Tissue repair and fixation system and methods

Abstract

A tissue repair or fixation system comprises an implant and a delivery tool configured to deploy the implant at least partially into tissue of a patient. The implant includes first and second tissue anchors and an adjustable suture assembly coupled thereto. The adjustable suture assembly includes a knotless locking element.

The following is claimed: 
     
         1 . A tissue repair or fixation device comprising:
 first and second tissue anchors sized and shaped to be disposed in a tubular member of a delivery tool; and   a flexible connecting element coupling the first and second tissue anchors, the connecting element at least partially formed from a tubular braided suture material and including:
 a distal segment of the braided suture material attached to the first tissue anchor; 
 an intermediate segment of the braided suture material extending proximally from the distal segment and including a locking element and an adjustable loop, wherein a portion of the intermediate segment extends internally within the braided suture material of the locking element, and wherein the second tissue anchor is slidably coupled to the braided suture material of the adjustable loop; and 
 a proximal segment of the braided material extending proximally from the intermediate segment and operable by a user to be placed in tension to reduce the length of the adjustable loop. 
   
     
     
         2 . The tissue repair or fixation device of  claim 1 , wherein the braided suture material is tubular and includes an outer wall, and wherein the locking element has a proximal end and a distal end, and wherein the portion of the intermediate segment extending internally within the braided suture material of the locking element enters the braided suture material at the proximal end of the locking element and exits the braided suture material at the distal end of the locking element. 
     
     
         3 . The tissue repair or fixation device of  claim 1 , wherein the braided suture material is tubular and includes an outer wall, and wherein the locking element has a proximal end and a distal end, and wherein the portion of the intermediate segment extending internally within the braided suture material of the locking element enters the braided suture material at the distal end of the locking element and exits the braided suture material at the proximal end of the locking element. 
     
     
         4 . The tissue repair or fixation device of  claim 1 , further comprising a retention line coupled to the second tissue anchor and extending proximally within the pusher tube, the retention line operable to inhibit ejection of the second tissue anchor from the delivery tool during deployment of the first tissue anchor. 
     
     
         5 . The tissue repair or fixation device of  claim 4 , wherein the second tissue anchor is slidably coupled to the braided suture material of the adjustable loop by a suture loop disposed around the braided suture material and attached to the second tissue anchor. 
     
     
         6 . The tissue repair or fixation device of  claim 5 , wherein the retention line is coupled to the suture loop. 
     
     
         7 . The tissue repair or fixation device of  claim 6 , wherein the first tissue anchor is fixedly attached to the distal segment of the braided suture material by a knot, and wherein the distal segment extends proximally from the first tissue anchor to the intermediate segment of the braided suture material. 
     
     
         8 . The tissue repair or fixation device of  claim 1 , wherein the flexible connecting element further comprises a resistance feature located proximal to the locking element, the resistance feature dimensioned to contact an inner surface of the tubular member of the delivery tool prior to deployment of the tissue repair or fixation device therefrom. 
     
     
         9 . The tissue repair or fixation device of  claim 8 , wherein the resistance feature is a knot or a resilient sphere or cylinder disposed over the suture material of the connecting element. 
     
     
         10 . The tissue repair or fixation device of  claim 1 , wherein the flexible connecting element is made from a single length of suture material. 
     
     
         11 . The tissue repair or fixation device of  claim 1 , wherein the first and second tissue anchors are made from stainless steel, nickel, titanium alloy, or titanium. 
     
     
         12 . The tissue repair or fixation device of  claim 1 , wherein the first and second tissue anchors are made from polytetrafluoroethylene, polypropylene, polyether etherketone, polyethylene, polyethylene terephthalate, polyurethane, acrylic or polycarbonate. 
     
     
         13 . The tissue repair or fixation device of  claim 1 , wherein the suture material of the connecting element is a size 2-0 or size 3-0 force fiber suture material. 
     
     
         14 . A tissue repair or fixation system comprising:
 a delivery tool having a substantially rigid outer tube with a pusher tube slidably disposed within the outer tube; and   a tissue repair or fixation device releasably coupled to the delivery tool including:
 a pair of tissue anchors serially disposed within a distal section of the outer tube; and 
 a flexible connecting element coupling the tissue anchors, the connecting element at least partially formed from a braided tubular suture material and including:
 a distal segment of the braided suture material attached to the first tissue anchors 
 an intermediate segment of the braided suture material extending proximally from the distal segment and including a knotless locking element and an adjustable loop, wherein the second tissue anchor is slidably coupled to the braided suture material of the adjustable loop; 
 a proximal segment of the braided suture material extending proximally from the intermediate segment and releasably coupled to the delivery tool; and 
 a retention line coupled to the second tissue anchor and extending proximally within the pusher tube, the retention line operable to inhibit ejection of the second tissue anchor from the delivery tool during deployment of the first tissue anchor. 
 
   
     
     
         15 . The tissue repair or fixation system of  claim 14 , wherein the second tissue anchor is slidably coupled to the braided suture material of the adjustable loop by a suture loop disposed around the braided suture material and attached to the second tissue anchor. 
     
     
         16 . The tissue repair or fixation system of  claim 15 , wherein the retention line is coupled to the suture loop. 
     
     
         17 . The tissue repair or fixation device of  claim 14 , wherein the flexible connecting element further comprises a resistance feature located proximal to the locking element, the resistance feature dimensioned to contact an inner surface of the outer tube of the delivery tool prior to deployment of the tissue repair or fixation device therefrom. 
     
     
         18 . The tissue repair or fixation system of  claim 17 , wherein the resistance feature is a knot or a resilient sphere or cylinder disposed over the suture material of the connecting element. 
     
     
         19 . The tissue repair or fixation system of  claim 14 , wherein the flexible connecting element is made from a single length of suture material. 
     
     
         20 . The tissue repair or fixation system of  claim 14 , wherein the suture material of the connecting element is a size 2-0 or size 3-0 force fiber suture material.