Abstract: A system for anterior cruciate ligament (ACL) reconstruction using holes in bone created by retrograde cutting. A rotary cutter, mounted onto an insertion post of a tibial guide, is inserted through an anteromedial portal and the rotary cutter placed on the anatomical origin of an ACL tibial insertion. A drill pin is drilled through the tibia and advanced until it contacts and engages a cannulation in the rotary cutter on the guide. Further rotation of the drill pin disengages the rotary cutter from the guide. The retrograde drill pin is then retracted and simultaneously rotated for retrograde cutting of a socket or tunnel of desired depth in the tibia. A similar system is provided to form a socket or tunnel in the femur except that a femur guide is used in place of the tibial guide.

Abstract: A method and construct for joint repair in which attachment of a double bundle graft ligament approximates anatomic orientation using interference fixation in a single bone tunnel. The double bundle graft features separable strands. A threaded screw is inserted between the separable strands and provides interference fixation of the graft against radially opposing walls defining the bone tunnel. Attachment of the graft using separated strands more closely approximate the configuration of the native ligament. The resulting reconstruction exhibits mechanical functionality that more accurately mimics that of the intact joint, with a minimum of associated tissue morbidity.

Abstract: Methods of arthroscopic harvesting of bone marrow aspirate from bone joints and therapeutic application of the bone marrow aspirate in a bone joint. The method of harvesting includes extracting bone marrow from a joint, adding a biomaterial, and adding clotting agent to form a clot.

Abstract: A bone drill that includes a shaft with a flexible portion having a proximal end and a distal end and a drill tip coupled to the distal end of the shaft. The bone drill also includes a cannulated sheath with a proximal end and a distal end, the sheath housing a portion of the shaft and having a curved portion at the distal end. The drill tip may also be housed within the curved portion of the sheath. The bone drill may also include a hub with an actuator mechanism, the hub being coupled to the sheath, wherein the actuator mechanism retracts the sheath to cause the drill tip to extend beyond the distal end of the sheath.

Abstract: Fixation of soft tissue to bone (or of soft tissue to soft tissue) is performed using a flexible material (for example, a suture strand, a braid, a suture tape, a stuffed suture, or a combination thereof) with a portion having an expanded footprint to provide a cushion or tissue protector between the flexible strand (suture) and the tissue to be attached. The suture and cushion may be manufactured from materials that have properties to amplify the body's healing response. The cushion may have any shape and geometry that provides cushioning action between the suture and the tissue to be fixated. The cushion may be provided along the length of the flexible strand (i.e., the flexible strand may be provided with a cushion) or the flexible strand may extend from the cushion.

Abstract: Techniques and reconstruction systems for fixation of bone to bone, or soft tissue to bone, that allow a double-bundle type construct with only three tunnels, a single graft and individual tensioning in each of the three tunnels. Alternative double-bundle ACL/PCL fixation techniques are provided that employ a double-bundle type construct with only a single graft and three tunnels/sockets. The double-bundle ACL and PCL techniques and constructs allow individual tensioning of each of the bundles (e.g., tensioning of each of the anteromedial (AM) and posterolateral (PL) bundles of the ACL) and eliminate the need for additional fixation devices (for example, interference screws) to secure the bundles within the bone tunnels/sockets.

Abstract: A method and construct for joint repair in which attachment of a double bundle graft ligament approximates anatomic orientation using interference fixation in a single bone tunnel. The double bundle graft features separable strands. A threaded screw is inserted between the separable strands and provides interference fixation of the graft against radially opposing walls defining the bone tunnel. Attachment of the graft using separated strands more closely approximate the configuration of the native ligament. The resulting reconstruction exhibits mechanical functionality that more accurately mimics that of the intact joint, with a minimum of associated tissue morbidity.

Abstract: A system for anterior cruciate ligament (ACL) reconstruction using holes in bone created by retrograde cutting. A rotary cutter, mounted onto an insertion post of a tibial guide, is inserted through an anteromedial portal and the rotary cutter placed on the anatomical origin of an ACL tibial insertion. A drill pin is drilled through the tibia and advanced until it contacts and engages a cannulation in the rotary cutter on the guide. Further rotation of the drill pin disengages the rotary cutter from the guide. The retrograde drill pin is then retracted and simultaneously rotated for retrograde cutting of a socket or tunnel of desired depth in the tibia. A similar system is provided to form a socket or tunnel in the femur except that a femur guide is used in place of the tibial guide.

Abstract: An insert-molded suture anchor with a biodegradable polymer body in which a loop of suture is totally contained within the polymer. The suture anchor body features a drive end that is shaped to be received into a recess in the end of a hand driver. Anchoring ribs are formed along the remaining length of the anchor. The loop of suture which includes and eyelet for attaching a suture strand is totally embedded within the anchor body during the insert-molding fabrication process. The anchor is produced by placing the suture in an injection mold, and injecting biodegradable polymer into the mold.

Abstract: Knotless fixation of soft tissue to bone is accomplished using a bone anchor configured to provide interference fixation of a soft-tissue connector. The soft-tissue connector is provided in the form of a flat narrow piece of material. Additional fixation strength can be provided by configuring the bone anchor to penetrate into or through the soft-tissue connector. The bone anchor is installed into a pre-formed hole or socket in the bone.

Abstract: A method and apparatus for anterior cruciate ligament (ACL) reconstruction using sockets in bone created by retrograde cutting. A retrograde rotary cutter, inserted onto an insertion post of a tibial guide, is inserted through an anteromedial portal and the rotary cutter placed on the anatomical origin of an ACL tibial insertion. A retrograde drill pin, guided by a drill guide, is drilled through the tibia until it contacts the rotary cutter. Once the cutter is disengaged from the guide and securely engaged in the retrograde drill pin, the retrograde drill pin is retracted for retrograde cutting of a socket of desired depth in the tibia.

Abstract: An all-inside double-socket ACL reconstruction technique, according to which a femoral socket and a closed tibial socket are provided to accommodate retrograde fixation of at least one graft (for example, a semitendonosus allograft) within the sockets. The closed tibial socket is formed by using a retrograde drill device provided with a retrograde drill cutter detachable from a retrograde drill guide pin. The femoral socket may be formed by the retrograde drill method or by a conventional method, and may be carried out before or after the formation of the tibial socket. The graft is secured in the knee by employing a transversal implant, or by employing an interference screw, and/or a continuous loop/button construct.

Abstract: Techniques, mixtures, mixing and delivery kits, and improved delivery instruments for implantation of micronized allograft tissue over a microfractured defect. Allograft cartilage tissue is delivered over a cartilage defect that has been debrided and microfractured, without the need for a periosteal covering or separate type of patch sewn over the top. The allograft tissue may be any micronized cartilage particulates obtained by various methods, for example, cartilage delivered in its native form, dehydrated via lyophilization, “freeze-dried,” dehydrated via desiccation, or dehydrated by any other method.

Abstract: Biologic partial menisci (biologic partial meniscal replacements/constructs) used to replace at least a part of a meniscus, and methods of forming such biologic partial menisci. Meniscal cartilage is employed to form a moldable allograft paste. A sterile mold that replicates a meniscus (for example, the medial or lateral meniscus) is provided in various sizes and is used as a biologic mold to recreate the anatomic shape of the meniscus. The moldable paste is inserted (for example, injected) into the mold and allowed to set into a stable, anatomically shaped meniscus (the biologic partial meniscus). Fibrin glue or other biologic adhesives or strengtheners may be optionally added to provide further biomechanical strength. Once the biologic partial meniscus is removed from the mold, it is provided at the surgical site and attached to the excised meniscus (placed into the correct anatomical shape) to complete the meniscal repair.

Abstract: Methods of arthroscopic resurfacing of anatomical tissue utilizing a biological component strengthened with glue or similar material. The biological component is selected from the group consisting of blood, blood components, PRP, bone marrow aspirate (BMA) and autologous conditioned plasma (ACP). The biological component/glue composition may be inserted (by injection and/or by employing a biologic resurfacing mold, for example) into, or in the vicinity of, the anatomical tissue. Upon insertion within, or contact with, the anatomical tissue, the biological component/glue composition is designed to coagulate and solidify (or partially solidify) within minutes, to advance healing or tissue growth of the anatomical tissue. The biological component/glue composition may optionally comprise components such as growth factors, antiseptic chemicals and/or antibiotics and/or electrolytes, or hormones or site-specific hybrid proteins, among others.

Abstract: A system and surgical methods for repairing tears in meniscal tissue using meniscal darts. In a preferred embodiment, the system includes a cannulated insertion sheath, a meniscal dart, and a disposable dart driver preloaded with a meniscal dart at its distal end. The insertion sheath is located near a meniscal tear, and sharp prongs on the tip of the sheath are used to secure and position the central fragment of the torn meniscus. The dart driver with a preloaded dart is advanced through the cannulation of the insertion sheath such that the preloaded meniscal dart at the distal end of the driver is inserted through the meniscal tear.

Abstract: A retracting two-piece cannula for distracting soft tissue from bone (e.g., the articular surface of a knee) to provide a surgical workspace for osteochondral repair. After inserting an outer cannula provided with a threaded outer surface into an incision (preferably widened by one or more dilators), the outer cannula is rotated to engage the threaded outer surface with the soft tissue to be distracted. An inner cannula is then inserted into the outer cannula and advanced until it contacts the articular surface. Further relative movement between the inner and outer cannulas causes the outer cannula to be drawn away from the articular surface, thereby retracting the soft tissue and establishing the workspace. The inner and outer cannula are then locked together to maintain the workspace, and an osteochondral core may be introduced through the inner cannula.

Abstract: A method and construct for joint repair in which attachment of a double bundle graft ligament approximates anatomic orientation using interference fixation in a single bone tunnel. The double bundle graft features separable strands. A threaded screw is inserted between the separable strands and provides interference fixation of the graft against radially opposing walls defining the bone tunnel. Attachment of the graft using separated strands more closely approximate the configuration of the native ligament. The resulting reconstruction exhibits mechanical functionality that more accurately mimics that of the intact joint, with a minimum of associated tissue morbidity.

Abstract: A method of producing blood serum containing prophylactically or therapeutically active proteins, including obtaining blood from a patient, incubating the blood at a suitable temperature to induce production of prophylactically or therapeutically active proteins, and removing the prophylactically or therapeutically active proteins from the blood.

Abstract: A fenestrated suture anchor for fixation of tissue to bone. In a preferred embodiment, the suture includes an implant, such a swivel implant with a forked tip for capturing suture. The implant is secured in a hole in bone by advancing a fixation device, such as a cannulated interference screw, to engage and fully seat the implant. The cannulated fixation device is provided with a plurality of openings or fenestrations of various dimensions and geometries to provide multiple pathways through the anchor (i.e., though the interior of the body and through the fenestrations) to allow blood to flow to increase the healing zone, for example, for rotator cuff repair, while also promoting bone in-growth.