Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: According to one example, a medical tray for a surgical procedure is disclosed. The medical tray can optionally comprise: a housing; and one or more tray inserts configured to be received within the housing and having a first major surface and one or more support. The one or more tray inserts are configured to receive a plurality of dental surgical instruments via a plurality of receptacles formed therein. The plurality of receptacles having corresponding openings in the first major surface. The one or more tray inserts configured to be at least one of: removable from the housing and configured with the one or more supports so as to be positionable exterior to and independent of the housing, or the plurality of receptacles are angled such that the dental surgical instruments when received therein are positioned at an acute angle relative to the first major surface.

Abstract: A plate assembly for attaching a bone flap to a skull is provided and may include a first plate member attached to the bone flap and a second plate member supported by the first plate member and movable between a retracted position and an extended position relative to the first plate member. The second plate member may be removed from a cut line between the bone flap and the skull in the retracted position and may extend over the cut line in the extended position.

Abstract: According to one example, a holding device system including a two-part holding frame having a blank holder coupled to a main frame is disclosed. The two-part holding frame can define a processing space and a fixation space. The holding device system can further include at least one fixation element having a head positioned within the fixation space and a threaded shaft extending within and engaged with a bore of the two-part holding frame. In one example, when the blank holder is coupled to the main frame, the at least one fixation element is unable to be removed from the two-part holding frame.

Abstract: Described herein are examples of orthopedic drill bits and methods of preparing a bone of a living being for fixation. An example method includes coupling a drive attachment of a drill bit to a mounting attachment of a driver, and placing a guide at a desired location on the bone. The guide has an opening corresponding to an area of bone to be removed. The guide provides proper positioning and alignment for drilling a hole. With the guide in place, the method further includes aligning the drill bit with the opening on the guide and drilling a hole in the bone. Once the hole is drilled, the method includes de-coupling the drill bit from the driver, and bending the drill bit at the drive attachment while the drill bit is still in the bone. In some examples, additional method steps follow preparation of the hole.

Abstract: An expandable intervertebral implant comprises an expandable cage comprising a central frame, a superior endplate, an inferior endplate, an anterior adjustment mechanism and a posterior adjustment mechanism. The central frame including an anterior (distal) threaded bore and a posterior (proximal) bore. The superior (upper) end plate movably coupled along a posterior portion of the central frame. The inferior (lower) end plate movably coupled along the posterior portion of the central frame opposite the superior end plate. The anterior adjustment mechanism including an anterior wedge coupled to an anterior screw movable within the anterior threaded bore. The posterior adjustment mechanism including a posterior wedge coupled to a posterior screw movable within the posterior bore.

Abstract: Disclosure herein are knotless suture anchor constructs and methods of use thereof. The suture anchor constructs can include a bone anchor and a suture. The bone anchor can include a suture anchoring member and can define a cavity and a longitudinal passage extending from a trailing end of the bone anchor at least partially therethrough to the cavity. The suture anchoring member can be located in the cavity. The suture can be coupled to the suture anchoring member and can include a tensioning portion, a repair portion, and an intermediate portion. The intermediate portion can form a suture loop extending along the longitudinal passage.

Abstract: A soft tissue repair device. The device includes an inserter having a distal portion, a first anchor carried externally onto the distal portion, a second anchor carried externally onto the distal portion, and a flexible strand coupling the first and second anchors and forming an adjustable knotless loop.

Abstract: A device or system to adapt navigation trackers from various manufacturers to a variety of instruments to be navigated during a surgical procedure is disclosed. An adapter for coupling a navigation tracking array to an instrument including a drive shaft and a tracking device holder. The drive shaft can include a handle interface, an instrument connection, and an intermediate section including a circular locking groove extends proximally from a positioning flange. The tracking device holder can be configured to secure a navigation tracking array to the drive shaft and include an elongated body and a locking button. The elongated body can include an inner bore extending along a longitudinal length of the elongated body and adapted to receive the intermediate section of the drive shaft. The locking button can retain the tracking device holder along the drive shaft while allowing for rotation about the longitudinal axis.

Abstract: A glenoid implant comprises a body comprising: an articular surface and a scapula-engaging surface, the scapula-engaging surface including first and second portions angled relative to each other; and a fixation feature extending from the scapula-engaging surface. A method comprises: forming a planar bone surface at a glenoid using a guide pin; forming a first bore into the glenoid located near the guide pin; forming a second bore into the glenoid offset from the first bore; inserting an augment ream guide into the first and second bores; and forming an angled bone surface at the glenoid relative to the planar bone surface using the augment ream guide. A ream guide comprises: a base having first and second surfaces; a bone peg extending from the first surface; an alignment peg spaced from the bone peg; and a guide peg extending from the second surface at an oblique angle to the bone peg.

Abstract: A bone or tissue repair device can deploy first and second anchors from a distal end of a bore of a needle. A cylindrical first anchor can be disposed in the bore proximal to a distal end of the bore. A cylindrical second anchor can be disposed in the bore proximal to the first anchor. A pusher wire can include teeth positioned at a distal end of the pusher wire. The pusher wire and teeth can be configured to engage an interior of the first anchor; advance distally, with respect to the needle, to force the first anchor distally out of the bore; retract proximally, with respect to the needle and the second anchor, to position the teeth inside an interior of the second anchor; engage the interior of the second anchor; and advance distally, with respect to the needle, to force the second anchor distally out of the bore.

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 method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.

Abstract: An instrumentation set for preparing a proximal tibia during a bi-cruciate retaining procedure can include a tibial resection block and a stylus. The tibial resection block can be configured to be fixed to an anterior portion of the proximal tibia. The tibial resection block can define a slot that extends in a medial-lateral direction when the tibial resection block is fixed to the proximal tibia. The stylus can have a first block attachment feature and a second block attachment feature. The first block attachment feature can be offset from the stylus a first distance. The second block attachment feature can be offset from the stylus a second distance. The first and second block attachment features of the stylus can be selectively and alternatively received by the slot of the tibial resection block to position the stylus at distinct offset locations relative to the slot.

Abstract: A plate system for securing a first sternal portion and a second sternal portion of a separated sternum can include a first plate and a second plate. The first plate can include a first body and a first hook. The first body can include a first reduction bore. The first hook can extend from the first body. The first hook can be engageable with a lateral portion of the first sternal portion. The second plate can include a second body and a second hook. The second body can include a second reduction bore. The second hook can extend from the second body. The second hook can be engageable with a lateral portion of the second sternal portion opposite the first hook.

Abstract: A failsafe for a transdermal apparatus for a prosthetic appendage can include a first plate, a second plate, and a breakaway connector. The first plate can have a central axis, a proximal portion, and a distal end. The distal end can be opposite the proximal portion, and the distal end can be securable with a prosthetic external to skin and can be configured to simulate an appendage of a patient. The second plate can be aligned with the central axis and can include a proximal end and a distal portion. The proximal end can be securable to a transdermal implant, and can extend proximally from the second plate. The distal portion can be opposite the proximal end, and the distal portion can be configured to interface with the proximal portion of the first plate. The breakaway connector can be couplable within the second plate and the first plate.

Abstract: An interbody implant can comprise a cage and a porous structure. The cage can comprise an anterior segment, a medial segment, a posterior segment and a lateral segment contiguously connected to each other to define an interior space. The porous structure can be located in the interior space and can be bounded by the cage. The porous structure can comprise opposed superior and inferior surfaces exposed through the cage, an internal cavity located in an interior of the porous structure, and a plurality of ports connecting the internal cavity to the superior and inferior surfaces. A superior-inferior stiffness of the interbody implant can be defined by the porous structure. The porous structure can be compressed within a patient by movement of the spine to biologically stimulate bone growth in vertebrae adjacent the interbody implant. The implant can be configured for lateral, anterior and posterior insertion at different spine levels.

Abstract: A self-adjusting suture construct can include a suture extending from a passive end to an active end. The passive end can include a first loop that the active end can be passed through to form a second loop. The active end can then be pulled to tighten the second loop around a portion of a patient's anatomy. The active end can be passed through an anchor and the anchor can be implanted to lock the tightened second loop.

Abstract: A soft tissue repair assembly. The assembly includes a flexible member having first and second ends, and a strand passing through the flexible member. The strand has first and second strand ends extending through the flexible member, such that pulling at least one of the first and second strand ends changes the flexible member from a first shape suitable for insertion through soft tissue to a second shape suitable for securely lodging the soft tissue repair assembly relative to soft tissue.

Abstract: Spinal surgical procedures can benefit from a rod reduction instrument with a ratchet lock-out mechanism. The instrument can include an inner shaft, an outer housing and a ratchet mechanism. The inner shaft can include a threaded proximal portion and a distal end that includes a plurality of engagement members adapted to receive a pedicle screw. The outer housing can be slidably received over the inner shaft, and include a top sleeve and a bottom sleeve. The top sleeve can include the ratchet mechanism to selectively engage the threaded proximal portion of the inner shaft and the bottom sleeve can engage a connecting rod. The ratchet mechanism can include an engagement feature to selectively engage the threaded proximal portion of the inner shaft, and a locking mechanism to selectively lock the engagement feature of the ratchet mechanism against the threaded proximal portion of the inner shaft.