Abstract: Various exemplary methods and devices are provided for removing abnormalities from bone. In general, the methods and devices can be used to allow excess bone to be scraped from a bone surface. In an exemplary embodiment, a scraper tool is provided that includes an elongate shaft having a plurality of blades movably disposed therein. The blades can be configured to move as a unit between a retracted configuration, in which the blades can be entirely disposed within the elongate shaft, and an advanced configuration, in which at least a portion of the blades can extend distally from the elongate shaft and/or flare away from one another. A distal portion of each of the blades can have a radius of curvature corresponding to a radius of curvature of the bone to be scraped.

Abstract: A cannula system provides a cannula formed of a soft conformable material such as silicone and having an exterior thread. The cannula lacks rigidity, especially axially, and an obturator therefor is provided with an external thread to interact with the cannula an maintain its shape as it is inserted into a patient's body.

Abstract: Devices, systems, and methods for driving an implant into bone to a predetermined depth are described herein. In one embodiment, a medical driver tool is provided that includes a housing having a proximal end configured to receive an impacting force, an elongate shaft extending distally from the housing and having a distal tip configured to drive an implant into bone, and a release mechanism coupled between the housing and the elongate shaft. The release mechanism can have an engaged position in which the elongate shaft is axially immovable relative to the housing and a disengaged position in which the elongate shaft is axially movable relative to the housing. The release mechanism can be configured to move from the engaged position to the disengaged position in response to a force applied to move at least a portion of the release mechanism proximally relative to the housing.

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: Systems and methods for preparing a tissue repair construct for a ligament reconstruction procedure using a reinforced whip-stitching are provided. The described techniques include passing a needle having suture tails attached thereto through a first surface of a graft at an origin point so that a portion of the suture tails exits on a second, opposite surface of the graft while a terminal length of the suture tails is maintained on the first surface of the graft. Multiple suture loops are formed by repeatedly passing the needle with the suture tails around opposite sides of the graft and through the first surface of the graft at subsequent entry points spaced apart along a length of the graft. Each loop is formed so that the construct is reinforced by having a terminal length of each of the suture tails disposed between the first surface of the graft and the loop.

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 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: 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: 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: 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: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

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 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 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: Methods and devices are provided for implanting a cross-pin through a bone tunnel, such as in an arthroscopic surgical procedure. In general, the methods and devices allow a cross-pin hole to be formed in a medial side of a knee bone such that it intersects a bone tunnel formed in the knee bone. In one embodiment, a cross-pinning guide device is provided that can be configured to angularly position the cross-pin hole relative to the bone tunnel to allow the cross-pin hole to intersect the bone tunnel without passing through another side, e.g., a lateral side, of the knee bone. The knee bone can be a femur or a tibia such that the cross-pin hole and the bone tunnel can each be entirely formed in the femur or in the tibia.

Abstract: A tunnel notcher and guidewire delivery device is provided for creating a notch and positioning a guidewire within a bone tunnel. In general, the device includes an elongate member having proximal and distal ends with an inner lumen extending therebetween that is adapted to receive a guidewire. The device also includes a cutting element disposed on a distal portion of the elongate member that is adapted to remove bone within an opening of a bone tunnel. In use, the device 10 can be at least partially positioned within a bone tunnel containing a bone plug, and it can be manipulated to form a notch within or adjacent to an opening of the bone tunnel using the cutting element 18. The device 10 is also effective to deliver a guidewire 16 to the bone tunnel at a location adjacent to the notch.

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 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. 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: 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: 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.