Methods and devices are provided for anchoring a ligament or tendon to bone. In general, various inserter tools are provided for simultaneously delivering an expandable sheath and an expander into bone. With both components of the implant mounted on the same tool, the sheath and a ligament can be advanced into a bone hole and the expander, which trails behind the sheath during delivery of the sheath, can be advanced into the sheath to expand the sheath and anchor the sheath and ligament within the bone hole.

Surgical devices and methods are provided for anchoring tissue to bone, and more particularly methods and devices are provided for preventing over-insertion of an expander into a sheath of a two-piece anchor. For example, a tendon anchoring system is provided with an anchor assembly and an inserter tool. The anchor assembly includes a sheath with a threaded lumen and a threaded expander screw configured to be threadably disposed within the sheath to cause the sheath to expand outward. The inserter tool includes an elongate outer shaft with a distal end configured to couple to a proximal end of the sheath, and an elongate inner shaft with a distal drive tip configured to engage a proximal end of the expander screw. In one embodiment, the inner shaft can be rotatable relative to the outer shaft to thread the expander screw into the sheath, and the inner shaft can be prevented from rotating relative to the outer shaft when the expander screw is fully threaded into the sheath to prevent over-insertion of the expander screw into the sheath.

The present disclosure relates, in some aspects, to orthopedic implants for securing soft tissue to bone and methods for using the same. One particular implant comprises a first exposed porous surface region, having pores for promoting bone ingrowth, and a second exposed porous surface, having pores for promoting soft tissue ingrowth. At least some of the pores of the first exposed porous surface region may be seeded with osteocytic factors and at least some of the pores of the second exposed porous surface region may be seeded with fibrocytic factors. Such orthopedic implants can advantageously facilitate regeneration of the soft tissue to bone interface.

A method and apparatus for coupling a soft tissue implant into a looking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction

A method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.

Methods of attaching a soft tissue to an adjacent bone at a defect site are provided. An adjustable loop region of a flexible construct contained in a bore defined by a fastener is passed through a tissue. The adjustable loop is passed through the tissue. The fastener is passed back through the adjustable loop to fold the adjustable loop upon itself. The fastener is attached to the bone. An adjusting arm on the flexible construct is engaged to reduce the size of the adjustable loop and secure the soft tissue to the bone.

An implant suitable for being anchored with the aid of mechanical vibration in an opening provided in bone tissue. The implant is compressible in the direction of a compression axis under local enlargement of a distance between a peripheral implant surface and the compression axis. The implant includes a coupling-in face which serves for coupling a compressing force and the mechanical vibrations into the implant, which coupling-in face is not parallel to the compression axis. The implant also includes a thermoplastic material which, in areas of the local distance enlargement, forms at least a part of the peripheral surface of the implant.

Techniques and reconstruction systems for soft tissue surgical repairs. The biceps tenodesis technique of the present invention provides fixation of a single diameter of the biceps tendon in a socket without the need for externalizing the tendon and without the need to pass any suture (or similar material) through any portion of the tendon (i.e., without the need to stitch or whipstitch any area/portion of the tendon). The technique improves the biomechanics of the combined fixation and helps overcome surgeons' concerns about rapid return to ADLs.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

Embodiments of the invention include methods and devices for securing a suture, graft, or other material to tissue with an anchor. The anchor of some embodiments includes an eyelet through which the suture, graft, or other material may be passed and mechanisms for selectively engaging the suture, graft, or other material through the eyelet. The mechanisms of some embodiments may also reinforce the anchor to provide a strengthened anchor to withstand actions such as impacting the anchor during insertion or applying bending stress to the anchor.