Abstract: A milling system for use in resecting at least a portion of a joint articulation surface of a bone includes an alignment guide having a top surface and an opposing bottom surface with an opening extending therebetween. Fasteners are used to secure the alignment guide to the bone so that the alignment guide is suspended above the bone. A template is removably mounted to the alignment guide so that a plurality of guide paths extending through the template are aligned with the opening in the alignment guide. A mill extends down through the guide path and has a burr on the end thereof for resecting the bone.

Abstract: The present invention comprises a set of instruments and a method for their use in preparing a knee joint to receive knee implants. The inventive instruments and method are generally suitable for knee joint surgery. Furthermore, they include features that make them suitable for performing a minimally invasive knee surgery in which a smaller than normal incision is made and oriented to preserve the quadriceps mechanism and protect the suprapatellar pouch. The instruments permit switching from a minimally invasive technique to a standard open technique at any point in the procedure. An illustrative set of instruments for total knee arthroplasty and an associated minimally invasive technique are described.

Abstract: A milling system for use in resecting at least a portion of a joint articulation surface of a bone includes a template having a base with a top surface, an opposing bottom surface, and an opening extending therebetween. One or more fasteners are used to removably mount the template on a bone. A guide is movably mounted on the template and projecting across at least a portion of the opening of the template. The guide is selectively movable across at least a portion of the opening of the template. A rotatable mill is mounted on the guide. The mill is selectively movable along at least a portion of the length of the guide.

Abstract: A femoral knee prosthesis system for resurfacing a resected articular surface at the distal end of a femur includes a femoral component adapted to mate with the resected articular surface; and an attachment member. The interior surface of the femoral component is configured to connect to the first attachment member when the femoral component is mated on the resected articular surface of the femur and when the first attachment member is passed through the medial side or the lateral side of the resected articular surface. The femoral component is available in one-piece and two-piece systems. Mating femoral components (e.g., tapered or with lips that interlock with grooves) are also disclosed.

Abstract: A revisable intervertebral implant may include two end plates designed to detachably receive a variety of intermediate components including articulating bearing inserts, elastic inserts, and fusion blocks. Each intermediate component may be secured to a snap insert that snaps into engagement with the corresponding end plate in response to pressure urging the intermediate component toward the end plate along a cephalad-caudal direction. The end plates may first be secured to the corresponding vertebral bodies, and then the intermediate component(s) may be snapped into locking engagement with the implanted end plates to complete in-situ assembly of the intervertebral implant. The implant may easily be revised by snapping the intermediate component(s) out of engagement with the end plates, removing the intermediate component(s), inserting the new intermediate component(s) into the space between the end plates, and snapping the new intermediate component(s) into engagement with the end plates.

Abstract: A method is provided for depositing a hard wear resistant surface onto a porous or non-porous base material of a medical implant. The wear resistant surface of the medical implant device may be formed by a Laser Based Metal Deposition (LBMD) method such as Laser Engineered Net Shaping (LENS). The wear resistant surface may include a blend of multiple different biocompatible materials. Further, functionally graded layers of biocompatible materials may be used to form the wear resistant surface. Usage of a porous material for the base may promote bone ingrowth to allow the implant to fuse strongly with the bone of a host patient. The hard wear resistant surface provides device longevity, particularly when applied to bearing surfaces such as artificial joint bearing surfaces or a dental implant bearing surfaces.

Abstract: Accessing a spine from a curved postero-lateral approach may include a curved cannula positioned along a curved path from an opening in the skin to a location proximate to the spine. Positioning of the distal end of a radiolucent curved access cannula may be assisted by use of one or more radio-opaque markers. Markers may be positioned to form a cross hair image in fluoroscopy to assist in cannula placement. Radio-opaque inserts placed in and extended beyond the curved access cannula may have radiolucent windows to allow viewing of the cannula's radio-opaque markers. An appropriately placed curved access cannula may be clamped to prevent subsequent movement. Appropriate tools may be introduced through the curved access cannula and the distal radio-opaque tool heads may be viewed relative to the radio-opaque markers. The curved access cannula may be attached to the spine through one or more screws.

Abstract: A system for open or arthroscopic surgical repair of torn or damaged meniscal tissue has a repair member and an instrument. The repair member is a suture, flexible or rigid implant. The instrument has at a portion that is shaped to slide within a meniscal capsular tunnel. The meniscal capsular tunnel is an opening in the knee soft tissue passing from the anterior side of the knee adjacent to the mensical tissue to the posterior side of the knee in both the medial and lateral directions. The instrument interacts with the repair member to either insert it into the meniscus from the posterior side, or to facilitate securing of the repair member so that the repair member holds the meniscal tissue together on either side of a meniscal tear to foster healing of the damaged tissue.

Abstract: A method of depositing a hard wear resistant surface onto a porous or non-porous base material of a medical implant. The medical implant device formed by a Laser Based Metal Deposition (LBMD) method. The porous material of the base promotes bone ingrowth allowing the implant to fuse strongly with the bone of a host patient. The hard wear resistant surface provides device longevity when applied to bearing surfaces such as artificial joint bearing surface or a dental implant bearing surface.

Abstract: A revisable intervertebral implant may include two end plates designed to detachably receive a variety of intermediate components including articulating bearing inserts, elastic inserts, and fusion blocks. Each intermediate component may be secured to a snap insert that snaps into engagement with the corresponding end plate in response to pressure urging the intermediate component toward the end plate along a cephalad-caudal direction. The end plates may first be secured to the corresponding vertebral bodies, and then the intermediate component(s) may be snapped into locking engagement with the implanted end plates to complete in-situ assembly of the intervertebral implant. The implant may easily be revised by snapping the intermediate component(s) out of engagement with the end plates, removing the intermediate component(s), inserting the new intermediate component(s) into the space between the end plates, and snapping the new intermediate component(s) into engagement with the end plates.

Abstract: A femoral knee prosthesis system for resurfacing a resected articular surface at the distal end of a femur includes a femoral component adapted to mate with the resected articular surface; and an attachment member. The interior surface of the femoral component is configured to connect to the first attachment member when the femoral component is mated on the resected articular surface of the femur and when the first attachment member is passed through the medial side or the lateral side of the resected articular surface. The femoral component is available in one-piece and two-piece systems. Mating femoral components (e.g., tapered or with lips that interlock with grooves) are also disclosed.

Abstract: A system for open or arthroscopic surgical repair of torn or damaged meniscal tissue has a repair member and an instrument. The repair member is a suture, flexible or rigid implant. The instrument has at a portion that is shaped to slide within a meniscal capsular tunnel. The meniscal capsular tunnel is an opening in the knee soft tissue passing from the anterior side of the knee adjacent to the mensical tissue to the posterior side of the knee in both the medial and lateral directions. The instrument interacts with the repair member to either insert it into the meniscus from the posterior side, or to facilitate securing of the repair member so that the repair member holds the meniscal tissue together on either side of a meniscal tear to foster healing of the damaged tissue.

Abstract: Superior and/or inferior facets of one or more facet joints may be replaced by superior and/or inferior facet joint prostheses. In one embodiment, a kit of superior or inferior prostheses is provided, in which the prostheses have at least two dimensions that vary among members of the kit independently of each other. Each prosthesis may have a bone engaging surface having a surface that is polyaxially rotatable against a corresponding resection of a vertebra. Each prosthesis may also have an articulating surface shaped such that, after attachment to the spine, the replaced or partially replaced facet joints provide a larger medial-lateral range of motion when the spine is flexed than when the spine is extended. Crosslinks may be used to connect left and right prosthesis together in such a manner that they are stabilized in a position in which they are seated directly against the vertebra.

Abstract: An implantable segmented intramedullary structure adapted to be received in the intramedullary canal of a bone configurable between a relatively flexible, bent configuration for implantation or extraction and a relatively rigid, straightened configuration for bone treatment. The segmented intramedullary structure comprises a plurality of interconnected segments with a first interface and a complementarily-shaped second interface such that the first interface of a segment cooperatively engages the second interface of an adjacent segment. The segments define a channel for a tensioning member to lock the structure in a compressed configuration.

Abstract: Methods of manufacturing, assembling, or treating a patient with an implantable segmented intramedullary structure adapted to be received in the intramedullary canal of a bone configurable between a relatively flexible, bent configuration for implantation or extraction and a relatively rigid, straightened configuration for bone treatment. The segmented intramedullary structure comprises a plurality of interconnected segments with a first interface and a complementarily-shaped second interface such that the first interface of a segment cooperatively engages the second interface of an adjacent segment. The segments define a channel for a tensioning member to lock the structure in a compressed configuration.

Abstract: Implants and methods are presented for surgically repairing a hip joint with a proximal femoral prosthesis that comprises femoral head component and a femoral stem component. The femoral stem component comprises a neck portion, a flange portion, a transitional body region and an elongated stem. The femur is prepared for implantation of the femoral hip prosthesis by resecting the proximal femur and reaming a symmetric intramedullary cavity in the femur. The femoral hip prosthesis is then inserted the on the resected femur and in the intramedullary cavity. The femoral hip prosthesis elastically deforms when loaded during use to apply dynamic compressive loads and displacement to the calcar region of the resected proximal femur.

Abstract: A system for accessing a spine from a curved postero-lateral approach may include a curved cannula positioned along a curved path from an opening in the skin to a location proximate the spine. The location may be at the L4-L5 vertebral level, and the curved path may lie in a plane oblique to the transverse, coronal and sagittal planes of the spine, and avoid the iliac crest. A targeting post may be inserted adjacent the spine to determine the location, and a guide member may be inserted to establish the curved path. A micrometer assembly may adjust a cephalad-caudal displacement between the post and the guide member. One or more intermediate cannulas may be inserted over the guide member to dilate tissues prior to insertion of the main cannula. An interbody device may be implanted into an intervertebral space through the cannula.

Abstract: A modular implantable segmented intramedullary structure adapted to be received in the intramedullary canal of a bone configurable between a relatively flexible, bent configuration for implantation or extraction and a relatively rigid, straightened configuration for bone treatment. The segmented intramedullary structure comprises a plurality of interconnected segments with a first interface and a complementarily-shaped second interface such that the first interface of a segment cooperatively engages the second interface of an adjacent segment. The segments define a channel for a tensioning member to lock the structure in a compressed configuration.

Abstract: A guide assembly for forming a tunnel through a proximal end of a tibia includes a brace having a first end and an opposing second end. A template is mounted on the first end of the brace. The template is adapted to rest on a lateral or medial facet at a proximal end of the tibia. A tubular guide sleeve has a proximal end and an opposing distal end. The tubular guide sleeve is adjustably mounted on the second end of the brace such that when the template is disposed on the lateral or medial facet of the tibia, the distal end of the tubular guide sleeve can be selectively biased against a lateral, medial, or anterior side of a proximal end of the tibia.

Abstract: A screw, driving device, and method are provided for repairing a tissue injury of a patient, such as a meniscal tear in a knee or osteochondritis dissecans. The screw has a root, a distal section having a narrowing cross section toward the distal end, and a thread along at least a portion of the root between the proximal end and the distal end. Along a leading section extending from the distal end, the helical pitch is substantially constant; along a trailing section between the leading section and the root's proximal end, the helical pitch decreases. The substantially constant pitch along the leading section assists in preventing a stripping of the helical section. At the proximal end is a head having a diameter greater than a major root diameter of the central section. The head is for improving the tissue retention characteristics of the screw.