Abstract: Osteochondral sockets are formed using a retrograde drill assembly. The retrograde drill assembly includes a guide pin having a fluted tip and an externally threaded portion. A removable cutter head has internal threads that engage the threads of the guide pin. The guide pin is drilled through bone, exposing the external threads in a joint space requiring repair. The cutter is threaded onto the guide pin, and the assembly is retrograded with rotation to form a socket in the bone. The cutter is disengaged from the guide pin for disassembly and removal from the bone, making way for an implant to be installed in the pocket. The implant can be drawn into the socket using an attached strand threaded through the bone socket and out of the bone.

Abstract: The length of a bone fracture fixation screw may be intraoperatively adjusted with the aid of a cutting jig that includes a measuring block which is slidable along a rail adjacent a measuring scale and a holding block to facilitate cutting the distal end of the screw once the desired length has been determined. A tip sharpener may be incorporated into the cutting jig or may be provided separately, for reforming a point at the distal tip of the cut fixation screw.

Abstract: A surgical implant for securing ligament grafts into a joint. The implant is formed entirely of allograft cortical bone, and has a tapered tip with a suture eye. A length of suture is knotted or looped through the eye. The suture is used to draw the implant transversely through a looped graft construct to fix the graft by spanning a bone socket, for example. In a preferred embodiment, the implant is used for knee ligament repair by forming a longitudinal socket in a bone. A flexible strand is drawn with the pin through the bone. A looped portion of the flexible strand is diverted so as to protrude out of the entrance to the longitudinal socket. The ends of the flexible strand remain accessible on either side of the bone. The ligament graft is captured within the strand loop protruding from the entrance to the socket. The strand is retracted into the socket, drawing the graft into the socket by pulling on the accessible ends of the flexible strand. The graft is fixed in the socket using the transverse implant.

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 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 meniscal allograft with a bone block having a trapezoidal shape in cross-section and a technique for using a meniscus allograft having a trapezoidal shaped bone block are disclosed. A groove is formed initially in the bone using drill bits. Dilators are used to increase the size of the drilled groove. The orthogonal corner at the bottom of the groove is shaped using a rasp. A smooth dilator compacts the bone in the acute angle at the bottom of the groove opposite the orthogonal corner to create the final trapezoid shape of the bone groove. A meniscal allograft having a bone block of corresponding trapezoidal shape is prepared using a workstation and three cutting jigs to make three corresponding cuts. The trapezoidal bone block of the meniscal allograft is then installed within the bone groove.

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 retrograde osteochondral autograft transfer system that ensures that grafted healthy bone is implanted into the recipient site in a retrograde manner as opposed to a conventional anterior manner, so that the grafted healthy bone is flush with the bone surface of the recipient size. The retrograde osteochondral autograft transfer system of the present invention employs two identically-sized harvesters which are aligned with each other for transfer and reversal of a harvested osteochondral core, such that the core can be introduced into the recipient site through a tunnel leading to the recipient site, with an articular surface of the core advanced in a leading position.

Abstract: A torque driver includes a torque measurement assembly for indicating the amount of torque being applied during implanting of an interference screw. The torque measurement assembly includes a proximal cup and a distal cup, and a coil spring fixed between the cups. A torque scale is marked on one of the cups, while a reference marking is provided on the other. When used to insert an interference screw, the driver head is inserted into the socket of the screw and the driver is turned, which causes the torque spring to tighten. As the spring tightens, the reference mark moves relative to the scale to indicate the torque measurement exerted on the spring. Using this torque driver, a surgeon can be made aware if too much torque is being exerted or if a desired minimum torque load for achieving a desirable level of fixation strength for the graft is not reached.

Abstract: The length of a bone fracture fixation screw may be intraoperatively adjusted with the aid of a cutting jig that includes a measuring block which is slidable along a rail adjacent a measuring scale and a holding block to facilitate cutting the distal end of the screw once the desired length has been determined. A tip sharpener may be incorporated into the cutting jig or may be provided separately, for reforming a point at the distal tip of the cut fixation screw.

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 device for tensioning suture which includes two telescopically slidable cannulated tubes. An adjustment wheel is coupled to and turns a threaded post which is threadingly engaged with the proximal end of one of the slidable tubes. A suture end is passed through the cannulated tubes of the suture tensioning device and secured to the adjustment wheel. Rotating the adjustment wheel counterclockwise increases the overall length of the suture tensioning device and increases tension on the suture.

Abstract: A surgical implant for securing ligament grafts into a joint. The implant is formed entirely of allograft cortical bone, and has a tapered tip with a suture eye. A length of suture is knotted or looped through the eye. The suture is used to draw the implant transversely through a looped graft construct to fix the graft by spanning a bone socket, for example. In a preferred embodiment, the implant is used for knee ligament repair by forming a longitudinal socket in a bone. A flexible strand is drawn with the pin through the bone. A looped portion of the flexible strand is diverted so as to protrude out of the entrance to the longitudinal socket. The ends of the flexible strand remain accessible on either side of the bone. The ligament graft is captured within the strand loop protruding from the entrance to the socket. The strand is retracted into the socket, drawing the graft into the socket by pulling on the accessible ends of the flexible strand. The graft is fixed in the socket using the transverse implant.

Abstract: A surgical method for transosseous fixation of a bone-tendon-bone (BTB) graft into a joint is disclosed. A longitudinal tunnel formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A portion of the strand is diverted so as to protrude out of the entrance to the longitudinal tunnel. The strand portion is attached to a loop extending from the bone block of the BTB graft, preferably by forming the loop around the strand. The strand attached to the bone block loop is retracted into the tunnel, drawing the attached BTB graft into the tunnel. The BTB graft is fixed in the tunnel using a transverse implant passed through the loop.

Abstract: A suture hook for use in arthroscopic repairs of the shoulder has a tapered shaft and a handle disposed on the proximal end of the shaft. An O-ring post for holding suture is disposed on the handle. A curved hook on the distal end of the shaft terminates in a sharp point for piercing tissue. A slot is formed distally on the convex side of the hook for receiving a loop of the suture. A length of suture loaded as a loop onto the suture anchor is held in the slot and secured by wrapping the suture tails around the O-ring post. The loaded suture hook is advanced through tissue by piercing the tissue with the sharp tip. The suture is then released from the post and the hook is retrograded leaving the loop of suture available for further surgical manipulation.

Abstract: An arthroscope cannula for a sleeveless arthroscope. The arthroscope cannula is provided with an elongated shaft, a distal end with a threaded portion which allows the arthroscope cannula to securely lock into the knee capsule, and a proximal end for receiving the sheathless arthroscope. The cannula includes a slidable retention clip that is advanced on the shaft of the cannula to a position against the skin to maintain traction and stabilize the cannula against retraction, and to distend the joint capsule.

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: Apparatus for autogenous or allograft transplantation of articular cartilage with bone from one site, such as in the knee, to another to treat chondral defects. Graft harvesters and recipient site harvesters create identically-sized donor graft osteochondral cores and recipient sockets. Collared pins disposed within the harvesters facilitate removal of the harvested cores. Windows formed in the side of the harvester tubes allow visualization of the graft, such as when being inserted into the recipient socket. A removable three-piece driver/extractor is provided to allow for impact-driving and depth control of the harvesters at the selected sites.

Abstract: In a method of performing a hyaline cartilage allograft transplantation procedure in which a surgeon has pre-operatively determined a size of allograft to be needed for the procedure, a service provider facilitates the procedure by arranging, upon receiving an order from the surgeon or a hospital for an allograft of a specified diameter, for the delivery of a precut allograft core along with a customized set of instrumentation for performing the transplantation to the surgeon or hospital prior to the scheduled time of the operation. The service provider also arranges for the return of any non-disposable instrumentation to the service provider after the operation.

Abstract: Endosteal fixation of a ligament graft with a bioabsorbable interference screw installed in a retrograde manner in ACL reconstruction. The bioabsorbable interference screw is insert-molded with a length of suture extending from the distal tip of the screw for pulling the interference screw into the joint and into position for retrograde insertion at the top of the tibial tunnel. The interference screw has a cannulation extending partially through the screw from the leading tip. The cannulation is shaped to receive a correspondingly shaped driver. The driver is inserted into the tibial tunnel to engage the screw. By turning the driver, the interference screw is turned into the tibial tunnel in a retrograde manner. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.