Bone anchor insertion device

Abstract

A bone anchor insertion device comprises a handle, a nosepiece connected to a distal end of the handle, a bone anchor connected to the nosepiece, and an actuator disposed on the handle for deploying the bone anchor, which suture is also fixed to a portion of soft tissue to be attached to a portion of bone. A suture ratchet or tensioning mechanism is disposed in the handle for tensioning suture which is associated with the bone anchor. This mechanism permits precise tensioning, while also permitting one-handed operation, thereby allowing the practitioner to use his or her other hand for other activities, such as camera operation or the like.

1 . A bone anchor insertion device, comprising: 
 a handle;    a nosepiece connected to a distal end of said handle;    a bone anchor connected to said nosepiece;    an actuator disposed on said handle for deploying said bone anchor; and    a suture tensioning mechanism disposed in said handle for tensioning suture which is associated with said bone anchor.    
     
     
         2 . (Canceled)  
     
     
         3 . (Canceled)  
     
     
         4 . The bone anchor insertion device as recited in  claim 1 , wherein said suture is fixed to a portion of soft tissue to be attached to a portion of bone.  
     
     
         5 . The bone anchor insertion device as recited in  claim 1 , wherein said bone anchor comprises a tubular body which is adapted to received said suture therethrough.  
     
     
         6 - 14 . (Canceled)  
     
     
         15 . A method for making an orthopedic repair, by re-attaching a portion of soft tissue to a portion of adjacent bone, using a bone anchor insertion device comprising a handle and a nosepiece attached to a distal end of said handle, said method comprising: 
 a) passing a length of suture through said portion of soft tissue so that a loop of suture is embedded therein;    b) passing a free end of said length of suture through said nosepiece, a bone anchor disposed thereon, and said handle; and    c) securing said free end of said length of suture to a suture tensioning mechanism in said handle.    
     
     
         16 . The method as recited in  claim 15 , said method further comprising: 
 d) locating said bone anchor so that it lies beneath a cortical bone surface of said portion of adjacent bone;    e) deploying said bone anchor so that it remains in place beneath said cortical bone surface; and    f) actuating said suture tensioning mechanism to tension said length of suture, thereby approximating said soft tissue portion to said adjacent bone portion as desired.    
     
     
         17 . The method as recited in  claim 16 , wherein said bone anchor insertion device further comprises a pull tube disposed in said nosepiece, and an actuator on said handle for moving said pull tube proximally a desired distance, said bone anchor deployment step further comprising actuating said handle actuator to move said pull tube proximally, until a laterally deployable portion of said bone anchor abuts a mandrel surface on said nosepiece and is thereby forced to laterally deploy.  
     
     
         18 . The method as recited in  claim 17 , wherein, subsequent to said bone anchor deployment step a connection between said bone anchor and said pull tube fractures upon continued proximal movement of said pull tube.  
     
     
         19 . The method as recited in  claim 18 , said bone anchor insertion device further comprising a suture plug attached to a distal end of said pull tube for immobilizing suture within said bone anchor, said method further comprising: 
 g) continuing to actuate said handle actuator, to thereby move said pull tube proximally, to thereby move said suture plug proximally to immobilize suture within said bone anchor.    
     
     
         20 . The method as recited in  claim 19 , and further comprising: 
 h) separating said bone anchor insertion device from said bone anchor and suture plug;    i) withdrawing said bone anchor insertion device from the repair site; and    j) trimming off said suture to complete the repair.    
     
     
         21 . The method as recited in  claim 20 , and further comprising repeating steps a) through j) to create another attachment between said portion of soft tissue and said adjacent bone.  
     
     
         22 . The method as recited in  claim 15 , wherein step b) comprises passing two free ends of said suture through said nosepiece, a bone anchor disposed therein, and said handle.  
     
     
         23 . A method for making an orthopedic repair, by re-attaching a portion of soft tissue to a portion of adjacent bone, using a bone anchor insertion device comprising a handle and a nosepiece attached to a distal end of said handle, said method comprising: 
 a) passing a length of suture through said portion of soft tissue so that a loop of suture is embedded therein;    b) inserting a pull tube, on which is disposed a bone anchor having a laterally deployable member, into said nosepiece;    c) passing at least one free end of said length of suture through said nosepiece, said bone anchor, and said handle, using snares;    d) locating said bone anchor so that it lies beneath a cortical bone surface of said portion of adjacent bone; and    e) actuating an actuator on said handle to move said pull tube proximally, until said bone anchor is engaged with a mandrel surface on said nosepiece and said laterally deployable member is forced to deploy.    
     
     
         24 . The method as recited in  claim 23 , and further comprising: 
 f) tensioning said length of suture to approximate said portion of soft tissue to said adjacent portion of bone, as desired.    
     
     
         25 . The method as recited in  claim 24 , and further comprising: 
 g) continuing to actuate said actuator on said handle to further move said pull tube proximally, to thereby move a suture plug attached to a distal end of said pull tube proximally to engage and immobilize suture disposed in said bone anchor.    
     
     
         26 . The method as recited in  claim 25 , and further comprising: 
 h) separating said bone anchor insertion device from said bone anchor and suture plug;    i) withdrawing said bone anchor insertion device from the repair site; and    j) trimming off said suture to complete the repair.    
     
     
         27 . The method as recited in  claim 26 , and further comprising repeating steps a) through j) to create another attachment between said portion of soft tissue and said adjacent bone.  
     
     
         28 . A bone anchor insertion device, comprising: 
 a handle;    a first snare for receiving a suture loop; and    a second snare for receiving the suture loop from said first snare.    
     
     
         29 . The bone anchor insertion device as recited in  claim 28 , wherein said first snare is relatively short and said second snare is relatively long.  
     
     
         30 . The bone anchor insertion device as recited in  claim 28 , wherein said device further comprises a nosepiece disposed distally of said handle and a bone anchor connected to said nosepiece, said second snare extending through said nosepiece, handle, and anchor and being removable from said device from a proximal end thereof.  
     
     
         31 . A method for making an orthopedic repair, by re-attaching a portion of soft tissue to a portion of adjacent bone, using a bone anchor insertion device comprising a first snare having a first loop and a second snare having a second loop, said method comprising: 
 a) threading a free end of a length of suture which extends from said portion of soft tissue through the first loop of said first snare; and    b) pulling said first snare distally to thereby draw said length of suture through the second loop of said second snare.    
     
     
         32 . The method as recited in  claim 31 , and further comprising a step of pulling said second snare proximally from said device, thereby threading said suture loop through said device.