Abstract: A surgical tool device for effecting implantation of an implant such as an acetabular cup during a hip replacement surgery is described. The surgical tool holder has a strike plate, a body, a proximal fixed handle, a distal rotate handle, an insert handle with threads, an impactor head, a shaft, the shaft pin, a shaft ring, and a spring. In use, when a surgical implant device is threaded onto the shaft, the surgeon merely rotates the assembly comprising the distal rotate handle and the insert handle with threads in one direction, which causes a distal threaded area of the shaft to rotate in a second, opposite direction to act as a lock-nut for the surgical implant. This movement simultaneously pulls the shaft toward the surgical tool holder proximal end. The pulling motion ensures the surgical implant device is positioned against the impactor head's contacting surface to provide a rigid assembly for good tactile feel during the implantation of the cup.

Abstract: A method and apparatus of performing a procedure relative to the glenohumeral joint. Resection of the glenoid and/or the humerus can proceed through an incision formed near the glenohumeral joint. The incision can be formed generally near a superior-lateral portion near the glenohumeral joint and allow less invasive access to the glenohumeral joint and the portions that form the glenohumeral joint. The procedure can be performed with no or little detaching of the subscapularis, and with no or little dislocating of the glenohumeral joint.

Abstract: An orthopedic device for correcting a femoral bone abnormality includes a patient-specific three-dimensional shell and a patient-specific guiding feature. The shell has an outer surface and an inner bone engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to and substantially cover a femoral head of a patient in only one position. The guiding feature is pre-operatively planned relative to the shell such that when the shell is fitted over the femoral head, the guiding feature can guide a removal tool for removing an abnormality portion of the proximal femur of the patient.

Abstract: A tissue retractor device suitable for spinal surgery. The device includes base apparatus to which three blades are circumferentially hinged, the blades closing upon each other in default position from spring bias. A pusher mechanism is threadably connected to the base which spreads the blades by rotating the pusher in its threads relative to the base, which converts rotational motion to translational motion to angular motion of the blades about their respective hinges. One blade is longer than the others to present a multipurpose tip to the user of the device, such a tip being useful in avoiding nerve roots or other anatomy obstructing the surgical path. A dilator is threadably connected to the pusher, the dilator having a long hollow tube connected to a hollow tip extending beyond the blades to slide over guide-wire and initially position the device at the operative site, prior to using the pusher to retract patient's tissue.

Abstract: A guidewire for use with an implant delivery system in delivering a sheet-like implant is disclosed. The guidewire can include a distal tissue fixation member for releasable connection to a first location proximate a treatment site. An implant delivery system can include a distal guidewire port for receiving the proximal end of the guidewire. The implant delivery system is tracked over the guidewire to a selected position defined by the guidewire attachment. The tissue fixation member includes means for temporarily or reversibly fixing the distal end of the guidewire to tissue, such as bone. The means for affixing can include a K-wire, a screw, a pin or other fixation member.

Abstract: Instrumentation for an open or arthroscopic Latarjet procedure that allows more control graft handling during the formation of the hole and proper positioning parallel to the articulating bone surface. The surgical instrumentation of the present invention includes an osteotome with a plurality of markings and a depth stop, a drill guide with jaws configured to securely engage an outer surface of the graft, and an offset guide to position the graft to the bone.

Abstract: Silver and/or zinc ion releasing implants, systems and method of operating, inserting and activating/inactivating them are described. In some variations the implant is configured as a bone implant that includes a bone-screw or intramedullary rod like body configured to receive a treatment cartridge having a plurality of ion-releasing members configured as an anode that can controllably engage with a catheter to turn galvanic release of ions on/off as desired. These devices may be configured to release silver ions (and/or zinc ions) above a predetermined level for a predetermined period of time and may maintain a concentration of ions over a relatively large volume of tissue. The ion-releasing members may be configured to reduce or prevent implant movement.

Abstract: An apparatus includes: a member configured to be received within an intramedullary canal, the member having an opening therethrough; a flexible elongate element sized to extend through the opening; a section having a first bone-engaging surface and a coupling structure for fixedly securing the section to the elongate element; and a further section having a bone-engaging surface and a coupling structure for fixedly securing the further section to the elongate element. In another form, an apparatus includes a first section having spaced first and second surface portions to engage a bone and a second section configured to extend into a bone. The first surface portion exerts a first force in a direction that is at an angle with respect to a force exerted by the second surface portion. Yet another form involves methods of using each apparatus.

Abstract: A system for replacing a natural nuclear disc in an intervertebral space has a spinal device configured for placement in the intervertebral space. An insertion tool is configured for holding the spinal device while the spinal device is inserted into the intervertebral space. A gripping member of the insertion tool has an end for adjustably holding the spinal device within the intervertebral space. A steering actuator of the insertion tool is operably connected to the spinal device and configured for pivoting the adjustably held spinal device within the intervertebral space while the steering actuator is controlled remotely from the intervertebral space.

Abstract: A spinal plate system that maintains intervertebral spacing and spinal stability is provided. One embodiment includes a spacer for establishing an initial condition of an adjustable spinal device. The spacer includes a first coupling portion configured to couple selectively with a first segment of the adjustable spinal device, a second coupling portion configured to couple selectively with a second segment of the adjustable spinal device, and a spacer body extending between the first coupling portion and the second coupling portion. The spacer prevents movement of the first segment of the spinal device relative to the second segment when the first coupling portion is coupled selectively with the first segment and the second coupling portion is coupled selectively with the second segment.

Abstract: An instrument for establishing orientation of a pelvic prosthesis comprises a tripod having an angularly adjustable guide rod on it. The tips of the legs define a plane, and the guide rod is set by the surgeon to a defined orientation with respect to this plane on the basis of preoperative studies. In use, two of the legs of the instrument are positioned by the surgeon at defined anatomical locations on the pelvis (e.g., a point in the region of the posterior/inferior acetabulum and a point on the anterior superior iliac spine). The third leg then lands on the pelvis at a point determined by the position of the first two points, as well as by the separations between the third leg and the other two legs. The position of the guide rod then defines with respect to the actual pelvis the direction for insertion of a prosthesis.

Abstract: A bone screw assembly includes an anchor portion and a head portion, such as a rod-receiving portion, movably mounted to the anchor portion to allow for controlled angulation between the anchor portion and the head portion. The anchor portion is pivotable in one or more selected directions about an axis relative to the head portion. A restriction member, which may be a rod seat, prevents the anchor portion from pivoting in one or more different directions about another axis relative to the head portion and/or a spinal fixation element received in the head portion. The restriction member may be inserted in the head portion to control direction that the anchor portion pivots relative to the head portion. The restriction member may also serve as a compression member and/or rod seat for seating a spinal rod coupled to the bone screw assembly.

Abstract: The present invention relates to a surgical K-wire for guiding a bone screw comprising a longitudinal channel, which said K-wire comprises a proximal and a distal end, wherein a closure element for closing-off the distal end outlet opening of the longitudinal channel of the bone screw is arranged or formed at the distal end. Furthermore, an improved surgical screw system is proposed comprising a bone screw and such a surgical K-wire.

Abstract: A screw back-out prevention mechanism for a bone fixation system is provided. The mechanism, when engaged, either locks or retains the screws of the bone fixation system in place thereby preventing the screws of the bone fixation system from backing out of the bone, and in turn reducing the risk of device separation or failure in the bone fixation system.

Abstract: An orientation guide comprising a housing arranged to couple to a surgical instrument. In one embodiment the orientation guide further comprises first and second indicators (22, 26). The first indicator (22) is pivotally coupled to the housing (20) such that the first indicator (22) can rotate relative to the housing (20) about a first axis (24) to maintain its angular position about the first axis (24) relative to a vertical axis irrespective of movement of the housing (20). The second indicator (26) surrounds the first indicator (22) and is pivotally coupled to the housing (20) such that the second indicator (26) can rotate relative to the housing (20) about a second axis (32) orthogonal to the first axis (24) to maintain its angular position about the second axis (32) relative to the vertical axis irrespective of movement of the housing (20).

Abstract: Surgical instrumentation for use in placing an implant into a disc space between a pair of spinal vertebrae may include: (a) a distractor having a distal end that may be placed into the disc space between the pair of spinal vertebrae; (b) an inserter for use in moving the implant toward the disc space between the pair of spinal vertebrae; and, (c) a distractor/inserter rail/groove interconnection that interconnects the distractor and the inserter for relative movement thereby.

Abstract: A cutting guide instrument for use in a cutting step in an orthopedic surgical procedure comprises a reference component comprising a first element which can be attached or otherwise aligned relative to the bone in a predetermined arrangement and a locator arm. The invention further comprises a cutting block comprising a reference surface which can be engaged by a cutting tool to define the location and orientation of the tool during the cutting step. The cutting block further comprises at least one fixation bore for receiving a fixation pin to fix the cutting block to the bone. The locator arm can be fitted against the reference surface so that the reference component and cutting block are arranged in a predetermined manner.

Abstract: A surgical instrument includes a needle extending between a proximal end and a distal end. The needle defines a longitudinal axis. The needle includes an elongated cavity that defines an opening disposed proximal to the distal end. A wire extends between a proximal end and a distal end configured for fixation with tissue. The wire is configured for movable disposal within the cavity. The distal end of the wire includes a retainer configured to prevent advancement of the retainer within the tissue. Methods of use are disclosed.

Abstract: Methods and apparatus for surgical treatment of vertebrae, comprising a brush-like tamp component for addressing cancellous bone and a slider component that may be distally advanced over the brush-like tamp component while both are (preferably) aligned within a working cannula providing access to a drill channel within the vertebrae. Distal advancement of the slider creates a combination of it and the brush-like component. A handle provides mechanical advantage.

Abstract: An installation tool that is useful for the efficient and effective placement of an article, such as an artificial disc, between adjacent vertebral bodies is provided. The installation tool can be provided as a kit having modular components which allow the surgeon to select from among a variety of components to assemble an installation tool that is optimized for its intended use. The installation tool of the invention generally includes a pair of opposed levers, each of which has a proximal handle portion and a distal portion. A fulcrum is disposed between the two levers to enable proper operation of the tool. The tool further includes a pusher block that is positioned between the two levers and is selectively movable between an initial location distal of the fulcrum and a final location adjacent the distal end of the levers. The pusher block includes a proximal end, a distal end, and a bore extending at least partially therethrough.