A heart valve therapeutic device has an elongate anchor wherein the anchor has a stiffness to hold its shape and location to support the valve element. The anchor may have a stylet or a shaped or stiff collar arranged to provide a desired shape to the anchor and it may be lockable. A prosthetic valve element has leaflets and is supported on the anchor by coupler at a desired location. There is an actuator for changing relative axial position of the proximal and distal couplers on the anchor. The anchor stiffness may be sufficient to provide sufficient support to resist axial forces from the ventricle in use without necessarily having a fixing element engaging heart tissue. The prosthetic leaflets may extend proximally and radially outwardly, so that there is excellent co-apting of the native leaflets (NL) against the prosthetic leaflets.

A system for fastening soft tissue to bone includes a bone screw having a threaded shaft and a screw head having an underside with malleable protuberances that project toward a distal end of the threaded shaft. A fixation plate is coupled with the threaded shaft. The fixation plate has a proximal face that opposes the underside of the screw head, a distal face that faces away from the underside of the screw head, an outer peripheral edge that extends between the proximal and distal faces, a central opening for receiving the threaded shaft, and protrusions spaced from one another around the outer peripheral edge that extend distally beyond the distal face of the fixation plate. The system includes an insertion tool having a handle and a tubular shaft extending distally from the handle. The tubular shaft has a proximal shaft section having an inner diameter that closely matches an outer diameter of the screw head, and a distal shaft section having an inner surface with a groove that seats the outer peripheral edge of the fixation plate for releasable retaining the fixation plate within the distal shaft section.

Systems and methods for soft tissue to bone repairs employing tensionable knotless anchors, without knot tying. The tensionable knotless anchors may be used by themselves or in combination with additional constructs (which may have a similar or different configuration, i.e., modified according to the specific repair) and with the flexible strands provided through tissue, around tissue, or through and around tissue to be repaired or fixated. The tensionable knotless anchors may be used to achieve simple stitch repairs, mattress stitch repairs or interlocked looped mattress repairs, among others. The tensionable knotless anchors may be also provided in a daisy chain configuration, i.e., with the suture from one anchor passed through the eyelet/loop of the shuttle/pull device of another anchor and repeated in a pattern.

Surgical constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct is formed from a suture filament and includes two terminal ends of filament and an intermediate portion disposed along at least a portion of a length extending between the terminal ends. The construct can have a first terminal end that is the first terminal end of the filament, and a second terminal end that includes a loop. The loop can be formed by disposing the second terminal end of the filament within a volume of a portion of the intermediate portion of the filament. In some disclosed methods, both terminal ends of the filament can be passed through tissue when performing soft tissue repairs. Various other embodiments of constructs and methods are provided, including constructs having two or more filaments associated with an anchor and methods of using such constructs.

An implant assembly may include a first component having a proximal plate and a distal portion extending from the proximal plate, a first screw of a first type, and a first screw of a second type. The proximal plate may have a proximal face, a distal face configured to abut bone, and a periphery. The proximal plate may define a plurality of apertures. An opening may be defined by the proximal plate and extend through the distal portion. Each of the plurality of apertures may be disposed between the opening and the periphery. The first screw of the first type may be sized and configured to be received in the opening and engage bone. The first screw of the second type may be sized and configured to be received in at least one of the plurality of apertures.

Suture delivered patches adapted for interposition, augmentation or repair devices for use in tendon and ligament repair, including rotator cuff repair, have been developed as well as methods for their delivery using suture guided arthroscopic methods. The repair patches may be provided from suitable biocompatible materials. The patches may be delivered using anchored sutures already in use during a surgical repair including, open, minimally invasive, endoscopic, and arthroscopic repair procedures. Additionally, fixation of the suture delivered repair patch is secured along with the normal suture securing workflow of the one or more sutures used to deliver the patch.

A suture anchor includes a threaded anchor body having a first central bore in communication with a second central bore. The suture anchor includes an internal eyelet formed of a loop disposed at least partially inside the first central bore. The ends extending from the loop are tied together to form at least one knot which is housed in the second central bore provided at the distal end of the anchor body. The knot increases the pullout strength of the suture even in soft bone, provides increased suture fixation, and eliminates the anchor “pull back.”

The present disclosure provides a wound closure device that includes (a) a biocompatible material configured to be brought into abutment with a tissue surface, and (b) a plurality of fixation components connected to and extending through the biocompatible material, where at least one of the plurality of fixation components is configured to allow a suture to be connected to and extend through the at least one fixation component.

Apparatus comprises: (A) a housing (248), percutaneously deliverable to a heart of a subject, slidable along a guidewire (242), and shaped to define at least one opening (249); (B) a guide member (250), percutaneously deliverable to the heart, percutaneously removable from the subject, couplable to the housing, and having: (i) a distal portion, comprising a chord-engaging element (252), configured to be percutaneously slidably coupled to and decouplable from at least one chordae tendineae (244), and (ii) a proximal portion, comprising a longitudinal element (251); and (C) a deployment tool, configured (i) to be reversibly coupled to a tissue anchor (50,280), (ii) to be slidably coupled to the longitudinal element of the guide member, and (iii) to anchor the tissue anchor to a papillary muscle (254) of the subject. Other embodiments are also described.

This disclosure relates to shield guide assembly and methods for restoring functionality to a joint. The shield guide assembly disclosed herein include a shield dimensioned to block access through the shield onto an adjacent bone surface region during formation of one or more features along the surgical site.