The present disclosure relates generally to an apparatus for anchoring a suture to a bone.
This section provides background information related to the present disclosure which is not necessarily prior art.
It is commonplace in arthroscopic procedures to employ sutures and anchors to secure soft tissues to bone. Various commercially available “soft” anchors include a careless sleeve of woven (braided) polyester, such as polyethylene terephthalate (PET). Such polyester sleeves serve as an anchor by bunching up against cortical bone when a suture threaded through the sleeve is pulled tight through a hole drilled into the bone.
While woven or braided polyester sleeves provide mechanical anchoring strength in the immediate time following surgery, they generally do not invite biological fixation to further stabilize the soft anchor inside of the bone. Woven or braided polyester sleeves do not encourage tissue infiltration and integration because, PEP, as with polymers in general, is hydrophobic, which does not enable cellular or tissue attachment. Additionally, the size of polyester filaments is much larger than the size of cells, which causes the filaments to be viewed as foreign bodies by cells and by the immune system. Accordingly, there remains a need to develop anchors that encourage cellular ingrowth and biological fixation to bone.
This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.
The present technology provides an anchor for coupling a suture to a bone. The anchor is composed of a non-woven material and includes an elongate tubular body that extends from a first end to a second end. The anchor is configured to receive a suture that enters the anchor through a first aperture and exits the anchor through a second aperture. Pulling free ends of the suture sets the anchor in an anchoring configuration when the anchor is inserted in a bore in a bone. The non-woven material includes electrospun fibers.
The present technology also provides an anchor for coupling a suture to a bone. The anchor has a solid or hollow elongate tubular body extending from a first end to a second end. The anchor is composed of non-woven electrospun fibers. The non-woven electrospun fibers include at least one modifying agent, at least one biological agent, or at least one antimicrobial agent. The tubular body can be hollow, such that it defines an internal passage, or the tubular body can be solid.
Additionally, the present technology provides a suture assembly that includes a flexible anchor and a suture that has a first free end and a second free end. The flexible anchor has an elongate tubular body that extends from a first end to a second end. The flexible anchor is of non-woven electrospun fibers. The suture is passed into the flexible anchor through a first opening and is passed out of the flexible anchor through a second opening, such that the first and second free ends of the suture are external to the flexible anchor. The suture assembly is configured to switch from a first configuration to a second locking configuration when the anchor is inserted into a bore prepared in a bone and the free ends are pulled in a direction that is generally coaxial with and away from bore.
Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.
Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.
Example embodiments will now be described more fully with reference to the accompanying drawings.
The terminology used herein is for the purpose of describing particular example embodiments only and is not intended to be limiting. As used herein, the singular forms “a,” “an,” and “the” may be intended to include the plural forms as well, unless the context clearly indicates otherwise. The terms “comprises,” “comprising,” “including,” and “having,” are inclusive and therefore specify the presence of stated features, elements, compositions, steps, integers, operations, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. Although the open-ended term “comprising,” is to be understood as a non-restrictive term used to describe and claim various embodiments set forth herein, in certain aspects, the term may alternatively be understood to instead be a more limiting and restrictive term, such as “consisting of” or “consisting essentially of.” Thus, for any given embodiment reciting compositions, materials, components, elements, features, integers, operations, and/or process steps, the present disclosure also specifically includes embodiments consisting of, or consisting essentially of, such recited compositions, materials, components, elements, features, integers, operations, and/or process steps. In the case of “consisting of,” the alternative embodiment excludes any additional compositions, materials, components, elements, features, integers, operations, and/or process steps, while in the case of “consisting essentially of,” any additional compositions, materials, components, elements, features, integers, operations, and/or process steps that materially affect the basic and novel characteristics are excluded from such an embodiment, but any compositions, materials, components, elements, features, integers, operations, and/or process steps that do not materially affect the basic and novel characteristics can be included in the embodiment.
Throughout this disclosure, the numerical values represent approximate measures or limits to ranges to encompass minor deviations from the given values and embodiments having about the value mentioned as well as those having exactly the value mentioned. Other than in the working examples provided at the end of the detailed description, all numerical values of parameters (e.g., of quantities or conditions) in this specification, including the appended claims, are to be understood as being modified in all instances by the term “about” whether or not “about” actually appears before the numerical value. “About” indicates that the stated numerical value allows some slight imprecision (with some approach to exactness in the value; approximately or reasonably close to the value; nearly). If the imprecision provided by “about” is not otherwise understood in the art with this ordinary meaning, then “about” as used herein indicates at least variations that may arise from ordinary methods of measuring and using such parameters.
As referred to herein, ranges are, unless specified otherwise, inclusive of endpoints and include disclosure of all distinct values and further divided ranges within the entire range. Thus, for example, a range of “from A to B” or “from about A to about B” is inclusive of A and of B. Disclosure of values and ranges of values for specific parameters (such as temperatures, molecular weights, weight percentages, etc.) are not exclusive of other values and ranges of values useful herein. It is envisioned that two or more specific exemplified values for a given parameter may define endpoints for a range of values that may be claimed for the parameter. For example, if Parameter X is exemplified herein to have value A and also exemplified to have value Z, it is envisioned that Parameter X may have a range of values from about A to about Z. Similarly, it is envisioned that disclosure of two or more ranges of values for a parameter (whether such ranges are nested, overlapping or distinct) subsume all possible combination of ranges for the value that might be claimed using endpoints of the disclosed ranges. For example, if Parameter X is exemplified herein to have values in the range of 1-10, or 2-9, or 3-8, it is also envisioned that Parameter X may have other ranges of values including 1-9, 1-8, 1-3, 1-2, 2-10, 2-8, 2-3, 3-10, and 3-9.
The present technology generally provides devices for anchoring a suture to a bone. The devices, for example, can be used to attach or secure soft tissue to a bone, to attach or secure bone to bone, or to attach or secure bone to structures. Non-limiting examples of soft tissue include tendons, ligaments, fascia, skin, fibrous tissues, synovial membranes, fat, muscles, nerves, and blood vessels. More particularly, the devices of the present technology include anchors that are composed of non-woven electrospun fibers. The anchors are configured such that they can be switched or transitioned from a first configuration to a second configuration when placed in a bore prepared in a bone. Additionally, the electrospun fibers mimic a physiological collagen matrix, which promotes cell growth and tissue integration, which provides mechanical stabilization to the anchor, and through the anchor, to any material attached or secured to a bone with the use of the anchor. In various embodiments, the electrospun fibers include an adjunct material, such as a modifying agent, biological agent, or antimicrobial agent that, for example, alter the anchor's response to water, enrich the fibers with cytokines or growth factors, or provide antimicrobial properties to the anchor.
As used herein, the term “electrospun fibers” refers to fibers generating through electrospinning. Such electrospun fibers have diameters of from about 1 nm to about 50 μm. However, in various embodiments, the electrospun fibers have diameters of from about 0.1 μm to about 10 μm. The electrospun fibers can be generated by any process known in the art. Although many variations may exist, in general electrospun fibers are generated by creating an electric field between a sessile droplet of a polymer solution or polymer melt at the tip of a needle or pipette and a stationary collector plate or a rotating collector spool. The electric field causes a jet to issue from the sessile drop of polymer solution or melt to the collector plate or spool. By using a collector plate, collected electrospun fibers can be molded otherwise formed into a geometric shape that is solid. For example, the fibers can be molded into a porous solid structure, such as a suture anchor, with any cross-sectional geometry. As non-limiting examples, the cross sectional geometry can be a circle, oval, square, diamond, rectangle, pentagon, hexagon, heptagon, octagon, etc. Alternatively, by using a rotating collector spool, collected electrospun fibers can be slid off of the spool to generate a hollow structure, such as a suture anchor, with a cross-section geometry matching the cross-section geometry of the spool. For example, when the spool has a circular cross-sectional geometry, the hollow structure will have a circular cross-sectional geometry. Similarly, when the spool has a triangular cross-sectional geometry, the hollow structure will have a triangular cross-sectional geometry. However, hollow structures with other cross-sectional shapes can be generated by altering the shape of the rotating spool.
The electrospun fibers can be generated from any polymer known in the art, such as natural degradable polymers, synthetic degradable polymers, and nondegradable polymers. Non-limiting examples of suitable natural degradable polymers include fibrin, collagen, laminin, fibronectin, elastin, chitosan, gelatin, hyaluronan, albumin, dextran, pectin, starch and combinations thereof. Non-limiting examples of suitable synthetic degradable polymers include polylactic acid (PLA), polyglycolic acid (PGA), poly(lactic-co-glycolic acid) (PLGA), polycaprolactone (PCL, including a caprolactone), polydioxanone (PDO), polyhdryoxybutyrate (PHB), poly(anhydrides), poly(trimethylene carbonate) (PTC), polyphophazenes, poly amino acids, such as, for example, poly(L-lysine), epsilon poly-lysine, poly(L-ornithine) (PLO) and poly(L-glutamic acid-4-co-L-tyrosine) (PLEY), and mixtures thereof. Non-limiting examples of suitable nondegradable polymers include polyesters, polycarbonate urethanes, polypropylene (PP), nylon, polyurethane (PU), polyester urethanes, polyetherurethanes, polyvinylchloride (PVC), polyethylene (PE), poly(tetrafluroethylene (PTFE), poly(methyl acrylate) (PMA), poly(methyl methacrylate (PMMA), ethylene-co-vinylacetate (EVA), poly(dimethylsiloxane) (PDMS), poly(ethylene terephthalate) (PET), poly(sulphone) (PS), poly(ethyleneoxide) (PEO), poly(ethyleneoxide-co-prpyleneoxide) (PEO-PPO), poly(vinylalcohol) (PVA), and mixtures thereof. Whether degradable or nondegradable, in various embodiments, the polymers are polyanionic, polycationic, hydrophilic, hydrophobic, amphipathic, cross-linked, or non-cross-linked. Additionally, the electrospun fibers themselves may be hollow or solid.
Various properties can be imparted into the electrospun fibers by including an adjunct material, such as a modifying agent, biological agent, antimicrobial agent, or combination thereof to the polymer during the electrospinning process. Therefore, the adjunct material can be directly incorporated into the electrospun fibers. Alternatively, the adjunct material can be indirectly incorporated into the electrospun fibers by dipping, soaking, or spraying after the electrospun fibers are generated.
With reference to
The anchor 100 comprises a tubular body 102 that extends from a first end 104 to a second end 106. The tubular body is composed of a non-woven, non-braided material. In particular, and as shown in
The flexible anchor 100 can have any properties that allow the flexible anchor 100 to change shape. In this regard, the flexible anchor 100 can be, for example, compliant, flexible, foldable, squashable, squeezable, deformable, limp, flaccid, elastic, low-modulus, soft, spongy or perforated, or have any other characteristic property that allows it to change shape. In some embodiments, the flexible anchor 100 includes an adjunct material or modifying agent.
The electrospun fibers 116 have a size that is much smaller than the size of filaments of typical yarns used to braid sutures. As such, the electrospun fibers 116 in the flexible anchor 100 have a diameter of from about 1 nm to about 50 μm. In some embodiments, the electrospun fibers 116 have a diameter that is near the size of mammalian tissues, such as collagen fibrils or collagen fiber bundles. Such electrospun fibers 116 have a diameter of from about 0.1 μm to about 10 μm and are mimetic of normal extracellular matrix components in terms of size and shape, which encourages cellular attachment and tissue ingrowth when positioned within a bore prepared in a bone (see
As discussed above, in various embodiments the electrospun fibers 116 in the flexible anchor 100 include an adjunct material, such as a modifying agent, biological agent, or antimicrobial agent Modifying agents include agents that alter, change, or enhance a property of the polymer included in the fibers 116. Such modifying agents may, for example, promote cellular attachment to the flexible anchor 100. In particular, hydrophilic agents can be used to impart hydrophilic properties upon hydrophobic polymers, or to enhance hydrophilic properties of hydrophilic polymers. Non-limiting examples of hydrophilic modifying agents that promote cellular attachment to the anchor 100 by way of the electrospun fibers 116 include chitosan, gelatin, collagen, silk fibroin, polyethylene glycol, poly-L-lysine, epsilon poly-lysine, blood serum albumin, elastin, fibronectin, hydrophilic biocompatible proteins or combinations thereof. Additionally, modifying agents include agents that provide osteoconductive and/or osteogenic properties to the electrospun fibers 116, such as, for example, ceramic materials selected from the group consisting of tricalcium phosphate, hydmxyapatite, bioglass, and combinations thereof.
In some embodiments, the electrospun fibers 116 include a biological agent that leaches into surrounding tissues after implantation or that contacts cells or tissues that infiltrate the flexible anchor 100. Therefore, the flexible anchor can serve as a drug delivery device. The biological agent can be a growth factor, a small molecule drug, or other molecule that stimulates cell infiltration, and/or that encourages differentiation and maturation of repair tissue, stimulates osteoblast activity, decreases osteoclast activity, and/or that decreases inflammation. Non-limiting examples of suitable biological agents include immunomodulatory host defense proteins, immunomodulatory synthetic mimics of host defense proteins, bisphosphonates, parathyroid hormone, teriparatide, recombinant parathyroid hormone derivatives, parathyroid hormone fragments, strontium ranelate, phenamil, naringin, interleukin-1 receptor antagonist (IL-1ra), soluble interleukin-1 receptor II (sIL-1RII), soluble tumor necrosis factor-receptor 1 (sTNF-RI), soluble tumor necrosis factor-receptor 2 (sTNF-RII), fibroblast growth factor (FGF), bone morphogenetic growth factors (BMPs, including BMP1, BMP2, BMP3, BMP4, BMP5, BMP6, and BMP7), insulin-like growth factor (IGF-I), epidermal growth factor EGF), hepatocyte growth factor (HGF), platelet-derived growth factor AB (PDGF-AB), platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor (VEGF), transforming growth factor-β1, (TGF-β1), and mixtures thereof. The biological agents that are proteins can be recombinant or non-recombinant, such as, for example, non-recombinant PDGF or recombinant PDGF.
In some embodiments, the electrospun fibers 116 include an antimicrobial agent that leaches into surrounding tissues after implantation or that contacts unwanted microbes that come into contact with the flexible anchor 100, such as undesired microbes incorporated during a surgical implantation of the anchor 100. Undesired microbes include bacteria, viruses, and fungi, therefore, the antimicrobial can be an antibiotic, an antiviral agent, an antifungal agent, or a combination thereof. Antibiotics useful herein include, for example, rifamycins (such as rifampin), tetracylines, fostbmycin, fusidic acid, glycylcyclines, aminoglycosides, quinolones, glycopeptides, bismuth thiols, sulfonamides, trimethoprim, macrolides, oxazolidinones, β-lactams, lincosamides, chloramphenicol, gramicidins, polymyxins, lipodepsipeptides, bacitracins, tetracyclines (such as minocycline), penicillin, ampicillin, cefazolin, clindamycin, erythromycins, levofloxacin, vancomycin, gentamycin, and mixtures thereof. In one embodiment, the antimicrobial agent comprises a mixture of vancomycin and gentamycin. Tetracycline antibiotics refer to a number of antibiotics of either natural, or semi-synthetic origin, derived from a system of four linearly annealed six-membered rings (1,4,4a,5,5a,6,11,12a-octahydronaphthacene) with a characteristic arrangement of double bonds. The tetracycline antibiotic can include one or more tetracyclines, and/or semi-synthetic tetracyclines such as doxycycline, oxytetracycline, demeclocycline, lymecycline, chlortetracycline, tigecycline and minocycline. A preferred tetracycline is minocycline or minocycline hydrochloride. Rifamycin class of antibiotics is a subclass of antibiotics from the ansamycin family of antibiotics. The present antibiotic agent or agents can include one or more rifamycin antibiotics from the group rifamycin B, rifampin or rifampicin, rifabutin, rifapentine and rifaximin. Antiviral agents include acyclovir, adenosine, arabinoside, thiadiazoles interferon and interferon inducing agents. Antifungal agents include amphotericin B, imidazoles, triazoles, thiazoles, allylamines, echinocandins, benzoic acid, hydroxypyridones, and 5-fluorocytosine. Antimicrobial peptides useful herein include, for example, host defense proteins, synthetic mimics of host defense proteins, defensins, magainins, cathetlicidins, protegrins, lantibiotics, nisins, and epsilon poly-lysine. Antiseptics and disinfectants include, for example, chlorhexidine, polyhexanide, triclosan, and iodine-delivering formulas such as betadine or povidone-iodine. Metal ions include various formulations of silver that effectively release silver ions, including silver salts and silver nanoparticles, or copper salts and copper nanoparticles that release copper ions. Other antimicrobial agents useful herein include salicylic acid and its metabolite methyl salicylate, and sugar alcohols and polyols (such as xylitol and erythritol). Such sugar alcohols can have antimicrobial properties by preventing bacterial adhesion or bacterial biofilm formation. Polysaccharides, such as chitosan and alginate, are also useful herein.
With further reference to
The anchor 100 is configured to be positioned in a prepared bore 300, as shown in
The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.
Number | Date | Country | |
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Parent | 14675082 | Mar 2015 | US |
Child | 15957301 | US |