CA-3112439-C - SYSTEM FOR REPAIRING SOFT TISSUE TEARS

Abstract

A system and method for repairing soft tissue tears such as meniscal tears. The anchor system has a first implant connected to a length of suture. The length of suture is folded such that a tensioning limb extends from the first implant and a locking limb extends from the first implant. The anchor system also includes a second implant fixed to the locking limb and an adjustment mechanism in the length of suture between the first implant and the second implant. The tensioning limb is passed through the adjustment mechanism. This creates an adjustment loop in the length of suture extending from the adjustment mechanism through the first implant. The adjustment loop is a one-way adjustable loop for moving the first implant and second implant in relative position to each other.

Inventors

• Giuseppe Lombardo

Assignees

• CONMED CORPORATION

Dates

Publication Date

20260505

Application Date

20190930

Priority Date

20180928

Claims (11)

1. CLAIMS What is claimed is: 1. An anchor system, comprising: a first implant and a second implant each connected to a separate length of suture, the length of suture folded such that a tensioning limb extends from the first implant and a locking limb extends from the first implant; an adjustment mechanism in the length of suture between the first implant and the second implant; and wherein the tensioning limb is passed through the adjustment mechanism, wherein the second implant is fixed to the locking limb via a pierce hitch in the locking limb, and wherein the pierce hitch is formed by inserting an end of the locking limb through a hole in the locking limb and the second implant is fixed to the locking limb by the length of suture passing through the pierce hitch.
2. 2. The system of claim 1, further comprising an adjustment loop in the length of suture extending from the adjustment mechanism through the first implant.
3. 3. The system of claim 1 or 2, wherein the adjustment mechanism is an eye splice.
4. 4. The system of claim 3, wherein the eye splice is in the locking limb.
5. 5. The system of any one of claims 1-4, wherein the first implant and the second implant are rectangular.
6. 6. The system of any one of claims 1-5, wherein the length of suture passes through a pair of apertures in the second implant and then through the pierce hitch.
7. 7. The system of any one of claims 1-5, further comprising a pair of spaced, adjacent apertures in each of the first and second implants.
8. 8. The system of claim 7, further comprising a radiused saddle between each aperture of the pair of spaced, adjacent apertures.
9. 9. The system of claim 7, wherein the length of suture extends through the pair of spaced, adjacent apertures in each of the first and second implants.
10. 10. The system of any one of claims 1-8, wherein the second implant is flat.
11. 11. Use of the system of any one of claims 1-10 for meni seal repair. 18 Date re~ue/date received 2024-06-03

Description

[0001] 1. [0002] SYSTEM FOR REPAIRING SOFT TISSUE TEARS CROSS-REFERENCE TO RELATED APPLICATIONS INTENTIONALLY LEFT BLANK BACKGROUND OF THE INVENTION Field of the Invention The present invention is directed generally to surgical tools and instruments and, more particularly, to a system and method for repairing soft tissue tears such as meniscal tears. 2. Description of Related Art [0003] The meniscus is a piece of cartilage located within the knee joint, between the top of the tibia and the bottom of the femur. The meniscus serves to facilitate stable movement of the tibia and femur relative to one another, and to absorb shock and to spread load. The meniscus is frequently damaged (e.g., tom) as the result of injury and/or accident. A damaged meniscus can impede proper motion of the knee joint and cause pain, among other problems. [0004] More particularly, the essential role of an intact meniscus, and its importance for proper knee function, has been well documented and accepted by the general orthopedic community. An intact and functioning meniscus is critical to optimally distribute weightbearing forces that transfer through the knee joint while maintaining knee stability. The meniscus is also vital to preserving the articular cartilage surfaces of the knee. Loss of meniscal tissue is considered to be a key precursor to the development of knee osteoarthritis. [0005] A major challenge in repairing a tom meniscus is the fact that the tissue itself is a fibrous structure that is not uniformly vascular. The vascular zones of the meniscus comprise about one third of the meniscus tissue and are generally recognized as the "red-red" and "redwhite" zones. The "red-red" zone (i.e., the most highly vascularized portion of the meniscus) is an area in which meniscal repairs are known to heal easily and is located along its outer periphery. The "red-white" zone extends from the most vascular area towards the inner portions of the meniscus where the blood supply eventually declines to nonvascular tissue 1 Date Rei;ue/Date Received 2022-09-29 WO 2020/069486 PCT /0S2019/053727 (which is sometimes referred to as the "white-white" zone). It is believed that proper surgical technique is of great importance if a successful repair is to be achieved in the "red-white" zone. It is generally accepted knowledge that about 15% of all meniscal tears occur in the "red-red" zone, another 15% of meniscal tears occur in the "red-white" zone, and the remaining 70% of meniscal tears occur in the "white-white" (or non-vascularized) zone of the meniscus. [0006] Another significant challenge in repairing a tom meniscus is that the size and shape of the tears vary, making the reduction and apposition of the tom tissue difficult to accomplish. Without proper apposition and stability, tom meniscal tissue will not heal properly. [0007] The art of repairing tom meniscal tissue was first developed and pioneered throughout the 1980s by early sports medicine-focused surgeons. The earliest methods employed only suture in the repair. The techniques of "inside-out" and "outside-in" suturing became the so-called "gold standard for the repair of meniscal tissue. Both of these techniques focused on passing small diameter suture (size 2-0 or 3-0) through the meniscus, reducing and closing the tear, and then tying a suture knot over the knee capsule so as to fixate and stabilize the tear. A feature of these early all-suture repairs was that the surf ace of the meniscus was kept relatively smooth since the suture knot was outside of the knee joint, and the use of a needle and suture allowed the surgeon a great deal of flexibility in adequately reducing and stabilizing the tear. [0008] Eventually, these early surgeons began concomitant use of complementary techniques to promote a vascular response in the more non-vascular areas of the meniscus. Methods such as tear edge and meniscapsular rasping, the application of an interpositional blood clot, trephination to create a vascular channel, and fascial sheath or synovial flap coverage have been shown in several studies to be 150% more effective in healing a tom meniscus when compared to repairs that do not use such concomitant techniques. [0009] The specific issues and challenges associated with the aforementioned all-suture inside-out and outside-in repair techniques are centered primarily on issues relating to the "user interface" and to the "tethering" of the meniscus to the knee capsule. More particularly, the "user interface" issues generally relate to the technical demands required in the operating room: the skill of the surgeon and the number of assistants required to safely pass the needle and suture from the anterior portion of the meniscus through the posterior portion of the meniscus and exit out through the posterior/medial aspect of the knee joint (i.e., 2 WO 2020/069486 PCT /0S2019/053727 the so-called "inside-out" technique); or the passing of a needle and suture from the medial aspect of the exte