Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-24	In one embodiment, the bone engagement feature 830 is configured to engage with at least a portion of a first bone at a position that substantially matches a model position (i.e., model’s position) of a model of the resection guide engaging a bone model of the first bone. In the illustrated embodiment, bone engagement features 830 of the tibial resection guide 822 and/or the talus resection guide 824 can include a bone engagement surface that matches, at least partially matches, and/or substantially matches, a surface of the bones the respective guides will contact when the guides are positioned for use.	328	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Advantageously, the bone engagement surface have been generated based on models of at least a portion of the tibial resection guide 822 and/or talus resection guide 824 positioned on, or in relation to, models of one or more of the tibia 226 and talus 222. Because the bone engagement surface matches, or substantially matches, a contour of the surfaces of the bones, the bone engagement surface, when used, readily moves into the same position on the bone(s) as the model of the bone engagement surface had in relation to the models of the bones.	329	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In certain embodiments, the bone engagement feature 830 includes a bone engagement surface and a body section, the body section extends from the body and supports the bone engagement surface. In certain embodiments, where a bone engagement feature 830 is unneeded or undesired, a body section of a resection guides 820 may be replaced with an opening or a void. Said another way, the body (or a body section) may not be formed/fabricated in an area of a resection guides 820 where a bone engagement feature 830 is not needed or desired.	330	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 14B illustrates that a surgeon has provided user instructions 604 for including an additional bone engagement feature 830d. Specifically, the surgeon has requested that the body be extended on the lateral side, that the body include a bone engagement surface on its posterior side to engage bone of the talus 222 and that the talus resection feature 866 be configured to include a slot that extends in a plantar direction on the lateral side. In this embodiment, the surgeon may have requested the added bone engagement feature 830d to facilitate placement of the talus resection guide 824 on the talus 222. Alternatively, or in addition, the added bone engagement feature 830d may have been included to facilitate an osteotomy of the lateral side of the talus 222. For example, a surgeon may decide to resect a lateral extending process 223 of the talus 222. Advantageously, a surgeon can use embodiments of the present disclosure to obtain a resection guide 1404 that is patient-specific and customized to the needs and/or desires of the surgeon in order to provide improved patient care.	331	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 15A illustrates a lateral side view of a resection guide 1502 of an osteotomy system 1500, according to one embodiment. The resection guide 1502 of the osteotomy system 1500 can include some or all of the same or substantially the same features, aspects, and/or components as the resection guides 820 described herein with like components including the same reference numerals. Accordingly, the resection guide 1502 can or may include one or more tibia resection features 864, one or more talus resection feature 866, one or more bone attachment features 828, one or more bone engagement features 830, one or more landmark registration features 834, one or more alignment guides 874, one or more shafts 878, one or more openings 868, one or more resection guards 870, one or more fastener guides 890, and the like.	332	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the resection guide 1502 can be designed and/or fabricated by combining a tibial resection guide 822 with a talus resection guide 824 by adding more body structure that connects and joins the two resection guides 820. Thus, the resection guide 1502, in one embodiment, can include a tibial resection guide 1522 connected to a talus resection guide 1524 and an interconnecting body section 1526.	333	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 15A illustrates a lateral side view of the resection guide 1502. Those of skill in the art will appreciate that the tibial resection guide 1522 can be configured the same as or similarly to the tibial resection guide 822, including one or more bone attachment features 828 and/or one or more bone engagement surface 832 and/or one or more landmark registration features 834. Alternatively, or in addition, the talus resection guide 1524 can be configured the same as or similarly to the talus resection guide 824, including one or more bone attachment features 828 and/or one or more bone engagement surface 832 and/or one or more landmark registration features 834.	334	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In addition, the resection guide 1502 can include a bone probe 1528. In one embodiment, the bone probe 1528 is a structure that extends away from the interconnecting body section 1526 from a posterior side of the resection guide 1502. In one embodiment, the bone probe 1528 is configured to extend such that when the resection guide 1502 is in use the bone probe 1528 extends into a joint between a first bone (e.g., tibia 226) and a second bone (e.g., talus 222). In one embodiment, the bone probe 1528 is configured to engage, at least partially, with a landmark associated with one or the other or both of the first bone and the second bone. In one embodiment, the landmark of one or both of the bones may be a protrusion, a projection, a tuberosity, a cavity, a void, a divot, a tab, an extension, a hook, a curve, or the like of one or both of the bones and/or a structure on a surface of one or both of the bones. In one embodiment, a distal end of the bone probe 1528 can be patient-specific and configured to substantially match a surface of one or the other of the bones of a joint.	335	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the bone probe 1528 starts with a first width and tapers to a narrow width moving from a proximal end of the bone probe 1528 to a distal end of the bone probe 1528. In one embodiment, the bone probe 1528 can have a width that is similar to the width of the resection guide 1502 from medial to lateral. Alternatively, or in addition, the bone probe 1528 can have a width that is smaller than the width of the resection guide 1502 from medial to lateral. In another embodiment, the bone probe 1528 can have a width that is greater than the width of the resection guide 1502 from medial to lateral.	336	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the bone probe 1528 can have a superior surface 1530 and an inferior surface 1532. In one embodiment, one or the other or both of the superior surface 1530 and the inferior surface 1532 can include a bone engagement surface 832. In one embodiment, the bone engagement surface 832 can be configured to match and/or substantially match a corresponding surface of the first bone (e.g., tibia 226) and/or the second bone (e.g., talus 222).	337	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Those of skill in the art will appreciate that just as the resection guide 1502 can be designed to include a bone probe 1528, a body of the tibial resection guide 1522, the talus resection guide 1524, and/or a resection guide 1402 can include additional features that extend anteriorly from an anterior surface (the one facing away from the bone(s) when the device is in use with an anterior approach surgical procedure). These additional features can be referred to as resection guards or resection retractors and may serve to retain soft tissue around the edges of one or more incisions for the surgical procedure. In particular, these resection guards or resection retractors can be configured to extend anteriorly from the resection guide 1502 and of a distance sufficient to meet or exceed a skin surface for the patient during the surgical procedure. The resection guards or resection retractors may keep soft tissue from moving to close the incision(s) and obscuring a view for a surgeon and/or interfering with any cutting tools or other instruments during a surgical procedure.	338	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 15B illustrates an anterior view of a positioning guide 1534 of an osteotomy system, according to one embodiment. In one embodiment, the osteotomy system 800 include one or more guide anchors. The positioning guide 1534 may use the guide anchors.	339	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	A guide anchor is an anchor for a resection guide 820 (e.g., tibial resection guide 822, talus resection guide 824, resection guide 1402, resection guide 1502, etc.). The guide anchor serves to hold a resection guide in place during an osteotomy. In one embodiment, the guide anchor is implemented by way of a pin (e.g., fastener) and an opening in the resection guide 820. In the illustrated embodiment, the pins may be the pins of the bone attachment feature 828 and/or the pins of the resection guard 870 and/or the pins of the fastener guides 890.	340	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the pins of the fastener guides 890 may enter the tibia 226 in parallel to each other which enables the tibial resection guide 822 to be slid off of the pins of the fastener guides 890 once an osteotomy of the tibia 226 is completed with the pins remaining in the tibia 226. These pins may be referred to as tibia pins. Similarly, the pins of the bone attachment features 828 of the talus resection guide 824 may be deployed parallel to each other and may remain when the talus resection guide 824 is removed. These pins may be referred to as talus pins. The tibia pins and/or talus pins may be referred to as reference features.	341	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Advantageously, because the surgical procedure is preplanned using medical imaging of bones of a patient the same pins that serve as reference features can also serve as guide anchors. Those of skill in the art will appreciate that a reference feature can serve as an alignment feature or a resection guide anchor or both depending on the embodiment.	342	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The positioning guide 1534 engages the guide anchors, reference features (e.g., tibia pins and/or talus pins) to position the talus 222 relative to the tibia 226 for a reduction of osteotomies of each of these bones. Alternatively, or in addition, the positioning guide 1534 holds the reduction closed and stable once the positioning guide 1534 has been slid to contact one of the other or both of the bones.	343	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The positioning guide 1534 includes an anterior side 1536, posterior side 1538 (not shown), a medial side 1540, and a lateral side 1542. The positioning guide 1534 also includes a first proximal opening 1544, a second proximal opening 1546, first distal opening 1548, and a second distal opening 1550.	344	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, a surgeon uses the positioning guide 1534 after a first osteotomy of a first bone and a second osteotomy of a second bone. In one embodiment, the two bones are a tibia 226 and a talus 222 and the positioning guide 1534 is configured to have a size that extends along a superior-inferior axis across the resection interface, the reduced osteotomies. In one embodiment, a surgeon has retained the tibia pins in the tibia 226 and the talus pins in the talus 222. These pins may come from a tibial bone attachment feature and a talus bone attachment feature. The positioning guide 1534 is configured to cooperate with one of the tibial bone attachment feature and the talus bone attachment feature to abut a first osteotomy against a second osteotomy in a stable relationship to close the resection interface.	345	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	At this stage, a surgeon is prepared to reduce the osteotomies and prepare for provisional and/or permanent fixation. Next, a surgeon slips the first proximal opening 1544 and the second proximal opening 1546 over the tibia pins and the first distal opening 1548 and second distal opening 1550. Next, the surgeon slides the positioning guide 1534 towards the bones. As the positioning guide 1534 slides towards the bones, the osteotomies are reduced and the two resected surface of the bones are brought together. In one embodiment, the talus 222 may be translated toward the tibia 226 until the talus 222 abuts the tibia 226. At this stage, the positioning guide 1534 may be in contact with or near the surface of the bones. The positioning guide 1534 is in its final position and the resection interface is closed. A surgeon can now prepare for a subsequent step such as fixation.	346	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 16 is a flowchart diagram depicting a method for remediating a bone condition, according to one embodiment. FIG. 16 is a flowchart of an example method 1600. In some implementations, one or more method steps of FIG. 16 may be performed by a surgeon using one or more of the apparatuses, systems, and/or components described here.	347	Added by DJM Jan 2024	1/6/24, 10:01 PM

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