Methods and devices for knotless suture anchoring

Abstract

Methods and devices are provided for securing tissue to bone. A surgical system can include a guide, a suture anchor including a sheath and a screw, a first driver shaft, and a second driver shaft. The first driver shaft can be configured to be removably received within a lumen of the guide such that an awl tip thereof extends beyond a distal end of the sheath. The sheath and the guide can have first and second side openings, respectively, that can receive at least one suture therethrough. The second driver shaft can be configured to be removably received within the lumen of the guide when the first elongate shaft is removed therefrom, the second driver shaft having a distal driver member configured to be removably received within a proximal channel formed in the screw to drive the screw into mating engagement with the sheath.

What is claimed is: 
     
         1 - 8 . (canceled) 
     
     
         9 . A surgical system, comprising:
 a first elongate shaft;   a second elongate shaft; and   a suture anchor assembly including first and second portions;   wherein the first elongate shaft is configured to extend through the first portion of the suture anchor assembly so as to protrude distally beyond a distal end of the first portion of the suture anchor assembly to allow the first portion of suture anchor assembly to be driven into bone;   the second elongate shaft is configured to be removably coupled to the second portion of the suture anchor assembly;   the suture anchor assembly has a side opening formed therein that is configured to receive a suture therethrough; and   with the second elongate shaft removably coupled to the second portion of the suture anchor assembly, the second elongate shaft is configured to rotate from a first position, in which the side opening is not occluded, to a second position, in which the side opening is occluded.   
     
     
         10 . The system of  claim 9 , wherein the side opening is formed in the first portion of the suture anchor assembly; and
 the rotation of the second elongate shaft is configured to cause the second portion of the suture anchor assembly to move proximally within the lumen of the first portion of the suture anchor assembly.   
     
     
         11 . The system of  claim 10 , wherein the second portion of the suture anchor assembly moving proximally within the lumen of the first portion of the suture anchor assembly occludes the side opening. 
     
     
         12 . The system of  claim 10 , further comprising the suture;
 wherein, with the suture received through the side opening, the rotation of the second elongate shaft is configured to secure the suture between an outer wall of the second portion of the suture anchor assembly and an inner wall of the first portion of the suture anchor assembly.   
     
     
         13 . The system of  claim 9 , wherein the second elongate shaft is configured to be removably coupled to the second portion of the suture anchor assembly after the first portion of the suture anchor assembly has been driven into the bone and the first elongate shaft has been removed from the first portion of the suture anchor assembly so as to no longer extend through the first portion of the suture anchor assembly. 
     
     
         14 . The system of  claim 9 , further comprising a third elongate shaft;
 wherein, with the first elongate shaft extending through the first portion of the suture anchor assembly so as to protrude distally beyond the distal end of the first portion of the suture anchor assembly, the second elongate shaft extends distally from the third elongate shaft;   wherein the second elongate shaft has a second side opening formed therein;   wherein the third elongate shaft has a third side opening formed therein; and   wherein, with the first elongate shaft extending through the first portion of the suture anchor assembly so as to protrude distally beyond the distal end of the first portion of the suture anchor assembly and with the second elongate shaft extending distally from the third elongate shaft, the first, second, and third side openings communicate with one another such that the suture is configured to pass through the first, second, and third side openings.   
     
     
         15 . The system of  claim 9 , further comprising the suture;
 wherein, with the suture received through the side opening, the rotation of the second elongate shaft is configured to secure the suture between a wall of the bone and an outer wall of the suture anchor assembly.   
     
     
         16 . The system of  claim 9 , further comprising a cannulated tube;
 wherein the first elongate shaft is configured to be inserted into a lumen of the cannulated tube such that the first elongate shaft extends through the first portion of the suture anchor assembly so as to protrude distally beyond the distal end of the first portion of the suture anchor assembly; and   after the first elongate shaft has been inserted into and then removed from the lumen of the cannulated tube, the second elongate shaft is configured to be inserted into the lumen of the cannulated tube such that the second elongate shaft is removably coupled to the second portion of the suture anchor assembly.   
     
     
         17 . A surgical system, comprising:
 a sheath having a first side opening formed therein;   a plug;   a first driver configured to extend through the sheath and configured to advance the sheath into bone with a suture extending through the first side opening; and   a second driver configured to be removably coupled to the plug and, with the plug coupled thereto and with the first driver removed from the sheath, drive the plug into the sheath in the bone, thereby causing the suture to be secured between an outer wall of the sheath and the bone and between an outer wall of the plug and an inner wall of the sheath.   
     
     
         18 . The system of  claim 17 , further comprising a cannulated tube;
 wherein the first driver is configured to extend through the cannulated tube during the advancement of the sheath into the bone and to be removed from the cannulated tube after the advancement of the sheath into the bone; and   after the removal of the first driver from the cannulated tube, the second driver is configured to be advanced through the cannulated tube such that the second driver extends through the cannulated tube while driving the plug into the sheath in the bone.   
     
     
         19 . The system of  claim 18 , wherein the cannulated tube has a second side opening formed therein configured to be in communication with the first side opening such that the first driver is configured to advance the sheath into the bone with the suture extending through the first and second side openings. 
     
     
         20 . The system of  claim 18 , wherein the advancement of the second driver includes rotation of the second driver relative to the cannulated tube and the sheath. 
     
     
         21 . The system of  claim 17 , wherein the plug being driven into the sheath is configured to expand the sheath. 
     
     
         22 . The system of  claim 17 , wherein the first driver has an awl tip configured to form a hole in the bone; and
 the advancement of the sheath into the bone includes advancing the sheath into the hole.   
     
     
         23 . The system of  claim 17 , further comprising the suture. 
     
     
         24 . A surgical method, comprising:
 with a first elongate shaft extending through a first portion of a suture anchor assembly such that the first elongate shaft protrudes distally beyond a distal end of the first portion of the suture anchor assembly and with a suture extending through a side opening formed in the first portion of the suture anchor assembly, advancing the first portion of the suture anchor assembly into bone;   removing the first elongate shaft from the first portion of the suture anchor assembly; and   after removing the first elongate shaft from the first portion of the suture anchor assembly, rotating a second elongate shaft removably coupled to a second portion of the suture anchor assembly so as to move the second portion of the suture anchor assembly relative to the first portion of the suture anchor assembly such that the suture is secured between the bone and an outer wall of the first portion of the suture anchor assembly.   
     
     
         25 . The method of  claim 24 , wherein the rotation of the second elongate shaft causes the second portion of the suture anchor assembly to move proximally within a lumen of the first portion of the suture anchor assembly. 
     
     
         26 . The method of  claim 25 , wherein the second portion of the suture anchor assembly moving proximally within the lumen of the first portion of the suture anchor assembly occludes the side opening. 
     
     
         27 . The method of  claim 24 , wherein the rotation of the second elongate shaft also secures the suture between an outer wall of the second portion of the suture anchor assembly and an inner wall of the first portion of the suture anchor assembly. 
     
     
         28 . The method of  claim 24 , wherein during the advancement of the first portion of the suture anchor assembly, the first elongate shaft is disposed within a cannulated tube;
 the method further comprises, after removing the first elongate shaft from the first portion of the suture anchor assembly, disposing the second elongate shaft within the cannulated tube; and   the second elongate shaft is rotated with the second elongate shaft disposed within the cannulated tube.