Abstract: A method and suture anchor for treatment of spinal stenosis. The method includes the steps of cutting off a muscle origin or insertion from a spinous process, cutting off the spinous process at the transition to the lamina arcus vertebrae, at least partial resection of the lamina arcus vertebrae and thereby decompression of the spinal cord within the foramen vertebral, performing osteosynthesis of the spinous process, and placing a suture anchor within the spinous process and reattaching the muscle origin or insertion to the spinous process. Further methods for spine stabilization are provided wherein suture anchors are used to implement a tension band wiring. Further methods for reduction of unwanted effects after spinal treatment are provided.

Abstract: A sonotrode and methods for fixating an implant having thermoplastic properties in a recess of an object, the sonotrode having a distal end and a tapered tip configured to receive an implant, wherein an area of the tapered tip at the distal end of the body projected onto a plane normal to the z-axis fully covers an area of the distal end of the body projected onto the plane normal to the z-axis. A device and methods for fixating an implant having thermoplastic properties in a recess of an object, wherein the device comprises a stop member configured to stop a movement of the device when fixating the implant.

Abstract: A sonotrode and methods for fixating an implant having thermoplastic properties in a recess of an object, the sonotrode having a distal end and a tapered tip configured to receive an implant, wherein an area of the tapered tip at the distal end of the body projected onto a plane normal to the z-axis fully covers an area of the distal end of the body projected onto the plane normal to the z-axis. A device and methods for fixating an implant having thermoplastic properties in a recess of an object, wherein the device comprises a stop member configured to stop a movement of the device when fixating the implant.

Abstract: Methods for fixating an implant having thermoplastic properties in a recess of an object, wherein the device comprises a stop member configured to stop a movement of the device when fixating the implant.

Abstract: A surgical apparatus generates energy that is input onto an appliance. The appliance is one of an implant to be implanted in human or animal bone tissue by the input of the energy, and of a tool being an ultrasonic bone cutting and/or punching tool for cutting and/or punching living human or animal bone tissue by input of energy onto the implant in a surgical operation. The apparatus includes a control device and at least one handpiece, the handpiece being equipped to be held by a surgeon during the operation and to couple the energy into the appliance. The apparatus further includes a reading device equipped to read out, from an appliance data carrier, appliance data dedicated to the appliance. The control device checks, depending on the appliance data, whether the handpiece is suitable for the appliance and chooses operating parameters depending on the appliance data.

Abstract: A sonotrode suitable for use with an ultrasonic surgical instrument for cutting or punching bones, as well as a method for manufacturing the sonotrode.

Abstract: A method of anchoring a first object in a second object is described. The first object extends along an axis between a proximal end and a distal end and has a circumferential surface. The circumferential surface comprises at least one helical protrusion of a thermoplastic material. For anchoring, the first object is brought in contact with the second object, and mechanical vibration is coupled into the first object from a proximally facing coupling-in face thereof so as to drive the first object into the second object in a manner that the vibration and pressing cause the first object to be subject to a helical movement relative to the second object and cause thermoplastic material of the first object to become flowable and to penetrate into structures of the second object to yield, after resolidification, a positive fit connection with the second object.

Abstract: A dental implant includes an implant body with a coronally open cavity and at least one exit opening from an inside to the enossal outer surface. A thermoplastic element in the solid state is arranged in the cavity, and is brought into an at least partly flowable condition by applying a pressing force directed apically into the cavity, and mechanical oscillations. A portion of the flowable material of the thermoplastic element is pressed through the exit opening into surrounding bone tissue, when the implant body is arranged in an opening in the bone tissue and the enossal outer surface is in contact with the bone tissue. A re-solidification of the thermoplastic material after discontinuing the vibrations causes an anchoring through the connection between interpenetrated tissue and the implant body via the thermoplastic material penetrating both.

Abstract: A method of bonding a first object to a second object includes the steps of: providing the first object including thermoplastic material in a solid state, providing the second object including a proximal surface, applying a mechanical pressing force and a mechanical excitation capable to liquefy the thermoplastic material until a flow portion of the thermoplastic material is flowable and penetrates into structures of the second object, and stopping the mechanical excitation and letting the thermoplastic material resolidify to yield a positive-fit connection between the first and the second object. The second object has a region of low density, wherein the protrusion penetrates the region of low density at least partly before the thermoplastic material is made flowable, and wherein the first object includes a protruding portion after the step of letting the thermoplastic material resolidify, the protruding portion at least partly penetrates the region of low density.

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 method of attaching an object to a substrate with a fastener, and an associated fastener. The object is tensible and has an engagement portion. The fastener has a protrusion, which includes thermoplastic material in a solid state. The method includes applying a mechanical pressing force and a mechanical excitation capable to cause a movement of the fastener in a distal direction so that the protrusion penetrates into the substrate and liquefies the thermoplastic material until a flow portion of the thermoplastic material is flowable and penetrates into structures of the substrate. The engagement portion is moved in the distal direction by the movement of the fastener, wherein the movement of the engagement portion in the distal direction causes a tensioning force in the object, and wherein the fastener has a protruding portion extending at least partly into the substrate after the thermoplastic material resolidifies.

Abstract: An approach for attaching a superstructure, such as a crown, to an abutment by an approach that includes causing thermoplastic material to become flowable due to mechanical energy input, and to flow relative to an attachment structure to secure the superstructure and crown together.

Abstract: A method of bonding a first object to a second object includes the steps of: providing the first object including thermoplastic material in a solid state, providing the second object including a proximal surface, applying a mechanical pressing force and a mechanical excitation capable to liquefy the thermoplastic material until a flow portion of the thermoplastic material is flowable and penetrates into structures of the second object, and stopping the mechanical excitation and letting the thermoplastic material resolidify to yield a positive-fit connection between the first and the second object. The second object has a region of low density, wherein the protrusion penetrates the region of low density at least partly before the thermoplastic material is made flowable, and wherein the first object includes a protruding portion after the step of letting the thermoplastic material resolidify, the protruding portion at least partly penetrates the region of low density.

Abstract: A device and method for perforating a dense bone layer. The device includes a vibration generator for generating mechanical vibration, in particular ultrasonic vibration, and an instrument with an elongated shaft and a distal end piece including a perforator. The distal end piece is arranged at a distal end of the shaft and the proximal end of the shaft is connected or connectable to the vibration generator. The perforator has the form of a solid or a hollow cylinder. The vibration generator, the shaft and the distal end piece are adapted to each other for the shaft to transmit, when connected to the activated vibration generator, mechanical vibration from the vibration generator to the distal end piece and for vibrating the perforator in a direction parallel to its cylinder axis.

Abstract: A device for fixating a suture anchor beyond 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. The device includes a tool and a suture anchor. The tool has a proximal end suitable for being coupled to an energy source and a distal end suitable for arrangement of the suture anchor including the suture. The distal end includes a distal tool face and an axial channel with a distal mouth located in the distal tool face. The suture anchor has an anchor foot and a thermoplastic sleeve including the material having thermoplastic properties. The anchor foot holds a loop of a suture such that end sections of the suture reach through the thermoplastic sleeve and a portion of the distal tool face.

Abstract: A modular implant system, such as a spinal implant system, having an implant part, for example a (spinal) plate, and at least one fastener, wherein the implant part has a fastener receiving opening. The system also includes thermoplastic material, the thermoplastic material being equipped for being liquefied by mechanical vibration, especially ultrasonic vibration energy. The fastener receiving opening and the fastener can be shaped so that the fastener can be inserted relative to the implant part at a variable angle. The fastener, the plate and the thermoplastic material are equipped for the thermoplastic material, after re-solidification, to secure the fastener against at least one of an axial (back-out) movement of the fastener, a rotation of the fastener relative to the implant part, a variation of the angle of the fastener relative to the implant part.

Abstract: A method of mechanically securing a first object including a thermoplastic material in a solid state to a second object with a generally flat sheet portion, with a perforation of the sheet portion, and with the sheet portion having an edge along the perforation is provided, wherein the first object is positioned relative to the second object so that the edge is in contact with the thermoplastic material and wherein mechanical vibration energy is coupled into the assembly including the first and second objects until a flow portion of the thermoplastic material due to friction heat generated between the edge and the thermoplastic material becomes flowable and flows around the edge to at least partially embed the edge in the thermoplastic material. After the mechanical vibration stops, the thermoplastic material is caused to re-solidify, whereby the re-solidified thermoplastic material at least partially embedding the edge anchors the first object in the second object.

Abstract: A method for joining two objects by anchoring an insert portion provided on one of the objects in an opening provided on the other one of the objects. The anchorage is achieved by liquefaction of a thermoplastic material and interpenetration of the liquefied material and a penetrable material, the two materials being arranged on opposite surfaces of the insert portion and the wall of the opening. Before such liquefaction and interpenetration, an interference fit is established in which such opposite surfaces are pressed against each other, and, for the anchoring, mechanical vibration energy and possibly a shearing force are applied, wherein the shearing force puts a shear stress on the interference fit.

Abstract: A method of anchoring a first object in a second object. The second object defines an opening. The first object has an insert portion that defines an insertion axis and has an outer shape that may form an undercut with respect to axial directions. The method includes inserting the insert portion in the opening, with a hardenable composition (prepolymer; mortar) between a wall of the opening and the insert portion, and causing mechanical vibration energy to impinge to cause the hardenable composition to undergo a chemical hardening process to yield a hardened composition, so that a first connection between the first object and the hardened composition and a second connection between the hardened composition and the second object results, whereby the first object is anchored in the second object. The first connection and/or the second connection may include an adhesive connection and/or a positive-fit connection.

Abstract: A device for fixating a suture anchor beyond 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. The device includes a tool and a suture anchor. The tool has a proximal end suitable for being coupled to an energy source and a distal end suitable for arrangement of the suture anchor including the suture. The distal end includes a distal tool face and an axial channel with a distal mouth located in the distal tool face. The suture anchor has an anchor foot and a thermoplastic sleeve including the material having thermoplastic properties. The anchor foot holds a loop of a suture such that end sections of the suture reach through the thermoplastic sleeve and a portion of the distal tool face.