A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a single working suture and each of the suture anchors allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the working suture in place subsequent to tensioning. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a continuous array of single anchor to anchor stitches which can be placed close together in high density to form a line or region of stitches for a more robust securement of soft tissue to bone.

A delivery device for transtendinous implantation of a toggle-type suture anchor into bone is disclosed. The device includes a proximal housing having an outer tubular shaft extending distally with a lumen therethrough. An anchor delivery tube extends through the lumen of the outer tubular shaft having a proximal end affixed to the proximal housing. The anchor delivery tube includes a nub portion that is used to insert through the tendon and partly into bone to maintain registration with a bone hole into which an anchor is placed. A bone punch assembly extends through the lumen of the anchor delivery tube and the nub portion with a pointed distal end. When the bone punch is fully inserted, the pointed distal end extends a distance distal of the distal end of the nub portion.

Apparatus for securing an object to bone, the apparatus comprising: an anchor, the anchor comprising: a body comprising an opening for receiving a filament therein; and a locking element movably mounted to the body for selectively locking the filament to the body; and an inserter for deploying the anchor in bone, the inserter comprising: a handle; an overtube extending distally from the handle; a carriage movably mounted to the handle; a shaft movably mounted within the overtube and connected to the carriage and releasably connected to the body of the anchor, the shaft being hollow; and a rod movably mounted within the shaft and connected to the locking element.

An assembly includes a flexible fixation member, a suture, and a delivery device. The fixation member includes a body with two terminal ends. A suture passes through the flexible fixation member at various points along a length of the body such that portions of the fixation member are slidable relative to the suture and configurable to form a cluster within a surgical site. The delivery device includes a tubular member, an elongated inserter, and a trigger. The elongated inserter is slidably disposed within the tubular member. The inserter has a forked distal end configured to receive a portion of the flexible fixation member and the suture. The trigger is finger-engagable and fixedly coupled to the proximal end of the inserter. It is configured to advance and retract the inserter relative to the tubular member. The trigger includes a retention member for retaining a proximal end portion of the suture.

An assembly includes a flexible fixation member, a suture, and a delivery device. The fixation member includes a body with two terminal ends. A suture passes through the flexible fixation member at various points along a length of the body such that portions of the fixation member are slidable relative to the suture and configurable to form a cluster within a surgical site. The delivery device includes a tubular member, an elongated inserter, and a trigger. The elongated inserter is slidably disposed within the tubular member. The inserter has a forked distal end configured to receive a portion of the flexible fixation member and the suture. The trigger is finger-engagable and fixedly coupled to the proximal end of the inserter. It is configured to advance and retract the inserter relative to the tubular member. The trigger includes a retention member for retaining a proximal end portion of the suture.

Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a surgical implant is provided having a sheath and an expander that is received within the sheath. Various delivery tools, including a sheath inserter and a driver, are also provided. In use, the sheath inserter can be used to position a tendon within a prepared bone hole, and it can be used to deliver the sheath with a guidewire coupled thereto into the bone hole. The driver can be provided for delivering the expander into the sheath. A loader can optionally be used to load the driver and expander onto the guidewire coupled to the implanted sheath.

Methods of tissue repair. At least one example method includes: pulling a tissue in place over a bone location; abutting a distal end of a guide tool against the tissue at a first location, and driving a first bone anchor through a delivery tube of the guide tool, through the tissue, and into the bone at the first location, the first bone anchor coupled to a first suture line; abutting the distal end of the guide tool against the tissue at a second location displaced from the first location, and then driving a second bone anchor through the delivery tube, through the tissue, and into the bone at the second location, the second bone anchor associated with the first suture line; withdrawing the guide tool away from the tissue; and tightening the first suture line to create a first suture over the tissue.

Disclosed herein is a catheter device (2) for implanting a leaflet anchor (10) and a papillary anchor (9) into the heart as part of a procedure for implanting an artificial chordae line (14) that extends between the leaflet anchor (10) and the papillary anchor (9), the catheter device (2) comprising: a two-part housing section extending from a distal end (8) of the catheter device (2) along the length of the catheter device (2) toward the proximal end (4) of the catheter device (2), the two-part housing section being arranged to be placed between the papillary muscle and a leaflet (12) of the heart during use of the catheter device (2), and the two-part housing section comprising a distal part (8) at the distal end of the catheter device (2) and a proximal part (4) located on the proximal side of the distal part (8); a leaflet anchor deployment mechanism at the proximal part (4) of the housing section for deploying a leaflet anchor (10) for attachment to the leaflet (12) of the heart; a papillary anchor deployment mechanism at the distal part (8) of the housing section for deployment of a papillary anchor (9) for attachment to the papillary muscle, wherein the papillary anchor deployment mechanism is arranged for deployment of the papillary anchor (9) by moving it outward in the distal direction relative to the distal part (4); and a flexible joint (34) located between the proximal part (4) and the distal part (8) of the two-part housing section, wherein the flexible joint (34) allows a centreline of the distal part (8) to be angled relative to a centreline of the proximal part (4).

Disclosed herein is a kit for augmenting a primary repair construct in an articulating joint. The kit includes a flexible member, a first implant that fixes a first end of the flexible member in a first bone adjacent to the primary repair construct and a second implant that may selectively couple to the flexible member, and thereby fix a second end of the flexible member in a second bone adjacent to the primary repair construct. The kit also includes a tension adjusting construct that may operatively couple to the flexible member and controllable adjust a tension on the flexible member disposed between the first and second implant, the tension adjustable so as to define an angle of joint articulation at which the flexible member changes from being passive to augment the primary repair construct.

Disclosed herein are various embodiments of suture adjustment mechanisms for anchors configured to be inserted into a heart wall of a patient to anchor a suture as an artificial chordae under an appropriate tension for proper valve function. Suture adjustment mechanisms can be configured to retain suture ends extending from the leaflet to the anchor with sufficient force to prevent natural movement of the leaflet from adjusting a length of the suture between the anchor and the leaflet. Free ends of the suture can extend from the anchor external to the body as tensioning strands. A surgeon can supply sufficient force on the tensioning strands from external the body to adjust a length and tension of the suture between the anchor and the leaflet.