This disclosure is directed to a resilient interpositional arthroplasty implant for application into a joint to pad cartilage defects, cushion, and replace or restore the articular surface, which may preserve joint integrity, reduce pain and improve function. The implant may endure variable joint compressive and shear forces and cyclic loads. The implant may repair, reconstruct, and regenerate joint anatomy, and thereby improve upon joint replacement alternatives. The walls of this invention may capture, distribute and hold living cells until aggregation and hyaline cartilage regrowth occurs. The implant may be deployed into debrided joint spaces, molding and conforming to surrounding structures with sufficient stability so as to enable immediate limb use after outpatient surgery. Appendages of the implant may repair or reconstruct tendons or ligaments, and menisci by interpositional compliant polymer arthroplasties that promote anatomic joint motion.

A guide tool for guiding surgical instrumentation and facilitating insertion of surgical implants for repair of cartilage and/or bone damage and/or for remodeling of a joint surface for improved mobility in a finger or toe joint is disclosed. The guide tool includes an attachment part including a patient specific contact surface adapted to fit the proximal phalanxes or metatarsal bones in a toe or the distal-, middle-, or proximal phalanxes or metacarpal bones in a finger and further including a directing flange. A design model designing a guide tool described above and the use of the instruments are also disclosed.

A prosthetic device for use as an artificial meniscus is disclosed. The prosthetic device restores stress distribution, stability, and function to the knee joint after removal of the damaged natural meniscus. In some embodiments, the prosthetic device includes an anti-migration feature that inhibits extreme movement within the joint while permitting free floating over a significant range. In one aspect, the anti-migration feature is an enlarged anterior structure or a posterior meniscus remnant engaging channel while in another aspect, the anti-migration feature includes a tethering member. Still further, removable radiopaque features are provided to enhance trialing of the implant prior to final implantation within the joint.

An implantable medical device, for implantation in a mammal knee joint, comprising an artificial contacting surface adapted to replace at least one contacting surface of the knee joint and to be lubricated when implanted in said joint. The medical device further comprises a reservoir comprising a movable wall portion defining the volume of the reservoir, at least one inlet adapted to receive a lubricating fluid from the reservoir, at least one channel at least partly integrated in said artificial contacting surface, wherein the channel is fluidly connected with said at least one inlet for distributing said lubricating fluid to the surface of said artificial contacting surface. The medical device further comprises an operation device adapted to non-invasively transport said lubricating fluid from said reservoir to said artificial contacting surface, and an implantable injection port for refilling said reservoir, wherein the movable wall portion is moved when the reservoir is refilled, such that the volume of the reservoir is increased.

The disclosure is directed to a resilient implant for implantation into human or animal joints to act as a cushion allowing for renewed joint motion. The implant endures variable joint forces and cyclic loads while reducing pain and improving function after injury or disease to repair, reconstruct, and regenerate joint integrity. The implant is deployed in a prepared debrided joint space, secured to at least one of the joint bones and expanded in the space, molding to surrounding structures with sufficient stability to avoid extrusion or dislocation. The implant has opposing walls that move in varied directions, and an inner space filled with suitable filler to accommodate motions which mimic or approximate normal joint motion. The implant pads the damaged joint surfaces, restores cushioning immediately and may be employed to restore cartilage to normal by delivering regenerative cells.

Apparatus and methods are described, including apparatus for treating a cavity in a human body, the apparatus including a delivery tube. A barrier device has a collapsed and an expanded configuration, the barrier device moving from the collapsed to the expanded configuration upon being deployed from the delivery tube. A pushing element, slidably disposed within a lumen of the delivery tube, deploys the barrier device from the delivery tube by pushing the barrier device. One or more barrier-deployment elements are coupled to the barrier device and to the pushing element, the barrier-deployment elements being configured to conformingly contact the barrier device with tissue surrounding the cavity. The barrier device is configured to isolate the cavity from surrounding body fluid that is between the barrier device and the pushing element, following deployment of the barrier device from the delivery tube. Other applications are also described.

A bone positioning guide may include a main body member, a shaft, and a bone engagement member. The shaft can be movably connected to the main body member and have the bone engagement member rotatably coupled to its distal end. The bone engagement member can have a surface configured to engage a bone. The main body member can also include a tip opposite the bone engagement member for engaging a second bone. In use, the bone engagement member may be positioned in contact with a medial side of a first metatarsal while the tip is positioned in contact with a lateral side of a different metatarsal, such as a second metatarsal. The shaft can then be moved to advance the bone engagement member toward the tip, causing realignment of the first metatarsal.

A composite joint implant device replaces or repairs damaged meniscus tissue in an animal or human. In one embodiment, a composite joint implant comprises a polymeric body which is reinforced with a pre-formed engineered ligature mechanism. The ligature reinforces the polymeric body around the circumference and is used for attaching the device within an animal or human body. The ligature mechanism internally supports the transmission of vertical loads into tensile stresses. The ligature mechanism can be coated with a compatible material to promote integration with the polymeric body and coated with an encapsulation material.

Systems for distracting a facet joint and positioning a permanent implant in the joint are disclosed. The implants serve to retain a distracted position of the facet joint which is achieved with positioning of the leading end of a distraction tool in the facet joint and then distracting or enlarging the joint a desired amount. The permanent implant could be part of the distraction mechanism which can be separated from the delivery tool once the joint has been distracted or an auxiliary implant may be positioned before the distraction mechanism is removed from the distracted joint. The permanent implants can be solid, mechanical devices that may have fixation means thereon to hold them in place or injected fluids such as hydrogels or fluids confined within balloons.

This disclosure is directed to restoring joints by deploying a resilient interpositional arthroplasty implant. Such implants function to pad cartilage defects, cushion, and replace or restore the articular surface, which may preserve joint integrity, reduce pain and improve function. The implant may endure variable joint compressive and shear forces and cyclic loads. The implant may repair, reconstruct, and regenerate joint anatomy, and thereby improve upon joint replacement alternatives. The walls of this invention may capture, distribute and hold living cells until aggregation and hyaline cartilage regrowth occurs. The implant may be deployed into debrided joint spaces, molding and conforming to surrounding structures with sufficient stability so as to enable immediate limb use after outpatient surgery. Appendages of the implant may repair or reconstruct tendons or ligaments, and menisci by interpositional inflatable or compliant polymer arthroplasties that promote anatomic joint motion.