Abstract: An artificial ligament is provided having an elongate body and two ends, with a loop being provided at least one of the ends and a loop liner being provided within the loop. A kit of artificial ligaments is also provided with each ligament in the kit having a different fixed length. Also provided are methods for determining a length of artificial ligament to be used within a prosthetic knee joint, selecting a ligament from a range or kit of ligaments, and implanting a prosthetic knee joint assembly comprising an artificial ligament.

Abstract: A knee arthroplasty assembly for use in a patient's knee joint including a tibia and a femur is disclosed. The assembly can include a tool, a first accessory, and a second accessory. The tool can include a tibial component configured for placement against the tibia and a femoral component configured for placement against the femur. The femoral component can be moveably coupled to the tibial component to place the patient's knee joint in tension by separating the tibia and the femur. The first accessory can be removeably coupled to the tibial component of the tool. The second accessory can be referenced to the first accessory and can have a reference indicator that references the femur for determining a size of the femur.

Abstract: A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

Abstract: In some embodiments, a spinal stabilization system may be formed in a patient using quick-connect sleeve assemblies. Each quick-connect sleeve assembly can be coupled to a bone fastener assembly in a fast and intuitive way. In one embodiment, a quick-connect sleeve assembly has a detachable member and a movable member. Both members engage a collar of the bone fastener assembly. In one embodiment, the engagement can be locked via one or more locking features to facilitate screwing a bone fastener of the bone fastener assembly onto a vertebral body in a minimally invasive surgical procedure. Each quick-connect sleeve assembly has a low profile and is particularly shaped for minimally invasive entry.

Abstract: A polyaxial bone anchor including a housing, a bone screw, and a retainer for pivotably coupling the head of the bone screw to the housing. The retainer is positioned into the bore of the housing and includes a plurality of alternating tabs and slots circumferentially arranged to define a cavity for receiving the head portion of the bone screw therein. The retainer is axially moveable in the housing from a first position in which the head portion is not passable through the lower opening of the retainer to a second position in which the head portion is passable through the lower opening of the retainer.

Abstract: Methods and instruments for performing a kinematically-aligned total knee arthroplasty (TKA) are disclosed. Goals of the kinematically-aligned TKA can include restoration of (1) the femoral and tibial joint lines to the patient's natural joint line, (2) the patient's Hip-Knee-Ankle alignment to their constitutional alignment prior to developing osteoarthritis and (3) restoration of the patient's natural soft tissue laxity and envelope. A shim block assembly can be used in resecting the distal medial and lateral condyles to account for cartilage wear on the distal condyles from osteoarthritis. The shim block assembly can include a plurality of shims, and each shim can be attachable to or integral with a reference block. At least one of the plurality of shims can have a medial portion with a thickness different from a thickness of a lateral portion of the shim. The shims need not be joined together as a single medial/lateral component but may be independent of one another.

Abstract: A system, a method, and instruments for manipulating a surgical cord into spinal implants to assist in correcting a spinal deformity are described. The system may include a tensioner, a tensioner extension, and a counter tensioner. One of the instruments can include an elongate body, a dual coupler, and a nose member. The elongate body has a flexible cylindrical member adapted to carry tension along a longitudinal axis, where the flexible cylindrical member is sized to receive a surgical cord through a lumen within the flexible cylindrical member. The dual coupler is disposed on a proximal end of the elongate body, and include a bore for receiving a nose portion of a tensioner and for guiding the surgical cord into the tensioner. The nose member is disposed on a distal end of the elongate body, and be adapted to discharge the surgical cord from the elongate body.

Abstract: A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

Abstract: A tool body having a first clamp element positioned on a first tool arm and a drill guide positioned on a second tool arm. The surgical tool can also have a slider element slidable on the tool body, the slider element having a depth probe and a second clamp element. The second clamp element can be engaged with the first clamp element such that the first and second elements cooperate to define a clamp opening for receiving a supplemental screw.

Abstract: A polyaxial bone anchor including a housing, a bone screw, and a retainer for pivotably coupling the head of the bone screw to the housing. The retainer is positioned into the bore of the housing and includes a plurality of alternating tabs and slots circumferentially arranged to define a cavity for receiving the head portion of the bone screw therein. The retainer is axially moveable in the housing from a first position in which the head portion is not passable through the lower opening of the retainer to a second position in which the head portion is passable through the lower opening of the retainer.

Abstract: The present disclosure provides a modular instrument system for accessing a site within a patient's body, such as for example, to inject or remove material. In one exemplary embodiment, an access device is coupled to an adapter and power drilled into a site within a patient. Once the access device is in position, the adapter may be further attached to other instruments, or to an injection or extraction system. The adapter may accommodate various other connectors to make the instrument system compatible with a variety of other surgical instruments and tools.

Abstract: A method for placing a first guide wire in a patient is disclosed. The method can include locating a model axis in a model and placing a second guide wire at the model axis, the model axis corresponding to an anatomical axis of an anatomical feature. The method can include coupling a guide plate to the second guide wire and the model. The method can include coupling an axis guide to the guide plate. The method can include decoupling the guide plate and the axis guide as an alignment unit from the second guide wire and coupling the guide plate and the axis guide as an alignment unit to the anatomical feature of the patient. The method can include using the alignment unit to place the first guide wire in the anatomical feature of the patient at the anatomical axis of the anatomical feature.

Abstract: The disclosure includes methods and systems for making orthopedic connections where there is unique adjustability to the connection. Illustratively, one embodiment provides a connecting assembly for connecting a plurality of orthopedic components. Such connecting assemblies can include a first orthopedic component that provides a female bore. Additionally, the assembly can include a second orthopedic component that can be or include a male-type connecting member that is positionable in the bore of the first orthopedic component. In one preferred form, the male-type connecting member will be a quasi-spherical member. The quasi-spherical member can include a textured outer surface, e.g., for contacting one or more walls or surfaces in the bore in a fashion that removably locks or helps to removably lock or fix the quasi-spherical member in the bore.

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.

Abstract: Osteosynthesis constructs for treating bone fractures and bone screws for use in such systems are disclosed. The bone screws include a threaded front section configured for engagement with cortical bone, a threaded mid-section and an unthreaded neck section configured for limited movement within the near cortex of the bone. Osteosynthesis constructs of the type disclosed promote secondary healing by allowing for substantially parallel motion at the near and far cortex within the effective motion range for callus formation.

Abstract: An implant for a human rib can include an elongate body, a plurality of bores, and a placement tool interface. The elongate body can include a first portion including a flat outer face where the elongate body can be curved along a plane perpendicular to the flat outer face. The second portion can extend from the first portion to form a curved outer face. The plurality of bores can extend through the flat outer face of the first portion and into the second portion. The bores can extend partially into the curved outer face of the second portion. The placement tool interface can extend into the body.

Abstract: One aspect of the present disclosure provides a method of manufacturing an orthopedic prosthesis. This particular method includes providing a porous metal layer (22) positioned against a metal substrate at an interface between the porous metal layer and the metal substrate. Additional steps include providing an electrode (132) and providing an intermediate element or coating positioned between and in contact with the electrode and the porous metal layer where the intermediate element includes tantalum in contact with tantalum of the porous metal layer. In a further step, an electrical current is directed to the interface between the porous metal layer and the metal substrate to bond the porous metal layer to the metal substrate.

Abstract: Implementations described herein may include a system for manipulating implants coupled by a cord. The system may include a tensioner and a counter tensioner. The tensioner may include a nose assembly and a cord lock assembly for applying tension to the cord. The nose assembly may include a piston having a lumen extending therethrough for receiving the cord and a spring positionable in contact with an indicator region of the piston. The counter may be releasably coupleable to a head of an implant at a proximal end thereof and may guide the cord to a port proximate the distal end thereof, the port for receiving the nose assembly. The counter tensioner may enable translation of the implant relative to another implant implanted in an adjacent or nearby vertebrae. The indicator region of the piston may be visible through a window in a tensioner main body and may indicate cord tension when the nose assembly of the tensioner is coupled to the port of the counter tensioner and engaged with the cord.

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.