A self-drilling suture inserter including a shaft extending along a longitudinal axis having a proximal end and a distal end, which is connected to a tubular portion. The inserter also includes an inserter tip, which is attached to and extends distally from the shaft. The inserter tip comprises a suture anchor retention slot extending therethrough. The inserter tip also comprises a distal end with a drilling point. The tubular portion can also include an outer tube having a first inner volume and a suture tube having a second inner volume. The suture tube extends within the first inner volume of the outer tube.

An apparatus can include a first flexible member having first and second ends and a first body extending therebetween that defines a first passage portion. A second flexible member can include first and second ends and a second body extending therebetween that defines a second passage portion. The first end of the first flexible member can pass into and through the second passage portion in a first direction such that the first end extends outside of the second passage portion. The first end of the second flexible member can pass into and through the first passage portion in a second direction such that the first end of the second flexible member extends outside of the first passage portion to form a self-locking adjustable flexible member construct. Applying tension to the first ends can draw the passage portions and corresponding second ends toward each other.

A fibrous tissue repair device includes first and second tubular anchors having corresponding longitudinal passages. The tissue repair device includes corresponding first and second inserters. Each inserter has a shaft with a distal portion received in the longitudinal passage of the corresponding tubular anchor. A flexible strand couples the first and second anchors.

Disclosed is a device (100) for treatment of anal fistula. The device comprises a hollow wire (110) comprising a first end (112) and a second end (114) opposite to the first end, the hollow wire is operable to be received by a fistula track with both first and second ends projecting out of the fistula track. The device also comprises an insert (120) operable to be partially inserted into the first end of the hollow wire and to project out of the first end. The device further comprises an applicator (130) operable to be removably arranged on the second end of the hollow wire when the hollow wire is placed in the fistula track. The applicator is operable to be held for enabling the projected out insert to be inserted into second end for detachably coupling the first and second ends to form a closed loop around the fistula track.

Surgical constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct is formed from a suture filament and includes two terminal ends of filament and an intermediate portion disposed along at least a portion of a length extending between the terminal ends. The construct can have a first terminal end that is the first terminal end of the filament, and a second terminal end that includes a loop. The loop can be formed by disposing the second terminal end of the filament within a volume of a portion of the intermediate portion of the filament. In some disclosed methods, both terminal ends of the filament can be passed through tissue when performing soft tissue repairs. Various other embodiments of constructs and methods are provided, including constructs having two or more filaments associated with an anchor and methods of using such constructs.

An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

A method of suturing includes: (1) wrapping a first segment of a suture through a traction loop; (2) pulling the traction loop and the first segment through an opening in a suture lock; (3) continuing to pull the traction loop such that a second segment of the suture extends through the opening, wherein the second segment has a greater denier than the first segment such that the second segment more nearly fills an entire dimension of the opening than the first segment; and (4) locking the suture in place with the second segment in the opening.

This application describes a braided cord containing a braided sheath and optionally a core surrounded by the braided sheath. The braided cord has changing cross-sectional area ranging from 0.0004 mm.sup.2 to 30 mm.sup.2 and contains one or more sections having a tapering angle ranging from 1° to 60° when observed in one direction along the cord axis. The change in the cross-sectional area of the cord can be achieved by changing the thickness of the braided sheath and/or changing the cross-sectional area of the core when the core is present. The thickness of the braided sheath can be adjusted by changing the size and/or twist level of one or more sheath strands, changing the pick count of the braided sheath, and/or using one or more shaped sheath strands. This application also describes a process of producing the braided cord with changing cross-sectional area.

A surgical method can include passing at least two adjustable loops of a flexible construct through at least the first tissue to extend from an outer surface of the first tissue opposite a tissue engaging surface facing the second tissue, and attaching the two adjustable loops to a first selected area of the second tissue. The method can further include positioning an elongated locking member within the two adjustable loops such that the locking member extends between the two adjustable loops adjacent the outer surface, engaging the locking member with the outer surface by drawing the two adjustable loops towards the outer surface, and compressing the first tissue between the locking member and the second tissue by tensioning the two adjustable loops. Related tissue fixation devices are also provided.

A suture implant can include one or more suture cords having: a splice; a first free end extending from a first end of the at least one splice; an adjustable first loop extending from a second end of the at least one splice; a second free end extending from a first end of the at least one splice; a needled second loop having a cord portion extending from the first end of the at least one splice; a needle on the needled second loop; and an adjustable third loop extending from a second end of the at least one splice that has the second free end extending from the first end, wherein the second free end is connected to the adjustable third loop, wherein the adjustable first loop and adjustable third loop are interconnected and looped around each other.