A suture anchor, and a surgical filament assembly using same, capable of being fixated in a hole formed in a bone of a patient. The suture anchor preferably includes an anchor body having a distal end, a proximal end, a passage extending from the proximal end toward the distal end, at least one feature disposed on the exterior of the anchor to engage bone, and a filament knot patency element disposed within the passage and defining a channel having a sufficient minimum cross-sectional area to allow movement of a portion of a surgical filament therethrough when a removable sliding knot is formed, using the surgical filament, about the filament knot patency element. The surgical filament assembly preferably includes a first filament having a sliding knot removably positioned about the knot patency element, with a shortening limb and a tightening limb each extending from the sliding knot. The sliding knot defines an adjustable capture loop having two legs extending proximally to a bight, one leg transitioning into the shortening limb and passing through the channel of the knot patency element, the shortening limb being accessible to enable a user to shorten the capture loop. The tightening limb enables the user to tighten the sliding knot against an object extending through the capture loop to secure the object to the anchor.

Assemblies for securing fractured bone are provided. The assembly includes a first fixation element, a second fixation element, and an adjustable flexible member construct. The first fixation element having a male or a female sleeve is secured within a first portion of the fractured bone. The second fixation element having the other of the male or female sleeve telescopically received within the one of the male or female sleeve is secured within a second portion of the fractured bone. The adjustable flexible member construct extends between the first and second fixation elements and has at least one adjustable loop coupled to the first fixation element and the second fixation element and a pair of adjusting ends extending through an opening in the first fixation element. The pair of adjusting ends can be pulled to reduce a diameter of the adjustable loop and to compress fragments of the fractured bone.

Some embodiments of the present invention include a suture anchor with both knotless and knotted suture attachment capabilities, as well as methods for loading the suture in knotless and knotted configurations. Some embodiments of the present invention include a suture anchor with an inner implant body with a spreader that slides in relation to an outer expandable collar, such that pushing the expandable collar distally with an inserter causes the spreader to expand the collar against the surrounding bone to secure the suture anchor in place. Such embodiments may also include a detachment or breakaway feature between the inserter and the suture anchor to permit separation after anchor deployment. Some embodiments of the present invention include methods for deploying such suture anchors and expanding the expandable collars and/or detaching the inserter tools. Embodiments of the present invention may be used in various orthopedic applications such as, for example, shoulder repair.

Methods and devices for securing soft tissue to a rigid material such as bone are disclosed herein. A bone anchor is described that comprises a base and a top such that suture material may be compressed between surfaces on the base and top to secure the suture to the anchor. Also described is an inserter that can be used to insert the bone anchor into bone and move the anchor top relative to the anchor base to clamp suture material there between. Also described is a soft-tissue and bone piercing anchor and associated inserter. Methods are described that allow use of the bone anchors to provide multiple lengths of suture material to compress a large area of soft tissue against bone.

A surgical access device is disclosed and includes a housing, a cannula, a guide, and an expandable member. The cannula extends distally from the housing and defines a longitudinal axis. A wall of the cannula includes a first slot defined therein. The guide is engagable with the housing and defines a first channel. The first channel is disposed at a non-parallel angle relative to the longitudinal axis. The expandable member is disposed adjacent a distal portion of the cannula and is transitionable between a collapsed configuration and an expanded configuration. A first surgical instrument is insertable through the first channel of the guide and through the first slot of the cannula.

A knotless suture anchoring system includes an outer anchor having a central channel and a distal tip adapted to penetrate tissue. An inner anchor is positionable in the central channel of the outer anchor and a locking feature on one or both of the inner and outer anchors retains the inner anchor within the central channel. A continuous length of suture is coupled with the inner and outer suture anchors and has a free end. At least one of the inner and the outer anchors also has a cinching mechanism that allows the suture to be tensioned by passage of the suture through the cinching mechanism in a first direction while movement of the suture through the cinching mechanism in a second direction opposite the first direction is constrained.

Methods and devices for securing soft tissue to a rigid material such as bone are disclosed herein. A bone anchor is described that comprises a base and a top such that suture material may be compressed between surfaces on the base and top to secure the suture to the anchor. Also described is an inserter that can be used to insert the bone anchor into bone and move the anchor top relative to the anchor base to clamp suture material there between. Also described is a soft-tissue and bone piercing anchor and associated inserter. Methods are described that allow use of the bone anchors to provide multiple lengths of suture material to compress a large area of soft tissue against bone.

Devices and methods for occluding or promoting fluid flow through openings are disclosed. In one exemplary embodiment an occlusion device is provided having an expandable outer elongate tubular body, a guide member extending from a distal end of the outer body, and a slide tube disposed within the outer body, the proximal portions of the outer body and the slide tube being fixedly mated. The slide tube is configured to slide distally within the outer tubular body when the tubular body is expanded to form wings. A tether can be included as part of the device and it can be used to assist in positioning and locking a location of the device in an opening. Exemplary methods for delivering devices disclosed herein are also provided.

A surgical access device is disclosed and includes a housing, a cannula, a guide, and an expandable member. The cannula extends distally from the housing and defines a longitudinal axis. A wall of the cannula includes a first slot defined therein. The guide is engagable with the housing and defines a first channel. The first channel is disposed at a non-parallel angle relative to the longitudinal axis. The expandable member is disposed adjacent a distal portion of the cannula and is transitionable between a collapsed configuration and an expanded configuration. A first surgical instrument is insertable through the first channel of the guide and through the first slot of the cannula.

Embodiments of the invention include a tissue repair system and related components and associated methods that provide for suturing of tissue using three or more suture anchoring implants, including multiple pairs of connected implants in some embodiments, all of which may be deployed from a single device. Some embodiments achieve this by employing a push mechanism capable of being activated to advance the push mechanism incrementally to discrete positions within the device and deploy implants one at a time from the device.