Abstract: A joint prosthesis includes a bone engaging portion, such as a stem, and articulating component, such as a humeral head, and an insert component that supports the articulating component and is removable from the stem. A mating component mates with the humeral head and is configured to engage the insert component at adjustable angles according to the anatomy of the patient's joint. In a revision surgery, the stem remains within the patient's bone while the insert component is removed with the mating component and humeral head fixed to the insert component. A new insert component may be prepared with the mating component and humeral head oriented to replicate the angular orientation of the previous prosthesis. The new insert component is then mounted within an insert cavity in the implanted stem and rigidly fastened to complete the revision.

Abstract: A biocompatible tissue implant. The tissue implant may be bioabsorbable, consists of a biocompatible polymeric foam. The tissue implant also includes a biocompatible reinforcement member. The polymeric foam and the reinforcement member are soluble in a lyophilizing solvent. The reinforcement may be annealed and/or coated.

Abstract: Various methods and devices are provided for connecting spinal fixation elements, such as spinal rods, implanted in a patient's spinal column. In particular, various spinal cross connectors are provided for connecting to one or more spinal fixation elements implanted in a patient's spine. The cross connectors can have a variety of configurations, including a fixed or adjustable length, as well as various features that allow certain portions of the cross connectors to be angularly oriented.

Abstract: A suture anchor has a tubular body having an axial bore therethrough and having one or more purchase enhancements on an exterior surface of the body adapted to enhance purchase of the body within a bone hole, such as threads. A lateral port passes through the body from the bore to the exterior surface. A length of suture for attaching soft tissue to bone passes down along the exterior surface over the one or more purchase enhancements, over a distal end of the body, up into the bore through and then back out of the bore and up along the exterior surface over the one or more purchase enhancements.

Abstract: A keel punch impactor comprises a main body having an interior bore. A locking shaft is positioned in the interior bore of the main body, the locking shaft defining a shaft axis. An actuator is in contact with the locking shaft. The actuator is moveable between a first position and a second position. The position of the locking shaft is moved within the interior bore of the main body upon movement of the actuator. In particular, the locking shaft is moved such that the shaft axis is offset when the actuator is moved from the first position to the second position. When the shaft is moved, a head on the shaft is moved into or out of alignment with a boss extending from the main body of the keel punch impactor.

Abstract: A vertebra implant is provided that includes an elongate body with a first end configured to mate the first end to a first location on a vertebra, and a second end having at least one fastener configured to mate the second end to a second location on a vertebra. The elongate body also includes a deformable portion extending between the first and second ends that has an unexpanded configuration in which the deformable portion is configured to allow a tool to cut bone extending between the first and second ends when the first and second ends are mated to first and second locations on a vertebra, and an expanded configuration in which the deformable portion is deformed to increase a distance between the first and second ends such that a gap is created in the cut bone. The deformable portion is configured to maintain the first and second ends at a fixed distance apart when the deformable portion is in the expanded configuration.

Abstract: An intervertebral disc for placement between adjacent vertebrae comprising: an anterior side; a posterior side; a first lateral side; a second lateral side; an upper endplate having an inner surface and an outer surface, wherein the outer surface of the upper endplate is adapted for contacting a first vertebra; a lower endplate having an inner surface and an outer surface, wherein the outer surface of the lower endplate is adapted for contacting a second vertebra; and an elastic membrane extending from the inner surface of the upper endplate to the inner surface of the lower endplate and defining an inner volume that is at least partially filled with a fluid, wherein the elastic membrane is affixed to the inner surface of the upper endplate and to the inner surface of the lower endplate.

Abstract: A radially expandable sheath is provided having a substantially closed distal end with at least two sidewalls extending proximally therefrom and defining a central lumen. Each sidewall can have a substantially concave outer surface adapted to seat a graft member, and each side wall is at least partially separated by a longitudinally oriented slot that extends from a proximal end along a substantial length of each sidewall. The slot preferably terminates at a position just proximal to the distal end. The device can also include a sheath expander that is adapted to be disposed in the central lumen of the radially expandable sheath and that is configured to flex the sidewalls to radially expand the sheath so as to fix a graft member within a bone tunnel.

Abstract: An intervertebral implant for fusing vertebrae is disclosed. The implant may have a body with curved, posterior and anterior faces separated by two narrow implant ends, superior and inferior faces having a plurality of undulating surfaces for contacting vertebral endplates, and at least one depression in the anterior or posterior face for engagement by an insertion tool. The implant may also have one or more vertical through-channels extending through the implant from the superior face to the inferior face, a chamfer on the superior and inferior surfaces at one of the narrow implant ends, and/or a beveled edge along a perimeter of the superior and inferior faces. The implant configuration facilitates transforaminal insertion of the implant into a symmetric position about the midline of the spine so that a single implant provides balanced support to the spinal column. The implant may be formed of a plurality of interconnecting bodies assembled to form a single unit.

Abstract: An adjustable tibial trial insert includes an upper plate having an upper articular surface and a lower plate. A height-adjustment mechanism of the insert is coupled to and positioned generally between the upper plate and the lower plate and is configured to move between a closed position where the upper and lower plates are adjacent each other and an opened position where the upper and lower plates are spaced-apart from each other in order to adjust a height or thickness of the insert.

Abstract: Methods and devices are provided for fixing a ligament graft in a bone tunnel. In general, the methods and devices involve affixing a ligament graft within a bone tunnel using an adhesive. A fixation device can be inserted through the ligament graft in a direction transverse to an axis of the tunnel to maintain the ligament graft in contact with the adhesive. The fixation device can be removed when the adhesive is cured such that the ligament graft is fixed in the tunnel.

Abstract: Systems and methods for modifying the environment of target cell using genetically altered chondrocytes are provided. The genetically engineered chondrocytes can be used to express a therapeutic agent in a subject, including in an environment typically associated with chondrocytes and in an environment not typically associated with chondrocytes.

Abstract: An assembly for connecting a support element to a bone. The assembly comprises: a bone screw having a head at one end of a threaded shaft; and a clamp comprising: a base at a first end of the clamp delimiting an opening for receiving the head of the bone screw; and at least two side members extending from the base towards a second end of the clamp. The head of the bone screw and the clamp are configured to allow the head of the bone screw to be inserted into the base from the direction of the first end at a first orientation of the base to the bone screw, and to retain an inserted bone screw within the base at a second orientation of the base relative to the bone screw. This allows the screw to be inserted into the bone without requiring prior assembly of the screw and clamp. It also allows later revision whereby the clamp can be removed from the screw without requiring an implanted screw to be removed from the bone.

Abstract: A surgical access system for providing access to a surgical site in a patient includes a surgical access device defining a working channel for accessing a surgical site and an integrated light emitter for illuminating the surgical site. The light emitter is integrated in proximity to a distal end of the surgical access device. In some embodiments, the light emitter is offset from the distal end. In certain embodiments, the integrated light emitter includes a light transmission medium for transmitting light from a proximal end of the access device to the distal end.

Abstract: An instrument for holding a bone plate may include a first arm, a second arm connected to and adjustable relative to the first arm, a first connection tip at the distal end of the first arm configured to connect to the first side wall of the bone plate, and a second connection tip at the distal end of the second arm configured to connect to the second side wall of the bone plate. A stabilizing member is connected to the first connection tip. The stabilizing member is distally spaced apart from the first connection tip to form an opening for receiving a portion of bone between the first connection tip and the stabilizing member.

Abstract: A method of removing a nucleus pulposus from an intervertebral disc, involving rotating a distal end head of an instrument so that flexible protrusions thereon will cut nucleus pulposus native material.

Abstract: An instrument for positioning a bone graft relative to a bone plate includes an instrument body having a plurality of spaced apart graft chambers, a first one of the graft chambers having a first end, a second end, and a chamber length extending between the first end and the second end, the first end of the first graft chamber including a first chamber surface for receiving a first plate segment of a first bone plate, the second end of the first graft chamber including a second chamber surface for receiving a second plate segment of the first bone plate, the first graft chamber including a central chamber surface interposed between the first chamber surface and the second chamber surface for receiving a first bone graft, the central chamber surface having a first chamber length corresponding to the graft length of the first bone grafts.

Abstract: A number of orthopaedic surgical instruments are also disclosed. A method, apparatus, and system for fabricating such instruments are also disclosed.

Abstract: The invention concerns monolithic foam sleeves that comprises titanium or titanium alloy foam having a porosity of 50 to 85% and possess a proximal end, a distal end, an interior wall that defines an interior channel and extends from the proximal end to the distal end; and a terraced outer surface that tapers such that said sleeve is widest at the distal end and most narrow at the proximal end.

Abstract: A number of orthopaedic surgical instruments are also disclosed. A method, apparatus, and system for fabricating such instruments are also disclosed.