The present invention includes a hip-off-loading device including a pelvic assembly including a pelvic base plate configured for attachment to a human pelvis; a distraction adjustment mechanism coupled to the pelvic base plate, wherein the distraction adjustment mechanism is lockable, to provide for adjusting the distal distraction of the hip-off-loading device; and at least a portion of a rotation mechanism to provide for internal or external rotation or both, and to provide for non-dynamic interoperative adjustment of abduction, adduction, or both; a link movably coupled to the pelvic assembly to provide for internal or external rotation or both; and a femoral assembly coupled to the link and including a femoral attachment mechanism for attachment to a femur to provide for flexion, extension, or both.

A weight-bearing stance corrected foot orthotic (12) is adapted to be used on the foot (2) of a anaesthetised patient in the supine or prone position, the weight bearing stance corrected foot orthotic (12) adapted to dorsiflex the toes of the forefoot of the patient an angle of between 30° to 50° to the plane of the foot (2). A surgical foot orthotic (12) is formed by the steps of disposing a patient's foot (2) or both feet in a weight bearing neutral position and dorsiflexing the forefoot or forefeet of the patient such that patient's foot (2) or feet are in or towards the Windlass configuration. A first orthotic (5) correcting the stance of the patient in the weight bearing position with dorsiflexed forefoot is formed and this is scanned to form an electronic image of the corrective load bearing surface. The electronic image is modified to include one or more guide apertures or cut-outs (9) and a surgical corrected weight-bearing orthotic from the modified electronic image is 3-D printed with the one or more guide apertures or cut-outs.

A surgical kit includes a shield for covering a portion of the spine of a subject. The shield can include an attachment portion adapted to engage a bone fixation assembly which is adapted to be fixed on multiple vertebra bones of the subject. The bone fixation assembly can include a vertebra joining member secured between two bone anchors. Each bone anchor can include a fastener portion adapted to be implanted into a vertebra bone and a head coupling portion adapted to secure the vertebra joining member. The shield can be coupled to the bone fixation assembly via separate coupling elements, such as a clip or an adjustable link secured between two vertebra joining members of the bone fixation assembly. Alternatively, the shield can include an integral attachment portion configured to engage the bone fixation assembly directly.

Methods and devices for treating spinal deformities are provided. In one exemplary embodiment, a low-profile spinal anchoring device is provided for receiving a spinal fixation element, such as a tether, therethrough. The device generally includes a staple body that is adapted to seat a spinal fixation element, a fastening element for fixing the staple body to bone, and a locking assembly for coupling a spinal fixation element to the staple body. In one embodiment, the locking assembly includes a washer that is adapted to couple to the staple body such that the spinal fixation is disposed therebetween, and a locking nut that is adapted to engage the staple body to mate the washer to the staple body.

Bone anchor assemblies are disclosed herein that can provide for improved fixation as compared with traditional bone anchor assemblies. An exemplary assembly can include a bracket or wing that extends down from the receiver member and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a plate that is seated between the receiver member and the rod and accommodates one or more auxiliary bone anchors that augment the fixation of the assembly's primary bone anchor. Another exemplary assembly can include a hook that extends out from the receiver member to hook onto an anatomical structure or another implant to augment the fixation of the assembly's primary bone anchor. Surgical methods using the bone anchor assemblies described herein are also disclosed.

A pivotal bone anchor assembly includes a shank having a shank head with a partial spherical shape at a proximal end and an anchor portion opposite the shank head for fixation to the bone of a patient. The assembly also includes a receiver having an upper portion defining a channel for receiving an elongate rod and a base defining a cavity in communication with the channel and with a bottom surface of the receiver through a distal opening. The assembly further includes a retainer positionable into non-rotatable and non-pivotal engagement with an inner surface of the cavity prior to the shank head being received within the cavity, with the retainer having a central opening configured to receive and capture the shank head within the cavity while allowing for pivotal motion between the shank and the receiver in at least one plane, and with a lower portion of the retainer extending below the bottom surface of the receiver.

The invention provides surgical methods, devices, apparatus, and systems for supporting the thumb of a patient after basal joint arthroplasty. The embodiments of the invention comprise at least one index metacarpal anchor, at least one thumb metacarpal anchor, at least one sling for positioning the thumb metacarpal anchor relative to the index metacarpal anchor, and at least one anchor washer for tightening and securing the sling(s) without the need to tie the suture(s) components of the sling(s) into knots. Index and thumb metacarpal anchors comprise at least one bone-engaging element for engaging the respective metacarpal. The anchor washer may incorporate one or more sling-engagement mechanisms. Increasing the number of sling-engagement mechanisms associated with the anchor washer increases the surface area of the sling(s) and provides multiple sling elements to provide redundancy and increase the pull force of the sling(s) attachment(s) used to affix the thumb and index metacarpal anchors into a position relative to each other.

A coupling device is provided for coupling a rod to a bone anchoring element. The coupling device includes a receiving part having a first end, a second end, a central axis extending through the first end and the second end, and a channel for receiving a rod. The receiving part defines an accommodation space for accommodating a head of a bone anchoring element, the accommodation space having an opening for inserting the head. The coupling device further includes a pressure element arranged at least partially in the accommodation space, the pressure element having a flexible portion to clamp an inserted head, and a clamping element extending at least partially around the flexible portion of the pressure element. The clamping element is configured to move from a first position to a second position in which the clamping element exerts a clamping force onto the pressure element, where the movement includes rotating the clamping element around the central axis.

This disclosure details a surgical system and method, which is useful for treating an acromioclavicular (AC) joint. In an example, the disclosed system includes a cerclage which is provided relative to a coracoid process and which includes a loop. In that example, a clavicle is held relative to the coracoid process using a clavicle fixation assembly, which includes suture passed through the loop of the cerclage.

A pivotal bone anchor assembly includes a shank having an anchor portion and a head with a partially spherical outer surface, a drive socket, an annular planar top surface surrounding the drive socket, and a frusto-conical surface between the planar top surface and the partially spherical outer surface. The assembly further includes a receiver having a base defining an axial bore and an upper portion defining a channel configured to receive a rod, and an insert positionable within the axial bore having an upper surface engageable with the rod, a lower surface for transferring a downwardly-directed force toward the head, and a central aperture for accessing the drive socket, with the rod extending across the central aperture when the fixation rod is engaged by the upper surface. After the head, the insert, and the rod are positioned in the receiver, the frusto-conical surface remains spaced apart from the rod to in all pivotal orientations of the shank relative to the receiver.