A method of performing joint arthroplasty includes preparing a flat surface on a long bone, providing an instrument having a body and a punch extending from the body, the punch including a portion thereof having a shape similar to a stem of an implant, positioning a stop on the flat surface, rotating the stop with respect to the surface of the long bone based upon an indicia on one of the body and the stop so as to position the punch rotationally with respect to the surface to a desired orientation when the instrument is at least partially inserted into the stop, using the instrument to form a cavity in the long bone with the punch at the desired rotational orientation with the instrument inserted at least partially within the stop, the cavity having a shape similar to the stem of the implant, and implanting the stem into the cavity.

Methods and devices are disclosed for treating the vertebral column. An integrated fixation plate and spacer having a retaining structure within the screw holes of the fixation plate to resist backout of screws attaching the fixation plate to the bone is provided. A movable joint may be provided between the fixation plate and spacer. In some embodiments, a screw hole insert is also provided to resist shear forces acting between the screw and fixation plate. In some embodiments, an integrated fixation plate and spacer system is provided, comprising two or more integrated fixation plate and spacer implants, wherein the fixation plates of each implant has a complementary configuration to allow attachment of the implants at adjacent intervertebral spaces. Alternative fixation systems are also contemplated.

Soft tissue grafts, packaged soft tissue grafts, and methods of making and using soft tissue grafts are disclosed. One soft tissue graft includes processed tissue material having first and second opposed surfaces. The first and second opposed surfaces are bounded by first and second edges. The first edge has a concave shape that curves toward the second edge. The second edge has a convex shape that curves away from the first edge. The first surface comprises a plurality of apertures. At least one of the apertures is formed from a multi-directional separation in the first surface. One method of making a soft tissue graft includes positioning a cutting die on a surface of tissue material, pressing the cutting die into the tissue material to cut the tissue material, and processing the cut tissue material to create processed tissue material.

A method and apparatus for spinal fusion at the facet joint using an irregularly shaped implant where the orientation of the implant can be preselected before implantation.

In one embodiment, the present invention includes an intramedullary osteosynthesis or arthrodesis implant including a central body, a first pair of legs extending from the central body to a pair of leg tips, and a second pair of legs extending from the central body, in a direction opposite the first pair of legs, to a pair of leg tips such that the central body, first pair of legs and second pair of legs are positioned alongside a longitudinal axis.

A mounting bracket for a prosthetic foot configured to attach to a residual limb, comprising an upper member, a lower member and compression torsion joint. The upper member comprises an upper flange, a mating post, and mounting portion configured to attach to the residual limb. The lower member comprises a mating portion, a lower flange, and a mounting portion configured to attach to the prosthetic foot. The compression torsion joint couples the upper member to the lower member and is configured to limit the vertical movement and torsional movement of the upper member with respect to the lower member.

A system for spinal surgery includes a prosthesis comprising a plurality of bone anchors which engage an intervertebral construct for fusion or motion preservation. The fusion construct comprises a spacer optionally encircled by a jacket. The motion preservation construct may comprise an articulating disc assembly or an elastomeric disc assembly. Any of the constructs may occupy the intervertebral disc space between adjacent vertebrae after removal of an intervertebral disc. The anchors slidingly engage the construct to securely fix the prosthesis to the vertebrae. The anchors and jacket of the fusion construct provide a continuous load path across opposite sides of the prosthesis so as to resist antagonistic motions of the spine.

A surgical instrument and method are provided for removal of a spinal implant from the intervertebral disc space. The instrument includes a carriage body for interfacing with the implant, a housing for interfacing with the vertebrae, and a handle portion having a first portion rotatably coupled with a proximal end of the housing and a second portion rotatably engageable with a proximal attachment portion of the carriage body. A central passage of the housing extends between the proximal end and a distal engagement surface of the housing. The central passage is dimensioned to mate with the carriage body. Rotation of the handle portion about an axis causes translational movement of the carriage body along the axis. A modular inserter/distractor apparatus and method and an anchor remover and method are also provided.

An expandable support device for tissue repair is disclosed. The device can be used to repair hard or soft tissue, such as bone or vertebral discs. The device can have multiple flat sides that remain flat during expansi A method of repairing tissue is also disclosed. Devices and methods for adjusting (e.g., removing, repositioning, resizing) deployed orthopedic expandable support devices are also disclosed. The expandable support devices can be engaged by an engagement device. The engagement device can longitudinally expand the expandable support device. The expandable support device can be longitudinally expanded until the expandable support device is substantially in a pre-deployed configuration. The expandable support device can be then be physically translated and/or rotated.

A surgical instrument and method for inserting a spinal implant in the intervertebral disc space between two adjacent vertebrae and an anchor engageable with the implant and an adjacent vertebra are provided. The instrument includes an inserter having an engagement portion including a distal engagement surface for interfacing with the implant and a handle portion. The engagement portion includes a track for slidably translating the anchor toward the engagement surface. A kit is provided including the inserter and a tamp to force the anchor into engagement with the implant and the adjacent vertebra. The kit may also include a cutter for piercing the adjacent vertebra.