Abstract: An implant delivery system for delivering a sheet-like implant is disclosed. The implant delivery system includes a distal guidewire port for receiving the proximal end of guidewire after the guidewire distal end has been affixed to a first point on bone or other tissue. The implant delivery system is tracked over the guidewire to a selected position defined by the guidewire attachment. The device includes an implant spreader assembly disposed proximate the distal end of a delivery shaft. The implant spreader assembly includes a first arm and a second arm. The arms are coupled to the delivery shaft such that the first arm and second arm are moveable between a closed position and an open position. When pivoting to the open position the distal end of each arm travels in a generally transverse direction to spread a sheet-like implant.

Abstract: A joint replacement device includes a male component with a structure to couple to a bone on one side of a joint, and an outer articulation surface that is attached to the structure via a neck. A female component is configured to couple to a bone on an opposite side of the joint and includes a cavity that is surrounded by an inner articulation surface. An opening of the cavity is shaped to enable insertion of the outer articulation surface into the cavity when the outer articulation surface is aligned with the opening, and to prevent separation of the male component from the female component when rotated so as not to align with the opening. The neck is located within the opening and the outer articulation surface is rotatable within the outer articulation surface with a rotation that is limited by dimensions of the opening and the neck.

Abstract: A distal radioulnar joint prosthesis for replacing the distal radioulnar joint and a method for its implantation is provided. Such a device includes an ulnar component, a radial component, and a motion liner. The ulnar component includes a stem, a collar, and a shell. The radial component includes a hemispherical ball and plate. The hemispherical ball of the radial component is secured with the radial plate and articulates with the ulnar shell via the motion liner. The prosthesis is designed to more accurately replicate the biomechanics of the distal wrist than currently used implants.

Abstract: A method of reconstructing a patient's wrist. A prosthesis is provided having proximal and distal assemblies. The distal assembly has a body with a U-shaped portion. The proximal and distal assemblies have surfaces that cooperate to guide movement between the proximal and distal assemblies. The proximal assembly is fixed to the patient's radius. The hand is prepared for placement of the distal assembly by removing cartilage against a plurality of carpal bones without significantly altering the configuration of stable volume of at least one of the patient's carpal bones in the first carpal row. The U-shaped portion of the body is placed against a plurality of bones in the first carpal row. Separate locations on the body are secured to a plurality of carpal bones.

Abstract: Wrists implants and methods are disclosed. A wrist implant can advantageously allow motion with respect to a reconstructed wrist to more closely resemble natural motion. For example, in one aspect, motion can include movement in more than one direction to allow for flexion/extension, rotational, and translational movement. The wrist implant can include a radial implant component and/or a carpal implant component with a bearing component or member disposed therebetween. The radial implant can have a radial articulation surface having at least one variable radius of curvature and/or a tray having a variable width.

Abstract: An orthopaedic implant for use with a fastener having at least one of threads and grooves includes a body defining a long axis. The body includes an inner wall defining an elongated slot. The inner wall includes a pair of opposing walls and a single projection disposed on the inner wall. When the fastener is inserted into the slot, the single projection slidably fits within a groove of the fastener to limit sliding of the implant over the fastener along an axis substantially transverse to the long axis and to permit sliding of the implant over the fastener along the long axis.

Abstract: A method of implanting a wrist prosthesis in a distal portion of an ulna for articulation at least near a radius and a carpal complex of a wrist joint is provided. The method can include forming an incision near a distal portion of the radius and ulna joint. The method can also include resecting a distal portion of the ulna and positioning a stage member in a fixed position relative to the ulna. The method can further include sliding a bearing member relative to the stage member to hold the bearing member relative to the stage member and the distal ulna. The method can also include fixing the bearing member to a bearing fixation member extending from the stage member, and attaching soft tissue to at least one of the bearing member and the stage member.

Abstract: A method of implanting a distal radial wrist implant relative to a host radius while salvaging at least portions of fractured radial bone can include, determining a size of a host radius. A distal radial component can be selected based on the determination. The distal radial component can have a body that includes a first connection portion. A stem portion can be selected based on the determination. The stem portion can have a second connection portion. Portions of the fractured radial bone can be located around the body. The portions of the fractured radial bone can be secured relative to the body. The first connection portion of the distal radial component can be coupled with the second connection portion of the stem portion. The distal radial implant can be implanted relative to the host radius.

Abstract: A spacer for implantation into a subject is provided that includes a sterilized piece of cartilaginous allograft tissue. The piece forms a Y-shape with a base adapted to insert within a first carpo-metacarpal joint or carpo-metatarsal joint of the subject, and has a first area adapted to secure to a trapezium bone adjoining the joint, and a second arm adapted to secure to a proximal metacarpal or metatarsal bone adjoining the joint. A procedure for implanting the spacer includes exposing a target joint and abrading a bone surface interior to the joint to induce surface bleeding. The spacer base is then inserted into the joint. The spacer first arm is adhered to the first bone of the joint and the spacer second arm is adhered to the second bone of the joint. A kit is also provided for surgical implantation of the spacer.

Abstract: A prosthesis system for replacement of a head portion of a proximal radius can include an articulation component having a first connection portion. A first head component can have a second connection portion that connects to the first connection portion. A second head component can have a third connection portion that connects to the first connection portion. The second head component can have a distinct dimension from the first head component. A stem component can include a fourth connection portion that connects with either of the first or second head components. The stem component can have a stem anchoring portion that connects to the radius.

Abstract: A system and method of implanting a distal wrist implant relative to a host bone is presented. A distal radial component having a body including a first connection portion couplable to a stem is coupled to a second prosthetic coupled to a medial surface of the body. The second prosthetic replaces at least a portion of the sigmoid notch.

Abstract: A prosthesis having: a) a first assembly with a first base portion to be placed against, and operatively secured to, a patient's first bone; and b) a second assembly with a second base portion to be placed against, and operatively secured to, a patient's second bone. The first and second assemblies respectively define first and second surfaces that cooperate with each other to guide articulated movement between the first and second bones. At least one of the first and second base portions is configured to cooperate with a separate first component defining at least a part of one of the first and second surfaces to maintain the first component in an operative state. A second component is configured to define at least a part of the one of the first and second surfaces and can be placed in an operative state selectively in place of the first component.

Abstract: A method of reconstructing a patient's wrist. A prosthesis is provided having proximal and distal assemblies. The distal assembly has a body with a U-shaped portion. The proximal and distal assemblies have surfaces that cooperate to guide movement between the proximal and distal assemblies. The proximal assembly is fixed to the patient's radius. The hand is prepared for placement of the distal assembly by removing cartilage against a plurality of carpal bones without significantly altering the configuration of stable volume of at least one of the patient's carpal bones in the first carpal row. The U-shaped portion of the body is placed against a plurality of bones in the first carpal row. Separate locations on the body are secured to a plurality of carpal bones.

Abstract: Among other things, there are disclosed embodiments of implants for repairing or relieving damage to the distal radioulnar joint. A component for replacing at least part of the ulnar head includes a concave surface for accommodating a convex surface of a component for attachment to the radius, e.g. in the sigmoid notch of the radius.

Abstract: A joint resurfacing prosthetic implant system is disclosed having an anatomically-shaped implant to replace a joint at a pedal digit or finger, including a head having an elliptical bearing surface disposed for engaging the end of an adjacent bone and a seating surface opposite the bearing surface, an elongated stem extending distally from the seating surface, and a flange on the circumference of the device and extending distally from the seating surface. The flange includes one or more portals and a removed section configured to avoid impinging upon a tendon during and after implantation of the prosthetic. A specialized tool is also provided to facilitate the resection of the bone for implantation. The specialized tool includes an elliptical template having a cutting edge and a center insert that is sized and configured to match a reamer used to bore into the bone for insertion of the implant.

Abstract: A system and method of implanting a distal wrist implant relative to a host bone is presented. A distal radial component having a body including a first connection portion couplable to a stem is coupled to a second prosthetic coupled to a medial surface of the body. The second prosthetic replaces at least a portion of the sigmoid notch.

Abstract: Devices and methods are disclosed for joint replacement.

Abstract: Embodiments of the invention may provide a stem and a head and a liner that can be assembled together to form an implant, such as may be used in repair of the distal ulnoradial joint. A given head and liner and stem may be assembled to each other in more than one configuration, providing more than one possible external shape for a given set of stem and head and liner. The head may be non-symmetric about its midplane and may be open at both ends. A kit may contain more than one head assemblable to a given stem with an intermediate liner, with the various heads providing various different external shapes of the device.

Abstract: A prosthetic wrist can replace a portion of an anatomical wrist. A bone replacing portion can be provided that also includes an augment member to assist in fixation of the bone portion or the prosthesis to the bone. The various prosthesis embodiments can allow for a hemi- or total, or revision wrist arthroplasty. Modular portions can allow for intraopertative customization.

Abstract: Devices, implements and methods are provided for performing trapezioplasty of the osteoarthritic trapezium. Once a palmar osteophyte has been removed from the trapezium bone, a trapezial rasp is used to shape the central portion of the trapezium bone into an initial saddle shape. A contouring tool having a double curvature reverse saddle shape is used to contour the trapezium bone into a final, smooth saddle shape.

Abstract: Fibrocartilage implants characterized by circumferential fiber networks embedded in arcuate or torroidal scaffolds with orthogonal fiber networks embedded therein to prevent separation of the circumferential fiber networks. The fiber networks convert axial compressive forces on the scaffolds to tensile loads on the circumferential fibers. Artificial knee meniscus and vertebral disc implants are disclosed, as well as articular disc implants for joints such as the temporomandibular joint and wrist. Methods for implanting the fibrocartilage devices are also disclosed.

Abstract: A prosthesis for implantation in an animal or human subject, said prosthesis comprising a first component for attaching to a radius bone in use and a s second component for attaching to an ulna bone in use, the prosthesis further comprising a linage for linking the first and second components substantially rigidly with respect to one another in use. Preferably the prosthesis is configured to allow the linkage to move relative to the first and/or second components and be retained substantially rigidly at a selected position in normal use, such that the first and second components can be retained substantially rigidly relative to one another in normal use.

Abstract: A bone joint repair and replacement assembly. A first portion comprising a bone plate is configured to attach to a distal or proximal end of a bone proximate the joint, generally coaxially with an axis defined by the bone. A second portion comprising an articular surface is configured to attach to the first portion, generally normal with respect to the axis, and inserted into the joint. Although versions of the assembly can be configured for use with several different pivotal joints, the invention is particularly suitable for full or partial replacement of an elbow, wherein the articular surface is pivotally attached to the first portion. Another embodiment of the invention is provided to repair a fractured bone head proximate the joint, and still another embodiment of the invention is provided to repair rotator cuff-related shoulder injuries.

Abstract: The implant (20) is shaped to generally mimic the form of the trapezium (12), or portions thereof. For example, the implant optionally defines a first metacarpal projection (32) and a second metacarpal projection (34) spaced from the first metacarpal projection to form a C-type, or cuff-type receptacle (36) for receiving the first metacarpal (15) such as the first and second metacarpal projections extend along either side of the first metacarpal. The receptacle optionally acts as a support surface (36A) for the first metacarpal during articulation thereof. In some embodiments, the first metacarpal projection is configured to extend adjacent the end portion of the first metacarpal that is adjacent the CMC joint (10) and the second metacarpal projection is configured to extend into the space (19) between the end portions of the first and second metacarpals (15, 18), thereby helping maintain the intermetacarpal spacing between the first and second metacarpals.

Abstract: An osteoconductive vascularized porous metal implant device and method for implanting the vascularized device are described herein. The vascularized implant device comprises an implant which is porous titanium, tantalum or other metal which is biocompatible with the mammalian body and at least one vascular conduit which connects the porous implant to an animal vasculature, such as a human vascular system.

Abstract: A prosthesis for primary artrodhesis can be used for artroplasty and a prosthesis for artroplasty comprises members for artrodhesis. The prosthesis (1b) for primary artrodhesis comprises a locking member (33b) with an attachment portion (16b) which is insertable into a hole (8b) in a first attachment member (4b) of the prosthesis for location of the locking member therein, and a lockable member (34b) integral with a second attachment member (5b) of the prosthesis. The lockable member (34b) is configured for adjustable setting thereof relative to the locking member (33b) and for fixation thereof, in set position, to the locking member. Alternatively, the lockable member comprises an attachment portion which is insertable into a hole in the second attachment member for location of the lockable member therein.

Abstract: A carpometacarpal prosthesis system generally includes a trapezial implant for replacing an excised trapezium within a human hand and a component stem implant for replacing a partially excised first metacarpal. The component stem implant is adapted to be press fit within the medullary cavity of the partially excised first metacarpal bone of the human hand; the component stem when so implanted is adapted to effect universal movement of the first metacarpal bone relative to the trapezial implant thereby providing a restructured thumb metacarpal joint that restores substantially normal thumb function in terms of strength and flexibility.

Abstract: A fusion implant and fusion members for fusing target bones of an upper extremity. The fusion implant including internally threaded apertures of a first thread lead, and the 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. A guide clamp for facilitating forming of an implant cavity in adjacent bones for implantation of the fusion implant therein. A surgical method for facilitating fusion of adjacent target bones utilizing a fusion implant, fusion members, a targeting instrument and a guide clamp to reduce space between the adjacent bones such that they at least abut one another.

Abstract: The prosthetic material for replacing at least one portion of the radial glenoid of a radius includes a plate (2) extended by an endpiece (3) and a set of screws (4) for fastening the plate (2) on the receiving bone material (R). The plate (2) has a planar body (7) extended by an extension (5) forming a portion of the endpiece (3) and having an inner face (5?) extending in a general plane (D) that is angularly offset relative to the plane (P) of the plate body (7). This extension (5) co-operates with a fitted panel (6) forming the other portion of the endpiece (3) and having an outer face (3?) reproducing at least approximately at least a portion of the surface of the radial glenoid of the radius. The fitted panel is secured on the support extension (5) via a slideway structure (11, 13).

Abstract: An implant couples a first bone of a hand to a second bone of the hand. The implant includes a body that defines a median plane. The body also defines a first joint surface having a first central region that articulates with the first bone. The body further defines a second joint surface having a second central region that articulates with the second bone, and the second central region is disposed on an opposite side of the median plane of the body relative to the first central region. The first and second central regions correspond to profiles of first and second axial segments, respectively, the first and second axial segments are each one of a cylinder, a cone and a torus and are centered on first and second axes, respectively, and the first and second axes, as projected on the median plane, are substantially perpendicular to each other.

Abstract: System, including methods, apparatus, and kits, for replacement of at least one surface region of a distal radioulnar joint using at least one prosthesis. In some embodiments, the system may provide restoration of normal, unconstrained biomechanics of the joint, which may preserve rotation and translation and ensure durability of the joint.

Abstract: A method of implanting a prosthesis relative to a carpal complex of a wrist is provided. The method can include providing a carpal implant having a body including an ulnar flange and a radial flange, and locating a bone abutment surface of the ulnar flange against a triquetrum of the carpal complex. The method can also include locating a bone abutment surface of the radial flange against a scaphoid of the carpal complex, and locating a first dorsal flange extending from the ulnar flange against a posterior surface of the triquetrum.

Abstract: Among other things, there are disclosed embodiments of implants for repairing or relieving damage to the distal radioulnar joint. A component for replacing at least part of the ulnar head includes a concave surface for accommodating a convex surface of a component for attachment to the radius, e.g. in the sigmoid notch of the radius.

Abstract: A compressive force and compressive-shear force joint implant including a head defining at least one wear contact surface. At least the at least one wear contact surface is manufactured from a polycarbonate urethane material. The implant may further include a stem extending from the head opposite of the wear contact surface. The head may also be configured to define a second wear contact surface distinct from the first wear contact surface.

Abstract: System, including methods, apparatus, and kits, for replacement of at least one surface region of a distal radioulnar joint using at least one prosthesis. In some embodiments, the system may provide restoration of normal, unconstrained biomechanics of the joint, which may preserve rotation and translation and ensure durability of the joint.

Abstract: An articulating implant system is provided for fixation to a bone. The articulating implant system includes a fixation component for fixation to the bone and an articulating member for articulating against bone or cartilage. Specifically, a modular ulnar implant is provided in accordance with the articulating implant system of the present invention wherein the fixation component is a stem for insertion into the intramedullary canal of the distal ulna and the articulating member is a head for articulating with the radial sigmoid notch.

Abstract: A system and method of implanting a distal wrist implant relative to a host bone is presented. A distal radial component having a body including a first connection portion couplable to a stem is coupled to a second prosthetic coupled to a medial surface of the body. The second prosthetic replaces at least a portion of the sigmoid notch.

Abstract: System, including methods, apparatus, and kits, for replacement of at least one surface region of a distal radioulnar joint using at least one prosthesis. In some embodiments, the system may provide restoration of normal, unconstrained biomechanics of the joint, which may preserve rotation and translation and ensure durability of the joint.

Abstract: Wrists implants and methods are disclosed. A wrist implant can advantageously allow motion with respect to a reconstructed wrist to more closely resemble natural motion. For example, in one aspect, motion can include movement in more than one direction to allow for flexion/extension, rotational, and translational movement. The wrist implant can include a radial implant component and/or a carpal implant component with a bearing component or member disposed therebetween. The radial implant can have a radial articulation surface having at least one variable radius of curvature and/or a tray having a variable width.

Abstract: A prosthetic wrist having at least one of a radial insert, which is configured to be fixed to a radius of a patient, a carpal implant or a wrist bearing component. The carpal implant can include a body and a pair of flanges, each of which being skewed to the axis of the body in a manner that permits them to abut the ulnar side of the hamate bone and the radial side of the distal portion of the carpal bone complex, respectively. The radial insert may be provided with a plurality of modular portions to allow for selection and customization of an implant. Also the various portions can allow for a hemi- or total, or revision wrist arthroplasty. The modular portions can allow for intraopertative customization.

Abstract: A system and method of implanting a distal wrist implant relative to a host bone is presented. A distal radial component having a body including a first connection portion couplable to a stem is coupled to a second prosthetic coupled to a medial surface of the body. The second prosthetic replaces at least a portion of the sigmoid notch.

Abstract: A sigmoid notch resurfacing prosthesis for application to the sigmoid notch of the distal radius. The sigmoid notch prosthesis generally includes a saddle and a radius portion for attachment to the distal radius. The saddle may be formed from ultra high molecular weight polyethylene or another durable self-lubricating material. The saddle includes an at least partially concave contoured depression having rounded edges that is securable to the radius portion. The saddle may be secured by a sliding notch snap fit design. The prosthesis may be adapted for articulation with the natural head of the ulna or with an ulnar head prosthesis that has replaced the ulnar head.

Abstract: Thumb carpometacarpal (CMC) joint implants include a trapezium implant defining an articulating surface and a cooperating first metacarpal implant with a base portion of the first metacarpal defining an articulating surface. The first metacarpal base articulating-surface is configured to articulate against the trapezium implant articulating surface.

Abstract: A sigmoid notch resurfacing prosthesis for application to the sigmoid notch of the distal radius. The sigmoid notch prosthesis generally includes a saddle and a radius portion for attachment to the distal radius. The saddle may be formed from ultra high molecular weight polyethylene or another durable self-lubricating material. The saddle includes an at least partially concave contoured depression having rounded edges that is securable to the radius portion. The saddle may be secured by a sliding notch snap fit design. The prosthesis may be adapted for articulation with the natural head of the ulnar or with an ulnar head prosthesis that has replaced the ulnar head.

Abstract: A trapezium prosthesis is provided which includes a body having a frustocylindrical shape, the frustocylindrical shape including a frustum and an oppositely disposed planar base, the frustum being canted relative to a planar base. The prosthesis may be made of a swellable fluid absorbing polymer which imparts flexibility and/or resiliency to the prosthesis. The swellable fluid absorbing polymer may also provide the surface of the prosthesis with lubricity. In embodiments, the prosthesis has a first configuration and a second configuration, the first configuration being of reduced size relative to the second configuration. The prosthesis may also include a reinforcement member. In embodiments, the prosthesis includes a stem projecting outwardly from the frustum.

Abstract: A wrist implant requires minimal resection of the distal radius and preserves the sigmoid notch and articulation with the head of the distal ulna. The wrist implant generally includes a radius portion, a carpal portion and a carpal ball. The wrist implant includes a primary articulation and a secondary rotational articulation. The primary articulation occurs between the radius portion and the carpal ball. The secondary articulation occurs between the carpal ball and the carpal portion.

Abstract: A carpal plate for use in a wrist replacement prosthesis includes at least three non-linearly aligned, internally threaded openings, each opening defining a thread-screw axis with at least one thread-screw axis divergent from the other two thread-screw axes; and further including hollow core screws for the injection of a cement compound to aid in anchoring the screws into the cancellous portion of the carpal bones.

Abstract: A method of implanting a prosthesis relative to a carpal complex of a wrist is provided. The method can include providing a carpal implant having a body including an ulnar flange and a radial flange, and locating a bone abutment surface of the ulnar flange against a triquetrum of the carpal complex. The method can also include locating a bone abutment surface of the radial flange against a scaphoid of the carpal complex, and locating a first dorsal flange extending from the ulnar flange against a posterior surface of the triquetrum.

Abstract: A modular resurfacing implant for a radioscaphoid joint of a wrist includes a stem and an articular component coupled to the stem. The stem includes a threaded body for implantation into a distal radius and a connection member positioned at a second end of the stem. The articular component includes a body member configured to resurface a scaphoid fossa of the distal radius. The body member includes a concave top surface matching a curvature of the scaphoid fossa and a bottom surface having a post extending therefrom that is configured to mate with the connection member of the stem. The articular component is configured to resurface the scaphoid fossa while leaving a lunate fossa of the distal radius intact.

Abstract: A method of implanting a distal radial wrist implant relative to a host radius while salvaging at least portions of fractured radial bone can include, determining a size of a host radius. A distal radial component can be selected based on the determination. The distal radial component can have a body that includes a first connection portion. A stem portion can be selected based on the determination. The stem portion can have a second connection portion. Portions of the fractured radial bone can be located around the body. The portions of the fractured radial bone can be secured relative to the body. The first connection portion of the distal radial component can be coupled with the second connection portion of the stem portion. The distal radial implant can be implanted relative to the host radius.