A medical device for approximating and securing tissue without requiring knots includes a lock-head, a strap section, distal protuberance, and a leader section. The device also includes a transition section between the leader and the strap section and a stiffening section proximal to the protuberance. The leader section is used to draw the strap section into the body through small apertures in tissue and the transition section provides a gradual transition in stiffness and size between the leader and the strap section.

A method of repairing a fractured bone may include implanting a prosthetic stem into an intramedullary canal of the fractured bone. First and second bone segments of the fractured bone may be robotically machined to include first and second implant-facing surfaces that are substantially negatives of first and second surface portions of the first end of the prosthetic stem. The first and second tuberosities may be machined so that the first and second bone segments have first and second interlocking surfaces shaped to interlock with each other. During implantation, the first and second implant-facing surfaces are in contact with the first and second surface portions of the first end of the prosthetic stem, and the first interlocking surface interlocks with the second interlocking surface.

Disclosed herein are suture systems and method of use thereof. The suture systems can include a passer, a needle, a first suture, and a second suture. The needle can be sized to pass through a cavity defined by the passer and define an attachment member. The first suture can include a first end, a second end, and a portion sized to be received by the attachment member and pass through the passer. The second suture can include a suture passage extending from a suture inlet to a suture exit. The first suture can be operable to pull a portion of the second suture at least partially around an anatomical structure. The second suture can be operable to reduce an anatomical structure when a first end of the second suture is passed through the suture passage.

Methods and systems are provided for securing tissue to bone. A suture anchor system can include a cannulated suture anchor having at least one driven feature disposed in a lumen and a bone-engaging feature disposed on an external surface. A cannulated inserter member can have an elongate member with a lumen and can be disposed within the lumen of the anchor. The elongate member can have a drive feature that can engage the driven feature. The inner tube can be disposed within the lumen of the inserter member. The inner tube can have a lumen and a length greater than the anchor such that the inner tube extends distally beyond the anchor. A distal swivel member can have a lumen and a distal end having a suture separating feature. The distal swivel member can be mounted adjacent to the anchor and can be rotatable relative to the anchor.

A medical device includes a suture ring that defines an arcuate channel extending therein. A first arcuate needle passer is slidingly disposed within a first side of the arcuate channel and a second arcuate needle passer is slidingly disposed within a second side of the arcuate channel. A suture shuttle is passable between the first arcuate needle passer and the second arcuate needle passer and is configured to be releasably securable to the first arcuate needle passer and to the second arcuate needle passer.

A suture anchor comprises a tubular body having an axial bore therethrough and having one or more purchase enhancements on an exterior surface of the body adapted to enhance purchase of the body within a bone hole, such as threads. A lateral port passes through the body from the bore to the exterior surface and is formed of a slot entering the body from its proximal end. A length of suture for attaching soft tissue to bone passes down along the exterior surface over the one or more purchase enhancements, over a distal end of the body, up into the bore through and then back out of the bore and up along the exterior surface over the one or more purchase enhancements.

A method for coupling tissue with a flexible member including a tail and a self-locking construct coupled to the tail. The self-locking construct includes an adjustable first loop and an adjustable second loop coupled thereto. The method includes implanting an anchor in bone, the anchor slidably mounted to the tail. The tail is positioned relative to the tissue. An end of the tail is inserted through the first loop. The tail is passed through the first loop, the second loop is pulled into the anchor, and the self-locking construct is positioned relative to the tissue. The self-locking construct is tightened against the tissue by pulling on an end of the self-locking construct. The first loop is tightened onto the second loop.

Instruments and methods for surgical transosseous attachment to a bone include a guide able to guide the formation of intersecting bone tunnels and a passer able to pass a member through the bone tunnels.

Described herein is a simplified placement system and method for a tissue graft anchor by which a surgeon may introduce one or more sutures into a hole in a boney tissue, apply a precise amount of tension to the sutures to advance a soft tissue graft to a desired location, and then advance the anchor into the bone, preferably while maintaining the requisite pre-determined suture tension and without introducing spin to the suture. Particularly preferred embodiments allow for the one-handed operation, namely embodiments in which relative axial movement between the inner tensioning device and outer driver device is optionally physically constrained, for example by means of cooperating and/or compressive elements disposed in the respective hub and handle portions, are described herein. Other preferred embodiments of the present invention relate to multi-anchor constructs that may employ threaded implants exclusively, push-in implants exclusively, or a combination of threaded and push-in implants.

An apparatus and method are provided for a syndesmosis treatment construct configured to be placed into a cinched configuration that presses a first bone against a second bone. The syndesmosis treatment construct comprises a proximal fixator to contact the first bone and a distal fixator to contact the second bone. A first suture and a second suture are parallelly looped through the distal fixator. A free splice slidably rides on proximal ends and distal ends of both of the first and second sutures. The distal ends are looped through the proximal fixator and bound within a stitch splice. The proximal ends are passed outside of the stitch splice and through the proximal fixator. The free splices compress and seize the proximal ends during pulling of the proximal ends by a practitioner so as to maintain the cinched configuration.