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.

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 drill guide assembly for drilling a tunnel having a fixed, non-zero radius of curvature, where the drill guide assembly includes a housing and a sleeve, or cutting tube, configured to reciprocate within the distal portion where the sleeve, or cutting tube, is configured to receive a bone cutting instrument.

Abstract: A surgical guide wire or K-wire and method of use are provided. The K-wire or guide wire has opposite end portions and a shank portion in between. One end portion has a deformable end portion that, once outside of a confining guide passage, can be deformed to present a projected forward facing area that is larger than the transverse cross section of the K-wire or guide wire while in the passage. The increased area will provide increased resistance to additional forward axial movement into the surgical site.

Abstract: Provided herein are patient-specific surgical device that allow for a stable fitted position for use in shoulder surgery. The patient-specific surgical devices may have different functions such as a function as a guide.

Abstract: A method for repairing a defect in an interosseous membrane located between a first bone and a second bone. The method includes: coupling a flexible member to the first bone and the second bone, the flexible member extending past a first area of the interosseous membrane between the first bone and the second bone; and orienting the flexible member such that the flexible member extends generally parallel to fibers of the first area of the interosseous membrane.

Abstract: A system for the internal fixation of a fractured bone includes a bone plate with threaded holes and two types of guides threadedly connected within the threaded holes. One guide is taller and smaller in diameter, whereas the other guide is shorter and wider in diameter. The guides provide guidance for drilling a hole through the guide and screw hole, and optional bending of the plate at the guide. The guides have structure allowing the guides to be individually removed through rotation.

Abstract: A bone repairing kit including a drilling device, a pushing device, a clamping member and a hole saw is provided. An end of a tube body of the drilling device is a knife portion. When the tube body rotates with respect to a femur, a bone column is cut by the knife portion and located in the tube body. The pushing device includes a hollow tube and a push bar. The hollow tube is for receiving the tube body. The push bar is for touching and pushing the bone column in the tube body. The clamping member is for clamping the bone column. The hole saw includes a receiving body and cutting knives. The receiving body has a recess for receiving an end of the bone column. The cutting knives surrounding on an inner wall of the recess are for cutting an edge of the end of the bone column.

Abstract: A fusion implant and fusion members for fusing target fusion bones of a lower extremity. The fusion implant including internally threaded apertures of a first thread lead, and fusion members including threading of the first thread lead and threading of a second thread lead that is less than the first thread lead. The fusion implant and a targeting instrument being configured to couple to one another in a predefined orientation. The predetermined orientation resulting in alignment of aspects of the fusion implant with aspects of the targeting instrument. The targeting instrument providing both distraction and compression to the joint between the target fusion bones. A guide instrument for preparing one of the target fusion bones for fusion thereof. A surgical method for applying compression to the joint between the target fusion bones to facilitate fusion thereof utilizing a fusion implant, fusion members, a targeting instrument and a guide instrument.

Abstract: A humeral prosthesis includes a stem component and a partial humeral head component. The partial 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 partial humeral head component. The stem component is configured to be inserted within the humeral diaphyseal channel.

Abstract: A universal targeting apparatus includes a generally U-shaped body having one end configured to be coupled to the proximal end of the intramedullary implant and a mounting portion at an opposite end of said body. An arm is rotatably mounted to the mounting portion of the U-shaped body and includes bores defined at its opposite ends. Each bore is arranged at a different angle to correspond to the angle of a transverse aperture in the intramedullary implant. The arm can be rotated so an appropriate one of the angled bores is aligned with the transverse aperture to serve as a guide for creating targeting holes in the bone.

Abstract: An orthopedic device includes a patient-specific alignment guide operable for preparing a bone of a patient for resection during joint arthroplasty. The alignment guide includes a patient-specific bone engagement surface complementary to a surface of the bone of the patient and imaged from a bone scan of the patient. The alignment guide includes a plurality of guiding bores, and a plurality of alignment pins received through corresponding guiding bores for attaching the alignment guide to the bone. The alignment pins are resorbable and can be cut off during a resection of the bone.

Abstract: A method for estimating at least one of a fastener-hole depth and a fastener length prior to forming a hole in a bone can include selecting a position on a proximal side of a proximal cortical bone layer for forming the hole, transmitting a transmitted wave into the bone from the selected position, and receiving a reflected wave at the selected position after the transmitted wave has been reflected by a distal cortical bone layer. The method can further include determining a distance from the selected position to the distal cortical bone layer based on times at which the transmitted wave is transmitted and the reflected wave is received, and estimating the at least one of the fastener-hole depth and the fastener length based on the distance to the distal cortical bone layer.

Abstract: A device and method for defining a trajectory for instruments in a sacroiliac joint fusion procedure employs a handle and two movable guidance arms that are separated by an adjustable distance. The first guidance arm has a substantially straight pronged distal end terminating in a first prong, a second prong and a space between the first prong and second prong defining a first point in a straight trajectory for inserting screws into a sacroiliac joint. The guidance arm forms a receiving bore on a distal end thereof to define a second point in the trajectory. The pronged distal end is inserted through a posterior incision in the patient into a cored-out sacroiliac joint, with the second guidance arm outside the body, and the orientation of the alignment guide is adjusted by pivoting the alignment guide about the pronged distal end to determine a suitable trajectory.

Abstract: Apparatuses and methods deliver implants through a posterior aspect of a vertebral body such as a pedicle and place the implant or perform a procedure into the anterior aspect of the vertebral body. A representative apparatus includes an outer cannula, an advancer tube and a drill assembly. It is envisioned that at least one of the outer cannula, the advancer tube or the drill assembly can be viewed in vivo using for example, a CT scan or fluoroscope. Also included is an apparatus for forming an arcuate channel in bone material. The apparatus includes an advancer tube and a drill assembly.

Abstract: Apparatus for drilling a hole in material, the apparatus comprising: an angled drill guide comprising a curved distal section, a less-curved proximal section, and a lumen extending therebetween, wherein the less-curved proximal section comprises a flat extending therealong for reducing the effective diameter of the less-curved proximal section so as to minimize interference between the angled drill guide and the side wall of an access cannula.

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: A drilling guide adapted to drill a combihole through a bone for passing ligament grafts for ligament reconstruction, said drill guide comprising: a pair of adjacently located cannulae adapted to drill and form said combihole, said cannulae being conjoined to intersect each other.

Abstract: An easy to use mechanical apparatus intended for aiming a surgical tool is provided. Embodiments of the apparatus offer movement in multiple planes while guaranteeing, given proper placement of the leading end of a locator tool at a target, that the leading end of a second tool be placed at precisely the same target. Methods of using the apparatus as well as kits including the apparatus are also provided.

Abstract: A positional guide for use on a cannula shaft includes a shaft portion configured to form a first opening to receive a cannula shaft therein. One or more offset portions are connected to the shaft portion and configured to form second openings spaced apart from the first opening. The second openings are configured to each receive a stabilization device therein such that when the cannula shaft and the stabilization device are present in the first opening and the second openings, respectively, the cannula shaft and the stabilization device are disposed substantially parallel to each other. Methods are also disclosed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: Devices and methods are provided for positioning and forming bone tunnels. In one embodiment, a surgical drill guide apparatus is provided. The apparatus can include a first guide member having a longitudinal passageway extending therethrough for aiming a first guide pin along a first path to form a first bone tunnel. The apparatus can also include a second guide member having a longitudinal passageway extending therethrough for aiming a second guide pin along a second path to form a second bone tunnel. The first and second guide members can extend at an angle relative to one another and they can be offset such that axes of the guide members do not intersect.

Abstract: A stemless humeral component for replacing the humeral head of a patient's humerus includes a support flange having a number of cantilevered legs extending distally away from a bottom surface thereof. Instruments and methods for surgically installing the stemless humeral component are also disclosed.

Abstract: A drill guide assembly for drilling a tunnel having a fixed, non-zero radius of curvature, where the drill guide assembly includes a housing and a sleeve, or cutting tube, configured to reciprocate within the distal portion where the sleeve, or cutting tube, is configured to receive a bone cutting instrument.

Abstract: This application relates generally to guide pins and wires. More specifically, this application relates to guide pins and wires used in medical procedures such as bone fixation or fusion. One embodiment of the guide pin includes a distal end with a ball end cutter. Other embodiments of the guide pin include expandable prongs that can impede further advancement of the guide pin.

Abstract: Various embodiments of the present invention provide systems and methods for treating a proximal humeral fracture. A system according to one embodiment includes a longitudinal member configured to be received within the humeral shaft. The system includes a jig assembly configured to be coupled to the longitudinal member, wherein the jig assembly includes at least one hole defined therethrough that is configured to guide placement of at least one hole in the humeral shaft, and wherein the hole formed in the humeral shaft is configured to align with at least one hole in the humeral implant such that the jig assembly is configured to locate the position of the humeral implant in the humeral shaft.

Abstract: A system and method for identifying the position of the distal end of a bone guide wire is provided. A position and orientation of the proximal end of the guide wire is identified with the aid of a medical, optical tracking and navigation system and a reference device on the proximal end of the guide wire. The orientation of a bone in which the distal end of the guide wire is located is identified with the aid of the medical, optical tracking and navigation system and a reference device on the bone. By means of the ancillary conditions for the course of the guide wire, which are given by the position and orientation of the proximal end and the orientation of the bone, and by taking into account the physical properties of the guide wire, the position of the distal end of the bone guide wire is identified with the assistance of a computer.

Abstract: Devices for seizing sutures within osteal tunnels, including blindly seizing such sutures, having an interior end for insertion into an osteal tunnel, the interior end having a suture seizing mechanism; an exterior end having an activating mechanism for activating the suture seizing mechanism; a target ring, which is a component of the suture seizing mechanism, having an opening through which a suture to be seized can pass through; and a suture clamping component, which is a component of the suture seizing mechanism, for clamping the suture to be seized against a surface of the target ring.

Abstract: Methods and apparatus for installing intramedullary medical devices (e.g., intramedullary nails) are described herein. Intramedullary medical devices in accordance with this disclosure provide sustained compressive forces across a bone fusion site despite bone resorption processes. Intramedullary medical devices in accordance with this disclosure include pseudo-elastic shape memory alloys containing nickel and titanium. Portions of intramedullary medical devices, including shape memory alloy elements in the intramedullary medical devices, may have strains imparted upon them through the methods and apparatus described herein. Further aspects of surgery techniques are also performed and controlled through the methods and apparatus described herein.

Abstract: Methods and apparatus provide for modifying a patient's femur to receive a patellofemoral prosthesis, including: a distal punch, an anterior punch and a trochlear punch which are used in well defined orientations to remove material from the femur to accommodate complex geometries of a patellofemoral prosthesis; and optionally a guide operating to engage a distal end of the femur, the guide including a distal slot, an anterior slot and a transverse slot, which ensure that the punches achieve the desired orientations.

Abstract: The present invention relates to a clamping sleeve for clamping a cannulated drill and a guide wire for medical purposes, wherein the clamping sleeve can be introduced into the chuck of a drilling machine, comprising: at least one drill contact area which protrudes into the interior of the clamping sleeve in order to clamp the cannulated drill, through which the guide wire runs, when a force acts inwards on the outer side of the clamping sleeve; at least one wire contact area in order to clamp an exposed part of the guide wire which is not enveloped by the cannulated drill when the force acts inwards on the outer side of the clamping sleeve; wherein the at least one wire contact area and the at least one drill contact area lie sequentially in the longitudinal direction of the clamping sleeve.

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

Abstract: An apparatus for dictating an insertion trajectory and location for insertion of an elongate pin into a surface includes a primary leg having longitudinally spaced proximal and distal primary leg ends. At least one subordinate leg has longitudinally spaced proximal and distal subordinate leg ends. The proximal subordinate leg end is movably attached to the primary leg by a coupling mechanism allowing at least two degrees of freedom of motion of the subordinate leg relative to the primary leg. The distal subordinate leg end is configured for contact with the surface concurrently with contact of the distal primary leg end with the surface, to support the apparatus during use of the apparatus. The primary leg guides longitudinal translational movement of the elongate pin to insertion into the surface at the dictated insertion trajectory and location when the apparatus is supported in a predetermined guiding relationship with the surface.

Abstract: A surgical system for assisting in the implanting of a glenoid component of a shoulder prosthesis in a patient includes a guide having guide features for guiding application of the bone preparation tool to the glenoid and a series of graphic representations of the glenoid component shown being implanted on the glenoid with different implant positions, each of which is associated with one of the graphic representations.

Abstract: A bone-fixation system is disclosed, the system comprising a bone plate having a section with a plurality of holes and a recessed area at least partially surrounding one or more of the holes, the recessed area defining a floor surface situated below a top surface of the plate, the floor surface extending at least partially between some or all of the plurality of holes, and an aiming device having a plurality of holes arranged to align with the plurality of holes in the plate and an extension, the extension being receivable within the recessed area and defining a bottom surface adapted to at least partially rest on the floor surface.

Abstract: This invention relates to a technique for performing laminar osteotomy (dividing of the spinal lamina, a posterior structure of vertebra). The term osteotomy is derived from os (bone), tomy (to cut or remove), and laminoplasty (the reshaping of the lamina). This technique can be performed with or without visual assistance such as cameras used with endoscopy, or image guidance such as fluoroscopy, computer tomography (CT) or magnetic resonance imaging (MRI).

Abstract: A cutting guide for removing a lesion from a neck area of a femur has a body having first and second side rails. The first and second side rails are spaced in a direction perpendicular to the head neck axis of the femur when mounted adjacent a neck of the femur. A third rail has ends slidably mounted on the first and second side rails. The third rail can be resiliently deformable toward a surface of the neck of the femur. A carrier element slidably mounted on the third rail for movement therealong between the first rail and the second rail. A bone cutting tool such as a burr is mountable in the carrier element. The first and second rails are connected by a proximal rigid cross-member at first ends thereof adjacent a femoral head. The cross-member is shaped to conform to an outer surface of the femoral neck adjacent the femoral head. The second ends of the first and second rails are connected by a member having a mounting element thereon adjacent a trochanter area of the femur.

Abstract: A surgical clamp includes first and second supports respectively having first and second engagement sections. The first and second supports are pivotably connected at a connection by a pivotal portion such that the first and second supports are pivotable about a pivot axis extending through the connection. An opening is defined between the first and second engagement sections for receiving a bone of a patient. A connecting tube includes a first end fixed to the connection. A guiding tube includes an end connected to a second end of the connecting tube and is located in a central plane of the opening between the first and second engagement sections. The central plane includes the pivot axis and has equal spacing to the first and second engagement sections. A sliding rod is fixed to the connecting tube and includes a sliding groove slideably receiving a pole located on the pivotal portion.

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: A proximal humeral plate assembly can include a first plate, a coupler, a second plate, and a guide. The first plate can define a window and can have a first major surface adapted to conform to a native bone structure. The coupler can be formed on a second major surface of the first plate opposite the first major surface. The second plate can be adapted to engage the coupler, to cover the window, and to conform to the native bone structure. The second plate can include through holes adapted to receive bone screws. The guide can be adapted to engage the coupler and to guide at least one of a cutting tool and a dilation tool.

Abstract: A neural monitoring enabled insulating sleeve for use with a surgical instrument during a surgical procedure on a patient in patient body tissue includes a tubular portion having a proximal end, a distal end, and a bore extending therethrough. The bore is configured to receive the surgical instrument. The tubular portion being formed of a material that electrically insulates the surgical instrument from the patient body tissue and having a flexible portion configured to flex between a locked and an unlocked condition. A camming component is configured to interface at the proximal end of the tubular portion. It is configured to cam the flexible portion between the locked and unlocked condition.

Abstract: A system for preparing a trochlear region of a resected femur is disclosed. The system includes a reamer guide and a reamer. The reamer guide has a first arcuate portion, a second arcuate portion, a wall, a protrusion connected to the wall, a leg connected to one of the first or second arcuate portion, and a distal tip portion connected to the leg. The reamer is adapted to rotatably connect to the distal tip portion, and the reamer has a first end portion, a second end portion, and one or more flutes.

Abstract: Bone fixation system, including methods, apparatus, and kits, and comprising a bone plate and at least one instrument that attaches to the bone plate and provides at least one radiopaque region to facilitate positioning the bone plate on bone visualized by radiographic imaging. The instrument may be a handle assembly and/or a targeting guide.

Abstract: A drill guide system for a bone plate having holes includes a guide block having at least two drill guide bores alignable with a bone screw receiving hole in a bone plate. A locking element extending through at least one drill guide block bore into the bone plate bone screw receiving hole, the locking element having a partially threaded bore portion and having a bifurcated tip surrounding the threaded bore portion. The bifurcated tip capable of engaging an inwardly extending protrusion formed on an internal wall of a bone screw receiving hole in the bone plate. An axially moveable threaded rod has a head for contacting an outer surface of the guide block and an end portion engaging a portion of the bore in the bifurcated tip of the locking element for separating sections of the bifurcated tip on axial movement of the rod prior to the head contacting the second surface of the drill guide block.

Abstract: A tibial resurfacing system is provided that includes a drill guide, bone chisel and implant. In one aspect, the system includes a drill guide that includes a targeting ring that is shaped to be placed on the superior tibial surface and a bore section that is connected to the ring to create an axis through the tibia to the superior tibial surface in the vicinity of the targeting ring. The drill guide permits a drill pin and/or drill to be advanced through the tibia to the superior tibial surface. In another aspect, a bone chisel is provided that includes an elongated tubular structure having a first end and a bone-cutting end, and the bone-cutting end is terminated in a transverse angle thereby creating an elliptical bone-cutting face. In another aspect, an implant is provided that includes an angled bearing element formed of a cylindrical member having a first end and a second end.

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 and/or matched with at least one other apparatus used during the surgical procedure.

Abstract: A method and system (10) for the installation of a cutting guide (60) on a bone element (33) in orthopedic computer assisted surgery is provided. The method includes positioning a drill guide (30) against a distal end of the bone element (33), determining at least two pin locations on one of a medial (31) and a lateral side of the bone element (33), fastening locating pins (42) to the bone element (33) at the determined pin locations, removing the drill guide (30) and installing a CAS bone reference (20) in its place on the same locating pins (42), and subsequently mounting the cutting guide (60) to the same locating pins (42).

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 cannulated offset drill guide and surgical methods for repairing Bankart lesions. The cannulated offset drill guide comprising a shaft which is offset from the guide center line by about 1 to 3 mm, more preferably of about 1.5 mm. The cannulated offset drill guide is provided at its proximal end with a concave clear tip which allows a surgeon to visualize the drill and the insertion of an anchoring device, for example a suture anchor. The concave clear tip has beveled, smooth edges to prevent damage to adjacent bone and tissue, and to avoid damage to the rubber dam of the cannula through which the offset drill guide is inserted. The configuration of the concave clear tip is designed to engage and match the generally convex-curve articulating face of the glenoid, and to precisely aligning the offset drill guide with the glenoid face. The clear tip may also be employed in a standard drill guide having a shaft which is not offset from the center line of the guide.

Abstract: A kit of parts for use in unicondylar knee replacement of a patient having a femur and a tibia comprises a drill guide and an intramedullary rod, the intramedullary rod being sized to fit within the intramedullary canal of the femur of the patient. The drill guide is arranged so as to engage a distal end of the intramedullary rod to that which engages the patient's intramedullary canal, and is formed with a foot portion sized to fit between the patient's femur and tibia before any bone is removed from the femur or tibia. The drill guide provides a guide for drilling of at least one hole in the femur. A further kit of parts for use in unicondylar knee replacement of a patient having a femur and a tibia comprises a femoral component for implantation in the femur, the femoral component having a bearing surface having a radius of curvature, and a guide spoon.