Abstract: A medical implement particularly useful in arthroscopic surgery, includes: a handle having a proximal end configured for manual gripping by a user, a distal end for manipulation during the surgery, an internal passageway extending through the handle from the proximal end to the distal end thereof, and a longitudinally-extending slot extending longitudinally through the handle from its outer surface to the passageway for side-loading the handle with a manipulatable member to be manipulated during surgery. A shield is located within the passageway in the handle. The shield is secured along one edge to the inner surface of handle defining the passageway, and includes an elastic section normally covering the longitudinally-extending slot. The elastic section of the shield is yieldable to permit side-loading of the manipulatable member into the passageway, but to prevent a side-loaded manipulatable member from passing outwardly from the passageway.

Abstract: A medical implement particularly useful in arthroscopic surgery, includes: a handle having a proximal end configured for manual gripping by a user, a distal end for manipulation during the surgery, an internal passageway extending through the handle from the proximal end to the distal end thereof, and a longitudinally-extending slot extending longitudinally through the handle from its outer surface to the passageway for side-loading the handle with a manipulatable member to be manipulated during surgery. A shield is located within the passageway in the handle. The shield is secured along one edge to the inner surface of handle defining the passageway, and includes an elastic section normally covering the longitudinally-extending slot. The elastic section of the shield is yieldable to permit side-loading of the manipulatable member into the passageway, but to prevent a side-loaded manipulatable member from passing outwardly from the passageway.

Abstract: A trans-soft tissue anchor implantation system in one embodiment includes a positioning wire having a tissue penetrating distal tip, a cannula for passage through the soft tissue and a suture anchor. The cannula has an axial lumen therethrough sized to accommodate at least the positioning wire, a thin-walled distal portion and a tissue engaging feature, such as an arcuate groove, on at least a portion of an outer surface of the cannula proximal of and adjacent to the distal portion. Tissue, such as a tendon, expands into the groove allowing a surgeon to manipulate the tissue with the cannula.

Abstract: A medical implement particularly useful in arthroscopic surgery, includes: a handle having a proximal end configured for manual gripping by a user, a distal end for manipulation during the surgery, an internal passageway extending through the handle from the proximal end to the distal end thereof, and a longitudinally-extending slot extending longitudinally through the handle from its outer surface to the passageway for side-loading the handle with a manipulatable member to be manipulated during surgery. A shield is located within the passageway in the handle. The shield is secured along one edge to the inner surface of handle defining the passageway, and includes an elastic section normally covering the longitudinally-extending slot. The elastic section of the shield is yieldable to permit side-loading of the manipulatable member into the passageway, but to prevent a side-loaded manipulatable member from passing outwardly from the passageway.

Abstract: The present invention relates to trans-capsularly administering into a diseased joint an inhibitor of p38 MAP kinase or a different therapeutic agent.

Abstract: An implement for orientating a tool at a predetermined angle with respect to a plane of a target surface to be engaged by the tool, particularly for orientating a surgical cutting tool perpendicularly to bone tissue for harvesting and implanting a bone plug to repair damaged bone tissue, includes a rod having a distal end coupled to a head formed with three contact points arranged in a circular array around the longitudinal axis of the rod, such that the three contact points define a plane. The rod is coupled to the head with the longitudinal axis of the rod at the predetermined angle to the plane defined by the three contact points, such that when the three contact points of the rod are in contact with the target surface, the longitudinal axis of the rod is at the predetermined angle with respect to the plane of the target surface.

Abstract: Tissue repair suture plates and methods of use are provided which can, in general, allow soft tissue to be secured to bone. In one embodiment, a tissue repair suture plate can include a plurality of openings formed therethrough that can each be configured to have one or more sutures passed therethrough. Each of the sutures can be configured to be coupled to a soft tissue to be positioned against bone for healing thereagainst such that the soft tissue can have multiple sutures coupled thereto at different areas thereof. One or more bone fixation elements can be coupled to the plate and can be configured to attach the plate to the bone. The plate can be configured to move between a first configuration in which the plate has a first maximum length and a second configuration in which the plate has a second, greater maximum length.

Abstract: Various exemplary surgical fasteners are provided, and methods and devices are provided for deploying a surgical fastener. In general, the methods and devices allow a surgical fastener to be deployed to secure tissue to bone. In one embodiment, a surgical fastener can be configured to move between a first linear or compressed configuration, in which the fastener can have a first maximum diameter, and a second bent or expanded configuration, in which the fastener can have a second maximum diameter greater than the first maximum diameter. A delivery device can be configured to advance the fastener through tissue and into bone to attach the tissue to the bone. The delivery device can be configured to maintain the fastener in the compressed configuration such that when the fastener is released from the delivery device, the fastener can be configured to self-expand from the compressed configuration to the expanded configuration.

Abstract: Methods and devices are provided for forming bone tunnels. In general, the methods and devices allow multiple converging tunnels to be formed in bone, such as in an arthroscopic surgical procedure, e.g., a rotator cuff repair surgical procedure. One or more sutures can be advanced through the converging tunnels, and the suture(s) can be coupled to tissue. The suture(s) with the tissue coupled thereto can be tensioned, thereby helping to maximize an amount of the tissue in contact with the bone. In an exemplary embodiment, a guide device is provided that can be configured to allow a first tunnel to be formed in bone and to allow a plurality of additional tunnels to be formed in the bone at predetermined angular positions relative to the first tunnel such that each of the additional tunnels can extend transverse to the first tunnel and intersect the first tunnel.

Abstract: Methods and devices are provided for anchoring graft to bone. In one exemplary embodiment, a bone cavity is created in bone, a graft is partially advanced into the bone cavity, and a hardenable filler material is inserted into the cavity. The hardenable filler material can change from a viscous first state to a harder second state, compressing the graft against the walls of the bone cavity and thereby anchoring the graft within the cavity. The hardenable filler material can be inserted in an open sac, a closed sac, other carriers or housings, or directly into the bone cavity.

Abstract: Methods and devices are provided for placing surgical guide pins, reamers, and ligament grafts into bone. In one exemplary embodiment, the method can include advancing a guide pin that includes a proximal rigid portion and a flexible distal portion. The rigid proximal portion can be advanced into a femoral tunnel such that the flexible distal portion extends across an intra-articular space. The flexible portion of the guide pin can be bent to adjust a distance between the guide pin and articular cartilage. A cannulated reamer can be advanced over the flexible portion of the guide pin and the reamer can be manipulated to avoid contact with the articular cartilage in the intra-articular space. A ligament graft can be secured in the femoral tunnel created by the guide pin and the reamer.

Abstract: Methods and devices are provided for securing suture to tissue. In one exemplary embodiment, the implant can include an intermediate portion, a first radially expandable portion extending from the intermediate portion, and a second radially expandable portion extending from the intermediate portion. The implant can be configured to be inserted through a delivery device in a first configuration and deployed into a hole formed in tissue in a second configuration such that the intermediate portion is positioned within the hole. A suture can be inserted through a passageway of the intermediate portion positioned within the hole, and the suture can be tensioned to secure the tissue to bone.

Abstract: Methods and devices are provided for cutting and removing tissue from a body. In one exemplary embodiment, a surgical device is provided having a suction shaft and a cutting assembly. The suction shaft can have an inner passageway configured to receive tissue. The cutting assembly can include an outer shaft having at least one opening formed in a sidewall thereof configured to receive tissue. The cutting assembly can be configured to mate with the suction shaft, and it can include a cutting element configured to move relative to the opening to cut tissue disposed through the opening. Suction can be applied to cause the cut tissue to flow proximally through the suction shaft and away from the cutting assembly.

Abstract: An obturator provides access to a joint through a capsule surrounding the joint. A distal end of the obturator has a first distal location with a first width dimension and a second distal location with a second width dimension, wherein the second distal location is proximal to the first distal location and the second width dimension greater than the first width dimension. A retractable blade can extend from the obturator to be exposed between the first distal location and the second distal location.

Abstract: Systems, devices, and methods are provided for securing soft tissue to bone, for securing one or more objects using a surgical filament, and for drawing two or more tissues together so they can be secured in a desired location. One exemplary embodiment of a surgical repair construct that is configured to atraumatically pass through soft tissue to secure tissue in a knotless manner includes a snare linkage, a collapsible loop, and a flexible suture pin. The snare linkage can include a collapsible snare for receiving the collapsible loop, and in use the snare can be collapsed around the collapsible loop and advanced distally towards the bone until the snare is proximate to the tissue, while the collapsible loop can be collapsed distally towards the bone to bring the tissue into proximity with the bone. Other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Abstract: Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical soft tissue repair device includes a snare assembly coupled to a soft anchor in which the soft anchor has a first, unstressed configuration that can be used to insert the anchor into bone and a second, anchoring configuration that can be used to fixate the anchor in the bone. The snare assembly can be configured to actuate the anchor from the first configuration to the second configuration, and it can also be used to engage and approximate tissue by drawing the tissue closer to the anchor fixated in the bone. The snare assembly can be used in conjunction with a number of different anchor configurations, and other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Abstract: Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical repair construct includes an anchor, a filament having a snare on one end and a collapsible loop on another end, and a suture having a plurality of stationary protrusions. The suture is configured to be coupled to detached tissue and have its ends passed through an opening in the snare. The snare can be collapsed around the suture so at least one of the protrusions is proximal of the collapsed snare. The anchor can be disposed in bone and the filament coupled thereto. Accordingly, collapsing the snare around the suture couples the tissue to bone, and applying tension to a tensioning limb of the filament can collapse the loop to incrementally tighten and secure the tissue to bone. Other exemplary systems, devices, and methods for use with tissue repair are also provided.

Abstract: Systems, devices, and methods are provided for securing soft tissue to bone, for securing one or more objects using a surgical filament, and for drawing two or more tissues together so they can be secured in a desired location. One exemplary embodiment of a surgical repair method includes selecting a surgical repair construct that includes a snare linkage having a collapsible snare and a collapsible loop coupled to the snare linkage. Steps can be performed as part of the method such that the snare of the snare linkage is collapsed around a portion of the loop passing through the snare. The snare linkage and loop construct can be coupled to tissue and bone such that the snare and loop are both advanced distally towards bone to bring the tissue into proximity with the bone. Other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Abstract: A surgical anchor comprises a plurality of plates configured into a stack with successive plates within the stack being vertically arrayed with respect to the stack. The stack has an undeployed configuration, and a deployed configuration. In the deployed configuration one or more of the plates is positioned outwardly more laterally with respect to the stack than in the undeployed configuration so as to retain the anchor in a bone hole. A biasing member between the plates in the stack biases the one or more plates toward the deployed configuration. The biasing member can provide a torsional force to induce the plates to rotate and fan outwardly.

Abstract: A surgical impact tool comprises an electromagnetic impactor hermetically sealed within a sterilizable housing having one or more external mechanical coupling for transmitting an impact to an object external to the tool. The housing also contains an energy storage medium rechargeable through the hermetic seal, and electronic controls operable through the hermetic seal.