Abstract: Apparatus and methods are disclosed for securely, yet releasably, connecting separate parts. A shaft engages a cooperating socket to form a connection capable of sustaining service loads. The shaft has a protruding pin which slides within a slot in the socket to guide the shaft into locked engagement with the socket. The shaft also has a cantilever body which wedges into a tapered region in the socket to frictionally bind the shaft and socket together.

Abstract: Eccentrically shaped bone fixation implants interact with bone fragments or joints to compress the bone fragments or joint bones together. The eccentrically shaped bone fixation implants can have longer and shorter portions along an axis and a plurality of teeth with opposing beveled surfaces in different configurations to vary both the direction and amplitude of the compressive forces applied to the bone fragments or joint bones. Instrumentation for implanting and orienting the eccentrically shaped bone fixation implants are also disclosed herein.

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 tensioner system for use in tensioning graft strands in a knee reconstruction procedure can include a handle assembly, a tensioner assembly coupled relative to the handle assembly, and a drive shaft slidably received through and supported by the handle assembly. The tensioner assembly can include an arm support member rotatably coupled to the handle assembly and first and second arm members each rotatably coupled to lateral sides of the arm support member. Each arm member can include at least one graft attachment area adapted to be coupled to a graft strand. The arm support member can be configured to rotate about an axis perpendicular to a longitudinal axis of the tensioner system and perpendicular to an axis of rotation of each of the arm members. The drive shaft can include proximal and distal ends that extend beyond respective proximal and distal ends of the handle assembly.

Abstract: A spinal stabilization system includes vertebral engagement members and an intermediate structure. The vertebral engagement members are configured to be disposed between a first vertebra and a second vertebra. The vertebral engagement members generally include seating surfaces for accommodating at least a portion of a laminar region of adjacent vertebra and are adjustable between an operable and inoperable configuration. The intermediate structure extends between the vertebral engagement members. The structural cooperation of the vertebral engagement members and the intermediate structure is such that the engagement members distract the adjacent vertebrae.

Abstract: A surgical instrument and method for inserting a spinal implant in the intervertebral disc space between two adjacent vertebrae and an anchor engageable with the implant and an adjacent vertebra are provided. The instrument includes an inserter having an engagement portion including a distal engagement surface for interfacing with the implant and a handle portion. The engagement portion includes a track for slidably translating the anchor toward the engagement surface. A kit is provided including the inserter and a tamp to force the anchor into engagement with the implant and the adjacent vertebra. The kit may also include a cutter for piercing the adjacent vertebra.

Abstract: A soft tissue repair device can include a housing having a handle, a deployment system having an actuation member, and an insertion system having an inserter and a slider. The slider can be coupled to the actuation member and movable relative to the inserter between deployed and retracted positions. First and second anchors can be carried on an external surface of the slider such that the anchors are spaced apart and portions of the anchors are coaxial with the slider and each other. A flexible strand can couple the anchors. The insertion system can cooperate with the deployment system to move the slider to the deployed position to deploy the first anchor upon activating the actuation member a first time, and to move the slider to the deployed position from the retracted position to deploy the second anchor upon actuating the actuation member a second time after the first time.

Abstract: A system for providing dynamic stabilization and balance control at a vertebral motion segment has first and second bridge elements and at least one bias element. The bridge elements anchor to adjacent vertebrae with polyaxially adjustable anchoring members, and the bias elements attach to each bridge element to span between them. Each bias element has two fixation portions and a bias body extending between the fixation portions. Each bias element may comprise an elastically deformable material to provide dynamic stabilization with motion, or may comprise rigid material to provide rigid stabilization, and both bias element types may be included in one system. The bias elements are attachable to the bridge elements at discrete attachment locations, or at non-discrete attachment locations. Alternate embodiments may include three or more bridge elements on adjacent vertebrae, and multiple bias elements. A tensioning tool may provide adjustable tension to an elastically deformable bias element.

Abstract: Total ankle arthroplasty with a tibial plate, a talar plate and a middle or core component. The ankle arthroplasty may allow for varus or valgus accommodation through the use of a core component with various medial and lateral heights in varus and valgus orientations. In addition the resurfacing of the talus is accomplished with a talar plate with a curved orientation that is congruent to one surface of the core component to allow for appropriate ankle manipulation.

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 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/distracter apparatus and method and an anchor remover and method are also provided.

Abstract: Instrumentation for preparation of a bone includes a first guide having a first collet and a second collet. The first and second collets are formed around divergent first and second axes, and share a common opening. A bone preparation instrument may be inserted into each of the collets toward a bone. A second guide may be carried in the first guide, and a bone preparation instrument inserted through the second guide toward the bone, along a third axis.

Abstract: Systems for interbody fusion of adjacent bone portions may include an expanding implant and related instruments. An expanding implant may be formed as a linkage which is movable between a compact configuration and an expanded configuration. A shaft of the implant may increase and decrease in length to move between the compact and expanded configurations, and an implant width perpendicular to the length may be increased in the expanded configuration. The implant width may increase more in a first direction than a second direction opposite the first direction. An inserter instrument may releasably grasp the spacer and transform the implant between the compact and expanded configurations.

Abstract: A prosthetic patellar implant has a posterior articulation surface and an anterior attachment surface. The anterior attachment surface has a medial attachment surface and a lateral attachment surface. The medial and lateral attachment surfaces can be planar and angled relative to one another, meeting at a common intersection medially offset from the sagittal centerline of the implant. The medial and lateral attachment surfaces can include convexities. The anterior attachment surface can have one or more pegs and/or recesses.

Abstract: Systems for joint arthroplasty include prostheses which are secured to bone with sliding anchors. Examples include unicondylar and bicondylar knee prostheses for hemi-arthroplasty and total arthroplasty. Instruments guide the anchors into proper engagement with the prosthetic components. Methods of using the prostheses and instruments are disclosed.

Abstract: A compression and distraction shaft assembly applies compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. An hourglass-shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. Distraction pliers having cylindrical tips are used to apply distraction to vertebrae. Once handles are pressed to impart an appropriate amount of distraction to the vertebrae, they are locked in this position. Compression pliers having cylindrical tips are used to apply compression to vertebrae. Once handles are pressed to impart an appropriate amount of compression to the vertebrae, they are locked in this position.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: Interspinous implants including a spacer configured to fit between first and second adjacent spinous processes of a human spine, to maintain a minimum separation between the spinous processes. An implant also includes a fixation portion coupled to the spacer, in which the fixation portion engages at least one spinous process to hold the spacer in a stable position relative to the spinous process. An implant may be monolithic, non-fillable, and may be inserted between the spinous process from a lateral approach. The fixation portion may be configured as a bracket which can substantially encircle the spinous process, or as flanges which engage lateral sides of the spinous process(es). The spacer may be resilient, and may be expandable along the anterior/posterior direction between the spinous processes. An implant may provide resilient resistance during extension, and/or a uniform extension stop between the spinous processes.

Abstract: The present invention provides a compression and distraction shaft assembly used to apply compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. A hour glass shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. A distraction pliers having cylindrical tips is used to apply distraction to vertebrae. Once handles are pressed to impart appropriate amount of distraction to the vertebrae they are locked in this position. A compression pliers having cylindrical tips is used to apply compression to vertebrae. Once handles are pressed to impart appropriate amount of compression to the vertebrae they are locked in this position.

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.