Abstract: System, including methods, apparatus, and kits, for connecting bones and/or bone portions using a bone connector with a pivotable ball and socket joint.

Abstract: The present invention provides a cancellous bone scaffold to use in the replacement or repair of connective tissue such as ligaments and tendons. The cancellous bone scaffold has a fully demineralized segment with at least one adjacent mineralized end segment.

Abstract: A method and device for finding isometric points in the joints of mammals for use in surgical repair of a joint. Isometric points are first identified in radiographic or other two dimensional images and then located in the actual joint. A method for repairing a cruciate ligament-deficient canine stifle employing the method and device for finding isometric points is described. A method and apparatus for locating the axis of rotation of a joint is also described.

Abstract: This invention relates generally to orthopedic implants for reconstruction of severed, ruptured, or damaged ligaments. More particularly, this invention relates to an improved elastic replacement ligament made from metallic wires in a braided construction for replacement of a natural ligament of the body such as the anterior cruciate ligament of the knee.

Abstract: A graft fixation system for fixing graft material in a bone tunnel includes an expandable fixation member having a graft receiving eyelet disposed proximate its distal end, opposed bone engaging elements disposed about its periphery, and an expansion plug receiving opening defined in its proximal end. The system also includes an expansion plug having a diameter greater than the diameter of the expansion plug receiving opening so that forceable insertion of the expansion plug into the expansion plug receiving opening causes an expansion of the expandable fixation member driving the opposed bone engaging elements apart so as to fix the bone engaging elements, as well as the graft material, in a bone tunnel.

Abstract: An apparatus and method for Lisfranc repair using a suture-button construct. The method includes the steps of drilling a hole in a medial cuneiform and through a second metatarsal base, passing a needle with a pull-through suture strand through the hole, pulling the pull-through suture strand and simultaneously applying a lateral tension on a first suture strand such that the first button lies sideways and advancing the first button through the hole until the it exits the hole at the medial cuneiform, flipping the first button to engage it against the medial aspect of the medial cuneiform and applying a lateral tension on the first suture strand, pulling free ends of the first suture strand to advance a second button over the second metatarsal base and to engage it against the second metatarsal base, and securing the second button against the second metatarsal base by tying a Surgeon's knot and two reverse half-hitches.

Abstract: The disclosure describes implantable bioprosthesis having an implantable construct with a multi-fiber array of collagen fibers attached together.

Abstract: An apparatus and method for performing a surgery, especially an ACL replacement surgery, where a flexible strand insertion rod co-operates with a U-Guide apparatus to insert a flexible strand into a tunnel formed in a bone portion and to guide a pair of drill points to form a pair of tunnels transversely to the tunnel of the insertion rod. The drill points are guided through the insertion rod and the flexible strand is held over the drill points as the transverse tunnels are formed. The insertion rod is then removed from the tunnels formed in the bone and the flexible strand is held looped over the second drill point. Subsequently, a soft tissue replacement is affixed to one end of the flexible strand and pulled over up to the first drill point with the other end of the flexible strand. The first drill point is then used to pull a cross pin through the transverse tunnel to hold the looped end of the soft tissue replacement in place.

Abstract: A system and method for attaching soft tissue to bone is provided. In general, the apparatus includes an expandable body that is configured to expand into bone, and an expander pin that is adapted to be driven into the expandable body. The device can also include a tissue attachment apparatus that can be used to secure tissue to the device, thereby providing a method for attaching tissue to bone.

Abstract: The invention provides a tendon or ligament prosthesis having an undeployed configuration and a deployed configuration. The prosthesis has a resistance to tension in the undeployed configuration that is less than its resistance to tension in the deployed configuration. In the deployed configuration, the prosthesis is capable of twisting and bending. In one embodiment, the prosthesis has a meshwork of filaments woven, knitted or braided into a slender cylinder. In this embodiment, the prosthesis attains the deployed configuration by stretching the prosthesis from its undeployed configuration. The prosthesis may be used, for example, to replace an anterior or posterior cruciate ligament or to treat acromioclavicular joint separation, a rotator cuff tear, lateral collateral ligament tears, medial collateral ligament tears, or medial patello-femoral ligament tears. The invention also provides a method for replacing a tendon or ligament using the prosthesis of the invention.

Abstract: Methods are provided for producing a bioscaffold from natural tissues by oxidizing a decellularized tissue to produce a bioscaffold having pores therein. The pore size and porosity is increased to better accommodate intact cells so that live cells can better infiltrate and inhabit the bioscaffold. The bioscaffold may be freeze-dried or lyophilized, sterilized and (optionally) aseptically packaged for subsequent use. A further aspect of the present invention is a bioscaffold produced by the processes described herein. Methods of treatment using the bioscaffold as a graft or as a biomedical implant for implantation are also provided. Also provided are methods of seeding a bioscaffold with mammalian cells, wherein the seeding carried out either in vitro or in vivo, and wherein a bioscaffold produced as described herein is utilized for said seeding.

Abstract: A ligament incorporated into a prosthetic joint exhibiting a plasticized, elongated and deformable material. A fibrous material is internally disposed within the deformable material, the fibrous material terminating in first and second enlarged bead portions arranged in proximity to enlarged pocket defined ends associated with the deformable materials. First and second bones define a joint region therebetween, the deformable end pockets and bead portions being inserted through associated holes defined in joint proximate locations associated with the bones, so that actuation of a projection location of the fibrous material causes the bead portions to outwardly deflect the end pockets, resulting in the ligaments being anchored in place between the bones.

Abstract: A soft tissue fixation system, most typically applicable to orthopedic joint repairs, such as anterior cruciate ligament (ACL) knee repair procedures, comprises an implant which is placeable in a tunnel disposed in a portion of bone, wherein the tunnel is defined by walls comprised of bone. A first member is deployable outwardly to engage the tunnel walls for anchoring the implant in place in the tunnel, and a second member is deployable outwardly to engage tissue material to be fixed within the tunnel. The second member also functions to move the tissue material outwardly into contact with the tunnel walls to promote tendon-bone fixation. Extra graft length is eliminated by compression of the tendon against the bone at the aperture of the femoral tunnel, which more closely replicates the native ACL and increases graft stiffness. The inventive device provides high fixation of tendon to bone and active tendon-bone compression.

Abstract: A multi-region device for repair, regeneration or reconstruction in articular tissue injury such as torn ligaments and tendons is provided. The device comprises at least one degradable material and biocompatible non-degradable polymeric fiber-based material, in a three-dimensional braided scaffold. The two end sections are designed for attachment of the device at the site of implantation and are designed to allow bone cell ingrowth, and one or more middle regions are designed to allow ligament or tendon cell ingrowth.

Abstract: A graft ligament anchor includes a tubular body having a bore therethrough and proximal and distal ends. A flange is attached to the tubular body at the proximal end thereof and extends radially outwardly beyond the tubular body. A deformable wall is disposed in the tubular body bore and defines, at least in part, a chamber for retaining the graft ligament therein. An expansion device is configured for insertion into the tubular body axially of the tubular body, and for impinging upon the deformable wall to press the deformable wall, and hence the graft ligament received in the chamber, toward a wall of the bore, whereby to fix the graft ligament in the tubular body.

Abstract: The invention provides a ligament or tendon prosthesis. The prosthesis has at least two load bearing elements (6a, 6b) arranged in series and having different mechanical properties. The invention also provides a method for producing the prosthesis of the invention, as well as a method for replacing a torn or damaged ligament or tendon.

Abstract: A prosthesis for implantation into a human body is made by a method that includes the steps of providing a natural animal ligament or tendon that has a substrate, crosslinking and fixing the substrate, minimizing the antigens from the substrate, tanning the substrate to improve its mechanical properties, and coupling an active layer to the substrate.

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

Abstract: There are disclosed methods of performing an ACL repair. In one embodiment, the method includes providing a patella ligament with two native bone blocks and the patella ligament has a length greater than a native ACL. The length of the patella ligament is shortened to a desired length for an ACL repair while maintaining at least one native interface between the patella ligament and the native bone blocks. There are disclosed adjustable patella ligaments for ACL repair. In one embodiment, the ligament includes native bone blocks with the length between shortened from a length greater than a native ACL. A securing member is attached to one of the blocks and the patella ligament. At least one block is attached to the patella ligament by a native interface. Other embodiments are also disclosed.

Abstract: A tendon repair implant delivery system and methods incorporating a guide member having a temporary fixation member on or adjacent to the distal end. The point of fixation defines a target site for placement of the tendon repair implant which is subsequently affixed to the tendon.

Abstract: A device for elastic ligature of tissues comprises: a first and a second element, one of which exhibits a support portion for at least a rubber ring, the elements being slidably coupled to one another such that a reciprocal sliding between the elements determines a release of a rubber ring from the support portion; a trigger, manually manoeuvrable by an operator and acting on at least the second element for realising a reciprocal sliding between the elements; a connecting portion, connected to the trigger and to the second element and being elastically deformable in order to enable a reciprocal change of orientation between the trigger and the second element.

Abstract: The articular cartilage according to the invention is made of pure cartilage and is provided with incisions (12) on the surface facing the bone. The cartilage cells are preferably seeded on the surface provided with incisions (12). The method for producing the articular cartilage comprises the step of collecting cartilage from joints, wherein pure cartilage is collected without bone, and incisions are made on the surface of the cartilage intended to face the bone. It is preferably fresh frozen until use. The device for harvesting articular cartilage, comprises handle and cutting blade, wherein the cutting blade (4) is curvilinear and is provided with spacer elements (5), meanwhile the device for producing incisions in articular cartilages comprises handle (2) and a bridge (3) connected to said handle (2) and being provided with one or more cutting blade(s) (4).

Abstract: A device and method to provide a surgically inserted internal tether between the femur and tibia is provided which will prevent distraction of the healing anterior cruciate ligament in all degrees of flexion and extension, at all times. The anterior cruciate ligament tether preserves the four-bar cruciate linkage, critical for normal knee mechanics. In addition, placement of the tether provides bleeding into the knee in the region of the anterior cruciate ligament attachment sites and the consequent inflow of pluripotential cells and healing mediators.

Abstract: Methods of ligament repair are provided. A ligament graft is arranged in a tensioning device and placed adjacent to a heating surface. The heating surface is activated to heat the graft. The graft is tensioned while on the substantially dry heating surface to provide laxity to the graft. The size of the relaxed graft remains the same until the graft is implanted in a bone tunnel as either an anterior or posterior cruciate ligament graft.

Abstract: An implantable tendon protection system includes a body adapted to be implanted within a bursa overlying a tendon of a patient to protect the tendon. The body may be fixed to the tendon with adhesive, sutures, staples, and/or anchors. A surgical kit is provided with such a tendon protection system and an insertion cannula. Methods of protecting a tendon of a patient are also disclosed.

Abstract: A method according to embodiments of the present invention for repairing an Achilles tendon that has completely or partially ruptured leaving a distal stump extending from a calcaneus and a proximal stump, the proximal stump having a proximal stump end, and the distal stump having a distal stump end, includes attaching a first suture to the distal stump, positioning an augmentation patch against an anterior portion of the Achilles tendon, attaching a second suture to the proximal stump and to the augmentation patch, apposing the proximal stump end and the distal stump end such that a gap between the proximal stump end and distal stump end is minimized or eliminated, joining the first suture with the second suture to secure the proximal stump to the distal stump, and attaching the augmentation patch to the calcaneus.

Abstract: The invention provides compositions and methods for treatment of tendon and ligament injuries and/or repair of damaged tendons and ligament. The invention provides compositions comprising a biocompatible matrix and platelet-derived growth factor (PDGF).

Abstract: A ligament incorporated into a prosthetic joint exhibiting a plasticized, elongated and deformable material. A fibrous material is internally disposed within the deformable material, the fibrous material terminating in first and second enlarged bead portions arranged in proximity to enlarged pocket defined ends associated with the deformable materials. First and second bones define a joint region therebetween, the deformable end pockets and bead portions being inserted through associated holes defined in joint proximate locations associated with the bones, so that actuation of a projection location of the fibrous material causes the bead portions to outwardly deflect the end pockets, resulting in the ligaments being anchored in place between the bones.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: A method of providing a replacement anterior cruciate ligament (ACL) provides a tibial tunnel and at least one femoral tunnel for receiving the replacement ligament, the femoral and tibial tunnels not being colinear but rather in an orientation that more closely mimics the natural ACL. The femoral tunnel is formed through the anterior medial portal. A cross pinning guide having a femoral rod for insertion into the femoral tunnel, a spaced apart arc shaped track and a guide block having one or more bores aligned with the femoral rod whereby an instrument inserted through one of the bores creates a pilot hole for the cross pin which intersects the femoral tunnel and an appropriate angle thereof which avoids ligaments and other sensitive tissue can be selected by adjusting the guide block along the track.

Abstract: An apparatus and method is disclosed for performing a surgery, such as an orthopedic surgery. The apparatus can include a guide portion and an alignment portion. The guide portion can assist in positioning the alignment portion to assist in aligning an implant. The implant can be aligned and positioned to hold a graft relative to a bone portion.

Abstract: The present invention provides a bionanocomposite including a pre-selected decellularized tissue crosslinked with a pre-selected nanomaterial. Also provided is a process for fabricating the bionanocomposite. Additionally, applications for using the bionanocomposite as soft tissue repair materials or scaffolds for tissue engineering are described.

Abstract: A system and method for sharing and absorbing energy between body parts. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: Biomimetic artificial prostheses which are made from polyester, such as polyethylene terephthalate, and a method for the biomimetic functionalization of such prostheses. The method includes a step involving the grafting of biologically-active polymers or copolymers to the polyester surface of the prostheses, the grafting step consisting of the peroxidation of the surface by ozonation followed by a step including the radical polymerization of a solution of at least one monomer. The method also includes an optional step consisting in impregnating the prostheses with type I and/or II collagen and/or fibronectins. The prostheses thus obtained enable a normal and uniform regrowth of the fibroblasts, thereby significantly improving the biological integration of such polyester prostheses.

Abstract: Novel silver-triclosan salts are provided which have antimicrobial properties and may be used as pharmaceutical compositions or to treat articles such as medical devices, packaging materials, and textiles.

Abstract: A prosthesis for implantation into a human body is made by a method that includes the steps of providing a natural animal ligament or tendon that has a substrate, crosslinking and fixing the substrate, minimizing the antigens from the substrate, tanning the substrate to improve its mechanical properties, and coupling an active layer to the substrate.

Abstract: The present invention provides a method of performing anterior cruciate ligament replacement. Specifically, a graft tissue is harvested from a patient and single tunnels are prepared in each of the tibia and the femur of the patient. The graft is secured in the femoral tunnel and separated into an anterior cruciate medial bundle and a anterior cruciate posterior lateral bundle. The bundles are inserted through the tibial tunnel. During insertion the posterior lateral bundle is positioned in a posterior lateral position in the tibial tunnel while the anterior cruciate medial bundle is positioned in an anterior cruciate medial position in the tibial tunnel. The anterior cruciate medial bundle is then tensioned while the patient's knee is in approximately 90 degrees of flexion, and the posterior lateral bundle is tensioned while the patient's knee is approximately in full extension. Each of the bundles is then secured in the tibial tunnel.

Abstract: The present invention provides a method of performing posterior cruciate ligament replacement. Specifically, a graft tissue is harvested from a patient and single tunnels are prepared in each of the tibia and the femur of the patient. The graft is secured in the femoral tunnel and separated into a posterior cruciate medial bundle and a posterior lateral bundle. The bundles are inserted through the tibial tunnel. During insertion the posterior lateral bundle is positioned in a posterior lateral position in the tibial tunnel while the posterior cruciate medial bundle is positioned in a posterior cruciate medial position in the tibial tunnel. The posterior cruciate medial bundle is then tensioned while the patient's knee is in approximately 90 degrees of flexion, and the posterior lateral bundle is tensioned while the patient's knee is approximately in full extension. Each of the bundles is then secured in the tibial tunnel.

Abstract: Improved methods and apparatuses for treatment of incontinence or pelvic organ prolapse are provided. A neo ligament for increasing the supportive function of the tissues supporting the urethra, bladder neck, or rectum is disclosed. Methods of using such a neoligament to treat incontinence are disclosed. Additionally, a self tensioning elastic tissue bolster for support of the tissues that support the urethra, rectum, and bladder neck are disclosed. A method of treating incontinence by injecting proliferative agents into supportive structures is disclosed. Methods and apparatus for transvaginal and transperitieai pelvic floor bolster treatment of incontinence and bladder pillar systems are also disclosed.

Abstract: A prosthetic knee implant for implantation into a mammal, which accommodates an anterior cruciate ligament substitute to provide stability to the knee implant. The prosthetic knee implant includes a femoral component having a pair of condylar surfaces and a tibial component having a surface portion adapted to slidably engage the femoral component upon rotation of the same. The femoral component further includes a recess between the condyles defining an aperture through the femoral component. The tibial component further includes a center portion defining an aperture through the tibial component substantially at its center. The femoral aperture and the tibial aperture are adapted to receive an anterior cruciate ligament substitute for biasing the mammalian femur and tibia together. Also disclosed is a method used to replace the total knee joint in a mammal with the improved prosthetic knee implant of the present invention.

Abstract: Described is an implant for use in medical applications and methods of making and using the implant. The implant includes a hydrated substrate and a diamond-like carbon coating on the substrate. The substrate may be a biological substrate, such as collagen or elastin. The implant may be used to replace or restore the function of damaged tissue in a patient requiring such treatment.

Abstract: The present invention provides a replacement ligament comprising first and second ends, two or more securing portions for securing said ligament to a portion of bone material and a body portion comprising a first component having a first, higher, elongation per unit load characteristic; and a second component having a second, lower, elongation per unit load characteristic. The first and second components are between said two or more securing portions and arranged in load series such that initial, lower, loading is reacted by said first component and subsequent, higher, loading is reacted by said second component.

Abstract: A system and method for attaching soft tissue to a prosthetic implant can include a prosthetic component that defines a soft tissue attachment region having an attachment surface thereon. A first construct can be formed of porous metal and be removably coupled to the attachment surface. A second construct can be positioned outboard of the soft tissue. A fastener can be engaged to the second construct capturing the soft tissue against the first construct. The fastener can be coupled on a distal end to the first prosthetic component.

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 surgical method of anchoring tissues in a target location, comprising tracking a cannulated dilator on a suture protruding from the target location and forming an enlarged opening in the target location using the cannulated dilator to enlarge the opening. A distal end of a guide wire is tracked through the dilator into the enlarged opening, and an anchoring device is slid on the guide wire to position the device in the enlarged opening. Advantageously, since the target location is dilated prior to receiving the anchoring device therein, a soft tissue disposed at the target location can be dilated before being anchored, to avoid possible damage to the tissue by the implanting device.

Abstract: The present invention concerns polymer materials useful for medical devices as well as medical devices prepared therefrom, including in particular surgical sutures, artificial ligaments, nets for tissue regeneration or vascular plugs. The present invention also concerns a method for preparing such articles, in particular filaments suitable for the preparation of sutures and nets.

Abstract: The present application relates to a method for determining the position or relative position of body parts, taking into account the anatomical symmetry, wherein at least one first-side body part is provided on the first side of an anatomical body, and at least one second-side body part is provided on the second side of the anatomical body, wherein the first side is separated from the second side by a body symmetry plane, said method comprising the steps of: providing first-side body part data which describes or implies the position of the at least one first-side body part; providing second-side body part data which describes the position of the at least one second-side body part; providing symmetry plane data which describes the position of the body symmetry plane; calculating the mirrored position or mirrored positions of the at least one second-side body part which results after the position of the at least one second-side body part has been mirrored on the body symmetry plane, on the basis of the second-s

Abstract: Musculoskeletal tissues produced in vitro are optimized in response to an externally applied mechanical load. The load applied may vary from tissue to tissue, depending upon the response desired, and may include intermittent axial, torsional, and bending loads to produce cortical structures. Compression alone is preferably applied to produce cancellous bone. A method according to the invention for culturing bone in vitro comprises: providing a culture vessel providing a scaffold material, supporting the scaffold material within the tissue culture vessel so as to be exposed to a tissue culture medium, and exerting a force on the scaffold material during growth of a bone construct (a cultured bone growth) around the scaffold material.

Abstract: An implant (5) for ligament and/or bone reconstruction is composed of biodegradable material suitable to be remodeled into vital bone and having mechanical strength for securely fixing a ligament in a bore or hole in bone with a press or form fit and/or reshaping a collapsed surface of bone into original shape. A surgical instrument (9) for ligament and/or bone reconstruction can be used to insert the implant (5) into bone and has a shaft member (3) having a first end (11), a second end and a longitudinal bore (15) having an inner diameter and pushing member (4) having a first end, second end and piston (16) in turn having an outer diameter smaller than or equal to inner diameter of the bore (10) so that the piston (16) of the pushing member (4) can be slidably arranged within the longitudinal bore (10).

Abstract: A system for forming a tendon-bone graft. The system can include a support member that is adapted to support the tendon-bone graft. The system can further include a first clamp that is adapted to engage the support member and the tendon-bone graft to orient and hold the tendon-bone graft on the support member in a first direction, and a second clamp that is adapted to engage the tendon-bone graft to clamp the tendon-bone graft to the support member in a second direction. The system can also include a shaping member that is operable to resect the tendon-bone graft. The shaping member can be moveable relative to at least one of the first clamp and the second clamp to resect the tendon-bone graft.