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Delete 		PER-12 In the illustrated embodiment, the osteotomy system 2000 includes at least one fastener 2010, a resection guide 2020 (two embodiments 2020a, 2020b), one or more pin guides 2200, and a positioning guide 2300. 295 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figures 21A-21J illustrate views of a resection guide 2020 of the osteotomy system of Figure 20, according to one embodiment. In one embodiment, the resection guide 2020a includes one or more resection features 2022 (e.g., posterior resection feature 2022a, anterior resection feature 2022b), one or more bone attachment features 2024 (e.g., first bone attachment feature 2024a, second bone attachment feature 2024b), one or more handles 2026 (e.g., handles 2026a,b), a body 2028, and a bone engagement surface 2033. 296 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figure 21A illustrates a perspective plantar-posterior view of one embodiment of a resection guide 2020a that includes posterior resection feature 2022a, anterior resection feature 2022b. The illustrated embodiment includes two resection features 2022 and two bone attachment features 2024. 297 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The body 2028 includes a lateral side 2030, a medial side 2032, an anterior side 2034, a posterior side 2036, a dorsal side 2038, and a plantar side 2040. See Figures 21A-21I. Generally, the sides of the body 2028 refer to the direction the sides face when a resection guide 2020 is in use. The medial side 2032 faces the bone of the patient and in the medial direction relative to the patient. The lateral side 2030 faces away from the patient and in the lateral direction. The anterior side 2034 faces in the anterior direction and the posterior side 2036 faces in the posterior direction relative to the patient. 298 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Resection features 2022 facilitate performing an osteotomy on a bone of a patient. The resection features 2022 may serve as a template or guide for manipulating a cutting tool to create the osteotomy. In one embodiment, the resection features 2022 guide a cutting tool along a predetermined trajectory to cut into and/or through the bone. 299 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figure 21B illustrates an embodiment of a resection guide 2020a that includes a posterior resection feature 2022a and an anterior resection feature 2022b. Figure 21B illustrates a perspective dorsal-posterior view of one embodiment of a resection guide 2020a. In certain embodiments, the posterior resection feature 2022a and anterior resection feature 2022b may be parallel to each other at a surface of the lateral side 2030 of the body 2028. Alternatively, or in addition, the posterior resection feature 2022a and anterior resection feature 2022b may be non-parallel with respect to each other at the surface of the lateral side 2030 of the body 2028. 300 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figure 21C illustrates a posterior perspective view of a resection guide 2020a. 301 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figure 21D illustrates an anterior perspective view of a resection guide 2020a. 302 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Referring to Figures 21C and 21D, the resection guide 2020a may include one or more one or more bone attachment features 2024. The one or more bone attachment features 2024 secure the resection guide 2020a to the bone for one or more osteotomies. In one embodiment, a single bone attachment feature 2024 may be sufficient to secure the resection guide 2020a for a surgical procedure. 303 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In the illustrated embodiment, a bone attachment feature 2024 is embodied in the form of an opening that extends from the lateral side 2030 to the medial side 2032. The opening is sized to receive and securely engage (e.g., by way of a friction fit) with a fastener 2010 deployed through the opening and into the bone. In one embodiment, a single bone attachment feature 2024. In another embodiment, a bone attachment feature 2024 may be made up of two or more bone attachment features (e.g., bone attachment feature 2024a and bone attachment feature 2024b) In the illustrated embodiment, the bone attachment features 2024 includes a first bone attachment feature 2024a and a second bone attachment feature 2024b. Using two bone attachment features 2024 can be advantageous because two bone attachment features 2024 secured to the bone can prevent the resection guide 2020a from rotating about one single bone attachment feature 2024. 304 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 One challenge in performing an osteotomy may be in how to control bone fragments formed by the osteotomy. Great effort is made to perform a surgical procedure with the smallest incisions to reduce the disruption of tissue and expedite healing and recovery. However, such efforts may increase the challenges of controlling bone fragments formed by the osteotomy. For example, suppose the resection guide 2020a is used for a wedge osteotomy. Upon successful completion of the osteotomy, a wedge bone fragment may be created below the resection guide 2020a. Advantageously in the illustrated embodiment, at least one bone attachment feature 2024 is positioned between the posterior resection feature 2022a and the anterior resection feature 2022b. Consequently, when an osteotomy using both the posterior resection feature 2022a and the anterior resection feature 2022b is completed, the resulting wedge bone fragment remains secured to the at least one bone attachment feature 2024. Of course, a fastener 2010 for the at least one bone attachment feature 2024 may extend into the bone to a depth such that the fastener 2010 does not interfere with completion of the wedge osteotomy. After the wedge osteotomy a surgeon can remove the wedge bone fragment, if desired, using the fastener 2010. 305 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In the illustrated embodiment, the bone attachment features 2024 are aligned with each other. In another embodiment, the bone attachment features 2024 may be unaligned with each other. In certain embodiments, the bone attachment features 2024 are configured such that fasteners 2010 that used with the bone attachment features 2024 are parallel to each other. In this way, the resection guide 2020a can be readily slid off of the fasteners 2010 while the fasteners 2010 remain in the bone. Advantageously, the remaining fasteners 2010 can be reused in subsequent steps of a surgical procedure. 306 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Those of skill in the art will appreciate that the one or more bone attachment features 2024 may be implemented in a variety of ways and/or with a variety of structures. For example, in one embodiment that a bone attachment features 2024 may be embodied as one or more prongs, pins, or spikes extending from the medial side 2032 of the resection guide 2020a. The pins, prongs or spikes may be driven into the bone by way of a mallet. Of course, other embodiments for the bone attachment feature 2024 may have a different configuration and still fall within the scope of the present disclosure. 307 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In certain embodiments, the resection guide 2020a can include one or more handles 2026. The handle 2026 can facilitate positioning and/or placement of the resection guide 2020a. In certain embodiments, the resection guide 2020a may not include handles 2026. Instead, a user may grasp the body 2028 for positioning. Alternatively, or in addition, the handle 2026 may be relatively straight and may be aligned with a longitudinal axis of the resection guide 2020a such that handle 2026 can be used as a visual guide for a surgeon to confirm the positioning, placement, and/or orientation of the resection guide 2020a on a bone of the patient. Of course, other aspects of the resection guide 2020a may serve the same or similar functions as a handle 2026, such that a dedicated handle 2026 may not be needed. 308 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Furthermore, handle 2026 may serve more than one function or purpose. In certain embodiments, one or more of the handles 2026 can serve as both a handle used by a user to position/orient the resection guide 2020a and/or as a landmark registration feature. 309 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 A landmark registration feature serves to assist a surgeon in mapping or converting from a position of a model of a resection guide 2020 one a model of one or more bones of a patient in a virtual environment and/or in a preoperative plan to an actual physical position on one or more bones of a patient during a procedure. In the illustrated embodiment, the resection guide 2020a includes at least one landmark registration feature. 310 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In particular, the resection guide 2020 may include a plantar landmark registration feature 2041a. In another embodiment, the resection guide 2020 may include a dorsal landmark registration feature 2041b. See for example, Figure 21E. Alternatively, or in addition, the resection guide 2020 can include a landmark registration feature 2041 that extends from any side of the resection guide 2020. 311 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The landmark registration feature 2041 is configured to engage with landmarks on the bone of the patient. Advantageously, the landmark registration feature 2041 can provide a surgeon with confidence and assurance in the placement and positioning of the resection guide 2020a on the bone because the landmark registration feature 2041 engages with one or more particular landmarks on the bone (e.g., a projection or a depression or cavity). The landmark registration features 2041 is one feature that assists a surgeon in transferring a position of an instrument model relative to a bone model of the patient to an instrument positioned on the actual bone of the patient during a surgical procedure. 312 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Next, the method 1100 may design 1110 a patient-specific cutting guide model based on the preliminary cutting guide model. The design step 1110 may be completely automated or may optionally permit a user to make changes to a preliminary cutting guide model or partially completed patient-specific cutting guide model before the patient-specific cutting guide model is complete. A preliminary cutting guide model and patient-specific cutting guide model are two examples of an instrument model. As used herein, "instrument model" refers to a model, either physical or digital, that represents an instrument, tool, apparatus, or device. Examples, of an instrument model can include a cutting guide model, a patient-specific cutting guide model, and the like. In one embodiment, a patient-specific cutting guide and a patient-specific cutting guide model may be unique to a particular patient and that patient’s anatomy and/or condition. 221 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The method 1100 may conclude by a step 1112 in which patient-specific cutting guide may be manufactured based on the patient-specific cutting guide model. Various manufacturing tools, devices, systems, and/or techniques can be used to manufacture the patient-specific cutting guide. As used herein, “manufacturing tool” or "fabrication tool" refers to a manufacturing or fabrication process, tool, system, or apparatus which creates an object, device, apparatus, feature, or component using one or more source materials. A manufacturing tool or fabrication tool can use a variety of manufacturing processes, including but not limited to additive manufacturing, subtractive manufacturing, forging, casting, and the like. The manufacturing tool can use a variety of materials including polymers, thermoplastics, metals, biocompatible materials, biodegradable materials, ceramics, biochemicals, and the like. A manufacturing tool may be operated manually by an operator, automatically using a computer numerical controller (CNC), or a combination of these techniques. 222 Added by DJM Jan 2024 1/6/24, 10:03 PM

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