Tibial implants for knee arthroplasty

Abstract

A tibial implant for knee arthroplasty comprises a tibial plate, a tibial keel and at least one anchoring projection. The size and shape of the tibial plate are set to be placed on the proximal end of the patient's tibia. The tibial plate comprises a relative proximal surface and a distal surface, wherein the distal surface is configured to engage the end of the tibia. The tibial keel extends distally from the distal surface of the tibial plate and is configured to be inserted into the proximal end of the tibia. The anchoring projection extends distally from the distal surface of the tibial plate and is configured to be inserted into the proximal end of the tibia.

Description

Technical Field

[0001] The present disclosure relates generally to knee arthroplasty, and in particular, to knee arthroplasty implants and methods of installing knee arthroplasty implants. Background Art

[0002] Knee arthroplasty is a surgical procedure for reconstructing and resurfacing a knee that has been damaged, such as due to arthritis, and is commonly referred to as a knee replacement. A total knee arthroplasty device replaces the tibiofemoral joint and the patellofemoral joint. The tibiofemoral joint is where the tibia and femur articulate. The patellofemoral joint is where the patella and femur articulate. In order to replace the tibiofemoral joint, the knee arthroplasty comprises a femoral trial (or implant) fixed to the distal end of the femur, a tibial tray (or implant) fixed to the proximal end of the tibia, and an insert placed therebetween. The femoral implant and the tibial implant cover the ends of the femur and tibia that form the knee joint, respectively, thereby reconstructing the knee. In order to replace the patellofemoral joint, the knee arthroplasty comprises a patellar prosthesis (or implant) to replace the dorsal side of the patella and form a replacement articulation surface that interfaces with the femoral trial. Summary of the invention

[0003] On the one hand, a tibial implant for knee arthroplasty comprises a tibial plate, the size and shape of which are set to be placed on the proximal end of the patient's tibia. The tibial plate comprises a relative proximal surface and a distal surface. The distal surface is configured to engage the end of the tibia. A tibial keel extends distally from the distal surface of the tibial plate and is configured to be inserted into the proximal end of the tibia. At least one anchoring projection extends distally from the distal surface of the tibial plate and is configured to be inserted into the proximal end of the tibia.

[0004] On the other hand, a method for verifying implantation of a tibial implant relative to the proximal end of a patient's tibia comprises: positioning the tibial implant relative to the proximal end of the tibia; positioning a position indicator of a position verification system relative to the tibial implant; determining the position of the tibial implant by tracking the position of the position indicator with a tracker of the position verification system; determining the position of the tibia; and verifying that the tibial implant is correctly positioned relative to the proximal end of the tibia by comparing the position of the tibial implant with the position of the tibia.

[0005] Other objects and features of the disclosure will be in part apparent and in part pointed out hereinafter. BRIEF DESCRIPTION OF THE DRAWINGS

[0006] Figure 1 is an anterior perspective view of a tibial implant according to one embodiment of the present disclosure;

[0007] Figure 2 yes Figure 1 A bottom perspective view of a tibial implant;

[0008] Figure 3 yes Figure 1 A bottom plan view of a tibial implant;

[0009] Figure 4 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0010] Figure 5 is a bottom plan view of a tibial implant according to another embodiment of the present disclosure;

[0011] Figure 6 yes Figure 5 A bottom perspective view of an enlarged fragment of a tibial implant;

[0012] Figure 7 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0013] Figure 8 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0014] Fig. 9 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0015] Fig.10 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0016] Fig.11 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0017] Fig.12 yes Fig.11 an enlarged fragmentary side elevation view of an anchoring protrusion of a tibial implant;

[0018] Fig.13 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0019] Fig.14 yes Fig.13 an enlarged fragmentary side elevation view of an anchoring protrusion of a tibial implant;

[0020] Fig.15 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0021] Fig.15A yes Fig.15 A bottom perspective view of an enlarged fragment of a tibial implant;

[0022] Fig.16 is an anterior bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0023] Fig.17 yes Fig.16 a posterior bottom perspective view of a tibial implant;

[0024] Fig.18 Yes Fig.16 A perspective view of an installation tool assembly with a tibial implant installed on the proximal end of a patient's tibia;

[0025] Fig.19 is a front perspective view of an insert guide of an installation tool assembly;

[0026] Fig. 20 is a rear perspective view of the embedded guide;

[0027] Fig.21 is a bottom perspective view of a tibial implant according to another embodiment of the present disclosure;

[0028] Fig. 22 yes Fig.21 A bottom plan view of a tibial implant;

[0029] Fig.23 is a side elevation view of a patella implant according to one embodiment of the present disclosure;

[0030] Fig.24 is a cross-section of the patellar implant;

[0031] Fig.25 is a bottom plan view of the patellar implant;

[0032] Fig.26 is a schematic illustration of a position verification system in which a position indicator engages a positioning guide of a tibial implant to verify the position of the tibial implant relative to the proximal end of a patient's tibia;

[0033] Fig. 27 yes Fig.26 A perspective view of a position indicator engaging a positioning guide of a femoral implant to verify the position of the femoral implant relative to the distal end of the patient's femur;

[0034] Fig.28 yes Fig.26 a perspective view of a position indicator engaging a tibial mounting tool attached to a tibial implant to verify the position of the tibial implant relative to the proximal end of the tibia;

[0035] Fig.29 yes Fig.26a perspective view of a position indicator engaging a femoral installation tool attached to a femoral implant to verify the position of the femoral implant relative to the distal end of the femur;

[0036] Fig.30 yes Fig.26 a perspective view of a position indicator engaging a tibial implant to verify the position of the tibial implant relative to the proximal end of the tibia;

[0037] Fig.31 yes Fig.26 a perspective view of a position indicator engaging a femoral implant to verify the position of the femoral implant relative to the distal end of the femur;

[0038] Fig.32 is a perspective view of a position indicator of a position verification system secured to a tibial mounting tool attached to a tibial implant for verifying the position of the tibial implant relative to the proximal end of the tibia;

[0039] Fig.33 yes Fig.32 a perspective view of a position indicator secured to a femoral installation tool attached to a femoral implant for verifying the position of the femoral implant relative to the distal end of the femur;

[0040] Fig.34 yes Fig.26 a perspective view of a position indicator secured to a tibial cap attached to a tibial implant for verifying the position of the tibial implant relative to the proximal end of the tibia; and

[0041] Fig.35 yes Fig.32 A perspective view of a position indicator secured to a femoral cap attached to a femoral implant for verifying the position of the femoral implant relative to the distal end of the femur.

[0042] Corresponding reference numerals indicate corresponding parts throughout the drawings. DETAILED DESCRIPTION

[0043] Various systems and methods for performing and carrying out knee arthroplasty are disclosed herein. The various systems for knee arthroplasty disclosed herein include: an implant (e.g., a tibial implant, a femoral implant, a patellar implant); a mounting or arthroplasty tool for mounting the implant; and a position verification system for determining and verifying the position of the implant relative to the bone. The various methods for knee arthroplasty disclosed herein include methods for mounting an implant and methods for verifying the position of the mounted implant relative to the bone.

[0044] refer to Figure 1-3One embodiment of a tibial tray or implant for knee arthroplasty according to one embodiment of the present disclosure is generally indicated at reference numeral 10. The tibial implant 10 includes a tibial plate 12 that is sized and shaped to be placed on the proximal end PE of the patient's tibia T ( Fig.18 ). The tibial plate 12 can generally have any size and shape to match the specific size and shape of the proximal end PE of the tibia T to which the tibial implant is attached. The tibial plate 12 includes a relative proximal surface 14 and a distal surface 16. The distal surface 16 of the tibial plate 12 is configured to engage the proximal end PE of the tibia T. The tibial plate 12 has a peripheral edge 18. In the illustrated embodiment, the tibial plate 12 includes a peripheral wall 20 extending proximally from the proximal surface 14. The peripheral wall 20 includes the peripheral edge 18. The peripheral wall 20 defines an insert receiving space 22, the size and shape of which are set to receive an insert (not shown). The peripheral wall 20 may include one or more recesses or notches 24 for receiving a portion of an insert to keep the insert in the insert receiving space 22. The proximal surface 14 defines the distal end or bottom end of the insert receiving space 22.

[0045] The tibial implant 10 can include at least one (e.g., a plurality) of positioning guides 26 configured to be positioned by a position verification system 1400 ( Fig.26 ) engages to verify the position of the tibial implant relative to the proximal end PE of the tibia T after the tibial implant is implanted (e.g., placed) on the proximal end of the tibia. As discussed in more detail below, the positioning guide 26 is used to locate or align the position verification system 1400 relative to the tibial implant 10. The size and shape of the positioning guide 26 are set to match the elements or components (e.g., position indicator 1402) of the position verification system 1400. Therefore, the positioning guide 26 is a contact point for the position verification system 1400. One or more positioning guides 26 are placed on the tibial implant 10 in a position that will be accessible after the implant is attached to the tibia T. In the embodiment shown, the positioning guide 26 is placed on the tibial plate 12. Specifically, the positioning guide 26 is placed on the peripheral edge 18 of the tibial plate 12, and it is desirable to be in the front part of the peripheral edge so that the positioning guide is easily accessible after the tibial implant 10 is implanted. Other positions of the positioning guide 26 are within the scope of the present disclosure. For example, the positioning guide 26 can be disposed on the proximal surface 14. The positioning guide 26 can be a positive element such as a protrusion or a negative element such as a recess. In the illustrated embodiment, the positioning guide 26 is a recess or a depression. Thus, the positioning guide 26 of the illustrated embodiment is configured to receive or be engaged by the position verification system 1400. The recess 26 can generally have any shape, such as, but not limited to, Figure 1The conical shape (for example, inverted cone) shown in, the conical shape with flat bottom, part spherical former, hemispherical, cylindrical, rectangular, square, cone shape etc. Positioning guide 26 is spaced apart from each other.In one embodiment, positioning guide 26 is configured to indicate the identification data of tibial implant 10, such as but not limited to the size of tibial implant, the part number of implant etc. The position of positioning guide 26 on tibial implant 10 and / or the distance between the positioning guide can be used for indicating or coding identification data.When position verification system 1400 is registered with positioning guide 26, the system can match the position of positioning guide and / or the distance between the positioning guide with the implant database containing possible implant list to determine the specific type of tibial implant 10 and / or confirm that correct tibial implant has been implanted on tibia T. For example, the distance between the positioning guides 26 can represent (e.g., encode) the size of the tibial implant 10 (e.g., the spacing between the positioning guides 26 varies with the size of the implant), and the position verification system 1400 can determine the size of the tibial implant by referencing an implant database to confirm that the correct size tibial implant has been implanted.

[0046] Tibial implant 10 includes tibial stem or keel 28. Tibial keel 28 is configured to be inserted into the proximal end PE of tibia T. Tibial keel 28 is attached to tibial plate 12. Tibial keel 28 generally extends distally from the distal surface 16 of tibial plate 12. In the embodiment shown, tibial keel 28 is generally straight. Tibial keel 28 can be solid or hollow (e.g., with a solid or hollow core). Tibial keel 28 can include coronal fins 30 (e.g., two coronal fins). The coronal fins 30 extend outward from the center of tibial keel 28 in a direction generally parallel to the coronal plane of the patient (e.g., a vertical side-to-side extension plane). In the embodiment shown, the coronal fins 30 are slightly angled relative to the coronal plane, such as about 15 degrees or less, to form a slight V shape. Tibial keel 28 can also include sagittal fins 32 (e.g., two sagittal fins). The sagittal fin 32 extends outward from the center of the tibial keel 28 in a direction generally parallel to the patient's sagittal plane (e.g., a vertical front-to-back extending plane). The coronal fin 30 and the sagittal fin 32 taper inwardly as the fins extend distally. The width of the sagittal fin 32 may also taper inwardly (e.g., in a direction generally parallel to the coronal plane) as the fins extend distally. The fins 30, 32 have rounded edges. The nose or tip of the tibial keel 28 tapers in the coronal plane (e.g., is curved). In other embodiments, the nose of the tibial keel 28 may also taper in the sagittal plane. Other configurations of the tibial keel are within the scope of the present disclosure, some of which are disclosed herein.

[0047] refer to Figure 2 and3 , the tibial implant 10 can include at least one anchoring projection 34. In the illustrated embodiment, the tibial implant 10 includes four anchoring projections 34, but more or fewer anchoring projections are also within the scope of the present disclosure. The anchoring projections 34 are spaced apart from each other on the distal surface 16 of the tibial plate 12. In the illustrated embodiment, the four anchoring projections 34 are arranged around the tibial keel 28 in a generally X-shaped arrangement, with the tibial keel at the center of the X. Other arrangements of the anchoring projections 34 are within the scope of the present disclosure.

[0048] Each anchoring projection 34 is configured to be inserted into the proximal end PE of the tibia T. Each anchoring projection 34 is generally the same, and therefore one anchoring projection will be further described in detail with the understanding that the other anchoring projections have substantially the same configuration (e.g., disposed at different locations on the tibial plate 12). The anchoring projection 34 is attached to the tibial plate 12. The anchoring projection 34 generally extends distally from the distal surface 16 of the tibial plate 12. The anchoring projection 34 has a distal end or distal tip 36. In this embodiment, the distal tip 36 includes a recess. The recess can generally have any shape, such as but not limited to a cone (e.g., an inverted cone), but other shapes are also within the scope of the present disclosure, such as a flat-bottomed cone, a partial spherical former, a hemispherical, a cylindrical, a rectangular, a square, a cone, etc. When the tibial implant 10 is implanted in the tibia T, the recess maximizes the press fit of the anchoring projection 34 with the bone to increase the compression between the anchoring projection and the bone, thereby stimulating the healing of the bone. In addition, the recess helps to form a sharp front distal edge at the distal tip 36 to help insert the anchoring projection 34 into the proximal end PE of the tibia T. In the embodiment shown, the anchoring projection 34 has a generally circular, conical shape (e.g., bullet shape), but other shapes such as circular, blade-shaped or hollow shapes are also within the scope of the present disclosure. The anchoring projection 34 includes a plurality of ribs 38 extending proximally from the distal tip 36. The ribs 38 extend proximally to the distal surface 16 of the tibial plate 12. In the embodiment shown, the anchoring projection 34 includes six ribs 38, but more (e.g., 20) or fewer (e.g., 4) ribs are also within the scope of the present disclosure. The ribs 38 are arranged circumferentially around the anchoring projection 34. The ribs 38 have beveled edges, but in other embodiments may have rounded, chamfered, sharp, rounded, etc. edges. In this embodiment, the ribs 38 are curved (e.g., slightly curved) about the longitudinal axis of the anchoring protrusion 34. The longitudinal axis extends proximally and distally through the distal tip 36 of the anchoring protrusion 34. In other words, the ribs 38 are spirally or partially spirally curved about the longitudinal axis. In the illustrated embodiment, each rib 38 includes a proximal portion extending generally straight distally from the distal surface 16 and a distal portion extending distally from the proximal portion in a curved manner about the longitudinal axis to the distal tip 36. As the ribs extend distally, the ribs 38 gradually narrow inwardly (e.g., toward the longitudinal axis) toward the distal tip 36. The taper may be straight or curved. Other configurations of the ribs 38 are within the scope of the present disclosure. Adjacent ribs 38 define a groove 40 therebetween. The groove 40 extends from the distal surface 16 to the distal tip 36, and the shape of the groove generally corresponds to the shape of the rib 38. Therefore, the groove 40 is also curved about the longitudinal axis. The design of the rib 38 (and more broadly, the anchoring protrusion 34) minimizes bone displacement, minimizes the risk of fracture, and increases the surface area of ​​the anchoring protrusion for bone ingrowth.Other configurations of anchoring protrusions are within the scope of the present disclosure, some of which are disclosed herein.The anchoring protrusions 34 can be solid or hollow (eg, have a solid or hollow core).

[0049] Tibial implant 10 can include one or more porous areas.Porous areas are placed on the tibial implant and tibia T (bone in a broad sense) engagement position.After the tibial implant is placed on the bone, the porous area enables bone to grow inwardly into the tibial implant 10 to form a firm connection between the implant and the bone.This allows the tibial implant 10 to be inserted into the tibia T without the cement conventionally used in knee arthroplasty, thereby reducing the procedure time, cement-related complications and surgeon pressure.The porosity of the porous area can be within the inclusive range of about 40%-90%, or more preferably within the inclusive range of about 50%-80%.The porous area can have a thickness of about 1mm to 1.5mm.In the embodiment shown, the distal surface 16 of the tibial plate 12 is porous (e.g., porous area).Other parts of the tibial implant 10 can include porous areas. For example, in one embodiment, at least a portion of the tibial keel 28 and / or the anchoring projection 34 is porous so that after the tibial implant 10 is inserted into the proximal PE of the tibia T or implanted on the proximal PE of the tibia T, bone can grow into the tibial keel and / or the anchoring projection 34, respectively. Any surface of the tibial keel 28 and the anchoring projection 34 can be porous. Preferably, the porous area extends distally along the tibial keel 28 and the anchoring projection 34 from the distal surface 16 of the tibial plate 12. Preferably, the porous area of ​​the tibial keel 28 and / or the anchoring projection 34 extends distally from the distal surface 16 to exceed and include a distance of about 10mm. This allows bone to grow into the tibial keel 28 and / or the anchoring projection 34, while still allowing the tibial implant 10 to be easily removed in the future if the implant needs to be adjusted or replaced. The porous region of the tibial keel 28 and / or anchoring projection 34 can extend over (e.g., cover) more of the tibial keel and / or anchoring projection 34, including the entirety thereof, to enable a more secure connection between the tibial keel and / or anchoring projection 34, but if removal is desired, removal and replacement of such a tibial implant from the bone will be more difficult. In one embodiment, the porous region includes a plurality of tibial keels 28 and / or anchoring projections 34 that are coupled together to form a lattice ( Figure 2 and 25 ) of hexagonal pillars, but any suitable porous structure is also within the scope of the present disclosure.

[0050] The tibial implant 10 can be made using conventional manufacturing processes and methods and / or additive manufacturing processes and methods (e.g., three-dimensional (3D) printing). In one manufacturing method, additive manufacturing is used to construct the entire tibial implant 10. In this method, the tibial implant 10 is constructed by an additive manufacturing machine (e.g., a 3D printer), which typically constructs the implant on a base plate and post-processes the implant before removing the implant from the base plate. In another manufacturing method, hybrid manufacturing is used to construct the tibial implant 10, which combines conventional manufacturing methods with additive manufacturing. In this hybrid method, the tibial plate 12 of the implant 10 can be first created by conventional manufacturing methods such as cold forming (e.g., stamping, cutting, deformation) metal blanks or by forging the tibial plate. Then, the tibial plate 12 is placed in an additive manufacturing machine, which constructs additional elements (e.g., keel 28, anchoring protrusion 34, porous area, etc.) on the tibial plate. Preferably, the porous region of tibial implant 10 is constructed using additive manufacturing. An additive manufacturing machine constructs (e.g., is configured to construct on the assembly) a porous region (e.g., a lattice of hexagonal pillars) on a component (e.g., tibial plate 12) of a tibial implant. Compared with conventional methods, additive manufacturing is more likely to enable the construction of more complex porous structures. For example, conventional manufacturing methods cannot construct a porous region of a lattice comprising hexagonal pillars. Various additive manufacturing processes can be used to create porous regions, such as 3D printing, direct metal laser sintering (DMLS), titanium deposition spraying, etc. Other methods of constructing porous regions are within the scope of the present disclosure. For example, subtractive manufacturing processes such as laser etching or acid etching can be used to construct porous regions.

[0051] Other configurations of tibial implants are within the scope of the present disclosure.For example, a tibial implant can have one or more of the tibial keels and / or anchoring projections as described below.

[0052] refer to Figure 4 , the anchoring projection of the tibial implant 110 according to another embodiment of the present disclosure is generally indicated at reference numeral 134. In this embodiment, the ribs 138 of the anchoring projection 134 are generally straight and parallel to and extend toward the longitudinal axis (e.g., not bent around the longitudinal axis). In this embodiment, the distal tip 136 of the anchoring projection 134 includes an end point (e.g., a conical end point).

[0053] refer to Figure 5 and 6 The anchoring protrusion of the tibial implant 210 according to another embodiment of the present disclosure is generally indicated at reference numeral 234. In this embodiment, the anchoring protrusion 234 includes four ribs 238 ( Figure 5 ). The ribs 238 are also generally straight and extend parallel to and toward the longitudinal axis. The distal tip 236 also includes an endpoint similar to the anchoring protrusion 134. In this embodiment, the ribs 238 are spaced apart from the distal surface 16 of the tibial paddle 12. The ribs 238 extend proximally from the distal tip 236 to a position intermediate the distal tip and the distal surface 16. Each rib 238 includes a proximal surface that faces the distal surface 16 and is spaced apart from the distal surface. The proximal surface of the rib 238, the distal surface 16 of the tibial paddle 12, and the bottom of the rib (not shown) together define a space for bone (e.g., tibia T) to grow into the rib and surround the rib. In other embodiments, the ribs 238 may extend all the way to the distal surface 16, such as Fig.16 , 17 , 21 and 22 in the ribs of the anchoring protrusion 234A.

[0054] refer to Figure 7 , the anchoring projection of the tibial implant 310 according to another embodiment of the present disclosure is generally indicated at reference numeral 334. In this embodiment, the anchoring projection 334 is cylindrical (e.g., having a cylindrical shape). The anchoring projection 334 comprises a cylindrical outer surface 335 and a front surface or distal surface 336. The distal surface is generally planar (e.g., the distal end 336 is generally blunt) and has a circular shape. The edge or corner between the outer surface 335 and the distal surface 336 is circular, but can be beveled, chamfered, sharp, rounded, etc. in other embodiments.

[0055] refer to Figure 8 , the anchoring projection of the tibial implant 410 according to another embodiment of the present disclosure is generally indicated at reference numeral 434. In this embodiment, the anchoring projection 434 is generally cylindrical with a cylindrical outer surface 435. The distal end 436 includes a recess, which in the embodiment shown is an inverted cone, but other configurations as described herein are also within the scope of the present disclosure. In this embodiment, the width or diameter of the bottom of the inverted cone recess at the distal end 436 is generally equal to the width or diameter of the cylindrical outer surface 435, but the bottom of the recess with a smaller width is also within the scope of the present disclosure. The anchoring projection 434 includes a sharp front edge or distal edge between the recess at the distal end 436 and the cylindrical outer surface 436.

[0056] refer to Fig. 9, the anchoring projection of the tibial implant 510 according to another embodiment of the present disclosure is generally indicated at reference numeral 534. In this embodiment, the anchoring projection 534 has a generally polygonal (e.g., hexagonal) shape that gradually narrows inwardly when the anchoring projection extends distally. The surface 541 of the polygon is concave. Therefore, the edge between the surfaces generally defines a ridge 538 of the anchoring projection 534 with a sharp edge. In this embodiment, the distal end 536 has a generally flat distal surface.

[0057] refer to Fig.10 , the anchoring protrusion of the tibial implant 610 according to another embodiment of the present disclosure is generally indicated at reference numeral 634. In this embodiment, the anchoring protrusion 634 has a generally polygonal (e.g., hexagonal) shape that gradually narrows inwardly when the anchoring protrusion extends distally. The surface 641 of the polygon is concave. Therefore, the edge between the surfaces generally defines the ridge 638 of the anchoring protrusion 634. In this embodiment, the ridge 638 is rounded. The distal end 636 has a recess, such as an inverted cone.

[0058] refer to Fig.11 and 12 , the anchoring projection of the tibial implant 710 according to another embodiment of the present disclosure is generally indicated at the reference numeral 734. In this embodiment, the anchoring projection 734 has a generally polygonal (e.g., hexagonal) shape that gradually narrows inward when the anchoring projection extends distally. The polygonal surface 741 is concave. Therefore, the edge between the surface 741 generally defines a ridge 738 of the anchoring projection 734 with a sharp edge. The ridge 738 is generally bent around the longitudinal axis LA of the anchoring projection when the ridge extends distally. Therefore, when the anchoring projection extends distally, the polygonal cross-sectional shape is generally rotated around the longitudinal axis LA. The distal end 736 has a recess, such as an inverted hexagonal cone, but other shapes such as those described herein are also within the scope of the present disclosure. The anchoring projection 734 includes a sharp front edge or distal edge 737 between the recess at the distal end and the surface 741 at the distal end 736. The distal edge 737 has a polygonal (eg, hexagonal) shape made of a plurality of linear segments. The linear segments of the distal edge 737 are generally coplanar.

[0059] refer to Fig.13 and 14, the anchoring projection of the tibial implant 810 according to another embodiment of the present disclosure is generally indicated at the reference numeral 834. In this embodiment, the anchoring projection 834 has a generally polygonal (e.g., hexagonal) shape that gradually narrows inward when the anchoring projection extends distally. The polygonal surface 841 is concave. Therefore, the edge between the surface 841 generally defines a ridge 838 of the anchoring projection 834 with a sharp edge. The ridge 838 is generally bent around the longitudinal axis LA of the anchoring projection when the ridge extends distally. Therefore, when the anchoring projection extends distally, the polygonal cross-sectional shape is generally rotated around the longitudinal axis LA. The distal end 836 has a recess, such as an inverted hexagonal cone, but other shapes such as those described herein are also within the scope of the present disclosure. The anchoring projection 834 includes a sharp front edge or distal edge 837 between the recess at the distal end and the surface 841 at the distal end 836. The distal edge 837 has a generally polygonal (e.g., hexagonal) shape made of a plurality of segments. In this embodiment, the line segments of the distal edge 837 are arcuate or curved (e.g., generally curved about an axis (e.g., a horizontal axis) extending generally perpendicular to the longitudinal axis LA). Thus, the distal edge 837 has a generally sawtooth configuration, wherein the teeth or endpoints are disposed at the intersection of two curved segments and the ridge 838 (e.g., defined by the intersection).

[0060] refer to Fig.15 and 15A , the anchoring projection of the tibial implant 910 according to another embodiment of the present disclosure is generally indicated at reference numeral 934. In this embodiment, the anchoring projection 934 includes a cylindrical wall 939 extending distally from the distal surface 16 to the distal end 936. The cylindrical wall 939 includes a generally cylindrical outer surface 935 and a generally cylindrical inner surface 943. The cylindrical inner surface 943 defines a cavity or recess 945 of the anchoring projection, which is functionally similar to other recesses of the anchoring projection described herein. The cavity 945 extends from the distal surface 16 to the distal end 936. The distal end 936 includes a generally flat distal surface. The inner and / or outer circumferential edges of the distal surface can be beveled, rounded, chamfered, sharp, rounded, etc. In the embodiment shown, the inner edge of the distal surface of the distal end 936 is beveled. The outer surface 943 and the inner surface 934 each include one or more (eg, a plurality) circumferential ridges 938 defined by circumferential, generally concave grooves extending into the cylindrical wall 939. The ridges 938 are spaced longitudinally along the cylindrical wall 939.

[0061] refer to Fig.16 and 17, the tibial keel for tibial implant 1010 according to another embodiment of the present disclosure is generally indicated at reference numeral 128. In this embodiment, tibial keel 128 is arched or curved. When tibial keel 128 extends distally from the distal surface 16 of tibial plate 12, the tibial keel bends around the transverse axis of the patient (e.g., generally parallel to the lateral or side-to-side axis of the distal surface of the tibial plate). In other words, tibial keel 128 bends toward the front portion (e.g., in the forward direction) of tibial implant 1010. Therefore, when tibial implant 1010 is implanted on tibia T, tibial keel 128 bends toward the tibial tuberosity of the patient. The tibial tuberosity is a cortical protrusion that is usually used as a landmark in orthopedic surgery. In contrast to other keel designs, the nose of tibial keel 128 is aimed at tibial tuberosity to ensure other cortical fulcrum (cortical purchase) and the chance of lifting off can be reduced by placing closer to cortical bone. In addition, compared with straight keel design, curved tibial keel 128 has larger surface area. The larger anterior surface or anterior surface and rear surface or rear surface of tibial keel 128 provide larger resistance for lifting tibial implant 10 from tibia T. In addition, due to the curved design, a part of the rear surface of tibial keel 128 faces distally, thereby increases the total amount of the surface area facing distally, which improves the ability of tibial implant 1010 to resist sinking. Except that tibial keel 128 is curved, the coronal fin 130 and sagittal fin 132 of described tibial keel comprise piercing edge. The edge of fin 130,132 can be tapered, sharp and / or serrated. Conventional insertion techniques require that keel features be drilled and / or broached into tibia T before inserting the implant. The piercing edge of tibial keel 128 helps to insert tibial implant 1010 without any prior bone preparation or minimal prior bone preparation. In addition, in this embodiment, tibial keel 128 also includes anchoring projections or spikes 131. Anchoring projections 131 are configured to be inserted into the proximal end PE of tibia T to further fix tibial implant 1010 to tibia. In the embodiment shown, anchoring projections 131 are placed on the rear side of tibial keel 128, adjacent to the edge of coronal fin 130.

[0062] refer to Figure 18-20, a mounting tool assembly for mounting a curved keel tibial implant such as implant 1010 on the proximal end PE of a patient's tibia T is generally indicated at reference numeral 1200. The mounting tool assembly 1200 includes a tibial trial handle 1202 and an embedding guide 1212. The handle 1202 includes a footprint template 1204 for determining the size of the tibial implant 1010 to be implanted on the tibia T. The footprint template 1204 may include one or more holes or spaces 1206 to allow the tibial keel and / or anchoring protrusion to be inserted into the proximal end PE of the tibia T when the footprint template covers the tibia. The footprint template 1204 is releasably connected to one end of a shaft 1208. The shaft 1208 has a generally circular cross-sectional shape. As explained in more detail below, the shaft 1208 includes a positioning recess or recessed portion 1210 for positioning the embedding guide 1212 on the handle 1202.

[0063] The embedding guide 1212 is configured to insert the tibial implant 1010 into the proximal end PE of the tibia T in a curved manner (e.g., with a curved or arcuate path CP). The embedding guide 1212 includes a mounting portion 1214 and a driving portion 1216. The mounting portion 1214 is configured to be connected (e.g., releasably connected) to the handle 1202. The mounting portion 1214 defines a handle opening 1218, the size and shape of which are set to accommodate the shaft 1208 of the handle. The handle opening 1218 has opposite open ends to allow the mounting portion 1214 to slide over the end of the shaft 1208 and along the shaft of the handle 1202. The handle opening 1218 has a cross-sectional shape that matches or corresponds to the cross-sectional shape of the shaft 1208 of the handle 1202. Therefore, in the embodiment shown, the handle opening 1218 has a circular cross-sectional shape. The mounting portion 1214 includes a detent or catch 1220 configured to position and secure the mounting portion on the handle 1202. The detent 1220 is sized and shaped to be inserted into one of the recesses 1210 along the handle to position and lock the insert guide 1212 in place on the handle 1202. Fig. 20 ), the pawl 1220 generally extends into the handle opening 1220. When the inlay guide 1212 is mounted on the handle 1202, the pawl 1220 extends into the recess 1210 when the pawl is in the locked position. The pawl 1220 can be biased toward the locked position, such as by a spring or a living hinge. The pawl is moved to a released position (not shown) so that the pawl 1220 is spaced apart from the recess 1210 (e.g., the handle opening 1218), which allows the inlay guide 1212 to move or slide along the handle 1202.

[0064] The driving portion 1216 embedded in the guide 1212 is configured to maintain the tibial implant 1010 and drive the tibial implant into the proximal end PE of the tibia T. The driving portion 1216 is pivotally connected to the mounting portion 1214. In the embodiment shown, the driving portion 1216 is connected to the mounting portion 1214 by a hinge 1222 (e.g., an axis extending through the aligned openings in the mounting portion and the driving portion). Therefore, the driving portion 1216 rotates generally around the rotation axis AR to drive the tibial implant 1010 into the tibia T. The driving portion 1216 includes a connection head 1224 configured to be releasably connected to the tibial implant 1010. Specifically, the connection head 1224 extends into the insert receiving space 22 and the recess 24 and engages the inner surface of the peripheral wall 20 to be connected to the tibial implant 1010. The connection head 1224 is configured to form a snap fit or compression fit with the tibial implant 1010 to releasably connect to the tibial implant. The connection head 1224 includes an insert 1226, 1228 (e.g., a front insert and a rear insert). The insert 1226, 1228 is configured to be inserted into the insert receiving space 22 and / or the recess 24. The insert 1226, 1228 is generally in line with a portion of the peripheral wall 20 of the tibial implant 1010. The insert 1226, 1228 is elastically biased away from each other. The insert 1226, 1228 is moved away from each other and engages the peripheral wall 20 of the tibial implant 1010 to fix the tibial implant to the embedding guide 1212. In order to attach tibial implant 1010 or release the tibial implant from coupling head 1224, inserts 1226, 1228 are pushed toward each other to allow the inserts to move into or out of the insert receiving space 22. In the illustrated embodiment, elastically deflectable arms 1230 couple inserts 1226, 1228 together. Arm 1230 also defines a portion of hinge 1222. The illustrated arm 1230 generally has a U-shape. Coupling head 1224 also includes contact surface 1232, which is configured to be engaged or struck by a hammer (not shown) to rotate drive portion 1216 around axis of rotation AR and drive tibial implant 1010 into the proximal end PE of tibia T. The drive portion 1216 is configured so that when the tibial implant 1010 is attached to the coupling head 1224, the axis of curvature about which the curved tibial keel 128 is curved is generally colinear with the rotation axis AR. The drive portion 1216 is allowed to move the tibial implant 1010 along a curved path that generally corresponds to and matches the curve of the tibial keel 128.

[0065] In one method of operation using the installation tool assembly 1200, the surgeon uses the handle 1202 to select the appropriate size of the tibial implant 1010. The surgeon uses the footprint template 1204, which is a procedure generally known in the art, to determine the size of the tibial implant 1010 to be implanted on the proximal end PE of the tibia T. The handle 1202 is also fixed in place relative to the tibia T using conventional methods known in the art. Once the size of the tibial implant 1010 is determined, the surgeon selects the tibial implant of the correct size and attaches it to the connecting head 1224 of the embedding guide 1216. The tibial implant 1010 is attached to the connecting head 1124 by moving the installation inserts 1226, 1228 toward each other so that the installation inserts can be inserted into the insert receiving space 22. Once in the insert receiving space 22, the installation inserts 1226, 1228 are moved away from each other and engage the peripheral wall 20 to fix the implant to the embedding guide 1216. The surgeon then inserts the shaft 1208 of the handle 1202 through the handle opening 1218 of the mounting portion 1214 and slides the embedded guide 1216 along the handle. The surgeon aligns the pawl 1220 with the desired recess 1210 to arrange and fix the embedded guide 1212 at the desired position along the handle 1202. Afterwards, the surgeon uses a hammer to impact the contact surface 1232 and drives the tibial implant 1010 into the tibia T. The hammer rotates the driving portion 1216 and the tibial implant 1010 around the rotation axis AR, thereby moving the tibial implant 1010 along a curved path. In one embodiment, the surgeon can completely hammer the tibial implant 1010 into the proximal end PE of the tibia T before removing the installation tool assembly 1200. In another embodiment, the surgeon can partially hammer the tibial implant 1010 into the proximal end PE of the tibia T and then remove the installation tool assembly 1200. After removing the installation tool assembly 1200, the surgeon drives the rest of the tibial implant 1010 into the tibia T. For example, the surgeon can drive the tibial implant into the middle position, such as about halfway into the tibia T. In this embodiment, when the implant is further driven into the tibia T, the curved tibial keel 128 continues to guide the tibial implant 1010 along a curved path. In order to separate the tibial implant 1010 from the tibial implant 1010, the surgeon moves the installation inserts 1226, 1228 toward each other and then moves out of the insert receiving space 22. As mentioned above, the tibial keel 128 of the tibial implant 1010 has a sharp edge, which allows the tibial implant 1010 to be implanted without some of the pre-bone preparation required for implanting a conventional tibial implant. Specifically, the step of preparing the tibia T for the tibial keel (e.g., pre-drilling a hole) is eliminated.Additionally, implantation of the curved keel tibial implant 1010 as described herein reduces dislocation, distraction, and spacing required to install the tibial implant as compared to conventional straight keel implant techniques.

[0066] refer to Fig.21 and 22 , the tibial keel for tibial implant 1110 according to another embodiment of the present disclosure is generally indicated at reference numeral 228. In this embodiment, tibial keel 228 has coronal fin 230 and sagittal fin 232. In this embodiment, the edge of the fin and the nose of tibial keel 228 are generally blunt (e.g., generally planar). In addition, the sagittal fin 232 of tibial keel 228 includes concave side 233. Other configurations of tibial keel are within the scope of the present disclosure. For example, in one embodiment, tibial implant includes a tibial keel (not shown) that is angled with vertical such as forward tilting (rather than forward bending). The tilt angle of tibial keel makes it easier to implant tibial implant on the proximal end PE of tibia T. The tilted tibial keel allows the tibial implant to start at a more forward or front position and then move backward or backward due to the tilted keel when the implant is driven to the proximal end PE of tibia T. Being able to begin implanting the tibial implant at a more anterior position provides greater clearance between the implant and the rest of the patient's body (such as the femur) and / or other surgical tools compared to a straight keel, making it easier to insert the implant into the tibia T.

[0067] It should be understood that the elements, features and methods of the tibial implants 10, 110, 210, 310, 410, 510, 610, 710, 810, 910, 1010, 1110 described herein can be applied to other bone implants, including but not limited to femoral implants and patellar implants. For example, in other bone implants such as patellar implants, the porous area of ​​the tibial implant is combined. Examples of such patellar implants are generally composed of Figure 23-251310 in the figure. The size and shape of the patella implant 1310 are set to be implanted on the dorsal side of the patella. The patella implant 1310 includes a proximal or articulated surface 1314 and an opposite distal surface 1316. The distal surface 1316 is configured to engage the dorsal side of the patella. The articulated surface 1314 has a partial dome shape. As discussed above, the patella implant 1310 includes a porous area. Specifically, the distal surface 1316 is porous (e.g., a porous area). In the embodiment shown, a portion of the distal surface 1316 is porous, but in other embodiments, the entire distal surface 1316 can be porous. The porous portion of the distal surface 1316 is generally located at the center of the distal surface and is spaced apart from the peripheral edge of the distal surface. The porous area has a generally circular shape that is arranged in a larger circle of the distal surface 1316. As shown in the illustrated embodiment, the porous region includes generally hexagonal struts coupled together to form a lattice, but any suitable porous structure is also within the scope of the present disclosure. As mentioned above, the porosity of the distal surface 1316 allows the patella implant 1310 to be inserted into or implanted on the patella without the cement conventionally used in knee arthroplasty, thereby reducing procedure time, cement-related complications, and surgeon stress.

[0068] The patella implant 1310 includes a cap 1350 and a bottom or anchor 1352 coupled together. The cap 1350 defines (e.g., includes) a portion of the articulation surface 1314 and a distal surface 1316. In the illustrated embodiment, a portion of the distal surface 1316 defined by the cap 1350 is not porous. The cap 1350 can be made of a polymer material or any other suitable material. The bottom 1352 defines a portion of the distal surface 1316. In the illustrated embodiment, a portion of the distal surface 1316 defined by the bottom 1352 is porous. The bottom 1352 also includes at least one (e.g., multiple) anchoring protrusion 1334 similar to the anchoring protrusion discussed above. In the illustrated embodiment, the patella implant 1310 includes three anchoring protrusions 1334, but more or fewer anchoring protrusions are also within the scope of the present disclosure. Each anchoring protrusion 1334 generally extends distally from the distal surface 1316. In this embodiment, each anchoring projection 1334 is cylindrical (e.g., has a cylindrical shape) with an oblate conical distal tip 1336. The anchoring projection 1334 is also solid ( Fig.24 ), but in other embodiments, the anchoring protrusion can be hollow. The bottom 1352 can be made of metal or any other suitable material.

[0069] The cap 1350 and the base 1352 are configured to be coupled together to form the patella implant 1310. In the illustrated embodiment, the cap 1350 and the base 1352 are configured to form a snap-fit ​​connection. The base 1352 includes a support ring 1354 having opposing inner and outer circumferential edges or surfaces. Fig.24 As shown in , the inner and outer edges of the support ring 1354 gradually narrow away from each other as the edges extend generally upward. Therefore, the proximal end of the support ring 1354 is wider than the distal end of the support ring (e.g., a generally dovetail cross-sectional shape). The cap 1350 includes a generally circumferential channel 1356 or recess that is sized and shaped to accommodate the support ring 1354. The support ring 1354 and the channel 1356 have corresponding sizes and shapes. The cap 1350 includes opposing inner and outer circumferential surfaces that define the sides of the channel 1356. The inner and outer surfaces of the cap 1350 correspond to the taper of the inner and outer edges of the support ring 1354. As shown in FIG. Fig.24 As shown in, when the surface generally extends upward, the inner surface and outer surface of the cap 1350 also gradually narrow away from each other. Therefore, the passage 1356 has a mouth narrower than its bottom (e.g., dovetail cross-sectional shape in general). In order to assemble the patella implant 1310, the support ring 1354 of the bottom 1352 is inserted into the passage 1356 of the cap 1350. The cap 1350 is elastically deformable and can be deformed into the mouth of the enlarged passage 1356 to allow the support ring 1354 to pass through the passage before returning or rebounding toward its initial or static state, thereby fixing the cap and the bottom 1352 together. The cap 1350 engages the support ring 1354 to fix the bottom 1352 to the cap. The gradually narrowing inner surface and outer surface of the cap 1350 and the support ring 1354 engage each other respectively, so that the cap and the bottom 1352 are fixed together. The support ring 1352 also provides rigidity to the patella implant 1310 and provides a mounting platform for the porous structure (eg, hexagonal posts).

[0070] The bottom 1352 can be constructed using the manufacturing techniques and processes discussed herein. For example, the bottom 1352 can be constructed using hybrid manufacturing as mentioned above. In the hybrid manufacturing process, the support ring 1354 and the anchoring protrusion 1334 can first be created by conventional manufacturing methods such as cold forming (e.g., stamping, cutting, deformation) a metal blank or by forging. The partially formed bottom 1352 is then placed in an additive manufacturing machine on which the porous area is built. The cap 1350 is then attached to the bottom 1352 to complete the construction of the patella implant 1350. The polymer cap 1350 can be formed by conventional methods such as compression molding.

[0071] refer to Figure 26-35, discloses various different systems and methods for verifying the implantation of an implant relative to a patient's bone. The following description describes different systems and methods for verifying the position or placement of a knee arthroplasty implant relative to a bone. For example, these systems and methods can be used to verify the position of any implant in a tibial implant 10 or the implant disclosed herein relative to the proximal end PE of a patient's tibia T. However, it should be understood that, in addition to knee arthroplasty, these systems and methods for verifying the position of an implant can also be used in other surgical applications.

[0072] Total knee arthroplasty relies on the correct placement of femoral and tibial implants. In conventional knee arthroplasty surgery, the final placement of the implant depends on the surgical skills of placing the implant on the bone and making a saw cut on the bone where the implant is located. There are a variety of different systems for creating saw cuts in bones. For example, the saw cut of the implant can be driven by a manual, non-computer-assisted instrument, or driven with the help of a navigation instrument that provides computer-assisted feedback on the positioning of the saw cut, or driven with a surgical robot that provides robot-assisted guidance for positioning the saw cut. Further details about surgical robots and robot-assisted guidance for positioning the saw cut can be found in U.S. Patent Application No. 16 / 737,054 filed on January 8, 2020, the entire contents of which are incorporated herein by reference. Although implants usually follow the saw cut, in conventional knee arthroplasty, the final position of the implant still depends on surgical experience, skills, feel, and eyes. The following systems and methods provide verification and confirmation of the position of the implant on the patient's bone.

[0073] It should be understood that the systems (e.g., surgical robots, tracking systems, etc.) and methods for performing knee arthroplasty disclosed in U.S. patent application Ser. No. 16 / 737,054 can be used to perform, guide, assist and / or combine knee arthroplasty using the systems (e.g., implants, position verification systems, etc.) and methods (e.g., implant implantation, position verification, etc.) described herein.

[0074] refer to Fig.26, a position verification system according to one embodiment of the present disclosure is generally indicated at reference numeral 1400. The position verification system 1400 is configured to verify or determine the position of a tibial implant 10 relative to the proximal PE of a tibia T. The position verification system 1400 can be used during and / or after implanting the tibial implant 10 on the proximal PE of the tibia T. The position verification system 1400 includes a position indicator 1402 and a tracker 1410 (e.g., a tracking system). The position indicator 1402 is configured to indicate the position of the tibial implant 10. The tracker 1410 is configured to track or locate the position of the position indicator 1402 in real time (in 3D space) in order to determine the position of the tibial implant 10. The position indicator 1402 is configured to be positioned relative to the tibial implant 10 to indicate the position of the tibial implant. The position indicator 1402 includes a plurality of (e.g., four) tracking marks or indicators 1404 tracked by the tracker 1410. Indicator 1404 is a visual or optical marker recognized by tracker 1410. In the illustrated embodiment, indicator 1404 is a sphere or ball, but any suitable optical marker is within the scope of the present disclosure. Position indicator 1402 has a fixed geometry and tracker 1410 knows the geometry of the position indicator. Therefore, by tracking the position of indicator 1404 on position indicator 1402, tracker 1410 can determine or infer the location that the position indicator is contacting or coupled to. Fig.26 In the embodiment shown in, position indicator 1402 comprises stylus. Stylus 1402 has a tip. In one embodiment, the tip of stylus 1402 is a ball or sphere. As will be explained in more detail below, the surgeon can engage the tip of stylus 1402 with different components (e.g., tibial implant 10, arthroplasty tool, etc.) to determine the position of tibial implant. Tracker 1410 knows the position of the tip of stylus 1402 relative to indicator 1404. Tracker 1410 can use indicator 1404 and known stylus geometry to determine the position of the tip of stylus 1402, and thereby determine the position where the tip of stylus is in contact or engaged with it. Other configurations of position indicator 1402 are within the scope of the present disclosure, some of which are described herein. For example, position indicator 1402 can be a dynamic reference array as described in U.S. Patent Application No. 16 / 737,054.

[0075] Tracker 1410 tracks or locates position indicator 1402 to determine the position of the position indicator in 3D space. Tracker 1410 can be a camera-based tracker (e.g., a camera tracking system), such as a camera-based tracker described in U.S. Pat. No. 16 / 737,054. Tracker 1410 includes one or more cameras 1412 that are wired or wirelessly coupled (e.g., communicate with) to tracking computer 1414. Camera 1412 is configured to capture an image (e.g., picture, video, etc.) of position indicator 1402, and tracking computer 1414 determines the position of position indicator and tibial implant 10 based on indicator 1404 in the image from camera. Tracking computer 1414 can include a display (e.g., a video display) to output information to the surgeon, such as the position of tibial implant 10 relative to the proximal end PE of tibia T. Tracker 1410 can also determine the position of bone (for example, tibia T) in 3D space, as described in U.S. Patent Application No. 16 / 737,054, but other modes determining the position of bone are within the scope of the present disclosure.Usually, tracker 1410 compares the position of tibia T with the position of tibial implant 10 to determine the position of implant relative to tibia.Tracker 1410 then outputs or displays this information to the surgeon.It should be appreciated that position verification system 1400 can be a part for larger surgical system (for example, larger robotic surgical system).

[0076] The position verification system 1400 can be used to determine the position of the tibial implant 10 relative to the proximal end PE of the tibia T in a variety of different ways. Fig.26In an operation method shown in, a position verification system 1400 is configured to cooperate or align with one or more positioning guides 26 of a tibial implant 10 to determine the position of the tibial implant. In this embodiment, a position indicator 1402 (e.g., the tip of a stylus) cooperates or aligns with one or more positioning guides 26 of a tibial implant 10. For example, the tip of the stylus 1402 is inserted into the recess 26 of the tibial implant 10. The tracker 1410 then determines the position of one or more positioning guides 26 (e.g., recess) to determine the position of the tibial implant 10 relative to the proximal PE of the tibia T. For example, in an exemplary method, a surgeon positions the tibial implant 10 relative to the proximal PE of the tibia, such as by placing the tibial implant on the proximal end of the tibia. Afterwards, the surgeon positions the position indicator 1402 relative to the tibial implant 10. The tracker 1410 tracks the position indicator 1402 to determine the position of the tibial implant 10 (e.g., the position of the tibial implant in 3D space). In this embodiment, the surgeon uses the stylus 1402 to register or engage (e.g., contact) with the tip, each positioning guide 26 (e.g., the position indicator directly engages the implant). When the position indicator 1402 is positioned relative to the tibial implant 10, the tracker 1410 tracks the position of the position indicator. Specifically, the tracker 1410 tracks the stylus 1402 to determine the position of the positioning guide 26 and infer or determine the position of the tibial implant. In one embodiment, the surgeon informs the tracker 1410 of the time when the stylus 1402 is registered with the positioning guide 26 by the user interface of the tracker, so the tracker knows which positions of the position indicator correspond to the position (e.g., positioning guide) of the tibial implant 10. As with the position indicator 1402, in this embodiment, the tracker 1410 knows the geometry of the tibial implant 10 and can determine the position of the tibial implant based on the known tibial implant geometry and the position of the positioning guide 26. In one embodiment, the tracker 1410 accesses the geometry of the implant based on the position of the positioning guide 26. As mentioned above, the position of the positioning guide 26 can be used to encode information specific to the style (e.g., type, size, etc.) of the implant. After determining the position of the positioning guide 26, the tracker 1410 can access the implant database and use the positioning guide information (e.g., the distance between the positioning guides) to locate the specific implant and associated implant information in the database, such as name, type, size, geometry, etc. In other embodiments, the surgeon can manually provide this information or input information to the tracker through a user interface, thereby allowing the tracker to access the correct implant entry in the implant database.

[0077] Continuing the method, at a certain point, tracker 1410 determines or is informed of the position of tibia T (e.g., the position of tibia in 3D space). This can be before, during or after determining the position of tibial implant 10. Then, the position of tibial implant 10 in 3D space is compared with the position of tibia T in 3D space to verify whether tibial implant is correctly positioned on the proximal end PE of tibia. Tracker 1410 provides feedback about the position of tibial implant 10 relative to tibia T to the surgeon. Tracker 1410 can compare the position of tibia T with the position of tibial implant 10, or information can be displayed to allow the surgeon to compare the position of tibia with the position of tibial implant. Tracker 1410 or the surgeon can compare the position of tibial implant 10 relative to tibia T (e.g., thereon) with a baseline or ideal position to determine whether tibial implant is correctly positioned. Ideal position is as predetermined by the surgeon and is the theoretically perfect position of tibial implant 10 on tibia T (e.g., relative to the proximal end PE of tibia). If the position of the tibial implant 10 relative to the tibia T is aligned with the ideal position (or within a suitable error margin), the tibial implant is correctly positioned and the surgeon can proceed with the remainder of the surgical procedure. If the position of the tibial implant 10 relative to the tibia T is not aligned with the ideal position, the surgeon adjusts the position of the implant as needed before continuing the surgical procedure. After repositioning the tibial implant 10, the surgeon can repeat the above steps to determine whether the new position or adjusted position of the tibial implant is correct. The same process can be used to determine the position of other implants relative to the bone. For example, if Fig. 27 As shown in , the same process can be used to verify the position of the femoral implant 11 by aligning the position indicator 1402 of the position verification system 1400 with one or more positioning guides 26 of the femoral implant 11.

[0078] refer to Fig.28In another method of operation, the position verification system 1400 is configured to cooperate or align with one or more positioning guides 26 on an arthroplasty tool 1420 (e.g., a tibial mounting tool, a femoral mounting tool) to determine the position of the tibial implant 10. The arthroplasty tool 1420 is configured to be releasably attached to the tibial implant 10. When the arthroplasty tool 1420 and the tibial implant 10 are coupled together, the arthroplasty tool is rigidly and immovably fixed to the tibial implant. The arthroplasty tool 1420 can be any suitable tool, such as an implant (e.g., a tibial implant, a femoral implant) holder. As described above, the arthroplasty tool 1420 includes one or more positioning guides 26. In this embodiment, a position indicator 1402 (e.g., the tip of a stylus) cooperates or aligns with one or more positioning guides 26 of the arthroplasty tool 1420 (e.g., the position indicator indirectly engages the implant through the tool). The tracker 1410 then determines the position of one or more positioning guides 26 (e.g., recesses) to determine the position of the arthroplasty tool 1420 and then the position of the tibial implant 10. For example, in an exemplary method, the surgeon positions the tibial implant 10 relative to the proximal PE of the tibia, such as by placing the tibial implant on the proximal end of the tibia. In one embodiment, the surgeon can use the arthroplasty tool 1420 to place the tibial implant 10 and attach the tool to the implant. In another embodiment, after the tibial implant is implanted on the tibia T, the surgeon attaches the arthroplasty tool 1420 to the tibial implant 10. Afterwards, the surgeon positions the position indicator 1402 relative to the tibial implant 10. The tracker 1410 tracks the position indicator 1402 to determine the position of the tibial implant 10. In this embodiment, the surgeon uses the stylus 1402 to align or engage (e.g., contact) with the tip, each positioning guide 26 of the arthroplasty tool 1420. When the position indicator is aligned with the positioning guide 26 of the arthroplasty tool 1420, the tracker 1410 tracks the position of the position indicator 1402. The tracker 1410 tracks the stylus 1402 to determine the position of the positioning guide 26 and infer or determine the position of the arthroplasty tool 1420 and the position of the tibial implant 10. As with the position indicator 1402, in this embodiment, the tracker 1410 knows the geometry of the tibial implant 10, the geometry of the arthroplasty tool 1420, and the relative orientation and position of the tibial implant and the arthroplasty tool when the arthroplasty tool is attached to the tibial implant. The tracker 1410 uses this information to determine the position of the tibial implant based on the position of the positioning guide 26. As discussed above, the positioning guide 26 can be used to access relevant information about the arthroplasty tool (e.g., the geometry, orientation and positioning of the tibial implant attached to the tool).

[0079] After the tracker 1410 determines the position of the tibial implant 10, the process is generally the same as the above process. The tracker 1410 determines or is informed of the position of the tibia T. The position of the tibial implant 10 is then compared with the position of the tibia T to verify whether the tibial implant is correctly positioned on the proximal PE of the tibia. If the position of the tibial implant 10 relative to the tibia T is correct, the surgeon can continue with the rest of the surgical procedure. If the position of the tibial implant 10 is incorrect relative to the position of the tibia T, the surgeon adjusts the position of the implant as needed before continuing with the surgical procedure. The same process can be used to determine the position of other implants relative to the bone. For example, if Fig.29 As shown in , the same process can be used to verify the position of the femoral implant 11 by aligning the position indicator 1402 of the position verification system 1400 with one or more positioning guides 26 of the arthroplasty tool 1420 connected to the femoral implant.

[0080] refer to Fig.30In another method of operation, a position verification system 1400 is configured to engage a tibial implant 10 at a plurality of different locations on the tibial implant to determine the position of the tibial implant. In this embodiment, the surgeon brushes or moves a position indicator 1402 (e.g., the tip of a stylus) on all or part of the tibial implant 10. When the position indicator engages the tibial implant 10 and moves thereon, a tracker 1410 tracks the position indicator 1402 to generate information (e.g., cloud points or cloud point data) corresponding to the size, shape and position of the tibial implant. For example, in an exemplary method, the surgeon positions the tibial implant 10 relative to the proximal PE of the tibia, such as by placing the tibial implant on the proximal end of the tibia. Afterwards, the surgeon positions the position indicator 1402 relative to the tibial implant 10. The tracker 1410 tracks the position indicator 1402 to determine the position of the tibial implant 10. In this embodiment, the surgeon brushes or moves the tip of a stylus 1402 on the tibial implant 10 or its target area. For example, the surgeon can move the stylus back and forth on the tibial implant 10. In this embodiment, the tip of the stylus 1402 is configured to not damage (e.g., scrape) the tibial implant 10 when the tip slides on the implant. When the position indicator brushes the tibial implant, the tracker 1410 tracks the position of the position indicator 1402. The tracker 1410 tracks the stylus 1402 to determine the position of the tibial implant 10. When the tracker 1410 tracks the stylus, cloud point data corresponding to the size, shape (e.g., profile) and position of the tibial implant 10 can be generated. Like the position indicator 1402, in this embodiment, the tracker 1410 knows the geometry of the tibial implant 10 and uses this information to determine the position of the tibial implant based on the cloud point data. Similar to the positioning guide 26 discussed above, in one embodiment, the cloud point data can be used to access the relevant information (e.g., geometry) about the tibial implant 10 from the implant database. The tracker 1410 may use a surface matching algorithm to align the geometry information or data from the implant database of the tibial implant 10 with the cloud point data to determine the position of the tibial implant 10 .

[0081] After the tracker 1410 determines the position of the tibial implant 10, the process is generally the same as the process described in the above-mentioned embodiment. The tracker 1410 determines or is informed of the position of the tibia T. The position of the tibial implant 10 is then compared with the position of the tibia T to verify whether the tibial implant is correctly positioned on the proximal PE of the tibia. If the position of the tibial implant 10 relative to the tibia T is correct, the surgeon can continue with the rest of the surgical procedure. If the position of the tibial implant 10 is incorrect relative to the position of the tibia T, the surgeon adjusts the position of the implant as needed before continuing with the surgical procedure. The same process can be used to determine the position of other implants relative to the bone. For example, as Fig.30 The same process can be used to verify the position of the femoral implant by swiping the position indicator 1402 of the position verification system 1400 over the femoral implant 11 as shown in FIG.

[0082] refer to Fig.32 , another embodiment of a position indicator of the positioning system 1400 is generally indicated at reference numeral 1403. In this embodiment, the position indicator 1403 is an array mounted (e.g., connected) to an arthroplasty device such as a tool, an accessory, or an implant. The array 1403 includes a frame supporting an indicator 1404. The position indicator 1403 can be releasably connected to the arthroplasty device or fixed to the arthroplasty device. When the position indicator 1403 is mounted on the arthroplasty device, the position indicator is rigidly and immovably fixed to the arthroplasty device. As discussed above, the position indicator 1403 includes an indicator 1404. In this embodiment, the position indicator 1403 is rigidly connected to an arthroplasty tool 1420, such as an implant holder. As discussed above, the arthroplasty tool 1420 is configured to be releasably attached to the tibial implant 10.

[0083] In an exemplary method of operation, a position verification system 1400 is configured to track a position indicator 1403 connected to an arthroplasty tool 1420 to determine the position of a tibial implant 10. In this embodiment, the position verification system 1400 can provide feedback to the surgeon about the placement of the tibial implant 10 during and after implantation is complete. By being able to determine the position of the tibial implant 10 relative to the tibia T during implantation, the quality and quantity of the available bone stock can be improved. This can also eliminate the extra step of checking the position of the implant after implantation. In an exemplary method, a position verification system 1400 is used during implantation to guide the tibial implant 10 to the position on the tibia T. The surgeon attaches an arthroplasty tool 1420 with a position indicator 1403 to the tibial implant 10 (e.g., the surgeon positions the position indicator relative to the tibial implant). The surgeon then positions the tibial implant 10 relative to the proximal PE of the tibia. The surgeon uses arthroplasty tool 1420 to move tibial implant 10 to the appropriate position on the proximal end PE of tibia T (e.g., to move the tibial implant toward the tibia). Tracker 1410 tracks position indicator 1403 to determine the position of tibial implant 10. When the position indicator moves toward tibia T along with arthroplasty tool 1420 and tibial implant 10, tracker 1410 tracks the position of position indicator 1403. Tracker 1410 determines or infers the position of tibial implant 10 based on the position of position indicator 1403. In this embodiment, tracker 1410 knows the geometry of tibial implant 10, the geometry of arthroplasty tool 1420 (including the position of position indicator 1403 relative to arthroplasty tool) and the relative orientation and position of tibial implant and arthroplasty tool when arthroplasty tool is attached to tibial implant. Tracker 1410 uses this information to determine the position of tibial implant based on the position of position indicator 1403.

[0084] In one embodiment, the relevant information determining the position of the tibial implant 10 (e.g., the geometry of the tibial implant, the geometry of the arthroplasty tool 1420 (including the position of the position indicator 1403 relative to the arthroplasty tool) and the relative orientation and position of the tibial implant and the arthroplasty tool when the arthroplasty tool is attached to the tibial implant) can be stored in the implant database. In this embodiment, the surgeon can inform the tracker 1410 which tibial implant 10 and arthroplasty tool 1420 are being used and access appropriate information from the implant database through the user interface. In another embodiment, the relevant information for determining the position of the tibial implant 10 is taught to the tracker 1410. In this embodiment, the tibial implant 10 is attached to the arthroplasty tool 1420 and then shown to the tracker 1410, which then determines (e.g., collects) necessary information. For example, the surgeon can use the variable area of ​​the tibial implant to calibrate the positioning of the tibial implant 10 relative to the arthroplasty tool 1420. In this embodiment, the tracker 1410 can prompt the surgeon to contact specific points on the tibial implant 10 and / or arthroplasty tool 1420 using the stylus 1402 to calibrate the tracker 1410 using a surface matching algorithm.

[0085] After tracker 1410 determines the position of tibial implant 10, process is generally the same as the process described in the above-described embodiment. Tracker 1410 determines or is informed of the position of tibia T. Then the position of tibial implant 10 is compared with the position of tibia T to verify whether tibial implant is moving towards the correct position on the proximal end PE of tibia. When using position verification system 1400 during tibial implant 10 is placed or implanted on tibia T, tracker 1410 or surgeon can compare the position of tibial implant with ideal position to verify that tibial implant is moving towards the ideal position (for example, consistent with the ideal position) (when tibial implant is implanted on the proximal end PE of tibia T). If tibial implant 10 is moving towards the ideal position, the surgeon can continue to move tibial implant 10 towards tibia T (for example, insert) and make it enter tibia T without any adjustment. If the tibial implant does not move toward the ideal position (e.g., is off track), the surgeon can make necessary adjustments and corrections when moving the tibial implant 10 toward and into the tibia T. In this way, the position verification system 1400 guides the tibial implant 10 toward the ideal position.

[0086] In another exemplary method, after the tibial implant is implanted on the tibia T, the arthroplasty tool 1420 is connected or reconnected to the tibial implant 10 to verify the position of the tibial implant relative to the tibia. In this embodiment, the surgeon attaches the arthroplasty tool 1420 with a position indicator 1403 to the tibial implant 10 implanted in the tibia T (for example, the surgeon positions the position indicator relative to the tibial implant). Tracker 1410 tracks the position indicator 1403 to determine the position of the tibial implant 10. Tracker 1410 tracks or locates the position of the position indicator 1403 installed on the arthroplasty tool 1420 that is connected to the tibial implant 10. Tracker 1410 locates the position indicator 1403 to determine or infer the position of the tibial implant 10. As explained above, tracker 1410 knows the geometry of tibia implant 10, the geometry of arthroplasty tool 1420 (comprising position indicator 1403 with respect to the position of arthroplasty tool) and the relative orientation and the position of tibia implant and arthroplasty tool when arthroplasty tool is attached to tibia implant. Tracker 1410 uses this information to determine the position of tibia implant 10 based on the position of position indicator 1403.

[0087] After the tracker 1410 determines the position of the tibial implant 10, the process is generally the same as the process described in the above-mentioned embodiment. The tracker 1410 determines or is informed of the position of the tibia T. The position of the tibial implant 10 is then compared with the position of the tibia T to verify whether the tibial implant is correctly positioned on the proximal end PE of the tibia. When the position verification system 1400 is used to verify the position of the tibial implant 10 relative to the tibia T after the implant is implanted, the tracker 1410 or the surgeon can compare the position of the tibial implant with the ideal position to verify or confirm that the tibial implant is in the correct position on the tibia. If the position of the tibial implant 10 relative to the tibia T is aligned with the ideal position, the tibial implant is correctly positioned and the surgeon can proceed to the rest of the surgical operation. If the position of the tibial implant 10 is not aligned with the ideal position relative to the position of the tibia T, the surgeon adjusts the position of the implant as needed before proceeding with the surgical operation. After verifying the position of the tibial implant 10, the arthroplasty tool 1420 can be removed or disengaged from the implant. These same processes can be used to determine the position of other implants relative to the bone. For example, Fig.33 As shown in , the same process can be used to verify the position of the femoral implant 11 by tracking the position indicator 1403 of the position verification system 1400 mounted on the arthroplasty tool 1420 connected to the femoral implant.

[0088] refer to Fig.34In one embodiment, the position verification system 1400 includes an implant cap 1422. The implant cap 1422 is configured to be releasably coupled to an implant. The size and shape of the implant cap 1422 is set to be coupled to an implant of the type to which the cap corresponds. For example, for a tibial implant 10 ( Fig.34 ) can be similar to the insert and its size and shape are set to be fixed in the insert receiving space 22 of the implant. In another embodiment, the implant cover 1422 is used for the femoral implant 11 ( Fig.35 ) and its size and shape are set to be fixed on the implant. When implant cover 1422 is connected to the implant, the implant cover is rigidly and immovably fixed to the implant. Preferably, implant cover 1422 is generally assembled on the articulated surface of the implant. Generally, the tracker 1410 uses the position of the implant cover 1422 to determine the position of the implant. In this embodiment, the position indicator 1402, 1403 is rigidly connected to the implant cover 1422. Fig.34 One type of position indicator 1402 is shown, namely a stylus, which is coupled to an implant cap 1422 of a tibial implant 10, and Fig.35 Another type of position indicator 1403 is shown, i.e. an array, which is coupled to the implant cap for femoral implant 11. Other types of position indicators can be coupled to the implant cap. In one embodiment, implant cap 1422 can be coupled to the implant to verify the position of the implant after the implant is placed on the bone. In another embodiment, implant cap 1422 can be coupled to the implant to guide implantation when the implant is being implanted on the bone.

[0089] Still reference Fig.34In an exemplary method of operation, a position verification system 1400 is configured to track a position indicator 1402 coupled to an implant cap 1422 to determine the position of a tibial implant 10. In this embodiment, the position verification system 1400 can provide feedback to the surgeon about the placement of the tibial implant 10 during and after implantation is complete. In an exemplary method, a position verification system 1400 is used during implantation to guide the tibial implant 10 to a position on the tibia T. The surgeon attaches an implant cap 1422 with a position indicator 1402 to the tibial implant 10 (e.g., the surgeon positions the position indicator relative to the tibial implant). The surgeon also attaches an arthroplasty tool 1420 to the tibial implant 10. In one embodiment, the implant cap 1422 is placed between the tibial implant 10 and the arthroplasty tool 1420 and moves with the arthroplasty tool. The surgeon then positions the tibial implant 10 relative to the proximal PE of the tibia. The surgeon uses arthroplasty tool 1420 to move tibial implant 10 to the appropriate position on the proximal end PE of tibia T (e.g., to move the tibial implant toward the tibia). Tracker 1410 tracks position indicator 1402 to determine the position of tibial implant 10. When the position indicator moves toward tibia T along with implant cap 1422, arthroplasty tool 1420 and tibial implant 10, tracker 1410 tracks the position of position indicator 1402. Tracker 1410 tracks position indicator 1402 to determine the position of implant cap 1422 and determine or infer the position of the tibial implant 10 connected thereto. In this embodiment, tracker 1410 knows the geometry of tibial implant 10, the geometry of implant cap 1422 (including the position of position indicator 1402 relative to the implant cap) and the relative orientation and position of tibial implant and implant cap when implant cap is attached to tibial implant. The tracker 1410 uses this information to determine the position of the tibial implant 10 based on the position of the position indicator 1402. Such relevant information known to the tracker 1410 for determining the position of the tibial implant 10 may be stored in an implant database and / or taught to the tracker as explained above.

[0090] After the tracker 1410 determines the position of the tibial implant 10, the process is generally the same as the process described in the above-described embodiment.The tracker 1410 determines or is informed of the position of tibia T.Then the position of the tibial implant 10 is compared with the position of tibia T to verify whether the tibial implant is moving towards the correct position on the proximal end PE of the tibia.When using the position verification system 1400 during the tibial implant 10 is placed or implanted on the tibia T, the tracker 1410 or the surgeon can compare the position of the tibial implant with the ideal position to verify that the tibial implant is moving towards the ideal position (for example, consistent with the ideal position) (when the tibial implant is implanted on the proximal end PE of tibia T).If the tibial implant 10 is moving towards the ideal position, the surgeon can continue to move the tibial implant 10 towards the tibia T (for example, insert) and make it enter the tibia T without any adjustment.If the tibial implant does not move towards the ideal position, the surgeon can make necessary adjustments and corrections when the tibial implant 10 is moved towards the tibia T and made to enter the tibia. In this manner, the position verification system 1400 guides the tibial implant 10 toward the ideal position.

[0091] In another exemplary method, after the tibial implant is implanted on tibia T, implant cap 1422 is coupled to tibial implant 10 to verify the position of tibial implant relative to tibia. In this embodiment, the surgeon attaches the implant cap 1422 with position indicator 1402 to the tibial implant 10 implanted in tibia T (for example, the surgeon positions the position indicator relative to the tibial implant). Tracker 1410 tracks position indicator 1402 to determine the position of tibial implant 10. Tracker 1410 tracks or locates the position of the position indicator 1402 installed on the implant cap 1422 that is coupled to tibial implant 10. Tracker 1410 locates position indicator 1402 to determine or infer the position of tibial implant 10. As explained above, tracker 1410 knows the geometry of tibia implant 10, the geometry of implant cap 1422 (comprising the position of position indicator 1402 relative to implant cap) and the relative orientation and the position of tibia implant and implant cap when implant cap is attached to tibia implant. Tracker 1410 uses this information to determine the position of tibia implant 10 based on the position of position indicator 1402.

[0092] After the tracker 1410 determines the position of the tibial implant 10, the process is generally the same as the process described in the above-mentioned embodiment. The tracker 1410 determines or is informed of the position of the tibia T. The position of the tibial implant 10 is then compared with the position of the tibia T to verify whether the tibial implant is correctly positioned on the proximal end PE of the tibia. When the position verification system 1400 is used to verify the position of the tibial implant 10 relative to the tibia T after the implant is implanted, the tracker 1410 or the surgeon can compare the position of the tibial implant with the ideal position to verify or confirm that the tibial implant is in the correct position on the tibia. If the position of the tibial implant 10 relative to the tibia T is aligned with the ideal position, the tibial implant is correctly positioned and the surgeon can proceed to the rest of the surgical operation. If the position of the tibial implant 10 is not aligned with the ideal position relative to the position of the tibia T, the surgeon adjusts the position of the implant as needed before proceeding with the surgical operation. After verifying the position of the tibial implant 10, the implant cover 1422 can be removed or disengaged from the implant. These same processes can be used to determine the position of other implants relative to the bone. For example, Fig.35 As shown in , the same process can be used to verify the position of the femoral implant 11 by tracking the position indicator 1403 of the position verification system 1400 mounted on the implant cover 1422 connected to the femoral implant.

[0093] Unless otherwise specified or indicated, the order of performing or carrying out the operations in the embodiments of the various aspects of the disclosure described herein is not essential. That is, the operations may be carried out in any order and / or simultaneously, and the embodiments of the various aspects of the disclosure may include more or less operations than those disclosed herein. For example, it is considered that performing or carrying out a particular operation before, simultaneously with, or after another operation is within the scope of the disclosure.

[0094] The tracking systems and methods described herein can also be used to determine the position of other elements and objects other than implants. In one embodiment, the tracking systems and methods described herein are used to determine the position of the bone to which the implant is attached. For example, in a method similar to Fig.30 and 31 In one embodiment shown in , the surgeon can brush or move a position indicator 1402 (e.g., the tip of a stylus) over all or a portion of the tibia T or its proximal end PE to determine the position of the tibia.

[0095] It is obvious that implant 10,110,210,310,410,510,610,710,810,910,1010,1110,1310 disclosed herein are generally similar to each other, therefore, for ease of understanding, in the case of using similar or similar parts between various implants (or its element), adopt the reference numerals with identical last two numerals.For example, tibial keel 28 is similar to tibial keel 228, therefore, these two tibial keels have identical last two numerals " 28 ".Therefore, unless otherwise clearly stated, the above description about implant and its element is equally applicable to all similar implants and its element.For example, at least some descriptions in the description relevant to anchoring projection 34 may also be applicable to anchoring projection 134 and / or vice versa.

[0096] It is obvious and should be understood that the elements, features and / or teachings set forth in each embodiment disclosed herein are not limited to the elements, features and / or teachings described in the specific embodiment. Therefore, it is obvious and should be understood that the elements, features and / or teachings described in one embodiment can be applied to one or more other embodiments in other embodiments disclosed herein. For example, it should be understood that any of the tibial keels disclosed herein can have sharp edges present on the tibial keel 128. In another example, the methods and features of a position verification method can be used together with another position verification method.

[0097] Modifications and changes may be made to the disclosed embodiments without departing from the scope of the present disclosure as defined in the following claims.

[0098] When introducing elements of the present disclosure or embodiments thereof, the articles "a," "an," "the," and "said" are intended to mean that there are one or more of the elements. The terms "comprising," "including," and "having" are intended to be inclusive and mean that there may be additional elements other than the listed elements.

[0099] As various changes could be made in the above constructions, products and methods without departing from the scope of the disclosure, it is intended that all matter contained in the above description and shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense.

Claims

1. A tibial implant for knee arthroplasty, the tibial implant comprising: a tibial paddle sized and shaped for placement on a proximal end of a patient's tibia, the tibial paddle comprising opposing proximal and distal surfaces, the distal surface configured to engage the proximal end of the tibia; a tibial keel extending distally from the distal surface of the tibial paddle and configured to be inserted into the proximal end of the tibia; as well as at least one anchoring projection extending distally from the distal surface of the tibial paddle and configured to be inserted into the proximal end of the tibia; Wherein the tibial implant further comprises: at least one positioning guide configured to be engaged by a position verification system to verify the position of the tibial implant relative to the proximal end of the tibia after the tibial implant is placed on the proximal end of the tibia, and The at least one positioning guide comprises a plurality of positioning guides spaced apart from each other.

2. The tibial implant of claim 1, wherein the at least one positioning guide is disposed on the tibial plate.

3. The tibial implant of claim 2, wherein the tibial paddle includes a peripheral edge, and the at least one positioning guide is disposed on the peripheral edge of the tibial paddle.

4. The tibial implant of claim 3, wherein the at least one positioning guide comprises a recess in the tibial paddle.

5. The tibial implant of claim 1, wherein the distal surface of the tibial paddle is porous to enable bone ingrowth into the tibial paddle after the tibial paddle is placed on the proximal end of the tibia.

6. The tibial implant of claim 1, wherein at least a portion of the tibial keel is porous to enable bone ingrowth into the tibial keel after the tibial keel is inserted into the proximal end of the tibia.

7. The tibial implant of claim 1, wherein the at least one anchoring projection has a distal tip and a plurality of ribs extending proximally from the distal tip.

8. The tibial implant of claim 7, wherein the rib is disposed circumferentially around the at least one anchoring projection.

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