Fenestrated swivel anchor for knotless fixation of tissue

Abstract

A method and device for knotless fixation of tissue. A swivel anchor having a rotatable implant is used to capture suture for surgical tissue repair without requiring suture knots. The implant may be provided with a conical metal tip which is self-punching and avoids the need for pre-drilling a hole in bone. The implant includes a closed aperture to allow free sliding of a suture strand. The swivel anchor is secured in a hole in bone by advancing a fenestrated fixation device, such as a cannulated interference screw, over the body of the implant.

1 . A method of tissue fixation comprising:
 providing a suture;   securing the suture to the tissue to be fixated; and   anchoring the suture into a bone using a swivel implant and a cannulated fixation device having a threaded body, wherein the suture is anchored in the bone by the steps of:
 preloading the cannulated fixation device on a shaft of a driver; 
 capturing the suture attached to the tissue with swivel implant, the swivel implant being releasably attached at a distal end of the driver; 
 inserting the swivel implant with the captured suture into the bone; and 
 anchoring the suture into the bone by rotating the driver to rotate and advance the cannulated fixation device while keeping the implant stationary, thereby securing the suture and providing tissue fixation without tying any knots in the suture. 
   
     
     
         2 . The method of  claim 1 , wherein the fixation device is a cannulated interference screw. 
     
     
         3 . The method of  claim 1 , wherein the swivel implant has a conical portion terminating at a pointed tip at a most distal end of the conical portion. 
     
     
         4 . The method of  claim 1 , wherein the cannulated fixation device is provided with a plurality of openings or side fenestrations, thereby providing tissue fixation and multiple pathways for blood to pass through the threaded body and up through the cannulation of the fixation device when the cannulated fixation device is inserted into the bone socket. 
     
     
         5 . The method of  claim 1 , wherein the suture attached to the tissue is captured by feeding the suture through an aperture of the swivel implant, the swivel implant being releasably attached at a distal end of the driver. 
     
     
         6 . The method of  claim 5 , further comprising the step of pulling on one end of the suture to draw the suture through the aperture of the swivel implant such that the tissue to be fixated attached to the suture is drawn toward the swivel implant inserted into the bone.