A method of ankle replacement includes forming an anterior cut in a bone and forming a stem hole in a distal end of the bone. The stem hole is formed using a plurality of broaches positioned against the distal end of the bone through the anterior cut. A first portion and a second portion of a stem implant are inserted into the stem hole through the anterior cut in the bone. The first portion is coupled to the second portion using a coupling device inserted through the anterior cut in the bone. The stem implant is impacted into the stem hole using an offset impactor.

An interbody implant includes an implant body extending between an anterior surface and a posterior surface. The implant body includes a first vertebral engaging surface and a second vertebral engaging surface. At least one of the vertebral engaging surfaces defines a cavity configured for disposal of bone growth detectable via medical imaging. Systems, spinal constructs, surgical instruments and methods are disclosed.

A surgical implant having a plastic (e.g., PEEK) component having an exposed surface, wherein at least a portion of the exposed surface has a plurality of parallel microgrooves that (i) enhance bone growth and osseointegration with adjacent bone and, after the osseointegration, (ii) increase pull-out force of the surgical implant from the adjacent bone. In certain embodiments, the microgrooves have widths of less than or equal to 12 micrometers, depths of less than or equal to 12 micrometers, crests of less than or equal to 12 micrometers, and a periodicity of less than or equal to 24 micrometers.

Techniques and systems for distracting a spinal disc space and supporting adjacent vertebrae are provided. Trial instruments are insertable into the disc space to determine a desired disc space height and to select a corresponding implant. Implants can be also be self-distracting and the implant providing the desired disc space height can be implanted in the spinal disc space.

Technologies are generally provided for devices, systems, and methods to provide spinal fixation, spinal stabilization, and/or spinal fusion. Example devices may include a first end and a second end with a middle portion extending between the first and second end. The first end may be configured to be in contact with a portion of a first or upper vertebra and the second end may be configured to be in contact with a portion of a second or lower vertebra in an adjacent vertebral pair. Portions of the vertebra which may be in contact with the device may include lamina, processes, vertebral bodies, and facet joints. The example devices may include bone engagement features, such as screws or similar fasteners, to enhance stabilization and fixation when in contact with the vertebrae. Additionally, the devices may include a bone integration feature to promote bone growth and to facilitate fusion between the vertebrae.

A wedge has an outer perimeter and includes a top surface extending generally in a first plane and having a top osteointegration surface disposed thereon. A bottom surface extends in a second plane that extends obliquely with respect to the first plane. The first plane intersects the second plane outside the outer perimeter of the implant and includes a bottom osteointegration surface disposed thereon. A plurality of side surfaces extends between the top surface and the bottom surface and defines the outer perimeter, wherein at least a portion of the plurality of side surfaces is devoid of any osteointegration surface.

A system and method for improving mechanical assemblies, such as prosthetic implants, intended to be installed in living tissue such as bone. Force-imparting devices are adapted and may include angularity, which may be introduced with specialized additive manufacturing, which may impart congruent cross-sections while providing variable stiffness. In some cases, the variable stiffness may be “stretchy” in a longitudinal direction and “rigid” in a radial directional which may provide an assembly bias. Additive manufacturing may allow the material of a prosthesis to be varied (e.g., density/porosity) to create variable stiffness over a length.

Disclosed is a prosthetic joint assembly for joining a humerus bone to a scapula bone, comprising a humeral component adapted for engagement with said humerus bone and a concave dish; a scapular component adapted for engagement with said scapula bone and a convex surface adapted to engage said concave dish; wherein when said components are implanted and engaged in a rest position said prosthetic center of rotation is displaced in a direction that is inferior and medial relative to a natural center of rotation and said humerus bone is displaced in a direction that is inferior relative to said natural center of rotation.

An interbody spacer is provided including a body portion defining a longitudinal axis. The body portion includes a distal end portion, a proximal end portion, opposed side surfaces that extend between the distal and proximal end portions, and top and bottom surfaces configured and adapted to engage vertebral bodies. The interbody spacer includes first orifices defined through the top surface. The first orifices include orifices having first and second cross-sectional configurations and the first orifices are arranged in rows extending along the longitudinal axis.

Disclosed is a medical device having a substrate having an exposed surface and a texture over at least part of the exposed surface. The texture includes a plurality of nanofeatures that inhibit bacterial adhesion on the surface and that also inhibit bacterial growth on the surface and have a size range between about 0.01 nanometers and about 1,000 nanometers. The texture can include a plurality of nanofeatures applied thereto such that the texture has a first particle size at a first location, a second particle size at a second location, and a gradient of particle size from the first particle size to the second particle size between the first location and the second location.