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 method of surgically repairing tissue, comprising:
selecting an anchor capable of being fixated in bone and having a filament engagement feature;
selecting a first filament having a noose with first and second noose limbs connected to the filament engagement feature of the anchor and emerging 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, and 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 tissue as a single unit;
fixating the anchor in bone;
selecting at least the sleeve and passing it through the tissue to be repaired;
passing at least the free filament limbs through the noose;
tensioning the tissue as desired after the anchor is fixated in bone, the noose strangulating the free filament limbs when tension is applied to at least one of the free filament limbs and the noose; and
removing the sleeve from the patient.
2. The method of claim 1 wherein the sleeve is formed from a braided suture.
3. The method of claim 1 wherein the first filament is a braided suture and a section of one of the first and second free filament limbs serves as the sleeve.
4. The method of claim 3 wherein the sleeve section has more than ten percent fewer picks per unit length than the picks per unit length for the remainder of the first filament.
5. The method of claim 1 wherein the sleeve is positioned over the entire portion of the first and second free filament limbs before implantation of the anchor in a patient.
6. The method of claim 5 wherein the sleeve is further positioned beyond the filament engagement feature to cover at least some of the first and second noose limbs.
7. The method of claim 1 wherein passing the free filament limbs through the noose includes passing them with the sleeve as a single unit.
8. The method of claim 1 wherein the noose is retractable toward the anchor.
9. The method of claim 1 wherein the noose is formed from at least one half hitch.
10. A method of creating a surgical filament snare assembly, comprising:
selecting an anchor capable of being fixated in bone and having a filament engagement feature;
selecting a first filament having first and second ends;
forming at least one half hitch with a central opening in the first filament between the first and second ends;
passing the first and second ends through the central opening to define a noose with first and second noose limbs;
tightening the half hitch to form a slidable knot for the noose; and
passing the first and second filament ends through the filament engagement feature of the anchor to 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 strangulating the free filament limbs when tension is applied to at least one of the free filament limbs and the noose opening.
11. The method of claim 10 further including adding 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 tissue as a single unit.
12. The method of claim 11 wherein the first filament is a braided suture and a section of one of the first and second free filament limbs serves as the sleeve.