1610 results about "Ligament" patented technology

Devices formed of or including biocompatible polyhydroxyalkanoates are provided with controlled degradation rates, preferably less than one year under physiological conditions. Preferred devices include sutures, suture fasteners, meniscus repair devices, rivets, tacks, staples, screws (including interference screws), bone plates and bone plating systems, surgical mesh, repair patches, slings, cardiovascular patches, orthopedic pins (including bone filling augmentation material), adhesion barriers, stents, guided tissue repair / regeneration devices, articular cartilage repair devices, nerve guides, tendon repair devices, atrial septal defect repair devices, pericardial patches, bulking and filling agents, vein valves, bone marrow scaffolds, meniscus regeneration devices, ligament and tendon grafts, ocular cell implants, spinal fusion cages, skin substitutes, dural substitutes, bone graft substitutes, bone dowels, wound dressings, and hemostats. The polyhydroxyalkanoates can contain additives, be formed of mixtures of monomers or include pendant groups or modifications in their backbones, or can be chemically modified, all to alter the degradation rates. The polyhydroxyalkanoate compositions also provide favorable mechanical properties, biocompatibility, and degradation times within desirable time frames under physiological conditions.

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.

This invention relates to a method for repair of a ligament and / or tendon in a patient comprising applying a patch to said ligament or tendon, wherein the patch is flexible, and bio-compatible and comprises a support layer and a matrix layer.

An adjustable, knotless button / loop construct for fixation of ankle syndesmosis tibio-fibular diastasis and an associated method of ankle repair using the same. The knotless construct comprises a pair of buttons attached to a flexible, continuous, self-cinching, adjustable loop integrated with two splices that are interconnected. The knotless construct is passed through fibular and tibia tunnels and the buttons are secured on the cortical surfaces of tibia and fibula. One of the buttons (for example, an oblong button) is secured on the medial side of the tibia by passing the button and the flexible, adjustable loop though the fibular and tibia tunnels and then flipping and seating the button outside the tibia. The length of the flexible adjustable loop is adjusted so that the second button (for example, a round button) is appropriately secured on the lateral fibula.

A method is provided for performing a total knee arthroplasty. The method includes making a primary incision near a knee joint of a patient and resecting medial and lateral condyles of the femur of the leg to create at least one femoral cut surface. The resecting step is performed without dislocating the knee joint. The method also includes balancing various ligament tensions to obtain desired tension and moving a femoral component of a total knee implant through the primary incision. The method further includes positioning the femoral component with respect to the at least one femoral cut surface.

Implantable medical grafts fabricated of metallic or pseudometallic films of biocompatible materials having a plurality of microperforations passing through the film in a pattern that imparts fabric-like qualities to the graft or permits the geometric deformation of the graft. The implantable graft is preferably fabricated by vacuum deposition of metallic and / or pseudometallic materials into either single or multi-layered structures with the plurality of microperforations either being formed during deposition or after deposition by selective removal of sections of the deposited film. The implantable medical grafts are suitable for use as endoluminal or surgical grafts and may be used as vascular grafts, stent-grafts, skin grafts, shunts, bone grafts, surgical patches, non-vascular conduits, valvular leaflets, filters, occlusion membranes, artificial sphincters, tendons and ligaments.

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.

Disclosed is a device and method of bicompartmental arthroplasty of the knee. The device permits arthroplasty of the medial or lateral and patellofemoral compartments of the knee while leaving the opposite compartments and the anterior and posterior cruciate ligaments intact. The device provides a femoral prosthesis component that includes a trochlear surface and a tibial prosthesis component which can be secured to the tibia. The femoral component is essentially “u” shaped having an anterior leg upon which the trochlear surface is positioned and a posterior leg which engages the posterior surface of the distal end of the femur. The femoral component also has a convex articulating surface which engages a concave articulating surface of the tibial prosthesis component to approximate the articulation of a healthy knee.

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 graft fixation system for fixing graft material in a bone tunnel includes an expandable fixation member having a graft receiving eyelet disposed proximate its distal end, opposed bone engaging elements disposed about its periphery, and an expansion plug receiving opening defined in its proximal end. The system also includes an expansion plug having a diameter greater than the diameter of the expansion plug receiving opening so that forceable insertion of the expansion plug into the expansion plug receiving opening causes an expansion of the expandable fixation member driving the opposed bone engaging elements apart so as to fix the bone engaging elements, as well as the graft material, in a bone tunnel.

An integrated prosthetic assembly for implanting a prosthetic joint between two bones and including at least one ligament graft. The assembly includes a plurality of joint components, a plurality of base components, and at least one drill guide keyed to one of the base components at a predetermined angle for forming a predetermined tunnel in one of the bones.

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.

Disclosed is a device and method of bicompartmental arthroplasty of the knee. The device permits arthroplasty of the medial or lateral and patellofemoral compartments of the knee while leaving the opposite compartments and the anterior and posterior cruciate ligaments intact. The device provides a femoral prosthesis component that includes a trochlear surface and a tibial prosthesis component which can be secured to the tibia. The femoral component is essentially “u” shaped having an anterior leg upon which the trochlear surface is positioned and a posterior leg which engages the posterior surface of the distal end of the femur. The femoral component also has a convex articulating surface which engages a concave articulating surface of the tibial prosthesis component to approximate the articulation of a healthy knee. The patellar prosthesis is applied to the posterior surface of the patella and articulates with the trochlear exterior surface of the femur.

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.

A bioabsorbable implantable device for replacing sutures in construction of a composite graft in ligament replacement surgery. In certain embodiments the device has a female component and a male component where the female component receives and secures the male component. In other embodiments the components of the device are in the shape of a rivet or a staple. The bioabsorbable implantable devices can be used for securing tendon grafts to bone blocks and for holding together the fibers of the tendon graft when the bone-tendon-bone graft is inserted into a patient during surgery. The bioabsorbable implantable device may also be part of a package for use in surgery. The package includes a sterile container for holding at least a graft that is of a predetermined length and width. The package may also include bone blocks. The package is marked as to the graft size including the width and the length of the graft. The graft and the bone blocks may be autogenous, allogenic or constructed from man-made materials.

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

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 interspinous spacer comprising:a) a first brace having an upper throughhole and a lower throughhole,b) a second brace having an upper throughhole and a lower throughhole,c) a ligament having a first end and a second end,wherein the ligament extends from the upper throughhole of the first brace through the upper throughhole of the second brace.

A device and method to provide a surgically inserted internal tether between the femur and tibia is provided which will prevent distraction of the healing anterior cruciate ligament in all degrees of flexion and extension, at all times. The anterior cruciate ligament tether preserves the four-bar cruciate linkage, critical for normal knee mechanics. In addition, placement of the tether provides bleeding into the knee in the region of the anterior cruciate ligament attachment sites and the consequent inflow of pluripotential cells and healing mediators.

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.

An adjustable, knotless button / loop construct for fixation of ankle syndesmosis tibio-fibular diastasis and an associated method of ankle repair using the same. The knotless construct comprises a pair of buttons attached to a flexible, continuous, self-cinching, adjustable loop integrated with two splices that are interconnected. The knotless construct is passed through fibular and tibia tunnels and the buttons are secured on the cortical surfaces of tibia and fibula. One of the buttons (for example, an oblong button) is secured on the medial side of the tibia by passing the button and the flexible, adjustable loop though the fibular and tibia tunnels and then flipping and seating the button outside the tibia. The length of the flexible adjustable loop is adjusted so that the second button (for example, a round button) is appropriately secured on the lateral fibula.