Surgical constructs for tissue fixation and methods of tissue repairs

1 . A method of tissue repair comprising the steps of:

inserting through a portal into a joint space a surgical construct formed of a single filament extending between and coupling at least two peripheral support structures, wherein the single filament passes through or around each of the at least two peripheral support structures at least once and at multiple locations;

securing a first tissue to a second tissue with the surgical construct and with a plurality of fixation devices by

securing the surgical construct to one of the plurality of fixation devices and installing the one of the plurality of fixation devices into the first tissue;

separating proximal limbs of the at least two peripheral support structures to form a tensionable, spreadable suture web, the tensionable, spreadable suture web being expandable and adjustable to various widths;

subsequently, adjusting a width of the tensionable, spreadable suture web to correspond to a width of area to be covered of the second tissue;

spreading the tensionable, spreadable suture web over the area to be covered of the second tissue to fixate and uniformly compress the second tissue;

securing each of the at least two peripheral support structures to other of the plurality of fixation devices and installing the other of the plurality of fixation devices with the at least two peripheral support structures into or onto the second tissue;

and

tensioning the tensionable, spreadable suture web and the tissue repair subsequent to securing the plurality of fixation devices within the first tissue and the second tissue.

2 . The method of claim 1 , wherein the step of tensioning the tensionable, spreadable suture web includes pulling on the single filament coupled to the at least two peripheral support structures of the tensionable, spreadable suture web, to approximate the first tissue to the second tissue.

3 . The method of claim 1 , wherein the step of securing the first tissue to the second tissue comprises the steps of:

passing the at least two peripheral support structures over the second tissue; and

pulling on the at least two peripheral support structures to separate them and to spread the tensionable, spreadable suture web over the second tissue.

4 . The method of claim 1 , wherein the step of securing the each of the at least two peripheral support structures to the other of the plurality of fixation devices further comprises threading each of the at least two peripheral support structures through apertures or eyelets of the other of the plurality of fixation devices.

5 . The method of claim 1 , wherein at least one of the plurality of fixation devices is an all suture soft anchor.

6 . The method of claim 1 , wherein at least one of the plurality of fixation devices is a hard body anchor.

7 . The method of claim 1 , wherein the first tissue is bone and the second tissue is soft tissue.

8 . The method of claim 1 , wherein the tensionable, spreadable suture web includes the single filament coupled two peripheral support structures, wherein the two peripheral support structures are sutures or suture tapes.

9 . The method of claim 1 , wherein the suture web has a triangular configuration.

10 . The method of claim 1 , wherein the tissue repair is rotator cuff repair.

11 . The method of claim 1 , wherein the tissue repair is a knotless tissue repair.

12 . A method of knotless tissue repair comprising the steps of:

connecting a plurality of fixation devices to a tensionable surgical web formed by passing at least one filament through or around a first peripheral strand and through or around a second peripheral strand, wherein the tensionable surgical web has a triangular configuration;

installing the plurality of fixation devices into hard tissue;

positioning the tensionable surgical web over soft tissue to be secured to the hard tissue; and

subsequently, tensioning the tensionable surgical web to secure the soft tissue to the hard tissue by pulling on the at least one filament of the tensionable surgical web to decrease a width of the tensionable surgical web.

13 . The method of claim 12 , wherein the plurality of fixation devices are knotless anchors or knotless soft suture anchors, or combinations thereof.

14 . The method of claim 12 , wherein the step of installing the plurality of fixation devices comprises securing each of the plurality of fixation devices into the hard tissue before the step of tensioning the tensionable surgical web.

15 . A method of tissue repair comprising the steps of:

inserting through a portal into a joint space a surgical construct, wherein the surgical construct is formed of a filament and a single strand furcated into at least two peripheral limbs, wherein the filament extends between and couples the at least two peripheral limbs by passing through or around each of the at least two peripheral limbs at least once and at multiple locations;

securing the single strand to a knotless fixation device and installing the knotless fixation device into bone;

separating and pulling apart the at least two peripheral limbs to form a spreadable, tensionable web with a triangular configuration;

spreading the spreadable, tensionable web over soft tissue to be attached to the bone;

securing each of the at least two peripheral limbs to additional fixation devices; and

subsequently, tensioning the spreadable, tensionable web to fixate and uniformly compress the soft tissue.

16 . The method of claim 15 , wherein the filament is suture, and the single strand is suture or tape.