Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: Reamer instruments and related methods are disclosed herein, e.g., for reaming bone to facilitate in situ assembly of a bone anchor. In some embodiments, the instrument can include a feedback mechanism configured to alert the user when sufficient bone has been removed to facilitate assembly of the bone anchor. The feedback mechanism can be triggered by a movable shaft of the instrument that is displaced by the shank portion of the bone anchor as the surrounding bone is reamed.

Abstract: Various bone anchor assemblies and methods are provided for anchoring tissue to bone. In one embodiment, an anchor assembly for anchoring a tendon to bone is provided and includes a substantially cylindrical sheath having bone-engaging surface features formed on an external surface thereof, and having an inner lumen formed therein and extending from an open proximal end to a substantially closed distal. The substantially closed distal end includes at least one tendon anchoring feature extending distally therefrom and configured to facilitate anchoring of a tendon to bone. The anchor assembly further includes an expander having a generally elongate cylindrical configuration and being sized and shaped to be received within the inner lumen of the sheath.

Abstract: A discectomy tool comprising: a) a cannula having an outer surface having a longitudinal bore therein, a proximal end and a distal end; b) a steering wire disposed in the longitudinal bore; c) a flexible, hollow transmission shaft disposed in the cannula, the shaft having a throughbore, a proximal end portion, a distal end portion and an outer surface having a thread extending therefrom; d) an irrigation source fluidly connected to the throughbore; e) a cutting tip attached to the distal end portion of the transmission shaft.

Abstract: Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough.

Abstract: Instruments and methods for selectively coupling to an object are provided, for example surgical instruments that can form a rigid connection with an object and also be disassembled for cleaning, sterilization, etc. One embodiment includes an elongate shaft with a longitudinal groove, a first partial circumferential groove that intersects with a distal end of the longitudinal groove, and a second at least partial circumferential groove formed distal to the first partial circumferential groove. The instrument also includes a sleeve disposed over the elongate shaft that includes a protrusion extending from an internal wall that is received within the longitudinal groove to constrain movement of the sleeve relative to the elongate shaft. The sleeve further includes a lock that interfaces with the second at least partial circumferential groove when the protrusion is disposed in the first partial circumferential groove to further selectively constrain axial and rotational movement of the sleeve.

Abstract: Implant connectors and related methods are disclosed herein. In some embodiments, a connector can include a low-profile portion to facilitate use of the connector in surgical applications where space is limited. In some embodiments, a connector can include a biased rod-pusher to allow the connector to “snap” onto a rod and/or to “drag” against the rod, e.g., for provisional positioning of the connector prior to locking.

Abstract: Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a surgical implant is provided having a sheath and an expander that is received within the sheath. Various delivery tools, including a sheath inserter and a driver, are also provided. In use, the sheath inserter can be used to position a tendon within a prepared bone hole, and it can be used to deliver the sheath with a guidewire coupled thereto into the bone hole. The driver can be provided for delivering the expander into the sheath. A loader can optionally be used to load the driver and expander onto the guidewire coupled to the implanted sheath.

Abstract: Systems, devices, and methods are provided for securing soft tissue to bone, for securing one or more objects using a surgical filament, and for drawing two or more tissues together so they can be secured in a desired location. One exemplary embodiment of a surgical repair construct that is configured to atraumatically pass through soft tissue to secure tissue in a knotless manner includes a snare linkage, a collapsible loop, and a flexible suture pin. The snare linkage can include a collapsible snare for receiving the collapsible loop, and in use the snare can be collapsed around the collapsible loop and advanced distally towards the bone until the snare is proximate to the tissue, while the collapsible loop can be collapsed distally towards the bone to bring the tissue into proximity with the bone. Other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Abstract: Surgical tissue retraction systems and methods are described herein. Such systems and methods can be employed in some embodiments to provide medial-lateral tissue retraction to increase access to a surgical site. In one embodiment, a surgical instrument can include a body configured to couple to an implantable anchor, a first tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto, and a second tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto. Further, the first and second tissue manipulating implements can be opposed to one another such that they can move any of toward and away from one another.

Abstract: Systems and methods for opposing abnormal motion of an adjacent bone are provided. One exemplary embodiment of a surgical method includes delivering and securing a bone barrier to a bone bed of a glenoid such that at least a portion of the bone barrier extends laterally beyond the bone bed and can oppose, prevent, and/or reduce abnormal motion of an adjacent bone (e.g., a humeral head). The bone barrier can be secured along a periphery of a glenoid of a shoulder. More particularly, the bone barrier can be placed and secured such that at least a portion of the bone barrier extends laterally over the glenoid and can oppose abnormal motion of the humeral head. In some embodiments at least one suture anchor and suture can secure the bone barrier to the bone bed.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: Devices and methods for reinforcing tissue grafts are described herein. In one embodiment, an implant is described that includes a proximal end portion having a through-hole formed therein, a distal end portion, and a reinforcing insert disposed in the through-hole. The insert includes a proximal face, a distal face opposed to the proximal face, a first upper surface extending between the proximal and distal faces and having a generally convex shape that abuts against at least a portion of a sidewall of the through-hole, and a second lower surface extending between the proximal and distal faces and having a generally concave shape. The second lower surface and portions of the sidewall of the through-hole not abutted by the first upper surface form a reinforced through-hole of the implant.

Abstract: A tissue repair construct having first and second implants coupled via a flexible element is provided. The flexible element forms an adjustable loop closed with a sliding knot, and has first and second free ends extending from the knot formed by wrapping the second end around the first end. The second implant can have a changeable configuration. The construct can be placed within a surgical site in a patient's body such that the first implant is passed into a bone adjacent to soft tissue and the second implant is disposed on an opposed side of the soft tissue. The first free end of the flexible element is configured to be tensioned to decrease a size of the loop and thereby change the configuration of the second implant and to thereby cause at least the second implant to move towards the first implant.

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: Devices, systems, and methods to improve both the reliability of soft tissue repair procedures and the speed at which the procedures are completed are provided. The devices and systems include one or more tissue augmentation constructs, which include constructs that are configured to increase a footprint across which suture applied force to tissue when the suture is tied down onto the tissue. The tissue augmentation constructs can be quickly and easily associated with the repair suture, and can be useful in many different tissue repair procedures that are disclosed in the application. In one exemplary embodiment, one or more constructs are disposed on a suture threader, which can be used to associate the construct(s) with a repair suture(s) being used to repair the soft tissue. Tissue augmentation constructs can include various blocks and patches, among other formations. Exemplary methods for manufacturing the tissue augmentation constructs are also provided.

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: Devices and methods for securing a graft with respect to bone are provided. One exemplary embodiment of a surgical implant includes a flexible filament body and a suture filament or repair construct that extends through the filament body at multiple locations. The repair construct is formed into one or more coils, which can receive a graft. The flexible filament body can be configured to be actuated between unstressed and anchoring configurations, the latter of which sets a location of the suture filament, and associated graft, in a bone tunnel. More particularly, the flexible filament body can ball up, or become denser, to a size that cannot pass into the bone tunnel in which the suture filament holding the graft is disposed. The present disclosure also provides for feedback units to assist a surgeon in knowing a location of the implant. Further, other exemplary devices and methods are provided.

Abstract: Methods and systems are provided for securing tissue to bone. A surgical system can include a driver having a proximal handle and a driver shaft extending therefrom, a distal awl shaft, a proximal awl shaft separate from the distal awl shaft and movable with respect to the distal awl shaft, a suture anchor, and a dilator feature distal to the suture anchor. The distal and proximal awl shafts are receivable in at least part of a lumen of the driver. In a bone forming configuration of the system, in which the distal awl shaft is driven into bone, a distal end of the proximal awl shaft abuts a proximal end of the distal awl shaft. The proximal awl shaft can be moved proximally, such as by activating an awl handle coupled thereto, with respect to the distal awl shaft to move the system in a suture anchor insertion configuration.