Abstract: A system for establishing an intramedullary path includes a body sized and configured to be received within a resected bone space. The body defines a first aperture that extends through the body and is sized and configured to receive a surgical tool therethrough. A first bone engaging structure extends from the body in a first direction and includes a first surface that is complementary to a surface topography of a first bone. When the first surface of the bone engaging structure engages the surface topography of the first bone to which the first surface is complementary, an axis defined by the first aperture is substantially collinear with a mechanical axis of the first bone.

Abstract: A method for performing spinal fixation and instrumentation. A first incision may be made through the skin and a passageway may be created to the spine. A screw may be inserted through the passageway and into a vertebrae. The screw may have a head portion including a channel. An insertion guide may be operable connected to the screw. The insertion guide may have first and second longitudinal slots. Additional screws may each be inserted through separate incisions or through the first incision. Insertion guides may be operably connected to a head portion of each screw. A sleeve may be positioned into one insertion guide in a first position to guide a rod through at least one other insertion guide. The sleeve may be rotated to a second position to allow the rod to move down the slots of the insertion guide(s) and into the head portion of the screw.

Abstract: An assembly includes a guide component having (i) a base defining a first passageway, and (ii) a handle attached to the base, the base including a first coupling component. The assembly further includes a first sheath defining a second passageway, the first sheath including a second coupling component configured to cooperate with the first coupling component to couple the first sheath to the base. The first passageway is aligned with the second passageway when the first sheath is coupled to the base. The assembly further includes a stop structure defining a central passage, the stop structure including an external surface having a plurality of keyways defined therein. The first sheath includes a key member configured to be selectively received in any one of the plurality of keyways. The stop structure is fixed in relation to the first sheath when the key member is positioned in any one of the plurality of keyways.

Abstract: A customized patient-specific acetabular orthopaedic surgical instrument is disclosed. A method for fabricating and using the orthopaedic surgical instrument us also disclosed.

Abstract: According to various embodiments, a multi-use tool may include a member having a first surface and a second surface. The first surface can engage at least one of a shell and/or bearing liner for insertion thereof. The second surface may engage at least one of a shell and/or bearing liner for removal thereof.

Abstract: An instrument for locating a femoral mechanical axis and identifying the locations of at least three points in space in relation to the center of a femoral head, the instrument including a base member, an extension arm clamp translationally and pivotally attached to the base member, an extension arm translationally and pivotally attached to the extension arm clamp, a swiveling arm pivotally attached to a distal end of the extension arm, the swiveling arm including a lateral locator member at a proximal end and a medial locator member at a distal end, a bracket pivotally attached to the swiveling arm, and a locating arm removably attached to the bracket, the locating arm including a middle locator member.

Abstract: A drill guide uses a hole in a layer to guide a drill along an axial trajectory while permitting off-axis excursions of the drill during use. A number of such drill guides at varying heights from a target surface may be used sequentially or concurrently to enforce the axial trajectory in three dimensions during a surgical operation. A drill guide may include a hole in a layer that establishes a single point along the axial trajectory, or the drill guide may include multiple layers in a single device to establish two or more points along the trajectory while allowing off-axis insertion of a drill into the guide. The drill guide may be cuttable to accommodate intraoperative changes to the axial trajectory. In embodiments, a window or the like may be provided to permit a surgeon to view drill depth, drill orientation, the surgical site and the like during a procedure.

Abstract: A targeting device used in the insertion of an intramedullary nail into a bone. The targeting device includes a guide barrel having a frame portion formed of a non-radiolucent material. The guide barrel also includes a radiolucent material molded over the frame. In addition, the frame includes openings configured to allow a surgeon to view a relatively greater area around the guide barrel in an image of the assembly during surgery.

Abstract: A spinal facet fusion device is provided. The device includes a working sleeve having a first surface with a first port and a second port extending there through. The first port has a first perimeter and the second port having a second perimeter, wherein the first port is larger than the second port. A guide wire sleeve having a body with a proximal end and a distal end and a first outer perimeter is provided. The first outer perimeter is sized and shaped to be slidingly disposed within the second port, the guide wire sleeve having a channel extending longitudinally from the proximal end through the distal end, the body further having a stop feature on the distal end. An implementing device having a second outer perimeter is sized to be slidingly received within the first perimeter.

Abstract: A device for centering and guiding at least one drill bit of a dental handpiece when drilling a hole in the jaw of a patient in cooperation with a surgical guide equipped with a tubular drill bushing. A support holds a tubular guide sleeve permanently in a coaxial and sliding position with respect to the drill bit. The tubular guide sleeve is able to engage with slight play in the tubular drill bushing. The support insures the engagement of the guide sleeve in the tubular drill bushing at the latest when the drill bit starts to drill in the patient's jaw, thus insuring the centering and guiding of the drill bit.

Abstract: The various embodiments disclosed herein relate to implantable devices for the treatment of a structural bone and deformity. More specifically, the various embodiments include systems, devices, and methods for implantation of a flexible or tension band for treating such a deformity, including hallux valgus.

Abstract: A guide apparatus including a body having a proximal end, a distal end, a hole formed therethrough, and a central axis defined therethrough, and a projection member coupled to the distal end of the body. An outer diameter of the body is larger than an outer diameter of the projection member. Further, the projection member does not obstruct a pathway defined by the hole.

Abstract: Provided herein are patient-specific surgical guiding tools for positioning on a socket of a ball-and-socket joint, e.g. a glenoid cavity. The guiding tools comprise a central contact element fitting within the socket and one or more lateral contact elements fitting on the rim of the socket. The guiding tools allow accurate positioning of surgical tools such as alignment elements, according to a pre-operational planning. Methods for the manufacture and use of said guiding tools are also provided.

Abstract: Techniques and reconstruction systems for ACL repair by providing cross-pin fixation of a graft within a tibial tunnel. The invention provides tibial fixation techniques according to which cross-pin fixation of a graft (for example, an Anterior Tibialis allograft) is achieved on the tibial side, close to the jointline, by a single incision and with cortical fixation.

Abstract: A graft attachment apparatus including at least two separately formed filament loops, and a fixation member comprising at least one opening configured to receive the at least two separately formed filament loops. The at least two separately formed filament loops are coupled to the fixation member. Further, each of the at least two separately formed filament loops are continuous loops.

Abstract: A nail cap cannula for directing a nail cap useable with an intramedullary nail system including an intramedullary nail and a targeting guide.

Abstract: A distance indicator for indicating the distance that a device has traveled includes an elongate housing with a guidewire connector configured for operative connection to a guidewire to hold the housing stationary with respect thereto. A plunger is operatively connected to the housing for longitudinal motion with respect to the housing. A first plunger end is configured to operatively contact the device. As the guidewire connector is holding the housing stationary with respect to the guidewire, the first plunger end is placed into operative contact with the device with the plunger and housing in a first relative plunger/housing position. The device moves longitudinally. The plunger moves into a second relative plunger/housing position assisted by the operative connection between the first plunger end and the device. The longitudinal difference between the first and second relative plunger/housing positions indicates a distance that the device has moved longitudinally with respect to the guidewire.

Abstract: Systems (10, 110, 1010, 1110) for identifying landmarks (31, 131, 1028, 1128) on orthopedic implants (30, 130, 1024, 1124) are disclosed. The systems (10, 110, 1010, 1110) include a field generator (16, 116, 1016, 1116) for generating a magnetic field and an orthopedic implant (30, 130, 1024, 1124) located within the magnetic field. The implant (30, 130, 1024, 1124) includes at least one landmark (31, 131, 1028, 1128), an optional removable probe (1029, 1129) and a first magnetic sensor (32, 132, 1026, 1126).

Abstract: A guide and method for cutting bones adjacent a joint at locations referenced to the joint anatomy is presented.

Abstract: A device for applying a medical element has a housing defining a longitudinal axis with a channel disposed therethrough. The housing has a proximal and a distal opening. The device also has at least one sensing device positioned adjacent to the distal opening. The device also has a signaling device disposed adjacent the housing. The at least one sensing device interogates a bone location for one or more variables of the bone location as the device is moved over the bone location. The at least one sensing devices outputs a signal to the device and the signaling device signals an identification of a homogenous bone region. The medical element is applied to the homogenous bone location coaxially from the proximal opening through the channel and through the distal opening without removal of the device from the homogenous bone region.

Abstract: An implant system having an inserter or implant-drill guide defining a plurality of overlapping bores or elongated passageways. The inserter or implant-drill bit guide provides a drill jig for defining a complementary-shaped drilled-out area in the first and second vertebra. The implant comprises a plurality or lobes or lobate shapes that are adapted in size to be snugly fit into the implant receiving area.

Abstract: Methods and devices are disclosed for manipulating the hyoid bone, such as to treat obstructive sleep apnea. A conformable implant is positioned adjacent a hyoid bone. The spatial orientation of the hyoid bone is manipulated, to affect the configuration of the airway. The implant restrains the hyoid bone in the manipulated configuration. The implant is positioned adjacent to pharyngeal structures to dilate the pharyngeal airway and/or to support the pharyngeal wall against collapse. The implant may be attached to the hyoid bone using a clamp delivery tool that is adapted to releasably engage the implant.

Abstract: Apparatus and methods for accessing an inferior vertebra, a superior vertebra, and a disc space therebetween via a transpedicular approach in the inferior vertebra that may include creating a channel normal to the pedicle and using an offset guide to create a second transpedicular channel at an angle to the first, normal pedicle channel where the second transpedicular channel passes into the inferior vertebra, superior vertebra, or the disc space therebetween.

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: 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 guide assembly for facilitating placement of a fixation member within a medullary canal of a radius is provided. According to one embodiment, a guide assembly includes a guide fastener configured to attach to a fixation member and a guide member configured to receive the guide fastener such that the guide member is secured to the fixation member. The guide assembly also includes an interchangeable distal guide member configured to engage and be disengaged from the guide member. The distal guide member defines a plurality of fastener guide openings for guiding respective fasteners through a plurality of fastener openings defined in the fixation member.

Abstract: A drill guide includes at least one drill guide lumen and a handle coupled to the at least one drill guide lumen. The drill guide lumen includes a proximal opening, a distal opening, and a longitudinal opening therebetween. The handle is movable between a first position relative to the drill guide lumen and a second position relative to the drill guide lumen.

Abstract: An instrument guide with device coupler, a handle and one or more instrument guide lumens is detachably coupled to an orthopedic implant to facilitate drilling of the fastener holes or to facilitate insertion of self-tapping or self-dripping fasteners. The handle is preferably detachable to facilitate access to the instrument guide lumens. The device coupler detachably engages the implantable device and aligns the instrument guide lumens with the fastener openings on the device.

Abstract: A system for inserting an intramedullary nail into a bone includes (a) a handle extending from a proximal end to a distal end configured to couple to an intramedullary nail only in a desired orientation and (b) an aiming device extending from a proximal end to a distal end configured for attachment to the proximal end of the handle. The aiming device includes a guide opening extending therethrough sized and shaped to accommodate a protective sleeve therein. The guide opening is located and oriented so that, when the aiming device and the handle are coupled to one another, a bone fixation receiving hole in an intramedullary nail coupled to the handle is aligned with the guide opening. The aiming device further includes a locking pin fixedly mounted thereto. The locking pin extends into the guide opening to engage a protective sleeve inserted therein.

Abstract: A Lisfranc injury between a second metatarsal and medial cuneiform is repaired by gaining access to the injury site and placing two arm members of a novel drill guide around the two neighboring bones at the injury site, drilling a guide wire through the two bones guided by the drill guide to a desired depth, measuring the depth of the guide wire to determine the proper length for a bone screw for securing the two bones, drilling a cannulated drill bit into the two bones to a drill depth using the guide wire as a guide, and threading a bone screw into the two bones.

Abstract: A tool comprises a first body shaped to detachably receive a bone implant having a first portion with a first flat surface adapted to be attached to a bone and a second portion with a second flat surface oriented at a pre-determined angle relative to the first flat surface, the bone implant having at least one fastener hole penetrating each of the first and second portions. A second body has a surface or member. The second body is adjustably connected to the first body to selectably position the surface or member relative to the bone implant.

Abstract: A system and method for developing customized apparatus for use in one or more surgical procedures is disclosed. The system and method incorporates a patient's unique anatomical features or morphology, which may be derived from capturing MRI data or CT data, to fabricate at least one custom apparatus. According to a preferred embodiment, the customized apparatus comprises a plurality of complementary surfaces based on a plurality of data points from the MRI or CT data. Thus, each apparatus may be matched in duplicate and oriented around the patient's own anatomy, and may further provide any desired axial alignments or insertional trajectories. In an alternate embodiment, the apparatus may further be aligned with at least one other apparatus used during the surgical procedure.

Abstract: A drill system for forming a curved tunnel in a bone includes a drill bit guidance device. The drill bit guidance device includes an elongated stationary outer tube extending along a first axis and an elongated inner tube. The elongated inner tube is configured to slidably move within the elongated stationary outer tube along the first axis and to exit from a distal end of the elongated outer tube. The elongated inner tube has a partially slotted distal end portion including a plurality of semi-cross-sectional slots extending perpendicular to the first axis. Each slot is configured to collapse inward in the slot direction when exiting the distal end of the elongated outer tube, thereby curving the distal end portion of the elongated inner tube.

Abstract: An attachment mechanism, method of manufacture and method of use are described for releasably attaching a first component and a second component of an orthopaedic apparatus. The attachment mechanism comprises a boss extending from a surface of the first component, and having a free end and a side wall. A retaining mechanism is provided in the second component. The retaining mechanism comprises a plurality of walls defining an aperture in the second component to receive the boss therein. At least part of one of the plurality of walls is a resiliency flexible member engineered to apply sufficient force to a part of the side wall of the boss when inserted in the aperture to provide an interference fit between the boss and the plurality of walls of the aperture to releasably retain the boss within the aperture.

Abstract: A surgical instrument having a first assembly with a first radio-opaque portion providing a profile of a first portion of an intramedullary implant or canal in a bone, and a second assembly having a second radio-opaque portion providing a profile of a second portion of the intramedullary implant or canal. The surgical instrument may also include a third radio-opaque portion providing an alignment feature to provide a fluoroscopic planar check for the surgical instrument.

Abstract: A method and system for guiding a drill or nail to intersect both bone and an aperture in an implanted implant. In an exemplary embodiment of the invention, a vector is defined interconnecting a path of a tool or cross-implant and the bone and implanted implant. In an exemplary embodiment of the invention, the vector is defined using a light source and two sensors or a light source and a sensor which is on an opposite side of said bone from said source.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

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: An adjustable drill depth guide includes a first sleeve, a second sleeve and a stop member. The first sleeve includes a longitudinal axis and defines a helical slot disposed about the longitudinal axis. The second sleeve is concentrically arranged relative to the first sleeve and is axially adjustable relative to the first sleeve for adjusting a length of the adjustable drill depth guide. The stop member extends radially from the second sleeve and is disposed in the helical slot. The stop member is selectively received at various positions along the helical slot to positively locate the second sleeve relative to the first sleeve in the axial direction.

Abstract: Apparatuses are provided for arthroscopic rotator cuff repair incorporating a transhumeral bone tunnel. The apparatus comprises a number of components that can also be considered a repair system to include a drill guide, a marking hook, and a drill with a removable tip that serves as a bone anchor. In additional aspects of the invention, the components of the drill guide assembly comprise a cannulated marking hook and a drill guide with multiple bores. In additional aspects of the invention, an implantable bone anchor is provided that is especially adapted for placement through a bone tunnel, and wherein the implantable anchor is collapsible to increase the effective size of the anchor for securing the anchor to the far side opening of the bone tunnel through which the anchor was placed.

Abstract: A tool set for preparing a joint, inserting an implant or removing an implant from a joint in an open or less invasive procedure generally comprises a set of nested tools, pin guides, jigs, and/or immobilization elements. The nested tool set comprises at least one pin and at least one cannulated tool. In some embodiments, the cannula can comprise tangs that project from the distal end of the cannula. The tangs can be offset such that drilling would remove different amounts of bone relative to drilling through a centered drill guide. The cannulated tool kit generally can comprise at least one tool guide/cannula, drill bits/reamer, syringe, and/or inserter. With the pin positioned into the joint, at least one cannula is positioned over and around the pin. The channel of the cannula guides the other tools into the joint. A plurality of cannulae in a nested arrangement can be used to afford selectively sized channels for tools and/or implants based on selected cannulae configuration.

Abstract: A method of preparing a distal femur for implantation of a femoral implant is described. The distal femur is resected to accommodate placement of a trial implant thereon. The trial implant is then placed against the resected distal femur to locate an optimal position for the femoral implant. The trial implant comprises one or more apertures through which holes are drilled in the distal femur and into which trial pegs are inserted into the distal femur to secure the trial implant to the distal femur. The surgeon then evaluates whether the holes in the femur are located appropriately to securely implant the femoral implant onto the femur. The trial implant is ultimately removed in favor of a final implant.

Abstract: Methods and apparatus for integrating an electromagnetic navigation system and a tool and aligning the tool with a target are presented, including a sensor tool, a tool, a field generator, a display, and a computer. The sensor tool attaches to a target component in a unique position relative to target features. The field generator is fixed relative to the tool except in rotation about a tool axis. The display is adjustably mounted to the tool and automatically adjusts image parameters. Target registration and error compensation methods are provided. The system detects magnetic field and signal disturbances that may lead to inaccurate navigation, filters navigation data, and adjusts filtering parameters based on detected conditions. Apparatus for proximally locking an IM nail such that a clear passage through the cannulation of the nail is maintained are provided.

Abstract: Disclosed herein is a tool for guiding a drill hole along a central axis of a femur head and neck for preparation of a femur head that is the subject of a hip resurfacing surgery. In one embodiment, the tool includes a mating region and a guide hole. The mating region is configured to matingly receive a predetermined surface of the femur. The mating region and guide hole are positionally correlated or referenced with each other such that when the mating region matingly receives the predetermined surface of the femur, the guide hole will be generally coaxial with a central axis extending through the femur head and the femur neck.

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: A targeting device (1) for guiding a drill arrangement (11, 12) for forming an arc-shaped bore in an assembly of adjacent bones or bone fragments, comprises a support frame (2; 5; 7), a pivoting device (8) mounted to the support frame (2; 5; 7) and arranged to receive the drill arrangement (11; 12) and to allow a pivoting movement of the drill arrangement (11; 12) along an arc-shaped path having a predetermined radius of curvature rc around a pivot axis (9). The support frame (2; 5; 7) is provided with at least three fixation devices (3; 4; 6) each configured to fix one of the bones (14; 15; 16) or fragments of the bone assembly to define a fixed position in space of the bone assembly (14; 15; 16) with respect to the pivoting device (8) when the bone assembly is installed to the support frame (2; 5; 7).

Abstract: A surgical template system for use in working on a bone comprises: a tool guide block comprising at least one guide aperture for receiving and guiding a tool to work on a bone; locating means comprising a plurality of locating members, each member having a respective end surface for positioning against a surface of the bone; and attachment means for non-adjustably attaching the tool guide block to the locating means such that, when attached, the member end surfaces are secured in fixed position with, respect to each other, for engaging different respective portions of the surface of the bone, and the at least one guide aperture is secured in a fixed position with respect to the end surfaces. Corresponding methods of manufacturing a surgical template system, methods of manufacturing locating means for a surgical template system, methods of fitting a prosthesis to a bone, surgical methods, and surgical apparatus are described.

Abstract: An assembly for use in cutting a bone during a surgical procedure comprises a cutting tool and a guide block. The cutting tool includes a blade and a drive unit for imparting a cutting motion to the blade. The guide block can be positioned against the bone and has a reference surface for guiding the blade during the cutting step, the guide block having a screen surface which provides a point of reference to indicate proper alignment of the blade. The cutting tool includes means for directing a collimated beam of light in a direction parallel to the blade, on to the screen surface on the guide block when the blade is in contact with the guide surface, the distance between the blade axis and the light beam being equal to the distance between the reference surface and the point of reference on the screen surface.

Abstract: A device to maintaining temporary engagement with a bone plate and a bone, the device comprising: (a) a first biased appendage positioned opposite a second biased appendage, the first and second biased appendages including an arcuate vertical profile that partially defines an interior region; (b) a platform concurrently coupled to the first and second biased appendages, the platform also partially defining the interior region, the platform including a through hole open to the interior region; and, (c) a first tab extending from at least one of the first biased appendage, the second biased appendage, and the platform, the first tab extending into the interior region to engage a bone plate.

Abstract: A drill guide comprises a mounting arrangement for mounting the drill guide on an article. The drill guide further includes first and second guide arrangements and a holding arrangement for holding the first and second drill guides. The holding arrangement is adjustable between a release position in which the positions of the first and second guide arrangements are adjustable relative to the holding arrangement and a holding position in which the first and second guide arrangements are held by the holding arrangement in a fixed position.