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Delete 		PER-12 The selection module 1234 may be configured to select a template cutting guide model 1236 for an osteotomy procedure configured to correct the deformity identified by the deformity module 1220. In one embodiment, the provision module 1230 may select a template cutting guide model 1236 from a set of template cutting guide models 1236 (e.g., a library, set, or repository of template cutting guide models 1236). In one embodiment, the template cutting guide model 1236 may include digital models. In another embodiment, the template cutting guide model 1236 may include physical models. In such an embodiment, the repository 1502 may be a warehouse or other inventory repository. Where the template cutting guide model 1236 are physical models, the systems, modules, and methods of this disclosure can be used and the physical model may be milled or machined (e.g., a CNC machine) to form a patient specific cutting guide that conforms to the bone surfaces of the patient. 243 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Selection of a suitable template cutting guide model 1236 may be completely automated and/or may be partially automated and/or may depend on confirmation from a user before a generated preliminary cutting guide model or a proposed template cutting guide model 1236 becomes the preliminary cutting guide model 1238. In another embodiment, the selection module 1234 may facilitate a manual selection by a user of a template cutting guide model 1236 that would become the preliminary cutting guide model 1238. The selection module 1234 may use the anatomic data 1212 or the bone model 1204 or a combination of these to select a suitable template cutting guide model that would become the preliminary cutting guide model 1238. 244 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In another embodiment, the generator 1232 may facilitate revisions or edits by a user of a generated cutting guide model that will become the preliminary cutting guide model 1238. The selection module 1234 may use the anatomic data 1212 or the bone model 1204 or a combination of these to select a suitable template cutting guide model that would become the preliminary cutting guide model 1238. 245 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The repository 1502 may include any number of, and/or a variety of template cutting guide models 1236. The template cutting guide models 1236 may be distinguished based on a gender or age of the patient, which joint of a midfoot, hind foot, or ankle will be cut, which material will be used for the template cutting guide, and the like. The template cutting guide model 1236 may differ from each other in what degree of deformity correction the template cutting guide model 1236 is designed to provide. In addition, the template cutting guide models 1236 may be distinguished based how one or more features of the template cutting guide model 1236 are positioned, arranged, and/or configured relative to each other. For example in certain template cutting guide models 1236, the number, position, and/or configuration of alignment features and/or bone attachment features (e.g., holes) may vary based on needs or preferences of patients, the nature of the deformity, and/or surgeon preferences. 246 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In certain embodiments, the template cutting guide models 1236 may vary in how the slots (e.g., resection features, See Figure 6) for the cuts are positioned, angled, and oriented relative to each other and/or to a longitudinal axis of respective bones at a joint for use with the template cutting guide model 1236. For example in one template cutting guide model 1236 the slot 1352 for a resection of a metatarsal bone may be perpendicular to a longitudinal axis of the metatarsal bone and the slot 1350 may be angled relative to a longitudinal axis of the cuneiform or cuboid bone such that once the two bones are brought together the deformity is corrected. Alternatively, in another template cutting guide model 1236 the slot for a resection of a metatarsal bone may be angled relative to a longitudinal axis of the metatarsal bone and the slot 1350 may be perpendicular to a longitudinal axis of the cuneiform or cuboid bone such that once the two bones are brought together the deformity is corrected. 247 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The selection module 1234 may be configured to automatically select a template cutting guide model 1236 and/or provide an automatic template cutting guide model 1236 recommendation that can be changed by a user, such as a surgeon. For example, in one embodiment, the provision module 1230 and/or selection module 1234 includes an artificial intelligence or machine learning module. The artificial intelligence or machine learning module is configured to implement one or more of a variety of artificial intelligence modules that may be trained for selecting a template cutting guide model 1236 based on anatomic data 1212 and/or other input parameters. In one embodiment, the artificial intelligence or machine learning module may be trained using a large data set of anatomic data 1212 for suitable template cutting guide models 1236 identified and labeled in the dataset by professionals for use to treat a particular deformity 1226. The artificial intelligence or machine learning module may implement, or use, a neural network configured according to the training such that as the artificial intelligence or machine learning module is able to select a suitable template cutting guide model 1236. The template cutting guide model 1236 selected by the selection module 1234 can become the preliminary cutting guide model 1238. 248 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figure 16 illustrates an exemplary design module 1250 configured to design a patient specific cutting guide model, according to one embodiment. The design module 1250 may accept a preliminary cutting guide model 1238 and generate a patient specific cutting guide model 1602. In one embodiment, the design module 1250 includes a contour module 1604, an application module 1606, and/or an optional modification module 1608. 249 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Referring now to FIG 16, the design module 1250 may modify the preliminary cutting guide model 1238 such that the bone-facing and/or bone-contacting surfaces of the preliminary cutting guide model 1238 match a contour of the surfaces and/or joint of bones of a joint that is to be resected using the preliminary cutting guide model 1238. 250 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The contour module 1604 may determine a contour of the bones that will contact the preliminary cutting guide model 1238. The contour module 1604 may use a bone model 1204 and/or anatomic data 1212 to determine the contour. For example, the contour module 1604 may determine the shapes of the medial cuneiform 202 and/or the first metatarsal 208. 251 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Next, a surgeon can resect a distal articular surface of the medial cuneiform 202 and a proximal articular surface of the first metatarsal 208 by way of the second slot 370 and the first slot 360. After resection, the distal end of the medial cuneiform 202 includes a planar cut surface and the proximal end of the first metatarsal 208 includes a planar cut surface. Figure 4 illustrates that the bone engagement surface 324 conforms to the surface of the two bones (e.g., medial cuneiform 202 and first metatarsal 208). 125 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figures 5A, 5B illustrate a perspective view of a first cuneiform and a first metatarsal with one embodiment of a patient-specific cutting guide. Prior to resection completed in the illustrated stage of Figure 4, a surgeon may desire to check or confirm that the desired cutting guide is being used and that a selected cutting guide will provide a desired alignment between the bones of the foot after the resection and fixation steps. 126 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Accordingly, in the illustrated embodiment, the cutting guide 300 may include one member of a coupler 410 configured to engage a corresponding member of the coupler coupled to an alignment guide 420. Those of skill in the art appreciate that various designs of a coupler may be used. In the illustrated embodiment, the coupler 410 includes an opening 412 (See Figure 20) that may extend from the superior side 320 into the body 310 through to the inferior side 322 and a post 414. In one embodiment, the opening 412 may include one of the slots, such as second slot 370. The post 414 may include an engagement member 416. 127 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In one embodiment, the opening 412 and the post 414 engage each other in a friction fit. For example, the post 414 may slide into the second slot 370 and the engagement member 416 may slide into the opening 412. In one embodiment, the engagement member 416 may include tabs that are biased outward and greater than a diameter of the opening 412 such that the tabs engage the opening 412 when inserted and release the opening when the tabs are pressed together. 128 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The alignment guide 420 includes a body 422, an inferior end 424, and superior end 426 and one or more openings 428 near the superior end 426. The openings 428 may be aligned. A surgeon may use the alignment guide 420 by engaging the coupler 410 to couple the alignment guide 420 to the cutting guide 300. Next, a surgeon may insert one or more K-wires through the openings. The openings 428 and alignment guide 420 may be configured such that K-wires within the openings extend along an anterior-posterior axis and indicate the orientation and alignment of the medial cuneiform 202 and first metatarsal 208 once the osteotomy procedure is completed. A surgeon may compare this alignment with the orientation and alignment of other bones of the patient. In this manner, a surgeon can confirm that osteotomy procedure will accomplish the desired outcome once completed. 129 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figures 6A-6C are top perspective, top, bottom, respectively, of a patient-specific cutting guide 600 according to one embodiment. The cutting guide 600 may be designed to facilitate resection of a first cuneiform near a distal end and a first metatarsal near a proximal end with planar cuts at the proper angles to provide dual-plane correction of the orientation of the first metatarsal relative to the first cuneiform, thereby providing correction in a lateral direction, in a plantar direction, and/or a dorsal direction. 130 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 As shown, the cutting guide 600 may have a body 610 with a monolithic construction and the general shape of a rectangular shape. The body 610 includes a proximal side 612, a distal side 614, a medial side 616, a lateral side 618, a superior side 620, and an inferior side 622. In the illustrated embodiment, the body 610 may also include a proximal arm 630 that extends from the body 610 and a distal arm 640 that extends from the body 610. The proximal side 612 is the side closest to the core of the patient when the cutting guide 600 is in use. The distal side 614 is the side furthest from the core of the patient when the cutting guide 600 is in use. The medial side 616 is the side facing medially when the cutting guide 600 is in use. The lateral side 618 is the side facing laterally when the cutting guide 600 is in use. The superior side 620 is the side facing up away from the bone(s) when the cutting guide 600 is in use. The inferior side 622 is the side facing down, facing, and/or contacting the bone(s) (e.g., contacting a surface of one or more bones) when the cutting guide 600 is in use. 131 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 The inferior side 622 may be custom contoured to match the shapes of one or more of the surfaces of the first cuneiform and/or the first metatarsal. In one embodiment, the inferior side 622 may include a bone engagement surface 624. The bone engagement surface 624 can be shaped to match a first surface of a first bone and a second surface of a second bone of a joint. 132 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In one example, the bone engagement surface 624 can be shaped such that the bone engagement surface 624 matches a surface of a cuneiform bone and a surface of a metatarsal bone of a tarsometatarsal (“TMT”) joint. The bone engagement surface 624 can be so shaped because it is fabricated from a bone model of the patient’s bones. The body 610 is configured, designed, and/or fabricated to seat transverse to a joint (e.g., a TMT joint) with the bone engagement surface 624 engaging a first surface of a first bone and a second surface of a second bone. 133 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 Figures 6A-6C includes similar components, parts, devices, apparatus, features, and aspects as those disclosed and described in relation to Figures 3A-19H, however the difference in Figures 6A-6C is that body 610, bone engagement surface 624, and/or one or more arms (e.g., proximal arm 630 and/or distal arm 640) are configured to couple to the bones and extend transverse to the joint, at least partially, if not completely, on the dorsal sides of the bones. Accordingly, the cutting guide 600 may be referred to as a dorsal cutting guide. 134 Added by DJM Jan 2024 1/6/24, 10:03 PM
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Delete 		PER-12 In addition, the cutting guide 600 may be configured to avoid contact with soft tissue such as nerves, tendons, blood vessels, and the like that may run along a medial and/or a lateral side of the first metatarsal 208. Accordingly, the cutting guide 600 may be fabricated to seat transverse to the TMT joint such that the bone engagement surface contacts a dorsal surface of the a first bone (e.g., medial cuneiform 202) and/or a second bone (e.g., first metatarsal 208). For example, the proximal arm 630 and/or distal arm 640 may be positioned more laterally than in other embodiments. 135 Added by DJM Jan 2024 1/6/24, 10:03 PM

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