Abstract: Sutures with pre-tied knots for use in percutaneous surgical procedures and devices for easily and quickly tying complex suture knots are disclosed.

Abstract: A patient specific trial repositioning block is disclosed which extends the know operating technique using patient-specific cutting blocks by virtue of the fact that the soft-tissue situation or ligament tension conditions can be checked and corrected intraoperatively. The trial repositioning block can be dimensioned according to the tibia structure and femur structure. During use of the trial positioning block in an operation, the block can bring the femur to lie in a planned corrected end position on the tibia. Trial repositioning can be performed after the sectioning of the tibia, and the operator, after sectioning of the tibia, can already have an accurate picture of the end result of the operation.

Abstract: An assembly (10) for use in knee replacement surgery comprising a tibial base plate (14) which, in use, engages a tibia (200), and a tensioning element (33), (34) operable, in use, to engage between the tibial base plate (14) and a femur (300) to set the gap between the tibial base plate (14) and the femur (300) when the femur (300) and tibia (200) are in extension.

Abstract: Methods are disclosed for designing a tibial implant to minimize cortical impingement of a keel or other fixation structure when the tibial implant is implanted in the tibia bone. The design of the keel or other fixation structure on the tibial baseplate can be based on determining a common area between defined cancellous regions of at least two tibia bones. Methods are disclosed for designing a femoral component having a stem extension such that the stem can be sufficiently placed in the diaphysis of the femur when the femoral component is implanted. The method includes determining a canal axis in a femur that creates adequate engagement between a reamer and the diaphysis of the femur.

Abstract: The present disclosure relates to a system and method of knee ligament balancing for knee replacement procedures. The disclosure provides a system of components to implant to achieve ligament balancing. In addition, instruments and methods are provided to achieve the desired balance of the ligaments before final fixation.

Abstract: A method and instruments to assemble a femoral orthopaedic prosthesis is disclosed. The system may also include prosthetic trial components, which may be used to size and select the components of the orthopaedic prosthesis. The system may include components of the orthopaedic prosthesis such as, for example, a prosthetic femoral component, a prosthetic tibial component, a prosthetic stem component, and a prosthetic sleeve component.

Abstract: A method and instruments to assemble an orthopaedic prosthesis is disclosed. The system may also include prosthetic trial components, which may be used to size and select the components of the orthopaedic prosthesis. The system may include components of the orthopaedic prosthesis such as, for example, a prosthetic femoral component, a prosthetic tibial component, a prosthetic stem component, and a prosthetic sleeve component.

Abstract: Methods and apparatuses including apparatuses that can be used in a unicompartmental knee replacement procedure, a bicompartmental knee replacement procedure comprised of two unicompartmental knee replacements, a knee replacement procedure that utilizes a single femoral component and two unicompartmental tibial components, and other types of knee replacement procedures are disclosed. According to one example, an apparatus for guiding a tibial bone cut during knee replacement surgery is disclosed. The apparatus can comprise a mounting portion and a cutting portion. The mounting portion can be configured to couple with an alignment mechanism. The cutting portion can be connected to the mounting portion and can define a capture for a proximal cut. The cutting portion can have an aperture disposed adjacent a first end of the capture.

Abstract: Embodiments of the invention include devices and methods for implanting arthroplasty devices. Some embodiments include designs that allow for use of x-ray images as the only images used to fully and accurately preoperatively and intraoperatively size and align arthroplasty device components and prepare all necessary tissue.

Abstract: A system is provided for positioning a cutting guide on a femur of a knee to make a cut along a distal end of the femur during knee surgery. The system may generally include an adjustable femoral attachment member configured to attach to a cut distal end of the femur, a cutting guide removably attachable to the femoral attachment member and configured to guide a surgical saw to make an additional cut on the distal end of the femur, and a force sensor for positioning between the femoral attachment member and a proximal end of a tibia of the knee. The force sensor may include a medial portion for sensing a medial force in the knee and a lateral portion for sensing a lateral force in the knee.

Abstract: Methods and apparatuses including an apparatus for guiding a femoral bone cut during knee replacement surgery are disclosed. The apparatus can comprise a cut guide having a first side, a second side, a third side, and one or more slots. The first side can be configured to interface with a resected surface of a femur. The second side can be spaced from the first side. The one or more slots can be defined by the apparatus and extend from the first side to the second side. The third side can be disposed between the first side and the second side and can have at least one projection extending therefrom. The at least one projection can be configured to guide a cutting tool into the one or more slots.

Abstract: A patient-specific guiding system for guiding an instrument relative to a portion of an anatomical feature of a patient. The patient-specific guiding system includes a patient-specific guide. The guide includes a first portion having a first patient-specific inner surface that conforms to a first surface of the anatomical feature and an outer surface opposite the first patient-specific inner surface. The first portion also includes a guide surface for use in guiding the instrument relative to the anatomical feature. The guide also includes a second portion having a second patient-specific inner surface that conforms to a second surface of the anatomical feature and an outer surface opposite the second patient-specific inner surface. The second portion is removably connected to the first portion.

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

Abstract: An orthopaedic joint replacement system is shown and described. The system includes a number of prosthetic components configured to be implanted into a patient's knee. The system also includes a number of surgical instruments configured for use in preparing the bones of the patient's knee to receive the implants. A method or technique for using the surgical instruments to prepare the bones is also disclosed.

Abstract: The present invention relates to a method for determining the mechanical axis of a bone using an electronic device which is rigidly attached to the bone and comprises a video camera, wherein: the mechanical axis is determined from the positions of two points which define the mechanical axis; the first of the two points is determined as the center of rotation when the bone is pivoted about the first point, the center of rotation being determined from an output signal of the camera which captures a stationary marker device; and the second point is the exit point of the mechanical axis on the outer surface at the opposite end of the bone to the first point.

Abstract: A bone void filling prosthesis, which includes a body and a plurality of legs. The body includes an aperture extending therethrough. The plurality of legs are each connected to the body. Each of the plurality of legs includes at least one selectively removable portion for adjusting a length of each of the plurality of legs.

Abstract: Patient-specific instrumentation for use when performing articular joint repair is provided. A patient-specific jig is adapted to be positioned over a bone at an articular surface thereof for assisting in preparing the bone surface for reception of a prosthesis. The jig comprises a bone contacting portion adapted to matingly contact a portion of the articular surface of the bone and a cutting slot adapted to receive therein a saw blade for resecting the articular surface of the bone. The cutting slot may be press-fitted into the opening of a cut guide. A patient-specific plate and a patient-specific rotational guide are also provided for guiding a positioning of the prosthesis over the resected surface of the bone. A method for manufacturing the patient-specific jig is further provided.

Abstract: An orthopedic distraction device is provides. The orthopedic distraction device includes a first upper paddle for engaging a first bone of a joint, a lower paddle for engaging a second bone of the joint and a displacement mechanism. The displacement mechanism includes a drive assembly operable to move the upper paddle relative to the lower paddle. The lower paddle is releasably connected to the displacement mechanism.

Abstract: Various aspects of a surgical assistive device and method to provide assistance in neurosurgery are disclosed herein. The surgical assistive device includes circuitry that determines initial positional shift in the anatomical portion of a subject caused by an incision into a protective portion. A first depth value is estimated based on the plurality of stereo images that are captured from different specified positions of the surgical image capture device to capture views of the anatomical surface of the anatomical portion through the incision. A residual shift in a position of a surgical region of interest is determined with respect to the estimated first depth value. Surgical guidance information is generated to indicate a correct depth of the surgical region of interest in a surgical cavity, based on the determined residual shift. Display of the generated surgical guidance information is controlled on a display screen coupled to the surgical assistive device.

Abstract: An orthopedic distraction device is provides. The orthopedic distraction device includes a first upper paddle for engaging a first bone of a joint, a lower paddle for engaging a second bone of the joint and a displacement mechanism. The displacement mechanism includes a drive assembly operable to move the upper paddle relative to the lower paddle. The lower paddle is releasably connected to the displacement mechanism.

Abstract: A method of surgically preparing a proximal end of a tibia includes inserting an intramedullary orthopedic surgical instrument into a medullary canal of the tibia, securing an attachment device to the intramedullary orthopedic surgical instrument, attaching a cutting block to the attachment device, resecting the proximal end of the tibia using the cutting block to form a surgically-prepared surface, positioning a tibial base trial on the surgically-prepared surface, and inserting a keel punch through a slot defined in the tibial base trial and into the surgically-prepared surface of the tibia.

Abstract: A spiked head assembly for a tibial jig for use during an orthopedic surgical procedure, includes a body and a mount for mounting the spiked head assembly on the tibial jig. The spiked head assembly comprises an elongate member having a central longitudinal axis, a first end and a second end and superior and inferior surfaces. The elongate member also has least one securing spike provided on the inferior surface towards the second end of the elongate member and configured to engage with a bone mass and arms extending from the elongate member in a direction perpendicular to the inferior surface. The arms are spaced apart from a plane that includes the central longitudinal axis and extends substantially perpendicularly to the inferior surface, so that the arms and the inferior surface define an access space for the surgical procedure.

Abstract: A method and system for performing a total joint arthroplasty procedure on a patient's damaged bone region. A CT image or other suitable image is formed of the damaged bone surfaces, and location coordinate values (xn,yn,zn) are determined for a selected sequence of bone surface locations using the CT image data. A mathematical model z=f(x,y) of a surface that accurately matches the bone surface coordinates at the selected bone slice locations, or matches surface normal vector components at selected bone surface locations, is determined. The model provides a production file from which a cutting jig and an implant device (optional), each patient-specific and having controllable alignment, are fabricated for the damaged bone by automated processing.

Abstract: Methods for forming prosthetic implants, including femoral implants, are discussed. While the methods can include any suitable step, in some cases, they include providing a master negative mold defining an internal space shaped to form a femoral component configured to replace a distal portion of a femur, wherein the femoral component comprises at least one of: an anterior flange that is disposed at an anterior proximal end of the femoral component, and a proximal extension disposed at a proximal portion of a posterior condyle of the femoral component, the proximal extension comprising a concave articulation surface that is configured to articulate against at least one of: a tibial prosthetic component and a tibia; filling the master negative mold with a molding material to form a molded femoral component; and removing at least one of: the anterior flange, and the proximal extension from the molded femoral component to form a modified molded femoral component. Other implementations are described.

Abstract: In a first aspect of the invention relates to a medical guide device for working on a bone. This guide device includes a holding arrangement, which is holdable firmly against a bone, for holding the guide device firmly against the bone and a saw template with a guide slot for a saw blade. In an adjustment position, the holding arrangement and the saw template engage with one another and are arranged to be movable in relation to one another. The holding arrangement and the saw template are movable from the adjustment position into a sawing position in which they are held firmly and immovably in relation to one another. Said guide device includes a coupling arrangement for coupling the holding arrangement and the saw template in the adjustment position and in the sawing position.

Abstract: A method of preparing a knee joint for a prosthesis in a patient includes mating a patient-specific three-dimensional curved inner surface of a femoral alignment guide onto a corresponding three-dimensional femoral joint surface of the patient. The patient-specific three-dimensional curved inner surface is preoperatively configured from medical scans of the knee joint of the patient. First and second holes are drilled into an anterior portion of the femoral joint surface through corresponding first and second guiding apertures of the femoral alignment guide.

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 orthopedic surgical procedure is also disclosed.

Abstract: A spinal device for carrying out a surgical procedure on vertebrae by a posterior or posterolateral approach, including at least one tube, at least one spinal screw capable of engaging with the proximal end of a tube, wherein the device also comprises a connection accessory, having means of reversible fastening to at least one of said tubes, said connection part being configured such as to keep at least one of said tubes in an open angular position.

Abstract: A cutting guide assembly comprises a mounting block having a guide surface into which may be mounted an articulated mounting arm. The mounting arm has a first post which is retained in the mounting block and a second post. A cutting tool attachment component is provided to attach the cutting tool to the cutting guide assembly. The cutting tool attachment component has a first surface against which the saw blade can be retained for oscillation around an axis of oscillation, and a shaft which cooperates with the second post such that the longitudinal axis of the shaft is collinear with the axis of oscillation of the saw blade. When the saw blade is retained against the first surface, the plane of oscillation is parallel to, and displaced from, the guide surface of the mounting block.

Abstract: A bone resection guide, which includes a profiling guide. The profiling guide includes a first planar bone contact surface, a first guide surface and at least one outline corresponding to at least a portion of a first implant.

Abstract: An instrument (10) and method are provided for total knee arthroplasty (TKA). The instrument separates a patient's tibia and femur, in both extension and flexion, to measure a gap and an angle therebetween. The instrument includes various modular accessories (16, 54, 70, 80, 90, 100) that provide flexibility of usage throughout the TKA procedure and that accommodate different surgical philosophies.

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

Abstract: Aspects of the present disclosure involve systems, methods, computer program products for customized arthroplasty cutting guides or jigs. In particular, the present disclosure provides for a method of creating a customized arthroplasty cutting jig from one or more two-dimensional (2D) images of the patient's joint. The method includes receiving the 2D images of the joint from an imaging device, reformatting the images, and creating a customized jig template from the images. One or more landmarks are electronically marked on one or more of the series of 2D images of the patient's joint through a computing device. Once the template for the cutting jig is created utilizing one or more of the electronic markers on the 2D images, a cutting or milling program is generated by the computing device that may then be provided to a milling machine to create the cutting jig corresponding to the milling program.

Abstract: A bone cutting guide for osteochondral transplantation, including a cutting guide block having a distal portion and a posterior portion, said distal portion having a distal cutting guide slot disposed therethrough, said posterior portion having a posterior cutting guide slot disposed therethrough; a plurality of condylar rails attached to said cutting guide block; a tower cutting guide disposed superior to said cutting guide block and having at least one cutting guide track disposed at an angle of between 0 and 180 degrees in relation to the angle of said posterior cutting guide slot; and fixation structure for attaching said cutting guide block and said tower cutting block to bone.

Abstract: The invention relates in particular to a system for attaching a first bone segment to a second bone segment, the two segments belonging to the same bone, in which the first and second segments are held together via a hinge resulting from the partial transverse cutting of said bone, characterized by the fact that said system comprises: two targets suitable for attaching to the two segments of said bone; a navigation system suitable for acquiring the three-dimensional positions and orientations of the targets; —a processing system suitable for calculating, based on the data sent from the navigation system, the angles corresponding to the three-dimensional alignment of said two segments; a display unit suitable for displaying the information to the surgeon; at least one milling guide; a plurality of implants of different sizes.

Abstract: A patient matched instrument for a patient's femur is disclosed. The instrument includes a body having a cutting slot and a patient matched surface that mates with the patient's trochlear groove, a first leg portion extending from the body, a second leg portion extending from the body; and each leg portion has a contacting pad for tangential contact with the patient's femoral medial and lateral condyles.

Abstract: Methods and apparatuses for phototherapy to treat skin disorders. In particular, described herein are phototherapy dressings for use with phototherapy UV light applicators (sources) to treat skin disorders such as psoriasis. The dressings described herein may include a support body onto which a medicament formed of a hydrogel and coal tar and/or coal tar extract is held. The dressing may be configured so that at least half (50%) of the UV light within a therapeutic range of wavelengths is through the dressing including the medicament to the patient's skin. The dressings may be adapted for use in conjunction with a phototherapy UV light sources.

Abstract: A method and system for performing a total joint arthroplasty procedure on a patient's damaged bone region. A CT image or other suitable image is formed of the damaged bone surfaces, and location coordinate values (xn,yn,zn) are determined for a selected sequence of bone surface locations using the CT image data. A mathematical model z=f(x,y) of a surface that accurately matches the bone surface coordinates at the selected bone slice locations, or matches surface normal vector components at selected bone surface locations, is determined. The model provides a production file from which a cutting jig and an implant device (optional), each patient-specific and having controllable alignment, are fabricated for the damaged bone by automated processing.

Abstract: In various examples, an apparatus includes an instrument body including a protrusion configured to be sized according to an anatomy of a bone of a patient. A guide is configured to guide an aspect of a resection procedure of the bone, wherein the protrusion, when sized, is configured to abut the patient's bone to maintain the instrument body in a first position with respect to the bone during at least part of the resection procedure.

Abstract: A distal femur cutting block comprising a first portion defining a first external surface, the first external surface including one or more first passages therethrough; and a second portion defining a second external surface, the second external surface including one or more second passages therethrough, the first portion hingedly connected to the second portion, wherein the first portion and the second portion may be rotated relative to each other through the hinged connection; and a third surface opposite one of the first surface or the second surface, the third surface comprising contours configured to substantially mate with at least one condyle of the distal femur.

Abstract: An implantation instrument for an expandable intervertebral fusion implant that includes a base piece and a cover piece that are configured to bear on a facing end plate of one of two adjacent vertebrae, the cover piece being adjustable in height with respect to the base piece, and a ratchet mechanism being provided between the base piece and the cover piece to effect a stepped adjustment of height and secure an adopted height again reversal, the implantation instrument being configured for expanding the intervertebral fusion implant and comprising a force measurer that interacts with a displacement measurer to indicate an expansion attained by a particular actuating force.

Abstract: A method and apparatus for performing an orthopaedic surgical procedure on a femur includes attaching a proximal end of an intramedullary adaptor to an intramedullary orthopaedic surgical instrument, securing a distal end of an intramedullary adaptor to a base cutting block, inserting the intramedullary orthopaedic surgical instrument into a medullary canal using the base cutting block, and positioning the base cutting block on a distal end of the femur.

Abstract: A system includes a guide arm, a ratchet arm frame configured to be coupled to the guide arm, a ratchet arm configured to be coupled to the ratchet arm frame, and a sagittal sizing guide body configured to be coupled to the ratchet arm. The sagittal sizing guide body includes a first radiopaque object disposed at a first position and a second radiopaque object disposed at a second position that is spaced apart from the first position. The first radiopaque object has a length that corresponds to a length of a second prosthesis component. When the surgical alignment system is positioned for use on a patient, the first radiopaque object identifies a location at which a first resection of a first bone is to be performed. The second radiopaque object has a profile that corresponds to a profile of a first prosthesis component for installation on a second bone.

Abstract: A ligament balancer for a knee is disclosed that includes a first guide portion having a first guide hole extending there through, and a second guide portion having a second guide hole extending there through, the first and second guide portions being moveable with respect to each other along a movement axis, the balancer being adapted such that, in use, the movement axis is substantially parallel to the anterior/posterior axis of a distal femoral surface. Also disclosed is a kit of parts that includes the ligament balancer and a drill guide for a knee, the drill guide includes first and second connected arms, each arm comprising at least two guide openings extending there through, the guide openings being spaced longitudinally along each arm, longitudinal axes of the first and second arms intersecting at a predetermined angle. Also disclosed is a method of attaching a cutting block to a distal femoral surface as part of a knee replacement procedure.

Abstract: A system includes a cartridge having an elongate body extending from a first end to a second end and having a top side and a bottom side. The cartridge defines a first hole adjacent to the first end that extends through the cartridge from the bottom side to the top side. The top side of the cartridge defines a pair of parallel slots that extend perpendicular with respect to a longitudinal axis of the cartridge. Each slot of the pair of parallel slots is equidistant from a central axis defined by the first hole.

Abstract: A tibia cutting jig mechanism (TCJM) is provided having a number N1 of spaced apart TCJM contact points that correspond to a number N1 of spaced apart knee contact points on at least one of a tibia plateau surface and a tibia shaft surface. The TCJM contact points are positioned in contact with the tibia contact points, and a cut bar guide is positioned in contact with the TCJM to provide a location and an angular orientation of a cut bar plane that is to be used to resection and remove a selected portion of the patient's tibia. The TCJM is removed from the patient's knee, and a selected portion of the patent's tibia is resectioned and removed. The number N1 is at most about seven in some embodiments.

Abstract: A robotic surgical system is provided. The robotic surgical system includes a robotic mechanism having a force transmitting member and a computer connected with the robotic mechanism. The robotic surgical system also includes an optical sensing system connected with the computer, at least one navigation member configured to couple to one or more tissues of a patient, and a tool suitable for use in resecting at least a portion of a first bone of a joint in a patient and at least a portion of a second bone of the joint in the patient.

Abstract: A method for aligning an orthopedic implant in a joint replacement includes determining the bone and cartilage deficiency from an undegenerated state caused by wear of a joint. Then a resection of a bone in the joint is made based on the deficiency of bone and cartilage from the undegenerated state and the size of a joint implant so as to locate the joint surface of the implant in the undegenerated cartilage location. The condylar wear from the undegenerated states may be assessed at a distal and posterior location on each of a medial and a lateral femoral condyle. A distal cut is made on the femur at a location adjusting for the condylar wear from the undegenerated state. The distal cut varus-valgus angle is oriented parallel to a plane across the distal femur after adjusting for wear in the distal location on the medial and lateral condyle.

Abstract: Aspects of the present disclosure involve systems, methods, computer program products, and the like, for utilizing a series of images of a patient's anatomy to determine a cut plane for use during a knee procedure. To determine a cut plane for use during a knee replacement procedure, the 2D images may be analyzed by a computer program to determine a best fit plane through one or more points along the proximal surface of the tibia and to determine one or more features of depressions within the proximal surface. With these landmarks identified in the images, a cut plane through the tibia for use during a TKA procedure may be determined. Further, the location of these features in the images may be determined by analyzing the gray scale value of one or more pixels around a selected point on the image. The pixel with the lowest gray scale value may then be assumed to be the edge of the cortical bone in the 2D image.

Abstract: A surgical cutting block according to an exemplary aspect of the present disclosure includes, among other things, a block body including a top surface having a first thickness that extends between a first surface and an opposing second surface of the block body and a capture disposed at the top surface. The capture includes a second thickness that is less than the first thickness of the top surface.