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.

Apparatus is provided, including an implant including a tissue-adjusting member including a longitudinal member, and a tissue anchor coupled to the tissue-adjusting member and configured to be anchored into the tissue of the patient. A tissue-coupling element is coupled to the longitudinal member. A delivery tool is reversibly couplable to the implant and is configured to deliver the implant to the tissue of the patient. The delivery tool includes an elongate shaft, a tissue-coupling-element holder coupled to a portion of the elongate shaft, the tissue-coupling-element holder being configured to hold the tissue-coupling element during delivery of the implant to the tissue of the patient, and an actuating element configured to rotate the tissue anchor so as to facilitate anchoring of the tissue anchor into the tissue of the patient while not rotating the tissue-coupling-element holder with respect to the shaft.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

A reconstruction system and associated techniques for soft tissue repairs and repair augmentation. The reconstruction system is an internal soft tissue brace formed of at least one fixation device (for example, anchors or screws) and a replacement/reinforcement construct (for example, a suture construct in the form of a suture tape such as FiberTape® or a collagen tape or a suture with biological material or a collagen coated material, or a collagen patch, or a biological construct such as Arthroflex). The reinforcement construct and fixation devices may be used as a suture repair alone (to replace the ligament or tendon), or in conjunction with other traditional soft tissue repair procedures, acting as a reinforcement system for the repaired soft tissue.

An implant device (100d) for engagement with a bone of a subject, said the implant device (100d) comprising a distal end (102d), a proximal end (104d), a central shaft (106d), a longitudinal central axis (108d) and a helical thread portion (110d) having a leading edge (114d) and a trailing edge (116d). A portion of the leading edge (114d) extends in a direction towards the distal end (102d) of the implant further than the most distal portion of the root (112d) of the thread portion (110d); and wherein the trailing edge (116d) extends in a direction of from the most proximal portion of the root (112d) in a radial outward direction and towards the distal end (102d); and a crest portion (118d) disposed between the leading edge (114d) and the trailing edge (116d) and wherein said the crest portion (118d) forms a radially outward portion of the thread portion (110d). Hence, the implant device (100d) improved the axial pull-out strength and reduced stress concentration.

Methods and systems are provided for securing tissue to bone. A surgical system can include a driver having a proximal handle and a driver shaft extending therefrom, a distal awl shaft, a proximal awl shaft separate from the distal awl shaft and movable with respect to the distal awl shaft, a suture anchor, and a dilator feature distal to the suture anchor. The distal and proximal awl shafts are receivable in at least part of a lumen of the driver. In a bone forming configuration of the system, in which the distal awl shaft is driven into bone, a distal end of the proximal awl shaft abuts a proximal end of the distal awl shaft. The proximal awl shaft can be moved proximally, such as by activating an awl handle coupled thereto, with respect to the distal awl shaft to move the system in a suture anchor insertion configuration.

A system and method for attaching tissue to bone are provided. In one embodiment, a system for attaching tissue to bone includes a suture, suture anchor, inserter tool, drill, and drill guide having an outer guide and an inner guide. A method for attaching tissue to bone includes attaching a suture to tissue, nesting the suture in a notch on the distal end of the outer guide, passing the suture through a lumen formed in the outer guide, and inserting an inner guide in a lumen formed in the outer guide. The drill guide protects the suture from rotational movement of the drill and allows a user to maintain alignment between the drill guide and the drilled hole. As a result, a suture anchor can be more easily positioned within the drilled hole.

A tissue defect closure system includes an endoscopic surgical fixation device and an implant. The endoscopic surgical fixation device includes a handle assembly and an elongated outer tube having a distal end and including a plurality of fasteners disposed therein. The implant includes an elongated hollow body having a proximal end and a distal end, and defines an elongated pocket therein. The elongated pocket is dimensioned to engage the elongated outer tube of the endoscopic surgical fixation device.

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.

The present invention provides minimally invasive anchor drill devices for drilling pilot holes and inserting hardware into the pilot holes. The devices perform both functions without needing to be removed from a site of drilling, ensuring accurate placement of hardware while streamlining minimally invasive surgical procedures. The present invention also provides suture anchors capable of simultaneously supporting locking and re-tensioning suture configurations. The anchor drill devices and suture anchors can be used together for anchor-first procedures, suture-first procedures, and procedures linking several anchors together through combinations of locking and re-tensioning suture engagements.