Dave's PCF WIP: Paragraphs

Paragraphs

Actions	Matter	Content	Para #	Notes	Modified
View Edit Delete	PER-24	Advantageously, the components of the system 700 can be specifically designed for a particular patient. Alternatively, or in addition, the components of the system 700 can be specifically designed for a class of patients. Each of the components of system 700 can be designed, adapted, engineered and/or manufactured such that each feature, attribute, or aspect of the component is specifically designed to address one or more specific indications present in a patient. Advantageously, the cuts made for the osteotomy procedure can be of a size, position, orientation, and/or angle that provides for an optimal osteotomy with minimal risk of undesirable resection. In one embodiment, the components of system 700 can be configured such that an osteotomy is performed that enables a correction in more than one plane in relation to the parts of the body of the patient. For example, cut channels or resection features 722 in a resection guide 720 can be oriented and configured such that when the bones are fused/fixated the correction results from translation, rotation, and/or movement of bones or bone parts in two or more planes (e.g., sagittal and transverse) once the fragments or bones are reduced.	234	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In certain embodiments, the exemplary system 700 may include a plurality of fasteners 710, resection guides 720, and/or complementary components 730. For example, a surgeon may plan to resect a plurality of osteotomies from the bone(s) in order to accomplish a desired correction. In one example, one or more wedge segments may be resected from a medial side of a patient's foot and another one or more wedge segments may be resected from a lateral side of the patient's foot. These wedge segments may extend part way into the foot, or through from one side of the foot to the other. Of course, multiple wedge segments may be formed on one side of the foot as well.	235	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Additionally, a surgeon may use one or more components in an exemplary system 700 to make multiple cuts in the bone(s). The multiple cuts may be centered over or around an apex of a deformity or positioned at other locations within the foot such that when the multiple cuts are made, any resected segments removed, or added bone void fillers introduced, and/or bones and/or bone fragments translated and/or rotated the combined angles, surfaces, removed segments, and/or added portions cooperate to provide a desired correction. Each of the components of the exemplary system 700 can be identified, defined, and reviewed using the apparatuses, systems, and/or methods of the present disclosure.	236	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In certain embodiments, the components of system 700 may be made as small as possible to minimize the amount of soft tissue that is opened in the patient for the osteotomy procedure. Alternatively, or in addition, walls and/or sides of the components may be beveled and/or angled to avoid contact with other hard tissue or soft tissues in the operating field for the osteotomy procedure.	237	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 for certain osteotomy procedures a complementary component 730 may not be needed or a given complementary component 730 may be optional for use in the osteotomy procedure. Similarly, those of skill in the art will appreciate that certain features of the fasteners 710, resection guides 720, and/or complementary components 730 can be combined into one or more of apparatus or devices or may be provided using a plurality of separate devices.	238	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIG. 8 illustrates an exemplary ankle fusion osteotomy system 800, according to one embodiment. The osteotomy system 800 can include one or more fasteners 810 and/or two or more sets of fasteners (810a, 810b, 810c, 810d), one or more resection guides 820, and zero or one or more complementary components 730. In the illustrated embodiment, the resection guides 820 include a tibial resection guide 822 and a talus resection guide 824. The resection guides 820 may also include one or more of resection features 826, bone attachment features 828, bone engagement feature 830, and/or landmark registration feature 834. In certain embodiments, a bone engagement feature 830 can include a bone engagement surface 832.	239	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	While specific embodiments of complementary components 730 are not specifically shown here in relation to the osteotomy system 800, those of skill in the art will appreciate that complementary components 730 can be similar in feature, design, implementation, configuration, and purpose as those described in relation to the osteotomy system 700 and can be used for the osteotomy system 800. Thus, the osteotomy system 800 can include one or more alignment guides 740, rotation guides 750, correction guides 760, compression guides 770, positioning guides 780, fixation guides 790, navigation guides 792, implants 794, or the like.	240	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Either or both of the resection guides 820 may be custom patient-specific resection guides made for a particular patient and/or for a particular surgical procedure. Various aspects of the resection guides 820 may be patient-specific, including, but not limited to, an angle and/or orientation for a resection feature of the resection guide 820, a position of the resection feature, a depth of the resection feature, a size of the resection guide 820, a configuration and/or composition of a bone contacting surface such as a bone engagement surface of the resection guide 820, and the like.	241	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the tibial resection guide 822 includes a body 836 that includes an anterior side 838, a posterior side 840, a medial side 842, a lateral side 844, a superior side 846, and an inferior side 848. The talus resection guide 824 may also include a body 850 that includes an anterior side 852, a posterior side 854, a medial side 856, a lateral side 858, a superior side 860, and an inferior side 862.	242	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In the illustrated embodiment, the tibial resection guide 822 and talus resection guide 824 are separate instruments. Advantageously, using two separate resection guides can enable a surgeon to adapt intraoperatively to an amount of rotation and/or translation of one or more bones the soft tissue around the bones will permit. Specifically, one resection guide (e.g., tibial and/or talus) may include a resection feature with a first angle for correction, a second resection guide may include a resection feature with a second angle for correction greater than the first, a third resection guide may include a resection feature with a third angle for correction greater than the second, and so forth. These different resection guides may be part of a kit available to the surgeon during the surgery. In this manner, a surgeon can choose a resection guide with a preferred angle for correction during the surgery.	243	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In another embodiment, the tibial resection guide 822 and talus resection guide 824 and/or components of the tibial resection guide 822 and talus resection guide 824 may be combined into a single instrument. In another embodiment, the tibial resection guide 822 and/or talus resection guide 824 may include a coupler that enables the tibial resection guide 822 and talus resection guide 824 to be coupled together before or during a surgical procedure.	244	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In certain embodiments, a position of one or more of a resection feature 826 of the tibial resection guide 822 and/or a resection feature 826 of the talus resection guide 824 can be determined and/or defined at least partially based on a bone model of at least a portion of a bone of a patient's foot. In one embodiment, the resection features 826 may be positioned to remove a minimal amount of bone and implement a deformity correction.	245	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the position and/or configuration of the resection feature 826 may be determined, defined, and/or dictated by both a bone model of a portion of a patient's foot and user instructions 604. Advantageously, the user instructions 604 may identify certain goals for the resection feature 826 such as minimal size (i.e., width, length, depth), shape, contour, position, orientation, trajectory, and the like. Since the resection feature 826 guides the formation of an osteotomy, the configuration of the resection feature 826 provided by the user instructions 604 can also define an osteotomy created using the resection feature 826.	246	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	The resection feature 826 of the tibial resection guide 822 may be referred to as a tibia resection feature 864 and the resection feature 826 of the talus resection guide 824 may be referred to as a talus resection feature 866. In certain embodiments, this means that a user, or end user, may review the bone model, and a model of the tibial resection guide 822 and/or the talus resection guide 824 and based on these models determine, at least in part, where to position the resection feature 826 (e.g., tibia resection feature 864 and talus resection feature 866) within a resection guide 820. Advantageously, by reviewing and working with the models, a user and/or end user can minimize the amount of bone removed to perform a successful surgical procedure. Determining a position for the resection features 826 in a model of an instrument can be directly reflected in a fabricated instrument based on the model. In one embodiment, the position of a resection feature can be based on user instructions 604. Alternatively, or in addition, other features of a resection guide 820 can be based, at least partially, on user instructions 604.	247	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In one embodiment, the tibia resection feature 864 is configured to guide a cutting tool to form a first osteotomy in a tibia of a patient. The talus resection feature 866 is configured to guide the cutting tool to form a second osteotomy in a talus of the patient. The first osteotomy and second osteotomy are configured to cooperate with each other to form a resection interface between the tibia and the talus of the patient. The resection interface is an interface between a resected portion of the tibia and a resected portion of the talus. In certain embodiments, these resected portions (e.g., cut faces) are brought into contact and fixation is deployed to promote fusion of the talus to the tibia at the resection interface. In certain embodiments, the resection interface includes no implant or other structure between the resected portion of the tibia and the resected portion of the talus. In contrast to an arthroplasty surgical procedure, the resection guides 820 are used for a bone fusion procedure, an arthrodesis. Thus, the interface in the embodiments of the present disclosure are for facilitating a joint fusion.	248	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	FIGS. 9A-9F illustrate views of a resection guide 820 (e.g., tibial resection guide 822) of the osteotomy system of FIG. 8, according to one embodiment. The tibial resection guide 822 includes one or more resection features 826, one or more bone attachment features 828 (e.g., a fastener 810 and opening), and one or more bone engagement features 830 which may include one or more bone engagement surfaces 832. In certain embodiments, bone engagement features 830 implemented in a tibial resection guide 822 are referred to as tibial bone engagement features.	249	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	Advantageously, the resection features 826 can be positioned, sized, and/or oriented to enable a surgeon to resect any particular shape in the bone for the osteotomy procedure. In the illustrated embodiment, the resection features 826 are configured to direct a cutting tool at an angle in one or more planes into the bone. The angle may be normal to a longitudinal axis of the bone, at an oblique angle, at an acute angle, or at an obtuse angle relative to a longitudinal axis of the bone. Advantageously, the size, shape, and angle of the resection can be predefined and can be determined preoperatively and/or can be patient-specific. In manner, the tibial resection guide 822 serves to provide for a patient-specific osteotomy procedure. Alternatively, or in addition, the resection features 826 can be configured to enable a surgeon to readily resect in a plantar direction and/or a dorsal direction. In certain embodiments, the resection features 826 may include an opening on one end or the other or both ends to permit the surgeon to position a cutting tool to make desired cuts that can extend laterally or medially.	250	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In addition, the tibial resection guide 822 includes an anterior side 838, posterior side 840, a medial side 842, lateral side 844, superior side 846, and an inferior side 848. Generally, the sides of the tibial resection guide 822 refer to the direction the sides face when the resection guide 820 is in use. In certain embodiments, the tibial resection guide 822 can include a landmark registration feature 834.	251	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In the illustrated embodiment, at least one landmark registration feature 834 extends from the posterior side 840. Advantageously, the landmark registration feature 834 can provide a surgeon with confidence and assurance in the placement and positioning of the tibial resection guide 822 on the bone because the landmark registration feature 834 can be configured to engage with a particular landmark on the bone (e.g., a projection or a depression or cavity). Alternatively, or in addition, the landmark registration feature 834 can include a contoured bone engagement surface 832 that can further facilitate registration of the landmark registration feature 834 and/or tibial resection guide 822 with the bone. In this manner, a surgeon can be assured intraoperatively that the tibial resection guide 822 is being positioned as desired.	252	Added by DJM Jan 2024	1/6/24, 10:01 PM
View Edit Delete	PER-24	In certain embodiments, the landmark registration feature 834 can be shaped like a hook to engage a surface or structure of a bone. Alternatively, or in addition, the tibial resection guide 822 may include a landmark registration feature 834 on each end (lateral and medial), together the landmark registration features 834 can engage one or more landmarks of a surface of the bone such that the surgeon can accurately position and register the tibial resection guide 822 to the bone.	253	Added by DJM Jan 2024	1/6/24, 10:01 PM

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