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.

Abstract: An internet-based patient health outcome data collection system, and a system for accessing information from the collected database. The system includes a web-based patient and doctor interface that allows both a patient and doctor to separately input data into the data collection database. The web-based patient interface allows a patient to input data such as responses to questions regarding levels of pain, function, satisfaction, quality of life, activities of daily living, unexpected results, and questions, pre- and post-procedure. The doctor interface also includes an analysis tool that allows the doctor to analyze the data from a specific patient, a group of patients, or all the patients, with specific characteristics as chosen by the doctor. The doctor interface also allows the doctor to compare an individual patient against a group of the doctor's patients, all patients in the study that meet criteria chosen by the doctor, or global data.

Abstract: A hand instrument for retrieving suture and advancing a suture knot within a patient. The instrument has a shaft with proximal and distal ends. A hinged jaw in the form of a crabclaw disposed on the distal end of the shaft captures suture within a closed aperture formed by the jaws or is used to pinch the suture between the jaws. A hand mechanism disposed on the proximal end of the shaft opens and closes the jaw.

Abstract: A method and device for knotless fixation of tissue. A swivel anchor having a rotatable implant is used to capture suture for surgical tissue repair without requiring suture knots. The implant may be provided with a conical metal tip which is self-punching and avoids the need for pre-drilling a hole in bone. The implant includes a closed aperture to allow free sliding of a suture strand. The swivel anchor is secured in a hole in bone by advancing a fenestrated fixation device, such as a cannulated interference screw, over the body of the implant.

Abstract: Apparatus and methods for delivering a clotted biological component (such as blood, autologous conditioned plasma (ACP), platelet-rich plasma (PRP), bone marrow aspirate (BMA), demineralized bone matrix, anticoagulants and/or clotting agents, or combination of these materials) into a tissue void (for example, a bone void such as a bone tunnel, socket, opening or cavity), and then cutting the clotted biological component with a cutting or shearing mechanism at the tissue surface. The apparatus is provided with a tube and a cutting or shearing mechanism (provided on or within the distal end of the tube) that is actuated to cut or break off the clot at the desired insertion length. The tube may then be placed over the next tissue void so that the obturator drives the next clot into the next tissue void until all tissue voids are filled. Upon insertion at the defect site, the biological component advances the healing of the damaged tissue and tissue growth.

Abstract: A suture anchor has a continuous thread spiraling around a tapering central core. At the distal end, the suture anchor terminates in a rounded point. At the proximal end of the suture anchor is an eye for receiving suture. The suture anchor has a large thread surface per turn of thread. Anti-backout ridges can be formed on the front and/or back faces of the threads. A driver for the suture anchor is provided, the driver including a shaft having a central axis, a length, a distal end, and a proximal end. The shaft is provided at its distal end with an opening aligned with the central axis of the shaft, for receiving the hexagonal proximal end of the suture anchor. One or more sutures threaded through the suture eye are threaded through the hollow tubular shaft. The suture is pulled into and captured by V-shaped notches on the proximal end of the handle to hold the suture anchor in place on the distal end of the driver under the tension of the captured sutures.

Abstract: A method and apparatus for arthroscopic unicompartmental knee surgery which include a femoral component and a tibial component. The femoral component is installed in a trough in the femoral condyle formed by using a template, a plurality of drill pins and a plurality of corresponding cutters. The template is aligned with the curvature of the femoral condyle, the two drill pins are passed through the template and drilled into the femur, cutters are advanced over the corresponding drill pins to make holes in the femur, and the remaining hourglass shaped bone is removed with osteotomy pliers to form the trough. A tibial socket for the tibial component is formed in a retrograde manner.

Abstract: A two sided cylindrical chondral resurfacing implant that covers areas of the highest contact between the tibia and femur. A dual-sided rotary drill cutter is employed to create a tibial socket from outside in. A full femoral trough is made with the opposite side of the rotary drill cutter by simply moving the knee through flexion and extension. In this manner, automatic alignment of femoral and tibial components is achieved due to the “transtibial” nature of the femoral preparation.

Abstract: A high strength abrasion resistant surgical suture material with improved tie down characteristics is color coded for visualization and identification purposes. The suture features a multifilament cover formed of strands of ultra high molecular weight long chain polyethylene braided with polyester, nylon or a bioabsorbable material. Selected nylon fibers in the cover are provided in a color contrasting with the other cover fibers to provide an identifiable trace. The cover surrounds a core formed of twisted strands of ultrahigh molecular weight polyethylene. The suture, provided in a #2 size, has the strength of #5 Ethibond, is ideally suited for most orthopedic procedures, and can be attached to a suture anchor or a curved needle.

Abstract: Osteochondral repair of damaged articular joint surfaces is achieved using implants in the form of cylindrical osteochondral plugs. The plugs have an articular surface formed on at least one end. If articular surfaces are provided on both ends of the implant, the articular surfaces have differently curved surfaces. The defective cartilage is removed to create a recipient socket for the implant. An implant sized to fit the recipient socket is chosen from a plurality of implants provided to the surgeon. The implants are preferably formed of a hydrogel material such as Salubria™, although metal or allograft implants can also be used.

Abstract: A method and apparatus for repairing isolated chondral defects using synthetic implants. Lesions in articular tissue are corrected by forming a recipient socket in the tissue. A donor graft of a size corresponding to the recipient socket is harvested from a synthetic specimen made of a synthetic tissue material, such as poly (vinyl) alcohol hydrogel. The donor graft is implanted into the recipient socket.

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: Apparatus and methods for delivering a clotted biological component (such as blood, autologous conditioned plasma (ACP), platelet-rich plasma (PRP), bone marrow aspirate (BMA), demineralized bone matrix, anticoagulants and/or clotting agents, or combination of these materials) into a tissue void (for example, a bone void such as a bone tunnel, socket, opening or cavity), and then cutting the clotted biological component with a cutting or shearing mechanism at the tissue surface. The apparatus is provided with a tube and a cutting or shearing mechanism (provided on or within the distal end of the tube) that is actuated to cut or break off the clot at the desired insertion length. The tube may then be placed over the next tissue void so that the obturator drives the next clot into the next tissue void until all tissue voids are filled. Upon insertion at the defect site, the biological component advances the healing of the damaged tissue and tissue growth.

Abstract: An arthroscopic method of glenoid resurfacing with a meniscal allograft. The glenohumeral joint is debrided and holes are formed around the anterior and posterior perimeter of the glenoid rim. A meniscal allograft is prepared by removing it from its bone block and then bringing together its two horns to form a ring. Subsequent to the formation of the graft ring, a series of loops are installed along the edge of the graft. The loops correspond to the holes on the glenoid surface. Once the graft has been successfully placed on the glenoid, the loops are positioned in close proximity to the pre-drilled holes. Fixation devices such as anchors may be installed over the loops, to attach the perimeter of the graft to the glenoid through the pre-drilled holes.

Abstract: A rotary abrader allowing for improved visibility during surgery and improved aspiration of waste material. This is accomplished by providing a hood or sheath formed of a clear material and available in various shapes and sizes. The clear hood or sheath is also provided with a flattened, angled portion at a tip of the hood, to assist with retraction of the labral tissue while burring the glenoid rim. Slots are provided on the cannulated tube to provide aspiration of waste material and used to attach the hood to the cannulated tube.

Abstract: A method of securing a graft in a bone tunnel, in which graft is secured within the tunnel at both the entrance and the exit ends of the tunnel to provide bicortical fixation of the graft in the bone. Interference screws or other fixation devices are used to secure the graft within the tunnel. For tibial tunnel fixation using an interference screw, the back end of the distal screw is angled so that it closely approximates the angle of the outer tibial tunnel rim. The distal screw is non-cannulated to prevent hematomas from being formed by blood flowing from the tibial tunnel into the surrounding soft tissue. The proximal screw has a restricted cannula to minimize the flow of synovial fluid entering the tibial tunnel. Advantageously, the space between the two screws fills with blood to promote faster healing and incorporation of the graft in the tibial tunnel.