinement, and
upon the first suture being received by the first end of the shuttle suture and the second end of the shuttle suture being pulled:
the first suture passes into the longitudinally extending suture entwinement; and
the longitudinally extending suture entwinement locks the first suture to the anchor.
2 . The anchor of claim 1 , wherein:
the at least one passage comprises a first passage and a second passage,
the longitudinally extending suture entwinement is proximate to the second passage, and
the shuttle suture passes in the first passage and loops to pass into the second passage in the second direction into and through the longitudinally extending suture entwinement.
3 . The anchor of claim 1 , wherein the longitudinally extending suture entwinement is in a generally double helix formation comprising the shuttle suture and a first portion of the first suture and is configured to allow the shuttle suture to move longitudinally in only one direction with respect the first portion of the first suture.
4 . The anchor of claim 1 , wherein the longitudinally extending suture entwinement comprises the shuttle suture and a first portion of the first suture being generally interlaced or coiled with one another.
5 . The anchor of claim 1 , further comprising an entwinement suture fixed to the shell, wherein the longitudinally extending suture entwinement:
is in a generally double helix formation comprising the shuttle suture and the entwinement suture: and
is configured to allow the shuttle suture and the first suture to move longitudinally in only one direction with respect the entwinement suture.
6 . The anchor of claim 1 , wherein the longitudinally extending suture entwinement comprises the shuttle suture and an entwinement suture being generally interlaced or coiled with one another.
7 . The anchor of claim 2 , further comprising a partition defining the first passage and the second passage,
wherein:
the partition defines a partition passage and a post,
the shuttle suture passes through the partition passage when the shuttle suture passes from the first passage to the second passage, and
the first suture is tied to the post to attach the first suture to the shell.
8 . The anchor of claim 7 , wherein:
the shell defines at least one lateral passage in communication with at least one of the first passage, the second passage, and the partition passage, and
the at least one lateral passage is configured to allow access to the first suture sufficient for attaching the first suture to the post.
9 . An anchor for implantation in tissue, the anchor comprising:
an elongated shell defining at least one first passage;
a partition defining at least one second passage generally perpendicularly intersecting the at least one first passage and in communication with the exterior of the shell;
a first suture in the at least one first passage attached to the partition;
a unidirectional suture locking mechanism in the at least one first passage; and
a shuttle suture having a first end and a second end; the first end being configured to engage the first suture,
wherein:
the shuttle suture passes in a first direction in the at least one passage and loops to pass in a second direction generally opposite to the first direction into and through the unidirectional suture locking mechanism, and
upon the first suture being received by the first end of the shuttle suture and the second end of the shuttle suture being pulled, the first suture passes into the unidirectional suture locking mechanism, and the unidirectional suture locking mechanism locks the first suture to the anchor.
10 . The anchor of claim 9 , wherein the unidirectional suture locking mechanism comprises a woven sleeve.
11 . The anchor of claim 9 , wherein the unidirectional suture locking mechanism comprises a finger trap.
12 . The anchor of claim 9 , wherein the unidirectional suture locking mechanism comprises a noose.
13 . The anchor of claim 9 , wherein the unidirectional suture locking mechanism comprises a pre-tied knot.
14 . The anchor of claim 9 , wherein the unidirectional suture locking mechanism comprise a suture entwinement comprising the shuttle suture and at least one of the first suture and an entwinement suture.
15 . The anchor of claim 9 , wherein
the shell comprises a first end in communication with at least one of the first passage and the second passage and a second end opposite the first end, and
the anchor further comprises a body member attached to the second end and defining a suture passage configured for receiving at least one of the first suture and the shuttle suture.
16 . The anchor of claim 15 , wherein the body member is configured to pivot with respect to the shell.
17 . An anchor for implantation in tissue, the anchor comprising:
an elongated woven shell defining a passage;
a first suture having a first end and a second end,
wherein:
the first suture passes through the passage along the length of the elongated woven shell, and
the first end is configured to engage with the second end in a manner that attaches the first suture to the elongated woven shell;
a unidirectional suture locking mechanism in the passage connected to the first suture; and
a shuttle suture having a first end and a second end,
wherein:
the first end is configured to engage the first suture,
the shuttle suture passes in a first direction in the at least one passage and into and through the unidirectional suture locking mechanism, and
upon the first suture being received by the first end of the shuttle suture and the second end of the shuttle suture being pulled, the first suture passes into the unidirectional suture locking mechanism, and the unidirectional suture locking mechanism locks the first suture to the anchor.
18 . The anchor of claim 17 , wherein:
the elongated woven shell is generally U-shaped, and
the shuttle suture passes in a first direction in the at least one passage and loops to pass in a second direction generally opposite to the first direction into and through the unidirectional suture locking mechanism.
19 . The anchor of claim 17 , wherein:
the first end of the first suture comprises a loop, and
the second end of the first suture passes through the loop in a manner that attaches the first suture to the elongated woven shell.
20 . The anchor of claim 17 , wherein the unidirectional suture locking mechanism comprises at least one of a group consisting of a woven sleeve, an elongated suture entwinement, a finger trap type device, a pre-tied knot, and a hangman noose.