A suture including a knotted end effector is provided. The suture includes a body portion defining a longitudinal axis and an end effector formed from the body portion. The end effector includes first and second extensions which extend outwardly from the longitudinal axis in opposite directions when the end effector is in a permanent configuration. The extensions of the end effector extend substantially along the longitudinal axis when the end effector is in a temporary position. In embodiments, at least a portion of the end effector includes a shape memory material.