Suture anchor and installation tool

Claim 2

Apparatus for attaching an object to a workpiece comprising: an anchor comprising a body and at least two barbs; said body having a longitudinal axis, a maximum cross-section transverse to said longitudinal axis, a distal portion having an outer end and an inner end, a proximal portion having an outer end and an inner end, and a middle portion joining said inner end of said distal portion and said inner end of said proximal portion; said middle portion and said proximal portion together defining at least two equally-circumferentially-spaced channels extending inwardly from an axial projection of said maximum transverse cross-section of said distal portion, said channels extending longitudinally from said inner end of said distal portion to said outer end of said proximal portion, each of said channels having a base which is substantially parallel to said longitudinal axis in said middle portion and which slants outwardly relative to said longitudinal axis as it extends from said inner end of said proximal portion to said outer end of said proximal portion, said channels being separated by longitudinal walls extending radially outwardly from said longitudinal axis to an outer surface located on said axial projection of said maximum transverse cross-section; one of said barbs extending axially and radially outwardly from said inner end of said distal portion adjacent the base of each of said channels to an outer end located radially outwardly of said axial projection of said maximum transverse cross-section, each said barb being curved in its normal, unrestrained state but capable of being deformed into a substantially straight configuration; and attachment means associated with said proximal portion for connecting an object to said anchor.

Claim 3

The apparatus of claim 1 wherein said barbs are made of nickel titanium alloy.

Claim 4

The apparatus of claim 1 wherein said distal portion of said body defines at least two bores extending longitudinally from said inner end of said distal portion toward said outer end of said distal portion, one bore adjacent said base of each of said channels, and wherein each of said barbs comprises a piece of wire having a first end and a second end, said first end of each said wire fixedly engaging one of said bores in said inner end of said distal portion.

Claim 5

The apparatus of claim 1 wherein there are two barbs, and further wherein said attachment means comprises an opening having a second longitudinal axis, said opening extending through said proximal portion and said second longitudinal axis being located in the plane containing said first longitudinal axis.

Claim 6

The apparatus of claim 4 wherein said attachment means further includes a cord-like connecting element threaded through said opening so as to securely engage said attachment means and provide at least one free end for attachment to said object.

Claim 7

The apparatus of claim 5 wherein said opening is formed in said proximal portion so as to provide a smoothly contoured bearing surface in said proximal portion against which said cord-like element may be slid after said anchor has been deployed in said hole.

Claim 8

The apparatus of claim 1 wherein there are three barbs and three channels.

Claim 9

The apparatus of claim 1 wherein said anchor is made of a titanium alloy material.

Claim 10

The apparatus of claim 1 wherein all of said cross-sections are substantially circular.

Claim 11

The apparatus of claim 1 wherein said workpiece is bone.

Claim 14

The system of claim 11 wherein portions of said object are attached to said attachment means, and further wherein said tool comprises: an elongated, hollow shaft having a longitudinal axis, an axial bore having a cross-section transverse to said longitudinal axis corresponding to but slightly larger than said maximum transverse cross-section of said anchor body, a proximal end and a distal end, a plurality of circumferentially-spaced longitudinal first slots in said shaft, said slots extending proximally from said distal end along said shaft and sized to accommodate the barbs of an anchor received in said axial bore; at least one longitudinal second slot in said shaft, said at least one slot extending proximally from said distal end along said shaft and sized to accommodate the object attached to said attachment means of an anchor received in said axial bore; and an elongated, solid shaft longer than said hollow shaft having a second longitudinal axis and a cross-section transverse to said second longitudinal axis corresponding to but slightly smaller than the cross-section of said axial bore in said hollow shaft, said solid shaft being adapted for insertion into and through said hollow shaft.

Claim 15

The system of claim 12 wherein said tool is formed of stainless steel.

Claim 16

The system of claim 12 wherein said object comprises a suture.

Claim 17

The system of claim 14 wherein at least two lengths of suture emanate from said anchor, and further wherein said tool comprises at least two longitudinal second slots.

Claim 18

The system of claim 12 wherein each of said shafts has a proximal end, and a handle is attached to each of said proximal ends of said shafts.

Claim 19

The system of claim 16 wherein said handles matingly engage each other when said shafts are oriented with respect to each other in at least one use position.

Claim 20

The system of claim 12 wherein said solid shaft includes a distal end and wherein the portion of said solid shaft adjacent said distal end has a transverse cross-section smaller than the transverse cross-section of the remainder of said solid shaft.

Claim 21

The system of claim 11 wherein portions of said object are attached to said attachment means and wherein said tool comprises: an elongated, rigid shaft, said shaft including a distal end, a proximal end, a first small diameter portion adjacent said distal end and a second intermediate diameter portion located between said first small diameter portion and the remainder of said shaft, said second intermediate diameter portion defining capturing means disposed about the outer surface of said intermediate portion; a deformable, tubular sleeve having a second distal end, a second proximal end, walls having a thickness approximately equal to the difference between the radius of said intermediate portion and the radius of said remainder portion of said shaft, and a length smaller than the combined length of said small diameter portion and said intermediate diameter portion of said shaft; a counterbore formed in said distal end of said sleeve and adapted to receive said anchor body; a plurality of circumferentially-spaced longitudinal radial slots in said sleeve, said slots extending proximally from said second distal end along said sleeve, said slots being adapted to receive the barbs of an anchor engaging said installation tool and said object attached to said attachment means, and a rib located substantially adjacent said proximal end of said sleeve, said rib extending inwardly from said wall of said sleeve; said sleeve being mounted about said intermediate diameter portion of said shaft such that in a first position the rib extends inwardly from the wall of the sleeve and engages said capturing means of said intermediate portion of said shaft, and in a second position said proximal end of said sleeve abuts said remainder portion of said shaft.

Claim 22

The system of claim 19 wherein said capturing means comprises a groove formed in the outer surface of said intermediate portion of said shaft.

Claim 23

The system of claim 19 wherein said capturing means comprises a pair of spaced projections formed on the outer surface of said said intermediate portion of said shaft.

Claim 24

Apparatus for deploying an anchor of the sort comprising a body and at least two barbs, said body having a longitudinal axis, a maximum cross-section transverse to said longitudinal axis slightly smaller than the transverse cross-section of said hole, a distal portion having an inner end and an outer end, a proximal portion having an inner end and an outer end, and a middle portion joining said inner end of said distal portion and said inner end of said proximal portion, said middle portion and said proximal portion together defining at least two equally-circumferentially-spaced channels extending inwardly from an axial projection of said maximum transverse cross-section of said distal portion, said channels extending longitudinally from said inner end of said distal portion to said outer end of said proximal portion, each of said channels having a base which is substantially parallel to said longitudinal axis in said middle portion and which slants outwardly relative to said longitudinal axis as it extends from said inner end of said proximal portion to said outer end of said proximal portion, said channels being separated by longitudinal walls extending radially outwardly from said longitudinal axis to an outer surface located on said axial projection of said maximum transverse cross-section, one of said barbs extending axially and radially outwardly from said inner end of said distal portion adjacent the base of each of said channels to an outer end located radially outwardly of said axial projection of said maximum transverse cross-section, each said barb being curved in its normal unrestrained state but capable of being deformed into a substantially straight configuration, and attachment means associated with said second portion for connecting an object to said anchor, said apparatus comprising: an installation tool comprising: an elongated, hollow shaft having a longitudinal axis, an axial bore having a cross-section transverse to said longitudinal axis corresponding to but slightly larger than said maximum transverse cross-section of said anchor body, a proximal end and a distal end, a plurality of circumferentially-spaced longitudinal first slots in said shaft, said slots extending proximally from said distal end along said shaft, said slots being sized to accommodate the barbs of an anchor engaged by said tool; at least one longitudinal second slot in said shaft, said at least one slot being sized to accommodate an object attached to said attachment means; and plunger means including an elongated, solid shaft longer than said hollow shaft having a second longitudinal axis and a cross-section transverse to said second longitudinal axis corresponding to but slightly smaller than the cross-section of said axial bore in said hollow shaft, said solid shaft being adapted for insertion into and through said hollow shaft, whereby when said middle and proximal portions of said anchor body are received and held within said axial bore at said distal end of said shaft, said plunger means may be brought into engagement with said outer end of said proximal portion of said anchor body and be utilized to expel said anchor from said hollow shaft and to drive said anchor into said hole.

Claim 25

Apparatus for deploying an anchor of the sort comprising a body and at least two barbs, said body having a longitudinal axis, a maximum cross-section transverse to said longitudinal axis slightly smaller than the transverse cross-section of said hole, a distal portion having an inner end and an outer end, a proximal portion having an inner end and an outer end, and a middle portion joining said inner end of said distal portion and said inner end of said proximal portion, said middle portion and said proximal portion together defining at least two equally-circumferentially-spaced channels extending inwardly from an axial projection of said maximum transverse cross-section of said distal portion, said channels extending longitudinally from said inner end of said distal portion to said outer end of said proximal portion, each of said channels having a base which is substantially parallel to said longitudinal axis in said middle portion and which slants outwardly relative to said longitudinal axis as it extends from said inner end of said proximal portion to said outer end of said proximal portion, said channels being separated by longitudinal walls extending radially outwardly from said longitudinal axis to an outer surface located on said axial projection of said maximum transverse cross-section, one of said barbs extending axially and radially outwardly from said inner end of said distal portion adjacent the base of each of said channels to an outer end located radially outwardly of said axial projection of said maximum transverse cross-section, each said barb being curved in its normal unrestrained state but capable of being deformed into a substantially straight configuration, and attachment means associated with said second portion for connecting an object to said anchor, said apparatus comprising: an installation tool comprising: an elongated, hollow shaft having a longitudinal axis, an axial bore having a cross-section transverse to said longitudinal axis corresponding to but slightly larger than said maximum transverse cross-section of said anchor body, a proximal end and a distal end, a plurality of circumferentially-spaced longitudinal first slots in said shaft, said slots extending proximally from said distal end along said shaft, said slots being sized to accommodate the barbs of an anchor engaged by said tool; at least one longitudinal second slot in said shaft, said at least one slot being sized to accommodate an object attached to said attachment means; and plunger means including an elongated, solid shaft longer than said hollow shaft having a second longitudinal axis and a cross-section transverse to said second longitudinal axis corresponding to but slightly smaller than the cross-section of said axial bore in said hollow shaft, said solid shaft being adapted for insertion into and through said hollow shaft, whereby when said middle and proximal portions of said anchor body are received and held within said axial bore at said distal end of said shaft, said plunger means may be brought into engagement with said outer end of said proximal portion of said anchor body and be utilized to expel said anchor from said hollow shaft and to drive said anchor into said hole.

Claim 26

Apparatus for deploying an anchor of the sort comprising a body and at least two barbs, said body having a longitudinal axis, a maximum cross-section transverse to said longitudinal axis slightly smaller than the transverse cross-section of said hole, a distal portion having an inner end and an outer end, a proximal portion having an inner end and an outer end, and a middle portion joining said inner end of said distal portion and said inner end of said proximal portion, said middle portion and said proximal portion together defining at least two equally-circumferentially-spaced channels extending inwardly from an axial projection of said maximum transverse cross-section of said distal portion, said channels extending longitudinally from said inner end of said distal portion to said outer end of said proximal portion, each of said channels having a base which is substantially parallel to said longitudinal axis in said middle portion and which slants outwardly relative to said longitudinal axis as it extends from said inner end of said proximal portion to said outer end of said proximal portion, said channels being separated by longitudinal walls extending radially outwardly from said longitudinal axis to an outer surface located on said axial projection of said maximum transverse cross-section, one of said barbs extending axially and radially outwardly from said inner end of said distal portion adjacent the base of each of said channels to an outer end located radially outwardly of said axial projection of said maximum transverse cross-section, each said barb being curved in its normal unrestrained state but capable of being deformed into a substantially straight configuration, and attachment means associated with said second portion for connecting an object to said anchor, said apparatus comprising: an installation tool comprising: an elongated, rigid shaft, said shaft including a distal end, a proximal end, a first small diameter plunger portion adjacent said distal end and a second intermediate diameter portion located between said first small diameter plunger portion and the remainder of said shaft, said second intermediate diameter portion defining capturing means disposed about the outer surface of said intermediate portion of said shaft; tubular means associated with said distal and intermediate portions said shaft adapted to receive and hold said middle and proximal portions of said anchor body, said tubular means including: a deformable, tubular sleeve having a second distal end, a second proximal end, walls having a thickness approximately equal to the difference between the radius of said intermediate portion and the radius of said remainder portion of said shaft, and a length smaller than the combined length of said small diameter portion and said intermediate diameter portion of said shaft; a counterbore formed in said distal end of said sleeve and adapted to receive said anchor body; a plurality of circumferentially-spaced longitudinal slots in said sleeve, said slots extending proximally from said second distal end along said sleeve, said slots being adapted to receive the barbs of an anchor engaging said installation tool and an object attached to said attachment means, and a rib located substantially adjacent said proximal end of said sleeve, said rib extending inwardly from said wall of said sleeve; said sleeve being mounted about said intermediate diameter portion of said shaft such that in a first position the rib extends inwardly from the wall of the sleeve and engages said capturing means disposed about the outer surface of said intermediate portion of said shaft, and in a second position said proximally end of said sleeve abuts said remainder portion of said shaft, whereby when said middle and proximal portions of said anchor are received and held within said tubular means adjacent said second distal end thereof, said distal end of said shaft may be brought into engagement with said outer end of said proximal portion of said anchor body and be utilized to expel said anchor from said tubular means and to drive said anchor into said hole.

Claim 27

Apparatus for deploying an anchor of the sort comprising a body and at least two barbs, said body having a longitudinal axis, a maximum cross-section transverse to said longitudinal axis slightly smaller than the transverse cross-section of said hole, a distal portion having an inner end and an outer end, a proximal portion having an inner end and an outer end, and a middle portion joining said inner end of said distal portion and said inner end of said proximal portion, said middle portion and said proximal portion together defining at least two equally-circumferentially-spaced channels extending inwardly from an axial projection of said maximum transverse cross-section of said distal portion, said channels extending longitudinally from said inner end of said distal portion to said outer end of said proximal portion, each of said channels having a base which is substantially parallel to said longitudinal axis in said middle portion and which slants outwardly relative to said longitudinal axis as it extends from said inner end of said proximal portion to said outer end of said proximal portion, said channels being separated by longitudinal walls extending radially outwardly from said longitudinal axis to an outer surface located on said axial projection of said maximum transverse cross-section, one of said barbs extending axially and radially outwardly from said inner end of said distal portion adjacent the base of each of said channels to an outer end located radially outwardly of said axial projection of said maximum transverse cross-section, each said barb being curved in its normal unrestrained state but capable of being deformed into a substantially straight configuration, and attachment means associated with said second portion for connecting an object to said anchor, said apparatus comprising: an installation tool comprising: an elongated, rigid shaft, said shaft including a distal end, a proximal end, a first small diameter plunger portion adjacent said distal end and a second intermediate diameter portion located between said first small diameter plunger portion and the remainder of said shaft, said second intermediate diameter portion defining capturing means disposed about the outer surface of said intermediate portion of said shaft; tubular means associated with said distal and intermediate portions said shaft adapted to receive and hold said middle and proximal portions of said anchor body, said tubular means including: a deformable, tubular sleeve having a second distal end, a second proximal end, walls having a thickness approximately equal to the difference between the radius of said intermediate portion and the radius of said remainder portion of said shaft, and a length smaller than the combined length of said small diameter portion and said intermediate diameter portion of said shaft; a counterbore formed in said distal end of said sleeve and adapted to receive said anchor body; a plurality of circumferentially-spaced longitudinal slots in said sleeve, said slots extending proximally from said second distal end along said sleeve, said slots being adapted to receive the barbs of an anchor engaging said installation tool and an object attached to said attachment means, and a rib located substantially adjacent said proximal end of said sleeve, said rib extending inwardly from said wall of said sleeve; said sleeve being mounted about said intermediate diameter portion of said shaft such that in a first position the rib extends inwardly from the wall of the sleeve and engages said capturing means disposed about the outer surface of said intermediate portion of said shaft, and in a second position said proximally end of said sleeve abuts said remainder portion of said shaft, whereby when said middle and proximal portions of said anchor are received and held within said tubular means adjacent said second distal end thereof, said distal end of said shaft may be brought into engagement with said outer end of said proximal portion of said anchor body and be utilized to expel said anchor from said tubular means and to drive said anchor into said hole.

Claim 30

The method of claim 24 wherein step (b) occurs at any point prior to step (e).

Claim 31

The method of claim 24 wherein said attachment means comprises an opening extending transverse relative to said longitudinal axis of said anchor body through said proximal portion of said anchor body, and further including the step of threading one cord-like member through said opening prior to step (d) such that said cord-like member is securely attached to said proximal portion and at least one end of said cord-like member extends out of said hole after step (f).

Claim 32

The method of claim 24 wherein said object includes at least one attachment means-engaging portion, step (h) occurs prior to step (d), and said installation tool further comprises: an elongated, hollow shaft having a longitudinal axis, an axial bore having a cross-section transverse to said longitudinal axis corresponding to but slightly larger than said maximum transverse cross-section of said anchor body, a proximal end and a distal end, a plurality of circumferentially-spaced longitudinal first slots in said shaft, said slots extending proximally from said distal end along said shaft, and adapted to receive the barbs of an anchor disposed in said tool; at least one longitudinal second slot in said shaft, said at least one slot extending proximally from said distal end along said shaft and adapted to receive said object attached to said attachment means, and an elongated, solid shaft longer than said hollow shaft having a second longitudinal axis and a cross-section transverse to said second longitudinal axis corresponding to but slightly smaller than the cross-section of said axial bore in said hollow shaft, said solid shaft being adapted for insertion into and through said hollow shaft.

Claim 33

The method of claim 27 wherein said attachment means comprises an opening extending transversely relative to said longitudinal axis of said anchor body through said proximal portion of said anchor body, and further including the step of threading one end of a cord-like member through said bore prior to step (d) such that said cord-like member is securely attached to said proximal portion and at least one end of said cord-like member extends out of said hole after step (f).

Claim 34

The method of claim 24 wherein said object includes at least one attachment means engaging portion, step (h) occurs prior to step (d), and said installation tool further comprises: an elongated, rigid shaft, said shaft including a distal end, a proximal end, a first small diameter portion adjacent said distal end and a second intermediate diameter portion located between said first small diameter portion and the remainder of said shaft, said second intermediate diameter portion defining capturing means disposed about the outer surface of said intermediate portion of said shaft; a deformable, tubular sleeve having a second distal end, a second proximal end, walls having a thickness approximately equal to the difference between the radius of said intermediate portion and the radius of said remainder portion of said shaft, and a length smaller than the combined length of said small diameter portion and said intermediate diameter portion of said shaft; a plurality of circumferentially-spaced longitudinal radial slots in said sleeve, said slots extending proximally from said second distal end along said sleeve and adapted to receive the barbs and suture of an anchor attached to said installation tool; a rib located substantially adjacent said proximal end of said sleeve, said rib extending inwardly from said wall of said sleeve; said sleeve being mounted about said intermediate diameter portion of said shaft such that in a first position the rib extends inwardly from the wall of the sleeve and engages said capturing means disposed about the outer surface of said intermediate portion of said shaft, and in a second position said proximal end of said sleeve abuts said remainder portion of said shaft.

Claim 35

The method of claim 29 wherein said attachment means comprises an opening extending transversely relative to said longitudinal axis of said anchor body through said proximal portion of said anchor body, and further including the step of threading one end of a cord-like member through said opening prior to step (d) such that said cord-like member is securely attached to said proximal portion and at least one end of said cord-like member extends out of said hole after step (f).

Claim 36

The method of claim 29 wherein said capturing means comprises a groove formed in the outer surface of said intermediate portion of said shaft.

Claim 37

The method of claim 29 wherein said capturing means comprises a pair of spaced projections formed on the outer surface of said intermediate portion of said shaft.

Claim 38

Apparatus for attaching an object to a workpiece comprising: an anchor comprising a body and at least two barbs; said body having a longitudinal axis, a maximum cross-section transverse to said longitudinal axis, a distal portion having an outer end and an inner end, a proximal portion having an outer end and an inner end, and a middle portion joining said inner end of said distal portion and said inner end of said proximal portion; said middle portion and said proximal portion together defining at least two equally-circumferentially-spaced channels extending inwardly from an axial projection of said maximum transverse cross-section of said distal portion, said channels extending longitudinally from said inner end of said distal portion toward said outer end of said proximal portion, each of said channels having a base which is substantially parallel to said longitudinal axis in said middle portion and which slants outwardly relative to said longitudinal axis as it extending from said inner end of said proximal portion toward said outer end of said proximal portion, said channels being separated by longitudinal walls extending radially outwardly from said longitudinal axis to an outer surface located on said axial projection of said maximum transverse cross-section; one of said barbs extending axially and radially outwardly from said inner end of said distal portion adjacent the base of each of said channels to an outer end located radially outwardly of said axial projection of said maximum transverse cross-section, each said barb being capable of being deformed so that its outer end is positioned closer to said axial projection of said maximum transverse cross-section; and attachment means associated with said proximal portion for connecting an object to said anchor.

Claim 39

Apparatus for attaching an object to a workpiece comprising: an anchor comprising a body and at least two barbs; said body having a longitudinal axis, a maximum cross-section transverse to said longitudinal axis, a distal portion having an outer end and an inner end, a proximal portion having an outer end and an inner end, and a middle portion joining said inner end of said distal portion and said inner end of said proximal portion; said middle portion and said proximal portion together defining at least two equally-circumferentially-spaced channels extending inwardly from an axial projection of said maximum transverse cross-section of said distal portion, said channels extending longitudinally from said inner end of said distal portion toward said outer end of said proximal portion, each of said channels having a base which is substantially parallel to said longitudinal axis in said middle portion and which slants outwardly relative to said longitudinal axis as it extending from said inner end of said proximal portion toward said outer end of said proximal portion, said channels being separated by longitudinal walls extending radially outwardly from said longitudinal axis to an outer surface located on said axial projection of said maximum transverse cross-section; one of said barbs extending axially and radially outwardly from said inner end of said distal portion adjacent the base of each of said channels to an outer end located radially outwardly of said axial projection of said maximum transverse cross-section, each said barb being capable of being deformed so that its outer end is positioned closer to said axial projection of said maximum transverse cross-section; and attachment means associated with said proximal portion for connecting an object to said anchor.

Claim 40

Apparatus for deploying an anchor of the sort comprising a body and at least two barbs into a hole formed in bone, said body having a distal end, a proximal end terminating in a proximal end surface, a longitudinal axis, and a maximum cross-section transverse to said longitudinal axis slightly smaller than the transverse cross-section of said hole, said barbs extending axially and radially outwardly from said body to an outer end located radially outwardly of an axial projection of said maximum transverse cross-section, each said barb being capable of being deformed so that its outer end is positioned closer to said axial projection of said maximum transverse cross-section, and said body comprising attachment means for connecting an object to said anchor, said apparatus comprising: an installation tool comprising: an elongated shaft having a longitudinal axis, a first distal end and a first proximal end; tubular means associated with said distal end of said shaft adapted to receive and hold said proximal end of said anchor body and to allow said distal end of said anchor body to extend distally from said tubular means, said tubular means comprising a tubular element having a longitudinal axis substantially aligned with the longitudinal axis of said shaft, a second proximal end surrounding the portion of said shaft adjacent said first distal end and a maximum cross-section transverse to its longitudinal axis larger than the cross-section of said hole, whereby when the proximal end of an anchor is received and held by said tubular means, the distal end of said anchor can be positioned within said bone hole and said second distal end of said tubular means will reside outside and bear against the bone adjacent said bone hole; and plunger means adapted for engagement with said proximal end surface of said anchor body, said plunger means being axially movable through said tubular means so as to expel said anchor from said tubular means and to drive said anchor into said hole, said plunger means being adapted to extend out of the distal end of said tubular means and into said hole when driving said anchor into said hole.

Claim 41

Apparatus for deploying an anchor of the sort comprising a body and at least two barbs into a hole formed in bone, said body having a distal end, a proximal end terminating in a proximal end surface, a longitudinal axis, and a maximum cross-section transverse to said longitudinal axis slightly smaller than the transverse cross-section of said hole, said barbs extending axially and radially outwardly from said body to an outer end located radially outwardly of an axial projection of said maximum transverse cross-section, each said barb being capable of being deformed so that its outer end is positioned closer to said axial projection of said maximum transverse cross-section, and said body comprising attachment means for connecting an object to said anchor, said apparatus comprising: an installation tool comprising: an elongated shaft having a longitudinal axis, a first distal end and a first proximal end; tubular means associated with said distal end of said shaft adapted to receive and hold said proximal end of said anchor body and to allow said distal end of said anchor body to extend distally from said tubular means, said tubular means comprising a tubular element having a longitudinal axis substantially aligned with the longitudinal axis of said shaft, a second proximal end surrounding the portion of said shaft adjacent said first distal end and a maximum cross-section transverse to its longitudinal axis larger than the cross-section of said hole, whereby when the proximal end of an anchor is received and held by said tubular means, the distal end of said anchor can be positioned within said bone hole and said second distal end of said tubular means will reside outside and bear against the bone adjacent said bone hole; and plunger means adapted for engagement with said proximal end surface of said anchor body, said plunger means being axially movable through said tubular means so as to expel said anchor from said tubular means and to drive said anchor into said hole, said plunger means being adapted to extend out of the distal end of said tubular means and into said hole when driving said anchor into said hole.

Claim 42

Apparatus according to claim 34 wherein said tubular means are mounted to said shaft, said plunger means are formed at said distal end of said shaft, and said tubular means are free to rotate circumferentially about said shaft.

Claim 43

Apparatus according to claim 34 wherein the portion of said shaft adjacent said distal end of said shaft has a maximum cross-section transverse to said longitudinal axis smaller than the transverse cross-section of said hole.