Abstract: A fixation device for securing soft tissue or suture to bone, such as in the case of rotator cuff repair and primary or secondary ACL tibial side fixation, is disclosed. The fixation device includes an implant screw and a washer that attaches to the head of the screw, yet allows the screw to be turned independently of the washer during insertion of the screw. The washer can be a cap-shaped washer, for covering and securing suture knot bundles around the implant screw, or a spiked cap, for engaging soft tissue. If necessary, the length of the implant screw may be cut to adjust its length.

Abstract: An instrument for surgical suturing includes a shaft, and a needle disposed slidably for longitudinal travel with respect to the shaft. A prong formed on one end of the shaft projects across a longitudinal axis of the needle and has an opening formed through the prong that provides a clearance through which a tip portion of the needle passes when it is advanced. Slots formed on a surface of the prong facing the shaft releasably hold suture across the opening. The suture is held in the slots by passing the suture strands separately back around the sides of the prong, then together up through a channel formed on the prong above the slots, and securing the strands in a pinch slot formed in a handle of the instrument. Advancing the needle through the clearance allows a hook formed on the tip of the needle to capture the suture. Once withdrawn, the needle draws the suture back through tissue pierced during advancement.

Abstract: An instrument for surgical suturing includes a shaft, and a needle disposed slidably for longitudinal travel with respect to the shaft. A prong formed on one end of the shaft projects across a longitudinal axis of the needle and has an opening formed through the prong that provides a clearance through which a tip portion of the needle passes when it is advanced. Slots formed on a surface of the prong facing the shaft releasably hold suture across the opening. Advancing the needle through the clearance allows a hook formed on the tip of the needle to capture the suture. Once withdrawn, the needle draws the suture back through tissue pierced during advancement. The suture is released from the slots and drawn back through the tissue for further knot tying and suturing to effect the tissue repairs.

Abstract: A corkscrew suture anchor has a continuous thread spiraling around a tapering central core. At the distal end, the suture anchor terminates in a rounded point. At the proximal end of the suture anchor is an eye for receiving suture. The suture anchor has a large thread surface per turn of thread. Anti-backout ridges can be formed on the front and/or back faces of the threads. A driver for the suture anchor is provided, the driver including a shaft having a central axis, a length, a distal end, and a proximal end. The shaft is provided at its distal end with an opening aligned with the central axis of the shaft, for receiving the hexagonal proximal end of the suture anchor. One or more sutures threaded through the suture eye are threaded through the hollow tubular shaft. The suture is pulled into and captured by V-shaped notches on the proximal end of the handle to hold the suture anchor in place on the distal end of the driver under the tension of the captured sutures.

Abstract: A surgical method for transosseous fixation of a BTB graft into a joint is disclosed. A longitudinal tunnel formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A looped portion of the strand is diverted so as to protrude out of the entrance to the longitudinal tunnel. The loop is severed so that one end of the strand is passed through a hole in the bone block of the BTB graft. The free ends of the loop are subsequently reattached using a knot to form a reformed loop. The strand with the reformed loop is retracted into the tunnel, drawing the attached BTB graft into the tunnel. The BTB graft is fixed in the tunnel using a transverse implant.

Abstract: A high strength abrasion resistant surgical suture material with improved tie down characteristics is color coded for visualization and identification purposes. The suture features a multifilament cover formed of strands of ultra high molecular weight long chain polyethylene braided with polyester, nylon or a bioabsorbable material. Selected nylon fibers in the cover are provided in a color contrasting with the other cover fibers to provide an identifiable trace. The cover surrounds a core formed of twisted strands of ultrahigh molecular weight polyethylene. The suture, provided in a #2 size, has the strength of #5 Ethibond, is ideally suited for most orthopedic procedures, and can be attached to a suture anchor or a curved needle.

Abstract: Endosteal fixation of a ligament graft with an interference fixation device installed in a retrograde manner in ACL reconstruction is disclosed. The interference fixation device may be a screw or a ribbed implant fitted with a length of reinforced suture or wire for pulling the interference fixation device through the tibial tunnel. The suture extends beyond the leading tip of the interference fixation device a sufficient length to allow the interference fixation device to be passed into the joint by pulling on the suture or wire exiting the tibial tunnel. A driver or an impaction device, such as a slap hammer, is employed to advance and insert the interference fixation device in a retrograde manner into the tibial tunnel. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

Abstract: A corkscrew suture anchor has a continuous thread spiralling around a tapering central core. At the distal end, the suture anchor terminates in a rounded point. At the proximal end of the suture anchor is an eye for receiving suture. The suture anchor has a large thread surface per turn of thread. Anti-backout ridges can be formed on the front and/or back faces of the threads. A driver for the suture anchor is provided, the driver including a shaft having a central axis, a length, a distal end, and a proximal end. The shaft is provided at its distal end with an opening aligned with the central axis of the shaft, for receiving the hexagonal proximal end of the suture anchor. One or more sutures threaded through the suture eye are threaded through the hollow tubular shaft. The suture is pulled into and captured by V-shaped notches on the proximal end of the handle to hold the suture anchor in place on the distal end of the driver under the tension of the captured sutures.

Abstract: In a method of performing a hyaline cartilage allograft transplantation procedure in which a surgeon has pre-operatively determined a size of allograft to be needed for the procedure, a service provider facilitates the procedure by arranging, upon receiving an order from the surgeon or a hospital for an allograft of a specified diameter, for the delivery of a precut allograft core along with a customized set of instrumentation for performing the transplantation to the surgeon or hospital prior to the scheduled time of the operation. The service provider also arranges for the return of any non-disposable instrumentation to the service provider after the operation.

Abstract: Endosteal fixation of a ligament graft with an interference fixation device installed in a retrograde manner is disclosed. An interference screw is installed at the top of the tibial tunnel, through the tibial plateau, in a procedure for ACL reconstruction. The interference screw is fitted with a length of suture for pulling the screw onto a driver placed through the tibial tunnel. The suture is secured to the screw using a knot, an adhesive, insert molding, and equivalents. The suture extends beyond the leading tip of the screw a sufficient length to allow the screw to be passed into the joint by pulling on the suture exiting the tibial tunnel. A driver fits into a drive opening in the leading front end of the screw. Turning the driver advances the screw in a retrograde manner into the tunnel. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

Abstract: A torque driver for measuring the amount of torque being applied during implanting of an interference screw, includes a handle, drive shaft and drive head, a sleeve disposed around the proximal portion of the shaft, and a torque measurement assembly connected between the handle and the sleeve. The torque measurement assembly includes a proximal cup and a distal cup, and a coil spring encased between the cups, with one end of the spring fixed in the proximal cup and the other end of the spring fixed in the distal cup. The proximal cup is fixed to the distal end of the sleeve, and the proximal portion of the sleeve is fixed in the handle. The distal cup is fixed to the drive shaft, which rotates freely within the sleeve. Thus, the drive shaft and distal cup move together as one unit while the handle, sleeve, and proximal cup move together as one unit, so that the two units are physically connected to each other only by the torque spring.

Abstract: An insert-molded push in suture anchor has a biodegradable polymer body molded around a loop of suture. A tapered end disposed on the proximal end of the body is received into a recess in the distal end of a hand driver. Anchoring ribs are formed along the remaining length of the anchor. The suture is held securely within the anchor body during the insert molding process. The anchor is produced by placing the braided suture within an injection mold, and injecting biodegradable polymer into the mold. Using a preferred plication driver, the push in suture anchor can be utilized for capsular plication procedures.

Abstract: A method of securing a graft in a bone tunnel, in which graft is secured within the tunnel at both the entrance and the exit ends of the tunnel to provide bicortical fixation of the graft in the bone. Interference screws or other fixation devices are used to secure the graft within the tunnel. For tibial tunnel fixation using an interference screw, the back end of the distal screw is angled so that it closely approximates the angle of the outer tibial tunnel rim. The distal screw is non-cannulated to prevent hematomas from being formed by blood flowing from the tibial tunnel into the surrounding soft tissue. The proximal screw has a restricted cannula to minimize the flow of synovial fluid entering the tibial tunnel. Advantageously, the space between the two screws fills with blood to promote faster healing and incorporation of the graft in the tibial tunnel.

Abstract: An interactive template to be used as an information guide and training aid for surgical techniques facilitates learning of a surgical technique by providing an animated segment using diagrams, drawings, and/or graphics which allow a user to clearly and easily visualize each step in the procedure. The interactive template may be a compact disc (“CD”) or a collection of “pages” accessible through a network such as an intranet or the Internet. Upon accessing the template, the user is presented with a selection tool by which to select a category of information desired to be viewed, such as a list of surgical procedures or instrumentation, a video or animated demonstration of a selected procedure or on the use of a selected instrument, literature on a selected procedure, a glossary, information about the sponsoring company, etc.

Abstract: A method for selling a product and all phases of service and support to a customer for optimal use of the product includes customizing a product for a surgical allograft procedure to be performed and providing the customized product and services as an integrated turnkey package to a medical provider. The products include bone and soft tissue allografts for all types of orthopedic reconstructive procedures and a loan of the associated instrumentation. The service portion of the package includes training support on use of the instruments, training of operating room personnel, technical and customer support both before the performance of the procedure and on-site support. After completion of the surgical procedure, the service provider arranges for the return of the loaned instrumentation.

Abstract: Endosteal fixation of a ligament graft with an interference fixation device installed in a retrograde manner is disclosed. An interference screw is installed at the top of the tibial tunnel, through the tibial plateau, in a procedure for ACL reconstruction. The interference screw is fitted with a length of suture for pulling the screw onto a driver placed through the tibial tunnel. The suture is secured to the screw using a knot, an adhesive, insert molding, and equivalents. The suture extends beyond the leading tip of the screw a sufficient length to allow the screw to be passed into the joint by pulling on the suture exiting the tibial tunnel. A driver fits into a drive opening in the leading front end of the screw. Turning the driver advances the screw in a retrograde manner into the tunnel. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

Abstract: Methods of performing opening wedge osteotomies are disclosed in which healing of the osteotomy defect is enhanced by packing the opening with pre-packaged, wedge-shaped bone grafts. The bone wedges are provided in sets of three: two larger outer pieces and a smaller inner piece that fits behind a bone plate. The wedge pieces are made of allograft bone or synthetic bone material. Outer surfaces of the two larger pieces preferably are cortical bone or cortical bone-like material.

Abstract: A surgical implant for securing ligament grafts into a joint. The implant is formed entirely of allograft cortical bone, and has a tapered tip with a suture eye. A length of suture is knotted or looped through the eye. The suture is used to draw the implant transversely through a looped graft construct to fix the graft by spanning a bone socket, for example. In a preferred embodiment, the implant is used for knee ligament repair by forming a longitudinal socket in a bone. A flexible strand is drawn with the pin through the bone. A looped portion of the flexible strand is diverted so as to protrude out of the entrance to the longitudinal socket. The ends of the flexible strand remain accessible on either side of the bone. The ligament graft is captured within the strand loop protruding from the entrance to the socket. The strand is retracted into the socket, drawing the graft into the socket by pulling on the accessible ends of the flexible strand. The graft is fixed in the socket using the transverse implant.

Abstract: A method of securing a graft in a bone tunnel, in which graft is secured within the tunnel at both the entrance and the exit ends of the tunnel to provide bicortical fixation of the graft in the bone. Interference screws or other fixation devices are used to secure the graft within the tunnel. For tibial tunnel fixation using an interference screw, the back end of the distal screw is angled so that it closely approximates the angle of the outer tibial tunnel rim. The distal screw is non-cannulated to prevent hematomas from being formed by blood flowing from the tibial tunnel into the surrounding soft tissue. The proximal screw has a restricted cannula to minimize the flow of synovial fluid entering the tibial tunnel. Advantageously, the space between the two screws fills with blood to promote faster healing and incorporation of the graft in the tibial tunnel.

Abstract: A corkscrew suture anchor has a continuous thread spiralling around a tapering central core. At the distal end, the suture anchor terminates in a rounded point. At the proximal end of the suture anchor is an eye for receiving suture. The suture anchor has a large thread surface per turn of thread. Anti-backout ridges can be formed on the front and/or back faces of the threads. A driver for the suture anchor is provided, the driver including a shaft having a central axis, a length, a distal end, and a proximal end. The shaft is provided at its distal end with an opening aligned with the central axis of the shaft, for receiving the hexagonal proximal end of the suture anchor. One or more sutures threaded through the suture eye are threaded through the hollow tubular shaft. The suture is pulled into and captured by V-shaped notches on the proximal end of the handle to hold the suture anchor in place on the distal end of the driver under the tension of the captured sutures.