Abstract: Methods and instrumentation for implantation of an intervertebral disc prosthesis are provided. A guide tool with sagittal and coronal reference features guides placement of guide pins relative to a sagittal plane and a coronal plane of the vertebrae. A retainer lockable to the guide pins has a ratcheting mechanism providing distraction or compression. A rasp, planer or other tools may be aligned to the retainer and inserted into the intervertebral space to prepare the vertebral endplates. An interoperatively adjustable trial is alignable to the retainer and measures an angularity of the intervertebral space. A prosthesis with keying features may be mounted to a prosthesis inserter with complementary features, held by pivotable arms and compressed between prongs. The inserter may be aligned to the retainer and advanced to implant the prosthesis in the intervertebral space. A prosthesis remover may grip one prosthetic end plate and extract the entire prosthesis.

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, a compression limiter to selectively reduce compression in the one-way slide to facilitate adjustment of the line, means for adjusting the line, or a line cutter.

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. A guide member may he first inserted to establish the path between the tissues and fascia, and one or more intermediate cannulas may be temporarily inserted over the guide member to dilate the tissues prior to insertion of the main cannula. An interbody device may be implanted in an intervertebral space through the cannula. The system may include a guide bar removably coupled to a targeting post. The targeting post may be inserted adjacent the spine to provide a target, and the guide bar may be removably attached to the guide member, to guide it along the path to the target location. An external support arm may be secured to any other component of the system.

Abstract: Disclosed herein are systems and methods for filling bone voids which may be present at the time of surgery. The systems disclosed herein generally include a baseplate component, a spacer component, and void filler component. The spacer component is generally assembled to the baseplate component with a taper or press-fit, for example, in one of a plurality of selected axial positions. The void filler component is then generally assembled to the spacer component in one of a plurality of selected axial positions. The void filler component preferably has an outer surface with portions having varying diameters such that the outer surface thereof can be received within a canal of a bone and contact the bone forming the canal at different locations in order to aid in stabilizing the assembled components in the canal.

Abstract: An implantable bone anchor assembly for fixing an elongated member such as a spinal rod may include a bone anchor, a coupling head configured to receive the bone anchor and the elongated member, and a locking mechanism. The locking mechanism may provide compressive force to simultaneously fix the position of the elongated member and lock out polyaxial rotation of the bone anchor relative to the coupling head. The locking mechanism may include an engagement member with an oblique surface configured to slide along an oblique surface of the coupling head into engagement with the elongated member. The bone anchor may comprise a head portion and a threaded portion which may be coupled with the coupling head and joined together during manufacture. The assembly may further include a pin and/or a collar to retain the bone anchor. The bone anchor may be side-loaded into the coupling head.

Abstract: A knee prosthesis including femoral and tibial implants, a tibial insert and a cam post assembly. The femoral implant is secured to a femur and has a cam feature and condyles. The tibial implant is secured to a tibia. The tibial insert has articulating surfaces that match the contours of the condyles of the femoral implant, and may have a medial boss that aligns with the tibial implant to provide rotation about a medially displaced rotation axis. A cam post is secured to the tibial implant and passes through a channel of the tibial insert. A motion limiting structure provides limits to motion between the tibial insert and the tibial baseplate. The cam post assembly interacts with the femoral implant cam feature and allows more anatomically correct rollback and femoral external rotation during knee flexion, and varus/valgus support to the 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. A guide member may be first inserted to establish the path between the tissues and fascia, and one or more intermediate cannulas may be temporarily inserted over the guide member to dilate the tissues prior to insertion of the main cannula. An interbody device may be implanted in an intervertebral space through the cannula. The system may include a guide bar removably coupled to a targeting post. The targeting post may be inserted adjacent the spine to provide a target, and the guide bar may be removably attached to the guide member, to guide it along the path to the target location. An external support arm may be secured to any other component of the system.

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: 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. A guide member may be first inserted to establish the path between the tissues and fascia, and one or more intermediate cannulas may be temporarily inserted over the guide member to dilate the tissues prior to insertion of the main cannula. An interbody device may be implanted in an intervertebral space through the cannula. The system may include a guide bar removably coupled to a targeting post. The targeting post may be inserted adjacent the spine to provide a target, and the guide bar may be removably attached to the guide member, to guide it along the path to the target location. An external support arm may be secured to any other component of the system.

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: An implantable fixation system for fusing a joint between a first bone and a second bone. The system may include an anchor, standoff, bolt, and cortical washer. The system may be implanted across the joint along a single trajectory, the length of the system adjustable to provide compressive force between the anchor and the cortical washer. The system may be implanted across a tibiotalar joint with the anchor positioned in the sinus tarsi. A spacing member may be inserted between the two bones and the fixation system implanted to extend through an opening in the spacing member. The spacing member may be anatomically shaped and/or provide deformity correction. An ankle arthroplasty system may include a tibial plate, a talar plate, and a bearing insert. The plates may be anchored to the tibia and talus along a single trajectory. The ankle arthroplasty system may be revisable to a fusion system.

Abstract: An implantable fixation system for fusing a joint between a first bone and a second bone. The system may include an anchor, standoff, bolt, and cortical washer. The system may be implanted across the joint along a single trajectory, the length of the system adjustable to provide compressive force between the anchor and the cortical washer. The system may be implanted across a tibiotalar joint with the anchor positioned in the sinus tarsi. A spacing member may be inserted between the two bones and the fixation system implanted to extend through an opening in the spacing member. The spacing member may be anatomically shaped and/or provide deformity correction. An ankle arthroplasty system may include a tibial plate, a talar plate, and a bearing insert. The plates may be anchored to the tibia and talus along a single trajectory. The ankle arthroplasty system may be revisable to a fusion system.

Abstract: An implantable fixation system for fusing a joint between a first bone and a second bone. The system may include an anchor, standoff, bolt, and cortical washer. The system may be implanted across the joint along a single trajectory, the length of the system adjustable to provide compressive force between the anchor and the cortical washer. The system may be implanted across a tibiotalar joint with the anchor positioned in the sinus tarsi. A spacing member may be inserted between the two bones and the fixation system implanted to extend through an opening in the spacing member. The spacing member may be anatomically shaped and/or provide deformity correction. An ankle arthroplasty system may include a tibial plate, a talar plate, and a bearing insert. The plates may be anchored to the tibia and talus along a single trajectory. The ankle arthroplasty system may be revisable to a fusion system.

Abstract: Knee prosthesis instrumentation including an insertion tool and a removal tool. The insertion tool may include an offset to provide clearance from a femoral component of the knee prosthesis. The removal tool may be wedge shaped to at least partially encircle a post of the knee prosthesis for removal. A mallet may be used with the instruments to provide additional force for prosthesis insertion or removal. A slide hammer may be incorporated into the instruments themselves.

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: 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 cam feature and condyles. 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. The tibial insert has a medial boss that aligns with the medial cavity allowing it to rotate about the rotational axis. A cam post is secured to the tibial implant and passes through a channel of the tibial insert providing anterior and posterior stops for the rotation of the tibial insert about the rotational axis. The cam post interacts with the femoral implant cam feature and, with the tibial insert, allows more anatomically correct rollback and femoral external rotation during knee flexion.

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: 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 porous PEEK implant system which may provide tissue ingrowth throughout the body of the implant. The implant may comprise a solid or porous PEEK core. The porous PEEK implants may be of general shape and size but provide the structure necessary to carry out the function of the implant. The porous PEEK implant pores may be seeded with agents to encourage tissue ingrowth as well as other agents such as antibiotics, anesthetics, analgesics and the like.