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.

Abstract: A bone anchoring device includes an anchoring element having a shank to be anchored in a bone or a vertebra and a head, a connection element for connecting at least two anchoring elements, a receiving part having a first end receiving the head, wherein the head is pivotable in the receiving part, and a second end comprising a recess for receiving the connection element, a first pressure element which exerts pressure on the head to lock the head in the receiving part, and a second pressure element which exerts pressure on the connection element to press the connection element against the first pressure element. The contour of the surface of at least the first pressure element or the second pressure element facing the connection element deviates from the contour of the surface of the connection element.

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

Abstract: An apparatus and method is disclosed for performing a surgery, such as an orthopedic surgery. The apparatus can include a guide portion and an alignment portion. The guide portion can assist in positioning the alignment portion to assist in aligning an implant. The implant can be aligned and positioned to hold a graft relative to a bone portion.

Abstract: A transverse suspension device for ACL graft fixation in a femoral tunnel includes a body section and a smooth head section forming the leading end of the device. The body and smooth head sections each may be cannulated along their entire lengths. The head section may further include a recess-engaging section extending proximally from the distal end and is operable to engage with a recess formed in the bone tunnel. The device may further include a graft loop support section between the recess-engaging section and the body section adapted to stably support the graft loop.

Abstract: A system and method for sharing and absorbing energy between body parts. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: A system and method for sharing and absorbing energy between body parts. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: Apparatus for use in supporting a graft ligament within a bone tunnel, the apparatus comprising a graft ligament plug, the graft ligament plug comprising a groove extending along one side of the plug, across the front end of the plug, and then back down the opposing side of the plug, with the groove being sized such that when a graft ligament is disposed in the groove, the graft ligament will protrude out of the groove and engage adjoining portions of the bone tunnel so as to facilitate osseointegration therewith; wherein the graft ligament plug is formed in two opposing halves, such that the graft ligament can be positioned within the groove and thereafter clamped between the opposing two halves of the graft ligament plug when the two opposing halves are brought together so as to form the complete graft ligament plug.

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: An implantable device for stabilizing at least a portion of a spinal column. The implantable device comprises an implantable artificial facet joint and one or more artificial ligaments connecting the implanted artificial facet joint to a third vertebra disposed adjacent to either the first or the second vertebra. The artificial facet joint, when implanted, spans a first vertebra and a second vertebra, adjacent to the first vertebra.

Abstract: A transcutaneous prosthetic device having at least one soft tissue fixture adapted to be fixed to the musculo-tendinous soft tissues of a residual limb, an anchor for an external prosthesis that is fixedly coupled, directly or indirectly, to the bone of the residual limb and at least one transmission means, at least part of the transmission means being housed within a body. The transmission means allowing transmission of one or more signals between the soft tissue fixture and an external prosthesis. The transmission means may comprises a connecting means connecting the soft tissue fixture and an external prosthesis. The connecting means may comprise a mechanical or an electrical connector. The connecting means may comprise a sealed connection within the transcutaneous component, to provide an effective barrier between the internal and external environments.

Abstract: Disclosed herein is an improved Bone Tendon Bone graft for use in orthopedic surgical procedures. Specifically exemplified herein is a Bone Tendon Bone graft comprising one or more bone blocks having a groove cut into the surface thereof, wherein said groove is sufficient to accommodate a fixation screw. Also disclosed is a porcine bone tendon bone graft for use in orthopedic procedures. Also disclosed are multiple embodiments of assembled bone tendon bone blocks for use in orthopedic surgeries. Additionally, a method of harvesting grafts that has improved efficiency, increases the quantity of extracted tissue and minimizes time required by surgeon for implantation is disclosed.

Abstract: A surgical anchor device for the repair of a torn ligament or tendon, primarily the anterior cruciate ligament in the knee, is used to affix the ligament within a femoral bone tunnel in the distal portion of the femur from the intra-articular surface, the device providing a pulley for a suture, wherein a free end of the suture may be pulled away from the device to draw the suture attached to the ligament graft within the femoral bone tunnel securing the ligament graft within the bone tunnel. Installation of the device is provided by insertion of the device through a tibial hole, through the femoral tunnel out of the lateral femoral cortex, pulling the attached sutures simultaneously to flatten the device against the lateral femoral cortex, attaching one end of the suture to the ligament graft and pulling the other end of the suture until the graft is situated properly within the femoral bone tunnel and tying the free end of the suture to retain the graft within the femoral bone tunnel.

Abstract: This application describes apparatuses and methods for musculoskeletal tissue engineering. Specifically, graft collar and scaffold apparatuses are provided for promoting fixation of musculoskeletal soft tissue to bone. This application provides for graft collars comprising biopolymer mesh and/or polymer-fiber mesh for fixing tendon to bone. In one aspect, the graft collar comprises more than one region, wherein the regions can comprise different materials configured to promote integration of and the regeneration of the interfacial region between tendon and bone. This application also provides for scaffold apparatuses and methods for fixing musculoskeletal soft tissue to bone. The scaffold apparatus is multiphasic, preferably triphasic, and each phase is configured promote growth and proliferation of a different cell and its associated tissue. In one aspect, the scaffold apparatus is triphasic, with phases comprising materials to promote growth and proliferation of fibroblasts, chondroblasts, and osteoblasts.

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: 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 method for fabricating a device for repairing torn tissue or muscle such as the meniscus of the knee. The device includes a pair of anchoring members having a plurality of barb-like projections extending outwardly therefrom. The anchoring members are joined by a flexible linking member which connects the ends of the anchoring members opposite one another. Such a device can be fabricated by insert molding of the appropriate members together.

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: A method for anchoring autologous or artificial tendon grafts in bone is provided. In one embodiment, the method includes affixing a stabilizing element in bone; and placing the stem of an insertion element therein. A tendon graft may be secured to the insertion element either before or after its placement in the stabilizing element. Two such anchors may be linked with one or multiple grafts, in either a two-ply or four-ply arrangement.

Abstract: 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: The invention relates to an apparatus for fixing a ligament, which comprises a bone-anchoring element having a proximal end and a distal end which has a bore running in the longitudinal direction, and which comprises a clamping sleeve having a proximal end and a distal end, which clamping sleeve can be accommodated in the bore. The clamping sleeve is radially expandable, with the result that the ligament can be fixed between the clamping sleeve and the bore of the bone-anchoring element.

Abstract: A prosthetic knee implant for implantation into a mammal, which accommodates an anterior cruciate ligament substitute to provide stability to the knee implant. The prosthetic knee implant includes a femoral component having a pair of condylar surfaces and a tibial component having a surface portion adapted to slidably engage the femoral component upon rotation of the same. The femoral component further includes a central femoral recess between the condyles providing access to the femur for drilling a channel through which a cruciate ligament substitute may be integrated into the femur. The tibial component further includes a center portion defining an aperture through which the ligament substitute maybe threaded through the tibia and integrated therein, or anchored upon its surface. Also disclosed is a method used to replace the total knee joint in a mammal with the improved prosthetic knee implant of the present invention.

Abstract: A prosthetic knee implant for implantation into a mammal, which accommodates an anterior cruciate ligament substitute to provide stability to the knee implant. The prosthetic knee implant includes a femoral component having a pair of condylar surfaces and a tibial component having a surface portion adapted to slidably engage the femoral component upon rotation of the same. The femoral component further includes a recess between the condyles defining an aperture through the femoral component. The tibial component further includes a center portion defining an aperture through the tibial component substantially at its center. The femoral aperture and the tibial aperture are adapted to receive an anterior cruciate ligament substitute for biasing the mammalian femur and tibia together. Also disclosed is a method used to replace the total knee joint in a mammal with the improved prosthetic knee implant of the present invention.

Abstract: Methods and devices for the repair of a ruptured ligament using a scaffold device are provided. Aspects of the invention, may include a scaffold attached by a suture to an anchor. In aspects of the invention, the anchor may be secured to a bone near or at the repair site.

Abstract: The present invention provides a replacement ligament comprising first and second ends, two or more securing portions for securing said ligament to a portion of bone material and a body portion comprising a first component having a first, higher, elongation per unit load characteristic; and a second component having a second, lower, elongation per unit load characteristic. The first and second components are between said two or more securing portions and arranged in load series such that initial, lower, loading is reacted by said first component and subsequent, higher, loading is reacted by said second component.

Abstract: A method for securing a graft ligament in a bone tunnel is provided. The method includes looping a graft ligament through a graft hole in a graft ligament support block, advancing the graft ligament support block into the bone tunnel, withdrawing the graft ligament support block back down the bone tunnel, advancing a graft ligament support block into the bone tunnel, with a graft ligament being looped through a graft hole in the graft ligament support block, and forming a transverse tunnel in the host bone, with a transverse fixation pin hole in the graft ligament support block being aligned with the transverse tunnel in the host bone. The method further includes pinning the graft ligament support block within the bone tunnel by advancing a transverse fixation pin along the transverse tunnel in the host bone and into the transverse fixation pin hole in the graft ligament support block.

Abstract: Endosteal fixation of a ligament graft with a bioabsorbable interference screw installed in a retrograde manner in ACL reconstruction. The bioabsorbable interference screw is insert-molded with a length of suture extending from the distal tip of the screw for pulling the interference screw into the joint and into position for retrograde insertion at the top of the tibial tunnel. The interference screw has a cannulation extending partially through the screw from the leading tip. The cannulation is shaped to receive a correspondingly shaped driver. The driver is inserted into the tibial tunnel to engage the screw. By turning the driver, the interference screw is turned into the tibial tunnel in a retrograde manner. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

Abstract: A system and method for attaching soft tissue to a prosthetic implant can include a prosthetic component that defines a soft tissue attachment region having an attachment surface thereon. A first construct can be formed of porous metal and be removably coupled to the attachment surface. A second construct can be positioned outboard of the soft tissue. A fastener can be engaged to the second construct capturing the soft tissue against the first construct. The fastener can be coupled on a distal end to the first prosthetic component.

Abstract: A system for use in reconstructing a ligament is provided. The system includes a graft ligament support block and an installation tool. The support block includes a body having a distal and proximal ends and a longitudinal axis extending therebetween, the proximal end being tapered so as to facilitate withdrawal of the support block through a bone tunnel, a graft hole extending through the body transverse to the longitudinal axis and configured to receive a graft ligament therein and a transverse fixation pin hole extending through the body transverse to the longitudinal axis and configured to receive a transverse fixation pin therein. The installation tool includes a holder having a shaft with distal and proximal ends and longitudinal axis extending therebetween, the proximal end of the shaft including at least one finger for engagement in the opening and a handle mounted to the proximal end of the shaft.

Abstract: A polymeric suture anchor for deployment in a preformed bone hole to secure soft tissue to bone in a knotless manner. The suture anchor comprises a hollow outer member and a hollow inner member longitudinally movable within the outer member. Suture is directed along a tortuous path distally through the lumens of both the inner and outer members, transversely across an eyelet situated at the distal end of the inner member and proximally through the lumens of both the inner and outer members. A suture-locking mechanism is provided along the tortuous path to crimp the suture by placing the anchor in a suture locked configuration. This is accomplished by moving the inner member proximally relative to the outer member in order to engage the suture-locking mechanism. The anchor is maintained in this configuration by the engagement of interlocking surfaces on the inner and outer members.

Abstract: A method of attaching or reattaching a ligament, tendon, cartilage or other soft tissue to a bone mass has the steps of: positioning or placing the ligament, tendon, cartilage or other soft tissue adjacent to the bone mass; anchoring or otherwise fastening the ligament, tendon, cartilage or soft tissue to the bone mass; and transmitting shock waves to the ligament, tendon or other soft tissue and the bone mass. Preferably the ligament, tendon, cartilage or other soft tissue is positioned in the path of the emitted shock waves and away from geometric focal volume or point of the emitted shock waves. The shock waves may be transmitted during the surgical procedure or post operatively in one or more treatment dosages or both. In so treating the ligament, tendon, cartilage or other soft tissue should be positioned at a distance away from any geometric focal point to minimize hemorrhaging. The soft tissue may include cartilage or muscle tissue.

Abstract: The invention concerns an anchoring screw (1) in a bone tunnel (6) for a relay strip (8) made of synthetic material or a suture, comprising: a cylindrical proximal portion (3) of length ranging between 0 and 10 mm and a conical intermediate portion (4), whereon are provided a blunted thread (2) with a large pitch, the intermediate portion having a convergent section in the direction of, a smooth cylindrical distal portion at the rounded end and foam whereof the diameter is not less than the diameter of the bone tunnel (6).

Abstract: Various embodiments described herein provide methods and apparatus for achieving the secure and stable fixation of a graft ligament within a bone tunnel using a screw that includes a cylindrical wall having a leading end and a trailing end, threads arranged on an outside surface of the cylindrical wall, and a plurality of portals arranged in the cylindrical wall and adapted to receive a plurality of prongs of a screwdriver.

Abstract: An orthopedic implant including an implant element adapted to be attached to at least one bone, the implant element including at least one throughgoing bone growth region adapted to be located in bone growth communication with the at least one bone and configured such that bone growth therein creates a grown bone suture binding the implant element to the at least one bone.

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 system for ligament reconstruction includes placing a first jig having a first plurality of drill guide holes on a first bone of the joint, forming two intersecting holes in the first bone using the first plurality of drill guide holes, placing a second jig having a second plurality of drill guide holes on a second bone of the joint, forming a tunnel and a first branch hole and a second branch hole in the second bone using the second plurality of drill guide holes, placing a tendon having sutured ends through the two intersecting holes, extending the sutured ends through the tunnel and through the first and second branch holes so that the first and second ends of the tendon are positioned within the tunnel, and affixing the tendon within the tunnel. The apparatus of this system has specially formed jigs placed over bones.

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: An implant (5) for ligament and/or bone reconstruction is composed of biodegradable material suitable to be remodeled into vital bone and having mechanical strength for securely fixing a ligament in a bore or hole in bone with a press or form fit and/or reshaping a collapsed surface of bone into original shape. A surgical instrument (9) for ligament and/or bone reconstruction can be used to insert the implant (5) into bone and has a shaft member (3) having a first end (11), a second end and a longitudinal bore (15) having an inner diameter and pushing member (4) having a first end, second end and piston (16) in turn having an outer diameter smaller than or equal to inner diameter of the bore (10) so that the piston (16) of the pushing member (4) can be slidably arranged within the longitudinal bore (10).

Abstract: A method and apparatus for tendon repair includes an elongated member of a generally tubular shape having two barbed sections with oppositely directed barbs and a middle portion between the barbed sections. The barbs are cut from the tubular body leaving a mesh-like body of interconnected struts. The middle portion is also formed of interconnected struts. A needle and suture is connected at both opposite ends of the elongated member and used to pull the barbed sections into respective ends of a severed tendon. The barbs bite into the tendon tissue to hold the ends together. The sutures are preferably cut off at the tendon surface at a location spaced from the rejoined ends. One or more of the tendon repair devices may be used to repair each tendon, optionally with perimeter stitching at the rejoined ends.

Abstract: A graft ligament anchor comprises a ligament engagement member in the form of an expandable elastomeric sleeve of substantially cylindrical shape for disposition in an opening in a bone alongside of a portion of a ligament, and a locking member for disposition in the engagement member . Movement of the locking member in the engagement member causes the locking member to expand the engagement member and thereby urge, the ligament toward a wall of the opening so as to secure the ligament to the wall. A method for attaching a graft ligament to a bone comprises providing an opening in the bone, inserting the ligament and a ligament engagement member in the opening, with the ligament disposed alongside the engagement member, inserting a locking member in the engagement member and moving the locking member to engage the engagement member to urge the engagement member, and the ligament, toward a wall of the opening to secure the ligament to the wall.

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 and wherein the apparatus includes a clamshell type, button wedge having a football shaped body with top and bottom portions hinged at one end and with locking structure at an opposite end 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 wedge are clamped together.

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: Endosteal fixation of a ligament graft with a bioabsorbable interference screw installed in a retrograde manner in ACL reconstruction. The bioabsorbable interference screw is insert-molded with a length of suture extending from the distal tip of the screw for pulling the interference screw into the joint and into position for retrograde insertion at the top of the tibial tunnel. The interference screw has a cannulation extending partially through the screw from the leading tip. The cannulation is shaped to receive a correspondingly shaped driver. The driver is inserted into the tibial tunnel to engage the screw. By turning the driver, the interference screw is turned into the tibial tunnel in a retrograde manner. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

Abstract: A textile-based plate implant (and related methods) that supports tissue ingrowth within the implanted implant structure and is suitable for use in a variety of surgical applications, including but not limited to anterior, posterior and lateral surgical approaches directed towards the lumbar, thoracic and cervical regions of the spine.

Abstract: A surgical method and implant for directing and securing a replacement ligament into the femur or tibia of the knee. A transverse tunnel may be formed in the femur approximately perpendicular to a femoral tunnel. A flexible strand passing through the transverse tunnel may be used to draw the replacement ligament into the femoral tunnel. The implant may then be placed into the transverse tunnel and through the replacement ligament to secure the replacement ligament in place. The implant may include an eyelet to receive the flexible strand and a tapered portion forming a shoulder to prevent the implant from being inserted too far into the transverse tunnel. The implant may also have a multi-angular configured portion to secure the implant within the transverse tunnel through an interference fit.

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. A pin passing member maintains one end of the filamentary wire in the transverse tunnel as the graft is being moved into place in the femoral and tibial 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: A graft ligament is looped through a graft hole in a graft ligament support block, and the graft ligament support block is mounted to an installation tool. Then the installation tool is used to advance the graft ligament support block into a 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 a transverse fixation pin hole in the graft ligament support block. Then the graft ligament support block is secured in place by pinning the graft ligament support block within the tunnel, i.e., by advancing a transverse fixation pin along the transverse tunnel and into the transverse fixation pin hole in the graft ligament support block. Then the installation tool is detached from the graft ligament support block and withdrawn from the surgical site.

Abstract: Apparatus and method is disclosed for securing a graft ligament in a bone tunnel. A method is disclosed comprising the steps of forming a first bone tunnel and a second bone tunnel being transverse to, and intersecting one another; positioning a closed loop of a flexible member within the first bone tunnel and a portion of the second bone tunnel such that the closed loop extends out of the first bone tunnel and the second bone tunnel, parting the closed loop outside the second bone tunnel so as to create a first free end and a second free end, and passing the second free end through the opposite end of a second free end through the opposite end of second bone tunnel, and positioning the graft ligament over a portion of the flexible member extending out of the first opening; and pulling the flexible member so as to draw the graft ligament into the first bone tunnel.