Surgical constructs with collapsing suture loop and methods for securing tissue
Surgical constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct is formed from a suture filament and includes two terminal ends of filament and an intermediate portion disposed along at least a portion of a length extending between the terminal ends. The construct can have a first terminal end that is the first terminal end of the filament, and a second terminal end that includes a loop. The loop can be formed by disposing the second terminal end of the filament within a volume of a portion of the intermediate portion of the filament. In some disclosed methods, both terminal ends of the filament can be passed through tissue when performing soft tissue repairs. Various other embodiments of constructs and methods are provided, including constructs having two or more filaments associated with an anchor and methods of using such constructs.
1. A surgical repair method, comprising:
inserting an anchor having surgical filament associated therewith in bone in proximity to detached soft tissue, the surgical filament having a first portion with a loop formed therefrom, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume;
passing the terminal end of the second portion of the filament through a portion of the detached soft tissue;
forming a snare in the loop of the first portion of the filament after the anchor has been inserted in bone in proximity to detached soft tissue;
passing the terminal end of the second portion through the snare;
collapsing the snare to engage the soft tissue;
advancing the collapsed snare distally to bring the tissue into proximity with the bone; and
deconstructing the coaxial region by removing the portion of the filament from the volume of the filament in which it was disposed.
2. The method of claim 1 , further comprising passing the loop through a portion of the detached soft tissue before forming the snare in the loop.
3. The method of claim 2 , wherein the anchor has a second surgical filament associated therewith, the second surgical filament having a first portion with a loop formed therefrom, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume, the method further comprising:
passing the terminal end of the second portion of the second filament through a portion of the detached soft tissue;
passing the loop of the second filament through a portion of the detached soft tissue;
after passing the loop of the second filament through a portion of the detached soft tissue, forming a snare in the loop of the first portion of the second filament;
passing the terminal end of the second portion of the second filament through the snare of the second filament;
collapsing the snare of the second filament to engage the soft tissue;
advancing the collapsed snare of the second filament distally to bring the tissue into proximity with the bone;
deconstructing the coaxial region of the second filament by removing the portion of the second filament from the volume of the second filament in which it was disposed,
wherein deconstructing the coaxial region of the first filament results in a first limb and a second limb extending from the collapsed snare of the first filament, and deconstructing the coaxial region of the second filament results in a first limb and a second limb extending from the collapsed snare of the second filament;
attaching the first and second limbs of the first filament and the first and second limbs of the second filament to a second anchor; and
applying tension to the first and second limbs of the first and second filaments to secure a location of the limbs with respect to the second anchor.
4. The method of claim 3 , wherein applying tension to the first and second limbs of the first and second filaments to secure a location of the limbs with respect to the second anchor further comprises inserting the second anchor into bone with the first and second limbs of the first and second filaments being disposed between an outer wall of the anchor and the bone.
5. The method of claim 3 , wherein the locations of the first and second limbs of the first and second filaments with respect to the second anchor are secured without tying a knot in either of the first or second filaments.
6. The method of claim 2 , wherein the anchor has a second surgical filament associated therewith, the second surgical filament having a first portion with a snare formed therein, a second portion that includes a terminal end, and a coaxial region formed between the first and second portions by disposing a portion of the filament into its own volume, the method further comprising:
passing the terminal end of the second portion of the second filament through a portion of the detached soft tissue;
passing the terminal end of the second portion of the second filament through the snare of the second filament;
collapsing the snare of the second filament to engage the soft tissue; and
advancing the collapsed snare of the second filament distally to bring the tissue into proximity with the bone, the first filament being disposed between the collapsed snare of the second filament and the soft tissue.
7. The method of claim 1 , further comprising tying at least one locking knot with the filament at a location that is proximate to the collapsed snare to secure a location of the filament with respect to the tissue.