Abstract: A tissue graft attachment device includes a platform member including a first edge and a second edge connected to the first edge by a top side and a substantially curved bottom side. The platform member defines a slot extending between the first edge and the second edge, a first opening between the slot and the first edge, and a second opening between the slot and the second edge. The tissue graft attachment device includes a first filament passing through the first opening, a second filament passing through the second opening, and a graft connecting element passing through the slot to form a loop.

Abstract: An assembly for coupling a first portion of an anatomy to a second portion of the anatomy includes an anchor having an anchor body and a first and second bores through the anchor body. A first adjustable suture construct having a body portion passes through the first bore of the anchor and includes first and second adjustable loops slidable relative to a passage portion defined in the body portion of the first adjustable suture construct. A similar second adjustable suture construct passes through the second bore of the anchor.

Abstract: An apparatus for stabilizing a joint with low relative motion during orthopedic surgery. The apparatus includes a press-fit fastener body and a coupler. The press-fit fastener body has a proximal end and a distal end and is configured to be press-fit into a tunnel in a first bone member. The coupler is located on or is part of the press-fit fastener body and is configured to receive at least one flexible element trailing from at least one suture anchor. At least a portion of the suture anchors are located within a second bone member.

Abstract: A system and method for making an orthopedic repair by fixing a soft tissue graft to bone, utilizes an implant including a body wedge having first and second outwardly expandable wedge portions, a wing portion having outwardly expandable wings, and a deployment member which is movable distally into the implant to deploy the wedge portions and the wings into an expanded deployed orientation.

Abstract: The invention is directed to an anchor for fixing a tendon or a ligament in a bone comprising: an elongated tubular body having a bore extending along a longitudinal axis, said tubular body comprising first and second independent parts slidably contacting each other, the first and second independent parts each having an outer circumferential surface along a length thereof parallel to the longitudinal axis, and each having an elongated partial inner bore, such that the tubular body is capable of mounting a tendon or ligament within the partial inner bore.

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 implementations for therapy to facet joints connecting vertebrae are disclosed including: A) Facet joint stabilization that may be implemented using stabilization band that maintains tension between two anchors. The stabilization band may be retained in any one of a number of ways including the use of an anti-slip device such as a mechanically deformed crimp that abuts one of the anchors. B) Facet joint augmentation may be implemented by dilating the facet joint and inserting a facet joint spacer before adding a facet joint stabilization assembly. The facet joint augmentation may include connecting a tail section of the facet joint spacer to the first anchor used in the facet joint stabilization assembly. C) Facet joint immobilization may be implemented by inserting a fastener across the facet joint and into the vertebra so that the assembled fastener expands inside the vertebra.

Abstract: A method of improving the mechanical properties of a tissue patch is provided. The method includes the steps of providing a tissue patch and placing at least one barbed suture along at least a portion of the tissue patch. The method may further include the step of placing one or more additional barbed sutures in a laterally spaced relation to the barbed suture. The barbed suture may be biodegradable or non-biodegradable.

Abstract: A fixation device and method for retaining a graft. The device including: an elongate body having a first end and a second end; a transverse passage for retaining a graft retainer element; a first aperture located in the first end, and a second aperture in the second end; the first aperture and second aperture defining respective ends of a longitudinal through path. The method using the fixation device for drawing a graft through a first tunnel defined in a first bone and reining the graft when through.

Abstract: A fixation implant and associated methods are presented. The fixation implant includes first and second ends, each of which is separable from the implant body and useable to fix a material relative to a bone.

Abstract: A construct is disclosed that may be used to repair or replace a natural ligament. The construct may be formed of materials for biocompatibility and/or resorbtion. The construct may be provided or connected to a soft anchor for connection to a bone portion.

Abstract: A method and apparatus for re-attaching the labrum of a hip joint.

Abstract: An adjustable, knotless button/loop/needle construct for fixation of cranial cruciate ligament deficient stifle. The adjustable, knotless construct includes two fixation devices (for example, two buttons) and at least one flexible, adjustable loop attached to at least one of the fixation devices (e.g., the buttons). Preferably, a needle is attached to each of the fixation devices (e.g., the buttons). The adjustable, knotless construct has an adjustable loop length and allows adjustment in one direction while preventing or locking the construct from loosening in the opposite direction, due to applied tensile forces. The construct and technique of the present invention provides an improved knotless system for cruciate ligament repair.

Abstract: An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Abstract: Devices, systems and/or methods for repairing soft tissue, such as, a lacerated tendon. A repair device includes a frame having a tubular structure with a longitudinal length and struts at least partially defining the tubular structure. The frame includes a first portion and a second portion with an intermediate portion therebetween, each extending along the longitudinal length. The intermediate portion is configured to substantially maintain a fixed position and is configured to be positioned over first and second ends of the lacerated tendon to substantially maintain the first end abutted against the second end. The first portion and the second portion of the frame are configured to be positioned over separate portions of the tendon and configured to move and elongate along a length of the respective first portion and second portion of the frame as the portions of the tendon elongate.

Abstract: An all-inside double-socket ACL reconstruction technique, according to which a femoral socket and a closed tibial socket are provided to accommodate retrograde fixation of at least one graft (for example, a semitendonosus allograft) within the sockets. The closed tibial socket is formed by using a retrograde drill device provided with a retrograde drill cutter detachable from a retrograde drill guide pin. The femoral socket may be formed by the retrograde drill method or by a conventional method, and may be carried out before or after the formation of the tibial socket. The graft is secured in the knee by employing a transversal implant, or by employing an interference screw, and/or a continuous loop/button construct.

Abstract: The present disclosure relates to a soft tissue graft anchor. The anchor includes a plurality of prongs, each prong including a distal end and a proximal end, wherein the prongs are coupled at their distal ends to form an inner cavity having an opening, at least one of the prongs including a fin, the fin extending perpendicular to a longitudinal axis of the prong and including a pointed end. A tissue graft anchor assembly, a method for tissue repair, and instrumentation for use therewith are also disclosed.

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

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 method of providing a soft-tissue transplant to a receiving bone includes providing a transplant graft, comprising an elongated soft tissue, having first and second soft tissue ends longitudinally separated by a soft tissue body, and a bone block directly connected with the first soft tissue end. The bone block and soft tissue have been integrally formed as a unitary whole. An anchor cavity is machined in the receiving bone. The anchor cavity is shaped to substantially accept the bone block in a mating relationship. A majority of a volume of the bone block is placed in the anchor cavity. The bone block is fastened within the anchor cavity.

Abstract: A based device for use as tissue repair includes a median part between two end parts. The median and end parts have a different tensile stiffness.

Abstract: Apparatus and method for reconstructing a ligament.

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: 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: 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: An adjustable, knotless button/loop/needle construct for fixation of cranial cruciate ligament deficient stifle. The adjustable, knotless construct includes two fixation devices (for example, two buttons), at least one flexible, adjustable loop attached to at least one of the fixation devices (e.g., the buttons), and two needles (each needle being attached to one fixation device, e.g., the buttons). The adjustable, knotless construct has an adjustable loop length and allows adjustment in one direction while preventing or locking the construct from loosening in the opposite direction, due to applied tensile forces. The construct and technique of the present invention provides an improved knotless system for cruciate ligament repair.

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

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: The present invention has multiple aspects relating to a bone-tendon-bone graft and components thereof. Embodiments of the present invention comprise an intermediate bone block that is used to adjustably secure soft tissue (e.g., tendon) in a patient. Preferred intermediate bone blocks comprise at least one machined segment of cortical bone, cancellous bone or both. Embodiments of intermediate bone blocks of the present invention are used singly or in combination with one or more bone blocks to form a bone block assembly for securing soft tissue. The present invention further relates to an assembled bone-tendon-bone graft suitable for implantation in humans comprising the intermediate bone block and a length of soft tissue. In a preferred embodiment, a bone-tendon-bone graft comprises a length of soft tissue (e.g., tendon) extending from a first assembled bone block to a second bone block and then doubles back to said first assembled bone block.

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: A helicoil interference fixation system comprising: a helicoil comprising a helical body comprising a plurality of turns separated by spaces therebetween, the helical body terminating in a proximal end and a distal end, and at least one internal strut extending between at least two turns of the helical body; and an inserter for turning the helicoil, the inserter comprising at least one groove for receiving the at least one strut; the helicoil being mounted on the inserter such that the at least one strut of the helicoil is mounted in the at least one groove of the inserter, such that rotation of the inserter causes rotation of the helicoil.

Abstract: Methods and devices are provided for placing surgical guide pins, reamers, and ligament grafts into bone. In one exemplary embodiment, the method can include advancing a guide pin that includes a proximal rigid portion and a flexible distal portion. The rigid proximal portion can be advanced into a femoral tunnel such that the flexible distal portion extends across an intra-articular space. The flexible portion of the guide pin can be bent to adjust a distance between the guide pin and articular cartilage. A cannulated reamer can be advanced over the flexible portion of the guide pin and the reamer can be manipulated to avoid contact with the articular cartilage in the intra-articular space. A ligament graft can be secured in the femoral tunnel created by the guide pin and the reamer.

Abstract: A surgical fastener apparatus, for securing a surgical mesh material to body tissue including a pair of anchors each having retaining structure formed on an outer surface thereof; and a suture tether interconnecting the pair of anchors to one another. The pair of anchors having a substantially cylindrical body having a conically tapered distal end and a planar proximal end. The retaining structure includes a series of semi-circular angled projections having a planar proximal surface and a tapered distal end, wherein a center of each of the angled projections is spaced a distance from a longitudinal central axis of the body portion. The surgical fastener is made from a bioabsorbable material which reabsorbs into body tissue at an appropriate rate, such as for example, polyglycolic acid and polylactic acid.

Abstract: An implantable interference screw for use in a soft tissue repair, the screw having a bioresorbable body comprising a plurality of interconnected pores, the body having an instrument interface in one end and a thread around an exterior of the body starting from distal end. The plurality of interconnected pores of the resorbable body are substantially filled with a bioresorbable polymer.

Abstract: An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.

Abstract: An intervertebral connection system wherein the bone anchor has a helical configuration.

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: 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 apparatus for anchoring at least two graft ligaments within a longitudinal bone tunnel includes a longitudinal sleeve having at least two 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 and at least partially located between the bone tunnel and the sleeve. An actuating member has proximal and distal actuating member ends. An asymmetrically offset profile is defined by the sleeve and/or the actuating member. The asymmetrically offset profile has engagement thresholds. The actuating member is inserted into the sleeve to cause frictional engagement of each graft ligament with both the bone tunnel and at least one ligament-contacting surface, the frictional engagement of each graft ligament being temporally spaced apart from the frictional engagement of at least one other graft ligament.

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. A method for attaching a graft ligament to a bone is also provided.

Abstract: An instrument for placing a graft into a bone tunnel comprises an elongated shaft having a forked distal end comprising a pair of tines. A suture spans a space defined between the tines whereby the graft may be positioned between the tines and against the suture so as to be manipulated into the bone tunnel. The tendon folds about the suture, the suture having a releasable tension such that the instrument can be removed from the bone, leaving the tendon behind without the tendon hanging up on the suture.

Abstract: An instrument for placing a graft into a bone tunnel comprises an elongated shaft having a forked distal end comprising a pair of tines. A suture spans a space defined between the tines whereby the graft may be positioned between the tines and against the suture so as to be manipulated into the bone tunnel. The tendon folds about the suture, the suture having a releasable tension such that the instrument can be removed from the bone, leaving the tendon behind without the tendon hanging up on the suture.

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: 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 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 instrument set for fixing a cord-like implant in a bone comprises a retaining element which can be inserted into the bone. The retaining element comprises a recess for receiving a transverse pin and is also used to fix the implant. In addition, the retaining element comprises a guide for receiving the implant, the guide being configured in such a way that the implant can be guided in a loop formation around the transverse pin distally from the retaining element.

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: An assembly is described for repairing torn tendons by reattaching them to a bone, in particular although not exclusively for repairing a torn rotator cuff tendon, which allows for reduction of the gap between the tendon and the humerus by pushing the tendon onto its attachment site. Also described is a method of repairing a torn rotator cuff tendon by pushing it onto its attachment site and suturing through the humeral head.