Abstract: Patient-specific systems and methods are provided for assisting in medical procedures, and can include producing patient-specific devices from computer models of a patient's anatomy, including a first patient-specific device configured to identify and allow access to a resection area in an operation location for a medical procedure; a second patient-specific device configured to refine the procedure, following use of the first patient-specific device and in some embodiments, to identify and allow access to installation locations for an implant and/or surgical hardware; and/or a third patient specific device configured to assist in confirming placement of the implant and/or surgical hardware and refining the procedure, following use of the first and second patient-specific devices. Each of these devices may be developed from patient-specific computer model data via patient-specific image data and may enhance a variety of procedures.

Abstract: Methods of designing and manufacturing a number of low-profile metallic customized, patient-specific orthopaedic surgical instruments are disclosed.

Abstract: Tools and methods are used for aligned total knee arthroplasty (TKA) of anatomically or kinematically aligned knee. A block tool system references a distal femoral cut to provide a guide for the tibial cut. The block tool system can be used with the leg in full extension or in flexion. The block tools system includes a femur positioning block, an alignment arm coupled to the femur block, a femural cutting block, a tibial positioning block and a tibial cutting block.

Abstract: The present invention provides a surgical method of universal osteotomy device comprises the steps of: placing a first body component and a second body component on the surface of a bone; engaging an engaging member with a connecting member; inserting at least one aiming bone pin in at least one aiming hole to confirm the cutting direction; cutting along a guide slot to produce an osteotomy; spreading said osteotomy; placing a bone plate to maintain the osteotomy; wherein the surface of the first body component and the surface of the second body component have an average curvature of bone surface or a uniform curvature.

Abstract: An orthopedic implant is specifically configured for use in osteotomies, in which part of the implant extends into an intramedullary portion of a first bone segment and a plate portion is external to the cortical surface of an adjacent bone segment to fix the segments to allow them to fuse. The body of the implant has a first end and a second end where the end which is inserted into the bone has a chamfer and a through hole having a hole axis optionally at an oblique angle to the longitudinal axis of the implant, and which can receive a screw, peg or pin. The second end of the implant includes a plate portion with at least two offset screws.

Abstract: A system for creating decision support material indicating damage to an anatomical joint of a patient. The system is configured to: i) receive a series of radiology images of at least a part of the anatomical joint; ii) obtain a three-dimensional image representation of the at least part of the anatomical joint; iii) identify tissue parts of the anatomical joint using image analysis; iv) determine damage to the anatomical joint by analyzing said image representation; v) mark damage to the anatomical joint in the obtained three-dimensional image representation; and vi) generate decision support material. The analysis comprises: detecting an irregular shape of a contour of a tissue part; and/or detecting that the intensity in an area within or adjacent to bone and/or cartilage parts differs from a predetermined value; and/or comparing at least one identified tissue part with a template representing a predefined damage pattern for an anatomical joint.

Abstract: An alignment device for aligning an orthopedic plate with a bone attachment site includes one or more one light sources that are secured to an orthopedic plate holder with a mounting interface and in a location spaced from the orthopedic plate that is releasably secured to the distal end of the plate holder. The light sources are configured to project an illuminated indication pattern of variable intensity onto the plane the orthopedic plate and aligned with the primary axis of interest of the orthopedic plate, and which indication pattern extends a sufficient lateral distance away from the plate holder to allow the medical professional to align the axis of interest of the orthopedic plate with an out-of-view bone attachment site using at least one superficial anatomic landmark on the exterior of the patient and remote from the bone attachment site.

Abstract: Osteotomy systems, devices, and methods for using the osteotomy systems are disclosed. The osteotomy system including an alignment device, at least one k-wire for insertion into the alignment device, and a cut guide with at least one hole for receiving at least one k-wire and a slot for receiving a saw blade. An osteotomy kit including an alignment device, cut guide, and position rotation device. The alignment device, cut guide, position rotation device, and bone plate are also disclosed. Finally, a method for fusing bones using the osteotomy system is also disclosed.

Abstract: The instrument for artificial knee joint replacement surgery includes a holding mechanism that includes a holding portion having a contact portion to be brought into contact with a contact target of a patient on whom artificial knee joint replacement surgery is to be performed and that holds the patient in a state in which the contact portion is in contact with the contact target, and an indicating mechanism that is attached to the holding mechanism and includes a position identification target indicating portion to be arranged at a position corresponding to a position identification target in a state in which the holding mechanism holds the patient. The position at which the position identification target indicating portion is to be arranged is determined based on a positional relationship between the contact target and the position identification target that is obtained in advance prior to surgery.

Abstract: A method and one or more devices for a capitolunate fusion includes a cutting block for attaching to the capitate bone and for cutting the capitate and lunate bones to fit a corresponding plate. The cutting block is removed and a fusion plate is fixed to the capitate and lunate bone with the plate having a capitate section and a lunate section with the capitate section and lunate section of the plate in a generally perpendicular arrangement to allow optimal fusion of the capitate and lunate bones. Further devices include a three and four bone fusion cutting block and fusion plate.

Abstract: A pin placement instrument for placing a pin in a bone comprises an anatomical interface with a hook-like portion being opened in a lateral direction of the instrument to receive a bone therein in a planned position. A drill guide is connected to the anatomical interface and defining at least one guide slot in a longitudinal direction of the instrument. The guide slot has a lateral opening over its full length in the drill guide to allow lateral withdrawal of the instrument in said lateral direction with the pin placed in the bone passing through the lateral opening. A bushing is removably placed in said guide slot via said longitudinal direction in a planned fit, the bushing defining a throughbore aligned with the guide slot and adapted to receive the pin extending in said longitudinal direction when the bushing is in the guide slot for pin placement.

Abstract: A cut block positioning jig including a first alignment member, a second alignment member, and both first and second guide members. The first alignment member is movable towards and away from a patient's bone to which the positioning jig is mounted to arrange the jig at a predetermined position relative to the bone based on x-rays of the patient. The second alignment member is movable towards and away from the bone to arrange the jig at the predetermined position relative to the bone. The first and second guide members are configured to direct cut block support members to the bone to couple a cut block to the bone to provide the bone with patient-specific cuts.

Abstract: A number of low-profile metallic customized, patient-specific orthopaedic surgical instruments are disclosed.

Abstract: In order to position an ankle prosthesis including a tibial implant and a talus implant provided with a talo-calcaneal anchoring keel, the invention proposes a surgical instrumentation assembly including: a tibial phantom (60) of the tibial implant, adapted so as to be attached to the tibia (T) of a patient, and an aiming guide (80) adapted for setting into place an instrumentation element (90) through the talus (A) and the calcaneus (C) of the patient, along an axis (Z-Z) for implanting the talo-calcaneal anchoring keel, the tibial phantom and the aiming guide mechanically cooperating with each other to restrict movement of the tibial phantom and the aiming guide relative to each other along vertical and medio-lateral directions, wherein the aiming guide is configured to guide placement of the instrumentation element.

Abstract: Devices and techniques for adjusting an alignment for a first metatarsal may include making a plurality of cuts along the length of the first metatarsal. In different applications of the technique, a plurality of transverse cuts may or may not be made intersecting the longitudinal cuts. In either case, the cuts can separate the first metatarsal into two individual portions and release a removable wedge of bone. The different portions of the metatarsal can be moved relative to each other to adjust an anatomical alignment of one portion relative to another portion, for example in multiple planes. After suitably adjusting the alignment of the different bone portions, the portions can be fixed together.

Abstract: A combination of a first assembly for guiding resection of a femur and tibia of a knee joint and a second assembly including femoral and tibial knee components. The combination of the first assembly and the second assembly provides optimal placement and positioning of the femoral and tibial knee components to achieve near-normal knee kinematics and tension. The preparation for and placement of the prosthetic knee components provides medial-pivoting kinematics mimicking that of the natural knee thereby promoting improved outcome for the patient.

Abstract: This surgical ankle repair method comprises providing an instrumentation assembly for positioning an ankle prosthesis including a talar alignment instrument and a cutting block. The talar alignment instrument is positioned such that fins of the talar alignment instrument are disposed in gutters that extend below the tibia and around the trochlea of the talus. The talar alignment instrument is aligned so that the fins are parallel to the rotational plane of the talus. Alignment of the reference markers is confirmed. The talar alignment instrument is attached to the talus. The cutting block is fastened to the talar alignment instrument. The talus is rotated such that the tibial alignment structure is in a parallel alignment to the longitudinal axis of the tibia. The tibial alignment structure is attached to the tibia. A resection of the talus and at least one resection of the tibia is performed using the cutting block.

Abstract: Systems and methods for performing an osteotomy are presented. Examples include forming a fusion osteotomy at a metatarsocuneiform joint of the first ray of a human foot.

Abstract: A customized surgical cutting guide mounted on a femur for TKR comprises a base having a plurality of cylinders located thereon, a pair of arms branching from a top of the base and each having a column located at a tip thereof, and a convex portion protruding from a bottom of the base and abutting against a corresponding portion of the femur. And wherein each cylinder has a through hole extending therethrough for allowing a kirschner pin to pass through, and wherein each column abuts against a corresponding portion of the femur and has a mounting hole extending therethrough for positioning the arms onto the corresponding positions of the femur, and wherein the arms, the cylinders, and the convex portion are located at the same side of the base.

Abstract: A resection guide can be configured to guide a resection tool toward a graft source or a tissue body. The resection guide can include a resection guide body with at least one opening, and a guide member configured to be at least partially inserted into the at least one opening.

Abstract: A prosthesis suited for orthopedic implantation comprising a modular intramedullary rod that provides intramedullary guidance and that supports an artificial joint surface that can articulate with another artificial joint surface in various ways. Intramedullary guidance systems and methods introduce some and/or all surgical tools and ankle prostheses components through the tibia, using minimal invasive exposure. The systems and methods align the talus and tibia for the installation of one or more ankle prostheses components, and also maintain that alignment during the installation using intramedullary guidance.

Abstract: Methods and systems for installing an implant in an intramedullary canal are discussed. In an example, an intramedullary sounder tool has a sounder head including a plurality of teeth extending proximally from a distal tip towards a shank extending from the sounder head, each tooth comprising a distal cutting edge, a middle scraping edge, and a proximal cutting edge. The sounder head can be advanced into the intramedullary canal until the scraping edge engages cortical bone. If the scraping edge does not engage cortical bone, sounder tools having successively larger diameters can be advanced into the intramedullary canal until a scraping edge does engage the cortical wall, thereby avoiding cutting and damaging of the cortical bone. At such point, the width of the intramedullary canal and the implant used therein can be determined using markings on the shank that indicate the diameter of the sounder head.

Abstract: Knee arthroplasty instrument systems directly reference and align with the anterior distal with the anterior distal femoral cortex, the mechanical axis of the leg, and Whiteside's line. The anterior femoral resection is aligned in the same plane as the anterior distal femoral cortex. The center of the femoral head, the medial/lateral center of the distal femur, the medial/lateral center of the proximal tibia, and the second toe, medial/lateral center of the ankle, or anterior tibial spine are all aligned to the mechanical axis of the leg while the leg is in full extension and the knee joint is distracted. Whiteside's line is referenced while the distal femur is intact, before any distal femoral resection, and the anterior and posterior femoral resections and chamfer cuts are aligned to this reference using a jig. Methods of using the instrument systems are disclosed.

Abstract: A method of determining an optimal position of a glenoid implant. The method includes identifying a center point of a patient's glenoid fossa based on an image of the patient's glenoid fossa; determining the optimal position of the glenoid implant based on the location of the center point relative to a medial point of the patient's scapula; and selecting orientation of an alignment pin based on the determined optimal glenoid implant position such that the glenoid fossa will be prepared to receive the glenoid implant at the optimal position when the glenoid fossa is prepared with a cutting device or guide coupled to the alignment pin.

Abstract: A patient specific glenoid guide is provided to facilitate properly aligned implantation of a glenoid prosthesis into a patient. The guide shape is designed preoperatively based on the unique configuration of the scapula of the patient. The guide orientation is chosen preoperatively based on one or more of the bone structure of the patient, the wear pattern of the patient's glenoid cavity, the anchoring means of the glenoid prosthesis, or other aspects.

Abstract: Methods and systems for determining a patient specific soft tissue location within a joint are discussed. For example, a method can include imaging a target location for an orthopedic implant to collect image data regarding a morphology of the patient, the morphology including at least one of bone size and bone feature. The method can additionally include accessing stored soft tissue data and bone data corresponding to the target location of the orthopedic implant, locating a soft tissue of the patient based at least in part upon the soft tissue data and bone data and the image data, and displaying data including the location of the soft tissue of the patient. This data can be used to created patient specific surgical jigs according to one example of the present application.

Abstract: An instrument for establishing orientation of a pelvic prosthesis comprises a tripod having an angularly adjustable guide rod on it. The tips of the legs define a plane, and the guide rod is set by the surgeon to a defined orientation with respect to this plane on the basis of preoperative studies. In use, two of the legs of the instrument are positioned by the surgeon at defined anatomical locations on the pelvis (e.g., a point in the region of the posterior/inferior acetabulum and a point on the anterior superior iliac spine). The third leg then lands on the pelvis at a point determined by the position of the first two points, as well as by the separations between the third leg and the other two legs. The position of the guide rod then defines with respect to the actual pelvis the direction for insertion of a prosthesis.

Abstract: An orthopedic joint replacement system is shown and described. The system includes a number of prosthetic components configured to be implanted into a patient's knee. The system also includes a number of surgical instruments configured for use in preparing the bones of the patient's knee to receive the implants. A method or technique for using the surgical instruments to prepare the bones is also disclosed.

Abstract: Set suitable for use in a bone-shortening osteotomy of a predetermined distance, the set comprising: an implant (1) with threaded holes (8); an accessory (2) with successively a first segment (5), a second segment (6) and a third segment (7); wherein the first segment comprises first threaded holes (9) and wherein the third segment comprises second threaded holes (9), and wherein the second segment comprises two guides (10) which are each adapted to guide a saw blade (17) so that the osteotomy of predetermined distance (d) can be performed via the two guides.

Abstract: Methods and devices for performing an osteotomy produce a bone cut producing a multi-planar change in the alignment of a bone portion by rotating it relative to another bone portion.

Abstract: A device for use in placing a prosthesis in a patient during joint replacement surgery is disclosed. The device may comprise a body formed using medical imaging data corresponding to an anatomic structure of the patient and a final installation position of the prosthesis. The body may extend between a lower surface and an upper surface and may have an aperture extending therethrough. The body may also have an anatomic alignment member extending outward from an outer surface of the body and include an inner surface opposite the outer surface. The inner surface may define at least part of the aperture. The prosthesis alignment member may extend from the inner surface and the prosthesis alignment member may include a prosthesis alignment surface configured to align with a prosthesis in the final installation position.

Abstract: An orthopedic joint replacement system is shown and described. The system includes a number of prosthetic components configured to be implanted into a patient's knee. The system also includes a number of surgical instruments configured for use in preparing the bones of the patient's knee to receive the implants. A method or technique for using the surgical instruments to prepare the bones is also disclosed.

Abstract: Embodiments of the invention relate to an ancillary surgical instrument including at least a first contact point to come into contact with a first reference point of an operating area; a second contact point intended to come into contact with a second reference point of the operating area; a contact area intended to come into contact with a third reference point of the operating area; a determination unit for determining an orientation reference of the ancillary instrument in a Galilean orientation reference; and a communication unit for communication the determined orientation reference.

Abstract: Patient-specific guides for a tibial tubercle osteotomy are provided. The guides include a guide body defining a portion with a bone-engaging surface that conforms as a negative surface to a corresponding surface of a specific patient's tibia, and a guide portion that guides a surgical instrument to a specific location on the specific patient's tibia, wherein the bone-engaging surface and guide portion are configured during a pre-operative planning stage. Methods for performing a tibial tubercle osteotomy with the patient-specific guides are also provided.

Abstract: A surgical kit suitable for repair of articular surfaces in the talocrural joint, includes: a surgical implant having a cap with an outer surface conforming to a talus dome surface and an inner surface having a central implant anchoring peg extending perpendicularly from said inner surface, a hollow tubular shell suitable for correct pre-drilling for implantation of the surgical joint implant in the dome of the talus, and a saw guide conforming and fixable to the lower portion of the tibia and providing saw guide surfaces in at least one plane, suitable for osteotomy of a lower portion of a tibia to expose the dome of the talus.

Abstract: Systems and methods to provide patient-specific cutting blocks that allow for bone resurfacing procedures, such as milling or burring, with simplified devices. A computer assisted surgical cutting block is produced having a surface region that matches with the surface region of a patient's bone to be altered. A cutting tool may be provided having a contoured bone mating surface and a contoured and patient-specific shaped cutting guide surface located in a plane above the bone mating surface. One or more channels are provided in the cutting block, and as the surgeon moves the cutting tool (a milling or burring, for example) in the channels, the tool cuts the bone both laterally along the surface of the bone and vertically into the bone according to the cutting guide surface and other preselected surface features of the cutting block.

Abstract: A tibial cutting guide includes upper and lower portions having patient-matched surfaces. The upper portion defines resection slots for forming resections about the tibial eminence. The lower portion defines two pin slots for receiving alignment pins such that in use the position of the resection slots relative to the tibial eminence can be adjusted by sliding the cutting guide along the alignment pins placed in the tibia through the pin slots. The lower portion defines a resection slot for guiding a saw blade to form a horizontal plateau resection, and two pin holes for receiving fixation pins. A method includes positioning a patient-matched cutting guide on the proximal tibia; intra-operatively adjusting the position of the cutting guide in two degrees of freedom by sliding the cutting guide along fixation pins placed in the tibia; and resecting the tibia about the tibial eminence.

Abstract: Intramedullary nails, systems, and methods. The intramedullary nail may include a generally elongate body extending from a first, distal end to a second, proximal end. The distal end may include one or more openings configured to receive one or more bone anchors that extend transversely through the distal end intramedullary nail, and thereby configured to secure the distal end of the nail. The proximal end may also include one or more openings configured to receive one or more bone anchors that extend transversely through the proximal end of the intramedullary nail, and thereby configured to secure the proximal end of the nail.

Abstract: An instrument for clamping and trimming the bone tendon portion of a graft to a desired size, comprising a pair of elongated handles each having jaws at one end; the handles being hinged together at a pivot point allowing the jaws to open and close in a scissor arrangement, the jaws defining a generally U-shaped trapezoidal receptacle when the jaws are closed about the bone tendon portion of the graft to be trimmed and the jaws comprising respective upper guide surfaces along their upper edges whereby, when a bone tendon portion is positioned in the U-shaped trapezoidal receptacle, the upper guide surfaces function as a guide for a blade of a saw to trim any excess portion of the bone tendon portion protruding above the upper guide surfaces.

Abstract: A method for making a surgical guide for bone harvesting identifying in a three-dimensional image of a bone one or more sensitive anatomic structures and a volume of bone suitable for being removed. The volume is delimited by a portion of an outer surface of the bone defining a perimeter and by a mantle extending from the perimeter inside of the bone. The method also includes designing the surgical guide which includes defining a guide surface including a work area delimited by guide walls. The method also includes angling at least one of the guide walls so that the guide wall includes a face that constitutes a geometrical extension of a portion of the mantle when the guide is rested on the outer surface of the bone such that the face includes at least one segment forming a predetermined angle with respect to the guide surface.

Abstract: A humeral cut guide member for resectioning or resurfacing a humeral head, including a bone-engagement member including a first patient-specific bone-engagement surface that is complementary and made to substantially mate and nest in only one position on a specific patient's humeral head; a registration member connected to the bone-engagement member including a second patient-specific bone engagement surface that is sized and made to substantially mate and nest in only one position with the specific patient's bicipital groove; and a cut guide plate connected to the bone-engagement member and defining an elongated slot.

Abstract: A guide pin piercing jig includes a curved frame, a front cylinder unit provided at a front end of the frame, and a rear cylinder unit provided at a rear end of the frame, in which the front cylinder unit has a positioning projection and a boring aiming portion at a tip thereof, the rear cylinder unit has a plurality of parallel guide pin insertion cylinders into which to insert the guide pins and a tentative fixing unit provided at a tip of the rear cylinder unit, and the rear cylinder unit is provided at a rear end of the frame slidably so as be directed to a tip of the front cylinder unit. It becomes possible to aim at a proper portion of a living body bone through which to bore a bone tunnel and to pierce the living body bone with guide pins for hollow drills from behind the living body bone to the proper aiming portion in a proper direction.

Abstract: A surgical method for forming a void in bone includes the steps of positioning a support member securely within an intramedullary canal of a bone; attaching a guide member having a longitudinal axis to the support member in a fixed and offset relation to the intramedullary canal; connecting a cutting member having a cutting head to the guide member in a slidable arrangement along the longitudinal axis of the guide member such that the cutting head faces a first bone segment; and cutting the first bone segment along the longitudinal axis of the guide member, thereby forming a first offset bone void.

Abstract: An orthopedic device for correcting a femoral bone abnormality includes a patient-specific three-dimensional shell and a patient-specific guiding feature. The shell has an outer surface and an inner bone engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to and substantially cover a femoral head of a patient in only one position. The guiding feature is pre-operatively planned relative to the shell such that when the shell is fitted over the femoral head, the guiding feature can guide a removal tool for removing an abnormality portion of the proximal femur of the patient.

Abstract: A surgical device for osteotomy allows for accurate determination of the angle at which a bone in the human or animal body should be corrected, and for precisely maintaining the angle constant during the entire surgical procedure. The surgical device having on its distal end a circular segment fixed to a distal end of a first blade and further moveably connected to a distal end of a second blade. The distal end of the second blade is allowed to move along the circular segment, wherein the proximal ends of the first and second blade converge at an angle. At least a pair of pin guide openings are provided in parallel for inserting and positioning at least two parallel pins or drill bits. The surgical device provides unique fixed reference means allowing to perform a precise surgery according to predetermined parameters and angles even at the final stages of the operation.

Abstract: Embodiments of the invention include instruments and methods for preparing a femur to receive a femoral component of a knee arthroplasty system, with some embodiments configured to enable anterior referencing techniques, posterior referencing techniques, and to facilitate intraoperative switching between anterior and posterior referencing techniques. Other embodiments of the invention include cutting blocks and methods for preparing a femur to receive a knee arthroplasty system femoral component, with some embodiments including cutting blocks that can be used in both an anterior referencing technique and a posterior referencing technique, thereby reducing the number of cutting blocks required to provide an instrument set capable of implanting all available sizes of femoral components with both anterior and posterior referencing techniques.

Abstract: Method and apparatus for performing an anterior distal femoral resection. A distal femoral resection is formed and used as a surface from which to base an anterior distal femoral resection cutting guide apparatus. The cutting guide apparatus may include a position block and an attached cutting guide. The position block is placed against the anterior distal femoral resection, and the orientation of the anterior cutting guide is set, at least in part, based on the anterior distal femoral resection.

Abstract: A cutting system includes a cutting base and a first cutting guide. The cutting base has a body including a first flange, a second flange, and defines a first slot. A first set of holes is defined in the first flange, and a second set of holes is defined in the second flange. The first cutting guide has a body defining at least one opening. The first cutting guide also includes a set of pegs that extend inferiorly from the body. The set of pegs is sized and configured to be received within the first set of holes to align the at least one opening with the first slot in a first orientation and to be received within the second set of holes to align the at least one opening with the first slot in a second orientation.

Abstract: A method of changing a bone angle includes creating an osteotomy between a first portion and a second portion of a tibia of a patient; creating a cavity in the tibia by removing bone material along an axis extending in a substantially longitudinal direction from a first point at the tibial plateau to a second point; placing a non-invasively adjustable implant into the cavity, the non-invasively adjustable implant comprising an adjustable actuator having an outer housing and an inner shaft, telescopically disposed in the outer housing, and a driving element configured to be remotely operable to telescopically displace the inner shaft in relation to the outer housing; coupling one of the outer housing or the inner shaft to the first portion of the tibia; coupling the other of the outer housing or the inner shaft to the second portion of the tibia; and remotely operating the driving element to telescopically displace the inner shaft in relation to the outer housing, thus changing an angle between the first porti

Abstract: A guide device for assessing the length and offset of a hip of a patient is disclosed. The guide device includes an overlay portion and an alignment portion. The overlay portion is configured to enable assessment of the relative location of the guide device to the original femoral head of a patient using a marking on the overlay portion. Reference points for positioning the guide device are created on the femur. When the guide device is positioned at the reference points it can be used to position a replacement femoral head in the same position as the patient's original femoral head by aligning the replacement femoral head with the marking on the overlay portion.