Methods and devices for repairing triangular fibrocartilage complex tears

Abstract

Methods and devices for repairing the TFCC of a patient's wrist are provided. In general, the device includes first and second anchor bodies that are connected to one another by a suture. The first anchor body is configured to be passed through a portion of the TFCC of a patient's wrist and an anchoring tissue, preferably using a delivery device, such that the first anchor body is positioned across a torn portion of the TFCC, the second anchor body is positioned across the anchoring tissue, and the suture extends therebetween. The suture can then be tensioned to anchor the TFCC to the anchoring tissue.

1 . An anchor system for repairing tears in the triangular fibrocartilage complex, comprising: 
 a first anchor body having a central portion adapted to receive a suture, and opposed wing members extending from opposed sides of the central portion, the wing members defining a length that is greater than a height of the central portion;    a second anchor body having a circular base with a substantially cylindrical central portion extending therefrom, the second anchor body include a bore extending through the circular base and the substantially cylindrical central portion for receiving a suture; and    a suture loop extending through the central portion of the first and second anchor bodies, and including a slip knot formed therein and positioned adjacent the second anchor body.    
     
     
         2 . The anchor system of  claim 1 , wherein the first and second anchor bodies each have a size adapted to be used to repair tears in the triangular fibrocartilage complex of a patient's wrist.  
     
     
         3 . The anchor system of  claim 1 , wherein the central portion of the first anchor body is substantially semi-circular, and the opposed wing members are formed from an elongate, generally cylindrical member coupled to the central portion.  
     
     
         4 . The anchor system of  claim 3 , wherein the elongate, generally cylindrical member has a length that is greater than a maximum diameter of the central portion.  
     
     
         5 . The anchor system of  claim 4 , wherein the length of the elongate member is in the range of about 3.5 mm to 4.5 mm and the maximum diameter of the central portion is in the range of about 2.0 mm to 4.0 mm.  
     
     
         6 . The anchor system of  claim 4 , wherein the length of the elongate member is about 4.0 mm and the maximum length of the central portion is about 3.0 mm.  
     
     
         7 . The anchor system of  claim 1 , wherein the first anchor body includes a bore extending through the central portion for receiving the suture.  
     
     
         8 . The anchor system of  claim 1 , wherein the second anchor body further comprises a recess formed at one end of the bore and adapted to seat the slip knot formed on the suture.  
     
     
         9 . The anchor system of  claim 8 , wherein the circular base is positioned radially outward of the recess.  
     
     
         10 . The anchor system of  claim 1 , wherein the first and second anchor bodies are formed from a bioabsorbable polymeric material.  
     
     
         11 . The anchor system of  claim 1 , wherein the suture is selected from the group consisting of non-bioabsorbable and bio-absorbable sutures.  
     
     
         12 . The anchor system of  claim 1 , further comprising a delivery device adapted to seat the first anchor body.  
     
     
         13 . The anchor system of  claim 12 , wherein the delivery device is adapted to seat a plurality of anchor bodies.  
     
     
         14 . The anchor system of  claim 12 , wherein the delivery device includes an elongate needle having a channel formed in at least a distal portion thereof and adapted to slidably receive at least a portion of the first anchor body.  
     
     
         15 . The anchor system of  claim 14 , wherein the opposed wing members of the first anchor body are formed from an elongate, generally cylindrical member coupled to the central portion, the elongate, generally cylindrical member being adapted to be slidably disposed within the channel formed in the elongate needle of the delivery device.  
     
     
         16 . The anchor system of  claim 14 , wherein the substantially cylindrical central portion of the second anchor body has an outer diameter that is substantially the same as or less than an inner diameter of the channel in the elongate needle of the delivery device.  
     
     
         17 . The anchor system of  claim 14 , wherein at least the distal-most portion of the delivery needle has a diameter in the range of about 16 to 18 gauge.  
     
     
         18 . The anchor system of  claim 14 , further comprising a handle member coupled to the elongate needle, and a trigger mechanism formed on the handle and effective to, upon actuation, advance the first anchor body in a distal direction.  
     
     
         19 . The anchor system of  claim 14 , further comprising a handle member coupled to the elongate needle and having a suture-receiving channel formed therein.  
     
     
         20 . A method for repairing tears in the triangular fibrocartilage complex of a patient's wrist, comprising: 
 passing a delivery device through a portion of a torn triangular fibrocartilage complex of a patient's wrist at a first location, the delivery device carrying first and second anchor bodies that are connected to one another by a suture;    releasing the first anchor body from the delivery device such that the first anchor body is resting against an anchoring tissue;    passing the delivery device through a portion of the torn triangular fibrocartilage complex of a patient's wrist at a second location adjacent to the first location;    releasing the second anchor body from the delivery device such that the second anchor body is resting against the anchoring tissue adjacent to the first anchor body, and the suture extends from the first anchor body and second anchors bodies across the torn triangular fibrocartilage complex, and a portion of the suture rests against a tissue surface opposed to the anchoring tissue; and    tensioning the suture to re-approximate the torn triangular fibrocartilage complex.    
     
     
         21 . The method of  claim 20 , wherein the tissue surface that a portion of the suture rests against comprises the triangular fibrocartilage complex.  
     
     
         22 . The method of  claim 20 , wherein the anchoring tissue is the triangular fibrocartilage complex, and the tissue surface that a portion of the suture rests against is selected from the group consisting of the dorsal capsule and the extensor carpi ulnaris subsheath, and the ulna bone.  
     
     
         23 . The method of  claim 20 , wherein the anchoring tissue is the triangular fibrocartilage complex, and the tissue surface that a portion of the suture rests against comprises the radius bone.