Abstract: A system for performing anterior cruciate ligament reconstructions is provided. The system includes a surgical guide instrument defining an elongate body having a hand-graspable handle and a head section including a distal phalange and a proximal open-faced slot. The distal phalange is contoured to anatomically conform to the femur and includes a notch section engageable with the intercondylar notch. The open-faced slot includes a stop member. The system further includes a guide wire operably receivable by a guide wire sheath to form a guide wire assembly. The guide wire assembly is received by the open-faced slot wherein the stop member is structured to stop the sheath from exiting the slot. The surgical guide instrument can direct the guide wire to an anatomic position on the femur and ensure a safe and usable femoral tunnel.

Abstract: Methods and devices are provided for implanting a cross-pin through a bone tunnel, such as in an arthroscopic surgical procedure. In general, the methods and devices allow a cross-pin hole to be formed in a medial side of a knee bone such that it intersects a bone tunnel formed in the knee bone. In one embodiment, a cross-pinning guide device is provided that can be configured to angularly position the cross-pin hole relative to the bone tunnel to allow the cross-pin hole to intersect the bone tunnel without passing through another side, e.g., a lateral side, of the knee bone. The knee bone can be a femur or a tibia such that the cross-pin hole and the bone tunnel can each be entirely formed in the femur or in the tibia.

Abstract: A dual reconstructive wire system for use with an anatomy can include a first guide wire, a second guide wire, a first guide instrument, a first cannulated insertion instrument, and a second cannulated insertion instrument. The first guide wire can pass through the first cannulated insertion instrument such that a first end and a second end of the first guide wire extends beyond the first end and the second end, respectively of the first cannulated insertion instrument. The second guide wire can pass through the second cannulation insertion instrument such that a first end and a second end of the second guide wire extends beyond the first end and the second end, respectively of the second cannulated insertion instrument.

Abstract: Instruments and associated methods are disclosed for treating joints, and particularly bone tissue. One of these instruments may be a positioning instrument for controlled delivery of a device to a target site of the bone tissue being treated. The positioning instrument may comprise an alignment guide having a device portal for insertion of a device therethrough. The positioning instrument may have an indicator probe having an extended arm, and a handle portion for maneuvering the positioning instrument. Another instrument may be a device for placement through the device portal of the alignment guide and to the target site. The device may comprise an implant insertion tool, an injection catheter, a cavity creation tool such as a bone drill, for example, or the device may be an implantable device.

Abstract: Methods and instruments for reconstructing soft tissues of a skeletal joint such as for example of the foot or hand are presented.

Abstract: The present invention relates generally to tools, tool kits and methods useful for performing surgery an SI joint. The method includes implanting a graft into a SI joint of a patient by creating an incision in the patient, dilating the incision, creating a void in the SI joint, and inserting a graft into the void thereby substantially immobilizing the patient's SI joint.

Abstract: Milling strategies for machining dental ceramic materials are provided that reduce milling time while maintaining strength, accuracy and marginal integrity.

Abstract: Described is an arthroscopic bone transplanting procedure for transplanting a section of a first bone to a second bone. The described procedure is particularly useful for the treatment an anterior shoulder instability, where the first bone is the coracoid and the second bone is the glenoid. Also described is a kit of medical instruments particularly useful in such a procedure.

Abstract: An expansion and compression instrument for fracture fixation. The instrument includes a first handle member, a second handle member, a bearing assembly, and a replaceable tip insert. The bearing assembly axially receives a driver, such as a hexagonal head screwdriver. The replaceable tip insert is adapted to engage an aperture of a fracture fixation plate. The driver is adapted to engage the head of a bone screw, partially threaded into bone proximate the fracture and disposed through a longitudinal slot of the plate. Manual manipulation of the handle members together or apart causes the driver head and replaceable tip insert to become farther apart or closer together, respectively. This in turn, causes the bone screw to be displaced along the longitudinal slot, expanding or compressing the fracture, respectively. Once the fracture has been expanded or compressed to the desired degree, rotation of the screwdriver, facilitated by the bearing assembly, tightens the bone screw, locking the plate into place.

Abstract: A system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.

Abstract: Disclosed are femoral and tibial drill guides for use in posterior cruciate ligament replacement surgery. Each of the drill guides includes an arc shaped member and an elongate guide member, a stopper member, and an alignment arm member coupled thereto. Prior to preparing a tibial tunnel with a tibial drill guide and a femoral tunnel with a femoral drill guide, a rasp and/or cutter can be used to remove any remnants of the posterior cruciate ligament left prior to replacement thereof. The tibial drill guide includes a concave blocking surface and a viewing aperture on the alignment arm member to block the advancement and view the location of a guide pin exiting from a posterior portion of a tibia, respectively.

Abstract: A drill guide for use with a bone plate is provided in accordance with various aspects of the present teachings. The drill guide can include a body and a quick-connect coupling arrangement. The body can have a proximal end, a distal end and can define a guide passage therebetween. The distal end can have a bone plate engaging portion. The quick-connect coupling arrangement can be associated with the bone plate engaging portion, and can include first and second lobes projecting radially outward from an outer surface of the bone plate engaging portion. The bone plate engaging portion and the first and second lobes can be operable to be slidably received in a bone screw hole in the bone plate so as to removably couple the drill guide to the bone plate in a predetermined orientation relative to the bone screw hole.

Abstract: An orthopaedic implant insertion instrument including an insertion handle and a radiolucent aiming guide and method of using same. The insertion handle may be formed of steel and is used for inserting an orthopaedic implant, such as an intramedullary nail or bone plate, into a patient. The radiolucent aiming guide is used to properly locate and guide a drill and/or other insertion instruments for installing fixation elements, such as screws, pins, nails, bolts, blades, etc., through the orthopaedic implant and into the affected bone to secure the implant in position and facilitate healing. The aiming guide is substantially hollow and tubular and is preferably formed of a carbon fiber material.

Abstract: A method for treating back pain by stabilizing the sacroiliac joint. The method includes fusing a sacrum bone to an ilium bone or otherwise mechanically immobilizing the sacroiliac joint by inserting at least two implants into voids formed within or between the articular surfaces of each sacroiliac joint of a patient without substantially distracting the joint. The voids are arranged within each joint at either a converging orientation or a diverging orientation. A kit containing the implants and tools required to insert the implants into the joint are also described.

Abstract: A device for holding a surgical tool includes a first member extending along a longitudinal axis between a first end and a second end. The first end includes an inner surface defining a conduit extending transverse to the longitudinal axis. The conduit includes a first portion and a second portion defining a first chamber. A cap has an inner surface including a first section configured to engage an outer surface of the first member and a second section defining a second chamber extending transverse to the longitudinal axis. The second chamber is in communication with the first chamber when the cap engages the first member such that the first and second chambers define a cavity. A pivoting member is movably disposed in the cavity and includes an inner surface defining a passageway. A second member is disposed within the passageway. Methods of use are disclosed.

Abstract: A hinged pivoting guide for positioning a femoral tunnel in anterior cruciate ligament (ACL) reconstruction locates a drilling hole for placement that optimally penetrates a minimal depth of soft tissue (skin, muscle, etc.) yet directs drilling into a sufficiently rigid and structurally sound area of the femur. The hinged guide allows placement of an aimer point at a desired drilling exit location on the femur. The hinge is adapted to secure the aimer at a degree of rotation about an axis defined by the hinge rotation, such that the axis passes through the aimer point throughout rotation of the hinge while maintaining the aimer point in line with an insertion guide slideably movable through the aperture in the handle, the aperture defined by an insertion axis extending toward the aimer point such that the aimer point remains disposed at the intersection of the hinge axis and the insertion axis.

Abstract: Devices and methods for orthopedic support are disclosed. The device can have a first rigid section hingedly attached to a second rigid section. A tunnel through the bone near the implantation target site can be created. The device can be inserted into and pass through and out of the tunnel to the target site.

Abstract: A method and instrument for preparing a surface of a joint is provided. The glenoid surface is adapted for receiving a prosthetic component having a feature closely conforming to the surface. The prosthetic component provides a bearing surface for a head portion of a long bone. The instrument includes a guide having a first feature and a second feature and a tool. The tool is used for cooperation with the first feature for preparing the surface. The first feature is adapted to at least partially control the position of the tool as it prepares the surface. The second feature is adapted to assist in positioning of the guide with respect to the joint.

Abstract: The present invention relates to guiding instruments for acetabular cup reamers, which allow for a much more accurate and precise reaming of the acetabular implant zone. The invention further provides combinations of acetabular cup reamers and guiding instruments therefor and methods for their manufacture and their use.

Abstract: Techniques and instrumentation for elbow reconstruction, specifically, for repairs of the ulnar collateral ligament (UCL). The instrumentation provides for precise formation of sockets and tunnels along with easy suture/graft passage while accommodating all forms of elbow UCL reconstruction techniques. A V-drill guide is provided with a handle and two drill sleeves having intersecting trajectories for creating an intersecting V-shaped bone tunnel in the ulna. An adjustable humeral guide has an adjustable arm with an arc shape, and a peg and a block extending from each end of the adjustable arm. The peg is shaped to fit within an already-formed humeral socket. The block allows a drill to pass through and form other tunnels which intersect with the originally-formed tunnel at various positions.

Abstract: A system, devices and methods are provided for facilitating stabilization of periarticular fractures. The system includes a compression plate and one or more of a cerclage cable for encircling the bone and securing the compression plate to the bone, a crimp lug for securing the cable in tension relative to the bone and/or a plate, and a supplemental plate coupled to the compression plate and adapted to receive bicortical or unicortical bone screws to further secure the compression plate relative to the bone. In addition, the system includes a cable tensioner for temporarily retaining the cable in tension and then applying a tension to the cable until a desired compression is effected between a plate and bone and while a cable retaining structure is secured to the cable to retain the applied tension on the cable. Also provided is a jig for use with plates for minimally invasive fracture stabilization.

Abstract: A femoral hip stem explant system has an alignment body which is attached to two locations of a femoral bone and has several lockable collet type adjustment features to set the shaft of a reamer or end mill exactly in coincidence with the femoral bone cavity axis. The shaft of the end mill or reamer is supported by a sleeve member, which is inserted into a drill guide central aperture. The drill guide aperture is adjusted first and locked to be in line with the femoral bone cavity. Each of the sleeve members has the same mating outer diameter, which fits into the drill guide central aperture. Accordingly, the sleeve members can be interchanged into the drill guide aperture with shafts of differently sized reamers or end mills.

Abstract: Provided are: a screw guide template, screw guide template system, and drilling method whereby a hole can be drilled in an accurate position of a member to be drilled, in an accurate direction; and a spinal fixation method whereby a spinal fixation screw can be inserted into an accurate position in an accurate direction. The screw guide template (20) comprises: a close-contact face (21) to be closely contacted to the member; and a through hole (22) having one opening (23a) on the close-contact face; the close-contact face has a shape in male-female relation with a surface shape (31) of the member including a portion (32) to be drilled; and when the close-contact face is closely contacted to the portion to be drilled, the opening and portion to be drilled overlap each other so that the through hole is coaxial with the hole to be drilled by the drilling means.

Abstract: The present invention relates to a system and methods generally aimed at monitoring the trajectory of surgical instruments and especially for monitoring the trajectory of surgical instrument used during pedicle fixation to ensure the proper placement of pedicle screws.

Abstract: A Pedicle Drill Guide is a radiolucent device which allows preliminary positioning of a needle/trochar near the pedicle in the AP view and adjusting the final position of the lateral view without changing the initial position of the AP position. This guide allows simultaneous alignment of both AP and Lateral views for ultimate ideal or perfect pathway for the pedicle cannulization.

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: Methods for the prevention, or delayed onset or progression of, bone marrow edema or bone marrow lesion, and subchondral treatment to prevent the progression of osteoarthritis of a joint are disclosed. The methods involve treating the subchondral bone, while preserving, as much as possible, the joint's articular and cartilage surface. The methods could be performed before, during, or after an initial arthroscopic surgery to repair the joint. Associated devices and instruments for treatment of the subchondral bone are also disclosed.

Abstract: A bone fixation system that may be configured to move at least one of a first bone segment and a second bone segment relative to the other, is disclosed. The system may include a first lever and a second lever pivotally coupled to the first lever. The first lever may include a first handle, a first jaw extending from the first handle, and an aperture extending through the first jaw. The aperture may be configured to receive a fixation element to thereby fixedly couple the first lever to a bone plate. The second lever may include a second handle, a second jaw extending from the second handle, and an aperture extending through the second jaw. The aperture may be configured to receive a temporary fixation element to operatively couple the second lever to the second bone segment.

Abstract: A device for in situ milling of joint surfaces, including a milling device and a joint clamping device. The joint clamp device is designed to be inserted between two joint components forming a joint, particularly bones, and for pushing the joint components apart with a predetermined or adjustable tension, wherein the joint clamping device includes a recess in which the milling device can be inserted, wherein the milling device includes a face milling cutter.

Abstract: Instrumentation for an open or arthroscopic Latarjet procedure that allows more control graft handling during the formation of the hole and proper positioning parallel to the articulating bone surface. The surgical instrumentation of the present invention includes an osteotome with a plurality of markings and a depth stop, a drill guide with jaws configured to securely engage an outer surface of the graft, and an offset guide to position the graft to the bone.

Abstract: A method of repairing a prior sacroiliac fusion that was not effective at stabilizing a sacroiliac joint. The prior sacroiliac fusion used a first fastening device that extended between an ilium and a sacrum. At least one aperture is formed that at least partially extends through at least one of an ilium and a sacrum. An undercutting system is inserted at least partially into the aperture and is used to cut tissue between the ilium and the sacrum. A second fastening device is inserted into the first aperture to retain the ilium in a stationary position with respect to the sacrum.

Abstract: The present disclosure relates to a device for use in ligament reconstruction surgery. The device includes a handle, a tube coupled to the handle, and a locking mechanism coupled to the handle. A method for use during ligament reconstruction surgery is also disclosed.

Abstract: Fusion of cervical spinal vertebrae with one or more fixation devices can be accomplished with the described tools and methods. For example, a guidewire introducer can include a tubular introducer cannula and a handle. The handle can be angularly offset from the introducer cannula such that positioning of the introducer on the cervical spine does not interfere with a patient's head. A sheath assembly can include inner and outer sheath bodies and a handle. The handle is angularly offset from the sheath bodies such that the sheath assembly can be applied to the cervical spine without interference to the patient's head. The sheath body can be curved or straight. Various tools such as drills, tapping devices, compression tools, and pin release tools can be applied to the cervical spine through the sheath body to apply the fixation device. The tools can include elongate flexible shafts.

Abstract: A surgical aiming system is disclosed comprising a one or more fixation plates, an aiming assembly, a one or more nails and a plurality of screws. Said aiming assembly comprising a channeling assembly and a plurality of channels. Said one or more fixation plates comprising a plurality of plate apertures capable of receiving a portion of said plurality of screws. Said plurality of channels in said aiming assembly are capable of aligning a portion of said plurality of screws with said plurality of plate apertures in a first fixation plate. Said plurality of channels receive and align said plurality of screws as they are secured to said first bone. Said first fixation plate being extramedullary attached to a portion of said surface of said first bone; and said plurality of channels of said aiming assembly being aligned to identify a one or more intramedullary locations within said first bone.

Abstract: An anatomic femoral guide positions bone tunnels corresponding to the AM and PL bundles in ACL repair and reconstruction procedures. A template guide disposed in a surgical field proximate to a surgical member such as a femur or tibia defines a surgical footprint of the resulting bone tunnel. The template includes apertures corresponding to the size of the bone tunnels for the respective (AM or PL) bundles, and allows positioning at the drilling site to identify the size and location of the bone tunnel, as well as the relative distance between tunnels for double bundle procedures. An offset angle in the template provides differing orientations of the template apertures for visualizing the actual bone tunnel placement. The template has an aperture positionable parallel to a tibial plateau formation on the tibia, and the template orients a second aperture angled by the offset angle for positioning the second tunnel.

Abstract: A patella drill guide includes a base portion rotatably mounted on a bone-gripping component. A trial portion with a contoured articulation surface is above the base portion. The base portion and trial portion have aligned drill guide bores. The base portion and trial portion can be rotated together on the bone-gripping component to optimize the positions of the drill guide bores with respect to the patella surface, thereby optimizing the locations of the mounting pegs of the patella implant component on the patella to optimize the orientation of the patella implant component. The base and the bone-gripping component may be unitary so that the entire assembly rotates on the patella about the central longitudinal axis of the bone-gripping component.

Abstract: A trephine drill bit comprising a body and a tip connected to the body, wherein the tip includes a reduced area having a smaller diameter than the body, the reduced area ending in a stop to indicate when the trephine drill bit should no longer be introduced. A method is also disclosed.

Abstract: A reconstruction system and method for fixation of bone to bone, or soft tissue to bone. The reconstruction system comprises two fixation devices (for example, two buttons) joined by a continuous loop of flexible material. Each button is provided with at least one opening that allows the passage of the flexible material. The button may be formed, for example, of metal, peek or plla. The flexible material may be a suture such as a FIBERWIRE® suture.

Abstract: An orthopedic device includes a patient-specific acetabular guide that can be used for preparing an acetabulum of a patient to receive an acetabular implant. The acetabular guide has a dome-shaped body with a peripheral annular rim and an outer three-dimensional surface configured to match an acetabulum of a specific patient's hip joint from three-dimensional medical images of the patient's hip joint. A patient-specific registration guide is removably attached to the peripheral rim and has a longitudinal bore defining a patient-specific alignment axis with an alignment orientation configured for guiding an acetabular implant for the patient. The registration guide has a patient-specific undersurface configured to mate with a corresponding surface of periacetabular surface of the acetabulum of the patient.

Abstract: A Tibiotalar Arthrodesis Guide (TAG) used for fusion of the talus to the tibia is comprised of several basic components. The main component is a straight guide post upon which other components can slide. A curved arm is featured at the end of the straight guide post, featuring points at the ends which serve as indicators of the pins' exit sites based upon the lines of action of the parallel pins. The parallel guide cylinders are positioned on a movable arm which translates superiorly and inferiorly on the guide post of the handle, allowing a surgeon to adjust the device for varying ankle sizes. A “home-run” pin guide cylinder for a home-run guide pin is oriented superiorly and at an angle to the parallel guide cylinders. Using a similar concept as the parallel guide cylinders, the “home-run” guide is also attached to a movable arm that can translate inferiorly and superiorly along the main guide post.

Abstract: A cervical fixation system and method for repairing odontoid fractures includes securing an anterior plate to caudal portion of C2 body below the odontoid neck. The anterior plate houses lag screw within a posterior shaft. A cannulated fixation device crosses the fracture site with fixation into the cephalad fragment. The lag screw can be pulled caudally into the plate with a compression screw to apply a compression force across the fracture site.

Abstract: Methods are described wherein bone constructs of a patient are used to arthroscopically attach sutures to torn or dysfunctional tissue. A suture or multiple sutures are passed through intersecting/bisecting tunnels formed in the bone. An end of the suture extends from each of the tunnels, and the ends are used to secure the tissue to the bone, such as by arthroscopic tying of the ends, and pulling the tissue against the bone. Devices for performing the methods are also described.

Abstract: An insertion instrument for inserting an orthopedic implant into a bone and guiding an implant attachment element into the bone comprising: a body having a first end and a second end and a bore extending along a central axis; a fixed arm and a deflectable arm coupled to the body second end, the fixed arm spaced from the deflectable arm forming an attachment element receiving passageway therebetween extending along the central axis, the fixed arm having an implant engaging free end spaced a fixed distance from the central axis; and an actuator mounted on the first end of the body for moving the deflectable arm away from the fixed arm while allowing the attachment element to traverse the passageway.

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

Abstract: A system for assisting a surgeon in implanting hook plate-type bone plates includes a cannulated multiple barreled drill guide, a cannulated inserter/impactor, and a cannulated fastener coupling the inserter/impactor to a bone plate. The multiple barreled drill guide facilitates the drilling of at least two parallel holes at the distal end of a bone at the correct position and angle of entry, and includes a body and two drill guide channels coupled to the body in substantially parallel orientation relative to each other, with a guide pin aperture disposed between and substantially parallel to the drill guide tubes. The inserter/impactor likewise includes a central channel accommodating the same guide pin employed to place and align the multiple barreled drill guide.

Abstract: Orthopaedic surgical instruments including a base trial adapted to be positioned on a proximal end of a patient's resected tibia, and a guide tower including a tower base adapted to be positioned on the base trial. A method of use is also described.

Abstract: A drill guide comprising: a body comprising a hole extending therethrough for guiding a drill; and an alignment tool, the alignment tool being operable to connect the body to an intramedullary rod, such that the orientation of the body is fixable with respect to the intramedullary rod in an anteroposterior plane and in a transverse plane.

Abstract: An apparatus for targeting and forming drill channels in the tibia in the area of a knee joint during reconstruction of an anterior cruciate ligament, having a handle, which includes a drill sleeve for configuring a first target point on the tibia and an arm extending beyond the distal end of the drill sleeve for determining a second target point on the tibial plateau. To provide an apparatus for targeting and forming drill channels in the tibia that is adaptable to the patient's individual anatomical idiosyncrasies, it is proposed that at least one portion of the arm should be configured as elastically reshapable.

Abstract: A drill guide includes an outer body and an inner sleeve. The outer body defines a main bore. The outer body includes a tip extending therefrom, wherein the tip is coaxial with the main bore. The tip includes a plurality of deflectable leaves. The inner sleeve defines a receiving bore, and the inner sleeve is adapted to be removably received within the main bore.

Abstract: An aiming plate for orienting tools toward target features of an implant. The aiming plate features a first and a second surface and has a reversible attachment mechanism for attaching to an implant to orientate one of the first and second surfaces to face the implant. The aiming plate also features first and second through holes. The first through hole for receiving a tool extends along a first hole axis from the first surface to the second surface. The second through hole for receiving a tool is positioned adjacent the first through hole and extends along a second hole axis from the first surface to the second surface. The through holes arranged so that the first hole axis is divergent with respect to the second hole axis.