Abstract: A soft tissue repair device can include a housing having a handle, a deployment system having an actuation member, and an insertion system having an inserter and a slider. The slider can be coupled to the actuation member and movable relative to the inserter between deployed and retracted positions. First and second anchors can be carried on an external surface of the slider such that the anchors are spaced apart and portions of the anchors are coaxial with the slider and each other. A flexible strand can couple the anchors. The insertion system can cooperate with the deployment system to move the slider to the deployed position to deploy the first anchor upon activating the actuation member a first time, and to move the slider to the deployed position from the retracted position to deploy the second anchor upon actuating the actuation member a second time after the first time.

Abstract: A system for providing dynamic stabilization and balance control at a vertebral motion segment has first and second bridge elements and at least one bias element. The bridge elements anchor to adjacent vertebrae with polyaxially adjustable anchoring members, and the bias elements attach to each bridge element to span between them. Each bias element has two fixation portions and a bias body extending between the fixation portions. Each bias element may comprise an elastically deformable material to provide dynamic stabilization with motion, or may comprise rigid material to provide rigid stabilization, and both bias element types may be included in one system. The bias elements are attachable to the bridge elements at discrete attachment locations, or at non-discrete attachment locations. Alternate embodiments may include three or more bridge elements on adjacent vertebrae, and multiple bias elements. A tensioning tool may provide adjustable tension to an elastically deformable bias element.

Abstract: Total ankle arthroplasty with a tibial plate, a talar plate and a middle or core component. The ankle arthroplasty may allow for varus or valgus accommodation through the use of a core component with various medial and lateral heights in varus and valgus orientations. In addition the resurfacing of the talus is accomplished with a talar plate with a curved orientation that is congruent to one surface of the core component to allow for appropriate ankle manipulation.

Abstract: A system for spinal surgery includes a prosthesis comprising a plurality of bone anchors which engage an intervertebral construct for fusion or motion preservation. The fusion construct comprises a spacer optionally encircled by a jacket. The motion preservation construct may comprise an articulating disc assembly or an elastomeric disc assembly. Any of the constructs may occupy the intervertebral disc space between adjacent vertebrae after removal of an intervertebral disc. The anchors slidingly engage the construct to securely fix the prosthesis to the vertebrae. The anchors and jacket of the fusion construct provide a continuous load path across opposite sides of the prosthesis so as to resist antagonistic motions of the spine.

Abstract: A surgical instrument and method are provided for removal of a spinal implant from the intervertebral disc space. The instrument includes a carriage body for interfacing with the implant, a housing for interfacing with the vertebrae, and a handle portion having a first portion rotatably coupled with a proximal end of the housing and a second portion rotatably engageable with a proximal attachment portion of the carriage body. A central passage of the housing extends between the proximal end and a distal engagement surface of the housing. The central passage is dimensioned to mate with the carriage body. Rotation of the handle portion about an axis causes translational movement of the carriage body along the axis. A modular inserter/distracter apparatus and method and an anchor remover and method are also provided.

Abstract: The present invention provides devices and methods for attachment of an endolumenal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve or other therapeutic or diagnostic device, within a patient's digestive tract. In one application of the invention, an endolumenal bypass sleeve is removably attached in the vicinity of the gastroesophageal junction to treat obesity and/or its comorbidities, such as diabetes. The bypass sleeve may be at least partially deployed by eversion.

Abstract: Systems for interbody fusion of adjacent bone portions may include an expanding implant and related instruments. An expanding implant may be formed as a linkage which is movable between a compact configuration and an expanded configuration. A shaft of the implant may increase and decrease in length to move between the compact and expanded configurations, and an implant width perpendicular to the length may be increased in the expanded configuration. The implant width may increase more in a first direction than a second direction opposite the first direction. An inserter instrument may releasably grasp the spacer and transform the implant between the compact and expanded configurations.

Abstract: Methods are disclosed for replaceable attachment of an endoluminal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve device or an attachment cuff, within a patient's digestive tract for treatment of obesity.

Abstract: A prosthetic patellar implant has a posterior articulation surface and an anterior attachment surface. The anterior attachment surface has a medial attachment surface and a lateral attachment surface. The medial and lateral attachment surfaces can be planar and angled relative to one another, meeting at a common intersection medially offset from the sagittal centerline of the implant. The medial and lateral attachment surfaces can include convexities. The anterior attachment surface can have one or more pegs and/or recesses.

Abstract: Instrumentation for preparation of a bone includes a first guide having a first collet and a second collet. The first and second collets are formed around divergent first and second axes, and share a common opening. A bone preparation instrument may be inserted into each of the collets toward a bone. A second guide may be carried in the first guide, and a bone preparation instrument inserted through the second guide toward the bone, along a third axis.

Abstract: A compression and distraction shaft assembly applies compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. An hourglass-shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. Distraction pliers having cylindrical tips are used to apply distraction to vertebrae. Once handles are pressed to impart an appropriate amount of distraction to the vertebrae, they are locked in this position. Compression pliers having cylindrical tips are used to apply compression to vertebrae. Once handles are pressed to impart an appropriate amount of compression to the vertebrae, they are locked in this position.

Abstract: Systems for joint arthroplasty include prostheses which are secured to bone with sliding anchors. Examples include unicondylar and bicondylar knee prostheses for hemi-arthroplasty and total arthroplasty. Instruments guide the anchors into proper engagement with the prosthetic components. Methods of using the prostheses and instruments are disclosed.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: The present invention provides devices and methods for attachment of an endolumenal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve or other therapeutic or diagnostic device, within a patient's digestive tract. In one application of the invention, an endolumenal bypass sleeve is removably attached in the vicinity of the gastroesophageal junction to treat obesity and/or its comorbidities, such as diabetes. The bypass sleeve may be at least partially deployed by eversion.

Abstract: The present invention provides a compression and distraction shaft assembly used to apply compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. A hour glass shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. A distraction pliers having cylindrical tips is used to apply distraction to vertebrae. Once handles are pressed to impart appropriate amount of distraction to the vertebrae they are locked in this position. A compression pliers having cylindrical tips is used to apply compression to vertebrae. Once handles are pressed to impart appropriate amount of compression to the vertebrae they are locked in this position.

Abstract: A line lock system may include a line routed through a plate. The plate may have an elongated body with a plurality of passageways. The line is routed to form at least one one-way slide so no knots are required. The system may include filaments routed through the passageways of the plate or around a dogbone feature of the plate. The filaments may be used to toggle the plate after passage through a hole to prevent withdrawal of the plate back through the hole. The system may include a line lock stabilizer or counter-tension tool to stabilize the line lock as the line is adjusted. The system may include a compression limiter to selectively reduce compression in the one-way slide to facilitate adjustment of the line. The line lock stabilizer, counter-tension tool, or compression limiter may be a filament.

Abstract: Methods and instrumentation for implantation of an intervertebral disc prosthesis are provided. A guide tool with sagittal and coronal reference features guides placement of guide pins relative to a sagittal plane and a coronal plane of the vertebrae. A retainer lockable to the guide pins has a ratcheting mechanism providing distraction or compression. A rasp, planer or other tools may be aligned to the retainer and inserted into the intervertebral space to prepare the vertebral endplates. An interoperatively adjustable trial is alignable to the retainer and measures an angularity of the intervertebral space. A prosthesis with keying features may be mounted to a prosthesis inserter with complementary features, held by pivotable arms and compressed between prongs. The inserter may be aligned to the retainer and advanced to implant the prosthesis in the intervertebral space. A prosthesis remover may grip one prosthetic end plate and extract the entire prosthesis.

Abstract: A line lock system may include a line routed through a plate. The plate may have an elongated body with a plurality of passageways. The line is routed to form at least one one-way slide so no knots are required. The system may include filaments routed through the passageways of the plate or around a dogbone feature of the plate. The filaments may be used to toggle the plate after passage through a hole to prevent withdrawal of the plate back through the hole. The system may include a line lock stabilizer or counter-tension tool to stabilize the line lock as the line is adjusted, a compression limiter to selectively reduce compression in the one-way slide to facilitate adjustment of the line, means for adjusting the line, or a line cutter.

Abstract: A system for accessing a spine from a curved postero-lateral approach may include a curved cannula positioned along a curved path from an opening in the skin to a location proximate the spine. A guide member may he first inserted to establish the path between the tissues and fascia, and one or more intermediate cannulas may be temporarily inserted over the guide member to dilate the tissues prior to insertion of the main cannula. An interbody device may be implanted in an intervertebral space through the cannula. The system may include a guide bar removably coupled to a targeting post. The targeting post may be inserted adjacent the spine to provide a target, and the guide bar may be removably attached to the guide member, to guide it along the path to the target location. An external support arm may be secured to any other component of the system.