Abstract: A Lisfranc injury between a second metatarsal and medial cuneiform is repaired by gaining access to the injury site and placing two arm members of a novel drill guide around the two neighboring bones at the injury site, drilling a guide wire through the two bones guided by the drill guide to a desired depth, measuring the depth of the guide wire to determine the proper length for a bone screw for securing the two bones, drilling a cannulated drill bit into the two bones to a drill depth using the guide wire as a guide, and threading a bone screw into the two bones.

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: Devices and methods for use in hip replacement surgery can incorporate computer models of a patient's acetabulum and surrounding bone structure, a first patient-specific jig designed from the computer model and configured to correspond to a final installation position and orientation of a prosthetic him implant, a second patient-specific jig, also designed from the computer model, configured to refine the procedure, if necessary, following use of the first patient-specific jig, and/or a third patient specific jig, designed from the computer model, configured to refine the procedure, if necessary, following use of the first and second patient-specific jigs, allowing the surgeon to properly position and orient the hip prosthesis. Also shown and described are novel devices for implanting an acetabular cup.

Abstract: Tools or other instruments can be used by a surgeon to complete an orthopedic procedure. One tool can include a reference block and a cutting block coupled to the reference block via an adjuster. The reference block can include a body portion and a depth arm having at least one longitudinal groove extending along a side surface. The adjuster can be coupled to the cutting block and configured to move the cutting block along the depth arm. The adjuster can include a roller having an elongate body, the roller including at least one circular guide member and a turn knob positioned along the elongate body, and a resilient member having a base and at least one leg extending from the base, where the adjuster is configured to couple the cutting block to the depth arm.

Abstract: A tool comprises a first body shaped to detachably receive a bone implant having a first portion with a first flat surface adapted to be attached to a bone and a second portion with a second flat surface oriented at a pre-determined angle relative to the first flat surface, the bone implant having at least one fastener hole penetrating each of the first and second portions. A second body has a surface or member. The second body is adjustably connected to the first body to selectably position the surface or member relative to the bone implant.

Abstract: Devices and methods for use in hip replacement surgery can incorporate computer models of a patient's acetabulum and surrounding bone structure, a first patient-specific jig designed from the computer model and configured to correspond to a final installation position and orientation of a prosthetic him implant, a second patient-specific jig, also designed from the computer model, configured to refine the procedure, if necessary, following use of the first patient-specific jig, and/or a third patient specific jig, designed from the computer model, configured to refine the procedure, if necessary, following use of the first and second patient-specific jigs, allowing the surgeon to properly position and orient the hip prosthesis. Also shown and described are novel devices for implanting an acetabular cup.

Abstract: Robotic surgical tools, systems, and methods for preparing for and performing robotic surgery include a memory mounted on the tool. The memory can perform a number of functions when the tool is loaded on the tool manipulator: first, the memory can provide a signal verifying that the tool is compatible with that particular robotic system. Secondly, the tool memory may identify the tool-type to the robotic system so that the robotic system can reconfigure its programming. Thirdly, the memory of the tool may indicate tool-specific information, including measured calibration offsets indicating misalignment of the tool drive system, tool life data, or the like. This information may be stored in a read only memory (ROM), or in a nonvolatile memory which can be written to only a single time. The invention further provides improved engagement structures for coupling robotic surgical tools with manipulator structures.

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: 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 surgical instrument having a first assembly with a first radio-opaque portion providing a profile of a first portion of an intramedullary implant or canal in a bone, and a second assembly having a second radio-opaque portion providing a profile of a second portion of the intramedullary implant or canal. The surgical instrument may also include a third radio-opaque portion providing an alignment feature to provide a fluoroscopic planar check for the surgical instrument.

Abstract: Instruments and methods for preparing an intervertebral space for receiving an implant. An adjustable trial implant has an adjustable stop mechanism having a stop member connected thereto to vary the distance that a body portion of the trial implant can move into the intervertebral space. Cutting tools for forming cutouts in the adjacent vertebrae use the trial implant and/or a guide to position a cutting tool which may be a burr or a chisel. The chisel cutting tool can be moveable relative to a selected trial implant or the chisel cutting tools can be fixed onto a trial implant shaped body portion.

Abstract: Apparatuses are provided for arthroscopic rotator cuff repair incorporating a transhumeral bone tunnel. The apparatus comprises a number of components that can also be considered a repair system to include a drill guide, a marking hook, and a drill with a removable tip that serves as a bone anchor. In additional aspects of the invention, the components of the drill guide assembly comprise a cannulated marking hook and a drill guide with multiple bores. In additional aspects of the invention, an implantable bone anchor is provided that is especially adapted for placement through a bone tunnel, and wherein the implantable anchor is collapsible to increase the effective size of the anchor for securing the anchor to the far side opening of the bone tunnel through which the anchor was placed.

Abstract: The invention provides an apparatus and method for sizing a distal portion of a femur during knee arthroplasty. A sizer according to the invention includes a body that can be removably attached to the distal portion of the femur and that is operable to support a module that is removably attachable to the body. The body with attached module is operable for use in measuring the size of the distal portion of the femur. The module can be attached to the body either before or after the body has been attached to the distal portion of the femur and can be detached from the body either before or after the body is detached from the distal portion of the femur.

Abstract: An anti-backout stylus comprising a stylus and a locking stylus holder. The locking stylus holder engages the stylus at a series of discrete positions during insertion of the stylus into the holder. The locking stylus holder prevents inadvertent backing out of the stylus by preventing the stylus from being withdrawn to a previous one of the discrete positions. The locking stylus holder can preferably be selectively disengaged from the stylus to allow for selective withdrawal of the stylus. Each engagement of one of the discrete positions by the locking stylus holder preferably indicates a femoral size. The discrete positions are preferably defined by detents formed on the stylus and a stop member on the locking stylus holder. The locking stylus holder can be provided on an anterior rough cut guide, with the anterior rough cut guide preferably mountable on an intramedullary rod.

Abstract: The present invention relates to guiding instruments and methods for the manufacture thereof, for facilitating the positioning of an implant in a socket of a ball-and-socket joint, by allowing the positioning an alignment element such as a pin, wire, screw or drill.

Abstract: A system for repairing a soft tissue or bone defect can include a plurality of sizing guides each having a base with a different perimeter size and a plurality of apertures aligned with a plurality of cannulated guide shafts extending therefrom. A plurality of perimeter cutting devices can each have a base with a perimeter size corresponding to the different perimeter size of each sizing guide base, a cutting edge on a perimeter thereof, and a plurality of apertures corresponding in location to the plurality of apertures in each sizing guide base. A cutting member guide can have at least one aperture configured to receive a portion of a cutting member therein. The plurality of implants can have a perimeter size and shape corresponding to each base of the plurality of perimeter cutting devices.

Abstract: An assembly for use in cutting a bone during a surgical procedure comprises a cutting tool and a guide block. The cutting tool includes a blade and a drive unit for imparting a cutting motion to the blade. The guide block can be positioned against the bone and has a reference surface for guiding the blade during the cutting step, the guide block having a screen surface which provides a point of reference to indicate proper alignment of the blade. The cutting tool includes means for directing a collimated beam of light in a direction parallel to the blade, on to the screen surface on the guide block when the blade is in contact with the guide surface, the distance between the blade axis and the light beam being equal to the distance between the reference surface and the point of reference on the screen surface.

Abstract: The invention relates to surgical guides which are of use during reconstructive bone surgery for guiding a surgical instrument or tool. More particularly, the guides are characterized in that they are fitted to the implant rather than to the bone.

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 method of manufacturing an arthroplasty jig is disclosed herein. The method may include the following: generate two dimensional image data of a patient joint to undergo arthroplasty, identify in the two dimensional image data a first point corresponding to an articular surface of a bone forming the joint, identify a second point corresponding to an articular surface of an implant, identify a location of a resection plane when the first point is correlated with the second point, and create the arthroplasty jig with a resection guide located according to the identified location of the resection plane.

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: A computer-assisted surgery system for guiding alterations to a bone, comprises a trackable member secured to the bone. The trackable member has a first inertial sensor unit producing orientation-based data. A positioning block is secured to the bone, and is adjustable once the positioning block is secured to the bone to be used to guide tools in altering the bone. The positioning block has a second inertial sensor unit producing orientation-based data. A processing system providing an orientation reference associating the bone to the trackable member comprises a signal interpreter for determining an orientation of the trackable member and of the positioning block. A parameter calculator calculates alteration parameters related to an actual orientation of the positioning block with respect to the bone.

Abstract: A medical device for preparing a bone of a joint of a patient includes a numerically controlled instrument having a housing including a controller, a processor and a tool driver, a patient-specific reference guide removably couplable to the housing, and a cutting tool removably coupled to the tool driver. The patient-specific reference guide has a three-dimensional inner surface preoperatively configured to mirror and mate with a corresponding surface of a bone of a joint of a patient in only one position. The patient-specific reference guide is configured to automatically register the numerically controlled instrument to the patient's bone portion intraoperatively. The cutting tool is movable along a patient-specific tool path determined during the preoperative plan for preparing a portion of the bone.

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: Apparatus for performing an open wedge, high tibial osteotomy, the apparatus comprising: cutting apparatus for forming an osteotomy cut in the tibia, the cutting apparatus comprising: targeting apparatus for identifying a cutting plane through the tibia and a boundary line for terminating a cut made along the cutting plane, wherein the boundary line is located within the tibia, parallel to the anterior-posterior slope of the tibia and parallel to the sagittal plane of the patient.

Abstract: An instrument assembly for resecting a distal femur for receipt of a knee implant, comprising an intramedullary rod and resection instruments. A valgus portion of the intramedullary rod has series of engagement members positioned to provide a plurality of engagement positions for use in fixing the resection instruments on the valgus portion. The resection instruments are configured to selectively engage and selectively lock on the valgus rod at the engagement positions via the engagement members. The engagement members preferably comprise pairs of substantially vertical indents arranged in parallel along opposing sides of said valgus portions. The resection instruments preferably engages and locks to said engagement members via a sliding rod engagement member. The resection instruments preferably include a distal cut guide having a distal resection slot and a femoral resection block.

Abstract: An orthopaedic alignment guide component is provided for preparing a patient's bone socket, such as the glenoid of the patient's scapula, to receive a prosthetic glenoid component. The orthopaedic alignment guide component includes a guide body for inserting a guide pin into the patient's scapula and an inferior referencing arm for referencing an inferior surface of the patient's scapula.

Abstract: A surgical kit for preparing a joint surface to receive an implant includes a patient-specific guide for a joint surface. The patient-specific guide has a patient-specific surface complementary to a surface of the joint for nesting engagement, and a guiding element oriented along a patient-specific alignment axis. The alignment axis is determined during a preoperative plan of the specific patient for implant alignment. The kit includes a guiding tool couplable to the guiding element of the patient-specific guide and a three-dimensional orientation device removably couplable the guiding tool for intra-operative calibration, such that, after calibration, the orientation device can be removably coupled to a shaft of a surgical instrument to align the shaft along the alignment axis.

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: A method of, and apparatus for, arthroplasty of a knee joint comprising obtaining a desired spacing of the femur from the tibia by inserting a spacer into the knee joint between the femur and the tibia. The spacer is used as a reference for securing a guide jig in position about the knee joint for guiding resection of one or both of the femur and tibia for fitting of tibial and/or femoral prostheses. A method of resecting the femur while moving the tibia through an arc of motion to remove bone to the desired depth, a method of determining the position of the guide jig, the guide jog, an alignment device and the spacer are also described.

Abstract: An apparatus for locating a central axis of a spinal column and method of using the same is disclosed. The apparatus and method includes one or more members capable of spanning a center line which may then be identified by at least one additional member positioned therebetween. Furthermore, the device may contain or be capable of accommodating various additional tools for marking the location of the central axis of a spinal column.

Abstract: The relationship between first and second portions of a bone in a patient's body is changed by moving a wedge member into a slot formed in the bone. Force is applied against hard cortical bone by the wedge member. This force pivots the first portion of the bone relative to the second portion of the bone about an axis extending through bone interconnecting the first and second portions of the bone. As the wedge member moves into the bone, a side surface of the wedge member is moved into alignment with an outer side surface of the bone. The wedge member is fixedly connected with the bone. The wedge member is rigid so that the bone can immediately be load bearing. One or more openings may be provided in the wedge member to enable bone to grow through the wedge member. The wedge member may contain a material which promotes growth of bone through the wedge member.

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: The invention relates to a device, system, and method for making an incision into a patient's bone using a cutting block, wherein locations of reference objects of the patient's body are defined with respect to a reference coordinate system. The device may include: a cutting guide having an incision plane; a localization reference for determining a spatial position of the incision plan (the localization reference secured to the cutting guide); a fixation device secured to the bone; an adjusting device for setting a position of the incision plane relative to the bone, wherein a location of the adjusting device is defined with respect to a base coordinate system; and a pre-adjusting device for aligning the base coordinate system with respect to the reference coordinate system.

Abstract: An accessory for removing material for prostheses surgery including a plastic part and an insert made of a material harder than the bone material, the insert being embedded in the plastic part such that if the device is brought to a selected temperature, the accessory deteriorates itself.

Abstract: A device for positioning a cutting guide with respect to a bone comprising a body forming the cutting guide or intended to be fixed to the cutting guide; a least two contact members intended to freely contact the bone; and adjustment means for individually varying the relative position of the body with respect to each contact member.

Abstract: The present invention relates to surgical guides, and methods for their manufacture. The invention provides surgical guides comprising at least one alignment element and at least two guiding elements. The alignment elements can constrain the guiding elements into an initial position which guides a surgical operation, and optionally at least one target position different from the initial position.

Abstract: A bone cutting assembly. The bone cutting assembly includes a guide pin having a distal tip that may be securely inserted into a bone to define a cutting axis and a housing having a cam surface and features which allow the housing to be temporarily secured to the bone. The bone cutting assembly further includes a burr mounting arm which can be fitted on to the guide pin so that it can swing around the cutting axis and also translate up and down the guide pin. The burr mounting arm is configured to act against the cam surface as it is swung around the guide pin, so that the arm is caused to move up or down relative to the guide pin by the action of the cam surface.

Abstract: A convertible patient-specific guide for use in arthroplasty has a body having a patient-specific three-dimensional undersurface closely mateable engageable in only one position with a corresponding joint surface of a specific patient. The convertible guide includes patient-specific guiding formations extending from the body and configured for guiding both a total arthroplasty of the joint and a partial arthroplasty of the joint, such that the arthroplasty to be performed is intraoperatively changeable.

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 patient-matched cutting block including a surface or point contact features adapted to at least partially conform to or reference a patient specific anatomy. The cutting block having guide slots configured for guiding the movement of cutting tools relative to the patient specific anatomy or features configured to mate to and guide standard cutting guides relative to patient specific anatomy in order to form plateau and eminence resections of the patient specific anatomy.

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 apparatus used in spinal surgery for creating a space of selected shape and dimensions across the disc space between adjacent vertebral bodies of the spine.

Abstract: A method of forming a shoulder prosthesis includes resecting an end portion of a humerus to form a resected end of the humerus and a resected portion separated from the humerus, the resected portion having an outer convex surface and an inner surface. The inner surface of the resected portion is processed to include a concave articular surface. The outer convex surface of the resected portion is implanted in the resected end of the humerus. An implant having a convex articular surface is secured to a glenoid. The concave articular surface of the resected portion is articulated with the convex articular surface of the implant.

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 guide for removal of bone during arthroplasty. The cutting guide includes a housing having a three-dimensional guide path and an arm coupled to the housing and extending through the guide path. The arm includes a burr. As the arm is slid along the path, the burr simultaneously cuts in two planes on 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: Systems, including methods, apparatus, and kits, for performing osteotomies to cut bone and, optionally, to adjust bone length.

Abstract: The present invention relates to stopping tool guides for use during surgical interventions and combinations of these stopping tool guides with surgical guides. The present invention further relates to methods for the manufacture of such stopping tool guides and combinations thereof with surgical guides. The stopping tool guides and combinations of such stopping tool guides with surgical guides according to the present invention are particularly useful in surgical osteotomy.

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.