Abstract: A system for establishing an anchorage in an operation site of a human or animal patient with the aid of a material having thermoplastic properties and vibration energy. The system includes a transmitting piece connected or connectable to an energy source for generating vibration energy, and a housing with an opening. The transmitting piece is arranged moveably within the housing, the opening being adapted to the transmitting piece for a distal portion of the transmitting piece to be able to protrude from the opening. The system also includes a driver being activatable for exerting a compression force on the transmitting piece, and a thermoplastic element arranged to be compressible between the transmitting piece and a counter element by the compression force. Furthermore, the system is equipped for shock-free initial positioning and pre-pressing of the transmitting piece against the thermoplastic element.

Abstract: Methods and devices for fixation of soft tissue to bone are provided. In one embodiment, a suture anchor is provided having an elongate cylindrical body with proximal and distal ends and an inner lumen extending therethrough. The elongate body can be configured so that upon partial insertion into a bone hole, it is securely anchored within the bone hole and a suture extending through the inner lumen is freely slidable. It can also configured so that, upon further insertion into the bone hole, at least a portion of the elongate body compresses to lock the suture within the inner lumen such that the suture is prevented from sliding. In another embodiment, a suture anchor is provided having arms that have an open position for receiving a suture therebetween, and a closed position in which the suture is retained but allowed to slide freely.

Abstract: A wound closure device having a filamentary element having a proximal end and a distal end, and a stop element coupled thereto and having a leading edge area defined by thickness and a width and having a total surface area. The leading edge area is substantially perpendicular to a longitudinal axis of the filamentary element. The device may have a ratio of the leading edge area to the total surface area that is less than 10%, a ratio of the length to the maximum thickness of the stop element that is at least 4, or a ratio of the length to the width of the stop element is at least 1 for any given thickness.

Abstract: A device for sealing an aperture in a tissue includes: a foot including a distal portion configured to be disposed distal to the tissue when the device is implanted in a position to seal the aperture; and a flexible wing positionable against a distal surface of the tissue adjacent the aperture such that the flexible wing is disposed between the distal portion of the foot and the distal surface adjacent the aperture.

Abstract: A knotless tissue repair assembly for attachment of tissue to bone includes an anchoring implant with a length of suture threaded therethrough. The implant is preferably a soft flexible three-dimensional structure. The implant may be actuated from a first elongate low profile shape into a second short radially expanded shape having a larger diameter than the hole through which it was placed. The suture extends through the anchor, through a tissue to be secured, and back through a designated suture-binding region or passageway within the anchor enabling the suture to be secured therein and without the need for a physician to tie a knot. Further tension applied to a suture leg approximates the tissue to the anchor until a desired tension or distance between the tissue and anchor is achieved.

Abstract: Assemblies, devices and methods are provided for suture management associated with surgical procedures for anchoring suture to bone. Suture elements mounted to suture anchors are terminated in suture loops or tags, and associated stop members that in combination with visual coding provide suture identification, prevent accidental unmounting of suture from suture anchors, and reduce the number of suture legs requiring active management during complex arthroscopic repairs. The present invention also provides exemplary drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: A cannula tool in combination with other tools is used to provide multiple instruments necessary for surgical procedures. The cannula tool is used in combination with a piercing tool to form a dilator instrument to access a treatment site and in combination with a plunger tool to deliver biological or grafting material to a treatment site. Each of the plunger and piercing tools includes a guide lumen to track the tools over a K-wire or other guide device for placement at the treatment site. The application discloses asymmetrical piercing and plunger tools for placement proximate to a facet joint for treatment.

Abstract: A plating system is described that uses various configurations of bone fixation implants that are configured to attach to one or more portions of a bone. An exemplary bone fixation implant includes a two-dimensional structure comprising a bone-engaging surface and a tissue-engaging surface. A plurality of openings is defined in the two-dimensional structure, and arranged across a length and a width of the bone fixation implant. At least some of openings are configured to receive an attachment member for securing the bone fixation implant to an underlying bone structure. The tissue-engaging surface is configured to engage an overlying tissue structure for encouraging incorporation of the tissue structure into the bone fixation implant to promote stabilization of the underlying bone structure during healing. In certain embodiments, at least 50% of the area defined by and/or between the length and the width of the two-dimensional structure is an opening.

Abstract: A knotless suture anchor construct for securing a tissue in a desired position relative to a bone hole. The construct includes an anchor body extending between first and second ends and having first and second sides. The construct also includes a filament having a first end and a second end. The filament is woven through a plurality of passing locations along the anchor body such that the first end of the filament extends from the first end of the anchor body and the second end of the filament extends from the second end of the anchor body. The construct additionally includes a first loop in the filament between a first adjacent pair of the plurality of passing locations and a second loop in the filament between a second adjacent pair of the plurality of passing locations. In a pre-deployment configuration, the second loop extends through the first loop.

Abstract: The present invention relates to devices for closing a passageway in a body, for example a patent foramen ovale (PFO) in a heart, and related methods of using such closure devices for closing the passageway. The method includes introducing a mechanical closure device into an atrium of the heart and transeptally deploying the closure device across the interatrial septum to provide proximation of the septum secundum and septum primum.

Abstract: Apparatus for reconstructing a ligament, the apparatus comprising a fixation device for maintaining a graft ligament in a bone hole, the fixation device comprising a fixation screw comprising a body having screw threads formed thereon; and a ligament spacer mounted to the fixation screw, the ligament spacer comprising a canted face disposed opposite the fixation screw; such that the fixation screw and ligament spacer may be advanced into the bone hole with the graft ligament so that the fixation screw and the ligament spacer maintain the graft ligament within the bone hole and the canted face of the ligament spacer is aligned with the adjacent surface of the bone.

Abstract: Cosmetic threads for reducing wrinkle size include at least one synthetic collagen fiber that wells after placement under the skin.

Abstract: A method for reconstructing a joint according to an exemplary aspect of the present disclosure includes, among other things, fixating at least one suture inside a joint space, retrieving the at least one suture from inside the joint space, passing the at least one suture through a graft at a location external to the joint space, shuttling the graft into the joint space, and fixating the graft using the at least one suture.

Abstract: An aspect of the present teachings includes a method of percutaneously treating a paravalvular leakage. In a preferred embodiment, the method includes providing an anchor having an elongate anchor member and a tensioning member, positioning the anchor through a paravalvular leakage, deploying the anchor wherein at least a part of the distal portion of the elongate anchor member is on one side of the paravalvular leakage, and applying tension to the tensioning member so that at least a part of the distal portion of the elongate anchor member transitions from the elongate configuration to the shortened configuration. Another aspect of the present teachings includes a device that can be used in a method of percutaneously treating a paravalvular leakage.

Abstract: Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium, through the mitral valve, and into the left ventricle. A ventricular anchor is deployed from the catheter and into a wall of the left ventricle, leaving a ventricular suture attached to the ventricular anchor and extending proximally through the catheter. A leaflet anchor is deployed to secure a mitral valve leaflet to a leaflet suture, with the leaflet suture extending proximally through the catheter. The leaflet suture is secured to the ventricular suture to limit a range of travel of the leaflet in the direction of the left atrium. Also disclosed is an assembled in situ mitral valve leaflet restraint, having a neo papillary muscle and a neo chordae tendinea.

Abstract: A device for repairing a heart valve includes at least one hollow inner portion, a first flexible outer portion, and a second flexible outer portion. The first flexible outer portion and the second flexible outer portion are connected to the at least one hollow inner portion. The first flexible outer portion and the second flexible outer portion each include a frame formed from a loop of metal. The frames each have a central longitudinal section formed by substantially straight parallel segments and a shaped portion that connects the substantially straight parallel segments. The first flexible outer portion and the at least one hollow inner portion are configured to compress tissue of a first heart valve leaflet therebetween. The second flexible outer portion and the at least one hollow inner portion are configured to compress tissue of a second heart valve leaflet therebetween.

Abstract: A bone anchoring element comprising a shaft (2) for anchoring in a bone, with a plurality of barb elements (7) arranged in at least one helical line around the shaft axis (M) is described, wherein said barb elements are elastically movable relative to the shaft. The bone anchoring element (1) is easy to press into a core hole bore in a bone. The barb elements (7) act in a similar manner as do the threads on a conventional bone screw and thus provide for depth positioning. Moreover, the barb elements at the same time secure the bone anchoring element and prevent it from sliding-out.

Abstract: Devices and methods for soft tissue reconstruction are provided. One exemplary embodiment of a device includes a body a suture filament extending through through-holes formed in the body. The suture is formed into an overhand knot having three collapsible openings with filament limbs extending from the knot. The limbs can be passed through the thru-holes of the body and selectively into the collapsible openings of the overhand knot to form coils extending to an opposite side of the body. For example, one limb can be passed through first and second collapsible openings to form two coils, while the other limb can be passed through the first and third collapsible openings to form two coils. The collapsible openings are collapsed around the limbs disposed in the openings, resulting in a secured overhand knot. Other configurations of knots, as well as devices and methods for use in tissue reconstruction, are also provided.

Abstract: Tissue anchors, kits that include a tissue anchor, and methods of anchoring tissue to a bone are described. An example embodiment of a tissue anchor includes a screw and a stem releasably attached to the screw. The screw defines a first opening, a second opening, and a lumen that extends from the first opening to the second opening. A portion of the stem is sized and configured to be received within the lumen defined by the screw.

Abstract: A method, for use with an implantable medical device, including the steps of stretching a mounting tab in such a manner that an aperture on the mounting tab increases in size and separating the mounting tab from a bone anchor by moving the stretched mounting tab in such a manner that the bone anchor does not extend through the aperture in the mounting tab.

Abstract: A wound or incision closure apparatus comprises a first and second panel. Each of the panels comprises a bottom adhesive layer, a medial substrate layer, and an upper load distribution layer which connect the two panels. A sensory or therapeutic element is disposed adjacent, within, or between two or more of the layers. The sensory or therapeutic element can provide sensing and/or therapy for the incision and/or monitor the incision so that the therapy can be customized and updated.

Abstract: An orthopedic attachment system includes a first bone anchor, a second bone anchor, and a flexible connector. The flexible connector is connected between the first bone anchor and the second bone anchor. The flexible connector includes a sliding loop, a tensioning end and a fixed end. The sliding loop is connected to a sling loop bone anchor, and the fixed end is connected to the fixed end bone anchor. The tensioning end is slidably connected and lockable to the fixed end. A flexible connector, a method for attaching a flexible connector between at least two bone anchors in a patient's body, and a method of making a flexible connector are also disclosed.

Abstract: Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a suture anchor is provided that includes a proximal component, a distal component, and an intermediate component positioned between the distal component and the proximal component. The proximal and distal components can each be configured to move independent of one another and to move relative to the intermediate component. In this way, the proximal, intermediate, and distal components of the suture anchor can be configured to cooperate with one another to prevent removal of the suture anchor from a bone hole in which the suture anchor is disposed and to lock a suture relative to the suture anchor and to the bone hole.

Abstract: A surgical fixation assembly includes a shank having an outer surface. The outer surface of the shank includes a threaded portion. The surgical fixation assembly includes a first cupped washer supported on the shank, a sleeve, and a nut threadably engaged with the threaded portion of the shank. The nut is positioned to slide the sleeve axially along the shank to deform the first cupped washer and enable the first cupped washer to penetrate osseous tissue for securing the shank to osseous tissue.

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: A suture tape construct having a first section formed from a fibrous filament that extends from a first end to a second end and has a pair of a one-way protrusions extending therefrom. An anchor is positioned along the suture construct and, when the construct is deployed, is captured between the protrusions. The anchor may be a second section formed from braided suture material that is woven about the first section. The braided suture material can be deployed to form an all suture anchor while protrusions extending from the suture anchor proximately to the location of the deployed suture anchor prevent movement of the second section relative to the first section, thus forming a non-sliding suture tape anchored by the deployed braided material. The anchor may be a threaded anchor having an eyelet that is captured between the protrusions.

Abstract: An insertion device includes an elongate member and a stylet. The elongate member has a proximal end portion, a distal end portion, and defines a lumen therethrough. The stylet has a distal end portion, a proximal end portion, and is slidably coupled to the elongate member. The stylet is configured to move from a first position to a second position with respect to the elongate member. The distal end portion of the stylet is configured to removably couple a mesh carrier thereto. A portion of the distal end portion of the stylet is disposed outside of the lumen of the elongate member when the stylet is in its first position and is disposed within the lumen when the stylet is in its second position.

Abstract: The first fixing member and the second fixing member are arranged such that the first clamping surface and the second clamping surface face each other in an axis line direction of the insertion portion. When the manipulation portion is manipulated and the insertion portion and manipulation member is rotated relatively, the first clamping surface and the second clamping surface are configured to approach by screw-fitting with the second fixing member and the first fixing member. When a predetermined manipulation is performed to the manipulation portion, a coupling between the manipulation member and the other is configured to be released.

Abstract: A device having one or more adjustable loops or coils associated with an implant body for use in soft tissue reconstructions is provided. One exemplary embodiment of a device includes a body and a suture filament, with the filament being used to form a self-locking sliding knot disposed on a top side of the body and a plurality of adjustable coils that are substantially disposed on the body's bottom side. Terminal ends of the filament located above the body's top side can be passed through an opening of a Lark's Head knot from opposite sides, thus forming a self-locking sliding knot, and then the terminal ends can be tensioned to adjust a circumference of the coils. Changing a coil's circumference changes a location of a ligament graft disposed on the coil. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

Abstract: A method for treating reflux esophagitis includes orally inserting an endoscope into a digestive canal; an esophageal side opening forming an esophageal side opening in a mucosal layer in a part of an esophagus; a tunnel forming step of introducing the endoscope between the mucosal and a muscle layer from the esophageal side opening forming a tunnel; an abdominal cavity side opening passing from the tunnel to an abdominal cavity closer to an anus; a protrusion step of a distal end portion of the endoscope passing through the tunnel from the abdominal cavity side opening into the abdominal cavity; and a stenosis forming a wrap on a part of an outer circumference of the digestive canal near the diaphragm closer to the anus using a medical instrument inserted into a channel of the endoscope in the abdominal cavity to form a local stenosis inside the digestive canal forming a wrap.

Abstract: Surgical constructs and methods of soft tissue repairs. A tendon is approximated to bone with a surgical construct in the form of a soft anchor that includes a soft anchor sheath and shuttling sutures passed through the soft anchor sheath. The soft anchor sheath loaded with the shuttling sutures is inserted either unicortically or bicortically. Suture limbs extending from sutured tendon are passed/shuttled through the sheath by employing the shuttling sutures. The tendon is secured into or onto the bone. The suture limbs may be passed through the soft anchor sheath in various directions and/or orientations and/or locations.

Abstract: Systems and methods for sealing an opening in a wall within the body of a patient are disclosed. In one embodiment, the system has an elongated body coupled to a vascular closure device and a resisting member, the elongated body having a high resistance portion and a low resistance portion and being constructed and arranged to interface with a resisting member to apply a conforming force to a vascular closure device. In some exemplary embodiments, the elongated body comprises a large diameter portion positioned in a proximal end region of the elongated body. Methods and other embodiments are disclosed.

Abstract: A soft anchor surgical fixation device includes two soft anchoring implants. The implants have a first elongate state where the implants may slide easily through a bone hole or tunnel, and a second axially compressed state where the implants are prevented from sliding through the bone hole or tunnel. The device also includes a suture pathway extending at least partially along and through the sidewalls of the implants. Tension on the suture transitions the implants from the first elongate state to the second compressed state.

Abstract: An adjustable anchor system provides for securing tissue to bone and includes an anchor with a collapsible suture loop affixed thereto and a tissue suture connected to the collapsible suture loop. After the tissue suture is loaded into the tissue and the anchor implanted into the bone the collapsible loop is collapsed to tension the tissue suture.

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: System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, the delivery catheter further includes a rotatable actuator rod having a threaded fastener at a distal end thereof, and a fixation device releasably coupled by a threaded connection to the threaded fastener of the actuator rod. The fixation device includes a first arm moveable between a closed position and an open position, a second arm moveable between a closed position and an open position.

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: Methods for reconstructing a joint include fixating at least one suture inside a joint space, retrieving the at least one suture from inside the joint space, passing the at least one suture through a graft at a location external to the joint space, shuttling the graft into the joint space, and fixating the graft to bone using the at least one suture.

Abstract: A graft retention device has an elongated body with first and a second ends, and a midpoint therebetween. A pair of elongated slots through the body defines a tang therebetween. At least one of the slots have an open first end into the body at the body first end such that the first end is closed via a retention line between the tang and the body. A graft retention loop disposed over the tang is slidable therealong from a first position closer to the body first end and a second position closer to the midpoint.

Abstract: This disclosure relates to suture-implant constructs, surgical devices configured to deliver suture-implant constructs, and methods of repairing damaged tissue.

Abstract: A device for engagement with a bone includes a dynamically expandable tip (12), a dynamically expandable ring (40), or other dynamically expandable insert (60, 62, 401L) that reacts to forces pushing the implant into bone tissue. The tip (12), ring (40) or insert (60, 62, 401L) expands at least normal to the direction of motion, increasing contact area between the surrounding bone tissue and the material and thereby reducing the occurrence of high areas of contact stress in the adjacent bone tissue. The tip (12), ring (40) or insert (60, 62, 401L) translates forces along an axis of motion into lateral frictional forces that can resist penetration into the bone tissue without the need for additional operator or patient interaction. A method of reducing migration of the device for engagement includes the steps of providing the device and inserting the device within bone tissue.

Abstract: An inserter device that has a driver, a removable inserter tip (or plurality of inserter tips) and a cannulation device slidable over the inserter tip is provided, wherein the removable inserter tip is provided as an interchangeable component of the device, one configuration of the interchangeable inserter tip being of a substantially hexagonal cross-sectional shape (suitable for accommodating a screw-in fixation device (screw), and another configuration of the interchangeable inserter tip being of a substantially circular cross-sectional shape (suitable for accommodating a push-in anchor). A suture anchor assembly has the inserter device that is used with a plug-in anchor, a screw-in anchor, or interchangeably with a plug-in or screw-in anchor, is also disclosed. A method for assembling the suture anchor assembly as well as a method of using the surgical assembly for tissue repair are also provided.

Abstract: Disclosed are devices, methods and/or systems for securing tissue to bone, including a suture anchor implant having a body through which a suture eyelet extends transversely, and one or more suture pinch slits extending proximally from the suture eyelet, the suture pinch slit(s) angled relative to the longitudinal axis of the anchor such that a distal end of at least one suture pinch slit is positioned within a suture recess extending along the body and a proximal end of the at least one suture pinch slit is positioned outside of the suture recess.

Abstract: Bone anchors having improved fixation are discussed. The bone anchors include an anchor body and radially protruding ribs that extend approximately parallel to a longitudinal axis of the bone anchor. A leading distal edge of each rib may be configured in a tapered “knife-edge” configuration. Such ribs may mitigate the plow-out effect, preserving contact between the ribs and the surrounding bone along the length of the anchor. Furthermore, such ribs provide increased surface area, improving fixation strength.

Abstract: A button inserter apparatus for the insertion of a surgical button includes an inserter handle and an elongated inserter shaft connected at one end to the inserter handle. An inserter head is connected to the inserter shaft at an end opposite to the inserter handle. The inserter head includes opposing engagement projections for engaging and retaining a surgical button there between. One of the engagement projections is longitudinally movable relative to the other of the engagement projections. A button engage and release assembly extends from the inserter handle to the inserter head, and selectively prevents relative longitudinal movement between the engagement projections, and selectively permits relative movement of the engagement projections and thereby release of the surgical button. The engage and release assembly is operable from the inserter handle to cause relative longitudinal movement of the engagement projections and release of the surgical button.

Abstract: A suture management member including a body being elongate in a first direction and having a suture-receiving recess in a second direction transverse to the first direction. The suture-receiving recess extends partially through the body and separates the body into a first portion and a second portion. The first portion is being biased towards the second portion to securely retaining a suture within the suture-receiving recess.

Abstract: A deployment device for bringing a sealing plug into position within a puncture tract or incision, and bringing an anchor into position adjacent a tissue puncture, is provided. The deployment device is designed to facilitate easier positioning of the sealing plug, wherein a separate tamping tool is not required. The sealing plug is held in place on the shaft of the anchor by a structure, for example, a knob or boss. The anchor, anchor shaft, and sealing plug may be made of various biocompatible resorbable materials such that the anchor may resorb very quickly, leaving the tissue or artery lumen clear, and the sealing plug may resorb more slowly, to assist in maintaining hemostasis. The deployment device may include a bypass device which maintains the anchor in either an extended or bent configuration. Further, the anchor may include at least one rib, to provide support to the anchor.

Abstract: A soft anchor, anchor assembly, and methods of inserting soft anchors into bone are disclosed herein.

Abstract: A device 10 for gathering tissue of a heart valve leaflet 2 may include an outer tube 16 extending in an elongation direction, a capture tool 22 moveable in the outer tube between a contained position and a use position, and a tissue securing component 32 disposed at a distal end 17 of the outer tube and adapted to be applied to tissue 8 captured by the capture tool to hold the captured tissue in a gathered configuration. The capture tool may include a first element 20 and a second element 22 that are moveable relative to one another in the elongation direction. The first and second elements 20, 22 may be operable to capture tissue 8 of the heart valve leaflet 2 therebetween and to draw the captured tissue into the outer tube 16 in the gathered configuration.

Abstract: A skin expansion system (1) for reducing a wound surrounded by tissue, the skin expansion system (1) comprising; an elastically deformable tie (5) intended to extend between the tissues surrounding the wound in such a way that tension in the tie (5) produces traction along the tissues surrounding the wound in order to bring said tissues closer together, the tie (5) having first (5a) and second opposing ends, a tensioner (10) suitable for maintaining tension in the tie (5), in which the tie (5) is suitable for suturing the wound by passing directly through the tissues surrounding the wound in at least two suturing points, the tie being made from a biocompatible material and comprising a suture needle (6) rigidly connected to the first end (5a).