Abstract: Finger traps for collapsible suture loops are provided. In general, a suture coupled to an implant can be tensioned to facilitate desirable positioning of the implant relative to tissue in a patient's body. The suture can include a finger trap and a knot. In general, the finger trap is a hollow area of the suture through which the suture passes through itself and is configured to slide in a single direction when under tension. In an exemplary embodiment, the knot is located along a length of the suture that is closer than the finger trap to a tail of the suture that is being pulled to tension the suture.

Abstract: Systems and methods for fixating a graft in a bone tunnel are provided. In general, the system includes a tissue fixation device having a delivery configuration and a deployed configuration, at least one graft retention loop coupled to the tissue fixation device, and a drill pin having a sidewall surrounding a cavity at a proximal end of the pin and at least one longitudinally oriented opening in the sidewall in communication with the cavity, the cavity being configured to fully seat the tissue fixation device. The drill pin is configured to substantially contain therein the tissue fixation device when in the delivery configuration and to enable deployment of the tissue fixation device through the opening. Drill pins configured to contain a tissue fixation device are also provided.

Abstract: Devices and methods for soft tissue reconstruction are provided. One exemplary embodiment of a device includes a body a suture filament extending through through-holes formed in the body. The suture is formed into an overhand knot having three collapsible openings with filament limbs extending from the knot. The limbs can be passed through the thru-holes of the body and selectively into the collapsible openings of the overhand knot to form coils extending to an opposite side of the body. For example, one limb can be passed through first and second collapsible openings to form two coils, while the other limb can be passed through the first and third collapsible openings to form two coils. The collapsible openings are collapsed around the limbs disposed in the openings, resulting in a secured overhand knot. Other configurations of knots, as well as devices and methods for use in tissue reconstruction, are also provided.

Abstract: Systems and methods for fixating a graft in a bone tunnel are provided. In general, the system includes a tissue fixation device having a delivery configuration and a deployed configuration, at least one graft retention loop coupled to the tissue fixation device, and a drill pin having a sidewall surrounding a cavity at a proximal end of the pin and at least one longitudinally oriented opening in the sidewall in communication with the cavity, the cavity being configured to fully seat the tissue fixation device. The drill pin is configured to substantially contain therein the tissue fixation device when in the delivery configuration and to enable deployment of the tissue fixation device through the opening. Drill pins configured to contain a tissue fixation device are also provided.

Abstract: Devices and methods for soft tissue reconstruction are provided. One exemplary embodiment of a device includes a body a suture filament extending through through-holes formed in the body. The suture is formed into an overhand knot having three collapsible openings with filament limbs extending from the knot. The limbs can be passed through the thru-holes of the body and selectively into the collapsible openings of the overhand knot to form coils extending to an opposite side of the body. For example, one limb can be passed through first and second collapsible openings to form two coils, while the other limb can be passed through the first and third collapsible openings to form two coils. The collapsible openings are collapsed around the limbs disposed in the openings, resulting in a secured overhand knot. Other configurations of knots, as well as devices and methods for use in tissue reconstruction, are also provided.

Abstract: A device having one or more adjustable loops or coils associated with an implant body for use in soft tissue reconstructions is provided. One exemplary embodiment of a device includes a body and a suture filament, with the filament being used to form a self-locking sliding knot disposed on a top side of the body and a plurality of adjustable coils that are substantially disposed on the body's bottom side. Terminal ends of the filament located above the body's top side can be passed through an opening of a Lark's Head knot from opposite sides, thus forming a self-locking sliding knot, and then the terminal ends can be tensioned to adjust a circumference of the coils. Changing a coil's circumference changes a location of a ligament graft disposed on the coil. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

Abstract: Devices and methods for fixating a graft tendon in a bone tunnel for a ligament reconstruction or repair procedure are provided. In general, the described implantable tissue fixation device includes first and second elongate, substantially rigid support members that are discrete elements separated from each other, and at least one flexible member connecting the rigid support members. The tissue fixation device can have changeable dimensions such that it has at least one dimension that is smaller in a delivery configuration than in a deployed configuration. In both delivery and deployed configurations, the first and second rigid support members are positioned in a non-intersecting orientation with respect to one another. A graft retention loop coupled to the tissue fixation device has the graft tendon coupled thereto and extending into the bone tunnel so as affix the graft into the bone.

Abstract: A buckle useful for cortical fixation has a graft retention loop slidably affixed thereto for movement from a first position adjacent a first end of the buckle to a second position at about the midpoint of the buckle. The buckle, with a graft over the loop, is drawn up lengthwise through a bone tunnel through a tibia and then flipped sideways to rest against the surface of the bone with the loop and graft depending back into the tunnel. The sliding attachment of the loop permits flipping of the buckle minimizes the flipping distance, which is the excess amount of the loop which must be pulled free of the tunnel to allow the buckle to be flipped sideways.

Abstract: Methods and devices are provided for securing tissue to bone. In general, a suture leader can have leading and trailing ends, and an inner passageway configured to receive a strand of suture therein. More specifically, the trailing end of the leader can be configured to receive the strand of suture therein to form an overlapping region of suture leader and suture. When the suture is positioned in the leader, an outer diameter of the leading end of the leader can be less than an outer diameter of the over lapping region. The leader can have a lower bending stiffness than the suture so that the leader can be more easily folded into a bend. In certain aspects, the suture leader can be formed from a substantially flexible, braided material so that the leader can be configured to contract when a pulling force is applied to the leader. In another embodiment, the suture leader can have a pre-formed crease configured to mate with a threading tool.

Abstract: Methods and devices are provided for anchoring suture to bone. In one embodiment, an elongate weave of fibers can be provided having a first portion with a first pick count and a second portion with a second pick count that is greater than the first pick count. The first portion can have a cross-section that deforms in response to a force that is applied thereto. The first portion can have a collapsible diameter and can have a bending stiffness that is lower than a bending stiffness of the second portion of the suture. The first portion can also have a first pattern that is different than a second pattern on the second portion of the suture. The first portion can be threaded into a suture anchor such that it can be doubled over upon itself. The present invention also provides exemplary sutures and drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: 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.

Abstract: A device having one or more adjustable loops or coils associated with an implant body for use in soft tissue reconstructions is provided. One exemplary embodiment of a device includes a body and a suture filament, with the filament being used to form a self-locking sliding knot disposed on a top side of the body and a plurality of adjustable coils that are substantially disposed on the body's bottom side. Terminal ends of the filament located above the body's top side can be passed through an opening of a Lark's Head knot from opposite sides, thus forming a self-locking sliding knot, and then the terminal ends can be tensioned to adjust a circumference of the coils. Changing a coil's circumference changes a location of a ligament graft disposed on the coil. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

Abstract: Adjustable length surgical screws and inserters for adjustable length surgical screws and methods of using the screws and inserters are provided. In general, a fixation device such as a surgical screw can be configured to have an adjustable length. The fixation device can have one or more break points along a longitudinal axis thereof. In an exemplary implementation, the fixation device can include a plurality of break points. The plurality of break points can be formed at different predetermined axial positions along the fixation device's longitudinal axis. The fixation device can be configured to break at each of its one or more break points, for example breaking along a plane that is substantially perpendicular to the longitudinal axis of the fixation device.

Abstract: A graft retention device has an elongated body with a first and second ends and a midpoint therebetween. A pair of elongated slots formed through the body defines a tang therebetween. A graft retention loop is disposed over the tang and is slidable therealong. A trailing line connects to the body adjacent the slots and extends therefrom through the graft retention loop toward the first end. Tension applied to the trailing line thus tends to urge the graft retention loop away from the first end and toward the midpoint.

Abstract: Various exemplary methods, systems, and devices for blood flow are provided. In general, an implant can be configured to be implanted in bone and to delay clotting of blood flowing from the bone. The implant can include an anti-coagulation agent to delay the clotting of the blood. The anti-coagulation agent can be a coating on the implant, can be natural to a material forming the implant, or can be impregnated into a material forming the implant. In an exemplary embodiment, the implant is implanted in a bone in a surgical procedure for securing a soft tissue to bone, such as a rotator cuff repair procedure or an anterior cruciate ligament (ACL) repair procedure.

Abstract: A suture anchor, and a surgical filament assembly using same, capable of being fixated in a hole formed in a bone of a patient. The suture anchor preferably includes an anchor body having a distal end, a proximal end, a passage extending from the proximal end toward the distal end, at least one feature disposed on the exterior of the anchor to engage bone, and a filament knot patency element disposed within the passage and defining a channel having a sufficient minimum cross-sectional area to allow movement of a portion of a surgical filament therethrough when a removable sliding knot is formed, using the surgical filament, about the filament knot patency element. The surgical filament assembly preferably includes a first filament having a sliding knot removably positioned about the knot patency element, with a shortening limb and a tightening limb each extending from the sliding knot.

Abstract: Devices and methods for fixating a graft tendon in a bone tunnel for a ligament reconstruction or repair procedure are provided. In general, the described implantable tissue fixation device includes first and second elongate, substantially rigid support members that are discrete elements separated from each other, and at least one flexible member connecting the rigid support members. The tissue fixation device can have changeable dimensions such that it has at least one dimension that is smaller in a delivery configuration than in a deployed configuration. In both delivery and deployed configurations, the first and second rigid support members are positioned in a non-intersecting orientation with respect to one another. A graft retention loop coupled to the tissue fixation device has the graft tendon coupled thereto and extending into the bone tunnel so as affix the graft into the bone.

Abstract: 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.

Abstract: Various methods and devices are provided for use of a cannula. For example, provided herein is a flexible cannula having an elongate body with an elongate shaft extending between a proximal hub and a distal dam. A lumen can extend through the cannula. The dam is in the form of a flexible annular member formed on a distal end of the shaft. The dam and the hub have diameters greater than a diameter of the shaft. A flexible, expandable sleeve is removably positioned on the distal end of the shaft of the cannula. The sleeve deformably encapsulates the dam such that the dam is folded against the shaft of the cannula. An obturator is also provided having an elongate shaft configured to be removably positioned within the lumen of the cannula. The shaft can be configured to fit within the lumen in a clearance fit.

Abstract: A suture anchor, and a surgical filament assembly using same, capable of being fixated in a hole formed in a bone of a patient. The suture anchor preferably includes an anchor body with a passage extending from a proximal end toward a distal end, and at least one bone engaging feature on the exterior of the anchor. A knot patency element disposed within the passage holds a removable sliding knot formed, using the surgical filament. A tightening limb of the sliding knot enables the user to tighten the sliding knot against an object extending through a capture loop to secure the object to the anchor.