Surgical constructs that at least one fixation device, at least one flexible strand the forms at least one adjustable loop, and a self-locking mechanism, and methods of tissue repair using the same.

A suture assembly including a first suture having a generally O-shaped configuration having a first arm, a second arm, a first bridge connecting the first arm to the second arm, and a second bridge connecting the first arm to the second arm. The first bridge opposes the second bridge so that the first suture includes a closed loop. A second suture having a first arm, a second arm and a bridge connecting the first arm to the second arm. The first arm of the second suture is wrapped around the first arm of the first suture in a first direction, and the second arm of the second suture is wrapped around the second arm of the first suture in a second, opposite direction. The suture assembly is capable of assuming (i) a longitudinally-extended, radially-contracted first configuration, and (ii) a longitudinally-contracted, radially-expanded second configuration.

A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably connected, to the filament engagement feature of the anchor. The first and second noose limbs emerge from the anchor as first and second free filament limbs which are capable of being passed through tissue to be repaired and then passable through the noose. The noose, such as one or more half-hitches, is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after the anchor is fixated. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs at least through the tissue as a single unit.

An anchor device and system for coupling soft tissue to osseous tissue includes a stopper member that supports a loop of suture material. A fixing member includes features that allow it to be rigidly coupled to surrounding bone and thus hold the stopper member in a cavity within the bone. The loop of suture material, in turn, supports a second suture device, which is coupled to, and thus retains, the soft tissue. In certain embodiments, the fixing member includes a wadding structure having a generally elastic property.

Suture constructs and methods for soft tissue to bone repairs. The suture construct is a soft, suture-based anchor which is self-cinching and has a specific, accordion-type configuration (i.e., with the ability to fold from a first, extended position to a second, folded or compressed position). The suture-based anchor may be formed essentially of a flexible material such as a high strength surgical suture, suture chain, or suture.

A method and apparatus for surgically repairing a tear in soft tissue is disclosed. A plurality of collapsible tubes are positioned about the suture. The collapsible tubes are pushed through soft tissue and orthopedic mesh on opposite sides of a tear in soft tissue. When tension is applied to the suture, the tubes are compressed to fix the suture to the soft tissue and draw the soft tissue portions together.

A knotless tissue repair assembly for attachment of tissue to bone includes an anchoring implant with a length of suture threaded therethrough. The implant is preferably a soft flexible three-dimensional structure. The implant may be actuated from a first elongate low profile shape into a second short radially expanded shape having a larger diameter than the hole through which it was placed. The suture extends through the anchor, through a tissue to be secured, and back through a designated suture-binding region or passageway within the anchor enabling the suture to be secured therein and without the need for a physician to tie a knot. Further tension applied to a suture leg approximates the tissue to the anchor until a desired tension or distance between the tissue and anchor is achieved.

A suture assembly, including a button having two apertures and a suture defining a lumen and forming a double loop, formed by a double trap formed in the suture, opposed to the button, and in which a first portion of the suture is threaded through the lumen of the double trap and a second portion of the suture is also threaded through the lumen of the double trap, so that two portions of suture are positioned together in the double trap. The first portion of the suture, after emerging from the double trap, is threaded through the lumen again, thereby forming a second trap, increasing resistance of the double loop to expansion, the double loop being threaded through the apertures of the button, the suture having two suture ends that are threaded through the button apertures and accessible on a side of the button opposed to the double loop.

An adjustable fixation device includes a cleat portion and a suture portion, where the suture portion has a loop portion and a suture tail. Pulling on the suture tail places in tension a graft coupled to the loop portion. The suture is arranged to convey a mechanical advantage so that substantial force can be readily and controllably applied to the graft.

Disclosed are systems and methods for performing soft tissue repair by delivering a suture through the soft tissue and underlying bone at two or more fixation points that can be spaced apart from each other and connected by the suture on the surface of the soft tissue. The two or more fixation points and the suture connected there between can be a continuous strand of suture, which can form a stitching assembly that can provide sufficient fixation in the bone and minimize disruption to the soft tissue and bone. In an example, the suture can be delivered into the bone using one or more implants that can catch the suture to drive the suture through the tissue and into the bone. The one or more implants can include structural features to aid in securing the suture to the implant. In an example, the suture can include structural features or be formed of a material to aid in fixation of the suture in the bone.