artificial devices

Abstract

The prosthetic device includes a base plate having a peripheral bore, a central screw extending from a bone-contacting surface of the base plate, and a peg having an osteogenic coating. The peg is coupled to the peripheral bore and can extend a first length beyond the bone-contacting surface of the base plate into a hole formed in the bone, the depth of the hole being greater than the first length.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims the benefit of and priority to U.S. Provisional Patent Application No. 63 / 413,761, filed October 6, 2022, U.S. Provisional Patent Application No. 63 / 380,018, filed October 18, 2022, and U.S. Provisional Patent Application No. 63 / 520,400, filed August 18, 2023, each of which is incorporated by reference herein in its entirety.

[0002] FIELD OF THE INVENTION The present disclosure relates generally to orthopedics, and more particularly to components for insertion into bone. [Background technology]

[0003] Orthopedic surgeons attempt to replace or correct musculoskeletal components affected by trauma, injury, and / or disease. Joint replacement surgery, such as for the hip or shoulder, is a fairly common orthopedic procedure. Such surgery requires the insertion of an implant into bone to help anchor a joint replacement component, such as a ball-and-socket component of a hip or shoulder joint. There are two types of bone: cortical and cancellous. Cortical bone is the hard outer layer of bone, and cancellous bone is the spongy inner layer of bone. Existing bone implants often use long bicortical screws that extend through the first cortical bone layer, the cancellous bone layer, and finally the second cortical bone layer. Some patients do not have enough dense bone available to provide adequate screw fixation, necessitating the use of screws in that area, potentially reducing overall structural fixation. There is a need for systems, methods, and apparatus for prosthetic devices that can be inserted when bicortical screw fixation cannot be achieved and additional peripheral augmentation fixation would be beneficial. Summary of the Invention

[0004] According to some implementations of the present disclosure, a prosthetic device includes a base plate having a peripheral bore, a central screw extending from a bone-contacting surface of the base plate, and a peg having an osteogenic coating. The peg is coupled to the peripheral bore and can extend a first length beyond the bone-contacting surface of the base plate into a hole formed in the bone. The depth of the hole in the bone is greater than the first length.

[0005] According to some implementations of the present disclosure, a method of installing a prosthetic device includes providing a prosthetic device. The prosthetic device includes a base plate, a central screw, and a peg. The base plate includes a peripheral bore. The peg has a first length. The method also includes providing a bone and drilling a hole of a second length in the bone. The method includes inserting a central screw through the base plate into the bone. The method further includes inserting the peg into the hole through the peripheral bore. [Brief explanation of the drawings]

[0006] Disclosed herein are system, apparatus, and method implementations related to prosthetic devices. This description includes the following drawings: [Figure 1A] FIG. 1 illustrates a top perspective view of an assembled modular prosthetic device according to some implementations. [Figure 1B] FIG. 1B illustrates a bottom perspective view of an assembled modular prosthetic device according to some implementations. [Figure 2A] FIG. 1 illustrates a top perspective view of an exploded modular prosthetic device according to some implementations. [Figure 2B] FIG. 1B illustrates a bottom perspective view of an exploded modular prosthetic device according to some implementations. [Figure 3A] 1A-1C are side and cross-sectional views of a peg according to some implementations. [Figure 3B] 1A-1C are side and cross-sectional views of a peg according to some implementations. [Figure 4] 1 illustrates a cross-sectional view of a prosthetic device implanted in a shoulder, according to some implementations. [Figure 5] A method for placing a prosthetic device, according to some implementations. [Figure 6A] FIG. 1 illustrates a top perspective view of an assembled, one-piece prosthetic device according to some implementations. [Figure 6B] FIG. 10 illustrates a bottom perspective view of an assembled, one-piece prosthetic device according to some implementations. [Figure 7A] FIG. 1 illustrates a top perspective view of a disassembled integrated prosthetic device according to some implementations. [Figure 7B] FIG. 1B illustrates a bottom perspective view of an exploded integrated prosthetic device according to some implementations. [Figure 8] FIG. 1 illustrates a top perspective view of a disassembled one-piece prosthetic device having an implant component for use with the prosthetic device, according to some implementations. DETAILED DESCRIPTION OF THE INVENTION

[0007] The present disclosure will now be described with reference to the accompanying drawings, wherein like reference numerals are used to denote similar or equivalent elements throughout. Certain aspects of the present disclosure are described below with reference to example implementations for illustration.

[0008] Described herein are systems, methods, and devices that attempt to minimize, if not eliminate, the shortcomings of currently available bone implants. For example, in some implementations, the systems, methods, and devices described herein do not use any bicortical screws or use relatively few bicortical screws (e.g., some implementations of the present disclosure use one, two, or three screws instead of four). Rather, the systems, methods, and devices described herein utilize at least one peripheral peg in addition to or instead of one or more traditional bicortical screws. Reduced reliance on bicortical screws to implant prosthetic devices can also make joint replacement surgery more amenable, since a relatively smaller amount of dense bone (e.g., bone hard enough to accept and adequately retain bicortical screws) is required. Discussion of FIGS. 1A-3B provides an overview of such prosthetic devices.

[0009] 1A-2B, a modular prosthetic device 100 according to some implementations of the present disclosure is shown. The prosthetic device 100 includes a base plate 110, a central screw 120 and neck adapters extending in opposite directions from the center of the base plate 110, peripheral screws 140, and pegs 150. The peripheral screws 140 and pegs 150 are insertable into the base plate 110.

[0010] The prosthetic device 100 includes a base plate 110 having four peripheral bores 112A-D (best shown in FIGS. 2A and 2B) into which various fasteners can be inserted to secure the base plate 110 to bone. While four peripheral bores 112A-D are shown in FIGS. 1A-2B, this is not required, and in some implementations, the base plate 110 includes more or fewer than four peripheral bores 112A-D. For example, the base plate 110 can include one, two, three, five, six, or more peripheral bores 112A-D. Each of the peripheral bores 112A-D has threads 114A-D that cooperate with the threaded head of a fastener inserted into the peripheral bore 112A-D. However, this is not required, and in some implementations, one or more of the peripheral bores 112A-D do not have threads 114A-D, and the fastener is inserted via, for example, a press fit.

[0011] The base plate 110 has a bone-contacting surface 116A (best shown in FIGS. 1B and 2B ) and an opposite surface 116B (best shown in FIGS. 1A and 2A ) on opposite surfaces of the base plate 110. The bone-contacting surface 116A faces the bone into which the prosthetic device 100 is inserted. In some implementations, the bone-contacting surface 116A of the base plate 110 has an osteogenic coating to promote bone ingrowth and / or ingrowth, which may help improve fixation between the base plate 110 and the bone. The base plate 110 also includes a central bore 118 extending through the center of the base plate 110 and a boss 119. The boss 119 extends from the bone-contacting surface 116A of the base plate 110. The boss 119 helps to position the base plate 110 on the patient's bone. In some implementations, the boss 119 is made of the same material as the base plate 110, and in further implementations, the boss 119 and the base plate 110 are unitary. In some implementations, the boss 119 has an osteogenic coating to promote bone ingrowth and / or surface growth and further reduce the potential for micromotion. However, this is not required, and in some implementations, the boss 119 does not have an osteogenic coating.

[0012] The prosthetic device 100 also includes a central screw 120 (best shown in FIGS. 2A and 2B ) that is inserted into and extends through a central bore 118 of the base plate 110. In some implementations, the central screw 120 provides the primary fixation of the prosthetic device 100. The central screw 120 also serves to compress the bone into which it is inserted. Bone compression is advantageous for the installation of the prosthetic device 100 because it improves the stability of the prosthetic device 100, facilitates osseointegration (bone ingrowth into the prosthetic device 100), and minimizes the potential for micromotion.

[0013] The central screw 120 also extends through the boss 119. The boss 119 provides additional thickness to the base plate 110 and gives additional structure to the central screw 120, which helps to, for example, prevent the base plate 110 from rotating and / or pivoting relative to the central screw 120.

[0014] The central screw 120 has a keyed upper portion 122 to allow a tool, such as a screwdriver, to temporarily mate with the central screw 120 and facilitate insertion of the central screw 120 into the central bore 118 ( FIG. 2B ) and into the bone. However, the keyed upper portion 122 is not necessary, and in some implementations, the central screw 120 does not have a keyed upper portion 122. In some such implementations, the central screw 120 can be inserted into the central bore 118 via a press fit with the aid of a tool, such as a mallet, and / or by any other suitable means. In some implementations, the central bore 118 is threaded and the central screw 120 has a cooperating threaded head. However, this is not required, and in some implementations, the central bore 118 is not threaded and / or the central screw 120 does not have a threaded head.

[0015] The prosthetic device 100 also includes a neck adapter 130 (best shown in FIGS. 2A and 2B ) that is attachable to the base plate 110. The neck adapter 130 can be attached to the base plate 110 via partial insertion into a central bore 118 (best shown in FIG. 2A ). When coupled to the base plate 110, the neck adapter 130 protrudes from the base plate 110 in a direction opposite to the direction in which the central screw 120 extends. Although not shown in FIGS. 1A-2B , the neck adapter 130 is useful for attaching additional implant components, such as a glenosphere (see, for example, glenosphere 380 in FIG. 8 , described below). As shown, the central bore 118 is not threaded, which helps to facilitate insertion of the neck adapter 130 into the central bore 118. However, in some alternative implementations, the neck adapter 130 can be threaded into the central bore 118.

[0016] The prosthetic device 100 also includes a peripheral screw 140. The peripheral screw 140 can be inserted into one or more of the peripheral bores 112A-D. As shown in FIGS. 1A-2B , the peripheral screw 140 is inserted into the right-most peripheral bore 112D. The peripheral screw 140 helps to stabilize and anchor the prosthetic device 100 into the bone. However, the peripheral screw 140 is not required, and in some implementations, the prosthetic device 100 does not have any peripheral screws 140. In other implementations, the prosthetic device 100 has one, two, three, or more peripheral screws 140.

[0017] The peripheral screw 140 has a keyed upper portion 142 to allow a tool such as a screwdriver to temporarily mate with the peripheral screw 140 and facilitate insertion of the peripheral screw 140 into the peripheral bore 112D ( FIG. 2A ) and into the bone. However, the keyed upper portion 142 is not necessary, and in some implementations, the peripheral screw 140 does not have a keyed upper portion 142. In some such implementations, the peripheral screw 140 can be inserted into the peripheral bore 112D via a press fit with the aid of a tool such as a mallet and / or by any other suitable means. The peripheral screw 140 also has a threaded head 144 that can cooperate with the threads 114D of the peripheral bore 112D into which the peripheral screw 140 is inserted. The threaded head 144 of the peripheral screw 140 helps to secure the peripheral screw 140 within the peripheral bore 112D. However, the threaded head 144 of the peripheral screw 140 is not required, and in some implementations, the peripheral screw 140 does not have a threaded head 144. In such implementations, the peripheral screw 140 may be inserted into the peripheral bore 112D via, for example, a press fit, adhesive, and / or any other suitable means.

[0018] The prosthetic device 100 also includes a peg 150 configured to be inserted into one of the peripheral bores 112A-D and into a hole in a bone. The peg 150 has an osteogenic coating 152 (best shown in FIGS. 3A and 3B ) that covers at least a portion of the surface of the peg 150 and helps promote bone ingrowth and / or ingrowth (as described in more detail below with respect to FIGS. 3A and 3B ). The osteogenic coating 152 helps provide additional fixation of the peg 150 within the bone over time. However, the osteogenic coating 152 is not required, and in some implementations, the peg 150 does not have an osteogenic coating 152. There can be any suitable number of pegs 150 in the prosthetic device 100. For example, in some implementations, there are zero, one, two, three, four, five, or more pegs 150.

[0019] The peg 150 is designed to have a length such that the distal end 154 of the peg 150 does not touch the bone when the peg 150 is seated inside the bone hole. Having the distal end 154 of the peg 150 not touching the bone is advantageous because the length of the peg 150 is not dictated by the depth of the prepared hole in the bone. Thus, there is greater flexibility in selecting the length of the peg 150. Additionally, the distal end 154 of the peg 150 not contacting the bone prevents or at least reduces bone ingrowth and / or ingrowth on the distal end 154 of the peg. The absence or reduction of bone ingrowth and / or overgrowth on the distal end 154 of the peg facilitates subsequent revision compared to a prosthetic device 100 in which the distal end 154 of the peg 150 contacts the bone. Thus, in some implementations, the distal end 154 of the peg 150 is free of the osteogenic coating 152 to further reduce bone ingrowth and / or ingrowth on the distal end 154 of the peg 150. However, this is not required, and in some implementations, the distal end 154 of the peg 150 touches bone and / or has the osteogenic coating 152, for example, to further improve fixation within the bone.

[0020] The distal end 154 of the peg 150 can have any of a variety of suitable shapes, including, but not limited to, flat, conical, concave, convex, grooved, rounded, etc., or any combination thereof. The peg 150 can also have any of a variety of suitable shapes, including a cross-section having a circular, triangular, rectangular, conical, tapered, frusto-conical, etc., or any combination thereof. One advantage of a peg 150 that is at least partially tapered near at least its distal end 154 is that the tapered shape facilitates insertion of the peg 150 into a bone hole. Furthermore, the peg 150 can be of any suitable length. In some implementations, the peg 150 has a length of about 10 millimeters to about 30 millimeters, about 12 millimeters to about 28 millimeters, about 15 millimeters to about 25 millimeters, about 18 millimeters to about 22 millimeters, or any other suitable length.

[0021] Peg 150 also has a keyed top 156 to allow a tool, such as a screwdriver, to temporarily mate with peg 150 and facilitate insertion of peg 150 into peripheral bore 112A and into a bone hole. Note, however, that in some implementations, peg 150 does not have keyed top 156. In such implementations, for example, peg 150 may be inserted into peripheral bore 112A via a press fit with the aid of a tool, such as a mallet, and / or by any other suitable means.

[0022] The peg 150 has, for example, a threaded head 158 for cooperating with the threads 114A of the peripheral bore 112A into which the peg 150 is inserted. The threaded head 158 of the peg 150 serves to secure the peg 150 to the peripheral bore 112A. However, the threaded head 158 of the peg 150 is not required, and in some implementations, the peg 150 does not have a threaded head 158. In such implementations, the peg 150 may be inserted into the peripheral bore 112A via, for example, a press fit, an adhesive, and / or any other suitable means.

[0023] The pegs 150 and the peripheral screws 140 can have various relationships with respect to their respective lengths. In some implementations, the peripheral screws 140 are longer than the pegs 150. In other implementations, the peripheral screws 140 are shorter than or the same length as the pegs 150. For example, in some implementations, the length of the peripheral screws 140 is 5% to 10% longer, 10% to 15% longer, 15% to 20% longer, 20% to 25% longer, 25% to 30% longer, 30% to 40% longer, 40% to 50% longer, 50% to 60% longer, or any other percentage longer than the length of the pegs 150.

[0024] Both the pegs 150 and the peripheral screws 140 help prevent rotational movement of the base plate 110 relative to the central axis of the prosthetic device 100 ( FIGS. 1A-1B ). The pegs 150 and peripheral screws 140 also help provide additional fixation points to the bone for the prosthetic device 100. However, the greater the number of pegs 150 and peripheral screws 140, the greater the footprint of the prosthetic device 100, and therefore the more difficult and potentially more damaging it is to remove the prosthetic device 100. Therefore, the ideal number of peripheral screws 140 and / or pegs 150 on the prosthetic device 100 will vary depending on the size, density, and type of bone in which the prosthetic device 100 will be placed. For example, larger, denser bones can often accommodate more peripheral screws 140 and / or pegs 150, whereas smaller, weaker bones may only be able to accommodate a single peripheral screw 140 and / or a single peg 150.

[0025] The peripheral threads 140 provide short-term and long-term stability to the prosthetic device 100. The pegs 150 help provide enhanced long-term stability to the prosthetic device 100. To achieve enhanced long-term stability, the osteogenic coating 152 of the pegs 150 promotes bone ingrowth and / or overgrowth along the sides of the pegs 150. Thus, the pegs 150 become relatively more anchored in the bone over time as bone ingrowth and / or overgrowth occurs in and against the osteogenic coating 152. While anchoring the sides of the pegs 150 to bone is desirable for long-term stability, anchoring the distal ends 154 of the pegs 150 is avoided to facilitate later removal of the pegs 150, such as during a revision procedure.

[0026] During a revision procedure, the prosthetic device 100 is removed from the bone, which can cause stress on the bone supporting the prosthetic device 100, especially if there is bone ingrowth and / or overgrowth on the prosthetic device 100. To reduce stress on the bone during the revision procedure, the distal ends 154 of the pegs 150 do not contact the bone. Additionally, the distal ends 154 of the pegs 150 are free of the osteogenic coating 152, making it less likely that bone ingrowth and / or overgrowth will occur at the distal ends 154 of the pegs 150. However, this is not required, and in some implementations, the distal ends 154 of the pegs 150 have an osteogenic coating 152 on them. In other implementations, the distal ends 154 of the pegs 150 have a coating that helps prevent osseointegration. In some such implementations, the distal end portion of the peg 150 has a shape (e.g., a conical shape, a conical shape, a spherical shape, or the like, or any combination thereof) that differs from the cylindrical shape of the depicted body 151. In some such implementations, the distal end of such a body is not coated with an osteogenic coating 152.

[0027] The ideal number of peripheral screws 140 and pegs 150 will depend on how much short-term and long-term stability is desired, respectively, as well as the density, type, and size of the bone into which the prosthetic device 100 will be implanted.

[0028] 3A and 3B, additional details of a peg 150 according to some implementations of the present disclosure are shown. The peg 150 has a body 151 and a threaded head 158. As shown, the body 151 of the peg 150 is not threaded. That is, the body 151 of the peg 150 is not threaded, which is at least one way in which the peg 150 differs from screw-type fasteners. When the peg 150 is coupled with, for example, the first peripheral bore 112A (as shown in FIG. 1A), the body 151 of the peg 150 extends from the bone-contacting surface 116A of the base plate 110. As described above, the peg 150 has an osteogenic coating 152 to promote bone ingrowth and / or surface growth. The osteogenic coating 152 can take any suitable form. For example, the osteogenic coating 152 may include one or more of a smooth or coarse grained metal (such as titanium or alumina), hydroxyapatite, calcium phosphate, zoledronic acid, any other suitable material, or any combination thereof. According to some implementations, the osteogenic coating 152 has a smooth surface, a roughened surface, a grooved surface, or a combination thereof. In some implementations, the thickness w of the osteogenic coating 152 (FIG. 3B) c may be uniform or nearly uniform along the length of the peg 150. However, such is not required. For example, in some implementations, the thickness or width w of the osteogenic coating 152 may be c varies depending on the length of the peg 150. For example, according to some implementations, the osteogenic coating 152 has a uniform thickness, a non-uniform thickness, and / or a tapered thickness. In some implementations, the thickness w of the osteogenic coating 152 c The thickness w of the osteogenic coating 152 tapers along the length of the peg 150 toward the distal end 154 of the peg 150. In some such implementations, the tapered thickness w of the osteogenic coating 152 c facilitates insertion of the peg 150 into the hole in the bone.

[0029] As best seen in FIG. 3B, the diameter of the peg 150 having the osteogenic coating 152 is approximately the diameter w of the body 151 of the peg 150 alone.p The diameter of the peg 150 having the osteogenic coating 152 is greater than the diameter w p )+(2 * (Thickness of osteogenic coating 152 w c The diameter w of the body 151 of the peg 150 is calculated as p and the width w of the osteogenic coating 152 c may have any suitable measurement. p must be rigid and sufficient to avoid fracture, and the width w of the osteogenic coating 152 c must be large enough to promote bone ingrowth / surface growth.

[0030] In some implementations, the hole in the bone into which the peg 150 is inserted has a diameter that is greater than or equal to the diameter of the body 151 of the peg 150 alone, but the diameter of the hole is also smaller than the diameter of the peg 150 (including the body 151 and osteogenic coating 152 of the peg 150). In such implementations, when the peg 150 is inserted into the hole, the peg 150 compresses the bone due to the outward spreading force of the osteogenic coating 152 against the bone. This bone compression helps to anchor the peg 150 within the bone and promotes bone ingrowth and / or overgrowth on the outer surface of the peg 150.

[0031] Osteogenic Coating 152 Thickness w c is the diameter of the peg 150 p For example, in some implementations, the thickness w of the osteogenic coating 152 may be defined as c : Diameter of body 151 of peg 150 p The ratio of is in the range of about 1:50 to about 1:1, about 1:25 to about 1:2, and / or about 1:10 to 1:3. c In some implementations, the thickness w of the osteogenic coating 152 is in the range of about 0.1 mm to about 1.5 mm, about 0.2 to about 1 mm, about 0.3 to about 0.8 mm, and / or about 0.4 to about 0.6 mm. cis about 0.1 mm, about 0.15 mm, about 0.2 mm, about 0.25 mm, about 0.3 mm, about 0.4 mm, about 0.5 mm, about 0.6 mm, about 0.7 mm, about 0.8 mm, about 0.9 mm, about 1 mm, about 1.1 mm, about 1.2 mm, about 1.3 mm, about 1.4 mm, about 1.5 mm, or any number therebetween. In some implementations, the diameter w of the body 151 of the peg 150 is about 0.1 mm, about 0.15 mm, about 0.2 mm, about 0.25 mm, about 0.3 mm, about 0.4 mm, about 0.5 mm, about 0.6 mm, about 0.7 mm, about 0.8 mm, about 0.9 mm, about 1 mm, about 1.1 mm, about 1.2 mm, about 1.3 mm, about 1.4 mm, about 1.5 mm, or any number therebetween. p In some implementations, the diameter w of the body 151 of the peg 150 is in the range of about 1 mm to about 5 mm, about 1.5 mm to about 4 mm, and / or about 2 mm to about 3 mm. p is about 1 mm, about 1.25 mm, about 1.5 mm, about 1.75 mm, about 2 mm, about 2.25 mm, about 2.5 mm, about 2.75 mm, about 3 mm, about 3.25 mm, about 3.5 mm, about 3.75 mm, about 4 mm, about 4.25 mm, about 4.5 mm, about 4.75 mm, about 5 mm, or any number therebetween.

[0032] The osteogenic coating 152 can be applied in a variety of ways. For example, the osteogenic coating 152 can be applied as a single layer or in multiple layers. Furthermore, the osteogenic coating 152 can be electroplated, spray coated, and / or 3D printed in a single pass or multiple passes. The osteogenic coating 152 can be applied to the distal end 154 of the peg 150, which is later removed, or the osteogenic coating 152 can not be applied to the distal end 154 at all. However, this is not required, and in some implementations, the osteogenic coating 152 remains on the distal end 154 of the peg 150.

[0033] While the discussion of Figures 1A-3B describes a prosthetic device 100 including pegs 150, the discussion of Figure 4 provides additional details regarding the use of such a prosthetic device 100 in a patient's bone.

[0034] 4, a cross-sectional view of the prosthetic device 100 is shown implanted in a patient's shoulder 167. Although shown in the shoulder, the prosthetic device 100 may be used in any suitable location. For example, the prosthetic device 100 may be used in the knee, hip, foot, ankle, etc.

[0035] The central screw 120 of the prosthetic device may be inserted into the central bore 118 and extend through the boss 119 and through a hole in the bone. The peg 150 is inserted into one of the peripheral bores 112A and extends through a peripheral hole in the bone 160. The peripheral screw 140 is also inserted into one of the peripheral bores 112C and through a hole in the bone. The peripheral screw 140 is bicortical because it extends through the cortical portion of the bone 168, through the cancellous portion of the bone 166, and then back through the cortical portion of the bone 168. Because the cortical bone 168 is stronger than the cancellous bone 166, the peripheral screw 140 can achieve bicortical fixation, which provides good short-term stability of the prosthetic device 100. However, bicortical fixation of the peripheral screw 150 is not always possible. For example, in the case of smaller and / or weaker bones, the peripheral screw 150 may not be able to be bicortically fixed without causing undue harm to the bone. Thus, in some implementations, particularly when bicortical fixation of the peripheral screws 150 is not medically recommended, no peripheral screws 140 are used in the prosthetic device 100. In some such implementations, only pegs 150, or multiple pegs 150, are inserted into the peripheral bores 112A-D. The pegs 150 can achieve additional stability of the prosthetic device 100 over time as bone ingrowth and / or surface growth occurs in the osteogenic coating 152 of the pegs 150.

[0036] As shown in FIG. 4 , the bone hole 160 into which the peg 150 is inserted has a bottom 162. The distal end 154 of the peg 150 does not contact the bottom 162 of the bone hole 160, and the distal end 154 of the peg 150 generally does not touch the bone. The distal end 154 of the peg 150 does not have intimate contact with the bone to facilitate subsequent removal of the peg 150 from the bone hole 160. For example, the lack of contact between the distal end 154 of the peg 150 and the bone prevents direct force from being applied to the bone at the bottom 162 of the hole during removal of the peg 150. To further prevent any direct force from being applied to the bone at the bottom 162 of the hole 160 during removal of the peg 150, in some implementations, the distal end 154 of the peg 150 does not have an osteogenic coating 152. Thus, bone ingrowth and / or surface growth on the distal end 154 of the peg 150 is not promoted by the osteogenic coating 152. The absence of the osteogenic coating 152 on the distal end 154 of the peg 150 is advantageous for later removal of the peg 150, as bone cannot easily grow and / or attach to the distal end 154 of the peg 150.

[0037] To avoid contact between the distal end 154 of the peg 150 and the bone, the depth of the bone hole 160 (the distance between the bone contacting surface 116A of the base plate 110 and the bottom 162 of the hole 160) is greater than the length of the peg 150 inserted into the hole 160 (the distance between the bone contacting surface 116A of the base plate 110 and the distal end 154 of the peg 150). Because the length of the bone hole 160 is greater than the length of the peg 150, the distal end 154 of the peg 150 cannot reach or contact the bottom 162 of the hole 160, allowing for greater flexibility in selecting the length of the peg 150. For example, in some embodiments, the depth of the hole 160 is 5% to 10%, 10% to 15%, 15% to 20%, 20% to 25%, 25% to 30%, 30% to 40%, 40% to 50%, 50% to 60%, or any other percentage greater than the length of the peg 150. In some embodiments, the length of the peg 150 (measured from the distal end 154 of the peg 150 to the bone-contacting surface 116A of the base plate 110 when the peg 150 is fully seated within the base plate 110) is between about 10 millimeters and about 30 millimeters. In some embodiments, the length of the hole 160 (measured from the bottom 162 of the hole 160 to the bone-contacting surface 116A of the base plate 110) is between about 11 millimeters and about 34 millimeters. In some implementations, the distal end 154 of the peg 150 is at least about 1 millimeter from the bottom 162 of the hole 160 when the peg 150 is fully seated in the base plate 110. In some implementations, the distal end 154 of the peg 150 is at least about 2, 3, 4, 5, 6, 7, 8, 9, 10 millimeters from the bottom 162 of the hole 160 when the peg 150 is fully seated in the base plate 110. The spacing between the distal end 154 of the peg 150 and the bottom 162 of the hole 160 helps to prevent osseointegration of the distal end 154 of the peg 150 with the bone.

[0038] In some implementations, the length of the hole in the bone 160 and the length of the peg 150 are selected based on the location of the cancellous bone 166 and / or the cortical bone 168. For example, as shown in FIG. 4 , the length of the hole in the bone 160 is such that the bottom 162 of the hole 160 is in the cortical bone 168, and the length of the peg 150 is such that the distal end 154 of the peg 150 is in the cancellous bone 166. Because cancellous bone 166 compresses more easily than cortical bone 168, inserting the peg 150 into cancellous bone 166 places less strain on the bone than inserting the peg 150 into cortical bone 168. Having the length of the bone hole 160 such that the bottom 162 of the hole 160 is in the cortical bone 168 also presents advantages. In such implementations, the distal end 154 of the peg 150 does not contact the cortical bone 168. Because the distal end 154 of the peg 150 does not contact the cortical bone 168, the geometry of the peg 150 does not need to be such that it can cut through the cortical bone 168. Therefore, the shaft of the peg 150 can be completely covered with the osteogenic coating 152 to maximize bone ingrowth / surface growth onto the peg 150.

[0039] Because the distal end 154 of the peg 150 does not contact the bottom 162 of the hole 160, there is a gap 164 between the distal end 154 of the peg 150 and the bottom 162 of the hole 160 into which the peg 150 is inserted. In some implementations, the distance of this gap 164 is within a range of about 0.5 mm to about 30 mm, about 1 mm to about 20 mm, about 2 mm to about 10 mm, about 3 mm to about 5 mm, about 3.5 mm to about 4.5 mm, and / or about 4 mm.

[0040] According to some implementations, the bone hole 160 has a diameter w p In some implementations, the osteogenic coating has a thickness w c Thus, the diameter of the peg 150 with the osteogenic coating 152 exceeds the diameter of the bone hole 160 by a total diameter (2 * w c +w pIn such implementations, when the peg 150 is inserted into the hole 160 in the bone, the bone is compressed by the osteogenic coating 152. This compression helps to anchor the peg 150 within the bone and promotes bone ingrowth and / or overgrowth on the outer surface of the peg 150.

[0041] 5, a method of installing a prosthetic device in a bone is described according to some implementations of the present disclosure. The method begins at step 170 by providing a prosthetic device. In some implementations, the prosthetic device comprises a base plate including a peripheral bore, a central screw, and a peg. The prosthetic device may be any suitable prosthetic device, such as, for example, the prosthetic devices 100, 200 described herein.

[0042] The method continues at step 172, where a hole is drilled in the bone. For example, the surgeon may use one or more bill bits to drill the hole in the bone. The bone in which the hole is drilled may be any suitable bone. For example, the bone may be the humerus and / or scapula in a shoulder replacement situation, or the tibia and / or femur in a knee replacement situation. The drilling may be accomplished with the aid of a tool. For example, a drill, hammer, drill bit, pin vise, Dremel, drill press, or any other suitable tool may be used. The hole may be of any suitable diameter and length, as discussed in more detail herein.

[0043] The method continues at step 174 where a central screw is inserted through the base plate and into the bone. The central screw serves to provide fixation of the base plate to the bone. The central screw may be inserted into a hole in the bone, or it may create its own path through the bone while being screwed into the bone (e.g., it may be a self-tapping screw).

[0044] The method continues at step 176, where pegs are inserted through the peripheral bores and into the drilled holes. The pegs help provide fixation of the base plate to the bone and prevent the base plate from rotating or pivoting relative to the central screw. In some implementations of this method, the length of the pegs is less than the length of the holes, so that the distal ends of the pegs do not touch the bone. The lack of contact between the distal ends of the pegs and the bone is desirable to allow more flexibility in selecting the length of the pegs and to reduce loading on the bone during subsequent revision and / or removal of the prosthetic device.

[0045] In some implementations, these operations do not necessarily occur in the order shown in the flow diagram of Figure 5. As an example, step 176 can occur before step 174. For example, the pegs may be integral with the base plate, or the pegs may be inserted into the peripheral bores and holes before the central screw is inserted through the base plate and into the hole. Performing step 176 before step 174 can be useful to provide additional rotational stability to the prosthetic device when inserting the central screw through the base plate and into the bone.

[0046] 5 may be performed sequentially and / or in parallel. As one example, step 170 may be performed simultaneously or at least partially concurrently with steps 172, 174, and / or 176. As a further example, step 172 may be performed simultaneously or at least partially concurrently with steps 170, 174, and / or 176. Step 174 may be performed simultaneously or at least partially concurrently with steps 170, 172, and / or 176, and / or step 176 may be performed simultaneously or at least partially concurrently with steps 170, 172, and / or 174.

[0047] While the discussion of Figures 1A-5 describes a prosthetic device 100 including a peg 150 and a central screw 120, the discussion of Figures 6A-7B provides additional details regarding a prosthetic device 200 including a peg 250 in which the central screw 220 is integrally formed with the base plate 210.

[0048] 6A-7B , an integrated prosthetic device 200 according to some implementations of the present disclosure is shown. The integrated prosthetic device 200 includes a base plate 210, a central screw 220, a neck adapter 230, peripheral screws 240, and pegs 250, which are the same as or similar to the base plate 110, the central screw 120, the neck adapter 130, the peripheral screws 140, and the pegs 150, except that in the integrated prosthetic device 200, the base plate 210, the central screw 220, and the neck adapter 230 are integrated and not separate, distinct elements like the base plate 110, the central screw 120, and the neck adapter 130 of the prosthetic device 100 described herein.

[0049] An advantage of having the central screw 220 integral with the base plate 210 is that rotational and / or pivotal movement of the base plate 210 relative to the central screw 220 is avoided. Additionally, having the central screw 220 integral with the base plate 210 mitigates the marginal utility of using a boss to provide additional stability to the relationship between the central screw 220 and the base plate 210. A base plate 210 that does not include a boss helps reduce the footprint of the base plate 210 on the bone on which the prosthetic device 200 is placed. However, according to some implementations, the integral prosthetic device 200 includes a boss connected to the base plate 210 through which the central screw 220 extends. In such implementations, the boss helps reinforce the integral connection between the central screw 220 and the base plate 210.

[0050] FIG. 8 is a top perspective exploded view of the integrated prosthetic device 300, which is the same as the integrated prosthetic device 200 of FIGS. 6A-7B, except that the integrated prosthetic device 300 includes an implant component 380 according to some implementations.

[0051] The neck adapter 230 cooperates with an implant component 380. As shown in FIG. 8 , the implant component 380 is a glenosphere. However, the implant component 380 need not be a glenosphere. For example, the implant component 380 may be a socket, a liner, a spacer, a femoral component, a tibial component, and / or any other suitable component of an implant. The implant component 380 is secured to the prosthetic device 200 via an implant component screw 382. In some embodiments, the implant component screw 382 extends through the implant component 380 and into the neck adapter 230. However, the implant component screw 382 is not required. Instead, and in some embodiments, the implant component 380 is attached to the prosthetic device 200 via adhesives, nails, sutures, or the like, or a combination thereof. While the implant component 380 and implant component screw 382 are shown with the integrated prosthetic device 200, this is not required. Thus, in some implementations, the implant component 380 and implant component screw 382 are used with the modular prosthetic devices 100 described herein.

[0052] In summary, the implementations discussed above offer numerous advantages over current and past prosthetic devices and practices. Because the pegs do not need to be as long as peripheral screws, the prosthetic device is a viable option for more bone types, sizes, and conditions than prosthetic devices that do not utilize pegs. Additionally, the osteogenic coating on the pegs provides long-term stability of the prosthetic device and improves overall structural fixation.

Claims

1. 1. An artificial device comprising: a base plate including a peripheral bore; a central screw extending from the bone-contacting surface of the base plate; a peg having an osteogenic coating, the peg configured to be coupled to the peripheral bore such that the peg extends a first length beyond the bone-contacting surface of the base plate and into a hole formed in the bone, the hole having a depth greater than the first length.

2. The prosthetic device of claim 1 , wherein the osteogenic coating comprises a particulate metal.

3. The prosthetic device of claim 1 , wherein the hole has a first diameter and the peg including the osteogenic coating has a second diameter that is larger than the first diameter.

4. 4. The prosthetic device of claim 3, wherein the body of the peg has a third diameter, the third diameter being one of less than and equal to the first diameter.

5. The prosthetic device of claim 1 , wherein the bone-contacting surface of the base plate includes an osteogenic coating.

6. The prosthetic device of claim 1 , wherein the peg extends into the bone such that a distal end of the peg resides in a cancellous portion of the bone.

7. 10. The prosthetic device of claim 1, further comprising a peripheral screw configured to be coupled to a second peripheral bore of the base plate such that the peripheral screw extends a second length beyond the bone contacting surface, the second length being greater than the first length.

8. The prosthetic device of claim 1 , wherein a gap is defined between the distal end of the peg and the bottom of the hole formed in the bone.

9. The prosthetic device of claim 8 , wherein the gap is at least 1 millimeter.

10. The prosthetic device of claim 1 , wherein the distal ends of the pegs are configured to avoid contacting the cortical portion of the bone.

11. The prosthetic device of claim 1 , wherein the peripheral bore includes a threaded portion.

12. 1. A method of placing a prosthetic device in a patient, comprising: providing a prosthetic device including a base plate having a peripheral bore, a central screw, and a peg, the peg having a first length; Drilling a hole of a second length into the patient's bone; inserting the central screw through the base plate and into the bone; and inserting the peg through the peripheral bore into the hole.

13. The method of claim 12 , wherein the pegs have an osteogenic coating.

14. The method of claim 13 , wherein the osteogenic coating comprises a particulate metal.

15. 14. The method of claim 13, wherein the peg including the osteogenic coating has a first diameter and the hole has a second diameter, the first diameter being larger than the second diameter.

16. 16. The method of claim 15, wherein the peg without the osteogenic coating has a third diameter, the third diameter being one of less than and equal to the second diameter.

17. The method of claim 12 , wherein the bone is compressed during insertion of the pegs.

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