Abstract: A member of a rigid flexible elastic material, the member including a body portion and an aperture portion with the member adapted for delivery through an axial longitudinal channel of a percutaneous delivery subsystem, the aperture portion including an expanded mode having a lateral dimension greater than an inner diameter of the channel when the aperture portion extends outside the channel and a collapsed mode wherein the lateral dimension is not greater than the inner diameter of the channel when the aperture portion is within the channel, the channel including a first axial opening and a second axial opening with the aperture portion transitioning from the expanded mode to the collapsed mode when inserted into the openings and the aperture transitioning from the collapsed mode to the expanded mode when exiting from the openings.

Abstract: A surgical suturing device including a needle assembly having a needle housing and a needle with an elongated rod that slides inside of the needle housing and has a notch at its proximal end. The handle assembly includes a longitudinal handle housing sized and configured to releasably receive the needle assembly, a thumb slide assembly movable longitudinally on the handle housing, a needle latch connected to the thumb slide assembly and having a releasable latching relationship with the notch of the needle rod, a locking lever pivotally connected to the handle housing that releasably engages a depression on an exterior of the needle housing, and a locking lever latch makes contact with the locking lever and holds it the locking position.

Abstract: A surgical suturing device having an axis extending between a proximal end and a distal end is operable to move a suture through body tissue. An actuating rod extends between the handle assembly and the shaft. A needle assembly at the distal end of the actuating rod is movable with the actuating rod between an extended state and a retracted state. Bifurcated portions of the needle assembly define a suture slot, the bifurcated portions have a proximate relationship when the needle assembly is in the retracted state and having a separated relationship when the needle assembly is in the extended state. The needle assembly is biased to the retracted state and the bifurcated portions are biased to the separated relationship. A handle assembly is configured to releasably receive the needle assembly and is operable to move the needle assembly between a free suture state and a captured suture state.

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: 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: Systems and methods for preparing a ligament graft construct for a ligament reconstruction or repair procedure are provided. In general, the described techniques utilize a reinforcement material having at least one suture tail extending therefrom. The reinforcement material is a ribbon or a ribbon-like flattened portion attached to or integrally formed with the at least one suture tail. To prepare a tissue repair construct, the reinforcement material is positioned on a first surface of a graft to extend from an end thereof and the at least one suture tail, coupled to a needle, is repeatedly passed through the reinforcement material and the surface of the graft to a second surface of the graft, and around a side portion of the graft to thereby create multiple suture loops. The tissue repair construct can be formed on each end of the graft.

Abstract: A suture anchor comprises a tubular body having an axial bore therethrough and having one or more purchase enhancements on an exterior surface of the body adapted to enhance purchase of the body within a bone hole, such as threads. A lateral port passes through the body from the bore to the exterior surface and is formed of a slot entering the body from its proximal end. A length of suture for attaching soft tissue to bone passes down along the exterior surface over the one or more purchase enhancements, over a distal end of the body, up into the bore through and then back out of the bore and up along the exterior surface over the one or more purchase enhancements.

Abstract: An improved implant inserter, and method of using same, with an elongated, substantially rigid shaft having a proximal surface which is capable of receiving a driving force, and a substantially rigid tip portion having a distal end and a proximal end. At least the distal end of the tip portion is capable of being placed within an implant such as a suture anchor. The inserter further includes a compliant region disposed between the tip portion and the shaft which requires less lateral force to bend than the tip portion, at least when the tip portion has been placed within the implant.

Abstract: Assemblies and methods suitable for knotless arthroscopic repair of tissue defects include two fixation members coupled by two limbs of suture comprising a continuous loop. A unidirectional restriction element that can be a preformed locking, sliding suture knot proximate to one of the fixation members, provides tensioning of the repair.

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.

Abstract: A member of a rigid flexible elastic material, the member including a body portion and an aperture portion with the member adapted for delivery through an axial longitudinal channel of a percutaneous delivery subsystem, the aperture portion including an expanded mode having a lateral dimension greater than an inner diameter of the channel when the aperture portion extends outside the channel and a collapsed mode wherein the lateral dimension is not greater than the inner diameter of the channel when the aperture portion is within the channel, the channel including a first axial opening and a second axial opening with the aperture portion transitioning from the expanded mode to the collapsed mode when inserted into the openings and the aperture transitioning from the collapsed mode to the expanded mode when exiting from the openings.

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: A suture anchor is provided including an elongate shank defining a longitudinal axis and having at least one bone-engaging thread formed thereon, and a drive head having a proximal end and a distal end mated to the elongate shank. The drive head has a substantially oval shape and includes at least one suture attachment member formed in a portion of the drive head. The configuration of the drive head is particularly advantages in that it provides a suture anchor having improved physical properties, including a high failure torque and a high stripping strength.

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: 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: Methods and devices are provided for anchoring suture to tissue, incorporating anchoring devices constructed substantially from suture. The anchoring devices are constructed as longitudinally extended, preformed knot configurations that upon deployment are reconfigured to form anchoring knots having an increased cross-section relative to the preformed knot configuration, for secure lodging in tissue. The anchoring devices are suitable for single and multi-anchor surgical procedures in soft tissue or bone, and multiple anchors can be delivered using a single delivery device.

Abstract: A member of a rigid flexible elastic material, the member including a body portion and an aperture portion with the member adapted for delivery through an axial longitudinal channel of a percutaneous delivery subsystem, the aperture portion including an expanded mode having a lateral dimension greater than an inner diameter of the channel when the aperture portion extends outside the channel and a collapsed mode wherein the lateral dimension is not greater than the inner diameter of the channel when the aperture portion is within the channel, the channel including a first axial opening and a second axial opening with the aperture portion transitioning from the expanded mode to the collapsed mode when inserted into the openings and the aperture transitioning from the collapsed mode to the expanded mode when exiting from the openings.

Abstract: Adjustable length surgical screws and inserters for adjustable length surgical screws and methods of using the screws and inserters are provided. In general, a fixation device such as a surgical screw can be configured to have an adjustable length. The fixation device can have one or more break points along a longitudinal axis thereof. In an exemplary implementation, the fixation device can include a plurality of break points. The plurality of break points can be formed at different predetermined axial positions along the fixation device's longitudinal axis. The fixation device can be configured to break at each of its one or more break points, for example breaking along a plane that is substantially perpendicular to the longitudinal axis of the fixation device.

Abstract: Methods and devices are provided for fixing a ligament graft in a bone tunnel. In general, the methods and devices involve affixing a ligament graft within a bone tunnel using an adhesive. A fixation device can be inserted through the ligament graft in a direction transverse to an axis of the tunnel to maintain the ligament graft in contact with the adhesive. The fixation device can be removed when the adhesive is cured such that the ligament graft is fixed in the tunnel.

Abstract: A guide provides for placing a suture anchor into an outer rim of a glenoid cavity of a patient adjacent an edge of a glenoid labrum. The guide comprises an elongated guide tube having an axial lumen with a distal opening a rim engagement member pivotally attached to the elongated tube adjacent the distal opening. The rim engagement member has a first contact surface and a second contact surface each of which are distal of the guide tube and are separated from each other and disposed on opposite lateral sides of the guide tube whereby to allow placement of the contact member over the glenoid rim, with subsequent angular positioning of the guide tube and passage of an instrument down the lumen to the labrum.