A tissue repair construct having first and second implants coupled via a flexible element is provided. The flexible element forms an adjustable loop closed with a sliding knot, and has first and second free ends extending from the knot formed by wrapping the second end around the first end. The second implant can have a changeable configuration. The construct can be placed within a surgical site in a patient's body such that the first implant is passed into a bone adjacent to soft tissue and the second implant is disposed on an opposed side of the soft tissue. The first free end of the flexible element is configured to be tensioned to decrease a size of the loop and thereby change the configuration of the second implant and to thereby cause at least the second implant to move towards the first implant.

A sternal tie assembly having a pair of hook-shaped needles, a length of sternal tie extending from a proximal end of each of the needles, and a pair of posterior plugs, each of the posterior plugs being slidably mounted on the tie and tethered, via suture material, to the proximal end of a respective one of the needles. A method of use of the sternal tie assembly includes creation of a hole or channel in sternum, manubrium, rib, rib cartilage, intercostal muscle, or other tissue, drawing a portion of the tie and the suture material through the channel formed in the tissue by the needle, severing the needle from the tie and suture material, continuing to advance the suture material until a post of each of the posterior plugs is pulled into the respective channel in the tissue, or at least until a head of the plug is disposed against the channel in the tissue, then threading an anterior plug onto each exposed end of the sternal tie, securing the anterior plugs into respective anterior openings in the tissue, then crossing and twisting the sternal tie ends together until the tissue ends are closed together.

A system for coupling a tendon to a bone may include a tendon coupling device engageable with a tendon, a fastener to secure the tendon coupling device to the tendon, a bone coupling device, and a flexible element. The flexible element may include a first portion and a second portion. The first portion of the flexible element may be couplable with the fastener to securably attach the flexible element to the tendon. The bone coupling device may include a bone-facing surface engageable with a surface of the bone proximate a bone tunnel formed through the bone, and a hole formed through the bone coupling device. The second portion of the flexible element may be receivable through the bone tunnel and the hole formed through the bone coupling device to engage an opposing surface of the bone coupling device and securably couple the tendon to the bone.

An implantable device may be provided with first and second bone anchors, at least one suture and a force-generating component. In some embodiments, the first bone anchor is configured to anchor in or on a first bone segment and the second bone anchor is configured to anchor in or on a second bone segment. The at least one suture may interconnect the first bone anchor and the second bone anchor. The force-generating component may be connected to the at least one suture and configured to impart a force thereto. The first bone anchor, the second bone anchor, the at least one suture and the force-generating component may be configured to cooperate together to draw the first bone segment and the second bone segment toward one another with a force in a predetermined range. Methods of device construction and use are also provided.

A soft tissue repair device. The device includes an inserter having a distal portion, a first anchor carried externally onto the distal portion, a second anchor carried externally onto the distal portion, and a flexible strand coupling the first and second anchors and forming an adjustable knotless loop.

An implant includes a curved first plate section having a curvature about a longitudinal axis extending in a longitudinal direction. The first plate section has a first hole and a second hole. The first hole and the second hole are positioned to receive respective bone screws for attaching the implant to a first curved surface of a bone having a syndesmosis. A second plate section extends continuously from the first plate section. The second plate section has at least a third hole that is positioned to be offset from the first hole and the second hole in a direction that is anterior or posterior from the first hole and the second hole in a case where the longitudinal axis is aligned along a superior-inferior direction. The third hole is configured to receive at least one screw or at least one button for holding a suture at a position offset from the first line segment hole and the second hole in the anterior or posterior direction, for reducing the syndesmosis.

A tissue repair system for securing a first tissue to a second tissue is disclosed including an instrument with a handle, a shaft extending distally from the handle and a housing having a locked cover. A tissue anchor is disposed at a distal end of the shaft, and operatively coupled to an actuation member of the handle via a deployment member. The actuation member is configured to actuate the deployment member, deploy the tissue anchor and thereby couple the tissue anchor with the first tissue. The system also includes a repair member, for coupling the tissue anchor to the second tissue. Repair member has a first end operatively coupled to the tissue anchor and a second end attached to at least one coupling means. The repair member second end and coupling means are housed within the instrument housing. Actuation of the actuation member is configured to unlock the housing cover.

A fibular nail for repairing distal fibular fractures is provided that does not require a transfibular-transtibial interlocking screw for stabilization. The nail provides transverse apertures permitting fixation of the proximal and distal portions of a fractured fibula to the nail. The nail has apertures for securing the fibula to the nail on the proximal side of a fracture and on the distal side of a fracture. Optionally, the nail may be connected to the tibia for stabilization.

A suture gripping device is described. The device includes a body formed from a flat piece of shape-memory material. The body has at least one slot extending from an edge of the body towards a medial position of the body and a first folding plane for folding a first portion of the body away from a second portion of the body to provide a bent configuration. The bent configuration is converted to a flat configuration when the temperature of the device is raised above the transition temperature of the shape-memory material. This conversion generates a gripping force against the suture when the suture is held in the slot.

A non-invasive device for anchoring a suture includes a sheet to which a suture can be attached and an adhesive that can affix the sheet to bone. The method provides placing effective amount of an adhesive on a bone and attaching the suture to the adhesive and allowing the adhesive to set.