Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-24	Although FIG. 16 shows example blocks or steps of a method 1600, in some implementations, a method 1600 may include additional steps, fewer steps, different steps, or differently arranged steps than those depicted in FIG. 16. Additionally, or alternatively, two or more of the steps of a method 1600 may be performed in parallel.	357	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the present disclosure can include an alternative method to the method 1600 and/or a separate method which includes: obtaining a prescription for an osteotomy system and/or for a component of an osteotomy system. The alternative method may include modifying an instrument model of an instrument to be included in the osteotomy system. In one embodiment, the modifications to the instrument model may be made based on or due to or at least in response to a received prescription. Next the alternative method, may include sending a report, a message, a notification, a set of models that includes a bone model and/or a model of one or more instruments of the osteotomy system, or the like to a surgeon who issued the prescription for review by the surgeon. The surgeon may then provide feedback in response to the report, a message, a notification, a set of models that includes a bone model and/or a model of one or more instruments of the osteotomy system, or the like. Optionally, the alternative method may include implementing any feedback provided by the surgeon. Of course, the method could iterate with more notices of changes to the surgeon and feedback provided by the surgeon, until a satisfactory design (i.e., approved by the surgeon) is generated. Next, the alternative method could conclude by arranging for and/or fabricating the osteotomy system and/or components of the osteotomy system.	358	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIGS. 17A-17E illustrate different views of one or more stages in a surgical procedure that includes one or more embodiments of the present disclosure. Reference is made to FIGS. 8-10F, 12A-12D and FIG. 16.	359	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 17A illustrates a stage of the method 1600 in which a tibial resection guide 822 is positioned 1602 on an anterior surface of a distal end of a tibia 226. In one embodiment, the tibial resection guide 822 and/or talus resection guide 824 may be made of metal such that they have a greater mass than resection guides 820 fabricated from materials having a lower mass such as polymers and/or ceramics. Using a resection guide 820 with a greater mass can facilitate registering the resection guide 820 to a bone surface during positioning steps.	360	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In the illustrated embodiment, the surgeon has made an incision that permits access to an anterior surface of a distal end of a tibia and an anterior surface of a proximal end of a talus of a patient’s foot. Pins of two bone attachment features 828 (e.g., one or more tibial bone attachment features) have also been deployed to secure the tibial resection guide 822 to the tibia 226. Note that the tibial resection guide 822 includes an alignment guide 874, but the shaft 878 has not yet been inserted.	361	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 17B illustrates a stage in the surgical procedure in which the shaft 878 is inserted in the alignment guide 874. A surgeon has deployed the alignment guide 874 according to one embodiment. A surgeon can now visually check manually, and/or with flouroscopy, a position of the tibial resection guide 822 in relation to a mechanical axis 880 of the tibia 226. In the illustrated embodiment, the surgeon has also deployed a plurality of resection guards 870.	362	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 17C illustrates a lateral view with the fibula 228 and tibia 226 transparent. This illustrates a view a surgeon can take using the resection guards 870 and/or shafts 878 in relation to the mechanical axis 880. Advantageously, a surgeon can check the position, alignment, and/or trajectories in all three planes before performing a first osteotomy. In this manner, the surgeon can confirm that the osteotomy will be where intended and planned.	363	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, FIG. 17D illustrates the ankle joint after method step 1610 is completed. Those of skill in the art will appreciate that the surgeon may opt to deploy the talus resection guide 824 prior to forming a first osteotomy using a cutting tool. Alternatively, or in addition, the surgeon may insert a cutting tool into a tibia resection feature 864 and cut the tibia 226 to form a first osteotomy prior to positioning a talus resection guide 824.	364	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Once the example talus resection guide 824 is positioned, a surgeon may deploy a set of fasteners/pins as part of one or more bone attachment feature 828 (e.g., one or more talus bone attachment features) to secure the example talus resection guide 824 to the talus 222.	365	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Next a surgeon may operate the example talus resection guide 824 by inserting 1614 a cutting tool such as a rectangular oscillating blade or a burr attached to a manual, mechanical, pneumatic, or electric driver into a resection feature to cut the talus 222 for an osteotomy. If the surgeon has not yet formed a first osteotomy using the tibial resection guide 822, the surgeon may also insert 1608 a cutting tool (possibly the same cutting tool as used for the tibial resection) into a resection feature of the tibial resection guide 822 to form a first osteotomy.	366	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, FIG. 17E illustrates a stage in which a tibial resection guide 822 and a talus resection guide 824 have been removed. Pins in the tibia 226 may be retained and pins in the talus 222 may be retained. A first osteotomy has been formed at the distal end of the tibia 226 and a second osteotomy has been formed at the proximal end of the talus 222. A resection interface that includes the two osteotomies can now be closed. Once closed, and/or the osteotomies are reduced, a surgeon can proceed with fixation across the first osteotomy and the second osteotomy to enable fusion for the tibia 226 to the talus 222. In one embodiment, a surgeon may deploy a positioning guide 1534 to assist with the reduction and/or to hold the reduction in a stable relationship while fixation is deployed.	367	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 18 illustrates an exemplary ankle fusion osteotomy system 1800, according to one embodiment. In one embodiment, the exemplary ankle fusion osteotomy system 1800 is specifically designed for use on a lateral side of the patient’s ankle (e.g., using a lateral approach). Those of skill in the art will appreciate that the same or a similar exemplary ankle fusion osteotomy system 1800 can be used on a medial side of the patient’s ankle (e.g., using a medial approach). Those of skill in the art will also appreciate that a surgical procedure that conducts an ankle fusion on an ankle from a medial or lateral approach generally includes steps to perform an osteotomy on the malleolus (medial or lateral depending on the approach) and retracting or holding a distal end of the malleolus out of the way for the osteotomy steps on the tibia 226 and/or talus 222. Those of skill in the art will appreciate that the osteotomy system 1800 can include one or more components that are patient-specific and/or one or more components that are not patient-specific. Thus, the osteotomy system 1800 can be a combination of patient-specific components and/or non-patient-specific components.	368	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The osteotomy system 1800 can include one or more fasteners 810 and/or two or more sets of fasteners (810a, 810b, 810c), one or more resection guides 1820, and zero or one or more complementary components 730. In the illustrated embodiment, the resection guides 1820 include a first resection guide 1822 and a second resection guide 1824. The resection guides 1820 may also include one or more of resection features 1826, bone attachment features 1828, bone engagement feature 1830, and/or landmark registration feature 1834. In certain embodiments, a bone engagement feature 1830 can include a bone engagement surface 1832.	369	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	While specific embodiments of complementary components 730 are not specifically shown here in relation to the osteotomy system 1800, those of skill in the art will appreciate that complementary components 730 can be similar in feature, design, implementation, configuration, and purpose as those described in relation to the osteotomy system 700 and can be used for the osteotomy system 1800. Thus, the osteotomy system 1800 can include one or more alignment guides 740, rotation guides 750, correction guides 760, compression guides 770, positioning guides 780, fixation guides 790, navigation guides 792, implants 794, or the like.	370	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Either or both of the resection guides 1820 may be custom patient-specific resection guides made for a particular patient and/or for a particular surgical procedure. Various aspects of the resection guides 1820 may be patient-specific, including, but not limited to, an angle and/or orientation for a resection feature of the resection guide 1820, a position of the resection feature, a depth of the resection feature, a size of the resection guide 1820, a configuration and/or composition of a bone contacting surface such as a bone engagement surface of the resection guide 1820, and the like.	371	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Either or both of the resection guides 1820 of osteotomy system 1800 can include some or all of the same or substantially the same features, aspects, alternatives, and/or components as other example resection guides described herein with like components including the same or similar reference numerals. Accordingly, the resection guide 1822 can or may include a first resection feature 1864, a second resection feature 1866, one or more bone attachment features 1828, one or more bone engagement features 1830, one or more alignment guides 1874, one or more shafts 1878, one or more openings 1876, one or more resection guards 1870 (not shown), one or more fastener guides 1890 (not shown), and the like. The bone engagement features 1830 may include one or more bone engagement surfaces 1832. Alternatively, or in addition, either or both of the resection guides 1820 can include one or more stabilizers 1892 and one or more sights 1894.	372	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The resection guides 1822 may each include a body that includes an anterior side, a posterior side, a medial side, a lateral side, a superior side, and an inferior side. In certain embodiments, a first resection guide 1822 may be combined with a second resection guide 1824 into a single resection guide 1820.	373	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the resection guides 1820 may differ from other resection guides described herein because the first resection feature 1864 and/or the second resection feature 1866 may differ from other example resection features described herein.	374	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In the illustrated embodiment, the first resection feature 1864 and the second resection feature 1866 are configured to form one or more osteotomies for a “dome” osteotomy. A dome osteotomy is a form of osteotomy that results in resected bone surface resembling or taking the shape of a dome or hemisphere. In the illustrated embodiment, the dome osteotomy can be accomplished by a resection feature that forms a curved osteotomy. In certain embodiments, a curved osteotomy can be a challenge for form using a cutting tool such as a reciprocating saw blade. However, where the cutting tool is a burr, a curved osteotomy is easier to form.	375	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In the illustrated embodiment, the first resection feature 1864 and second resection feature 1866 are configured to facilitate forming a curved osteotomy (and/or an angled curved osteotomy). Specifically, in one embodiment, the first resection feature 1864 and/or second resection feature 1866 may include a plurality of openings arranged in a curved pattern. Each of the openings may be sized to accept a cutting tool such as a burr. The burr drills a hole in bone opposite the opening. Alternatively, or in addition, the burr can be angled to resect bone between the openings. By forming bone tunnels or holes using the plurality of openings a surgeon can form a curved osteotomy (and/or an angled curved osteotomy) in the bone. Furthermore, angling the burr once in the bone can enable a surgeon to interconnect adjacent bone tunnels to complete the osteotomy.	376	Added by DJM Jan 2024	1/6/24, 10:01 PM

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