Abstract: Patient specific surgical instruments, and in particular cutting guides, and methods of use and manufacture are described. The surgical instrument can be used in an orthopaedic arthroplasty procedure to be carried out on a joint of a patient and can allowing soft tissue balancing for the joint. The instrument comprises a body having an attachment area configured using data specific to a bone of the joint of the patient so as to attach to the bone in a unique position. The instrument includes at least a first cutting guide and an adjustment mechanism operable to change the position of the cutting guide relative to the bone.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: A cutting tool is provided with an arcuate cutting blade that preferably engages a guide tool to create a curved resected surface during an arthorplasty procedure. In one embodiment, a depth of the cutting blade is sufficient to permit the simultaneous creation of resected surfaces on two bones that articulate, such as both the femor and the tibia for a given condyle, without the need to reposition the guide or the leg. In another embodiment, a cutting member has a generally rectangular cross-section along a longitudinal axis with a first and second surface having cutting teeth defined thereon and a third and fourth surface adapted to interface with a cutting guide positioned proximate the bone. In this embodiment, the cutting tool can resect the bone in two different directions without reorienting the cutting member.

Abstract: Disclosed herein is a minimally invasive ball joint implant and prosthesis for the treatment of arthritis, trauma, and other medical conditions leading to joint destruction and pain, as well as methods of use. In various cases, the prosthesis does not require reaming into the intramedullary canal and does not require diaphyseal fit for any bones associated with the joint, thereby resulting in more rapid and complete recovery. In various cases, the prosthesis incorporates an anchoring stem specifically designed to be impacted into the bone and to facilitate bony ingrowth after implantation, thereby strengthening the implanted prosthesis and preventing rotation thereof.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: A method and apparatus for performing an open wedge osteotomy utilizing a keyed, wedge-shaped implant for disposition in a keyed, wedge-shaped opening created in a bone. The keys may be disposed in vertical or horizontal arrangements. In addition, a shear rib key hole may be formed adjacent the wedge-shaped opening in the bone.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: An implant resection system for preparing an implant site to replace a defect in an articular surface of a first bone includes a guide configured to be coupled generally perpendicular to the first bone proximate to the defect. The guide includes a body portion defining a plurality of excision passageways. The excision passageways each define a generally cylindrical core pathway configured to extend generally perpendicular to the first bone which partially overlaps with an adjacent generally cylindrical core pathway. A projection associated with each of the plurality of the generally cylindrical core pathways defines a truncated cylindrical excision site extending through a portion of the articular surface. Each truncated cylindrical excision site partially overlaps with at least one adjacent truncated cylindrical excision site.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: Reciprocating rasps for the surgical preparation of the bone prior to the implantation of a glenoid or acetabular component with complex geometry are disclosed. Surgical methods for the use of such reciprocating rasps are also disclosed.

Abstract: A veterinary precision fixation device for use in tibial plateau leveling osteotomy procedures includes a jig assembly having a center jig member having a first and a second end, a first jig leg pivotally coupled to the first end, and a second jig leg pivotally coupled to the second end. The device also includes a saw positioning assembly including a positioning arm and a guide leg, the positioning assembly being operably connected to the jig assembly. The device further includes a saw guide assembly having a saw fixation member slidably coupled to at least one slide bar wherein the slide bar is coupled to the guide leg of the saw positioning assembly. A method for using the precision fixation device in a tibial plateau leveling osteotomy is also provided for making a substantially perpendicular cut of the tibia.

Abstract: A surgical sagittal saw blade and a complementary cutting guide for use with the blade. The blade includes a bar shaped to be releasably secured in a static position to a complementary surgical sagittal saw. A blade head with teeth is mounted to the bar to pivot. One or more drive links connected to the saw extend to the blade head to pivot the blade head. The cutting guide and blade bar have complementary features for holding the blade bar to above a surface of the cutting guide. The features that hold the blade bar to the cutting guide allow the blade to move over the cutting guide surface while constrain the blade from moving out of the plane immediately above the cutting guide surface.

Abstract: A kit (10) for removal of bone (12) adjacent to an implanted prosthesis (14), said kit (10) comprising: a guide (16) for cooperation with the prosthesis (14); and a tool (20) constrainable by said guide (16) for removal of the bone (12).

Abstract: Techniques and instrumentation for elbow reconstruction, specifically, for repairs of the ulnar collateral ligament (UCL). The instrumentation provides for precise formation of sockets and tunnels along with easy suture/graft passage while accommodating all forms of elbow UCL reconstruction techniques. A V-drill guide is provided with a handle and two drill sleeves having intersecting trajectories for creating an intersecting V-shaped bone tunnel in the ulna. An adjustable humeral guide has an adjustable arm with an arc shape, and a peg and a block extending from each end of the adjustable arm. The peg is shaped to fit within an already-formed humeral socket. The block allows a drill to pass through and form other tunnels which intersect with the originally-formed tunnel at various positions.

Abstract: A virtual implant placement method and system comprising models of implants and/or bones linked to tracking assemblies mounted onto the bones. A joint model is constructed intraoperatively based on the positions of the tracking assemblies to determine the positions of cut planes.

Abstract: A method for implanting a malleolar implant in an ankle joint. A spacer block is positioned between a lower portion of a tibia and an upper portion of an astragalus in the ankle joint. A guide attached to the spacer block is positioned opposite an outer surface of a fibular malleolus. A bore aligned with the guide is formed through the fibular malleolus. The spacer block is removed from between the tibia and the astragalus. A shank of the malleolar implant is engaged with the bore from an inner surface of the fibular malleolus. The shank is advanced into the bore so an inner surface of a head of the malleolar implant engages the inner surface of the fibular malleolus.

Abstract: A cutting guide (12) for guiding a saw blade (22) during preparation of a metatarsal (14) of a foot (10) for a procedure, such as to receive a metatarsal implant (20), includes a housing (242) and an aligner (38). The housing (242) is adapted to be positioned substantially adjacent to the metatarsal (14). The housing (242) includes a saw guide (30) for receiving and guiding the saw blade (22). The aligner (38) is coupled to the housing (242). The foot (10) includes one or more additional metatarsals, and the aligner (38) is used to align the saw guide (30) relative to one of the additional metatarsals. The aligner (38) can extend substantially perpendicular to the saw guide (30). Additionally, the aligner (38) can be used to be substantially aligned with a longitudinal axis (40) of one of the additional metatarsals. The cutting guide (12) can further include a handle (244) that is secured to the housing (242).

Abstract: A system for orienting objects relative to an anatomical feature of a patient includes a guide with a reference guide surface. The system also includes a referencing object that is guided by the reference guide surface toward the anatomical feature to be fixed to the anatomical feature in a reference orientation relative to the anatomical feature. Moreover, the system includes an instrument with at least a portion that is transparent. The referencing object is viewable through the transparent portion of the instrument to align the referencing object with the instrument and to orient the instrument in the reference orientation relative to the anatomical feature.

Abstract: A method for promoting fusion of and/or stabilizing a facet joint between two adjacent vertebrae comprises clamping the two adjacent vertebrae across the facet joint to apply a compressive force across the joint. Apparatus for promoting fusion of and/or stabilizing a facet joint comprises at least one cinchable tether and at least one locking member coupled with the tether for locking the cinched tether to maintain compressive force across the facet joint. The tether is adapted to extend through at least one hole through each of two adjacent vertebrae, across the facet joint.

Abstract: A tool for separating an acetabular shell of a hip prosthesis from the surrounding pelvic bone includes a fixture which attaches to the acetabular shell and has a chisel guide mounted on it. A chisel associated with the chisel guide is curved to conform to the outer periphery of the acetabular shell, and the chisel guide causes the chisel to circumscribe the acetabular shell as the chisel is inserted between the acetabular shell and the pelvis.

Abstract: An improved osteotomy guide and retraction device for use during the performance of bunionectomies, whereby the improved device provides a self-supporting instrument that does not require independent fastening means to secure the device in the desired position at the surgical site, and a method of use of the device.

Abstract: A surgical resection guide comprising: a housing (36); a stylus arm (38) extending through the housing (36) and a linear adjustment mechanism. The linear adjustment mechanism comprises: a shaft (30) at least partially received within a bore extending through the housing (36) such that the shaft (30) can slide along its longitudinal axis relative to the housing (36), the shaft (30) incorporating a shaft tooth (50); and a dial (44) rotatably coupled to the housing (36) and incorporating a helical dial groove (48) defining a longitudinal axis offset from the longitudinal axis of the shaft (30). The shaft tooth (50) engages the dial groove (48) such that rotating the dial (44) relative to the housing (36) causes the shaft tooth (50) to slide along the dial groove (48) causing the shaft (30) to slide within the bore along its longitudinal axis. The housing (36) and the stylus arm (38) can rotate about the shaft (30) without causing the shaft (30) to slide within its bore along its longitudinal axis.

Abstract: Described herein are methods and devices useful for reaming and shaping the surfaces of a joint in a mammalian body. The reaming and shaping devices and methods are particularly useful in preparation of a joint for a minimally invasive joint replacement or resurfacing, though they may he used as part of any appropriate arthroplasty procedure.

Abstract: The present disclosure relates to bone resurfacing. One embodiment includes a method for preparing an implant site in bone, comprising establishing a first working axis extending from said bone; establishing a second working axis extending from said bone, the second working axis is displaced from the first working axis; creating a first socket in the bone by reaming about the first working axis; and creating a second socket in the bone, adjacent the first socket, by reaming about the second working axis.

Abstract: Various embodiment of the present invention provide a distal femoral trial that allows a surgeon to cut the central box geometry of a distal femur using an implant-shaped trial. The trial includes a cutting guide that is removable from the trial and adjustable with respect to the trial. The guide is intended to control the depth and direction of the cutting instruments used to prepare the femur for the a posterior stabilized implant.

Abstract: An instrument for preparing a surface of a joint is provided. The glenoid surface is adapted for receiving a prosthetic component having a feature closely conforming to the surface. The prosthetic component provides a bearing surface for a head portion of a long bone. The instrument includes a guide having a first feature and a second feature and a tool. The tool is used for cooperation with the first feature for preparing the surface. The first feature is adapted to at least partially control the position of the tool as it prepares the surface. The second feature is adapted to assist in positioning of the guide with respect to the joint.

Abstract: A system locates a femoral cutting guide on a distal end of a femur. The femoral cutting guide establishes at least a first reference plane to perform a distal femoral planar cut. The system generally includes a mounting rod operable to insert into the distal end of the femur. An index member is operable to abut the distal end of the femur. A bridge member extends from the index member. A cutting guide member extends from the bridge member. The cutting guide member includes a first channel that establishes the first reference plane. A mounting mechanism releasably couples the cutting guide member to the bridge member. The mounting mechanism is operable to generate a sliding resistance between the bridge member and the cutting guide member that is generally overcome to position the cutting guide member relative to the femur.

Abstract: A surgical apparatus may include a guide apparatus to be used in an arthroscopic procedure and to interact with a passageway through a body portion formed by intersecting first and second holes that may lead into the body portion from different positions, e.g., from two different locations on a bone. The guide apparatus may include first and second guide members having first and second passages, respectively, that communicate with the first and second holes. The surgical apparatus may also include a suture retriever arranged to retrieve, from the second passage, a suture fed into the first passage. A method may include forming a passageway including first and second intersecting holes. First and second guide tubes may be positioned relative to the first and second holes, a suture or suture-like material may be provided into the first guide tube, and the suture or suture-like material may be retrieved from the second guide tube.

Abstract: A system for guiding resurfacing operations on at least a portion of a joint of at least one bone is provided and uses a guide with actuators (motors) controlled by a computer to position a cutting tool relative to a bone so that the bone surface can be cut in a flexible and accurate manner.

Abstract: Provided is a method and device for shaping a greater tuberosity of a humerus in preparing for receiving a prosthetic humeral head. The device shaves bone from the greater tuberosity such that the greater tuberosity is not resected or completely removed.

Abstract: A milling system is disclosed for creating a cavity in a bone. The cavity has a cross section which has a generally triangular profile having a first side generally parallel with an axis of the bone and a second side forming an acute angle with the first side. The cavity is contiguous with a pre-existing conical cavity in the bone. The system comprises a drive shaft, a frame for carrying a cutter and a cutter for cutting the cavity. The drive shaft has a proximal end configured for coupling to a drive means and a distal end configured to form a portion of a drive joint for coupling the drive shaft to a cutter. The frame includes a shaft and a cutter mount for mounting a cutter at a first angle approximating the acute angle with respect to the shaft. The mount includes a bracket extending laterally from the shaft to a bearing configured to receive a portion of a cutter and maintain the received cutter oriented at the first angle during rotation.

Abstract: An orthopaedic cutting guide assembly and method of cutting a bone are described. A component has a guide for guiding a cutting instrument and at least a first mechanism for securing the component to a bone. A movement indicator has a mechanism for securing the movement indicator to the bone independently of the component. The component includes at least one indicium by which movement of the component relative to the bone can be indicated by relative movement of the movement indicator and the indicium.

Abstract: A resection guide having an alignment barrel with holes that pass through the entire cross-section of the alignment barrel is disclosed. An alignment guide is mounted on the alignment barrel. Alignment guide can translate and rotate with respect to alignment barrel. The alignment guide has holes that extend through it. A resection plate is located at one end of the alignment guide. The resection plate has a resection surface. The resection guide is located on a bone using a navigation system and attached to the bone by driving two nails through the holes on the alignment barrel and one nail through one of the holes on the alignment guide. The resection surface is used to guide a tool for resecting the bone.

Abstract: Method for performing an open wedge, high tibial osteotomy, utilizing an apparatus comprising a wedge-shaped implant for disposition in a wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least one key for disposition in at least one corresponding keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia, wherein each of the at least one keys comprises an interior bore for receiving a fixation screw, at least one fixation screw for disposition in the interior bore of the at least one key, and further wherein the apparatus is configured so that when the at least one fixation screw is received in the interior bore, the at least one fixation screw terminates within the bore.

Abstract: A kit for removal of bone adjacent to an implanted prosthesis. The kit includes a guide for cooperation with the prosthesis and a tool constrainable by the guide for removal of the bone. The guide may include a first portion of the guide that is co-operable with the tool and a second portion of the guide that is co-operable with the prosthesis.

Abstract: A support arrangement for use in supporting a bone during a surgical operation. The arrangement includes one or more supports located by a guide means, each support including means to fit around and support said bone during said operation.

Abstract: We describe various alignable tools, in particular, trials and chisels, that may be used in preparing an intervertebral site in a spine, the site being suitable for placement of a prosthetic intervertebral disc as a replacement for a natural disc in that spine. We also describe methods of using those tools.

Abstract: Systems and methods for planning surgical procedures involving custom medical implants that can involve the selection, design and/or creation of custom medical implants and/or the selection, modification, and/or design of custom surgical procedures related to those implants. Certain embodiments allow implants to be selected, designed, created, or otherwise customized and then placed in patients using non-standard surgical techniques. The invention provides greater flexibility in implant use by allowing a surgeon to revise, create, or otherwise select surgical techniques for custom implants and, ultimately, provide better treatment in a greater variety of medical circumstances. Certain embodiments of the invention involve computer assisted surgery to provide for implant-related surgery involving non-standard surgical steps and/or implants.

Abstract: The invention relates to a system for the minimally invasive treatment of a bone fracture, especially of a proximal humeral or femoral fracture. The inventive system has an osteosynthesis plate having a supporting section in the cortical substance and an additional fastening section on the bone. A second linking section of the guide element and the shaft of the fixing element are configured as an axially displaceable anti-tilt slide bearing. The system has at least one anti-twist screw in the supporting section for preventing the detached bone fragment from rotation.

Abstract: An instrument for preparing a surface of a joint is provided. The glenoid surface is adapted for receiving a prosthetic component having a feature closely conforming to the surface. The prosthetic component provides a bearing surface for a head portion of a long bone. The instrument includes a guide having a first feature and a second feature and a tool. The tool is used for cooperation with the first feature for preparing the surface. The first feature is adapted to at least partially control the position of the tool as it prepares the surface. The second feature is adapted to assist in positioning of the guide with respect to the joint.

Abstract: The application relates to a method of orienting a bone-milling cutter and an impact instrument for a hip-prosthesis cup in an acetabulum. The method includes initially positioning a manipulation cup by a manipulation joint head and representing this position by at least one guide rod or fixation rod that is fixed in a bone. The method also includes removing the manipulation cup and adjusting a position of both the bone-milling cutter and the impact instrument with respect to either the guide rod itself or a guide rod that is attached to a holding device disposed on at least one fixation rod.

Abstract: An ancillary tool (10) comprising a trial humeral trochlea (202) that is representative of an anatomical humeral trochlea when the trial humeral trochlea is in place with respect to corresponding cubital (SC) and/or radial (SR) articular surfaces and a cut-out guide (30) for cutting an ulna (C) and/or a radius (R), wherein the cut-out guide (30) is adapted to be positioned with respect to the trial humeral trochlea (202). The cut-out guide (30) is also adapted to be positioned with respect to an ulna (C) and/or to a radius (R) equipped with the trial humeral trochlea (202).

Abstract: Systems and processes for tracking anatomy, instrumentation, trial implants, implants, and references, and rendering images and data related to them in connection with surgical operations, for example total knee arthroplasties (“TKA”). These systems and processes are accomplished by using a computer to intraoperatively obtain images of body parts and to register, navigate, and track surgical instruments.

Abstract: A system for resecting a tibia and femur during arthroplasty includes anchoring devices, a three-way alignnment guide attachable to an anchoring device. The alignment guide provides for locating a resection guide in three degrees of freedom, including one translation and two rotations. The resection guide is coupled to a computer navigation system.

Abstract: In an embodiment, the methodology of the present invention is based on the use of an intraoperative navigation system and of a compact alignment guide for alignment of implant components. In an embodiment, an alignment guide of the present invention includes a first component fixable to a bone element; a second mobile component, and a third mobile component, wherein the second mobile component and two control mechanisms form a first link, wherein the two control mechanisms are working in parallel to perform adjustments in two degrees of freedom, wherein the third mobile component and three control mechanisms form a second link, wherein the three control mechanisms are working in parallel to perform adjustments in three additional degrees of freedom, and wherein the first link adjustments and the second link adjustments are performed in series to provide a total adjustment of five degrees of freedom relative to the first component.

Abstract: Methods and devices for performing hip replacement surgery are described. According to one embodiment, a method comprising providing an incision locator, the incision locator comprising at least one location indicator and at least one incision indicator, the location indicator configured to align with a central axis of the femur, and the incision indicator configured to guide a proper placement of a surgical incision when the location indicator is aligned, aligning the location indicator with at least one anatomical feature of the patient, making an incision in the proper location as guided by the incision indicator, and completing the surgical procedure is described.

Abstract: An orthopedic device for a shoulder joint includes a patient-specific alignment guide. The alignment guide includes a cap having a three-dimensional engagement surface customized in a pre-operative plan by computer imaging to be complementary and closely mate and conform to a humeral head of a proximal humerus of a patient. The alignment guide includes a tubular element extending from the cap and defining a longitudinal guiding bore for guiding an alignment pin at a patient-specific position and orientation determined in the pre-operative plan, and an orientation feature on the cap. The orientation feature is designed to orient the cap relative to the humeral head when the orientation feature is aligned with a landmark of the proximal humerus.

Abstract: A method of using a guide system for resecting a bone through incisions of the type utilized for arthroscopic procedures is provided. The guide system comprises a first alignment pin, a second alignment pin and a wire saw. The first alignment pin is configured to be inserted through a first incision into a bone in a first orientation. The second alignment pin is configured to inserted through a second incision into the bone in a second orientation. The first alignment pin and the second alignment pin are configured and oriented to define a resection plane of reference through which the bone is to be resected and the wire saw is configured to be inserted through the first and second incisions to be guided by the first and second alignment pins while being moved to resect the bone.

Abstract: The invention relates to a spinal disc endoprosthesis. The endoprosthesis has a resilient body formed of one or more materials which may vary in stiffness from a relatively stiff exterior annular gasket portion to a relatively supple central nucleus portion. Concaval-convex elements at least partly surround that nucleus portion so as to retain the nucleus portion and gasket between adjacent vertebral bodies in a patient's spine. Assemblies of endoprosthetic discs, endoprosthetic vertebral bodies, and endoprosthetic longitudinal ligaments may be constructed. To implant this endoprosthesis assembly, information is obtained regarding the size, shape, and nature of a patient's damaged spine. Thereafter, one or more prosthetic vertebral bodies and disc units are constructed in conformity with that information. Finally, the completed and conformed vertebral body and disc assembly is implanted in the patient's spine.