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: An orthopedic device for correcting a femoral bone abnormality includes a patient-specific three-dimensional shell and a patient-specific guiding feature. The shell has an outer surface and an inner bone engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to and substantially cover a femoral head of a patient in only one position. The guiding feature is pre-operatively planned relative to the shell such that when the shell is fitted over the femoral head, the guiding feature can guide a removal tool for removing an abnormality portion of the proximal femur of the patient.

Abstract: Devices, kits, and methods that may be used to establish a distal femoral resection position or a proximal tibial resection position and a prosthetic gap in a total knee arthroplasty procedure are provided. Devices for establishing a distal femoral resection position or a proximal tibial resection position may comprise a support that attaches to and references a proximal resected tibia or distal resected femur and supports and establishes the position of a resection guide. A kit may comprise a device for establishing a distal femoral resection position or proximal tibial resection position and additional components that complement the device or facilitate application of the device during a total knee arthroplasty procedure. Methods for establishing a distal femoral resection position or a proximal tibial resection position are also provided.

Abstract: A method of preparing a knee joint for a prosthesis in a patient includes mating a patient-specific three-dimensional curved inner surface of a femoral alignment guide onto a corresponding three-dimensional femoral joint surface of the patient. The patient-specific three-dimensional curved inner surface is preoperatively configured from medical scans of the knee joint of the patient. First and second holes are drilled into an anterior portion of the femoral joint surface through corresponding first and second guiding apertures of the femoral alignment guide.

Abstract: Described herein are low-profile electrodes for use with an angioplasty shockwave catheter. A low-profile electrode assembly may have an inner electrode, an insulating layer disposed over the inner electrode such that an opening in the insulating layer is aligned with the inner electrode, and an outer electrode sheath disposed over the insulating layer such that an opening in the outer electrode sheath is coaxially aligned with the opening in the insulating layer. This layered configuration allows for the generation of shockwaves that propagate outward from the side of the catheter. In some variations, the electrode assembly has a second inner electrode, and the insulating layer and outer electrode may each have a second opening that are coaxially aligned with the second inner electrode. An angioplasty shockwave catheter may have a plurality of such low-profile electrode assemblies along its length to break up calcified plaques along a length of a vessel.

Abstract: An endoscopic forceps is provided and includes a housing having a shaft. An end effector assembly operatively connects to a distal end of the shaft and has a pair of first and second jaw members. One of the first and second jaw members is movable relative to the other jaw member from an open position, to a clamping position. One of the first and second jaw members includes one or more cam slots defined therein and configured to receive a cam member that upon movement thereof rotates the movable jaw member from the open position to the clamping position. A resilient member is operably coupled to the jaw member that includes the one or more cam slots. The resilient member is configured to provide a camming force to the cam slot and to bias the first and second jaw members in the clamping position.

Abstract: Methods and devices are provided for performing minimally invasive surgical procedures. In one embodiment, a surgical device is provided that include an elongate shaft having a distal portion configured to be movable between a first configuration in which the distal portion of the shaft is substantially straight or linear and a second configuration in which the distal portion of the shaft is articulated at a compound angle. The shaft's distal portion can include two articulation joints to facilitate formation of the compound angle.

Abstract: A rongeur (34) for driving a cutting unit (240) that includes an outer (240) tube and a cutting implement (302) able to both rotate in move longitudinally in the outer tube The rongeur includes a body (36) to which a rotating spindle (102) for actuating the cutting implement is mounted. The spindle is designed to allow the inner tube to while, rotating move longitudinally relative to the spindle. A mechanism (150, 180) attached to the body selectively displaces the drive inner tube so the distal end of the cutting implement can be advanced towards and retracted away from the distal end of the outer tube.

Abstract: A surgical instrument for use in releasing soft tissue within the human body. The surgical instrument has a handle with proximal and distal ends with a tube connected to the distal end. The surgical instrument also includes a blade member that slidingly engages the tube moving along the length of the tube to cut soft tissue. Further included in the surgical instrument is a guard member that is attached to the blade member. The guard member has a hood portion and a capture portion. The hood portion is connected to the blade member with the distally positioned capture portion acting to displace surrounding tissue while capturing certain soft tissue structures resulting in the blade member being in operative position to cut and release the soft tissue. A surgical instrument kit including a plurality of modular surgical instruments and method for releasing soft tissue using the surgical instrument are also disclosed.

Abstract: A surgical method utilizes a cutting blade having a thickness along a cutting edge of between about 0.0005 inch and about 0.020 inch and preferably between about 0.001 inch and 0.010 inch. The blade is moved in contact with relatively hardly tissues which are disposed adjacent to softer tissues at a surgical site in a patient. The blade is ultrasonically vibrated during the moving of the blade, whereby the hard tissue is cut with a modicum of damage being inflicted on the soft tissue.

Abstract: A surgical apparatus comprises a body, a shaft assembly, a rotation input assembly, and an end effector. The shaft assembly defines a longitudinal axis and a first fluid passageway. The rotation input assembly is operable to rotate the shaft assembly about the longitudinal axis. The rotation input assembly defines a second fluid passageway. The second fluid passageway is in fluid communication with the first fluid passageway. The end effector is located at a distal end of the shaft assembly. The end effector comprises an ultrasonic blade. The end effector is in fluid communication with the first fluid passageway such that the end effector is configured to receive fluid communicated through the first and second fluid passageways.

Abstract: An inner member rotatable in an angled outer tubular member of a rotary surgical cutting instrument includes first and second tubular members. The first tubular member includes rigid proximal and distal portions comprised of a first material and a flexible intermediate portion comprised of a second material. The proximal portion includes a hub. The distal portion terminates at a distal end configured to couple with a cutting tip. The intermediate portion extends between and is fixedly coupled to the proximal and distal portions.

Abstract: An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has multiple links that allow the creation of a deflection angle. A wire passes through the links and once the links are positioned with the desired deflection angle, tension is placed on the wire to lock the links into the current position. The clearing tool is inserted through a window into the epidural space, and once the tension is applied to the wire, the clearing tool becomes rigid to allow advancement of the clearing tool within the epidural space. The clearing tool is then removed from the epidural space, and the medical lead is inserted through the window and cleared epidural space until reaching the target site.

Abstract: The invention relates to a device for controlling corporeal structures, especially for introducing puncture needles or operation probes. Said device comprises a base plate (1), at least one base holder (2) applied to the base plate (1), and holding rods (3, 4) that are fixed to the base holder in a fixed manner and are used to hold and position a targeting device (10) for a medical instrument (8). The aim of the invention is to create one such device in such a way that it has a simple structure and can guide medical instruments in a variable and precise manner. To this end, the targeting device (10) is mounted on two adjustment arms (7) that can be respectively displaced in the X and/or Y plane, on the free ends of the holding rods (3, 4), by means of an actuating drive (6).

Abstract: A cannula assembly including a housing, a rotatable member, a first plurality of membranes, and a second plurality of membranes is disclosed. The housing may include a distal end defining a distal opening, wherein the distal end is configured to couple to a cannula tube aligned with the distal opening, and a proximal end defining a proximal opening. The rotatable member may be positioned within the housing and may define a passage in fluid communication with the distal opening, a first opening in fluid communication with the passage, and a second opening in fluid communication with the passage. The first plurality of membranes may be arranged as a stack at the first opening, wherein each of the first plurality of membranes defines an aperture. The second plurality of membranes may be arranged as a stack at the second opening, wherein each of the second plurality of membranes defines an aperture.

Abstract: The invention pertains to an apparatus comprising a needle configured to define a path through tissue of a patient, tubing configured to slidably receive the needle via a proximal opening, an anchor configured to slidably receive at least a portion of the tubing, and an anchor deployment member comprising a body and an anchor engagement member. Such an apparatus may be used to introduce and anchor an implantable medical device element within a patient.

Abstract: A surgical instrument includes a stationary shaft defining a conduit and a movable shaft slidably disposed therein. A surgical tool extends distally from the movable shaft and a cup extends distally from the stationary shaft. The cup includes a body defining one or more channels, an annular rim disposed at the distal end portion thereof and defining a plurality of apertures each in fluid communication with one of the channels, and a cap disposed at the proximal end portion of the body and defining a lumen fluidly coupling the one or more channels with the conduit. A central aperture of the cap slidably receives the surgical tool and/or the movable shaft as the movable shaft slides from a retracted position, wherein the surgical tool is disposed proximally of the distal end portion of the cup, and an extended position, wherein the surgical tool extends through and distally from the cup.

Abstract: A surgical bone holding implement for manipulating a bone, comprising a handle and an elongated shaft including a bone engaging tip. The handle is positionable with respect to the elongated shaft between first and second positions, for mounting a drill member on the proximal end of the elongated shaft in one position, and for manipulating the bone by means of the handle in a second position.

Abstract: A bone fixation device that includes a rail body housing that has a top portion, a bottom portion, a first end portion, a second end portion, and a rail channel extending along a longitudinal axis of the rail body housing. The rail channel is defined between the top portion, the bottom portion, the first end portion, and the second end portion. The movable clamp assembly is movably coupled to the rail body housing within the rail channel and the position of the movable clamp assembly within the rail channel is adjustable. The movable clamp assembly also includes at least one semi-spherical collet defining a central channel configured to receive a bone fastener and orient the bone fastener in any of a plurality of orientations with respect to the rail body housing.

Abstract: Systems and methods for joint replacement are provided. The systems and methods include a surgical orientation device and at least one orthopedic fixture. The surgical orientation device and orthopedic fixtures can be used to locate the orientation of an axis in the body, to adjust an orientation of a cutting plane or planes along a bony surface, to distract a joint, or to otherwise assist in an orthopedic procedure or procedures.

Abstract: Devices, methods and systems for stabilizing at least a portion of the spinal column are provided. Devices include anchors and coupling members for engaging an elongate member. Systems include an elongate member sized to span a distance between at least two vertebral bodies and being at least partially formed of a flexible material. A number of anchors and coupling members are used to secure the elongate member to each of the vertebral bodies. The anchors can be compressed towards one another and the elongate member secured thereto and/or the elongate member can be tensioned to provide corrective forces to the spine.

Abstract: Open implant closure structures include a helically wound guide and advancement flange form having pivot-splay accommodating and splay control surfaces with opposing load flanks in initial non-parallel relation.

Abstract: A spinal screw assembly is provided. The assembly may be provided with a screw and a movable head in which angulation of the screw relative to the movable head is constrained so that angulation within limits is allowed in one plane but lesser or no angulation is allowed in another plane. Methods to assemble the disclosed apparatus are also disclosed.

Abstract: A rotational connector insertable into a surgical incision onto a top of a pedicle screw in a first orientation and rotated into a second orientation to engage a primary fusion rod. The rotational connector may include a revision rod coupled to one end thereof.

Abstract: A bone hook apparatus is provided that includes a base, a rod receptacle disposed on a proximal side of the base, a first hook distally extending from the base and oriented in a first direction, and a second hook distally extending from the base and oriented in a second direction opposing the first direction, the first hook and second hook together configured to receive the bone. Kits and spinal constructs employing the bone hook apparatus are also described.

Abstract: The disclosed subject matter includes a fastener, a system and methods for use and manufacture. The fastener can include a head disposed at a proximal end of the fastener, a shaft connected to the head, and at least one of the head and the shaft can include a plurality of flat surfaces. A collar can extend about the longitudinal axis of the fastener and can have a proximal-most surface spaced in a longitudinal axis direction away from a proximal-most surface of the fastener. The collar can include a plurality of petals spaced about the longitudinal axis, each of the plurality of petals including a flat surface facing a respective one of the plurality of flat surfaces of the at least one of the head and the shaft. A plate and/or a cage can be included with the fastener for use in a spinal connection, kit or repair system.

Abstract: A spine stabilization system having a base plate having a plurality of screw holes and a plurality of corresponding screw locking mechanisms. The present invention also provides an extension plate having a plurality of screw holes and corresponding screw locking mechanisms. The extension plate is dimensioned and configured with an extension portion, the extension portion having a screw hole and a screw locking mechanism and a finger portion having a connection element and to contact and connect with the base plate. The base plate is provided a graft window having edges, wherein at least one of the edges being configured to receive and connect with the connection element.

Abstract: A bone plate system is provided that includes bone plates and bone anchor assemblies for being inserted into bone plate bores to secure the bone plates to one or more bones. In one aspect, the bone plate system includes a bone anchor assembly having a locking cap and a locking fastener connected to a head portion of a bone anchor. The bone anchor assembly is driven into a bone plate bore before the locking fastener is shifted to expand the locking cap and fix the bone anchor assembly within the bore. In another aspect, the bone plate system includes a bone anchor assembly having a locking cap that deflects radially inward due to contact with the bone plate at large bone anchor assembly insertion angles. In addition, a bone anchor assembly having a preassembled condition with a locking cap resisting back out of a locking fastener.

Abstract: A spinal rod insertion instrument includes a hollow, monolithic body having a proximal end and a distal end. The body defines a passageway that extends along a first axis between the proximal and distal ends. The distal end includes first and second arms defining a slot therebetween. The first and second arms are configured to releasably retain a spinal rod therebetween. Also provided is a method of securing a spinal rod to a coupling element attached with a pedicle screw.

Abstract: A system to stabilize a fracture includes an intramedullary rod having a first end and a second end and configured for placement within a medullary bone canal of a bone. The intramedullary rod includes a first rod hole at the second end. The system also includes an intramedullary rod plate having a first plate hole and a second plate hole. The system also includes a first fastener configured to be received by the first plate hole, wherein the first fastener passes through an outer surface of the bone and through the first rod hole at the second end of the intramedullary rod such that the first fastener secures the intramedullary rod plate to the intramedullary rod. The system further includes a second fastener configured to pass through the second plate hole and into the bone such that the second fastener secures the intramedullary rod plate to the bone.

Abstract: A sliding plate variable angle locking mechanism includes a bone plate, a first sliding plate, a locking ring and a bone screw. The bone plate includes a plate cavity, a bone plate surface and a shelf. The plate hole defines a plate hole diameter. The first sliding plate a central hole that defines a sliding plate hole diameter. The sliding plate hole diameter is smaller than the plate hole diameter. The first sliding plate is positioned in the plate cavity in an assembled configuration. The locking ring is movably mountable to the bone plate. The locking ring hole diameter is greater than the sliding plate hole diameter. The bone screw head diameter is greater than the sliding plate hole diameter. The head threads are configured to form internal threads in the central hole of the first sliding plate when the bone screw is driven into the first sliding plate.

Abstract: The invention encompasses a bone screw for use in the human body including a shaft having a threaded region along at least a portion of its length and a screw head including a locking mechanism to secure the screw, for example to a bone plate. In certain embodiments, the thread has an outer diameter dimensioned to pass through the screw hole in the implant. The screw head is configured to cooperatively engage at least a portion of the screw hole of the implant so as to prevent the screw from coming out of the implant and avoided soft tissue damage and other complications associated with unintended screw removal.

Abstract: In some embodiments, apparatus for the fixation of proximal humerus fractures includes an implantable humerus plate having a proximal portion adapted to be positioned at a head and medial calcar of the humerus, a distal portion adapted to be positioned along a shaft of the humerus, and a plurality of calcar openings provided through the proximal portion adapted to receive calcar fasteners that extend into the medial calcar.

Abstract: A fixation device is disclosed for the fixation of proximal humerus fractures includes an implantable humerus plate having a proximal portion adapted to be positioned at a head and medial calcar of the humerus, a distal portion adapted to be positioned along a shaft of the humerus, and a plurality of calcar openings provided through the proximal portion adapted to receive calcar fasteners that extend into the medial calcar. The calcar fasteners are grouped into a rafted configuration and the tips of each fastener are positioned into the calcar region so that torsional forces bearing upon the calcar regions are distributed into the rafted fastener support, thereby avoiding varus collapse of the humerus head after fixation of the fracture.

Abstract: A self-locking cable gripper includes a housing having a void which tapers between openings at the housing's top and bottom. A collapsible member having a central passage is adjacent the bottom opening. A pair of half jaws are between the collapsible member and the top opening, sized such that they move towards each other as the jaws are moved toward the bottom opening due to the taper of the void. The top and bottom openings, central passage, and inner surfaces of the jaws define a channel capable of receiving a cable passed through the housing from its bottom to its top opening. When the cable is pulled in the direction opposite that with which it was installed, the half jaws are drawn toward the housing's bottom opening such that their inner surfaces are urged towards each other, thereby locking the cable in place while it is under tension.

Abstract: This disclosure details surgical instrumentation and related techniques for performing bone reconstruction surgeries. The surgical instrumentation may be used to size and shape a graft, such as an allograft. The appropriately sized and shaped graft is subsequently used to reconstruct damaged bone. A surgical instrumentation set is used to prepare the graft. The surgical instrumentation set includes a graft workstation, a plurality of sizing blocks and a plurality of cutting blocks.

Abstract: Various torque-limiting screwdrivers, systems, and methods are disclosed. The screwdriver can include a body supporting a motor configured to rotate a screw engaged with the screwdriver. The screwdriver can include a controller configured to implement torque-limiting functionality, such as by monitoring the amount of torque applied to the screw and reducing or stopping rotation of the screw when certain torque-limiting criteria are met. Some embodiments include a threshold point, after which the torque-limiting functionality can be engaged. Some embodiments include a slowdown point, after which the rotational speed of the screw is reduced.

Abstract: An electrosurgical dissection apparatus is disclosed, and includes a thermally insulating body, a thermally conductive insert, at least one active electrode, and at least one return electrode. The at least one active electrode is disposed on the thermally conductive insert, and the at least one return electrode is spaced from the at least one active electrode by a portion of the thermally insulating body. The thermally conductive insert is configured to cauterize tissue dissected by radiofrequency energy passing from the at least one active electrode to the at least one return electrode.

Abstract: Body tissue ablation is carried out by inserting a probe into a body of a living subject, urging the probe into contact with a tissue in the body, generating energy at a power output level, and transmitting the generated energy into the tissue via the probe. While transmitting the generated energy the ablation is further carried out by determining a measured temperature of the tissue and a measured power level of the transmitted energy, and controlling the power output level responsively to a function of the measured temperature and the measured power level. Related apparatus for carrying out the ablation is also described.

Abstract: A high-frequency generator for an electric surgical instrument that treats a living tissue includes a power supply that generates a power, and a resonant circuit that excites a high-frequency signal. The resonant circuit includes a parallel resonant circuit which is connected to the power supply, and a series resonant circuit which is coupled to the parallel resonant circuit and is connected to the electric surgical instrument. The parallel resonant circuit has a higher parallel resonant frequency than a series resonant frequency of the series resonant circuit.

Abstract: A treatment system includes a fluid cooling supply system for chilling and delivering liquid coolant to a patient. The fluid cooling supply system includes a cooling device and a heat exchanger device. The heat exchanger device is biased to the cooling device and is in fluid communication with a treatment device in a patient. The fluid cooling supply system includes at least one biasing mechanism to provide a given biasing force between the heat exchanger device and the cooling device to effectuate and improve heat transfer. The liquid coolant may be circulated through an energy delivery device positioned in an airway of a patient to preserve tissue. The system is controlled to circulate liquid coolant at a given temperature and pressure for a selected amount of time during pulmonary treatment of a patient.

Abstract: A surgical forceps includes a knife bar having a knife translatable between a retracted position, a first extended position, and a second extended position. A trigger is operably coupled with the knife bar such that movement of the trigger between an un-actuated position, a first actuated position, and a second actuated position correspondingly moves the knife. An actuator is movable between locked and unlocked positions such that: with the trigger in the un-actuated or first actuated position and the actuator in the locked position, movement of the trigger to the second actuated position is inhibited; with the trigger in the second actuated position and the actuator in the locked position, the trigger is retained in the second actuated position; and with the actuator in the unlocked position, the trigger is movable between the un-actuated or first actuated position and the second actuated position.

Abstract: A surgical instrument includes a housing having an elongated shaft that extends therefrom and a handle pivotable relative thereto. An end effector assembly is attached to a distal end of the shaft and includes first and second jaw members. The first jaw member is pivotably attached to a distal end of the shaft and the second jaw member extends along a longitudinal axis defined therethrough and fixed to the distal end of the shaft by a living hinge. The first jaw member, upon actuation of the handle, is movable relative to the second jaw member between spaced-apart position, an approximated position for grasping tissue, and a second position for over-compressing tissue grasped between jaw members. A knife is disposed within a channel defined within the second jaw member and is exposed to cut tissue when the first jaw member over-travels to over-compress the second jaw member.

Abstract: An apparatus includes an interface assembly and a shaft assembly. The interface assembly is for use with a robotic system and includes a first drive assembly. The first drive assembly includes a first slot having a distal recess and a transverse recess. The shaft assembly is removably couplable with the interface assembly and includes an end effector and a first coupling feature. The first drive assembly of the interface assembly actuates the end effector of the shaft assembly. The first coupling feature is couplable with the first slot of the first drive assembly to longitudinally fix the shaft assembly relative to the interface assembly.

Abstract: A method and apparatus are disclosed for delivering energy substantially distal to an electrosurgical device. Embodiments of a device of the present invention may comprise an elongate member having one or more electrically insulated portions and a distal face comprising one or more electrically exposed conductive portions for delivering energy substantially distal to the elongate member. At least one of the one or more electrically insulated portions may extend from a proximal region of the elongate member to a distal end of the elongate member. In addition, a method is provided for creating a lesion at a target site within a body of a human or animal using an electrosurgical device.

Abstract: A cutting device includes an elongated shaft that extends between a proximal end and a distal end. A distal arm extends from the distal end of the elongated shaft. The distal arm includes an inner surface defining a cavity and an outer surface defining a blunt tip. At least one proximal arm extends from the distal end of the elongated shaft at a position proximal to the distal arm. The at least one proximal arm having an inner surface defines a cavity including a cutting portion configured to cut tissue.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input. The system, delivery devices, and methods can damage tissue and manage scarring and stenosis.

Abstract: Some implementations provide an apparatus for percutaneous delivery of laser energy, the apparatus including two or more hollow spikes, each having an insertion end and a coupling end, each including an optical fiber embedded as a permanent fixture therein, each optical fiber capable of emitting laser from the insertion end of the corresponding hollow spike; and\a hub coupled to the two or more hollow spikes at the respective coupling ends of each hollow spike, the hub including a connector for coupling the apparatus to a laser generator.

Abstract: The present invention provides a laser system and laser handpiece and process for skin treatment. The system includes components for producing a continuous or pulse laser beam, and components for delivering a substance to the damaged region of skin. The system is designed to control and utilize the laser beam for damaging small volume of skin tissue and using a disposable tip to deliver a substance which is applied simultaneously or with some delay producing a combination of laser action with the action of a named substance at the same time.

Abstract: An optical radiation delivery structure including a waveguide conduit having a surgical access portion and a handle portion. The handle portion includes a gripping portion and a waveguide lock, which is configured to have only a locked state and an unlocked state. In some embodiments, the handle portion includes a gripping portion and a counterbalance region, such that a center of mass of the waveguide conduit is disposed towards a proximal end of the waveguide conduit.