Abstract: Devices and methods for acquiring and fastening tissues folds within an internal organ, such as the stomach, and for applying the methods and devices to producing reductions in organ volume or repair of bariatric procedures, are disclosed. An exemplary method for forming a continuous laterally extending tissue fold involves forming a succession of laterally extending folds having adjacent overlapping fold portions. One exemplary tissue-acquisition device has an open-end roller-and-arm structure that allows individual tissue folds to be formed and fastened, then advanced to an adjacent region within the stomach, for capture of a new fold that will form an extension of the existing fold(s).

Abstract: A surgical device is disclosed which includes a handle assembly, an elongated member and a disposable loading unit. The handle assembly includes a mode selection mechanism configured to alternate the surgical device between a first grasping mode of operation and a second clamping mode of operation. The handle assembly includes a rotation control member and an articulation lever. The rotation control member is configured to facilitate rotation of the elongated member with respect to the handle assembly. The articulation lever is configured to facilitate articulation of the tool assembly about an axis substantially perpendicular to the longitudinal axis of elongated member. In one embodiment, the tool assembly includes a cartridge assembly having a plurality of staples and an anvil assembly configured to clamp and staple tissue in the second clamping mode of operation of the device.

Abstract: Tissue fasteners carried on a tissue piercing deployment wire fasten tissue layers of a mammalian body together include a first member, a second member, and a connecting member extending between the first and second members. One of the first and second members has a configuration alterable by a deployment wire to permit release of the fastener from the deployment wire after deployment and without causing excessive tissue trauma.

Abstract: A pivot mechanism for use with a surgical device includes a first jaw member, a second jaw member, and a pivot pin. The first jaw member includes at least one circular aperture. The second jaw member includes at least one square-like aperture. The pivot pin is configured to engage the at least one circular aperture of the first jaw member and the at least one square-like aperture of the second jaw member such that the first jaw member is pivotably coupled to the second jaw member.

Abstract: The present disclosure relates to a surgical fastener applying apparatus (10) for sequentially applying fasteners to body tissue. The apparatus includes a clamping half-section (12) having a distal anvil attachment portion (12b) and a proximal handle portion (12a), a cartridge receiving half-section (14) having a handle portion (22) and an elongated channel portion (24), the elongated channel portion being configured to releasably receive a single use loading unit and the handle portion being configured to releasably receive a firing assembly (20), an anvil member (16) configured to be releasably supported within the distal anvil attachment portion of the clamping half-section and a firing assembly configured to be releasably supported within the handle portion of the cartridge receiving half-section.

Abstract: Surgical stapling apparatus are disclosed including an anvil having a working surface with a shaped topography; and a staple cartridge, in juxtaposition with the anvil. The staple cartridge includes a working surface with shaped topography which is complementary to the shaped topography of the working surface of the shaped anvil. When the anvil and the staple cartridge are approximated with or toward one another, at least a portion of the working surface of the anvil cooperates with at least a portion of the working surface of the staple cartridge to enhance alignment of the staple cartridge and the anvil in at least one of a transverse and longitudinal direction.

Abstract: The present disclosure relates to electromechanical surgical systems configured for use with removable disposable loading units and/or single use loading units for clamping, cutting and/or stapling tissue. A force transmitting assembly of surgical instrument transmits a rotation of a rotatable drive member of the surgical instrument to the rotation receiving member of the end effector. A distal neck assembly of the surgical instrument includes at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces to the end effector; and an articulating neck assembly interconnecting the tubular body and the distal neck housing. The articulating neck assembly is configured to enable off-axis articulation of the distal neck assembly. The rotatable drive member extends through the articulating neck assembly.

Abstract: A surgical stapling apparatus includes a staple cartridge and an anvil member. The staple cartridge includes a plurality of surgical fasteners disposed in rows of retention slots. The staple cartridge may have an annular or linear configuration of retention slots. The tissue contacting surface of the staple cartridge may be tapered or stepped. The anvil member has a tissue contacting surface that includes a number of pockets arranged for substantially aligning with the retention slots. In addition, the tissue contacting surface of the anvil member may complement the tissue contacting surface of the staple cartridge.

Abstract: A staple cartridge for use with a surgical stapling apparatus includes a cartridge body including a tissue contacting surface defining a plurality of staple retaining slots, a staple disposed within each staple retaining slot of the cartridge body, and a substantially circular buttress. The buttress includes an inner portion, an outer portion, and a middle portion extending between the inner portion and the outer portion. At least one stiffened region joins the buttress to the tissue contacting surface of the cartridge body. The inner portion, the middle portion, the outer portion, and the at least one stiffened region are all formed from a common material.

Abstract: This patent application is for the design of a vascular occluding bridged self-expanding metal stent (VOBSEMS) for fixed and immobile selective vascular occlusion and thrombosis of arteries and veins. Current vascular self-expanding metal stents (SEMS) are designed to open atherosclerotic arteries such as coronary arteries. Once deployed the SEMS remains immobile and permanent across the stenosis of the artery. In contradistinction to the SEMS which opens occluded stenotic arteries, the VOBSEMS is used to occlude and clot arterial and venous blood flow. The VOBSEMS clots blood vessels with unique metal bridges located inside the stent. The unique metal bridges are made of platinol a memory metal alloy identical to the stent, but imbedded with dacron fibers to promote clotting. The bridges are positioned inside of the VOBSEMS and secured to the stent by bridge end loop design. The bridges are staggered and rotated inside the stent with a spiral staircase appearance.

Abstract: A control apparatus for a tourniquet device, to which tourniquet device a first compression cuff and/or at least one second compression cuff can be connected, with the compression cuffs having different volumes. The tourniquet device has an inflation apparatus for inflating the connected compression cuff. In order to present a tourniquet apparatus that enables the most efficient and in particular fast inflation of the tourniquet cuff possible and at the same time the most error-free operation of the tourniquet apparatus possible, a parameter set for controlling an inflation process of the respective compression cuff is associated with each compression cuff and is stored in a data memory of the control apparatus. The parameter set associated with each compression cuff depends on the volume of the compression cuff.

Abstract: A tool head assembly for a hand held tool The assembly includes a body for attaching to the hand held tool; a continuous cutting band having a cutting edge for cutting into a subject; at least one tension member coupled to the body for holding the cutting band under tension; and at least one drive member coupled to the body for rotating the cutting band with respect to the body.

Abstract: A reamer used in orthopedic surgery that reams and collects bone cement. The reamer may come in different diameters and is used when removal of bone cement is necessary, as is commonly done in revision surgeries. The reamer has a cutting tip with a fluted opening connected to a hollow body in which the bone cement chips or shavings collect after passing through the tip. The other end of the reamer has a hub that can connect to a drill. As the reamer advances into the IM canal it shaves the bone cement off of the walls and/or the bottom of the intramedullary canal. The reamer has a central channel extending throughout its length through which a guide wire may be placed.

Abstract: A surgical pelvic drill for operating hip osteoarthritis adapted to create a hole in the pelvic bone of a human patient is provided. The pelvic drill is adapted to create a through-going hole placed in the acetabulum area from the abdominal side of the pelvic bone of the human patient. The pelvic drill comprises: a driving member, a bone contacting organ in connection with said driving member, an operating device adapted to operate said driving member. The bone contacting organ is adapted to create a hole in the acetabulum area starting from the abdominal side of the pelvic bone through repetitive or continuous movement. A surgical and a laparoscopic/arthroscopic method of using said pelvic drill is further provided.

Abstract: A surgical apparatus having a locking mechanism that receives a cutting burr and that may include a loading and running position. The locking mechanism may include a motor driven spindle that carries a locking pawl and a detent pawl that lock the cutting burr in place an prevent the cutting burr from inadvertently falling out of the surgical drill instrument when in its load position. A diamond-shaped portion of the cutting burr may be formed in a six-sided diamond configuration and a perpendicular back end surface. The end of the cutting burr may include another diamond-shaped portion formed in a six-sided diamond shape surface that mates with a complementary surface formed in the receiving end of the spindle of the motor/locking mechanism. In an aspect, the attachment of the cutting burr is such that the cutting burr has substantially zero axial movement and runs true in the running condition.

Abstract: Osteotomy tools and procedures are provided that include a sets of guides in which pins are placed through conduits in the guides with a close tolerance and into into the bone at predetermined angles. One one pin is placed at a correction angle subtending from one of a pair of parallel pins placed across an osteotomy site. After the osteotomy is completed, a bone correction is achieved by rotating the pin at the correction angle to be parallel to the one of the parallel pins located across the osteotomy site. A parallel pin guide is placed over these two pins to maintain the bone correction and stabilize the osteotomy, allowing fixation of the corrected bone segments.

Abstract: An apparatus for indicating the position and length of a bone tunnel, including a first member configured to couple with a drill guide; and a second member in spaced relation to the first member, the second member comprising an indicator configured to provide an indication of thickness of a boney member with the first member disposed on a first side of the boney member and the second member disposed on a second side of the boney member.

Abstract: The present invention discloses a guiding element and a guiding assembly for spinal drilling operation. The guiding element is configured to be dispose at a vertebra which comprises a lamina. The guiding element comprises a main body, two connection parts, and two locating parts. The main body has two stand portions and each of the stand portion comprises a clamping part. Each of the connection parts comprises a first end and a second end. The two first ends extends away from each other. Each locating part connects to each stand portion through each connection part. Each clamping part comprises two hook portions. Each side, which is configured to be in contact against the vertebra, of the hook portions has a curvature corresponding to the surface of the lamina, so that the main body is configured to be disposed at the lamina and across the vertebra through the hook portions.

Abstract: A catheter system includes a shaft main body having a rotation axis lumen including a rotation central axis, a revolving lumen that revolves around the rotation axis lumen when the shaft main body is rotated about the rotation central axis, a side-by-side portion in which at least a portion of the rotation axis lumen and at least a portion of revolving lumen exist in side-by-side relationship, and a branch part at which the revolving lumen branches off from the side-by-side portion on a distal side relative to the branch part. The revolving lumen on the distal side relative to the branch part is formed of a distal shaft which has a proximal-side bending portion that bends in such a direction as to become farther away from the rotation axis lumen in radial direction and an opening that communicates with the revolving lumen.

Abstract: A medical device and method are disclosed which can cause a filter included in a cylinder to capture a capturing target by causing a fluid including a circulating flow to flow inside and around the cylinder introduced into a living body. The medical device has a filter, a cylinder, and an impeller. The filter captures a capturing target present inside a living body. The cylinder includes a lumen having the filter arranged therein, an aspiration section, which is open on the distal side of the lumen, and a discharge section which is open on a side surface on a proximal side of the lumen. The impeller is arranged on a proximal side of the filter in the lumen, and causes the lumen to aspirate the capturing target together with a fluid by causing the fluid to flow from the aspiration section toward the discharge section inside the living body.

Abstract: A medical device for retrieving small fragments from within a patient's anatomy includes a collection wire configured for entering the patient's anatomy. The collection wire includes a distal end with a plurality of tips that are configured to attract stone fragments from the patient's anatomy.

Abstract: The present invention provides methods and devices for treating endovascular disease. Vibrational energy is delivered to change compliance and increase permeability at the treatment area. To improve clinical outcomes, one or more therapeutic drugs may be delivered to the treatment area.

Abstract: A surgical end effector is provided having upper and lower jaws pivotally coupled to one another by at least one connecting member that is configured to allow a gap between the jaws to be set at a desired height. In one embodiment, the connecting member can be pivotably coupled to the upper jaw and fixed within a slot in the lower jaw. The connecting member can be fixed within the slot in one of multiple positions so as to position first and second tissue contacting surfaces of the upper and lower jaws at a predetermined distance from one another when the first and second jaws are in the closed position. The connecting member can include a pin formed thereon that extends into a bore formed in the upper jaw. Alternatively, the upper jaw can include a pin formed thereon that extends into a bore formed in the connecting member.

Abstract: A surgical grasping instrument is provided which includes a body portion having an elongate tubular member extending from the body portion and a jaw assembly movably mounted on a distal end of the elongate tubular member. The jaw assembly includes first and second jaws having arcuate grasping portions for securely grasping a circular surgical stapler anvil shaft. The jaw assembly is mounted on a movable head portion which is movable relative to a longitudinal axis of the elongate tubular member to rotate and articulate the jaw assembly relative to the longitudinal axis to manipulate the anvil within the body of a patient.

Abstract: Various exemplary methods and devices for actuating surgical instruments are provided. In general, a surgical device can include one or more actuation shafts configured to facilitate actuation of the device. In an exemplary embodiment, the device can include four actuation shafts, two actuation shafts to facilitate articulation of the device, one actuation shaft to facilitate opening and closing of jaws at a distal end of the device, and one actuation shaft to facilitate moving a cutting element of the device. In an exemplary embodiment, each of the one or more actuation shafts can include a distal elongate member and a proximal elongate member having a proximal end attached to a distal end of the distal elongate member. The proximal elongate member can be rigid, and the distal elongate member can be flexible.

Abstract: A catheter device 10 with a cutting structure or means 16 on the distal portion 14 is disclosed, along with a medical procedure for using the device. The catheter 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Abstract: A system for effecting ischemic necrosis in a foreskin of a penis includes an inner ring having an inner surface comprising an inner diameter and an outer surface comprising an outer diameter and at least one circumferential groove; and an outer ring configured to substantially fit around the circumferential groove of the inner ring, wherein the inner ring is configured to fit to a portion of a glans of the penis that lies between an inner surface of the foreskin and the glans of the penis and the at least one outer ring is configured to fit an outer surface of the foreskin, the inner ring and the outer ring thereby compressing the foreskin in the circumferential groove with a compression force, and wherein the compression force is sufficient to effect ischemic necrosis in the foreskin.

Abstract: A double-joint sickle knife for an endoscopy therapy includes a knife head, a knife base, a knife body, an outer sheath, a guide wire, a handle and a sliding rod. The knife head is connected with one end of the knife base by a transverse joint, and the other end of the knife base is connected with a head end of the knife body by a longitudinal joint. The outer sheath is sleeved on the outside of the knife body and capable of sliding along the knife body. The tail end of the knife body is connected with one end of the handle, and a sliding rod for adjusting the transverse joint is arranged on the handle. The guide wire is electric conductive. One end of the guide wire is connected with the knife head, and passes through the knife base, the knife body, the handle and the sliding rod successively. The other end of the guide wire is connected with the power port.

Abstract: A catheter system includes a shaft main body including an elongated hollow outer tube and an inner tube accommodated in the inside of the elongated hollow outer tube. The hollow inside of the inner tube is suctioned from the proximal end side thereof. The outer tube has an opening formed in a circumferential surface thereof and an attaching portion provided therein on the distal end side with respect to the opening. The inner tube can move in an axial direction with respect to the outer tube, and at least a distal end side end portion thereof can move back and forth between a proximal end side position with respect to the opening and the attaching portion.

Abstract: A multi-purpose vascular device defines a lumen allowing fluid communication there through and has a coil with a side of the coil winds having solid physical connections between the coil winds to prevent the connected coil wind side from expanding following the application of force by an actuating member which causes the connected coil winds to have a predetermined configuration in an unstressed state. The application of longitudinal force causes the unconnected coil winds to expand, resulting in the vascular device assuming a different configuration.

Abstract: The present invention relates to a trocar assembly comprising a cannula (40) and an obturator (1) arranged, in use, to be received within and extend through the cannula (4). The obturator (1) comprises a shaft (2) and a head (4). The shaft (2) is arranged to extend through the cannula (40) and having an external diameter which is less than the internal diameter of the cannula (40). The head (2) is arranged to protrude beyond the cannula (40). At least a portion of the head (4) has an external diameter which is greater than the internal diameter of the cannula (40). Said portion of the head (4) comprises a radially extending cut-out (18) such that the portion of the head (4) is radially collapsible for withdrawal through the cannula (40). The obturator (1) further comprises a locking member (30) which is received within the cut-out (18) to prevent withdrawal of the obturator (1).

Abstract: An access port for minimally invasive surgery includes an elongate, tubular main body portion, a connector configured to fix at least a portion of the access port to a stationary object; and a slot extending over a length of the main body portion in a lengthwise direction, wherein the slot extends through a wall of the main body portion, from an outside surface of the main body portion to an inside surface of the main body portion.

Abstract: One aspect of the present disclosure relates to a surgical guidance tool configured to facilitate delivery of a neurostimulator to a target craniofacial region of a subject. The surgical guidance tool can include a main body, a securing mechanism, and an adjustable guide mechanism. The main body can have a distal end, a proximal end, and a longitudinal axis extending between the distal and proximal ends. The securing mechanism can be disposed at the distal end and configured to secure a neurostimulator delivery tool to the main body. The guide mechanism can be configured to temporarily mate with a bodily target location of the subject and facilitate positioning of the neurostimulator delivery tool about the target craniofacial region. The guide member can be slidably attached to the distal end and selectively translatable along the longitudinal axis of the main body.

Abstract: A device for fine needle aspiration comprising: an inner tubular member; an outer tubular member disposed around the inner tubular member, wherein the outer tubular member comprises a plurality of slots; an outer housing disposed around the outer tubular member; a biasing member disposed between the outer tubular member and the outer housing. The device also comprises a rod coupled to the inner tubular member, where the rod extends through the outer tubular member and the rod is configured to be moved from a first slot in the plurality of slots to a second slot in the plurality of slots.

Abstract: Embodiments disclose uterine manipulators, dye delivery systems and fornix delineators that address several issues, such as minimizing surgical error, minimizing loss of parts inside a patients, enabling easy manipulation of a patient's anatomy, securing and removing the device into and from the patient atraumatically, preventing loss of pnuemoperitoneum, and securing the device fastener and components efficiently and atraumatically. An embodiment includes a uterine manipulator having a fornix delineator, uterine shaft, outer tube, fastener, handle, inlet, tip, ring and connecting string, and/or occluder.

Abstract: A self pedicure foot covering includes a sock with an outer surface that is covered by outwardly abrasive areas separated by an elastic area. The outwardly abrasive areas include an instep patch, a toe patch, a heel patch, a left side patch and a right side patch that are arranged in a pattern that is symmetrical about a plane that bisects the sock. The elastic area has a distribution that allows the sock to fit a continuum of different sized feet, and the symmetrical pattern allows the sock to equally fit a left foot and a right foot. The different abrasive area patches have different grit sizes.

Abstract: A personal care appliance includes a housing, a drive assembly provided in the housing, and a workpiece member. The drive assembly includes a stator and an armature adjacent the stator, wherein the stator, when energized, is structured to cause the armature to oscillate back and forth. The personal care appliance further includes a mounting assembly having a pivot arm having a shaft member and first and second mounting members. The workpiece member is coupled to the first end portion of the shaft member such that oscillation of the armature causes the workpiece member to oscillate relative to the housing.

Abstract: Disclosed is an external fixation system. The external fixation system can comprise a ring frame, a strut, and a pivot housing connecting the strut to the ring frame. The pivot housing can comprise a first compression member, a second compression member, and a post assembly. The first compression member can be attached to the ring frame. The second compression member can be spaced from the first compression member and attached to the first compression member. The post assembly can be connected to the strut via an attachment post protruding from a spherical component and passing through the first compression member. The spherical component can be compressed between the first compression member and the second compression member to retain the post assembly in a fixed position.

Abstract: A spinal implant provides supplemental fixation and/or stabilization of the spine via connection to one or more existing or new spinal fixation and/or stabilization spinal constructs. The supplementary spinal fixation/stabilization implant has a first attachment device configured to couple to an existing or new spinal fixation/stabilization construct and a second attachment device configured to couple to the existing or new spinal fixation/stabilization construct at a second location. The first and second attachment devices are joined to each other via a connector.

Abstract: Bone plates and assemblies for stabilizing bony structures. More particularly, the bone plates having an elongate body to which an integrated rod is formed. Integrated rod portion may be captured by a bone anchor with a receiving member. The bone plate is movable from a first position to a second position and may have an aperture for lagging the bone plate to the bone.

Abstract: A system for non-invasively adjusting the curvature of a spine includes a housing having a first end and a second end, a first rod having a first end telescopically disposed within a cavity of the housing along a first longitudinal axis at the first end of the housing and having a first threaded portion extending thereon, and a second end configured to be coupled to a first portion of a spinal system of a subject, a second rod having a first end telescopically disposed within the cavity along a second longitudinal axis at the second end of the housing and having a second threaded portion extending thereon, and a second end configured to be coupled to a second portion of the spinal system of the subject, a driving member rotatably disposed within the cavity and configured to be activated from a location external to the body of the subject.

Abstract: A fixation system is described that can be secured to a bony structure, such as a pedicle of a vertebrae. For example, the fixation system can include a pedicle screw and a receiver element. The receiver element can have a pair of upper opposing projections with a first channel formed therebetween and shaped to receive a part of a connecting rod. The receiver element can further include a pair of lower opposing projections with a second channel formed therebetween and shaped to mate with the pedicle screw. The fixation system can further include an expanding element that forms a tubular shape when a compressive force is applied along a plurality of flexible arms of the expanding element. The plurality of flexible arms can be self-expanding and bow radially outward when the compressive force is released.

Abstract: An interspinous implant is provided. The interspinous implant can include a first member having a first end and a second end. At least one of the first end and the second end can include a mating portion. The interspinous implant can also include a second member, which can have a first end, a second end and at least one receiving portion formed adjacent to at least one of the first end and the second end. The at least one receiving portion can receive the mating portion to couple the first member to the second member at a desired orientation. The interspinous implant can also include a first extension, which can be substantially opposite the mating portion, and adapted to engage a spinous process. The interspinous implant can comprise a second extension, which can be substantially opposite the at least one receiving portion, and adapted to engage a second process.

Abstract: Systems, methods, and apparatuses for fusion, stabilization, or fixation of bones are provided.

Abstract: An implantable fixation system for fusing a joint between a first bone and a second bone. The system may include an anchor, standoff, bolt, and cortical washer. The system may be implanted across the joint along a single trajectory, the length of the system adjustable to provide compressive force between the anchor and the cortical washer. The system may be implanted across a tibiotalar joint with the anchor positioned in the sinus tarsi. A spacing member may be inserted between the two bones and the fixation system implanted to extend through an opening in the spacing member. The spacing member may be anatomically shaped and/or provide deformity correction. An ankle arthroplasty system may include a tibial plate, a talar plate, and a bearing insert. The plates may be anchored to the tibia and talus along a single trajectory. The ankle arthroplasty system may be revisable to a fusion system.

Abstract: The instant invention is a novel method and construct for temporary or definitive minimally invasive treatment of a broken humerus. The method includes the steps of tunneling an elongated (or short) plate having a contoured distal end subcutaneously in the subcutaneous fat layer substantially parallel to the fractured humerus; and attaching the ends of the plate to the fractured humerus. The plate remains disposed in the subcutaneous fat layer and away from, but parallel to the humerus once attached to the humerus.

Abstract: Bone plate systems are provided for surgical implants and bone repair. The bone plate is multi-tiered for receiving bone anchors screws for securing a plurality of bones or bone fragments in a desired relationship. The plate members include throughbores for receiving a pivot base therein, with head ends of the bone anchors being secured in the pivot bases. The throughbores may permit and define a translation path for the pivot base and the bone anchor secured therein relative to the plate. Pivot members extending between the pivot base and the plate member facilitate pivoting and optional translation of the pivot base relative to the plate. With the bone anchor seated within the pivot base, an apparatus for inhibiting screw back out is employed.

Abstract: A bone plate having at least one screw hole adapted to receive a bone screw, a blocker having a blocking end for blocking a bone screw from further backout of bone the blocker being predisposed in a blocking position wherein the blocking end at least partially overlaps a portion of the screw hole, the blocker being moveable from the blocking position by contact with the bone screw during insertion of the bone screw into the screw hole, and a blocker fixation element having an open orientation at which the blocker can move from the blocking position and a closed orientation preventing substantial movement of the blocker from the blocking position. The blocker fixation element cannot be moved to the closed orientation unless the screw head passes the blocker, thereby revealing that the blocker fixation element is in position to prevent substantial movement of the blocker.

Abstract: Disclosed herein is an article comprising a first screw and a second screw, the first screw being reversibly attached to the second screw such that a longitudinal axis of the first screw coincides with or is parallel to a longitudinal axis of the second screw; the first screw and the second screw each comprising a biodegradable composition, the biodegradable composition comprising a metal or metal alloy comprising magnesium, strontium, zinc, calcium or a combination comprising at least one of the foregoing. Methods of making and using the article are also disclosed herein.

Abstract: The embodiments provide provides devices, instruments, and associated methods for treating joint pain. A joint is evaluated using magnetic resonance imaging to detect any defects in the subchondral bone. For example, using T2-weighted MRI images, bone marrow lesions or edemas can be identified, and using T1-weighted MRI images, associated regions of sclerotic bone adjacent to the bone marrow lesion can be identified. The treatment method may involve introducing a bone void filler material at the site to address the bone marrow lesion or edema, and/or drilling and inserting an implant to address the sclerotic bone, bone marrow lesion or edema, and insufficiency or stress fractures. An access path is mapped to a location in the subchondral region where the insufficiency fracture resides. The access path attempts to preserve an articular surface of the joint. A reinforcing member that stabilizes the insufficiency fracture is then implanted via the access path.