Patient specific instruments and methods for joint prosthesis

A method for manufacturing a patient specific guide, comprising:

• receiving location and orientation information including a position of at least two bushings disposed in at least two bone locations;
• receiving location and orientation information including the position of at least two bone locations;
• based upon the location and orientation information, manufacturing a patient specific guide configured to position at least one tool guide surface relative to at least one of the bone locations, the manufacturing including forming a first member to mate with the first bushing and forming a second member to mate with the second bushing, the first and second members having a length sufficient to create clearance from the bone when the first and second members are so mated.

A system for preparing an ankle bone to receive an ankle prosthesis, comprising:

• a patient specific cutting guide having an anterior surface, a posterior surface, and at least one tool engaging surface extending through the cutting guide from the anterior surface, the posterior surface comprising a first protrusion extending from a first end fixed to the posterior surface to a second end disposed away from the first end of the first protrusion;
• the posterior surface comprising a second protrusion extending from a first end fixed to the posterior surface to a second end disposed away from the first end of the second protrusion;
• wherein the first and second protrusion are spaced apart and have a length such that when the patient specific cutting guide is coupled with at least one ankle bone a clearance gap is provided between the posterior surface and the ankle bone.