Abstract: Artificial disc augmentation for natural intervertebral discs using a solution of polymers. Once inserted into the disc the polymers crosslink to form hydrogels in vivo. Crosslinking of the polymers is activated by changes in temperature, pH, or ionic activity.

Abstract: A femoral slideway and a femoral slideway/femur-size template combination is employed to create an installed knee prosthesis that creates a reduced amount of stress in the collateral ligaments relative to previous prostheses. In one embodiment, the reduced stress is achieved by employing a femoral slideway/femur-size template combination which results in installation of a femoral slideway which has a smaller dorsal-ventral dimension than a corresponding dimension of the femur prior to resection.

Abstract: A spinal implant for replacing the natural nucleus of the disc made from a polymer such as hydrogel having a radiopaque material located within the polymer. The material may be in the form of a powder disbursed throughout the polymer or may be in he form of a powder disbursed in layers or in other specific locations within the polymer. The radiopaque material is metal such as gold, tungsten, titanium, tantalum or platinum. The metal may also be in the form of a foil or wire located within the hydrogel such as polyurethane, thereby making the implant visible on x-rays. Other polymers besides hydrogel may be used with the radiopaque material being disbursed therein.

Abstract: A method of using body tissue includes removing tissue from a donor site and separating at least one component from the tissue while maintaining the tissue cells in a viable condition. The viable tissue cells are then implanted in a patient. The tissue cells may be positioned on a structural support before implantation in a patient. The method may also include harvesting cancellous bone and extruding the cancellous bone cells while maintaining the cells in a viable condition.

Abstract: Open chambered spacers, implanting tools and methods are provided. The spacers 500′ include a body 505′ having a wall 506′ which defines a chamber 530′ and an opening 531′ in communication with the chamber 530′. In one embodiment the wall 506′ includes a pair of arms 520′, 521′ facing one another and forming a mouth 525′ to the chamber 530′. Preferably, one of the arms 520′ is truncated relative to the other, forming a channel 526. In one aspect the body 505′ is a bone dowel comprising an off-center plug from the diaphysis of a long bone. The tools 800 include spacer engaging means for engaging a spacer and occlusion means for blocking an opening defined in the spacer. In some embodiments, the occlusion means 820 includes a plate 821 extendable from the housing 805.

Abstract: A method and apparatus for repairing isolated chondral defects using synthetic implants. Lesions in articular tissue are corrected by forming a recipient socket in the tissue. A donor graft of a size corresponding to the recipient socket is harvested from a synthetic specimen made of a synthetic tissue material, such as poly (vinyl) alcohol hydrogel. The donor graft is implanted into the recipient socket.

Abstract: An intervertebral disc is treated by providing supplemental nutrition to increase viability and longevity. In the preferred embodiment, the invention uses one or more porous stents that function to irrigate the disc space. The stents provide channels for diffusion of fluids and nutrients from the vertebral endplates. The stents may extend across the vertebral endplates to facilitate the transfer of nutrients and oxygen from the vertebral bodies.

Abstract: A tool for deploying an expandable structure into interior body regions provides a catheter body having an interior lumen. The catheter body carries an expandable structure. A stylet is sized configured for passage through the lumen and adapted to straighten the expandable structure during deployment into an interior body region.

Abstract: Fibrocytes, annulus fibrosis cells, cells that differentiate into annulus fibrosis cells, or cells that function like annulus fibrosis cells are harvested and combined with the extracellular matrix of the annulus fibrosis from a recently deceased human or animal to produce an engineered annulus fibrosis. Any suitable material(s) are then added to the engineered disc tissue to restore disc height. For example, a shape-memory material or alloy that changes shape from a long narrow shape to a spherical shape would facilitate insertion through a relatively small incision followed by useful height restoration. Additional therapeutic substances like culture medium, growth factors, differentiation factors, hydrogels, polymers, antibiotics, anti-inflammatory medications, or immunosuppressive medications could be added to the transplanted annulus fibrosis tissue. The process can be used to replace or repair other tissues or organs of the body such as the meniscus of the knee.

Abstract: Transplanted meniscus tissue is used to treat degenerative disc disease, disc herniation, or other pathologic conditions of the spine. Harvested fibrocytes are added to a meniscus removed from a suitable donor, preferably a recently deceased human. The harvested meniscus could be processed to kill the cells but preserve the extracellular matrix. Killing the cells of the allograft meniscus minimizes the risk of disease transmission and graft refection. Fibrocytes or chondrocytes would be added to the harvested meniscus extracellular matrix prior to insertion of the engineered meniscus into a patient's spine. Alternatively, the cells could be added to the harvested meniscus during or after the meniscus is placed into a patient's spine.

Abstract: Fibrocytes, annulus fibrosis cells, cells that differentiate into annulus fibrosis cells, or cells that function like annulus fibrosis cells are harvested and combined with the extracellular matrix of the annulus fibrosis from a recently deceased human or animal to produce an engineered annulus fibrosis. Autograft tendons are then used to strengthen the annulus fibrosis and to augment or replace the nucleus pulpous. In accordance with a preferred embodiment, tendons such as the palmaris longus are harvested from the patient, a suitable living donor, or a recently deceased human. The tendons are sewn or otherwise attached to the inside of the annulus fibrosis using percutaneous or laparoscopic procedures. The tendons aid the nucleus and/or replace the nucleus by absorbing the compression forces between vertebrae and by transferring the compression forces to the augmented annulus fibrosis.

Abstract: Modular bone implants, means of assembly, and their method of use are presented.

Abstract: A method of using body tissue is disclosed. Pieces of body tissue are obtained, they are shaped to form an article having a desired configuration, and the article is implanted into a patient's body.

Abstract: A surgical method of repair and reconstruction of the spinal disc wall (annulus) after surgical invasion or pathologic rupture, incorporating suture closure, or stent insertion and fixation, designed to reduce the failure rate of conventional surgical procedures on the spinal discs. The design of the spinal disc annulus stent allows ingrowth of normal cells of healing in an enhanced fashion strengthening the normal reparative process.

Abstract: A surgical method of repair and reconstruction of the spinal disc wall (annulus) after surgical invasion or pathologic rupture, incorporating suture closure, or stent insertion and fixation, designed to reduce the failure rate of conventional surgical procedures on the spinal discs. The design of the spinal disc annulus stent allows ingrowth of normal cells of healing in an enhanced fashion strengthening the normal reparative process.

Abstract: A surgical method of repair and reconstruction of the spinal disc wall (annulus) after surgical invasion or pathologic rupture, incorporating suture closure, or stent insertion and fixation, designed to reduce the failure rate of conventional surgical procedures on the spinal discs. The design of the spinal disc annulus stent allows ingrowth of normal cells of healing in an enhanced fashion strengthening the normal reparative process.

Abstract: A patello-femoral joint prosthesis is provided which allows smooth tracking of the articulating surfaces through a full range of joint motion. A novel configuration of a femoral implant component that facilitates superior adhesion to bone is also provided. Also provided is a patello-femoral joint replacement system, which permits precise, reproducible bone preparation techniques that uniquely permit later revision and full knee joint replacement procedures with minimal complications. Also provided are a drill guide and a cutting guide, each being configured to provide three point stabilization during operation.

Abstract: An implant for improved engagement between modular components is provided. The implant includes a body member for insertion, in use, in a natural femoral neck; and a rod for insertion, in use, in the intramedullary canal of a femur. The body member has a first engagement surface and the rod has a second engagement surface such that the first and second engagement surfaces are configured for complementary engagement with each other. One of the first or second engagement surfaces may be a protrusion while the other of the first or second engagement surfaces may be a recess for receiving the protrusion. The implant may further include a locking member, a stabilizing member and a guide means. A domed head portion is provided for attachment to a medial end of the body member and insertion, in use, in a natural or prosthetic acetabulum.

Abstract: A surgical method of repair and reconstruction of the spinal disc wall (annulus) after surgical invasion or pathologic rupture, incorporating suture closure, or stent insertion and fixation, designed to reduce the failure rate of conventional surgical procedures on the spinal discs. The design of the spinal disc annulus stent allows ingrowth of normal cells of healing in an enhanced fashion strengthening the normal reparative process.

Abstract: A system and method for installing a shoulder prosthesis. The method includes removing the original humeral head and shaping the proximal end of the humerus with one or more implements to prepare the humerus to receive the shoulder prosthesis.

Abstract: A device for use in ligament grafting includes a holder for receiving a ligament graft. A sheath is mounted over the holder in an expanded diameter state. The ligament graft is removed from the hollow body with the sheath so that the ligament graft is captured in the sheath in a reduced diameter state and a substantial length of the sheath extends from opposite ends of the graft.

Abstract: In a method of performing a hyaline cartilage allograft transplantation procedure in which a surgeon has pre-operatively determined a size of allograft to be needed for the procedure, a service provider facilitates the procedure by arranging, upon receiving an order from the surgeon or a hospital for an allograft of a specified diameter, for the delivery of a precut allograft core along with a customized set of instrumentation for performing the transplantation to the surgeon or hospital prior to the scheduled time of the operation. The service provider also arranges for the return of any non-disposable instrumentation to the service provider after the operation.

Abstract: Expandable implants for intervertebral disc repair, and methods and apparatuses for delivering the same into the disc. The present implants can also be used for repair of bone fractures. The implants generally comprise a compressed form having a size adapted for insertion into a defect in the intervertebral disc, and a composition that allows the implant to expand from the compressed form into an expanded form after the implant is inserted into the defect. The expanded form of the implant has a configuration that fills the defect in the disc. The defect in the disc can be an annular defect that resulted from repair of a herniation of the disc, or a nucleus that needs to be repaired. The composition used to make the implant can comprise a shape memory alloy (SMA) or any other suitable material.

Abstract: The present invention features a regenerative bone implant. The implant includes a biocompatible and biodegradable matrix having pores, and a biocompatible and biodegradable biopolymer disposed in the pores and covalently bonded to the matrix. Optionally, the implant can further include a bone formation promoter that is also disposed in the pores and can be covalently bonded to the matrix.

Abstract: Methods and devices are provided for regenerating a meniscus. The devices comprise a layer of toughened naturally occurring extracellular matrix. The devices may, optionally, further comprise a biologic material to provide a framework for meniscus regeneration. The methods comprise the steps of removing a portion of a meniscus to provide a space, and inserting a device comprising a layer of toughened naturally occurring extracellular matrix into the space.

Abstract: This invention relates to a malleolar implant for partial or total ankle prosthesis, comprising a head, intended to bear against the astragalus or astragalian prosthetic component and a shank provided to be introduced in a bore in the fibula, characterized in that said shank is provided with means for hooking a traction member adapted to be manoeuvred from the outer side of the fibula, in order to position said shank in said bore.

Abstract: A bone joining implant includes a tubular body. The tubular body has an axially extending outer surface defining an outer dimension of substantially uniform cross-section and including a smooth leading insertion portion and a bone engaging trailing portion.

Abstract: The present invention relates generally to intervertebral disc devices and methods and instrumentation for intervertebral disc procedures. An intervertebral disc repair and diagnostic device that is minimally invasive, actively guided, and provides direct and consistent access to the inner surface of the posterior anulus, which will not unintentionally exit the posterior anulus and cause harm to the spinal cord, is provided.

Abstract: Fibrocytes, annulus fibrosis cells, cells that differentiate into annulus fibrosis cells, or cells that function like annulus fibrosis cells are harvested and combined with the extracellular matrix of the annulus fibrosis from a recently deceased human or animal to produce an engineered annulus fibrosis. Any suitable material(s) are then added to the engineered disc tissue to restore disc height. For example, a shape-memory material or alloy that changes shape from a long narrow shape to a spherical shape would facilitate insertion through a relatively small incision followed by useful height restoration. Additional therapeutic substances like culture medium, growth factors, differentiation factors, hydrogels, polymers, antibiotics, anti-inflammatory medications, or immunosuppressive medications could be added to the transplanted annulus fibrosis tissue. The process can be used to replace or repair other tissues or organs of the body such as the meniscus of the knee.

Abstract: Fibrocytes, annulus fibrosis cells, cells that differentiate into annulus fibrosis cells, or cells that function like annulus fibrosis cells are harvested and combined with the extracellular matrix of the annulus fibrosis from a recently deceased human or animal to produce an engineered annulus fibrosis. Autograft tendons are then used to strengthen the annulus fibrosis and to augment or replace the nucleus pulpous. In accordance with a preferred embodiment, tendons such as the palmaris longus are harvested from the patient, a suitable living donor, or a recently deceased human. The tendons are sewn or otherwise attached to the inside of the annulus fibrosis using percutaneous or laparoscopic procedures. The tendons aid the nucleus and/or replace the nucleus by absorbing the compression forces between vertebrae and by transferring the compression forces to the augmented annulus fibrosis.

Abstract: An intervertebral nucleus prosthesis is proposed, which is characterized in that it consists of at least one, in particular, spherical body movable in two directions of a plane and made of a rigid, non-oxidizing, biocompatible material with a diameter adapted to the biological nucleus, the spherical body being mounted non-displaceably but freely rotatably about its center in a cage and protruding at both opposite sides in the form of a spherical cap from the cage. Also proposed is a method for implanting such a prosthesis.

Abstract: Transplanted meniscus tissue is used to treat degenerative disc disease, disc herniation, or other pathologic conditions of the spine. Harvested fibrocytes are added to a meniscus removed from a suitable donor, preferably a recently deceased human. The harvested meniscus could be processed to kill the cells but preserve the extracellular matrix. Killing the cells of the allograft meniscus minimizes the risk of disease transmission and graft refection. Fibrocytes or chondrocytes would be added to the harvested meniscus extracellular matrix prior to insertion of the engineered meniscus into a patient's spine. Alternatively, the cells could be added to the harvested meniscus during or after the meniscus is placed into a patient's spine.

Abstract: A surgical method of repair and reconstruction of the spinal disc wall (annulus) after surgical invasion or pathologic rupture, incorporating suture closure, or stent insertion and fixation, designed to reduce the failure rate of conventional surgical procedures on the spinal discs.

Abstract: Apparatus and methods for treating a spinal disc are disclosed. An opening is created in the annulus fibrosis, and nucleus pulposus is removed from the interior of the disc. The interior is lined with a nonporous, bioabsorbable liner, and filled with a fill material, such as nucleus pulposus, to cause the liner to expand to engage tissue surrounding the interior. The liner may be a sheet of extra-cellular matrix material that is introduced into the interior, or a bladder of extra-cellular matrix material including a neck communicating with an interior region of the bladder. The sheet or bladder may be carried by a delivery device, e.g., a catheter or rod. After the interior region is filled, the opening is closed using a plug or other closure device. The plug may include threads on its external surface for securing the plug in the opening.

Abstract: Living annulus fibrosis cells are combined with annulus fibrosis extracellular matrix obtained from recently deceased human or animal donors to restore disc function and eliminate pain in patients with disc disease. Additional therapeutic substances like culture medium, growth factors, differentiation factors, hydrogels, polymers, antibiotics, anti-inflammatory medications, or immunosuppressive medications could be added to the transplanted annulus fibrosis tissue. The process can be used to replace or repair other tissues or organs of the body such as the meniscus of the knee.

Abstract: A method of treating a diseased or traumatized intervertebral disc is based upon the transplantation of one or more dehydrated biologic tissues into the disc space. In the preferred embodiment, dehydrated nucleus pulposis tissue is used, which may be combined with live nucleus cells. The dehydration allows the insertion of the transplanted cells and/or tissue through a smaller annular hole. Dehydration also decreases the volume of the material transferred, thus allowing the surgeon to insert more into the disc space. Once in the body, the materials hydrate by imbibing fluid from the surrounding area. In the case of nucleus pulposis tissue, the subsequent hydration helps to restore disc height and help prevent extrusion of disc material through the hole in the annulus. One or more therapeutic substances may be added, including culture media, growth factors, differentiation factors, hydrogels, polymers, antibiotics, anti-inflammatory medications, or immunosuppressive medications.

Abstract: Cells grown on a microcarrier are separated from the microcarrier by enzymatically digesting the microcarrier. More specifically, chondrocytes may be grown on dextran microcarrier beadlets and then the beadlets digested using dextranase to separate the chondrocytes from the carrier. Cells can also be grown on chitosan microcarriers to be used for implantation. In addition, cells can be grown on polysaccharide polymers to be used as implant devices. Various polymers serve as scaffolds for cells to be used for implantation. The polymers can be used for cell culture as well as for preparing scaffolds useful for tissue replacement such as cartilage tissue.

Abstract: A system for stabilizing the vertebral column without requiring the excision of bone from the superior or inferior vertebrae or the resection of the adjacent anterior or posterior longitudinal ligaments. The system includes a stabilizing device and a deployment system composed of first and second coacting tools. The stabilizing device is made up of an expandable threaded insert and an expansion screw. The threaded insert is a hollow cylindrical member having a central cylindrical threaded bore, and a self tapping helical thread extending about the outer periphery of the member. The member is split at its proximal end in communication with the bore to form a pair of slots extending parallel to its longitudinal axis. The expandable insert is arranged to be screwed by the first tool into the intervertebral space between the superior and inferior vertebrae to a desired depth and with the slots oriented in a plane generally perpendicular to the longitudinal axis of the vertebral column.

Abstract: The present invention relates to a method and instrumentation for gaining access to areas in and around joints for treatment and to provide new implants and instrumentation adapted for the new method. In a transosseous core approach of the present invention, the joint is entered through a pathway provided in a portion of a joint bone. Such pathway is preferably made by taking out a bone core from the bone in or adjacent to the joint, wherever possible without substantially compromising physical integrity and physiological viability of the joint. Typically the main route for the transosseous core approach traverses through a more-accessible bone of the joint which can be aligned with a less-accessible bone of the joint in order to facilitate treatment of articular surfaces and/or other structures in the joint. The transosseous pathway into the joint is preferably provided by novel surgical instruments such as a core cutter, cartilage punch, hemostatic device, and retractable axial/transaxial cutting device.

Abstract: A glenoid component includes an oval body having a concave lateral articulating surface and an opposing medial surface with a keel extending from the medial surface. The keel extends along a line which is anteriorly offset from the center line of the concave surface and is not collinear with any radius of the concave surface. New methods and tools are provided for the implantation of the glenoid component. Sizer drill guides are provided with an alignment arm which assures that the anterior/posterior angle of the pilot hole is approximately 65 degrees. An improved reamer tool is provided which allows the practitioner to attach a reamer head of selected size to the reamer rather than choosing among several reamers of different size at the time of the procedure. A new keel drill guide is provided which locates three drill guide holes in a plane which is offset approximately 2 mm anterior of the pilot hole.

Abstract: Osteoarticular allografts are transplanted by techniques which ensure substantial surface contour matching. Specifically, surgical techniques are provided whereby a plug from an osteochondral allograft may be transplanted to a cavity site which remains after a condylar defect is removed from a patient's condyle. In this regard, the present invention essentially includes placing an osteochondral allograft in substantially the same orientation as the patient condyle, and then removing the transplantable plug therefrom and forming the cavity site in the patient condyle while maintaining their relative same orientation. In this manner, the surface of the transplanted plug is matched to the contour of the excised osteochondral tissue.

Abstract: An intervertebral spacer adapted for implanting between adjacent vertebral bodies of a human spine as a load-bearing replacement for a spinal disc. The spacing member includes an external, non-porous, concavo-convex contour with respect to one dimension of said spacing member. The spacing member is preferably constructed from a rigid, non-resilient load-bearing material that is incapable of elastic deformation. The spacing member is inserted with the aid of a sheathed trocar device that is releasably attached to the spacer, to enable implantation and selective positioning of the spacer by the surgeon from the posterior side of the spine, without the need to retract the dural nerve or the posterior longitudinal ligament.

Abstract: A subcutaneously assembled in place orthopedic construct is provided, such as for fixation of the spine. The construct includes a first bar and a second bar for attachment to the spine. A crossbar connects the first and second bar, to provide additional structural support. Each of the first bar, the second bar, and the crossbar may be inserted in a minimally invasive procedure, and constructed in place to form the orthopedic device. Each of the first bar, second bar, and crossbar may comprise an inflatable container, adapted for inflation with a hardenable media and cured in place. Methods and delivery structures are also disclosed.

Abstract: Laterally expanding vertebral spacer devices are provided for repairing damaged vertebral discs. The vertebral spacer devices maintain the height of a distracted vertebral disc space while providing stability to the spine. In one form of the invention, a vertebral spacer device is provided with a first arm movably coupled to a second arm. The first and second arms are laterally expandable from a first width for insertion into the disc space to a second width after insertion into the disc space. The first and second arms also define a cavity therebetween for placement of bone growth material.

Abstract: A tissue press for shaping or compressing a piece of tissue comprises first and second members movable relative to each other. A first forming element of a predetermined shape is selectively engageable on the first member. A second forming element of predetermined shape is selectively engageable on the second member. The first and second forming elements are positionable on opposite sides of the piece of tissue. The first and second members are relatively movable between a first spaced apart condition and a second condition in which the piece of tissue is held between the first and second forming elements. Means are preferably provided for monitoring and controlling the amount of pressure applied to the piece of tissue, in order to maintain the tissue in a viable living condition. Means may also be provided for draining off fluid from compressed tissue, so that the tissue can be implanted in a compressed state and imbibe fluid from the host site.

Abstract: An intervertebral prosthesis for implantation between adjacent vertebrae of the human spine is shown. The prosthesis is formed as a unitary cage body configured and sized to be inserted between adjacent vertebrae in a single step implantation procedure. The cage body is banana shaped as viewed from above, the body having an exterior surface and an interior surface, the interior surface defining an internal recess for receiving cancellous bone material during an implantation procedure. The cage body can be formed as an interlinked mesh.

Abstract: A prosthetic femoral component is located in a prepared socket in a femur which has been resected at a position on the proximal side of its neck. The component includes an insert portion and an enlarged proximal head portion the distal end of the head portion being adapted for location in the prepared socket. The component takes advantage of the bone at the periphery of the socket which enables the insert and the part of the head concerned to be accurately and firmly located in the bone. The presence of the bone at the outer edges of the socket helps to stabilize the component. The insert portion can be dimensioned to pass through the neck of the femur with which it is to be used or to be shorter depending upon the requirements.

Abstract: Apparatus and methods aid the annulus in controlling vertebral motion, thereby preventing additional annular tears, and decreasing pain from annular tears. A biocompatible fabric or mesh is attached to the annulus. The material may be attached to the inside and/or outside of the annulus by stitches, staples, adhesives, or other suitable techniques. Alternatively, the fabric may be attached to the vertebra above and below the disc by screws, staples, tacks, or porous material for bone ingrowth such as titanium.

Abstract: The present invention is directed to a synthetic biomaterial compound based on stabilized calcium phosphates and more particularly to the molecular, structural and physical characterization of this compound. The compound comprises calcium, oxygen and phosphorous, wherein at least one of the elements is substituted with an element having an ionic radius of approximately 0.1 to 1.1 Å. The knowledge of the specific molecular and chemical properties of the compound allows for the development of several uses of the compound in various bone-related clinical conditions.

Abstract: Bioactive compositions that induce or enhance the repair of damaged or diseased connective tissues upon contact of the tissues with the compositions in vivo include an effective amount of pleiotrophin. A delivery vehicle is also included in the compositions. The compositions may be delivered to the repair sites by injection or by implantation.