Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-24	In one embodiment, the position and/or configuration of the resection feature 826 may be determined, defined, and/or dictated by both a bone model of a portion of a patient's foot and user instructions 604. Advantageously, the user instructions 604 may identify certain goals for the resection feature 826 such as minimal size (i.e., width, length, depth), shape, contour, position, orientation, trajectory, and the like. Since the resection feature 826 guides the formation of an osteotomy, the configuration of the resection feature 826 provided by the user instructions 604 can also define an osteotomy created using the resection feature 826.	246	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The resection feature 826 of the tibial resection guide 822 may be referred to as a tibia resection feature 864 and the resection feature 826 of the talus resection guide 824 may be referred to as a talus resection feature 866. In certain embodiments, this means that a user, or end user, may review the bone model, and a model of the tibial resection guide 822 and/or the talus resection guide 824 and based on these models determine, at least in part, where to position the resection feature 826 (e.g., tibia resection feature 864 and talus resection feature 866) within a resection guide 820. Advantageously, by reviewing and working with the models, a user and/or end user can minimize the amount of bone removed to perform a successful surgical procedure. Determining a position for the resection features 826 in a model of an instrument can be directly reflected in a fabricated instrument based on the model. In one embodiment, the position of a resection feature can be based on user instructions 604. Alternatively, or in addition, other features of a resection guide 820 can be based, at least partially, on user instructions 604.	247	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the tibia resection feature 864 is configured to guide a cutting tool to form a first osteotomy in a tibia of a patient. The talus resection feature 866 is configured to guide the cutting tool to form a second osteotomy in a talus of the patient. The first osteotomy and second osteotomy are configured to cooperate with each other to form a resection interface between the tibia and the talus of the patient. The resection interface is an interface between a resected portion of the tibia and a resected portion of the talus. In certain embodiments, these resected portions (e.g., cut faces) are brought into contact and fixation is deployed to promote fusion of the talus to the tibia at the resection interface. In certain embodiments, the resection interface includes no implant or other structure between the resected portion of the tibia and the resected portion of the talus. In contrast to an arthroplasty surgical procedure, the resection guides 820 are used for a bone fusion procedure, an arthrodesis. Thus, the interface in the embodiments of the present disclosure are for facilitating a joint fusion.	248	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIGS. 9A-9F illustrate views of a resection guide 820 (e.g., tibial resection guide 822) of the osteotomy system of FIG. 8, according to one embodiment. The tibial resection guide 822 includes one or more resection features 826, one or more bone attachment features 828 (e.g., a fastener 810 and opening), and one or more bone engagement features 830 which may include one or more bone engagement surfaces 832. In certain embodiments, bone engagement features 830 implemented in a tibial resection guide 822 are referred to as tibial bone engagement features.	249	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Advantageously, the resection features 826 can be positioned, sized, and/or oriented to enable a surgeon to resect any particular shape in the bone for the osteotomy procedure. In the illustrated embodiment, the resection features 826 are configured to direct a cutting tool at an angle in one or more planes into the bone. The angle may be normal to a longitudinal axis of the bone, at an oblique angle, at an acute angle, or at an obtuse angle relative to a longitudinal axis of the bone. Advantageously, the size, shape, and angle of the resection can be predefined and can be determined preoperatively and/or can be patient-specific. In manner, the tibial resection guide 822 serves to provide for a patient-specific osteotomy procedure. Alternatively, or in addition, the resection features 826 can be configured to enable a surgeon to readily resect in a plantar direction and/or a dorsal direction. In certain embodiments, the resection features 826 may include an opening on one end or the other or both ends to permit the surgeon to position a cutting tool to make desired cuts that can extend laterally or medially.	250	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In addition, the tibial resection guide 822 includes an anterior side 838, posterior side 840, a medial side 842, lateral side 844, superior side 846, and an inferior side 848. Generally, the sides of the tibial resection guide 822 refer to the direction the sides face when the resection guide 820 is in use. In certain embodiments, the tibial resection guide 822 can include a landmark registration feature 834.	251	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In the illustrated embodiment, at least one landmark registration feature 834 extends from the posterior side 840. Advantageously, the landmark registration feature 834 can provide a surgeon with confidence and assurance in the placement and positioning of the tibial resection guide 822 on the bone because the landmark registration feature 834 can be configured to engage with a particular landmark on the bone (e.g., a projection or a depression or cavity). Alternatively, or in addition, the landmark registration feature 834 can include a contoured bone engagement surface 832 that can further facilitate registration of the landmark registration feature 834 and/or tibial resection guide 822 with the bone. In this manner, a surgeon can be assured intraoperatively that the tibial resection guide 822 is being positioned as desired.	252	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In certain embodiments, the landmark registration feature 834 can be shaped like a hook to engage a surface or structure of a bone. Alternatively, or in addition, the tibial resection guide 822 may include a landmark registration feature 834 on each end (lateral and medial), together the landmark registration features 834 can engage one or more landmarks of a surface of the bone such that the surgeon can accurately position and register the tibial resection guide 822 to the bone.	253	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In the illustrated embodiment, the tibial resection guide 822 is shaped such that the superior side 846 is not as wide as the inferior side 848. This shape can be advantageous because this enables the tibial resection guide 822 to be smaller towards the proximal end of the tibia 226. The inferior side 848 may be just large enough to support the resection feature 826. This triangular shape of the tibial resection guide 822 allows for a minimal length and width for the opening in the skin and soft tissue of the patient in order to secure the tibial resection guide 822 to the tibia 226.	254	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIGS. 9E and 9F illustrate the bone engagement surface 832 of an example tibial resection guide 822. The bone engagement surface 832 facilitates registration of the tibial resection guide 822 to the tibia 226. The position of the tibial resection guide 822 on a distal end of the tibia 226 may be determined by a surgeon preoperatively.	255	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 9F illustrates that the bone engagement surface 832 may be part of a tibial bone engagement feature 830 which may be part of a tibial resection guide 822. A bone engagement feature is any structure configured to engage or assist in the engagement of one or more bones. Thus, any structure that engages or assists in the engagement of a resection guides 820 with a bone is a bone engagement feature.	256	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 9F illustrates two examples of a bone engagement feature 830, tibial bone engagement feature of the tibial resection guide 822. In the illustrated embodiment, the bone engagement feature 830 includes a body section (i.e. part of the body 836) that is coupled to and/or supports a bone engagement surface 832. The bone engagement surface 832 is configured to register to (i.e. seated or fit with) a surface of the tibia, directly below and/or in contact with the body section when the tibial resection guide 822 is in use. As one example, this means that projections from the surface of the tibia 226 fit within voids in the bone engagement surface 832 when the tibial resection guide 822 is in use and in a desired position relative to a position of a model of the tibial resection guide 822 in relation to a model of a patient’s tibia 226.	257	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 9F illustrates that structurally, the tibial resection guide 822 may be able to function without the body sections identified as part of the bone engagement features 830. However, in the illustrated embodiment, the size (length, width, height) of the tibial resection guide 822 may be determined, defined, and/or dictated at least in part based on user instructions 604. Thus, the surgeon may also provide instructions for the number, size, and/or configuration of bone engagement feature 830 of the tibial resection guide 822. The bone engagement features 830 may not be needed structurally, however, they may be very helpful to a surgeon in positioning the tibial resection guide 822 in a desired position relative to a bone of a patient.	258	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	These user instructions 604 may have initiated the design and/or fabrication of the tibial resection guide 822. For example, a surgeon may have desired to have as much surface area on the posterior side 840 as possible while still keeping the overall size of the tibial resection guide 822 as small as practicable. Accordingly, in the illustrated embodiment, a surgeon may have indicated that two bone engagement feature 830 that includes bone engagement surface 832 are to be positioned and sized as indicated between the bone attachment features 828 and the tibia resection feature 864. In this manner, a surgeon may maximize an amount of surface area of the tibial resection guide 822 that contacts a tibia 226 to facilitate initial positioning intraoperatively to match or substantially match a position planned using a model of the tibial resection guide 822 and a model of the tibia 226. In certain embodiments, a surgeon may, at their discretion, include in the user instructions 604, instructions to add another body section that includes a bone engagement surface 832 to a medial side 842, a lateral side 844, a superior side 846, and/or an inferior side 848 of the tibial resection guide 822.	259	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 9G illustrates a cross section view of the tibial resection guide 822 in FIG. 9F taken along line 9G. FIG. 9G illustrates angles for bone attachment features 828 (e.g., fasteners 810 in openings). In the illustrated embodiment, the angles cause the bone attachment features 828 to diverge as they extend into the bone. Advantageously, a surgeon may predefine an angle for one or more bone attachment features 828 preoperatively.	260	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 9H illustrates a cross section view of the tibial resection guide 822 in FIG. 9F taken along line 9H. FIG. 9H illustrates angles for openings 868 that can cooperate with fastener 810 to provide resection guards 870. In the illustrated embodiment, the angle of the opening 868 nearest the lateral side 844 starts on the anterior side 838 and extends medially through the tibial resection guide 822 such that the fastener 810 extends at this same angle into the tibia 226. In contrast, the angle of the opening 868 nearest the a medial side 842 starts on the anterior side 838 and extends perpendicular to the anterior side 838 through the tibial resection guide 822 such that the fastener 810 extends at this same angle into the tibia 226. Advantageously, a surgeon may predefine one or more of these angles for resection guards 870 preoperatively.	261	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIGS. 10A-10F illustrate views of a resection guide 820 (e.g., talus resection guide 824) of the osteotomy system of FIG. 8, according to one embodiment. The talus resection guide 824 includes one or more resection features 826 (e.g., resection features 826a-b), one or more bone attachment features 828 (e.g., a fastener 810 and opening), and one or more bone engagement features 830, which may include a bone engagement surface 832. In certain embodiments, bone engagement features 830 implemented in a talus resection guide 824 are referred to as talus bone engagement features.	262	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 10F illustrates that the bone engagement surface 832 may be part of a bone engagement feature 830 which may be part of a talus resection guide 824. In the illustrated embodiment, the bone engagement surface 832 may be part of a talus bone engagement feature 830. FIG. 10F illustrates one example of a bone engagement feature 830, talus bone engagement feature of the talus resection guide 824. In the illustrated embodiment, the bone engagement feature 830 includes a body section (i.e. part of the body 850) that is coupled to and/or supports a bone engagement surface 832. The bone engagement surface 832 is configured to register to (i.e. seated or fit with) a surface of the talus, directly below and/or in contact with the body section when the talus resection guide 824 is in use. As one example, this means that projections from the surface of the talus 222 fit within voids in the bone engagement surface 832 when the talus resection guide 824 is in use and in a desired position relative to a position of a model of the talus resection guide 824 in relation to a model of a patient’s talus 222.	263	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 10F illustrates that structurally, the talus resection guide 824 may be able to function without the body section identified as part of the bone engagement features 830. However, in the illustrated embodiment, the size (length, width, height) of the talus resection guide 824 may be determined, defined, and/or dictated at least in part based on user instructions 604. Thus, the surgeon may also provide instructions for the number, size, and/or configuration of bone engagement feature 830 of the talus resection guide 824. The bone engagement features 830 may not be needed structurally, however, they may be very helpful to a surgeon in positioning the talus resection guide 824 in a desired position relative to a bone of a patient.	264	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	These user instructions 604 may have initiated the design and/or fabrication of the talus resection guide 824. For example, a surgeon may have desired to have increased surface area on the posterior side 854 and medial side of the talus resection guide 824 as possible while still keeping the overall size of the talus resection guide 824 as small as practicable. Accordingly, in the illustrated embodiment, a surgeon may have indicated that one bone engagement feature 830 that includes bone engagement surface 832 is to be positioned and sized as indicated on the medial side between the resection feature 826a and the resection feature 826b. In this manner, a surgeon may selectively include surface area on the posterior side 854 of the talus resection guide 824 that contacts a talus 222 to facilitate initial positioning intraoperatively to match or substantially match a position planned using a model of the talus resection guide 824 and a model of the talus 222. In certain embodiments, a surgeon may, at their discretion, include in the user instructions 604, instructions to add another body section that includes a bone engagement surface 832 to a lateral side 858, a medial side 856, superior side 860, and/or inferior side 862 of the talus resection guide 824.	265	Added by DJM Jan 2024	1/6/24, 10:01 PM

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