Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	TMC-PAT-4	FIGS. 9A-9F illustrate views of an example resection guide 820b of the system 800 of FIG. 8, according to one embodiment. The resection guide 820b includes a proximal end 824 and a distal end 826. The resection guide 820b includes a body 900, resection features embodied as a proximal resection feature 902 and a distal resection feature 904, a window 906, and a bone attachment feature. In the illustrated embodiment, the bone attachment feature is embodied as a first bone attachment feature 908, a second bone attachment feature 910. In addition, the resection guide 820b includes a patient-specific bone engagement feature 912. In certain embodiments, the resection guide 820b may include one or more landmark registration features 960. Other embodiments may not include landmark registration features 960.	284	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	The body 900 connects and/or supports the structures and/or features and/or aspects of the resection guide 820b. The resection guide 820b includes a superior side 914, an inferior side 916, a proximal side 918, a distal side 920, a medial side 922, and a lateral side 924. In one embodiment, the resection guide 820b is configured for use on a dorsal side of a midfoot of a patient. The surgical procedure may include a medial approach and/or a dorsal approach or an approach between the medial and the dorsal sides of the midfoot. The names of the sides of the resection guide 820b refer to the position of the sides when the resection guide 820b is in use on one or more bones of a midfoot of a patient.	285	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In the illustrated embodiment, the proximal resection feature 902 and distal resection feature 904 may extend through the body 900 from the superior side 914 to the inferior side 916. In one embodiment, the proximal resection feature 902 may guide a cutting tool to form a first osteotomy in one or more bones that extends along a first trajectory 928 (See FIG. 9F, 9G). Similarly, the distal resection feature 904 may guide a cutting tool to form a second osteotomy in one or more bones that extends along a second trajectory 930 (See FIG. 9F, 9G). In one embodiment, the first trajectory may be determined at least partially based on a bone model of a patient’s foot, the bone model defined based on medical imaging of the patient’s foot. Alternatively, or in addition, the second trajectory may be at least partially determined based on the bone model and/or the first trajectory.	286	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	The body 900 may include resection features 902, 904 that guide a cutting tool to resect one or more bones, such as a medial cuneiform and/or a first metatarsal in the manner needed to make the desired resection. For example, the resection features 902, 904 may be used to guide a planar cutting blade, an arcuate cutting blade, a drill or mill, a burr, and/or the like. The resection features 902, 904 may guide a reciprocating planar blade, such as that of a surgical bone saw, that forms planar cuts in a first cuneiform and a first metatarsal. Various manual or powered tools may be used to form the cuts. In one embodiment, a sagittal bone saw can be used.	287	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In one embodiment, the proximal resection feature 902 guides a cutting tool to form a first osteotomy in one or more bones of a patient. Similarly, the distal resection feature 904 is used to form a second osteotomy in one or more bones of the patient. Advantageously, the first osteotomy and the second osteotomy can be configured to resect a desired amount, size, and/or shape of bone or bones and/or soft tissue from a midfoot of the patient.	288	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In one example, the resection features 902, 904 may take the form of a proximal resection feature 902 and a distal resection feature 904. In one embodiment, the proximal resection feature 902 and the distal resection feature 904 extend from the superior side 914 to the inferior side 916. For example, the proximal resection feature 902 may extend through the body 900 of the resection guide 820b from the superior side 914 to the inferior side 916 along a first trajectory 928. Similarly, the proximal resection feature 902 may extend through the body 900 of the resection guide 820b from the superior side 914 to the inferior side 916 along a second trajectory 930.	289	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	The position of the proximal resection feature 902 and/or distal resection feature 904 within the body 900, with relation to each other, the orientation of the proximal resection feature 902 and/or distal resection feature 904 between the proximal side 918 and the distal side 920, and/or the angle of the proximal resection feature 902 and/or distal resection feature 904 through the body 900 may be at least partially determined based on a bone model of a patient’s foot. The bone model may be of one bone or of a plurality of bones. The bone model may be defined based on medical imaging of the patient’s foot. In one embodiment, the first trajectory 928 may be at least partially determined based on the bone model. Similarly, the second trajectory 930 may be at least partially determined based on at least one of the bone model and the first trajectory 928. In this manner, at least in certain embodiments, the number, position, orientation, size, length, angle of incidence to the inferior side 916, and the like are or can be patient-specific. Of course, a surgeon can alter or adjust any of these aspects of the resection guide 820b to enable fabrication of a guide that meets the surgeon’s needs, preferences, and/or the needs of the patient and/or the surgical procedure. In one embodiment, the first trajectory 928 and/or the second trajectory 930 are patient-specific.	290	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In the illustrated embodiment, both the proximal resection feature 902 and the distal resection feature 904 are implemented as slots having two closed ends. Of course, the proximal resection feature 902 and/or distal resection feature 904 can be implemented using a variety of openings, holes, and/or structures. For example, in one embodiment, a proximal resection feature 902 and/or distal resection feature 904 can be implemented as a series of adjacent holes that can be used with a burr cutting tool to form holes in bone for a resection.	291	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	As mentioned previously, the method 100 may be used to correct a wide variety of bone conditions. One example of the method 100 will be shown and described in connection with FIG. 1B, for correction of a bunion deformity of the foot.	149	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In certain embodiments, one or more of a method, apparatus, and/or system of the disclosed solution can be used for training a surgeon to perform a patient-specific procedure or technique. In one embodiment, the CAD model generated and/or patient-specific instrumentation, implants, and/or plan for conducting an operative procedure can be used to train a surgeon to perform a patient-specific procedure or technique.	150	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In one example embodiment, a surgeon may submit a CT scan of a patient’s foot to an apparatus or system that implements the disclosed solution. Next, a manual or automated process may be used to generate a CAD model and for making the measurements and correction desired for the patient. In the automated process, an advanced computer analysis system, machine learning and automated/artificial intelligence may be used to generate a CAD model and/or one or more patient-specific instruments and/or operation plans. For example, a patient-specific instrument may be fabricated that is registered to the patient’s anatomy using a computer-aided machine (CAM) tool. In addition, a CAM tool may be used to fabricate a 3D structure representative of the patient’s anatomy, referred to herein as a patient-specific synthetic cadaver. (e.g., one or more bones of a patient’s foot). Next, the patient-specific instrument and the patient-specific synthetic cadaver can be provided to a surgeon who can then rehearse an operation procedure in part or in full before going into an operating room with the patient.	151	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In certain embodiments, the patient-specific instrument or instrument can be used to preposition and/or facilitate pre-drilling holes for a plate system for fixation purposes. Such plate systems may be optimally placed, per a CT scan, after a correction procedure for optimal fixation outcome. In another embodiment, the CAD model and/or automated process such as advanced computer analysis, machine learning and automated/artificial intelligence may be used to measure a depth of through a patient-specific resection guide for use with robotics apparatus and/or systems which would control the depth of each cut within the guide to protect vital structures below or adjacent to a bone being cut. In another embodiment, the CAD model and/or automated process such as advanced computer analysis, machine learning and automated/artificial intelligence may be used to define desired fastener (e.g. bone screw) length and/or trajectories through a patient-specific instrument and/or implant. The details for such lengths, trajectories, and components can be detailed in a report provided to the surgeon preparing to perform a procedure.	152	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	FIG. 1B is a flowchart diagram depicting a method 120 for correcting or remediating a bone condition, according to one embodiment. The method 120 may be used to prepare for an orthopedic procedure which corrects or remediates a bone, muscle, deformity, and/or tendon condition of a patient.	153	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	As shown, the method 120 may begin with a step 122 in which a CT scan (or another three-dimensional image) of the patient’s foot is obtained. The step 122 may include capturing a scan of select bones of a patient or may include capturing additional anatomic information, such as the entire foot. Additionally, or alternatively, the step 122 may include receipt of previously captured image data. Capture of the entire foot in the step 122 may facilitate proper alignment of the first metatarsal with the rest of the foot (for example, with the second metatarsal). Performance of the step 122 may result in generation of a three-dimensional model of the patient’s foot, or three-dimensional surface points that can be used to construct such a three-dimensional model.	154	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	After the step 122 has been carried out, the method 120 may proceed to a step 124 in which a CAD model of the relevant portion of the patient’s anatomy is generated. The CAD model may optionally include the bones of the entire foot, like the CT scan obtained in the step 122. In alternative embodiments, the step 124 may be omitted in favor of direct utilization of the CT scan data, as described in connection with the step 104.	155	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In a step 126, the CAD model and/or CT scan data may be used to model patient-specific instrumentation that can be used to correct or remediate a bone condition. Such instrumentation may include a guide. In one example, the guide can seat or abut or contact a surface of a bone and including an opening that guides a trajectory for a fastener for a procedure. In some embodiments, performance of the step 126 may include modelling the guide with a bone engagement surface that is shaped to match contours of the surfaces of the bone, such that the bone engagement surface can lie directly on the corresponding contours of the bone.	156	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In a step 128, the model(s) may be used to manufacture patient-specific instrumentation and/or instruments. This may include manufacturing an instrument with the bone engagement surface and/or other features as described above. As in the step 108, the step 128 may additionally or alternatively involve provision of one or more instruments and/or implants from among a plurality of predetermined configurations or sizes. Further, the step 128 may additionally, or alternatively, involve provision of instructions for placement and/or anchorage of one or more instruments and/or instruments to carry out the procedure.	157	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	In a step 130, the manufactured instrument may be used in surgery to facilitate treatment of the condition. In certain embodiments, a bone engagement surface of the instrument may be placed against the corresponding contours of the bone. The instrument may include an opening and/or trajectory guide to guide insertion of a trajectory guide such as a temporary fastener such as a K-wire. The instrument may then be removed, and the remaining steps of a surgical procedure performed.	158	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	Method 100 and method 120 are merely exemplary. Those of skill in the art will recognize that various steps of the method 100 and the method 120 may be reordered, omitted, and/or supplemented with additional steps not specifically shown or described herein.	159	Added by DJM Jan 2024	1/3/24, 4:24 AM
View Edit Delete	TMC-PAT-4	As mentioned previously, the method 120 is one species of the method 100; the present disclosure encompasses many different procedures, performed with respect to many different bones and/or joints of the body. Exemplary steps and instrumentation for the method 120 will further be shown and described in connection with the present disclosure. Those of skill in the art will recognize that the method 120 may be used in connection with different instruments; likewise, the instruments of the present disclosure may be used in connection with methods different from the method 100 and the method 120.	160	Added by DJM Jan 2024	1/3/24, 4:24 AM

Page 179 of 438, showing 20 record(s) out of 8,747 total