Patent Description:
Arthroscopic procedures often include sutures and anchors to secure soft tissue to bone. Despite their widespread use, sutures and suture anchors, as well as methods for their use, can be improved. For example, tying sutures to anchors can be very time consuming and difficult to perform. As a result, the cost of the procedure can be increased and the capacity of the surgeon can be limited. Current suture anchor constructs can include a sliding suture that usually requires a surgeon to tie knots in order to fix the suture to the anchor. <CIT>, <CIT>, <CIT> and <CIT> relate to suture anchors.

The systems disclosed herein address the issues with sliding sutures.

The invention is disclosed in independent claim <NUM>. Further exemplary embodiments are shown in the dependent claims.

To better illustrate the systems disclosed herein, a non-limiting list of examples is provided below.

The invention provides a suture anchor construct comprising: an anchor including a post and a body, the body defining a central hole extending from a trailing end of the body along a central axis towards a leading end of the body; a first suture including a first tail, a second tail, and a first intermediate portion, the first intermediate portion located proximate the post, the first and second tails passing through the central hole; and a second suture having a third tail, a fourth tail, and a second intermediate portion, the second intermediate portion secured to the post, the third and fourth tails passing through the central hole characterised in that the post includes a barb, the barb passing through the second intermediate portion.

Also described in Example <NUM> is a suture anchor construct comprising: an anchor including a post and a body, the body defining: a central hole extending from a trailing end of the body along a central axis; and a radial hole located proximate a leading end of the body and passing through the body, the post extending from a first portion of the radial hole to a second portion of the radial hole; a first suture including a first tail, a second tail, and a first intermediate potion, the first intermediate portion located proximate the post, the first and second tails passing through the central hole; and a second suture including a third tail, a fourth tail, and a second intermediate portion, the second intermediate portion forming a hitch knot that fixedly secures the second suture to the post, the third and fourth tails passing through the central hole.

In Example <NUM>, the subject matter of Example <NUM> optionally includes wherein the second intermediate portion is located in between the post and the first intermediate portion.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the first intermediate portion is located in between the post and the second intermediate portion.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the hitch knot includes the second intermediate portion forming a loop that is wrapped around the post.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the hitch knot includes a sliding knot.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the post defines a through hole, the second suture passing through the through hole, the hitch knot located at a distal end of the through hole.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the first suture passes through the hitch knot.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the post includes a barb, the hitch knot tied to the barb.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the first suture is secured to the post.

Example <NUM> is a suture anchor construct comprising: an anchor having a post and a body defining: a central hole extending from a trailing end of the body along a central axis, and a radial hole located proximate a leading end of the body and passing through the body, the post extending from a first portion of the radial hole to a second portion of the radial hole; a first suture having a first tail, a second tail, and a first intermediate portion located proximate the post, the first and second tails passing through the central hole; and a second suture having a third tail, a fourth tail, and a second intermediate portion secured to the post, the third and fourth tails passing through the central hole.

In Example <NUM>, the subject matter of Example <NUM> optionally includes wherein the post includes a first portion and a second portion located in between the first portion and the trailing end of the body, the second intermediate portion wrapped around the first portion.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the second intermediate portion secured to the post includes the post having a barb that passes through the second intermediate portion.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include wherein the second intermediate portion secured to the post includes the second intermediate portion partially surrounds the post.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include a plug configured to fit into the central hole, the plug includes first and second passages, the first tail passing through the first passage and the second tail passing through the second passage.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include a pin passing through the second intermediate portion proximate the post.

In Example <NUM>, the subject matter of any one or more of Examples <NUM>-<NUM> optionally include a tube located proximate the post, the third and fourth tails passing through the tube.

In Example <NUM>, the suture anchor constructs of any one of or any combination of Examples <NUM>-<NUM> are optionally configured such that all elements or options recited are available to use or select from.

The above-mentioned and other features and advantages of this disclosure, and the manner of attaining them, will become more apparent and the disclosure itself will be better understood by reference to the following description of embodiments taken in conjunction with the accompanying drawings, wherein:.

Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate exemplary embodiments of the disclosure, and such exemplifications are not to be construed as limiting the scope of the disclosure in any manner.

As disclosed herein, fixed sutures within an anchor can eliminate the need for a surgeon to tie knots for fixation. The free ends of the fixed sutures can be passed through soft tissue to a knotless anchor for a faster procedure. The suture constructs disclosed herein can include a fixed suture configuration where at least one suture is fixed to an anchor without a surgeon having to tie a knot or otherwise secure the suture to the anchor. As a result, the free ends of a suture can be passed through soft tissue and directly passed to a knotless anchor resulting in decreased time for a procedure. For example, the free ends of a fixed suture can be passed through the supraspinatus tendon, the subscapularis tendon, or the infraspinatus tendon during a rotator cuff repair procedure and then secured to each other using knots.

As used herein proximal refers to a location on a bone anchor that is closer to the physician. Distal refers to a location on a bone anchor that is away from the physician. Leading end refers to a tip or distal portion of a bone anchor. Trailing end refers to a tail or proximal portion of a bone anchor.

Turning now to the figures, <FIG> shows a surgical site <NUM> in accordance with at least one example of the present disclosure. As shown in <FIG>, surgical site <NUM> can include a bone <NUM> in which one or more suture anchor constructs <NUM> may be implanted. Each of suture anchor constructs <NUM> can include an anchor <NUM>, a first suture <NUM>, and a second suture <NUM>. Suture anchor constructs <NUM> can be used to secure tissue <NUM> to bone <NUM> as disclosed herein. Surgical site <NUM> can represent any surgical procedure where tissue can be attached to or otherwise anchored to bone.

<FIG> shows a method <NUM> for securing tissue to bone and will be described with reference to <FIG>. During surgery, a surgeon can drill one or more holes <NUM> in bone <NUM> (<NUM>). Drilling holes <NUM> can include using a drill guide or other surgical instruments to locate holes <NUM> and/or sturdy the drilling equipment used to drill holes <NUM>.

After holes <NUM> are drilled anchors <NUM> can be implanted into bone <NUM> (<NUM>). Implanting anchors <NUM> can include using an inserter to screw anchors <NUM>, which can include a threaded exterior surface, into bone <NUM>. Anchors <NUM> can also include barbs, a porous metal coating, and/or other features to secure anchors <NUM> within holes <NUM>. Thus, anchors <NUM> can be pressed into bone <NUM> as well as screwed into bone <NUM>.

With anchors <NUM> securely implanted into bone <NUM>, any combination of first and second sutures <NUM> and <NUM> can be passed thought tissue <NUM> (<NUM>). Any one of second sutures <NUM>, which are fixedly secured to a respective anchor <NUM>, can be passed through tissue <NUM>. As disclosed herein, the fixed nature of second suture <NUM> can allow the surgeon to secure tissue <NUM> to bone <NUM> without the need to first secure second suture <NUM> to anchors <NUM>. First sutures <NUM> can also be passed through tissue <NUM> in preparation for securing tissue <NUM> to bone <NUM>.

After passing at least one of first sutures <NUM> or second sutures <NUM> through tissue <NUM>, tissue <NUM> can be secured to bone <NUM> (<NUM>). For example, using second sutures <NUM>, which are now secured to bone <NUM> in an immovable manner, the surgeon can pull free ends of second sutures <NUM> to apply tension to tissue <NUM> and manipulate tissue <NUM> into a desired position. Once tissue <NUM> is in a desired position, the surgeon can tie the free ends of first and second sutures <NUM> and <NUM> together or to other sutures and/or anchors.

By having second sutures <NUM> secured to anchors <NUM>, time can be saved in the operating room because the surgeon or other medical staff can pass seconds suture <NUM> through the tissue and have it anchored down with a knotless anchor, such as anchors <NUM>, before inserting anchors <NUM>. In addition, second sutures <NUM> being secured to anchors <NUM> can aid the surgeon in positioning tissue <NUM> due to the fixed nature of a portion of second suture <NUM>.

<FIG> shows a suture anchor construct <NUM>, such as suture anchor construct <NUM>, in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM>, a first suture <NUM>, and a second suture <NUM>. Anchor <NUM> can include a body <NUM> that defines a central hole <NUM> and a radial hole <NUM>. Anchor <NUM> can include a post <NUM> that extends from a first portion of radial hole <NUM> to a second portion of radial hole <NUM>. Stated another way, post <NUM> can span from one side of anchor <NUM> to another side of anchor <NUM> within radial hole <NUM>. Radial hole <NUM> and post <NUM> can be located proximate to the leading end of anchor <NUM>.

First suture <NUM> can include a first tail <NUM>, a second tail <NUM>, and a first intermediate portion <NUM> located in between first tail <NUM> and second tail <NUM>. Second suture <NUM> can include a third tail <NUM>, a fourth tail <NUM>, and a second intermediate portion <NUM> located in between third tail <NUM> and fourth tail <NUM>.

Consistent with embodiments disclosed herein, first suture <NUM> can be free to move about post <NUM>. By having first suture <NUM> being free to move, a surgeon can reposition first suture <NUM> as need. By repositioning first suture <NUM> the surgeon can adjust the lengths of first tail <NUM> and second tail <NUM> without having to cut first suture <NUM>. The surgeon also has the option to tie knots if they want, or they can remove first suture <NUM> if they want.

Second suture <NUM> can be secured to post <NUM>. As shown in <FIG>, second intermediate portion <NUM> can be wrapped around post <NUM>. A knot <NUM> can be tied in second intermediate portion <NUM> to fixedly secure second suture <NUM> to post <NUM>. For example, knot <NUM> can be sliding or fixed hitch knot. Knot <NUM> can also be tied first first and anchor <NUM> can then be overmolded to form post <NUM> and secure second suture <NUM> to post <NUM>.

By having second suture <NUM> secured to post <NUM>, the surgeon can initially secure tissue to a bone, such as bone <NUM>, in which anchor <NUM> can be implanted. The secured nature of second suture <NUM> can allow the surgeon to initially secure tissue, such as tissue <NUM>, to a bone. For example, using second suture <NUM>, the surgeon can pass fourth tail <NUM> through the tissue and manipulate fourth tail <NUM> to position the tissue. Fourth tail <NUM> can then be tied to third tail <NUM>, first suture <NUM>, bone, and/or other anatomical or implanted structures within the patient.

Tails <NUM>, <NUM>, <NUM>, and <NUM> can be used to secure the tissue. For example, once the tissue is secured using fourth tail <NUM>, the surgeon can then use first tail <NUM> and second tail <NUM> to further secure the tissue.

<FIG> shows first suture <NUM> located in between second suture <NUM> and an interior surface <NUM>. This configuration can allow first suture <NUM> to move relative to post <NUM> and second suture <NUM>.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM>, a first suture <NUM>, and a second suture <NUM>. Anchor <NUM> can include a body <NUM> that defines a central hole <NUM> and a radial hole <NUM>. Anchor <NUM> can include a post <NUM> that extends from a first portion of radial hole <NUM> to a second portion of radial hole <NUM>. Post <NUM> can define a through-hole <NUM>. Radial hole <NUM> and post <NUM> can be located proximate to a leading end of anchor <NUM>.

First suture <NUM> can include a first tail <NUM>, a second tail <NUM>, and a first intermediate portion <NUM> located in between first tail <NUM> and second tail <NUM>. Second suture <NUM> can include a third tail <NUM>, a fourth tail <NUM>, and a second intermediate portion <NUM> located in between third tail <NUM> and fourth tail <NUM>. As shown in <FIG>, first suture <NUM> can pass around post <NUM>. In addition, first tail <NUM> and/or second tail <NUM> can pass through through-hole <NUM>.

Consistent with embodiments disclosed herein, first suture <NUM> can be free to move about post <NUM> as disclosed above with respect to <FIG>.

Second suture <NUM> can be secured to post <NUM>. As shown in <FIG>, second intermediate portion <NUM> can be tied into a knot <NUM>. Knot <NUM> can be tied at a midpoint of second suture <NUM> or at any point along second suture <NUM>.

The diameter of through-hole <NUM> can be smaller than the knot <NUM>. As a result, knot <NUM> cannot pass back through through-hole <NUM>. In other words, tension on third and fourth tails, <NUM> and <NUM>, can cause knot <NUM> to become wedged in through-hole <NUM>. While <FIG> shows through-hole <NUM> having a cylindrical profile, through-hole <NUM> can have a conical profile. Thus, as tension in third and fourth tails, <NUM> and <NUM>, is increased, the force applied to knot <NUM> by the walls of through-hole <NUM> can increase.

By having second suture <NUM> secured to post <NUM>, the surgeon can initially secure tissue to a bone, such as bone <NUM>, in which anchor <NUM> can be implanted. The secured nature of second suture <NUM> can allow the surgeon to initially secure tissue, such as tissue <NUM>, to a bone as disclosed above with respect to <FIG>.

<FIG> shows first suture <NUM> located in between second suture <NUM> and an interior surface <NUM>. This configuration can allow first suture <NUM> to move relative to post <NUM> and second suture <NUM> as disclosed above with respect to <FIG>. Still consistent with embodiments disclosed herein, first suture <NUM> can be fixed to post <NUM>. In addition, first suture <NUM> can pass through knot <NUM>.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM>, a first suture <NUM>, and a second suture <NUM>. Anchor <NUM> can include a body <NUM> that defines a central hole <NUM> and a radial hole <NUM>. Anchor <NUM> can include a post <NUM> that extends from a first portion of radial hole <NUM> to a second portion of radial hole <NUM>. Radial hole <NUM> and post <NUM> can be located proximate to a leading end of anchor <NUM>.

Second suture <NUM> can be secured to post <NUM>. As shown in <FIG>, second intermediate portion <NUM> can be wrapped around post <NUM>. A pin <NUM> can pass through second intermediate portion <NUM> to fixedly secure second suture <NUM> to post <NUM>.

By having second suture <NUM> secured to post <NUM>, the surgeon can initially secure tissue to a bone, such as bone <NUM>, in which anchor <NUM> can be implanted. The secured nature of second suture <NUM> can allow the surgeon to initially secure tissue, such as tissue <NUM>, as disclosed above with respect to <FIG>.

<FIG> shows first suture <NUM> located in between second suture <NUM> and an interior surface <NUM>. This configuration can allow first suture <NUM> to move relative to post <NUM> and second suture <NUM> as disclosed above with respect to <FIG>. Still consistent with embodiments disclosed herein, first suture <NUM> can be fixed to post <NUM>. For example, pin <NUM> can pass through first suture <NUM> just as with second suture <NUM>. In addition, a second pin (not shown) can pass through first suture <NUM> to second suture <NUM>.

<FIG> shows a suture anchor construct <NUM> in accordance with claim <NUM> of the present disclosure. Suture anchor construct <NUM> includes an anchor <NUM>, a first suture <NUM>, and a second suture <NUM>. Anchor <NUM> includes a body <NUM> that defines a central hole <NUM> and an optional radial hole <NUM>. Anchor <NUM> includes a post <NUM> that extends from a first portion of radial hole <NUM> to a second portion of radial hole <NUM>. Radial hole <NUM> and post <NUM> are located proximate to a leading end of anchor <NUM>.

First suture <NUM> includes a first tail <NUM>, a second tail <NUM>, and a first intermediate portion <NUM> located in between first tail <NUM> and second tail <NUM>. Second suture <NUM> includes a third tail <NUM>, a fourth tail <NUM>, and a second intermediate portion <NUM> located in between third tail <NUM> and fourth tail <NUM>.

Second suture <NUM> is secured to post <NUM>. As shown in <FIG>, post <NUM> includes a protrusion or barb <NUM>. Barb <NUM> extends from a distal side of post <NUM>. Barb <NUM> includes a point that allows barb <NUM> to pierce and pass through second suture <NUM>. Still consistent with embodiments disclosed herein, second suture <NUM> can be tied to barb <NUM> instead of or in addition to being punctured by barb <NUM>.

First suture <NUM> can move relative to post <NUM> and second suture <NUM> as disclosed above with respect to <FIG>. Still consistent with embodiments disclosed herein, first suture <NUM> can be fixed to post <NUM>. For example, barb <NUM> can pass through first suture <NUM> or first suture <NUM> can be tied to barb <NUM> just as with second suture <NUM>.

First suture <NUM> and second suture <NUM> can be secured to post <NUM>. As shown in <FIG>, post <NUM> can define a hole <NUM> which can divide post <NUM> into two portions. Tails <NUM>, <NUM>, <NUM>, and <NUM> can be passed through hole <NUM> and wrapped around a distal portion of post <NUM>. As shown in <FIG>, first suture <NUM> and second suture <NUM> can be woven together to further secure first suture and second suture <NUM> to the distal portion of post <NUM>.

By having first suture <NUM> and second suture <NUM> secured to post <NUM>, the surgeon can initially secure tissue to a bone, such as bone <NUM>, in which anchor <NUM> can be implanted. The secured nature of first suture <NUM> and second suture <NUM> can allow the surgeon to initially secure tissue, such as tissue <NUM>, to a bone as disclosed above with respect to <FIG>.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM> and a first suture <NUM>. Anchor <NUM> can include a body <NUM> that defines a central hole <NUM> and a radial hole <NUM>. Anchor <NUM> can include a post <NUM> that extends from a first portion of radial hole <NUM> to a second portion of radial hole <NUM>. Radial hole <NUM> and post <NUM> can be located proximate to a leading end of anchor <NUM>.

First suture <NUM> can include a first tail <NUM>, a second tail <NUM>, and a first intermediate portion <NUM> located in between first tail <NUM> and second tail <NUM>. While not shown, suture construct <NUM> can include a second suture as with other suture constructs disclosed herein.

First suture <NUM> can be secured to post <NUM>. As shown in <FIG>, post <NUM> can define a hole <NUM> which can divide post <NUM> into two portions. Tails <NUM> and <NUM> can be passed through hole <NUM> and wrapped around a proximal portion of post <NUM>. In leu of a knot, a plug <NUM> can be inserted into central hole <NUM>. Upon insertion of plug <NUM>, plug <NUM> can become wedged into central hole <NUM>. Friction between body <NUM>, first suture <NUM> and plug <NUM> can secure first suture to anchor <NUM>.

As disclosed herein, by having first suture <NUM> secured to post <NUM> the surgeon can initially secure tissue to a bone as disclosed above with respect to <FIG>.

First suture <NUM> can be secured to second suture <NUM>. As shown in <FIG>, first intermediate portion <NUM> and second intermediate portion <NUM> can be tied together. A knot <NUM> formed by tying first suture <NUM> and second suture <NUM> together can be located at a distal end of post <NUM>. The configuration shown in <FIG> allows first suture <NUM> and second suture <NUM> to move relative to anchor <NUM>, but not relative to one another.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM> and a first suture <NUM>. Anchor <NUM> can include a body <NUM> that defines a central hole <NUM> and a radial hole <NUM>. Radial hole <NUM> and central hole <NUM> can form an eyelet. The eyelet can be used to secure first suture <NUM> to anchor <NUM>.

First suture <NUM> can include a first tail <NUM>, a second tail <NUM>, and a first intermediate portion <NUM> located in between first tail <NUM> and second tail <NUM>. While not shown, suture construct <NUM> can include a second suture or any number of sutures as with other suture constructs disclosed herein.

First suture <NUM> can be secured to anchor <NUM>. As shown in <FIG>, first intermediate portion <NUM> can be wrapped around a distal portion of body <NUM> to form a loop that can be located outside of anchor <NUM>. First tail <NUM> and second tail <NUM> can travel back through central hole <NUM> and exit anchor <NUM>. When anchor <NUM> is inserted into bone, first intermediate portion <NUM> can be pinched in between body <NUM> and the bone, thus locking first suture <NUM> in a fixed portion.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor having a post <NUM> (the anchor body is not shown) and a first suture <NUM>. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture <NUM> can be secured to the anchor. As shown in <FIG>, first intermediate portion <NUM> can be wrapped around post <NUM> and sewn together. For example, first intermediate portion <NUM> can be wrapped around post <NUM> and another short section of suture <NUM> can pierced through both first tail <NUM> and second tail <NUM>. After piercing first intermediate portion <NUM>, suture <NUM> can be tied into a knot <NUM> to secure first suture <NUM> to post <NUM>.

The number of short sections of sutures <NUM> can equal the number of regular sutures, such as first suture <NUM>, or be different. For example, a single short section of suture <NUM> can pierce any number of regular sutures. In addition, each regular suture or groups of regular sutures can have their own respective short section of suture <NUM>.

First suture <NUM> can be secured to the anchor. As shown in <FIG>, first intermediate portion <NUM> can be wrapped around post <NUM> and a tube <NUM> can be used to secure first suture <NUM> to post <NUM>. For example, first intermediate portion <NUM> can be wrapped around post <NUM> and both first tail <NUM> and second tail <NUM> can be fed through tube <NUM>. Tube <NUM> can be tight fitting so as to maintain a position on first tail <NUM> and second tail <NUM> once placed thereon. To secure first suture <NUM> to post <NUM> tube <NUM> can be pushed until it meets post <NUM>.

The number of tubes <NUM> can equal the number of regular sutures, such as first suture <NUM> or be different. For example, a tube <NUM> can be located on any number of regular sutures. In addition, each regular suture or groups of regular sutures can have their own respective tube <NUM>.

Tube <NUM> can be a rubber band type device. The rubber band type device can be attached to both first tail <NUM> and second tail <NUM>. The rubber band type device can pull first tail <NUM> and second tail <NUM> together to prevent them from sliding.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM> having a body <NUM> that defines a radial hole <NUM> and a first suture <NUM>.

First suture <NUM> can be secured to anchor <NUM>. As shown in <FIG>, first suture <NUM> can be passed through radial hole <NUM>. Once anchor <NUM> is implanted into bone, first suture <NUM> can be compressed in between body <NUM> and the bone. The compression of first suture <NUM> can secure first suture <NUM> into a fixed state.

First suture <NUM> can be secured to post <NUM>. As shown in <FIG>, first intermediate portion <NUM> can be wrapped around post <NUM> and itself to secure first suture <NUM> to post <NUM>. For example, first intermediate portion <NUM> can be wrapped around post <NUM> and both first tail <NUM> and second tail <NUM> can be fed through loop <NUM> formed by first intermediate portion <NUM>. For instance, first suture <NUM> can be folded in half to create loop <NUM>. Loop <NUM> can then be wrapped around post <NUM>. First tail <NUM> and second tail <NUM> can then be passed through loop <NUM>.

The number of loops <NUM> can equal the number of regular sutures, such as first suture <NUM>. For example, a loop <NUM> can be formed for each regular suture. In addition, one or more regular sutures can be passed through a loop <NUM> formed by a different suture. As a result, a single loop <NUM> can be used to secure one or more sutures to post <NUM>.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor having a post <NUM> (the anchor body is not shown), a first suture <NUM>, and a second suture <NUM>. Post <NUM> can include a barb <NUM> that protrudes from a distal portion of post <NUM>. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture <NUM> and second suture <NUM> can be secured to post <NUM>. As shown in <FIG>, first intermediate portion <NUM> can be folded to form a loop <NUM> and a knot <NUM> tied in first suture <NUM>. Second intermediate portion <NUM> can be folded to form a loop <NUM> and a knot <NUM> tied in second suture <NUM>. Loops <NUM> and <NUM> can be placed around barb <NUM> thus, securing first suture <NUM> and second suture <NUM> to the anchor. Knots <NUM> and <NUM> can be hitch knots or slip nots that allow loops <NUM> and <NUM> to collapse onto barb <NUM> to prevent first suture <NUM> and second suture <NUM> from slipping off of barb <NUM>.

First suture <NUM> can be secured to post <NUM>. As shown in <FIG>, first intermediate portion <NUM> can wrapped around post <NUM>. After wrapping first intermediate portion <NUM> around post <NUM>, first tail <NUM> can piece second tail <NUM> one or more times to secure first suture <NUM> to post <NUM>. While <FIG> shows a single suture, the number of sutures can be greater than one. Each of the sutures can be twisted together to both secure the sutures together and to post <NUM>. In addition, each suture can be twisted separately or in combination with a sub grouping of sutures.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM> having a body <NUM> and a post <NUM> and a first suture <NUM>. The anchor can define a central hole <NUM> and a first radial hole <NUM> and a second radial hole <NUM>.

First suture <NUM> and can be secured to post <NUM>. As shown in <FIG>, first intermediate portion <NUM> can wrap partially around a distal end of post <NUM> and through first radial opening <NUM>. First tail <NUM> and second tail <NUM> can then re-enter central hole <NUM> via second radial passage <NUM> and exit anchor <NUM>. Once anchor <NUM> is implanted in bone <NUM>, first suture <NUM> can be compressed between bone <NUM> and anchor <NUM>.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor having a post <NUM> (the anchor body is not shown), a first suture <NUM>, and a second suture <NUM>. The anchor can define a central hole and a radial hole as disclosed herein with respect to other anchors.

First suture <NUM> can include a first tail <NUM> and a second tail <NUM> tied into a knot <NUM>. Second suture <NUM> can include a third tail <NUM> and a fourth tail <NUM> tied into a knot <NUM>. The size of knots <NUM> and <NUM> are such that they will not fit through a through hole <NUM>. While <FIG> shows first suture <NUM> and second suture <NUM> tied individually, first suture <NUM> and second suture <NUM> can be tied together.

<FIG> shows a suture anchor construct <NUM> in accordance with at least one example of the present disclosure. Suture anchor construct <NUM> can include an anchor <NUM>, a first suture <NUM>, and a second suture <NUM>. First suture <NUM> can include a first tail <NUM>, a second tail <NUM>, and a first intermediate portion <NUM> located in between first tail <NUM> and second tail <NUM>. Second suture <NUM> can include a third tail <NUM>, a fourth tail <NUM>, and a second intermediate portion <NUM> located in between third tail <NUM> and fourth tail <NUM>.

Anchor <NUM> can be formed from a braided material, such as suture materials. As shown <FIG>, the braided material can be formed from a plurality of strands <NUM>. Also as shown in <FIG>, first suture <NUM> and second suture <NUM> can pass in between various strands <NUM> to penetrate anchor <NUM>. To pass first suture <NUM> and second suture <NUM> in between the various strands <NUM>, a snare (not shown) can be used. The snare can include a wire that forms a loop or hook that can first be passed through anchor <NUM>. First suture <NUM> and second suture <NUM> can then be passed through the loop or hook of the snare and pulled through anchor <NUM>.

As shown in <FIG>, second intermediate portion <NUM> can be tied into a knot <NUM>. Knot <NUM> can secure second suture <NUM> to anchor <NUM>. Knot <NUM> can be bigger than the space between the various strands <NUM> used to form anchor <NUM>. The larger size of knot <NUM> can hinder movement of second suture <NUM> upon implanting anchor <NUM>.

Suture anchor construct <NUM> by passing first suture <NUM> and second suture <NUM> through anchor <NUM> as described herein and forming knot <NUM> to secure second suture <NUM> to anchor <NUM>. Suture anchor construct <NUM> can also be prepared by the manufacturer and delivered with first suture <NUM> and second suture <NUM> already connected to anchor <NUM> with knot <NUM> already formed to secure second suture <NUM> to anchor <NUM>.

During surgery, the surgeon can use an inserter to press anchor <NUM> into a hole drilled into bone. Upon extracting the inserter, anchor <NUM> can remain in the hole and expand, thereby securing anchor <NUM> in the hole. First tail <NUM>, a second tail <NUM>, third tail <NUM>, and a fourth tail <NUM> can extend from the hole for use by the surgeon in securing tissue to the bone.

The various knots disclosed herein can be tied in a variety of fashions. The inserter used to install the anchors can be used to pull the knots tight. For example, a suture can be wrapped around the end of the inserter and pushed through a gap such as the central passage in the trailing end the anchor. The suture can include a pre-tied, but loose, knot located at the end of the inserter that is tightened using the inserter. Tightening the knot can create a suture anchor construct that is larger than the central passage in the anchor that the suture and inserter shaft are pushed through. The inserter can then be removed and the suture tied inside the anchor, unable to slide.

Claim 1:
A suture anchor construct (<NUM>, <NUM>) comprising:
an anchor (<NUM>) including a post (<NUM>) and a body (<NUM>), the body defining a central hole (<NUM>) extending from a trailing end of the body (<NUM>) along a central axis towards a leading end of the body;
a first suture (<NUM>) including a first tail (<NUM>), a second tail (<NUM>), and a first intermediate portion (<NUM>), the first intermediate portion located proximate the post (<NUM>), the first and second tails passing through the central hole (<NUM>); and
a second suture (<NUM>) having a third tail (<NUM>), a fourth tail (<NUM>), and a second intermediate portion (<NUM>), the second intermediate portion secured to the post (<NUM>), the third and fourth tails passing through the central hole (<NUM>),
characterised in that the post (<NUM>) includes a barb (<NUM>), the barb (<NUM>) passing through the second intermediate portion (<NUM>).