Abstract: A method and apparatus for arthroscopic biceps tenodesis wherein the method involves arthroscopically determining that biceps tenodesis is desirable; arthroscopically separating the long head of the biceps tendon from bone attachment; creating and placing a wedge at the proximal end of the long head of the biceps tendon; and allowing the tendon to slide through the glenohumeral joint and the wedge structure to be wedged in the bicipital groove. In some embodiments, the apparatus includes a button clamp wedge having top and bottom portions having mating protrusions and recesses to lock the top and bottom portions together, such that staggered ribs on the top portion and bottom portion grip top and bottom surfaces of the long head of the tendon when the top and bottom portions of the button clamp wedge are locked together. Some embodiments of the button clamp wedge have hinged portions similar to a clamshell.

Abstract: A fixation device for securing tissue to a bone. The fixation device includes an anchor having a hollow body defining a longitudinal passage, and a plug configured to be received in at least a portion of the passage. The body comprises a cylindrical portion and a tapered tip portion. The cylindrical portion comprises a plurality of thin-walled window covers such that after implantation the window covers are resorbed first relative to other portions of the cylindrical portion for defining a plurality of apertures on the cylindrical portion.

Abstract: An implantable device is provided for soft-tissue or soft tissue-to-bone repair, fixation, augmentation, or replacement that includes a biomimetic and biodegradable nanofiber scaffold. Also provided is a fully synthetic implantable multiphased scaffold which includes, in a single continuous construct, a plurality of phases to mimic the natural anatomy of a tendon or ligament and their insertion sites. Also provided are scaffold apparatuses for musculoskeletal tissue engineering.

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

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

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

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

Abstract: A device for implantation in a bone is disclosed, wherein this device is a component part of a system, for controlled loading of the reconstructure anterior crucual ligament (ACL) of a knee joint. The device may comprise an outer body, which is provided with a damping mechanism between a distal end and a proximal end. Arranged inside the damping mechanism there is at least one securing element for fixing at least one thread which, at the proximal end of the device, is guided out from the outer body through an aperture in the base.

Abstract: A method and construct for joint repair in which attachment of a double bundle graft ligament approximates anatomic orientation using interference fixation in a single bone tunnel. The double bundle graft features separable strands. A threaded screw is inserted between the separable strands and provides interference fixation of the graft against radially opposing walls defining the bone tunnel. Attachment of the graft using separated strands more closely approximate the configuration of the native ligament. The resulting reconstruction exhibits mechanical functionality that more accurately mimics that of the intact joint, with a minimum of associated tissue morbidity.

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

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

Abstract: A method and apparatus for reconstructing a ligament using 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 fixation pin hole preferably extending substantially perpendicular to the longitudinal axis of the body. A graft ligament is looped through the graft hole, and the support block is advanced into the bone tunnel, with the two free ends of the looped graft ligament extending back out the bone tunnel. Next, a transverse tunnel is formed in the host bone, with the transverse tunnel being aligned with the fixation pin hole. Then the support block is secured in place by pinning the support block within the tunnel, i.e., by advancing a fixation pin along the transverse tunnel in the host bone and into the fixation pin hole in the support block.

Abstract: A continuous loop and button construct and technique for ligament repair and fixation, including bone to bone, or soft tissue to bone. The continuous loop, which is attached to the button, is formed of a flexible material and is provided with at least one joined region (a bridged, stitched, bonded or knotted region) to form a closed loop figure-8 construct with proximal and distal openings with respect to the fixation device. The figure-8 construct (either bridged, stitched, bonded or knotted) is adapted for attachment to a bone block of a BTB graft, for example, and used for ligament reconstruction.

Abstract: An assembly for securing a plurality of ligaments to a bone includes a first portion exhibited by such as a ring shaped clamp with a tab and slot or a split stem incorporating a plurality of spaced apart ring shaped clamps compressively gripping about the ligaments. A second portion includes at least one of a screw or a ring extending portion engaging a ligament end loop or an undercut recess seating portion extending from an end of a body also incorporating the first portion, and such that the second portion extends from an end of the ligaments and mounts to the bone. The ligaments may further include first and second end-to-end attached sections, between which are configured angled and opposing/aligning incisions.

Abstract: A system and method to assist in securing a soft tissue replacement in a bone tunnel includes an expandable member having an opening and an expandable portion. A delivery structure includes a connection portion selectively coupled to the opening of the expandable member. The delivery structure is adapted to inject a flowable medium into the expandable member thereby expanding the expandable portion and urging the soft tissue replacement into a bone surface defining the bone tunnel.

Abstract: An apparatus and method for fixing a selected graft relative to a selected anatomical portion. An anchor may be provided that may be interconnected with a selected graft portion that is operable to pass through a selected bore and then moved into an operable position to engage a selected portion of the bore to substantially eliminate the possibility of the graft moving in an unselected direction through the bore.

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

Abstract: A fixing tool used in a ligament reconstruction operation to fix a tendon graft having a bone plug can be inserted into a bone tunnel formed at a bone. The fixing tool includes a fixing member having a main body part provided with a through-hole and two spike parts which extend almost parallelly and can be stricken into the bone and a fixing screw including 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 is penetrated through 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 be adjusted a tensile force of the tendon graft by adjusting an amount of screwing of the fixing screw into the bone plug after the head part of the fixing screw contacts to the fixing member.

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 system for a knee joint includes a first fastener and a second fastener operable to be connected to the tibia and femur, respectively. Furthermore, the system includes a flexible prosthetic ligament member. The ligament member is operably coupled to the first and second fasteners to support the tibia and the femur for relative movement. The ligament member extends from a first end to a second end, and includes an outer wall that defines a hollow longitudinal passage portion. The first end extends into and out of the longitudinal passage portion through the outer wall to define a first adjustable loop, and the second end extends into and out of the longitudinal passage portion through the outer wall to define a second adjustable loop.

Abstract: A medical device comprises an elongated, flexible band equipped with ratchet members and connected to a device head having a channel dimensioned for reception of the band. A lock member is connected to the head and configured to interlock the ratchet members when the band is pulled through the channel to form a reverse-motion brake. A protrusion and a matching protrusion receiving member are arranged in the head in connection with the channel entrance and in the band in connection with the band-head interface. The protrusion receiving member is dimensioned for reception of the protrusion when the band is close to fully pushed into the head.

Abstract: An implantable device is provided for soft-tissue or soft tissue-to-bone repair, fixation, augmentation, or replacement that includes a biomimetic and biodegradable nanofiber scaffold. Also provided is a fully synthetic implantable multiphased scaffold which includes, in a single continuous construct, a plurality of phases to mimic the natural anatomy of a tendon or ligament and their insertion sites. Also provided are scaffold apparatuses for musculoskeletal tissue engineering.

Abstract: A textile prosthesis comprising a unitary body of predetermined shape having structural integrity, the body including at least one anchorage body portion for attachment to an anatomical body part, the body being composed of a combination of binding yarns and tensile load bearing filaments, the binding yarns being located at least in the or in each of said anchorage body portions and being interconnected to one another by sewn stitches, the tensile load bearing filaments being located in between said stitches so as to be constrained to extend through said unitary body along predetermined pathways extending in one or more predetermined directions so as to render the body resistance to stretch when a tensile load is applied in said one or more predetermined directions.

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

Abstract: The invention is directed toward a sterile bone-tendon-bone assembly with two allograft bone blocks constructed with a cancellous portion and a cortical end portion. Each bone block has an outer curved surface with two opposing longitudinal arcuate grooves cut into the exterior surface which will allow a tendon replacement member to be wrapped around the bone block. The second bone block being in reversed orientation to the first bone block.

Abstract: A method and construct for joint repair in which attachment of a double bundle graft ligament approximates anatomic orientation using interference fixation in a single bone tunnel. The double bundle graft features separable strands. A threaded screw is inserted between the separable strands and provides interference fixation of the graft against radially opposing walls defining the bone tunnel. Attachment of the graft using separated strands more closely approximate the configuration of the native ligament. The resulting reconstruction exhibits mechanical functionality that more accurately mimics that of the intact joint, with a minimum of associated tissue morbidity.

Abstract: A bone alignment implant includes a first bone fastener with a first bone engager that is adapted for fixation into the metaphyseal bone and a second bone fastener with a second bone engager that is adapted for fixation into the metaphyseal bone. A link connecting the two fasteners spans across the physis. These implants act as a flexible tethers between the epiphyseal and the metaphyseal sections of bone during bone growth. These implants are designed to adjust and deform during the bone realignment process. When placed on the convex side of the deformity, the implant allows the bone on the concave side of the deformity to grow. During the growth process the bone is then realigned. A similar procedure is used to correct torsional deformities.

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

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

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

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

Abstract: The present invention discloses a graft attachment device for cruciate ligament reconstruction comprises a body having a screw portion with a threading area on the front end of the body, a connection member disposed on the front end, a gap formed between the front end and a predetermined portion of the body adapted for a rope-type member pass through, a pivoting member pivoted on the rear end of the body with its front end, the rear end of the pivoting member having a juncture portion for fixing a ligament, thereby the device could be screwed and fixed on a bone when rotating the device, and seamed a ligament on the rear end of the device.

Abstract: The invention provides a biomaterial and a method of selecting a biomaterial for a rotator cuff repair procedure. The biomaterial includes a bone-tendon allograft and the use of the biomaterial in rotator cuff repairs may provide immediate bone-tendon integrity and function, which may result in lower failure rates and enhanced clinical success.

Abstract: A method of repairing a rotator cuff is disclosed. The method includes accessing a surgical site including a humerus and a rotator cuff tendon, debriding the rotator cuff tendon and creating a defect in the humerus. The method further includes providing a bone-tendon assembly including at least one graft tendon and at least one bone segment, attaching the at least one bone segment of the bone-tendon assembly within the bone defect such that the at least one graft tendon extends from the humerus and attaching the at least one graft tendon to the rotator cuff tendon.

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: The present invention has multiple aspects. In its simplest aspect, the present invention is directed to an intermediate bone block comprising a machined segment of cortical bone, cancellous bone or both, the intermediate having a face comprising one to ten compression surfaces and one to ten cavities, the compression surfaces suitable for compressing soft tissue, the cavities for receiving and holding overflow soft tissue. The cavities are preferably channels, and more preferably channels having an omega cross-sectional profile. The invention is also directed to bone block assemblies suitable for binding to a soft tissue to form an implantable graft, and to such implantable grafts. A particularly preferred graft is a bone-tendon-bone graft.

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 is directed to bone block assemblies suitable for binding to a soft tissue to form an implantable graft, and to such implantable grafts. A particularly preferred graft is a bone-tendon-bone graft. In its simplest aspect, the present invention is directed to an intermediate bone block comprising a machined segment of cortical bone, cancellous bone or both.

Abstract: The present invention has multiple aspects. In its simplest aspect, the present invention is directed to an intermediate bone block comprising a machined segment of cortical bone, cancellous bone or both, the intermediate having a face comprising one to ten compression surfaces and one to ten cavities, the compression surfaces suitable for compressing soft tissue, the cavities for receiving and holding overflow soft tissue. The cavities are preferably channels, and more preferably channels having an omega cross-sectional profile. The invention is also directed to bone block assemblies suitable for binding to a soft tissue to form an implantable graft, and to such implantable grafts. A particularly preferred graft is a bone-tendon-bone graft.

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: Sheaths for implantable fixation devices and methods of using the sheaths are disclosed. Sheaths 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: A graft fixation device (1) comprising a sheath (2) having a body (9) that defines an inner longitudinal bore (8) and a member (3) for receipt within said bore (8), wherein said sheath (2) comprises at least one projection (15) moveably connected to said sheath body (9) and said at least one projection (15) is arranged so as to be displaceable radially outwardly of said sheath body (9) upon receipt of said member (3) within said bore (8).

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: The present disclosure provides an implantable medical device comprising a composite graft material including a first biologic component, such as an acellular tissue matrix, and a second non-biologic component.

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: 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: Devices, systems and methods for fixation of tendon to bone are described. An exemplary surgical implant is a modified bone anchor that is able to grasp the tendon and hold it firmly in a bone tunnel. Once deployed, the anchor delivers lateral compression to the tendon, providing direct tendon to bone compression to facilitate healing. The anchor has different versions which allow it to be attached to the tendon prior to insertion into the bone tunnel, or be inserted between tendon arms when the surgical procedure dictates. The resulting tendon to bone compression allows for the firm fixation in a manner markedly simpler than traditional techniques. A modification of this anchor can also allow the anchor to grasp and hold suture. This variation facilitates the technique for knotless rotator cuff repair.

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 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: The present disclosure relates to an anchor for fixating a tissue graft to bone. The anchor includes a through hole extending an entire length of the anchor and a polymer composition having shape memory qualities. Other anchors and methods for fixating a tissue graft to bone are also disclosed.