# US 2019/0167254 A1 · Suture securing assemblies

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- Number: US 2019/0167254 A1
- Document ID: US20190167254A1
- Status: Published application
- Kind: A1
- Application number: 16/320,616
- Filed: 2017-07-26
- Published: 2019-06-06
- Earliest claimed: 2016-07-28
- Assignees: Smith & Nephew, Inc.
- Applicants: Smith & Nephew, Inc.
- Inventors: Marc Joseph Balboa; Geoffrey Ian Karasic; Matthew Edwin Koski; Nehal Navinbhai Patel
- Web page: https://patentgrep.com/patent/US20190167254A1

## 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 2/0811: {Fixation devices for tendons or ligaments}
- A61B 2017/00004: {(bio)absorbable, (bio)resorbable or resorptive}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0412: {having anchoring barbs or pins extending outwardly from suture anchor body}
- A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening}
- A61B 2017/0422: {by insertion of a separate member into the body of the anchor}
- A61B 2017/0424: {the separate member staying in the anchor after placement}
- A61B 2017/0429: {the barbs being expanded by a mechanical mechanism which also locks them in the expanded state}
- A61F 2002/0835: {with deformation of anchor parts, e.g. expansion of dowel by set screw}
- A61F 2002/0852: {Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes}
- A61F 2002/0888: {Anchor in or on a blind hole or on the bone surface without formation of a tunnel}
- A61F 2220/0016: with sharp anchoring protrusions, e.g. barbs, pins, spikes
- A61F 2250/0012: for adjusting elasticity, flexibility, spring rate or mechanical tension
- 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

A suture securing assembly comprises a two-bodied anchor and an associated delivery system which enhances fixation of a micro anchor in a bone hole or tunnel, as well as improving suture lock within bone. Initially, the two bodies are separated by a length of an inner shaft of the delivery system. The proximal body is fixed on the inner shaft of the delivery system and cannot move relative to the handle until after insertion into the bone, when the delivery system is disengaged from the anchor. The distal body further includes expansion wings and/or other features for increasing suture lock within the bone hole.

## Claims

### Claim 1

A suture securing assembly, comprising:
an inserter, the inserter comprising:
an outer shaft having a proximal end, a distal end, and a longitudinal cannulation extending between the proximal and distal ends; and
an inner shaft disposed within the cannulation such that a portion of the inner shaft extends from the distal end of the outer shaft, the inner shaft axially moveable relative to the outer shaft; and
an anchor, the anchor comprising:
a cannulated proximal body disposed on the inner shaft of the inserter near the distal end of the outer shaft;
a distal body disposed on the inner shaft near a distal end of the inner shaft, the distal body having a transverse through hole for passage of a suture;
wherein the distal body is moveable by the inner shaft in a proximal direction relative to the proximal body; and
wherein the proximal body is prevented by a portion of the inserter from moving in a distal direction relative to the distal body.

### Claim 2 (depends on 1)

The assembly of claim 1, further comprising a handle attached to the proximal end of the outer shaft, the handle comprising a rotatable knob threadingly attached to the handle, the knob being attached to the inner shaft for retracting the inner shaft relative to the outer shaft.

### Claim 3 (depends on 1)

The assembly of claim 1, wherein at least one of the proximal body and the distal body is made from any combination of metal, polymer, bioabsorbable, or biocomposite material.

### Claim 4 (depends on 1)

The assembly of claim 1, wherein a cavity of the distal body defines a first locking feature and the inner shaft defines a second locking feature for mechanical engagement with the first locking feature.

### Claim 5 (depends on 4)

The assembly of claim 4, wherein the first locking feature is a first plurality of threads formed on an inner surface of the cavity, and the second locking feature is a second plurality of threads formed on an outer surface of the inner shaft, the second plurality of threads configured to mate with the first plurality of threads.

### Claim 6 (depends on 4)

The assembly of claim 4, wherein the first locking feature is a hole formed in the cavity and the second locking feature is a plurality of barbs on an outer surface of the inner shaft, the hole configured to press over the barbs.

### Claim 7 (depends on 4)

The assembly of claim 4, wherein the engagement between the first locking feature and the second locking feature allows articulation of the distal body relative to the proximal body about any axis.

### Claim 8 (depends on 1)

The assembly of claim 1, wherein the distal body comprises expansion wings for engagement with a prepared bone hole.

### Claim 9 (depends on 1)

The assembly of claim 1, further comprising a flexible strand in the form of a closed loop extending through the through hole, the flexible strand for coupling to a suture.

### Claim 10 (depends on 9)

The assembly of claim 9, wherein the flexible strand comprises at least one of suture, plastic and malleable metal.

### Claim 11 (depends on 1)

The assembly of claim 1, wherein a surface of the distal body between the proximal end and the through hole comprises a plurality of passive wings, the passive wings being outwardly flexible upon insertion into bone.

### Claim 12 (depends on 11)

The assembly of claim 11, wherein the passive wings are comprised of one of PEEK, other plastics, and metals.

### Claim 13 (depends on 1)

The assembly of claim 1, wherein the distal body and/or the proximal body comprises features for allowing rotation of the distal body relative to the proximal body in a first direction, but preventing rotation of the distal body relative to the proximal body in a second direction.

### Claim 14

A method of securing a suture in a bone hole, the method comprising:
passing a length of suture through a through hole of a distal body of an anchor;
placing the distal body at the bottom of a prepared bone hole, a proximal body of the anchor being separated by a distance from the distal body such that the proximal body is located outside of the bone hole;
tensioning the length of suture;
inserting a portion of the proximal body into the bone hole such that legs of the length of suture are fixed between the proximal body and the bone hole, the distance between the proximal body and the distal body being unchanged;
retracting the distal body toward the proximal body, creating suture slack in the bone hole; and
driving the distal body and the proximal body together into the bone hole;
wherein the suture slack in the bone hole is removed.

### Claim 15 (depends on 14)

The method of claim 14, wherein the distal body is spaced apart from the proximal body of the anchor along a length of an inner shaft of an inserter, and wherein retracting the distal body toward the proximal body comprises retracting the inner shaft relative to a handle of the inserter.

### Claim 16 (depends on 14)

The method of claim 14, wherein, when driving the distal body and the proximal body together into the bone hole, there is no relative motion between the distal body and the proximal body.

### Claim 17

A method of securing a suture in a bone hole, the method comprising:
passing a length of suture through a through hole of a distal body of an anchor, the anchor comprising a cannulated proximal body disposed on an inner shaft of an inserter near a distal end of an outer shaft of the inserter, the distal body disposed on the inner shaft near a distal end of the inner shaft, the distal body having radially expanding wings at a proximal end;
approximating the distal body to a hole formed in bone;
tensioning the length of suture;
inserting the proximal body and the distal body into the bone hole, the distance between the proximal body and the distal body being unchanged;
retracting the distal body toward the proximal body by retracting the inner shaft relative to a handle of the inserter such that the wings engage the proximal body, causing the wings to radially expand; and
further retracting the inner shaft such that the proximal body and the distal body are disengaged from the inner shaft;
wherein the length of suture is compressed between the distal body and the bone hole.

### Claim 18 (depends on 17)

The method of claim 17, wherein passing the length of suture through the through hole of the distal body comprises passing the length of suture with a suture threader.

### Claim 19 (depends on 17)

The method of claim 17, wherein the inner shaft is coupled to a knob of a handle, and wherein retraction of the inner shaft comprises rotating the knob of the handle.

### Claim 20 (depends on 19)

The method of claim 19, wherein the handle comprises a first set of features for engagement with a second set of features on the knob, the engagement providing audible and tactile feedback to a user.

### Claim 21 (depends on 19)

The method of claim 19, wherein the handle comprises a stop feature for limiting retraction of the inner shaft relative to the handle.

### Claim 22 (depends on 17)

The method of claim 17, further comprising passing the length of suture through tis