Abstract: A soft tissue graft suitable for replacing a tendon or ligament is fastened in a bone opening provided in a human or animal patient by press-fitting an end portion of the graft and a fastener into the bone opening such that the graft end portion is pressed against a first portion of the bone wall inside the bone opening. The fastener is anchored in a second portion of the bone wall by liquefying a material having thermoplastic properties by the fastener and making the fastener penetrate into the bone wall. An end portion of the graft is tied to the fastener with the aid of at least one suture extending from the graft end portion. Tying is carried out after anchoring, during anchoring or between anchoring and press-fitting. The tied connection between the fastener and the graft end portion successfully counteracts potential graft slipping.

Abstract: An implant for stabilizing two separated bone portions relative to each other an implant includes a peg, a bridge assembly and a securing element. The peg and bridge assembly include at least two peg portions and a bridge portion, wherein the bridge portion is arranged between the peg portions and wherein the peg and bridge portions are rigidly connected. The peg and bridge assembly is positioned relative to the bone portions such that one peg portion extends into the bone tissue of each one of the bone portions and the bridge portion extends across the gap separating the bone portions. The securing element is anchored in the bone tissue of one of the bone portions, its proximal end extending through an opening in an assembly portion extending parallel to a bone surface or across a notch in a proximal edge of an assembly portion.

Abstract: A light diffuser, which is particularly suitable for introducing diffuse light into a tissue, is produced by interpenetration of a diffuser material in a liquid state into a boundary layer of a porous shaping material, by which process a diffuser surface is formed having a surface structure which represents essentially a negative of the pore structure of the shaping material and includes undercut structures induced by a surface tension. The light diffuser is e.g. produced by introducing a diffuser blank including material that is liquefiable through mechanical vibration into the shaping material and simultaneously stimulating it with mechanical vibrations, such that the liquefiable material liquefies at least there where it is in contact with the shaping material and is pressed into the shaping material. An in situ production of the diffuser is particularly advantageous for photodynamic therapy in bone tissue.

Abstract: A device for fixing a first and a second tissue part or a tissue part and an implant part to each other is provided, providing a fastener including a thermoplastic material and a fastening instrument. The fastening instrument includes a first instrument component with a first contact surface facing toward a distal side and a second instrument component has a foot with a second contact surface distally of the first contact surface and facing toward a proximal side. The first instrument component and the second instrument component are displaceable with respect to each other, so that the fastener is compressible between the first and second contact surfaces by application of a relative force between the components. The instrument also includes an energy source for coupling mechanical energy into one of the instrument components to soften and/or melt an end portion of the fastener.

Abstract: A device and method for fixating soft tissue to hard tissue with the aid of a suture anchor and a suture or with the aid of a headed anchor, wherein the anchor is forced into the hard tissue and then anchored therein by in situ liquefaction of a material having thermoplastic properties. The device includes a vibration tool and the anchor and possibly a support element, wherein the anchor includes an anchor foot and a thermoplastic sleeve. The thermoplastic sleeve includes the material having thermoplastic properties. The anchor foot has a distal end suitable for being forced into hard tissue and it is connected to the distal end of the vibration tool and the thermoplastic sleeve sits on a proximal face of the anchor foot, the vibration tool and/or a proximal portion of the anchor foot extending into or through the thermoplastic sleeve.

Abstract: An implant or endoprosthesis suitable to be implanted in human or animal tissue includes two (or more than two) parts to be joined in situ. Each one of the parts includes a joining location, the two joining locations facing each other when the device parts are positioned for being joined together, wherein one of the joining locations includes a material which is liquefiable by mechanical vibration and the other one of the joining locations includes a material which is not liquefiable by mechanical vibration and a structure (e.g. undercut cavities or protrusions) suitable for forming a positive fit connection with the liquefiable material. The joining process is effected by pressing the two device parts against each other and by applying ultrasonic vibration to one of the device parts when the two parts are positioned relative to each other such that the two joining locations are in contact with each other.

Abstract: An anchoring method of anchoring an anchoring element in a construction object is provided, where a surface of which object has at least one of pores in a surface, structures in a surface (such as an arrangement of ridges with undercut), a inhomogeneous characteristic with makes the penetration of a surface by a liquid under pressure possible, thereby creating pores filed by the liquid underneath the surface, and of a cavity. The method includes the steps of: providing a first element and a second element, the first element comprising a thermoplastic material; positioning the first element in a vicinity of said surface and/or of said cavity, respectively, and positioning the second element in contact with the first element; and causing a third element to vibrate while loading the first element with a force, thereby applying mechanical vibrations to the first element, and simultaneously loading the first element with a counter-force by the second element.

Abstract: An anchorage in tissue is produced by holding a vibrating element and a counter element against each other such that their contact faces are in contact with each other, wherein at least one of the contact faces includes a thermoplastic material which is liquefiable by mechanical vibration. While holding and then moving the two elements against each other, the vibrating element is vibrated and due to the vibration the thermoplastic material is liquefied between the contact faces, and due to the relative movement is made to flow from between the contact faces and to penetrate tissue located adjacent to outer edges of the contact faces. For liquefaction of the thermoplastic material and for displacing it from between the contact faces, no force needs to act on the tissue surface which is to be penetrated by the liquefied material.

Abstract: A suture anchor includes a material having thermoplastic properties and is fixated in a hard tissue opening by liquefying at least part of this material and letting it penetrate into walls of the hard tissue opening. During the named fixation and preferably towards the end of it, the suture being held in a distal suture conduit is locked relative to the hard tissue by being clamped between the suture anchor and the wall of the hard tissue opening or by being clamped or braked through collapse of the suture conduit.

Abstract: A human or animal joint is treated by introduction of a device between the suitably prepared articulating surfaces of the joint, and the device is anchored in both these articular surfaces with a material having thermoplastic properties. For allowing at least limited articulation of the joint after implantation, the device includes two articulating portions, wherein one of the articulating portions is anchored in each articulating surfaces of the joint. On implantation a proximal face of the device is contacted with a vibrating tool and the vibration is transmitted through parts of the device to locations in which the material having thermoplastic properties is near the bone tissue of the articulating surfaces of the joint and in which liquefaction is desired. The liquefied material penetrates the bone tissue and, on re-solidification forms a positive fit connection between the device and the bone tissue.

Abstract: In a human or animal patient, two bone portions separated by a cut or fracture are stabilized in a desired position relative to each other by bringing the two bone portions into this desired position, by pulling them against each other, by providing an opening having a mouth on a bone surface and reaching across the cut or fracture and walls in both bone portions, by inserting an implant into the opening and anchoring the implant in the walls of the opening with the aid of a material having thermoplastic properties and energy transmitted into the implant for in situ liquefaction of at least part of the material having thermoplastic properties. One exemplary application of the stabilizing procedure concerns the two tibial bone portions separated by tibial plateau leveling osteotomy in a canine patient suffering from cranial cruciate ligament damage or rupture in a stifle joint.

Abstract: A tool for fixating a suture anchor in a hard tissue opening with the aid of a material having thermoplastic properties and energy transmitted to the suture anchor for in situ liquefaction of at least part of the material having thermoplastic properties, includes a distal face, an axial channel and a substantially tube-shaped interface piece fitting into the axial channel of the tool, wherein the axial channel and a proximal end of the interface piece are equipped with catch elements cooperating for catching the interface piece in the axial channel when the interface piece is moved in a proximal direction in the axial channel.

Abstract: A method of anchoring an implant in hard tissue, and/or hard tissue replacement material, includes the steps of providing an initial opening in the hard tissue, providing a thermoplastic augmentation element, a tool and a counter element, compressing the augmentation element between the tool and the counter element while energy is coupled into the tool and while a periphery of a liquefaction interface of the tool and the augmentation element and/or of a liquefaction interface of the augmentation element and the counter element is in the opening, thereby liquefying material of the augmentation element at the liquefaction interface(s) to yield liquefied material, causing portions of the liquefied material to penetrate into structures of the hard tissue, allowing the liquefied material to harden and to thereby become augmentation material, removing the tool and the counter element, and anchoring the implant in the opening including at least some of the augmentation material.

Abstract: An implant suitable for being anchored with the aid of mechanical vibration in an opening provided in bone tissue. The implant is compressible in the direction of a compression axis under local enlargement of a distance between a peripheral implant surface and the compression axis. The implant includes a coupling-in face which serves for coupling a compressing force and the mechanical vibrations into the implant, which coupling-in face is not parallel to the compression axis. The implant also includes a thermoplastic material which, in areas of the local distance enlargement, forms at least a part of the peripheral surface of the implant.

Abstract: An implant designed e.g. as a replacement for an articulating surface of a human or animal joint is secured to the bone tissue with the aid of a plurality of fasteners (3). The implant (2) comprises a bone side to be brought into contact with the bone tissue, which bone side is equipped with a plurality of fastening structures restricted to this bone side. The fasteners (3) comprise a distal and a proximal side, wherein the distal side is equipped for being anchored in bone tissue and the proximal side is equipped for being connected with one of the fastening structures of the implant (2). The distal sides of the fasteners (3) are anchored in the bone tissue of the appropriately prepared bone and the implant (2) is then attached to the anchored fasteners (3) by connecting the fastening structures with the proximal sides of the fasteners (3), wherein the implant (2) is pressed against the proximal sides of the anchored fasteners (3).

Abstract: A spine stabilization device having an interbody spacer shaped to be inserted between a vertebral body of an upper vertebra and a vertebral body of a lower vertebra. The device further includes a fixation device to be inserted after placement of the interbody spacer, the fixation device having a support portion securing the interbody spacer against escaping from between the vertebral bodies into a ventral direction. The support portion rests against a portion of an anterior surface of the interbody spacer, and includes an anchor. The anchor has an anchoring material portion that is inserted, in a liquid state, into cancellous bone tissue of at least one of the vertebral bodies of the upper and lower vertebra, to thereby infiltrate the cancellous bone tissue, and to harden thereafter so as to fix the support portion to the vertebral body.

Abstract: An anterior cervical includes a plate portion for stabilizing a human or animal spine by being placed ventrally of the spinal column and affixed to two or more different vertebral bodies, and a plurality of fastening portions adapted to be anchored in the different vertebral bodies. At least one of the fastening portions is rigidly connected to the plate portion and includes a sheath element with a longitudinal opening that is accessible from a proximal side and at least one hole that reaches from the longitudinal opening to an outside. The anterior cervical plate further includes a thermoplastic element that may be inserted in the sheath element and that is capable of being liquefied by, for example, mechanical energy acting on the thermoplastic element.

Abstract: A pedicle anchor device is provided and is equipped for being used like a pedicle screw, i.e. for being implanted in the vertebra from dorsal direction (but generally at an angle to the sagittal plane, slightly inward towards the sagittal plane) through the pedicle so that a distal portion of the device protrudes into the vertebral body. The pedicle anchor device includes a pedicle anchor device body with a head portion, a shaft portion and a longitudinal bore that extends from a proximal end of the pedicle anchor device body and has a hole or a plurality of holes from the longitudinal bore outward, for example radially outward.

Abstract: A device for the anchoring of a suture in tissue includes a guide sleeve, a sonotrode, an anchor and the suture. The guide sleeve has a distal part with a smaller cross section and a proximal part with a larger cross section. The sonotrode extends through the lumen of the guide sleeve and has a distal end and a proximal end, the proximal end being designed for coupling the sonotrode to a vibration source (e.g. an ultrasonic device). The anchor is arranged at the distal end of the device and includes an anchor foot and an anchoring sleeve sitting on a shoulder of the anchor foot. The anchoring sleeve consists of a material which is liquefiable through mechanical vibrations. A middle portion of the suture runs through the anchor foot and two end portions of the suture are attached to the guide sleeve.

Abstract: The fusion device for fusing a synovial joint of a human or animal patient, in particular a human facet joint, finger joint or toe joint, includes two pin-shaped anchorage portions (1) and arranged therebetween a stabilization portion (2). The anchorage portions (1) include a thermoplastic material which is liquefiable by mechanical vibration. The stabilization portion (2) preferably has a surface which is equipped for enhancing osseointegration. The anchorage portions (1) have a greater thickness (T1) and a greater depth (D) than the stabilization portion (2). Then the fusion device is pushed between the articular surfaces and mechanical vibration, in particular ultrasonic vibration, is applied to the proximal face (4) of the fusion device. Thereby the liquefiable material is liquefied where in contact with the bone tissue and penetrates into the bone tissue, where after re-solidification it constitutes a positive fit connection between the fusion device and the bone tissue.