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.

Methods and systems are provided for securing tissue to bone. A suture anchor system can include an inserter tool having a lumen and an inserter shaft with an anchor receiving portion that is proximal to a distal extension. The anchor receiving portion can have a drive feature and the distal extension can have a diameter less than the anchor receiving portion. An anchor can be disposed on the anchor receiving portion of the inserter tool, and can have a driven feature disposed in a lumen configured to engage the drive member of the anchor receiving portion and a bone-engaging feature disposed on an external surface. A suture seating member can be removably disposed on the distal extension, can be rotatable independent of the anchor, and can have a lumen with an opening on a distal end, where the distal end of the suture seating member has a suture seating surface.

Methods and systems are provided for securing tissue to bone. A suture anchor can include an elongate body having a proximal end and a distal end and an external surface with a plurality of longitudinally spaced bone-engaging features formed at least partially circumferentially thereon over at least a portion of a length of the suture anchor. The proximal end can have a lumen extending at least partially into the elongate body and the distal end can have a suture engaging feature proximate thereto. A first series of bone-engaging features can have a dimension that increases from a distal to a proximal end of each bone-engaging feature of the first series of bone-engaging features. A second series of bone-engaging features can have a dimension that decreases from a distal to a proximal end of each bone-engaging feature of the second series of bone-engaging features.

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.

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.

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 patient's stomach may be secured to the patient's diaphragm. A method to accomplish this includes visualizing a wall of a patient's stomach adjacent the patient's diaphragm from within the patient's stomach, inserting a fastener deployment apparatus down the patient's esophagus and into the mammalian's stomach, and fastening the patient's stomach to the patient's diaphragm with the fastener deployment apparatus and from within the stomach. The procedure may be employed to advantage to treat a hiatal hernia, for example, either alone or in conjunction with the restoration of the patient's gastroesophageal flap valve.

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.

An anchor for anchoring tensile members to bone includes: a housing having a hollow interior; a collet in the interior of the housing, having a central bore for accepting tensile members therethrough and an exterior surface, wherein the collet is configured to be swaged around the tensile members; a sleeve having opposed interior and exterior surfaces, the sleeve disposed in the hollow interior of the housing and positioned adjacent to the collet, so as to be movable between first and second positions; wherein at least one of the exterior surface of the collet and the interior surface of the sleeve is tapered and the sleeve and the collet are arranged such that movement of the sleeve from the first position to the second position will cause the collet to swage radially inwards around the tensile members; and a flange element, wherein the housing is pivotally mounted to the flange element.

Suture constructs and methods for soft tissue to bone repairs. The suture construct is a soft, suture-based anchor which is self-cinching and has a specific, accordion-type configuration (i.e., with the ability to fold from a first, extended position to a second, folded or compressed position). The suture-based anchor may be formed essentially of a flexible material such as a high strength surgical suture, suture chain, or suture.