1568 results about "Ligament" patented technology

A replacement device for resurfacing a joint surface of a femur and a method of making and installing such a device is provided. The custom replacement device is designed to substantially fit the trochlear groove surface, of an individual femur. Thereby creating a "customized" replacement device for that individual femur and maintaining the original kinematics of the joint. The replacement device may be defined by four boundary points, and a first and a second surface. The first of four points is 3 to 5 mm from the point of attachment of the anterior cruciate ligament to the femur. The second point is near the bottom edge of the end of the natural articulatar cartilage. The third point is at the top ridge of the right condyle and the fourth point at the top ridge of the left condyle of the femur. The top surface is designed so as to maintain centrally directed tracking of the patella perpendicular to the plane established by the distal end of the femoral condyles and aligned with the center of the femoral head.

Apparatus and methods for conditioning and pre-tensioning soft tissue grafts during joint repair surgery, such as during repair of the anterior cruciate ligament (ACL). The inventive apparatus is advantageously adapted and configured so as to enable a surgeon to independently apply a desired tensile load to individual graft strands or graft bundles of a multi-strand tissue graft. The inventive methods enable each graft strand or bundle to be properly tensioned so as to both “condition” the graft to prevent subsequent stretching, relaxation or elongation following surgery, which can destabilize the joint, and to pre-tension each graft strand or bundle to a predetermined amount so that each contributes to the strength and stability of the joint, thus resulting in a stronger and more durable joint. The tensioning device is advantageously equipped with structure for attachment to a patient's limb during the conditioning and pre-tensioning procedure. It has multiple adjustable tension applicators that can be independently manipulated so as to apply a separate tensile load to one or more ends of a tissue graft strand attached to each adjustable tension applicator.

The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A filamentary loop is threaded through the femoral tunnel and tibial tunnel and partially through the transverse tunnel. A replacement graft is formed into a loop and moved into the tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

A soft tissue fixation system, most typically applicable to orthopedic joint repairs, such as anterior cruciate ligament (ACL) knee repair procedures, comprises an implant which is placeable in a tunnel disposed in a portion of bone, wherein the tunnel is defined by walls comprised of bone. A first member is deployable outwardly to engage the tunnel walls for anchoring the implant in place in the tunnel, and a second member is deployable outwardly to engage tissue material to be fixed within the tunnel. The second member also functions to move the tissue material outwardly into contact with the tunnel walls to promote tendon-bone fixation. Extra graft length is eliminated by compression of the tendon against the bone at the aperture of the femoral tunnel, which more closely replicates the native ACL and increases graft stiffness. The inventive device provides high fixation of tendon to bone and active tendon-bone compression. Graft strength has been found to be greater than 1,000 N (Newtons), which is desirable for ACL reconstruction systems.

Methods and devices are provided for replacing a spinal disc. In an exemplary embodiment, artificial disc replacements and methods are provided wherein at least a portion of a disc replacement can be implanted using a posterolateral approach. With a posterolateral approach, the spine is accessed more from the side of the spinal canal through an incision formed in the patient's back. A pathway is created from the incision to the disc space between adjacent vertebrae. Portions of the posterolateral annulus, and posterior lip of the vertebral body may be removed to access the disc space, leaving the remaining annulus and the anterior and posterior longitudinal ligaments in tact. The disc implant can be at least partially introduced using a posterolateral approach, yet it has a size that is sufficient to restore height to the adjacent vertebrae, and that is sufficient to maximize contact with the endplates of the adjacent vertebrae.

An apparatus and method for assembling a soft tissue reconstruction system having first and second anchor assemblies. The apparatus includes a base plate, a first mounting block mounted to the base plate and having a first reference surface against which the first anchor assembly is mountable, a second mounting block slidably mounted to the base plate and having a second reference surface against which a bone anchor of the second anchor assembly is mountable, a measurement bar extending from the second mounting block and slidable relative to the first mounting block, a support block slidably mounted to the measurement bar having a third reference surface for abutting against a tissue presentation surface of the second anchor assembly, and a tensioning device for tensioning a graft attached to the first anchor assembly. Indicia on the measurement bar indicate the proper locations of the reference surfaces and components mounted/abutted thereto.

An embodiment of the invention includes a surgical device for coagulating soft tissue such as atrial tissue in the treatment of atrial fibrillation, atrial flutter, and atrial tachycardia; tendon or ligament shrinkage; or articular cartilage removal. The surgical device integrates a suction mechanism with the coagulation mechanism improving the lesion creation capabilities of the device. The surgical device comprises an elongate member having an insulative covering attached about conductive elements capable of coagulating soft tissue when radiofrequency or direct current energy is transmitted to the conductive elements. Openings through the insulative covering expose regions of the conductive elements and are coupled to lumens in the elongate member which are routed to a vacuum source. Suction causes the soft tissue to actively engage the opening thus the integrated, exposed conductive elements to facilitate the coagulation process and ensure the lesions created are consistent, continuous, and transmural. The embodiments of the invention can also incorporate cooling mechanisms associated with the conductive elements and coupled to a fluid source to passively transport fluid along the contacted soft tissue surface to cool thus pushing the maximum temperature deeper into tissue.

A method for percutaneously removing ligamentum flavum tissue in a spine to treat spinal stenosis may involve percutaneously advancing a distal portion of a tissue removal cannula into the ligamentum flavum tissue, uncovering a side-opening aperture disposed on the distal portion of the cannula to expose a tissue cutter disposed in the cannula, and cutting ligamentum flavum tissue using the tissue cutter while the aperture is uncovered. A device for percutaneously removing ligamentum flavum tissue in a spine to treat spinal stenosis may include a cannula including a side-facing aperture, an aperture cover slidably coupled with the cannula and configured to advance and retract to cover and uncover the aperture, and a tissue cutter slidably disposed within the cannula and configured to extend through the aperture to cut ligamentum flavum tissue.

Dynamic knee balancing devices, systems and methods provide for enhanced total knee arthroplasty (“TKA”) procedures. Devices generally include a stationary femoral member for removably attaching to a distal femur and an adjustable femoral member coupled with the stationary member for adjusting ligament tension of the knee. The adjustable femoral member includes at least one positioning feature for providing positional and/or orientation information for facilitating the TKA procedure. Additionally, the adjustable femoral member is movably couplable with a tibial member engaged with the proximal tibia to allow movement of the knee through a range of motion without removing the device from the joint space. When the adjustable femoral member is adjusted, the positional feature(s) move relative to the distal femur to provide positional information.

A method and device for finding isometric points in the joints of mammals for use in surgical repair of a joint. Isometric points are first identified in radiographic or other two dimensional images and then located in the actual joint. A method for repairing a cruciate ligament-deficient canine stifle employing the method and device for finding isometric points is described. A method and apparatus for locating the axis of rotation of a joint is also described.

A method and device for the placement of sutures and for the purpose of approximating tissue. The invention relates to devices for approximation, ligation and fixation of tissue using a suture, to various constituent parts comprising said devices, and particularly to the placement of sutures into certain difficult to access ligamental structures, to the approximation of tissue separated by means of an endosurgical trocar being inserted into a body cavity, and to approximation, ligation, and fixation of body tissue using both traditional open surgical and endosurgical techniques and instruments. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off. The invention also provides for the placement of sutures for the endoscopic approximation, fixation, and ligation of tissues within a body cavity including the driving and retrieval of needle and suture combinations, and facilitating the tying of knots.

An expansible ear canal insert for treating TMJ disorders and headaches which acts directly on the TMJ and associated ligament and muscle structures to reduce stress and loads placed on the articulator disc located between the temporal bone and the mandible, as well as supportive muscles and ligaments near the TMJ. The insert is adapted to expand by application of body heat. In the expanded condition, the insert provides support to the TMJ and associated ligament and muscle structures.

Apparatus and methods for treating back pain of a patient by denervation of an intervertebral disc or a region of the posterior longitudinal ligament by the controlled application of heat to a target tissue. In one embodiment, the invention may include a procedure combining both decompression of a disc, and denervation of the annulus fibrosus. In one embodiment, a method of the invention includes positioning an active electrode of an electrosurgical instrument in at least close proximity to an intervertebral disc, and applying at least a first high frequency voltage between the active electrode and a return electrode, wherein nervous tissue within the annulus fibrosus is inactivated, and discogenic pain of the patient is alleviated. In one embodiment, the invention includes positioning a first electrode of a dual-shaft electrosurgical instrument at a first location in relation to a target disc, positioning a second electrode of the instrument at a second location, and applying a high frequency voltage between the first and second electrodes, wherein the first and second electrodes are disposed on separate shafts of the instrument.

Total prosthesis of a knee including a femoral element fitted with two condyles, a first of the condyles being external, a second of the condyles being internal, and a tibial plateau fitted with custom-made recesses to hold the condyles, wherein at least one of the condyles is integral on one of its sides with a convex cam ensuring posterior stability of the prosthesis. The tibial plateau has at least one track placed in the immediate vicinity of the recess holding the condyle integral with the cam, the at least one track being circumscribed by at least one curved abutment and at least one horizontal recess between posterior and anterior extremities of the tibial plateau. Provision is made between the condyles of the femoral element and the recesses of the tibial plateau for a free space and a notch for passage of a posterior cruciate ligament of a knee.

The equal tension applying device is used to apply equal tension to a group of tendons. The device comprises a 3 to 9 inch elongate flexible member and a hook at each end of the flexible member. Typically a torn ACL is replaced with two loops of tendons defining 4 tendon strands. The ends of each strand have sutures therein. The tendon loops are fixed in a femoral tunnel with a fixation pin and extend into and through a tibial tunnel. The method includes the steps of: tying the ends of the sutures together to form a loop, placing a hook of the elongate tensioning device over the suture loop, applying tension on the device, followed by anchoring the ends of the tendon strands to the tibia.