All-suture anchor

Abstract

Disclosed herein is a suture anchor configured to secure a positioning of a second tissue about and / or relative a first tissue. The suture anchor may include an anchor and a suture. The anchor may be a suture itself, and may optionally include one or more slots that extend across an anchor body of the anchor. A repair suture may be configured to be secured to the anchor via the slot and / or the anchor body. The suture, via being secured to the anchor, may be used to secure the positioning of a second tissue relative to a first tissue. Together, the anchor and the repair suture may be an all-suture anchor. The anchor may be secured to the first tissue by transitioning from an unfolded configuration to a folded configuration. The anchor may transition to the folded configuration by applying tension to the repair suture that is coupled to the anchor.

Description

PCT APPLICA TION CINCH-001PCTALL-SUTURE ANCHORCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims priority to U.S. Provisional Patent Application No.63 / 754,047; filed on February 5, 2025; entitled “ALL-SUTURE ANCHOR” the entire disclosure of which is incorporated by reference herein.

[0002] The present application claims priority to U.S. Provisional Patent Application No.63 / 767,759; filed on March 6, 2025; entitled “ALL-SUTURE ANCHOR” the entire disclosure of which is incorporated by reference herein.FIELD OF TECHNOLOGY

[0003] The present disclosure relates to suture anchors. Specifically, the present disclosure relates to all-suture anchors and methods of use.BACKGROUND

[0004] Suture anchors may be used to secure a positioning of one tissue relative to another tissue.SUMMARY

[0005] Disclosed herein, in some aspects, is a device, comprising: an anchor comprising an anchor body; and a suture at least partially weaved through the anchor body, the suture having a suture tail configured to extend from the anchor body; wherein the anchor is configured to transition from an unfolded configuration to a folded configuration when tension is applied to the suture tail.

[0006] In some embodiments, the anchor body is a suture. In some embodiments, the anchor body comprises a suture tape, woven mat, interconnected fibers, multiple twisted fibers, layered fibers, or any combination thereof.

[0007] In some embodiments, the anchor body defines a length that extends along a longitudinal axis, a width that extends along a lateral axis, and a vertical that extends along a vertical axis, the longitudinal axis extending between the proximal end and the distal end of the anchor body. In some embodiments, the anchor body is configured to fold along the length when the anchor transitions to the folded configuration. In some embodiments, the anchor in the folded configuration creates one or more pleats that extend at least partially vertically. InPCT APPLICA TION CINCH-001PCTsome embodiments, the suture extends substantially along or substantially parallel with the longitudinal axis of the anchor body.

[0008] In some embodiments, the anchor further comprises a material disposed about the anchor body, the material configured to provide bulk to the anchor body. In some embodiments, the material is configured to be weaved about the anchor body. In some embodiments, the material comprises an additional suture. In some embodiments, the material is configured to extend along the anchor body at least in a partially longitudinal direction, at least in a partially lateral direction, or both.

[0009] In some embodiments, the anchor is configured to be secured to a first tissue. In some embodiments, the anchor is configured to be secured to the first tissue via transitioning the anchor from the unfolded configuration to the folded configuration. In some embodiments, the first tissue comprises a first bone or a first soft tissue. In some embodiments, the anchor is configured to secure a positioning of a second tissue relative to the first tissue. In some embodiments, the second tissue comprises a second bone or a second soft tissue. In some embodiments, the first tissue comprises the first bone. In some embodiments, the anchor is configured to be inserted within a bone hole of the first bone when in the unfolded configuration, such that transitioning the anchor to the folded configuration secures the anchor within the bone hole. In some embodiments, the anchor body interacts with an inner surface of the bone within the bone hole when the anchor is in a folded configuration, such that a pullout strength of the anchor within the bone hole is increased. In some embodiments, the anchor further comprises a material disposed about the anchor body, the material configured to provide bulk to the anchor body, so as to increase an interaction between the anchor body and the inner surface of the bone within the bone hole.

[0010] In some embodiments, the anchor is configured to be passed through an aperture in the first soft tissue when in the unfolded configuration, so as to pass from a first surface to a second surface of the soft tissue, wherein transitioning the anchor to the folded configuration secures the anchor to the second surface of the soft tissue about the aperture. In some embodiments, the anchor in the folded configuration is too large to pass through the aperture.

[0011] In some embodiments, the suture comprises a first portion and a second portion, wherein when the suture is weaved through the anchor body, the first portion is configured to be secured to the anchor, the second portion comprising the suture tail. In some embodiments, the second portion of the suture is configured to extend proximally away from first portion of the suture secured to the anchor. In some embodiments, the second portion of the suture is configured to secure a positioning of the second tissue relative to the first tissue. In somePCT APPLICA TION CINCH-001PCTembodiments, the suture comprises a suture passageway therein. In some embodiments, the second portion of the repair suture is configured to be i) secured to the second tissue and ii) passed through the suture passageway of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture. In some embodiments, the second portion of the repair suture passes through the suture passageway of the repair suture via a first and second opening thereof. In some embodiments, the device (any described herein) further comprises a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture. In some embodiments, the first portion of the repair suture is secured to the anchor via i) a knotted configuration, ii) a bunched-up configuration of the repair suture, iii) ultrasonic welding, iv) an adhesive, stitching, or v) any combination thereof.

[0012] In some embodiments, the anchor defines one or more routing sections for the suture, wherein each routing section corresponds to a path of the suture at least partially in a longitudinal direction and proximally towards the proximal end of the anchor body.

[0013] Disclosed herein, in other aspects, is a device, comprising: an anchor comprising an anchor body and optionally a slot; and a repair suture configured to be extended at least partially through the i) anchor body, ii) the optional slot, or iii) both, wherein the repair suture is configured to be extended at least partially through the optional slot by being inserted through the slot; wherein the anchor is configured to transition from an unfolded configuration to a folded configuration.

[0014] In some embodiments, the repair suture is configured to be extended at least partially through the anchor body by being weaved through the anchor body. In some embodiments, the repair suture comprises a repair suture tail extending from the anchor body. In some embodiments, the anchor is configured to transition to the folded configuration when tension is applied to the repair suture tail. In some embodiments, the repair suture being weaved through the anchor body defines a suture path through the anchor body.

[0015] In some embodiments, any device described herein further comprises a material disposed about the anchor body, the material configured to provide bulk to the anchor body. In some embodiments, the material is configured to be weaved about the anchor body. In some embodiments, the material comprises an additional suture. In some embodiments, the material is configured to extend along the anchor body at least in a partially longitudinal direction, at least in a partially lateral direction, or both. In some embodiments, the material extends along a length of the anchor body in a diagonal configuration. In some embodiments, the material is configured to i) extend along a first side of the anchor body between a first lateral face and aPCT APPLICA TION CINCH-001PCTsecond lateral face of the anchor body, ii) at least partially wrap about the second lateral face, and iii) extend along a second side of the anchor body towards the first lateral face.

[0016] In some embodiments, the slot is disposed within the anchor body, thereby defining a channel therethrough. In some embodiments, the slot protrudes from a surface of the anchor body. In some embodiments, the anchor body and the slot are integrally formed. In some embodiments, the anchor body and the slot are separate components coupled together. In some embodiments, the slot is removably coupled to the anchor body.

[0017] In some embodiments, the anchor body comprises a proximal end and a distal end, wherein the slot extends between the proximal end and the distal end. In some embodiments, the slot extends substantially from the proximal end to the distal end. In some embodiments, the slot comprises a first opening and a second opening. In some embodiments, the second opening is disposed about i) the distal end of the anchor body, or ii) a location between the proximal end and the distal end of the anchor body. In some embodiments, the first opening is disposed about i) the proximal end of the anchor body, or ii) a location between the proximal end and the distal end of the anchor body. In some embodiments, the first opening, the second opening, or both, is configured to receive at least a portion of the repair suture therethrough. In some embodiments, the slot defines a channel therethrough having a maximum dimension from about 0.05mm to about 5mm.

[0018] In some embodiments, the anchor body is a suture. In some embodiments, the anchor body comprises a suture tape, woven mat, interconnected fibers, multiple twisted fibers, layered fibers, or any combination thereof.

[0019] In some embodiments, the anchor body defines a length that extends along a longitudinal axis, a width that extends along a lateral axis, and a vertical that extends along a vertical axis, the longitudinal axis extending between the proximal end and the distal end of the anchor body. In some embodiments, the length of the anchor body is from about 1mm to about 100mm. In some embodiments, the width of the anchor body is from about 0.1mm to about 50mm. In some embodiments, the vertical of the anchor body is from about 0.5mm to about 10mm.

[0020] In some embodiments, the anchor body is configured to fold along the length when the anchor transitions to the folded configuration. In some embodiments, the anchor in the folded configuration creates one or more pleats that extend at least partially vertically. In some embodiments, the i) repair suture, ii) the slot, or iii) both, extends substantially along or substantially parallel with the longitudinal axis.PCT APPLICA TION CINCH-001PCT

[0021] In some embodiments, the anchor is configured to be secured to a first tissue. In some embodiments, the anchor is configured to be secured to the first tissue via transitioning the anchor from the unfolded configuration to the folded configuration. In some embodiments, the first tissue comprises a first bone or a first soft tissue. In some embodiments, the anchor is configured to secure a positioning of a second tissue relative to the first tissue. In some embodiments, the second tissue comprises a second bone or a second soft tissue.

[0022] In some embodiments, the first tissue comprises the first bone. In some embodiments, the anchor is configured to be inserted within a bone hole of the first bone when in the unfolded configuration, such that transitioning the anchor to the folded configuration secures the anchor within the bone hole. In some embodiments, the material of any one of Claims 37-40 disposed about the anchor body is configured to increase an interaction between the anchor body and the first tissue. In some embodiments, the anchor body interacts with an inner surface of the bone within the bone hole when the anchor is in a folded configuration, such that a pullout strength of the anchor within the bone hole is increased. In some embodiments, the pullout strength is from about 3 ON to about 200N.

[0023] In some embodiments, a proximal portion of the anchor body forms a flap when the anchor is transitioned to the folded configuration, wherein the flap is configured to extend at least partially longitudinally and parallel with another portion of the anchor body within the bone hole. In some embodiments, the first tissue comprises the first soft tissue. In some embodiments, the anchor is configured to be passed through an aperture in the first soft tissue when in the unfolded configuration, so as to pass from a first surface to a second surface of the soft tissue, wherein transitioning the anchor to the folded configuration secures the anchor to the second surface of the soft tissue about the aperture. In some embodiments, the anchor in the folded configuration is too large to pass through the aperture.

[0024] In some embodiments, for any anchor described herein, the repair suture comprises a first portion and a second portion, wherein when the repair suture is extended through the anchor body or is inserted through the slot, the first portion is configured to be secured to the anchor. In some embodiments, the second portion of the repair suture is configured to extend proximally away from first portion of the repair suture secured to the anchor. In some embodiments, applying tension on the second portion of the repair suture in at least a partial proximal direction is configured to transition the anchor from the unfolded configuration to the folded configuration. In some embodiments, the second portion of the repair suture is configured to secure a positioning of the second tissue relative to the first tissue.PCT APPLICA TION CINCH-001PCT

[0025] In some embodiments, the repair suture comprises a suture passageway therein. In some embodiments, the second portion of the repair suture is configured to be i) secured to the second tissue and ii) passed through the suture passageway of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture. In some embodiments, the second portion of the repair suture passes through the suture passageway of the repair suture via a first and second opening thereof. In some embodiments, the device further comprising a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture.

[0026] In some embodiments, the first portion of the repair suture is secured to the anchor via a knotted configuration, a bunched-up configuration of the repair suture, ultrasonic welding, an adhesive, stitching, or any combination thereof.

[0027] In some embodiments, the anchor body or the slot comprises a first opening disposed at a proximal portion of the slot or the anchor body, a second opening disposed a distal portion of the slot or the anchor body, one or more openings disposed on the slot or the anchor body along a first side or a second side of the length of the anchor body, or any combination thereof. In some embodiments, the first portion of the repair suture is secured to the second opening, a third opening of the one or more openings, or both.

[0028] In some embodiments, the anchor defines one or more routing sections for the repair suture, wherein each routing section corresponds to a path of the repair suture at least partially in a longitudinal direction and proximally towards the proximal end of the anchor body. In some embodiments, for each routing section, the repair suture path is disposed within the slot channel or the anchor body, along a first side of the anchor body, outside of the optional slot channel, or along a second side of the anchor body, outside of the optional slot channel. In some embodiments, the anchor defines four routing sections. In some embodiments, the four routing sections comprise a repair suture path disposed within the slot channel or the anchor body, disposed along a first side of the anchor body, outside of the optional slot channel, and disposed along a second side of the anchor body, outside of the optional slot channel.

[0029] In some embodiments, the repair suture is a first repair suture, the device further comprising a second repair suture. In some embodiments, the second repair suture is similar to any repair suture described herein. In some embodiments, the first repair suture and the second repair suture are configured to be inserted through the slot simultaneously or sequentially.

[0030] In some embodiments, the slot is a first slot, the device further comprising a second optional slot. In some embodiments, the second slot is physically separate from the first slot. In some embodiments, the second slot is similar to any slot described herein. In somePCT APPLICA TION CINCH-001PCTembodiments, the second repair suture is configured to be inserted through the second slot or extended through the anchor body, wherein the second repair suture optionally defines a repair suture path different from the repair suture path of the first repair suture. In some embodiments, the second suture is configured to secure a positioning of the second tissue, a third tissue, or both, relative to the first tissue.

[0031] In some embodiments, the device further comprising one or more additional slots, and one or more additional repair sutures, each additional repair suture configured to be inserted through a corresponding additional slot or through a corresponding repair suture path via the anchor body. In some embodiments, the one or more additional slots comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional slots. In some embodiments, the one or more additional repair sutures comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional repair sutures. In some embodiments, the anchor defines one or more routing sections for each slot of the one or more additional slots.

[0032] In some embodiments, for any anchor described herein, the slot is a first slot, the device further comprising a second slot. In some embodiments, the second slot is similar to any slot described herein. In some embodiments, the repair suture comprises a first portion, a second portion, and a middle portion, wherein the first portion is configured to pass through at least a portion of the first slot, the second portion is configured to pass through at least a portion of the second slot, and wherein the middle portion is configured to extend from a distal opening of the first slot to a distal opening of the second slot, such that the repair suture is secured to the anchor via the middle portion extending outside and between the first and second slot. In some embodiments, the first and second portions of the repair suture are configured to extend proximally away from the anchor. In some embodiments, applying tension on the first portion, the second portion, or both, of the repair suture in at least a partial proximal direction transitions the anchor from the unfolded configuration to the folded configuration.

[0033] In some embodiments, the first and second portions of the repair suture are configured to secure a positioning of the second tissue relative to the first tissue. In some embodiments, the first and second portions are configured to be secured to each other. In some embodiments, the first and second portions are configured to be secured to each other via a knotted configuration.

[0034] In some embodiments, the repair suture comprises a suture passageway about the second portion of the repair suture. In some embodiments, the first portion of the repair suture is configured to be i) secured to the second tissue and ii) passed through the suture passageway of the second portion of the repair suture, such that the anchor secures the positioning of thePCT APPLICA TION CINCH-001PCTsecond tissue via a knotless configuration of the repair suture. In some embodiments, the first portion of the repair suture passes through the suture passageway of the second portion of the repair suture via a first and second opening thereof. In some embodiments, the device further comprising a passing suture configured to shuttle the first portion of the repair suture through the suture passageway of the second portion of the repair suture.

[0035] In some embodiments, for any device described herein, the first slot, the second slot, the anchor body, or any combination thereof, comprises a first opening disposed at a proximal portion of the respective slot or anchor body location, a second opening disposed a distal portion of the respective slot or anchor body location, one or more openings disposed on the respective slot or the anchor body along a first side or a second side of the length of the anchor body, or any combination thereof. In some embodiments, the anchor defines one or more routing sections for the repair suture with respect to the first slot, the second slot, the anchor body, or any combination thereof, wherein each routing section corresponds to a path of the repair suture at least partially in a longitudinal direction and proximally towards the proximal end of the anchor body. In some embodiments, for each routing section for the respective slot, the repair suture path is disposed within the slot channel, along a first side of the anchor body outside of the slot channel, or along a second side of the anchor body outside of the slot channel.

[0036] In some embodiments, the anchor defines four routing sections for the first slot, the second slot, or both (respective slot). In some embodiments, the four routing sections for the respective slot comprise a repair suture path disposed within the slot channel, disposed along a first side of the anchor body outside of the slot channel, and disposed along a second side of the anchor body outside of the slot channel.

[0037] In some embodiments, the repair suture is a first repair suture, the device further comprising a second repair suture. In some embodiments, the second repair suture is similar to any repair suture described herein. In some embodiments, the first repair suture and the second repair suture are configured to be inserted through the first slot, second slot, or both, simultaneously or sequentially. In some embodiments, the second slot is physically separate from the first slot.

[0038] In some embodiments, the device further comprising one or more additional slots, and one or more additional repair sutures, each additional repair suture configured to be inserted through a corresponding additional slot. In some embodiments, the one or more additional slots comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional slots. In some embodiments, the one or more additional repair sutures comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional repairPCT APPLICA TION CINCH-001PCTsutures. In some embodiments, the anchor defines one or more routing sections for each slot of the one or more additional slots.

[0039] In some embodiments, for any slot described herein, the slot is closed at a proximal end of the slot, a distal end of the slot, or both. In some embodiments, the slot is closed by being welded shut. In some embodiments, the slot is closed at the proximal end and distal end thereof, such that the slot comprises one or more openings along a first side, a second side, or both, of the length of the anchor body.

[0040] In some embodiments, the anchor transitions to the folded configuration at least partially based on interacting with a support surface. In some embodiments, the support surface comprises a portion of the first tissue, a portion of a separate device, or both.

[0041] Disclosed herein, in some aspects, is a device comprising: a first anchor comprising the anchor from any previous Claim; a second anchor comprising the anchor from any previous Claim; and a repair suture, wherein the repair suture is configured to be inserted through i) the anchor body, or ii) the slot, of the first and second anchors, wherein the first anchor, the second anchor, or both are configured to transition to the folded configuration when a tension is applied to the repair suture, thereby securing the first anchor, the second anchor, or both, to the first tissue.

[0042] In some embodiments, the repair suture at a first portion is secured to the first anchor at a distal end thereof, such that a second portion of the repair suture is configured to extend proximally away from the first anchor. In some embodiments, the second anchor optionally comprises a first slot and a second slot, wherein second portion of the repair suture is configured to extend from the first anchor and through i) the anchor body, or ii) both the first and second slots, of the second anchor, such that the second portion of the repair suture is configured to be secured to the second anchor via a middle portion of the second portion that extends between i) a distal portion, or ii) a distal opening, of the first and second slots of the second anchor. In some embodiments, the second portion of the repair suture is configured to extend from the second anchor to the second tissue, to secure a positioning of the second tissue relative to the first tissue. In some embodiments, the repair suture secures the positioning of the second tissue via any knotless configuration described herein.

[0043] In some embodiments, the device further comprising a third anchor and a second repair suture, wherein the third anchor comprises the first anchor of any device described herein, wherein the second repair suture is configured to be inserted through i) the anchor body, or ii) the slot(s), of the third and second anchors, wherein the third anchor, the second anchor, or both are configured to transition to the folded configuration when a tension is applied to thePCT APPLICA TION CINCH-001PCTsecond repair suture, thereby securing the third anchor, the second anchor, or both, to the first tissue.

[0044] In some embodiments, the second repair suture at a first portion is secured to the third anchor at a distal end thereof, such that a second portion of the second repair suture is configured to extend proximally away from the third anchor. In some embodiments, the second portion of the second repair suture is configured to extend from the third anchor and through i) the anchor body, or ii) both the first and second slots of the second anchor, such that the second portion of the second repair suture is configured to be secured to the second anchor via a middle portion of the second portion of the second anchor that extends between a i) distal portion, or ii) distal opening of the first and second slots of the second anchor. In some embodiments, the second portion of the second repair suture is configured to extend from the second anchor to the second tissue, to secure a positioning of the second tissue relative to the first tissue. In some embodiments, the second repair suture secures the positioning of the second tissue via any knotless configuration described herein.

[0045] In some embodiments, the first anchor, the second anchor, the third anchor, or any combination thereof, defines via any slot thereof one or more routing sections of any routing section described herein.

[0046] Disclosed herein, in some aspects, is a system comprising: any device described herein; and an inserter assembly configured to insert one or more anchors of the device. In some embodiments, the inserter comprises a guide tool and an insertion tool coupled to the guide tool. In some embodiments, the insertion tool is integrally coupled to the guide tool. In some embodiments, the insertion tool is removably coupled to the guide tool.

[0047] In some embodiments, the guide tool comprises a handle and a guide shaft extending therefrom. In some embodiments, the insertion tool comprises a knob, a screw at least partially threadably couplable to an inner portion of the knob, a screw seat configured to receive at least a portion of the screw, an inserter shaft extending distally away from the screw seat, and a tensioning shaft extending distally away from the screw or screw seat, wherein the tensioning shaft is configured to at least be partially disposed within the inserter shaft, wherein the screw is configured to at least partially extend between the knob and the screw seat. In some embodiments, the insertion tool is configured to at least partially be disposed within a portion of the handle. In some embodiments, the screw seat is configured to be at least partially disposed within a receptacle of the handle, and wherein the inserter shaft, the tensioning shaft, or both, is configured to be disposed within a portion of the guide shaft, so as to extend distally away from the handle. In some embodiments, rotation of the knob is configured to move i) thePCT APPLICA TION CINCH-001PCTscrew in a longitudinal direction due to the threaded coupling between the screw and inner portion of the knob, ii) the tensioning shaft in a longitudinal direction, or iii) both.

[0048] In some embodiments, the knob comprises one or more distal protrusions that are configured to be inserted at least partially within a portion of the handle distal to one or more clips of the handle, such that the knob is configured to rotate freely within said portion of the handle. In some embodiments, the one or more clips of the handle is configured to prevent free rotation of the knob when the knob is aligned with the clips.

[0049] Disclosed herein, in some aspects, is a method of securing a positioning of a second tissue relative to a bone, the method comprising: inserting any anchor described herein within a bone hole of the bone; transitioning the anchor to the folded configuration by applying tension to the second portion of the repair suture; coupling the repair suture to the second tissue; passing the second portion of the repair suture through the suture passageway of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture; and optionally tensioning the second portion of the repair suture to further secure positioning of the second tissue relative to the first tissue.

[0050] In some embodiments, passing the second portion of the repair suture through the suture passageway is via the passing suture. In some embodiments, the method further comprising a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture.

[0051] Disclosed herein, in some aspects, is a method of securing a positioning of a second tissue relative to a bone, the method comprising: inserting any anchor described herein within a bone hole of the bone; transitioning the anchor to the folded configuration by applying tension to the first portion, the second portion, or both, of the repair suture; coupling the repair suture to the second tissue; securing the first portion of the repair suture to the second portion of the repair suture, such that the anchor secures the positioning of the second tissue via a tied configuration of the repair suture; and optionally tensioning the repair suture to further secure positioning of the second tissue relative to the first tissue. In some embodiments, securing the first portion of the repair suture to the second portion of the repair suture is via a knot.

[0052] Disclosed herein, in some aspects, is a method of securing a positioning of a second tissue relative to a bone, the method comprising: inserting any first anchor as described herein within a first bone hole of the bone; inserting any second anchor as described herein within a second bone hole of the bone; transitioning the first anchor, the second anchor, or both, to the folded configuration by applying tension to the second portion of the repair suture; coupling the repair suture to the second tissue; passing the second portion of the repair suture throughPCT APPLICA TION CINCH-001PCTthe suture passageway of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture; and optionally tensioning the second portion of the repair suture to further secure positioning of the second tissue relative to the first tissue.

[0053] In some embodiments, passing the second portion of the repair suture through the suture passageway is via the passing suture. In some embodiments, the method further comprising a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture.

[0054] In some embodiments, the method further comprising inserting any third anchor as described herein within a third bone hole of the bone; transitioning the third bone to the folded configuration by applying tension to the second portion of the second repair suture; coupling the second repair suture to the second tissue; passing the second portion of the second repair suture through the suture passageway of the second repair suture, such that the second and third anchor secures the positioning of the second tissue via a knotless configuration of the second repair suture; and optionally tensioning the second portion of the second repair suture to further secure positioning of the second tissue relative to the first tissue.

[0055] In some embodiments, wherein one or more of anchors of any anchor described herein is inserted (e.g., within any bone hole described herein) using any inserter assembly described herein. In some embodiments, the second portion of any repair suture described herein, or the first and second portion of any repair suture described herein, is coupled to the screw, such that longitudinal movement of the screw in a proximal direction via the knob applies the tensioning to the repair suture. In some embodiments, wherein a deployment suture is coupled with any first anchor described herein, any third anchor described herein, or both, wherein each deployment suture is coupled to the screw of a respective inserter assembly, such that longitudinal movement of the screw in a proximal direction via the knob applies the tensioning to the respective deployment suture, so as to at least partially transition the respective anchor into a folded configuration.

[0056] Disclosed herein, in some aspects, is a device comprising: a first anchor comprising any anchor described herein, wherein the slot of the first anchor is a first slot, the first anchor further comprising a second slot; a second anchor comprising any anchor described herein, wherein the slot of the second anchor is a first slot, the second anchor further comprising a second slot; a first repair suture; and a second repair suture, wherein the first repair suture is configured to be inserted through the first slot of the first anchor and configured to be secured about a distal end thereof, such that the first repair suture is configured to extend from a proximal end of thePCT APPLICA TION CINCH-001PCTfirst slot of the first anchor to and through the first slot of the second anchor via the proximal end of the first slot of the second anchor, and further configured to extend from the distal end of the first slot of the second anchor, and wherein the second repair suture is configured to be inserted through the second slot of the first anchor and configured to be secured about a proximal end thereof, such that the second repair suture extends from a distal end of the second slot of the first anchor to and through the second slot of the second anchor via the distal end of the second slot of the second anchor, and further configured to extend from the proximal end of the second slot of the second anchor.

[0057] In some embodiments, the first repair suture extending between the proximal ends of the first slot of the first and second anchors defines a suture passageway within the first repair suture, and wherein the second repair suture extending between the distal ends of the second slot of the first and second anchors defines a suture passageway within the second repair suture.

[0058] In some embodiments, the first repair suture extending from the distal end of the first slot of the second anchor is configured to pass through the suture passageway of the second repair suture and extend therefrom towards the first anchor, the first repair suture extending from the suture passageway of the second repair suture defining a terminal portion of the first repair suture.

[0059] In some embodiments, the second repair suture extending from the proximal end of the second slot of the second anchor is configured to pass through the suture passageway of the first repair suture and extend therefrom towards the first anchor, the second repair suture extending from the suture passageway of the first repair suture defining a terminal portion of the second repair suture.

[0060] In some embodiments, the terminal portions of the first and second repair sutures are configured to pass through an aperture in the first anchor. In some embodiments, the terminal portions of the first and second repair sutures are configured to be coupled together at a coupling point, such that applying tension to the coupled terminal portions i) transitions the first anchor, the second anchor, or both, to the folded configuration, ii) creates a clamping force between the first and second anchors, or iii) both.

[0061] Disclosed herein, in some aspects, is a method comprising: inserting a first repair suture through a slot of a first anchor comprising any anchor described herein, wherein the slot of the first anchor is a first slot, the first anchor further comprising a second slot; securing a first end of the first repair suture about a distal end of the first slot of the first anchor; extending the first repair suture from a proximal end of the first slot of the first anchor to a second anchor comprising any anchor described herein, wherein the slot of the second anchor is a first slot,PCT APPLICA TION CINCH-001PCTthe second anchor further comprising a second slot, wherein the first repair suture extending from the proximal end of the first slot to the second anchor defines a passing portion of the first repair suture comprising a first passageway therethrough; passing the first repair suture through the first slot of the second anchor via a proximal end of the first slot of the second anchor; inserting a second repair suture through the second slot of the first anchor; securing a first end of the second repair suture about a proximal end of the second slot of the first anchor; extending the second repair suture from a distal end of the second slot of the first anchor to the second anchor, wherein the second repair suture extending from the distal end of the second slot to the second anchor defines a passing portion of the second repair suture comprising a second passageway therethrough; passing the second repair suture through the second slot of the second anchor via a distal end of the second slot of the second anchor; extending the first repair suture from a distal end of the first slot of the second anchor through and from the second passageway of the second repair suture to the first anchor, the first repair suture extending from the second passageway to the first anchor defining a first terminal portion; extending the second repair suture from a proximal end of the second slot of the second anchor through and from the first passageway of the first repair suture to the first anchor, the second repair suture extending from the first passageway to the first anchor defining a second terminal portion; passing the first and second terminal portions through an aperture in the first aperture; and securing the first and second terminal openings to each other at a coupled portion, such that, applying tension to the coupled portion i) transitions the first anchor, the second anchor, or both, to the folded configuration, ii) creates a clamping force between the first and second anchors, or iii) both.

[0062] In some embodiments, the method further comprising: creating a first hole within a first bone; creating a second hole within a second bone; passing the first anchor through the first and second holes, such that the second anchor is disposed about a first surface of the first bone, and the first anchor is disposed about a second surface of the second bone, such that applying the tension to the coupled portion applies a clamping force between the first and second bone towards each other.

[0063] In some embodiments, the method further comprises: creating a first hole within a first bone; creating a second hole within a second bone; passing said first anchor through the first and second holes, such that the second anchor is disposed about a first surface of the first bone, and the first anchor is disposed about a second surface of the second bone, such that applying the tension to the coupled point i) transitions the first anchor, the second anchor, or both, to thePCT APPLICA TION CINCH-001PCTfolded configuration, ii) creates a clamping force between the first and second anchors, or iii) both.BRIEF DESCRIPTION OF DRAWINGS

[0064] These and other features, aspects, and advantages are described below with reference to the drawings, which are intended to illustrate, but not to limit, the invention. In the drawings, like characters denote corresponding features consistently throughout similar embodiments.

[0065] FIGS. 1A-1C illustrate a front view, a front-perspective view, and a top view of an anchor that may be a part of a suture anchor, according to an embodiment described herein.

[0066] FIGS. 2A-2C illustrate a transition of an anchor from an unfolded configuration to a folded configuration, as part of another suture anchor, according to an embodiment described herein.

[0067] FIGS. 3A-3C illustrate a front-perspective view, a front view, and a front cutaway view of the suture anchor of FIG. 2 A, according to an embodiment described herein.

[0068] FIGS. 4A-4C illustrate a front-perspective view, a front view, and a side view of another suture anchor, according to an embodiment described herein.

[0069] FIGS. 5 A-5C illustrate a front-perspective view, a front view, and a top view of another suture anchor, according to an embodiment described herein.

[0070] FIG. 6 illustrates a top view of the anchor of the suture anchor of FIG. 5 A, according to an embodiment described herein.

[0071] FIGS. 7A-7C illustrate the suture anchor of FIGS. 2A-2C, transitioning from an unfolded configuration to a folded configuration when inserted within a bone hole, according to an embodiment described herein.

[0072] FIG. 8 illustrates the suture anchor of FIG. 5 A with a passing suture, according to an embodiment described herein.

[0073] FIG. 9 illustrates the suture anchor of FIG. 5 A in a folded configuration within a bone hole, according to an embodiment described herein.

[0074] FIG. 10 illustrates a suture anchor construct having two anchors, according to an embodiment described herein.

[0075] FIG. 11 illustrates the suture anchor construct of FIG. 10 having the two anchors in a folded configuration inserted in a bone hole, according to an embodiment described herein.

[0076] FIG. 12 illustrates another suture anchor construct, having three anchors, according to an embodiment described herein.PCT APPLICA TION CINCH-001PCT

[0077] FIGS. 13A-13D illustrate a syndesmotic suture anchor construct and its components, according to an embodiment described herein.

[0078] FIGS. 14A-14C illustrate an application of the syndesmotic suture anchor construct of FIG. 13 A, according to an embodiment described herein.

[0079] FIGS. 15 A- 15B illustrate a front view and a front cutaway view of an inserter assembly, according to an embodiment described herein.

[0080] FIGS. 16A-16N illustrate a method for inserting a suture anchor within a bone and securing a positioning of a soft tissue, according to an embodiment described herein.

[0081] FIGS. 17A-17F illustrate a method for inserting a suture anchor construct within a bone and securing a positioning of a soft tissue, according to an embodiment described herein.

[0082] FIGS. 18A-18B illustrate a lateral row suture anchor construct, according to an embodiment described herein.

[0083] FIGS. 19A-19C illustrate a front perspective view, a front view, and a side view, respectively, of another suture anchor in an unfolded configuration, according to an embodiment described herein.

[0084] FIGS. 19D-19F depict a front perspective view, a side view, and a top view, respectively, of the suture anchor of FIG. 19A that has been transitioned to the folded configuration, according to an embodiment described herein.

[0085] FIGS. 20A-20C illustrate a front perspective view, a front view, and a side view, respectively, of another suture anchor in an unfolded configuration, according to an embodiment described herein.

[0086] FIGS. 20D-20F depict a front perspective view, a side view, and a top view, respectively, of the suture anchor of FIG. 20A, that has been transitioned to the folded configuration, according to an embodiment described herein.

[0087] FIGS. 21 A-21D illustrate a front perspective view, a front view, a side view, and a top view respectively, of another anchor in an unfolded configuration, according to an embodiment described herein.

[0088] FIGS. 21E-21F illustrate a front perspective view, and a side view respectively, of a suture anchor having the anchor of FIG. 21 A that has been transitioned to the folded configuration, according to an embodiment described herein.

[0089] FIGS. 22A-22D illustrate a front perspective view, a front view, a side view, and a top view respectively, of another anchor in an unfolded configuration, according to an embodiment described herein.PCT APPLICA TION CINCH-001PCT

[0090] FIGS. 22E-22F illustrate a front perspective view, and a side view respectively, of a suture anchor having the anchor of FIG. 22A that has been transitioned to the folded configuration, according to an embodiment described herein.

[0091] FIGS. 23A-23E illustrate an example method for forming a suture knot as part of a suture anchor construct, according to an embodiment described herein.

[0092] FIGS. 24A-24C illustrate an example method for forming the suture anchor construct described in FIGS. 23A-23E, according to an embodiment described herein.

[0093] FIGS. 25A-25G illustrate an example method for deploying the suture anchor construct described in FIGS. 24A-24C, according to an embodiment described herein.

[0094] FIGS. 26A-26E illustrate another example method for coupling two tissues together using a suture anchor construct described herein, according to an embodiment described herein.

[0095] FIGS. 27A-27D illustrate a front perspective view, a front view, a side view, and a top view respectively, of another anchor in an unfolded configuration, according to an embodiment described herein.

[0096] FIGS. 27E-27F illustrate a front perspective view, and a side view respectively, of a suture anchor having the anchor of FIG. 27A that has been transitioned to the folded configuration, according to an embodiment described herein.

[0097] FIGS. 28A-28D illustrate a front perspective view, a front view, a side view, and a top view respectively, of another anchor in an unfolded configuration, according to an embodiment described herein.

[0098] FIGS. 28E-28F illustrate a front perspective view, and a side view respectively, of a suture anchor having the anchor of FIG. 28A that has been transitioned to the folded configuration, according to an embodiment described herein.

[0099] FIGS. 29A-29I illustrate another example method for coupling two tissues together using an anchor described herein, according an embodiment described herein.DETAILED DESCRIPTION OF THE INVENTION

[0100] Disclosed herein, in some aspects, is a suture anchor configured to secure a positioning of a second tissue about and / or relative a first tissue. The suture anchor may include an anchor and a suture. The anchor may be a suture itself, and may include one or more slots that extend across an anchor body of the anchor. In some cases, the anchor does not include any slots. The anchor body may include one or more sutures that are weaved about each other and / or together. A different suture (e.g., a repair suture, as described herein) may be configured to be secured to the anchor via the slot and / or by being extended through the anchor body (e.g., within thePCT APPLICA TION CINCH-001PCTweaving of the anchor body). As referred to herein, the suture being extended through the anchor body may include (but not limited to) i) extending (or passing) through and / or along a length of the anchor body, and / or ii) extending from one side of the anchor body to another side of the anchor body (e.g., passing through the anchor body from one side to the opposite side), which may occur multiple times. In some cases, such extending through the anchor body may be referred to as weaving about the anchor body.

[0101] The repair suture, via being secured to the anchor, may be used to secure the positioning of a second tissue relative to a first tissue. Together, the anchor and the repair suture may be an all-suture anchor. The anchor may be secured to the first tissue by transitioning from an unfolded configuration to a folded configuration. The anchor may transition to the folded configuration by applying tension to the repair suture that is secured, or at least coupled to the anchor.Suture Anchor Types and Components

[0102] FIGS. 1A-1C depict an embodiment of an anchor 100 for a suture anchor described herein, where FIGS. 1A-1C depict a front view, a front perspective view, and a top view, respectively, of the anchor 100. The anchor 100 may include an anchor body 102, and one or more slots 104. As described herein, however, for any anchor described herein (e.g., 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800), the anchor may not include any slots. The anchor body 102 may be of any size and / or shape. The anchor body 102, as shown in an unfolded configuration (contra a folded configuration such as in FIG. 2C), depicted with a rectangular cross-section in FIGS. 1A-1C. The anchor body may however include a crosssection that is circular, square, ellipsoid, any other polygon, or any unspecified shape. Further, for any anchor described herein (e.g., 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800), although each anchor (e.g., anchor body 102) for any anchor described herein may appear to be depicted as a rectangular structure, the anchor body may be constructed via one or more threads (e.g., sutures) that are weaved about each other and / or together to create the anchor body 102. For example, the anchor body 102 may be constructed via a suture braider. As such it may be possible to insert (e.g., extend, pass), for example another suture or object, through any portion of the anchor body 102, by inserting (e.g., extending, passing) it through a weaved portion (e.g., woven filaments, woven threads, woven sutures, etc.) of the anchor body. In some cases, inserting another suture or object through the anchor body may create its own suture path(s) (for example through the anchor body).PCT APPLICA TION CINCH-001PCT

[0103] In some cases, the anchor body comprises the slot (e.g., the anchor body defines the slot(s) and / or channel(s) therethrough). In some cases, the anchor body and the slot are separate components.

[0104] In some cases, for any reference of a slot herein, this may simply refer to a path of one or more sutures (e.g., repair sutures, passing sutures, etc.) within an anchor body (e.g., which may be along a longitudinal portion of the anchor body, or simply going from one side of the anchor body to another side of the anchor body). This may be particularly true when the anchor does not include a slot, which may be for any anchor described herein. In some cases, any reference to an opening of a slot, may simply refer to a portion along the anchor body where a suture (e.g., repair suture, passing suture, etc.) extends through (exits or enters, e.g., to and / or from) an anchor body.

[0105] The anchor body 102 may include a length 108 (see FIG. 1A) that extends along a longitudinal axis 114 (see FIG. IB), a width 110 (see FIGS. 1 A, 1C) that extends along a lateral axis 116 (see FIG. IB), and a thickness 112 (see FIG. 1C) that extends along a vertical axis 118 (see FIG. IB). As used herein, the term “thickness” and “thick” may be interchangeably used with the term “vertical” and “vertically.” The anchor body 104 may have a length from about 1mm to about 100mm, a width from about 0.1mm to about 50mm, and / or a thickness from about 0.5mm to about 10mm.

[0106] As described herein, the anchor 100 may further include one or more slots 104, where FIGS. 1A-1C depict the anchor 100 having two slots 104. Each slot 104 may define a respective channel 128 therethrough. The channel 128 may be configured to receive one or more sutures (e.g., a repair suture, passing suture, deployment suture, as described herein).

[0107] Each slot 104 may be integrated with the anchor body 102. For example, FIGS. 1B-1C depict the anchor body 102 defining the shape and size of each slot 104, wherein each slot 104 extends through the anchor body 104. In some embodiments, one or more of the slots 104 is a separate component coupled along a face of the anchor body (e.g., a face defined by the longitudinal and lateral planes). For example, the one or more of the slots 104 that are separate from the anchor body 102 may be coupled via stitching, welding, gluing, etc., and in some cases may be removably coupled, such as using hook-and-loop fasteners, tape, etc.

[0108] Each slot 104 may extend longitudinally across the anchor body 102. In some embodiments, one or more of the slots 104 may extend in any other direction, such as laterally, vertically, and / or at least partially i) longitudinally, ii) laterally, iii) vertically, or iv) a combination thereof. Accordingly, each slot may be independently routed, and / or sized (e.g., each slot can each be configured to pass any number of specific sutures therethrough).PCT APPLICA TION CINCH-001PCT

[0109] Each slot 104 may extend across an entire length of the anchor body 102, as depicted in FIGS. 1 A-1B. Specifically, the slot 104 is depicted as extending from a proximal end 120 of the anchor body 102 to a distal end 122 of the anchor body 102. In some embodiments, each slot 104 of the one or more slots of the anchor 100 may independently extend an entire width or thickness of the anchor body. In some embodiments, one or more of the slots 104 may extend only partially across the anchor body 102 in a respective dimension (longitudinal, lateral, thickness). For example, the slots 104 may extend between the proximal 120 and distal 122 ends of the anchor body 102 for only a portion of the length 108 of the anchor body.

[0110] As described herein, each slot 104 may include a channel 128 that is located within the slot and extends therethrough. Each channel 128 within the slot 104 may be sized to receive one or more sutures (e.g., repair sutures, passing sutures, deployment sutures, etc.). Each slot 104 may have a channel having a size defined by a maximum dimension 130 that is from about 0.05mm to about 5mm. For example, the maximum dimension 130 of the size of the slot channel 128 may be a diameter of the slot channel, a width of the slot channel, a thickness of the slot channel, etc. Each slot 104, which may include a maximum dimension 130 of the channel 128 and a thickness of a wall defining the slot 104, may have a maximum dimension from about 0.05mm to about 49.95mm. The maximum dimension of the slot 104 may be larger than the thickness of the anchor body 102, as depicted in FIG. 1B-1C. Thus, at least a portion of the slot 104 may protrude from a planar face of the anchor body 102. As depicted in FIGS.1B-1C, each slot 104 protrudes (e.g., vertically) from a planar portion of a first side 124 and a planar portion of a second side 126. In some embodiments, one or more of the slots 104 protrudes (e.g., vertically) from a planar portion of only one face of the anchor body 102. In some embodiments, the maximum dimension of one or more of the slots 104 is less than a thickness of the anchor body 102, and does not protrude from the planar portion of either face of the anchor body 102. In some embodiments, the maximum dimension of one or more of the slots is less than a thickness of the anchor body 102, but still protrudes from a planar portion of one face of the anchor body 102 due to the positioning of the slot 104 relative to the anchor body 102.

[0111] Each slot 104 may include one or more openings to allow access to the channel 128 within the slot 104. The slots 104 in FIGS. 1 A-1C are depicted with having a first opening 106 located at a proximal end of the slot 104, which is located at a proximal end 120 of the anchor body, and a second opening 107 located at a distal end of the slot 104, which is located at a distal end 122 of the anchor body 104. In some embodiments, the slot 104 includes one or more additional openings located along a portion of the slot 104 between the proximal and distalPCT APPLICA TION CINCH-001PCTends of the slot. For example, each additional opening located along a portion of the slot 104 between the proximal and distal ends of the slot 104 may be therefore disposed on a first and / or second side of the anchor body 104 (as described herein). Each additional opening may provide access to the channel 128 within the respective slot 104. Each additional opening may be sized to receive one or more sutures, as described herein. In some embodiments, one or more additional openings are disposed about a first side 124 of the anchor body 102, a second side 126 of the anchor body 102, or both (see FIGS. 4A-4C for example). For example, in some embodiments, a third opening of the slot is disposed about a first side 124 of the anchor body, and a fourth opening of the slot 104 is disposed about a second side 126 of the anchor body. In some embodiments, the third and fourth openings are disposed substantially at the same longitudinal positioning relative to the anchor body 102, such that a suture can extend substantially vertically across the thickness of the anchor body 102 from the third opening to the fourth opening. In some embodiments, the third opening is disposed longitudinally proximally or distally to the fourth opening. In some embodiments, the anchor body 102 does not include a first and / or a second opening about the proximal and distal ends of the slot 104 respectively, but includes one or more openings between the proximal and distal ends of the slot 104. For example, one or both of the proximal end and the distal end of any slot for any anchor described herein (e.g., 100, 200, 400, 500, 1900, 2000, 2100, 2200) may be closed or substantially closed, such as being welded (e.g., ultrasonically welded). Accordingly, one or both of the proximal and distal ends of the anchor body may be flat or substantially flat (e.g., as would be depicted in FIG. 1C across the top portion).

[0112] As described herein, the anchor 100 may be a suture, or at least partially formed of a suture. For example, the anchor body 102 may be a suture tape, woven mat, interconnected fibers, multiple twisted fibers, layered fibers, or any combination thereof. The slot 104 may be defined within the anchor body 102, or suture, thereby forming the anchor 100. The anchor may also not include any slots. The anchor 100 may also be and / or include any material or component that is not a suture. The anchor 100 may be flexible so as to be configured to transition from and / or between an unfolded configuration (e.g., see FIGS. 1 A-1C) and a folded configuration (e.g., see FIG. 2C).

[0113] Some of the components listed herein, such as relating to the anchor (e.g., anchor body 102, slot 104, etc.) use the same number from figure to figure. It should be appreciated that these components use the same numbers solely for ease of reference and to facilitate comprehension for the reader. While these components may use the same numbers, differences may be present in these components as illustrated in the various figures in which they appearPCT APPLICA TION CINCH-001PCTand as described in the specification herein. For example, the characteristics, parameters, dimensions, etc. of the anchor body 102 and slot 104 described for anchor 100 may be the same or similar for anchor 200, 400, 500, described herein, wherein differences may include location and / or number of openings on the slot. Another example of a difference may be the number of slots, though each anchor may include any number of slots.

[0114] With reference to FIGS. 2A-2C, a suture anchor 10 including an anchor 200 and a suture 202 (e.g., repair suture) is depicted. The anchor 200 may include an anchor body 102 that is similar to the anchor body described herein (e.g., FIGS. 1 A-1C). The anchor 200 may include a slot 104 that may be similar to anchor 104 from FIGS. 1 A-1C), except wherein each slot 104 includes an opening 204 disposed along a first side 124 of the anchor body 104. The repair suture 202 may be any suture type, such as for example, round suture, coreless round suture, suture tape, knotless suture tape, straight fibers, monofilament sutures, resorbable fibers, or any combination thereof. The repair suture may have a size from about USP 10-0 to about USP #10 or 0.5mm wide suture tape to 40mm wide suture tape. For any suture (e.g., 202, 502) described herein, the suture may be at least partially coreless (e.g., hollow, e.g., a hollow braid), and in some cases may define a suture passageway therein. In some cases, such hollow sutures, may collapse on itself once tension is applied.

[0115] In some cases, the suture (e.g., 202, 502 as described herein) is configured to extend at least partially within and / or through a slot. In some cases, where there is no slot, the suture is configured to extend at least partially through the anchor body. For example, the suture may be configured to be weaved through and / or about the anchor body. In some cases, the weaving about the anchor body refers to the suture simply crossing through the anchor body from one side to another. For example, see FIG. 26A, where suture 202 for anchor 2800 is shown extending along a length about one side of the anchor body, then going through the anchor body from the one side to the opposite side of the anchor body, extending along a length about the opposite side (not shown in FIG. 26A), then going through the anchor body to return to the first side (this may occur multiple times).

[0116] FIGS. 2A-2C depict the anchor 200 transitioning from an unfolded configuration (FIG.2A) to a folded configuration (FIG. 2C). As used herein, the terms “deploy” and “deployed” may be used interchangeably with the terms “fold” and “folded”. As depicted in FIG. 2 A, the repair suture 202 is inserted through the slots 104 of the anchor 200. A first portion of the repair suture 202a and a second portion of the repair suture 202b are depicted extending proximally from a third opening 204 of each of the slots 104 about the first side 124 of the anchor body 102. The repair suture 202 is also depicted as extending through the channel 128 within eachPCT APPLICA TION CINCH-001PCTslot 104 from the third opening 204 to the second opening 107 of each slot at the distal end thereof, wherein a middle portion 202c of the repair suture 202 is depicted extending between the second opening 107 of each slot 104. As described herein, the anchor 200 may not include any slots, such that a suture (e.g., repair suture) may be passed through the anchor body (e.g., through woven filaments, threads, sutures, etc.), which in some cases, creates its own suture path(s). Anchor 2800 as depicted in FIG. 26A illustrates an example of a suture 202 passed through an anchor 2800.

[0117] Accordingly, by applying tension to the suture 202, for example applying tension to one or both of the first and second portions 202a, b, the repair suture 202 is secured to the anchor 100 via middle portion 202c of the repair suture 202 being pulled towards the anchor body 102 portion between the second openings 107 of each slot (and / or two portions of the anchor body that the suture 202 extends from). Tension may be applied to one or both of the first and second portions 202 a,b in any direction, such as proximally, at least partially proximally, at least partially proximally laterally, at least partially proximally vertically, and / or at least partially proximally distally.

[0118] In some embodiments, the anchor body 102 begins to folds due to an initial resistance by the anchor 200 to move in the direction of the tension applied to the repair suture. For example, as described herein, the anchor 200 may be disposed within a bone hole (e.g., see bone hole 708 in FIGS. 7A-7C), where at least a portion of the anchor body 102 may interact with an inner surface of the bone hole when being pulled in at least partially a direction of tension applied to the repair suture. In some embodiments, there is a press fit between the anchor 200 and the bone hole (e.g., with an inner surface 710 of the bone hole 708). Accordingly, in some embodiments, such interaction between the anchor body 102 and the inner surface of the bone hole may provide at least some resistance to movement of the anchor body 102 in the direction of the tension (e.g., out of the bone hole), such that the middle portion 202c of the repair suture 202 may provide a clamping effect on the anchor body 102 by being pulled in the direction (at least partially) of the tensioning applied to the first and second portions 202a, b of the repair suture 202. Thus, when tension is applied to one or both of first and second portions 202 a,b, the middle portion 202c may pull up on the distal end 122 of the anchor body 102, such that the anchor may start to compress (e.g., fold) against itself. In some cases, the anchor continues to fold until a given force (e.g., a certain force of the tension being applied to the first and / or second portions 202a, b) is reached. In some cases, said given force may be about 3 ON to about 200N, such as for example about 75N to about 200N. The given force may correspond to a pullout strength (e.g., pullout force), which corresponds to the forcePCT APPLICA TION CINCH-001PCTrequired to pull the anchor 200 out and / or away from the first tissue (e.g., pulling the anchor 200 out of a bone hole 708 as depicted in FIGS. 7A-7C).

[0119] In some embodiments, a support surface, such as a ledge or other edge that may be provided via the first tissue, allows the anchor 200 to be pressed against it when tension (e.g., to the repair suture) is applied. For example, anchor 200 may interact (e.g., in an upward, or proximal manner) against the support surface of the first tissue, thereby increasing a pullout strength for the anchor 200 when coupled to the first tissue (e.g., disposed in a bone hole 708). With respect to the first tissue being a bone 704 with a bone hole 708, as described herein in FIGS. 7A-7C, the cortical shell (e.g., 706) may provide a hard edge of some sort and may act as a support surface. In some embodiments, as described herein in FIG. 16L, a distal portion of an inserter shaft 1506 may be used as a support surface to help deploy (e.g., fold) the anchor 200. Accordingly, when the anchor 200 is pulled up against the inserter shaft 1506, it may help fully deploy (e.g., fold, such as FIG. 2C) the anchor 200. A fully deployed (e.g., folded configuration) anchor 200 may increase pullout strength by about 150% to about 500%, such as about 200% to about 300%, as compared to without having any support surface.

[0120] With reference to FIG. 2B, continued tension applied to the repair suture 202, causes the anchor body 102 to begin to fold (e.g., see folds 208a, b) and with continued tension the anchor will enter a semi-deployed state (e.g., FIG. 2B) until a pullout force (e.g., pullout strength, as described herein) is reached, at which time the anchor 200 may move (e.g., proximally in a bone hole 708, as described herein) and interact with a support surface (e.g., the inserter shaft 1506) which, with continued tension applied (e.g., to one or both of the first and second portions 202a, b), may force the anchor 200 to fully deploy into its folded configuration (FIG. 2C). In the folded configuration, the anchor body may no longer be able to fold.

[0121] Alternatively, or additionally, the middle portion 202c may cause a portion of the anchor body 102 (e.g., at the distal end) to flap at least partially vertically, thereby providing at least some resistance to movement for the anchor body 102.

[0122] As depicted in FIGS. 2B-2C, the anchor body 102 may fold along its length, and in the vertical direction, such that a vertical distance spanned by the anchor body 102 will increase. For example, the anchor body 102 in the unfolded configuration (e.g., see FIG. 2A) may span a vertical distance that is substantially equal to the thickness 112 of the anchor body, whereas the vertical distance spanned 210 (see FIG. 2C) by the anchor body 102 increases to larger than the thickness 112 of the anchor body and continues to increase until the anchor body 102 stops folding. Accordingly, as described herein, the increasing spanned vertical distance 210 mayPCT APPLICA TION CINCH-001PCTincrease the interaction between the anchor body 102 and a bone hole inner surface, thereby further increasing a resistance (e.g., pull-out strength) for removing the anchor 200 from within the bone hole (see FIGS. 7A-7C for example).

[0123] In some embodiments, the anchor body 102 folds to the folded configuration in an accordion manner. In some embodiments, the anchor body 102, in the folded configuration, includes one or more pleats formed via the folds (e.g., 208a, b). As described herein, in some embodiments, the number of folds 208 and / or number of pleats of the anchor body 102 in the folded configuration is based on a location of the slot openings (e.g., 204), number of slot openings the repair suture 202 (and / or deployment suture(s)) passes through, and / or routing of the repair suture through one or more slots (e.g., see FIGS. 4A-4C).

[0124] In some embodiments, in addition to or alternative to the anchor body 102 folding in a vertical direction, the anchor body 102 may fold in a lateral direction. For example, the anchor body 102 may be configured to fold along its length and with any combination of a lateral and vertical direction. In some embodiments, the anchor body 102 may be configured to fold along its length, width, and / or thickness (e.g., vertical).

[0125] FIGS. 3A-3C depict a front perspective view, a front view, and a front cutaway view of the suture anchor 10 having an unfolded anchor body 102 and a suture 202 inserted through the slots of the anchor, similar to depiction of the suture anchor from FIG. 2A. With respect to FIG. 3C, the proximal portion of the slots 104 depict an interior of the slot 104 without a suture 202 therein.

[0126] FIGS. 4A-4C depict a front perspective view, a front view, and a side view, respectively, of another embodiment of a suture anchor 12 described herein, having an anchor 400. The anchor 400 includes an anchor body 102 similar to as described herein (e.g., see anchor 10), and one or more slots 104 similar to as described herein (e.g., see 104 for anchor 10). As described herein, the anchor 400 may not include any slots, such that a suture (e.g., repair suture) may be passed (e.g., extended) through the anchor body (e.g., through woven filaments, threads, sutures, etc.). The slot(s) 104 may further include one or more openings along a first 124 and / or second 126 side of the anchor body 102. These openings may be in addition to a first opening 106 and / or a second opening 107 that may be located at a proximal and distal end of each slot 104 respectively (as described herein). As depicted in FIGS. 4A-4C, the slots 104 include a third opening 402 and a fourth opening 404 on a first side 124 of the anchor body 102, and the slots 104 further include a fifth opening 406 disposed on the second side 126 of the anchor body 102. As described herein, any number of slot openings may be disposed on either the first 124 and / or second 126 sides of the anchor body 102 (e.g., see FIGS.PCT APPLICA TION CINCH-001PCT19A-19F, and FIGS. 20A-20F, as described herein). In some embodiments, one or both of the first opening 106 and the second opening 107 are not present, and thus the openings to the channel 128 within the slot(s) 124 are on the first 124 and / or second 126 sides of the anchor body 102.

[0127] Each of the openings 106, 107, 402, 404, 406 may be configured to receive one or more sutures therethrough, providing access in and out of the channel 128 within a respective slot 104. As depicted in FIGS. 4A-4C, the suture anchor 12 includes a suture 202 that enters and exits the channel 128 within each slot 104 at multiple locations (via the multiple openings). As described herein, such openings may not be pre-existing in the anchor body (for example if the anchor does not have any slots, or even if there are slots), but may be where the suture (e.g., 202) extends from and / or through the anchor body 102 (e.g., where the suture 502 is passed through woven filaments, threads, sutures, etc., for example). Accordingly, each slot 104 (and / or anchor body) may independently define one or more routing sections (e.g., 408, 410, 412) for a repair suture 202 with respect to the respective slot channel (and / or anchor body). Each routing section may define a respective path for the repair suture along the anchor body. Each routing section may be defined between any two openings on the slot 104, between an opening on the slot and the proximal and / or distal end of the slot, between an opening on the slot and the proximal 120 and / or distal end 122 of the anchor body 102, or at least extending from one opening on the slot 104.

[0128] For example, each slot 104 (and / or anchor body) of the suture anchor 12 in FIGS. 4A-4C define three routing sections 408, 410, 412 for the repair suture 202. The first routing section 408 for each slot 104 is depicted as having the repair suture 202 passing within the slot channel 128, such as for example between the second opening 107 and the third opening 402. The second routing section 410 is depicted as having the repair suture 202 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the third 402 and fourth 404 openings of the slot 104. The third routing section 412 is depicted as having the repair suture 202 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the fifth 406 opening and the proximal end 120 of the anchor body.

[0129] As described herein, the anchor 400 may not include any slots, where the repair suture 202 may be passed (e.g., extended) through the anchor body material (e.g., passed through the woven sutures, threads, filaments, etc., for example), which in some cases, creates its own suture path(s).PCT APPLICA TION CINCH-001PCT

[0130] The anchor 400 may further define one or more crossover sections where the repair suture 202 extends between the first side 124 and the second side 126 of the anchor body 102. For example, the anchor 400 includes a first crossover section between fourth 404 and fifth 406 openings.

[0131] In some embodiments, each routing section may have a specified length in a longitudinal direction (as described herein). For example, routing sections 408, 410, 412 may each have a length that corresponds to 1 / 3 of a length 108 of the anchor body 102. In other embodiments, each routing section for a respective slot 102 may have a length independent of the length of another routing section, such that any one routing section may have a length that is greater than, less than, or equal to the length of another routing section. The sum of the lengths of all the routing sections for a slot 102 may or may not equal to a length 108 of the anchor body 102.

[0132] In some embodiments, each of the one or more said routing sections (e.g., 408, 410, 412) is also configured to provide a clamping effect to the anchor body 102 when tension is applied to the repair suture 202 (e.g., as described herein). For example, tension applied to the first and second portions 202a, b of the suture 202 may cause the middle portion 202c to apply a clamping effect on the anchor body (e.g., as described herein for FIGS. 2B-C). Additionally, as the anchor body folds, the anchor body 102 may be caused to fold further, or flare out further (e.g., in a vertical direction) about the third 402, fourth, 404, and / or fifth 406 openings, and / or with respect to each routing section (e.g., 408, 410, 412). Such additional flaring out (e.g., vertically) may be due to the stress applied by the repair suture to the anchor body 102 at such openings about the slot. Furthermore, the top routing section 412 may act as a flap and may fold over, when the anchor 400 transitions to the folded configuration, which, in the example of a bone hole 708, may extend at least partially along a length of the bone hole 708, thereby providing a portion of the anchor body partially running parallel to another portion of the anchor body, and thereby further increasing a vertical span of the anchor in the folded configuration (see e.g., flap 1922 in FIGS. 19D)-.

[0133] Accordingly, in comparison with having just a middle portion (e.g., 202c) that provides a clamping effect, which causes an initial folding or flaring out (e.g., in the vertical direction) of the anchor body 102 about the distal end 122 of the anchor body, additional locations about the anchor body 102 (e.g., about each routing section) may also initially fold or increase in how much the anchor body folds (e.g., flares out in a vertical direction), thereby increasing the interaction and / or providing a more robust interaction between the anchor body 102 in the folded configuration with the first tissue (as described herein).PCT APPLICA TION CINCH-001PCT

[0134] In some embodiments, having additional routing sections is more desirable for an anchor body 102 having a smaller length, given that a single clamping effect (e.g., via middle portion 202c as described herein) may not generate sufficient pleats and / or pleats of sufficient size that interact with the first tissue to secure the anchor 200 to the first tissue.

[0135] FIGS. 19A-19F depict another embodiment of a suture anchor 28, having an anchor 1900. The suture anchor 28 may be similar to the suture anchor 12 in FIGS. 4A-4C, except that the suture anchor 28 is depicted as defining four routing sections 1912, 1914, 1916, 1918 as opposed to three routing sections depicted with suture anchor 12. As described herein, the anchor 1900 may not include any slots, such that a suture (e.g., repair suture) may be passed (e.g., extended) through the anchor body (e.g., through woven filaments, threads, sutures, etc.), which in some cases, creates its own suture path(s).

[0136] FIGS. 19A-19C depict a front perspective view, a front view, and a side view, respectively, of suture anchor 28 with the anchor 1900 in an unfolded configuration. The anchor 1900 is depicted as including openings 1902, 1904, 1906, 1908, 1910 along the length of the anchor body 102, which may be in addition to a first opening 106 and / or a second opening 107 that may be located at a proximal and distal end of each slot 104 respectively (as described herein). As depicted in FIGS. 19A-19C, the slots 104 include a third opening 1902 and a fourth opening 1904 on a first side 124 of the anchor body 102, a fifth opening 1906 and sixth opening 1908 disposed on the second side 126 of the anchor body 102, and a seventh opening 1910 disposed on the first side 124 of the anchor body 102. In some embodiments, one or both of the first opening 106 and the second opening 107 are not present with the anchor 1900, and thus the openings to the channel 128 within the slot(s) are on the first 124 and / or second 126 sides of the anchor body 102.

[0137] Each of the openings 106, 107, 1902, 1904, 1906, 1908, and / or 1910 may be configured to receive one or more sutures therethrough, providing access in and out of the channel 128 within a respective slot 104. As described herein, such openings may not be pre-existing in the body (for example if the anchor does not have slots, or even if there are slots), but may be where the suture (e.g., 502) extends from and / or through the anchor body 102 (e.g., where the suture 502 is passed through woven filaments, threads, sutures, etc., for example). Similar to as depicted in FIGS. 4A-4C, FIGS. 19A-19C depicts the repair suture 202 entering and exiting the channel 128 within each slot 104 (and / or anchor body) at multiple locations (via the multiple openings). Accordingly, the slot 104 (and / or anchor body) defines four routing sections (e.g., 1912, 1914, 1916, 1918), as described herein for repair suture 202 with respect to the respective slot channel.PCT APPLICA TION CINCH-001PCT

[0138] For example, the first routing section 1912 for each slot 104 is depicted as having the repair suture 202 passing within the slot channel 128, such as for example between the second opening 107 and the third opening 1902. The second routing section 1914 is depicted as having the repair suture 202 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the third 1902 and fourth 1904 openings of the slot 104. The third routing section 1916 is depicted as having the repair suture 202 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the fifth 1906 opening and the sixth opening 1908 of the slot 104. The fourth routing section 1918 is depicted as having the repair suture 202 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the seventh opening 1910 and the proximal end 120 of the anchor body.

[0139] The anchor 1900 may further define one or more crossover sections where the repair suture extends between the first side 124 and the second side 126 of the anchor body 102. For example, the anchor 1900 includes a first crossover section between fourth 1904 and fifth 1906 openings, and a second crossover section between sixth 1908 and seventh 1910 openings.

[0140] In some embodiments, the length of each routing sections 1912, 1914, 1916, 1918 may each have a length that corresponds to 1 / 4 of a length 108 of the anchor body 102. As described herein, each routing section for a respective slot 102 may have a length independent of the length of another routing section, such that any one routing section may have a length that is greater than, less than, or equal to the length of another routing section.

[0141] FIGS. 19D-19F depict a front perspective view, a side view, and a top view of the suture anchor 28 that has been transitioned to the folded configuration. As depicted, the folded configuration may include one or more folds 1920, wherein applying tension to one or both of the first 202a and second 202b portions may cause the slot openings 1902, 1904, 1906, 1908, 1910 to somewhat be aligned longitudinally (e.g., FIG. 19E depicts a substantial alignment longitudinally, though it may not have to be substantially aligned). Accordingly, the folded configuration of the anchor body 102, and / or the one or more folds (e.g., 1920) of the anchor body 102 may be based on the location of the slot openings 1902, 1904, 1906, 1908, 1910.

[0142] Moreover, as depicted in FIGS. 19D-19E, the suture anchor 28 in the folded configuration may also include a flap 1922, which may at least partially correspond to top routing section 1918. The flap 1922, may by folded to extend along a longitudinal direction, such as when disposed in a bone hole 708, thereby causing a portion of the anchor body 102 at flap 1922 to extend at least partially parallel longitudinally with another portion of the anchor body 102 (e.g., extends partially longitudinally with folds 1920 and / or pleats portions thatPCT APPLICA TION CINCH-001PCTextend longitudinally). As such, this increases a vertical span of the anchor body 102 in the folded configuration, thereby further increasing an interaction between the anchor body 102 and the first tissue (e.g., inner surface 710 of bone hole 708) and / or a support surface (e.g., cortical shell 706 and / or inserter shaft 1506), as described herein.

[0143] FIGS. 20A-20F depict another embodiment of a suture anchor 30, having an anchor 2000. The suture anchor 30 may be similar to the suture anchor 14 in FIGS. 5A-5C, except that the suture anchor 30 is depicted as defining four routing sections 2012, 2014, 2016, 2018, similar to the routing sections depicted with suture anchor 28 in FIGS. 19A-19F. As described herein, the anchor 2000 may not include any slots, such that a suture (e.g., repair suture) may be passed (e.g., extended) through the anchor body (e.g., through woven filaments, threads, sutures, etc.), which in some cases, creates its own suture path(s).

[0144] FIGS. 20A-20C depict a front perspective view, a front view, and a side view, respectively, of suture anchor 30 with the anchor 2000 in an unfolded configuration. The anchor 2000 is depicted as including openings 2002, 2004, 2006, 2008, 2010 along the length of the anchor body 102, which may be in addition to a first opening 106 and / or a second opening 107 that may be located at a proximal and distal end of each slot 104 respectively (as described herein). As depicted in FIGS. 20A-20C, the slots 104 include a third opening 2002 and a fourth opening 2004 on a first side 124 of the anchor body 102, a fifth opening 2006 and sixth opening 2008 disposed on the second side 126 of the anchor body 102, and a seventh opening 2010 disposed on the first side 124 of the anchor body 102. In some embodiments, one or both of the first opening 106 and the second opening 107 are not present, and thus at least some of the openings to the channel 128 within the slot(s) may be on the first 124 and / or second 126 sides of the anchor body 102. For example, one or both of the first opening 106 and second opening 107 may not be present, or may be shut (e.g., welded, or via other configurations). FIGS. 20A-20F depict the opening 107 being present (where a first portion 502a of the suture 502 is secured about), and whereas the second portion 502b of the suture 502 extends from an opening (e.g., 2010) to the channel about a side of the anchor body 102.

[0145] Each of the openings 106, 107, 2002, 2004, 2006, 2008, and / or 2010 may be configured to receive one or more sutures therethrough, providing access in and out of the channel 128 within a respective slot 104. As described herein, such openings may not be pre-existing in the body (for example if the anchor does not have slots, or even if there are slots), but may be where the suture (e.g., 202) extends from and / or through the anchor body 102 (e.g., where the suture 202 is passed through woven filaments, threads, sutures, etc., for example). Similar to as depicted in FIGS. 19A-19C with respect to repair suture 202, FIGS. 20A-20C depicts thePCT APPLICA TION CINCH-001PCTrepair suture 502 entering and exiting the channel 128 within each slot 104 at multiple locations (via the multiple openings). Accordingly, the slot 104 (and / or anchor body) defines four routing sections (e.g., 2012, 2014, 2016, 2018), as described herein for repair suture 502 with respect to the slot channel (and / or anchor body).

[0146] For example, the first routing section 2012 for slot 104 is depicted as having the repair suture 502 passing within the slot channel 128, such as for example between the second opening 107 and the third opening 1902. The second routing section 2014 is depicted as having the repair suture 502 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the third 2002 and fourth 2004 openings of the slot 104. The third routing section 2016 is depicted as having the repair suture 502 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the fifth 2006 opening and the sixth opening 2008 of the slot 104. The fourth routing section 2018 is depicted as having the repair suture 502 extend along at least a portion of the length of the anchor body 102 outside of the slot channel 128 between the seventh opening 2010 and the proximal end 120 of the anchor body.

[0147] The anchor 2000 may further define one or more crossover sections where the repair suture extends between the first side 124 and the second side 126 of the anchor body 102. For example, the anchor 2000 includes a first crossover section between fourth 2004 and fifth 2006 openings, and a second crossover section between sixth 2008 and seventh 2010 openings.

[0148] In some embodiments, the length of each routing sections 2012, 2014, 2016, 2018 may each have a length that corresponds to 1 / 4 of a length 108 of the anchor body 102. As described herein, each routing section for a respective slot 102 may have a length independent of the length of another routing section, such that any one routing section may have a length that is greater than, less than, or equal to the length of another routing section.

[0149] FIGS. 20D-20F depict a front perspective view, a side view, and a top view of the suture anchor 30 that has been transitioned to the folded configuration. As depicted, the folded configuration may include one or more folds 2020, wherein applying tension to the second 502b portion may cause the slot openings 2002, 2004, 2006, 2008, 2010 to somewhat be aligned longitudinally (e.g., FIG. 20E depicts a substantial alignment longitudinally of the slot openings, though it may not have to be substantially aligned). Accordingly, the folded configuration of the anchor body 102, and / or the one or more folds (e.g., 2020) of the anchor body 102 may be based on the location of the slot openings 2002, 2004, 2006, 2008, 2010.

[0150] Moreover, as depicted in FIGS. 20D-20E, the suture anchor 30 in the folded configuration may also include a flap 2022, which may at least partially correspond to topPCT APPLICA TION CINCH-001PCTrouting section 2018. The flap 2022, may be folded to extend along a longitudinal direction, such as when disposed in a bone hole 708, thereby causing a portion of the anchor body 102 at flap 2022 to extend at least partially parallel longitudinally with another portion of the anchor body 102 (e.g., extends partially longitudinally with folds 1920 and / or pleats portions that extend longitudinally). As such, this increases a vertical span of the anchor body 102 in the folded configuration, thereby further increasing an interaction between the anchor body 102 and the first tissue (e.g., inner surface 710 of bone hole 708) and / or a support surface (e.g., cortical shell 706 and / or inserter shaft 1506), as described herein.

[0151] For any anchor described herein, including anchor 400, 1900, 2000, any one of the routing sections may be defined longitudinally but along the thickness portion 112 of the anchor body 102.

[0152] For any anchor described herein, including anchor 400, 1900, 2000, the slot may only extend partially longitudinally for an anchor body. For example, with respect to anchor 1900, 2000, any one slot may only extend from the second opening 107 to the third opening (1902, 2002). The remaining openings, such as 1904, 2004, etc. may be defined by the anchor body 102 (e.g., openings within the anchor body).

[0153] FIGS. 5A-5C depict a front perspective view, a front view, and a top view of another embodiment of a suture anchor 14 described herein, having an anchor 500 and a repair suture 502. FIG. 6 further depicts a top view of the anchor 500 without the suture 502.

[0154] The anchor 500 includes an anchor body 102 similar to the anchor body as described herein (e.g., see FIGS. 1A-1B), and includes a single slot 104, which is similar to the slot as described herein (e.g., see FIGS. 1 A-1B). The suture anchor 500 further includes a repair suture 502, similar in type and characteristic as described herein (e.g., 202). As depicted in FIGS. 5A-5C, the repair suture 502 may only extend along a longitudinal portion of the anchor body 104, either within or outside the slot channel 102, once (e.g., as compared to suture anchor 10, 12, where the repair suture 202 extends along the length of the anchor body twice via two slots 104). For example, the repair suture 502 at a first portion 502a may be secured to the anchor body 102 at a distal end 122 of the anchor body 102, wherein the second portion 502b of the repair suture 502 may extend at least partially proximally from the distal end 122 of the anchor body 102. As described herein, the anchor 500 may not include any slots, such that a suture (e.g., repair suture) may be passed (e.g., extended) through the anchor body (e.g., through woven filaments, threads, sutures, etc.), which in some cases, creates its own suture path (s).

[0155] The first portion 502a of the repair suture 502 may be secured to the anchor body 102 by being configured so as to span a maximum distance 504 (see FIG. 5C) that is larger than aPCT APPLICA TION CINCH-001PCTmaximum distance of the slot opening (e.g., second opening 107) at the distal end of the slot (e.g., see FIG. 5C, where the first portion 502a is depicted as having a maximum distance 504 larger than a maximum distance 506 of the entire slot 104, and thereby also larger than a maximum distance 130 of the opening of the slot at the second end 107). For example, the first portion 502a of the repair suture 502 may be formed into a knotted configuration, may be folded, may bunched up, etc., thereby helping secure the repair 502 about the second end 107.

[0156] In another example, the first portion 502a of the repair suture may be attached to the anchor body 102 and / or first tissue. For example, the first portion 502a may be attached to the anchor body 102 and / or first tissue through ultrasonic welding, through use of an adhesive, through stitching, etc.

[0157] In some embodiments, the first portion 502a of the repair suture is secured to the anchor body 102 via a combination of having a maximum distance 504 spanning larger than a maximum distance 130 of the second opening and being attached to the distal end 122 of the anchor body 102. For example, the first portion 502a of the repair suture may be secured to the anchor body 102 by being formed into a knot and being ultrasonically welded to the distal end 122 of the anchor body 102 and / or to the first tissue.

[0158] The second portion 502b of the repair suture may extend proximally from the second opening, optionally through the slot 104 (as depicted in FIGS. 5A-5C), and / or from the first opening 106 at the proximal end of the slot 104. In other embodiments, the second portion 502b of the suture may extend from an opening of the slot 102 disposed on a first and / or second side of the anchor body 102 (e.g., similar to slot opening 204 in FIG. 2A). Similarly, in some embodiments, the first portion 502a of the suture may be secured to the slot 102 at an opening along a first and / or second side of the anchor body. In some embodiments, the anchor 500 does not include an opening at the proximal and / or distal end of the slot 102.

[0159] In some embodiments, the first portion 502a of the repair suture is secured at a proximal end of the anchor body 102 and / or slot 104, such that the second portion 502b extends from an opening at a distal end of the slot 104 and / or an opening distal to the proximal end of the anchor body 102 and / or slot. The second portion 502b of the repair suture 502 therefore may extend proximally from said opening distal to the proximal end and first portion 502b, thereby causing the repair suture 502 to pass along a length of the anchor body (within or outside the slot channel 128) twice (contrast to the depiction in FIGS. 5A-5C).

[0160] In some embodiments, applying tension to the second portion 502b transitions the anchor 500 from an unfolded configuration (e.g. as depicted in FIGS. 5A-5C) to a folded configuration (e.g., similar to FIGS. 20D-20F for suture anchor 30, which also includes aPCT APPLICA TION CINCH-001PCTsecond portion 502b secured at a distal end of the anchor body, but differs from anchor 500 in that anchor 1900 defines four routing sections). The anchor 500 may transition to the folded configuration similar to as depicted in FIGS. 2A-2C, wherein the first portion 502a of the repair suture may provide a clamping effect on the anchor body 102, thereby creating one or more folds (e.g., 208) and / or pleats about the anchor body 102. As described herein, the anchor body 102 may fold about its length and / or in a vertical direction. Accordingly, a vertical distance spanned by the anchor body 102 may increase as the anchor 500 transitions to the folded configuration, which may allow further interaction between the anchor body 102 and the first tissue, to help secure the anchor 500 to the first tissue.

[0161] In other embodiments, the anchor 500 may be configured similar to the anchor 400 in FIGS. 4A-4C, and / or anchor 2000 in FIGS. 20A-20F, wherein the slot 102 on the anchor 14 may include one or more additional openings about a first 124 and / or second side 126 of the anchor body 102. Thus, the additional openings about the first 124 and / or second side 126 of the anchor body 102 may define one or more routing sections for the repair suture 502 (e.g., see 408,410,412 in FIGS. 4A-4C, and 2012, 2014, 2016, 2018 in FIGS. 20A-20F). Accordingly, the one or more routing sections may provide additional clamping effect locations as the anchor 500 transitions to the folded configuration, e.g., via applying tension on the second portion 502c of the repair suture.

[0162] FIGS. 21A-21D depict another embodiment of an anchor 2100, which may be similar to the anchor 500 of suture anchor 14 in FIGS. 5A-5C, and / or the anchor 2000 of suture anchor 30 in FIGS. 20A-20F, except that the suture 502 is not depicted, and the anchor 2100 is depicted as having one or more materials 2102 disposed about the anchor body 102. The one or more materials 2102 may at least partially protrude from the anchor body 102 in a longitudinal, lateral, and / or vertical direction. As described herein, the anchor 2100 may not include any slots, such that a suture (e.g., repair suture) may be passed through the anchor body (e.g., through woven filaments, threads, sutures, etc.), which in some cases, creates its own suture path(s).

[0163] FIGS. 21A-21D depict a front perspective view, a front view, a side view, and a top view, respectively, of the anchor 2100 in an unfolded configuration. The anchor 2100 may include the openings depicted in FIGS. 20A-20F (e.g., 2002, 2004, 2006, 2008, 2010) along the length of the anchor body 102, which may be in addition to a first opening 106 and / or a second opening 107 that may be located at a proximal and distal end of each slot 104 respectively (as described herein). Accordingly, the anchor 2100 may define one or more routing sections, as described herein. In some embodiments, one or both of the first openingPCT APPLICA TION CINCH-001PCT106 and the second opening 107 are not present, and thus at least some of the openings to the channel 128 within the slot(s) may be on the first 124 and / or second 126 sides of the anchor body 102. For example, one or both of the first opening 106 and second opening 107 may not be present, or may be shut (e.g., welded, or via other configurations). FIGS. 21E-21F depict the opening 107 being present (where a first portion 502a of the suture 502 is secured about), and whereas the second portion 502b of the suture 502 extends from an opening (e.g., 2010) to the channel about a side of the anchor body 102.

[0164] The one or more materials 2102 may provide additional bulk to the anchor body 102, so as to help further secure the anchor body 102 about a first tissue (e.g., within a bone hole 708, as described herein). The one or more materials 2102 may be embedded with the anchor body 102. The one or more materials may each extend from one lateral face (e.g., see 2104) of the anchor body 102 to an opposite lateral face of the anchor body 102. The one or more materials 2102 may each weave about the anchor body 102 between the first side 124 and the second side 126 as it extends between the lateral faces 2104 of the anchor body 102.

[0165] The one or more materials 2102 may extend in a slightly distal orientation (e.g., at a distal angle with respect to the lateral axis 116 (e.g., see FIG. IB)). There may be a plurality of materials 2102, each extending once between the lateral faces 2104. Alternatively or additionally, there may be one or materials that extend between the lateral faces 2104 (e.g. from a first lateral face to a second lateral face), then wraps 2102c (see FIG. 21 A) about (at least partially) a lateral face 2104 (e.g., second lateral face), and extends again between the lateral faces of the anchor body (e.g., from the second lateral face to the first lateral face). For example, in some cases, a material 2102 may extend at least at a partial distal angle (as described herein) and between lateral faces 2104, such that the material continues to weave about the anchor body 102 and wraps around the lateral faces 2104 multiple times so as to extend from a proximal end 120 of the anchor body to a distal end 122 of the anchor body. As a non-limiting example, the anchor 2100 may include two materials 2102 (e.g., see 2102a, 2102b in FIG. 2 IB) that each have an end disposed laterally and / or vertically opposite or substantially opposite, but aligned or substantially aligned longitudinally, about a proximal end 120 or proximal portion of the anchor body, where the two materials 2102 are weaved about the anchor body 102 in a criss-cross manner from the proximal end 120 or proximal portion of the anchor body 102 to the distal end 122 or distal portion the anchor body 102.

[0166] The one or more materials 2102 may include one or more sutures, a type of filament, string, etc., or any combination thereof. Additionally or alternatively, the one or more materials may include PLLA, PGA, UHMWPE, PEEK, Polyester, PLGA, or any combination thereof.PCT APPLICA TION CINCH-001PCT

[0167] FIGS. 21E-21F depict a front perspective view, and a side view of a suture anchor 32, which includes the anchor 2100 from FIGS. 21A-21D, and the suture 502. Moreover, the anchor 2100 is depicted as having been transitioned to the folded configuration. As depicted, the folded configuration may include one or more folds 2020, wherein applying tension to the second 502b portion may cause the slot openings (e.g., see FIGS. 20D-20F, openings 2002, 2004, 2006, 2008, 2010) to somewhat be aligned longitudinally. The suture anchor 32 in the folded configuration may also include a flap 2122, which may at least partially correspond to top routing section 2018 (see FIGS. 20A-20F for example).

[0168] Moreover, the one or more materials 2102 are depicted to be disposed about the anchor body 102 of anchor 2100 when transitioned to the folded configuration. The one or more materials may provide additional bulk to the suture anchor 32 in the folded configuration, thereby further increasing an interaction between the anchor body 102 and the first tissue (e.g., inner surface 710 of bone hole 708) and / or a support surface (e.g., cortical shell 706 and / or inserter shaft 1506), as described herein. This may help further secure the anchor 2100 with the first tissue (e.g., increase a pull-out strength required to remove the anchor from, for example, a bone hole 708). The one or more materials may also provide a gripping feature for increasing an interaction between the anchor body 102 and the first tissue.

[0169] As described herein, the one or more materials 2102 may be included with any anchor described herein (e.g., 500, 2000).

[0170] FIGS. 22A-22D depict another embodiment of an anchor 2200, which may be similar to the anchor 200 of suture anchor 10 in FIGS. 3 A-3C, anchor 400 of suture anchor 12 in FIGS.4A-4C, and / or the anchor 1900 of suture anchor 28 in FIGS. 19A-19F, except that the suture 202 is not depicted, and the anchor 2200 is depicted as having one or more materials 2202 disposed about the anchor body 102. The one or more materials 2202 may at least partially protrude from the anchor body 102 in a longitudinal, lateral, and / or vertical direction. As described herein, the anchor 2200 may not include any slots, such that a suture (e.g., repair suture) may be passed (e.g., extended) through the anchor body (e.g., through woven filaments, threads, sutures, etc.), which in some cases, creates its own suture path(s).

[0171] FIGS. 22A-22D depict a front perspective view, a front view, a side view, and a top view, respectively, of the anchor 2200 in an unfolded configuration. The anchor 2200 may include the openings depicted in FIGS. 19A-19F (e.g., 1902, 1904, 1906, 1908, 1910) along the length of the anchor body 102, which may be in addition to a first opening 106 and / or a second opening 107 that may be located at a proximal and distal end of each slot 104 respectively (as described herein). Accordingly, the anchor 2200 may define one or morePCT APPLICA TION CINCH-001PCTrouting sections, as described herein. In some embodiments, one or both of the first opening 106 and the second opening 107 are not present, and thus at least some of the openings to the channel 128 within the slot(s) may be on the first 124 and / or second 126 sides of the anchor body 102. For example, one or both of the first opening 106 and second opening 107 may not be present, or may be shut (e.g., welded, or via other configurations). FIGS. 22E-22F depict the opening 107 being present on both slots 104 (where a middle portion 202c of the suture 202 extends between the slots 104), and whereas the ends 202a, 202b of the suture 202 extends from a respective opening (e.g., 1910) to the channel about a side of the anchor body 102.

[0172] The one or more materials 2202 may provide additional bulk to the anchor body 102, so as to help further secure the anchor body 102 about a first tissue (e.g., within a bone hole 708, as described herein). The one or more materials 2202 may be embedded with the anchor body 102. The one or more materials may each extend from one lateral face (e.g., see 2104) of the anchor body 102 to an opposite lateral face of the anchor body 102. The one or more materials 2202 may each weave about the anchor body 102 between the first side 124 and the second side 126 as it extends between the lateral faces 2104 of the anchor body 102.

[0173] The one or more materials 2202 may extend in a slightly distal orientation (e.g., at a distal angle with respect to the lateral axis 116 (e.g., see FIG. IB)). There may be a plurality of materials 2202, each extending once between the lateral faces 2104. Alternatively or additionally, there may be one or materials that extend between the lateral faces 2204 (e.g. from a first lateral face to a second lateral face), then wraps 2202c (see FIG. 22A) about (at least partially) a lateral face 2104 (e.g., second lateral face), and extends again between the lateral faces of the anchor body (e.g., from the second lateral face to the first lateral face). For example, in some cases, a material 2202 may extend at least at a partial distal angle (as described herein) and between lateral faces 2104, such that the material continues to weave about the anchor body 102 and wraps around the lateral faces 2104 multiple times so as to extend from a proximal end 120 of the anchor body to a distal end 122 of the anchor body. As a non-limiting example, the anchor 2100 may include two materials 2202 (e.g., see 2202a, 2202b in FIG. 2 IB) that each have an end disposed laterally and / or vertically opposite or substantially opposite, but aligned or substantially aligned longitudinally, about a proximal end 120 or proximal portion of the anchor body, where the two materials 2202 are weaved about the anchor body 102 in a criss-cross manner from the proximal end 120 or proximal portion of the anchor body 102 to the distal end 122 or distal portion the anchor body 102.PCT APPLICA TION CINCH-001PCT

[0174] The one or more materials 2202 may include one or more sutures, a type of filament, string, etc., or any combination thereof. Additionally or alternatively, the one or more materials may include PLLA, PGA, UHMWPE, PEEK, Polyester, PLGA, or any combination thereof.

[0175] FIGS. 22E-22F depict a front perspective view, and a side view of a suture anchor 34, which includes the anchor 2200 from FIGS. 22A-22D, and the suture 202. Moreover, the anchor 2200 is depicted as having been transitioned to the folded configuration. As depicted, the folded configuration may include one or more folds 1920, wherein applying tension to the one or both of first and second portions 202a, 202b of the suture 202 may cause the slot openings (e.g., see FIGS. 19D-19F, openings 1902, 1904, 1906, 1908, 1910) to somewhat be aligned longitudinally. The suture anchor 34 in the folded configuration may also include a flap 1922, which may at least partially correspond to top routing section 1918 (see FIGS. 19A-19F for example).

[0176] Moreover, the one or more materials 2202 are depicted to be disposed about the anchor body 102 of anchor 2200 when transitioned to the folded configuration. The one or more materials may provide additional bulk to the suture anchor 34 in the folded configuration, thereby further increasing an interaction between the anchor body 102 and the first tissue (e.g., inner surface 710 of bone hole 708) and / or a support surface (e.g., cortical shell 706 and / or inserter shaft 1506), as described herein. This may help further secure the anchor 2200 with the first tissue (e.g., increase a pull-out strength required to remove the anchor from, for example, a bone hole 708). The one or more materials may also provide a gripping feature for increasing an interaction between the anchor body 102 and the first tissue.

[0177] FIGS. 27A-27D depict a front perspective view, a front view, a side view, and a top view, respectively, of the anchor 2700 in an unfolded configuration. As described herein, although each anchor (e.g., anchor body 102) for any anchor described herein may appear to be depicted as a rectangular structure, the anchor body may be constructed via one or more threads (e.g., sutures) that are weaved about each other and / or together to create the anchor body 102. As such it may be possible to insert (e.g., pass, extend), for example another suture or object, through any portion of the anchor body 102, by inserting (e.g., passing, extending) it through a weaved portion.

[0178] The anchor 2700 may include the openings depicted in FIGS. 20A-20F (e.g., 2002, 2004, 2006, 2008, 2010) along the length of the anchor body 102. As described, such openings may be pre-existing, or may be a point entry and / or exit of another structure (e.g., suture) from within a weaved portion (for example) of the anchor body 102. Moreover, anchor 2700 may not include any slots, as described herein for other anchors. As such, anchor 2700 may notPCT APPLICA TION CINCH-001PCTinclude any openings along a proximal end 120 and / or distal end 122 of the anchor body 102. A suture (e.g., 202) may nonetheless be able extend into and / or from a proximal end 120 and / or distal end 122.

[0179] The anchor 2700 may define one or more routing sections, as described herein (e.g., FIGS. 20A-20F). In some embodiments, at least some of the openings, which may be points where the suture enters and / or exits an anchor body, may be on the first 124 and / or second 126 sides of the anchor body 102. FIGS. 27E-27F depicts a first portion 502a of the suture 502 being secured about and / or entering along the distal end 122 of the anchor, and whereas the second portion 502b of the suture 502 extends from an opening (e.g., 2010) to the channel about a side of the anchor body 102.

[0180] The one or more materials 2102 may provide additional bulk to the anchor body 102, so as to help further secure the anchor body 102 about a first tissue (e.g., within a bone hole 708, as described herein). The one or more materials 2102 may be embedded with the anchor body 102. The one or more materials may each extend from one lateral face (e.g., see 2104) of the anchor body 102 to an opposite lateral face of the anchor body 102. The one or more materials 2102 may each weave about the anchor body 102 between the first side 124 and the second side 126 as it extends between the lateral faces 2104 of the anchor body 102. The one or more materials 2102 may be weaved about the anchor body 102 weaving (as described herein).

[0181] The one or more materials 2102 may extend in a slightly distal orientation (e.g., at a distal angle with respect to the lateral axis 116 (e.g., see FIG. IB)). There may be a plurality of materials 2102, each extending once between the lateral faces 2104. Alternatively or additionally, there may be one or materials that extend between the lateral faces 2104 (e.g. from a first lateral face to a second lateral face), then wraps 2102c (see FIG. 27 A) about (at least partially) a lateral face 2104 (e.g., second lateral face), and extends again between the lateral faces of the anchor body (e.g., from the second lateral face to the first lateral face). For example, in some cases, a material 2102 may extend at least at a partial distal angle (as described herein) and between lateral faces 2104, such that the material continues to weave about the anchor body 102 and wraps around the lateral faces 2104 multiple times so as to extend from a proximal end 120 of the anchor body to a distal end 122 of the anchor body. As a non-limiting example, the anchor 2700 may include two materials 2102 (e.g., see 2102a, 2102b in FIG. 27B) that each have an end disposed laterally and / or vertically opposite or substantially opposite, but aligned or substantially aligned longitudinally, about a proximal end 120 or proximal portion of the anchor body, where the two materials 2102 are weaved about the anchor bodyPCT APPLICA TION CINCH-001PCT102 in a criss-cross manner from the proximal end 120 or proximal portion of the anchor body 102 to the distal end 122 or distal portion the anchor body 102. The two materials (2102a, b) however may not need to be aligned longitudinally (for any anchor described herein).

[0182] The one or more materials 2102 may include one or more sutures, a type of filament, string, etc., or any combination thereof. Additionally or alternatively, the one or more materials may include PLLA, PGA, UHMWPE, PEEK, Polyester, PLGA, or any combination thereof.

[0183] FIGS. 27E-27F depict a front perspective view, and a side view of a suture anchor 36, which includes the anchor 2700 from FIGS. 27A-27D, and the suture 502. Moreover, the anchor 2700 is depicted as having been transitioned to the folded configuration. As depicted, the folded configuration may include one or more folds 2020, wherein applying tension to the second 502b portion may cause the openings (e.g., see FIGS. 20D-20F, openings 2002, 2004, 2006, 2008, 2010) to somewhat be aligned longitudinally. As described herein, such openings may not be pre-existing in the body, but may be where the suture (e.g., 502) extends from and / or through the anchor body 102. The suture anchor 36 in the folded configuration may also include a flap 2122, which may at least partially correspond to top routing section 2018 (see FIGS. 20A-20F for example).

[0184] Moreover, the one or more materials 2102 are depicted to be disposed about the anchor body 102 of anchor 2700 when transitioned to the folded configuration. The one or more materials may provide additional bulk to the suture anchor 36 in the folded configuration, thereby further increasing an interaction between the anchor body 102 and the first tissue (e.g., inner surface 710 of bone hole 708) and / or a support surface (e.g., cortical shell 706 and / or inserter shaft 1506), as described herein. This may help further secure the anchor 2700 with the first tissue (e.g., increase a pull-out strength required to remove the anchor from, for example, a bone hole 708). The one or more materials may also provide a gripping feature for increasing an interaction between the anchor body 102 and the first tissue.

[0185] FIGS. 28A-28D depict a front perspective view, a front view, a side view, and a top view, respectively, of the anchor 2800 in an unfolded configuration. As described herein, although each anchor (e.g., anchor body 102) for any anchor described herein may appear to be depicted as a rectangular structure, the anchor body may be constructed via one or more threads (e.g., sutures) that are weaved about each other and / or together to create the anchor body 102. As such it may be possible to insert (e.g., extend, pass), for example another suture or object, through any portion of the anchor body 102, by inserting (e.g., extending, passing) it through a weaved portion.PCT APPLICA TION CINCH-001PCT

[0186] The anchor 2800 may include the openings depicted in FIGS. 19A-19F (e.g., 1902, 1904, 1906, 1908, 1910) along the length of the anchor body 102. Accordingly, the anchor 2800 may define one or more routing sections, as described herein. As described, such openings may be pre-existing, or may be a point entry and / or exit of another structure (e.g., suture) from within a weaved portion of the anchor body 102. Moreover, anchor 2800 may not include any slots, as described herein for other anchors. As such, anchor 2800 may not include any openings along a proximal end 120 and / or distal end 122 of the anchor body 102. A suture (e.g., 202) may nonetheless be able extend into and / or from a proximal end 120 and / or distal end 122. For example, FIGS. 28E-28F depict a middle portion 202c of the suture 202 extending from two portions along a distal end of the anchor body, and whereas the ends 202a, 202b of the suture 202 extends from a portion about a side of the anchor body 102.

[0187] The one or more materials 2202 may provide additional bulk to the anchor body 102, so as to help further secure the anchor body 102 about a first tissue (e.g., within a bone hole 708, as described herein). The one or more materials 2202 may be embedded with the anchor body 102. The one or more materials may each extend from one lateral face (e.g., see 2104) of the anchor body 102 to an opposite lateral face of the anchor body 102. The one or more materials 2202 may each weave about the anchor body 102 between the first side 124 and the second side 126 as it extends between the lateral faces 2104 of the anchor body 102.

[0188] The one or more materials 2202 may extend in a slightly distal orientation (e.g., at a distal angle with respect to the lateral axis 116 (e.g., see FIG. IB)). There may be a plurality of materials 2202, each extending once between the lateral faces 2104. Alternatively or additionally, there may be one or materials that extend between the lateral faces 2204 (e.g. from a first lateral face to a second lateral face), then wraps 2202c (see FIG. 28A) about (at least partially) a lateral face 2104 (e.g., second lateral face), and extends again between the lateral faces of the anchor body (e.g., from the second lateral face to the first lateral face). For example, in some cases, a material 2202 may extend at least at a partial distal angle (as described herein) and between lateral faces 2104, such that the material continues to weave about the anchor body 102 and wraps around the lateral faces 2104 multiple times so as to extend from a proximal end 120 of the anchor body to a distal end 122 of the anchor body. As a non-limiting example, the anchor 2800 may include two materials 2202 (e.g., see 2202a, 2202b in FIG. 28B) that each have an end disposed laterally and / or vertically opposite or substantially opposite, but aligned or substantially aligned longitudinally, about a proximal end 120 or proximal portion of the anchor body, where the two materials 2202 are weaved about the anchor body 102 in a criss-cross manner from the proximal end 120 or proximal portion of the anchor bodyPCT APPLICA TION CINCH-001PCT102 to the distal end 122 or distal portion the anchor body 102. In some cases, the two materials 2202 a,b may not be aligned longitudinally.

[0189] The one or more materials 2202 may include one or more sutures, a type of filament, string, etc., or any combination thereof. Additionally or alternatively, the one or more materials may include PLLA, PGA, UHMWPE, PEEK, Polyester, PLGA, or any combination thereof.

[0190] FIGS. 28E-28F depict a front perspective view, and a side view of a suture anchor 38, which includes the anchor 2800 from FIGS. 28A-28D, and the suture 202. Moreover, the anchor 2800 is depicted as having been transitioned to the folded configuration. As depicted, the folded configuration may include one or more folds 1920, wherein applying tension to the one or both of first and second portions 202a, 202b of the suture 202 may cause the openings 1902, 1904, 1906, 1908, 1910 to somewhat be aligned longitudinally. As described herein, such openings may not be pre-existing in the body, but may be where the suture (e.g., 202) extends from and / or through the anchor body 102. The suture anchor 38 in the folded configuration may also include a flap 1922, which may at least partially correspond to top routing section 1918 (see FIGS. 19A-19F for example). The anchor 2800 is also depicted in FIG. 26A, which provides an example of a suture that is passed through the anchor 2800, where the anchor has no slots.

[0191] Moreover, the one or more materials 2202 are depicted to be disposed about the anchor body 102 of anchor 2800 when transitioned to the folded configuration. The one or more materials may provide additional bulk to the suture anchor 38 in the folded configuration, thereby further increasing an interaction between the anchor body 102 and the first tissue (e.g., inner surface 710 of bone hole 708) and / or a support surface (e.g., cortical shell 706 and / or inserter shaft 1506), as described herein. This may help further secure the anchor 2800 with the first tissue (e.g., increase a pull-out strength required to remove the anchor from, for example, a bone hole 708). The one or more materials may also provide a gripping feature for increasing an interaction between the anchor body 102 and the first tissue.

[0192] As described herein, the one or more materials 2202 may be included with any anchor described herein (e.g., 100, 200, 400, 1900, 2000, 2100, 2200, 2700, 2800).

[0193] As described herein, the suture anchors 10, 12, each depict two slots, while suture anchor 14 depicts one slot, and each suture anchor 10, 12, 14 depict one suture passing through the respective slot(s). As described herein, however, any suture anchor may include any number of slots and / or sutures. For example, each suture anchor, may have i) an anchor having 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more slots, and / or ii) 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more repair sutures. In some embodiments, one or more of the slots is configured to receive a plurality ofPCT APPLICA TION CINCH-001PCTsutures therethrough. For example, one or more of the slots are configured to receive 2, 3, 4, 5, 6, 7, 8, 9, 10, or more sutures therethrough (e.g., repair sutures, passing sutures, deployment sutures, etc.). In some embodiments, some of the one or more slots configured to receive a plurality of sutures therethrough may include any number of openings, wherein each opening may be configured to receive one or more sutures therethrough. For example, where a plurality of sutures is inserted through a slot, said slot may designate a specific routing for each suture therethrough, by having each suture pass through specific openings that may be different from each other. Accordingly, each slot for any respective suture anchor may have any number of routing sections for any number of sutures that pass therethrough, and each routing section may have any length (as described herein).

[0194] In some embodiments, any suture anchor described herein may have a plurality of sutures secured to the anchor in any number of different ways. For example, a suture anchor may have a first suture secured to its anchor via a middle portion extending between two slots (e.g., see 202c FIGS. 2A, 3A), while a second suture having a portion secured to a distal end of the anchor body and / or slot (e.g., see 502a in FIGS. 5A, 5B).

[0195] Any suture anchor described herein (e.g., 10, 12, 14) may be configured to secure a positioning of a second tissue relative to a first tissue. In some embodiments, the first tissue and / or second tissue include a bone, a soft tissue, etc. The bone for a first and / or a second tissue may include any bone for a subject, where non-limiting examples include the humerus, glenoid, tibia, femur, talus, metacarpal, metatarsal, elbow. The soft tissue for a first and / or second tissue may include tendons, ligaments, fat, capsule, etc.

[0196] With respect to a bone as a first tissue, any suture anchor described herein may be configured to be secured to the bone. In some embodiments, the suture anchor is secured within a bone hole of the bone. The suture anchor may be first inserted within the bone hole in an unfolded configuration (as described herein), and then transitioned into the folded configuration, thereby enabling the suture anchor to be secured within the bone hole.Tied Configuration for Suture Anchor

[0197] FIGS. 7A-7C depict an example of a suture anchor 10 described herein securing a positioning of a second tissue 702 relative to a first tissue 704. The first tissue 704 is a bone, as described herein, whereas the second tissue 702 is a soft tissue, as described herein. The bone 704 includes a cortical shell 705, and a cancellous portion 706 of the bone. The bone 704 is depicted as having a bone hole 708 created therein (e.g., see FIG. 16B herein for an example of a bone hole being created). The bone hole 708 may extend through the cortical shell 705 andPCT APPLICA TION CINCH-001PCTat least a portion of the cancellous portion 706. The bone hole 708 may include an inner surface 710, for example within the cancellous portion. The bone hole 708 may include a bone hole opening 712 located at a proximal end of the bone hole. In further iterations the bone hole may extend all the way through both cortical shell layers and the cancellous layer in between.

[0198] With continued reference to FIGS. 7A-7C, the suture anchor depicted is suture anchor 10 (e.g., FIGS. 2A-2C), but it should be noted that any suture anchor described herein (including for example 12, 14 and other variations described herein but not depicted in a figure) can be used.

[0199] With reference to FIG. 7A, the suture anchor 10 is depicted as being inserted within the bone hole 708 in an unfolded configuration (e.g., anchor body 102 of anchor 200 is in an unfolded configuration). The anchor body may or may not at least partially interact with the inner surface 710 of the bone hole in the unfolded configuration. For example, a maximum dimension of the bone hole (e.g., bone hole diameter) may be configured to receive the anchor 200 in the unfolded configuration with little or no interaction between the anchor body 102 and the inner surface 710 of the bone. The first and second portions 202a, b of the suture 202 is depicted as extending proximally from the anchor 20 and the bone hole 708. Each of the first 202a and second portion 202b of the suture 202 is depicted as being located about different surfaces (e.g., different sides) of the soft tissue 702.

[0200] With reference to FIG. 7B, the suture anchor 10 is depicted as transitioning from the unfolded configuration towards the folded configuration, which may be due to tension being applied to the first 202a and / or second 202b portions of the suture 202. The tension to the first 202a and / or second 202b portions of the suture may be applied in a proximal direction, or at least partially in a proximal direction. For example, the first 202a and / or second 202b portions of the suture may be pulled. Accordingly, the middle portion 202c may provide a clamping effect about the anchor body 102, causing a distal end of the anchor body 102 to fold about a length of the anchor body, and at least partially in a vertical direction, such that the anchor body 102 increases its interaction with the inner surface 710 of the bone hole 708. For example, a vertical span (as described herein) of the anchor body 102 in the folded configuration may be larger than the maximum dimension of the bone hole. The maximum dimension of the bone hole diameter may be from about 0.25mm to about 10mm.

[0201] As more tension is applied, the anchor body 102 continues fold along its length, thereby continuing to increase its interaction with the inner surface 710 of the bone hole 708. Accordingly, increasing interaction results in an increasing pull-out strength required for the anchor 200 to be pulled out from within the bone hole 708.PCT APPLICA TION CINCH-001PCT

[0202] With reference to FIG. 7C, tension is continued to be applied to the first 202a and / or second 202b portions of the suture, wherein the anchor 200 is transitioned into the folded configuration. The anchor 200, in the folded configuration, includes several folds (as described herein), wherein such folds and / or pleats generated (as described herein) interact with the inner surface 710 of the bone hole 708 in such a manner that the increased pull-out strength of the anchor 200 within the bone hole 708, secures the anchor 200 within the bone hole 708. As described herein, the pull-out strength may be due to the friction between the interaction of the anchor 200 in the folded configuration and the inner surface 710 of the bone hole 708.

[0203] In some embodiments, the pull-out strength (as described herein) of the anchor 200 when transitioned to the folded configuration and located within the bone hole 708 is from about 35N to about 500N, which may be with or without a support surface as described herein. In some embodiments, a length of the anchor body, the number of sutures (e.g., repair sutures, deployment sutures, etc.) passed through the one or more slots of the anchor, the one or more routing sections for each slot (as described herein, e.g., see FIGS. 4A-4C) of the anchor, and / or a bone hole maximum dimension may influence a pull-out strength of an anchor (of a suture anchor) in a folded configuration that is disposed within a bone hole 708.

[0204] In some cases, anchor 200 in the folded configuration may extend beyond the bone hole / tunnel (e.g., beyond a width of the bone hole 708, as depicted in FIG. 7C). For example, once deployed, the anchor 200 may become wider in width horizontally and may thereby displace the cancellous bone to create a wider bulkier mass subcortical. This added width (of the anchor), when pulled up against the cortical shell, may help prevent the anchor 200 from pulling out of the bone hole 708. Alternatively or additionally, the anchor may interact against a bone hole wall (without or minimal displacement of the cancellous bone), and that interaction with the bone hole wall helps prevent the anchor 200 from pulling up.

[0205] This description of the deployed anchor in the bone hole (both displacing the cancellous bone, as depicted in FIG. 7C, and if simply interacting against the existing bone hole wall), is applicable to all anchors described herein (including, for example, as depicted in FIGS. 9, 11, 16L, 16M, 16N, 17F, and / or 18B).

[0206] As depicted in FIG. 7C, the first 202a and second 202b portions of the suture may be secured to each other, such as for example being tied together. The first 202a and second 202b portions of the suture may be tensioned before and / or after being secured to each other, wherein having the first 202a and / or second 202b portions of the suture disposed about the soft tissue 702 (e.g., wrapped around the soft tissue as depicted in FIG. 7C), and by having the suture 202 secured to the bone 704 via the anchor 200 in the folded configuration, secures a positioningPCT APPLICA TION CINCH-001PCTof the soft tissue 702 relative to the bone 704. In some embodiments, the suture 202 further provides a clamping effect between the soft tissue 702 and the bone 704, thereby providing a force to bring the soft tissue 702 and the bone 704 closer together, and / or have the soft tissue 702 and / or bone 704 more firmly coupled together (e.g., more firmly secured together). Accordingly, this is an example of a suture anchor securing the second tissue relative to the first tissue in a tied configuration.Knotless Configuration for Suture Anchor

[0207] FIG. 8 depicts an embodiment of the suture anchor 14 described herein (e.g., see FIGS.5A-5C), having a first portion 502a of a repair suture 502 secured about a distal end 122 of the anchor body 102, and a second portion 502b of the suture extending proximally from the anchor body 102. FIG. 8 further depicts a passing suture 802 that may be used to help said suture anchor 14 to secure a positioning of the second tissue relative to the first tissue (as described herein). The passing suture 802 may include a first portion 802a and a second portion 802b, and the passing suture may further include a passing loop 804 located at an end of the second portion 802b of the passing suture. The repair suture 502 may include a suture passageway within spanning at least a portion of the suture 502. For example, the second portion 502b of the repair suture may include a passageway within along a portion 806, and further include a first opening 808 and a second opening 810 that enables access in and out of the passageway within the repair suture. The passing suture 802 may be configured to pass through said repair suture passageway, as depicted in FIG. 8. For example, as depicted, the first portion 802a of the passing suture may be passed through and out the passageway within the repair suture (e.g., see 806). The repair suture, such as an end segment of the second portion 502b (e.g., an end of the second portion 502b), may be configured to couple with the passing loop 804 of the passing suture, such that displacement of the passing suture (e.g., by the second portion 802b and / or passing loop 804) would displace the end segment of the second portion 502b. Accordingly, pulling on the first portion 802a of the passing suture 802 so as to pull the second portion 802b and the passing loop 804 of the passing suture 802 through the repair suture passageway (e.g., see 806) may pull the second portion 502b of the repair suture (e.g., the end segment of the second portion 502b). Accordingly, the repair suture 502 would be passed through itself, forming a loop in between (e.g., see 902 in FIG. 9) that may be tightened together as more of the repair suture 502 is passed through itself via the repair suture passageway.

[0208] In some cases, at least a portion of the second portion 502b comprises a coreless configuration (e.g., at least a portion of the suture may be hollow, e.g., a hollow braid), whichPCT APPLICA TION CINCH-001PCTmay be configured for a suture or a portion of the first portion 802a, second portion 802b, passing loop 804, and / or second portion 502b to be passed therethrough. As such, the passing suture may enter (e.g., simply be inserted through, and / or there may be a designated opening) at 808, extend through a portion 806 of the suture (which may be defined as a suture passageway), and then exit (via just going through suture (braid for example), and / or via a designated opening) at 810. In some cases, once there is tension on and / or applied to the suture (e.g., 502b), the suture may collapse (and therefore on the suture within the suture), which may create a finger trap (thereby securing the suture within suture configuration).

[0209] FIG. 9 depicts the positioning of the second tissue (e.g., soft tissue 702 from FIGS. 7A-7C) being secured relative to the first tissue (e.g., bone 704 from FIGS. 7A-7C), using the suture anchor 14 from FIG. 8. Similar to as described in FIGS. 7A-7C, the suture anchor 14 is inserted into the bone hole 708 in the unfolded configuration, and the anchor body 102 may or may not interact with the inner surface 710 of the bone hole. As described in FIGS. 5A-5C, applying tension to the repair suture at the second portion (e.g., 502b) in at least partially a proximal direction, transitions the anchor 500 to the folded configuration, thereby securing the anchor 500 within the bone hole 708 (as described in FIGS. 7A-7C). The repair suture, at for example the second portion 502b, may also be passed through and / or around the soft tissue 702, and then passed through itself via the repair suture passageway (e.g., see 806 as described in FIG. 8), so as to secure the positioning of the soft tissue 702 relative to the bone 704. Further applying tension to the repair suture (e.g., at the second portion 502b), may further tighten the loop 902 formed via passing the repair suture 502 through itself (as described in FIG. 8), thereby providing a clamping effect between the soft tissue 702 and the bone 704. Accordingly, this is an example of the suture anchor 14 securing the second tissue relative to the first tissue in a knotless configuration.Suture anchor constructs

[0210] Disclosed herein, in some aspects, are suture constructs for securing a positioning of at least one tissue, each of which may be any second tissue as described herein (e.g., soft tissue 702), relative to at least one other tissue, each of which may be any first tissue as described herein (e.g., bone 704). In some embodiments, any one suture construct may include a plurality of suture anchors, which may include any number and / or combination of any suture anchor described herein. For example, a suture construct may include any number and / or combination of anchors 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800 described herein.PCT APPLICA TION CINCH-001PCT

[0211] FIG. 10 depicts an exemplary suture construct 16 having two suture anchors 200, 500, and a suture 502 (for example) extending between the two suture anchors. In some embodiments, a first anchor 500, which is similar to the anchor as described herein in FIGS.5A-5C, has a suture 502 secured at a first portion 502a at a distal end 122 of the anchor body 102 (as described herein in FIGS. 5A-5C). The first portion 502b of the suture is depicted as extending from the first anchor 500 to a second anchor 200, where it passes through a first slot (e.g., 104 as described herein) of the second anchor 200, which is similar to the anchor as described herein in FIGS. 2A-2C, and wherein the second portion 502b then exits the first slot and enters the second slot of the anchor 200 at a distal end of the anchor 200, wherein a portion 1002 of the second portion 502b is shown extending between the first and second slots of the anchor 200 at the distal end. The second portion 502b is further depicted as extending proximally through and out the second slot of the second anchor 200 and back towards the first anchor 500, wherein the second portion 502b is passed through a passageway within the repair suture itself (e.g., see passageway section 806 in FIG. 8), and thereafter having a free end 1004 allowed to have tension applied to.

[0212] FIG. 11 depicts the suture anchor construct 16 as having both anchors 200, 500 inserted into a first tissue (e.g., bone 704), and both anchors 200, 500 being transitioned into the folded configuration to be secured to the first tissue. The repair suture 502 may be configured to pass around and / or through one or more different second tissues (e.g., 702 soft tissue, not shown), to secure a positioning of said one or more second tissues relative to the first tissue. In some embodiments, the anchors (e.g., 200, 500) of a suture construct are each inserted and secured to different tissues (e.g., different bones).

[0213] FIG. 12 depicts another embodiment 18 of a suture anchor construct described herein, having a first anchor 500, a second anchor 200, a third anchor 1200, a first repair suture 502 (with first 502a and second 502b portions), and a second repair suture 1202 (with first 1202a and second 1202b portions). The suture anchor construct 18 is similar to suture anchor construct 16 except that it has a third anchor (e.g., 1200) and a second repair suture 1202 that extends between the third anchor 1202 and second anchor 200. The configuration of the first anchor 500, first suture 502, and second anchor 200 are similar to the suture anchor construct 16 as described in FIGS. 10-11, while the configuration of the third anchor 1200, second suture 1202, and second anchor 200 are also similar to the suture anchor construct 16 as described in FIGS. 10-11. The second anchor 200 may include two slots, wherein each slot is configured to receive both the first and second sutures 502 and 1202 passing therethrough individually and / or simultaneously. A portion 1002 for the second portion 502b of the first suture, and a portionPCT APPLICA TION CINCH-001PCT1206 for the second portion 1202b extend between the first and second slots of the anchor 200 at a distal end of the anchor body. Each second portion 502b, 1202b may include a respective free end 1004, 1204 that can be used to further pull each respective repair suture 502, 1202 through itself (e.g., via the respective suture passageway), and further apply tension to a respective second tissue relative to a respective first tissue.

[0214] The suture anchor construct 18 may have all three anchors 200, 500, 1200 being secured to the same first tissue (e.g., a bone), and have both sutures 502, 1202 used to secure a positioning of the same second tissue (e.g., soft tissue) to the first tissue. In some embodiments, the first anchor 500 and first suture 502 may be used to secure a primary second tissue, while the third anchor 1200 and second suture 1202 may be used to secure a secondary second tissue that is different from the primary second tissue. In some embodiments, the first anchor 500 and third anchor 1202 are secured to different first tissues (e.g., different bones).

[0215] FIGS. 18A-18B depict yet another embodiment of a suture anchor construct 26 described herein. The suture anchor construct 26 is depicted as including one anchor (e.g., 500 as described herein), but may include two or more anchors of any type described herein. The suture anchor construct 26 may include the suture anchor 14, which includes the anchor 500 and repair suture 502. The first portion 502a of the repair suture 502 may be configured to be secured at a distal end 122 of the anchor body 102, and a second portion 502b may be configured to extend proximally from the anchor 500, and configured to have tension applied thereto, which may transition the anchor 500 to a folded configuration.

[0216] The suture anchor construct 26 may further be configured to secure two or more additional sutures. As depicted, a plurality of suture tails 1802 from different sutures may be passed through a portion of the first portion 502a of the repair suture 502. For example, the suture tails 1802 may be passed through a knotted portion of the first portion 502a, before the first portion 502a is tightened. Accordingly, applying tension to the second portion 502b may tighten the first portion 502a, including the knotted configuration, thereby securing the suture tails 1802 through the first portion 502a.

[0217] The suture tails 1802 may be passed around the anchor body 102 (e.g., when inserted in a bone hole, for example) and / or through a slot 104 of the anchor 500 to reach the first portion 502a, and may be passed around the anchor body 102 and / or through a slot 104 to extend away from the anchor 500 (e.g., to extend away from the bone hole). As depicted in FIG. 18B, applying tension to the second portion 502b tightens the first portion 502a to secure the suture tails 1802 therethrough, and further transitions the anchor 500 to the foldedPCT APPLICA TION CINCH-001PCTconfiguration, thereby further securing the suture tails 1802 and the anchor 500 about the first tissue.

[0218] The plurality of suture tails 1802 may have an opposite end that is secured about a different tissue, including a bone and / or soft tissue. The suture tails 1802 may each be secured about a different tissue at different locations. Accordingly, by having the suture tails 1802 be secured using suture anchor construct 26 via the anchor 500, the suture tails 1802 form a lateral row of suture tails 1802, that may be used to secure one or more tissues at multiple locations. An example use case includes rotator cuff repair and Achilles tendon repair.Syndesmotic Suture Anchor Construct

[0219] In some embodiments, a suture anchor construct described herein is configured for syndesmotic repair. FIGS. 13A-13E depict an embodiment of a suture anchor construct 20 configured for syndesmotic repair. The suture anchor construct 20 is depicted as including two anchors, a first anchor 100 and a second anchor 1301, and two sutures, a first repair suture 502 and a second repair suture 1306. Each anchor for any syndesmotic suture anchor construct may include any anchor 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800 and / or suture 202, 502 described herein.

[0220] With reference to FIG. 13A, the first anchor 100 and the second anchor 1301 may be similar to anchor 100 as described in FIGS. 1 A-1C. For example, the second anchor 1301 may include an anchor body 1302 that is similar anchor body 102 (as described herein), and slots 1304a, b may each be similar to slot 104 (as described herein). The first suture 502 and the second suture 1306 may be similar to suture 502 as described in FIGS. 5A-5C and FIG. 8. For example, each of first and second sutures 502, 1306 may include a passageway portion 806, 1308 within, similar to as passageway portion 806 described in FIG. 8. This may alternatively or additionally include at least a portion of the first and second suture 502, 1306 being coreless (e.g., hollow) sutures (e.g., as described for FIG. 8).

[0221] Each of the first repair suture 502 and the second repair suture 1306 may be secured to the first anchor 100. For example, with reference to FIG. 13B, a first portion 502a of the first repair suture 502 is depicted as being secured at a distal end 1318 of the anchor body 102, while a second portion 502b of the repair suture is passed through a first slot 104a of the anchor 100, exiting a proximal end 1320 of the anchor body 102. Similarly, a first portion 1306a of the second repair suture 1306 is depicted as being secured at the proximal end 1320 of the anchor body 102, while a second portion 1306b is passed through a second slot 104b of the anchor 100, exiting the distal end 1318 of the anchor body 102. The first portion 502a, 1306a may bePCT APPLICA TION CINCH-001PCTsecured to the anchor, at each respective slot 104a, b similarly to as described in FIGS. 5A-5C with respect to the first portion 502a and the anchor 500.

[0222] FIG. 13C depicts the routing of the first repair suture 502 for the suture anchor construct 20 depicted in FIG. 13 A, wherein the arrows depict the direction of the routing of the second portion 502b of the first suture 502. The second portion 502b of the first suture 502 is depicted as exiting the proximal end 1320 of the first anchor body 102 of the first anchor 100, and then entering a proximal portion 1322 of the second anchor 1301, passing through a first slot 1304a, exiting a distal end 1324 of the second anchor body 1302. The second portion 502b of the first suture 502 is then passed through a passageway portion 1308 of the second portion 1306b of the second suture 1302 that exited distal end 1318 of the first anchor body 102 (as described herein). The second portion 502b exits the passageway portion 1308 of the second suture 1306, and passes through an aperture 1314 within the first anchor body 102 to extend from a first side 1326 of the first anchor body 102. The first side 1326 of the first anchor body 102 may be opposite a second side of the first anchor body 102 that faces a first side 1328 of the second anchor body 1302 (see FIGS. 13 C-D for example).

[0223] FIG. 13D depicts the routing of the second suture 1306 for the suture anchor construct 20 depicted in FIG. 13 A, wherein the arrows depict the direction of the routing of the second portion 1306b of the second suture 1306. The second portion 1306b of the second suture 1306 is depicted as exiting the distal end 1318 of the anchor body 102 of the first anchor 100, and then entering a distal portion 1324 of the second anchor 1301, passing through a second slot 1304b of the second anchor 1301, exiting a proximal end 1322 of the second anchor body 1302. The second portion 1306b of the second suture 1306 is then passed through a passageway portion 806 of the second portion 502b of the first suture 502 that exited proximal end 1320 of the first anchor body 102 (as described herein). The second portion 1306b exits the passageway portion 806 of the first suture 502, and passes through the aperture 1314 within the first anchor body 104 to extend from the first side 1326 of the first anchor body 102.

[0224] The passageway portions 806, 1308 are similar to that of passageway portion 806 as described herein in FIG. 8 for repair suture 502. Accordingly, each of first and second sutures 502, 1306 may include one or more respective openings (not shown) about the second portions 502b, 1306b for access to enter and exit the respective passageway portions 806, 1308.

[0225] With reference to FIG. 13A, the second portions 502b, 1306b, depicted as extending away from the first side 1326 of the first anchor 100, include a terminal end of the first and second sutures 502, 1306. The terminal ends of the first and second sutures 502, 1306 are depicted as being secured together 1310. The terminal ends may be secured in anyPCT APPLICA TION CINCH-001PCTconfiguration, such as being knotted together, welded together (e.g., ultrasonic welding), secured using an adhesive, secured using any other fastening means, or any combination thereof. The secured end 1310, the second portion 502b of the first suture 502 extending from the first side 1326, and the second portion 1306b of the second suture 1306 extending from the first side 1326, together form a loop 1312.

[0226] Applying tension on the second portion 502b, the second portion 1306b, the secured portion 1310, and / or the loop 1312 may transition the first anchor 100, the second anchor 1301, or both to a folded configuration. Further, applying tension on the second portion 502b, the second portion 1306b, the secured portion 1310, and / or the loop 1312 may provide a clamping effect between the first and second anchors 100, 1301, thereby reducing a distance between the two anchors 100, 1301 (see e.g., FIGS. 14A-14B). The suture anchor construct 20 is configured to maintain a reduced distance between anchors 100, 1301 due at least in part of the passing of the first repair suture 502 through a portion of the second repair suture 1301, and vice versa. The suture anchor construct 20 may be prevented from loosening, or increasing a distance between the first and second anchors 100, 1301, and thereby may be in a locked configuration.

[0227] As described herein, the suture anchor construct 20 may be used to secure a positioning of a second tissue relative to a first tissue. The suture anchor construct 20 may be used for syndesmotic repair, wherein the first and second tissue are each a bone. For example, with reference to FIG. 14C, the first tissue may be a first bone 1330, such as the fibula, whereas the second tissue may be a second bone 1332, such as the tibia. Other examples for the first and second bones include the metacarpals, metatarsals, and / or about the acromioclavicular joint (e.g., between clavicle and / or scapula). A hole 1334, 1336 is created through the first 1330 and second 1332 bones, wherein the second anchor 1301 is depicted as being passed through first and second holes 1334, 1336. The second anchor 1301 may optionally be pulled through the holes 1334, 1336 via a passing suture 1316 (optional). Accordingly, the first anchor 100 is depicted as being located about a first side 1338 of the first bone 1330 that is opposite a second side 1340 of the first bone 1330, while the second anchor 1301 is depicted as being located about a second side 1342 of the second bone 1332 that is opposite a first side 1344 of the second bone 1332. The repair suture 502, 1306, e.g., second portions 502b, 1306b, are also passed through the holes 1334, 1336, extending between the anchors 100, 1301.

[0228] As described in FIGS. 14A-14B, applying tension on the second portion 502b, the second portion 1306b, the secured portion 1310, and / or the loop 1312 may transition the first anchor 100, the second anchor 1301, or both to a folded configuration, and / or may provide a clamping effect between the first and second anchors 100, 1301. Accordingly, transitioning thePCT APPLICA TION CINCH-001PCTfirst anchor 100 and / or the second anchor 1301 to a folded configuration may help secure the anchors 100, 1301 about the respective bones 1330, 1332, such that one or both of anchors 100, 1301 may span a maximum distance that is larger than a maximum distance (e.g., diameter) of the holes 1334, 1336, thereby helping reduce or prevent the ability of either anchor 100, 1301 from passing through the holes. Additionally, or alternatively, the clamping effect between anchors 100, 1301 may impart a clamping force between the second side 1340 of the first bone and the first side 1344 of the second bone, thereby either securing the relative positioning between the first and second bones 1330, 1332 and / or reducing a distance between them. In some cases, a passing loop 1402 may be coupled to a portion of the suture anchor construct 20, which may enable at least a portion of the suture construct (e.g., anchor 1301, and / or in some cases, anchor 100) to be pulled through a channel (e.g., through a tissue), prior to providing the clamping effect (such that the tissue may be between anchors 100, 1301).Method of Securing a Positioning of a Second Tissue Relative to a First Tissue

[0229] FIG. 15A depicts a front view of an inserter assembly 22 that may be used to insert an anchor described herein (e.g., 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800) into a first tissue (as described herein), and further may be configured to transition the anchor to a folded configuration (as described herein). FIG. 15B depicts a front cutaway view of the inserter assembly 22 from FIG. 15 A.

[0230] The inserter assembly 22 may be a single integrated tool. In some embodiments, the inserter assembly 22 includes two or more separable components. For example, the inserter 22 may include a handle 1502 and guide shaft 1504 extending from the handle 1502 (e.g., extending distally from the handle). The guide shaft 1504 may be a hollow shaft. The guide shaft 1504, at a proximal portion, may be disposed at least partially within a portion of the handle 1502. In some embodiments, the handle 1502 and the guide shaft 1504 form a guide tool 24 (see e.g., FIG. 16 A).

[0231] The inserter assembly 22 may further include an insertion tool that may be coupled to the guide tool 24. With reference to FIGS. 15A-15B, the insertion tool may include a knob 1512, a screw seat 1528 that may be coupled to and extending distally from the knob 1512, and a screw 1510 that is configured to be at least partially disposed within the screw seat 1528. The screw 1510 may also be configured to be at least partially inserted within a channel within the knob 1512. The screw 1510 may be configured to be threadably engaged with the channel within the knob 1512, such that rotation of either the knob 1512 or screw 1510 relative to thePCT APPLICA TION CINCH-001PCTother allows for longitudinal movement of the screw 1510 relative to the knob 1512, e.g., longitudinal movement proximally or distally.

[0232] The insertion tool of the insertor assembly 22 may further include an inserter shaft 1506 configured to be coupled to the knob 1512 and / or screw seat 1528, and extend distally from the screw seat 1528. The insertion tool may further include a tensioning shaft 1508 that may be configured to be coupled to the screw 1510, and may extend distally from the screw and / or screw seat 1528. The tensioning shaft 1508 may be configured to be inserted within a channel of the inserter shaft 1506 and and / or extend along a length of the inserter shaft 1506.

[0233] In some embodiments, the insertion tool is configured to be coupled with the guide tool 24. For example, the knob 1512, the screw seat 1528, the screw 1510, the inserter shaft 1506, and the tensioning shaft 1508, which may form the insertion tool (as described herein), may be coupled to the guide tool 24 that includes the handle 1502 and the guide shaft 1504 (e.g., see FIGS. 15A-15B). The insertion tool may be at least partially inserted within the handle 1502, such that the screw seat 1528, the screw 1510, the inserter shaft 1506, and / or the tensioning shaft 1508 may be at least partially inserted within the handle 1502, such as a receptacle 1529 within the handle 1502.

[0234] The inserter shaft 1506 may be configured to be at least partially disposed within a channel of the guide shaft 1504 and / or extend along a length of the guide shaft 1504. The screw 1510 may be coupled with the tensioning shaft 1508, such that movement of the screw 1510 (e.g., longitudinal movement) also moves the tensioning shaft 1508.

[0235] The inserter shaft 1506 may be configured to insert an anchor, as described herein. The anchor may be disposed at a distal portion of the inserter shaft 1506. The inserter assembly 22 may include a safety pin 1518, configured to prevent longitudinal displacement of the inserter shaft 1506 and / or tensioning shaft 1508. For example, the safety pin 1518 may prevent the inserter shaft 1506, and any anchor disposed at a distal portion of the inserter shaft, from prematurely extending from a distal portion of the guide shaft 1504.

[0236] FIGS. 16A-16M depict an example method of securing a positioning of a second tissue (as described herein) relative to a first tissue (as described herein). The first tissue, for example, may be the bone 704 as described herein, and the tissue may be a soft tissue 702 as described herein.

[0237] FIG. 16A depicts the guide tool 24, wherein a distal end of the guide shaft 1504 is depicted to interact with a surface of a first tissue (e.g., bone 704 as described herein). FIG.16B depicts a drill 1602 that is inserted through the guide shaft 1504, and used to drill a bone hole (e.g., 708 as described herein).PCT APPLICA TION CINCH-001PCT

[0238] As depicted in FIG. 16C, the drill 1602 is removed and the insertion tool (as described herein) is coupled with the guide tool 24 to form the inserter assembly 22. The inserter shaft 1506 is depicted with an anchor coupled at a distal portion thereof, which may be any anchor described herein (e.g., anchor 500 is depicted as reference for FIGS. 16C-16M). The insertion tool is inserted such that the inserter shaft (e.g., with or without the anchor 500) is passed through the guide shaft 1504 and reaches a top of the bone 704. As depicted, a spacing 1520 between the knob 1512 and handle 1502 may exist. Moreover, the second portion 502b of the suture 502 (e.g., see FIGS. 5A-5C described herein) may extend to a proximal portion of the screw 1510 (see FIG. 16K for example).

[0239] As depicted in FIG. 16D, the insertion tool may be moved distally towards the handle 1502 so as to insert the anchor 500 at least partially within the bone hole (e.g., 708). In some embodiments, the insertion tool is pushed down, and / or struck with a hammer or mallet, such that a distal portion of the knob 1512 may be at least partially inserted within a portion of the handle 1502. For example, FIG. 16E depicts distal protrusions 1524 of the knob 1512 that, when struck with a mallet for example, pass over clips 1522 disposed about a proximal portion of the handle 1502. In some embodiments, by passing over the clips 1522, the distal protrusions 1524, and thereby the knob 1512, are able to rotate freely while being coupled to the handle. FIG. 16F depicts a distal portion of the tensioning shaft 1508, which may include a fork 1526 at a distal end. The fork 1526 may be configured to be coupled with the anchor 500, and place the anchor further within the bone hole (e.g., 708 as described herein), which may be further than as far as the inserter shaft 1506 may extend into the bone hole. The inserter shaft 1506 and / or tensioning shaft 1508 may be placed further within the bone hole via rotation of the knob 1512.

[0240] FIGS. 16G-16I depicts rotation of the knob 1512, which moves the screw 1510 proximally through the knob 1512, and thereby moves the tensioning shaft 1508 proximally, while the inserter shaft 1506 remains about or at least partially within the bone hole. In some embodiments, the inserter shaft 1506 is disposed about 2mm to about 8mm within the bone hole. As the screw 1510 is moved proximally, tension is being applied to the second portion 502b of the suture in a proximal direction, thereby beginning to transition the anchor 500 to a folded configuration.

[0241] FIGS. 16J-16L depict the anchor 500 transitioned to a folded configuration, wherein the screw 1510 is moved further proximally, and extends proximally beyond the knob 1512. The second portion 502b of the suture is depicted as being secured to a proximal portion of the screw 1510, such as for example, optionally about a groove 1528 disposed on the screw 1510.PCT APPLICA TION CINCH-001PCTIn some embodiments, the anchor 500 is transitioned to the folded configuration by being pulled and / or tensioned against the inserter shaft 1506 when disposed within or about the bone hole. As described herein, the inserter shaft 1506 may act as a support surface for the anchor to be at least partially folded (e.g., deployed) against.

[0242] FIG. 16M depicts the second tissue (e.g., 702 described herein) secured against the bone 704, via the anchor 500, similar to the knotless configuration as described in FIG. 9, wherein the inserter assembly 22 has been removed, and the second portion 502b of the suture is removed from the screw 1510.

[0243] FIG. 16N depicts a secured second tissue 702 with the bone 704 via a tied configuration, e.g., using anchor 200 as depicted in FIGS. 7A-7C described herein, which may be secured similar to as the method in FIGS. 16A-16M, except that the first and second suture portions 202a, b extend from the anchor and are secured to the screw 1510 (instead second portion 502b as described in FIGS. 16C-16L).

[0244] FIGS. 17A-17F depict an example method for securing at least one second tissue (e.g., soft tissue 702 as described herein) with at least one first tissue (e.g., bone 704 as described herein) using a suture anchor construct described herein. FIGS. 17A-17F depict using suture anchor construct 16 as an example.

[0245] As depicted, two separate inserter assemblies 22 may be used to insert each anchor (e.g., 500, 200) of the suture anchor construct 16. In some embodiments, one or both of the inserter assemblies 22 is provided as having the guide tool 24 coupled with the insertion tool. Accordingly, with respect to FIGS. 17B-17C, a separate guide may be used to drill each bone hole 708 for the bone (e.g., 704) for each anchor 200, 500. In some embodiments, both inserter assemblies 22 may have the sutures routed through each anchor 200, 500, such as described in FIGS. 7A-7C, prior to inserting the anchors 200,500 into the respective bone holes.

[0246] As depicted in FIGS. 17D-17F, each anchor 200, 500 may then be inserted to each respective bone hole, similar to as described herein in FIGS. 16A-16M. Each anchor may then be transitioned to the folded configuration similar to as described in FIGS. 16C-16N. In some embodiments, instead of having the second portion 502b or the first and / or second portions 202a, b being tensioned via being secured to the screw 1510, one or more separate deployment sutures 1702, 1704 may be used to transition one or both of anchors 200, 500. For example, one or both of deployment suture 1702, 1704 may be secured to a proximal portion of the screw 1510 for a respective inserter assembly 22, that when tensioned (e.g., in the proximal direction) as the screw 1510 is moved proximally, transitions the respective anchor(s) 200, 500 to the folded configuration. In some embodiments, one or both of the deployment sutures are passedPCT APPLICA TION CINCH-001PCTthrough at least a portion of the slot(s) of the respective anchor(s) 200, 500. The deployment sutures 1702, 1704 may further be trimmed and / or may be used to further secure a positioning of the second tissue (similar to the repair suture, for example).

[0247] With respect to FIG. 17F, the second portion 502b of the repair suture may also be tensioned to further secure the second tissue relative the first tissue (e.g., bone).

[0248] FIGS. 23A-24C depict yet another example of a suture anchor construct and components thereof, where the full suture construct 2408 is depicted in FIG. 24C. The suture construct 2408 may include any suture anchor described herein (e.g., 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800) with an additional suture (e.g., 2302) coupled thereto. In some embodiments, the additional suture 2302 is configured in a knot, with each of the two free ends (e.g., 2305, 2306) configured to be inserted through a respective suture anchor.

[0249] FIGS. 23A-23E depict an example method for preparing the additional suture 2302 into a knot. A post, rod, or any elongated structure 2303, including any cylindrical body, may be provided to form the knot. For reference, this elongated structure 2303 will be referred to as a rod herein. For simplicity of depiction, FIGS. 23 A-23E depict a finger as being the rod 2303, so as to show how the additional suture is wrapped around the rod. The additional suture 2302 may be configured in a U-shape arrangement, to form a loop 2304 (e.g., see FIG. 23 A) with the two free ends 2305, 2306 of the additional suture 2302 straightened and aligned. The two free ends 2305, 2306 may then be wrapped around the rod 2303 to the left of the loop 2304 (FIG. 23B), and then the two free ends may be wrapped around the rod 2303 to the right of the loop 2304 (FIG. 23C), such that the two free ends 2305, 2306 form somewhat of an X-shape 2308 about the rod 2303. The two free ends are then passed through the loop 2304 (FIG. 23D), and pulled and / or tightened, thereby collapsing the loop and forming a knot 2312 about the rod 2303 (FIG. 23E).

[0250] FIGS. 24A-24C depict the forming of the suture construct 2408 using a knot 2312 (formed via the additional suture 2302, as described in FIGS. 23A-23E). As described herein, any suture anchor described herein may be used for suture construct 2408. For reference, FIGS.24A-24C use suture anchor 2200 as an example for the suture construct 2408. The rod 2303 may be passed through a first portion and / or a second portion of the suture anchor 2200, wherein the knot 2312 may be disposed along the rod 2303 between said coupling with the first and second portions of the suture anchor 2200. In some cases, the rod 2303 is passed through the suture anchor 2200 first, and then the knot 2312 is formed about the rod using the additional suture 2302 (as described in FIGS. 23A-23E).PCT APPLICA TION CINCH-001PCT

[0251] In some embodiments, the suture anchor 2200 may have a suture 202 coupled thereto. For example, the suture 202 may be at least partially passed through the slots 104 of the suture anchor. In some cases, two ends of the suture 202 may extend from one or more openings 106 disposed about a proximal end 120 of the suture anchor 2200. In some cases, the two ends of the suture 202 may be coupled to the suture anchor 200 and extend therefrom in a similar manner as shown in FIG. 22E (e.g., see ends 202a, 202b).

[0252] As depicted in FIG. 24B, one of the free ends 2306 of the additional suture 2302 may be passed through a portion (e.g., a distal portion) of the suture anchor 2200, while the other free end 2305 may be passed through another portion (e.g., a proximal portion) of the suture anchor 2200 (see FIG. 24C), thereby directly coupling the additional suture 2302 to the suture anchor 2200, and forming suture construct 2408. Accordingly, the suture construct 2408 may have one or both free ends 2305, 2306 extending therefrom, as well as one or both ends 202a, b of suture 202 also extending therefrom.

[0253] As depicted in FIGS. 24A-24C, in some cases the rod 2303 may be coupled with a pull tab 2402, which may allow for the rod 2303 to be pulled. In some cases, the rod 2303 may include one or more passing loops 2404 extending from an end of the rod (e.g., an end of the rod opposite to the end coupled to the pull tab 2402). As described herein, the passing loops may be used to shuttle sutures through an anchor (e.g., 2200 - see FIGS. 25B-25C). Having multiple passing loops may allow to split the number of sutures (to be shuttled or pulled through an anchor) across the multiple passing loops (e.g., each passing loop 2404 receives one or more of the sutures) when loading them (e.g. shuttling or pulling) into the anchor (e.g., 2200). Accordingly, in the case where there are two passing loops 2404, loading each passing loop 2404 with one suture (to be shuttled) may allow for two smaller suture bulk that is pulled (e.g., shuttled) through the anchor instead of one large bulk. This may help reduce the force to load the sutures into the anchor. In some cases, the passing loops 2404 have free ends 2406, which may be inserted into and / or through the rod 2303. The rod 2303 may be crimped (at one or both ends, and / or a portion thereabout) so as to help hold the passing loops 2404. In some cases, portions of the free ends 2406 that extend beyond the rod may be trimmed. In other cases, the free ends 2406 simply extend from the opposite end in the rod 2303.

[0254] FIGS. 25A-25G depict an example method for securing at least one second tissue (e.g., soft tissue 702 as described herein) with at least one first tissue (e.g., bone 704 as described herein) using suture anchor construct 2408. In some cases, a suture inserter assembly 2502, which may be similar to suture inserter assembly 22, is provided for securing the suture construct 2408 to one or both of the first tissue and the second tissue. In some cases, the suturePCT APPLICA TION CINCH-001PCTends 202a and / or 202b of suture 202, and / or the two free ends 2305, 2306 of the additional suture 2302, are passed through the guide shaft 2506 of the inserter assembly 2502, and into a cleat of the inserter assembly. Accordingly, the suture ends 202 a,b, 2305, and / or 2306 may extend from a proximal end of the inserter assembly 2502.

[0255] As depicted in FIGS. 25B-25C, in some cases, free sutures 2510, 2512 (e.g., from another anchor site, see for example FIGS. 11, 17E-17F, etc.) may be passed through the passing loops 2404 (FIG. 25B). The pull tab may then be used to pull the rod 2303 and / or the passing loops 2404, so as to pull the free sutures 2510, 2512 through the center of the knot 2312 and / or through the suture anchor 2200.

[0256] As depicted in FIG. 25D, a knob 2504 of the inserter assembly 2502 may be rotated so as to pull on the deployment suture 202 (e.g., ends 202a, b), thereby deploying the suture anchor 2200 (see FIG. 25E-25F).

[0257] The free sutures 2510, 2512 may be pulled or tightened so as to tension said free sutures. The suture ends 202a, b may then be uncleated from the inserter assembly, whereby continuing to rotate on the knob 2504 may further lock the knot 2312 (which may thereby lock a tension of the free sutures 2510, 2512). In some cases, the free sutures 2510, 2512 may use a protrusion 2508 on the inserter assembly 2502 to be cleated about, such as when the knot 2312 is being locked. The free ends 2510, 2512 may then be secured about a tissue (e.g., second tissue), and another anchor site.

[0258] The method described in FIGS. 25A-25G may help to fixate more tissue with one anchor (e.g., 2200, 2700, 2800 etc.), which may help reduce the amount or trauma to a tissue (e.g., bone). For example, the passing loops (e.g., 2404) may be configured to receive multiple free ends of sutures that may each be coupled with a tissue (soft tissue, bone, etc.) and / or other anchor, which may then be passed through the anchor 2200. The anchor 2200 may be deployed (e.g., when coupled to another tissue, such as bone, or soft tissue), thereby securing the anchor, and further securing a relative positioning of multiple other tissues.

[0259] FIGS. 26A-26E depict another example method for coupling two or more tissues (e.g., soft tissue, bone, etc.) to each other. FIGS. 26A-26E may be another example of another suture anchor construct. FIGS. 26A-26E may be another example of a syndesmotic repair. FIG.26A depicts the components for the method, which may include one or more passing sutures 2602 having one or more passing loops 2604. The passing suture(s) 2602 may be coupled to a tool 2606 (e.g., cutting tool, drill bit, drill, etc.), which may be used to tunnel through a tissue (e.g., bone, soft tissue, etc.). The components may further include an anchor, which may be any anchor described herein (e.g., 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800).PCT APPLICA TION CINCH-001PCTFor the purposes of this example, anchor 2800 is referred. The anchor 2800 may have one or more sutures 202 passed therethrough (as described herein). The suture 202 may include suture tails 202 a,b (as described herein). The components may further include a pull tab 2608 coupled with a rod 2610 (e.g., similar to 2402, 2303). The pull tab 2608 and / or rod 2610 maybe coupled with one or more other passing sutures 2611, which may include one or more passing loops 2612. The passing suture(s) 2611 may be extended through the anchor body of the anchor 2800 (as described herein). This may include the passing suture 2611 being weaved about the second anchor 2800 (which may be similar to how suture 202 is extended through for the first anchor 2800) in FIG. 26A.

[0260] With reference to FIG. 26B, two tissues, here depicted as bone 704 (but may be any type of tissue, including soft tissue), are to be coupled together via a suture anchor, as described herein. The tool 2606, which may be coupled with passing suture(s) 2602 and corresponding passing loop(s) 2604, is depicted as being tunneled through both bones 704, thereby creating a channel within each bone, and pulling the passing suture(s) 2602 therethrough.

[0261] FIG. 26C depicts the anchor 2800, and the suture(s) 202 being inserted within the passing loop(s) 2604, and coupled thereto. Accordingly, the suture(s) 202 may then be pulled through the channels within the bone(s) 704. FIG. 26D depicts the passing suture ends 202a, 202b extending from the bone 704 channels, which further caused the first anchor 2800 to transition into the deployed (e.g., folded) configuration, thereby securing itself against a side of a first bone 704. Further FIG. 26D depicts the suture ends 202a and 202b inserted through and coupled to passing loop(s) 2612. As such, pulling on the pull tab 2608, allows for the passing loop(s) 2612 and suture tails 202a and 202b to be pulled through and secured to a second anchor 2800, which transitions said second anchor 2800 into the deployed (e.g., folded) configuration (see FIG. 26E).

[0262] Accordingly, the second anchor 2800, now in the deployed configuration, secured against the second bone 704, thereby securely coupling the two bones 704 to each other. In some cases, pulling on the suture tails 202a, b enables the second anchor 2800 to be pulled towards first anchor 2800, but obstructed due to the inability to pass through the channel in the bones 704 (thereby providing a secure coupling). Specifically, both the first and second anchors 2800, in the deployed configuration, are unable to pass through the channels within the bones 704.

[0263] FIGS. 29A-29I depict another example embodiment and method for securing a positioning of two or more tissues about each other. As described herein, the tissue(s) may be bone, soft tissue, etc. FIGS. 29A-29I may be another example of another suture anchorPCT APPLICA TION CINCH-001PCTconstruct. FIGS. 29A-29I may be another example of a syndesmotic repair. FIG. 29 A depicts example components that may be used with said method, which may include one or more anchors, (e.g., 2800a, b) and / or one or more sutures (e.g., 202). The anchor(s) may be any type of anchor described herein (e.g., 100, 200, 400, 500, 1900, 2000, 2100, 2200, 2700, 2800). The suture(s) may be any suture described herein (e.g., 202, 502, etc.). For the purposes of describing the embodiment in FIGS. 29A-29I, the anchor 2800 will be used. A first anchor 2800a and a second anchor 2800b may be used. In some cases, the first and second anchors 2800 a,b may be identical. In some cases, the anchors 2800 a,b may have some differences, such as type, length, material, etc. As depicted in FIG. 29A, the second anchor 2800b may be longer than the first anchor 2800a.

[0264] FIG. 29B depicts the first anchor 2800a, being folded (e.g., dual fold, tri-fold, similar to the folded configuration of the anchor 2800 in FIGS. 28E-28F, etc.). Once folded, the suture 202 may be passed through the anchor 2800a, and then back down through the anchor 2800a. FIG. 29C depicts a side view of the folded anchor 2800a with the suture passed through the anchor body, and then passed through the anchor body again from the top (though not visible from FIG. 29C since only one side is shown). Accordingly, two suture ends (e.g., tails) 202 a,b are configured to extend from the anchor 2800a at a bottom portion, while the suture exiting and entering the anchor body at the top end secures the suture 202 to the anchor 2800a.

[0265] As depicted in FIGS. 29D-29E, the suture tails 202 a,b are configured to be passed through the second anchor 2800b. For example, FIG. 29D depicts the suture tail 202b being passed through the second anchor 2800b (e.g., from about a first end to about a second end), and then passing it back again through the second anchor 2800b (e.g., from about the second end to about first end). As such the suture tail 202b may be secured to the second anchor 2800b in a similar configuration and / or at least partially similar configuration as the suture 202 is secured to anchor 2800a. In some cases, the suture tail 202b is configured to be passed through the anchor body second anchor 2800b (which may include being weaved or at least partially weaved through the anchor body). The direction of the suture tail 202b is depicted with arrows in FIG. 29D, with the end of the suture tail 202b depicted as extending from the anchor 2800b towards the first anchor 2800a. FIG. 29E depicts the same action being performed for suture tail 202a, wherein it is passed through the second anchor 2800b (e.g., through the anchor body) a first time, then passed back and extending from the second anchor 2800b towards the first anchor 2800a (arrows in FIG. 29E depict direction of movement of suture tail 202a). Suture tail 202a may similarly be weaved or at least partially weaved about anchor 2800b, and secured thereto.PCT APPLICA TION CINCH-001PCT

[0266] FIG. 29F depicts the suture tail 202a that extends from the second anchor 2800b, to be inserted within and through the suture tail 202b that extends from the first anchor 2800a towards the second anchor 2800b. The insertion of suture tail 202a within suture tail 202b may be similar to any insertion of a suture within another suture as described herein. For example, in some cases, at least a portion of the suture 202 comprises a coreless configuration (e.g., at least a portion of the suture may be hollow, e.g., a hollow braid). As such, the suture tail 202a may enter (e.g., simply be inserted through, and / or there may be a designated opening) at a location 2904 located on suture tail 202b, for which the suture tail 202a may extend through suture tail 202b for a segment 2902, and then exit (via just going through suture (braid for example), and / or via a designated opening) suture tail 202b (as depicted to the left of the first anchor 2800a in FIG. 29F). In some cases, once there is tension on the suture (e.g., 202), the suture may collapse (and therefore collapse on the suture tail 202a within the segment 2902 of suture 202b), which may create a finger trap (thereby securing the suture within suture configuration). In some cases, the suture 202 defines a suture passageway (as described herein) along at least a portion (e.g., 2902) of the suture 202. Accordingly, the suture 202 may include an opening (e.g., about 2904) for the suture tail 202a to enter within the suture tail 202b, and may include another opening to exit the suture tail 202b.

[0267] FIG. 29G similarly depicts the suture tail 202b (that extends from second anchor 2800b towards the first anchor 2800a) being inserted within suture tail 202a (that extends from the first anchor 2800a towards the second anchor 2800b) about location 2908. The suture tail 202b may extend through suture tail 202a for a segment 2906 and then exit the suture tail 202a (as depicted to the left of first anchor 2800a in FIG. 29G). As described herein, the suture tail 202a (similar to suture tail 202b) may include a hollow portion for the suture tail 202b to pass within. The suture tail 202a may alternatively or additionally define a suture passageway therewithin, with openings for entry and exit.

[0268] As depicted in FIG. 29H, the implant (which include the first and second anchors 2800 a,b and suture 202) may be used to couple two bones 704a, b. The second anchor 2800b may be pulled through a channel (which may be created) through the first and second bones 704 a,b, such that the first anchor 2800a is disposed about a first side (e.g., proximal side) of the first bone 704a, and the second anchor 2800b is disposed about a second side (e.g., distal side) of the second bone 704b. In some cases, the folded configuration of the first anchor 2800a may be unable to pass through the channel of the first bone 704a and / or second bone 704b, thereby securing the first anchor 2800a about the bone 704a. This is opposed to the secondPCT APPLICA TION CINCH-001PCTanchor 2800b, which in the unfolded configuration (e.g., undeployed), may be able to pass through the channels of the first and / or second bones 704 a,b.

[0269] As depicted in FIG. 291, pulling (which may include applying tension) on the suture tails 202 a,b (those that extend to the left of and away from the first anchor 2800a, depicted in FIG. 291) may help deploy the second anchor 2800b, which secures said second anchor 2800b about the second bone 704b (thereby unable to pass within the channels of the bones 704 a,b). Moreover, pulling on the suture tails may help reduce the distance between the first and second anchors 2800 a,b which may i) help reduce a distance between the bones 704 a,b, and / or ii) provide tension to the first and second anchors 2800 a,b about the portions of the corresponding bones 704 a,b, so as to help secure the anchors and thereby positioning of the two bones. For example, by passing the suture tails 202 a,b within the opposing suture tail portions (202 a,b), this may help create a finger trap, which enables this implant to self-lock once a distance between the anchors 2800 a,b is reduced and / or tension is applied to the suture tails.

[0270] Some of the components listed herein use the same number from figure to figure. It should be appreciated these components use the same numbers solely for ease of reference and to facilitate comprehension for the reader. While these components may use the same numbers, differences may be present in these components as illustrated in the various figures in which they appear and as described in the specification herein.

[0271] None of the steps described herein is essential or indispensable. Any of the steps can be adjusted or modified. Other or additional steps can be used. Any portion of any of the steps, processes, structures, and / or devices disclosed or illustrated in one embodiment, flowchart, or example in this specification can be combined or used with or instead of any other portion of any of the steps, processes, structures, and / or devices disclosed or illustrated in a different embodiment, flowchart, or example. The embodiments and examples provided herein are not intended to be discrete and separate from each other.

[0272] The section headings and subheadings provided herein are nonlimiting. The section headings and subheadings do not represent or limit the full scope of the embodiments described in the sections to which the headings and subheadings pertain. For example, a section titled “Topic 1” may include embodiments that do not pertain to Topic 1 and embodiments described in other sections may apply to and be combined with embodiments described within the “Topic 1” section.

[0273] The various features and processes described above may be used independently of one another, or may be combined in various ways. All possible combinations and subcombinations are intended to fall within the scope of this disclosure. In addition, certainPCT APPLICA TION CINCH-001PCTmethod, event, state, or process blocks may be omitted in some implementations. The methods, steps, and processes described herein are also not limited to any particular sequence, and the blocks, steps, or states relating thereto can be performed in other sequences that are appropriate. For example, described tasks or events may be performed in an order other than the order specifically disclosed. Multiple steps may be combined in a single block or state. The example tasks or events may be performed in serial, in parallel, or in some other manner. Tasks or events may be added to or removed from the disclosed example embodiments. The example systems and components described herein may be configured differently than described. For example, elements may be added to, removed from, or rearranged compared to the disclosed example embodiments.

[0274] Conditional language used herein, such as, among others, "can," "could," "might," "may," “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and / or steps. Thus, such conditional language is not generally intended to imply that features, elements and / or steps are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and / or steps are included or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Conjunctive language such as the phrase “at least one of X, Y, and Z,” unless specifically stated otherwise, is otherwise understood with the context as used in general to convey that an item, term, etc. may be either X, Y, or Z. Thus, such conjunctive language is not generally intended to imply that certain embodiments require at least one of X, at least one of Y, and at least one of Z to each be present.

[0275] The term “and / or” means that “and” applies to some embodiments and “or” applies to some embodiments. Thus, A, B, and / or C can be replaced with A, B, and C written in one sentence and A, B, or C written in another sentence. A, B, and / or C means that some embodiments can include A and B, some embodiments can include A and C, some embodiments can include B and C, some embodiments can only include A, some embodiments can include only B, some embodiments can include only C, and some embodiments can include A, B, and C. The term “and / or” is used to avoid unnecessary redundancy.PCT APPLICA TION CINCH-001PCT

[0276] The term “substantially” refers to less than or equal to + / — 1%, + / -2%, + / -3%, + / -4%, + / -5%, + / -6%, + / -7%, + / -8%, + / -9%, + / -10%, + / -11%, + / — 12%, + / — 14%, or + / -15% variation. As a non-limiting example, substantially parallel represents a range of-1 to 1 degree difference, -5 to 5 degree difference, or -15 degrees to 15 degrees of difference from being parallel, depending on the embodiments.

[0277] The term “maximum dimension” or “dimension” may refer to any form of measurement of a size, such as diameter, width, length, thickness, height, spacing, etc.

[0278] While certain example embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions disclosed herein. Thus, nothing in the foregoing description is intended to imply that any particular feature, characteristic, step, module, or block is necessary or indispensable. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions, and changes in the form of the methods and systems described herein may be made without departing from the spirit of the inventions disclosed herein.

Claims

PCT APPLICA TION CINCH-001PCTCLAIMSWe Claim:

1. A device, comprising:an anchor comprising an anchor body; anda suture at least partially weaved through the anchor body, the suture having a suture tail configured to extend from the anchor body;wherein the anchor is configured to transition from an unfolded configuration to a folded configuration when tension is applied to the suture tail.

2. The device of Claim 1, wherein the anchor body is a suture.

3. The device of Claim 2, wherein the anchor body comprises a suture tape, woven mat, interconnected fibers, multiple twisted fibers, layered fibers, or any combination thereof.

4. The device of Claim 1, wherein the anchor body defines a length that extends along a longitudinal axis, a width that extends along a lateral axis, and a vertical that extends along a vertical axis, the longitudinal axis extending between the proximal end and the distal end of the anchor body.

5. The device of Claim 4, wherein the anchor body is configured to fold along the length when the anchor transitions to the folded configuration.

6. The device of Claim 5, wherein the anchor in the folded configuration creates one or more pleats that extend at least partially vertically.

7. The device of Claim 4, wherein the suture extends substantially along or substantially parallel with the longitudinal axis of the anchor body.

8. The device of Claim 1, wherein the anchor further comprises a material disposed about the anchor body, the material configured to provide bulk to the anchor body.PCT APPLICA TION CINCH-001PCT9. The device of Claim 8, wherein the material is configured to be weaved about the anchor body.

10. The device of Claim 8, wherein the material comprises an additional suture.

11. The device of Claim 8, wherein the material is configured to extend along the anchor body at least in a partially longitudinal direction, at least in a partially lateral direction, or both.

12. The device of Claim 1, wherein the anchor is configured to be secured to a first tissue.

13. The device of Claim 12, wherein the anchor is configured to be secured to the first tissue via transitioning the anchor from the unfolded configuration to the folded configuration.

14. The device of Claim 13, wherein the first tissue comprises a first bone or a first soft tissue.

15. The device of Claim 14, wherein the anchor is configured to secure a positioning of a second tissue relative to the first tissue.

16. The device of Claim 15, wherein the second tissue comprises a second bone or a second soft tissue.

17. The device of Claim 14, wherein the first tissue comprises the first bone.

18. The device of Claim 17, wherein the anchor is configured to be inserted within a bone hole of the first bone when in the unfolded configuration, such that transitioning the anchor to the folded configuration secures the anchor within the bone hole.

19. The device of Claim 18, wherein the anchor body interacts with an inner surface of the bone within the bone hole when the anchor is in a folded configuration, such that a pullout strength of the anchor within the bone hole is increased.PCT APPLICA TION CINCH-001PCT20. The device of Claim 18, wherein the anchor further comprises a material disposed about the anchor body, the material configured to provide bulk to the anchor body, so as to increase an interaction between the anchor body and the inner surface of the bone within the bone hole.

21. The device of Claim 14, wherein the anchor is configured to be passed through an aperture in the first soft tissue when in the unfolded configuration, so as to pass from a first surface to a second surface of the soft tissue, wherein transitioning the anchor to the folded configuration secures the anchor to the second surface of the soft tissue about the aperture.

22. The device of Claim 21, wherein the anchor in the folded configuration is too large to pass through the aperture.

23. The device of Claim 1 or 22, wherein the suture comprises a first portion and a second portion, wherein when the suture is weaved through the anchor body, the first portion is configured to be secured to the anchor, the second portion comprising the suture tail.

24. The device of Claim 23, wherein the second portion of the suture is configured to extend proximally away from first portion of the suture secured to the anchor.

25. The device of Claim 23 wherein the second portion of the suture is configured to secure a positioning of the second tissue relative to the first tissue.

26. The device of Claim 25, wherein the suture comprises a suture passageway therein.

27. The device of Claim 26, wherein the second portion of the repair suture is configured to be i) secured to the second tissue and ii) passed through the suture passageway of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture.

28. The device of Claim 27, wherein the second portion of the repair suture passes through the suture passageway of the repair suture via a first and second opening thereof.PCT APPLICA TION CINCH-001PCT29. The device of Claim 28, further comprising a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture.

30. The device of Claim 23, wherein the first portion of the repair suture is secured to the anchor via i) a knotted configuration, ii) a bunched-up configuration of the repair suture, iii) ultrasonic welding, iv) an adhesive, stitching, or v) any combination thereof.

31. The device of Claim 1, wherein the anchor defines one or more routing sections for the suture, wherein each routing section corresponds to a path of the suture at least partially in a longitudinal direction and proximally towards the proximal end of the anchor body.

32. A device, comprising:an anchor comprising an anchor body and optionally a slot; anda repair suture configured to be extended at least partially through the i) anchor body, ii) the optional slot, or iii) both, wherein the repair suture is configured to be extended at least partially through the optional slot by being inserted through the slot;wherein the anchor is configured to transition from an unfolded configuration to a folded configuration.

33. The device of Claim 32, wherein the repair suture is configured to be extended at least partially through the anchor body by being weaved through the anchor body.

34. The device of Claim 32 or 33, wherein the repair suture comprises a repair suture tail extending from the anchor body.

35. The device of Claim 34, wherein the anchor is configured to transition to the folded configuration when tension is applied to the repair suture tail.

36. The device of any one of Claims 33 to 35, wherein the repair suture being weaved through the anchor body defines a suture path through the anchor body.

37. The device of any one of Claims 32 to 36, further comprising a material disposed about the anchor body, the material configured to provide bulk to the anchor body.PCT APPLICA TION CINCH-001PCT38. The device of Claim 37, wherein the material is configured to be weaved about the anchor body.

39. The device of Claim 37 or 38, wherein the material comprises an additional suture.

40. The device of any one of Claims 37 to 39, wherein the material is configured to extend along the anchor body at least in a partially longitudinal direction, at least in a partially lateral direction, or both.

41. The device of Claim 40, wherein the material extends along a length of the anchor body in a diagonal configuration.

42. The device of any one of Claims 37 to 41, wherein the material is configured to i) extend along a first side of the anchor body between a first lateral face and a second lateral face of the anchor body, ii) at least partially wrap about the second lateral face, and iii) extend along a second side of the anchor body towards the first lateral face.

43. The device of any one of Claims 32 to 42, wherein the slot is disposed within the anchor body, thereby defining a channel therethrough.

44. The device of any one of Claims 32 to 43, wherein the slot protrudes from a surface of the anchor body.

45. The device of any one of Claims 32 to 44, wherein the anchor body and the slot are integrally formed.

46. The device of any one of Claims 32 to 44, wherein the anchor body and the slot are separate components coupled together.

47. The device of Claim 46, wherein the slot is removably coupled to the anchor body.PCT APPLICA TION CINCH-001PCT48. The device of any one of Claims 32 to 47, wherein the anchor body comprises a proximal end and a distal end, wherein the slot extends between the proximal end and the distal end.

49. The device of Claim 48, wherein the slot extends substantially from the proximal end to the distal end.

50. The device of any one of Claims 32 to 49, wherein the slot comprises a first opening and a second opening.

51. The device of Claim 50, wherein the second opening is disposed about i) the distal end of the anchor body, or ii) a location between the proximal end and the distal end of the anchor body.

52. The device of Claim 50 or 51, wherein the first opening is disposed about i) the proximal end of the anchor body, or ii) a location between the proximal end and the distal end of the anchor body.

53. The device of any one of Claims 50-52, wherein the first opening, the second opening, or both, is configured to receive at least a portion of the repair suture therethrough.

54. The device of any one of Claims 32 to 53, wherein the slot defines a channel therethrough having a maximum dimension from about 0.05mm to about 5mm.

55. The device of any one of Claims 32 to 54, wherein the anchor body is a suture.

56. The device of Claim 55, wherein the anchor body comprises a suture tape, woven mat, interconnected fibers, multiple twisted fibers, layered fibers, or any combination thereof.PCT APPLICA TION CINCH-001PCT57. The device of any one of Claims 32 to 56, wherein the anchor body defines a length that extends along a longitudinal axis, a width that extends along a lateral axis, and a vertical that extends along a vertical axis, the longitudinal axis extending between the proximal end and the distal end of the anchor body.

58. The device of Claim 57, wherein the length of the anchor body is from about 1 mm to about 100 mm.

59. The device of Claim 57 or 58, wherein the width of the anchor body is from about 0.1 mm to about 50 mm.

60. The device of Claim 57, 58, or 59, wherein the vertical of the anchor body is from about 0.5 mm to about 10 mm.

61. The device of any one of Claims 32 to 60, wherein the anchor body is configured to fold along the length when the anchor transitions to the folded configuration.

62. The device of Claim 61, wherein the anchor in the folded configuration creates one or more pleats that extend at least partially vertically.

63. The device of any one of Claims 32 to 62, wherein i) the repair suture, ii) the slot, or iii) both, extends substantially along or substantially parallel with the longitudinal axis.

64. The device of any one of Claims 32 to 63, wherein the anchor is configured to be secured to a first tissue.

65. The device of Claim 64, wherein the anchor is configured to be secured to the first tissue via transitioning the anchor from the unfolded configuration to the folded configuration.PCT APPLICA TION CINCH-001PCT66. The device of Claim 64 or 65, wherein the first tissue comprises a first bone or a first soft tissue.

67. The device of Claim 64, 65, or 66, wherein the anchor is configured to secure a positioning of a second tissue relative to the first tissue.

68. The device of Claim 67, wherein the second tissue comprises a second bone or a second soft tissue.

69. The device of any of Claims 64-68, wherein the first tissue comprises the first bone.

70. The device of Claim 69, wherein the anchor is configured to be inserted within a bone hole of the first bone when in the unfolded configuration, such that transitioning the anchor to the folded configuration secures the anchor within the bone hole.

71. The device of Claim 70, wherein the anchor body interacts with an inner surface of the bone within the bone hole when the anchor is in a folded configuration, such that a pullout strength of the anchor within the bone hole is increased.

72. The device of Claim 70 or 71, wherein the material of any one of Claims 37-40 disposed about the anchor body is configured to increase an interaction between the anchor body and the first tissue.

73. The device of Claim 71 or 72, wherein the pullout strength is from about 30N to about 200N.

74. The device of any one of Claims 32 to 73, wherein a proximal portion of the anchor body forms a flap when the anchor is transitioned to the folded configuration, wherein the flap is configured to extend at least partially longitudinally and parallel with another portion of the anchor body within the bone hole.PCT APPLICA TION CINCH-001PCT75. The device any of Claims 64 to 68, wherein the first tissue comprises the first soft tissue.

76. The device of Claim 75, wherein the anchor is configured to be passed through an aperture in the first soft tissue when in the unfolded configuration, so as to pass from a first surface to a second surface of the soft tissue, wherein transitioning the anchor to the folded configuration secures the anchor to the second surface of the soft tissue about the aperture.

77. The device of Claim 76, wherein the anchor in the folded configuration is too large to pass through the aperture.

78. The device of any one of Claims 32 to 77, wherein the repair suture comprises a first portion and a second portion, wherein when the repair suture is extended through the anchor body or is inserted through the slot, the first portion is configured to be secured to the anchor.

79. The device of Claim 78, wherein the second portion of the repair suture is configured to extend proximally away from first portion of the repair suture secured to the anchor.

80. The device of Claim 79, wherein applying tension on the second portion of the repair suture in at least a partial proximal direction is configured to transition the anchor from the unfolded configuration to the folded configuration.

81. The device of Claim 78 or 79, wherein the second portion of the repair suture is configured to secure a positioning of the second tissue relative to the first tissue.

82. The device of any one of Claims 78 to 81, wherein the repair suture comprises a suture passageway therein.

83. The device of Claim 82, wherein the second portion of the repair suture is configured to be i) secured to the second tissue and ii) passed through the suture passageway of the repairPCT APPLICA TION CINCH-001PCTsuture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture.

84. The device of Claim 83, wherein the second portion of the repair suture passes through the suture passageway of the repair suture via a first and second opening thereof.

85. The device of Claim 83 or 84, further comprising a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture.

86. The device of any one of Claims 78 to 85, wherein the first portion of the repair suture is secured to the anchor via i) a knotted configuration, ii) a bunched-up configuration of the repair suture, iii) ultrasonic welding, iv) an adhesive, stitching, or v) any combination thereof.

87. The device of any one of Claims 78 to 86, wherein the anchor body or the slot comprises i) a first opening disposed at a proximal portion of the slot or the anchor body, ii) a second opening disposed a distal portion of the slot or the anchor body, iii) one or more openings disposed on the slot or the anchor body along a first side or a second side of the length of the anchor body, or iv) any combination thereof.

88. The device of Claim 87, wherein the first portion of the repair suture is secured to the second opening, a third opening of the one or more openings, or both.

89. The device of Claim 87 or 88, wherein the anchor defines one or more routing sections for the repair suture, wherein each routing section corresponds to a path of the repair suture at least partially in a longitudinal direction and proximally towards the proximal end of the anchor body.

90. The device of Claim 89, wherein for each routing section, the repair suture path is disposed i) within the slot channel or the anchor body, ii) along a first side of the anchor body, outside of the optional slot channel, or iii) along a second side of the anchor body, outside of the optional slot channel.PCT APPLICA TION CINCH-001PCT91. The device of Claim 89 or 90, wherein the anchor defines four routing sections.

92. The device of Claim 91, wherein each of the four routing sections comprise a repair suture path disposed any one of i) within the slot channel or the anchor body, ii) along a first side of the anchor body, outside of the optional slot channel, and iii) along a second side of the anchor body, outside of the optional slot channel.

93. The device of any one of Claims 32 to 92, wherein the repair suture is a first repair suture, the device further comprising a second repair suture.

94. The device of Claim 93, wherein the second repair suture is similar to the repair suture from any one of Claims 1-51.

95. The device of Claim 94, wherein the first repair suture and the second repair suture are configured to be inserted through the slot simultaneously or sequentially.

96. The device of any one of Claims 32 to 95, wherein the slot is a first slot, the device further comprising a second optional slot.

97. The device of Claim 96, wherein the second slot is physically separate from the first slot.

98. The device of Claim 97, wherein the second slot is similar to the slot from any one of Claims 1-55.

99. The device of any of Claims 96 to 98, wherein the second repair suture is configured to be inserted through the second slot or extended through the anchor body, wherein the second repair suture optionally defines a repair suture path different from the repair suture path of the first repair suture.PCT APPLICA TION CINCH-001PCT100. The device of Claim 99, wherein the second suture is configured to secure a positioning of the second tissue, a third tissue, or both, relative to the first tissue.

101. The device of any one of Claims 32 to 100, further comprising one or more additional slots, and one or more additional repair sutures, each additional repair suture configured to be inserted through a corresponding additional slot or through a corresponding repair suture path via the anchor body.

102. The device of Claim 101, wherein the one or more additional slots comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional slots.

103. The device of Claim 102, wherein the one or more additional repair sutures comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional repair sutures.

104. The device of any one of Claims 89 to 102, wherein the anchor defines one or more routing sections for each slot of the one or more additional slots.

105. The device of any one of Claims 32 to 100, wherein the slot is a first slot, the device further comprising a second slot.

106. The device of Claim 105, wherein the second slot is similar to the slot in any one of Claims 1-58.

107. The device of Claim 105 or 106, wherein the repair suture comprises a first portion, a second portion, and a middle portion, wherein the first portion is configured to pass through at least a portion of the first slot, the second portion is configured to pass through at least a portion of the second slot, and wherein the middle portion is configured to extend from a distal opening of the first slot to a distal opening of the second slot, such that the repair suture is secured to the anchor via the middle portion extending outside and between the first and second slot.PCT APPLICA TION CINCH-001PCT108. The device of Claim 107, wherein the first and second portions of the repair suture are configured to extend proximally away from the anchor.

109. The device of Claim 107 or 108, wherein applying tension on the first portion, the second portion, or both, of the repair suture in at least a partial proximal direction transitions the anchor from the unfolded configuration to the folded configuration.

110. The device of any one of Claims 107 to 109, wherein the first and second portions of the repair suture are configured to secure a positioning of the second tissue relative to the first tissue.

111. The device of Claim 110, wherein the first and second portions are configured to be secured to each other.

112. The device of Claim 111, wherein the first and second portions are configured to be secured to each other via a knotted configuration.

113. The device of Claim 111, wherein the repair suture comprises a suture passageway about the second portion of the repair suture.

114. The device of Claim 113, wherein the first portion of the repair suture is configured to be i) secured to the second tissue and ii) passed through the suture passageway of the second portion of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture.

115. The device of Claim 114, wherein the first portion of the repair suture passes through the suture passageway of the second portion of the repair suture via a first and second opening thereof.PCT APPLICA TION CINCH-001PCT116. The device of Claim 114 or 115, further comprising a passing suture configured to shuttle the first portion of the repair suture through the suture passageway of the second portion of the repair suture.

117. The device of any one of Claims 105-116, wherein the first slot, the second slot, the anchor body, or any combination thereof, comprises i) a first opening disposed at a proximal portion of the respective slot or anchor body location, ii) a second opening disposed a distal portion of the respective slot or anchor body location, iii) one or more openings disposed on the respective slot or the anchor body along a first side or a second side of the length of the anchor body, or iv) any combination thereof.

118. The device of Claim 117, wherein the anchor defines one or more routing sections for the repair suture with respect to the first slot, the second slot, the anchor body, or any combination thereof, wherein each routing section corresponds to a path of the repair suture at least partially in a longitudinal direction and proximally towards the proximal end of the anchor body.

119. The device of Claim 118, wherein for each routing section for the respective slot, the repair suture path is disposed within the slot channel, along a first side of the anchor body outside of the slot channel, or along a second side of the anchor body outside of the slot channel.

120. The device of Claim 118 or 119, wherein the anchor defines four routing sections for the first slot, the second slot, or both.

121. The device of Claim 120, wherein the four routing sections for the respective slot comprise a repair suture path disposed within the slot channel, disposed along a first side of the anchor body outside of the slot channel, and disposed along a second side of the anchor body outside of the slot channel.

122. The device of any one of Claims 32 to 121, wherein the repair suture is a first repair suture, the device further comprising a second repair suture.PCT APPLICA TION CINCH-001PCT123. The device of Claim 122, wherein the second repair suture is similar to the repair suture from any one of Claims 32 to 97.

124. The device of Claim 123, wherein the first repair suture and the second repair suture are configured to be inserted through the first slot, second slot, or both, simultaneously or sequentially.

125. The device of any one of Claims 32 to 97, wherein the second slot is physically separate from the first slot.

126. The device of Claim 125, further comprising one or more additional slots, and one or more additional repair sutures, each additional repair suture configured to be inserted through a corresponding additional slot.

127. The device of Claim 126, wherein the one or more additional slots comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional slots.

128. The device of Claim 127, wherein the one or more additional repair sutures comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more additional repair sutures.

129. The device of any one of Claims 125 to 128, wherein the anchor defines one or more routing sections for each slot of the one or more additional slots.

130. The device of any one of Claims 32 to 129, wherein for any slot of any one of Claims 1-87, the slot is closed at a proximal end of the slot, a distal end of the slot, or both.

131. The device of Claim 130, wherein the slot is closed by being welded shut.PCT APPLICA TION CINCH-001PCT132. The device of Claim 130 or 131, wherein the slot is closed at the proximal end and distal end thereof, such that the slot comprises one or more openings along a first side, a second side, or both, of the length of the anchor body.

133. The device of any one of Claims 32 to 132, wherein the anchor transitions to the folded configuration at least partially based on interacting with a support surface.

134. The device of Claim 133, wherein the support surface comprises a portion of the first tissue, a portion of a separate device, or both.

135. A device comprising:a first anchor comprising an anchor from any one of Claims 32 to 134;a second anchor comprising an anchor from any one of Claims 32 to 134; and a repair suture,wherein the repair suture is configured to be inserted through i) the anchor body, or ii) the slot, of the first and second anchors, wherein the first anchor, the second anchor, or both are configured to transition to the folded configuration when a tension is applied to the repair suture, thereby securing the first anchor, the second anchor, or both, to a first tissue.

136. The device of Claim 135, wherein the repair suture at a first portion is secured to the first anchor at a distal end thereof, such that a second portion of the repair suture is configured to extend proximally away from the first anchor.

137. The device of Claim 136, wherein the second anchor optionally comprises a first slot and a second slot, wherein the second portion of the repair suture is configured to extend from the first anchor and through i) the anchor body, or ii) both the first and second slots, of the second anchor, such that the second portion of the repair suture is configured to be secured to the second anchor via a middle portion of the second portion that extends between i) a distal portion, or ii) a distal opening, of the first and second slots, of the second anchor.PCT APPLICA TION CINCH-001PCT138. The device of Claim 137, wherein the second portion of the repair suture is configured to extend from the second anchor to the second tissue, to secure a positioning of the second tissue relative to the first tissue.

139. The device of Claim 138, wherein the repair suture secures the positioning of the second tissue via the knotless configuration of any one of Claims 82 to 85.

140. The device of any one of Claims 135 to 139, further comprising a third anchor and a second repair suture, wherein the third anchor comprises the first anchor of any one of Claims 93-97, wherein the second repair suture is configured to be inserted through i) the anchor body, or ii) the slot, of the third anchor and i) the anchor body, or ii) the first and second slots, of the second anchor, wherein the third anchor, the second anchor, or both are configured to transition to the folded configuration when a tension is applied to the second repair suture, thereby securing the third anchor, the second anchor, or both, to the first tissue.

141. The device of Claim 140, wherein the second repair suture at a first portion is secured to the third anchor at a distal end thereof, such that a second portion of the second repair suture is configured to extend proximally away from the third anchor.

142. The device of Claim 141, wherein the second portion of the second repair suture is configured to extend from the third anchor and through i) the anchor body, or ii) both the first and second slots, of the second anchor, such that the second portion of the second repair suture is configured to be secured to the second anchor via a middle portion of the second portion of the second anchor that extends between a i) distal portion, or ii) distal opening of the first and second slots, of the second anchor.

143. The device of Claim 142, wherein the second portion of the second repair suture is configured to extend from the second anchor to the second tissue, to secure a positioning of the second tissue relative to the first tissue.PCT APPLICA TION CINCH-001PCT144. The device of Claim 143, wherein the second repair suture secures the positioning of the second tissue via the knotless configuration of any one of Claims 82 to 85.

145. The device of any one of Claims 135 to 144, wherein the first anchor, the second anchor, the third anchor, or any combination thereof, defines via any slot thereof one or more routing sections of any previous Claim.

146. A system comprising:any device of any one of Claims 32 to 145; andan inserter assembly configured to insert one or more anchors of the device.

147. The system of Claim 146, wherein the inserter assembly comprises a guide tool and an insertion tool coupled to the guide tool.

148. The system of Claim 147, wherein the insertion tool is integrally coupled to the guide tool.

149. The system of Claim 147, wherein the insertion tool is removably coupled to the guide tool.

150. The system of any one of Claims 146 to 149, wherein the guide tool comprises a handle and a guide shaft extending therefrom.

151. The system of any one of Claims 146 to 150, wherein the insertion tool comprises a knob, a screw at least partially threadably couplable to an inner portion of the knob, a screw seat configured to receive at least a portion of the screw, an inserter shaft extending distally away from the screw seat, and a tensioning shaft extending distally away from the screw or screw seat, wherein the tensioning shaft is configured to at least be partially disposed within the inserter shaft, wherein the screw is configured to at least partially extend between the knob and the screw seat.PCT APPLICA TION CINCH-001PCT152. The system of Claim 151, wherein the insertion tool is configured to at least partially be disposed within a portion of the handle.

153. The system of Claim 152, wherein the screw seat is configured to be at least partially disposed within a receptacle of the handle, and wherein the inserter shaft, the tensioning shaft, or both, is configured to be disposed within a portion of the guide shaft, so as to extend distally away from the handle.

154. The system of Claim 151, 152, or 153, wherein rotation of the knob is configured to move i) the screw in a longitudinal direction due to the threaded coupling between the screw and inner portion of the knob, ii) the tensioning shaft in a longitudinal direction, or iii) both.

155. The system of any one of Claims 151 to 154, wherein the knob comprises one or more distal protrusions that are configured to be inserted at least partially within a portion of the handle distal to one or more clips of the handle, such that the knob is configured to rotate freely within said portion of the handle.

156. The system of Claim 155, wherein the one or more clips of the handle is configured to prevent free rotation of the knob when the knob is aligned with the clips.

157. A method of securing a positioning of a second tissue relative to a bone, the method comprising:inserting the anchor of any one of Claims 78 to 104 within a bone hole of the bone; transitioning the anchor to the folded configuration by applying tension to the second portion of the repair suture;coupling the repair suture to the second tissue;passing the second portion of the repair suture through the suture passageway of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture; andPCT APPLICA TION CINCH-001PCToptionally tensioning the second portion of the repair suture to further secure positioning of the second tissue relative to the bone.

158. The method of Claim 157, wherein passing the second portion of the repair suture through the suture passageway is via the passing suture.

159. The method of Claim 157, further comprising a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture.

160. A method of securing a positioning of a second tissue relative to a bone, the method comprising:inserting the anchor of any one of Claims 105 to 112 within a bone hole of the bone; transitioning the anchor to the folded configuration by applying tension to the first portion, the second portion, or both, of the repair suture;coupling the repair suture to the second tissue;securing the first portion of the repair suture to the second portion of the repair suture, such that the anchor secures the positioning of the second tissue via a tied configuration of the repair suture; andoptionally tensioning the repair suture to further secure positioning of the second tissue relative to the bone.

161. The method of Claim 160, wherein securing the first portion of the repair suture to the second portion of the repair suture is via a knot.

162. A method of securing a positioning of a second tissue relative to a bone, the method comprising:inserting a first anchor of any one of Claims 135 to 139 within a first bone hole of the bone;inserting a second anchor of any one of Claims 135 to 139 within a second bone hole of the bone;PCT APPLICA TION CINCH-001PCTtransitioning the first anchor, the second anchor, or both, to the folded configuration by applying tension to the second portion of the repair suture;coupling the repair suture to the second tissue;passing the second portion of the repair suture through the suture passageway of the repair suture, such that the anchor secures the positioning of the second tissue via a knotless configuration of the repair suture; andoptionally tensioning the second portion of the repair suture to further secure positioning of the second tissue relative to the bone.

163. The method of Claim 162, wherein passing the second portion of the repair suture through the suture passageway is via the passing suture.

164. The method of Claim 162, further comprising a passing suture configured to shuttle the second portion of the repair suture through the suture passageway of the repair suture.

165. The method of any one of Claims 162 to 164, further comprisinginserting a third anchor of any one of Claims 135 to 145 within a third bone hole of the bone;transitioning the third bone to the folded configuration by applying tension to the second portion of the second repair suture;coupling the second repair suture to the second tissue;passing the second portion of the second repair suture through the suture passageway of the second repair suture, such that the second and third anchor secure the positioning of the second tissue via a knotless configuration of the second repair suture; andoptionally tensioning the second portion of the second repair suture to further secure positioning of the second tissue relative to the bone.

166. The method of any one of Claims 157-165, wherein one or more of the anchors of any one of Claims 157-165 are inserted using the inserter assembly of any one of Claims 146-156.PCT APPLICA TION CINCH-001PCT167. The method of Claim 166, wherein the second portion of the repair suture of any one of Claims 157 to 159, or the first and second portion of the repair suture of any one of Claims 160 to 161, is coupled to the screw, such that longitudinal movement of the screw in a proximal direction via the knob applies the tensioning to the repair suture.

168. The method of Claim 166, wherein a deployment suture is coupled with the first anchor of any one of Claims 162 to 164, the third anchor of any one of Claims 145 to 166, or both, wherein each deployment suture is coupled to the screw of a respective inserter assembly, such that longitudinal movement of the screw in a proximal direction via the knob applies the tensioning to the respective deployment suture, so as to at least partially transition the respective anchor into a folded configuration.

169. A device comprising:a first anchor comprising the anchor from any one of Claims 32 to 134, wherein the slot of the first anchor is a first slot, the first anchor further comprising a second slot;a second anchor comprising the anchor from any one of Claims 32 to 134, wherein the slot of the second anchor is a first slot, the second anchor further comprising a second slot; a first repair suture; anda second repair suture,wherein the first repair suture is configured to be inserted through the first slot of the first anchor and configured to be secured about a distal end thereof, such that the first repair suture is configured to extend from a proximal end of the first slot of the first anchor to and through the first slot of the second anchor via the proximal end of the first slot of the second anchor, and further configured to extend from the distal end of the first slot of the second anchor, andwherein the second repair suture is configured to be inserted through the second slot of the first anchor and configured to be secured about a proximal end thereof, such that the second repair suture extends from a distal end of the second slot of the first anchor to and through the second slot of the second anchor via the distal end of the second slot of the second anchor, and further configured to extend from the proximal end of the second slot of the second anchor.PCT APPLICA TION CINCH-001PCT170. The device of Claim 169, wherein the first repair suture extending between the proximal ends of the first slot of the first and second anchors defines a suture passageway within the first repair suture, and wherein the second repair suture extending between the distal ends of the second slot of the first and second anchors defines a suture passageway within the second repair suture.

171. The device of Claim 170, wherein the first repair suture extending from the distal end of the first slot of the second anchor is configured to pass through the suture passageway of the second repair suture and extend therefrom towards the first anchor, the first repair suture extending from the suture passageway of the second repair suture defining a terminal portion of the first repair suture.

172. The device of Claim 170 or 171, wherein the second repair suture extending from the proximal end of the second slot of the second anchor is configured to pass through the suture passageway of the first repair suture and extend therefrom towards the first anchor, the second repair suture extending from the suture passageway of the first repair suture defining a terminal portion of the second repair suture.

173. The device of Claim 172, wherein the terminal portions of the first and second repair sutures are configured to pass through an aperture in the first anchor.

174. The device of Claim 173, wherein the terminal portions of the first and second repair sutures are configured to be coupled together at a coupling point, such that applying tension to the coupled terminal portions i) transitions the first anchor, the second anchor, or both, to the folded configuration, ii) creates a clamping force between the first and second anchors, or iii) both.

175. A method compri sing :inserting a first repair suture through a slot of a first anchor comprising the anchor from any one of Claims 32 to 134, wherein the slot of the first anchor is a first slot, the first anchor further comprising a second slot;PCT APPLICA TION CINCH-001PCTsecuring a first end of the first repair suture about a distal end of the first slot of the first anchor;extending the first repair suture from a proximal end of the first slot of the first anchor to a second anchor comprising the anchor from any one of Claims 32 to 134, wherein the slot of the second anchor is a first slot, the second anchor further comprising a second slot, wherein the first repair suture extending from the proximal end of the first slot to the second anchor defines a passing portion of the first repair suture comprising a first passageway therethrough;passing the first repair suture through the first slot of the second anchor via a proximal end of the first slot of the second anchor;inserting a second repair suture through the second slot of the first anchor; securing a first end of the second repair suture about a proximal end of the second slot of the first anchor;extending the second repair suture from a distal end of the second slot of the first anchor to the second anchor, wherein the second repair suture extending from the distal end of the second slot to the second anchor defines a passing portion of the second repair suture comprising a second passageway therethrough;passing the second repair suture through the second slot of the second anchor via a distal end of the second slot of the second anchor;extending the first repair suture from a distal end of the first slot of the second anchor through and from the second passageway of the second repair suture to the first anchor, the first repair suture extending from the second passageway to the first anchor defining a first terminal portion;extending the second repair suture from a proximal end of the second slot of the second anchor through and from the first passageway of the first repair suture to the first anchor, the second repair suture extending from the first passageway to the first anchor defining a second terminal portion;passing the first and second terminal portions through an aperture in the first aperture; andsecuring the first and second terminal openings to each other at a coupled portion, such that, applying tension to the coupled portion i) transitions the first anchor, the second anchor, or both, to the folded configuration, ii) creates a clamping force between the first and second anchors, or iii) both.PCT APPLICA TION CINCH-001PCT176. The method of Claim 175, further comprising:creating a first hole within a first bone;creating a second hole within a second bone;passing the first anchor through the first and second holes, such that the second anchor is disposed about a first surface of the first bone, and the first anchor is disposed about a second surface of the second bone, such that applying the tension to the coupled portion applies a clamping force between the first and second bone towards each other.

177. A method compri sing :creating a first hole within a first bone;creating a second hole within a second bone;passing the first anchor of any one of Claims 169-175 through the first and second holes, such that the second anchor is disposed about a first surface of the first bone, and the first anchor is disposed about a second surface of the second bone, such that applying the tension to the coupled point i) transitions the first anchor, the second anchor, or both, to the folded configuration, ii) creates a clamping force between the first and second anchors, or iii) both.

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