A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a single working suture and each of the suture anchors allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the working suture in place subsequent to tensioning. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a continuous array of single anchor to anchor stitches which can be placed close together in high density to form a line or region of stitches for a more robust securement of soft tissue to bone.

A toggle-type suture anchor for transtendinous implantation in bone to secure soft tissue thereto during repair of a tear, especially a rotator cuff repair. The anchor can include an elongate body with side surfaces defining a maximum diameter of the body. The body can also include proximal, middle and distal bores extending from the top surface to the bottom surface, each bore located at spaced intervals along the elongate body with a single suture passing into the proximal bore top surface and out the bottom surface, then back up through the distal bore bottom surface out the top surface leaving a length of suture extending past the middle bore bottom surface. To assure toggling in transtendinous delivery into bone, the elongate body can include a pair of fins extending both proximally and radially outward from the elongate body to prevent back out once placed in a bone hole.

A microfracture impactor tool including a housing defining a central axis, the housing can include a proximal portion and an opposite distal portion. A handle can be connected to the distal portion of the housing and can extend outward therefrom. The impactor tool can include a grip that is pivotably connected to the proximal portion of the body near the handle. The impactor tool can include an impactor wire configured to impact bone, and a guide tube connected to the distal portion of the housing that is configured to retain the impactor wire.

Disclosed herein are orthopedic impact tools and methods of use thereof. The orthopedic impact tools can include a housing, a tube assembly, a reverse impact plate, an anvil and an impact mechanism. The housing can include a hand grip portion and an impact mechanism housing portion. The tube assembly can include a first tube portion and a second tube portion. The reverse impact plate can be disposed in between the first tube portion and the second tube portion. The anvil can include a forward impact surface. The impact mechanism can include a motor, a piston, a ram, and a rotary to linear conversion mechanism drivingly connecting the motor to the piston. The piston can be disposed within the first tube portion and the ram can be disposed in the second tube portion and movable into contact between the reverse impact plate and the forward impact surface.

Disclosed herein are surgical impact tools and methods of use thereof. The surgical impact tools can include a roller assembly, an impact structure, and a tool holder. The roller assembly can be connected to a motor and include a plurality of rollers supported by a respective roller arm. The impact structure can define a spring and an impact cavity including forward and reverse impact surfaces. The impact structure can include a wall comprising a plurality of thread elements connected to the wall and engageable with the roller assembly. Each of the thread elements can include a pair of helical end surfaces and a pair of axially extending surfaces that are engaged by the plurality of rollers. During use rotation of the roller assembly against the helical ends of the thread elements can cause axial movement of the impact structure to apply a load on the spring and generate impact forces.

A method and apparatus are provided for transtendinous implantation of a toggle-type bone anchor. Measured from the top surface of the tendon, the entire bone anchor is inserted to a depth of greater than or equal to 20 mm. during a rotator cuff repair on the humeral head. The anchor is pushed by the same bone punch that formed the initial hole to assure proper depth of placement. Further, the apparatus includes a nub portion that, in use, protrudes into the bone hole formed by the bone punch and maintains registration with the bone hole when the bone punch is retracted. An angled distal end on the anchor initiates toggling during insertion into the bone and at least one proximal projecting fin prevents the anchor from backing out of the bone hole while facilitating further rotation of the anchor when a suture is pulled to complete toggling.

A toggle-type suture anchor that incorporates individual suture tensioning and locking without knot tying. The anchor includes an elongate toggle body having a working suture pre-threaded into a first passage and back up and out a second passage with a length running longitudinally adjacent the side of the anchor. A locking suture loop is pre-threaded into a third passage between the first and second passage and includes a collapsible loop that encircles a portion of the length of suture running longitudinally adjacent the side of the anchor. With the loop open, the working suture can slide through the anchor, however, when the loop is closed the working suture is locked in position to retain tension on the working suture. The anchor can be utilized in a pre-strung connected array of anchors.

Methods for creating high-density arrays of suture stiches through a tendon into bone for reattachment of a torn tendon, particularly a rotator cuff tendon. The method includes providing a pre-strung plurality of anchors, each anchor having at least one passage therethrough with a continuous length of suture slidably and serially threaded through the at least one passage of each anchor. Each of the anchors further includes a locking assembly for locking the suture within the individual anchor. A first anchor is implanted through the tendon and the suture is locked. A second anchor is implanted a selected close distance from the first anchor, then applying tension to the suture extending from the first anchor and passing through the second anchor the second anchor is locked to create a single suture tensioned and locked stitch between the first and second anchor. This process is repeated for each anchor in the array.

A toggle-type suture anchor for transtendinous implantation in bone to secure soft tissue thereto during repair of a tear, especially a rotator cuff repair. The anchor can include an elongate body with side surfaces defining a maximum diameter of the body. The body can also include proximal, middle and distal bores extending from the top surface to the bottom surface, each bore located at spaced intervals along the elongate body with a single suture passing into the proximal bore top surface and out the bottom surface, then back up through the distal bore bottom surface out the top surface leaving a length of suture extending past the middle bore bottom surface. To assure toggling in transtendinous delivery into bone, the elongate body can include a pair of fins extending both proximally and radially outward from the elongate body to prevent back out once placed in a bone hole.

A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a single working suture and each of the suture anchors allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the working suture in place subsequent to tensioning. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a continuous array of single anchor to anchor stitches which can be placed close together in high density to form a line or region of stitches for a more robust securement of soft tissue to bone.