# US 11,998,186 B2 · Devices and methods for tissue repair

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- Number: US 11,998,186 B2
- Document ID: US11998186B2
- Status: Granted
- Kind: B2
- Application number: 18/556,790
- Filed: 2022-04-26
- Published: 2024-03-14
- Granted: 2024-06-04
- Earliest claimed: 2021-04-26
- Assignees: Smith & Nephew, Inc.; Smith & Nephew Orthopaedics AG; Smith & Nephew Asia Pacific Pte. Limited
- Applicants: Smith & Nephew, Inc.; Smith & Nephew Orthopaedics AG; Smith & Nephew Asia Pacific Pte. Limited
- Inventors: Ali Hosseini; Christopher David MacCready; Kendra O'Malley; Geoffrey Ian Karasic; Zenan Qi; Benjamin Michael Hall; Chun Liu; Paul McGovern; Han Teik Yeoh
- Web page: https://patentgrep.com/patent/US11998186B2

## 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)}
- A61F 2/08: Muscles; Tendons; Ligaments
- A61B 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)}
- 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 17/06166: {Sutures (suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M)}
- A61B 2017/0404: {Buttons}
- A61B 2017/0406: {Pledgets}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening}
- A61B 2017/0416: {Packages or dispensers for suture anchors or for anchor applicators}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0459: {Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied}
- A61B 2017/0496: {for tensioning sutures}
- A61B 2017/06185: {hollow or tubular}
- A61F 2002/0852: {Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes}
- 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)

## Abstract

Methods and devices for tissue fixation. A cortical button with a rib between two slotted openings. The rib increases the cortical button structural rigidity without increasing palpability. An adjustable loop construct with two discrete locking passages that provides manageable loop reduction and improved tissue coupling. The adjustable loop construct may be coupled to tissue via a passing construct. An assembly with a reduction bar, a button and an adjustable loop construct, the assembly provided assembled in a first configuration that disassembles to guide steps of tissue fixation. The reduction bar may be assembled to the reduction bar for reducing the adjustable loop construct.

## Claims

### Claim 1

A cortical button configured to be passed through a bone tunnel in an elongate orientation before being flipped to a deployed configuration, the cortical button comprising:
an oblong body, having a length greater than a width, and a longitudinal axis;
the width extending from a first sidewall to a second sidewall of the body, the first and second sidewalls along the longitudinal axis between a first and a second end, the body also having a lower surface configured to engage an external bone surface when the cortical button is in the deployed configuration; and
a pair of slotted apertures extending through an entire thickness of the body and also extending through the first or second sidewall of the body, defining slotted aperture lateral openings, the slotted aperture lateral openings configured to receive a loop of a flexible strand therethrough;
a pair of enclosed apertures, adjacent the pair of slotted apertures; and
a rib extending from the oblong body lower surface and disposed between both the pair of slotted apertures and the pair of enclosed apertures, the rib coextensive along the longitudinal axis with both the pair of slotted and enclosed apertures.

### Claim 2 (depends on 1)

The cortical button of claim 1 further comprising a first end aperture disposed between the pair of slotted apertures and the first end, and a second end aperture disposed between the pair of enclosed apertures and the second end.

### Claim 3 (depends on 2)

The cortical button of claim 2 wherein the first and second end apertures are axially separated from the rib.

### Claim 4 (depends on 1)

The cortical button of claim 1 wherein the rib is an oblong solid body.

### Claim 5 (depends on 1)

The cortical button of claim 1 wherein the rib is an oblong body having a longitudinal axis coincident with and parallel to the cortical button longitudinal axis.

### Claim 6 (depends on 1)

The cortical button of claim 1 wherein the pair of slotted apertures each define medial surfaces that extend through the cortical button thickness and extend directly from lateral side surfaces of the rib.

### Claim 7 (depends on 1)

The cortical button of claim 1 wherein the rib is configured to compensate for a reduced structural integrity of the cortical button, the reduced structural integrity a result of the slotted aperture lateral openings.

### Claim 8 (depends on 1)

The cortical button of claim 1 wherein the rib extends perpendicularly less than 2 mm from the oblong body lower surface.

### Claim 9 (depends on 1)

The cortical button of claim 1 wherein the rib extends from the oblong body lower surface a distance that is less than the body thickness.

### Claim 10

A cortical button comprising:
an oblong body, having a length greater than a width, and a longitudinal axis;
the width extending from a first sidewall to a second sidewall of the body, the first and second sidewalls extending along the longitudinal axis between a first and a second end, the oblong body also having a lower surface configured to engage an external bone surface when the cortical button is in the deployed configuration; and
a pair of slotted apertures extending through an entire thickness of the body and also extending through one of the first or second sidewall, such that each of the pair of slotted apertures define a lateral opening for receiving a loop of a flexible strand therethrough;
a pair of enclosed apertures, adjacent the pair of slotted apertures; and
a rib extending from the lower surface and disposed between the pair of slotted apertures and the pair of enclosed apertures and coextensive along the longitudinal axis with both the pair of slotted apertures and the pair of enclosed apertures, the oblong body width defining a minimum diameter of a bone tunnel through which the cortical button is configured to pass, the rib configured to increase the structural integrity of the cortical button while preserving the minimum diameter.

### Claim 11 (depends on 10)

The cortical button of claim 10 wherein the rib is configured to increase the structural integrity and compensate for loss of structural integrity due to the lateral openings.

### Claim 12 (depends on 10)

The cortical button of claim 10 wherein the rib is coextensive along the longitudinal axis with the lateral openings.

### Claim 13 (depends on 10)

The cortical button of claim 10 further comprising a first end aperture and a second end aperture, both axially separated from the rib.

### Claim 14 (depends on 10)

The cortical button of claim 10 wherein the rib is an oblong solid body.

### Claim 15 (depends on 10)

The cortical button of claim 10 wherein the rib is an oblong body having a longitudinal axis coincident with and parallel to the cortical button longitudinal axis.

### Claim 16 (depends on 10)

The cortical button of claim 10 wherein the pair of slotted apertures each define medial surfaces that extend through the cortical button thickness and are continuous with outer lateral side surfaces of the rib.

### Claim 17 (depends on 10)

The cortical button of claim 10 wherein the rib extends perpendicularly from the lower surface, less than 2 mm.

### Claim 18 (depends on 10)

The cortical button of claim 10 wherein the rib extends from the lower surface distance that is less than the oblong body width.