EP-4142612-B1 - KNOTLESS ANCHOR INSERTION

Inventors

• PATEL, Ravi
• GAMACHE, DANIEL
• OTRANDO, BRIAN
• REPPERT, Timothy
• SHAINWALD, MARK
• JACOBS, JORDAN
• REPPUCCI, Steve

Dates

Publication Date

20260506

Application Date

20210427

Claims (10)

1. A surgical system, comprising: a handle (1206); an outer shaft (1208) extending distally from the handle and including an inner lumen; an inner shaft (1210) extending distally from the handle, the inner shaft being positioned in the inner lumen of the outer shaft, a distal end of the inner shaft being positioned distal to an open distal end of the outer shaft, and the distal end of the inner shaft having a notch (1204) formed therein that is configured to seat a suture therein, wherein the notch has an open distal end and a closed proximal end; and an anchor (1202) configured to be implanted in bone, the anchor including an inner lumen, and the inner shaft being positioned in the inner lumen of the anchor; wherein, with the distal end of the inner shaft positioned in a bone hole, the outer shaft is configured to translate longitudinally and distally relative to the inner shaft and thereby cause the anchor to translate longitudinally and distally into the bone hole; characterized by further comprising a pliable member (1216) that extends along the open distal end of the notch so as to define an enclosed passage in cooperation with the inner shaft, the enclosed passage being configured to seat the suture therethrough, wherein the pliable member is configured to bend such that the enclosed passage is opened to allow the suture to be released.
2. The system of claim 1, wherein, after the translation of the outer shaft, the outer shaft and the inner shaft are configured to simultaneously translate longitudinally and proximally relative to the anchor in the bone hole.
3. The system of claim 1, wherein, prior to the translation of the outer shaft, a distal end of the outer shaft abuts a proximal end of the anchor having the inner shaft positioned in the inner lumen of the anchor.
4. The system of claim 1, wherein the inner shaft includes a pair of distal arms (1220) that define the notch therebetween.
5. The system of claim 1, further comprising the suture seated in the notch.
6. The system of claim 5, wherein the suture is seated in the notch prior to the distal end of the inner shaft being positioned in the bone hole and is seated in the notch after the translation of the outer shaft such that the anchor traps the suture between an exterior surface of the anchor and a wall of the bone hole.
7. The system of claim 5, further comprising a suture retention member at the handle, the suture retention member being configured to releasably retain the suture therein.
8. The system of claim 1, further comprising a locking mechanism configured to move from a locked position, in which the outer shaft is prevented from translating longitudinally and distally relative to the inner shaft, to an unlocked position, in which the outer shaft is allowed to translate longitudinally and distally relative to the inner shaft.
9. The system of claim 1, further comprising a strike cap (1212) extending proximally from the handle and being operatively coupled to the outer shaft, the strike cap being configured to be hit by a tool and thereby cause the outer shaft to translate longitudinally and distally relative to the inner shaft.
10. The system of claim 1, further comprising the suture and a loading aid (1242); wherein the loading aid is configured to releasably couple to the inner shaft and is configured to guide the suture into the notch.

Description

CROSS REFERENCE TO RELATED APPLICATIONS The present application claims priority to U.S. Prov. Pat. App. No. 63/017,009 entitled "Knotless Anchor Insertion" filed April 29, 2020. FIELD The present disclosure relates generally to knotless anchor insertion. BACKGROUND A variety of injuries and conditions require repair of soft tissue damage, or reattachment of soft tissue to bone and/or surrounding tissue. For example, when otherwise healthy tissue has been torn away from a bone, such as a labrum tearing away from a glenoid (shoulder instability), surgery is often required to reattach the tissue to the bone, to allow healing and a natural reattachment to occur. A number of devices and methods have been developed for performing these surgical repairs. Some of the more successful methods including the use of suture fixation members, such as suture anchors, which typically include an anchor body having a suture attachment feature and a tissue or bone engaging feature for retaining the suture anchor within or adjacent to the tissue or bone. Depending on the specific injury, one or more suture anchors connected to, or interconnected by, one or more segment of suture, may be used to perform the repair. Surgery can also be required when a tear occurs in the substance of a single type of tissue. Sutures can also be used in conjunction with one or more suture anchors to repair such tissue tears. Sutures can be fastened to suture anchors and to tissue using knots tied by the surgeon during a repair procedure, or using "knotless" devices and methods, where one or more anchors and one or more sutures can be connected and tensioned without the surgeon needing to tie knots during the surgery. Knotless anchoring is of particular utility for minimally invasive surgeries, such as endoscopic or arthroscopic repairs, where the surgeon remotely manipulates the suture at the surgical site using tools inserted through a small diameter cannula, an endoscopic tube, or otherwise percutaneously, which can make the knotting process difficult and tedious. However, while knotless anchors can be very effective in reattaching soft tissue to bone, the small size of the anchor and patient anatomy can make it difficult to locate and insert the anchor into the bone hole. Additionally, visualization of the hole can be difficult due to challenging angles and the tight nature of the joint space. Accordingly, there remains a need for improved knotless anchor insertion. WO 2012/177386 A1 describes a suture anchor system and method including a suture anchor and a suture anchor drive. The suture anchor is positionable on a rod of the suture anchor drive. The rod defines an awl for forming a hole in a bone. The suture anchor drive further has an impactor for moving the suture anchor along the rod between a retracted position and an advanced position so as to implant the suture anchor in the bone with the awl positioned in the bone. WO 2017/210620 A1 describes a surgical tool that incorporates a suture guide and anchor driver supporting an anchor where the anchor is maintained at a distance from the suture guide until release of a detent mechanism. Thereafter, the anchor is allowed to move into proximity to the suture guide, fixing a suture supported by the suture guide to a substrate. US 2014/0364906 A1 describes a method for securing a suture to bone including loading the suture in a distal opening of an inserter of an assembly. The suture can be coupled to soft tissue. The assembly can include the inserter, an anchor carried by the inserter, a distal tip and a driver each coupled to the inserter. A hole can be formed in the bone with the distal tip, and the distal opening and a portion of the suture can be positioned in the hole. The driver can be actuated to allow movement relative to the inserter and can be advanced in a first direction to drive the anchor about the inserter into the hole to secure the distal tip, anchor and suture to the bone with an absence of a knot. The driver can be moved in a second direction to remove the inserter from the distal tip, anchor and suture. SUMMARY In general, systems and devices for knotless anchor insertion and methods of knotless anchor insertion are provided. Certain surgical methods are described with reference to the system of the present invention. Whilst no claim is directed to these methods per se, the system is capable of being used and is intended to be used in such methods. The present invention is defined by independent claim 1, with further optional features being defined by the dependent claims. A surgical system according to claim 1 is provided is provided. The embodiment includes a handle, an outer shaft extending distally from the handle and including an inner lumen, and an inner shaft extending distally from the handle. The inner shaft is positioned in the inner lumen of the outer shaft, a distal end of the inner shaft is positioned distal to an open distal end of the outer shaft, and the dist