Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
		Content		Paragraph Number	Notes	Any Field
View Edit Delete	IPP-0051-US14 cross roads	The drive coupler 1088 is connected to the drive shaft 1082 at the proximal end 1084. The drive coupler 1088 can be any of a variety of existing couplers suitable for connecting a tool that can rotate the driver 1080 about its longitudinal axis, move the driver 1080 axially, or transmit an axial force through the driver 1080. In one embodiment, the drive coupler 1088 is a conventional Association for Osteosynthesis (AO) quick connect having a D-shaped cross section and a groove for engaging a driving mechanism. The drive mechanism (not shown) may be a manual mechanism such as a handle adapted to engage the drive coupler 1088 or a powered mechanism, such as a drill.	185	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	In certain embodiments, the driver 1080 may include external drive threads 1090 in other embodiments, the driver 1080 may not include external drive threads 1090. In one embodiment, the external drive threads 1090 can be configured to engage internal threads 942 within the longitudinal opening 938 of the collar 908 (i.e., within the inserter 900). The external drive threads 1090 may be positioned along the drive shaft 1082 between the proximal end 1084 and distal end 1086 such that the external drive threads 1090 engage the internal threads 942 when the drive shaft 1082 is inserted within the inserter longitudinal passageway 941 far enough that the external helical threads 782 of interference member 770 can engage the internal helical threads 717 of the anchor body 702 as the external drive threads 1090 engage more of the internal threads 942. In this manner, the external drive threads 1090 may provide a mechanical advantage to assist in driving the interference member 770 into the anchor body 702.	186	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	In embodiments without external drive threads 1090, the drive shaft 1082 can still be used to urge the interference member 770 into the anchor body 702 (note FIGS. 97-104 are not necessarily drawn to scale). In such an embodiment, the drive shaft 1082 may press the interference member 770 towards the suture anchor 700 as the drive shaft 1082 is moved into the inserter longitudinal passageway 941. The drive shaft 1082 is long enough that the drive shaft 1082 can press the interference member 770 into and through the bore 756 such that the point 780 extends into the longitudinal passageway 714.	187	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	The drive feature 1092 is connected to the drive shaft 1082 at the distal end 1086. The drive feature 1092 can be configured to engage a drive recess 790 of an interference member 770. In one embodiment, the drive feature 1092 is a torx shape sized and configured to engage a drive recess 790 that is a torx recess.	188	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	FIG. 98 illustrates a stage in a sequence of using the suture anchor system 800 in another stage of the sequence illustrated in FIGS. 93-96. At this stage, the inserter 900 is connected to the suture anchor 700 and the tensioner 1000 is positioned to apply a desired level of tension to the one or more sutures 1034. A user has inserted the drive shaft 1082 into the inserter longitudinal passageway 941 and moved the interference member 770 until the point 780 extends into the longitudinal passageway 714 and the drive feature 1092 engages the drive recess 790 of the interference member 770. Next a user may attach a drive mechanism to the drive coupler 1088 and begin rotating the drive shaft 1082. This rotation causes at least one of the external helical threads 782 to engage with an internal helical thread 717 of the anchor body 702. Because the one or more sutures 1034 extend from the proximal opening 716 of the anchor body 702 from within the longitudinal passageway 714, engagement of at least one external helical thread 782 with an internal helical thread 717 of the anchor body 702 secures and compresses at least a portion of the one or more sutures 1034 between the interference member 770 and the anchor body 702. This engagement secures the one or more sutures 1034 with the same tension, or a slightly greater tension, in the one or more sutures 1034 that was present in the one or more sutures 1034 before the interference member 770 is screwed into the proximal opening 716 of the anchor body 702.	189	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	FIG. 99 is a perspective view of a driver 1080 for use within the system of FIG. 66 and the implant of FIG. 52 according to one embodiment. Specifically, FIG. 99 illustrates that the drive shaft 1082 can engage the interference member 770 as the interference member 770 is moved through the shaft 902 and into the suture anchor 700. FIG. 99 is not necessarily drawn to scale. The driver 1080 applies a torque to the interference member 770 and the least one or more external helical threads 782 of the interference member 770 to engage and/or mesh with at least one or more internal helical threads 717 of the anchor body 702.	190	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	The drive shaft 1082 is long enough to drive the interference member 770 by way of rotation to move completely into the longitudinal passageway 714. Rotation of the driver 1080 in a first direction causes at least one or more external helical threads 782 of the interference member 770 to engage and/or mesh with at least one or more internal helical threads 717 of the anchor body 702. Rotation of the driver 1080 in a second direction opposite the first direction causes external helical threads 782 of the interference member 770 to disengage from one or more internal helical threads 717 of the anchor body 702.	191	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	Advantageously, the drive feature 1092 of the driver 1080 and the drive recess 790 of the interference member 770 can be used both to insert, or drive, the interference member 770 axially into the anchor body 702 and to extract, remove, or back-out the interference member 770 from the anchor body 702. The ability to back the interference member 770 out of the anchor body 702 may be useful to a surgeon who desires to adjust tension in the one or more sutures 1034, remove the suture anchor 700, reposition the suture anchor 700, reconfigure or remove the one or more sutures 1034, or the like. This added flexibility can increase the options to a surgeon using the suture anchor 700 and can lead to move favorable surgical outcomes.	192	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	In certain embodiments, the drive feature 1092 and drive recess 790 may have a configuration different from the one illustrated. For example, the drive recess 790 may be a recess that includes a lip or hook and the drive feature 1092 may include a corresponding hook or lip that engages the one on the interference member 770. In this manner the drive feature 1092 may couple to the interference member 770 and permit one or both of axial force transmission and torque transmission from the driver 1080 to the interference member 770. Such alternative embodiments are within the scope of the present disclosure and enable the driver 1080 to move the interference member 770 into and retract the interference member 770 out of the anchor body 702.	193	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	FIGS. 100-101 are a sequence of perspective views illustrating use of the system of FIG. 66 and the implant of FIG. 52 according to one embodiment after the stage shown in FIG. 98. FIG. 100 shows that after the interference member 770 is secured within the longitudinal passageway 714, the driver 1080 can be removed.	194	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	At this stage, the suture anchor system 800 is prepared for disengagement/separation of the anchor body 702 from the proximal member 704. Also at this stage, the suture anchor 700 may already be inserted/placed/deployed within a patient. Alternatively, or in addition, a user may now, at this stage, deploy or insert the suture anchor 700 into a prepare location in a patient. In such an embodiment, the user may use the inserter 900 to position and press the suture anchor 700 into the desired location. The elongated inserter 900 and securely connected suture anchor 700 facilitate positioning and placement. In certain embodiments, the inserter 900 may be used for cannulated deployment.	195	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	Referring to FIG. 101, to separate the proximal member 704 from the anchor body 702, a user may insert a pushrod 1100 into the longitudinal opening 938 of the collar 908 at a proximal end of the suture anchor system 800/ inserter 900. This mounts the pushrod 1100 for axial translation within the inserter 900. The pushrod 1100 may include many similar features and aspects as the driver 1080. In certain embodiments, a driver 1080 can be used to serve the dual purposes of a driver 1080 and/or of a pushrod 1100.	196	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	Referring now to FIGS. 101-104, consequently, the pushrod 1100 may be an elongated cylindrical structure having a proximal end 1110, a distal end 1120, a coupler 1130, much like the drive coupler 1088 of the driver 1080, external threads 1140, much like the external drive threads 1090, a shaft 1150, much like the drive shaft 1082, and a push feature 1160. The coupler 1130 may be an AO quick connect coupler. In certain embodiments, the push feature 1160 is the same as the drive feature 1092. In the illustrated embodiment, the push feature 1160 is different from the drive feature 1092, the push feature 1160 does not include a torx or other drive shaped end. In the illustrated embodiment, the push feature 1160 includes a tapering diameter to a blunt end that fits within the drive recess 790 of the interference member 770. In other embodiments, the push feature 1160 may have a diameter wider than the drive recess 790 can may contact a top of the interference member 770. In another embodiment, the push feature 1160 may have a diameter or configuration that contacts the sidewall 750 of the anchor body 702.	197	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	Referring further to FIGS. 102-104, subsequent sequences of steps can be taken after the pushrod 1100 is inserted into the inserter 900, as shown in FIG. 101. A user may rotate the pushrod 1100 such that the external threads 1140 may engage internal threads 942 of the collar 908. This threaded engagement provides a mechanical force that moves/drives the push feature 1160 against the interference member 770. In FIG. 102, the push feature 1160 contacts the interference member 770 within the drive recess 790.	198	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	FIG. 103 shows magnified/close-up details of this contact, the push feature 1160, the interference member 770, and the anchor body 702. Note the one or more sutures 1034 between the interference member 770 and the internal helical threads 717 of the anchor body 702. FIG. 103 also illustrates that in one embodiment one or more external helical threads 782 of the interference member 770 may contact and/or engage with one or more internal helical threads 717 of the anchor body 702 while others make no contact and/or are not engaged with corresponding threads. In one embodiment, the external helical threads 782 may be knuckle threads. The knuckle threads may have an external helical thread pitch that differs from an internal helical thread pitch of the internal helical threads 717 of the anchor body 702.	199	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	In particular, FIG. 103 illustrates that the external helical threads 782 interface with internal helical threads 717 in a clearance fit. This clearance fit has a length of thread engagement (Arrow LTE) that is shorter than a length of the external helical threads 782 (Arrow EHT). Advantageously, such an interface may provide strong reliable fixation of the one or more sutures 1034 within the anchor body 702 and still prevent severing the one or more sutures 1034 within the anchor body 702.	200	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	Returning to the sequence of operations, FIG. 103 illustrates that the shaft 902 of the inserter 900 engages the proximal member 704 in an axial force transmitting relationship in a first direction 1170. In the illustrated embodiment, the axial force transmitting relationship is that the shaft 902 holds the proximal member 704 in place and places an axial force on the proximal member 704 in direction 1170.	201	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	Once the push feature 1160 contacts the interference member 770 (or sidewall 750) a user may next connect the coupler 1130 to a manual or powered tool and rotate the pushrod 1100 such that the external threads 1140 and internal threads 942 move past each other and move the pushrod 1100 in second direction 1180. This interaction is referred to herein as an axial force transmitting relationship in the second direction 1180. In one embodiment, the user may couple the pushrod 1100 to a manual or powered mechanism that imparts an axial force, such as a pounding force towards the distal end of the inserter 900. In such an embodiment, a user may simply pound on the pushrod 1100 with a mallet or hammer. In these embodiments, the pushrod 1100 may not include external threads 1140.	202	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	In the illustrated embodiment, the mechanical advantage of the external threads 1140 and internal threads 942 create a significant force that presses the push feature 1160 against the interference member 770 and/or the anchor body 702. Eventually, this force causes the frangible connection 706 to break (See FIG. 104 broken frangible connection 1190) which separates the anchor body 702 from the proximal member 704. The anchor body 702 then remains within a patient and the one or more sutures 1034 remain under tension while the interference member 770 is deployed and the anchor body 702 is deployed.	203	Added by DJM 9 2021	9/2/21, 12:00 AM
View Edit Delete	IPP-0051-US14 cross roads	The following are further examples of the present disclosure.	204	Added by DJM 9 2021	9/2/21, 12:00 AM

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