Abstract: Various methods and devices are provided for a graft fixation device for fixing a graft member within a bone tunnel. In one embodiment, a graft fixation device is provided having a radially expandable sheath adapted to be disposed within a bone tunnel, and a sheath expander adapted to be received within the radially expandable sheath to expand the sheath and thereby anchor a graft between the sheath and the bone tunnel. In an exemplary embodiment, the graft fixation device is particularly useful to affix a graft within a femoral tunnel.

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 graft retention device has an elongated body with a first and second ends and a midpoint therebetween. A pair of elongated slots formed through the body defines a tang therebetween. A graft retention loop is disposed over the tang and is slidable therealong. A trailing line connects to the body adjacent the slots and extends therefrom through the graft retention loop toward the first end. Tension applied to the trailing line thus tends to urge the graft retention loop away from the first end and toward the midpoint.

Abstract: A suture anchor is disclosed having an outer body with an axial bore which receives and inner body for rotation. Suture passes between the inner body and outer body and rotation of the inner body wraps the suture thereabout locking the suture thereto. Rotation of the inner body also effects radial expansion of at least a portion of the outer body to engage to anchor into a bone hole.

Abstract: Methods and devices are provided for delivering and affixing tissue replacements. In one embodiment, a tissue scaffold can be delivered into a patient through a cannula to a cavity formed at a defect site in tissue, e.g., cartilage. A delivery shaft can be used to deliver the scaffold through the cannula, and a loading device can help load the scaffold onto the delivery shaft. A delivery guide device can position and temporarily hold the scaffold within the cavity. The delivery guide device can guide one or more surgical instruments to the scaffold to affix the scaffold within the cavity, e.g., to bone underlying the scaffold, using at least one securing mechanism.

Abstract: A method of replacing an ACL with a graft. The method provides for the drilling bone tunnels in a femur and a tibia. A replacement graft is provided having first and second ends. A biodegradable composite screw is provided. The screw is made from a biodegradable polymer and a bioceramic or a bioglass. At least one end of the graft is secured in a bone tunnel using the biodegradable composite screw.

Abstract: A small diameter delivery device capable of delivering a tissue loaded scaffold arthroscopically to a tissue defect or injury site without reducing the pressure at the injury site is provided. The scaffold delivery device of the present invention comprises a plunger system that includes two main components: an insertion tube and an insertion rod. The insertion tube has a flared proximal end for holding a tissue scaffold prior to delivery. An elongate, hollow body extends from the flared proximal end to a distal end of the insertion tube, and defines a passageway that extends through the body for delivery of the tissue scaffold. The insertion rod has an elongate body that extends into a handle at a proximal end and a tip at a distal end. The insertion rod is configured to be removably disposed within the insertion tube for sliding along the passageway to effect delivery of the tissue scaffold through the insertion tube.

Abstract: Various exemplary methods and devices are provided for passing sutures around anatomical structures. In an exemplary embodiment, a suture delivery device is provided that includes a body portion having a suture delivery member disposed therein and configured to pass a suture around an anatomical structure. The suture delivery member can be movable between a retracted configuration in which the suture delivery member is disposed within the body portion and an advanced configuration in which the suture delivery member extends distally beyond the body portion and assumes an arcurate shape. The arcurate shape can correspond to a shape of the anatomical structure and can extend almost all of the way around the anatomical structure, for example at least around 270° of a circle, thus assisting a user in passing the suture around the anatomical structure without having to manually manipulate the suture delivery device at awkward angles around adjacent tissue.

Abstract: A surgical suturing device (10) having an axis extending between a proximal end and a distal end is operable to move a suture (32) through body tissue (34). A handle assembly (110) is coupled to an elongated shaft (14) having a hollow configuration. An actuating rod (16) is disposed to extend between the handle assembly (110) and the shaft (14). A thumb actuation assembly is coupled to a proximal end of the actuating rod (16) for moving the rod both axially and rotationally. A needle assembly (2) at the distal end of the actuating rod (16) is movable with the actuating rod (16) between an extended state and a retracted state and at various angular orientations.

Abstract: Methods and devices are provided for attaching soft tissue to bone. In general, a deployment device, insertion assembly, and suture anchor are provided. The insertion assembly is coupled between the deployment device and the suture anchor to allow the deployment device to deploy the suture anchor into bone. Each of the various components disclosed herein can be used alone, in combination with one another, or in combination with various other devices.

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

Abstract: Apparatuses for attaching tissue to bone are provided. In one exemplary embodiment, the apparatus includes an expandable body defining a bore, an expander pin having a shaft sized to be received in the bore of the expandable body, and an insertion shaft slidingly disposed in the bore of the expandable body and in a bore of the expander pin. The body is configured to expand laterally into and attach to bone when the expander pin is driven into the expandable body. The body includes a proximal main member having a distally extending threaded projection and a harder, distal tip member having a threaded recess in a proximal surface thereof such that the projection is threadedly interengageable with the recess. The expansion of the body by way of the pin can occur when the proximal main member and distal tip member are threadedly engaged. The insertion shaft is releasably secured to the expandable body and extends distally beyond the expandable body.

Abstract: A tissue fixation system provides a primary fixation plate with a depending graft retention loop and a longer auxiliary fixation plate which fits to the primary fixation plate via upwardly projecting pegs which fit into suture holes in the primary fixation plate. The system has particular utility in cortical fixation procedures in which a graft channel is over-drilled and a longer fixation plate is indicated.

Abstract: Methods and devices are provided for attaching soft tissue to bone. In general, a deployment device, insertion assembly, and suture anchor are provided. The insertion assembly is coupled between the deployment device and the suture anchor to allow the deployment device to deploy the suture anchor into bone. Each of the various components disclosed herein can be used alone, in combination with one another, or in combination with various other devices.

Abstract: Methods of reducing device drag on implantable articles are disclosed herein. The methods include coating the contact surfaces of implantable articles with bioabsorbable lubricating coatings.

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: A suture anchor driver has an elongated shaft, a handle at a proximal end of the shaft an anchor engagement at a distal end of the shaft and a clutch between the handle and the shaft. The clutch includes a slot for frictionally engaging a suture an engagement with the shaft and an engagement with the handle. The engagement with the shaft and the engagement with the handle are located with respect to one another such that driving torque applied to the handle urges open the slot to release its frictional engagement of the suture.

Abstract: Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a cannulated suture anchor is provided and it includes a suture-engaging member formed therein and configured to receive a suture therearound such that trailing ends of the suture can extend through the suture anchor. The present invention also provides exemplary sutures and drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

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: Methods and devices are provided for forming holes in bone to stimulate bone growth. In one exemplary embodiment, a surgical instrument set can include a driver having a first mating element, and a bone pick have a second mating element configured to releasably mate with the first mating element at any of a plurality of angular orientations. When releasably mated together, the driver and the bone pick can be configured to be adjustably positioned relative to one another with three degrees of freedom, e.g., pitch, yaw, and roll. The bone pick can include a piercing tip configured to form a hole in a bone, such as in microfracture. When the driver and the bone pick are releasably mated together, the driver can be configured to be struck, impacted, or otherwise manipulated to drive the piercing tip into the bone.