Abstract: Drill and/or guide wire guides and methods are usable with at least one orthopedic surgical implant screw, wherein the guides have a length defined between a first end and a second end located opposite to the first end and a thickness defined between a front side and a back side located opposite to the front side of the guide. The guides have a guide hole formed adjacent to the first end of the guide, wherein the guide hole extends through the thickness of the guide from the front side to the back side of the guide, wherein the guide hole has a diameter sized to receive a diameter of a drill bit or a guide wire. The guides have a slot formed on the front side of the guide and located adjacent to the front side of the guide, wherein the slot extends along at least a portion of the length of the guide, wherein the slot has a diameter sized to receive a diameter of a drill bit or a guide wire.

Abstract: The present invention includes a method and devices for treating osteonecrosis in, e.g., children, adolescents, and adults comprising: identifying a subject in need of treatment for osteonecrosis; drilling two or more holes into a bone in need of treatment for osteonecrosis; inserting two or more needles or cannulas into the holes in the bone; washing an interior of the bone with a washing fluid introduced through one or more of the needles or cannulas inserted into the bone; and after washing the interior of the bone introducing one or more bone growth promoting materials or cells into the bone.

Abstract: A two-step approach for image segmentation during the treatment planning process is disclosed. In a first step, an automatic segmentation method can be used to generate a first, provisional segmentation. The first, provisional segmentation may be generated using fast, but less accurate segmentation methods. The first provisional segmentation may be used to generate a default treatment plan for approval. Once the default treatment plan is approved, a more robust, second image segmentation may be performed. The second segmentation may be used to design patient-specific devices that can be used to deliver the patient-specific medical treatment.

Abstract: Intramedullary nails, aiming guide assemblies, and methods. The aiming guide assembly can include an aiming guide having an elongate proximal handle portion. A generally arcuate distal implant alignment tip connector portion is connected to the proximal handle portion and has a distal implant alignment tip extending along a tip axis parallel to a longitudinal axis of the proximal handle portion. A recon module may be releasably attached to a proximal end of the proximal handle portion. An oblique module may be releasably attached to the distal implant alignment tip portion.

Abstract: An adapter assembly for connecting a surgical loading unit to a handle assembly is provided. The adapter assembly includes a sleeve, a trocar assembly releasably securable within the sleeve, and a locking mechanism configured to releasably secure the trocar assembly within the sleeve.

Abstract: A device for resecting a femur includes a resection body provided with resection grooves configured to receive a cutting surgical instrument to obtain at least two sections of the femur. The resection body has two separate elements, selectively assembleable to each other in a stable and releasable manner. A first element is a cutting template, having the resection grooves. A second element is a measuring and reference member, having a plurality of measuring and reference holes configured to determine an angular offsetting with respect to a longitudinal axis of the femur, and an axial translation along the longitudinal axis of the femur between the two sections. A releasable holder is provided between the cutting template and the measuring and reference member. The measuring and reference holes are made on the measuring and reference member according to a matrix associated with axial and angular coordinates in ordered rows and columns.

Abstract: Medical devices for creating or expanding a cavity within bone of a patient are disclosed. In some circumstances, a medical device, such as an osteotome is designed to facilitate simultaneous advancement and articulation of a distal portion of the osteotome. Simultaneous advancement and articulation of the distal portion may reduce one or more forces on the distal portion of the osteotome relative to other methods in which advancement and articulation are separated in time, thereby decreasing the risk of breakage or other damage to the osteotome.

Abstract: Minimally invasive percutaneous methods, devices, and systems for placing guide wires in bones in a desired position and orientation and for facilitating the treatment of fractures such as but not limited to intertrochanteric fractures or other applications such as osteotomies. The methods, devices, and systems may allow for rapid and reproducible placement of a guide wire in a bone. Each degree of freedom may be controlled independently.

Abstract: A drill guide system provides a means of improved tunnel placement accuracy by allowing the drill guide to articulate to seat against the bone being drilled. The drill guide includes an articulating drill guide adapter constructed in four parts: a top cap, a thumbscrew, a lock tab, and a spring mechanism. The drill guide adapter is part of an aimer arm which mates with a handle on the proximal end and an aimer guide on the distal end. The drill guide adaptor allows the aimer guide to articulate relative to an irregular mating surface, allowing for increased area contact between the aimer guide template and bone. Examples of the drill guide adaptor also include a means for locking the aimer guide into place relative to the aimer arm.

Abstract: An instrument and method of using the instrument for setting a fracture in a bone and applying a bone plate to the fractured bone. The instrument includes a connector for connecting the instrument to the intramedullary rod. At least two tines are movably connected to the connector and configured to orient the fractured bone with respect to the rod. Each tine has a distal end configured to contact the bone. At least one plate carrier is configured to receive the bone plate. The at least one plate carrier is movably connected to the connector and configured to move relative to the connector and the tines to position the bone plate adjacent the bone in a predetermined alignment with the intramedullary rod.

Abstract: Systems and methods are described herein for resurfacing bones, and in particular, for detecting and resurfacing one or more femoroacetabular impingements (FAIs). A FAI resurfacing controller may be used to perform this detecting and resurfacing of FAIs. The FAI resurfacing controller may include a bone model generator to receive bone imaging and to generate a model of at least one osteophyte and of a surface of a native bone surrounding the at least one osteophyte. The FAI resurfacing controller may include an osteophyte identifier to set a virtual 3D boundary surface between native bone surface and the at least one osteophyte. The FAI resurfacing controller may include a resurfacing navigator to generate and output a navigation file. The navigation file may include the model with the 3D boundary surface between native bone surface and the at least one osteophyte.

Abstract: A prosthetic hip alignment apparatus includes a medical instrument (20) comprising a mount attachable to a bone and first (22), second (30), third (40) and fourth (60) members. Adjacent ones of the first, second, third and fourth members are rotatable with respect to each other about a first axis, and between one of the first to fourth members and another means permitting rotation about second and third axes is provided. One of the member mounts a level (64) and wherein one of said members mounts direction indicator (65).

Abstract: A bone graft delivery system can include an elongate tube and a handle having a trigger and a ratcheting mechanism. The trigger is actuated to deliver bone graft material through the tube. The bone graft delivery system can further include a distal tip at a distal end of the tube. The tip has one or more openings to deliver the bone graft material to a desired location and includes a surface suitable to act as a rasp for decorticating bone. A method for delivering bone graft material to a desired surgical location includes providing a bone graft delivery device, positioning the device adjacent the surgical location, decorticating bone, and delivering bone graft material to the surgical location.

Abstract: An implant system, alignment guide, bone fusion system and surgical method for correction of a flat foot or rocker-bottom deformity, such as a Charcot foot. The implant system includes a bone implant and an elongate member. The bone implant includes a proximal end, a distal end, a hole along a longitudinal axis, and at least one opening intersecting the hole. The elongate member includes a first end with a head portion, a second end with a coupling mechanism, and an opening along a longitudinal axis. The coupling mechanism of the elongate member engages the at least one opening to couple the bone implant to the elongate member.

Abstract: A fixing mechanism for a closed distal femur osteotomy according to an exemplary embodiment of the present invention is installed on a femur incised by the closed distal femur osteotomy, and the fixing mechanism includes: a body portion which is in close contact with the femur and has a plurality of coupling holes and an oblong hole; a head portion which is connected to one end of the body portion and has a plurality of coupling holes; screws which are inserted into the coupling holes; and a sliding screw which is inserted into the oblong hole by adjusting a coupling position, in which the head portion has a predetermined inclination angle in an upward direction based on a lower surface of the head portion.

Abstract: Apparatus for locating an attachment position for a reconstructed anterior cruciate ligament on an attachment surface of a bone comprises locating means 51, 61 arranged to locate at least one reference surface 4 of the bone and guide means 53, 54 arranged to define the attachment position in two dimensions on the attachment surface relative to the reference surface.

Abstract: A method for designing and making a rig that includes a hollow tubular shell, and the interior of said shell defines at least first and second intersecting cylinders. The method includes identifying a damage area, presenting a 3D view of identified damage area, generating a 3D model of a virtual rig, and producing a rig according to the virtually created rig. The generating includes virtually placing in 3D view a shape covering or partly covering damage area, and creating, based on the position of the virtually placed shape, a position of hollow tubular rig shell of the virtual rig; and selecting the at least first and second intersecting cylinders of the virtual rig, based on the size and form of the virtually placed shape, and creating a positioning surface of the virtual rig which is a bone and/or cartilage-engaging end of hollow tubular shell.

Abstract: An apparatus comprises a medial rail having a plurality of openings through the medial rail for receiving pins, screws or wires. An arm is pivotally mounted to the medial rail. The arm has at least a first track on a first side. A post has a connector slidably mounted to the first track of the arm for movement along the first track. A guide is slidably mounted for movement along the post. The guide has at least one opening through it and at least one pin for engaging a bone of a patient.

Abstract: A glenoid device for preparing a shoulder joint of a patient includes a reusable guide holder having a body between an upper surface and a lower surface and a bore passing through the body of the guide holder. The glenoid device also includes a patient-specific glenoid guide having a body with an upper and lower surface. The lower surface of the patient-specific glenoid guide is configured as a negative surface of a glenoid face based on preoperative image scans of the shoulder joint of the patient. The upper face of the patient-specific glenoid guide is configured to be coupled and contact the lower face of the guide holder, such that the bore of the guide holder is aligned along a patient-specific bore through the body of the patient-specific glenoid guide and along a corresponding alignment axis of the patient-specific glenoid guide.

Abstract: The present invention relates to systems and methods for spinal fusion procedures that can allow all components of the spinal fusion procedure to be inserted into the wound of a patient at once, and can thus minimize the number of components that must be separately inserted into a wound. This can be accomplished by providing a intervertebral fixation system that allows an intervertebral cage, vertebral fixation plate, and drill guides to be assembled into a single unit prior to insertion into a patient.

Abstract: This application describes surgical instruments and implants, including a rod reduction instrument, for building a posterior fixation construct across one or more segments of the spinal column. Extension guides are provided that attach to bone anchors implanted within the spine. The extension guides have a guide channel that align with a rod channel in the anchor to help direct the rod to the anchor. The rod reducer may be passed through the interior of the guide assemblies with a distal end arranged in a first position allowing the distal end to pass through the guide. Once through the guide the distal end may be expanded to provide dual contact on the rod at each end of the bone anchor rod channel.

Abstract: A method and device for attaching a bone plate to a bone includes the steps of placing a first surface of a wire insertion device against the bone, inserting a reference wire through an opening of the wire insertion device extending therethrough from the first surface of the wire insertion device to a second surface of the wire insertion device, removing the wire insertion device from the reference wire and positioning a bone plate on the bone by moving the bone plate in a transverse direction relative to a longitudinal axis of the reference wire so that the reference wire is received within a slot of the bone plate, the bone plate including a first surface facing toward the bone and a second surface opposing the first surface, the slot open to a lateral side surface connecting edges of the first and second surfaces.

Abstract: An improved method of implanting a bone graft in a joint and tools for accomplishing the same is disclosed. The present invention relates generally to tools and methods useful for treating a sacroiliac joint. In one embodiment, the present invention is a method including the steps of: creating a first incision in the patient's skin proximal to the patient's sacroiliac joint; creating an incision in the patient's skin over the patient's ilium; inserting a first working channel into said first incision and spreading said sacroiliac joint with an inserted end of said first working channel; inserting a second working channel into said second incision and forming a hole in said ilium; creating a void in said sacroiliac joint; inserting a graft into said void; and inserting a joint fusing device into said ilium and said sacrum.

Abstract: There is described a method for tracking a patient in a coordinate system of a surgical tool using an optical waveguide modeling system having one multicore optical fiber with a portion attached to the surgical tool and a portion attached to the patient. The method generally includes receiving a patient model representing a shape and orientation of at least one of a limb and a bone of the patient, generating a waveguide model representing a shape and orientation of the multicore optical fiber as attached to the surgical tool and to the patient, and tracking the patient model in the coordinate system by registering the patient model in the coordinate system using the waveguide model and known spatial relationships relating to the surgical tool, the portion of the multicore optical fiber attached to the surgical tool, and the portion of the multicore optical fiber attached to the patient.

Abstract: A bi-directional fixating transvertebral (BDFT) screw/cage apparatus is provided. The BDFT apparatus includes an intervertebral cage including a plurality of internal angled screw guides, a plurality of screw members, and a cage indentation adjacent to the screw guides that independently or supplemented by other screw locking mechanisms prevents the screw members from pulling out of the internal angled screw guides. The internal angled screw guides orient a first screw member superiorly and a second screw member inferiorly. The intervertebral cage is adapted for posterior lumbar intervertebral placement, anterior lumbar intervertebral placement, anterio-lateral thoracic intervertebral placement, or anterior cervical intervertebral placement.

Abstract: This disclosure relates to a targeting guide assembly for positioning a surgical instrument. The targeting guide assembly is used to accurately place a surgical instrument for establishing a precise path for subsequent screw placement, retrograde drilling, etc. A targeting guide assembly according to an exemplary aspect of the present disclosure includes, among other things, a first bracket, a second bracket rotatable relative to the first bracket and a cannula guide body movable within a slot of the first bracket.

Abstract: A method for providing therapy to a patient, the method comprising: providing microfracture therapy to the acetabular cup of the patient, wherein providing microfracture therapy to the acetabular cup of the patient comprises forming at least one hole extending from the acetabular shelf to the cortical bone bed of the acetabular cup, such that blood may flow from the cancellous bone underlying the cortical bone bed to the surface of the cortical bone bed, whereby to form a blood clot at the surface of the cortical bone bed.

Abstract: Methods and drill guide systems that provide internalization of the biceps tendon with use of fixation devices such as the Arthrex BicepsButton™ or Pectoralis Button tensioned outside a smaller converged drill hole. The technique converges two angled drill holes and use the button to fixate a reinforced (whipstitched) biceps tendon into a single bone versus stabilizing two bones. The biceps tendon is being pulled into the larger of the drilled holes and fixed by the button outside of the smaller drilled hole.

Abstract: Aligning the syndesmosis joint by a novel device and method includes establishing a first plane by attaching a bone plate to the posterolateral aspect of the distal fibula. A second transverse plane arranges perpendicular to the first nominal plane. A syndesmosis targeting guide device includes a post having a post axis extending perpendicular to the first plane and in the second plane. The device includes a curvilinear slider guide extending along an arc in the second plane. The slider is positioned to a first position and fixing that first position to establish a fixed entry point in the fibula wherein the fixed entry point lies in the second plane and further thereby establishing a desired trajectory in the second plane wherein the trajectory includes the fixed entry point based on the slider first position.

Abstract: A computer-assisted surgery system comprises instruments adapted to be used to perform tasks related to surgery. A reference device is in a fixed relation to a bone. A rotating magnet creates a magnetic field plane, the rotating magnet being connected to one of the instrument and the reference device. A magnetometer on the other of the instrument and the reference device produces signals as a function of at least its orientation relative to the magnetic field plane. A processing unit tracks said orientation of the instrument relative to the bone using said signals from the magnetometer subjected to the magnetic field plane.

Abstract: A surgical targeting system of an intramedullary nail, which includes an extracorporeally arranged external transmitting unit. Further included is a plurality of first transponder units coupled with and arrayed along the length of the intramedullary nail, each adapted to be actuated by the external transmitting unit. Additionally, a plurality of holes are disposed within and arrayed along the length of the intramedullary nail. Each of the plurality of holes are situated between each of the plurality of first transponder units. Further, a first transmission section is between the external transmitting unit and each of the plurality of first transponder units via which the plurality of first transponder units are actuated. Additionally included is a second transmission section through the intramedullary nail between the plurality of first transponder units and a second transponder unit.

Abstract: A positioning device for acetabular procedures is provided. The positioning device for acetabular procedures includes a base plate, a central pin guide hole, a first positioning hole, and a second positioning hole. The central pin guide hole is provided through a central portion of the base plate and configured for guiding a center pin to be disposed in a specific portion of an acetabulum of a patient. The first positioning hole is provided through a first edge portion of the base plate and configured for guiding a first stabilizing pin. The second positioning hole is provided through a second edge portion of the base plate and configured for guiding a second stabilizing pin. The positioning device further includes a third positioning hole provided through a third edge portion of the base plate and configured for guiding a third stabilizing pin.

Abstract: A surgical system includes an implant having a first attachment mechanism and an insertion instrument having a proximal end, a distal end, and a second attachment mechanism disposed at the distal end for removable connection with the first attachment mechanism. The proximal end of the insertion instrument is pivotable with respect to the implant. The insertion instrument can include an inserter and a guide. A method of using the surgical system is provided.

Abstract: A position guidance system for minimally invasive medical procedures includes a medical device having a first end configured for percutaneous insertion and a second end configured to remain exterior to a patient's skin, a hub connection provided at the second end of the medical device, at least one bubble level including a bubble configured to provide a visual indication of a deviation from a target angle for medical device insertion, and a connector configured to reversibly and repeatedly connect the bubble level to the hub connection of the medical device. When the bubble is positioned at a center of the bubble level, an actual insertion angle of the medical device is the same as the target angle. When the bubble is positioned off-center of the bubble level, the actual insertion angle of the medical device deviates from the target angle.

Abstract: A surgical instrument for fixing bone fragments is provided. The surgical instrument comprises a positioning member with two pad holding portions, two pad members each having a bone contacting surface and each configured to be releasably held at one of the pad holding portions of the positioning member so that the bone contacting surfaces of the two pad members face each other, and two guiding channels configured to receive a flexible elongated member, each guiding channel being formed in a region between the bone contacting surface of one of the pad members and the associated pad holding portion.

Abstract: An orthopedic surgical instrument includes a polymer 4-in-1 cutting block having a number of metallic cutting guides secured thereto. A pair of metallic bushings function as saw stops at the medial and lateral ends of the chamfer cutting slot.

Abstract: A drill guide system and method including a bone plate and a guide block removably engaged with the bone plate, and with drill guide passages in the guide block substantially aligned with bone screw openings in the bone plate and each having a conically-shaped inner guide surface. A fixed angle drill guide includes a distal portion selectively positioned within a selected one of the drill guide passages and has a conically-shaped outer guide surface matingly engaged with the conically-shaped inner guide surface of a selected drill guide passage to maintain orientation of the fixed angle drill guide at a predetermined fixed angular orientation. A variable angle drill guide includes a distal portion selectively positioned within a selected one of the drill guide passages and has an outer guide surface sized smaller than the conically-shaped inner guide surface of a selected drill guide passage to permit orientation of the variable angle drill guide at a variable angular orientation.

Abstract: A system for replacing a portion of an articular surface including providing an implant site and installing an implant into the implant site. The implant site includes a first and a second excision site which at least partially intersect with one another. Each of the first and second excision sites are formed by providing a respective axis and excising a portion of the articular surface relative to the respective axes.

Abstract: A device for use in total hip arthroplasty surgery is provided. The device includes a first guide member which includes a body having a top surface and a bottom surface, a plurality of first guide legs protruding from the body, and a plurality of protrusions extending from the body. The plurality of first guide legs include a contact area disposed on the open end of the first guide leg. The device also includes a third guide member which includes a tube, a plate configured to engage with the first guide member, and a plurality of holes disposed on the plate configured to receive the plurality of protrusions of the first guide member to couple the first guide member with the third guide member.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: Apparatus for locating an attachment position for a reconstructed anterior cruciate ligament on an attachment surface of a bone comprises locating means 51, 61 arranged to locate at least one reference surface 4 of the bone and guide means 53, 54 arranged to define the attachment position in two dimensions on the attachment surface relative to the reference surface.

Abstract: The present disclosure presents novel methods, procedures associated steps, and apparatuses to accomplish SI joint fusion in a minimally invasive manner. The preferred embodiment of the invention incorporates improved methods, procedures and apparatuses to facilitate a SI joint fusion providing a generally safer, more minimally invasive SI joint stabilization. In the method associated with the preferred embodiment of the invention, in one aspect, a path or a plurality of paths through an ilium to the sacrum is established, wherein a stabilizer device allows the securement of the sacrum to the ilium. In another aspect, a path or a plurality of paths to the SI joint is established, where bone fusion material allows fusion of the articular surface of the ilium and the articular surface of the sacrum of an SI joint.

Abstract: A transhumeral drill guide and protective sleeve are disclosed which are utilized in a method for shoulder joint surface replacement surgery that spares the rotator cuff. The method utilizes two passages to gain access to the glenohumeral joint, neither of which requires transection of the rotator cuff.

Abstract: A drill guide has a main body in which a drill insertion hole is formed and plural projection portions to be inserted into plural bone tunnels. The plural projection portions project forward from the main body parallel with the center line of the drill insertion hole, a virtual drill insertion hole which extends from the drill insertion hole of the main body is formed between the plural projection portions parallel with their center lines by cutting out confronting portions of the plural projection portions, and the length of at least one of the drill insertion hole and the virtual drill insertion hole is 5 mm or more. The drill guide can guide a drill so as to be correctly between plural bone tunnels bored through a living body bone without causing axis deviation so that a link bone tunnel for connecting the plural bone tunnels can be formed between them in the same direction as their direction.

Abstract: A method of fusing a sacroiliac joint including implanting a joint implant into the sacroiliac joint such that the joint implant passes through a posterior-inferior access region, the joint implant having an implanted position in the sacroiliac joint such that a portion of the joint implant is positioned within a caudal portion of an articular plane of the sacroiliac joint.

Abstract: A welled handle device comprising a base with a front and back end having a predetermined grippable silhouette or outer contour, a plurality of open wells formed in the base, and a tool portion connected to the front end of the base. The open wells contain regions which are substantially rough or textured and regions which are substantially smooth. A method of collecting medical waste comprising the steps of having waste on a hand or glove and gripping the grippable outer contour of the welled handle device, wherein at least some of the medical waste is collected within the wells of the handle.

Abstract: A technique for accessing extra articular lesions or abnormalities or intra osseous lesions or abnormalities or bone marrow lesions or all has the step of positioning the localizing pinning member onto cartilage or subchondral bone to define a virtual pathway through the cartilage or subchondral bone towards or into or through the lesion or abnormality or a desired target to create the virtual pathway utilizing an intra articular localizing pinning member to determine a location of the lesion or abnormality wherein the utilization of the localizing pinning member includes the step to locate or stabilize or both and thereafter using the virtual pathway to create an entry access.

Abstract: A device is for aligning an aiming hole of an aiming device with a locking hole of an intramedullary nail. The device includes a sensing unit sized and shaped for insertion through an aiming hole of an aiming device attachable to an intramedullary nail. The sensing unit detects a magnetic field produced by a magnet and outputs an alignment signal based on a magnetic field parameter at first and second locations relative to the magnet.

Abstract: The present disclosure relates to a guide assembly including a guide having a body and a joint including at least one through hole, wherein the joint is configured for sliding along a length of the body, and a first surgical device. The guide is coupled to the first surgical device and a longitudinal axis of the through hole is co-radial with an end of the first surgical device. Other guide assemblies and methods of creating multiple portals during surgery are also disclosed.

Abstract: An implant insertion device including a body having a first portion for coupling to a proximal end of an intramedullary rod and a second portion extending in a spaced position from the intramedullary rod in the vicinity of an aperture in a proximal end of the rod when the rod is coupled to the first portion. The second portion can include a targeting assembly having a passageway for receiving a guide sleeve and for pivoting the guide sleeve relative to the aperture through an angular range for inserting the fastener into the aperture of the rod. An implant insertion device for use with an implantable device is additionally provided.