Abstract: A distal femoral knee-replacement component provides additional points of cam action by either distinct bars or interconnected structural elements such as cam extensions to prevent early translation of the knee or dislocation of the femoral component over the tibial post which can occur in cruciate-substituting designs.

Abstract: Implantable assemblies for manipulating energy transferred by members defining an anatomical joint, and methods of implanting and using. The members of the anatomical joint collectively define a path of motion. An assembly includes a first component configured to be attached to a first member of the anatomical joint; a second component configured to be attached to a second member of the anatomical joint; and a joint joining the first and second components. The first component includes a first flex member and the second component includes a second flex member. The first and second flex members are configured to flex to absorb energy transferred by the members of the anatomical joint.

Abstract: A sensing assemblage (1) for capturing a transit time, phase, or frequency of energy waves propagating through a medium is disclosed to measure a parameter of the muscular-skeletal system. The sensing assemblage (1) comprises a transducer (2) and a waveguide (3). The transducer (2) is coupled to the waveguide (3) at a first location. A second transducer (11) can be coupled to the waveguide (3) at a second location. An interface material that is transmissive to acoustic energy waves can be placed between transducers (402, 404) and a waveguide (414) to improve transfer. The interface material (408, 410) can affix the transducers (402, 404) to the waveguide (414). Alternatively, a reflecting feature (5) can be placed at a second location of the waveguide (3) to reflect acoustic waves back to the transducer (2) where transducer (2) emits energy waves into the medium and detects propagated energy waves.

Abstract: A method and apparatus for anterior cruciate ligament (ACL) reconstruction using sockets in bone created by retrograde cutting. A retrograde rotary cutter, inserted onto an insertion post of a tibial guide, is inserted through an anteromedial portal and the rotary cutter placed on the anatomical origin of an ACL tibial insertion. A retrograde drill pin, guided by a drill guide, is drilled through the tibia until it contacts the rotary cutter. Once the cutter is disengaged from the guide and securely engaged in the retrograde drill pin, the retrograde drill pin is retracted for retrograde cutting of a socket of desired depth in the tibia.

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 system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.

Abstract: An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

Abstract: Methods and devices are provided for implanting a cross-pin through a bone tunnel, such as in an arthroscopic surgical procedure. In general, the methods and devices allow a cross-pin hole to be formed in a medial side of a knee bone such that it intersects a bone tunnel formed in the knee bone. In one embodiment, a cross-pinning guide device is provided that can be configured to angularly position the cross-pin hole relative to the bone tunnel to allow the cross-pin hole to intersect the bone tunnel without passing through another side, e.g., a lateral side, of the knee bone. The knee bone can be a femur or a tibia such that the cross-pin hole and the bone tunnel can each be entirely formed in the femur or in the tibia.

Abstract: A system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.

Abstract: Various embodiments are directed to femoral and tibial bases that form structures of an implantable mechanical energy absorbing system. A bone facing surface of each type of base has a main surface portion and a plurality of protrusions extending from the main surface portion. The base can be attached to a bone so that the main surface portion is disposed in contact with but not penetrating into soft tissue at a substantially uniform distance from the bone.

Abstract: Load transferring systems and related methods for transferring load in a joint are provided. The load transferring system may include two bases configured to couple to bones defining a joint and a spring configured to couple to the bases. The spring may be configured to exert a tensile force between the bases during flexion of the joint. The load transferring system may be employed to treat symptoms associated with osteoarthritis of the lateral compartment of the knee joint. Thus, the bases may respectively couple to the femur and tibia. The spring may exert tensile force therebetween during flexion of the knee joint so as to unload the lateral compartment of the knee joint by transferring load from the lateral compartment of the knee joint to the medial compartment of the knee joint.

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

Abstract: Implant apparatus and methods directed toward treating conditions involving the knee joint are disclosed. Full range of motion of the knee joint and tissue integrity are maintained in treatment approaches. In one particular approach, osteoarthritis of the knee joint is addressed by unloading one or more of the lateral and medial compartments.

Abstract: Methods for drilling an angled osteal tunnel into a bone by drilling or punching at least one first tunnel portion into the bone from a first surface location on the bone, the at least one first tunnel portion having an interior end within the bone and then drilling or punching at least one second tunnel portion into the bone from a second surface location on the bone using a guide component to guide a drill to the interior end of the first tunnel portion, whereby the at least one first tunnel portion and the at least one second tunnel portion intersect and connect at an angle, resulting in an angled osteal tunnel.

Abstract: An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

Abstract: A buckle useful for cortical fixation has a graft retention loop slidably affixed thereto for movement from a first position adjacent a first end of the buckle to a second position at about the midpoint of the buckle. The buckle, with a graft over the loop, is drawn up lengthwise through a bone tunnel through a tibia and then flipped sideways to rest against the surface of the bone with the loop and graft depending back into the tunnel. The sliding attachment of the loop permits flipping of the buckle minimizes the flipping distance, which is the excess amount of the loop which must be pulled free of the tunnel to allow the buckle to be flipped sideways.

Abstract: Described herein are methods and devices for use in repair of a patient's anterior cruciate ligament (ACL). These methods (and devices for performing them) allow the repair, rather than merely replacement, of the ACL. For example, described herein are anchoring devices that may be inserted into a bone and may anchor a scaffolding/support (e.g., graft) material within the bone so that the torn or damaged end of the ACL may be secured to the scaffolding/support material within the femoral notch. These anchoring devices and method of using them are particularly well suited for use with the continuous suture passers described herein, since these suture passers may allow access to previously inaccessible regions of the knee (or other body regions).

Abstract: Implantable assemblies/devices and methods are provided for manipulating energy transferred by members defining an articulating anatomical joint, wherein the members collectively define a path of motion. Assemblies/devices are provided with a first component configured to be attached to a first anatomical member of the anatomical joint, a second component configured to be attached to a second anatomical member of the anatomical joint; and a tension member joining the first and second components. The tension member is placed under tension to absorb energy transferred by the anatomical members when the first component is attached to the first anatomical member and the second component is attached to the second anatomical member and a distance between locations of attachment of the first and second components becomes smaller then an implant-defined distance between the locations.

Abstract: A fixation device for securing a transplant in a bone tunnel, having a strap with a plurality of protrusions disposed along its length, a fastening member with an aperture therein for passing the strap, and a connection element disposed at a distal end of the strap for engaging a transplant is provided. The fixation device is configured such that, when the distal side of the fastening member lies substantially flush against an outer surface of the bone, a longitudinal axis of the aperture is substantially parallel to a longitudinal axis of the bone tunnel. A method for securing a transplant in a bone tunnel using the aforementioned fixation device is also provided.

Abstract: A surgical implantation approach for preparing a patient and precisely and effectively placing an energy absorbing apparatus relative to the patient's anatomy. Various surgical implantation apparatus and methods for achieving proper device-to-anatomy juxtapositional relationships are employed in the implantation approach.

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

Abstract: Pathology of the human knee can arise from excessive and/or uneven loading of regions within the joint. Methods and apparatus are disclosed that enable displacement of soft tissue around the knee, without displacing or severing bone thereby altering the mechanical load distribution within the joint in a less invasive manner than previous techniques.

Abstract: A prosthetic knee joint assembly includes a femoral component and a bearing that supports articulation of the femoral component. The assembly further includes a tibial tray. Furthermore, the assembly includes a ligament link operably coupled to the tibial tray or the femoral component via a coupling component. The ligament link extending through the other of the tibial tray or the femoral component to couple to the respective one of the femur or tibia. The ligament link extends between first and second ends and includes an outer wall defining an interior longitudinal passage portion. First and second apertures extend through the wall. The first end extends through the first and second apertures and the longitudinal passage portion to define a first adjustable loop, and the second end extends through the first and second apertures and the longitudinal passage portion to define a second adjustable loop.

Abstract: Described herein are methods and devices for use in repair of a patient's anterior cruciate ligament (ACL). These methods (and devices for performing them) allow the repair, rather than merely replacement, of the ACL. For example, described herein are anchoring devices that may be inserted into a bone and may anchor a scaffolding/support (e.g., graft) material within the bone so that the torn or damaged end of the ACL may be secured to the scaffolding/support material within the femoral notch. These anchoring devices and method of using them are particularly well suited for use with the continuous suture passers described herein, since these suture passers may allow access to previously inaccessible regions of the knee (or other body regions).

Abstract: Various embodiments are directed to base components that are usable with implantable mechanical energy absorbing systems. According to one embodiment, the base component includes a low-profile body having a elongate, straight portion at a first end and a curved body portion at a second end. The second end is elevated as compared to the first end. An inner surface of the low-profile body has a raised portion extending along the elongate, straight portion of the low-profile body. The base component also includes a plurality of openings positioned along the low-profile body for alignment and purposes of affixation to body anatomy.

Abstract: An anchor assembly for autologous or artificial tendon grafts comprises an insertion element and a stabilizing element. The insertion element has a stem and a head containing an aperture large enough to receive a graft. The stabilizing element is adapted to be embedded in bone, and comprises a sleeve with a cavity arranged to receive and hold the insertion element stem. In use, the stabilizing element is affixed in the bone, and the stem of the insertion element is placed therein. A tendon graft may be secured to the insertion element either before or after its placement in the stabilizing element. Two such anchors may be linked with one or multiple grafts, in either a two-ply or four-ply arrangement.

Abstract: An apparatus for anchoring at least two graft ligaments within a longitudinal bone tunnel includes a longitudinal sleeve having at least two radially spaced ligament-contacting surfaces located in lateral opposition to a sleeve inner lumen. The sleeve is configured for at least partial insertion into the bone tunnel with each graft ligament positioned laterally adjacent a different ligament-contacting surface. The graft ligaments are at least partially located between the bone tunnel and the sleeve. An actuating member has longitudinally separated proximal and distal actuating member ends. An asymmetrically offset profile is defined by at least one of the sleeve and the actuating member. The asymmetrically offset profile has a plurality of longitudinally spaced engagement thresholds. The actuating member is inserted longitudinally into the sleeve to cause frictional engagement of each graft ligament with both the bone tunnel and at least one ligament-contacting surface.

Abstract: A method and system provide and use a patellar implant. The patellar implant includes a superior portion, an inferior portion opposite to the superior portion, an anterior portion, at least one suture attachment configured to allow the patellar implant to be attached using at least one suture. The superior portion being configured to reside below a patellar tendon and to elevate and/or tilt the patellar tendon. The inferior portion is configured to be seated in proximity to a tibia. The anterior portion is between the superior portion and the inferior portion. The anterior portion is placed in proximity to a patella. In one aspect, the method includes inserting the implant beneath the patellar tendon and between the patella and a position at which the patellar tendon is affixed to the tibia. In this aspect, the method also includes attaching the implant using at least one suture.

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

Abstract: A surgical implantation approach for preparing a patient and precisely and effectively placing an energy absorbing apparatus relative to the patient's anatomy. Various surgical implantation apparatus and methods for achieving proper device-to-anatomy juxtapositional relationships are employed in the implantation approach.

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 system for manipulating energy transferred by members defining a joint. The system includes a first attachment structure configured to be attached to a first member of the joint and a second attachment structure configured to be attached to a second member of the joint. There is also an adjustable energy absorbing device attached to the first attachment structure and second attachment structure, wherein adjusting the energy absorbing device changes the load manipulating characteristics of the energy absorbing device.

Abstract: A spacer implant designed for placement between the bones of a joint, which includes soft tissue components. The spacer includes a spacer body positionable between the bones and defined by an outer periphery. The spacer also includes at least one tether. Each of the tethers has a first end fixed to the spacer body and a second end extending outwardly from the outer periphery of the spacer body. The second end of each of the tethers is adapted to be fastened to any of the bones or the soft tissue components of the joint.

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: Positioning instruments and related methods are described for implanting an energy absorbing system for treating joints. The positioning instruments and methods allow the energy absorbing system to be positioned at a joint such that the desired motion will occur for the particular design of a particular energy absorbing system which is to be implanted. The positioning instruments include a locating instrument for locating an anatomical feature and a target location for implantation of the energy absorbing system, a verification instrument for verification of the target location, a placement guide for guiding placement of a part of the energy absorbing system, and positioning device for aligning portions of the energy absorbing system.

Abstract: Apparatus for reconstructing a ligament, the apparatus comprising: a fixation device for maintaining a graft ligament in a bone hole, the fixation device comprising: a fixation screw comprising a body having screw threads formed thereon; and a ligament spacer mounted to the fixation screw, the ligament spacer comprising a canted face disposed opposite the fixation screw; such that when a graft ligament is disposed within a bone hole, the fixation screw and ligament spacer may be advanced into the bone hole alongside the graft ligament so that the fixation screw creates an interference fit between the graft ligament and the wall of the bone hole, and the ligament spacer creates an interference fit between the graft ligament and the wall of the bone hole, with the canted face of the ligament spacer being aligned with the adjacent surface of the bone.

Abstract: The present invention relates to a collagen fiber construct composed of single collagen fibers, which is sterilized with alcohol and via irradiation and not populated with cells, wherein the single collagen fibers are isolated from collagen-containing tissue from mammals. The present invention also relates to a method for manufacturing a collagen fiber construct composed of single collagen fibers, which is sterilized with alcohol and via irradiation and is not populated with cells, wherein the single collagen fibers are isolated from collagen-containing tissue from rat tails. Finally, there is also described the use of the collagen fiber constructs as xenoimplants.

Abstract: A prosthetic knee joint assembly includes a femoral component that engages a femur and at least one bearing that supports articulation of the femoral component thereon. Also, the assembly includes a tibial tray that engages a tibia and that supports the bearing. A ligament link coupling component is included on the femoral component or the tibial tray. The ligament link coupling component is operable to couple to a ligament link to couple the ligament link to the femoral component or the tibial tray. Moreover, the assembly includes an opening included on the other of the femoral component or the tibial tray. The ligament link is received in the opening to bypass the other of the femoral component or the tibial tray to operably couple to the respective one of the femur or the tibia.

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: A surgical device includes a member having first and second opposing surfaces. The member includes an intermediate portion in which the first surface has a recessed surface portion. The intermediate portion defines a hole extending from the recessed surface portion to the second surface. End portions extend from the intermediate portion, and each end portion defines a hole extending from the first surface to the second surface. The member has a tapered surface portion on the second surface. The surgical device includes a second member sized to be received within the recessed surface portion. A method includes locating a tissue fixation device at an opening to a bone hole, and increasing the size of the tissue fixation device by placing the tissue fixation device within a larger device.

Abstract: A bone implant comprises an active agent on at least a portion thereof. The active agent is locally deliverable to bone proximate the implant in at least a two-phased release scheme. A first phase rapidly releases a first quantity of the active agent, and at least a second phase gradually releases a second quantity of the active agent, whereby bone formation stimulated by the active agent is modulated. In one embodiment, a porous implant comprises a porous portion coated with a calcium phosphate compound and which is contacted with a bisphosphonate compound to form a bisphosphonate layer chemically bound to the calcium phosphate at the surface of the porous portion and to form bisphosphonate molecules being non-chemically attached inside the pores of the porous portion. The non-chemically attached bisphosphonate molecules are released in the subject at a rate greater than that of the chemically bound bisphosphonate layer.

Abstract: A system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.

Abstract: A whip stitched graft construct and method of formation. The whip stitched graft construct includes a plurality of tendon strand regions or soft tissue grafts placed together so that at least a portion of the plurality of the tendon strand regions are stitched together by employing multiple suture passes placed according to a whip stitching technique. Preferably, the multiple suture passes start at about the mid length of the plurality of tendon strand regions and are advanced toward one of the free ends of the tendon strands. The whip stitched graft construct is provided with at least two regions, one region formed of at least a plurality of tendon strand regions tied and whip stitched together, and the other region formed of untied segments of the plurality of tendon strands.

Abstract: A prosthetic ligament for replacing a natural articular ligament, comprising a first intraosseous end part, called the tibial end part, and a second intraosseous end part, called the femoral end part, the two intraosseous end parts surrounding an intraarticular central part, characterized in that the first intraosseous end part is in the form of two cylindrical strands, and in that the second intraosseous end part forms a loop connected to the first intraosseous end part via the intraarticular central part, which is composed of at least two bundles of technical filaments, each of the bundles being connected to the first intraosseous end part at one end of its ends and to the second intraosseous end part at the other of its ends.

Abstract: A prosthetic bone implant, the bone implant forming one side of a joint and including a prosthesis and a soft tissue attachment component. The soft tissue attachment component is connected to the bone implant and extends outwardly therefrom and towards a joint line. The soft tissue attachment component is moveable with respect to the prosthesis while connected thereto.

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

Abstract: Described herein are methods and devices for use in repair of a patient's anterior cruciate ligament (ACL). These methods (and devices for performing them) allow the repair, rather than merely replacement, of the ACL. For example, described herein are anchoring devices that may be inserted into a bone and may anchor a scaffolding/support (e.g., graft) material within the bone so that the torn or damaged end of the ACL may be secured to the scaffolding/support material within the femoral notch. These anchoring devices and method of using them are particularly well suited for use with the continuous suture passers described herein, since these suture passers may allow access to previously inaccessible regions of the knee (or other body regions).

Abstract: A method of ligament reconstruction comprising forming a femoral tunnel and a tibial tunnel, forming a plurality of supplemental femoral tunnels through a sidewall of the femoral tunnel, and forming a plurality of supplemental tibial tunnels through a sidewall of the tibial tunnel. The plurality of supplemental femoral tunnels and plurality of supplement tibial tunnels providing a basis for suture material fixation of graft tissue/material over cortical bone.

Abstract: An apparatus and method for stabilization of a cranial cruciate ligament deficient stifle in canines using a suture-button construct.

Abstract: A graft construct formed of a plurality of single tendon strands or soft tissue grafts placed together so that at least a portion of one of the single tendon strands is wrapped around a portion of another of the single tendon strands by employing suturing, for example. The graft construct is provided with at least two regions, one region formed of at least a plurality of tendon strands tied together, and the other region formed of loose segments of the plurality of tendon strands.