SELF-PUNCHING SWIVEL ANCHOR AND METHOD FOR KNOTLESS FIXATION OF TISSUE
A method and device for knotless fixation of tissue. A swivel anchor having a rotatable implant is used to capture suture for surgical tissue repair without requiring suture knots. The implant may be provided with a conical metal tip which is self-punching and avoids the need for pre-drilling a hole in bone. The implant includes a closed aperture to allow free sliding of a suture strand. The swivel anchor is secured in a hole in bone by advancing a fixation device, such as a cannulated interference screw, over the body of the implant.
This application is a continuation-in-part of U.S. application Ser. No. 11/802,057, filed on May 18, 2007, which claims the benefit of U.S. Provisional Application Ser. No. 60/801,097, filed on May 18, 2006, the entire disclosures of which are incorporated herein by reference.FIELD OF THE INVENTION
The present invention relates to methods and instruments for fixation of sutures and tissue to bone.BACKGROUND OF THE INVENTION
When soft tissue tears away from bone, reattachment becomes necessary. Various devices, including sutures, screws, staples, wedges, anchors and plugs have been used in the prior art to secure soft tissue to bone. Surgical methods utilizing suture anchors alone are disadvantageous for reattachment of large areas of detached tissue because they often do not allow good tissue to bone contact.
Reattachment of soft tissue to bone typically requires the surgeon to pass suture material through selected tissue, form a plurality of surgical knots extracorporeally and then move the knots into position adjacent the desired tissue to be sutured. In such procedures, the surgeon must manually tie the knots on the suture strands after the suture is threaded through the selected tissues to be sutured. Knot tying during surgery, particularly arthroscopic surgery, is tedious and time-consuming. There is also a tendency for the knots to deform or collapse as the surgeon manually forces the knots down into the proper position. Also, the suture knots often are exposed to abrasion or cutting by sharp or rough areas along the walls of the bone canal into which anchors are typically inserted to provide fixation of tendon to bone.
Accordingly, a need exists for an improved method for attaching soft tissue to bone which does not require multiple suture knots and which allows the tendon to remain securely in place until the ligaments naturally attach to bone.SUMMARY OF THE INVENTION
The instruments and methods of the present invention overcome the disadvantages of the prior art, such as those noted above, by providing a swivel implant at the distal end of a driver that securely engages and locks into a cannulated ribbed body of an interference plug or screw. The swivel implant includes a closed aperture for receiving a strand attached to a graft, such that the strand is able to freely slide through the aperture.
In one embodiment of the invention, the strand is passed through the graft at desired points. A cannulated plug or screw is pre-loaded onto a driver provided with a swivel lock twist-in anchor at its distal end. The strand attached to the graft is passed through the aperture of the swivel implant located at the distal end of the driver. The distal end of the driver together with the implant is inserted directly into the bone. The driver may be rotated (in a clockwise direction, for example) to advance a screw over the anchor to complete insertion.
Other features and advantages of the present invention will become apparent from the following description of exemplary embodiments of the invention described with reference to the accompanying drawings.
The present invention provides apparatus and methods for knotless tissue fixation using a swivel anchor device.
First, and as illustrated in
Subsequent to the formation of the pilot holes, and as shown in
The swivel anchor and instruments of the present invention are now described in greater detail. As shown in
During installation of the knotless anchor having a swiveling implant 30, the screw 42 is first inserted onto cannulated rod 20 of the driver 68. As shown in
The knotless fixation device of the present invention advantageously minimizes or eliminates the need to tie knots. The use of such a swivel anchor also provides secure fixation of the suture construct—the secure suture construct results from the suture being pushed into a hole and held tightly by an anchors.
In the preferred embodiment of the present invention, as mentioned above, suture tape is used with the swivel anchor to fix tissue to bone. However, the swivel anchor of the present invention can be used with any type of flexible material or suture. In another preferred embodiment, an allograft or biological component may be used instead of suture or tape. The allograft or biological component may be comprised of tendon or pericardium, for example, which provides improved tissue repair. In yet additional embodiments, any combination of suture, suture tape, and allograft or biological component may be employed, depending on the characteristics of the specific surgical repair and/or as desired.
As illustrated in
Although the present invention has been described in relation to particular embodiments thereof, many other variations and modifications and other uses will become apparent to those skilled in the art. It is preferred, therefore, that the present invention be limited not by the specific disclosure herein.
1. A method of tissue fixation comprising:
- providing a suture;
- securing the suture to the tissue to be fixated; and
- anchoring the suture into the bone socket using a swivel implant and a fixation device, thereby providing tissue fixation.
2. The method of claim 1, wherein the fixation device is an interference screw or a plug.
3. The method of claim 1, wherein the swivel implant has a conical portion terminating at a pointed tip at its most distal end.
4. The method of claim 1, wherein the swivel implant has a closed aperture at its distal end.
5. The method of claim 1, further comprising the step of capturing the suture attached to the graft with the swivel implant.
6. The method of claim 5, wherein the step of capturing the suture further comprises passing the suture through a closed aperture of the swivel implant.
7. The method of claim 6, wherein the closed aperture has an eyelet configuration.
8. The method of claim 1, further comprising the steps of preloading the fixation device on a driver and, subsequently, providing the swivel implant at a distal end of the driver.
9. A suture anchor comprising:
- an anchor body; and
- an anchor tip rotatably attached to the anchor body.
10. The suture anchor of claim 9, wherein the anchor tip has a closed aperture.
11. The suture anchor of claim 9, wherein the anchor tip is a metal tip.
12. The suture anchor of claim 9, wherein the suture anchor is configured to allow rotational insertion without causing excessive twisting and knotting of a suture captured in the anchor tip.
13. The suture anchor of claim 9, wherein the anchor tip is configured to capture a suture.
14. The suture anchor of claim 9, wherein the anchor body has a cylindrical configuration.
15. The suture anchor of claim 9, wherein the anchor tip is detachable.
16. The suture anchor of claim 9, further comprising a fixation device for securing the suture anchor in bone.
17. The suture anchor of claim 16, wherein the fixation device is a cannulated interference screw or a plug.