US20050027307A1 - Unitary surgical device and method - Google Patents

Unitary surgical device and method Download PDF

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Publication number
US20050027307A1
US20050027307A1 US10/483,929 US48392904A US2005027307A1 US 20050027307 A1 US20050027307 A1 US 20050027307A1 US 48392904 A US48392904 A US 48392904A US 2005027307 A1 US2005027307 A1 US 2005027307A1
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United States
Prior art keywords
meniscus
surgical device
unitary surgical
ecm
tissue
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
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US10/483,929
Inventor
Herbert Schwartz
Prasanna Malaviya
Amit Singla
Mark Pelo
Pamela Plouhar
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DePuy Products Inc
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DePuy Products Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by DePuy Products Inc filed Critical DePuy Products Inc
Priority to US10/483,929 priority Critical patent/US20050027307A1/en
Assigned to DEPUY PRODUCTS, INC. reassignment DEPUY PRODUCTS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: PELO, MARK JOSEPH, PLOUHAR, PAMELA LYNN, SINGLA, AMIT KUMAR, SCHWARTZ, HERBERT EUGENE, MALAVIYA, PRASANNA
Publication of US20050027307A1 publication Critical patent/US20050027307A1/en
Priority to US11/928,710 priority patent/US20080294193A1/en
Abandoned legal-status Critical Current

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Definitions

  • the present invention relates generally to surgical devices for approximating, repairing or regenerating damaged or diseased fibrocartilage, and to surgical methods using such devices.
  • Articular cartilage is a type of hyaline cartilage that lines the surfaces of the opposing bones in a diarthrodal joint (e.g., knee, hip, shoulder, etc.). Articular cartilage provides a near frictionless articulation between the bones, while also functioning to absorb and transmit the compressive and shear forces encountered in the joint. Further, since the tissue associated with articular cartilage is aneural, these load absorbing and transmitting functions occur in a painless fashion in a healthy joint.
  • Intra-articular fibrocartilage can be present in the form of a discus articularis, that is, as a plate or ring of fibrocartilage in the joint capsule separating the joint surfaces (articular cartilage) of the bones of the joint.
  • fibrocartilage is present, for example, in the temporomandibular joint, between vertebrae, and in the knee joint.
  • the intra-articular fibrocartilage comprises the meniscus, a crescent-shaped or semi-lunar-shaped disc of tissue that is located between the femoral condyles and the tibial plateau.
  • the meniscus primarily functions as a shock absorber, absorbing the shock of compressive and shear forces in the knee.
  • the meniscus also provides a substantially frictionless surface for articulation of the knee joint.
  • Cartilage health can be adversely affected by disease, aging, or trauma.
  • the adverse effects of disease, aging and trauma can be in the form of a tear in the cartilage or in the form of a breakdown of the cartilage matrix.
  • meniscus degeneration can also occur by aging; as a person ages, the meniscus can become soft in places, so that even common motions like squatting can cause meniscal tears.
  • a tear repair is most commonly performed when the tear is a clean longitudinal vertical lesion in the vascular red zone of the meniscus.
  • the basic strategy is to stabilize the tear by limiting or eliminating radial separation of the faces of the tear when the meniscus is load bearing.
  • Meniscectomies involve the surgical removal of part of the meniscus. Such procedures have generally been performed in cases of radial tears, horizontal tears, vertical longitudinal tears outside the vascular zone, complex tears, or defibrillation. Although meniscectomies provide immediate relief to the patient, in the long term the absence of part of the meniscus can cause cartilage wear on the condylar surface, eventually leading to arthritic conditions in the joint.
  • U.S. Pat. No. 6,042,610 assigned to ReGen Biologics, Inc. discloses the use of a collagen scaffold device comprising a bioabsorbable material made at least in part from purified natural fibers.
  • the purified natural fibers are cross-linked to form the device of that patent.
  • the device produced can be used to provide augmentation for a damaged meniscus.
  • Related U.S. Pat. Nos. 6,042,610; 5,735,903; 5,681,353; 5,306,311; 5,108,438; 5,007,934; 4,880,429 also disclose a meniscal augmentation device for establishing a scaffold adapted for ingrowth of meniscal fibrochondrocytes.
  • ECMs extracelluar matrices
  • SIS small intestine submucosa
  • the SIS material is derived from porcine small intestinal submucosa that models the qualities of its host when implanted in human soft tissues. Further, it is taught that the SIS material provides a natural matrix with a three-dimensional structure and biochemical composition that attracts host cells and supports tissue remodeling.
  • SIS products such as OASISTM and SURGISISTM, are commercially available from Cook Biotech Inc., Bloomington, Ind.
  • RESTORE® Orthobiologic Implant is available from DePuy Orthopaedics, Inc. in Warsaw, Ind.
  • the DePuy product is described for use during rotator cuff surgery, and is provided as a resorbable framework that allows the rotator cuff tendon to regenerate.
  • the RESTORE Implant is derived from porcine small intestine submucosa, a naturally occurring ECM composed primarily of collagenous proteins, that has been cleaned, disinfected, and sterilized. Other biological molecules, such as growth factors, glycosaminoglycans, etc., have also been identified in SIS.
  • ECM ECM
  • tissue remodeling While small intestine submucosa is available, other sources of ECM are known to be effective for tissue remodeling. These sources include, but are not limited to, stomach, bladder, alimentary, respiratory, and genital submucosa. In addition, liver basement membrane is known to be effective for tissue remodeling. See, e.g., U.S. Pat. Nos. 6,379,710, 6,171,344, 6,099,567, and 5,554,389, hereby incorporated by reference. Further, while ECM is most often porcine derived, it is known that these various ECM materials can be derived from non-porcine sources, including bovine and ovine sources.
  • the ECM material may also include partial layers of laminar muscularis mucosa, muscularis mucosa, lamina basementum layer and/or other such tissue materials depending upon other factors such as the source from which the ECM material was derived and the delamination procedure.
  • the present invention is directed toward devices and surgical methods for the repair and regeneration of diseased or damaged intra-articular fibrocartilage such as the meniscus in the human knee joint.
  • the present invention provides a unitary surgical device for implantation in a patient for repairing a body tissue in the patient.
  • the unitary surgical device comprises first and second biocompatible anchors and biocompatible tissue repair material extending between and connected to the first and second anchors.
  • the anchors and tissue repair material are connected to each other prior to surgery.
  • the first anchor includes at least one of the following: a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable male locking member.
  • the second anchor includes at least one of the following: a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable female locking member.
  • the biocompatible tissue repair material includes at least one of the following: a fixed length of suture; a sheet of collagen-containing material; laminar ECM material; formed ECM material; comminuted ECM material; ECM fibers; ECM foam material; a sheet of bioresorbable material; and a base connected to the first anchor and to the second anchor and a different material secured to the base, at least one of the base and the different material including ECM material.
  • the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating intra-articular fibrocartilage tissue in the patient.
  • the unitary surgical device comprises a first fixating mechanism, a second fixating mechanism and tissue repair material extending between and connected to the first and second fixating members prior to surgery.
  • the first fixating mechanism includes at least one of the following: a length of suture; a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable male locking member.
  • the second fixating mechanism includes at least one of the following: a length of suture; a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable female locking member.
  • the tissue repair material includes at least one of the following: a sheet of ECM material connected to the first anchor and the second anchor; laminar ECM material connected to the first anchor and the second anchor; ECM foam; comminuted ECM; ECM fibers; cross-linked ECM material; formed ECM material; and a bioresorbable base connected to the first anchor and the second anchor and a different material on the base, where at least one of the base and the different material includes ECM.
  • the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating intra-articular fibrocartilage tissue in the patient.
  • the unitary surgical device comprises a base having at least two layers and a length of suture disposed or positioned between the layers of the base. At least part of the unitary surgical device is made from ECM material.
  • the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating meniscal tissue in the patient.
  • the unitary surgical device comprises a base having two panels.
  • the two panels have a V-shaped configuration in cross-section, and meet along an apex portion.
  • the two panels have end portions spaced distally from the apex portion.
  • the end portions are spaced from each other to provide a gap.
  • the unitary surgical device may also include tissue regeneration material between the two panels of the base.
  • the unitary surgical device also includes opposing anchors on the end portions of the base panels. The opposing anchors are suitable for fixation to the native meniscus.
  • the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating tissue in the patient.
  • the unitary surgical device comprises a base made of a bioresorbable polymer and ECM material on the base.
  • the unitary surgical device includes a first fixating member secured to the base prior to surgery. The first fixating member is suitable for fixation to the patient's tissue.
  • the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating tissue in the patient.
  • the unitary surgical device comprises a base made of ECM material and a first fixating member secured to the base prior to surgery.
  • the first fixating member is suitable for fixation to the patient's tissue.
  • the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating tissue in the patient.
  • the unitary surgical device comprises a base having two opposing edges and a plurality of holes along one of the edges of the base.
  • the unitary surgical devices includes ECM material.
  • the present invention provides a method of repairing a tear in the meniscus in the knee of a patient.
  • the meniscus has an articulating surface and a non-articulating surface.
  • the tear results in the meniscus having two inner surfaces.
  • the method comprises the acts of providing a unitary surgical device having a pair of resorbable anchors and a fixed length of suture connected to the anchors. After the tear in the meniscus is located, the unitary surgical device is implanted to approximate the two inner surfaces of the meniscus at the tear, with suture extending across the articulating surface of the meniscus across the tear and the resorbable anchors being spaced from the tear.
  • the present invention provides a method of repairing a damaged meniscus in the knee of a patient.
  • the meniscus has a non-articulating surface, a peripheral rim and an inner portion.
  • the method comprises the acts of providing a wedge-shaped unitary surgical device including a fixating mechanism. A portion of the damaged meniscus inward of the peripheral rim of the meniscus is removed.
  • the unitary surgical device is implanted with a portion inward of the peripheral rim.
  • the unitary surgical device is fixated to the meniscus by fixating at least part of the base of the unitary surgical device to the meniscus with the fixating mechanism.
  • FIG. 1 is a diagrammatic perspective view of a meniscus with a tear
  • FIG. 2 is a cross-section taken along line 2 - 2 of the meniscus of FIG. 1 ;
  • FIG. 3 is a perspective view of a first embodiment of a unitary surgical device of the present invention.
  • FIG. 4 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 3 fixated to the meniscus;
  • FIG. 5 is a perspective view of a second embodiment of a unitary surgical device of the present invention.
  • FIG. 6 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 5 fixated to the meniscus;
  • FIG. 7 is a perspective view of a third embodiment of a unitary surgical device of the present invention.
  • FIG. 8 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 7 fixated to the meniscus;
  • FIG. 9 is a perspective view of a fourth embodiment of a unitary surgical device of the present invention.
  • FIG. 10 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 9 fixated to the meniscus;
  • FIG. 11 is an elevation of a fifth embodiment of a unitary surgical device of the present invention.
  • FIG. 12 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 11 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 13 is a top plan view of a sixth embodiment of a unitary surgical device of the present invention.
  • FIG. 14 is an elevation of the unitary surgical device of FIG. 13 ;
  • FIG. 15 is a perspective diagrammatic view of a meniscus, with a void left by a partial meniscectomy and with the unitary surgical device of FIGS. 13-14 in the process of being implanted;
  • FIG. 16 is a perspective diagrammatic view of the meniscus of FIG. 15 , shown with the unitary surgical device of FIGS. 13-15 fixated to the meniscus;
  • FIG. 17 is a cross-section of the meniscus and unitary surgical device of FIG. 16 , taken along line 17 - 17 of FIG. 16 ;
  • FIG. 18 is a top plan view of a seventh embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 19 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 18 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 20 is an elevation of an eighth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 21 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 20 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 22 is a top plan view of a ninth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 23 is a perspective view of the unitary surgical device of FIG. 22 , shown with the top panel of the base folded over the mass of tissue regeneration material;
  • FIG. 24 is a perspective diagrammatic view of a meniscus, with a void left by a partial meniscectomy
  • FIG. 25 is a perspective diagrammatic view of a meniscus, with a void left by a partial meniscectomy and with the unitary surgical device of FIGS. 22-23 in the process of being implanted;
  • FIG. 26 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIGS. 22-23 and 25 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 27 is a top plan view of a tenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 28 is a bottom plan view of an eleventh embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 29 is a perspective, partially cut-away view of a meniscus with the unitary surgical device of FIG. 27 fixated to the meniscus;
  • FIG. 29A is a bottom plan view of a twelfth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 29B is a side elevation of the embodiment of FIG. 29A ;
  • FIG. 30 is a perspective view of a thirteenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 31 is a is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 30 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 32 is an elevation of a fourteenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 33 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 32 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 34 is a perspective view of a fifteenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 35 is an elevation of a sixteenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 36 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 35 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 37 is an elevation of a seventeenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 38 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 37 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 39 is an elevation of an eighteenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 40 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 39 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 41 is an enlarged cross-section through a part of a laminar base of a unitary surgical device, such as the device of FIG. 35 , with an implanted tack used as one of the anchors of the device;
  • FIG. 42 is a perspective view of a nineteenth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 43 is an enlarged plan view of a mesh used as the base of a unitary surgical device.
  • FIG. 44 is a top plan view of a twentieth embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 45 is a top plan view of a twenty-first embodiment of a unitary surgical device incorporating the teachings of the present invention.
  • FIG. 46 is a cross-section through a torn meniscus, showing the unitary surgical device of FIG. 44 in place within the meniscal tear prior to approximation of the tissue;
  • FIG. 47 is a cross-section through a torn meniscus, showing the unitary surgical device of FIG. 45 in place within the meniscal tear prior to approximation of the tissue;
  • FIG. 48 is a cross-section through a torn meniscus, showing the unitary surgical device of FIGS. 44 and 47 in place within the meniscal tear after approximation of the meniscal tissue;
  • FIG. 49 is a cross-section through a torn meniscus, showing the unitary surgical device of FIGS. 45 and 48 in place within the meniscal tear after approximation of the meniscal tissue;
  • FIG. 50 is a perspective view of a twenty-second embodiment of the unitary surgical device of the present invention.
  • FIG. 51 is a perspective view of a portion of a meniscus, showing the unitary surgical device of FIG. 50 in use in repairing a tear in the meniscus;
  • FIG. 52 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 37 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 53 is a perspective view of a twenty-third embodiment of the unitary surgical device of the present invention, in place on a meniscus.
  • a variety of unitary surgical devices 10 utilizing the principles of the present invention are illustrated in the accompanying drawings.
  • the illustrated surgical devices 10 are for implantation in a patient for repairing a body tissue in the patient.
  • the illustrated embodiments would most commonly be used in repairing intra-articular fibrocartilage, such as the meniscus of the knee, although the invention is not so limited unless expressly called for in the claims.
  • a meniscus, or part of a meniscus is diagrammatically illustrated at 12 in the accompanying drawings ( FIGS. 1-2 , 4 , 6 , 8 , 10 , 12 , 15 - 17 , 19 , 21 , 24 - 26 , 29 , 31 , 33 , 36 , 38 , 40 , 46 - 49 , 51 and 52 ).
  • FIGS. 1-2 , 4 , 6 , 8 , 10 , 46 , 47 and 51 An example of a meniscal tear is shown at 14 in FIGS. 1-2 , 4 , 6 , 8 , 10 , 46 , 47 and 51 .
  • the invention is also expected to be useful in the treatment of damaged and diseased intra-articular fibrocartilage in other body parts as well.
  • each unitary surgical device 10 includes at least one fixating element 15 and at least one tissue repair element 20 , as an integral unit, prior to the time that the surgical devices are implanted in the patient.
  • each unitary surgical device 10 also includes a second fixating element 17 .
  • suture may be incorporated into the device prior to the time the device is implanted in the patient.
  • the surgeon may choose to use additional material during surgery. For example, the surgeon may opt during surgery to use an additional fixating mechanism that was not an integral part of the original device, if the surgeon believes that additional stabilization is necessary or desirable.
  • tissue repair element and “tissue repair material” are intended to include materials such as suture, whether of natural or synthetic origin, as well as tissue or cartilage regeneration material.
  • Tissue or cartilage regeneration material encompasses naturally occurring extracellular matrix (ECM) materials that provide a collagen scaffold for tissue repair and regeneration.
  • ECM extracellular matrix
  • One such ECM material that may be used for the tissue or cartilage regeneration material is submucosa, and small intestine submucosa (SIS) in particular.
  • Other bioremodelable collagenous tissue matrices, whatever the source, are intended to be included within “tissue regeneration material”, including purified collagenous tissues.
  • SIS is intended to include small intestine submucosa unless otherwise limited.
  • ECM is intended to include all SIS, as well as materials made from the other sources of submucosa identified above (e.g., bladder, stomach and liver tissue from bovine, ovine and porcine sources) and materials derived from liver basement membrane (from whatever source) unless otherwise limited.
  • a naturally occurring ECM to clean, delaminate, and/or comminute the ECM, to cross-link the collagen within the ECM, and to form a foam or other structure from the ECM. It is also within the definition of naturally occurring ECM to fully or partially remove one or more components or subcomponents of the naturally occurring matrix.
  • naturally occurring extracellular matrix or “naturally occurring ECM” are intended to refer to extracellular matrix material that has been cleaned, disinfected, sterilized, and optionally cross-linked.
  • naturally occurring ECM and “naturally occurring extracellular matrix” are also intended to include foam material made from naturally occurring ECM as described in copending U.S. patent application Ser. No. 10/195,354 entitled “Porous Extracellular Matrix Scaffold and Method” (Attorney Docket No. 265280-71146, DEP-747), the toughened material made from naturally occurring ECM as described in U.S. patent application Ser. No.
  • bioresorbable, resorbable and bioabsorbable are intended to be interchangeable. All three terms are intended to mean materials that are naturally degradable in vivo over time. All are intended to include both natural and man-made materials, and to include new materials as they are developed, unless a specific material or type of material is identified in the claims.
  • Intra-articular fibrocartilage is intended to include the meniscus in the knee joint. It is also intended to include fibrocartilage separating the joint surfaces (articular cartilage) of the bones of other joints and separating the surfaces of adjacent vertebrae. “Intra-articular fibrocartilage” thus includes, for example, fibrocartilage in the temporomandibular joint and between vertebrae.
  • 11-23 , 25 - 42 , 44 - 47 and 53 are shaped for use in the meniscus, it should be understood that the principles of the present invention may be applied to surgical devices to be used in repairing and regenerating damaged or diseased intra-articular fibrocartilage in other joints in the body.
  • ECM material, and combinations of ECM material and synthetic materials, for use in the present invention can be prepared as described in the following United States Patents, utility applications for United States patents, and provisional applications for United States Patents, the disclosures of which are incorporated by reference herein: U.S. Pat. No. 4,902,508, entitled “Tissue Graft Composition”; U.S. Pat. No. 4,956,178, entitled “Tissue Graft Composition”; U.S. Pat. No. 5,281,422, entitled “Graft for Promoting Autogenous Tissue Growth”; U.S. Pat. No. 5,372,821, entitled “Graft for Promoting Autogenous Tissue Growth”; U.S. Pat. No.
  • the “ECM” for use in the present invention can be disinfected as described in U.S. Pat. No. 6,206,931, entitled “Graft Prosthesis Materials” or U.S. Pat. No. 5,460,962, entitled “Peracetic Acid Sterilization of Collagen or collagenous Tissue,” which are incorporated by reference herein in their entireties, or may be disinfected generally through the use of a disinfecting agent such as a 0.15% peracetic acid in 20% ethanol solution.
  • ECM material as used herein includes commercially available materials, unless otherwise expressly limited. Such commercially available materials include those available from DePuy Orthopaedics, Inc. of Warsaw, Ind. (e.g., RESTORED® Orthobiologic Implant), for example.
  • ECM ECM materials, including “SIS”, as used herein, are not limited to the materials or processes described in the preceding paragraphs unless expressly indicated otherwise; the patents, provisional applications, utility applications and commercial products identified in the preceding paragraphs are identified for purposes of illustration only.
  • each unitary surgical device 10 of this group includes two fixating elements 15 , 17 : a first anchor 16 and a second anchor 18 .
  • Each unitary surgical device also includes tissue repair material 20 extending between and connected to the first anchor 16 and second anchor 18 .
  • the tissue repair material 20 is connected to the two fixating members 15 , 17 prior to surgery, and prior to terminal sterilization of the unitary surgical devices.
  • the tissue repair material 20 comprises suture.
  • a second group of unitary surgical devices 10 is illustrated in FIGS.
  • each illustrated unitary surgical device 10 of this group also includes two fixating elements 15 , 17 and tissue repair material 20 extending between and connected to the fixating members 15 , 17 .
  • the tissue repair material 20 includes a tissue regeneration material 22 ; the tissue repair material 20 may also include other elements such as suture or a base 21 .
  • fixating elements 15 , 17 may include anchors 16 , 18
  • the fixating elements may also include suture, either alone or in combination with the anchors 16 , 18 .
  • the fixating members 15 , 17 may comprise: one or more anchors 16 , 18 ; one or more anchors 16 , 18 combined with suture 16 g, 18 g; or suture 16 g, 18 g alone. All of these elements in the second group are secured together prior to surgery and prior to terminal sterilization of the unitary surgical devices.
  • the anchor 16 may comprise: a barbed dart, as illustrated at 16 a in FIGS. 3-4 , 7 - 8 , 9 - 10 , 30 - 34 and 50 - 52 ; a tack, as illustrated at 16 b in FIGS. 35-36 ; a backstop, as illustrated at 16 c in FIGS. 5-6 ; a male locking member, as illustrated at 16 d in FIGS. 37-40 ; or a pair of connected anchors such as the pair of barbed darts 16 a connected by a length of suture.
  • the first fixating member 15 may also comprise a length of suture, as shown at 16 g in FIGS.
  • the first fixating member 15 may also comprise combinations of anchors and other materials, such as a combination of a barbed dart 16 a as an anchor and a length of suture 16 g, as shown in FIGS. 30-31 and 46 - 47 , or a combination of a male locking member 16 d and a length of suture 16 g, as shown in FIGS. 39-40 , for example.
  • each material in the illustrated embodiments is a biocompatible and bioabsorbable one, that is, one that will eventually be broken down, assimilated, diminuted or excreted, or both assimilated and diminuted or excreted by the body of the patient.
  • a second fixating member 17 may include a second anchor 18 .
  • the second anchor 18 may comprise a top hat-shaped fixating member, as illustrated at 18 a in FIGS. 3-4 ; a backstop, as illustrated at 18 b in FIGS. 5-8 ; barbed dart, as illustrated at 18 c in FIGS. 9-10 , 27 , 30 - 31 and 50 - 51 ; a receiving opening, as shown at 18 d in FIG.
  • the second fixating member 17 may also comprise a length of suture, as shown at 18 g in FIGS. 13-23 , 25 - 26 , 28 - 29 , 42 and 44 - 45 .
  • the second fixating member 17 may also comprise combinations of materials, such as a combination of an anchor 18 such as a barbed dart 18 c and a length of suture 18 g, as shown in FIGS. 30-31 and 46 - 47 , for example.
  • each material in the illustrated embodiments is a biocompatible and bioabsorbable one.
  • two anchors 16 a - 16 g, 18 a - 18 g can be used.
  • two anchors may be used of the same or different shape, such as: a barbed dart 16 a with a top hat-shaped structure 18 a, as shown in FIGS. 3-4 ; a barbed dart 16 a with another barbed dart as shown at 16 a and 18 c in FIGS. 9-10 ; a barbed dart with a backstop, as shown at 16 a and 18 b in FIGS. 7-8 ; a tack 16 b can be used with another tack 18 e, as shown in FIGS.
  • the anchors 16 , 18 may be constructed of biocompatible polymers, bioremodelable collagenous matrices and combinations of such materials.
  • Other materials such as bioactive agents, other biologically derived agents, biocompatible inorganic materials, cells, and biological lubricants can also be included as part of the anchors.
  • biocompatible polymer and “biocompatible polymers” is intended to include both synthetic polymers and biopolymers (e.g., collagen).
  • biocompatible polymers include: polyesters of [alpha]-hydroxycarboxylic acids, such as poly(L-lactide) (PLLA) and polyglycolide (PGA); poly-p-dioxanone (PDO); polycaprolactone (PCL); polyvinyl alcohol (PVA); polyethylene oxide (PEO); polymers disclosed in U.S. Pat. Nos. 6,333,029 and 6,355,699; and any other bioresorbable and biocompatible polymer, co-polymer or mixture of polymers or co-polymers that are utilized in the construction of prosthetic implants.
  • polyesters of [alpha]-hydroxycarboxylic acids such as poly(L-lactide) (PLLA) and polyglycolide (PGA); poly-p-dioxanone (PDO); polycaprolactone (PCL); polyvinyl alcohol (PVA); poly
  • Bioremodelable collagenous tissue matrix and “naturally occurring bioremodelable collagenous tissue matrix” are intended to include matrices derived from native tissue selected from the group comprising skin, artery, vein, pericardium, heart valve, dura mater, ligament, bone, cartilage, bladder, liver, stomach, fascia and intestine, whatever the source.
  • naturally occurring bioremodelable collagenous tissue matrix is intended to refer to matrix material that has been cleaned, processed, sterilized, and optionally cross-linked, it is not within the definition of a naturally occurring bioremodelable collagenous tissue matrix to extract and purify the natural components or subcomponents (e.g., collagen) and reform or reconstitute a matrix material from purified natural components or subcomponents.
  • the anchors 16 , 18 may be used as the anchors 16 , 18 in some of the illustrated embodiments.
  • the backstop elements shown at 16 c, 18 b and 19 in FIGS. 5-8 , 45 , 47 and 50 - 52 and top-hat-shaped element 18 a shown in FIGS. 3-4 may be taken from the RAPIDLOCTM Meniscal Repair System available from the MITEK® Products division of ETHICON, INC. of Westwood, Mass.
  • each anchor 16 a - 16 f, 18 a - 18 f may be constructed from a naturally occurring material such as naturally occurring extracellular matrices (ECM), such as small intestine submucosa (SIS).
  • ECM extracellular matrices
  • SIS small intestine submucosa
  • each anchor 16 a - 16 f, 18 a - 18 f may be configured as a monolithic structure formed from naturally occurring ECM which is cured to be rigid and hardened.
  • ECM material from which the anchor is fabricated is cured to produce a structure that possesses the necessary hardness and toughness to be inserted into and through the native meniscus and to be retained in the native meniscus for at least a predetermined period of time.
  • ECM material with the necessary hardness and toughness for use as the anchors may be fabricated by compacting comminuted or shredded naturally occurring ECM material into bar or rod stock by compressing the material together and then curing the material such that it is very rigid and hardened. The curing may be accomplished by simple air drying or by heated air drying of the formed stock. The material may additionally be cross-linked to further improve its mechanical properties.
  • one or more of the anchors 16 a - 16 f, 18 a - 18 f may be constructed with a cured and hardened SIS.
  • comminuted SIS material is placed in a container and allowed to air dry for a predetermined period of time (e.g., as long as several days) at room temperature. Over such a time, water evaporates from the SIS material thereby shrinking the material.
  • the shrunk material is very tough and hard and, as a result, may be machined as described herein.
  • a curing profile utilizing predetermined amounts of heat and/or pressure may be designed to facilitate the curing of the naturally occurring ECM material (e.g., SIS).
  • the ECM material e.g., SIS
  • the anchor 16 a - 16 f, 18 a - 18 f may be turned on a lathe or similar equipment to produce the desired configuration of the anchor, such as the barbed darts.
  • certain features of the anchor e.g., the barbed darts
  • various barb configurations may be formed on part of the anchor, by, for example, use of a cutting machine.
  • contemporary techniques may also be utilized to form the cured naturally occurring ECM into the desired configuration of the anchor 16 a - 16 f, 18 a - 18 f.
  • a programmable laser cutting machine may be used to cut the raw stock of cured ECM.
  • the laser cutting machine may be programmed to cut the raw stock in a pattern which produces a desired configuration of the anchor.
  • laser cutting also provides other benefits. Such laser cutting of the ECM can produce barbed darts having cut edges which are sealed and fused together to enhance the attachment capability of the barbed darts.
  • the material selected for the anchors 16 a - 16 f, 18 a - 18 f may also comprise mixtures or composites of the materials described above.
  • the anchors 16 a - 16 f, 18 a - 18 f could comprise both a biocompatible polymer and ECM material.
  • shape of the barbed darts 16 a, 18 c that may be used with the present invention, reference is made to barbed dart configuration shown in U.S. Pat. No. 5,702,463 as one example of a shape of barbed dart that may be useful.
  • the commercially available backstop is inserted through a needle, as shown in the Mitek Products document “RAPIDLOC MENISCAL REPAIR SYSTEM, Surgical Technique for Repair of Meniscal Tears”. If this technique and instrumentation is to be used to insert the anchors of the present invention, then the anchors should be sized accordingly.
  • Typical barbed darts can be expected to be in the range of about 1 mm in maximum diameter and about 3 mm in length. It should be understood that these dimensions are provided for purposes of illustration only; the present invention is not limited to any particular size of anchor unless expressly set forth in the claims.
  • fixating elements 15 , 17 include or consist of suture 16 g, 18 g, such as in FIGS. 11-23 , 25 - 31 , 42 and 44
  • any suitable suture material may be used, such as commercially available suture.
  • Acceptable suture may be obtained from the MITEK PRODUCTS division of ETHICON, INC. of Westwood, Mass.; examples include PANACRYLTM absorbable suture, ETHIBOND® EXCEL polyester suture, PDS® polydioxanone suture and PROLENE® polypropylene suture.
  • the tissue repair material 20 in the illustrated embodiments includes: suture; a base; tissue regenerating material; or combinations of these materials.
  • the tissue repair material 20 comprises a fixed length of suture; the suture in the illustrated embodiment has a length of about 4-5 mm.
  • a surgical kit could contain several unitary surgical devices 10 , each with a pair of anchors 16 , 18 separated by a variety of fixed lengths of suture 20 as the tissue repair material.
  • the lengths for the sutures portions of the devices 10 in the kit could range, for example, from 2 mm to about 1 cm.
  • several kits could be provided each with a plurality of unitary surgical devices of a particular length. It should be understood that these lengths are provided for purposes of illustration only, the present invention is not limited to tissue repair material of these or any particular lengths unless expressly called for in the claims.
  • the suture used for the tissue repair material 20 in these embodiments may be standard commercially available suture made of conventional materials. Acceptable suture may be obtained from the sources identified above.
  • FIGS. 3-10 illustrate examples of such unitary surgical devices 10 wherein the tissue repair material 20 comprises suture.
  • Embodiments of the invention utilizing a base 21 as part of the tissue repair material 20 are illustrated in FIGS.11-23 , 25 - 42 , 44 - 47 .
  • the base component 21 of the tissue repair material may comprise a third fixating member, such as backstop element 19 shown in FIG. 50 .
  • the base 21 may provide structural support to the unitary surgical device 10 .
  • the base may comprise a sheet, as shown in FIGS. 11-23 , 25 - 42 , and 44 - 45 , and may be a laminar sheet, as illustrated in FIG. 41 .
  • the base component may comprise a formed structure, as illustrated in FIG. 42 .
  • the formed structures could be laminar or could be formed in other manners as disclosed below.
  • the base component 21 may also comprise one or more layers of mesh structures, for example, woven materials as illustrated in FIG. 43 , non-woven materials, knitted materials, warp-knitted materials, braided materials, foamed materials and combinations of those materials; if more than one layer of a mesh structure is provided, the layers may be juxtaposed or spaced, with other material sandwiched between the layers, for example.
  • the base material should have sufficient strength so that the connection to the anchors 16 , 18 and the connection of the anchors 16 , 18 to the patient's native tissue is maintained during implantation of the unitary surgical device 10 and for a suitable period of time after implantation.
  • the base 21 should have sufficient strength for a sufficient time to allow the healing process to progress to the point where the structural stability provided by the base 21 is no longer needed.
  • no particular strength should be implied the claims unless expressly recited.
  • the base 21 in any of the embodiments of FIGS. 11-23 , 25 - 42 , 44 - 47 could comprise a biocompatible polymer, a bioremodelable collagenous matrix, a naturally occurring ECM (and in particular SIS) or combinations of these materials.
  • the tissue regeneration material 22 may be carried by the base 21 or may comprise the base 21 .
  • the base could also comprise these materials together with bioactive agents, other biologically derived agents, cells, a biological lubricant, or a biocompatible inorganic material. In the claims, no particular material or combination of materials should be implied for the base unless expressly recited.
  • a base 21 made out of or including a biocompatible polymer suitable polymers are defined above. These polymers can be provided in the form of, for example, meshes of woven or non-woven materials, laminar sheets, knitted materials, warp-knitted materials, braided materials, or one or more layers of foamed polymer.
  • suitable polymers are defined above. These polymers can be provided in the form of, for example, meshes of woven or non-woven materials, laminar sheets, knitted materials, warp-knitted materials, braided materials, or one or more layers of foamed polymer.
  • the ECM could comprise material derived from a mammalian submucosa source, such as SIS.
  • the ECM base could be formed as a laminate structure, as illustrated in FIG. 41 .
  • the layers may be laminated together and bonded by both mechanical compression and application of vacuum and/or heated air which accomplishes the bonding and also dries the product.
  • U.S. Pat. No. 5,955,110 which is incorporated by reference herein in its entirety, for a description of a method of making layered SIS material.
  • a suitable SIS base may also be formed as described in copending U.S. patent application Ser. No.
  • a vacuum plate or platen with a cavity in a desired shape may be provided, with a vacuum pump connected to the cavity by a tube.
  • the cavity may be provided with a plurality of openings leading to a manifold space within the platen which is connected to the pump.
  • Several layers of naturally occurring ECM, such as SIS, are placed on the plate. These layers are preferably initially in a moist and flexible state. These moist, flexible layers are pulled down into the cavity by the vacuum to form a molded recess for receiving a mass of biological material.
  • a flat vacuum plate or platen could also be used to form flat sheet forms of ECM material. These and other techniques may be employed to form the base into a desired shape, such as the wedge shape shown in FIGS. 11-23 , 25 - 26 and 30 - 40 .
  • ECM electrospray forming material
  • a thick slurry of comminuted ECM fibers dry the slurry into a sheet, pocket or other form, such as the form illustrated in FIG. 42 , for example, and heat the material under combinations of pressure, vacuum and heat to bond and dry the product.
  • one or more such sheets could be laminated together or with strips of ECM material. It is expected that other shapes and forms could also be formed of such materials.
  • the thick slurry could include both ECM material and a biocompatible polymer as a structural reinforcement, or the slurry of ECM material could be supported on and fused with a supporting structure made of ECM or some biocompatible polymer.
  • the material for the base can be cross-linked by known methods.
  • chemical or physical cross-linking can be used.
  • Chemical cross-linking methods include the use of aldehydes, carbodiimides, glycation agents, enzymes or the like.
  • Physical cross-linking methods include freeze-drying and fusion by physical means such as heat (thermal cross-linking), radiation (ultraviolet or gamma irradiation) or combinations such as by drying at elevated temperatures (dehydrothermal cross-linking).
  • Cross-linking may also be used to impart to the base 21 biological lubricants such as hyaluronic acid (HA).
  • HA hyaluronic acid
  • a portion or all of the base 21 may be perforated to allow easy chemical and cellular transfer.
  • cells, bioactive agents, biologically derived agents, biological lubricants and biocompatible inorganic materials may be added to the base.
  • the base 21 may also include a foamed or hybrid structure, and may include other materials as disclosed in applications for United States Patent filed concurrently herewith and previously filed, which are incorporated by reference herein in their entireties: U.S. patent application Ser. No. 10/172,347 entitled “Hybrid Biologic-Synthetic Bioabsorbable Scaffolds” which was filed on Jun. 14, 2002; Ser. No. 10/195,341 entitled “Hybrid Biologic/Synthetic Porous Extracellular Matrix Scaffolds” (Attorney Docket No. 265280-71144, DEP-751) filed herewith; Ser. No.
  • the base 21 may take any one of several shapes and configurations.
  • the base 21 may comprise a single substantially flat panel.
  • the base 21 may comprise two integral panels 24 , 26 joined along a linear or curved apex 28 ; the two illustrated panels 24 , 25 diverge outward from the apex 28 to define a wedge-shaped or V-shaped structure in cross-section.
  • the side edges 30 , 32 of each panel 24 , 26 may also diverge outwardly from the apex 28 , as shown in FIGS. 13, 18 , 22 - 23 and 30 .
  • the base 21 may comprise a pillow-like structure, like a sac made of the base material, with a mass of tissue regeneration material held within the sac or pillow structure.
  • a mass of tissue regeneration material 22 such as ECM, is included as part of the tissue repair material 20 .
  • the mass of tissue regeneration material 22 comprises a separate mass that is secured to the base 21 .
  • a plurality (three) of masses of tissue regeneration material 22 are fixed to the base 21 .
  • a single mass of tissue regeneration material 22 is positioned between the two panels 24 , 26 near the apex 28 ; the masses of tissue regeneration material 22 in these illustrated embodiments are wedge-shaped or V-shaped in cross-section, although it should be understood that other shapes are within the scope of the invention.
  • the mass of tissue regeneration material could also comprise a loose pack of comminuted or shredded ECM material.
  • the SIS material could comprise rolls of comminuted SIS.
  • the unitary surgical device need not include any additional tissue regeneration material; for example, if the base 21 comprises one or more layers of ECM mesh or an ECM foam, then it may not be necessary to include a separate mass of tissue regeneration material.
  • tissue regeneration material 22 may be secured to the base 21 by use of a compatible adhesive.
  • Synthetic adhesives are commercially available, such as polycaprolactone (PCL.
  • Biological adhesives are also available, such as commercially available materials containing transglutaminase or fibrin, for example.
  • Other biological adhesives are also known, as described in U.S. Pat. No. 6,326,025 “Tissue Reactive Adhesive Compositions” and in published U.S. Pat. Apps. 200200344533 “Bioerodable Polymeric Adhesives for Tissue Repair” and 20020031551 “Bioerodable Polymeric Adhesives for Tissue Repair.”
  • the adhesive can be applied to the tissue regeneration material 22 and to the base 21 .
  • the tissue regeneration material 22 may be secured to a pillow or sac-like base by substantially enclosing the mass of tissue regeneration material within the base structure, such as by suturing three or four sides of the base structure around the mass of tissue regeneration material, by using a compatible adhesive around the perimeter of the base surrounding the mass of tissue regeneration material.
  • the tissue regeneration material may also be secured to the base by positioning the tissue regeneration material in a formed receiving structure or pocket, as in the embodiment of FIG. 42 .
  • layers of SIS material could be laminated around all or part of the mass of tissue regeneration material. Chemical and physical cross-linking may also be used to secure the mass of tissue regeneration material 22 to the base 21 .
  • Chemical cross-linking methods of securing these materials 21 , 22 together include the use of aldehydes, carbodiimides, glycation agents, enzymes (e.g., transglutaminase), biologics (e.g., fibrin) or the like.
  • Physical cross-linking methods include freeze-drying and fusion by physical means such as heat (thermal cross-linking), radiation (ultraviolet or gamma irradiation) or combinations such as by drying at elevated temperatures (dehydrothermal cross-linking).
  • the mass or plug of tissue regeneration material 22 may comprise comminuted and/or lyophilized naturally occurring ECM (e.g., SIS) with the desired porosity and material density.
  • ECM e.g., SIS
  • the material density and/or porosity of the mass or plug may be varied to control cell migration and proliferation.
  • ECM e.g., SIS
  • ECM e.g., SIS
  • ECM e.g., SIS
  • SIS SIS
  • threads e.g., SIS
  • mesh e.g., SIS
  • SIS e.g., SIS
  • non-wovens e.g., SIS
  • braided materials ECM (e.g., SIS) solutions, ECM (e.g., SIS) gel, ECM (e.g., SIS) paste, ECM (e.g., SIS) foam, and combinations of such materials.
  • the material may be prepared as described in U.S. Pat. No. 5,352,463, entitled “Tissue Graft for Surgical Reconstruction of a Collagenous Meniscus and Method Therefor”, which is incorporated by reference herein in its entirety. It should be understood that separate reference in the above list to the forms of ECM should not be taken to imply that the listed references are exclusive; for example, ECM non-wovens, ECM threads and ECM foam may all include ECM fibers.
  • the mass or plug of tissue regeneration material 22 , and the base 21 , or the combination of the base and the tissue regeneration material may include materials described in U.S. Pat. No. 6,179,872 B1, entitled “Biopolymer Matt for Use in Tissue Repair and Reconstruction” and U.S. Pat. No. 6,153,292, entitled “Biopolymer Foams for Use in Tissue Repair and Reconstruction”, which are both incorporated by reference herein in their entireties.
  • the mass or plug of tissue regeneration material 22 and the base, or the combination of the base and the tissue regeneration material may include materials disclosed in the following copending and concurrently filed U.S. patent applications, which are incorporated by reference herein: Ser. No.
  • the mass of plug of tissue regeneration material 22 could also comprise other collagenous materials.
  • a commercial product such as the Collagen Meniscus Implant made by ReGen Biologics, Inc. of Franklin Lakes, N.J. could be combined with other elements of the present invention to form a unitary surgical device.
  • Other collagen scaffolds are described in the following U.S. Pat. Nos. 6,042,610; 5,735,903; 5,479,033; 5,306,311; 5,007,934; and 4,880,429.
  • Porous ECM (e.g., SIS) foam for the tissue regeneration material 22 may be fabricated by lyophilizing (i.e., freeze-drying) comminuted ECM (e.g., SIS) suspended in water.
  • the material density and pore size of the resultant foam may be varied to fit the needs of the design by controlling, amongst other things, the rate of freezing of the comminuted ECM suspension and/or the amount of water in which the comminuted ECM is suspended at the on-set of the freezing process.
  • the first step in developing a foam with a desired pore size and density is the procurement of comminuted ECM.
  • scissor-cut ECM runners e.g., SIS runners about 6 inches long
  • the ECM material is processed and thereafter collected in a receptacle at the output of the machine.
  • the material is then processed through the machine a second time under similar conditions.
  • ECM fiber thin, long fibers about 200 microns thick ⁇ 1-5 mm long suspended substantially uniformly in water. It should be understood that this size of ECM fiber is identified as an illustrative example only; the invention is not limited to a particular size of ECM fiber material unless the claims expressly call for a particular size.
  • the process parameters for the comminution process should be selected to produce ECM material that is capable of commingling, intermixing or intertwining, rather than producing a powder.
  • Process parameters that can be varied using the above-identified 1700 series ComitrolTM machine include the choice of blade used, whether water is used, the amount of water used, the speed at which the blades turn and the number of times the material is passed through the machine.
  • cutting head 140084-10 and a Vericut, sealed impeller from Urschel Laboratories may be used, with a flow of water of about two (2) gallons per minute, with the cutting head run at a constant speed of about 9300 rpm.
  • a first pass through the machine at these parameters will produce fibrous ECM material of varying sizes, and a second pass will produce ECM fibers of more uniform size.
  • the comminuted ECM suspension or slurry is then centrifuged, excess water is poured off and the remaining slurry is poured into a dish.
  • a small amount of the comminuted ECM material in the dish is pinched between the thumb and index finger and gently lifted from the dish; if the comminuted SIS material is fibrous, at least a small amount of additional ECM, beyond the portion pinched between the thumb and index finger, will lift along with the material that has been pinched.
  • This additional comminuted ECM material lifts with the material that is between the thumb and index finger because the individual pieces of comminuted ECM material are commingled or intertwined. Such material should be suitable for the production of a foam. It is expected that other shapes and sizes of ECM material, and mixtures of shapes and sizes of ECM material, may be useful in producing an ECM foam. For example, it is expected that one could comminute ECM to produce ECM flakes that can intermingle to form an appropriate slurry.
  • cohesive ECM pieces and “cohesive SIS pieces” are intended to include ECM and SIS material that has been comminuted or otherwise processed to produce ECM and SIS pieces that are capable of commingling or intertwining (in the wet or dry state) to form a cohesive mass of discrete elements, regardless of the shape or shapes of the individual ECM or SIS pieces.
  • One method of demonstrating that the ECM material comprises cohesive pieces is the “pinch test” described above. Examination of the final ECM foam product produced may also provide evidence that the base material comprised cohesive ECM pieces.
  • pieces is intended to include any fiber, strip, ribbon, sliver, filament, shred, bit, fragment, part, flake, slice, cut, chunk, or other portion of solid or solid-like material.
  • ECM fiber and SIS fiber are also intended to include ECM and SIS material that has been comminuted or otherwise processed to produce a material wherein at least some of the individual pieces of ECM and SIS material have lengths greater than their widths and thicknesses. It should be understood that unless otherwise expressly limited by the claims, use of the terms “ECM pieces” and “SIS pieces” should be construed to mean that the material includes such pieces, but should not be considered to imply that the material consists of such pieces exclusively. Such terms should also not be construed to imply that any particular process has been used to produce the material.
  • the suspension of SIS fibers is dried.
  • a lyophilization process freeze drying
  • the suspension of SIS fibers is frozen at a controlled temperature drop rate to control the size of the formed ice crystals.
  • the process of lyophilization sublimes ice crystals directly to vapor under vacuum and low temperatures. This process leaves voids in the spaces previously occupied by ice crystals.
  • These voids and the SIS fibrous material form a network of compartments with SIS material defining interconnected walls of the network compartments.
  • One exemplary machine for performing such a freeze drying process is a Virtis GenesisTM Series lyophilizer which is commercially available from SP Industries, Inc. of Gardiner, N.Y.
  • the process parameters of the lyophilization process may be varied to produce foams of varying pore sizes and material densities.
  • the SIS fibrous material may be tightly compacted by removing the water in a substantially uniform manner so as to achieve a relatively high density. Thereafter, the SIS fibrous material is flash-frozen using liquid nitrogen prior to lyophilization of the SIS.
  • the SIS fibrous material is first tightly compacted by removing the water in a substantially uniform matter so as to achieve a relatively high density. Thereafter, the SIS is frozen at a relatively fast rate (e.g., > ⁇ 1° C./min.) to a temperature of about ⁇ 80° C. prior to lyophilization of the SIS.
  • interconnected passageways may be used for movement of cells such as chondrocytes in vivo. These interconnected passageways can also be used for the introduction of bioactive agents, biologically derived agents (e.g., stimulants), cells, biocompatible inorganic materials, biocompatible polymers and/or biological lubricants that may be combined with the foam as described below prior to implantation.
  • bioactive agents e.g., stimulants
  • cells e.g., cells
  • biocompatible inorganic materials e.g., biocompatible polymers and/or biological lubricants
  • the interconnected passageways defined by the three-dimensional pores also serve as passageways for materials used during the manufacturing process, such as compounds used for chemical cross-linking the foam.
  • the tissue regeneration material 22 may be chemically cross-linked with, for example, aldehydes, carbodiimides, glycation agents, enzymes (e.g., transglutaminase), biologics (e.g., fibrin) or the like.
  • the tissue regeneration material 22 may also be physically cross-linked, by, for example: freeze-drying, heat fusion (thermal cross-linking), radiation fusion (ultraviolet or gamma irradiation) or combinations of fusion techniques such as by drying at elevated temperatures (dehydrothermal cross-linking).
  • the base 21 and/or the mass of tissue regeneration material 22 may also be impregnated with bioactive agents, biologically derived agents, cells, biocompatible polymers, biocompatible inorganic materials and biological lubricants.
  • the materials could be cross-linked or otherwise affixed to the ECM base and/or mass.
  • cells e.g., fibrochondrocytes
  • any such cells are preferably fibrochondrocytes or mesenchymal stem cells.
  • Bioactive agents include one or more of the following: chemotactic agents; therapeutic agents (e.g., antibiotics, steroidal and non-steroidal analgesics and anti-inflammatories, anti-rejection agents such as imnmunosuppressants and anti-cancer drugs); various proteins (e.g., short chain peptides, bone morphogenic proteins, glycoprotein and lipoprotein); cell attachment mediators; biologically active ligands; integrin binding sequence; ligands; various growth and/or differentiation agents (e.g., epidermal growth factor, IGF-I, IGF-II, TGF- ⁇ I-III, growth and differentiation factors, vascular endothelial growth factors, fibroblast growth factors, platelet derived growth factors, insulin derived growth factor and transforming growth factors, parathyroid hormone, parathyroid hormone related peptide, bFGF; TGF ⁇ superfamily factors; BMP-2; BMP4; BMP-6; BMP-12; sonic hedgehog; GDF
  • bioactive agent and “bioactive agents” unless expressly limited otherwise. It should be understood that the above agents are identified by way of example only, and the present invention is not limited to any particular agent unless expressly called for in the claims.
  • Bioly derived agents include one or more of the following: bone (autograft, allograft, and xenograft) and derivates of bone; cartilage (autograft, allograft and xenograft), including, for example, meniscal tissue, and derivatives; ligament (autograft, allograft and xenograft) and derivatives; derivatives of intestinal tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of storn ach tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of bladder tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of alimentary tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of respiratory tissue (autograft, allograft and xenograft), including for example sub
  • biologically derived agents Purified ECM and other collagen sources are also intended to be included within “biologically derived agents.” If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of “biologically derived agent” and “biologically derived agents” unless expressly limited otherwise. It should be understood that the above agents are identified by way of example only, and the present invention is not limited to any particular agent unless expressly called for in the claims.
  • Cells include one or more of the following: chondrocytes; fibrochondrocytes; osteocytes; ostoeblasts; osteoclasts; synoviocytes; bone marrow cells; mesenchymal cells; stromal cells; stem cells; embryonic stem cells; precursor cells derived from adipose tissue; peripheral blood progenitor cells; stem cells isolated from adult tissue; genetically transformed cells; a combination of chondrocytes and other cells; a combination of osteocytes and other cells; a combination of synoviocytes and other cells; a combination of bone marrow cells and other cells; a combination of mesenchymal cells and other cells; a combination of stromal cells and other cells; a combination of stem cells and other cells; a combination of embryonic stem cells and other cells; a combination of precursor cells isolated from adult tissue and other cells; a combination of peripheral blood progenitor cells and other cells; a combination of stem cells isolated from adult tissue and other cells; and
  • Bio lubricants include: hyaluronic acid and its salts, such as sodium hyaluronate; glycosaminoglycans such as dermatan sulfate, heparan sulfate, chondroitin sulfate and keratan sulfate; synovial fluid and components of synovial fluid, including mucinous glycoproteins (e.g., lubricin), tribonectins, articular cartilage superficial zone proteins, surface-active phospholipids, lubricating glycoproteins I, II; vitronectin; and rooster comb hyaluronate.
  • mucinous glycoproteins e.g., lubricin
  • tribonectins e.g., lubricin
  • articular cartilage superficial zone proteins e.g., articular cartilage superficial zone proteins
  • surface-active phospholipids e.g., lubricating glycoproteins I, II;
  • Bio lubricant is also intended to include commercial products such as ARTHEASETM high molecular weight sodium hyaluronate, available in Europe from DePuy International, Ltd. of Leeds, England, and manufactured by Bio-Technology General (Israel) Ltd., of Rehovot, Israel; SYNVISC® Hylan G-F 20, manufactured by Biomatrix, Inc., of Ridgefield, N.J.
  • HYLAGAN® sodium hyaluronate available from Sanofi-Synthelabo, Inc., of New York, N.Y., manufactured by FIDIA S.p.A., of Padua, Italy
  • HEALON® sodium hyaluronate available from Pharmacia Corporation of Peapack, N.J. in concentrations of 1%, 1.4% and 2.3% (for ophthalmologic uses).
  • Biocompatible inorganic materials include materials such as hydroxyapatite, all calcium phosphates, alpha-tricalcium phosphate, beta-tricalcium phosphate, calcium carbonate, barium carbonate, calcium sulfate, barium sulfate, polymorphs of calcium phosphates, ceramic particles and combinations of such materials. If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of “biocompatible inorganic material” and “biocompatible inorganic materials” unless expressly limited otherwise.
  • biocompatible inorganic materials can be used with the anchors, bases, and tissue repair material (including tissue regeneration material) of the present invention.
  • the unitary surgical devices 10 of FIGS. 11-23 , 27 - 40 and 42 may be sized to fit the standard gap 70 left in the meniscus by a meniscectomy so that one unitary surgical device can be implanted to fill this gap 70 . It may be desirable to make a plurality of sizes of such unitary surgical devices 10 to encompass the standard range of gaps 70 left by meniscectorn ies. In addition, it may be desirable to plan to be able to use more than one unitary surgical device 10 to fill the gap 70 left by the meniscectomy, so that a plurality of unitary surgical devices 10 may be implanted adjacent to or overlapping with one another to fill the gap 70 during the surgery.
  • the anchors may be formed as described above.
  • the anchors 16 a - 16 g, 18 a - 18 g may be formed to include, or machined to include an opening so that one end of each length of suture may be secured to one anchor.
  • the anchors 16 , 18 could be tubular so that one end of suture can be threaded through each anchor and then knotted to secure them together.
  • the anchors could have a hole through which the suture end is threaded and then knotted.
  • threads of suture 34 may be placed between two layers of base material prior to completely forming the base so that the suture threads 34 become integral with the base 21 during the forming process.
  • the lengths of the suture threads 34 should be great enough so that the suture ends extend substantially beyond the parallel end edges 36 , 38 of the unitary surgical device to define the first fixating element 15 and second fixating element 17 at the opposite ends of the suture thread 34 .
  • a plurality of suture threads may be made integral with each base. In the embodiments of FIGS.
  • the three suture threads 34 for this embodiment may be aligned so that one length of suture is positioned along the longitudinal centerline of the base, and additional lengths of suture are positioned between the longitudinally aligned thread and the long edges 30 , 32 of the base 21 , and aligned with the shape of the long edges 30 , 32 of the base 21 .
  • the laminar base 21 may then be made as described in the provisional application with each suture thread 34 in place between two layers.
  • the finished unitary surgical device 10 will include the suture affixed to the base.
  • the base 21 of FIG. 22 may then be folded about axis 48 to form the wedge-shaped structure shown in FIG. 23 , with the linear apex 28 at the axis 48 .
  • additional anchors such as barbs, tacks, or backstops, for example, could be secured to the free ends of the suture, as illustrated in the embodiment of FIGS. 30-31 .
  • fewer or more strands of suture may be used for the devices illustrated in FIGS. 22-23 and 30 - 31 ; for example, two strands of suture could be used, or four strands of suture could be used.
  • the suture threads 34 could be positioned in or on the base material prior to final forming of the base.
  • the base may then be formed as described above with the suture formed as an integral part of the base.
  • suture could also be adhered to the base or could be sewn to the base.
  • an anchor such as a barb may be positioned on the surface of base laminates, as shown in FIG. 41 , where anchor 16 b is shown on layers 23 i - 23 l of laminate. Then, additional layers, such as layers 23 a - 23 h shown in FIG. 41 , may be placed on the initial base laminate 23 i - 23 l, surrounding part of the anchor 16 b. The unitary surgical device may then be formed with the anchor 16 b becoming secured to at least some of the layers of the base as the layers are dried, heated and compressed. Other forms of anchor can be positioned on the base during fabrication of the base so that completion of the base also secures the anchors to the base to form a unitary structure.
  • any of the anchors could also be secured to the base after the base is formed by, for example, using an adhesive to secure the anchor to the base.
  • Suitable adhesives for this purpose include commercially available materials such as those containing fibrin or transglutaminase. It should be understood that other methods for securing the anchors to the base are within the scope of this invention; the invention is not limited to any particular method of securing the elements together unless expressly called for in the claims.
  • kits may be prepared for use in surgery by providing prepackaged unitary surgical devices or kits.
  • a single unitary surgical device can be packaged and terminally sterilized, so that the surgeon may simply open the package and implant the device.
  • a kit could include several unitary surgical devices 10 , each with a pair of anchors 16 , 18 separated by a variety of fixed lengths of suture 20 as the tissue repair material.
  • each device could be made in a plurality of sizes, such as small, medium and large; a kit could comprise a group of unitary surgical devices of all sizes or a group of unitary surgical devices all of one size, for example.
  • Conventional commercially available packaging materials and sterilization techniques can be used. For example, gamma irradiation or electron beam irradiation can be used for this terminal sterilization. It should be understood however, that the present invention is not limited to any particular packaging material or sterilization technique unless expressly called for in the claims.
  • the terminally sterilized implant can subsequently be seeded with living cells and packaged in an appropriate medium for the cell type used.
  • a cell culture medium comprising Dulbecco's Modified Eagles Medium (DMEM) can be used with standard additives such as non-essential aminoacids, glucose, ascorbic acid, sodium pyrovate, fungicides, antibiotics, etc., in concentrations deemed appropriate for cell type, shipping conditions, etc.
  • DMEM Dulbecco's Modified Eagles Medium
  • All of the embodiments of the present invention may be used in surgical repair of a damaged meniscus 12 , as illustrated in FIGS. 1-2 , where the meniscal injury is illustrated as a meniscal tear 14 extending down from the top bearing surface 50 of the meniscus 12 between the inner arcuate edge 52 of the meniscus 12 and the back or outer arcuate surface 54 of the meniscus 12 . It should be understood that the drawings show the meniscus 12 in simplified form for purposes of illustration only.
  • the first group of illustrated unitary surgical repair devices are useful for surgical meniscal repairs. With each of these devices, the objective is the same: to position the anchors 16 , 18 beyond the tear 14 , and to position the tissue repair material 20 , comprising suture in the embodiments of FIGS. 4-10 , across the tear 14 .
  • a surgical kit would generally be provided with several unitary surgical devices 10 , with varying lengths of suture, provided in the kit.
  • the meniscal tear is evaluated and the meniscus is prepared in the standard manner. From the initial evaluation, the surgeon determines the length of device that is needed to extend across the meniscal injury for the particular patient, and then selects one of the devices from the surgical kit.
  • At least one of the anchors such as first anchor 16
  • first anchor 16 is positioned within the meniscus 12
  • second anchor 18 is positioned on the back arcuate surface 54 of the meniscus, with the suture 20 connecting the anchors and extending across the tear 14 .
  • the first anchor 16 is pushed far enough into the meniscus to approximate the two inner surfaces 56 , 58 of the meniscal tear 14 .
  • the shapes of the anchors 16 , 18 hold their final position. Neither anchor is exposed on a bearing surface of the meniscus.
  • the anchor 18 that bears against the back non-bearing surface 54 of the meniscus is positioned first, and then the anchor 16 that extends into the interior of the meniscus is positioned.
  • a tubular needle such as that used with the RAPIDLOCTM Meniscal Repair System could be employed.
  • Such a device could have a cable or similar structure running through the needle and connected to a trigger or similar device to selectively implant one of the anchors. The surgeon could insert the needle through the top articular surface 50 of the meniscus, and push the needle through the body of the meniscus until reaching the back surface 54 . The trigger may then be operated to release one of the anchors, such as anchor 18 in FIG. 4 , against the back surface 54 of the meniscus.
  • a length of suture 20 extends out of the top surface 50 of the meniscus and extends to the other anchor 16 .
  • the surgeon may then use a pair of forceps of similar device and push the anchor 16 through the top surface 50 and into the body of the meniscus until the two surface 56 , 58 at the tear are approximated.
  • Both anchors 16 , 18 should then stay in place, holding the meniscus as shown in FIG. 4 so that the meniscus can heal.
  • Similar surgical procedures may be used to implant the embodiments of the unitary surgical devices 10 illustrated in FIGS. 6 and 10 . It should be understood that this surgical technique is provided by way of example only, and that the present invention is not limited to any particular surgical technique unless expressly called for in the claims. Additional unitary surgical devices 10 can be implanted until all the tissue surfaces are adequately approximated and the tear is stabilized.
  • the base 21 and tissue regeneration material 22 are thin, and nearly planar in cross section.
  • the anchoring devices 16 , 18 are used for delivering the unitary surgical device to the proper location in the meniscal tear 14 , between the two inner surfaces 54 , 56 of the meniscal tear 14 .
  • first anchor 16 or first and second anchors 16 , 18
  • the anchoring device or devices 16 , 18 are moved through the back 54 of the meniscus until one of the faces 60 of the unitary surgical device 10 is juxtaposed with the inner surface 58 of the meniscal tear 14 , as shown in FIGS. 46 and 47 .
  • the remaining suture at the back of the meniscus may be cut off, removed and discarded.
  • FIGS. 48 and 49 illustrate the meniscus with the tear 14 approximated to the implanted unitary surgical device 10 .
  • the surfaces of the meniscus and the implanted unitary surgical device are secured together with suture, shown at 64
  • FIG. 49 the surfaces are secured together with another unitary surgical device 10 of the type shown in FIG. 4 .
  • Instruments that may be used in delivering the unitary surgical devices of FIG. 45 may include a Meniscal Applier (REF 228000) available from the Mitek Products division of Ethicon, Inc., of Westwood, Mass.
  • the Mitek Meniscal Applier may be modified to provide a greater curvature if desired.
  • 90° mosquito forceps may also be used to implant the unitary surgical devices.
  • the surgeon may remove a portion of the meniscus as illustrated in FIGS. 15 and 24 .
  • the surgeon will remove the damaged or diseased tissue, as shown in FIGS. 15 and 24 , leaving a generally wedge-shaped void 70 .
  • FIGS. 15 and 24 are simplified for purposes of illustration; the actual area of removed tissue may look different from that illustrated.
  • the portion of the meniscus that is removed is from the inner arcuate edge 52 of the meniscus to a position inward of the back arcuate surface 54 of the meniscus, so that an arcuate portion of the back 54 of the meniscus remains after the meniscectomy.
  • This back portion to the meniscus shown at 72 in FIGS. 15-17 , 19 , 21 , 24 - 26 , 29 , 31 , 33 , 36 , 38 and 40 .
  • the meniscectomy can extend to the highly vascularized red zone of the meniscus, the back portion 72 can include more than red zone tissue.
  • the surgeon may opt to use one of the embodiments of the unitary surgical device 10 illustrated in FIGS. 11-23 , 25 - 40 and 42 .
  • the unitary surgical device 10 of the FIG. 11 embodiment is wedge shaped in cross-section, and may be placed so that the tissue regeneration material and the base 21 fit within the void 70 left after part of the meniscus has been removed.
  • the first and second anchors 16 , 18 comprise two lengths of suture secured to a disc 73 of biocompatible and bioabsorbable material.
  • the first and second anchoring sutures extend through a part of the tissue regeneration material 22 , and out through the lower face of the base 21 .
  • anchoring sutures 16 , 18 may be pushed through the back portion 72 of the meniscus as shown in FIG. 12 , and pulled tight until the back surface 74 of the device 10 is juxtaposed with the front surface 76 of the back portion 72 of the meniscus. The ends of the two anchoring sutures 16 , 18 may then be tied against the back surface 54 of the meniscus 12 as shown in FIG. 12 .
  • the base 21 is somewhat larger than the wedge of tissue regeneration material 22 , extending rearward of the back surface 74 of the tissue regeneration material 22 and forming upper and lower projections 80 , 82 as shown in FIG. 14 .
  • the first and second anchoring sutures 16 , 18 comprise a length of suture extending substantially across one dimension of the base 21 at the back of the base, and out through holes 78 in the base 21 .
  • the two anchor sutures 16 , 18 may be inserted with a needle or similar device (not shown) through the front surface 76 of the back red portion 72 of the meniscus, or through the bottom surface of the body of the meniscus.
  • the two anchoring sutures 16 , 18 may be pushed through the body of the meniscus and through the arcuate back surface 54 , where they may be tied off, as shown in FIG. 17 .
  • the unitary surgical device substantially fills the void 70 left by the meniscectomy.
  • the front surface 76 of the vascularized portion 72 of the meniscus abuts the back surface 74 of the tissue regeneration material 22 so that the blood vessels may deliver cells and other materials to the tissue regeneration material 22 for the healing process.
  • the anchoring sutures 16 , 18 may also be along the top of the base 21 , as shown in the embodiment of FIGS. 18-19 , and the upper projection 80 may be greater than the lower projection 82 . It should be understood that the lower projection could also be made to be greater than the upper projection 80 .
  • the anchoring sutures 16 , 18 can also be connected directly to the back surface 74 of the mass of tissue regeneration material 22 .
  • these anchoring sutures 16 , 18 could be positioned prior to final forming of the tissue regeneration material, adhered to the tissue regeneration material or mechanically attached to the tissue regeneration material, such as by sewing the suture to the tissue regeneration material; any of these methods of securing the anchors 16 , 18 to the tissue regeneration material 22 would be performed prior to implantation of the unitary surgical device.
  • the top portion of the base 21 need not be secured to the mass of tissue regeneration material 22 , the top portion of the base 21 could instead be sutured to the back vascularized portion 72 of the meniscus, as shown at 86 in FIG. 21 .
  • a plurality of anchors 16 , 18 , 40 , 42 , 44 , 46 may be provided.
  • the unitary surgical device 10 of FIGS. 22-23 may be implanted by extending one group of sutures 16 , 40 , 44 over the top of the vascularized portion 72 of the meniscus, one group of sutures 18 , 42 , 46 under the vascularized portion 72 of the meniscus, and moving the unitary surgical device toward the vascularized portion 72 , so that the unitary surgical device 10 fills the void 70 in the meniscus.
  • All of the sutures 16 , 18 , 40 , 42 , 44 , 46 may than be anchored to the back surface 54 of the vascularized portion of the meniscus as shown in FIG. 26 .
  • the upper projection 80 and under projection 82 both cover the portion of the upper surface 50 between the surfaces 76 and 54 and the portion of the lower surface 88 of the meniscus between the surfaces 76 and 54 .
  • the unitary surgical device 10 need not be wedge shaped.
  • the base 21 could comprise a flat sheet with a pillow or other mass of tissue regeneration material 22 shaped to fill the void 70 left by the meniscectomy.
  • the unitary surgical device 10 may then be fixated to the meniscus 12 by using a needle to push the anchoring sutures 16 , 18 through the top surface 50 of the meniscus, and then through the body of the meniscus and out through the back surface 54 of the meniscus, where the anchoring sutures 16 , 18 may be tied, thereby fixating the unitary surgical device to the meniscus.
  • the unitary surgical device 10 of the FIG. 42 embodiment may be fixated in a similar manner.
  • a flat base 21 could be provided with a wedge or otherwise shaped mass of tissue regeneration material 22 fixed to the base.
  • the base 21 could include two fixating members 15 , 17 comprising, for example, two lengths of suture 16 g, 18 g.
  • a third fixating member 77 could also be included in the unitary surgical device.
  • the third fixating member 77 comprises a backstop and a length of suture affixed to the mass of tissue regeneration material 22 , with the length of suture extending through the mass of tissue regeneration material as in the embodiment of FIGS. 11-12 .
  • a unitary surgical device substantially like that shown in FIGS. 28-29 may be provided with barbed darts affixed to the ends of sutures to define the first and second anchors 16 , 18 .
  • the unitary surgical device 10 of the FIG. 27 embodiment may be fixated to the meniscus 12 in a manner similar to that shown in FIG. 29 , except instead of tying the ends of suture for fixation, the barbed darts 16 , 18 may be pressed into the body of the meniscus to thereby fixate the device 10 to the meniscus.
  • each anchor 16 , 18 , 40 , 42 , 44 , 46 includes a barbed dart at the end of a length of suture.
  • the anchors 16 , 18 , 40 , 42 , 44 , 46 are moved over and under the portion of the meniscus behind the void 70 and the barbed darts are pushed into the body of the meniscus through the back 54 of the meniscus.
  • the barbed darts are pushed in until the unitary surgical device is properly fixated.
  • the barbs on the darts prevent the darts from being pulled out.
  • FIGS. 32-33 is similar to that of FIGS. 20-21 , except that instead of using suture as the first and second anchors 16 , 18 , barbed darts are affixed to extend outward from the back 74 of the mass of tissue regeneration material 22 .
  • the upper and lower projections 80 , 82 are moved over and under the surfaces 50 , 88 of the vascularized portion 72 of the meniscus behind the void 70 until the barbed darts enter the face 76 of the meniscus at the back of the void 70 created during the meniscectomy.
  • the barbs on the dart fixate the implant in place against the meniscus. It should be understood that although only one anchoring barbed dart 16 is illustrated in FIGS.
  • top panel 24 of the base 21 may be affixed to the mass of tissue regeneration material by adhesion, cross-linking, mechanical fixation or the like, the top panel 24 can also be free from such connection and can be surgically fixated to the body of the meniscus as described above with respect to the embodiment of FIGS. 20-21 .
  • the first and second anchors comprise mating darts and holes.
  • the darts extend upward from the bottom projection 82 and the mating holes are in the upper projection 80 .
  • the darts are long enough to extend through the body of part of the meniscus.
  • the embodiment of FIG. 34 may be fixated by placing the device 10 in the void 70 in the meniscus, positioning the bottom projection 82 under part of the meniscus so that the darts extend upward through the meniscus and exit the top of the meniscus.
  • the top panel 24 of the base 21 may then be pressed down so that the tops of the darts extend through the holes and lock the top and bottom portions of the base together and to the meniscus.
  • the first and second anchors 16 , 18 comprise tacks, and an additional pair of tacks are provided as third and fourth anchors 40 , 42 .
  • the mass of tissue regeneration material 22 is affixed to the top panel 24 of the base 21 by adhesive, cross-linking (chemical or physical) or through mechanical means.
  • the tacks are provided on both the upper and lower projections 80 , 82 .
  • the mass of tissue regeneration material fits within the void 70 left after the meniscectomy, and the projections 80 , 82 are positioned over and under the upper and lower surfaces 50 , 88 of the meniscus 12 , between the surfaces 76 and 54 of the meniscus.
  • the tacks extend into the body of the meniscus between the surfaces 76 and 54 , thereby fixating the unitary surgical device 10 to the meniscus.
  • the unitary surgical device is implanted in a manner similar to the other embodiments.
  • the device 10 is positioned so that the void 70 is substantially filled by the mass of tissue regeneration material 22 .
  • the top panel 24 is moved to place the upper projection 80 over the top surface 50 of the portion of the meniscus behind the void 70 and the bottom panel is moved to place the lower projection 82 under the lower surface 88 of the meniscus behind the void 70 .
  • the female locking member 18 is pushed upward through the lower surface 88 and into the body of the meniscus, and the male locking member 16 is pushed downward through the upper surface 50 into the body of the meniscus until at least part of the male locking member 16 is received in the female locking member 18 , thereby fixating the device 10 to the meniscus.
  • the device 10 may be fixated by first implanting the female locking member 18 using a hollow needle delivery system, like that described above for implanting the device 10 of FIGS. 3 and 4 .
  • the female locking member 18 is pushed through the surface 76 , through the body of the meniscus and out through the surface 54 .
  • the suture extends through this passageway and through part of the implant, such as through the mass of tissue regeneration material 22 and through the top panel 24 of the base.
  • the device 10 may be moved into position with the mass of tissue regeneration material located in the void 70 and against the vascularized portion 72 of the meniscus.
  • the male locking member 16 is then pushed into the female locking member, thereby fixating the unitary surgical device 10 to the meniscus 12 .
  • FIG. 50 may be used either as a means of approximating the inner surfaces of a meniscal tear, as shown in FIG. 51 , or as a means of fixating a tissue regenerating implant after a partial meniscectomy, as shown in FIG. 52 .
  • the base 20 backstop element 19 in FIG. 50
  • the base 20 may be inserted using a commercially available device such as a Mitek Meniscal Applier, as described above.
  • the unitary surgical device 10 of FIG. 50 may be inserted as described above, or could be inserted from the outer, non-articulating side of the meniscus.
  • the anchors 16 a, 18 c could be pushed through the outer non-articulating surface 54 of the meniscus, through the body of the meniscus, up through the upper articulating surface 50 of the meniscus and through the overlying upper portion 80 of the top panel 24 of the implant. The anchors 16 a, 18 c may then be moved across a portion of the upper surface of the top panel 24 of the implant and back into the body of the outer portion 72 of the meniscus to fixate the implant in place.
  • FIG. 53 An additional embodiment of a unitary surgical device is illustrated in FIG. 53 .
  • the upper projection 80 has a plurality of pre-formed holes along the outer edge. Each hole could thereby comprise a fixating member, as shown at 15 and 17 FIG. 53 . These holes could be pre-formed in the base 21 so that the surgeon may easily and quickly suture the unitary surgical implant 10 of FIG. 53 to the outer vascular area 72 of the meniscus through the holes 15 , 17 , as shown in FIG. 53 .
  • the a length of suture shown at 90 in FIG. 53
  • a backstop shown at 92 in FIG. 53
  • the backstop 92 could be positioned against the outer arcuate surface 54 of the meniscus, and then the suture 90 could be stitched to both the unitary surgical device 10 and the vascularized area 72 of the meniscus using, for example, a corkscrew needle (not shown). With such pre-formed holes in the unitary surgical device, there is little risk of damaging the device during implantation.

Abstract

Unitary surgical devices (10) are disclosed. One group of the illustrated devices has a pair of biocompatible, bioresorbable anchors (16, 18) connected to fixed lengths suture. The anchors (16, 18) and fixed length of suture are connected to each other prior to surgery. Another group of unitary surgical devices has a pair of fixating mechanisms (15, 17) connected to a base (21) prior to surgery. The second group of illustrated devices generally includes extracellular matrix material either as part of the base (21) or supported on the base (21). The extracellular matrix material serves as tissue regenerating material. In the second group of unitary surgical devices, the fixating mechanisms illustrated generally comprise suture, anchors or pre-formed holes in the base. All of the illustrated unitary surgical devices are useful in repairing a damaged meniscus. The first group of unitary surgical devices can be used to approximate inner surfaces of a tear in the meniscus. The second group of devices can be used either as an insert to be placed between and approximated to the inner surfaces of the tear or as an insert to replace a void in the meniscus left after a menisectomy.

Description

    CROSS REFERENCE TO RELATED APPLICATIONS
  • Cross reference is made to copending U.S. patent applications Ser. No. 10/195,794 entitled “Meniscus Regeneration Device and Method” (Attorney Docket No. 265280-71141, DEP-745); Ser. No. 10/195,719 entitled “Devices from Naturally Occurring Biologically Derived Materials” (Attorney Docket No. 265280-71142, DEP-748); Ser. No. 10/195,347 entitled “Cartilage Repair Apparatus and Method” (Attorney Docket No. 265280-71143, DEP-749); Ser. No. 10/195,341 entitled “Hybrid Biologic/Synthetic Porous Extracellular Matrix Scaffolds” (Attorney Docket No. 265280-71144, DEP-751); Ser. No. 10/195,606 entitled “Cartilage Repair and Regeneration Device and Method” (Attorney Docket No. 265280-71145, DEP-752); Ser. No. 10/195,354 entitled “Porous Ektracellular Matrix Scaffold and Method” (Attorney Docket No. 265280-71146, DEP-747); Ser. No. 10/195,334 entitled “Cartilage Repair and Regeneration Scaffolds and Method” (Attorney Docket No. 265280-71180, DEP-763); Serial No. 10/195,633 entitled “Porous Delivery Scaffold and Method” (Attorney Docket No. 265280-71207, DEP-762), each of which is assigned to the same assignee as the present application, each of which is filed concurrently herewith, and each of which is hereby incorporated by reference. Cross reference is also made to U.S. patent application Ser. No. 10/172,347 entitled “Hybrid Biologic-Synthetic Bioabsorbable Scaffolds” which was filed on Jun. 14, 2002, which is assigned to the same assignee as the present application, and which is hereby incorporated by reference.
  • FIELD OF THE INVENTION
  • The present invention relates generally to surgical devices for approximating, repairing or regenerating damaged or diseased fibrocartilage, and to surgical methods using such devices.
  • BACKGROUND OF THE INVENTION
  • Articular cartilage is a type of hyaline cartilage that lines the surfaces of the opposing bones in a diarthrodal joint (e.g., knee, hip, shoulder, etc.). Articular cartilage provides a near frictionless articulation between the bones, while also functioning to absorb and transmit the compressive and shear forces encountered in the joint. Further, since the tissue associated with articular cartilage is aneural, these load absorbing and transmitting functions occur in a painless fashion in a healthy joint.
  • Human joints also have another type of cartilage present: intra-articular fibrocartilage. Intra-articular fibrocartilage can be present in the form of a discus articularis, that is, as a plate or ring of fibrocartilage in the joint capsule separating the joint surfaces (articular cartilage) of the bones of the joint. Such fibrocartilage is present, for example, in the temporomandibular joint, between vertebrae, and in the knee joint. In the knee joint, the intra-articular fibrocartilage comprises the meniscus, a crescent-shaped or semi-lunar-shaped disc of tissue that is located between the femoral condyles and the tibial plateau. The meniscus primarily functions as a shock absorber, absorbing the shock of compressive and shear forces in the knee. The meniscus also provides a substantially frictionless surface for articulation of the knee joint.
  • When cartilage tissue is no longer healthy, there can be debilitating pain in the joint. Cartilage health can be adversely affected by disease, aging, or trauma. The adverse effects of disease, aging and trauma can be in the form of a tear in the cartilage or in the form of a breakdown of the cartilage matrix.
  • In the knee, the meniscus is frequently damaged in twisting injuries. It is also damaged with repetitive impact over time. Meniscus degeneration can also occur by aging; as a person ages, the meniscus can become soft in places, so that even common motions like squatting can cause meniscal tears.
  • Common surgical procedures for treating meniscal damage include tear repairs and meniscectomies. A tear repair is most commonly performed when the tear is a clean longitudinal vertical lesion in the vascular red zone of the meniscus. The basic strategy is to stabilize the tear by limiting or eliminating radial separation of the faces of the tear when the meniscus is load bearing. Many devices and surgical procedures exist for repairing meniscal tears by approximating the faces of the meniscus at the tear. Examples of such devices and procedures are disclosed in the following U.S. Pat. Nos.: 6,319,271; 6,306,159; 6,306,156; 6,293,961; 6,156,044; 6,152,935; 6,056,778; 5,993,475; 5,980,524; 5,702,462; 5,569,252; 5,374,268; 5,320,633; and 4,873,976.
  • Meniscectomies involve the surgical removal of part of the meniscus. Such procedures have generally been performed in cases of radial tears, horizontal tears, vertical longitudinal tears outside the vascular zone, complex tears, or defibrillation. Although meniscectomies provide immediate relief to the patient, in the long term the absence of part of the meniscus can cause cartilage wear on the condylar surface, eventually leading to arthritic conditions in the joint.
  • U.S. Pat. No. 6,042,610 assigned to ReGen Biologics, Inc., hereby incorporated by reference, discloses the use of a collagen scaffold device comprising a bioabsorbable material made at least in part from purified natural fibers. The purified natural fibers are cross-linked to form the device of that patent. The device produced can be used to provide augmentation for a damaged meniscus. Related U.S. Pat. Nos. 6,042,610; 5,735,903; 5,681,353; 5,306,311; 5,108,438; 5,007,934; 4,880,429 also disclose a meniscal augmentation device for establishing a scaffold adapted for ingrowth of meniscal fibrochondrocytes.
  • It is also known to use naturally occurring extracelluar matrices (ECMs) to provide a scaffold for tissue repair and regeneration. One such ECM is small intestine submucosa (SIS). SIS has been described as a natural biomaterial used to repair, support, and stabilize a wide variety of anatomical defects and traumatic injuries. See, for example, Cook® Online News Release provided by Cook Biotech Inc. at “www.cookgroup.com”. The SIS material is derived from porcine small intestinal submucosa that models the qualities of its host when implanted in human soft tissues. Further, it is taught that the SIS material provides a natural matrix with a three-dimensional structure and biochemical composition that attracts host cells and supports tissue remodeling. SIS products, such as OASIS™ and SURGISIS™, are commercially available from Cook Biotech Inc., Bloomington, Ind.
  • Another SIS product, RESTORE® Orthobiologic Implant, is available from DePuy Orthopaedics, Inc. in Warsaw, Ind. The DePuy product is described for use during rotator cuff surgery, and is provided as a resorbable framework that allows the rotator cuff tendon to regenerate. The RESTORE Implant is derived from porcine small intestine submucosa, a naturally occurring ECM composed primarily of collagenous proteins, that has been cleaned, disinfected, and sterilized. Other biological molecules, such as growth factors, glycosaminoglycans, etc., have also been identified in SIS. See: Hodde et al., Tissue Eng., 2(3): 209-217 (1996); Voytik-Harbin et al., J. Cell. Biochem., 67: 478-491 (1997); McPherson and Badylak, Tissue Eng., 4(1): 75-83 (1998); Hodde et al., Endothelium 8(1): 11-24; Hodde and Hiles, Wounds, 13(5): 195-201 (2001); Hurst and Bonner, J. Biomater. Sci. Polym. Ed., 12(11): 1267-1279 (2001); Hodde et al., Biomaterial, 23(8): 1841-1848 (2002); and Hodde, Tissue Eng., 8(2): 295-308 (2002). During seven years of preclinical testing in animals, there were no incidences of infection transmission from the implant to the host, and the SIS material has not adversely affected the systemic activity of the immune system. See: Allman et al., Transplant, 17(11): 1631-1640 (2001); Allman et al., Tissue Eng., 8(1):53-62 (2002).
  • While small intestine submucosa is available, other sources of ECM are known to be effective for tissue remodeling. These sources include, but are not limited to, stomach, bladder, alimentary, respiratory, and genital submucosa. In addition, liver basement membrane is known to be effective for tissue remodeling. See, e.g., U.S. Pat. Nos. 6,379,710, 6,171,344, 6,099,567, and 5,554,389, hereby incorporated by reference. Further, while ECM is most often porcine derived, it is known that these various ECM materials can be derived from non-porcine sources, including bovine and ovine sources. Additionally, the ECM material may also include partial layers of laminar muscularis mucosa, muscularis mucosa, lamina propria, stratum compactum layer and/or other such tissue materials depending upon other factors such as the source from which the ECM material was derived and the delamination procedure.
  • The following U.S. patents, hereby incorporated by reference, disclose the use of ECMs for the regeneration and repair of various tissues: U.S. Pat. Nos. 6,379,710; 6,187,039; 6,176,880; 6,126,686; 6,099,567; 6,096,347; 5,997,575; 5,993,844; 5,968,096; 5,955,110; 5,922,028; 5,885,619; 5,788,625; 5,733,337; 5,762,966; 5,755,791; 5,753,267; 5,711,969; 5,645,860; 5,641,518; 5,554,389; 5,516,533; 5,460,962; 5,445,833; 5,372,821; 5,352,463; 5,281,422; and 5,275,826.
  • SUMMARY OF THE INVENTION
  • The present invention is directed toward devices and surgical methods for the repair and regeneration of diseased or damaged intra-articular fibrocartilage such as the meniscus in the human knee joint.
  • In one aspect, the present invention provides a unitary surgical device for implantation in a patient for repairing a body tissue in the patient. The unitary surgical device comprises first and second biocompatible anchors and biocompatible tissue repair material extending between and connected to the first and second anchors. The anchors and tissue repair material are connected to each other prior to surgery. The first anchor includes at least one of the following: a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable male locking member. The second anchor includes at least one of the following: a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable female locking member. The biocompatible tissue repair material includes at least one of the following: a fixed length of suture; a sheet of collagen-containing material; laminar ECM material; formed ECM material; comminuted ECM material; ECM fibers; ECM foam material; a sheet of bioresorbable material; and a base connected to the first anchor and to the second anchor and a different material secured to the base, at least one of the base and the different material including ECM material.
  • In another aspect, the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating intra-articular fibrocartilage tissue in the patient. The unitary surgical device comprises a first fixating mechanism, a second fixating mechanism and tissue repair material extending between and connected to the first and second fixating members prior to surgery. The first fixating mechanism includes at least one of the following: a length of suture; a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable male locking member. The second fixating mechanism includes at least one of the following: a length of suture; a bioresorbable barbed dart; a bioresorbable tack; a bioresorbable backstop; and a bioresorbable female locking member. The tissue repair material includes at least one of the following: a sheet of ECM material connected to the first anchor and the second anchor; laminar ECM material connected to the first anchor and the second anchor; ECM foam; comminuted ECM; ECM fibers; cross-linked ECM material; formed ECM material; and a bioresorbable base connected to the first anchor and the second anchor and a different material on the base, where at least one of the base and the different material includes ECM.
  • In another aspect, the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating intra-articular fibrocartilage tissue in the patient. The unitary surgical device comprises a base having at least two layers and a length of suture disposed or positioned between the layers of the base. At least part of the unitary surgical device is made from ECM material.
  • In another aspect, the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating meniscal tissue in the patient. The unitary surgical device comprises a base having two panels. The two panels have a V-shaped configuration in cross-section, and meet along an apex portion. The two panels have end portions spaced distally from the apex portion. The end portions are spaced from each other to provide a gap. The unitary surgical device may also include tissue regeneration material between the two panels of the base. The unitary surgical device also includes opposing anchors on the end portions of the base panels. The opposing anchors are suitable for fixation to the native meniscus.
  • In another aspect, the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating tissue in the patient. The unitary surgical device comprises a base made of a bioresorbable polymer and ECM material on the base. In addition, the unitary surgical device includes a first fixating member secured to the base prior to surgery. The first fixating member is suitable for fixation to the patient's tissue.
  • In another aspect, the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating tissue in the patient. The unitary surgical device comprises a base made of ECM material and a first fixating member secured to the base prior to surgery. The first fixating member is suitable for fixation to the patient's tissue.
  • In another aspect, the present invention provides a unitary surgical device for surgical implantation in a patient for regenerating tissue in the patient. The unitary surgical device comprises a base having two opposing edges and a plurality of holes along one of the edges of the base. The unitary surgical devices includes ECM material.
  • In another aspect, the present invention provides a method of repairing a tear in the meniscus in the knee of a patient. The meniscus has an articulating surface and a non-articulating surface. The tear results in the meniscus having two inner surfaces. The method comprises the acts of providing a unitary surgical device having a pair of resorbable anchors and a fixed length of suture connected to the anchors. After the tear in the meniscus is located, the unitary surgical device is implanted to approximate the two inner surfaces of the meniscus at the tear, with suture extending across the articulating surface of the meniscus across the tear and the resorbable anchors being spaced from the tear.
  • In another aspect, the present invention provides a method of repairing a damaged meniscus in the knee of a patient. The meniscus has a non-articulating surface, a peripheral rim and an inner portion. The method comprises the acts of providing a wedge-shaped unitary surgical device including a fixating mechanism. A portion of the damaged meniscus inward of the peripheral rim of the meniscus is removed. The unitary surgical device is implanted with a portion inward of the peripheral rim. The unitary surgical device is fixated to the meniscus by fixating at least part of the base of the unitary surgical device to the meniscus with the fixating mechanism.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The invention will be better understood by reference to the figures of the drawings wherein like numbers denote like parts throughout and wherein:
  • FIG. 1 is a diagrammatic perspective view of a meniscus with a tear;
  • FIG. 2 is a cross-section taken along line 2-2 of the meniscus of FIG. 1;
  • FIG. 3 is a perspective view of a first embodiment of a unitary surgical device of the present invention;
  • FIG. 4 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 3 fixated to the meniscus;
  • FIG. 5 is a perspective view of a second embodiment of a unitary surgical device of the present invention;
  • FIG. 6 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 5 fixated to the meniscus;
  • FIG. 7 is a perspective view of a third embodiment of a unitary surgical device of the present invention;
  • FIG. 8 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 7 fixated to the meniscus;
  • FIG. 9 is a perspective view of a fourth embodiment of a unitary surgical device of the present invention;
  • FIG. 10 is a cross-section of a torn meniscus showing the unitary surgical device of FIG. 9 fixated to the meniscus;
  • FIG. 11 is an elevation of a fifth embodiment of a unitary surgical device of the present invention;
  • FIG. 12 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 11 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 13 is a top plan view of a sixth embodiment of a unitary surgical device of the present invention;
  • FIG. 14 is an elevation of the unitary surgical device of FIG. 13;
  • FIG. 15 is a perspective diagrammatic view of a meniscus, with a void left by a partial meniscectomy and with the unitary surgical device of FIGS. 13-14 in the process of being implanted;
  • FIG. 16 is a perspective diagrammatic view of the meniscus of FIG. 15, shown with the unitary surgical device of FIGS. 13-15 fixated to the meniscus;
  • FIG. 17 is a cross-section of the meniscus and unitary surgical device of FIG. 16, taken along line 17-17 of FIG. 16;
  • FIG. 18 is a top plan view of a seventh embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 19 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 18 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 20 is an elevation of an eighth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 21 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 20 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 22 is a top plan view of a ninth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 23 is a perspective view of the unitary surgical device of FIG. 22, shown with the top panel of the base folded over the mass of tissue regeneration material;
  • FIG. 24 is a perspective diagrammatic view of a meniscus, with a void left by a partial meniscectomy;
  • FIG. 25 is a perspective diagrammatic view of a meniscus, with a void left by a partial meniscectomy and with the unitary surgical device of FIGS. 22-23 in the process of being implanted;
  • FIG. 26 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIGS. 22-23 and 25 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 27 is a top plan view of a tenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 28 is a bottom plan view of an eleventh embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 29 is a perspective, partially cut-away view of a meniscus with the unitary surgical device of FIG. 27 fixated to the meniscus;
  • FIG. 29A is a bottom plan view of a twelfth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 29B is a side elevation of the embodiment of FIG. 29A;
  • FIG. 30 is a perspective view of a thirteenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 31 is a is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 30 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 32 is an elevation of a fourteenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 33 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 32 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 34 is a perspective view of a fifteenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 35 is an elevation of a sixteenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 36 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 35 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 37 is an elevation of a seventeenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 38 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 37 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 39 is an elevation of an eighteenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 40 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 39 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy;
  • FIG. 41 is an enlarged cross-section through a part of a laminar base of a unitary surgical device, such as the device of FIG. 35, with an implanted tack used as one of the anchors of the device;
  • FIG. 42 is a perspective view of a nineteenth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 43 is an enlarged plan view of a mesh used as the base of a unitary surgical device;
  • FIG. 44 is a top plan view of a twentieth embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 45 is a top plan view of a twenty-first embodiment of a unitary surgical device incorporating the teachings of the present invention;
  • FIG. 46 is a cross-section through a torn meniscus, showing the unitary surgical device of FIG. 44 in place within the meniscal tear prior to approximation of the tissue;
  • FIG. 47 is a cross-section through a torn meniscus, showing the unitary surgical device of FIG. 45 in place within the meniscal tear prior to approximation of the tissue;
  • FIG. 48 is a cross-section through a torn meniscus, showing the unitary surgical device of FIGS. 44 and 47 in place within the meniscal tear after approximation of the meniscal tissue;
  • FIG. 49 is a cross-section through a torn meniscus, showing the unitary surgical device of FIGS. 45 and 48 in place within the meniscal tear after approximation of the meniscal tissue;
  • FIG. 50 is a perspective view of a twenty-second embodiment of the unitary surgical device of the present invention;
  • FIG. 51 is a perspective view of a portion of a meniscus, showing the unitary surgical device of FIG. 50 in use in repairing a tear in the meniscus;
  • FIG. 52 is a cross-section of a meniscus, after a partial meniscectomy, showing the unitary surgical device of FIG. 37 fixated to the meniscus and at least partially filling the void left by the partial meniscectomy; and
  • FIG. 53 is a perspective view of a twenty-third embodiment of the unitary surgical device of the present invention, in place on a meniscus.
  • DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS
  • A variety of unitary surgical devices 10 utilizing the principles of the present invention are illustrated in the accompanying drawings. The illustrated surgical devices 10 are for implantation in a patient for repairing a body tissue in the patient. The illustrated embodiments would most commonly be used in repairing intra-articular fibrocartilage, such as the meniscus of the knee, although the invention is not so limited unless expressly called for in the claims. A meniscus, or part of a meniscus, is diagrammatically illustrated at 12 in the accompanying drawings (FIGS. 1-2, 4, 6, 8, 10, 12, 15-17, 19, 21, 24-26, 29, 31, 33, 36, 38, 40, 46-49, 51 and 52). An example of a meniscal tear is shown at 14 in FIGS. 1-2, 4, 6, 8, 10, 46, 47 and 51. The invention is also expected to be useful in the treatment of damaged and diseased intra-articular fibrocartilage in other body parts as well.
  • As used herein “unitary” refers to the fact that the surgical devices 10 include at least one fixating element 15 and at least one tissue repair element 20, as an integral unit, prior to the time that the surgical devices are implanted in the patient. Preferably, each unitary surgical device 10 also includes a second fixating element 17. Thus, for example, suture may be incorporated into the device prior to the time the device is implanted in the patient. However, it should be understood that although at least one of each element is included in the device, the surgeon may choose to use additional material during surgery. For example, the surgeon may opt during surgery to use an additional fixating mechanism that was not an integral part of the original device, if the surgeon believes that additional stabilization is necessary or desirable.
  • As used herein, “tissue repair element” and “tissue repair material” are intended to include materials such as suture, whether of natural or synthetic origin, as well as tissue or cartilage regeneration material. Tissue or cartilage regeneration material encompasses naturally occurring extracellular matrix (ECM) materials that provide a collagen scaffold for tissue repair and regeneration. One such ECM material that may be used for the tissue or cartilage regeneration material is submucosa, and small intestine submucosa (SIS) in particular. Other bioremodelable collagenous tissue matrices, whatever the source, are intended to be included within “tissue regeneration material”, including purified collagenous tissues. As used herein, “SIS” is intended to include small intestine submucosa unless otherwise limited. Moreover, as used herein, “ECM” is intended to include all SIS, as well as materials made from the other sources of submucosa identified above (e.g., bladder, stomach and liver tissue from bovine, ovine and porcine sources) and materials derived from liver basement membrane (from whatever source) unless otherwise limited. For the purposes of this invention, it is within the definition of a naturally occurring ECM to clean, delaminate, and/or comminute the ECM, to cross-link the collagen within the ECM, and to form a foam or other structure from the ECM. It is also within the definition of naturally occurring ECM to fully or partially remove one or more components or subcomponents of the naturally occurring matrix. However, it is not within the definition of a naturally occurring ECM to extract or separate and purify the natural components or subcomponents (e.g., collagen or growth factor) and reform a matrix material from these extracted and purified components or subcomponents. Also, while reference is made to SIS, it is understood that other naturally occurring ECMs such as stomach, bladder, alimentary, respiratory, and genital submucosa, and liver basement membrane, for example, whatever the source (e.g., bovine, porcine, ovine, etc.) are within the scope of this invention. Thus, in this application, the terms “naturally occurring extracellular matrix” or “naturally occurring ECM” are intended to refer to extracellular matrix material that has been cleaned, disinfected, sterilized, and optionally cross-linked. The terms “naturally occurring ECM” and “naturally occurring extracellular matrix” are also intended to include foam material made from naturally occurring ECM as described in copending U.S. patent application Ser. No. 10/195,354 entitled “Porous Extracellular Matrix Scaffold and Method” (Attorney Docket No. 265280-71146, DEP-747), the toughened material made from naturally occurring ECM as described in U.S. patent application Ser. No. 10/195,794 entitled “Meniscus Regeneration Device and Method” (Attorney Docket No. 265280-71141, DEP-745), and the hardened material made from naturally occurring ECM as described in U.S. patent application Ser. No. 10/195,719 entitled “Devices from Naturally Occurring Biologically Derived Materials” (Attorney Docket No. 265280-71142, DEP-748), all filed concurrently herewith as U.S. Provisional Patent Applications and incorporated by reference below.
  • As used herein, bioresorbable, resorbable and bioabsorbable are intended to be interchangeable. All three terms are intended to mean materials that are naturally degradable in vivo over time. All are intended to include both natural and man-made materials, and to include new materials as they are developed, unless a specific material or type of material is identified in the claims.
  • As used herein, “intra-articular fibrocartilage” is intended to include the meniscus in the knee joint. It is also intended to include fibrocartilage separating the joint surfaces (articular cartilage) of the bones of other joints and separating the surfaces of adjacent vertebrae. “Intra-articular fibrocartilage” thus includes, for example, fibrocartilage in the temporomandibular joint and between vertebrae. Although the embodiments of the invention illustrated in FIGS. 11-23, 25-42, 44-47 and 53 are shaped for use in the meniscus, it should be understood that the principles of the present invention may be applied to surgical devices to be used in repairing and regenerating damaged or diseased intra-articular fibrocartilage in other joints in the body.
  • ECM material, and combinations of ECM material and synthetic materials, for use in the present invention can be prepared as described in the following United States Patents, utility applications for United States patents, and provisional applications for United States Patents, the disclosures of which are incorporated by reference herein: U.S. Pat. No. 4,902,508, entitled “Tissue Graft Composition”; U.S. Pat. No. 4,956,178, entitled “Tissue Graft Composition”; U.S. Pat. No. 5,281,422, entitled “Graft for Promoting Autogenous Tissue Growth”; U.S. Pat. No. 5,372,821, entitled “Graft for Promoting Autogenous Tissue Growth”; U.S. Pat. No. 5,445,833, entitled “Tendon or Ligament Graft for Promoting Autogenous Tissue Growth”; U.S. Pat. No. 5,733,337, entitled “Tissue Repair Fabric”; U.S. Pat. No. 5,788,625, entitled “Method of Making Reconstructive SIS Structure for Cartilaginous Elements In Situ”; U.S. Pat. No. 5,922,028, entitled “Multi-layered SIS Tissue Graft Construct for Replacement of Cartilaginous Elements In Situ”; U.S. Pat. No. 5,955,110, entitled “Multilayered Submucosal Graft Constructs and Method for Making the Same”; U.S. Pat. No. 5,993,844, entitled “Chemical Treatment, Without Detergents or Enzymes, of Tissue to Form an Acellular collagenous Matrix”; U.S. Pat. No. 6,176,880, entitled “Tissue Graft Construct for Replacement of Cartilaginous Structures”; U.S. Publication No. US-2002-0038151-A1, published Mar. 28, 2002, entitled “Reinforced Small Intestine Submucosa”; U.S. Publication No. US-2001-0002446-A1, published May 31, 2001, entitled “Tissue Graft Construct for Replacement of Cartilaginous Structures”; U.S. patent application Ser. No. 09/767,346, filed Jan. 23, 2001, entitled “Tissue Graft Construct for Replacement of Cartilaginous Structures”; U.S. Provisional Application Ser. No. 60/305,786, entitled “Meniscus Regeneration Device and Method”, filed on Jul. 16, 2001.
  • The “ECM” for use in the present invention can be disinfected as described in U.S. Pat. No. 6,206,931, entitled “Graft Prosthesis Materials” or U.S. Pat. No. 5,460,962, entitled “Peracetic Acid Sterilization of Collagen or collagenous Tissue,” which are incorporated by reference herein in their entireties, or may be disinfected generally through the use of a disinfecting agent such as a 0.15% peracetic acid in 20% ethanol solution.
  • As described above, ECM material as used herein includes commercially available materials, unless otherwise expressly limited. Such commercially available materials include those available from DePuy Orthopaedics, Inc. of Warsaw, Ind. (e.g., RESTORED® Orthobiologic Implant), for example.
  • It should also be understood that “ECM” materials, including “SIS”, as used herein, are not limited to the materials or processes described in the preceding paragraphs unless expressly indicated otherwise; the patents, provisional applications, utility applications and commercial products identified in the preceding paragraphs are identified for purposes of illustration only.
  • Referring now to the illustrated embodiments of the present invention, one group of unitary surgical devices 10 is illustrated in FIGS. 3-10 and 50-52. As illustrated in FIGS. 3, 5, 7, 9 and 50, each unitary surgical device 10 of this group includes two fixating elements 15, 17: a first anchor 16 and a second anchor 18. Each unitary surgical device also includes tissue repair material 20 extending between and connected to the first anchor 16 and second anchor 18. The tissue repair material 20 is connected to the two fixating members 15, 17 prior to surgery, and prior to terminal sterilization of the unitary surgical devices. In this group, the tissue repair material 20 comprises suture. A second group of unitary surgical devices 10 is illustrated in FIGS. 11-23, 2540,42 and 44-49. As illustrated in FIGS. 11, 13, 15, 18, 20, 22, 23, 27, 28, 30, 34, 35, 37, 39, 44, 45 and 50, each illustrated unitary surgical device 10 of this group also includes two fixating elements 15, 17 and tissue repair material 20 extending between and connected to the fixating members 15, 17. In this second group, the tissue repair material 20 includes a tissue regeneration material 22; the tissue repair material 20 may also include other elements such as suture or a base 21. In addition, in this second group, although the fixating elements 15, 17 may include anchors 16, 18, the fixating elements may also include suture, either alone or in combination with the anchors 16, 18. Thus, the fixating members 15, 17 may comprise: one or more anchors 16, 18; one or more anchors 16, 18 combined with suture 16 g, 18 g; or suture 16 g, 18 g alone. All of these elements in the second group are secured together prior to surgery and prior to terminal sterilization of the unitary surgical devices.
  • In both groups of devices, where at least one of the fixating members 15, 17 includes an anchor, the anchor 16 may comprise: a barbed dart, as illustrated at 16 a in FIGS. 3-4, 7-8, 9-10, 30-34 and 50-52; a tack, as illustrated at 16 b in FIGS. 35-36; a backstop, as illustrated at 16 c in FIGS. 5-6; a male locking member, as illustrated at 16 d in FIGS. 37-40; or a pair of connected anchors such as the pair of barbed darts 16 a connected by a length of suture. The first fixating member 15 may also comprise a length of suture, as shown at 16 g in FIGS. 11-15, 17-23, 25-26, 28-29, 42 and 44. The first fixating member 15 may also comprise combinations of anchors and other materials, such as a combination of a barbed dart 16 a as an anchor and a length of suture 16 g, as shown in FIGS. 30-31 and 46-47, or a combination of a male locking member 16d and a length of suture 16 g, as shown in FIGS. 39-40, for example. Whatever form of fixating member is selected, each material in the illustrated embodiments is a biocompatible and bioabsorbable one, that is, one that will eventually be broken down, assimilated, diminuted or excreted, or both assimilated and diminuted or excreted by the body of the patient. If a second fixating member 17 is used, it may include a second anchor 18. The second anchor 18 may comprise a top hat-shaped fixating member, as illustrated at 18 a in FIGS. 3-4; a backstop, as illustrated at 18 b in FIGS. 5-8; barbed dart, as illustrated at 18 c in FIGS. 9-10, 27, 30-31 and 50-51; a receiving opening, as shown at 18 d in FIG. 34; a tack, as illustrated at 18 e in FIGS. 35-36; a female locking member, as illustrated at 18 f in FIGS. 37-40. The second fixating member 17 may also comprise a length of suture, as shown at 18 g in FIGS. 13-23, 25-26, 28-29,42 and 44-45. The second fixating member 17 may also comprise combinations of materials, such as a combination of an anchor 18 such as a barbed dart 18 c and a length of suture 18 g, as shown in FIGS. 30-31 and 46-47, for example. As in the case of the first fixating member 15, whatever structure or form is selected for the second fixating member 17, each material in the illustrated embodiments is a biocompatible and bioabsorbable one.
  • In unitary surgical devices 10 using two fixating members 15, 17, various combinations of the above-described anchors 16 a-16 g, 18 a-18 g can be used. For example, two anchors may be used of the same or different shape, such as: a barbed dart 16 a with a top hat-shaped structure 18 a, as shown in FIGS. 3-4; a barbed dart 16 a with another barbed dart as shown at 16 a and 18 c in FIGS. 9-10; a barbed dart with a backstop, as shown at 16 a and 18 b in FIGS. 7-8; a tack 16 b can be used with another tack 18 e, as shown in FIGS. 35-36, or with some other structure. All of these combinations may be used with suture as the tissue repair material 20 in the first group of embodiments, and all of them may be used with the second group of embodiments as well. It should be understood that these combinations are identified for purposes of illustration only. The present invention is not limited to these combinations unless expressly set forth in the claims.
  • A variety of materials may be used for the first and second anchors 16, 18. For example, the anchors may be constructed of biocompatible polymers, bioremodelable collagenous matrices and combinations of such materials. Other materials, such as bioactive agents, other biologically derived agents, biocompatible inorganic materials, cells, and biological lubricants can also be included as part of the anchors.
  • As used herein, “biocompatible polymer” and “biocompatible polymers” is intended to include both synthetic polymers and biopolymers (e.g., collagen). Examples of biocompatible polymers include: polyesters of [alpha]-hydroxycarboxylic acids, such as poly(L-lactide) (PLLA) and polyglycolide (PGA); poly-p-dioxanone (PDO); polycaprolactone (PCL); polyvinyl alcohol (PVA); polyethylene oxide (PEO); polymers disclosed in U.S. Pat. Nos. 6,333,029 and 6,355,699; and any other bioresorbable and biocompatible polymer, co-polymer or mixture of polymers or co-polymers that are utilized in the construction of prosthetic implants. If other such polymers have therapeutic value in the orthopaedic field, it is anticipated that at least some of them will have use in the present invention, and at least some of them should be included in “biocompatible polymers.” In addition, as new biocompatible, bioresorbable materials are developed, it is expected that at least some of them will be useful materials from which orthopaedic devices may be made. It should be understood that the above materials are identified by way of example only, and the present invention is not limited to any particular material unless expressly called for in the claims.
  • “Bioremodelable collagenous tissue matrix” and “naturally occurring bioremodelable collagenous tissue matrix” are intended to include matrices derived from native tissue selected from the group comprising skin, artery, vein, pericardium, heart valve, dura mater, ligament, bone, cartilage, bladder, liver, stomach, fascia and intestine, whatever the source. Although “naturally occurring bioremodelable collagenous tissue matrix” is intended to refer to matrix material that has been cleaned, processed, sterilized, and optionally cross-linked, it is not within the definition of a naturally occurring bioremodelable collagenous tissue matrix to extract and purify the natural components or subcomponents (e.g., collagen) and reform or reconstitute a matrix material from purified natural components or subcomponents.
  • It is understood and intended that there is substantial overlap between “bioremodelable collagenous tissue matrices” and “extracellular matrices”; the different expressions are used in this specification and claims to ensure complete coverage of the invention. It is believed that the teachings of the present invention will be useful for materials falling with both definitions.
  • Some commercially available products may be used as the anchors 16, 18 in some of the illustrated embodiments. For example, the backstop elements shown at 16 c, 18 b and 19 in FIGS. 5-8, 45, 47 and 50-52 and top-hat-shaped element 18 a shown in FIGS. 3-4 may be taken from the RAPIDLOC™ Meniscal Repair System available from the MITEK® Products division of ETHICON, INC. of Westwood, Mass.
  • In addition, the anchors 16 a-16 f, 18 a-18 f may be constructed from a naturally occurring material such as naturally occurring extracellular matrices (ECM), such as small intestine submucosa (SIS). In such a case, each anchor 16 a-16 f, 18 a-18 f may be configured as a monolithic structure formed from naturally occurring ECM which is cured to be rigid and hardened. As such, it should be appreciated that the ECM material from which the anchor is fabricated is cured to produce a structure that possesses the necessary hardness and toughness to be inserted into and through the native meniscus and to be retained in the native meniscus for at least a predetermined period of time.
  • ECM material with the necessary hardness and toughness for use as the anchors may be fabricated by compacting comminuted or shredded naturally occurring ECM material into bar or rod stock by compressing the material together and then curing the material such that it is very rigid and hardened. The curing may be accomplished by simple air drying or by heated air drying of the formed stock. The material may additionally be cross-linked to further improve its mechanical properties.
  • As a specific example, one or more of the anchors 16 a-16 f, 18 a-18 f may be constructed with a cured and hardened SIS. In this case, comminuted SIS material is placed in a container and allowed to air dry for a predetermined period of time (e.g., as long as several days) at room temperature. Over such a time, water evaporates from the SIS material thereby shrinking the material. The shrunk material is very tough and hard and, as a result, may be machined as described herein.
  • It should be appreciated that other process parameters may be established to facilitate the curing process. For example, a curing profile utilizing predetermined amounts of heat and/or pressure may be designed to facilitate the curing of the naturally occurring ECM material (e.g., SIS).
  • Once the ECM material (e.g., SIS) is cured to a desired hardness and toughness, it may be machined with conventional machining equipment to desired shapes such as in the shape of a barbed dart as illustrated in FIGS. 3-4, 7-10, 27, 30-33 and 46-47. For example, the anchor 16 a-16 f, 18 a-18 f may be turned on a lathe or similar equipment to produce the desired configuration of the anchor, such as the barbed darts. However, based on the specific design of the anchor, it should be appreciated that certain features of the anchor (e.g., the barbed darts) may be separately or additionally machined to produce a desired shape or geometry. For example, various barb configurations may be formed on part of the anchor, by, for example, use of a cutting machine.
  • In addition to conventional cutting machining techniques (e.g., lathing and cutting), contemporary techniques may also be utilized to form the cured naturally occurring ECM into the desired configuration of the anchor 16 a-16 f, 18 a-18 f. For example, a programmable laser cutting machine may be used to cut the raw stock of cured ECM. Specifically, the laser cutting machine may be programmed to cut the raw stock in a pattern which produces a desired configuration of the anchor. In addition to providing for cutting with precision tolerances, laser cutting also provides other benefits. Such laser cutting of the ECM can produce barbed darts having cut edges which are sealed and fused together to enhance the attachment capability of the barbed darts.
  • It should be understood that the material selected for the anchors 16 a-16 f, 18 a-18 f may also comprise mixtures or composites of the materials described above. For example, the anchors 16 a-16 f, 18 a-18 f could comprise both a biocompatible polymer and ECM material. With regard to the shape of the barbed darts 16 a, 18 c that may be used with the present invention, reference is made to barbed dart configuration shown in U.S. Pat. No. 5,702,463 as one example of a shape of barbed dart that may be useful. It should be understood that the shapes of the barbed darts 16 a, 18 c and other anchors 16 b-16 f, 18 a-18 b, 18 d-18 f shown in the accompanying drawings are provided for purposes of illustration only. The present invention is not limited to any particular shape of barbed dart or other anchor unless expressly set forth in the claims. It should also be understood that the sizes of the anchors in the drawings shown are provided for purposes of illustration only. The actual sizes of the anchors may be different from those illustrated, and may vary with the method used to implant them. For example, the commercially available backstop is inserted through a needle, as shown in the Mitek Products document “RAPIDLOC MENISCAL REPAIR SYSTEM, Surgical Technique for Repair of Meniscal Tears”. If this technique and instrumentation is to be used to insert the anchors of the present invention, then the anchors should be sized accordingly. Typical barbed darts can be expected to be in the range of about 1 mm in maximum diameter and about 3 mm in length. It should be understood that these dimensions are provided for purposes of illustration only; the present invention is not limited to any particular size of anchor unless expressly set forth in the claims.
  • Where the fixating elements 15, 17 include or consist of suture 16 g, 18 g, such as in FIGS. 11-23, 25-31, 42 and 44, any suitable suture material may be used, such as commercially available suture. Acceptable suture may be obtained from the MITEK PRODUCTS division of ETHICON, INC. of Westwood, Mass.; examples include PANACRYL™ absorbable suture, ETHIBOND® EXCEL polyester suture, PDS® polydioxanone suture and PROLENE® polypropylene suture.
  • Whatever structure and material is chosen for the anchors 16, 18, the anchors are connected to a tissue repair material 20 in the illustrated unitary surgical devices 10. The tissue repair material 20 in the illustrated embodiments includes: suture; a base; tissue regenerating material; or combinations of these materials.
  • In the embodiments of FIGS. 3-10, the tissue repair material 20 comprises a fixed length of suture; the suture in the illustrated embodiment has a length of about 4-5 mm. A surgical kit could contain several unitary surgical devices 10, each with a pair of anchors 16, 18 separated by a variety of fixed lengths of suture 20 as the tissue repair material. The lengths for the sutures portions of the devices 10 in the kit could range, for example, from 2 mm to about 1 cm. Alternatively, several kits could be provided each with a plurality of unitary surgical devices of a particular length. It should be understood that these lengths are provided for purposes of illustration only, the present invention is not limited to tissue repair material of these or any particular lengths unless expressly called for in the claims. The suture used for the tissue repair material 20 in these embodiments may be standard commercially available suture made of conventional materials. Acceptable suture may be obtained from the sources identified above. FIGS. 3-10 illustrate examples of such unitary surgical devices 10 wherein the tissue repair material 20 comprises suture.
  • Embodiments of the invention utilizing a base 21 as part of the tissue repair material 20 are illustrated in FIGS.11-23, 25-42, 44-47. The base component 21 of the tissue repair material may comprise a third fixating member, such as backstop element 19 shown in FIG. 50. In addition, the base 21 may provide structural support to the unitary surgical device 10. The base may comprise a sheet, as shown in FIGS. 11-23, 25-42, and 44-45, and may be a laminar sheet, as illustrated in FIG. 41. The base component may comprise a formed structure, as illustrated in FIG. 42. The formed structures could be laminar or could be formed in other manners as disclosed below. The base component 21 may also comprise one or more layers of mesh structures, for example, woven materials as illustrated in FIG. 43, non-woven materials, knitted materials, warp-knitted materials, braided materials, foamed materials and combinations of those materials; if more than one layer of a mesh structure is provided, the layers may be juxtaposed or spaced, with other material sandwiched between the layers, for example. The base material should have sufficient strength so that the connection to the anchors 16, 18 and the connection of the anchors 16, 18 to the patient's native tissue is maintained during implantation of the unitary surgical device 10 and for a suitable period of time after implantation. Generally, the base 21 should have sufficient strength for a sufficient time to allow the healing process to progress to the point where the structural stability provided by the base 21 is no longer needed. However, in the claims no particular strength should be implied the claims unless expressly recited.
  • The base 21 in any of the embodiments of FIGS. 11-23, 25-42, 44-47 could comprise a biocompatible polymer, a bioremodelable collagenous matrix, a naturally occurring ECM (and in particular SIS) or combinations of these materials. The tissue regeneration material 22 may be carried by the base 21 or may comprise the base 21. The base could also comprise these materials together with bioactive agents, other biologically derived agents, cells, a biological lubricant, or a biocompatible inorganic material. In the claims, no particular material or combination of materials should be implied for the base unless expressly recited.
  • For a base 21 made out of or including a biocompatible polymer, suitable polymers are defined above. These polymers can be provided in the form of, for example, meshes of woven or non-woven materials, laminar sheets, knitted materials, warp-knitted materials, braided materials, or one or more layers of foamed polymer. Reference is also made to the materials disclosed in copending U.S. Ser. No. 10/195,341 entitled “Hybrid Biologic/Synthetic Porous Extracellular Matrix Scaffolds” (Attorney Docket No. 265280-71144, DEP-751), filed concurrently herewith, along with U.S. patent application Ser. No. 10/172,347 entitled “Hybrid Biologic-Synthetic Bioabsorbable Scaffolds” which was filed on Jun. 14, 2002, both of which are incorporated by reference herein in their entireties.
  • For a base 21 made out of or including ECM material, several options are available. The ECM could comprise material derived from a mammalian submucosa source, such as SIS. The ECM base could be formed as a laminate structure, as illustrated in FIG. 41. The layers may be laminated together and bonded by both mechanical compression and application of vacuum and/or heated air which accomplishes the bonding and also dries the product. Reference is made to U.S. Pat. No. 5,955,110, which is incorporated by reference herein in its entirety, for a description of a method of making layered SIS material. A suitable SIS base may also be formed as described in copending U.S. patent application Ser. No. 10/195,794 entitled “Meniscus Regeneration Device and Method” (Attorney Docket No. 265280-71141, DEP-745), which is incorporated by reference herein in its entireties. A vacuum plate or platen with a cavity in a desired shape may be provided, with a vacuum pump connected to the cavity by a tube. The cavity may be provided with a plurality of openings leading to a manifold space within the platen which is connected to the pump. Several layers of naturally occurring ECM, such as SIS, are placed on the plate. These layers are preferably initially in a moist and flexible state. These moist, flexible layers are pulled down into the cavity by the vacuum to form a molded recess for receiving a mass of biological material. A flat vacuum plate or platen could also be used to form flat sheet forms of ECM material. These and other techniques may be employed to form the base into a desired shape, such as the wedge shape shown in FIGS. 11-23, 25-26 and 30-40.
  • Other sheet forms of ECM are expected to be useful to provide a base 21 or combination base 21 and tissue regeneration material 22. For example, it is anticipated that one could make a thick slurry of comminuted ECM fibers, dry the slurry into a sheet, pocket or other form, such as the form illustrated in FIG. 42, for example, and heat the material under combinations of pressure, vacuum and heat to bond and dry the product. In addition, one or more such sheets could be laminated together or with strips of ECM material. It is expected that other shapes and forms could also be formed of such materials. It is expected that other materials could be intermixed with the ECM material as well; for example, the thick slurry could include both ECM material and a biocompatible polymer as a structural reinforcement, or the slurry of ECM material could be supported on and fused with a supporting structure made of ECM or some biocompatible polymer.
  • In any of the above examples, the material for the base, such as ECM, can be cross-linked by known methods. For example, chemical or physical cross-linking can be used. Chemical cross-linking methods include the use of aldehydes, carbodiimides, glycation agents, enzymes or the like. Physical cross-linking methods include freeze-drying and fusion by physical means such as heat (thermal cross-linking), radiation (ultraviolet or gamma irradiation) or combinations such as by drying at elevated temperatures (dehydrothermal cross-linking). Cross-linking may also be used to impart to the base 21 biological lubricants such as hyaluronic acid (HA).
  • A portion or all of the base 21 may be perforated to allow easy chemical and cellular transfer. In addition, if desired, cells, bioactive agents, biologically derived agents, biological lubricants and biocompatible inorganic materials may be added to the base.
  • The base 21 may also include a foamed or hybrid structure, and may include other materials as disclosed in applications for United States Patent filed concurrently herewith and previously filed, which are incorporated by reference herein in their entireties: U.S. patent application Ser. No. 10/172,347 entitled “Hybrid Biologic-Synthetic Bioabsorbable Scaffolds” which was filed on Jun. 14, 2002; Ser. No. 10/195,341 entitled “Hybrid Biologic/Synthetic Porous Extracellular Matrix Scaffolds” (Attorney Docket No. 265280-71144, DEP-751) filed herewith; Ser. No. 10/195,606 entitled “Cartilage Repair and Regeneration Device and Method” (Attorney Docket No. 265280-71145, DEP-752) filed herewith; and Ser. No. 10/195,354 entitled “Porous Extracellular Matrix Scaffold and Method” (Attorney Docket No. 265280-71146, DEP-747) filed herewith.
  • The base 21 may take any one of several shapes and configurations. For example, as illustrated in FIGS. 27-29, the base 21 may comprise a single substantially flat panel. As illustrated in FIGS. 10-23, 25-26 and 30-40, the base 21 may comprise two integral panels 24, 26 joined along a linear or curved apex 28; the two illustrated panels 24, 25 diverge outward from the apex 28 to define a wedge-shaped or V-shaped structure in cross-section. The side edges 30, 32 of each panel 24, 26 may also diverge outwardly from the apex 28, as shown in FIGS. 13, 18, 22-23 and 30. The base 21 may comprise a pillow-like structure, like a sac made of the base material, with a mass of tissue regeneration material held within the sac or pillow structure.
  • In each of the embodiments of FIGS. 11-23, 25-40,42 and 44-45, a mass of tissue regeneration material 22, such as ECM, is included as part of the tissue repair material 20. In each of these embodiments, the mass of tissue regeneration material 22 comprises a separate mass that is secured to the base 21. In the embodiment of FIG. 44, a plurality (three) of masses of tissue regeneration material 22 are fixed to the base 21. In the embodiments of FIGS. 11-23, 25-26 and 30-40, a single mass of tissue regeneration material 22 is positioned between the two panels 24, 26 near the apex 28; the masses of tissue regeneration material 22 in these illustrated embodiments are wedge-shaped or V-shaped in cross-section, although it should be understood that other shapes are within the scope of the invention. As illustrated in FIG. 42, the mass of tissue regeneration material could also comprise a loose pack of comminuted or shredded ECM material. As disclosed in U.S. Provisional Patent Application Ser. No. 60/305,786, the SIS material could comprise rolls of comminuted SIS. It should also be understood that, depending on the material used for the base 21, the unitary surgical device need not include any additional tissue regeneration material; for example, if the base 21 comprises one or more layers of ECM mesh or an ECM foam, then it may not be necessary to include a separate mass of tissue regeneration material.
  • If a separate mass of tissue regeneration material 22 is used, it may be secured to the base 21 by use of a compatible adhesive. Synthetic adhesives are commercially available, such as polycaprolactone (PCL. Biological adhesives are also available, such as commercially available materials containing transglutaminase or fibrin, for example. Other biological adhesives are also known, as described in U.S. Pat. No. 6,326,025 “Tissue Reactive Adhesive Compositions” and in published U.S. Pat. Apps. 200200344533 “Bioerodable Polymeric Adhesives for Tissue Repair” and 20020031551 “Bioerodable Polymeric Adhesives for Tissue Repair.” The adhesive can be applied to the tissue regeneration material 22 and to the base 21. The tissue regeneration material 22 may be secured to a pillow or sac-like base by substantially enclosing the mass of tissue regeneration material within the base structure, such as by suturing three or four sides of the base structure around the mass of tissue regeneration material, by using a compatible adhesive around the perimeter of the base surrounding the mass of tissue regeneration material. The tissue regeneration material may also be secured to the base by positioning the tissue regeneration material in a formed receiving structure or pocket, as in the embodiment of FIG. 42. In addition, layers of SIS material could be laminated around all or part of the mass of tissue regeneration material. Chemical and physical cross-linking may also be used to secure the mass of tissue regeneration material 22 to the base 21. Chemical cross-linking methods of securing these materials 21, 22 together include the use of aldehydes, carbodiimides, glycation agents, enzymes (e.g., transglutaminase), biologics (e.g., fibrin) or the like. Physical cross-linking methods include freeze-drying and fusion by physical means such as heat (thermal cross-linking), radiation (ultraviolet or gamma irradiation) or combinations such as by drying at elevated temperatures (dehydrothermal cross-linking).
  • The mass or plug of tissue regeneration material 22 may comprise comminuted and/or lyophilized naturally occurring ECM (e.g., SIS) with the desired porosity and material density. The material density and/or porosity of the mass or plug may be varied to control cell migration and proliferation. Additional examples of materials that are usable for the mass of tissue regeneration material include ECM (e.g., SIS) powder, ECM (e.g., SIS) fibers, ECM (e.g., SIS) threads, ECM (e.g., SIS) mesh, ECM (e.g., SIS) wovens, ECM (e.g., SIS) non-wovens, ECM (e.g., SIS) braided materials, ECM (e.g., SIS) solutions, ECM (e.g., SIS) gel, ECM (e.g., SIS) paste, ECM (e.g., SIS) foam, and combinations of such materials. For the powder, solutions, gel and paste forms of SIS, the material may be prepared as described in U.S. Pat. No. 5,352,463, entitled “Tissue Graft for Surgical Reconstruction of a Collagenous Meniscus and Method Therefor”, which is incorporated by reference herein in its entirety. It should be understood that separate reference in the above list to the forms of ECM should not be taken to imply that the listed references are exclusive; for example, ECM non-wovens, ECM threads and ECM foam may all include ECM fibers.
  • The mass or plug of tissue regeneration material 22, and the base 21, or the combination of the base and the tissue regeneration material may include materials described in U.S. Pat. No. 6,179,872 B1, entitled “Biopolymer Matt for Use in Tissue Repair and Reconstruction” and U.S. Pat. No. 6,153,292, entitled “Biopolymer Foams for Use in Tissue Repair and Reconstruction”, which are both incorporated by reference herein in their entireties. The mass or plug of tissue regeneration material 22 and the base, or the combination of the base and the tissue regeneration material may include materials disclosed in the following copending and concurrently filed U.S. patent applications, which are incorporated by reference herein: Ser. No. 10/195,794 entitled “Meniscus Regeneration Device and Method” (Attorney Docket No. 265280-71141, DEP-745); Ser. No. 10/195,719 entitled “Devices from Naturally Occurring Biologically Derived Materials” (Attorney Docket No. 265280-71142, DEP-748); Ser. No. 10/195,347 entitled “Cartilage Repair Apparatus and Method” (Attorney Docket No. 265280-71143, DEP-749); Ser. No. 10/195,341 entitled “Hybrid Biologic/Synthetic Porous Extracellular Matrix Scaffolds” (Attorney Docket No. 265280-71144, DEP-751); Ser. No. 10/195,606 entitled “Cartilage Repair and Regeneration Device and Method” (Attorney Docket No. 265280-71145, DEP-752); Ser. No. 10/195,354 entitled “Porous Extracellular Matrix Scaffold and Method” (Attorney Docket No. 265280-71146, DEP-747); Ser. No. 10/195,334 entitled “Cartilage Repair and Regeneration Scaffolds and Method” (Attorney Docket No. 265280-71180, DEP-763); and Ser. No. 10/195,633 entitled “Porous Delivery Scaffold and Method” (Attorney Docket No. 265280-71207, DEP-762), along with U.S. patent application Ser. No. 10/172,347 entitled “Hybrid Biologic-Synthetic Bioabsorbable Scaffolds” which was filed on Jun. 14, 2002.
  • The mass of plug of tissue regeneration material 22 could also comprise other collagenous materials. For example, it is expected that a commercial product such as the Collagen Meniscus Implant made by ReGen Biologics, Inc. of Franklin Lakes, N.J. could be combined with other elements of the present invention to form a unitary surgical device. Other collagen scaffolds are described in the following U.S. Pat. Nos. 6,042,610; 5,735,903; 5,479,033; 5,306,311; 5,007,934; and 4,880,429.
  • Porous ECM (e.g., SIS) foam for the tissue regeneration material 22 may be fabricated by lyophilizing (i.e., freeze-drying) comminuted ECM (e.g., SIS) suspended in water. The material density and pore size of the resultant foam may be varied to fit the needs of the design by controlling, amongst other things, the rate of freezing of the comminuted ECM suspension and/or the amount of water in which the comminuted ECM is suspended at the on-set of the freezing process.
  • The following is a specific example of a process for fabricating an exemplary ECM foam. It should be understood that the present invention is not limited to the materials, devices, or process steps of the following example unless expressly called for in the claims. The first step in developing a foam with a desired pore size and density is the procurement of comminuted ECM. To do this, scissor-cut ECM runners (e.g., SIS runners about 6 inches long) are positioned in a 1700 series Comitrol™ machine which is commercially available from Urschel Laboratories of Valparaiso, Ind. The ECM material is processed and thereafter collected in a receptacle at the output of the machine. The material is then processed through the machine a second time under similar conditions. Water is introduced during the process, and the resultant material is a “slurry” of ECM fiber (thin, long fibers about 200 microns thick×1-5 mm long) suspended substantially uniformly in water. It should be understood that this size of ECM fiber is identified as an illustrative example only; the invention is not limited to a particular size of ECM fiber material unless the claims expressly call for a particular size.
  • Generally, the process parameters for the comminution process should be selected to produce ECM material that is capable of commingling, intermixing or intertwining, rather than producing a powder. Process parameters that can be varied using the above-identified 1700 series Comitrol™ machine include the choice of blade used, whether water is used, the amount of water used, the speed at which the blades turn and the number of times the material is passed through the machine. As an example, cutting head 140084-10 and a Vericut, sealed impeller from Urschel Laboratories may be used, with a flow of water of about two (2) gallons per minute, with the cutting head run at a constant speed of about 9300 rpm. A first pass through the machine at these parameters will produce fibrous ECM material of varying sizes, and a second pass will produce ECM fibers of more uniform size. To test the comminuted material to determine whether it is appropriate for the production of an ECM foam, the comminuted ECM suspension or slurry is then centrifuged, excess water is poured off and the remaining slurry is poured into a dish. By hand, a small amount of the comminuted ECM material in the dish is pinched between the thumb and index finger and gently lifted from the dish; if the comminuted SIS material is fibrous, at least a small amount of additional ECM, beyond the portion pinched between the thumb and index finger, will lift along with the material that has been pinched. This additional comminuted ECM material lifts with the material that is between the thumb and index finger because the individual pieces of comminuted ECM material are commingled or intertwined. Such material should be suitable for the production of a foam. It is expected that other shapes and sizes of ECM material, and mixtures of shapes and sizes of ECM material, may be useful in producing an ECM foam. For example, it is expected that one could comminute ECM to produce ECM flakes that can intermingle to form an appropriate slurry.
  • As used herein, unless the claims are otherwise expressly limited, the terms “cohesive ECM pieces” and “cohesive SIS pieces” are intended to include ECM and SIS material that has been comminuted or otherwise processed to produce ECM and SIS pieces that are capable of commingling or intertwining (in the wet or dry state) to form a cohesive mass of discrete elements, regardless of the shape or shapes of the individual ECM or SIS pieces. One method of demonstrating that the ECM material comprises cohesive pieces is the “pinch test” described above. Examination of the final ECM foam product produced may also provide evidence that the base material comprised cohesive ECM pieces.
  • As used herein, “pieces” is intended to include any fiber, strip, ribbon, sliver, filament, shred, bit, fragment, part, flake, slice, cut, chunk, or other portion of solid or solid-like material. “ECM fiber” and “SIS fiber” are also intended to include ECM and SIS material that has been comminuted or otherwise processed to produce a material wherein at least some of the individual pieces of ECM and SIS material have lengths greater than their widths and thicknesses. It should be understood that unless otherwise expressly limited by the claims, use of the terms “ECM pieces” and “SIS pieces” should be construed to mean that the material includes such pieces, but should not be considered to imply that the material consists of such pieces exclusively. Such terms should also not be construed to imply that any particular process has been used to produce the material.
  • After the suspension has been formed, the suspension of SIS fibers is dried. To do so, a lyophilization process (freeze drying) is used. In particular, the suspension of SIS fibers is frozen at a controlled temperature drop rate to control the size of the formed ice crystals. Without allowing the material to thaw, the process of lyophilization sublimes ice crystals directly to vapor under vacuum and low temperatures. This process leaves voids in the spaces previously occupied by ice crystals. These voids and the SIS fibrous material form a network of compartments with SIS material defining interconnected walls of the network compartments. One exemplary machine for performing such a freeze drying process is a Virtis Genesis™ Series lyophilizer which is commercially available from SP Industries, Inc. of Gardiner, N.Y.
  • The process parameters of the lyophilization process may be varied to produce foams of varying pore sizes and material densities. For example, to produce foams having a relatively small pore size and a relative high material density, the SIS fibrous material may be tightly compacted by removing the water in a substantially uniform manner so as to achieve a relatively high density. Thereafter, the SIS fibrous material is flash-frozen using liquid nitrogen prior to lyophilization of the SIS. To produce foams having a moderate pore size and a moderate material density, the SIS fibrous material is first tightly compacted by removing the water in a substantially uniform matter so as to achieve a relatively high density. Thereafter, the SIS is frozen at a relatively fast rate (e.g., >−1° C./min.) to a temperature of about −80° C. prior to lyophilization of the SIS.
  • As shown in the photomicrographs (FIGS. 1-3) in co-pending U.S. patent application Ser. No. 10/195,354 entitled “Porous Extracellular Matrix Scaffold and Method” (Attorney Docket No. 265280-71146, DEP-747), filed by Prasanna Malaviya, Herbert Schwartz and Pamela Plouhar, the result of using the above-described process and materials is an ECM foam comprising a three-dimensional web of naturally occurring ECM defining a plurality of three-dimensional pores. The foam has three-dimensional pores throughout its height, width and thickness; the three-dimensional pores are interconnected to define a plurality of interconnected passageways. These interconnected passageways may be used for movement of cells such as chondrocytes in vivo. These interconnected passageways can also be used for the introduction of bioactive agents, biologically derived agents (e.g., stimulants), cells, biocompatible inorganic materials, biocompatible polymers and/or biological lubricants that may be combined with the foam as described below prior to implantation. The interconnected passageways defined by the three-dimensional pores also serve as passageways for materials used during the manufacturing process, such as compounds used for chemical cross-linking the foam.
  • The tissue regeneration material 22 may be chemically cross-linked with, for example, aldehydes, carbodiimides, glycation agents, enzymes (e.g., transglutaminase), biologics (e.g., fibrin) or the like. The tissue regeneration material 22 may also be physically cross-linked, by, for example: freeze-drying, heat fusion (thermal cross-linking), radiation fusion (ultraviolet or gamma irradiation) or combinations of fusion techniques such as by drying at elevated temperatures (dehydrothermal cross-linking).
  • The base 21 and/or the mass of tissue regeneration material 22 may also be impregnated with bioactive agents, biologically derived agents, cells, biocompatible polymers, biocompatible inorganic materials and biological lubricants. The materials could be cross-linked or otherwise affixed to the ECM base and/or mass. Alternatively, cells (e.g., fibrochondrocytes) may be cultured on the ECM base and/or mass, and as a result, subsequently be implanted as part of the unitary surgical device at the time of implantation. For the meniscus repair device, any such cells are preferably fibrochondrocytes or mesenchymal stem cells.
  • “Bioactive agents” include one or more of the following: chemotactic agents; therapeutic agents (e.g., antibiotics, steroidal and non-steroidal analgesics and anti-inflammatories, anti-rejection agents such as imnmunosuppressants and anti-cancer drugs); various proteins (e.g., short chain peptides, bone morphogenic proteins, glycoprotein and lipoprotein); cell attachment mediators; biologically active ligands; integrin binding sequence; ligands; various growth and/or differentiation agents (e.g., epidermal growth factor, IGF-I, IGF-II, TGF-β I-III, growth and differentiation factors, vascular endothelial growth factors, fibroblast growth factors, platelet derived growth factors, insulin derived growth factor and transforming growth factors, parathyroid hormone, parathyroid hormone related peptide, bFGF; TGFβ superfamily factors; BMP-2; BMP4; BMP-6; BMP-12; sonic hedgehog; GDF5; GDF6; GDF8; PDGF); small molecules that affect the upregulation of specific growth factors; tenascin-C; hyaluronic acid; chondroitin sulfate; fibronectin; decorin; thromboelastin; thrombin-derived peptides; heparin-binding domains; heparin; heparan sulfate; DNA fragments and DNA plasmids. If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of “bioactive agent” and “bioactive agents” unless expressly limited otherwise. It should be understood that the above agents are identified by way of example only, and the present invention is not limited to any particular agent unless expressly called for in the claims.
  • “Biologically derived agents” include one or more of the following: bone (autograft, allograft, and xenograft) and derivates of bone; cartilage (autograft, allograft and xenograft), including, for example, meniscal tissue, and derivatives; ligament (autograft, allograft and xenograft) and derivatives; derivatives of intestinal tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of storn ach tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of bladder tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of alimentary tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of respiratory tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of genital tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of liver tissue (autograft, allograft and xenograft), including for example liver basement membrane; derivatives of skin (autograft, allograft and xenograft); platelet rich plasma (PRP), platelet poor plasma, bone marrow aspirate, demineralized bone matrix, insulin derived growth factor, whole blood, fibrin and blood clot. Purified ECM and other collagen sources are also intended to be included within “biologically derived agents.” If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of “biologically derived agent” and “biologically derived agents” unless expressly limited otherwise. It should be understood that the above agents are identified by way of example only, and the present invention is not limited to any particular agent unless expressly called for in the claims.
  • “Cells” include one or more of the following: chondrocytes; fibrochondrocytes; osteocytes; ostoeblasts; osteoclasts; synoviocytes; bone marrow cells; mesenchymal cells; stromal cells; stem cells; embryonic stem cells; precursor cells derived from adipose tissue; peripheral blood progenitor cells; stem cells isolated from adult tissue; genetically transformed cells; a combination of chondrocytes and other cells; a combination of osteocytes and other cells; a combination of synoviocytes and other cells; a combination of bone marrow cells and other cells; a combination of mesenchymal cells and other cells; a combination of stromal cells and other cells; a combination of stem cells and other cells; a combination of embryonic stem cells and other cells; a combination of precursor cells isolated from adult tissue and other cells; a combination of peripheral blood progenitor cells and other cells; a combination of stem cells isolated from adult tissue and other cells; and a combination of genetically transformed cells and other cells. If other cells are found to have therapeutic value in the orthopaedic field, it is anticipated that at least some of these cells will have use in the present invention, and such cells should be included within the meaning of “cell” and “cells” unless expressly limited otherwise. It should be understood that the above cells are identified by way of example only, and the present invention is not limited to any particular type of cell unless expressly called for in the claims.
  • “Biological lubricants” include: hyaluronic acid and its salts, such as sodium hyaluronate; glycosaminoglycans such as dermatan sulfate, heparan sulfate, chondroitin sulfate and keratan sulfate; synovial fluid and components of synovial fluid, including mucinous glycoproteins (e.g., lubricin), tribonectins, articular cartilage superficial zone proteins, surface-active phospholipids, lubricating glycoproteins I, II; vitronectin; and rooster comb hyaluronate. “Biological lubricant” is also intended to include commercial products such as ARTHEASE™ high molecular weight sodium hyaluronate, available in Europe from DePuy International, Ltd. of Leeds, England, and manufactured by Bio-Technology General (Israel) Ltd., of Rehovot, Israel; SYNVISC® Hylan G-F 20, manufactured by Biomatrix, Inc., of Ridgefield, N.J. and distributed by Wyeth-Ayerst Pharmaceuticals of Philadelphia, Pa.; HYLAGAN® sodium hyaluronate, available from Sanofi-Synthelabo, Inc., of New York, N.Y., manufactured by FIDIA S.p.A., of Padua, Italy; and HEALON® sodium hyaluronate, available from Pharmacia Corporation of Peapack, N.J. in concentrations of 1%, 1.4% and 2.3% (for ophthalmologic uses). If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of “biological lubricant” and “biological lubricants” unless expressly limited otherwise. In addition, as new biological lubricants are identified or developed, it is expected that at least some of them will be useful materials for the present invention. It should be understood that the above materials are identified by way of example only, and the present invention is not limited to any particular material unless expressly called for in the claims.
  • “Biocompatible inorganic materials” include materials such as hydroxyapatite, all calcium phosphates, alpha-tricalcium phosphate, beta-tricalcium phosphate, calcium carbonate, barium carbonate, calcium sulfate, barium sulfate, polymorphs of calcium phosphates, ceramic particles and combinations of such materials. If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of “biocompatible inorganic material” and “biocompatible inorganic materials” unless expressly limited otherwise.
  • It is expected that various combinations of bioactive agents, biologically derived agents, cells, biological lubricants, biocompatible inorganic materials, biocompatible polymers can be used with the anchors, bases, and tissue repair material (including tissue regeneration material) of the present invention.
  • The unitary surgical devices 10 of FIGS. 11-23, 27-40 and 42 may be sized to fit the standard gap 70 left in the meniscus by a meniscectomy so that one unitary surgical device can be implanted to fill this gap 70. It may be desirable to make a plurality of sizes of such unitary surgical devices 10 to encompass the standard range of gaps 70 left by meniscectorn ies. In addition, it may be desirable to plan to be able to use more than one unitary surgical device 10 to fill the gap 70 left by the meniscectomy, so that a plurality of unitary surgical devices 10 may be implanted adjacent to or overlapping with one another to fill the gap 70 during the surgery.
  • To make a unitary surgical device 10 that includes two anchors 16, 18 connected by a length of suture as the tissue repair material 20, the anchors may be formed as described above. The anchors 16 a-16 g, 18 a-18 g may be formed to include, or machined to include an opening so that one end of each length of suture may be secured to one anchor. For example, the anchors 16, 18 could be tubular so that one end of suture can be threaded through each anchor and then knotted to secure them together. Or, the anchors could have a hole through which the suture end is threaded and then knotted.
  • To make a unitary surgical device 10 that includes both a laminar base and suture, as in the embodiments of FIGS. 22-23, 25-26 and 30-31, threads of suture 34 may be placed between two layers of base material prior to completely forming the base so that the suture threads 34 become integral with the base 21 during the forming process. As illustrated, the lengths of the suture threads 34 should be great enough so that the suture ends extend substantially beyond the parallel end edges 36, 38 of the unitary surgical device to define the first fixating element 15 and second fixating element 17 at the opposite ends of the suture thread 34. As illustrated, a plurality of suture threads may be made integral with each base. In the embodiments of FIGS. 22-23 and 30-31, three long strands of suture 34 are used, so that the resulting unitary surgical device has a total of six fixating elements: the first fixating element 15, the second fixating element 17, a third fixating element 40, a fourth fixating element 42, a fifth fixating element 44, and a sixth fixating element 46. The three suture threads 34 for this embodiment may be aligned so that one length of suture is positioned along the longitudinal centerline of the base, and additional lengths of suture are positioned between the longitudinally aligned thread and the long edges 30, 32 of the base 21, and aligned with the shape of the long edges 30, 32 of the base 21. The laminar base 21 may then be made as described in the provisional application with each suture thread 34 in place between two layers. The finished unitary surgical device 10 will include the suture affixed to the base. The base 21 of FIG. 22 may then be folded about axis 48 to form the wedge-shaped structure shown in FIG. 23, with the linear apex 28 at the axis 48. If desired, additional anchors such as barbs, tacks, or backstops, for example, could be secured to the free ends of the suture, as illustrated in the embodiment of FIGS. 30-31. It should be understood that fewer or more strands of suture may be used for the devices illustrated in FIGS. 22-23 and 30-31; for example, two strands of suture could be used, or four strands of suture could be used.
  • For non-laminar bases, the suture threads 34 could be positioned in or on the base material prior to final forming of the base. The base may then be formed as described above with the suture formed as an integral part of the base. In any case, suture could also be adhered to the base or could be sewn to the base.
  • To make the embodiments of FIGS. 34-38, an anchor such as a barb may be positioned on the surface of base laminates, as shown in FIG. 41, where anchor 16 b is shown on layers 23 i-23 l of laminate. Then, additional layers, such as layers 23 a-23 h shown in FIG. 41, may be placed on the initial base laminate 23 i-23 l, surrounding part of the anchor 16 b. The unitary surgical device may then be formed with the anchor 16 b becoming secured to at least some of the layers of the base as the layers are dried, heated and compressed. Other forms of anchor can be positioned on the base during fabrication of the base so that completion of the base also secures the anchors to the base to form a unitary structure.
  • Any of the anchors could also be secured to the base after the base is formed by, for example, using an adhesive to secure the anchor to the base. Suitable adhesives for this purpose include commercially available materials such as those containing fibrin or transglutaminase. It should be understood that other methods for securing the anchors to the base are within the scope of this invention; the invention is not limited to any particular method of securing the elements together unless expressly called for in the claims.
  • All of the illustrated embodiments of the invention may be prepared for use in surgery by providing prepackaged unitary surgical devices or kits. Thus, for example, after making any of the illustrated embodiments of unitary surgical device, a single unitary surgical device can be packaged and terminally sterilized, so that the surgeon may simply open the package and implant the device. It may be desirable to prepackage a kit including several unitary surgical devices of different sizes. As discussed above, for the embodiments of FIGS. 3-10, a kit could include several unitary surgical devices 10, each with a pair of anchors 16, 18 separated by a variety of fixed lengths of suture 20 as the tissue repair material. For the embodiments of FIGS. 11-23, 25-40,42 and 44-45, 53, each device could be made in a plurality of sizes, such as small, medium and large; a kit could comprise a group of unitary surgical devices of all sizes or a group of unitary surgical devices all of one size, for example. Conventional commercially available packaging materials and sterilization techniques can be used. For example, gamma irradiation or electron beam irradiation can be used for this terminal sterilization. It should be understood however, that the present invention is not limited to any particular packaging material or sterilization technique unless expressly called for in the claims.
  • If any of the embodiments are to be seeded with living cells such as chondrocytes, the terminally sterilized implant can subsequently be seeded with living cells and packaged in an appropriate medium for the cell type used. For example, a cell culture medium comprising Dulbecco's Modified Eagles Medium (DMEM) can be used with standard additives such as non-essential aminoacids, glucose, ascorbic acid, sodium pyrovate, fungicides, antibiotics, etc., in concentrations deemed appropriate for cell type, shipping conditions, etc.
  • Use of the illustrated embodiments of the invention is described below. All of the embodiments of the present invention may be used in surgical repair of a damaged meniscus 12, as illustrated in FIGS. 1-2, where the meniscal injury is illustrated as a meniscal tear 14 extending down from the top bearing surface 50 of the meniscus 12 between the inner arcuate edge 52 of the meniscus 12 and the back or outer arcuate surface 54 of the meniscus 12. It should be understood that the drawings show the meniscus 12 in simplified form for purposes of illustration only.
  • The first group of illustrated unitary surgical repair devices, illustrated in FIGS. 4-10, are useful for surgical meniscal repairs. With each of these devices, the objective is the same: to position the anchors 16, 18 beyond the tear 14, and to position the tissue repair material 20, comprising suture in the embodiments of FIGS. 4-10, across the tear 14. For each of these embodiments, a surgical kit would generally be provided with several unitary surgical devices 10, with varying lengths of suture, provided in the kit. The meniscal tear is evaluated and the meniscus is prepared in the standard manner. From the initial evaluation, the surgeon determines the length of device that is needed to extend across the meniscal injury for the particular patient, and then selects one of the devices from the surgical kit. Using the embodiments illustrated in FIGS. 4 and 8, at least one of the anchors, such as first anchor 16, is positioned within the meniscus 12, while the second anchor 18 is positioned on the back arcuate surface 54 of the meniscus, with the suture 20 connecting the anchors and extending across the tear 14. The first anchor 16 is pushed far enough into the meniscus to approximate the two inner surfaces 56, 58 of the meniscal tear 14. The shapes of the anchors 16, 18 hold their final position. Neither anchor is exposed on a bearing surface of the meniscus. For the embodiments of FIGS. 4 and 8, preferably the anchor 18 that bears against the back non-bearing surface 54 of the meniscus is positioned first, and then the anchor 16 that extends into the interior of the meniscus is positioned. A tubular needle such as that used with the RAPIDLOC™ Meniscal Repair System could be employed. Such a device could have a cable or similar structure running through the needle and connected to a trigger or similar device to selectively implant one of the anchors. The surgeon could insert the needle through the top articular surface 50 of the meniscus, and push the needle through the body of the meniscus until reaching the back surface 54. The trigger may then be operated to release one of the anchors, such as anchor 18 in FIG. 4, against the back surface 54 of the meniscus. At this stage, a length of suture 20 extends out of the top surface 50 of the meniscus and extends to the other anchor 16. The surgeon may then use a pair of forceps of similar device and push the anchor 16 through the top surface 50 and into the body of the meniscus until the two surface 56, 58 at the tear are approximated. Both anchors 16, 18 should then stay in place, holding the meniscus as shown in FIG. 4 so that the meniscus can heal. Similar surgical procedures may be used to implant the embodiments of the unitary surgical devices 10 illustrated in FIGS. 6 and 10. It should be understood that this surgical technique is provided by way of example only, and that the present invention is not limited to any particular surgical technique unless expressly called for in the claims. Additional unitary surgical devices 10 can be implanted until all the tissue surfaces are adequately approximated and the tear is stabilized.
  • In some instances, it may be desirable to facilitate healing of the torn meniscus by using a unitary surgical device 10 of the type shown in FIGS. 44 and 45. With these embodiments of the invention, the base 21 and tissue regeneration material 22 are thin, and nearly planar in cross section. The anchoring devices 16, 18 are used for delivering the unitary surgical device to the proper location in the meniscal tear 14, between the two inner surfaces 54, 56 of the meniscal tear 14. With these devices, the first anchor 16, or first and second anchors 16, 18, are inserted on the end of one or two needles (not shown), and the needles are pushed through the inner surface 58 of the meniscal tear 14 and through the body of the meniscus and out through the back side 54 of the meniscus 12. The anchoring device or devices 16, 18 are moved through the back 54 of the meniscus until one of the faces 60 of the unitary surgical device 10 is juxtaposed with the inner surface 58 of the meniscal tear 14, as shown in FIGS. 46 and 47. The remaining suture at the back of the meniscus may be cut off, removed and discarded. Once the unitary surgical device 10 is in place in the meniscal tear 14 as shown in FIGS. 46-47, the surgeon may then approximate the meniscal inner surface 56 and the opposite face 62 of the base 21 of the unitary surgical device 10, and secure the parts in this position using suture or another unitary surgical device, such as one of the devices of FIGS. 4-10. FIGS. 48 and 49 illustrate the meniscus with the tear 14 approximated to the implanted unitary surgical device 10. In FIG. 48, the surfaces of the meniscus and the implanted unitary surgical device are secured together with suture, shown at 64, while in FIG. 49, the surfaces are secured together with another unitary surgical device 10 of the type shown in FIG. 4.
  • Instruments that may be used in delivering the unitary surgical devices of FIG. 45 may include a Meniscal Applier (REF 228000) available from the Mitek Products division of Ethicon, Inc., of Westwood, Mass. The Mitek Meniscal Applier may be modified to provide a greater curvature if desired. 90° mosquito forceps may also be used to implant the unitary surgical devices.
  • If the injury or damage to the meniscus 12 is so severe that a meniscectomy or partial meniscectomy is necessary, the surgeon may remove a portion of the meniscus as illustrated in FIGS. 15 and 24. Generally, the surgeon will remove the damaged or diseased tissue, as shown in FIGS. 15 and 24, leaving a generally wedge-shaped void 70. It should be understood that the illustrations in FIGS. 15 and 24 are simplified for purposes of illustration; the actual area of removed tissue may look different from that illustrated. The portion of the meniscus that is removed is from the inner arcuate edge 52 of the meniscus to a position inward of the back arcuate surface 54 of the meniscus, so that an arcuate portion of the back 54 of the meniscus remains after the meniscectomy. This back portion to the meniscus, shown at 72 in FIGS. 15-17, 19, 21, 24-26, 29, 31, 33, 36, 38 and 40. Although the meniscectomy can extend to the highly vascularized red zone of the meniscus, the back portion 72 can include more than red zone tissue.
  • With part of the meniscus 12 removed, the surgeon may opt to use one of the embodiments of the unitary surgical device 10 illustrated in FIGS. 11-23, 25-40 and 42. Considering each embodiment in order, the unitary surgical device 10 of the FIG. 11 embodiment is wedge shaped in cross-section, and may be placed so that the tissue regeneration material and the base 21 fit within the void 70 left after part of the meniscus has been removed. The first and second anchors 16, 18 comprise two lengths of suture secured to a disc 73 of biocompatible and bioabsorbable material. The first and second anchoring sutures extend through a part of the tissue regeneration material 22, and out through the lower face of the base 21. These anchoring sutures 16, 18 may be pushed through the back portion 72 of the meniscus as shown in FIG. 12, and pulled tight until the back surface 74 of the device 10 is juxtaposed with the front surface 76 of the back portion 72 of the meniscus. The ends of the two anchoring sutures 16, 18 may then be tied against the back surface 54 of the meniscus 12 as shown in FIG. 12.
  • In the embodiment of FIG. 13, the base 21 is somewhat larger than the wedge of tissue regeneration material 22, extending rearward of the back surface 74 of the tissue regeneration material 22 and forming upper and lower projections 80, 82 as shown in FIG. 14. In this embodiment, the first and second anchoring sutures 16, 18 comprise a length of suture extending substantially across one dimension of the base 21 at the back of the base, and out through holes 78 in the base 21. The two anchor sutures 16, 18 may be inserted with a needle or similar device (not shown) through the front surface 76 of the back red portion 72 of the meniscus, or through the bottom surface of the body of the meniscus. The two anchoring sutures 16, 18 may be pushed through the body of the meniscus and through the arcuate back surface 54, where they may be tied off, as shown in FIG. 17. As shown in FIGS. 16-17, the unitary surgical device substantially fills the void 70 left by the meniscectomy. As shown in FIG. 17, the front surface 76 of the vascularized portion 72 of the meniscus abuts the back surface 74 of the tissue regeneration material 22 so that the blood vessels may deliver cells and other materials to the tissue regeneration material 22 for the healing process.
  • The anchoring sutures 16, 18 may also be along the top of the base 21, as shown in the embodiment of FIGS. 18-19, and the upper projection 80 may be greater than the lower projection 82. It should be understood that the lower projection could also be made to be greater than the upper projection 80.
  • As shown in FIGS. 20-21, the anchoring sutures 16, 18 can also be connected directly to the back surface 74 of the mass of tissue regeneration material 22. To make such a unitary surgical device 10, these anchoring sutures 16, 18 could be positioned prior to final forming of the tissue regeneration material, adhered to the tissue regeneration material or mechanically attached to the tissue regeneration material, such as by sewing the suture to the tissue regeneration material; any of these methods of securing the anchors 16, 18 to the tissue regeneration material 22 would be performed prior to implantation of the unitary surgical device. Also as shown in FIG. 20, the top portion of the base 21 need not be secured to the mass of tissue regeneration material 22, the top portion of the base 21 could instead be sutured to the back vascularized portion 72 of the meniscus, as shown at 86 in FIG. 21.
  • As shown in the embodiment of FIGS. 22-23, 25 and 26, a plurality of anchors 16, 18, 40, 42, 44, 46 may be provided. As shown in FIGS. 25-26, the unitary surgical device 10 of FIGS. 22-23 may be implanted by extending one group of sutures 16, 40, 44 over the top of the vascularized portion 72 of the meniscus, one group of sutures 18, 42, 46 under the vascularized portion 72 of the meniscus, and moving the unitary surgical device toward the vascularized portion 72, so that the unitary surgical device 10 fills the void 70 in the meniscus. All of the sutures 16, 18, 40, 42, 44, 46 may than be anchored to the back surface 54 of the vascularized portion of the meniscus as shown in FIG. 26. As can be seen from FIG. 26, in this embodiment the upper projection 80 and under projection 82 both cover the portion of the upper surface 50 between the surfaces 76 and 54 and the portion of the lower surface 88 of the meniscus between the surfaces 76 and 54.
  • As shown in the embodiment of FIGS. 28-29, the unitary surgical device 10 need not be wedge shaped. The base 21 could comprise a flat sheet with a pillow or other mass of tissue regeneration material 22 shaped to fill the void 70 left by the meniscectomy. The unitary surgical device 10 may then be fixated to the meniscus 12 by using a needle to push the anchoring sutures 16, 18 through the top surface 50 of the meniscus, and then through the body of the meniscus and out through the back surface 54 of the meniscus, where the anchoring sutures 16, 18 may be tied, thereby fixating the unitary surgical device to the meniscus. The unitary surgical device 10 of the FIG. 42 embodiment may be fixated in a similar manner.
  • In addition, as shown in the embodiment of FIGS. 29A-29B, a flat base 21 could be provided with a wedge or otherwise shaped mass of tissue regeneration material 22 fixed to the base. The base 21 could include two fixating members 15, 17 comprising, for example, two lengths of suture 16 g, 18 g. A third fixating member 77 could also be included in the unitary surgical device. In the embodiment of FIGS. 29A-29B, the third fixating member 77 comprises a backstop and a length of suture affixed to the mass of tissue regeneration material 22, with the length of suture extending through the mass of tissue regeneration material as in the embodiment of FIGS. 11-12.
  • As shown in FIG. 27, a unitary surgical device substantially like that shown in FIGS. 28-29 may be provided with barbed darts affixed to the ends of sutures to define the first and second anchors 16, 18. The unitary surgical device 10 of the FIG. 27 embodiment may be fixated to the meniscus 12 in a manner similar to that shown in FIG. 29, except instead of tying the ends of suture for fixation, the barbed darts 16, 18 may be pressed into the body of the meniscus to thereby fixate the device 10 to the meniscus.
  • The embodiment of FIGS. 30-31 is similar to the embodiment of FIGS. 22-23 and 25-26, except in the embodiment of FIGS. 30-31, each anchor 16, 18, 40, 42, 44, 46 includes a barbed dart at the end of a length of suture. To implant this embodiment, the anchors 16, 18, 40, 42, 44, 46 are moved over and under the portion of the meniscus behind the void 70 and the barbed darts are pushed into the body of the meniscus through the back 54 of the meniscus. The barbed darts are pushed in until the unitary surgical device is properly fixated. The barbs on the darts prevent the darts from being pulled out.
  • The embodiment of FIGS. 32-33 is similar to that of FIGS. 20-21, except that instead of using suture as the first and second anchors 16, 18, barbed darts are affixed to extend outward from the back 74 of the mass of tissue regeneration material 22. To implant this unitary surgical device, the upper and lower projections 80, 82 are moved over and under the surfaces 50, 88 of the vascularized portion 72 of the meniscus behind the void 70 until the barbed darts enter the face 76 of the meniscus at the back of the void 70 created during the meniscectomy. The barbs on the dart fixate the implant in place against the meniscus. It should be understood that although only one anchoring barbed dart 16 is illustrated in FIGS. 22-23, it is contemplated that more than a single anchoring device may be used in this embodiment. In addition, although the top panel 24 of the base 21 may be affixed to the mass of tissue regeneration material by adhesion, cross-linking, mechanical fixation or the like, the top panel 24 can also be free from such connection and can be surgically fixated to the body of the meniscus as described above with respect to the embodiment of FIGS. 20-21.
  • In the embodiment of FIG. 34, the first and second anchors comprise mating darts and holes. The darts extend upward from the bottom projection 82 and the mating holes are in the upper projection 80. The darts are long enough to extend through the body of part of the meniscus. The embodiment of FIG. 34 may be fixated by placing the device 10 in the void 70 in the meniscus, positioning the bottom projection 82 under part of the meniscus so that the darts extend upward through the meniscus and exit the top of the meniscus. The top panel 24 of the base 21 may then be pressed down so that the tops of the darts extend through the holes and lock the top and bottom portions of the base together and to the meniscus.
  • In the embodiment of FIGS. 35-36, the first and second anchors 16, 18 comprise tacks, and an additional pair of tacks are provided as third and fourth anchors 40, 42. In the embodiment of FIGS. 35-36, the mass of tissue regeneration material 22 is affixed to the top panel 24 of the base 21 by adhesive, cross-linking (chemical or physical) or through mechanical means. The tacks are provided on both the upper and lower projections 80, 82. When implanted, the mass of tissue regeneration material fits within the void 70 left after the meniscectomy, and the projections 80, 82 are positioned over and under the upper and lower surfaces 50, 88 of the meniscus 12, between the surfaces 76 and 54 of the meniscus. The tacks extend into the body of the meniscus between the surfaces 76 and 54, thereby fixating the unitary surgical device 10 to the meniscus.
  • In the embodiment of FIGS. 37-38, the unitary surgical device is implanted in a manner similar to the other embodiments. The device 10 is positioned so that the void 70 is substantially filled by the mass of tissue regeneration material 22. Then, the top panel 24 is moved to place the upper projection 80 over the top surface 50 of the portion of the meniscus behind the void 70 and the bottom panel is moved to place the lower projection 82 under the lower surface 88 of the meniscus behind the void 70. The female locking member 18 is pushed upward through the lower surface 88 and into the body of the meniscus, and the male locking member 16 is pushed downward through the upper surface 50 into the body of the meniscus until at least part of the male locking member 16 is received in the female locking member 18, thereby fixating the device 10 to the meniscus.
  • In the embodiment of FIGS. 39-40, the device 10 may be fixated by first implanting the female locking member 18 using a hollow needle delivery system, like that described above for implanting the device 10 of FIGS. 3 and 4. The female locking member 18 is pushed through the surface 76, through the body of the meniscus and out through the surface 54. The suture extends through this passageway and through part of the implant, such as through the mass of tissue regeneration material 22 and through the top panel 24 of the base. The device 10 may be moved into position with the mass of tissue regeneration material located in the void 70 and against the vascularized portion 72 of the meniscus. The male locking member 16 is then pushed into the female locking member, thereby fixating the unitary surgical device 10 to the meniscus 12.
  • The embodiment of FIG. 50 may be used either as a means of approximating the inner surfaces of a meniscal tear, as shown in FIG. 51, or as a means of fixating a tissue regenerating implant after a partial meniscectomy, as shown in FIG. 52. To approximate the surfaces of a tear as shown in FIG. 51, the base 20 (backstop element 19 in FIG. 50) may be inserted using a commercially available device such as a Mitek Meniscal Applier, as described above. Additional standard equipment may then be used to move the first and second anchors 16 a, 18 c through the non-articulating outer surface 54 of the meniscus, up through the upper articulating surface 50 of the meniscus, across the tear 14, and back into the body of the meniscus until the anchors 16 a, 18 c are embedded in the meniscus. To fixate a separate tissue regenerating implant as illustrated in FIG. 52, the unitary surgical device 10 of FIG. 50 may be inserted as described above, or could be inserted from the outer, non-articulating side of the meniscus. The anchors 16 a, 18 c could be pushed through the outer non-articulating surface 54 of the meniscus, through the body of the meniscus, up through the upper articulating surface 50 of the meniscus and through the overlying upper portion 80 of the top panel 24 of the implant. The anchors 16 a, 18 c may then be moved across a portion of the upper surface of the top panel 24 of the implant and back into the body of the outer portion 72 of the meniscus to fixate the implant in place.
  • An additional embodiment of a unitary surgical device is illustrated in FIG. 53. In this embodiment, the upper projection 80 has a plurality of pre-formed holes along the outer edge. Each hole could thereby comprise a fixating member, as shown at 15 and 17 FIG. 53. These holes could be pre-formed in the base 21 so that the surgeon may easily and quickly suture the unitary surgical implant 10 of FIG. 53 to the outer vascular area 72 of the meniscus through the holes 15, 17, as shown in FIG. 53. To implant such a device, the a length of suture, shown at 90 in FIG. 53, with a backstop, shown at 92 in FIG. 53, could be used. The backstop 92 could be positioned against the outer arcuate surface 54 of the meniscus, and then the suture 90 could be stitched to both the unitary surgical device 10 and the vascularized area 72 of the meniscus using, for example, a corkscrew needle (not shown). With such pre-formed holes in the unitary surgical device, there is little risk of damaging the device during implantation.
  • Additional surgical techniques can be employed in implanting surgical device of the type described in copending U.S. patent application Ser. No. 10/195,794 entitled “Meniscus Regeneration Device and Method” (Attorney Docket No. 265280-71141, DEP-745) by Prasanna Malaviya, Herbert Schwartz, David Whalen, Mark Pelo, Phil Jenks, Pamela Plouhar and Jerry Lower.
  • While only specific embodiments of the invention have been described and shown, it is apparent that various alternatives and modifications can be made thereto. Moreover, those skilled in the art will also recognize that certain additions can be made to these embodiments. It is, therefore, the intention in the appended claims to cover all such alternatives, modifications and additions as may fall within the true scope of the invention.

Claims (13)

1. A unitary surgical device for implantation in a patient for repairing a body tissue in the patient, the unitary surgical device comprising:
a first biocompatible anchor including at least one of the following:
a bioresorbable barbed dart;
a bioresorbable tack;
a bioresorbable backstop; and
a bioresorbable male locking member;
a second biocompatible anchor including at least one of the following:
a bioresorbable barbed dart;
a bioresorbable tack;
a bioresorbable backstop; and
a bioresorbable female locking member; and
biocompatible tissue repair material extending between and connected to the first anchor and to the second anchor prior to surgery, the tissue repair material including at least one of the following:
a fixed length of suture;
a sheet of collagen-containing material;
a sheet of biologically remodelable collagenous matrix;
laminar ECM material;
formed ECM material;
comminuted ECM material;
ECM fiber;
ECM foam material;
cross-linked ECM material;
a sheet of bioresorbable material; and
a base and a different material secured to the base, at least one of the base and the different material including ECM material.
2. The unitary surgical device of claim 1 wherein the tissue repair material includes tissue regeneration material.
3. The unitary surgical device of claim 2 wherein the tissue regeneration material includes ECM material.
4. The unitary surgical device of claim 3 wherein the ECM material includes material derived from mammalian submucosa.
5. The unitary surgical device of claim 1 wherein the ECM material includes material derived from mammalian submucosa.
6. The unitary surgical device of claim 1 wherein at least one of the anchors is sized and shaped to bear against a non-articulating surface of the meniscus of the patient.
7. The unitary surgical device of claim 1 wherein the tissue repair material is sized and shaped to extend over a portion of patient's meniscus and to extend over an area from which a portion of the patient's meniscus has been removed.
8. The unitary surgical device of claim 1 wherein the tissue repair material is wedge-shaped in cross-section.
9. The unitary surgical device of claim 1 wherein the tissue repair material further includes suture and a backstop.
10. The unitary surgical device of claim 1 further comprising a package holding the unitary surgical device.
11-54. (Cancelled)
55. A unitary surgical device for implantation in a patient for repairing a body tissue in the patient, the unitary surgical device comprising:
a first biocompatible anchor including at least one of the following:
a bioresorbable barbed dart;
a bioresorbable tack;
a bioresorbable backstop; and
a bioresorbable male locking member;
a second biocompatible anchor including at least one of the following:
a bioresorbable barbed dart;
a bioresorbable tack;
a bioresorbable backstop; and
a bioresorbable female locking member; and
biocompatible tissue repair material extending between and connected to the first anchor and to the second anchor prior to surgery, the tissue repair material including at least one of the following:
a fixed length of suture;
a sheet of bioremodelable collagenous matrix;
bioremodelable collagenous tissue matrix having a density greater than 0.5 g/cm3 connected to the first fixating mechanism and the second fixating mechanism;
bioremodelable collagenous tissue matrix having a density greater than 0.7 g/cm3 connected to the first fixating mechanism and the second fixating mechanism;
bioremodelable collagenous tissue matrix having a density greater than 0.9 g/cm3 connected to the first fixating mechanism and the second fixating mechanism;
bioremodelable collagenous tissue matrix seeded with cells;
bioremodelable collagenous tissue matrix combined with a biological lubricant;
formed bioremodelable collagenous tissue matrix material;
pieces of bioremodelable collagenous tissue matrix;
bioremodelable collagenous tissue matrix foam;
cross-linked bioremodelable collagenous tissue matrix;
a sheet of bioresorbable material; and
a base and a different material secured to the base, at least one of the base and the different material including bioremodelable collagenous tissue matrix.
56-64. (Cancelled)
US10/483,929 2001-07-16 2002-07-15 Unitary surgical device and method Abandoned US20050027307A1 (en)

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US10/483,929 US20050027307A1 (en) 2001-07-16 2002-07-15 Unitary surgical device and method

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Cited By (110)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030033022A1 (en) * 2001-07-16 2003-02-13 Plouhar Pamela Lynn Cartilage repair and regeneration device and method
US20030036797A1 (en) * 2001-07-16 2003-02-20 Prasanna Malaviya Meniscus regeneration device and method
US20030044444A1 (en) * 2001-07-16 2003-03-06 Prasanna Malaviya Porous extracellular matrix scaffold and method
US20030078617A1 (en) * 2001-07-16 2003-04-24 Schwartz Herbert E. Unitary surgical device and method
US20040059416A1 (en) * 1999-06-22 2004-03-25 Murray Martha M. Biologic replacement for fibrin clot
US20040143344A1 (en) * 2001-07-16 2004-07-22 Prasanna Malaviya Implantable tissue repair device and method
US20040220574A1 (en) * 2001-07-16 2004-11-04 Pelo Mark Joseph Device from naturally occuring biologically derived materials
US20040230303A1 (en) * 2003-05-16 2004-11-18 Gomes Katherine A. Cartilage allograft plug
US20050222687A1 (en) * 2004-04-02 2005-10-06 Gordana Vunjak-Novakovic Cartilage implant assembly and method for implantation
US20050251268A1 (en) * 2003-05-16 2005-11-10 Musculoskeletal Transplant Foundation Cartilage allograft plug
US20050249772A1 (en) * 2004-05-04 2005-11-10 Prasanna Malaviya Hybrid biologic-synthetic bioabsorbable scaffolds
US20060135638A1 (en) * 2004-12-22 2006-06-22 Pedrozo Hugo A Method for organizing the assembly of collagen fibers and compositions formed therefrom
US20060190042A1 (en) * 2004-11-05 2006-08-24 Arthrotek, Inc. Tissue repair assembly
US20060189993A1 (en) * 2004-11-09 2006-08-24 Arthrotek, Inc. Soft tissue conduit device
US20060210643A1 (en) * 2003-04-29 2006-09-21 Truncale Katherine A G Cartilage repair mixture containing allograft chondrocytes
US20060263335A1 (en) * 2003-03-27 2006-11-23 Regentec Ltd. Porous matrix
US20070026053A1 (en) * 2005-07-28 2007-02-01 Pedrozo Hugo A Joint resurfacing orthopaedic implant and associated method
US20070167950A1 (en) * 2005-12-22 2007-07-19 Tauro Joseph C System and method for attaching soft tissue to bone
US20070185532A1 (en) * 2006-02-03 2007-08-09 Arthrotek, Inc. Soft tissue repair assembly and associated method
US20070208360A1 (en) * 2004-02-13 2007-09-06 Demarais Denise M Methods and devices for reducing hollow organ volume
US20070288023A1 (en) * 2006-06-12 2007-12-13 Greg Pellegrino Soft tissue repair using tissue augments and bone anchors
US20080097606A1 (en) * 2006-10-19 2008-04-24 Cragg Andrew H Knee joint prosthesis and hyaluronate compositions for treatment of osteoarthritis
US20080132925A1 (en) * 2004-02-27 2008-06-05 Satiety, Inc. Methods and devices for reducing hollow organ volume
US20080140094A1 (en) * 2006-12-11 2008-06-12 Schwartz Herbert E Unitary surgical device and method
US20080177301A1 (en) * 2006-10-02 2008-07-24 The Cleveland Clinic Foundation Apparatus and method for anchoring a prosthetic structure to a body tissue
US20080220044A1 (en) * 2007-03-06 2008-09-11 Semler Eric J Cancellous construct with support ring for repair of osteochondral defects
US20080255676A1 (en) * 2007-01-24 2008-10-16 Musculoskeletal Transplant Foundation Two piece cancellous construct for cartilage repair
US20080274157A1 (en) * 2003-04-29 2008-11-06 Gordana Vunjak-Novakovic Cartilage implant plug with fibrin glue and method for implantation
US20090149893A1 (en) * 2007-12-05 2009-06-11 Semler Eric J Cancellous Bone Implant for Cartilage Repair
US7594922B1 (en) 2005-04-07 2009-09-29 Medicine Lodge, Inc System and method for meniscal repair through a meniscal capsular tunnel
US20090291112A1 (en) * 2003-05-16 2009-11-26 Truncale Katherine G Allograft osteochondral plug combined with cartilage particle mixture
US20090306688A1 (en) * 2008-06-10 2009-12-10 Patel Umesh H Quilted implantable graft
US20090319045A1 (en) * 2004-10-12 2009-12-24 Truncale Katherine G Cancellous constructs, cartilage particles and combinations of cancellous constructs and cartilage particles
US20090318966A1 (en) * 2004-06-02 2009-12-24 Kfx Medical Corporation System and method for attaching soft tissue to bone
US20100015202A1 (en) * 2007-03-06 2010-01-21 Semler Eric J Cancellous construct with support ring for repair of osteochondral defects
US7658751B2 (en) 2006-09-29 2010-02-09 Biomet Sports Medicine, Llc Method for implanting soft tissue
US7815926B2 (en) 2005-07-11 2010-10-19 Musculoskeletal Transplant Foundation Implant for articular cartilage repair
US7838630B2 (en) 1999-06-22 2010-11-23 Children's Medical Center Corporation Biologic replacement for fibrin clot
US7857830B2 (en) 2006-02-03 2010-12-28 Biomet Sports Medicine, Llc Soft tissue repair and conduit device
US7905903B2 (en) 2006-02-03 2011-03-15 Biomet Sports Medicine, Llc Method for tissue fixation
US7905904B2 (en) 2006-02-03 2011-03-15 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US7909851B2 (en) 2006-02-03 2011-03-22 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US7914539B2 (en) 2004-11-09 2011-03-29 Biomet Sports Medicine, Llc Tissue fixation device
US7959650B2 (en) 2006-09-29 2011-06-14 Biomet Sports Medicine, Llc Adjustable knotless loops
US20110166673A1 (en) * 2008-06-10 2011-07-07 Patel Umesh H Quilted implantable graft
US20110185560A1 (en) * 2008-08-18 2011-08-04 Qioptiq Photonics Gmbh & Co. Kg Method for producing an objective
US8034090B2 (en) 2004-11-09 2011-10-11 Biomet Sports Medicine, Llc Tissue fixation device
US20110270393A1 (en) * 2008-06-04 2011-11-03 James Marvel Buffer for a human joint and method of arthroscopically inserting
US8062334B2 (en) 2004-06-02 2011-11-22 Kfx Medical Corporation Suture anchor
US8088130B2 (en) 2006-02-03 2012-01-03 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8118836B2 (en) 2004-11-05 2012-02-21 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8128658B2 (en) 2004-11-05 2012-03-06 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US8137382B2 (en) 2004-11-05 2012-03-20 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US8221454B2 (en) 2004-02-20 2012-07-17 Biomet Sports Medicine, Llc Apparatus for performing meniscus repair
US8251998B2 (en) 2006-08-16 2012-08-28 Biomet Sports Medicine, Llc Chondral defect repair
US8298262B2 (en) 2006-02-03 2012-10-30 Biomet Sports Medicine, Llc Method for tissue fixation
US8303604B2 (en) 2004-11-05 2012-11-06 Biomet Sports Medicine, Llc Soft tissue repair device and method
US8343536B2 (en) 2007-01-25 2013-01-01 Cook Biotech Incorporated Biofilm-inhibiting medical products
US8343227B2 (en) 2009-05-28 2013-01-01 Biomet Manufacturing Corp. Knee prosthesis assembly with ligament link
US8361113B2 (en) 2006-02-03 2013-01-29 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US20130060334A1 (en) * 2010-02-25 2013-03-07 Orteq B.V. Meniscus repair assembly and method
US8500818B2 (en) 2006-09-29 2013-08-06 Biomet Manufacturing, Llc Knee prosthesis assembly with ligament link
US8506597B2 (en) 2011-10-25 2013-08-13 Biomet Sports Medicine, Llc Method and apparatus for interosseous membrane reconstruction
US8562647B2 (en) 2006-09-29 2013-10-22 Biomet Sports Medicine, Llc Method and apparatus for securing soft tissue to bone
US8562645B2 (en) 2006-09-29 2013-10-22 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US8574235B2 (en) 2006-02-03 2013-11-05 Biomet Sports Medicine, Llc Method for trochanteric reattachment
US8597327B2 (en) 2006-02-03 2013-12-03 Biomet Manufacturing, Llc Method and apparatus for sternal closure
US8652171B2 (en) 2006-02-03 2014-02-18 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US8652172B2 (en) 2006-02-03 2014-02-18 Biomet Sports Medicine, Llc Flexible anchors for tissue fixation
US8672969B2 (en) 2006-09-29 2014-03-18 Biomet Sports Medicine, Llc Fracture fixation device
US8771352B2 (en) 2011-05-17 2014-07-08 Biomet Sports Medicine, Llc Method and apparatus for tibial fixation of an ACL graft
US8801783B2 (en) 2006-09-29 2014-08-12 Biomet Sports Medicine, Llc Prosthetic ligament system for knee joint
US8840645B2 (en) 2004-11-05 2014-09-23 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8936621B2 (en) 2006-02-03 2015-01-20 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US8968364B2 (en) 2006-02-03 2015-03-03 Biomet Sports Medicine, Llc Method and apparatus for fixation of an ACL graft
US8998949B2 (en) 2004-11-09 2015-04-07 Biomet Sports Medicine, Llc Soft tissue conduit device
US9017381B2 (en) 2007-04-10 2015-04-28 Biomet Sports Medicine, Llc Adjustable knotless loops
US9078644B2 (en) 2006-09-29 2015-07-14 Biomet Sports Medicine, Llc Fracture fixation device
US9149267B2 (en) 2006-02-03 2015-10-06 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9259217B2 (en) 2012-01-03 2016-02-16 Biomet Manufacturing, Llc Suture Button
US9271713B2 (en) 2006-02-03 2016-03-01 Biomet Sports Medicine, Llc Method and apparatus for tensioning a suture
US9308242B2 (en) 2006-09-28 2016-04-12 Children's Medical Center Corporation Methods and products for tissue repair
US9314241B2 (en) 2011-11-10 2016-04-19 Biomet Sports Medicine, Llc Apparatus for coupling soft tissue to a bone
US9357991B2 (en) 2011-11-03 2016-06-07 Biomet Sports Medicine, Llc Method and apparatus for stitching tendons
US9370350B2 (en) 2011-11-10 2016-06-21 Biomet Sports Medicine, Llc Apparatus for coupling soft tissue to a bone
US9381013B2 (en) 2011-11-10 2016-07-05 Biomet Sports Medicine, Llc Method for coupling soft tissue to a bone
US9538998B2 (en) 2006-02-03 2017-01-10 Biomet Sports Medicine, Llc Method and apparatus for fracture fixation
WO2017040057A1 (en) * 2015-09-05 2017-03-09 Apex Medical Device Design Llc Pyramid-shaped breast implant for augmentation, reconstruction, or lift and methods of use and production of the same
US9615822B2 (en) 2014-05-30 2017-04-11 Biomet Sports Medicine, Llc Insertion tools and method for soft anchor
US9636209B2 (en) 2011-03-08 2017-05-02 Mimedx Group, Inc. Collagen fiber ribbons with integrated fixation sutures and methods of making the same
US9701940B2 (en) 2005-09-19 2017-07-11 Histogenics Corporation Cell-support matrix having narrowly defined uniformly vertically and non-randomly organized porosity and pore density and a method for preparation thereof
US9700291B2 (en) 2014-06-03 2017-07-11 Biomet Sports Medicine, Llc Capsule retractor
US9757495B2 (en) 2013-02-01 2017-09-12 Children's Medical Center Corporation Collagen scaffolds
US9757119B2 (en) 2013-03-08 2017-09-12 Biomet Sports Medicine, Llc Visual aid for identifying suture limbs arthroscopically
US9801708B2 (en) 2004-11-05 2017-10-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9918827B2 (en) 2013-03-14 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US9918826B2 (en) 2006-09-29 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US9936940B2 (en) 2013-06-07 2018-04-10 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US9955980B2 (en) 2015-02-24 2018-05-01 Biomet Sports Medicine, Llc Anatomic soft tissue repair
US10039543B2 (en) 2014-08-22 2018-08-07 Biomet Sports Medicine, Llc Non-sliding soft anchor
US10077420B2 (en) 2014-12-02 2018-09-18 Histogenics Corporation Cell and tissue culture container
US20180280608A1 (en) * 2017-03-31 2018-10-04 David S. Gillett Helical insertion infusion device
US10136886B2 (en) 2013-12-20 2018-11-27 Biomet Sports Medicine, Llc Knotless soft tissue devices and techniques
US10517587B2 (en) 2006-02-03 2019-12-31 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US10786232B2 (en) 2006-01-25 2020-09-29 The Children's Medical Center Corporation Methods and procedures for ligament repair
US10912551B2 (en) 2015-03-31 2021-02-09 Biomet Sports Medicine, Llc Suture anchor with soft anchor of electrospun fibers
US11259792B2 (en) 2006-02-03 2022-03-01 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US11259794B2 (en) 2006-09-29 2022-03-01 Biomet Sports Medicine, Llc Method for implanting soft tissue
US11311287B2 (en) 2006-02-03 2022-04-26 Biomet Sports Medicine, Llc Method for tissue fixation
US11484578B2 (en) 2012-02-01 2022-11-01 Children's Medical Center Corporation Biomaterial for articular cartilage maintenance and treatment of arthritis

Families Citing this family (598)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8556983B2 (en) 2001-05-25 2013-10-15 Conformis, Inc. Patient-adapted and improved orthopedic implants, designs and related tools
US8545569B2 (en) 2001-05-25 2013-10-01 Conformis, Inc. Patient selectable knee arthroplasty devices
US9603711B2 (en) 2001-05-25 2017-03-28 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US7468075B2 (en) 2001-05-25 2008-12-23 Conformis, Inc. Methods and compositions for articular repair
US8480754B2 (en) 2001-05-25 2013-07-09 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US8234097B2 (en) 2001-05-25 2012-07-31 Conformis, Inc. Automated systems for manufacturing patient-specific orthopedic implants and instrumentation
US8617242B2 (en) 2001-05-25 2013-12-31 Conformis, Inc. Implant device and method for manufacture
US10085839B2 (en) 2004-01-05 2018-10-02 Conformis, Inc. Patient-specific and patient-engineered orthopedic implants
US8882847B2 (en) 2001-05-25 2014-11-11 Conformis, Inc. Patient selectable knee joint arthroplasty devices
US8083745B2 (en) 2001-05-25 2011-12-27 Conformis, Inc. Surgical tools for arthroplasty
US7534263B2 (en) 2001-05-25 2009-05-19 Conformis, Inc. Surgical tools facilitating increased accuracy, speed and simplicity in performing joint arthroplasty
US7184814B2 (en) 1998-09-14 2007-02-27 The Board Of Trustees Of The Leland Stanford Junior University Assessing the condition of a joint and assessing cartilage loss
CA2354525A1 (en) 1998-09-14 2000-06-22 Stanford University Assessing the condition of a joint and preventing damage
US7239908B1 (en) 1998-09-14 2007-07-03 The Board Of Trustees Of The Leland Stanford Junior University Assessing the condition of a joint and devising treatment
EP1016377B1 (en) 1998-12-30 2006-04-26 Ethicon Inc. Suture locking device
US6179840B1 (en) 1999-07-23 2001-01-30 Ethicon, Inc. Graft fixation device and method
US20020095157A1 (en) 1999-07-23 2002-07-18 Bowman Steven M. Graft fixation device combination
US7153312B1 (en) 1999-12-02 2006-12-26 Smith & Nephew Inc. Closure device and method for tissue repair
US7887551B2 (en) 1999-12-02 2011-02-15 Smith & Nephew, Inc. Soft tissue attachment and repair
US6872226B2 (en) * 2001-01-29 2005-03-29 3F Therapeutics, Inc. Method of cutting material for use in implantable medical device
US8366787B2 (en) 2000-08-04 2013-02-05 Depuy Products, Inc. Hybrid biologic-synthetic bioabsorbable scaffolds
CA2365376C (en) 2000-12-21 2006-03-28 Ethicon, Inc. Use of reinforced foam implants with enhanced integrity for soft tissue repair and regeneration
US8439926B2 (en) 2001-05-25 2013-05-14 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
ATE504264T1 (en) 2001-05-25 2011-04-15 Conformis Inc METHODS AND COMPOSITIONS FOR REPAIRING THE SURFACE OF JOINTS
WO2003007790A2 (en) 2001-07-16 2003-01-30 Depuy Products, Inc. Hybrid biologic/synthetic porous extracellular matrix scaffolds
US20040254640A1 (en) * 2002-03-01 2004-12-16 Children's Medical Center Corporation Needle punched textile for use in growing anatomical elements
GB2387040B (en) * 2002-03-28 2004-03-10 Wheeler & Clinch Ltd A contact
US6974592B2 (en) * 2002-04-11 2005-12-13 Ocean Nutrition Canada Limited Encapsulated agglomeration of microcapsules and method for the preparation thereof
JP2006501936A (en) * 2002-10-04 2006-01-19 エラン ファーマ インターナショナル,リミティド Gamma irradiation of solid nanoparticle active agents
US20040078090A1 (en) 2002-10-18 2004-04-22 Francois Binette Biocompatible scaffolds with tissue fragments
US7824701B2 (en) 2002-10-18 2010-11-02 Ethicon, Inc. Biocompatible scaffold for ligament or tendon repair
KR101175774B1 (en) * 2002-11-04 2012-08-21 오션 뉴트리션 캐나다 리미티드 Microcapsules having multiple shells and method for the preparation thereof
CN1780594A (en) * 2002-11-07 2006-05-31 康复米斯公司 Methods for determining meniscal size and shape and for devising treatment
US9314235B2 (en) * 2003-02-05 2016-04-19 Smith & Nephew, Inc. Tissue anchor and insertion tool
US8197837B2 (en) 2003-03-07 2012-06-12 Depuy Mitek, Inc. Method of preparation of bioabsorbable porous reinforced tissue implants and implants thereof
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
WO2004105809A1 (en) * 2003-05-22 2004-12-09 Elan Pharma International Ltd. Sterilization of dispersions of nanoparticulate active agents with gamma radiation
ATE481057T1 (en) * 2003-05-28 2010-10-15 Cook Inc VALVE PROSTHESIS WITH VESSEL FIXING DEVICE
US8226715B2 (en) 2003-06-30 2012-07-24 Depuy Mitek, Inc. Scaffold for connective tissue repair
US10583220B2 (en) 2003-08-11 2020-03-10 DePuy Synthes Products, Inc. Method and apparatus for resurfacing an articular surface
GB0325141D0 (en) * 2003-10-28 2003-12-03 Xiros Plc Repair of damaged tissue on a bone site
US7316822B2 (en) * 2003-11-26 2008-01-08 Ethicon, Inc. Conformable tissue repair implant capable of injection delivery
US7901461B2 (en) 2003-12-05 2011-03-08 Ethicon, Inc. Viable tissue repair implants and methods of use
US20050136764A1 (en) * 2003-12-18 2005-06-23 Sherman Michael C. Designed composite degradation for spinal implants
US11395865B2 (en) 2004-02-09 2022-07-26 DePuy Synthes Products, Inc. Scaffolds with viable tissue
US8808352B2 (en) * 2004-02-09 2014-08-19 Cook Medical Technologies Llc Cast bioremodelable graft
US7455683B2 (en) * 2004-02-26 2008-11-25 Depuy Mitek, Inc. Methods and devices for repairing triangular fibrocartilage complex tears
WO2005092208A1 (en) * 2004-03-03 2005-10-06 Schwartz Biomedical, Llc Articular cartilage fixation device and method
US8221780B2 (en) 2004-04-20 2012-07-17 Depuy Mitek, Inc. Nonwoven tissue scaffold
US8137686B2 (en) 2004-04-20 2012-03-20 Depuy Mitek, Inc. Nonwoven tissue scaffold
WO2005104992A1 (en) * 2004-04-26 2005-11-10 Bioduct Llc Stent for avascular meniscal repair and regeneration
US20060002967A1 (en) * 2004-07-01 2006-01-05 Smestad Thomas L Resorbable implant with lubricious coating
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
WO2006050087A2 (en) * 2004-10-29 2006-05-11 Depuy Products, Inc. Coordinate instrument set
DE602005001827T2 (en) * 2004-10-29 2008-04-24 Depuy Products, Inc., Warsaw Instruments and kits for the suture assembly system
EP1652473A1 (en) 2004-10-29 2006-05-03 DePuy Products, Inc. Implant system with sizing templates
US8128640B2 (en) 2005-02-07 2012-03-06 Ivy Sports Medicine LLC System and method for all-inside suture fixation for implant attachment and soft tissue repair
JP5030797B2 (en) * 2005-02-07 2012-09-19 アイビー スポーツ メディシン、エルエルシー System and method for fully internal suture fixation of implant placement and soft tissue repair
US20090234453A1 (en) * 2005-03-17 2009-09-17 Active Implants Corporation Implant devices
EP2532310A3 (en) * 2005-04-29 2014-08-20 Cook Biotech Incorporated Volumetric grafts for treatment of fistulae and related methods and systems
US9060820B2 (en) 2005-05-18 2015-06-23 Sonoma Orthopedic Products, Inc. Segmented intramedullary fracture fixation devices and methods
US8961516B2 (en) 2005-05-18 2015-02-24 Sonoma Orthopedic Products, Inc. Straight intramedullary fracture fixation devices and methods
US7909825B2 (en) * 2006-11-22 2011-03-22 Sonoma Orthepedic Products, Inc. Fracture fixation device, tools and methods
EP1885263A1 (en) * 2005-05-18 2008-02-13 Sonoma Orthopaedic Products, Inc Minimally invasive actuable bone fixation devices, systems and methods of use
WO2010037038A2 (en) 2008-09-26 2010-04-01 Sonoma Orthopedic Products, Inc. Bone fixation device, tools and methods
US20070083236A1 (en) * 2005-06-24 2007-04-12 Smith & Nephew, Inc. Methods and devices for tissue repair
US20060293709A1 (en) * 2005-06-24 2006-12-28 Bojarski Raymond A Tissue repair device
US9492277B2 (en) * 2005-08-30 2016-11-15 Mayo Foundation For Medical Education And Research Soft body tissue remodeling methods and apparatus
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US7799087B2 (en) * 2005-08-31 2010-09-21 Zimmer Gmbh Implant
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US8308807B2 (en) * 2005-11-09 2012-11-13 Zimmer, Gmbh Implant with differential anchoring
US20070150064A1 (en) * 2005-12-22 2007-06-28 Depuy Spine, Inc. Methods and devices for intervertebral augmentation
US20070150063A1 (en) * 2005-12-22 2007-06-28 Depuy Spine, Inc. Devices for intervertebral augmentation and methods of controlling their delivery
US20070150059A1 (en) * 2005-12-22 2007-06-28 Depuy Spine, Inc. Methods and devices for intervertebral augmentation using injectable formulations and enclosures
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US20070179607A1 (en) * 2006-01-31 2007-08-02 Zimmer Technology, Inc. Cartilage resurfacing implant
US8623026B2 (en) 2006-02-06 2014-01-07 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools incorporating anatomical relief
AU2007212033B2 (en) 2006-02-06 2014-01-23 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US8500740B2 (en) 2006-02-06 2013-08-06 Conformis, Inc. Patient-specific joint arthroplasty devices for ligament repair
US20090048679A1 (en) * 2006-02-09 2009-02-19 Zimmer Gmbh Implant
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
WO2007125060A1 (en) * 2006-04-28 2007-11-08 Zimmer Gmbh Implant
US9339369B2 (en) * 2006-05-09 2016-05-17 Lifecell Corporation Reinforced biological tissue
NZ596403A (en) * 2006-06-05 2013-02-22 Ocean Nutrition Canada Ltd Microcapsules with improved shells with wax in the outer shell
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
EP2051646A4 (en) * 2006-08-07 2014-06-11 Howmedica Osteonics Corp Insertion system for implanting a medical device and surgical methods
US20080033487A1 (en) * 2006-08-07 2008-02-07 Bioduct, Llc Medical device for repair of tissue and method for implantation and fixation
US7506791B2 (en) 2006-09-29 2009-03-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical mechanism for limiting maximum tissue compression
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
WO2008045807A2 (en) 2006-10-09 2008-04-17 Active Implants Corporation Meniscus prosthetic device
US8192491B2 (en) 2006-10-09 2012-06-05 Active Implants Corporation Meniscus prosthetic device
CA2670438A1 (en) * 2006-11-22 2008-05-29 Sonoma Orthopedic Products, Inc. Curved orthopedic tool
JP2010510042A (en) * 2006-11-22 2010-04-02 ソノマ・オーソペディック・プロダクツ・インコーポレイテッド Tools for use in the placement of bone repair devices
US20080149115A1 (en) * 2006-11-22 2008-06-26 Sonoma Orthopedic Products, Inc. Surgical station for orthopedic reconstruction surgery
US20100136082A1 (en) * 2006-12-22 2010-06-03 Laboratoire Medidom S.A. In situ system for intra-articular chondral and osseous tissue repair
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
CA2675123C (en) * 2007-01-10 2017-04-11 Ocean Nutrition Canada Limited Vegetarian microcapsules
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US20080169332A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapling device with a curved cutting member
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
CA2618125A1 (en) * 2007-02-08 2008-08-08 Zimmer, Inc. Hydrogel proximal interphalangeal implant
US8753391B2 (en) * 2007-02-12 2014-06-17 The Trustees Of Columbia University In The City Of New York Fully synthetic implantable multi-phased scaffold
WO2008107483A2 (en) * 2007-03-07 2008-09-12 Coloplast A/S Mesh comprising ecm
EP2134409A4 (en) * 2007-03-09 2013-07-17 Anthem Orthopaedics Llc Implantable medicament delivery device and delivery tool and method for use therewith
US20090001130A1 (en) 2007-03-15 2009-01-01 Hess Christopher J Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets
FR2914178B1 (en) * 2007-03-27 2010-05-14 Cie De Rech En Composants Impl IMPLANTABLE REINFORCEMENT PROSTHESIS WITH MOUNTING MEANS
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US11857181B2 (en) 2007-06-04 2024-01-02 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
WO2008157412A2 (en) 2007-06-13 2008-12-24 Conformis, Inc. Surgical cutting guide
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US10441273B2 (en) 2007-07-03 2019-10-15 Ceterix Orthopaedics, Inc. Pre-tied surgical knots for use with suture passers
US8465505B2 (en) 2011-05-06 2013-06-18 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US9861354B2 (en) 2011-05-06 2018-01-09 Ceterix Orthopaedics, Inc. Meniscus repair
US8979935B2 (en) * 2007-07-31 2015-03-17 Zimmer, Inc. Joint space interpositional prosthetic device with internal bearing surfaces
US20100131069A1 (en) * 2007-08-01 2010-05-27 Jeffrey Halbrecht Method and system for patella tendon realignment
WO2009018365A1 (en) * 2007-08-01 2009-02-05 Jeffrey Halbrecht Method and system for patella tendon realignment
US20090082816A1 (en) * 2007-09-20 2009-03-26 Graham Matthew R Remodelable orthopaedic spacer and method of using the same
US20090082806A1 (en) * 2007-09-24 2009-03-26 Hs West Investments, Llc Meniscal repair system
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
JP5410110B2 (en) 2008-02-14 2014-02-05 エシコン・エンド−サージェリィ・インコーポレイテッド Surgical cutting / fixing instrument with RF electrode
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US8682052B2 (en) 2008-03-05 2014-03-25 Conformis, Inc. Implants for altering wear patterns of articular surfaces
US8152846B2 (en) * 2008-03-06 2012-04-10 Musculoskeletal Transplant Foundation Instrumentation and method for repair of meniscus tissue
US7611653B1 (en) * 2008-04-09 2009-11-03 Active Implants Corporation Manufacturing and material processing for prosthetic devices
US8016884B2 (en) 2008-04-09 2011-09-13 Active Implants Corporation Tensioned meniscus prosthetic devices and associated methods
US8361147B2 (en) * 2008-04-09 2013-01-29 Active Implants Corporation Meniscus prosthetic devices with anti-migration features
US7991599B2 (en) 2008-04-09 2011-08-02 Active Implants Corporation Meniscus prosthetic device selection and implantation methods
EP3141219A1 (en) * 2008-04-23 2017-03-15 Medtronic, Inc. Stented heart valve devices
EP2303193A4 (en) 2008-05-12 2012-03-21 Conformis Inc Devices and methods for treatment of facet and other joints
WO2009152273A1 (en) 2008-06-10 2009-12-17 Sonoma Orthopedic Products, Inc. Fracture fixation device, tools and methods
US9060766B2 (en) * 2008-08-25 2015-06-23 Daniel Larkin Suture fixation kit of parts, system, and device
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8333788B2 (en) * 2008-10-09 2012-12-18 Covidien Lp Knotted suture end effector
US8323316B2 (en) * 2008-10-09 2012-12-04 Covidien Lp Knotted suture end effector
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US20100121355A1 (en) 2008-10-24 2010-05-13 The Foundry, Llc Methods and devices for suture anchor delivery
WO2010059783A2 (en) 2008-11-21 2010-05-27 Lifecell Corporation Reinforced biologic material
US20100191332A1 (en) * 2009-01-08 2010-07-29 Euteneuer Charles L Implantable Tendon Protection Systems and Related Kits and Methods
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
CN102341048A (en) 2009-02-06 2012-02-01 伊西康内外科公司 Driven surgical stapler improvements
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
WO2010093950A1 (en) * 2009-02-12 2010-08-19 Osteotech, Inc. Delivery system cartridge
US8808297B2 (en) 2009-02-24 2014-08-19 Microport Orthopedics Holdings Inc. Orthopedic surgical guide
US8808303B2 (en) 2009-02-24 2014-08-19 Microport Orthopedics Holdings Inc. Orthopedic surgical guide
US9017334B2 (en) 2009-02-24 2015-04-28 Microport Orthopedics Holdings Inc. Patient specific surgical guide locator and mount
WO2010099463A2 (en) 2009-02-27 2010-09-02 University Of Pittsburgh-Of The Commonwealth System Of Higher Education Joint bioscaffolds
US9179910B2 (en) 2009-03-20 2015-11-10 Rotation Medical, Inc. Medical device delivery system and method
US8308814B2 (en) 2009-03-27 2012-11-13 Depuy Mitek, Inc. Methods and devices for preparing and implanting tissue scaffolds
US8241298B2 (en) 2009-03-27 2012-08-14 Depuy Mitek, Inc. Methods and devices for delivering and affixing tissue scaffolds
US20100286733A1 (en) * 2009-05-06 2010-11-11 Rockford Orthopaedic Sports Medicine Services, Llc Meniscal device
US20100292731A1 (en) 2009-05-12 2010-11-18 Foundry Newco Xl, Inc. Methods and devices to treat diseased or injured musculoskeletal tissue
US8545535B2 (en) 2009-05-12 2013-10-01 Foundry Newco Xi, Inc. Suture anchors with one-way cinching mechanisms
AU2010256415B2 (en) 2009-06-04 2015-04-02 Rotation Medical, Inc. Apparatus having bowstring-like staple delivery to a target tissue
EP3308743A1 (en) 2009-06-04 2018-04-18 Rotation Medical, Inc. Methods and apparatus for deploying sheet-like materials
DE102009032218A1 (en) 2009-07-06 2011-01-13 Aesculap Aktiengesellschaft Elevated implant for the reconstruction of meniscal defects or meniscal duodenal defects
US8814903B2 (en) * 2009-07-24 2014-08-26 Depuy Mitek, Llc Methods and devices for repairing meniscal tissue
US8790369B2 (en) 2009-07-24 2014-07-29 Depuy Mitek, Llc Apparatus and method for repairing tissue
US8828053B2 (en) 2009-07-24 2014-09-09 Depuy Mitek, Llc Methods and devices for repairing and anchoring damaged tissue
US9795410B2 (en) * 2009-08-27 2017-10-24 Cotera, Inc. Method and apparatus for force redistribution in articular joints
US9668868B2 (en) 2009-08-27 2017-06-06 Cotera, Inc. Apparatus and methods for treatment of patellofemoral conditions
US9278004B2 (en) 2009-08-27 2016-03-08 Cotera, Inc. Method and apparatus for altering biomechanics of the articular joints
US9861408B2 (en) 2009-08-27 2018-01-09 The Foundry, Llc Method and apparatus for treating canine cruciate ligament disease
US10349980B2 (en) 2009-08-27 2019-07-16 The Foundry, Llc Method and apparatus for altering biomechanics of the shoulder
US8377432B2 (en) * 2009-09-02 2013-02-19 Khay-Yong Saw Method and composition for neochondrogenesis
US9011454B2 (en) * 2009-11-09 2015-04-21 Ceterix Orthopaedics, Inc. Suture passer with radiused upper jaw
US11744575B2 (en) 2009-11-09 2023-09-05 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US9848868B2 (en) 2011-01-10 2017-12-26 Ceterix Orthopaedics, Inc. Suture methods for forming locking loops stitches
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8834568B2 (en) * 2010-02-04 2014-09-16 Paul S. Shapiro Surgical technique using a contoured allograft cartilage as a spacer of the carpo-metacarpal joint of the thumb or tarso-metatarsal joint of the toe
US20110196389A1 (en) * 2010-02-09 2011-08-11 Coloplast A/S Digital suture fixation system
US8257366B2 (en) * 2010-02-08 2012-09-04 Coloplast A/S Digital suture fixation system
AU2015205818B2 (en) * 2010-02-19 2017-07-13 Lifecell Corporation Abdominal wall treatment devices
JP5701908B2 (en) * 2010-02-19 2015-04-15 ライフセル コーポレーションLifeCell Corporation Abdominal wall treatment tool
US9198750B2 (en) * 2010-03-11 2015-12-01 Rotation Medical, Inc. Tendon repair implant and method of arthroscopic implantation
US9597064B2 (en) 2010-04-27 2017-03-21 DePuy Synthes Products, Inc. Methods for approximating a tissue defect using an anchor assembly
US9173645B2 (en) 2010-04-27 2015-11-03 DePuy Synthes Products, Inc. Anchor assembly including expandable anchor
US9743919B2 (en) 2010-04-27 2017-08-29 DePuy Synthes Products, Inc. Stitch lock for attaching two or more structures
US9451938B2 (en) 2010-04-27 2016-09-27 DePuy Synthes Products, Inc. Insertion instrument for anchor assembly
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8668739B2 (en) 2010-08-20 2014-03-11 Zimmer, Inc. Unitary orthopedic implant
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US8777004B2 (en) 2010-09-30 2014-07-15 Ethicon Endo-Surgery, Inc. Compressible staple cartridge comprising alignment members
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US11925354B2 (en) 2010-09-30 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US20120083659A1 (en) * 2010-10-05 2012-04-05 Caballero Gerardo A Foam Surgical Retractor
US8617240B2 (en) * 2010-11-17 2013-12-31 Charles D. Hightower Moldable cushion for implants
US9913638B2 (en) 2011-01-10 2018-03-13 Ceterix Orthopaedics, Inc. Transosteal anchoring methods for tissue repair
DE102011002536A1 (en) * 2011-01-11 2012-07-12 Aesculap Ag Packaging containing a medical product for the treatment of human or animal cartilage damage
WO2012145059A1 (en) 2011-02-15 2012-10-26 Rotation Medical, Inc. Methods and apparatus for fixing sheet-like materials to a target tissue
WO2012112698A2 (en) 2011-02-15 2012-08-23 Conformis, Inc. Patient-adapted and improved articular implants, procedures and tools to address, assess, correct, modify and/or accommodate anatomical variation and/or asymmetry
EP2675391B1 (en) 2011-02-15 2017-09-27 Rotation Medical, Inc. Apparatus for delivering and positioning sheet-like materials
US8771353B2 (en) 2011-03-08 2014-07-08 DePuy Synthes Products, LLC Method and implant for replacing damaged meniscal tissue
BR112013027794B1 (en) 2011-04-29 2020-12-15 Ethicon Endo-Surgery, Inc CLAMP CARTRIDGE SET
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US20130178898A1 (en) * 2011-07-06 2013-07-11 Imds Corporation Tissue approximation
US9694106B2 (en) 2011-07-11 2017-07-04 Mimedx Group, Inc. Synthetic collagen threads for cosmetic uses including skin wrinkle treatments and associated methods
US8900295B2 (en) * 2011-09-26 2014-12-02 Edwards Lifesciences Corporation Prosthetic valve with ventricular tethers
US10524778B2 (en) 2011-09-28 2020-01-07 Ceterix Orthopaedics Suture passers adapted for use in constrained regions
US9107661B2 (en) 2011-12-19 2015-08-18 Rotation Medical, Inc. Fasteners and fastener delivery devices for affixing sheet-like materials to bone or tissue
WO2013096224A1 (en) 2011-12-19 2013-06-27 Rotation Medical, Inc. Fasteners for affixing sheet -like materials to bone or tissue
WO2013096219A1 (en) 2011-12-19 2013-06-27 Rotation Medical, Inc. Apparatus and method for forming pilot holes in bone and delivering fasteners therein for retaining an implant
WO2013119321A1 (en) 2011-12-19 2013-08-15 Rotation Medical, Inc. Fasteners for affixing sheet -like materials to bone or tissue
WO2013101638A1 (en) 2011-12-29 2013-07-04 Rotation Medical, Inc. Methods and apparatus for delivering and positioning sheet -like materials in surgery
WO2013101641A2 (en) 2011-12-29 2013-07-04 Rotation Medical, Inc. Anatomical location markers and methods of use in positioning sheet-like materials during surgery
WO2013101640A1 (en) 2011-12-29 2013-07-04 Rotation Medical, Inc. Guidewire having a distal fixation member for delivering and positioning sheet-like materials in surgery
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US10278694B2 (en) 2012-02-23 2019-05-07 Northwestern University Indirect attachment of a needle to a mesh suture
WO2013126130A1 (en) * 2012-02-23 2013-08-29 Northwestern University Improved suture
CN104334098B (en) 2012-03-28 2017-03-22 伊西康内外科公司 Tissue thickness compensator comprising capsules defining a low pressure environment
MX353040B (en) 2012-03-28 2017-12-18 Ethicon Endo Surgery Inc Retainer assembly including a tissue thickness compensator.
RU2014143258A (en) 2012-03-28 2016-05-20 Этикон Эндо-Серджери, Инк. FABRIC THICKNESS COMPENSATOR CONTAINING MANY LAYERS
US9486226B2 (en) 2012-04-18 2016-11-08 Conformis, Inc. Tibial guides, tools, and techniques for resecting the tibial plateau
US9675471B2 (en) 2012-06-11 2017-06-13 Conformis, Inc. Devices, techniques and methods for assessing joint spacing, balancing soft tissues and obtaining desired kinematics for joint implant components
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
JP6290201B2 (en) 2012-06-28 2018-03-07 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Lockout for empty clip cartridge
US20140005718A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Multi-functional powered surgical device with external dissection features
BR112014032776B1 (en) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9700310B2 (en) 2013-08-23 2017-07-11 Ethicon Llc Firing member retraction devices for powered surgical instruments
US9468466B1 (en) 2012-08-24 2016-10-18 Cotera, Inc. Method and apparatus for altering biomechanics of the spine
US9498335B2 (en) * 2012-10-02 2016-11-22 Seth McCullen Implantable devices for musculoskeletal repair and regeneration
JP6382235B2 (en) 2013-03-01 2018-08-29 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Articulatable surgical instrument with a conductive path for signal communication
JP6345707B2 (en) 2013-03-01 2018-06-20 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Surgical instrument with soft stop
US9687230B2 (en) 2013-03-14 2017-06-27 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US10029030B2 (en) 2013-03-15 2018-07-24 Mimedx Group, Inc. Molded placental tissue compositions and methods of making and using the same
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
BR112015026109B1 (en) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc surgical instrument
MX369362B (en) 2013-08-23 2019-11-06 Ethicon Endo Surgery Llc Firing member retraction devices for powered surgical instruments.
US9247935B2 (en) 2013-09-23 2016-02-02 Ceterix Orthopaedics, Inc. Arthroscopic knot pusher and suture cutter
WO2015095133A1 (en) 2013-12-16 2015-06-25 Ceterix Orthopaedics, Inc. Automatically reloading suture passer devices having pre-tied knots and methods
US9770278B2 (en) 2014-01-17 2017-09-26 Arthrex, Inc. Dual tip guide wire
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
JP6462004B2 (en) 2014-02-24 2019-01-30 エシコン エルエルシー Fastening system with launcher lockout
US20150272557A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Modular surgical instrument system
US20150272571A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Surgical instrument utilizing sensor adaptation
BR112016021943B1 (en) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
CN204951031U (en) 2014-04-08 2016-01-13 赛特里克斯整形公司 Ware device is worn to draw by suture
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
JP6636452B2 (en) 2014-04-16 2020-01-29 エシコン エルエルシーEthicon LLC Fastener cartridge including extension having different configurations
US10299792B2 (en) 2014-04-16 2019-05-28 Ethicon Llc Fastener cartridge comprising non-uniform fasteners
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
BR112016023807B1 (en) 2014-04-16 2022-07-12 Ethicon Endo-Surgery, Llc CARTRIDGE SET OF FASTENERS FOR USE WITH A SURGICAL INSTRUMENT
CN106456158B (en) 2014-04-16 2019-02-05 伊西康内外科有限责任公司 Fastener cartridge including non-uniform fastener
AU2015255758B2 (en) 2014-05-09 2017-06-15 Rotation Medical, Inc. Medical implant delivery system for sheet-like implant
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
BR112017004361B1 (en) 2014-09-05 2023-04-11 Ethicon Llc ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
MX2017003960A (en) 2014-09-26 2017-12-04 Ethicon Llc Surgical stapling buttresses and adjunct materials.
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US9814499B2 (en) 2014-09-30 2017-11-14 Arthrex, Inc. Intramedullary fracture fixation devices and methods
EP3200728B1 (en) * 2014-10-02 2019-08-07 McCullen, Seth Anatomically designed meniscus implantable devices
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
AU2015343273B2 (en) 2014-11-04 2017-12-14 Rotation Medical, Inc. Medical implant delivery system and related methods
US10675019B2 (en) 2014-11-04 2020-06-09 Rotation Medical, Inc. Medical implant delivery system and related methods
EP3215025B1 (en) 2014-11-04 2020-12-23 Rotation Medical, Inc. Medical implant delivery system
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
BR112017012996B1 (en) 2014-12-18 2022-11-08 Ethicon Llc SURGICAL INSTRUMENT WITH AN ANvil WHICH IS SELECTIVELY MOVABLE ABOUT AN IMMOVABLE GEOMETRIC AXIS DIFFERENT FROM A STAPLE CARTRIDGE
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9238090B1 (en) 2014-12-24 2016-01-19 Fettech, Llc Tissue-based compositions
EP3242632B1 (en) * 2015-01-09 2021-02-24 Formae, Inc. Rigid segmented flexible anchors
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US20160249910A1 (en) 2015-02-27 2016-09-01 Ethicon Endo-Surgery, Llc Surgical charging system that charges and/or conditions one or more batteries
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
JP2020121162A (en) 2015-03-06 2020-08-13 エシコン エルエルシーEthicon LLC Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
JP2018515196A (en) 2015-05-06 2018-06-14 ローテーション メディカル インコーポレイテッドRotation Medical,Inc. Medical implant delivery system and related methods
EP3307204B1 (en) 2015-06-15 2021-11-24 Rotation Medical, Inc. Tendon repair implant
US10226245B2 (en) 2015-07-21 2019-03-12 Ceterix Orthopaedics, Inc. Automatically reloading suture passer devices that prevent entanglement
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10736633B2 (en) 2015-09-30 2020-08-11 Ethicon Llc Compressible adjunct with looping members
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US10405853B2 (en) 2015-10-02 2019-09-10 Ceterix Orthpaedics, Inc. Knot tying accessory
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
EP3397175B1 (en) 2015-12-31 2021-11-24 Rotation Medical, Inc. Fastener delivery system
US10314689B2 (en) 2015-12-31 2019-06-11 Rotation Medical, Inc. Medical implant delivery system and related methods
US10588625B2 (en) 2016-02-09 2020-03-17 Ethicon Llc Articulatable surgical instruments with off-axis firing beam arrangements
JP6911054B2 (en) 2016-02-09 2021-07-28 エシコン エルエルシーEthicon LLC Surgical instruments with asymmetric joint composition
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11064997B2 (en) 2016-04-01 2021-07-20 Cilag Gmbh International Surgical stapling instrument
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US10433840B2 (en) 2016-04-18 2019-10-08 Ethicon Llc Surgical instrument comprising a replaceable cartridge jaw
US9861410B2 (en) 2016-05-06 2018-01-09 Medos International Sarl Methods, devices, and systems for blood flow
US10932769B2 (en) 2016-05-26 2021-03-02 Ivy Sports Medicine, Llc System and method for all-inside suture fixation for implant attachment and soft tissue repair
WO2018066921A2 (en) * 2016-10-06 2018-04-12 아주대학교 산학협력단 Device for supporting semilunar cartilage hoop stress
US20180168608A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical instrument system comprising an end effector lockout and a firing assembly lockout
JP6983893B2 (en) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC Lockout configuration for surgical end effectors and replaceable tool assemblies
US10524789B2 (en) 2016-12-21 2020-01-07 Ethicon Llc Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration
US10675026B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Methods of stapling tissue
JP7010956B2 (en) 2016-12-21 2022-01-26 エシコン エルエルシー How to staple tissue
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US10588631B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical instruments with positive jaw opening features
US10888322B2 (en) 2016-12-21 2021-01-12 Ethicon Llc Surgical instrument comprising a cutting member
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US10835246B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Staple cartridges and arrangements of staples and staple cavities therein
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10675025B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Shaft assembly comprising separately actuatable and retractable systems
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US20180168598A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Staple forming pocket arrangements comprising zoned forming surface grooves
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US10980536B2 (en) 2016-12-21 2021-04-20 Ethicon Llc No-cartridge and spent cartridge lockout arrangements for surgical staplers
JP2020501779A (en) 2016-12-21 2020-01-23 エシコン エルエルシーEthicon LLC Surgical stapling system
US11452606B2 (en) 2017-05-02 2022-09-27 Orthonika Limited Composite joint implant
EP3400912B1 (en) 2017-05-10 2019-11-20 Howmedica Osteonics Corporation Patient specific composite knee replacement
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US11141154B2 (en) 2017-06-27 2021-10-12 Cilag Gmbh International Surgical end effectors and anvils
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US20190000461A1 (en) 2017-06-28 2019-01-03 Ethicon Llc Surgical cutting and fastening devices with pivotable anvil with a tissue locating arrangement in close proximity to an anvil pivot axis
EP4070740A1 (en) 2017-06-28 2022-10-12 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US11058424B2 (en) 2017-06-28 2021-07-13 Cilag Gmbh International Surgical instrument comprising an offset articulation joint
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10806828B2 (en) * 2017-11-15 2020-10-20 De Novo Orthopedics Inc. Methods for reattaching detached tissue to hard tissue using bioinductive patch
JP7317826B2 (en) 2017-12-07 2023-07-31 ローテーション メディカル インコーポレイテッド Medical implant delivery system and related methods
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US10682134B2 (en) 2017-12-21 2020-06-16 Ethicon Llc Continuous use self-propelled stapling instrument
KR20210010982A (en) * 2018-04-12 2021-01-29 옥소젠 코포레이션 Tissue graft with pre-made attachment points
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
AU2019441369A1 (en) * 2019-04-19 2021-11-11 Suturegard Medical, Inc. Hemi-bridge and methods of manufacturing and using same
US11612388B2 (en) * 2019-04-19 2023-03-28 Suturegard Medical Inc. Hemi-bridge and methods of manufacturing and using same
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11896476B2 (en) 2020-01-02 2024-02-13 Zkr Orthopedics, Inc. Patella tendon realignment implant with changeable shape
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
US20220031351A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with differential articulation joint arrangements for accommodating flexible actuators
PL435677A1 (en) * 2020-10-14 2022-04-19 Kinga Ciemniewska-Gorzela Collagen meniscal cap and a method of producing a collagen meniscal cap
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
WO2022146730A1 (en) * 2020-12-29 2022-07-07 Acell, Inc. Implantable pouch device and methods of making thereof
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US20220331082A1 (en) * 2021-04-16 2022-10-20 Warsaw Orthopedic, Inc. Woven mesh for enclosing bone material
US20220378424A1 (en) 2021-05-28 2022-12-01 Cilag Gmbh International Stapling instrument comprising a firing lockout
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters

Citations (90)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3562820A (en) * 1966-08-22 1971-02-16 Bernhard Braun Tubular sheet and strip form prostheses on a basis of biological tissue
US3727204A (en) * 1971-04-23 1973-04-10 Philips Corp Asynchronous buffer device
US4140678A (en) * 1977-06-13 1979-02-20 Ethicon, Inc. Synthetic absorbable surgical devices of poly(alkylene oxalates)
US4141087A (en) * 1977-01-19 1979-02-27 Ethicon, Inc. Isomorphic copolyoxalates and sutures thereof
US4205399A (en) * 1977-06-13 1980-06-03 Ethicon, Inc. Synthetic absorbable surgical devices of poly(alkylene oxalates)
US4208511A (en) * 1977-01-19 1980-06-17 Ethicon, Inc. Isomorphic copolyoxalates and sutures thereof
US4642120A (en) * 1983-03-23 1987-02-10 Ramot University Authority For Applied Research And Industrial Development Ltd. Repair of cartilage and bones
US4902508A (en) * 1988-07-11 1990-02-20 Purdue Research Foundation Tissue graft composition
US4926860A (en) * 1988-02-05 1990-05-22 Flexmedics Corporation ARthroscopic instrumentation and method
US5007934A (en) * 1987-07-20 1991-04-16 Regen Corporation Prosthetic meniscus
US5102421A (en) * 1990-06-14 1992-04-07 Wm. E. Anpach, III Suture anchor and method of forming
US5108438A (en) * 1989-03-02 1992-04-28 Regen Corporation Prosthetic intervertebral disc
US5203864A (en) * 1991-04-05 1993-04-20 Phillips Edward H Surgical fastener system
US5275826A (en) * 1992-11-13 1994-01-04 Purdue Research Foundation Fluidized intestinal submucosa and its use as an injectable tissue graft
US5281422A (en) * 1991-09-24 1994-01-25 Purdue Research Foundation Graft for promoting autogenous tissue growth
US5306311A (en) * 1987-07-20 1994-04-26 Regen Corporation Prosthetic articular cartilage
US5320633A (en) * 1992-12-10 1994-06-14 William C. Allen Method and system for repairing a tear in the meniscus
US5380334A (en) * 1993-02-17 1995-01-10 Smith & Nephew Dyonics, Inc. Soft tissue anchors and systems for implantation
US5514181A (en) * 1993-09-29 1996-05-07 Johnson & Johnson Medical, Inc. Absorbable structures for ligament and tendon repair
US5520691A (en) * 1990-11-06 1996-05-28 Branch; Thomas P. Method and apparatus for re-approximating tissue
US5591234A (en) * 1993-02-01 1997-01-07 Axel Kirsch Post-surgery orthopedic covering
US5593441A (en) * 1992-03-04 1997-01-14 C. R. Bard, Inc. Method for limiting the incidence of postoperative adhesions
US5595751A (en) * 1995-03-06 1997-01-21 Ethicon, Inc. Absorbable polyoxaesters containing amines and/or amido groups
US5597579A (en) * 1995-03-06 1997-01-28 Ethicon, Inc. Blends of absorbable polyoxaamides
US5607687A (en) * 1995-03-06 1997-03-04 Ethicon, Inc. Polymer blends containing absorbable polyoxaesters
US5618552A (en) * 1995-03-06 1997-04-08 Ethicon, Inc. Absorbable polyoxaesters
US5620698A (en) * 1995-03-06 1997-04-15 Ethicon, Inc. Blends of absorbable polyoxaesters containing amines and/or amido groups
US5632745A (en) * 1995-02-07 1997-05-27 R&D Biologicals, Inc. Surgical implantation of cartilage repair unit
US5641518A (en) * 1992-11-13 1997-06-24 Purdue Research Foundation Method of repairing bone tissue
US5711969A (en) * 1995-04-07 1998-01-27 Purdue Research Foundation Large area submucosal tissue graft constructs
US5730933A (en) * 1996-04-16 1998-03-24 Depuy Orthopaedics, Inc. Radiation sterilization of biologically active compounds
US5733868A (en) * 1996-04-16 1998-03-31 Depuy Orthopaedics, Inc. Poly(amino acid) adhesive tissue grafts
US5733337A (en) * 1995-04-07 1998-03-31 Organogenesis, Inc. Tissue repair fabric
US5735903A (en) * 1987-07-20 1998-04-07 Li; Shu-Tung Meniscal augmentation device
US5735897A (en) * 1993-10-19 1998-04-07 Scimed Life Systems, Inc. Intravascular stent pump
US5736372A (en) * 1986-11-20 1998-04-07 Massachusetts Institute Of Technology Biodegradable synthetic polymeric fibrous matrix containing chondrocyte for in vivo production of a cartilaginous structure
US5753267A (en) * 1995-02-10 1998-05-19 Purdue Research Foundation Method for enhancing functional properties of submucosal tissue graft constructs
US5755791A (en) * 1996-04-05 1998-05-26 Purdue Research Foundation Perforated submucosal tissue graft constructs
US5855610A (en) * 1995-05-19 1999-01-05 Children's Medical Center Corporation Engineering of strong, pliable tissues
US5855613A (en) * 1995-10-13 1999-01-05 Islet Sheet Medical, Inc. Retrievable bioartificial implants having dimensions allowing rapid diffusion of oxygen and rapid biological response to physiological change
US5855619A (en) * 1994-06-06 1999-01-05 Case Western Reserve University Biomatrix for soft tissue regeneration
US5859150A (en) * 1995-03-06 1999-01-12 Ethicon, Inc. Prepolymers of absorbable polyoxaesters
US5863551A (en) * 1996-10-16 1999-01-26 Organogel Canada Ltee Implantable polymer hydrogel for therapeutic uses
US5891558A (en) * 1994-11-22 1999-04-06 Tissue Engineering, Inc. Biopolymer foams for use in tissue repair and reconstruction
US5899939A (en) * 1998-01-21 1999-05-04 Osteotech, Inc. Bone-derived implant for load-supporting applications
US5906997A (en) * 1997-06-17 1999-05-25 Fzio Med, Inc. Bioresorbable compositions of carboxypolysaccharide polyether intermacromolecular complexes and methods for their use in reducing surgical adhesions
US6017348A (en) * 1995-03-07 2000-01-25 Innovasive Devices, Inc. Apparatus and methods for articular cartilage defect repair
US6027744A (en) * 1998-04-24 2000-02-22 University Of Massachusetts Medical Center Guided development and support of hydrogel-cell compositions
US6051750A (en) * 1992-08-07 2000-04-18 Tissue Engineering, Inc. Method and construct for producing graft tissue from an extracellular matrix
US6056778A (en) * 1997-10-29 2000-05-02 Arthrex, Inc. Meniscal repair device
US6056752A (en) * 1997-10-24 2000-05-02 Smith & Nephew, Inc. Fixation of cruciate ligament grafts
US6058777A (en) * 1997-02-20 2000-05-09 Murata Manufacturing Co., Ltd. Vibrating gyroscope including a pair of piezoelectric bodies with electrically floating interface
US6060640A (en) * 1995-05-19 2000-05-09 Baxter International Inc. Multiple-layer, formed-in-place immunoisolation membrane structures for implantation of cells in host tissue
US6068648A (en) * 1998-01-26 2000-05-30 Orthodyne, Inc. Tissue anchoring system and method
US6171344B1 (en) * 1996-08-16 2001-01-09 Children's Medical Center Corporation Bladder submucosa seeded with cells for tissue reconstruction
US6176880B1 (en) * 1996-04-05 2001-01-23 Depuy Orthopaedics, Inc. Tissue graft construct for replacement of cartilaginous structures
US6179872B1 (en) * 1998-03-17 2001-01-30 Tissue Engineering Biopolymer matt for use in tissue repair and reconstruction
US6179840B1 (en) * 1999-07-23 2001-01-30 Ethicon, Inc. Graft fixation device and method
US6187038B1 (en) * 1998-04-08 2001-02-13 Sulzer Carbomedics Inc. Small bore biologic graft with therapeutic delivery system
US6197296B1 (en) * 1993-03-29 2001-03-06 National Heart Research Fund Tissue equivalents
US6206931B1 (en) * 1996-08-23 2001-03-27 Cook Incorporated Graft prosthesis materials
US6214048B1 (en) * 1992-02-10 2001-04-10 Matsumoto Dental College Bone substitute product and method of producing the same
US6214049B1 (en) * 1999-01-14 2001-04-10 Comfort Biomedical, Inc. Method and apparatus for augmentating osteointegration of prosthetic implant devices
US6224892B1 (en) * 1997-03-01 2001-05-01 Smith & Nephew Plc Polyesterhydrogels
US6236025B1 (en) * 1999-03-19 2001-05-22 General Electric Company Acoustic sensing system for boil state detection and method for determining boil state
US6235057B1 (en) * 1995-01-24 2001-05-22 Smith & Nephew, Inc. Method for soft tissue reconstruction
US6334872B1 (en) * 1994-02-18 2002-01-01 Organogenesis Inc. Method for treating diseased or damaged organs
US20020019649A1 (en) * 1999-12-02 2002-02-14 Smith & Nephew, Inc., Delaware Corporation Closure device and method for tissue repair
US6355699B1 (en) * 1999-06-30 2002-03-12 Ethicon, Inc. Process for manufacturing biomedical foams
US6358284B1 (en) * 1996-12-10 2002-03-19 Med Institute, Inc. Tubular grafts from purified submucosa
US20020038151A1 (en) * 2000-08-04 2002-03-28 Plouhar Pamela L. Reinforced small intestinal submucosa (SIS)
US6364884B1 (en) * 1999-07-23 2002-04-02 Ethicon, Inc. Method of securing a graft using a graft fixation device
US6371958B1 (en) * 2000-03-02 2002-04-16 Ethicon, Inc. Scaffold fixation device for use in articular cartilage repair
US20020048595A1 (en) * 1995-02-22 2002-04-25 Peter Geistlich Resorbable extracellular matrix for reconstruction of cartilage tissue
US6379710B1 (en) * 1996-12-10 2002-04-30 Purdue Research Foundation Biomaterial derived from vertebrate liver tissue
US6379367B1 (en) * 1996-08-30 2002-04-30 Verigen Transplantation Service International (Vtsi) Ag Method instruments and kit for autologous transplantation
US6383221B1 (en) * 1999-01-22 2002-05-07 Osteotech, Inc. Method for forming an intervertebral implant
US6387693B2 (en) * 1996-06-04 2002-05-14 Sulzer Orthopedics Ltd. Method for producing cartilage tissue and implants for repairing enchondral and osteochondral defects as well as arrangement for carrying out the method
US20030014128A1 (en) * 2001-07-10 2003-01-16 Pathak Jogen K. System, method, and apparatus for measuring application performance management
US20030023316A1 (en) * 2000-08-04 2003-01-30 Brown Laura Jean Hybrid biologic-synthetic bioabsorable scaffolds
US20030021827A1 (en) * 2001-07-16 2003-01-30 Prasanna Malaviya Hybrid biologic/synthetic porous extracellular matrix scaffolds
US6517564B1 (en) * 1999-02-02 2003-02-11 Arthrex, Inc. Bioabsorbable tissue tack with oval-shaped head and method of tissue fixation using same
US20030032961A1 (en) * 2001-07-16 2003-02-13 Pelo Mark Joseph Devices from naturally occurring biologically derived materials
US20030033022A1 (en) * 2001-07-16 2003-02-13 Plouhar Pamela Lynn Cartilage repair and regeneration device and method
US20030036797A1 (en) * 2001-07-16 2003-02-20 Prasanna Malaviya Meniscus regeneration device and method
US20030036801A1 (en) * 2001-07-16 2003-02-20 Schwartz Herbert E. Cartilage repair apparatus and method
US20030044444A1 (en) * 2001-07-16 2003-03-06 Prasanna Malaviya Porous extracellular matrix scaffold and method
US20030049299A1 (en) * 2001-07-16 2003-03-13 Prasanna Malaviya Porous delivery scaffold and method
US6692499B2 (en) * 1997-07-02 2004-02-17 Linvatec Biomaterials Oy Surgical fastener for tissue treatment
US6840962B1 (en) * 1995-05-01 2005-01-11 Massachusetts Institute Of Technology Tissue engineered tendons and ligaments

Family Cites Families (71)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3272204A (en) 1965-09-22 1966-09-13 Ethicon Inc Absorbable collagen prosthetic implant with non-absorbable reinforcing strands
GB1405886A (en) 1971-11-01 1975-09-10 Astra Laekemedel Ab Synergistic compositions comprising penicillin and cephalosporin antibiotics
US4105034A (en) 1977-06-10 1978-08-08 Ethicon, Inc. Poly(alkylene oxalate) absorbable coating for sutures
US4130639A (en) 1977-09-28 1978-12-19 Ethicon, Inc. Absorbable pharmaceutical compositions based on isomorphic copolyoxalates
US4352463A (en) 1979-01-18 1982-10-05 Leisure Lawn, Inc. Motorized combination wet and dry lawn treatment spreader
US4400833A (en) 1981-06-10 1983-08-30 Kurland Kenneth Z Means and method of implanting bioprosthetics
US4418691A (en) 1981-10-26 1983-12-06 Massachusetts Institute Of Technology Method of promoting the regeneration of tissue at a wound
US4741330A (en) * 1983-05-19 1988-05-03 Hayhurst John O Method and apparatus for anchoring and manipulating cartilage
US4610397A (en) 1983-10-27 1986-09-09 Urschel Laboratories Incorporated Comminuting equipment
GB8400932D0 (en) * 1984-01-13 1984-02-15 Geistlich Soehne Ag Bone fracture fixation plates
US4873976A (en) 1984-02-28 1989-10-17 Schreiber Saul N Surgical fasteners and method
CA1295796C (en) 1984-03-27 1992-02-18 Conrad Whyne Biodegradable matrix and methods for producing same
US5128326A (en) 1984-12-06 1992-07-07 Biomatrix, Inc. Drug delivery systems based on hyaluronans derivatives thereof and their salts and methods of producing same
US4750492A (en) 1985-02-27 1988-06-14 Richards Medical Company Absorbable suture apparatus, method and installer
US4669473A (en) 1985-09-06 1987-06-02 Acufex Microsurgical, Inc. Surgical fastener
US4705040A (en) 1985-11-18 1987-11-10 Medi-Tech, Incorporated Percutaneous fixation of hollow organs
USRE34021E (en) 1985-11-18 1992-08-04 Abbott Laboratories Percutaneous fixation of hollow organs
US4884572A (en) 1986-05-20 1989-12-05 Concept, Inc. Tack and applicator for treating torn bodily material in vivo
US4880429A (en) 1987-07-20 1989-11-14 Stone Kevin R Prosthetic meniscus
US5116374A (en) * 1989-03-02 1992-05-26 Regen Corporation Prosthetic meniscus
US5350583A (en) 1988-03-09 1994-09-27 Terumo Kabushiki Kaisha Cell-penetrable medical material and artificial skin
US4956178A (en) 1988-07-11 1990-09-11 Purdue Research Foundation Tissue graft composition
US4919667A (en) * 1988-12-02 1990-04-24 Stryker Corporation Implant
US5376118A (en) 1989-05-10 1994-12-27 United States Surgical Corporation Support material for cell impregnation
US5061286A (en) 1989-08-18 1991-10-29 Osteotech, Inc. Osteoprosthetic implant
US5129906A (en) 1989-09-08 1992-07-14 Linvatec Corporation Bioabsorbable tack for joining bodily tissue and in vivo method and apparatus for deploying same
US5269809A (en) 1990-07-02 1993-12-14 American Cyanamid Company Locking mechanism for use with a slotted suture anchor
US5258015A (en) 1991-05-03 1993-11-02 American Cyanamid Company Locking filament caps
US5269783A (en) 1991-05-13 1993-12-14 United States Surgical Corporation Device and method for repairing torn tissue
EP0520177B1 (en) * 1991-05-24 1995-12-13 Synthes AG, Chur Resorbable tendon and bone augmentation device
US5236431A (en) 1991-07-22 1993-08-17 Synthes Resorbable fixation device with controlled stiffness for treating bodily material in vivo and introducer therefor
US5676689A (en) * 1991-11-08 1997-10-14 Kensey Nash Corporation Hemostatic puncture closure system including vessel location device and method of use
US5352463A (en) 1992-11-13 1994-10-04 Badylak Steven F Tissue graft for surgical reconstruction of a collagenous meniscus and method therefor
GB2280850B (en) 1993-07-28 1997-07-30 Johnson & Johnson Medical Absorbable composite materials for use in the treatment of periodontal disease
EP0713364A4 (en) 1993-08-13 1996-12-27 Shalaby W Shalaby Microporous polymeric foams and microtextured surfaces
US5466262A (en) 1993-08-30 1995-11-14 Saffran; Bruce N. Malleable fracture stabilization device with micropores for directed drug delivery
US5460962A (en) 1994-01-04 1995-10-24 Organogenesis Inc. Peracetic acid sterilization of collagen or collagenous tissue
WO1995019796A1 (en) 1994-01-21 1995-07-27 Brown University Research Foundation Biocompatible implants
US5773577A (en) 1994-03-03 1998-06-30 Protein Polymer Technologies Products comprising substrates capable of enzymatic cross-linking
US5501685A (en) 1994-04-26 1996-03-26 Spetzler; Robert F. Method for securing a cranial piece in position
US5693085A (en) 1994-04-29 1997-12-02 Scimed Life Systems, Inc. Stent with collagen
US5545178A (en) 1994-04-29 1996-08-13 Kensey Nash Corporation System for closing a percutaneous puncture formed by a trocar to prevent tissue at the puncture from herniating
US5479033A (en) 1994-05-27 1995-12-26 Sandia Corporation Complementary junction heterostructure field-effect transistor
US5630824A (en) * 1994-06-01 1997-05-20 Innovasive Devices, Inc. Suture attachment device
US5769899A (en) 1994-08-12 1998-06-23 Matrix Biotechnologies, Inc. Cartilage repair unit
US5569252A (en) 1994-09-27 1996-10-29 Justin; Daniel F. Device for repairing a meniscal tear in a knee and method
US5698213A (en) 1995-03-06 1997-12-16 Ethicon, Inc. Hydrogels of absorbable polyoxaesters
US5464929A (en) 1995-03-06 1995-11-07 Ethicon, Inc. Absorbable polyoxaesters
US5700583A (en) 1995-03-06 1997-12-23 Ethicon, Inc. Hydrogels of absorbable polyoxaesters containing amines or amido groups
WO1996031232A1 (en) 1995-04-07 1996-10-10 Purdue Research Foundation Tissue graft and method for urinary bladder reconstruction
US5554389A (en) 1995-04-07 1996-09-10 Purdue Research Foundation Urinary bladder submucosa derived tissue graft
US5865849A (en) * 1995-06-07 1999-02-02 Crosscart, Inc. Meniscal heterografts
US5725556A (en) * 1995-12-15 1998-03-10 M & R Medical, Inc. Suture locking apparatus
US5626614A (en) * 1995-12-22 1997-05-06 Applied Medical Resources Corporation T-anchor suturing device and method for using same
US5702462A (en) 1996-01-24 1997-12-30 Oberlander; Michael Method of meniscal repair
US5842477A (en) * 1996-02-21 1998-12-01 Advanced Tissue Sciences, Inc. Method for repairing cartilage
US5759208A (en) 1996-02-29 1998-06-02 The Procter & Gamble Company Laundry detergent compositions containing silicone emulsions
US6299905B1 (en) * 1996-04-16 2001-10-09 Depuy Orthopaedics, Inc. Bioerodable polymeric adhesives for tissue repair
US5668288A (en) 1996-04-16 1997-09-16 Depuy Orthopaedics, Inc. Polyester ionomers for implant fabrication
US5759190A (en) 1996-08-30 1998-06-02 Vts Holdings Limited Method and kit for autologous transplantation
CA2224366C (en) 1996-12-11 2006-10-31 Ethicon, Inc. Meniscal repair device
US6869938B1 (en) * 1997-06-17 2005-03-22 Fziomed, Inc. Compositions of polyacids and polyethers and methods for their use in reducing adhesions
US6010525A (en) * 1997-08-01 2000-01-04 Peter M. Bonutti Method and apparatus for securing a suture
US6132468A (en) * 1998-09-10 2000-10-17 Mansmann; Kevin A. Arthroscopic replacement of cartilage using flexible inflatable envelopes
US20020165611A1 (en) * 1998-12-22 2002-11-07 Robert-Jan Enzerink Graft material convenience package
GB9912240D0 (en) * 1999-05-27 1999-07-28 Smith & Nephew Implantable medical devices
JP2001185930A (en) * 1999-12-27 2001-07-06 Toyota Autom Loom Works Ltd Radio communication device of paddle for feeding
US6508821B1 (en) * 2000-01-28 2003-01-21 Depuy Orthopaedics, Inc. Soft tissue repair material fixation apparatus and method
JP4426285B2 (en) * 2001-06-28 2010-03-03 クック・バイオテック・インコーポレーテッド Graft prosthesis device containing renal capsule collagen
US20050027307A1 (en) * 2001-07-16 2005-02-03 Schwartz Herbert Eugene Unitary surgical device and method
US6989034B2 (en) * 2002-05-31 2006-01-24 Ethicon, Inc. Attachment of absorbable tissue scaffolds to fixation devices

Patent Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3562820A (en) * 1966-08-22 1971-02-16 Bernhard Braun Tubular sheet and strip form prostheses on a basis of biological tissue
US3727204A (en) * 1971-04-23 1973-04-10 Philips Corp Asynchronous buffer device
US4208511A (en) * 1977-01-19 1980-06-17 Ethicon, Inc. Isomorphic copolyoxalates and sutures thereof
US4141087A (en) * 1977-01-19 1979-02-27 Ethicon, Inc. Isomorphic copolyoxalates and sutures thereof
US4205399A (en) * 1977-06-13 1980-06-03 Ethicon, Inc. Synthetic absorbable surgical devices of poly(alkylene oxalates)
US4140678A (en) * 1977-06-13 1979-02-20 Ethicon, Inc. Synthetic absorbable surgical devices of poly(alkylene oxalates)
US4642120A (en) * 1983-03-23 1987-02-10 Ramot University Authority For Applied Research And Industrial Development Ltd. Repair of cartilage and bones
US5736372A (en) * 1986-11-20 1998-04-07 Massachusetts Institute Of Technology Biodegradable synthetic polymeric fibrous matrix containing chondrocyte for in vivo production of a cartilaginous structure
US5007934A (en) * 1987-07-20 1991-04-16 Regen Corporation Prosthetic meniscus
US6042610A (en) * 1987-07-20 2000-03-28 Regen Biologics, Inc. Meniscal augmentation device
US5306311A (en) * 1987-07-20 1994-04-26 Regen Corporation Prosthetic articular cartilage
US5735903A (en) * 1987-07-20 1998-04-07 Li; Shu-Tung Meniscal augmentation device
US4926860A (en) * 1988-02-05 1990-05-22 Flexmedics Corporation ARthroscopic instrumentation and method
US4902508A (en) * 1988-07-11 1990-02-20 Purdue Research Foundation Tissue graft composition
US5108438A (en) * 1989-03-02 1992-04-28 Regen Corporation Prosthetic intervertebral disc
US5102421A (en) * 1990-06-14 1992-04-07 Wm. E. Anpach, III Suture anchor and method of forming
US5520691A (en) * 1990-11-06 1996-05-28 Branch; Thomas P. Method and apparatus for re-approximating tissue
US5203864A (en) * 1991-04-05 1993-04-20 Phillips Edward H Surgical fastener system
US5281422A (en) * 1991-09-24 1994-01-25 Purdue Research Foundation Graft for promoting autogenous tissue growth
US6214048B1 (en) * 1992-02-10 2001-04-10 Matsumoto Dental College Bone substitute product and method of producing the same
US5593441A (en) * 1992-03-04 1997-01-14 C. R. Bard, Inc. Method for limiting the incidence of postoperative adhesions
US6051750A (en) * 1992-08-07 2000-04-18 Tissue Engineering, Inc. Method and construct for producing graft tissue from an extracellular matrix
US5641518A (en) * 1992-11-13 1997-06-24 Purdue Research Foundation Method of repairing bone tissue
US5516533A (en) * 1992-11-13 1996-05-14 Purdue Research Foundation Fluidized intestinal submucosa and its use as an injectable tissue graft
US5275826A (en) * 1992-11-13 1994-01-04 Purdue Research Foundation Fluidized intestinal submucosa and its use as an injectable tissue graft
US5320633A (en) * 1992-12-10 1994-06-14 William C. Allen Method and system for repairing a tear in the meniscus
US5591234A (en) * 1993-02-01 1997-01-07 Axel Kirsch Post-surgery orthopedic covering
US5380334A (en) * 1993-02-17 1995-01-10 Smith & Nephew Dyonics, Inc. Soft tissue anchors and systems for implantation
US5601558A (en) * 1993-02-17 1997-02-11 Smith & Nephew Endoscopy, Inc. Soft tissue anchors and systems for implantation
US6197296B1 (en) * 1993-03-29 2001-03-06 National Heart Research Fund Tissue equivalents
US5595621A (en) * 1993-09-29 1997-01-21 Johnson & Johnson Medical, Inc. Method of making absorbable structures for ligament and tendon repair
US5514181A (en) * 1993-09-29 1996-05-07 Johnson & Johnson Medical, Inc. Absorbable structures for ligament and tendon repair
US5735897A (en) * 1993-10-19 1998-04-07 Scimed Life Systems, Inc. Intravascular stent pump
US6334872B1 (en) * 1994-02-18 2002-01-01 Organogenesis Inc. Method for treating diseased or damaged organs
US5855619A (en) * 1994-06-06 1999-01-05 Case Western Reserve University Biomatrix for soft tissue regeneration
US5891558A (en) * 1994-11-22 1999-04-06 Tissue Engineering, Inc. Biopolymer foams for use in tissue repair and reconstruction
US6235057B1 (en) * 1995-01-24 2001-05-22 Smith & Nephew, Inc. Method for soft tissue reconstruction
US5632745A (en) * 1995-02-07 1997-05-27 R&D Biologicals, Inc. Surgical implantation of cartilage repair unit
US5866414A (en) * 1995-02-10 1999-02-02 Badylak; Stephen F. Submucosa gel as a growth substrate for cells
US5753267A (en) * 1995-02-10 1998-05-19 Purdue Research Foundation Method for enhancing functional properties of submucosal tissue graft constructs
US20020048595A1 (en) * 1995-02-22 2002-04-25 Peter Geistlich Resorbable extracellular matrix for reconstruction of cartilage tissue
US5620698A (en) * 1995-03-06 1997-04-15 Ethicon, Inc. Blends of absorbable polyoxaesters containing amines and/or amido groups
US5618552A (en) * 1995-03-06 1997-04-08 Ethicon, Inc. Absorbable polyoxaesters
US5607687A (en) * 1995-03-06 1997-03-04 Ethicon, Inc. Polymer blends containing absorbable polyoxaesters
US5859150A (en) * 1995-03-06 1999-01-12 Ethicon, Inc. Prepolymers of absorbable polyoxaesters
US5597579A (en) * 1995-03-06 1997-01-28 Ethicon, Inc. Blends of absorbable polyoxaamides
US5595751A (en) * 1995-03-06 1997-01-21 Ethicon, Inc. Absorbable polyoxaesters containing amines and/or amido groups
US6017348A (en) * 1995-03-07 2000-01-25 Innovasive Devices, Inc. Apparatus and methods for articular cartilage defect repair
US5885619A (en) * 1995-04-07 1999-03-23 Purdue Research Foundation Large area submucosal tissue graft constructs and method for making the same
US5711969A (en) * 1995-04-07 1998-01-27 Purdue Research Foundation Large area submucosal tissue graft constructs
US5733337A (en) * 1995-04-07 1998-03-31 Organogenesis, Inc. Tissue repair fabric
US6840962B1 (en) * 1995-05-01 2005-01-11 Massachusetts Institute Of Technology Tissue engineered tendons and ligaments
US6060640A (en) * 1995-05-19 2000-05-09 Baxter International Inc. Multiple-layer, formed-in-place immunoisolation membrane structures for implantation of cells in host tissue
US5855610A (en) * 1995-05-19 1999-01-05 Children's Medical Center Corporation Engineering of strong, pliable tissues
US5855613A (en) * 1995-10-13 1999-01-05 Islet Sheet Medical, Inc. Retrievable bioartificial implants having dimensions allowing rapid diffusion of oxygen and rapid biological response to physiological change
US5755791A (en) * 1996-04-05 1998-05-26 Purdue Research Foundation Perforated submucosal tissue graft constructs
US6176880B1 (en) * 1996-04-05 2001-01-23 Depuy Orthopaedics, Inc. Tissue graft construct for replacement of cartilaginous structures
US5730933A (en) * 1996-04-16 1998-03-24 Depuy Orthopaedics, Inc. Radiation sterilization of biologically active compounds
US5733868A (en) * 1996-04-16 1998-03-31 Depuy Orthopaedics, Inc. Poly(amino acid) adhesive tissue grafts
US6387693B2 (en) * 1996-06-04 2002-05-14 Sulzer Orthopedics Ltd. Method for producing cartilage tissue and implants for repairing enchondral and osteochondral defects as well as arrangement for carrying out the method
US6171344B1 (en) * 1996-08-16 2001-01-09 Children's Medical Center Corporation Bladder submucosa seeded with cells for tissue reconstruction
US6206931B1 (en) * 1996-08-23 2001-03-27 Cook Incorporated Graft prosthesis materials
US6379367B1 (en) * 1996-08-30 2002-04-30 Verigen Transplantation Service International (Vtsi) Ag Method instruments and kit for autologous transplantation
US5863551A (en) * 1996-10-16 1999-01-26 Organogel Canada Ltee Implantable polymer hydrogel for therapeutic uses
US6358284B1 (en) * 1996-12-10 2002-03-19 Med Institute, Inc. Tubular grafts from purified submucosa
US6379710B1 (en) * 1996-12-10 2002-04-30 Purdue Research Foundation Biomaterial derived from vertebrate liver tissue
US6058777A (en) * 1997-02-20 2000-05-09 Murata Manufacturing Co., Ltd. Vibrating gyroscope including a pair of piezoelectric bodies with electrically floating interface
US6224892B1 (en) * 1997-03-01 2001-05-01 Smith & Nephew Plc Polyesterhydrogels
US6034140A (en) * 1997-06-17 2000-03-07 Fziomed, Inc. Bioresorbable compositions of carboxypolysaccharide polyether intermacromolecular complexes and methods for their use in reducing surgical adhesions
US5906997A (en) * 1997-06-17 1999-05-25 Fzio Med, Inc. Bioresorbable compositions of carboxypolysaccharide polyether intermacromolecular complexes and methods for their use in reducing surgical adhesions
US6017301A (en) * 1997-06-17 2000-01-25 Fziomed, Inc. Bioresorbable compositions of carboxypolysaccharide polyether intermacromolecular complexes and methods for their use in reducing surgical adhesions
US6692499B2 (en) * 1997-07-02 2004-02-17 Linvatec Biomaterials Oy Surgical fastener for tissue treatment
US6056752A (en) * 1997-10-24 2000-05-02 Smith & Nephew, Inc. Fixation of cruciate ligament grafts
US6056778A (en) * 1997-10-29 2000-05-02 Arthrex, Inc. Meniscal repair device
US5899939A (en) * 1998-01-21 1999-05-04 Osteotech, Inc. Bone-derived implant for load-supporting applications
US6068648A (en) * 1998-01-26 2000-05-30 Orthodyne, Inc. Tissue anchoring system and method
US6179872B1 (en) * 1998-03-17 2001-01-30 Tissue Engineering Biopolymer matt for use in tissue repair and reconstruction
US6187038B1 (en) * 1998-04-08 2001-02-13 Sulzer Carbomedics Inc. Small bore biologic graft with therapeutic delivery system
US6027744A (en) * 1998-04-24 2000-02-22 University Of Massachusetts Medical Center Guided development and support of hydrogel-cell compositions
US6214049B1 (en) * 1999-01-14 2001-04-10 Comfort Biomedical, Inc. Method and apparatus for augmentating osteointegration of prosthetic implant devices
US6383221B1 (en) * 1999-01-22 2002-05-07 Osteotech, Inc. Method for forming an intervertebral implant
US6517564B1 (en) * 1999-02-02 2003-02-11 Arthrex, Inc. Bioabsorbable tissue tack with oval-shaped head and method of tissue fixation using same
US6236025B1 (en) * 1999-03-19 2001-05-22 General Electric Company Acoustic sensing system for boil state detection and method for determining boil state
US6355699B1 (en) * 1999-06-30 2002-03-12 Ethicon, Inc. Process for manufacturing biomedical foams
US6364884B1 (en) * 1999-07-23 2002-04-02 Ethicon, Inc. Method of securing a graft using a graft fixation device
US6179840B1 (en) * 1999-07-23 2001-01-30 Ethicon, Inc. Graft fixation device and method
US20020019649A1 (en) * 1999-12-02 2002-02-14 Smith & Nephew, Inc., Delaware Corporation Closure device and method for tissue repair
US6371958B1 (en) * 2000-03-02 2002-04-16 Ethicon, Inc. Scaffold fixation device for use in articular cartilage repair
US20030023316A1 (en) * 2000-08-04 2003-01-30 Brown Laura Jean Hybrid biologic-synthetic bioabsorable scaffolds
US20020038151A1 (en) * 2000-08-04 2002-03-28 Plouhar Pamela L. Reinforced small intestinal submucosa (SIS)
US20030014128A1 (en) * 2001-07-10 2003-01-16 Pathak Jogen K. System, method, and apparatus for measuring application performance management
US20030033022A1 (en) * 2001-07-16 2003-02-13 Plouhar Pamela Lynn Cartilage repair and regeneration device and method
US20030033021A1 (en) * 2001-07-16 2003-02-13 Plouhar Pamela Lynn Cartilage repair and regeneration scaffold and method
US20030036797A1 (en) * 2001-07-16 2003-02-20 Prasanna Malaviya Meniscus regeneration device and method
US20030036801A1 (en) * 2001-07-16 2003-02-20 Schwartz Herbert E. Cartilage repair apparatus and method
US20030044444A1 (en) * 2001-07-16 2003-03-06 Prasanna Malaviya Porous extracellular matrix scaffold and method
US20030049299A1 (en) * 2001-07-16 2003-03-13 Prasanna Malaviya Porous delivery scaffold and method
US20030032961A1 (en) * 2001-07-16 2003-02-13 Pelo Mark Joseph Devices from naturally occurring biologically derived materials
US20030021827A1 (en) * 2001-07-16 2003-01-30 Prasanna Malaviya Hybrid biologic/synthetic porous extracellular matrix scaffolds

Cited By (279)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040059416A1 (en) * 1999-06-22 2004-03-25 Murray Martha M. Biologic replacement for fibrin clot
US8642735B2 (en) 1999-06-22 2014-02-04 Children's Medical Center Corporation Biologic replacement for fibrin clot
US20080031923A1 (en) * 1999-06-22 2008-02-07 The Children's Medical Center Corporation Biologic Replacement for Fibrin Clot
US7838630B2 (en) 1999-06-22 2010-11-23 Children's Medical Center Corporation Biologic replacement for fibrin clot
US8025896B2 (en) 2001-07-16 2011-09-27 Depuy Products, Inc. Porous extracellular matrix scaffold and method
US20030078617A1 (en) * 2001-07-16 2003-04-24 Schwartz Herbert E. Unitary surgical device and method
US20040143344A1 (en) * 2001-07-16 2004-07-22 Prasanna Malaviya Implantable tissue repair device and method
US20040220574A1 (en) * 2001-07-16 2004-11-04 Pelo Mark Joseph Device from naturally occuring biologically derived materials
US8092529B2 (en) 2001-07-16 2012-01-10 Depuy Products, Inc. Meniscus regeneration device
US20030033022A1 (en) * 2001-07-16 2003-02-13 Plouhar Pamela Lynn Cartilage repair and regeneration device and method
US7819918B2 (en) 2001-07-16 2010-10-26 Depuy Products, Inc. Implantable tissue repair device
US8012205B2 (en) * 2001-07-16 2011-09-06 Depuy Products, Inc. Cartilage repair and regeneration device
US8337537B2 (en) 2001-07-16 2012-12-25 Depuy Products, Inc. Device from naturally occurring biologically derived materials
US20030033021A1 (en) * 2001-07-16 2003-02-13 Plouhar Pamela Lynn Cartilage repair and regeneration scaffold and method
US20030044444A1 (en) * 2001-07-16 2003-03-06 Prasanna Malaviya Porous extracellular matrix scaffold and method
US20030036797A1 (en) * 2001-07-16 2003-02-20 Prasanna Malaviya Meniscus regeneration device and method
US20060263335A1 (en) * 2003-03-27 2006-11-23 Regentec Ltd. Porous matrix
US9486558B2 (en) 2003-03-27 2016-11-08 Locate Therapeutics Limited Porous matrix
US10232087B2 (en) 2003-03-27 2019-03-19 Locate Therapeutics Limited Porous matrix
USRE42208E1 (en) 2003-04-29 2011-03-08 Musculoskeletal Transplant Foundation Glue for cartilage repair
US20080274157A1 (en) * 2003-04-29 2008-11-06 Gordana Vunjak-Novakovic Cartilage implant plug with fibrin glue and method for implantation
US20060210643A1 (en) * 2003-04-29 2006-09-21 Truncale Katherine A G Cartilage repair mixture containing allograft chondrocytes
USRE43258E1 (en) 2003-04-29 2012-03-20 Musculoskeletal Transplant Foundation Glue for cartilage repair
US20080133008A1 (en) * 2003-04-29 2008-06-05 Muscuoskeletal Transplant Foundation Cartilage repair mixture containing allograft chondrocytes
US8221500B2 (en) 2003-05-16 2012-07-17 Musculoskeletal Transplant Foundation Cartilage allograft plug
US7901457B2 (en) 2003-05-16 2011-03-08 Musculoskeletal Transplant Foundation Cartilage allograft plug
US20050251268A1 (en) * 2003-05-16 2005-11-10 Musculoskeletal Transplant Foundation Cartilage allograft plug
US20090291112A1 (en) * 2003-05-16 2009-11-26 Truncale Katherine G Allograft osteochondral plug combined with cartilage particle mixture
US20040230303A1 (en) * 2003-05-16 2004-11-18 Gomes Katherine A. Cartilage allograft plug
US8257365B2 (en) * 2004-02-13 2012-09-04 Ethicon Endo-Surgery, Inc. Methods and devices for reducing hollow organ volume
US8828025B2 (en) 2004-02-13 2014-09-09 Ethicon Endo-Surgery, Inc. Methods and devices for reducing hollow organ volume
US20070208360A1 (en) * 2004-02-13 2007-09-06 Demarais Denise M Methods and devices for reducing hollow organ volume
US8221454B2 (en) 2004-02-20 2012-07-17 Biomet Sports Medicine, Llc Apparatus for performing meniscus repair
US20080132925A1 (en) * 2004-02-27 2008-06-05 Satiety, Inc. Methods and devices for reducing hollow organ volume
US8057384B2 (en) 2004-02-27 2011-11-15 Ethicon Endo-Surgery, Inc. Methods and devices for reducing hollow organ volume
US20090043389A1 (en) * 2004-04-02 2009-02-12 Gordana Vunjak-Novakovic Cartilage implant plug with fibrin glue and method for implantation
US20050222687A1 (en) * 2004-04-02 2005-10-06 Gordana Vunjak-Novakovic Cartilage implant assembly and method for implantation
US20050249772A1 (en) * 2004-05-04 2005-11-10 Prasanna Malaviya Hybrid biologic-synthetic bioabsorbable scaffolds
US8109969B1 (en) 2004-06-02 2012-02-07 Kfx Medical Corporation System and method for attaching soft tissue to bone
US9414835B1 (en) 2004-06-02 2016-08-16 Kfx Medical, Llc System and method for attaching soft tissue to bone
US20090318966A1 (en) * 2004-06-02 2009-12-24 Kfx Medical Corporation System and method for attaching soft tissue to bone
US9655611B2 (en) 2004-06-02 2017-05-23 Kfx Medical, Llc System and method for attaching soft tissue to bone
US9044226B2 (en) 2004-06-02 2015-06-02 Kfx Medical Corporation System and method for attaching soft tissue to bone
US10561409B2 (en) 2004-06-02 2020-02-18 Kfx Medical, Llc System and method for attaching soft tissue to bone
US8529601B2 (en) 2004-06-02 2013-09-10 Kfx Medical Corporation System and method for attaching soft tissue to bone
US8512378B2 (en) 2004-06-02 2013-08-20 Kfx Medical Corporation Suture anchor
US8926663B2 (en) 2004-06-02 2015-01-06 Kfx Medical Corporation System and method for attaching soft tissue to bone
US8951287B1 (en) 2004-06-02 2015-02-10 Kfx Medical Corporation System and method for attaching soft tissue to bone
US8062334B2 (en) 2004-06-02 2011-11-22 Kfx Medical Corporation Suture anchor
US8267964B2 (en) 2004-06-02 2012-09-18 Kfx Medical Corporation System and method for attaching soft tissue to bone
US8100942B1 (en) 2004-06-02 2012-01-24 Kfx Medical Corporation System and method for attaching soft tissue to bone
US8292968B2 (en) 2004-10-12 2012-10-23 Musculoskeletal Transplant Foundation Cancellous constructs, cartilage particles and combinations of cancellous constructs and cartilage particles
US20090319045A1 (en) * 2004-10-12 2009-12-24 Truncale Katherine G Cancellous constructs, cartilage particles and combinations of cancellous constructs and cartilage particles
US9801708B2 (en) 2004-11-05 2017-10-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10265064B2 (en) 2004-11-05 2019-04-23 Biomet Sports Medicine, Llc Soft tissue repair device and method
US20060190042A1 (en) * 2004-11-05 2006-08-24 Arthrotek, Inc. Tissue repair assembly
US9504460B2 (en) 2004-11-05 2016-11-29 Biomet Sports Medicine, LLC. Soft tissue repair device and method
US8840645B2 (en) 2004-11-05 2014-09-23 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8137382B2 (en) 2004-11-05 2012-03-20 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US9572655B2 (en) 2004-11-05 2017-02-21 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8128658B2 (en) 2004-11-05 2012-03-06 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US8118836B2 (en) 2004-11-05 2012-02-21 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8303604B2 (en) 2004-11-05 2012-11-06 Biomet Sports Medicine, Llc Soft tissue repair device and method
US11109857B2 (en) 2004-11-05 2021-09-07 Biomet Sports Medicine, Llc Soft tissue repair device and method
US8551140B2 (en) 2004-11-05 2013-10-08 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US8317825B2 (en) 2004-11-09 2012-11-27 Biomet Sports Medicine, Llc Soft tissue conduit device and method
US8034090B2 (en) 2004-11-09 2011-10-11 Biomet Sports Medicine, Llc Tissue fixation device
US8998949B2 (en) 2004-11-09 2015-04-07 Biomet Sports Medicine, Llc Soft tissue conduit device
US20060189993A1 (en) * 2004-11-09 2006-08-24 Arthrotek, Inc. Soft tissue conduit device
US7914539B2 (en) 2004-11-09 2011-03-29 Biomet Sports Medicine, Llc Tissue fixation device
US20060135638A1 (en) * 2004-12-22 2006-06-22 Pedrozo Hugo A Method for organizing the assembly of collagen fibers and compositions formed therefrom
US7594922B1 (en) 2005-04-07 2009-09-29 Medicine Lodge, Inc System and method for meniscal repair through a meniscal capsular tunnel
US20100010497A1 (en) * 2005-04-07 2010-01-14 Medicinelodge, Inc. System and method for meniscal repair through a meniscal capsular tunnel
US7815926B2 (en) 2005-07-11 2010-10-19 Musculoskeletal Transplant Foundation Implant for articular cartilage repair
US20070026053A1 (en) * 2005-07-28 2007-02-01 Pedrozo Hugo A Joint resurfacing orthopaedic implant and associated method
US9701940B2 (en) 2005-09-19 2017-07-11 Histogenics Corporation Cell-support matrix having narrowly defined uniformly vertically and non-randomly organized porosity and pore density and a method for preparation thereof
US20070167950A1 (en) * 2005-12-22 2007-07-19 Tauro Joseph C System and method for attaching soft tissue to bone
US11076846B2 (en) 2006-01-25 2021-08-03 The Children's Medical Center Corporation Methods and procedures for ligament repair
US11076845B2 (en) 2006-01-25 2021-08-03 The Children's Medical Center Corporation Methods and procedures for ligament repair
US10786239B2 (en) 2006-01-25 2020-09-29 The Children's Medical Center Corporation Methods and procedures for ligament repair
US10786238B2 (en) 2006-01-25 2020-09-29 The Children's Medical Center Corporation Methods and procedures for ligament repair
US10786232B2 (en) 2006-01-25 2020-09-29 The Children's Medical Center Corporation Methods and procedures for ligament repair
US8932331B2 (en) 2006-02-03 2015-01-13 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US11617572B2 (en) 2006-02-03 2023-04-04 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US8292921B2 (en) 2006-02-03 2012-10-23 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US10987099B2 (en) 2006-02-03 2021-04-27 Biomet Sports Medicine, Llc Method for tissue fixation
US8337525B2 (en) 2006-02-03 2012-12-25 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US8273106B2 (en) 2006-02-03 2012-09-25 Biomet Sports Medicine, Llc Soft tissue repair and conduit device
US10973507B2 (en) 2006-02-03 2021-04-13 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10932770B2 (en) 2006-02-03 2021-03-02 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US8361113B2 (en) 2006-02-03 2013-01-29 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US11065103B2 (en) 2006-02-03 2021-07-20 Biomet Sports Medicine, Llc Method and apparatus for fixation of an ACL graft
US8409253B2 (en) 2006-02-03 2013-04-02 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US20070185532A1 (en) * 2006-02-03 2007-08-09 Arthrotek, Inc. Soft tissue repair assembly and associated method
US11116495B2 (en) 2006-02-03 2021-09-14 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US10729430B2 (en) 2006-02-03 2020-08-04 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10729421B2 (en) 2006-02-03 2020-08-04 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US10716557B2 (en) 2006-02-03 2020-07-21 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US8088130B2 (en) 2006-02-03 2012-01-03 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10702259B2 (en) 2006-02-03 2020-07-07 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US10695052B2 (en) 2006-02-03 2020-06-30 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10687803B2 (en) 2006-02-03 2020-06-23 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8574235B2 (en) 2006-02-03 2013-11-05 Biomet Sports Medicine, Llc Method for trochanteric reattachment
US8597327B2 (en) 2006-02-03 2013-12-03 Biomet Manufacturing, Llc Method and apparatus for sternal closure
US8608777B2 (en) 2006-02-03 2013-12-17 Biomet Sports Medicine Method and apparatus for coupling soft tissue to a bone
US8632569B2 (en) 2006-02-03 2014-01-21 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US10675073B2 (en) 2006-02-03 2020-06-09 Biomet Sports Medicine, Llc Method and apparatus for sternal closure
US8652171B2 (en) 2006-02-03 2014-02-18 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US8652172B2 (en) 2006-02-03 2014-02-18 Biomet Sports Medicine, Llc Flexible anchors for tissue fixation
US10603029B2 (en) 2006-02-03 2020-03-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US10595851B2 (en) 2006-02-03 2020-03-24 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8721684B2 (en) 2006-02-03 2014-05-13 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US10542967B2 (en) 2006-02-03 2020-01-28 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10517587B2 (en) 2006-02-03 2019-12-31 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US8771316B2 (en) 2006-02-03 2014-07-08 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US10441264B2 (en) 2006-02-03 2019-10-15 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US10398428B2 (en) 2006-02-03 2019-09-03 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US11259792B2 (en) 2006-02-03 2022-03-01 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US10321906B2 (en) 2006-02-03 2019-06-18 Biomet Sports Medicine, Llc Method for tissue fixation
US10251637B2 (en) 2006-02-03 2019-04-09 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US10154837B2 (en) 2006-02-03 2018-12-18 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10098629B2 (en) 2006-02-03 2018-10-16 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US11039826B2 (en) 2006-02-03 2021-06-22 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US8936621B2 (en) 2006-02-03 2015-01-20 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US10092288B2 (en) 2006-02-03 2018-10-09 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8968364B2 (en) 2006-02-03 2015-03-03 Biomet Sports Medicine, Llc Method and apparatus for fixation of an ACL graft
US7909851B2 (en) 2006-02-03 2011-03-22 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US9005287B2 (en) 2006-02-03 2015-04-14 Biomet Sports Medicine, Llc Method for bone reattachment
US11284884B2 (en) 2006-02-03 2022-03-29 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US7905904B2 (en) 2006-02-03 2011-03-15 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US11311287B2 (en) 2006-02-03 2022-04-26 Biomet Sports Medicine, Llc Method for tissue fixation
US9149267B2 (en) 2006-02-03 2015-10-06 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9173651B2 (en) 2006-02-03 2015-11-03 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US11317907B2 (en) 2006-02-03 2022-05-03 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US11896210B2 (en) 2006-02-03 2024-02-13 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9271713B2 (en) 2006-02-03 2016-03-01 Biomet Sports Medicine, Llc Method and apparatus for tensioning a suture
US10022118B2 (en) 2006-02-03 2018-07-17 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US10004588B2 (en) 2006-02-03 2018-06-26 Biomet Sports Medicine, Llc Method and apparatus for fixation of an ACL graft
US7905903B2 (en) 2006-02-03 2011-03-15 Biomet Sports Medicine, Llc Method for tissue fixation
US11819205B2 (en) 2006-02-03 2023-11-21 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US10004489B2 (en) 2006-02-03 2018-06-26 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US11786236B2 (en) 2006-02-03 2023-10-17 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US11730464B2 (en) 2006-02-03 2023-08-22 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US9402621B2 (en) 2006-02-03 2016-08-02 Biomet Sports Medicine, LLC. Method for tissue fixation
US9993241B2 (en) 2006-02-03 2018-06-12 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US9414833B2 (en) 2006-02-03 2016-08-16 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US11446019B2 (en) 2006-02-03 2022-09-20 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US11723648B2 (en) 2006-02-03 2023-08-15 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US9801620B2 (en) 2006-02-03 2017-10-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US9468433B2 (en) 2006-02-03 2016-10-18 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US9763656B2 (en) 2006-02-03 2017-09-19 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US7857830B2 (en) 2006-02-03 2010-12-28 Biomet Sports Medicine, Llc Soft tissue repair and conduit device
US9492158B2 (en) 2006-02-03 2016-11-15 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9498204B2 (en) 2006-02-03 2016-11-22 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US11471147B2 (en) 2006-02-03 2022-10-18 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9510821B2 (en) 2006-02-03 2016-12-06 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US9510819B2 (en) 2006-02-03 2016-12-06 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US9532777B2 (en) 2006-02-03 2017-01-03 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9538998B2 (en) 2006-02-03 2017-01-10 Biomet Sports Medicine, Llc Method and apparatus for fracture fixation
US11589859B2 (en) 2006-02-03 2023-02-28 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US9561025B2 (en) 2006-02-03 2017-02-07 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US7749250B2 (en) 2006-02-03 2010-07-06 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US9642661B2 (en) 2006-02-03 2017-05-09 Biomet Sports Medicine, Llc Method and Apparatus for Sternal Closure
US9603591B2 (en) 2006-02-03 2017-03-28 Biomet Sports Medicine, Llc Flexible anchors for tissue fixation
US8298262B2 (en) 2006-02-03 2012-10-30 Biomet Sports Medicine, Llc Method for tissue fixation
US9622736B2 (en) 2006-02-03 2017-04-18 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US20070288023A1 (en) * 2006-06-12 2007-12-13 Greg Pellegrino Soft tissue repair using tissue augments and bone anchors
US8251998B2 (en) 2006-08-16 2012-08-28 Biomet Sports Medicine, Llc Chondral defect repair
US8777956B2 (en) 2006-08-16 2014-07-15 Biomet Sports Medicine, Llc Chondral defect repair
US9849213B2 (en) 2006-09-28 2017-12-26 Children's Medical Center Corporation Methods and products for tissue repair
US9308242B2 (en) 2006-09-28 2016-04-12 Children's Medical Center Corporation Methods and products for tissue repair
US8562645B2 (en) 2006-09-29 2013-10-22 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US10517714B2 (en) 2006-09-29 2019-12-31 Biomet Sports Medicine, Llc Ligament system for knee joint
US9724090B2 (en) 2006-09-29 2017-08-08 Biomet Manufacturing, Llc Method and apparatus for attaching soft tissue to bone
US8231654B2 (en) 2006-09-29 2012-07-31 Biomet Sports Medicine, Llc Adjustable knotless loops
US10695045B2 (en) 2006-09-29 2020-06-30 Biomet Sports Medicine, Llc Method and apparatus for attaching soft tissue to bone
US10610217B2 (en) 2006-09-29 2020-04-07 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US9788876B2 (en) 2006-09-29 2017-10-17 Biomet Sports Medicine, Llc Fracture fixation device
US8672968B2 (en) 2006-09-29 2014-03-18 Biomet Sports Medicine, Llc Method for implanting soft tissue
US10398430B2 (en) 2006-09-29 2019-09-03 Biomet Sports Medicine, Llc Method for implanting soft tissue
US9833230B2 (en) 2006-09-29 2017-12-05 Biomet Sports Medicine, Llc Fracture fixation device
US8672969B2 (en) 2006-09-29 2014-03-18 Biomet Sports Medicine, Llc Fracture fixation device
US8801783B2 (en) 2006-09-29 2014-08-12 Biomet Sports Medicine, Llc Prosthetic ligament system for knee joint
US8562647B2 (en) 2006-09-29 2013-10-22 Biomet Sports Medicine, Llc Method and apparatus for securing soft tissue to bone
US9918826B2 (en) 2006-09-29 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US11376115B2 (en) 2006-09-29 2022-07-05 Biomet Sports Medicine, Llc Prosthetic ligament system for knee joint
US9681940B2 (en) 2006-09-29 2017-06-20 Biomet Sports Medicine, Llc Ligament system for knee joint
US9414925B2 (en) 2006-09-29 2016-08-16 Biomet Manufacturing, Llc Method of implanting a knee prosthesis assembly with a ligament link
US10004493B2 (en) 2006-09-29 2018-06-26 Biomet Sports Medicine, Llc Method for implanting soft tissue
US11672527B2 (en) 2006-09-29 2023-06-13 Biomet Sports Medicine, Llc Method for implanting soft tissue
US7658751B2 (en) 2006-09-29 2010-02-09 Biomet Sports Medicine, Llc Method for implanting soft tissue
US9539003B2 (en) 2006-09-29 2017-01-10 Biomet Sports Medicine, LLC. Method and apparatus for forming a self-locking adjustable loop
US10835232B2 (en) 2006-09-29 2020-11-17 Biomet Sports Medicine, Llc Fracture fixation device
US9078644B2 (en) 2006-09-29 2015-07-14 Biomet Sports Medicine, Llc Fracture fixation device
US10743925B2 (en) 2006-09-29 2020-08-18 Biomet Sports Medicine, Llc Fracture fixation device
US7959650B2 (en) 2006-09-29 2011-06-14 Biomet Sports Medicine, Llc Adjustable knotless loops
US11096684B2 (en) 2006-09-29 2021-08-24 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US11259794B2 (en) 2006-09-29 2022-03-01 Biomet Sports Medicine, Llc Method for implanting soft tissue
US9486211B2 (en) 2006-09-29 2016-11-08 Biomet Sports Medicine, Llc Method for implanting soft tissue
US8500818B2 (en) 2006-09-29 2013-08-06 Biomet Manufacturing, Llc Knee prosthesis assembly with ligament link
US10349931B2 (en) 2006-09-29 2019-07-16 Biomet Sports Medicine, Llc Fracture fixation device
US20080177301A1 (en) * 2006-10-02 2008-07-24 The Cleveland Clinic Foundation Apparatus and method for anchoring a prosthetic structure to a body tissue
US8287594B2 (en) 2006-10-19 2012-10-16 Intersect Partners, Llc Knee joint prosthesis and hyaluronate compositions for treatment of osteoarthritis
US20110172768A1 (en) * 2006-10-19 2011-07-14 Cragg Andrew H Knee joint prosthesis and hyaluronate compositions for treatment of osteoarthritis
US20080097606A1 (en) * 2006-10-19 2008-04-24 Cragg Andrew H Knee joint prosthesis and hyaluronate compositions for treatment of osteoarthritis
US7871440B2 (en) 2006-12-11 2011-01-18 Depuy Products, Inc. Unitary surgical device and method
US20080140094A1 (en) * 2006-12-11 2008-06-12 Schwartz Herbert E Unitary surgical device and method
US11612391B2 (en) 2007-01-16 2023-03-28 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US8906110B2 (en) 2007-01-24 2014-12-09 Musculoskeletal Transplant Foundation Two piece cancellous construct for cartilage repair
US7837740B2 (en) 2007-01-24 2010-11-23 Musculoskeletal Transplant Foundation Two piece cancellous construct for cartilage repair
US20080255676A1 (en) * 2007-01-24 2008-10-16 Musculoskeletal Transplant Foundation Two piece cancellous construct for cartilage repair
US8343536B2 (en) 2007-01-25 2013-01-01 Cook Biotech Incorporated Biofilm-inhibiting medical products
US20080220044A1 (en) * 2007-03-06 2008-09-11 Semler Eric J Cancellous construct with support ring for repair of osteochondral defects
US8435551B2 (en) 2007-03-06 2013-05-07 Musculoskeletal Transplant Foundation Cancellous construct with support ring for repair of osteochondral defects
US20100015202A1 (en) * 2007-03-06 2010-01-21 Semler Eric J Cancellous construct with support ring for repair of osteochondral defects
US9861351B2 (en) 2007-04-10 2018-01-09 Biomet Sports Medicine, Llc Adjustable knotless loops
US10729423B2 (en) 2007-04-10 2020-08-04 Biomet Sports Medicine, Llc Adjustable knotless loops
US11185320B2 (en) 2007-04-10 2021-11-30 Biomet Sports Medicine, Llc Adjustable knotless loops
US9017381B2 (en) 2007-04-10 2015-04-28 Biomet Sports Medicine, Llc Adjustable knotless loops
EP2197391A2 (en) * 2007-10-15 2010-06-23 Andrew H. Cragg Knee joint prosthesis and hyaluronate compositions and systems useful for osteoarthritis
EP2197391A4 (en) * 2007-10-15 2013-10-23 Andrew H Cragg Knee joint prosthesis and hyaluronate compositions and systems useful for osteoarthritis
US20090149893A1 (en) * 2007-12-05 2009-06-11 Semler Eric J Cancellous Bone Implant for Cartilage Repair
US8764829B2 (en) * 2008-06-04 2014-07-01 James Marvel Buffer for a human joint and method of arthroscopically inserting
US20110270393A1 (en) * 2008-06-04 2011-11-03 James Marvel Buffer for a human joint and method of arthroscopically inserting
US9295757B2 (en) * 2008-06-10 2016-03-29 Cook Biotech Incorporated Quilted implantable graft
US10688219B2 (en) * 2008-06-10 2020-06-23 Cook Biotech Incorporated Quilted implantable graft
US11351021B2 (en) 2008-06-10 2022-06-07 Cook Biotech Incorporated Quilted implantable graft
US20090306688A1 (en) * 2008-06-10 2009-12-10 Patel Umesh H Quilted implantable graft
US20110166673A1 (en) * 2008-06-10 2011-07-07 Patel Umesh H Quilted implantable graft
US20110185560A1 (en) * 2008-08-18 2011-08-04 Qioptiq Photonics Gmbh & Co. Kg Method for producing an objective
US11534159B2 (en) 2008-08-22 2022-12-27 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8343227B2 (en) 2009-05-28 2013-01-01 Biomet Manufacturing Corp. Knee prosthesis assembly with ligament link
US8900314B2 (en) 2009-05-28 2014-12-02 Biomet Manufacturing, Llc Method of implanting a prosthetic knee joint assembly
US10149767B2 (en) 2009-05-28 2018-12-11 Biomet Manufacturing, Llc Method of implanting knee prosthesis assembly with ligament link
US20130060334A1 (en) * 2010-02-25 2013-03-07 Orteq B.V. Meniscus repair assembly and method
US9636209B2 (en) 2011-03-08 2017-05-02 Mimedx Group, Inc. Collagen fiber ribbons with integrated fixation sutures and methods of making the same
US10653514B2 (en) 2011-03-08 2020-05-19 Mimedx Group, Inc. Collagen fiber ribbons with integrated fixation sutures and methods of making the same
US9216078B2 (en) 2011-05-17 2015-12-22 Biomet Sports Medicine, Llc Method and apparatus for tibial fixation of an ACL graft
US8771352B2 (en) 2011-05-17 2014-07-08 Biomet Sports Medicine, Llc Method and apparatus for tibial fixation of an ACL graft
US9445827B2 (en) 2011-10-25 2016-09-20 Biomet Sports Medicine, Llc Method and apparatus for intraosseous membrane reconstruction
US8506597B2 (en) 2011-10-25 2013-08-13 Biomet Sports Medicine, Llc Method and apparatus for interosseous membrane reconstruction
US9357991B2 (en) 2011-11-03 2016-06-07 Biomet Sports Medicine, Llc Method and apparatus for stitching tendons
US10265159B2 (en) 2011-11-03 2019-04-23 Biomet Sports Medicine, Llc Method and apparatus for stitching tendons
US11241305B2 (en) 2011-11-03 2022-02-08 Biomet Sports Medicine, Llc Method and apparatus for stitching tendons
US9314241B2 (en) 2011-11-10 2016-04-19 Biomet Sports Medicine, Llc Apparatus for coupling soft tissue to a bone
US10363028B2 (en) 2011-11-10 2019-07-30 Biomet Sports Medicine, Llc Method for coupling soft tissue to a bone
US11534157B2 (en) 2011-11-10 2022-12-27 Biomet Sports Medicine, Llc Method for coupling soft tissue to a bone
US10368856B2 (en) 2011-11-10 2019-08-06 Biomet Sports Medicine, Llc Apparatus for coupling soft tissue to a bone
US9381013B2 (en) 2011-11-10 2016-07-05 Biomet Sports Medicine, Llc Method for coupling soft tissue to a bone
US9370350B2 (en) 2011-11-10 2016-06-21 Biomet Sports Medicine, Llc Apparatus for coupling soft tissue to a bone
US9357992B2 (en) 2011-11-10 2016-06-07 Biomet Sports Medicine, Llc Method for coupling soft tissue to a bone
US9433407B2 (en) 2012-01-03 2016-09-06 Biomet Manufacturing, Llc Method of implanting a bone fixation assembly
US9259217B2 (en) 2012-01-03 2016-02-16 Biomet Manufacturing, Llc Suture Button
US11484578B2 (en) 2012-02-01 2022-11-01 Children's Medical Center Corporation Biomaterial for articular cartilage maintenance and treatment of arthritis
US11826489B2 (en) 2013-02-01 2023-11-28 The Children's Medical Center Corporation Collagen scaffolds
US11839696B2 (en) 2013-02-01 2023-12-12 The Children's Medical Center Corporation Collagen scaffolds
US10842914B2 (en) 2013-02-01 2020-11-24 The Children's Medical Center Corporation Collagen scaffolds
US9757495B2 (en) 2013-02-01 2017-09-12 Children's Medical Center Corporation Collagen scaffolds
US9757119B2 (en) 2013-03-08 2017-09-12 Biomet Sports Medicine, Llc Visual aid for identifying suture limbs arthroscopically
US9918827B2 (en) 2013-03-14 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US10758221B2 (en) 2013-03-14 2020-09-01 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US9936940B2 (en) 2013-06-07 2018-04-10 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US10842481B2 (en) 2013-06-07 2020-11-24 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US10806443B2 (en) 2013-12-20 2020-10-20 Biomet Sports Medicine, Llc Knotless soft tissue devices and techniques
US10136886B2 (en) 2013-12-20 2018-11-27 Biomet Sports Medicine, Llc Knotless soft tissue devices and techniques
US11648004B2 (en) 2013-12-20 2023-05-16 Biomet Sports Medicine, Llc Knotless soft tissue devices and techniques
US9615822B2 (en) 2014-05-30 2017-04-11 Biomet Sports Medicine, Llc Insertion tools and method for soft anchor
US9700291B2 (en) 2014-06-03 2017-07-11 Biomet Sports Medicine, Llc Capsule retractor
US11219443B2 (en) 2014-08-22 2022-01-11 Biomet Sports Medicine, Llc Non-sliding soft anchor
US10743856B2 (en) 2014-08-22 2020-08-18 Biomet Sports Medicine, Llc Non-sliding soft anchor
US10039543B2 (en) 2014-08-22 2018-08-07 Biomet Sports Medicine, Llc Non-sliding soft anchor
US11555172B2 (en) 2014-12-02 2023-01-17 Ocugen, Inc. Cell and tissue culture container
US10077420B2 (en) 2014-12-02 2018-09-18 Histogenics Corporation Cell and tissue culture container
US9955980B2 (en) 2015-02-24 2018-05-01 Biomet Sports Medicine, Llc Anatomic soft tissue repair
US10912551B2 (en) 2015-03-31 2021-02-09 Biomet Sports Medicine, Llc Suture anchor with soft anchor of electrospun fibers
US9707073B2 (en) 2015-09-05 2017-07-18 Apex Medical Device Design Llc Pyramid-shaped breast implant for breast augmentation and/or breast lift with a method of use and production of the same
WO2017040057A1 (en) * 2015-09-05 2017-03-09 Apex Medical Device Design Llc Pyramid-shaped breast implant for augmentation, reconstruction, or lift and methods of use and production of the same
US10729537B2 (en) 2015-09-05 2020-08-04 Apex Medical Device Design Llc Pyramid-shaped breast implant for breast augmentation, breast reconstruction, or breast lift with a method of use and production of the same
US20180280608A1 (en) * 2017-03-31 2018-10-04 David S. Gillett Helical insertion infusion device

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