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:
passing a terminal end of a surgical filament through soft tissue at a location proximate to bone in which the soft tissue is to be attached, the surgical filament having a first portion with a loop formed therefrom, the loop including a snare formed from a portion thereof, a second portion that includes the 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 terminal end and the loop extending proximally from the soft tissue;
passing the terminal end of the second portion through the snare;
collapsing the snare to engage the soft tissue;
deconstructing the coaxial region by removing the portion of the filament from the volume of the filament in which it was disposed;
associating the surgical filament with an anchor disposed in the bone; and
advancing the collapsed snare distally to bring the tissue into proximity with the bone.
2. The method of claim 1 , further comprising forming the snare from the loop of the first portion of the filament after passing the terminal end of a surgical filament through soft tissue.
3. The method of claim 1 , further comprising inserting the anchor in bone in proximity to the soft tissue.
4. The method of claim 1 , wherein passing the terminal end through soft tissue comprises passing the terminal end through the soft tissue from a proximal side to a distal side and then back through the soft tissue again to the proximal side.
5. The method of claim 1 , wherein passing the terminal end through soft tissue comprises separately passing the terminal end and the loop through the soft tissue from a distal side to a proximal side.
6. The method of claim 1 , wherein deconstructing comprises removing a second terminal end of the filament out of the volume out from the volume of the filament in which it was disposed such that the second terminal end extends proximally from the soft tissue.
7. The method of claim 1 , wherein advancing the collapsed snare distally to bring the tissue into proximity with the bone comprises trapping the surgical filament between the anchor and bone and inserting the anchor into bone, the inserting tensioning the surgical filament to advance the collapsed snare distally.
8. The method of claim 1 , wherein the anchor is a first anchor, the method further comprising, after associating the surgical filament with the first anchor disposed in bone, associating the surgical filament with a second anchor disposed in bone at a location proximate to the first anchor.
9. The method of claim 8 , further comprising, associating the surgical filament with a second anchor and disposing the second anchor in bone at a location proximate to the first anchor, wherein disposing the second anchor in bone comprises trapping the surgical filament between the second anchor and bone.
10. The method of claim 9 , wherein trapping the surgical filament between the second anchor and bone comprises tensioning the surgical filament and further collapsing the snare.
11. 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.
12. A surgical repair method, comprising:
passing a first terminal end of a surgical filament through soft tissue at a location proximate to bone in which the soft tissue is to be attached, the surgical filament having a first portion that includes the first terminal end, a second portion that includes a loop formed therefrom and a second terminal end, and a coaxial region formed between the first and second portions, by disposing the second terminal end of the surgical filament into its own volume, the first terminal end and the loop extending proximally from the soft tissue, and the loop of the second portion arranged to form cinch loop defining a receiving opening;
passing the first terminal end of the surgical construct through the receiving opening;
collapsing the receiving opening of the cinch loop;
deconstructing the coaxial region by removing the second terminal end of the surgical filament from the volume of the surgical filament in which it was disposed; and
associating the surgical filament with an anchor disposed in the bone; and
advancing the collapsed cinch loop distally to bring the tissue into proximity with the bone.
13. The method of claim 12 , further comprising forming the cinch loop in the second terminal end of the first surgical filament after the first terminal end has been passed through the soft tissue.
14. The method of claim 12 , 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.
15. The method of claim 12 , further comprising inserting the anchor in bone in proximity to the soft tissue.
16. The method of claim 12 , wherein passing the first terminal end through soft tissue comprises passing the first terminal end through the soft tissue from a proximal side to a distal side and then back through the soft tissue again to the proximal side.
17. The method of claim 12 , wherein passing the first terminal end through soft tissue comprises separately passing the first terminal end and the loop through the soft tissue from a distal side to a proximal side.
18. The method of claim 12 , wherein advancing the collapsed cinch loop distally to bring the tissue into proximity with the bone comprises trapping the surgical filament between the anchor and bone and inserting the anchor into bone, the inserting tensioning the surgical filament to advance the collapsed cinch loop distally.
19. The method of claim 12 , wherein the anchor is a first anchor, the method further comprising, after associating the surgical filament with the first anchor disposed in bone, associating the surgical filament with a second anchor disposed in bone at a location proximate to the first anchor.
20. The method of claim 19 , further comprising, associating the surgical filament with a second anchor and disposing the second anchor in bone at a location proximate to the first anchor, wherein disposing the second anchor in bone comprises trapping the surgical filament between the second anchor and bone.
21. The method of claim 20 , wherein trapping the surgical filament between the second anchor and bone comprises tensioning the surgical filament and further collapsing the snare.
22. The method of claim 12 , further comprising:
removing the second terminal end of the surgical filament from the coaxial region of the filament after collapsing the receiving opening of the cinch loop; and
tying at least one knot with the filament at a location that is proximate to the collapsed cinch loop to secure a location of the filament with respect to the tissue.
23. The method of claim 12 , wherein the surgical filament is associated with the anchor disposed in the bone after passing the first terminal end through the receiving opening.