Abstract: A prosthetic device for use as an artificial meniscus is disclosed. The prosthetic device restores shock absorption, stability, and function to the knee joint after removal of the damaged natural meniscus. In some embodiments, the prosthetic device is pre-tensioned to improve the fit of the prosthetic device within the knee joint and, thereby, maximize the contact area of the load-bearing surfaces to distribute loading through the prosthetic device in a manner substantially similar to that of a healthy natural meniscus. In some embodiments, the pre-tensioned prosthetic device is smaller, or scaled-down, relative to the size of a healthy natural meniscus.

Abstract: A technique for forming a dovetail shaped groove in bone necessary in allograft transplantation such as the meniscus or the Achilles tendon. The technique uses a single drill guide that is designed to create a dovetail shape in bone. The drill guide is provided with a first opening for receiving one drill sleeve placed in a fixed location, and a second opening having an oblong shape for receiving a second drill sleeve having an offset cannulation. The combination of the two drill sleeves allows the surgeon to place two guide pins and ream over each guide pin resulting in a dovetail shape in the bone.

Abstract: A prosthetic device for use as an artificial meniscus is disclosed. The prosthetic device restores stress distribution, stability, and function to the knee joint after removal of the damaged natural meniscus. In some embodiments, the prosthetic device includes an anti-migration feature that inhibits extreme movement within the joint while permitting free floating over a significant range. In one aspect, the anti-migration feature is an enlarged anterior structure or a posterior meniscus remnant engaging channel while in another aspect, the anti-migration feature includes a tethering member. Still further, removable radiopaque features are provided to enhance trialing of the implant prior to final implantation within the joint.

Abstract: An implantable repair device for the repair, augmentation or replacement of tissue, uses silk fibroin and has a smooth surface and a porous surface. The smooth surface has a measured Sa value of less than approximately 0.1 ?m when using Atomic Force Microscopy when samples of the repair device are fully hydrated by imaging through fluid in peak force tapping mode. A method of preparing such an implantable repair device includes preparing a gel from a fibroin solution in a mould, preparing a material by subjecting the gel to one or more steps of freezing and thawing the gel, and creating at least a porous surface on the device, wherein a portion of the mould is adapted to provide at least one smooth surface.

Abstract: A spacer for implantation into a subject is provided that includes a sterilized piece of cartilaginous allograft tissue. The piece forms a Y-shape with a base adapted to insert within a first carpo-metacarpal joint or carpo-metatarsal joint of the subject, and has a first arm adapted to secure to a trapezium bone adjoining the joint, and a second arm adapted to secure to a proximal metacarpal or metatarsal bone adjoining the joint. A procedure for implanting the spacer includes exposing a target joint and abrading a bone surface interior to the joint to induce surface bleeding. The spacer base is then inserted into the joint. The spacer first arm is adhered to the first bone of the joint and the spacer second arm is adhered to the second bone of the joint. A kit is also provided for surgical implantation of the spacer.

Abstract: A method and system for repairing a defect area in a surface of a joint include providing a mold having a first surface and a second surface, positioning the mold within the joint such that at least part of the mold first surface overlies the defect area, and depositing a repair material under the mold first surface within the defect area to create a repaired site within the joint.

Abstract: Methods of selecting and implanting prosthetic devices for use as a replacement meniscus are disclosed. The selection methods include a pre-implantation selection method and a during-implantation selection method. The pre-implantation selection method includes a direct geometrical matching process, a correlation parameters-based matching process, and a finite element-based matching process. The implant identified by the pre-implantation selection method is then confirmed to be a suitable implant in the during-implantation selection method. In some instances, the during-implantation selection method includes monitoring loads and/or pressures applied to the prosthetic device and/or the adjacent anatomy. In some instances, the loads and/or pressures are monitored by a trial prosthetic device comprising one or more sensors. Methods of implanting meniscus prosthetic devices are also disclosed.

Abstract: An improved uni-compartmental implant has a shaft having a proximal end attached to a head and a distal end, and one or more raised portions spaced apart along the shaft to resist back-out. The length between the head and distal end is preferably less than 50 mm, the distal end of the shaft has a diameter on the order of 2 to 3 mm, the proximal end of the shaft has a diameter on the order of 2 to 4 mm, and the head has a diameter ranging from 4 mm or less to 20 mm or more, making the device suitable for knee arthroscopy and other applications.

Abstract: An implant system for implantation at a joint, the implant system including an implant device (10), the implant device comprising a body portion (20) having first (15) and second (16) ends, and a first elongate member (40), extending from the first or second end of the body portion, the implant system further comprising a corresponding fixation device (70) for securing the first elongate member to a subject, the fixation device comprising at least one latching element, the first elongate member comprising at least one cooperating element, the at least one cooperating element being capable of cooperating with said at least one latching element of the fixation device in use.

Abstract: Each of an osteochondral plug graft and a kit comprises a trapezoid shaped construct configured for osteochondral implanting. An osteochondral regeneration method comprises forming a recipient socket in a chondral area of an articular joint in need of repair; harvesting a trapezoid shaped graft from another chondral area; and implanting the trapezoid shaped graft into the recipient socket.

Abstract: The invention is directed toward an instrumentation kit used to replace a damaged human knee joint meniscus with an allograft meniscus implant. The kit includes a workstation having a base and upright end sections with a clamping assembly is mounted on the end sections and a movable cutting guide mounted to a side wall of each end section. The tibia is then drilled with a drill to a desired depth and length and a groove is formed in the tibia with an osteotome so that the width is the same as the width of the bone base of the meniscus implant which has been trimmed in the workstation.

Abstract: Flexible cartilage-replacing implants are disclosed that use either or both of (1) enlarged peripheral rim components, and/or (2) elongated flexible reinforcing members that are embedded around the peripheral edge of an implant device. These types of anchoring devices, especially when used in combination, can provide flexible implants that can be implanted arthroscopically into synovial joints, for complete replacement of damaged cartilage segments.

Abstract: A prosthetic device for use as an artificial meniscus is disclosed. The prosthetic device restores shock absorption, stability, and function to the knee joint after removal of the damaged natural meniscus. In some embodiments, the prosthetic device is pre-tensioned to improve the fit of the prosthetic device within the knee joint and, thereby, maximize the contact area of the load-bearing surfaces to distribute loading through the prosthetic device in a manner substantially similar to that of a healthy natural meniscus. In some embodiments, the pre-tensioned prosthetic device is smaller, or scaled-down, relative to the size of a healthy natural meniscus.

Abstract: A method and apparatus for replacing damaged meniscal tissue includes a meniscus implant including a porous body having a plurality of interconnected open micro-pores and one or more open cavities for receiving meniscal tissue. The interconnected micro-pores are arranged to allow fluid to flow into the porous body and are in fluid communication with the one or more open cavities.

Abstract: A buffer (10) for placement in a human knee between the femur and tibia comprises an outer sack (14) formed of a pliable material and having a one-way valve (22), a generally circularly shaped inner ring (16) received within the outer sack (14), and a friction reducing fluid (18) received within the outer sack (14) via the one-way valve (22). The inner ring (16) includes top and bottom surfaces (38,40) angled inwardly with respect to each other, such that the ring (16) is generally concave. The buffer (10) is configured for insertion between the femur and tibia so as to at least partially prevent the bones from contacting each other, which reduces the pain and discomfort associated with a loss of articular cartilage (12). The buffer (10) is arthroscopically inserted in the knee using an especially designed sleeve (20) configured for support of the buffer (10) during insertion.

Abstract: Methods and apparatuses for treatment of various joint conditions include a device inserted into a joint space. During delivery, the profile of the device is constrained in at least one dimension to minimize invasive impact on tissue and/or bone. The device may be restrained for implantation by a thread or a rigid elongate member. After insertion, the device may expand at the implantation site.

Abstract: A system and method for sharing and absorbing energy between body parts. In one aspect, the method involves identifying link pivot locations, fixing base components and minimally invasive insertion techniques. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: An arthroplasty device is provided having an interpenetrating polymer network (IPN) hydrogel that is strain-hardened by swelling and adapted to be held in place in a joint by conforming to a bone geometry. The strain-hardened IPN hydrogel is based on two different networks: (1) a non-silicone network of preformed hydrophilic non-ionic telechelic macromonomers chemically cross-linked by polymerization of its end-groups, and (2) a non-silicone network of ionizable monomers. The second network was polymerized and chemically cross-linked in the presence of the first network and has formed physical cross-links with the first network. Within the IPN, the degree of chemical cross-linking in the second network is less than in the first network. An aqueous salt solution (neutral pH) is used to ionize and swell the second network. The swelling of the second network is constrained by the first network resulting in an increase in effective physical cross-links within the IPN.

Abstract: A prosthesis for reducing injury to soft tissues of the body, comprising an implantable member adapted to simulate at least one of a size or a shape of a naturally occurring bursa, where the member may be inflatable or otherwise expandable, flexible or rigid, and may be composed of a biocompatible, biodegradable, or non-biodegradable material. The member is adapted to be implanted at a musculoskeletal attachment site or at a site between a muscle and a bone, and is shaped and sized to reduce injury to the site. The prosthesis may also include a plug which seals the prosthesis automatically upon removal of an inflation tube.

Abstract: Various methods for treating a joint are disclosed herein. According to one method, a joint is surgically treated by performing a surgical repair treatment on tissue within the joint capsule; implanting a load reducing device at the joint and entirely outside of the joint capsule to reduce load transmitted by the treated tissue to allow for the tissue within the joint capsule to heal; and partially unloading the joint during healing of the surgical repair site.

Abstract: Methods of selecting and implanting prosthetic devices for use as a replacement meniscus are disclosed. The selection methods include a pre-implantation selection method and a during-implantation selection method. The pre-implantation selection method includes a direct geometrical matching process, a correlation parameters-based matching process, and a finite element-based matching process. The implant identified by the pre-implantation selection method is then confirmed to be a suitable implant in the during-implantation selection method. In some instances, the during-implantation selection method includes monitoring loads and/or pressures applied to the prosthetic device and/or the adjacent anatomy. In some instances, the loads and/or pressures are monitored by a trial prosthetic device comprising one or more sensors. Methods of implanting meniscus prosthetic devices are also disclosed.

Abstract: A knee prosthesis for use in a total knee replacement surgical procedure may include a femoral component, a tibial component and a meniscal component. Optionally, the prosthesis may also include a patellar component. The femoral component may include a bone attachment side and a joint facing side, the latter including an anterior joint surface, a posterior joint surface having a cross-sectional shape defining a portion of a cylinder, and medial and lateral grooves between the anterior and posterior joint surfaces. The meniscal component may include a number of features designed to mate with the femoral component to provide relatively natural movement and range of motion about the knee joint as well as stability and resistance to wear and tear.

Abstract: Technologies related to tumid implants and pumps are generally described. In some examples, a tumid implant device may comprise an enclosed sack membrane adapted to fit between bones in a joint. Articulation of the joint may cause a first layer of the membrane to move through a first boundary section into a second layer of the membrane, while the second layer moves through a second boundary section into the first layer. A working fluid may be disposed inside the sack membrane, and a reservoir may optionally be coupled to the membrane via a gate. The working fluid may be expelled from the sack membrane into the reservoir, and may re-enter the sack membrane from the reservoir in response to changes in pressure in the joint. The working fluid may be conducted into the reservoir or sack membrane by a pump, and several artery pump designs are disclosed.

Abstract: Implant devices, and method of using the same, are provided. The implant devices have a head and a stem. The head has an upper surface, a perimeter surface, and a lower surface. The upper surface is blended into the perimeter surface. The perimeter surface is blended into the lower surface. The upper surface has a general shape of at least a portion of a superior articular surface of a talus and at least a portion of a medial articular surface of a talus. The stem has a cylindrical portion, which optionally has at least one circumferential groove.

Abstract: Methods and devices for correcting wear pattern defects in joints. The methods and devices described herein allow for the restoration of correcting abnormal biomechanical loading conditions in a joint brought on by wear pattern defects, and also can, in embodiments, permit correction of proper kinematic movement.

Abstract: The present disclosure relates to an orthopedic implant that may be used to repair and/or replace focal defects in an individual's articular cartilage. In one exemplary embodiment, the present invention provides a unitary orthopedic implant that includes a bone contacting layer and an articulating layer. In exemplary embodiments, the bone contacting layer may have a thickness of between about 1 millimeter and 3 millimeters. In exemplary embodiments, the articulating layer may have a thickness of between about 1 millimeter and 2 millimeters. As a result, the orthopedic implant may have an overall thickness of between about 2 millimeters and about 5 millimeters.

Abstract: Methods and apparatus for treating meniscal tissue damage are disclosed, including a biocompatible meniscal repair device comprising a biocompatible tissue repair scaffold and a cell growth conduit flap. The tissue repair scaffold is adapted to be placed in contact with a defect in the meniscus and can preferably provide a structure for supporting meniscal tissue and/or encouraging tissue growth. The cell growth conduit flap, which is attached to the tissue repair scaffold, allows communication between the synovium and the tissue repair scaffold.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: A meniscus implant including a c-shaped scaffold having an arcuate middle section extending between an anterior end and a posterior end. A reinforcing network of fibers independent from the scaffold is embedded therein. Fibers of said network fibers exit each end of the scaffold to form respective anterior and posterior attachment segments which extend parallel to a central axis of the scaffold. The network of fibers is configured to convert an axial compressive force on said scaffold to tensile loads on said attachment points.

Abstract: The present invention relates to methods for determining meniscal size and shape for use in designing therapies for the treatment of various joint diseases. The invention uses an image of a joint that is processed for analysis. Analysis can include, for example, generating a thickness map, a cartilage curve, or a point cloud. This information is used to determine the extent of the cartilage defect or damage and to design an appropriate therapy, including, for example, an implant. Adjustments to the designed therapy are made to account for the materials used.

Abstract: Fibrocartilage implants characterized by circumferential fiber networks embedded in arcuate or torroidal scaffolds with orthogonal fiber networks embedded therein to prevent separation of the circumferential fiber networks. The fiber networks convert axial compressive forces on the scaffolds to tensile loads on the circumferential fibers. Artificial knee meniscus and vertebral disc implants are disclosed, as well as articular disc implants for joints such as the temporomandibular joint and wrist. Methods for implanting the fibrocartilage devices are also disclosed.

Abstract: Implants for resurfacing or repairing one or more articular cartilage bearing surfaces of a biological organism include an engineered tissue and a biocompatible porous substrate secured to the engineered tissue for attaching the implant to a native bone of the biological organism. The engineered tissue includes a scaffold containing a biocompatible material, and a plurality of living chondrocytes supported by the scaffold. Methods for culturing chondrocytes for incorporation into a biocompatible implant are provided. A bioreactor for producing functional cartilaginous tissue from a cell-seeded scaffold and a system for producing functional cartilaginous tissue are also provided.

Abstract: This invention includes a subchondral bone repair system, comprising a structural component and a fluid settable component and an optional non-core component. The fluid settable component may penetrate into any pores of the structural component, and set to a solid, thereby fixing the structural component in place. The fluid settable component will penetrate interporously into the pores of the subchondral bone tissue surrounding the device, beneficially displacing any fluid to reduce edema in the affected bone region. Furthermore, the settable component, once solid is osteoconductive to promote repair and regrowth of bone in the affected region, and will also transmit mechanical force stimuli (such as compressive forces) directed through the structural component, into the adjacent bone tissue, thereby providing appropriate force stimuli necessary for appropriate tissue growth.

Abstract: An articular cartilage fixation device and method for repairing and regenerating diseased or injured soft tissue such as articular cartilage of the knee, hip, shoulder, and the like. A cartilage flap or cartilage repair device is retained within the chondral or osteochondral defect for a sufficient amount of time such that the cartilage repair device can perform its function and facilitate an appropriate healing response. A plurality of biocompatible anchors are attached to a plurality of flexible members and are shaped to seat into the tissue beneath or near the defect such that the cartilage flap is retained within the defect.

Abstract: A method of making prosthetic knee menisci to be implanted in place of deteriorated or damaged native menisci, said prosthetic menisci being internally reinforced and sequentially moulded in open form from a suitable biocompatible elastomeric polymer material, said prosthetic menisci subsequently being transformed into closed, hollow forms; said hollow forms being sized for femoral and tibial condylar surfaces and filled or inflated after implantation by injection into them of a gel or settable polymer to shape them into congruence with the femoral and tibial condyles, the surfaces of said menisci being chemically and/or physically treated to improve the efficiency of lubrication by synovial fluid and to provide enhanced wear characteristics, and said prosthetic menisci being restricted in translation within the interarticular space by anchorage of their anterior and posterior horns to the tibia and by the provision of secondary locating elements.

Abstract: Methods of using cartilage implant devices are provided. The methods include locating articular cartilage having a lesion, and utilizing an implant having dimensions compatible with the lesion. The method further includes forming a cavity in the articular cartilage, subchondral bone, and cancellous bond, and engaging the implant with the cavity so that the lower face of the articular end of the implant abuts against the subchondral bone, and the stem of the implant abuts against the cancellous bone.

Abstract: Biologic partial menisci (biologic partial meniscal replacements/constructs) used to replace at least a part of a meniscus, and methods of forming such biologic partial menisci. Meniscal cartilage is employed to form a moldable allograft paste. A sterile mold that replicates a meniscus (for example, the medial or lateral meniscus) is provided in various sizes and is used as a biologic mold to recreate the anatomic shape of the meniscus. The moldable paste is inserted (for example, injected) into the mold and allowed to set into a stable, anatomically shaped meniscus (the biologic partial meniscus). Fibrin glue or other biologic adhesives or strengtheners may be optionally added to provide further biomechanical strength. Once the biologic partial meniscus is removed from the mold, it is provided at the surgical site and attached to the excised meniscus (placed into the correct anatomical shape) to complete the meniscal repair.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: Disclosed herein are methods and devices for repairing articular surfaces. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function.

Abstract: Prosthetic knee menisci to be implanted in place of deteriorated native menisci to prevent damage to the articular cartilage of the femoral and tibial condyles and, thereby, to arrest the progressive development of osteoarthritis; said prosthetic menisci being made as a hollow form and inflated after implantation by injection of a settable polymer to shape them into congruence with the femoral and tibial condyles; being sized for the femoral and tibial condylar surfaces; having internal reinforcement for strength and durability; being made from materials having elastomeric characteristics similar to those of native menisci; having bearing surfaces treated chemically and/or physically to improve the efficiency of lubrication by synovial fluid and to enhance the wear characteristics of the bearing surfaces; and being restricted in translation within the interarticular space by anchorage of their anterior and posterior horns and by the provision of secondary locating elements.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: Disclosed herein are methods and devices for repairing articular surfaces in a knee joint. The articular surface repairs are customizable or highly selectable for each patient and geared toward providing optimal fit and function. Kits are also provided to enable customized repairs to be performed.

Abstract: Methods of using implant devices are provided herein. The implant devices of the methods herein have an articular end and a stem, the stem having an oval-shaped cross-section. The articular end has an upper surface, a side surface, and a lower surface. The upper surface and lower surface each intersect the side surface. The upper surface has a first surface curvature, a central surface curvature, and a second surface curvature. The stem extends from the lower surface in a direction away from the upper surface of the articular end.

Abstract: Flexible cartilage-replacing implants are disclosed that use either or both of (1) enlarged peripheral rim components, and/or (2) elongated flexible reinforcing members that are embedded around the peripheral edge of an implant device. These types of anchoring devices, especially when used in combination, can provide flexible implants that can be implanted arthroscopically into synovial joints, for complete replacement of damaged cartilage segments.

Abstract: A method of repairing an articular cartilage defect with the partial joint resurfacing implant includes surgically creating an opening in the articular cartilage defect site. The method also includes obtaining a partial resurfacing implant which is implanted into the opening. The partial resurfacing implant includes a top articulating portion, an implant fixation portion, and a locking mechanism. The implant fixation portion including an upper segment coupled to the top articulating portion and a bone interfacing segment configured to facilitate insertion into the articular cartilage defect site. The method further includes the bone interfacing segment being inserted into the opening with the top articulating portion and adjacent articular cartilage being positioned to each other to facilitate motion and load transfer over the defect site. Another method of repairing an articular cartilage defect with a partial joint resurfacing implant and a partial joint resurfacing implant are also disclosed.

Abstract: Provided herein is a biocompatible implant for meniscus tissue engineering. Particularly, the biocompatible implant comprises a multi-layered crescent-shaped silk fibroin scaffold, in which each layer comprises distinct pore size and/or pore orientation, e.g., to mimic native meniscus complex architecture. Accordingly, the biocompatible implant can be used for repairing any meniscal defect or promoting meniscal regeneration in a subject.

Abstract: Disclosed are osteochondral constructs that can be utilized to encourage both bone and articular cartilage tissue repair in synovial joints. Disclosed constructs are composites including a hydrogel portion for implant in a cartilage defect site and an adjacent portion for implant in a bone defect site. The portion to be implanted in a bone defect site can include a polymeric/ceramic composite material. Disclosed constructs also include a polymeric anchor that can secure the construct at the desired site. Disclosed constructs can also include capillary channeled fibers within the bone portion of the construct that can provide improved nutrient flow to and waste flow from cells growing and developing on and in the construct.

Abstract: The present disclosure provides a tissue product comprising a tissue sheet. The sheet can be formed from a plurality of tissue matrix fragments.