Abstract: Low profile reamers and methods of use are provided which can, in general, allow a hole to be drilled in bone. In one embodiment, a low profile retractable bone reamer is provided having an elongate shaft with a cutting element disposed on a distal end of the elongate shaft that can be configured to drill a hole in bone. The elongate shaft and cutting element can have first and second longitudinally separated portions that are movably coupled to each other. The reamer can be configured to move between a retracted configuration, in which a the reamer has a reduced, low profile configuration, and a non-retracted configuration, in which both longitudinally separated portions of the cutting element can be positioned adjacent to one another to form a single cutting element.

Abstract: Various exemplary methods and devices are provided for improved surgical sutures, suture systems, and methods for suturing. In general, the sutures, suture systems, and methods can allow a suture to form a secure, closed loop without tying a knot. The suture can include a barbed portion configured to be threaded through a hollow portion. The barbed portion can have a plurality of barbs thereon, which can grasp onto an inner wall of the hollow portion when disposed therein to help secure the loop at a desired size. The barbs can all be oriented in one direction that corresponds to a direction of movement of the suture when the loop is being tightened. Thus, the barbs can be configured to allow for a size of the loop to be easily reduced to any desired size to approximate tissue, but can be configured to resist subsequent expansion of the loop to ensure that the tissue remains in place.

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: Systems and methods are provided for passively dissipating a rotational speed of a fluid-driven rotatable shaft. In particular, a dissipation member is provided for dissipating the rotational speed of a shaft having an end effector formed thereon. As the rotational speed of the shaft increases, the dissipation member will apply a counter-torque to the shaft, thereby limiting the rotational speed of the shaft. In an exemplary embodiment, the counter-torque has a non-linear dependence on the rotational speed of the shaft, such that the counter-torque increases at a rate greater than a rate of increase in the rotational speed.

Abstract: Low profile reamers and methods of use are provided which can, in general, allow a hole to be drilled in bone. In one embodiment, a low profile retractable bone reamer is provided having an elongate shaft with a cutting element disposed on a distal end of the elongate shaft that can be configured to drill a hole in bone. The elongate shaft and cutting element can have first and second longitudinally separated portions that are movably coupled to each other. The reamer can be configured to move between a retracted configuration, in which a the reamer has a reduced, low profile configuration, and a non-retracted configuration, in which both longitudinally separated portions of the cutting element can be positioned adjacent to one another to form a single cutting element.

Abstract: Methods and devices are provided for anchoring graft to bone. In one exemplary embodiment, a bone cavity is created in bone, a graft is partially advanced into the bone cavity, and a hardenable filler material is inserted into the cavity. The hardenable filler material can change from a viscous first state to a harder second state, compressing the graft against the walls of the bone cavity and thereby anchoring the graft within the cavity. The hardenable filler material can be inserted in an open sac, a closed sac, other carriers or housings, or directly into the bone cavity.

Abstract: Methods and devices are provided for cutting and removing tissue from a body. In one exemplary embodiment, a surgical device is provided having a suction shaft and a cutting assembly. The suction shaft can have an inner passageway configured to receive tissue. The cutting assembly can include an outer shaft having at least one opening formed in a sidewall thereof configured to receive tissue. The cutting assembly can be configured to mate with the suction shaft, and it can include a cutting element configured to move relative to the opening to cut tissue disposed through the opening. Suction can be applied to cause the cut tissue to flow proximally through the suction shaft and away from the cutting assembly.

Abstract: Methods and devices are provided for anchoring graft to bone. In one exemplary embodiment, a bone cavity is created in bone, a graft is partially advanced into the bone cavity, and a hardenable filler material is inserted into the cavity. The hardenable filler material can change from a viscous first state to a harder second state, compressing the graft against the walls of the bone cavity and thereby anchoring the graft within the cavity. The hardenable filler material can be inserted in an open sac, a closed sac, other carriers or housings, or directly into the bone cavity.

Abstract: Methods and devices are provided for cutting and removing tissue from a body. In one exemplary embodiment, a surgical device is provided having a suction shaft and a cutting assembly. The suction shaft can have an inner passageway configured to receive tissue. The cutting assembly can include an outer shaft having at least one opening formed in a sidewall thereof configured to receive tissue. The cutting assembly can be configured to mate with the suction shaft, and it can include a cutting element configured to move relative to the opening to cut tissue disposed through the opening. Suction can be applied to cause the cut tissue to flow proximally through the suction shaft and away from the cutting assembly.

Abstract: Surgical constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct is formed from a suture filament and includes two terminal ends of filament and an intermediate portion disposed along at least a portion of a length extending between the terminal ends. The construct can have a first terminal end that is the first terminal end of the filament, and a second terminal end that includes a loop. The loop can be formed by disposing the second terminal end of the filament within a volume of a portion of the intermediate portion of the filament. In some disclosed methods, both terminal ends of the filament can be passed through tissue when performing soft tissue repairs. Various other embodiments of constructs and methods are provided, including constructs having two or more filaments associated with an anchor and methods of using such constructs.

Abstract: A device having one or more adjustable loops or coils associated with an implant body for use in soft tissue reconstructions is provided. One exemplary embodiment of a device includes a body and a suture filament, with the filament being used to form a self-locking sliding knot disposed on a top side of the body and a plurality of adjustable coils that are substantially disposed on the body's bottom side. Terminal ends of the filament located above the body's top side can be passed through an opening of a Lark's Head knot from opposite sides, thus forming a self-locking sliding knot, and then the terminal ends can be tensioned to adjust a circumference of the coils. Changing a coil's circumference changes a location of a ligament graft disposed on the coil. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

Abstract: Methods and devices are provided for cutting and removing tissue from a body. In one exemplary embodiment, a surgical device is provided having a suction shaft and a cutting assembly. The suction shaft can have an inner passageway configured to receive tissue. The cutting assembly can include an outer shaft having at least one opening formed in a sidewall thereof configured to receive tissue. The cutting assembly can be configured to mate with the suction shaft, and it can include a cutting element configured to move relative to the opening to cut tissue disposed through the opening. Suction can be applied to cause the cut tissue to flow proximally through the suction shaft and away from the cutting assembly.

Abstract: Various devices, systems, and methods are provided for securing soft tissue to bone. In one exemplary embodiment, a two-piece inserter tool is provided that includes a tip portion that is configured to be removably coupled to a handle portion. A distal portion of the tip portion can be configured to be coupled to a suture anchor, and the tip portion and the anchor can be passed through a continuous suture loop prior to mating the tip portion to the handle portion.

Abstract: Methods and devices are provided for anchoring suture to bone. In one embodiment, an elongate weave of fibers can be provided having a first portion with a first pick count and a second portion with a second pick count that is greater than the first pick count. The first portion can have a cross-section that deforms in response to a force that is applied thereto. The first portion can have a collapsible diameter and can have a bending stiffness that is lower than a bending stiffness of the second portion of the suture. The first portion can also have a first pattern that is different than a second pattern on the second portion of the suture. The first portion can be threaded into a suture anchor such that it can be doubled over upon itself. The present invention also provides exemplary sutures and drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: Methods and devices are provided for securing tissue to bone. In general, a suture leader can have leading and trailing ends, and an inner passageway configured to receive a strand of suture therein. More specifically, the trailing end of the leader can be configured to receive the strand of suture therein to form an overlapping region of suture leader and suture. When the suture is positioned in the leader, an outer diameter of the leading end of the leader can be less than an outer diameter of the over lapping region. The leader can have a lower bending stiffness than the suture so that the leader can be more easily folded into a bend. In certain aspects, the suture leader can be formed from a substantially flexible, braided material so that the leader can be configured to contract when a pulling force is applied to the leader. In another embodiment, the suture leader can have a pre-formed crease configured to mate with a threading tool.

Abstract: Methods and devices are provided for anchoring graft to bone. In one exemplary embodiment, a bone cavity is created in bone, a graft is partially advanced into the bone cavity, and a hardenable filler material is inserted into the cavity. The hardenable filler material can change from a viscous first state to a harder second state, compressing the graft against the walls of the bone cavity and thereby anchoring the graft within the cavity. The hardenable filler material can be inserted in an open sac, a closed sac, other carriers or housings, or directly into the bone cavity.

Abstract: Methods and devices are provided for cutting and removing tissue from a body. In one exemplary embodiment, a surgical device is provided having a suction shaft and a cutting assembly. The suction shaft can have an inner passageway configured to receive tissue. The cutting assembly can include an outer shaft having at least one opening formed in a sidewall thereof configured to receive tissue. The cutting assembly can be configured to mate with the suction shaft, and it can include a cutting element configured to move relative to the opening to cut tissue disposed through the opening. Suction can be applied to cause the cut tissue to flow proximally through the suction shaft and away from the cutting assembly.

Abstract: A high pressure fluid jet system is provided, which is useful for cutting hard material during a surgical procedure. The cutting of hard material is more efficient as the system delivers abrasive solid particles with the high pressure fluid. A method of effecting cutting during a surgical procedure is also provided. In an exemplary embodiment, a surgical tool that is effective to deliver a pressurized stream of fluid through a nozzle is provided, and the pressurized stream of fluid is delivered through the surgical tool and out of the nozzle to hard material within a patient to effect cutting of the hard material within the patient in a desired pattern. The fluid that cuts the hard material can include a delivery liquid having a plurality of abrasive solid particles that are formed from an organic material. The abrasive solid particles can be entrained in the pressurized fluid stream or the pressurized fluid stream can erode a solid or suspension form of the abrasive particles.

Abstract: Compositions and methods are provided for tissue constructs that promote wound healing. The composition comprises a dimensionally stable fibrin construct for local administration to a wound site or region. In one embodiment, the fibrin construct is a wound healing composition, including components that promote wound healing, such as platelets, growth factors, white blood cells and fibrin clots. In another embodiment, the tissue treatment composition includes (i) aggregated fibrin, (ii) blood cells, and (iii) optionally, growth factors and/or other proteins.

Abstract: Methods and devices are provided for preparing and implanting tissue scaffolds. Various embodiments of scribing tools are provided that are configured to mark one or more predetermined shapes around a defect site in tissue. The shape or shapes marked in tissue can be used to cut a tissue scaffold having a shape that matches the shape or shapes marked in tissue. In one embodiment, the scribing tool used to mark a shape in tissue can also be used to cut the tissue scaffold.