Abstract: The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

Abstract: A bone fixation system includes a bone fixation element adapted for mounting on a bone of a patient. The bone fixation element has a body with a channel extending through a portion thereof. A line extends through the channel of the bone fixation element. A tubular collet is at least partially disposed within the channel of the bone fixation element and has the line extending therethrough. The tubular collet includes a threaded portion engaging with the bone fixation element and a nose portion having a least one slit formed thereon. The collet is configured such that when the collet is further advanced into the channel of the bone fixation element at least a portion of the nose portion radially inwardly constricts to securely engage the line.

Abstract: A new approach for reconstructing a ligament, the new approach comprising: creating a bone tunnel within a host bone, the bone tunnel having a proximal end and a distal end, and defining a central axis extending from the proximal end to the distal end; creating an intervening layer of bone between the central axis of the bone tunnel and a rigid portion of the host bone, the intervening layer having a first side and a second side in opposition to one another, the first side of the intervening layer facing toward the central axis of the bone tunnel and the second side of the intervening layer facing toward the rigid portion of the surrounding host bone; and compressing the intervening layer of bone against a graft ligament positioned within the bone tunnel.

Abstract: The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

Abstract: The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

Abstract: A surgical implant made of a polymer, copolymer, polymer mixture or polymer composite that dissolves in the organ system. The manufacturing material is dyed with the coloring agent D&C Violet No. 2 or D&C Green No. 6. Preferably, the amount of the coloring agent is at most approximately 0.03 percent by weight and the implant is sterilized by radiation.

Abstract: An innovative bone anchor and methods for securing soft tissue, such as tendons, to bone, which permit a suture attachment that lies entirely beneath the cortical bone surface. Advantageously, the suturing material between the soft tissue and the bone anchor is secured without the need for tying a knot. The suture attachment to the bone anchor involves the looping of a length of suture around a pulley within the bone anchor, tightening the suture and attached soft tissue, and compressing the suture against the bone anchor. The bone anchor may be a tubular body having a lumen with a locking plug that compresses the suture therein. The pulley may be a pin located near a distal end of the tubular body around which the length of suture is looped. Alternatively, a pulley may be a bridge portion of the tubular body between two spaced apertures in the wall of the body. The locking plug may include a shaft and an enlarged head that interferes with the tubular body to provide a positive stop.

Abstract: A fixation screw, graft ligament anchor assembly, and method for fastening a graft ligament in a bone tunnel. The screw comprises an elongated shank having a distal end and a proximal end, and a central axis extending from the distal end to the proximal end. Screw threads are disposed on the shank and extend from the distal end to the proximal end. The proximal end defines an end plane disposed transversely to the axis and at an angle thereto other than a normal angle.

Abstract: A surgical method for transosseous fixation of a bone-tendon-bone (BTB) graft into a joint is disclosed. A longitudinal tunnel formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A portion of the strand is diverted so as to protrude out of the entrance to the longitudinal tunnel. The strand portion is attached to a loop extending from the bone block of the BTB graft, preferably by forming the loop around the strand. The strand attached to the bone block loop is retracted into the tunnel, drawing the attached BTB graft into the tunnel. The BTB graft is fixed in the tunnel using a transverse implant passed through the loop.

Abstract: A surgical method for transosseous fixation of a BTB graft into a joint is disclosed. A longitudinal tunnel formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A looped portion of the strand is diverted so as to protrude out of the entrance to the longitudinal tunnel. The loop is severed so that one end of the strand is passed through a hole in the bone block of the BTB graft. The free ends of the loop are subsequently reattached using a knot to form a reformed loop. The strand with the reformed loop is retracted into the tunnel, drawing the attached BTB graft into the tunnel. The BTB graft is fixed in the tunnel using a transverse implant.

Abstract: Method and apparatus for reconstructing a ligament. A graft ligament support block comprises a body, a graft hole, and a transverse fixation pin hole extending through the body. An installation tool is provided for inserting the support block into a bone tunnel and forming a transverse tunnel aligned with the pin hole. In use, a graft ligament is looped through the graft hole, and the support block is mounted to the tool. The tool is used to advance the support block into the bone tunnel, with two free ends of the graft ligament extending out the bone tunnel. A transverse tunnel is formed aligned with the pin hole. The support block is secured in place by pinning the support block within the tunnel by advancing a fixation pin along the transverse tunnel and into the pin hole in the support block.

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 crosspin for supporting a graft ligament in a first bone tunnel formed in a bone. The crosspin is positioned in a second bone tunnel extending transverse to, and intersecting, the first bone tunnel. The crosspin is adapted to be drawn through the second bone tunnel by a flexible member attached to a distal portion of the cross pin. The crosspin includes a connector for releasably connecting the distal portion of the crosspin to an intermediate portion, such that the distal portion is separable from said intermediate portion.

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 anchoring element serves for anchoring a ligament transplant in a channel in a bone. The anchoring element has a body which can be brought into an intermediate space between an inner wall of a channel within a bone and a ligament transplant introduced into the channel. The body serves for clamping the ligament transplant in the channel. The body has an outer flexible sheath filled with particles which are of low compressibility, the particles within the outer flexible sheath allowing the outer flexible sheath to accommodate to a shape of the intermediate space between the ligament and the channel (FIG. 4).

Abstract: A method of securing soft tissue to a prosthesis that has a retaining member secured thereto is disclosed. The method includes looping a first end portion of a first band around the retaining member such that both the first end portion of the first band and a second end portion of the first band extend outwardly from the retaining member. The method further includes looping a first end portion of a second band around the retaining member such that both the first end portion of the second band and a second end portion of the second band extend outwardly from the retaining member. Moreover, the method includes securing the soft tissue to (i) the first end portion and the second end portion of the first band, and (ii) the first end portion and the second end portion of the second band.

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: A surgical method for loading ligament grafts into a joint. A longitudinal socket formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A looped portion of the strand is diverted so as to protrude out of the entrance to the longitudinal socket. The ends of the strand remaining accessible on either side of the bone. The ligament graft is captured within the strand loop protruding from the entrance to the socket. The strand is retracted into the socket, drawing the graft into the socket by pulling on the accessible ends of the flexible strand. The graft is fixed in the socket using a transverse implant.

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 graft ligament anchor comprises a graft ligament engagement member disposed in an opening in a bone, the graft ligament engagement member being arranged to receive a graft ligament alongside the engagement member, and a locking member for disposition in the opening, and at least in part engageable with the graft ligament engagement member. Movement of the locking member in the opening causes the locking member to urge the engagement member, and the graft ligament therewith, toward a wall of the opening, to secure the graft ligament to the wall of the opening.

Abstract: The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

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 bioabsorbable interference screw having a tapered profile which extends along substantially the entire length of the screw. The tapered profile makes the screw easy to insert while providing superior fixation resulting from a progressively increasing diameter. Upon insertion, the screw engages cortical bone at the back end of the bone tunnel and fills all but 5-10 mm. of the tunnel, thereby providing increased fixation strength while also promoting fast healing. The screw includes a head provided with a specially designed drive socket with radially extending slots at its outer end for receiving corresponding protrusions on the shaft of screwdriver. The drive socket optimizes the torque capacity of the screw. To maintain wall thickness, the socket has a taper corresponding to the tapered outer profile of the screw. The taper of the socket also permits easy insertion of the tip and shaft of the driver into the screw.

Abstract: A system and method for attaching soft tissue to bone. The invention comprises the provision and use of a novel two-part anchor for attaching soft tissue and the like to bone. In one form of the invention, the two-part anchor generally comprises a stake and a cap. The stake is adapted to be positioned in bone and form a stake for impalement by a piece of soft tissue. The cap is adapted to cap soft tissue which has been impaled on the stake and thereby bind the soft tissue to the stake and, hence, to the bone in which the stake is set.

Abstract: A system and method for attaching soft tissue to bone. The invention comprises the provision and use of a novel two-part anchor for attaching soft tissue and the like to bone. In one form of the invention, the two-part anchor generally comprises a stake and a cap. The stake is adapted to be positioned in bone and form a stake for impalement by a piece of soft tissue. The cap is adapted to cap soft tissue which has been impaled on the stake and thereby bind the soft tissue to the stake and, hence, to the bone in which the stake is set.

Abstract: An alloplastic ligament has a surface covered by titanium or aluminum oxide ceramic, or by zirconium oxide ceramic or by tantalum, so that the synthetic material of the ligament is not in direct contact with the surrounding body environment. A ligament prosthesis, in particular an artificial cruciate ligament, has ends for securing the alloplastic ligament to the bone, in particular to the femur and the tibia, by a hollow screw of self-cutting outer screw threads for screwing into the bone and with inner screw threads. A sleeve having outer screw threads for screwing into the hollow screw and with a securement of the ligament end on the sleeve is also provided.

Abstract: An apparatus and method for fixation of a soft tissue graft. The apparatus may include a member having a first surface and a second surface. Each of the surfaces extend a distance relative to one another. A member is operable to resist movement of the apparatus relative to an anatomical portion. An interference member may be provided to fixedly associate the apparatus with the anatomical structure.

Abstract: A radially expandable sheath is provided having a substantially closed distal end with at least two sidewalls extending proximally therefrom and defining a central lumen. Each sidewall can have a substantially concave outer surface adapted to seat a graft member, and each side wall is at least partially separated by a longitudinally oriented slot that extends from a proximal end along a substantial length of each sidewall. The slot preferably terminates at a position just proximal to the distal end. The device can also include a sheath expander that is adapted to be disposed in the central lumen of the radially expandable sheath and that is configured to flex the sidewalls to radially expand the sheath so as to fix a graft member within 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: A tissue fixation device is provided that is preferably used to secure a ligament or graft within a prepared bone tunnel, for example in ACL replacement. The tissue fixation device generally includes an elongate member having a shaft portion that is adapted to be at least partially disposed within a bone tunnel, and a guide member that forms a portion of the proximal end of the elongate member. The guide member has a graft-seating surface that is effective to seat a graft and to position the graft toward one side of a bone tunnel when the device is disposed within the bone tunnel. The device also includes a graft-retaining member formed on at least a portion of the graft-seating surface.

Abstract: A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A replacement graft is formed into a loop and moved into the femoral and tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

Abstract: Apparatus and method for reconstructing a ligament.

Abstract: A medical device that attaches to tissue without requiring stitching includes a tissue fixation device having a first sub-loop and a second sub-loop, and an assisting member disposed through the first sub-loop and through the second sub-loop. The tissue fixation device includes an adjustable, flexible member formed by inserting one end portion of the flexible member through another end portion of the flexible member, and first and second sub-loops formed by crossing a portion of the flexible member over a different portion of the flexible member.

Abstract: A method for the reconstruction of the anterior cruciate ligament of a patient is described.

Abstract: A surgical method for loading ligament grafts into a joint. A longitudinal socket formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A looped portion of the strand is diverted so as to protrude out of the entrance to the longitudinal socket. The ends of the strand remaining accessible on either side of the bone. The ligament graft is captured within the strand loop protruding from the entrance to the socket. The strand is retracted into the socket, drawing the graft into the socket by pulling on the accessible ends of the flexible strand. The graft is fixed in the socket using a transverse implant.

Abstract: Disclosed is a bone fixation device of the type useful for connecting soft tissue or tendon to bone or for connecting two or more bones or bone fragments together. The device comprises an elongate body having a distal anchor thereon. A proximal anchor is axially movably disposed with respect to the distal anchor, to accommodate different bone dimensions and permit appropriate tensioning of the fixation device.

Abstract: A transverse suspension device for ACL graft fixation in a femoral tunnel comprising a body section and a smooth head section forming the leading end of the device, the body and smooth head sections each being cannulated along the entire lengths thereof; the head section comprising a recess-engaging section extending proximally from the distal end thereof and operable to engage with a recess formed in the bone tunnel, and a graft loop support section between the recess-engaging section and the body section adapted to stably support the graft loop thereover.

Abstract: A device and method that provides stabilisation across a joint of a patient, wherein the device comprising at least one substantially elastic member, the substantially elastic member having a first end and a second end, wherein the first end has a means to allow fixation to a first side of the joint by a first fixation device and the second end has a means to allow fixation to a second side of a joint by a second fixation device.

Abstract: A method and apparatus for reconstructing a ligament. In one preferred form of the invention, there is provided a graft ligament support block which comprises a body, and a graft hole and a transverse fixation pin hole extending through the body, with both the graft hole and the transverse fixation pin hole preferably extending substantially perpendicular to the longitudinal axis of the body. And in one preferred form of the invention, the invention also comprises an installation tool for inserting the graft ligament support block into the bone tunnel and, while supporting the graft ligament support block in the bone tunnel, forming a transverse tunnel in the host bone, with the transverse tunnel in the host bone being aligned with the transverse fixation pin hole in the graft ligament support block. In one preferred method of use, a graft ligament is looped through the graft hole in the graft ligament support block, and the graft ligament support block is mounted to the installation tool.

Abstract: A tendon anchor is used for attaching a tendon to a bone without sutures within a bore drilled into the bone. A first elongated anchor member and a second elongated anchor member each have opposite ends and have an engaging portion on at least one end thereof which are adapted to engage into a cylindrical wall of the bore in the bone. The first and second members have a channel provided in one end thereof for receiving and holding a central portion of a tendon during insertion and when in final position in the bore in the bone, the first and second elongated members engage one another at a location intermediate the opposite ends thereof. The members are adapted to move relative to one another in a scissor like fashion when the members are inserted into the bore of the bone they are in a substantially closed scissor position with the central portion of the tendon engaged and held in the channel of each member.

Abstract: A soft tissue reconstruction system and method for fixating and anchoring a graft within a bone tunnel, which is especially adapted for reconstructing a defective anterior cruciate ligament. The reconstruction system is assembled ex-vivo by threading a graft through an opening disposed on a first shaft connected to a first bone anchor, and fixing a ring member around the graft and a second shaft for securing the graft to the second shaft that is connected to a second bone anchor. After the assembled reconstruction system is inserted into the bone tunnel, the first bone anchor is anchored to bone material adjacent one end of the bone tunnel, and the second bone anchor is anchored to bone material adjacent another end of the bone tunnel.

Abstract: A graft retaining implant is provided for retaining a graft in a bone tunnel. Instruments and methods are also provided for use with the graft retaining implant.

Abstract: A method for repairing a ligament using a crimp tube and a connector made of nylon or other suitable material. The method optionally utilizes a tensioner, a crimper, and a clamp. The method includes cutting open the skin and soft tissue surrounding the ligament, drilling holes through the bones surrounding the ligament, inserting a connector through the holes with the connector having a previously tightened knot at one end, placing a crimp tube around the connector at the opposite end of the connector from the knot, securing the connector in the tensioner, tightening the connector with the tensioner, crimping the crimp tube closed with the crimper against the connector, thereby securely coupling the bones together, and reattaching the skin and soft tissue.

Abstract: A novel fixation system for fixing a graft ligament in a bone tunnel. The fixation system comprises an interference screw comprising a body having a distal end and a proximal end, screw threads extending longitudinally along the body, and a transversely-extending region formed in the body for receiving a transverse pin therein, whereby to securely lock the interference screw, and hence the graft ligament, to the bone. In accordance with a further feature of the present invention, there is provided a method for attaching a graft ligament to a bone, the method comprising the steps of: (i) drilling a tunnel in the bone; (ii) positioning the graft ligament in the bone tunnel; (iii) placing an interference screw in the bone tunnel so as to force the graft ligament laterally against the opposite side of the bone tunnel; and (iv) advancing a transverse pin transversely through the bone and through the interference screw so as to securely lock the interference screw, and hence the graft ligament, to the bone.

Abstract: Apparatus and method for reconstructing a ligament.

Abstract: A prosthetic implant kit for implantation in a bone joint between first and second bones, such as the knee joint between a femur and a tibia, such joint having bone tunnels formed in each of the first and second bones, and the implant assembly being intended to be introduced into the bone tunnels and to be fixated therein, and implant kit assembly comprising:

Abstract: Sheaths for implantable fixation devices have a flexible body with a perforated wall, and an interior of the body is sized and shaped to receive the fixation device. Sheaths include a plurality of flexible or inflexible tubes arranged to form a ring, where the central cavity defined by the ring is sized and shaped to receive the fixation device.

Abstract: The invention relates to an anchoring device for urging a ligament transplant against the wall of a bone hole during ligament replacement and for fixing the anchor in position in the said bone hole. The device has a first component and a second component designed for mutual sliding co-operation between a first anchor inserting position and a second fixation position. The sliding co-operation is provided along respective parallel inner mating surfaces of each component which surfaces are each in angular relation to the respective component outer surfaces and in opposed angular relation to each other so that in the anchor insertion position the width of the said anchoring device is in an elongate narrow mode with respect to a bone hole and, in the fixation position, the width of the said anchoring device is in a compressed wide mode to thereby urge the ligament against the wall of the bone hole. A method of ligament fixation in a bone hole is also disclosed.

Abstract: A surgical method for loading ligament grafts into a joint. A longitudinal socket formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A looped portion of the strand is diverted so as to protrude out of the entrance to the longitudinal socket. The ends of the strand remaining accessible on either side of the bone. The ligament graft is captured within the strand loop protruding from the entrance to the socket. The strand is retracted into the socket, drawing the graft into the socket by pulling on the accessible ends of the flexible strand. The graft is fixed in the socket using a transverse implant.

Abstract: The invention is directed toward a cancellous bone block assembly with at least one tendon replacement member being extended between two shaped cancellous bone blocks. Each substantially cylindrically shaped cancellous bone block has a central through going bore, a flat exterior longitudinal surface and a channel longitudinally cut in the exterior of the bone block body opposite the flat longitudinal surface. The tendon replacement member is inserted through the central through going bore around the end of the block and looped back along the flat longitudinal side where it is tied to the back of the tendon loop. A channel cut in the exterior surface is adapted to receive an interference screw to keep the block anchored in a bone tunnel previously cut in the respective bone.