Abstract: An external fixator for positioning a first element or the like relative to a second element or the like.

Abstract: A distal femoral sizing instrument includes an intramedullary rod for referencing the patient's intramedullary canal. A valgus module mounts to the intramedullary rod at a bore of the valgus. The bore of the module has a slant with respect to the flat reference surface of a valgus block. The module slidably connects to the block. The valgus block, referencing guide and a stylus (for connecting the valgus block and cutting together) are removed as a unit before shaping of the distal femur. An indexing system includes a gauge having a series of openings corresponding to "anterior" referencing and to "posterior" referencing. During anterior referencing, the gauge allows the surgeon to select the next smaller size prosthesis if the size falls in between available sizes. In posterior referencing, the gauge allows the surgeon to select the next larger size prosthesis if the gauge measures a size that falls in between available sizes.

Abstract: Cardiovascular and other medical implants fabricated from low-modulus Ti--Nb--Zr alloys to provide enhanced biocompatibility and hemocompatibility. The cardiovascular implants may be surface hardened by oxygen or nitrogen diffusion or by coating with a tightly adherent, hard, wear-resistant, hemocompatible ceramic coating. The cardiovascular implants include heart valves, total artificial heart implants, ventricular assist devices, vascular grafts, stents, electrical signal carrying devices such as pacemaker and neurological leads, defibrillator leads, and the like. It is contemplated that the Ti--Nb--Zr alloy can be substituted as a fabrication material for any cardiovascular implant that either comes into contact with blood thereby demanding high levels of hemocompatibility, or that is subject to microfretting, corrosion, or other wear and so that a low modulus metal with a corrosion-resistant, hardened surface would be desirable.

Abstract: Cardiovascular and other medical implants fabricated from low-modulus Ti--Nb--Zr alloys to provide enhanced biocompatibility and hemocompatibility. The cardiovascular implants may be surface hardened by oxygen or nitrogen diffusion or by coating with a tightly adherent, hard, wear-resistant, hemocompatible ceramic coating. The cardiovascular implants include heart valves, total artificial heart implants, ventricular assist devices, vascular grafts, stents, electrical signal carrying devices such as pacemaker and neurological leads, defibrillator leads, and the like. It is contemplated that the Ti--Nb--Zr alloy can be substituted as a fabrication material for any cardiovascular implant that either comes into contact with blood thereby demanding high levels of hemocompatibility, or that is subject to microfretting, corrosion, or other wear and so that a low modulus metal with a corrosion-resistant, hardened surface would be desirable.

Abstract: A method of preparing fretting wear resistant titaniumbase alloy orthopaedic implants includes the steps of shot peening the surface of the implant with spherical ceramic beads of a selected size and density, and with selected intensity such that the fretting wear resistance of the implant is increased and wherein the implant surface is uniformly peened to create a compressively-stressed region within the surface of approximately 100-300 microns depth.

Abstract: A tibial prosthesis apparatus and its insertion/removal tool includes a tibial tray that receives a polymeric tray liner with an articulating surface. Dovetail connections are provided for interconnecting the liner and the tibial tray. An instrument is provided that can either insert or remove the liner relative to the tray. The surgeon is provided with cam and hook portions that are at the hooking end of the instrument opposite the lever end. The cam engages the anterior surface of the liner while the hook attaches to the tibial tray and the lever end is rotated to cam the insert into a locked position during insertion. The hook engages the distal side of the liner so that the surgeon can rotate the instrument to disengage or remove the liner from the tray.

Abstract: A modular tibial trial prosthesis for attachment to a patient's surgically cut proximal tibia includes a tibial tray having proximal and distal surfaces, the distal surface to be fitted against the patient's surgically prepared proximal tibia during knee joint replacement surgery. The proximal surface of the tray accepts any one of a plurality of plastic liner inserts that fits the tray at the proximal tray surface with an interlocking connection. The liner inserts each have a distal surface for attachment to the tray and a proximal articulating surface that is receptive of a distal femoral articulating surface. The proximal articulating surface has concavely-shaped portions. The concavely-shaped portions of the liner inserts provide different articular geometries for selection by the user. A plurality of spacers of different thicknesses can be positioned in between a selected one of the plastic liner inserts and the tibial tray. Each spacer has proximal and distal surfaces.

Abstract: A trial femoral prosthesis for use in knee joint replacement surgery includes a trial prosthesis body that is generally J-shaped. The prosthesis body provides a distal articulating surface and a proximal non-articulating surface. The articulating surface includes medial and lateral condylar portions, a distal portion, and an anterior portion. An elongated stem extends from the distal non-articulating surface for anchoring the trial prosthesis to the intramedullary canal of the patient's femur. Wedge trial insert members are connectable to the trial prosthesis body at the non-articulating surface. The inserts can be of different shape and different thicknesses and can be independently placed on opposite sides of the stem. However, the prosthesis body can be used independently without any inserts. The apparatus assists a surgeon who is going to revise a total knee that had been previously implanted. If a surgeon needs a wedge insert for the trial, a corresponding wedge is placed on the final knee implant.

Abstract: A surgical method of measuring bone strain to detect fracture consolidation includes the steps of affixing an external fixation device to the patient's bone that has a fracture site to be healed and wherein the fixation device supports an elongated optical fiber. Light is transmitted through the optical fiber to an exit point. The light intensity within the optical fiber is measured, preferably at the exit point as the light travels through the optical fiber. Light intensity is measured to monitor strain in the fixation device as the fracture site heals. A physician then determines when the site has fully healed by observing changes in light intensity as the patient's bone rather than the fixation device carries more of the patient's normal body loading.

Abstract: A surgical instrument for shaping a patient's bone tissue at the joint to receive an implant includes a cutting block body that is sized and shaped to fit a patient's long bone at the joint during joint replacement surgery. The block is attachable to the patient's bone tissue at the joint area. A flat cutting guide surface on the block body is provided for guiding a surgeon's saw blade when the surgeon cuts bone tissue at the joint. A saw capture removably attaches to the block body at or near the flat cutting guide surface. The saw capture also provides a flat cutting guide surface thereon that is positioned generally parallel to the cutting guide surface on the block body during use, a gap being formed therebetween. Wedge locking connections are provided for affixing the saw capture to the block body at the flat cutting guide surface. The connection includes first and second interlocking connecting portions that are respectively on the block body and saw capture.

Abstract: A suture securing device for intracorporeally securing a suture. The device includes a surgically implantable body having a tissue abutting side and a suture loop side, and a passage through the body having an opening adjacent the tissue abutting side and another opening adjacent the suture loop side. When a loop of suture is positioned through the passage from the tissue abutting side and emerges from the suture loop side and a free portion of suture is passed through the loop, the loop clamps upon the free portion when the loop is retracted back into the passage.

Abstract: A suture anchor and anchor driver device for securely and accurately positioning and installing the suture anchor in place. The anchor has a rounded or pointed head and one or more ridges around it to help force fit the anchor into a hole and to hold it in place. A suture is positioned through the anchor for subsequent use during the surgical procedure. The driver device has a handle and an elongated shaft and is used to position and install the anchor in place. The anchor preferably snap fits onto the end of the shaft. A depth guide can be integrally or removably positioned on the shaft to ensure correct depth of placement. Alternately, the driver shaft is hollow and the anchor is positioned inside it and is implanted with a pusher member. The ends of the suture are affixed to the driver handle. Grooves can be provided on the driver and the anchor to prevent the suture from interfering with the positioning and installation procedure.

Abstract: A cutting implement dispenser for use with surgical instruments having replaceable cutting implements includes a support structure on which a replacement implement is carried. Operating a release mechanism movably attached to the support releases the implement from the support.

Abstract: Cardiovascular and other medical implants fabricated from low-modulus Ti--Nb--Zr alloys to provide enhanced biocompatibility and hemocompatibility. The cardiovascular implants may be surface hardened by oxygen or nitrogen diffusion or by coating with a tightly adherent, hard, wear-resistant, hemocompatible ceramic coating. The cardiovascular implants include heart valves, total artificial heart implants, ventricular assist devices, vascular grafts, stents, electrical signal carrying devices such as pacemaker and neurological leads, defibrillator leads, and the like. It is contemplated that the Ti--Nb--Zr alloy can be substituted as a fabrication material for any cardiovascular implant that either comes into contact with blood thereby demanding high levels of hemocompatibility, or that is subject to microfretting, corrosion, or other wear and so that a low modulus metal with a corrosion-resistant, hardened surface would be desirable.

Abstract: A composite cutting block for preparing a patient's distal femur to receive a knee prosthesis includes a first block body having a triangular cross section that engages the patient's distal femur using bone tissue connectors such as bone spikes. A pair of inclined surfaces form acute angles with a flat surface, the inclined surfaces defining anterior and posterior chamfer cutting guide surfaces. A second block body has an undersurface with an elongated inverted "T" shaped slot. The first block body fits the slot so that the flat distal surfaces of the first block body and the flat distal surface of the second block body are in planes that are closely positioned upon assembly. A connector in the form of a threaded shaft holds the first block body in the slot of the second block body to define an assembled position.

Abstract: A knee cutting instrument apparatus includes an elongated alignment rod that can enable a surgeon to define alignment with a patient's long bone. An instrument block body can slide upon the alignment rod between its end portions. A locking member forms a connection with the rod at a selected position along the rod. The locking member includes a cam locking arrangement that rotates about a pivot on the instrument body. The cam has a handle portion or arm that enables a user to rotate the cam and its locking tab about its pivot. Part of the locking cam includes a locking tab having a slot that extends circumferentially about ninety degrees (90.degree.) around the pivot of the cam. The slot is positioned radially in between the pivot and the periphery of the locking member at a locking member bearing surface. The slot provides a closed end portion and an open end portion that communicates with the locking member periphery at a positioned spaced away from the bearing surface.

Abstract: The method of implanting a femoral and a tibial knee prosthesis and instruments for surgically implanting the femoral and tibial prosthesis component as disclosed. The method includes the formation of a plurality of surgical cuts on the patient's distal femur. A trial tibial prosthesis is then fitted to the surgically prepared distal femur. The trial prosthesis has a femoral articulating surface and a non-articulating surface that fits the patient's distal femur at the surgical cuts. A surgeon then forms a transverse cut on the patient's proximal tibia. The surgeon places a tibial trial prosthesis on the patient's proximal tibia, the trial prosthesis including a tibial trial stem that fits the patient's intramedullary canal, a tibial trial metallic tray or plate, and a plastic trial insert that fits the tibial tray or plate. The plastic insert includes a tibial articulating surface that can articulate with the femoral articulating surface.

Abstract: A distal femoral cutting block apparatus for use in knee surgery includes an instrument body that has generally flat opposing parallel surfaces and a plurality flat peripheral surfaces to form a generally rectangular body. The body provides anterior and posterior surfaces and medial and lateral surfaces. The transverse slot carries a valgus module that is movably disposed in the slot. The valgus module includes a tubular sleeve member having a pair of opposed sides that abut the body at the slot. A portion of the tubular sleeve member is threaded and the threaded portion extends away from the body. An open ended bore extends through the tubular member. The open ended bore of the tubular sleeve member of the module accommodates an intramedullary rod that fits the patient s intramedullary canal. A lock nut engages the threaded section of the module for locking the module in a desired position on the cutting block body by engaging the threaded portion and the instrument body to rigidly affix them together.