Abstract: Meniscal repair devices, systems, and methods are provided.

Abstract: Devices and methods for fixating a graft tendon in a bone tunnel for a ligament reconstruction or repair procedure are provided. In general, the described implantable tissue fixation device includes first and second elongate, substantially rigid support members that are discrete elements separated from each other, and at least one flexible member connecting the rigid support members. The tissue fixation device can have changeable dimensions such that it has at least one dimension that is smaller in a delivery configuration than in a deployed configuration. In both delivery and deployed configurations, the first and second rigid support members are positioned in a non-intersecting orientation with respect to one another. A graft retention loop coupled to the tissue fixation device has the graft tendon coupled thereto and extending into the bone tunnel so as affix the graft into the bone.

Abstract: Various devices, systems, and methods for anchoring sutures are provided In general, a suture anchor can include a groove formed in an exterior surface thereof and configured to seat a suture at least partially therein. The suture can be configured to automatically become seated in the groove during the advancement of the anchor into bone, such as by being rotated therein using a driver tool. The suture and the groove can have cooperating sizes such that the suture seated in the groove extends radially outward therefrom to be partially located outside of the anchor. This external portion of the suture can be press fit between the anchor and the bone, thereby securing both the anchor and the suture to the bone. This securing can occur as part of driving the anchor into bone.

Abstract: Instruments and methods for harvesting a tissue structure such that a tendon graft are provided. In general, the surgical instrument includes an elongate shaft and an end effector pivotally coupled to a distal end thereof. The end effector defines a tissue seating passage configured to seat therethrough a portion of the tendon when the end effector is in use. The end effector is configured to be manipulated such that either its first or second end is positioned as a leading end. A method for using the end effector to harvest a tendon includes using the end effector to strip and cut the tendon at one end thereof when the first end of the end effector is a leading end, manipulating the end effector such that its second end becomes the leading end, and using the end effector to strip and cut the tendon at another, opposite end thereof.

Abstract: Methods and devices are provided for implanting a cross-pin through a bone tunnel, such as in an arthroscopic surgical procedure. In general, the methods and devices allow a cross-pin hole to be formed in a medial side of a knee bone such that it intersects a bone tunnel formed in the knee bone. In one embodiment, a cross-pinning guide device is provided that can be configured to angularly position the cross-pin hole relative to the bone tunnel to allow the cross-pin hole to intersect the bone tunnel without passing through another side, e.g., a lateral side, of the knee bone. The knee bone can be a femur or a tibia such that the cross-pin hole and the bone tunnel can each be entirely formed in the femur or in the tibia.

Abstract: Meniscal repair devices, systems, and methods are provided.

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: Meniscal repair devices, systems, and methods are provided.

Abstract: Various devices, systems, and methods for anchoring sutures are provided In general, a suture anchor can include a groove formed in an exterior surface thereof and configured to seat a suture at least partially therein. The suture can be configured to automatically become seated in the groove during the advancement of the anchor into bone, such as by being rotated therein using a driver tool. The suture and the groove can have cooperating sizes such that the suture seated in the groove extends radially outward therefrom to be partially located outside of the anchor. This external portion of the suture can be press fit between the anchor and the bone, thereby securing both the anchor and the suture to the bone. This securing can occur as part of driving the anchor into bone.

Abstract: Devices and methods for tissue and graft procedures are provided that are designed to fail under a certain amount of force, providing sensory feedback that a particular activity may be providing too much stress on a surgical implant. For example, a surgical implant can include a sacrificial element in the form of a filament designed to break when a certain threshold value of force is met or exceeded, while a second filament that has the ability to withstand higher values of force, is able to maintain the repair after the first filament fails. In other embodiments, the sacrificial element includes a filament engagement mechanism associated with a suture anchor configured to fail at a threshold value of force, and a second filament engagement mechanism of the anchor can maintain the repair after the first one fails. Many implants configurations are provided, as are various surgical methods incorporating sacrificial elements.

Abstract: Instruments and methods for harvesting a tissue structure such that a tendon graft are provided. In general, the surgical instrument includes an elongate shaft and an end effector pivotally coupled to a distal end thereof. The end effector defines a tissue seating passage configured to seat therethrough a portion of the tendon when the end effector is in use. The end effector is configured to be manipulated such that either its first or second end is positioned as a leading end. A method for using the end effector to harvest a tendon includes using the end effector to strip and cut the tendon at one end thereof when the first end of the end effector is a leading end, manipulating the end effector such that its second end becomes the leading end, and using the end effector to strip and cut the tendon at another, opposite end thereof.

Abstract: A tissue fixation system provides a primary fixation plate with a depending graft retention loop and a longer auxiliary fixation plate which fits to the primary fixation plate via upwardly projecting pegs which fit into suture holes in the primary fixation plate. The system has particular utility in cortical fixation procedures in which a graft channel is over-drilled and a longer fixation plate is indicated.

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: Meniscal repair devices, systems, and methods are provided.

Abstract: A suture anchor assembly includes a main suture strand, a plurality of suture arms, and a plurality of suture anchor elements connected to the main suture strand by a suture arm. The suture anchor elements are configured to rest against a cortex of a bone to provide an anchor when they are in a deployed configuration. The suture anchor assemblies can be employed in place of or in addition to traditional suture anchors. The assemblies, kits, and methods described herein can be utilized in a variety of procedures and locations in the body where anchoring a graft or tissue adjacent a bone is desired, including, for example, rotator cuff repair and ligament (e.g., the anterior cruciate ligament or ACL) reconstruction and/or repair.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose on a first portion of at least a first limb and has a second portion connected to the filament engagement feature of the anchor. Preferably, at least one free filament limb, which in some embodiments is a length of the first filament and in other embodiments is a second filament, is capable of being passed through tissue to be repaired and has at least one end passable through the noose to enable incremental tensioning of the tissue after the anchor is fixated in bone. The noose strangulates the free filament limb when tension is applied to at least one of the free filament limb and the noose.

Abstract: Various methods and devices are provided for use of a cannula. For example, provided herein is a flexible cannula having an elongate body with an elongate shaft extending between a proximal hub and a distal dam. A lumen can extend through the cannula. The dam is in the form of a flexible annular member formed on a distal end of the shaft. The dam and the hub have diameters greater than a diameter of the shaft. A flexible, expandable sleeve is removably positioned on the distal end of the shaft of the cannula. The sleeve deformably encapsulates the dam such that the dam is folded against the shaft of the cannula. An obturator is also provided having an elongate shaft configured to be removably positioned within the lumen of the cannula. The shaft can be configured to fit within the lumen in a clearance fit.

Abstract: Meniscal repair devices, systems, and methods are provided.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose on a first portion of at least a first limb and has a second portion connected to the filament engagement feature of the anchor. Preferably, at least one free filament limb, which in some embodiments is a length of the first filament and in other embodiments is a second filament, is capable of being passed through tissue to be repaired and has at least one end passable through the noose to enable incremental tensioning of the tissue after the anchor is fixated in bone. The noose strangulates the free filament limb when tension is applied to at least one of the free filament limb and the noose.

Abstract: A suture anchor assembly includes a main suture strand, a plurality of suture arms, and a plurality of suture anchor elements connected to the main suture strand by a suture arm. The suture anchor elements are configured to rest against a cortex of a bone to provide an anchor when they are in a deployed configuration. The suture anchor assemblies can be employed in place of or in addition to traditional suture anchors. The assemblies, kits, and methods described herein can be utilized in a variety of procedures and locations in the body where anchoring a graft or tissue adjacent a bone is desired, including, for example, rotator cuff repair and ligament (e.g., the anterior cruciate ligament or ACL) reconstruction and/or repair.