Tissue fastener

Abstract

A tissue fastener comprises a shaft having a member disposed thereon for lodging the shaft within the tissue, the shaft having a region that is relatively flexible to render a tissue engaging head disposed at a proximal end of the shaft movable with respect to the shaft. In one embodiment, the region comprises substantially an entire length of the shaft and is made from flexible material, such as a mesh, onto which the member and the head are molded. In another embodiment, the shaft comprises generally rigid material, and the region comprises a flexible joint between the shaft and the head. The flexible joint comprises a breakable (e.g., frangible) section of the shaft, and a flexible member (e.g., a plurality of filaments or a flexible tube) extends between the shaft and the head past the breakable section.

What is claimed is:  
     
         1 . A tissue fastener comprising 
 a shaft having a member disposed thereon for lodging the shaft within the tissue, and    a tissue engaging head disposed at a proximal end of the shaft,    a region of the shaft being relatively flexible to render the head movable with respect to the shaft.    
     
     
         2 . The tissue fastener of  claim 1  wherein the region comprises substantially an entire length of the shaft.  
     
     
         3 . The tissue fastener of  claim 2  wherein the region comprises flexible material.  
     
     
         4 . The tissue fastener of  claim 3  wherein the flexible material comprises a mesh.  
     
     
         5 . The tissue fastener of  claim 1  wherein the shaft comprises a mesh material, the member and the head being molded onto the mesh.  
     
     
         6 . The tissue fastener of  claim 1  wherein the member comprises at least one barb.  
     
     
         7 . The tissue fastener of  claim 1  wherein the shaft comprises generally rigid material and the region comprises a flexible joint between the shaft and the head.  
     
     
         8 . The tissue fastener of  claim 7  wherein the flexible joint comprises a frangible section of the shaft, and further comprising a flexible member extending between the shaft and the head past the frangible section.  
     
     
         9 . The tissue fastener of  claim 8  wherein the breakable section is defined by at least one opening disposed through a wall of the shaft.  
     
     
         10 . The tissue fastener of  claim 8  wherein the flexible member comprises a plurality of filaments.  
     
     
         11 . The tissue fastener of  claim 8  wherein the flexible member comprises a flexible tube.  
     
     
         12 . The tissue fastener of  claim 8  wherein the flexible member extends along substantially an entire length of the shaft.  
     
     
         13 . The tissue fastener of  claim 8  wherein the shaft and the head comprise an integral molded unit, the flexible member being molded therewithin.  
     
     
         14 . The tissue fastener of  claim 1  made from polymeric material.  
     
     
         15 . The tissue fastener of  claim 1  made from bioabsorbable material.  
     
     
         16 . The tissue fastener of  claim 1  wherein the shaft is hollow and defines an interior passage, the head including an opening in communication with the passage.  
     
     
         17 . The tissue fastener of  claim 16  wherein the passage is open at a distal end of the shaft.  
     
     
         18 . The tissue fastener of  claim 16  wherein the passage is closed at a distal end of the shaft.  
     
     
         19 . The tissue fastener of  claim 1  wherein the head has a flat distal surface.  
     
     
         20 . The tissue fastener of  claim 1  wherein the head has a toothed distal surface.  
     
     
         21 . A tissue fastener comprising 
 a shaft,    a member disposed at a distal region of the shaft for lodging the shaft within the tissue, and    a tissue engaging head disposed at a proximal end of the shaft,    the shaft being relatively flexible between the member and the head to render the head movable with respect to the shaft.    
     
     
         22 . The tissue fastener of  claim 21  wherein the shaft comprises a mesh extending between the member and the head.  
     
     
         23 . A tissue fastener comprising 
 a generally rigid shaft having a member disposed thereon for lodging the shaft within the tissue,    a tissue engaging head disposed at a proximal end of the shaft, and    a flexible joint between the shaft and the head to render the head movable with respect to the shaft.    
     
     
         24 . The tissue fastener of  claim 23  wherein the flexible joint comprises a breakable section of the shaft, and further comprising a flexible member extending between the shaft and the head past the breakable section.  
     
     
         25 . The tissue fastener of  claim 24  wherein the breakable section is frangible.  
     
     
         26 . The tissue fastener of  claim 23  wherein the flexible member comprises a plurality of filaments.  
     
     
         27 . The tissue fastener of  claim 23  wherein the flexible member comprises a flexible tube.  
     
     
         28 . Apparatus comprising 
 a tissue fastener comprising a shaft having a member disposed thereon for lodging the shaft within the tissue, and a tissue engaging head disposed at a proximal end of the shaft, a region of the shaft being relatively flexible to render the head movable with respect to the shaft, and    an insertion tool engageable with the tissue fastener for inserting the tissue fastener into tissue.    
     
     
         29 . The apparatus of  claim 28  wherein 
 the member is disposed at a distal region of the shaft for lodging the shaft within the tissue, the tissue engaging head is disposed at a proximal end of the shaft, and the shaft is relatively flexible between the member and the head,  
 the insertion tool comprising an engagement portion for engaging the member.  
 
     
     
         30 . The apparatus of  claim 29  wherein the head includes an aperture, the engagement portion of the tool being configured to extend through the aperture when engaged with the member.  
     
     
         31 . A method for tissue attachment comprising 
 providing a tissue fastener comprising a shaft having a member disposed thereon for lodging the shaft within the tissue, and a tissue engaging head disposed at a proximal end of the shaft, a region of the shaft being relatively flexible to render the head movable with respect to the shaft, and    inserting the tissue fastener through a first tissue and into a second tissue so that the member lodges within the second tissue and the head urges the first tissue against the second tissue.    
     
     
         32 . The method of  claim 31  wherein the first tissue and the second tissue are regions of a common tissue structure.  
     
     
         33 . The method of  claim 32  wherein the tissue structure is cartilage and, prior to the inserting, the first region is separated from the second region by a tear in the cartilage.  
     
     
         34 . The method of  claim 31  wherein the first tissue is soft tissue and the second tissue is bone.  
     
     
         35 . A method for making a tissue fastener comprising 
 providing a shaft having a member disposed thereon for lodging the shaft within the tissue, and a tissue engaging head disposed at a proximal end of the shaft, and    making a region of the shaft relatively flexible to render the head movable with respect to the shaft.    
     
     
         36 . The method of  claim 35  further comprising making the region comprise substantially an entire length of the shaft.  
     
     
         37 . The method of  claim 36  further comprising making the region from flexible material.  
     
     
         38 . The method of  claim 37  wherein the flexible material comprises a mesh.  
     
     
         39 . The method of  claim 35  wherein the shaft comprises a mesh material, and further comprising molding the member and the head onto the mesh.  
     
     
         40 . The method of  claim 35  wherein the shaft comprises generally rigid material, the making comprising forming a flexible joint between the shaft and the head in the region.  
     
     
         41 . The method of  claim 40  wherein the forming comprises providing a breakable section of the shaft, and further comprising extending a flexible member between the shaft and the head past the breakable section.  
     
     
         42 . The method of  claim 41  further comprising forming the breakable section to be frangible.  
     
     
         43 . The method of  claim 42  further comprising defining the breakable section by at least one opening disposed through a wall of the shaft.  
     
     
         44 . The method of  claim 41  wherein the flexible member comprises a plurality of filaments.  
     
     
         45 . The method of  claim 41  wherein the flexible member comprises a flexible tube.  
     
     
         46 . The method of  claim 41  further comprising extending the flexible member along substantially an entire length of the shaft.  
     
     
         47 . The method of  claim 41  further comprising molding the shaft and-the head as an integral unit, and molding the flexible member therewithin.  
     
     
         48 . The method of  claim 35  further comprising making the tissue fastener from polymeric material.  
     
     
         49 . The method of  claim 35  further comprising making the tissue fastener from bioabsorbable material.  
     
     
         50 . The method of  claim 35  further comprising providing the shaft with an interior passage, and forming an opening in the head in communication with the passage.  
     
     
         51 . The method of  claim 50  further comprising opening the passage at a distal end of the shaft.  
     
     
         52 . The method of  claim 50  further comprising closing the passage at a distal end of the shaft.  
     
     
         53 . The method of  claim 35  further comprising providing the head with a flat distal surface.  
     
     
         54 . The method of  claim 35  further comprising providing the head with a toothed distal surface.