The invention comprises a medical implant system with implant having a fastener hole for a fastener and further including a fusion screw, positioned to avoid interference with the implant fastener. The medical implant system also includes a guide that is mounted in the fastener hole and from an edge of the implant which provides for defined adjustability for angulation, and optionally depth, to allow for placement of the fusion screw so as to avoid impingement with the implant and the fasteners that secure it in place. The invention also relates to a method of surgery using the system.

An aspect of the disclosure relates to an intramedullary device configured for ankle fusion. The intramedullary device for ankle fusion includes: a housing configured to be coupled to a calcaneus bone; and a rod configured to be coupled to a tibia bone, wherein a distal end of the housing includes an external thread. The rod is configured for telescopic movement relative to the housing, and to retract relative to the housing to cause ankle fusion. After fusion is achieved, the rod can be distracted to correct a limb length discrepancy.

Bone anchor assemblies and methods are provided having a multi-component bone anchor that is configured to allow the shank of the bone anchor to be bottom loaded into a receiver member. In one embodiment, a bone anchor assembly is provided having a shank with a distal threaded portion and a proximal head portion, a receiver member having an aperture formed in a distal end thereof through which the head portion of the shank can be received, the receiver member defining a polyaxial seat, a non-expandable outer ring configured to be polyaxially disposed within the polyaxial seat of the receiver member and defining a central opening through which the head portion of the shank can be received, and an expandable inner ring having an inner surface configured to mate with the head portion of the shank and an outer surface configured to mate with an inner surface of the outer ring to thereby lock the outer ring in a fixed position relative to the shank.

A bone plate system comprises a bone screw and a bone plate having at least two screw-receiving hole structures, at least one of the hole structures comprising an eccentric portion adjacent a first seating area for biasing bone in an inferior fusion area into dynamic compression as the screw is advanced, and a cowl portion that at least partially defines a second seating area and being positioned to enable cross-screw compression of an inferior fusion area. The screw is seatable in either the first or second seating area at the option of a surgeon. A surgical method generally comprises inserting a bone screw into the compression plate and compressing bone in an inferior fusion area by either dynamic or cross-screw compression.

A compression screw driver system including a drive member having a shaft extending from a proximal end to a distal end. A drive selection member is positioned about the shaft and is axially moveable along the shaft between an engagement position and a disengaged position. A distal portion of the drive selection member defines a first engagement structure. A compression sleeve is positioned over the distal end of the shaft. The proximal end of the compression sleeve defines a second engagement structure which complements the first engagement structure and the distal end of the compression sleeve defines a contact surface. In the engagement position the first and second engagement structures are engaged and the compression sleeve rotates with the drive member and in the disengaged position the first and second engagement structures are disengaged and the compression sleeve remains stationary while the drive member rotates.

Compression devices for joining tissue and methods for using and fabricating the same.

A suture anchor driver has an elongated shaft, a handle at a proximal end of the shaft an anchor engagement at a distal end of the shaft and a clutch between the handle and the shaft. The clutch includes a slot for frictionally engaging a suture an engagement with the shaft and an engagement with the handle. The engagement with the shaft and the engagement with the handle are located with respect to one another such that driving torque applied to the handle urges open the slot to release its frictional engagement of the suture.

A method for fusing two adjacent stacked bones includes the following. First, inserting first and second pins into first and second locations of a first surface of one of the two adjacent stacked bones, respectively. Next, inserting a dilator over each of the first and second pins to dilate tissue around the first and second pins. Next, inserting a tissue protector over the dilator and removing the dilator. Next, inserting a cannulated drill through the tissue protector over each of the first and second pins and drilling first and second openings in the first and second locations, respectively, wherein the first and second opening extend through the two adjacent stacked bones. Next, tapping threads in the first opening and inserting a first bone fusing implant in the first opening, wherein the first bone fusing implant comprises threads configured to engage the threads of the first opening. Next, impacting a broach into the second opening to generate a pattern corresponding to a pattern of a second bone fusing implant and then inserting the second bone fusing implant in the second opening.

A compression device may include, but is not limited to, a threaded body, a sliding element, and a compression element connecting the threaded body and the sliding element. According to one embodiment, upon implantation, the threaded body contacts a first bony fragment and the sliding element contacts to a second bony fragment. In at least one embodiment, upon being engaged, the compression element applies sustained tension to the sliding element and opposing tension to the threaded body, thereby compressing the first bony fragment and the second bony fragment along a plane of contact promoting healing.

Anterior cruciate ligament reconstruction methods and devices are designed to achieve an anatomically accurate double bundle anterior cruciate ligament reconstruction by using a single femoral and tibial tunnel. The method and devices reconstruct the two bundles of the anterior cruciate ligament in a single femoral and tibial tunnel using a bone-patellar tendon-bone graft. The methods and devices enable an accurate anatomical reconstruction of the anteromedial and posterolateral bundles by creating a single femoral and tibial tunnel as opposed to creating two tunnels in the tibia and femur.