Method and apparatus for coupling soft tissue to a bone

A method for placing an ACL graft in a patient, comprising:

• forming a tibial tunnel in a tibia and a femoral tunnel in a femur in a patient;
• locating an adjustable suture construct in the femoral tunnel with a fixation member that is coupled to the adjustable suture construct positioned outside the femur proximate a first opening in an outer surface of the femur and with an ACL graft that is coupled to a first adjustable loop and a second adjustable loop of the adjustable suture construct extending back through the femoral tunnel, through a second opening in the outer surface of the femur, and into the tibial tunnel, the adjustable suture construct including a first suture with a first free end and a second free end, the first free end of the first suture passing through the fixation member and through a first longitudinal passage in the first suture to form the first adjustable loop, the second free end of the first suture passing through the fixation member and through a second longitudinal passage in the first suture to form the second adjustable loop, the first longitudinal passage being separate from the second longitudinal passage in the first suture;
• and
• pulling on the first free end and the second free end of the first suture outside the femoral tunnel so as to:
• force the fixation member against surfaces around the first opening in the outer surface of the femur, reduce the size of the first adjustable loop and the size of the second adjustable loop, and pull the ACL graft through the femoral tunnel toward the fixation member.

A method for placing an ACL graft in a patient, the method comprising:

• delivering a fixation member through a tibial tunnel and through a femoral tunnel to a location outside the femur proximate a first opening in an outer surface of the femur, the first opening in the outer surface of the femur providing access to the femoral tunnel, wherein a first suture coupled to the fixation member includes a first free end that passes through the fixation member and through a first longitudinal passage in the first suture to form a first adjustable loop that extends in the femoral tunnel alongside a segment of the first free end of the first suture and that is coupled to a leading end of an ACL graft, wherein the first suture includes a second free end that passes through the fixation member and through a second longitudinal passage in the first suture to form a second adjustable loop that extends in the femoral tunnel alongside a segment of the second free end of the first suture and that is also coupled to the leading end of the ACL graft, the first longitudinal passage being separate from the second longitudinal passage in the first suture;
• and
• pulling on the first free end and the second free end of the first suture outside the femoral tunnel so as to:
• advance the segment of the first free end and the segment of the second free end through the femoral tunnel away from the fixation member, force the fixation member against surfaces around the first opening in the outer surface of the femur, reduce the size of the first adjustable loop and the size of the second adjustable loop, and pull the leading end of the ACL graft through the femoral tunnel toward the fixation member.

A method for placing an ACL graft in a patient, comprising:

• forming a tibial tunnel in a tibia and a femoral tunnel in a femur in a patient;
• coupling an ACL graft to a first adjustable loop and a second adjustable loop of an adjustable suture construct, the adjustable suture construct including a first suture with a first free end and a second free end, the first free end of the first suture passing through a first aperture in the first suture, along a first longitudinal passage in the first suture, and out a fourth aperture in the first suture to form the first adjustable loop, the second free end of the first suture passing through a second aperture in the first suture, along a second longitudinal passage in the first suture, and out a third aperture in the first suture to form the second adjustable loop, wherein the first aperture, the second aperture, the third aperture, and the fourth aperture are all separate apertures in the first suture;
• locating the adjustable suture construct in the femoral tunnel with a fixation member that is coupled to the adjustable suture construct positioned outside the femur proximate a first opening in an outer surface of the femur and with the ACL graft extending from the first adjustable loop and from the second adjustable loop back through the femoral tunnel, through a second opening in the outer surface of the femur, and into the tibial tunnel;
• and
• pulling on the first free end and the second free end of the first suture outside the femoral tunnel so as to:
• force the fixation member against surfaces around the first opening in the outer surface of the femur, reduce the size of the first adjustable loop and the size of the second adjustable loop, and pull the ACL graft through the femoral tunnel toward the fixation member.