# US 10,441,269 B1 · Deformable fastener system

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- Number: US 10,441,269 B1
- Document ID: US10441269B1
- Status: Granted
- Kind: B1
- Application number: 16/510,484
- Filed: 2019-07-12
- Published: 2019-10-31
- Granted: 2019-10-15
- Earliest claimed: 2005-10-05
- Assignees: P Tech, LLC
- Applicants: P Tech, LLC
- Inventors: Peter M. Bonutti; Glen A. Phillips
- Web page: https://patentgrep.com/patent/US10441269B1

## CPC

- A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)}
- A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)}
- A61B 17/0483: {Hand-held instruments for holding sutures (A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30)}
- A61B 17/0487: {Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122)}
- A61B 17/1637: {Hollow drills or saws producing a curved cut, e.g. cylindrical (A61B10/025, A61B17/1695 take precedence)}
- A61B 17/1671: {for the spine}
- A61B 17/1675: {for the knee}
- A61B 17/17: Guides {or aligning means} for drills {, mills, pins or wires}
- A61B 17/683: {comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut}
- A61B 17/7053: {with parts attached to bones or to each other by flexible wires, straps, sutures or cables}
- A61B 17/7064: {Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor}
- A61B 17/7067: {Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor}
- A61B 17/82: for bone cerclage {(apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842)}
- A61B 17/842: {Flexible wires, bands or straps (A61B17/72, A61B17/82, A61B17/86 take precedence)}
- A61B 17/844: {with expandable anchors or anchors having movable parts}
- A61B 17/8861: {Apparatus for manipulating flexible wires or straps (devices for inserting Kirschner wires A61B17/1697)}
- A61B 17/8863: {Apparatus for shaping or cutting osteosynthesis equipment by medical personnel}
- A61B 17/8869: {Tensioning devices}
- A61F 2/0811: {Fixation devices for tendons or ligaments}
- A61F 2/30749: {Fixation appliances for connecting prostheses to the body}
- A61F 2/4405: {for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes (devices implanted between spinous or transverse processes A61B17/7062)}
- A61F 2/441: {made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel}
- A61L 27/58: Materials at least partially resorbable by the body
- A61B 17/00491: {Surgical glue applicators}
- A61B 17/0467: {Instruments for cutting sutures (surgical cutting instruments A61B17/32)}
- A61B 17/0485: {Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet}
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/1757: {for the spine}
- A61B 17/685: {Elements to be fitted on the end of screws or wires, e.g. protective caps}
- A61B 2017/00004: {(bio)absorbable, (bio)resorbable or resorptive}
- A61B 2017/00398: {using powered actuators, e.g. stepper motors, solenoids}
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00818: {Treatment of the gastro-intestinal system}
- A61B 2017/00876: {magnetic}
- A61B 2017/00893: {pharmaceutically effective}
- A61B 2017/00898: {expandable upon contact with fluid}
- A61B 2017/00951: {adhesive}
- A61B 2017/0404: {Buttons}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0458: {Longitudinal through hole, e.g. suture blocked by a distal suture knot}
- A61B 2017/0464: {for soft tissue}
- A61B 2017/0488: {Instruments for applying suture clamps, clips or locks}
- A61B 2017/0496: {for tensioning sutures}
- A61B 2017/06176: {with protrusions, e.g. barbs}
- A61B 2017/2926: {Details of heads or jaws}
- A61B 2090/035: {preventing further rotation}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61F 2/0063: {Implantable repair or support meshes, e.g. hernia meshes}
- A61F 2/08: Muscles; Tendons; Ligaments
- A61F 2/28: Bones
- A61F 2/442: {Intervertebral or spinal discs, e.g. resilient (non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455)}
- A61F 2002/2817: {Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]}
- A61F 2002/30062: {(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive}
- A61F 2002/30462: {retained or tied with a rope, string, thread, wire or cable}
- A61F 2002/30677: {Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body}
- A61F 2002/4435: {Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes}
- A61F 2002/444: {for replacing the nucleus pulposus}
- A61F 2210/0004: bioabsorbable
- A61F 2310/00293: containing a phosphorus-containing compound, e.g. apatite
- A61F 2310/00359: Bone or bony tissue
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61L: METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES (preservation of bodies or disinfecting characterised by the agents employed A01N; preserving, e.g. sterilising, food or foodstuffs A23; preparations for medical, dental or toiletry purposes A61K)

## Abstract

The guidance and positioning device may be a system for creating a passage in tissue, positioning fasteners or other implants, and tensioning an elongated fastening member, like a suture, thread, wire, or pin. In some embodiments, the device may allow for the implantation of multiple sutures and fasteners in tissue. A fastener may be positioned at the distal end of a flexible pushrod. The fastener may be connected with the pushrod or may be loosely fitted with the distal end of the pushrod. A suture may be looped through or connected with the fastener such that one, two, or more sections, legs, strands, or portions of the suture extend from the fastener.

## Claims

### Claim 1

A fastener system comprising:
a flexible hollow fastener comprising a mesh of biocompatible fibers; and
a flexible elongate fastening member configured to extend through the flexible hollow fastener, wherein legs of the flexible elongate fastening member are configured to extend from the flexible hollow fastener,
wherein the flexible hollow fastener is configured to deform from a first configuration to a second configuration to secure the flexible hollow fastener in a first body tissue when at least one of the legs of the flexible elongate fastening member is tensioned relative to the body tissue,
wherein the flexible elongate fastening member is configured to slide through the flexible hollow fastener under tension when the flexible hollow fastener is in the first configuration and the second configuration, and
wherein the flexible elongate fastening member is configured to secure a second body tissue to the first body tissue.

### Claim 2 (depends on 1)

The fastener system of claim 1, wherein the flexible hollow fastener is a suture anchor.

### Claim 3 (depends on 1)

The fastener system of claim 1, wherein the flexible elongate fastening member includes a suture.

### Claim 4 (depends on 1)

The fastener system of claim 1, wherein at least one leg of the flexible elongate fastening member is fixed to the flexible hollow fastener.

### Claim 5 (depends on 1)

The fastener system of claim 1, further comprising a second fastener configured to connect to at least one leg of the flexible elongate fastening member and configured to at least one of retain tension in the flexible elongate fastening member and secure the flexible elongate fastening member in a position.

### Claim 6 (depends on 1)

The fastener system of claim 1, wherein at least one of the flexible hollow fastener and the flexible elongate fastening member are biodegradable.

### Claim 7 (depends on 1)

The fastener system of claim 1, wherein at least one of the flexible hollow fastener and the flexible elongate fastening member are biologically inductive.

### Claim 8 (depends on 1)

The fastener system of claim 1, wherein at least a portion of the elongate fastening member is fabricated in part with polyethylene.

### Claim 9

A fastener system comprising:
a flexible hollow fastener comprising biocompatible material;
a flexible elongate fastening member configured to extend through the flexible hollow fastener, wherein legs of the flexible elongate fastening member are configured to extend from the flexible hollow fastener; and
a second fastener configured to connect to at least one leg of the flexible elongate fastening member,
wherein the flexible hollow fastener is configured to deform from a first configuration to a second configuration to secure the flexible hollow fastener in a first body tissue when at least one of the legs of the flexible elongate fastening member is tensioned relative to the body tissue,
wherein the flexible elongate fastening member is configured to slide through the secured flexible hollow fastener under tension when the flexible hollow fastener is in the first configuration and the second configuration,
wherein the flexible elongate fastening member is configured to secure a second body tissue to the first body tissue, and
wherein the second fastener is configured to at least one of retain tension in the flexible elongate fastening member and secure the flexible elongate fastening member in a position.

### Claim 10 (depends on 9)

The fastener system of claim 9, wherein the flexible hollow fastener is a suture anchor.

### Claim 11 (depends on 9)

The fastener system of claim 9, wherein the flexible elongate fastening member includes a suture.

### Claim 12 (depends on 9)

The fastener system of claim 9, wherein at least one leg of the flexible elongate fastening member is fixed to the flexible hollow fastener.

### Claim 13 (depends on 9)

The fastener system of claim 9, wherein at least one of the flexible hollow fastener and the flexible elongate fastening member are biodegradable.

### Claim 14 (depends on 9)

The fastener system of claim 9, wherein at least one of the flexible hollow fastener and the flexible elongate fastening member are biologically inductive.

### Claim 15 (depends on 9)

The fastener system of claim 9, wherein at least a portion of the elongate fastening member is fabricated in part with polyethylene.

### Claim 16

A fastener system comprising:
a flexible hollow fastener comprising biocompatible material; and
a flexible elongate fastening member configured to extend through the flexible hollow fastener, wherein legs of the flexible elongate fastening member are configured to extend from the flexible hollow fastener,
wherein the flexible hollow fastener is configured to deform from a first configuration to a second configuration to secure the flexible hollow fastener in a first body tissue when at least one of the legs of the flexible elongate fastening member is tensioned relative to the body tissue,
wherein the flexible elongate fastening member is configured to slide through the secured flexible hollow fastener under tension when the flexible hollow fastener is in the first configuration and the second configuration,
wherein the flexible elongate fastening member is configured to secure a second body tissue to the first body tissue, and
wherein at least one of the flexible hollow fastener and the flexible elongate fastening member comprises a biodegradable material.

### Claim 17 (depends on 16)

The fastener system of claim 16, wherein the flexible hollow fastener is a suture anchor.

### Claim 18 (depends on 16)

The fastener system of claim 16, wherein the flexible elongate fastening member includes a suture.

### Claim 19 (depends on 16)

The fastener system of claim 16, wherein at least one leg of the flexible elongate fastening member is fixed to the flexible hollow fastener.

### Claim 20 (depends on 16)

The fastener system of claim 16, further comprising a second fastener configured to connect to at least one leg of the flexible elongate fastening member and configured to at least one of retain tension in the flexible elongate fastening member and secure the flexible elongate fastening member in a position.

### Claim 21 (depends on 16)

The fastener system of claim 16, wherein at least one of the flexible hollow fastener and the flexible elongate fastening member are biologically inductive.

### Claim 22

A fastener system comprising:
a flexible hollow fastener comprising biocompatible material; and
a flexible elongate fastening member configured to extend through the flexible hollow fastener, wherein legs of the flexible elongate fastening member are configured to extend from the flexible hollow fastener,
wherein the flexible hollow fastener is configured to deform from a first configuration to a second configuration to secure the flexible hollow fastener in a first body tissue when at least one of the legs of the flexible elongate fastening member is tensioned relative to the body tissue,
wherein the flexible elongate fastening member is configured to slide through the secured flexible hollow fastener under tension when the flexible hollow fastener is in the first configuration and the second configuration,
wherein the flexible elongate fastening member is configured to secure a second body tissue to the first body tissue, and
wherein at least one of the flexible hollow fastener and the flexible elongate fastening member comprises a biologically inductive material.

### Claim 23 (depends on 22)

The fastener system of claim 22, wherein the flexible hollow fastener is a suture anchor.

### Claim 24 (depends on 22)

The fastener system of claim 22, wherein the flexible elongate fastening member includes a suture.

### Claim 25 (depends on 22)

The fastener system of claim 22, wherein at least one leg of the flexible elongate fastening member is fixed to the flexible hollow fastener.

### Claim 26 (depends on 22)

The fastener system of claim 22, further comprising a second fastener configured to connect to at least one leg of the flexible elongate fastening member and configured to at least one of retain tension in the flexible elongate fastening member and secure the flexible elongate fastening member in a position.

### Claim 27 (depends on 1)

The fastener system of claim 1, wherein the fastener system is knotless.

### Claim 28 (depends on 9)

The fastener system of claim 9, wherein the fastener system is knotless.

### Claim 29 (depends on 16)

The fastener system of claim 16, wherein the fastener system is knotless.

### Claim 30 (depends on 22)

The fastener system of claim 22, wherein the fastener system is knotless.