This disclosure includes soft-tissue fasteners for coupling an implant to soft tissue, bone fasteners for coupling an implant to bone, fastener-delivery apparatuses (e.g., tools) for delivering such soft-tissue fasteners and bone fasteners, fastener cartridges for use with certain of the fastener-delivery apparatuses. The present fasteners generally include at least one barbed shaft and an enlarged head spaced from a distal end of the shaft. Some of the present fasteners include two barbed shafts and an enlarged head spanning the two shafts. This disclosure also includes kits that comprise a plurality of fasteners (e.g., a plurality of soft-tissue fasteners, a plurality of bone fasteners, or both). Some of the present kits also include one or more of the present fastener-delivery apparatuses or tools; for example, a plurality of fasteners with a single, reloadable tool; a plurality of tools each pre-loaded with a fastener; and/or a plurality of cartridges each pre-loaded with a fastener and a common tool for use with the cartridges.

A suture anchor for knotless fixation of tissue. The suture anchor includes an implant configured to hold a suture to be anchored in bone without requiring suture knots. The suture is secured in bone by inserting the implant holding the suture into a hole in the bone, and advancing a fixation device, such as a cannulated interference screw, over a shaft at the proximal end of the implant.

A polyaxial bone anchoring device includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for pivotably holding a head of a bone anchoring element, and a pressure member configured to be positioned in the receiving part and to exert pressure onto the head to lock the head in the receiving part. The pressure member includes a pressure exerting surface and a deformable portion having a free end, wherein the deformable portion is configured to assume at least a first configuration and a second configuration. The polyaxial bone anchoring device further includes a locking member configured to be inserted into the channel and to exert a force onto the deformable portion. When the head and the pressure member and the locking member are in the receiving part, the free end of the deformable portion is supported in the receiving part, and the locking member is movable in the channel along the longitudinal direction in such a manner that the locking member first contacts the deformable portion and exerts a force onto the deformable portion to bring the deformable portion from the first configuration into the second configuration thereby locking the head. Thereafter the locking member comes into contact with the rod and locks the rod.

Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a surgical implant is provided having a sheath and an expander that is received within the sheath. Various delivery tools, including a sheath inserter and a driver, are also provided. In use, the sheath inserter can be used to position a tendon within a prepared bone hole, and it can be used to deliver the sheath with a guidewire coupled thereto into the bone hole. The driver can be provided for delivering the expander into the sheath. A loader can optionally be used to load the driver and expander onto the guidewire coupled to the implanted sheath.

Surgical constructs, assemblies and methods of tissue fixation are disclosed. A surgical construct includes a spreadable web attached to a plurality of peripheral strands. The spreadable web may be tensionable and may include one or more flexible filaments or strands. At least one of the filaments is coupled to the peripheral strands. The filaments may extend from the peripheral strands in different directions and/or orientations. The spreadable web is expandable and can be adjusted to various widths. The spreadable web may be knotless. The spreadable web may be tensionable. The surgical construct may be attached to one or more knotted or knotless fixation devices.

A bone anchor for coupling tissue to bone comprising an anchor body having a hollow interior, an open proximal end in fluid communication with the hollow interior, and a distal end; and a suture anchor extending from the anchor body and distal to the open proximal end.

In one embodiment, the present disclosure may be a method for preparing a soft tissue graft, comprising: passing a suture material through the soft tissue graft adjacent to a graft support filament at a first longitudinal location along the filament and graft, such that the suture material passes through the graft on a first side of the filament; passing the suture material over the filament and back through the graft adjacent to the filament at a second longitudinal location spaced longitudinally along the filament and graft from the first longitudinal location, such that the suture material passes through the graft on the first side of the filament; and tensioning the suture material to secure the filament to the graft along a length of the suture material between the first longitudinal location and the second longitudinal location.

In one embodiment, the present disclosure may be a method for preparing a soft tissue graft, comprising: passing a suture material through the soft tissue graft adjacent to a graft support filament at a first longitudinal location along the filament and graft, such that the suture material passes through the graft on a first side of the filament; passing the suture material over the filament and back through the graft adjacent to the filament at a second longitudinal location spaced longitudinally along the filament and graft from the first longitudinal location, such that the suture material passes through the graft on the first side of the filament; and tensioning the suture material to secure the filament to the graft along a length of the suture material between the first longitudinal location and the second longitudinal location.

A method and apparatus for coupling a soft tissue implant into a locking 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.

Various exemplary methods and devices for tensioning grafts are provided. In general, a surgical device can include a grip and a frame. The frame can have two opposed segments. The segments can be spaced apart from one another and can each be configured to have at least one suture attached thereto. The sutures attached to the frame can each be configured to attach to a graft. The two segments can be configured to dynamically move toward and away from each other in response to tension that is applied to the sutures attached to the frame. The frame can include an indicator configured to provide an indication of the tension applied to the sutures. The grip can have at least one opening therein. The at least one opening can be configured to have a surgical instrument passed therethrough.