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Delete 		PER-24 FIGs. 14A-14B illustrate views of resection guides of an osteotomy system 1400, according to alternative embodiments. FIG. 14A illustrates an alternative embodiment of a resection guide 820. The osteotomy system 1400 includes resection guide 1402. 317 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The resection guide 1402 of osteotomy system 1400 can include some or all of the same or substantially the same features, aspects, and/or components as the resection guides 820 described herein with like components including the same reference numerals. Accordingly, the resection guide 1402 can or may include one or more tibia resection features 864, one or more talus resection feature 866, one or more bone attachment features 828, one or more bone engagement features 830, one or more alignment guides 874, one or more shafts 878, one or more openings 868, one or more resection guards 870, one or more fastener guides 890, and the like. 318 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The resection guide 1402 may differ from other resection guides 820 described herein because the resection guide 1402 may include one or more tibia resection features 864 connected to one or more talus resection feature 866 by a single body. The body may extend from a distal end of the tibia 226 to the proximal end of the talus 222 across the ankle joint. In one embodiment, the single body may simply connect the tibia resection feature 864 and/or talus resection feature 866. Alternatively, or in addition, the single body may include a posterior side that includes a bone engagement surface configured to engage bones of the tibia and talus and engage with a space between the bones within the ankle joint. Advantageously, such a bone engagement surface can assist a surgeon in ensuring that that resection guide 1402 is properly positioned before being connected and/or attached to the bone(s). In one embodiment, the part of the body between the tibia resection feature 864 and the talus resection feature 866 can be a bone engagement feature 830. 319 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 As described herein, a surgeon can dictate whether the resection guides 820 is a single guide as in resection guide 1402, whether a bone engagement feature 830 is between the resection features 826, how many bone engagement features 830 to include, how many resection features to include, the configuration of the resection features, the configuration of the bone engagement features, and the like. A surgeon can also control whether the resection guide 1402 will include fastener guides 890 and/or an alignment guide 874. In one embodiment, a portion of the body that extends from a distal end of the tibia 226 to the proximal end of the talus 222 across the ankle joint (e.g., between the resection features 826) may also include a plurality of openings in a pattern. The openings may be six sided (i.e., hexagons). The openings may serve to facilitate visibility for a surgeon of the bones and/or space between the bones of the joint, particularly when the surgeon uses flouroscopy to confirm positioning and/or steps for a surgical procedure. 320 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The resection guide 1402 can include a first resection feature 826 (e.g., tibia resection feature 864) coupled to a body of the resection guide 1402. The resection feature 826 can be configured to guide a cutting tool for form a first osteotomy in a first bone, such as a tibia 226. The first osteotomy is defined at least partially based on user directions and/or at least partially based on a bone model of at least a portion of the first bone (e.g., tibia 226). The bone model can be based on medical imaging of a patient’s foot. Alternatively, or in addition, the resection guide 1402 can also include a second resection feature 826 (e.g., talus resection feature 866) coupled to a body of the resection guide 1402. The resection feature 826 can be configured to guide a cutting tool for form a second osteotomy in a second bone, such as a talus 222. The second osteotomy can be shaped to form a resection interface with the first osteotomy. 321 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In addition, the resection guide 1402 can include a second bone attachment feature 828 in addition to a first attachment feature 828 of the resection guide 1402. The second bone attachment feature 828 can be configured to secure the resection guide 1402 to a second bone (e.g., talus 222). In one embodiment, the first bone and the second bone are part of a common joint. Securing the resection guide 1402 to a first bone (e.g., tibia 226) and a second bone (e.g., talus 222) can be assist a surgeon in performing the osteotomies just as outlined preoperatively, because the bone models used to prepare the resection guide 1402 and/or a preoperative plan may be dependent on each bone involved in the surgical procedure being in a predetermined position. 322 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 Advantageously, securing the resection guide 1402 to both a first bone with a first bone attachment feature 828 and a second bone with a second bone attachment feature 828 can ensure that the two bones are in the same position as the bone models used to design the resection guide 1402. This means that securing the two bones intraoperatively to the resection guide 1402 will also result in positioning and/or orienting the two bones for the osteotomies. Accurate bone positioning during the surgical procedure that corresponds to the bone positioning in a model (e.g., bone model(s) and/or instrument model(s)) ensures that angles, trajectories, sizes, and/or shapes designed into the instrument (e.g., resection guide 1402) will be used and leveraged during the surgical procedure. 323 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIG. 14B illustrates an alternative embodiment of a resection guide 820. The osteotomy system 1400 includes resection guide 1404. The resection guide 1404 can include some or all of the same or substantially the same features, aspects, and/or components as the resection guide 1402 described herein with like components including the same reference numerals. Accordingly, the resection guide 1404 can or may include one or more tibia resection features 864, one or more talus resection feature 866, one or more bone attachment features 828, one or more bone engagement features 830, one or more alignment guides 874, one or more shafts 878, one or more openings 868, one or more resection guards 870, one or more fastener guides 890, and the like. 324 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 The resection guide 1404 may differ from resection guide 1402 because the resection guide 1402 may include a tibial resection guide 822 that is or can be coupled to a talus resection guide 824 by a coupler 1406. In resection guide 1404 there is an open space between tibia resection feature 864 and talus resection feature 866. The coupler 1406 can be implemented in a variety of forms. In the illustrated embodiment, the coupler 1406 includes a pin of one of the tibial resection guide 822 and talus resection guide 824 that engages an opening in the other of the tibial resection guide 822 and talus resection guide 824. In the illustrated embodiment, the tibial resection guide 822 includes a pin 1408 that fits within an opening 1410 of the talus resection guide 824 to engage the coupler 1406. A surgeon may couple the tibial resection guide 822 preoperatively or intraoperatively. 325 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 As with the resection guide 1402 the resection guide 1404 may include a plurality of bone engagement features 830a, 830b, 830c. Alternatively, or in addition, certain bone engagement features 830 may be omitted from a particular resection guide 1404 based on user instructions 604. 326 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In one embodiment, the inclusion of these bone engagement features 830 and/or the configuration (i.e., size, shape, etc.) of the bone engagement feature 830 can be based at least partially user instructions 604 and at least partially on a bone model of at least a portion of one or more a tibia 226 and/or a talus 222 of a patient. In one embodiment, the bone model may influence a configuration of a bone engagement surface(s) of the resection guide 1404. Alternatively, or in addition, certain aspects of the bone engagement features 830 may be based on a default configuration provided for the osteotomy system 1400. 327 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In one embodiment, the bone engagement feature 830 is configured to engage with at least a portion of a first bone at a position that substantially matches a model position (i.e., model’s position) of a model of the resection guide engaging a bone model of the first bone. In the illustrated embodiment, bone engagement features 830 of the tibial resection guide 822 and/or the talus resection guide 824 can include a bone engagement surface that matches, at least partially matches, and/or substantially matches, a surface of the bones the respective guides will contact when the guides are positioned for use. 328 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 Advantageously, the bone engagement surface have been generated based on models of at least a portion of the tibial resection guide 822 and/or talus resection guide 824 positioned on, or in relation to, models of one or more of the tibia 226 and talus 222. Because the bone engagement surface matches, or substantially matches, a contour of the surfaces of the bones, the bone engagement surface, when used, readily moves into the same position on the bone(s) as the model of the bone engagement surface had in relation to the models of the bones. 329 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In certain embodiments, the bone engagement feature 830 includes a bone engagement surface and a body section, the body section extends from the body and supports the bone engagement surface. In certain embodiments, where a bone engagement feature 830 is unneeded or undesired, a body section of a resection guides 820 may be replaced with an opening or a void. Said another way, the body (or a body section) may not be formed/fabricated in an area of a resection guides 820 where a bone engagement feature 830 is not needed or desired. 330 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIG. 14B illustrates that a surgeon has provided user instructions 604 for including an additional bone engagement feature 830d. Specifically, the surgeon has requested that the body be extended on the lateral side, that the body include a bone engagement surface on its posterior side to engage bone of the talus 222 and that the talus resection feature 866 be configured to include a slot that extends in a plantar direction on the lateral side. In this embodiment, the surgeon may have requested the added bone engagement feature 830d to facilitate placement of the talus resection guide 824 on the talus 222. Alternatively, or in addition, the added bone engagement feature 830d may have been included to facilitate an osteotomy of the lateral side of the talus 222. For example, a surgeon may decide to resect a lateral extending process 223 of the talus 222. Advantageously, a surgeon can use embodiments of the present disclosure to obtain a resection guide 1404 that is patient-specific and customized to the needs and/or desires of the surgeon in order to provide improved patient care. 331 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIG. 15A illustrates a lateral side view of a resection guide 1502 of an osteotomy system 1500, according to one embodiment. The resection guide 1502 of the osteotomy system 1500 can include some or all of the same or substantially the same features, aspects, and/or components as the resection guides 820 described herein with like components including the same reference numerals. Accordingly, the resection guide 1502 can or may include one or more tibia resection features 864, one or more talus resection feature 866, one or more bone attachment features 828, one or more bone engagement features 830, one or more landmark registration features 834, one or more alignment guides 874, one or more shafts 878, one or more openings 868, one or more resection guards 870, one or more fastener guides 890, and the like. 332 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In one embodiment, the resection guide 1502 can be designed and/or fabricated by combining a tibial resection guide 822 with a talus resection guide 824 by adding more body structure that connects and joins the two resection guides 820. Thus, the resection guide 1502, in one embodiment, can include a tibial resection guide 1522 connected to a talus resection guide 1524 and an interconnecting body section 1526. 333 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 FIG. 15A illustrates a lateral side view of the resection guide 1502. Those of skill in the art will appreciate that the tibial resection guide 1522 can be configured the same as or similarly to the tibial resection guide 822, including one or more bone attachment features 828 and/or one or more bone engagement surface 832 and/or one or more landmark registration features 834. Alternatively, or in addition, the talus resection guide 1524 can be configured the same as or similarly to the talus resection guide 824, including one or more bone attachment features 828 and/or one or more bone engagement surface 832 and/or one or more landmark registration features 834. 334 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In addition, the resection guide 1502 can include a bone probe 1528. In one embodiment, the bone probe 1528 is a structure that extends away from the interconnecting body section 1526 from a posterior side of the resection guide 1502. In one embodiment, the bone probe 1528 is configured to extend such that when the resection guide 1502 is in use the bone probe 1528 extends into a joint between a first bone (e.g., tibia 226) and a second bone (e.g., talus 222). In one embodiment, the bone probe 1528 is configured to engage, at least partially, with a landmark associated with one or the other or both of the first bone and the second bone. In one embodiment, the landmark of one or both of the bones may be a protrusion, a projection, a tuberosity, a cavity, a void, a divot, a tab, an extension, a hook, a curve, or the like of one or both of the bones and/or a structure on a surface of one or both of the bones. In one embodiment, a distal end of the bone probe 1528 can be patient-specific and configured to substantially match a surface of one or the other of the bones of a joint. 335 Added by DJM Jan 2024 1/6/24, 10:01 PM
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Delete 		PER-24 In one embodiment, the bone probe 1528 starts with a first width and tapers to a narrow width moving from a proximal end of the bone probe 1528 to a distal end of the bone probe 1528. In one embodiment, the bone probe 1528 can have a width that is similar to the width of the resection guide 1502 from medial to lateral. Alternatively, or in addition, the bone probe 1528 can have a width that is smaller than the width of the resection guide 1502 from medial to lateral. In another embodiment, the bone probe 1528 can have a width that is greater than the width of the resection guide 1502 from medial to lateral. 336 Added by DJM Jan 2024 1/6/24, 10:01 PM

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