Abstract: An endoscopic surgical instrument for passing a suture through tissue includes a first jaw member, a needle, and a capture feature actuable to grip and retain the suture after the suture has been passed through a tissue body. An actuation mechanism can both move the needle between retracted and extended positions, and move the capture feature between open and closed configurations, via a single actuation. The capture feature may be a trap door which is axially translatable relative to the first jaw member to overlap a portion of the first jaw member and trap a portion of the suture between the trap door and the overlapped portion. The first jaw member may be movable relative to a second jaw member to grasp a tissue body. The instrument can grasp a tissue body, pass the suture through the tissue, capture and retain the suture without being repositioned relative to the tissue.

Abstract: An endoscopic surgical instrument for passing a suture through tissue includes a first jaw member, a needle, and a capture feature actuable to grip and retain the suture after the suture has been passed through a tissue body. An actuation mechanism can both move the needle between retracted and extended positions, and move the capture feature between open and closed configurations, via a single actuation. The capture feature may be a trap door which is axially translatable relative to the first jaw member to overlap a portion of the first jaw member and trap a portion of the suture between the trap door and the overlapped portion. The first jaw member may be movable relative to a second jaw member to grasp a tissue body. The instrument can grasp a tissue body, pass the suture through the tissue, capture and retain the suture without being repositioned relative to the tissue.

Abstract: A milling system for use in resecting at least a portion of a joint articulation surface of a bone includes an alignment guide having a top surface and an opposing bottom surface with an opening extending therebetween. Fasteners are used to secure the alignment guide to the bone so that the alignment guide is suspended above the bone. A template is removably mounted to the alignment guide so that a plurality of guide paths extending through template are aligned with the opening in the alignment guide. A mill extends down through the guide path and has a burr on the end thereof for resecting the bone.

Abstract: A prosthesis for the replacement of at least a portion of the bone of a facet located on a mammalian vertebra, comprising: an articulating surface that articulates with another facet; a bone contacting surface that contacts a surface of the vertebra, the articulating surface being connected to the bone contacting surface; and a fixation element that attaches the bone contacting surface to the vertebra, the fixation element being adapted for implantation into an interior bone space of a pedicle of the vertebra; wherein the prosthesis is configured so that no portion of the prosthesis contacts the posterior arch of the vertebra.

Abstract: An implantable spinous process fixation device includes a first plate component having an elongated plate and front and back cross plates extending at right angle to the front and back of the elongated plate, respectively, a top pivoting plate and a bottom pivoting plate. The top and bottom pivoting plates are configured to pivot around an axis perpendicular to the front and back cross plates and the elongate plate has an inner surface facing an inner surface of the top pivoting plate and an inner surface of the bottom pivoting plate.

Abstract: A method is provided for depositing a hard wear resistant surface onto a porous or non-porous base material of a medical implant. The wear resistant surface of the medical implant device may be formed by a Laser Based Metal Deposition (LBMD) method such as Laser Engineered Net Shaping (LENS). The wear resistant surface may include a blend of multiple different biocompatible materials. Further, functionally graded layers of biocompatible materials may be used to form the wear resistant surface. Usage of a porous material for the base may promote bone ingrowth to allow the implant to fuse strongly with the bone of a host patient. The hard wear resistant surface provides device longevity, particularly when applied to bearing surfaces such as artificial joint bearing surfaces or a dental implant bearing surfaces.

Abstract: A graft ligament strand tensioner includes a frame member for slidingly retaining loops of sutures extending from graft ligament strands. The tensioner further includes a collar portion, and is provided with a handle having a core portion on which the collar portion is disposed for axial movement, and a grip portion. The tensioner still further includes a spherical member connected to the handle and having rounded surfaces facing the collar portion. The collar portion is tiltingly movable on the spherical member rounded surfaces when manipulation of the handle, to pull sutures on the frame member taut, causes the collar portion to engage the spherical member rounded surfaces. The sliding retention of the sutures and the tilting movement of the collar portion provide substantial equalization of tension in the sutures and thereby the graft ligament strands.

Abstract: Superior and/or inferior facets of one or more facet joints may be replaced by superior and/or inferior facet joint prostheses. In one embodiment, a kit of superior or inferior prostheses is provided, in which the prostheses have at least two dimensions that vary among members of the kit independently of each other. Each prosthesis may have a bone engaging surface having a surface that is polyaxially rotatable against a corresponding resection of a vertebra. Each prosthesis may also have an articulating surface shaped such that, after attachment to the spine, the replaced or partially replaced facet joints provide a larger medial-lateral range of motion when the spine is flexed than when the spine is extended. Crosslinks may be used to connect left and right prosthesis together in such a manner that they are stabilized in a position in which they are seated directly against the vertebra.

Abstract: An implantable spinous process fixation device includes a k-shaped component comprising an elongated plate and top and bottom deformable plates extending at first and second angles from a first surface of the elongated plate, respectively, thereby defining first and second spaces between the elongated plate and the top and bottom deformable plates and a compression element configured to compress and move the first and second deformable plates toward the elongated plate and to change the first and the second angles, respectively. The first and second spaces are configured to receive first and second spinous processes, respectively. Compressing and moving the first and second deformable plates toward the elongated plate results in engaging the first surface of the elongated plate and first surfaces of the top and bottom deformable plates with lateral surfaces of the first and second spinous processes, respectively.

Abstract: Modular bone implants, means of assembly, and their method of use are presented.

Abstract: An implantable spinous processes fixation device including a first S-shaped plate having a first surface configured to engage a first lateral surface of a first spinous process and a second surface configured to engage a second lateral surface of a second spinous process and a second S-shaped plate having a first surface configured to engage a second lateral surface of the first spinous process and a second surface configured to engage a first lateral surface of the second spinous process. The first and second S-shaped plates are configured to pivot around an axis perpendicular to the center portions of the first and second S-shaped plates.

Abstract: An implant for on a resected articulation surface of a bone includes a tray having a top surface and opposition surface. An opening extends completely through the tray between the top surface and the bone apposition surface. A bearing member is mounted on the top surface of the tray, the bearing member having a top articular surface. Anchor downwarly projects away from the bone apposition surface of the tray, the anchor being adapted to engage the bone and being configured so that the anchor can selective pass completely through the opening of the tray. A fastener connects the anchor to the tray.

Abstract: The present invention provides an intervertebral implant for replacing intervertebral disc material and controlling relative motion between adjacent vertebral bodies. The intervertebral implant may have at least one end plate and an intermediate component which slides into engagement with the end plate. The intermediate component may be engageable with the end plate from an anterior approach, or a right or left lateral approach. The intermediate component can be a set of bearing surfaces which articulate to provide relative motion between two vertebral bodies, an elastic insert which deforms to provide motion between two vertebral bodies, or a rigid insert which prevents relative motion between two vertebral bodies. The intermediate component is replaceable with a different intermediate component which provides a different function. The present invention also provides one or more retaining members which snap into engagement with the end plate and secure the intermediate component to the end plate.

Abstract: An implant system provides motion preservation or stabilization between two spinal vertebrae. An associated instrumentation system is capable of delivering and removing the implants from either the anterior, left lateral or right lateral positions. The instrumentation system also provides instrumentation for delivering the implant end plates into the disc space, adjusting the position of the end plates in situ, compressing end plates into the vertebral bodies, interoperatively determining the height and angulation of bearings, delivering bearings together and then independently connecting them to the end plates. The system provides alternative instrumentation for revising the motion preservation disc from at least three directions. The system further provides alternative instrumentation for converting the motion preservation disc system to an interbody fusion device from at least three directions.

Abstract: A revisable intervertebral implant may include two end plates designed to detachably receive a variety of intermediate components including articulating bearing inserts, elastic inserts, and fusion blocks. Each intermediate component may be secured to a snap insert that snaps into engagement with the corresponding end plate in response to pressure urging the intermediate component toward the end plate along a cephalad-caudal direction. The end plates may first be secured to the corresponding vertebral bodies, and then the intermediate component(s) may be snapped into locking engagement with the implanted end plates to complete in-situ assembly of the intervertebral implant. The implant may easily be revised by snapping the intermediate component(s) out of engagement with the end plates, removing the intermediate component(s), inserting the new intermediate component(s) into the space between the end plates, and snapping the new intermediate component(s) into engagement with the end plates.

Abstract: A milling system for use in resecting at least a portion of a joint articulation surface of a bone includes an alignment guide having a top surface and an opposing bottom surface with an opening extending therebetween. Fasteners are used to secure the alignment guide to the bone so that the alignment guide is suspended above the bone. A template is removably mounted to the alignment guide so that a plurality of guide paths extending through the template are aligned with the opening in the alignment guide. A mill extends down through the guide path and has a burr on the end thereof for resecting the bone.

Abstract: A milling system for use in resecting at least a portion of a joint articulation surface of a bone includes a template having a base with a top surface, an opposing bottom surface, and an opening extending therebetween. One or more fasteners are used to removably mount the template on a bone. A guide is movably mounted on the template and projecting across at least a portion of the opening of the template. The guide is selectively movable across at least a portion of the opening of the template. A rotatable mill is mounted on the guide. The mill is selectively movable along at least a portion of the length of the guide.

Abstract: A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.

Abstract: Apparatus and method for reconstructing a ligament.

Abstract: An orthopedic fastener is designed to attach an implant to bone in such a manner that, until the fastener is tightened, the implant may be rotationally adjusted against the bone. The implant may have a semispherical bone apposition surface that permits polyaxial rotation of the implant against the bone. The orthopedic fastener has an interpositional member and a compression member. The interpositional member may be a split ring with a conical exterior surface that mates with a conical surface of the implant. The compression member has a threaded bore that engages a proximal end of a fixation member implanted in the bone such that, in response to rotation of the compression member, the interpositional member is sandwiched securely between the implant and the compression member. The conical surface of the implant compresses the interpositional member about a semispherical surface of the compression member, thereby restricting rotation of the implant.