Abstract: A surgical technique for the delivery of bone graft to a medullary canal and implantation of a prosthetic device includes placing bone graft into an elongate hollow tube and arranging a plunger having an elongate rod portion into the hollow tube. The hollow tube, bone graft and plunger assembly are inserted into the medullary canal which has been prepared for the assembly by reaming the medullary canal with a reamer corresponding in size to the hollow tube. The hollow tube is withdrawn from the medullary canal while the plunger is pushed into the canal, resulting in bone graft exiting the hollow tube and being packed by the plunger. A trial prosthesis is used to shape the bone graft within the canal for the prosthesis. Space for a cement mantle can be left through the use of an appropriately sized trial prosthesis.

Abstract: A layer of material is interposed between a metallic texture coating and the substrate of a component of a prosthetic implant, the layer being bonded to the substrate and, in turn, receiving the metallic texture coating so as to deter propagation of fatigue-induced cracks from the metallic texture coating into the substrate.

Abstract: A patella clamp and method for use in resecting a patella for the reception of a patellar prosthesis holds the patella in a preparation position and provides the surgeon with a direct and interoperative accurate visual indication of the bone thickness of the patella prior to and subsequent to resection, as well as a direct and interoperative accurate visual indication of an interoperatively settable depth of resection, all without the necessity for introducing supplemental instruments or other apparatus during the resection procedure.

Abstract: A patellar component of a prosthetic knee joint includes a domed portion having a peak offset from the center of the patellar component for effecting compensation for the displacement of the mechanical joint line upon implant of the prosthetic knee joint so as to enable affixation of the patellar component within the natural patella with sufficient bone coverage while attaining appropriate sliding engagement of the patellar component with a patellar groove in the femoral component of the prosthetic knee joint during articulation of the knee.

Abstract: Biocompatible titanium base alloys for medical devices which are intended to remain on or in a living human being for an extended period of time, such as surgical and medical implants. The alloys are free from toxic elements such as Al, Ni, Co, Fe, Cr, Mo, and W. They are quaternary alloys of Ti with between about 2.5% up to 13% Zr, about 20% to about 40% Nb, about 4.5% to about 25% Ta, all percentages being by weight, the balance being Ti and the total of Ta plus Nb being between about 35% and 52% by weight. The ration of Nb/Ta is between 2 and 13. These alloys may also contain limited amounts of non-toxic interstitial elements, such as C, N, and O. The relative proportions of Ti, Zr, Ta, and Nb are such that the modulus of elasticity is below 65 GPa.

Abstract: A knee prosthesis in which engagement between the femoral component and the tibial component of the knee prosthesis takes place at a contact area along articular surface areas including complementary medial-lateral surface profile contours having a single medial-lateral articular radius defining an arcuate profile, and anterior-posterior surface profile contours along the femoral component and the tibial component, the anterior-posterior surface profile contour of the femoral component having an essentially constant anterior-posterior articular radius throughout regions of the femoral component which contact the tibial component within a primary range of flexion, the center of the anterior-posterior articular radius being located along a line extending laterally between the medial and lateral attachment points of the collateral ligaments of the knee, such that the contact area along the articular surface areas is maintained at a maximum throughout at least the primary range of flexion for minimizing stresses

Abstract: A femoral sizing guide of the type in which a sizing guide block is located at the distal femur utilizing locator feet for engaging the posterior condyles to assist in the location of a femoral cutting guide of suitable size in the implant of a femoral knee prosthesis includes a coupling arrangement by which locator feet of selected size are independently coupled interoperatively with the sizing guide block for enabling a surgeon to compensate for conditions encountered at the implant site, during the implant procedure, and attain a stable placement of the femoral sizing guide at the distal femur for accurate sizing and location of the femoral knee prosthesis.

Abstract: A tibial resection guide is aligned with the direction of the mechanical axis of the leg of a recipient of a total knee prosthesis through the use of a proximal alignment member at the proximal portion of an external tibial alignment shaft coupled to the tibia, the proximal alignment member having a guideway for the reception of an external alignment rod affixed to the distal femur of the recipient and so as to extend in the direction of the mechanical axis.

Abstract: An instrument system and method are disclosed for preparing a distal femur for the implant of a femoral component of a knee prosthesis by the removal of natural bone in the intercondylar area of the distal femur to prepare a femoral notch, including a patella recess, subsequent to establishing distal, anterior and chamfer surfaces at the distal femur. The instrument system includes a femoral notch cutting guide for placement over the distal, anterior and chamfer surfaces of the prepared distal femur, and a femoral notch cutting punch. The femoral notch cutting punch is engaged with a first guideway in the femoral notch cutting guide to remove natural bone from the intercondylar area and establish the patella recess, and subsequently is engaged with a second guideway in the femoral notch cutting guide, transverse to the first guideway, to remove natural bone from the intercondylar area and complete the femoral notch.

Abstract: Apparatus and method for locating holes to be drilled in natural bone, such as a scapula at a site for a prosthetic implant component, such as a glenoid component to be affixed to the scapula for providing a bearing for a humeral head in a shoulder prosthesis, the apparatus and method including seating a guide block against the scapula at the site for the glenoid component, the guide block having an upper end and a lower end spaced in a longitudinal direction from the upper end, drilling a first hole in the scapula along a first transverse direction by guiding a drill through a first drill guide bore adjacent the upper end of the guide block and extending in the first transverse direction through the guide block, the guide block including a second drill guide bore adjacent the lower end of the guide block and extending in a second transverse direction through the guide block, inserting a locator pin into the first hole in the scapula, with the locator pin projecting from the guide block along one of the first

Abstract: An interbody spinal prosthetic implant is placed between adjacent vertebral bodies of the vertebrae of a spine to maintain a desired orientation and spacing between the adjacent vertebral bodies and support the adjacent vertebral bodies for fusion at the desired orientation and spacing, the prosthetic implant including a rigid member of biocompatible material having vertically opposite upper and lower load-bearing surfaces spaced apart a distance providing a height corresponding to the desired spacing, the rigid member having a wedge-shaped configuration in horizontal planes, the wedge-shaped configuration tapering from relatively narrower widths adjacent the front end toward relatively wider widths adjacent the rear end of the rigid body and providing the rigid body with an overall width wider than the height of the rigid body, and an ogival tip at the front end of the rigid member.

Abstract: An improvement in a surgical instrument set and procedure for the preparation of a proximal femur to receive a revision femoral implant component includes a revision broach for mimicking a selected one of a plurality of revision femoral implant components and the insertion of the revision broach into the proximal femur to a location which emulates the location of the selected one of the plurality of revision femoral implant components, and utilizing a stop member positioned at a selected one of a plurality positions located longitudinally along the revision broach and corresponding to one of a plurality of resection levels determined by the selected revision femoral implant component to maintain the revision broach seated at the emulating location during subsequent trial reduction utilizing a trial neck and a trial head coupled to the revision broach.

Abstract: Apparatus and method for the preparation of the proximal tibia for resection at a selected resection level utilize an external alignment shaft having an exposed upper end for the reception of a tibial resection guide over the exposed upper end for movement downwardly along the alignment shaft, securement to the alignment shaft at a resection location along the alignment shaft, and affixation to the proximal tibia at the resection level, the alignment shaft having an upper rod detachable from a lower tubular member for withdrawal of the upper rod from the lower tubular member, and for withdrawal upwardly from the tibial resection guide while the tibial resection guide is maintained affixed to the proximal tibia at the resection location, for full access of the tibial resection guide to a resection device to accomplish resection of the proximal tibia.

Abstract: An acetabular shell is implanted at an acetabulum in a deficient pelvis to establish an effective acetabular site with increased support in posterior and superior directions for an acetabular bearing insert to be affixed in place in the acetabular shell for the reception of a femoral head of a femoral component of a prosthetic hip implant, the acetabular shell including a domed portion having a convex outer surface for engaging the acetabulum, a concave inner surface for reception of the bearing insert, the inner surface extending along a spherical contour up to a generally hemispherical extent, and a rim between the outer and inner surfaces, the rim being placed adjacent an equatorial location along the domed portion and including a superior segment, an inferior segment longitudinally opposite the superior segment, a posterior segment and an anterior segment laterally opposite the posterior segment, an anchoring plate integral with the domed portion adjacent the superior segment of the rim, and a supplementa

Abstract: A surgical technique for the delivery of bone graft to a medullary canal and implantation of a prosthetic device includes placing bone graft into an elongate hollow tube and arranging a plunger having an elongate rod portion into the hollow tube. The hollow tube, bone graft and plunger assembly are inserted into the medullary canal which has been prepared for the assembly by reaming the medullary canal with a reamer corresponding in size to the hollow tube. The hollow tube is withdrawn from the medullary canal while the plunger is pushed into the canal, resulting in bone graft exiting the hollow tube and being packed by the plunger. A trial prosthesis is used to shape the bone graft within the canal for the prosthesis. Space for a cement mantle can be left through the use of an appropriately sized trial prosthesis.

Abstract: Method and apparatus for determining the direction of the mechanical axis of the femur of a patient in relation to the corresponding knee of the patient in connection with resecting the distal femur for the reception of a femoral knee prothesis include at least partially suspending the patient's leg to locate the knee at a suspended position wherein external forces on the knee, such as the weight of the leg, are balanced and the knee remains essentially stationary at the suspended position, applying a force to the femur at a predetermined location relative to the mechanical axis of the femur, directing the applied force in a direction such that the knee remains undeflected from the suspended position while the force is applied to the femur in that direction, and employing that direction of the applied force to indicate the direction of the mechanical axis of the femur.

Abstract: Structural elements of biocompatible material are interlocked with one another in an array to repair, augment or replace natural bone, the structural elements each including a hub having a center, and a plurality of posts projecting from the hub and spaced from one another to establish inter-post spaces between adjacent posts, each post having a root at the hub, an opposite tip, a length, and a transverse cross-sectional configuration, the number of posts and the relative length, cross-sectional configuration, and location of adjacent posts in each structural element being such that the inter-post spaces of one structural element will receive the posts of adjacent structural elements in the array to promote interlocking of adjacent structural elements in a relatively tightly meshed relationship for resisting shear stress in essentially all directions within the array.

Abstract: Method and apparatus for locating functional structures of the lower leg during knee implant surgery by determining the location of the weight-bearing axis. The functional center of the hip is located by fixing the acetabulum of the patient, rotating the femur about its head to several locations, measuring changes of position of a reference point on the femur and computing an imaginary sphere having a center corresponding to the location of the functional center of the hip.

Abstract: Method and apparatus for determining the direction of the mechanical axis of the femur of a patient in relation to the corresponding knee of the patient in connection with resecting the distal femur for the reception of a femoral knee prothesis include at least partially suspending the patient's leg to locate the knee at a suspended position wherein external forces on the knee, such as the weight of the leg, are balanced and the knee remains essentially stationary at the suspended position, applying a force to the femur at a predetermined location relative to the mechanical axis of the femur, directing the applied force in a direction such that the knee remains undeflected from the suspended position while the force is applied to the femur in that direction, and employing that direction of the applied force to indicate the direction of the mechanical axis of the femur.

Abstract: Affixation of a glenoid component of a prosthetic shoulder implant is enhanced and forces exerted upon the glenoid component during service are managed by the location and orientation of affixation pegs on the glenoid component, and especially the location of a medially extending superior affixation peg closely adjacent the superior edge of the glenoid component, and the offset orientation of an inferior affixation peg, relative to the superior affixation peg, the glenoid component including intermediate affixation pegs extending medially and spaced from one another in the anterior-posterior direction intermediate the superior affixation peg and the inferior affixation peg.