Abstract: Devices, systems and/or methods for fixating soft tissue to bone are provided. In one embodiment, a repair device for fixating soft tissue to bone with a bone anchor includes a soft tissue anchor and one or more flexible members. The soft tissue anchor includes a base with multiple legs extending from the base. The one or more flexible members are coupled to the base and configured to extend from the base to the bone anchor with a fixed length. With this arrangement, the fixed length of the one or more flexible members is configured to maintain a substantially fixed pre-determined distance between the soft tissue anchor and the bone anchor such that, as the bone anchor is seated into bone, the one or more flexible members pulls the soft tissue anchor down against the soft tissue to fixate the soft tissue to the bone.

Abstract: The present disclosure includes a polyaxial bone fixation element for use in spinal fixation to interconnect a longitudinal spinal rod with a patient's vertebra. The polyaxial bone fixation element preferably includes a bone anchor, a collet, a body, and a locking cap. The polyaxial bone fixation element preferably enables in-situ assembly. That is, the polyaxial bone fixation element is preferably configured so that in use, the bone anchor may be secured to the patient's vertebra prior to being received within the body. Accordingly, the polyaxial bone fixation element enables a surgeon to implant the bone anchor without the body to maximize visibility and access around the anchoring site. Once the bone anchor has been secured to the patient's vertebra, the body can be snapped-onto the bone anchor. The bone anchor preferably also includes a second tool interface so that a surgical instrument can be directly coupled to the bone anchor.

Abstract: The present disclosure relates to a fixation device. The fixation device includes a base portion including a first leg, a second leg, and a groove located between the first and second legs and a top portion extending from the base portion. A tissue repair device and a method of tissue repair are also disclosed.

Abstract: There is described a suture anchor with anchor members moveable as between a suture-unlocked configuration and suture-locked configuration. In one embodiment, the anchor members include an outer anchor member with features, e.g., flexible barbs, configured to secure the suture anchor in the suture-locked configuration to material proximate a pre-formed hole in bone material. The outer anchor member is also configured with a bore to receive suture material, and which is sized and shaped to receive an inner anchor member therein. The inner anchor member includes securing features such as projections that compress the suture material against the surface of the bore when the suture anchor is actuated from the suture-unlocked configuration to the suture-locked configuration.

Abstract: Methods and devices are provided for fixing a ligament graft in a bone tunnel. In general, the methods and devices involve affixing a ligament graft within a bone tunnel using an adhesive. A fixation device can be inserted through the ligament graft in a direction transverse to an axis of the tunnel to maintain the ligament graft in contact with the adhesive. The fixation device can be removed when the adhesive is cured such that the ligament graft is fixed in the tunnel.

Abstract: The present disclosure relates to a delivery device. The delivery device including a handle assembly, the assembly including a handle and a connector coupled to the handle, the connector including a channel and an opening to the channel; and a shaft coupled to the handle, the shaft including a proximal end and a distal end, the distal end including threads, grooves intersecting the threads, and a depth stop. Other delivery devices, screws, and delivery device/screw combinations are also disclosed.

Abstract: A biocompatible interference screw for soft tissue or bone-to-bone fixation comprises a screw body extending from a screw head to a distal tip of the screw. The screw body has an outer surface, and comprises polyether-ether-ketone (PEEK) material. Advantageously, the body outer surface has a textured surface finish for substantially improving pull-out strength of the interference screw. The textured surface finish is textured, in preferred embodiments, with a minimum of approximately 16 micro inches of surface roughness. The screw head comprises a tapered square keyhole for receiving a distal end of a driver instrument. The screw comprises a series of threads, which have a relatively smooth profile, in order to prevent graft tissue laceration as the screw is being inserted. The distal tip of the screw body comprises a narrow tip, and a distal end of the screw body is angled inwardly toward the narrow distal tip.

Abstract: The present disclosure relates to a soft tissue graft anchor. The anchor includes a plurality of prongs, each prong including a distal end and a proximal end, wherein the prongs are coupled at their distal ends to form an inner cavity having an opening, at least one of the prongs including a fin, the fin extending perpendicular to a longitudinal axis of the prong and including a pointed end. A tissue graft anchor assembly, a method for tissue repair, and instrumentation for use therewith are also disclosed.

Abstract: The present disclosure relates to a fixation device. The fixation device includes a base portion including a first leg, a second leg, and a groove located between the first and second legs and a top portion extending from the base portion. A tissue repair device and a method of tissue repair are also disclosed.

Abstract: There are disclosed various embodiments of surgical tacks for use in surgical procedures. The tacks generally include a head and a barrel portion extending distally from the head. Preferably, the head and the barrel portion define a throughbore for receipt of a drive instrument. A thread on the head is provided to engage threads in the installation tool. A tissue thread is provided on the barrel portion to engage tissue. Distal and proximal surfaces of the tissue thread may be oriented at various angles relative to the barrel portion. There is also disclosed an insertion instrument to insert one or more tacks as well as a method of use. There is further disclosed a model device for use in explaining the operation of the instrument.

Abstract: Apparatus, systems and methods are used to repair, reconstruct and/or replace spinal features. A flexible longitudinal fixation component such a suture is passed around or through a portion of a spine, with the end sections of the component either being attached to one another or coupled to at least one bone implant. The bone implant may be a bone anchor or may form part of a pedicle screw assembly. The flexible longitudinal fixation component may pass through an anulus fibrosis (AF) and at least one intra-aperture component situated within a void or defect in an AF. The intra-aperture component may be composed of a porous mesh, allograft tissue or xenograft tissue. The intra-aperture component preferably includes one or more proximal-to-distal channels facilitating the intentional initial passage of nucleus pulposis (NP) tissue while preventing the extrusion of the NP long term.

Abstract: An apparatus and method for fixation of a soft tissue graft. The apparatus may include a member having a first surface and a second surface. Each of the surfaces extend a distance relative to one another. A member is operable to resist movement of the apparatus relative to an anatomical portion. An interference member may be provided to fixedly associate the apparatus with the anatomical structure.

Abstract: A medical implant includes a body having a conical portion and adapted for implantation into a person's body. A plurality of threads formed around an exterior surface of the conical portion of the body are adapted to help secure the implant in place within the person's body.

Abstract: The present disclosure relates to a tissue repair assembly. The assembly includes an interference device and a fixation device coupled to the interference device, wherein the fixation device includes a coupling portion and a capturing portion. Other assemblies and methods are also disclosed.

Abstract: The present invention provides a novel split barbed fixation device for tenodesis, soft tissue reattachment of tendons and ligaments to bones. The insertion device is adapted for an entirely arthroscopic approach while achieving fixation strength with ultimate pullout resistance comparable to interference screws. The device includes an integrated tendon grasper that provides for easy manipulation of the tendon arthroscopically while eliminating the need for external whip stitching of the tendon, thereby reducing preparation time. The device further includes elements that prevent the fixation implant from being destabilized or rotating during deployment and manipulation, including: a depth limiting sheath, a first implant retainer, a first implant retaining step, a tendon grasping needle tube, and an implant keyway for mating the implant to the tube.

Abstract: An arthrodesis anchor as a monolithic piece has prongs supporting barbs extending radially therefrom. A neck between the ends may be angled to accommodate final alignment of resected surfaces of joints to be bonded. The neck may receive a tool for buttressing a first inserted end against further penetration into a joint while the second inserted end is inserted into the other adjacent joint. The proximal and intermediate phalangeal joints may be trimmed and pilot drilled, and may be broached with or without a K-wire guide. A first end may be inserted by a tool, typically into the proximal joint, but the order may be reversed. The second end may then be inserted into a pilot in the base of the intermediate joint.

Abstract: Methods and devices are provided for fixing a ligament graft in a bone tunnel. In general, the methods and devices involve affixing a ligament graft within a bone tunnel using an adhesive. A fixation device can be inserted through the ligament graft in a direction transverse to an axis of the tunnel to maintain the ligament graft in contact with the adhesive. The fixation device can be removed when the adhesive is cured such that the ligament graft is fixed in the tunnel.

Abstract: A fixation implant tightly secures ligament transplants and the like on or in bone tissue. The fixation implant has an elongate body, which has a front end for application and includes at least in some areas an expandable material which, after the implantation, exerts an expansion pressure on a surrounding bone substance. The body has an outer wall, which is provided at least in some areas with profiles extending substantially transverse to the longitudinal extent. The body is provided at its rear end with an engagement means for an insertion instrument, or it has an opening into a central recess for an expansion body. The expandable material is arranged substantially along the entire longitudinal extent of the body. The expandable material can exert pressure on the profiled areas in such a way that the external diameter of the body increases.

Abstract: A cannulated compression screw is used as an orthopedic implant and has a threaded distal end with an insertion tip that includes at least one and preferably two, three or four flutes to allow the screw to be self-tapping. Optionally, the screw also includes one or more reverse cutting flutes proximal to the insertion tip. The distal threads are cancellous threads having a generally constant minor diameter and a generally constant major diameter and a generally constant thread pitch. An intermediate portion of the screw is non-threaded and the proximal end includes a compression wedge or taper that has at least one, and preferably two to five flutes that terminate before the top of the screw. The proximal end further includes a radiused bevel to the terminal surface that includes a hexagonal torque driving recess. The diameter of the non-threaded shaft section is constant distal from the compression wedge to the distal tip where it defines the minor diameter of the threaded portion.

Abstract: Orthopaedic devices are disclosed. The devices include a part that is made of extracellular matrix material that has been hardened. One method of hardening the extracellular matrix is to comminute naturally occurring extracellular matrix and dry the comminuted material. The hardened extracellular matrix material can be machined to form a variety of orthopaedic devices.

Abstract: Various methods and devices are provided for a graft fixation device for fixing a graft member within a bone tunnel. In one embodiment, a graft fixation device is provided having a radially expandable sheath adapted to be disposed within a bone tunnel, and a sheath expander adapted to be received within the radially expandable sheath to expand the sheath and thereby anchor a graft between the sheath and the bone tunnel. In an exemplary embodiment, the graft fixation device is particularly useful to affix a graft within a femoral tunnel.

Abstract: A surgical screw fastener device and method for pulling a graft through a first tunnel defined in a first bone. The surgical screw fastener including a body having a proximal end and a distal end, and an exterior screw thread located around the body for threadedly engaging a wall of the first tunnel. The device can have a first coupling element at the proximal end of the body, wherein the first coupling element adapted to couple a driver tool. The device can further have a second coupling element for rotatable coupling of a first end of the graft with respect to the device.

Abstract: The present invention relates to dynamic bone fixation elements and a surgical method to stabilize bone or bone fragments. The dynamic bone fixation elements preferably include a bone engaging component and a load carrier engaging component. The bone engaging component preferably includes a plurality of threads for engaging a patient's bone and a lumen. The load carrier engaging component preferably includes a head portion for engaging a load carrier (e.g., bone plate) and a shaft portion. The shaft portion preferably at least partially extends into the lumen. Preferably at least a portion of an outer surface of the shaft portion is spaced away from at least a portion of an inner surface of the lumen via a gap so that the head portion can move with respect to the bone engaging component. The distal end of the shaft portion is preferably coupled to the lumen.

Abstract: A method and apparatus for reattaching soft tissue to a selected boney structure using a rivet. Generally, a rivet having first portion and a second portion is provided to fully secure a soft tissue in the boney structure. The first portion of the rivet retains the soft tissue via a suture which is threaded through the first portion. The second portion of the rivet has at least one expanding member which engages the boney structure upon contact with the first portion of the rivet. Thus, the soft tissue is fully secured to the boney structure, ensuring proper healing.

Abstract: A system for use in reconstructing a ligament is provided. The system includes a graft ligament support block and an installation tool. The support block includes a body having a distal and proximal ends and a longitudinal axis extending therebetween, the proximal end being tapered so as to facilitate withdrawal of the support block through a bone tunnel, a graft hole extending through the body transverse to the longitudinal axis and configured to receive a graft ligament therein and a transverse fixation pin hole extending through the body transverse to the longitudinal axis and configured to receive a transverse fixation pin therein. The installation tool includes a holder having a shaft with distal and proximal ends and longitudinal axis extending therebetween, the proximal end of the shaft including at least one finger for engagement in the opening and a handle mounted to the proximal end of the shaft.

Abstract: A method for securing a graft to a bone includes forming a tunnel in the bone, positioning the graft in the tunnel, and securing the graft in the tunnel with an anchor. The method also includes attaching a distal end of an elongated anchor sleeve to a proximal end of the anchor and inserting a pre-compressed harvested bone material having a cruciate cross-section through the anchor sleeve into to a bore defined in the anchor. The bore has a mating cruciate cross-section. The method also includes removing the anchor sleeve after inserting the bone material into the anchor.

Abstract: A method for securing a soft tissue replacement in a bone tunnel includes forming a first and second tunnel in the bone. The second tunnel intersects the first tunnel and defines a first and second access passage. A first flexible member is passed through the tunnel and includes a first end extending out of the first passage, an intermediate portion supporting the soft tissue replacement and a second end extending out of the second passage. The first end of the first flexible member is fastened to an insertion member. A crosspin is positioned between the first passage and the insertion member. The second end of the first flexible member is advanced until a distal portion of the crosspin advances into the first access passage. The insertion member is impacted thereby pushing the crosspin into an engaged position with the bone.

Abstract: A method and apparatus for performing a surgical repair may involve fixation of a repair material, such as a ligament or tendon in knee ligament repair procedure, to an internal cortical contact area in a bone. The cortical bone contact area may be located immediately adjacent an opening in the bone's surface through which the repair material extends. The repair material may be engaged with the contact area by way of a fixation device, such as a device that is attached to the repair material and functions as a stop member. An illustrative fixation device may include an annular portion with an aperture through with the repair material passes. The repair material may be attached to a securing portion that extends from the annular portion.

Abstract: A novel fixation system for fixing a graft ligament in a bone tunnel. The fixation system comprises an interference screw comprising a body having a distal end and a proximal end, screw threads extending longitudinally along the body, and a transversely-extending region formed in the body for receiving a transverse pin therein, whereby to securely lock the interference screw, and hence the graft ligament, to the bone. In accordance with a further feature of the present invention, there is provided a method for attaching a graft ligament to a bone, the method comprising the steps of: (i) drilling a tunnel in the bone; (ii) positioning the graft ligament in the bone tunnel; (iii) placing an interference screw in the bone tunnel so as to force the graft ligament laterally against the opposite side of the bone tunnel; and (iv) advancing a transverse pin transversely through the bone and through the interference screw so as to securely lock the interference screw, and hence the graft ligament, to the bone.

Abstract: A method and apparatus for performing a surgical repair may involve fixation of a repair material, such as a ligament or tendon in knee ligament repair procedure, to an internal cortical contact area in a bone. The cortical bone contact area may be located immediately adjacent an opening in the bone's surface through which the repair material extends. The repair material may be engaged with the contact area by way of a fixation device, such as a device that is attached to the repair material and functions as a stop member. An illustrative fixation device may include an annular portion with an aperture through with the repair material passes. The repair material may be attached to a securing portion that extends from the annular portion.

Abstract: A surgical method and implant for directing and securing a replacement ligament into the femur or tibia of the knee. A transverse tunnel may be formed in the femur approximately perpendicular to a femoral tunnel. A flexible strand passing through the transverse tunnel may be used to draw the replacement ligament into the femoral tunnel. The implant may then be placed into the transverse tunnel and through the replacement ligament to secure the replacement ligament in place. The implant may include an eyelet to receive the flexible strand and a tapered portion forming a shoulder to prevent the implant from being inserted too far into the transverse tunnel. The implant may also have a multi-angular configured portion to secure the implant within the transverse tunnel through an interference fit.

Abstract: An expandable osteosynthesis implant has branches each connected at one end to a seat which is pierced by an orifice, suitable for being slid from a posterior direction between the facing faces of two consecutive vertebrae in order to hold them a given distance apart and restore stability of the spinal column. The branches and the seat define a hollow cage which, in a “rest” position, has an outside general shape that is a cylinder of circular section, and a portion at least of the inside volume of the cage towards the distal ends of the branches is in the form of a circular truncated cone whose large base is towards the seat, which implant has at least three branches and, inside the inside volume at least one spacer suitable for passing through the orifice and the large base of the truncated cone.

Abstract: The present disclosure relates to a tissue repair assembly. The assembly includes an interference device and a fixation device coupled to the interference device, wherein the fixation device includes a coupling portion and a capturing portion. Other assemblies and methods are also disclosed.

Abstract: A transverse suspension device for ACL graft fixation in a femoral tunnel includes a body section and a smooth head section forming the leading end of the device. The body and smooth head sections each may be cannulated along their entire lengths. The head section may further include a recess-engaging section extending proximally from the distal end and is operable to engage with a recess formed in the bone tunnel. The device may further include a graft loop support section between the recess-engaging section and the body section adapted to stably support the graft loop.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined computed tomography (CT) imagable fiducial locator head, an integral bone screw, and an integral divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example includes a fluid/gel-absorbing coating or cover into which a magnetic resonance (MR) imagable fluid is introduced, thereby permitting both CT and MR imaging. Protective caps and collars may be used to protect the fiducial marker from mechanical impact and/or to guide the fiducial marker during affixation. A bull's-eye or other template is used to select a center of a substantially spherical fiducial marker head on an image, such as for use during patient registration.

Abstract: A system for securing a graft within a bone includes a tubular cross pin having an interior surface bounding a passageway extending between a proximal end and an opposing distal end, the distal end terminating at a distal end face. A guide pin has an exterior surface extending between a proximal end and an opposing distal end, the exterior surface including an outwardly projecting shoulder. The guide pin is removably received within the passageway of the cross pin such that the distal end face of the cross pin biases against the shoulder and a proximal portion of the guide pin freely projects beyond the proximal end of the cross pin.

Abstract: A method and apparatus for reattaching soft tissue to a selected boney structure using a rivet. Generally, a rivet having first portion and a second portion is provided to fully secure a soft tissue in the boney structure. The first portion of the rivet retains the soft tissue via a suture which is threaded through the first portion. The second portion of the rivet has at least one expanding member which engages the boney structure upon contact with the first portion of the rivet. Thus, the soft tissue is fully secured to the boney structure, ensuring proper healing.

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

Abstract: A graft ligament is looped through a graft hole in a graft ligament support block, and the graft ligament support block is mounted to an installation tool. Then the installation tool is used to advance the graft ligament support block into a bone tunnel, with the two free ends of the looped graft ligament extending back out the bone tunnel. Next, a transverse tunnel is formed in the host bone, with the transverse tunnel being aligned with a transverse fixation pin hole in the graft ligament support block. Then the graft ligament support block is secured in place by pinning the graft ligament support block within the tunnel, i.e., by advancing a transverse fixation pin along the transverse tunnel and into the transverse fixation pin hole in the graft ligament support block. Then the installation tool is detached from the graft ligament support block and withdrawn from the surgical site.

Abstract: A surgical method for loading ligament grafts into a joint. A longitudinal socket formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A looped portion of the strand is diverted so as to protrude out of the entrance to the longitudinal socket. The ends of the strand remaining accessible on either side of the bone. The ligament graft is captured within the strand loop protruding from the entrance to the socket. The strand is retracted into the socket, drawing the graft into the socket by pulling on the accessible ends of the flexible strand. The graft is fixed in the socket using a transverse implant.

Abstract: A jamming retainer for fixing a ligament in a bone tunnel without excessive sideways pressure on the ligament that may result in tissue necrosis the jamming retainer including a substantially rigid body with a bore or loop for receiving a ligament or tendon and a bore or ring for receiving a suture for towing the jamming retainer and ligament or tendon through a bone tunnel. Once positioned, the jamming retainer is fixed in the bone tunnel with an interference screw.

Abstract: Procedures for the fusion of the sacroiliac joint advantageously make use of an implant selected to distract the joint upon insertion and to maintain or increase tension upon insertion. The implant can have a varying structure along its length. In some method described herein for fusing the sacroiliac joint using an implant, an implant is screwed into the sacroiliac joint between the sacrum bone and the iliac bone. The implant comprises a shaft, a tool engagement flange at top end of the shaft, a pointed tip comprising no more than about 20 percent of the length of the screw, and threads spiraling around the shaft. For screws of particular interest, the volume displacement perpendicular to the shaft increases at least about 5 percent from a point adjacent the tip to a point near the top of the shaft. Some of the desirable screw designs can be used in other orthopedic application, especially situations involving varying bone hardness.

Abstract: A helical screw dilator system and method including a helical screw dilator having a proximal end, a distal end, and an axial length, the helical screw dilator including a piercing tip at the distal end; a threaded dilation portion operably connected to the piercing tip along the axial length, the threaded dilation portion having an outer surface increasing in circumference with distance from the distal end and having threads disposed about the outer surface; and a shaft between the threaded dilation portion and the proximal end and a guidewire lumen through the center to guide the system to its destination.

Abstract: A method and apparatus for performing a surgical repair may involve fixation of a repair material, such as a ligament or tendon in knee ligament repair procedure, to an internal cortical contact area in a bone. The cortical bone contact area may be located immediately adjacent an opening in the bone's surface through which the repair material extends. The repair material may be engaged with the contact area by way of a fixation device, such as a device that is attached to the repair material and functions as a stop member. An illustrative fixation device may include an annular portion with an aperture through with the repair material passes. The repair material may be attached to a securing portion that extends from the annular portion.