Suture anchor and methods of knotless tissue fixation
Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair systems include self-cinching constructs with splices and loops having attached flexible materials that are pre-loaded onto modified knotless anchors (for example, swivel and/or screw-in suture anchors and/or push-in suture anchors with a distal eyelet) to position the self-locking, adjustable construct at the repair site. The systems allow for knotless tensioning of the tissue after the knotless anchors have been implanted.
1. A method of tissue repair, comprising the steps of: providing a surgical device comprising a fixation device and a flexible construct extending through the fixation device, the flexible construct comprising a flexible strand with a splice formed within the flexible strand, an adjustable loop having an adjustable perimeter, a free end, a fixed end, and a flexible material attached to the adjustable loop;
installing the fixation device into a first tissue;
passing the flexible strand with the attached flexible material through a second tissue after installing the fixation device into the first tissue to secure the flexible material to the second tissue;
pulling on the free end to bunch up the flexible material and provide tensioning of the second tissue relative to the first tissue; and
subsequently reducing a distance between the first and second tissues.
2. The method of claim 1 , further comprising the steps of:
pre-loading the flexible construct onto the fixation device;
securing the fixation device to a driver;
inserting the fixation device into a hole in the first tissue; and
pulling on the free end to tension the construct.
3. The method of claim 1 , wherein the fixation device is a knotless anchor.
4. The method of claim 1 , wherein the flexible strand is a suture formed of ultrahigh molecular weight polyethylene.
5. The method of claim 1 , wherein the splice is formed within the fixation device and the fixed end is a knot.
6. The method of claim 1 , wherein the flexible material is a suture, suture tape, suture chain, textile, mesh or netting.
7. The method of claim 1 , further comprising the step of
attaching a passing suture to the flexible member to pull the suture with the attached flexible material through the second tissue.
8. The method of claim 1 , wherein
the first tissue is bone; and
the second tissue is soft tissue.
9. A method of attaching tissue to bone using an anchor assembly including a driver and an anchor, the anchor comprising: an anchor body having a distal end, a proximal end, a longitudinal axis, and a flexible construct pre-loaded within the anchor body, the flexible construct including a suture with a flexible material slidingly attached to the suture and also with a suture passing instrument attached to the suture; the method comprising the steps of:
providing the anchor pre-loaded with the suture having the attached flexible material by extending the suture within a cannulation of the anchor, the suture being secured by a knot at a most distal end of the anchor;
pulling the suture passing instrument to allow the suture to pass through itself, within the anchor body, and to form a splice and an adjustable suture loop, the flexible material being attached to the adjustable suture loop;
removing the suture passing instrument and installing the anchor pre-loaded with suture into a first tissue with the driver;
removing the driver;
passing the suture with the attached flexible material through a second tissue after installing the anchor into the first tissue, to secure the flexible material to the second tissue to be fixated; and
pulling on a free end of the suture to bunch up the flexible material and approximate the second tissue to the first tissue.
10. The method of claim 9 , further comprising the step of
attaching a passing suture to the flexible member to pull the suture with the attached flexible material through the second tissue.
11. The method of claim 9 , wherein
the first tissue is bone; and
the second tissue is soft tissue.