Soft tissue repair device and method

Abstract

A soft tissue repair device can include a housing having a handle, a deployment system having an actuation member, and an insertion system having an inserter and a slider. The slider can be coupled to the actuation member and movable relative to the inserter between deployed and retracted positions. First and second anchors can be carried on an external surface of the slider such that the anchors are spaced apart and portions of the anchors are coaxial with the slider and each other. A flexible strand can couple the anchors. The insertion system can cooperate with the deployment system to move the slider to the deployed position to deploy the first anchor upon activating the actuation member a first time, and to move the slider to the deployed position from the retracted position to deploy the second anchor upon actuating the actuation member a second time after the first time.

1 .- 20 . (canceled) 
     
     
         21 . A meniscal tissue repair device, comprising:
 a housing;   an inserter extending from the housing, the inserter including an open distal end and a longitudinal bore that extends through the inserter to the open distal end;   a first flexible suture anchor deployable from the inserter at first location along an outer surface of a meniscus;   a second flexible suture anchor deployable from the inserter at a second location along the outer surface of the meniscus, wherein, in a pre-deployment condition of the meniscal tissue repair device, the second flexible suture anchor is located proximal of the first flexible suture anchor along the inserter;   a suture coupling the first flexible suture anchor to the second flexible suture anchor;   a cam pivotable about a pivot point that is located within the housing, the cam including a first plurality of teeth that extend in an arcuate manner along the cam;   a cam follower including a second plurality of teeth that extend in a linear manner along the cam follower, the second plurality of teeth meshing with the first plurality of teeth such that pivoting the cam about the pivot point causes the cam follower to move linearly within the housing; and   a slider slidably received in the longitudinal bore of the inserter, the slider including a proximal portion coupled to the cam follower such that linear movement of the cam follower within the housing causes the slider to move linearly within the longitudinal bore of the inserter, the slider further comprising an anchor engagement portion that includes a flattened area distal of the proximal portion, the flattened area having a thickness that is less than an outside diameter of a first portion of the slider adjacent the flattened area, wherein, in the pre-deployment condition of the meniscal tissue repair device, the slider extends distally past the second flexible suture anchor toward the first flexible suture anchor to position the flattened area between the second flexible suture anchor and the first flexible suture anchor in the longitudinal bore of the inserter,   wherein, from the pre-deployment condition of the meniscal tissue repair device, the cam is pivotable about the pivot point in a first rotational direction to advance the slider within the longitudinal bore of the inserter to a first deployment position and thereby force the first flexible suture anchor from the inserter via an engagement of the first flexible suture anchor with the anchor engagement portion,   wherein the cam is pivotable about the pivot point in a second rotational direction opposite the first rotational direction to retract the slider within the longitudinal bore of the inserter from the first deployment position to a second deployment position and thertby move the anchor engagement portion proximally past at least part of the second flexible suture anchor, and   wherein the cam is pivotable about the pivot point in the first rotational direction to advance the slider within the longitudinal bore of the inserter from the second deployment position to a third deployment position and thereby force the second flexible suture anchor from the inserter via an engagement of the second flexible suture anchor with the anchor engagement portion.   
     
     
         22 . The meniscal tissue repair device of  claim 21 , wherein the slider has a first width at the first portion of the slider that is adjacent the flattened area and a second width at the flattened area that is greater than the first width. 
     
     
         23 . The meniscal tissue repair device of  claim 21 , wherein the slider has a first cross-sectional area at the first portion of the slider that is adjacent the flattened area and a second cross-sectional area at the flattened area that is equal to the first width. 
     
     
         24 . The meniscal tissue repair device of  claim 21 , wherein, in the pre-deployment condition of the meniscal tissue repair device, the slider extends through the second flexible suture anchor. 
     
     
         25 . The meniscal tissue repair device of  claim 21 , wherein the engagement of the first flexible suture anchor with the anchor engagement portion includes the anchor engagement portion contacting an intermediate portion of the first flexible suture anchor, the intermediate portion located between a first end and a second end of the first flexible suture anchor. 
     
     
         26 . A meniscal tissue repair device, comprising:
 a housing;   an inserter extending from the housing, the inserter including an open distal end and a longitudinal bore that extends through the inserter to the open distal end;   a first flexible suture anchor deployable from the inserter at a first location along an outer surface of a meniscus;   a second flexible suture anchor deployable from the inserter at a second location along the outer surface of the meniscus, wherein, in a pre-deployment condition of the meniscal tissue repair device, the second flexible suture anchor is located proximal of the first flexible suture anchor along the inserter;   a suture coupling the first flexible suture anchor to the second flexible suture anchor;   a cam pivotable about a pivot point that is located within the housing, the cam including a first plurality of teeth that extend in an arcuate manner along the cam;   a cam follower including a second plurality of teeth that extend in a linear manner along the cam follower, the second plurality of teeth meshing with the first plurality of teeth such that pivoting the cam about the pivot point causes the cam follower to move linearly within the housing; and   a slider slidably received in the longitudinal bore of the inserter, the slider including a proximal portion coupled to the cam follower such that linear movement of the cam follower within the housing causes the slider to move linearly within the longitudinal bore of the inserter, the slider further including an anchor engagement portion distal of the proximal portion, wherein, in the pre-deployment condition of the meniscal tissue repair device, the slider extends distally past the second flexible suture anchor toward the first flexible suture anchor to position the anchor engagement portion between the second flexible suture anchor and the first flexible suture anchor in the longitudinal bore of the inserter,   wherein, from the pre-deployment condition of the meniscal tissue repair device, the cam is pivotable about the pivot point in a first rotational direction to advance the slider within the longitudinal bore of the inserter to a first deployment position and thereby force the first flexible suture anchor from the inserter via an engagement of the first flexible suture anchor with the anchor engagement portion,   wherein the cam is pivotable about the pivot point in a second rotational direction opposite the first rotational direction to retract the slider within the longitudinal bore of the inserter from the first deployment position to a second deployment position and thereby move the anchor engagement portion proximally past at least part of the second flexible suture anchor, and   wherein the cam is pivotable about the pivot point in the first rotational direction to advance the slider within the longitudinal bore of the inserter from the second deployment position to a third deployment position and thereby force the second flexible suture anchor from the inserter via an engagement of the second flexible suture anchor with the anchor engagement portion.   
     
     
         27 . The meniscal tissue repair device of  claim 26 , wherein the second plurality of teeth correspond to predetermined translation distances of the slider. 
     
     
         28 . The meniscal tissue repair device of  claim 26 , wherein, in the pre-deployment condition of the meniscal tissue repair device, the slider extends through the second flexible suture anchor. 
     
     
         29 . The meniscal tissue repair device of  claim 26 , wherein the anchor engagement portion includes a flattened area. 
     
     
         30 . The meniscal tissue repair device of  claim 29 , wherein the flattened area has a thickness that is less than an outside diameter of a first portion of the slider adjacent the flattened area. 
     
     
         31 . The meniscal tissue repair device of  claim 30 , wherein the slider has a first width at the first portion of the slider that is adjacent the flattened area and a second width at the flattened area that is greater than the first width. 
     
     
         32 . The meniscal tissue repair device of  claim 31 , wherein the slider has a first cross-sectional area at the first portion of the slider that is adjacent the flattened area and a second cross-sectional area at the flattened area that is the same as the first width. 
     
     
         33 . The meniscal tissue repair device of  claim 26 , wherein the engagement of the first flexible suture anchor with the anchor engagement portion includes the anchor engagement portion contacting an intermediate portion of the first flexible suture anchor, the intermediate portion located between a first end and a second end of the first flexible suture anchor. 
     
     
         34 . A meniscal tissue repair device, comprising:
 a housing;   an inserter extending from the housing, the inserter including an open distal end and a longitudinal bore that extends through the inserter to the open distal end;   a first flexible suture anchor deployable from the inserter at a first location along an outer surface of a meniscus;   a second flexible suture anchor deployable from the inserter at a second location along the outer surface of the meniscus, wherein, in a pre-deployment condition of the meniscal tissue repair device, the second flexible suture anchor is located proximal of the first flexible suture anchor along the inserter;   a suture coupling the first flexible suture anchor to the second flexible suture anchor;   a cam pivotable about a pivot point that is located within the housing, the cam including a first plurality of teeth that extend in an arcuate manner along the cam;   a cam follower including a second plurality of teeth that extend in a linear manner along the cam follower, the second plurality of teeth meshing with the first plurality of teeth such that pivoting the cam about the pivot point causes the cam follower to move linearly within the housing; and   a slider slidably received in the longitudinal bore of the inserter and including a proximal portion coupled to the cam follower such that linear movement of the cam follower within the housing causes the slider to move linearly within the longitudinal bore of the inserter, wherein, in the pre-deployment condition of the meniscal tissue repair device, the slider extends distally past the second flexible suture anchor toward the first flexible suture anchor in the longitudinal bore of the inserter, the slider further comprising an anchor engagement portion that includes a flattened area distal of the proximal portion, wherein the slider has a first width at a first portion of the slider adjacent the flattened area and a second width at the flattened area that is greater than the first width,   wherein the cam is pivotable about the pivot point: (i) a first time and in a first rotational direction to advance the slider within the longitudinal bore of the inserter for deploying the first flexible suture anchor from the inserter at the first location along the outer surface of the meniscus; (ii) a second time and in a second rotational direction opposite the first rotational direction to retract the slider relative to the second flexible suture anchor within the longitudinal bore of the inserter; and (iii) a third time and back in the first rotational direction to advance the slider within the longitudinal bore of the inserter for deploying the second flexible suture anchor from the inserter at the second location along the outer surface of the meniscus.   
     
     
         35 . The meniscal tissue repair device of  claim 34 , wherein the flattened area has a thickness that is less than an outside diameter of the first portion of the slider that is adjacent the flattened area. 
     
     
         36 . The meniscal tissue repair device of  claim 34 , wherein the slider has a first cross-sectional area at the first portion of the slider that is adjacent the flattened area and a second cross-sectional area at the flattened area that is equal to the first width. 
     
     
         37 . The meniscal tissue repair device of  claim 34 , wherein the cam follower has a rectangular shape. 
     
     
         38 . The meniscal tissue repair device of  claim 34 , wherein, in the pre-deployment condition of the meniscal tissue repair device, the slider extends longitudinally through a longitudinal bore of the second flexible suture anchor. 
     
     
         39 . The meniscal tissue repair device of  claim 34 , wherein, in the pre-deployment condition of the meniscal tissue repair device, the flattened area is positioned between the second flexible suture anchor and the first flexible suture anchor in the longitudinal bore of the inserter. 
     
     
         40 . The meniscal tissue repair device of  claim 39 , wherein the cam is pivotable about the pivot point the second time to retract the slider within the longitudinal bore of the inserter and move the flattened area in a proximal direction past at least part of the second flexible suture anchor. 
     
     
         41 . The meniscal tissue repair device of  claim 34  further comprising an outer tube, the outer tube comprising an open distal end and a longitudinal bore that extends through the outer tube to the open distal end, the inserter received in the longitudinal bore of the outer tube. 
     
     
         42 . The meniscal tissue repair device of  claim 34  further comprising a stop located in the longitudinal bore of the inserter, and wherein, in the pre-deployment condition of the meniscal tissue repair device, the second flexible elongated tube anchor is located between the first flexible elongated tube anchor and the stop.