System for articular surface replacement

1. A method of replacing a portion of an articular surface comprising:

forming a first excision site centered around a first axis extending generally outwardly from said articular surface, wherein said first axis is substantially normal to said articular surface;

forming a second excision site centered around a second axis extending generally outwardly from said articular surface, wherein said second and said second axes are aligned at a predetermined relationship with respect to each other, and wherein said first and said second excision sites partially overlap.

2. A method of replacing a portion of an articular surface comprising:

securing a first guide wire to bone beneath said articular surface along said first axis, and

advancing a first reamer over said first guide wire to form a first excision site centered around a first axis extending generally outwardly from said articular surface; and

forming a second excision site centered around a second axis extending generally outwardly from said articular surface, said first and said second axes aligned at a predetermined relationship with respect to each other;

wherein said first and said second excision sites partially overlap.

3. The method of claim 2 , further comprising securing a second guide wire to bone beneath said articular surface along said second axis, and advancing a second reamer over said second guide wire to form said second excision site.

4. A method of replacing a portion of an articular surface comprising:

forming an implant site in a portion of said articular surface, said implant site having a perimeter surrounded by a remaining portion of said articular surface, wherein forming said implant site comprises:

forming a first excision site relative to a first axis relative to said articular surface; and

forming a second excision site relative to a second axis relative to said articular surface, wherein a portion of said first and said second excision sites partially intersect; and

installing an implant into said implant site such that said implant is received within implant site and a perimeter of said implant is surrounded by said remaining portion of said articular surface, said implant having a load bearing surface comprising a contour based on an original contour of said articular surface.

5. A method according to claim 4 , wherein forming said first excision site comprises excising said articular surface along a first circular excision path centered around said first axis.

6. A method according to claim 4 , further comprising aligning a drill guide relative to said first axis to establish said second axis at a predetermined relationship relative to said first axis, said drill guide comprising a locating feature corresponding to said second axis.

7. A method according to claim 5 , wherein forming said first excision site comprises advancing a first reamer rotating around said first axis into said articular surface along said first axis.

8. A method according to claim 5 , further comprising securing a first guide pin into said bone along said first axis, and advancing a first reamer over said first guide pin into said articular surface along said first axis.

9. A method according to claim 4 , wherein said first axis is substantially normal to said articular surface.

10. A method according to claim 4 , wherein forming said second excision site comprises excising said articular surface along a second circular excision path centered around said second axis.

11. A method according to claim 10 , wherein forming said second excision site comprises advancing a second reamer rotating around said second axis into said articular surface along said second axis.

12. A method according to claim 10 , further comprising securing a second guide pin into said bone along said second axis, and advancing a second reamer over said second guide pin into said articular surface along said second axis.

13. A method according to claim 4 , further comprising establishing said second axis at a predetermined relationship with respect to said first axis using a drill guide.

14. A method according to claim 13 , wherein said drill guide comprises:

a body portion including:

a first portion configured to be aligned along said first axis; and

a first opening extending through said body portion, said first opening configured to be aligned along said second axis at a predetermined relationship with respect to said first axis.

15. A method according to claim 14 , wherein said body portion of said drill guide further includes a second opening extending through said body portion, said second opening configured to be aligned along said first axis.

16. A method according to claim 14 , wherein said body portion includes an arcuate member having a bone facing surface that generally conforms to said articular surface.

17. A method according to claim 4 , further comprising securing a location element into bone along said first axis, said location element configured to be secured to said implant.

18. A method according to claim 17 , wherein said location element is configured to be secured in said bone at a predetermined height relative to said articular surface.

19. The method of claim 18 , wherein said predetermined height is selected such that a portion of said location element is tangential with an arc defined by said articular surface.

20. The method of claim 18 , wherein said location element includes a threaded portion configured to engage bone, said method further comprising adjusting said predetermined height by rotating said location element relative to said articular surface.

21. The method of claim 20 , further comprising securing said implant to said location element, wherein said predetermined height is selected such that said load bearing surface is substantially flush with said articular surface.

22. A method according to claim 21 , wherein securing said implant to said location element includes engaging mating tapered surfaces of said implant and said location element to form a friction connection therebetween.

23. A method of replacing a portion of an articular surface comprising:

forming a first excision site centered around a first axis extending generally outwardly from said articular surface;

forming a second excision site centered around a second axis extending generally outwardly from said articular surface, wherein said second and said second axes are aligned at a predetermined relationship with respect to each other, and wherein said first and said second excision sites partially overlap; and

forming a third excision site centered around a third axis extending generally outwardly from said articular surface, wherein said third axis is at a predetermined relationship with respect to said first and said second axes.

24. The method of claim 23 , further comprising securing a first guide wire to bone beneath said articular surface along said first axis, and advancing a first reamer over said first guide wire to form said first excision site.

25. The method of claim 24 , further comprising securing a second guide wire to bone beneath said articular surface along said second axis, and advancing a second reamer over said second guide wire to form said second excision site.

26. The method according to claim 23 , further comprising securing a location element into bone along said first axis, said location element configured to be secured to an implant configured to be at least partially received in said first and said second excision sites.

27. The method of claim 26 , wherein said location element includes a threaded portion configured to engage bone, said method further comprising adjusting said predetermined height by rotating said location element relative to said articular surface such that said load bearing surface of said implant is substantially flush with said articular surface.

28. The method according to claim 27 , further comprising securing said implant to said location element.

29. The method of claim 28 , wherein securing said implant to said location element includes engaging mating tapered surfaces of said implant and said location element.

30. The method according to claim 23 , further comprising:

establishing said first axis; and

aligning a first drill guide relative to said first axis to establish said second axis.

31. The method of claim 30 , wherein said first drill guide comprises:

a body portion including:

a first portion configured to be aligned along said first axis; and

a first opening extending through said body portion, said first opening configured to be aligned along said second axis at a predetermined relationship with respect to said reference axis.

32. The method of claim 31 , wherein said first portion includes a second opening extending through said body portion, said second opening configured to be aligned along a first axis extending outward from said articular surface.

33. The method according to claim 31 , wherein establishing said first axis includes using a second drill guide.

34. A method of replacing a portion of an articular surface comprising:

forming a first excision site centered around a first axis extending generally outwardly from said articular surface;

forming a second excision site centered around a second axis extending generally outwardly from said articular surface, said first and said second axes aligned at a predetermined relationship with respect to each other, wherein said first and said second excision sites partially overlap; and

securing a location element into bone along said first axis, said location element configured to be secured to an implant configured to be at least partially received in said first and said second excision sites.

35. The method of claim 34 , wherein said location element includes a threaded portion configured to engage bone, said method further comprising adjusting said predetermined height by rotating said location element relative to said articular surface such that said load bearing surface of said implant is substantially flush with said articular surface.

36. The method according to claim 35 , further comprising securing said implant to said location element.

37. The method of claim 36 , wherein securing said implant to said location element includes engaging mating tapered surfaces of said implant and said location element.