An implant assembly for a long bone having a longitudinal axis. The implant assembly has a stem that is received in a surgically prepared medullary canal of the long bone. The stem defines at least one transverse through-opening that extends through the stem from a first portion of the outer surface of the stem to an opposed second portion of the outer surface of the stem. Each transverse through-opening has a central axis that is substantially perpendicular to the longitudinal axis of the stem. Each transverse through-opening receives a fastener and has a longitudinal dimension, measured relative to the longitudinal axis of the stem, that is sufficient to permit axial movement, relative to the longitudinal axis of the stem, of the stem relative to each fastener.

Systems are described for conducting minimally invasive medical interventions utilizing instruments and assemblies thereof to stabilize and/or fixate a dysfunctional sacroiliac (SI) joint. The systems include a drill guide having a bone dislodging member adapted to create a pilot SI joint opening in the dysfunctional SI joint through an incision comprising a length no greater than 3.0 cm; portions of the pilot SI joint opening being disposed in the sacrum and ilium bone structures. The drill guide includes a tri-mode fixation system adapted to position and stabilize the drill guide during creation of the pilot SI joint opening in the dysfunctional SI joint and delivery of the SI joint prosthesis therein. The systems also include a SI joint prosthesis configured to be inserted into the pilot SI joint opening of the dysfunctional SI joint, a prosthesis deployment assembly configured to engage the SI joint prosthesis and advance the SI joint prosthesis into the dysfunctional SI joint, and a bone harvesting assembly adapted to extract and collect dislodge bone material from the bone dislodging member after creation of the pilot SI joint opening.

A bone screw fixation system includes a bone screw body having a screw head at one end of the screw and a screw tip at an opposite end of the screw, the screw head having an internal complex geometric shaped drive and internal threads within the screw head; and a screw inserter compatible with the screw head and having a complex geometric shaped drive configured to matingly engage the internal complex geometric shaped drive of the screw head and a threaded tip configured to thread into the internal threads of the screw head.

The present disclosure is directed offset adapters, trial implant systems, shoulder implant systems, and methods for total shoulder replacement, wherein the eccentricity of a humeral head relative to a humeral anchor and resected proximal portion of a humerus is selectable by a surgeon. A humeral head implant system includes a humeral head, an adapter, and humeral anchor. An offset adapter is operable to connect the humeral head to a humeral anchor. The offset adapter includes a first tapered cylindrical portion having a first axis, a second tapered cylindrical portion having a second axis, and the first axis being eccentrically disposed relative to the second axis of the adapter. A trial humeral head system includes a trial humeral head, a pin guide, and a trial adapter.

A method is disclosed for introducing a spinal disc implant into an intervertebral space of a subject. The subject is placed in a lateral position, and the anterior face of the spinal disc intervertebral space is accessed, between the L5 and S1 vertebrae, from an anterior and lateral retroperitoneal approach. An operative corridor to the anterior face of the spinal disc space is established by introducing a retractor instrument anterolaterally to the spinal disc space between the anterior superior iliac spine and the anterior inferior iliac spine. The damaged spinal disc contents are removed from the intervertebral space through the operative corridor, and the implant is advanced into the intervertebral space at an oblique angle and pivoted to position the implant substantially laterally within the intervertebral space. Elongated retractor and insertion instruments, as well as a modified disc implant, are also disclosed for carrying out the method.

This disclosure provides vertebral implants, fastening devices for vertebral implants, and implant instrumentation, and various combinations thereof. In some embodiments, the implant comprises a peripheral wall extending according to a vertical axis between upper and lower surfaces of the implant, with each such surface configured to be placed in contact with a vertebral structure, respectively, at the top and the bottom of the vertebral segment replaced by the implant. Some embodiments comprise fastening means, deployment of which anchors the implant in the lower and upper vertebral structures. Some fastening means may be deployed by sliding parallel to the vertical axis of the implant, and may comprise a plate with at least one part remaining in contact with the peripheral wall of the implant when deployed and a pointed end projecting from one of the upper and lower surfaces of the implant to enter a vertebral structures on completion of deployment.

A device for insertion into a gap between adjacent, spaced apart bony elements includes an adjustable length interconnecting member having a distal and a proximal retention plate secured to opposite ends of the interconnecting member. The distal retention plate has a non-rotated position and a plurality of rotated positions. The non-rotated position aligns the distal retention plate with the gap prior to and during insertion of the distal retention plate into the gap. The distal retention plate is rotated after it has exited the gap on a distal side of the gap to prevent its return into the gap. The proximal retention plate is misaligned with the gap so that it cannot enter into the gap. The rotated distal retention plate cooperates with the proximal retention plate to hold bony elements such as adjacent vertebral bodies in a stable relationship to one another when the interconnecting member is shortened.

Assemblies of one or more implant structures make possible the achievement of diverse interventions involving the fusion and/or stabilization of the SI-joint and/or lumbar and sacral vertebra in a non-invasive manner, with minimal incision, and without the necessitating the removing the intervertebral disc. The representative lumbar spine interventions, which can be performed on adults or children, include, but are not limited to, SI-joint fusion or fixation; lumbar interbody fusion; translaminar lumbar fusion; lumbar facet fusion; trans-iliac lumbar fusion; and the stabilization of a spondylolisthesis.

The present invention relates to the diagnosis and treatment of joint-related diseases, in particular osteoarthritis. Based on the analysis of the microarchitecture, such as microchannels, of the subchondral bone, the present invention provides methods for evaluating the health state of a joint as well as determining whether a joint is prone to develop or has already developed a disease correlated to joint and cartilage destruction. The invention further provides for membranes and other implants mimicking healthy subchondral bone structure suitable for promoting regeneration of joint structure and function.

A spinal implant is provided including an upper surface, a lower surface, a front surface and a back surface, two side surfaces extending between the upper surface and the lower surface, the two side surfaces extending between the front surface and the back surface and an opening positioned closer to the back surface than the front surface. The opening is provided to contain graft material that spans between a cortical rim of the upper vertebral body and the cortical rim of the lower vertebral body. The method includes packing the opening with graft material, wherein the graft material spans between the decorticated cortical rim of the upper vertebral body and the decorticated cortical rim of the lower vertebral body.