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 and a vertebral fixation plate to be assembled into a single unit prior to insertion into a patient.

Abstract: A patient-specific guide tool for guiding an instrument toward a bone for implantation of a prosthetic device is disclosed. The guide tool includes a body portion having a guide element, and a patient-specific portion having at least one patient-specific mating feature that is configured to engage a soft tissue at or near the bone. A method of manufacturing a guide tool for guiding an instrument toward a bone is also disclosed.

Abstract: A system that includes a cervical plate and an intervertebral cage, the cervical plate having a mounting section that renders the cervical plate mountable to a reference feature located on the front wall of the intervertebral cage, the reference feature being positioned to set a distance between an eyelet of the cervical plate and an edge of the front wall to position the eyelet over a mounting location on a vertebra when the mounting section is mounted to the reference feature.

Abstract: A bone void forming assembly includes a support member having a head portion and an elongate portion extending therefrom. A guide member is connected to the support member and has a guide body including a channel extending therethrough. The channel defines an axis offset and obliquely angled relative to an axis of the elongate portion. The assembly also includes reamer having a cutting head and a stop member. A bushing is slidably connected to the reamer between the stop member and cutting head and is slidably connectable to the guide body via the channel.

Abstract: A method of surgically preparing a sacroiliac joint comprising: a) approaching a sacroiliac joint space with a joint preparation tool comprising a cutting element including an exterior having an asymmetric cutting band such that the first side includes a first surface having a first texture and the second side includes a second surface having a second texture, the first and second textures being different such that the first texture is substantially smoother than the second texture; and b) delivering at least a portion of the cutting element non-transversely into the sacroiliac joint space for decortication, the cutting element being oriented in the sacroiliac joint space such that the first surface opposes the generally softer sacrum and the second surface opposes the generally harder ilium in order to more aggressively prepare the surface of the ilium while not over-preparing the sacrum to provide a robust biologic environment for intra-articular fusion.

Abstract: Patient specific instruments, systems and methods for maintaining, correcting and/or resurfacing joint surfaces. A tibia alignment guide including a body with a first surface and a second surface, a base portion coupled to and extending away from the first surface of the body, and a tower portion coupled to and extending away from a top surface of the body.

Abstract: Devices, systems, and methods for locking a drill guide into a polyaxial hole while maintaining the form and function of the polyaxial hole are provided herein. In some embodiments, the drill guide includes a hollow outer body extending from a proximal end to a distal end and having a slot disposed proximate the proximate end, wherein the distal end is configured as a reverse collet having a plurality of prongs; an inner body having a central channel extending therethrough; and a lever coupled to the inner body through the slot, wherein the slot is shaped such that rotation of the lever results in motion along a central axis of the drill guide, and wherein a distal end of the inner body is configured to prevent radially inward deflection of the plurality of prongs when the inner body is in a lowermost position.

Abstract: Provided is a femoral tunnel guide device including: a handle; a guide tube coupled to the handle and extending in one direction: and an offset unit extending from the guide tube and spaced apart by a predetermined distance from a virtual extension line of the guide tube in the one direction.

Abstract: An aiming guide system configured for connection to a bone plate including an aiming arm and a connection assembly. The aiming arm has a rigid body extending from a proximal end to a distal end with a plurality of aiming holes defined through the rigid body between the proximal end and the distal end thereof. The distal end defines an attachment slot through the body. The connection assembly is configured to engage an attachment screw hole of the bone plate and the attachment slot such that the aiming arm is fixed in position relative to the bone plate with each of the aiming holes aligned with a respective hole along the bone plate.

Abstract: A targeting system (1) for the guided insertion of a guide wire (50) or a bone screw comprising: a stabilization body (2) fixed to the bone by means of stabilization screws (3); a guide sleeve (4) adapted to receive a guide cannula (5) for the insertion of the guide wire (50) or bone screw; articulated connection means (6) adapted to connect the stabilization body (2) to the guide sleeve (4) and allow the relative spatial position of the guide sleeve (4) to be varied with respect to the stabilization body (2).

Abstract: A positioning device is provided, having a guiding bow, wherein the guiding bow at least in section thereof is designed as or comprises a push-in section to be inserted into a sleeve of a push-in sleeves arrangement; wherein the guiding bow comprises or is connected to an adjusting device, wherein the adjusting device comprises at least one targeting device, and wherein the targeting device is designed to receive, at least in section, an interlocking device or an instrument for acting on the interlocking device.

Abstract: An instrument for collecting tissue from a body cavity includes a hollow tubular body having a tubular wall. The hollow tubular body can collect material from a body cavity in a coring mode or an aspiration mode. The tubular wall defines a passage that extends from a proximal end portion of the tubular body to a distal end portion of the tubular body. A middle section of the tubular body includes an articulating section that allows the middle section to articulate relative to the proximal end portion. The distal end portion includes at least one suction port extending from an outer wall surface to an inner wall surface of the tubular wall. The suction port provides a path of fluid communication between the outer wall surface and the passage for drawing in tissue from a body cavity when the tubular body is connected to a source of negative pressure.

Abstract: Described herein is a bone implant including at least one bone-engaging surface designed to mate with an implant-engaging surface of a bone. In the preferred embodiment, the bone-engaging surface of the implant includes a wave pattern comprising at least one peak extending in a proximal direction or at least one valley extending in a distal direction. The implant-engaging surface of the bone also includes a matching wave pattern having at least one peak and valley. Upon mating the engaging surfaces, a bone-implant interface may be created wherein the peaks and valleys of the wave patterns are aligned. As a result, there is good surface contact area at the bone-implant interface which helps prevent loosening or rotating of the implant.

Abstract: A surgical drill alignment guide is disclosed that can provide an accurate trajectory for placement of a bone screw along a longitudinal axis of a bone.

Abstract: A bone drill guiding device including a drill entry part comprising a cannula having a distal end portion and sized to receive a bone drill, a drill exit part comprising a fixation tip portion and a coupling that rigidly couples the drill entry part and the drill exit part so that longitudinal axes of the cannula distal portion and the fixation tip portion are arranged on a single mutual axis. In some embodiments, the coupling is a linear sliding coupling that parallels the single mutual axis.

Abstract: Dental instrumentation for use in guiding a cutting tool to remove tooth structure from a working tooth is prepared. A digital model of cutting guide shell structure for placement around a portion of the tooth to be treated is combined with preset tool movements to be made by the cutting tool by one or more processors to define final cutting guide data corresponding to final cutting guide structure for guiding the cutting tool. A digital model of a fixation instrument configuration for fixing the dental instrumentation to an adjacent tooth to the working tooth is combined with the final cutting guide data by one or more processors to define final instrument configuration data corresponding to a final instrument configuration for releasably fixing the dental instrumentation to the adjacent tooth and for guiding the cutting tool in the removal of the tooth structure from the tooth to be treated.

Abstract: A targeting kit comprises (i) a mounting arrangement for releasably mounting the targeting kit on an implant, (ii) first and second guide members having an elongate shape with a bore running along its longitudinal axis (iii) a holding arrangement for holding the first and second guide members, the holding arrangement being adjustable between a release condition, in which the positions of the first and second guide members are adjustable, and a holding condition, in which the first and second guide members are in a fixed position, and (iv) a bridging arrangement between the mounting arrangement and the first and second guide members, to space the first and second guide members with respect to the mounting arrangement, the bridging arrangement being adjustable between a release condition, in which the position of the mounting arrangement is adjustable, and a holding condition, in which the first and second guide members are fixedly spaced.

Abstract: Adjustable drill guides and related methods are disclosed herein. An exemplary drill guide can include an adjustment mechanism that allows for precise incremental adjustment of the drill guide's depth setting while securely maintaining the device at a fixed setting between adjustments. The adjustment mechanism can improve the safety and security of the drill guide, for example by limiting adjustment only to those situations where it is specifically intended by the user, thereby reducing or eliminating the risk of inadvertent depth adjustment. In some embodiments, a drill guide can include high visibility, easy-to-read depth indications while maintaining a slender profile and without shifting the user's eye gaze, for example by employing a multi-surface moving scale having a text height that is at least twice the adjustment increment. Handles, protection sleeves, navigation adapters, and various other accessories that can be used with or without a drill guide are also disclosed herein.

Abstract: A patient-specific surgical guide including at least one guiding element for guiding a surgical instrument to treat a subcutaneous anatomical structure of the patient. A first patient-specific contact element with a first patient-specific contact surface to fit a portion of the subcutaneous anatomical structure is rigidly connected to the at least one guiding element. The patient-specific surgical guide includes at least one second patient-specific contact element having at least one support element for supporting a percutaneous pin or needle whose tip is intended to contact a point of the subcutaneous anatomical structure or an anatomical structure rigidly connected thereto. An elongated junction member rigidly couples the at least one guiding element to the at least one second contact element.

Abstract: The present invention provides a drill guide for orthopedic surgery. The drill guide is configured to facilitate drilling of a bone tunnel with a correct and repeatable placement. The drill guide is designed for drilling of the femoral bone during knee surgery. More particularly, in certain embodiments the drill guide is designed for ACL repair and replacement surgery. In a preferred embodiment of the present invention, the guide has 5 members: a center rail, a side rail, an anteromedial slider, a femoral slider, and a center pin.

Abstract: A pocket hole jig includes a body with a base surface positionable against a workpiece, and a drill guide pivotally coupled to the body. The drill guide defines a guide axis such that a drill bit is insertable into the drill guide along the guide axis. The drill guide is pivotable relative to the body to adjust an inclination angle of the guide axis relative to the base surface.

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: A spinal construct comprises a body defining a first groove. A transverse rod is formed with the body. A first band is disposable in the first groove. A base is connectable with the body and engageable with the first band. The base defines a second groove and a slot. A second band is disposable in the second groove and defines an opening aligned with the slot. A shaft is connectable with the base and engageable with the second band. The shaft is configured to penetrate tissue. The opening is aligned with the slot to facilitate an angular range of movement of the shaft relative to the body. Implants, systems, instruments and methods are disclosed.

Abstract: A patient-specific navigational guide for use in spinal surgery, comprising two tubular guiding members integral with a supporting frame and extending from a proximal opening to a distal opening for guiding a surgical operation on a patient's vertebra. The contact members are designed to mate with a corresponding plurality of contact areas on the patient's vertebra in order to define a unique coupling configuration of the patient-specific navigational guide on the patient's vertebra. Said contact members comprise at least one pair of a first main contact member, designed to abut, at least partially, on the upper articular process, or facet, of the patient's vertebra, and a pair of second main contact members, designed to abut on a contact area corresponding to the lamina of the patient's vertebra. Said tubular guiding members each have a slot extending from the proximal opening to the distal opening.

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 patient-specific pin guide for performing a total ankle arthroplasty can comprise a tibia pin guide, a talus pin guide and an interlocking component. A patient-specific cutting guide system for performing a total ankle arthroplasty can comprise a talus cutting guide and a tibia cutting guide. A method of performing a total ankle arthroplasty can comprise: coupling a patient-specific talus pin guide to a talus; coupling a patient-specific tibia pin guide to a tibia; positioning an interlocking device between the patient-specific tibia pin guide and the patient-specific talus pin guide; inserting guide pins into the patient-specific tibia and talus pin guides; removing the patient-specific talus and tibia pin guides from the guide pins; and coupling patient-specific talus and tibia cutting guides to the talus and tibia using at least some of the guide pins to alternatively perform resections on the tibia and talus.

Abstract: A system for creating a patient-specific jig model for patellar resurfacing surgery comprises a patellar implant positioning module for obtaining a planned position of a patellar implant on a model of the patella, the model being anatomically patient-specific. A patella resurfacing calculator module calculates a position and/or orientation of a resurfacing plane and attachment bore in the patella as a function of the planned position of the patellar implant.

Abstract: A positioning and alignment instrument, and methods of use thereof, are provided for facilitating the alignment and insertion of a device, such as a guide wire, into bone. The instrument includes a handheld anchoring component and a rotatable guidance component. During use, the anchoring component is anchored into bone via anchoring protrusions, such that the position and orientation of the anchoring component is fixed relative to the bone. The guidance component, which is mechanically supported by the anchoring component, includes a device guide channel for receiving the device and guiding the device towards an insertion location adjacent to the distal end of the anchoring component. The guidance component is rotatable relative to the anchoring component about a rotation axis that is located adjacent to the distal end of the anchoring component, such that the insertion location remains adjacent to the distal end of the anchoring component under rotation.

Abstract: A surgical guide assembly for selecting a target site for insertion of a fixation implant, the surgical guide used in conjunction with fluoroscopy or other x-ray-based imaging for selecting a target site into bone based upon a rendered radiographic image of the bone. The guide includes a planar radiolucent guide tool with radiopaque markers and seats for accommodating securement components that can be engaged in apertures within securement seats of the radiolucent guide tool and contacted or positioned adjacent target bone for establishing a path to a bone target to guide the placement of an implant relative to a reference point, such as a first implant. In the guide tool may include visual indicia corresponding with one or more of the securement seats.

Abstract: Methods and systems disclosed herein provide systems and methods for anchor placement.

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: Drill guides are disclosed herein that include a tapered projection that hooks under a bone to position the drill guide relative to the bone. The drill guide is used to drill a hole that receives a suture anchor.

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: 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: 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 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.