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: 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: 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: 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: An instrument for placing a graft into a bone tunnel comprises an elongated shaft having a forked distal end comprising a pair of tines. A suture spans a space defined between the tines whereby the graft may be positioned between the tines and against the suture so as to be manipulated into the bone tunnel. The tendon folds about the suture, the suture having a releasable tension such that the instrument can be removed from the bone, leaving the tendon behind without the tendon hanging up on the suture.

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: A radially expandable sheath is provided having a substantially closed distal end with at least two sidewalls extending proximally therefrom and defining a central lumen. Each sidewall can have a substantially concave outer surface adapted to seat a graft member, and each side wall is at least partially separated by a longitudinally oriented slot that extends from a proximal end along a substantial length of each sidewall. The slot preferably terminates at a position just proximal to the distal end. The device can also include a sheath expander that is adapted to be disposed in the central lumen of the radially expandable sheath and that is configured to flex the sidewalls to radially expand the sheath so as to fix a graft member within a bone tunnel.

Abstract: A novel high tensile strength semi-absorbable composite suture with minimized non-absorbable mass. The suture has a core made from a bioabsorbable polymer. The core is covered by a braided sheath. The braided sheath is made from an absorbable yarn and a bioabsorbable yarn. The bioabsorbable yarn is made from a least one filament of a bioabsorbable polymer. The nonabsorbable yarn is made from at least one filament of ultra high molecular weight polyethylene.

Abstract: Methods and compositions are disclosed for an intra-articular injection for the treatment of osteoarthritis. The methods and compositions comprising combinations of hyaluronic acid and a bone morphogenetic protein, like rhGDF-5, can be useful for any synovial joint, including the knee, shoulder, hip, ankle, hands, spinal facet, or temporomandibular joint, both for the relief of pain and for slowing disease progression.

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: 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: A biocompatible tissue implant. The tissue implant may be bioabsorbable, consists of a biocompatible polymeric foam. The tissue implant also includes a biocompatible reinforcement member. The polymeric foam and the reinforcement member are soluble in a lyophilizing solvent. The reinforcement may be annealed and/or coated.

Abstract: Compositions and methods are provided for treating joint conditions, such as osteoarthritis and/or the pain associated therewith. The compositions and methods utilize a first component, namely hyaluraonic acid (“HA”), in combination with a lyophilized second component that is effective to at least temporarily reduce the viscosity of the HA. In an exemplary embodiment, the second component is one or more glycosaminoglycans (“GAG”), such as chondroitin sulfate (“CS”), including CS4 and/or CS6, dermatan sulfate, heparin, heparan sulfate, and keratan sulfate.

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 suture anchor can also include at least a proximal portion having dual threads to facilitate engagement with bone. 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: A depth gauge and method provide for accurate measurement of a socket portion of a bone tunnel in an ACL reconstruction.

Abstract: Methods and device for extracting and collecting tissue, which can be used for example in tissue engineering and grafting applications, are disclosed. In one embodiment, a device can include an outer tube. A rotatable shaft can be disposed within the outer tube can have a tissue harvesting tip formed on its distal end, the tissue harvesting tip being effective to excise tissue upon rotation thereof. A tissue collection device can be included to receive and collected excised tissue, and the tissue collection device can indicate the amount of tissue collected therein. For example, the tissue collection device can include a straining element which collects excised tissue and an indicator by which to assess the amount of collected tissue. In some embodiments, the tissue collection device can translate to indicate the amount of collected tissue.

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: Devices, systems, and methods are provided for managing suture filaments when performing soft tissue repair. One exemplary embodiment of a surgical suture management device is in the form of a suture loop management card. The card can generally be configured to hold open a collapsible loop of suture until a force applied to the loop is greater than a threshold tension. The card can include a number of different features that help to keep the loop open until the threshold tension is achieved, including features designed to prevent the filament from being mistakenly offloaded. The card can be configured to be removably inserted into a handle of an inserter tool for use as a surgical tissue repair system. Other devices, systems, and methods for performing soft tissue repair are also provided.

Abstract: Devices and systems for use in soft tissue repair are provided, as are methods of manufacturing the same. In one exemplary embodiment, an implantable surgical construct includes an implant and a continuous braided closed filament loop that is attached to the implant. The continuous loop can be formed from a single strand of filament such that portions of the filament, sometimes referred to as tails, can be arranged with respect to each other to form a braided configuration. A related method of manufacture can involve passing portions of a single strand of filament around different sets of posts and selectively over and under each other to create the braided configuration. Other devices, systems, and methods of manufacturing are also provided, including some that involve using multiple strands of suture to form a continuous braided closed filament loop.

Abstract: Devices, systems, and methods are provided for gauging a bone tunnel. In one exemplary embodiment, a graft repair system can include an elongate pin, an elongate pusher shaft configured to be positioned over one opposed end of the pin when the pin is positioned within a bone tunnel, and a gauge member configured to be positioned over another opposed end of the pin when the pin is positioned within the bone tunnel. When the pusher shaft abuts the bone adjacent one of the open ends of the bone tunnel and the gauge member abuts the bone adjacent the other open end of the bone tunnel, an indicator mark on the pin can be visible through one or more windows formed in the gauge member. The indicator mark's position relative to each of the one or more windows can indicate one or more characteristics related to the bone tunnel.