Abstract: An improved total disc replacement system and related methods, wherein a pair of anchor plates, each adapted to engage a vertebral body, and a translating internal member are provided. The translating internal member boasts the ability to move or translate between the anchor plates without compromising the conformity of the interface between the translating internal member and the anchor plates. In a significant aspect, the anchor plates may be locked in place relative to one another after implantation to effect fusion between the vertebral bodies.

Abstract: A modular keel or stem for use as a tibial implant has a central stem portion including a tongue-like coupling portion for insertion into a grooved portion in a bone contacting portion of a tibial baseplate. The modular keel or stem may also include a pair of anti-rotation fins or ribs which extend medially and posteriorly on the medial side and laterally and posteriorly on the lateral side. Proximal portions of the ribs or fins may engage receptacles in the bone contacting of the tibial baseplate. A locking element is provided for engaging the keel or stem coupling portion and the baseplate after the coupling portion of the keel is inserted into the groove to prevent the disassembly the keel from the baseplate. In one embodiment, the baseplate is capable of being inserted in a direction offset from the anterior-posterior direction, such as a medial-lateral direction, after the keel has been implanted. A polymeric bearing insert is provided for placement onto the baseplate in a standard manner.

Abstract: A method of replacing at least a portion of an intervertebral disc of an intervertebral disc space of a spinal column, the intervertebral disc space defined at least by respective endplates of first and second adjacent vertebral bones, the method comprising the steps of inserting at least one intervertebral disc replacement trial into the intervertebral disc space to distract same in a direction along a longitudinal axis of the spinal column and simultaneously inserting first and second members of an intervertebral disc replacement device into an intervertebral disc space of the spinal column. The method also comprising maintaining first and second articulation surfaces of the respective first and second members of an intervertebral disc replacement device as a single assembly by way of an insertion plate. This may include the use of an insertion handle that is adapted to detachably engage the insertion plate.

Abstract: A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A replacement graft is formed into a loop and moved into the femoral and tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. A pin passing member maintains one end of the filamentary wire in the transverse tunnel as the graft is being moved into place in the femoral and tibial tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

Abstract: A system for forming a tendon-bone graft. The system can include at least one support that is adapted to support the tendon-bone graft. The system can further include at least one clamp that is adapted to engage the tendon-bone graft to clamp the tendon-bone graft to the at least one support. The system can also include at least one cutting member that is operable to resect the tendon-bone graft. The at least one cutting member or the at least one support can be moveable relative to the other of the at least one cutting member or the at least one support to resect the tendon-bone graft.

Abstract: A method of determining the size and/or placement of a prosthetic disc in a disc space between adjacent endplates of two vertebrae in a selected spinal area, comprising: using a computer to identify the disc space parameters of height, width, depth and lordosis between the adjacent vertebral endplates; using a computer to create an artificial volume corresponding to an actual prosthetic disc that can be positioned in the disc space in accordance with a manufacturer's size and lordosis specifications for prosthesis; using a computer to determine the center of the disc space and the center of rotation of the prosthetic disc volume; using a computer to position the prosthetic disc volume in the disc space such that the center of rotation of the prosthetic disc volume is positioned posterior to the center of the disc space; and using a computer to determine the prosthetic disc volume that fits within the disc space in accordance with a surgeon's or manufacturer's specification for prosthesis.

Abstract: A method of reconstructing a ruptured anterior cruciate ligament in a human knee. Femoral and tibial tunnels are drilled into the femur and tibia. A transverse tunnel is drilled into the femur to intersect the femoral tunnel. A filamentary loop is threaded through the femoral tunnel and tibial tunnel and partially through the transverse tunnel. A replacement graft is formed into a loop and moved into the tibial tunnels using a surgical needle and suture. A flexible filamentary member is simultaneously moved along with the loop into the femoral and transverse tunnels. The filamentary member is used as a guide wire in the transverse tunnel to insert a cannulated cross-pin to secure a top of the looped graft in the femoral tunnel.

Abstract: A human implantable meniscus device having a unique anchoring system for locking the device into a bone and reinforcing fibers in order to mimic the mechanical characteristics of natural meniscus.

Abstract: A meniscus implant having a compressible bearing element with an articulation surface. The implant also includes a bone-securing element extending downwardly from the bearing element and configured to be engaged within a channel created within a tibial plateau.

Abstract: An osteochondral transplantation procedure according to which a harvested graft is implanted in an area of a patient's body and is tracked relative to the area during the implantation. Images are displayed that correspond to the tracking.

Abstract: A method of treating an intervertebral disc having an annulus fibrosis and a nucleus pulposus is disclosed. The method can include inserting a guide needle to the annulus fibrosis, inserting an injection needle through the guide needle, penetrating the annulus fibrosis within the injection needle, and injecting collagen material into the intervertebral disc.

Abstract: Spinal implant devices include: (a) a spinal implant; and (b) at least on suture extending through a bone tunnel and attached to the spinal implant to fixate the spinal implant in the body.

Abstract: A tibial insert includes a platform defining an upper bearing surface and a bottom surface. A keel of the tibial insert is coupled to the bottom surface of the platform and a rod of the tibial insert extends through a portion of the keel. A surgical method for knee arthroplasty is also disclosed.

Abstract: Allogenic or xenogenic materials are used to provide intervertebral disc nucleus implants and/or annular plugs. The allogenic or xenogenic materials comprise natural disc annulus material, which may have a portion of the anterior longitudinal ligament attached. The tissue may be used “as is” without an additional core or covering, or it may be used in combination with other materials. The material may be rolled, folded, layered and/or sutured, stapled, or glued to provide a solid plug of natural biological material. The implant may be provided as a dehydrated, substantially rod-shaped segment having a diameter less than the diameter of the hydrated material, and may have one or more ends of the dehydrated rod terminate with a further reduced diameter portion, preferably a point.

Abstract: A method of resurfacing a femoral head involves using a chamfered reamer to ream only a top portion of the femoral head above an anterior lateral portion of the femoral head where the retinacular vessels supply blood to the femoral head. As no cylindrical reaming is performed on the lateral portions of the femoral head, damage to the retinacular vessels is avoided. The method thereby preserves femoral head vascularity. A surgical instrument tray for enabling a surgeon to perform this method includes both a reamer and a spherometer for assessing the sphericity of the femoral head to determine whether osteophyte growth on the femoral head is likely to cause femoro acetabular impingement. The instrument tray can also include a tool, such as a bone chisel or burr, for removing the osteophytes to restore the sphericity of the femoral head, rather than removing the osteophytes using a cylindrical reamer.

Abstract: A glenoid component used for shoulder arthroplasty is adapted to be implanted into a scapula and engaged by a head of a humeral component. The glenoid component includes a body having a first articulating surface and a second medial surface opposite to the first articulating surface. The first articulating surface is adapted to engage with a humeral head. A plurality of fixed pegs each have a first end adapted to engage a cavity formed in the scapula and a second end extending from the medial surface. A central peg fixation mechanism is provided that is configured to couple an optional central fixation peg to the medial surface.

Abstract: Osteochondral repair of damaged articular joint surfaces is achieved using implants in the form of cylindrical osteochondral plugs. The plugs have an articular surface formed on at least one end. If articular surfaces are provided on both ends of the implant, the articular surfaces have differently curved surfaces. The defective cartilage is removed to create a recipient socket for the implant. An implant sized to fit the recipient socket is chosen from a plurality of implants provided to the surgeon. The implants are preferably formed of a hydrogel material such as Salubria™, although metal or allograft implants can also be used.

Abstract: Image analysis methods for gleno-humeral joint morphology. At least one specific structure is approximated as an elliptical structure at a plurality of transverse sections. At least one pathological feature on the structure is recognized. At least one structural spatial property of a 3D structure is calculated based on the structural property of the elliptical structure, thus determining the morphology of the 3D structure. Structural deformities are evaluated according to the morphology of the 3D structure. The pathological features on the sections are integrated to obtain at least one 3D pathological feature property, and a treatment is determined accordingly.

Abstract: A spinal nucleus implant is provided which includes an implant body and an interiorly embedded support member which extends out from the implant body. In one embodiment, the support member is fabric selected from the group consisting of mesh, woven fabric and nonwoven fabric. In one embodiment, the support member includes at least one portion which is located outside of the body, said portion adapted to engage one or more guides for orienting the implant. In one embodiment, the implant is capable of expanding from a compact, substantially dehydrated configuration to an expanded hydrated configuration. A method of manufacturing a spinal nucleus implant is provided which includes coagulating a liquid polymer such that at least a portion of said support member extends beyond the perimeter of the polymer to form a spinal nucleus implant having an interiorly disposed support member which extends out of the polymer. A method of implanting such a spinal nucleus implant is provided.

Abstract: The invention provides a prosthesis structure for anchorage to the joint end of an articulatory part of a joint in a human or animal body which comprises an engagement element which presents a flat or a substantially flat engagement surface for engaging with a complementary joint end surface provided at the joint end and an elongate fixture connected to and spaced from the engagement surface for insertion into a complementary bore provided at the joint end at a distance from the joint end surface. The invention further provides that the elongate fixture forms an acute angle with the engagement surface.

Abstract: Methods and devices for fixing a defect in a vertebral disc of a patient. One method includes inserting a guide wire into a disc using an anterior approach to create a path. At least a portion of the herniated nucleus pulposus is removed. A disc reconstruction device is then advanced into the disc and fastened to the disc or at least one of the surrounding vertebrae. Alternatively, a passage could be formed in the cranial or caudal vertebra using an angled anterior approach that terminates in a region of the disc containing the herniated nucleus pulposus. At least a portion of the herniated nucleus pulposus is removed. A disc reconstruction device that has a bone in-growth component and a soft tissue in-growth component is then implanted in the passage. Devices having bone and soft tissue in-growth components and having a flexible spine with a plurality of ribs are also described.

Abstract: A prosthetic glenoid component for attachment to a glenoid surface of a scapula to replace a natural socket of a shoulder and to provide a bearing surface for a head portion of an arm bone or humerus. The glenoid component has a metal back with integrally formed attachment legs which are cemented into corresponding holes formed in the glenoid surface, and also has an opening for receiving a hollow metal cage which is screwed into the glenoid surface.

Abstract: A flanged interbody spinal fusion implant for insertion at least in part between adjacent vertebral bodies has opposed upper and lower surfaces adapted to contact each of the adjacent vertebral bodies from within the disc space, a leading end for insertion between the adjacent vertebral bodies, and a trailing end opposite the leading end. The trailing end has a height greater than the maximum height of the disc space forming a flanged portion adapted to overlie a part of the anterior aspects of the vertebral bodies adjacent and proximate the disc space to be fused. The flanged portion has at least two bone screw receiving holes, at least one each adapted to overlie each of the adjacent vertebral bodies at least in part. The implant has at least one locking element to lock one or more of the bone screws inserted in the bone screw receiving holes. Instrumentation for inserting the implant, forming screw holes in the vertebral body, and for locking the locking elements are disclosed.

Abstract: A method of promoting regeneration of surface cartilage of a joint includes the steps of covering the area to be treated with a patch which includes a sheet of collagen membrane material. The collagen membrane material has at least one barrier layer to prevent passage of cells therethrough. The collagen membrane further includes a matrix layer predominantly of collagen II having an open sponge-like texture. The patch is fixed over the area to be treated, and the area is allowed to regenerate cartilage.

Abstract: A method for treating a non-weight bearing arthritic joint involves resecting at least one of the opposed joint surfaces to expose a cancellous bone surface. A bioresorbable implant is mounted to one of the joint surfaces so that the resected joint surface rubs against the surface of the implant. This causes the fibroblast to change into fibrocartilage at the resected bone surface as the implant is resorbed thereby effectively replacing the implant with fibrocartilage during such resorption.

Abstract: An interbody spinal fusion implant for insertion across a disc space between adjacent vertebral bodies of a human spine has a body two top side and two bottom side junctions, with at least a pair of diagonally opposed junctions having a distance therebetween that does not significantly exceed the implant body height. The implant also includes one or more bone penetrating protrusions extending outwardly from at least the upper and lower walls of the implant. The implant is inserted on its side between adjacent vertebral bodies and then rotated 90 degrees into place. The protrusions penetrate the endplates upon rotation, thereby securing the implant within the spine. The implant has at least one passage therethrough from the upper wall to the lower wall to promote fusion through the implant. Because of the specialized opposed junctions overdistraction between the adjacent vertebral bodies is avoided when the implant is rotated from an initial insertion position to a final deployed position.

Abstract: A nonmodular tibial prosthesis having a retainer for a modular bearing on the superior surface of a tibial base, a nonmodular primary bearing directly molded to the base, and a mechanical release member mounted on the tibial base in contact with the nonmodular primary bearing. The release member includes a wedge portion with a superiorly posteriorly inclined face, and is designed to be driven anteriorly upon actuation so as to force the primary bearing off of the tibial base, after which the primary bearing and release member are removed and replaced with a modular bearing.

Abstract: An intervertebral spacer adapted for implanting between adjacent vertebral bodies of a human spine as a load-bearing replacement for a spinal disc. The spacing member includes an external, non-porous, concavo-convex contour with respect to one dimension of the spacing member. The spacing member is preferably constructed from a rigid, non-resilient load-bearing material that is incapable of elastic deformation. The spacing member is inserted with the aid of a sheathed trocar device that is releasably attached to the spacer, to enable implantation and selective positioning of the spacer by the surgeon from the posterior side of the spine, without the need to retract the dural nerve or the posterior longitudinal ligament.

Abstract: An implant holder is provided having first and second gripping arms, each having a proximal portion with a mating element formed thereon for selectively mating to a medical device, and a distal portion adapted to at least partially circumferentially engage and axially align with a rod-receiving member, e.g., a head, of a spinal implant. The spinal implant holder further includes an actuator mechanism coupled to the first and second gripping arms and effective to move the gripping arms between an open position, in which the gripping arms can be positioned around the rod-receiving head of a spinal implant, and a closed position, in which the gripping arms engage the rod-receiving head of the spinal implant. A rod reduction device is also provided and includes an elongate inserter tool having a proximal end and a distal end with a fastener-retaining member formed thereon and adapted to retain a fastener therein.

Abstract: An apparatus and method for implanting an intervertebral cage containing a bone graft and fusing adjacent vertebrae together while maintaining or correcting the angular alignment and balance of the spine. An improved method for anterior interbody fusion to form a fused bone segment having a predetermined fixed angular orientation. The apparatus has a fusion cage and has a set of expansion caps that operably expand the cage from which one is selected to adjust the orientation between adjacent vertebrae with facing surfaces at a predetermined angle relative to each other. A connecting bolt is threaded to the rear of the cage unit to hold the cap in position.

Abstract: One aspect of the present invention relates to an implantable medical device comprising a surface coated with a polyelectrolyte multilayer, wherein said surface is glass, metal, plastic, polymer, or fiberglass. Another aspect of the present invention involves a method of preparing a PEM-coated implantable medical device, comprising the step of applying a film to a surface of an implantable medical device, wherein said film comprises a polyelectrolyte multilayer and said surface is glass, metal, plastic, polymer, or fiberglass.

Abstract: An orthopedic implant device and method is disclosed. Specifically, a knee mold system is disclosed, including elastic tibial and femoral molds, each of which may be configured and dimensioned as a unitary mold for in situ placement during a surgical procedure. Each mold may be manufactured from an elastic material that may be disposable. The tibial mold may further comprise a sidewall forming a cavity, markings for relative depth measurement, and depth rings for use as a guide for scoring, cutting, and/or trimming and tearing away an excess portion of the tibial mold. The femoral mold may further comprise a sidewall defining a cavity, two legs extending from a body of the femoral mold for forming the artificial condyles, and an eyelet for aiding in placement and removal of the femoral mold. The resulting prosthetic tibial and femoral components may form an articulation surface that mimics, at least in part, the natural articulation surface of the knee.

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: Cephalad and caudal vertebral facet joint prostheses and methods of use are provided. The cephalad prostheses are adapted and configured to be attached to a lamina portion of a vertebra without blocking a pedicle portion of the cephalad vertebra.

Abstract: A spinal implant insertion instrument for intervertebral implant surgery formed from a hollow first element of various external diameters, including a channel to accommodate and incorporate a vertebral pedicle, and a second element joined by a hinge to the first element, allowing reduction of the external diameter of the leading edge of the spinal implant insertion element sufficient to allow the passage of the spinal implant insertion instrument into the intervertebral disc space in a safe fashion, as the first maneuver, to be followed by activation of the second element upon the first, restoring the internal diameter of the spinal implant insertion instrument to a sufficient radius to allow successive passage of cutting, reaming, tapping instruments, and subsequent implantation of a spinal interbody implant device.

Abstract: A device and method of attaching an elongated rod to different vertebral members to form a spinal fixation system. The device comprises a securement member having a first section that is positioned within the vertebral member. A second section extends laterally outward from the first section. A receiving member is mounted to the second section to receive the elongated rod. Receiving member includes a receiver for receiving and attaching to the second section. The receiving member is laterally movable along the lateral section for positioning the elongated rod relative to the spine of the patient. The length of the second section provides for mounting the first section at a variety of anatomically conducive locations on the vertebral member while supporting the elongated rod.

Abstract: A prosthesis is provided for implantation into a body joint, such as a knee joint compartment between a femoral condyle and its corresponding tibial plateau, without requiring bone resection. The prosthesis includes a body having a generally elliptical shape in plan and including opposed top and bottom surfaces. The body includes a supporting portion and a coating portion, where the supporting portion has at least one surface at least partially disposed within an interior of the body and the coating portion has at least one surface disposed on an exterior of the body. The supporting portion is constructed from a higher modulus material than the coating portion such that the body is at least slightly deformable.

Abstract: Tissue culture and banking is used to guard against the spread of transmittable diseases. In one disclosed example, living nucleus pulposis cells obtained from recently deceased human or animal donors are used to restore disc function and eliminate pain in patients with disc disease. In the preferred embodiment, the donor nucleus is morselized to allow insertion through a small puncture in the annulus fibrosis with a needle and syringe. Although the description makes specific reference to human disc cells, the invention may be used as a way to provide disease-free disc tissue derived from animal sources, and is applicable as well to other types of biologic tissues and materials such pancreas cells, cartilage cells, and so forth. Additional therapeutic substances like culture medium, growth factors, differentiation factors, hydrogels polymers, antibiotics, anti-inflammatory medications, or immunosuppressive medications could be added to the transplanted cells or tissue.

Abstract: A method of reconstructing a joint having two bones separated by cartilaginous material is provided. The method comprises the steps of removing a portion of the cartilaginous material to create a defect site, positioning an anatomically shaped reconstructive structure comprising multiple layers of submucosa and having a thickness of about 1 to about 12 millimeters adjacent to the defect site, and securing the reconstructive structure to the defect site. The method can further comprise the steps of positioning a barrier layer between the bleeding bone and the reconstructive structure, securing the barrier layer to the bleeding bone, and securing the reconstructive structure to the barrier layer.

Abstract: A lordotic guard and method for guiding a bone removal device to form an implantation space in the human spine and, if desired, for inserting a spinal implant into the implantation space.

Abstract: A method of replacing at least a portion of an intervertebral disc of an intervertebral disc space of a spinal column, the intervertebral disc space defined at least by respective endplates of first and second adjacent vertebral bones, the method comprising the steps of inserting at least one intervertebral disc replacement trial into the intervertebral disc space to distract same in a direction along a longitudinal axis of the spinal column and simultaneously inserting first and second members of an intervertebral disc replacement device into an intervertebral disc space of the spinal column.

Abstract: An intervertebral implant for fusing vertebrae is disclosed. The implant has a body with curved, substantially parallel posterior and anterior faces separated by two narrow implant ends, superior and inferior faces having a plurality of undulating surfaces for contacting upper and lower vertebral endplates, and at least one depression at a first end for engagement by an insertion tool. The arcuate implant configuration facilitates insertion of the implant from a transforaminal approach into a symmetric position about the midline of the spine so that a single implant provides balanced support to the spinal column. The implant may be formed of a plurality of interconnecting bodies assembled to form a single unit. An implantation kit and method are also disclosed.

Abstract: This invention is directed to orthopedic implants and systems. The invention also relates to methods of implant design, manufacture, modeling and implantation as well as to surgical tools and kits used therewith. The implants are designed by analyzing the articular surface to be corrected and creating a device with an anatomic or near anatomic fit; or selecting a pre-designed implant having characteristics that give the implant the best fit to the existing defect.

Abstract: Method an device for providing information after insertion of a prosthesis in a hip joint comprising prosthesis stem, and a prosthesis cup and based on this information the position of the components of a hip prosthesis is provided. The prosthesis stem and the prosthesis cup or the part of the body in which the prosthesis is provided can include markers that can be shown on an X-ray picture. The X-ray picture is downloaded in an image processing program having assistance lines for determining the position of the prosthesis components. The X-ray picture is downloaded automatically or manually in the image processing program. The assistance lines are brought into coincidence with the images of the markers on the X-ray picture. Thereafter a calculation unit in the image processing unit calculates the angles for the respective prosthesis components.

Abstract: A device for determining the aperture angle of a joint includes a detection device for detecting positions of joint components and/or positions of structures connected to or to be connected to the joint and a computational unit for ascertaining the aperture angle of the joint based on the detected positions.

Abstract: A bone prosthesis for implantation at a joint includes a stem having a tip generally at one end thereof. The stem is sized and shaped for reception in a bone at the joint such that the tip of the stem is exposed to locations outside of the bone. The stem has a passageway extending from a first location on the bone prosthesis to a second location on the bone prosthesis.

Abstract: A tubular spacer and a method for the manufacture of it is described. The tubular spacer has a first rim on its first end, a second rim on its opposite second end and a tapered section adjacent to at least one end. The spacer is suitable for use in tubular bone surgery where it is required that the spacer adapt to different bone cross-sections. Thus, in making the spacer, a circular cylinder having a tubular jacket body is expanded and/or narrowed at one or both of its ends. Methods for usiong the spacers and kits for making the spacers also are disclosed.

Abstract: An apparatus comprising a carrier cartridge, a deployment cannula releasably connected to the carrier cartridge, a folding die, and one or more force application members. A force applied on a prosthetic nucleus by the force application members in the direction of the carrier cartridge toward the deployment cannula causes the prosthetic nucleus to move through the folding die and become loaded into the deployment cannula. The distal end of the cannula is placed into the chamber of the intervertebral disc and the prosthetic nucleus is ejected from the deployment cannula so as to implant the prosthetic nucleus in the chamber of the intervertebral disc.

Abstract: A flanged interbody spinal fusion implant for insertion at least in part between adjacent vertebral bodies has opposed upper and lower surfaces adapted to contact each of the adjacent vertebral bodies from within the disc space, a leading end for insertion between the adjacent vertebral bodies, and a trailing end opposite the leading end. The trailing end has a height greater than the maximum height of the disc space forming a flanged portion adapted to overlie a part of the anterior aspects of the vertebral bodies adjacent and proximate the disc space to be fused. The flanged portion has at least two bone screw receiving holes, at least one each adapted to overlie each of the adjacent vertebral bodies at least in part. The implant has at least one locking element to lock one or more of the bone screws inserted in the bone screw receiving holes. Instrumentation for inserting the implant, forming screw holes in the vertebral body, and for locking the locking elements are disclosed.

Abstract: The invention provides a prosthesis structure for anchorage to the joint end of an articulatory part of a joint in a human or animal body which comprises an engagement element which presents a flat or a substantially flat engagement surface for engaging with a complementary joint end surface provided at the joint end and an elongate fixture connected to and spaced from the engagement surface for insertion into a complementary bore provided at the joint end at a distance from the joint end surface. The invention further provides that the elongate fixture forms an acute angle with the engagement surface.