Abstract: Robotic system and methods for robotic arthroplasty are provided. The robotic system includes a machining system and a guidance system. The guidance station tracks movement of one or more of various objects in the operating room, such as a surgical tool, a tibia of a patient, a talus of the patient, or a component of an implant. The guidance system tracks these objects for purposes of displaying their relative positions and orientations to the surgeon and, in some cases, for purposes of controlling movement of the surgical tool of the machining system relative to virtual cutting boundaries or other virtual objects associated with the tibia and talus to facilitate preparation of bone to receive an ankle implant system.

Abstract: This disclosure concerns suburethral and pelvic support structures which utilize tissue soldering materials instead of, or in addition to, traditional tissue anchors and suture knots. It further concerns methods of treating patients that includes implanting these structures and activating the tissue soldering materials to attach the structures to a tissue in the body of the patient.

Abstract: An instrument for bending a surgical rod includes first and second arm assemblies. The first arm assembly includes first and second arms having respective first and second receiving portions configured to receive the surgical rod therein. The second arm assembly includes third and fourth arms having respective third and fourth receiving portions configured to receive the surgical rod therein. The instrument is reconfigurable from an initial configuration in which the first and third receiving portions of the respective first and third arms engage the surgical rod such that spreading of the first and third receiving portions in a first direction bends the surgical rod in a first orientation and spreading of the first and third receiving portions in a second direction bends the surgical rod in a second orientation opposite to the first orientation.

Abstract: A medical device system may include an elongate shaft having a lumen extending from a proximal end to a distal end, a proximal release wire, and a distal release wire. The proximal release wire may extend distally from a proximal end configured to remain outside the body to a distal end and may be slidably disposed within the lumen of the elongate shaft. The distal release wire may extend distally from a proximal end to a distal end and may be slidably disposed within the lumen of the elongate shaft. The proximal end of the distal release wire may be slidably coupled to the distal end of the proximal release wire. The distal release wire may be configured to releasably attach a medical device to the distal end of the elongate shaft.

Abstract: A suture transport system is disclosure for placing a flexible member along a tunnel, the system including a means of transporting a flexible member along a tunnel from a first opening in the tunnel through to a second opening at an opposite end of the tunnel, such that the flexible member extends from both the first and second opening. The system also includes a means of capturing a portion of the flexible member at the second opening, to inhibit the flexible member from retracting into the tunnel second opening. The means of capturing includes an aperture for capturing the portion of the flexible member.

Abstract: A joint stabilization (reduction) system and associated methods and tools for placement of the system in an open or minimally invasive technique. The joint stabilization system includes a flexible prosthetic band for stabilizing the bones in proper position and a connector mechanism for joining the two ends of the prosthetic band around the bones. One end of the prosthetic band can be permanently attached to the connector.

Abstract: A method of, and apparatus for, directing an elongate flexible component with a length through a part of a human body. The method includes the steps of: obtaining an apparatus having an elongate body with a length between axially spaced leading and trailing ends and a notch through a peripheral surface of the elongate body; directing a midlength part of the elongate flexible component into the notch to place the elongate flexible component into an operative position on the apparatus; and with the elongate flexible component in the operative position, advancing the elongate body through the part of the human body and thereby causing a portion of the elongate flexible component to be drawn by a drawing surface on the elongate body through the part of the human body.

Abstract: The present application generally relates to orthopedic stabilization systems, and in particular, to systems including clamps. The clamps can be used in addition to or to replace hooks that grasp onto bone members, such as the lamina. One example of such a clamp is an in-line clamp that includes a central opening for receiving a rod member, a first opening for receiving a set screw and a second opening for receiving an elastic member therethrough. Another example of such a clamp is an off-set clamp that includes an upper plate, a bottom plate, and an opening for receiving a rod therein. The upper plate can be separated from the bottom plate to make space for an elastic member that can be secured within the plates. Tulip clamps that utilize one or more elastic members are also provided.

Abstract: A spinal fixation device is provided, comprising a body member having a first side and an opposite second side, and an elongate flexible strap having a first section and a second section. The first section of the strap is attached or attachable to attachment means of the body member arranged at a first location thereof. The second section of the strap is sized and shaped to pass through a passageway arranged at a second location of the body member. The strap has a series of teeth and the passageway of the body member has a latch configured for engaging one of the teeth. The teeth and the latch are configured to allow a movement of the second section of the strap through the passageway in a tightening direction from the first side to the second side of the body member, and to prevent a movement of the second section in the opposite direction.

Abstract: A method and apparatus are provided for transtendinous implantation of a toggle-type bone anchor. Measured from the top surface of the tendon, the entire bone anchor is inserted to a depth of greater than or equal to 20 mm. during a rotator cuff repair on the humeral head. The anchor is pushed by the same bone punch that formed the initial hole to assure proper depth of placement. Further, the apparatus includes a nub portion that, in use, protrudes into the bone hole formed by the bone punch and maintains registration with the bone hole when the bone punch is retracted. An angled distal end on the anchor initiates toggling during insertion into the bone and at least one proximal projecting fin prevents the anchor from backing out of the bone hole while facilitating further rotation of the anchor when a suture is pulled to complete toggling.

Abstract: A toggle-type suture anchor that incorporates individual suture tensioning and locking without knot tying. The anchor includes an elongate toggle body having a working suture pre-threaded into a first passage and back up and out a second passage with a length running longitudinally adjacent the side of the anchor. A locking suture loop is pre-threaded into a third passage between the first and second passage and includes a collapsible loop that encircles a portion of the length of suture running longitudinally adjacent the side of the anchor. With the loop open, the working suture can slide through the anchor, however, when the loop is closed the working suture is locked in position to retain tension on the working suture. The anchor can be utilized in a pre-strung connected array of anchors.

Abstract: A system for implanting an anchor into bone, the system comprising a curved cannulated guide for percutaneous insertion, having a proximal end and a distal end; a flexible drill insertable through the curved guide from the proximal end to the distal end, the flexible drill having a shaft having a flexible portion; and a flexible inserter for inserting a suture anchor into a bore at the anatomical site formed by the flexible drill, the flexible inserter having a shaft having a flexible portion, wherein the flexible portions of both the flexible drill and flexible inserter include a series of discrete, interlocking segments.

Abstract: System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Abstract: Provided is a device for tensioning a wire in conjunction with an external bone fixation (EBF) device. A swivel hinge body comprises two forks extending in a plane parallel from the swivel hinge body. A lower lip extends from the swivel hinge body below and in parallel with the two forks. A swivel pin and a swivel block are positioned between the lower lip and the plane of the two forks and held in place by the swivel pin such that the swivel block is able to rotate in an arc with respect to the lower lip and the swivel hinge body. The swivel block comprises a face, wherein the face is configured to fit against an edge of a component of the EBF device such that, when the tensioning mechanism is applying tension to the wire, the swivel hinge body is prevented from deflecting to one side.

Abstract: An apparatus and technique for infernally securing a plurality of bone segments together. The device incorporates a plate-like structure stabilizing the fracture and integrated fasteners to attach straps circumscribing the bone segments.

Abstract: System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Abstract: A dynamic longitudinal connecting member assembly includes an anchor member having an integral or otherwise fixed elongate core of circular or non-circular cross-section. The core is pre-tensioned and extends through at least one elastic spacer and at least one outer sleeve. The anchor member and the outer sleeve each attach to at least one bone anchor. In operation, the core is held in tension by the spacer.

Abstract: A surgical instrument comprises a first arm including a first closed loop engageable with a first spinal implant disposed with a first vertebral surface. A second arm is movable relative to the first arm and includes a second closed loop engageable with a second spinal implant disposed with a second vertebral surface. Surgical systems, constructs, implants and methods are disclosed.

Abstract: A translaminar pedicle anchor suspension system (referred as T-PAS system) applicable to vertebral surgeries is disclosed. The T-PAS system comprises: at least one pedicle anchor capable of being fixed to a pedicle of a lower vertebral segment, at least one suspension ligament having one end thereof fixed to the pedicle anchor, and at least one washer capable of fixing the other end of the suspension ligament to a contralateral side of a lamina of an upper vertebral segment. By using the suspension ligament to suspend the upper vertebral segment via a tunnel drilled on the lamina, not only the spine can be dynamically stabilized, but also the use of traditional pedicle screws and bone fusion can be avoided.

Abstract: System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at or near the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, and having a curved distal end configured to be extended laterally outward from the distal opening in a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Abstract: A dacryocystorhinostomy (DCR) tool (10) includes a perforating shaft (30) having a distal perforating tip (32) configured to form a bypass between a lacrimal sac and a nasal cavity through a lateral side of the lacrimal sac, a lacrimal bone, and nasal mucosa. A DCR guide (20) includes a nasal guide component (40) configured to be inserted into the nasal cavity and having a distal guide tip (42); and a lacrimal guide component (50) shaped so as to define a guide channel (52) that orients the DCR guide (20) with respect to the distal perforating tip (32) during advancing of the distal perforating tip (32) through a lacrimal passageway and into the lacrimal sac, until contact of the distal perforating tip (32) with the distal guide tip (42) blocks further advancing of the distal perforating tip (32). The DCR guide (20) constrains the distal guide tip (42) to fall in a path of advancement of the distal perforating tip (32). Other embodiments are also described.

Abstract: In one example, an implant holder supports a guiding connector that attaches to a vertebrae and that secures to an elongated support member by a cable tie. The implant holder has a handle portion that has a shaft that extends between proximal and distal ends of the handle portion. The distal end of the handle portion can be positioned proximate to the guiding connector when the guiding connector is supported by the implant holder. The implant holder has at least one holder defining a channel therethrough that receives the shaft of the handle portion such that the at least one holder is slidable along the shaft. The at least one holder secures the cable tie and at least one wing of the guiding connector to the handle portion.

Abstract: A method for treating a spine comprising the steps of: connecting at least one first fastener that defines an implant cavity with at least one vertebral level of a first portion of vertebrae; connecting at least one second fastener with at least one vertebral level of a second portion of the vertebrae; manipulating the vertebrae; manipulating a spinal rod to a selected configuration; connecting the spinal rod with the at least one first fastener such that the spinal rod is disposed at a selected position with the implant cavity; connecting a tether to a second fastener and the spinal rod; and reducing the spinal rod to a selected position relative to the second fastener with the tether. Systems, spinal constructs and surgical instruments are disclosed.

Abstract: A system for reduction of vertebral bodies (or vertebrae) various embodiments includes a reducer, and extender, and a hollow tube. The reducer couples to the extender, which in turn couples to an elongated member, such as a rod, and to a bone fastener assembly. The reducer allows reduction of the vertebral body incrementally, and by a desired amount. The reducer may include or may be used in conjunction with a holding device or holder in order to hold or keep the amount of reduction constant or steady once the desired amount of reduction has been obtained. The reducer may use one of several embodiments, including embodiments that use threaded assemblies or members, inclining members or wedges, offset cams, scissor jacks, and/or levers.

Abstract: A clamp assembly for orthopedic use having a housing that includes a top surface, a recess, a distal base and a bottom surface, the recess defining a longitudinal axis and extending through the housing from the top surface through the distal base and toward the bottom surface, and at least two through slots, each one of being disposed at a bottom or a side a surface of the housing. The assembly including a securement assembly positionable within the recess in a co-axial relationship to a mating surface on the recess, and a band sized for travel along a predetermined path defined in part by the through slots in the housing, wherein at least one of the through slots is a starting point for travel of the band along the predetermined path.

Abstract: A device for correcting a placement of a guide wire in a bone includes a body extending from a proximal end to a distal end; a central channel extending through the body from the proximal end to the distal end along a central axis, the central channel sized and shaped to receive a guide wire slidably therein; and a first correction channel extending through the body from the proximal end to the distal end. The first correction channel is sized and shaped to receive a guide wire therein at an angle relative to the central axis of the central axis of the central channel.

Abstract: Guides, devices, instruments, and systems for fixing a fractured bone are disclosed. An insertion guide includes a handle member and a guide member coupled to a second end of the handle member. The guide member being curved relative to the longitudinal axis of the handle member. A bone fixation system including an insertion guide, a guide wire and a fastener. The insertion guide including a handle member and a guide member coupled to an end of the handle member. The guide member being curved and including a through hole for receiving the guide wire. The fastener including a cannulation for receiving the guide wire. Methods of using a bone fixation systems for fixing fractured bones are also disclosed.

Abstract: A wire tensioner tip includes a body having a first extension and a second extension spaced apart to define a ring slot. An engagement body is disposed within the ring receiving slot. The engagement body includes one or more projections configured to engage an outer surface of a ring positioned within the ring receiving slot. A coupling element extends from the body and is configured to couple the body to a wire tensioner.

Abstract: A minimally invasive bone fracture positioning device includes a sleeve, a movable unit, and a support. The sleeve includes an alignment portion located on a longitudinal axis of the sleeve. The movable unit includes a positioning portion. The positioning portion is located on the longitudinal axis and is spaced from the alignment portion. The movable unit is mounted in a radial direction of the sleeve. The movable unit is slideable relative to the sleeve along the longitudinal axis. A support is coupled to the sleeve and the movable unit. The movable unit is spaced from the sleeve by the support.

Abstract: Devices and methods for implantation of an orthopedic device between skeletal segments using limited surgical dissection. The implanted devices are used to adjust and maintain the spatial relationship(s) of adjacent bones. Depending on the implant design, the motion between the skeletal segments may be increased, limited, modified, or completely immobilized.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: An orthopedic implant system includes a wedge implant. The implant includes a body having an upper surface extending generally in a first plane. The upper surface has a first plurality of longitudinal grooves and a second plurality of transverse grooves extending therealong. Portions of the upper surface extend between adjacent longitudinal grooves and transverse grooves form individual peaks. A lower surface extends generally in a second plane, parallel to the first plane. The lower surface has a third plurality of longitudinal grooves and a fourth plurality of transverse grooves extending therealong. Portions of the lower surface extend between adjacent longitudinal grooves and transverse grooves form individual peaks.

Abstract: Various methods and devices are provided for tensioning a tether. In one embodiment, a tether tensioning device is provided and includes an elongate shaft adapted to be positioned adjacent to a bone anchor implanted in bone, and a tensioning mechanism pivotally associated with the elongate shaft and adapted to couple to a tether seated across the bone anchor and to pivot relative to the elongate shaft to apply a tensioning force to the tether.

Abstract: The invention relates to a suturing device used to place sutures inside the human body during various medical procedures. The suturing device includes an elongate body member, a needle deployment mechanism and a needle receiving portion. The elongate body member has a distal portion that defines an opening. The needle deployment mechanism is disposed at least partially within the elongate body member for moving a needle out of the opening at the distal portion of the elongate body member into a tissue; and the needle receiving portion is provided at the distal portion of the elongate body member to capture the needle. The needle receiving portion has a non-planar surface with walls that are non-parallel with respect to a longitudinal direction of the needle receiving portion such that the walls converge to form an aperture formed in the needle receiving portion to receive the needle.

Abstract: This disclosure provides design, material, manufacturing method, and use alternatives for medical devices. An example medical device may include a medical device for delivery of a surgical closure member. The medical device includes an elongate tubular member having a proximal end, a distal end and a lumen extending therein. The elongate tubular member is adapted to be delivered through the working channel of an endoscope and the lumen is adapted to receive a surgical closure member. The medical device also includes a tissue support extending from the distal end of the elongate tubular member. The tissue support includes a support surface and the support surface is adapted to support tissue as a surgical closure member engages the tissue thereon.

Abstract: Scoliosis can be treated by systems for anterior vertebral body tethering described herein. In some embodiments, installation tools of a system for anterior vertebral body tethering can be used to sequentially tension segments of a tether between adjacent vertebral screws in a controllable and user-friendly manner.

Abstract: A cable-lock device includes a housing, having a length-axis between a distal end for accepting a cable and a proximal end for exiting a cable, including a first bore parallel to the length-axis of the housing and configured to allow passage of the cable, a second bore off-center from and parallel to the first bore including a tappet axially displaceable in the second bore and parallel to the length axis of the housing, and a third bore oblique to the first bore which intersects with the first bore including a locking roller axially displaceable in the third bore with a predetermined angulation to the length-axis of the housing, a resilient structure which exerts a force on the locking roller in the direction of the intersection of the first bore and the third bore, and a fastener unit at the proximal end of the third bore.

Abstract: A bone anchoring system having a flexible member with a first end and a second end opposite the first end. A fastener provided at a first end of the flexible member for retaining the flexible member within a bone. A rigid member is provided to ensure movement or pull-through of the flexible member does not occur.

Abstract: An assembly for remotely manipulating a patient's spine. A compressor/distractor mechanism attaches to spinal anatomy or vertebral screws on adjacent vertebrae at a spinal surgical site on a patient's spine. A flexible cable is operatively connected to the compressor/distractor mechanism and to a control mechanism. The control mechanism manipulates the flexible cable, controlling the compressor/distractor mechanism to compress or distract the vertebrae. A rotatable surgical table with a remote control can be used in place of the compressor/distractor mechanism and the control mechanism. The rotatable surgical table can rotate the patient to place the spinal surgical site in a desired compressed or distracted position, and to place the patient in a desired orientation with respect to a horizontal reference plane.

Abstract: The present invention generally relates to methods and device for treatment of spinal deformity, wherein at least one tether is utilized to maintain the distance between the spine and the an ilium to (1) prevent increase in abnormal spinal curvature, (2) slow progression of abnormal curvature, and/or (3) impose at least one corrective displacement and/or rotation.

Abstract: A surgical instrument comprises a first member defining a cavity and including a locking surface disposed with the cavity. The locking surface is engageable with a longitudinal member to fix a tether with the first member. A second member includes an inner surface that defines a longitudinal passageway configured for disposal of a surgical driver engageable with a spinal construct. The second member further includes at least one mating element being engageable with the spinal construct. An actuator is connected with the members and is configured to incrementally tension the tether. Systems, implants and methods are disclosed.

Abstract: Provided is a wire stretcher, which is an apparatus which compresses the portion of the k-wire getting out behind the squeezing apparatus, the k-wire being passed through the wire retainer fitted on the bone surface, by rotating the holding part subsequent to being passed through the wire stretcher, thanks to the k-wire channel therein, and which enables, by rotating the outer body, the inner body with which the compressed k-wire is connected and the mid body to advance together in direction X, thereby stretching the k-wire.

Abstract: A target apparatus for aligning a surgical drilling instrument that includes a pointer mechanism for arranging at a location on a bone where a drilled hole that is to be formed is intended to emerge, a guide mechanism for guiding the surgical drilling instrument, and an adjustable connection mechanism with a first end, which is connected to the guide mechanism, and a second end, which is connected to the pointer mechanism. The adjustable connection mechanism comprises a first component, a second component and a locking mechanism. The second component is movable relative to the first component along a predetermined path. The first component is elastically deformable by the locking mechanism such that the second component can be locked relative to the first component by clamping.

Abstract: A tissue fixation system is provided for dynamic and rigid fixation of tissue. A fastener connected with an elongate fastening member, such as a cable, wire, suture, rod, or tube, is moved through a passage between opposite sides of tissue. A medical device is used to secure the fastener to the elongate fastening member. The medical device includes a tensioning mechanism for tensioning the elongate fastening member. As crimping mechanism is used to secure the fastener to the elongated member, where a cutting mechanism cut the excess portion of the elongated member.

Abstract: Various embodiments relate to a mini cable tensioner for introducing tension on a cable, the mini cable tensioner including a tensioning tube, a tensioning grip, including a collet opener as an internal structure of the tensioning grip, a tensioning unit, including a collet axially positioned in a cone sheath, a tensioning rod having a proximal end connected to an end stop nut and a distal end connected to the cone sheath, a tensioning nut rotatable on the tensioning rod, an inner spring configured to actuate the collet in a first direction, and an outer spring configured to actuate the tensioning rod in a second direction, the second direction being opposite to the first direction.

Abstract: In accordance with one aspect of the present disclosure, an instrument for tensioning a surgical cable is provided that includes a rotary tensioner that is rotatable in a tensioning rotary direction to apply tension to the surgical cable. The instrument further includes a body supporting the rotary tensioner, a pawl portion of the body configured to be received at least partially in a recess of a ratchet gear of the rotary tensioner, and a living hinge portion of the body supporting the pawl portion.

Abstract: Surgical cable passer instruments and methods for passing surgical cable around a bone through a surgical incision are disclosed. First and second handle tube portions comprise respective cable guide tubes and handle extensions. A proximal portion of the cable guide tube portions is fixed to a distal portion of the respective handle extension. Each handle tube portions comprise a cannula extending between a near port at a proximal end and a far port at a distal end for passage of surgical cable therebetween. Arc segments of a first cable guide tube and a second cable guide tube define a bone aperture therebetween for passing around a bone. A releasable hinge portion joins a first handle tube portion and a second handle tube portion at distal ends of a first and second handle extension.

Abstract: The instruments and methods of the present disclosure include an outer shaft, an inner shaft, a roller, and an actuator. In some examples, the outer shaft includes a lumen extending from a proximal end to a distal end. The inner shaft is disposed within the lumen. The roller rotatably is coupled with the distal end at an axis and configured to engage the fixation rod. The actuator operably couples with the inner shaft to translate the inner shaft within the lumen and cause rotation of the roller to impart linear movement on the fixation rod.

Abstract: A method and instrument for tensioning a flexible tie used for fastening an implant on a bony element by forming a first loop around it. In some embodiments, the instrument comprises a shaft having a distal end configured for contact with a rod, a moving part slidably engaged with the shaft, a holder connected to the moving part and configured to hold an end of the flexible tie, and a tension control member comprising a trigger that pivots relative to the moving part. In some embodiments, the method comprises coupling the end of the flexible tie to the instrument and squeezing the trigger to shorten the first loop of the flexible tie around the bony element, causing the moving part and the holder holding the end of the flexible tie to move in translation away from the distal end of the shaft, thereby exerting tension on the flexible tie.

Abstract: An articulating wire passer for passing a surgical wire around a bone broadly comprises a handle, rigid guide section, support guide, trigger, push rod, articulable member, tensioner, and wire catcher. The articulable member includes a number of pivotable segments configured to be advanced from an extended position to an engaged position via ratcheting action between the trigger and push rod. Tension in the surgical wire induced by the tensioner causes the pivotable segments to pivot as they advance from the rigid guide section and thus draw the surgical wire around the bone. The wire catcher allows the user to retrieve the surgical wire from the articulable member on the other side of the bone.