Abstract: A device for attaching connective tissue to bone has a longitudinal axis and comprises an annular toggle member and a body member disposed distally of the toggle member, such that there is an axial space between the toggle member and the body member. The toggle member is movable between an undeployed position wherein the toggle member has a smaller profile in a direction transverse to the axis and a deployed position wherein the toggle member has a larger profile in the direction transverse to the axis. When installed in a desired procedural site, in suitable bone, suturing material extends axially through a center aperture in the annular toggle member, without being secured to or contacting the toggle member. This approach permits a suture attachment which lies entirely beneath the cortical bone surface, and which further permit the attachment of suture to the bone anchor without the necessity for tying knots, which is particularly arduous and technically demanding in the case of arthroscopic procedures.

Abstract: An electrosurgical system and method for treating hard and soft tissues in the body comprises a shaft, a distal end section, an active electrode associated with the distal end section, a first fluid supply adapted to deliver a first electrically conductive fluid to the target site, and a second fluid supply adapted to deliver a second electrically conductive fluid to the active electrode. The system is adapted to treat a wide variety of hard tissues such as, for example, bones, calcified structures, calcified deposits, teeth, plaque, kidney-stones, gall-stones and other types of tissue by generating plasma in the vicinity of the active electrode, and applying the plasma to the tissue or structures.

Abstract: Joint temperature monitoring and control systems and methods are described herein in which the temperature of a fluid within a body or joint space is determined and/or monitored despite the energy generated during treatment by an ablation probe. One or more temperature sensors are positioned along the probe proximally of the electrode assembly and measure the temperature of an electrically conductive fluid without being overly influenced by the surgical effect occurring proximate the electrode assembly. The controller coupled to the probe can also be configured to set temperature limits and treatment times as well as moderating joint temperature by altering the electrically conductive fluid flow.

Abstract: Systems and methods are provided for priming or purging an electrosurgical fluid irrigation system. The electrosurgical system can include a high frequency power supply, a fluid delivery system, a handheld device having one or more electrodes, and one or more connectors for connecting the handheld device to the fluid delivery system and the RF generator. The electrosurgical system may be configured to deliver RF current and irrigation fluid until a threshold current level is detected, which is indicative of a continuous flow of fluid at the electrode and purging completion. The systems and methods of purging an electrosurgical system may further include dynamically controlling an RF output and fluid delivery system in accordance with varied parameters of detected threshold current levels.

Abstract: Implant and delivery systems for soft tissue repair which affix soft tissue portions to a region of bone are described. Generally, the assembly includes two bone anchors preloaded through an inserter handle such that each anchor is penetrated into the bone directly. The first anchor is inserted through the tissue and into the bone, where it is locked into position. The first anchor has a suture or wire that protrudes through the tissue and threads through the second anchor and is secured to a rotatable suture reel located along the handle. The second anchor is inserted through the tissue and into the bone independently of the first anchor. Once the second anchor is deployed, the suture or wire is tensioned to secure the soft tissue to the bone and a suture plug within the second anchor is deployed to lock the suture or wire in place.

Abstract: Systems for single tunnel, double bundle anterior cruciate ligament reconstruction include implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. The instruments are also used to exercise and insert the ligament graft constructs. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on a single femoral tunnel, single or double tibial tunnels, and one or more ligament grafts.

Abstract: Methods and apparatus for installing intramedullary medical devices (e.g., intramedullary nails) are described herein. Intramedullary medical devices in accordance with this disclosure provide sustained compressive forces across a bone fusion site despite bone resorption processes. Intramedullary medical devices in accordance with this disclosure include pseudo-elastic shape memory alloys containing nickel and titanium. Portions of intramedullary medical devices, including shape memory alloy elements in the intramedullary medical devices, may have strains imparted upon them through the methods and apparatus described herein. Further aspects of surgery techniques are also performed and controlled through the methods and apparatus described herein.

Abstract: An electrosurgical wand. At least some of the illustrative embodiments are electrosurgical wands configured as a surgical forceps including opposed legs that defines respective distal end portions, the legs of the forceps operable to be actuated between an open position and a closed position, an active and return electrode disposed on one of the respective distal end portions, a discharge aperture on one of the distal end portions coupled to a first fluid conduit, and an aspiration aperture through the return electrode on the other of the distal end portions fluidly coupled to a second fluid conduit. In embodiments, the position of the forceps' legs, and the electrical energy applied to the electrodes, is adjusted to provide dissection or coagulation to the tissue. A stop or latch on the forceps' legs may maintain the active and return electrode a fixed distance from one another.

Abstract: The present disclosure includes a knotless suture anchoring system for anchoring a suture with respect to a body cavity, including a bone anchor body with at least one rigid anchoring structure to secure the anchor body within the body cavity. The anchor body has a longitudinal bore and cross-pin extending across the bore. A retention member is coupled to the anchor body with a break notch therebetween, which may selectively fracture to separate the body from the retention member. Additionally there is a suture cutout on the retention member and a relief feature positioned along the break notch and approximately diametrically opposed from the suture cutout, the relief feature acting to alter the force dissipation along the break notch during the separation of the retention member from the anchor body.

Abstract: Systems and methods are provided for priming or purging an electrosurgical fluid irrigation system. The electrosurgical system can include a high frequency power supply, a fluid delivery system, a handheld device having one or more electrodes, and one or more connectors for connecting the handheld device to the fluid delivery system and the RF generator. The electrosurgical system may be configured to deliver RF current and irrigation fluid until a threshold current level is detected, which is indicative of a continuous flow of fluid at the electrode and purging completion. The systems and methods of purging an electrosurgical system may further include dynamically controlling an RF output and fluid delivery system in accordance with varied parameters of detected threshold current levels.

Abstract: Joint temperature monitoring and control systems and methods are described herein in which the temperature of a fluid within a body or joint space is determined and/or monitored despite the energy generated during treatment by an ablation probe. One or more temperature sensors are positioned along the probe proximally of the electrode assembly and measure the temperature of an electrically conductive fluid without being overly influenced by the surgical effect occurring proximate the electrode assembly. The controller coupled to the probe can also be configured to set temperature limits and treatment times as well as moderating joint temperature by altering the electrically conductive fluid flow.

Abstract: An innovative bone anchor and methods for securing soft tissue, such as tendons, to bone are described herein. Such devices and methods permit a suture attachment that lies beneath the cortical bone surface and does not require tying of knots in the suture.

Abstract: An electrosurgical controller with wave-shaping. At least some embodiments are methods including generating an alternating current (AC) voltage signal within an electrosurgical controller. The generating may be by inducing an intermediate AC voltage signal on a secondary winding of a first transformer, and wave-shaping the intermediate AC voltage signal by a second winding of a second transformer coupled to the first transformer, and thereby creating a final AC voltage signal. Thereafter, the method includes applying the final AC voltage signal to electrical pins of a connector configured to couple to an electrosurgical wand.

Abstract: A bipolar, plasma-generating electrosurgical apparatus and system wherein the return electrode is enclosed within an electrosurgical shaft, and the active electrode is located on the outside surface of the shaft such that in treating the tissue, the tissue is exposed to plasma generated on the active electrode, but is minimally exposed to electric fields generated between the active and return electrodes. Due to the configuration of the electrodes, electric fields generated between the electrodes are directed away from the target tissue and inwardly towards the return electrode within the shaft, thereby electrical stimulation of neuromuscular structures in the tissue by the electric fields is minimized.

Abstract: An electrosurgical wand is described, for treating a target tissue using electrosurgical energy, which has an elongate shaft with a handle end and a distal end. A first active electrode surface is disposed on the distal end of the shaft and a first digester electrode surface is recessed away from the first active electrode surface and electrically connected with the first active electrode surface. An aspiration aperture is also disposed adjacent the first active electrode surface and fluidly connected with an aspiration lumen, wherein the first digester electrode surface is disposed within the aspiration lumen.

Abstract: An electrosurgical controller with wave-shaping. At least some embodiments are methods including generating an alternating current (AC) voltage signal within an electrosurgical controller. The generating may be by inducing an intermediate AC voltage signal on a secondary winding of a first transformer, and wave-shaping the intermediate AC voltage signal by a second winding of a second transformer coupled to the first transformer, and thereby creating a final AC voltage signal. Thereafter, the method includes applying the final AC voltage signal to electrical pins of a connector configured to couple to an electrosurgical wand.

Abstract: System and method for selectively applying electrical energy to structures within or on the surface of a patient's body and controlling the flow of an electrically conductive fluid from the application site to provide or maintain a desired operating condition of the electrosurgical device. An electrosurgical probe is in communication with a fluid transport apparatus through a fluid transport lumen having an opening at an end proximate the application site and disposed proximate the electrosurgical probe. A controller in communication with the fluid transport apparatus provides control signals to the fluid transport apparatus in response to at least one operating parameter associated with the system. Based on the received control signals, the fluid transport apparatus adjusts a flow rate of the electrically conductive fluid at the application site through the fluid transport lumen in response to at least one operating parameter associated with the system.

Abstract: A knotless suture system formed from two lengths of suture joined at a suture junction point, with at least four suture limbs extending from the suture junction. The knotless suture system provides the ability to construct a suture bridge for soft tissue repair and fixation across a medial and lateral row bone fixation anchor configuration while passing the suture system in a simplified method of suture management.

Abstract: A knotless suture system formed from two lengths of suture joined at a suture junction point, with at least four suture limbs extending from the suture junction. The knotless suture system provides the ability to construct a suture bridge for soft tissue repair and fixation across a medial and lateral row bone fixation anchor configuration while passing the suture system in a simplified method of suture management.

Abstract: System and method for selectively applying electrical energy to structures within or on the surface of a patient's body and controlling the flow of an electrically conductive fluid from the application site to provide or maintain a desired operating condition of the electrosurgical device. An electrosurgical probe is in communication with a fluid transport apparatus through a fluid transport lumen having an opening at an end proximate the application site and disposed proximate the electrosurgical probe. A controller in communication with the fluid transport apparatus provides control signals to the fluid transport apparatus in response to at least one operating parameter associated with the system. Based on the received control signals, the fluid transport apparatus adjusts a flow rate of the electrically conductive fluid at the application site through the fluid transport lumen in response to at least one operating parameter associated with the system.