A bone suture assembly including a flexible generally cylindrical sleeve, a plurality of lengths of suture extending through the generally cylindrical sleeve, and at least one sleeve securing thread associated with the generally cylindrical sleeve. A bone suture retaining method including engaging a suture with a bone engaging sleeve, inserting the suture and the bone engaging sleeve engaged thereby into a transosseous tunnel formed into a bone by pulling the bone engaging sleeve into the transosseous tunnel and retaining the suture and the bone engaging sleeve in the transosseous tunnel by virtue of the bone engaging sleeve being unable to fit through an aperture in the bone.

In general, devices, systems, and methods for driving an anchor into bone are provided. In one embodiment, a surgical tool is provided that includes a driver tool with a handle and an elongate shaft. A resistance element is disposed within the handle. An inner portion of an anchor is retained on a distal end of the elongate shaft, and a guidewire extends between the resistance element and an outer portion of the anchor that is in bone. As force is applied distally to the handle, the guidewire pushes the anchor into the bone before overcoming force of the resistance element and thereby allowing the inner portion of the anchor to be driven into the outer portion of the anchor.

A tendon stretching mechanism which engages the torn tendon using sutures. A second end of the sutures is exposed through the skin. Using a tensioning mechanism, a selectively pull is applied to the second end of the sutures to gradually stretch the tendon. This stretching of the tendon may take a week or more or until the tendon has been sufficiently elongated for reattachment to the bone. The tensioning mechanism is either manually operated or is automatic.

A ligament fixation method can include forming a bone tunnel to a predetermined depth from a surface of a bone; mounting a reconstruction ligament to the ligament fixation device. The reconstruction ligament can be disposed along outer surfaces of plate-like pressing segments of a ligament fixation device and an outer surface of a connection segment that connects the pressing segments. The method can also include inserting the ligament fixation device into the bone tunnel from the connection-segment side; fastening a screw to a receiving section of the ligament fixation device from an opening of the ligament fixation device to increase a distance between the pair of pressing segments and to compress the reconstruction ligament between each pressing segment and an inner surface of the bone tunnel; and fixing the reconstruction ligament to the bone by causing a part of the screw to dig into the bone.

A ligament fixation device for fixing a ligament to a bone tunnel includes: a fixation device body having a flat surface, wherein the fixation device body has a mounting section for mounting the ligament or a pulling member thereto and a torque application portion configured to apply torque about an axis orthogonal to the flat surface, the pulling member being provided for mounting the ligament, and wherein the mounting section includes a pair of through-holes provided in the noncircular flat surface.

A minimally invasive surgical drill guide includes an elongated drill jig having at least one drill guide opening for defining a location and drill element guide axis for placement of a surgical drill element. The drill jig can have an engagement end with engagement structure. A positioning arm includes an elongated shaft with an axis and a locating end portion shaped to engage a bony part of a patient. The elongated shaft can have engagement structure for engaging to the engagement structure of the drill jig to support the drill jig crosswise relative to the position arm and to support the drill guide opening of the drill jig at a location remote from the axis of the elongated shaft of the positioning arm. The drill jig can be detachable from the positioning arm. A method for minimally invasive surgical drilling is also disclosed.

A system and method for loading a suture construct on a soft tissue graft with a graft assembly. The graft assembly includes a frame with an opening extending between a proximal end and a distal end. The frame has a wall with a first side extending to a first edge and a second side extending to a second edge. A lumen extends between the first side and the second side and a plurality of channels extend through the wall between the first edge and the second edge. The graft assembly also includes a transverse hole extending through the proximal end of the frame and a pin removably inserted into the transverse hole.

Devices, systems, and methods to improve both the reliability of soft tissue repair procedures and the speed at which the procedures are completed are provided. The devices and systems include one or more tissue augmentation constructs, which include constructs that are configured to increase a footprint across which suture applied force to tissue when the suture is tied down onto the tissue. The tissue augmentation constructs can be quickly and easily associated with the repair suture, and can be useful in many different tissue repair procedures that are disclosed in the application. In one exemplary embodiment, one or more constructs are disposed on a suture threader, which can be used to associate the construct(s) with a repair suture(s) being used to repair the soft tissue. Tissue augmentation constructs can include various blocks and patches, among other formations. Exemplary methods for manufacturing the tissue augmentation constructs are also provided.

A minimally invasive surgical drill guide includes an elongated drill jig having at least one drill guide opening for defining a location and drill element guide axis for placement of a surgical drill element. The drill jig can have an engagement end with engagement structure. A positioning arm includes an elongated shaft with an axis and a locating end portion shaped to engage a bony part of a patient. The elongated shaft can have engagement structure for engaging to the engagement structure of the drill jig to support the drill jig crosswise relative to the position arm and to support the drill guide opening of the drill jig at a location remote from the axis of the elongated shaft of the positioning arm. The drill jig can be detachable from the positioning arm. A method for minimally invasive surgical drilling is also disclosed.

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.