220 results about "Rotator muscles" patented technology

A chain of loops of braided high strength suture for surgical applications. The suture chain is advantageous for use in knotless fixation of soft tissue to bone, and can be used for knotless side-to-side suturing of U-shaped defects, such as rotator cuff tears.

A chain of loops of braided high strength suture for surgical applications. The suture chain is advantageous for use in knotless fixation of soft tissue to bone, and can be used for knotless side-to-side suturing of U-shaped defects, such as rotator cuff tears.

A knotless suture anchor provides a method for securing soft tissue to a rigid structure such as bone. The anchor has an inner member that receives suture thread and rotates within an outer tubular member. As the inner member rotates, the suture thread is wrapped onto the inner member thereby increasing contact with the outer tubular member which applies pressure to the wrapped suture thread to retain it in position on the inner member while simultaneously and adjustably tensioning the suture thread. A ratchet prevents undesirable counter-rotation, although the ratchet can be released to permit loosening of the suture thread. Also described is a suture bridge and suture platform for providing further stabilization of a tendon. A method for repairing rotator cuff tears is also described.

A chain of loops of braided high strength suture for soft tissue to bone fixation. The suture chain is advantageous for use in knotless fixation of soft tissue to bone, and can be used for knotless side-to-side suturing of U-shaped defects, such as rotator cuff tears. The soft tissue to bone fixation includes: (i) providing a first medial row constructed with a first plurality of fixation devices, at least one of the first plurality of fixation devices being an anchor; (ii) providing a second lateral row constructed with a second plurality of fixation devices, at least one of the second plurality of fixation devices being a knotless fixation device, (iii) providing a suture loop construct that includes at least two loops formed of and connected by suture; and (iv) fixating the suture loop construct so that it extends over the soft tissue and is secured in place by at least one of the fixation devices or anchors.

The present invention provides a method and devices for shoulder replacement surgery that spares the rotator cuff. The method utilizes two anterosuperior passages to gain access to the glenohumeral joint, neither of which requires transaction of the rotator cuff. In addition a transhumeral portal created through the second anterosuperior passage for use as a working tunnel. Specialized instruments and implants are provided to work through both the anterosuperior passage as well as the transhumeral portal.

Devices, systems and methods for fixation of tendon to bone are described. An exemplary surgical implant is a modified bone anchor that is able to grasp the tendon and hold it firmly in a bone tunnel. Once deployed, the anchor delivers lateral compression to the tendon, providing direct tendon to bone compression to facilitate healing. The anchor has different versions which allow it to be attached to the tendon prior to insertion into the bone tunnel, or be inserted between tendon arms when the surgical procedure dictates. The resulting tendon to bone compression allows for the firm fixation in a manner markedly simpler than traditional techniques. A modification of this anchor can also allow the anchor to grasp and hold suture. This variation facilitates the technique for knotless rotator cuff repair.

A knotless tissue fixation (such as an arthroscopic rotator cuff repair) with a criss-cross suture pattern. The criss-cross pattern is obtained by (i) providing a first medial row constructed with a first plurality of fixation devices, at least one of the first plurality of fixation devices being an anchor; (ii) providing a second lateral row constructed with a second plurality of fixation devices, at least one of the second plurality of fixation devices being a knotless fixation device; and (iii) providing a structure formed of suture, suture chain, tape or allograft / biological component, and extending the structure in a criss-cross pattern, over the soft tissue, so that the structure is secured in place by the anchors.

The present invention provides compositions and methods for attaching tendon to bone. The present invention provides compositions and methods for treating rotator cuff injuries. In one embodiment, a method for treating rotator cuff injuries comprises providing a composition comprising PDGF disposed in a biocompatible matrix and applying the composition to at least one site of tendon reattachment on the humeral head.

In a first aspect the present invention provides a glenoid prosthesis assembly for use in shoulder joint arthroplasty to address conditions where deterioration of the rotator cuff mechanism of the shoulder joint is severe, the assembly comprising a first shell component to be affixed to a scapula by fixing means, and a smaller second component adapted to nest within the first component and having an articulation surface for articulating with a humeral head, the first component being over-sized relative to the glenoid surface of a scapula whereby the first component may be first affixed to at least two of the glenoid, acromion and coracoid processes of the scapula in use by the fixing means and the second component may be cemented in place within the first component allowing initial adjustability in the poise of the second component relative to the first component. Amongst other aspects the invention also provides a modular proximal humeral prosthesis system for use in shoulder joint arthroplasty which enables the proximal humeral prosthesis to be changed between anatomical and reverse of anatomical configurations to address differing degrees of shoulder joint deterioration.

Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair includes the steps of (i) providing a medial row formed of a plurality of medial anchors, the medial anchors comprising suture or tape attached to each of the bodies of the medial anchors, the suture or tape forming a loop when the medial anchors are placed within tissue; (ii) passing traction sutures through each of the corresponding loop of the nearest medial anchor; (iii) passing through the tissue (rotator cuff) the free limbs of the suture or tape attached to each of the medial anchors, and one end of the traction suture (passed through the corresponding loop) at their respective points; (iv) bringing the other end of the traction suture (through a lateral cannula) underneath the tissue (the rotator cuff) and then securing the passed end of the traction suture to a graft or patch located underneath the tissue (rotator cuff); and (v) adjusting the position of the graft or patch by pulling end of the traction suture passed through the tissue (rotator cuff).

A shoulder model and methods of shoulder arthroscopy using the shoulder model. The shoulder model includes an acromioclavicular (AC) joint assembly, a joint capsule assembly, a scapula mount, a shoulder musculature, a skin, and a base. The AC joint assembly is mounted on the scapula mount and the joint assembly is attached to the AC joint assembly and fastened using a screw / nut to form the shoulder assembly. The shoulder assembly is placed in the shoulder musculature and the skin is rolled over the shoulder musculature and zipped in place. The bones of the shoulder assembly are made of foam-cortical shell, the shoulder musculature is made of foam, the soft tissue components are made of thermoplastic elastomers, and the skin is made of vinyl. A method of practicing shoulder arthroscopy using the shoulder model includes mounting the shoulder model in a beach chair position, making anatomical references, establishing a posterior viewing portal, inserting cannulas into the glenohumeral joint or the subacromial space, creating a labral disruption or a rotator cuff tear, and repairing the rotator cuff tear or labral disruption.

A method, system and device for securing a repair, such as a rotator cuff repair and includes an anchor placed within a hole formed in bone and a cannulated screw inserted into the hole after the anchor has been inserted to effectuate a firm and secure connection of tissue to bone, particularly when the quality of the bone does not permit optimal fixation. The method, system and device allows superior tissue fixation to bone with the ease of knotless suture anchor application.

Implant delivery systems for delivering sheet-like implants include a delivery shaft, an implant expander, a sheath, and a sheet-like implant. In some embodiments, the delivery shaft has a proximal end and a distal end. The implant expander is mounted to the distal end of the delivery shaft. The implant expander includes a central portion and a plurality of leg portions radiating from the central portion. The implant expander is evertable between an unstressed configuration in which a distal surface of the implant expander defines a concave surface, and a first compact configuration in which the distal surface of the implant expander defines a convex surface. The implant expander has a first lateral extent when the implant expander is free to assume the unstressed configuration. The sheath defines a lumen having a lumen diameter. At least a portion of the delivery shaft is slidably disposed in the lumen. The lumen diameter is smaller than the first lateral extent of the implant expander so that the sheath holds the implant expander in the first compact configuration when slidably disposed therein. The sheet-like implant overlays at least a portion of the distal surface of the implant expander with portions of the sheet-like implant extending between the leg portions of the implant expander and the sheath. Methods of treating a rotator cuff of a shoulder are also disclosed.

A glenoid component for treatment of rotator cuff arthropathy includes attachment to the coracoid process by a pin or post imbedded into a hole formed in the coracoid process. The glenoid component preferably also has a keel for extending into the glenoid fossa and protrusions such as ridges cemented to the acromion process. This way, an attachment point is preferably provided in / on the coracoid process, the acromion process, and the glenoid fossa, and at least two of the attachment points include a protrusion extending into a hole / slot drilled or otherwise formed in the bone. A jig is used for guiding / drilling into the bone, wherein the jig has both a glenoid fossa drill guide and a coracoid drill guide. The coracoid drill guide includes structure that abuts against opposing sides of the base of the coracoid process to prevent rotation of the jig relative to the scapula.

A fenestrated suture anchor for fixation of tissue to bone. In a preferred embodiment, the suture includes an implant, such a swivel implant with a forked tip for capturing suture. The implant is secured in a hole in bone by advancing a fixation device, such as a cannulated interference screw, to engage and fully seat the implant. The cannulated fixation device is provided with a plurality of openings or fenestrations of various dimensions and geometries to provide multiple pathways through the anchor (i.e., though the interior of the body and through the fenestrations) to allow blood to flow to increase the healing zone, for example, for rotator cuff repair, while also promoting bone in-growth.

Devices, systems and methods for fixation of tendon to bone are described. An exemplary surgical implant is a modified bone anchor that is able to grasp the tendon and hold it firmly in a bone tunnel. Once deployed, the anchor delivers lateral compression to the tendon, providing direct tendon to bone compression to facilitate healing. The anchor has different versions which allow it to be attached to the tendon prior to insertion into the bone tunnel, or be inserted between tendon arms when the surgical procedure dictates. The resulting tendon to bone compression allows for the firm fixation in a manner markedly simpler than traditional techniques. A modification of this anchor can also allow the anchor to grasp and hold suture. This variation facilitates the technique for knotless rotator cuff repair.

A device has been developed to augment the rotator cuff tendon tissue as it proceeds in healing. The device has two purposes: to provide initial stability to the rotator cuff repair site to allow early mobilization of the upper extremity of the patient, and to allow for reinforcement of rotator cuff tendon repairs to increase the likelihood of successful rotator cuff tendon repairs. The device consists of an inter-connected, open pore structure that enables even and random distribution and in-growth of tendon cells. The braided structure allows for distribution of mechanical forces over a larger area of tissue at the fixation point(s).

A method and adjustable apparatus for stabilizing and strengthening the shoulder muscles and rotator cuff provides an active range of motion activities that can be performed with or without resistance. In particular, the method and apparatus provide for scapular retraction and protraction, shoulder flexion, extension, adduction and abduction, as well as internal and external shoulder rotation, performed horizontally and vertically. All of these motions are beneficial to the shoulder joint because they allow the joint to move freely throughout its normal range of motion using natural mechanics of the rotator cuff and surrounding muscles. The method and apparatus provide the essential benefit of stabilizing the shoulder and rotator cuff throughout these motions so that the user's range of motion and strength building is optimized. The method and apparatus also provide for self myofascial release techniques to decrease spasm.

A suture anchor is disclosed which has an elongated body having a distal end, a proximal end and an exterior surface. An axially oriented bore extends into the body from the proximal end and a proximal portion of the bore has a plurality of abutment surfaces for engaging a tool. The bore includes one or more axially oriented suture passages leading to a suture attachment within the bore. A length of suture extends into the at least one suture passage from the body proximal end and extends to the suture attachment. A screw thread spirals about a portion of the exterior surface of the body adjacent the at least one suture passage. Between the bore and the exterior surface of the body the body has a wall thickness and wherein the suture passage comprises the area where the wall thickness goes to zero.

Interposition and augmentation devices for tendon and ligament repair, including rotator cuff repair, have been developed as well as methods for their delivery using arthroscopic methods. The devices are preferably derived from biocompatible polyhydroxyalkanoates, and preferably from copolymers or homopolymers of 4-hydroxybutyrate. The devices may be delivered arthroscopically, and offer additional benefits such as support for the surgical repair, high initial strength, prolonged strength retention in vivo, flexibility, anti-adhesion properties, improved biocompatibility, an ability to remodel in vivo to healthy tissue, minimal risk for disease transmission or to potentiate infection, options for fixation including sufficiently high strength to prevent suture pull out or other detachment of the implanted device, eventual absorption eliminating future risk of foreign body reactions or interference with subsequent procedures, competitive cost, and long-term mechanical stability. The devices are also particularly suitable for use in pediatric populations where their eventual absorption should not hinder growth.

A surgical construct having a flexible strand with a middle region and at least two opposing tail regions that are spliced to form a single tail. The middle region has a first diameter and the opposing tail regions have a second diameter, which is smaller than the first diameter. The tail regions may have similar or different diameters. Because of the thin spliced tail regions, the suturing construct of the present invention can be easily inserted into suture / tape passing and retrieving instruments and passed through soft tissue (such as a rotator cuff). Once the suturing construct has been passed through tissue, the splice may be cut to allow the suture / tape to have again individual tails.

A fixation implant generally includes at least one shaft configured to securely fit into a hole formed in bone. The shaft is of sufficient length relative to the interior diameter of the hole and, in some preferred embodiments, has locking protuberances, like threads, ridges, or barbs, that resist removal of the shaft from the hole in the bone when different types of forces, such as tensile or bending forces, are applied to the implant. The shaft is generally cylindrical in shape, however, in various embodiments, different cross-sections could be used. In a preferred embodiment the implant has a flattened and bent end portion emerging from only one side of the shaft. At the other side of the implant the outer surface of the shaft and the emerging end portion form a smooth surface, without any projections. This smooth surface at the end of the implant prevents irritation of the surrounding tissue. The end portion has a mating surface configured to grip a portion of the soft tissue surrounding the hole between the bone and the mating surface. The longitudinal axis of the shaft is oriented at an angle of less than 90 degrees relative to the mating surface. In this fashion, the implant anchors soft tissue, such as rotator cuff tissue, to bone.

A shoulder sling is provided for the treatment of, for example, gleno-humeral dislocations and subluxations, capsular shifts, postoperative rotator cuff repair, postoperative Bankart procedures and soft tissue strains and repairs. The sling includes a support pillow abuts the wearer's torso, and a pouch that receives the wearer's arm. A plurality of straps suspend the pillow and pouch from the wearer's non-treatment shoulder. One of the straps prevents the pillow from shifting relative to the user, thus securely maintaining the wearer's arm at desired angles of abduction and external rotation. The pillow further includes an attached exercise grip and an indicator line that aids a physician in properly fitting the sling to the wearer.

There is provided a device for use in making an arthroscopic rotator cuff repair comprising an awl having a gripping portion and a shaft for transmitting force to a hooked bone-penetrating portion for forming bone tunnels, the bone-penetrating portion having a sharp tip. The awl may also function as a suture passer and comprise an eyelet situated below the tip for receiving a suture and passing it through the curved bone tunnel. A kit comprising a suture passer of substantially the same shape and of a size as the awl is also provided to pass suture through the bone tunnel formed by the awl. The suture passer is preferably blunt. Methods of using the device and kit are also provided. The method may comprise piercing the bone in a first and second location to form a bone tunnel of substantially continuous curvature and passing a suture therethrough.

The invention provides a tendon or ligament prosthesis having an undeployed configuration and a deployed configuration. The prosthesis has a resistance to tension in the undeployed configuration that is less than its resistance to tension in the deployed configuration. In the deployed configuration, the prosthesis is capable of twisting and bending. In one embodiment, the prosthesis has a meshwork of filaments woven, knitted or braided into a slender cylinder. In this embodiment, the prosthesis attains the deployed configuration by stretching the prosthesis from its undeployed configuration. The prosthesis may be used, for example, to replace an anterior or posterior cruciate ligament or to treat acromioclavicular joint separation, a rotator cuff tear, lateral collateral ligament tears, medial collateral ligament tears, or medial patello-femoral ligament tears. The invention also provides a method for replacing a tendon or ligament using the prosthesis of the invention.

A shoulder model and methods of shoulder arthroscopy using the shoulder model. The shoulder model includes an acromioclavicular (AC) joint assembly, a joint capsule assembly, a scapula mount, a shoulder musculature, a skin, and a base. The AC joint assembly is mounted on the scapula mount and the joint assembly is attached to the AC joint assembly and fastened using a screw / nut to form the shoulder assembly. The shoulder assembly is placed in the shoulder musculature and the skin is rolled over the shoulder musculature and zipped in place. The bones of the shoulder assembly are made of foam-cortical shell, the shoulder musculature is made of foam, the soft tissue components are made of thermoplastic elastomers, and the skin is made of vinyl. A method of practicing shoulder arthroscopy using the shoulder model includes mounting the shoulder model in a beach chair position, making anatomical references, establishing a posterior viewing portal, inserting cannulas into the glenohumeral joint or the subacromial space, creating a labral disruption or a rotator cuff tear, and repairing the rotator cuff tear or labral disruption.

A suture anchor is disclosed which has an elongated body having a distal end, a proximal end and an exterior surface. An axially oriented bore extends into the body from the proximal end and a proximal portion of the bore has a plurality of abutment surfaces for engaging a tool. The bore includes one or more axially oriented suture passages leading to a suture attachment within the bore. A length of suture extends into the at least one suture passage from the body proximal end and extends to the suture attachment. A screw thread spirals about a portion of the exterior surface of the body adjacent the at least one suture passage. Between the bore and the exterior surface of the body the body has a wall thickness and wherein the suture passage comprises the area where the wall thickness goes to zero.