Abstract: A metatarsal alignment apparatus and methods are provided for orienting and maintaining a 1st metatarsal bone in a natural anatomical position during surgical procedures for treating a hallux valgus deformity by way of arthrodesis of the 1st metatarsocuneiform joint. The metatarsal alignment apparatus includes a cuneiform block for pinning a cuneiform bone and a distal metatarsal block for pinning a 1st metatarsal bone. The cuneiform block is threadably engaged with a shaft for moving the cuneiform block longitudinally with respect to the distal metatarsal block. The distal metatarsal block is adjustable within a distal frame to facilitate moving transversely and rotating the 1st metatarsal bone with respect to the cuneiform bone. The distal metatarsal block may be fixated by way of a lock screw to fixate the orientation of the 1st metatarsal bone with respect to the cuneiform bone during preparing the 1st metatarsocuneiform joint for arthrodesis.

Abstract: A metatarsal alignment apparatus and methods are provided for orienting and maintaining a 1st metatarsal bone in a natural anatomical position during surgical procedures for treating a hallux valgus deformity by way of arthrodesis of the 1st metatarsocuneiform joint. The metatarsal alignment apparatus includes a cuneiform block for pinning a cuneiform bone and a distal metatarsal block for pinning a 1st metatarsal bone. The cuneiform block is threadably engaged with a shaft for moving the cuneiform block longitudinally with respect to the distal metatarsal block. The distal metatarsal block is adjustable within a distal frame to facilitate moving transversely and rotating the 1st metatarsal bone with respect to the cuneiform bone. The distal metatarsal block may be fixated by way of a lock screw to fixate the orientation of the 1st metatarsal bone with respect to the cuneiform bone during preparing the 1st metatarsocuneiform joint for arthrodesis.

Abstract: A vertebral rod connector includes a first portion configured to engage a fastener construct and define a first longitudinal axis. A second portion is configured to engage a vertebral rod and define a second longitudinal axis disposed transverse to the first longitudinal axis. A flexible linking portion is disposed for connecting the first portion with the second portion. The linking portion has a bifurcated configuration oriented transverse to the first longitudinal axis. Methods of use are disclosed.

Abstract: A device for trimming an osteochondral plug graft to an implantable configuration, includes a blade assembly terminating in a configured leading cutting blade and a plug graft housing comprising a substantially longitudinal holding sleeve having a bore and oriented complementarily to the longitudinal structure of the blade assembly to receive the longitudinal structure within the sleeve bore with the assembly cutting blade in close tolerance along an inner bore surface of the longitudinal housing structure.

Abstract: A tissue extender includes a ring defining a proximal end opening to engage a head of a subcutaneous screw, a first extender portion coupled to the ring at a proximal end of the first extender portion, and a second extender portion coupled to the ring at a proximal end of the second extender portion. The first extender portion includes a first coupling portion disposed at a distal end of the first extender portion, and the second extender portion includes a second coupling portion at a distal end of the second extender portion. The first and second extender portions define two side openings disposed on opposite sides of the tissue extender. The distal ends of the first and second extender portions together define a distal end opening. The first coupling portion engages the second coupling portion when the tissue extender is in an extended state. The distal end opening is larger in the extended state than in an unextended state.

Abstract: An elongated connecting element and system for dynamic spinal stabilization is disclosed. The connecting element and system provides for resistance to shear forces applied to the connecting element as well as provides for rotational stability of a resilient intermediate element disposed between two end members.

Abstract: A device for trimming an osteochondral implant according to which a body member has a bore for receiving the graft and a cutting slot extending transverse to the bore for receiving a cutting blade. A mechanism adjusts the graft in the bore relative to the slot so that the graft can be cut to a predetermined length with the cutting blade in the slot.

Abstract: A method is disclosed and can include engaging a harvest guide with bony tissue and placing a cutting device within the harvest guide. The harvest guide can maintain the cutting device substantially perpendicular to a tangent through a point on the bony tissue aligned with the cutting device. The cutting device can be an osteochondral chisel, a trephine, or a combination thereof.

Abstract: A surgical procedure and a device used in the procedure according to which one end portion of a guide rod is inserted into the condyle of a damaged area of a human. The rod is used as a guide for a drill bit and a chisel to cut an opening in the condyle.

Abstract: A cutting instrument and method of use for preparing an osteochondral plug for implantation into a bone defect site. The instrument includes a dual function cutting block, a base holder, a rod mechanism and a trimming mechanism. The cutting block has a bore sized to receive the plug, at least one trimming channel and a transverse paring slot. The cutting block functions to hold the plug within the bore to allow for length and cross-sectional sizing. The base holder is constructed to fix the cutting block in a first orientation that allows the rod mechanism to position the plug within the cutting block for accurate length sizing. The base holder is also constructed to fix the cutting block in a second orientation which aligns the cutting block with the trimming mechanism so that an angled blade may engage the trimming channel and cut at least two sides of the plug.

Abstract: The system includes a pair of elongate connecting elements positionable along two or more vertebrae of a spinal column segment. Also included is a crosslink device which is structured to form a mechanical connection between the two connecting elements and is capable of spanning a range of distances separating the two connecting elements to accommodate medial-lateral separation of the connecting elements as the spinal column segment grows over time.

Abstract: An instrument for harvesting an osteochondral plug graft in an implantable configuration, comprises a support pod comprising an elongated tubular member distally terminating in at least three splayed legs; a drill bit encompassed within a longitudinal axis of the tubular member; and a guide wire encompassed within a longitudinal axis of passageway of the drill bit and terminating at a threaded distal end for removably fixing a distal end of the instrument in a position oriented normal to an osteochondral surface for harvesting an osteochondral plug graft in an implantable normal configuration.

Abstract: Apparatus for applying sustained tension on tether in treatment site includes a positioning mechanism, gripping mechanism and pressurized fluid actuated mechanism. The positioning mechanism is operable to position the pressurized fluid actuated mechanism at a fixed distance relative to treatment site, and to engage a target at treatment site and secure the tether proximate to the target. The gripping mechanism is operable to selectively grip the tether and maintain tether when tether is held in tension. The pressurized fluid actuated mechanism is selectively operable to apply desired pulling force on gripping mechanism directed away from treatment site so as to transmit and apply in a sustained manner the desired pulling force on the tether independently from the tether displacement and place it under desired level of tension while the tether is being secured.

Abstract: An apparatus for attachment to a vertebral body for correcting spinal deformities. The apparatus has a plate member having an upper surface and a lower surface. The upper surface having at least one receiving member defining a channel for receiving a flexible connection member. The at least one receiving member having a proximal portion and a distal portion. The proximal and distal portions interfacing along a frangible connection such that the at least one receiving member extends axially from the upper surface a first distance when the frangible connection is unbroken and the at least one receiving member extends axially from the upper surface a second distance when the frangible connection is broken. The second distance is less than the first distance.

Abstract: Embodiments for a spinal implant having elements that are accessible by a surgical approach and releasably engagable by a surgical tool for improved revision of the spinal implant about a patient's spine.

Abstract: Apparatus and methods for assessing tissue characteristics such as the dimensions and volume of an osteolytic lesion are disclosed. The apparatus may utilize ultrasound to provide visual and volumetric feedback related to a lesion or other tissue. Further the apparatus may be utilized to determine whether the lesion has been completely removed and filled with the appropriate amount of graft material.

Abstract: A system for anchoring at least a portion of material to a vertebral body is disclosed. The anchoring system comprises a base configured to affix to the vertebral body, configured to receive the at least a portion of material, and configured to receive a fastener so as to apply pressure to the at least a portion of material so as to anchor the at least a portion of material to the base. Another system further comprises an anchoring mechanism configured to engage with the base and configured to anchor the at least a portion of material, wherein the anchoring mechanism comprises at least one elastic element configured to engage with a fastener and configured to apply pressure to the at least a portion of material so as to anchor the at least a portion of material to the base.

Abstract: The invention relates to a surgical implant that provides an artificial diarthroidal-like joint, suitable for use in replacing any joint, but particularly suitable for use as an intervertebral disc endoprosthesis. The invention contains two rigid opposing shells, each having an outer surface adapted to engage the surfaces of the bones of a joint in such a way that the shells are immobilized by friction between their outer surfaces and the surfaces of the bone. These outer surfaces are sufficiently rough that large frictional forces strongly resist any slippage between the outer surface and the bone surfaces in the joint. They may be convex, and when inserted into a milled concavity, are immediately mechanically stable. Desirably, the outer surfaces of the shells are adapted to allow for bony ingrowth, which further stabilizes the shells in place.

Abstract: The invention relates to a surgical implant that provides an artificial diarthroidal-like joint, suitable for use in replacing any joint, but particularly suitable for use as an intervertebral disc endoprosthesis. The invention contains two rigid opposing shells, each having an outer surface adapted to engage the surfaces of the bones of a joint in such a way that the shells are immobilized by friction between their outer surfaces and the surfaces of the bone. These outer surfaces are sufficiently rough that large frictional forces strongly resist any slippage between the outer surface and the bone surfaces in the joint. They may be convex, and when inserted into a milled concavity, are immediately mechanically stable. Desirably, the outer surfaces of the shells are adapted to allow for bony ingrowth, which further stabilizes the shells in place.

Abstract: Systems and methods of shaping surfaces of vertebral bodies include a reference guide instrument that can be positioned relative to a disc space between vertebral bodies and referenced to the caudally located endplate of the disc space. The reference guide instrument can then be employed to guide preparation instruments to the vertebral bodies in an orientation and spacing referenced to the caudal endplate of the subject disc space to shape vertebral surfaces to receive an implant.