Abstract: A resection guide locator includes a bone engagement portion with surfaces that are complementary to the surface topographies of a bone to be resected during surgery. A housing includes a socket defined by a resilient annular wall that is sized and arranged so to accept a resection guide by press-fit to thereby position and hold the resection guide within the socket. The resection guide is maintained in a predetermined, preferred position while the surfaces are releasably locked in position on the bone. A method is disclosed for forming and using the resection guide locator.

Abstract: An adjustable apparatus for guiding medical instruments used in attaching bone plates. The apparatus has a handle assembly, guide member, a spacer, and an actuation member. The actuation member extends from the handle assembly and actuates the spacer between a position adjacent the guide member and a position spaced from the guide member. The spacer has a through hole that may axially align with a lumen extending through the guide member when in the first position and which is moved out of axial alignment with the lumen in the second position. The spacer may function as a depth stop to control the maximum depth a drill bit can extend from the guide member.

Abstract: A surgical guide system for dental implantology has a plate (10) provided with a guide sleeve (2) delimiting a through hole with an axis oriented to a predetermined direction. A drill (4) for osteotomy has a spindle connected to a handpiece with drilling portion (41), the drill (4) being for association with the guide sleeve (2) during osteotomy. The diameter (d41) of the drilling head portion (41) is larger than the inner diameter (d2) of the guide sleeve (2) and the spindle is of smaller diameter, such that the association of the drill (4) to any of the guide sleeves (2) can be performed only by inserting the spindle through a gingival side of the sleeves. Upon association of the drill with the sleeve, the drilling head (41) protrudes from the gingival side (2G) thereof. The surgical guide has a void (100) accommodating the drilling head (41) of the drill.

Abstract: An aiming guide aligns a surgical tool with a hole in a bone plate. The aiming guide includes an arm portion having a longitudinal axis, top and bottom surfaces, and first and second ends. The aiming guide further includes a handle portion having upper and lower ends. The handle portion is, at its lower end, connected to the bone plate. The handle portion is, at its upper end, connected to the arm portion. Bores extend from the top surface to the lower surface of the arm portion. Each bore is configured and dimensioned to receive a tool guide in at least two different preset positions which locates the channel in at least two different hole positions. The bore includes two diametrically opposed slots extending along at least a portion of a length of the bore, the slots configured and dimensioned to mate with diametrically opposed knobs extending radially outward from a tool guide. The tool guide has a head and a sleeve portion, which has a centered channel.

Abstract: A patient-specific acetabular guide for use in orienting an acetabular component with respect to an acetabulum of a patient as part of a surgical procedure includes a body having a bottom contact surface that has a portion that is shaped and configured to initimately receive and interlockingly mate with an acetabular notch of the patient's acetabulum in accordance with a three-dimensional image of the acetabulum of the specific patient. The three-dimensional image can be in the form of a three-dimensional virtual model of the patient's acetabulum that is constructed at least in part on 3D image data of the pelvic region of the patient.

Abstract: Disclosed herein are systems and methods for shaping bone voids during revision procedures of total knee replacements. The systems disclosed herein generally include a cannulated reamer assembly, a reaming guide assembly, a guide tube assembly, a trial stem assembly, and an optional insertion/removal tool. Metaphyseal reconstruction devices can be used to fill the bone voids in conjunction with the systems and methods disclosed herein.

Abstract: An apparatus and method for positioning a guide tube fixation device at a spinal structure of a patient are provided. The method includes attaching an attachment element to the spinal structure, attaching a guide tube to the attachment element, wherein said guide tube is calibrated prior to attachment, and navigating a part of the guide tube to a predetermined location relative to a target region of the patient. The apparatus includes an attachment device for attaching to the spinal structure, a joint attached to the attachment device, and a guide tube holding device attached to the joint and operable to hold and/or guide a guide tube, said guide tube configured to guide a cannula, needle and/or fluid to a desired site or location.

Abstract: A device serves for guiding a drilling tool for forming a second bore in a bone, which second bore intersects an already existing first bore. A frame, having a first end and a second end has a rod-shaped body arranged at its first end. Said rod-shaped body is designed to be inserted into said already existing first bore. A guide sleeve is arranged at said second end of said frame and has a longitudinal axis intersecting said rod-shaped body in an area of its distal end. A fixing device is provided at said guide sleeve, said fixing device protrudes distally from said guide sleeve, said protruding fixing device can be placed on a body of a patient to be treated in an area where said second bore is to be formed.

Abstract: A device and technique for the preparation and implantation of osteochondral allografts for resurfacing of a human joint. The grafts are prepared to a uniform shell thickness using the described invention.

Abstract: A device for introduction into a body in a straight configuration and assuming within the body a predefined curved configuration, includes an elongated element formed from a number of segments interconnected so as to form effective binges therebetween. When the elongated element is confined to a straight state, the effective hinges transfer compressive forces from each segment to the next so that the elongated element can be pushed to advance it through a conduit. When the elongated element is not confined to a straight state, the effective hinges allow deflection of each segment relative to adjacent segments until abutment surfaces of the segments come into abutment, thereby defining a fully flexed state of the elongated element with a predefined curved configuration. The device can be produced with a wide range of two-dimensional and three-dimensional curved forms, and has both medical and non-medical applications.

Abstract: The present invention relates to a surgical drill guide having an anchoring mechanism for locking the drill guide to a bone plate. The anchoring mechanism is adapted to be received through an opening of a bone plate and rotated to lock the drill guide to the bone plate. The anchoring mechanism can be rotated by a driver, which has a distal end key that fits into a corresponding socket of on the proximal portion of the anchoring mechanism. The present invention also relates to a kit including a bone plate, a driver, and the drill guide and a method for using the kit to perform surgery.

Abstract: A multi-positional dual drill guide for use in orthopedic surgical procedures provides two independent drill guides which are independently, pivotally and removably secured along a pivotal drill guide plate comprising two separate and independent guide plate sections, selectively aligning each of the two drill guides for drilling an intersecting bone channel into a common bone from different locations for the passage of a suture and associated tissue during an orthopedic repair of a joint. The drill guide provide for three dimensional movement of the drill guides to provide a range of drilling angles from nearly zero degrees up to 180-degrees apart and in a three dimensional array, the drill.

Abstract: A multi-positional dual drill guide for use in orthopedic surgical procedures provides two independent drill guides which are independently, pivotally and removably secured along a pivotal drill guide plate comprising two separate and independent guide plate sections, selectively aligning each of the two drill guides for drilling an intersecting bone channel into a common bone from different locations for the passage of a suture and associated tissue during an orthopedic repair of a joint. The drill guide provide for three dimensional movement of the drill guides to provide a range of drilling angles from nearly zero degrees up to 180-degrees apart and in a three dimensional array, the drill.

Abstract: A method of surgically preparing a patella for implantation of a patella prosthetic component is disclosed.

Abstract: An aiming arm can include at least a pair of radiographic markers that define a first radiographic image characteristic when a radiographic image source is not adequately aligned with the aiming arm, and a second desired radiographic image characteristic when the radiographic image source is adequately aligned with the aiming arm. Once the radiographic image source has been aligned with the aiming arm, the position of the aiming arm relative to an underlying implant can be visually inspected to determine whether the aiming arm is aligned with the underlying implant.

Abstract: A pin placement instrument for placing a pin in a bone comprises an anatomical interface with a hook-like portion being opened in a lateral direction of the instrument to receive a bone therein in a planned position. A drill guide is connected to the anatomical interface and defining at least one guide slot in a longitudinal direction of the instrument. The guide slot has a lateral opening over its full length in the drill guide to allow lateral withdrawal of the instrument in said lateral direction with the pin placed in the bone passing through the lateral opening. A bushing is removably placed in said guide slot via said longitudinal direction in a planned fit, the bushing defining a throughbore aligned with the guide slot and adapted to receive the pin extending in said longitudinal direction when the bushing is in the guide slot for pin placement.

Abstract: A drill guide includes a first bone plate that extends along a first middle plane, and a second bone plate that extends along a second middle plane. The drill guide further includes a first articulation and a second articulation that is connected to the first articulation. The first and second articulations are arranged between the first and the second bone plate. Each of the first and second articulations is releasably lockable.

Abstract: A device for drilling a hole in bone and for inserting bone screws into the drilled hole is provided. The device comprises a trocar, drill sleeve and protection sleeve in a telescopically nested configuration. The drill sleeve and protection sleeve may have an axial locking feature that allows the two pieces to be handled together as a unit by preventing inadvertent separation. The axial locking feature may comprise an integral annular ridge provided on one sleeve that cooperates with an annular groove provided on the other sleeve. One sleeve may also have at least one slot allowing the locking feature to be disengaged prior to separation of the sleeves. The sleeves may be easily separated with one hand by the user by the application of an axial separation force between a pair of flanges provided with the sleeves, and by a radial compression force applied to at least a portion of the drill sleeve.

Abstract: A system and method for detecting and measuring changes in angular position with respect to a reference plane is useful in surgical procedures for orienting various instruments, prosthesis, and implants with respect to anatomical landmarks. One embodiment of the device uses dual orientation devices of a type capable of measuring angular position changes from a reference position. One such device provides information as to changes in position of an anatomical landmark relative to a reference position. The second device provides information as to changes in position of a surgical instrument and/or prosthesis relative to the reference position.

Abstract: A humeral prosthesis includes a stem component and a humeral head component. The humeral head component has a configuration that is similar to the curvature of the humeral head to allow the head to reconstruct the anatomy of the damaged humerus. The stem component is threaded and cannulated and engages the humeral head component. The stem component is configured to be inserted within the humeral diaphyseal channel. When engaged the humeral head component and the stem component form an articulated joint allowing the humeral head component to articulate with respect to the stem component.

Abstract: A guide assembly for use in preparing a femur for soft tissue reconstruction is provided. The guide assembly can include a guide shaft member that can extend from a proximal end to a distal end thereof and can include a distal region encompassing the distal end. The distal region can have a first bend in a first direction and a second bend in a second direction different than the first direction.

Abstract: A pin guide for the surgical operation of an avascular necrosis of a femoral head includes a guide body having a central pin guide hole extending along a centerline of the guide body and a plurality of side pin guide holes formed so as to make a specified angle with the central pin guide hole. The side pin guide holes are radially arranged around the central pin guide hole at a front side of the guide body and joined to the central pin guide hole at a rear side of the guide body.

Abstract: An orthopaedic surgical instrument that includes a patella resection guide is disclosed. The patella resection guide includes a body having a substantially planar upper surface that defines a patella cutting guide surface and a first jaw having a first tooth, and a second jaw positioned opposite the first jaw. The second jaw is movable relative to the first jaw and includes a second tooth extending toward the first tooth that defines an axis along which the second jaw is moveable relative to the first jaw. The patella cutting guide surface defines a resection plane that extends through a patient's patella when the patella is positioned between the first jaw and the second jaw.

Abstract: A replacement device for resurfacing a joint surface of a femur and a method of making and installing such a device is provided. The custom replacement device is designed to substantially fit the trochlear groove surface, of an individual femur, thereby creating a “customized” replacement device for that individual femur and maintaining the original kinematics of the joint. The top surface is designed so as to maintain centrally directed tracking of the patella perpendicular to the plane established by the distal end of the femoral condyles and aligned with the center of the femoral head.

Abstract: A method and instrumentation for performing a patellofemoral arthroplasty orthopaedic procedure includes coupling an anterior cutting block to a femur of a patient such that the cutting block references local anatomy of the femur. The anterior cutting block is used to perform a number of bone cuts to establish a trochlear cavity in the femur. The trochlear cavity is formed such that a trochlear prosthesis may be inset into the cavity and substantially flush with the surrounding cartilage. A finishing burring guide and burr bit may be used to detail the shape and/or size of the trochlear cavity. Additionally, a trochlear drill guide may be used to facilitate establishing peg holes in the patient's femur to receive corresponding pegs of the trochlear prosthesis.

Abstract: A parallel drill guide and system which maintains contact on the bone at various angles. The parallel drill guide comprises a fixed sleeve and a parallel, axially slidable, sleeve for guiding the insertion of two parallel wires or pins into bone at any angle while maintaining contact between the bone and the guide. The drill guide is also provided with a locking mechanism that locks the slidable sleeve into position at any lateral distance relative to the fixed sleeve, using a novel off-axis locking device.

Abstract: A method for fusing bones using a guide pin and a fastener is disclosed. The method includes inserting a guide pin into two bones. The guide pin including at least one radial marking The method also including imaging the two bones and guide pin and analyzing the position of the at least one radial marking of the guide pin relative to the two bones. In addition, the method includes selecting a fastener, inserting a drill over the guide pin, drilling an opening through at least one of the two bones, and inserting the fastener into the opening. The guide pin may include an exterior surface with a first end and a second end, a cutting edge at the first end, and at least one radial marking near the first end. A system including a guide pin, a fastener, and a drill is also disclosed.

Abstract: A method for forming a surgery guide for osteotomy shapes a block of material for conformance to at least a portion of the dental arch of a patient. At least one guide feature is shaped to protrude from a surface of the shaped block material. A drill guide sleeve is seated on the at least one guide feature. The shaft of a drill is guided into the sleeve and a hole drilled through the shaped block material.

Abstract: Instruments and techniques to pass a suture are presented. In one illustrative example, a suture passer includes a guide operable to guide the formation of a tunnel in a bone and guide passage of a suture through the tunnel so formed.

Abstract: An orthopaedic surgical instrument includes a patella drill guide having a first bracket, a second bracket coupled to the first bracket and moveable relative to the first bracket. The second bracket includes a drill plate having a plurality of guide holes defined therein.

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.

Abstract: Instrumentation for preparation of a bone includes a first guide having a first collet and a second collet. The first and second collets are formed around divergent first and second axes, and share a common opening. A bone preparation instrument may be inserted into each of the collets toward a bone. A second guide may be carried in the first guide, and a bone preparation instrument inserted through the second guide toward the bone, along a third axis.

Abstract: A trajectory frame for use with surgical navigation systems includes a base having a patient access aperture formed therein. A yoke is mounted to the base and is rotatable about a roll axis. A platform is mounted to the yoke and is rotatable about a pitch axis. An elongated guide is secured to the platform and includes opposite proximal and distal end portions and a bore that extends from the proximal end portion to the distal end portion. The guide is configured to removably receive various devices therein for quick release therefrom, including an optical tracking probe (which may be a universal tracker) detectable by a camera-based tracking system or an EM probe detectable by an EM navigation system, a microelectrode probe driver adapter, a drill guide and drill bit, skull fixation device and driver, and a catheter guide.

Abstract: A system for anterior cruciate ligament (ACL) reconstruction using holes in bone created by retrograde cutting. A rotary cutter, mounted onto an insertion post of a tibial guide, is inserted through an anteromedial portal and the rotary cutter placed on the anatomical origin of an ACL tibial insertion. A drill pin is drilled through the tibia and advanced until it contacts and engages a cannulation in the rotary cutter on the guide. Further rotation of the drill pin disengages the rotary cutter from the guide. The retrograde drill pin is then retracted and simultaneously rotated for retrograde cutting of a socket or tunnel of desired depth in the tibia. A similar system is provided to form a socket or tunnel in the femur except that a femur guide is used in place of the tibial 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 method and instrument is used for inserting a bone screw through a hole in a bone plate into bone at a maximum angulation of a bone screw central longitudinal axis with respect to a central axis of the hole. The maximum angulation places the head of the bone screw at or below an outwardly facing surface of the bone plate. The instrument has a distal end including a gauge element spaced proximally from an end surface of the distal end when in contact with a counterbore surrounding the plate hole a distance less than a depth of the counterbore. The instrument is tilted with respect to a central axis of the bone plate hole to an angle wherein the gauge element remains at or below the outwardly facing surface of the bone plate adjacent the counterbore. A hole is drilled through a guide bore in the instrument.

Abstract: A replacement device for resurfacing a joint surface of a femur and a method of making and installing such a device is provided. The custom replacement device is designed to substantially fit the trochlear groove surface, of an individual femur, thereby creating a “customized” replacement device for that individual femur and maintaining the original kinematics of the joint. The top surface is designed so as to maintain centrally directed tracking of the patella perpendicular to the plane established by the distal end of the femoral condyles and aligned with the center of the femoral head.

Abstract: A replacement device for resurfacing a joint surface of a femur and a method of making and installing such a device is provided. The custom replacement device is designed to substantially fit the trochlear groove surface, of an individual femur, thereby creating a “customized” replacement device for that individual femur and maintaining the original kinematics of the joint. The top surface is designed so as to maintain centrally directed tracking of the patella perpendicular to the plane established by the distal end of the femoral condyles and aligned with the center of the femoral head.

Abstract: Systems, devices and methods that improve the placement of orthopedic components and/or instrumentation during surgery. In one particular embodiment, the systems, devices and methods provide drill guides that remove the need for three-handed placement of implant components and reduce complications of implant and fixation member placement. Also disclosed is a sheath with a rounded tip that engages a spherical recess of a patient matched cutting block to reduce the ability of the first fixation pin to communicate unintentional moment/torque to the patient matched instrument through a new articulation between the pin and the guide. Once the first fixation pin has been placed to secure the patient matched instrument to the bone, the effect of subsequent pins is greatly diminished. Subsequent pins may or may not also be decoupled rotationally.

Abstract: A system and method may be used for accessing an articular surface and for preparing an implant site on the articular surface. The method may include locating a portion of the articular. An access passage may be drilled towards the articular surface though bone behind the articular surface. An implant site may be excised in the articular surface relative to an axis defined by the access passage.

Abstract: A method of surgically preparing a tibia for implantation of a tibial prosthetic component is disclosed.

Abstract: A method and tool for creating a location for a fixation device to be secured to a bone. The method includes bringing a bone cutting tool extending along a longitudinal axis into engagement with an outer surface of the bone. The bone cutting tool is rotated about the longitudinal axis while driving it from the outer surface of the bone to a predetermined depth in the bone to form a bore. The bone cutting tool is then continuously rotated at the predetermined depth to establish an enlarged bone pocket at a distal end of the bore. The bone pocket defines a shoulder extending around a circumference between the bone pocket and bore. The bone cutting tool is removed from the bone pocket and bore. The fixation device is then inserted into the bone pocket through the bore, where it is seated against the bone pocket shoulder.

Abstract: The invention relates to surgical bone holding forceps provided with a drilling guide that allows for drilling parallel to the pointed jaws of the forceps clamped to a bone. Another aspect of the invention is the friction-based, stepless locking mechanism that retains the forceps arms in position with the jaws clamped to the bone.

Abstract: A drill guide includes a first bone plate that extends along a first middle plane, and a second bone plate that extends along a second middle plane. The drill guide further includes a first articulation and a second articulation that is connected to the first articulation. The first and second articulations are arranged between the first and the second bone plate. Each of the first and second articulations is releasably lockable.

Abstract: A jig for a bone fixation device, including those that comprise a guide; and a connecting element reversibly engagable with the bone fixation device; wherein the guide defines a non-rectilinear path and is adapted to receive the connecting element; and wherein the connecting element is remotely operable, and is adapted to permit a tool to be engaged with the bone fixation device. Other embodiments of the present invention include methods for placing a bone fixation device in a bone, using a jig of the present invention comprising the step of reversibly engaging the bone fixation device with the jig.

Abstract: An apparatus for inserting a suture anchor into an internal anatomical site through a cannula, or percutaneously, has a curved hollow guide for insertion into the cannula and/or tissue. The guide has a proximal end and a distal end. The distal end has a “parabolic” shape for engaging the intended anatomical site such as a glenoid. A flexible obturator is insertable through the curved guide from the proximal end to the distal end to facilitate insertion of the guide through the cannula. A flexible drill is insertable through the curved guide from the proximal to the distal end once the guide is in place. A flexible inserter is provided for inserting a suture anchor into a bore at the anatomical site formed by the flexible drill.

Abstract: A reamer guide system may include a reamer guide that is configured to guide a reamer to at least two bones that are to be reamed to form a countersink. The reamer guide may be configured to temporarily couple to the at least two bones that are to be reamed so as to prevent substantial separation of the at least two bones during the reaming. The reamer guide system may further include a positioning aid that is configured to receive a locating element. The locating element is configured to temporarily couple to a target location adjacent the bones that are to be reamed. The reamer is configured to receive the locating element and advance along the locating element to the target location.

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 a main body extending at one end into an indicator probe for visual determination of a target site of a bone to be treated, and at an opposite end into a handle. A rail extends from the main body. The instrument also includes an alignment guide having a device portal for insertion of a device therethrough, the alignment guide being detachable and movable along a length of the rail. 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: 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: A guide apparatus having a body having a central axis defined therethrough and a first channel and a second channel formed therethrough, a handle coupled to the body, the handle having a locking mechanism configured to prevent movement of the body relative to the handle in a first direction along the central axis of the body, and an arm coupled to the handle, the arm configured to engage at least a portion of a bone.