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.

An innovative dome toe resurfacing system for performing metatarsophalangeal joint replacement is disclosed. The present invention comprises a prosthetic implant for metatarsophalangeal joint, and one or more cone extensions that covers portions of the prosthesis that extends into the metatarsal bone and phalanx bone. The cone extensions include a plurality of ridges that will catch bone on insertion and provide a press fit. The present invention also includes a cone and cup reaming system wherein one or more reamers will ream a cone/cup shape for the articular surfaces, and prepare the metatarsal and phalangeal canals for the insertion of the cone extensions. The cone extensions have ends that fit the reamed cone/cup shape wherein the cone/cup shape resembles the natural anatomy of articular surfaces of metatarsophalangeal joint.

Apparatus and method of removing a liner attached to an implanted acetabular shell. A surgical site is accessed where the acetabular shell has already been implanted into a patient. A rim plate having a through opening is placed over the acetabular shell. A pilot hole is then drilled into the attached liner through the opening in the placed rim plate. After the drilling, the rim plate is removed to expose the drilled hole. A removal tool is inserted into the drilled pilot hole. The attached liner is then disengaged from the implanted acetabular shell with the inserted removal tool.

An apparatus and methods are provided for an improved ankle prosthesis, comprising a talar component which includes a talar upper face defining a first articular surface and which extends between a talar anterior edge and an opposite talar posterior edge according to a first average direction, said first articular surface being curved according to said first average direction, said first articular surface comprising a first curved portion and a second curved portion, each extending according to said first average direction, said first curved portion having a first curvature and said second curved portion having a second curvature, said prosthesis being characterized in that said first curved portion and said second curved portion define respectively an anterior portion and a posterior portion of said first articular surface, said first curvature being greater than said second curvature.

An endplate plunger for implanting a growth-promoting tether between opposed adjacent vertebrae. The endplate plunger includes resilient arm assemblies that store potential energy when the endplate plunger is in a retracted configuration. In transitioning from the retracted configuration to a deployed configuration, the potential energy is released in a burst of kinetic energy, causing tip portions at the distal ends of the resilient arm assemblies to be thrust into the adjacent vertebrae. In some embodiments, each tip portion forms a cleft in the respective vertebral endplate and deposits the tether therein. The tether is thereby anchored directly in the clefts, without need for separately formed anchors. In some embodiments, devices and methods are disclosed to route the tether through an implanted spinal implant.

A method of manufacturing an implant, including mixing a first quantity of biocompatible polymer particles, a second quantity of bioactive ceramic particles, and a third quantity of fugitive material particles to define an admixture, forming the admixture to define a composite body having an inferior portion, a superior portion and a central portion disposed between the inferior and superior portions, heating the admixture to fuse the first quantity of bioactive polymer particles to define a composite implant body, and infiltrating the composite implant body with a solvent to remove fugitive material particles to yield a network of interconnected pores and to define a porous implant body. The fugitive material particles are hollow spheres partially filled with a material selected from the group comprising air, bioactive agents, biological growth enhancers, drugs, and biocompatible polymer material, combinations thereof.

A modular spacer device for a knee joint includes a tibial element adapted to be constrained to an end of the tibial bone and a femoral element adapted to be constrained to an end of the femoral bone and to be articulated on the tibial element. The tibial element has first and second surfaces opposite to each other, and the femoral element has first surface and second surfaces opposite to each other. The first surface of the femoral element is convex and laterally has a curved, ammonite-shaped contour with a curvature radius that increases starting from a rear section with a curvature radius R1, a first central section having a curvature radius R2, a second central section having a curvature radius R3, and a front section having a curvature radius R4, with R1≤R2≤R3≤R4.

The present invention relates to an expandable prosthetic implant device for engagement between vertebrae generally comprising an inner member, outer member, and gear member positioned coaxial with respect to each other such that the inner and outer members are moveable relative to each other along an axis. The gear member is axially fixed to the outer member and freely rotatable with respect to the outer member and the gear member threadedly engages a threaded portion of the inner member to translate inner member along the axis. The implant is configured to engage the vertebrae in a predetermined alignment and the gear member includes gear teeth exposed to the exterior and configured to be accessible by a tool member at a plurality of angular positions around the perimeter of the implant device.

An acetabular shell insertion tool with an anti-rotation feature is provided. The insertion tool attaches to an acetabular shell including a center hole having an internal threading and an anti-rotation recess disposed around the center hole and having a predetermined shape. The insertion tool includes an outer shaft and an inner shaft disposed within the outer shaft. The outer shaft has an anti-rotation projection shaped to be received in the anti-rotation recess of the acetabular shell so as to prevent rotation of the outer shaft relative to the acetabular shell, thereby preventing the insertion tool from disengaging from the shell. The inner shaft has a threaded tip adapted to be threaded into the internal threading of the center hole to lock the insertion tool to the acetabular shell.

The present invention describes methods, devices and instruments for resurfacing or replacing facet joints, uncovertebral joints and costovertebral joints. The joints can be prepared by smoothing the articular surface on one side, by distracting the joint and by implant insertion.

Implants can be stabilized against a first articular surface by creating a high level of conformance with said first articular surface, while smoothing the second articular surface with a surgical instrument with a smooth mating implant surface.