Abstract: A method for determining treatment of orthopaedic imbalances including the steps of: mounting upper and lower jaw dentition models to an articulator; setting the position of the models to replicate the relative positions of the jaw dentitions of a patient; determining from an x-ray or scan: (i) the outline of the patient's condylar head; and (ii) the pattern and depth of the patient's fossae; displaying a reproduction of the outline of the patient's condylar head; displaying a reproduction of the pattern and depth of the patient's fossae and eminance; adjusting the relative position of the models to remedy orthopaedic imbalances, which adjustment causes relative movement of: (i) the display of the condylar head; and (ii) the display of the pattern and depth of the fossae and eminance; and recording adjustments made to the relative position of the fossae/eminence and condoylar head and the upper and lower jaw dentition models.

Abstract: A digital dental x-ray sensor device includes a rounded, three dimensional housing that lacks corners, edges, or other relatively sharp features that are known to cause discomfort when used in a patient's mouth. The rounded housing can be spherical, ellipsoid, or any similar regular or irregular rounded shape, and can be formed by ensuring that all curves of the surface of the rounded housing have a minimum radius that is sufficient to prevent features that can dig into the soft tissue of the inside of a patient's mouth.

Abstract: A method and system is disclosed for acquiring image data of a subject. The image data can be collected with an imaging system using various selection techniques. The selection techniques may be used to assist in generating selected images for viewing. Selection techniques may include moving a filter to filter a selected portion of an imaging beam.

Abstract: Disclosed is a method and corresponding system for correcting the pileup effect in energy-discriminating photon-counting detectors. According to a first aspect, there is provided a method for pileup correction in a non-paralyzable energy-discriminating photon-counting x-ray detector operating based on a number of energy bins. The method includes adding, for each of a number of energy bins, a correction term to the detected signal of the energy bin, the correction term being a product of two separable parameterized functions, each of which includes at least one parameter, where a first parameterized function depends on a weighted sum of the detected signal over the energy bins, and where a second parameterized function depends on the detected signal(s) in one or several energy bin(s). By assuming separability and ignoring any cross correlations, the number of parameters and the complexity of the pileup correction algorithm are reduced substantially.

Abstract: Dual energy x-ray images may be generated by combining higher and lower energy images of a subject's tissue region with weighting factor values determined based on thicknesses of different tissue types corresponding to the imaged tissue region. Different weighting factor values may be applied to different pixels of the higher or lower energy images. Weighting factor values may, for example, be retrieved from memory, calculated, interpolated and/or extrapolated or the like. The higher and lower energy images and the weighting factor values may be linearly combined to generate a dual energy x-ray image. In some embodiments the weighting factor values may increase contrast of a tissue type.

Abstract: A system including initialization, imaging, alignment, processing, and setting modules. The initialization module obtains patient parameters for a patient and procedure and surgeon parameters. The initialization module selects first settings for an x-ray source based on the patient, procedure, and surgeon parameters. The image module obtains a first sample set of images of a region-of-interest of the patient and a master sample set of images. The first sample set was acquired as a result of the x-ray source operating according to the first settings. The alignment module aligns the first sample set to the master sample set. The processing module processes pixel data corresponding to a result of the alignment based on a pixel parameter or one of the patient parameters. The setting module adjusts the first settings to provide updated settings. X-ray dosage associated with the updated settings is less than x-ray dosage associated with the first settings.

Abstract: An overall full-angle coincidence brain PET detector (1) and an overall apparatus, said detector (1) comprising a plurality of PET detection modules (7), each PET detection module (7) consisting of PET detection crystals (10), a photoelectric sensor array (8) and light guides (9), and all the PET detection crystals (10) being arranged towards the inner cavity. The plurality of PET detection modules (7) form a detection chamber (3) having an opening (4), each of the length, width and height of an inner cavity of the detection chamber (3) is no greater than 35 to 50 cm, and the opening (4) of the detection chamber (3) is located at the lower side of the detection chamber (3). The cross-sectional area at the opening (4) is greater than the maximum cross-sectional area of a head (2) in the horizontal direction. Except for the opening (4), all the PET detection modules (7) are non-detachably connected together.

Abstract: Medical imaging methods for processing a three-dimensional (3D) image data set with two-dimensional X-ray images from an X-ray machine using a target function. Methods can include providing a 3D image data set of at least one examination zone in which anatomical structures are present, segmenting the image data set to provide a 3D vascular structure model and a 3D bone structure model, recording a first two-dimensional (2D) X-ray image containing at least a portion of the vascular structure and at least a portion of the bone structure, recording a second 2D X-ray image of the examination zone at a different contrast agent concentration, and subtracting the first and second 2D X-ray images to generate a subtraction image. An optimum projective geometry may then be determined using a three-part target function based on the 3D image data and the 2D X-ray images.

Abstract: A radiographing control apparatus includes a hardware processor. A radiographic imaging apparatus is exposed to a radiation from an irradiating apparatus through the subject. The hardware processor retrieves pre-exposure image data which the radiographic imaging apparatus generates by performing a pre-exposure to the subject at a pre-exposure dose of less than a dose of a subsequent main exposure, and calculates a total dose required to obtain diagnostic image data to be used for diagnosis. The hardware processor outputs a main exposure dose based on the calculated total dose to the irradiating apparatus and the radiographic imaging apparatus. The hardware processor retrieves main exposure image data which the radiographic imaging apparatus generates by performing the main exposure to the subject at the main exposure dose, and combines the main exposure image data with the pre-exposure image data to generate the diagnostic image data.

Abstract: In one embodiment, a method is provided. The method includes transmitting a first set of ultrasound waves to determine whether there is fluid flow at a target area. The first set of ultrasound waves are transmitted at a first pulse repetition frequency. The method also includes determining whether there is fluid flow in a second area based on the first set of ultrasound waves. The second area is between the target area and an ultrasound probe. The method further includes transmitting a second set of ultrasound waves to detect fluid flow at the target area in response to determining that there is fluid flow in the second area between the target area and the ultrasound probe. The second set of ultrasound waves are directed towards the target area. The second set of ultrasound waves are transmitted at a second pulse repetition frequency.

Abstract: An ultrasound diagnostic apparatus (1) includes a gate setting unit (11) that sets a Doppler gate in a blood vessel region by performing an image analysis on a B-mode image in which at least the blood vessel region is imaged; a Doppler processing unit (6) that generates a Doppler waveform image on the basis of Doppler data in the Doppler gate; a display unit (8) that displays the B-mode image and the Doppler waveform image; and an image enlargement unit (9) that, in a case where both the B-mode image and the Doppler waveform image are frozen by a user, displays an enlarged B-mode image in which the blood vessel region including the Doppler gate is enlarged, on the display unit (8).

Abstract: The invention relates to a method of identifying, from a number of ultrasound images (34) acquired during an ultrasound examination of a subject (6), the ultrasound image best suited to analyze a pre-determined anatomical structure of the subject. The method comprises the steps of (a) Providing a number of ultrasound images (34) acquired during an ultrasound examination of the subject; (b) Deriving at least one biometric parameter (96) related to the anatomical structure from a physical examination of the subject, (c) Retrieving a reference image (38) showing a target view of the anatomical structure (35); (d) For each of the number of ultrasound images (34), calculating an image similarity index between the ultrasound image and the reference image, (e) For at least the ultrasound image(s) having the best image similarity index, determining (100) a biometric parameter from the ultrasound image, and calculating a biometric similarity index, i.e.

Abstract: A compression assembly is coupled to the gantry of an ultrasound breast imaging system. The compression assembly includes a pair of compression paddles mounted on a positioning track. Each compression paddle houses a transducer and has a compression material surface for patient contact. A motor moves the compression paddles along the positioning track to immobilize the breast for ultrasound imaging.

Abstract: A medical imaging element support unit is for use in fixing a medical imaging element (26) releasably against a region of skin of a subject. The support unit includes a support body (14), having a base for engaging with skin of a subject in use and having a coupling means (22) for releasably coupling the medical imaging element (26) to the support body in use. A pneumatic positioning mechanism facilitates adjustment of a position of the medical imaging element relative to the support body, this being fluidly supplied by an air pump mechanism. The same air pump mechanism facilitates releasable fixation of the support body (14) to the skin, through creation of a configurable suction force at the skin engagement surface.

Abstract: Systems and methods for measuring changes in smart hydrogel microresonator structures positioned in an in vivo or other environment, having an acoustic resonance frequency in an ultrasound range. The system includes a smart hydrogel microresonator structure positioned within the environment configured to exhibit a change in resonance frequency in response to interaction with one or more predefined analytes in the environment. The system includes an ultrasound transducer for querying the smart hydrogel microresonator structure at or near its resonance frequency. The system also includes a computer system configured to receive ultrasound data as provided by query of the smart hydrogel microresonator structure and to determine changes in resonance frequency, amplitude or intensity of the ultrasound query wave, or mean grayscale value (MGV) associated with the ultrasound data of the smart hydrogel microresonator structure due to the change in resonance frequency.

Abstract: An exemplary ultrasound (US) apparatus, can include, for example, a flexible substrate, a plurality of ultrasound transducers coupled to the flexible substrate, and an integrated circuit(s) (IC(s)) mounted on the substrate to drive and control the transducer array, where the IC(s) can be configured to control an excitation phase of the ultrasound transducers based at least in part on a shape of the flexible substrate. The ultrasound transducers can be an array of bulk piezoelectric transducers. The substrate can be a flexible printed circuit board. The IC(s) can be configured to separately control (i) a transmission of ultrasound energy from each of the transducers, (ii) a magnitude, or a (iii) phase, where the IC(s) can be configured to use the phase to focus the transmitted energy compensating for a curvature of the ultrasound apparatus.

Abstract: An ultrasound apparatus includes: a display unit configured to display on an ultrasound image a measuring device image including a plurality of measuring points which indicate points on the ultrasound image that are to be measured, and an adjusting portion for adjusting the plurality of measuring points; an input unit configured to receive a touch input for changing a position of the adjusting portion; and a controller configured to adjust a position of at least one of the plurality of measuring points based on the changed position of the adjusting portion, and to obtain a measurement value based on positions of the plurality of measuring points including the at least one measuring point, the position of which is adjusted, wherein the plurality of measuring points are disposed apart from the adjusting portion.

Abstract: A method for determining a physical characteristic on a punctual location inside a medium, comprising the steps of: sending an emitted sequence comprising emitted pulses having different amplitudes, receiving a received sequence comprising received pulses corresponding to echoes of said emitted pulses, calculating a phase difference between the received pulses relative to the emitted pulses, and determining the physical characteristic on the bases of said phase difference.

Abstract: Systems and methods for removing the bias induced by noise from power Doppler images to achieve improvements of microvessel image contrast are provided. In one example, the noise-induced bias can be suppressed by utilizing the characteristics of uncorrelated noise in the ultrasound image from data acquired or compounded at different transmitting angles. In another example, the noise-induced bias can be suppressed due to the lack of correlation between adjacent ultrasound images. These example implementations may also be combined, as will be described below.

Abstract: A biopsy device includes a probe, a needle, a cutter, and a manually actuated needle firing assembly. The needle extends from the probe. The cutter is disposed within the needle. The cutter defines a cutter lumen and at least partially defines a vent lumen between an exterior of the cutter and an interior of the needle. The needle firing assembly includs a catch and a release. The catch is reliantly biased to fire the needle. The release is configured to engage the catch to thereby hold the catch in a cocked position.

Abstract: A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device configured to deploy and implant anchor devices for such purposes.

Abstract: A laparoscopic surgical apparatus for performing a surgical procedure through a single incision in a patient's body includes a gross positioning arm supported on a moveable platform, the gross positioner including a head; at least one articulated tool positioning apparatus coupled via a tool controller to an underside of the head, the articulated tool positioning apparatus being configured to receive a tool for performing surgical operations, the tool controller being actuated by the head to cause movements of the articulated tool positioning apparatus for performing surgical operations; and wherein the gross positioner is configured to permit the head to be positioned to facilitate insertion of the articulated tool positioning apparatus through the incision into the patient's body.

Abstract: Provided herein are systems for preparing and delivering fibrin sealant to a surface and methods of use thereof. In one embodiment, the system comprises: a. a quantity of a liquid mixture disposed within a container, the mixture comprising: I. fibrin or II. fibrinogen and Factor II; and b. a resin bed disposed within a vessel, the vessel capable of being in fluid communication with the container, wherein when in fluid communication, passage of the mixture through the vessel results in modification of the concentration of small molecules inhibitor(s) and/or inducer(s) within the mixture, favoring fibrin clot formation.

Abstract: A unitary adhesive retractor is provided for supporting a patient's excess/redundant tissue to maintain the excess/redundant tissue away from an incision or other existing wound. The retractor defines a top-to-bottom length and a side-to-side width greater than one-half the top-to-bottom length, and comprises a stretchable, air-permeable fabric layer adherable directly to the excess/redundant tissue by means of a silicone gel adhesive which coats at least a substantial portion of a bottom surface of the fabric layer. When the retractor is placed in tension upon application of the retractor to a patient, due to the weight of the excess/redundant tissue, forces generated by the weight of the excess/redundant tissue are transferred through the gel adhesive to the fabric layer, such that the gel substantially protects the dermis of the patient from sheer forces generated by the weight of the excess/redundant tissue being evenly distributed to the dermis of the patient.

Abstract: A surgical access system includes a connector including an arm, a coupling element, a rod, and a ridged slider. The arm includes first and second notched sections disposed in opposed lateral sides thereof. The coupling element includes a body section defining an opening therethrough, and opposed tabs protruding therefrom that are configured to receive the second notched section therebetween such that the arm is pivotably coupled to the coupling element. The rod includes a shaft having a plurality of angled grooves defined partially along a length thereof. The rod extends through the opening of the coupling element and the first notched section of the arm. The ridged slider includes a first surface having a plurality of ridges extending along a partial length thereof. The ridged slider extends through the coupling element with the plurality of ridges operably engaged with the plurality of angled grooves of the rod.

Abstract: A cinch deployment system includes a delivery system and a releasable cinch including an inner tubular, a compressible gripper having a suture passage, the gripper positioned within the inner tubular housing, and a resilient structure biased to compress the gripper to reduce the size of the suture passage. The resilient structure has a first configuration in which the resilient structure is constrained from applying sufficient compression to the gripper to prevent movement of the gripper on the suture, and a second configuration in which sufficient compression is applied to secure the gripper on the suture. The resilient structure is moved from the first to the second configuration by movement of the retainer moved by the deployment system.

Abstract: A tissue anchor includes a driver head associated with a proximal portion of the tissue anchor, a pointed tip portion associated with a distal portion of the tissue anchor, a tissue-engagement portion disposed between the driver head and the pointed tip portion, and a cover configured to cover at least a portion of the tissue-engagement portion.

Abstract: Various devices, systems, and methods are provided for securing soft tissue to bone. In one exemplary embodiment, a two-piece inserter tool is provided that includes a tip portion that is configured to be removably coupled to a handle portion. A distal portion of the tip portion can be configured to be coupled to a suture anchor, and the tip portion and the anchor can be passed through a continuous suture loop prior to mating the tip portion to the handle portion.

Abstract: Side bite surgical suturing instruments or portions thereof for endoscopic, laparoscopic, endoluminal, and/or transluminal suturing facilitate the use of larger needles to get a bigger bite while suturing.

Abstract: A horizontal-transvertebral curvilinear nail-screw (HTCN) including a body portion having a first end and a second end, wherein the first end is opposed to the second end; and a head at the first end of the body portion, wherein the body portion has a predetermined curvilinear shape and includes a pointed tip at the second end of the body portion, and a method of surgically implanting universal horizontal-transvertebral curvilinear nail-screws (HTCN) into a plurality of adjacent vertebrae.

Abstract: In various embodiments, a tissue thickness compensator can comprise a compressible extracellular matrix and a bioabsorbable material dispersed within the extracellular matrix, wherein the bioapsorption of the bioabsorbable material is configured to leave behind channels in the extracellular matrix. The tissue thickness compensator can also comprise generation means for generating the ingrowth of tissue into the channels. In at least one embodiment, the tissue thickness compensator can comprise dissolvable wicking members which, when dissolved, can leave behind channels in the tissue thickness compensator. In certain embodiments, the tissue thickness compensator can comprise at least one rupturable capsule.

Abstract: The invention provides a fastening device for laparoscopic hernia repair. The coordinated operation of two insertion members stabilizes a fastener during closure and locking to ensure that the fastener is locked in the intended location before the device releases from the fastener. One of the insertion members includes a pair of prongs that exhibit a closed configuration when they are disposed in a recess at an end of the fastener. The fastener has a hook at one end and a loop at the other end. The insertion members push the fastener out from the device and through the tissue. A curvature in at least one of the insertion members pushes the hook through the loop all while the prongs are in the recess in the fastener, thereby stabilizing the fastener with respect to the device.

Abstract: Systems, devices and methods to improve safety and efficiency in an operating room comprise providing a suture package that holds new suture needles and needle receptacles for storing used needles. The devices can be safely worn for the surgeon to self-dispense new suture needles in the near surgical field and to secure the used needles into a needle trap or a needle retainer located on his extremity, on his operative instruments or on the surgical drapes. The device may provide automated and/or simplified needle counting both during use and after removal from the surgical field. The device may be configured for ergonomic and efficient use so as to minimize the actions and motions of the surgeon to dispense and secure the needle.

Abstract: A surgical stapling apparatus is disclosed which comprises cartridge body and a layer. The layer is implantable against tissue by staples deployed from the cartridge body and deformed by an anvil. The cartridge and the layer comprise co-operating features which reduce relative movement between the cartridge and the layer. Such co-operating features can also releasably retain the layer to the cartridge body. In addition to or in lieu of the above, the anvil and the layer comprise co-operating features which reduce relative movement between the anvil and the layer. Such co-operating features can also releasably retain the layer to the anvil. In certain instances, the layer can be positioned against the anvil, but releasably attached to the cartridge. The layer can comprise buttress material and/or a tissue thickness compensator, for example.

Abstract: A surgical stapling device includes an adapter assembly and a reload assembly. The adapter assembly includes an elongate body and a channel member coupled to the elongate body. The reload assembly includes an anvil and a cartridge assembly that includes a cartridge body and a channel extension. A proximal portion of the cartridge body is received within the channel member to secure the reload assembly to the adapter assembly. The channel extension is received about a distal portion of the cartridge body and is engaged with the channel member to support the cartridge body.

Abstract: A surgical instrument. In one form, the surgical instrument includes a housing that has an interchangeable shaft assembly removably attached thereto. The interchangeable shaft assembly includes an elongate shaft that has a surgical end effector operably coupled thereto for selective articulation relative to the elongate shaft. An articulation system is configured to selectively apply articulation motions to the surgical end effector when the articulation system is in an actuated orientation. A locking arrangement prevents detachment of the interchangeable shaft assembly from the housing when the articulation system is in the actuated orientation.

Abstract: A surgical instrument includes an anvil and an elongate channel. The elongate channel includes a plurality of first electrical contacts and a plurality of electrical connectors comprising a plurality of second electrical contacts, wherein the electrical connectors are spring-biased such that a gap is maintained between the first electrical contacts and the second electrical contacts. The surgical instrument further includes a staple cartridge releasably attachable to the elongate channel, wherein the staple cartridge has a cartridge body comprising a plurality of staple cavities, a plurality of staples deployable from the staple cavities into the tissue, and a plurality of third electrical contacts, wherein the attachment of the staple cartridge to the elongate channel moves the electrical connectors causing the second electrical contacts to bridge the gap and become electrically coupled to the first electrical contacts.

Abstract: Methods for resetting a fuse in a surgical instrument are disclosed.

Abstract: A wound closure apparatus pertaining to the field of skin wound sutures, comprising a window body, zippers, and fixators. The window body comprises a body wall and top wall. The zippers are set at both sides of the window body. One end of the zippers are connected to the fixators, and the other end are connected to the window body. fixed adhesive layers are set on the bottom surface of the fixators facing the skin. The wound closure apparatus enables functional modules necessary for wound treatment to reliably, continuously, and directly act on the treatment area, effectively preventing exudate accumulation from causing the suture device to fall off the wound, secondary infection, suture failure, or staggered malunion, allowing for better physiological regeneration and healing.

Abstract: Apparatus and related methods for sequentially positioning and retaining opposing sides of a tissue wound. The apparatus includes a device body having a head portion for positioning between first and second sides of the wound, with the head portion defining first and second retention zones on opposed side of the head portion. The device body further includes first and second approximation arms. The device body further includes a trigger assembly defining three stages of operation. A first stage of operation positions the first approximation arm proximate the first retention zone. A second stage of operation positions the second approximation arm proximate the second retention zone with the first approximation arm remaining in approximation to the first retention zone. A third stage of operation advances a fastener into the first and second retention zones. In this manner, the apparatus sequentially positions the first and second sides with respect to the head portion.

Abstract: A medical device for an anastomosis is provided. The medical device distinguishes an inner tubular layer, an outer tubular layer, and a support element defining a longitudinal axis. It further distinguishes two or more independent C-rings distributed and positioned at an acute orientation angle relative to the longitudinal axis of the support element at one end of the support element. The support element and the two or more C-rings are embedded in between the inner and the outer tubular layers. The types of applications one could envision are e.g. a proximal anastomosis, distal anastomosis, or side-to-side anastomoses, in a customized pre-fabricated graft. Embodiments of the invention could also be incorporated into an anastomotic connector device design. Embodiments of the invention could further be envisioned as vascular grafts applications such as Coronary Artery Bypass Graft (CABG), dialysis access grafts and peripheral vascular applications.

Abstract: A surgical anvil assembly for use with a circular stapling instrument includes an anvil center rod defining a longitudinal axis and an anvil head pivotally coupled to the anvil center rod and movable between a first operative condition and a second tilted condition. The anvil assembly further includes a locking assembly configured to selectively lock the anvil head in each of the first and second conditions.

Abstract: Proposed is a banana clip for removing hemorrhoids, and a surgical tool set including the banana clip. The banana clip includes a clip main-body having a first clip arm and a second clip arm, connected to each other by a flexible bending portion in a manner that maintains a predetermined bend angle with respect with each other, which are closed with an outside force in a state where the hemorrhoids to be removed are interposed therebetween and thus are tied tightly around the hemorrhoids; and a holding guide, guiding relative motions of the first clip arm and the second clip arm when the clip main-body is bent inward.

Abstract: Provided is an endoscope clip and an operation method for a clip. The clip includes a clip arm that is configured to be transitioned between a first, second and third configurations. The clip includes a slider to operate the clip arm to be transitioned between the configurations, and a limiter configured to restrict movement of the slider so as to restrict the transition of the clip arm from one configuration to another of the configurations.

Abstract: A surgical clip may include a first leg member having a first inner surface with a concave curvature, a second leg member having second inner surface with a convex curvature, and a hinge member pivotally coupling the first leg member and the second leg member. The first leg member may have a first thickness in a compression direction, a first width in a lateral direction, and a first length in a longitudinal direction. The second leg member may have a second thickness in the compression direction, a second width in the lateral direction, and a first length in the longitudinal direction. The first width may be greater than the first thickness along at least half of the first length, and/or the second width may be greater than the second thickness along gat least half of the second length.

Abstract: A cartridge may include a pair of side walls separated by a compartment, the compartment being configured to receive a surgical clip, and a base member supporting the pair of side walls. The pair of side walls may extend at an acute angle relative to a vertical axis of the base member to hold the surgical clip at the acute angle. The acute angle may be greater than 10° and/or about 20-30°. The cartridge may also include a pedestal extending between the pair of side walls and configured to support the surgical clip, where the pedestal is disposed at the acute angle. The cartridge may further include a retainer configured to retain the surgical clip in the compartment, the retainer including a pair of fingers configured to contact the surgical clip, where the pair of fingers are oriented at the acute angle.

Abstract: An occlusive implant with a backbone support structure can be delivered into a body vessel using a delivery assembly that can engage with at least a portion of the implant. The assembly can utilize an engagement member and an engagement socket or a catheter or sheath to removably couple the engagement member with the implant. When the implant is advanced to a target location in the body vessel, the implant can be released to restrict flow of a fluid through the vessel and/or promote occlusion of the vessel.

Abstract: Disclosed is a bone cutting and shortening system and the method of using the same, the system comprising a bone plate and a cutting guide adapted to slidingly engage by inserting the cutting guide into the bone plate from the overhead direction, the cutting guide adapted to facilitate parallel cutting planes on a bone at precisely ascertainable offset distances, and the bone plate adapted to stabilize the shortened bone after cutting.

Abstract: This disclosure relates to surgical instruments for alignment of bone cuts during surgeries on joints and in particular, during total replacement of joints. The surgical instrument comprises a contact surface shaped to fit a prepared end of the first bone of the joint and an artificial articular surface that imitates the native articular surface of the first bone that has been removed by the preparation of the first bone. The artificial articular surface is pivotable in relation to the surgical instrument. The instrument can be fitted onto the prepared bone and coronal balancing can be performed. After fixing a further instrument to the second bone the joint can be balanced in flexion. At the optimal flexion angle, the slope and the cutting depth can be adjusted to achieve alignment. The further instrument is then used as a guide for cutting the second bone at the resulting cutting depth, slope and varus/valgus angle.

Abstract: Systems and methods related to use of a measurement system in conjunction with a powered instrument for determination of the placement of a tool portion relative to the anatomy of a patient utilizing the powered instrument. The measurement system may include a displacement sensor that indicates the relative displacement of the tool portion relative to the anatomy. The system may also include a sensor for monitoring a tool drive signal representative of a tool drive parameter that is characteristic of the tool portion acting on the anatomy. The tool drive signal may be analyzed relative to a given amount of axial displacement as measured by the displacement sensor to avoid false indications of placement based on noise and or other artifacts in the tool drive signal that may result from characteristics of the anatomy and/or operational behaviors of the surgeon utilizing the instrument.