Abstract: A swivel adapter (26) has a base (60) with an outward facing first side (57) and a pivot surface (55) extending from the first side. A Center adapter (52) is mounted for pivoting motion on the pivot surface and has an outward facing first device connector (46). A clamp (78) has a clamp operator (80) operable to clamp the center adapter on the pivot surface at a desired orientation with respect to the base. A base unit handle (34) has a clamping mechanism (128, 138, 156, 164) connected to a body (120) having two split bores (36, 122), which is operable to clamp and unclamp the split bores on respective shafts. The clamping mechanism has linkage (138, 156) connected to a closing handle (164) to provide a mechanical advantage to the handle during the clamping action.

Abstract: Ankle implant systems and methods are provided that can allow a surgeon to select the type of prosthesis desired during an ankle surgical operation. The surgeon can implant a set of standardized fixation components into the tibia and/or fibula bones and the talus bone. Once implanted, the surgeon can select a bearing component from a number of bearing components that allow for different size patients, but also modify the manner in which the prosthesis functions (either semiconstrained or unconstrained). In one embodiment, an ankle implant can include a talar component having a lower surface with a bone fixation portion for fixation to a talus bone. A tibial component has an upper surface with a bone fixation portion for fixation of the tibial component to a tibia bone and/or a fibula bone, and the tibial component also has a lower surface with at least one protrusion extending from the lower surface.

Abstract: Prosthetic wrist implants and methods are provided. The prosthetic wrist implant includes a radial component including a base member having an upper bearing surface and a lower surface having an elongated radial stem for fixation to a radius bone. The elongated radial stem can be in an off-center position in relation to a center of the lower surface. A carpal component is also provided including a substantially planar base member having an upper surface and a lower surface with at least one socket protrusion extending therefrom, and may further included an elongated carpal post member for fixation to one or more carpal bones. An articulating bearing component for placement between the radial and carpal components is provided and includes an upper surface defining at least one socket recess and a lower bearing surface for cooperative engagement with the upper bearing surface of the radial component.

Abstract: This invention relates to a flowable collagen/glycosaminoglycan (GAG) material including particles of collagen/GAG matrix that, when hydrated, can be effectively delivered to wounds having varying depths and geometries. The flowable collagen/GAG matrix allows a more intimate contact between the wound matrix and the wound bed, and provides a structural framework that serves as a scaffold for cell ingrowth.

Abstract: A system and method are disclosed for automatically limiting the drainage of a bodily fluid such as cerebrospinal fluid (CSF) from a patient into a collection chamber. The collection chamber includes a vent having an hydrophobic filter for the passage of air to facilitate the movement of CSF yet to maintain a closed system. The system includes a buoyant float hingedly connected with the top of the collection chamber in one embodiment. When fluid rises in the collection chamber to a predetermined volume, buoyant force raises the float and causes a seal plug mounted on top of the float to seal one of an inflow port or a vent port. The float is limited to pivoting movement in one plane and to a certain angle within that plane. The system and method avoid overdrainage of CSF from the patient and overfilling of the collection chamber.

Abstract: A skull pin assembly for use with a skull clamp includes a skull pin that is slidable into contact with a head of a patient. A pin load applicator is removably connectable to the skull pin assembly and includes a loading shaft that is able to apply a force against an inner end of the skull pin. The pin load applicator also has a biasing element operable to apply a force on the loading shaft that, in turn, transfers the force to the skull pin. A load force indicator is connected to the loading shaft and provides an indication of the force being applied by the skull pin. The pin load applicator permits the force being applied by the skull pin to be adjusted to a desired value; and thereafter, the pin load applicator is removed from the skull pin assembly without changing the desired skull pin force.

Abstract: An improved neurosurgical sponge contains less than 0.45 EU/cm3 of bacterial endotoxins. A neurosurgical kit includes a plurality of sponges in a container, wherein the plurality of sponges contains less than 2.15 EU. Methods of producing the surgical sponge and using the surgical sponge in a surgical method are described. Rayon containing less than 0.45 EU of bacterial endotoxins per cm3 of rayon is also described.

Abstract: A matrix for tissue growth includes: (a) a first layer including a first assembly of collagen fibers; (b) a plurality of projections on a top surface of the first layer; and (c) a second layer bonded to a bottom portion of the first layer and including a second assembly of collagen fibers, wherein the second layer has a lower density than the first layer, and the matrix includes pores effective to support cell growth into the matrix. A method for providing the matrix is also described.

Abstract: A radiolucent halo-type retractor (20) having a radiolucent curvilinear fixed member (32) connected to a radiolucent curvilinear movable member (34). Each of the fixed and movable members has a radiolucent male coupling (44, 46) projecting outward from a convex surface (40, 42) to receive a female coupling of a retractor arm. The ends (60, 68) of the movable member are separated by a distance less than a distance separating the ends (56, 64) of the fixed member. Radiolucent starburst connectors (58, 62) are disposed on first ends of the fixed and movable members to secure the fixed and movable members at a desired angular orientation. Radiolucent starburst connectors (66, 70) are also disposed on second ends of the fixed and movable members to secure the fixed and movable members at a desired angular orientation. A pin (72) rotatably connects the first ends. A locking shaft (76) rotatably connects the second ends and is operable to lock the fixed and movable members in a desired orientation.

Abstract: Provided is a multi-lumen intrathecal catheter capable of use for circulating a fluid through a portion of the spinal cord of a patient and having an insertable portion adapted for insertion into the spinal cord, comprising: a first lumen having a distal and a proximal end, the proximal end being adapted to being connected to a reservoir containing a fluid; a first fluid exchange section connected to the distal end of the first lumen having at least one inlet; a second lumen having a distal and a proximal end; and a second fluid exchange section connected to the distal and of the second lumen having at least one outlet, wherein at least one inlet and at least one outlet are offset from each other.

Abstract: Methods and systems for lowering elevated intracranial pressure utilizing a fluid drainage controller which regulates the drainage of cerebral spinal fluid based on a cardiac or other transient component of the patient's intracranial pressure. The cardiac component of the intracranial pressure increases as the accumulation of cerebral spinal fluid in the patient's subarachnoid space increases, but is not directly a function of the absolute mean or baseline intracranial pressure. Thus, control based on the cardiac component is relatively independent of patient position and the risk of over or under draining the cerebral spinal fluid is lessened.

Abstract: A method treats a patient for adult-onset dementia of the Alzheimer's type by removing a portion of the patient's cerebrospinal fluid, preferably (although not necessarily) by transporting the fluid to another portion of the patient's body. An apparatus for removing cerebrospinal fluid includes (1) a conduit with a first opening and a second opening, the first opening of the conduit being disposed in fluid communication with a space within a patient's subarachnoid space, the second opening being disposed in fluid communication with another portion of the patient's body; and (2) a flow rate control device attached to the conduit.

Abstract: Compositions of cross-linked collagen and a glycosaminoglycan are provided which retain characteristics rendering them useful as tissue engineering matrices or scaffolds following terminal sterilization. Also provided are methods for producing these compositions and terminally sterilized matrices or scaffolds from these compositions as well as methods of using these matrices or scaffolds as tissue engineering devices.

Abstract: A process for selectively modifying pendent functionalities of a polymer containing the pendent functionalities and hydrolytically unstable backbone functionalities is provided. The process includes: (a) providing the polymer in a solvent system (preferably an ether-containing solvent system) adapted to maintain the polymer in a dissolved or partially dissolved state, wherein the pendent functionalities of the polymer are more accessible than the hydrolytically unstable backbone functionalities; and (b) adding at least one additive to the solvent system to selectively modify at least one of the pendent functionalities. The process is especially well suited for specifically acid hydrolyzing pendent esters of PDTE.

Abstract: A process for selectively modifying pendent functionalities of a polymer containing the pendent functionalities and hydrolytically unstable backbone functionalities is provided. The process includes: (a) providing the polymer in a solvent system (preferably an ether-containing solvent system) adapted to maintain the polymer in a dissolved or partially dissolved state, wherein the pendent functionalities of the polymer are more accessible than the hydrolytically unstable backbone functionalities; and (b) adding at least one additive to the solvent system to selectively modify at least one of the pendent functionalities. The process is especially well suited for specifically acid hydrolyzing pendent esters of PDTE.

Abstract: Provided is, among other things, a method of treating in an animal infection or neoplasm of cerebrospinal tissue characterized by a risk of death, the method comprising: (a) injecting a physiologically acceptable fluid for cerebrospinal perfusion into a first catheter into the cerebrospinal pathway, which fluid for cerebrospinal perfusion has an therapeutically effective amount an agent, the agent selected for effectiveness against the infection as identified or diagnosed; (b) withdrawing fluid at a second catheter into the cerebrospinal pathway to create a flow and flow pathway between the first and second catheters; and (c) maintaining the flow for a period of time adapted to perfuse at least 1 CSF volume.

Abstract: Dural substitutes are provided, which include collagen treated and/or prepared to be physiologically compatible and substantially free of active viruses and prions. Suitable forms for the dural substitutes include a sponge, a film, a non-woven matrix, a felt or a combination of at least two of the foregoing forms. Also provided are a method for preparing dural substitutes and a method for promoting meningeal tissue growth.

Abstract: A porous particle having a generally isopycnic density with liquid growth medium, a sponge-like character and a diameter of less than 2 mm which is formed from a homogenous biologically compatible matrix is described. This particle is useful in various systems for culturing anchorage-dependent and -independent cells, and is adaptable to large scale tissue culture which permits harvesting of cell products. The method of making such a particle includes preparing a solution containing a biologically compatible material, forming droplets from the solution, freezing the droplets, drying the droplets by sublimation to form a particle, and crosslinking the biologically compatible material in the particle.

Abstract: The present invention relates to a method of skin regeneration of a wound or burn in an animal or human. This method comprises the steps of initially covering the wound with a collagen glycosaminoglycan matrix, allowing infiltration of the grafted GC matrix by mesenchymal cells and blood vessels from healthy underlying tissue and applying a cultured epithelial autograft sheet grown from epidermal cells taken from the animal or human at a wound free site on the animal's or human's body surface. The resulting graft has excellent take rates and has the appearance, growth, maturation and differentiation of normal skin.