Adjustable loop with locking knot

Abstract

Systems, devices, and methods for soft tissue repair are generally provided and they generally involve the use of surgical filaments that are configured in a variety of manners to minimize and/or eliminate the tying of knots during a surgical procedure. Moreover, systems and devices described herein can provide for a reversible locking knot, which allows for additional tension to be applied to the repair if adjustments are required after the construct has been locked. The reversible locking knot can be “flipped” or actuated without requiring the knot to be untied and then retied. Further, systems and devices described herein can additionally be used to associate implantable bodies and suture constructs within a bone to secure soft tissue while not restricting the relative movements of operative sutures once the implantable body has been deployed.

What is claimed is: 
     
         1 . A suture construct, comprising:
 a filament loop having a slidable knot, the filament loop defining an opening having an adjustable diameter;   an adjustable limb extending from the slidable knot and configured to adjust the adjustable diameter of the opening when tension is applied thereto to move the adjustable limb with respect to the slidable knot;   a fixed loop extending from the slidable knot, the fixed loop defining an opening having a fixed diameter, the fixed loop having a first, unlocked configuration and a second, locked configuration; and   an implantable body coupled to the filament loop,   wherein, when the fixed loop is in the first, unlocked configuration, the adjustable limb is movable with respect to the slidable knot and the adjustable diameter of the filament loop is adjustable, and when the fixed loop is in the second, locked configuration, the adjustable limb is prevented from moving with respect to the slidable knot such that the adjustable diameter of the filament loop is fixed.   
     
     
         2 . The suture construct of  claim 1 , wherein the filament loop, the adjustable limb, and the fixed loop are formed from a single filament. 
     
     
         3 . The suture construct of  claim 1 , wherein the implantable body comprises a filament. 
     
     
         4 . The suture construct of  claim 1 , wherein the implantable body comprises at least one cortical button. 
     
     
         5 . The suture construct of  claim 1 , wherein the fixed loop is rotatable with respect to the slidable knot such that rotation of the fixed loop with respect to the slidable knot moves the fixed loop from the first, unlocked configuration to the second, locked configuration. 
     
     
         6 . The suture construct of  claim 1 , wherein the second, locked configuration is reversible such that the fixed loop can be moved from the second, locked configuration to the first, unlocked configuration. 
     
     
         7 . The suture construct of  claim 1 , wherein the adjustable limb passes through the slidable knot and has a substantially straight configuration within the slidable knot when the fixed loop is in the first, unlocked configuration, and has a tortious configuration within the slidable knot when the fixed loop is in the second, locked configuration. 
     
     
         8 . An implant, comprising:
 a soft anchor configured to be fixated in bone and formed of a flexible construct, the soft anchor having an unstressed configuration with a first length and a first diameter and an anchoring configuration with a second length that is less than the first length and a second diameter that is greater than the first diameter;   a filament extending from the soft anchor and configured to apply tension to the soft anchor to move it from the unstressed configuration to the anchoring configuration; and   a suture attachment loop formed from the filament, the suture attachment loop defining an opening having a fixed diameter configured to receive a suture therethrough.   
     
     
         9 . The implant of  claim 8 , wherein the filament further comprises an adjustable anchor loop. 
     
     
         10 . The implant of  claim 9 , wherein the soft anchor is disposed on the adjustable anchor loop and the filament extending from the soft anchor is configured to adjust the diameter of the adjustable anchor loop. 
     
     
         11 . The implant of  claim 8 , wherein the filament further comprises a locking knot configured to have a first configuration in which the locking knot permits the soft anchor to be adjusted and a second configuration in which the locking knot locks the configuration of the soft anchor. 
     
     
         12 . A method of manufacturing a suture construct, comprising:
 forming an overhand knot on a limb of a single piece of suture, the suture having a first terminal end and a second terminal end, the overhand knot being in an uncollapsed configuration such that an opening is formed by the limb;   inserting the second terminal end of the suture through the opening of the overhand knot to create a sliding loop;   inserting the first end of the suture through the opening to form an eyelet; and   collapsing the overhand knot such that each of the sliding loop, the eyelet, the first end, and the second end extend from the collapsed overhand knot, with a size of the sliding loop being adjustable by the second end and the size of the eyelet being adjustable by the first end.   
     
     
         13 . The method of  claim 12 , further comprising:
 tying a half-hitch knot around a portion of the single piece of suture with the eyelet to form a lock,   wherein, upon actuation of the lock, a size of an opening defined by the sliding loop is fixed.   
     
     
         14 . The method of  claim 12 , further comprising threading a soft anchor onto the sliding loop.