The invention relates to a surgical method for creating a bone tunnel in target bone by utilizing a punch instrument which is sized and shaped for removal of a bone plug out of the target bone. By removing the bone plug, the femoral tunnel can be created. The punch instrument comprises an impaction handle and punch head having a bore. The punch head comprises a cutting edge arranged circumferentially around the bore at a cutting end of the punch head. By using of the punch instrument, a bone plug can be retrieved without creating bone drilling debris. Furthermore, the bone plug can be retrieved as a solid piece of graft, to be used to as a graft at another site in the body thereby promoting healing and reducing recovery time after surgery.

Filamentary fixation devices may be used in a variety of surgical procedures to secure soft tissue to bone. The present invention provides various devices, systems, kits and instrumentation for performing such surgical procedures including preparation of soft tissue and bone, preparation and manipulation of such filamentary fixation devices, and insertion and utilization of the fixation devices within a patient's anatomy. In one embodiment, a method for securing soft tissue to bone, the method includes accessing the soft tissue and the bone, passing a filament through the soft tissue, preparing a bore hole in the bone, loading the filament into a filamentary fixation device, implanting the filamentary fixation device, with the filament, into the bore hole, and tensioning the filament so that the filamentary fixation device and filament are secured within the bore hole.

The present invention includes a method and devices for treating osteonecrosis in, e.g., children, adolescents, and adults comprising: identifying a subject in need of treatment for osteonecrosis; drilling two or more holes into a bone in need of treatment for osteonecrosis; inserting two or more needles or cannulas into the holes in the bone; washing an interior of the bone with a washing fluid introduced through one or more of the needles or cannulas inserted into the bone; and after washing the interior of the bone introducing one or more bone growth promoting materials or cells into the bone.

Instruments and methods for surgical transosseous attachment to a bone include a guide able to guide the formation of intersecting bone tunnels and a passer able to pass a member through the bone tunnels.

Various exemplary methods, systems, and devices for instability repair are provided. In general, a surgical device can be configured to drill a hole in bone and to deliver a suture anchor into the hole. In this way, a single surgical device can drill the hole and deliver the anchor into the hole for securing soft tissue to the bone. The anchor can be configured to allow the soft tissue to be secured to the bone using a suture coupled to a suture anchor without the need to knot or otherwise tie the suture to secure the soft tissue in place relative to the bone.

The present disclosure relates to a system and method of knee ligament balancing for knee replacement procedures. The disclosure provides a system of components to implant to achieve ligament balancing. In addition, instruments and methods are provided to achieve the desired balance of the ligaments before final fixation.

A method, system and devices for the reconstruction of ribbon shaped ligaments following the anatomical native insertion sites of the ligaments in the corresponding bones is described. The reconstruction of the anterior cruciate ligament of the human knee is depicted. The system includes a device for positioning and creating bone-tunnels, the preparation of grafts and the fixation thereof. The devices intended for bone tunnel creation take into account the ribbon-shaped nature of the ligament and can be adjusted to patient specific anatomy and take into consideration the various typologies of the ligament insertion sites. The method and devices for graft preparation are construed to reflect the anatomy of ligaments under consideration as close as possible to native ligaments by imitating the ribbon-like nature of native ligaments. The presented fixation methods follow this principle and are intended to support the ribbon-like nature of the grafts and are intended to support in-growth of the grafts. Furthermore, accessories supporting preparation of the grafts are presented.

Methods and drill guide systems that provide internalization of the biceps tendon with use of fixation devices such as the Arthrex BicepsButton or Pectoralis Button tensioned outside a smaller converged drill hole. The technique converges two angled drill holes and use the button to fixate a reinforced (whipstitched) biceps tendon into a single bone versus stabilizing two bones. The biceps tendon is being pulled into the larger of the drilled holes and fixed by the button outside of the smaller drilled hole.

The present disclosure generally pertains to methods and kits for preparing an ACL repair surgical implant, the method including drilling femoral and tibial bone plugs of a tendon graft to create medial to lateral holes, and passing a braided suture around the tendinous portion of the tibial end, through soft tissue, and out the tibial end. Next, an anterior to posterior femoral hole is drilled, and a flat-braided suture is passed through the femoral medial to lateral hole and, using a bent needle, passed through junctions of the femoral bone plug and the tendinous portion and out through junctions of the tibial bone plug and the tendinous portion on both sides of the graft. Ends of the flat-braided suture are crisscrossed through the medial to lateral tibial hole. A bone-to-bone fixation suture assembly is passed through the anterior to posterior femoral hole.

The present invention includes a method and devices for treating osteonecrosis in, e.g., children, adolescents, and adults comprising: identifying a subject in need of treatment for osteonecrosis; drilling two or more holes into a bone in need of treatment for osteonecrosis; inserting two or more needles or cannulas into the holes in the bone; washing an interior of the bone with a washing fluid introduced through one or more of the needles or cannulas inserted into the bone; and after washing the interior of the bone introducing one or more bone growth promoting materials or cells into the bone.