Abstract: A surgical punch including an upper jaw and lower jaw that are coupled at their proximal ends. The jaws have cutting edges at their distal end configured to cut in a direction from the distal ends of the jaws towards the proximal ends of the jaws. The center of rotation of the cutting trajectory can be located above the initial cutting point of the lower jaw. The upper jaw can include a reversed slope leading edge. The jaws can be slidably coupled to each other. The coupling member can include a pin and slot to couple the movable jaw to an actuating rod.

Abstract: A tissue fastener comprises a shaft having a member disposed thereon for lodging the shaft within the tissue, the shaft having a region that is relatively flexible to render a tissue engaging head disposed at a proximal end of the shaft movable with respect to the shaft. In one embodiment, the region comprises substantially an entire length of the shaft and is made from flexible material, such as a mesh, onto which the member and the head are molded. In another embodiment, the shaft comprises generally rigid material, and the region comprises a flexible joint between the shaft and the head. The flexible joint comprises a breakable (e.g., frangible) section of the shaft, and a flexible member (e.g., a plurality of filaments or a flexible tube) extends between the shaft and the head past the breakable section.

Abstract: A method of securing a tissue graft within a bone passage includes providing a graft fixation member comprising a closed-loop having a pair of opposing loop sections and capturing a first loop section of the closed-loop within the fixation member. An opposing second loop section of the closed loop is passed through an opening in the tissue graft, and the second loop section of the closed loop is secured to the fixation member.

Abstract: A tissue fastener comprises a shaft having a member disposed thereon for lodging the shaft within the tissue, the shaft having a region that is relatively flexible to render a tissue engaging head disposed at a proximal end of the shaft movable with respect to the shaft. In one embodiment, the region comprises substantially an entire length of the shaft and is made from flexible material, such as a mesh, onto which the member and the head are molded. In another embodiment, the shaft comprises generally rigid material, and the region comprises a flexible joint between the shaft and the head. The flexible joint comprises a breakable (e.g., frangible) section of the shaft, and a flexible member (e.g., a plurality of filaments or a flexible tube) extends between the shaft and the head past the breakable section.

Abstract: A method of securing a tissue graft within a bone passage includes providing a graft fixation member comprising a closed-loop having a pair of opposing loop sections and capturing a first loop section of the closed-loop within the fixation member. An opposing second loop section of the closed loop is passed through an opening in the tissue graft, and the second loop section of the closed loop is secured to the fixation member.

Abstract: A method of securing a tissue graft within a bone passage includes providing a graft fixation member comprising a closed-loop having a pair of opposing loop sections and capturing a first loop section of the closed-loop within the fixation member. An opposing second loop section of the closed loop is passed through an opening in the tissue graft, and the second loop section of the closed loop is secured to the fixation member.

Abstract: A method of repairing cartilage (e.g., articular cartilage on the femur) and a set of instruments used in the method are provided. The damaged cartilage is removed from the bone to expose the underlying bone, grafts covered with cartilage (e.g., hyaline cartilage) are harvested from elsewhere in the body (e.g., other areas of the femur), and the grafts are inserted into holes drilled into the exposed area of bone. A guide is provided for use with surgical instruments during the procedure to orient the surgical instruments perpendicularly to the bone surface during use. The guide includes a guiding portion disposed along a longitudinal axis for engaging the surgical instrument, and a tissue-engaging portion oriented perpendicularly to the longitudinal axis. A set of surgical instruments used to carry out the method includes the guide, a drill for forming the graft-receiving holes, and an insertion tool for inserting the grafts. Other accessory instruments are also provided.

Abstract: A method of closing a tissue wound includes providing a wound closure device having a first anchor, a second anchor, and a flexible member movably attached to the second anchor, positioning the first anchor against tissue, passing the flexible member across the wound, positioning the second anchor against tissue, and pulling on a free end of the flexible member to shorten a length of the flexible member between the first and second anchors, thereby closing the wound. A wound closure device includes a first anchor, a second anchor; and a flexible member connecting the first anchor to the second anchor, the flexible member being movably attached to the second anchor, such that pulling on a free end of the flexible member shortens a length of the flexible member between the first and second anchors.

Abstract: A surgical apparatus includes a body configured for insertion into a bore of a surgical handpiece and a latch that includes a resilient member connected to the body. The resilient member has a latching structure configured to latchingly engage a surface of the surgical handpiece within the bore.

Abstract: A guide for positioning a tibial tunnel in anterior cruciate ligament (ACL) reconstruction. The guide includes a guide arm and a drill sleeve connected to the guide arm. A distal tip of the guide arm is configured to contact a femoral surface, and a distal tip of the drill sleeve is configured to contact a tibial surface when the distal tip of the guide arm contacts the femoral surface.

Abstract: A method of repairing cartilage (e.g., articular cartilage on the femur) and a set of instruments used in the method are provided. The damaged cartilage is removed from the bone to expose the underlying bone, grafts covered with cartilage (e.g., hyaline cartilage) are harvested from elsewhere in the body (e.g., other areas of the femur), and the grafts are inserted into holes drilled into the exposed area of bone. A guide is provided for use with surgical instruments during the procedure to orient the surgical instruments perpendicularly to the bone surface during use. The guide includes a guiding portion disposed along a longitudinal axis for engaging the surgical instrument, and a tissue-engaging portion oriented perpendicularly to the longitudinal axis. A set of surgical instruments used to carry out the method includes the guide, a drill for forming the graft-receiving holes, and an insertion tool for inserting the grafts. Other accessory instruments are also provided.

Abstract: A surgical apparatus includes a body configured for insertion into a bore of a surgical handpiece and a latch that includes a resilient member connected to the body. The resilient member has a latching structure configured to latchingly engage a surface of the surgical handpiece within the bore.

Abstract: A template for use in forming an insertion for cruciate ligament reconstruction surgery includes a template body that is inserted into the knee and positioned on a wall of the femoral notch of the knee. The template body includes openings sized and positioned to receive guidewires and to direct the guidewires into the wall of the femoral notch.

Abstract: A guide for positioning a tibial tunnel in anterior cruciate ligament (ACL) reconstruction. The guide includes a guide arm and a drill sleeve connected to the guide arm. A distal tip of the guide arm is configured to contact a femoral surface, and a distal tip of the drill sleeve is configured to contact a tibial surface when the distal tip of the guide arm contacts the femoral surface.

Abstract: A surgical apparatus includes a body configured for insertion into a bore of a surgical handpiece and a latch that includes a resilient member connected to the body. The resilient member has a latching structure configured to latchingly engage a surface of the surgical handpiece within the bore.

Abstract: A surgical instrument in which a surgical tool is carried distally of a bend region in a stationary support member by an assembly that transmits proximally applied forces through the bend region to both operate the surgical tool and selectively change the rotational orientation of the surgical tool with respect to the stationary member. In another aspect, in which the stationary member does not include a bend region, a rotatable member supported by the stationary member transmits rotational force to the surgical tool to selectively change the rotational orientation of the tool, and a driver member supported by the stationary member transmits axial force to the surgical tool to operate it.

Abstract: A soft tissue anchor delivery apparatus includes a gripping device having fingers at the distal end and configured such that they can hold a soft tissue anchor about the head portion of the anchor. An actuating tube slides over the gripper and the fingers, thus holding the fingers and the contained soft tissue anchor within the bore of the actuating tube. A pushrod is placed within the bore of the gripper. The pushrod has a countersunk head that is shaped such that it is a close fit for the head of the soft tissue anchor. The pushrod is connected to a tube having a bore so that the actuating pin of the soft tissue anchor can be pushed down into the head of the anchor. The pushrod is spring loaded so as to allow the pushrod to be driven distally upon retraction of the actuating tube, thus driving the anchor free of the deployed fingers and hence of the entire delivery system.

Abstract: A surgical instrument in which a surgical tool is carried distally of a bend region in a stationary support member by an assembly that transmits proximally applied forces through the bend region to both operate the surgical tool and selectively change the rotational orientation of the surgical tool with respect to the stationary member. In another aspect, in which the stationary member does not include a bend region, a rotatable member supported by the stationary member transmits rotational force to the surgical tool to selectively change the rotational orientation of the tool, and a driver member supported by the stationary member transmits axial force to the surgical tool to operate it.

Abstract: An apparatus and method for positioning a leg during surgery has a support for holding a substantial portion of one of the patient's legs on the side facing the other leg and a pivot located in the proximity of the patient's pelvis. After patient's pelvis is secured relative to the operating table, the distal end of the support can be moved for adjustment of the outer extremity of the patient's leg relative to the operating table to selectively position the leg relative to the patient's pelvis.

Abstract: A soft tissue anchor implantation device having a bore along its longitudinal axis through which a guiding K-wire or other guiding devices may be freely drawn, and into which an anchor expanding pin may be wedged to expand the anchor body and lodge it securely in a hole in a bone. In one embodiment the anchor has an elongated body with proximal and distal ends. The proximal end is supplied with an enlarged head having an underside equipped with downwardly extending spikes for gripping soft tissue.