Abstract: Systems and methods for AC joint dislocation surgical repairs, without knot tying. The surgical systems include two fixation devices (for example, a button and an anchor) joined by strand of flexible material having a knotless, self-cinching, adjustable loop with two splices that attach to the two fixation devices. The knotless, adjustable loop/fixation devices allow for tensioning of the AC repair after the anchor implantation.

Abstract: Suture constructs and methods for soft tissue to bone repairs. The suture construct is a soft anchor which is self-cinching and has the ability to compress from a first, extended, uncompressed position to a second, folded or compressed position. The soft anchor may have a tubular/sleeve/sheath shape and may be formed essentially of a flexible, soft material such as suture, for example, a loosely braided UHMWPE sheath having a tubular configuration.

Abstract: Techniques and reconstruction systems for knotless tissue fixation using a driver with a cannulated interference device or fixation device preloaded on the shaft of the driver. An eyelet, adjustable in size, is formed of a loading suture provided at the distal end of the driver shaft. A working suture attached to the tissue to be fixed is passed through the eyelet. The size of the eyelet is adjusted by the user once the working suture is passed through the eyelet, to capture the working suture with the eyelet. The cannulated interference device is then advanced down the shaft to secure the working suture in a bone socket.

Abstract: A tensioning construct with a tape securely attached to a locking button provided with a securing mechanism in the form of a trap door-like mechanism. The tape is looped so that the looped portion of the tape is passed around a feature of the button to allow easy sliding of the tape. One free end of the tape is fed through the securing mechanism (trap door) of the locking button while the other free end is fixed to the locking button. The button self-engages without the need of a locking instrument, to lock the tape as it is tightened during the cerclage repair. The tensioning construct may be provided as a pre-assembled construct.

Abstract: Techniques and reconstruction systems for knotless tissue fixation using a driver with a cannulated interference device or fixation device preloaded on the shaft of the driver. An eyelet, adjustable in size, is formed of a loading suture provided at the distal end of the driver shaft. A working suture attached to the tissue to be fixed is passed through the eyelet. The size of the eyelet is adjusted by the user once the working suture is passed through the eyelet, to capture the working suture with the eyelet. The cannulated interference device is then advanced down the shaft to secure the working suture in a bone socket.

Abstract: Methods and drill guide systems that provide internalization of the biceps tendon with use of fixation devices such as the Arthrex BicepsButton™ or Pectoralis Button tensioned outside a smaller converged drill hole. The technique converges two angled drill holes and use the button to fixate a reinforced (whipstitched) biceps tendon into a single bone versus stabilizing two bones. The biceps tendon is being pulled into the larger of the drilled holes and fixed by the button outside of the smaller drilled hole.

Abstract: A cannula with a tri-slot dam assembly including two primary dams as the main fluid seal and an adjacent outer “baffle-like dam” that prevents fluid pressure build-up and allows the fluid to leak out and not squirt out of the cannula. The baffle-like dam has a body formed of a low profile material and is provided with a plurality of small through holes or perforations to allow fluid to gently leak out. Fluid that enters the outer chamber leaks out of the through holes so that the fluid pressure between the baffle and the primary dams is very low. A spacer is optionally provided between the two primary dams and the outer dam to prevent the dams from interfering with each other and allow them to remain open.

Abstract: Apparatus and methods for tissue fixation/attachment/reattachment using a knotless tensionable suture construct. The knotless tensionable suture construct is a self-tensioning suture loop that can be tensioned and retensioned after the repair and can be cycled few times. The self-tensioning suture loop is formed of: (i) a simple metal surgical needle with a thin loop off the base of it to allow suture to slide through it; (ii) a single strand of surgical suture which can be of various sizes and colors; (iii) a large knot which is tied to create a large bulge to fix the construct to the device (this can be a knot or secondary piece of material, like a button); (iv) a splice formed by the single strand of suture going back through itself, the splice locking the suture in place; and (v) a suture tail that is pulled to reduce the loop size of the construct and tension the repair.

Abstract: A parallel drill guide and system which maintains contact on the bone at various angles. The parallel drill guide comprises a fixed sleeve and a parallel, axially slidable, sleeve for guiding the insertion of two parallel wires or pins into bone at any angle while maintaining contact between the bone and the guide. The drill guide is also provided with a locking mechanism that locks the slidable sleeve into position at any lateral distance relative to the fixed sleeve, using a novel off-axis locking device.

Abstract: A hybrid monofilament/braided surgical suture that combines a monofilament with a braided construction. The hybrid surgical suture may be formed by braiding yarns of high tenacity fibers tightly over a core in the form of a monofilament yarn. The monofilament may be any type of material, for example, a nylon, silk, polyester, polyethylene or polypropylene filament, among many others. The stiffness properties of the hybrid surgical suture allow the suture to be pushed through small and very small diameter tubes and cannulations (such as Lasso instruments, for example) yet fix securely with existing fixation devices (such as knotless suture anchors like PushLock® anchors).

Abstract: Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair systems include self-cinching constructs with splices and loops having attached flexible materials that are pre-loaded onto modified knotless anchors (for example, swivel and/or screw-in suture anchors and/or push-in suture anchors with a distal eyelet) to position the self-locking, adjustable construct at the repair site. The systems allow for knotless tensioning of the tissue after the knotless anchors have been implanted.

Abstract: A bone plate configured to accommodate flexible strands (flexible loops) attached to soft tissue to be attached to bone. The bone plate has a plurality of recessed eyelets on the distal edge of the plate, to allow the user (surgeon) to pass a flexible strand through the recessed eyelets and reattach the soft tissue to the plate at the anatomical location where the tissue was dissected. The recessed eyelets may have various shapes, forms and configurations and may be provided on or within a surface of the bone plate in any number, depending on the characteristics of the fractured bone or bone segments, or of the plate design. The eyelets preferably receive a flexible strand for fixation of soft tissue to the bone plate.

Abstract: A cannula with a tri-slot dam assembly including two primary dams as the main fluid seal and an adjacent outer “baffle-like dam” that prevents fluid pressure build-up and allows the fluid to leak out and not squirt out of the cannula. The baffle-like dam has a body formed of a low profile material and is provided with a plurality of small through holes or perforations to allow fluid to gently leak out. Fluid that enters the outer chamber leaks out of the through holes so that the fluid pressure between the baffle and the primary dams is very low. A spacer is optionally provided between the two primary dams and the outer dam to prevent the dams from interfering with each other and allow them to remain open.

Abstract: Soft anchor constructs and methods for soft tissue to bone repairs. The soft anchors may be knotted or knotless constructs. The soft anchors include a body formed of various soft materials (including, but not limited to, suture) and provided in various shapes and configurations that confer the anchors the ability to be easily inserted within bone tunnels or sockets and be bunched up within the bone tunnels or sockets. At least one closed loop or soft eyelet is attached to the soft anchor to allow additional sliding strands and/or shuttle/pull devices (suture passing devices) to pass through the eyelet and aid in the knotted or knotless fixation of tissue to bone.

Abstract: Suture constructs and methods for soft tissue to bone repairs. The suture construct is a soft anchor which is self-cinching and has the ability to compress from a first, extended, uncompressed position to a second, folded or compressed position. The soft anchor may have a tubular/sleeve/sheath shape and may be formed essentially of a flexible, soft material such as suture, for example, a loosely braided UHMWPE sheath having a tubular configuration.

Abstract: An instrument for passing sutures in tissue repair and/or other mini-open procedures. The instrument includes a pair of jaws mounted on a distal end of a shaft, a hand assembly mounted on a proximal end of the shaft, and a needle mounted on the hand assembly and through a cannulation of the shaft. The pair of jaws includes a lower jaw and an upper jaw, the lower jaw being provided with a slot configured to engage a plurality of sutures. The hand assembly has a finger lever with a ratchet and a releaser with a hook, the hand assembly being designed to move the needle from a first position to a second position, and to sequentially engage the needle with each of the plurality of sutures.

Abstract: Systems and methods for soft tissue to bone repairs employing tensionable knotless anchors, without knot tying. The tensionable knotless anchors may be used by themselves or in combination with additional constructs (which may have a similar or different configuration, i.e., modified according to the specific repair) and with the flexible strands provided through tissue, around tissue, or through and around tissue to be repaired or fixated. The tensionable knotless anchors may be used to achieve simple stitch repairs, mattress stitch repairs or interlocked looped mattress repairs, among others. The tensionable knotless anchors may be also provided in a daisy chain configuration, i.e., with the suture from one anchor passed through the eyelet/loop of the shuttle/pull device of another anchor and repeated in a pattern.

Abstract: Apparatus and methods for passing multiple sutures in tissue repair and/or other mini-open procedures. The apparatus includes a pair of jaws mounted on a distal end of a shaft, a hand assembly mounted on a proximal end of the shaft, and a needle mounted on the hand assembly and passing through a cannulation of the shaft. The pair of jaws includes a lower jaw and an upper jaw, the lower jaw being provided with a slot configured to sequentially engage multiple sutures inserted into the instrument. The handle assembly has a cam mechanism and a finger lever with a ratchet and a releaser with a hook, the handle assembly being designed to move the needle from a first position to a second position, and to thereby sequentially capture, in the needle, each of the multiple sutures inserted in the instrument, for subsequent passing through tissue.

Abstract: A bone plate with a new design that prevents the bushing from rotating and/or dislodging from the screw hole during screw insertion. The plate is provided with through-holes having internal walls with at least one flat that is configured to align with a corresponding flat provided on the outer wall of the bushing. The bushing is inserted by orienting the bushing in a direction perpendicular to the through-hole of the plate so that the center of the bushing is aligned with the center of the through-hole and the flat on the bushing is aligned with the flat on the through-hole of the bone plate. The bushing is introduced into the through hole until the centers are aligned, and then the bushing is rotated about 90 degrees so that the bushing is captured within the through-hole of the plate. Once captured, the bushing cannot rotate, dislodge from, or come out of the plate unless the bushing is turned 90 degrees.

Abstract: Systems and methods for AC joint dislocation surgical repairs, without knot tying. The surgical systems include two fixation devices (for example, a button and an anchor) joined by strand of flexible material having a knotless, self-cinching, adjustable loop with two splices that attach to the two fixation devices. The knotless, adjustable loop/fixation devices allow for tensioning of the AC repair after the anchor implantation.