Orthopedic implant comprising a peripheral orifice arrangement

Abstract

The present disclosure relates to orthopedic implants (20) and methods for repairing bone defects and restoring joint function. The implants disclosed herein include an augmented geometry (40) that can approximate the surface contour or bone void along the surgical site, and include a pattern of peripheral apertures (44) that can be used to improve fixation of the implant at the surgical site.

Description

[0001] Cross-referencing related applications

[0002] This application claims priority to U.S. Patent Application No. 16 / 837,201, filed April 1, 2020. Background Technology

[0003] This disclosure relates to orthopedic surgery, and more specifically, to orthopedic implants and methods for repairing bone defects and restoring joint function.

[0004] Many bones in the human musculoskeletal system contain articular surfaces. These surfaces connect with other bones to facilitate different types and degrees of joint movement. Articular surfaces may erode over time due to repeated use or wear, experience bone loss, or fracture due to traumatic impact. These types of bone defects can lead to joint instability and pain.

[0005] Bone defects may occur along the articular surface of the glenoid bone. Some techniques utilize bone grafts and / or implants to fill defects in the glenoid bone. Implants can be secured to the glenoid using one or more fasteners. Summary of the Invention

[0006] This disclosure relates to orthopedic implants and methods. The implants can be used during methods for repairing bone defects. The implants described herein can be used to restore joint function and include peripheral openings arranged in one or more patterns for receiving fasteners to secure the implant at the surgical site.

[0007] An orthopedic implant may include a substrate and an anchoring rod extending outward from a posterior surface. The substrate includes a plate body extending along a longitudinal axis between an anterior and a posterior surface. The plate body may include a main portion establishing the anterior surface, an amplification portion extending outward from the main portion to establish an amplification surface segment, and a plurality of peripheral apertures circumferentially distributed around the longitudinal axis. The periphery of the plate body may be generally circular. The peripheral apertures may be sized to receive corresponding fasteners for securing the substrate to a surgical site. The amplification surface segment may be arranged laterally relative to the longitudinal axis, and a first reference plane and a second reference plane, arranged perpendicularly to each other, extend along the longitudinal axis such that the first reference plane bisects the amplification surface segment. All peripheral apertures of the substrate arranged around the longitudinal axis may be circumferentially offset from both the first and second reference planes.

[0008] A kit for arthroplasty can include a set of base plates and a plurality of fasteners. Each base plate of the set of base plates can include a plate body having a body portion and a generally wedge-shaped augmentation portion that cooperate to establish an anterior surface and a posterior surface of the plate body, and a plurality of peripheral apertures extending between the anterior surface and the posterior surface. The peripheral apertures can be sized to receive respective ones of the fasteners to secure the plate body to a surgical site. A first reference plane can extend along a longitudinal axis of the plate body to bisect the augmentation portion. The set of base plates can include a first base plate and a second base plate, the peripheral apertures of the first base plate can be distributed circumferentially about the longitudinal axis to establish a first pattern such that one or more of the peripheral apertures extend along the first reference plane, and the peripheral apertures of the second base plate can be distributed circumferentially about the longitudinal axis to establish a second pattern that can be circumferentially offset from the first pattern with respect to the longitudinal axis, and the first and second patterns can have a common circumferential spacing between respective peripheral apertures.

[0009] A method of installing an orthopedic implant at a surgical site can include selecting a base plate from a set of base plates based on a surface profile of the surgical site. Each base plate of the set of base plates can include a plate body having a body portion and a generally wedge-shaped augmentation portion that cooperate to establish an anterior surface and a posterior surface of the plate body, and a plurality of peripheral apertures can extend between the anterior surface and the posterior surface. A first reference plane can extend along a longitudinal axis to bisect the augmentation portion. The set of base plates can include a first base plate and a second base plate, the peripheral apertures of the first base plate can be arranged to establish a first pattern such that one or more of the peripheral apertures extend along the first reference plane, and the peripheral apertures of the second base plate can be arranged to establish a second pattern that is circumferentially offset from the first pattern with respect to the longitudinal axis, and the first and second patterns can have a common circumferential spacing between respective peripheral apertures. The method can include positioning the selected base plate with respect to the surface profile of the surgical site, and can include positioning a fastener in a respective one of the peripheral apertures to secure the selected base plate to the surgical site. BRIEF DESCRIPTION OF DRAWINGS

[0010] Figure 1 A side view of an exemplary orthopedic implant including a base plate and a glenosphere is shown.

[0011] Figure 2 A perspective view of the implant of Figure 1 is shown with the glenosphere in an uninstalled position.

[0012] Figure 3 A plan view of the base plate of Figure 2 is shown including an exemplary pattern or layout of peripheral apertures.

[0013] Figure 4 A perspective view of the base plate of Figure 2 is shown.

[0014] Figure 5 A cross-sectional view of the implant of Figure 1 is shown.

[0015] Figure 6 A perspective view of the substrate of Figure 2 is shown.

[0016] Figure 7 An exemplary pattern or layout of peripheral apertures is shown.

[0017] Figure 8 A perspective view of the substrate is shown.

[0018] Figure 9 A plan view of the substrate of Figure 8 is shown, including an exemplary pattern or layout of peripheral apertures.

[0019] Figure 10 A cross-sectional view of the substrate of Figure 8 is shown.

[0020] Figure 11 A perspective cross-sectional view of the substrate of Figure 10 is shown.

[0021] Figure 12 A perspective view of the substrate of Figure 8 is shown.

[0022] Figure 13 A cross-sectional view of the substrate of Figure 12 is shown.

[0023] Figures 14-15 An exemplary pattern or layout of peripheral apertures is shown.

[0024] Figure 16 A side view of an exemplary orthopedic implant including a substrate and a glenosphere is shown.

[0025] Figure 17 A perspective view of the implant of Figure 14 is shown, with the glenosphere in an unmounted position.

[0026] Figures 18-19 A cross-sectional view of the substrate of Figure 16 is shown.

[0027] Figure 20 An exemplary pattern or layout of peripheral apertures is shown.

[0028] Figures 20A-20B An exemplary substrate profile is shown.

[0029] Figure 21 An exemplary method of mounting an orthopedic implant at a surgical site is shown.

[0030] Figure 22 An exemplary implant is shown positioned at a surgical site.

[0031] Figure 23 An exemplary implant is shown positioned at a surgical site.

[0032] Figures 24A-24E An exemplary implant is shown positioned at a surgical site. Figure 2 A substrate of the implant.

[0033] Figures 25A-25E An exemplary implant is shown positioned at a surgical site. Figure 8 A substrate of the implant.

[0034] Figure 26 A plan view of an exemplary orthopedic implant is shown, including a substrate having an augment portion in a first position.

[0035] Figure 27 A plan view of an exemplary orthopedic implant is shown, including a substrate having an augment portion in a second position. Figure 26 A plan view of an exemplary orthopedic implant is shown, including a substrate having an augment portion in a second position. DETAILED DESCRIPTION

[0036] The present disclosure relates to orthopedic implants and methods for repairing bone defects. The implants described herein can be used during arthroplasty surgery and incorporated into shoulder joint prostheses for restoring function to shoulders suffering from advanced cartilage disease. The disclosed implants can be used to address complex glenoid lesions that can have bone deficiency at many different orientations relative to the superior / inferior (S / I) plane of the glenoid surface. The implants can include an augment geometry configured to fill a bone void along the glenoid surface. The disclosed implants can include peripheral apertures arranged in a pattern. The disclosed patterns can be used to improve fixation of the respective implant at a surgical site, which can result in improved healing.

[0037] An orthopedic implant according to exemplary aspects of the present disclosure can include a substrate and can include an anchor stem extending outwardly from a posterior surface, the substrate including a plate body extending between an anterior surface and the posterior surface along a longitudinal axis. The plate body can include a body portion establishing the anterior surface and can include an augment portion extending outwardly from the body portion to establish an augment surface segment of the posterior surface. A plurality of peripheral apertures can be distributed circumferentially about the longitudinal axis. The peripheral apertures can be sized to receive respective fasteners for securing the substrate to a surgical site. The augment surface segment can be arranged transversely relative to the longitudinal axis, and a first reference plane and a second reference plane can be arranged perpendicularly to one another along the longitudinal axis such that the first reference plane bisects the augment surface segment, and all of the peripheral apertures of the substrate arranged about the longitudinal axis can be circumferentially offset from both the first reference plane and the second reference plane.

[0038] In some embodiments, the perimeter of the plate body can be substantially circular.

[0039] In some embodiments, the anchor stem can extend along the longitudinal axis.

[0040] In some embodiments, the plurality of peripheral apertures can be substantially equally distributed about the longitudinal axis.

[0041] In some embodiments, the plurality of peripheral apertures can include a total of four peripheral apertures.

[0042] In some embodiments, the third reference plane can extend along the longitudinal axis such that the first reference plane and the third reference plane establish an acute angle, and a pair of peripheral apertures can be arranged circumferentially along the third reference plane.

[0043] In some embodiments, the acute angle can be greater than 0 degrees but less than 45 degrees.

[0044] In some embodiments, the acute angle can be between 30 degrees and 60 degrees.

[0045] In some embodiments, the plurality of peripheral apertures can include a total of four peripheral apertures.

[0046] In some embodiments, the four peripheral apertures can be substantially evenly distributed about the longitudinal axis.

[0047] In some embodiments, the posterior surface can include a second surface segment arranged substantially perpendicular to the longitudinal axis, and the augment surface segment and the second surface segment can join at an interface to establish an obtuse angle.

[0048] In some embodiments, the obtuse angle can be between 140 degrees and 170 degrees.

[0049] In some embodiments, the implant includes a glenosphere including an articulating surface that can have a substantially convex geometry, and the glenosphere can be secured to the baseplate adjacent the anterior surface.

[0050] In some embodiments, the glenosphere can include a recess sized to at least partially receive the body portion of the baseplate.

[0051] In some embodiments, a perimeter of the body portion of the baseplate can be sized to cooperate with a perimeter of the recess to establish a Morse taper connection.

[0052] A kit for arthroplasty according to example aspects of the present disclosure can include a set of base plates and a plurality of fasteners. Each base plate of the set of base plates can include a plate body having a body portion and a generally wedge-shaped augmentation portion that can cooperate to establish an anterior surface and a posterior surface of the plate body, and each base plate can include a plurality of peripheral apertures extending between the anterior surface and the posterior surface. The peripheral apertures can be sized to receive respective ones of the fasteners to secure the plate body to a surgical site. A first reference plane can extend along a longitudinal axis of the plate body to bisect the augmentation portion. The set of base plates can include a first base plate and a second base plate. The peripheral apertures of the first base plate can be distributed circumferentially about the longitudinal axis to establish a first pattern, such that one or more of the peripheral apertures can extend along the first reference plane. The peripheral apertures of the second base plate can be distributed circumferentially about the longitudinal axis to establish a second pattern, the second pattern can be circumferentially offset from the first pattern with respect to the longitudinal axis, and the first pattern and the second pattern can have a common circumferential spacing between respective peripheral apertures.

[0053] In some embodiments, the implant can include an anchor stem that can extend outwardly from the posterior surface along the longitudinal axis. The implant can include a glenosphere that includes an articulating surface that can have a generally convex geometry, and the glenosphere can be releasably secured to a respective one of the base plates adjacent the anterior surface.

[0054] In some embodiments, a perimeter of the body portion can be generally circular, and the peripheral apertures of both the first pattern and the second pattern can be generally equally distributed about the longitudinal axis.

[0055] In some embodiments, a second reference plane can extend along the longitudinal axis and can be perpendicular to the first reference plane, and the second pattern can be established such that all of the peripheral apertures of the second base plate arranged about the longitudinal axis can be circumferentially offset from both the first reference plane and the second reference plane.

[0056] Methods of installing an orthopedic implant at a surgical site in accordance with example aspects of the present disclosure can include selecting a base plate from a set of base plates based on a surface profile of the surgical site. Each base plate of the set of base plates can include a plate body having a body portion and a generally wedge-shaped augmentation portion that can cooperate to establish an anterior surface and a posterior surface of the plate body, and each base plate can include a plurality of peripheral apertures extending between the anterior surface and the posterior surface. A first reference plane can extend along a longitudinal axis to bisect the augmentation portion. The set of base plates can include a first base plate and a second base plate. The peripheral apertures of the first base plate can be arranged to establish a first pattern such that one or more of the peripheral apertures can extend along the first reference plane. The peripheral apertures of the second base plate can be arranged to establish a second pattern that is circumferentially offset from the first pattern with respect to the longitudinal axis, and the first pattern and the second pattern can have a common circumferential spacing between respective peripheral apertures. The methods can include positioning the selected base plate with respect to the surface profile of the surgical site, and can include positioning a fastener in a respective one of the peripheral apertures to secure the selected base plate to the surgical site.

[0057] In some embodiments, the plurality of peripheral apertures can include a total of four peripheral apertures, a second reference plane can extend along the longitudinal axis and can be perpendicular to the first reference plane, two of the peripheral apertures of the first pattern can be arranged along the first reference plane, and the other two of the peripheral apertures of the first pattern can be arranged along the second reference plane, and the second pattern can be established such that all of the peripheral apertures of the second base plate can be circumferentially offset from both the first reference plane and the second reference plane.

[0058] In some embodiments, the anchor stem can extend outwardly from the posterior surface along the longitudinal axis. The methods can include positioning the anchor stem in a bone hole along the surgical site, and can include securing a glenosphere to the selected base plate. The glenosphere can include an articulating surface having a generally convex geometry.

[0059] Figures 1-6 An example orthopedic implant 20 is shown. Implant 20 can be used in various surgical procedures, such as arthroplasty procedures to repair a joint. For example, implant 20 can be incorporated into a shoulder joint prosthesis. Although the implants disclosed herein primarily refer to repairing defects in the glenoid during shoulder reconstruction procedures such as reverse total shoulder procedures, it should be understood that the disclosed implants can be used in other locations and other surgical procedures in a patient.

[0060] Reference Figures 1-2 Implant 20 includes a base plate 22 and a glenosphere 24 releasably secured to base plate 22. Base plate 22 includes an anterior (or first) surface 28( Figure 2 ) and a posterior surface 30( Figure 2The plate body 26 extends between an anterior (or first) surface 28 and a posterior (or second) surface 30 that is generally opposite the anterior surface 28. The posterior surface 30 can generally correspond to a medial side of a patient and the anterior surface 28 can generally correspond to a lateral side of the patient, for example, when implanted in a surgical site.

[0061] The baseplate 22 can include a stem or anchor rod 32 that extends outward from the posterior surface 30. A central axis of the anchor rod 32 can be offset from the longitudinal axis A. In Figure 2 In particular embodiments, the anchor rod 32 extends along the longitudinal axis A and has a generally cylindrical geometry. The anchor rod 32 can be sized for insertion into a glenoid or bone hole that can be formed to secure the baseplate 22, for example.

[0062] The anchor rod 32 can include a first rod portion 34 and a second rod portion 36. The first rod portion 34 can be integrally formed with the plate body 26. The anchor rod 32 and the plate body 26 can be separate and distinct components. The first rod portion 34 can be mechanically attached or otherwise secured to the second rod portion 36 using various techniques such as threading, bonding, and welding, among others. In Figures 5-6 In particular embodiments, the first rod portion 34 and the second rod portion 36 are connected via a reverse taper connection. The anchor rod 32 can be a single component.

[0063] With reference to Figure 2 , continuing with reference to Figure 1 , the plate body 26 includes a body portion 38 and an augmentation portion 40 that extends outward from the body portion 38. The body portion 38 can establish a perimeter 39 of the plate body 26. The perimeter 39 of the plate body 26 can have an elliptical geometry, for example. In Figures 3-4 In particular embodiments, the perimeter 39 of the plate body 26 has a generally circular geometry. The generally circular geometry can reduce reaming width and complexity in preparing a surgical site to accept the implant 20. The body portion 38 establishes the anterior surface 28 of the plate body 26. The augmentation portion 40 establishes at least a portion of the posterior surface 30.

[0064] The baseplate 22 and the glenosphere 24 can be formed using various materials. The baseplate 22 and the glenosphere 24 can be made of a metallic material. The implant 20 can include one or more coatings or layers 41 deposited along a surface of the baseplate 22. An example coating 41 can include calcium phosphate (CaP) having a porous structure to promote bone growth.

[0065] The augmentation portion 40 can be sized to approximate various defect geometries and surface contours that can be encountered along a surgical site. The augmentation portion 40 can be configured to at least partially fill a bony void in a glenoid. The augmentation portion 40 can be sized to establish a relatively smaller or larger overall volume of the baseplate 22. For example, the augmentation portion 40 can have a generally wedge-shaped geometry and can extend across an entire width of the body portion 38 (e.g., a "full wedge"), as shown in Figure 1 and 5 -6. The augmentation portion 40 can have other shapes or profiles, such as a generally stepped geometry.

[0066] The augmentation portion 40 extends outwardly from the body portion 38 to establish an augmented surface segment 42 of the posterior surface 30. The augmented surface segment 42 can be generally planar. The augmented surface segment 42 can be generally concave or convex. The augmented surface segment 42 can extend generally obliquely or across an entire width of the body portion 38, with the augmented surface segment 42 disposed laterally relative to the longitudinal axis A, as shown in Figure 2 and 4 The augmentation portion 40 can be sized such that the innermost (e.g., lowest) and outermost (e.g., highest) points of the augmented surface segment 42 relative to the longitudinal axis A are defined along a perimeter of the augmentation portion 40.

[0067] The augmented surface segment 42 can be disposed at various angles relative to the body portion 38 to establish a relatively smaller or larger overall volume of the baseplate 22. The augmented surface segment 42 can establish an acute angle a relative to a reference plane that is perpendicular to the longitudinal axis A, as shown in Figure 5 The angle a can be greater than 0 degrees, but can be less than 45 degrees. For example, the angle a can be equal to or greater than about 5 degrees and less than or equal to about 45 degrees. The angle a can be about 10 or 20 degrees. For purposes of this disclosure, the term "about" means ±5% of the stated value, unless otherwise disclosed.

[0068] The baseplate 22 can include a plurality of peripheral apertures (or holes) 44 along the anterior surface 28 of the plate body 26. The peripheral apertures 44 can extend between the anterior surface 28 and the posterior surface 30 of the plate body 26, with at least some or each of the peripheral apertures 44 extending through a thickness of the augmentation portion 40 between the augmented surface segment 42 of the anterior surface 28 and the posterior surface 30, as shown in Figure 5 The size of each peripheral aperture 44 can be set to receive a respective peripheral fastener PF (shown in dashed lines in Figure 3 for illustrative purposes) for securing the baseplate 22 to a surgical site. Example fasteners can include compression screws, as shown by the peripheral fasteners PF of Figures 24A-25E .

[0069] The baseplate 22 can include one or more recesses 50 extending inwardly from the anterior surface 28 of the plate body 26. The recesses 50 can be sized to receive an insert or tool T to insert or otherwise position the baseplate 22 along a surgical site (shown in dashed lines in Figure 6 for illustrative purposes). The recesses 50 can be omitted.

[0070] The glenosphere 24 includes an articulating surface 25 that can have a generally convex geometry, as shown in Figure 2 and 5 The articulating surface 25 can cooperate with a humeral component having a generally concave complementary geometry. The anterior surface 28 can have a generally concave geometry, as shown in Figures 5-6 The glenosphere 24 can be omitted, and the anterior surface 28 can act as an articulating surface that cooperates with a humeral component having a generally convex complementary geometry.

[0071] The glenosphere 24 can be mechanically attached or releasably secured to the baseplate 22 adjacent the anterior surface 28, as shown in Figure 1 and 5 In Figure 5 , the glenosphere 24 can include a recess 27 sized to at least partially receive the body portion 38 of the baseplate 22 adjacent the anterior surface 28. The recess 27 can be sized to surround an edge of the baseplate 22 along the anterior surface 28. The perimeter of the body portion 38 of the baseplate 22 can be sized to cooperate with the perimeter of the recess 27 to establish a Morse taper connection to secure the glenosphere 24 to the baseplate 22. The plate body 26 can include a central aperture 43 extending along the longitudinal axis A. The glenosphere 24 can include an aperture 29 sized to receive a fastener F (shown in dashed lines in Figure 5 for illustrative purposes). The fastener F can include threads that cooperate with threads along the central aperture 43. The fastener F can be used to align and / or secure the glenosphere 24 to the baseplate 24 relative to the longitudinal axis A. The fastener F and / or the apertures 29, 43 can be omitted. The anchor stem 32 can be omitted, and the aperture 43 can be sized to receive a fastener, such as a compression screw, to secure the baseplate 24 to a surgical site (shown in dashed lines by a fastener F' in Figure 7 for illustrative purposes).

[0072] With reference to Figure 3 , continued reference is made to Figures 1-2The peripheral orifices 44 can be distributed circumferentially about the longitudinal axis A to establish a respective pattern (or layout) 48. Each pattern 48 can be predefined relative to the geometry of the substrate 22 and the amplification portion 40. The perimeter of the amplification portion 40 is shown in dashed line for illustrative purposes. The pattern 48 can be defined relative to the front surface 28 of the plate body 26. The peripheral orifices 44 can be arranged relative to the first reference plane Rl and the second reference plane R2 to establish the pattern 48. The first reference plane Rl and the second reference plane R2 can be arranged perpendicular to one another and can extend along the longitudinal axis A such that the first reference plane Rl can bisect the amplification surface segment 42 of the amplification portion 40. The amplification portion 40 can be sized such that the amplification surface segment 42 is defined along the first reference plane Rl relative to the innermost (e.g., lowest) and outermost (e.g., highest) points of the longitudinal axis A.

[0073] Figure 4 A perspective view of the substrate 22 is shown relative to the reference plane Rl. Figure 5 A cross-sectional view of the substrate 22 is shown taken along the first reference plane Rl and through the maximum thickness of the amplification portion 40. Figure 6 A cross-sectional view of the substrate 22 is shown taken along the second reference plane R2. The first reference plane Rl and the second reference plane R2 can divide the substrate 22 into four quadrants I-VI. The substrate 22 can be symmetrical on opposite sides of the first reference plane Rl. The substrate 22 can be asymmetrical on opposite sides of the first reference plane Rl.

[0074] The pattern 48 can be defined such that one or more of the peripheral orifices 44 extend along the first reference plane Rl. In Figure 3 In one example, the pattern 48 can be established from a total of four peripheral orifices 44. The four peripheral orifices 44 can be spaced apart at approximately 90 degree increments about the longitudinal axis A such that the orifices 44 are substantially equally distributed about the longitudinal axis A. Two of the peripheral orifices 44 can extend along and be aligned with the first reference plane Rl (indicated at 44-1, 44-3) and the other two of the peripheral orifices 44 can extend along and be aligned with the second reference plane R2 (indicated at 44-2, 44-4). The pattern 48 can be defined such that the substrate 22 is free of any peripheral orifices between adjacent pairs of the peripheral orifices 44.

[0075] Other example patterns can be utilized with any of the substrates disclosed herein and can utilize fewer or more than four peripheral orifices. One or more of the peripheral orifices 44-1 through 44-4 can be omitted. For example, orifices 44-2, 44-4 can be omitted such that the pattern 48 is established from a pair of opposing orifices 44-1, 44-3, or vice versa. In Figure 7In particular embodiments, the pattern 48' includes a total of three peripheral apertures 44' (indicated at 44-1' / 44-3', 44-5', and 44-6'). The apertures 44-1' / 44-3' can extend along the first reference plane R1'. The apertures 44-5', 44'6 can be circumferentially offset from or otherwise spaced apart from both the first reference plane R1' and the second reference plane R2'.

[0076] Reference is made to Figure 5 Continuing reference is made to Figures 2-4 Each peripheral aperture 44 can extend along a respective passage axis PA. The passage axis PA can be parallel to the longitudinal axis A. In Figure 5 In particular embodiments, the passage axis PA is generally transverse to the longitudinal axis A, which can increase the spacing between the ends of adjacent fasteners inserted through the peripheral apertures 44. At least some of the peripheral apertures 44 can intersect the respective notches 45 along the perimeter 39 of the plate body 26.

[0077] Various patterns or layouts of peripheral apertures can be established to approximate various different surface contours and void geometries that a surgeon can encounter in preparing for a procedure. A set of orthopedic implants can be provided to a surgeon in a kit for arthroplasty, including any of the implants and patterns disclosed herein. The kit can include a set of base plates having any of the base plates, augment geometries, and peripheral aperture patterns disclosed herein. The kit can also include fasteners that are received in the respective peripheral apertures to secure the respective base plates to a surgical site.

[0078] Figures 8-13 An example orthopedic implant 120 is shown. Reference is made to Figure 8 The implant 120 can include a base plate 122 having a plate body 126 extending along a longitudinal axis A between an anterior (or first) surface 128 and a posterior (or second) surface 130 generally opposite the anterior surface 128. The base plate 122 can include a central strut or anchor rod 132 that can extend outwardly along the longitudinal axis A from the posterior surface 130. The plate body 126 can include a body portion 138, and an augment portion 140 can extend outwardly from the body portion 138. The body portion 138 can establish the anterior surface 128 of the plate body 126. The augment portion 140 can establish at least a portion of the posterior surface 130 and can have a generally wedge-shaped geometry.

[0079] The base plate 122 can include a plurality of peripheral apertures (or holes) 144 along the anterior surface 128 of the plate body 126 for securing the base plate 122 to a surgical site. The peripheral apertures 144 can extend between the anterior surface 128 and the posterior surface 130, with at least some or each of the peripheral apertures 144 extending through a thickness of the augment portion 140 between the augment surface segments 142 of the anterior surface 128 and the posterior surface 130, asFigure 13 Each peripheral aperture 144 can be sized to receive a respective fastener for securing the substrate 122 to a surgical site.

[0080] Referring to Figure 9 , with continued reference to Figure 8 , the peripheral apertures 144 can be distributed circumferentially about the longitudinal axis A to establish a respective pattern (or layout) 148. The peripheral apertures 144 can be arranged relative to the first reference plane Rl and the second reference plane R2 such that the pattern 148 is different from the pattern 48 of the peripheral apertures 44 Figure 3 ). The first reference plane Rl can bisect the augmented surface segment 142 of the augmented portion 140 (shown in dashed lines for illustrative purposes). At least some of the peripheral apertures 144 can be circumferentially offset (e.g., arranged “diagonally”) or otherwise spaced apart from both the first reference plane Rl and the second reference plane R2 relative to the longitudinal axis A. In Figure 9 , all of the peripheral apertures 144 of the substrate 122 arranged about the longitudinal axis A can be circumferentially offset relative to the longitudinal axis A from both the first reference plane Rl and the second reference plane R2.

[0081] Various numbers of peripheral apertures 144 can be used to establish the pattern 148. In Figure 9 , the substrate 122 can include a total of four peripheral apertures 144 (indicated at 144-1 through 144-4). However, it should be appreciated that fewer than or more than four peripheral apertures 144 can be utilized in accordance with the teachings disclosed herein. The peripheral apertures 144 can be substantially uniformly distributed about the longitudinal axis A. The peripheral apertures 144 can be non-uniformly distributed about the longitudinal axis A such that some of the apertures 144 are relatively closer or farther apart than other adjacent pairs of the apertures 144.

[0082] The substrates 22, 122 can be provided as a set of substrates (e.g., a first substrate and a second substrate), with each substrate 22, 122 establishing a respective pattern 48, 148 (e.g., a first pattern and a second pattern). The peripheral apertures 44 of the pattern 48 and the peripheral apertures 144 of the pattern 148 can have a common number of peripheral apertures 44 / 144 and can have a common circumferential spacing between respective adjacent apertures 44 / 144 relative to the longitudinal axis A. The substrate 122 can have the same outer profile or shape as the substrate 22.

[0083] The peripheral apertures 144 can be arranged such that the pattern 148 is circumferentially offset relative to the longitudinal axis A from the pattern 48 Figure 3 ). For example, the substrate 122 can be devoid of any peripheral apertures 144 along the first reference plane Rl, as Figures 9-11 illustrated. Figures 10-11A cross-sectional view of the substrate 122 taken along the first reference plane R1 and through the maximum thickness of the amplification portion 140 is shown. The peripheral apertures 44, 144 of the two patterns 48, 148 can be substantially equally distributed about the longitudinal axis A.

[0084] In Figure 9 , the third reference plane R3 can extend along the longitudinal axis A such that the first reference plane R1 and the third reference plane R3 establish an acute angle β. The fourth reference plane R4 can extend along the longitudinal axis A such that the second reference plane R2 and the fourth reference plane R4 establish an acute angle The third reference plane R3 can be perpendicular to the fourth reference plane R4. One or more of the apertures 144 can be arranged circumferentially along the third reference plane R3, and one or more of the apertures 144 can be arranged circumferentially along the fourth reference plane R4. One pair of opposing apertures 144-1, 144-3 can be arranged along the third reference plane R3 (see also Figures 12-13 ), and another pair of opposing apertures 144-2, 144-4 can be arranged along the fourth reference plane R4, as shown in Figure 9 . The angle β and / or the angle may be greater than 0 degrees, for example between about 25 degrees and about 75 degrees, or more narrowly between about 30 degrees and about 60 degrees, for example about 45 degrees. The angle β and / or the angle may be greater than 0 degrees, but can be less than 45 degrees. The angle β and the angle may be the same, or can be different. The angle β and the angle may be equal, and the pattern 148 of apertures 144 can be circumferentially offset or shifted from the pattern 48 of apertures 44 by the angle β with respect to the longitudinal axis A.

[0085] In Figure 14 , the pattern 148' can be circumferentially offset or shifted from the pattern 48 (see Figure 3 ) in a counterclockwise direction with respect to the longitudinal axis A'. The apertures 144' of the pattern 148' can be circumferentially offset by an amount less than the apertures 144 of the pattern 148. The angle β' and the angle may be less than 45 degrees, for example about 30 degrees. In Figure 15 , the pattern 148" can be circumferentially offset or shifted from the pattern 48 in a clockwise direction with respect to the longitudinal axis A". The angle β" and the angle may be less than 45 degrees, for example about 30 degrees. The values of the disclosed angles β and / or angles may be positive (e.g., clockwise) or negative (e.g., counterclockwise) with respect to the respective reference planes R1, R2.

[0086] Less than or more than four circumferentially offset peripheral apertures can be utilized. One or more of the peripheral apertures 144-1 through 144-4 can be omitted. For example, apertures 144-2, 144-4 can be omitted, such that the pattern 148 can be established by a pair of opposing apertures 144-1, 144-3, or vice versa. As another example, apertures 144-1, 144-2 can be omitted, such that the pattern 148 is established by apertures 144-3, 144-4, or vice versa.

[0087] Figures 16-19 An exemplary orthopedic implant 220 is shown. Referring to Figures 16-17 , the implant 220 includes a base plate 222 having a plate body 226 extending along a longitudinal axis A between an anterior (or first) surface 228 and a posterior (or second) surface 230 that can be generally opposite the anterior surface 228. The base plate 222 can include a central post or anchor stem 232 that can extend outwardly from the posterior surface 230 along the longitudinal axis A. The plate body 226 includes a body portion 238 and an augment portion 240 that can extend outwardly from the body portion 238. The body portion 238 can establish the anterior surface 228 of the plate body 226. The augment portion 240 can establish at least a portion of the posterior surface 230 and can have a generally wedge-shaped geometry.

[0088] The augment portion 240 can be sized to extend less than the entire width of the body portion 238 (e.g., a "partial wedge"). The posterior surface 230 can include an augment surface segment 242 established by the augment portion 240 and a second surface segment 247 that are joined at an interface 246. The second surface segment 247 can be disposed along a reference plane that can be generally perpendicular to the longitudinal axis A, as shown in Figure 19 . Figure 19 A cross-sectional view through the maximum thickness of the augment portion 240 is shown. The augment portion 240 can be sized to span about ½ of the width of the plate body 226 with the interface 246 established along the longitudinal axis A (e.g., a "half wedge"), as shown in Figure 16 . The augment portion 240 can be sized to be less than or greater than ½ of the width of the plate body 226, such as about ¾ of the width of the plate body 226 (e.g., a "¾ wedge").

[0089] The augment surface segment 142 can establish an acute angle a relative to a reference plane that can be perpendicular to the longitudinal axis A, as shown in Figure 19 . For example, the angle a can be equal to or greater than about 5 degrees and more narrowly equal to or less than about 45 degrees. The angle a can be about 15, 25, or 35 degrees. The geometry of the augment portion 240 can be utilized with any of the base plates and / or peripheral aperture patterns disclosed herein.

[0090] The substrate 222 can include a plurality of peripheral apertures (or holes) 244 along the front surface 228 of the plate body 226 for securing the substrate 222 to a surgical site, as shown in Figure 17 . The peripheral apertures 244 can extend between the front surface 228 and the rear surface 230 of the plate body 226, with at least some or each of the peripheral apertures 244 extending through the thickness of the augmented portion 240 between the augmented surface segments 242 of the front surface 228 and the rear surface 230, as shown in Figure 18 . In Figure 18 , only some of the peripheral apertures 244 can extend through the augmented portion 240, and at least one of the apertures 244 can extend between the front surface 288 and a second surface segment 247 of the rear surface 230. The size of each peripheral aperture 244 can be set to receive a respective fastener for securing the substrate 222 to a surgical site.

[0091] With reference to Figures 17-19 , and with continued reference to Figure 16 , the peripheral apertures 244 can be distributed circumferentially about the longitudinal axis A to establish a respective pattern (or layout) 248. The pattern 248 can be in accordance with any of the pattern arrangements disclosed herein. The pattern 248 can correspond to the pattern 148 of Figure 9 , with Figure 18 being a cross-sectional view taken along the third reference plane R3 or the fourth reference plane R4, and Figure 19 being a cross-sectional view of the substrate 222 taken along the first reference plane Rl.

[0092] Figure 20 An exemplary pattern (or layout) 348 is shown. The substrate 322 includes an augmented portion 340 (shown in dashed lines) that can extend less than the entire width of the plate body 326. The peripheral apertures 344 (indicated at 344-1 through 344-3) can be distributed circumferentially about the longitudinal axis A to establish the pattern 348. Each aperture 344 can be circumferentially offset from the adjacent reference planes Rl, R2 to establish a respective angle β (indicated at β-1 through β-3). The angles β-1 through β-3 can be different such that the apertures 344 are distributed non-uniformly about the longitudinal axis A.

[0093] Other substrate shapes or profiles can be utilized. In Figure 20A , the perimeter 339' of the substrate 322' can have an elliptical, non-circular geometry established by points PI ', P2' along a major axis and points P3', P4' along a minor axis of the ellipse. For example, the major and minor axes can be aligned with the first reference plane Rl'and the second reference plane R2'. In Figure 20AIn particular embodiments, the perimeter 339" of the substrate 322" can have an oval geometric shape established by points P1', P2' along a major axis and points P3', P4' along a minor axis of the oval. For example, the major axis and the minor axis can be aligned with the first reference plane R1" and the second reference plane R2".

[0094] Figure 21 An exemplary method of installing an orthopedic implant at a surgical site is shown in flowchart 480. For example, the method can be used to perform arthroplasty for restoring function to a shoulder afflicted with advanced cartilage disease, such as repairing a bone defect along a glenoid. The method 480 can be utilized with any of the orthopedic implants, augment geometries, and peripheral aperture patterns disclosed herein. Fewer or additional steps than those recited below can be performed within the scope of the present disclosure, and the recited order of steps is not intended to limit the present disclosure.

[0095] A kit for arthroplasty can be provided at block 482. The kit can include any of the components disclosed herein, including a set of substrates, a plurality of peripheral fasteners, and one or more glenospheres. At step 484, a substrate can be selected from the set of substrates based on a surface profile of the surgical site. An exemplary surface profile of a surgical site S is shown by Figure 22 Another exemplary surface profile of a surgical site S' is shown by Figure 23 Other exemplary surface profiles of a surgical site S are disclosed in Figures 24A-24E and 25A-25E. The set of substrates can include at least a first substrate (e.g., substrate 22) and a second substrate (e.g., substrate 122). Each of the substrates can include peripheral apertures arranged to establish a respective pattern, including any of the patterns disclosed herein. The peripheral apertures of the second substrate can be arranged to establish a second pattern (e.g., pattern 148) that can be circumferentially offset from the first pattern (e.g., pattern 48) of the first substrate with respect to a longitudinal axis. The first and second patterns can have a common circumferential spacing between respective peripheral apertures.

[0096] Referring to Figure 22 , with continued reference to Figure 21 At step 486, the surgical site S can be prepared for receiving a prosthesis 410 including an implant 420. The implant 420 can include a substrate 422 and a glenosphere 424. The implant 420 including the substrate 422 can correspond to any of the implants and substrates disclosed herein. The back surface of the substrate 422 can include an augment portion 440 that can be sized to abut a surface along the surgical site S and / or fill a bone void. The augment portion 440 can have a generally wedge-shaped geometry.

[0097] One or more operations to prepare the surgical site S, such as one or more reaming, milling, and drilling operations, can be performed to establish a desired geometry of the surgical site. Step 486 can include forming a recess or bone hole BH at the surgical site S by removing tissue, such as bone B, at the surgical site S, such as an articulating surface of a glenoid. The bone hole BH' can be formed to remove tissue from a defect of the bone B', as shown in Figure 23 The size of the bone hole BH' can be set to at least partially receive the augmented portion 440' of the base plate 422'. The defect in the glenoid can be characterized by a Walch classification. The surgeon can measure the bone loss using imaging of the surgical site, such as radiographic or computed tomography techniques, or can estimate the profile of the defect using one or more arthrometers and / or measuring devices placed on the bone surface. The size of the bone hole BH' can be set to approximate the profile of the defect. The size of the base plate 422" can be set such that the augmented portion 440" can extend less than the entire width of the base plate 422" (shown in dashed lines in Figure 23 for illustrative purposes).

[0098] At step 488, a selected base plate 422 can be positioned relative to the surface profile of the surgical site S and the bone hole BH. Step 488 can include positioning the anchor stem 432 of the selected base plate 422 in the bone hole BH to secure the base plate 422 at the surgical site S.

[0099] At step 490, one or more fasteners can be positioned in a respective one of the peripheral apertures along the respective passage axis PA (shown in dashed lines in Figure 22 for illustrative purposes) to secure the selected base plate to the surgical site S, as shown by the peripheral fasteners PF and the peripheral apertures 44, 144 of the base plates 22, 122 of Figures 24A-24E and 25A-25E. In Figures 24A-24E and 25A-25E, the peripheral fasteners PF can be compression screws that can be used to apply and maintain compression between the respective base plate 22, 122 and the articular surface of the glenoid, which can reduce relative motion and can reduce tissue formation that might otherwise occur due to spacing between the contacting surfaces of the base plate and the glenoid.

[0100] At step 492, a head portion or a glenosphere 424 can be secured to the selected base plate 422, which can provide an articulating surface for cooperating with an opposing articulating member M. The articulating member M can be an implant secured to a humerus, for example. The base plate 422 can provide the articulating surface.

[0101] Figures 24A-24E The implant 20 positioned relative to the surgical site S is shown from different perspectives. Figures 25A-25EImplants 120 positioned relative to surgical sites S are shown from different perspectives. Figures 25A-25E may correspond to Figures 24A-24E the same perspective. Figures 24A-24E Geometries of surgical sites S of 25A-25E can be the same or different. For example, Figures 24A-24E Implants 20, 120 of 25A-25E can be installed relative to respective surgical sites S using Figure 21 methods 480.

[0102] Each peripheral aperture 44, 144 can be sized to receive a respective peripheral fastener PF to secure the plate body 26, 126 to the surgical site S. The peripheral fastener PF can extend at least partially through a thickness of bone tissue at the surgical site S.

[0103] In Figure 24A , the base plate 22 can be arranged such that the first and second reference planes R1, R2 can be generally aligned with superior / inferior (S / I) and / or anterior / posterior (A / P) planes of the patient. One or more of the peripheral apertures 44 and peripheral fasteners PF can be positioned along the S / I and / or A / P planes.

[0104] In Figure 25A , the first reference plane R1 of the base plate 122 can be arranged such that the first and second reference planes R1, R2 can be generally aligned with S / I and A / P planes. All of the peripheral apertures 144 can be circumferentially offset from the first and second reference planes R1, R2, the S / I plane, and / or the A / P plane.

[0105] Figures 26-27 An exemplary orthopedic implant 520 is shown. The implant 520 includes a base plate 522, which can include a plate body 526 and an augment portion 540 positioned relative to a body portion 538. The body portion 538 and augment portion 540 can be separate and distinct components. The base plate 522 can include a plurality of peripheral apertures 544 that can establish a pattern or layout 548. The apertures 544 can be arranged according to any of the patterns disclosed herein.

[0106] The augment portion 540 can include one or more channels 550 extending along respective paths 552. The channels 550 can be elongated slots and can be generally arcuate, as Figures 26-27The passage axis PA of the respective aperture 544 can be generally aligned with the path 522 of the respective channel 550. A first reference plane Rl can bisect the augment portion 540, and a second reference plane R2 can be perpendicular to the first reference plane R2. The base plate 522 can include a locking mechanism 554 that can be moved between an unlocked mode and a locked mode. For example, the locking mechanism 554 can include a retaining pin that can selectively engage one or more recesses along the body portion 538.

[0107] The augment portion 540 can be rotated in the direction RD (e.g., clockwise) about the longitudinal axis A of the base plate 522 in the unlocked mode. The locking mechanism 554 can be moved to the locked mode, which can limit movement of the augment portion 540 relative to the body portion 538. Figure 27 ) about the longitudinal axis A of the base plate 522 in the unlocked mode. The locking mechanism 554 can be moved to the locked mode, which can limit movement of the augment portion 540 relative to the body portion 538. Figure 26 The augment portion 540 is shown in a first position relative to the longitudinal axis A and the peripheral aperture 544. Figure 27 The augment portion 540' is shown in a second, different position relative to the longitudinal axis A' and the peripheral aperture 544'. As shown in FIG. 54, the augment portion 540' can be positioned such that a first reference plane Rl'and a second reference plane R2' established by the augment portion 540' can be different in position from the first reference plane Rl and the second reference plane R2 established by the augment portion 540 of FIG. 53. Figure 27 The augment portion 540' is shown in a second, different position relative to the longitudinal axis A' and the peripheral aperture 544'. As shown in FIG. 54, the augment portion 540' can be positioned such that a first reference plane Rl'and a second reference plane R2' established by the augment portion 540' can be different in position from the first reference plane Rl and the second reference plane R2 established by the augment portion 540 of FIG. 53. Figure 26 The augment portion 540' is shown in a second, different position relative to the longitudinal axis A' and the peripheral aperture 544'. As shown in FIG. 54, the augment portion 540' can be positioned such that a first reference plane Rl'and a second reference plane R2' established by the augment portion 540' can be different in position from the first reference plane Rl and the second reference plane R2 established by the augment portion 540 of FIG. 53.

[0108] The novel implants and methods of the present disclosure can provide versatility in securing the implant to the bone with fasteners at the surgical site. The disclosed implants and augment geometries can be used to closely approximate the dimensions of a bone surface, such as a bone void, which can result in improved healing at the surgical site. By selecting a pattern based on the geometry of the surgical site and the thickness of the bone at the respective locations of the peripheral apertures, the disclosed peripheral aperture patterns can be used to improve the fixation of the respective implant. The disclosed base plates can have a circular or non-circular geometry. The disclosed base plates having a generally circular geometry can be used to orient the augment portion of the base plate in multiple directions to establish a "best fit" for the augment portion while ensuring that the peripheral screws can be in an optimal position. Additionally, having multiple orientations for the augment portion can help preserve glenoid bone during preparation of the base plate.

[0109] While various non-limiting embodiments are described as having particular components or steps, embodiments of the present disclosure are not limited to those particular combinations. It is possible to use some of the components or features from any of the non-limiting embodiments in combination with features or components from any of the other non-limiting embodiments.

[0110] It is to be understood that the same or similar elements identified in the several figures have been identified with like reference numerals. It is also to be understood that, although particular component arrangements are disclosed in these exemplary embodiments, other arrangements can also benefit from the teachings of the present disclosure.

[0111] The foregoing description should be interpreted as illustrative of the present disclosure and not in any limiting sense. Those of ordinary skill in the art will understand that certain modifications can be made within the scope of the present disclosure.

Claims

1. An orthopedic implant comprising: a base plate including a plate body extending between an anterior surface and a posterior surface along a longitudinal axis, and including an anchoring stem extending outwardly from the posterior surface; wherein the plate body includes a body portion establishing the anterior surface, a wedge-shaped augmentation portion extending outwardly from the body portion to establish an augmentation surface segment of the posterior surface, and a plurality of peripheral apertures distributed circumferentially about the longitudinal axis, wherein the peripheral apertures are sized to receive respective fasteners for securing the base plate to a surgical site; wherein the augmentation surface segment is disposed transversely relative to the longitudinal axis, and a first reference plane and a second reference plane, which are disposed perpendicular to one another, extend along the longitudinal axis such that the first reference plane extends through a maximum thickness of the augmentation portion to bisect the augmentation surface segment; and wherein all of the peripheral apertures of the base plate disposed about the longitudinal axis are circumferentially offset from both the first reference plane and the second reference plane.

2. The implant of claim 1, wherein a perimeter of the plate body is circular.

3. The implant of claim 1, wherein the anchoring stem extends along the longitudinal axis.

4. The implant of claim 1, wherein the plurality of peripheral apertures are equally distributed about the longitudinal axis.

5. The implant of claim 4, wherein the plurality of peripheral apertures includes a total of four peripheral apertures.

6. The implant of claim 1, wherein a third reference plane extends along the longitudinal axis such that the first reference plane and the third reference plane establish an acute angle, and a pair of the peripheral apertures are disposed circumferentially along the third reference plane.

7. The implant of claim 6, wherein the acute angle is greater than 0 degrees but less than 45 degrees.

8. The implant of claim 6, wherein the acute angle is between 30 degrees and 60 degrees.

9. The implant of claim 8, wherein the plurality of peripheral apertures includes a total of four peripheral apertures.

10. The implant of claim 9, wherein the four peripheral apertures are evenly distributed about the longitudinal axis.

11. The implant of claim 1, wherein the posterior surface includes a second surface segment disposed perpendicular to the longitudinal axis, and the augmentation surface segment and the second surface segment join at an interface to establish an obtuse angle.

12. The implant of claim 11, wherein the obtuse angle is between 140 degrees and 170 degrees.

13. The implant of claim 1, further comprising a glenosphere including a hinged surface having a convex geometry, and wherein the glenosphere is secured to the base plate proximate the anterior surface.

14. The implant of claim 13, wherein the glenosphere includes a recess sized to at least partially receive the body portion of the base plate.

15. The implant of claim 14, wherein a perimeter of the body portion of the base plate is sized to cooperate with a perimeter of the recess to establish a Morse taper connection.

16. A kit for arthroplasty comprising: a set of base plates; and a plurality of fasteners; wherein each base plate of the set of base plates includes a plate body having a body portion and a wedge-shaped augmentation portion that cooperate to establish an anterior surface and a posterior surface of the plate body, and a plurality of peripheral apertures extending between the anterior surface and the posterior surface, wherein the peripheral apertures are sized to receive respective ones of the fasteners to secure the plate body to a surgical site, and wherein a first reference plane extends along a longitudinal axis of the plate body and through a maximum thickness of the augmentation portion to bisect the augmentation portion; and wherein the set of base plates includes a first base plate and a second base plate, the peripheral apertures of the first base plate being distributed circumferentially about the longitudinal axis to establish a first pattern such that one or more of the peripheral apertures extend along the first reference plane, and the peripheral apertures of the second base plate being distributed circumferentially about the longitudinal axis to establish a second pattern that is circumferentially offset from the first pattern relative to the longitudinal axis, and the first and second patterns having a common circumferential spacing between respective peripheral apertures.

17. The kit of claim 16, wherein an anchor stem extends outwardly from the posterior surface along the longitudinal axis, and the kit further comprises: a glenosphere including an articulating surface having a convex geometry, and the glenosphere is releasably secured to a respective one of the base plates adjacent the anterior surface.

18. The kit of claim 16, wherein a perimeter of the body portion is circular, and the peripheral apertures of both the first and second patterns are equally distributed about the longitudinal axis.

19. The kit of claim 18, wherein a second reference plane extends along the longitudinal axis and is perpendicular to the first reference plane, and the second pattern is established such that all of the peripheral apertures of the second base plate arranged about the longitudinal axis are circumferentially offset from both the first and second reference planes.

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