Knotless suture anchor

Abstract

Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a suture anchor is provided that includes a proximal component, a distal component, and an intermediate component positioned between the distal component and the proximal component. The proximal and distal components can each be configured to move independent of one another and to move relative to the intermediate component. In this way, the proximal, intermediate, and distal components of the suture anchor can be configured to cooperate with one another to prevent removal of the suture anchor from a bone hole in which the suture anchor is disposed and to lock a suture relative to the suture anchor and to the bone hole.

What is claimed is: 
     
         1 - 5 . (canceled) 
     
     
         6 . A surgical system, comprising:
 a surgical instrument including a proximal portion and a distal portion, the distal portion including a first thread;   an anchor configured to be implanted in bone, the anchor including an internal thread and an external thread; wherein:   the anchor is configured to move from a first configuration to a second configuration and from the second configuration to a third configuration;   in the first configuration the internal thread of the anchor is threadably engaged with the first thread of the surgical instrument, and the external thread of the anchor is not threadably engaged with the bone;   in the second configuration the internal thread of the anchor is threadably engaged with the first thread of the surgical instrument, and the external thread of the anchor is threadably engaged with the bone;   in the third configuration the internal thread of the anchor is not threadably engaged with the first thread of the surgical instrument, and the external thread of the anchor is threadably engaged with the bone;   the proximal portion of the surgical instrument is configured to move relative to the distal portion of the surgical instrument and thereby cause the anchor to move from the first configuration to the second configuration; and   the proximal and distal portions of the surgical instrument are configured to move relative to the proximal portion of the surgical instrument and thereby cause the anchor to move from the second configuration to the third configuration.   
     
     
         7 . The system of  claim 6 , wherein the movement of the proximal and distal portions of the surgical instrument is configured to unthread the internal thread and the first thread of the surgical instrument. 
     
     
         8 . The system of  claim 6 , wherein the anchor has a hole formed through a sidewall thereof;
 the hole is configured to receive a suture therethrough; and   the movement of the anchor from the first configuration to the second configuration is configured to cause the suture to be fixed between the bone and the external thread of the anchor.   
     
     
         9 . The system of  claim 6 , wherein the anchor includes a proximal portion that includes the external thread, and the anchor includes a distal portion that includes the internal thread. 
     
     
         10 . The system of  claim 9 , wherein the movement of the anchor from the second configuration to the third configuration is configured to cause the distal portion of the anchor to move proximally relative to the proximal portion of the anchor. 
     
     
         11 . The system of  claim 9 , wherein the anchor includes an intermediate portion;
 in the first and second configurations the distal portion of the anchor seats a first portion of the intermediate portion of the anchor therein; and   in the third configuration the distal portion of the anchor seats a second, larger portion of the intermediate portion of the anchor therein.   
     
     
         12 . The system of  claim 11 , wherein in the first, second, and third configurations the intermediate portion of the anchor seats the proximal portion of the anchor therein. 
     
     
         13 . The system of  claim 9 , wherein the anchor includes an intermediate portion with a hole formed through a sidewall thereof;
 the hole is configured to receive a suture therethrough; and   the movement of the anchor from the second configuration to the third configuration is configured to fix the suture between the distal portion of the anchor and the intermediate portion of the anchor.   
     
     
         14 . The system of  claim 13 , wherein the movement of the anchor from the first configuration to the second configuration is configured to cause the suture to be fixed between the bone and the external thread of the anchor. 
     
     
         15 . The system of  claim 9 , wherein the movement of the anchor from the second configuration to the third configuration is configured to cause the distal portion of the anchor to increase in width. 
     
     
         16 . A surgical method, comprising:
 threading an external thread of an anchor into bone using a surgical instrument that is threadably engaged with an internal thread of the anchor; and   after threading the external thread of the anchor into the bone, moving the surgical instrument, which is threadably engaged with the internal thread of the anchor, proximally relative to a proximal portion of the anchor, thereby simultaneously causing
 a distal portion of the anchor to increase in width, and 
 the distal portion of the anchor to move proximally relative to the proximal portion of the anchor. 
   
     
     
         17 . The method of  claim 16 , wherein moving a proximal portion of the surgical instrument relative to a distal portion of the surgical instrument causes the threading of the external thread of the anchor into the bone; and
 moving the proximal and distal portions of the surgical instrument relative to the proximal portion of the surgical instrument causes the distal portion of the anchor to move proximally relative to the proximal portion of the anchor.   
     
     
         18 . The method of  claim 16 , wherein moving the surgical instrument proximally includes axial translation of the surgical instrument relative to the proximal portion of the anchor; and
 the method further comprises, after the distal portion of the anchor has increased in width and after the distal portion of the anchor has moved proximally relative to the proximal portion of the anchor, rotating the surgical instrument relative to the proximal and distal portions of the anchor, thereby causing the surgical instrument to unthread from the internal thread of the anchor.   
     
     
         19 . The method of  claim 16 , wherein the anchor includes an intermediate portion in which the proximal portion of the anchor is seated during the threading of the external thread of the anchor into the bone and during the proximal movement of the distal portion of the anchor relative to the proximal portion of the anchor; and
 the proximal movement of the distal portion of the anchor is also relative to the intermediate portion of the anchor.   
     
     
         20 . The method of  claim 16 , the threading of the external thread of the anchor into the bone causes a suture extending through a hole formed in a sidewall of the anchor to be fixed between the bone and the external thread of the anchor. 
     
     
         21 . The method of  claim 20 , wherein the hole is formed in an intermediate portion of the anchor; and
 the proximal movement of the distal portion of the anchor causes the suture to be fixed between the distal portion of the anchor and the intermediate portion of the anchor.   
     
     
         22 . The method of  claim 21 , wherein the proximal movement of the distal portion of the anchor is also relative to the intermediate portion of the anchor. 
     
     
         23 . A surgical method, comprising:
 with a cannulated proximal portion of an anchor seated in a cannulated intermediate portion of the anchor and with a suture extending through a hole in the anchor, rotating the proximal portion of the anchor relative to a cannulated distal portion of the anchor, thereby threading the proximal portion of the anchor into bone and causing a first length of the suture to become fixed between the bone and the proximal portion of the anchor; and   after threading the proximal portion into the bone, moving the distal portion of the anchor proximally relative to the proximal and intermediate portions of the anchor, thereby causing the distal portion of the anchor to increase in width and causing a second length of the suture to become fixed between the distal portion of the anchor and the intermediate portion of the anchor.   
     
     
         24 . The method of  claim 23 , wherein rotating a proximal portion of a surgical instrument relative to a distal portion of the surgical instrument causes the rotation of the proximal portion of the anchor relative to the distal portion of the anchor; and
 translating the proximal and distal portions of the surgical instrument proximally relative to the proximal and intermediate portions of the anchor causes the movement of the distal portion of the anchor proximally relative to the proximal and intermediate portions of the anchor.   
     
     
         25 . The method of  claim 24 , wherein the surgical instrument is threadably engaged with the distal portion of the anchor during the rotation of the proximal portion of the surgical instrument relative to the distal portion of the surgical instrument; and
 the method further comprises, after the movement of the distal portion of the anchor proximally relative to the proximal and intermediate portions of the anchor, rotating the surgical instrument relative to the distal portion of the anchor such that the surgical instrument unthreads from the distal portion of the surgical instrument.   
     
     
         26 . The method of  claim 23 , wherein moving the distal portion of the anchor proximally relative to the proximal and intermediate portions of the anchor also causes the distal portion of the anchor to decrease in height.