Prosthetic implants including frames for fixation to bone and related methods

Abstract

The present invention is entitled "Prosthetic implants including frames for fixation to bone and related methods." The present disclosure provides prosthetic implants to be used in various surgical repairs including procedures such as total shoulder arthroplasty and reverse total shoulder arthroplasty. The implants include two main parts: a frame and a prosthetic component. The frame includes an aperture configured to receive the prosthetic component, allowing the prosthetic component to be in direct contact with bone at the surgical site. Various configurations are provided that allow the prosthetic component to be coupled to or otherwise engaged with the frame, and at least some of the configurations enable reverse procedures to be performed without having to completely rework and / or modify the bone. A variety of procedures resulting from the improved implants are also provided.

Description

Technical Field

[0001] This disclosure relates in general to prosthetic implants, and more specifically to prosthetic implants including frames for fixation to bone and related methods for deploying such implants in a patient. Background Technology

[0002] Throughout a patient's life, total shoulder arthroplasty may be necessary due to reasons such as illness or trauma. Figure 1A As shown, in anatomical total shoulder arthroplasty, a humeral prosthesis 10 can be used to replace the natural head of the patient's humerus. The humeral prosthesis 10 typically includes an elongated column component 12 implanted into the intramedullary canal of the patient's humerus and a hemispherical prosthetic head component 14 fixed to the column component 12. Additionally, the natural glenoid surface of the scapula can be resurfacing or otherwise replaced with an anatomical glenoid implant 20. The anatomical glenoid implant 20 typically includes a concave bearing surface 24 on which the prosthetic head component 14 of the humeral prosthesis 10 performs articular movement. A stud or keel 22 may protrude from the distal end of the implant 20 and may be cemented into the glenoid cavity of the patient's scapula.

[0003] Anatomical glenoid implants are typically made of polyethylene. Polyethylene is a ductile material with relatively low strength, hardness, and stiffness, but relatively high ductility and impact strength. To improve durability and bone fixation, some polyethylene implants are reinforced with metal backplates. For example, Figure 1B An anatomical glenoid implant 20' is shown, having a metal backplate 30 disposed on the distal surface of a polyethylene component 32. Such metal-backed implants can have several drawbacks, such as increased wear rate, glenoid loosening, stress shielding, excessive glenoid bone loss or other osteolysis, and / or separation of the polyethylene component from the metal backplate. Attempts to address some of these drawbacks include adjusting the thickness of the polyethylene component. However, making the polyethylene component too thin can lead to accelerated implant wear. Conversely, making the polyethylene component too thick can result in excessive tension on the rotating sleeve and increased load on the polyethylene component.

[0004] In some clinical situations, reverse total shoulder arthroplasty may be preferred to alter shoulder mechanics, for example, when a patient's natural shoulder has degenerated to a degree of joint instability and pain. Reverse shoulder implants can be used to reverse the anatomy or structure of the healthy shoulder. For example, as... Figure 1CAs shown, in reverse total shoulder arthroplasty, a humeral prosthesis 50 can be used to replace the natural head of the patient's humerus. The humeral prosthesis 50 typically comprises an elongated column portion 52 implanted into the intramedullary canal of the patient's humerus and a concave prosthetic head portion 54 (referred to as the humeral cup) fixed to the column portion 52. Additionally, a reverse glenoid implant, such as a hemispherical glenoid ball 60, can be fixed to the glenoid bone of the patient's scapula. This reverse configuration allows the patient's deltoid muscle (one of the larger and stronger shoulder muscles) to lift the arm.

[0005] In some patients, anatomical-to-reverse total shoulder arthroplasty may be performed to convert a previously reconstructed shoulder joint from an anatomical configuration to a reverse configuration. On the glenoid side, the previously deployed anatomical glenoid implant (e.g., 20 or 20') can be replaced with a reverse glenoid implant (e.g., glenoid ball 60). Such replacements often involve complex and challenging procedures due to the independent configurations and components of the respective implants. In some clinical cases, bone loss and / or further degeneration of the glenoid bone may also occur during the procedure, which can compromise the integrity of the anatomical-to-reverse conversion.

[0006] Therefore, there is a need for improved prosthetic implants and related methods for securing the implants to the bone in a manner that avoids the drawbacks of conventional metal-backed implants (such as the devices and methods described above in relation to anatomical shoulder reconstruction surgery). Additionally, there is a need for improved prosthetic implants and related methods for performing anatomical-to-reverse full shoulder conversion in an efficient manner that overcomes these complexities. Summary of the Invention

[0007] This disclosure provides a combination of a frame and a prosthetic component for use with an upper implant, specifically for glenoid repair surgery. However, those skilled in the art will appreciate that the implants provided herein, or in other words, those deduced from this disclosure, can be used in other applications and other parts of a patient's body, not limited to humans (i.e., any animal). As described herein, the combination of the frame and the prosthetic component allows direct contact between the prosthetic component and the implantation site. The frame defines an orifice through which the distally facing surface of the prosthetic component can directly engage with the bone at the implantation site. The frame and prosthetic component provided herein offer a variety of different configurations that allow the prosthetic component to be secured or otherwise coupled to the frame while also engaging with the bone. The frame provides stability, and the prosthetic component provides the desired direct contact with the bone. In many embodiments, the frame may be made of one or more metals, and the prosthesis may be made of one or more plastic materials. Some non-limiting examples of configurations for engaging prosthetic components with a frame include bone anchor recesses, anchor bolts, snap-fit ​​connector interfaces and components, and removable frame adapters (e.g., T-bars). This disclosure also allows for the beneficial effects of using some of the same components (such as the frame) for both conventional repairs (e.g., total shoulder arthroplasty) and reverse repairs (e.g., reverse total shoulder arthroplasty).

[0008] In one exemplary embodiment, the prosthetic implant includes a prosthetic component and a frame. The prosthetic component has a proximal bearing surface and a distally facing surface, wherein the distally facing surface is opposite to the proximal bearing surface. The frame is configured to be anchored in the bone. The frame defines an orifice through which a portion of the prosthetic component is configured to be disposed, and the frame includes one or more attachment interfaces. The one or more attachment interfaces are configured to attach the prosthetic component to the frame such that the distally facing surface of the prosthetic component extends through the orifice of the frame to directly contact the bone.

[0009] The frame may include one or more metals. The frame may also include an annular body. The annular body may include a substantially flat proximal surface and a substantially convex distal surface. The inner wall of the annular body may define an aperture in the frame.

[0010] In some embodiments, the frame includes one or more bone anchor recesses for anchoring the frame to bone. Each of the one or more bone anchor recesses may define a through-hole through which a bone anchor is inserted into the bone. Openings through the frame allow access to the bone anchor recess. The frame may include a plurality of anchor bolts for anchoring the frame to bone. The anchor bolts may extend distally from the frame.

[0011] One or more attachment interfaces of the frame may include one or more snap-fit ​​connector interfaces. In some such embodiments, the prosthesis component may include a body that itself includes one or more snap-fit ​​connectors configured to engage with one or more snap-fit ​​connector interfaces of the frame. When the snap-fit ​​connector of the prosthesis component is attached to the snap-fit ​​connector interface of the frame, the distally facing surface of the prosthesis component may directly contact the bone through an opening in the frame.

[0012] In addition to or instead of a frame comprising one or more metals, the prosthetic component may comprise one or more plastic materials. The prosthetic component may include pillars extending from the distally facing surface of the prosthetic component. The pillars may be configured to engage voids formed in the bone. In some embodiments, the distally facing surface of the prosthetic component may include a cross-sectional profile shaped as a negative image of the cross-sectional profile forming the orifice of the frame.

[0013] The proximal bearing surface and the distal surface can have various shapes, including each having a convex shape, each having a concave shape, and one having a convex shape while the other has a concave shape. For example, in some exemplary embodiments, the distal surface of the prosthesis component may include a convex shape, and the proximal bearing surface of the prosthesis component may include a concave shape.

[0014] One or more attachment interfaces of the frame may have various configurations. For example, in some cases, one or more attachment interfaces of the frame may include a removable frame adapter. The removable frame adapter may define one or more locking screw retainers, and the removable frame adapter may be configured to extend across the orifice between opposing legs of the frame. In some such embodiments, the frame may include a distal surface defining opposing recesses configured to guide the removable frame adapter across the orifice of the frame between opposing legs of the frame. The prosthesis component may define one or more through-holes that may correspond to one or more locking holes of the removable frame adapter. Additionally, the prosthesis component may be configured to be attached to the frame by inserting locking screws through one or more through-holes of the prosthesis component and into one or more locking screw holes of the removable frame adapter. The distally facing surface of the prosthesis component may define a recess for aligning the prosthesis component with the removable frame adapter. In some embodiments, the implant may include a prosthesis head. The head may have a hemispherical shape and be attachable to a proximal bearing surface of the prosthesis component. The prosthetic component may include a column extending from the distally facing surface of the prosthetic component. The column may be configured to engage with a cavity formed in the bone.

[0015] For example, one or more attachment interfaces of the frame may include one or more locking screw recesses accessible through an orifice. The locking screw recesses may define one or more corresponding locking screw holes. In some embodiments, the locking screw recesses may include at least two screw recesses projecting from opposing legs of the frame into the orifice. The prosthesis component may define one or more through-holes that may correspond to one or more locking holes of the one or more locking screw recesses. Additionally, the prosthesis component may be configured to be coupled to the frame by inserting a locking screw through one or more through-holes of the prosthesis component and into the locking screw hole of the locking screw recess. The distally facing surface of the prosthesis component may include one or more guides for aligning the prosthesis component with the locking screw recess. In some embodiments, the implant may include a prosthesis head. The head may have a hemispherical shape and be coupled to a proximal bearing surface of the prosthesis component. In some such embodiments, the prosthesis head may define an opening through which a locking screw is inserted through one or more through-holes of the prosthesis component and into the locking screw hole of the locking screw recess. The prosthetic component may include a column extending from the distally facing surface of the prosthetic component. The column may be configured to engage with a cavity formed in the bone.

[0016] For example, one or more attachment interfaces of the frame may include a plurality of anchor bolts. The anchor bolts may protrude from the frame and can be used to anchor the frame to bone. One or more of such bolts may define one or more bores therein. The prosthesis component may define one or more holes corresponding to one or more bores defined in the anchor bolts. Additionally, the prosthesis component may be configured to be coupled to the frame by inserting a locking screw through a hole in the prosthesis component and into one or more bores defined in the anchor bolts. In some such embodiments, the distally facing surface of the prosthesis component may have a cross-sectional profile shaped as a negative image of the cross-sectional profile forming the orifice of the frame. Unthreaded bores may be defined in at least one of the anchor bolts of the frame. In some such embodiments, the prosthesis component may include an anti-rotation bolt protruding from the distal bearing surface of the prosthesis component. The anti-rotation bolt may be configured to mate with an unthreaded bore. In some embodiments, the implant may include a prosthesis head. The head may have a hemispherical shape and be coupled to the proximal bearing surface of the prosthesis component. The prosthetic component may include a column extending from the distally facing surface of the prosthetic component. The column may be configured to engage with a cavity formed in the bone.

[0017] In some implementations, the implant may include a bone screw. The bone screw may be configured to be disposed within a post of the prosthetic component to anchor the prosthetic component to the bone.

[0018] One or more attachment interfaces may include at least two attachment interfaces. In some such embodiments, a first attachment interface may be configured to attach a prosthetic glenoid component to the frame, and a second attachment interface may be configured to attach a prosthetic glenoid bulb component to the frame.

[0019] In one exemplary method of inserting a prosthetic implant into a patient, the method includes anchoring a frame to bone and attaching a prosthetic component to the frame. The frame defines an orifice, and the prosthetic component is attached to the frame such that the prosthetic component passes through the orifice of the frame and comes into direct contact with the bone.

[0020] The method may also include removing the prosthetic component from the frame and attaching different prosthetic components to the frame while the frame remains anchored to the bone. The different prosthetic components may be components with a configuration similar to the initial prosthetic component, or they may have a different configuration.

[0021] The operation of attaching the prosthetic component to the frame can be performed in several ways. For example, in some cases, it may involve pressing the prosthetic component into an opening in the frame such that the prosthetic component snaps onto one or more snap-fit ​​connector interfaces of the frame. Alternatively or otherwise, it may involve inserting a removable frame adapter into an opening in the frame and manipulating the frame adapter to extend across the opening between opposing legs of the frame. The frame adapter may define one or more screw holes, and the method may also require aligning one or more through-holes in the prosthetic component with one or more screw holes in the frame adapter. Locking screws may be inserted through one or more through-holes in the prosthetic component and into one or more screw holes in the frame adapter.

[0022] As another non-limiting example, attaching a prosthetic component to a frame may include aligning one or more through-holes in the prosthetic component with one or more screw holes defined in one or more locking screw recesses, the one or more locking screw recesses protruding from the frame into the openings. The method may also include inserting a locking screw through a bore in the prosthetic component and into one or more screw holes in the locking screw recesses of the frame. As another non-limiting example, attaching a prosthetic component to a frame may include aligning one or more through-holes in the prosthetic component with one or more bores defined in one or more of a plurality of anchor bolts projecting distally from the frame. The method may also include inserting a locking screw through a through-hole in the prosthetic component and into one or more bores defined in one or more of the anchor bolts.

[0023] In some embodiments, the prosthetic component may be either an anatomical glenoid component or a reverse glenoid component. The frame may include one or more metals. The prosthetic component may include one or more plastic materials. Attached Figure Description

[0024] The accompanying drawings, which are incorporated herein and form part of this specification, illustrate exemplary embodiments and, together with the general description given above and the detailed description given below, explain the features of various embodiments:

[0025] Figure 1A A partially transparent side view of an example of anatomical shoulder joint reconstruction, including a prior art anatomical glenoid implant attached to the scapula;

[0026] Figure 1B A side perspective view of an example of a prior art anatomical glenoid implant with a metal backplate;

[0027] Figure 1C A partially transparent side view of an example of reverse shoulder joint reconstruction, including a prior art reverse glenoid implant attached to the scapula;

[0028] Figure 2A A front perspective view of an exemplary embodiment of an anatomical shoulder joint implant;

[0029] Figure 2B for Figure 2A Rear perspective view of an anatomical shoulder implant;

[0030] Figure 2C for Figure 2A Rear view of an anatomical shoulder implant;

[0031] Figure 2D for Figure 2A An exploded perspective view of the components of an anatomical shoulder implant, including an anatomical glenoid component and a frame.

[0032] Figure 3A for Figure 2D The front perspective of the frame;

[0033] Figure 3B for Figure 3A The side view of the frame;

[0034] Figure 3C for Figure 3A The rear perspective of the frame;

[0035] Figure 3D for Figure 3A The rear view of the frame;

[0036] Figure 4A for Figure 2D A front perspective view of the anatomical glenoid component;

[0037] Figure 4B for Figure 4ASide view of the anatomical glenoid component;

[0038] Figure 4C for Figure 4A Rear perspective view of the anatomical glenoid component;

[0039] Figure 4D for Figure 4A Second rear perspective view of the anatomical glenoid component;

[0040] Figure 5A , Figure 5B and Figure 5C To insert anatomical shoulder joint implants (such as...) Figure 2A A schematic diagram of an exemplary embodiment of a method for deploying an anatomical shoulder joint implant into a patient;

[0041] Figure 6A A front perspective view of an exemplary embodiment of a reverse-position shoulder joint implant, the implant comprising a structure similar to... Figure 3A The framework of the framework;

[0042] Figure 6B for Figure 6A Rear perspective view of a reverse-positioned shoulder implant;

[0043] Figure 6C for Figure 6A Rear view of a reverse-positioned shoulder implant;

[0044] Figure 6D for Figure 6A An exploded perspective view of the components of a reverse-positioned shoulder implant, which includes... Figure 6A The frame, removable attachment rods, and reverse-positioned glenoid components;

[0045] Figure 7A for Figure 6C A front perspective view of a portion of the reverse-positioned glenoid component (sometimes referred to as the pad in this text);

[0046] Figure 7B for Figure 7A Rear perspective view of the pad;

[0047] Figure 8A for Figure 6C A frontal perspective view of another part of the reverse glenoid component (sometimes referred to as the glenoid ball in this article);

[0048] Figure 8B for Figure 8A Rear perspective view of the glenoid fossa;

[0049] Figure 9A , Figure 9B , Figure 9C and Figure 9D To accommodate reverse-positioned shoulder implants (such as...) Figure 6A A schematic diagram of an exemplary embodiment of a method for deploying a reverse-positioned shoulder implant into a patient.

[0050] Figure 10A A front perspective view of another exemplary embodiment of an anatomical shoulder joint implant;

[0051] Figure 10B for Figure 10A Rear perspective view of an anatomical shoulder implant;

[0052] Figure 10C for Figure 10A Rear view of an anatomical shoulder implant;

[0053] Figure 10D for Figure 10A An exploded perspective view of the components of an anatomical shoulder implant, including an anatomical glenoid component and a frame.

[0054] Figure 11A for Figure 10C The front perspective of the frame;

[0055] Figure 11B for Figure 11A The side view of the frame;

[0056] Figure 11C for Figure 11A The rear perspective of the frame;

[0057] Figure 11D for Figure 11A The rear view of the frame;

[0058] Figure 12A for Figure 10C A front perspective view of the anatomical glenoid component;

[0059] Figure 12B for Figure 12A Side view of the anatomical glenoid component;

[0060] Figure 12C for Figure 12A A front view of the anatomical glenoid component (the rear view of the anatomical glenoid component is a mirror image of the front view shown in the figure).

[0061] Figure 12D for Figure 12A Rear view of the anatomical glenoid component;

[0062] Figure 13A , Figure 13B and Figure 13C To insert anatomical shoulder joint implants (such as...) Figure 10A A schematic diagram of an exemplary embodiment of a method for deploying an anatomical shoulder joint implant into a patient;

[0063] Figure 14A A front perspective view of an exemplary embodiment of a reverse-position shoulder joint implant, the implant comprising a structure similar to... Figure 11A The framework of the framework;

[0064] Figure 14B for Figure 14A Rear perspective view of a reverse-positioned shoulder implant;

[0065] Figure 14C for Figure 14A Rear view of a reverse-positioned shoulder implant;

[0066] Figure 14D for Figure 14A An exploded perspective view of the components of a reverse-positioned shoulder implant, which includes... Figure 14A The frame and the reverse-positioned glenoid component;

[0067] Figure 15A for Figure 14A Rear perspective view of the reverse-positioned glenoid component;

[0068] Figure 15B for Figure 15A Rear view of the reverse-positioned glenoid component;

[0069] Figure 15C for Figure 15A An exploded perspective view of the components of the reverse glenoid assembly, which include the glenoid ball, pad, central bone screw and multiple locking screws;

[0070] Figure 16A , Figure 16B and Figure 16C To accommodate reverse-positioned shoulder implants (such as...) Figure 14A A schematic diagram of an exemplary embodiment of a method for deploying a reverse-positioned shoulder implant into a patient.

[0071] Figure 17A A front perspective view of yet another exemplary embodiment of an anatomical shoulder joint implant;

[0072] Figure 17B for Figure 17A Rear perspective view of an anatomical shoulder implant;

[0073] Figure 17C for Figure 17A Rear view of an anatomical shoulder implant;

[0074] Figure 17D for Figure 17A An exploded perspective view of the components of an anatomical shoulder implant, including an anatomical glenoid component and a frame.

[0075] Figure 18A for Figure 17C The front perspective of the frame;

[0076] Figure 18B for Figure 18A The side view of the frame;

[0077] Figure 18C for Figure 18A The rear perspective of the frame;

[0078] Figure 18D for Figure 18A The rear view of the frame;

[0079] Figure 19A for Figure 17C Side view of the anatomical glenoid component;

[0080] Figure 19B for Figure 19A Rear perspective view of the anatomical glenoid component;

[0081] Figure 19C for Figure 19A Rear view of the anatomical glenoid component;

[0082] Figure 20A , Figure 20B and Figure 20C To insert anatomical shoulder joint implants (such as...) Figure 17A A schematic diagram of an exemplary embodiment of a method for deploying an anatomical shoulder joint implant into a patient;

[0083] Figure 21A A front perspective view of an exemplary embodiment of a reverse-position shoulder joint implant, the implant comprising a structure similar to... Figure 18A The framework of the framework;

[0084] Figure 21B for Figure 21A Rear perspective view of a reverse-positioned shoulder implant;

[0085] Figure 21C for Figure 21A Rear view of a reverse-positioned shoulder implant;

[0086] Figure 21D for Figure 21A An exploded perspective view of the components of a reverse-positioned shoulder implant, which includes... Figure 21A The frame and the reverse-positioned glenoid component;

[0087] Figure 22A for Figure 21D A front perspective view of a portion of the reverse-positioned glenoid component (sometimes referred to as the pad in this text);

[0088] Figure 22B for Figure 22A Rear perspective view of the pad;

[0089] Figure 22C for Figure 22A Side view of the pad;

[0090] Figure 22D for Figure 22A Rear view of the pad;

[0091] Figure 23A for Figure 21C A frontal perspective view of another part of the reverse glenoid component (sometimes referred to as the glenoid ball in this article);

[0092] Figure 23B for Figure 23A Rear perspective view of the glenoid fossa;

[0093] Figure 24A , Figure 24B , Figure 24C and Figure 24D A schematic diagram of an exemplary embodiment of a method for deploying a reverse shoulder implant (as shown in Figure 21A) into a patient.

[0094] Figure 25A A side view of yet another exemplary embodiment of a reverse-positioned shoulder joint implant;

[0095] Figure 25B for Figure 25A Rear perspective view of a reverse-positioned shoulder implant;

[0096] Figure 26 To include Figure 25A A front perspective view of the frame in a reverse-positioned shoulder implant;

[0097] Figure 27 To include Figure 25A Rear perspective view of the padding in a reverse-positioned shoulder implant; and

[0098] Figure 28A , Figure 28B and Figure 28C To accommodate reverse-positioned shoulder implants (such as...) Figure 25A A schematic diagram of an exemplary implementation of a method for deploying a reverse-positioned shoulder implant into a patient. Detailed Implementation

[0099] Certain exemplary embodiments will now be described to provide a full understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments, and the scope of this disclosure is defined only by the claims. Features shown or described in conjunction with one exemplary embodiment may be combined with features of other embodiments. Such modifications and variations are intended to be included within the scope of this disclosure. The size and shape of the device and its components may depend on a variety of factors, including, but not limited to, the anatomy and preferences of the subject (i.e., the patient) who will use the device within its body, the size and shape of the components to be used with the device, the method and procedure in which the device will be used, and the preferences of the surgeon operating the device and / or otherwise performing the associated surgery. For example, in at least some of the exemplary embodiments, the frame of the prosthetic implant is substantially elliptical in shape, but those skilled in the art will recognize that the frame may be configured to have other shapes (e.g., circular, rectangular), depending at least in part on the shape, size and configuration of other components (e.g., prosthetic components) used with the frame, the anatomical structures in which the frame is disposed (e.g., various bones), and the surgeon’s preferences.

[0100] In this disclosure, unless otherwise specified, components with similar names in embodiments generally have similar features and / or uses. Additionally, several terms may be used interchangeably in this disclosure, but those skilled in the art will understand. Furthermore, with regard to the use of linear or circular dimensions in the description of the disclosed devices and methods, such dimensions are not intended to limit the type of shape that can be used in conjunction with such devices and methods. Those skilled in the art will recognize that equivalent forms of such linear and circular dimensions can be readily determined for any geometry (e.g., those skilled in the art refer to width and diameter, respectively, which can be readily applied to circular and linear dimensions). Moreover, with regard to the use of terminology in this disclosure to describe the orientation, orientation, and / or relative position of the prosthetic devices and components disclosed in this invention, and / or for performing the methods of assembling and / or implanting such devices disclosed in this invention, such terminology is not intended to be limiting. For example, those skilled in the art will recognize that terms for orientation, orientation, and / or relative position (e.g., proximal, distal, medial, lateral, etc.) are used interchangeably, depending at least in part on the perspective of the surgeon or other operator.

[0101] This disclosure relates in its entirety to prosthetic implants for expanding or replacing the glenoid surface of the shoulder joint, and provides improvements over existing designs of such implants. As discussed in more detail below, embodiments of the provided prosthetic implants typically include a frame or edge made of metal or other suitable material, which is anchored to the bone and allows a prosthetic glenoid component to be attached thereto. For example, in some embodiments, an anatomical glenoid component made of polyethylene may be configured to removably snap onto the frame. Among its beneficial effects is that the frame improves the fixation of such plastic components to the bone compared to conventional fixation techniques. The frame also allows the distal surface of the polyethylene component to have direct plastic component-bone contact through orifices in the frame, which reduces stress shielding, glenoid loosening, and overall wear, and has other beneficial effects.

[0102] In some embodiments, the frame of the prosthetic implant may include or be adapted to include more than one attachment interface to convert from one type of glenoid component to another type of glenoid component while the frame remains anchored to the bone. For example, as discussed in more detail below, the frame may be used to facilitate the anatomical to reverse conversion of the shoulder joint by removing the anatomical glenoid component from a first attachment interface (e.g., a set of snap-fit ​​connector interfaces) and attaching the reverse glenoid component to a second attachment interface (e.g., a removable frame adapter, locking screw recess, and / or anchor bolt). Thus, the frame allows the shoulder implant to be easily converted from an anatomical configuration to a reverse configuration.

[0103] While the various embodiments disclosed herein relate to implants including frames for securing prosthetic components to the glenoid side of the shoulder joint, those skilled in the art will understand how the disclosures provided herein can be adapted to use frames for securing prosthetic components, such as prosthetic heads or cups, to the humeral side of the shoulder joint. Without departing from the spirit of this disclosure, those skilled in the art will also understand how the disclosures provided herein can be adapted for use with devices and procedures associated with other joints, such as, but not limited to, the elbow, ankle, hip, and / or knee joints.

[0104] Figures 2A-2D An exemplary embodiment of an anatomical shoulder implant 100 is shown. The prosthetic implant 100 may include a frame 110 and an anatomical glenoid component 150. The frame 110 is anchorable to bone and includes a plurality of attachment interfaces 120 for attaching the glenoid component 150 to the frame. Additionally, the frame 110 may define an opening 130 (see [link to documentation]). Figure 3AThe distal portion 150d of the glenoid component 150 can directly contact the bone through the orifice when attached to the frame. As discussed in more detail below, in some embodiments, the frame 110 can be modified using a removable frame adapter configured to allow the shoulder implant 100 to be converted into a reverse-positioned shoulder implant.

[0105] In the illustrated embodiment, frame 110 is made of metal. Exemplary metals that can be used to manufacture the frame include titanium alloys (e.g., Ti-6Al-4V), tantalum, stainless steel (e.g., 316L), cobalt-chromium alloys, combinations thereof (or combinations with other materials), and / or any metal composites / alloys thereof. However, those skilled in the art will recognize that other materials can be used to manufacture the frame, including but not limited to ceramics, polyethylene, polycarbonate, polyetheretherketone, or any combination thereof. Anatomical glenoid component 150 may be made of plastic or plastic materials. Exemplary plastic materials that can be used to manufacture anatomical glenoid component 150 may include polyethylene, polyethylene derivatives, polycarbonate, polyetheretherketone, and combinations thereof (or combinations with other materials). However, those skilled in the art will recognize that other materials can be used to manufacture the anatomical glenoid component, including but not limited to titanium alloys (e.g., Ti-6Al-4V), tantalum, stainless steel (e.g., 316L), cobalt-chromium alloys, ceramics, coatings with frictional advantages of hardness, or any combination thereof.

[0106] like Figures 3A-3D As shown in more detail, the frame 110 may have a generally annular body 112. In the illustrated embodiment, the frame shape is substantially elliptical. However, those skilled in the art will recognize that the frame may be configured to have other shapes (e.g., circular, rectangular), depending at least in part on the shape, size, and configuration of other components (e.g., prosthetic components) used with the frame, the anatomical structures in which the frame is disposed (e.g., various bones), and the surgeon's preferences. The annular frame body 112 may have a substantially flat proximal surface 112p that provides a platform against which the proximal portion 150p of the anatomical glenoid component 150 abuts when attached to the frame 110. The distal surface 112d of the annular frame body 112 may have a substantially convex shape configured to directly engage with a substantially concave surface of the glenoid bone in the patient's scapula. Those skilled in the art will recognize that the proximal surface 112p and distal surface 112d of the annular frame body 112 may have different shapes or surface topologies, for example, depending on factors such as the relative surfaces of the prosthetic components and / or the bone intended to engage the frame.

[0107] Frame 110 may also include one or more bone anchor recesses for anchoring the frame to bone. In an illustrated embodiment, a pair of bone anchor recesses 114a and 114b (collectively referred to as 114) are configured to project distally from substantially opposite ends of the annular frame body 112. As shown, bone anchor recess 114a may be located at the upper end 112s of frame body 112, and bone anchor recess 114b may be located at the lower end 112i. Each of the bone anchor recesses 114 may have a substantially tubular shape defining a threaded through-hole 116a or an unthreaded through-hole 116b (collectively referred to as 116). Multiaxial screws or other bone anchors (not shown) may be driven distally or otherwise inserted through the holes 116 for anchoring frame 110 to bone. As shown, bone anchor recesses 114 are accessible through orifice 130. Although a pair of bone anchor recesses 114 are shown, the frame may include more or fewer than two bone anchor recesses for anchoring the frame to the bone. Alternatively, in some embodiments, the bone anchor recesses may be accessible outside the periphery of the annular frame body 112, but at the cost of increasing the area occupied by the frame.

[0108] The orifice 130 of the frame 110 may be defined by the inner wall of the annular frame body 112. In an illustrated embodiment, the orifice has a generally elliptical cross-sectional profile and may even include a stepped configuration, such as shown in FIG. 3A, such that the orifice has multiple diameters depending on the depth within it. Such a stepped configuration can help allow screws, etc., to be discreetly seated within the inner wall of the orifice, the stepped configuration being shaped to conform to the shape of the distally facing surface of the screw. Alternatively, in some embodiments, the frame may define the orifice with cross-sectional profiles of different shapes, including but not limited to rectangular, polygonal, circular, or custom shapes, or multiple orifices of these possible shapes. The dimensions of the frame orifice 130 may be configured to maximize the direct contact surface area between the glenoid component 150 and the bone. For example, in some embodiments, the frame orifice 130 may be configured to have a cross-sectional area ranging from approximately 20 square millimeters to approximately 2400 square millimeters. In some embodiments, the cross-sectional area of ​​the frame aperture 130 may be equal to a percentage of the total cross-sectional area or occupied area covered by the frame 110, ranging from approximately 10% to approximately 99%. In some embodiments, the cross-sectional profile of the frame aperture 130 may have a maximum length 130L ranging from approximately 20 mm to approximately 60 mm and a maximum width 130W ranging from approximately 20 mm to approximately 40 mm.

[0109] In the illustrated embodiment, frame 110 includes a plurality of snap-fit ​​connector interfaces 120a, 120b, 120c, 120d, 120e, and 120f (collectively referred to as 120) for attaching the anatomical glenoid component 150 to frame 110. Figure 3D As shown, the snap-fit ​​connector interface 120 can be defined in the distal surface 112d of the annular frame body 112. The snap-fit ​​connector interface 120 can be configured as a slot, groove, or other recess, and is sometimes referred to as a recessed connection part, connector, or interface. (As opposed to...) Figures 4A-4D In more detail, the snap-fit ​​connector interface 120 may be configured to allow the corresponding snap-fit ​​connector of the anatomical glenoid component 150 to connect or otherwise engage the frame 110 when pressed together.

[0110] The snap-fit ​​connector interfaces 120 of the frame 110 may be evenly distributed around the distal surface 112d of the annular body. For example, in the illustrated embodiment, two snap-fit ​​connector interfaces 120a and 120b are defined at the upper end 112s of the annular frame body 112 adjacent to the bone anchor recess 114a, two snap-fit ​​connector interfaces 120c and 120d are defined at the lower end 112i of the annular frame body adjacent to the bone anchor recess 114b, and two snap-fit ​​connector interfaces 120e and 120f are defined on the opposing leg-like members of the annular frame body between the upper and lower ends. Although the accompanying drawings show frame 110 as including six snap-fit ​​connector interfaces 120, the frame may include more or fewer six (e.g., 1, 2, 3, 4, 5, 7, 8, 9, 10, etc.) snap-fit ​​connector interfaces defined at various locations in the distal surface 112d of the annular body 112. Alternatively or in addition, in some embodiments, one or more of the snap-fit ​​connector interfaces 120 may be defined in the proximal surface 112p of the annular body 112.

[0111] like Figures 4A-4D As shown, the anatomical glenoid component 150 may have a generally disc-shaped body, which includes a proximal portion 150p and a distal portion 150d. The proximal portion 150p may have a proximal bearing surface 152, and a humeral prosthesis (e.g., Figure 1A 10) of the prosthetic head (e.g., Figure 1A14) Joint movement is possible on this surface. The proximal bearing surface 152 may have a substantially concave shape that substantially resembles the depression of a healthy glenoid bone. The proximal portion 150p may define a distally facing ridge 154 at the interface between the proximal portion 150p and the distal portion 150d of the glenoid member 150. When the glenoid member 150 is attached to the frame 100, the ridge 154 may serve as a stop against the proximal surface 112p of the frame 110. In the illustrated embodiment, the ridge 154 protrudes outward at the upper end 150s and the lower end 150i of the member 150.

[0112] The distal portion 150d of the anatomical glenoid component 150 may have a custom shape configured for insertion into the orifice 130 of the frame 110. For example, in the illustrated embodiment, the custom shape of the distal portion 150d has a cross-sectional profile configured to generally form a negative image of the cross-sectional profile of the frame orifice 130. The distal portion 150 may also define a recess (or resection portion) 150r configured to circumferentially (or at least partially) the bone anchor recess 114 and thus prevent recess interference during attachment of the glenoid component 150 to the frame 110. The distal portion 150d may have a generally convex distal bearing surface 156 configured to directly engage with the substantially concave surface of the glenoid bone in the patient's scapula, and thus maximize the contact surface area between the glenoid component 150 and the glenoid bone.

[0113] Those skilled in the art will recognize that the distal bearing surface 156 of the anatomical glenoid component 150 may have different shapes or surface topologies, depending, for example, on the relative surface topology of the target bone. In some embodiments, the distal portion 150d of the glenoid component 150 may include bone engagement posts 158 projecting outward from the distal bearing surface 156. As described in more detail below, the bone engagement posts 158 may be configured to engage holes or voids drilled into the glenoid bone. Although one bone engagement post 158 ​​is shown in the figures, more or fewer bone engagement posts (e.g., 0, 2, 3, 4 or more posts) may be configured to project from the distal bearing surface 156 of the anatomical glenoid component 150.

[0114] As discussed above, frame 110 may include multiple snap-fit ​​connector interfaces 120 for attaching the anatomical glenoid component 150 to the frame. See also Figure 4C and Figure 4DThe anatomical glenoid component 150 may include a plurality of snap-fit ​​connectors 157a, 157b, 157c, 157d, 157e, and 157f (collectively referred to as 157), which are configured to connect to or otherwise engage corresponding snap-fit ​​connector interfaces 120a, 120b, 120c, 120d, 120e, and 120f (collectively referred to as 120) of the frame 110. In an illustrated embodiment, each of the snap-fit ​​connectors 157 may be a tongue or protrusion projecting laterally from the distal portion 150d of the prosthesis component 150 and configured to engage with the frame 110 at the location of the snap-fit ​​connector interface 120. Connectors 157 may sometimes be referred to as protruding coupling components, connectors, or interfaces. Those skilled in the art will recognize that the snap-fit ​​connector 157 may have alternative shapes and / or configurations for engaging the snap-fit ​​connector interface 120 when the anatomical glenoid component 150 is pressed against the frame 110. As a non-limiting example, the male and female connectors may be reversed between the two components 110, 150.

[0115] Figures 5A-5C This is a schematic diagram of an exemplary embodiment of a method for deploying an anatomical shoulder implant 100 in a patient's scapula. In the illustrated embodiment, the anatomical shoulder implant 100 may be implanted as part of an anatomical total shoulder arthroplasty, such that the implant 100 is secured to the glenoid bone of the patient's scapula to accommodate a humeral prosthesis (e.g., Figure 1A The prosthetic head of 14) provides a corresponding concave bearing surface. While the illustrated method uses the implant 100 described above, at least some of the components associated with or otherwise combined with the implant 100 may not be readily visible. Based on the disclosure provided herein and its related examples, those skilled in the art will understand how the various components of the implant 100 engage with various parts of the patient's anatomy and / or the components of the implant 100 relative to... Figures 5A-5C The surgical procedures disclosed include the tools used in conjunction with these procedures.

[0116] See Figure 5AThe glenoid bone 502 of the patient's scapula can be prepared with a generally smooth concave surface for mounting the implant 100. Those skilled in the art will recognize that a reamer (not shown) or other tools can be used to prepare the concave surface of the glenoid bone 502 to mate with the convex distal surfaces of the frame 110 and the anatomical glenoid component 150. Additionally, one or more holes or openings 504a, 504b, 504c can be drilled in the glenoid bone 502 for mounting the implant 100 (three holes or openings as shown). For example, holes 504a and 504b can be configured to receive tubular bone anchor recesses 114a and 114b of the frame 110, and hole 504c can be configured to receive a bone-jointing post 158 ​​of the anatomical glenoid component 150. In some embodiments, those skilled in the art will recognize that a stop drill aligned with a guide pin and / or guide plate (not shown) and other tools can be used to drill the holes.

[0117] See Figure 5B The frame 110 can be anchored to the glenoid bone 502. For example, in the illustrated embodiment, the frame 110 can be anchored to the bone by inserting bone anchor recesses 114a and 114b into drilled holes 504a and 504b. A multiaxial bone screw 510 or other bone anchor can then be driven distally or otherwise inserted through each recess into the glenoid bone 502. In some embodiments, a screwdriver (not shown) can be used to drive the bone screw 510 into the glenoid bone. Once the frame 110 is anchored to the bone, the frame aperture 130 exposes the concave portion 502a of the glenoid bone 502, including the hole 504c.

[0118] See Figure 5C The anatomical glenoid component 150 can be attached to the frame 110 such that the distal portion 150d of the glenoid component directly contacts the glenoid bone 502a through the frame opening 130. For example, as shown, the convex distal surface 156 and the column 158 of the glenoid component can directly contact the glenoid bone 502a through the frame opening 130. By configuring the convex distal surface 156 of the glenoid component 150 and the convex distal surface 112d of the frame 110 to have the same or substantially the same radius of curvature R, the surface area of ​​direct contact between the component and the bone can be maximized.

[0119] In some embodiments, the anatomical glenoid component 150 can be attached to the frame 110 by inserting a post 158 ​​through an opening 130 into a drilled hole 504c, and pressing the component distally through the opening 130 until it snaps onto the frame. For example, the anatomical glenoid component 150 can snap onto the frame when the component's snap-fit ​​connector 157 (not visible) is connected to or otherwise engaged with the frame 110's snap-fit ​​connector interface 120 (not visible). The post 158 ​​may be slightly oversized relative to the diameter of the drilled hole 504c to achieve a pressure fit.

[0120] As discussed above, in some clinical situations, it may be necessary to perform reverse total shoulder arthroplasty, which involves reversing the anatomy or structure of the patient's shoulder joint. For example, on the glenoid side, a reverse glenoid implant, including a hemispherical glenoid ball (i.e., the "ball" in the ball-and-socket joint), can be fixed to the glenoid bone of the patient's scapula. In some patients, it may be necessary to perform an anatomical-to-reverse conversion to replace a previously deployed anatomical glenoid implant with a reverse glenoid implant. Due to the independent configuration and components of the respective implants, such replacements often involve complex and challenging procedures. Therefore, as relative to... Figures 6A-6D In more detail, this document provides a reverse shoulder implant that can be configured to reuse the previously anchored frame (e.g., 110) of an anatomical shoulder implant (e.g., 100) to facilitate anatomical-to-reverse conversion in a manner that avoids such complexities.

[0121] Figures 6A-6D An exemplary embodiment of a reverse-position shoulder implant 200 is shown. The prosthetic implant 200 may include a frame 110', a frame adapter 140, and a reverse-position glenoid component 250. In the illustrated embodiment, the frame 110' includes an annular body 112', bone anchor recesses 114a' and 114b' (collectively referred to as 114'), and snap-fit ​​connector interfaces 120a', 120b', 120c', 120d', 120e', and 120f' (collectively referred to as 120') defined in the annular frame body. Except as described below or readily understood by those skilled in the art, the frame 110' is identical or substantially identical to the frame 110 described above. Therefore, for the sake of brevity, a detailed description of the structure and function of the frame 110' is omitted herein.

[0122] In some embodiments, the frame adapter 140 may be a removable attachment rod configured to extend substantially horizontally across the frame aperture 130' between the opposing legs of the frame 110'. For example, in an illustrated embodiment, the frame adapter 140 is configured to extend across the frame aperture 130' such that the terminals 140a and 140b of the frame adapter 140 are received within corresponding recesses 120e' and 120f' defined in the distal surface 112d' of the annular frame body 112'. In some embodiments, the recesses 120e' and 120f' may be corresponding to those described above. Figures 3A-3D The snap-fit ​​connector interfaces 120e and 120f are the same.

[0123] Frame adapter 140 may define a pair of locking screw holes 142a and 142b (collectively referred to as 142), which are configured to receive corresponding locking screws (not shown) for attaching the reverse glenoid component 250 to frame 110'. Although two locking screw holes 142 are shown in the figures, more or fewer locking screw holes (e.g., 1, 3, 4, 5, 6 or more) may be defined in frame adapter 140. In some embodiments, frame adapter 140 may have a cross-sectional shape that allows the frame adapter to be used as an alignment key. For example, in the illustrated embodiment, frame adapter 140 has a T-shaped cross-section configured to receive corresponding T-shaped recesses defined in the reverse glenoid component 250 (e.g., Figure 7B Within 262r).

[0124] The reverse glenoid component 250 may include a base plate 260 and a hemispherical prosthetic head 290 coupled to the base plate. According to this disclosure, those skilled in the art will understand that the reverse glenoid component 250 is a prosthetic component as provided herein, wherein the base plate 260 is part of or coupled to the distal surface of the prosthetic component, and the hemispherical prosthetic head 290 is part of or coupled to the proximal bearing surface of the prosthetic component. (See FIG7A and...) Figure 7BAs shown, substrate 260 (sometimes referred to herein as a "pad") may include a generally disc-shaped platform 262 and cylindrical posts 268 extending outwardly from its distal surface 262d. One or more through holes may be defined extending through the proximal surface 262p and distal surface 262d of the pad platform 262. In the illustrated embodiment, a pair of through holes 264a and 264b (collectively referred to as 264) are defined in the pad platform 262 and configured to align with corresponding locking screw holes 142a and 142b of the frame adapter 140. Although two through holes 264 are shown in the figures, more or fewer through holes (e.g., one, three, four, five, six or more) may be defined in the pad platform 262, depending, for example, on the number of locking screw holes defined in the frame adapter.

[0125] In some embodiments, the distal surface 262d of the pad platform 262 may define a recess 262r having a cross-sectional shape that is a negative image of the cross-sectional shape of the frame adapter 140. In an illustrated embodiment, the recess 262r has a T-shaped cross-section configured to receive the T-shaped frame adapter 140. In some embodiments, by aligning the recess 262r to mate with the frame adapter, the through-hole 264 of the pad platform 262 may be aligned with the locking screw hole 142 of the frame adapter 140.

[0126] The cylindrical post 268 may be configured to project substantially perpendicular to the distal surface 262d of the pad platform 262. The post 268 may be configured to be inserted into a hole or cavity formed in bone (e.g., the glenoid bone of a patient's scapula). In some embodiments, a central bore 266 may be defined to extend through the pad platform 262 and at least partially along the length of the post 268. As discussed in more detail below, the central bore 266 may be configured to receive a connecting element for securing the prosthesis head 290 to the pad 260.

[0127] like Figure 8A and Figure 8B As shown, the prosthetic head 290 (sometimes referred to herein as the "glenotum") may have a generally hemispherical body 292. For attaching the glenotum 290 to the pad 260, the glenotum body 292 may define an open cavity 294 configured to mate with the disc-shaped pad platform 262. In some embodiments, the glenotum 290 and the pad 260 may be configured to form a conical lock when the pad platform 262 is received within the cavity 294.

[0128] Alternatively or otherwise, a connecting element 296 for attaching the glenoid sphere 290 to the pad 260 may project distally from the distally facing surface 292d of the glenoid sphere body 292. As shown in the illustrated embodiments, the connecting element 296 may be a threaded or unthreaded shaft configured to lock into a bore 266 of the pad 260. For example, in some embodiments, the glenoid sphere 290 may be manipulated to screw or press the connecting element 296 into the bore 266 of the pad 260. Those skilled in the art will recognize that the glenoid sphere and the pad may be attached together using other techniques and / or mechanisms for securing one component relative to another.

[0129] In some embodiments, either or both of the pad 260 and glenoid bulb 290 may be made of any number of implantable metallic materials or other biocompatible materials to form the implant. Some non-limiting examples of materials suitable for forming various component implants may include titanium, tantalum, cobalt-chromium alloys, stainless steel, and other metals known to those skilled in the art, as well as some plastic materials such as, but not limited to, polyetheretherketone (PEEK) and ultra-high molecular weight polyethylene (UHMWPE). In some cases, the various components (e.g., pad 260 and glenoid bulb 290) may be made of the same material, while in other embodiments, one or more components may be made of different materials. Furthermore, those skilled in the art will recognize that a variety of different material blends can be used to form any component of the implants provided herein or, in other words, those derived from this disclosure.

[0130] Figures 9A-9D This is a schematic diagram of an exemplary embodiment of a method for deploying a reverse shoulder implant 200 in a patient's scapula. In the illustrated embodiment, the reverse shoulder implant 200 may be deployed as part of an anatomical-to-reverse conversion in total shoulder arthroplasty, in which the anatomical glenoid component 150 of the anatomical shoulder implant 100 is removed and replaced with a reverse glenoid component 250. While the illustrated embodiment describes an anatomical-to-reverse conversion, those skilled in the art will recognize that the reverse shoulder implant 200 provided herein can be deployed without prior deployment of an anatomical glenoid implant.

[0131] See Figure 9A and Figure 9B The frame 110' is shown anchored to the glenoid bone 502 and exposing a concave portion 502a of the glenoid bone, including a drilled hole 504c'. In the illustrated embodiment, the frame 110' is anchored to the bone by inserting multiaxial bone screws 510 through bone anchor recesses 114a, 114b. In the illustrated anatomical-to-reverse conversion, the anchored frame 110' can be repositioned relative to the previously deployed configuration described above. Figures 5A-5C The frame (e.g., 110) described is the same as that used in part of the anatomical total shoulder arthroplasty. The anatomical glenoid component 150 (not shown) of a previously deployed anatomical glenoid implant can be removed in a previous treatment step.

[0132] Frame adapter 140 can be inserted into aperture 130' of frame 110' (shown in a partially transparent manner). Once inserted, frame adapter 140 can be manipulated such that the adapter extends substantially horizontally across frame aperture 130' between opposing legs of frame 110'. For example, as shown in the illustrated embodiment, frame adapter 140 can be manipulated within frame aperture 130' such that the terminals 140a and 140b of frame adapter 140 are received within corresponding recesses 120e' and 120f' defined in the distal surface of annular frame body 112'. In some embodiments, recesses 120e' and 120f' can be defined to provide clearance for frame adapter 140 when it is rotated to be horizontally aligned within frame 110'. In some embodiments, the cross-sectional profile of the frame adapter 140 may be configured to at least partially externalize the hole 504c' when the adapter is aligned in the opposing recesses 120e' and 120f' of the frame 110.

[0133] See Figure 9C The pad 260 can be mounted on the frame 110, so that the column 268 (shown in) Figure 9D The through holes 264a and 264b are inserted into the drilled hole 504c, and the through holes 264a and 264b are aligned with the locking screw holes 142a and 142b of the frame adapter 140. In some embodiments, the through holes 264a and 142b of the pad 260 and the locking screw holes 142b of the frame adapter 140 can be made by orienting the pad platform 262 such that a recess 262r is defined in its distal surface (see...). Figure 7B The locking screws 520a and 520b (collectively referred to as 520) can be driven distally or otherwise inserted into the through-hole 264 of the pad platform 262 and the locking screw hole 142 of the frame adapter 140. As the locking screws 520 are inserted into the frame adapter 140, the pad platform 262 and the frame adapter 140 can move toward each other, causing them to press against the annular frame body 112'.

[0134] See Figure 9D The glenoid sphere 290 can be attached to the pad 260. For example, in some embodiments, the connecting element 296 (not visible) of the glenoid sphere body 292 can be threaded or press-fitted to the center bore 266 of the pad 260. Figure 9CAlternatively, when the disc-shaped pad platform 262 is received within a cavity 294 (not visible) defined in the glenoid body 292, the glenoid 290 and the pad 260 may form a conical lock.

[0135] Figures 10A-10D Another exemplary embodiment of the anatomical shoulder implant 1100 is shown. The prosthetic implant 1100 may include a frame 1110 and an anatomical glenoid component 1150. The frame 1110 may be anchored to bone and includes a plurality of attachment interfaces 1120 for attaching the anatomical glenoid component 1150 to the frame. Additionally, the frame 1110 may define an orifice 1130 through which a distal portion 1150d of the glenoid component 1150 may directly contact the bone when attached to the frame. As discussed in more detail below, in some embodiments, the frame 1110 may be configured to allow the shoulder implant 1100 to be converted into a reverse-positioned shoulder implant.

[0136] like Figures 11A-11D As shown, frame 1110 may include an annular body 1112 defining an opening 1130, bone anchor recesses 1114a and 1114b (collectively referred to as 1114), snap-fit ​​connector interfaces 1120a, 1120b, 1120c, and 1120d (collectively referred to as 1120), and locking screw recesses 1140a and 1140b (collectively referred to as 1140). Except as described below or readily understood by those skilled in the art, frame 1110, annular frame body 1112, bone anchor recess 1114, snap-fit ​​connector interface 1120, and opening 1130 are identical or substantially identical to those described above for frame 110, annular frame body 112, bone anchor recess 114, snap-fit ​​connector interface 120, and opening 130. Therefore, for the sake of brevity, a detailed description of their structure and function is omitted herein.

[0137] In some embodiments, the locking screw recess 1140 may be a cantilever block configured to extend inwardly from opposing leg-like members of the annular frame body 1112, allowing the recess to be accessed through the frame aperture 1130. In some embodiments, the locking screw recess 1140 may be aligned along the central horizontal axis AA of the frame 1110. The locking screw recess 1140 may define corresponding threaded holes 1142a and 1142b (collectively referred to as 1142) configured to receive corresponding locking screws (not shown). For example, as relative to... Figures 14A-14CIn more detail, the locking screw recess 1140 can be used to attach the reverse-positioned glenoid component to the frame 1110, thus eliminating the need for a separate frame adapter. Although two locking screw recesses 1140 are shown in the figures, more or fewer than two locking screw recesses (e.g., one, three, four, five, six or more locking screw recesses) may be included as part of the frame 1110.

[0138] like Figures 12A-12D As shown, the anatomical glenoid component 1150 may have a generally disc-shaped body comprising a proximal portion 1150p and a distal portion 1150d. The proximal portion 1150p may include a concave proximal bearing surface 1152 and a distally facing ridge 1154. The distal portion 1150d of component 1150 may have a convex distal surface 1156 and a cylindrical post 1158 projecting substantially perpendicularly from the distal surface. Except as described below or readily understood by those skilled in the art, the anatomical glenoid component 1150 (including, but not limited to, its proximal portion 1150p and distal portion 1150d) is the same as or substantially the same as the anatomical glenoid component 150 described above (including, but not limited to, its proximal portion 150p and distal portion 150d). Therefore, for the sake of brevity, a detailed description of its structure and function is omitted herein.

[0139] The distal portion 1150d of the anatomical glenoid component 1150 may have a custom shape configured for insertion into the orifice 1130 of the frame 1110. For example, in the illustrated embodiment, the custom shape of the distal portion 1150d has a cross-sectional profile configured to generally form a negative image of the cross-sectional profile of the frame orifice 1130. The distal portion 1150 may also define a plurality of recesses (or resection portions) 1150r configured to externally (or at least partially externally) the bone anchor recess 1114 and the locking screw recess 1140 and thus prevent recess interference during attachment of the glenoid component 1150 to the frame. As described above, the distal portion 1150d may have a generally convex distal bearing surface 1156 configured to directly engage with the substantially concave surface of the glenoid bone in the patient's scapula, and thus maximize the contact surface area between the glenoid component 1150 and the bone.

[0140] As discussed above, frame 1110 may include multiple snap-fit ​​connector interfaces 1120 for attaching the anatomical glenoid component 1150 to the frame. See also Figures 12A-12DThe anatomical glenoid component 1150 may include a plurality of snap-fit ​​connectors 1157a, 1157b, 1157c, and 1157d (collectively referred to as 1157), which are configured to connect to or otherwise engage corresponding snap-fit ​​connector interfaces 1120a, 1120b, 1120c, and 1120d (collectively referred to as 1120) of the frame 1110. In an illustrated embodiment, each of the snap-fit ​​connectors 1157 may be shaped as a hook or clamp projecting distally from a ridge 1154 of the proximal portion 1150p of the glenoid component. In some embodiments, the snap-fit ​​connector 1157 may be configured to engage with the frame 1110 at a location defined in the snap-fit ​​connector interface 1120 within the annular frame body 1112. Those skilled in the art will recognize that the snap-fit ​​connector 1157 may have alternative shapes and / or configurations for engaging the snap-fit ​​connector interface 1120 when the anatomical glenoid component 1150 is pressed onto the frame 1110. Similarly, the disclosure above, which is more generally applicable to convex interfaces (e.g., 157, 1157) and concave interfaces (e.g., 120, 1120) with respect to connector 157 and interface 120, applies to connector 1157 and interface 1120.

[0141] Figures 13A-13C A schematic diagram of an exemplary embodiment of a method for deploying an anatomical shoulder implant 1100 in a patient's scapula. In the illustrated embodiment, the anatomical shoulder implant 1100 may be implanted as part of an anatomical total shoulder arthroplasty, such that the implant 1100 is fixed to the glenoid bone of the patient's scapula to accommodate a humeral prosthesis (e.g., Figure 1A The prosthesis head of 14) provides a corresponding concave bearing surface. While the illustrated configuration uses the implant 1100 described above, at least some of the components associated with or otherwise combined with the implant 1100 may not be readily visible. Based on the disclosure provided herein and its related examples, those skilled in the art will understand how the various components of the implant 1100 engage with various parts of the patient's anatomy and / or the components of the implant 1100 relative to... Figures 13A-13C The surgical procedures disclosed include the tools used in conjunction with these procedures.

[0142] See Figure 13AThe glenoid bone 502 of the patient's scapula can be enlarged so that the surfaces of the glenoid bone 502 are substantially conformable to the convex distal surface 1112d of the frame 1110 and the convex distal surface 1156 of the anatomical glenoid component 1150, respectively. Those skilled in the art will recognize that a reamer (not shown) or other tools can be used to prepare the glenoid bone 502 with a generally smooth concave surface having the same or substantially the same radius of curvature as the convex surfaces of the frame 1110 and the glenoid component 1150.

[0143] In addition, such as Figure 13A As shown, one or more holes may be drilled in the glenoid bone 502 to receive a component of the implant 1100 configured to project distally into the bone. As discussed above with respect to FIG. 5A, holes 504a and 504b may be drilled to the diameter of bone anchor recesses 1114a and 1114b for receiving the frame 1110, and hole 504c may be drilled to receive a bone engagement post 1158 of the anatomical glenoid component 150. Additionally, in the illustrated embodiment, holes 504d and 504e may be drilled in the bone to receive locking screw recesses 1140a and 1140b. Those skilled in the art will recognize that holes may be drilled in the bone using a stop drill or other bone reaming tools. In some embodiments, holes may be drilled at the appropriate location using one or more guide plates (not shown) and / or other alignment tools.

[0144] See Figure 13B The frame 1110, defining the orifice 1130, can be anchored to the glenoid bone 502. For example, in an illustrated embodiment, the frame 1110 can be mounted to the glenoid bone 502 such that four recesses (i.e., bone anchor recesses 1114 and locking screw recesses 1142) are inserted into holes 504a, 504b, 504d, and 504e (not visible). After the frame 1110 is mounted to the glenoid bone 502, the frame can be anchored to the bone by driving a multiaxial bone screw 510 or other bone anchor distally or otherwise inserting it through each of the bone anchor recesses 1114. In some embodiments, a screwdriver (not shown) can be used to drive the bone screw 510 into the glenoid bone. Once anchored to the bone, the orifice 1130 of the frame 1110 exposes the concave portion 502a of the glenoid bone 502, including the drilled hole 504c'.

[0145] See Figure 13CThe anatomical glenoid component 1150 can be attached to the frame 1110 such that the distal portion 1150d of the glenoid component directly contacts the glenoid bone 502a through the frame aperture 130. For example, as shown, the convex distal surface 1156 and column 1158 of the glenoid component 1150 can directly contact the glenoid bone 502a through the frame aperture 1130. By configuring the convex distal surface 1156 of the glenoid component 1150 and the convex distal surface 1112d of the frame 1110 to have the same or substantially the same radius of curvature R', the direct contact surface area between the component and the bone can be maximized.

[0146] In some embodiments, the anatomical glenoid component 1150 can be attached to the frame 1110 by inserting a post 1158 through an opening 1130 into a drilled hole 504c' and pressing the component distally through the opening 1130 until it snaps onto the frame. For example, the anatomical glenoid component 1150 can snap onto the frame when the component's snap-fit ​​connector 1157 (not visible) is connected to or otherwise engaged with the frame 1110's snap-fit ​​connector interface 1120 (not visible). The post 1158 may be slightly oversized relative to the diameter of the drilled hole 504c' to achieve a pressure fit.

[0147] As described in more detail below, this document provides a reverse shoulder implant that can be configured to reuse the anchoring frame 1110 of a previously deployed anatomical shoulder implant 1100 to facilitate anatomical-to-reverse conversion. For example, locking screw recesses 1140 of the frame 1110 can be used to attach a reverse glenoid component to the frame, thereby eliminating the need for a separate frame adapter.

[0148] Figures 14A-14C An exemplary embodiment of a reverse-positioned shoulder implant 1200 is shown. The prosthetic implant 1200 may include a frame 1110' and a reverse-positioned glenoid component 1250. As shown, the reverse-positioned glenoid component 1250 can be directly attached to the frame 1110' by mounting the reverse-positioned glenoid component 1250 onto the frame and driving it distally or otherwise inserting locking screws 1280a and 1280b (collectively referred to as 1280) through threaded holes 1142a and 1142b (collectively referred to as 1142) in locking screw recesses 1140a' and 1140b' (collectively referred to as 1140') defined in the frame.

[0149] As shown in the illustrated embodiment, frame 1110' may include an annular body 1112', bone anchor recesses 1114a' and 1114b' (collectively referred to as 1114'), snap-fit ​​connector interfaces 1120a', 1120b', 1120c' and 1120d' (collectively referred to as 1120'), and locking screw recesses 1140'. Except as described below or as will be readily understood by those skilled in the art, frame 1110' is the same as or substantially the same as the frame 1110 described above. Therefore, for the sake of brevity, a detailed description of the structure and function of frame 1110' is omitted herein.

[0150] like Figures 15A-15C As shown, the reverse glenoid assembly 1250 may include a base plate 1260, a prosthesis head 1290, frame locking screws 1280a and 1280b (collectively referred to as 1280), glenoid ball locking screws 1282a and 1282b (collectively referred to as 1282), and a central bone screw 1284. In some embodiments, the components 1260, 1290, 1280, 1282, and 1284 of the reverse glenoid assembly 1250 may be assembled prior to attachment to the frame 1110'.

[0151] The base plate 1260 (sometimes referred to herein as a "pad") may include a generally disc-shaped platform 1262 and a cylindrical post 1268 extending outward from the distal surface 1262d of the platform. Through holes 1264a and 1264b (collectively referred to as 1264) may be defined in the pad platform 1262 to receive a locking screw 1280 for attaching the reverse-positioned glenoid assembly 1250 to the frame 1110'. The through hole 1264 may be threaded or unthreaded. The through hole 1264 may be oriented such that the locking screw 1280 may be driven at a normal angle or a tilt angle or otherwise inserted into the locking screw recess 1140' of the frame 1110'. In some embodiments, a guide rail 1270 may project outward from the distal surface 1262d of the pad platform 1262. The guide rail 1270 can be configured to align the locking screw 1280 of the reverse-positioned glenoid component 1250 with the locking screw recess 1140' of the frame 1110'.

[0152] In some embodiments, the cylindrical post 1268 may be configured to extend distally from the distal surface 1262d of the platen platform 1262. The platen post 1268 may be configured to be inserted into a hole or cavity formed in bone (e.g., the glenoid bone of a patient's scapula). In some embodiments, a central through-hole 1266 may be defined to extend through the length of the platen platform 1262 and the platen post 1268. Optionally, a central bone screw 1284 may be driven or otherwise inserted through the central hole 1266 and into the glenoid bone, for example, to provide additional anchoring support.

[0153] The prosthesis head 1290 (sometimes referred to herein as the "glenoid ball") may have a generally hemispherical body 1292. To form the reverse-positioned glenoid component 1250, the glenoid ball 1290 may be attached to the pad 1260 by driving a glenoid ball locking screw 1282 proximally or otherwise inserting it into the glenoid ball body 1292 via through holes 1263a and 1263b (collectively referred to as 1263) defined in the pad platform 1262. As described in more detail below, the glenoid ball body 1292 may define an open cavity 1294 (see...). Figure 16C The open cavity can be configured to mate with a disc-shaped pad platform 1262. In some embodiments, the glenoid ball 1290 and the pad 1260 can be configured to form a conical lock when the pad platform 1262 is received within the cavity 1294. Those skilled in the art will recognize that the glenoid ball and the pad can be attached together using other techniques and / or mechanisms for securing one component relative to another. As described in more detail below, the reverse glenoid component 1250 formed by the pad 1260 and the glenoid ball 1290 can be attached to the frame 1110' by mounting the component to the frame and driving or otherwise inserting a locking screw 1280 into a locking screw recess 1140' of the frame. Additionally, based on this disclosure, those skilled in the art will understand that the reverse glenoid component 1250 is a prosthetic component as provided herein, wherein the substrate 1260 is part of or connected to the distal surface of the prosthetic component, and the hemispherical prosthetic head 1290 is part of or connected to the proximal bearing surface of the prosthetic component.

[0154] Figures 16A-16C This is a schematic diagram of an exemplary embodiment of a method for deploying a reverse shoulder implant 1200 in a patient's scapula. In the illustrated embodiment, the reverse shoulder implant 1200 may be deployed as part of an anatomical-to-reverse conversion in total shoulder arthroplasty, in which the anatomical glenoid component 1150 of the anatomical shoulder implant 1100 is removed and replaced with a reverse glenoid component 1250. While the illustrated embodiment describes an anatomical-to-reverse conversion, those skilled in the art will recognize that the reverse shoulder implant 1200 provided herein can be deployed without prior deployment of an anatomical glenoid implant.

[0155] See Figure 16AThe frame 1110' is shown anchored to the glenoid bone 502 and exposing a concave portion 502a of the glenoid bone, including a drilled hole 504c'. In the illustrated embodiment, the frame 1110' is anchored to the bone by driving or otherwise inserting a multiaxial bone screw 510 through bone anchor recesses 1114a', 1114b'. In the illustrated anatomical-to-reverse conversion, the anchored frame 1110' can be repositioned relative to the previously deployed configuration described above. Figures 11A-11D The frame (e.g., 1110) is the same as that used in part of the described anatomical total shoulder arthroplasty. The anatomical glenoid component 1150 (not shown) of a previously deployed anatomical glenoid implant can be removed in a previous treatment step.

[0156] See Figure 16B The assembled reverse-position glenoid assembly 1250 can be mounted on the frame 1110' such that the post 1268 is inserted distally into a drilled hole 504c (not visible) through the frame hole 1130' and into the glenoid bone 502a. The reverse-position glenoid assembly can be manipulated such that the frame locking screws 1280a and 1280b protruding from the distal surface 1262d of the pad platform 1262d are aligned with the locking screw recesses 1140a' and 1140b' of the frame 1110'. In some embodiments, the locking screw 1280 can be aligned with the locking screw recess 1140 by rotating the reverse-position glenoid assembly until the recess is positioned between the guide rails 1290, for example, as Figure 14C As shown.

[0157] See Figure 16C The reverse-positioned glenoid component 1250 can be secured to the frame 1110' by driving or otherwise inserting the frame locking screw 1280 into the threaded hole 1142 defined in the locking screw recess 1140. In some embodiments, the locking screw 1280 can be accessed through an opening or port 1296 defined at the apex V of the glenoid body 1292. The port 1296 can be configured to lead to a cavity 1294 in which the corresponding head of the locking screw 1280 is exposed. For example, a screwdriver (not shown) can be inserted through the port 1296 and into the cavity 1294 of the glenoid body 1292 to drive the locking screw 1280 through the hole 1264 of the pad platform 1262 and into the locking screw recess 1140' of the frame 1110'. Optionally, a screwdriver can be inserted through port 1296 and into cavity 1294 of glenoid body 1292 to drive central bone screw 1284 through central hole 1266 of pad 1260 and into glenoid bone, for example to provide additional anchoring support.

[0158] Figures 17A-17DAnother exemplary embodiment of the anatomical shoulder implant 2100 is shown. The prosthetic implant 2100 includes a frame 2110 and an anatomical glenoid component 2150. The frame 2110 is anchorable to bone and includes a plurality of attachment interfaces 2120a, 2120b, and 2120c (collectively referred to as 2120) for attaching the anatomical glenoid component 2150 to the frame. Additionally, the frame 2110 may define an orifice 2130 through which a distal portion 2150d of the glenoid component 2150 can directly contact the bone when attached to the frame. As described in more detail below, in some embodiments, the frame 2110 may be configured to allow the shoulder implant 2100 to be converted into a reverse-positioned shoulder implant.

[0159] like Figures 18A-18D As shown, frame 2110 may include an annular body 2112 defining an opening 2130, anchor bolts 2114a, 2114b, and 2114c (collectively referred to as 2114), and snap-fit ​​connector interfaces 2120a, 2120b, and 2120c (collectively referred to as 2120). Except as described below or readily understood by those skilled in the art, frame 2110, annular frame body 2112, snap-fit ​​connector interface 2120, and opening 2130 are identical or substantially identical to those of frame 110, annular frame body 112, snap-fit ​​connector interface 120, and opening 130 described above. Therefore, for the sake of brevity, a detailed description of their structure and function is omitted.

[0160] In the illustrated embodiment, frame 2110 includes three bolts 2114a, 2114b, and 2114c (collectively referred to as 2114) configured to anchor the frame to bone. As opposed to Figures 21A-21C In more detail, anchor bolt 2114 can also be used to convert anatomical shoulder implant 1100 into reverse shoulder implant. Anchor bolt 2114 may have a generally cylindrical shape extending distally from frame 2110. For example, as shown, anchor bolt 2114a may be located at the upper end 2112s of frame body 2112, and anchor bolts 2114b and 2114c may be located at the lower end 2112i.

[0161] Although three bone anchor bolts 2114 are shown, the frame may include more or fewer bolts (e.g., 1, 2, 4, 5, 6 or more bolts) for anchoring the frame to the bone. In some embodiments, the outer surfaces of the anchor bolts 2114 and the distal surface 2112d of the frame 2110 may be coated with a material that enhances fixation to the bone, such as titanium-based materials available from DePuySynthes Products, Inc. (principally located in Raynham, Massachusetts). Those skilled in the art will recognize that other materials can be used to enhance the fixation of the frame to the bone, including but not limited to hydroxyapatite, Or simply a highly textured surface. Such materials may be used in conjunction with any disclosure provided herein or, in other words, derived from this disclosure.

[0162] One or more of the anchor bolts 2114 may define a threaded bore that extends at least partially along the length of the bolt. For example, in the illustrated embodiment, anchor bolts 2114b and 2114c define threaded bores 2116b and 2116c (collectively referred to as 2116), respectively. As relative to... Figures 21A-21C In more detail, the threaded bore 2116 of the anchor bolt can be configured to receive a locking screw to attach another prosthetic component (such as a reverse glenoid component) to the frame 2110.

[0163] In some embodiments, snap-fit ​​connector interfaces 2120 may be defined in the distal surface 2112d of the frame 2110. For example, as shown in the illustrated embodiment, snap-fit ​​connector interfaces 2120a and 2120b may be defined at the upper end 2112s of the frame 2110 on adjacent sides of anchor bolt 2114a, and snap-fit ​​connector interface 2120c may be defined at the lower end 2112i of the frame between anchor bolts 2114b and 2114c. Although four snap-fit ​​connector interfaces 2120 are shown, the frame may define more or fewer than four snap-fit ​​connector interfaces for attaching the anatomical glenoid component 2150 to the frame (e.g., 1, 2, 3, 5, 6, 7, 8 or more snap-fit ​​connector interfaces).

[0164] like Figures 19A-19C As shown, the anatomical glenoid component 2150 may have a generally disc-shaped body comprising a proximal portion 2150p and a distal portion 2150d. The proximal portion 2150p may include a concave proximal bearing surface 2152 and a distally facing ridge 2154. The distal portion 2150d of component 2150 may have a convex distal surface 2156 and a cylindrical column 2158 projecting substantially perpendicularly from the distal surface. Except as described below or readily understood by those skilled in the art, the anatomical glenoid component 2150 (including, but not limited to, its proximal portion 2150p and distal portion 2150d) is the same as or substantially the same as the anatomical glenoid component 150 described above (including, but not limited to, its proximal portion 150p and distal portion 150d). Therefore, for the sake of brevity, a detailed description of its structure and function is omitted herein.

[0165] The distal portion 2150d of the anatomical glenoid component 2150 may have a custom shape configured for insertion into the orifice 2130 of the frame 2110. For example, in the illustrated embodiment, the custom shape of the distal portion 2150d has a cross-sectional profile configured to generally form a negative image of the cross-sectional profile of the frame orifice 2130. The distal portion 2150 may also define a plurality of recesses (or resection portions) 2150r configured to at least partially externally anchor bolts 2114, thus preventing bolt interference during attachment of the anatomical glenoid component 2150 to the frame. As described above, the distal portion 2150d may have a generally convex distal bearing surface 2156 configured to directly engage with the substantially concave surface of the glenoid bone in the patient's scapula, and thus maximize the contact surface area between the glenoid component 2150 and the bone.

[0166] As discussed above, frame 2110 may include a plurality of snap-fit ​​connector interfaces 2120 for attaching the anatomical glenoid component 2150 to the frame. In an illustrated embodiment, the anatomical glenoid component 2150 may include a plurality of snap-fit ​​connectors 2157a, 2157b, and 2157c (collectively referred to as 2157) configured to connect to or otherwise engage corresponding snap-fit ​​connector interfaces 2120a, 2120b, and 2120c (collectively referred to as 2120) of frame 2110. In an illustrated embodiment, each of the snap-fit ​​connectors 2157 may be shaped as a hook or clamp projecting distally from a ridge 2154 of the proximal portion 2150p of the glenoid component. In some embodiments, the snap-fit ​​connectors 2157 may be configured to engage with frame 2110 at locations defined in the snap-fit ​​connector interfaces 2120 within the annular frame body 2112. Those skilled in the art will recognize that the snap-fit ​​connector 2157 may have alternative shapes and / or configurations for engaging the snap-fit ​​connector interface 2120 when the anatomical glenoid component 2150 is pressed onto the frame 1110. Similarly, the disclosure above, which is more generally applicable to convex interfaces (e.g., 157, 1157, 2157) and concave interfaces (e.g., 120, 1120, 2120) relative to connector 157 and interface 120, applies to connector 2157 and interface 2120.

[0167] Figures 20A-20CA schematic diagram of an exemplary embodiment of a method for deploying an anatomical shoulder implant 2100 in a patient's scapula. In the illustrated embodiment, the anatomical shoulder implant 2100 may be implanted as part of an anatomical total shoulder arthroplasty, such that the implant 2100 is fixed to the glenoid bone of the patient's scapula to accommodate a humeral prosthesis (e.g., Figure 1A The prosthesis head of 14) provides a corresponding concave bearing surface. While the illustrated configuration uses the implant 2100 described above, at least some of the components associated with or otherwise combined with the implant 2100 may not be readily visible. Based on the disclosure provided herein and its related examples, those skilled in the art will understand how the various components of the implant 2100 engage with various parts of the patient's anatomy and / or the components of the implant 2100 relative to... Figures 20A-20C The surgical procedures disclosed include the tools used in conjunction with these procedures.

[0168] See Figure 20A The glenoid bone 502 of the patient's scapula can be enlarged so that the surface of the glenoid bone 502 is substantially conformable to the convex distal surface 2112d of the frame 2110 and the convex distal surface 2156 of the anatomical glenoid component 2150. Those skilled in the art will recognize that a reamer (not shown) or other tools can be used to prepare the glenoid bone 502 with a generally smooth concave surface having the same or substantially the same radius of curvature as the convex surfaces of the frame 2110 and the glenoid component 2150.

[0169] In addition, such as Figure 20A As shown, one or more holes may be drilled in the glenoid bone 502 to receive a component of the implant 2100 configured to project distally into the bone. Holes 504a, 504b, and 504c may be drilled to the diameter of bone anchor bolts 2114a, 2114b, and 2114c that receive the frame 2110. Additionally, hole 504d may be drilled to receive a bone engagement post 2158 of the anatomical glenoid component 2150. Those skilled in the art will recognize that holes can be drilled in the bone using stop drills or other bone reaming tools. In some embodiments, holes may be drilled at the appropriate location using one or more guide plates (not shown) and / or other alignment tools.

[0170] See Figure 20BThe frame 2110, defining the orifice 2130, can be anchored to the glenoid bone 502. For example, in the illustrated embodiment, the frame 2110 can be anchored to the glenoid bone 502 by inserting bone anchoring bolts 2114a, 2114b, and 2114c into the corresponding holes 504a, 504b, and 504c (not visible). The bolts 2114 may be slightly oversized relative to the diameter of the drilled holes 504a, 504b, and 504c, which allows for a pressure fit. Once the frame 2110 is anchored to the bone, the orifice 2130 of the frame 2100 exposes the concave portion 502a of the glenoid bone 502, including the drilled hole 504d.

[0171] See Figure 20C The anatomical glenoid component 2150 can be attached to the frame 2100 such that the distal portion 2150d of the component directly contacts the glenoid bone 502a through the frame aperture 2130. For example, as shown, the convex distal surface 2156 and column 2158 of the glenoid component 2150 can directly contact the glenoid bone 502a through the frame aperture 2130. By configuring the convex distal surface 2156 of the glenoid component 2150 and the convex distal surface 2112d of the frame 2110 to have the same or substantially the same radius of curvature R", the direct contact surface area between the component and the bone can be maximized.

[0172] In some embodiments, the anatomical glenoid component 2150 can be attached to the frame 2110 by inserting a post 2158 through a frame aperture 2130 into a drilled hole 504d, and pressing the component distally through the aperture until it snaps onto the frame. For example, the anatomical glenoid component 2150 can snap onto the frame when the component's snap-fit ​​connector 2157 (not visible) is connected to or otherwise engaged with the frame 2110's snap-fit ​​connector interface 2120 (not visible). The post 2158 may be slightly oversized relative to the diameter of the drilled hole 504d' to achieve a pressure fit.

[0173] The following text is relative to Figures 21A-21C In more detail, a reverse shoulder implant can be configured to reuse the anchoring frame 2110 of a previously deployed anatomical shoulder implant 2100 to facilitate anatomical-to-reverse conversion. For example, threaded bores 2116 of one or more anchor bolts 2114 of the frame 2110 can be used to attach a reverse glenoid component to the frame.

[0174] Figures 21A-21DAn exemplary embodiment of a reverse-positioned shoulder implant 2200 is shown. The prosthetic implant 2200 may include a frame 2110' and a reverse-positioned glenoid component 2250. In the illustrated embodiment, the frame 2110' may include an annular body 2112' defining an orifice 2130', anchor bolts 2114a', 2114b', and 2114c' (collectively referred to as 2114'), and snap-fit ​​connector interfaces 2120a', 2120b', and 2120c' (collectively referred to as 2120'). Except as described below or readily understood by those skilled in the art, the frame 2110' is identical or substantially identical to the frame 2110 described above. Therefore, for the sake of brevity, a detailed description of its structure and function is omitted.

[0175] In some embodiments, the reverse glenoid component 2250 may include a base plate 2260 and a hemispherical prosthetic head 2290 coupled to the base plate. According to this disclosure, those skilled in the art will understand that the reverse glenoid component 2250 is a prosthetic component as provided herein, wherein the base plate 2260 is part of or coupled to the distal surface of the prosthetic component, and the hemispherical prosthetic head 2290 is part of or coupled to the proximal bearing surface of the prosthetic component. Figures 22A-22D As shown, substrate 2260 (sometimes referred to herein as a "pad") may include a proximal portion 2260p and a distal portion 2260d. The proximal portion 2260p of pad 2260 may include a generally disk-shaped platform 2262 having a proximal surface 2262p and a distal surface 2262d. The distal portion 2260d of pad 2260 may have a custom shape configured for insertion into a hole 2130' in frame 2110'. In the illustrated embodiment, the proximal portion 2260p may be offset downward from the distal portion 2260d such that the distal surface 2262d of pad platform 2262 forms a ridge. Thus, when pad 2260 is attached to frame 2100', distal surface 2262d may abut against proximal surface 2112p' of frame 2110'.

[0176] One or more through holes may be defined extending through the proximal surface 2262p and the distal surface 2262d of the pad platform 2262. In the illustrated embodiment, a pair of through holes 2264a and 2264b (collectively referred to as 2264) are defined in the pad platform 2262 and configured to align with threaded bores 2116b' and 2116c' defined in the anchor bolts 2114b' and 2114b' when the pad 2260 is mounted on the frame 2110. Although two through holes 2262 are shown in the figures, more or fewer through holes (e.g., one, three, four, five, six or more) may be defined in the pad platform 2262.

[0177] In some embodiments, the customized shape of the distal portion 2260d may have a cross-sectional profile configured to be a negative image of the cross-sectional profile that typically forms the frame aperture 2130'. The distal portion 2260d may also define a recess (or resection portion) 2260r configured to externally (or at least partially externally) the anchor bolt 2114' of the frame 2110', preventing bolt interference during attachment of the pad 2260 to the frame. In some embodiments, the distal portion 2260d of the pad 2260 may have a generally convex distal bearing surface 2266 configured to directly engage with the generally concave surface of the glenoid bone in the patient's scapula, thus maximizing the contact surface area between the pad 2260 and the glenoid bone. Those skilled in the art will recognize that the distal bearing surface 2266 of the pad 2260 may have different shapes or surface topologies, depending at least in part on the relative surface topology of the target bone. This applies to either the bearing surface or its complementary surface provided in this disclosure.

[0178] In some embodiments, the distal portion 2260d of the pad 2260 may include a cylindrical post 2268. As shown in the illustrated embodiment, the post 2268 may be configured to project substantially perpendicular to the distal surface 2266 of the pad 2260. The post 2268 may be inserted into a hole or cavity formed in bone (e.g., the glenoid bone of a patient's scapula). In some embodiments, a through-hole 2270 may be defined extending through the pad 2260 along a central longitudinal axis BB extending through the post 2268. Figures 21A-21C As shown, the central bore 2270 can be configured to receive a bone screw 2284, for example, for anchoring an implant to bone. In other embodiments, the central bone screw may be omitted.

[0179] like Figure 23A and Figure 23B As shown, the prosthesis head 2290 (sometimes referred to herein as the "glenotum") may have a generally hemispherical body 2292. For attaching the glenotum 2290 to the pad 2260, the glenotum body 2292 may define an open cavity 2294, which may be configured to mate with the disc-shaped platform 2262 of the pad 2260. In some embodiments, the glenotum 2290 and the pad platform 2262 may be configured to form a conical lock when the pad platform is received within the glenotum cavity 2294.

[0180] Alternatively or otherwise, the connecting element 2296 may project distally from the distally facing surface 2294d of the cavity 2294 of the glenoid body 2292 for attaching the glenoid 2290 to the pad 2260. As shown in the illustrated embodiments, the connecting element 2296 may be a threaded or unthreaded shaft configured to lock into the central through-hole 2270 of the pad 2260. For example, in some embodiments, the glenoid 2290 may be manipulated to screw or press the connecting element 2296 into the through-hole 2270 of the pad 2260. Those skilled in the art will recognize that the glenoid and the pad can be attached together using other techniques and / or mechanisms for securing one component relative to another.

[0181] Figures 24A-24D This is a schematic diagram of an exemplary embodiment of a method for deploying a reverse shoulder implant 2200 in a patient's scapula. In the illustrated embodiment, the reverse shoulder implant 2200 may be deployed as part of an anatomical-to-reverse conversion in total shoulder arthroplasty, in which the anatomical glenoid component of the anatomical shoulder implant 1100 is removed and replaced with a reverse glenoid component 1250. While the illustrated embodiment describes an anatomical-to-reverse conversion, those skilled in the art will recognize that the reverse shoulder implant 1200 provided herein can be deployed without prior deployment of an anatomical implant.

[0182] See Figure 24A The frame 2110' is shown anchored to the glenoid bone 502 and exposing a concave portion 502a of the glenoid bone, including a drilled hole 504d'. In the illustrated embodiment, the frame 2110' is anchored to the bone by three anchor bolts 2114a', 2114b', and 2114c'. As discussed above, the outer surface of the anchor bolts 2114' and the distal surface 2112d' (not visible) of the frame 2110' may be coated with a material that enhances fixation to the bone, such as... In the illustrated anatomical to reverse conversion, the anchoring frame 2110' can be positioned relative to the previously deployed configuration described above. Figures 20A-20C The frame (e.g., 2110) described is the same as that used in part of the anatomical total shoulder arthroplasty. The anatomical glenoid component 2150 (not shown) of a previously deployed anatomical glenoid implant can be removed in a previous treatment step.

[0183] See Figure 24BThe pad 2260 can be attached to the frame 2110'. To attach the pad 2260 to the frame 2110', the distal portion 2260d of the pad 2260 can be inserted distally through the frame opening 2130', such that the post 2268 is inserted into the previously drilled hole 504d' (not visible). The pad 2260 can continue to be inserted distally until the distal surface 2262d of the pad platform 2262 abuts against the proximal surface 2112p' of the frame 2110'. When the pad 2260 is inserted into the frame opening 2130', the custom shape of its distal portion 2260d can be used as a key for aligning the through hole 2264 of the pad platform 2262 with the threaded bore 2116' of the anchor bolt 2114'. To secure the spacer 2260 to the frame 2110', locking screws 2280a and 2280b (collectively referred to as 2280) can be driven distally or otherwise inserted into the through-hole 2264 of the spacer 2260 and into the threaded bore 2116' of the corresponding anchor bolt 2114'. Optionally, bone screws 2284 can be driven distally or otherwise inserted through the central through-hole 2270 of the spacer 1260 and into the bone.

[0184] See Figure 24C The glenoid sphere 2290 may be attached to the pad 2260. For example, in some embodiments, the connecting element 2296 of the glenoid sphere body 2292 may be threaded or press-fitted into the central bore 2270 of the pad 2260. Alternatively or otherwise, when the disc-shaped pad platform 2262 is received within a cavity 2294 (not visible) defined in the glenoid sphere body 2292, the glenoid sphere 2290 and the pad 2260 may form a conical lock.

[0185] In some embodiments, a removable collet 2298 may be disposed within the central through-hole 2270 of the pad 2260. The collet 2298 may be sized to engage the connecting element 2296 of the glenoid bulb 2290 when the diameter of the connecting element is smaller than the diameter of the central through-hole 2270. For example, in some embodiments, the collet 2298 may be inserted to reduce the diameter of the central through-hole 2270 of the pad 2260 after the bone screw 2284 has been driven distally or otherwise inserted through the hole 2270 into the bone 502a, the bone screw having a maximum diameter larger than that of the connecting element 2296. In some embodiments, the chuck 2298 may be implemented as shown and described in U.S. Patent Application 16 / 044,473, filed July 24, 2018, entitled “BASEPLATE OF A MODULAR SHOULDER JOINT PROSTHESISAND RELATED METHODS FOR IMPLANTING THE SAME,” the entire contents of which are incorporated herein by reference.

[0186] like Figure 24D As shown, when the reverse-positioned glenoid component 2250 is attached to the frame 2110', the distal portion 2260d of the pad 2260 can directly contact the glenoid bone 502a through the frame aperture 2130'. For example, in the illustrated embodiment, the convex distal surface 2266 and the post 2268 of the pad 2260 can directly contact the glenoid bone 502a through the frame aperture 2130. By configuring the convex distal surface 2266 of the pad 2260 and the convex distal surface 2112d of the frame 2110' to have the same or substantially the same radius of curvature R”', the surface area of ​​direct contact between the component and the bone can be maximized.

[0187] Figure 25A and Figure 25B Another exemplary embodiment of a reverse-positioned shoulder implant 3200 is shown. The prosthetic implant 3200 may include a frame 3110 and a reverse-positioned glenoid component 3250. The frame 3110 may define an orifice 3130 through which a distal portion 3250d of the reverse-positioned glenoid component 3250 can directly contact the bone when attached to the frame. In some embodiments, the reverse-positioned glenoid component 3250 may include a base plate 3260 and a hemispherical prosthesis 3290 coupled to the base plate. Optionally, peripheral bone screws 3282a and 3282b (collectively, 3282) may be driven or otherwise inserted through the base plate 3260 to further anchor the implant 3200 to the bone.

[0188] Except as described below or as will be readily understood by those skilled in the art, frame 3110 may be the same as or substantially the same as frame 2110 described above. For example, in the illustrated embodiment, frame 3110 may include an annular body 3112 defining an opening 3130 and anchor bolts 3114a, 3114b and 3114c (collectively referred to as 3114). Therefore, for the sake of brevity, a detailed description of the structure and function of frame 3110 is omitted herein.

[0189] like Figure 26 As shown, each of the anchor bolts 3114 of the frame 3110 may have a substantially cylindrical shape and extend distally from the frame. For example, in the illustrated embodiment, anchor bolt 3114a may be located at the upper end 3112s of the frame body 3112, and anchor bolts 3114b and 3114c may be located at the lower end 3112i. Each of the anchor bolts 3114a, 3114b, and 3114c may define corresponding bores 3116a, 3116b, and 3116c (collectively referred to as 3116) extending at least partially along the length of the bolt. The bores 3116 defined within the anchor bolts 3114 may be threaded or unthreaded. As a non-limiting example, in the illustrated embodiment, the bore 3116a of the anchor bolt 3114a may be a threadless bore, and the bores 3116b and 3116c of the corresponding anchor bolts 3114b and 3114c may be threaded bores.

[0190] As relative to Figures 28A-28C In more detail, the bore 3116 of the anchor bolt 3114 can be configured to attach the reverse glenoid component 3250 to the frame 3110. As described above, in some embodiments, the reverse glenoid component 3250 may include a base plate 3260 and a hemispherical prosthetic head 3290 coupled to the base plate. According to this disclosure, those skilled in the art will understand that the reverse glenoid component 3250 is a prosthetic component as provided herein, wherein the base plate 3260 is part of or coupled to the distal surface of the prosthetic component, and the hemispherical prosthetic head 3290 is part of or coupled to the proximal bearing surface of the prosthetic component. Figure 27 As shown, substrate 3260 (sometimes referred to herein as “pad”) may include a proximal portion 3260p and a distal portion 3260d.

[0191] In some embodiments, the proximal portion 3260p of the pad 3260 may include a generally disc-shaped platform 3262 having a proximal surface 3262p and a distal surface 3262d. In some embodiments, one or more through holes may be defined to extend through the proximal surface 3262p and the distal surface 3262d of the pad platform 3262 to receive locking screws (not shown) for attaching the pad to the frame. For example, in an illustrated embodiment, a pair of through holes 3264a and 3264b (collectively referred to as 3264) are defined in the pad platform 3262 and may be configured to align with threaded bores 3116b and 3116c defined in anchor bolts 3114b and 3114c when the pad 3260 is mounted on the frame 3110. Although two through holes are shown in the accompanying drawings, more or fewer through holes (e.g., 1, 3, 4, 5, 6 or more) may be defined in the pad platform 3262 for attaching the pad to the frame.

[0192] In some embodiments, the distal portion 3260d of the pad 3260 may include a plate-shaped flange 3270 and an unthreaded bolt 3272 disposed at the upper end 3270s of the flange. The bolt 3272 may be configured to be inserted into the unthreaded bore 3116a of the anchor bolt 3114a at the upper end 3112s of the frame 3110. In some embodiments, the flange 3270 may have a cross-sectional profile configured for insertion into an aperture 3130 of the frame 3110. For example, the cross-sectional profile of the flange 3270 may be configured to generally form a negative image of the cross-sectional profile of the frame aperture 3130. Flange 3270 may also define a recess (or resection portion) 3270r configured to externally (or at least partially externally) anchor bolts 3114b and 3114c of frame 3110, preventing bolt interference during attachment of pad 3260 to frame. Additionally, as shown in the illustrated embodiment, through holes 3266a and 3266b (collectively, 3266) may be defined to extend through pad platform 3262 and flange 3270. Thus, in some embodiments, through hole 3266 may be used to allow bone screws, etc., to be driven distally or otherwise inserted through pad 3260 into bone.

[0193] In some embodiments, the distal portion 3260d of the pad 3260 may include a cylindrical post 3276. As shown in the illustrated embodiment, the post 3276 may be configured to project substantially perpendicular to the flange 3270 of the pad 3260. The post 3276 may be inserted into a hole or cavity formed in bone (e.g., the glenoid bone of a patient's scapula). In some embodiments, a central bore 3278 may be defined extending through the pad 3260 along a central longitudinal axis CC extending through the post 3276. In some embodiments, the central bore 3278 may be configured to receive a bone screw or other anchor (not shown) for securing the implant to the bone. In some embodiments, the central bore 3278 of the pad 3260 may be configured to receive a connecting element (not visible) of the prosthesis head 3290.

[0194] Figures 28A-28C This is a schematic diagram of an exemplary embodiment of a method for deploying a reverse shoulder implant 3200 in a patient's scapula. In the illustrated embodiment, the reverse shoulder implant 3200 may be deployed as part of an anatomical-to-reverse conversion in total shoulder arthroplasty, in which the anatomical glenoid component of a previously deployed anatomical shoulder implant is removed and replaced with a reverse glenoid component 3250. While the illustrated embodiment describes an anatomical-to-reverse conversion, those skilled in the art will recognize that the reverse shoulder implant 3200 provided herein can be deployed without prior deployment of an anatomical implant.

[0195] See Figure 28A The frame 3110 is shown anchored to the glenoid bone 502 and exposing a concave portion of the glenoid bone, including a drilled hole 504d. In the illustrated embodiment, the frame 3110 is anchored to the bone by three anchor bolts 3114a, 3114b, and 3114c. In the illustrated anatomical-to-reverse conversion, the anchored frame 3110 may be pre-deployed as part of an anatomical total shoulder arthroplasty. The anatomical glenoid component (e.g., 2150 (not shown)) of the previously deployed anatomical glenoid implant may be removed in a previous treatment step.

[0196] To attach the pad 3260 to the frame 3110, the distal portion 3260d of the pad 3260 can be inserted distally through the frame bore 3130, such that the post 3276 is inserted into the previously drilled hole 504d. The pad 3260 can continue to be inserted distally until the distal surface 3262d of the pad platform 3262 abuts against the proximal surface 3112p of the frame 3110. The pad 3260 can be manipulated such that the anti-rotation bolt 3272, protruding distally from the flange 3270, is inserted into the unthreaded bore 3116a of the anchor bolt 3114a. When the pad 3260 is inserted into the frame opening 2130', the custom shape of the distal flange 3270 can be used as a key to align the through hole 3264 of the pad platform 3262 with the threaded bores 3116b and 3116c of the anchor bolts 3114b and 3114c.

[0197] See Figure 28B In some embodiments, to secure the spacer 3260 to the frame 3110, locking screws 3280a and 3280b (collectively, 3280) may be driven distally or otherwise inserted into the through-hole 3264 (not visible) of the spacer 3260 and into the threaded bores 3116b and 3116c (not visible) of the corresponding anchor bolts 3114b and 3114c. Optionally, peripheral bone screws 3282a and 3282b (collectively, 3282) may be driven distally or otherwise inserted into the bone through the corresponding through-hole 3266 of the spacer 3260.

[0198] See Figure 28C The prosthesis head 3290 (sometimes referred to herein as the "glenohumeral ball") may be attached to the pad 3260. In the illustrated embodiment, the glenohumeral ball 3290 may have a substantially hemispherical body 3292. Except as described below or as will be readily understood by those skilled in the art, the glenohumeral ball 3290 may be the same as or substantially the same as the glenohumeral ball 2290 described above. Therefore, for the sake of brevity, a detailed description of the structure and function of the glenohumeral ball 3290 is omitted herein.

[0199] For example, as mentioned above, relative to Figures 24A-24D As described, when the pad platform 3262 is received within the open cavity (not visible) of the glenoid body 3292, the glenoid ball 3290 can be attached to the glenoid ball 3260 by forming a conical lock. Alternatively or otherwise, the connecting element (not visible) of the glenoid ball 3290 can be configured to lock into the central through-hole 3278 of the pad 3260. For example, in some embodiments, the glenoid ball 3290 can be manipulated to screw or press the connecting element into the through-hole 3270 of the pad 3260. Those skilled in the art will recognize that the glenoid ball and the pad can be attached together using other techniques and / or mechanisms for securing one component relative to another.

[0200] The foregoing specific embodiments of the disclosed embodiments are provided to enable any person skilled in the art to make or use the claims. Various modifications to these embodiments will be apparent to those skilled in the art, and the general principles defined herein may be applied to other embodiments without departing from the scope of the claims. Therefore, this disclosure is not intended to be limited to the embodiments shown herein, but is to be given the broadest scope accorded to the following claims and the principles and novel features disclosed herein. All publications and references cited herein are expressly incorporated herein by reference in their entirety.

Claims

1. A prosthetic implant, comprising: A prosthetic component having a proximal bearing surface and a distal surface, the distal surface being opposite to the proximal bearing surface; and A frame configured to be anchored in bone, the frame defining an orifice through which a portion of the prosthesis component is configured to be disposed, and the frame including one or more attachment interfaces configured to attach the prosthesis component to the frame such that the distally facing surface of the prosthesis component extends through the orifice of the frame to directly contact the bone. The frame further includes a plurality of anchor bolts for anchoring the frame to the bone, the plurality of anchor bolts extending distally from the frame.

2. The implant according to claim 1, characterized in that, The frame comprises one or more metals.

3. The implant according to claim 1, characterized in that, The prosthetic component comprises one or more plastic materials.

4. The implant according to claim 1, characterized in that, The frame also includes one or more bone anchor recesses for anchoring the frame to bone, each of the one or more bone anchor recesses defining a through-hole through which the bone anchor is inserted into the bone.

5. The implant according to claim 4, characterized in that, The one or more bone anchor recesses are accessible through the orifices in the frame.

6. The implant according to claim 1, characterized in that, The prosthesis component also includes a post extending from the distally facing surface of the prosthesis component, the post being configured to engage with a void formed in the bone.

7. The implant according to claim 1, characterized in that, It also includes a prosthesis head having a hemispherical shape and being attached to the proximal bearing surface of the prosthesis component.

8. The implant according to claim 1, characterized in that, The frame’s one or more attachment interfaces include one or more snap-fit ​​connector interfaces.

9. The implant according to claim 8, characterized in that, When the one or more snap-fit ​​connectors of the prosthesis component are attached to the one or more snap-fit ​​connector interfaces of the frame, the distally facing surface of the prosthesis component directly contacts the bone through the opening of the frame.

10. The implant according to claim 1, characterized in that, The one or more attachment interfaces of the frame include a removable frame adapter that defines one or more locking screw holes and is configured to extend across the holes between opposing legs of the frame.

11. The implant according to claim 10, characterized in that, The prosthetic component defines one or more through holes, the one or more through holes corresponding to the one or more locking screw holes of the removable frame adapter, and The prosthetic component is configured to be attached to the frame by inserting a locking screw through one or more through holes in the prosthetic component and into one or more locking screw holes in the removable frame adapter.

12. The implant according to claim 1, characterized in that, The one or more attachment interfaces of the frame include one or more locking screw recesses that can reach through the orifice and define one or more corresponding locking screw holes.

13. The implant according to claim 12, characterized in that, The prosthetic component defines one or more through holes, the one or more through holes corresponding to the one or more locking screw holes of the one or more locking screw recesses, and The prosthetic component is configured to be attached to the frame by inserting a locking screw through one or more through holes in the prosthetic component and into one or more locking screw holes in one or more locking screw recesses.

14. The implant according to claim 1, characterized in that, The one or more attachment interfaces of the frame include a plurality of anchor bolts protruding from the frame for anchoring the frame to bone, and one or more of the anchor bolts defining one or more bores therein. The prosthetic component defines one or more holes, the one or more holes corresponding to the one or more bores defined in the one or more anchor bolts, and The prosthetic component is configured to be coupled to the frame by inserting a locking screw through one or more holes in the prosthetic component and into one or more bores defined in one or more anchor bolts.

15. The implant according to claim 14, characterized in that, The unthreaded bore is defined in at least one of the plurality of anchor bolts of the frame, and The prosthetic component includes an anti-rotation bolt protruding from the distal bearing surface of the prosthetic component, the anti-rotation bolt being configured to engage with the threadless bore.

16. The implant according to claim 1, characterized in that, The one or more attachment interfaces of the framework include: At least a first attachment interface, said at least a first attachment interface being configured to attach a prosthetic glenoid component to the frame; and A second attachment interface is configured to attach a prosthetic glenoid component to the frame.

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