Reverse shoulder system

Abstract

The present disclosure relates to a joint assembly configured to be coupled to a bone anchor. The joint assembly may include a joint body (280) having a first end (281) and a second end (282), wherein an articular surface (293) is disposed on or adjacent to the first end. The joint body may include a bone anchor interface (288) disposed between the first end and the second end of the joint body. The bone anchor interface may include: a channel (284) formed in a circumferential surface of the joint body; a locking member (253) disposed in the channel; and / or a deflectable portion (254) disposed between the locking member and the second end of the joint body.

Description

[0001] Incorporation by reference to any priority application

[0002] This application claims the benefit of priority to U.S. Provisional Application No. 62 / 908,921, filed October 1, 2019, which is hereby incorporated by reference in its entirety. Background Art Technical Field

[0003] The present application relates to apparatus and methods for reverse shoulder prostheses.

[0004] Related technical description

[0005] Arthroplasty is the standard treatment for shoulder arthritis. A typical anatomic shoulder replacement attempts to mimic the anatomic condition. A metal humeral stem and humeral head replacement are attached to the humerus of the arm and replace the humeral side of the arthritic shoulder joint. This humeral head replacement can articulate with the natural glenoid socket or with a counter-glenoid resurfacing device.

[0006] For more severe cases, reverse reconstruction may be used. In a reverse reconstruction, the kinematics of the shoulder joint are reversed by securing a ball-shaped device (sometimes called a glenosphere) to the glenoid and implanting a humeral implant with a cavity that can receive the glenosphere.

[0007] One challenge with reverse shoulder assemblies is that the joint body is typically made of a low-friction polymer and the humeral anchor is made of metal. The metal and polymer used in the reverse joint body may wear at different rates. Additionally, in typical assemblies, there is a risk of accidental disconnection between the joint body and the anchor. Therefore, there is a constant need for improved shoulder prosthesis components and assemblies. Summary of the Invention

[0008] There is a need for improved connecting components for connecting parts of a shoulder joint assembly together, for example to prevent relative movement between the components of the joint assembly.

[0009] Certain aspects of the present disclosure relate to a joint component configured to couple to a bone anchor. The joint component may include a joint body having a first end and a second end. An articular surface may be disposed on or adjacent to the first end. A bone anchor interface may be disposed between the first end and the second end of the joint body. The bone anchor interface may include: a locking member configured to secure the joint component to the bone anchor; and / or a deflectable portion disposed at the second end of the joint body. The deflectable portion may be configured to deflect circumferentially through a surface of a humeral anchor to provide a load directed from the second end of the joint body toward the first end of the joint body upon deflection.

[0010] The joint body may include a lateral surface configured to cover a rim of the bone anchor when the locking member is engaged with the bone anchor.

[0011] The bone anchor interface may include a channel formed in a circumferential surface of the joint body.The locking member may be disposed in the channel.

[0012] The deflectable portion may include at least two segments cantilevered from a central portion of the joint body to the second end of the joint body. The deflectable portion may include a compression groove disposed between each of the at least two segments. The deflectable portion may include a tapered surface disposed on an outer periphery thereof. The deflectable portion may be disposed between the locking member and the second end of the joint body.

[0013] The joint component may include a rotation control area disposed at a periphery of the joint body between the first end and the second end. The rotation control area may include a protrusion disposed in a first direction and a recess disposed in a second direction. The first direction may be transverse to the second direction. The protrusion may be a first protrusion and may further include a second protrusion disposed opposite the first protrusion. The recess may be a first recess and may further include a second recess disposed opposite the first recess.

[0014] Any of the joint components described herein may be included in a kit. The kit includes a bone anchor having a bone anchor recess formed therein. The bone anchor recess may extend from a first end. A bone-engaging outer surface may extend from the first end to a second end opposite the first end. The bone anchor recess may include: a first peripheral portion adjacent to the first end, the first peripheral portion configured to engage the locking member of the joint component; and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion may be configured to engage the deflectable portion. Optionally, the kit may include a bracket or spacer having a first end and a second end, the bracket configured to engage the bone anchor recess of the bone anchor at least at the second peripheral portion. The first end of the bracket may include a bracket recess formed therein. The bracket recess may include: a first peripheral portion adjacent to the first end, the first peripheral portion configured to engage the locking member of the joint component; and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion is configured to engage the deflectable portion.

[0015] Certain aspects of the present disclosure relate to a humeral assembly. The humeral assembly may include a humeral anchor (e.g., with or without a stem) and a joint assembly. The humeral anchor may be configured to be anchored in a bone. The humeral anchor may include a first end, a second end, and a recess extending between the first end and the second end. The recess may be accessible from the first end of the humeral anchor and include a first peripheral portion adjacent to the first end and a second peripheral portion between the first peripheral portion and the second end of the humeral anchor. The joint assembly may be configured to be inserted into the recess to be fastened to the humeral anchor therein. The joint assembly may include a joint body having: an articular surface disposed on or adjacent to the first end of the joint body; and a humeral anchor interface disposed between the first end and the second end of the joint body. The humeral anchor interface may include: a channel formed in a circumferential surface of the joint body; a locking member disposed in the channel; and / or a deflectable protrusion disposed between the locking member (e.g., a locking ring or C-ring) and the second end of the joint body.

[0016] The deflectable protrusion can be configured to be positioned in the second peripheral portion of the recess and, when so positioned, deflect circumferentially through a surface of the second peripheral portion and / or provide a load between the locking member and a surface of the first peripheral portion. When the humeral anchor and the joint assembly are coupled together, the deflectable protrusion is configured to engage a surface surrounding the second peripheral portion before the locking member engages the first peripheral portion of the recess of the humeral anchor.

[0017] Certain aspects of the present disclosure relate to a joint assembly configured to couple with a bone anchor. The joint assembly may include a joint body having a first end and a second end, wherein an articular surface is disposed on or adjacent to the first end. The joint body may include a bone anchor interface disposed between the first end and the second end of the joint body. The bone anchor interface may include: a channel formed in a circumferential surface of the joint body; a locking member disposed in the channel; and / or a deflectable portion disposed between the locking member and the second end of the joint body. The deflectable portion may be configured to deflect circumferentially through the surface of a humeral anchor and / or to provide a load directed from the second end of the joint body toward the first end of the joint body when deflected in a frustoconical manner.

[0018] The joint body may include a transverse surface disposed between the channel and the first end of the joint body. The transverse surface may be configured to cover an edge of the humeral anchor when the locking member is engaged with the humeral anchor.

[0019] The joint body may include a rotation control region disposed at a periphery of the joint body between the first end and the second end. The rotation control region includes at least one protrusion disposed in a first direction and at least one recess disposed in a second direction. The first direction may be transverse to the second direction.

[0020] The deflectable portion may include a tapered surface disposed on an outer periphery thereof. In some configurations, the deflectable protrusion includes a blind hole along a centerline of the joint body. In some configurations, the deflectable portion includes at least two segments, such as four segments, cantilevered from a central portion of the joint body to the second end of the joint body. The deflectable portion may also include a compression groove disposed between each of the at least two segments.

[0021] Any of the joint assemblies described herein may form part of a kit. The kit may include a bone anchor having a bone anchor recess formed therein. The bone anchor recess extends from a first end. A bone-engaging outer surface extends from the first end to a second end opposite the first end. The bone anchor recess may have: a first peripheral portion adjacent to the first end, the first peripheral portion configured to engage the locking member of the joint assembly; and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion may be configured to engage the deflectable portion of the joint assembly.

[0022] In some embodiments, the kit may include a bracket having a first end and a second end, the bracket being configured to engage the bone anchor recess of the bone anchor at least at the second peripheral portion. The first end of the bracket may include a bracket recess formed therein. The bracket recess may include: a first peripheral portion adjacent to the first end, the first peripheral portion configured to engage the locking member of the joint assembly; and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion may be configured to engage the deflectable portion.

[0023] In use, a bone anchor can be positioned in the end of a patient's long bone. The joint assembly can be rotationally aligned with the bone anchor by rotationally aligning a first rotational alignment feature (e.g., a protrusion or a recess) of the joint assembly with a second rotational alignment feature (e.g., a reverse form of the first rotational alignment feature) disposed in a recess. The recess can be formed in the bone anchor or in a bracket that is coupled to the bone anchor disposed at the end of the long bone. The joint assembly can be advanced into the bone anchor until the counterload protrusion is disposed within the tapered surface of the recess. For example, the joint assembly can be advanced until the tapered outer surface of the counterload protrusion engages with the tapered surface of the recess so that sections of the counterload protrusion move toward each other across the compression groove of the counterload protrusion. The joint assembly can be further advanced until the locking member of the joint assembly deflects within a channel formed in the central portion of the joint body. The joint assembly can be further advanced until the locking member of the joint assembly is aligned with the channel disposed around the recess in the bone anchor to permit the locking member to span the gap between the channel in the joint body and the channel disposed around the recess. When the counter-load protrusion is deflected by the tapered surface of the recess, the counter-load protrusion reduces, minimizes, or eliminates movement of the joint assembly relative to the bone anchor after the locking member spans the gap between the channel in the joint body and the channel disposed around the recess.

[0024] Certain aspects of the present disclosure relate to a shoulder prosthesis assembly comprising a bone anchor and a joint assembly. The bone anchor may comprise a metal body, and the joint assembly may comprise a polymer body. The bone anchor may comprise a body having a bone engaging side to be placed against the bone and an assembly side opposite the bone engaging side. The assembly side may comprise a recess disposed around a mounting area. The mounting area may comprise a channel disposed peripherally around the mounting area. The channel provides a first retaining surface. The joint assembly comprises a body portion and a locking member. The body extends along a central insertion axis between a first portion configured to be inserted into the mounting area and a second portion opposite the first portion. The second portion comprises an articular surface.

[0025] In an assembly with a locking member, the locking member may include an arcuate member that is arranged around the first portion of the joint body. The arcuate member has a second retaining surface. The second retaining surface may be arranged at an angle (e.g., an acute angle) to a plane that is arranged perpendicular to the central insertion axis. The first portion of the second retaining surface may be arranged to be further away from the joint surface than the first retaining surface in the direction of the central insertion axis when the joint assembly is engaged with the bone anchor. The second portion of the second retaining surface may be arranged to be closer to the joint surface than the first retaining surface in the direction of the central insertion axis when the joint assembly is engaged with the bone anchor. The first retaining surface may be arranged between the inner end and the outer end of the second retaining surface when the locking member engages the channel of the bone anchor.

[0026] The locking member may further include an elastic body. The first end of the elastic body may extend from the first end of the arcuate member. The second end of the elastic body may dock with or engage the polymeric body. The first portion of the main body portion may include a recess configured to receive the elastic body in only one position. The elastic body may be configured to center the arcuate member relative to the central insertion axis. For example, the elastic body stores strain energy when a deflecting force is applied to deflect the first end of the locking member away from a centered position, and releases the strain energy upon removal of the deflecting force to return the locking member toward the centered position.

[0027] Certain aspects of the present disclosure relate to a shoulder prosthesis assembly comprising a bone anchor and a joint assembly. The bone anchor may comprise a metal body, and the joint assembly may comprise a polymer body. The bone anchor may comprise a bone engaging side for placement against the bone and an assembly side opposite the bone engaging side. The assembly side may comprise a recess disposed around a mounting area. The mounting area may comprise a channel disposed peripherally around the mounting area. The channel comprises a first retaining surface. The joint assembly may comprise a main body portion and a locking member. The main body portion extends along a central insertion axis between a first portion configured to be inserted into the mounting area and a second portion opposite the first portion. The second portion comprises an articular surface.

[0028] Certain aspects of the present disclosure relate to a joint portion comprising a body portion (e.g., a polymer body portion) and a locking member. The body portion extends along a central insertion axis between a first portion configured to be inserted into a bone anchor and a second portion opposite the first portion. The second portion includes an articular surface. The locking member may include: an arcuate member disposed about the first portion; and a locator body having a first end coupled to the arcuate member and a second end coupled to the polymer body. The locator body is configured to be received in a recess of the body portion in a predefined orientation and / or position.

[0029] Any feature, structure or step disclosed herein may be replaced or combined with any other feature, structure or step disclosed herein, or omitted. In addition, for the purpose of summarizing the present disclosure, certain aspects, advantages and features of the present invention have been described herein. It will be understood that any or all of these advantages may not be achieved according to any specific embodiment of the present invention disclosed herein. Various aspects of the present disclosure are not necessary or essential. BRIEF DESCRIPTION OF THE DRAWINGS

[0030] These and other features, aspects, and advantages are described below with reference to the accompanying drawings, which are intended for illustrative purposes and should in no way be construed as limiting the scope of the embodiments. In addition, the various features of the different disclosed embodiments can be combined to form additional embodiments, which are part of this disclosure. In the figures, similar reference numerals consistently represent corresponding features throughout similar embodiments. The following is a brief description of each of the accompanying drawings.

[0031] Figure 1 A reverse total shoulder arthroplasty system in a shoulder joint is shown, the system including a humeral stem anchor.

[0032] Figure 2 A schematic diagram of a shoulder arthroplasty system is shown, which includes an arthroplasty kit that can be used to perform an anatomical or reverse arthroplasty, and to perform one of the following conversions: from an anatomical arthroplasty to a reverse arthroplasty, or from a reverse arthroplasty to an anatomical arthroplasty.

[0033] Figure 3A An example of a joint assembly is shown.

[0034] Figure 3B Shown Figure 3A A cross-sectional view of the joint assembly, the section being taken along line 3B-3B.

[0035] Figure 3C Shown Figure 3ABottom perspective view of the joint assembly.

[0036] Figure 3D A joint assembly is shown having an asymmetric joint body configuration with an angled medial edge or surface.

[0037] Figure 3E Shown Figure 3D A cross-sectional view of the joint assembly, the section being taken along line 3E-3E.

[0038] Figure 3F A joint assembly with an alternative humeral anchor interface is shown.

[0039] Figure 3G Shown Figure 3E A cross-sectional view of a joint component, with the cross-sectional plane extending through the center of the component in the medial-lateral direction.

[0040] Figure 4A Shown is a diagram from the Figure 2 A perspective view of the humeral anchor and joint assembly of the system is shown, and illustrating the articulation features of these components.

[0041] Figure 4B Shown after the joint assembly has been inserted Figure 4A humeral anchor and joint components.

[0042] Figure 4C Shown Figure 4B Cross-sectional view of the humeral component, the section being taken at section plane 4C-4C transverse to the direction of insertion of the reverse joint component.

[0043] Figure 4D Shown Figure 4B Top view of the assembled humeral component.

[0044] Figure 4E Shown Figure 4D A cross-sectional view of a portion of the humeral anchor and joint assembly, the section being taken along line 4E, 4F-4E, 4F.

[0045] Figure 4F Shown Figure 4D A cross-sectional view of the humeral component of , the section being taken along line 4E, 4F-4E, 4F.

[0046] Figure 5A A humeral assembly including a stemmed humeral anchor, a bracket, and a joint assembly is shown.

[0047] Figure 5B Shown Figure 5A The humeral component of the bracket.

[0048] Figure 6A An example of a joint assembly is shown.

[0049] Figure 6B Shown Figure 6A Bottom view of the joint assembly.

[0050] Figure 6C Shown Figure 6A The locking member of the joint assembly.

[0051] Figure 6D Shown before insertion of the joint assembly Figure 6A A perspective view of the humeral anchor and joint assembly of FIG. 1 and illustrating the articulation features of these components.

[0052] Figure 6E Shown in Figure 6D A partial enlarged cross-section of the connection between the humeral anchor and the joint component is shown.

[0053] Figure 6F Shown in Figure 6D A partial enlarged cross-section of the connection between the humeral anchor and the joint component is shown.

[0054] Figure 6G Shown in Figure 6D A partial enlarged cross-section of the connection between the humeral anchor and the joint component is shown.

[0055] Figure 7 Another example of a joint assembly is shown.

[0056] Figure 8A Another example of a locking member is shown.

[0057] Figure 8B Shown Figure 8A A variation of the locking member shown.

[0058] Figure 9A Another example of a joint assembly and fracture stem is shown.

[0059] Figure 9B Shown Figure 9A Bottom perspective view of the joint assembly.

[0060] Figure 10A Another example of a joint assembly is shown.

[0061] Figure 10B Shown is a Figure 10A Partial cross-section of a joint component.

[0062] Figure 11 Another example of a joint assembly is shown.

[0063] Figure 12 Another example of a joint assembly is shown. DETAILED DESCRIPTION

[0064] The present application relates in various embodiments to novel and inventive shoulder implants that can be part of hemi-shoulder and total shoulder arthroplasty systems. Figure 1 A reverse approach is shown in which the humerus H is fitted with a joint body 84 having a concave articular surface 85. The glenoid region of the scapula is fitted with a spherical joint body, which is commonly referred to as a glenosphere 87 (sometimes referred to as the glenosphere). In this case, the concave articular surface 85 is placed on the humeral articular portion of the glenosphere 87, which is fixed relative to the scapula. The reverse joint body 84 is mounted to a bracket 89, which is disposed between the reverse humeral joint body 84 and a stem anchor 83 surgically implanted in the humerus H. The humerus H is prepared by providing access to the medullary cavity of the humerus H.

[0065] I. Systems and kits with common implant components

[0066] Figure 2 1 is a schematic diagram of a total arthroplasty system according to various embodiments, the total arthroplasty system including an arthroplasty kit 100 that can be used to perform an anatomical or reverse arthroplasty, or to convert from an anatomical arthroplasty to a reverse arthroplasty or vice versa. The kit 100 can include one or more stemless humeral anchors 103, one or more stemmed humeral anchors 113, and one or more articular components 161. The stemless humeral anchor 103 can have a tapered profile with a distal portion 105 and a proximal portion 107 of the anchor 104. Figure 2 The distal portion 105 of the illustrated anchor 103 can have one or more distally extending tabs 109. The tabs 109 can be configured to secure the anchor 103 into the humerus.

[0067] like Figure 2 As shown, the stemless anchor 103 can be provided in multiple sizes to accommodate patients of different body shapes, different degrees of bone damage to the humerus, etc. In some embodiments, the lateral dimensions of the stemless anchor 103 can be varied so as to fit within resections of different sizes of the humerus. For example, the kit 100 may include a plurality of stemless anchors 103A, 103B, 103C, 103D, ... 103n, where n is the number of different sizes. Although in Figure 2Four sizes are shown in FIG (e.g., n=4 with anchors 103A-103D), but in other embodiments, the kit may include any suitable number of anchors. In some embodiments, the length l1 of the stemless anchors 103A-103D may also vary so as to extend into the humerus to a depth selected by the clinician based on the specific patient being treated. Additionally, the anchors 103A-103D may have different wing lengths l f The wings 109 are adapted to accommodate humeral bones of different sizes.

[0068] In various embodiments, the fin length l of the anchors 103A-103D is f can be significantly different to advantageously provide a wide range of anchor strengths to the humerus and to accommodate patients with varying degrees of bone damage. Figure 2 In an arrangement of, for example, the first anchor 103A may have the shortest overall length l1 and the shortest overall wing length l f The fourth anchor 103D may have a longest overall length l1 and a longest overall wing length l f In various embodiments, the ratio of the total length l1 of one anchor 103 (e.g., the largest anchor 103) to the total length l1 of another anchor 103 (e.g., the smallest anchor 103) in the kit 100 can be in the range of 1.15 to 2.5, in the range of 1.18 to 2.5, in the range of 1.2 to 2.5, in the range of 1.2 to 2, in the range of 1.2 to 1.8, in the range of 1.2 to 1.6, in the range of 1.3 to 1.6, or in the range of 1.25 to 1.4.

[0069] The kit 100 may also include one or more stemmed humeral anchors 113. The kit 100 may include one or more humeral stem anchors 112, each of which includes a proximal metaphyseal portion 120 and an elongated metaphyseal portion 116 extending from the proximal metaphyseal portion. The metaphyseal portion 116 is sometimes referred to herein as a stem or stem portion. In some embodiments, the kit 100 may also include a trauma or fracture stem anchor 140, which can be used in patients who have experienced a humeral H fracture. The stemmed humeral anchor 113 can be used in patients in whom the stemless anchor 103 may not be adequately fastened to the humerus, such as in patients who have experienced severe osteoporosis. In cases where the humerus has been broken into one or more pieces, a trauma or fracture stem can be used. Like the stemless anchor 103, the kit 100 may include a humeral stem anchor 113 (sometimes referred to herein as a stemmed anchor) having a plurality of different sizes, such as different lateral sizes and / or different lengths l2. For example, Figure 2As shown, the stemmed humeral anchor 113 can have corresponding lengths l2 that are longer than the length l1 of the stemless anchor 103. Advantageously, including stemmed anchors 113 of different sizes in the kit 100 can enable a clinician to select the appropriate size for a particular patient based on the patient's bone size and health condition to ensure that the anchor 113 is securely implanted in the patient's body. In various embodiments, the length l2 of the stemmed humeral anchor can be in the range of 55 mm to 175 mm. In contrast, the shortest length l1 of the stemless humeral anchor 103 can be in the range of 16 mm to 28 mm. In various embodiments, the stemmed humeral anchors 113, 140 can be configured to enter the intramedullary canal of the humerus H for additional anchoring.

[0070] Advantageously, the kit 100 may include one or more shared humeral components for use with the stemless humeral implant 103 or the stemmed humeral implant 113, depending on which implant 103 or 113 may be more suitable for the humeral anatomy of a particular patient. For example, the shared humeral components of the kit 100 may include a plurality of joint components or assemblies 161 that may be used in conjunction with the stemless implant 103 or the stemmed implant 113. As explained herein, both the stemless humeral anchor 103 and the stemmed humeral anchor 113 may include shared engagement features that may be used with the same set of tools and / or joint components. For example, as described herein, the stemless anchor 103 and the stemmed anchor 113 may include convex and concave locking features that are configured to engage with the same set of joint components.

[0071] For example, the kit 100 may include an anatomical joint component 160 that is configured to mechanically couple to both the stemless humeral implant 103 and the stemmed humeral implant 113. The clinician may select the anatomical joint component 160 for a procedure that is suitable for anatomical reconstruction. The anatomical joint component 160 may include a coupler 168 and a joint body 164 (anatomical) that is configured to mechanically engage the coupler 168. Figure 2 As shown, the joint body 164 of the anatomical joint component 160 may include a rounded convex surface that is configured to engage the glenoid surface of the patient. A coupler 168 may be used for mechanically connecting the anatomical joint body 164 (e.g., a rounded or substantially spherical surface) to a stemless humeral implant 103 or a stemmed humeral implant 113, depending on the patient's humeral bone structure. The joint body 164 and the coupler 168 may comprise a metal, such as cobalt, chromium or titanium. In some embodiments, the joint body includes a high temperature carbon layer at least on the joint surface. In various embodiments, the kit 100 may include an anatomical joint component 160 with multiple sizes.

[0072] The kit 100 may also include a reverse joint component 180 that is configured to be mechanically coupled to both the stemless humeral implant 103 and the stemmed humeral implant 113. The clinician may select a reverse joint component 180 for an operation suitable for reverse anatomical reconstruction. The reverse joint component 180 may include a reverse joint body 184 and a locking device 188 that is configured to secure the reverse joint component 180 to the stemless humeral implant 103 or the stemmed humeral implant 113, depending on the clinician's advice during surgery. As shown, the reverse joint body 184 may include a rounded concave surface (e.g., substantially spherical) that is configured to engage with a glenosphere (not shown, but in some cases combined with the kit as a larger surgical kit) that is connected to the patient's glenoid. In addition, in some embodiments, the kit 100 can include a wear-resistant reverse joint component 180A that can be substantially similar to the reverse joint component 180 but can be further formed to include vitamin E to promote long-term compatibility with the patient's anatomy. The reverse components 180, 180A can comprise a polymer, including, for example, ultra-high molecular weight polyethylene. In various embodiments, the kit 100 can include reverse joint components 180, 180A in multiple sizes.

[0073] During the arthroplasty procedure, the clinician can examine the bony structure of the humerus and / or scapula to determine whether the anatomy is suitable for a stemless humeral anchor or a stemmed humeral anchor, and whether the anatomy is suitable for anatomic reconstruction or reverse anatomic reconstruction. Figure 2 The illustrated kit 100 can provide the clinician with a total arthroplasty system that includes components that are compatible with either a stemless anchor or a stemmed anchor, and with either an anatomical or reverse anatomical construction. For example, during surgery, the clinician may observe that the patient has sufficient humeral bone structure such that the stemless anchor 103 can be used to minimize damage to the patient's anatomical structure. The clinician can also choose whether to perform an anatomical reconstruction or a reverse construction, and thus can select either the anatomical joint component 160 or the reverse joint component 180, 180A.

[0074] Similarly, if during a shoulder arthroplasty procedure, the clinician determines that the patient's bone structure is compromised or otherwise more suitable for a stemmed anchor 113, the clinician can select the appropriately sized stemmed anchor 113. The clinician can also choose whether to perform an anatomical reconstruction or a reverse reconstruction, and thus can select an anatomical joint component 160 or a reverse joint component 180, 180A. Advantageously, Figure 2The kit 100 includes interchangeable or interoperable components that can be used with either a stemmed anchor or a stemless anchor and used with an anatomical reconstruction or a reverse anatomical reconstruction. Since a common humeral joint component 161 (e.g., an anatomical or reverse anatomical joint body) can be used with either a stemless anchor 103 or a stemmed anchor 113, a clinician can make or change reconstruction decisions during surgery. The kit 100 can therefore enable a clinician to quickly determine the most appropriate reconstruction procedure for a patient and can provide the clinician with the components to be used for that reconstruction procedure.

[0075] As explained above, for humeral fractures, the kit 100 may also include one or more wound stems 140. Advantageously, the one or more wound stems 140 may include engagement features that are substantially similar or identical to the engagement features in the stemless anchor 103 and the humeral stem anchor 112, such that the stemless anchor 103, the humeral stem anchor 112, and the one or more wound stems 140 may be used with the same set of common joint components 161 and tools. Thus, advantageously, the kit 100 may provide a set of common implant tools and a set of common joint components 161 that may be used with either the stemless humeral anchor 103 or the stemmed humeral anchor 113 and that may be used for anatomical reconstruction or reverse anatomical reconstruction.

[0076] In some embodiments, the coupler 168 may include a proximal extension 163A and a distal extension 163B configured to connect to the joint body 164. The distal extension 163B for the fracture stem 140 can be received within the recess 217 of the fracture stem 140 for anatomical reconstruction. The disc or intermediate portion 162 disposed between the proximal and distal extensions 163A, 163B can be eliminated because the recess 217 can be elevated toward the resection plane. In modified embodiments, the recess 217 is recessed from the distal end of the second recess (e.g., extends distally from the distal end of the second recess). In these embodiments, the disc or intermediate portion 162 provides a spacer function when used in the wound stem 140. Additional details regarding the wound stem can be found in International Application No. PCT / US2015 / 065126, filed December 15, 2015, the entire contents of which are hereby incorporated herein by reference in their entirety for all purposes.

[0077] The final implant may adopt any suitable configuration, such as any configuration described in the following: application number PCT / US2019 / 054007, entitled "SHOULDER PROSTHESIS COMPONENTS AND ASSEMBLIES"; and application number PCT / US2019 / 054023, entitled "MODULAR HUMERAL HEAD", which were filed on the same day as the present application and have agent reference numbers TRNXSH.104WO2 and TRNXSH.105WO, respectively. The final implant may adopt any configuration as disclosed in the following: application number 62 / 908,725, entitled "SHOULDER PROSTHESIS COMPONENTS AND ASSEMBLIES", which were filed on the same day as the present application and have agent reference number TRNXSH.104PR2. The entire contents of each application listed in the above paragraphs are hereby incorporated by reference in their entirety for all purposes.

[0078] II. Examples of Components of a Humeral Component

[0079] As described above, the present application discloses some kits and systems that provide common components and can include multiple types of joint assemblies.For example, a humeral assembly can include a joint portion and an anchor.

[0080] Figures 3A to 3C An example joint portion 261 is shown, which is sometimes referred to herein as a joint component. The joint portion 261 includes a joint body 280, such as a reverse component having a concave articular surface, but in some procedures, as explained above, the clinician may choose an anatomical joint component, such as Figure 2 160. In some embodiments, as described in more detail below, the joint portion 261 can be a joint assembly, such as a polymeric joint body 280 and a locking member 253. In other embodiments, the joint portion 261 can be a single piece, such as a polymeric joint body 280.

[0081] like Figure 3A As shown, the joint body 280 may include a first or proximal end 281 and a second or distal end 282. The joint body 280 may have an articular surface 293 disposed at the first end 281 and a humeral anchor interface 288 disposed at the second end 282. The humeral anchor interface 288 of the joint body 280 may secure the joint body 280 to the anchor 203.

[0082] The joint body 280 includes a main body portion 287 proximal to the humeral anchor interface 288. The main body portion 287 can be defined by an outer wall 299, which can be curved or tapered. The maximum diameter of the main body portion 287 can be between 34 mm and 42 mm. The main body portion 287 can also include a rim portion 291 between the articular surface 293 and the outer wall 299. The rim portion 291 can have a first thickness T1 less than or equal to 5.0 mm or less than or equal to 3.0 mm (see Figure 3B ). The joint body 280 may include markings 279 to provide an indication of the anatomical orientation for implantation. For example, the markings 279 may provide an indication of the side of the joint body 280 that should be aligned with the lateral surface of the humerus. Figure 3B As shown, the marking 279 can be a notch on the edge portion 291 of the main body portion 287. However, the marking 279 can be printed or otherwise visually indicated on the edge portion 291 or elsewhere on the joint body 280.

[0083] The joint body 280 may further include a transverse surface 286 disposed between the first end 281 and the second end 282 of the joint body 280. The transverse surface 286 may define a distal surface of the body portion 287. The transverse surface 286 may be configured to cover the edge or proximal surface 239 of the anchor 203 when assembled (see FIG. Figure 4A and Figure 4F When assembled with the humeral anchor 203, the body portion 287 can overhang or underhang the anchor 203 by less than or equal to 2.0 mm or less than or equal to about 1.0 mm, depending on the size of the humeral component.

[0084] The body portion 287 can have a second thickness T2 between the distal-most point or apex of the articular surface 293 and the lateral surface 286 (see FIG. Figure 3B ). The distal-most point or vertex of the articular surface 293 is proximal to or in line with the transverse surface 286. In other configurations, the distal-most point or vertex of the articular surface 293 may be distal to the transverse surface 293. The thickness T2 may be less than or equal to about 25 mm, less than or equal to about 20 mm, less than or equal to about 15 mm, less than or equal to about 10 mm, less than or equal to about 5 mm, or less than or equal to about 1 mm. In some embodiments, the thickness T2 may be 0 mm. In use, if the thickness T2 is insufficient, the clinician may use spacers to increase the thickness to achieve the desired thickness between the distal-most point of the articular surface 293 and the proximal side 239 of the anchor 203. For example, if the clinician takes a low resection or soft tissue relaxation, the clinician may use spacers to construct the stem.

[0085] like Figures 3A to 3BAs shown, joint body 280 can be symmetrical about central axis L. For example, the center of the radius of curvature of joint surface 293 or the center of rotation can be aligned with the central axis L of joint body 280. The symmetry of joint body 280 may be desirable for a handleless reverse configuration or a handle with an angle of inclination (for example, an angle of inclination of about 135 degrees). The symmetry of joint body 280 may be desirable when the scapula form makes the movement of the arm toward the patient not cause contact between the humeral implant assembly and the scapula bone. In the case where contact may occur, scapula notch and / or component wear may be caused. Therefore, as discussed further below, angled proximal edges can be used. As discussed below, for other biomechanical adaptations, angled inserts may be useful.

[0086] In other configurations, the body portion 287 may be angled to achieve a desired tilt angle. For example, Figures 3D to 3E Another joint portion 261A is shown in which the proximal portion of the joint body 280 is angled relative to the lateral surface 286. The center of rotation of the joint surface 293 can be aligned with the central axis L of the joint body 280. In other embodiments, the center of rotation can be angled so that the center of the radius of curvature or the center of rotation is not aligned with the central axis L of the joint body 280. The angle between the lateral surface 286 and the proximal edge or rim portion 291 can be between 7.5 degrees and 17.5 degrees, for example, 10 degrees. The angled joint body 280 may be desirable for conversion from stemless anatomy to reverse or for a stem with an oblique angle (e.g., an oblique angle of about 145 degrees).

[0087] like Figure 3CAs shown, the joint body 280 may include a rotation control zone 285 disposed between the first end 281 and the second end 282 of the joint body 280, for example, at a perimeter between the lateral surface 286 and the second end 282 of the joint body 280. The rotation control zone 285 may include at least one first alignment feature, such as a protrusion 252. For example, the protrusion 252 may be a convex tab. The rotation control zone 285 may include a first protrusion 252 and a second protrusion 252, the second protrusion 252 being circumferentially spaced from the first protrusion 252, for example, on opposite sides of the first protrusion 252. In addition to or in lieu of the first alignment feature, the rotation control zone 285 may include at least one second alignment feature different from the first alignment feature, such as a recess 251. For example, the recess 251 may be a concave groove. The rotation control zone 285 may include a first recess 251 and a second recess 251, the second recess 251 being circumferentially spaced from the first recess 251, for example, on opposite sides of the first recess 251. As shown, the rotation control region 285 includes different types of alignment features, such as protrusions 252 and recesses 251. For example, the protrusions 252 may extend in a first direction and the recesses 251 may extend in a second direction. The first direction may be transverse to the second direction.

[0088] like Figures 3A to 3B As shown, the humeral anchor interface 288 can include a channel 284 formed in a surface (e.g., a circumferential surface) of the humeral anchor interface 288. The channel 284 can be disposed between the first end 281 and the second end 282 of the joint body 280, such as between the rotation control region 285 and the first end 281 of the joint body 280.

[0089] As explained above, the joint portion 261 can be a joint assembly having a joint body 280 and a locking member 253 that is seated in the channel 284 of the humeral anchor interface 288. The locking member 253 can reversibly secure the joint body 280 against the anchor 203. Figure 3A As shown, the locking member 253 can be a locking ring 258 (e.g., a C-ring) having interruptions to facilitate radial compression of the locking member 253. The locking member 253 can include chamfered proximal and / or distal edges to facilitate insertion of the articulated portion 261 into the anchor 203. For example, as shown Figure 3B As shown, locking member 253 has a chamfered distal edge 259 .

[0090] The humeral anchor interface 288 can include a counter-load or deflectable portion 254 projecting laterally from the rotation control region 285 and / or at the second end 282 of the joint body 280. At least a distal portion of the deflectable portion 254 can include a frustoconical or tapered surface 257 to facilitate insertion into the anchor 203.

[0091] The deflectable portion 254 may include at least two segments 255, such as three segments or four segments, cantilevered from the central portion of the joint body 280 to the second end 282 of the joint body 280. The deflectable portion 254 may also include a compression groove 256 disposed between each of the at least two segments 255. For example, Figure 3B As shown, the deflectable portion 254 can include four segments 255 separated by intersecting compression slots 256. The compression slots 256 enable the deflectable portion 254 to be compressed in a direction transverse to the longitudinal axis L or in an annular direction.

[0092] Other humeral anchor interfaces 288 may also be provided to the joint body 280. For example, Figures 3F to 3G The humeral portion 261B is shown in which the humeral anchor interface 288 includes a deflectable portion 254. The deflectable portion 254 can be a compressible plug that exhibits annular compression. The deflectable portion 254 can include a protrusion 297 having a blind hole 298 that extends proximally from the second end 282 and extends through the protrusion 297. The blind hole 298 can extend along the central axis L of the joint body 280. The protrusion 297 can define a continuous perimeter without any gaps, grooves, or other discontinuities. At least the distal portion of the deflectable portion 254 can include a frustoconical or tapered surface to facilitate insertion into the humeral anchor 203.

[0093] Figures 4A to 4F An example of a humeral component is shown that includes an anchor 203 and an articulating portion 261. As shown, the anchor 203 is stemless, but the humeral anchor may also include a stem (see FIG. Figure 5A Any of the features described herein with respect to the stemless anchor 203 may be applied to a humeral anchor that includes a stem or bracket. In some embodiments, the anchor 203 may be unitary or a single piece. In other embodiments, the anchor 203 may include a first portion or anchor portion and a second portion or bracket portion adapted to be connected to a stemless anchor or a stemmed anchor (see Figure 5B ). A single articulating portion 261 may be compatible with each of a sessile anchor, a stemmed anchor, and / or a bracket.

[0094] like Figure 4A As shown, the first recess 231 can extend distally from the proximal side 239 of the anchor 203 and into the proximal portion 207. The first recess 231 can be sized and shaped to receive a distal or lateral portion of the joint body 280. Figure 4AAs shown, a first recess 231 can be provided in the proximal portion 207 of the anchor 203. A second recess 232 can extend distally from the first recess 231 into the first segment 205A of the anchor 203. The first recess 231 and the second recess 232 can have different volumes. For example, the volume of the first recess 231 (and / or the diameter or major lateral dimension of the first recess 231) can be larger than the volume of the second recess 232 (and / or the diameter or major lateral dimension of the second recess 232). Thus, the combined space formed by the recesses 231, 232 can become larger toward the proximal side 239 of the anchor 203 and smaller toward the distal end 205 of the anchor 203.

[0095] like Figure 4A As shown, the anchor 203 can include an inner periphery 233 disposed around the first recess 231 adjacent to the proximal side 239 of the anchor 203. The inner periphery 233 can be a surface portion extending from the distal inner surface 235 to the proximal side 239 of the anchor 203. The inner periphery 233 can include one or more alignment features configured to interface with corresponding features of the rotation control region 285 of the articulation portion 261. For example, the anchor 203 can include one or more female locking features 243 disposed in the inner periphery 233 and / or one or more male locking features 241 disposed in the inner periphery 233.

[0096] like Figure 4A As shown, the anchor 203 may include a plurality (e.g., two or a pair) of concave locking features 243 spaced apart from one another along the inner periphery 233. The concave locking features 243 may be circumferentially spaced apart, such as being disposed opposite one another on the inner periphery 233 across the recess 231. Figure 4C As shown, a first concave locking feature 243A can be provided at the medial portion M of the anchor 203, and a second concave locking feature 243B can be provided at the lateral portion L of the anchor 203. In other examples, the first concave locking feature 243A can be provided in the anterior portion of the anchor 203, and the second concave locking feature 243B can be provided in the posterior portion of the anchor 203. An angle can be defined between the concave locking features 243A, 243B, such as 180 degrees, 120 degrees, 90 degrees, 60 degrees, or other angular spacing therebetween. More than two concave locking features 243A or 243B can be provided, such as three provided at 120-degree intervals, four provided at 90-degree intervals, and six provided at 60-degree intervals. The spacing between the locking features 243A, 243B can be unequal in some embodiments.

[0097] In addition to or in lieu of the female locking features 243, the inner periphery 233 may include a plurality (eg, two or a pair) of male locking features 241 that are circumferentially spaced apart from each other, such as disposed opposite each other. Figure 4C As shown, a first male locking feature 241A can be provided at a front portion A of the anchor 203, and a second male locking feature 241B can be provided at a rear portion P of the anchor 203. Where both the female locking feature 243 and the male locking feature 241 are present, the female locking feature 243 can be circumferentially spaced from the male locking feature 241.

[0098] like Figure 4A and Figure 4C As shown, the male locking features 241 may include protrusions 247 extending radially inward relative to the inner periphery 233 toward the first recess 231. The protrusions 247 may be elongated in a longitudinal direction oriented proximally-distally within the first recess 231, e.g., parallel to the insertion direction of the articulation portion 261. The protrusions 247 may extend from adjacent portions of the periphery 233 toward a central portion of the first recess 231. Portions of the periphery 233 adjacent to the protrusions 247 may be concave in configuration relative to the protrusions 247 facing the first recess 231. For example, each male locking feature 241 may be adjacent to a pair of concave recesses 242 formed in the inner periphery 233. Like the concave locking features 243, the male locking features 241 may be sized relative to corresponding locking features of the articulation portion 261, providing an interference fit between the articulation portion 261 and the anchor 203.

[0099] like Figure 4A As shown, the inner periphery 233 may include a channel 244 that extends circumferentially along the inner periphery 233. The channel 244 may be distal to the proximal side 239. The gap between the proximal side 239 and the channel 244 may be less than or equal to 3.0 mm. The channel 244 may include a plurality of segments circumferentially disposed between the female locking feature 243 and the male locking feature 241 (see FIG. Figure 4A ). The channel 244 can include any suitable number of segments, such as four, six segments, etc. As explained below, the channel 244 can be sized relative to the locking member 253 of the articulation portion 261 to provide a snap or interference fit with the locking member 253. In various embodiments, the channel 244 can include a distal-facing surface that can secure the locking member 253 of the articulation portion 261 to the anchor 203.

[0100] In use, when a clinician inserts the articulating portion 261 into the anchor 203, the clinician can, for example, use the rotational control region 285 to align the humeral anchor interface 288 of the articulating body 280 relative to the first recess 231 of the anchor 203. The articulating portion 261 can include a first rotational alignment feature (e.g., a protrusion 252 or a recessed slot 251), with a second rotational alignment feature (e.g., a negative version of the first rotational alignment feature) disposed in the recess of the anchor 203. When assembled, the engagement between the rotational control region and a corresponding feature of the anchor 203 can also serve as an anti-rotation feature to inhibit relative rotation between the anchor 203 and the articulating portion 261.

[0101] When properly aligned, the at least one protrusion 252A, 252B of the humeral anchor interface 288 engages with the corresponding concave locking features 243A, 243B of the anchor 203, and / or the at least one concave groove 251 of the humeral anchor interface 288 engages with the corresponding convex locking features 241A, 241B of the anchor 203 (see FIG. Figure 4C ). The rotation control region 285 of the articulation portion 261 and the inner periphery 233 of the anchor 203 can be sized such that when the articulation portion 261 is inserted into the first recess 231, an interference fit or friction fit is formed between the articulation portion 261 and the anchor 203. For example, the concave locking feature 243 can be sized relative to the corresponding protrusion 252 of the articulation portion 261 to provide an interference connection between the articulation portion 261 and the anchor 203. Such an interference fit can include the concave locking feature 243 being smaller in plan view than the corresponding outer surface of the articulation portion 261. As another example, the interference fit can include the convex locking feature 241 being smaller in plan view than the corresponding outer surface of the articulation component 261, e.g., the protrusion 247 can extend into and engage the corresponding outer surface of the articulation component 261.

[0102] In embodiments where one or more alignment or locking features have different shapes and / or sizes, rotational position can be more easily confirmed intraoperatively. For example, it can be visually confirmed that the protrusion 252 is rotationally correctly positioned relative to the corresponding concave locking feature 243, and / or it can be visually confirmed that the concave groove 251 is rotationally correctly positioned relative to the corresponding convex locking feature 241. By providing two opposing protrusions 252, only two rotational positions are required to secure the joint portion 261 to the anchor 203. In some cases, these two positions provide identical shoulder joint biomechanics during assembly. The two positions are rotationally symmetrical. In other embodiments, the two positions provide two biomechanical options, allowing the surgeon to choose between two positions of the joint component 280 relative to the anchor 203. In the first rotational position, the first protrusion 252A is positioned in the upper-positioned first concave recess 243A, and the second protrusion 252B is positioned in the lower-positioned second concave recess 243B. In the second rotational position, the first protrusion 252A is positioned in the lower-positioned second concave recess 243B, and the second protrusion 252B is positioned in the upper-positioned first concave recess 243B. A different number of alignment or locking features is also contemplated. For example, only a single alignment feature may be present on the rotation control region 285 to provide the correct rotational position.

[0103] After the joint portion 261 is pushed into the anchor 203, the counter-load protrusion of the joint portion 261 is disposed in the recess of the anchor 203 (see Figure 4E). The first contact between the articulation portion 261 and the anchor 203 can be between the distal portion of the deflectable portion 254 and the proximal portion of the second recess 232. When the articulation portion 261 is coupled to the anchor 203, the deflectable portion 254 can be positioned in the second recess 232 of the anchor 203. The articulation portion 261 can be advanced until the deflectable portion 254 abuts against the surface surrounding the second recess 232. The deflectable portion 254 can abut against the surface surrounding the second recess 232 before the locking member 253 engages the channel 284 of the anchor 203. For example, the articulation portion 261 can be advanced until the tapered outer surface 257 of the deflectable portion 254 abuts against the tapered surface of the second recess 232. After contact, the segments of the deflectable portion 254 move toward each other over the compression grooves 256 of the deflectable portion. When the deflectable portion 254 of the joint body 280 contacts the surface defining the second recess 232, the deflectable portion 254 can be deflected circumferentially due to the load applied by or from the surface defining the second recess 232. This deflection of the deflectable portion 254 reduces, minimizes, or eliminates movement, even micro-movement, of the joint portion 261 relative to the anchor 203. When the humeral component is assembled, the deflectable portion 254 is sufficiently deflected so that the load is applied in a direction opposite to the direction of advancement. The deflectable portion 254 can also provide a load between the locking member 253 and the peripheral portion 233 of the first recess 231.

[0104] The joint assembly can be further advanced until the locking member 253 of the joint portion 261 is deflected within the channel 244 formed in the anchor 203 (see FIG. Figure 4F ). The locking member 253 can be used to lock the joint portion 261 into the anchor 203 and prevent the joint portion 261 from translating vertically outward from the anchor 203. The locking member 253 can be transformed between a rest configuration before the joint portion 261 is inserted into the anchor 203 and a compressed configuration when the humeral component is assembled. In the compressed configuration, the locking member 253 can be radially compressed compared to the rest configuration. In the rest configuration, the inner periphery of the locking member can be disposed within the channel 284, and the outer periphery of the locking member 253 can be disposed outside the channel 284 (see Figure 4A In the compressed configuration, the inner periphery of the locking member 253 can be disposed within the channel 284 and the outer periphery of the locking member 253 can be disposed within the channel 244 of the humeral anchor 203 (see FIG. Figure 4F ).

[0105] Although the above examples are described with respect to stemless anchors, features of anchor 203 are applicable to anchors having a stem, a fracture stem, or a modular component such as a bracket or other spacer configured to extend into the humeral shaft. Figure 5AA humeral component with a stem is shown. Similar to the stemless humeral component, Figure 5A The stemmed humeral component may include an anchor 203 and an articulating portion 261. Figure 5A As shown, the anchor 203 may include a bracket 289 that is mounted to the metaphyseal portion of the stem 283, for example, by mating tapered portions forming a Morse taper connection. The articulating portion 261, which may include any of the features described above, may be mounted to the bracket 289, for example, using any of the humeral anchor interface features described above.

[0106] like Figure 5B As shown, the bracket 289 includes Figure 4A 23. The bracket 289 may include similar internal features to the stemless anchor 203 shown in FIG. For example, the bracket 289 includes a first recess 231 and a second recess 232 extending distally from the first recess 231. The bracket 289 also includes an inner periphery 233 disposed about the first recess 231. As described above, the inner periphery 233 may include one or more alignment or locking features configured to interface with the rotation control region 285 of the articulation portion 261. The inner periphery 233 may include a circumferential channel 244 extending circumferentially along the inner periphery 233. The channel 244 may be sized relative to the locking member 253 of the articulation portion 261 to provide a snap or interference fit with the locking member 253.

[0107] As discussed above, the clinician can optionally provide a bracket 289 or other spacer to fill the soft tissue space. For example, if the clinician takes a low resection or soft tissue relaxation, the clinician can use a bracket 289 or other spacer to build the handle. The bracket 289 or spacer will build the thickness between the distal most point of the articular surface and the proximal side of the handle 283.

[0108] Figures 6A to 6G Another articulation portion 352 is shown that is configured to couple to the anchor 304. The articulation portion 352 can be configured as an articulation component or assembly that includes functionally and physically distinct components. The anchor 304 can include any of the features described above with respect to any of the anchors 103, 203, 113, or 140. For example, the anchor 203 can be a stemless anchor. A single articulation portion 352 can be compatible with each of a stemless anchor, a stemmed anchor, and / or a bracket. The anchor 304 has a body portion 308, such as a metal body (see Figure 6D). The body portion 308 has a bone engaging side 312 configured to be placed against a bone and an assembly side 316 opposite the bone engaging side. The bone engaging side 312 can form a portion of any anchor described herein, including a stemless anchor or a stemmed anchor. The assembly side 316 has a mounting area 324 configured to receive at least a portion of the articulation portion 352, which can include one or more recesses extending toward the bone engaging side. The mounting area 324 can include a channel 385 disposed around its periphery.

[0109] Figures 6A to 6B Different views of joint portion 352 are provided. Joint portion 352 may include any of the features of joint portion 261. As described above, joint portion 352 includes joint body 356, such as an inverted component having a concave articular surface, but in some procedures, as explained above, the clinician may choose to anatomize the joint component, such as Figure 2 160. In some embodiments, as described in more detail below, the joint portion 352 can be a joint assembly, such as a polymeric joint body 356 and a locking member 302. In other embodiments, the joint portion 352 can be a single piece, such as a polymeric joint body 356.

[0110] like Figure 6A As shown, the joint body 356 includes a first portion or distal portion 364 and a second portion or proximal portion 368. The joint body 356 has an articulating surface 372 disposed in the second portion 368. The first portion 364 of the joint body 356 includes a distal surface 386 that is configured to be disposed in the mounting area 324 of the anchor 304. The first portion 364 of the joint body 356 may include one or more pegs 353 (see FIG. 1 ) from the distal surface 386. Figure 6B The one or more pegs 353 may correspond to one or more corresponding recesses 321 in the proximal side 320 of the bone anchor 304 (see Figure 6DAt least one peg 353 may be eccentrically positioned, displaced relative to the center 360 of the joint body 356. In one embodiment, multiple pegs 353 are provided, each of which is eccentric. Some variations may include a central recess provided in the proximal surface 320 of the bone anchor 304, for example, for mounting an anatomical joint component, such as component 160. The peg 353 facilitates rotational alignment between the joint portion 352 and the anchor 304. In some embodiments, the joint body 356 may include a central peg or other protrusion extending from the distal surface 386 of the joint body 356. Any of the pegs 353 may engage the anchor 304, for example, by mating with a tapered portion forming a Morse taper connection. Although the joint body 356 shown includes the peg 353, in other embodiments, the joint body 356 may include one or more recesses extending proximally from the distal surface 368. The recesses may correspond to one or more pegs extending proximally from the proximal surface 320 of the anchor 304. In another variation, each of the anchor 304 and the joint body 356 has at least one peg and at least one recess to provide an advantageous combination of connection features.

[0111] like Figure 6A As shown, the second portion 368 of the joint body 356 may include a channel 384 disposed between the articular surface 372 and the distal surface 386. The channel 384 may be formed in a surface (eg, a lateral peripheral or circumferential surface) of the second portion 368. Figure 6B As shown, the second portion 368 can include a recess 342 on the distal surface 386 of the joint body 356. The recess 342 can extend from the channel 384. For example, the recess 342 can extend proximally from the distal surface 386 of the joint body 356 to a depth in the channel 384.

[0112] As explained above, the joint portion 352 may include a locking member 302 to ensure mechanical fixation between the joint body 356 and the anchor 304. The locking member 302 may be constructed of a resilient material such as titanium or another resilient metal. Figures 6A to 6B As shown, the locking member 302 can be disposed about the joint body 356, for example, within the channel 384 of the second portion 368. The locking member 302 can reversibly secure the joint body 356 against the anchor 304 by a simple compressive load achieved via an impactor and a mallet without using any other tools for assembling the joint body 356 to the anchor 304. When the joint portion 352 is coupled to the anchor 304, the locking member 302 is deflected into the anchor channel 385 such that the outer periphery 390 of the locking member 302 is disposed within the anchor channel 385 and the inner periphery 388 is disposed within the joint body channel 384 (see FIG. Figure 6E ).

[0113] The locking member 302 may include an arcuate member 306 disposed at least partially around the first portion 364 of the joint body 356, such as at least partially within the joint body channel 384. Figures 6B to 6C As shown, the arcuate member 306 may include a discontinuity 374 between the first end 366 of the arcuate member 306 and the second end 378 of the arcuate member to facilitate radial compression of the locking member 302 .

[0114] The inner periphery 388 and / or the outer periphery 390 of the locking member 302 may include one or more stress reducing features 392. For example, Figure 6C As shown, the arcuate member 306 includes a scalloped edge or a series of cutouts along at least a portion or the entire inner periphery 388, but in other examples, the scalloped edge can be along the outer periphery 390. Although these figures show a scalloped edge, other stress-reducing features can include a reduction in thickness measured between the proximal and distal surfaces of the locking member 302. The stress-reducing feature 392 facilitates bending and deflection of the arcuate member 306 to avoid plastic deformation during assembly. The stress-reducing feature 392 also helps maintain the integrity of the locking member 302 when a compressive force is applied to the humeral component.

[0115] like Figure 6E As shown, the outer periphery 390 of the locking member 302 can have a first or distal edge 328 and a second or proximal edge 310 that is angled relative to the first edge 328 to form an apex. The second or proximal edge 310 can be disposed at an angle α relative to a plane PLN that is perpendicular to the central insertion axis 360 or disposed along the anchor retaining surface 322. The anchor retaining surface 322 defines the upper edge of the anchor channel 385. The angle α can be greater than 0 degrees and less than or equal to 20 degrees, such as approximately 15 degrees. For locking member materials with a higher friction factor, the angle α can be greater than 20 degrees. For example, the angle α can be less than or equal to approximately 45 degrees or less than or equal to approximately 30 degrees.

[0116] like Figure 6EAs shown, the second edge 310 of the locking member 302 may include a first portion 310A and a second portion 310B. To maintain a secure connection between the joint body 356 and the anchor 304, at least a portion of the first portion 310A of the second edge 310 must extend into the channel 385 in the anchor 304. When the joint body 356 is inserted into the anchor 304, the distal edge 328 of the locking member 302 is advanced toward the distal edge of the channel 385. After compression, the locking member 302 elastically recovers so that the proximal edge 310 contacts the retaining surface 322. When the joint body 356 is coupled to the anchor 304, the first portion 310A is disposed further from the joint surface 372 than the retaining surface 322 of the anchor 304 in the direction of the central insertion axis 360. The second portion 310B of the second edge 310 is at least along the same plane as the retention surface 332 of the anchor channel 385, or is disposed closer to the articular surface 372 than the retention surface 332 in the direction of the central insertion axis 360.

[0117] When the locking member 302 is deflected into the anchor channel 352, an interference fit exists between the anchor 304 and the locking member 302. An angle α of less than or equal to about 45 degrees (or less than or equal to about 30 degrees or less than or equal to about 20 degrees, such as less than or equal to about 15 degrees) between the second edge 310 of the locking member 302 and the plane PLN maintains contact between the locking member 302 and the anchor 304 regardless of a pulling force F pulling the joint body 352 apart from the anchor 304. T How. Figure 6E As shown, the friction force F between the locking member 302 and the anchor 304 F will prevent the locking member 302 from being released from the anchor channel 385, while the reaction force F R The locking member 302 will be prevented from sliding further into the anchor channel 385. The friction force F F and reaction force F R The combination of the locking member 302 and the anchor 304 reduces or eliminates movement between the joint body 356 and the joint body 356. For example, the locking member 302 allows no more than 0.05 mm of movement, or even no movement, between the anchor 304 and the joint body 356 in the longitudinal and / or lateral directions. The angled locking member 302 allows the humeral assembly to accommodate large forces applied to the shoulder joint without the risk of disintegration or the risk of creating a gap.

[0118] The shape of the outer periphery 388 also enables the locking member 302 to tolerate a range of clearances between the anchor passage 385 and the joint body passage 384. For example, the locking member 302 maintains fixation between the joint body 356 and the bone anchor 304 regardless of whether there is a maximum clearance between the anchor passage 385 and the joint body passage 384 (or a maximum clearance between the anchor passage 385 and the joint body passage 384). Figure 6F Is there a minimum gap between the anchor channel 385 and the joint body channel 384 (or a relatively large gap between the anchor channel 385 and the joint body channel 384)? Figure 6G other relatively small gaps in the same way).

[0119] The locking member 302 may also include a resilient body 314 extending from the arcuate member 306. The resilient body 314 may have a shape that generally corresponds to the shape of the recess 342 in the joint body 356. The recess 342 may be configured to receive the resilient body 314 in a limited number of positions or only one position, such as a central position. The recess 342 may be shaped to accommodate the resilient body 314 while allowing some movement of the body 314 because the joint body 356 does not impede the loading and unloading of the body 314. This feature facilitates proper orientation of the locking member 302 relative to the joint body 356. Proper orientation facilitates easy removal of the locking member 302 because the locking member is always in the same position.

[0120] like Figure 6C As shown, the elastic body 314 includes a first end 318 and a second end 322. The first end 318 of the elastic body 314 can extend from the first end 366 of the arc-shaped member 306. The second end 322 of the elastic body 314 is disposed radially inward of the arc-shaped member 306. In this configuration, the second end 378 of the arc-shaped member 306 forms one free end of the locking member 302, and the second end 322 of the elastic body 314 forms the other free end of the locking member 302. The second end 322 of the elastic body 314 can overlap the arc-shaped member 306, but be disposed radially inward.

[0121] like Figure 6C As shown, the elastic body 314 may include a radial portion 362 extending radially inward from the arcuate member 306. The elastic body 314 may also include an arcuate portion 370 extending from the radial portion 362. The arcuate portion 370 may be concentric with the arcuate member 306. For example, the arcuate portion 370 may be radially inward of the arcuate member 306 and span at least a length of the gap 374 in the arcuate member 306.

[0122] The locking member 302 can be coupled to the body portion 356 to maintain the locking member 302 in a predefined position and orientation. For example, the second end 322 of the elastic body 314 can be coupled to the body portion 356. Figure 6BAs shown, the second end 322 of the resilient body may include a first engagement feature 358 that couples to a second engagement feature 357 of the body portion 356. The first engagement feature 358 may include an opening or a peg, and the engagement feature 357 of the body portion 356 may include the inverse of the first engagement feature 358. If the engagement feature 357 is a peg, the engagement feature 358 may be an aperture formed in the second end 322.

[0123] The second end 322 of the elastic body 314 can be enlarged to form a locating member body. The locating member body can be arranged in the recess 342 with a predefined orientation and / or position relative to the central insertion axis 360. The predefined orientation and / or position can be a single orientation and / or position, such as a centered position in the recess 342. In some embodiments, the elastic body 314 can have an arcuate portion, and the wall in the portion of the recess 342 in which the body is positioned can have an arcuate shape. The side edges of the elastic body 314 can be spaced apart from the opposite walls of the recess 342, for example, equally spaced apart. In some embodiments, the spacing of the elastic body 314 relative to the wall of the recess 342 can increase along the length of the body in a direction away from the engagement features 357, 358.

[0124] As described above, the locking member 302 can be shaped to accommodate a certain range of gaps between the anchor passage 385 and the joint body passage 384. However, this may cause the locking member 302 to be misaligned with respect to the central axis 360 of the shoulder implant. The elastic body 314 can be configured to center the arcuate member 306 with respect to the central insertion axis 360. For example, the elastic body 314 stores strain energy when applying a deflection force to deflect the locking member 302 away from a centered position (e.g., approximately center point 360), and releases the strain energy to return the locking member 302 toward the centered position after removing the deflection force.

[0125] Other configurations of the locking member may achieve one or more of the benefits described above. For example, Figure 7 A joint portion 452 is shown that includes a joint body 456 and a locking member 402. The locking member 402 may include any of the features described above with respect to the locking member 302.

[0126] like Figure 7As shown, the locking member 402 includes an arcuate member 406 disposed at least partially around the joint body 456. The arcuate member 406 may include a discontinuity 474 between a first end 466 of the arcuate member 406 and a second end 478 of the arcuate member to facilitate radial compression of the locking member 402. The inner periphery 488 and / or the outer periphery 490 of the locking member 402 may include one or more stress reducing features 492 to facilitate bending and deflection of the arcuate member 406 to avoid plastic deformation. For example, as shown, the arcuate member 406 includes a scalloped edge, a series of cutouts along at least a portion of the outer periphery 488. Although Figure 7 Scalloped edges are shown, but other stress-reducing features are possible, such as a reduced thickness or, in some embodiments, providing material treatments along the edge or perimeter of the locking member 402 or between the proximal and distal edges of the locking member. The sections 493 between the stress-reducing features 492 can include any of the features of the outer periphery 390 described above to facilitate engagement between the articulation portion 452 and the anchor.

[0127] As shown, the arcuate member 406 includes a first arcuate portion 406A extending from a first end 466 and a second arcuate portion 406B extending from a second end 478. The locking member 402 may also include an elastic body 414 extending between the first arcuate portion 406A and the second arcuate portion 406B. The elastic body 414 includes a base 415 positioned radially inwardly of the arcuate member 406. In one embodiment, the base 415 spans at least a length of the gap 474 in the arcuate member 406. The elastic body 414 may also include a first radial member 462A extending from the base 402 to the first arcuate portion 406A and a second radial member 462B extending from the base to the second arcuate portion 406B. In one embodiment, the base 415 includes an overhanging portion 464 extending from one of the first radial members 462A, 462B to the wall of the recess 442. In one embodiment, the overhang 464 spaces the first radial member 462A from the walls of the recess 442 so that the walls do not constrain the movement of the member 462A. The base 415 may have an overhang 464 at each end to provide this spacing function for the two members 462A, 462B.

[0128] The elastic body 414 can have a shape that generally corresponds to the shape of the recess 442 in the joint body 456. The recess 442 can be configured to receive the elastic body 414 in a limited number of positions or only a single position, such as a central position. For example, the general form of the recess 442 can be T-shaped. The portion of the recess 442 that receives the base 415 can be wider than a portion of the base retaining portion of the recess that extends from the periphery to the recess. Similarly, the base 415 of the elastic body 414 can be wider than the combined width of the radial members 462A, 462B. The elastic body 414 can form a C-shape, an inverted or reverse or inverse C-shaped recess that can receive a portion of the bottom side or distal or medial side of the joint body 456.

[0129] The resilient body 414 can be configured to center the arcuate member 406 relative to the central insertion axis 460. For example, the resilient body 414 stores strain energy when a deflecting force is applied to deflect the locking member 402 away from a centered position (e.g., approximately the center point 460), and releases the strain energy to return the locking member 402 toward the centered position after the deflecting force is removed.

[0130] Figure 8A Another locking member 502 is shown that includes a different configuration of the resilient body. The locking member 502 can include any of the features described above with respect to the locking members 302, 402.

[0131] As shown, the locking member 502 includes an arcuate member 506 having a discontinuity 574 between a first end 566 of the arcuate member 506 and a second end 578 of the arcuate member 506 to facilitate radial compression of the locking member 502. The arcuate member 506 may also include one or more stress-reducing features 592 disposed along at least a portion or the entire inner periphery 590 and / or outer periphery 588 of the arcuate member 506. Figure 8B As shown, the locking member 502A may include stress-reducing features 592 only along the inner periphery 590 of the arcuate member 506. In another variation, the stress-reducing features 592 may be located only on the outer periphery 588 of the arcuate member 506. In either configuration, the outer periphery 588 may have an angled configuration as described above with respect to the locking member 302.

[0132] The locking member 502 may also include one or more elastic bodies 514 (e.g., at least two elastic bodies, at least three elastic bodies, or in one case, only three elastic bodies) extending from the inner periphery 590 of the arcuate member 506. Each of the elastic bodies 514 has a first end 518 extending from the arcuate member 506 and a second free end 522 positioned radially inward of the first end 518. The elastic bodies 514 may have an arcuate shape from the first end 518 to the second end 522. The elastic bodies 514 may be circumferentially spaced apart from each other. For example, the second end 522 of each elastic body 514 may be circumferentially spaced apart from the first end 518 of an adjacent elastic body 514 (e.g., equally spaced apart and, in the case of only three bodies 514, spaced apart by 120 degrees).

[0133] When coupled to the joint body, the elastic body 514 can be disposed within the joint body channel. Each elastic body 514 can be configured to center the arcuate member 506 relative to the central insertion axis. For example, each elastic body 514 stores strain energy when a deflection force is applied to deflect the locking member 502 away from the centered position, and releases the strain energy to return the locking member 502 toward the centered position after the deflection force is removed. Where more than one elastic body 514 is provided, the bodies can work together to move the locking member 502 toward the centered position. For example, in one of the bodies 514 (e.g., Figure 8A When the stored strain energy of the locking member 502 (also at 3 o'clock) is released, the adjacent span of the locking member 502 (also at 3 o'clock) can deflect away from the body 514 (e.g., at Figure 8A In the example, member 502 may move toward the right, thereby increasing the gap between member 502 and the adjacent body 514 at the 3 o'clock position. This may cause a corresponding deflection of another span of locking member 502 (e.g., at 10 o'clock) toward the other of the bodies 514 (e.g., body 514 connected to member 502 at 12 o'clock, extending to a free end between 9 o'clock and 10 o'clock), which may cause strain energy to be stored in the other body 514 (thereby reducing the gap between locking member 502 and body 514 at the 10 o'clock position). Storing strain energy in the other elastic body 514 can limit the movement of locking member 502 (rightward in this example) so that the elastic body 514 does not overcorrect by moving the locking member 502 eccentrically (e.g., too far to the right).

[0134] As explained above, for humeral fractures, the kit 100 may also include one or more fracture stems 140 . Figure 9A Another articulating portion 652 is shown that is configured to couple to the fracture stem 140. Figure 9AA stem is shown, but the stem may be a sessile or stemmed anchor that includes any of the features described above with respect to any of the anchors 103, 203, 113, 140, or 304. Thus, the connection features of the stem 140 may be shared between variations of these additional humeral anchors to provide a common component in variations of the kit 100 in which the connection features of the stem 140 are present in other anchors in the kit.

[0135] The proximal end of the stem 140 includes a peripheral wall 621 defining a cavity 619. Cavity 619 is radially spaced from and surrounds the aperture 617 located at the proximal end of the stem 140. The aperture 617 may be at least partially formed in a raised portion 623. The raised portion 623 of the aperture 617 enables the stem 140 to be compatible with anatomical joint components similar to the anatomical joint component 160, but which may exclude the disc or intermediate portion 162 provided in the coupler 168. Modifications to the coupler 160 may provide two adjacent cones without a spacer similar to the disc or intermediate portion 162. The raised portion 623 extends proximally from a base 627 of the cavity 619. The proximal surface 624 of the raised portion 623 may be in the same plane or substantially the same plane as the proximal surface 622 of the peripheral wall 621. The stem 140 may also include a channel 625 surrounding the inner periphery of the peripheral wall 621.

[0136] The joint portion 652 can be configured as a joint component or assembly that includes functionally and physically distinct components. A single joint portion 652 may be compatible with each of a stemless anchor, a stemmed anchor, and / or a bracket. The joint portion 652 may include any of the features described above with respect to the joint portions 261, 352, 452. As described above, the joint portion 652 includes a joint body 656, such as an inverted component having a concave articular surface 672, but in some procedures, as explained above, the clinician may choose to anatomize the joint component, such as Figure 2 160. In some embodiments, as described in more detail below, the joint portion 652 can be a joint assembly, such as a polymeric joint body 656 and a locking member 602. In other embodiments, the joint portion 652 can be a single piece, such as a polymeric joint body 656.

[0137] like Figure 9BAs shown, the joint body 656 includes a first portion or distal portion 664 and a second portion or proximal portion 668. The joint body 656 has an articular surface 672 disposed in the second portion 668. The first portion 664 of the joint body 656 includes a distal surface 686 that is configured to be disposed in the cavity 619 of the fracture stem 140. For example, the first portion 664 of the joint body 656 may include a recess 690 extending proximally from the distal surface 686. The shape of the recess 690 may correspond to the raised portion 623 in the proximal side of the fracture stem 140 (see FIG. Figure 9A ). The recess 690 may be asymmetrical about at least one axis to facilitate proper rotational alignment with the raised portion 623, for example to allow for only one, two, or another limited number of rotational positions in which the recess 690 can accommodate the raised portion 623. For example, Figure 9B As shown, the recess 690 may have a straight portion 690a on its outer side and a curved portion 690b on its inner side. In other embodiments, the recess 690 may be symmetrical about all axes, for example, circular. When the articulating portion 652 is coupled to the fracture stem 140, the surface 688 of the recess 690 covers the raised portion 623 without filling the hole 617.

[0138] The joint body 656 may include markings 679 to provide an indication of the anatomical orientation for implantation. For example, the markings 679 may provide an indication of the side of the joint body 656 that should be aligned with the lateral surface of the humerus. Figure 9B As shown, the marking 679 can be an indentation on the distal surface 686 of the joint body 656. However, the marking 679 can be printed or otherwise visually indicated on the distal surface 686 or elsewhere on the joint body 656.

[0139] The joint body 656 may include a channel 684 disposed between the joint surface 672 and the distal surface 686. The channel 684 may be formed in a surface, such as a lateral peripheral or circumferential surface. As explained above, the joint portion 652 may include a locking member 602 to ensure mechanical fixation between the joint body 656 and the fracture stem 140. The locking member 602 may be constructed of a resilient material such as a resilient metal. The locking member 602 may include any of the features of the locking members 253, 302, 502, 502A described above.

[0140] like Figures 9A to 9BAs shown, the locking member 602 can be disposed about the articulating body 656, for example, within the channel 684. The locking member 602 can reversibly secure the articulating body 656 against the stem 140 by simple compression loading via an impactor and a mallet, without the use of any other tools for assembling the articulating body 656 to the stem 140. When the articulating body 652 is coupled to the stem 140, the locking member 602 is deflected such that the outer periphery of the locking member 602 is disposed within the stem channel 625 and the inner periphery of the locking member 602 is disposed within the articulating body channel 684.

[0141] Figure 10A Another joint portion 752 is shown that is compatible with one or more other humeral anchors in the variations of the stem 140 or kit 100. The joint portion 752 can include any of the features described above with respect to the joint portions 261, 352, 452, 652. In some embodiments, the joint portion 752 can be a joint assembly, such as a polymeric joint body 756 and a locking member 702. In other embodiments, the joint portion 752 can be a single piece, such as a polymeric joint body 756.

[0142] like Figure 10A As shown, the joint body 756 includes a first portion or distal portion 764 and a second portion or proximal portion 768. The joint body 756 has an articular surface 772 disposed in the second portion 768. The first portion 764 of the joint body 756 includes a distal surface 786 configured to be disposed in the cavity 619 of the fracture stem 140 (see FIG. Figure 9A ). For example, the first portion 764 of the joint body 756 may include a recess 790 extending proximally from the distal surface 786. The shape of the recess 790 may correspond to the raised portion 623 in the proximal surface of the fracture stem 140 (see Figure 9A ). Recess 790 may include any of the features of recess 690 described above. Joint body 756 may also include markings 779 to provide an indication of anatomical orientation for implantation. Markings 779 may include any of the features of markings 679, 279.

[0143] The first portion 764 of the joint body 756 may also include a counter-load or deflectable portion 754 that projects distally from a distal surface of the joint body 756, such as from a distally facing surface 788 within the recess 790. As shown, the deflectable portion 754 has a cylindrical profile, but in other configurations, the deflectable portion 754 may have a frusto-conical profile or other profile. When inserted into the hole 617 of the fracture stem 140, the deflectable portion 754 may be capable of compressing toward the central longitudinal axis L (see FIG. Figure 10B). The deflectable portion 754 may include any of the features of the deflectable portion 254. For example, the deflectable portion 754 may include at least two segments 755, such as three segments or four segments, cantilevered from a central portion of the joint body 756. The deflectable portion 754 may also include a compression groove 789 disposed between each of the at least two segments 755. For example, as Figure 10A As shown, the deflectable portion 754 can include four segments 755 separated by intersecting compression grooves 756. When the deflectable portion 754 is inserted into the aperture 617, the one or more compression grooves 756 enable the deflectable portion 754 to be compressed in a direction transverse to the longitudinal axis L or in an annular direction.

[0144] The joint body 756 may include a channel 784 disposed between the joint surface 772 and the distal surface 786. The channel 784 may be formed in a surface, such as a lateral or circumferential surface. The joint portion 752 may include a locking member 702 to ensure mechanical fixation between the joint body 756 and the fracture stem 140. The locking member 702 may be constructed of a resilient material, such as a resilient metal. The locking member 702 may include any of the features of the locking members 253, 302, 502, 502A, and 602 described above.

[0145] like Figure 10B As shown, the locking member 702 can be disposed about the articulating body 756, for example, within the channel 784. The locking member 702 can reversibly secure the articulating body 756 against the stem 140 by simple compressive loading via an impactor and mallet, without the use of any other tools for assembling the articulating body 756 to the stem 140. When the articulating body 752 is coupled to the stem 140, the locking member 702 is deflected such that the outer periphery of the locking member 702 is disposed within the stem channel 625 and the inner periphery is disposed within the articulating body channel 784.

[0146] The locking member 702 may include a proximal edge 702a and a distal edge 702b. The distal edge 702b may be angled relative to the proximal edge 702a (see FIG. Figure 10B When the articulation portion 752 is inserted into the fracture stem 140, the distal edge 702b of the locking member 702 is advanced toward the distal edge 625b of the channel 625. After compression, the locking member 702 elastically recovers so that the proximal edge 702a of the locking member 702 contacts the proximal edge 625a of the channel 625.

[0147] When the humeral implant is fully assembled, the locking member 702 can be disposed along a plane PLN distal to the proximal surface of the stem 140. The PLN can extend laterally through the deflectable portion 752. The locking member 702 can be disposed between the distal surface 786 of the joint body 756 and the distal end 773 of the joint body 756. This provides a compact arrangement along the axis L. This arrangement allows the connection of the deflectable portion 752 to the coupler of the anatomical joint component to be close to or at the proximal end of the stem 140.

[0148] In a variation of the deflectable portion 752, a continuous protrusion may be provided without the slot 789. For example, similar to Figure 3F The blind hole 298 of the protrusion of the embodiment of the present invention can be formed in the protrusion having a tapered outer profile and a closed interior.

[0149] Figures 11 to 12 Other engagement features are shown that may be used in conjunction with any of the articulating portions identified above to couple the articulating portion with a fracture stem 140 or other bone anchor.

[0150] Figure 11 The joint body 856 is shown having a distal surface 886. The joint body 856 may include a recess 890 extending proximally from the distal surface 886. The shape of the recess 890 may correspond to the raised portion 623 in the proximal surface of the fracture stem 140 (see FIG. Figure 9A ). Recess 890 may include any of the features described above for recess 690. Joint body 856 may also include marking 879, which may include any of the features of markings 679, 279.

[0151] The joint body 856 may include one or more deformable protrusions 894 extending from the distal surface 886. The one or more deformable protrusions 894 may correspond to one or more corresponding recesses in the proximal surface of the bone anchor. The one or more deformable protrusions 894 are compressed when inserted into the one or more corresponding recesses. The one or more deformable protrusions 894 may comprise a deformable material, for example, a deformable polymer material such as UHMWPE. The one or more deformable protrusions 894 may comprise a continuous perimeter without any gaps, grooves, or other discontinuities. At least one deformable protrusion 894 may be eccentrically positioned, displaced relative to the center of the joint body 856. For example, each of the one or more deformable protrusions 894 may be radially disposed between the recess 890 and the outer perimeter 896 of the distal surface 886. The one or more deformable protrusions 894 may also facilitate rotational alignment between the joint portion 852 and the bone anchor. Any of the deformable protrusions 894 may engage the fracture stem 140, for example, by a press fit. Although the illustrated joint body 856 includes three deformable protrusions 894 , a fewer or greater number of deformable protrusions 894 may be feasible.

[0152] Figure 12 The joint body 956 is shown with a distal surface 986. The joint body 956 includes a first portion or distal portion 964 and a second portion or proximal portion 968. The joint body 956 has an articular surface disposed in the second portion 968. The first portion 964 of the joint body 956 includes the distal surface 986, which is configured to be disposed in the cavity 619 of the fracture stem 140 (see FIG. Figure 9A ).

[0153] The joint body 956 may include a recess 990 extending proximally from the distal surface 986. The shape of the recess 990 may correspond to the raised portion 623 in the proximal surface of the fracture stem 140 (see Figure 9A ). Recess 990 may include any of the features of recess 690 described above. For example, recess 990 may have a straight portion 990a on its lateral side and a curved portion 990b on its medial side. Joint body 956 may also include marking 979 having any of the features of markings 679, 279.

[0154] The entire distal portion 964 can be compressed to form a press-fit connection when inserted into the cavity 619 of the fracture stem 140. The distal portion 964 can be divided into at least two segments 987, such as three segments or four segments, by the compression groove 989. For example, Figure 12As shown, the distal portion 964 may include three segments 987 separated by compression grooves 956 extending from an outer periphery 996 to the recess 990. The distal portion 964 may include a first segment 987 along a straight portion 990a of the outer side or recess 990 and at least one segment 987, for example, two segments 987, along a curved portion 990b of the inner side or recess 990. The distal portion 964 may include two compression grooves 989 aligned along the transverse axis X. The distal portion may include at least one additional compression groove 989 on an axis perpendicular to the transverse axis X. The compression grooves 989 enable the distal portion 964 to be compressed in an annular direction when the distal portion 964 is inserted into the cavity 619 of the fracture stem 140.

[0155] the term

[0156] Although certain embodiments have been described herein, the implants and methods described herein can be used interchangeably with any joint component, as the context may dictate.

[0157] As used herein, the terms "proximal" and "distal" are defined from the perspective of the implant. Thus, proximal refers to the direction of the joint components and distal refers to the direction of the anchor components (such as the handle of the humeral anchor when assembling the implant, or the threaded or porous surface or other anchoring structure of a stemless anchor).

[0158] Unless specifically stated otherwise, or understood otherwise in the context of use, conditional language such as "can," "may," "might," or "could" is generally intended to convey that certain embodiments include certain features, elements, and / or steps even though other embodiments do not. Thus, such conditional language is generally not intended to imply that a feature, element, and / or step is in any way required for one or more embodiments.

[0159] The terms "comprising," "including," "having," and the like are synonymous and are used inclusively in an open manner and do not exclude additional elements, features, actions, operations, and the like. Additionally, the term "or" is used in its inclusive sense (and not in its exclusive sense) such that, for example, when used to connect a list of elements, the term "or" means one, some, or all of the elements in the list. Furthermore, unless otherwise indicated, the articles "a," "an," and "the" as used in this application and the appended claims should be construed to mean "one or more" or "at least one."

[0160] The ranges disclosed herein also encompass any and all overlapping ranges, subranges, and combinations thereof. Language such as "up to," "at least," "greater than," "less than," "between," and the like includes the referenced values. Numerical values ​​preceded by terms such as "about" or "approximately" include the stated values ​​and should be interpreted as appropriate (e.g., as accurately as reasonably possible in each case, such as ±5%, ±10%, ±15%, etc.). For example, "about 1" includes "1." Phrases preceded by terms such as "substantially," "generally," and the like include the stated phrases and should be interpreted as appropriate (e.g., as much as reasonably possible in each case). For example, "substantially spherical" includes "spherical." Unless otherwise noted, all measurements are under standard conditions, including temperature and pressure.

[0161] As used herein, a phrase referring to "at least one" of a list of items refers to any combination of those items, including individual members. As an example, "at least one of A, B, or C" is intended to cover: A, B, C, A and B, A and C, B and C, and A, B and C. Unless specifically stated otherwise, or understood otherwise in the context of use, transitional language such as the phrase "at least one of X, Y, and Z" generally conveys that a certain item, term, etc. may be at least one of X, Y, or Z. Thus, such transitional language is generally not intended to imply that certain embodiments require the presence of at least one X, at least one Y, and at least one Z, respectively.

[0162] Although certain embodiments and examples have been described herein, it should be emphasized that many variations and modifications may be made to the humeral head assembly shown and described in this disclosure, and the elements of the humeral head assembly should be understood to be differently combined and / or modified to form additional embodiments or acceptable examples. All such modifications and variations are intended to be included within the scope of this disclosure. A wide variety of designs and methods are possible. None of the features, structures, or steps disclosed herein are necessary or essential.

[0163] Several embodiments have been described in conjunction with the accompanying drawings. However, it should be understood that the drawings are not drawn to scale. Distances, angles, etc. are illustrative only and do not necessarily bear an exact relationship to the actual size and layout of the devices shown. Components may be added, removed, and / or rearranged. In addition, the disclosure herein of any particular feature, aspect, method, property, characteristic, trait, attribute, element, etc., implemented in conjunction with various embodiments, may be applied to all other embodiments described herein. Additionally, it will be appreciated that any method described herein may be practiced using any device suitable for performing the recited steps.

[0164] For the purposes of this disclosure, certain aspects, advantages, and novel features are described herein. It will be understood that not all such advantages may be achieved according to any particular embodiment. Thus, for example, one skilled in the art will recognize that the present disclosure may be embodied or implemented in a manner that achieves one advantage or group of advantages as taught herein without necessarily achieving other advantages as may be taught or suggested herein.

[0165] In addition, although illustrative embodiments have been described herein, it will be understood by those skilled in the art that the scope of the present invention extends beyond the specifically disclosed embodiments to any and all embodiments, adaptations and / or modifications of equivalent elements, modifications, omissions, combinations or sub-combinations of the specific features and aspects of these embodiments (e.g., aspects throughout the various embodiments), and uses of the present invention as those skilled in the art would understand based on this disclosure. The limitations in the claims are to be broadly interpreted based on the language employed in the claims and are not limited to the examples described in this specification or during the examination of the application, which examples should be considered non-exclusive. In addition, the actions of the disclosed processes and methods can be modified in any way, including by reordering the actions and / or inserting additional actions and / or deleting actions. Therefore, the description and examples are intended to be considered illustrative only, with the true scope and spirit being indicated by the claims and the full scope of their equivalents.

[0166] Any method disclosed herein does not need to be performed in the order described. The methods disclosed herein include certain actions taken by the practitioner; however, the methods may also include, explicitly or implicitly, any third-party instructions regarding these actions. For example, an action such as "couple the glenoid guide to the glenoid rim" includes "instructing the glenoid guide to couple to the glenoid rim."

Claims

1. A joint component configured to couple with a bone anchor, the joint component comprising: A joint body having a first end and a second end; wherein the joint body comprises: an articular surface disposed on or adjacent the first end; and a bone anchor interface, the bone anchor interface being disposed between the first end and the second end of the joint body, the bone anchor interface comprising: a channel formed in a circumferential surface of the joint body; a locking member positioned in the channel and configured to secure the joint component to the bone anchor, the locking member comprising: an arcuate member disposed at least partially within the channel of the joint body; and one or more elastic bodies having a first end extending from the arcuate member and a second end disposed radially inwardly of the arcuate member, the elastic body being disposed within the channel of the joint body; and A deflectable portion is disposed at the second end of the joint body, the deflectable portion being configured to deflect circumferentially through a surface of a humeral anchor to provide a load directed from the second end of the joint body toward the first end of the joint body upon deflection.

2. The joint component of claim 1, wherein the deflectable portion comprises at least two segments cantilevered from a central portion of the joint body to the second end of the joint body. 3 . The joint component of claim 2 , further comprising a compression groove disposed between each of the at least two segments.

4. The joint component of any one of claims 1 to 3, wherein the deflectable portion includes a tapered surface provided on an outer periphery thereof.

5. The joint component of any one of claims 1 to 3, wherein the joint body includes a lateral surface configured to cover a rim of the bone anchor when the locking member is engaged with the bone anchor. 6 . The joint component according to claim 1 , further comprising a rotation control zone provided at a periphery of the joint body between the first end and the second end. 7 . The joint component of claim 6 , wherein the rotation control region includes a protrusion disposed in a first direction and a recess disposed in a second direction.

8. The joint component of claim 7, wherein the first direction is transverse to the second direction. 9 . The joint component according to claim 7 , wherein the protrusion is a first protrusion and further comprises a second protrusion disposed opposite to the first protrusion. 10 . The joint component according to claim 7 , wherein the recess is a first recess and further comprising a second recess disposed opposite to the first recess.

11. The joint component of any one of claims 1 to 3, wherein the deflectable portion is provided between the locking member and the second end of the joint body.

12. A kit comprising: A joint component as claimed in any one of the preceding claims; as well as a bone anchor having: a bone anchor recess formed therein, the bone anchor recess extending from a first end; a bone engaging outer surface extending from the first end to a second end opposite the first end, the bone anchor recess having: a first peripheral portion adjacent the first end, the first peripheral portion configured to engage the locking member of the joint component; and a second peripheral portion between the first peripheral portion and the second end, the second peripheral portion configured to engage the deflectable portion.

13. The kit of claim 12 , further comprising a bracket having a first end and a second end, the bracket being configured to engage the bone anchor recess of the bone anchor at least at the second peripheral portion, wherein the first end of the bracket includes a bracket recess formed therein, the bracket recess having: a first peripheral portion adjacent to the first end, the first peripheral portion being configured to engage the locking member of the joint component; and a second peripheral portion between the first peripheral portion and the second end, the second peripheral portion being configured to engage the deflectable portion.

14. A humeral component, comprising: a humeral anchor configured to be anchored in bone, the humeral anchor comprising a first end, a second end, and a recess extending between the first end and the second end, the recess being accessible from the first end of the humeral anchor and comprising a first peripheral portion adjacent the first end and a second peripheral portion adjacent the first peripheral portion; a joint assembly configured to be inserted into the recess to be secured therein to the humeral anchor, the joint assembly comprising a joint body having: an articular surface disposed on or adjacent a first end of the joint body; and a humeral anchor interface disposed between the first end and the second end of the joint body, the humeral anchor interface comprising: a channel formed in a circumferential surface of the joint body; a locking member disposed in the channel, the locking member comprising: an arcuate member disposed at least partially within the channel of the joint body; and one or more elastic bodies having a first end extending from the arcuate member and a second end disposed radially inwardly of the arcuate member, the elastic body being disposed within the channel of the joint body; and a deflectable protrusion disposed at the second end of the joint body; wherein the deflectable protrusion is configured to be positioned in the second peripheral portion of the recess and, when so positioned, deflect circumferentially to provide a friction load on a surface of the second peripheral portion, thereby providing a load between the locking member and a surface of the first peripheral portion.

15. The humeral component of claim 14, wherein the deflectable projection comprises at least two segments cantilevered from a central portion of the joint body to the second end of the joint body.

16. The humeral component of claim 15, further comprising a compression groove disposed between each of the at least two segments.

17. The humeral component of any one of claims 14 to 15, wherein the deflectable projection includes a tapered surface disposed on an outer periphery thereof.

18. The humeral component of claim 15, wherein the deflectable projection comprises four segments, each segment comprising the second end cantilevered from a central portion of the joint body to the joint body.

19. The humeral component of any one of claims 14 to 16, wherein the deflectable projection comprises a blind hole along a centerline of the joint body.

20. The humeral component of any one of claims 14 to 16, wherein the deflectable projection is configured to engage a surface surrounding the second peripheral portion of the recess of the humeral anchor before the locking member engages the first peripheral portion.

21. The humeral component of any one of claims 14 to 16, wherein the humeral anchor comprises a stemless core.

22. The humeral component of any one of claims 14 to 16, wherein the humeral anchor comprises a stemmed anchor.

23. The humeral component of any one of claims 14 to 16, wherein the humeral anchor comprises: a first portion configured to be inserted into a resected humerus; and a second portion configured to be coupled with the first portion, the recess being formed in the second portion.

24. The humeral component of claim 23, wherein the second portion comprises a bracket configured to engage the joint component.

25. The humeral component of any one of claims 14 to 16, wherein at least one of a protrusion and a recess provided in the humeral anchor interface is configured to form an interference fit with a protrusion or a recess formed in the first peripheral portion of the recess of the humeral anchor.

26. The humeral component of any one of claims 14 to 16, wherein the deflectable projection is disposed between the locking member and the second end of the joint body.

27. A shoulder joint prosthesis assembly, comprising: A bone anchor comprising a metal body having a bone engaging side to be placed against bone and an assembly side opposite the bone engaging side, the assembly side comprising: a recess disposed about a mounting area; and a channel disposed circumferentially about the mounting area, the channel comprising a first retaining surface; A joint assembly, comprising: a polymeric body extending along a central insertion axis between a first portion configured to be inserted into the mounting area and a second portion opposite the first portion, the second portion including an articular surface; and A locking member, the locking member comprising: an arcuate member disposed at least partially around the first portion, the arcuate member including a second retaining surface; and an elastic body having a first end extending from the arc-shaped member and a second end disposed radially inward of the arc-shaped member; Wherein the second retaining surface is arranged at an angle to a plane arranged perpendicular to the central insertion axis, so that the first portion of the second retaining surface is arranged to be farther away from the joint surface than the first retaining surface in the direction of the central insertion axis when the joint assembly is engaged with the bone anchor, and the second portion of the second retaining surface is arranged to be closer to the joint surface than the first retaining surface in the direction of the central insertion axis when the joint assembly is engaged with the bone anchor.

28. The shoulder prosthesis assembly of claim 27, wherein the angle is greater than 0 degrees.

29. The shoulder prosthesis assembly of claim 27 or 28, wherein the first portion of the polymeric body includes a recess configured to receive the elastomeric body in only one position.

30. The shoulder prosthesis assembly of any one of claims 27 to 28, wherein the resilient body stores strain energy when a deflecting force is applied to deflect the locking member away from a neutral position, and releases the strain energy to return the locking member toward the neutral position after the deflecting force is removed.

31. The shoulder prosthesis assembly of any one of claims 27-28, wherein the second end of the elastomeric body is coupled to the polymeric body.

32. The shoulder prosthesis assembly of any one of claims 27-28, wherein an inner periphery or an outer periphery of the arcuate member includes a stiffness reducing feature.

33. The shoulder prosthesis assembly of any one of claims 27 to 28, wherein the elastic body comprises: a radial portion extending radially inward from the first end of the arcuate member; and an arcuate portion extending from the radial portion.

34. The shoulder prosthesis assembly of claim 33, wherein the arcuate portion is concentric with the arcuate member.

35. The shoulder prosthesis assembly of claim 33, wherein the arcuate member defines a gap between the first end of the arcuate member and the second end of the arcuate member.

36. The shoulder prosthesis assembly of claim 35, wherein the arcuate portion overlaps the gap.

37. The shoulder prosthesis assembly of any one of claims 27-28, wherein the locking member further comprises a second arcuate member disposed at least partially around the first portion.

38. The shoulder prosthesis assembly of claim 37, wherein the resilient body extends between the first arcuate member and the second arcuate member.

39. The shoulder prosthesis assembly of claim 38, wherein the elastomeric body includes a base at the second end of the elastomeric body, the base configured to be secured in the recess of the first portion of the polymeric body.

40. The shoulder prosthesis assembly of claim 39, wherein the resilient body includes a first deflectable member at the other end, the first deflectable member extending from the base to the first end of the arcuate member.

41. The shoulder prosthesis assembly of claim 40, wherein the resilient body further comprises a second deflectable member extending from the base to the second arcuate member.

42. A shoulder prosthesis assembly as described in any one of claims 27 to 28, wherein the locking member includes at least one additional elastic body, the at least one additional elastic body having a first end extending from the arcuate member and a second end arranged radially inward of the arcuate member, and the at least one additional elastic body is circumferentially spaced from the elastic body.

43. The shoulder prosthesis assembly of claim 42, wherein the at least one additional elastic body comprises two elastic bodies.

44. A shoulder joint prosthesis assembly, comprising: A bone anchor comprising a metal body having a bone engaging side to be placed against bone and an assembly side opposite the bone engaging side, the assembly side comprising: a recess disposed about a mounting area; and a channel disposed circumferentially about the mounting area, the channel comprising a first retaining surface; A joint assembly, comprising: a polymeric body extending along a central insertion axis between a first portion configured to be inserted into the mounting area and a second portion opposite the first portion, the second portion including an articular surface; and A locking member, the locking member comprising: an arc-shaped member disposed around the first portion; and An elastic body has a first end extending from the arcuate member and a second end disposed radially inward of the arcuate member, the elastic body being configured to center the arcuate member relative to the central insertion axis.

45. The shoulder prosthesis assembly of claim 44, further comprising a locator body at the second end of the elastomeric body, the locator body configured to engage the polymeric body in a predefined position and / or orientation.

46. ​​The shoulder prosthesis assembly of claim 45, wherein the polymeric body includes a recess, and wherein the locator body is further configured to be disposed in the recess in only one rotational position relative to the central insertion axis.

47. The shoulder prosthesis assembly of any one of claims 44 to 46, wherein the second end of the elastomeric body is coupled to the polymeric body.

48. A shoulder prosthesis assembly as described in any one of claims 44 to 46, wherein the arcuate member includes a second retaining surface, the second retaining surface is arranged along a plane arranged at an acute angle to a plane perpendicular to the central insertion axis, and when the locking member is engaged with the channel of the bone anchor, the first retaining surface is arranged between the inner end and the outer end of the second retaining surface.

49. The shoulder prosthesis assembly of any one of claims 44 to 46, wherein the elastic body stores strain energy when a deflecting force is applied to deflect the locking member away from a neutral position, and releases the strain energy to return the locking member toward the neutral position after the deflecting force is removed.

50. The shoulder prosthesis assembly of any one of claims 44 to 46, wherein an inner periphery or an outer periphery of the arcuate member includes a stiffness reducing feature.

51. A shoulder joint prosthesis assembly, comprising: a polymeric body extending along a central insertion axis between a first portion configured to be inserted into a bone anchor and a second portion opposite the first portion, the second portion including an articular surface; as well as a locking member, the locking member comprising: an arc-shaped member disposed around the first portion; and a keeper body having a first end coupled to the arcuate member and a second end coupled to the polymeric body, the keeper body being configured to be received in the recess of the polymeric body in a predefined orientation and position, The keeper body is configured to store strain energy when a deflecting force is applied to deflect the first end of the locking member away from a centered position, and to release the strain energy to return the locking member toward the centered position after the deflecting force is removed.

52. The shoulder prosthesis assembly of claim 51, wherein the predefined orientation is a rotational position relative to the central insertion axis.

53. The shoulder prosthesis assembly of claim 51, wherein the predefined position is a neutral position.

54. The shoulder prosthesis assembly of any one of claims 51 to 53, further comprising: A bone anchor comprising a metal body having a bone engaging side to be placed against bone and an assembly side opposite the bone engaging side, the assembly side comprising: a recess disposed about a mounting area, the recess configured to receive the first portion of the polymeric body of the shoulder prosthesis assembly; and a groove disposed circumferentially about the mounting area, the groove configured to receive the arcuate member of a connecting component.

55. The shoulder prosthesis assembly of any one of claims 51 to 53, wherein the keeper body is coupled to the polymer body.

56. The shoulder prosthesis assembly of any one of claims 51 to 53, wherein an inner periphery or an outer periphery of the arcuate member includes a stiffness reducing feature.

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