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 assembly comprising:
a slidable knot having on one side thereof a cinch noose loop defined by a first filament and a second filament, the slidable knot having on the other side thereof first and second filament limbs; and
a flexible sleeve removably encapsulating at least a portion of the first and second filament limbs;
fixing an anchor in bone in proximity to detached soft tissue;
passing a first end of each of the first and second filament limbs through a portion of the detached soft tissue and around an engagement feature of the anchor such that the cinch noose loop extends from one side of the anchor and the sleeve extends from another side of the anchor;
passing the first end of each of the first and second filament limbs through the cinch noose loop;
collapsing the cinch noose loop around the first and second filament limbs disposed therethrough to engage the soft tissue; and
advancing the collapsed cinch noose loop distally to bring the tissue into proximity with the bone.
2. The method of claim 1 , further comprising applying one or more knots proximate to the collapsed cinch noose loop following the advancing step to maintain the tissue at a desired location in proximity to the bone.
3. The method of claim 1 , wherein proximal portions of the first ends of the first and second filament limbs are encapsulated in the flexible sleeve when the first and second filament limbs are passed through the tissue.
4. The method of claim 3 , wherein passing the first end of each of the first and second limbs through the opening of the cinch noose loop further comprises passing at least a portion of the sleeve through the cinch noose loop.
5. The method of claim 4 , wherein advancing the collapsed cinch noose loop comprises advancing the collapsed cinch noose loop past a distal-most end of the flexible sleeve, and the method further comprises removing the flexible sleeve from the first and second filament limbs.
6. The method of claim 1 , wherein a distal end of the sleeve terminates prior to a proximal end of the anchor.
7. The method of claim 1 , wherein the sleeve is slidably disposed around a portion of the filament engagement feature such that the sleeve extends from both sides of the anchor.
8. The method of claim 1 , further comprises passing at least one of a first end of the surgical filament assembly and a second end of a surgical filament assembly through a surgical cannula.
9. The method of claim 1 , wherein the passing, collapsing, and advancing steps are effected without tying a knot in the first or second filaments or in the first and second filament limbs.