1. Field of the Invention
This invention relates generally to fixation devices which are implanted within the body.
2. Description of the Related Art
Conventionally, fixation between bone and bone, or between bone and soft tissue (such as muscle or tendon) when used in interference-type applications or approximation is created using screw-type implants. These screws generally require pilot holes and a driver to install and provide the required fixation or interference.
A conventional interference screw implant 10 for orthopedic fixation applications is shown in
Though this type of implant has proved very useful, it has several drawbacks. For example, the use of pilot drills and holes, while effective in improving implant retention, adds additional steps and expense to the surgical procedure.
Another significant drawback of current implant designs relates to their use with soft tissue, in that soft tissue may be damaged by the screw threads as the screw moves along the tissue during installation. This is a problem especially for interference-type screw applications.
One additional drawback common to the majority of existing implant types is that they only partially take advantage of the natural bone structure to improve retention. As mentioned previously, most implants are installed into pilot holes which have been pre-drilled to a specific size. These holes are drilled into bone which is composed of basically two types: cortical and cancellous. These two types of bone vary greatly in their mechanical properties, and traditional implants fail to capitalize on those variations. Cortical bone is a dense bone material and forms a type of shell which protects the much softer cancellous bone. Traditional implants typically create an opening in the cortical bone which is relatively large relative to the implant, which tends to reduce the influence of the cortical bone on overall implant retention strength.
There have been many advances in the design of these sorts of implants, and significant research has been conducted regarding the design of traditional screw-type implants. This research is primarily focused on addressing the above issues to help support the overall goal of longevity and overall implant retention over time. Several advances have been made which address some of the concerns summarized above, such as tapered thread designs, rounded threads, and various drive mechanisms. However, all of these changes are iterations on a traditional screw-design theme, and as such do not fully overcome the above-noted drawbacks.
The present invention is directed to a shape-changing anatomical implant useful for the fixation of bone and soft tissue, which overcomes or mitigates some of the drawbacks noted above.
The present implant, referred to herein as an ‘anchor’, has activated and de-activated states. The anchor includes an activation means which converts the anchor from its de-activated state to its activated state, and one or more members which extend away from the activation means and thereby change the shape of the anchor when the anchor is activated. The anchor is suitable for installation within bone and/or soft tissue when in its de-activated state, and then when activated, the shape change acts to increase the force with which the anchor is retained within the bone and/or soft tissue in which it is installed.
Several different embodiments are described, including some which include a pointed tip with which the anchor can be driven into tissue, and others which require a pilot hole. The embodiments employ several different types of activation means, as well as several different member-types. However, all embodiments are arranged to be suitable for installation into a particular tissue when de-activated, and to be firmly anchored within the tissue when installed and activated.
These and other features, aspects, and advantages of the present invention will become better understood with reference to the following description and claims.
a-2c are perspective, plan and detailed views, respectively, of a shape-changing anchor per the present invention which employs wedge-shaped body portions.
a-3b are elevation and plan views, respectively, of another possible embodiment of a shape-changing anchor per the present invention which employs wedge-shaped body portions.
c and 3d are plan views illustrating the operation of one possible embodiment of a spring mechanism which temporarily allows the anchor to return to the deactivated state, as might be used with an anchor as shown in
a-4d are elevation views illustrating the use of a mating tool with a shape-changing anchor per the present invention which employs wedge-shaped body portions.
a-5d are perspective, side elevation and front elevation views of a non-piloted version of a shape-changing anchor per the present invention.
a-6g are perspective views of a piloted version of a shape-changing anchor per the present invention and its various components.
i-6j are plan views of the anchor of
k and 6L are plan and corresponding sectional views of an embodiment of a shape-changing anchor per the present invention which employs leaf springs as an activation means.
a and 7b are plan views of another possible embodiment of a shape-changing anchor per the present invention, shown in its de-activated and activated states, respectively.
a-9c are plan, sectional and magnified views, respectively, of another possible embodiment of a shape-changing anchor per the present invention.
a-10c are perspective, schematic and plan views, respectively, of a shape-changing anchor per the present invention which employs spike-shaped members.
a-11c are perspective, plan and sectional views, respectively, of another possible embodiment of a shape-changing anchor per the present invention which employs spike-shaped members.
a and 12b are plan and sectional views, respectively, of one possible embodiment of a nut which inhibits the de-activation of a shape-changing anchor per the present invention.
a and 13b are plan and sectional views, respectively, of another possible embodiment of a nut which inhibits the de-activation of a shape-changing anchor per the present invention.
The present shape-changing anatomical anchor is useful for the fixation of bone and soft tissue. Several exemplary embodiments are described and many others are possible; however, common to all embodiments is that each has ‘activated’ and ‘de-activated’ states, and is equipped with a means by which the anchor can be converted from its de-activated to its activated state. The anchor also has one or more members which are arranged to extend away from the activation means and thereby change the shape of the anchor when the anchor is converted to its activated state.
An anchor as described herein is suitable for installation within bone and/or soft tissue when in its de-activated state. Then, once installed and activated, the anchor's shape change acts to increase the force with which the anchor is retained within the bone and/or soft tissue, thereby making it more difficult for the anchor to be pulled out or dislocated. In some embodiments, the activation means is arranged such that it can also convert the anchor from its activated state back to its de-activated state. This can be useful if there is a need to remove or relocate the anchor after it has been installed and activated.
Embodiments are described which are to be installed directly within bone and/or soft tissue without the use of a pilot hole, while others are arranged such that at least a portion of the anchor is installed in a pilot hole formed within the tissue in which the anchor is to be installed.
The present anchor is useful for many different fixation applications. For example, an anchor as described herein could be used to enable the orthopedic fixation of soft tissue to bone, the fixation of bone to bone, or the fixation of bone to tissue which has been inserted in a bone tunnel formed in the bone. For example, the anchor can be used in an ACL/PCL replacement procedure, where it acts to fix the tendon graft bundle into the femoral or tibial canal. Another possible application would be to use the anchor in soft tissue to suspend a bladder neck, as a means of treating incontinence.
Anchors as described herein can be made from a number of different materials. Examples of materials that might be used include metals, plastics, PEEK, bioresorbables, and bioconductives.
One possible embodiment 20 is shown in
Each wedge-shaped body portion has at least one sloped surface, with a sloped surface of one body portion of each pair stacked atop a sloped surface of the other body portion of each pair, such that the pair of wedge-shaped body portions tends to slide along their sloped surfaces in opposite directions when subjected to a force applied substantially perpendicular to the directions of movement. Thus, as oriented in
The activation means includes a central shaft 24 that runs through each of the wedge-shaped body portions. The activation force is then applied along an axis parallel to that of the central shaft. Here, central shaft 24 is threaded at one end and includes a bottom portion 26 at its other end, and the wedge-shaped body portions are disposed around the shaft between the bottom portion and a nut 28 threaded onto the top of the shaft. The activation force is then applied by threading nut 28 towards bottom portion 26 so as to compress the wedge-shaped body portions against each other, causing them to slide radially outwards, away from shaft 24; a plan view of the anchor with its wedge-shaped body portions extended away from shaft 24 is shown in
In general, an anchor of this type is arranged such that, when de-activated, the force applied substantially perpendicular to the directions of movement is less than that required to force the wedge-shaped body portions away from the central shaft. But, when activated, the applied force is sufficient to force the wedge-shaped body portions to expand radially away from the central shaft.
The central shaft 24 and the wedge-shaped body portions are preferably arranged such that the body portions cannot rotate about the shaft; this is illustrated in
As shown in
Alternatively, as shown in
It may be desirable to be able to return an activated anchor back to its de-activated state, to adjust the location of the anchor, for example, or to remove it. One possible means by which this process can be assisted is illustrated in
The activation means of an anchor per the present invention preferably includes a torque feature arranged to receive a mating tool which, when engaged with the torque feature and operated, acts to activate the anchor. Such a torque feature is seen in
This is illustrated in more detail in
In
An anchor per the present invention may be a ‘piloted’ type—i.e., arranged to be installed within a pilot hole, or a ‘non-piloted type’—which is installed directly within bone and/or soft tissue without the use of a pilot hole. An example of the latter type is shown in
The anchor 60 is shown in its de-activated state in
The present anchor, as well as the other anchor embodiments described below, may be arranged such that its members can be locked in their extended positions or inhibited from returning to their de-activated positions once the anchor has been activated; such a locking or inhibiting means may be permanent, or temporary—with the possibility of being overridden by the user. For example, a set of mating flats or detents or similar features could be employed to keep the activation means from returning to its de-activated position once the anchor has been activated.
One possible application for this type of anchor would be for tissue approximation to bone, in which case sutures 74 could be attached to the anchor as shown in
The anchor's shape-changing design improves anchor retention in two ways: (1) by increasing the surface area/contact area with the softer cancellous bone 72b, and (2) by allowing the device to bear up on the high strength cortical bone 72a (as shown in
Another possible piloted embodiment 80 is shown in
An assembled anchor is shown in
There are numerous methods by which this anchor can be activated. In this example, the desired shape-changing effect is obtained by means of a central camshaft around which body portions 82 and 84 are disposed. The anchor is arranged such that, when de-activated, the shaft is in a first position such that the body portions are not extended away from the camshaft, and when activated, the camshaft is rotated such that the body portions are forced away from the camshaft.
An exemplary camshaft 90 is shown in
By way of assembly (
i and 6j describe the cam action that defines this design. The camshaft 90 nests between the two body portions 82, 84 while in its de-activated state (
One possible alternative to a cam arrangement is shown in the plan and sectional views of
The anchor is preferably arranged such that at least one of its body portions includes an uneven face portion—such as serrated edges 102 shown on body portion 84 in
As noted above, an anchor as shown in
a and 7b illustrate a variation on this design, and show how the number of body portions could increase to allow for different form factors for alternative anchor shapes. These include a tri-lobed design as shown in
This embodiment also includes an arrangement in which body portions 14 are locked in their extended positions or inhibited from returning to their de-activated positions once the anchor has been activated. Here, each body portion 114 includes a pin 116 and teeth 117, with the anchor arranged such that the pin of one body portion engages the teeth of another body portion to form ratchet arrangements which inhibit the body portions from returning to their de-activated positions after the anchor has been activated.
Note that, instead of a camshaft, a shape-changing anchor per the present invention might utilize a screw thread having a diameter that varies along its length, to improve the mechanical advantage of the camming action.
There are numerous methods by which an anchor having the general design of that shown in
As illustrated in
Another possible embodiment is shown in
An anchor of this sort includes a top cap 136 and at least one planar surface 138 on which at least one of the pivot points and spikes resides. Planar surfaces 138 are substantially parallel to top cap 136 and preferably positioned at respective fixed distances below the cap, and central drive shaft 132 passes through each of the planar surfaces.
Some form of mechanical coupling is required between drive shaft 132 and spikes 130. For example, shaft 132 can include one or more gears, and each of spikes 130 can include a gear which meshes with a respective one of the drive shaft gears to effect the mechanical coupling.
Drive shaft 132 preferably includes a torque feature such as the hex head at the top of the shaft shown in FIG. 10a. A mating tool is preferably designed such that, when engaged with the torque feature and operated, it acts to rotate the shaft and thereby activate the anchor. The anchor preferably includes a counter-rotation feature which, when held stationary while the mating tool is operated, prevents spikes 130 from rotating around shaft 132 when the shaft is rotated. For example, the holes 140 shown in top cap 136 in
An alternative version of the ‘spike’ embodiment shown in
As noted above, the present anchor may be arranged such that its members can be locked in their extended positions or inhibited from returning to their de-activated positions once the anchor has been activated. There are many ways in which this can be achieved; two exemplary possibilities are shown in the plan views of
Note that the rotation inhibiting means shown in
The embodiments of the invention described herein are exemplary and numerous modifications, variations and rearrangements can be readily envisioned to achieve substantially equivalent results, all of which are intended to be embraced within the spirit and scope of the invention as defined in the appended claims.
This application claims the benefit of provisional patent application No. 61/000,248 to D. Skinlo et al., filed Oct. 23, 2007.
Number | Date | Country | |
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61000248 | Oct 2007 | US |