Methods and devices are provided for anchoring suture to tissue, incorporating anchoring devices constructed substantially from suture. The anchoring devices are constructed as longitudinally extended, preformed knot configurations that upon deployment are reconfigured to form anchoring knots having an increased cross-section relative to the preformed knot configuration, for secure lodging in tissue. The anchoring devices are suitable for single and multi-anchor surgical procedures in soft tissue or bone, and multiple anchors can be delivered using a single delivery device.

The invention features bone screws having a threaded screw body and a screw head attached to one end of the screw body, the bone screw further including: a) an interior channel extending longitudinally through the screw head and through at least a portion of the screw body, wherein the interior channel has a width of less than 5.0 millimeters; and b) a plurality of radially-disposed delivery channels connecting the interior channel to the exterior of the screw body, each delivery channel having exterior openings. The invention further features devices that include a bone screw and a delivery manifold detachably attached to the screw head of the bone screw. In addition, the invention features methods of treating a patient having a bone defect by using a bone screw described herein.

Various self-cinching suture anchors, self-cinching suture anchor systems, and methods of use are provided. In one exemplary embodiment, a suture anchor is provided that includes an outer member and an inner member configured to be received within the outer member. The inner and outer members can define a gap that allows a suture to be movably disposed within the outer member, e.g., within the gap, when the inner member is disposed within the outer member. The inner member can be configured to be secured within the outer member by a knot of the suture having a diameter greater than a width of the gap so as to fix the inner member within the outer member, while still allowing uni-directional tensioning of the suture.

A knotless anchor for attachment of tissue to bone includes a rigid anchor body and a suture extending there from. The suture is hollow and includes a fixed limb portion secured to the rigid anchor body. A soft suture tunnel extends in a longitudinal direction through the fixed limb portion of the suture. A free suture limb is passed through the tissue, back to the anchor, and through the soft suture tunnel, thereby creating a closable suture loop around the tissue. Tension applied to the free suture limb closes the suture loop, and approximates the tissue to the anchor body. When the anchor is deployed in a bone hole, external features of the anchor body grip the walls of the bone hole and simultaneously compress the suture, thereby preventing tissue pull-out. Anchor assemblies and methods of tissue fixation are also disclosed.

An intramedullary nail implant for positioning in a bone having a head and a shaft defining an intramedullary canal. The implant includes a distal portion having a shaft extending along a central axis and configured for positioning within the intramedullary canal. A proximal portion extends proximally from the distal portion. The proximal portion defines a contact surface which extends at least in part medially of the central axis such that it is configured to extend within a medial portion of the bone head. A method of implanting the nail is also provided.

A method of tissue repair that includes installing a surgical construct in a bone hole. The surgical construct has a fixation device that is preloaded with a primary flexible strand. After installing the surgical construct in the bone hole, the method includes coupling at least one secondary flexible strand to the primary flexible strand for subsequent use in repairing the tissue.

A compression screw comprising a threaded shaft and a head associated with the proximal end of the shaft. The head has a plurality of outwardly extending projections spaced from one another so as to define a plurality of recesses there between for receiving a screw drive in such a way that rotational force may be transferred from the screw drive to the screw. The projections of the head may be provided with suture fixation holes or a suture coupling may be positioned over the shaft so as to extend between the projections of the head.

Systems and methods of placing one or more suture loops into tissue, such as the base of the tongue, are described. A system can include a variable-thickness suspension line for suspending tissue, including a suture having a first thickness dimension; an elastomer surrounding a portion of the suture and defining a central segment of the suspension line having a second thickness dimension greater than the first thickness dimension, and at least one transition zone extending from the central segment of the suspension line to a lateral end of the suspension line, the transition zones having a thickness dimension that tapers from the second thickness dimension to the first thickness dimension.

An anchoring system includes an anchor including an anchor body and a distal member located at a distal end of the anchor body, the distal member having a suture receiving aperture; and an implant delivery device, comprising: a cannulated outer shaft, the cannulated outer shaft configured to engage a proximal end of the anchor body for driving the anchor into a bore; and an inner shaft slidably received in the cannulated outer shaft, wherein a distal end of the inner shaft is extendable distally beyond a distal end section of the cannulated outer shaft such that, when the cannulated outer shaft is engaging the proximal end of the anchor body, the distal end of the inner shaft is extendable through the anchor body to a distance beyond the distal end of the anchor body to engage a suture located within the suture receiving aperture, wherein the anchoring system is configured such that the suture can be tensioned at a location within the bore distal from the anchor body before the anchor body is implanted within the bore.

The present invention provides improved suture inserter devices. The inserter devices are configured to securely hold a suture anchor with elements for routing and securing an attached suture thread and suture needle.