Apparatus and method for securing tissue to bone with a suture

Abstract

The embodiments provided for herein relate to apparatus and methods for securing tissue to bone using a suture anchoring system that provides enhanced tactile feedback and does not require tying a suture knot. In each embodiment, a surgeon can individually tension the free ends of the suture to fine-tune the placement of the tissue with respect to the bone, and then secure the suture without tying a knot. In several embodiments, the device may be transformed between locked and unlocked suture states, thereby allowing further fine-tuning of the tension in the suture. In other embodiments, the device may permit unidirectional movement of a suture, while preventing slippage or movement of the suture and tissue in the opposite direction.

1 - 19 . (canceled)  
   
   
       20 . A method of coupling a tissue to a bone comprising: 
 positioning a bone anchor in an opening in a bone, the bone anchor comprising: 
 a body, the body comprising a cavity having a proximal end, a distal end, one or more side surfaces, an opening at the proximal end, and an inner surface at the distal end of the cavity;  
 a cam pivotally coupled to the body and positioned at least partially in the cavity, wherein the cam is configured to pivot between a first position and a second position; and  
 a suture length positioned in the space between the cam and the inner surface at the distal end of the cavity; and  
   coupling at least a portion of the suture to a tissue.    
   
   
       21 . The method of  claim 20 , further comprising tensioning the suture length in a first direction such that the cam pivots toward the first position and moves the suture in the first direction.  
   
   
       22 . The method of  claim 20 , further comprising tensioning the suture length in a second direction such that the cam pivots toward the inner surface and grips the suture between the cam and the inner surface at the distal end of the cavity such that movement of the suture in the second direction is inhibited.  
   
   
       23 . The method of  claim 20 , further comprising coupling a loop portion of the suture to a tissue structure prior to positioning both end portions in the in the space between the cam and the inner surface.  
   
   
       24 . The method of  claim 20 , further comprising coupling a loop portion of the suture to a tissue structure prior to positioning both end portions in the space between the cam and the inner surface, wherein tensioning the suture in the first direction moves the tissue structure toward the bone.  
   
   
       25 . The method of  claim 20 , further comprising pre-loading the suture on the bone anchor prior to inserting the bone anchor in the bone opening.  
   
   
       26 . The method of  claim 20 , wherein the bone anchor further comprises one or more coupling members extending radially from the body, wherein the coupling members are configured to move inward as the bone anchor is placed in an opening in a bone, and the coupling members are further configured to inhibit the bone anchor from moving out of the opening in the bone.  
   
   
       27 . The method of  claim 20 , wherein the bone anchor is positioned in the bone opening using an inserter, the inserter being configured to be reversible coupled to a portion of the bone anchor.