Bone anchor connection methods and materials

Abstract

Bone anchor connection methods and materials are disclosed. A method of using the bone anchor includes inserting a first anchor into a first hole in a bone (the first anchor including one or more sutures), forming a second anchor using the one or more sutures from the first anchor, inserting the second anchor into a second hole in the bone, and withdrawing at least one of the one or more sutures exiting the second anchor. The suture includes a body with a first end, a second end, and a length, and at least a portion of the body between the first and second ends has a cross-sectional area greater than the cross-sectional areas at the first and second ends. The anchor includes a first body and a second body inserted within the first body in a braided pattern.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims priority under 35 USC § 119(e) to U.S. Provisional Application No. 63 / 373284, filed August 23, 2022, which is incorporated herein by reference in its entirety.

[0002] The present invention relates generally to bone anchor connection systems used in general surgery and soft tissue fixation. More particularly, but not exclusively, the present invention relates to bias-locking anchor mechanisms and systems and surgical methods using bias-locking anchor mechanisms and systems. [Background technology]

[0003] When a patient's bones are injured, their soft tissues may also be injured. Currently available treatments for soft tissue injuries are not always safe, and the soft tissues may not heal properly. Thus, improved fixation devices and methods are needed to enable soft tissue repair of the soft tissues surrounding or associated with the soft tissue injury. Summary of the Invention [Problem to be solved by the invention]

[0004] Aspects of the present invention provide bone anchor connection systems, devices, implants, and methods of using bone anchor connection systems, devices, and implants for fixating soft tissue. [Means for solving the problem]

[0005] In one aspect, a method of connecting bone anchors is provided, the method comprising the steps of inserting a first anchor into a first hole in a bone, the first anchor including one or more sutures; forming a second anchor using one or more sutures from the first anchor; inserting a second anchor into a second hole in the bone; and pulling a tail of at least one of the one or more sutures extending from the second anchor.

[0006] In another aspect, a suture is provided, comprising: a body having a first end, a second end, and a length; At least a portion of the body between the first and second ends has a cross-sectional area that is greater than the cross-sectional area at the first and second ends.

[0007] In yet another aspect, an anchor is provided, comprising: a first body; a second body inserted within the first body in a knitting pattern; The knitting pattern is at least one first opening positioned along the length of the first body; at least one second opening positioned along a length of the first body and spaced apart in at least one direction from the at least one first opening; The second body is inserted into the at least one first opening, passes over the outer surface of the first body, and is inserted into the at least one second opening.

[0008] These and other objects, features and advantages of the present invention will become apparent from the following detailed description of various embodiments of the invention taken in conjunction with the accompanying drawings. [Brief explanation of the drawings]

[0009] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the present invention and, together with the detailed description, serve to explain the principles of the present invention. The drawings are only for the purpose of illustrating preferred embodiments and are not to be construed as limiting the invention. It is emphasized that, in accordance with standard industry practice, various features have not been drawn to scale. In fact, dimensions of various features may be arbitrarily increased or reduced for clarity of illustration. The above and other objects, features, and advantages of the present invention will become apparent from the following detailed description taken in conjunction with the accompanying drawings.

[0010] [Figure 1A] FIG. 10 illustrates a top view of a knitting pattern for a bias lock anchor mechanism according to one aspect of the present disclosure. [Figure 1B] FIG. 1 illustrates a top view of a knit pattern according to one aspect of the present disclosure. [Figure 2] 1 illustrates an anchor assembly positioned within a bone according to one aspect of the present disclosure. [Figure 3] 3 shows the anchor assembly of FIG. 2 with a sleeve for receiving the suture tails from the anchor assembly according to one embodiment of the present disclosure. [Figure 4] 4 illustrates the anchor assembly of FIG. 3 after the sleeve has been placed into the bone, according to one embodiment of the present disclosure. [Figure 5] 3 shows the anchor assembly of FIG. 2 with a fabric anchor positioned in a bone according to one embodiment of the present disclosure. [Figure 6] 1 illustrates a suture with a varying cross-sectional area along its length, according to one aspect of the present disclosure. [Figure 7] 1 shows a suture with ridged surfaces along its length according to one aspect of the present disclosure. [Figure 8A] 7 illustrates the suture of FIG. 6 inserted into an anchor positioned in a bone at a first position, according to one embodiment of the present disclosure. [Figure 8B] 8B illustrates the suture, anchor, and bone of FIG. 8A in a second position according to one embodiment of the present disclosure. [Figure 9]FIG. 10 is a perspective view of a knitting pattern for a bias lock anchor mechanism according to one aspect of the present disclosure. [Figure 10] FIG. 1 shows a bottom perspective view of a simulated bone portion with two anchors according to one embodiment of the present disclosure. [Figure 11] FIG. 11 shows a top perspective view of the simulated bone portion of FIG. 10 with the suture in a first position, according to one embodiment of the present disclosure. [Figure 12] FIG. 11 shows a top perspective view of the simulated bone portion of FIG. 10 with the suture in a second position, according to one embodiment of the present disclosure. [Figure 13] FIG. 11 shows a top perspective view of the simulated bone portion of FIG. 10 with the suture in a third position, according to one embodiment of the present disclosure. [Figure 14] FIG. 11 shows a top perspective view of the simulated bone portion of FIG. 10 with the suture in a fourth position, according to one embodiment of the present disclosure. [Figure 15] FIG. 11 shows a top perspective view of the simulated bone portion of FIG. 10 with the suture in a fifth position, according to one embodiment of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0011] Generally, bone anchor attachment methods are disclosed herein. Additionally, bias-locking anchor mechanisms, devices, and implants for use in the bone anchor attachment methods are described.

[0012] In this detailed description and the claims that follow, the terms proximal, distal, anterior, posterior, medial, lateral, superior, and inferior are defined according to standard usage to designate specific portions of a bone or implant according to terms of relative placement or direction in natural bone. For example, "proximal" refers to the portion of the device or implant closest to the body, and "distal" refers to the portion of the device or implant furthest from the body. With respect to directional terms, "anterior" refers to a direction toward the front of the body, "posterior" refers to a direction toward the back of the body, "medial" refers to a direction toward the midline of the body, "lateral" refers to a direction toward the side of the body or away from the midline of the body, "superior" refers to an upward direction, and "inferior" refers to a direction below another object or structure.

[0013] Similarly, positions or directions may be used herein with reference to anatomical structures or surfaces. For example, the devices and methods disclosed herein, and their aspects, components, features, etc., may be described with respect to one side of the body for purposes of brevity. However, because the human body is relatively symmetrical or mirror-image about a line of symmetry (the midline), it is expressly contemplated that the devices and methods described and / or illustrated herein, and their aspects, components, features, etc., may be changed, altered, modified, reconfigured, or otherwise modified for use with or in association with the other side of the body for the same or similar purposes without departing from the spirit and scope of the present invention.

[0014] Referring to the drawings, wherein like reference numerals are used throughout the several views to indicate like or similar components, and with particular reference to Figures 1-15, bias locking anchor mechanisms, devices, and implants for use in bone anchor attachment methods are illustrated.

[0015] 1A-15, a bone anchor attachment method is illustrated. Specifically, as shown in FIGS. 10-15, the method includes placing a first anchor 10 into a first hole 102 in a patient's bone 100. The first anchor 10 can then be set by pulling on the exiting suture tails 18a, 18b. One or more of the exiting suture tails 18a, 18b from the first anchor 10 can then be taken and pulled through sleeves or fabric sections 15, 16. The sleeves 15, 16 can then be used to create a second anchor 30 during the surgical procedure. The newly assembled second anchor 30 can then be placed onto an insertion tool (not shown). The second anchor 30 can be the same as or similar to the first anchor 10, for example, as described in more detail below. The second anchor 30 can then be inserted into a second hole 104 in the patient's bone 100, as shown in FIG. 10. Once the second anchor 30 is placed, one or more sutures 18a, 18b are passed consecutively between the first anchor 10 and the second anchor 30, as shown in FIGS. 11-15. If additional anchors 10, 30 are needed, one or more of the suture tails 18a, 18b from the second anchor 30 or a subsequent anchor can be taken and pulled through the sleeves 15, 16 to create the additional anchors 10, 30. The additional anchors 10, 30 can then be placed into an insertion tool (not shown) and inserted into additional holes in the patient's bone 100. The span (distance) between each anchor 10, 30 can be used to depress soft tissue or for other surgical purposes, as will be understood by those skilled in the art. Once the desired number of anchors 10, 30 have been placed into the patient's bone 100, the suture tails 18a, 18b from the last anchor can be secured using a clip (not shown) or tied to prevent loosening of the structure. The clip may be, for example, as described in U.S. Provisional Patent Application No. 63 / 253,869, filed October 8, 2021, or U.S. Patent No. 11,311,284, issued April 26, 2022, both of which are incorporated herein in their entireties.

[0016] 1A-1B, additional details regarding anchors 10, 30 used to fabricate or form bias-lock anchor mechanisms are shown. For example, FIGS. 1A-1B illustrate various weave patterns for suture 12 that can be used to fabricate bias-lock anchor mechanisms from textile anchor 10. Suture 12 includes loop 11 and suture limbs or suture tails 18a, 18b at opposite ends of suture 12. As shown, the dashed line of suture 12 is positioned on the far side or bottom of anchor 10, and the solid line of suture 12 is positioned on the top of anchor 10. FIG. 1A illustrates that the holes in the patient's bone may be aligned or angled relative to one another. Additionally, FIG. 9 illustrates that the holes in the patient's bone are aligned. Whether the holes are aligned or angled, the main line or second end of suture tail 18b must be positioned below loop 11. By positioning the suture tail 18b below the loop 11, the bias lock anchor mechanism provides a bias amount of friction when the suture tail or first end 18a is pulled relative to the second end 18b. The bias lock anchor mechanism may have any number of anchors 10, 30 to provide the desired number of loops 11 for fixation of the patient's soft tissue. As shown in FIG. 1A, the bias lock anchor mechanisms each include two loops 11, while FIG. 1B illustrates a bias lock anchor mechanism with four loops 11. Additionally, the number of retaining loops 11 can be increased as needed to increase the friction required to prevent slippage of the suture or sutures braided within the anchor 10.

[0017] The first body, sleeve 15, or fabric portion 16 can be fabricated from a woven or braided textile material made of closely packed fibers of a medical-grade polymer. The medical-grade polymer can be, for example, UHMWPE, polyester, PTFE, PEEK, nylon, or other medical-grade woven polymers. The first body 15, 16 can have a generally rectangular shape, as shown in FIGS. 1A, 1B, and 9. The ends of the first body 15, 16 can be, for example, tapered, rounded, or chamfered. At least one end of the first body 15, 16 can have a thickened region, for example, to facilitate grasping and insertion. The first body 15, 16 can have a series of at least two or more holes. The holes can be, for example, reinforced holes. The holes can be fabricated along the length of the first body 15, 16 to allow for the threading of a suture or suture material 12 through the first body 15, 16. The holes may be, for example, aligned, angled, or roughly positioned as shown in FIGS. 1A-1B. The first bodies 15, 16 may also include an insertion hole extending the length of the first bodies 15, 16. The insertion hole may be fabricated at one end for attachment to an insertion tool for placement into the holes 102, 104 in the bone 100. The first bodies 15, 16 may be, for example, about 0.2 mm to 5 mm thick, and more preferably about 1 mm thick. The outer rectangular outline of the first bodies 15, 16 may be, for example, about 1 mm to 20 mm wide and about 5 mm to 60 mm long. In one embodiment, the outer rectangular outline of the first bodies 15, 16 may be, for example, about 5 mm wide and about 25 mm long.

[0018] In other embodiments, other bodies 15, 16 may be present that have a generally cylindrical cross-section and have the suture 12 passing through a central region. The suture 12 may enter and exit the sleeve 15, 16 at various locations designed to deform the shape of the sleeve 15, 16 when the suture 12 is tensioned. The other bodies 15, 16 may have a length of, for example, about 4 mm to 80 mm, preferably about 40 mm. The generally cylindrical diameter of the sleeve 15, 16 may be, for example, about 0.5 mm to 10 mm, preferably about 2.5 mm. The cylindrical diameter will depend on the quantity and size of the mating assembly components.

[0019] The second elongate body or suture 12 may be, for example, one or more bodies or sutures made of suture or suture-like material. The second body 12 passes through the first body 10, 30 in a specific pattern, entering and exiting the first body 10, 30. The specific pattern of the second body 12 causes the first body 10, 30 to fold back on itself. The specific pattern of the second body 12 may also allow the second body 12 to slip when one suture limb 18a is pulled, and lock or have higher resistance to slip when the opposite suture limb 18b is pulled. The slip-to-no-slip ratio may be, for example, about 1:2 to 1:20, more preferably about 1:2, 1:5, 1:10, or 1:20. The slip ratio may be determined based on the knitting pattern, material friction, texture, shape, and denier of the second body 12. When comparing tension on one end of a suture to the other, the slip ratio is always greater than the 1:1 ratio of the coefficient of friction to the resistance to tension. Thus, there is always a bias toward one of the ends 18a, 18b being tensioned. The second body 12 can have a vertical cross-sectional area that varies larger or smaller along the length of the suture limbs 18a, 18b. More specifically, the suture 12 can have a smaller cross-sectional area, for example, at the ends 18a, 18b, transitioning to a larger cross-sectional area toward the central region of the suture 12. Furthermore, the second body 12 can have a generally circular, flat, rectangular, or square cross-section. For a second body 12 with a circular or square cross-section, the cross-section can be, for example, about 0.1 mm to 3 mm, more preferably about 0.5 mm to 1.5 mm. For a second body 12 with a rectangular cross-section, the cross-section can be, for example, about 0.05 mm to 5 mm, more preferably about 0.5 mm to 1.5 mm. The second body 12 may also transition from a variety of cross-sectional shapes and sizes along the length of the body 12. Furthermore, the second body 12 may have an overall longitudinal length of, for example, about 10" (inches) to 100", with a preferred length being about 50".

[0020] The first body 15, 16 and the second body 12 can be assembled for use as a bone anchor or anchor assembly 10, 30 for securing soft tissue to bony structures during a surgical procedure. The anchor assembly 10, 30 fabricated from the first body 15, 16 and the second body 12 can use the suture limbs 18a, 18b from the third body anchor assembly 10, 30 to be initially placed within the bone 100. The first and second body assemblies 15, 16, 12 can then be assembled by a person in the operating room during a surgical procedure. During the intraoperative assembly process, a suture shuttle or nitinol wire can be used to place the second body 12 or multiple bodies into a predetermined location within the first body 15, 16.

[0021] 2, anchor assembly 10 is shown having sleeve 15 with sutures 18a, 18b inserted into bone 100 and two suture limbs 18a, 18b extending from anchor 10 above bone 100. While sleeve 15 is shown in FIG. 2, it is also contemplated that anchor assembly 10 may include fabric portion 16, as shown in FIG. 1B. As shown, when sleeve 15 is inserted into bone 100, sleeve 15 curves to provide a larger surface area than opening 102, securing anchor 10 to bone 100.

[0022] As shown in Figure 3, the two suture limbs 18a, 18b can be placed through the second sleeve 15 or fabric 16. Figure 4 shows the tubular sleeve 15 placed into the bone 100 through the opening 104, while Figure 5 shows the fabric anchor 16 placed into the bone 100. After placement of the anchor 10 into the bone 100, the suture limbs 18a, 18b can lock to prevent further slippage. The suture limbs 18a, 18b can be locked by (1) placing a clamping mechanism on the exposed suture ends 18a, 18b, (2) tying a knot using the suture ends 18a, 18b, (3) tying a knot using the suture ends 18a, 18b and the suture material that transitions between the two anchors 10, 30, or (4) using a shuttle suture to pull the suture limbs 18a, 18b back into the second anchor 30.

[0023] In some embodiments, the suture 12 may have a cross-sectional area that varies along its length, as shown, for example, in FIG. 6 . The suture 12 may include two suture tails or limbs 40a, 40b at opposite ends of its length and an intermediate suture portion 40c. The intermediate suture portion 40c may have a larger cross-sectional area than the suture limbs 40a, 40b, for example. Furthermore, the cross-sectional area of the suture limb 40b may be larger than the cross-sectional area of the suture limb 40a, for example. At least one second body 12 is disposed through the first body 15, 16, with the smallest cross-sectional area disposed through the first body 15, 16. The assembly 10, 30 of the bodies 12, 15, 16 is then placed into a hole formed in the bone 100, and tension is applied to cause the sleeves 15, 16 to converge and actuate. As the suture rims 40a, 40b are pulled, the larger cross section 40c of the second body 12 is gradually fed through the first body 15, 16, adding material below the cortex and expanding the size of the first body 15, 16, making it more resistant to pullback through the hole it was placed through. Assembly of the first body 15, 16 and the second body 12 can be (1) performed intraoperatively in the operating room and coupled to an anchor already placed in the bone via the second body rims 40a, 40b, (2) performed uncoupled during surgery, or (3) performed in a manufacturing environment prior to surgery.

[0024] Another embodiment of the suture 12 is shown in FIG. 7. The suture 12 shown in FIG. 7 includes a ridge surface 19. The ridge surface 19 is defined by alternating peaks 20 and valleys 21 along the length of the suture 12. The ridge surface 19 provides an increased surface texture to assist in securing the anchor 10 beneath the bone 100. The second body 12, as shown in FIG. 7, has substantially vertical ridges 19, e.g., 1 to 90 degrees from the longitudinal axis. The ridges 19 may extend along some or all of the length of the suture 12. The distance between each peak 20 or valley 21 may be, e.g., about 0.1 mm to 5 mm. The delta between the peaks 20 and valleys 21 may be, e.g., about 0.1 mm to 1 mm.

[0025] 8A-8B, the suture 12 of FIG. 6 is shown being inserted into bone 100 using two anchors 10, 30. As shown in FIG. 8A, the suture 12 is inserted into the anchor 10 starting from the smaller cross-sectional area 40a. Once the suture 12 is coupled to the sleeve 15 or fabric portion 16 to form the anchor 10, the anchor 10 is placed into the bone 100 through the opening 102. Next, the suture rim 40a is pulled, introducing successively larger cross-sectional areas (40a, 40b, 40c) into the anchor 10 and positioning it below the surface of the bone 100. As the suture rim 40a is pulled, the amount of material positioned within the sleeve 15 increases, thereby increasing the size of the sleeve 15 below the surface of the bone 100. The suture rim 40a can then be inserted into the second anchor 30, which can then be placed into the opening 104 in the bone 100.

[0026] 8B, suture limb 40a can be pulled to move larger cross-sectional areas 40b, 40c of suture 12 through sleeve 15 so that cross-sectional area 40c is positioned within sleeve 15. As cross-sectional areas 40b, 40c are pulled through sleeve 15, the size of sleeve 15 below the surface of bone 100 increases. The increased size of sleeve 15 helps secure anchor 30 below bone 100.

[0027] 10-15, after insertion of at least two anchors 10, 30, the suture limbs 18a, 18b are shown tied together with a knot. FIG. 11 shows a first anchor 10 inserted through an opening 102 in a bone 100 and a second anchor 30 inserted through an opening 104 in the bone 100. The sutures 12 extend from the opening 102 to the opening 104, forming a first loop 106 above the bone 100, and the suture limbs 18a, 18b extend from the opening 104 away from the bone 100. As shown in FIG. 12, the suture limbs 18a, 18b can be inserted through the first loop 106 to form a second loop 108 between the second opening 104 and the suture limbs 18a, 18b. Referring now to FIG. 13, the suture limbs 18a, 18b are reinserted through the second loop 108. The suture limbs 18a, 18b are then pulled to tighten the suture 12 across the bone 100, as shown in Figure 14. Finally, once the tensioning of the suture limbs 18a, 18b is complete, the suture 12 is pulled tight across the top of the bone 100, and the knot 110 secures the suture 12 in place above the opening 104.

[0028] As will be recognized by those skilled in the art based on the teachings herein, many variations and modifications can be made to the above-described and other embodiments of the present disclosure without departing from the scope of the present disclosure. The devices, implants, and / or systems disclosed herein, including the accompanying abstract and drawings, may be substituted with alternative components or features as disclosed in other embodiments that serve the same, equivalent, or similar purpose as known to those skilled in the art, achieve the same, equivalent, or similar result, and provide similar functionality for their intended purpose. Furthermore, the devices, implants, and systems may include more or fewer components or features than the embodiments described and illustrated herein. Therefore, this detailed description of the presently preferred embodiments should be understood as illustrative, rather than limiting, of the disclosure.

[0029] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms "comprise" (any form of "comprise," such as "comprises," "comprising," etc.), "have" (any form of "have," such as "has," "having," etc.), "include" (any form of "include," such as "includes," "including," etc.), and "contain" (any form of "contain," such as "contains," "containing," etc.) are open-ended linking verbs. Consequently, a method or device that comprises, has, includes, or contains one or more steps or elements possesses those one or more steps or elements, and is not limited to possessing only those one or more steps or elements. Similarly, a method step or device element that comprises, has, includes, or contains one or more features may possess those one or more features, and is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a particular way may be configured in at least that way, and may also be configured in ways not listed.

[0030] The present invention has been described with reference to preferred embodiments. It will be understood that the architectural and operational embodiments described herein are examples of several possible configurations for providing the same general features, characteristics, and general system operation. Alternative modifications and alterations will occur to those skilled in the art upon reading and understanding the foregoing detailed description. It is intended that the present invention be construed as including all such modifications and alterations.

Claims

1. 1. A method of retaining soft tissue to bone, comprising: inserting a first anchor into a first hole in the bone, the first anchor including one or more sutures; forming a second anchor using one or more sutures from the first anchor; inserting a second anchor into a second hole in the bone; and pulling a tail of at least one of the one or more sutures extending from the second anchor.

2. The step of inserting a first anchor into a first hole in the bone includes: placing a first anchor in a first hole in the bone; and setting the first anchor by pulling on at least one suture tail.

3. The step of forming the second anchor includes: obtaining at least one of a sleeve and a fabric portion; removing one or more of the at least one suture tail; and inserting one or more of the at least one suture tail through the at least one sleeve and fabric portion to form a second anchor.

4. The step of inserting a second anchor into a second hole in the bone includes: placing a second anchor in a second hole in the bone; and setting the second anchor by pulling at least one suture tail extending from the second anchor.

5. forming at least one third anchor; 10. The method of claim 1, further comprising inserting the at least one third anchor into at least one third hole in the bone.

6. The method of claim 5 , wherein the at least one suture tail exits from a final anchor of the at least one third anchor.

7. The method of claim 6, further comprising the step of locking at least one suture tail to leave a final anchor.

8. The step of locking the at least one suture tail includes:

8. The method of claim 7, further comprising inserting a clip into the at least one suture tail to secure the at least one suture tail in place.

9. The step of locking the at least one suture tail includes:

8. The method of claim 7, further comprising tying the at least one suture tail to secure the at least one suture tail in place.

10. a body having a first end, a second end, and a length; A suture, wherein at least a portion of the body between the first and second ends has a cross-sectional area that is greater than the cross-sectional area at the first and second ends.

11. At least one portion of the body is a first portion positioned between the first end and the second end, the first portion having a first length and a first width; The suture of claim 10, wherein the width at the first end and the width at the second end are less than the first width.

12. At least one portion of the body is a second portion positioned between the first portion and the first end, the second portion having a second length and a second width; a third portion positioned between the first portion and the second end, the third portion having a third length and a third width; the first length is greater than the second length and the third length; the first width is greater than the second width and the third width; 12. The suture of claim 11, wherein the width at the first end and the width at the second end are less than the second width and the third width.

13. A first body; a second body inserted within the first body in a knitting pattern; The knitting pattern is at least one first opening positioned along a length of the first body; at least one second opening positioned along a length of the first body and spaced apart in at least one direction from the at least one first opening; The anchor, wherein the second body is inserted into the at least one first opening, passes over an outer surface of the first body, and is inserted into the at least one second opening.

14. The anchor of claim 13 , wherein the first body is selected from a sleeve and a fabric portion.

15. The anchor of claim 13 , wherein the second body is at least one suture.

16. the at least one first opening is two first openings; the at least one second opening is two second openings; each of the first and second openings is linearly positioned along a length of the first body; 14. The anchor of claim 13, wherein the first openings alternate with the second openings along the length of the first body.

17. the at least one first opening is two first openings; the at least one second opening is two second openings; each of the first and second openings positioned offset from one another along a length of the first body and a width of the first body; 14. The anchor of claim 13, wherein the first openings alternate with the second openings along the length of the first body.

18. the at least one first opening is two first openings; the at least one second opening is two second openings; each of the first and second openings being offset from one another along the length of the first body and linearly positioned along the width of the first body; 14. The anchor of claim 13, wherein the first openings alternate with the second openings along the length of the first body.

19. the at least one first opening is at least two first openings; The anchor of claim 13 , wherein the at least one second opening is at least two second openings.

20. The second body is The middle part and a first suture tail; a second suture tail; the first suture tail has a first resistance when pulled; the second suture tail has a second resistance when pulled; The anchor of claim 13 , wherein the first resistance is greater than the second resistance.

21. 1. A method of retaining soft tissue to bone, comprising: inserting a first anchor into a first hole in the bone, the first anchor including one or more sutures; forming a second anchor using one or more sutures from the first anchor; inserting a second anchor into a second hole in the bone; and pulling a tail of at least one of the one or more sutures extending from the second anchor.

22. The step of inserting a first anchor into a first hole in the bone includes: placing a first anchor in a first hole in the bone; and setting the first anchor by pulling on at least one suture tail.

23. The step of forming the second anchor includes: obtaining at least one of a sleeve and a fabric portion; removing one or more of the at least one suture tail; and inserting one or more of the at least one suture tail through the at least one sleeve and fabric portion to form a second anchor.

24. The step of inserting a second anchor into a second hole in the bone includes: placing a second anchor in a second hole in the bone; and setting the second anchor by pulling at least one suture tail extending from the second anchor.

25. forming at least one third anchor; The method of any of claims 21 to 24, further comprising inserting the at least one third anchor into at least one third hole in the bone.

26. 26. The method of claim 25, wherein at least one suture tail exits from a final anchor of the at least one third anchor.

27. 27. The method of claim 26, further comprising locking at least one suture tail to leave a final anchor.

28. The step of locking the at least one suture tail includes:

28. The method of claim 27, further comprising inserting a clip into the at least one suture tail to secure the at least one suture tail in place.

29. The step of locking the at least one suture tail includes:

28. The method of claim 27, further comprising tying the at least one suture tail to secure the at least one suture tail in place.

30. a body having a first end, a second end, and a length; A suture, wherein at least a portion of the body between the first and second ends has a cross-sectional area that is greater than the cross-sectional area at the first and second ends.

31. At least one portion of the body is a first portion positioned between the first end and the second end, the first portion having a first length and a first width; 31. The suture of claim 30, wherein the width at the first end and the width at the second end are less than the first width.

32. At least one portion of the body is a second portion positioned between the first portion and the first end, the second portion having a second length and a second width; a third portion positioned between the first portion and the second end, the third portion having a third length and a third width; the first length is greater than the second length and the third length; the first width is greater than the second width and the third width; The suture of any one of claims 30 to 31, wherein the width at the first end and the width at the second end are smaller than the second width and the third width.

33. A first body; a second body inserted within the first body in a knitting pattern; The knitting pattern is at least one first opening positioned along a length of the first body; at least one second opening positioned along a length of the first body and spaced apart in at least one direction from the at least one first opening; The anchor, wherein the second body is inserted into the at least one first opening, passes over an outer surface of the first body, and is inserted into the at least one second opening.

34. 34. The anchor of claim 33, wherein the first body is selected from a sleeve and a fabric portion.

35. The anchor according to any one of claims 33 to 34, wherein the second body is at least one suture.

36. the at least one first opening is two first openings; the at least one second opening is two second openings; each of the first and second openings is linearly positioned along a length of the first body; 36. The anchor of any of claims 33 to 35, wherein the first openings alternate with the second openings along the length of the first body.

37. the at least one first opening is two first openings; the at least one second opening is two second openings; each of the first and second openings positioned offset from one another along a length of the first body and a width of the first body; The anchor of any of claims 33 to 36, wherein the first openings alternate with the second openings along the length of the first body.

38. the at least one first opening is two first openings; the at least one second opening is two second openings; each of the first and second openings being offset from one another along the length of the first body and linearly positioned along the width of the first body; 38. The anchor of any of claims 33 to 37, wherein the first openings alternate with the second openings along the length of the first body.

39. the at least one first opening is at least two first openings; The anchor of any one of claims 33 to 38, wherein the at least one second opening is at least two second openings.

40. The second body is The middle part and a first suture tail; a second suture tail; the first suture tail has a first resistance when pulled; the second suture tail has a second resistance when pulled; 40. The anchor of any one of claims 33 to 39, wherein the first resistance is greater than the second resistance.

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