Abstract: A bone anchoring element is provided which has a shaft for anchoring in a bone. The shaft includes a tubular body having two open ends. At least one barb element is connected to the shaft. The barb element is cut into the tubular body. The barb element includes a free end and a base connecting the barb element to the shaft. The barb element has a first portion adjacent to the base and a second portion adjacent to the free end. The second portion is inclined relative to the first portion in a direction off said shaft.

Abstract: A medical device having body contacting surfaces provided with a film of amorphous calcium phosphate having a thickness of 1 nm to 10000 nm and an average dissolution rate calculated as the time taken to remove 95% of the film of at least 1 nm h?1 as determined in accordance with ASTM Standard P1926-03. The characteristics of the film are such that the film is relatively rapidly dissolved from the surface by body fluids. This dissolution of the surface film of amorphous calcium phosphate is sufficiently fast to prevent the attachment of bacteria, thus preventing them forming a biofilm and keeping the cells in a planktonic (non-biofilm) state where they are more vulnerable to the body's defences. The invention is particularly applicable to implants (e.g. orthopaedic implants such as prosthetic hips) but may also be applied to “non-implanted” devices such as surgical instruments.

Abstract: A device for fastening post-craniotomy bone flaps, used to secure bone fragments or flaps separated by a cranial bone mass during a surgical operation, the device comprising some external support means to the outer edges of the cranial bone mass and the bone flap; and some internal support means for the inner edges of the cranial bone mass and bone flap. The external support means and internal support means are joined via an intermediate element consisting of a shape-memory material. The external support means and internal support means consist of two platforms or two bands of shape-memory material.

Abstract: A method for stabilization of a cranial cruciate ligament in canines using a suture-button construct. The method includes the steps of drilling a hole across the femur and the tibia, passing a needle with a pull-through suture strand through the femoral hole, and applying a tensile force to the pull-through suture strand and a suture tape such that a first button lies sideways for passage through the femoral hole, advancing the first button through the femoral hole until the first button exits the femoral hole, passing the needle with the pull-through suture strand through the tibial hole, applying a tensile force to the pull-through suture strand and the suture tape such that the first button lies sideways for passage through the tibial hole, flipping the first button to engage it against the tibia, pulling free ends of the suture tape to advance a second button and to seat and secure it against the femur.

Abstract: A method for bunion repair using a suture-button construct. The suture-button construct includes a first button, a second button, a first suture strand, a pull-through suture strand and a needle. The first and second buttons have apertures to facilitate the suture strands to pass through the buttons. The first suture strand is double looped through the first and second buttons and the pull-through suture strand is looped through one of the apertures of the first button. The pull-through suture strand also loops through an eyelet of the needle and thus, is operatively associated with the needle. A suture anchor-button construct can also be used for bunion repair.

Abstract: A method for fabricating a device for repairing torn tissue or muscle such as the meniscus of the knee. The device includes a pair of anchoring members having a plurality of barb-like projections extending outwardly therefrom. The anchoring members are joined by a flexible linking member which connects the ends of the anchoring members opposite one another. Such a device can be fabricated by insert molding of the appropriate members together.

Abstract: A bone anchor is provided that can toggle in two planes for secure anchorage within a bone cavity. The bone anchor includes an oblique suture channel configured such that a suture strand extending through the bone anchor can be tensioned to toggle the bone anchor inside the bone cavity. The suture strand can be located on the same side of the anchor body to maximize the area of the anchor surface which engages bone, resulting in increased engagement into bone and resistance to tensile forces.

Abstract: The disclosed screw assemblies include a screw that attaches onto the bone, a housing member that connects and inter-locks the bone screw to the rod, and one or more locking members that permit immobilization of various components of the assembly relative to one another while still permitting some relative movement. The bone screws and bone screw assemblies described herein permit flexible stabilization of the spine.

Abstract: A bone anchor having a rivet having a proximal end and a head distal to an elongate body, a sleeve having an internal channel for slidably receiving the body, and an expansion nut having a channel therethrough for slidably receiving said body, proximal of said sleeve is provided. The sleeve further has a shoulder provided within the internal channel in the region of the proximal end for engaging the expansion nut. The rivet, sleeve and expansion nut are arranged such that movement of the rivet from a first position to a second position causes the sleeve to cam over the rivet head and expansion nut until said expansion nut engages said shoulder, forcing the sleeve to expand into a wall of a bone hole.

Abstract: A surgical guide wire or K-wire and method of use are provided. The K-wire or guide wire has opposite end portions and a shank portion in between. One end portion has a deformable end portion that, once outside of a confining guide passage, can be deformed to present a projected forward facing area that is larger than the transverse cross section of the K-wire or guide wire while in the passage. The increased area will provide increased resistance to additional forward axial movement into the surgical site.

Abstract: An improved fastener apparatus includes an outer sleeve which is moved into a patient's body tissue. A distal end portion of the outer sleeve is expanded in the patient's body tissue. An inner sleeve is moved axially through the outer sleeve and a distal end of the inner sleeve is expanded in the patient's body tissue. The fastener apparatus may be provided with an external thread convolution on either or both of the inner and outer sleeves. During expansion of the distal end portion of either the inner or outer sleeve, a proximal end portion of the outer sleeve may be gripped and pulled to offset forces applied to the distal end portion of one of the sleeves. Although inner and outer sleeves may advantageously be utilized, the fastener apparatus may be constructed with only a single sleeve if desired.

Abstract: An apparatus and method for joining members together using a self-drilling screw apparatus or stapling apparatus are disclosed. The screw apparatus includes a worm drive screw, a spur gear and superior and inferior screws which turn simultaneously in a bi-directional manner. A rotating mechanism drives the first and second screw members in opposite directions and causes the screw members to embed themselves in the members to be joined. The screw apparatus can be used to join members such as bones, portions of the spinal column, vertebral bodies, wood, building materials, metals, masonry, or plastics. A device employing two screws (two-in-one) can be combined with a capping horizontal mini-plate. A device employing three screws can be combined in enclosures (three-in-one). The stapling apparatus includes grip handles, transmission linkages, a drive rod a fulcrum and a cylinder.

Abstract: In an exemplary embodiment, the present invention provides a resilient support member capable of being installed inside an intervertebral disc to provide support to an intervertebral disc that has a compromised annulus fibrosis. In one embodiment, the intradiscal member includes an upper support surface, a lower support surface, and an outer wall. In another embodiment, the intradiscal member includes an inner wall defining a volume. In yet another embodiment, the intradiscal member includes a fastening element. The present invention also provides a method for installing the intradiscal member in the nucleus pulposus region of an intervertebral disc.

Abstract: A bone anchor including a bone engaging element and an implant engaging element. The bone engaging element includes a first portion formed of a first material and a second portion formed of a second material and extending at least partially along a length of the first portion, and with the second portion of the bone engaging element positioned between the first portion and adjacent bone tissue when the bone engaging element is engaged with the bone to provide an interface with the adjacent bone tissue. In one embodiment, the first portion of the bone engaging element exhibits a first level of rigidity and the second portion exhibits a second level of rigidity less than the first level of rigidity. In another embodiment, the bone engaging element includes external threads, with the second portion of the bone engaging element defining at least a portion of the external threads.

Abstract: Mechanisms for connecting an elongated member for orthopedic support or therapy to bone or other tissue are disclosed. Embodiments may include a receiver member with a channel for accommodating an elongated member such as a spinal rod and a channel for accommodating a bone-engaging member, a bone-engaging member that is insertable into the channel in the receiver member, and a lock member for locking the receiver member, bone-engaging member, and elongated member together. The channels may be variously oriented with respect to each other. Methods for using such embodiments are also disclosed.

Abstract: A knotless suture anchor and method for its insertion into tissue are provided. The suture anchor includes an inner member including a proximal shaft and a distal securing member shaped to secure the inner member to the tissue, the proximal shaft including a first locking part and at least one hole extending therethrough for receiving the suture thread; and a collar member including an axial bore shaped to receive the proximal shaft of the inner member, a second locking part, and at least one hole extending therethrough and assigned to the hole of the proximal shaft of the inner member, the collar member being axially slidable into unlocked and locked positions relative to the proximal shaft of the inner member, the collar member being relatively axially slidable into the locked position only to secure the suture thread.

Abstract: A joint between two bone segments is fused by passing an elongated, rectilinear bone fusion device over a guide pin across the joint and into tight engagement within bores formed in the bone segments, to thereby restrict movement of the elongated bone fusion device across the joint. The elongated, rectilinear bone fusion device also provides bony in-growth within the bores along the exterior surface of the bone fusion device.

Abstract: A stabilization device for bones or vertebrae includes a substantially cylindrical elastic element. The elastic element has a first end and a second end opposite to the first end. An elastic section extends between the first end and the second end. The elastic section includes at least first and second helical coils. The first and second helical coils are arranged coaxially so that the first helical coil extends at least in a portion between the second helical coil. The elastic element may form, for example, a portion of a rod, bone anchoring element, or plate.

Abstract: A bone fastener for stabilizing bone fragments includes a single or multiple components coupleable with one another and displaceable to a locked position of the bone fastener.

Abstract: An exemplary tulip assembly configured to be coupled to a head of a bone fixation device includes an inner tulip member including a lower portion configured to couple the head of the bone fixation device and an upper portion including a plurality of flexible protrusions extending from the lower portion. According to one exemplary embodiment the plurality of flexible protrusions are configured to provisionally couple a rod. The exemplary tulip assembly also includes an outer tulip member including a first position and a second position, the first position being configured to enable an expansion of the lower portion of the inner tulip member and the second position being configured to compressibly lock the lower portion of the inner member on the bone fixation device. Moreover, the present exemplary tulip assembly also includes a cap having a generally planar top and at least one locking member extending from the top.

Abstract: An intervertebral joint with one embodiment comprising a socket screw, a ball screw, and two support screws. The socket screw and ball screw form a socket joint between two vertebral members. A first support screw braces the socket screw. A second support screw braces the ball screw.

Abstract: A bone treatment device comprises a shaft having a tubular wall, a lumen extending within the tubular wall, openings through the tubular wall, and anchoring elements adjacent the openings that can be deployed out of the openings in the presence of an actuating force within the shaft lumen. The bone treatment device may further comprise an actuator configured to be received within the shaft lumen to deploy the anchoring elements out of the openings.

Abstract: A method of performing vertebral facet fusion by lateral approach and related devices. The lateral approach to facet fusion involves identifying the lateral mass and introducing any of the fixation methods known or described herein laterally at one or more facets through the use of a Kirschner wire guide, a cannulated bone drill and cooperatively cannulated staple guide. A surgical bone staple have a perforated bridge is used across the lateral facet joint where fixation is required. Where fusion is desired, a bone screw have lateral perforations of the shank is inserted through the cannulated staple guide and bridge perforation at the joint to promote fusion. A staple cap and graft container for overlay grafting may be utilized for additional fusion. The method involves less surgical time, reduced blood loss and discomfort for the patient as compared to the posterior approach.

Abstract: The present invention relates a system to be used with an implanting tool having a tip part. The system has a longitudinal axis and comprises a polymeric screw (31) having a head (11) and an adapter between the screw (31) and the implanting tool. The adapter comprises a first part (32) which fits the tip part of the implanting tool. The first part comprises a first element and the system comprises a second element. The first element and the second element are connected to each other with a torque limiting junction having a first maximum torque when the screw is screwed in and a second maximum torque when the screw is screwed off. The shape of the first element and the second element is such that the second maximum torque of the torque limiting junction is greater than the first maximum torque, thus allowing the removal of the polymeric screw (31) from its position.

Abstract: A spine stabilization device is provided, the spine stabilization device including an interbody spacer shaped to be inserted between a vertebral body of an upper vertebra and a vertebral body of a lower vertebra, and including a top surface oriented towards the lower endplate of the vertebral body of the upper vertebra and a bottom surface oriented towards the upper endplate of the vertebral body of the lower vertebra; and a fixation device to be inserted after placement of the interbody spacer, the fixation device including a support portion securing the interbody spacer against escaping from between the vertebral bodies of the upper and lower vertebra into a ventral direction, the support portion shaped to rest against a portion of an anterior surface of the interbody spacer, and further including an anchor, the anchor including an anchoring material portion that is configured to be inserted, in a liquid state, into cancellous bone tissue of at least one of the vertebral body of the upper vertebra and of th

Abstract: A method for performing minimally invasive surgery to reduce lumbar scoliosis in a patient is disclosed. The method involves performing an orthopedic exercise or maneuver on a patient to reduce scoliosis, and anchoring the ilioposoas muscles to a region of the femur to permanently reduce the scoliosis. During the exercise or maneuver, a lumbar x-ray is taken on both sides of the patient to determine which side the scoliosis reduction is greatest. The side with the greatest reduction is the side where the surgery takes place.

Abstract: Apparatuses, systems, and methods including integrated feedback for in-situ surgical device contouring or bending are disclosed. One embodiment is a system including a bone anchor, a longitudinal member coupled with the bone anchor, an instrument adapted to bend the longitudinal member, a sensor configured to provide an output indicative of force exerted by the bone anchor on a bone coupled with the bone anchor when the instrument applies force to the longitudinal member, and an indicator configured to provide an indication when the output meets or exceeds a threshold. Another embodiment further includes a second sensor configured to provide a second output indicative of temperature of the longitudinal member and wherein the instrument is further configured to apply heat to the longitudinal member and the indicator is further configured to provide an indication when the second output meets or exceeds a second threshold.

Abstract: Various embodiments of a vertebral tension band assembly and associated connection structure are provided. The tension band assemblies may be attached to vertebral bodies to, for example, connect one vertebrae to another, retain the band in approximately a preferred position by application of tension to the band during insertion and/or limit, impede, inhibit, reduce or interfere with the separation from one vertebra to another and may further block, impede, interfere with, inhibit, reduce or present an obstacle to dislodgement of a spinal implant from between the vertebrae to which it is attached. Flexible band portions of the assemblies may be treated and/or configured to promote bony integration between the band and the associated vertebrae, limit tissue adhesion to the band, and/or to elute a therapeutic substance from the installed band to the surgical site.

Abstract: Medical devices having more than one degradation zone or degradation mechanism are used for orthopedic repair devices and soft tissue fixation devices.

Abstract: A sternal closure clamp device for securing and retaining longitudinally divided halves of a sternum, the device having four laterally extending engagement members that are positioned in inter-rib spaces on both sides of the sternum. The engagement members are connected to a centralized main body in a manner that allows the engagement members to be shortened or contracted such that the sternal halves may be pressed together and held in abutting relation. Each of the engagement members contracts in a direction non-perpendicular to the sternal incision, and the engagement members on a given side are non-parallel to each other such that device has a generally X-shaped configuration.

Abstract: A chain of loops of braided high strength suture for surgical applications. The suture chain is advantageous for use in knotless fixation of soft tissue to bone, and can be used for knotless side-to-side suturing of U-shaped defects, such as rotator cuff tears.

Abstract: The present invention is an apparatus and method for stabilizing the facet joints of the spine. One aspect of the present invention is the stabilization of the facet joint by insertion of a facet implant through two opposing facet surfaces. The facet joint is not fixedly frozen by insertion of the screw, but instead the facet surfaces are flexibly and movably anchored to preserve movement because the screw or anchor includes a flexible intermediate portion which is positioned between the facet surfaces. The facet implant may be in the form of a screw or other anchor with the intermediate portion in the form of a polyaxial head, a cord, a spring, etc. The facet implant may furthermore be used in conjunction with a facet spacer that is placed between the first and second facet.

Abstract: A method for attaching soft tissue to bone. The method includes forming a bore in a bone, placing the soft tissue adjacent to the bone and above the bore, at least partially inserting a fixation device into the bore, and delivering biologic material through the soft tissue at an interface area between the soft tissue and the bone.

Abstract: A connector assembly including a bone anchoring element including a spherical head, a double collet that includes an inner clamping portion formed by inner surfaces of a plurality of resilient fingers, the resilient fingers defining a first wedge surface and a second wedge surface, an outer closure element that includes an inner clamping portion that corresponds in shape to an outer contour of the double collet, the outer closure element including a pair of arms that define a channel shaped for receiving therein a connector element, and an interface ring that includes a base formed with an inner wedge surface and a pair of wing extensions that extend from the base.

Abstract: A bone anchor system anchors a support member to a bone. The bone anchor system comprises a body having a shank adapted for insertion into a hole in the bone. A head is formed on the shank. The head has a support engagement portion adapted to secure the support member to the body. A passage extends from an entry point to an exit point formed in the body. An expandable member has a flexible wall at least partially enclosing an anchoring chamber. The expandable member has an expanded state configured to conform to a cavity in the bone. The anchoring chamber is in fluid communication with the exit point. The expandable member is adapted to expand when a filler material is provided into the anchoring chamber. A portion of the expandable member conforms to the cavity and the body and the support member are substantially anchored to the bone.

Abstract: A cannula has a flange and a body with slots extending through the entire flange and into the body. The cannula may also have a longitudinal slot extending its entire length. An obturator used with the cannula may also have a longitudinal slot extending along its length. A surgical method using these instruments includes separating lengths of suture and managing the suture by placing lengths of suture in the slots in the cannula. The cannula and obturator may be used after suture is already in place by placing the suture in the longitudinal slots and then introducing the cannula and obturator to the tissue defect site. The cannula may also be used to deliver a therapeutic implant to the tissue defect site. The instruments and method may be used in mensical surgery.

Abstract: A bone anchoring nail is provided having a threadless shaft with a free end, a head opposite to the free end, the head having a substantially U-shaped recess for accommodation of a rod or a rod-shaped element, a longitudinal bore extending through the shaft and opening towards any one of the head and the free end and a plurality of openings extending through the wall of the shaft and being in communication with the bore. The bone anchoring nail allows quick insertion and reliable fixation enhanced by the in-growth of blood vessels.

Abstract: An apparatus and method for fixing a selected graft relative to a selected anatomical portion. An anchor may be provided that may be interconnected with a selected graft portion that is operable to pass through a selected bore and then moved into an operable position to engage a selected portion of the bore to substantially eliminate the possibility of the graft moving in an unselected direction through the bore.

Abstract: A system for spinal surgery includes a prosthesis comprising a plurality of bone anchors which engage an intervertebral construct for fusion or motion preservation. The fusion construct comprises a spacer optionally encircled by a jacket. The motion preservation construct may comprise an articulating disc assembly or an elastomeric disc assembly. Any of the constructs may occupy the intervertebral disc space between adjacent vertebrae after removal of an intervertebral disc. The anchors slidingly engage the construct to securely fix the prosthesis to the vertebrae. The anchors and jacket of the fusion construct provide a continuous load path across opposite sides of the prosthesis so as to resist antagonistic motions of the spine.

Abstract: Methods and systems for performing a surgical procedure using implantable sensors are disclosed. The method includes providing one or more implantable sensors, each sensor configured for implantation adjacent to an anatomical feature of a patient; imaging the patient to determine the relative positions of the one or more implantable sensors relative to the anatomical features of the patient; inserting an implant adjacent to at least one of the anatomical features; and tracking the position of the implant relative to the at least one anatomical feature during the inserting of the implant using the implantable sensors.

Abstract: A device is formed by a discontinuous process into a bone screw, plate, or fastener, wherein the device has a degree of polymer alignment and strength, and upon reheating above glass transition temperature of the polymer, the device remains dimensionally stable, as it maintains its dimensions, strength, and degree of polymer orientation. In practice of the present invention, the polymer slug is pressed into the die cavity by the actuation of ram press, causing the slug to conform to the die cavity.

Abstract: A medical device that includes a cannulated needle, a first knotting element portion releaseably engaged with the needle, a second knotting element portion also releaseably engaged with the needle, a knotting element deployment actuator that abuts the second knotting element portion, and an anchor deployment actuator in communication with the interior of the needle, wherein the knotting element deployment actuator and anchor actuator are slidably manipulable from a proximal handle of the device, and held in a coaxial relationship with each other. The first knotting element portion may be releaseably engaged by means including shearing posts and adhesives, and the second knotting element portion may be releaseably engaged by means including detents and adhesives.

Abstract: Surgical procedures, kits and implants for alleviating human incontinence, and particularly providing improved methods and apparatus to secure a urethral sling to pubic bone in a sub-urethral location to support the urethra and alleviate incontinence are disclosed. Bone anchors, e.g., bone screws, are driven into pubic bones with exposed bone anchor heads and necks configured to receive and support a urethral sling applied to the bone anchors with and without retainers applied against the urethral sling to retain portions of the urethral sling between the bone anchor heads and the pubic bones.

Abstract: A system for installing a vertebral stabilization system. The system includes an installation tool including a handle portion and a shaft extending distally from the handle portion. The shaft includes a conduit and a staple mechanism. The system also includes a flexible implant member extending along the conduit configured to be advanced out from a distal end of the shaft, and a staple housed in the staple mechanism. The staple is configured to secure the flexible implant member to a vertebra. The handle portion is configured to selectively advance the flexible implant member from the shaft and to selectively actuate the staple mechanism.

Abstract: A cannulated screw which maintains compression at the interface between two or more materials in a medical or other setting to effectively secure bone to bone while minimizing separation between the bones and the securement interface. The cannulated screw has a flattened tip, which enables the cannulated screw to more readily bore or self-tap into bone or other material. The flattened tip of the cannulated screw comprises a plurality of cutting teeth which facilitate boring of the flattened tip of the cannulated screw into the material into which the screw is being inserted. In one embodiment, three progressive cutting teeth are provided on the flattened tip of the cannulated screw.

Abstract: A graft fixation device comprising a sheath having a body that defines an inner longitudinal bore and a member for insertion within the bore. The sheath includes at least two projections movably connected to the sheath body by a distal hinge. The distal hinge causes the projection to pivot inwardly as the sheath is placed in a bone tunnel, and to be displaceable radially outwardly of the sheath body upon insertion of the member within the bore.

Abstract: Intramedullary osteosynthesis device is capable of adopting a profiled H-shape in a closed introductory state in order to be easily implantable and an X-shape in an open implanted state for good fixation in the bone.

Abstract: A composite comprising an inorganic porous bone matrix and a compatible, bioabsorbable polymer or copolymer of a lactone monomer or mixture thereof, the composite having been prepared by the apatitic calcium phosphate, pr an osteoconductive, bioabsorbable derivative thereof, initiated ring-opening polymerization or copolymerization of the lactone monomer within the pores of said bone matrix and a method of manufacture thereof.

Abstract: A bone screw assembly includes a screw body, including anchor portion and rod-receiving portion, and a rod seat movably mounted in the screw body to allow for controlled angulation between a spinal connection element disposed in the rod seat and the screw body. The rod seat is pivotable in one or more selected directions about one or more axes relative to the screw body. The rod seat may include a first lower rod seat element disposed in a recess of the screw body having a cylindrical bottom surface to facilitate pivoting in a first direction. A second lower rod seat element is stacked on the first lower rod seat element and has a conical bottom surface abutting a top surface of the first lower rod seat element to facilitate pivoting in a second direction.

Abstract: A screw and coupling element assembly for use with an orthopedic rod implantation apparatus includes a screw with a head and a shaft extending from the head, a coupling element with a seat within which the head is seatable such that the shaft protrudes from the coupling element, and a locking element mateable with the coupling element and when mated is selectively movable through a plurality of positions including unlocked and locked positions. When in the unlocked position, the locking element presents a rod-receiving channel and the head is movable in the seat such that the shaft is directable in a plurality of angles relative to the coupling element. When in the locked position, a rod disposed within the rod-receiving channel is fixed relative to the coupling element and the head is immovable in the seat such that the shaft is fixed at an angle relative to the coupling element.