Abstract: In the present invention, a bioabsorbable implant is described, which implant is manufactured of bioabsorbable polymer, copolymer, polymer alloy or fiber reinforced and/or particle filled composite, which implant is pushed into a hole or drill canal made in a bone, for fixing a bone graft into the drillhole, wherein the implant comprises: (1) at least one elongated body, (2) at least one gripping element to lock the implant into the drillhole, and (3) a platform surface for location of a bone block between the implant and the wall of the drillhole. The implant also may be equipped with (4) an additional arresting means, which effectively prevents the slipping of the bone block out of the drillhole.

Abstract: A fastener for use in soft tissue repair includes a resorbable polymer or suture core having one or more collagen bands in surrounding relation to the core. The bands are expandable between a dehydrated state for insertion and a hydrated state for healing, and are dimensioned and positioned to bring two sides of a tear into apposition to promote healing of the tear. The fastener insertion method includes driving an elongated tube across the tear, inserting a fastener down the tube until it breaches the tears and removing the tube, leaving the fastener in position to expand and promote healing of the tear.

Abstract: Carbonated hydroxyapatite compositions and their preparation are described. The compositions are biologically resorbable and are prepared as flowable masses which can be administered by syringe to set in situ to serve as a support structure, filler, prosthesis or the like. Optionally the compositions may include proteins or serve as a depot for compositions of phrarmacological interest.

Abstract: Carbonated hydroxyapatite compositions and their preparation are described. The compositions are biologically resorbable and are prepared as flowable masses which can be administered by syringe to set in situ to serve as a support structure, filler, prosthesis or the like.

Abstract: A method for repairing fractured bone. The method includes the steps of reducing the fracture, securing a fixation device to the bone through at least one hole formed in the bone in order to stabilize the fracture, removing the fixation device from said bone after the fracture has healed, providing an osteoductive resorbable bone implant, and inserting the resorbable bone implant into the hole in the bone so that bone growth into the hole is facilitated.

Abstract: A joint prosthesis comprising a metallic body having a plurality of negative surface features such as through-slots, deep grooves, tunnels or pits, or valleys defined between projecting fingers or flutes. The metallic body constitutes the structural component of the prosthesis, such as a shell, plate or stem. A second part attaches to and extends the body to provide both a fit and a change in the initial stiffness. The second part provides a time-evolving structural coupling, such that the prosthesis initially fits the patient's remnant bone to provide rigid fixation, while the mechanical properties shift with time in vivo to change its contact or loading characteristics. In one embodiment a femoral stem joint prosthesis is modular and the first, or structural component, accommodates bio-absorbable second components of varying geometries and dimensions which fit a range of bore sizes, and achieve different stiffnesses or strengths affecting load or strain distribution.

Abstract: Carbonated hydroxyapatite compositions and their preparation are described. The compositions are biologically resorbable and are prepared as flowable masses which can be administered by syringe to set in situ to serve as a support structure, filler, prosthesis or the like. Optionally the compositions may include proteins or serve as a depot for compositions of phrarmacological interest.

Abstract: An inorganic glass having an aliphatic polymer covalently bonded to the surface thereof is disclosed for providing improved adhesion to a matrix polymer when the glass is employed as a composite filler, as well as for the formation of a composite absent a separate matrix polymer. The polymer is grafted onto the glass by a method which includes the steps of pretreating the surface of the glass with an activator which an activating moiety to the surface, functionalizing the pretreated surface by bonding functional moieties thereto, and polymerizing a cycloaliphatic monomer onto the functionalized surface in the presence of a ring opening polymerization catalyst. Also disclosed are novel inorganic glasses which contain both silicate and phosphate linkages.

Abstract: A biocompatible osteosynthesis plate operable for being enhanced in a substantially secured relation to a plurality of adjacent bone portions is provided. The biocompatible osteosynthesis plate includes an elongated section having a top face and a bottom face, at least one fastener opening disposed between the top face and the bottom face, and means disposed upon elongated section to permit the formation of additional fastener openings therethrough during a surgical procedure. The osteosynthesis plate is in a first configuration at a first thermochemical state and is operable to be converted to a second thermochemical state so that it may be deformed prior to fixation. The osteosynthesis plate may further include means disposed upon the elongated section for enhancing structural rigidity, which may be provided as one or more raised surfaces, or rails, disposed upon the top face of the osteosynthesis plate.

Abstract: The invention provides an artificial dura mater comprising a sheet made of bioabsorbable synthetic polymers formed from copolymers of lactic acid and .epsilon.-caprolactone.

Abstract: A method for fixing a bone block in a bone tunnel comprising the steps of placing the bone block in the bone tunnel, advancing spaced-apart first and second metal wires through the bone, transversely of the bone tunnel, so as to intersect the bone block and extend through the bone block, removing one of the wires and replacing the one removed wire with a first absorbable rod, and removing the other of the wires and replacing the other removed wire with a second absorbable rod, whereby to retain the bone block in the bone tunnel with the absorbable rods.

Abstract: A surgical fastening system for attaching one piece of tissue to another piece of tissue. The system comprises a surgical fastener, an installation tool for deploying the surgical fastener in tissue, and a method for using the same.

Abstract: The invention is of a family of bioabsorbable intermedullary rods, implantation systems and associated methodologies for implantation. Applicant's invention permits its users to use intermedullary rods when indicated for fracture fixation, yet avoid complications of presently available steel rods, including the post-utility presence of implants after a bone has healed.

Abstract: Compositions for bone repair have been developed based on linear hydrophobic degradable polymers and monomers or macromers, at least one of which includes an anhydride linkage. The monomers and/or macromers crosslink each other but not to the linear polymer to form semi-interpenetrating networks. The compositions can include various excipients, therapeutic and/or diagnostic agents. The compositions can be polymerized in the presence of dissolvable particles such as inorganic salts and proteinaceous materials to provide a porous polymer network. The compositions can be injected into a patient and polymerized in situ or can be polymerized ex vivo and implanted. When polymerized ex vivo, the composition can be shaped into various articles, such as pins, screws, and hollow tubes, which can be used to repair broken bones.

Abstract: Processes are set forth for forming high strength thermoplastic polymer bone fixation devices used, for example, in orthopedic surgery, where "strength" is quantified in terms of a given device's pullout strength, tensile modulus, shear strength and breaking torque strength. Products of the aforementioned process are contemplated by the invention as well, with both "bioabsorbable" devices, for example, screws which are absorbable in an animal body and do not need to be removed after the bone in which they are inserted has healed; and non-bioabsorbable devices being described.

Abstract: A bone fixation screw system and method of utilization thereof is provided for a bone having first and second sections with a fracture interface there between. A preferred embodiment of the bone fixation screw system includes a side plate having a first part for placement adjacent the bone second section and a second part angled from the first part providing a barrel. The barrel is adapted for insertion into a transsectionally extending bore into the bone in at least the second section of the bone. A lag screw is also provided for positional retention of the first section of the bone with respect to the second section of the bone. The lag screw also has a first part of a resorbable material for threaded connection of the lag screw within the bore of the bone in at least the first section of the bone, the lag screw having a second part connected with the first part made from a stronger nonresorbable material.

Abstract: A method of assembling an improved bio-absorbable cartilage repair system includes the step of directly inserting the insert into a cavity in the delivery unit so as to leave a top of the insert exposed. A flexible, porous fabric piece, consisting substantially of bio-absorbable material, is then applied over the exposed top of the inserted insert and through a plurality of the windows of the delivery unit sidewall. The fabric piece includes a central body portion configured and dimensioned to substantially cover the exposed top of the inserted insert, and a plurality of leg portions extending outwardly from the body portion, the leg portions being configured and dimensioned to fit through the windows. Substantially all of each leg portion is next pulled through a respective window to cause the body portion to deform the inserted insert into assuming the shape of the cavity therebelow. Finally, the leg portions projecting from the windows are trimmed.

Abstract: A membrane for temporarily covering a recess in the endogenic bone tissue filled with an osteogenic material, such as hydroxyapatite granules, as is needed following reconstruction of bones in plastic surgery or operations on the jaw, is composed of resorbable membrane material.

Abstract: The element (20) according to the invention comprises a biodegradable body which is, before or during the implantation of an orthopaedic prosthesis (1), inserted into a recess (2) in the prosthesis (1) such that the rigidity of the prosthesis is increased. The element (20) provides mechanical connection between the shell segments (1a, 1b, 1c) so that the element (20) performs a supporting function which reduces the elastic properties of the outer shell (1). The ability of the biodegradable element (20) to transfer forces is increasingly reduced after the implantation so that the outer shell (1) of the artificial acetabulum has increasingly more elastic properties depending on the mechanical properties determined by the structure. Some time after the implantation, the biodegradable element (20) degrades so much that it no longer transfers any forces.

Abstract: A bone fastener including an expandable member having an axial channel and an elongated element insertable into the axial channel is described. The expandable member is configured to be insertible into a bore drilled in bone. The distal end of the expandable member also may include a structure for axially releasing the expandable member from an emplacement device that places the expandable member into a bone opening. In one embodiment, the structure for axially releasing includes a frangible membrane capable of being severed from the expandable member during emplacement of the expandable member in a bone opening. A rivet for coupling an object to bone for use with an expandable member is also described. The distal end of the elongated element is shaped into a radially projecting portion adapted for engagement with a washer that contacts the object to be coupled. The washer, having upper and lower surfaces and a bore defined between the surfaces, is disposed around a portion of the shaft.

Abstract: An apparatus and method for tightening and crimping a surgical wire used for orthopedic purposes. The apparatus of this invention includes a pair of operating handles which are biased apart and which operate a pair of opposed jaws to which they are connected. Disposed on opposite sides of the operating handles are a pair of capstans. The jaws are adapted to hold a crimp member therein without deforming it while opposite ends of a length of wire are passed through the crimping member in opposite directions. Each end of the wire is wrapped about an associated capstan. A ratchet handle simultaneously rotates both capstans to wrap the opposite ends of the wire. Once the desired traction force has been achieved, the jaws are further activated to crimp the crimp member. A ring-shaped crimp member is also disclosed which has a central opening extending along the axis thereof and two parallel channels, one channel being disposed on either side of the central opening.

Abstract: An anchor including a shank formed from a hardened product of a calcium phosphate compound. The anchor having a strength capable of retaining its original shape, before, during and after insertion into a pre-drilled hole of a bone, and a brittleness capable of causing its original shape to disintegrate as a result of a breakage of the shank upon an application of a driving force from the screw to the shank during a driving of the screw through the anchor inserted in the bone. The present invention also relates to a method for fixing a screw in a bone. Using the anchor of the present invention, it becomes possible to easily and reliably fix a screw in a bone having a reduced strength.

Abstract: Bone fractures are stabilized by submerging a bone-lock mending key into the bone, avoiding detection of the key through the skin. A fractured bone typically includes two bone segments having complementary surfaces that mate at the fracture site. Bone repair begins by forming respective gripping channels in the two bone segments. The gripping channels are positioned such that, when the segments are mated at the fracture site, the channels form a continuous gripping socket that spans the fracture. The gripping socket is shaped to provide a longitudinal passage with multiple extensions proceeding outward from the passage. The extensions may comprise fingers, branches, and other apertures channeled outward from the longitudinal passage, thereby forming gripping features such as ridges, flanges, and other protuberances of bone.

Abstract: A method of surgically implanting into a site with cancellous bone a bio-absorbable cartilage repair system including an assembly. The method includes the steps of partially preparing the site to receive the assembly by removing at least a portion of the damaged or destroyed articular cartilage, and then removably fixing the forward tip of a guide wire in the cancellous bone under the removed articular cartilage. The guide wire is then utilized to further prepare the site to receive the assembly by drilling and countersinking the subchondral cancellous bone and to seat the assembly into the drilled and countersunk subchondral cancellous bone until the assembly is flush with the surrounding articular surface. The guide wire is then removed.

Abstract: A surgical system including: (1) a thermoplastic, body absorbable, bodily tissue fixation plate having a plurality of formations and a plurality of through-bores arranged in alternating relation along with plate; (2) body absorbable fasteners adapted for insertion into the through-bores to secure the plate to underlying bodily tissue; and (3) heating apparatus including a wand having a heating tip of a configuration adapted to substantially matingly cooperate with the formations to facilitate heating and bending of the plate into conformance with the underlying bodily tissue.

Abstract: A post-surgery orthopedic covering for a recess in endogenic bone tissue filled with an osteogenic material, such as hydroxyapatite granules, has a covering membrane with a stiffening layer which can be integrated with the covering membrane, or provided as a separate stiffening element.

Abstract: Polymeric medical fixation screws with multiple cannulations and thereby a reduced risk of shearing while being torqued into place are provided. The polymeric screws have at least two cannulae, on either side of a central longitudinal axis of the screw, extending parallel to the longitudinal axis. Torquing instruments are inserted into the cannulae so that the applied torque force for driving the screws into a bone hole is distributed along the shaft of the screw. In one embodiment, the invention provides interference screws, while in other embodiments the invention provides medical fixation screws with heads and soft tissue-to-bone anchors or suture anchors. The polymeric screws may be fabricated from virtually any suitable biocompatible polymers or composites, including bioabsorbable polymers and their composites.

Abstract: A biocompatible osteosynthesis plate operable for being enhanced in a substantially secured relation to a plurality of adjacent bone portions is provided. The biocompatible osteosynthesis plate includes an elongated section having a top face and a bottom face, at least one fastener opening disposed between the top face and the bottom face, and means disposed upon elongated section to permit the formation of additional fastener openings therethrough during a surgical procedure. The osteosynthesis plate is in a first configuration at a first thermochemical state and is operable to be converted to a second thermochemical state so that it may be deformed prior to fixation. The osteosynthesis plate may further include means disposed upon the elongated section for enhancing structural rigidity, which may be provided as one or more raised surfaces, or rails, disposed upon the top face of the osteosynthesis plate.

Abstract: A fastener, driving device, and method are provided for repairing a tear in soft tissue of a patient, a particular exemplary embodiment comprising a meniscal tear in a knee. The fastener has a variable-pitch helical protrusion along a central portion that decreases from the distal end to the proximal end, which can serve to bring two sides of the tear into apposition as the fastener is advanced across the two sides of the tear in a screwing motion. The fastener material preferably is a biodegradable, biocompatible, nontoxic plastic that is specifically designed to be biodegradable generally within the time span of the healing process. A delivery device for introducing the fastener is also provided that includes an elongated needle rotationally coupled with the fastener, the turning of which turns the fastener, advancing the fastener into the tissue.

Abstract: An orbital implant is provided with a passageway extending from the anterior surface inwardly to receive a peg prior to implantation in the patient. The peg is made of non microporous material so that surrounding tissue will encapsulate the peg without adhering to it. This provides for later coupling of the ocular prosthesis to the implant without the necessity of a second operative procedure, and also allows the peg to be easily removed surgically if deemed necessary by the surgeon. The implant itself can be of any suitable material, but the implant is preferably made of biodegradable material having a matrix with random voids throughout to enhance tissue ingrowth into the implant. The matrix can be created by foxing or molding a suitable material, or the matrix can be formed from microporous thread of an inert material that is knitted, crocheted or otherwise formed into the desired size and shape.

Abstract: A process for enhancing the security of implantable surgical devices secured to bone tissue comprising implanting in bone tissue a surgical device with a biocompatible adhesive and/or sealant selected from the group consisting of: p1 (a) a material made from monomers of the formula:CHR.sup.1 .dbd.CX.sup.1 Y.sup.1wherein X.sup.1 and Y.sup.1 are each strong electron withdrawing groups, and R.sup.1 is hydrogen or, provided that X.sup.1 and Y.sup.1 are both cyano groups, a C.sub.1 -C.sub.4 alkyl group;(b) a semi-crystalline aliphatic poly(ester) of the formula:[--0--R.sup.11 --C(0)--].sub.y,wherein R.sup.11 is selected from the group consisting of --CR.sup.12 H--, --(CH.sub.2).sub.3 --0--, --CH.sub.2 --CH.sub.2 --O--CH.sub.2 --, CR.sub.12 H--CH.sub.2, --(CH.sub.2).sub.4 --, --(CH.sub.2).sub.z --O--C(O)-- and --(CH.sub.2).sub.z --C(O)--CH.sub.2 --; R.sup.

Abstract: An ionomer suture exhibits excellent properties. The suture may be monofilament or multifilament, and methods of making and using the suture are disclosed.

Abstract: A biodegradable, bioresorbable, three-dimensional template for repair and replacement of diseased or injured bone which provides mechanical strength to bone while also providing a guide for growth of bone tissue. Preferably, the template is formed of biodegradable materials, for example, poly(L-lactic acid), poly(D, L-lactic acid), poly (D, L-lactic-co-glycolic acid), poly (glycolic acid), poly (.epsilon.-caprolactone), polyortho esters, and polyanhydrides, and has the capacity of being rendered porous, either in vitro or in vivo. A pore-forming component, which may or may not be a polymeric material, is mixed within a continuous matrix formed of a biodegradable material, the pore-forming component having a rate of degradation which exceeds that of the matrix. Differential dissolution or biodegradation provides porosity to the template.

Abstract: A self-inserting absorbable orthopedic fixation device having a bioabsorbable fastening body portion for fastening body tissue, and having bone penetrating elements such as hard, pointed tips for penetrating bone or hard tissue fixed thereto. The pointed tips may be fabricated from metals or ceramics. The fixation device may be in the form of staples, pins, screws, and the like.

Abstract: Block copolymers have one of the block made from hard phase forming monomers and another block made from soft phase forming monomers copolymerized with randomly intermingled units of other soft phase forming monomers. Particularly useful copolymers are initiated with a polyalkylene oxide initiator. The copolymers are useful in forming surgical articles, including both monofilament and multifilament sutures.

Abstract: The present invention relates to methods to provide superior fixation of orthopedic devices within bones, through use of a resorbable cement material. As well, methods to provide temporary fixation of orthopedic devices within bones until the natural bone tissue may ingrow with the device are also disclosed. The methods are broadly applicable to repair of fractures or other divisive or compressive maladies in bones, augmentation of the osteopenic skeleton, and attachment of prostheses.

Abstract: An interference bone fixation screw fabricated from bioabsorbable material includes a body having a proximal end, a distal end and a screw thread disposed therealong from the proximal end to the distal end. A drive recess is formed in the body to extend longitudinally from the proximal end toward the distal end for receiving a rotatable driver. The drive recess defines a plurality of radial force receiving surfaces for receiving concentric forces from the driver applied perpendicularly to the force receiving surfaces.

Abstract: Bioresorbable bone prosthesis material containing particles of calcium carbonate, originating, for example, from coral skeleton, dispersed within a polymer matrix, the said particles being smaller than 1 mm in size and representing from 40 to 70% of the total weight, and the said polymer being a bioresorbable polymer.

Abstract: Bone-treating devices made of biodegradable polymers having a high-density and a high-orientation along the major axis, which have a density of 1.260 g/cm.sup.3 or more (when measured by the sink and float method) and which possess the bending strength and the bending strength-retaining characteristic defined by the following equations:A.gtoreq.B.gtoreq.23 (kgf/mm.sup.2) (1)B/A.gtoreq.0.85 (2)wherein A is the initial bending strength and B is the bending strength after 90-days immersion of the devices in a phosphate buffer at 37.degree. C. and preparing the same.

Abstract: Block copolymers wherein one of the blocks is made from hard phase forming monomers and another of the blocks is made from soft phase forming monomers copolymerized with randomly intermingled units of other soft phase forming monomers. The copolymers are useful in forming surgical articles, including both monofilament and multifilament sutures.

Abstract: Block copolymers wherein one of the blocks is made from hard phase forming monomers and another of the blocks is made from soft phase forming monomers copolymerized with randomly intermingled units of other soft phase forming monomers. The copolymers are useful in forming surgical articles, including both monofilament and multifilament sutures. The block copolymer preferably comprising:a) a proportion of glycolic acid ester units as end blocks, andb) a center block comprising 1,4 dioxan-2-one randomly polymerized with 1,3 dioxane-2-one.

Abstract: A device for repairing torn tissue or muscle such as the meniscus of the knee. The device consists of a pair of needles detachably secured to a pair of anchoring members having a plurality of barb-like projections extending outwardly therefrom. The anchoring members are joined by a suture which connects the ends of the anchoring members opposite the needles.

Abstract: A surgical interference implant including an elongated body formed of a biocompatible material and having a distal end and a proximal end. The proximal end defines an element for engaging a driver, and lacks an enlarged head member. The body defines a conical region having a smooth outer surface which extends proximally along a first, distal portion of the body to enable initial linear insertion of the body into a bone tunnel. A helical thread is disposed about a second, proximal portion of the body to enable subsequent rotational insertion of the body deeper into the bone tunnel.

Abstract: A prosthesis for the correction of a flatfoot condition of a patient, which is designed for insertion inside a recess or tarsal sinus defined between a first bone or astragalus and a second bone or calcaneus; wherein the prosthesis is made of bioreabsorbable material. The prosthesis has a club-shaped body or a slightly conical body.

Abstract: The instant device is made up of a guide wire component, a proximal wedge component and a distal wedge component with the proximal wedge component having a side with an inclined medial face, two suture grooves on this side above its inclined face, a stop face inclined obtusely to and outwardly from its inclined face and a guide wire hole through its head extending through its length and terminating in its inclined face as well as serrated bone biting edges located on its opposite side and with the distal wedge component having two suture thread holes in its medial face and at its base and a guide wire hole on the side where its inclined face is found below and between its two suture thread holes and at its base, and a stop face inclined obtusely and inwardly from its inclined face as well as a beveled bone biting edge at its top such that simultaneous application of downward pressure on the head of the proximal wedge component and upward pressure on suture thread threaded through suture thread holes in the di

Abstract: Polymer blends of glycolide and/or lactide homopolymer and/or glycolide/lactide copolymer and polycaprolactone and/or polytrimethylene carbonate homopolymer or copolymers thereof and absorbable surgical devices manufactured therefrom having improved mechanical properties, such as improved impact resistance and improved cyclic flex, are disclosed.

Abstract: A surgical system including: (1) a thermoplastic, body absorbable, bodily tissue fixation plate having a plurality of formations and a plurality of through-bores arranged in alternating relation along with plate; (2) body absorbable fasteners adapted for insertion into the through-bores to secure the plate to underlying bodily tissue; and (3) heating apparatus including a wand having a heating tip of a configuration adapted to substantially matingly cooperate with the formations to facilitate heating and bending of the plate into conformance with the underlying bodily tissue.

Abstract: The device relates to reconstructive surgery and orthopedics, and includes a central rod introducible into medullary canals of bone fragments of a bone, and a tubular element fittable on the rod at the place of the missing portion of the bone, the tubular element being equidimensional with the missing portion of the bone. The tubular element is shaped as a shell made of biocompatible polymers, and a layer of a porous polymer material is insertable between the rod and the shell incorporating a biomass of homogenized bone tissues. The invention is used for restoration of missing portions of bone which have been lost due to extensive injuries or wounds or as a result of pathologic changes of the bone tissue (such as may be caused by tumors or tuberculous infections).

Abstract: The invention provides an article for joining the pieces of a fractured bone, characterized in that the article is composed of a high-molecular weight material which is absorbable in the living body and that the article is in the form of a tubular body having a hollow interior and a cutout extending over the entire length of the tubular body in the longitudinal direction thereof.

Abstract: A device for repairing torn tissue or muscle such as the meniscus of the knee. The device consists of a pair of needles detachably secured to a pair of anchoring members having a plurality of barb-like projections extending outwardly therefrom. The anchoring members are joined by a suture which connects the ends of the anchoring members opposite the needles.