ALL-SUTURE ANCHOR
Provided herein are suturing systems, methods of anchoring to a bone, methods for anchoring a soft tissue to a bone, and methods of anchoring a first soft tissue portion to a second soft tissue portion. An exemplary suturing system includes an anchor and a suture inserter device. The anchor includes a plurality of anchor inserts coupled to a portion of the suture between a first end and second end of the anchor. The anchor has an insertion configuration that is substantially linear and a deployed configuration that is at least partially nonlinear. The suture inserter device includes a housing comprising a housing lumen and a housing shaft disposed therein, and an inserter fork coupled to the housing shaft. The housing shaft is axially translatable, and the inserter fork is axially translatable, via the housing shaft, between a distal position and a proximal position.
1 . A suturing system comprising:
(a) an anchor assembly comprising:
(i) a suture;
(ii) a first anchor coupled to a distal portion of the suture; and
(iii) a second anchor coupled to the suture proximal to the first anchor; and
(b) a suture inserter device comprising:
(i) a housing comprising a first housing lumen therethrough and a first needle, wherein the first anchor couples to the first needle, wherein the first needle is axially translatable within the first housing lumen between a primary configuration and a secondary configuration; and
(ii) a second needle receiving a portion of the suture proximal to the first anchor and distal to the second anchor.
2 . The suturing system of claim 1 , wherein the first anchor comprises a plurality of first anchor inserts, and wherein the second anchor comprises a plurality of second anchor inserts.
3 . The suturing system of claim 2 , wherein at least two of the plurality of first anchor inserts are coupled, wherein at least two of the plurality of second anchor inserts are coupled, or both.
4 . The suturing system of claim 2 , wherein at least a portion of the plurality of first anchor inserts, plurality of second anchor inserts, or both, have a shape comprising a sphere, a cylinder, a pyramid, a torus, a cone, a prism, or any combination thereof.
5 . The suturing system of claim 1 , wherein the housing, the first needle, the second needle, or a combination thereof, comprise an indicator of the distance between the distal point of the first housing lumen and the distal point of the first needle and/or the second needle.
6 . The suturing system of claim 1 , wherein the suture inserter device further comprises a needle slider coupled to the first needle, wherein the first needle slider translates the first needle within the first housing lumen between the primary configuration and the secondary configuration.
7 . The suturing system of claim 1 , wherein the housing comprises a second housing lumen, the second needle translatable within the second housing lumen between a second primary configuration and a second secondary configuration.
8 . The suturing system of claim 7 , wherein the housing, the first needle, or both, comprise an indicator of the distance between the distal point of the first housing lumen and the distal point of the first needle.
9 . The suturing system of claim 7 , wherein the housing, the second needle, or both, comprise an indicator of the distance between the distal point of the second housing lumen and the distal point of the second needle.
10 . The suturing system of claim 7 , wherein the suture inserter device further comprises a first needle inserter coupled to the needle, wherein the first needle inserter translates the first needle within the first housing lumen between the first primary configuration and the first secondary configuration.
11 . The suturing system of claim 7 , wherein the suture inserter further comprises a second needle slider coupled to the second needle, wherein the second needle inserter translates the second needle within the housing lumen between the second primary configuration and the second secondary configuration.
12 . The suturing system of claim 1 , wherein each anchor has an outer width or diameter of less than about 5 mm.
13 . A method of suturing a first soft tissue portion to a second soft tissue portion, the method comprising:
providing a suturing system comprising;
a. an anchor assembly comprising:
i. a suture;
ii. a first anchor coupled to a distal portion of the suture; and
iii. a second anchor coupled to the suture proximal to the first anchor; and
b. a suture inserter device comprising:
i. a housing comprising a first housing lumen therethrough and a first needle, wherein the first anchor couples to the first needle, wherein the first needle is axially translatable within the first housing lumen between a primary configuration and a secondary configuration; and
ii. a second needle receiving a portion of the suture proximal to the first anchor and distal to the second anchor;
piercing the first soft tissue portion at a first side thereof with the first needle in the primary configuration, and thereby passing the first anchor through the first soft tissue portion to a second side thereof;
translating the first needle within the first housing lumen to the secondary configuration, thereby retracting the first needle, and leaving the first anchor displaced at the second side of the first soft tissue portion;
piercing the second soft tissue portion at a first side thereof with the second needle, and thereby passing the second anchor through the second soft tissue portion to a second side thereof;
tensioning the suture so as to transition the first anchor and the second from the insertion configuration to the deployed configuration; and
extracting the second needle from the second soft tissue portion.
14 . The method of claim 13 , further comprising trimming the suture, tightening the suture, locking the suture, or any combination thereof.
15 . The method of claim 13 , wherein the first anchor comprises a plurality of first anchor inserts, and wherein the second anchor comprises a plurality of second anchor inserts.
16 . The method of claim 15 , wherein at least two of the plurality of first anchor inserts are coupled, wherein at least two of the plurality of second anchor inserts are coupled, or both.
17 . The method of claim 13 , wherein the first portion of the soft tissue is a portion of a first soft tissue, and wherein the second soft tissue portion is a portion of a second soft tissue.
18 . A method of suturing a first soft tissue portion to a second soft tissue portion, the method comprising:
providing a suturing system comprising;
a. an anchor assembly comprising:
i. a suture;
ii. a first anchor coupled to a distal portion of the suture; and
iii. a second anchor coupled to the suture proximal to the first anchor; and
b. a suture inserter device comprising:
i. a housing comprising a first housing lumen and a second housing lumen therethrough;
ii. a first needle translatable within the first housing lumen between a first primary configuration and a first secondary configuration, wherein the first anchor couples to the first needle; and
iii. a second needle translatable within the second housing lumen between a second primary configuration and a second secondary configuration, wherein the second needle is sized to receive a portion of the suture proximal to the anchor.
piercing the first soft tissue portion at a first side thereof with the first needle in the primary configuration, and thereby passing the first anchor through the first soft tissue portion to a second side thereof;
translating the first needle within the first housing lumen to the first secondary configuration, thereby retracting the first needle, and leaving the first anchor displaced at the second side of the first soft tissue portion;
piercing the second soft tissue portion at a first side thereof with the second needle, and thereby passing the second anchor through the second soft tissue portion to a second side thereof;
tensioning the suture so as to transition the first anchor and the second from the insertion configuration to the deployed configuration and
translating the second needle within the second housing lumen to the second secondary configuration, thereby retracting the second needle, and leaving the second anchor displaced at the second side of the first soft tissue.
19 . The method of claim 18 , further comprising trimming the suture, tightening the suture, locking the suture, or any combination thereof.
20 . The method of claim 18 , wherein the first anchor comprises a plurality of first anchor inserts, and wherein the second anchor comprises a plurality of second anchor inserts.