Abstract: A method of suturing includes: (1) wrapping a first segment of a suture through a traction loop; (2) pulling the traction loop and the first segment through an opening in a suture lock; (3) continuing to pull the traction loop such that a second segment of the suture extends through the opening, wherein the second segment has a greater denier than the first segment such that the second segment more nearly fills an entire dimension of the opening than the first segment; and (4) locking the suture in place with the second segment in the opening.

Abstract: Suture constructs and methods for soft tissue to bone repairs. The suture construct is a soft, suture-based anchor which is self-cinching and has a specific, accordian-type configuration (i.e., with the ability to fold from a first, extended position to a second, folded or compressed position). The suture-based anchor may be formed essentially of a flexible material such as a high strength surgical suture, suture chain, or suture.

Abstract: Various bone anchor assemblies and methods are provided for anchoring tissue to bone. In one embodiment, an anchor assembly for anchoring a tendon to bone is provided and includes a substantially cylindrical sheath having bone-engaging surface features formed on an external surface thereof, and having an inner lumen formed therein and extending from an open proximal end to a substantially closed distal. The substantially closed distal end includes at least one tendon anchoring feature extending distally therefrom and configured to facilitate anchoring of a tendon to bone. The anchor assembly further includes an expander having a generally elongate cylindrical configuration and being sized and shaped to be received within the inner lumen of the sheath.

Abstract: A surgical tool incorporates a suture guide with and ananchor 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: A surgical fixation system can include a fixation device, a loop connected to the fixation device, a graft carried by the loop, and a reinforcement material. Surgical fixation systems can be used in various tissue reconstruction procedures, including but not limited to, ACL and PCL reconstructions. The graft and the reinforcement material may be tensioned independently of one another to avoid stress shielding the graft.

Abstract: An assembly for correcting unbalanced growth plate activity including: (a) an implant formed of wire having (i) a longitudinal central section (2), (ii) a first end (3) configured as a first loop (4) in a form of a first helical coil (9) having a central axis (5) that is transverse to a longitudinal axis of the central section, and (iii) a second end (6) configured as a second loop (7) having a central axis (8) that is transverse to the longitudinal axis of the central section; (b) a first bone screw having a shaft section that is insertable through the first loop; and (c) a second bone screw having a shaft section that is insertable through the second loop. A kit for correcting unbalanced growth plate activity and to a method for correcting unbalanced growth plate activity are also disclosed.

Abstract: A ligament assembly comprising a first ligament anchor (9) connected to a second ligament anchor (14) by a ligament (18) a resilient element (40) being associated with the first ligament anchor (9) and a ligament tension adjuster (44, 50) being associated with the second ligament anchor (14). The resilient element (40) may be disposed within the first ligament anchor (9) and the ligament tension adjuster (44, 50) may be disposed within the second ligament anchor (14).

Abstract: An apparatus and method for the repair of disruptions between bones. The apparatus defines a combination of sleeves, strands and crimps are provided to secure the bones, using a dual sided drill guide to prepare the bones for installation of the apparatus, which is adjusted upon installation to suit the appropriate alignment and tension of the apparatus. The method includes the preparation of the bones, the installation of the apparatus and the adjustment of the apparatus to properly align and tension the apparatus for repair of the bone.

Abstract: A delivery system includes an elongated shaft component, a self-expanding valve prosthesis, at least one cinching suture, and a radially-expandable sleeve. The valve prosthesis is disposed over a distal portion of the elongated shaft component and includes a compressed configuration for delivery and an expanded configuration for deployment. The at least one cinching suture removably couples the valve prosthesis to the elongated shaft component and radially compresses the valve prosthesis into the compressed configuration for delivery. The sleeve is secured to and encircles an outer surface of the valve prosthesis. The sleeve has a delivery state with a first diameter extending over a full length of the valve prosthesis in the compressed configuration and a deployed state with a greater second diameter extending over the full length of the valve prosthesis in the expanded configuration. The sleeve is configured to prevent paravalvular leakage in situ in the deployed state.

Abstract: The invention discloses an implant. The implant may include a first flap and a second flap. The first flap may further include a first portion, a second portion and a transition region. The first portion may be configured to be attached proximate a sacrum. The second portion may be configured to be attached to an anterior vaginal wall. The transition region lies between the first portion and the second portion. The second flap may be fabricated such that a portion of the second flap is configured to be attached to a posterior vaginal wall. The implant may be configured such that a value corresponding to a biomechanical parameter defining a biomechanical attribute of the portion of the first flap attaching to the anterior wall is different from a value of the biomechanical parameter defining the biomechanical attribute of the portion of the second flap attaching to the posterior wall.

Abstract: The present invention features systems for orthopedic repair of, for example, a joint. The present systems deviate from conventional systems by virtue of combining a finer prosthetic ligament with a robust anchor. The relationship between these components and their various features are described herein and result in joint reconstruction in human and veterinary settings that is less likely to fail over time.

Abstract: An implantable orthopedic device. The device includes: a proximal anchor, configured to be implanted inside a first metatarsal; the anchor having a collar larger than the opening in a metatarsal in which the proximal anchor is implanted; the collar preventing cable to bone contact; a distal anchor, configured to be implanted inside a second metatarsal, adjacent to the first metatarsal; the distal anchor having a male thread, a nut threadable onto the male thread of the distal anchor, and a cord mechanically interconnecting the proximal and distal anchors. A shock absorber includes an elongate housing threadedly positioned within the anchor; the shock absorber accommodates a cord holder mechanically connected to the housing via a damping member, the cord holder is freely rotatable within the housing to prevent the cord from twist kinking when the housing is rotated to adjust a tension force.

Abstract: A system and method for sharing and absorbing energy between body parts. In one aspect, the method involves identifying link pivot locations, fixing base components and minimally invasive insertion techniques. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a surgical implant is provided having a sheath and an expander that is received within the sheath. Various delivery tools, including a sheath inserter and a driver, are also provided. In use, the sheath inserter can be used to position a tendon within a prepared bone hole, and it can be used to deliver the sheath with a guidewire coupled thereto into the bone hole. The driver can be provided for delivering the expander into the sheath. A loader can optionally be used to load the driver and expander onto the guidewire coupled to the implanted sheath.

Abstract: A device, a kit and a method are presented for permanently augmenting the pump function of the left heart. The basis for the presented innovation is an augmentation of the physiologically up and down movement of the mitral valve during each heart cycle. By means of catheter technique, minimal surgery, or open heart surgery implants are inserted into the left ventricle, the mitral valve annulus, the left atrium and adjacent tissue in order to augment the natural up and down movement of the mitral valve and thereby increasing the left ventricular diastolic filling and the piston effect of the closed mitral valve when moving towards the apex of said heart in systole and/or away from said apex in diastole.

Abstract: An improved device provides a cost-effective, time-effective way to stably and reliably affix soft tissues (e.g., tendon or ligament) to the surface of anatomical structures with comparable or greater strength and stiffness (e.g., bone). The device does not require specialized procedures or tools. A single device applies both incremental tensioning and compression to the soft tissue being affixed. The device allows the user, typically a physician or veterinarian, to reliably manipulate, control, and maintain tissue tension. The device is versatile, and can accommodate attachment of soft tissues of different sizes and mechanical properties to bone or to other soft tissues. These features provide flexibility to human and veterinary health practitioners in a variety of specialized areas including orthopedics, joint stabilization, soft tissue repair, spinal surgery, and plastic surgery.

Abstract: The present disclosure relates to an assembly for fixing a ligament in bone. The assembly includes a suspension member and an implant having a mechanism for fixedly receiving the suspension member and at least partially suspending the suspension member and the received bone graft within the implant, allowing for bony in-growth. A method of fixing a ligament in bone is also disclosed.

Abstract: A facet joint prosthesis comprising an inferior prosthetic portion and a superior prosthetic portion is disclosed. Inferior prosthetic portion includes a first anchor member and a first articulating member and superior prosthetic portion includes a second anchor member and a second articulating member. The first articulating member comprises a support portion and first articulating surface and the second articulating member comprises a second articulating surface, and first and second articulating surfaces are configured and dimensioned to contact or engage one another. A flexible element is positioned between the support portion and the first articulating surface.

Abstract: A prosthetic anchor to be attached to a natural or prosthetic structure of a human or animal. The anchor includes a central layer with first and second surface. A plurality of fiber bundles, each with a medial portion, are concentrically embedded within the central layer to substantially define a horseshoe-shaped pattern. A substrate element is configured to be secured to the natural or prosthetic structure and to receive the second surface of the central layer. A securing element operably coupled to the second surface of the central layer is configured to secure the central layer to the substrate element in at least two positions.

Abstract: An implantable orthopedic device. The device includes: a proximal anchor, configured to be implanted inside a first metatarsal; the anchor having a collar larger than the opening in a metatarsal in which the proximal anchor is implanted; the collar preventing cable to bone contact; a distal anchor, configured to be implanted inside a second metatarsal, adjacent to the first metatarsal; the distal anchor having a male thread, a nut threadable onto the male thread of the distal anchor, and a cord mechanically interconnecting the proximal and distal anchors. A shock absorber includes an elongate housing threadedly positioned within the anchor; the shock absorber accommodates a cord holder mechanically connected to the housing via a damping member, the cord holder is freely rotatable within the housing to prevent the cord from twist kinking when the housing is rotated to adjust a tension force.

Abstract: A tendon anchor, a housing, a protuberance located substantially on the housing, a cut-out area located substantially on the housing and located substantially across from the protuberance, and a plurality of elongated tendon gripping projections located substantially adjacent to the protuberance and the cut-out area for substantially retaining the tendon within the tendon anchor.

Abstract: Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair systems include self-cinching constructs with at least one splice area, a turning loop (turning eyelet), a fixed end and a tensioning limb. The eyelet is fixed and is created into the suture splice by splicing or knotting, or by other known methods in the art. The eyelet is configured to redirect the tensioning of the construct (the force of tensioning).

Abstract: Systems, methods and devices for tensioning posterior crucial ligaments during cruciate or bi-cruciate ligament-sparing arthroplasty. Non-limiting examples of such systems may include at least one series of tibial inserts of equal size; the at least one series of tibial inserts having at least one set of tibial inserts of equal thickness. The at least one set of tibial inserts of equal thickness may include at least two tibial inserts having different geometries in a posterior portion, the different geometries being configured to change the tension in the posterior cruciate ligament (PCL). The different geometries in the posterior portions of the tibial inserts are configured so as to allow the posterior cruciate ligament to be tensioned or loosened independently of the tibial insert thickness and/or size.

Abstract: A tensioner system for use in tensioning graft strands in a knee reconstruction procedure can include a handle assembly, a tensioner assembly coupled relative to the handle assembly, and a drive shaft slidably received through and supported by the handle assembly. The tensioner assembly can include an arm support member rotatably coupled to the handle assembly and first and second arm members each rotatably coupled to lateral sides of the arm support member. Each arm member can include at least one graft attachment area adapted to be coupled to a graft strand. The arm support member can be configured to rotate about an axis perpendicular to a longitudinal axis of the tensioner system and perpendicular to an axis of rotation of each of the arm members. The drive shaft can include proximal and distal ends that extend beyond respective proximal and distal ends of the handle assembly.

Abstract: A system and method for sharing and absorbing energy between body parts. In one aspect, the method involves identifying link pivot locations, fixing base components and minimally invasive insertion techniques. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: A system is disclosed for repairing and reconstructing an injured intra-articular, extra-articular ligament or tendon to a bone. The system includes realigning the axis of a bone, and further includes fixing fragments of a bone together. Novel devices, instruments and methods are disclosed, including a cortical loop for engaging a bundle of soft-tissue and capturing the bundle against a bone surface, an anchor for stabilizing a fractured bone, a guide for directing an orthopedic blade, and a hinged external jig arranged to position and guide the blade. Methods are disclosed for connecting soft-tissue to a bone and for bone alignment.

Abstract: A system for use in graft fixation in a knee reconstruction procedure can include a first femoral fixation member adapted to be retained relative to a first end of a femoral tunnel and a first self-locking adjustable flexible member construct having a passage portion with a pair of free ends and a pair of self-locking adjustable loops. The first flexible member construct can be interconnected to the first femoral fixation member. A second femoral fixation member can be coupled to the first flexible member construct and can be adapted to be positioned in the femoral tunnel relative to a second end of the femoral tunnel adjacent a joint space between the femur and a tibia. A second self-locking adjustable flexible member construct having a passage portion with a pair of free ends and a pair of self-locking adjustable loops can be interconnected to the second femoral fixation member.

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

Abstract: An implant delivery system for delivering a sheet-like implant is disclosed. The device includes an implant spreader assembly disposed proximate the distal end of a delivery shaft. The implant spreader assembly includes a first arm and a second arm. The arms are coupled to the delivery shaft such that the first arm and second arm are moveable between a closed position and an open position. When the first and second arms are in the closed position, the arms extend generally in the longitudinal direction. When pivoting to the open position the distal end of each arm travels in a generally transverse direction to spread a sheet-like implant.

Abstract: A method of repairing soft tissue of a joint of a human extremity, such as a hand or foot. The method includes maintaining a metapodial bone intact; inserting a suture passing instrument into a space adjacent the metapodial and phalangeal bones; passing the suture through a volar ligament near a distal end of the metapodial bone and reattaching the volar ligament to the proximal phalanx. The method also includes making an incision on the dorsal aspect of the extremity to expose the dorsal aspect; inserting the distal portion of the suture passer instrument through the incision on the dorsal aspect of the extremity; inserting the distal portion of the suture passing instrument into a tendon sheath connected to a volar plate; and passing a portion of a suture through the volar plate.

Abstract: Methods and instruments for repairing soft tissues of a skeletal joint, such as, for example, of the foot or hand are presented. The method includes the steps of maintaining the metapodial bone intact; forming a bone tunnel through the proximal phalanx between volar and dorsal aspects of the proximal phalanx; passing a repair suture through the soft tissue to be repaired; passing the repair suture through the bone tunnel; and securing the suture. The method may be used for the repair of soft tissue, such as a volar ligament and/or a collateral ligament.

Abstract: A system for a knee joint includes a first fastener and a second fastener operable to be connected to the tibia and femur, respectively. Furthermore, the system includes a flexible prosthetic ligament member. The ligament member is operably coupled to the first and second fasteners to support the tibia and the femur for relative movement. The ligament member extends from a first end to a second end, and includes an outer wall that defines a hollow longitudinal passage portion. The first end extends into and out of the longitudinal passage portion through the outer wall to define a first adjustable loop, and the second end extends into and out of the longitudinal passage portion through the outer wall to define a second adjustable loop.

Abstract: A graft ligament anchor includes a tubular body having a bore therethrough and proximal and distal ends. A flange is attached to the tubular body at the proximal end thereof and extends radially outwardly beyond the tubular body. A deformable wall is disposed in the tubular body bore and defines, at least in part, a chamber for retaining the graft ligament therein. An expansion device is configured for insertion into the tubular body axially of the tubular body, and for impinging upon the deformable wall to press the deformable wall, and hence the graft ligament received in the chamber, toward a wall of the bore, whereby to fix the graft ligament in the tubular body.

Abstract: A tensioner system for use in tensioning graft strands in a knee reconstruction procedure can include a handle assembly, a tensioner assembly coupled relative to the handle assembly, and a drive shaft slidably received through and supported by the handle assembly. The tensioner assembly can include an arm support member rotatably coupled to the handle assembly and first and second arm members each rotatably coupled to lateral sides of the arm support member. Each arm member can include at least one graft attachment area adapted to be coupled to a graft strand. The arm support member can be configured to rotate about an axis perpendicular to a longitudinal axis of the tensioner system and perpendicular to an axis of rotation of each of the arm members. The drive shaft can include proximal and distal ends that extend beyond respective proximal and distal ends of the handle assembly.

Abstract: Various implementations for therapy to facet joints connecting vertebrae are disclosed including: A) Facet joint stabilization that may be implemented using stabilization band that maintains tension between two anchors. The stabilization band may be retained in any one of a number of ways including the use of an anti-slip device such as a mechanically deformed crimp that abuts one of the anchors. B) Facet joint augmentation may be implemented by dilating the facet joint and inserting a facet joint spacer before adding a facet joint stabilization assembly. The facet joint augmentation may include connecting a tail section of the facet joint spacer to the first anchor used in the facet joint stabilization assembly. C) Facet joint immobilization may be implemented by inserting a fastener across the facet joint and into the vertebra so that the assembled fastener expands inside the vertebra.

Abstract: An all-inside double-socket ACL reconstruction technique, according to which a femoral socket and a closed tibial socket are provided to accommodate retrograde fixation of at least one graft (for example, a semitendonosus allograft) within the sockets. The closed tibial socket is formed by using a retrograde drill device provided with a retrograde drill cutter detachable from a retrograde drill guide pin. The femoral socket may be formed by the retrograde drill method or by a conventional method, and may be carried out before or after the formation of the tibial socket. The graft is secured in the knee by employing a transversal implant, or by employing an interference screw, and/or a continuous loop/button construct.

Abstract: A surgical tensioning assembly providing a means to apply a variable and selective force to tissues, such as replacement ligaments, during a ligament reconstruction surgery. The assembly provides a means to apply a selective, measurable and a generally balanced force on multiple tissues. One embodiment of the tensioning assembly includes a set of subassemblies, namely an engagement subassembly, a variable force subassembly and an equalizing subassembly. These subassemblies are operably connected to each other such that they are able to provide tension on tissues connected to the assembly. In one embodiment the tensioning assembly further includes a mounting subassembly that provides a means to connect the tensioning assembly to a person's body. Methods of use of the surgical tensioning assembly are also disclosed to include novel methods of cycling and conditioning tissue used in a knee ligament replacement surgery.

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: Methods for drilling an angled osteal tunnel into a bone by drilling or punching at least one first tunnel portion into the bone from a first surface location on the bone, the at least one first tunnel portion having an interior end within the bone and then drilling or punching at least one second tunnel portion into the bone from a second surface location on the bone using a guide component to guide a drill to the interior end of the first tunnel portion, whereby the at least one first tunnel portion and the at least one second tunnel portion intersect and connect at an angle, resulting in an angled osteal tunnel.

Abstract: A bearing component 2 for a joint replacement prosthesis comprises a first bearing element 4; a second bearing element 6, and a linking element 8, operatively connecting the first and second bearing elements 4, 6 and permitting relaDative motion there between. The flexible linking element 8 prevents dislocation of mobile bearings in a total knee replacement prosthesis. The invention also relates to a bridging element which retains the linking element 8 with some play, which acts as a ligament support 2051, and which causes a deflection of the line of action of a ligament 1018. A joint replacement prosthesis is also disclosed comprising a biasing element 1140 or a tensioning element 1220 operatively coupled to the artificial ligament 1018. The biasing element 1140 or tensioning element 1220 may be housed in the stem of a tibial tray 1006.

Abstract: An instrument for placing a graft into a bone tunnel comprises an elongated shaft having a forked distal end comprising a pair of tines. A suture spans a space defined between the tines whereby the graft may be positioned between the tines and against the suture so as to be manipulated into the bone tunnel. The tendon folds about the suture, the suture having a releasable tension such that the instrument can be removed from the bone, leaving the tendon behind without the tendon hanging up on the suture.

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 buckle useful for cortical fixation has a graft retention loop slidably affixed thereto for movement from a first position adjacent a first end of the buckle to a second position at about the midpoint of the buckle. The buckle, with a graft over the loop, is drawn up lengthwise through a bone tunnel through a tibia and then flipped sideways to rest against the surface of the bone with the loop and graft depending back into the tunnel. The sliding attachment of the loop permits flipping of the buckle minimizes the flipping distance, which is the excess amount of the loop which must be pulled free of the tunnel to allow the buckle to be flipped sideways.

Abstract: A tensioner system for use in tensioning graft strands in a knee reconstruction procedure can include a handle assembly, a tensioner assembly coupled relative to the handle assembly, and a drive shaft slidably received through and supported by the handle assembly. The tensioner assembly can include an arm support member rotatably coupled to the handle assembly and first and second arm members each rotatably coupled to lateral sides of the arm support member. Each arm member can include at least one graft attachment area adapted to be coupled to a graft strand. The arm support member can be configured to rotate about an axis perpendicular to a longitudinal axis of the tensioner system and perpendicular to an axis of rotation of each of the arm members. The drive shaft can include proximal and distal ends that extend beyond respective proximal and distal ends of the handle assembly.

Abstract: A fixation device for securing a transplant in a bone tunnel, having a strap with a plurality of protrusions disposed along its length, a fastening member with an aperture therein for passing the strap, and a connection element disposed at a distal end of the strap for engaging a transplant is provided. The fixation device is configured such that, when the distal side of the fastening member lies substantially flush against an outer surface of the bone, a longitudinal axis of the aperture is substantially parallel to a longitudinal axis of the bone tunnel. A method for securing a transplant in a bone tunnel using the aforementioned fixation device is also provided.

Abstract: The present invention provides a novel split barbed fixation device for tenodesis, soft tissue reattachment of tendons and ligaments to bones. The insertion device is adapted for an entirely arthroscopic approach while achieving fixation strength with ultimate pullout resistance comparable to interference screws. The device includes an integrated tendon grasper that provides for easy manipulation of the tendon arthroscopically while eliminating the need for external whip stitching of the tendon, thereby reducing preparation time. The device further includes elements that prevent the fixation implant from being destabilized or rotating during deployment and manipulation, including: a depth limiting sheath, a first implant retainer, a first implant retaining step, a tendon grasping needle tube, and an implant keyway for mating the implant to the tube.

Abstract: Described herein are methods and devices for use in repair of a patient's anterior cruciate ligament (ACL). These methods (and devices for performing them) allow the repair, rather than merely replacement, of the ACL. For example, described herein are anchoring devices that may be inserted into a bone and may anchor a scaffolding/support (e.g., graft) material within the bone so that the torn or damaged end of the ACL may be secured to the scaffolding/support material within the femoral notch. These anchoring devices and method of using them are particularly well suited for use with the continuous suture passers described herein, since these suture passers may allow access to previously inaccessible regions of the knee (or other body regions).

Abstract: An anchor assembly for autologous or artificial tendon grafts comprises an insertion element and a stabilizing element. The insertion element has a stem and a head containing an aperture large enough to receive a graft. The stabilizing element is adapted to be embedded in bone, and comprises a sleeve with a cavity arranged to receive and hold the insertion element stem. In use, the stabilizing element is affixed in the bone, and the stem of the insertion element is placed therein. A tendon graft may be secured to the insertion element either before or after its placement in the stabilizing element. Two such anchors may be linked with one or multiple grafts, in either a two-ply or four-ply arrangement.

Abstract: Systems, methods and devices for tensioning posterior cruciate ligaments during cruciate or bi-cruciate ligament-sparing arthroplasty. Non-limiting examples of such systems may include at least one series of tibial inserts of equal size; the at least one series of tibial inserts having at least one set of tibial inserts of equal thickness. The at least one set of tibial inserts of equal thickness may include at least two tibial inserts having different geometries in a posterior portion, the different geometries being configured to change the tension in the posterior cruciate ligament (PCL). The different geometries in the posterior portions of the tibial inserts are configured so as to allow the posterior cruciate ligament to be tensioned or loosened independently of the tibial insert thickness and/or size.