Methods of tissue repairs
Methods for tissue repairs with mattress stitch are disclosed. A mattress stitch is created with a suturing construct that includes one or more soft-body anchors and a flexible strand attached to the soft-body anchors. A free, tensionable end of the flexible strand is removably attached to a suture passer and passed through the tissue. The free end is then passed through the soft-body anchors to form a knotless, continuous, uninterrupted, flexible, adjustable, self-locking, tensionable loop around and through the tissue.
1 . A method of suturing comprising:
fixedly attaching a first end of a flexible construct to a fixation device;
removably attaching a second end of the flexible construct to a suture passer;
inserting the suture passer and the second end of the flexible construct into a joint space while the fixation device is maintained outside the joint space;
advancing the second end of the flexible construct through tissue to be sutured so that the second end enters and exits the tissue at two separate locations;
pulling the suture passer out of the tissue;
passing the second end of the flexible construct through a body of the fixation device maintained outside of the joint space to form a tensionable loop around and through the tissue, wherein the fixation device is a soft-body fixation device; and
securing the fixation device over the tissue.
2 . The method of claim 1 , wherein all steps are conducted while the fixation device is maintained outside the joint space.
3 . The method of claim 1 , wherein the soft-body fixation device consists essentially of suture.
4 . The method of claim 1 , wherein the flexible construct is fixedly attached to the fixation device by a loop or a knot.
5 . The method of claim 1 , wherein a shuttle/pull device extends through the body of the soft-body fixation device.
6 . The method of claim 5 , wherein the step of passing the second end of the flexible construct through the body of the fixation device further comprises:
passing the second end of the flexible construct through a closed eyelet of the shuttle/pull device; and
pulling the shuttle/pull device to allow the second end of the flexible construct to form the tensionable loop, wherein the tensionable loop is a knotless, continuous, uninterrupted, flexible, adjustable, self-locking loop.
7 . The method of claim 1 , wherein the tissue is soft tissue, or soft tissue and graft.
8 . The method of claim 1 , further comprising:
pulling the second end to tension the tensionable loop around and through the tissue; and
passing the second end through another body of another fixation device to form another tensionable loop around and through the tissue.
9 . The method of claim 8 , wherein the another fixation device is a soft-body fixation device consisting essentially of suture.
10 . The method of claim 1 , wherein the first end of the flexible construct is provided with a locking structure disposed on at least a portion of the first end.
11 . The method of claim 10 , wherein the locking structure includes one or more barbs for engaging a tubular sheath of the fixation device.
12 . The method of claim 10 , wherein the locking structure includes a plurality of spikes or barbs that angle outwardly in a direction toward the body of the fixation device to form a one-way lock with the fixation device.
13 . A method of suturing comprising:
securing a first end of a flexible construct to a soft-body fixation device;
removably attaching a second end of the flexible construct to a suture passer;
advancing the suture passer and the second end of the flexible construct into a joint space and through tissue to be sutured so that the second end enters and exits the tissue at two separate locations, while the soft-body fixation device with the first end are maintained outside the joint space;
pulling the suture passer with the second end of the flexible construct out of the tissue;
passing the second end of the flexible construct through a body of the soft-body fixation device to form a knotless, adjustable, self-locking, tensionable loop around and through the tissue; and
forming a mattress stitch connected to the soft-body fixation device, wherein the mattress stitch is located on one side of the tissue to be sutured, and the soft-body fixation device is located on and abuts another side of the tissue to be sutured, wherein all steps are conducted while the soft-body fixation device is maintained outside the joint space.
14 . The method of claim 13 , wherein the first end of the flexible construct is provided with a locking mechanism to lock the knotless, adjustable, self-locking, tensionable loop and prevent loosening.
15 . The method of claim 14 , wherein the step of forming a mattress stitch further comprises passing the second end of the flexible construct through another body of another soft-body fixation device to form another knotless, adjustable, self-locking, tensionable loop around and through the tissue.
16 . The method of claim 13 , wherein the step of forming a mattress stitch further comprises passing the second end of the flexible construct through multiple soft-body fixation devices to form multiple knotless, adjustable, self-locking, tensionable loop around and through the tissue.