Abstract: A flip retrograde cutting instrument and method of retrograde drilling using such an instrument. A method of forming a socket includes providing a flip retrograde cutter, inserting the cutter into a joint with a blade of the cutter in a straight position, pivoting the blade to a non-straight flip position, locking the blade in the flip position, and retrograde drilling a socket using the blade in the flip position.

Abstract: An adjustable, knotless button/loop/needle construct for fixation of cranial cruciate ligament deficient stifle. The adjustable, knotless construct includes two fixation devices (for example, two buttons), at least one flexible, adjustable loop attached to at least one of the fixation devices (e.g., the buttons), and two needles (each needle being attached to one fixation device, e.g., the buttons). The adjustable, knotless construct has an adjustable loop length and allows adjustment in one direction while preventing or locking the construct from loosening in the opposite direction, due to applied tensile forces. The construct and technique of the present invention provides an improved knotless system for cruciate ligament repair.

Abstract: An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Abstract: An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

Abstract: An arthroscopic tibial sizer provided with a collapsible loop (for example, a nitinol loop) and a pin indicator located at about the center of the collapsible loop. The collapsible loop is formed of a flexible wire (for example, nitinol wire) and is designed to collapse so that it can be inserted through an arthroscopic portal and into the joint, and then to expand out to its original diameter once inside the joint space, for visual sizing. The collapsible loop may be provided in various diameters (i.e., 14, 17 or 20 mm, for example) to match various implant sizes. The pin indicator indicates the center of the loop and provides identification of the center of the tibial defect.

Abstract: An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

Abstract: A three-dimensional mesh or screen in the shape of a simple flat piece of material that can be provided adjacent the graft (i.e., in between graft bundles, or around the graft, or between the graft and the fixation device) for improved strength and structural support for graft fixation. The mesh provides improved methods for installing and securing ligament grafts (such as double-bundle cruciate ligament grafts) with enhanced reconstruction results.

Abstract: An adjustable button/loop device for securing biologic material in bone, such as for ACL reconstruction. The device has a pair of button/loop constructs, each including a flexible, adjustable loop integrated with a fixation device (for example, a wedge). Biologic material (for example, soft tissue, graft, ligament or tendon) is secured to the two fixation devices, and the construct is inserted into a pair of bone sockets/tunnels, such as into a tunnel in the tibia and a socket in the femur. The biologic material is secured within the bone by passing the buttons though respective bone sockets/tunnels, flipping and seating the buttons outside the bone, and then adjusting the lengths of the flexible adjustable loops passing through the buttons and the respective fixation devices, with the graft extending between the fixation devices thereby appropriately secured in the bone.

Abstract: A device for tensioning suture which includes a cannulated tube that allows a suture to be fed through at least a portion of the tube. An adjustment device (for example, a wheel or a knob) is actuated to turn a threaded post on the end of the tube. A length of suture passes through at least a portion of the cannulated tube and is secured into a forked pin attached to the adjustment device. Turning the adjustment device draws against the suture, increasing therefore the tension on the suture. The suture tensioning device may be employed in conjunction with a tensiometer.

Abstract: A device for tensioning suture which includes a cannulated tube that allows a suture to be fed through at least a portion of the tube. An adjustment device (for example, a wheel or a knob) is actuated to turn a threaded post on the end of the tube. A length of suture passes through at least a portion of the cannulated tube and is secured into a forked pin attached to the adjustment device. Turning the adjustment device draws against the suture, increasing therefore the tension on the suture. The suture tensioning device may be employed in conjunction with a tensiometer.

Abstract: A continuous loop and button construct and technique for ligament repair and fixation, including bone to bone, or soft tissue to bone. The continuous loop, which is attached to the button, is formed of a flexible material and is provided with at least one joined region (a bridged, stitched, bonded or knotted region) to form a closed loop figure-8 construct with proximal and distal openings with respect to the fixation device. The figure-8 construct (either bridged, stitched, bonded or knotted) is adapted for attachment to a bone block of a BTB graft, for example, and used for ligament reconstruction.

Abstract: Methods and instruments for repairing a damaged acetabular labrum. The arc length of a portion of an acetabular rim proximal to the damaged (torn or broken) region of the acetabular labrum is measured, and a graft, such as a meniscal allograft or a gracilis autograft, is trimmed according to the measurement and secured in the damaged region of the acetabular labrum as a replacement. Various instruments, such as a wheel mounted on an arm, a measuring member with spaced tines, or a hollow arm with a graduated wire, can be used to measure the arc length of the damaged region of the acetabular labrum.

Abstract: An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Abstract: An adjustable, knotless button/loop construct for fixation of ankle syndesmosis tibio-fibular diastasis and an associated method of ankle repair using the same. The knotless construct comprises a pair of buttons attached to a flexible, continuous, self-cinching, adjustable loop integrated with two splices that are interconnected. The knotless construct is passed through fibular and tibia tunnels and the buttons are secured on the cortical surfaces of tibia and fibula. One of the buttons (for example, an oblong button) is secured on the medial side of the tibia by passing the button and the flexible, adjustable loop though the fibular and tibia tunnels and then flipping and seating the button outside the tibia. The length of the flexible adjustable loop is adjusted so that the second button (for example, a round button) is appropriately secured on the lateral fibula.

Abstract: An adjustable, knotless button/loop/needle construct for fixation of cranial cruciate ligament deficient stifle. The adjustable, knotless construct includes two fixation devices (for example, two buttons), at least one flexible, adjustable loop attached to at least one of the fixation devices (e.g., the buttons), and two needles (each needle being attached to one fixation device, e.g., the buttons). The adjustable, knotless construct has an adjustable loop length and allows adjustment in one direction while preventing or locking the construct from loosening in the opposite direction, due to applied tensile forces. The construct and technique of the present invention provides an improved knotless system for cruciate ligament repair.

Abstract: A method and apparatus for arthroscopic unicompartmental knee surgery which include a femoral component and a tibial component. The femoral component is installed in a trough in the femoral condyle formed by using a template, a plurality of drill pins and a plurality of corresponding cutters. The template is aligned with the curvature of the femoral condyle, the two drill pins are passed through the template and drilled into the femur, cutters are advanced over the corresponding drill pins to make holes in the femur, and the remaining hourglass shaped bone is removed with osteotomy pliers to form the trough. A tibial socket for the tibial component is formed in a retrograde manner.

Abstract: Measuring devices and methods of determining the appropriate graft length for reconstructive surgery, for example for an all-inside ACL reconstruction ligament repair. The measuring device accurately determines the graft length based on the total length between the femoral and tibial tunnels (sockets) plus the intraarticular space between them. The measuring device may comprise two small, cannulated beads (preferably polished metal) and three strands (for example, three suture strands). The beads may have a diameter of about 5 mm and the three sutures may preferably have distinct and different colors.

Abstract: A two sided cylindrical chondral resurfacing implant that covers areas of the highest contact between the tibia and femur. A dual-sided rotary drill cutter is employed to create a tibial socket from outside in. A full femoral trough is made with the opposite side of the rotary drill cutter by simply moving the knee through flexion and extension. In this manner, automatic alignment of femoral and tibial components is achieved due to the “transtibial” nature of the femoral preparation.

Abstract: Techniques and reconstruction systems for tissue repairs employing a Z-shaped button with a flexible strand or loop (which may have a fixed or adjustable length). The Z-shaped button has a distinctive Z-shape or an S-shape configuration, that allows a smaller length button to achieve comparable contact area as with a longer length button. The Z-shaped button allows for truncated flipping distance yet permits maximum cortical bone contact. The continuous loop/Z-shaped button construct may be used for fixation of bone to bone, or of soft tissue to bone.

Abstract: An arthroscopic tibial sizer provided with a collapsible loop (for example, a nitinol loop) and a pin indicator located at about the center of the collapsible loop. The collapsible loop is formed of a flexible wire (for example, nitinol wire) and is designed to collapse so that it can be inserted through an arthroscopic portal and into the joint, and then to expand out to its original diameter once inside the joint space, for visual sizing. The collapsible loop may be provided in various diameters (i.e., 14, 17 or 20 mm, for example) to match various implant sizes. The pin indicator indicates the center of the loop and provides identification of the center of the tibial defect.