Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	TMC-PAT-4	Those of skill in the art will appreciate that a patient-specific bone engagement feature 912 can take a variety of forms and/or configurations and can include a single structure or a plurality of structures that together form the patient-specific bone engagement feature 912. The patient-specific bone engagement feature 912 can be a single surface (e.g., a bone engagement surface) that is contoured, a plurality of surfaces or portions or sections that are contoured to match a contour of a bone or tissue surface, a surface in cooperation with a body structure that accounts for rises or falls in a contour of the one or more bones. Alternatively, or in addition, a patient-specific bone engagement feature 912 can include a structure and/or arm or other structure that extends from the body 900 and supports a contoured bone engagement surface.	323	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In the example of FIG. 9C, the patient-specific bone engagement feature 912 can take the form of a bone engagement surface 944. The bone engagement surface 944 may include a portion, some, or all of a surface of one side of a resection guide 820b. In certain embodiments, a bone engagement surface 944 can include two or more sections 944a, 944b. Each section may be a bone engagement surface 944. Alternatively, or in addition, one section may be a bone engagement surface 944 and another section may be planar or not contoured to match or mirror a surface of one or more bones and/or other tissue of a patient.	324	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In certain embodiments, the bone engagement surface 944 includes a patient-specific feature that is defined to interface with at least a portion of a surface that includes one or more bones of a patient. The patient-specific feature can be a single feature or a plurality of features. These features may be structures that are configured and sized to fit into and/or engage with corresponding features of a surface. For example, one feature may be a protrusion, projection, extension, or the like sized and shaped to fit within a recess or opening or cavity in a surface of, or between, bones of a patient. Alternatively, a patient-specific feature can be an opening, recess, cavity, detent, or the like sized and shaped to accept a projection, extension or the like from a surface or other structure of, or between bones, of a patient.	325	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In one embodiment, an example patient-specific bone engagement feature 912 includes a bone engagement surface 944 that is one at least a portion of one side of the resection guide 820b. The bone engagement surface 944 includes one or more patient-specific features. In one embodiment, the feature is a contoured surface. In another embodiment, the feature may be a plurality of extensions and/or recesses that match, mate, and/or fit within corresponding extensions and/or recesses of a surface. The patient-specific feature is defined to interface with at least a portion of a surface that includes one or more bones of a patient. In the illustrated embodiment, the bone engagement surface 944 covers some of the inferior side 916 of the resection guide 820b. In another embodiment, the bone engagement surface 944 can cover all of the inferior side 916.	326	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In one embodiment, the bone engagement surface 944 is on a bone facing and/or bone contacting side of a resection guide 820b. In certain embodiments, the bone engagement surface 944 can extend across at least sixty-percent of a surface area of a side of the resection guide 820b. In another embodiment, can extend across at least ninety-percent of a surface area of a side of the resection guide 820b. In another embodiment, can extend across one hundred percent of a surface area of a side of the resection guide 820b. In another embodiment, can extend across at least twenty-percent of a surface area of a side of the resection guide 820b.	327	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	Referring to FIG. 9E, in certain embodiments, the patient-specific bone engagement feature (e.g., a bone engagement surface 944) is coupled to an inferior side 916 of the body 900. Alternatively, or in addition, the body 900 can extend from a medial side M of a foot bone over a dorsal side D of the foot bone to a lateral side L of the foot bone. In this manner, the patient-specific bone engagement feature can contact at least three points on the foot bone. These three contact points can provide a stable and secure placement of the resection guide 820b. In certain embodiments, the patient-specific bone engagement feature (e.g., a bone engagement surface 944) is configured to engage at least a portion of a cuneiform and at least a portion of a metatarsal of a patient when the resection guide 820b is used. The patient-specific bone engagement feature, such as a bone engagement surface 944 and/or a landmark registration feature 960 (discussed below), can include a contour that is at least partially determined based on a bone model of a patient’s foot. The bone model may be defined based on medical imaging of the patient’s foot.	328	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	FIGs 9A, 9D, 9E, 9F, and 9G illustrate a landmark registration feature 960. The landmark registration feature 960 serves to facilitate registration of a guide 820b. In one embodiment, the landmark registration feature 960 is configured to contact and/or engage with a surface of one or more bones. In another embodiment, the landmark registration feature 960 is configured to contact and/or engage with one or more landmarks of one or more bones or other tissues of a patient. In another embodiment, the landmark registration feature 960 is configured to contact and/or engage with a joint and/or parts of a joint, such as a TMT joint, of a patient. For example, in one embodiment, the landmark registration feature 960 is configured to fit between articular surfaces of a cuneiform and a metatarsal of a TMT joint.	329	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	The resection guide 820b can include one or a plurality of landmark registration features 960. In the illustrated embodiment, the resection guide 820b includes a landmark registration feature 960 that may also be referred to as a “joint seeker” or “seeker”. Given the shape of the example landmark registration feature 960, the landmark registration feature 960 may also be referred to as a blade.	330	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	The landmark registration features 960 can extend from one or more sides of the resection guide 820b. In the illustrated embodiment, the landmark registration feature 960 extends from inferior side 916. Specifically, in the illustrated example, the landmark registration feature 960 extends from a lateral side of the inferior side 916. Those of skill in the art will appreciate that the landmark registration features 960 can have various lengths, widths, and thicknesses.	331	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	Advantageously, the landmark registration features 960 can also include a bone engagement surface section that may function like a bone engagement surface 944. For example, the landmark registration feature 960 may include a proximal surface 962 and a distal surface 964. In certain embodiments, one or the other, or both of the proximal surface 962 and the distal surface 964 may be contoured to correspond to an articular or other surface of one or more bones of a patient. Thus, the proximal surface 962 and/or the distal surface 964 may include a bone engagement surface 944.	332	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In the illustrated embodiment, one landmark registration feature 960 extends from the inferior side 916. Advantageously, the landmark registration feature 960 can provide a surgeon with confidence and assurance in the placement and positioning of the resection guide 820b in a joint (e.g., TMT joint) because the landmark registration feature 960 can be configured to engage with a particular landmark of the joint, on one of the bones, or other patient anatomy (e.g., a projection or a depression or cavity). In this manner, a surgeon can be assured intraoperatively that the resection guide 820b is being positioned in a desired position in accordance with a preoperative plan.	333	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In certain embodiments, the landmark registration feature 960 can be shaped like a hook, arm, or extension that extends to engage a surface of bone (See FIGS. 10A-10G). Alternatively, or in addition, the resection guide 820b may include a landmark registration feature 960 on different sides or on opposite sides. Together the landmark registration features 960 can engage one or more landmarks of a surface of the bone and/or a joint such that the surgeon can accurately position and register the resection guide 820b.	334	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	The landmark registration features 960 are connected to the body 900 and configured to contact or engage with one or more bones of the patient. Advantageously, the landmark registration feature 960 can be defined from the bone model 404. Consequently, the landmark registration feature 960 can be sized, shaped, and/or configured to engage particular landmarks of one or more bones, one or more surfaces, and/or one or more joints of the bones of the patient.	335	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	Referring to FIGs. 9B and 9C, the example resection guide 820b has a length that extends from the proximal end 824 or proximal side 918 to the distal end 826 or distal side 920 such that the body 900 spans a tarsometatarsal (“TMT”) joint of a patient. Specifically, the body 900 can be sized to extend from a cuneiform to a metatarsal of a patient. In one embodiment, the body 900 extends from a medial cuneiform 202 across a first TMT and to a first metatarsal 208. Advantageously, a resection guide 820b that spans the TMT is configured to prepare both a cuneiform and a metatarsal for an arthrodesis procedure using a single resection guide 820b.	336	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	As described in the present disclosure, a resection guide 820b can be specifically designed for a particular patient. The resection guide 820b is patient-specific. The resection guide 820b facilitates making one or more osteotomies through one or more bones of a midfoot of a patient. In addition, the resection guide 820b assists a surgeon in knowing that a position of a resection guide 820b during surgery is the same or substantially the same as a predetermined position defined earlier. In one embodiment, the predetermined position is a position that has been defined and/or confirmed and/or agreed to by the surgeon using the bone model 404 and/or a model of the resection guide 820b. In the system 400, for example, a surgeon can use a registration module 440 to register a preliminary model of the resection guide 820b to one or more bones of the bone model 404. Using the apparatus 402, a surgeon can leverage a patient-specific model of one or more bones of a patient and a model of the resection guide 820b to define one or more patient-specific bone engagement features for the resection guide 820b. In this manner, the predetermined position includes a position on one or more bones of a patient. The predetermined position may be defined preoperatively using a model of a resection guide and a bone model.	337	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	Referring still to FIGs. 9A through 9G, the body 900 may further have features that facilitate visualization of a user an orientation and/or axes of one or more bones of the midfoot. For example, in the illustrated embodiment, the resection guide 820b may include at least one alignment feature. An alignment feature may be integrated into the resection guide 820b or the alignment feature may be a separate feature from the resection guide 820b. The alignment feature can be a strategically placed opening sized to hold a guide pin or K-wire such that the K-wire indicates a direction and/or trajectory of a bone or an axis of a bone.	338	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	FIG. 9H illustrate a perspective view of an alignment guide 980 that can be used with certain embodiments. Prior to resection or making any osteotomies, a surgeon may desire to check or confirm that the desired resection guide 820b is being used and that a selected resection guide 820b will provide a desired alignment between the bones of the foot after the resection and fixation steps.	339	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	Accordingly, in the illustrated embodiment, the resection guide 820b may include one member of a coupler configured to engage a corresponding member of the coupler coupled to an alignment guide 980. Those of skill in the art appreciate that various designs of a coupler may be used. In the illustrated embodiment, the coupler includes an opening 838 (See FIGs. 9A-9C) that may extend from the superior side 914 into the body 900 through to the inferior side 916 and a post 982. In one embodiment, the opening 838 may include one of the slots or resection features, such as proximal resection feature 902. The post 982 may include an engagement member 984.	340	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In one embodiment, the opening 838 and the post 982 engage each other in a friction fit. For example, the post 982 may slide into the proximal resection feature 902 and the engagement member 984 may slide into the opening 838. In one embodiment, the engagement member 984 may include tabs that are biased outward and greater than a diameter of the opening 838 such that the tabs engage the opening 838 when inserted and release the opening when the tabs are pressed together.	341	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	The alignment guide 980 includes a body 986, an inferior end 988, and superior end 990 and one or more openings 992 near the superior end 990. The openings 992 may be aligned. A surgeon may use the alignment guide 980 by engaging the coupler to couple the alignment guide 980 to the resection guide 820b. Next, a surgeon may insert one or more K-wires through the openings 992. The openings 992 and alignment guide 980 may be configured such that K-wires within the openings extend along an anterior-posterior axis and indicate the orientation and alignment of a first cuneiform and first metatarsal once an osteotomy procedure is completed. A surgeon may compare this alignment with the orientation and alignment of other bones of the patient (e.g., a second metatarsal). In this manner, a surgeon can confirm that an osteotomy procedure will accomplish the desired outcome once completed.	342	Added by DJM Jan 2024	1/3/24, 4:24 AM

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