A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

Embodiments of the invention include methods and devices for securing a suture, graft, or other material to tissue with an anchor. The anchor of some embodiments includes an eyelet through which the suture, graft, or other material may be passed and mechanisms for selectively engaging the suture, graft, or other material through the eyelet. The mechanisms of some embodiments may also reinforce the anchor to provide a strengthened anchor to withstand actions such as impacting the anchor during insertion or applying bending stress to the anchor.

Described herein is a simplified placement system and method for a tissue graft anchor by which a surgeon may introduce one or more sutures into a hole in a boney tissue, apply tension to the sutures to advance a soft tissue graft to a desired location, and then advance the anchor into the bone while maintaining suture tension and without introducing spin to the suture.

Various exemplary methods and devices for tensioning grafts are provided. In general, a surgical device can include a grip and a frame. The frame can have two opposed segments. The segments can be spaced apart from one another and can each be configured to have at least one suture attached thereto. The sutures attached to the frame can each be configured to attach to a graft. The two segments can be configured to dynamically move toward and away from each other in response to tension that is applied to the sutures attached to the frame. The frame can include an indicator configured to provide an indication of the tension applied to the sutures. The grip can have at least one opening therein. The at least one opening can be configured to have a surgical instrument passed therethrough.

Systems and tools are provided for anchoring a ligament or tendon to bone. In one embodiment, a sheath is provided having a first sidewall with proximal and distal ends and a second sidewall with proximal and distal ends. The distal ends of the first and second sidewalls can be coupled to one another by a hinge pin such that the first and second sidewalls pivot relative to one another about the hinge pin. A sheath inserter tool is also provided and it can be configured to couple to the sheath and to advance the expandable sheath, with a tendon disposed therearound, into a bone hole. An expander is also provided for expanding the sheath. In this way, a tendon or ligament is delivered into the bone hole and the sheath and tendon are locked within the bone hole.

Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a biceps tenodesis system is provided and includes a sheath inserter tool, an expandable sheath configured to couple to the sheath inserter tool, an expander inserter tool, and an expander configured to couple to the expander inserter tool. The sheath inserter tool is configured to advance the expandable sheath, with a tendon disposed therearound, into a bone hole, and the expander inserter tool is configured to advance the expander through an outer shaft of the sheath inserter tool and to drive the expander into the sheath. The expander is configured to be received within a lumen extending at least partially through the expandable sheath to thereby expand the sheath. In this way, the system delivers the tendon or ligament into the bone hole and locks the sheath and tendon within the bone hole.

A ligament-tensioning device and method for activation of the ligament and/or capsule system in the implantation of a joint implant. The device includes a distal bearing plate for bearing against a distal skeletal part, and also includes first and second proximal bearing plates, each of which partially overlaps the distal bearing plate in a first in-use position, for bearing against a proximal skeletal part. The device further includes means for relative displacement of the proximal bearing plates to increase their spacing from the distal bearing plate. The displacement means includes a scissor-type guide means that supports the respective proximal bearing plate in the ventral-dorsal as well as the medial-lateral parallel position with respect to the distal bearing plate.

Techniques and instruments for surgical transosseous attachment to a bone include a guide able to guide the formation of intersecting bone tunnels and a retriever able to retrieve a suture through the bone tunnels.

Described herein is a simplified placement system and method for a tissue graft anchor by which a surgeon may introduce one or more sutures into a hole in a boney tissue, apply a precise amount of tension to the sutures to advance a soft tissue graft to a desired location, and then advance the anchor into the bone, preferably while maintaining the requisite pre-determined suture tension and without introducing spin to the suture. Particularly preferred embodiments allow for the one-handed operation. To that end, embodiments in which relative axial movement between the inner tensioning device and outer driver device is optionally physically constrained, for example by means of cooperating and/or compressive elements disposed in the respective hub and handle portions, are described herein.

Apparatus for tissue graft fixation. A tissue graft fixation device includes a main body part (15) provided with a pair of suture through holes (20, 25) positioned on opposite sides of a spherically radiused screw through hole (30), the pair of suture through holes sized to receive sutures, the spherically radiused screw through hole sized to receive a radiused head of a securing screw, and two spike parts (35, 40) extending substantially parallel to each other from an underside of the main body, the spike parts spaced apart at a predetermined distance slightly shorter than a diameter of a formed bone tunnel and adapted be stricken into a bone.