A soft tissue repair system is provided for covering or filling openings in the annulus of an intervertebral disc. The soft tissue repair system uses a single plug or a combination of a first plug and a second plug. The second plug is a flowable plug such as an adhesive material or a material that hardens to a flexible plug material. Each plug is configured to close the opening in the annulus and can be positioned within the opening, over the opening at the exterior surface or over the opening at the interior surface. The plug can also be combined with a clamping mechanism that engages the annulus to secure the plug in the opening.

The invention relates to an implant (1) for sealing a defect (7c) in the annulus fibrosus (7a) of an intervertebral disc (7), comprising a retaining portion (3) for introducing into the defect (7c), a flexible sealing element which is connected to an inner end of the retaining portion, and a securing element (2) which is connected to the outer end of the retaining portion and which can be fixed to a vertebra (8) adjoining the intervertebral disc in order to hold the retaining portion (3) in a fixed position. According to the invention, this is achieved in that a securing limb (2), which is angled relative to the longitudinal axis of the retaining portion, is arranged on the outer end of the retaining portion (3), said securing limb being designed for laterally contacting a bony structure of a vertebra adjacent to the intervertebral disc and being securable on the vertebra by means of a fixing element which can be moved relative to the securing limb. The sealing element has inner reinforcements.

An orthopaedic surgical system for use in a direct anterior approach orthopaedic surgical hip replacement procedure on a patient's femur includes a proximal guide instrument for guiding a flexible insertion instrument to install a cement restrictor component. A method of installing a cement restrictor component during performance of a direct anterior approach orthopaedic surgical hip replacement procedure is also disclosed.

An expandable, intervertebral spacer includes a top component and a base component in engagement with the top component, the base component defining at least one channel for receiving a hardening material, and placement of the hardening material within the channel causes the top component to move between a first position in which the top component is a first distance from the base component and a second position in which the top component is a second distance from the base component, the second distance being greater than the first distance. The hardening material can be removed from the channel by a flexible coring tool, and the top component forced toward the base component to collapse the spacer.

The invention relates to an implant (1) for sealing a defect (7c) in the annulus fibrosus (7a) of an intervertebral disc (7), comprising a retaining portion (3) for introducing into the defect (7c), a flexible sealing element which is connected to an inner end of the retaining portion, and a securing element (2) which is connected to the outer end of the retaining portion and which can be fixed to a vertebra (8) adjoining the intervertebral disc in order to hold the retaining portion (3) in a fixed position. According to the invention, this is achieved in that a securing limb (2), which is angled relative to the longitudinal axis of the retaining portion, is arranged on the outer end of the retaining portion (3), said securing limb being designed for laterally contacting a bony structure of a vertebra adjacent to the intervertebral disc and being securable on the vertebra by means of a fixing element which can be moved relative to the securing limb. The sealing element has inner reinforcements.

The invention relates to an implant (1) for sealing a defect (7c) in the annulus fibrosus (7a) of an intervertebral disc (7), comprising a retaining portion (3) for introducing into the defect (7c), a flexible sealing element which is connected to an inner end of the retaining portion, and a securing element (2) which is connected to the outer end of the retaining portion and which can be fixed to a vertebra (8) adjoining the intervertebral disc in order to hold the retaining portion (3) in a fixed position. According to the invention, this is achieved in that a securing limb (2), which is angled relative to the longitudinal axis of the retaining portion, is arranged on the outer end of the retaining portion (3), said securing limb being designed for laterally contacting a bony structure of a vertebra adjacent to the intervertebral disc and being securable on the vertebra by means of a fixing element which can be moved relative to the securing limb. The sealing element has inner reinforcements.

A surgical operating instrument includes a handle, a first driving shaft operably connected with the handle, a second driving shaft, and a gear assembly. The gear assembly includes a first gear member received on the first driving shaft, a second gear member slidably received on the second driving shaft, and a lever member. The lever member is operable to place the second gear member into engagement with the first gear member thereby coupling the second driving shaft with the first driving shaft to provide a first operating mode wherein the handle operates to rotate both the first and second driving shafts, and place the second gear member out of engagement with the first gear member thereby decoupling the second driving shaft from the first driving shaft to provide a second operating mode wherein the handle operates to rotate solely the first driving shaft.

A soft tissue repair system is provided for covering or filling openings in the annulus of an intervertebral disc. The soft tissue repair system uses a single plug or a combination of a first plug and a second plug. The second plug is a flowable plug such as an adhesive material or a material that hardens to a flexible plug material. Each plug is configured to close the opening in the annulus and can be positioned within the opening, over the opening at the exterior surface or over the opening at the interior surface. The plug can also be combined with a clamping mechanism that engages the annulus to secure the plug in the opening.