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.

What is claimed is: 
     
         1 . A bone anchor insertion device, comprising:
 a handle assembly comprising;
 a housing; 
 a hand lever pivotally attached to the handle housing, the hand lever having a drive arm; 
 a rack mechanism having at least two teeth operable to successively engage with the drive arm so as to move the rack mechanism as the hand lever is actuated; and 
   at least one elongate sleeve extending from the distal end of the housing; and   a pull tube coaxially disposed with the at least one elongate sleeve and coupled to the rack mechanism, a distal end of the pull tube selectively coupled to a bone anchor.   
     
     
         2 . The bone anchor insertion device of  claim 1 , the handle assembly further comprising at least one ratchet wheel operable to engage at least one length of suture associated with the bone anchor, the ratchet wheel coupled to at least one suture knob operable to be rotated to as to selectively apply tension to the length of suture. 
     
     
         3 . The bone anchor insertion device of  claim 1 , the handle assembly further comprising a function switch having a first position operable to limit the displacement of the rack mechanism during actuation by the hand lever and a second position operable to release the rack mechanism to move. 
     
     
         4 . The bone anchor insertion device of  claim 1 , wherein the at least two teeth of the rack mechanism define at least two operations of the anchor device, the operations comprising deploying the bone anchor and deploying a suture plug element coupled to the rack mechanism. 
     
     
         5 . The bone anchor insertion device of  claim 4 , wherein the at least two teeth of the rack mechanism further define a third operation comprising detaching at least a portion of the bone anchor from the pull tube. 
     
     
         6 . The bone anchor insertion device of  claim 1 , wherein actuation of the hand lever is operable to displace the rack mechanism and pull tube proximally so as to deploy an anchoring portion of the bone anchor. 
     
     
         7 . The bone anchor insertion of  claim 1 , wherein the hand lever is operable to drive the rack mechanism so as to uncouple at least a portion of the bone anchor from the pull tube. 
     
     
         8 . The bone anchor insertion device of  claim 1 , further comprising a suture plug coupled to the rack mechanism and wherein actuation of the hand lever is operable to drive the rack mechanism so as to deploy the suture plug into the bone anchor. 
     
     
         9 . The bone anchor insertion device of  claim 1 , the at least one elongate sleeve comprising a first elongate sleeve having a distal lateral opening and a second elongate sleeve disposed coaxially with the first elongate sleeve having a longitudinal slot adjacent the lateral opening and wherein the lateral opening has a first position relative to the longitudinal slot operable to limit movement of a length of suture associated with the bone anchor away from the bone anchor. 
     
     
         10 . The bone anchor insertion device of  claim 9 , wherein the lateral opening is moveable to a second position relative to the longitudinal slot, operable to release the length of suture. 
     
     
         11 . A bone anchor insertion device, comprising:
 a handle housing;   a handle assembly comprising;
 a hand lever pivotally attached to the handle housing, the hand lever further comprising a drive arm; 
 a rack mechanism selectively engageable with the drive arm; 
   at least one elongate tubular element extending from the handle housing; and   a pull tube coaxially disposed within the at least one elongate tubular element, the pull tube having a distal end selectively coupled to a bone anchor and a proximal end coupled to the rack mechanism;   wherein a first actuation of the hand lever is operable to move the rack mechanism so as to deploy a bone locking element of the bone anchor and wherein a subsequent actuation of the hand lever moves the rack mechanism so as to deploy a suture locking element into the bone anchor.   
     
     
         12 . The bone anchor insertion device of  claim 11  wherein actuation of the hand lever is operable to move the rack mechanism so as to disconnect at least a portion of the bone anchor from the pull tube. 
     
     
         13 . The bone anchor insertion device of  claim 11  wherein the rack mechanism comprises at least two teeth operable to serially engage with the drive arm as the hand lever is actuated. 
     
     
         14 . The bone anchor insertion device of  claim 11 , the handle assembly further comprising at least one ratchet wheel operable to engage at least one length of suture associated with the bone anchor, the ratchet wheel coupled to at least one suture knob operable to be rotated to as to selectively apply tension to the length of suture. 
     
     
         15 . The bone anchor insertion device of  claim 11 , further comprising a function switch having a first position operable to limit the displacement of the rack mechanism and a second position operable to release the rack mechanism. 
     
     
         16 . The bone anchor insertion device of  claim 11 , wherein the at least one elongate tubular element comprises a first elongate sleeve having a distal suture opening and a second elongate sleeve with a longitudinal slot, disposed coaxially with the first elongate sleeve, wherein the longitudinal slot, the suture opening and the first elongate sleeve cooperate to limit the motion and store a portion of a length of suture coupled to the bone anchor in a proximal location. 
     
     
         17 . The bone anchor insertion device of  claim 16 , wherein the first elongate sleeve is rotatable relative to the second elongate sleeve, between a first position wherein the length of suture is stored in the proximal location and a second position wherein the length of suture is released. 
     
     
         18 . A method for making an orthopedic repair, by re-attaching a portion of soft tissue to a portion of adjacent bone comprising:
 passing a free end of a length of suture through an elongate sleeve, a bone anchor, and a handle housing of a bone anchor insertion device, the bone anchor insertion device comprising the handle housing, the handle housing including a hand lever pivotally attached to the handle housing, the hand lever having a drive arm mechanically coupled to a rack mechanism disposed within the housing, and the elongate sleeve extending distally from the housing, the bone anchor associated with the elongate sleeve;   inserting said bone anchor under a cortical bone surface;   actuating the hand lever so as to drive the rack mechanism to a first position and deploy an anchoring element of the bone anchor;   actuating the hand lever so to further drive the rack mechanism to a second position and disconnect at least a portion of the bone anchor from the bone anchor device; and   actuating the hand lever so as to drive the rack mechanism to a third position and deploy a suture plug into the bone anchor.   
     
     
         19 . The method of  claim 18  wherein after the step of actuating the hand lever so as to drive the rack mechanism to the first position, moving a function switch coupled to the rack mechanism from a first position that limits the displacement of the rack mechanism to a second position to release the rack mechanism.