Implants are formed from a multiple staged process that combines both additive and subtractive techniques. Additive techniques melt powders and fragments of a desired material, then successively layer the molten material into the desired implant shape, without compressing or remelting for homogenization of the layers, thereby producing an implant that is substantially free of pores and inclusions. Subtractive techniques refine implant surfaces to produce a bioactive roughened surface comprised of macro, micro, and nano structural features that facilitate bone growth and fusion.

A hip implant having two distinct bodies, a neck body and a bone fixation body. The neck body is formed from a solid metal and has an interface for connecting to a femoral ball. The bone fixation body has an elongated shape and is formed as a porous structure that is inserted into an intramedullary canal of a patient.

An implant stabilizes two adjacent bones of a joint, while enabling a natural kinematic relative movement of the bones. Support components are connected to each bone of the joint, and a flexible core is interposed between them. The core and at least one of the support components are provided with a smooth sliding surface upon which the core and support component may slide relative to each other, enabling a corresponding movement of the bones. The surfaces may have a mating curvature, to mimic a natural movement of the joint. The core is resilient, and may bend or compress, enabling the bones to move towards each other, and or to bend relative to each other.

Methods of inserting and retaining interbody fusion material are disclosed. In some embodiments, the methods include inserting an anchored implant comprising a bone anchoring portion and an engagement portion. A method may also include inserting at least one bone fusion material within a disc space between two adjacent vertebral bodies. In some embodiments, a method includes driving the bone anchoring portion into an outer surface of at least one of the adjacent vertebral bodies and recessing the bone anchoring portion within the outer surface of the at least one adjacent vertebral body.

Methods for altering the natural history of degenerative disc disease and osteoarthritis of the spine are proposed. The methods focus on the prevention, or delayed onset or progression of, subchondral defects such as bone marrow edema or bone marrow lesion, and subchondral treatment to prevent the progression of osteoarthritis or degenerative disc disease in the spine and thereby treat pain.

A method of forming an implant to be implanted into living bone. The implant includes titanium. The method includes deforming at least a portion of a surface of the implant to produce a first micro-scale topography. The method further includes removing at least a portion of the surface to produce a second micro-scale topography superimposed on the first topography. The second micro-scale topography is generally less coarse than the first micro-scale topography. The method further includes adding a submicron topography superimposed on the first and second micro-scale topographies, the submicron topography including tube-like structures.

An oblique expanding fusion cage device including a body with a superior portion and an inferior portion. The superior portion and the inferior portion have a proximal end and a distal end. The fusion cage device also includes a pathway, an opening, and an expanding member. The pathway travels from the proximal end to the distal end of the device between the superior and inferior portions. The opening in the proximal end of the body enables access to the pathway. The expanding member may be removably inserted into the opening and is moveable toward the distal end of the body, wherein the expanding member engages the superior portion and the inferior portion as the expanding member moves distally within the pathway.

Methods for altering the natural history of degenerative disc disease and osteoarthritis of the spine are proposed. The methods focus on the prevention, or delayed onset or progression of, subchondral defects such as bone marrow edema or bone marrow lesion, and subchondral treatment to prevent the progression of osteoarthritis or degenerative disc disease in the spine and thereby treat pain.

An implant has an implant surface of layered coatings. A method of manufacturing is for an implant having an implant surface. The implant having an implant surface has a micro-pattern layer on the implant surface made by micro-machining, and a primary component layer deposited over the micro-pattern layer that promotes bio-integration of the implant. The micro-pattern layer has micro-trenches in predefined dimensions and arranged in a periodic array.

A method of forming a nanocrystalline surface on an implant is disclosed. The method comprises the act of roughening at least a portion of the implant surface to form a roughened surface. The method further comprises the act of, without forming an alkoxide on the roughened surface, depositing nanocrystals on the roughened surface. The nanocrystals comprise a material having a property that promotes osseointegration.