Method and device for producing an anchorage in human or animal tissue

A method of producing an anchorage in a load-bearing tissue with the aid of mechanical vibration and a thermoplastic material which is liquefiable by the mechanical vibration, the method comprising the steps of:

• providing a device, the device comprising:
• a vibrating element with a distal end and a proximal end, the vibrating element being capable of transmitting vibration from its proximal end to its distal end, and wherein the distal end comprises a first contact face facing away from the proximal end,
• a counter element distally from the vibrating element with a contact end and an opposite end, wherein the contact end comprises a second contact face being adapted to the first contact face to be able to be positioned against the first contact face,
• wherein the liquefiable thermoplastic material is located on at least the second contact face,
• wherein the counter element comprises a foot piece of a material not liquefiable by the mechanical vibration, and an anchoring piece comprising the liquefiable thermoplastic material,
• wherein the foot piece is located distally from the anchoring piece,
• and wherein the counter element further comprises a flexible force transmitting member being coupled to the foot piece and reaching past or through at least the distal end of the vibrating element, said flexible force transmitting member comprising at least one of a suture, a wire, a cable, a ribbon, a fabric of filaments, and a flexible sleeve,
• wherein the flexible force transmitting member is accessible from a proximal side, and wherein the flexible force transmitting member is capable of transmitting a pulling force exerted on the flexible force transmitting member to the foot piece as a counter force to a pushing force exerted to the vibrating element, wherein the anchoring piece is arranged to be compressed between the foot piece and the vibrating element as a result of the pushing force and the counter force;
• the method comprising the further steps of positioning the device relative to tissue, causing a first force and mechanical vibration to be coupled into the vibrating element and a second force coupled into the force transmitting member to compress the thermoplastic material until at least a portion of the thermoplastic material is liquefied, flows out from between the contact faces and is pressed into the tissue.

An assembly for producing an anchorage in tissue with, the assembly comprising:

• a foot piece forming a distal end of the assembly and comprising a proximal foot piece contact face,
• an anchoring piece proximally of the foot piece, the anchoring piece comprising a distal anchoring piece contact face,
• the foot piece contact face and the anchoring piece contact face being shaped to rest against one another during the process of producing an anchorage,
• the assembly further comprising a suture,
• wherein the foot piece is shaped to hold the suture slidably or non-slidably in a manner that a pulling force applied to the suture pulls on the foot piece,
• wherein the anchoring piece comprises a thermoplastic material capable of being reversibly liquefied by energy and of interpenetrating bone tissue in a liquid state and of thereby being, after re-solidification, anchored in the bone tissue,
• wherein the suture is accessible from a proximal side and wherein the suture is capable of transmitting a pulling force exerted on said suture to the foot piece as a counter force to a pushing force exerted to the vibrating element, wherein the anchoring piece is arranged to be compressed between the foot piece and the vibrating element as a result of the pushing force and the counter force.