Abstract: Minimally invasive methods and devices for introducing a spinal fixation element into a surgical site in a patient's spinal column are provided. In general, the method involves advancing a spinal fixation element in a first, lengthwise orientation along a pathway extending from a minimally invasive percutaneous incision to a spinal anchor site. As the spinal fixation element approaches the spinal anchor site, the fixation element can be manipulated to extend in a second orientation, which is preferably substantially transverse to the first orientation, to position the fixation element in relation to one or more spinal anchors.

Abstract: Apparatus is provided, including a tube (421) shaped to define a tube lumen at least one implant (100) reversibly coupled to the tube (421), and configured for implantation within a body of a patient. The apparatus also comprises two or more longitudinal guide members (470) disposed at least in part along a distal portion of the tube (421), the longitudinal guide members (470) having distal portions thereof configured to be reversibly coupled to the implant (100), and arranged such that application of a force to a first one of the longitudinal guide members (470) steers the distal portion of the tube (421) toward a first location along the implant (100), and application of a force to a second one of the longitudinal guide members (470) steers the distal portion of the tube (421) toward a second location along the implant (100). Other embodiments are also described.

Abstract: A prosthetic mitral valve with a compressible and expandable stent that, when expanded, is circumferentially oval, elliptical, or D-shaped, with a major axis and a minor axis ratio of from about 3:4 to about 4:5. Embodiments of the stent comprise three commissure posts disposed towards an outflow end and three curved cusp regions between adjacent commissure posts. Three flexible leaflets are attached to the commissure posts in a tri-foil configuration. Embodiments of the prosthetic mitral valve include an atrial ring disposed at the inflow end of the stent.

Abstract: A method for replacing a proximal interphalangeal joint with a modular implant assembly is provided. During a first surgical procedure, a first stem component of the implant assembly having a first articulation component removably attached thereto is implanted in a proximal phalanx bone. A second stem component of the implant assembly having a second articulation component removably attached thereto is implanted in a middle phalanx bone. During a second surgical procedure performed after the first surgical procedure, the first articulation component is removed from the first stem component and the second articulation component is removed from the second stem component. A third articulation component is attached to the first stem component and a fourth articulation component is attached to the second stem component. The second surgical procedure is performed without removing the first stem component from the first bone and without removing the second stem component from the second bone.

Abstract: A joining arrangement between a main tube (3) and a side arm (5) in a side arm stent graft (1). The side arm (5) is stitched into an aperture (11) in the main tube and is in fluid communication with it. The aperture is triangular, elliptical or rectangular and the side arm is cut off at an angle to leave an end portion having a circumferential length equal to the circumference of the aperture. The side arm can also include a connection socket (76) comprising a first resilient ring (79) around the arm at its end, a second resilient ring (80) spaced apart along the arm from the first ring and a zig zag resilient stent (82) between the first and second rings. The zig-zag resilient stent can be a compression stent. Both the main tube and the side arm are formed from seamless tubular biocompatible graft material.

Abstract: A posterior spinal prosthesis is configured to cover exposed portions of a spinal column especially, but not necessarily, as a result of a medical spinal procedure and particularly, to provide posterior coverage of an exposed spinal cord, soft tissue, Foramen and/or adipose tissue, associated with one or more vertebrae as a result of the removal the spinous processes and/or the spinous process and laminar hoods from the one or more vertebrae of the spine as a result of a spinal decompression procedure or other reason. A plate forming the prosthesis is connectable to spine rod constructs implanted on lateral sides of the vertebrae and projects in the posterior direction relative to the connection. The plate is generally curved in the superior/inferior direction to provide either a lordotic or kyphotic curvature depending on the portion of the spine to which the prosthesis is utilized.

Abstract: A surgically implantable metacarpal-phalangeal prosthetic replacement device having engaging male and female components. The male and female components each include a conically shaped shank. The male head portion connected to the first conically shaped shank includes two spaced-apart lateral condyles having convex condylar surfaces and an intercondylar portion juxtaposed between the first and second convex condyles. The female component has a female head portion connected to the second conically shaped shank. The female head portion includes spaced-apart lateral side portions having concave recessed load-bearing surfaces that are complementary to and moveably engage the convex condylar surfaces of the male component. The lateral sides portions further define an intermediate concave condylar recess that moveably engages the outwardly extending intercondylar portion.

Abstract: Implantable medical grafts fabricated of metallic or pseudometallic films of biocompatible materials having a plurality of microperforations passing through the film in a pattern that imparts fabric-like qualities to the graft or permits the geometric deformation of the graft. The implantable graft is preferably fabricated by vacuum deposition of metallic and/or pseudometallic materials into either single or multi-layered structures with the plurality of microperforations either being formed during deposition or after deposition by selective removal of sections of the deposited film. The implantable medical grafts are suitable for use as endoluminal or surgical grafts and may be used as vascular grafts, stent-grafts, skin grafts, shunts, bone grafts, surgical patches, non-vascular conduits, valvular leaflets, filters, occlusion membranes, artificial sphincters, tendons and ligaments.

Abstract: An embodiment of a bone stabilization and distraction system of the present disclosure includes a light-sensitive liquid; a light source for providing light energy; a light-conducting fiber for delivering the light energy from the light source to cure the light-sensitive liquid; a delivery catheter having a proximal end in communication with the light-conducting fiber and the light-sensitive liquid, an inner lumen for passage of the light-conducting fiber, and an inner void for passage of the light-sensitive liquid; and an expandable body removably engaging a distal end of the delivery catheter, wherein the expandable body has a closed end, a sealable open end, an inner cavity for passage of the light-sensitive liquid, an external surface and an internal surface, and wherein the expandable body has an insertion depth with a fixed dimension, a width with a fixed dimension, and a thickness with a changeable dimension.

Abstract: A device for improving the function of a heart valve comprises: a support member formed from a shape memory material, and a restraining member providing a restraining action on a course of the support member. The support member may abut one side of the valve conforming to the shape of the valve annulus upon said shape memory material assuming an activated shape while the restraining member restrains the course of the support member. The restraining action is removable for allowing the support member to assume a desired, altered course. The restraining member may be biodegradable to be degraded within a patient or may be detachable from the support member to be withdrawn. The support member according to another embodiment presents a shape change in that an increased cross-section is associated with a shortened length of the support member. The support member according to yet another embodiment has a first and a second activated shape.

Abstract: A prosthetic medical device is formed by the combination of a biological tissue a shape memory polymer structure. The biological tissue provides an in-situ physiological function of the device. The shape memory polymer provides a capability for minimizing the device profile during insertion and then deploying after placement into a memory shape that achieves suitable mechanical structure and stability within an anatomical lumen or cavity. This configuration may be applied to form various prosthetic devices including aortic, mitral, and tricuspid valves in the heart; venous valves; anti-reflux valves for the lower esophageal sphincter; and other biological valve structures. Alternatively, an entirely non-biologic implementation using only shape memory polymer-based structures may be used as a prosthetic valve device.

Abstract: Devices and methods for use in a hip replacement surgical procedure. One aspect includes methods and devices for reaming selective regions of the femoral canal. This may include reaming distal and proximal sections of the femoral canal prior to reaming a middle region of the canal. Another aspect includes a dummy implant and methods of use. The dummy implant is inserted into the femoral canal and may be used for one or more of retraction of the femur, gauging a space with the acetabulum, and further revising the femoral cut. The aspects may be used together in a single surgical procedure or separately in different surgical procedures.

Abstract: A joint prosthesis system is suitable for cementless fixation. The system has two metal implant components and a bearing. One of the metal implant components has an articulation surface for articulation with the bearing. The other metal implant component has a mounting surface for supporting the bearing. One of the metal implant components includes a solid metal portion and a porous metal portion. The porous metal portion has surfaces with different characteristics, such as roughness, to improve bone fixation, ease removal of the implant component in a revision surgery, reduce soft tissue irritation, improve the strength of a sintered bond between the solid and porous metal portions, or reduce or eliminate the possibility of blood traveling through the porous metal portion into the joint space. A method of making the joint prosthesis is also disclosed. The invention may also be applied to discrete porous metal implant components, such as augment.

Abstract: Endovascular prostheses are disclosed that are configured to repair a native venous valve having improper or non-existent valve leaflet coaptation caused by vessel weakness and/or distention. The prostheses are configured to be implanted in the venous system immediately downstream of the malfunctioning valve and act as repair devices to restore proper function to the venous valve by reconfiguring and supporting the valve leaflets and thereby improving their coaptation.

Abstract: The invention relates to a stent comprising terminal anchoring elements. Said stent (10) is provided with a tubular wall that extends along a longitudinal, flexible tubular axis (26), is formed from a flexible grid structure, and has tube ends (20) lying on opposing axis ends. Said wall consists of annular wall segments (11) that are lined up along the axis and are interconnected by means of connection segments (12). The annular wall segments (11) contain wall elements (14, 15) having an elastic structure.

Abstract: A disassembly tool for disassembly of a first component of a prosthesis to a second component of the prosthesis for use in joint arthroplasty. The tool includes a first member having a radial portion operably associated with the first component and adapted to exert a radial force on the first component. A second member operably associated with the second component is also included and the second member has a second member longitudinal axis. A drive mechanism is coupled to the second member, such that as the drive mechanism is activated, the second member exerts a force against the second component in the direction of the longitudinal axis. Such exertion of force against the second member further causes the second member to move relative to the first member along the second member longitudinal axis.

Abstract: A prosthesis system for repair of a transected body vessel is provided. The system can include first and second prostheses each including a tubular graft body and a support structure. Each prosthesis can be expandable between a compressed and an expanded configuration. In the expanded configuration, outer surfaces of the first and second prostheses can engage walls of the body vessel. The system can include a sleeve member formable into a tubular body. The first and second prostheses can be coupled to one another at a joint to form a coupled prosthesis. The sleeve member can receive the coupled prosthesis and cover the joint to inhibit leakage therefrom. The prosthesis system can connect first and second portions of the body vessel to permit blood flow therethrough. The sleeve member can be discrete to the coupled prosthesis or can have one end fixedly attached to the coupled prosthesis.

Abstract: A method of forming a shoulder prosthesis includes resecting an end portion of a humerus to form a resected end of the humerus and a resected portion separated from the humerus, the resected portion having an outer convex surface and an inner surface. The inner surface of the resected portion is processed to include a concave articular surface. The outer convex surface of the resected portion is implanted in the resected end of the humerus. An implant having a convex articular surface is secured to a glenoid. The concave articular surface of the resected portion is articulated with the convex articular surface of the implant.

Abstract: An osteoimplant includes at least partially demineralized cancellous bone as a substrate, which is impregnated with demineralized cortical bone matrix (DBM). The implant may include a binding agent to adhere the DBM to the cancellous bone substrate, and may also include a soft tissue barrier that covers a portion of the external surface of the implant. The cancellous bone substrate may be selectively demineralized, so as to provide regions with greater malleability, and other regions with greater structural properties.

Abstract: A prosthetic valve device, a method for making a valve device, and a method for implanting a valve device into a recipient are provided. The valve device includes at least one flexible member formed at least partially from a woven layer. The woven layer includes a first material and a second material being at least partially woven together. The at least one flexible member is movable between a first position that permits fluid flow in a first direction and a second position that substantially prevents fluid flow in a second direction. The valve has a first, unexpanded configuration and a second, expanded configuration.