Abstract: An orthopedic intramedullary sleeve apparatus for internal bone fixation for bone fracture treatment of a patient. The apparatus may comprise a multilayer sleeve component comprising one or more access valves disposed on a surface of the sleeve. Each access valve may comprise one or more resealable ports for injecting polymers or monomers or resins or any curable types of cement. The sleeve component may be positioned inside the intramedullary cavity in a minimally invasive way and removed from the intramedullary cavity.

Abstract: Attachment devices and methods of using the same are disclosed. The attachment devices can be fenestrated. The fenestrations can control the flow of fluid out of and/or into the device.

Abstract: The present disclosure provides an apparatus, system, and method for positioning, holding, and/or distracting the bones and associated ligaments and tissue of the knee during surgery. In one aspect of the present disclosure, a modular distractor system may provide enhanced structurally stability and support of a patient's limb, which may provide stability, resulting in a better outcome for the patient. In another aspect of the present disclosure, modular distractor components are described, which provide for interchangeability and a tailored approach that accommodates variable patient limb size and specific surgical application.

Abstract: A system for delivering bone cement into a bone is provided. The system can include a hydraulic system actuatable to deliver a bone cement mixture from a bone cement container, through a cannula and into a bone. The hydraulic system can have more than one pressure relief mechanism for decreasing pressure in the hydraulic system to cease delivery (e.g., substantially instantaneously) of the bone cement into the bone.

Abstract: Various exemplary methods and devices are provided for passing sutures around anatomical structures. In an exemplary embodiment, a suture delivery device is provided that includes a body portion having a suture delivery member disposed therein and configured to pass a suture around an anatomical structure. The suture delivery member can be movable between a retracted configuration in which the suture delivery member is disposed within the body portion and an advanced configuration in which the suture delivery member extends distally beyond the body portion and assumes an arcuate shape. The arcuate shape can correspond to a shape of the anatomical structure and can extend almost all of the way around the anatomical structure, for example at least around 270° of a circle, thus assisting a user in passing the suture around the anatomical structure without having to manually manipulate the suture delivery device at awkward angles around adjacent tissue.

Abstract: A device and method for producing a bone cement paste from a monomer liquid and a cement powder, wherein the device comprises a cartridge with a cylindrical interior chamber for mixing the parent components, whereby the interior chamber of the cartridge is closed on the front side up to a delivery opening for expelling the bone cement paste from the interior chamber, a delivery plunger which is arranged in the interior chamber of the cartridge and which is supported in a linearly movable manner in the direction of the delivery opening, the cement powder, which is arranged in the interior chamber of the cartridge between the delivery opening and the delivery plunger, a monomer receptacle with an interior chamber in which a monomer liquid container containing the monomer liquid is contained, whereby in the monomer receptacle, a conveying plunger is arranged movable in the longitudinal direction of the monomer receptacle, a compressed gas connection, whereby the conveying plunger is arranged between the monomer

Abstract: A dissection device may include an inflatable balloon disposed at a distal end of a catheter, the catheter having an inflation lumen extending through the catheter to an interior space defined within the inflatable balloon. The inflatable balloon may include a top wall, a bottom wall spaced apart from the top wall, an outer perimeter wall extending between the top wall and the bottom wall, and a plurality of inner walls each extending between the top wall and the bottom wall and in sealing contact with the outer perimeter wall at a first end of the inner wall. The inflatable balloon may include a series of interconnected chambers including a central chamber in direct fluid communication with the inflation lumen, and laterally disposed chambers each having an opening fluidly connecting to each adjacent chamber.

Abstract: A system for performing interbody fusion surgery including an expandable intervertebral spacer and specialized instruments for choosing the correct size of implant, implanting the device within the intervertebral space, and for delivery of bone graft or bone substitute to the interior of the implant.

Abstract: An apparatus (1) for mixing a paste material with gas includes: a mixing part (2) that mixes the paste material with the gas using a piston pump (10); and a static mixer (3) that is connected to the mixing part to stir a mixture obtained by mixing the paste material with the gas in the mixing part. The static mixer includes one or a plurality of stirring sections through which the mixture passes, the stirring section has a shape that allows a flow of the mixture passing through the stirring section to be stirred. A ratio of a volume of the piston pump to a volume of at least one of the stirring sections of the static mixer is within a range from 1:0.2 to 1:5.

Abstract: A method for providing therapy to a patient, the method comprising: providing microfracture therapy to the acetabular cup of the patient, wherein providing microfracture therapy to the acetabular cup of the patient comprises forming at least one hole extending from the acetabular shelf to the cortical bone bed of the acetabular cup, such that blood may flow from the cancellous bone underlying the cortical bone bed to the surface of the cortical bone bed, whereby to form a blood clot at the surface of the cortical bone bed.

Abstract: A composition for the adhesion of biological tissues to one another, for the adhesion of a material to a biological tissue, for the adhesion of an adhesive or of a substance to the surface of a biological tissue, for blocking an orifice in a biological tissue, for reinforcing a biological tissue and/or for fixing and stabilising a biological tissue. A monomer that is polymerisable under the effect of ultraviolet (UV) radiation and in that the viscosity of said composition is less than 10 mPa·s at 20° C.

Abstract: Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

Abstract: A bone fusion method, system and device for insertion between bones that are to be fused together and/or in place of one or more of the bones, such as, for example, the vertebrae of a spinal column. The bone fusion device comprises one or more extendable tabs having a central rib. The bone fusion device includes one or more support channels configured to receive an insertion instrument that is then secured to the bone fusion device via a coupling mechanism. As a result, the coupled device is able to be securely positioned between vertebrae using the insertion instrument with minimal risk of slippage.

Abstract: A subperiosteal syringe assembly for storing, containing and delivering bone graft material to a location within the tissue of a jaw for use in a medical procedure. The syringe assembly has a lumen body that is maneuverable within the subperiosteal tissue to deposit bone graft material at the desired surgical site. Embodiments include a lumen body that has a flat shape, such as an elliptical shape. A plunger is provided to deliver the syringe contents. The syringe may be loaded with bone graft material, and some embodiments may be supplied pre-loaded with bone graft material. An end cap seals the open end of the lumen, and may function as a septum that may be punctured with a needle to introduce a liquid substance, such as a growth factor, into the lumen where the bone material is stored. The syringe may be designed to incorporate surgical navigation and laparoscopic systems.

Abstract: A separator element (300) is designed to prevent the passage of granulate along an axial direction (L) but to allow the passage of liquid along the axial direction (L). The separator element (300) has an internal thread (310) open towards its proximal end, and an external thread (320) open towards the distal end. At its proximal end, the separator element additionally has at least one resilient locking arm (330) which is arranged on the outer circumference and winch extends with its free end in the proximal direction. In this way, the separator element can be mounted on the discharge opening of a container (100) and, by means of a closure piece (400), can be fixed on the container in such a way that the separator element remains on the container when the closure piece is removed.

Abstract: A graft material injector device and method are disclosed. The injector device includes an elongated injector tube and a side loading aperture for receiving graft material. A graft material loader and a cover for the side loading aperture may optionally be included.

Abstract: Systems and methods for treating bone, such as vertebral compression fractures are disclosed. A method includes controllably applying energy to a bone cement volume outside of a patient's body to selectively accelerate the polymerization rate of the bone fill material volume prior to introduction into a bone. The method further includes sequentially introducing a plurality of cement carrying structures with the accelerated polymerization rate bone cement volume into the bone. A system for use in the method includes at least one elongated cement-carrying structure sized to carry a bone cement volume therein and an energy source operatively coupleable to the cement-carrying structure. The energy source applies energy to the bone cement volume to selectively accelerate a polymerization rate thereof. An elongated injector insertable into the bone has a passageway that removably receives the elongated cement-carrying structure to allow delivery of the accelerated polymerization rate bone cement into the bone.

Abstract: The present invention relates in certain embodiments to medical devices for treating vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the flow of bone cement into the interior of a vertebra and the application of forces causes by the cement flow. An exemplary system utilizes Rf energy in combination a conductive bone cement for selectively polymerizing the inflow plume to increase the viscosity of the cement. In one aspect of the invention, the system utilizes a controller to control bone cement flow parameters to either allow or disallow cement interdigitation into cancellous bone. A method of the invention includes pulsing the flows of bone cement wherein high acceleration of the flow pulses can apply expansion forces across the surface of the cement plume to reduce a vertebral fracture.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: A covering for delivering a substance or material to a surgical site is provided. The covering, with substance provided therein, may be referred to as a delivery system. Generally, the covering may be a single or multi-compartment structure capable of at least partially retaining a substance provided therein until the covering is placed at a surgical site. Upon placement, the covering may facilitate transfer of the substance or surrounding materials. For example, the substance may be released (actively or passively) to the surgical site. The covering may participate in, control, or otherwise adjust, the release of the substance.

Abstract: A cover for use in protecting a resected surface of a long bone for use in joint arthroplasty is provided. The cover includes a generally planar portion having opposed generally parallel first and second surfaces defining a periphery extending from the first surface and the second surface. The cover also includes a lip extending from the first surface at the periphery of the planar portion in a direction not planar with the generally planar portion.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: A bone cement comprising a first component and a second component, wherein contacting the first component and the second component produces a mixture which attains a high viscosity an initial period and the viscosity of the mixture remains relatively stable for a working time of at least 5 minutes after the initial setting period, and the mixture is suitable for in-vivo use.

Abstract: The embodiments provide devices and methods that both strengthen the bone and stimulate the bone. Bone fractures or non-unions are stabilized, integrated or healed, which results in reduction of a bone defect, such as a bone marrow lesion or edema. In addition, the distribution of forces in a joint are restored or altered to relieve pain. In general, a joint is evaluated by taking an image of the joint and one or more subchondral defects are detected. At least one of the subchondral defects may be diagnosed as the source of pain and an extent of treatment for the subchondral defect is determined. The disclosed devices and techniques are particularly suited for treating chronic defects or injuries, where the patient's natural healing response has not resolved the defect. The present disclosure also provides several exemplary treatment modalities for the different extents of treatment needed.

Abstract: A device and method of delivering a medical tool which may be a resector, cutter, probe, or the like, including a memory arm compacted in a small diameter state which expands in a relaxed memory state, is disclosed. Said delivery may include using a hollow sheath to pre-compact or preload a memory blade into a compact position, transferring said compacted memory blade into a cannula, and deploying said memory blade from the distal end of said cannula whereby the memory blade returns to its normal expanded memory state and a deployment nut can be used to control the extension or the withdrawal of the memory arm and blade.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: Systems and methods for treating bone, such as vertebral compression fractures are disclosed. A method includes controllably applying energy to a bone cement volume outside of a patient's body to selectively accelerate the polymerization rate of the bone fill material volume prior to introduction into a bone. The method further includes sequentially introducing a plurality of cement carrying structures with the accelerated polymerization rate bone cement volume into the bone. A system for use in the method includes at least one elongated cement-carrying structure sized to carry a bone cement volume therein and an energy source operatively coupleable to the cement-carrying structure. The energy source applies energy to the bone cement volume to selectively accelerate a polymerization rate thereof. An elongated injector insertable into the bone has a passageway that removably receives the elongated cement-carrying structure to allow delivery of the accelerated polymerization rate bone cement into the bone.

Abstract: An orthopedic implant system includes an external fixation device implantable at a selected location within a corporeal body and configured for delivering at least one therapeutic agent to the corporeal body. The external fixation device includes an implantable pin, a sheath coupled with the pin, a reservoir coupled with the sheath and a plurality of channels. The pin defines the plurality of channels. The reservoir is configured for receiving the at least one therapeutic agent. The plurality of channels are configured for conveying the at least one therapeutic agent from the reservoir to a treatment site relative to the corporeal body.

Abstract: A laterally deflectable asymmetric implant for implanting into a body may comprise a deflectable piece having distal and proximal ends and assuming a straightened insertion state. The backbone may abut or interconnect with said deflectable piece at the distal end of the deflectable piece. In a fully deflected state the implant may define an asymmetric shape, e.g. a D-shaped loop, defining an at least partially enclosed volume. The deflectable piece may comprise a sequence of segments interconnected at effective hinges. Longitudinal pressure applied to the proximal end of the deflectable piece (or applied to the backbone in an opposite direction) may cause relative longitudinal movement between the backbone and the proximal end of the deflectable piece and may generate outward horizontal movement of the deflectable piece away from the backbone. In one embodiment, the implant is implanted using lateral access into an anterior zone of a vertebra and deployed posteriorly.

Abstract: A device and method of delivering a medical tool which may be a resector, cutter, probe, or the like, including a memory arm compacted in a small diameter state which expands in a relaxed memory state, is disclosed. Said delivery may include using a hollow sheath to pre-compact or preload a memory blade into a compact position, transferring said compacted memory blade into a cannula, and deploying said memory blade from the distal end of said cannula whereby the memory blade returns to its normal expanded memory state and a deployment nut can be used to control the extension or the withdrawal of the memory arm and blade.

Abstract: Systems, devices, and methods are provided for orthopedic implants. The implants may include a base member, such as an acetabular shell or an augment, that is configured to couple with an augment, flange cup, mounting member, or any other suitable orthopedic attachment. An implant may include abuse member that has at least two projections with a gap between the projections. The gap between the projections allows the implant to be implanted around another implanted component, such as around a bone screw of an acetabular shell. The implant may include a fixation element, such as a screw or a cement trough, on one or more projections to couple the implant to an implanted acetabular shell. The implant may also include timing marks to facilitate alignment with corresponding marks on another implanted component.

Abstract: A manifold has at least one manifold aperture extending therethrough and selectively placed in fluid communication with a fluid source. An insertion structure has at least one interior cavity at least partially defined by a structure shell and is selectively placed in fluid communication with a corresponding manifold aperture. The insertion structure is configured for selective placement in a penetrating relationship with a patient tissue below a surface of the patient tissue. At least one shell perforation extends through the structure shell and places the interior cavity in fluid communication with a surrounding ambient space. At least one fluid path extends from the fluid source, through the manifold aperture, into the interior cavity, through at least one shell perforation, and at least one of a proximate relationship and a contacting relationship with the patient tissue beneath the outer surface thereof. A fluid is directed along the fluid path.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: Systems and methods for the treatment of a joint are provided. These systems and methods may also include a subchondral treatment of bone of the same joint. These joint treatment methods may be non-surgical or surgical. Also provided are devices and instruments associated with the methods.

Abstract: A device includes an outer member extending between a first end and a second end. The outer member comprises an inner surface defining a passage. The device includes an inflatable member having a first end extending from the second end of the outer member and a second end. The inflatable member includes an inner surface defining a chamber. The inner surface of the outer member is continuous with the inner surface of the inflatable member. The device includes an inner member having a first end positioned within the passage and a second end coupled to the second end of the inflatable member such that the inner member does not engage the inner surface of the outer member. Systems and methods are disclosed.

Abstract: A method of applying bone cement for an orthopedic procedure of a patient includes coupling a proximal end of a nozzle component to a bone cement applicator and applying bone cement on a surface of an implant or on a bone surface through an elongated distal opening of a distal portion of the nozzle component. The method includes separating the distal portion from an intermediate portion of the nozzle component at a frangible connecting portion and exposing a circular distal end of the intermediate portion.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: A manifold has at least one manifold aperture extending therethrough and selectively placed in fluid communication with a fluid source. An insertion structure has at least one interior cavity at least partially defined by a structure shell and is selectively placed in fluid communication with a corresponding manifold aperture. The insertion structure is configured for selective placement in a penetrating relationship with a patient tissue below a surface of the patient tissue. At least one shell perforation extends through the structure shell and places the interior cavity in fluid communication with a surrounding ambient space. At least one fluid path extends from the fluid source, through the manifold aperture, into the interior cavity, through at least one shell perforation, and at least one of a proximate relationship and a contacting relationship with the patient tissue beneath the outer surface thereof. A fluid is directed along the fluid path.

Abstract: A device includes an inflatable member extending between a first end and a second end. An inner surface of the inflatable member defines a first passageway in the first end and a chamber in the second end. An inner member is disposed in the first passageway and extends through the chamber. The inner member includes an inner surface defining a second passageway. A second end of the inflatable member is bonded to an outer surface of the inner member. A guide is member disposed in the second passageway. An outer member includes a first end having a projection including a threaded outer surface. The outer member includes an inner surface defining a third passageway having the inflatable member disposed therein. A cap includes a threaded inner surface that engages the threaded outer surface of the projection. Methods of use are provided.

Abstract: A void containment apparatus and its method of use during an invasive procedure on the body are disclosed. The void containment apparatus includes an elongated housing and a balloon. The balloon is capable of being inflated and deflated. When inflated, the balloon provides a seal around a void and allows delivery or extraction of material into or out of the void with minimal leakage outside the void.

Abstract: Systems and methods for treating bone, such as vertebral compression fractures are disclosed. A method includes controllably applying energy to a bone cement volume outside of a patient's body to selectively accelerate the polymerization rate of the bone fill material volume prior to introduction into a bone. The method further includes sequentially introducing a plurality of cement carrying structures with the accelerated polymerization rate bone cement volume into the bone. A system for use in the method includes at least one elongated cement-carrying structure sized to carry a bone cement volume therein and an energy source operatively coupleable to the cement-carrying structure. The energy source applies energy to the bone cement volume to selectively accelerate a polymerization rate thereof. An elongated injector insertable into the bone has a passageway that removably receives the elongated cement-carrying structure to allow delivery of the accelerated polymerization rate bone cement into the bone.

Abstract: A device for injecting a viscous fluid into the body includes a tubular structure defining an inner bore for passage of the viscous fluid and a pushing piston (21) engaged in the inner bore. The tubular structure is a single-piece metal tubular body (3) extending from the first end (4) to a second end (5) provided with a connector (7) for sealable fastening of a trans-tissue injection vector. The pushing piston (21) has a metal rod (22) having a straight transverse section that is constant over its entire length and complementary, while allowing for operational clearance, with that of the bore of the metal tubular body (3).

Abstract: A spinal surgery tool system including an elongated conduit and an implant is disclosed. The implant assumes a straight configuration within the elongated conduit and is deployable from the elongated conduit into a closed or nearly-closed loop configuration for deployment interposed between two tissue surfaces to define an enclosed volume. The conduit and the implant are configured such that, when the implant is deployed in the loop configuration, an opening formed in a proximal portion of the implant forms a contiguous channel with a passageway along the conduit so as to provide a continuous access channel along the elongated conduit into the enclosed volume.

Abstract: The present invention relates to an apparatus and method for near-simultaneous and integrated delivery of bone graft material during the placement of surgical cages or other medical implants in a patient's spine. The integrated fusion cage and graft delivery device according to various embodiments delivers and disperses biologic material through a fusion cage to a disc space and, without withdrawal from the surgical site, may selectably detach the fusion cage for deposit to the same disc space. The integrated fusion cage and graft delivery device is formed such that a hollow tube and plunger selectively and controllably place bone graft material and a fusion cage in or adjacent to the bone graft receiving area.

Abstract: An antibiotic delivery system including an intramedullary stem that is adapted to be removably mounted into a medullary canal of a bone. The stem includes a body having an inlet adapted to be in fluid communication with a source of liquid-borne antibiotic and a plurality of outlets disposed along the stem. A channel extends between the inlet and the plurality of outlets for delivering a fluid-borne antibiotic from the inlet to the plurality of outlets so as to distribute the antibiotic along the medullary canal in a controlled fashion. A method of treating an infected joint during a two-stage re-implantation of an orthopedic implant is also disclosed.

Abstract: An antibiotic delivery system including an intramedullary stem that is adapted to be removably mounted into a medullary canal of a bone. The stem includes a body having an inlet adapted to be in fluid communication with a source of liquid-borne antibiotic and a plurality of outlets disposed along the stem. A channel extends between the inlet and the plurality of outlets for delivering a fluid-borne antibiotic from the inlet to the plurality of outlets so as to distribute the antibiotic along the medullary canal in a controlled fashion. A method of treating an infected joint during a two-stage re-implantation of an orthopedic implant is also disclosed.

Abstract: An antibiotic delivery system including an intramedullary stem that is adapted to be removably mounted into a medullary canal of a bone. The stem includes a body having an inlet adapted to be in fluid communication with a source of liquid-borne antibiotic and a plurality of outlets disposed along the stem. A channel extends between the inlet and the plurality of outlets for delivering a fluid-borne antibiotic from the inlet to the plurality of outlets so as to distribute the antibiotic along the medullary canal in a controlled fashion. A method of treating an infected joint during a two-stage re-implantation of an orthopedic implant is also disclosed.

Abstract: An antibiotic delivery system including an intramedullary stem that is adapted to be removably mounted into a medullary canal of a bone. The stem includes a body having an inlet adapted to be in fluid communication with a source of liquid-borne antibiotic and a plurality of outlets disposed along the stem. A channel extends between the inlet and the plurality of outlets for delivering a fluid-borne antibiotic from the inlet to the plurality of outlets so as to distribute the antibiotic along the medullary canal in a controlled fashion. A method of treating an infected joint during a two-stage re-implantation of an orthopedic implant is also disclosed.

Abstract: An antibiotic delivery system including an intramedullary stem that is adapted to be removably mounted into a medullary canal of a bone. The stem includes a body having an inlet adapted to be in fluid communication with a source of liquid-borne antibiotic and a plurality of outlets disposed along the stem. A channel extends between the inlet and the plurality of outlets for delivering a fluid-borne antibiotic from the inlet to the plurality of outlets so as to distribute the antibiotic along the medullary canal in a controlled fashion. A method of treating an infected joint during a two-stage re-implantation of an orthopedic implant is also disclosed.