Visual aid for identifying suture limbs arthroscopically

A flexible suture for coupling tissue includes a first suture portion extending to a first end and a second suture portion extending to a second end. A plurality of braided strands form the first and second suture portions. An identifier characteristic is formed into the plurality of braided strands. The identifier characteristic extends from the first end of the first suture portion to the second end of the second suture portion, and the identifier characteristic distinguishes the first suture portion from the second suture portion.

FIELD

The present disclosure relates to suture constructions and, more particularly, to suture loop constructions containing visual aids for identifying suture limbs arthroscopically.

BACKGROUND

Arthroscopic surgery is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. The surgery is performed through portals (or cannulas) in the body through which the endoscope and tools are inserted. Often the surgeon is working in small, tight areas.

It is common for surgeons to use sutures to secure soft tissues to bone, bone to bone, and tissue to tissue. Often when working in the small tight area, the surgeon may have difficulty distinguishing the suture limbs or tying the suture limbs without moving the tissue or bone.

SUMMARY

The present teachings provide for a flexible suture for coupling tissue. The flexible suture includes a first suture portion extending to a first end and a second suture portion extending to a second end. A plurality of braided strands that form the first and second suture portions. An identifier characteristic is formed into the plurality of braided strands. The identifier characteristic extends from the first end of the first suture portion to the second end of the second suture portion, and the identifier characteristic distinguishes the first suture portion from the second suture portion.

The present teachings also provide for a flexible suture for coupling tissue that includes a first suture limb extending to a first end and a second suture limb extending to a second end. A plurality of braided strands that form the first and second suture limbs. A first structural identifier characteristic is formed into the plurality of braided strands of the first suture limb. A second structural identifier characteristic is formed into the plurality of braided strands of the second suture limb. The first and second structural identifiers differentiate the structure of the first suture limb from the structure of the second suture limb.

The present teachings also provide for a flexible suture for coupling tissue that includes a first suture limb extending to a first end and a second suture limb extending to a second end. A plurality of braided strands that form the first and second suture limbs. One of the first and second suture limbs includes a dyed portion.

The present teachings also provide for flexible suture for coupling tissue that includes a first suture limb extending to a first end and a second suture limb extending to a second end. A plurality of braided strands that form the first and second suture limbs. The first suture limb forms a braided cylinder, and the second suture limb forms a braided flat ribbon.

A flexible suture for coupling tissue that includes a first suture section that extends from a first end to a second end. A second suture section that extends from a third end to a fourth end. A plurality of braided strands that form the first and second suture sections. An identifier characteristic that is formed into the plurality of braided strands. The identifier characteristic extends from the first end to the second end of the first suture section and from the third end to the fourth end of the second suture section, and the identifier characteristic distinguishes the first suture limb from the second suture limb. A coupler attaches the first suture section to the second suture section.

DETAILED DESCRIPTION

With initial reference toFIG. 1A, a suture construct is generally illustrated at reference numeral10. The suture construct10generally includes a first terminal end14and a second terminal end18and may include an identification characteristic such as a tracer22to identify the suture10. The tracer22may extend from the first terminal end14to the second terminal end18of the suture construct10. As shown in more detail inFIG. 2, the suture construct10may include an outer wall26formed from a plurality of strands30braided together. Each strand30may further include a plurality of fibers34braided together to form the strand30. The tracer22may be one or more of the plurality of strands30or fibers34.

When the tracer22extends from the first terminal end14to the second terminal end18of the suture construct10, the suture construct10is easier to form because it can be manufactured in a single continuous step. There is no need to stop the machine during manufacturing to add or subtract any of the strands that are braided into the suture.

The suture construct10and tracer22may be made of any suitable flexible material or member, and need not be made of a suture. The suture construct10may also be made of a variety of different materials. When the suture construct10and tracer22are made of sutures, any suitable suture can be used.

For example, the braided suture may be a 16-strand hollow-core suture (seeFIG. 2). In this example, 16 strands are braided together to form the outer wall26, leaving a hollow passage28through the center extending from the first terminal end14to the second terminal end18. Each strand30is formed from the plurality of fibers34that are braided together. The tracer22may be at least one strand or a plurality of strands in the suture construct10. Any suitable braided suture can be used.

The suture construct10and tracer22may be of a variety of different materials. For example, the strands30of suture construct10may be of a polyethylene material that is substantially translucent or colorless. The tracer22may be of a polyester or nylon material that is either white or dyed a contrasting color to identify the tracer22in the suture construct10. The tracer22assists the surgeon in differentiating between suture strands with the trace and suture strands without the trace. The tracer22may be modified from the first terminal end14to the second terminal end18of the suture construct10to assist the surgeon in distinguishing the first end14from the second18.

With additional reference toFIG. 1B, sutures generally are manufactured in a spool and then cut to a specific length (for example only, 38 inches) to form the suture construct10. Once cut to length, the suture construct10may be attached to an exemplary anchor38. While a rigid anchor is illustrated, the surgeon can use any known anchor including a flexible anchor. The suture construct10may further include a first suture limb42adjacent to the first terminal end14and a second suture limb46adjacent to the second terminal end18. The length of the first suture limb42may be equivalent to half the length of the suture construct10(for example only, 19 inches), equivalent to a portion that is less than half the length of the suture construct10, or equivalent to a portion that is more than half the length of the suture construct10. To help distinguish between the first suture limb42and the second suture limb46, which can be particularly helpful for a surgeon during surgery, the first suture limb42and the second suture limb46can be provided with different colors, patterns, or designs, for example. Accordingly, when the suture is threaded through the eyelet of the anchor38, the two limbs42and46may be distinguished, helping to identify their direction of travel.

In the embodiment ofFIGS. 1Aand B, the first suture limb42is distinguished from the second suture limb46in the number of picks per inch (PPI), or tightness, of the tracer22braided into the suture. The PPI is the number of traces visible per inch along the suture. For example, the PPI of the tracer22in the first suture limb42may be 30 PPI; whereas, the PPI of the tracer22in the second suture limb46may be 60 PPI, or twice as tight as the first suture limb42. This difference is apparent by visual inspection because the colored tracer22will appear twice as often on the second suture limb46as it does on the first suture limb42.

Now referring toFIG. 3, the suture construct10can be used to attach a portion of soft tissue50to bone54. The suture construct10is threaded through the anchor38. The anchor38is secured to the bone54by engaging a plurality of threads58on the anchor38into the bone54using an anchor implant or driving tool (not pictured). The first suture limb42may be passed through the soft tissue50, becoming a post. The second suture limb46is passed around the outside of the soft tissue50and is knotted to the post42. The suture limb42passing through the soft tissue50is used as the post when securing the first and second suture limbs42,46, because it is desirable for there to be minimal movement of the suture limb in the soft tissue50. By knowing which end of the suture is the post and which end is to be knotted to the post, via the tracer22, the surgeon can perform the procedure more quickly and efficiently during arthroscopic surgery.

Now referring toFIGS. 4A-C, the suture construct10may be used to repair a tear62in soft tissue66. The suture construct10is threaded through the soft tissue, the first suture limb42on a first side of the tear62and the second suture limb46on an opposite, second side of the tear62(FIG. 4A). One of the suture limbs, for example only, the first suture limb42, is determined to function as the post. The other suture limb, for example only, the second suture limb46, is knotted around the post42(FIG. 4B). The knot is then pulled tight closing the tear62in the soft tissue66(FIG. 4C). Again, by knowing which end of the suture is the post and which end is to be knotted to the post, via the tracer22, the surgeon can perform the procedure more quickly and efficiently during arthroscopic surgery.

Now referring toFIGS. 5A-D, a second embodiment of a suture construct100is illustrated. The suture construct100generally includes a first terminal end104and a second terminal end108and may include an identifier characteristic such as a color coating112on only a portion of the suture100. The suture construct100may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30. Further, the suture construct100may also be of a monofilament construct (not shown). The suture construct100may be divided into two portions, a first suture limb116adjacent to the first terminal end104and a second suture limb120adjacent to the second terminal end108, that may be distinguished by the color coating112.

The plurality of fibers34may be of an all-white polyethylene material that is braided to form the plurality of strands30. The second suture limb120may be coated with a dye or other material that is known to adhere to the polyethylene material. The dye or other material may be of a contrasting color to the all-white polyethylene and therefore may provide the color coating112on a portion of the suture construct100. The color coating112may be applied to the entire second suture limb120(FIG. 5A) or may be applied in specific locations of the second suture limb120(FIG. 5C), distinguishing the second suture limb120from the first suture limb116. The differences between the first suture limb116and the second suture limb120become more apparent when the suture construct100is threaded through the anchor38. The differences in appearance help to identify the direction of travel and corresponding ends of each suture limb116,120.

The plurality of fibers34may also contain a material known to be radiopaque, for example barium sulfate, that is braided to form the plurality of strands30. A radiopaque material is known in the art to be visible in x-ray images and to the naked eye. The second suture limb120may be coated with a radiopaque material such as barium sulfate. The radiopaque material may be of a contrasting color to the plurality of strands30and therefore may provide the color coating112on a portion of the suture construct100. The color coating112may be applied to the entire second suture limb120(FIG. 5A) or may be applied in specific locations of the second suture limb120(FIG. 5C), distinguishing the second suture limb120from the first suture limb116.

Now referring toFIGS. 6A-B, a third embodiment of a suture construct200is illustrated. The suture construct200generally includes a first suture limb204and a second suture limb208and may include an identifier characteristic such as a tracer210on a portion of the suture200. The tracer210may extend the entire length of the suture limb204. The suture construct200may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30.

The first suture limb204may be connected to the second suture limb208to form a continuous suture construct200. The first suture limb204may include a first terminal end212and a second terminal end216, and the second suture limb208may include a first terminal end220and a second terminal end224. The first and second suture limbs204,208may be tied together with a knot, adhered or epoxied together, locked together by passing each strand through the opposite strand, or fixed together by any means known in the art. When passing the strands through opposite ends, the suture from one end is passed between the braided strands, along the hollow core, and out through the braided strand or retained in the hollow core.

The second end216of the first suture limb204may be locked within the second suture limb208, and the second end224of the second suture limb208may be locked within the first suture limb204(FIG. 6B). The first suture limb204may include a first aperture228, and the second suture limb208may include a second aperture232. The first and second apertures228,232are formed during the braiding process as loose portions between pairs of strands defining the suture. The second terminal end216is passed through the second aperture232and into the hollow passage28of the 16-strand hollow-core suture. The second terminal end224is passed through the first aperture228and into the hollow passage28of the 16-strand hollow-core suture. When tightened, the second terminal end216of the first suture limb204and the second terminal end224of the second suture limb208resist the reverse movement. It is envisioned that the second terminal end216of the first suture limb204and the second terminal end224of the second suture limb208may be passed through the hollow passage28several times through multiple apertures in the first and second suture limbs204,208. Further, the second terminal end216of the first suture limb204and the second terminal end224of the second suture limb208may be retained in the hollow passage28or passed out through the braided strand.

The first and second suture limbs204,208may be of different colors or sizes to assist the surgeon in differentiating between the different limbs204,208. For example, the first suture limb204may include the tracer22extending from the first end212to the second end216and being of a polyethylene or nylon material that has been dyed black. The second suture limb208may not include the tracer22or may include the tracer22being of a contrasting color such as red. The first and second suture limbs204,208may also be of different sizes or diameters. For example, the first suture limb204may be braided tighter than the second suture limb208, or vice versa. The second suture limb208may have a larger diameter than the first suture limb204, and the first suture limb204may have a higher stiffness than the second suture limb208, or vice versa.

Now referring toFIG. 7, a fourth embodiment of a suture construct300is illustrated. The suture construct300generally includes a first suture limb304adjacent to a first terminal end308and a second suture limb312adjacent to a second terminal end316. The suture construct300may further include an identifier characteristic such as a tracer320on a portion of the suture300. The tracer320may extend from the first terminal end308to the second terminal end316. The suture construct300may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30.

The tracer320may be one or more of the plurality of strands30or fibers34braided into the suture construct300similar to that of the embodiment illustrated inFIGS. 1a-b. The suture construct300and tracer320can be made of any suitable flexible material or member, and need not be made of a suture. When the suture construct300and tracer320are made of sutures, any suitable suture can be used.

The suture construct300and tracer320may be of a variety of different materials. For example, the strands30of suture construct300may be of a polyethylene material that is substantially translucent or colorless and may also include a polyester or nylon material that is white in color. The tracer320may be of a polyester or nylon material that is either white or dyed a contrasting color to identify the tracer320in the suture construct300. The tracer320assists the surgeon in differentiating between suture strands with the trace and suture strands without the trace.

The tracer320may be braided so that it is visual to an observer for a first portion324of the suture construct300. The first portion324may be the same length as, and correspond to, the first suture limb304. The tracer320then may be braided in the hollow passage28so that it is not visible to the observer for a second portion328of the suture construct300. The second portion328may be the same length as, and correspond to, the second suture limb312. After the second portion328the tracer320may be braided so that it is visual to the observer again. This pattern may be followed for the length of several suture constructs300during manufacturing and then cut to specified suture construct300lengths (for example only, 38 inches) at a later time.

Now referring toFIG. 8, a fifth embodiment of a suture construct400is illustrated. The suture construct400generally includes a first suture limb404adjacent to a first terminal end408and a second suture limb412adjacent to a second terminal end416. The suture construct may further include an identifier characteristic such as a tracer420on a portion of the suture400. The tracer420may extend from the first terminal end408to the second terminal end416of the suture construct400. The suture construct400may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30.

The tracer420may be one or more of the plurality of strands30or fibers34braided into the suture construct400similar to that of the embodiment illustrated inFIGS. 1A-B. The suture construct400and tracer420can be made of any suitable flexible material or member, and need not be made of a suture. When the suture construct400and tracer420are made of sutures, any suitable suture can be used.

The suture construct400and tracer420may be of a variety of different materials. For example, the strands30of suture construct400may be of a polyethylene material that is substantially translucent or colorless or white in color. The tracer420may be of a polyester or nylon material that is white in color. The tracer420assists the surgeon in differentiating between suture strands with the trace and suture strands without the trace.

The tracer420may be braided into the suture construct400such that it is visible to the observer. After manufacturing of the suture construct400is complete, a first portion424of the suture construct400may be dipped in a dye solution of a contrasting color to dye the tracer420braided into the first portion424. The first portion424may be the same length as the first suture limb404. The dye adheres to the polyester or nylon material of the tracer420and does not adhere to the polyethylene fibers in the suture construct420. Only the first portion424of the suture construct400is dyed a contrasting color so that the first suture limb404is differentiated from the second suture limb412. By braiding a white tracer420into the suture construct400during manufacturing and dying the tracer420at a later time, a plurality of suture constructs400can be manufactured at one time and later be dyed different colors.

Now referring toFIG. 9, a sixth embodiment of a suture construct500is illustrated. The suture construct500generally includes a first suture limb504and a second suture limb508. The suture construct500may include an identifier characteristic such as a tracer (not pictured) extending the entire length of the suture construct500as discussed in previous embodiments, but inclusion of the tracer in the suture construct500is not necessary for the sixth embodiment. The suture construct500may be the 16-strand hollow-core suture and may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30. The suture construct500may further be threaded through an eyelet of an anchor512.

The suture construct500may be braided similar to that of the embodiment illustrated inFIGS. 1A-B. The suture construct500can be made of any suitable flexible material or member, and need not be made of a suture. When the suture construct500is made of sutures, any suitable suture can be used. For example, the fibers34forming the strands30of suture construct500may be of a polyethylene material that is substantially translucent or colorless or white in color.

The suture construct500may include a structural identifier characteristic, such as knots, extending the entire length of the suture construct500. One of the first and second suture limbs504,508may include knots516in specific locations along the suture limb, for example the second suture limb508, as illustrated. The knots516along the second suture limb508may assist the surgeon in differentiating between the first suture limb504and the second suture limb508and may help to identify the direction of travel of each suture limb504,508.

Once the suture construct500is braided as discussed in previous embodiments, the suture construct500may be cut to length. The suture construct500may be threaded through the eyelet of the anchor512. Preformed knots516may be placed in specific locations along either the first suture limb504or the second suture limb508(for example only, the second suture limb508). The anchor512is secured in the bone54, and the first suture limb504without the knots516is threaded through the soft tissue50(see alsoFIG. 3). The first suture limb504becomes the post. The second suture limb508is passed around the outside of the soft tissue50and is knotted to the post504. The first suture limb504passing through the soft tissue50is used as the post when securing the first and second suture limbs504,508, because it is desirable for there to be minimal movement of the suture limb in the soft tissue50. Further, the first suture limb504is desirable to pass through the soft tissue50because the first suture limb504does not contain knots516that may become caught or do more damage or tearing to the soft tissue50.

Now referring toFIGS. 10A-B, a seventh embodiment of a suture construct600is illustrated. The suture construct600generally includes a first suture limb604adjacent to a first terminal end608and a second suture limb612adjacent to a second terminal end616. The suture construct600may further include an identifier characteristic such as a tracer620on a portion of the suture600. The tracer620may extend from the first terminal end608to the second terminal end616. The suture construct600may be the 16-strand hollow-core suture and may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30.

The tracer620may be one or more of the plurality of strands30or fibers34braided into the suture construct600. The suture construct600and tracer620can be made of any suitable flexible material or member, and need not be made of a suture. When the suture construct600and tracer620are made of sutures, any suitable suture can be used.

The suture construct600and tracer620may be of a variety of different materials. For example, the strands30of suture construct600may be of a polyethylene material that is substantially translucent or colorless or white in color. The tracer620may be of a polyester or nylon material that is a contrasting color. The tracer620assists the surgeon in differentiating between suture strands with the trace and suture strands without the trace.

Each suture construct600may be cut from a suture group624. The suture group624may be manufactured by braiding 16 strands30(of the plurality of fibers34) together for a specific length (for example only, 1 inch) and then splitting the strands30into a first group628and a second group632of 8 strands each. One of the first group628and the second group632contains the plurality of strands30of the tracer620. Each group of strands628,632is individually braided for a specific length (for example only, 38 inches). The 16 strands30are then braided together. This pattern is repeated several times to form the suture group624. The resulting suture group624is cut at a first portion636where the 16 strands30are braided together and at a second portion640along the first group628and the second group632a specific length (for example only, 19 inches) from where the 16 strands split into two groups of 8 strands each. Once cut, each suture construct600is in a condition ready for use.

Now referring toFIG. 11, an eighth embodiment of a suture construct700is illustrated. The suture construct700generally includes a first suture limb704adjacent to a first terminal end708and a second suture limb712adjacent to a second terminal end716. The suture construct700may further include an identification characteristic such as a tracer720on a portion of the suture700. The tracer720may extend from the first terminal end708to the second terminal end716. The suture construct700may be the 16-strand hollow-core suture and may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30.

The suture construct700and tracer720can be made of any suitable flexible material or member, and need not be made of a suture. When the suture construct700and tracer720are made of sutures, any suitable suture can be used. For example, the strands30of suture construct700may be of a polyethylene material that is substantially translucent or colorless or white in color. The tracer720may be of a polyester or nylon material that is a contrasting color. The tracer720assists the surgeon in differentiating between suture strands with the trace and suture strands without the trace.

The tracer720may be sewn in to the suture construct700after the suture construct700has been braided into the 16-strand hollow-core suture as described above. The tracer720may only be sewn into a portion of the suture construct700corresponding to the second suture limb712to differentiate the second suture limb712from the first suture limb704. The tracer may also be sewn into the portion of the suture construct700corresponding to the second suture limb712so that it is visible on the second suture limb712and may be sewn into the hollow passage28of the suture construct700over a portion corresponding to the first suture limb704so that it is not visible but extends the entire length of the suture construct10.

Now referring toFIGS. 12A-C, a ninth embodiment of a suture construct800is illustrated. The suture construct800generally includes a first suture limb804and a second suture limb808. The suture construct800may include an identifier characteristic such as a tracer (not pictured) extending the entire length of the suture construct800as discussed in previous embodiments, but inclusion of the tracer in the suture construct800is not necessary for the ninth embodiment. The suture construct800may be the 16-strand hollow-core suture and may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30. One of the first suture limb804and the second suture limb808may include a structural identifier, such as a loop or a bifurcation, to assist the surgeon in differentiating between the first and second suture limbs804,808. Further, the suture construct800may include a structural identification characteristic extending the entire length of the suture800that differentiates a first suture limb804from a second suture limb808.

Referring specifically toFIG. 12A, once the suture construct800is braided according to previous embodiments, the suture construct800may be cut to length. The suture construct800may then be threaded through the eyelet of an anchor812. The second suture limb808may be looped back to the eyelet of the anchor812and secured in order to form a loop for identification and ability to manipulate. The anchor812is secured in the bone54, and the second suture limb808with the loop is passed through the soft tissue50(see alsoFIG. 3). The second suture limb808becomes the post. The first suture limb804is passed around the outside of the soft tissue50and is knotted to the post808. The second suture limb808passing through the soft tissue50is used as the post when securing the first and second suture limbs804,808, because it is desirable for there to be minimal movement of the suture limb in the soft tissue50and the loop in the second suture limb808is easy to grab with a tool arthroscopically.

Referring specifically toFIG. 12B, once the suture construct800is braided according to previous embodiments, the suture construct800may be cut to length. The suture construct800may be threaded through the eyelet of the anchor812. A loop816may be secured along the length of the second suture limb808for identification and manipulation. The loop816may be secured to the suture limb808similarly to the locking method discussed in the third embodiment200. The second suture limb808may include a first aperture820and a second aperture824. The first and second apertures820,824are formed during the braiding process as loose portions between pairs of fibers defining the suture. A first end828of the loop816is passed through the first aperture820and into the hollow passage28of the 16-strand hollow-core suture. A second end832is passed through the second aperture824and into the hollow passage28of the 16-strand hollow-core suture. When tightened, the first end828and the second end832resist reverse movement and the loop816remains secured to the second suture limb808.

The anchor812is secured in the bone54, and the second suture limb808with the loop816is passed through the soft tissue50arthroscopically (see alsoFIG. 3). The second suture limb808becomes the post. The first suture limb804is passed around the outside of the soft tissue50and is knotted to the loop816on the post808. The second suture limb808passing through the soft tissue50is used as the post when securing the first and second suture limbs804,808, because it is desirable for there to be minimal movement of the suture limb in the soft tissue50and the loop in the second suture limb808is easy to grab with a tool arthroscopically.

Referring specifically toFIG. 12C, once the suture construct800is braided according to previous embodiments, the suture construct800may be cut to length. The suture construct800may be threaded through the eyelet of the anchor812. A bifurcation836may be formed along the length of the second suture limb808for identification and manipulation. The bifurcation836may be formed during the braiding process as a loose portion between pairs of fibers defining the suture.

The anchor812is secured in the bone54, and the second suture limb808with the bifurcation836is passed through the soft tissue50arthroscopically (see alsoFIG. 3). The second suture limb808becomes the post. The first suture limb804is passed around the outside of the soft tissue50and is knotted to the bifurcation836on the post808. The second suture limb808passing through the soft tissue50is used as the post when securing the first and second suture limbs804,808, because it is desirable for there to be minimal movement of the suture limb in the soft tissue50, and the bifurcation836in the second suture limb808is easy to grab with a tool arthroscopically.

During the process to secure the first suture limb804to the second suture limb808, the first suture limb804is passed through the bifurcation836in the second suture limb808. The strands30of fibers34in the second suture limb808may be tightened applying pressure to the first suture limb804. When tightened, the first suture limb804resists reverse movement and may be knotted around the second suture limb808.

Now referring toFIG. 13, a tenth embodiment of a suture construct900is illustrated. The suture construct900generally includes a first suture limb904adjacent to a first terminal end908and a second suture limb912adjacent to a second terminal end916. The suture construct900may include an identifier characteristic such as a tracer (not pictured) extending the entire length of the suture construct900as discussed in previous embodiments, but inclusion of the tracer in the suture construct900is not necessary for the tenth embodiment. The suture construct900can be made of any suitable flexible material or member, and need not be made of a suture. When the suture construct900is made of sutures, any suitable suture can be used. For example, the strands30of suture construct900may be of a polyethylene material that is substantially translucent, colorless, or white in color.

The suture construct900may include an identification characteristic on a plurality of portions to assist the surgeon in identifying the first terminal end908and the second terminal end916. A first portion920that may correspond to the first suture limb904may be the 16-strand hollow-core suture discussed previously and may include the outer wall26formed from the plurality of strands30braided together (FIG. 2). Each strand30may further include the plurality of fibers34braided together to form the strand30. A second portion924that may correspond to the second suture limb912may be a 16-strand flat braided ribbon construct formed from the plurality of strands30braided together. Each strand30may further include the plurality of fibers34braided together to form the strand30. The round or cylindrical shape of the first portion920is distinguished from the flat shape of the second portion924both by touch and sight to assist the surgeon in distinguishing the first suture limb904from the second suture limb912.

During manufacture of the first portion920of the suture construct900, each of the 16 strands30is braided around the remainder of the strands30to form the cylindrical shape. During manufacture of the second portion924of the suture construct900, the strands30are braided horizontally back and forth to create a flat braid. While manufacturing the suture construct900, the different braid patterns are alternated to form a single long suture group that can then be cut to appropriate suture lengths (for example only, 38 inches).

With additional reference toFIGS. 14-22, a method for forming a suture tail12′, or any other suture strand in which it would be advantageous to distinguish between two different suture portions, will now be described. With initial reference toFIG. 14, a second portion68′ of the suture tail12′ is illustrated. The second portion68′ includes a first end68A′ and a second end68B′. Second end18′ of the suture tail12′ is at the second end68B′ of the second portion68′. As illustrated inFIG. 15, a threader, such as the threader92′ or any suitable threading device, is inserted through a first area of the second portion68′ of the suture tail12′ to define a first tail sleeve68C′. The threader92′ is also inserted through a second area to define a second tail sleeve68D′. The second tail sleeve68D′ is closer to the first end68A′ than the first tail sleeve68C′.

With the threader92′ extending through each of the first tail sleeve68C′ and the second tail sleeve68D′, the first end68A′ is inserted into the threader92′ and grasped by the threader92′. The threader92′ is then withdrawn through the second tail sleeve68D′ and the first tail sleeve68C′ in order to draw the first end68A′ through the second tail sleeve68D′ and into the first tail sleeve68C′, as illustrated inFIG. 16. Therefore, the second portion68′ defines a loop68E′. Again, since the tail16′ is made from braided fibers, the first tail sleeve68C′ and the second tail sleeve68D′ are formed by a passage formed by the braided fibers that extends from the first end66A′ to the second end66B′. Ends of each of the first tail sleeve68C′ and the second tail sleeve68D′ are formed by openings in the braided fibers.

With additional reference toFIG. 17, the first portion66′ of the suture tail12′ includes a first end66A′ that is opposite to a second end66B′. The threader92′ is inserted through the first portion66′ at or proximate to the second end66B′ to define a third tail sleeve66C′ in the first portion66′. The second end68B′ of the second portion68′ is inserted through the threader92′, and the threader92′ is withdrawn through the third tail sleeve66C′ in order to draw the second portion68′ into the third tail sleeve66C′, as illustrated inFIG. 18.

With additional reference toFIG. 19, the first end66A′ of the first portion66′ is inserted through the loop68E′ of the second portion68′, and the first end66A′ is pulled, which pulls the third tail sleeve66C′ over and past the first tail sleeve68C′ and onto the second tail sleeve68D′, as illustrated inFIG. 20. With additional reference toFIG. 21, an excess area of the second portion68′ proximate to the first end68A′ is cut from a remainder of the second portion68′. As illustrated inFIG. 22, the first portion66′ and the second portion68′ are then pulled apart to strengthen the connection between the first portion66′ and the second portion68′, and thereby form the suture tail12′ of the knotless suture anchor device10′.

To make it easier for a surgeon to distinguish between the first portion66′ and the second portion68′ of the suture tail12′, the first portion66′ and the second portion68′ can be configured in any suitable manner to facilitate distinction therebetween, such as visual distinction therebetween. For example, the first portion66′ and the second portion68′ can include or consist of different colors, and/or different design patterns, and/or any of the tracers22,210,320,420,620,720described herein configured in any suitable manner to distinguish the first and second portions66′ and68′ from one another. The first and second portions66′ and68′ can also have different thicknesses or weights. The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.