Abstract: According to the invention there is provided an intravascular catheter and thrombectomy procedure utilizing the catheter. The catheter comprises a flexible jacket with a distal working head having a canalizing tip rotatable at high speeds for removing thrombus from the lumen of a vessel. A flexible drive assembly extends through the jacket to rotate the tip and a plurality of infusion ports are formed adjacent the distal end of the jacket, capable of delivering a fluid contrast media at relatively high volumetric flow rates into the lumen of the vessel to locate the site of the thrombus. The canalizing tip is then rotated at high speed to homogenize and remove the thrombus from the lumen.

Abstract: According to the invention there is provided an intravascular catheter comprising an elongated flexible jacket having opposed proximal and distal ends and a central passageway extending between and interconnecting the ends. A rotating working head is located at the distal end of the jacket. A flexible drive cable extends through the passageway of the jacket, having a driving end operatively connected to the working head for rotating it, and a driven end operatively connected to a high-speed motor. The working head is rotatably mounted in a bearing sleeve which is further attached to the catheter jacket. The working head is actuated, by a actuator which adjust the a pair of tip portions from an at least initial retracted position with a first effective working diameter to an extended position with a second effective working diameter greater than the first effective diameter. Centrifugal forces generated by rotation of the cable cause the tip portions to assume the greater effective working diameter.

Abstract: According to the invention, there is provided a trial implant comprising a modular bracket defining a structure having an internal surface adapted to be seated on the distal aspect of a resected femur bone and an external surface with a shape resembling the normal distal condyle of the femur. The bracket has an elongated central opening appointed to expose the resected bone of the femur, including a pair of tracks for guiding a tool along a predetermined path for controlled shaping of a patellar groove in the bone exposed through the opening. An end mill guide cooperates with the bracket to receive another tool to form a deep recess for accommodating a posterior-stabilizing housing. After the recess is formed, the guide is replaced with an insert having a posterior-stabilizing housing which covers the opening of the bracket and articulates with a proximal aspect of the tibia during interoperative trial reduction of the knee joint.

Abstract: A surgical device for accurately positioning and cutting a patellar groove in a resected distal femur to receive a patellar track portion of a prosthesis, including a guide element adapted to fit over the distal end of a resected femur, having a central opening which exposes the central, distal an anterior aspects of the femur, each side of the opening being provided with a track, extending the length of the patella track, and, a cutting tool having a cutting surface, perferably convex, adapted to fit into the central opening for the purpose of cutting or abrading a groove into the femur as the tool is moved along the opening. The tool, which is preferably a rotary cutter provided with independently rotatable track-engaging surfaces on each side of the opening is adapted to engage and move along the track.

Abstract: The present invention relates to a distal femoral surface shaping guide for mounting on an intramedullary alignment which references the central long axis of the femur in shaping the distal femoral surface and a method for shaping the distal femur using that shaping guide with particular applicability for shaping one condyle for attachment of a unicondylar prosthesis. The alignment guide of the present invention is adjustable relative to the surface of the condyle to insure that the distal femoral condyle is resected relative to that surface. The alignment guide of the present invention utilizes visual sighting studs and provides a main body which remains attached to the intramedullary alignment guide throughout the entire shaping of the distal femur.

Abstract: The invention provides an improved prosthetic toe joint adapted for replacement of a human toe joint which includes at least one one-piece member for implantation into the bone of the joint. The implant has a concave articulating surface which articulates against another one-piece component having a mating convex surface or against a mating convex bone surface. This one part component is provided with a flexible hinge section at the junction of its stem and the enlarged head portions. The hinge section is formed from a section of the stem which extends laterally outwardly on both sides of the stem portion adjacent the junction with the head. The laterally enlarged section is provided with a longitudinal channel extending through its midsection to form a hinge. Each of the one-piece components is preferably molded of a flexible elastomeric, physiologically inert material, for example medical grade silicone rubber.

Abstract: A method of making a polymeric body having a porous surface by (a) applying a fluid polymeric composition to a mold surface of a leachable foam having open pores thereon, (b) curing the composition to form the polymeric body, and (c) leaching the foam from the polymeric body with a suitable solvent which does not dissolve the polymeric body. The method is especially suitable for making porous silicone elastomer bodies by using polystyrene foam as the mold material and the method is useful for forming hollow, porous-surfaced polymeric bodies, e.g. mammary and vascular prostheses.

Abstract: A tissue expander and a method for making a tissue expander which includes (a) a fluid-tight envelope which is inflatable by a single means for inflation and which has an expandable upper section formed of (i) a first elastic portion and (ii) a second elastic portion formed of a material having a lower modulus of elasticity than that of the material forming the first portion, so that during the inflation of said envelope the modulus of elasticity of each portion at least partially controls the amount of expansion of each portion, thereby allowing the envelope to assume a complex shape. The tissue expander also has a means for inflating the envelope with a biocompatible fluid.

Abstract: Described herein is an improved injection reservoir of the type which is employed to permit subcutaneous inflation of inflatable, implantable prostheses such as tissue expanders. The improved injection reservoir has a lozenge shape when viewed from above which permits this injection reservoir to be more easily inserted and removed subcutaneously. In a more preferred embodiment, the injection reservoir has a low profile shape such that its height is no more than forth percent of its width.

Abstract: This invention provides a multiple lumen implant in which the inner lumen is of a substantially spherical shape and is unattached or free-floating. The invention provides a construction which is able to provide and maintain a high projection and to simulate the natural flow of breast tissue during a variety of activities in which the patient may participate on a daily basis.

Abstract: A prosthetic shim and a method for use of prosthetic shims to provide level support and increase the effective thickness of a femoral knee joint component having at least one fixation peg extending from the face which is to seat against the distal end of a femur. The shim is for placement between the femoral component and the femur and comprises a platform having a first surface to cooperatively engage the joint component face and a second surface to engage the distal end of the femur. The shim preferably has a means for securing the shim in place, such as spikes extending from the second surface to be driven into the femur. The platform preferably is shaped and dimensioned to be effective if placed centrally relative to the joint component face, covers a majority of the joint component face, and has an opening corresponding to each peg of the joint component so that the shim can be placed over each peg.

Abstract: This invention relates to a femoral trial prosthesis/rasp assembly for use in hip implant surgery. The novel handle assembly grips the combination trial prosthesis/rasp in a secure manner by clamping over and locking onto a post on the trial prosthesis/rasp which later serves as a mounting piece for a femoral prosthesis head used in trial reductions. The handle assembly preferably comprises a straight member which has a recess for reception of one half of the post and a pivotable lever which contains an opposing recess which fits over the remainder of the post when a screw is tightened to bring the two recesses together over the post. The trial prosthesis/rasp is cooperatively engaged by a projection located at the end of the handle assembly to hold the trial prosthesis/rasp in a preselected orientation with respect to the handle assembly during use. The trial prosthesis/rasp is easily released from the handle by turning the screw to permit the lower portion of the straight member and lever to separate.

Abstract: There is disclosed a surgically implantable prosthetic joint implant adapted for length adjustment after initial surgery to compensate, for example, for growth of a juvenile patient. A stem for bone implantation has a flange for overlying the bone end and a threaded portion for adjusting axially with respect to an overlying sleeve which carries at its extremity an articulating component of the joint. A pin in the sleeve and elongated slot in the stem restrain relative rotation but allow axial relative movement as the stem is urged into or out of the sleeve by rotation of a nut coacting with the threads on the stem while being axially restrained by the sleeve. The nut is described as having a ring of gear teeth to be actuated by an insertable gear-carrying key. An alternative embodiment uses an accessible recessed bolt for moving the stem into or out of the sleeve.