Abstract: An arthroscopic method for reattaching a rotator cuff tendon to a humeral head may comprise creating a trough in the top of the humeral head, creating a cavity in the lateral portion of the humeral head, creating one or more tunnels between the cavity and the trough, retrieving sutures affixed to a loose end of the tendon through the trough, at least one tunnel, and the cavity; and passing the sutures through a tensioning and securing device, which is then implanted in the cavity, and the sutures are variously pulled or released to pull, tension, or release the sutures until the tendon is secured in the trough. The trough is preferably created using a unique extendable, angled surgical burr.

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 placement assembly used for positioning and holding a ligament graft within a selected bone tunnel. The assembly includes a graft pulley, a surgical suture, and a graft pulley placement instrument. The graft pulley includes a pulley portion and a bone anchoring portion. The pulley portion is adapted to receive the surgical suture and for surgical suture to be drawn through it, to act as a pulley. The bone anchoring portion comprises at least one flexible wing that is adapted to selectively fix the graft pulley within a bone tunnel. At least one wing is adapted to flex during insertion into a bone tunnel and then resist flex and thereby resist movement back out of the tunnel and hence wedge itself within the tunnel. The graft instrument may be selectively attached to the graft pulley and includes a handle and elongate body, adapted to insert the graft pulley into the selected bone tunnel.

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: Systems for single tunnel, double bundle anterior cruciate ligament reconstruction include 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. The instruments are also used to exercise and insert the ligament graft constructs. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on a single femoral tunnel, single or double tibial tunnels, and one or more ligament grafts.

Abstract: Distensible ligaments and distensible ligament systems are provided, including apparatuses, systems, devices, hardware, methods, and combinations for distensible systems.

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 forceble 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: A tensioner system for use in tensioning graft strands in a knee reconstruction procedure can include a handle assembly, a tensioner assembly coupled relative to the handle assembly, and a drive shaft slidably received through and supported by the handle assembly. The tensioner assembly can include an arm support member rotatably coupled to the handle assembly and first and second arm members each rotatably coupled to lateral sides of the arm support member. Each arm member can include at least one graft attachment area adapted to be coupled to a graft strand. The arm support member can be configured to rotate about an axis perpendicular to a longitudinal axis of the tensioner system and perpendicular to an axis of rotation of each of the arm members. The drive shaft can include proximal and distal ends that extend beyond respective proximal and distal ends of the handle assembly.

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: 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 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 fixing tool used in a ligament reconstruction operation includes a fixing member having a main body part provided with a through-hole and two spike parts which can be stricken into the bone and a fixing screw. The fixing screw includes a shaft part having a self-tap portion and a male screw portion, a head part, and a lumen. The fixing screw can be screwed into the bone plug in a state where a guide pin pierced into the bone plug penetrates the lumen of the fixing screw and a pulling member mounted to the bone plug and extended from the bone tunnel is being pulled. The fixing screw can adjust a tensile force of the tendon graft by adjusting the amount of screwing of the fixing screw into the bone plug after the head part of the fixing screw contacts the fixing member.

Abstract: A soft tissue tensioning system comprises a manual suture tensioning device having a bar and a finger guard which is orthogonal to the bar. A lateral suture cleat is disposed on each lateral end of the bar, and a primary suture cleat extends about a top and a bottom of each of the opposed lateral ends of the bar.

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 prosthetic device and method to restore extraocular muscle function. The device includes a housing; a biasing component disposed in the housing; a proximal connector operatively connected to a proximal end of the biasing component; and a distal connector operatively connected to a distal end of the biasing component, wherein the proximal connector is configured for being secured with respect to an orbital bone and the distal connector adapted to be secured to the paralyzed or absent muscle stump, e.g. on the globe, or to the eyelid.

Abstract: A placement assembly used for positioning and holding a ligament graft within a selected bone tunnel. The assembly includes a graft pulley, a surgical suture, and a graft pulley placement instrument. The graft pulley includes a pulley portion and a bone anchoring portion. The pulley portion is adapted to receive the surgical suture and for surgical suture to be drawn through it, to act as a pulley. The bone anchoring portion comprises a portion adapted to selectively fix the graft pulley within a bone tunnel. The graft instrument may be selectively attached to the graft pulley and includes a handle and elongate body, adapted to insert the graft pulley into the selected bone tunnel. Once the graft pulley is in place, the placement instrument may then be detached and withdrawn leaving the graft pulley firmly fixed within the bone tunnel and can then be used to position a ligament graft.

Abstract: A placement assembly used for positioning and holding a ligament graft within a selected bone tunnel. The assembly includes a graft pulley, a surgical suture, and a graft pulley placement instrument. The graft pulley includes a pulley portion and a bone anchoring portion. The pulley portion is adapted to receive the surgical suture and for surgical suture to be drawn through it, to act as a pulley. The bone anchoring portion comprises at least one flexible wing that is adapted to selectively fix the graft pulley within a bone tunnel. At least one wing is adapted to flex during insertion into a bone tunnel and then resist flex and thereby resist movement back out of the tunnel and hence wedge itself within the tunnel. The graft instrument may be selectively attached to the graft pulley and includes a handle and elongate body, adapted to insert the graft pulley into the selected bone tunnel.

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 surgical tensioning assembly providing a means to apply a variable and selective force to tissues, such as replacement ligaments, during a ligament reconstruction surgery. The assembly provides a means to apply a selective, measurable and a generally balanced force on multiple tissues. One embodiment of the tensioning assembly includes a set of subassemblies, namely an engagement subassembly, a variable force subassembly and an equalizing subassembly. These subassemblies are operably connected to each other such that they are able to provide tension on tissues connected to the assembly. In one embodiment the tensioning assembly further includes a mounting subassembly that provides a means to connect the tensioning assembly to a person's body. Methods of use of the surgical tensioning assembly are also disclosed to include novel methods of cycling and conditioning tissue used in a knee ligament replacement surgery.

Abstract: The invention relates to fixation of tension members, e.g., artificial tendons, and to transmitting force from tissues to energy converters or to natural or prosthetic bones or other prostheses. In one embodiment, a medical device is provided for implantation in a subject. The medical device includes an anchor block having a knob extending from its surface, such knob configured to engage a looped tension member. In one embodiment, the tension member includes a looped portion configured to engage the knob, an intermediate portion, and a tissue engaging portion configured to engage tissue in a subject. The looped portion is connected to the tissue engaging portion via the intermediate portion. In another embodiment, a system is provided for providing a function to a subject and includes at least one looped tension member, an operational device, and at least one medical device configured to couple the looped tension member and the operational device.

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: 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: The present invention has multiple aspects relating to assembled self fixing bone-tendon-bone (BTB) grafts and BTB implants. A preferred application in which self fixing assembled bone-tendon-bone (BTB) grafts and implants of the present technology can be used is for ACL repairs in a human patient. In one embodiment, a self fixing BTB graft is characterized by the presence of threads along at least a portion of the exterior surface of one or both bone blocks. In another embodiment, a self fixing assembled bone-tendon-bone implant comprises a removable tendon tensioner which imparts a predetermined tension on the tendon of the BTB graft.

Abstract: Apparatus and methods for repairing damaged tendons or ligaments. Various repair apparatus include an elongate tensile member and a pair of anchor assemblies connected for movement along the tensile member on either side of a repair site, such as a tear or laceration. The anchor assemblies or structures may take many forms, and may include barbed, helical, and crimp-type anchors. In the preferred embodiments, at least one anchor structure is movable along the elongate tensile member to assist with adjusting a tendon segment to an appropriate repair position and the anchor structure or structures are then lockable onto the elongate tensile member to assist with affixing the tendon at the repair position. Tendon and/or ligament-to-bone repair apparatus and methods employ similar concepts.

Abstract: An implant for fastening ligaments or tendons to a bone or bone replacement, generally referred to as a bone member. The implant has a housing, a device for fixing or attaching a ligament or tendon, and a device for being fastened to the bone member. The fixing device can be displaced relative to the fastening device. At least one motor is provided for displacing the fixing device relative to the fastening device. The motor is connected to a receiver for telemetrically triggering the motor. The implant allows the tension of the ligament or tendon and the position of the attachment of the ligament or the tendon to be post-operatively adjusted in an optimal fashion.

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: Ligament-tensioning device for activation of the ligament and/or capsule system in the implantation of a joint implant, having a distal bearing plate for bearing against a distal skeletal part and having first and second proximal bearing plates, each of which partially overlaps the distal bearing plate in a first in-use position, for bearing against a proximal skeletal part, and having means for relative displacement of the proximal bearing plates to increase their spacing from the distal bearing plate. The displacement means have a scissor-type guide means that supports the respective proximal bearing plate in the ventral-dorsal as well as the medial-lateral parallel position with respect to the distal bearing plate.

Abstract: A plurality of supplemental femoral tunnels are formed to provide a basis for suture material fixation of graft tissue/material over cortical bone as replacement or compliment to implants; forming a plurality of supplemental tibial and femoral tunnels connecting with the commonly created tibial and femoral tunnels to provide a basis for suture material fixation of graft tissue/material over cortical bone as replacement or compliment to implants. Inserting the first end of a strand of suture material through the tibial and femoral tunnels and then through each supplemental femoral tunnel. The other end of each of each strand of suture materials is attached to a graft. Another set of strands of suture material is attached to the opposite end of the graft and through the supplemental tibial tunnels. The strands of suture material are pulled graft into the tunnels wherein the graft is positioned in the tibia and femoral tunnels for healing.

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: 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 securing element is intended for connecting a ligament to a bone part of a human or animal. The securing element comprises a wire or thread which is intended to be connected to the ligament. A clamping element of the securing element clamps' at least one part of the wire or thread in a releasable manner, for which purpose the clamping element comprises a first clamping part and a second clamping part. The first clamping part is provided with a conical first surface and the second clamping part is provided with a corresponding conical second surface on a side facing the first clamping part, in order for the at least one part of the ligament coupling element to be clamped between the first and second surfaces. The clamping element can be actuated from outside the body.

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: Embodiments of a dynamically adjustable artificial chordae tendinae implant are described. In some embodiments the implant includes a body portion, including an adjustable portion. In some embodiments, the implant includes a plurality of adjustable portions. In some embodiments the adjustable element can include a shape memory material. The adjustable portion can be configured to transform from a first conformation to a second conformation in response to an activation energy. In some embodiments, the activation energy can be one of electromagnetic energy, acoustic energy, light energy, thermal energy, electrical energy, mechanical energy, or a combination of energies. The implant couples a heart valve leaflet to a papillary muscle. Activation of the shape memory material regulates tension between the muscle and valve leaflet improving coaptation of heart valve leaflets, and reducing or eliminating regurgitation.

Abstract: An appliance (1) for tensioning ligaments, especially articular ligaments, of a human or animal body, having at least one handle (2), the or each handle (2) being in operative engagement with, in each case, a tensioning element (3) associated therewith, and with the or each handle (2) in each case a force indicator (4), which indicates a force exerted on a or each tensioning element (3) associated with the or each handle (2) on tensioning of one or more ligaments, and a displacement indicator (5), which indicates the excursion of the tensioning element (3) in question from a reference position, and with the or each force indicator (4) and/or with the or each displacement indicator (5) there is/are associated at least one marker (7A-7H), which is arranged to be detected without contact by a measurement value ascertainment system (20) associated with the appliance (1), and also a device (20), comprising the appliance (1), for ascertaining force-displacement characteristic curves of ligaments, and also a method

Abstract: An implant and method for the repair of a tendon or a ligament along at least one load direction. The implant includes at least one first anchor portion and at least one tension member oriented along a load direction. The first anchor portion preferably has a larger surface area of engagement with the tendon or ligament to spread loads across more tissue. The tension member is preferably secured to the first anchor portion with an overlapping attachment. Tension on the tension member is preferably adjustable by the surgeon.

Abstract: A sheath for organizing soft tissue includes a first tube having a flexible body sized and shaped to receive a fixation device, and a second tube coupled to the first tube having a flexible body sized and shaped to receive a soft tissue graft. A method for implanting soft tissue in a bone tunnel includes coupling a soft tissue graft to a sheath assembly; and positioning the sheath assembly relative to the soft tissue graft based on a measured depth of a bone tunnel. A set of surgical devices for implanting soft tissue grafts in a bone tunnel includes a sheath assembly, a measurement device for measuring the depth of the bone tunnel, a securing element configured to secure the sheath assembly to the soft tissue graft at a position determined by the measured bone tunnel depth, and a tensioning device configured to organize a plurality of soft tissue grafts.

Abstract: The equal tension applying device is used to apply equal tension to a group of tendons. The device comprises a 3 to 9 inch elongate flexible member and a hook at each end of the flexible member. Typically a torn ACL is replaced with two loops of tendons defining 4 tendon strands. The ends of each strand have sutures therein. The tendon loops are fixed in a femoral tunnel with a fixation pin and extend into and through a tibial tunnel. The method includes the steps of: tying the ends of the sutures together to form a loop, placing a hook of the elongate tensioning device over the suture loop, applying tension on the device, followed by anchoring the ends of the tendon strands to the tibia.

Abstract: A graft ligament strand tensioner includes a frame member for slidingly retaining loops of sutures extending from graft ligament strands. The tensioner further includes a collar portion, and is provided with a handle having a core portion on which the collar portion is disposed for axial movement, and a grip portion. The tensioner still further includes a spherical member connected to the handle and having rounded surfaces facing the collar portion. The collar portion is tiltingly movable on the spherical member rounded surfaces when manipulation of the handle, to pull sutures on the frame member taut, causes the collar portion to engage the spherical member rounded surfaces. The sliding retention of the sutures and the tilting movement of the collar portion provide substantial equalization of tension in the sutures and thereby the graft ligament strands.

Abstract: An orthopedic flip-wing tissue retainer (2) comprises a flip-wing (7), tissue-retaining means (8) and a joint formed between the flip-wing (7) and the tissue-retaining means (8). The tissue retainer (2) is easily installed and used to anchor a biological tissue. The tissue retainer (2) can be used in combination with other devices to replace or repair a ligament or tendon in a joint. In particular, when used for ligament replacement, the tissue retainer (2) eliminates or at least minimizes the twisting that typically occurs during conventional surgery. In addition, the tension of the ligament graft can be precisely adjusted by using a tension-adjusting device (3 or 203) in combination with the flip-wing tissue retainer (2). The tension-adjusting device (203) can include a ball (204)-and-socket (205) joint.

Abstract: Apparatus is disclosed for reconstructing a ligament, the apparatus including a bone fixation element having a central bore and adapted for positioning in a bone tunnel, a flexible filament configured for holding a graft ligament, and a crimp configured for attachment to the flexible filament so as to prevent movement of the graft ligament in the bone tunnel.

Abstract: The equal tension applying device is used to apply equal tension to a group of tendons. The device comprises a 3 to 9 inch elongate flexible member and a hook at each end of the flexible member. Typically a torn ACL is replaced with two loops of tendons defining 4 tendon strands. The ends of each strand have sutures therein. The tendon loops are fixed in a femoral tunnel with a fixation pin and extend into and through a tibial tunnel. The method includes the steps of: tying the ends of the sutures together to form a loop, placing a hook of the elongate tensioning device over the suture loop, applying tension on the device, followed by anchoring the ends of the tendon strands to the tibia.

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: A ligament graft system and method are provided for securely anchoring a ligament graft to patient bone, principally for use with autogenous hamstring graft tendons utilized for ligament replacement such as reconstruction of the anterior cruciate ligament of the human knee. An elongated ligament graft is assembled between femoral and tibial fixation units, and the thus-assembled system is fitted into and through generally aligned tibial and femoral tunnels formed in patient bone. A pivotally mounted anchor pin at a leading end of the femoral fixation unit positionally shifts upon emergence from the femoral tunnel to overlie and seat securely upon cortical bone. A trailing or lower end of the tibial fixation unit is adapted to engage and seat against cortical bone, wherein the tibial fixation unit can be adjustably positioned to variably select the tension applied to the ligament graft.

Abstract: Apparatus for forming an artificial tie or ligament between different internal parts within a mammalian body, the apparatus comprising a strip (10) of preferably mesh type fabric formed of a material which is suitable for remaining in the body, and a drawstring (12) which is looped between different points along the length of the strip (10). By drawing the drawstring (12) the length of the strip (10) can be reduced. Opposite ends of the strip (11, 13) are in use attached to the different internal parts, and then those parts can be pulled together by applying tension to the drawstring (12), and once the length of the strip (10) has been reduced, tying off the drawstring (12) to hold the strip (10) in its reduced length condition. The apparatus is specifically useful for use in a method of treating vault or vaginal prolapse. The invention extends to a method of treating vault or vaginal prolapse.

Abstract: The device for conditioning an organic ligament to be implanted, in particular a ligament as a cruciate ligament replacement, is equipped with first and second receiving elements for receiving and tensioning the ligament at two spaced locations. The first receiving elements is connected to means for the periodic translatory adjustment of the first receiving element with respect to the ligament.

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

Abstract: A sheath for organizing soft tissue includes a first tube having a flexible body sized and shaped to receive a fixation device, and a second tube coupled to the first tube having a flexible body sized and shaped to receive a soft tissue graft. A method for implanting soft tissue in a bone tunnel includes coupling a soft tissue graft to a sheath assembly; and positioning the sheath assembly relative to the soft tissue graft based on a measured depth of a bone tunnel. A set of surgical devices for implanting soft tissue grafts in a bone tunnel includes a sheath assembly, a measurement device for measuring the depth of the bone tunnel, a securing element configured to secure the sheath assembly to the soft tissue graft at a position determined by the measured bone tunnel depth, and a tensioning device configured to organize a plurality of soft tissue grafts.

Abstract: Apparatus and methods for conditioning and pre-tensioning soft tissue grafts during joint repair surgery, such as during repair of the anterior cruciate ligament (ACL). The inventive apparatus is advantageously adapted and configured so as to enable a surgeon to independently apply a desired tensile load onto individual strands of a multiple-stranded soft tissue graft, such each of a pair of ham strings. The inventive methods advantageously ensure that each strand of a multiple-strand soft tissue graft is adequately tensioned so as to both “condition” the graft to prevent subsequent stretching, relaxation or elongation following surgery, which can destabilize the joint, and pre-tension each strand of the graft to a desired amount so that each significantly contributes to the strength and stability of the joint, thus resulting in a stronger and more durable joint.

Abstract: The equal tension applying device is used to apply equal tension to a group of tendons. The device comprises a 3 to 9 inch elongate flexible member and a hook at each end of the flexible member. Typically a torn ACL is replaced with two loops of tendons defining 4 tendon strands. The ends of each strand have sutures therein. The tendon loops are fixed in a femoral tunnel with a fixation pin and extend into and through a tibial tunnel. The method includes the steps of: tying the ends of the sutures together to form a loop, placing a hook of the elongate tensioning device over the suture loop, applying tension on the device, followed by anchoring the ends of the tendon strands to the tibia.