Guide tools for installation of fixation devices. At least one example embodiment includes: a delivery tube, the delivery tube defines a slot that runs from the distal end to the proximal end; a guide tube coupled to the delivery tube; and a handle coupled to the proximal end of the delivery tube and coupled to the proximal end of the guide tube. The handle may include a first channel into an interior of the delivery tube through the slot, and a receptacle in operational relationship to the delivery tube and the first channel.

Knots and methods of forming knots made of flexible material for use in a surgical environment are described. The knots include one or more ways to unlock at least a portion of the knot.

A multi-suture knotless anchor and related method for securing soft tissue, such as tendons, to bone are described. The suture anchor includes a body, a sleeve, and an outer deformable bone locking structure. The bone locking structure has a first low profile configuration for insertion into the bone, and a second larger profile configuration for engaging the bone when actuated. The bone anchor and methods permit a suture attachment that lies beneath the cortical bone surface and does not require tying of knots in the suture.

Described are devices, implants, kits, and related methods for treating pelvic conditions such as urinary in incontinence, in a male or a female patient. The invention includes, in one embodiment, a multi-piece implant, including a tissue support piece, extension portion, and one or more self-fixating tips. The device may be employed through a medial incision in the pelvic region of the patient.

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 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.

Meniscal repair devices, systems, and methods are provided.

Fixation device cartridges. At least one example embodiment is a cartridge including: a first tube; a second tube parallel to first tube; a first spacer coupled to the first tube and the second tube such that slots of the first and second tubes face each other; a second spacer coupled to the first tube and the second tube, the first and second spacers defining a suture volume between the slots of the first and second tubes, and the slot of the first tube and the slot of the second tube open into the suture volume; a first bone anchor disposed within the first tube, a first suture line associated with the first bone anchor and extending through the slot; and a second bone anchor disposed within the second tube and coupled to the first suture line.

An annuloplasty structure includes a contracting member. A fastener is configured to receive the contracting member therethrough, the fastener including a housing and a clamping structure disposed therein. The fastener has an open state in which the contracting member can pass through the fastener, and is biased toward assuming a closed state in which the clamping structure clamps onto the contracting member disposed through the fastener. A stop is coupled to the fastener in a manner that maintains the fastener in the open state. A tool includes static and dynamic cutting elements, and is configured to (a) apply tension to the contracting member by pulling the contracting member proximally through the fastener, (b) lock the tension in the contracting member by pulling the stop proximally out from the fastener, and (c) sever the contracting member by moving the dynamic cutting element. Other embodiments are also described.

Various exemplary systems and devices for knotless anchor insertion and methods of knotless anchor insertion are provided. In general, an inserter tool is configured for knotless anchor insertion in a soft tissue repair surgical procedure. The inserter tool is configured to insert an anchor into a bone of a patient to secure a soft tissue relative to the bone. A suture coupled to the soft tissue is secured relative to the bone by being trapped between an exterior surface of the anchor and a bone surface defining a hole in the bone in which the anchor is positioned.