Abstract: A tissue repair construct having first and second implants coupled via a flexible element is provided. The flexible element forms an adjustable loop closed with a sliding knot, and has first and second free ends extending from the knot formed by wrapping the second end around the first end. The second implant can have a changeable configuration. The construct can be placed within a surgical site in a patient's body such that the first implant is passed into a bone adjacent to soft tissue and the second implant is disposed on an opposed side of the soft tissue. The first free end of the flexible element is configured to be tensioned to decrease a size of the loop and thereby change the configuration of the second implant and to thereby cause at least the second implant to move towards the first implant.

Abstract: A device having an implantable body associated with at least two filaments or sutures and configured for use in soft tissue reconstructions is provided. One exemplary embodiment includes an implantable body, an adjustable filament loop for holding ligament grafts that is coupled to the body, and a shuttle suture removably coupled to the implantable body and configured for shuttling the body through at least a portion of a bone tunnel. The loop can be defined by a self-locking knot, and one or more loop-adjusting limbs can extend from the knot, with a portion of the limb(s) also extending into a hollow portion of the shuttle suture. In some embodiments having two adjustable limbs, an intermediate portion of each limb can be the portions disposed in respective hollow portions of the shuttle suture. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

Abstract: The present invention relates to bone-implants for treating a lesion on a bone, comprising: a bone anchor, a container in communication with the bone anchor and an osteoconductive bone-filler material inside the container, and methods thereof.

Abstract: An endoluminal pursestring device is provided and includes a handle assembly, a shaft, an elongated fork, a plurality of surgical fasteners disposed with the shaft, and a suture engaged with the surgical fasteners. The suture is secured to a head of each of the surgical fasteners, and extends proximally through the handle assembly. In use, a distal end of the endoluminal pursestring device is positioned adjacent tissue surrounding a lumen, and the handle assembly is rotated to cause the distal-most surgical fastener to be rotated into the tissue. The following surgical fasteners are also rotated into other portions of the tissue surrounding a lumen. The suture connecting each of the surgical fasteners is then pulled such that the surgical fasteners are pulled together, thereby closing the lumen.

Abstract: A surgical instrument includes a handle assembly having a gear drive mechanism. The gear drive mechanism includes a variable radius gear to provide a desired mechanical advantage to a user during actuation of a movable handle of the surgical instrument.

Abstract: A suture anchor for knotless fixation of tissue. A swivel suture anchor has an anchor tip for receiving a suture strand, for surgical tissue repair without requiring suture knots. Tension on the repair constructs is adjustable. The swivel anchor is secured in a hole in bone by advancing a fixation device, such as a cannulated interference screw, over the body of the anchor.

Abstract: Devices, systems, and methods to improve both the reliability of soft tissue repair procedures and the speed at which the procedures are completed are provided. The devices and systems include one or more tissue augmentation constructs, which include constructs that are configured to increase a footprint across which suture applied force to tissue when the suture is tied down onto the tissue. The tissue augmentation constructs can be quickly and easily associated with the repair suture, and can be useful in many different tissue repair procedures that are disclosed in the application. In one exemplary embodiment, one or more constructs are disposed on a suture threader, which can be used to associate the construct(s) with a repair suture(s) being used to repair the soft tissue. Tissue augmentation constructs can include various blocks and patches, among other formations. Exemplary methods for manufacturing the tissue augmentation constructs are also provided.

Abstract: A stimulation system for delivery of a stimulation signal to a hypoglossal nerve of a patient to treat obstructive sleep apnea. The stimulation system includes an implantable receiver coil configured to be implanted under a mandible of the patient; a nerve electrode coupled to the implantable receiver coil, the nerve electrode configured to deliver the stimulation signal to the hypoglossal nerve of the patient; an external pulse generator configured to generate the stimulation signal; and an external transmitter coil configured to wirelessly transmit the stimulation signal from the external pulse generator to the implantable receiver coil, the external transmitter coil being carried by an adhesive patch configured to be placed on the skin adjacent the implantable receiver coil under the mandible of the patient.

Abstract: A locking suture construct having suture material with a first end and a second end, each attached to a first body in a slidable manner, a constricting member formed in the second end of the suture material, and a bight in the suture material between the first end and the second end. The bight can be pulled through the constricting member around a second body to create a locking loop. The first end and the second end are passed through the locking loop. Pulling the first end increases a perimeter of the locking loop and moves the constricting member toward the second body. When the constricting member reaches the second body, pulling the first end reduces the perimeter of the locking loop and moves/rotates the constricting member around the second body toward the first body to hold the first body in relative position to the second body.

Abstract: Instruments and methods for surgical transosseous attachment to a bone include a guide able to guide the formation of intersecting bone tunnels and a passer able to pass a member through the bone tunnels.

Abstract: A suture anchoring device for fixing a soft tissue to a bone tissue is disclosed that enables the exchange of sutures between anchors after implantation. The suture anchoring device may include a body that is inserted into the bone tissue, a suture exchange fitting situation within a passage formed within the body, and one or more pre-loaded sutures looped through the suture exchange fitting and projecting proximally from a proximal opening formed in the body. Surgical kits and surgical methods for performing various repair procedures using one or more suture anchoring device are also disclosed.

Abstract: A suture anchor has a tubular body having an axial bore therethrough with one or more purchase enhancements on an exterior surface of the body adapted to enhance purchase of the body within a bone hole. These are preferably screw threads. A distal nose of the suture body has a smooth exterior surface. A length of suture passes down along the exterior surface over the purchase enhancements, over the distal nose, and up into the bore. The smooth exterior surface of the distal nose allows tension of the suture to be held by the engagement of the nose within the bone hole thus making it easier to obtain proper tension as the remaining portion is engaged into the bone hole to provide final fixation.

Abstract: A surgical screw for fixation into bone or soft tissue. The surgical screw includes a cannulated body having a proximal end and a distal end. The distal end of the cannulated body has a tapered tip and a plurality of threads extend around the exterior of the cannulated body. An introducer extends distally from the tapered tip and has a diameter (which can be variable or constant) which is less than a diameter of the tapered tip. The surgical screw is cannulated such that a channel extends through the body from the proximal end to (and sometimes through) the distal end.

Abstract: Tissue fasteners carried on a tissue piercing deployment wire fasten tissue layers of a mammalian body together include a first member, a second member, and a connecting member extending between the first and second members. One of the first and second members has a configuration alterable by a deployment wire to permit release of the fastener from the deployment wire after deployment and without causing excessive tissue trauma.

Abstract: The invention proposes an orthodontic anchorage device, which may be used in combination with others, comprising a plate with two, three or four pointed end stems distributed on one of its surfaces and at least two holes at the ends adapted for the insertion of micro screws. These stems are intended to slightly rest on the bone through the palatine mucosa, preventing the entire appliance from digging into the palate.

Abstract: According to some embodiments, an implant for correcting a deformity in or near a joint of a subject includes an implant body having an internal lumen, a suture side hole or window extending through a wall of the implant body and providing access to the internal lumen through an exterior of the implant body, a tension assembly comprising a first bone anchor and a second bone anchor, wherein the first and second bone anchors are configured to be placed on opposite sides of the implant body, and an adjustable suture loop coupling the first bone anchor to the second bone anchor, wherein at least a portion of the at least one adjustable suture loop is positioned within the internal lumen of the implant body.

Abstract: A surgical tool incorporates a suture guide and anchor driver supporting an anchor where the anchor is maintained at a distance from the suture guide until release of a detent mechanism. Thereafter, the anchor is allowed to move into proximity to the suture guide, fixing a suture supported by the suture guide to a substrate, the entire procedure being achievable with a single hand.

Abstract: Tissue repair systems which use knotless all-suture anchors and have the ability to lock multiple repair sutures within the anchor construct. The anchor construct includes a tension suture wrapped or looped upon itself to create an open eyelet, through which multiple repair sutures originating in soft tissue are passed. The location of the eyelet may be anywhere inside the all-suture anchor or adjacent to the exterior of the anchor body. Tensioning of the tension suture causes the eyelet to restrict movement of the repair sutures and secures them within or against the anchor body.

Abstract: An anchor device and system for coupling soft tissue to osseous tissue includes a stopper member that supports a loop of suture material. A fixing member includes features that allow it to be rigidly coupled to surrounding bone and thus hold the stopper member in a cavity within the bone. The loop of suture material, in turn, supports a second suture device, which is coupled to, and thus retains, the soft tissue. In certain embodiments, the stopper member includes a mechanical linkage for coupling it to the fixing member, and surface features that resist withdrawal of the fixing member from the bone.

Abstract: Disclosed herein are an implant with an attachment feature and a method for attaching to the same. The implant may include a cavity with a porous layer disposed within a non-porous layer wherein the non-porous layer defines a chamber. The chamber may receive and confine liquefiable material and direct liquefiable material to permeate through the porous layer. A method of attaching a device to the implant may include liquefying a liquefiable portion of the device and allowing the liquefied material to interdigitate with the second layer and then solidify to prevent pullout.

Abstract: A delivery system for delivering a plurality of helical tissue anchors to repair a wall defect. Coaxially contained within the outer sheath are inner tubular members. The first inner tubular member designed to deploy a first helical tissue anchor, a second inner tubular member designed to deploy a second helical tissue anchor, and a centered inner tubular member contains a cinching mechanism. The two helical tissue anchors are connected to a suture or strap that pull the two helical tissue anchors together to close a tissue defect. A cinching mechanism holds the anchors and tissue defect together and cut the suture or strap.

Abstract: A method and apparatus for surgically repairing a tear in soft tissue is disclosed. A plurality of collapsible tubes are positioned about the suture. The collapsible tubes are pushed through soft tissue and orthopedic mesh on opposite sides of a tear in soft tissue. When tension is applied to the suture, the tubes are compressed to fix the suture to the soft tissue and draw the soft tissue portions together.

Abstract: A surgical buttress assembly for a surgical stapling apparatus includes a buttress and a release strap. The buttress includes a buttress body portion supporting a toe strap that extends distally from the buttress body portion. The release strap is releasably coupled to the toe strap of the buttress. The release strap is movable relative to the buttress to separate the release strap from the buttress.

Abstract: A knotless anchor assembly method and device comprising an anchor and a compression member, wherein the anchor further comprises a pilot tip and anchor body. During procedures to tension the knotless anchor assembly, the anchor is driven into bone or other surface or component, and the tension member is urged into the anchor body recess. The compression member is secured in the anchor body to lock the tension member in place. The knotless anchor assembly gives the surgeon or user the ability to optimize tensioning by having the ability to change tension in the tension member by adjusting the compression member during or after the repair.

Abstract: Meniscal repair devices, systems, and methods are provided.

Abstract: An apparatus includes a flexible fixation member having a body with a longitudinal extent and a width, the body defining a plurality of openings through the body, each of the plurality of openings formed substantially cross wise through the width of the body, and a suture having two terminal ends, the suture being interwoven through each of the plurality of openings in the body of the fixation member such that multiple portions of the fixation member are slidably coupled to the suture and configurable to form a cluster within a surgical site.

Abstract: The present disclosure relates to repair devices, repair systems, and methods for repair of regurgitant tricuspid valves. A repair method includes positioning a repair device at a tricuspid valve. The repair device includes a pair of proximal arms and a pair of corresponding opposing distal arms, with each proximal arm and corresponding opposite distal arm forming an arm pair. The arms are actuated so that leaflet tissue is grasped between the proximal and distal arms, with a first leaflet being grasped by a first arm pair and a second leaflet being grasped by a second arm pair. A suture line is anchored at the second leaflet. Then, the repair device is pivoted to grasp and suture a third tricuspid leaflet to tie the second and third leaflets together. The clip remains deployed to tie the first and third leaflets together.

Abstract: A knotless anchor for attachment of tissue to bone includes a rigid anchor body and a suture extending there from. The suture is hollow and includes a fixed limb portion secured to the rigid anchor body. A soft suture tunnel extends in a longitudinal direction through the fixed limb portion of the suture. A free suture limb is passed through the tissue, back to the anchor, and through the soft suture tunnel, thereby creating a closable suture loop around the tissue. Tension applied to the free suture limb closes the suture loop, and approximates the tissue to the anchor body. When the anchor is deployed in a bone hole, external features of the anchor body grip the walls of the bone hole and simultaneously compress the suture, thereby preventing tissue pull-out. Anchor assemblies and methods of tissue fixation are also disclosed.

Abstract: A system and method for closing a fascial opening is disclosed. The system may include a strap that may be locked into each of a pair of anchors placed anterior to a muscle and on opposite sides of a fascial opening, one or more delivery tubes for delivering the anchors, and a needle for pulling the strap into each anchor. The method may include the steps of placing a dilating port through a skin incision, inserting an anchor through the dilating port, placing a strap into the body cavity, whereupon the strap may be pulled through the anchor. A second anchor may be placed on the contralateral side of the defect so that the strap may be pulled through the second anchor and cinched tightly closing the defect. The anchors may have a locking aperture that engages with the strap.

Abstract: A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a single working suture and each of the suture anchors allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the working suture in place subsequent to tensioning. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a continuous array of single anchor to anchor stitches which can be placed close together in high density to form a line or region of stitches for a more robust securement of soft tissue to bone.

Abstract: A delivery device for transtendinous implantation of a toggle-type suture anchor into bone is disclosed. The device includes a proximal housing having an outer tubular shaft extending distally with a lumen therethrough. An anchor delivery tube extends through the lumen of the outer tubular shaft having a proximal end affixed to the proximal housing. The anchor delivery tube includes a nub portion that is used to insert through the tendon and partly into bone to maintain registration with a bone hole into which an anchor is placed. A bone punch assembly extends through the lumen of the anchor delivery tube and the nub portion with a pointed distal end. When the bone punch is fully inserted, the pointed distal end extends a distance distal of the distal end of the nub portion.

Abstract: An apparatus and method is disclosed for securing tissue to a bone comprising a novel screw anchor for insertion into a bone by a novel rotational driver. The screw anchor and rotation driver enables the screw to be completely embedded into the bone while permitting a suture to be threaded through a transverse aperture in the screw. The rotation driver facilitates insertion and engagement of a capture with one of a series of protuberance formed along a length of a suture. In addition, the method is disclosed of forming the series of protuberance.

Abstract: Methods for creating high-density arrays of suture stiches through a tendon into bone for reattachment of a torn tendon, particularly a rotator cuff tendon. The method includes providing a pre-strung plurality of anchors, each anchor having at least one passage therethrough with a continuous length of suture slidably and serially threaded through the at least one passage of each anchor. Each of the anchors further includes a locking assembly for locking the suture within the individual anchor. A first anchor is implanted through the tendon and the suture is locked. A second anchor is implanted a selected close distance from the first anchor, then applying tension to the suture extending from the first anchor and passing through the second anchor the second anchor is locked to create a single suture tensioned and locked stitch between the first and second anchor. This process is repeated for each anchor in the array.

Abstract: An assembly and method are provided for incorporation into suture anchor designs to facilitate the locking of a slidable working suture after it has been tensioned. The assembly can be utilized on multiple anchors in a pre-strung chain on a single working suture to create continuous, individually tensioned suture bridges between anchors in series, without knot tying. Further, the bridges are independently locked with selected tension for the particular application. An anchor body having at least one suture receiving passage therethrough is threaded with a working suture wherein the working suture flosses through the passage when tension is applied to the working suture. A locking cord extends through a second passage through the anchor body, the locking cord having a collapsible loop extending out the second passage and encircling a portion of the working suture, wherein collapsing the loop locks the working suture after tensioning.

Abstract: A retrievable puncture anchor includes a fixator with a cylindrical structure, a retrievable thread secured to one end of the fixator, and a push cable flexibly connected to a middle part of the fixator. Via the retrievable puncture anchor, tissues may be connected, fixed and matched with each other, or the tissues may be auxiliarily fixed, so that endoscopic surgery may be facilitated with simplified surgical process, and the puncture anchor may be retrieved after the surgery.

Abstract: A surgical tool, comprising a needle comprising an aperture of sufficient diameter for receiving a screw; a tool, insertable into said aperture for inserting said screw and capable of engaging with and turning the screw; said screw comprising a shaft having threads in a first direction, a head having a bottom face having a flange, and a coil; said coil wound around the screw shaft in an opposing second direction as to the first direction; said coil comprising a coil end which is defined to engage with the flange on the bottom face.

Abstract: The present invention relates generally to a closure system for use in surgical procedures.

Abstract: A method and apparatus for reattaching soft tissue to a boney structure using an expanding suture anchor. The method can include providing a suture anchor and forming a cavity in the boney structure for receipt of the suture anchor. The method can also include coupling the soft tissue to a suture and coupling the suture to the suture anchor. The method can further include deploying the suture anchor to fix the suture to the suture anchor and the suture anchor to the cavity.

Abstract: A repair suture consists of a strand of suture material formed into a continuous loop. One end of the loop may be thicker than the other. The repair suture may be part of a suture assembly including the repair suture, a linking suture having a looped end and a straight end, and a suture anchor. The suture anchor may have a suture bridge that divides the cross-sectional area of the interior of the anchor into two unequal sections. The suture assembly may be used to create luggage tag configurations for repairing tissue or for attaching tissue to bone. In a double-row method with medial row compression, loose suture ends from the medial row are inserted into a lateral row anchor having a proximal anchor body, a distal tip, and internal locking elements for locking the distal tip to the proximal anchor body.

Abstract: An apparatus and methods are provided for a suture anchor to fixate sutures and tissue to bone. The suture anchor comprises an elongate member to be inserted into a bone hole. Barbs along the length of the elongate member engage with an inner wall of the bone hole. An eyelet in a distal aspect of the elongate member is configured to receive a suture. First and second channels extend helically along opposite sides of the elongate member. The eyelet includes first and second openings on opposite sides of the distal aspect. The first opening and the first channel enable applying tension to the suture after implantation into the bone hole. The second opening enables placing the suture into a final position along the barbs after implantation into the bone hole. A proximal aspect of the elongate member receives an instrument for implanting the suture anchor into the bone hole.

Abstract: A suture anchor for use in a knotless, suture-first technique for securing soft tissue to bone comprises a proximal anchor body and a distal tip having an eyelet configured to receive an end of a repair suture. Internal locking elements on the distal tip and the proximal anchor body are provided for locking the tip and anchor body together when the suture anchor is implanted in a bone. A suture assembly for use in an alternate knotless technique comprises a suture anchor, a repair suture, and a shuttle suture. Both the repair suture and the shuttle suture rea looped at one end and straight at the other end. In the alternate technique, the loop and tail of the repair suture are manipulated to form a luggage tag configuration extending around the tissue, and the shuttle suture is used to tightly secure the luggage tag configuration and tissue against the bone.

Abstract: A device for shearing tissue in a human or animal body may include a first member made of a first material and a second member made of a second material. A thread is connected to the first member and to the second member, and the first and second materials show magnetic attraction between one another. A means is provided for pulling the thread between the first and second members.

Abstract: Tissue fixation and repair constructs and methods of repair using the same are provided. An exemplary tissue fixation and repair construct can include a first implantable anchor coupled to a suture having a fixed tail and a tensioning tail. The fixed tail can include an overhand knot located distally adjacent to the finger trap, such that the overhand knot substantially abuts the finger trap when adjacent thereto, a fixed stopper knot configured to prevent further movement of the fixed tail through a second implantable anchor when the second implantable anchor is placed onto the suture, and a finger trap. The tensioning tail can be passed through the finger trap and overhand knot, and can be used to adjust the tension of the tissue fixation and repair construct when the first implantable anchor and the second implantable anchor are inserted into bone.

Abstract: A device for soft tissue biopsy or excision for either handheld or stereotactic table use may comprise a work element configured to selectively open and close at least one articulable beak configured to penetrate tissue, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks and provisions for simultaneous beak closing under rotation may be incorporated.

Abstract: A readily implantable knotless suture anchor that de-couples the angle of insertion of the anchor from the tissue passage step and other steps of conventional procedures. An anchor provides an internal locking mechanism configured such that: suture knots do not have to be tied; suture and tissue tension can be easily adjusted intraoperatively; and suture passage and tensioning can be done at a variety of positions and angles. A method includes: passing a first suture through a patient's tissue and then through a loop of a shuttle suture; pulling the free end of the shuttle suture until the first suture passes through an internal suture locking mechanism; applying tension in the first suture until adequate tension is achieved with respect to the tissue; automatically engaging an internal locking member; and securing the first suture against further relative movement with respect to the anchor.

Abstract: A suturing device, in particular for suturing lacerations of the meniscus, comprises an elongated body provided with a longitudinal cavity extending along a main direction, at least a first and a second implant slidably inserted in the cavity and arranged in sequence along the main direction and a surgical thread slidably inserted in the cavity and connected to the first and second implant. Such first and second implant comprise, respectively, a first and a second wedge-shaped element arranged in sequence and extending from an enlarged portion to a tapered portion along the main direction.

Abstract: A method for securing a strand to a fixation member for arthroscopic fixation, wherein the fixation member includes a channel on an exterior surface and an aperture therethrough. The method includes passing a strand having first and second ends through a flexible sleeve, passing the sleeve through the aperture of the fixation member in a first direction, tensioning the strand, and pulling the sleeve in a second direction different than the first direction to secure the sleeve to the fixation member without tying the strand on the fixation member.

Abstract: A system and methods for gathering, tensioning, and clamping a plurality of suture leads may be used for any of a range of possible surgical applications. The system includes a suture clamp assembly that includes receptacle and plug components, wherein suture leads passed into the receptacle are secured when the plug is inserted into the receptacle to lock the suture leads in place, a gathering suture that includes a gathering loop, an instrument for securement of the plurality of suture leads, and optionally an anchor affixed to the gathering suture. The system may be used to address rotator cuff repairs, labral repair, biceps tenodesis, acromioclavicular joint stabilization, and applications in other joints and bones within a body.

Abstract: A lock and method for suspending suture(s) from bone and providing a secure fixation of the suture(s) within the lock including a generally cylindrical outer shell having a tapered interior cavity or canal and tapered inner wall and a distal end, a generally cylindrical plug having a tapered exterior peripheral surface sized and adapted to be insertable into the outer shell cavity and to form a tight, compression holding or fixation of the suture to the lock, and the plug having a radially extending shoulder or protrusion, whereby insertion of the inner plug into the shell causes, the shoulder or protrusion to expand or snap outwardly and over the distal end of the outer shell and to lock the plug to the outer shell, whereby the suture(s) are locked into place within and to the shell, thereby providing rigid fixation and compression of the suture material.

Abstract: Fixation assemblies having a button captured by a continuous (i.e., closed) loop of thread, such as ultra high molecular weight polyethylene (UHMWPE) fiber are disclosed herein. Preferred assemblies are constructed such that the intact button cannot be detached from the continuous loop without breaking or opening the loop of fiber. The closed fiber advantageously contains at least one or two stitched, or otherwise secured or reinforced, sections positioned on the loop.