Abstract: An apparatus for facilitating the mounting of a prosthetic articulation surface to a patient tissue includes an anchoring base including a central fastener aperture extending longitudinally therethrough. A first base end is laterally spaced from the central fastener aperture. A second base end is laterally spaced from the first base end with the central fastener aperture laterally interposed therebetween. Both of the first and second base ends include a plate engagement feature. An anchor plate includes a central coupler aperture extending longitudinally therethrough. An outer perimeter is spaced laterally apart from the central coupler aperture. A plate rim extends laterally inward from the outer perimeter to substantially laterally surround the central coupler aperture. At least one plate fastener aperture extends longitudinally through the plate rim. At least one base engagement feature is located on the plate rim and is selectively engageable with the plate engagement feature of the anchoring base.

Abstract: Reciprocating rasps for the surgical preparation of the bone prior to the implantation of a glenoid or acetabular component with complex geometry are disclosed. Surgical methods for the use of such reciprocating rasps are also disclosed. Some of the methods include inserting a guide pin into the glenoid of the patient, advancing a reciprocating surgical rasp over the guide pin, reciprocating the surgical rasp so as to abrade bone tissue to form a cavity shaped to receive the glenoid component, and implanting the glenoid component in the cavity.

Abstract: A manifold has at least one manifold aperture extending therethrough and selectively placed in fluid communication with a fluid source. An insertion structure has at least one interior cavity at least partially defined by a structure shell and is selectively placed in fluid communication with a corresponding manifold aperture. The insertion structure is configured for selective placement in a penetrating relationship with a patient tissue below a surface of the patient tissue. At least one shell perforation extends through the structure shell and places the interior cavity in fluid communication with a surrounding ambient space. At least one fluid path extends from the fluid source, through the manifold aperture, into the interior cavity, through at least one shell perforation, and at least one of a proximate relationship and a contacting relationship with the patient tissue beneath the outer surface thereof. A fluid is directed along the fluid path.

Abstract: An apparatus for transferring location and/or trajectory information from a reference surface to a patient tissue surface for guiding placement of a landmark includes a landmark guiding structure. At least two locating feet are provided, each being laterally spaced from, and indirectly connected to, the landmark guiding structure. A holdaway structure is connected to each locating foot and to the landmark guiding structure. The landmark guiding structure is placed in desired location and/or a desired trajectory with respect to the reference surface. Each locating foot is adjusted into guiding contact with a particular portion of the reference surface. Each locating foot is maintained in the guiding contact position, and the apparatus is placed with each locating foot in guiding contact with a particular portion of the patient tissue surface. A method of transferring location and/or trajectory information from a reference surface to a patient tissue surface is also disclosed.

Abstract: Reciprocating rasps for the surgical preparation of the bone prior to the implantation of a glenoid or acetabular component with complex geometry are disclosed. Surgical methods for the use of such reciprocating rasps are also disclosed. Some of the methods include inserting a guide pin into the glenoid of the patient, advancing a reciprocating surgical rasp over the guide pin, reciprocating the surgical rasp so as to abrade bone tissue to form a cavity shaped to receive the glenoid component, and implanting the glenoid component in the cavity.

Abstract: A method and instrument for preparing a surface of a joint is provided. The glenoid surface is adapted for receiving a prosthetic component having a feature closely conforming to the surface. The prosthetic component provides a bearing surface for a head portion of a long bone. The instrument includes a guide having a first feature and a second feature and a tool. The tool is used for cooperation with the first feature for preparing the surface. The first feature is adapted to at least partially control the position of the tool as it prepares the surface. The second feature is adapted to assist in positioning of the guide with respect to the joint.

Abstract: A method of making a glenoid component for shoulder arthroplasty includes obtaining a model of a glenoid vault morphology normalized from a population of a plurality of scapulae, the model being defined by a plurality of mutually parallel, triangular cross-sections, and producing a stem portion of the glenoid component based on the model.

Abstract: A biocompatible tissue graft includes a first layer of a bioremodelable collageneous material, a second layer of biocompatible synthetic or natural remodelable or substantially remodelable material attached to the first layer; and at least one fiber that is stitched in a reinforcing pattern in the first layer and/or second layer to mitigate tearing and/or improve fixation retention of the graft, and substantially maintain the improved properties while one or more of the layers is remodeling.

Abstract: A method for retraction useable in joint arthroplasty. The method includes using a joint retractor having a first arm and a second arm. The first arm has a first portion and a second portion and the second arm having a first portion and a second portion. The retractor is inserted into a surgical opening of a patient's shoulder joint. The second portion of the first arm is placed against the coracoid process and the second portion of the second arm is placed against the resected humerus. The first portions of the first and second arms are hung over the resected tissue to allow exposure of the glenoid.

Abstract: An apparatus for providing a reference indication to a patient tissue includes a primary locating block having a patient-specific primary mating surface contoured for mating contact with a portion of the patient tissue in a predetermined primary mating orientation custom-configured responsive to preoperative imaging of the patient tissue. At least one mounting feature is provided to the primary locating block. At least one secondary item is configured for selective engagement with the primary locating block. The secondary item is at least one of a noncustomized secondary item and a patient-specific secondary item. The secondary item provides a reference indication to at least a portion of the patient tissue. The mounting feature of the primary locating block is configured for engagement with at least one secondary item in a predetermined secondary mounting relationship. The secondary mounting relationship is custom-configured for the patient tissue responsive to preoperative imaging of the patient tissue.

Abstract: A directed structure placement guide assists with positioning at least one directed structure in at least one of a predetermined insertion trajectory and a predetermined insertion location with respect to a patient tissue surface during preparation of the patient tissue surface to receive an implant. The implant has a tissue-contacting surface. A guide base has a distal base surface mimicking the structure of at least a portion of a tissue-contacting surface of the implant. The guide base also has a proximal base surface longitudinally spaced from the proximal base surface. At least one insertion guiding structure is movably supported by the guide base and is adjustable into a guiding configuration in which at least one of the predetermined insertion trajectory and the predetermined insertion location is selectively imparted to the directed structure.

Abstract: A method of performing arthroplasty includes preparing a head of a long bone to receive a prosthesis using a reamer. The reamer includes a first cutting structure having an inner concave surface that defines a first cavity and terminates in a generally circular leading edge. The inner concave surface includes a first cutting feature that is spaced apart from the leading edge. An elongate member extends from the first cutting structure into the first cavity toward the leading edge that includes a second cutting feature. A second cutting structure is secured to the elongate member and positioned within the first cavity. The second cutting structure extends outwardly from the elongate member toward the inner concave surface and includes a third cutting feature.

Abstract: A positioning apparatus for guiding resection of a patient tissue and guiding placement of a prosthetic implant component in a desired implant position with respect to the resected patient tissue and method of use are described. A locating block includes a mating surface contoured for mating contact with the patient tissue. A cutting plane indicator provides a physical indication of a desired cutting plane for the resection. A placement indicator is spaced apart from the locating block and includes a component-contacting feature. An elongate spacing arm is operative to space the placement indicator apart from the locating block. The spacing arm is configured to place the component-contacting feature of the placement indicator at a predetermined placement position in three-dimensional space relative to the patient tissue. The placement position predetermination is at least partially based upon pre-operative imaging of the patient tissue.

Abstract: An apparatus for providing a reference indication to a patient tissue includes a primary locating block having a patient-specific primary mating surface contoured for mating contact with a portion of the patient tissue in a predetermined primary mating orientation custom-configured responsive to preoperative imaging of the patient tissue. At least one mounting feature is provided to the primary locating block. At least one secondary item is configured for selective engagement with the primary locating block. The secondary item is at least one of a noncustomized secondary item and a patient-specific secondary item. The secondary item provides a reference indication to at least a portion of the patient tissue. The mounting feature of the primary locating block is configured for engagement with at least one secondary item in a predetermined secondary mounting relationship. The secondary mounting relationship is custom-configured for the patient tissue responsive to preoperative imaging of the patient tissue.

Abstract: A reamer for use in performing arthroplasty includes a first cutting structure having an inner concave surface that defines a first cavity and terminates in a generally circular leading edge. The inner concave surface includes a first cutting feature that is spaced apart from the leading edge. An elongate member extends from the first cutting structure into the first cavity toward the leading edge that includes a second cutting feature. A second cutting structure is secured to the elongate member and positioned within the first cavity. The second cutting structure extends outwardly from the elongate member toward the inner concave surface and includes a third cutting feature.

Abstract: A method of installing a prosthesis assembly includes installing a base component in a prepared glenoid vault, axially aligning a plurality of slots in one of a stretched glenoid bearing component and a base component with a plurality of ridges in the other of the glenoid bearing component and the base component, each of the plurality of slots having a maximum length which is greater than a maximum length of a respective one of the plurality of ridges, engaging each of the plurality of ridges with the respective one of the plurality of grooves thereby rotatably coupling the glenoid bearing component and the base component and limiting axial movement of the glenoid bearing component relative to the base component, and placing the bearing surface into articulating contact with a humeral head.

Abstract: An apparatus transfers predetermined spatial positioning information to an adjustable tool. Means are provided for temporarily holding at least a carrier portion of the adjustable tool stationary relative to a manipulable reference surface. Means are provided for imparting predetermined spatial positioning information to the reference surface in a first degree of freedom. Means are provided for imparting predetermined spatial positioning information to the reference surface in a second degree of freedom. The predetermined spatial positioning information is imparted to the reference surface in the first and second degrees of freedom to generate a pre-set reference surface. At least a portion of the adjustable tool is held stationary relative to the pre-set reference surface. At least a functional portion of the adjustable tool is manipulated into a predetermined setting position relative to the reference surface. The predetermined setting position reflects a position of the pre-set reference surface.

Abstract: A positioning apparatus for guiding resection of a patient tissue and guiding placement of a prosthetic implant component in a desired implant position with respect to the resected patient tissue and method of use are described. A locating block includes a mating surface contoured for mating contact with the patient tissue. A cutting plane indicator provides a physical indication of a desired cutting plane for the resection. A placement indicator is spaced apart from the locating block and includes a component-contacting feature. An elongate spacing arm is operative to space the placement indicator apart from the locating block. The spacing arm is configured to place the component-contacting feature of the placement indicator at a predetermined placement position in three-dimensional space relative to the patient tissue. The placement position predetermination is at least partially based upon pre-operative imaging of the patient tissue.

Abstract: A prosthesis assembly configured for use with a scapula in one embodiment includes a spherical humeral component, an elongated glenoid bearing including a first bearing surface with (i) a first spherical end portion with a first radius of curvature, (ii) a second spherical end portion with a second radius of curvature, and (iii) a central portion located between the first spherical end portion and the second spherical end portion, and a first coupling portion extending from a second bearing surface opposite the bearing surface, and a base configured to rotatably support the elongated glenoid bearing, wherein the first radius of curvature is substantially equal to the second radius of curvature and the central portion does not have a radius of curvature that is substantially equal to the second radius of curvature.

Abstract: A method and instrument for preparing a surface of a joint is provided. The glenoid surface is adapted for receiving a prosthetic component having a feature closely conforming to the surface. The prosthetic component provides a bearing surface for a head portion of a long bone. The instrument includes a guide having a first feature and a second feature and a tool. The tool is used for cooperation with the first feature for preparing the surface. The first feature is adapted to at least partially control the position of the tool as it prepares the surface. The second feature is adapted to assist in positioning of the guide with respect to the joint.