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 - 20 . (canceled)
21 . A surgical repair method, comprising:
coupling a surgical filament that extends from a first portion with a cinch loop formed therefrom to a second portion that includes a terminal end through soft tissue at a location proximate to bone in which the soft tissue is to be attached;
passing the terminal end of the second portion through the cinch loop;
collapsing the cinch loop to engage the soft tissue; and
advancing the collapsed cinch loop distally to bring the tissue into proximity with the bone; and
locking a position of the tissue relative to the bone by trapping a portion of the surgical filament within bone.
22 . The method of claim 21 , wherein coupling the surgical filament further comprises passing a terminal end of the surgical filament through the soft tissue such that the terminal end and the cinch loop extend proximally from the soft tissue.
23 . The method of claim 21 , further comprising inserting an anchor in bone in proximity to the soft tissue.
24 . The method of claim 23 , further comprising advancing the anchor in bone to increase trapping the surgical filament between the anchor and bone throughout advancement of the anchor into bone, the inserting tensioning the surgical filament to advance the collapsed cinch loop distally.
25 . The method of claim 24 , 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.
26 . The method of claim 25 , 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.
27 . The method of claim 26 , wherein trapping the surgical filament between the second anchor and bone comprises tensioning the surgical filament and further collapsing the cinch loop.
28 . The method of claim 21 , wherein the position of the tissue relative to bone is locked without tying at least one locking knot with the surgical filament.
29 . The method of claim 21 , wherein advancing the collapsed cinch loop distally further comprises applying tension to the terminal end of the second portion to cause the collapsed cinch loop to slide distally toward the soft tissue to a position adjacent to the soft tissue.
30 . The method of claim 21 , 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.
31 . The method of claim 21 , 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.
32 . The method of claim 21 , further comprising forming a coaxial region in the surgical filament by disposing a portion of the surgical filament between the first and second portions into its own volume.
33 . The method of claim 32 , further comprising deconstructing the coaxial region by removing the portion of the filament from the volume of the filament in which it was disposed.
34 . The method of claim 33 , 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.
35 . 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 and a second portion that includes a loop formed therefrom and a second terminal end, with 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 filament through the receiving opening;
collapsing the receiving opening of the cinch loop;
advancing the collapsed cinch loop distally to bring the tissue into proximity with the bone; and
passing at least a portion of the surgical filament into the bone to trap the filament within the bone.
36 . The method of claim 35 , further comprising inserting an anchor in bone in proximity to the soft tissue, the anchor distally advancing the portion of the surgical filament to trap the surgical filament.
37 . The method of claim 36 , wherein the portion of the surgical filament is disposed between the anchor and the bone to prevent the portion of the surgical filament from backing out of the bone.
38 . The method of claim 35 , wherein the position of the tissue relative to bone is locked without tying at least one locking knot with the surgical filament.
39 . The method of claim 35 , 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.
40 . The method of claim 35 , further comprising advancing the anchor in bone to increase trapping the surgical filament between the anchor and bone throughout advancement of the anchor into bone, the inserting tensioning the surgical filament to advance the collapsed cinch loop distally.