Method and apparatus for forming a self-locking adjustable loop
A self-locking adjustable loop construction and a method of forming the construction are disclosed. The construction can include a flexible member having a first end, a second end and a first portion therebetween. The first end can be passed back through the first portion at a first point such that the first end passes through the first portion from a first side of the flexible member to a second opposite side of the flexible member. The first end can be passed through the first portion at a second point spaced apart from the first point such that the first end passes through the first portion from the second side to the first side so as to place the second end outside of the first portion.
1. A method of forming a self-locking adjustable loop, comprising:
providing a flexible member having a first end, a second end and a first portion and a second portion therebetween;
passing in a first direction the first end of the flexible member through the first portion at a first point such that the first end passes through the first portion from a first side of the flexible member to a second opposite side of the flexible member;
passing in the first direction the first end of the flexible member through the first portion at a second point spaced apart from the first point such that the first end passes through the first portion from the second side of the flexible member to the first opposite side of the flexible member so as to place the first end outside of the first portion, wherein the first end is passed through the first and second points in the first direction other than parallel to a longitudinal axis of the first portion to form a first adjustable loop; and
passing the second end of the flexible member through the second portion spaced apart from the first portion in a second direction opposite the first direction the first end passes through the first portion to form a second adjustable loop.
2. The method according to claim 1 , further comprising:
forming the first portion into an accordion configuration having a plurality of leg portions connected to each other;
wherein passing in the first direction the first end of the flexible member through the first portion at a first point includes passing the first end though a first leg portion of the plurality of leg portions from the first side to the second side of the first portion in a direction other than parallel to a longitudinal axis of the first leg portion; and
wherein passing in the first direction the first end through the first portion at a second point includes passing the first end through a second leg portion adjacent the first leg portion such that the first end passes through the second leg portion from the second side to the first side of the first portion in a direction other than parallel to a longitudinal axis of the second leg portion so as to place the first end outside of the accordion configuration.
3. The method according to claim 2 , wherein forming the first portion into an accordion configuration includes forming the first portion into an accordion configuration having at least six leg portions.
4. The method according to claim 2 , further comprising passing the first end through the first and second leg portions in the first direction substantially perpendicular to the respective, longitudinal axes of the first and second leg portions.
5. The method of claim 2 , further comprising forming the first portion into the accordion configuration proximate the second end of the flexible member.
6. The method according to claim 2 , further comprising passing the second end of the flexible member through the first and second leg portions of the second portion in the second direction opposite the first direction the first end was passed through the first and second leg portions of the first portion to form the two adjustable loops.
7. The method according to claim 6 , wherein passing the second end of the flexible member through the first and second leg portions of the second portion includes passing the first end through the first leg portion from a first side to a second side of the second portion and then passing the second end through the second leg portion from the second side to the second side of the second portion.
8. The method according to claim 2 , further comprising:
providing a portable flexible member forming device having first and second members each having a plurality of projections extending therefrom that are configured to intermesh with each other when the forming device is moved from an open position to a closed position;
positioning the first portion of the flexible member between the plurality of projections of the respective first and second members in the open position such that a longitudinal length of the flexible member is substantially perpendicular to a longitudinal length of each of the plurality of projections of the first and second portions;
forming the first portion into the accordion configuration intraoperatively by moving the first and second members to the closed position such the respective pluralities of projections intermesh with each other while the flexible member is positioned therebetween; and
passing the first end of the flexible member through an access port of the forming device in the closed position such that the first end passes in the first direction through the first and second leg portions.
9. The method according to claim 1 , wherein providing a flexible member includes providing a suture having a solid construction formed with a braided structure, a ribbon structure, or a monofilament structure, or combinations thereof.
10. The method according to claim 1 , wherein providing a flexible member includes providing braided ribbon construction having a rectangular shape in cross-section.
11. The method according to claim 1 , further comprising forming the flexible member into a pleated configuration having a plurality of interconnected layers extending along an entire length of the flexible member, the plurality of interconnected layers configured to be substantially parallel to each other in a compressed state of the flexible member.
12. The method according to claim 1 , wherein passing the first end of the flexible member through the first portion at the first point includes passing the first end of the flexible member through the first portion at the first point such that the first end passes through the first portion from the first side of the flexible member to the second opposite side of the flexible member in the first direction other than parallel to the longitudinal axis of the first portion; and
wherein passing the first end through the first portion at the second point includes passing the first end through the first portion at the second point spaced apart from the first point such that the first end passes through the first portion from the second side of the flexible member to the first side of the flexible member in the first direction other than parallel to the longitudinal axis of the first portion.
13. The method according to claim 1 , further comprising passing in the second opposite direction the second end of the flexible member through first and second leg portions of the second portion where the second end is passed through the first leg portion from a first side to a second side of the second portion and passed through the second leg portion from the second side to the first side of the second portion.
14. A method of forming a self-locking adjustable loop, comprising:
providing a flexible member having a first end, a second end, and a first portion and a second portion therebetween;
passing in a first direction the first end of the flexible member through the first portion at a first point such that the first end passes through the first portion from a first side of the flexible member to a second opposite side of the flexible member in the first direction other than parallel to a longitudinal axis of the first portion;
passing in the first direction the first end through the first portion at a second point such that the first end passes through the first portion from the second side of the flexible member to the first side of the flexible member in the first direction other than parallel to the longitudinal axis of the first portion so as to place the first end outside of the first portion, the second point being spaced apart longitudinally from the first point; and
passing the second end of the flexible member through the second portion spaced apart from the first portion in a second direction opposite the first direction the first end passes through the first portion to form two adjustable loops.
15. The method according to claim 14 , further comprising:
passing in the first direction the first end through the first portion at a third point from the first side of the flexible member to the second side of the flexible member, and passing in the first direction the first end through the first portion at a fourth point from the second side of the flexible member to the first side of the flexible member;
wherein the third and fourth points are spaced apart from each other and the first and second points.
16. The method according to claim 15 , wherein passing the first end through the first portion at the first, second, third and fourth points includes passing the first end through the first portion at the first, second, third and fourth points in the first direction substantially perpendicular to the longitudinal axis of the first portion.
17. A method of forming a self-locking adjustable loop comprising:
providing a flexible member having a first end, a second end, a first portion, and a spaced apart second portion between the first end and the second end;
passing in a first direction the first end of the flexible member through the first portion at a first point such that the first end passes through the first portion from a first side to a second opposite side of the first portion;
passing in the first direction the first end through the first portion at a second point spaced apart from the first point such that the first end passes through the first portion from the second side to the first side of the first portion to form a first adjustable loop;
passing in a second opposite direction the second end of the flexible member through the second portion at a third point such that the second end passes through the second portion from a first side to a second opposite side of the second portion; and
passing in the second opposite direction the second end through the second portion at a fourth point spaced apart from the third point such that the second end passes through the second portion from the second side to the first side of the second portion to form a second adjustable loop.
18. The method according to claim 17 , wherein passing the first end of the flexible member through the first portion at the first point includes passing the first end of the flexible member through the first portion at the first point such that the first end passes through the first portion from the first side to the second opposite side in the first direction other than parallel to the longitudinal axis of the first portion; and
wherein passing the first end through the first portion at the second point includes passing the first end through the first portion at the second point spaced apart from the first point such that the first end passes through the first portion from the second side to the first side in the first direction other than parallel to the longitudinal axis of the first portion.