Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
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
View Edit Delete	TMC-PAT-4	Those of skill in the art will appreciate that instead of an opening 838, a resection guide 820a, 820b, 820c may include one or more holes in the body 900 sized to accept one or more pins or K-wires. The holes in the body 900 can be strategically positioned such that with the resection guide in a desired position, K-wires or pins that are deployed through the holes indicate trajectories for one or more bones involved in the surgical procedure. These K-wires/pins may extend through the body 900 parallel to a longitudinal axis of a cuneiform bone and/or a metatarsal. These K-wires/pins may be used to check a position of a resection guide in relation to a longitudinal axis of one or more of the bones. A surgeon may deploy and use K-wires/pins passing through the body 900 to check positions and/or alignments before completing the surgical procedure. Alternatively, or in addition, the K-wires or pins that deployed through the holes may indicate trajectories for where longitudinal axes of the one or more bones will be after the surgical procedure. Thus, in certain embodiments, holes in the body 900 and K-wires/pins passing through the holes may be used to check position and/or trajectories before an osteotomy and/or holes in the body 900 and K-wires/pins passing through the holes may be used to check position and/or trajectories for where bones will be postoperatively.	343	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	FIGS. 10A-10F illustrate views of resection guide 820c. The resection guide 820c may have many structures, features, and functions, operations, and/or configuration similar or identical to those of the resection guide 820b described in relation to FIGS. 7-9F, like parts are identified with the same reference numerals. Accordingly, the resection guide 820c may include one or more resection features 902, 904, a window 906, a first bone attachment feature 908 or set of proximal openings, a second bone attachment feature 910 or set of distal openings, a bone engagement feature 912 that can include one or more bone engagement surfaces 944, one or more landmark registration features, and the like. The resection guide 820c may include a body 900, a superior side 914, an inferior side 916, a proximal side 918, a distal side 920, a medial side 922, and/or a lateral side 924. And embodiments of the resection guide 820c may include an anchor feature 942 and one or more markings 970. As with the resection features 722 of other embodiments of resection guide 720, the resection features 722a,b can include an open end 729 and a closed end 731.	344	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In addition, the resection guide 820c may have a different design and/or configuration than the resection guide 820b. For example, the size, shape, and/or design of the body 900 may be different. Furthermore, certain features of the resection guide 820c may be different from the resection guide 820b.	345	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In the illustrated embodiment, the body 900 connects the proximal resection feature 902 to the distal resection feature 904. Alternatively, or in addition, the body 900 also connects to the first bone attachment feature 908 and the second bone attachment feature 910.	346	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In the illustrated embodiment, the body 900 connects to the first bone attachment feature 908 by way of a connector 1002a or coupler 1002. Alternatively, or in addition, the body 900 may include a body 900 that connects to the second bone attachment feature 910 by way of a connector 1002b or coupler 1002. The connectors 1002 may be a part of the body 900 or separate components. The connector 1002a is between the first bone attachment feature 908 and the proximal resection feature 902. The connector 1002b is between the second bone attachment feature 910 and the distal resection feature 904.	347	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In the illustrated embodiment, the bone attachment features, connectors, and/or size and shape of the body can be optimized to use enough material such as biocompatible materials (e.g., titanium) to provide the required strength and structural integrity, while minimizing the amount of material used to fabricate the resection guide 820c. Such optimizations can result in the use of connectors in place of using a larger main body portion of the body. Furthermore, the length, width, and height of the body 900 may be optimized to use the least amount of material and still provide the desired level of structural strength and integrity.	348	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In certain embodiments, a user may provide user instructions that affect the size, shape, and/or configuration of the body 900, the connectors, bone attachment features, anchors, and/or landmark registration features. For example, the user may wish to make the body 900 as small and narrow as possible. A larger resection guide 820c may require larger incisions which could lead to longer recovery times for a patient. However, the smaller the body 900, the less surface area of a patient-specific bone engagement feature, such as a bone engagement surface on a bone facing side of the resection guide 820c. The smaller patient-specific bone engagement feature may make positioning the resection guide 820b in a predetermined position more challenging. Thus, the user (e.g., surgeon) may weigh the benefits and challenges in the trade-off between the size and shape of the body 900 and corresponding size of a patient-specific bone engagement feature versus the ease of positioning the resection guide 820b during the surgical procedure. Those of skill in the art will appreciate that the resection guide 820c can have a variety of features, configurations, sizes and/or attributes that can be based at least in part on needs or preferences of patients, the nature of the deformity, and/or surgeon preferences.	349	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	FIG. 10A is a proximal perspective view of the resection guide 820c. FIG. 10A illustrates that the first bone attachment feature 908 is offset relative to the second bone attachment feature 910, these bone attachment features are not aligned along a longitudinal axis of the resection guide 820c, in certain embodiments. In certain embodiments, the alignment or nonalignment of the bone attachment features may be due patient-specific needs, a preoperative plan, surgeon preferences, or the like.	350	Added by DJM Jan 2024	1/3/24, 4:24 AM

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