Abstract: An intervertebral disc device is provided comprising a distal probe sized to be extended from a distal end of an introducer that is percutaneously delivered into an interior of an intervertebral disc, a distal section of the probe comprising a flexible neck which tapers in a proximal to distal direction, and a distal tip which is larger in cross sectional diameter than the flexible neck adjacent the distal tip, the flexible neck and distal tip serving to prevent the probe distal end from piercing an internal wall of the intervertebral disc; and a proximal handle for externally guiding the probe within an intervertebral disc.

Abstract: An intervertebral disc device is provided comprising a probe capable of being extended from a distal end of an introducer that is percutaneously delivered into an interior of an intervertebral disc, the probe forming a loop when extended from the distal end of the introducer, the loop having first and second proximal ends external to the introducer which are brought together adjacent the introducer distal end to form the loop by the proximal ends being either attached to or entering the distal end of the introducer; and a proximal handle for externally causing the probe to be extended from the distal end of the introducer and externally guiding the probe within an intervertebral disc.

Abstract: An electrosurgical instrument is provided which includes a holding formation, a probe shaft, an electric conductor, and a probe tip. The probe shaft is secured to the holding formation and has an elongated section extending therefrom. The electric conductor extends along the elongated section. The probe tip is located on a distal end of the probe shaft opposing the holding formation. The probe tip defines a volatization chamber with a mouth out of the probe tip. The probe tip includes an electrode, to which RF current is provided through the electric conductor. The electrode heats an area adjacent to the probe tip. The electrode also heats a liquid in the first volatization chamber to evaporate the liquid into a vapor pocket that ejects from the first volatization chamber through the mouth out of the probe tip. A pump effect is created so that the liquid maintains the probe tip at a more stable temperature.

Abstract: An apparatus for treating disrupted articular cartilage comprising an elongate probe member having proximal and distal extremities and a handle coupled to the proximal extremity of the elongate probe member. The distal extremity has a peripheral wall defining a cavity and a distal opening communicating with the cavity. A controllable environment is created within the cavity when the distal extremity is placed substantially flush against the disrupted articular cartilage. An electrode is positioned within the cavity at a distance spaced inwardly of the distal opening. The disrupted articular cartilage is sealed to form a substantially continuous surface when energy is supplied to the electrode. A method of using the apparatus is provided.

Abstract: An intervertebral disc device is provided comprising a distal probe sized to be extended from a distal end of an introducer that is percutaneously delivered into an interior of an intervertebral disc, a distal section of the probe comprising a flexible neck which tapers in a proximal to distal direction, and a distal tip which is larger in cross sectional diameter than the flexible neck adjacent the distal tip, the flexible neck and distal tip serving to prevent the probe distal end from piercing an internal wall of the intervertebral disc; and a proximal handle for externally guiding the probe within an intervertebral disc.

Abstract: A surgical instrument comprising a handle and an elongated probe connected to the handle. The elongated probe has a terminus distal to the handle. At least one electrode that includes an electrode surface is positioned on the terminus so that a line from a geometric center of the electrode surface and substantially perpendicular to the electrode surface intersects at an angle a longitudinal axis formed by the elongated probe. A conductor is provided for attaching the at least one electrode to the handle.

Abstract: An intervertebral disc device is provided comprising a distal sheath sized to be extended from a distal end of an introducer that is percutaneously delivered into an interior of an intervertebral disc, a distal section of the sheath being predisposed to adopting a bent configuration when extended from the introducer; a probe adapted to be extended from a distal end of the sheath, the bent section of the sheath causing the probe to adopt a same bent configuration; and a proximal handle for externally guiding the probe within an intervertebral disc.

Abstract: A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus.

Abstract: A method for treating tissue having a surface in an arthroscopic environment of a mammalian body having a body temperature with a probe having a proximal end and an electrode at a distal end. The method includes the steps of providing a warmed irrigating solution having a temperature approximating the body temperature, delivering the warmed irrigating solution into the arthroscopic environment, introducing the distal extremity of the probe into the arthroscopic environment, positioning the electrode adjacent the surface of the tissue and supplying thermal energy to the electrode so as to treat the tissue. The warmed irrigating solution inhibits undesirable heating below the surface of the tissue.

Abstract: A liquid medicament dispenser for controlled infusion delivery of liquid medication to a patient. The dispenser includes an elastomeric bladder for housing the liquid medication, an inlet in communication with the bladder for receiving the liquid medication into the bladder, and an outlet in communication with the bladder for discharging the liquid medication into an infusion tube for delivering the liquid medication to the patient. A flow regulator for controlling flow rate of the liquid medication through the infusion tube includes a flow rate adjuster with a manually operable adjuster knob for setting flow rate and an encasement housing releasably securable about the adjuster knob for impeding access to the adjuster once the proper rate has been set.

Abstract: A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus.

Abstract: A thermal energy delivery apparatus has a probe including a distal end and a proximal end. A first electrode is positioned at the distal end of the probe. The first electrode is configured to deliver sufficient thermal energy to a fibrillated cartilage surface to reduce a level of fibrillation of the fibrillated cartilage surface. A cabling is coupled to the proximal end of the probe. A method for thermal protection of non-targeted tissues that may be exposed to thermal probes used during arthroscopic procedures includes a pre-procedural cooling Lavage. The pre-cooled tissues provide a convective buffer for tissues not intended for thermal intervention, thereby reducing collateral damage.

Abstract: A thermal energy controller system useful in medical procedures includes a controller coupled to a probe, and a thermal element to vary probe temperature. The controller includes memory storing a non-continuous algorithm that permits user-selectable settings for various probe types such that controller operation is self-modifying in response to the selected probe setting. Probe output power Pout is constant in one mode to rapidly enable probe temperature to come within a threshold of a target temperature. The controller can then vary Pout dynamically using a proportional-integral-derivative (PID) algorithm Pout=Kp·P+Ki·I+Kd·D, where feedback loop coefficients Kp, Ki, Kd can vary dynamically depending upon magnitude of an error function e(t) representing the difference between a user-set desired target temperature and sensed probe temperature.

Abstract: A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus.

Abstract: An electrosurgical probe is provided to vaporize, cut, coagulate or remove tissue from a body structure. A method of surgically treating a mammal includes providing a surgical instrument including a length of shaft and an active electrode having a curved current density edge with at least one convex surface; and ablating a tissue surface with said surgical instrument.

Abstract: Systems and methods are described for treating osteochondral pathologies. An implantable prosthesis for treating osteochondral pathologies includes: a porous substrate; and a substance positioned within the porous substrate that is elutable with regard to the porous substrate. The systems and methods provide advantages because a baited route is provided to attract mesenchymal stem cells from the cancellous bone underlying the articular surfaces up to chondral lesions within the joint, thereby promoting the growth of chondrocytes in the area of the chondral lesions.

Abstract: An apparatus and method are provided for control contraction of tissue that includes collagen fibers. The apparatus includes a handpiece, and an electrode with an electrode proximal end associated with the handpiece. A distal end of the electrode has a geometry that delivers a controlled amount of energy to the tissue for a desired contraction of the collagen fibers. This is achieved while dissociation and breakdown of the collagen fibers is minimized. The handpiece, with electrode, is adapted to be introduced through an operating cannula in percutaneous applications. Additionally, an operating cannula may be included in the apparatus and be attached to the handpiece. The apparatus and method provides for a desired level of contraction of collagen soft tissue without dissociation or breakdown of collagen fibers.

Abstract: An orthopedic apparatus, for effecting a change in ligaments, joint capsules and connective tissue through the controlled contraction of collagen fibers, includes a trocar. The trocar has a trocar elongated body with a trocar longitudinal axis, a trocar distal end that is laterally deflectable relative to the trocar longitudinal axis, and a trocar proximal end. An electrode is positioned at the trocar distal end. The electrode delivers substantially uniform energy across an energy delivery surface of the electrode. The energy delivery surface is positioned next to an area of collagen fibers to cause a controlled amount of contraction of the collagen fibers while minimizing dissociation and breakdown of the collagen fibers. A handle is positioned at the proximal end of the trocar. The handle includes an actuating member and a locking member.

Abstract: An electrosurgical probe is provided to vaporize, cut, coagulate or remove tissue from a body structure. A method of surgically treating a mammal includes providing a surgical instrument including a length of shaft and an active electrode having a curved current density edge with at least one convex surface; and ablating a tissue surface with said surgical instrument.

Abstract: Systems and methods are described for treating osteochondral pathologies. An implantable prosthesis for treating osteochondral pathologies includes: a porous substrate; and a substance positioned within the porous substrate that is elutable with regard to the porous substrate. The systems and methods provide advantages because a baited route is provided to attract mesenchymal stem cells from the cancellous bone underlying the articular surfaces up to chondral lesions within the joint, thereby promoting the growth of chondrocytes in the area of the chondral lesions.