Abstract: Low profile reamers and methods of use are provided which can, in general, allow a hole to be drilled in bone. In one embodiment, a low profile retractable bone reamer is provided having an elongate shaft with a cutting element disposed on a distal end of the elongate shaft that can be configured to drill a hole in bone. The elongate shaft and cutting element can have first and second longitudinally separated portions that are movably coupled to each other. The reamer can be configured to move between a retracted configuration, in which a the reamer has a reduced, low profile configuration, and a non-retracted configuration, in which both longitudinally separated portions of the cutting element can be positioned adjacent to one another to form a single cutting element.

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 connective tissue scaffold including opposed first and second anchoring segments formed from a plurality of bioresorbable polymeric fibers oriented in a direction substantially parallel to a longitudinal axis of the scaffold and a plurality of bioresorbable polymeric fibers oriented in a direction substantially transverse to a longitudinal axis of the scaffold. A central segment joins the first and second anchoring segments and includes a plurality of bioresorbable polymeric fibers oriented in a direction substantially parallel to the longitudinal axis of the scaffold. The scaffold can also a tissue particle and/or biological component.

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: 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: Various arthroscopic shavers are provided that minimize contact between bodily fluid and the shaver hand piece. Arthroscopic shavers generally include a cutting assembly mated to a hand piece. In one embodiment, the shaver includes a hub that connects the cutting assembly with the hand piece and has an exit port configured to transport cut tissue and fluid from the device. In another embodiment, the shaver includes a hub configured to retrofit existing shaver hand pieces having interior lumens for removing cut tissue and fluid. The hub further includes an exit port that diverts fluid away from the hand piece.

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: Various methods and devices are provided for accessing an interior surgical site using an access portal which can be inserted and removed with minimal tissue damage and which can form a seal with tissue while inserted. Generally, a device is provided having a rigid elongate surgical access member with a lumen extending therethrough that is configured to receive a surgical tool. The device can also include a flexible sleeve having a lumen extending therethrough that is configured to receive the elongate surgical access member. A substantially rigid collar is provided disposed adjacent to a proximal end of the flexible sleeve and having a lumen extending therethrough that is configured to receive the elongate surgical access member.

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: Assemblies, devices and methods are provided for suture management associated with surgical procedures for anchoring suture to bone. Suture elements mounted to suture anchors are terminated in suture loops or tags, and associated stop members that in combination with visual coding provide suture identification, prevent accidental unmounting of suture from suture anchors, and reduce the number of suture legs requiring active management during complex arthroscopic repairs. The present invention also provides exemplary 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 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: Systems and methods for modifying the environment of target cell using genetically altered chondrocytes are provided. The genetically engineered chondrocytes can be used to express a therapeutic agent in a subject, including in an environment typically associated with chondrocytes and in an environment not typically associated with chondrocytes.

Abstract: A suture passing mechanism is disclosed having an elongated delivery member and a suture capture fitting at a distal end of the delivery member. The suture capture fitting includes a recess for receiving a length of suture. The recess is bounded by a proximal wall and a lateral opening leads therein. An expeller at the recess is adapted to expel suture out of the recess through the lateral opening.

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 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: A perforation instrument and method of using same, including a shaft capable of being inserted into a joint of a patient, having a longitudinal axis, and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone. The instrument is capable of being altered between an exposed condition wherein the tip of the at least one piercing member is exposed and a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue.

Abstract: Surgical sutures are provided. In general, the surgical sutures can include a plurality of directional indicators that each visually indicate a same direction, e.g., a direction toward one free end of the suture. The directional indicators can be configured to indicate a position of the suture relative to a patient and/or other medical device(s). The directional indicators can be a function of the suture itself so as to be an integral part thereof. In other words, threads, also referred to as “strands,” that form the suture can define the directional indictors. The suture can be braided using threads of two different colors so as to form the directional arrows as an integral part of the suture when the suture is braided in manufacturing of the suture.

Abstract: A device having an implantable body associated with at least two filaments or sutures and configured for use in soft tissue reconstructions is provided. One exemplary embodiment includes an implantable body, an adjustable filament loop for holding ligament grafts that is coupled to the body, and a shuttle suture removably coupled to the implantable body and configured for shuttling the body through at least a portion of a bone tunnel. The loop can be defined by a self-locking knot, and one or more loop-adjusting limbs can extend from the knot, with a portion of the limb(s) also extending into a hollow portion of the shuttle suture. In some embodiments having two adjustable limbs, an intermediate portion of each limb can be the portions disposed in respective hollow portions of the shuttle suture. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

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 are provided for passively dissipating a rotational speed of a fluid-driven rotatable shaft. In particular, a dissipation member is provided for dissipating the rotational speed of a shaft having an end effector formed thereon. As the rotational speed of the shaft increases, the dissipation member will apply a counter-torque to the shaft, thereby limiting the rotational speed of the shaft. In an exemplary embodiment, the counter-torque has a non-linear dependence on the rotational speed of the shaft, such that the counter-torque increases at a rate greater than a rate of increase in the rotational speed.