Surgical filament snare assemblies
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.
1. A surgical repair method, comprising:
selecting a surgical filament snare assembly comprising:
a collapsible loop formed of a first filament, the collapsible loop having a first end and a second end;
a continuous loop coupled to the first end of the collapsible loop, the continuous loop defining an opening and being formed of a second filament; and
a sliding knot formed on the second end of the collapsible loop and being movable towards the first end of the collapsible loop to decrease a size of an opening in the collapsible loop and movable away from the first end of the collapsible loop to increase the size of the opening in the collapsible loop;
fixing an anchor in bone in proximity to detached soft tissue;
passing the continuous loop, and a portion of the collapsible loop most proximate to the continuous loop, through a portion of the detached soft tissue and around an engagement feature of the anchor such that the continuous loop extends from one side of the anchor and the sliding knot extends from another side of the anchor;
forming a Lark's Head loop on the continuous loop, the Lark's Head loop having a cinchable opening;
passing the second end of the collapsible loop, including the sliding knot, through the cinchable opening;
tightening the cinchable opening against the sliding knot such that the Lark's Head loop is distal of the sliding knot; and
collapsing the collapsible loop by moving the sliding knot distally towards the bone to bring the tissue into proximity with the bone.
2. The method of claim 1 , wherein forming a Lark's Head loop comprises passing a first end of the continuous loop through the opening thereof.
3. The method of claim 1 , wherein collapsing the collapsible loop further comprises applying a distal force to the sliding knot using a knot pusher device.
4. The method of claim 1 , wherein a tensioning limb formed from a portion of the first filament of collapsible loop extends from the sliding knot, and collapsing the collapsible loop further comprises applying a force to the tensioning limb in a proximal direction to collapse the collapsible loop.
5. The method of claim 1 , further comprising:
tying a first non-sliding knot on a portion of the second filament to form the continuous loop and join the continuous loop to the second filament; and
tying a second knot on another portion of the second filament to form an additional loop and join the additional loop to the second filament, the additional loop being slidingly coupled to the first end of the collapsible loop.
6. The method of claim 5 , wherein forming a Lark's Head loop comprises passing a first end of the continuous loop through the opening thereof.
7. The method of claim 1 , wherein the passing, collapsing, and advancing steps are effected without tying a knot in the first or second filaments.