Suture locking devices for performing tensionable knotless surgical procedures

Abstract

Systems and methods are provided for performing tensionable knotless surgical procedures. A suture locking device that includes a one-way locking mechanism may be utilized for tensioning and locking one or more strands of suture during the surgical procedure. The one-way locking mechanism may be established by one or more locking barbs of the suture locking device.

Description

SUTURE LOCKING DEVICES FOR PERFORMING TENSIONABLE KNOTLESS SURGICAL PROCEDURESInventors:Andrew Christian Petry Peter J. Dreyfuss Allen Holowecky Joshua Dines Philipp Morodcr Matthew Provencher Justin William Griffin Erik Kubiak Paul C. BradyThomas DooneyTodd W. BarrettCarlson, Gaskey & Olds 400 W. Maple Road, Suite 350Birmingham, Ml 48009(248) 988-8360SUTURE LOCKING DEVICES FOR PERFORMING TENSIONABLE KNOTLESS SURGICAL PROCEDURESCROSS-REFERENCE TO RELATED APPLICATIONS[oooi] This application claims priority to U.S. Patent Application No. 18 / 420,917, which was filed on January 24, 2024 and the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.

[0002] This application further claims priority to U.S. Patent Application No. 18 / 420,930, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.

[0003] This application further claims priority to U.S. Patent Application No. 18 / 420,938, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.

[0004] This application further claims priority to U.S. Patent Application No. 18 / 420,948, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.[ooos] This application further claims priority to U.S. Patent Application No. 18 / 420,959, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.

[0006] This application further claims priority to U.S. Patent Application No. 18 / 420,973, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.

[0007] This application further claims priority to U.S. Patent Application No. 18 / 420,985, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.[ooos] This application further claims priority to U.S. Patent Application No. 18 / 420,996, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.

[0009] This application further claims priority to U.S. Patent Application No. 18 / 421,005, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.[oooio] This application further claims priority to U.S. Patent Application No. 18 / 421 ,014, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 620,280, which was filed on January 12, 2024.[oooii] This application further claims priority to U.S. Patent Application No. 18 / 421,160, which was filed on January 24, 2024 and claims the benefit of United States Provisional Application No. 63 / 622,989, which was filed on January 19, 2024.[ooon] This application further claims the benefit of United States Provisional Application No. 63 / 674,389, which was filed on July 23, 2024.

[0013] This application further claims the benefit of United States Provisional Application No. 63 / 674,025, which was filed on July 22, 2024.

[0014] The entire disclosure of each of the above applications is incorporated herein by reference in its entirety.BACKGROUND[ooois] This disclosure relates to the field of surgery, and more particularly to various surgical locking devices that are capable of locking suture when performing a variety of tensionable knotless surgical procedures.

[0016] Repetitive trauma to a joint, such as a knee, ankle, hip, elbow, or shoulder joint, for example, may result in the development of tissue defects (e.g., soft tissue tears, cartilage defects, etc.). If not treated, tissue defects could further deteriorate, thereby causing joint instability and discomfort.SUMMARY

[0017] This disclosure relates to systems and methods for performing tensionable knotless surgical procedures, such as tissue repairs or reconstructions, for example. Surgical locking devices that include a one-way locking mechanism may be utilized when performing the tensionable knotless surgical procedures for tensioning and locking one or more strands of suture.[ooois] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a cap portion, a barrel portion, a cannulation formed through the cap portion and the barrel portion, and a plurality of locking barbs arranged within thecannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation.

[0019] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone.

[0020] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a cap portion, a barrel portion, a first cannulation and a second cannulation formed through the cap portion and the barrel portion, and a plurality of locking barbs arranged within the first cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the first cannulation.

[0021] An exemplary surgical method may include, inter alia, connecting a suture to a graft, shuttling the suture through a first cannulation and a second cannulation of a locking ferrule, inserting the locking ferrule into a socket formed in a bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the first cannulation to prevent movement of the suture in a second direction relative to the bone.

[0022] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a cap portion, a barrel portion, a cannulation formed through the cap portion and the barrel portion, a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation, and a slot that is connected to the cannulation.

[0023] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction relative to the bone, locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone, and cieating the suture within a slot of the locking ferrule.

[0024] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a body, a cannulation formed through the body, a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation, and a side opening that is formed through the body and is connected to the cannulation.

[0025] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, passing the suture through a first side opening of the locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone.

[0026] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a body, a cannulation formed through the body, a first side opening formed through the body and connected to the cannulation, and a plurality of locking barbs arranged within the first side opening and configured to establish a one-way locking mechanism for locking a suture that is passed through the first side opening.

[0027] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, passing the suture through a first side opening of the locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction, and locking the suture within the first side opening to prevent movement of the suture in a second direction.

[0028] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a body, a first cannulation formed through the body, a second cannulation formed through the body, and a first plurality of locking barbs arranged within the first cannulation and configured to establish a first one-way locking mechanism for locking a first portion of a suture that is received through the first cannulation.

[0029] An exemplary suture locking device may include, inter alia, a dual chamber locking ferrule that includes a first cannulation and a second cannulation, a suture received through each of the first cannulation and the second cannulation, and a one-way locking mechanism that is configured to allow the suture to be tensioned in one direction but prevent the suture from being tensioned in an opposite direction.

[0030] An exemplary suture locking device may include, inter alia, a surgical button including a first opening and a second opening, and a plurality of locking barbs that establish a one-way locking mechanism for locking a suture relative to the surgical button.

[0031] Another exemplary suture locking device may include, inter alia, a bone plate including an opening, and a plurality of locking barbs that establish a one-way locking mechanism for locking a suture relative to the bone plate.

[0032] An exemplary suture locking device may include, inter alia, a bone plate including an opening, and a locking ferrule inscrtablc within the opening and including a one-way locking mechanism configured for locking a suture relative to the bone plate.

[0033] An exemplary surgical method may include, inter alia, inserting a locking ferrule into an opening of a bone plate, passing a suture through or around a tissue, passing the suture through an eyelet portion of the locking ferrule, and tensioning the suture in a first direction to knotlessly secure the tissue at a desired position relative to the bone plate.

[0034] An exemplary suture locking device may include, inter alia, an arthroplasty implant including an opening, and a locking ferrule insertable within the opening and including a one-way locking mechanism configured for locking a suture relative to the arthroplasty implant.

[0035] An exemplary surgical method may include, inter alia, passing a suture through or around a tissue, inserting the suture through an opening of an arthroplasty implant, passing the suture through a cannulation of a locking ferrule, and tensioning the suture in a first direction to knotlessly secure the tissue at a desired position relative to the arthroplasty implant.

[0036] An exemplary suture locking device may include, inter alia, a suture anchor including an internal bore, and a locking ferrule positioned within the internal bore and including a one-way locking mechanism configured for locking a suture relative to the suture anchor.

[0037] An exemplary surgical method may include, inter alia, inserting a suture anchor into a bone, passing a suture through or around a tissue, shuttling the suture through a cannulation of a locking ferrule, and tensioning the suture in a first direction relative to the cannulation to knotlessly secure the tissue at a desired position relative to the bone.

[0038] An exemplary bone plate assembly may include, inter alia, a bone plate including an opening, a locking ferrule received within the opening and including a one-way locking mechanism, and a suture received through the locking ferrule and locked relative to the bone plate by the one-way locking mechanism.

[0039] An exemplary suture anchor assembly may include, inter alia, a suture anchor including an internal bore, a locking ferrule received within the internal bore and including a oneway locking mechanism, and a suture received through the locking ferrule and locked relative to the suture anchor by the one-way locking mechanism.

[0040] An exemplary surgical method may include, inter alia, attaching a graft to a tissue, loading a suture through the graft, implanting a suture anchor into a bone, shuttling the suturethrough the suture anchor, loading the suture through a cannulation of a locking ferrule, tensioning the suture in a first direction, and locking the suture within the cannulation to prevent movement of the suture in a second direction.

[0041] Another exemplary surgical method may include, inter alia, attaching a suture to a tissue, loading the suture through a surgical device, implanting the surgical device into a bone, loading the suture through a cannulation of a locking ferrule, inserting the locking ferrule into the bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone.

[0042] An exemplary suture locking system may include, inter alia, a surgical fixation device including an opening, a locking ferrule insertable within the opening and including a oneway locking mechanism provided within a cannulation of the locking ferrule, and a suture received through the cannulation. The one-way locking mechanism is configured to allow the suture to be tensioned in a first direction while preventing the suture from moving in a second direction.

[0043] Another exemplary suture locking system may include, inter alia, a suture anchor including a body portion and a suture portion connected to the body portion, a locking ferrule received within a lumen of a tail of the suture portion and including a one-way locking mechanism provided within a cannulation of the locking ferrule, and a suture received through the cannulation. The one-way locking mechanism is configured to allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction.

[0044] Yet another exemplary suture locking system may include, inter alia, a suture anchor including a sheath having an internal bore, a locking ferrule including a one-way locking mechanism, and a suture received through the internal bore of the sheath and the locking ferrule.

[0045] The embodiments, examples, and alternatives of the preceding paragraphs, the claims, or the following description and drawings, including any of their various aspects or respective individual features, may be taken independently or in any combination. Features described in connection with one embodiment are applicable to all embodiments, unless such features are incompatible.

[0046] The various features and advantages of this disclosure will become apparent to those skilled in the art from the following detailed description. The drawings that accompany the detailed description can be briefly described as follows.BRIEF DESCRIPTION OF THE DRAWINGS

[0047] Figure 1 illustrates a locking ferrule that can be used for performing various tensionable knotless surgical procedures.

[0048] Figure 2 is a top view of the locking ferrule of Figure 1.

[0049] Figure 3 is a cross-sectional view through section 3-3 of Figure 2.

[0050] Figure 4A schematically illustrates locking a suture relative to the locking ferrule of Figures 1-3.

[0051] Figure 4B illustrates a plurality of rows of locking barbs of the locking ferrule of Figure 1.

[0052] Figure 4C illustrates a suture having a varying thickness.

[0053] Figure 5 schematically illustrates a surgical method for performing a tissue repair.

[0054] Figure 6 schematically illustrates another exemplary surgical method for performing a tissue repair.

[0055] Figure 7 schematically illustrates yet another exemplary surgical method for performing a tissue repair.

[0056] Figure 8 illustrates another exemplary locking ferrule that can be used for performing various tensionable knotless surgical procedures.

[0057] Figure 9 is a top view of the locking ferrule of Figure 8.

[0058] Figure 10 illustrates the locking ferrule of Figures 8 and 9 with a shuttle device.

[0059] Figure 11 illustrates the locking ferrule of Figures 8 and 9 with an adjustable loop.

[0060] Figure 12 schematically illustrates another exemplary surgical method for performing a tissue repair.

[0061] Figure 13 illustrates another exemplary locking ferrule that can be used for performing various tensionable knotless surgical procedures.

[0062] Figure 14 is a top view of the locking ferrule of Figure 13.

[0063] Figure 15 illustrates an exemplary slot of a locking ferrule.

[0064] Figure 16 illustrates another exemplary slot of a locking ferrule.

[0065] Figure 17 schematically illustrates a suture passed through the locking ferrule of Figures 13 and 14 and arranged to provide a loop.

[0066] Figure 18 illustrates another exemplary locking ferrule.

[0067] Figure 19 illustrates another exemplary locking ferrule.

[0068] Figure 20 illustrates a suture that includes partitions.

[0069] Figure 21 illustrates another exemplary locking ferrule.

[0070] Figure 22 schematically illustrates locking a suture relative to the locking ferrule of Figure 21.

[0071] Figure 23 illustrates another exemplary locking ferrule.

[0072] Figure 24 illustrates another exemplary locking ferrule.

[0073] Figure 25 illustrates an exemplary surgical button.

[0074] Figure 26 illustrates another exemplary surgical button.

[0075] Figure 27 illustrates an exemplary bone plate.

[0076] Figure 28 illustrates another exemplary bone plate.

[0077] Figure 29 illustrates another exemplary bone plate.

[0078] Figure 30 schematically illustrates locking a suture relative to the bone plate of Figure 29.

[0079] Figure 31 illustrate an exemplary arthroplasty implant.

[0080] Figure 32 schematically illustrates locking a suture relative to the arthroplasty implant of Figure 31.

[0081] Figure 33 illustrates an exemplary suture anchor.

[0082] Figure 34 schematically illustrates a surgical method for performing a tissue repair.

[0083] Figure 35 illustrates yet another exemplary locking ferrule.

[0084] Figure 36 illustrates an exemplary bone plate assembly.

[0085] Figure 37 schematically illustrates locking a suture relative to the bone plate assembly of Figure 36.

[0086] Figure 38 illustrates a locking ferrule of the bone plate assembly of Figure 36.

[0087] Figure 39 is a cross-sectional view through section 4-4 of Figure 38.

[0088] Figure 40 illustrates an exemplary locking ferrule.

[0089] Figure 41 illustrates another exemplary locking ferrule.

[0090] Figure 42 illustrates a suture having a varying thickness.

[0091] Figure 43 illustrates another exemplary bone plate assembly.

[0092] Figure 44 illustrates a surgical method for performing a tissue repair.

[0093] Figure 45 illustrates another exemplary locking ferrule.

[0094] Figure 46 illustrates a suture anchor assembly.

[0095] Figure 47 illustrates another surgical method for performing a tissue repair.

[0096] Figure 48 illustrates another locking ferrule that can be used for performing various tensionable knotless tissue repairs.

[0097] Figure 49 is an end view of the locking ferrule of Figure 48.

[0098] Figure 50 is a cross-sectional view through section 3-3 of Figure 48.

[0099] Figure 51 is a cross-sectional view through section 4-4 of Figure 49.[oooioo] Figure 52 schematically illustrates loading a suture through a locking ferrule.[oooroi] Figure 53 schematically illustrates locking a suture relative to a locking ferrule.[oooio2] Figures 54, 55, 56, 57, 58, and 59 schematically illustrate a surgical method for performing a tissue repair.[000103] Figures 60, 61, and 62 schematically illustrate another exemplary surgical method for performing a tissue repair.[000104] Figure 63 illustrates an exemplary suture locking system.[oooios] Figure 64 is an exploded view of the suture locking system of Figure 63.[000106] Figure 65 is a cross-sectional view through section 3-3 of Figure 64.[000107] Figure 66 illustrates a plurality of rows of locking barbs of a locking ferrule of the suture locking system of Figures 63-65.[oooios] Figure 67 illustrates an exemplary suture of the suture locking system of Figures 63-65.[oooio9] Figure 68 schematically illustrates a surgical method for performing a tissue repair.[ooono] Figures 69 and 70 illustrate another exemplary suture locking system.[oooni] Figure 71 illustrates yet another exemplary suture locking system.DETAILED DESCRIPTION[oooii2] This disclosure relates to systems and methods for performing tensionable knotless surgical procedures. A locking ferrule or other suture locking device that includes a one-way locking mechanism may be utilized as part of the tensionable knotless repairs for tensioning and locking one or more strands of suture. These and other features of this disclosure are described in further detail below.[oooii3] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a cap portion, a barrel portion, a cannulation formed throughthe cap portion and the barrel portion, and a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation.[oooii4] In any further embodiment, the cap portion includes a top surface, a bottom surface, and a side wall that extends between the top surface and the bottom surface.[oooii5] In any further embodiment, the barrel portion protrudes from the bottom surface of the cap portion.[000116] In any further embodiment, the barrel portion includes an interior wall and an outer diameter wall.[oooii7] In any further embodiment, at least a portion of the plurality of locking barbs protrudes inwardly from the interior wall.[000118] In any further embodiment, each of the plurality of locking barbs is angled in a direction toward the cap portion.[oooii9] In any further embodiment, the plurality of locking barbs are arranged in at least a first row and a second row within the cannulation.[000120] In any further embodiment, a first portion of the plurality of locking barbs of the first row are staggered relative to a second portion of the plurality of locking barbs of the second row.[000121] In any further embodiment, each of the plurality of locking barbs includes a pointed tip.[000122] In any further embodiment, the suture includes a varying thickness.[000123] In any further embodiment, the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.[000124] In any further embodiment, the cap portion and the barrel portion establish a unitary structure that includes a top hat-like appearance.[000125] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone.[000126] In any further embodiment, the locking ferrule includes a cap portion that is received against an outer surface of the bone and a barrel portion that extends into the passage.[oooi27] In any further embodiment, the suture is shuttled through the cannulation before inserting the locking ferrule into the passage.[000128] In any further embodiment, the suture is shuttled through the cannulation after inserting the locking ferrule into the passage.[000129] In any further embodiment, the suture is attached to a graft, and tensioning the suture in the first direction pulls the graft into a socket formed in the bone.[000130] In any further embodiment, the method includes shuttling a second suture through a second cannulation of a second locking ferrule, inserting the second locking ferrule into a second passage formed in the bone, tensioning the second suture in the first direction relative to the bone, and locking the second suture within the second cannulation to prevent movement of the second suture in the second direction.[000131] In any further embodiment, the surgical method is an ulnar collateral ligament (UCL) reconstruction.[000132] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a cap portion, a barrel portion, a first cannulation and a second cannulation formed through the cap portion and the barrel portion, and a plurality of locking barbs arranged within the first cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the first cannulation.[000133] An exemplary surgical method may include, inter alia, connecting a suture to a graft, shuttling the suture through a first cannulation and a second cannulation of a locking ferrule, inserting the locking ferrule into a socket formed in a bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the first cannulation to prevent movement of the suture in a second direction relative to the bone.[000134] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a cap portion, a barrel portion, a cannulation formed through the cap portion and the barrel portion, a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation, and a slot that is connected to the cannulation.[000135] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction relative to the bone, locking the suture within thecannulation to prevent movement of the suture in a second direction relative to the hone, and clearing the suture within a slot of the locking ferrule.[oooi36] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a body, a cannulation formed through the body, a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation, and a side opening that is formed through the body and is connected to the cannulation.[oooi37] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, passing the suture through a first side opening of the locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone.[000138] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a body, a cannulation formed through the body, a first side opening formed through the body and connected to the cannulation, and a plurality of locking barbs arranged within the first side opening and configured to establish a one-way locking mechanism for locking a suture that is passed through the first side opening.[000139] An exemplary surgical method may include, inter alia, shuttling a suture through a cannulation of a locking ferrule, passing the suture through a first side opening of the locking ferrule, inserting the locking ferrule into a passage formed in a bone, tensioning the suture in a first direction, and locking the suture within the first side opening to prevent movement of the suture in a second direction.[000140] An exemplary locking ferrule for performing a tensionable knotless surgical procedure may include, inter alia, a body, a first cannulation formed through the body, a second cannulation formed through the body, and a first plurality of locking barbs arranged within the first cannulation and configured to establish a first one-way locking mechanism for locking a first portion of a suture that is received through the first cannulation.[oooi4i] An exemplary suture locking device may include, inter alia, a dual chamber locking ferrule that includes a first cannulation and a second cannulation, a suture received through each of the first cannulation and the second cannulation, and a one-way locking mechanism that isconfigured to allow the suture to be tensioned in one direction but prevent the suture from being tensioned in an opposite direction.[oooi42] An exemplary suture locking device may include, inter alia, a surgical button including a first opening and a second opening, and a plurality of locking barbs that establish a one-way locking mechanism for locking a suture relative to the surgical button.[oooi43] Another exemplary suture locking device may include, inter alia, a bone plate including an opening, and a plurality of locking barbs that establish a one-way locking mechanism for locking a suture relative to the bone plate.[oooi44] An exemplary suture locking device may include, inter alia, a bone plate including an opening, and a locking ferrule insertable within the opening and including a one-way locking mechanism configured for locking a suture relative to the bone plate.[000145] An exemplary surgical method may include, inter alia, inserting a locking ferrule into an opening of a bone plate, passing a suture through or around a tissue, passing the suture through an eyelet portion of the locking ferrule, and tensioning the suture in a first direction to knotlessly secure the tissue at a desired position relative to the bone plate.[000146] An exemplary suture locking device may include, inter alia, an arthroplasty implant including an opening, and a locking ferrule insertable within the opening and including a one-way locking mechanism configured for locking a suture relative to the arthroplasty implant.[000147] An exemplary surgical method may include, inter alia, passing a suture through or around a tissue, inserting the suture through an opening of an arthroplasty implant, passing the suture through a cannulation of a locking ferrule, and tensioning the suture in a first direction to knotlessly secure the tissue at a desired position relative to the arthroplasty implant.[oooi48] An exemplary suture locking device may include, inter alia, a suture anchor including an internal bore, and a locking ferrule positioned within the internal bore and including a one-way locking mechanism configured for locking a suture relative to the suture anchor.[000149] An exemplary surgical method may include, inter alia, inserting a suture anchor into a bone, passing a suture through or around a tissue, shuttling the suture through a cannulation of a locking ferrule, and tensioning the suture in a first direction relative to the cannulation to knotlessly secure the tissue at a desired position relative to the bone.[oooiso] An exemplary bone plate assembly may include, inter alia, a bone plate including an opening, a locking ferrule received within the opening and including a one-way lockingmechanism, and a suture received through the locking ferrule and locked relative to the bone plate by the one-way locking mechanism.[000151] An exemplary suture anchor assembly may include, inter alia, a suture anchor including an internal bore, a locking ferrule received within the internal bore and including a oneway locking mechanism, and a suture received through the locking ferrule and locked relative to the suture anchor by the one-way locking mechanism.[oooi52] An exemplary surgical method may include, inter alia, attaching a graft to a tissue, loading a suture through the graft, implanting a suture anchor into a bone, shuttling the suture through the suture anchor, loading the suture through a cannulation of a locking ferrule, tensioning the suture in a first direction, and locking the suture within the cannulation to prevent movement of the suture in a second direction.[oooi53] Another exemplary surgical method may include, inter alia, attaching a suture to a tissue, loading the suture through a surgical device, implanting the surgical device into a bone, loading the suture through a cannulation of a locking ferrule, inserting the locking ferrule into the bone, tensioning the suture in a first direction relative to the bone, and locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone.[oooi54] An exemplary suture locking system may include, inter alia, a surgical fixation device including an opening, a locking ferrule insertable within the opening and including a oneway locking mechanism provided within a cannulation of the locking ferrule, and a suture received through the cannulation. The one-way locking mechanism is configured to allow the suture to be tensioned in a first direction while preventing the suture from moving in a second direction.[000155] Another exemplary suture locking system may include, inter alia, a suture anchor including a body portion and a suture portion connected to the body portion, a locking ferrule received within a lumen of a tail of the suture portion and including a one-way locking mechanism provided within a cannulation of the locking ferrule, and a suture received through the cannulation. The one-way locking mechanism is configured to allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction.[oooi56] Yet another exemplary suture locking system may include, inter alia, a suture anchor including a sheath having an internal bore, a locking ferrule including a one-way locking mechanism, and a suture received through the internal bore of the sheath and the locking ferrule.[oooi57] Figures 1 -4C illustrate an exemplary locking ferrule 10 that can be used when performing various tensionable knotlcss surgical procedures. For example, the locking ferrule 10 could be utilized during surgical methods for attaching tissue (e.g., ligament, tendon, graft, etc.) to bone or for repairing any other type of tissue effect. The locking ferrule 10 could be used in conjunction with a variety of orthopedic surgical repairs or reconstructions, including but not limited to ulnar collateral ligament repairs, AC joint repairs, rotator cuff repairs, Achilles tendon repairs, patellar tendon repairs, and biceps tendon repairs, among many others.[oooi58] The locking ferrule 10 is an exemplary suture locking device that can include a cap portion 12 and a barrel portion 14 that protrudes from the cap portion 12. The cap portion 12 and the barrel portion 14 may be formed together as part of a unitary structure of the locking ferrule 10. In an embodiment, the cap portion 12 and the barrel portion 14 are arranged to provide a top hat-like appearance of the locking ferrule 10. However, the specific size, shape, and material makeup of the locking ferrule 10 are not intended to limit this disclosure.[000159] The cap portion 12 of the locking ferrule 10 may include a top surface 16, a bottom surface 18, and a side wall 20 that extends between the top surface 16 and the bottom surface 18. The bottom surface 18 may include a slightly concave curvature for conforming to the contour of a bone. The barrel portion 14 may protrude outwardly from the bottom surface 18 of the cap portion 12. As further detailed below, the locking ferrule 10 may be positioned relative to a bone such that the barrel portion 14 is accommodated within a socket or tunnel formed in the bone and the cap portion 12 is seated relative to the cortex of the bone. In the seated position, the top surface 16 of the cap portion 12 faces away from the bone and the bottom surface 18 faces toward the bone.[000160] A cannulation 22 may extend through the cap portion 12 and the barrel portion 14. The cannulation 22 may establish an internal passageway for accommodating one or more strands of suture 24 (see Figure 4A) or other structures (e.g., wires, shafts, etc.). The locking ferrule 10 of this embodiment may therefore provide a “single-chamber” design.[oooi6i] The cannulation 22 may be circumscribed by an interior wall 26 of the locking ferrule 10. The interior wall 26 may be established by both the cap portion 12 and the barrel portion 14. The cannulation 22 may be straight or may taper in a direction toward a distal tip of the barrel portion 14. An outer diameter wall 28 of the barrel portion 14 may be smooth or could alternatively include threads, barbs, or other features for facilitating bone fixation.[oooi62] A plurality of locking barbs 30 may protrude inwardly from the interior wall 26. The locking barbs 30 may therefore occupy at least a portion of the open space of the cannulation 22. In an embodiment, the locking barbs 30 are integrally formed (e.g., molded) features of the body of the locking ferrule 10. The locking barbs 30 may be provided along an entire length of the cannulation 22 or at only select portions thereof. The locking barbs 30 may be either rigid or flexible structures.[oooi63] The locking barbs 30 may be arranged in multiple rows along the length of the cannulation 22. For example, the locking barbs 30 may be arranged in a least a first row R1 and a second row R2 (see Figure 4B). In an embodiment, the locking barbs 30 of the second row R2 are staggered relative to the locking barbs 30 of the first row R1 (see Figure 4B).[oooi64] Each locking barb 30 may include a sharp or pointed tip 32, and, in this implementation, each locking barb 30 may be angled in a direction toward the cap portion 12. The locking barbs 30 may therefore establish a one-way locking mechanism that pennits one or more sutures 24 to pass through the cannulation 22 in a first direction DI while preventing the suture(s) 24 from being tensioned or otherwise moved in a second direction D2. The staggered relationship of the rows of locking barbs 30 can maximize engagement with the suture 24 once it is passed through the cannulation 22.[oooi65] The suture 24 may be FiberWire®, FiberTape®, or any other suitable suture product. FiberWire® and FiberTape® are suture products marketed and sold by Arthrex, Inc. However, other suture products could be utilized for the suture 24 within the scope of this disclosure. The size and type of suture utilized in conjunction with the locking ferrule 10 are not intended to limit this disclosure.[000166] The suture 24 may include a varying thickness. The suture 24 may therefore include one or more tapered regions 25 where the suture 24 transitions between a thickened section 27 and a thinned section 29 (see, e.g., Figure 4C). The thinned sections 29 can facilitate passing the suture 24 through the cannulation 22, such as via a suitable suture loader that can be provided as part of a suture locking system that includes the locking ferrule 10, for example, and the thickened sections 27 can provide greater surface area for the locking barbs 30 to engage in order to sufficiently lock the suture 24 relative to the locking ferrule 10.[oooi67] In an embodiment, the thickened sections 27 of the suture 24 are about twice as thick as the thinned sections 29. However, other ratios (e.g., 1.5:1, 3:1, etc.) between the relativethicknesses (e.g., outer diameters) of the thickened sections 27 and the thinned sections 29 are contemplated within the scope of this disclosure.[000168] Figure 5 schematically illustrates an exemplary surgical method in which the locking ferrule 10 of Figures 1-4 may be utilized to tension and lock suture 24 during a surgical repair. In this embodiment, the surgical method may involve securing a graft 34 (e.g., a harvested muscle, tendon, or ligament) to a bone 36 (e.g., a humerus), such as part of an ulnar collateral ligament (UCL) reconstruction, for example.[oooi69] The surgical method may include preparing a socket 38 in the bone 36. The socket 38 may be sized for receiving a portion of the graft 34. One or more sutures 24 may be attached to the graft 34 and can be used to pull or otherwise position the graft 34 within the socket 38. The suture 24 may be passed through the cannulation 22 of the locking ferrule 10 either before or after inserting the barrel portion 14 of the locking ferrule into a passage 40 of the bone 36 that is connected to the socket 38.[000170] At this point of the surgical method, the graft 34 may be reduced into place within the socket 38. The suture 24 may subsequently be tensioned and locked in place by the locking ferrule 10. For example, after loading the suture 24 through the cannulation 22 of the locking ferrule 10, the suture 24 may be tensioned in the direction DI to allow the pointed tips 32 of the locking barbs 30 to interdigitate with the section of the suture 24 accommodated within the cannulation 22, thereby locking the suture 24 in place and preventing it from sliding back in the second direction D2. The graft 34 can therefore be securely tensioned and fixated within the socket 38 of the bone 36.[000171] In the above surgical method, a single locking ferrule 10 is used to tension and lock the suture 24. However, other surgical methods, such as a docking technique for performing an UCL repair, for example, may involve the use of multiple locking ferrules 10 for securing a graft 42 relative to a bone 44 (see Figure 6). One locking ferrule 10 may inserted into each bone tunnel45 that is formed in the bone 44 as part of the docking technique.[000172] Figure 7 schematically illustrates another exemplary surgical method in which the locking ferrule 10 of Figures 1-4 may be utilized to tension and lock suture 24 during a surgical procedure. In this embodiment, the surgical method may involve securing suture 24 to a first bone46 (e.g., a coracoid) and a second bone 48 (e.g., a clavicle), such as pail of an acromioclavicular (AC) joint repair, for example.[oooi73] The suture 24 may be secured relative to the first bone 46 by a button 50. The suture 24 may subsequently be tensioned and locked in place relative to the second bone 48 using the locking ferrule 10. For example, after loading the suture 24 through the cannulation 22 of the locking ferrule 10, the suture 24 may be tensioned in the direction DI to allow the pointed tips 32 of the locking barbs 30 to interdigitate with the section of the suture 24 accommodated within the cannulation 22, thereby locking the suture 24 in place and preventing it from sliding back toward the second direction D2. The suture 24 may be passed through the cannulation 22 of the locking ferrule 10 either before or after inserting the barrel portion 14 of the locking ferrule 10 into a passage 52 formed in the second bone 48. The suture 24 may tensioned until the second bone 48 is located at a desired position relative to the first bone 46.[oooi74] Figures 8-11 illustrate another exemplary locking ferrule 110 that can be used when performing various tensionable knotless surgical procedures. The locking ferrule 110 is similar to the locking ferrule 10 described above and includes a cap portion 112 and a barrel portion 114 that protrudes from the cap portion 112. The cap portion 112 and the barrel portion 114 may be formed together as part of a unitary structure of the locking ferrule 110. In an embodiment, the cap portion 112 and the barrel portion 114 are arranged to provide a top hat-like appearance of the locking ferrule 110. However, the specific size, shape, and material make-up of the locking ferrule 110 are not intended to limit this disclosure.[oooi75] The cap portion 112 of the locking ferrule 110 may include a top surface 116, a bottom surface 118, and a side wall 120 that extends between the top surface 116 and the bottom surface 118. The bottom surface 118 may include a slightly concave curvature for conforming to the contour of a bone. The barrel portion 114 may protrude outwardly from the bottom surface 118 of the cap portion 112. An outer diameter wall 128 of the barrel portion 114 may be smooth or could alternatively include threads, barbs, or other features for facilitating bone fixation.[000176] A first cannulation 122A and a second cannulation 122B may extend through the cap portion 112 and the barrel portion 114. The first and second cannulations 122A, 122B may establish internal passageways for accommodating one or more strands of suture 124 (see, e.g., Figures 10 and 11) through the locking ferrule 110. The locking ferrule 110 of this embodiment may therefore provide a “dual-chamber” design.[oooi77] A dividing wall 154 may separate the first cannulation 1 2A and the second cannulation 122B from one another. The dividing wall 154 may be established by both the cap portion 112 and the barrel portion 114 of the locking ferrule 110.[oooi78] The first cannulation 122A may include a plurality of locking barbs 130. The locking barbs 130 may protrude inwardly from an interior wall 126A that circumscribes the first cannulation 122A. The locking barbs 130 may therefore occupy at least a portion of the open space of the first cannulation 122A. In an embodiment, the locking barbs 130 are integrally formed (e.g., molded) features of the body of the locking ferrule 110. The locking barbs 130 may be provided along an entire length of the cannulation 122A or at only select portions thereof. Each locking barb 130 may include a sharp or pointed tip 132, and, in an exemplary implementation, each locking barb 130 may be angled in a direction toward the cap portion 112. The locking barbs 130 may establish a one-way locking mechanism that permits one or more sutures 124 (see Figure 10) to be passed through the first cannulation 122A in a first direction DI while preventing the suture(s) 24 from being tensioned or otherwise moved in a second direction D2.[000179] The second cannulation 122B may be circumscribed by an interior wall 126B. The second cannulation 122B may exclude locking barbs, and therefore the interior wall 126B can provide a substantially smooth surface that allows one or more sutures 124 to be shuttled through the locking ferrule 110 prior to being locked in place via the locking barbs 130 of the first cannulation 122A.[000180] As shown in Figure 10, the one or more sutures 24 may be shuttled through the second cannulation 122B and then through the first cannulation 122A of the locking ferrule 110 using a shuttle device 156. The shuttle device 156 may be a passing wire or another suture, for example. The one or more sutures 124 may be passed through an eyelet 158 of the shuttle device 156, and a free end 160 of the shuttle device 156 may then be pulled (in the first direction DI) to pass the suture 124 through the locking ferrule 110.[oooi8i] Alternatively, as shown in Figure 11, an adjustable spliced loop 162 may be preattached to the locking ferrule 110 via the first and second cannulations 122A, 122B. A graft 134 or other component may be looped through and / or around the adjustable spliced loop 162. A tensioning strand 164 of the adjustable spliced loop 162 may then be tensioned to reduce the size of the adjustable spliced loop 162 and thereby move the graft 134 into a desired position relative to the locking ferrule 110. The locking barbs 130 of the first cannulation 122A can lock the reducedposition of the adjustable spliced loop 162 (and thus the graft 134) when tension is released on the tensioning strand 164.[oooi82] A post 169 may protrude from a distal end of the barrel portion 114 at a location between the first cannulation 122A and the second cannulation 122B. The post 169 may be curved to provide a smooth surface for suture 124 to glide over as it is being shuttled through the locking ferrule 110.[oooi83] The locking ferrule 110 described above and shown in Figures 8-11 may be utilized to tension and knotlessly fixate one or more sutures 124 as pail of various surgical methods. Figure 12 schematically illustrates one such surgical method for securing a graft 134 (e.g., a harvested muscle, tendon, or ligament) to a bone 136 (e.g., an ulna), such as part of an ulnar collateral ligament (UCL) reconstruction, for example.[oooi84] The surgical method may include preparing a socket 138 in the bone 136. The locking ferrule 110 may be inserted into the bottom of the socket 138 either before or after connecting the suture 124 that is attached to the graft 134 to the locking ferrule 110.[oooi85] At this point of the surgical method, the graft 134 may be reduced into place relative to the socket 138. The suture 124 may subsequently be tensioned and locked in place using the locking ferrule 110. For example, after loading the suture 124 through the first and second cannulations 122 A, 122B of the locking ferrule 110, the suture 124 may be tensioned in the direction DI to allow the pointed tips 132 of the locking barbs 130 to interdigitate with the section of the suture 124 accommodated within the first cannulation 122 A, thereby locking the suture 124 in place and preventing it from sliding in the second direction D2.[000186] Figures 13-17 illustrate another exemplary locking ferrule 210 that can be used when performing various tensionable knotless surgical procedures. The locking ferrule 210 is similar to the locking ferrule 10 described above may include a cap portion 212 and a barrel portion 214 that protrudes from the cap portion 212. A cannulation 222 may extend through the cap portion 212 and the barrel portion 214 for establishing an internal passageway for accommodating one or more strands of suture 224, for example.[oooi87] The cannulation 222 may be circumscribed by an interior wall 226 of the locking ferrule 210. An outer diameter wall 228 of the barrel portion 214 may be smooth or could alternatively include threads, barbs, or other features for facilitating bone fixation.[oooi88] A plurality of locking barbs 230 may protrude inwardly from the interior wall 226. The locking barbs 230 may therefore occupy at least a portion of the open space of the cannulation 222. The locking barbs 230 may establish a one-way locking mechanism that permits suture 224 to pass through the cannulation 222 in a first direction while preventing the suture(s) from being tensioned or otherwise moved in a second direction.[oooi89] One or more slots 266 may be formed in the cap portion 212. Each slot 266 may open into the cannulation 222. Each slot 266 may function as a cleat for locking the suture 224 relative to the locking ferrule 210. The size and shape of the slots 266 is not intended to limit this disclosure as is evident from the exemplary design options illustrated in Figures 14, 15, and 16.[000190] In an embodiment, the slots 266 do not extend through a side wall 220 of the cap portion 212 (see Figures 14 and 15). In another embodiment, the slots 266 extend through the side wall 220 of the cap portion 212 for facilitating suture loading into the cannulation 222 (see Figure 16).[000191] In an embodiment, suture 224 may be arranged within the cannulation 222 in a manner that forms a loop 268 in the suture 224 (see, e.g., Figure 17). The loop 268 can be used to suspend a graft within a bone tunnel, for example. Free ends 270 of the suture 224 may be cleated within the slots 266 to help force the portions of the suture 224 that are passed through the cannulation 222 into increased engagement with the locking barbs 230.[000192] In the embodiments described above, the exemplary locking ferrules include both a cap portion and a barrel portion that are arranged together to provide a top hat-like appearance of the locking ferrule. However, other locking ferrule implementations could exclude the cap portion, and therefore locking ferules that do not exhibit a top hat-like appearance are also contemplated within the scope of this disclosure. For example, Figure 18 illustrates an exemplary locking ferrule 310 that includes a barrel portion 314 without an integrated cap portion. The barrel portion 314 may be tubular shaped and may be constructed from either metallic materials or plastic materials. However, the specific size, shape, and material make-up of the barrel portion 314 are not intended to limit this disclosure.[oooi93] A cannulation 322 may extend through the barrel portion 314 and may establish an internal passageway for accommodating one or more strands of suture 324. The cannulation 322 may be circumscribed by an interior wall 326 of the locking ferrule 310. An outer diameter wall328 of the barrel portion 314 may be smooth or could alternatively include threads, barbs, or other features for facilitating bone fixation.[oooi94] A plurality of locking barbs 330 may protrude inwardly from the interior wall 326. The locking barbs 330 may therefore occupy at least a portion of the open space of the cannulation 322. The locking barbs 330 may establish a one-way locking mechanism that permits one or more sutures 324 to pass through the cannulation 322 in a first direction while preventing the suture(s) from being tensioned or otherwise moved in a second direction.[oooi95] One or more side openings 372 may be formed through the barrel portion 314. Each side opening 372 may open through both the interior wall 326 and the outer diameter wall 328. The side openings 372 are therefore connected to the cannulation 322.[000196] In an embodiment, the suture 324 may be arranged within the cannulation 322 in a manner that forms a loop 368 in the suture 324. The loop 368 can be used to suspend a graft within a bone tunnel or fixate soft tissue or bone, for example. Free ends 370 of the suture 324 may be passed through each side opening 372 and then tensioned to help force the portions of the suture 324 that are passed through the cannulation 322 into increased engagement with the locking barbs 330.[oooi97] Figure 19 illustrates another exemplary locking ferrule 410 that includes a barrel portion 414 without an integrated cap portion. A cannulation 422 may extend through the barrel portion 414 and may establish an internal passageway for accommodating one or more strands of suture 424. The cannulation 422 may be circumscribed by an interior wall 426 of the locking ferrule 410. An outer diameter wall 428 of the barrel portion 314 may be smooth or could alternatively include threads, barbs, or other features for facilitating bone fixation.[000198] One or more side openings 472 may be formed through the barrel portion 414. Each side opening 472 may open through both the interior wall 426 and the outer diameter wall 428. The side openings 472 are therefore connected to the cannulation 422.[000199] Each side opening 472 may include a plurality of locking barbs 430. The locking barbs 430 may establish a one-way locking mechanism that permits the suture 424 to pass through the side openings 472 in a first direction while preventing the suture(s) from being tensioned or otherwise moved in a second direction. Although not specifically shown in the exemplary embodiment, the cannulation 422 could be provided with additional locking barbs.[000200] Free ends 470 of the suture 424 may be passed through each side opening 472 and then tensioned to lock the suture 424 in place relative to the locking ferrule 410. In an embodiment, the suture 424 may include a plurality of partitions 474 (see Figure 20) that can interface with the locking barbs 430 of the side openings 472 to create a “rip-stop” effect as the free end 470 of the suture 424 is being tensioned.[000201] Figures 21 and 22 illustrate yet another exemplary locking ferrule 510 that includes a barrel portion 514 without an integrated cap portion. A first cannulation 522A and a second cannulation 522B may extend through the barrel portion 514. A dividing wall 554 may separate the first cannulation 522A and the second cannulation 522B from one another.[000202] The first and second cannulations 522A, 522B may establish internal passageways for accommodating one or more strands of suture 524 (see Figure 22) through the locking ferrule 510. The locking ferrule 510 of this embodiment therefore provides another “dual-chamber” design.[000203] The first cannulation 522A may include a plurality of locking barbs 530. The locking barbs 530 may protrude inwardly from an interior wall 526A that circumscribes the first cannulation 522A. The locking barbs 530 may therefore occupy at least a portion of the open space of the first cannulation 522A. The locking barbs 530 may establish a one-way locking mechanism for locking suture 524 relative to the locking ferrule 510.[000204] The second cannulation 522B may be circumscribed by an interior wall 526B. In an embodiment, the second cannulation 522B excludes locking barbs, and therefore the interior wall 526B can be configured to provide a substantially smooth surface that allows the suture 524 to be shuttled through the locking ferrule 510 prior to being locked in place via the locking barbs 530 of the first cannulation 522A. The suture 524 may be retained relative to the second cannulation 522B by a knot 576.[000205] In another embodiment, the second cannulation 522B includes an additional plurality of locking barbs 530 (see Figures 23 and 24). If provided within the second cannulation 522B, the additional locking barbs 530 may be angled in the same direction (see Figure 23) or in an opposite direction (see Figure 24) as the locking barbs 530 of the first cannulation 522A.[000206] Figure 25 illustrates an exemplary surgical button 678, which is another exemplary suture locking device that can be utilized when performing various tensionable knotless surgicalprocedures (e.g., syndesmosis procedures, etc.). The size, shape, and material-makeup of the surgical button 678 arc not intended to limit this disclosure.[000207] The surgical button 678 may include a first opening 680 and a second opening 682 formed through a body of the surgical button 678 and separated by a bridge 684. The first and second openings 680, 682 may establish through-passages for accommodating and locking one or more strands of suture 624 relative to the surgical button 678.[000208] The first opening 680 may include a plurality of locking barbs 630. The locking barbs 630 may establish a one-way locking mechanism for locking the suture 624 relative to the surgical button 678. The second opening 682 may exclude locking barbs and therefore provides a substantially smooth surface that allows the suture 624 to be shuttled through the surgical button 678 prior to being locked in place via the locking barbs 630.[000209] The suture 624 may be shuttled through the second opening 682 and then through the first opening 680 of the surgical button 678 using a shuttle device 656. The shuttle device 656 may be a passing wire or another suture, for example. The suture 624 may be passed through an eyelet 658 of the shuttle device 656, and a free end 660 of the shuttle device 656 may then be pulled (in the direction 677) to shuttle the suture 624 through the surgical button 678.[000210] In the illustrated embodiment, the locking barbs 630 are integrally formed features of the body of the surgical button 678. However, the locking barbs 630 could alternatively be provided within a separate locking ferrule 610 that is insertable into the first opening 680 or the second opening 682 of the surgical button 678 (see, e.g., Figure 26).[000211] Figure 27 illustrates an exemplary bone plate 786, which is another exemplary suture locking device that can be utilized when performing various tensionable knotless surgical procedures (e.g., syndesmosis procedures, clavicle fracture repairs, etc.). The size, shape, and material-makeup of the bone plate 786 are not intended to limit this disclosure.[000212] The bone plate 786 may include a plurality of openings 788 formed through a plate body of the bone plate 786. The openings 788 may establish through-passages for accommodating other devices, such as suture, screws, etc. and / or for locking one or more strands of suture 724 relative to the bone plate 786.[000213] One or more of the openings 788 may include a plurality of locking barbs 730. The locking barbs 730 may establish a one-way locking mechanism for locking the suture 724 relativeto the bone plate 786. The suture 724 may be passed through the opening 788 in a first direction and may be prevented from moving in a second direction by the locking barbs 730.[000214] In an embodiment, the locking barbs 730 may only be provided at select portions of the respective opening, with remaining portions left smooth by omitting the locking barbs (see, e.g., opening identified at 788-2). In another embodiment, at least a portion of the openings 788 of the bone plate 786 may completely omit any locking barbs 730 (see, e.g., openings identified at 788-3 and 788-4).[000215] In the illustrated embodiment, the locking barbs 730 are integrally formed features of the plate body of the bone plate 786. However, the locking barbs 730 could alternatively be provided as pail of a separate locking ferrule 710 that is insertable into one of the openings 788 of the bone plate 786 (see, e.g., Figure 28).[000216] Figures 29 and 30 illustrate another exemplary bone plate 886. The bone plate 886 may include one or more openings 888 formed through a plate body of the bone plate 886.[000217] A locking ferrule 810 may be inserted into any one of the openings 888. The locking ferrule 810 may include an engagement portion 890 and an eyelet portion 892. The engagement portion 890 may be configured to connect to the opening 888, such as via a threaded engagement, for example. The eyelet portion 892 may be configured to receive and lock suture 824 relative to the bone plate 886.[000218] The eyelet portion 892 may include a plurality of locking barbs 830. The locking barbs 830 may establish a one-way locking mechanism for locking the suture 824 relative to the bone plate 886. The suture 824 may be passed through the eyelet portion 892 in a first direction and may be prevented from moving in a second direction by the locking barbs 830.[000219] After inserting the locking ferrule 810 into one of the openings 888, the suture 824 may be passed through or around a tissue 894 (e.g., bone, see Figure 30) and then passed through the eyelet portion 892. The suture 824 may then be tensioned to knotlessly secure the tissue 894 at a desired position relative to the bone plate 886.[000220] Figures 31 and 32 illustrate an exemplary arthroplasty implant 996, which is another exemplary suture locking device that can be utilized when performing various tensionable knotless surgical procedures (e.g., shoulder arthroplasty procedures, etc.). The size, shape, and material-makeup of the arthroplasty implant 996 are not intended to limit this disclosure.[000221] The arthroplasty implant 996 may include one or more openings 988 formed through a body of the arthroplasty implant 996. A locking ferrule 910 may be inserted into any one of the openings 988. The locking ferrule 910 may include a cannulation 922 that includes a plurality of locking barbs 930. The locking barbs 930 may establish a one-way locking mechanism for locking the suture 924 relative to the locking ferrule 910.[000222] In an embodiment, the suture 924 may be passed through or around a tissue 994 (e.g., tendon, see Figure 32), be passed through the opening 988, and then be passed through the cannulation 922 of the locking ferrule 910. The suture 924 may then be tensioned to knotlessly secure the tissue 994 at a desired position relative to the arthroplasty implant 996.[000223] Figures 33 and 34 illustrate an exemplary suture anchor 1098, which is another exemplary suture locking device that can be utilized when performing various tensionable knotless surgical procedures (e.g., soft tissue-to-bone fixation, etc.). The suture anchor 1098 may include a sheath 1099 and a shuttle device 1056 received through the sheath 1099. The sheath 1099 may be a “soft” body made exclusively of soft, suture-based materials. The shuttle device 1056 may be a passing wire or another suture, for example.[000224] The suture anchor 1098 may additionally include one or more locking ferrules 1010 that may be positioned within an internal bore 1097 of the sheath 1099. Each locking ferrule 1010 may include a cannulation 1022 that includes a first plurality of locking barbs 1030A. The locking barbs 1030A may establish a one-way locking mechanism for locking suture 1024 relative to the locking ferrule 1010. An outer diameter wall 1028 of the locking ferrule 1010 may include a second plurality of barbs 1030B that are configured to engage the internal wall of the sheath 1099 for locking a position of the locking ferrule 1010 within the internal bore 1097.[000225] In an embodiment, the sheath 1099 of the suture anchor 1098 may be inserted into a socket 1095 formed in a bone 1093. The socket 1095 may be a preformed opening formed in the bone 1093 that is sized for receiving the sheath 1099. The suture 1024 may be passed through or around a tissue 1094 (e.g., ligament, tendon, etc., see Figure 34) and may then be passed through an eyelet 1058 of the shuttle device 1056. A free end 1060 of the shuttle device 1056 may then be pulled to shuttle the suture 1024 through the sheath 1099. The suture 1024 may then be further tensioned to knotlessly secure the tissue 1094 at a desired position relative to the bone 1093.[000226] Figure 35 illustrates another exemplary locking ferrule 1110 that includes a barrel portion 1114, which may be provided either with or without an integrated cap portion. Acannulation 1122 may extend through the barrel portion 1114 and may establish an internal passageway for accommodating one or more strands of suture 1124. The cannulation 1122 may be circumscribed by an interior wall 1126 of the locking ferrule 1110. An outer diameter wall 1128 of the barrel portion 1114 may be smooth or could alternatively include threads, barbs, or other features for facilitating bone fixation.[000227] A plurality of locking barbs 1130 may protrude inwardly from the interior wall 1126. The locking barbs 1130 may therefore occupy at least a portion of the open space of the cannulation 1122. The locking barbs 1130 may establish a one-way locking mechanism that permits suture 1124 to pass through the cannulation 1122 in a first direction while preventing the suture 1124 from being tensioned or otherwise moved in a second direction.[000228] In an embodiment, the cannulation 1122 may extend along a longitudinal centerline axis B that extends at an oblique angle a relative to a longitudinal centerline axis A of the barrel portion 1114. Arranging the cannulation 1122 at the oblique angle a through the locking ferrule 1110 can help force the suture 1124 into increased engagement with the locking barbs 1130.[000229] Figures 36-37 illustrate an exemplary bone plate assembly 1210 that can be used when performing various tensionable knotless surgical procedures. For example, the bone plate assembly 1210 could be utilized during surgical methods for performing tissue repairs. The bone plate assembly 1210 could be used in conjunction with a variety of orthopedic surgical repairs or reconstructions, including but not limited to cerclage procedures, syndesmosis repairs, clavicle fracture repairs, among many others.[000230] The bone plate assembly 1210 is an exemplary suture locking device / system that may include a bone plate 1212, one or more locking ferrules 1214 that are removably securable relative to the bone plate 1212, and one or more sutures 1218. The size, shape, and materialmakeup of the bone plate 1212 are not intended to limit this disclosure.[000231] The bone plate 1212 may include one or more openings 1216 formed through a plate body of the bone plate 1212. The openings 1216 may establish through-passages for accommodating other devices, such as suture, screws, etc., and / or for locking one or more strands of suture 1218 relative to the bone plate 1212.[000232] The locking ferrule 1214 may include an engagement portion 1220 and an eyelet portion 1222. The engagement portion 1220 may be received through one of the openings 1216 and may be configured to clip to the bone plate 1212, for example. When the engagement portion1220 is secured to the bone plate 1212, the eyelet portion 1222 extends outside of the opening 1216 (e.g., above or proud of a top surface 1224 of the bone plate 1212) and may be configured for receiving and locking the suture 1218 relative to the bone plate 1212.[000233] Referring now to Figures 38-39, with continued reference to Figures 36-37, the engagement portion 1220 of the locking ferrule 1214 may include a pair of flexible retention legs 1226. Each flexible retention leg 1226 may include a foot 1228 that protrudes outwardly from its respective flexible retention leg 1226 at distal end thereof. The flexible retention legs 1226 may flex in a first direction (e.g., toward one another) for inserting the locking ferrule 1214 through the opening 1216 of the bone plate 1212, and the flexible retention legs 1226 may flex in a second direction (e.g., away from one another) for securing the locking ferrule 1214 to the bone plate 1212. For example, when the flexible retention legs 1226 are flexed in the first direction, a distance between the feet 1228 is small enough to pass through the opening 1216. Once the feet 1228 have been inserted completely through the opening 1216, the flexible retention legs 1226 may spring outwardly in the second direction to engage a portion (e.g. a bottom surface 1225) of the bone plate 1212 that surrounds the opening 1216, thereby clipping the locking ferrule 2114 to the bone plate 1212.[000234] The eyelet portion 1222 of the locking ferrule 2114 may be either cylindrical shaped (see Figure 38) or ovoid shaped (see Figure 40), for example. The eyelet portion 1222 may further embody either a single barrel design (see Figure 38) or a double barrel design (see Figure 41).[000235] A cannulation 1230 may extend through the eyelet portion 1222 of the locking ferrule 1214. The cannulation 1230 may establish a through-passageway for accommodating one or more strands of the suture 1218. The cannulation 1230 may be circumscribed by an inner diameter wall 1232 of the eyelet portion 1222. The cannulation 1230 may be straight or may taper toward one direction. An outer diameter wall 1234 of the eyelet portion 1222 may provide a smooth surface.[000236] A plurality of locking barbs 1236 may protrude inwardly from the inner diameter wall 1232 of the eyelet portion 1222. The locking barbs 1236 may therefore occupy at least a portion of the open space of the cannulation 1230. In an embodiment, the locking barbs 1236 are integrally formed (e.g., molded) features of the eyelet portion 1222. The locking barbs 1236 may be provided along an entire length of the cannulation 1230 or at only select portions thereof. The locking barbs 1236 may be either rigid or flexible structures.[000237] The locking barbs 1236 may be arranged in multiple rows along the length of the cannulation 1230. For example, the locking barbs 1236 may be arranged in a least a first row R1 and a second row R2 (see Figure 39). In an embodiment, the locking barbs 1236 of the second row R2 are staggered relative to the locking barbs 1236 of the first row R1 (see Figure 39).[000238] Each locking barb 1236 may include a sharp or pointed tip 1238, and each locking barb 1236 may be angled in the same direction, such as toward a common end of the eyelet portion 1222. The locking barbs 1236 may therefore establish a one-way locking mechanism that permits the suture 1218 to pass through the cannulation 1230 in a first direction DI while preventing the suture 1218 from being tensioned or otherwise moved in a second direction D2. The staggered relationship of the adjacent rows of locking barbs 1236 may provide for maximum engagement with the suture 1218 once it has been passed through the cannulation 1230.[000239] The suture 1218 may be FiberWire®, FiberTape®, or any other suitable suture product. FiberWire® and FiberTape® are suture products marketed and sold by Arthrex, Inc. However, other suture products could be utilized within the scope of this disclosure. The size and type of suture utilized in conjunction with the locking ferrule 1214 are not intended to limit this disclosure.[000240] The suture 1218 may include a varying thickness. The suture 2118 may therefore include one or more tapered regions 1240 where the suture 1218 transitions between a thickened section 1242 and a thinned section 1244 (see Figure 42). The thinned sections 1244 can facilitate passing the suture 1218 through the cannulation 1230, such as via a suitable suture loader that can be provided as pail of the suture locking device / system, for example, and the thickened sections 1242 can provide greater surface area for the locking barbs 1236 to engage in order to sufficiently lock the suture 1218 to the locking ferrule 1214 and thus relative to the bone plate 1212.[000241] In an embodiment, the thickened sections 1242 of the suture 1218 are about twice as thick as the thinned sections 1244. However, other ratios (e.g., 1.5:1, 3:1, etc.) between the relative thicknesses (e.g., outer diameters) of the thickened section 1242 and the thinned section 1244 are contemplated within the scope of this disclosure.[000242] Either before or after clipping the locking ferrule 1214 in place within one of the openings 1216 of the bone plate 1212, the suture 1218 may be passed through or around a tissue 1246 (e.g., bone, ligament, tendon, muscle, etc., see Figure 37) and then be passed through the eyelet portion 1222 of the locking ferrule 1214. The suture 1218 may then be tensioned toknotlessly secure the tissue 1246 at a desired position relative to the bone plate 1212. Tensioning the suture 1218 in the first direction DI allows the pointed tips 1238 of the locking barbs 1236 to interdigitate with the portion of the suture 1218 accommodated within the cannulation 1230, thereby locking the suture 1218 in place and preventing it from sliding back in the second direction D2.[000243] Notably, in the above implementations, the cannulation 1230 extends along an axis that is substantially parallel to the top surface 1224 of the bone plate 1212. Accordingly, the suture 1218 can be tensioned in a direction that is parallel with the top surface 1224 of the bone plate 1212. However, the cannulation 1230 could alternatively be configured such that the suture 1218 is passed and tensioned along a direction that is transverse (e.g., substantially perpendicular) to the top surface 1224 of the bone plate 1212.[000244] Figures 43 and 44 illustrate another exemplary bone plate assembly 13110 that may include a bone plate 13112, a locking ferrule 13114, and suture 13118. The bone plate 13112 may include one or more openings 13116 formed through a plate body of the bone plate 13112. The locking ferrule 13114 may be positioned within any one of the openings 13116 when performing a surgical procedure (e.g., syndesmosis procedure, cerclage procedure, etc.).[000245] The locking ferrule 13114 may include a body 13115 that can be either disk-shaped (see Figures 43-44) or cylindrical shaped (see Figure 45), for example. A cannulation 13130 may extend through the body 13115 for establishing a through-passage for accommodating one or more strands of the suture 13118. The cannulation 13130 may include a plurality of locking barbs 13136. The locking barbs 13136 may be arranged in one or more rows along the length of the cannulation 13130 and establish a one-way locking mechanism that permits the suture 13118 to pass through the cannulation 13130 in a first direction DI while preventing the suture 13118 from being tensioned or otherwise moved in a second direction D2.[000246] The suture 13118 may be passed through, around or otherwise secured relative to a tissue 13146 and may then be passed through the cannulation 13130 of the locking ferrule 13114. The suture 13118 may then be tensioned in the first direction DI to knotlessly lock the suture 13118 relative to the bone plate 13112 and thereby secure the tissue 13146 at a desired position. In this implementation, the locking ferrule 13114 may be retained within the opening 13116 of the bone plate 13112 by the tension created by locking the suture 13118 within the cannulation 13130 of the locking ferrule 13114 (see, for example, Figure 44).[000247] Figures 46 and 47 illustrate an exemplary suture anchor assembly 14250, which is another suture locking dcvicc / systcm that can be utilized when performing various tensionable knotless surgical procedures (e.g., soft tissue-to-bone fixation, etc.). The suture anchor assembly 14250 may include a suture anchor 14252, a locking ferrule 14214 that may be attached to the suture anchor 14252, and a suture 14218.[000248] The suture anchor 14252 may include an anchor body 14254. The anchor body 14254 may be a relatively rigid plastic or metallic body. The size and material make-up of the anchor body 14254 are not intended to limit this disclosure. An outer wall 14235 of the anchor body 14254 may include bone engagement features 14256 (e.g., threads, barbs, ledges, etc.) for facilitating bone fixation.[000249] The anchor body 14254 may include an internal bore 14258. The internal bore 14258 may longitudinally extend at least partially through the anchor body 14254.[000250] The locking ferrule 14214 may include an engagement portion 14220 and an eyelet portion 14222. The engagement portion 14220 may be received within the internal bore 14258 for attaching the locking ferrule 14214 to the anchor body 14254. When the engagement portion 14220 is secured to the anchor body 14254, the eyelet portion 14222 is positioned directly over top of the anchor body 14254 and may be configured for receiving and locking the suture 14218 relative to the suture anchor 14252.[000251] The engagement portion 14220 of the locking ferrule 14214 may include a pair of flexible retention legs 14286. Each flexible retention leg 14286 may include a foot 14288 that protrudes outwardly from its respective flexible retention leg 14286 at distal end thereof. The flexible retention legs 14286 may flex in a first direction (e.g., toward one another) for inserting the locking ferrule 14214 into the internal bore 14258 of the suture anchor 14252, and the flexible retention legs 14286 may flex in a second direction (e.g., away from one another) for securing the locking ferrule 14214 to the suture anchor 14252. For example, when the flexible retention legs 14286 are flexed in the first direction, a distance between the feet 14288 is small enough to allow the engagement portion 14220 to enter into the internal bore 14258. Once the feet 14288 have been inserted far enough into the internal bore 14258, the flexible retention legs 14286 may spring outwardly in the second direction to engage a ledge portion 14260 of an expanded diameter section 14262 of the internal bore 14258, thereby securing the locking ferrule 14214 to the suture anchor 14252.[000252] A cannulation 14230 may extend through the eyelet portion 14222 of the locking ferrule 14214. The cannulation 14230 may establish a through-passage for accommodating one or more strands of suture 14218. The cannulation 14230 may be circumscribed by an inner diameter wall 14232 of the eyelet portion 14222. An outer diameter wall 14234 of the eyelet portion 14222 may provide a smooth surface.[000253] A plurality of locking barbs 14236 may protrude inwardly from the inner diameter wall 14232 of the eyelet portion 14222. The locking barbs 14236 may therefore occupy at least a portion of the open space of the cannulation 14230. The locking barbs 14236 may be arr anged in one or more rows along the length of the cannulation 14230. Each locking barb 14236 may include a sharp or pointed tip 14238, and each locking barb 14236 may be angled in a common direction relative to the eyelet portion 14222. The locking barbs 14236 may therefore establish a one-way locking mechanism that permits the suture 14218 to pass through the cannulation 14230 in a first direction DI while preventing the suture 14218 from being tensioned or otherwise moved in a second direction D2.[000254] In an embodiment, the anchor body 14254 of the suture anchor 1452 may be inserted into a socket 14264 formed in a bone 14266. The socket 14264 may be a preformed opening formed in the bone 14266 that is sized for receiving the anchor body 14254 of the suture anchor 14252. The suture 14218 may be passed through or around a tissue 14246 (e.g., ligament, tendon, etc.) and may then be shuttled through the cannulation 14230 of the eyelet portion 14222 of the locking ferrule 14214. The suture 14218 may then be tensioned to reduce and knotlessly secure the tissue 14246 at a desired position relative to the bone 14266.[000255] Figures 48-53 illustrate another exemplary locking ferrule 1510 that can be used when performing various tensionable knotless tissue repairs. For example, the locking ferrule 1510 could be utilized during surgical methods for attaching tissue (e.g., ligament, tendon, graft, etc.) to bone or for repairing any other type of tissue effect. The locking ferrule 1510 could be used in conjunction with a variety of orthopedic surgical repairs, including but not limited to rotator cuff repairs, biceps tendon repairs, and subscapularis repairs, among many others.[000256] The locking ferrule 1510 may include a body 1512 that extends along a longitudinal axis A between a proximal end 1514 and a distal end 1516. The body 1512 may be tubular’ shaped and may be constructed from either metallic materials or plastic materials. However, the specific size, shape, and material make-up of the body 1512 are not intended to limit this disclosure.[000257] A cannulation 1518 may extend through the body 1512 and may establish an internal passageway for accommodating one or more strands of suture 1520 (see, for example, Figures 52 and 53). The cannulation 1518 may extend across an entire length of the body 1512 and thus extends from the proximal end 1514 to the distal end 1516. The longitudinal axis A may bisect the cannulation 1518.[000258] The body 1512 may include an outer diameter wall 1522 and an inner diameter wall 1524. The outer diameter wall 1522 may be smooth or could alternatively include threads, barbs, or other features for facilitating fixation to bone. The inner diameter wall 1524 may circumscribe the cannulation 1518. In some embodiments, the cannulation 1518 may taper in a direction toward the distal end 1516 and is therefore narrower within the distal end 1516 compared to within the proximal end 1514.[000259] A plurality of locking barbs 1526 may protrude inwardly from the inner diameter wall 1524. The locking barbs 1526 may therefore occupy at least a portion of the open space of the cannulation 1518. In an embodiment, the locking barbs 1526 are integrally formed (e.g., molded) features of the body 1512 of the locking ferrule 1510. The locking barbs 1526 may be provided along an entire length of the cannulation 1518 or at only select portions thereof. The locking barbs 1526 may be either rigid or flexible structures.[000260] The locking barbs 1526 may be arranged in multiple rows along the length of the cannulation 1518. For example, the locking barbs 1526 may be arranged in a least a first row R1 and a second row R2 (see Figure 51). In an embodiment, the locking barbs 1526 of the second row R2 are staggered relative to the locking barbs 1526 of the first row R1 (see Figure 51).[00026I] Each locking barb 1526 may include a sharp or pointed tip 1528, and each locking barb 1526 may be angled in a common direction (e.g., here, toward the proximal end 1514). The locking barbs 1526 may therefore establish a one-way locking mechanism that permits one or more sutures 1520 to pass through the cannulation in a first direction DI while preventing the suture(s) 1520 from being tensioned or otherwise moved back in a second direction D2. The staggered relationship of the rows of locking barbs 1526 may provide for maximum engagement with the suture 1520 one it is passed through the cannulation 1518.[000262] Referring now primarily to Figures 52 and 53, with continued reference to Figures 48-51, one or more sutures 1520 may be passed through the cannulation 1518. The suture 1520 may be FiberWire®, FiberTape®, or any other suitable suture product. FiberWire® andFiberTape® are suture products marketed and sold by Arthrex, Inc. However, other suture products could be utilized for the suture 1520 within the scope of this disclosure. The size and type of suture utilized in conjunction with the locking ferrule 1510 are not intended to limit this disclosure.[000263] The suture 1520 may include a varying thickness. The suture 1520 may therefore include one or more tapered regions 1530 where the suture 1520 transitions between a thickened section 1532 and a thinned section 1534. The thinned sections 1534 can facilitate passing the suture 1520 through the cannulation 1518, such as via a suitable suture loader 1536 that can be provided as part of a suture locking system that includes the locking ferrule 1510, for example, and the thickened sections 1532 can provide greater surface area for the locking barbs 1526 to engage in order to sufficiently lock the suture 1520 relative to the locking ferrule 1510 after loading the suture 1520 through the cannulation 1518.[000264] In an embodiment, the thickened sections 1532 of the suture 1520 are about twice as thick as the thinned sections 1534. However, other ratios (e.g., 1.5:1, 3:1, etc.) between the relative thicknesses (e.g., outer diameters) of the thickened section 1532 and the thinned section 1534 of the suture 1520 are contemplated within the scope of this disclosure.[000265] The suture 1520 may be passed through the cannulation 1518 of the locking ferrule 1510 using the suture loader 1536. An eyelet 1538 of the suture loader 1536 may be passed through the cannulation 1518 (e.g., by inserting the eyelet 1538 at the proximal end 1514 of the body 1512 and then moving the suture loader 1536 in the second direction D2). One or more thinned sections 1534 of the suture 1520 may then be loaded through the eyelet 1538. The suture loader 1536 may then be pulled, via a handle 1540, in the first direction DI to pass the suture 1520 through the cannulation 18.[000266] Once the suture 1520 has been passed through the cannulation 1518, the suture 1520 may be further tensioned in the first direction DI to lock the suture 1520 relative to the locking ferrule 1510. The locking barbs 1526 substantially prevent the suture 1520 from backing up or otherwise moving in the second direction D2. The pointed tips 1528 of the locking barbs 1526 may interdigitate with one or more of the thickened sections 1532 to lock the suture 1520 and prevent it from moving in the second direction D2.[000267] Although shown as locking a single folded suture 1520 in the above implementations, the locking ferrule 1510 could be configured to receive and lock multiple strands of suture and / or sutures of varying sizes.[000268] The locking ferrule 1510 described above and shown in Figures 48-53 may be utilized to tension and knotlcssly fixate one or more sutures as part of various surgical methods. Figures 54-59 schematically illustrate one such surgical method for attaching a graft 1546 relative to a tissue 1542 and a bone 1544. The tissue 1542 may have partially or completely tom away from the bone 1544 during vigorous exercise or sporting activities, for example. When such tears occur, reattachment is often necessary to repair the tissue defect. The graft 1546 may be secured over top of the tissue 1542 in order to augment the repair. Notably, the various figures provided to schematically illustrate the method are not necessarily drawn to scale, and some features may be exaggerated or minimized to emphasize certain details of a particular component, assembly, or system.[000269] The graft 1546 could include either an allograft or an autograft. In an embodiment, the graft 1546 is an acellular dermal extracellular matrix. ArthroFlex®, sold by Arthrex, Inc., is one type of graft suitable for use when performing the surgical method of Figures 54-59. In other implementations, the graft 1546 could be a suture patch or any other type of synthetic scaffold.[000270] The surgical method schematically illustrated in Figures 54-59 could be used in conjunction with a variety of orthopedic surgical repairs, including but not limited to rotator cuff repairs, for example. The bone 1544 may therefore be associated with any joint of the human musculoskeletal system (e.g., shoulder, knee, hip, ankle, etc.).[000271] In an embodiment, the surgical method is performed as an arthroscopic procedure by working through various arthroscopic portals. However, the exemplary surgical method could alternatively be performed as an open procedure within the scope of this disclosure. The exemplary surgical method may be employed to achieve secure fixation of the graft 1546 after repairing or reconstructing the tissue 1542 in a manner that provides mechanical strength and augments healing of the tissue 1542.[000272] Referring first to Figures 54-55, after optionally repairing the underlying tissue 1542 and fixating a medial side 1548 of the graft 1546 to the tissue 1542, such as with one or more mattress stitches 1555, for example, the surgical method may include loading one or more sutures 1520 through a lateral side 1550 of the graft 1546. The sutures 1520 may be loaded through and connected to the graft 1546 using any known stitching technique. In an alternative embodiment, the medial side 1548 of the graft 1546 may be fixated to the tissue using one or more medially placed fixation devices (e.g., suture anchors).[000273] Next, a lateral row of fixation devices may be implanted into the bone 1544. The lateral row of fixation devices may include one or more suture anchors 1552. The suture anchors 1552 of the lateral row may be placed laterally from an edge 1554 of the tissue 1542 and laterally from the lateral side 1550 of the graft 1546. However, other implantation locations could be selected based on the performing surgeon’s preferences and depending on the type of orthopedic procedure being performed. Notably, although two suture anchors 1552 are illustrated as being part of the lateral row in the illustrated embodiment, a greater or fewer number of lateral fixation devices could be utilized as part of the surgical method within the scope of this disclosure.[000274] Each suture anchor 1552 may include an anchor body 1556 and a shuttle device 1566 that is connected to the anchor body 1556. The anchor body 1556 may extend between a proximal end portion 1558 and a distal end portion 1560. The anchor body 1556 may include a single piece or two-piece design, and thus the distal end portion 1560 could be a separate piece that is attached to the proximal end portion 1558. The distal end portion 1560 may be blunt or could be sharp and thus configured to pierce or punch through tissue / bone.[000275] The anchor body 1556 may include a plurality of bone engagement features 1562 that are designed to engage a bone wall when the suture anchor 1552 in inserted into the bone 1544. The bone engagement features 1562 can include barbs, circular ledges, threads, or any other type of bone engagement feature or combination of features.[000276] A cannulated passage 1564 may extend at least partially through the anchor body 1556. The shuttle device 1566, which may be a passing wire or another suture, for example, may be accommodated within the cannulated passage 1564 and may be connected to the anchor body 1556. For example, the shuttle device 1566 may be received through a proximal eyelet 1568 of the distal end portion 1560 for slidably connecting the shuttle device 1566 relative to the anchor body 1556. The proximal eyelet 1568 may be at least partially accommodated within the cannulated passage 1564.[000277] The anchor body 1556 may be made of a relatively rigid, biocompatible material, such as a biocomposite material or PEEK material, for example. However, other materials or combinations of material could be utilized to construct the anchor body 1556 of each suture anchor 1552.[000278] The anchor body 1556 of each suture anchor 1552 may be inserted into a socket 1570 formed in the bone 1544. Each socket 1570 may be a preformed opening formed in the bone1544 that is sized for receiving the anchor body 1556 of one of the suture anchors 1552. Alternatively, the socket 1570 could be formed during insertion of the anchor body 1556 into the bone 1544.[000279] Referring to Figure 56, the surgical method may proceed by shuttling the sutures 1520 previously loaded through the lateral side of the graft 1546 through the anchor bodies 1556 of the suture anchors 1552 of the lateral row. For example, a free end 1572 of each suture 1520 from the graft 1546 may be passed through an eyelet 1574 of the shuttle device 1566 of a first of the suture anchors 1552, and then a free end 1576 of the shuttle device 1566 may be pulled (e.g., in the direction of arrow 1578) to allow the suture 1520 to pass through the cannulated passage 1564 and be accommodated through the proximal eyelet 1568 of the distal end portion 1560 of the anchor body 1556, thereby operably connecting the suture 1520 to the suture anchor 1552. This suture shuttling process may be repeated to shuttle the free end 1572 of another suture 1520 from the graft 1546 through the anchor body 1556 of a second of the suture anchors 1552 of the lateral row. Notably, the sutures 1520 may be shuttled through the anchor bodies 1256 either before or after implanting the anchor body 1556 of each suture anchor 1552 into its respective socket 1570 in the bone 1544.[000280] At this point of the surgical method, the sutures 1520 from the graft 1546 are preliminarily fixated relative to the bone 1544 by the suture anchors 1552. Each suture 1520 may subsequently be further tensioned and locked in place using the locking ferrule 1510. For example, as shown in Figures 57 and 58, after loading the suture 1520 that is connected to the first of the suture anchors 1552 through the cannulation 1518 of the locking ferrule 1510 using the suture loader 1536, the suture 1520 may be tensioned in the direction DI to allow the locking ferrule 1510 to slide down the suture 1520 in the direction D2 toward the suture anchor 1552. Further tension of the suture 1520 in the direction DI allows the pointed tips 1528 of the locking barbs 1526 to interdigitate with the suture 1520 to lock the suture 1520 in place and prevent it from sliding back in the second direction D2.[00028I] Once a sufficient amount of tension has been applied to the suture 1520, the locking ferrule 1510 may slide into engagement with the suture anchor 1552. For example, the locking ferrule 1510 may be accommodated within the cannulated passage 1564 of the anchor body 1556 of the suture anchor 1552 (see Figure 59).[000282] The process shown in Figures 57-59 may be repeated to tension and lock the additional suture 1520 associated with the second of the suture anchors 1552 of the lateral row with an additional locking ferrule 1510. The excess length of the sutures 1520 that extend outside of the cannulations 1518 of the locking ferrules 1510 may be removed (e.g., cut) once tensioning and locking is complete.[000283] Figures 60-62 schematically illustrate another surgical method in which the locking ferrule 1510 of Figures 48-53 may be utilized to tension and lock suture during a surgical repair. In this embodiment, the surgical method may involve securing a tissue 1580 (e.g., muscle, tendon, etc.) to a bone 1582, such as part of a subpectoral or suprapectoral biceps tenodesis procedure or a subscapularis repair, for example.[000284] Referring first to Figure 60, the surgical method may include creating a looping stitch 1584 (e.g., with suture) within the tissue 1580 and inserting a cortical button 1586 within the bone 1582 at a desired attachment point for the tissue 1580. The cortical button 1586 may be inserted into a tunnel 1588 formed in the bone 1582. The tunnel 1588 may be a unicortical or bicortical tunnel formed in the bone 1582 that is sized for receiving the cortical button 1586. The cortical button 1586 may be inserted into the tunnel 1588 and then flipped to a position against a cortical shelf 1590 of the bone 1582. A suture limb 1592 of the looping stitch 1584 may be connected to the cortical button 1586 prior to its insertion into the tunnel 1588.[000285] After flipping the cortical button, the tissue 1580 may be reduced into place relative to the bone 1582. The suture limb 1592 may subsequently be tensioned and locked in place using the locking ferrule 1510. For example, as shown in Figure 61, after loading the suture limb 1592 through the cannulation 1518 of the locking ferrule 1510, the suture limb 1592 may be tensioned in the direction DI to allow the locking ferrule 1510 to slide in the direction D2 down and into the tunnel 1588. Further tension of the suture limb 1592 allows the pointed tips 1528 of the locking barbs 1526 to interdigitate with the section of the suture limb 1592 accommodated within the cannulation 1518, thereby locking the suture limb 1592 in place and preventing it from sliding back in the second direction D2. The tissue 1580 is therefore securely tensioned and fixated relative to the bone 1582.[000286] The locking ferrule 1510 may be positioned within the tunnel 1588 such that it overlies the cortical button 1586 (see Figure 62). In an exemplary implementation, the locking ferrule 1510 may include a cap portion 1594 that is configured to seat against an outer cortex 1596of the bone 1582 to prevent over-insertion of the locking ferrule 1510. The cap portion 1594 may be an integrally formed feature of the locking ferrule 1510, and when included, can provide a top hat-like appearance of the locking ferrule 1510.[000287] Figures 63-66 illustrate various aspects of an exemplary suture locking system 1610 that can be used when performing various tensionable knotless surgical procedures. For example, the suture locking system 1610 could be utilized during surgical methods for compressing tissue to another tissue (e.g., soft tissue to bone, soft tissue to another soft tissue, etc.). The suture locking system 1610 could be used during a variety of orthopedic surgical repairs, including but not limited to cerclage procedures, AC joint repairs, syndesmosis repairs, and fracture repairs, among many others.[000288] The suture locking system 1610 may include a surgical fixation device 1612, a locking ferrule 1614, and at least one suture 1616. The surgical fixation device 1612 may be a surgical button or a surgical bone plate, for example. The surgical fixation device 1612 may be made from any biocompatible material or combination of materials, including but not limited to polymeric materials, metallic materials, or embroidered materials.[000289] The surgical fixation device 1612 may include a top surface 1618 and a bottom surface 1620. One or more openings 1622 may be formed through the surgical fixation device 1612 such that each opening 1622 penetrates through both the top surface 1618 and the bottom surface 1620. The opening 1622 may be sized to receive the locking ferrule 1614.[000290] The locking ferrule 1614 may include a cap portion 1624 and a tube or barrel portion 1626 that protrudes from the cap portion 1624. The cap portion 1624 and the barrel portion 1626 may be formed together as part of a unitary structure of the locking ferrule 1614. In an embodiment, the cap portion 1624 and the barrel portion 1626 are arranged to provide a top hatlike appearance of the locking ferrule 1614. The specific size, shape, and material make-up of the locking ferrule 1614 are not intended to limit this disclosure.[000291] The cap portion 1624 of the locking ferrule 1614 may include a top surface 1621, a bottom surface 1623, and a side wall 1625 that extends between the top surface 1621 and the bottom surface 1623. The barrel portion 1626 may protrude outwardly from the bottom surface 1623 of the cap portion 1624.[000292] The locking ferrule 1614 may be positioned within the opening 1622 of the surgical fixation device 1612 such that the cap portion 1624 is received in abutting contact with the topsurface 1618 of the surgical fixation device 1612 and the barrel portion 1626 extends at least partially through the opening 1622. The top surface 1621 of the cap portion 1624 may or may not be positioned flush with the top surface 1618 of the surgical fixation device 1612 once the locking ferrule 1614 is fully seated within the opening 1622. A distal tip 1627 of the barrel portion 1626 may extend to a position that is flush with the bottom surface 1620 of the surgical fixation device 1612 or could protrude outwardly thereof once the locking ferrule 1614 is fully seated within the opening 1622.[000293] The cap portion 1624 is oversized relative to the opening 1622. The cap portion 1624 can thus act as a washer or buttress to prevent the locking ferrule 1614 from being pulled through the surgical fixation device 1612 when the suture locking system 1610 is used during a surgical method.[000294] A cannulation 1628 may extend through the cap portion 1624 and the barrel portion 1626 of the locking ferrule 1614. The cannulation 1628 may each establish an internal passageway for accommodating one or more strands of the suture 1616. The cannulation 1628 may be circumscribed by an interior wall 1630 of the locking ferrule 1614. The interior wall 1630 may be established by both the cap portion 1624 and the barrel portion 1626. An outer diameter wall 1632 of the locking ferrule 1614 could provide a smooth surface or could alternatively include threads, barbs, or other mating features for facilitating fixation within the opening 1622 of the surgical fixation device 1612.[000295] A plurality of locking barbs 1634 may protrude inwardly from the interior wall 1630. The locking barbs 1634 may therefore occupy at least a portion of the open space of the cannulation 1628. In an embodiment, the locking barbs 1634 are integrally formed (e.g., molded) features of the body of the locking ferrule 1614. The locking barbs 1634 may be provided along an entire length of the cannulation 1628 or at only select portions thereof. The locking barbs 1634 may be either rigid or flexible structures.[000296] The locking barbs 1634 may be arranged in multiple rows along the length of the cannulation 1628. For example, the locking barbs 1634 may be arranged in a least a first row R1 and a second row R2 (see Figure 66). In an embodiment, the locking barbs 1634 of the second row R2 are staggered relative to the locking barbs 1634 of the first row R1 (see Figure 66).[000297] Each locking barb 1634 may include a sharp or pointed tip 1636, and, in an exemplary implementation, each locking barb 1634 may be angled in a direction toward the topsurface 1621 of the cap portion 1624 of the locking ferrule 1614. The locking barbs 1634 are therefore configured to establish a one-way locking mechanism that permits one or more sutures 1616 to pass through the cannulation 1628 in a first direction DI while preventing the suture(s) 1616 from being tensioned or otherwise moved in a second direction D2. The staggered relationship of the rows of locking barbs 1634 can maximize engagement with the suture 1616 once it is passed through the cannulation 1628.[000298] The suture 1616 may be FiberWire®, FiberTape®, or any other suitable suture product. FiberWire® and FiberTape® are suture products marketed and sold by Arthrex, Inc. However, other suture products could be utilized for the suture 1616 within the scope of this disclosure. The size and type of suture utilized in conjunction with the suture locking system 1610 are not intended to limit this disclosure.[000299] The suture 1616 may include a varying thickness. For example, the suture 1616 may include one or more tapered regions 1638 where the suture 1616 transitions between a thickened section 1640 and a thinned section 1642 (see Figure 5). The thinned sections 1642 can facilitate passing the suture 1616 through the cannulations 6128, such as via a suitable suture loader that can be provided as part of the suture locking system 1610, and the thickened sections 1640 can provide greater surface area for the locking barbs 1634 to engage in order to sufficiently lock the suture 1616 after tensioning the suture 1616 relative to the locking ferrule 1614.[000300] In an embodiment, the thickened sections 1640 of the suture 1616 are about twice as thick as the thinned sections 1642. However, other ratios (e.g., 1.5:1, 3:1, etc.) between the relative thicknesses (e.g., outer diameters) of the thickened sections 1640 and the thinned sections 1642 are contemplated within the scope of this disclosure.[000301] The suture locking system 1610 described above and shown in Figures 63-67 may be utilized to tension and knotlessly fixate the one or more sutures 1616 as part of various surgical methods. Figure 68 schematically illustrates one such surgical method that can be performed for compressing or fixating a first tissue 1644 (e.g., a soft tissue or bone) relative to a second tissue 1646 (e.g., another soft tissue or bone).[000302] An additional surgical fixation device 1648, here a suture anchor, may first be implanted within or otherwise positioned relative to the second tissue 1646 during the surgical method. The surgical fixation device 1648 may be considered an additional subcomponent of the suture locking system 1610 in this implementation. The suture 1616 may be attached to a body1650 of the surgical fixation device 1648 prior to or subsequent to implantation of the surgical fixation device 1648 relative to the second tissue 1646. In an embodiment, the body 1650 is a sheath made exclusively of soft, suture-based materials. The body 1650 may include an internal bore 1670 for accommodating the suture 1616. However, other configurations are contemplated within the scope of this disclosure.[000303] The suture 1616 may be passed through the second tissue 1646 and then through the first tissue 1644 after the surgical fixation device 1648 has been positioned / implanted relative to the second tissue 1646. The suture 1616 may then be accommodated through the cannulation 1628 of the locking ferrule 1614, which as shown, may be pre -positioned within the opening 1622 of the surgical fixation device 1612.[000304] Thereafter, the suture 1616 may be tensioned in the first direction DI to shorten a length L of the suture 1616 extending between the surgical fixation devices 1612, 1648. The suture 1616 may be tensioned to achieve a desired amount of compression between the first and second tissues 1644, 1646, thereby drawing the tissues toward one another or even into direct contact with one another if desired. The locking barbs 1634 of the locking ferrule 1614 prevent the suture 1614 from sliding back in the second direction D2 subsequent to tensioning in the first direction DI. Furthermore, the cap portion 1624 prevents the locking ferrule 1614 from pulling through the surgical fixation device 1612 during and subsequent to the tensioning.[000305] Figures 69 and 70 illustrate another exemplary suture locking system 16110 that can be utilized to tension and lock a suture 16116 during a surgical procedure, such as a tissue repair, for example. The suture locking system 16110 may include a suture anchor 16112, a locking ferrule 16114, and one or more strands of the suture 16116.[000306] The suture anchor 16112 may include a body portion 16152 and a suture portion 16154 that is connected to the body portion 16152. The body portion 16152 of the suture anchor 16112 may be made from any biocompatible material, including but not limited to suitable polymeric materials or metallic materials. The body portion 16152 may include a cannulated passage 16156. In an embodiment, the cannulated passage 16156 extends entirely through the body portion 16152.[000307] The suture portion 16154 may be accommodated within the cannulated passage 16156. A knot 16158 of the suture portion 16154 may retain the suture portion 16154 within the cannulated passage 16156 and thus relative to the body portion 16152. A tail 16160 of the sutureportion 16154 may extend outside of the body portion 16152. In an embodiment, the knot 16158 and the tail 16160 of the suture portion 16154 arc located at opposite ends of the body portion 16152. However, other configurations are contemplated within the scope of this disclosure.[000308] The locking ferrule 16114 may include an inner diameter wall 16130 and an outer diameter wall 16132. A cannulation 16128 may extend through the locking ferrule 16114 and may establish an internal passageway for accommodating one or more strands of the suture 16116. The cannulation 16128 may be circumscribed by the inner diameter wall 16130.[000309] A plurality of locking barbs 16134 may protrude inwardly from the inner diameter wall 16130. The locking barbs 16134 may therefore occupy at least a portion of the open space of the cannulation 16128. Each locking barb 16134 may include a sharp or pointed tip 16136, and, in this implementation, each locking barb 16134 may angled in a common direction within the cannulation 16128. The locking barbs 16134 may therefore establish a one-way locking mechanism that permits the suture 16116 to pass through the cannulation 16128 in a first direction DI while preventing the suture 16116 from being tensioned or otherwise moved in a second direction D2.[000310] The locking ferrule 16114 may be inserted into a lumen 16164 of the tail 16160 of the suture portion 16154 of the suture anchor 16112. Another plurality of barbs 16162 may protrude outwardly from the outer diameter wall 16132 of the locking ferrule 16114. The plurality of barbs 16162 are configured to engage an internal wall 16166 of the tail 16160 that circumscribes the lumen 16164 for locking a position of the locking ferrule 16114 within the lumen 16164.[000311] In the embodiment of Figure 69, the suture 16116 may be shuttled into the lumen 16164 and then through the cannulation 16128 of the locking ferrule 16114 before exiting back through an outer jacket 16199 of the tail 16160 of the suture portion 16154. The suture 16116 may then be tensioned in the direction DI to allow the pointed tips 16136 of the locking barbs 16134 to interdigitate with the section of the suture 16116 accommodated within the cannulation 16128, thereby locking the suture 16116 in place and preventing it from sliding back toward the second direction D2.[000312] In the embodiment of Figure 70, the suture 16116 may be shuttled through the cannulated passage 16156 of the body portion 16152 prior to passing the suture 16116 into the lumen 16164 of the tail 16160 and then through the cannulation 16128 of the locking ferrule 16114. The suture 16116 may then be tensioned in the first direction DI to allow the pointed tips 16136of the locking barbs 16134 to interdigitate with the section of the suture 16116 accommodated within the cannulation 16128, thereby locking the suture 16116 in place and preventing it from sliding back toward the second direction D2.[000313] Figure 71 illustrates another exemplary suture locking system 16210 that can be utilized to tension and lock a suture 16216 during a surgical repair (e.g., soft tissue-to-bone fixation, etc.). The suture locking system 16210 may include a suture anchor 16212, a locking ferrule 16214, and the suture 16216.[000314] The suture anchor 16212 may include a body 16250. The body 16250 may be a sheath made exclusively of soft, suture-based materials. However, other configurations are contemplated within the scope of this disclosure. The suture 16216 may be passed through an internal bore 16270 of the body 16250 to connect the suture 16216 to the suture anchor 16212.[000315] The locking ferrule 16214 may include an inner diameter wall 16230 and an outer diameter wall 16232. A cannulation 16228 may extend through the locking ferrule 16214 and may establish an internal passageway for accommodating one or more strands of the suture 16216. The cannulation 16228 may be circumscribed by the inner diameter wall 16230.[000316] A plurality of locking barbs 16234 may protrude inwardly from the inner diameter wall 16230. The locking barbs 16234 may therefore occupy at least a portion of the open space of the cannulation 16228. Each locking barb 16234 may include a sharp or pointed tip 16236, and, in this implementation, each locking barb 16234 may angled in a common direction within the cannulation 16228. The locking barbs 16234 may therefore establish a one-way locking mechanism that permits the suture 16216 to pass through the cannulation 16228 in a first direction DI while preventing the suture 16216 from being tensioned or otherwise moved in a second direction D2.[000317] The suture locking system 16210 described above can be used to perform a variety of surgical methods, such as a method for attaching a tissue 16272 (e.g., ligament, tendon, muscle, etc.) to a bone 16274, for example. The tissue 16272 may have tom away from the bone 16274 during vigorous exercise or sporting activities, for example. When such tear s occur, reattachment is often necessary to repair the tissue defect.[000318] An exemplary surgical method may include preparing a socket 16276 in the bone 16274. The socket 16276 may be a preformed opening formed in the bone 16274 that is sized for receiving the suture anchor 16212.[000319] The suture 16216 may be passed through or around the tissue 16272 and may then be shuttled through both the internal bore 16270 of the body 16250 and the cannulation 16228 of the locking ferrule 16214. The suture 16216 may then be tensioned in the direction DI to knotlessly secure the tissue 16272 at a desired position relative to the bone 16274. Tensioning the suture 16216 in the first direction DI allows the pointed tips 16236 of the locking barbs 16234 to interdigitate with the portion of the suture 16216 accommodated within the cannulation 16228, thereby locking the suture 16216 in place and preventing it from sliding back in the second direction D2. The locking ferrule 16214 may be positioned within the socket 16276 at a position that overlies the suture anchor 1812 either during or subsequent to tensioning the suture 16216 in the first direction D 1.[000320] The suture locking devices / systems of this disclosure may be utilized for performing various tensionable knotless surgical repairs. The suture locking devices / systems provide for tensioning and retensioning suture(s) at various points of the repair, including subsequent to implantation of accompanying fixation devices, thus providing numerous advantages over prior tissue repair systems and techniques.[000321] Notably, the various figures accompanying this disclosure are not necessarily drawn to scale, and some features of the disclosed suture locking systems may be exaggerated or minimized to emphasize certain details of a particular component or system.[000322] Although the different non-limiting embodiments are illustrated as having specific components or steps, the embodiments of this disclosure are not limited to those particular combinations. It is possible to use some of the components or features from any of the non-limiting embodiments in combination with features or components from any of the other non-limiting embodiments.[000323] It should be understood that like reference numerals identify corresponding or similar elements throughout the several drawings. It should further be understood that although a particular component arrangement is disclosed and illustrated in these exemplary embodiments, other arrangements could also benefit from the teachings of this disclosure.[000324] The foregoing description shall be interpreted as illustrative and not in any limiting sense. A worker of ordinary skill in the art would understand that certain modifications could come within the scope of this disclosure. For these reasons, the following claims should be studied to determine the true scope and content of this disclosure.

Claims

CLAIMSWhat is claimed is:

1. A locking ferrule for performing a tensionable knotless surgical procedure, comprising: a cap portion; a barrel portion; a cannulation formed through the cap portion and the barrel portion; and a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation.

2. The locking ferrule as recited in claim 1, wherein the cap portion includes a top surface, a bottom surface, and a side wall that extends between the top surface and the bottom surface.

3. The locking ferrule as recited in claim 2, wherein the barrel portion protrudes from the bottom surface of the cap portion.

4. The locking ferrule as recited in claim 1, wherein the barrel portion includes an interior wall and an outer diameter wall, and optionally wherein at least a portion of the plurality of locking barbs protrudes inwardly from the interior wall.

5. The locking ferrule as recited in claim 1, wherein each of the plurality of locking barbs is angled in a direction towaid the cap portion.

6. The locking ferrule as recited in claim 1 , wherein the plurality of locking barbs are arranged in at least a first row and a second row within the cannulation, and optionally wherein a first portion of the plurality of locking barbs of the first row are staggered relative to a second portion of the plurality of locking barbs of the second row.

7. The locking ferrule as recited in claim 1, wherein each of the plurality of locking barbs includes a pointed tip.

8. The locking ferrule as recited in claim 1 , wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

9. The locking ferrule as recited in claim 1, wherein the cap portion and the barrel portion establish a unitary structure that includes a top hat-like appearance.

10. A locking ferrule for performing a tensionable knotless surgical procedure, comprising: a cap portion; a barrel portion; a first cannulation formed through the cap portion and the barrel portion; a second cannulation formed through the cap portion and the barrel portion; and a plurality of locking barbs arranged within the first cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the first cannulation.

11. The locking ferrule as recited in claim 10, wherein the cap portion includes a top surface, a bottom surface, and a side wall that extends between the top surface and the bottom surface, and optionally wherein the barrel portion protrudes from the bottom surface of the cap portion.

12. The locking ferrule as recited in claim 10 or 11, wherein the barrel portion includes an interior wall and an outer diameter wall, and optionally wherein at least a portion of the plurality of locking barbs protrudes inwardly from the interior wall.

13. The locking ferrule as recited in any of claims 10 to 12, wherein each of the plurality of locking barbs is angled in a direction toward the cap portion.

14. The locking ferrule as recited in any of claims 10 to 13, wherein the plurality of locking barbs are arranged in at least a first row and a second row within the first cannulation, and optionally wherein a first portion of the plurality of locking barbs of the first row are staggered relative to a second portion of the plurality of locking barbs of the second row.

15. The locking ferrule as recited in any of claims 10 to 14, wherein each of the plurality of locking barbs includes a pointed tip.

16. The locking ferrule as recited in any of claims 10 to 15, wherein the second cannulation excludes any locking barbs.

17. The locking ferrule as recited in any of claims 10 to 16, comprising a shuttle device configured for shuttling the suture through the second cannulation and the first cannulation.

18. The locking ferrule as recited in any of claims 10 to 17, comprising an adjustable spliced loop accommodated within the first cannulation and the second cannulation.

19. The locking ferrule as recited in any of claims 10 to 18, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

20. The locking ferrule as recited in any of claims 10 to 19, wherein the cap portion and the barrel portion establish a unitary structure that includes a top hat-like appearance.

21. A locking ferrule for performing a tensionable knotless surgical procedure, comprising: a cap portion; a barrel portion; a cannulation formed through the cap portion and the barrel portion; a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation; and a slot that is connected to the cannulation.

22. The locking ferrule as recited in claim 21, wherein the cap portion includes a top surface, a bottom surface, and a side wall that extends between the top surface and the bottom surface, and optionally wherein the barrel portion protrudes from the bottom surface of the cap portion.

23. The locking ferrule as recited in claim 21 or 22, wherein the barrel portion includes an interior wall and an outer diameter wall, and optionally wherein at least a portion of the plurality of locking barbs protrudes inwardly from the interior wall.

24. The locking ferrule as recited in any of claims 21 to 23, wherein each of the plurality of locking barbs is angled in a direction toward the cap portion.

25. The locking ferrule as recited in any of claims 21 to 24, wherein the plurality of locking barbs are arranged in at least a first row and a second row within the cannulation, and optionally wherein a first portion of the plurality of locking barbs of the first row are staggered relative to a second portion of the plurality of locking barbs of the second row.

26. The locking ferrule as recited in any of claims 21 to 25, wherein each of the plurality of locking barbs includes a pointed tip.

27. The locking ferrule as recited in any of claims 21 to 26, wherein the slot is formed in the cap portion and is configured as a cleat for locking the suture relative to the locking ferrule.

28. The locking ferrule as recited in claim 27, wherein the slot extends through a side wall of the cap portion.

29. The locking ferrule as recited in claim 27, wherein the slot does not extend through a side wall of the cap portion.

30. The locking ferrule as recited in any of claims 21 to 29, wherein the suture is arranged within the cannulation in a manner that forms a loop.

31. The locking ferrule as recited in any of claims 21 to 30, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

32. A locking ferrule for performing a tensionable knotless surgical procedure, comprising: a body; a cannulation formed through the body; a plurality of locking barbs arranged within the cannulation and configured to establish a one-way locking mechanism for locking a suture that is shuttled through the cannulation; and a first side opening formed through the body and connected to the cannulation.

33. The locking ferrule as recited in claim 32, wherein the body includes a barrel portion that includes an interior wall and an outer diameter wall, and optionally wherein the plurality of locking barbs protrude inwardly from the interior wall.

34. The locking ferrule as recited in claim 32 or 33, wherein the plurality of locking barbs are arranged in at least a first row and a second row within the cannulation, and optionally wherein a first portion of the plurality of locking barbs of the first row are staggered relative to a second portion of the plurality of locking barbs of the second row.

35. The locking ferrule as recited in any of claims 32 to 34, wherein each of the plurality of locking barbs includes a pointed tip.

36. The locking ferrule as recited in any of claims 32 to 35, comprising a second side opening formed through the body and connected to the cannulation, and optionally wherein the suture is arranged to extend through the first side opening, the cannulation, and the second side opening in a manner that forms a loop, and further optionally wherein a first free end of the suture passes through the first side opening, and a second free end of the suture passes through the second side opening.

37. The locking ferrule as recited in any of claims 32 to 36, wherein a free end of the suture passes through the first side opening.

38. The locking ferrule as recited in any of claims 32 to 37, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

39. A locking ferrule for performing a tensionable knotless surgical procedure, comprising: a body; a cannulation formed through the body; a first side opening formed through the body and connected to the cannulation; and a first plurality of locking barbs arranged within the first side opening and configured to establish a first one-way locking mechanism for locking a suture that is received through the first side opening.

40. The locking ferrule as recited in claim 39, wherein the body includes a barrel portion that includes an interior wall and an outer diameter wall, and optionally wherein the first side opening opens through both the interior wall and the outer diameter wall.

1. The locking ferrule as recited in claim 39 or 40, wherein each of the first plurality of locking barbs includes a pointed tip.

42. The locking ferrule as recited in any of claims 39 to 41, comprising a second side opening formed through the body and connected to the cannulation.

43. The locking ferrule as recited in claim 42, wherein a first free end of the suture passes through the first side opening, and a second free end of the suture passes through the second side opening, and optionally comprising a second plurality of locking barbs arranged within the second side opening and configured to establish a second one-way locking mechanism for locking the suture.

44. The locking ferrule as recited in any of claims 39 to 43, wherein a free end of the suture passes through the first side opening.

45. The locking ferrule as recited in any of claims 39 to 44, comprising a second plurality of locking barbs arranged within the cannulation and configured to establish a second one-way locking mechanism for locking the suture.

46. The locking ferrule as recited in any of claims 39 to 45, wherein the suture includes a plurality of partitions that interface with the first plurality of locking barbs to create a rip-stop effect as a free end of the suture is being tensioned.

47. The locking ferrule as recited in any of claims 39 to 46, wherein the suture includes a varying thickness.

48. A locking ferrule for performing a tensionable knotless surgical procedure, comprising: a body; a first cannulation formed through the body;a second cannulation formed through the body; and a first plurality of locking barbs arranged within the first cannulation and configured to establish a first one-way locking mechanism for locking a first portion of a suture that is received through the first cannulation.

49. The locking ferrule as recited in claim 48, wherein the body includes a dividing wall that separates the first cannulation and the second cannulation from one another.

50. The locking ferrule as recited in claim 48 or 49, wherein a first interior wall of the body circumscribes the first cannulation, and a second interior wall of the body circumscribes the second cannulation.

51. The locking ferrule as recited in claim 50, wherein the first plurality of locking barbs protrudes inwardly from the first interior wall, and optionally wherein each of the first plurality of locking barbs is angled in a common direction relative to the body.

52. The locking ferrule as recited in any of claims 48 to 51, wherein each of the first plurality of locking barbs includes a pointed tip.

53. The locking ferrule as recited in any of claims 48 to 52, wherein the second cannulation excludes any locking barbs, and optionally wherein the suture is retained relative to the second cannulation by a knot.

54. The locking ferrule as recited in any of claims 48 to 53, comprising a second plurality of locking barbs arranged within the second cannulation and configured for locking a second portion of the suture that is received through the second cannulation.

55. The locking ferrule as recited in claim 54, wherein the second plurality of locking barbs are angled in a same direction as the first plurality of locking barbs.

56. The locking ferrule as recited in claim 54, wherein the second plurality of locking barbs are angled in an opposite direction as the first plurality of locking barbs.

57. The locking ferrule as recited in any of claims 48 to 56, wherein the suture includes a varying thickness.

58. A suture locking device, comprising: a dual chamber locking ferrule that includes a first cannulation and a second cannulation; a suture received through each of the first cannulation and the second cannulation; and a one-way locking mechanism that is configured to allow the suture to be tensioned in one direction but prevent the suture from being tensioned in an opposite direction.

59. The suture locking device as recited in claim 58, wherein the one-way locking mechanism includes a first plurality of locking barbs provided within the first cannulation, and optionally wherein the second cannulation excludes any locking barbs, and further optionally wherein the suture is retained relative to the second cannulation by a knot.

60. The suture locking device as recited in claim 58 or 59, wherein the one-way locking mechanism includes a first plurality of locking barbs provided within the first cannulation and a second plurality of locking barbs provided within the second cannulation.

61. The suture locking device as recited in claim 60, wherein the second plurality of locking barbs are angled in a same direction as the first plurality of locking barbs.

62. The suture locking device as recited in claim 60, wherein the second plurality of locking barbs are angled in an opposite direction as the first plurality of locking barbs.

63. The suture locking device as recited in any of claims 58 to 62, comprising a dividing wall that separates the first cannulation and the second cannulation from one another.

64. A suture locking device, comprising: a surgical button including a first opening and a second opening; and a plurality of locking barbs that establish a one-way locking mechanism for locking a suture relative to the surgical button.

65. The suture locking device as recited in claim 54, wherein the plurality of locking barbs are integrally formed features of a body of the surgical button, and optionally wherein the plurality of locking barbs are provided within the first opening of the surgical button, and further optionally wherein the second opening excludes any locking barbs, and further optionally comprising a shuttle device configured to shuttle the suture through the first opening and the second opening.

66. The suture locking device as recited in claim 54, wherein the plurality of locking barbs are provided within a locking ferrule that is insertable into the first opening of the surgical button, and optionally wherein the second opening excludes any locking barbs, and further optionally comprising a shuttle device configured to shuttle the suture through the second opening and the locking ferrule.

67. The suture locking device as recited in any of claims 64 to 66, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

68. A suture locking device, comprising: a bone plate including an opening; and a plurality of locking barbs that establish a one-way locking mechanism for locking a suture relative to the bone plate.

69. The suture locking device as recited in claim 68, wherein the plurality of locking barbs are integrally formed features of a plate body of the bone plate, and optionally wherein a first portion of the opening includes the plurality of locking barbs and a second portion of the opening excludes any locking barbs, and further optionally wherein the bone plate includes a second opening that excludes any locking barbs.

70. The suture locking device as recited in claim 68, wherein the plurality of locking barbs are provided within a locking ferrule that is insertable into the opening of the bone plate, and optionally wherein the bone plate includes a second opening that excludes any locking barbs.

71. The suture locking device as recited in any of claims 68 to 70, wherein the plurality of locking barbs arc each angled in a common direction within a cannulation of the locking ferrule and optionally are arranged in at least a first row and a second row within the cannulation.

72. The suture locking device as recited in any of claims 68 to 71, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

73. A suture locking device, comprising: a bone plate including an opening; and a locking ferrule insertable within the opening and including a one-way locking mechanism configured for locking a suture relative to the bone plate.

74. The suture locking device as recited in claim 73, wherein the one-way locking mechanism is configured to allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction, and optionally wherein the one-way locking mechanism is established by a plurality of locking barbs provided within a cannulation of the locking ferrule, and further optionally wherein the plurality of locking barbs are each angled in a common direction within the cannulation.

75. The suture locking device as recited in claim 74, wherein the cannulation extends through an eyelet portion of the locking ferrule, and optionally comprising an engagement portion connected to the eyelet portion and configured to engage the opening of the bone plate.

76. The suture locking device as recited in claim 73, wherein the locking ferrule includes an engagement portion received through the opening and an eyelet portion that extends to a location outside of the opening, and optionally wherein the eyelet portion provides the one-way locking mechanism, and further optionally wherein the one-way locking mechanism includes a plurality of locking barbs that allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction.

77. The suture locking device as recited in any of claims 73 to 76, wherein the bone plate includes a second opening that provides a smooth wall.

78. The suture locking device as recited in any of claims 73 to 77, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

79. A suture locking device, comprising: an arthroplasty implant including an opening; and a locking ferrule insertable within the opening and including a one-way locking mechanism configured for locking a suture relative to the arthroplasty implant.

80. The suture locking device as recited in claim 79, wherein the one-way locking mechanism is configured to allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction, and optionally wherein the one-way locking mechanism is established by a plurality of locking barbs provided within a cannulation of the locking ferrule, and further optionally wherein the cannulation extends through a tubular' body of the locking ferrule.

81. The suture locking device as recited in claim 80, wherein the plurality of locking barbs are each angled in a common direction within the cannulation.

82. The suture locking device as recited in claim 80 or 81, wherein the plurality of locking barbs are arranged in at least a first row and a second row along the cannulation, and optionally wherein a first portion of the plurality of locking barbs of the first row are staggered relative to second portion of the plurality of locking barbs of the second row.

83. The suture locking device as recited in any of claims 79 to 82, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section, and further optionally wherein the thickened section is about twice as thick as the thinned section.

84. A suture locking device, comprising: a suture anchor including an internal bore; anda locking ferrule positioned within the internal bore and including a one-way locking mechanism configured for locking a suture relative to the suture anchor.

85. The suture locking device as recited in claim 84, wherein the one-way locking mechanism is configured to allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction, and optionally wherein the one-way locking mechanism is established by a plurality of locking barbs provided within a cannulation of the locking ferrule.

86. The suture locking device as recited in claim 85, wherein the cannulation extends through a tubular’ body of the locking ferrule, and optionally wherein the plurality of locking barbs are each angled in a common direction within the cannulation.

87. The suture locking device as recited in claim 85, wherein the plurality of locking barbs are arranged in at least a first row and a second row along the cannulation, and optionally wherein a first portion of the plurality of locking barbs of the first row are staggered relative to second portion of the plurality of locking barbs of the second row.

88. The suture locking device as recited in claim 85, wherein the locking ferrule includes a second plurality of barbs provided at an outer diameter wall of the locking ferrule.

89. The suture locking device as recited in any of claims 84 to 88, wherein the internal bore extends through a sheath of the suture anchor, and optionally wherein the sheath is a soft body made exclusively of soft, suture-based materials.

90. The suture locking device as recited in claim 89, wherein an outer diameter wall of the locking ferrule includes a second plurality of barbs that are configured to engage an internal wall of the sheath, and optionally comprising a shuttle device received through the sheath and configured to shuttle the suture through the sheath and the locking ferrule.

91. The suture locking device as recited in any of claims 84 to 90, wherein the suture includes a varying thickness, and optionally wherein the suture includes at least one tapered region where the suture transitions between a thickened section and a thinned section.

92. A bone plate assembly, comprising: a bone plate including an opening; a locking ferrule received within the opening and including a one-way locking mechanism; and a suture received through the locking ferrule and locked relative to the bone plate by the one-way locking mechanism.

93. The bone plate assembly as recited in claim 92, wherein the one-way locking mechanism is configured to allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction, and optionally wherein the one-way locking mechanism is established by a plurality of locking barbs provided within a cannulation of the locking ferrule.

94. The bone plate assembly as recited in claim 93, wherein the cannulation extends through an eyelet portion of the locking ferrule, and optionally comprising an engagement portion connected to the eyelet portion, and further optionally wherein the engagement portion includes a pair of flexible retention legs that are configured to clip the locking ferrule to the bone plate.

95. The bone plate assembly as recited in claim 92, wherein the locking ferrule includes an engagement portion received through the opening and an eyelet portion that extends to a location outside of the opening.

96. The bone plate assembly as recited in claim 95, wherein the eyelet portion provides the one-way locking mechanism, and optionally wherein the one-way locking mechanism includes a plurality of locking barbs that allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction, and further optionally wherein the engagement portion includes a pair of flexible retention legs that are configured to clip the locking ferrule to the bone plate.

97. The bone plate assembly as recited in any of claims 92 to 96, wherein the suture retains the locking ferrule within the opening, and optionally wherein the locking ferrule includes a body that is disk- shaped or cylindrical shaped.

98. A suture anchor assembly, comprising: a suture anchor including an internal bore; a locking ferrule received within the internal bore and including a one-way locking mechanism; and a suture received through the locking ferrule and locked relative to the suture anchor by the one-way locking mechanism.

99. The suture anchor assembly as recited in claim 98, wherein the locking ferrule includes an engagement portion received within the internal bore and an eyelet portion that extends to a location outside of the internal bore, and optionally wherein the eyelet portion provides the oneway locking mechanism.

100. The suture anchor assembly as recited in claim 99, wherein the one-way locking mechanism includes a plurality of locking barbs that allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction, and optionally wherein each of the plurality of locking barbs includes a pointed tip.

101. The suture anchor assembly as recited in claim 99, wherein the engagement portion includes a pair of flexible retention legs that are configured to clip the locking ferrule to the suture anchor, and optionally wherein the flexible retention legs are configured to flex toward one another for inserting the locking ferrule into the internal bore and are further configured to flex away from one another to engage a ledge portion of the internal bore.

102. The suture anchor assembly as recited in any of claims 98 to 101, wherein an anchor body of the suture anchor is comprised of a rigid plastic or metallic material.

103. A surgical method, comprising: loading a suture through a graft; implanting a suture anchor into a bone; shuttling the suture through the suture anchor; loading the suture through a cannulation of a locking ferrule; tensioning the suture in a first direction; andlocking the suture within the cannulation to prevent movement of the suture in a second direction.

104. The surgical method as recited in claim 103, wherein a locking barb of the locking ferrule locks the suture relative to a body of the locking ferrule, and optionally wherein the locking barb protrudes inwardly from an inner diameter wall of the locking ferrule, and further optionally wherein the locking barb engages a thickened section of the suture to prevent its movement in the second direction.

105. The surgical method as recited in claim 103 or 104, wherein loading the suture through the cannulation includes: pulling the suture through the cannulation in the first direction with a suture loader; and optionally comprising moving an eyelet of the suture loader in the second direction through the cannulation prior to pulling the suture through the cannulation.

106. The surgical method as recited in claim 105, wherein pulling the suture through the cannulation includes: pulling a thinned section of the suture through the cannulation.

107. The surgical method as recited in any of claims 103 to 106, wherein shuttling the suture through the suture anchor includes: passing the suture through a proximal eyelet of a distal end portion of an anchor body of the suture anchor.

108. The surgical method as recited in any of claims 103 to 107, comprising: positioning the locking ferrule within a cannulated passage of the suture anchor while tensioning the suture in the first direction.

109. The surgical method as recited in any of claims 103 to 108, comprising: repairing a tear in the tissue prior to attaching the graft to the tissue.

110. The surgical method as recited in any of claims 103 to 109, comprising, prior to loading the suture through the graft: attaching a graft to a tissue.

111. The surgical method as recited in any of claims 103 to 110, wherein the suture anchor is implanted at a location this is lateral to both an edge of the tissue and a lateral side of the graft.

112. The surgical method as recited in any of claims 103 to 111, comprising: loading a second suture through the graft; implanting a second suture anchor into the bone; shuttling the second suture through the second suture anchor; loading the second suture through a second cannulation of a second locking ferrule; tensioning the second suture; locking the second suture within the second cannulation to prevent movement of the second suture; and optionally comprising positioning the second locking ferrule within a cannulated passage of the second suture anchor while tensioning the suture.

113. A surgical method, comprising: attaching a suture to a tissue; loading the suture through a surgical device; implanting the surgical device into a bone; loading the suture through a cannulation of a locking ferrule; inserting the locking ferrule into the bone; tensioning the suture in a first direction relative to the bone; and locking the suture within the cannulation to prevent movement of the suture in a second direction relative to the bone.

114. The surgical method as recited in claim 113, wherein the locking ferrule is received over top of the surgical device within the bone.

115. The surgical method as recited in claim 113 or 1 14, wherein the surgical device is a cortical button, and optionally wherein the cortical button is implanted within a tunnel formed in the bone.

116. The surgical method as recited in claim 115, wherein the tunnel is a unicortical tunnel.

117. The surgical method as recited in any of claims 113 to 115, wherein the tissue is a muscle.

118. A suture locking system, comprising: a surgical fixation device including an opening; a locking ferrule insertable within the opening and including a one-way locking mechanism provided within a cannulation of the locking ferrule; and a suture received through the cannulation, wherein the one-way locking mechanism is configured to allow the suture to be tensioned in a first direction while preventing the suture from moving in a second direction.

119. The suture locking system as recited in claim 118, wherein the surgical fixation device is a surgical button or a bone plate.

120. The suture locking system as recited in claim 118, wherein the suture is connected to a second surgical fixation device, and optionally wherein the second surgical fixation device is a suture anchor.

121. The suture locking system as recited in any of claims 118 to 120, wherein the locking ferrule includes a cap portion and a barrel portion, and further wherein the barrel portion is received through the opening and the cap portion is oversized relative to the opening.

122. The suture locking system as recited in any of claims 118 to 121, wherein the one-way locking mechanism is established by a plurality of locking barbs provided within the cannulation.

123. A suture locking system, comprising: a suture anchor including a body portion and a suture portion connected to the body portion; a locking ferrule received within a lumen of a tail of the suture portion and including a oneway locking mechanism provided within a cannulation of the locking ferrule; anda suture received through the cannulation, wherein the one-way locking mechanism is configured to allow the suture to be tensioned in a first direction and prevent the suture from moving in a second direction.

124. The suture locking system as recited in claim 123, wherein a plurality of locking barbs protrude inwardly from an inner diameter wall of the locking ferrule, and comprising a plurality of barbs that protrude outwardly from an outer diameter wall of the locking ferrule to engage an interior wall of the tail.

125. The suture locking system as recited in claim 123 or 134, wherein the suture extends through a cannulated passage of the body portion of the suture anchor.

126. The suture locking system as recited in any of claims 123 to 125, wherein a knot of the suture portion secures the suture portion to the body portion of the suture anchor, and optionally wherein the knot and the tail are located at opposite ends of the body portion.

127. A suture locking system, comprising: a suture anchor including a sheath having an internal bore; a locking ferrule including a one-way locking mechanism; and a suture received through the internal bore of the sheath and the locking ferrule.

128. The suture locking system as recited in claim 127, wherein the one-way locking mechanism allows the suture to be tensioned in a first direction and prevents the suture from moving in a second direction relative to the locking ferrule.

129. The suture locking system as recited in claim 127 or 128, wherein the one-way locking mechanism is established by a plurality of locking barbs provided within a cannulation of the locking ferrule.

130. The suture locking system as recited in any of claims 127 to 129, wherein the sheath is comprised exclusively of soft, suture-based materials.

Images