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: 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 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: 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: 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: 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: 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: 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 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: 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 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.

Abstract: Provided is a preoperatively designed guidance tool for intraoperative use during acetabular cup replacement surgery, comprising: a patient-specific template having at least one surface that registers with a selected surface of the patient's acetabulum; and a guide portion that provides an orientation or a position and orientation of an acetabular cup according to a preoperatively planned orientation or position and orientation. The guidance tool may further comprise a verification tool that cooperates with the guide portion and includes at least one mating surface that registers with a selected surface of the patient's anatomy, wherein correct positioning of the verification tool on the patient's anatomy confirms correct orientation of the patient-specific template in the patient's acetabulum.

Abstract: An apparatus (10) for removing bone material comprises a distal cutting instrument (12) and a proximal cutting instrument (14). The distal cutting instrument has at least one first cutting edge (30), a shoulder (20), and a shaft portion (22). The shaft portion (22) has an anti-rotation feature. The at least one first cutting edge (30) removes bone material when moved in a first direction. The proximal cutting instrument (14) is removably attached to the shaft portion (22). The proximal cutting instrument (14) has a first end portion (68) and a second end portion (66). The second end portion (66) contacts the shoulder (20) of the distal reamer (12) when the proximal reamer is mounted to the shaft portion (22). The proximal reamer (14) has at least one second cutting edge (32) and an aperture. The aperture is adapted to receive the anti-rotation feature of the shaft portion (22) of the distal reamer (12). The at least one second cutting edge (32) removes bone material when moved in a second direction.

Abstract: A bone sizing guide for assessing the size of an end of a bone includes a body (6) having a foot component (2) with a first surface (10) to rest against an end surface of the bone and a foot (12) extending transverse to the first surface to contact a side surface of the bone. A superstructure (40) is coupled to the body so that the superstructure can slide relative to the body towards and away from the body, at least one of the superstructure and the body being adjustable so that the rotational direction in which the superstructure extends relative to the foot component about a first axis extending transverse to the first surface is adjustable. A stylus (53) extends from the superstructure transverse to the first surface of the body, the stylus having a tip to contact a surface of the bone, and a scale (64) is coupled to or formed on a first one of the superstructure and the body. An indicator (52) is coupled to or formed on a second one of the superstructure and the body to identify a position on the scale.

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: Methods and devices for preparing an acetabulum for receiving an acetabular component in a hip replacement procedure. The methods may include aligning a first guide in an acetabular notch of the acetabulum and determining a reference point in the acetabulum. The first guide is removed from the acetabulum and then a second guide is positioned in the acetabulum and oriented with the reference point. While the second guide is positioned in the acetabulum, the acetabular margin is reamed with a reamer. During reaming, the reamer is contacted against a rim of the second guide which prevents additional reaming of the acetabular notch below the rim of the second guide.

Abstract: A trial kit for a hinged knee implant system is disclosed. The trial kit includes a tibial base plate trial, an adaptor and a tibial bearing insert trial. The adaptor and insert trial can be assembled and the assembly mounted on the tray trial by sliding the assembly in an anterior-posterior direction on the tray trial. The adaptor has a post with a cross-piece. The insert trial has openings and channels to receive the post and cross-piece. The openings are sized, shaped and oriented so that the cross-piece of the elongate post must be oriented in different directions to pass through the different openings.

Abstract: A method is used for aligning an acetabular cup insertion instrument by taking a single lateral view pre-operative digital x-ray of a standing patient's pelvis. The natural pelvic tilt angle is determined by locating an anterior pelvic plane (APP) which is defined by first, second and third points on the anterior of the pelvis and determining the angle between the APP and a coronal plane perpendicular to the surface on which the patient is standing. The patient is then placed on a surface of an operating room table in a supine position. A position tracking device is placed on the patient's pelvis to track movement. Thereafter an operating room navigation or orientation system is used to relocate the APP defined by the first, second and third points. A cup insertion instrument having a position tracking device thereon is oriented using the navigation or orientation system.

Abstract: A depth gauge and method provide for accurate measurement of a socket portion of a bone tunnel in an ACL reconstruction.

Abstract: Methods and devices to treat discogenic lumbar back pain are disclosed. Electrodes are implanted within the anterior epidural space of the patient. A pulse generator that is connected to the electrodes delivers electrical impulses to sympathetic nerves located within the posterior longitudinal ligament (PLL) of the lumbar spine and outer posterior annulus fibrosus of the intervertebral disc. In alternate embodiments, energy directed to nerves in the PLL may be from light or mechanical vibrations, or the nerves may be cooled. The electrodes may also be used diagnostically to correlate spontaneous nerve activity with spinal movement, fluctuations in autonomic tone and the patient's experience of pain. The electrodes may also be used to generate diagnostic evoked potentials. The diagnostic data are used to devise parameters for the therapeutic nerve stimulation. Automatic analysis of the data may be incorporated into a closed-loop system that performs the nerve stimulation automatically.

Abstract: One embodiment of a system described herein can include an axis guide for placement over a patient's right and left ASIS and at least two guides attachable to the axis guide to provide a through hole that is perpendicular to the axis guide. The system can further include at least two probes that can fit through the through holes and extend beyond an end of the axis guide by a predetermined distance, as well as at least two bone engaging pins that fit through the through holes. When the guides are assembled to the axis guide and the probes are assembled to the guides, the axis guide can be placed so that the probes contact the patient's pelvis and the probes can be replaced by the pins to mount the pins to the patient's pelvis in a known orientation.

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 detection and indication device for the detection and indication of the presence or absence of a stabilization bar in the tulip head of a pedicle screw includes a housing. The housing is adjusted in such a way that it can be connected with elongated flanks of the pedicle screw or a downtube coupled to the pedicle screw in a detachable manner. A detection bar can be mounted axially movable in the housing. The relative positioning of the detection bar to the housing indicates a detection result. A system for spinal stabilization includes at least one pedicle screw with a tulip head and elongated flanks or a downtube coupled to the pedicle screw, at least one stabilization bar and a detection and display device.

Abstract: Disclosed is a modular trial system to select a neck length. The system may be in a hexagonal or click embodiments. A neck member may having at least a locating step with a locating step face. A head member may have at least a first groove and a second groove in an internal bore. The head member may be rotated relative to the neck member to select various trial lengths of the neck.

Abstract: A template operable to reestablish the center of rotation of a native femoral head at the head of an implanted prosthesis. The template includes a first member with a marking passage and optional cutting guide and a second member with a target. The first member of the template can be placed on a femur and the second member can be moved in the proximal-distal, medial-lateral and anterior-posterior directions to fix the center of the target at the center of rotation of a femoral head. The head of a prosthesis can be manipulated to come in contact with the target to reestablish the center of rotation of the native femoral head.