Abstract: A surgical apparatus comprising a first distraction mechanism, a second distraction mechanism, and a third distraction mechanism. The surgical apparatus is configured to be placed in a joint of the musculoskeletal system to precisely separate the first bone from the second bone to support one or more bone cuts for installing a prosthetic joint. The first distraction mechanism simultaneously changes a height of a first side and a second side of the joint. The change in height is equal on the first and second sides. The second distraction mechanism changes the height on the first side of the joint but not the second side. The third distraction mechanism changes the height of the second side of the joint but not the first side. The surgical apparatus further includes at least one module to measure loading applied by the joint to the surgical apparatus.

Abstract: A computer-assisted surgery system comprises a first surgical device with a tracking unit tracked during a surgical procedure and adapted to perform a first function associated to the surgical procedure. A second surgical device is adapted to perform a second function associated to the surgical procedure. A triggered unit is triggered when the first surgical device and the second surgical device reach a predetermined proximity relation. A surgical procedure processing unit tracks the first surgical device. A trigger detector detects a triggering of the triggered unit. A CAS application operates steps of a surgical procedure. A controller commands the CAS application to activate a selected step associated with the second function in the surgical procedure when the trigger detector signals a detection. An interface displays information about the selected step in the surgical procedure.

Abstract: Injectable, ready-to-use two-paste cement-forming compositions comprise a first paste and a second paste. The first paste comprises a non-aqueous oil-based suspension of monocalcium phosphate monohydrate (MCPM) powder, at least one surfactant effective to improve compatibility of the oil and the MCPM, and an organic acid, with an oil to MCMP powder weight ratio of about 0.2 to about 0.5. The second paste comprises an aqueous suspension of ?-tricalcium phosphate (?-TCP) powder and a gel-forming polymer, with a water to ?-TCP powder weight ratio of about 0.3 to about 0.5. The molar ratio of ?-TCP powder to MCPM powder is greater than 1. An article of manufacture comprises a first compartment in which the first paste is contained, and a second compartment in which the second paste is contained. The compositions are useful for bone repair or replacement.

Abstract: A tool for manipulating flexible and non-flexible fastening devices. The tool assembly has a flexible rod for insertion into the distal end of the fastening device. A handle assembly interacts with proximal end of the flexible rod and the proximal end of the fastening device to control of the fastening device by initiating rotation at the distal end of the fastening device.

Abstract: Implementations described herein include surgical distraction devices having a distal movement assembly having a pusher plate comprising a first slot extending along a first axis disposed in a first side and a second slot extending along a second axis disposed in a second side thereof. The first axis is oriented at an angle of from about 60 to about 160 degrees from the second axis. The device further includes a first and second paddles, each paddle having a corresponding engagement mechanism for movably coupling the respective first or second paddle to the pusher plate when engaged in the respective slot. Rotational actuation of the proximal drive assembly causes proximal or distal movement of the pusher plate, causing the first and second engagement members to move relative to their respective slots, thereby moving the first paddle and the second paddle in opposing directions. Methods of using such surgical distraction devices to determine size of an intervertebral space are also described.

Abstract: A surgical system may include a conductive stylet with a distal end advanceable into bone material and a proximal end coupled to a stylet hub. A handle is non-removably attached to the stylet hub, and removably attachable to an insulative cannula hub. The cannula hub is non-removably attached to a conductive cannula that surrounds the stylet when the handle is attached to the proximal end of the insulative cannula hub. An outer insulative sheath is slideably engaged to insulative cannula hub, and has a radiopaque distal tip. An electrical signal source may be applied to the stylet hub to conduct a pedicle integrity assessment. The handle and stylet may be removed from the cannula assembly, leaving the cannula assembly in place at the surgical site.

Abstract: A fluoroscopy-based system/method for correcting at least an inclination angle of an acetabular cup during total hip arthroplasty. A computing device processes an image of the surgical area to determine distortion, at least as a function of the reference object in the image. Thereafter, the computing device generates a correction factor and measures an inclination angle of an initially positioned acetabular cub in an anterior posterior image of a patient's pelvis, and corrects, as a function of the correction factor, the measured inclination angle to provide an accurate inclination angle of the acetabular cup.

Abstract: One aspect relates to a device for the production of a bone cement dough from a monomer liquid and a cement powder comprising a cartridge with an internal space; a cartridge head with a dispensing opening; a conveying plunger that is supported in the internal space of the cartridge such that it is pushable in the direction of the dispensing opening; a dispensing plunger between the dispensing opening and the conveying plunger that is supported in the internal space of the cartridge such that it is pushable in the direction of the dispensing opening; a first hollow space, in which the cement powder is arranged; a second hollow space that is bordered by the dispensing plunger and the conveying plunger; a rear-side part of the internal space of the cartridge; and a conducting means that connects the second hollow space to the rear-side part of the internal space of the cartridge such as to bypass the conveying plunger and be permeable to the monomer liquid.

Abstract: A syringe mixing device has a cylindrical syringe housing, an end cap, a nozzle cap, a removable stir rod mixer assembly, a large mouth funnel, and optional locking clip. The cylindrical syringe housing has an internal chamber for holding material, a distal end and a proximal end. Adjacent the proximal end is a pair of finger grips. The end cap has a proximal end for attaching to the distal end of the syringe housing. The end cap has a nozzle configured to pass material ejected from the syringe housing. The nozzle cap is for sealing the nozzle. The large mouth funnel is configured to fasten at a throat end to the distal end of the cylindrical syringe housing. The funnel has a slope shaped chamber configured to receive and pass material for mixing into the internal chamber of the syringe housing. The syringe mixing device further has a removable plunger.

Abstract: Systems and methods for providing assistance to a surgeon for minimizing errors during a surgical procedure are disclosed. A method includes creating a Three-Dimensional (3D) model of a patient using at least one image of an affected area of the patient. Surgical paths are retrieved for performing a surgical procedure. A surgical path, selected by a surgeon, may be displayed as overlaid on the 3D model. A haptic barrier and a hard barrier may be defined for different types of tissues and feedbacks may be associated with the haptic barrier and the hard barrier. Position of a surgical tool of a robotic surgical system may be monitored in real-time during a surgical procedure. Movement of the surgical tool into one of the haptic barrier and the hard barrier may be detected and a suitable feedback may be provided, based on the movement.

Abstract: A bone anchor includes a flexible strand defining a first adjustable loop and a friction knot coupled to a proximal end of the first adjustable loop. The friction knot is configured to allow adjustment of the first adjustable loop in a first configuration and is configured to prevent adjustment of the first adjustable loop in a second configuration. A knot capsule includes a body defining an internal knot cavity. The friction knot and a portion of the first adjustable loop are positioned within the internal knot cavity. The internal knot cavity defines one or more impingement surfaces configured to maintain the friction knot in a fixed position within the internal knot cavity when the friction knot is in the second configuration.

Abstract: Systems for distracting a facet joint and positioning a permanent implant in the joint are disclosed. The implants serve to retain a distracted position of the facet joint which is achieved with positioning of the leading end of a distraction tool in the facet joint and then distracting or enlarging the joint a desired amount. The permanent implant could be part of the distraction mechanism which can be separated from the delivery tool once the joint has been distracted or an auxiliary implant may be positioned before the distraction mechanism is removed from the distracted joint. The permanent implants can be solid, mechanical devices that may have fixation means thereon to hold them in place or injected fluids such as hydrogels or fluids confined within balloons.

Abstract: A method of placing an implant for intervertebral fusion between adjacent vertebral bodies in a patient includes inserting the implant in a space between the adjacent vertebral bodies such that both a first intervertebral spacer body and a second intervertebral spacer body contact each of the adjacent vertebral bodies. The first intervertebral spacer body is spaced apart from the second intervertebral spacer body. An expandable container portion of the implant disposed between the first intervertebral spacer body and the second intervertebral spacer body is filled with fill material such that the expandable container expands to contact each of the adjacent vertebral bodies.

Abstract: A bone fixation element is described. The bone fixation element includes first and second channels, a connection channel, and at least one fenestration. The first channel includes a first proximal channel portion and a first distal channel portion. The first proximal channel portion extends from a proximal end of the first channel toward a distal end, and the first distal channel portion extends from the first proximal channel portion to the distal end. The connection channel extends between the distal end of the first channel and a distal end of the second channel such that the first channel is in fluid communication with the second channel via the connection channel. The at least one fenestration extends from at least one of the first and second channels to an outer surface of the bone fixation element.

Abstract: A spine plate implant utilizes cam lock setscrews to retain bone screws in the plate once implanted. A cam lock setscrew is received in a setscrew pocket adjacent a configured bone screw bore of the plate and is configured to allow a bone screw to be received in the plate when in an unlocked rotational position, and to retain the received bone screw when in a locked rotational position. The bone screw may include a tang that allows engagement with external teeth of the cam lock setscrew when the cam lock setscrew is rotated into the locked position. Once the cam lock setscrew is in the locked position, the bone screw is inhibited from backing out of the bone screw bore. When the cam lock setscrew is in the unlocked position, a flat of the cam lock setscrew is adjacent the bone screw tang so the bone screw may be removed.

Abstract: Disclosed is an implant through which a liquid or pasty material can be injected in a targeted manner. This implant is composed of: a main implant with a lumen extending along its entire length, the body of the main implant being of hexagonal cross section, with the plane faces drilled with internally threaded holes which open into the lumen and are intended to remain open or to be plugged by one or more micro screws of the complementary implants, the distal end and proximal end of the implant being threaded; one or more complementary implants, for each of which the micro screw thereof, intended to cooperate with the internally threaded holes of the main implant, is connected to its insertion sleeve by way of a separable zone. The implant is intended in particular for surgical interventions.

Abstract: Devices and methods are provided for optimized spinal fixation using additive manufacturing techniques to create implants with optimized structure for various surgical approaches, anatomies, etc. One exemplary embodiment includes a cage having an X-shaped connection that can bear a load during cage impaction. The cage can be additively manufactured to incorporate features such as variable wall thickness or material density to adjust properties of the cage, including load bearing capability, flexibility, radiolucency, etc. The cage can further include one or more of the connectors disposed between upper and lower endplates. In some embodiments, the cage can include a feature for coupling an insertion device thereto for introducing the cage into the body of a patient. In some embodiments, a plate can be appended to or integrally formed with a proximal end of the cage to assist with securing the cage to vertebral bodies.

Abstract: A knee trial which is coupled to identify the mobility of an implant before the implant is implanted by total knee arthroplasty, and more particularly, a detachable knee trial which includes a plate trial, an insert trial, and an adapter for easy attachment and detachment of the two trials, wherein the adapter includes an elastic member on one side thereof to firmly couple the two trials by pressing the plate trial and the insert trial with opposite ends of the elastic member and to alleviate the burdens of an operator and a patient by allowing the adapter to be attached and detached even only with a simple operation of pressing the adapter and compressing the elastic member by a hand and promptly and precisely performing an operation of selecting an implant of a suitable size while applying various trials in the total knee arthroplasty process and shortening surgery time, alleviating the burdens of a surgeon and a patient, and wherein one side of the adapter is formed of plastic, making it possible to couple

Abstract: Artificial intervertebral discs include an annulus fibrosus portion and a nucleus pulposus portion. Annulus fibrosus portions disclosed and contemplated herein include a plurality of layers. Fibers within the layers are arranged to provide a crisscross pattern between adjacent layers. Nucleus pulposus portions disclosed and contemplated herein can include a flexible, sealed enclosure.

Abstract: A surgical apparatus configured to be placed in the musculoskeletal system to precisely separate a first bone from a second bone. The surgical apparatus has one or more sensors to measure one or more parameters and supports one or more bone cuts for installing a prosthetic component. The surgical apparatus has at least one distraction mechanism configured to increase or decrease a height between a first support structure and a second support structure. A tilt mechanism comprises the at least one distraction mechanism. The tilt mechanism couples through a first pivot point and a second pivot point and adjusts a tilt of the second support structure relative to the first support structure. In one embodiment, loading applied to the second support structure is distributed between the first pivot point and the second pivot point during operation of the surgical apparatus.