Reverse shoulder system

Abstract

The present disclosure relates to a joint assembly configured to couple with a bone anchor. The joint assembly may include a joint body (280) having a first end (281) and a second end (282) with an articular surface (293) disposed on or adjacent 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), the locking member being 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] This application is a divisional application of Chinese Patent Application No. 202080069827.1, filed September 30, 2020, which is the entry into China of International Patent Application PCT / US2020 / 053625.

[0002] Incorporation by reference of any priority application

[0003] This application claims priority to U.S. Provisional Application No. 62 / 908,921, filed October 1, 2019, which is hereby incorporated by reference in its entirety. BACKGROUND TECHNICAL FIELD

[0004] The present application relates to devices and methods for reverse shoulder prostheses.

[0005] Description of Related Art

[0006] Arthroplasty is the standard treatment for treating shoulder arthritis. A typical anatomical shoulder joint replacement attempts to mimic anatomical conditions. 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. Such humeral head replacements can articulate with the native glenoid fossa or a relative glenoid surface resurfacing device.

[0007] For more severe cases, a reverse reconstruction can be employed. In a reverse reconstruction, the kinematics of the shoulder joint are reversed by fastening a spherical device, sometimes referred to as a glenosphere, to the glenoid and implanting a humeral implant having a cavity capable of receiving the glenosphere.

[0008] 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 can wear at different rates. Additionally, in typical assemblies, there is a risk of unintended disconnection between the joint body and the anchor. Thus, there is a continuing need for improved shoulder prosthesis components and assemblies. SUMMARY

[0009] There is a need for improved connection components for connecting multiple parts of a shoulder joint assembly together, for example, to prevent relative motion between the components of the joint assembly.

[0010] Certain aspects of the present disclosure relate to an articulating component configured to couple with a bone anchor. The articulating component can include an articulating body having a first end and a second end. An articulating surface can be disposed on or adjacent to the first end. A bone anchor interface can be disposed between the first end and the second end of the articulating body. The bone anchor interface can include a locking member configured to secure the articulating component to the bone anchor and / or a deflectable portion disposed at the second end of the articulating body. The deflectable portion can be configured to deflect circumferentially over a surface of a humeral anchor to provide a load directed from the second end of the articulating body to the first end of the articulating body when deflected.

[0011] The articulating body can include a lateral surface configured to cover a rim of the bone anchor when the locking member is engaged with the bone anchor.

[0012] The bone anchor interface can include a channel formed in a circumferential surface of the articulating body. The locking member can be disposed in the channel.

[0013] The deflectable portion can include at least two segments cantilevered from a central portion of the articulating body to the second end of the articulating body. The deflectable portion can include a compression slot disposed between each of the at least two segments. The deflectable portion can include a tapered surface disposed on an outer perimeter thereof. The deflectable portion can be disposed between the locking member and the second end of the articulating body.

[0014] The articulating component can include a rotation control zone disposed at a perimeter of the articulating body between the first end and the second end. The rotation control zone can include a protrusion disposed in a first direction and a recess disposed in a second direction. The first direction can be transverse to the second direction. The protrusion can be a first protrusion and can further include a second protrusion disposed opposite the first protrusion. The recess can be a first recess and can further include a second recess disposed opposite the first recess.

[0015] Any of the joint components described herein can be included in a kit. The kit includes a bone anchor having a bone anchor recess formed therein. The bone anchor recess can extend from a first end. A bone-engaging outer surface can extend from the first end to a second end opposite the first end. The bone anchor recess can include a first perimeter portion adjacent the first end configured to engage the locking member of the joint component and a second perimeter portion between the first perimeter portion and the second end. The second perimeter portion can be configured to engage the deflectable portion. Optionally, the kit can include a carrier or spacer having a first end and a second end, the carrier configured to engage the bone anchor recess of the bone anchor at least at the second perimeter portion. The first end of the carrier can include a carrier recess formed therein. The carrier recess can include a first perimeter portion adjacent the first end configured to engage the locking member of the joint component and a second perimeter portion between the first perimeter portion and the second end. The second perimeter portion is configured to engage the deflectable portion.

[0016] Certain aspects of the present disclosure relate to a humeral assembly. The humeral assembly can include a humeral anchor (e.g., a stemmed or unstemmed) and a joint assembly. The humeral anchor can be configured to anchor in a bone. The humeral anchor can include a first end, a second end, and a recess extending between the first end and the second end. The recess can be accessible from the first end of the humeral anchor and include a first perimeter portion adjacent the first end and a second perimeter portion between the first perimeter portion and the second end of the humeral anchor. The joint assembly can be configured to be inserted into the recess to be secured therein to the humeral anchor. The joint assembly can include a joint body having a joint surface disposed on or adjacent a first end of the joint body and a humeral anchor interface disposed between the first end and a second end of the joint body. The humeral anchor interface can include a channel formed in a circumferential surface of the joint body, a locking member disposed in the channel, and / or a deflectable tab disposed between the locking member (e.g., a locking ring or C-ring) and the second end of the joint body.

[0017] The deflectable protrusion may be configured to be positioned within the second peripheral portion of the recess, and when so positioned, to circumferentially deflect through the surface of the second peripheral portion and / or to provide load between the locking member and the surface of the first peripheral portion. When the humeral anchor and the joint assembly are coupled together, the deflectable protrusion is configured to engage the surface surrounding the second peripheral portion before the locking member engages the first peripheral portion of the recess of the humeral anchor.

[0018] Some aspects of this disclosure relate to a joint assembly configured to engage with a skeletal anchor. The joint assembly may include a joint body having a first end and a second end, wherein a joint surface is disposed on or adjacent to the first end. The joint body may include a skeletal anchor interface disposed between the first and second ends of the joint body. The skeletal 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 a surface of the humeral anchor, and / or to provide a load from the second end of the joint body toward the first end of the joint body upon truncated conical deflection.

[0019] The joint body may include a lateral surface disposed between the channel and the first end of the joint body. The lateral surface may be configured to cover the edge of the humeral anchor when the locking member engages with the humeral anchor.

[0020] The joint body may include a rotation control area disposed on the periphery of the joint body between the first end and the second end. The rotation control area 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.

[0021] The deflectable portion may include a tapered surface disposed on its outer periphery. In some configurations, the deflectable protrusion includes a blind hole along the centerline of the joint body. In some configurations, the deflectable portion includes at least two segments, such as four segments, extending from the center 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.

[0022] Any of the joint assemblies described herein can form part of a kit. The kit can 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 can have a first perimeter portion adjacent the first end configured to engage the locking member of the joint assembly and a second perimeter portion between the first perimeter portion and the second end. The second perimeter portion can be configured to engage the deflectable portion of the joint assembly.

[0023] In some embodiments, the kit can include a carrier having a first end and a second end configured to engage the bone anchor recess of the bone anchor at least at the second perimeter portion. The first end of the carrier can include a carrier recess formed therein. The carrier recess can include a first perimeter portion adjacent the first end configured to engage the locking member of the joint assembly and a second perimeter portion between the first perimeter portion and the second end. The second perimeter portion can be configured to engage the deflectable portion.

[0024] In use, a bone anchor can be positioned in an end of a long bone of a patient. A 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 counterform of the first rotational alignment feature) disposed in a recess. The recess can be formed in the bone anchor or in a cradle coupled with the bone anchor disposed at the end of the long bone. The joint assembly can be advanced into the bone anchor until an anti-load protrusion is disposed within a tapered surface of the recess. For example, the joint assembly can be advanced until a tapered outer surface of the anti-load protrusion engages the tapered surface of the recess to move segments of the anti-load protrusion toward one another across a compression slot of the anti-load protrusion. The joint assembly can be further advanced until a locking member of the joint assembly is deflected within a channel formed in a central portion of the joint body. The joint assembly can be further advanced until the locking member of the joint assembly aligns with a channel disposed about the recess in the bone anchor to permit the locking member to span a gap between the channel in the joint body and the channel disposed about the recess. The anti-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 about the recess when the anti-load protrusion is deflected by the tapered surface of the recess.

[0025] Certain aspects of the present disclosure relate to a shoulder joint prosthesis assembly including a bone anchor and a joint assembly. The bone anchor can include a metallic body, while the joint assembly includes a polymeric body. The bone anchor can include a body having a bone-engaging side to be placed against a bone and an assembly side opposite the bone-engaging side. The assembly side can include a recess disposed about a mounting region. The mounting region can include a channel disposed about the mounting region peripherally. The channel provides a first retention surface. The joint assembly has 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 region and a second portion opposite the first portion. The second portion includes an articulating surface.

[0026] In assemblies having a locking member, the locking member can include an arcuate member disposed about the first portion of the joint body. The arcuate member has a second retention surface. The second retention surface can be disposed at an angle (e.g., an acute angle) from a plane disposed normal to the central insertion axis. A first portion of the second retention surface can be disposed further from the articular surface in the direction of the central insertion axis than the first retention surface when the joint assembly is engaged with the bone anchor. A second portion of the second retention surface can be disposed closer to the articular surface in the direction of the central insertion axis than the first retention surface when the joint assembly is engaged with the bone anchor. The first retention surface can be disposed between inner and outer ends of the second retention surface when the locking member engages the passage of the bone anchor.

[0027] The locking member can also include a resilient body. A first end of the resilient body can extend from the first end of the arcuate member. A second end of the resilient body can abut or engage the polymer body. The first portion of the body portion can include a recess configured to receive the resilient body in only one position. The resilient body can be configured to center the arcuate member with respect to the central insertion axis. For example, the resilient body stores strain energy when a deflection force is applied to deflect a first end of the locking member away from a centered position, and releases the strain energy to return the locking member toward the centered position after the deflection force is removed.

[0028] Certain aspects of the present disclosure relate to a shoulder joint prosthesis assembly including a bone anchor and a joint assembly. The bone anchor can include a metallic body, while the joint assembly includes a polymeric body. The bone anchor can include a bone-engaging side to be placed against a bone and an assembly side opposite the bone-engaging side. The assembly side can include a recess disposed about a mounting region. The mounting region can include a passage disposed perimetrically about the mounting region. The passage includes a first retention surface. The joint assembly can include a body portion and a locking member. The body portion extends along a central insertion axis between a first portion configured to be inserted into the mounting region and a second portion opposite the first portion. The second portion includes an articular surface.

[0029] Certain aspects of the present disclosure relate to an articular portion including a body portion (e.g., a polymeric 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 can include an arcuate member disposed about the first portion and a positioner body having a first end coupled to the arcuate member and a second end coupled to the polymeric body. The positioner body is configured to be received in a recess of the body portion in a predefined orientation and / or position.

[0030] Any feature, structure, or step disclosed herein can be replaced with or combined with any other feature, structure, or step disclosed herein, or omitted. Additionally, for purposes of summarizing the disclosure, certain aspects, advantages, and features of the present disclosure have been described herein. It is to be understood that not necessarily all such advantages can be achieved in accordance with any particular embodiment of the present disclosure. Various aspects of the disclosure are not necessarily required or inherent to the practice of the disclosure. BRIEF DESCRIPTION OF DRAWINGS

[0031] These and other features, aspects, and advantages of the present disclosure are described below with reference to the drawings, which are intended to illustrate the principles of the disclosure and not to limit its scope. 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 drawings, like reference numerals refer to corresponding features throughout the several embodiments. The following is a brief description of the drawings.

[0032] Figure 1 A reverse total shoulder arthroplasty system in a shoulder joint is shown, the system including a humeral stem anchor.

[0033] Figure 2 A schematic view of a shoulder arthroplasty system is shown, the shoulder arthroplasty system including an arthroplasty kit that can be used to perform an anatomic or reverse arthroplasty, for performing a conversion from an anatomic arthroplasty to a reverse arthroplasty, or from a reverse arthroplasty to an anatomic arthroplasty.

[0034] Figure 3A An example of an articular assembly is shown.

[0035] Figure 3B A cross-sectional view of the articular assembly of Figure 3A is shown, the cross-section taken along line 3B-3B.

[0036] Figure 3C A cross-sectional view of the articular assembly of Figure 3Abottom perspective view of the joint assembly of

[0037] Figure 3D A joint assembly is shown having an asymmetric joint body configuration with an angled medial edge or face.

[0038] Figure 3E A joint assembly is shown having an asymmetric joint body configuration with an angled medial edge or face. Figure 3D cross-sectional view of the joint assembly of

[0039] Figure 3F A joint assembly is shown having an asymmetric joint body configuration with an angled medial edge or face.

[0040] Figure 3G A joint assembly is shown having an asymmetric joint body configuration with an angled medial edge or face. Figure 3E cross-sectional view of the joint assembly of

[0041] Figure 4A A perspective view of the humeral anchor and joint assembly from the system of Figure 2 is shown prior to insertion of the joint assembly, and the engagement features of these components are shown.

[0042] Figure 4B A humeral anchor and joint assembly of Figure 4A is shown after the joint assembly has been inserted.

[0043] Figure 4C A cross-sectional view of the humeral assembly of Figure 4B is shown taken at cross-sectional plane 4C-4C transverse to the insertion direction of the reverse joint assembly.

[0044] Figure 4D A top view of the assembled humeral assembly of Figure 4B is shown.

[0045] Figure 4E A cross-sectional view of the partial assembly of the humeral anchor and joint assembly of Figure 4D is shown taken along lines 4E,4F-4E,4F.

[0046] Figure 4F A cross-sectional view of the humeral assembly of Figure 4D is shown taken along lines 4E,4F-4E,4F.

[0047] Figure 5A A humeral assembly is shown including a stemmed humeral anchor, a carrier, and a joint assembly.

[0048] Figure 5B A carrier of the humeral assembly of Figure 5A is shown.

[0049] Figure 6A An example of an articulating assembly is shown.

[0050] Figure 6B A bottom view of the articulating assembly of Figure 6A is shown.

[0051] Figure 6C A lock member of the articulating assembly of Figure 6A is shown.

[0052] Figure 6D A perspective view of the humeral anchor and articulating assembly of Figure 6A is shown prior to insertion into the articulating assembly and shows the engagement features of these components.

[0053] Figure 6E A partially enlarged cross-section of the connection between the humeral anchor and articulating assembly shown in Figure 6D is shown.

[0054] Figure 6F A partially enlarged cross-section of the connection between the humeral anchor and articulating assembly shown in Figure 6D is shown.

[0055] Figure 6G A partially enlarged cross-section of the connection between the humeral anchor and articulating assembly shown in Figure 6D is shown.

[0056] Figure 7 Another example of an articulating assembly is shown.

[0057] Figure 8A Another example of a lock member is shown.

[0058] Figure 8B A variant of the lock member shown in Figure 8A is shown.

[0059] Figure 9A Another example of an articulating assembly and fracture handle is shown.

[0060] Figure 9B A bottom perspective view of the articulating assembly of Figure 9A is shown.

[0061] Figure 10A Another example of an articulating assembly is shown.

[0062] Figure 10B A partial cross-section of the articulating assembly of Figure 10A coupled to the anchor is shown.

[0063] Figure 11 Another example of an articulating assembly is shown.

[0064] Figure 12 Another example of a joint assembly is shown. DETAILED DESCRIPTION

[0065] The present application relates, in various examples, to a shoulder implant having novelty and originality. The shoulder implant can be part of a hemi- and total shoulder arthroplasty system. Figure 1 A reverse method is shown in which the humerus H is fitted with a joint body 84 having a concave joint 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 a glenosphere). In this case, the concave joint surface 85 is placed on the humeral articulating portion of the glenosphere 87, which is fixed relative to the scapula. The reverse joint body 84 is mounted to a bracket 89 disposed between the reverse humeral joint body 84 and a stem anchor 83 implanted in the humerus H by surgical procedure. The humerus H is prepared by providing access to the medullary canal of the humerus H.

[0066] I. Systems and kits having a shared implant component

[0067] Figure 2 is a schematic illustration of a total arthroplasty system according to various embodiments, including an arthroplasty kit 100 that can be used to perform either an anatomic or a reverse arthroplasty, or to convert from one to the other. The kit 100 can include one or more stemless humeral anchors 103, one or more stemmed humeral anchors 113, and one or more joint components 161. The stemless humeral anchors 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 anchor 103 shown can have one or more fins 109 extending distally. The fins 109 can be configured to secure the anchor 103 into the humerus.

[0068] As Figure 2 The stemless anchors 103 can be provided in multiple sizes to accommodate patients of different body types, different degrees of bone damage in the humerus, etc. In some embodiments, the lateral dimension of the stemless anchors 103 can vary so as to fit within different sized resections of the humerus. For example, the kit 100 can include a plurality of stemless anchors 103A, 103B, 103C, 103D... 103n, where n is the number of different sizes. Although four different sizes are shown in Figure 2Four sizes are shown (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 shankless anchors 103A-103D may also be varied to allow for extension in the humerus to a depth chosen by the clinician based on the specific patient being treated. Additionally, the anchors 103A-103D may have different flap lengths l1. f The wing 109 is designed to accommodate humerus of different sizes.

[0069] In various implementation schemes, the wing length l of anchor 103A-103D f These can vary significantly to provide a wide range of anchor strengths to the humerus and accommodate patients with varying degrees of bone damage. Figure 2 In the arrangement, for example, the first anchor 103A may have a minimum total length l1 and a minimum total blade length l f The fourth anchor 103D can have the longest total length l1 and the longest total blade 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 kit 100 may be in the range of 1.15 to 2.5, 1.18 to 2.5, 1.2 to 2.5, 1.2 to 2, 1.2 to 1.8, 1.2 to 1.6, 1.3 to 1.6, or 1.25 to 1.4.

[0070] Kit 100 may also include one or more shank humeral anchors 113. 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, kit 100 may also include a traumatic or fracture stem anchor 140, which may be used in a patient who has experienced a fracture of the humerus H. The shank humeral anchor 113 may be used in patients in whom the shankless anchor 103 may not be adequately secured to the humerus, such as in patients who have experienced severe osteoporosis. A traumatic or fracture stem may be used in cases where the humerus has been fractured into one or more pieces. Like the shankless anchor 103, kit 100 may include humeral stem anchors 113 (sometimes referred to herein as shank anchors), which may have multiple different sizes, such as different lateral dimensions and / or different lengths l2. For example, such as Figure 2As shown, the stemmed humeral anchor 113 may have a corresponding length l2, which is longer than the length l1 of the sessile anchor 103. Advantageously, including stemmed anchors 113 of different sizes in kit 100 allows clinicians to select the appropriate size for a particular patient based on the patient's bone size and health condition to ensure secure implantation of the anchor 113. In various embodiments, the length l2 of the stemmed humeral anchor may range from 55 mm to 175 mm. In contrast, the shortest length l1 of the sessile humeral anchor 103 may range from 16 mm to 28 mm. In various embodiments, the stemmed humeral anchors 113, 140 may be configured to enter the intramedullary cavity of the humerus H for additional anchoring.

[0071] Advantageously, kit 100 may include one or more common humeral components for use with either the shankless 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 common humeral components of kit 100 may include multiple articular components or assemblies 161 that can be used in conjunction with either the shankless implant 103 or the stemmed implant 113. As explained herein, both the shankless humeral anchor 103 and the stemmed humeral anchor 113 may include common engagement features that can be used with the same set of tools and / or articular components. For example, as described herein, the shankless anchor 103 and the stemmed anchor 113 may include convex and concave locking features configured to engage with the same set of articular components.

[0072] For example, kit 100 may include an anatomical joint component 160 configured to mechanically connect to both a stemless humeral implant 103 and a stemmed humeral implant 113. Clinicians may select the anatomical joint component 160 for surgeries suitable for anatomical reconstruction. The anatomical joint component 160 may include a connector 168 and a joint body 164 (anatomical), the joint body being configured to mechanically engage the connector 168. Figure 2 As shown, the joint body 164 of the anatomical joint component 160 may include a rounded convex surface configured to engage the patient's glenoid surface. A connector 168 may be used to mechanically attach 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 connector 168 may comprise metals such as cobalt, chromium, or titanium. In some embodiments, the joint body includes at least a high-temperature carbon layer on the joint surface. In various embodiments, the kit 100 may include the anatomical joint component 160 in multiple sizes.

[0073] The kit 100 can also include a reverse joint component 180 configured to mechanically couple to both the stemless humeral implant 103 and the stemmed humeral implant 113. The clinician can select the reverse joint component 180 for a procedure that is appropriate for reverse anatomic reconstruction. The reverse joint component 180 can include a reverse joint body 184 and a locking device 188 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 preference during the procedure. As shown, the reverse joint body 184 can include a rounded concave surface (e.g., substantially spherical) configured to engage with a glenosphere (not shown, but in some cases combined with the kit as a larger surgical kit) connected to the glenoid of the patient. Further, 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 enhance long-term compatibility with the patient's skeletal structure. 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 having a plurality of sizes.

[0074] During the arthroplasty procedure, the clinician can examine the skeletal structure of the humerus and / or scapula to determine whether the anatomy is appropriate for a stemless humeral anchor or a stemmed humeral anchor, and whether the anatomy is appropriate for anatomic reconstruction or reverse anatomic reconstruction. Advantageously, Figure 2 The illustrated kit 100 can provide the clinician with a full arthroplasty system including components compatible with either a stemless anchor or a stemmed anchor, and compatible with either anatomic construction or reverse anatomic construction. For example, during the procedure, the clinician can observe that the patient has sufficient humeral skeletal structure such that a stemless anchor 103 can be used to reduce damage to the patient's anatomy. The clinician can also select whether to perform anatomic reconstruction or reverse construction, and thus can select either the anatomic joint component 160 or the reverse joint component 180, 180A.

[0075] Similarly, if during the shoulder arthroplasty procedure the clinician determines that the patient's skeletal structure is damaged or otherwise more appropriate for a stemmed anchor 113, the clinician can select a stemmed anchor 113 of an appropriate size. The clinician can also select whether to perform anatomic reconstruction or reverse construction, and thus can select either the anatomic joint component 160 or the reverse joint component 180, 180A. Advantageously, Figure 2The kit 100 includes interchangeable or interoperable components that can be used in a stemmed or unstemmed anchor and with an anatomic or reverse anatomic reconstruction. Because a common humeral articulation component 161 (e.g., an anatomic or reverse anatomic articulation body) can be used with either an unstemmed anchor 103 or a stemmed anchor 113, the clinician can make or change reconstruction decisions during a surgical procedure. The kit 100 can therefore enable the clinician to quickly determine the reconstruction procedure that is best suited for the patient and can provide the clinician with the components that will be used for that reconstruction procedure.

[0076] As explained above, for humeral fractures, the kit 100 can also include one or more trauma stems 140. Advantageously, the one or more trauma stems 140 can include engagement features that are substantially similar or identical to the engagement features in the unstemmed anchor 103 and the humeral stem anchor 112, such that the unstemmed anchor 103, the humeral stem anchor 112, and the one or more trauma stems 140 can be used with the same set of common articulation components 161 and tools. Thus, advantageously, the kit 100 can provide a set of common implant tools and a set of common articulation components 161 that can be used with either an unstemmed humeral anchor 103 or a stemmed humeral anchor 113 and that can be used for anatomic or reverse anatomic reconstruction.

[0077] In some embodiments, the coupler 168 can include a proximal extension 163A and a distal extension 163B configured to connect to the articulation body 164. The distal extension 163B for the fracture stem 140 can be received within the recess 217 of the fracture stem 140 for anatomic reconstruction. The disc or intermediate portion 162 disposed between the proximal extension 163A and the distal extension 163B can be eliminated because the recess 217 can be elevated toward the resection plane. In modified embodiments, the recess 217 is recessed from (e.g., extends distally from) a distal end of the second recess. In these embodiments, the disc or intermediate portion 162 provides a spacer function when used in the trauma stem 140. Additional details regarding trauma stems can be found in International Application No. PCT / US2015 / 065126, filed December 15, 2015, the entirety of which is hereby incorporated by reference herein in its entirety for all purposes.

[0078] The final implant may employ any suitable configuration, such as any configuration described in the following: application number PCT / US2019 / 054007 entitled "SHOULDER PROSTHESIS COMPONENTS AND ASS EMBLIES"; and application number PCT / US2019 / 054023 entitled "MODULAR HUMERAL HEAD," which were filed on the same day as this application and accordingly have attorney reference numbers TRNXSH.104WO2 and TRNXSH.105WO. The final implant may employ any configuration disclosed in the following: application number 62 / 908,725 entitled "SHOULDER PROSTHESIS COMPONENTS AND ASSEMBLIES," which was filed on the same day as this application and has attorney reference number TRNXSH.104PR2. The entire contents of each application listed in the foregoing paragraphs are hereby incorporated herein by reference in their entirety for all purposes.

[0079] II. Examples of components of humeral assemblies

[0080] As described above, this application discloses kits and systems that provide common components and may include various types of joint assemblies. For example, a humeral assembly may include a joint portion and anchors.

[0081] Figures 3A-3C An example joint portion 261 is shown, which is sometimes referred to herein as a joint component. Joint portion 261 includes a joint body 280, such as a reverse component having a concave articular surface; however, in some surgeries, as explained above, clinicians may choose to dissect joint components, such as… Figure 2 The anatomical joint component 160. In some embodiments, as described in more detail below, the joint portion 261 may be a joint assembly, such as a polymer joint body 280 and a locking member 253. In other embodiments, the joint portion 261 may be a single piece, such as the polymer joint body 280.

[0082] like Figure 3A As shown, the joint body 280 may include a first end or proximal end 281 and a second end 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 can fasten the joint body 280 to the anchor 203.

[0083] The joint body 280 includes a body portion 287 proximal to the humeral anchor interface 288. The body portion 287 may be defined by an outer wall 299, which may be curved or tapered. The maximum diameter of the body portion 287 may be between 34 mm and 42 mm. The body portion 287 may also include an edge portion 291 between the joint surface 293 and the outer wall 299. The edge portion 291 may 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 indication of anatomical orientation for implantation. For example, markings 279 may indicate the side of the joint body 280 that should be aligned with the lateral surface of the humerus. Figure 3B As shown, the mark 279 may be a notch on the edge portion 291 of the main body portion 287. However, the mark 279 may be printed or otherwise visually indicated on the edge portion 291 or at other locations on the joint body 280.

[0084] The joint body 280 may further include a transverse surface 286 disposed between a first end 281 and a second end 282 of the joint body 280. The transverse surface 286 may define the distal side of the body portion 287. The transverse surface 286 may be configured to cover the edge or proximal side 239 of the anchor 203 during assembly (see [link to documentation]). Figure 4A and Figure 4F When assembled with the humeral anchor 203, the main body portion 287 may be suspended above or below the anchor 203 at a distance of 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 assembly.

[0085] The main body portion 287 may have a second thickness T2 between the farthest point or vertex of the joint surface 293 and the transverse surface 286 (see [link]). Figure 3B The distal point or vertex of articular surface 293 is proximal to or in line with the transverse surface 286. In other configurations, the distal point or vertex of articular surface 293 may be distal to the transverse surface 293. 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, thickness T2 may be 0 mm. In use, if thickness T2 is insufficient, clinicians may use spacers to increase the thickness to achieve the desired thickness between the distal point of articular surface 293 and the proximal side 239 of anchor 203. For example, if a clinician is performing a low resection or soft tissue relaxation, a spacer may be used to construct a stem.

[0086] like Figures 3A-3BAs shown, the joint body 280 can be symmetrical about the central axis L. For example, the center of curvature or center of rotation of the joint surface 293 can be aligned with the central axis L of the joint body 280. The symmetry of the joint body 280 can be desirable for a stemless reverse configuration or a stem with a tilt angle (e.g., a tilt angle of about 135 degrees). The symmetry of the joint body 280 can be desirable when the scapula form such that movement of the arm toward the patient does not result in contact between the humeral implant component and the scapula bone. In cases where contact can occur, it can result in scapula notching and / or component wear. Thus, as discussed further below, an angled proximal edge can be used. As discussed below, an angled insert can be useful for other biomechanical adaptations.

[0087] In other configurations, the body portion 287 can be angled to achieve a desired tilt angle. For example, Figures 3D-3E Another joint portion 261A is shown in which the proximal portion of the joint body 280 is angled relative to the transverse 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 such that the center of curvature or center of rotation is not aligned with the central axis L of the joint body 280. The angle between the transverse surface 286 and the proximal edge or rim portion 291 can be between 7.5 and 17.5 degrees, for example, 10 degrees. The angled joint body 280 can be desirable for a stemless conversion of anatomic to reverse or a stem with a tilt angle (e.g., a tilt angle of about 145 degrees).

[0088] As Figure 3CAs shown, the joint body 280 can include a rotation control region 285 disposed between the first end 281 and the second end 282 of the joint body 280, for example, at the periphery between the lateral surface 286 and the second end 282 of the joint body 280. The rotation control region 285 can include at least one first alignment feature, such as a protrusion 252. For example, the protrusion 252 can be a convex tab. The rotation control region 285 can include a first protrusion 252 and a second protrusion 252 circumferentially spaced apart 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 region 285 can include at least one second alignment feature different from the first alignment feature, such as a recess 251. For example, the recess 251 can be a concave slot. The rotation control region 285 can include a first recess 251 and a second recess 251 circumferentially spaced apart 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 the protrusion 252 and the recess 251. For example, the protrusion 252 can extend in a first direction and the recess 251 can extend in a second direction. The first direction can be transverse to the second direction.

[0089] As Figures 3A-3B 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, for example, between the rotation control region 285 and the first end 281 of the joint body 280.

[0090] As explained above, the joint portion 261 can be a joint assembly having a joint body 280 and a locking member 253 installed 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. As Figure 3A shown, the locking member 253 can be a split locking ring 258 (e.g., a C-shaped ring) to facilitate radial compression of the locking member 253. The locking member 253 can include a chamfered proximal and / or distal edge to facilitate insertion of the joint portion 261 into the anchor 203. For example, as Figure 3B shown, the locking member 253 has a chamfered distal edge 259.

[0091] The humeral anchor interface 288 can include an anti-load or deflectable portion 254 projecting outwardly from the rotation control region 285 and / or projecting 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.

[0092] The deflectable portion 254 may include at least two segments 255, such as three or four segments, extending from the central portion of the joint body 280 to a second end 282 of the joint body 280. The deflectable portion 254 may also include compression grooves 256 disposed between each of the at least two segments 255. For example, as... Figure 3B As shown, the deflectable portion 254 may include four segments 255 separated by intersecting compression grooves 256. The compression grooves 256 allow the deflectable portion 254 to be compressed in a direction transverse to the longitudinal axis L or in a circumferential direction.

[0093] Other humeral anchor interfaces 288 may also be provided to the joint body 280. For example, Figures 3F-3G The humeral portion 261B is shown, wherein the humeral anchor interface 288 includes a deflectable portion 254. The deflectable portion 254 may be a compressible plug exhibiting annular compression. The deflectable portion 254 may include a protrusion 297 having a blind hole 298 extending proximally from the second end 282 and extending through the protrusion 297. The blind hole 298 may extend along the central axis L of the joint body 280. The protrusion 297 may define a continuous periphery without any gaps, grooves, or other features. At least the distal portion of the deflectable portion 254 may include a truncated conical or tapered surface to facilitate insertion into the humeral anchor 203.

[0094] Figures 4A-4F An example of a humeral assembly including an anchor 203 and a joint portion 261 is shown. As shown, the anchor 203 is shankless, but humeral anchors may also include a shank (see [link to documentation]). Figure 5A Any features described herein with respect to the shankless anchor 203 can be applied to humeral anchors that include a shank or bracket. In some embodiments, anchor 203 may be integral or a single piece. In other embodiments, anchor 203 may include a first portion or anchor portion and a second portion or bracket portion adapted for connection to a shankless anchor or a shank anchor (see [link to documentation]). Figure 5B The individual joint portion 261 may be compatible with each of the shankless anchor, shank anchor, and / or bracket.

[0095] like Figure 4A As shown, the first recess 231 extends distally from the proximal side 239 of the anchor 203 and into the proximal portion 207. The size and shape of the first recess 231 can be configured to receive the distal or lateral portion of the joint body 280. Figure 4AAs shown, a first recess 231 can be disposed in the proximal portion 207 of the anchor 203. A second recess 232 can extend distally from the first recess 231 into the first section 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 greater 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 get larger toward the proximal face 239 of the anchor 203 and smaller toward the distal end 205 of the anchor 203.

[0096] As shown, the anchor 203 can include an inner periphery 233 disposed adjacent the proximal face 239 of the anchor 203 around the first recess 231. The inner periphery 233 can be a surface portion extending from the distal inner surface 235 to the proximal face 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 joint 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. Figure 4A As shown, the anchor 203 can include a plurality (e.g., two or a pair) of female locking features 243 spaced apart from one another along the inner periphery 233. The female locking features 243 can be circumferentially spaced apart, e.g., disposed opposite one another on the inner periphery 233 across the recess 231. As shown, a first female locking feature 243A can be disposed at a medial portion M of the anchor 203 and a second female locking feature 243B can be disposed at a lateral portion L of the anchor 203. In other examples, the first female locking feature 243A can be disposed in an anterior portion of the anchor 203 and the second locking feature 243B can be disposed in a posterior portion of the anchor 203. An angle can be defined between the female locking features 243A, 243B, e.g., 180 degrees, 120 degrees, 90 degrees, 60 degrees, or other angular spacing therebetween. More than two female locking features 243A or 243B can be provided, e.g., three at 120 degree spacing, four at 90 degree spacing, six at 60 degree spacing. The spacing between the locking features 243A, 243B can not be equal in some embodiments.

[0097] Figure 4A As shown, the anchor 203 can include a plurality (e.g., two or a pair) of male locking features 241 circumferentially spaced apart from one another, e.g., disposed opposite one another. As shown, a first male locking feature 241A can be disposed at a medial portion M of the anchor 203 and a second male locking feature 241B can be disposed at a lateral portion L of the anchor 203. In other examples, the first male locking feature 241A can be disposed in an anterior portion of the anchor 203 and the second male locking feature 241B can be disposed in a posterior portion of the anchor 203. An angle can be defined between the male locking features 241A, 241B, e.g., 180 degrees, 120 degrees, 90 degrees, 60 degrees, or other angular spacing therebetween. More than two male locking features 241A or 241B can be provided, e.g., three at 120 degree spacing, four at 90 degree spacing, six at 60 degree spacing. The spacing between the locking features 241A, 241B can not be equal in some embodiments. Figure 4C As a supplement or alternative to the female locking features 243, the inner periphery 233 can include a plurality (e.g., two or a pair) of male locking features 241 circumferentially spaced apart from one another, e.g., disposed opposite one another. As shown, a first male locking feature 241A can be disposed at a medial portion M of the anchor 203 and a second male locking feature 241B can be disposed at a lateral portion L of the anchor 203. In other examples, the first male locking feature 241A can be disposed in an anterior portion of the anchor 203 and the second male locking feature 241B can be disposed in a posterior portion of the anchor 203. An angle can be defined between the male locking features 241A, 241B, e.g., 180 degrees, 120 degrees, 90 degrees, 60 degrees, or other angular spacing therebetween. More than two male locking features 241A or 241B can be provided, e.g., three at 120 degree spacing, four at 90 degree spacing, six at 60 degree spacing. The spacing between the locking features 241A, 241B can not be equal in some embodiments.

[0098] ​​Figure 4C As shown, the first convex locking feature 241A can be disposed at the front portion A of the anchor 203, and the second convex locking feature 241B can be disposed at the rear portion P of the anchor 203. When both the concave locking feature 243 and the convex locking feature 241 are present, the concave locking feature 243 can be circumferentially spaced from the convex locking feature 241.

[0099] like Figure 4A and Figure 4C As shown, the convex locking feature 241 may include a protrusion 247 extending radially inward toward the first recess 231 relative to the inner periphery 233. The protrusion 247 may elongate in a longitudinal direction oriented proximal-distal in the first recess 231, for example, parallel to the insertion direction of the joint portion 261. The protrusion 247 may extend from an adjacent portion of the periphery 233 toward the central portion of the first recess 231. The portion of the periphery 233 adjacent to the protrusion 247 may be concave relative to the protrusion 247 in its structure facing the first recess 231. For example, each convex locking feature 241 may be adjacent to a pair of concave recesses 242 formed in the inner periphery 233. Similar to the concave locking features 243, the convex locking features 241 may be sized relative to a corresponding locking feature of the joint portion 261, which provides an interference fit between the joint portion 261 and the anchor 203.

[0100] like Figure 4A As shown, the inner periphery 233 may include a channel 244 extending circumferentially along the inner periphery 233. The channel 244 may be located 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 multiple segments circumferentially disposed between the concave locking feature 243 and the convex locking feature 241 (see...). Figure 4A Channel 244 may include any suitable number of segments, such as four, six, etc. As explained below, channel 244 may be sized relative to the locking member 253 of joint portion 261 to provide engagement or interference fit with locking member 253. In various embodiments, channel 244 may include a distally facing surface that can secure the locking member 253 of joint portion 261 to anchor 203.

[0101] In use, when a clinician inserts the joint portion 261 into the anchor 203, the clinician can align the humeral anchor interface 288 of the joint body 280 relative to the first recess 231 of the anchor 203, for example, using the rotational control region 285. The joint portion 261 can include a first rotational alignment feature (e.g., a protrusion 252 or a concave slot 251), with a second rotational alignment feature (e.g., a counterform of the first rotational alignment feature) disposed in the recess of the anchor 203. When assembled, the engagement between the rotational control region and the corresponding feature of the anchor 203 can also act as an anti-rotation feature to inhibit relative rotation between the anchor 203 and the joint portion 261.

[0102] When properly aligned, at least one protrusion 252A, 252B of the humeral anchor interface 288 interfaces with a corresponding concave locking feature 243A, 243B of the anchor 203, and / or at least one concave slot 251 of the humeral anchor interface 288 interfaces with a corresponding convex locking feature 241A, 241B of the anchor 203 (see FIG. 3B). The rotational control region 285 of the joint portion 261 and the inner perimeter 233 of the anchor 203 can be sized such that an interference fit or a friction fit is formed between the joint portion 261 and the anchor 203 when the joint portion 261 is inserted into the first recess 231. For example, the concave locking feature 243 can be sized relative to the corresponding protrusion 252 of the joint portion 261 to provide an interference connection between the joint portion 261 and the anchor 203. Such an interference fit can include a face of the concave locking feature 243 that is smaller than a corresponding outer surface of the joint portion 261. As another example, the interference fit can include a face of the convex locking feature 241 that is smaller than a corresponding outer surface of the joint member 261, for example, the protrusion 247 can extend into and engage the corresponding outer surface of the joint member 261. Figure 4C

[0103] ​In embodiments where one or more of the alignment or locking features have different shapes and / or sizes, the rotational position can be more easily confirmed intraoperatively. For example, the protrusions 252 can be visually confirmed to be properly positioned rotationally relative to the corresponding concave locking features 243, and / or the concave slots 251 can be visually confirmed to be properly positioned rotationally relative to the corresponding convex locking features 241. By providing two opposing protrusions 252, only two rotational positions can achieve securement of the joint portion 261 to the anchor 203. In some cases, the two positions provide the same biomechanics of the shoulder joint when assembled. The two positions are rotationally symmetrical. In other embodiments, the two positions provide two options with respect to biomechanics, such that the surgeon can choose between the two positions of the joint component 280 relative to the anchor 203. In a first rotational position, the first protrusion 252A is positioned in the first concave recess 243A positioned superiorly, and the second protrusion 252B is positioned in the second concave recess 243B positioned inferiorly. In a second rotational position, the first protrusion 252A is positioned in the second concave recess 243B positioned inferiorly, and the second protrusion 252B is positioned in the first concave recess 243B positioned superiorly. Different numbers of alignment or locking features can also be contemplated. For example, there can only be a single alignment feature on the rotational control region 285 to provide the correct rotational position.

[0104] After the joint portion 261 is advanced into the anchor 203, the counterload protrusion of the joint portion 261 is disposed within the recess of the anchor 203 (see FIG. 23). The joint portion 261 is then secured to the anchor 203 by the counterload protrusion 262 of the joint portion 261 engaging the recess 244 of the anchor 203. The counterload protrusion 262 of the joint portion 261 is configured to engage the recess 244 of the anchor 203 in a manner that prevents the joint portion 261 from rotating relative to the anchor 203. In some embodiments, the counterload protrusion 262 of the joint portion 261 is configured to engage the recess 244 of the anchor 203 in a manner that prevents the joint portion 261 from rotating relative to the anchor 203 in a first rotational direction. In other embodiments, the counterload protrusion 262 of the joint portion 261 is configured to engage the recess 244 of the anchor 203 in a manner that prevents the joint portion 261 from rotating relative to the anchor 203 in a second rotational direction. In some embodiments, the counterload protrusion 262 of the joint portion 261 is configured to engage the recess 244 of the anchor 203 in a manner that prevents the joint portion 261 from rotating relative to the anchor 203 in both the first rotational direction and the second rotational direction. Figure 4E). The first contact between the articulating portion 261 and the anchor 203 can be between a distal portion of the deflectable portion 254 and a proximal portion of the second recess 232. The deflectable portion 254 can be positioned in the second recess 232 of the anchor 203 when the articulating portion 261 is coupled to the anchor 203. The articulating portion 261 can be advanced until the deflectable portion 254 abuts a surface that surrounds the second recess 232. The deflectable portion 254 can abut the surface that surrounds the second recess 232 before the locking member 253 engages the channel 284 of the anchor 203. For example, the articulating portion 261 can be advanced until the tapered outer surface 257 of the deflectable portion 254 abuts the tapered surface of the second recess 232. After contact, segments of the deflectable portion 254 move toward each other over the compression groove 256 of the deflectable portion. The deflectable portion 254 can deflect circumferentially when the deflectable portion 254 of the articulating body 280 contacts the surface that defines the second recess 232 due to a load exerted by or from the surface that defines the second recess 232. This deflection of the deflectable portion 254 reduces, minimizes, or eliminates motion, even micro-motion, of the articulating portion 261 relative to the anchor 203. The deflectable portion 254 is sufficiently deflected so that a load is exerted in a direction opposite the advancement direction when the humeral assembly is assembled. The deflectable portion 254 can also provide a load between the locking member 253 and the peripheral portion 233 of the first recess 231.

[0105] The articulating assembly can be further advanced until the locking member 253 of the articulating portion 261 deflects within the channel 244 formed in the anchor 203 (see Figure 4F ). The locking member 253 can be used to lock the articulating portion 261 into the anchor 203 and prevent the articulating portion 261 from translating vertically outward from the anchor 203. The locking member 253 can transition between a rest configuration before the articulating portion 261 is inserted into the anchor 203 and a compressed configuration when the humeral assembly is assembled. In the compressed configuration, the locking member 253 can be radially compressed compared to the rest configuration. In the rest configuration, an inner periphery of the locking member can be disposed within the channel 284 and an outer periphery of the locking member 253 can be disposed outside of 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 in the channel 244 of the humeral anchor 203 (see Figure 4F ).

[0106] While the above examples are described with respect to a stemless anchor, features of the anchor 203 can be applied to anchors having a stem configured to extend into the humeral shaft, a fracture stem, or a modular component such as a tray or other spacer. For example, Figure 5AA humeral component with a stem is shown. Similar to the stemless humeral component, Figure 5A a stemmed humeral component can include an anchor 203 and an articular portion 261. As shown, Figure 5A the anchor 203 can include a cradle 289 that is mounted to a metaphyseal end portion of the stem 283, for example, by mating tapered portions that form a Morse taper connection. The articular portion 261, which can include any of the features described above, can be mounted to the cradle 289, for example, using any of the humeral anchor interface features described above.

[0107] As shown, Figure 5B the cradle 289 includes similar internal features to the stemless anchor 203 shown in Figure 4A For example, the cradle 289 includes a first recess 231 and a second recess 232 that extends distally from the first recess 231. The cradle 289 also includes an inner periphery 233 disposed about the first recess 231. As described above, the inner periphery 233 can include one or more alignment or locking features that are configured to interface with the rotational control region 285 of the articular portion 261. The inner periphery 233 can include a circumferential channel 244 that extends circumferentially along the inner periphery 233. The channel 244 can be sized relative to the locking member 253 of the articular portion 261 to provide a snap or interference fit with the locking member 253.

[0108] As discussed above, the clinician can optionally provide the cradle 289 or other spacer to fill soft tissue space. For example, if the clinician takes a low resection or the soft tissue is lax, the clinician can use the cradle 289 or other spacer to build up the stem. The cradle 289 or spacer will build up the thickness between the distal most point of the articular surface and the proximal face of the stem 283.

[0109] Figures 6A-6G Another articular portion 352 configured to be coupled to an anchor 304 is shown. The articular portion 352 can be configured as an articular 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. The single articular portion 352 can be capable of being compatible with each of stemless anchors, stemmed anchors, and / or cradles. The anchor 304 has a body portion 308, for example, a metallic body (see Figure 6DThe main body portion 308 has a bone engagement side 312 configured to rest against a bone and an assembly side 316 opposite the bone engagement side. The bone engagement side 312 may form part of any anchor described herein, including shankless or shank anchors. The assembly side 316 has a mounting region 324 configured to receive at least a portion of the joint portion 352, the mounting region including one or more recesses extending toward the bone engagement side. The mounting region 324 may include a channel 385 disposed around its periphery.

[0110] Figures 6A-6B Different views of joint portion 352 are provided. Joint portion 352 may include any features of joint portion 261. As described above, joint portion 352 includes joint body 356, such as a reverse component having a concave articular surface, but in some surgeries, as explained above, clinicians may choose to dissect joint components, such as... Figure 2 The anatomical joint component 160. In some embodiments, as described in more detail below, the joint portion 352 may be a joint assembly, such as a polymer joint body 356 and a locking member 302. In other embodiments, the joint portion 352 may be a single piece, such as the polymer joint body 356.

[0111] 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 articular surface 372 disposed in the second portion 368. The first portion 364 of the joint body 356 includes a distal surface 386 configured to be disposed in the mounting region 324 of the anchor 304. The first portion 364 of the joint body 356 may include one or more studs 353 from the distal surface 386 (see [link to documentation]). Figure 6B One or more anchor posts 353 may correspond to one or more corresponding recesses 321 in the proximal side 320 of the skeletal anchor 304 (see...). Figure 6DAt least one stud 353 may be centrifugally positioned, displaced relative to the center 360 of the joint body 356. In one case, multiple studs 353 are provided, each of which is centrifugal. Some variations may include a central recess disposed in the proximal side 320 of the skeletal anchor 304, for example, for mounting anatomical joint components, such as component 160. The stud 353 facilitates rotational alignment between the joint portion 352 and the anchor 304. In some embodiments, the joint body 356 may include a central stud or other protrusions extending from the distal surface 386 of the joint body 356. Any of the studs 353 may engage the anchor 304, for example, by mating tapered portions forming a Morse taper connection. Although the illustrated joint body 356 includes studs 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 studs extending proximally from the proximal side 320 of the anchor 304. In another variation, each of the anchor 304 and the joint body 356 has at least one stud and at least one recess to provide an advantageous combination of connection features.

[0112] like Figure 6A As shown, the second portion 368 of the joint body 356 may include a channel 384 disposed between the joint surface 372 and the distal surface 386. The channel 384 may be formed in a surface of the second portion 368 (e.g., a lateral peripheral or circumferential surface). Figure 6B As shown, the second portion 368 may include a recess 342 on the distal surface 386 of the joint body 356. The recess 342 may extend from the channel 384. For example, the recess 342 may extend proximally from the distal surface 386 of the joint body 356 to a certain depth in the channel 384.

[0113] 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 made of an elastic material such as titanium or another elastic metal. Figures 6A-6B As shown, the locking member 302 may be disposed around the joint body 356, for example, within the channel 384 of the second portion 368. The locking member 302 reversibly secures the joint body 356 against the anchor 304 by a simple clamping load via an impactor and a mallet, without the need for any other tools used to assemble the joint body 356 to the anchor 304. When the joint portion 352 is engaged with 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 [reference]). Figure 6E ).

[0114] The locking member 302 can include an arcuate member 306 disposed at least partially about the first portion 364 of the joint body 356, for example at least partially within the joint body passage 384. As shown, the arcuate member 306 can include an interruption 374 between a first end 366 of the arcuate member 306 and a second end 378 of the arcuate member to facilitate radial compression of the locking member 302. Figures 6B-6C As shown, the arcuate member 306 includes a scalloped edge or series of cutouts along at least a portion or the entire inner periphery 388, although in other examples the scalloped edge can be along the outer periphery 390. While these figures show a scalloped edge, other stress reduction features can include a reduction in thickness measured between the proximal surface and the distal surface of the locking member 302. The stress reduction features 392 facilitate bending and deflection of the arcuate member 306 to avoid plastic deformation during assembly. The stress reduction features 392 also help maintain the integrity of the locking member 302 when a compressive force is applied to the humeral component.

[0115] The inner periphery 388 and / or the outer periphery 390 of the locking member 302 can include one or more stress reduction features 392. For example, as shown, the arcuate member 306 includes a scalloped edge or series of cutouts along at least a portion or the entire inner periphery 388, although in other examples the scalloped edge can be along the outer periphery 390. While these figures show a scalloped edge, other stress reduction features can include a reduction in thickness measured between the proximal surface and the distal surface of the locking member 302. The stress reduction features 392 facilitate bending and deflection of the arcuate member 306 to avoid plastic deformation during assembly. The stress reduction features 392 also help maintain the integrity of the locking member 302 when a compressive force is applied to the humeral component. Figure 6C As shown, the outer periphery 390 of the locking member 302 can have a first edge or distal edge 328 and a second edge or proximal edge 310 disposed at an angle relative to the first edge 328 to form an apex. The second edge or proximal edge 310 can be disposed at an angle a 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 an upper edge of the anchor passage 385. The angle a can be greater than 0 degrees and less than or equal to 20 degrees, for example about 15 degrees. For locking member materials with higher friction factors, the angle a can be greater than 20 degrees. For example, the angle a can be less than or equal to about 45 degrees or less than or equal to about 30 degrees.

[0116] Figure 6E As shown, the outer periphery 390 of the locking member 302 can have a first edge or distal edge 328 and a second edge or proximal edge 310 disposed at an angle relative to the first edge 328 to form an apex. The second edge or proximal edge 310 can be disposed at an angle a 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 an upper edge of the anchor passage 385. The angle a can be greater than 0 degrees and less than or equal to 20 degrees, for example about 15 degrees. For locking member materials with higher friction factors, the angle a can be greater than 20 degrees. For example, the angle a can be less than or equal to about 45 degrees or less than or equal to about 30 degrees.

[0117] As shown, the outer periphery 390 of the locking member 302 can have a first edge or distal edge 328 and a second edge or proximal edge 310 disposed at an angle relative to the first edge 328 to form an apex. The second edge or proximal edge 310 can be disposed at an angle a 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 an upper edge of the anchor passage 385. The angle a can be greater than 0 degrees and less than or equal to 20 degrees, for example about 15 degrees. For locking member materials with higher friction factors, the angle a can be greater than 20 degrees. For example, the angle a can be less than or equal to about 45 degrees or less than or equal to about 30 degrees. Figure 6E ​As shown, the second edge 310 of the locking member 302 can include a first portion 310A and a second portion 310B. To maintain the fixation 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 passage 385 in the anchor 304. Upon insertion of the joint portion 352 into the anchor 304, the distal edge 328 of the locking member 302 is urged toward the distal edge of the passage 385. Upon compression, the locking member 302 elastically recovers such that the proximal edge 310 contacts the retaining surface 322. When the joint body 356 is coupled with 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 retaining surface 332 of the anchor passage 385, or is disposed closer to the joint surface 372 than the retaining surface 332 in the direction of the central insertion axis 360.

[0118] When the locking member 302 is deflected into the anchor passage 352, there is an interference fit between the anchor 304 and the locking member 302. An angle a between the second edge 310 of the locking member 302 and the plane PLN 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, for example less than or equal to about 15 degrees) will maintain contact between the locking member 302 and the anchor 304 regardless of the pulling force F T How. As Figure 6E As shown, the frictional force F F will prevent the locking member 302 from being released from the anchor passage 385, while the reaction force F R will prevent the locking member 302 from sliding further into the anchor passage 385. The frictional force F F in combination with the reaction force F R reduce or eliminate movement between the joint body 356 and the anchor 304. For example, the locking member 302 allows no more than 0.05 mm of movement between the anchor 304 and the joint body 356 in the longitudinal and / or transverse directions, or even no movement. The angled locking member 302 allows the humeral assembly to accommodate large forces exerted on the shoulder joint without the risk of disassembly or elimination of manufacturing voids.

[0119] The shape of the outer periphery 388 also enables the locking member 302 to accommodate a range of voids 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 void (or no void) between the anchor passage 385 and the joint body passage 384.Figure 6F (Similar to other relatively large gaps) or there is a minimum gap between the anchor channel 385 and the joint body channel 384 (or the same as other relatively large gaps) Figure 6G (Similar to other relatively small gaps).

[0120] 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 generally corresponding 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 locations or only one location (such as a central location). The recess 342 may be shaped to receive the resilient body 314 while allowing some movement of the body 314, since the joint body 356 does not impede the loading and unloading of the body 314. This feature contributes to the correct orientation of the locking member 302 relative to the joint body 356. Correct orientation facilitates easy removal of the locking member 302, as the locking member is always in the same location.

[0121] 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 extends from the first end 366 of the arcuate member 306. The second end 322 of the elastic body 314 is disposed radially inward of the arcuate member 306. In this configuration, the second end 378 of the arcuate 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 may overlap with the arcuate member 306, but is disposed in a radially inward position.

[0122] 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 at least span a certain length of the gap 374 in the arcuate member 306.

[0123] Locking member 302 can be coupled to body portion 356 to hold locking member 302 in a predefined position and orientation. For example, the second end 322 of resilient body 314 can be coupled to body portion 356. Figure 6BAs shown, the second end 322 of the resilient body can include a first engagement feature 358 that couples to a second engagement feature 357 of the body portion 356. The first engagement feature 358 can include an opening or a peg, and the engagement feature 357 of the body portion 356 can include a reverse of the first engagement feature 358. If the engagement feature 357 is a peg, the engagement feature 358 can be an aperture formed in the second end 322.

[0124] The second end 322 of the resilient body 314 can be enlarged to form a positioning member body. The positioning member body can be disposed in the recess 342 in 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 within the recess 342. In some embodiments, the resilient body 314 can have an arcuate portion, and the walls of the portion of the recess 342 in which the body is positioned can have an arcuate shape. The side edges of the resilient body 314 can be spaced apart from the opposing walls of the recess 342, for example, equally. In some embodiments, the spacing of the resilient body 314 relative to the walls of the recess 342 can increase along the length of the body in a direction away from the engagement features 357, 358.

[0125] As described above, the locking member 302 can be shaped to accommodate a range of gaps between the anchor passage 385 and the joint body passage 384. However, this can result in the locking member 302 being off-center relative to the central axis 360 of the shoulder implant. The resilient body 314 can be configured to center the arcuate member 306 relative to the central insertion axis 360. For example, the resilient body 314 stores strain energy when a deflection force is applied to deflect the locking member 302 away from a centered position (e.g., about the central point 360), and releases the strain energy to return the locking member 302 toward the centered position after the deflection force is removed.

[0126] Other configurations of the locking member can 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 can include any of the features described above with respect to the locking member 302.

[0127] As 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 can include an interruption 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 can include one or more stress reduction features 492 to facilitate bending and deflection of the arcuate member 406 so as 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 a scalloped edge is shown, other stress reduction features are possible, such as a reduced thickness, or in some embodiments, a material treatment technique provided along an edge or periphery of the locking member 402 or between the proximal and distal edges of the locking member. Sections 493 between the stress reduction features 492 can include any of the features of the outer periphery 390 described above to facilitate engagement between the joint portion 452 and the anchor. Figure 7 Although a scalloped edge is shown, other stress reduction features are possible, such as a reduced thickness, or in some embodiments, a material treatment technique provided along an edge or periphery of the locking member 402 or between the proximal and distal edges of the locking member. Sections 493 between the stress reduction features 492 can include any of the features of the outer periphery 390 described above to facilitate engagement between the joint portion 452 and the anchor.

[0128] As shown, the arcuate member 406 includes a first arcuate portion 406A extending from the first end 466 and a second arcuate portion 406B extending from the second end 478. The locking member 402 can also include a resilient body 414 extending between the first arcuate portion 406A and the second arcuate portion 406B. The resilient body 414 includes a base 415 positioned radially inward 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 resilient body 414 can 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 overhang 464 extending away from one of the first radial members 462A, 462B to a wall of the recess 442. In one embodiment, the overhang 464 spaces the first radial member 462A from the wall of the recess 442 so that the wall does not constrain movement of the member 462A. The base 415 can have an overhang 464 at each end to provide this spacing function for both members 462A, 462B.

[0129] The resilient 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 resilient body 414 in a limited number of positions or only a single position, such as a centered 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 of the resilient body 414 can be wider than a portion of the recess that extends from the perimeter to a portion of the base retention portion of the recess. Similarly, the base 415 of the resilient body 414 can be wider than the combined width of the radial members 462A, 462B. The resilient body 414 can form a C-shape, an inverted or reversed or inverse C-shape recess that can receive a portion of the bottom side or distal or medial face of the joint body 456.

[0130] 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 deflection force is applied to deflect the locking member 402 away from a centered position (e.g., about the central point 460) and releases the strain energy to return the locking member 402 toward the centered position after the deflection force is removed.

[0131] Figure 8A Another locking member 502 is shown that includes different configurations of resilient bodies. The locking member 502 can include any of the features described above with respect to the locking members 302, 402.

[0132] As shown, the locking member 502 includes an arcuate member 506 that has an interruption 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 can also include one or more stress reduction features 592 disposed along at least a portion of an inner perimeter 590 and / or an outer perimeter 588 of the arcuate member 506. As Figure 8B As shown, the locking member 502A can include stress reduction features 592 along only the inner perimeter 590 of the arcuate member 506. In another variation, the stress reduction features 592 can be located only on the outer perimeter 588 of the arcuate member 506. In either configuration, the outer perimeter 588 can have a beveled configuration as described above with respect to the locking member 302.

[0133] The locking member 502 may further include one or more resilient bodies 514 extending from the inner periphery 590 of the arcuate member 506 (e.g., at least two resilient bodies, at least three resilient bodies, or in one case only three resilient bodies). Each of the resilient 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 resilient bodies 514 may have an arcuate shape from the first end 518 to the second end 522. The resilient bodies 514 may be circumferentially spaced apart from each other. For example, the second end 522 of each resilient body 514 may be circumferentially spaced from the first end 518 of the adjacent resilient body 514 (e.g., equally spaced and spaced apart at 120 degrees in the case of only three bodies 514).

[0134] When coupled to the joint body, the elastic body 514 may be disposed within the joint body channel. Each elastic body 514 may 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 deflecting force is applied to deflect the locking member 502 away from the centered position, and releases the strain energy after the deflecting force is removed to return the locking member 502 to the centered position. When more than one elastic body 514 is provided, these bodies may 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 in the main body (spanning the 3 o'clock position) is released, the adjacent segment of the locking member 502 (also at the 3 o'clock position) can be offset away from the main body 514 (e.g., in...). Figure 8A In this configuration, member 502 can move to 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 offset of another segment of locking member 502 (e.g., at the 10 o'clock position) towards another body 514 (e.g., the body 514 connected to member 502 at the 12 o'clock position, which extends to its free end between the 9 and 10 o'clock positions), which may cause strain energy to be stored in the other body 514 (thus 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 limits the movement of locking member 502 (to the right in this example) so that the elastic body 514 does not overcorrect by moving the locking member centrifugally (e.g., too far to the right).

[0135] As explained above, for humeral fractures, kit 100 may also include one or more fracture stems 140. Figure 9A Another joint portion 652 configured to be attached to the fracture stem 140 is shown. Although Figure 9AA bone fracture stem is shown, but the bone fracture stem can be a stemless anchor or a stemmed anchor including 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 bone fracture stem 140 can be shared among variations of these additional humeral anchors to provide common components in variations of the kit 100 in which the connection features of the stem 140 are present in other anchors in the kit.

[0136] The proximal end of the bone fracture stem 140 includes a peripheral wall 621 that defines a cavity 619. The cavity 619 is radially spaced from and surrounds the bore 617 at the proximal end of the stem 140. The bore 617 can be at least partially formed in a raised portion 623. The raised portion 623 of the bore 617 enables the bone fracture stem 140 to be compatible with anatomic joint components similar to the anatomic joint component 160, but can exclude the disc or intermediate portion 162 provided in the coupler 168. A modified version of the coupler 160 can 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. A proximal surface 624 of the raised portion 623 can be in the same plane or substantially the same plane as a proximal surface 622 of the peripheral wall 621. The bone fracture stem 140 can also include a channel 625 that surrounds an inner periphery of the peripheral wall 621.

[0137] 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 can be capable of being compatible with each of stemless anchors, stemmed anchors, and / or cradles. The joint portion 652 can 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 inverse component having a concave joint surface 672, but in some procedures, as explained above, the clinician can select an anatomic joint component, such as the anatomic joint component 160. In some embodiments, as described in greater detail below, the joint portion 652 can be a joint assembly, e.g., a polymeric joint body 656 and a locking member 602. In other embodiments, the joint portion 652 can be a single piece, e.g., a polymeric joint body 656. Figure 2 As described above, the joint portion 652 can include a joint body 656, such as an inverse component having a concave joint surface 672, but in some procedures, as explained above, the clinician can select an anatomic joint component, such as the anatomic joint component 160. In some embodiments, as described in greater detail below, the joint portion 652 can be a joint assembly, e.g., a polymeric joint body 656 and a locking member 602. In other embodiments, the joint portion 652 can be a single piece, e.g., a polymeric joint body 656.

[0138] Figure 9B ​As 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, which is configured to be disposed in a 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 a protrusion 623 in the proximal side of the fracture stem 140 (see...). Figure 9A The recess 690 may be asymmetrical about at least one axis to facilitate proper rotational alignment with the protrusion 623, for example, to allow the recess 690 to receive only one, two, or another limited number of rotational positions of the protrusion 623. For example, as 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 joint portion 652 is engaged with the fracture stem 140, the surface 688 of the recess 690 covers the protrusion 623 without filling the hole 617.

[0139] The joint body 656 may include markings 679 to provide indication of anatomical orientation for implantation. For example, markings 679 may indicate the side of the joint body 656 that should be aligned with the lateral surface of the humerus. Figure 9B As shown, the mark 679 may be a notch on the distal surface 686 of the joint body 656. However, the mark 679 may be printed or otherwise visually indicated on the distal surface 686 or at other locations on the joint body 656.

[0140] 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 the surface, such as in 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 made of an elastic material such as a resilient metal. The locking member 602 may include any of the features of the locking members 253, 302, 502, and 502A described above.

[0141] like Figures 9A-9BAs shown, locking member 602 may be disposed around joint body 656, for example, disposed within channel 684. Locking member 602 reversibly secures joint body 656 against fracture handle 140 by a simple compressive load via an impactor and mallet, without the use of any other tools for assembling joint body 656 to fracture handle 140. When joint portion 652 is engaged with fracture handle 140, locking member 602 is deflected such that the outer periphery of locking member 602 is disposed within handle channel 625 and the inner periphery of locking member 602 is disposed within joint body channel 684.

[0142] Figure 10A Another joint portion 752 compatible with one or more other humeral anchors in variations of the fracture stem 140 or kit 100 is shown. Joint portion 752 may include any of the features described above with respect to joint portions 261, 352, 452, 652. In some embodiments, joint portion 752 may be a joint assembly, such as a polymer joint body 756 and a locking member 702. In other embodiments, joint portion 752 may be a single piece, such as the polymer joint body 756.

[0143] 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, which is configured to be disposed in a cavity 619 of the fracture stem 140 (see...). 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 proximal portion 623 in the fracture stem 140 (see...). Figure 9A The recess 790 may include any features of the recess 690 described above. The joint body 756 may also include a marker 779 to provide an indication of anatomical orientation for implantation. The marker 779 may include any features of the markers 679 and 279.

[0144] The first portion 764 of the joint body 756 may also include a counter-load or deflectable portion 754 that protrudes distally from the distal side of the joint body 756, for example 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 truncated conical profile or other profiles. When inserted into the hole 617 of the fracture stem 140, the deflectable portion 754 may be able to compress toward the central longitudinal axis L (see [link to relevant documentation]). Figure 10B). The deflectable portion 754 can include any features of the deflectable portion 254. For example, the deflectable portion 754 can 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 can also include a compression slot 789 disposed between each of the at least two segments 755. For example, as shown in Figure 10A the deflectable portion 754 can include four segments 755 separated by intersecting compression slots 756. Upon insertion of the deflectable portion 754 into the hole 617, the one or more compression slots 756 enable the deflectable portion 754 to be compressed in a direction transverse to the longitudinal axis L or in an annular direction.

[0145] The joint body 756 can include a channel 784 disposed between the joint surface 772 and a distal surface 786. The channel 784 can be formed in a surface, such as a lateral perimeter or circumferential surface. The joint portion 752 can include a locking member 702 to ensure mechanical fixation between the joint body 756 and the fracture handle 140. The locking member 702 can be composed of a resilient material, such as a resilient metal. The locking member 702 can include any features of the locking members 253, 302, 502, 502A, 602 described above.

[0146] As shown in Figure 10B the locking member 702 can be disposed about the joint body 756, such as within the channel 784. The locking member 702 reversibly secures the joint body 756 against the fracture handle 140 by simple compression loading via a mallet and a wooden hammer, without using any other tools for assembly of the joint body 756 to the fracture handle 140. When the joint portion 752 is coupled to the fracture handle 140, the locking member 702 is deflected such that an outer perimeter of the locking member 702 is disposed within the handle channel 625 and an inner perimeter is disposed within the joint body channel 784.

[0147] The locking member 702 can include a proximal edge 702a and a distal edge 702b. The distal edge 702b can be disposed at an angle relative to the proximal edge 702a (see Figure 10B ). Upon insertion of the joint portion 752 into the fracture handle 140, the distal edge 702b of the locking member 702 is advanced toward the distal edge 625b of the channel 625. Upon compression, the locking member 702 elastically recovers such that the proximal edge 702a of the locking member 702 contacts the proximal edge 625a of the channel 625.

[0148] When the humeral implant has been fully assembled, the locking member 702 can be disposed along a plane PLN distal to the proximal face of the fracture stem 140. The PLN can extend transversely through the deflectable portion 752. The locking member 702 can be disposed between a 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 with the coupler of the anatomical joint component to be close to or at the proximal end of the fracture stem 140.

[0149] In a variation of the deflectable portion 752, a continuous protrusion can be provided that does not have a slot 789. For example, similar to the blind hole 298 of the protrusion of the embodiment of Figure 3F , a blind hole can be formed in the protrusion having a tapered outer profile and a closed interior.

[0150] Figures 11-12 Other engagement features are shown that can be used to couple the joint portion with the fracture stem 140 or other bone anchor in conjunction with any of the joint portions identified above.

[0151] Figure 11 A joint body 856 is shown having a distal surface 886. The joint body 856 can include a recess 890 extending proximally from the distal surface 886. The shape of the recess 890 can correspond to the raised portion 623 (see Figure 9A ) in the proximal face of the fracture stem 140. The recess 890 can include any of the features of the recess 690 described above. The joint body 856 can also include the indicia 879 including any of the features of the indicia 679, 279.

[0152] The joint body 856 can include one or more deformable protrusions 894 extending from the distal surface 886. The one or more deformable protrusions 894 can correspond to one or more corresponding recesses in the proximal face of the bone anchor. The one or more deformable protrusions 894 are compressed upon insertion into the one or more corresponding recesses. The one or more deformable protrusions 894 can comprise a deformable material, for example a deformable polymeric material such as UHMWPE. The one or more deformable protrusions 894 can comprise a continuous perimeter without any gaps, slots, or other discontinuities. At least one deformable protrusion 894 can be positioned eccentrically, displaced from the center of the joint body 856. For example, each of the one or more deformable protrusions 894 can be disposed radially between the recess 890 and the outer perimeter 896 of the distal surface 886. The one or more deformable protrusions 894 can also facilitate rotational alignment between the joint portion 852 and the bone anchor. Any of the deformable protrusions 894 can 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 can be possible.

[0153] Figure 12 A joint body 956 is shown having a distal surface 986. The joint body 956 includes a first or distal portion 964 and a second or proximal portion 968. The joint body 956 has an articulating surface disposed in the second portion 968. The first portion 964 of the joint body 956 includes the distal surface 986 configured to be disposed in the cavity 619 of the fracture stem 140 (see Figure 9A ).

[0154] The joint body 956 can include a recess 990 extending proximally from the distal surface 986. The recess 990 can correspond in shape to the raised portion 623 (see Figure 9A ) in the proximal face of the fracture stem 140. The recess 990 can include any of the features of the recess 690 described above. For example, the recess 990 can have a straight portion 990a on its outer side and a curved portion 990b on its inner side. The joint body 956 can also include the indicia 979 having any of the features of the indicia 679, 279.

[0155] The entire distal portion 964 can be compressed upon insertion into the cavity 619 of the fracture stem 140 to form a press fit connection. The distal portion 964 can be divided into at least two segments 987, for example three segments or four segments, by compression slots 989. For example, as shown in FIG. 48, the distal portion 964 can be divided into a first segment 987a, a second segment 987b, and a third segment 987c. The first segment 987a can be disposed between the recess 990 and the second segment 987b. The second segment 987b can be disposed between the first segment 987a and the third segment 987c. The third segment 987c can be disposed between the second segment 987b and the outer perimeter 896 of the distal surface 986. Figure 12As shown, the distal portion 964 can include three segments 987 separated by compression grooves 956 extending from the outer periphery 996 to the recess 990. The distal portion 964 can include a first segment 987 along a straight portion 990a of the outer side or recess 990 and at least one segment 987, e.g., two segments 987, along a curved portion 990b of the inner side or recess 990. The distal portion 964 can include two compression grooves 989 aligned along the transverse axis X. The distal portion can 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 the annular direction when the distal portion 964 is inserted into the cavity 619 of the fracture handle 140.

[0156] Terminology

[0157] Although certain embodiments have been described herein, the implants and methods described herein are capable of using any joint component interchangeably as the context can dictate.

[0158] As used herein, the relevant terms “proximal” and “distal” are to be defined from the perspective of the implant. Thus, proximal refers to the direction of the joint component and distal refers to the direction of the anchor component, such as the stem of a humeral anchor, or the threaded or porous surface or other anchoring structure of a stemless anchor, when the implant is assembled.

[0159] Conditional language, such as “can,” “could,” “might,” or “may,” among others, unless specifically stated otherwise, generally refers to circumstances wherein a feature, element, or step can exist or can not exist, or can occur or can not occur. The use of such conditional language, unless otherwise specifically noted, is also intended in the context of describing features, elements, and / or steps in the embodiments that can or can not be present in some embodiments. The disclosure can include various embodiments and examples of features, elements, and / or steps that can or can not be present in some embodiments.

[0160] The terms “comprising,” “including,” “containing,” “have” and “including” are synonymous and are used in an open-ended fashion and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, in a list of two or more items, the term “or” means one, some, or all of the elements in the list. In addition, the articles “a,” “an,” and “the” as used in this application and the appended claims should not be construed as meaning “one and only one” or “the only,” but rather “one or more.” Unless specifically stated otherwise, and as can be appreciated by those skilled in the art, throughout the present application, numbers such as 1, 2, 3, etc. are used as identification for the purpose of clarity only and are not to be construed as limiting the scope of the application.

[0161] The scope of the disclosure also encompasses any and all overlaps, sub- ranges, and combinations thereof. Language such as "up to," "at least," "greater than," "less than," "between," and the like includes the number recited. Numerical amounts preceded by a term such as "about" or "approximately" include the recited amount and should be interpreted in the context according to the use (e.g., as accurately as reasonably possible, e.g., ±5%, ±10%, ±15%, etc.). For example, "about 1" includes "1." Phrases preceded by a term such as "substantially," "essentially," or "approximately" include the recited phrase and should be interpreted in the context according to the use (e.g., as much as is reasonably possible under the circumstances). For example, "substantially spherical" includes "spherical." Unless otherwise stated, all measurements are at standard conditions including temperature and pressure.

[0162] As used herein, the phrase "at least one of a list of items refers to any combination of those items, including single 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 otherwise specified, or as understood by one of ordinary skill in the art, connective language, such as the phrase "at least one of X, Y, and Z," is generally intended to convey the same meaning as the phrase "at least one of X, Y, or Z."

[0163] While certain embodiments and examples have been described herein, it is emphasized that many variations and modifications can be made to the humeral head assembly shown and described in the present disclosure, the elements of which should be understood to be combined and / or modified differently to form additional embodiments or acceptable examples. All such modifications and variations are intended to be included herein within the scope of the present disclosure. A wide variety of designs and methods are possible. None of the features, structures, or steps described herein are essential or indispensable.

[0164] Some embodiments have been described in connection with the accompanying drawings. However, it is to be understood that the drawings are not to scale. Distances, angles, etc. are merely illustrative and do not necessarily bear a strict relationship to actual dimensions and layout of the devices illustrated. Components can be added, removed, and / or rearranged. Additionally, the disclosure herein of any particular feature, aspect, method, property, characteristic, quality, attribute, element, or the like in connection with any specific embodiment(s) set forth herein can be introduced into any other embodiment(s) set forth herein. Additionally, it will be recognized that any methods described herein can be practiced using any device suitable for performing the recited steps.

[0165] For purposes of the present disclosure, certain aspects, advantages, and novel features are described herein. It will be understood that not all such advantages can be achieved in all embodiments of the present disclosure. Accordingly, for example, those skilled in the art will recognize that the present disclosure can be embodied or carried out in a manner that achieves one advantage or a group of advantages as taught or suggested herein without necessarily achieving other advantages as can be taught or suggested herein.

[0166] Furthermore, while illustrative embodiments have been described herein, those skilled in the art will appreciate that the scope of the present application extends beyond the specifically disclosed embodiments to other equivalent and / or similar embodiments, adaptations, and / or modifications, as can occur to those skilled in the art upon a reading of the above description and appended claims, in view of the instant disclosure. The limitations in the claims are to be interpreted broadly based on the language read in light of the prior art de scribed, and throughout the specification and examples. The scope of the present application is limited only by the claims. Numerous other embodiments are envisaged which do not depart from the scope of the present application. None of the action taken in this regard is a disclaimer of any aspect of the application, and it is expressly intended to encompass all such aspects and modifications within the scope of the claims. Further, the language used in the specification should not be limited to the meaning that it has in the context of the disclosure, but should be interpreted according to the full breadth permitted by the law.

[0167] Any method disclosed herein does not require the steps to be performed in the order disclosed. The methods disclosed herein include certain actions taken by a practitioner; however, the methods can also include any third-party instruction of, or related to, the actions. For example, an action such as "coupling the glenoid guide with the glenoid rim" includes "instructing to couple the glenoid guide with the glenoid rim."

Claims

1. A joint component, comprising: The joint body includes: The main body includes: A joint surface, wherein the joint surface is disposed on or adjacent to the first end of the joint body; A lateral surface defining the distal side of the body portion, the lateral surface being configured to cover the edge of the humeral anchor; and The humeral anchor interface includes: Channel, the channel being formed by a circumferential surface; and A deflectable portion, wherein the deflectable portion is disposed at the second end of the joint body, the deflectable portion being configured to deflect circumferentially; and A rotation control area is disposed between the main body portion and the humeral anchor interface, the rotation control area including at least one first alignment feature and at least one second alignment feature.

2. The joint component of claim 1, wherein the at least one first alignment feature includes a first protrusion and the at least one second alignment feature includes a first recess.

3. The joint component of claim 2, wherein the at least one first alignment feature includes a second protrusion and the at least one second alignment feature includes a second recess.

4. The joint component as claimed in claim 3, wherein The first protrusion extends in a first direction. The first recess extends in a second direction different from the first direction, and The first recess is located between the first protrusion and the second protrusion.

5. The joint component as claimed in claim 4, wherein... The second protrusion extends parallel to the first protrusion; and The second recess extends parallel to the first recess.

6. The joint component of claim 2, wherein the first protrusion extends in a first direction, the first direction being transverse to the direction in which the first recess extends.

7. The joint component as claimed in any of the preceding claims, wherein the deflectable portion comprises at least two segments extending from the central portion of the main body portion.

8. The joint component of claim 7, wherein the compression groove is disposed between each of the at least two segments.

9. The joint component of claim 1, wherein the deflectable portion includes a tapered surface on its outer periphery.

10. The joint component of claim 1, further comprising a locking ring disposed within the channel and configured to secure the joint body to the bone anchor.

11. The joint component of claim 10, wherein the locking ring comprises a break.

12. The joint component of claim 1, wherein the joint body includes markings to provide anatomical orientation for implantation.

13. The joint component of claim 1, wherein the main body portion includes an edge portion between the joint surface and the outer wall.

14. The joint component of claim 13, wherein the proximal portion of the joint body is angled relative to the transverse surface.

15. The joint component of claim 14, wherein the center of the radius of curvature of the joint surface is not aligned with the central axis of the joint body.

16. An arthroplasty kit, comprising: The joint component as described in claim 1; as well as A humeral anchor, the skeletal anchor having an edge, the humeral anchor including a first recess surrounded by the edge and extending from the proximal side to the distal side, the first recess being sized and configured to receive the humeral anchor interface of the joint component.

17. The arthroplasty kit of claim 16, wherein, The humeral anchor includes a second recess extending distally from the first recess, the volume of the second recess being different from the volume of the first recess, and the second recess being sized and configured to receive the deflectable portion of the joint component.

18. The arthroplasty kit of claim 16, further comprising a bracket having a first end and a second end, the first end of the bracket being configured to engage a first recess of the bone anchor, and the second end of the bracket including a bracket recess for engaging the joint component.

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