Systems and methods for bone to bone, or soft tissue to bone, repairs without knot tying. The repair systems include self-cinching constructs which are tensionable and which include a flexible strand with a knotless, adjustable loop with at least one splice and a shuttle/pull device attached to the flexible strand. A final splice is formed by pulling on the shuttle/pull device subsequent to the knotless, adjustable loop being assembled with or secured to tissue (for example, a soft tissue graft or BTB graft), to allow desired tensioning of the graft to be fixated relative to the bone.

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 ligament assembly comprising a first ligament anchor (9) connected to a second ligament anchor (14) by a ligament (18) a resilient element (40) being associated with the first ligament anchor (9) and a ligament tension adjuster (44, 50) being associated with the second ligament anchor (14). The resilient element (40) may be disposed within the first ligament anchor (9) and the ligament tension adjuster (44, 50) may be disposed within the second ligament anchor (14).

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, system and devices for the reconstruction of ribbon shaped ligaments following the anatomical native insertion sites of the ligaments in the corresponding bones is described. The reconstruction of the anterior cruciate ligament of the human knee is depicted. The system includes means for positioning and creating bone-tunnels, the preparation of grafts and the fixation thereof. The devices intended for bone tunnel creation take into account the ribbon-shaped nature of the ligament and can be adjusted to patient specific anatomy and take into consideration the various typologies of the ligament insertion sites. The method and devices for graft preparation are construed to reflect the anatomy of ligaments under consideration as close as possible to native ligaments by imitating the ribbon-like nature of native ligaments. The presented fixation methods follow this principle and are intended to support the ribbon-like nature of the grafts and are intended to support in-growth of the grafts. Furthermore, accessories supporting preparation of the grafts are presented.

A cable-lock device includes a housing, having a length-axis between a distal end for accepting a cable and a proximal end for exiting a cable, including a first bore parallel to the length-axis of the housing and configured to allow passage of the cable, a second bore off-center from and parallel to the first bore including a tappet axially displaceable in the second bore and parallel to the length axis of the housing, and a third bore oblique to the first bore which intersects with the first bore including a locking roller axially displaceable in the third bore with a predetermined angulation to the length-axis of the housing, a resilient structure which exerts a force on the locking roller in the direction of the intersection of the first bore and the third bore, and a fastener unit at the proximal end of the third bore.

A method of reinforcing a biological construct according to an exemplary aspect of the present disclosure includes, among other things, attaching a suture loop/needle construct to a reinforcement material and stitching the reinforcement material to a biological construct to form a reinforced biological construct. The reinforcement material is attached to the suture loop/needle construct prior to approximating the reinforcement material to the biological construct.

An adjustable, knotless button/loop/needle construct for fixation of cranial cruciate ligament deficient stifle. The adjustable, knotless construct includes two fixation devices (for example, two buttons) and at least one flexible, adjustable loop attached to at least one of the fixation devices (e.g., the buttons). Preferably, a needle is attached to each of the fixation devices (e.g., the buttons). The adjustable, knotless construct has an adjustable loop length and allows adjustment in one direction while preventing or locking the construct from loosening in the opposite direction, due to applied tensile forces. The construct and technique of the present invention provides an improved knotless system for cruciate ligament repair.

A sling suspension system for supporting the thumb of a patient after basal joint arthroplasty, the sling suspension system comprising: an index metacarpal anchor, a thumb metacarpal anchor and a sling for securing the thumb metacarpal anchor to the index metacarpal anchor; the index metacarpal anchor comprising at least one bone-engaging element for engaging the index metacarpal and a sling-engaging element for capturing the sling to the index metacarpal anchor; the thumb metacarpal anchor comprising at least one bone-engaging element for engaging the thumb metacarpal and a sling-engaging element for capturing the sling to the thumb metacarpal anchor; and the sling comprising an elongated body having a first anchor-engaging element for securing the sling to the sling-engaging element of the index metacarpal anchor, and a second anchor-engaging element for securing the sling to the sling-engaging element of the thumb metacarpal anchor, wherein the second anchor-engaging element is adjustable.

Systems and methods for preparing a ligament graft construct for a ligament reconstruction or repair procedure are provided. In general, the described techniques utilize a reinforcement material having at least one suture tail extending therefrom. The reinforcement material is a ribbon or a ribbon-like flattened portion attached to or integrally formed with the at least one suture tail. To prepare a tissue repair construct, the reinforcement material is positioned on a first surface of a graft to extend from an end thereof and the at least one suture tail, coupled to a needle, is repeatedly passed through the reinforcement material and the surface of the graft to a second surface of the graft, and around a side portion of the graft to thereby create multiple suture loops. The tissue repair construct can be formed on each end of the graft.