Multiple-cam, posterior-stabilized knee prosthesis

A distal femoral knee-replacement component provides additional points of cam action to facilitate a more normal rollback while inhibiting initial translation which could lead to increased wear and sub-optimal patella femoral mechanics. The inventive component preferably includes additional points of cam action, useable separately or together, to prevent early translation at the initiation of flexion, and a distinct point of cam action to prevent a dislocation of the femoral component over the tibial post which often occurs in cruciate-substituting designs. The preferred embodiment includes three distinct point of cam action. The first is preferably located substantially where existing cams are found, namely, at a point spaced apart a slight distance posteriorly relative to the post in full extension. A second point of cam action is located immediately adjacent the posterior aspect of the superior post to minimize and, ideally, prevent anterior translation at the initiation of flexion.

Shoulder prosthesis with anatomic reattachment features

A humeral prosthesis features improved anatomic attachment areas for tendon or bone. In the preferred embodiment, in contrast to existing devices, at least one set of tendon/bone attachment points are provided along a line, at least a portion of which is divergent with respect to the axis of the stem. One or more sets of attachment points may be further be provided along a line which is substantially parallel to the axis of the stem, resulting in a "T" "L" or "U" shape. Alternatively, attachment points having a changing degree of diversion with respect to the axis of the stem may be provided along a common, curved line. The attachment points may simply be apertures formed through the body of the implant though, in the preferred embodiment, the apertures are provided on raised tabs. An area of bone-ingrowth material may be provided adjacent the attachment points, and may include a separate fastening mechanism such as a threaded hole to receive a screw. A groove may also be provided in any ...

Prosthetic element removal apparatus and methods

Guide means direct a cutting tool into the interface between a prosthesis and surrounding bone are provided to bring about a more controlled separation and removal thereof for revision or other purposes. Such guides may be placed on the prosthetic element itself or, alternatively, on a separate component aligned with the prosthesis. In the particular case of a stemmed prosthesis such as a proximal femoral component, the invention preferably provides one or more tracks, channels, grooves or slots longitudinally oriented along the stem of the implant, enabling an osteotome, for example, to be inserted thereinto and tapped down along the side of the implant between the prosthesis and the surrounding bone to bring about a cleaner and more controlled separation. Preferably, sufficient guide means are provided around the body of the implant so that as the cutting tool is inserted along the plurality of tracks, very little fusion remains between the implant and the surrounding bone, thereby enabling ...

Apparatus for positioning a prosthetic element to achieve a desired orientation for cementation

Apparatus and method are disclosed for maintaining the proper positioning of an implant (310, 504) within a prepared bone cavity (312) during cement injection and curing. First stabilization means (340, 480), implantable within the bone cavity, minimize lateral movement of the implant distal end, while second stabilization means (330, 334, 406, 404), physically separate from the first stabilization means (340, 480), minimize both the lateral movement of the implant proximal end and the rotational movement of the implant overall. In the preferred embodiment, the second stabilization means (330, 334) includes an aperture cap (334) removable securable to the end of a prepared bone. This cap (334), preferably further includes first and second ports (322, 336) associated, respectively, with cement injection and cement over-pressurization. In an alterative embodiment, the second stabilization means (406, 404) includes a manually operated mechanism enabling (404) the implant (504) to be temporarily ...

In vitro mechanical loading of musculoskeletal tissues

Musculoskeletal tissues produced in vitro are optimized in response to an externally applied mechanical load. The load applied may vary from tissue to tissue, depending upon the response desired, and may include intermittent axial, torsional, and bending loads to produce cortical structures. Compression alone is preferably applied to produce cancellous bone. A method according to the invention for culturing bone in vitro comprises: providing a culture vessel providing a scaffold material, supporting the scaffold material within the tissue culture vessel so as to be exposed to a tissue culture medium, and exerting a force on the scaffold material during growth of a bone construct (a cultured bone growth) around the scaffold material. Applicable apparatus preferably includes a culture vessel, holders for holding a scaffold within the tissue culture vessel, means for introducing a tissue culture medium to the tissue culture vessel, and an actuator adapted to apply a force to developing bone ...

Surgical drape adapted for use with radiological equipment

A surgical drape provides a volume to accommodate radiological equipment such as a C-arm x-ray device without pulling the bottom of the drape up which could otherwise interrupt the sterile field. In one preferred embodiment, the space is created with pleated or gathered section, which receives the equipment as it is brought up laterally without lifting any portion of the material overall. A different embodiment of the invention includes a tunnel or tent formed in the material, generally without pleating. In this case, the tunnel or tent extends from the bottom of the drape to or above a patient-contacting procedural area. As a further option, in either the pleated or shaped configurations, additional material may be included to form a slit to further shroud the radiological equipment when positioned for a medial-lateral exposure. As yet a further option to all embodiments, the bottom edge of the drape may include an adhesive, integral weights, or both, to keep the bottom edge in close proximity, or actually adhered, to the floor, to further prevent lifting.

Anti-impingement femoral prostheses

A proximal femoral prosthesis minimizes impingement, thereby affording an enhanced range of motion as compared to existing devices. The central portion of the neck of a prosthesis according to the invention is oriented distally relative to a straight line drawn between the ball portion and a point of interconnection to the exposed portion of the stem. Such a configuration reduces impingement in flexion/internal rotation and extension/external rotation, assuming an appropriately placed acetabular component. In the preferred embodiment, the neck is curved between the head and the neck. In alternative embodiments, the neck may be provided in straight and/or modular segments. The invention is compatible with neck-shaft angles, offsets, head sizes, and other dimensions commonly designated with respect to available implants.

Invertible wound dressing and method of making the same

A hospital type of bandage integrates an absorbent pad and non-stick layer with a fluid-impermeable outer layer and an adhesive in a single composite structure. In a preferred embodiment the invention further includes means which may be used to turn the bandage inside out upon removal, so that surfaces once contacting a patient are no longer externally exposed. A bandage according to the invertible embodiment preferably includes a pocket formed on the side of the bandage facing away from the patient after application, this pocket being large enough to accommodate at least a portion of a human hand, and inside this pocket and located opposite the entrance is a means for grasping which may be pulled outwardly through pocket opening, thereby inverting the entire structure. Various forms of devices for grasping are possible as alternatives, including a string, a tab and a tab with one or more finger-receiving holes. Means are further included for sealing the inverted structure, preferably in the form of a flap and associated adhesive.

Apparatus and method for preparing box cuts in a distal femur with a cutting guide attached to an intramedullary stem

Improved bone cutting guides enable a surgeon to better gauge required resection characteristics. In one embodiment at least a portion of the guide is transparent, thereby enabling the user to optimize cut estimates and to visualize the resection as it is being performed. In another embodiment, at least a portion of the outer surface of the body is shaped to interact with another bone or prosthetic element associated with a joint, thereby enabling the device to function both as a trial and as a cutting guide. In this embodiment as well the guide may be at least partially transparent to improve visualization. Although primarily intended for use in femoral-side knee arthroplasty, the invention is applicable to any procedure which might benefit from improved bone-cutting accuracy.

Multiple-cam, posterior-stabilized knee prosthesis

A distal femoral knee-replacement component provides additional points of cam action by either distinct bars or interconnected structural elements such as cam extensions to prevent early translation of the knee or dislocation of the femoral component over the tibial post which can occur in cruciate-substituting designs.

Optimizing patellar femoral mechanics through alternative depth referencing

In knee-replacement surgery, restoration is achieved with respect to the patellar femoral joint in the distal plane is, thereby optimizing patellar femoral mechanics. The depth of the trochlea is increased with increasing implant size. In the preferred embodiment, this is achieved by referencing the extent of the lateral femoral condyle or trochlear region, and resecting the distal femur in accordance with the extent of the lateral femoral condyle or trochlear region. As an alternative, the invention provides for distal femoral and proximal tibial components having bone-contacting and articulating surfaces which account for the measured extent of the lateral femoral condyle or trochlear region. A method of preparing a distal femur according to the invention includes the steps of installing a rod or stem within the intramedullary canal, and attaching a referencing fixture thereto. The extent of the lateral femoral condyle or trochlear region is measured using the referencing fixture, and ...

Display method and system for surgical procedures

A method and system includes multiple displays that can be separately controlled by users who are part of a surgical team. The first display will include information to assist a first user through the steps of a surgical procedure and the second display will assist a second user though the steps taken by the second user to perform the surgical procedure.

Multiple-cam, posterior-stabilized knee prosthesis

A distal femoral knee-replacement component provides additional points of cam action by either distinct bars or interconnected structural elements such as cam extensions to prevent early translation of the knee or dislocation of the femoral component over the tibial post which can occur in cruciate-substituting designs.

Reduction-based joint replacement apparatus and methods

A reduction-based orthopedic system facilitates the installation of a properly oriented prosthetic component of the type having an articulating surface adapted to co-act in a joint. A trialing component attachable to an anchoring unit includes an articulating surface corresponding to that of the prosthetic component, enabling a desired orientation to be established through a trial reduction. A cutting guide is provided which is physically indexed to the trialing component and the prosthesis, such that when the bone is modified using the guide, the prosthetic component automatically assumes the desired orientation. The apparatus invention may further include apparatus for locking the trialing component into place upon establishing the desired orientation, with the anchoring unit being rigidly coupleable to the anchoring unit bone through attachment to the trialing component in locked position. In an alternative configuration, the bone-cutting guide is coupleable to the anchoring unit through ...

MULTIPLE-CAM, POSTERIOR-STABILIZED KNEE PROSTHESIS

A distal femoral knee-replacement component provides additional points of cam action by either distinct bars or interconnected structural elements such as cam extensions to prevent early translation of the knee or dislocation of the femoral component over the tibial post which can occur in cruciate-substituting designs.

Apparatus for positioning prosthetic component prior to cement injection

Apparatus and methods are disposed for maintaining the proper positioning of a prosthetic implant having proximal and distal ends within a prepared bone cavity during cement injection and curing. First stabilization means, implantable within the bone cavity, minimize lateral movement of the distal end of the implant, while second stabilization means, physically separate from the means for minimizing lateral movement of the distal end of the implant, minimize both the lateral movement of the proximal end of the implant and the rotational movement of the implant overall. In the preferred embodiment, the second stabilization means includes an apertured cap removably securable to the end of a bone having the prepared cavity through which the implant is inserted and held in place. This cap, which may either be entirely rigid or include a pliable membrane in the vicinity of the aperture, preferably further includes a first port associated with cement injection and a second port associated with ...

Method and apparatus for positioning a prosthetic element relative to a bone to achieve a desired orientation

Apparatus and methods are disposed for maintaining the proper positioning of a prosthetic implant having proximal and distal ends within a prepared bone cavity during cement injection and curing. First stabilization means, implantable within the bone cavity, minimize lateral movement of the distal end of the implant, while second stabilization means, physically separate from the means for minimizing lateral movement of the distal end of the implant, minimize both the lateral movement of the proximal end of the implant and the rotational movement of the implant overall. In the preferred embodiment, the second stabilization means includes an apertured cap removably securable to the end of a bone having the prepared cavity through which the implant is inserted and held in place. This cap, which may either be entirely rigid or include a pliable membrane in the vicinity of the aperture, preferably further includes a first port associated with cement injection and a second port associated with ...

PCL retaining ACL substituting TKA apparatus and method

A new class of total knee replacement includes a posterior cruciate ligament retaining anterior cruciate ligament substituting apparatus and method. Particular design considerations include: 1) a specific extension surface separate from the flexion surface, 2) rotational control in full extension to create the so-called screw-home mechanism, 3) translation restraints that will substitute for ACL function including a CAM-post or other abutment mechanism while allowing normal PCL function which should improve natural proprioception, 4) a modified femoral component with separate radii of curvature for the flexion and extension arcs of at least one condyle, and 5) a tibial component with slope built into the posterior aspect of its bone contacting surface on both sides of the PCL.

Bone-conserving orthopedic instrumentation and appliances

Apparatus and surgical techniques provide alternative cutting fixtures and other features to improve bone resection accuracy and joint stability. According to one embodiment, stabilizers are removably attached to a cutting guide to temporarily lengthen the surface against which a saw or other cutting device rests. Another embodiment provides differently shaped saw blades, having curved distal ends and right-angle bends applicable to box cuts of the type associated with cruciate sacrifice knee-replacement surgery. Methods are also disclosed whereby the box cuts, distal and posterior augment cuts may be approached from a distal perspective, both laterally and medially. A different embodiment provides a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint. Yet a further alternative embodiment teaches a device for determining the joint line relative to a tibia using the fibula as reference.

Bone cutting guides for use in the implantation of prosthetic joint components

Improved bone-cutting guides enable a surgeon to better gauge required resection characteristics. A body having an outer surface and an inner surface configured to be positioned against a bone surface to be modified includes one or more openings enabling a bone-cutting tool to be used though the body so as to perform resections beneath the inner surface. To stabilize the bone-cutting tool during the execution of a particular resection, the invention preferably further includes one of more guides which may be temporarily positioned relative to the upper surface of the body. In one embodiment, the outer surface of the body may be shaped to co-act in a joint as part of a trial reduction. For example, the outer surface may be shaped according to a natural proximal tibia, enabling a knee joint reduction to be performed prior to resection. Rather than shaping the outer surface of the body to co-act in a joint as part of a trial reduction, the outer surface of the body may instead be configured ...

Method and apparatus for aligning a prosthetic element

Methods and apparatus facilitate the positioning of a prosthetic element relative to a bone so as to achieve a desired orientation. An anchoring unit rigidly attaches to a point of the bone surrounding a region associated with receiving the prosthetic element, and at least one structural member is used to physically couple the prosthetic element to the anchoring unit. The combination of the anchoring unit and structural member includes one or more fasteners which may be loosened to temporarily remove the prosthetic element once a desired orientation is achieved, while facilitating re-installation of the element in accordance with the desired orientation following the temporary removal. In a preferred embodiment, the prosthetic element is an acetabular implant, and the surrounding bone forms part of a human pelvis. Regardless of the application, the element may take the form of a trial or a final implant.

MULTIPLE-CAM, POSTERIOR-STABILIZED KNEE PROSTHESIS

A distal femoral knee-replacement component provides additional points of cam action by either distinct bars or interconnected structural elements such as cam extensions to prevent early translation of the knee or dislocation of the femoral component over the tibial post which can occur in cruciate-substituting designs.

IN-VITRO MECHANICAL LOADING OF MUSCULOSKELETAL TISSUES

Musculoskeletal tissues produced in vitro are optimized in response to an externally applied mechanical load. The load applied may vary from tissue to tissue, depending upon the response desired, and may include intermittent axial, torsional, and bending loads to produce cortical structures. Compression alone is preferably applied to produce cancellous bone. A method according to the invention for culturing bone in vitro comprises: providing a culture vessel providing a scaffold material, supporting the scaffold material within the tissue culture vessel so as to be exposed to a tissue culture medium, and exerting a force on the scaffold material during growth of a bone construct (a cultured bone growth) around the scaffold material. Applicable apparatus preferably includes a culture vessel, holders for holding a scaffold within the tissue culture vessel, means for introducing a tissue culture medium to the tissue culture vessel, and an actuator adapted to apply a force to developing bone ...

Versatile bone plate systems particularly suited to minimally invasive surgical procedures

A bone plate adapted for distal radius fixation and other indications includes a first plate portion including one or more fastener-receiving apertures, a second plate portion also including one or more fastener-receiving apertures, and a mechanism coupling the first and second plate portions. The mechanism facilitates a first state, wherein the plate portions may be articulated to achieve a desired angular orientation, and a second state, wherein the plates are rigidly locked into position at the desired angular orientation. Patentably distinct plate extensions, locking screws, and drill guides are also disclosed.

Modular acetabular reconstruction plate

Modular acetabular reconstruction apparatus includes a generally cup-shaped portion adapted for fixation within a human pelvis and one or malleable extension arms adjustable in multiple dimensions. Each arm preferably includes one or more apertured sections spaced apart from one another by a necked-down section enabling each arm to be manipulated in three dimensions for intimate physical conformity with surrounding bone. The back surface of the generally cup-shaped portion may be adapted for a cemented or a non-cemented interface within a human pelvis; as such, the back surface may be adapted for porous bone in-growth. According to a disclosed method, the step of bending each arm in multiple dimensions may be carried out a part of a trial joint reduction. Various bending tools and techniques are also set forth.

Instrumentation and methods for refining image-guided and navigation-based surgical procedures

Automated surgical procedures, including procedures carried out in conjunction with image-guided surgical navigation systems, are improved using tools and techniques to refine bone modifications. A system-level embodiment of the invention includes a memory for storing information relating to a desired modification of a bone, a bone-modification tool, and tracking apparatus for determining the position and orientation of the bone and the bone-modification tool to ensure that the modification performed by the tool corresponds to the desired modification. In the preferred embodiment, the bone-modification tool is used to refine a previously resected surface by a few millimeters or a few degrees to achieve the desired modification. A method of preparing a bone to receive a prosthetic implant according to the invention includes the steps of using an image-guided surgical navigation system to surface a bone, determining if the surface is optimized for the prosthetic implant, and if not, using ...

PCL RETAINING ACL SUBSTITUTING TKA APPARATUS AND METHOD

A new class of total knee replacement includes a posterior cruciate ligament retaining anterior cruciate ligament substituting apparatus and method. Particular design considerations include: 1) a specific extension surface separate from the flexion surface, 2) rotational control in full extension to create the so-called screw-home mechanism, 3) translation restraints that will substitute for ACL function including a CAM-post or other abutment mechanism while allowing normal PCL function which should improve natural proprioception, 4) a modified femoral component with separate radii of curvature for the flexion and extension arcs of at least one condyle, and 5) a tibial component with slope built into the posterior aspect of its bone contacting surface on both sides of the PCL.

Implantation of prosthetic components based upon joint reduction

Improved bone cutting guides enable a surgeon to better gauge required resection characteristics. In one embodiment at least a portion of the guide is transparent, thereby enabling the user to optimize cut estimates and to visualize the resection as it is being performed. In another embodiment, at least a portion of the outer surface of the body is shaped to interact with another bone or prosthetic element associated with a joint, thereby enabling the device to function both as a trial and as a cutting guide. In this embodiment as well the guide may be at least partially transparent to improve visualization. Although primarily intended for use in femoral-side knee arthroplasty, the invention is applicable to any procedure which might benefit from improved bone-cutting accuracy.

Bone cutting guide and method to accommodate different-sized implants

A bone-modification device includes a plurality of cutting guides, wherein at least one of the guides is used to resect or otherwise modify a bone to receive a prosthetic element of a particular size, and one or more additional guides to modify or resect the bone in conjunction with a prosthetic element of a different size. In one disclosed example, the guides are configured to resect a distal femur so as to receive a femoral prosthesis in conjunction with knee-replacement surgery, wherein a plurality of guide sets are provided for anterior, posterior, and associated chamfer cuts for a plurality of differently sized femoral prosthesis. In this instance, the guide preferably features one or more sets of spaced-apart saw-receiving slots, including a first slot to resect the bone to receive a femoral prosthesis of a first size, and a second slot to resect the bone to receive a femoral prosthesis of a second size, different from the first.

Shoulder prosthesis with anatomic reattachment features

A humeral prosthesis features improved anatomic attachment areas for tendon or bone. In the preferred embodiment, in contrast to existing devices, at least one set of tendon/bone attachment points are provided along a line, at least a portion of which is divergent with respect to the axis of the stem. One or more sets of attachment points may be further be provided along a line which is substantially parallel to the axis of the stem, resulting in a "T" "L" or "U" shape. Alternatively, attachment points having a changing degree of diversion with respect to the axis of the stem may be provided along a common, curved line. The attachment points may simply be apertures formed through the body of the implant though, in the preferred embodiment, the apertures are provided on raised tabs. An area of bone-ingrowth material may be provided adjacent the attachment points, and may include a separate fastening mechanism such as a threaded hole to receive a screw. A groove may also be provided in any ...

Joint replacement method and apparatus

Apparatus and surgical techniques provide alternative cutting fixtures and other features to improve bone resection accuracy and joint stability. According to one embodiment, stabilizers are removably attached to a cutting guide to temporarily lengthen the surface against which a saw or other cutting device rests. Another embodiment provides differently shaped saw blades, having curved distal ends and right-angle bends applicable to box cuts of the type associated with cruciate sacrifice knee-replacement surgery. Methods are also disclosed whereby the box cuts, distal and posterior augment cuts may be approached from a distal perspective, both laterally and medially. A different embodiment provides a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint. Yet a further alternative embodiment teaches a device for determining the joint line relative to a tibia using the fibula as reference.

Joint replacement methods and apparatus

Apparatus and surgical techniques provide alternative cutting fixtures and other features to improve bone resection accuracy and joint stability. According to one embodiment, stabilizers are removably attached to a cutting guide to temporarily lengthen the surface against which a saw or other cutting device rests. Another embodiment provides differently shaped saw blades, having curved distal ends and right-angle bends applicable to box cuts of the type associated with cruciate sacrifice knee-replacement surgery. Methods are also disclosed whereby the box cuts, distal and posterior augment cuts may be approached from a distal perspective, both laterally and medially. A different embodiment provides a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint. Yet a further alternative embodiment teaches a device for determining the joint line relative to a tibia using the fibula as reference.

Anti-impingement femoral prostheses

A proximal femoral prosthesis minimizes impingement, thereby affording an enhanced range of motion as compared to existing devices. The central portion of the neck of a prosthesis according to the invention is oriented distally relative to a straight line drawn between the ball portion and a point of interconnection to the exposed portion of the stem. Such a configuration reduces impingement in flexion/internal rotation and extension/external rotation, assuming an appropriately placed acetabular component. In the preferred embodiment, the neck is curved between the head and the neck. In alternative embodiments, the neck may be provided in straight and/or modular segments. The invention is compatible with neck-shaft angles, offsets, head sizes, and other dimensions commonly designated with respect to available implants.

Set of bandages for a healing wound

Shoulder prosthesis with anatomic reattachment features

Apparatus and methods are disposed for maintaining the proper positioning of a prosthetic implant having proximal and distal ends within a prepared bone cavity during cement injection and curing. First stabilization means, implantable within the bone cavity, minimize lateral movement of the distal end of the implant, while second stabilization means, physically separate from the means for minimizing lateral movement of the distal end of the implant, minimize both the lateral movement of the proximal end of the implant and the rotational movement of the implant overall. In the preferred embodiment, the second stabilization means includes an apertured cap removably securable to the end of a bone having the prepared cavity through which the implant is inserted and held in place. This cap, which may either be entirely rigid or include a pliable membrane in the vicinity of the aperture, preferably further includes a first port associated with cement injection and a second port associated with ...

Shoulder prosthesis with anatomic reattachment features

Apparatus and methods are disposed for maintaining the proper positioning of a prosthetic implant having proximal and distal ends within a prepared bone cavity during cement injection and curing. First stabilization means, implantable within the bone cavity, minimize lateral movement of the distal end of the implant, while second stabilization means, physically separate from the means for minimizing lateral movement of the distal end of the implant, minimize both the lateral movement of the proximal end of the implant and the rotational movement of the implant overall. In the preferred embodiment, the second stabilization means includes an apertured cap removably securable to the end of a bone having the prepared cavity through which the implant is inserted and held in place. This cap, which may either be entirely rigid or include a pliable membrane in the vicinity of the aperture, preferably further includes a first port associated with cement injection and a second port associated with ...

Anti-impingement femoral prostheses

A proximal femoral prosthesis minimizes impingement, thereby affording an enhanced range of motion as compared to existing devices. The central portion of the neck of a prosthesis according to the invention is oriented distally relative to a straight line drawn between the ball portion and a point of interconnection to the exposed portion of the stem. Such a configuration reduces impingement in flexion/internal rotation and extension/external rotation, assuming an appropriately placed acetabular component. In the preferred embodiment, the neck is curved between the head and the neck. In alternative embodiments, the neck may be provided in straight and/or modular segments. The invention is compatible with neck-shaft angles, offsets, head sizes, and other dimensions commonly designated with respect to available implants.

Display method and system for surgical procedures

A method and system includes multiple displays that can be separately controlled by users who are part of a surgical team. The first display will include information to assist a first user through the steps of a surgical procedure and the second display will assist a second user though the steps taken by the second user to perform the surgical procedure.

Instrumentation and methods for refining image-guided and navigation-based surgical procedures

Automated surgical procedures, including procedures carried out in conjunction with image-guided surgical navigation systems, are improved using tools and techniques to refine bone modifications. A system-level embodiment of the invention includes a memory for storing information relating to a desired modification of a bone, a bone-modification tool, and tracking apparatus for determining the position and orientation of the bone and the bone-modification tool to ensure that the modification performed by the tool corresponds to the desired modification. In the preferred embodiment, the bone-modification tool is used to refine a previously resected surface by a few millimeters or a few degrees to achieve the desired modification. A method of preparing a bone to receive a prosthetic implant according to the invention includes the steps of using an image-guided surgical navigation system to surface a bone, determining if the surface is optimized for the prosthetic implant, and if not, using ...

Compression tissue repair apparatus and methods

Instruments and methods facilitate expeditious minimally invasive surgical procedures. A tissue fastener is provided with a female portion and a male portion with a head and a shaft configured to engage with the female portion. A first elongated member is used to hold the female portion of the fastener behind tissue to be repaired. A second elongated member is used to hold the male portion of the fastener in front of tissue to be repaired in alignment with the female portion. The second elongated member is slideable relative to the first elongated member, allowing a user to pierce and compress the tissue as the male portion engages with the female portion. In the preferred embodiment, the male and female portions of the fastener are constructed of a bioabsorbable material such as polylactic acid. The shaft of the male fastener is preferably ribbed or barbed, the female portion of the fastener includes an aperture with features that engage with the ribs or barbs of the male portion, thereby ...

Bone cutting guides for use in the implantation of prosthetic joint components

Improved bone cutting guides enable a surgeon to better gauge required resection characteristics. In one embodiment at least a portion of the guide is transparent, thereby enabling the user to optimize cut estimates and to visualize the resection as it is being performed. In another embodiment, at least a portion of the outer surface of the body is shaped to interact with another bone or prosthetic element associated with a joint, thereby enabling the device to function both as a trial and as a cutting guide. In this embodiment as well the guide may be at least partially transparent to improve visualization. Although primarily intended for use in femoral-side knee arthroplasty, the invention is applicable to any procedure which might benefit from improved bone-cutting accuracy.

Composite bandage particularly suited to non-planar patient contact

A hospital type of bandage integrates an absorbent pad and non-stick layer with a fluid-impermeable outer layer and an adhesive in a single composite structure. In a preferred embodiment the invention further includes means which may be used to turn the bandage inside out upon removal, so that surfaces once contacting a patient are no longer externally exposed. A bandage according to the invertible embodiment preferably includes a pocket formed on the side of the bandage facing away from the patient after application, this pocket being large enough to accommodate at least a portion of a human hand, and inside this pocket and located opposite the entrance is a means for grasping which may be pulled outwardly through pocket opening, thereby inverting the entire structure. Various forms of devices for grasping are possible as alternatives, including a string, a tab and a tab with one or more finger-receiving holes. Means are further included for sealing the inverted structure, preferably in ...

MULTIPLE-CAM, POSTERIOR-STABILIZED KNEE PROSTHESIS

A distal femoral knee-replacement component provides additional points of cam action by either distinct bars or interconnected structural elements such as cam extensions to prevent early translation of the knee or dislocation of the femoral component over the tibial post which can occur in cruciate-substituting designs. 1. A total knee replacement system for use in posterior cruciate substituting knee replacement procedures , comprising:a tibial component including a tibial post with anterior and posterior portions defined by a line generally bisecting the tibial post in a coronal plane;wherein the posterior portion of the tibial post includes a posterior post surface with convex and concave posterior post surface portions in a sagittal plane, and wherein the concave surface portion constitutes a majority of the posterior post surface;a femoral component with one medial and one lateral condylar protrusion forming separated bearing surfaces configured to articulate with corresponding separated surfaces on the tibial component through a range of motion including flexion and extension;wherein the femoral component includes an intercondylar bridging structure forming a femoral cam with surfaces in a sagittal plane that articulate only with the posterior post surface of the tibial component, the surfaces including a superior convex surface, an intermediate concave surface, and an inferior convex posterior surface; andwherein the entire intermediate concave surface of the femoral cam remains posterior to the anterior portion of the tibial post throughout the range of motion.2. The total knee replacement system of claim 1 , wherein a line drawn from a most superior aspect of the superior convex surface to a most inferior aspect of the concave surface forms an “s” shape in the sagittal plane.3. The total knee replacement system of claim 1 , wherein the posterior convex surface of the intercondylar bridging structure contacts the posterior portion of the tibial post before ...

MULTIPLE-CAM, POSTERIOR-STABILIZED KNEE PROSTHESIS

A distal femoral knee-replacement component provides additional points of cam action by either distinct bars or interconnected structural elements such as cam extensions to prevent early translation of the knee or dislocation of the femoral component over the tibial post which can occur in cruciate-substituting designs. 1. A total knee replacement system , comprising:a tibial component having a tibial post with a posterior portion;a femoral component with medial and lateral condylar protrusions forming separated bearing surfaces configured to articulate with the tibial component;wherein the posterior portion of the tibial post has a concave surface in the sagittal plane and a convex surface in the transverse plane, with the sagittal plane being defined as a vertical plane extending from front to back, and with the transverse plane being defined as a horizontal plane perpendicular to the sagittal plane; andwherein the femoral component includes an intercondylar femoral cam mechanism configured to articulate with the posterior portion of the tibial post, the femoral cam mechanism including an intercondylar bridging structure with convex and concave distal surfaces in the sagittal plane, and a concave surface in the transverse plane to facilitate rotation of the femoral component relative to the tibial component in the transverse plane.2. The total knee replacement system of claim 1 , wherein a portion of the femoral cam mechanism forms an “s” shape in the sagittal plane.3. The total knee replacement system of claim 1 , wherein the convex surface of the intercondylar bridging structure contacts the posterior aspect of the post before 90 degrees of flexion.4. The total knee replacement system of claim 1 , wherein the femoral cam mechanism includes an additional sagittal convex surface.5. The total knee replacement system of claim 4 , wherein the concave distal surface is located between the two sagittal convex surfaces.6. The total knee replacement system of claim 5 , ...

Multiple-cam, posterior-stabilized knee prosthesis

A total knee replacement system includes a tibial component having a tibial post with a posterior portion, and a femoral component with medial and lateral condylar protrusions forming separated bearing surfaces configured to articulate with the tibial component. In one disclosed embodiment the posterior portion of the tibial post has a concave surface in the sagittal plane and a convex surface in the transverse plane, and the femoral component includes an intercondylar femoral cam mechanism configured to articulate with the posterior surface of the tibial post. The femoral cam mechanism may include an intercondylar bridging structure with distinct bars or interconnected structural elements providing convex and concave distal surfaces in the sagittal plane, and a concave surface in the transverse plane to facilitate rotation of the femoral component relative to the tibial component in the transverse plane.

Multiple-cam, posterior-stabilized knee prosthesis

A total knee replacement system including a distal femoral knee replacement component and a tibial component having a bearing surface and a tibial post with a posterior surface, wherein the distal femoral knee replacement component includes a body having a pair of medial and lateral condylar protrusions and an intercondylar region therebetween dimensional to receive the tibial post, the body further having a cam mechanism bridging the intercondylar region, the cam mechanism having a least a first, second and third cam surface areas, with each having a convex shape in the sagittal plane with different centers of radius wherein none of cam surface areas engage the posterior surface of the tibial post when the knee is in extension and wherein the cam mechanism includes at least one concave cam surface area between at least two of the three convex cam surface areas.

Composite wound dressing including inversion means

A hospital type of bandage integrates an absorbent pad and non-stick layer with a fluid-impermeable outer layer and an adhesive in a single composite structure. In a preferred embodiment the invention further includes means which may be used to turn the bandage inside out upon removal, so that surfaces once contacting a patient are no longer externally exposed. A bandage according to the invertible embodiment preferably includes a pocket formed on the side of the bandage facing away from the patient after application, this pocket being large enough to accommodate at least a portion of a human hand, and inside this pocket and located opposite the entrance is a means for grasping which may be pulled outwardly through pocket opening, thereby inverting the entire structure. Various forms of devices for grasping are possible as alternatives, including a string, a tab and a tab with one or more finger-receiving holes. Means are further included for sealing the inverted structure, preferably in the form of a flap and associated adhesive.

Invertible wound dressings and method of making the same

A hospital type of bandage integrates an absorbent pad and non-stick layer with a fluid-impermeable outer layer and an adhesive in a single composite structure. In a preferred embodiment the invention further includes means which may be used to turn the bandage inside out upon removal, so that surfaces once contacting a patient are no longer externally exposed. A bandage according to the invertible embodiment preferably includes a pocket formed on the side of the bandage facing away from the patient after application, this pocket being large enough to accommodate at least a portion of a human hand, and inside this pocket and located opposite the entrance is a means for grasping which may be pulled outwardly through pocket opening, thereby inverting the entire structure. Various forms of devices for grasping are possible as alternatives, including a string, a tab and a tab with one or more finger-receiving holes. Means are further included for sealing the inverted structure, preferably in the form of a flap and associated adhesive.

Bandage with thermal insert

A hospital type of bandage integrates an absorbent pad and non-stick layer with a fluid-impermeable outer layer and an adhesive in a single composite structure. In a preferred embodiment the invention further includes means which may be used to turn the bandage inside out upon removal, so that surfaces once contacting a patient are no longer externally exposed. A bandage according to the invertible embodiment preferably includes a pocket formed on the side of the bandage facing away from the patient after application, this pocket being large enough to accommodate at least a portion of a human hand, and inside this pocket and located opposite the entrance is a means for grasping which may be pulled outwardly through pocket opening, thereby inverting the entire structure. Various forms of devices for grasping are possible as alternatives, including a string, a tab and a tab with one or more finger-receiving holes. Means are further included for sealing the inverted structure, preferably in the form of a flap and associated adhesive.

Healing wound bandaging kit and method

A wound healing bandaging kit includes a plurality of bandages, each with a flexible layer having a patient-contacting-surface and an outer surface. The outer surface on one of the bandages in the kit includes visual indicia portraying a neutral or negative message, and the outer surface on one of the bandages in the kit includes visual indicia portraying of a positive message. In the preferred embodiment, the visual indicia of a neutral or negative message includes the graphical image of a person's face with a neutral expression or a frown, and the visual indicia of a positive message includes the graphical image of a person's face with a smile. A method of treating a wound includes the steps of providing a wound healing bandaging kit with a plurality of bandages, one of which portrays a neutral or negative message, and another of which portrays a positive message. The bandage with the visual indicia portraying of a neutral or negative message is applied initially after a cut, bruise, surgical incision or trauma; the bandage with the visual indicia portraying a positive message is then applied after the cut, bruise, surgical incision or trauma has had an opportunity to heal.

Method for supporting a surgical procedure and system for assisting the performance of a surgical procedure

Verfahren zum Unterstützen einer chirurgischen Maßnahme mittels eines chirurgischen Navigationssystems (108; 328), wobei das Verfahren folgende Schritte umfasst: – Anzeigen einer von dem chirurgischen Navigationssystem (108; 328) generierten ersten Anzeigedarstellung (N; P) auf einer Anzeigeeinrichtung (116; 336), wobei die erste Anzeigedarstellung (N; P) ein von dem chirurgischen Navigationssystem (108) generiertes Bild enthält und die erste Anzeigedarstellung (N; P) eine von mehreren Hauptdarstellungen (N, N + Y, N + Z; P, P + Y, P + Z) ist, die einen ersten Benutzer (102; 322) durch die chirurgische Maßnahme leiten, und die erste Anzeigedarstellung (N; P) von dem ersten Benutzer (102; 322) steuerbar ist; – Anzeigen einer von dem chirurgischen Navigationssystem (108; 328) generierten zweiten Anzeigedarstellung (N'; P') auf einer Anzeigeeinrichtung (118; 336), wobei die zweite Anzeigedarstellung (N'; P') der ersten Anzeigedarstellung (N; P) zugeordnet ist und die zweite Anzeigedarstellung (N'; P') eine von mehreren Hilfsdarstellungen (N', N' + Y, N' + Z; P', P' + Y, P' + Z) ist, die Informationen anzeigen, die einen zweiten Benutzer (104; 324) durch die chirurgische Maßnahme leiten,; und – Ändern der ersten und/oder der zweiten Anzeigedarstellung (N; P; N'; P') in eine andere Darstellung aus der Vielzahl der Hauptdarstellungen (N, N + Y, N + Z; P, P + Y, P + Z) und der Vielzahl der Hilfsdarstellungen (N', N' + Y, N' + Z; P', P' + Y, P' + Z), wobei die Änderung auf einer Interaktion des ersten und/oder des zweiten Benutzers (102, 104; 322, 324) basiert; dadurch gekennzeichnet, dass die zweite Anzeigedarstellung (N'; P') durch den zweiten Benutzer (104; 324) unabhängig von der Steuerung des ersten Benutzers (102; 322) steuerbar ist, wobei die erste und die zweite Anzeigedarstellung (N; P; N'; P') unterschiedliche, aber zusammengehörende, auf die Maßnahme bezogene ...

Bone cutting guides for use in the implantation of prosthetic joint components

Improved bone cutting guides enable a surgeon to better gauge required resection characteristics. In one embodiment at least a portion of the guide (204) is transparent (208, 210), thereby enabling the user to optimize cut estimates and to visualize the resection as it is being performed. In another embodiment, at least a portion of the outer surface of the body (404) is shaped to interact with another bone or prosthetic element associated with a joint, thereby enabling the device to function both as a trial and as a cutting guide. In this embodiment (404) as well the guide may be at least partially transparent to improve visualization. Although primarily intended for use in femoral-side knee arthroplasty, the invention is applicable to any procedure which might benefit from improved bone-cutting accuracy.

Surgical measure execution supporting method for use in operation theater, involves changing main and auxiliary representations based on interaction of users, where auxiliary representation is independently controlled

The method involves displaying a main representation generated by a surgical navigation system (108) on a display device, where the main representation contains an image generated by the system. An auxiliary representation generated by the navigation system is displayed on the display device. The auxiliary representation is assigned to the main representation. The main and the auxiliary representations are changed based on an interaction of users, where the auxiliary representation is controlled independent of control of the main representation. An independent claim is also included for a system for supporting an execution of a surgical measure.

Knochenschneideführungseinheit zur verwendung beim implantieren von gelenkprothesenkomponenten

Method and apparatus for positioning a prosthetic element relative to a bone to achieve a desired orientation

Method and apparatus for aligning a prosthetic element

Methods and apparatus facilitate the positioning of a prosthetic element relative to a bone so as to achieve a desired orientation. An anchoring unit (14) rigidly attaches to a point of the bone surrounding a region associated with receiving the prosthetic element, and at least one structural member (16) is used to physically couple the prosthetic element (12) to the anchoring unit. The combination of the anchoring unit and structural member includes one or more fasteners (26, 28, 29) which may be loosened to temporarily remove the prosthetic element once a desired orientation is achieved, while facilitating re-installation of the element in accordance with the desired orientation following the temporary removal. In a preferred embodiment the prosthetic element (12) is an acetabular implant, and the surrounding bone forms part of a human pelvis. Regardless of the application, the element may take the form of a trial or a final implant.

Bone cutting guides for use in the implantation of prosthetic joint components

Improved bone cutting guides enable a surgeon to better gauge required resection characteristics. In one embodiment at least a portion of the guide is transparent, thereby enabling the user to optimize cut estimates and to visualize the resection as it is being performed. In another embodiment, at least a portion of the outer surface of the body is shaped to interact with another bone or prosthetic element associated with a joint, thereby enabling the device to function both as a trial and as a cutting guide. In this embodiment as well the guide may be at least partially transparent to improve visualization. Although primarily intended for use in femoral-side knee arthroplasty, the invention is applicable to any procedure which might benefit from improved bone-cutting accuracy.