Suture based clamping device

1. A suture-button system comprising:

(a) a plurality of suture strands;

(b) a primary button having a plurality of primary apertures and a primary threaded portion, wherein a proximal face of the primary button comprises a countersink, wherein:

(i) a first suture strand of the plurality of suture strands is inserted through a first set of the plurality of primary apertures; and

(ii) a second suture strand of the plurality of suture strands is inserted through a second set of the plurality of primary apertures; and

(iii) the first set is different from the second set;

(c) a secondary button having a plurality of secondary apertures, wherein:

(i) the first suture strand and the second suture strand are each inserted through a first and second secondary aperture of the plurality of secondary apertures, such that the system is configured to have at least one targeted tissue of a subject to be clamped between a distal surface of the primary button and a proximal surface of the secondary button upon applying a tension to one or both of the first suture strand and the second suture strand; and

(d) a lock having a secondary threaded portion, wherein the secondary threaded portion is configured to be removably coupled to the primary threaded portion, wherein coupling the secondary threaded portion of the lock to the primary threaded portion prevents one or both of the first suture strand and the second suture strand from translating through the plurality of primary apertures, thereby configured to secure the clamping of the targeted tissue, wherein at least a portion of the lock extends beyond a distal face of the primary button when the primary button is coupled to the lock.

2. The system of claim 1 , wherein the plurality of primary apertures comprises at least 4 primary apertures.

3. The system of claim 1 , wherein the plurality of primary apertures are equally spaced on the primary button.

4. The system of claim 1 , wherein the first set of primary apertures are equally spaced relative to each other and in at least a partially circular array about the primary threaded portion, and the second set of primary apertures are equally spaced relative to each other and in at least a partially circular array about the primary threaded portion.

5. The system of claim 1 , wherein the primary threaded portion comprises a female threaded portion.

6. The system of claim 1 , wherein a distal surface of the secondary button comprises a channel connecting two or more of the plurality of secondary apertures.

7. The system of claim 1 , wherein an aspect ratio between a length and width of the secondary button is about 1:1 to about 4:1.

8. The system of claim 1 , wherein the lock comprises a head and wherein the secondary threaded portion extends from the head.

9. The system of claim 8 , wherein a distal surface of the head is tapered outwards from a center axis of the lock.

10. The system of claim 9 , wherein the distal surface of the head is tapered outwards from the center axis of the lock by about 20° to about 89°.

11. The system of claim 1 , wherein the lock comprises a driver feature, an alignment feature, or both.

12. The system of claim 11 , wherein the driver feature and the alignment feature are generally concentric.

13. The system of claim 11 , wherein the driver feature is proximal to the alignment feature.

14. The system of claim 13 , wherein a maximum inner diameter of the driver feature is greater than a maximum inner diameter of the alignment feature.

15. The system of claim 1 , wherein the first suture strand or the second suture strand is a #1 size suture, a #2 size suture, a #3 size suture, a #4 size suture, a #5 size suture, a #6 size suture, or a #7 size suture.

16. The system of claim 1 , wherein the first suture strand or the second suture strand has a length of about 100 mm to about 1,200 mm.

17. The system of claim 1 , wherein the plurality of suture strands comprises 3, 4, 5, 6 or more suture strands.

18. A method of securing one or more sutures, the method comprising:

(a) providing a suture-button system comprising:

(i) a first suture strand and a second suture strand,

(ii) a primary button having a first set of primary apertures and a second set of primary apertures, wherein the first set is different from the second set, wherein a proximal face of the primary button comprises a countersink, and wherein the primary button has a primary threaded portion

(iii) a secondary button having a first secondary aperture and a second secondary aperture, and

(iv) a lock having a secondary threaded portion, wherein the secondary threaded portion is configured to be removably coupled to the primary threaded portion, wherein coupling the secondary threaded portion of the lock to the primary threaded portion prevents one or both of the first suture strand and the second suture strand from translating through the first set and the second set, wherein at least a portion of the lock extends beyond a distal face of the primary button when the primary button is coupled to the lock;

(b) inserting the first suture strand and the second suture strand each through the first secondary aperture and the second secondary aperture,

(c) inserting the first suture strand through a first primary aperture and a second primary aperture of the first set; and

(d) inserting the second suture strand through a first primary aperture and a second primary aperture of the second set.

19. The method of claim 18 , further comprising inserting the secondary button through a hole in a bone or tissue.

20. The method of claim 19 , further comprising rotating the secondary button after its insertion through the hole in the bone or tissue such that a proximal face of the secondary button lies against the bone or tissue.

21. The method of claim 20 , further comprising tightening one or both of the first suture strand and the second suture strand with respect to the primary button, the secondary button, or both, such that the bone or tissue is clamped between a distal surface of the primary button and the proximal surface of the secondary button upon applying a tension to one or both of the first suture strand and the second suture strand.

22. The method of claim 18 , wherein an aspect ratio between a length and width of the secondary button is about 1:1 to about 4:1.

23. The method of claim 18 , further comprising coupling the secondary threaded portion of the lock with the primary threaded portion of the primary button.

24. The method of claim 18 , wherein (b)-(d) occurs in any sequential order.

25. The method of claim 18 , wherein the first set of primary apertures are equally spaced relative to each other and in at least a partially circular array about the primary threaded portion of the primary button, and the second set of primary apertures are equally spaced relative to each other and in at least a partially circular array about the primary threaded portion.