System And Method For All-Inside Suture Fixation For Implant Attachment And Soft Tissue Repair

Abstract

A system for repairing a meniscus includes a suture that includes a first anchor, a second anchor, and a flexible portion connecting the first anchor and the second anchor. The flexible portion includes a self-locking slide knot between the first anchor and the second anchor. The system also includes a needle having a longitudinal extending bore and an open end. The bore is configured to receive the first anchor and the second anchor. The system further includes a body portion operatively connected to the needle at a distal end of the body portion. The body portion has a lumen. The system also includes a pusher configured to rotate and slide within the lumen of the body portion and the longitudinal extending bore of the needle. The pusher has first and second stop surfaces, each of which is constructed and arranged to engage a proximal end of the body portion.

1 . A method of repairing a tissue using an applicator comprising:
 inserting a distal end of the applicator at a first location on the tissue of a patient;   rotating a proximal portion of the applicator about a longitudinal axis defined by the applicator; and   expelling a first anchor from the distal end.   
     
     
         2 . The method of  claim 1 , wherein rotating the proximal portion includes rotating the proximal portion in a first direction, the method further comprising rotating a second portion of the applicator in a second direction. 
     
     
         3 . The method of  claim 2 , wherein the second rotating step occurs after the expelling step. 
     
     
         4 . The method of  claim 1 , further comprising:
 removing the distal end of the applicator from the tissue of the patient;   inserting the distal end of the applicator at a second location on the tissue of the patient;   rotating the proximal portion of the applicator about the longitudinal axis;   expelling a second anchor from the distal end.   
     
     
         5 . The method of  claim 1 , wherein rotating the proximal portion of the applicator includes rotating the proximal portion of the applicator 90°. 
     
     
         6 . The method of  claim 1 , wherein the first anchor includes a projection and the applicator includes a slot adjacent the distal end, the method further comprising receiving the projection of the first anchor through the slot of the applicator. 
     
     
         7 . The method of  claim 6 , wherein the protrusion is rectangular and the slot is sized to receive the protrusion. 
     
     
         8 . The method of  claim 1 , wherein the applicator includes a protrusion adjacent the distal end, the method further comprising, prior to the expelling step, positioning the first anchor to contact the protrusion. 
     
     
         9 . The method of  claim 1 , wherein the tissue is a meniscus. 
     
     
         10 . The method of  claim 4 , wherein the tissue is a meniscus, and at least one of the first location and the second location is selected such that the distal end of the applicator travels distally through a tear in the meniscus. 
     
     
         11 . A method of repairing a tissue using an applicator comprising:
 inserting a distal end of the applicator at a first location on the tissue of a patient;   rotating a portion of the applicator about a longitudinal axis defined by the applicator, the portion of the applicator configured to be manually held by a user; and   expelling a first anchor from the distal end.   
     
     
         12 . The method of  claim 11 , wherein rotating the portion includes rotating the portion in a first direction, the method further comprising rotating a second portion of the applicator in a second direction. 
     
     
         13 . The method of  claim 11 , further comprising:
 removing the distal end of the applicator from the tissue of the patient;   inserting the distal end of the applicator at a second location on the tissue of the patient;   rotating the portion of the applicator about the longitudinal axis;   expelling a second anchor from the distal end.   
     
     
         14 . The method of  claim 11 , wherein rotating the portion of the applicator includes rotating the portion of the applicator 90°. 
     
     
         15 . The method of  claim 11 , wherein the first anchor includes a projection and the applicator includes a slot adjacent the distal end, the method further comprising receiving the projection of the first anchor through the slot of the applicator. 
     
     
         16 . The method of  claim 11 , wherein the applicator includes a protrusion adjacent the distal end, the method further comprising, prior to the expelling step, positioning the first anchor to contact the protrusion. 
     
     
         17 . A method of repairing a tissue using an applicator comprising:
 inserting a first end of the applicator at a first location on the tissue of a patient;   rotating a second end of the applicator about a longitudinal axis defined by the applicator, the second end being opposite the first end; and   expelling a first anchor from the first end.   
     
     
         18 . The method of  claim 17 , wherein rotating the second end includes rotating the second end in a first direction, the method further comprising rotating a first portion of the applicator in a second direction. 
     
     
         19 . The method of  claim 17 , further comprising:
 removing the first end of the applicator from the tissue of the patient;   inserting the first end of the applicator at a second location on the tissue of the patient;   rotating the second end of the applicator about the longitudinal axis;   expelling a second anchor from the first end.   
     
     
         20 . The method of  claim 17 , wherein rotating the second end of the applicator includes rotating the second end of the applicator 90°.