Abstract: A cutting guide for guiding a cut in a radius, the radius being adjacent to an ulna, the cutting guide comprising: a cut guiding portion, an opposed ulnar mounting portion and a linking portion extending therebetween; the cutting guide being delimited by a cutting guide peripheral surface defining a bone facing portion, the bone facing portion being contoured to match the shape of the radius and ulna.

Abstract: A computer-implemented method determines an orientation parameter value of a prosthetic component. The method includes receiving a first desired separation distance between a tibial prosthetic component and a femoral prosthetic component at a first flexion position of a knee joint and estimating a first estimated separation distance between the tibial prosthetic component and the femoral prosthetic component at the first flexion position of the knee joint for at least one potential orientation of the femoral prosthetic component. The method also includes determining a first orientation parameter value of the femoral prosthetic component by comparing the first estimated separation distance to the first desired separation distance and outputting the first orientation parameter value via a user interface.

Abstract: Instrumentation and methods are provided for knee arthroplasty which permit rotation of a distal femoral component in the sagittal plane. A guide provides for determination of both a femoral component size and rotation angle at which to install the implant in any specific patient.

Abstract: Intramedullary nails, systems, and methods. The intramedullary nail may include a generally elongate body extending from a first, distal end to a second, proximal end. The distal end may include one or more openings configured to receive one or more bone anchors that extend transversely through the distal end intramedullary nail, and thereby configured to secure the distal end of the nail. The proximal end may also include one or more openings configured to receive one or more bone anchors that extend transversely through the proximal end of the intramedullary nail, and thereby configured to secure the proximal end of the nail. In some embodiments, the proximal end may further include a cross-locking feature, which includes a second bone anchor that interlocks with a first bone anchor, for example, for enhanced bone purchase and bony fixation.

Abstract: A retractor includes a first arm, a second arm, and a translating member. The first arm comprises a proximal portion configured to retain a first retractor member and a distal portion configured to rotate relative to the proximal portion about a first axis. The second arm is configured to retain a second retractor member, such that rotation of the distal portion about the first axis causes the first retractor member to pivot toward or away from the second retractor member when the first retractor member and the second retractor member are coupled to the first arm and the second arm, respectively. The translating member is coupled between the proximal portion and the distal portion, and is configured to receive a drive force that causes the translating member to bias the distal portion to pivot relative to the proximal portion about the first axis.

Abstract: Systems, kits, and methods are provided that may be used to assess a prosthetic gap in a resected joint, including an angular alignment of the resected bone surfaces in the joint. A system can comprise a reference spacer assembly comprising a spacer body with an elongated handle and one or two reference spacer plates. A kit can comprise a plurality of spacer bodies and reference spacer plates that can be selected and assembled by an operator to modularly produce assembled reference spacer devices having a range of different configurations. Methods for assessing a prosthetic gap, including a prosthetic gap dimension, a prosthetic gap symmetry, a tibial resection posterior slope, and a distal femoral resection angle, are also provided.

Abstract: An elliptical, optical-tracking marker comprises an inner marker body that is filled with radially spread color spectrum points with respect to a center point of the inner marker body. A color value of each spectrum point of the inner marker body is calculated as a function of an angle defined between a horizontal line crossing the central point of the inner marker body and a line crossing the central point of the inner marker as well as the given pixel in such a manner, that the color values of the respective spectrum points vary in accordance with a sinusoidal pattern along an elliptical path around the center point, in particular along a circular path centered around the center point. A method and a system for determining a 3D position of an object in space use the characteristics of this marker by detecting and analyzing the sinusoidal pattern.

Abstract: A thickness gage including a transparent measurement tube configured to receive and be slidingly engaged over a tubular shaft of a retrograde reamer. The tubular shaft has linear graduation marks on its surface for identifying linear measures for use in measuring a thickness of a bridge bone gap. The linear graduation marks are located on the tubular shaft surface such that at least some of the linear graduation marks can be observed through the transparent measurement tube. Each linear graduation mark, when aligned with a proximal end of the measurement tube, provides a linear measure of the distance between a distal end of the measurement tube and a cutting member of the retrograde reamer positioned so that its central axis is disposed at a non-zero angle relative to a longitudinal axis of the tubular shaft. Such a distance corresponds to the thickness of the bridge bone gap.

Abstract: A joint balancing insert with an actuated mechanism is for balancing a joint during a joint surgery is disclosed. The joint balancing insert includes a first plate, a second plate and an actuator there between. The second plate includes an integrated mounting portion for mounting a cutting block used to guide surgical cuts of the joint during the joint surgery. Various configurations of the integrated mounting portion may be implemented in the insert to provide for mounting various types of cutting blocks, such as cutting blocks for tibial cuts, femoral cuts, and distal femoral cuts.

Abstract: Devices, kits, and methods that may be used to establish a distal femoral resection position or a proximal tibial resection position and a prosthetic gap in a total knee arthroplasty procedure are provided. Devices for establishing a distal femoral resection position or a proximal tibial resection position may comprise a support that attaches to and references a proximal resected tibia or distal resected femur and supports and establishes the position of a resection guide. A kit may comprise a device for establishing a distal femoral resection position or proximal tibial resection position and additional components that complement the device or facilitate application of the device during a total knee arthroplasty procedure. Methods for establishing a distal femoral resection position or a proximal tibial resection position are also provided.

Abstract: One variation of a method for augmenting a surgical field with virtual guidance content includes: accessing a scan representing a tissue of a patient; combining the scan with a generic virtual anatomical model to define a custom virtual anatomical model of the tissue; defining a cut trajectory along an intersection between a virtual model of a surgical implant and the custom virtual anatomical model of the tissue; aligning a virtual cut surface to the cut trajectory to locate the virtual model of the surgical guide relative to the custom virtual anatomical model; accessing an image of a surgical field; detecting the tissue in the image; aligning the custom virtual anatomical model to the tissue detected in the image; defining a target real location for a real surgical guide in the surgical field; and generating a frame depicting the target real location of the surgical guide in the surgical field.

Abstract: The present disclosure provides a provisional tibial prosthesis system for a set of prosthetic knee joints for implantation in a natural knee, the provisional tibial prosthesis system including a bearing component and a bearing support, the spacing of the bearing component from the bearing support is adjustable to allow for representation of a variety of different sized final tibial prostheses. In this system, only one provisional bearing component corresponding to each level of constraint is needed and shims are used to adjust the spacing of the bearing component from the beating support. The shims are slidably insertable between the bearing component and the bearing support in an anterior/posterior direction to allow for adjustment of the spacing of the bearing component from the bearing support. The number of provisional components needed during knee surgery is reduced and adjustment of the system only requires the knee joint to be distracted by a distance equal to the height of a particular shim.

Abstract: Embodiments of the invention include a system and method for coupling a graft to a bone. A graft preparation tool may be used to place one or more holes in a graft and an offset measurement tool may be used to determine the distance of the one or more holes from an edge of the graft to be aligned with a portion of the bone. One or more complementary holes may then be created in the bone and fasteners applied through the holes to couple the graft to the bone.

Abstract: Systems, devices, and methods are provided for measuring forces in the space of a knee during surgery. Such forces can be caused by tension in the ligaments of the knee. A femoral member is engaged with a distal femur. While the knee is flexed, partially extended, or fully extended, a force sensor and a gauge shim can be placed in the gap between the femoral member and the tibial plateau to measure the forces therebetween. The force sensor provides an accurate and quantifiable measurement of force, making knee replacement surgery and ligament tension balancing more accurate, standardized and repeatable. The force sensor comprises an elongate housing which comprises a thin force sensing distal portion and a proximal handle portion.

Abstract: Provided herein are systems, devices, assemblies, and methods for localization of one or more tags in a patient.

Abstract: In one embodiment, a device for measuring a length of a bone tunnel is provided. The device includes: a gauge comprising an annular shaft coupled to a handle, the handle including a constrained channel configured for receiving a passing pin from the annular shaft and displaying the passing pin in relation to a scale. In another embodiment, a method for measuring length of the bone tunnel is provided. A method and another device are provided.

Abstract: Methods and instruments for performing a kinematically-aligned total knee arthroplasty (TKA) are disclosed. Goals of the kinematically-aligned TKA can include restoration of (1) the femoral and tibial joint lines to the patient's natural joint line, (2) the patient's Hip-Knee-Ankle alignment to their constitutional alignment prior to developing osteoarthritis and (3) restoration of the patient's natural soft tissue laxity and envelope. A shim block assembly can be used in resecting the distal medial and lateral condyles to account for cartilage wear on the distal condyles from osteoarthritis. The shim block assembly can include a plurality of shims, and each shim can be attachable to or integral with a reference block. At least one of the plurality of shims can have a medial portion with a thickness different from a thickness of a lateral portion of the shim. The shims need not be joined together as a single medial/lateral component but may be independent of one another.

Abstract: An adjustable spacer instrument, kit of parts and surgical methods of use in a knee arthroplasty procedure are described. The adjustable spacer comprises a first member having a substantially planar upper surface and a second member having a substantially planar lower surface. An angular adjustment mechanism is interposed between the first member and the second member, and is operable to adjust the degree of tilt between the upper surface and the lower surface. A releasable lock is provided which can maintain the degree of tilt. The spacer instrument can be used with the knee in extension or flexion to allow various cuts or re-cuts to be made to the tibia or femur while the ligaments are in balance or to balance the ligaments.

Abstract: This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the cervical spinal column. The construct includes a sled adapted for positioning in a facet joint and two receivers slideably mounted on the sled. The receivers are adapted to support surgical instruments such as a drill, a tap, and a screw. The sled assists in orienting the instruments at a desired angle with respect to the spine.

Abstract: Measuring tool, surgical constructs, and methods for measuring distances between two or more locations. A measuring device allows for simple and accurate intraoperative length measurements to be made. A measuring device has a distal end that can hold a flexible strand in a hole, eyelet, claw, or other suitable means. A shaft of the device has calibration markings on it, with the zero point at the end opposite the distal tip.

Abstract: A technique for accessing extra articular lesions or abnormalities or intra osseous lesions or abnormalities or bone marrow lesions or all has the step of positioning the localizing pinning member onto cartilage or subchondral bone to define a virtual pathway through the cartilage or subchondral bone towards or into or through the lesion or abnormality or a desired target to create the virtual pathway utilizing an intra articular localizing pinning member to determine a location of the lesion or abnormality wherein the utilization of the localizing pinning member includes the step to locate or stabilize or both and thereafter using the virtual pathway to create an entry access.

Abstract: A detachable actuator arm as part of or in combination with an osteogenesis distractor device, the actuator arm being detachable from the distraction mechanism of the distractor device by manipulation of a proximally disposed release mechanism.

Abstract: Disclosed is a surgical alignment and distraction frame and associated methods of use that facilitates correction of a sagittal imbalance. The alignment and distraction frame works in conjunction with pedicle screw installation guide assemblies to impart the desired correction. The alignment frame can be utilized to ensure the pedicle screw housings are aligned (to facilitate rod coupling) in concert with the completion of a correction maneuver.

Abstract: A thickness gage including a transparent measurement tube configured to receive and be slidingly engaged over a tubular shaft of a retrograde reamer. The tubular shaft has linear graduation marks on its surface for identifying linear measures for use in measuring a thickness of a bridge bone gap. The linear graduation marks are located on the tubular shaft surface such that at least some of the linear graduation marks can be observed through the transparent measurement tube. Each linear graduation mark, when aligned with a proximal end of the measurement tube, provides a linear measure of the distance between a distal end of the measurement tube and a cutting member of the retrograde reamer positioned so that its central axis is disposed at a non-zero angle relative to a longitudinal axis of the tubular shaft. Such a distance corresponds to the thickness of the bridge bone gap.

Abstract: At least one bone fixation device comprising a stem having a maximum outer diameter is inserted into the sacroiliac joint through a minimally invasive incision path sized approximately at or about the maximum outer diameter of the stem in soft tissue, into the iliac bone, across the sacroiliac joint and into the sacrum. The stem is inserted through the incision path to a position within the sacroiliac joint between the iliac bone and the sacrum, to fuse the sacroiliac joint, without invasive joint preparation, removal of cartilage, or scraping at or near the sacroiliac joint. Desirably, at least a portion of the stem includes a surface permitting bony in-growth.

Abstract: There is provided a method (100) for aligning and positioning an implant (305). The method (100) comprises creating a reference using a guide (500) configured in accordance with patient specific data; fixing the reference using a reference marker (920) and delivering the implant (305) with an impactor (1005) aligned in accordance with the reference. Guide light emission means (515a) may be employed to create the reference, reference marker light emission means (515b) may be employed to fix the reference and impactor light emission means (515c) may be employed to align an impactor (1005).

Abstract: Disclosed is a femoral resection guide for measuring and guiding resection of anterior portion and posterior portion of a femur and method thereof. The femoral resection guide comprises a front block, a rear block, a reference gauge means and a locking means. A main scale marked portion is provided corresponding to the front scale member and the rear scale member in order to obtain a size of a patient's femur. The front block and the rear block are respectively provided with a resection guide surface for guiding a cutting tool to cut the femur. Moreover, the positions of the front resection guide surface and the rear resection guide surface in relation to the distal section of the femur can be adjusted, so that the problem of over or insufficient resection can be avoided, and the purchase cost and the storage space of the femoral resection instruments can be significantly reduced.

Abstract: A prosthetic joint is secured to the bones forming the original joint by utilizing strictly mechanical fasteners, for example, a threaded rod engaging a tapped intramedullary canal. Cross locking members may be provided. The need for bone cement is avoided. The prosthetic joint may be used to replace one end of one bone forming the joint, utilizing the naturally occurring end of the other bone. Alternatively, both bone ends may be replaced with prosthetic joint portions. The decision to replace one or both bone ends may be made mid-surgery. The prosthetic joint portions are secured together utilizing ligament reconstruction members made from portions of the patient's tendons or allograft tendons. A bearing forming the interface between the two joint portions is designed to wear in order to protect the remaining components from wear, and to be easily replaced in relatively simple future surgeries.

Abstract: A femoral drill guide assembly constructed in accordance to one example of the present disclosure includes a handle portion, a parallel slider, a perpendicular slider, a feeder guide and a receiving guide. The handle portion can extend along a first plane and include a first adjustable mating portion formed thereon. The parallel slider can have a second and a third adjustable mating portion thereon. The first and second adjustable mating portions can selectively move relative to each other causing the parallel slider to move relative to the handle portion between a plurality of positions along the first plane. The perpendicular slider can extend along a second plane and have a fourth adjustable mating portion thereon. The third and fourth adjustable mating portions can selectively move relative to each other causing the perpendicular slider to move relative to the parallel slider between a plurality of positions along the second plane.

Abstract: A trial acetabular cup having a signal generating device located thereon.

Abstract: Methods and apparatus for performing knee arthroplasty, including, but not limited to, bicruciate retaining knee arthroplasty, are described herein. Methods and apparatus for preparing a distal femur for a femoral implant as well as methods and apparatus for preparing a proximal tibia for a tibial implant are described. These methods and apparatus, in at least some embodiments and uses, facilitate decreasing the complexity of knee arthroplasty procedures such as bicruciate retaining procedures, while maintaining, if not improving on, the safety, accuracy and/or effectiveness of such procedures.

Abstract: Devices and methods are provided for immobilizing facet joints of the vertebral column. Embodiments of the invention provide an implant that is inserted in a facet joint from which cartilage has been removed, and which retains the approximate original spacing of the facets in the joint. A retaining arrangement, such as an adhesive, a threaded fastener, or a screw is then used to secure the implant in the joint.

Abstract: An anchor delivery tool is described. The tool includes a shaft and a handle coupled to a proximal portion of the shaft. The handle includes a hub, with a knob and a nose cone coupled to the hub. The knob and nose cone may be spring loaded so as to selectively retain a length of suture disposed therebetween. The tool further includes an anchor, such as a suture anchor, coupled to a distal portion of the shaft.

Abstract: A spinal fusion implant including a body and a jacket is disclosed. The jacket includes at least two radiopaque markers extending therefrom for use in determining the position of the implant after placement between intervertebral bodies. Methods of implanting and evaluating positioning of the implant are also disclosed.

Abstract: An acetabular component alignment device for total hip arthroplasty comprises a calibration component allowing for aligning a main instrument axis (5) of the acetabular component depending on a set of two patient specific calibration parameters relating to rotational offsets of the acetabular component, whereas the device is constructed in such a way that calibration parameters may be chosen such that a second parameter of the set of calibration parameters is adjustable independently from a first parameter of the set of calibration parameters by rotating the acetabular component around the main instrument axis (5) of the acetabular component.

Abstract: The present disclosure relates to a device for use during ligament reconstruction surgery. The device includes a handle and a shaft coupled to the handle, the handle including a first channel for housing of an insert, a second channel, a third channel for housing of the shaft, a first window, a second window, and a groove. A method for use during ligament reconstruction surgery is also disclosed.

Abstract: Telerobotic, telesurgical, and surgical robotic devices, systems, and methods selectively calibrate end effector jaws by bringing the jaw elements into engagement with each other. Commanded torque signals may bring the end effector elements into engagement while monitoring the resulting position of a drive system, optionally using a second derivative of the torque/position relationship so as to identify an end effector engagement position. Calibration can allow the end effector engagement position to correspond to a nominal closed position of an input handle by compensating for wear on the end effector, the end effector drive system, then manipulator, the manipulator drive system, the manipulator/end effector interfacing, and manufacturing tolerances.

Abstract: Methods for suturing tissue by forming a locking loop of suture material. In particular, method of using a suture passer to arthroscopically create a locking loop of suture in difficult to access tissues. As used herein a locking loop of suture is a loop of suture that is passed through a tissue from a first side to a second side of the tissue; one or more of the legs of the loop extending from the first side are passed through the tissue to the second side of the tissue and are then passed through the loop, and the loop is cinched to tighten closed over the one or more legs. The resulting locking loops stitches are extremely strong and distribute the stresses across the tissue in a desirable manner.

Abstract: The present disclosure relates to a device for use during ligament reconstruction surgery. The device includes a handle and a shaft coupled to the handle, the handle including a first channel for housing of an insert, a second channel, a third channel for housing of the shaft, a first window, a second window, and a groove. A method for use during ligament reconstruction surgery is also disclosed.

Abstract: Methods, systems, and apparatus, including computer-readable storage media, for surgical alignment using references. In one general aspect, a method includes coupling a guide to a joint, the guide defining an axis and having an outer contour formed to substantially conform to a portion of the joint. The first reference is attached at a fixed position relative to the joint. A positioning system is used to determine a position of the axis relative to the first reference, where the position of the axis is determined based upon the position of the guide while the guide is coupled to the joint. The guide is removed from the joint, and after the guide is removed from the joint, an instrument is positioned relative to the axis based on a position of a second reference relative to the first reference.

Abstract: Measuring tool, surgical constructs, and methods for measuring distances between two or more locations. A measuring device allows for simple and accurate intraoperative length measurements to be made. A measuring device has a distal end that can hold a flexible strand in a hole, eyelet, claw, or other suitable means. A shaft of the device has calibration markings on it, with the zero point at the end opposite the distal tip.

Abstract: Devices, systems and methods are provided for facilitating knee balancing during a knee replacement surgery. A system can include a force sensor, a main body, a moveable sensor platform, and an adjustment mechanism. The force sensor can sense one or more forces applied within a knee joint, including forces applied on a medial side and a lateral side. The movable sensor platform can be coupled between the force sensor and the main body. The adjustment mechanism can adjust the moveable sensor platform, relative to the main body, thereby adjusting a collective height of the system. A method can include inserting portions of a knee balancing system into a gap formed between a cut distal end of a femur and a cut proximal end of a tibia, adjusting an adjustable mechanism of the system to increase or decrease a collective system height, and sensing and displaying the medial and lateral forces.

Abstract: Instrumentation and methods are provided for knee arthroplasty which permit rotation of a distal femoral component in the sagittal plane. A guide provides for determination of both a femoral component size and rotation angle at which to install the implant in any specific patient.

Abstract: Rasps for preparing bones of various patients to receive a prosthetic implant and a method for using the same. Multiple rasps may be provided as a set. Within the set, the rasps generally correspond to the size and shape of a single prosthetic implant, such as a prosthetic femoral hip stem, and have a range of bone removal and bone compression capabilities to account for unique bone characteristics of the various patients. A surgeon may select a desired rasp from the set provided depending on the patient's unique bone characteristics.

Abstract: The present invention relates to devices and methods directed towards accessing and forming holes in bone tissue including penetrating vertebral bones during surgical treatments of the spine, for example, to cannulate pedicles and form pilot holes for placing pedicle screws.

Abstract: A cut block positioning jig including a first alignment member, a second alignment member, and both first and second guide members. The first alignment member is movable towards and away from a patient's bone to which the positioning jig is mounted to arrange the jig at a predetermined position relative to the bone based on x-rays of the patient. The second alignment member is movable towards and away from the bone to arrange the jig at the predetermined position relative to the bone. The first and second guide members are configured to direct cut block support members to the bone to couple a cut block to the bone to provide the bone with patient-specific cuts.

Abstract: An adjustable spacer instrument and method of use in a knee arthroplasty procedure are described. The instrument comprises a first member having a substantially planar upper surface and a second member having a substantially planar lower surface. An angular adjustment mechanism is interposed between the first and second members and is operable to adjust the degree of tilt between the upper surface and the lower surface and includes a releasable lock which can maintain the degree of tilt.

Abstract: A modular femoral prosthesis for use during performance of a hip revision procedure includes a proximal body component, a distal stem component, and a locking bolt. Surgical instruments and methods for use in implanting such a modular femoral prosthesis are disclosed.

Abstract: Embodiments of the invention include devices and methods for implanting arthroplasty devices. Some embodiments include designs that allow for use of x-ray images as the only images used to fully and accurately preoperatively and intraoperatively size and align arthroplasty device components and prepare all necessary tissue.

Abstract: A guide for use prior to, or concurrently with, resecting a portion of a patient's bone includes a body, an anterior adjustment member, at least one posterior adjustment foot, at least one adjustable condylar alignment pin, an adjustable anterior arm, and means to direct guide pins into the femur. The body has multiple apertures configured to accept pins. The anterior adjustment member is coupled to the body and moves toward/away from the femur and contacts an anterior portion of the femur. The posterior adjustment foot is coupled to the body and moves toward/away from the femur and contacts a posterior portion of the femur. The anterior arm is coupled to the anterior adjustment member and is configured to contact the femur proximal of the anterior adjustment member. The rotation arm is coupled to the body and provides guides to drill into the femur.