Abstract: Systems and methods for repairing tears in soft tissue, e.g., meniscal tissue, by employing cinch stitching. More specifically, the present invention provides apparatus and methods for meniscal repair using a suture implant construct. The suture implant construct includes a first and second implant which are connected to each other via a length of suture. The implants are designed to be loaded on external surfaces of the first and second trocars.

Abstract: A device for tensioning suture which includes a cannulated tube that allows a suture to be fed through at least a portion of the tube. An adjustment device (for example, a wheel or a knob) is actuated to turn a threaded post on the end of the tube. A length of suture passes through at least a portion of the cannulated tube and is secured into a forked pin attached to the adjustment device. Turning the adjustment device draws against the suture, increasing therefore the tension on the suture. The suture tensioning device may be employed in conjunction with a tensiometer.

Abstract: Instruments and methods that allow for a minimally invasive way to harvest a tissue graft which has been typically done as a full open procedure. The instrument is a hybrid stripper/cutter device provided with both stripping and cutting blades/mechanisms that allow stripping and cutting of the tissue graft with the same hybrid instrument. The present invention also provides a minimally invasive technique for stripping and cutting (resecting) a tissue graft by employing a single, hybrid stripper/cutter instrument. The technique provides a consistently good-quality graft with improved cosmetic results, and is simple and easily reproducible.

Abstract: Surgical constructs and methods for tissue to bone repair employing a tissue construct reinforced with a reinforcement (reinforcing) material such as suture, tape, weave or mesh, among many others. The reinforced construct preferably includes a stitched reinforced region formed by employing a suture loop construct with a free floating needle that is attached to the suture loop, and also with a piece of material (a reinforcement or reinforcing material) attached to the suture loop. The reinforced construct may be attached to any fixation device and/or any bone tunnel.

Abstract: Techniques and reconstruction systems for fixation of bone to bone, or soft tissue to bone, that allow a double-bundle type construct with only three tunnels, a single graft and individual tensioning in each of the three tunnels. Alternative double-bundle ACL/PCL fixation techniques are provided that employ a double-bundle type construct with only a single graft and three tunnels/sockets. The double-bundle ACL and PCL techniques and constructs allow individual tensioning of each of the bundles (e.g., tensioning of each of the anteromedial (AM) and posterolateral (PL) bundles of the ACL) and eliminate the need for additional fixation devices (for example, interference screws) to secure the bundles within the bone tunnels/sockets.

Abstract: Methods and apparatus for arthroscopically-assisted preparation of the tibia to accept an unicompartmental implant that includes the step of removing bone from the tibial plateau to correct depth, diameter and proper angle by employing a tibial rasp comprising a cutter with a plurality of teeth on the bottom surface and a side surface (for example, the front side). The tibial rasp may be used in conjunction with an additional starter rasp that can cut only in one direction (for example, cutting to establish only the depth of the tunnel or socket).

Abstract: Techniques and reconstruction systems for ACL repair by providing cross-pin fixation of a graft within a tibial tunnel. The invention provides tibial fixation techniques according to which cross-pin fixation of a graft (for example, an Anterior Tibialis allograft) is achieved on the tibial side, close to the jointline, by a single incision and with cortical fixation.

Abstract: A specialized obturator that has a curved configuration designed specifically for entry through the anterior joint and out the back of the knee in the ideal position for a posterior portal. The curved obturator is shaped to avoid intact knee ligaments and femoral condyles. The obturator is provided with an eyelet located at the tip and may be employed with a cannula similar to a PassPort™ Button cannula, but with one or more sutures placed through the “neck” behind the collar. A standard “inside-out” cannula may be used as well, but dimensioned for the specialized obturator.

Abstract: An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Abstract: An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Abstract: An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

Abstract: A three-dimensional mesh or screen in the shape of a simple flat piece of material that can be provided adjacent the graft (i.e., in between graft bundles, or around the graft, or between the graft and the fixation device) for improved strength and structural support for graft fixation. The mesh provides improved methods for installing and securing ligament grafts (such as double-bundle cruciate ligament grafts) with enhanced reconstruction results.

Abstract: An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

Abstract: An adjustable button/loop device for securing biologic material in bone, such as for ACL reconstruction. The device has a pair of button/loop constructs, each including a flexible, adjustable loop integrated with a fixation device (for example, a wedge). Biologic material (for example, soft tissue, graft, ligament or tendon) is secured to the two fixation devices, and the construct is inserted into a pair of bone sockets/tunnels, such as into a tunnel in the tibia and a socket in the femur. The biologic material is secured within the bone by passing the buttons though respective bone sockets/tunnels, flipping and seating the buttons outside the bone, and then adjusting the lengths of the flexible adjustable loops passing through the buttons and the respective fixation devices, with the graft extending between the fixation devices thereby appropriately secured in the bone.

Abstract: Systems and methods for bone to bone, or soft tissue to bone, repairs without knot tying. The repair systems include self-cinching constructs which are tensionable and which include a flexible strand with a knotless, adjustable loop with at least one splice and a shuttle/pull device attached to the flexible strand. A final splice is formed by pulling on the shuttle/pull device subsequent to the knotless, adjustable loop being assembled with or secured to tissue (for example, a soft tissue graft or BTB graft), to allow desired tensioning of the graft to be fixated relative to the bone.

Abstract: A continuous loop and button construct and technique for ligament repair and fixation, including bone to bone, or soft tissue to bone. The continuous loop, which is attached to the button, is formed of a flexible material and is provided with at least one joined region (a bridged, stitched, bonded or knotted region) to form a closed loop figure-8 construct with proximal and distal openings with respect to the fixation device. The figure-8 construct (either bridged, stitched, bonded or knotted) is adapted for attachment to a bone block of a BTB graft, for example, and used for ligament reconstruction.

Abstract: An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Abstract: A method and apparatus for arthroscopic unicompartmental knee surgery which include a femoral component and a tibial component. The femoral component is installed in a trough in the femoral condyle formed by using a template, a plurality of drill pins and a plurality of corresponding cutters. The template is aligned with the curvature of the femoral condyle, the two drill pins are passed through the template and drilled into the femur, cutters are advanced over the corresponding drill pins to make holes in the femur, and the remaining hourglass shaped bone is removed with osteotomy pliers to form the trough. A tibial socket for the tibial component is formed in a retrograde manner.

Abstract: Techniques and reconstruction systems for ACL repair by providing cross-pin fixation of a graft within a tibial tunnel. The invention provides tibial fixation techniques according to which cross-pin fixation of a graft (for example, an Anterior Tibialis allograft) is achieved on the tibial side, close to the jointline, by a single incision and with cortical fixation.

Abstract: Methods and apparatus for arthroscopically-assisted preparation of the tibia to accept an unicompartmental implant that includes the step of removing bone from the tibial plateau to correct depth, diameter and proper angle by employing a tibial rasp comprising a cutter with a plurality of teeth on the bottom surface and a side surface (for example, the front side). The tibial rasp may be used in conjunction with an additional starter rasp that can cut only in one direction (for example, cutting to establish only the depth of the tunnel or socket).