Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Application	Content	Paragraph Number	Notes	Modified
		Content		Paragraph Number	Notes	Any Field
View Edit Delete	PER-8 PROV	The surgical osteotomy may be the Evans calcaneal osteotomy or the medializing calcaneal osteotomy. The first bone may be the calcaneus. The cutting guide may further have a second bone engagement surface shaped to match a second contour of the calcaneus such that, with the first bone engagement surface overlying the first contour and the second bone engagement surface overlying the second contour, the first guide feature is positioned to guide a cutter to resect the calcaneus to perform the Evans calcaneal osteotomy or the medializing calcaneal osteotomy.	21	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	The system may further have an implant with a first bone-facing surface with a first shape that matches a first profile of a first resected surface of the first bone after resection of the first bone with the cutting guide, and a second bone-facing surface comprising a second shape that matches a second profile of a second resected surface of the first bone or a second bone of the one or more bones after resection of the first bone or a second bone with the cutting guide.	22	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	According to some embodiments, a cutting guide may be provided for correcting a bunion present a patient’s foot. The cutting guide may have a first bone engagement surface shaped to match a first contour on cuneiform of the patient’s foot, and a second bone engagement surface shaped to match a second contour on a metatarsus of the patient’s foot. The cutting guide may further have a first slot that, with the first bone engagement surface overlying the first contour and the second bone engagement surface overlying the second contour, is positioned to guide resection of the cuneiform to define a first resected surface on the cuneiform. Further, the cutting guide may have a second slot that, with the first bone engagement surface overlying the first contour and the second bone engagement surface overlying the second contour, is positioned to guide resection of the metatarsus to define a second resected surface on the metatarsus. The first slot and the second slot may be positioned and oriented relative to each other such that, upon fusion of the cuneiform and the metatarsus between the first resected surface and the second resected surface, the bunion is at least partially corrected.	23	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figure 1A is a flowchart diagram depicting a method for correcting a bone condition, according to one embodiment.	24	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figure 1B is a flowchart diagram depicting a method for correcting bunion deformity of the human foot, according to one embodiment.	25	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figure 2 is a perspective view of a portion of a foot with a bunion deformity to be treated through use of the methods of Figures 1A and/or 1B, according to one embodiment.	26	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figures 3A, 3B, 3C, and 3D are top perspective, alternative top perspective, front elevation, and bottom perspective views, respectively, of a patient-specific cutting guide, according to one embodiment	27	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figure 4 is a perspective view of the foot of Figure 2, with the cutting guide of Figures 3A, 3B, 3C and 3D properly positioned on the first cuneiform and the first metatarsus, but as yet not attached to the first cuneiform and the first metatarsus.	28	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figure 5 is a perspective view of the foot of Figure 2, with the cutting guide of Figures 3A, 3B, 3C, and 3D properly positioned on the first cuneiform and the first metatarsus and attached to the first cuneiform and the first metatarsus in preparation for resection of the first cuneiform and the first metatarsus, according to one embodiment.	29	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figure 6A is a perspective view of the foot of Figure 2, after resection of the first cuneiform and the first metatarsus, removal of the cutting guide, and placement of the first metatarsus to abut the first cuneiform, according to one embodiment.	30	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figures 6B and 6C are dorsal views of the foot of Figure 2, before and after correction, respectively, according to one embodiment.	31	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figures 7A, 7B, 7C, and 7D are top perspective, alternative top perspective, front elevation, and bottom perspective views, respectively, of a patient-specific cutting guide according to one alternative embodiment.	32	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Figures 8A, 8B, and 8C are dorsal pre-operative, dorsal post-operative, and lateral post-operative views, respectively, of a foot treated with an Evans calcaneal osteotomy, according to one embodiment.	33	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	After the cut has been made to split the calcaneus 1000 into the first bone segment 1040 and the second bone segment 1042, the surgeon may angle the second bone segment 1042 relative to the first bone segment 1040 in the predetermined (previously modeled) relative orientation. This reorientation between the first bone segment 1040 and the second bone segment 1042 may leave a wedge-shaped gap between the first bone segment 1040 and the second bone segment 1042. In order to maintain the desired relative orientation, an implant 1060 with a wedge shape may be inserted into the gap and secured to the first bone segment 1040 and the second bone segment 1042. The implant 1060 may be fabricated specifically for the patient, since the precise angulation and position of the realignment may also be patient specific. As shown, the implant 1060 may have exterior surfaces that are contoured to match the contours of the adjoining portions of the first bone segment 1040 and the second bone segment 1042. Thus, the implant 1060 may provide secure fixation, while not protrude beyond the adjoining surfaces of the first bone segment 1040 and the second bone segment 1042. Thus, the implant 1060 may be devoid of proud edges or other protrusions that could otherwise interfere with motion between the calcaneus 1000 and the talus 1010, or with surrounding soft tissues, thus interfering with the patient’s post-operative gait.	105	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	In the embodiment of Figures 7A through 7D, the guide features may guide a reciprocating planar blade, such as that of a surgical bone saw, that forms planar cuts in the first cuneiform 210 and the first metatarsus 230. Thus, the guide features may take the form of a first slot 750 and a second slot 752, which may be positioned toward the center of the body 710, on opposite sides of the joint probe 720. Thus, upon proper positioning of the cutting guide 700, the first slot 750 may be positioned over the first cuneiform 210 to facilitate resection of the first cuneiform 210, while the second slot 752 may be positioned over the first metatarsus 230 to facilitate resection of the first metatarsus 230.	94	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	In operation, the cutting guide 700 may be used in a manner similar to that of the cutting guide 300. However, the cutting guide 700 may only be secured to each of the first cuneiform 210 and the first metatarsus 230 with a single pin or K-wire (not shown), as mentioned previously. Further, the cutting guide 700 is smaller than the cutting guide 300. Thus, the cutting guide 700 may be placed through a smaller, less invasive incision. One advantage to patient-specific instrumentation may be that instruments may be made smaller, since they are not limited to certain sizes. Many known instruments come in discrete sizes, each of which is designed to accommodate a range of patient anatomic dimensions. Thus, for given patient anatomy, the instrument must be large enough to treat the anatomy at either end of its range. This typically requires the instrument to be oversized for many anatomic dimensions it is designed to treat. Notably, the cutting guide 700 is merely one compact example; other cutting guides may be made even smaller; in some embodiments, cutting guides may be made that have a smaller width between holes (e.g., holes 740 on the cutting guide 700). As long as the holes are sufficiently far apart to avoid interference of the pins 500 with the operation of the cutting blade, the cutting guide may function appropriately. Thus, Lapidus and other procedures may be accomplished through a very narrow incision through the use of patient-specific instrumentation.	95	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Those of skill in the art will recognize that a wide variety of differently configured cutting guides may be used in conjunction with the method 120 set forth above. Further, a wide variety of patient-specific instruments may be used in connection with the method 100, including but not limited to cutting guides, gages, implant positioning guides, joint distractors, joint compressors, soft tissue retractors, and the like.	96	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	Furthermore, patient-specific cutting guides may be used for various other procedures on the foot, or on other bones of the musculoskeletal system. Patient-specific cutting guides may be used for various procedures involving osteotomy, including but not limited to arthroplasty, fusion, and deformity correction procedures. According to one example, patient-specific cutting guides similar to the cutting guide 300 and the cutting guide 700 may be used for the metatarsophalangeal (“MTP”) joint. A method similar to the method 100 may be employed.	97	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	In some embodiments, one or more articulating surfaces of a joint may be replaced and/or resurfaced. For example, for the MTP joint, a patient-specific cutting guide may be used to determine the angles of cuts on the distal metatarsus or the proximal phalanx in preparation for replacement or resurfacing of the metatarsal head and/or the proximal phalangeal base. Implants for either the metatarsus or the phalanx may be customized to match the patient’s original anatomy, such as the curvature of the MTP joint. In other embodiments, an MTP joint may be fused through the use of patient-specific cutting guides. Patient-specific cutting guides may be used to treat (for example, via fusion, resurfacing, and/or arthroplasty) any joint in the body, using methods similar to the method 100.	98	Added by DJM 7 2021	7/2/21, 12:00 AM
View Edit Delete	PER-8 PROV	According to other examples, patient-specific cutting guides may be used to carry out an Evans calcaneal osteotomy and/or a medializing calcaneal osteotomy. Patient-specific instruments will be shown and described in connection with Figures 8A through 11, in relation to an Evans calcaneal osteotomy, and a medializing calcaneal osteotomy.	99	Added by DJM 7 2021	7/2/21, 12:00 AM

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