Abstract: An instrument for establishing orientation of a pelvic prosthesis comprises a tripod having an angularly adjustable guide rod on it. The tips of the legs define a plane, and the guide rod is set by the surgeon to a defined orientation with respect to this plane on the basis of preoperative studies. In use, two of the legs of the instrument are positioned by the surgeon at defined anatomical locations on the pelvis (e.g., a point in the region of the posterior/inferior acetabulum and a point on the anterior superior iliac spine). The third leg then lands on the pelvis at a point determined by the position of the first two points, as well as by the separations between the third leg and the other two legs. The position of the guide rod then defines with respect to the actual pelvis the direction for insertion of a prosthesis.

Abstract: An intrabody implant disclosed and methods of use are disclosed. The implant has an inclined surface, forming a wedge shape having an acute angle adapted to be placed between at least 2 separated portions of a single bony structure (such as a vertebral body). In some embodiments, the implant may be used to support portions of a vertebral body that have been separated surgically as part of a pedicle subtraction osteotomy and to orient the portions at a more predictable lordotic angle.

Abstract: A joint prosthesis system, specifically a shoulder prosthesis, for shoulder replacement, revision and repair. The implants provide fixation into the best bone available to a surgeon. The implants are used in a superior-inferior and anterior-posterior construct forming a type of cross or X-shape. The implants allow for interchangeability of the articulating component as well as rotational orientation. The systems will allow for augments to accommodate bone loss. The implants may allow for additional security using screws or anchors inserted into the scapula.

Abstract: Disclosed are devices, methods and/or systems for tissue protectors and/or retractors having patient specific and/or patient adapted features that facilitate the accuracy and predictability of bone resection and tissue preparation during joint surgery, as well as improve the distraction of soft tissues, desirably preventing accidental injury to surrounding soft tissue structures and improving visualization.

Abstract: A method of percutaneous implantation of a pedicle screw system comprising the steps of implanting a first pedicle screw assembly in a first vertebra, the first pedicle screw assembly including a first coupling element connected with a first extension defining a first space and implanting a second pedicle screw assembly in a second vertebra, the second pedicle screw assembly including a second coupling element connected with a second extension and intersecting at least one a portion of the second extension with the first space.

Abstract: A joint distraction device for use in an arthroscopic surgery is provided. The device has a joint distraction mechanism, situated in between two bone fixation surfaces, and is capable of changing the relative distance between these two surfaces. The force generated by the mechanism should be sufficient to insert bone spikes affixed to the surfaces into bone, as well as distract the joint to create a sufficient enough gap to allow the intended procedure. With the surfaces and spikes engaged to bone at opposite sites of a joint, an increase in distraction force results in an increase in the relative distance results, hence increasing the space within the joint. Embodiments of this invention, compared to fracture table approaches, effectively eliminate the risk of pudendal nerve injury, allow for longer surgical times, and allow for much more controllable joint distraction.

Abstract: A surgical instrument including a customized patient-specific guide block is disclosed. The customized patient-specific guide block includes a first surface, a bone-facing surface, a second surface positioned opposite the first surface and the bone-facing surface, and a guide pin hole extending between the second surface and the bone-facing surface. The first surface has a customized prosthesis-specific negative contour shaped to match a corresponding contour of a prosthetic component, and the customized prosthesis-specific negative contour includes a concave surface shaped to match a convex surface of the corresponding contour of the prosthetic component. A method of performing an orthopaedic surgical procedure is also disclosed.

Abstract: A device for a patient-specific acetabular and/or femoral guide. The guides can be used in a selected resection of at least one of a femur and an acetabulum to increase a range of motion of the femur relative to the acetabulum. Generally, a natural acetabulum and femoral head are maintained.

Abstract: A surgical instrument including a pre-cut trial mounted on a pre-cut line which is cut shallower than a genuine-cut line. The pre-cut trial is modeled after the genuine implant which is mounted on resected surfaces formed by performing genuine-cutting and comprised of an end resected surface, posterior and anterior resected surfaces, and posterior and anterior chamfer-resected surfaces on the distal end of a femur, and the pre-cut trial is mounted on the pre-cut line, thus observing the extended and flexed positions of the femur and the state of flexion thereof so as to make judgment if the genuine implant is appropriate.

Abstract: Patient-matched surgical instruments, and methods for making patient-matched surgical instruments, may include patient-matched surgical instruments having an anatomy facing side with several discrete, physically separate anatomy contacting portions configured to match the anatomy of a particular patient. The anatomy contacting portions may be one or more of non-uniform in distribution, non-uniform in shape or non-uniform in surface area.

Abstract: The jig is formed based on a three-dimensional reconstruction of the bone elements of the joint from tomodensitometric data; the marking of points on the humerus being used as a basis for the positioning of the considered prosthetic element. The jig includes: a support base cooperating with the humeral head according to a single position, one portion of the base cooperating with the intertubercular sulcus or bicipital groove; a gripping portion; and a breakable area temporarily receiving a cutting block to allow its fixation to the humeral bone before enabling to perform the humeral resection.

Abstract: A method of performing a minimally invasive procedure on a hip joint of a patient to relieve a femoral acetabular impingement. An access device is placed through skin of the patient to provide minimally invasive access to a target volume of material that creates the femoral acetabular impingement. A cutting accessory is placed into the access device to remove material and relieve the femoral acetabular impingement. A tracking and control system establishes a virtual boundary that defines the target volume of material that creates the femoral acetabular impingement, tracks a position of the cutting accessory relative to the virtual boundary, and controls movement of the cutting accessory so that cutting is substantially maintained within the virtual boundary.

Abstract: Systems and methods provide patient-specific cutting blocks that allow for bone resurfacing procedures, such as milling or burring, with simplified devices. A computer assisted surgical cutting block is produced having a surface region that matches with the surface region of a patient's bone to be altered. A cutting tool may be provided having a contoured bone mating surface and a contoured and patient-specific shaped cutting guide surface, which is located in a plane above the bone mating surface. One or more channels are provided in the cutting block, and as the surgeon moves the cutting tool (a milling or burring, for example) in the channels the tool cuts the bone both laterally along the surface of the bone and vertically into the bone according to the cutting guide surface and other preselected surface features of the cutting block.

Abstract: A resection guide can be configured to guide a resection tool toward a graft source or a tissue body. The resection guide can include a resection guide body with at least one opening, and a guide member configured to be at least partially inserted into the at least one opening.

Abstract: A resection guide can be configured to guide a resection tool toward a graft source, and can include a resection guide body made from a first material, and a guide member made from a second material. The second material is harder than the first material.

Abstract: Disclosed herein are devices and methods for guiding a surgical instrument for resecting a portion of a humerus of a patient. The surgical instrument is a patient-specific cutting guide having a base portion having a contact surface shaped to substantially match an outer surface of a neck portion of the humerus. The guide includes at least one proximal stabilization member extending medially from the base portion and having a contact surface shaped to substantially match an outer surface of a head portion of the humerus. The guide further includes at least one distal stabilization member extending distally from the base portion and having a contact surface shaped to substantially match an outer surface of a shaft portion of the humerus. The base portion includes a guide slot for guiding the surgical instrument.

Abstract: A method of determining an optimal position of a glenoid implant. The method includes identifying a center point of a patient's glenoid fossa based on an image of the patient's glenoid fossa; determining the optimal position of the glenoid implant based on the location of the center point relative to a medial point of the patient's scapula; and selecting orientation of an alignment pin based on the determined optimal glenoid implant position such that the glenoid fossa will be prepared to receive the glenoid implant at the optimal position when the glenoid fossa is prepared with a cutting device or guide coupled to the alignment pin.

Abstract: An orthopedic device includes a first patient-specific element having a first patient-specific surface preoperatively configured to mate and conform to a first anatomic portion of a specific patient based on medical scans of the patient. The orthopedic device includes a second patient-specific element having a second patient-specific surface preoperatively configured to mate and conform to a second anatomic portion of a specific patient based on medical scans of the patient. An arcuate bridge couples the first and second patient-specific portions. The arcuate bridge is configured to provide clearance the patient's anatomy between the first and second anatomic portions.

Abstract: The present disclosure relates to systems and devices for positioning and placing multiple electrodes in a target surgical site. A guide block is disclosed which introduces electrodes into target tissue and includes an elongated, generally rectilinear bar having a plurality of slots defined therethrough. Each of the slots is configured to selectively receive and retain a corresponding electrode therein. The rectilinear bar is malleable and selectively bendable from a substantially linear configuration to a substantially curved configuration to facilitate positioning the guide block relative to target tissue.

Abstract: An implant for therapeutically separating bones of a joint has two endplates each having an opening through the endplate, and at least one ramped surface on a side opposite a bone engaging side. A frame is slideably connected to the endplates to enable the endplates to move relative to each other at an angle with respect to the longitudinal axis of the implant, in sliding connection with the frame. An actuator screw is rotatably connected to the frame. A carriage forms an open area aligned with the openings in the endplates. The openings in the endplates pass through the carriage to form an unimpeded passage from bone to bone of the joint. The carriage has ramps which mate with the ramped surfaces of the endplates, wherein when the carriage is moved by rotation of the actuator screw, the endplates move closer or farther apart.

Abstract: An orthopaedic surgical instrument assembly is disclosed. The assembly includes an orthopaedic surgical instrument including a first surface, and a measurement gauge removably coupled to the orthopaedic surgical instrument. The gauge includes an arm having a tip positioned proximal to the orthopaedic surgical instrument, and a plurality of markings defined on the arm. Each marking indicates a predetermined distance from the first surface of the orthopaedic surgical instrument. The assembly may be used during an orthopaedic surgical procedure on a femur, which is also described herein.

Abstract: Porous spacers (100) are provided for foot and ankle fusion. The porous spacers disclosed herein may be implanted between separate bones of a joint or between two segments of a single bone following an osteotomy procedure. Such spacers may be used in conjunction with an ankle resection system which includes a resection frame (150) and a resection guide (170). The resection frame can be anchored to the distal tibia and/or the talus and provides an opening (155) through which a bone cutting element can pass for cutting underlying bone. The resection guide can include one or more cutting slots (169, 171, 172) and the resection guide can be coupled to the resection frame with the one or more cutting slots positioned over the opening in the resection frame so that the bone cutting element can pass through the one or more cutting slots and through the opening in the resection frame for cutting the distal tibia and/or the talus.

Abstract: Tools or other instruments can be used by a surgeon to complete an orthopedic procedure. One tool can include a resection tower and a valgus guide. The resection tower can include a cutting block and a dial coupled with the cutting block. The resection tower can be configured such that rotational movement of the dial, about an axis, effectuates movement of the cutting block along a plane substantially parallel with the axis. The dial, when rotated in a first direction, can move between a first position, which corresponds to a minimum cutting depth of the cutting block, and a second position, which corresponds to a maximum cutting depth of the cutting block. The valgus guide can be coupled with the resection tower and includes a rotatable member. The rotatable member can include an angular surface with one or more variable depth splines providing varus/valgus angle adjustment of the cutting block.

Abstract: A posterior cervical fusion surgery assembly and method. The assembly includes a sled adapted to be positioned in a facet joint and two receivers slidably mounted on the sled. The receivers are adapted to support surgical instruments such as a drill, a tap, and a screw. The sled assists in orienting the instruments at a desired angle with respect to the spine.

Abstract: Systems and methods for shaping and filling offset bone voids during revision procedures of total knee replacements are disclosed. The systems disclosed herein generally include an intramedullary reamer, an offset driver, a cylindrical reaming tool, an offset reaming guide, and a conical reamer. An alternate embodiment of the system may also generally include an IM reamer, an offset driver, an offset broaching tool, and a second stage broaching tool. Yet another embodiment may generally include an elongate IM reamer, a cone reamer, a reamer guide shaft, a cone trial, a sizing template, a template guide, an offset lobe reamer, and offset lobe reamer retainer. Metaphyseal reconstruction devices and void filling cones can be used to fill the bone voids in conjunction with the systems and methods disclosed herein.

Abstract: The present disclosure provides a femoral cut guide for preparing a distal femur to receive a prosthetic femoral component of a knee implant. The prosthetic femoral component includes a central box. The femoral cut guide replicates the size and shape of the prosthetic femoral component, such that the femoral cut guide may serve as a trial or provisional component used to reduce and test the prepared knee joint before implanting the final prosthetic femoral component. The femoral cut guide includes a detachable box cut guide for preparing the distal femur to receive the central box of the prosthetic femoral component.

Abstract: A milling tool system for accurately preparing a portion of the tibia preparatory to making femoral resections. The milling tool system provides a minimally invasive procedure to provide an aperture within an exposed surface of the tibia, the aperture then being used as a referencing surface to accurately resect the femur. Once the femur resections have been made, the remaining uncut portions of the tibia are exposed and easily accessible for the tibial resections.

Abstract: Presented are methods and systems for determining, monitoring, and displaying the relative positioning of two rigid bodies during surgery. In particular, the present disclosure relates to methods and systems for positioning a prosthesis relative to a bone during a surgery as well as to systems and methods for verifying resulting relative positioning of adjacent bones.

Abstract: A cutting guide includes a jig assembly that is configured to attach to a second surface of a bone. The jig assembly includes a guide block that defines a jig recess and that is configured to be disposed adjacent to the first surface. Also, the cutting guide includes a tool support that is moveably coupled to the jig assembly, and the tool support is configured to couple to the cutting tool and moveably support the cutting tool on the jig assembly. Moreover, the cutting guide includes an adapter that is removably received within the jig recess to adapt a dimension of the jig recess according to a corresponding dimension of the pocket. The adapter includes at least one adapter surface that is configured to abut the guide portion of the cutting tool to thereby limit movement of the cutting portion relative to the first surface of the bone.

Abstract: A number of orthopaedic surgical instruments are disclosed. A method, apparatus, and system for fabricating such instruments are also disclosed.

Abstract: A technique and reconstruction system for ligament repair employing a continuous loop/button construct. The button has an oblong configuration and is provided with at least one inside eyelet that allows the passage of the continuous loop, preferably a suture loop. The continuous loop/button construct of the present invention may be used for fixation of bone to bone, or of soft tissue to bone.

Abstract: An orthopedic device includes a drill guide configured to be mounted on a patient-specific alignment guide for intraoperatively confirming alignment of the patient-specific alignment guide relative to a bone. The patient-specific alignment guide includes first and second referencing holes. The drill guide includes a main body with a first coupling member and a second coupling member. The first and second coupling members are configured to be received within the first and second referencing holes, respectively. The first and second coupling members each include corresponding first and second drill openings configured to align with the first and second referencing holes, respectively. The drill openings each guide a drilling tool toward the bone to drill corresponding holes in the bone. The main body also includes an alignment confirmation feature configured for confirming alignment of the patient-specific alignment guide relative to the bone before drilling holes in the bone.

Abstract: Apparatus and methods for tissue fixation using a bone plate configured to accommodate fixation devices (such as screws, for example) inserted at various angles. The bone plate is formed of a material softer than the material of the fixation devices, and is provided with fixation holes with rounded, curved interior walls (i.e., non-threaded holes) that allow the fixation devices to be inserted at various angles. The fixation holes have a diameter smaller than that of the fixation devices. As a result of the difference between the materials of the plate and of fixation devices, and of the difference between the diameters of the fixation holes and of the fixation devices, the fixation devices deform the interior walls of the fixation holes, therefore self-threading the holes at an advantageous angle.

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

Abstract: A method of surgically preparing a distal end of a femur for implantation of a femoral prosthetic component includes positioning a base cutting block and an intramedullary adaptor on the distal end of the femur such that a first end of the intramedullary adaptor is received in the medullary canal of the femur and the intramedullary adaptor is secured to the base cutting block, attaching a first modular cutting block to an anterior side of the base cutting block, resecting a first portion of the distal end of the femur using a cutting guide defined in the first modular cutting block, the cutting guide of the first modular cutting block, and resecting a second portion of the distal end of the femur using a base cutting guide defined in the base cutting block.

Abstract: A system for removing bone growths and realigning bones includes a bone planer and an osteotomy guide. The bone planer includes a hollow sleeve that has an end embeddable within a bone. The bone planer also includes a rotary blade that is coupled to the hollow sleeve. The rotary blade is positioned within and rotatable relative to the hollow sleeve. The osteotomy guide includes a distal portion and a proximal portion. The distal and proximal portions are slidably coupled together. Each of the distal and proximal portions includes an upright that defines a cut guide surface. A space defined between the cut guide surfaces defines a cut path corresponding with a desired cut through the bone.

Abstract: An orthopedic jig and pins therefore are disclosed that allow the pins to be pre-loaded into apertures through the jig before the jig is positioned at a desired location with respect to a bone during an orthopedic surgical procedure. At least one of the pin and/or jig includes a retention mechanism whereby the pin can be inserted into the bore and releasably restrained therein until the jig is place is the selected position and the pins driven into the bone.

Abstract: A surgical template system for use in working on a bone comprises: a tool guiding portion comprising a guide aperture for receiving and guiding a tool to work on the bone; and locating means for locating the tool guiding portion at a predetermined position with respect to the bone such that the guide aperture has a fixed orientation with respect to the bone. The locating means comprises: a locating member having a first locating surface, the first locating surface being adapted to conform to either a predetermined surface of cartilage covering a predetermined articular surface of the bone or a predicted surface of cartilage covering, or assumed to be covering, the predetermined articular surface of the bone; and an adapter member having a second locating surface and being adapted to attach to the locating member in an operative position in which the second locating surface is adapted to engage the predetermined articular surface of the bone if the cartilage is removed or not present.

Abstract: A directed structure placement guide assists with positioning at least one directed structure in at least one of a predetermined insertion trajectory and a predetermined insertion location with respect to a patient tissue surface during preparation of the patient tissue surface to receive an implant. The implant has a tissue-contacting surface. A guide base has a distal base surface mimicking the structure of at least a portion of a tissue-contacting surface of the implant. The guide base also has a proximal base surface longitudinally spaced from the proximal base surface. At least one insertion guiding structure is movably supported by the guide base and is adjustable into a guiding configuration in which at least one of the predetermined insertion trajectory and the predetermined insertion location is selectively imparted to the directed structure.

Abstract: A surgical cutting guide is described which can guide a cutting implement to cut in a pair of planes at a defined relative orientation. The cutting guide comprises a first plate defining a first cutting plane, a second plate defining a second cutting plane at an angle to the first cutting plane; and a base member to which both the first plate and the second plate are attached. The first and second cutting planes intersect each other at a line of intersection and both the first plate and the second plate extend beyond the line of intersection.

Abstract: A system is disclosed for repairing and reconstructing an injured intra-articular, extra-articular ligament or tendon to a bone. The system includes realigning the axis of a bone, and further includes fixing fragments of a bone together. Novel devices, instruments and methods are disclosed, including a cortical loop for engaging a bundle of soft-tissue and capturing the bundle against a bone surface, an anchor for stabilizing a fractured bone, a guide for directing an orthopedic blade, and a hinged external jig arranged to position and guide the blade. Methods are disclosed for connecting soft-tissue to a bone and for bone alignment.

Abstract: A surgical resection guide comprising: a housing (36); a stylus arm (38) extending through the housing (36) arranged such that when the housing (36) is coupled to the side of a bone, a tip of the stylus arm (38) is arranged to contact an end of a bone; 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 or groove (50); and a dial (44) rotatably coupled to the housing (36) and incorporating a helical dial groove or rib (48) defining a longitudinal axis offset from the longitudinal axis of the shaft (30).

Abstract: A system for performing a resection of a selected portion of an anatomy with a resection instrument. The system includes a first member, a first movement defining portion defined by the first member, a second member, and a second movement defining portion of the second member. The first member is fixable to the selected portion of the anatomy. The second member is configured to cooperate with the first member. The first movement defining portion and the second movement defining portion are operable to allow the second member to be moveable relative to the first member from a first position to a second position. The resection instrument is positionable relative to the second member in the first position and in the second position to form a selected resection of the selected portion of the anatomy.

Abstract: A bone plate includes a first three-part combination hole extending through a proximal portion of the plate, a first portion configured to engage a threaded head portion of a bone fixation element, a second portion configured to receive a bone fixation element along an axis substantially perpendicular to a longitudinal axis of the bone and a third portion defining a screw axis extending toward the distal end of the elongated body at a non-perpendicular angle relative to the longitudinal axis in combination with a first two-part combination hole extending through the proximal portion, a first threaded portion configured to engage a threaded head portion of a bone fixation element and a second portion defining an elongated slot extending along a longitudinal axis of the plate for receiving a bone fixation element so that the plate may slide along its longitudinal axis relative to the bone fixation element.

Abstract: A resection guide locator includes a bone engagement portion with surfaces that are complementary to the surface topographies of a bone to be resected during surgery. A housing includes a socket defined by a resilient annular wall that is sized and arranged so to accept a resection guide by press-fit to thereby position and hold the resection guide within the socket. The resection guide is maintained in a predetermined, preferred position while the surfaces are releasably locked in position on the bone. A method is disclosed for forming and using the resection guide locator.

Abstract: A guide for an implant site in bone. The guide includes a bone mating surface configured to engage a prepared bone surface at the implant site to position the guide at a predetermined orientation, and a patient-specific surface configured to engage a predetermined portion of a specific patient's natural anatomy to position the guide at the predetermined orientation.

Abstract: Instruments for use in implanting an orthopedic ankle prosthesis includes a center-transfer instrument and a number of bone cutting blocks. A method of using such instruments is also disclosed.

Abstract: A positioning apparatus for guiding resection of a patient tissue and guiding placement of a prosthetic implant component in a desired implant position with respect to the resected patient tissue and method of use are described. A locating block includes a mating surface contoured for mating contact with the patient tissue. A cutting plane indicator provides a physical indication of a desired cutting plane for the resection. A placement indicator is spaced apart from the locating block and includes a component-contacting feature. An elongate spacing arm is operative to space the placement indicator apart from the locating block. The spacing arm is configured to place the component-contacting feature of the placement indicator at a predetermined placement position in three-dimensional space relative to the patient tissue. The placement position predetermination is at least partially based upon pre-operative imaging of the patient tissue.

Abstract: The present invention relates in particular to a method of alignment of a first bone, with a first and a second ends, in relation with a second bone, with a first and a second end, both bones being in a same limb, the first end of said first bone being a part of a distal joint for the first bone, the second end of said second bone being a part of a proximal joint for the second bone, said second end of the first bone and said first end of the second bone constituting a middle joint between both bones, wherein this first bone will be partially cut, in a transversal way, into two segments to form a hinge and wherein a tracker has been attached beforehand to each of two said bone segments.

Abstract: An implantable device includes a body and a first mounting strip connected to a trailing end portion of the body. The body has a leading end portion, a first side surface, a second side surface, an upper surface, a lower surface and a central opening extending through the upper and lower surfaces. The central opening has an internal surface with an internal leading surface, a first internal side surface and a second internal side surface. A first depth is defined between the leading end and the internal leading surface, a first spacing is defined between the first side surface and the first internal side surface and a second spacing is defined between the second side surface and the second internal side surface. The first spacing is substantially the same as the second spacing.