Abstract: A system for spinal surgery includes a prosthesis comprising a plurality of bone anchors which engage an intervertebral construct for fusion or motion preservation. The fusion construct comprises a spacer optionally encircled by a jacket. The motion preservation construct may comprise an articulating disc assembly or an elastomeric disc assembly. Any of the constructs may occupy the intervertebral disc space between adjacent vertebrae after removal of an intervertebral disc. The anchors slidingly engage the construct to securely fix the prosthesis to the vertebrae. The anchors and jacket of the fusion construct provide a continuous load path across opposite sides of the prosthesis so as to resist antagonistic motions of the spine.

Abstract: A surgical rasping and/or shaving system functions in multiple orthopedic applications, including but not limited to shoulder, knee, hip, wrist, ankle, spinal, or other joint procedures. The system may comprise a tissue removal member with a rasping and/or shaving head which may be low profile and offer a flat cutting/rasping/shaving surface, or with a cutting head with at least one cutting edge. The tissue removal member is configured to be driven by an attached hub that translates a rotational movement into a reciprocating motion. Suction for removal of bone fragments or other tissues is provided through an opening spaced apart from or adjacent to the rasping surface. A radiofrequency ablation (RF) electrode may be carried on the system to provide ablation or coagulation of soft tissues.

Abstract: A system for spinal surgery includes a prosthesis comprising a plurality of bone anchors which engage an intervertebral construct for fusion or motion preservation. The fusion construct comprises a spacer optionally encircled by a jacket. The motion preservation construct may comprise an articulating disc assembly or an elastomeric disc assembly. Any of the constructs may occupy the intervertebral disc space between adjacent vertebrae after removal of an intervertebral disc. The anchors slidingly engage the construct to securely fix the prosthesis to the vertebrae. The anchors and jacket of the fusion construct provide a continuous load path across opposite sides of the prosthesis so as to resist antagonistic motions of the spine.

Abstract: A system for spinal surgery includes a prosthesis comprising a plurality of bone anchors which engage an intervertebral construct for fusion or motion preservation. The fusion construct comprises a spacer optionally encircled by a jacket. The motion preservation construct may comprise an articulating disc assembly or an elastomeric disc assembly. Any of the constructs may occupy the intervertebral disc space between adjacent vertebrae after removal of an intervertebral disc. The anchors slidingly engage the construct to securely fix the prosthesis to the vertebrae. The anchors and jacket of the fusion construct provide a continuous load path across opposite sides of the prosthesis so as to resist antagonistic motions of the spine.

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: A prosthesis for the replacement of at least a portion of the bone of a facet located on a mammalian vertebra, comprising: an articulating surface that articulates with another facet; a bone contacting surface that contacts a surface of the vertebra, the articulating surface being connected to the bone contacting surface; and a fixation element that attaches the bone contacting surface to the vertebra, the fixation element being adapted for implantation into an interior bone space of a pedicle of the vertebra; wherein the prosthesis is configured so that no portion of the prosthesis contacts the posterior arch of the vertebra.

Abstract: A surgical instrument and method are provided for removal of a spinal implant from the intervertebral disc space. The instrument includes a carriage body for interfacing with the implant, a housing for interfacing with the vertebrae, and a handle portion having a first portion rotatably coupled with a proximal end of the housing and a second portion rotatably engageable with a proximal attachment portion of the carriage body. A central passage of the housing extends between the proximal end and a distal engagement surface of the housing. The central passage is dimensioned to mate with the carriage body. Rotation of the handle portion about an axis causes translational movement of the carriage body along the axis. A modular inserter/distractor apparatus and method and an anchor remover and method are also provided.

Abstract: An orthopedic apparatus is provided for bridging a first bone unit to a second bone unit. The apparatus is demonstrated on a finger joint, wherein one of the bones and/or ligaments and/or tendons of the joint is/are injured. A method for implanting and using the apparatus also is presented. The apparatus includes a reformably deformable span portion which is generally circular and preferably rhombic. By deforming or reforming the span portion, it can be repositioned laterally, and/or it can be rotated to allow range of rotary motion so as to promote healing.

Abstract: A surgical instrument and method are provided for removal of a spinal implant from the intervertebral disc space. The instrument includes a carriage body for interfacing with the implant, a housing for interfacing with the vertebrae, and a handle portion having a first portion rotatably coupled with a proximal end of the housing and a second portion rotatably engageable with a proximal attachment portion of the carriage body. A central passage of the housing extends between the proximal end and a distal engagement surface of the housing. The central passage is dimensioned to mate with the carriage body. Rotation of the handle portion about an axis causes translational movement of the carriage body along the axis. A modular inserter/distractor apparatus and method and an anchor remover and method are also provided.

Abstract: Arthroplasty components include an articular surface and a bone-facing surface. The bone-facing surface bears at least one anchoring element adapted for an oblique implantation trajectory. The articular surface includes a larger radius of curvature in the superior-inferior direction than in the anterior-posterior direction. An inferior chamfer may be present on the articular surface. Instruments and implantation methods are also disclosed. Reamers include reamer heads coupled to various offset shaft configurations.

Abstract: A knee prosthesis including a femoral implant, a tibial implant, a tibial insert and a cam post. The femoral implant is secured to a femur and has a gap for receiving a natural PCL. The tibial implant is secured to a tibia. The tibial insert comprises a medial cavity with a rotational axis. The tibial insert has articulating surfaces that match the contours of the condyles of the femoral implant and a notch for retaining the natural PCL. The tibial insert has a medial boss that aligns with the medial cavity allowing it to rotate about the rotational axis. A post is secured to the tibial implant and enters a hole of the tibial insert providing anterior and posterior stops for the rotation of the tibial insert about the rotational axis.

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 apparatus for inserting a suture anchor into an internal anatomical site through a cannula, or percutaneously, has a curved hollow guide for insertion into the cannula and/or tissue. The guide has a proximal end and a distal end. The distal end has a “parabolic” shape for engaging the intended anatomical site such as a glenoid. A flexible obturator is insertable through the curved guide from the proximal end to the distal end to facilitate insertion of the guide through the cannula. A flexible drill is insertable through the curved guide from the proximal to the distal end once the guide is in place. A flexible inserter is provided for inserting a suture anchor into a bore at the anatomical site formed by the flexible drill.

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: A line lock system may include a line routed through a plate. The plate may have an elongated body with a plurality of passageways. The line is routed to form at least one one-way slide so no knots are required. The system may include filaments routed through the passageways of the plate or around a dogbone feature of the plate. The filaments may be used to toggle the plate after passage through a hole to prevent withdrawal of the plate back through the hole. The system may include a line lock stabilizer or counter-tension tool to stabilize the line lock as the line is adjusted. The system may include a compression limiter to selectively reduce compression in the one-way slide to facilitate adjustment of the line. The line lock stabilizer, counter-tension tool, or compression limiter may be a filament.

Abstract: A guide template for use in resurfacing a portion of a bone includes a body adapted for positioning over a natural or resected articulation surface of the bone. The body has a top surface and an opposing bottom surface that each extend between a proximal end and an opposing distal end. The body at least partially bounds an opening extending between the top surface and the bottom surface. At least a portion of the top surface or the bottom surface has a convex curvature or a concave curvature that extends between the proximal end and the opposing distal end. At least three spaced apart supports project below the bottom surface of the body such that the body can be supported by the supports. Fasteners are provided for securing the body to the bone.

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: Arthroplasty components include an articular surface and a bone-facing surface. The bone-facing surface includes a concave arrangement of planar surfaces which converge as they approach a middle portion of the articular surface. Instruments and implantation methods are also disclosed.

Abstract: A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.

Abstract: A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.