Abstract: Modular surgical instruments and related methods are disclosed herein, e.g., for performing rod reduction, derotation, and/or set screw insertion during spinal surgery. An exemplary system can include an instrument body configured to couple to a bone anchor assembly to provide a modular platform for carrying out various steps of a surgical procedure. For example, the instrument body can receive a reduction instrument therethrough for reducing a spinal rod into the bone anchor assembly. A derotation instrument can be attached to the reduction instrument for performing derotation maneuvers or applying other manipulation forces. A modular driver or handle adapter can be attached to the reduction instrument and/or to the derotation instrument to facilitate rod reduction. Any of the instrument body, the reduction instrument, and the derotation instrument can include a working channel therethrough.

Abstract: Systems and methods are described herein to generate a 3D surface scan of a surface profile of a patient's anatomy. The 3D surface scan may be generated by reflections of structured light off the surface profile of the anatomy. The 3D surface scan may be used during intra-operative surgical navigation by a localization system. Optionally, a pre-operative medical image may also be registered to the localization system or used to enhance the 3D surface scan.

Abstract: A polymeric mesh is disclosed. The polymeric mesh comprises an absorbable polymeric fiber and a non-absorbable polymeric fiber knitted together to form an interdependent, co-knit mesh structure. Also disclosed are methods for making the polymeric mesh and methods for using the polymeric mesh.

Abstract: The cable-locking plate with screw allows for compression of bone fractures using a tensioned cable. The cable-locking plate with screw allows the use of a cable as a flexible bridging member, such as a cable, helps create compression while accommodating the unusual shape. The cable-locking plate with screw allows a surgeon to tension a cable through the plate, then grip the cable by tightening a screw associated with the plate. The compression is created is across the fracture, not around the bone, thus avoiding compression of nerve and blood vessels along the bone's surface. The cable is guided into an ideal position using cable channels, allowing the surgeon to concentrate on tension and screw compression. The plate and cable system are then left in the patient while the bone mends. The cable-locking plate with screw is either left permanently or removed during a later surgery.

Abstract: A surgical planning and assessment system is disclosed. The system may include a computing system having a processor, a data store, a patient specific planning and analysis module, and a display. The system may be configured to access a database storing a plurality of possible surgical plans. The computing system may store a target surgical plan including a plurality of patient specific inputs including at least one preoperative medical image of a spine of a target patient and analyze the target surgical plan to determine a predicted alignment of the spine of the target patient. The computing system may develop a plurality of predictive models including a predicted alignment of the spine of the target patient based on the target surgical plan and suggest at least one alternative surgical plan with respect to the target surgical plan.

Abstract: A driver-specific back-out prevention mechanism is disclosed that includes a screw and a body. A first driver can be used for coupling and decoupling the screw with the body, and a second driver can only be used for adjusting the position of the screw in the receiving body. The body includes a cavity for receiving a head of the screw, with the cavity having an inward flange. The screw includes upper and lower sockets, with a channel extending though the head from the lower socket and a lock body disposed in the channel. Engagement with the first driver allows the locking body to move such that the fastener can be inserted and removed from the body. Engagement with the second driver displaces the locking body such that the locking body interferes with the flange such that screw fastener cannot be removed from the body by the second driver.

Abstract: A fracture fixation system includes a plate having a laterally extending bore passing therethrough and configured to receive a first wire when the plate is placed in contact with a bone. The plate has a recess for receiving and securing a first end of a first wire, and includes an entry hole and an exit hole to at opposite ends of a first bore to allow the first wire to pass through the plate. A screw is configured to capture said the wire in the first bore to maintain a desired tension on the first wire.

Abstract: Systems and methods to monitor and track the treatment of bones using a bone correction system are provided. The method includes implanting growth modulating implants of a bone correction system in two or more bones of a patient. Each growth modulating implant includes an implant body having at least one sensor device embedded in the implant body. The method includes receiving sensor data from the sensor devices and determining an operational status of the growth modulating implants, based on the received sensor data. The method includes determining, by the processor, a longitudinal growth or growth rate between the two or more bones, based on the received sensor data and causing a display device to selectively display a graphical user interface (GUI) representative of at least one of the longitudinal growth and the growth rate of the patient.

Abstract: A pivotal bone anchor assembly includes a body member with upright arms defining a channel for receiving a fixation rod, an axial bore having a bottom opening, a lower interior surface disposed about the bottom opening, and a downwardly facing recessed surface above the lower interior surface. The assembly also includes a shank comprising a partial spherical head positionable into the axial bore and an anchor portion for attachment to the bone. The assembly further includes a bushing insertable into the axial bore having an outer surface configured to resiliently snap under the downwardly facing surface so as to inhibit the bushing from moving upward in the axial bore, and a lower surface configured for biased engagement with the partial spherical head of the bone anchor, with the biased engagement providing a pre-lock press fitment about the partial spherical head so that the bone anchor and body member do not move freely with respect to each other prior to insert and securement of the fixation rod.

Abstract: A spinal fixation device is provided. The spinal fixation device includes a body portion including a stud portion defining a first annular groove. An outer housing is positionable on the stud portion of the body portion. An inner housing defines a second annular groove and is positionable between the outer housing and the stud portion. A ring member is positionable within each of the first and second annular grooves of the respective stud portion and inner housing to lock the inner housing to the body portion and to fixedly couple the outer housing to the stud portion.

Abstract: A wire driver for driving a wire or pin into living tissue includes a rotating drive shaft, a collet, and a wedge. The collet is held fast to the drive shaft and has a plurality of feet radially moveable relative for grasping the wire or pin. Each foot has an outwardly located curved ankle surface with a concave or convex profile. The wedge is disposed over the collet and is at least partly inside the bore of the drive shaft. The wedge rotates with the drive shaft and has a tapered inner surface in selective engagement with the curved ankle surfaces. The wedge is moveable longitudinally relative to the collet feet to bear against the feet and cause the feet to grasp the wire or pin. The wedge has a release position in which the wedge is spaced from the collet feet, releasing the wire or pin.

Abstract: The present invention relates to a prosthesis, such as a megaprosthesis, for a joint replacement or any segmental bone deficit. In particular, the present invention relates to a stem for a prosthesis having threads on at least part of an outer surface thereof. A prosthesis, such as a megaprothesis, is also provided. The prosthesis contains the threaded stem and a modular body engaged to the stem. The modular body contains a bone replace segment or a replacement joint, such as replacement knee joint, hip joint, shoulder joint, wrist joint, ankle joint, elbow joint, joints of the hand, joints of the foot, etc.

Abstract: Aspects of the present disclosure relate to systems for performing a surgical procedure using a power tool or power instrument with systems, devices and/or control units for adjusting, regulating, interrupting, and/or restoring electric current to the power tool or instrument during operation, for example, when the power tool or instrument is at a predetermined distance to a boundary of a safe zone or a target volume of operation.

Abstract: A driver-specific back-out prevention mechanism is disclosed that includes a screw and a body. A first driver can be used for coupling and decoupling the screw with the body, and a second driver can only be used for adjusting the position of the screw in the receiving body. The body includes a cavity for receiving a head of the screw, with the cavity having an inward flange. The screw includes upper and lower sockets, with a channel extending though the head from the lower socket and a lock body disposed in the channel. Engagement with the first driver allows the locking body to move such that the fastener can be inserted and removed from the body. Engagement with the second driver displaces the locking body such that the locking body interferes with the flange such that screw fastener cannot be removed from the body by the second driver.

Abstract: A medical inserting apparatus includes a screw nail which is inserted into a human body, a driver which inserts the screw nail into the human body, a current generator disposed in the driver to generate a predetermined current, a current meter disposed in the driver to measure the current, and a conductor element disposed in the screw nail and the driver along a lengthwise direction including an exposed portion to outside, wherein the conductor element includes a forward conductor element connected to the current generator to allow the current generated by the current generator to flow into the human body, and a reverse conductor element having one end electrically connected to the forward conductor element and the other end connected to the current generator, and including a variable resistor and the current meter installed to allow the current generated by the current generator to flow to the current meter by current division with resistance of the human body.

Abstract: Cerclage constructs, systems, kits and methods of cerclage repairs are disclosed. A cerclage construct can create a repair without metal cerclage and cabling (metal wires, cables, etc.) and/or metal components (metal fittings, screws, etc.). A cerclage construct includes a plurality of interconnected flexible strands that secure a first bone (bone graft or bone block) to a second bone (bone graft or bone block) with a simple and compact design. The cerclage construct is a flexible, tensionable construct that eliminates the need for metal components in a fracture repair.

Abstract: A screw fixing apparatus includes a screw inserted into a human body, and a screw anchor having an insertion hole that receives the screw. The screw anchor is inserted into the human body and the screw is inserted into the human body.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion receivable in an integral receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. A down-loadable compression insert with tool receiving arm extensions, a down-loadable friction fit split retaining ring and an uploadable shank upper portion cooperate to provide for pop- or snap-on assembly of the shank with the receiver either prior to or after implantation of the shank into a vertebra. The shank and receiver once assembled cannot be disassembled.

Abstract: Arcuate fixation members with varying configurations and/or features are provided, along with additional components for use therewith in provided intervertebral implants. The arcuate fixation members may be of different lengths, cross sectional geometries, and/or cross sectional areas. Applications of intervertebral implants utilizing arcuate fixation members are particularly suitable when a linear line-of-approach for delivering fixation members is undesirable.

Abstract: A bone implant that is elongate along a longitudinal axis includes an implant body including first and second wire segments extending between first and second ends along the axis. The wire segments are spaced from each other along a lateral direction that is perpendicular to the longitudinal axis to define first and second apertures each extending through the implant body along respective directions that are offset from the axis. At least one of the first and second apertures is configured to receive a bone fixation element for securing the implant to bone. The first and second wire segments abut each other at least at one end of the first and second apertures. The first and second wire segments define respective first and second prongs each located at the second end and configured to be inserted within bone so as to further secure the bone implant to bone.

Abstract: A receiver assembly for securing an elongate rod to a bone anchor includes a receiver having pair of upright arms that define an open channel configured to receive the elongate rod, a discontinuous helically wound receiver guide and advancement structure formed into the interior surfaces of the upright arms, and horizontally-elongated tool engaging grooves formed into upper portions of the outer surface of the upright arms. The receiver assembly further includes a closure configured for positioning within the open channel to secure the elongate rod to the receiver in a locked configuration, with the closure having an outer surface with a mating continuous helically wound closure guide and advancement structure configured to resist a tendency toward splaying between the upright arms upon a screwing in of the closure within the open channel by rotatable engagement with the receiver guide and advancement structure.

Abstract: A bone fixation system has a bone implant with an implant body. The implant body defines an upper surface, a bone-facing surface spaced from the upper surface along a transverse direction, and at least one aperture defined by an inner wall. A bone fixation element is configured for insertion at least partially through the aperture. The bone fixation element has a head and a shaft that extends relative to the head in a distal direction. The head defines a ridge and at least one thread that is spaced from the ridge in the distal direction. The ridge is configured to compress a bone implant against the at least one thread so as to fixedly retain the bone implant with respect to the head.

Abstract: An “extension ready” spinal support system that enables the extension to be accomplished with minimal disturbance to an existing spinal support structure to which the extension system is coupled. In some embodiments, the existing spinal support rod and pedicle screws can remain intact while extension subassemblies are mounted directly to the existing base rod receptacles. The extension subassemblies include a skirt portion that surrounds and engages the existing base receptacle to prevent splaying of the base receptacle. Additional resistance to splaying may be provided by a canted thread arrangement between the skirt and the base receptacle. In some embodiments, the extension receptacle is provided with a low profile (i.e., shortened axial length from the base rod receptacle) by providing a monoaxial rotation structure that rotates about but does not pitch relative to the extension axis and is shorter relative to polyaxial rotation structures.

Abstract: An ankle arthroplasty system may have a talar prosthesis and a tibial prosthesis, each of which has an articular surface and a bone engagement surface. Each bone engagement surface may have an anterior-posterior curvature and a medial-lateral curvature with a convex shape. A burr with a rotatable cutting element may be used to form a prepared surface on the talus or the tibia to receive the corresponding prosthesis. A cutting guide may be used to guide motion of the burr; the cutting guide may include a base and an arm movably coupled to the base. One of the base and the arm may have a guide surface, and the other may have a follower that slides along the guide surface to constrain motion of the burr such that the prepared surface has at least one concave curvature and one convex curvature.

Abstract: An expandable implant includes a structural insert to provide a robust connection between an insertion instrument and the expandable implant. The structural insert can be made from a different material than the remainder of the implant to withstand compressive, tensile, shear, and torsional loads which may be present while inserting the implant into a patient. The structural insert may be formed as part of a bottom member of the implant or may be a separate element inserted into the implant body. The structural insert may provide a threaded connection to an insertion instrument. The expandable implant may include a bone graft port in fluid communication with a bone graft opening extending through the implant body.

Abstract: A bioabsorbable osteosynthesis implant, having a polymeric main body and at least one macroscopic reinforcement structure, which is integrated in the main body and is made of a biodegradable metal or a metal alloy.

Abstract: A graft includes a biological graft. An embroidered textile supports the biological graft. Sutures attach the biological graft and the embroidered textile together.

Abstract: A bone fixation system including a bone plate, a flexible member, and an actuator. The flexible member connected to both the actuator and the bone plate whereby the actuator operates to move or control the movement of the flexible member. In one example, the actuator applies a force to the flexible member placing the flexible member in tension. Correspondingly, the flexible member transmits the force to the bone plate and operates to draw or pull the bone plate toward or to the actuator.

Abstract: The implantable prosthesis for replacing a human knee joint comprises a femoral prosthetic element (12) and a tibial prosthetic element (14) which are articulated with one another by means of a joint device (30) for the purpose of executing a knee bend. The tibial prosthetic element (14) has a through-opening (40) for the passage of a tool (84), a rod-like shaft anchoring part (32) or an intramedullary lengthening nail (80).

Abstract: A method of anchoring a support material to tissue includes forming an incision in a urogenital triangle of a patient for access to a pelvis of the patient; inserting a body portion of an anchor into a lumen in a cannula and having a spine portion of the anchor extending radially out of a wall of the cannula; and inserting a leading end of the cannula and the anchor into the incision. The method includes pushing the leading end of the cannula into periosteum tissue of the pelvis; engaging the spine portion of the anchor with the periosteum tissue; withdrawing the leading end of the cannula from the incision and leaving the anchor engaged in the periosteum tissue; and securing the support material to a suture that is attached to the anchor. The method includes delivering the support material through the incision to the pelvis.

Abstract: An implant for use in orthognathic surgery of a mandible may include a longitudinal plate member and a plurality of pre-configured guides coupled to the plate member. The longitudinal plate member is pre-bent to correspond to the post-operative shape of the mandible; and the guides are pre-configured to align the plate member with the mandible when the implant is positioned against the mandible after the mandible has been separated.

Abstract: A spinal implant tool set includes end guide tools having flexible back wall flaps that receive opposite ends of the rod and intermediate guide tools that hold the rod in intermediate locations between the end guide tools. Both the end and intermediate guide tools include an attachment structure for operably connecting the guide tool to a bone screw. A multi-function installation tool and a bone screw driver each mate and cooperate with the guide tools. A method utilizing the tool set allows a surgeon to percutaneously implant the bone screws and the rod in the patient.

Abstract: A bone implant that is elongate along a longitudinal axis includes an implant body including first and second side wire segments that are spaced from each other so as to define at least one apertures extending through the implant body. The at least one aperture is configured to receive a bone fixation element so as to secure the bone implant to bone.

Abstract: A puncture device, a puncture apparatus, and a method are disclosed, the puncture apparatus including a puncture device for puncturing a biological tissue, a urethral-insertion member, a vaginal insertion member, and a supporting member which supports the urethral-insertion member, vaginal insertion member and a puncture member of the puncture device. The puncture device includes a puncture needle for puncturing a biological tissue, a shaft portion and a connection portion for connecting the puncture needle and the shaft portion to each other, and an implant assembly positioned at a distal end of the puncture needle and having a needle tip portion for puncturing a biological tissue and a biological tissue supporting implant. The puncture needle has a form of a pipe and has a tubular portion. The biological tissue supporting implant is accommodated in the hollow portion.

Abstract: According to some embodiments, a method of accessing an intervertebral space of a patient's spine in a minimally invasive manner compromises creating a passage from a posterior end of a pedicle of a vertebral member using a probe, advancing the probe through the pedicle and to a main body portion of the vertebral member, advancing the probe through a superior endplate of the vertebral member and into the intervertebral space and enlarging the passage using at least one tap to create an enlarged passage from a posterior of the pedicle to the intervertebral space. In some embodiments, the enlarged passage traverses at least three cortical layers of the vertebral member.

Abstract: Disclosed herein are methods and devices for securing soft tissue to a rigid material such as bone. A tissue anchoring device is described that comprises an anchor body and a spreader such that tissue may be captured or compressed between outside surfaces on the anchor and inside surfaces of a bone tunnel to secure the tissue within the tunnel. Methods are described that enable use of the bone anchoring device to secure a tissue graft into the tibial and femoral bones during anterior cruciate ligament (“ACL”) reconstruction.

Abstract: An implant for use in orthognathic surgery of a mandible may include a longitudinal plate member and a plurality of pre-configured guides coupled to the plate member. The longitudinal plate member is pre-bent to correspond to the post-operative shape of the mandible; and the guides are pre-configured to align the plate member with the mandible when the implant is positioned against the mandible after the mandible has been separated.

Abstract: An orthopedic screw is used in a fixation device for treating fractures. The device has a body with holes to accept the bone screws. The bone screws have a layer of bioresorbable material on a surface portion of the head of the screw contiguous with the shaft. Engagement between the bone screws and the body is initially through the bioresorbable material, which engagement rigidly fixes the relative angular orientation between the bone screws and the body when the device is applied to a bone. As the bioresrobable material is resorbed the angular relation between the bone screws and the body is no longer rigidly fixed, thereby effecting a transformation from rigid osteosynthesis to flexible osteosynthesis to allow micromotion between the bone fragments which promotes healing.

Abstract: There are disclosed embodiments of screws for use in orthopedic surgery, particularly in pediatric patients. In some embodiments, inner and outer implantable members are provided, with the outer implantable member threadable on the inner implantable member to provide compression on two or more bone parts. In some embodiments, screw members are provided with a threaded shaft, and the thread continues into the head of the screw member to enable the thread to remain in pediatric bone.

Abstract: Embodiments of the invention relate generally to tissue anchors and methods of delivering same to the intervertebral disc or other sites within the body. In some embodiments, the anchors provide pull-out resistance, stability and/or maximize contact with tissue involving a minimum amount of penetration. In some embodiments, delivery methods are minimally invasive and include linear, lateral, and off-angle implantation or driving of anchors along, against or within tissue surfaces.

Abstract: An interbody fusion cage having upper and lower canals for receiving the heads of bone screws that have been pre-installed in opposing vertebral body endplates. In certain embodiments, the interbody fusion cage can include a main interbody device having a guide surface canal, and a rail component configured to slidingly engage the guide surface canal.

Abstract: An implant includes an implantable portion and a housing. The implantable portion has a head and a shank extending from the head. The shank has a solid outer surface and defines a radius of curvature. The housing is pivotally and rotatably coupled to the head and is configured to secure a rod to the implantable portion. The housing is fixed relative to the implantable portion when a rod is secured within the housing.

Abstract: A system and method for securing a medical implant within a patient includes disposing an anchor element around the implant, the anchor element including a pair of tabs each including an eyelet, and a flexible intermediate portion between the tabs, by positioning, the implant within the intermediate portion and folding the anchor element such that the tabs contact one another. The anchor element is positioned at a desired implantation position with the tabs proximate soft tissue of the patient. The method further includes inserting a distal tip of a fixation element delivery tool through the eyelets and into the soft tissue, the fixation element including at least one tissue anchor and an adjustable suture arrangement coupled to the tissue anchor. The tissue anchor is deployed from the delivery tool and into the soft tissue of the patient. The delivery tool is withdrawn and the adjustable suture arrangement is tightened.

Abstract: A variety of configurations of implant management devices are provided. The configurations provide different combinations of features for maintaining a location of an implant with respect to the device and managing filaments of the implant. One exemplary embodiment of a device includes a generally rectangular-shaped body having an implantable body retainer, an opening disposed a distance apart from the retainer and configured to receive a ligament graft therein, and a fold extending across the body and intersecting the opening. Folding one end of the body towards a bottom surface of the body along the fold can form a filament loop engaging region to hold in tension a filament loop extending from the implant. Additional filament(s) associated with the implant can be managed by various filament retention features. Methods for preparing a ligament graft for implantation by relying upon indicia formed on a surface of the device body are also provided.

Abstract: A technique for joint repair employing a suture/button construct and an applicator designed to securely engage a button of the suture/button construct. The button of the suture/button construct securely engages two shafts of the applicator (i.e., an angled, non-vertical flat face of the outer shaft and a threaded region of the inner shaft). Engagement to and disengagement from the applicator is conducted without rotation of the button. The applicator with the secured button is introduced into the tissue (for example, soft tissue or a bone tunnel) and the button is passed through the tissue.

Abstract: Spinal rod reduction apparatuses, systems, and methods are provided. In various examples, a rod reduction apparatus includes a first threaded member (130, 210, 330) including an engagement feature (138A, 138B, 220, 332, 334) configured to selectively anchor the first threaded member to the implantable screw assembly. A second threaded member (110, 230, 310) is configured to threadably engage with the first threaded member. The second threaded member is axially movable with respect to the first threaded member with rotation of the second threaded member. A spinal rod urging member (120, 240, 320) is axially movable with the second threaded member. The urging member includes a bearing surface (126, 242, 320) that is configured to selectively abut the spinal rod and selectively urge the spinal rod toward the implantable screw assembly with rotation of the second threaded member in a first rotational direction.

Abstract: The present invention provides methods and devices for treating the annulus of an intervertebral disc. The methods and devices can employ an expandable treatment device which is deployed at least partially in the subannular space. Fixation devices and methods are also disclosed, which help to secure the treatment device in place.

Abstract: An anchor-in-anchor fixation system is provided for securing underlying structure, such as bone. The fixation system includes a first bone anchor having a shaft for fixation to underlying bone, and a head that defines an internal bore. A second bone anchor extends through the bore and into underlying bone. A fixation assembly is also provided that includes one or more fixation systems coupled to an auxiliary attachment member configured for long bone fixation, spinal fixation, or fixation of other bones as desired.

Abstract: A bionic fixing apparatus is provided. The bionic fixing apparatus includes a flexible portion having at least one trench. The trench is disposed on the surface of the flexible portion and has a first end and a second end. An interval is disposed between the first end and the second end. The trench is disposed for spreading the stress applied on the bionic fixing apparatus and preventing stress concentration and stress shielding.

Abstract: A method includes inserting a first surgical device into an exposed first end of a first bone until a trailing end of the first surgical device is disposed adjacent to the first end of the first bone. A second surgical device is inserted into an exposed first end of a second bone while the first surgical device remains disposed within the first bone. A first portion of an implant is advanced into the second bone while being engaged with a passageway defined by the implant such that the implant is guided by the second surgical device. The second surgical device is removed from the second bone and from its engagement with the implant. The first bone is repositioned such that the first surgical device is aligned with the passageway defined by the implant, and the first bone is forced into engagement with a second portion of the implant.