A suture-based vessel closure device can perform the dilation of an arteriotomy puncture and does not require previous dilation of the arteriotomy puncture by a separate device or by a procedural sheath dilator. The suture-based vessel closure device can place one or more sutures across the vessel access site such that, when the suture ends are tied off after sheath removal, the stitch or stitches provide hemostasis to the access site.

A system for an anatomical joint includes a first fastener, a second fastener, a prosthetic ligament member, and a biasing member associated with at least one of the first and second fasteners. The first fastener is operable to be connected to a first bone portion. The second fastener is operable to be connected to a second bone portion. The prosthetic ligament member is flexible and is directly coupled to both the first and second fasteners to support the first bone portion and the second bone portion for relative movement. A portion of the prosthetic ligament member extends from the first fastener to the second fastener and has an adjustable length. The biasing member is operable to bias the prosthetic ligament member to thereby maintain tension in the prosthetic ligament member.

Systems and methods for preparing a ligament graft for a ligament reconstruction procedure are provided. In general, the described techniques utilize a graft preparation system having a holder and a delivery suture assembly removably coupled thereto. The delivery suture assembly can include a spine coupled with an anchor suture configured to form a self-tightening knot used to position the assembly around a graft and a plurality of suture windings configured to be affixed to the graft when the assembly is deployed. The assembly is delivered to the graft using the holder and the sutures can be affixed to the graft without penetrating therethrough. The spine helps to evenly distribute the load among the windings compressing the graft which are thus are capable of withstanding increased loads. Thus, an improved, simplified, and time- and labor-saving approach to preparing ligament grafts is provided.

A tissue repair apparatus includes a housing, a rotatable shaft at least partially disposed within the housing, and first and second curved needles coupled to the shaft. The housing defines a gap between a first edge of the housing and a second edge of the housing, the gap adapted to receive tissue. The first and second needles curved needles being articulable within the housing from a delivery position, at which the first and second needles are spaced from the gap, to a deployed position, at which the first and second needles extend through the gap. Actuation of the shaft simultaneously articulates the first and second needles and the first needle enters the gap before the second needle enters the gap.

An aortic closure device for trans-caval procedures having a deployment assembly having a housing, a release tube, and a delivery tube disposed within the release tube, a tamper disposed within the delivery tube, a sealing element, a suture assembly, and an actuator.

Exemplary systems and methods encompass suture knot tools and suture knot tools pre-loaded with sutures for use in tendon repair and other surgical procedures. Related methods may include forming a nail knot between a suture and a tissue of a patient during a surgical procedure by drawing tissue into a port sleeve of an arthroscopic system, moving the port sleeve relative to a free end portion of the tissue and a nail knot cinch of a suture, to allow the nail knot cinch of the suture to contact the free end portion of the tissue; and tightening the nail knot cinch of the suture about the free end portion of the tissue, so as to form the nail knot with the suture and the tissue.

An improvement to devices and methods for suturing tissue in various applications, such as percutaneous closure of arterial and venous puncture sites and the like, providing a self-locking or self-securing suture that does not require manual knot-tying to hold in apposition the tissue of the vessel wall on opposite sides of the puncture.

Tissue fixation and repair constructs and methods of repair using the same are provided. An exemplary tissue fixation and repair construct can include a first implantable anchor coupled to a suture having a fixed tail and a tensioning tail. The fixed tail can include an overhand knot located distally adjacent to the finger trap, such that the overhand knot substantially abuts the finger trap when adjacent thereto, a fixed stopper knot configured to prevent further movement of the fixed tail through a second implantable anchor when the second implantable anchor is placed onto the suture, and a finger trap. The tensioning tail can be passed through the finger trap and overhand knot, and can be used to adjust the tension of the tissue fixation and repair construct when the first implantable anchor and the second implantable anchor are inserted into bone.

A suture construct apparatus, including a self-cinching suture member having a first strand, a second strand, a sleeve defined on the second strand, and a self-cinching suture member fixed loop with a sheath positioned on the self-cinching suture member. The suture construct apparatus may further include an anchor disposed on the self-cinching suture member, a self-cinching suture member shuttling suture disposed on the self-cinching suture member fixed loop, and a sheath removably disposed around at least a portion of the self-cinching suture member. The first strand may pass through the sleeve and form a self-cinching suture member free end. The first strand may also be axially moveable through the sleeve.

Embodiments of a knot pusher and methods of use thereof are disclosed, that are usable for pushing a knot formed from a suture, two limbs of the suture extending from the knot. The knot pusher comprises a distal head defining top and bottom walls terminating in a distal knot pushing surface. The distal head includes at least two side grooves defined between the top and bottom walls that extend proximally from the knot pushing surface. Each of these side grooves is operable to receive one of the limbs of suture. The distal head additionally comprises a top wall suture receiving element for receiving one of the two limbs of the suture during advancement of the distal head to facilitate advancement of a sliding knot