Soft Tissue Fixation Using A Looped Suture Construct

Abstract

A looped suture construct is formed by looping a suture on itself and slidably connecting the suture through an anchoring structure such that a looped end and a free end of the suture are on opposite sides of the slidable connection. The anchoring structure may be bone, a suture anchor, or another structure securely attached to bone. The looped end and the free end are passed through the soft tissue to be repaired. The free end is then passed through the looped end. Tension is applied to the free end to draw the soft tissue into contact with the desired bone, whereupon the free end is secured to maintain the tension. The looped suture end remains open and positioned on one side or surface of the soft tissue. Suture anchors of the invention are pre-loaded with at least one suture having a looped end and at least one free end.

1 . A method of suturing soft tissue comprising:
 passing a loop of suture through soft tissue, the loop of suture exiting the tissue through a first tissue surface;   passing a free end of the suture through the soft tissue adjacent the loop of suture, the free end of the suture exiting the tissue through the first tissue surface, wherein the suture is slidably connected to a suture attaching mechanism of an anchoring structure such that the attaching mechanism is between the loop of suture and the free end of the suture;   passing the free end of the suture through the loop of suture;   applying tension to the free end of the suture such that the soft tissue is pulled into contact with a desired structure and the loop of suture remains open and positioned on the first tissue surface; and   securing the free end of the suture to maintain the applied tension.   
     
     
         2 . The method of  claim 1  further comprising prior to the passing of a free end of suture through the soft tissue:
 passing the free end of the suture through the suture attaching mechanism of the anchoring structure. 
 
     
     
         3 . The method of  claim 1  further comprising:
 passing a second free end of the suture through the soft tissue adjacent the loop of suture, the second free end of suture exiting the tissue through the first tissue surface, wherein the suture attaching mechanism is between the loop of suture and the second free end of the suture; 
 passing the second free end of the suture through the loop of suture; 
 applying tension to the second free end of the suture such that the soft tissue is pulled into contact with the desired structure and the loop of suture remains open and positioned on the first tissue surface; and 
 securing the second free end of the suture to maintain the applied tension on the second free end. 
 
     
     
         4 . The method of  claim 1  wherein the securing of the free end of the suture to maintain the applied tension comprises:
 securing a second free end of the suture to the free end of the suture to maintain the applied tension, wherein the suture attaching mechanism is between the loop of suture and the second free end of the suture. 
 
     
     
         5 . The method of  claim 4  further comprising before the securing of the second free end of the suture to the free end of the suture:
 passing the second free end of the suture through the soft tissue adjacent the loop of suture, the second free end of the suture exiting the tissue through the first tissue surface. 
 
     
     
         6 . The method of  claim 1  wherein the securing of the free end of the suture to maintain the applied tension comprises attaching the free end of the suture to a suture anchor implanted in the desired structure. 
     
     
         7 . The method of  claim 1  further comprising implanting the anchoring structure into the desired structure. 
     
     
         8 . The method of  claim 1  wherein the anchoring structure has the loop of suture and the free end of the suture pre-loaded therein such that the suture attaching mechanism is between the loop of suture and the free end of the suture. 
     
     
         9 . The method of  claim 1  wherein the anchoring structure comprises a suture anchor. 
     
     
         10 . The method of  claim 1  wherein the suture attaching mechanism comprises an eyelet. 
     
     
         11 . The method of  claim 1  wherein the desired structure comprises bone. 
     
     
         12 . The method of  claim 1  wherein the anchoring structure and the desired structure are the same. 
     
     
         13 . The method of  claim 1  wherein the soft tissue comprises a tendon, ligament, or muscle. 
     
     
         14 . A method of suturing soft tissue comprising:
 passing a first free end of suture through soft tissue, the first free end exiting the tissue through a first tissue surface;   passing the first free end of suture back through the soft tissue to form a loop of suture on the first tissue surface, the first free end exiting the tissue through a second tissue surface;   passing a second free end of the suture through the soft tissue adjacent the loop of suture, the second free end exiting the tissue through the first tissue surface, wherein the suture is slidably connected to a suture attaching mechanism of an anchoring structure such that the attaching mechanism is between the loop of suture and the second free end;   passing the second free end of the suture through the loop of suture;   applying tension to the first and second free ends of the suture such that the soft tissue is pulled into contact with a desired structure and the loop of suture remains open and positioned on the first tissue surface; and   securing the first and second free ends of the suture to maintain the applied tension.   
     
     
         15 . The method of  claim 14  further comprising passing the first free end of the suture through the suture attaching mechanism of the anchoring structure after forming the loop of suture. 
     
     
         16 . The method of  claim 15  wherein the securing of the first and second free ends comprises:
 passing the first free end of suture through the soft tissue after passing the first free end through the suture attaching mechanism, the first free end exiting the tissue through the first tissue surface; and 
 tying the first and second free ends of the suture together into a knot. 
 
     
     
         17 . The method of  claim 14  further comprising pre-loading the anchoring structure with the suture such that the suture attaching mechanism is between the first and second free ends of the suture. 
     
     
         18 . The method of  claim 17  further comprising implanting the anchoring structure into the desired structure. 
     
     
         19 . A method of forming a suture anchor comprising:
 forming a body configured to be implanted into bone;   connecting to or integrating with the body a suture attaching mechanism configured to provide a slidable connection to suture attached thereto;   looping a suture on itself to create a looped end of the suture and at least one free end of the suture; and   connecting the suture to the attaching mechanism such that the attaching mechanism is between the looped end and the at least one free end.   
     
     
         20 . The method of  claim 19  wherein the suture looped on itself has two free ends, the method further comprising after the looping of a suture on itself:
 bonding one of the two free ends to the suture itself to form the looped end and the at least one free end. 
 
     
     
         21 . The method of  claim 20  wherein the connecting of the suture to the attaching mechanism comprises connecting the suture to the attaching mechanism such that the looped end and the bonding of one the two free ends to the suture is on one side of the attaching mechanism and the at least one free end is on another side of the attaching mechanism. 
     
     
         22 . The method of  claim 20  wherein the connecting of the suture to the attaching mechanism comprises connecting the suture to the attaching mechanism such that the looped end is on one side of the attaching mechanism and the bonding of one the two free ends to the suture and the at least one free end are on another side of the attaching mechanism. 
     
     
         23 . A suture anchor comprising:
 a body configured to be implanted into bone;   a suture having a looped end and at least one free end; and   a suture attaching mechanism connected to or integrally formed with the body and configured to provide a slidable connection to suture connected thereto, the suture attaching mechanism connected to the suture between the looped end and the at least one free end.   
     
     
         24 . The suture anchor of  claim 23  wherein:
 the suture has two free ends; and 
 the suture attaching mechanism is connected to the suture between the looped end and the two free ends. 
 
     
     
         25 . The suture anchor of  claim 23  wherein the suture attaching mechanism comprises an eyelet. 
     
     
         26 . The suture anchor of  claim 23  further comprising a plurality of sutures slidably connected to the suture attaching mechanism, each of the plurality of sutures having a looped end and at least one free end, the suture attaching mechanism connected between each looped end and its respective at least one free end. 
     
     
         27 . The suture anchor of  claim 23  wherein the body comprises self-tapping threads. 
     
     
         28 . A looped suture construct comprising:
 a suture having a looped end and at least one free end; and   a suture anchor slidably connected to the suture such that the suture anchor is between the looped end and the at least one free end; wherein:   the looped end is open and positioned on a surface of a soft tissue;   the at least one end is passed through the soft tissue and the looped end and is tensioned such that the looped end remains open and positioned on the soft tissue surface; and   the at least one free end is secured to maintain the tension.   
     
     
         29 . The looped suture construct of  claim 28  wherein:
 the suture has a second free end; 
 the suture anchor is between the looped end and the second free end; and 
 the at least one free end is secured to the second free end to maintain the tension. 
 
     
     
         30 . The looped suture construct of  claim 28  wherein:
 the suture has a second free end; 
 the suture anchor is between the looped end and the second free end; 
 the second free end is passed through the looped end and tensioned such that the looped end remains open and positioned on the soft tissue surface; and 
 the second free end is secured to maintain the tension.