Knotless repair technique using tape/suture hybrid
Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair systems include self-cinching constructs with a fixation device, a flexible construct having a flexible strand abutting a suture tape, and a shuttle/pull device attached to the flexible strand and provided within the body of the fixation device. A splice is formed by pulling on the shuttle/pull device subsequent to the fixation device being secured into the bone, to allow the wide tape to be positioned over the tissue (for best compression and minimum tissue cut-thru) and suture for the implanted portion (for most efficient and least bone removal).
1. A surgical system for tissue repairs, comprising:
a fixation device comprising a body, a longitudinal axis, a proximal end and a distal end, the proximal end being configured to receive a driver head for driving the fixation device, at least a portion of the body being cannulated; and
a tensionable construct pre-loaded on the fixation device, the tensionable construct comprising a flexible material and a shuttling device having a loop at an end thereof, the shuttling device passing through a splice in the flexible material, the flexible material and the shuttling device extending through the body of the fixation device with the splice disposed in the body, the flexible material having a knot configured to abut the distal end of the fixation device, the flexible material having a first region with a first width and a second region with a second width which is greater than the first width, the second region being outside of the proximal end of the body of the fixation device remote from the knot at the distal end.
2. The surgical system of claim 1 , wherein the first region is suture and the second region is tape.
3. The surgical system of claim 1 , wherein the flexible material consists essentially of a tape with two suture ends.
4. The surgical system of claim 1 , wherein the shuttling device is configured to be pulled out of the body of the fixation device to allow the flexible material to pass through an eyelet of the shuttling device and through itself, to form a knotless closed loop and the splice.
5. The surgical system of claim 1 , wherein the first region and the second region are both formed of suture.
6. The surgical system of claim 5 , wherein the second region is formed of a number of yarns different from a number of yarns of the first region.
7. The surgical system of claim 1 , wherein the shuttling device is a suture passing instrument.
8. The surgical system of claim 1 , wherein the body has an opening at a most proximal end to receive the driver head for driving the fixation device, and an opening at a most distal end that is smaller than the knot of the flexible strand.
9. The surgical system of claim 1 , wherein the fixation device is an anchor with an anchor body provided with a plurality of circumferential ribs extending from an outer surface of the anchor body.
10. The surgical system of claim 1 , wherein the tissue is soft tissue.