Abstract: An implantable externally driven fluid delivery system for localized delivery of medical agents and drugs, such as antibiotics, may be provided herein. The fluid delivery system includes a housing that incorporates a filling septum connected to a flexible internal reservoir. The reservoir is connected to a miniature diaphragm pump with coupled magnetic components. The entire fluid delivery system is implantable into a body cavity or surgically formed location that provides for local medical agent delivery. The reservoir is filled via percutaneous injection through the skin into the septum. Fluid delivery is achieved through proximity of the external controller that generates an oscillating or reversing magnetic field suitable to actuate the pump's diaphragm resulting in controlled fluid flow. Once local drug delivery treatment is complete, the controller can be discarded.

Abstract: Femoral and/or tibial knee implant component includes a body and an elongate stem. The stem, at least for a substantial portion, has a polygonal shape when taken in cross-section generally perpendicular to its length. Modularity can be provided.

Abstract: Implant with multi-directional pivoting has a first component including a first articular surface and a fore-to-aft and side-to-side rotation device; and a second component including a second articular surface for mating with the first articular surface and a rotation device receptacle. The first component can be mated to the second component through cooperation of the rotation device and the rotation device receptacle, and the first component can cooperate with the second component in contact of the first and second articular surfaces and in articulation of the joint when the first component is mated to the second component. The implant can be an artificial joint which generally has natural load transfer capability. In a particular embodiment, the joint is a knee prosthesis; therein, the first and second components are femoral and tibial components, with the first articular surface a femoral condylar surface and the second articular surface a tibial condylar mating surface.

Abstract: Implant with multi-directional pivoting has a first component including a first articular surface and a fore-to-aft and side-to-side rotation device; and a second component including a second articular surface for mating with the first surface and a rotation device receptacle. The first component can be mated to the second through cooperation of the rotation device and receptacle, and the first component can cooperate with the second in articular surface contact. The joint may be a knee prosthesis comprising first femoral and second tibial components, with the first surface a femoral condylar surface and the second surface a tibial condylar surface. Therein, the fore-to-aft component can be considered flexion, with the side-to-side component considered version. A knee prosthesis can also be provided with a patella support on a smooth counter surface from full extension to flexion well past 100 degrees and/or with a mechanism preventing excessive downward tibial component travel.

Abstract: Ceramic surface can be coated with a metal or metal alloy and have extraordinary holding power between the surface and coating. For example, MgTTZ can be coated with CPT and may have a static shear strength for the coated surface of at least about 2,000 or 3,000 or 5,000 or 7,000 pounds or greater. The coated ceramic may be a prosthetic surgical load bearing implant.

Abstract: A hip positioner for hip surgery (e.g., total hip arthroplasty surgery) is disclosed in which the patient is in a lateral position with the hip upon which surgery is to be performed facing upwardly. The patient lies on a support board having a plurality of holes therein with pins inserted in selected ones of these holes so as to prevent the patient from rolling on to the patient's back. A stanchion is inserted in at least one of the holes on the front of the patient at or above the level of the patient's hips and a support arm extends horizontally from the stanchion toward the upper hip. A pad is carried on the distal portion of the support arm for positive engagement with a desired anatomical feature of the patient (preferably the crest of ilium of the patient's upper hip) thereby to hold the patient in such desired lateral position during surgery.

Abstract: A total joint arthroplasty is described having a first bearing member (e.g., the femoral head of the femoral component of a total arthroplasty hip joint) and a second bearing member (e.g., an acetabular component) cooperable with the first bearing member with the articulating surfaces of the bearing members in engagement with one another, and wherein at least one of the bearing members has a substrate of a magnesia-stabilized zirconia ceramic material and a bearing surface having a carbon coating applied to the bearing surface.

Abstract: Apparatus and method for determining the kinematics of a large joint (e.g., a knee) undergoing arthroplasty, for comparing the kinematics of the joint undergoing surgery with the kinematics of the normal joint, and for providing the surgeon with information allowing the balancing of the ligaments of the joint upon the installation of a prosthesis replacement joint. The apparatus includes optical targets mounted on joint replacement components fitted to the resected bones of the joint. One or more video cameras are used to obtain a series of images of the various optical targets as the extremity is flexed, extended, and rotated. A computer is responsive to the images of the targets to determine the kinematics of the joint as it is flexed, extended and rotated.

Abstract: An orthopedic component for total joint replacement that comprises a metal tray (3) and polymer liner (27), the metal tray having screw holes (7a, 7b) for fixation with screws (9) to bone and a circumferential rim or wall (15) with a smooth inner surface (21). The liner (27) is provided with a flexible sealing ridge (39) around its entire periphery, the sealing ridge being positioned so that it sealingly engages the tray rim so as to form a fluid-tight seal between the liner and the tray. The liner is provided with a locking mechanism comprised of tabs at the longitudinal ends of the liner which engage grooves in the front and rear of the tray.

Abstract: An orthopedic component for total joint replacement that comprises a metal tray (3) and polymer liner (27), the metal tray having screw holes (7a, 7b) for fixation with screws (9) to bone and a circumferential rim or wall (15) with a smooth inner surface (21). The liner (27) is provided with a flexible sealing ridge (39) around its entire periphery, the sealing ridge being positioned so that it sealingly engages the tray rim so as to form a fluid-tight seal between the liner and the tray. The liner is provided with a locking mechanism comprised of tabs at the longitudinal ends of the liner which engage grooves in the front and rear of the tray.

Abstract: A surgical cable system is provided which includes a surgical cable and a passer for passing the cable around a bone to which the cable is to be secured. The cable includes a main cable having a lead cable attached to one end of the main cable and a fastener preattached to the first end of the main cable. The lead cable has an enlargement (a bead) affixed to its free end. The passer includes a curved probe and a recess or cavity is provided in the probe near its tip and a slot extends from the cavity to the tip of the probe. The cavity is sized to accept the enlargement of the lead cable and the slot is sized to receive the lead cable so that as the probe is withdrawn (pulled) from under the bone, the lead cable and the main cable are pulled under the bone so as to minimize the space required to pass the cable. The lead cable and a portion of the main cable may then be inserted in the fastener.

Abstract: A posterior stabilized femoral trial apparatus for preparing a patient's femur to receive a posterior stabilized femoral prosthesis includes a trial body with proximal and distal portions, the distal portion having an articulating surface for articulating with a patient's tibial component. A module fits the trial body at the proximal surface, the module being selected from a kit or group of modules of differing sizes and shapes. The module includes a rasping surface that extends longitudinally. The trial body includes cutting surfaces at the posterior condyles. The module is removably attachable to the trial body at the proximal surface. During use, the apparatus of the present invention enables the surgeon to resect the patient's femur in a revision surgical case using the trial itself and more particularly the rasping surface and cutting surface thereon.

Abstract: The method of implanting a femoral and a tibial knee prosthesis and instruments for surgically implanting the femoral and tibial prosthesis component as disclosed. The method includes the formation of a plurality of surgical cuts on the patient's distal femur. A trial tibial prosthesis is then fitted to the surgically prepared distal femur. The trial prosthesis has a femoral articulating surface and a non-articulating surface that fits the patient's distal femur at the surgical cuts. A surgeon then forms a transverse cut on the patient's proximal tibia. The surgeon places a tibial trial prosthesis on the patient's proximal tibia, the trial prosthesis including a tibial trial stem that fits the patient's intramedullary canal, a tibial trial metallic tray or plate, and a plastic trial insert that fits the tibial tray or plate. The plastic insert includes a tibial articulating surface that can articulate with the femoral articulating surface.

Abstract: A bone cable strap and surgical instruments pass the cable strap around a bone, tension it, fasten it and trim the excess cable. The surgical instruments include: a cable passer which has an arcuate guiding member having a groove facing the bone to guide the cable around the bone; a cable tensioner having concentric tubular members with a cable clamp at one end, a nipple at the other end, and a handle in between such that turning the handle spreads the cable clamp away from the nipple; and a combination cable crimper-cutter having jaws with both crimping and cutting edges. The cable strap is comprised of a flexible cable having a ferrule pre-affixed to one end. The cable is passed under the bone using the cable passer. The free end of the cable is passed through the ferrule and the cable tensioner is used to draw the cable tight around the bone. The crimper-cutter is then used to fasten the ferrule in place about the cable and trim the excess cable.

Abstract: An acetabular component for a hip replacement system comprises an acetabular shell, and a liner having a seal for insertion into the acetabular shell. In the preferred embodiment, the shell has a smooth tapered surface in its peripheral inner surface, and the liner has several annular ridges protruding from its outer surface. Upon insertion of the liner into the shell, the annular ridges of the liner come into sealing engagement with the smooth tapered surface of the shell. This sealing engagement substantially prevents a migration of debris along an interface of the liner with the shell. The liner is provided with several peripheral tabs for interference fit with several peripheral notches in the shell. An interlock comprising another liner ridge and a shell groove, provide a positive engagement to hold the liner in the shell as it bottoms therein.

Abstract: A prosthesis component for implantation into a bone canal has a tapered diaphyseal segment with one or more ridges, the ridges arranged coaxially from the distal to the proximal end of the diaphyseal segment of the component. Each ridge has a sharp longitudinal edge and at least one transverse sharp leading edge which forms a step that cuts into bone adjacent to the bone canal during implantation. The amount of taper of the outer dimensions of the ridges is controlled by the number and size of the steps and corresponds to an amount of taper of a bone canal into which the component is to be implanted. The outer edges of the ridges are parallel to the central longitudinal axis of the prosthesis component or divergent from this axis no more than 3.degree. from distal to proximal. In one embodiment the cross-sectional shape of the component is generally rectangular and in another, the cross-sectional shape is generally cylindrical.

Abstract: A trial femoral prosthesis for use in knee joint replacement surgery includes a trial prosthesis body that is generally J-shaped. The prosthesis body provides a distal articulating surface and a proximal non-articulating surface. The articulating surface includes medial and lateral condylar portions, a distal portion, and an anterior portion. An elongated stem extends from the distal non-articulating surface for anchoring the trial prosthesis to the intramedullary canal of the patient's femur. Wedge trial insert members are connectable to the trial prosthesis body at the non-articulating surface. The inserts can be of different shape and different thicknesses and can be independently placed on opposite sides of the stem. However, the prosthesis body can be used independently without any inserts. The apparatus assists a surgeon who is going to revise a total knee that had been previously implanted. If a surgeon needs a wedge insert for the trial, a corresponding wedge is placed on the final knee implant.

Abstract: The method of implanting a femoral and a tibial knee prosthesis and instruments for surgically implanting the femoral and tibial prosthesis component as disclosed. The method includes the formation of a plurality of surgical cuts on the patient's distal femur. A trial tibial prosthesis is then fitted to the surgically prepared distal femur. The trial prosthesis has a femoral articulating surface and a non-articulating surface that fits the patient's distal femur at the surgical cuts. A surgeon then forms a transverse cut on the patient's proximal tibia. The surgeon places a tibial trial prosthesis on the patient's proximal tibia, the trial prosthesis including a tibial trial stem that fits the patient's intramedullary canal, a tibial trial metallic tray or plate, and a plastic trial insert that fits the tibial tray or plate. The plastic insert includes a tibial articulating surface that can articulate with the femoral articulating surface.

Abstract: A distal femoral cutting block apparatus for use in knee surgery includes an instrument body that has generally flat opposing parallel surfaces and a plurality flat peripheral surfaces to form a generally rectangular body. The body provides anterior and posterior surfaces and medial and lateral surfaces. The transverse slot carries a valgus module that is movably disposed in the slot. The valgus module includes a tubular sleeve member having a pair of opposed sides that abut the body at the slot. A portion of the tubular sleeve member is threaded and the threaded portion extends away from the body. An open ended bore extends through the tubular member. The open ended bore of the tubular sleeve member of the module accommodates an intramedullary rod that fits the patient s intramedullary canal. A lock nut engages the threaded section of the module for locking the module in a desired position on the cutting block body by engaging the threaded portion and the instrument body to rigidly affix them together.

Abstract: An acetabular component for a hip replacement system comprises an acetabular shell, and a liner having a seal for insertion into the acetabular shell. In the preferred embodiment, the shell has a smooth tapered surface in its peripheral inner surface, and the liner has several annular ridges protruding from its outer surface. Upon insertion of the liner into the shell, the annular ridges of the liner come into sealing engagement with the smooth tapered surface of the shell. This sealing engagement substantially prevents a migration of debris along an interface of the liner with the shell. The liner is provided with several peripheral tabs for interference fit with several peripheral notches in the shell. An interlock comprising another liner ridge and a shell groove, provide a positive engagement to hold the liner in the shell as it bottoms therein.