274 results about "Arthroscopy" patented technology

A cartilage replacement or repair prosthesis comprises a layer of streamlined elastomer elements, preferably in the form of spheres, supported in a matrix material so that the radially opposed surfaces of the spheres are positioned on opposite surfaces of the layer and make contact with the opposed surfaces of the femur and tibia and the forces exerted between these bones extend through the streamlined elements. The matrix material has a substantially lower resistance to deformation than the spheres to control the position of the spheres relative to one another without significantly restraining their load-responsive deformation under forces exerted between the femur and tibia. The layer, with its elastomeric inserts, is sufficiently thin and flexible to allow it to be rolled for arthroscopic insertion into a knee joint.

A rotatable surgical instrument having a protective hood with articulating bendable distal end is provided to improve and enable various orthopedic surgical procedures such as arthroscopy. The protective hood surrounds the surgical tool bit exposing only a portion of the tool bit for removing bone or soft tissue material and protects the nerve from the surgical tool bit. The protective hood can be controllably rotated from the instrument's hand piece to control the orientation of the attack angle of the surgical tool bit. Additionally, the bending of the distal end of the instrument can be controlled from the hand piece.

A thermal energy controller system useful in medical procedures includes a controller coupled to a probe, and a thermal element to vary probe temperature. The controller includes memory storing a non-continuous algorithm that permits user-selectable settings for various probe types such that controller operation is self-modifying in response to the selected probe setting. Probe output power Pout is constant in one mode to rapidly enable probe temperature to come within a threshold of a target temperature. The controller can then vary Pout dynamically using a proportional-integral-derivative (PID) algorithm Pout=Kp·P+Ki·I+Kd·D, where feedback loop coefficients Kp, Ki, Kd can vary dynamically depending upon magnitude of an error function e(t) representing the difference between a user-set desired target temperature and sensed probe temperature. Advantageously, target temperature can be rapidly attained without overshoot, allowing the probe system to be especially effective in arthroscopic tissue treatment.

The invention is an oscillating, high speed burring instrument comprised of a handpiece, an elongate arthroscopic catheter extending distally from handpiece and terminating in a flexible or hinged portion which itself terminates with an oscillating burr. At least the distal portion of torsional drive shaft is radially flexible to accommodate the flexibility of the flexible or hinged portion of the catheter. A high speed oscillation of the burr is employed effective for cutting or abrading bone, which is typically oscillated at 10 kHz or higher. The burr is oscillated over a substantial arc, namely a majority portion of a full circle. The burr is not shielded in any manner and is fully exposed to the operational theater. The burr cuts or abrades bone or hard matter, while leaving softer tissues substantially or entirely undamaged.

An instrument for arthroscopic suture passing having a shaft with a proximal end and a distal end. A jaw disposed on the distal end has a needle and a hook. The jaw opens and closes with respect to a stationary distal tip of the instrument. A handle disposed on the proximal end manipulates the jaw. A movable suture shuttle is disposed in the distal tip of the instrument. Arthroscopic suture passing takes place by initially loading a length of suture into the suture shuttle, and capturing the suture by moving the suture shuttle away from a position in which it would engage the needle and hook. The needle then is advanced through tissue using the handle to close the jaw against the stationery tip. The suture shuttle then is advanced to load the suture onto the hook. Opening the jaw draws the needle back through the tissue, pulling the suture in a loop through the tissue. A spring arm urges tissue off of the needle. The loop of suture then is available for further suturing or knot tying.

A technique for the arthroscopic delivery and fixation of an articular cartilage repair device or implant is provided. The technique includes the use of a cannula tube that functions as both a cartilage cutter and a guide to pass instruments into the body arthroscopically. One such instrument is an end-cutting reamer that both prepares the subchondral bone by re-surfacing it down to a specified depth and also simultaneously drills a pilot hole in the subchondral bone to accept the cartilage repair device. A delivery device is utilized to hold and deliver the cartilage repair device to the delivery site.

Implants with hydrogel layers reinforced by three-dimensional fiber arrays can replace hyaline cartilage. Such implants should replace an entire cartilage segment, rather than creating a crevice around a plug, so these implants must be thin and flat, they must cover large areas, the tips of any tufts or stitches must not reach the hydrogel surface, and they must be flexible, for arthroscopic insertion. The use of computerized stitching machines to create such arrays enables a redesigned and modified test sample to be made with no delays, and no overhead or startup costs. This provides researchers with improved tools for making and testing implants that will need to go through extensive in vitro, animal, and human testing before they can be approved for sale and use. Fiber-reinforced hydrogels also can be secured to strong shape-memory rims, for securing anchoring to bones.

A needle passer instrument for use in minimally invasive surgical procedures, including arthroscopy. The instrument has upper and lower jaws for engaging tissue and a handle. A removable needle engaging cartridge is mounted to the upper jaw. A surgical needle with attached suture is mounted in a needle passage in the lower jaw. A needle actuation rod engages the surgical needle and pushes the needle through tissue contained between the jaws. The needle is engaged by the cartridge, and the needle may be cut away from the suture.

Methods of arthroscopic harvesting of bone marrow aspirate from bone joints and therapeutic application of the bone marrow aspirate in a bone joint. The method of harvesting includes extracting bone marrow from a joint, adding a biomaterial, and adding clotting agent to form a clot.

A small diameter delivery device capable of delivering a tissue loaded scaffold arthroscopically to a tissue defect or injury site without reducing the pressure at the injury site is provided. The scaffold delivery device of the present invention comprises a plunger system that includes two main components: an insertion tube and an insertion rod. The insertion tube has a flared proximal end for holding a tissue scaffold prior to delivery. An elongate, hollow body extends from the flared proximal end to a distal end of the insertion tube, and defines a passageway that extends through the body for delivery of the tissue scaffold. The insertion rod has an elongate body that extends into a handle at a proximal end and a tip at a distal end. The insertion rod is configured to be removably disposed within the insertion tube for sliding along the passageway to effect delivery of the tissue scaffold through the insertion tube.

A total ankle replacement system, novel surgical method for total ankle replacement, and novel surgical tools for performing the surgical method are described. The total ankle replacement system includes the calcaneus in fixation of a lower prosthesis body, thereby significantly increasing the amount of bone available for fixation of the lower prosthesis body and allowing the lower prosthesis body to be anchored with screws. The total ankle replacement system further includes a long tibial stem which can also be anchored into the tibia with, for example, screws, nails, anchors, or some other means of attachment. The novel surgical arthroscopic method allows introduction of ankle prostheses into the ankle joint through an exposure in the tibial tubercle. Various novel surgical instruments, such as a telescoping articulating reamer and a talo-calcaneal jig, which facilitate the novel surgical method, are also described.

The present invention relates to biocompatible, biodegradable polyurethane / urea polymeric compositions that are capable of in-vivo curing with low heat generation to form materials suitable for use in scaffolds in tissue engineering applications such as bone and cartilage repair. The polymers are desirably flowable and injectable and can support living biological components to aid in the healing process. They may be cured ex-vivo for invasive surgical repair methods, or alternatively utilized for relatively non-invasive surgical repair methods such as by arthroscope. The invention also relates to prepolymers useful in the preparation of the polymeric compositions, and to methods of treatment of damaged tissue using the polymers of the invention.

Assemblies and methods suitable for knotless arthroscopic repair of tissue defects include two fixation members coupled by two limbs of suture comprising a continuous loop. A unidirectional restriction element that can be a preformed locking, sliding suture knot proximate to one of the fixation members, provides tensioning of the repair.

Methods and apparatus for arthroscopic tenodesis using sockets in bone created by retrograde cutting. A cannulated pin is drilled through bone and into a joint space in the normal, antegrade direction, guided by a drill guide. A strand provided through the cannulated pin is used to draw a retrodrill cutter into the joint space. The retrodrill cutter is threaded onto the cannulated pin, which is turned for retrograde cutting of a socket into the bone. The method is used to form a pair of sockets in the joint, which accept the respective ends of a replacement graft. The graft is brought into position in the joint space using loops formed in the strands, in a manner similar to introduction of the retrodrill cutter. The reconstruction is completed by securing suture attached to the graft ends with a button implant installed at the bone surface.

A bioabsorbable, cannulated tissue tack having an oblong head is used in sutureless soft tissue fixation to bone, particularly in arthroscopic shoulder surgery. A plurality of ribs are formed along the shaft of the tack. Repair of the glenohumeral joint is performed by installing the tack through a hole formed through the soft tissue of the labrum and into the cancellous bone of the glenoid rim. Aligning the oblong head of the tack lengthwise along the glenoid rim provides a low profile that avoids articular impingement on the tack head.

A method for gaining access to and removing mechanical fasteners such as pedicle screws. A small arthroscopic incision is made over the location of the fastener. A guide wire is then placed into the incision and attached to the fastener. A series of progressively enlarging dilator tubes are slipped into the incision to progressively enlarge its diameter. A screw extractor tube is placed into the incision, over the largest dilator tube. The screw extractor tube is advanced until its lower extreme surrounds the head of the fastener. The dilator tubes are then removed. At this point, the screw extractor tube holds open the incision and provides access to the fastener through its hollow interior. A specially designed extractor tool is inserted into the screw extractor tube. An arthroscope is preferably also inserted through the screw extractor tube so that the surgeon can visualize the process. Jaws on the end of the extractor tool are clamped to the fastener's head. The extractor tool is then rotated to back out the fastener. Once the fastener is freed from its installed position, the extractor tool withdraws it through the screw extractor tube. Other conventional processes—such as debridement—may then be performed through the screw extractor tube. Finally, the surgeon withdraws the screw extractor tube and closes the small incision.

An instrument for retrograde cutting of sockets or tunnels in bone for arthroscopic tenodesis. A retrograde cutter is used to form a recipient site socket from the inside out, i.e., using a retrograde technique, with minimal incisions of distal cortices and reduced intraarticular bone fragmentation of tunnel rims. The retrograde cutter is provided with a cutting blade that is configured to engage the shaft of the instrument and to lock onto the shaft.

Methods and apparatus for arthroscopic tenodesis using sockets in bone created by retrograde cutting. A dual-sided rotary drill cutter is used to form a tibial and femoral socket by retrograde and antegrade cutting, respectively. The method is used to form a pair of sockets in the joint, which accept the respective ends of a replacement graft. The dual-sided cutter is configured such that it cuts in both directions (retrograde and antegrade) and does not need to be flipped over between forming the respective sockets.

A tendon repair implant for treatment of a partial thickness tear in the supraspinatus tendon of the shoulder is provided. The implant may incorporate features of rapid deployment and fixation by arthroscopic means that compliment current procedures; tensile properties that result in desired sharing of anatomical load between the implant and native tendon during rehabilitation; selected porosity and longitudinal pathways for tissue in-growth; sufficient cyclic straining of the implant in the longitudinal direction to promote remodeling of new tissue to tendon-like tissue; and, may include a bioresorbable construction to provide transfer of additional load to new tendon-like tissue and native tendon over time.

An arthroscopic inflow and outflow sheath providing an improved inflow and outflow system reducing the diameter of a continuous flow system while providing fluid management during arthroscopy. The improved arthroscopic inflow and outflow sheath comprises an elongated atraumatic sheath having an inner surface, outer surface, proximal end, and distal end. The atraumatic sheath further comprises plurality of ribs or webs extending from the inner surface of the sheath and designed to contact an outer surface of the arthroscope thereby creating outer lumens facilitating the inflow and outflow of fluid to a surgical site.

An ultraviolet sterilizer for use during surgery is mounted in a base cabinet. The UV light source can be a laser, or an LED. An optical frequency multiplier can be used that outputs UV of less than 280 nm, or greater than 320 nm, to avoid burning the patient. A visible LED aiming light directs the UV light toward the surgery. A crosshair image can be projected to position the light.One lamp has a housing, a cavity, a handle, and an ocular plate to pass the UV and the aiming light. An articulated arm allows selective positioning of the lamp. Another lamp has a stylus, a handle, and a tip small enough for easy insertion into a small incision for arthroscopy. A fiber optic cable connects the UV and the aiming light to the lamp. Lenses or filters can be used with the fiber optic cable.An electronic power supply and a CPU connect to the UV and the aiming light sources. A keyboard inputs commands to the CPU. A sensor provides feedback.Another UV sterilizer is mounted on a ceiling of the operating room. A lamp has a housing with a cavity. Either a curved or a flat substrate is mounted in the cavity. Solid state UV elements are arrayed on the substrate, along with visible LEDs for aiming. Either a curved or a flat mirror is disposed behind the substrate. An ocular plate passes the UV and the aiming light, and protects the elements from damage. The ocular plate is a diffuser, a filter, or a fresnel lens.

A surgical assist device and method that can be used to assist a surgeon in site selection and suture placement to re-attach the glenoid labrum to the shoulder's glenoid bone. The device and method includes an arcuate shaped bow arm, an angle guide attached to the bow arm at a selected location along the bow arm, a sleeve guide, and a target tool releasably connected to the angle guide. A tip end of the sleeve guide is extended in surgery and is configured to intersect and pass through an aperture of the target tool. The tip end of the sleeve guide includes at least one tooth that embeds in the glenoid bone and holds the sleeve guide in position. A guide pin such as a suture carrier is extended through the sleeve guide. The sleeve guide is then removed leaving the sutures in the correct repair location.

Disclosed herein are embodiments of an electrosurgical device that include one or more floating electrodes and are specifically adapted to remove, cut, resect, ablate, vaporize, denaturize, drill, coagulate and form lesions in soft tissues, with or without externally supplied liquids, preferably in combination with a resectoscope, particularly in the context of urological, gynecological, laparoscopic, arthroscopic, and ENT procedures. Specific adaptations for urological and gynecological applications, for example kidney stone removal and BPH treatment, are also described.

A microfracture instrument for applying microfracture therapy to a bone, the microfracture instrument comprising:an elongated shaft comprising a distal end and a proximal end;a needle comprising a body terminating in at least one sharp point, the needle being movably mounted to the distal end of the shaft for movement between an extended position for engaging the bone with the at least one sharp point of the needle and a retracted position for withdrawing the at least one sharp point of the needle from the bone; anda drive shaft movably mounted to the elongated shaft, the drive shaft being connected to the body of the needle so that movement of the drive shaft relative to the elongated shaft moves the needle between its extended position and its retracted position.

A drill guide assembly for drilling a tunnel having a fixed, non-zero radius of curvature, where the drill guide assembly includes a housing and a sleeve, or cutting tube, configured to reciprocate within the distal portion where the sleeve, or cutting tube, is configured to receive a bone cutting instrument.

Disclosed herein are methods and surgical kits that can be used to fuse facet joints via a minimally invasive procedure (including an arthroscopic or percutaneous procedure). An exemplary method includes creating an incision; locating a facet joint with a distal end of a pin; sliding a substantially hollow drill guide over said pin wherein said drill guide comprises a proximal end, a distal end; removing said pin from within said drill guide; inserting a drill bit into said drill guide; drilling a hole into a bone of said facet joint; removing said drill bit; inserting a facet joint bone plug into said hole using a bone plug inserter having a raised portion at or near is proximal end, wherein said raised portion prevents over-insertion of said bone plug; and removing said drill guide.