Systems and methods for arthroscopic graft insertion

Abstract

A graft configured to be arthroscopically inserted into an implantation site in a patient includes a substantially planar portion defined by at least a first edge, a second edge, and a third edge, a first guide lumen disposed along a portion of the first edge, a second guide lumen disposed along a portion of the second edge, and a third guide lumen disposed along a portion of the third edge. And a guide cavity disposed along a portion of the third edge. Each of the first guide lumen, the second guide lumen, and the guide lumen is configured to receive a suture. The third edge is substantially perpendicular to the first edge and the second edge such that the guide cavity is substantially perpendicular to the first guide cavity and the second guide cavity.

Description

[0001] Cross-references to related applications This application claims priority to U.S. Provisional Application No. 63 / 515,775, filed July 26, 2023, which is incorporated herein by reference. Technical Field

[0002] This application relates to systems and methods for arthroscopic graft insertion. More specifically, this application relates to arthroscopic graft insertion systems and methods that can guide the graft into the patient using sutures and secure the graft to the implantation site using the same sutures. Background Technology

[0003] Arthroscopically delivered grafts (“grafts”) are used in surgeries including tendon and ligament repair to promote the growth of, for example, torn tendons onto the bone. These grafts are guided into the patient in a compressed state and, once vitro, unfold and attach to the implantation site.

[0004] During the guidance and implantation of the graft into the patient, the force exerted on the graft by the sutures must be controlled. During guidance, the graft must remain compressed and must unfold at the implantation site. Furthermore, during implantation, the graft must be able to withstand tension acting on it in multiple directions to ensure its durability throughout its service life and to ensure tendon repair.

[0005] Traditional graft geometry requires additional components (e.g., guides) to guide the graft into the patient, which can complicate the graft placement process. This conventional graft geometry can also render the graft unable to withstand tension during implantation, leading to poor patient outcomes. Summary of the Invention

[0006] This application discloses several embodiments of grafts configured for arthroscopic insertion into an implantation site within a patient. It also discloses methods and embodiments for using kits for arthroscopic insertion of grafts into implantation sites within a patient.

[0007] In one aspect of the disclosure, a graft can include a substantially planar portion defined by at least a first edge, a second edge, and a third edge. The graft can further include a first guide lumen disposed along a portion of the first edge, a second guide lumen disposed along a portion of the second edge, and a lead lumen disposed along a portion of the third edge. Each of the first guide lumen, the second guide lumen, and the lead lumen can be configured to receive a suture. The third edge can be substantially perpendicular to the first edge and the second edge, such that the lead lumen can be substantially perpendicular to the first guide lumen and the second guide lumen.

[0008] In some embodiments, the third edge is a distal edge of the graft, such that the lead lumen is disposed along a portion of the distal edge of the graft. In other embodiments, the third edge can include a proximal edge of the graft, such that the lead lumen is disposed along a portion of the proximal edge of the graft.

[0009] In some embodiments, the graft is configured to move from the first planar configuration to a compressed configuration when the suture is pulled a first amount, and to move from the compressed configuration to a second planar configuration when the suture is pulled a second amount.

[0010] In some embodiments, the graft includes an electrospun material. In other embodiments, the first edge and the second edge can be approximately 20 millimeters long, and the third edge can be approximately 30 millimeters long.

[0011] In some embodiments, the graft, in the compressed configuration, is sized to fit through a cannula and through an incision having a length between approximately 5 millimeters and approximately 8 millimeters.

[0012] In some embodiments, the graft includes a biocompatible material. In other embodiments, a portion of the first edge is less than a length of the first edge, a portion of the second edge is less than a length of the second edge, and a portion of the third edge is less than a length of the third edge.

[0013] In some embodiments, the graft further includes a fourth edge and a backout lumen disposed along a portion of the fourth edge. In some embodiments, a length of the lead lumen is at least 80% of a length of the first guide lumen and a length of the second guide lumen. In other embodiments, the length of the lead lumen is at least approximately 18 millimeters.

[0014] In some embodiments, the suture may include a continuous suture secured to the implantation site at least at a first location and at least at a second location along the length of the suture. In some embodiments, the suture may include a first material segment and a second material segment, the first material segment secured to the implantation site at a first location and the second material segment secured to the implantation site at a second location. In other embodiments, the first and second material segments are configured to be tied together. In some embodiments, the graft is configured to be secured to the implantation site at both the first and second locations.

[0015] In some embodiments, at least one of the first guide cavity and the second guide cavity includes a first cavity segment and a second cavity segment. In other embodiments, the suture is a sliding suture.

[0016] In another aspect, a method for arthroscopically inserting a graft into an implantation site within a patient is disclosed. In some embodiments, the graft may include a generally flat portion defined by at least a first edge, a second edge, and a third edge, with a first guide cavity disposed along the first edge, a second guide cavity disposed along the second edge, and a guide cavity disposed along the third edge. Each of the first, second, and guide cavities may be configured to receive a suture, wherein the third edge is generally perpendicular to the first and second edges, such that the guide cavity is generally perpendicular to the first and second guide cavities. The method may further include placing a suture within the first, second, and guide cavities of the graft, securing the suture to the implantation site at least at a first location along its length and at a second location along the length of the suture. The method may further include pulling the suture to allow the graft to travel along the suture and through an incision to the implantation site.

[0017] In some embodiments, the third edge is the distal edge of the graft, such that the guide cavity is arranged along a portion of the distal edge of the graft. In other embodiments, the third edge is the proximal edge of the graft, such that the guide cavity is arranged along a portion of the proximal edge of the graft.

[0018] In some embodiments, the method further includes: pulling the suture by a first amount to move the graft from a first flat structure to a compression structure, and pulling the suture by a second amount to move the graft from the compression structure to a second flat structure.

[0019] In some embodiments, the graft comprises an electrospun material. In other embodiments, the first and second edges are approximately 20 mm long, and the third edge is approximately 30 mm long. In other embodiments, in a compression configuration, the graft is sized to fit through a cannula and through an incision between approximately 5 mm and approximately 8 mm in length.

[0020] In some embodiments, the graft includes a biocompatible material. In some embodiments, a portion of the first edge is less than the length of the first edge, a portion of the second edge is less than the length of the second edge, and a portion of the third edge is less than the length of the third edge.

[0021] In other embodiments, the graft of the method further includes a fourth edge and a return cavity arranged along a portion of the fourth edge. In some embodiments, the length of the guide cavity is at least 80% of the length of the first guide cavity and the length of the second guide cavity. In some embodiments, the length of the guide cavity is at least about 18 mm.

[0022] In other embodiments, the suture comprises a continuous suture secured to the implantation site at least at a first location along its length and at least at a second location along its length. In some embodiments, the suture comprises a first material segment and a second material segment, the first material segment being secured to the implantation site at a first location and the second material segment being secured to the implantation site at a second location. In some embodiments, the method further comprises binding the first material segment and the second material segment together.

[0023] In other embodiments, the graft is configured to be secured to the implantation site at a first location and a second location. In some embodiments, at least one of the first guide cavity and the second guide cavity includes a first cavity segment and a second cavity segment. In some embodiments, the suture includes a sliding suture.

[0024] In another aspect, a kit for arthroscopically inserting a graft into an implantation site within a patient is disclosed. In some embodiments, the kit includes a suture, a cannula, and a graft comprising a generally flat portion defined by at least a first edge, a second edge, and a third edge, with a first guide cavity disposed along the first edge, a second guide cavity disposed along the second edge, and a guide cavity disposed along the third edge. Each of the first, second, and guide cavities may be configured to receive the suture. The third edge may be generally perpendicular to the first and second edges, such that the guide cavity is generally perpendicular to the first and second guide cavities, and the graft is configured to travel along the suture and through the cannula to reach the implantation site.

[0025] In one embodiment, a graft configured for arthroscopic insertion into a patient's implantation site may comprise a generally tubular body defined along a longitudinal axis by at least a distal and a proximal end. At least a first guide cavity may be disposed along the tubular body, and a first guide cavity may be disposed along the outer periphery of the distal end. Each of the first guide cavities may be configured to receive sutures. The outer periphery of the distal end lies in a plane that may be generally perpendicular to the longitudinal axis, such that the first guide cavity is generally perpendicular to the first guide cavity.

[0026] In some embodiments, the graft further includes a second guide cavity disposed along the tubular body. In some embodiments, at least a first guide cavity is disposed within the tubular body. In other embodiments, the graft includes an electrospun material.

[0027] In some embodiments, the length of the outer periphery of the distal end of the tube is between about 15 mm and about 30 mm. In some embodiments, the graft is sized to fit through a cannula and an incision between about 5 mm and about 8 mm in length. In other embodiments, the graft comprises a biocompatible material.

[0028] In some embodiments, the graft further includes a second guide cavity arranged along the outer periphery of the distal end of the tubular body. In some embodiments, the first guide cavity extends along a first segment of the outer periphery of the distal end of the tubular body, and the second guide cavity extends along a second segment of the outer periphery of the distal end of the tubular body.

[0029] In other embodiments, the graft further includes a return cavity arranged along the periphery of the proximal end of the tubular body. In some embodiments, the suture includes a continuous suture secured to the implantation site at least at a first location along its length and at least at a second location along its length. In some embodiments, the suture includes a first material segment and a second material segment, the first material segment secured to the implantation site at a first location and the second material segment secured to the implantation site at a second location. In other embodiments, the first and second material segments are configured to be tied together. In some embodiments, the graft is configured to be secured to the implantation site at both the first and second locations. In some embodiments, the suture is a sliding suture.

[0030] Details of one or more variations of the subject matter described herein are set forth in the accompanying drawings and the description below. Other features and advantages of the subject matter described herein will be apparent from the description and drawings and from the claims. Attached Figure Description

[0031] The accompanying drawings, which are incorporated in and form part of this specification, illustrate certain aspects of the subject matter disclosed herein and, together with the description, help to explain some principles associated with the disclosed embodiments. In the drawings, FIG. 1A and FIG. 1B An exemplary embodiment of a graft with four sides is shown, the graft being used for arthroscopic insertion into an implantation site in a patient; FIG. 1C An exemplary embodiment of a graft with three sides is shown, the graft being used for arthroscopic insertion into an implantation site in a patient; FIG. 2A to FIG. 2D The image shows the implantation site where the graft is inserted into the patient's body; FIG. 3 An exemplary method for inserting a graft according to the implementation scheme described herein is described; FIG. 4A and FIG. 4B Additional exemplary embodiments of a graft for insertion into an implantation site within a patient's body are shown; FIG. 5 An exemplary apparatus is shown for filling a cavity through an exemplary graft; FIG. 6A to FIG. 6L An anatomical site for inserting an exemplary graft into a patient is shown according to an embodiment described herein; FIG. 7A to FIG. 7C An exemplary graft with a fourth cavity is shown for removal from an anatomical site.

[0032] Where applicable, similar reference numerals in drawings indicate similar structures, features, or elements. Detailed Implementation

[0033] This article describes several implementation schemes and related methods for grafts configured for arthroscopic insertion into a patient. Such grafts can be used to promote inward tendon ingrowth into the bone, for example, in the repair of rotator cuffs.

[0034] This disclosure describes several embodiments of grafts with a cavity geometry configured to facilitate graft compression during graft placement into the patient by guiding tension applied to the graft by sutures. The cavity geometries described herein also avoid the need for additional guides, as they allow the graft to be directly guided into the implantation site within the patient by traveling along the sutures as the physician pulls on them. Therefore, the geometries of grafts as described herein simplify graft placement into the patient. As used herein, the term “cavity” describes a hole or annular hole that can be configured to receive sutures or any mechanism to guide, advance / shuttle, remove, fix, and compress the graft to, from, or at the implantation site. Furthermore, the term "graft" describes any device, including but not limited to sponges, scaffolds, and meshes, that can be configured for implantation into a patient and, after implantation, enhances the strength, healing, and / or regeneration of the native tissue. The grafts described herein can be configured to deliver a healing agent to the implantation site, thereby enhancing the strength, healing, and / or regeneration of the native tissue after implantation.

[0035] The cavity geometry also facilitates graft fixation and implantation at the implantation site. Once implanted, the geometry described herein ensures that, once the graft is removed from the body, the tension applied to the graft by the sutures causes it to spread at the implantation site in the desired manner. Additionally, the described geometry helps compress the graft against the native tissue at the implantation site and facilitates this compression while avoiding point fixation and bulging of the implanted graft. By ensuring multidimensional tension across the graft distribution during implantation, the described cavity and graft geometry contribute to ensuring graft durability.

[0036] The cavity and graft geometry described herein allows for the use of the same sutures to guide and secure the graft to the implantation site. Therefore, the described geometry eliminates the need for additional guides for graft guidance and removes any potential foreign bodies (e.g., staples) that would otherwise be used to secure the graft to the implantation site. Consequently, the graft described herein results in improved ease of guidance and implantation, while also improving patient outcomes.

[0037] This disclosure further describes several embodiments of a method for arthroscopically guiding a graft to an implantation site within a patient. The methods described herein allow for graft guidance using only one or more sutures, which are also used to secure the graft to the implantation site, without the need for an additional guide.

[0038] Now for reference FIG. 1A This illustrates a graft 100 according to an embodiment described herein. The graft 100 includes a generally flat portion 102 defined by at least a first edge 104, a second edge 106, and a third edge 108. A first guide cavity 110 is arranged along a portion of the first edge 104. A second guide cavity 112 is arranged along at least a portion of the second edge 106. A guide cavity 114 is arranged along at least a portion of the third edge 108. Each of the first guide cavity 110, the second guide cavity 112, and the guide cavity 114 is configured to receive a suture 116. As described below... FIG. 6A to FIG. 6LFurther described, suture 116 may include a single suture or at least two sutures. Third edge 108 is generally perpendicular to first edge 104 and second edge 106, such that guide cavity 114 is generally perpendicular to first guide cavity 110 and second guide cavity 112. As described herein, each of the first guide cavity 110, second guide cavity 112, and guide cavity 114 facilitates the guidance of graft 100 to the implantation site by directing graft 100 to an appropriate location within the patient's body. Additionally, each of the first guide cavity 110, second guide cavity 112, and guide cavity 114 is configured to assist in opening graft 100 at the implantation site after it has been guided to the implantation site. As described herein, each of the first guide cavity 110, second guide cavity 112, and guide cavity 114 is configured to compress graft 100 against the implantation site during implantation.

[0039] like FIG. 1A As shown, in some embodiments, the first guide cavity 110 is arranged along the entire length L1 of the first edge 104, the second guide cavity 112 is arranged along the entire length L2 of the second edge 106, and the guide cavity 114 is arranged along the entire length L3 of the third edge 108.

[0040] In some implementations... FIG. 1A The graft 100 further includes a fourth edge 113, along a portion of which a return cavity 115 is disposed. The return cavity 115 can be used to remove the graft 100 from the implantation site, as shown below with reference to Figure 2 and FIG. 6A to FIG. 6L Further described. Additionally, when the graft 100 is secured at the implantation site, each of cavities 110, 112, 114, and 115 provides a way to compress the graft onto the native tissue at the implantation site.

[0041] Now for reference FIG. 1B This illustration shows a graft 130 according to an embodiment described herein. The graft 130 includes a generally flat portion 102 defined by at least a first edge 104, a second edge 106, and a third edge 108. A first guide cavity 110 is disposed along a portion of the first edge 104. A second guide cavity 112 is disposed along at least a portion of the second edge 106. A guide cavity 114 is disposed along at least a portion of the third edge 108. Each of the first guide cavity 110, the second guide cavity 112, and the guide cavity 114 is configured to receive a suture 116. The third edge 108 is generally perpendicular to the first edge 104 and the second edge 106, such that the guide cavity 114 is generally perpendicular to the first guide cavity 110 and the second guide cavity 112. The graft 130 further includes a fourth edge 113.

[0042] like FIG. 1BAs shown, in some embodiments, a first guide cavity 110 is arranged along a portion of the length L1 of a first edge 104, a second guide cavity 112 is arranged along a portion of the length L2 of a second edge 106, and a guide cavity 114 is arranged along a portion of the length L3 of a third edge 108. In some embodiments, the portion of the length L1 of the first edge 104 where the first guide cavity 110 is arranged may be between approximately 50% and 100% of the length L1 of the first edge 104. In other embodiments, the portion of the length L2 of the second edge 106 where the second guide cavity 112 is arranged may be between approximately 50% and 100% of the length L2 of the second edge 106. In other embodiments, the portion of the length L3 of the third edge 108 where the guide cavity 114 is arranged may be between approximately 50% and 100% of the length L3 of the third edge 108.

[0043] exist FIG. 1A and FIG. 1B In the described embodiment, the third edge 108 is the distal edge of graft 100 and graft 130 such that the guide cavity 114 is arranged along the distal edge 108 of graft 100 (e.g., along the entire length L3) and along the distal edge 108 of graft 130 (e.g., along a portion of the length L3).

[0044] Typically, each of the first guide cavity 110, the second guide cavity 112, and the guide cavity 114 (“cavities 110, 112, 114”) may be arranged along any suitable portion of the lengths L1, L2, and L3 of the first edge 104, the second edge 106, and the third edge 108 (“edges 104, 106, 108”), respectively. A portion of the lengths L1, L2, L3 of the respective first edge 104, second edge 106, and third edge 108 where the cavities 110, 112, and 114 are arranged may be selected based on the surgical procedure intended to use graft 100 or graft 130.

[0045] By configuring each of the cavities 110, 112, 114 to be arranged along specific portions of lengths L1, L2, L3 of the respective edges 104, 106, 108, the force applied to the graft 100 or graft 130 by the suture 116 can be controlled during the guidance of the graft 100 or graft 130 to the implantation site within the patient. By controlling these forces, the graft 100 or graft 130 can be configured to move from a first unfolded or flattened configuration to a compressed (i.e., rolled up or generally cylindrical) configuration to pass through the cannula and incision, and, upon pulling the suture 116, to move from the compressed configuration to a second unfolded or flattened configuration to secure it at the implantation site, as follows: FIG. 2A to FIG. 2DFurther described. The first unfolded or flattened structure of graft 100 or graft 130 may resemble the second unfolded or flattened structure of graft 100 or graft 130. Factors such as the implantation site, the material of the implantation site (i.e., tissue type), the incision size, and the severity of the injury to be treated by inserting graft 100 or graft 130 may require grafts with cavities of specific lengths L1, L2, and L3 relative to the edges 104, 106, and 108.

[0046] In some embodiments, the length L1 of the first edge 104 and the length L2 of the second edge 106 are between about 5 mm and about 90 mm. In some embodiments, the length L1 of the first edge 104 and the length L2 of the second edge 106 are between about 5 mm and about 60 mm. In other embodiments, the length L1 of the first edge 104 and the length L2 of the second edge 106 are between about 50 mm and about 90 mm. In other embodiments, the length L1 of the first edge 104 and the length L2 of the second edge 106 are between about 20 mm and about 50 mm. In some embodiments, the length L1 of the first edge and the length L2 of the second edge are between about 17 mm and about 23 mm. In some embodiments, the length L1 of the first edge and the length L2 of the second edge are about 20 mm. In other embodiments, the length L3 of the third edge 108 is between about 27 mm and about 33 mm. In some embodiments, the length L3 of the third edge 108 is about 30 mm. Typically, the size of the graft described herein is selected based on the surgical procedure intended to use the graft (e.g., rotational sleeve repair, Achilles tendon repair, anterior cruciate ligament (ACL) repair, etc.). In some embodiments, the length of any one of edges 104, 106, and 108 may be between about 5 mm and about 90 mm.

[0047] The relative lengths of cavities 110, 112, and 114 (i.e., the relative lengths of the portions L1, L2, and L3 where cavities 110, 112, and 114 are respectively arranged) can be similarly selected to control the force applied to graft 100 or 130 by suture 116 during the guidance and implantation of graft 100 or 130 into the patient. By controlling the force applied to graft 100 or 130 by suture 116 during guidance and implantation, graft 100 or 130 can be moved from a first unfolded or flattened configuration to a compressed (i.e., rolled-up or generally cylindrical) configuration to pass through the cannula and incision, and from the compressed configuration to a second unfolded or flattened configuration to secure it at the implantation site.

[0048] In some embodiments, the length of the guide cavity 114 may be at least 80% of the length of the first guide cavity 110 and the length of the second guide cavity 112. In some embodiments, the length of the guide cavity 114 may be at least 50% of the length of the first guide cavity 110 and the length of the second guide cavity 112. Typically, the guide cavity 114 may be configured to have a length of approximately 18 mm.

[0049] FIG. 1C A graft 150 is shown, including a first edge 104 and a second edge 106, which define a generally flat portion 102. Similar to... FIG. 1A and FIG. 1B The described graft, graft 150, includes a first guide cavity 110 arranged along a portion of a length L1 of a first edge 104, and a second guide cavity 112 arranged along a portion of a length L2 of a second edge 106. FIG. 1C As shown, the graft 150 includes a third edge 118. A guide cavity 120 can be arranged along a portion of the length L3 of the third edge 118. FIG. 1C In one embodiment, the third edge 118 is the proximal edge of the graft 150, such that the guiding cavity 120 is arranged along a portion of the length L3 of the proximal edge 118 of the graft 150. Typically, each of the cavities 110, 112, 114, and 120 may be arranged along any suitable portion of their respective edges and may be configured to be arranged at least abutting the corners of their respective edges. By arranging each of the cavities 110, 112, 114, and 120 abutting the corners of their respective edges, the graft described herein is configured to unfold upon implantation in a patient and to be anchored in place by their corners, as further described herein. In this way, each of the cavities 110, 112, 114, and 120 assists in guiding the graft 100 to the implantation site, unfolding the graft 100 at the implantation site, and compressing the graft 100 against the implantation site after unfolding.

[0050] FIG. 2A to FIG. 2D An embodiment is shown in which a graft 100 is inserted into an implantation site 101 within a patient's body. The graft 100 may be, for example... FIG. 1A to FIG. 1C 100, 130, or 150 grafts, or as further described below. FIG. 4A to FIG. 4B Either of grafts 170 and 180.

[0051] like FIG. 2A As shown, suture 116 is fixed to the implantation site 101 at the first position 127 and the second position 128. FIG. 2A to FIG. 2DAs shown in the exemplary embodiments, the suture 116 may have segments 122, 123, 124, and 125. The dashed lines at positions 127 and 128 indicate that the suture 116 is arranged at least partially along the tissue underside of the implantation site 101. The suture 116 is configured as a sliding suture so that when pulled by a physician, the suture 116 can move relative to its fixed implantation site 101, as described herein.

[0052] In some embodiments, suture 116 comprises at least two material segments (e.g., segments 122 and 123 of suture 116 are formed by a first continuous material segment, and segments 124 and 125 of suture 116 are formed by a second continuous material segment). In some embodiments, suture 116 is a continuous suture (i.e., each of segments 122, 123, 124, and 125 of suture 116 is formed by the same, continuous material segment). As described below with reference to FIG6, in embodiments where suture 116 is a continuous suture, graft 100 may still be configured to receive at least two segments of suture material during guidance of graft 100 to implantation site 101, which may then be tied together and pulled through cavities 110, 112, and 114 of graft 100 such that the continuous material segment comprising segments 122 and 123 of suture 116 extends through the cavity of graft 100 during implantation.

[0053] like FIG. 2B As shown, a graft 100 having a generally flat portion 102 is configured to receive sutures 116. Each of the segments 122, 123, 124, and 125 of the suture 116 is configured to assist in guiding and securing the graft 100 to the implantation site 101. As further described below, fusiforming appropriate segments 122, 123, 124, and 125 through cavities 110, 112, 114, and 115 allows the physician to guide the graft 100 to the implantation site 101.

[0054] In an embodiment where the suture 116 includes a first material segment and a second material segment, the first material segment including segments 122 and 123 of the suture 116 is configured to be secured to the implantation site 101 at a first position 127, and the second material segment including segments 124 and 125 of the suture 116 is configured to be secured to the implantation site 101 at a second position 128. When segments 122 and 125 of the suture 116 are pulled proximally by an operator, securing the suture 116 to the first position 127 and the second position 128 provides pulling resistance. This resistance, when the suture 116 is pulled, causes the graft 100 to travel in a direction away from the operator, entering the patient and reaching the implantation site 101.

[0055] like FIG. 2CAs further shown, when the suture 116 is pulled a first amount proximally toward the operator (as indicated by the arrow), the graft 100 is configured to move from the first flat structure to the compression structure. FIG. 2C As shown, a compression structure can be a structure in which each side of the graft 100 bends inward toward the center of the flat portion 102 in the plane defined by the flat portion 102. For example, a compression structure of the graft 100 can be a structure in which the graft 100 is rolled into a cylindrical shape along the longitudinal axis or central axis of the flat portion 102. For example, a compression structure of the graft 100 can be a structure in which the graft 100 is rolled into a C-shape along the longitudinal axis or central axis of the flat portion 102. For example, a compression structure of the graft 100 can be a structure in which the graft 100 is rolled into a C-shape while each side of the graft 100 is also bent inward toward the center of the flat portion 102 in the plane defined by the flat portion 102. FIG. 2C As further shown, in its compressed configuration, the graft 100 is sized to fit through the cannula 126. The cannula 126 is positioned within an incision in the patient's body. In some embodiments, the graft 100 is sized to fit the cannula 126, which is positioned within an incision of approximately 5 mm to approximately 8 mm in length. Typically, any suitable arthroscopic portal leading to the implantation site 101 can be used. In some embodiments, the graft 100 may be sized to fit the cannula 126 with a diameter between approximately 2.5 mm and approximately 15 mm. In some embodiments, the graft 100 may be sized to fit the cannula 126 with a diameter between approximately 5 mm and approximately 10 mm. The cannula 126 may include a retractable fluid baffle to prevent fluid leakage from the patient's body during insertion of the graft 100 into the implantation site 101. In some embodiments, the cannula 126 may be used in conjunction with a graft compressor to guide the graft 100 to the implantation site 101. The graft compressor helps compress the graft 100 to pass through the fluid baffle of the cannula (such as cannula 126).

[0056] Then as FIG. 2D As shown, when the suture 116 is pulled a second amount proximally toward the operator (as indicated by the arrow), the graft 100 is configured to move from the compression configuration to the second flat configuration. The first flat configuration may resemble the second flat configuration. As discussed above, the relative lengths of cavities 110, 112, and 114 can be configured to ensure that the graft 100 can withstand the multidirectional tensions exerted on the graft 100 by the suture 116 after implantation. Overall, increasing the lengths of cavities 110, 112, and 114 facilitates the movement of the graft 100 from the compression configuration to the second flat configuration, and subsequently the fixation of the graft at the implantation site 101. Although FIG. 2DThe graft 100 is shown to be secured to the implantation site 101 at two corners. In general, the locations 127 and 128 and the cavity geometry of the graft 100 can be selected to secure the graft 100 to the implantation site 101 by means of any suitable portion of the graft.

[0057] FIG. 3 An exemplary method 300 is illustrated for arthroscopically inserting a graft into an implantation site within a patient. The graft inserted into the patient according to method 300 may be... FIG. 1A to FIG. 1C , FIG. 2A to FIG. 2D and FIG. 4A to FIG. 4B The graft in method 300 comprises any one of 100, 130, 150, 170, or 180. The graft of method 300 includes a generally flat portion defined by at least a first edge, a second edge, and a third edge. The graft of method 300 further includes a first guide cavity disposed along the first edge, a second guide cavity disposed along the second edge, and a guide cavity disposed along the third edge, each of the first guide cavity, the second guide cavity, and the guide cavity being configured to receive a suture. In some embodiments, the third edge of the graft of method 300 is generally perpendicular to the first and second edges of the graft of method 300, such that the guide cavity is generally perpendicular to the first and second guide cavities. The suture of method 300 may be, for example... FIG. 1A to FIG. 1C and FIG. 2A to FIG. 2D The suture 116 of any of the above. The suture of method 300 may be a sliding suture, as described above, so that when the physician pulls on a segment of the suture, the suture of method 300 may move relative to the implantation site, as described herein.

[0058] In some embodiments, the method includes the following step 302: placing a suture in a first guide cavity, a second guide cavity, and a guide cavity of the graft, fixing the suture to the implantation site at least at a first position along the length of the suture and at least at a second position along the length of the suture to the implantation site.

[0059] In some embodiments, the method further includes step 304: pulling the suture to allow the graft to travel along the suture and through the incision to reach the implantation site. As described above... FIG. 2A to FIG. 2DAs described herein, when an exemplary graft according to the embodiments described herein travels along the suture and through the incision to reach the implantation site, the graft is configured to move from a first flat configuration to a compression configuration to pass through the cannula and incision. The graft is then configured to unfold from the compression configuration to a second flat configuration for implantation at the implantation site. Once in the second flat configuration, the cavity geometry facilitates compression of the graft against the native tissue at the implantation site. The cavity geometry provides this compression while avoiding point fixation of the graft at the implantation site and preventing the graft from shrinking or bulging after implantation. The embodiments described herein improve graft durability and improve patient outcomes.

[0060] As described above, method 300 is performed using any of the exemplary grafts 100, 130, or 150 to facilitate graft delivery to the patient without the need for an additional guide. Grafts 100, 130, and 150 have a cavity geometry configured to direct the force generated by the pulling suture 116 onto the graft, causing the graft to move from a first flat configuration to a compressed configuration for passage through a cannula and incision, and then to a second flat configuration for implantation at the implantation site. The cavity geometry described herein also ensures that the graft can withstand the tension exerted on it by the sutures after delivery to the implantation site by method 300, during graft implantation and use, when the graft is subject to the sutures.

[0061] FIG. 4A An exemplary graft 170 according to an embodiment as described herein is shown. FIG. 4A A graft 170 with guide cavities 110 and 112 is shown, as described above. FIG. 1A to FIG. 1C As described. FIG. 4A As shown, the first guide cavity 110 may include a first cavity segment 110a, which is spaced apart from the second cavity segment 110b by a first interval distance, and / or the second guide cavity 112 may include a third cavity segment 112a, which is spaced apart from the fourth cavity segment 112b by a second interval distance. For example, the first interval distance and the second interval distance may be the same or different in length, and this length may be from about 1 millimeter (mm) to about 5 mm. Other lengths are within the scope of this disclosure. Generally, any one of the guide cavities 110 and 112 and the guide cavity 114 may be divided into any suitable number of segments and may be spaced apart by any suitable size interval distance. Each cavity segment of each of the guide cavities 110 and 112 and the guide cavity 114 may be arranged close to the corner of the graft 170 so that the graft 170 can be opened and anchored to the implantation site at its corner, as per [the description of the guide cavity 114]. FIG. 6A to FIG. 6L Further description.

[0062] FIG. 4BAn exemplary graft 180 according to the implementation described herein is shown. FIG. 4B The graft 180 includes a tubular body 182 having a distal end 184 and a proximal end 185. The distal end 184 of the tubular body 182 of the graft 180 includes a periphery 186 having a guide cavity 188 configured to receive sutures, such as... FIG. 1A to FIG. 1C The suture 116. The suture 116 can be used to guide the graft 180 into the implantation site 101, as per [the instructions / requirements]. FIG. 1A to FIG. 1C , FIG. 2A to FIG. 2D ,as well as FIG. 6A to FIG. 6L As described.

[0063] The outer periphery 186 of the tubular body 182 may include any number of guide cavities 188 arranged circumferentially thereon. Each guide cavity 188 may be spaced at any suitable interval along the outer periphery 186 of the tubular body 182 of the graft 180. FIG. 4B The graft 180 may include at least a first guide cavity 110, and may include two guide cavities 110 and 112, as described above. FIG. 1A to FIG. 1C As described. Each of the first and second guide cavities 188 extends along a corresponding segment of the outer periphery 186 of the distal end 184 of the tubular body 182 of the graft 180. For example, the first guide cavity 188 may extend along a first segment of the outer periphery 186 of the distal end 184 of the tubular body 182 of the graft 180, and the second guide cavity 188 may extend along a second segment of the outer periphery 186 of the distal end 184 of the tubular body 182 of the graft 180. The length of the outer periphery 186 of the tubular body 182 may be between about 15 mm and about 30 mm. In some embodiments, the length of the tubular body 182 may be between about 5 mm and 150 mm. In some embodiments, the length of the tubular body 182 may be between about 20 mm and 130 mm. In some embodiments, the length of the tubular body 182 may be between about 40 mm and 110 mm. In some embodiments, the length of the tubular body 182 may be between about 60 mm and 90 mm. In some embodiments, the length of the tubular body 182 may be approximately 75 millimeters.

[0064] The outer periphery 186 of the tubular body 182 may be configured to lie in a plane perpendicular to the central axis of the tubular body 182. In this manner, as described herein according to other embodiments, the guide cavity 188 of the graft 180 is arranged perpendicular to the guide cavities 110 and 112. The tubular body 182 may include a sleeve that itself serves as the guide cavity 110, or the tubular body 182 may define a sleeve in which any number of guide cavities 110 and 112 may be arranged to allow sutures of one or more lengths to extend through, thereby assisting in the positioning and securing of the graft 180 to the implantation site within the patient. The guide cavity 110 of the tubular body 182 may be configured to receive a suture 116 of a single length. The guide cavity 110 of the tubular body 182 may also be configured to receive sutures 116 of more than one length (e.g., two lengths) passing through. One or more sutures 116 received by the guide cavity 110 of the tubular body 182 are used to guide, advance, and position the tubular body 182 of the graft 180 to the implantation site in the patient's body, as described herein. The one or more sutures 116 received by the guide cavity 110 of the tubular body 182 may be sliding sutures, as described above, so that they can move relative to the implantation site when pulled by a physician, as described herein. In some embodiments, FIG. 4B The graft 180 may have a return cavity (e.g., return cavity 115) arranged peripherally along its proximal end. As described herein, the return cavity may be configured to receive sutures, and a physician may use the return cavity to assist in positioning the graft (such as, FIG. 4B The graft 180 was removed from the implantation site.

[0065] Tubular grafts (such as, FIG. 4B The graft 180) requires the physician to ensure that the distal end 184 of the tubular body 182 of the graft 180 and the implantation site (such as, FIG. 2A to FIG. 2D This can be particularly useful for surgeries where the implantation sites (101) are closely fitted together. In some implementations, FIG. 4B The graft 180 may be a generally hollow cylinder, which is packaged for use with a needle arranged below the central axis of the tubular body 182. In this embodiment, the needle may have a suture shuttle or a device for joining sutures at its distal end, and the sutures may be drawn through the tubular body 182 of the graft 180 to create a guide cavity 110 when the physician pulls the needle proximally.

[0066] FIG. 1A to FIG. 1C and FIG. 4A to FIG. 4BThe grafts 100, 130, 150, 170, and 180 may include electrospun materials. The electrospun materials are configured to withstand multidirectional tension, which the graft is subjected to when implanted in the patient, thereby increasing the durability and lifespan of the graft. FIG. 1A to FIG. 1C and FIG. 4A to FIG. 4B The grafts 100, 130, 150, 170 and 180 may further include biocompatible materials. FIG. 1A to FIG. 1C and FIG. 4A to FIG. 4B The grafts 100, 130, 150, 170 and 180 may further include allografts. FIG. 1A to FIG. 1C and FIG. 4A to FIG. 4B The grafts 100, 130, 150, 170 and 180 may further include scaffolds, meshes or sponges.

[0067] FIG. 5 An exemplary package of the graft described in the embodiments herein is shown. FIG. 5 The graft 100 can be FIG. 1A to FIG. 1C and FIG. 4A to FIG. 4B Any one of the following grafts: 100, 130, 150, 170, or 180. For example... FIG. 5 As shown, the graft 100 can be packaged via a fork 502 having tips 504 and 506. FIG. 5 The graft 100 can be packaged in the cavity 110 of the graft 100 by a tip 504, and in the cavity 112 of the graft 100 by a tip 506. FIG. 5 The cavity 110 of the graft 100 can be, for example, the first guide cavity 110 of FIG1. FIG. 5 The cavity 112 of the graft 100 can be, for example, the second guide cavity 112 of FIG. 1. As shown, the tips 504 and 506 are grooved to allow sutures (such as suture 116 of FIG. 1) to be easily inserted into and removed from cavities 110 and 112. After the sutures have been inserted into cavities 110 and 112, a physician can hold the proximal end of the fork 502 to remove the fork 502 from the graft 100, as described herein. The use of the fork 502 in the packaging of the exemplary graft 100 is anchor and suture agnostic: it can be used to package the graft 100 regardless of the anchor ultimately used to secure the graft 100 to the implantation site within the patient (e.g., if the graft 100 is directly secured to the implantation site 101 by means of suture 116, and / or if the graft 100 is secured to the bone by a bone anchor), and can be used to insert any suture 116 through cavities 110 and 112.

[0068] FIG. 6A to FIG. 6LAn example of inserting the exemplary graft 100 described herein into an implantation site 101 in a patient is shown. FIG. 6A to FIG. 6L The graft 100 can be any of the exemplary grafts 100, 130 and 150 as described above. FIG. 6A to FIG. 6L The graft includes a generally flat portion 102 defined by at least a first edge 104, a second edge 106, and a third edge 108. A first guide cavity 110 is arranged along a portion of the first edge 104. A second guide cavity 112 is arranged along at least a portion of the second edge 106. A guide cavity 114 is arranged along at least a portion of the third edge 108. Each of the first guide cavity 110, the second guide cavity 112, and the guide cavity 114 is configured to receive a suture 116. The third edge 108 is generally perpendicular to the first edge 104 and the second edge 106, such that the guide cavity 114 is generally perpendicular to the first guide cavity 110 and the second guide cavity 112.

[0069] exist FIG. 6A to FIG. 6L In one implementation, suture 116 includes two sutures 116a and 116b. FIG. 6A In this embodiment, sutures 116a and 116b are secured to the implantation site 101 within the patient. Suture 116a includes segments 122 and 123. Suture 116b includes segments 124 and 125. Sutures 116a and 116b can be secured to the implantation site 101 at corresponding locations, and corners of the graft can be configured to be positioned at said corresponding locations. Although in FIG. 6A to FIG. 6L The document outlines a series of specific steps for inserting the graft 100, but as long as the graft 100 can slide along the sutures 116a and 116b when the physician pulls on the segments of the sutures, the sutures 116a and 116b can be inserted into the cavity of the graft 100 in any suitable manner as described herein.

[0070] like FIG. 6B As shown, the device 606 is configured to be inserted through the first guide cavity 110 of the graft 100 in order to secure the segment 122 of the suture 116a. FIG. 6B The device 606 may be, for example, a loop, or any other device or material configured to secure the suture (such as suture 116a).

[0071] FIG. 6C An example is illustrated where the device 606 can be pulled proximally by a physician, thereby drawing the suture 116a through the first guide cavity 110 of the graft 100. FIG. 6D In the middle, device 606 (can be FIG. 6C The same device 606 is similarly inserted through the guide cavity 114 of the graft 100. FIG. 6E The portion 123 of the device 606 that secures the seam 116a is shown, and FIG. 6FThe diagram shows that by pulling the device 606 through the guide cavity 114 of the graft 100, the suture 116a is pulled through the guide cavity 114.

[0072] FIG. 6G The diagram shows a segment 123 of suture 116a tied to a segment 124 of suture 116b. The physician inserting the graft 100 into the implantation site 101 can selectively pull a segment 125 of suture 116b so that suture 116b is completely pulled outside the implantation site 101, and the knot formed by tying sutures 116a and 116b together is pulled through the insertion site of suture 116b; or the physician can keep suture 116b detached.

[0073] FIG. 6A to FIG. 6L The sutures 116a and 116b can be sliding sutures, allowing them to move relative to the implantation site 101 when pulled by the physician. FIG. 6H In the image, it can be seen that with the help of a doctor, suture 116b is completely pulled beyond the implantation site 101, and suture 116a has been pulled through the insertion site initially occupied by suture 116b. FIG. 6I In this process, device 606 is inserted into the second guide cavity 112, and the section 125 of the sewing thread 116b is secured. FIG. 6J In the middle, the doctor pulls the device 606 so that the suture 116b is pulled through the second guide cavity 112. FIG. 6K During the procedure, the doctor pulls on segments 122 and 123 of suture 116a to move the graft 100 toward the implantation site 101. As described above... FIG. 2A to FIG. 2D As discussed, when the graft 100 shuttles through the cannula toward the implantation site 101, the graft 100 moves from the first flat structure (such as...) FIG. 6A to FIG. 6K (As shown) Move to the compression structure (to pass through the sleeve, as above according to) FIG. 2A to FIG. 2D (As described) Move to the second flat structure. FIG. 6L A graft 100 is shown positioned at the implantation site 101 with a second flat configuration. Once the graft 100 is removed from the body, tension on the transverse anchors provided by sutures 116a and 116b helps keep the graft 100 open and implanted with a flat configuration. As described above, the tension on the transverse anchors provided by sutures 116a and 116b also helps to compress the graft against the native tissue after implantation, while avoiding point fixation of the graft to the tissue and preventing the graft from bulging or shrinking during implantation. Therefore, the cavity geometry described herein improves patch durability and patient outcomes.

[0074] Segments 122 and 123 of suture 116a can be anchored in any suitable manner, including anchoring within tissue or hard bone. In general, embodiments of the grafts (such as graft 180) described herein, and / or certain procedures using exemplary suture grafts, may not require the graft to be arranged in a flattened configuration, but can achieve a flattened configuration of the graft as needed.

[0075] like FIG. 7A As shown, in some embodiments, the graft 100 has an optional fourth return cavity, such as FIG. 1A The device 606 is insertable into the cavity 115 to remove the graft 100 from the implantation site 101 or to help change the position of the graft 100 at the implantation site 101, and can be used to secure the suture inserted into the cavity 115. The suture inserted into the cavity 115 can be a new suture that was not previously used to insert the graft 100 into the implantation site 101, or it can be a segment 125 of suture 116b. FIG. 7B As shown, the device 606 is pulled through the cavity 115 so that a segment 125 of the suture 116b is pulled through the cavity 115. FIG. 7C As shown, by pulling on section 125 of suture 116b, the graft 100 is moved backward along suture 116a (in an embodiment using discontinuous sutures, a new suture may be pulled through cavity 115 to cause the said backward movement along suture 116b).

[0076] Advantageously, the arthroscopic graft insertion system and method described herein allow for the easy insertion of grafts capable of withstanding multidimensional tension into the patient. This easy insertion is achieved through the special construction of guide cavities and pilot cavities, as described herein. These cavity constructions eliminate the need for cumbersome guides and simplify the guidance and implantation of the graft into the patient, while easily securing the graft to the final implantation site by controlling the multidirectional tension exerted on the graft by the sutures.

[0077] Although this disclosure is described in relation to grafts for the treatment of rotational sleeves, the systems and methods described herein are applicable to any medical or therapeutic device that utilizes implantable grafts.

[0078] In the foregoing description and claims, terms such as “at least one of” or “one or more of” may appear after consecutively listed elements or features, and the term “and / or” may also appear in two or more listed elements or features. Unless the context implies or explicitly objects, such terms as used above and below are intended to mean any one of the listed elements or features, or any combination of the listed elements or features with any of the other listed elements or features. For example, the terms “at least one of A and B;”, “one or more of A and B;”, and “A and / or B” are each intended to mean “A only, B only, or A and B together.” Similar interpretations may also be used for lists comprising three or more items. For example, the terms “at least one of A, B, and C;”, “one or more of A, B, and C;”, and “A, B, and / or C” are each intended to mean “A only, B only, C only, A and B together, A and C together, B and C together, or A and B and C together.” The use of the term "based on" in the above and claims is intended to mean "at least partially based on" so that unlisted features or elements are equally permissible.

[0079] The embodiments listed in the foregoing description do not represent all embodiments consistent with the subject matter described herein. Instead, they are merely some embodiments consistent with aspects related to the described subject matter. Although several variations have been described in detail herein, other modifications or combinations are possible. In particular, other features and / or variations may be provided in addition to those listed herein. For example, the embodiments described above may involve multiple combinations and sub-combinations of the disclosed features, and / or combinations and sub-combinations of one or more features other than those disclosed herein. Furthermore, the logic flowcharts drawn in the accompanying drawings and / or described herein do not necessarily require the specific order or sequence shown to achieve the desired results. The scope of the following claims may include other embodiments or implementations.

Claims

1. A graft configured for arthroscopic insertion into an implantation site in a patient, the graft comprising: A generally flat portion defined by at least a first edge, a second edge, and a third edge; A first guide cavity is arranged along a portion of the first edge. A second guide cavity arranged along a portion of the second edge, and A guide cavity arranged along a portion of the third edge; Each of the first guide cavity, the second guide cavity, and the guide cavity is configured to receive a suture. The third edge is substantially perpendicular to the first edge and the second edge, such that the guide cavity is substantially perpendicular to the first guide cavity and the second guide cavity.

2. The graft of claim 1, wherein the third edge is the distal edge of the graft, such that the guide cavity is arranged along a portion of the distal edge of the graft.

3. The graft of claim 1, wherein the third edge is the proximal edge of the graft, such that the guide cavity is arranged along a portion of the proximal edge of the graft.

4. The graft according to claim 1, wherein: When the suture is pulled by the first amount, the graft is configured to move from the first flat structure to the compression structure, and When the suture is pulled a second amount, the graft is configured to move from the compressed structure to the second flat structure.

5. The graft according to claim 1, wherein the graft comprises an electrospun material.

6. The graft of claim 3, wherein the first edge and the second edge are approximately 20 mm long, and wherein the third edge is approximately 30 mm long.

7. The graft according to claim 4, wherein, In the compressed configuration, the graft is sized to fit through the cannula and an incision between approximately 5 mm and approximately 8 mm in length.

8. The graft of claim 1, wherein the graft comprises a biocompatible material.

9. The graft according to claim 1, wherein: A portion of the first edge is smaller than the length of the first edge. A portion of the second edge is smaller than the length of the second edge, and A portion of the third edge is less than the length of the third edge.

10. The graft according to claim 2, further comprising: Fourth edge; as well as A retraction cavity is arranged along a portion of the fourth edge.

11. The graft of claim 1, wherein the length of the guide cavity is at least 80% of the length of the first guide cavity and the length of the second guide cavity.

12. The graft of claim 1, wherein the length of the guide cavity is at least about 18 mm.

13. The graft of claim 1, wherein the suture comprises a continuous suture, the continuous suture being fixed to the implantation site at least at a first location along the length of the suture and at least at a second location along the length of the suture.

14. The graft of claim 1, wherein the suture comprises a first material segment and a second material segment, the first material segment being fixed to the implantation site at a first position, and the second material segment being fixed to the implantation site at a second position.

15. The graft of claim 14, wherein the first material segment and the second material segment are configured to be tied together.

16. The graft of claim 13, wherein the graft is configured to be fixed to the implantation site at the first and second locations.

17. The graft of claim 1, wherein at least one of the first guide cavity and the second guide cavity comprises a first cavity segment and a second cavity segment.

18. The graft of claim 1, wherein the suture is a sliding suture.

19. A method for arthroscopically inserting a graft into an implantation site in a patient, the graft comprising: A generally flat portion defined by at least a first edge, a second edge, and a third edge; The first guide cavity is arranged along the first edge. The second guide cavity arranged along the second edge, and The guide cavity is arranged along the third edge. Each of the first guide cavity, the second guide cavity, and the guide cavity is configured to receive a suture. The third edge is generally perpendicular to the first edge and the second edge, such that the guide cavity is generally perpendicular to the first guide cavity and the second guide cavity; The method includes: The suture is placed in the first guide cavity, the second guide cavity, and the guide cavity of the graft, and the suture is fixed to the implantation site at least at a first position along the length of the suture and at least at a second position along the length of the suture; Pull the suture so that the graft travels along the suture and through the incision to reach the implantation site.

20. The method of claim 19, wherein the third edge is the distal edge of the implant, such that the guide cavity is arranged along a portion of the distal edge of the implant.

21. The method of claim 19, wherein the third edge is the proximal edge of the implant, such that the guide cavity is arranged along a portion of the proximal edge of the implant.

22. The method of claim 19, further comprising: Pull the suture by an initial amount to move the graft from the first flat structure to the compressed structure; as well as The suture is pulled a second amount so that the graft moves from the compressed structure to the second flat structure.

23. The method of claim 19, wherein the graft comprises an electrospun material.

24. The method of claim 21, wherein the first edge and the second edge are approximately 20 mm long, and wherein the third edge is approximately 30 mm long.

25. The method according to claim 22, wherein, When compressed, the graft is sized to fit through the cannula and an incision between approximately 5 mm and approximately 8 mm in length.

26. The method of claim 19, wherein the graft comprises a biocompatible material.

27. The method of claim 19, wherein: A portion of the first edge is smaller than the length of the first edge. A portion of the second edge is smaller than the length of the second edge, and A portion of the third edge is less than the length of the third edge.

28. The method of claim 21, wherein the graft further comprises: Fourth edge; as well as A retraction cavity is arranged along a portion of the fourth edge.

29. The method of claim 19, wherein the length of the guide cavity is at least 80% of the length of the first guide cavity and the length of the second guide cavity.

30. The method of claim 19, wherein the length of the guide cavity is at least about 18 mm.

31. The method of claim 19, wherein the suture comprises a continuous suture, the continuous suture being fixed to the implantation site at least at a first location along the length of the suture and at least at a second location along the length of the suture.

32. The method of claim 19, wherein the suture comprises a first material segment and a second material segment, the first material segment being fixed to the implantation site at a first position, and the second material segment being fixed to the implantation site at a second position.

33. The method of claim 32, further comprising binding the first material segment and the second material segment together.

34. The method of claim 31, wherein the graft is configured to be fixed to the implantation site at the first and second locations.

35. The method of claim 19, wherein at least one of the first guide cavity and the second guide cavity comprises a first cavity segment and a second cavity segment.

36. The method of claim 19, wherein the suture comprises a sliding suture.

37. A kit for arthroscopically inserting a graft into an implantation site in a patient, the kit comprising: stitching; casing; as well as The graft, comprising: A generally flat portion defined by at least a first edge, a second edge, and a third edge; The first guide cavity is arranged along the first edge. The second guide cavity arranged along the second edge, and The guide cavity is arranged along the third edge. Each of the first guide cavity, the second guide cavity, and the guide cavity is configured to receive a suture; wherein The third edge is substantially perpendicular to the first edge and the second edge, such that the guide cavity is substantially perpendicular to the first guide cavity and the second guide cavity. The graft is configured to travel along the suture through the cannula to reach the implantation site.

38. A graft configured for arthroscopic insertion into an implantation site in a patient, the graft comprising: A generally tubular body defined along a longitudinal axis by at least a distal end and a proximal end; At least one first guide cavity arranged along the tubular body, and A first guide cavity is arranged along the outer periphery of the distal end; The first guide cavity and each of the first guide cavities are configured to receive sutures; The outer periphery of the distal end is located in a plane substantially perpendicular to the longitudinal axis, such that the first guide cavity is substantially perpendicular to the first guide cavity.

39. The graft of claim 38, further comprising a second guide cavity arranged along the tubular body.

40. The graft of claim 38, wherein at least the first guide cavity is disposed inside the tubular body.

41. The graft of claim 38, wherein the graft comprises an electrospun material.

42. The graft of claim 38, wherein the length of the outer periphery of the distal end of the generally tubular body is between about 15 mm and about 30 mm.

43. The graft of claim 38, wherein the graft is sized to fit through a cannula and an incision of about 5 mm and about 8 mm in length.

44. The graft of claim 38, wherein the graft comprises a biocompatible material.

45. The graft according to claim 38, further comprising: A second guide cavity is arranged along the outer periphery of the distal end of the tubular body, wherein: The first guide cavity extends along a first segment of the outer periphery of the distal end of the tubular body, and The second guide cavity extends along a second segment of the outer periphery of the distal end of the tubular body.

46. ​​The graft of claim 38, further comprising: A retraction cavity is arranged along the outer periphery of the proximal end of the tubular body.

47. The graft of claim 38, wherein the suture comprises a continuous suture, the continuous suture being fixed to the implantation site at least at a first location along the length of the suture and at least at a second location along the length of the suture.

48. The graft of claim 38, wherein the suture comprises a first material segment and a second material segment, the first material segment being fixed to the implantation site at a first position, and the second material segment being fixed to the implantation site at a second position.

49. The graft of claim 48, wherein the first material segment and the second material segment are configured to be tied together.

50. The graft of claim 48, wherein the graft is configured to be fixed to the implantation site at the first and second locations.

51. The graft of claim 38, wherein the suture is a sliding suture.

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