Implantable Tendon Protection Systems and Related Kits and Methods

Abstract

An implantable tendon protection system includes a body adapted to be implanted within a bursa overlying a tendon of a patient to protect the tendon. The body may be fixed to the tendon with adhesive, sutures, staples, and/or anchors. A surgical kit is provided with such a tendon protection system and an insertion cannula. Methods of protecting a tendon of a patient are also disclosed.

1 . An implantable tendon protection system comprising:
 a body adapted to be implanted within a bursa overlying a tendon of a patient, the body comprising a tendon engaging surface configured to attach to the tendon.   
     
     
         2 . The system of  claim 1 , wherein the body further comprises a sliding surface adapted to slide with respect to the bursa. 
     
     
         3 . The system of  claim 1 , wherein the tendon engaging surface comprises adhesive. 
     
     
         4 . The system of  claim 1 , wherein the body is configured to be movable between a collapsed state in which the body may be received within a cannula cavity, and a deployed state in which the body may extend across an interior portion of the bursa. 
     
     
         5 . The system of  claim 1 , wherein the body is configured to attach to a partially torn tendon. 
     
     
         6 . The system of  claim 1 , wherein the body comprises a middle portion that is less flexible than an edge portion. 
     
     
         7 . The system of  claim 1 , wherein the body is constructed from individual layers. 
     
     
         8 . The system of  claim 7 , wherein a first layer comprises a sliding surface and a second layer comprises the tendon engaging surface. 
     
     
         9 . The system of  claim 8 , wherein the second layer comprises a mesh material. 
     
     
         10 . The system of  claim 8 , wherein the second layer comprises a plurality of fibers. 
     
     
         11 . The system of  claim 8 , wherein the second layer comprises a bioabsorbable material. 
     
     
         12 . The system of  claim 8 , further comprising one or more intermediate layers located at least partially between the first and second layers. 
     
     
         13 . The system of  claim 8 , further comprising a cushioning layer interposed between the first and second layers. 
     
     
         14 . The system of  claim 8 , further comprising an intermediate layer located at least partially between the first and second layers, the intermediate layer comprising at least one channel. 
     
     
         15 . The system of  claim 14 , wherein the at least one channel fluidly communicates with the tendon engaging surface. 
     
     
         16 . The system of  claim 8 , wherein the sliding surface has a lower coefficient of friction than that of the tendon engaging surface. 
     
     
         17 . A surgical kit comprising:
 the system of  claim 4 ; and   an insertion cannula comprising a portion configured to enter a body of a patient, the portion comprising a cavity for receiving the system when in the collapsed state, the insertion cannula further comprising a mechanism configured to remove the system from the cavity when the insertion cannula portion is within the body of the patient.   
     
     
         18 . The surgical kit of  claim 17 , wherein the removal mechanism comprises a push rod at least partially located within the insertion cannula and movable along a longitudinal axis of the insertion cannula. 
     
     
         19 . A method of protecting a tendon of a patient, the method comprising:
 inserting a device into an at least partially viable bursa of the patient to a position overlying the tendon; and   engaging a first surface of the implant with the tendon.   
     
     
         20 . The method of  claim 19 , further comprising attaching the device to the tendon. 
     
     
         21 . The method of  claim 20 , wherein the attaching step comprises the use of an adhesive. 
     
     
         22 . The method of  claim 21 , wherein the adhesive is urged through a channel in the device when the device is positioned within the body of the patient. 
     
     
         23 . The method of  claim 19 , wherein the inserting step comprises at least partially receiving the device within a portion of an insertion instrument, inserting the portion of the insertion instrument into the body of the patient, and removing the device from the insertion instrument while the portion is within the body. 
     
     
         24 . The method of  claim 19 , wherein the device is caused to assume the deployed state at least partially by introducing a fluid into an inflatable portion of the device. 
     
     
         25 . The method of  claim 19 , further comprising the step of delivering a therapeutic or diagnostic agent to tissue adjacent the device. 
     
     
         26 . The method of  claim 25 , wherein the therapeutic or diagnostic agent is selected from the group consisting of drugs, anti-inflammatory agents, painkillers, antibiotics, proteins, and hormones. 
     
     
         27 . The method of  claim 22 , wherein a second surface of the device is deployed to slide relative to the bursa. 
     
     
         28 . The method of  claim 19 , wherein the device serves to protect a damaged portion of the tendons. 
     
     
         29 . The method of  claim 19 , wherein the device does not substantially reinforce the engaged tendons by transmitting a significant load of the tendons. 
     
     
         30 . The method of  claim 19 , wherein the device serves to remove a stimulus from nerves in the engaged tendons. 
     
     
         31 . The method of  claim 30 , wherein the stimulus includes one or more of pressure, temperature, chemical, electrical and inflammation stimulus. 
     
     
         32 . The method of  claim 19 , wherein the device is not sutured to the tendons or other tissue. 
     
     
         33 . The method of  claim 19 , wherein the inserting step comprises the use of an arthroscopic instrument. 
     
     
         34 . The method of  claim 19 , wherein the tendon comprises a partially torn tendon. 
     
     
         35 . The method of  claim 20 , wherein the attaching step comprises securing the device to the tendon using a plurality of anchors. 
     
     
         36 . A method of treating a patient, comprising:
 identifying a partially torn portion of a tendon; and   covering the partially torn portion of the tendon.   
     
     
         37 . The method of  claim 36 , wherein covering the partially torn portion of the tendon comprises positioning a device over the partially torn portion of the tendon and fixing the device to the tendon. 
     
     
         38 . The method of  claims 37 , wherein fixing the device to the tendon comprises adhering the device to the tendon with an adhesive. 
     
     
         39 . The method of  claims 37 , wherein fixing the device to the tendon comprises suturing the device to the tendon with one or more sutures. 
     
     
         40 . The method of  claims 37 , wherein fixing the device to the tendon comprises stapling the device to the tendon with one or more staples. 
     
     
         41 . The method of  claims 37 , wherein fixing the device to the tendon comprises anchoring the device to the tendon with one or more anchors. 
     
     
         42 . The method of  claim 37 , wherein covering the partially torn portion of the tendon spreads impinging forces across a surface area of the device. 
     
     
         43 . The method of  claim 37 , further comprising delivering a therapeutic agent that promotes growth of tissue into pores defined by the device. 
     
     
         44 . The method of  claim 37 , further comprising delivering a therapeutic agent that promotes encapsulation of the device within a cellular encapsulation layer. 
     
     
         45 . The method of  claim 37 , further comprising delivering a therapeutic agent that induces the growth of synovial cells on an outer surface of the device. 
     
     
         46 . The method of  claim 37 , further comprising delivering a therapeutic agent that induces the growth of bursa cells on an outer surface of the device. 
     
     
         47 . The method of  claim 36 , further comprising delivering a therapeutic agent that desensitizes stimulated nerve receptors proximate the partially torn portion of the tendon. 
     
     
         48 . The method of  claim 36 , further comprising delivering a therapeutic agent that promotes the growth of a cellular encapsulation barrier over the partially torn portion of the tendon. 
     
     
         49 . The method of  claim 36 , wherein covering the partially torn portion of the tendon inhibits the partially torn portion of the tendon from becoming a tear extending through a total thickness of the tendon. 
     
     
         50 . The method of  claim 36 , wherein covering the partially torn portion of the tendon inhibits physical stimulus of the partially torn portion by adjacent tissues. 
     
     
         51 . The method of  claim 36 , wherein covering the partially torn portion of the tendon protects damaged tendon fibers from mechanical agitation by adjoining tissues. 
     
     
         52 . The method of  claim 36 , wherein covering the partially torn portion of the tendon alleviates pain. 
     
     
         53 . The method of  claim 52 , wherein alleviating pain restores shoulder function. 
     
     
         54 . The method of  claim 36 , wherein covering the partially torn portion of the tendon protects the partially torn portion of the tendon. 
     
     
         55 . The method of  claim 36 , wherein covering the partially torn portion of the tendon prevents abrasion of the partially torn portion of the tendon. 
     
     
         56 . The method of  claim 36 , wherein covering the partially torn portion of the tendon reduces friction between the partially torn portion of the tendon and adjacent tissues. 
     
     
         57 . The method of  claim 36 , wherein covering the partially torn portion of the tendon cushions forces applied to the partially torn portion of the tendon by adjacent tissues.