Stemless implant for superior approach

Abstract

The system configured to be implanted into a patient may include a first implantable component configured to be inserted into a reamed or broached portion of a patient's bone. The first implantable component may extend between a first end and a second end. The first implantable component may also include a central body extending from the first end of the first implantable component toward the second end of the first implantable component and one or more fins attached to the periphery of the central body. The fins may extend radially outward from the central body and extend from the first end of the first implantable component to the second end of the first implantable component. The central body and one or more fins may be configured to be inserted into a reamed or broached portion of a patient's bone from a superior approach.

Description

[Technical Field]

[0001] (Priority Claim) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 428,284, filed November 28, 2022, the benefit of which is hereby claimed and incorporated by reference in its entirety. [Background technology]

[0002] The present disclosure relates to implants, and more particularly, to implants configured to be inserted into a reamed or broached portion of bone.

[0003] The shoulder joint is a complex articulation between the scapula, clavicle, and humerus, allowing for a wide range of motion, at least in a properly functioning joint. In a properly functioning shoulder joint, the head of the humerus fits into a shallow socket in the scapula, typically called the glenoid fossa. Shoulder articulation involves movement of the humeral head in the glenoid fossa, and the anatomy of the articulating surfaces and surrounding tissues allows for a wide range of motion.

[0004] The shoulder joint can undergo degenerative changes caused by a variety of problems, including rheumatoid arthritis, osteoarthritis, rotator cuff arthroplasty, avascular necrosis, and fractures. When severe joint damage occurs and other treatment options prove ineffective, total shoulder replacement, partial shoulder replacement, or reverse shoulder replacement may be necessary. Total shoulder replacement can include a humeral prosthesis used to replace the natural humeral head. Total shoulder replacement also typically involves resurfacing the glenoid cavity with an artificial implant. The glenoid implant generally includes a glenoid cup shape to accept the artificial humeral head. Reverse shoulder replacement (prosthetic joint replacement) uses a separate set of artificial joints for the humerus and glenoid cavity. In reverse shoulder replacement, the humeral component includes a cup-shaped articular surface attached to a stem implanted in the humerus, and a spherical glenoid component is used to provide the articular surface of the humeral cup. Summary of the Invention [Problem to be solved by the invention]

[0005] The inventors of the present disclosure have recognized problems with shoulder implants, including at least 1) the need to dislocate the humerus during shoulder replacement surgery, 2) the need to release the subscapularis muscle of the rotator cuff during implant insertion, and 3) complications that arise when reattaching the subscapularis muscle after implant insertion. The following examples help address at least the above-mentioned problems with shoulder implants.

[0006] In one embodiment, the implant can be configured to be implanted into a reamed or broached portion of a patient's bone. The implant can extend between a first end and a second end. The implant can include a central body extending from the first end to the second end. The implant can also include one or more fins attached to the periphery of the central body. The central body and the one or more fins can form a major plane at the first end of the implant. The one or more fins can extend radially outward from the central body and from the first end of the central body to the second end of the implant. The central body and the one or more fins can be angled from the major plane so that the implant can be inserted into the reamed or broached portion of the bone from a direction generally parallel to the longitudinal axis of the patient's bone.

[0007] In another embodiment, a system configured to be implanted into a patient can include a first implantable component configured to be inserted into a reamed or broached portion of a patient's bone. The first implantable component can extend between a first end and a second end. The first implantable component can also include a central body extending from the first end of the first implantable component toward the second end of the first implantable component and one or more fins attached to the periphery of the central body. The fins can extend radially outward from the central body and from the first end of the first implantable component to the second end of the first implantable component. The central body and one or more fins can be configured to be inserted into the reamed or broached portion of a patient's bone from a superior approach.

[0008] In yet another embodiment, a method of performing arthroplasty on at least one of the glenoid cavity or humerus of a glenohumeral joint includes forming an entry incision in soft tissue superior and lateral to the glenohumeral joint, forming a passage from the entry incision to the glenohumeral joint, inserting a cutting instrument into the passage and cutting the natural head of the humerus along the articular margin of the humeral head while the humeral head is not dislocated relative to the glenoid cavity and remains in its anatomical position, and inserting an implant into the passage and fixating the implant relative to the humerus with the implant oriented so that the longitudinal axis of the implant's central body extends substantially parallel to the longitudinal axis of the humerus. The method also includes maintaining both the subscapularis and supraspinatus muscles associated with the glenohumeral joint intact and fully connected to the surrounding bone throughout the arthroplasty. [Brief explanation of the drawings]

[0009] In the drawings, which are not necessarily drawn to scale, like numbers may describe like elements in different views. Like numbers with different suffix letters may represent different examples of like elements. The drawings generally illustrate by way of example, but not by way of limitation, various embodiments discussed in this document.

[0010] [Figure 1] FIG. 1 is a perspective view of an implant inserted into a patient's humerus in accordance with at least one embodiment of the present disclosure. [Figure 2] FIG. 2 is a side view of an implant according to at least one embodiment of the present disclosure. [Figure 3] FIG. 3 is a perspective view of a body of an implant according to at least one embodiment of the present disclosure. [Figure 4] 4 is a cross-sectional perspective view of the implant of FIG. 3 taken along line 4-4 in accordance with at least one embodiment of the present disclosure. [Figure 5] FIG. 5 is a simplified flowchart illustrating a process for assembling and installing an implant in accordance with at least one embodiment of the present disclosure. [Figure 6] FIG. 6 is a perspective view of an example implant in accordance with at least one embodiment of the present disclosure. [Figure 7] FIG. 7 is a perspective view of an example implant in accordance with at least one embodiment of the present disclosure. [Figure 8] FIG. 8 is a flowchart detailing a method of inserting an implant in accordance with at least one embodiment of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0011] The present disclosure relates to a system including a stemless implant configured to be implanted into a reamed or broached portion of a patient's bone. More specifically, the present disclosure relates to a system including a stemless implant configured to be implanted into a reamed or broached portion of a patient's bone from a superior approach. The superior approach has the advantage that the bone can be resected, reamed, broached, and / or prepared for implant insertion, and the implant can be inserted into the bone without completely removing, tearing, or cutting the patient's subscapularis muscle. Preserving the patient's subscapularis muscle helps support the implant, shortening the patient's recovery time and improving functional outcomes.

[0012] The implant can include a central body extending from a first end of the implant toward a second end of the implant and one or more fins attached to the periphery of the central body. The fins can form a major planar surface at the first end of the implant. The central body and fins can be angled from the major planar surface such that the central body and fins can be inserted into a reamed or broached portion of a bone from a direction generally parallel to the longitudinal axis of the bone. A system including a stemless implant configured to be implanted into a reamed or broached portion of a patient's bone is described below with reference to FIGS. 1 through 8.

[0013] The above discussion is intended to provide an overview of the subject matter of this patent application. It is not intended to provide an exclusive or exhaustive description of the invention. The following description is included to provide further information about this patent application.

[0014] 1 is a perspective view of a system 100 implanted in a patient. In an embodiment, at least a portion of system 100 can be inserted into a patient's bone 102. System 100 can include a first implantable component, such as an implant (hereinafter referred to as "implant 104"), and a second implantable component, such as a prosthetic humeral head or cup member, each configured to interface with a glenoid attachment (hereinafter referred to as "glenoid interface component 106").

[0015] As shown in FIG. 1 , the bone 102 may be a humerus. In another example, the bone 102 may be any other bone of a patient. The bone 102 may be an elongated body including a longitudinal axis LA. In an embodiment, the bone 102 may be resected to define a resection surface 108. The bone 102 may be resected based on anatomical features of the bone 102. Because the bone 102 may be resected based on anatomical features, the bone 102 may be resected before reaming or broaching the bone 102.

[0016] The implant 104 can be configured to be inserted into a patient's bone 102. The implant 104 extends along a central axis CA between a first end 110 and a second end 112. The implant 104 can include a central body 114 and one or more fins (fins 116). As shown in FIG. 1 , the central body 114 and the fins 116 can extend from the first end 110 along the central axis CA at an angle φ. The central body 114, the fins 116, and the angle φ are described in further detail below with reference to FIGS. 3 and 4.

[0017] The glenoid interface component 106 may be configured to attach to the implant 104. The glenoid interface component 106 may be a prosthetic humeral head, as shown in FIG. 1. In another example, the glenoid interface component 106 may be a humeral cup or any other secondary attachment component configured to interface with another implant or part of the body. The glenoid interface component 106 is described in more detail below with reference to FIGS. 2, 5, and 6.

[0018] The resection surface 108 may be configured to receive the bone 102 of the system 100. The resection surface 108 may be resected at an angle θ, which is the angle between the longitudinal axis LA and the resection surface 108 of the bone 102. The angle θ may vary based on the anatomical shape of the bone 102. For example, the angle θ may be based on the articular margin of the humeral head of the bone 102. Because the implant 104 is configured to be inserted along a central axis CA, which may be approximately parallel to the longitudinal axis LA, the resection surface 108 may be less precise than in typical shoulder implant surgery. The reduced precision required for the resection surface 108 may save time and allow the implant process to be more adjustable to the patient's bone shape.

[0019] FIG. 2 is a side view of system 100 configured to be implanted into a patient. System 100 can include an attachment mechanism 118. Attachment mechanism 118 can be configured to attach implant 104 and glenoid interface component 106. In examples, attachment mechanism 118 can be a stand-alone unit, or in other examples, attachment mechanism 118 can be integrated with implant 104 or glenoid interface component 106, respectively. Attachment mechanism 118 can be configured to provide a gap between implant 104 and glenoid interface component 106, while attachment mechanism 118 couples implant 104 and glenoid interface component 106. Because attachment mechanism 118 creates a gap between implant 104 and glenoid interface component 106, implant 104 can be entirely within bone 102 (see FIG. 1 ) and glenoid interface component 106 can be outside of bone 102 and in contact with resection surface 108.

[0020] In the example of FIG. 2, the fins 116 may extend between the implant 104 and the glenoid interface component 106 in a direction that is approximately perpendicular to the resection surface 108 .

[0021] The implant 104 is described below with reference to Figures 3 and 4. Figure 3 is a perspective view of the implant 104. Figure 4 is a cross-sectional view of the implant 104 of Figure 3 taken along line 4-4.

[0022] 3 and 4, the central body 114 may be hollow. When the central body 114 is hollow, the central body 114 may be configured to receive the attachment mechanism 118.

[0023] As shown in FIGS. 1-4 , the fins 116 can have a shape that assists in inserting the implant 104 into the bone 102 in a direction generally parallel to the longitudinal axis LA of the bone 102. For example, the fins 116 can extend along a fin axis FA from the first end 110 to the second end 112. The fin axis FA can be generally parallel to the central axis CA. As shown in FIGS. 1-4 , the second end 112 of the implant 104 can be horizontal or, for example, can form a plane (e.g., a surface plane SP) that is generally perpendicular to the central axis CA. In an embodiment, the fins 116 can have a smaller horizontal cross-sectional area at the second end 112 and a maximum cross-sectional area at the first end 110. In another example, the fins 116 can have a minimum horizontal cross-sectional area at the second end 112, taper to a maximum cross-sectional area somewhere between the second end 112 and the first end 110, and then have a consistent cross-sectional area from the end of the taper to the first end 110. In yet another example, the fins 116 can have a minimum cross-sectional area at the second end 112, have a varying cross-sectional area while extending from the second end 112 to the first end 110, have a maximum cross-sectional area between the first end 110 and the second end 112, and have a minimum and maximum cross-sectional area at the first end 110. In another example, the fins 116 can be any shape that helps fill the area in the bone 102 below the resection surface 108. The larger the area of ​​the fins 116, the greater the distribution of stresses acting on the implant 104 and the more difficult it is to install the fins 116 in the patient's bone 102. In an embodiment, the fins 116 may include a varying thickness. For example, the fins 116 may have a minimum cross-sectional thickness at the distal end of the fins 116.

[0024] 5 is a schematic flowchart illustrating a process 500 for assembling and installing an implant, according to at least one example of the present disclosure. Process 500 includes at least the following operations: The following steps are discussed for illustrative purposes only and are not intended to be the only steps or the only order in which the steps may be implemented.

[0025] In one example, step 505 can be retrieving the prosthetic humeral head. The prosthetic humeral head can be inserted into a fixture, placed on a table, or held in a person's hand. The prosthetic humeral head can be positioned so that the cavity is exposed.

[0026] In one example, step 510 can be attaching a ring adapter within the cavity of the prosthetic humeral head. As shown in FIG. 1, the ring adapter can include markings that can be used to position the ring adapter within the cavity of the prosthetic humeral head. In such an example, the prosthetic humeral head can also have markings that can be configured to assist in locating the ring adapter within the cavity of the prosthetic humeral head.

[0027] In one example, step 515 may be attaching a stem adaptor within the cavity of the ring adaptor. In examples, the ring adaptor, the stem adaptor, or the ring adaptor and the stem adaptor are referred to as an attachment mechanism. As shown in Figure 5, the attachment mechanism (e.g., attachment mechanism 118 of Figure 2) may be attached to the prosthetic humeral head (e.g., glenoid interface component 106 of Figures 1 and 2) and extend from the prosthetic humeral head in a direction that allows the prosthetic humeral head and attachment mechanism to be inserted into the implant (e.g., central body 114 of implant 104 of Figures 1-4) from a superior approach.

[0028] In one example, step 520 can include inserting the implant into a reamed or broached portion of the bone. As described elsewhere, to prepare the bone for implant insertion, the bone must first be resected and reamed. As shown in FIG. 5, the implant can be inserted into the reamed or broached portion of the bone along the longitudinal axis of the bone.

[0029] In one example, step 525 may be inserting the implant into the reamed or broached portion of the bone so that the exposed surface of the implant is aligned with the resection surface. The implant is fully seated when the exposed surface is aligned with the resection surface, and the implant is ready to receive the prosthetic humeral head.

[0030] In one example, step 530 can be inserting the stem adaptor into the implant so that the stem adaptor is fully seated within the implant. As mentioned above, the stem adaptor and prosthetic humeral head can be installed from a direction along the longitudinal axis of the bone, as shown in FIG. 5. This direction can also be referred to as a superior approach.

[0031] An alternative example of an implantable system is described below with reference to Figures 6 and 7. Figure 6 is a perspective view of an example implant system (system 200). Figure 7 is a perspective view of a portion of an example system 200. In the example shown in Figures 6 and 7, system 200 may include an implant 204 and a glenoid attachment interface 206. In the example, implant 204 and glenoid attachment interface 206 may be similar to implant 104 and glenoid interface component 106, respectively. Implant 204 may extend between a first end 210 and a second end 212 and include a central body 214, fins 216, and attachment features 218.

[0032] As shown in FIGS. 6 and 7 , the attachment mechanism 218 can be a male trunnion mount configured to attach to the glenoid mounting interface 206 of the system 200. Here, the attachment mechanism 218 can extend within the implant 204, through the central body 214, and toward the second end 212 of the implant 204. In another example, the attachment mechanism 218 can extend within the implant 204, through the central body 214, and toward the second end 212 of the implant 204. As shown in FIGS. 6 and 7 , the attachment mechanism 218 can extend from the second end 212 of the implant 204 in a direction that is approximately perpendicular to the implant 204. In another embodiment, the attachment mechanism 218 can extend from the second end 212 of the implant 204 in a direction that is substantially aligned with the central body 214 of the implant 204. In such an example, the glenoid mounting interface 206 can be attached to the attachment mechanism 218 from a superior approach.

[0033] 6 and 7, the implant 204 may also include a collar 220. The collar 220 may extend around the first end 210 of the implant 204 and may be attached to each fin 216. The collar 220 may help support the fins 216 during implantation of the implant 104 into the patient's bone.

[0034] FIG. 8 illustrates a schematic diagram of a method 800 according to at least one example of the present disclosure. Method 800 can be a method of implanting a stemless implant from a superior approach. A more specific example of method 800 is described below. The steps or processes of method 800 are presented in a particular order for convenience and clarity, and many of the processes discussed may be performed in a different order or in parallel without substantially affecting other processes. The described method 800 includes processes performed by multiple different actors, devices, and / or systems. It should be understood that a subset of the processes described in method 800 may be attributed to a single actor, device, or system.

[0035] In step 805, method 800 can include creating an entry incision in the soft tissue above and outside the glenohumeral joint, where a surgeon can use a scalpel or any other knife to cut the patient's skin and soft tissue (e.g., muscle). The entry incision provides access to the patient's shoulder area and allows the surgeon to pass various tools (e.g., an endoscope, scalpel, or any other tool) into the patient's interior through the incision.

[0036] It will be appreciated that the incision may be oriented in any suitable direction, such as from anterior to posterior, generally parallel to the sagittal plane. In this regard, the incision is approximately 5 cm in length. Alternatively, or in addition, an inferior-inferior incision can be made, generally along a coronal plane. The skin incision can be made parallel to Langer's lines on the superior aspect of the shoulder, even at the lateral edge of the acromion. The incision may also be slightly medial. The incision may be of any suitable length and may depend on the surgeon's preference, the type of patient, the prosthesis being used, or other indications. Nevertheless, the incision may be from about 3 cm (about 1 inch) to about 20 cm (about 8 inches) in length, for example, from about 7.5 cm (about 3 inches) to about 10 cm (about 4 inches). It will be appreciated that the incision through the skin may be shorter than the area opened in the muscle. The incision may be used to gain access to the muscles surrounding various portions of the anatomy to be resected, including the natural humerus and natural glenoid. An incision can be used to gain access to the deltoid muscle.

[0037] A retractor may be used to open the incision. The retractor may be any suitable retractor, such as a Gelpi Style Retractor. It will be appreciated that the retractor may also be used to retract soft tissue such as muscles surrounding the glenohumeral joint, including the deltoid, although the Gelpi Style Retractor may also be used to widen the incision to gain access to the muscles. The retractor may be used to retract or position deep tissues typically near the glenohumeral joint.

[0038] At step 810, the method 800 can include creating a pathway from the entry incision to the glenohumeral joint. Here, the surgeon can use tools (e.g., an endoscope, a scalpel, or any combination of tools) to create a pathway from the patient's entry incision to the glenohumeral joint. This pathway allows for various tools to pass surgical fragments from the incision to the glenohumeral joint and from the glenohumeral joint back to the incision.

[0039] A passage through the deltoid muscle can provide access to various deeper soft tissue areas, such as the subdeltoid and subacromial bursae, without damaging the rotator cuff. Additionally, various other deep soft tissues can be dissected or moved to provide access to the shoulder joint or the capsule surrounding the shoulder joint. After all of these areas have been dissected or moved, access to the natural humerus or natural humeral head can be achieved.

[0040] Retractors can be used to hold open various soft tissue portions, such as the cuff interval, capsule, etc. It will be appreciated that the retractor may be any suitable retractor, including a scissor retractor, etc. Various other soft tissue portions may be proximal to the capsule and may be incised or resected. For example, the biceps tendon interconnecting a portion or near the natural humeral head can be resected, or, if already detached, moved to achieve better access to the natural humeral head. Additionally, once the soft tissue is incised, access to the natural glenoid cavity can also be seen.

[0041] While incisions near the shoulder or glenohumeral joint provide access to the deltoid muscle and the capsule and soft tissue surrounding the glenohumeral joint, various muscles and ligaments do not need to be resected or dissected when gaining access to the glenohumeral joint according to the processes discussed herein. For example, the subscapularis muscle and the ligaments attaching it to portions of the glenohumeral joint do not need to be dissected when gaining access to the glenohumeral joint according to embodiments of the teachings herein. The subscapularis muscle is generally anterior from the described approach and may be left intact or partially intact. Additionally, the supraspinatus muscle may be left intact or partially intact, as may all of the rotator cuff muscles. Rather, a passageway may be formed by separating the cuff interval rather than separating or dissecting various soft tissue portions. Furthermore, the natural humeral head need not be substantially or completely dislocated from the glenohumeral joint according to various aspects. Rather, the natural humeral head may be moved to allow access to various parts of the anatomy, but primary dislocation of the natural humeral head from the natural glenoid cavity is not required. The humerus may be left in its general anatomic position or may be retracted any suitable distance, such as from about 2 cm to about 8 cm.

[0042] The soft tissue over the lateral biceps is sharply dissected from the humerus to the superior surface of the subscapularis tendon, leaving the tendon undisturbed. The supraspinatus may be removed from the anterior aspect of the greater tuberosity over a distance of approximately 5 to 10 mm to further enhance exposure. No more than approximately 1 cm of dissection is required, maintaining the basic integrity of the tendon. This exposure of the rotator cuff typically provides a clearance of approximately 1.5 to 2 cm at the lateral edge without disrupting the rotator cuff mechanism. The Gelpi retractor can be moved from the deltoid to the rotator interval, providing greater exposure of the glenohumeral joint for instrumentation and implants.

[0043] In step 815, the method 800 can include inserting a cutting instrument through the passageway and cutting the natural head of the humerus along the articular margin of the humeral head, while the humeral head remains in its anatomical position without any dislocation relative to the glenoid cavity. For example, the surgeon may use a bone saw to cut the articular margin of the humeral head. Additionally, the cutting instrument can be a reamer used to widen a portion of bone to prepare the bone to receive an implant. Additionally, the cutting instrument can be a bore used to drill a bone during preparation so that the bone can receive an implant.

[0044] Once access to the glenohumeral joint is gained, various instruments can be used in the procedure, according to various aspects. It will be understood that any, all, or none of the instruments can be used in the procedure, according to various aspects. For example, the glenohumeral joint can be reamed into the natural humerus near the natural humeral head. Humeral reaming can occur from the superior, lateral humeral head. The entry point to the natural humeral head can be just below the anterior (i.e., natural) location of the biceps tendon. The arm can be slightly extended and the elbow can be placed at the patient's side, allowing the top of the natural humeral head to be lifted anteriorly, allowing the reamer to pass anterior to the acromion. This allows the natural humeral head to be retracted but remain substantially or completely out of sight. This can reduce trauma to the surrounding soft tissue. The superior approach allows for easier centering of the reamer on the humeral head and proximal shaft, reducing the initial incidence of varus stem placement or eccentric head use.

[0045] Once the natural humeral head has been resected, thus forming a resected natural humeral head, the natural glenoid cavity may be reamed with a reamer. Of course, the natural glenoid cavity may initially be prepared by a variety of procedures according to those commonly known in the art. As discussed above, various connectors may be placed on or above a sizer or other instrument to aid in achieving the superior approach described herein. The reamer may be interconnected with a reamer shaft and a drill motor. This allows the reamer to be rotated relative to the natural glenoid cavity to form the glenoid cavity in a selected shape and orientation. The natural glenoid cavity may need to be shaped to allow for implantation of a selected glenoid implant. Nevertheless, it will be understood that the natural glenoid cavity need not necessarily be resected and may articulate with an implant placed within the resected natural humerus.

[0046] Nevertheless, the reamer may be positioned relative to the natural glenoid cavity, with the shaft extending through the incision to allow interconnection with the drill motor. After a selected reaming time, the natural glenoid cavity can be prepared for implantation of the glenoid implant. As described above, a glenoid prosthesis may be positioned relative to the reamed natural glenoid cavity to assist in further glenoid cavity preparation.

[0047] Once the various bones of the anatomical structure, including the natural glenoid cavity and the natural humerus, have been resected, various implants can be implanted. Further preparation of the natural humerus may be required, such as broaching the IM canal of the natural humerus. Accordingly, broaches may be provided and used to broach selected portions of the proximal portion of the natural humerus. Broaches of various sizes may be used to gradually enlarge the broached area of ​​the natural humerus, as is commonly known in the art.

[0048] In step 820, the method 800 may include inserting an implant through the passageway and securing the implant to the humerus with the implant oriented such that the longitudinal axis of the central body of the implant extends approximately parallel to the longitudinal axis of the humerus.

[0049] After inserting the implant (e.g., implant 104 from FIG. 1 or implant 204 from FIG. 2) into the medullary canal using impaction, the humeral head (e.g., glenoid interface component 106 from FIG. 1 or glenoid attachment interface 206 from FIG. 2) may be coupled to a locking taper formed on the proximal end (e.g., attachment mechanism 118 from FIG. 1 or attachment mechanism 218 from FIG. 2). An impact force is applied to the stem in the direction of the central stem axis CA.

[0050] In step 825, method 800 can include maintaining both the subscapularis and supraspinatus muscles associated with the glenohumeral joint intact and fully connected to the surrounding bone throughout the entire arthroplasty. Here, because the implant allows for insertion from a superior approach, the implant system can be implanted into the patient without dislocating the humerus or tearing the subscapularis or supraspinatus muscles. Thus, the patient may recover more quickly and with increased predictability of success.

[0051] After implantation, the soft tissue balance can be reassessed, and then the rotator interval division can be closed. The deltoid muscle can be repaired to the acromion. The subcutaneous tissue and skin can then be closed according to the surgeon's usual routine.

[0052] The various parts described herein can be provided in a system. The system can include any suitable part that can be used in a selected procedure, such as a glenoid and / or humeral procedure, and can include multiple broaches, multiple humeral implants, multiple humeral heads, multiple glenoid implants, and any other suitable part. Thus, the system can be used for multiple procedures and does not need to be customized for a particular procedure or patient. Furthermore, the system can include multiple parts that allow it to be used in several procedures for many different anatomies, sizes, etc. Additionally, various other parts, such as reamers, glenoid templates, or other suitable parts, can be provided for multiple different patients.

[0053] Notes and Examples The following non-limiting examples detail certain aspects of the present subject matter to, among other things, solve the problems and provide the benefits discussed herein.

[0054] Example 1 is an implant configured to be implanted into a reamed or broached portion of a patient's bone, the implant extending between a first end and a second end, the implant comprising: a central body extending from the first end toward the second end; and one or more fins attached to the periphery of the central body such that the central body and the one or more fins form a major plane at the first end of the implant, the one or more fins extending radially outward from the central body and extending from the first end of the central body to the second end of the implant, the central body and the one or more fins angled from the major plane are such that the implant can be inserted into the reamed or broached portion of the bone from a direction generally parallel to the longitudinal axis of the patient's bone.

[0055] In Example 2, the subject matter of Example 1 is characterized in that the central body further comprises an attachment mechanism configured to attach the implant to a second implant part.

[0056] In Example 3, the subject matter of Example 2 includes the attachment mechanism being a male tapered trunnion extending at an elongated angle from the first end of the central body.

[0057] In Example 4, the subject matter of Example 3 includes the extension angle, the angle between the major plane and the central body, and the one or more fins being adjacent pairs.

[0058] In Example 5, the subject matter of Examples 3 and 4 includes that the stretching angle is perpendicular to the major plane.

[0059] In Example 6, the subject matter of Examples 2 through 5 includes that the attachment mechanism is a female tapered trunnion that extends inside the central body from the first end of the implant toward the second end of the implant.

[0060] In Example 7, the subject matter of Example 6 includes the female tapered trunnion extending inside the central body at an angle approximately equal to the angle between the major plane and the central body and one or more fins.

[0061] In Example 8, the subject matter of Examples 6-7 includes that the female tapered trunnion extends inside the central body approximately perpendicular to the major plane.

[0062] Example 9 is a system configured to be implanted in a patient, the system comprising: a first implantable component configured to be inserted into a reamed or broached portion of a patient's bone, the first implantable component extending between a first end and a second end, the first implantable component comprising: a central body extending from the first end of the first implantable component toward the second end of the first implantable component; and one or more fins attached to a periphery of the central body, the one or more fins extending radially outward from the central body and extending from the first end of the first implantable component toward the second end of the first implantable component, the central body and the one or more fins configured to be inserted into the reamed or broached portion of the patient's bone from a superior approach.

[0063] In Example 10, the subject matter of Example 9 includes the system further comprising an attachment mechanism configured to attach the first implantable component to the second implantable component.

[0064] In Example 11, the subject matter of Example 10 includes wherein the attachment mechanism is a male tapered trunnion extending from the first end of the first implantable component.

[0065] In Example 12, the subject matter of Example 11 includes the second implantable component being a prosthetic humeral head configured to be attached to the first implantable component via a male tapered trunnion.

[0066] In Example 13, the subject matter of Example 12 includes a male tapered trunnion extending from a first end of the first implantable component to enable the prosthetic humeral head to be impacted onto the first implantable component from a superior approach.

[0067] In Example 14, the subject matter of Examples 11 to 13 includes the second implantable component being a cup member configured to be attached to the first implantable component via a male tapered trunnion.

[0068] In Example 15, the subject matter of Example 14 includes a male tapered trunnion extending from the first end of the first implantable component, allowing the cup member to be impacted onto the first implantable component from a superior approach.

[0069] In Example 16, the subject matter of Examples 10 to 15 includes the attachment mechanism being a female tapered trunnion extending from the first end of the first implantable component inside the central body.

[0070] In Example 17, the subject matter of Example 16 includes a second implantable component being an artificial humeral head configured to be attached to the first implantable component via a female tapered trunnion, the female tapered trunnion extending inside a central body of the first implantable component so that the artificial humeral head can be impacted onto the first implantable component from a superior approach.

[0071] In Example 18, the subject matter of Examples 16-17 includes a second implantable component being a cup member configured to be attached to the first implantable component via a female tapered trunnion, the female tapered trunnion extending inside a central body of the first implantable component so that the cup member can be impacted onto the first implantable component from an upper approach.

[0072] Example 19 is a method of performing arthroplasty of at least one of the glenoid or humeral joint of a glenohumeral joint, comprising: forming an entry incision in the soft tissue superior and lateral to the glenohumeral joint; forming a passage from the entry incision to the glenohumeral joint; inserting a cutting instrument through the passage to cut the natural head of the humerus along the articular margin of the humeral head while the humeral head remains in its anatomical position without any dislocation relative to the glenoid cavity; inserting an implant through the passage and fixating the implant relative to the humerus such that the longitudinal axis of the central body of the implant extends substantially parallel to the longitudinal axis of the humerus; and maintaining both the subscapularis and supraspinatus muscles associated with the glenohumeral joint intact and fully connected to the surrounding bone throughout the arthroplasty.

[0073] In Example 20, the subject matter of Example 19 includes inserting a reamer through the entry incision, reaming the glenoid cavity with the reamer, inserting a glenoid implant through the passageway, and securing the glenoid implant to the glenoid cavity.

[0074] A twenty-first embodiment is an apparatus including means for carrying out any one of the first to twentieth embodiments.

[0075] The twenty-second embodiment is a system for implementing any one of the first to twentieth embodiments.

[0076] Example 23 is a method for carrying out any one of Examples 1 to 20.

[0077] In Example 24, the device or method of any one or any combination of Examples 1 to 24 can optionally be configured such that all of the listed elements or options are usable or selectable.

[0078] The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention may be practiced. These embodiments are also referred to herein as "examples," and such examples may include elements in addition to those shown or described. However, the inventors also contemplate examples in which only the elements shown or described are provided. Furthermore, the inventors also contemplate examples using any combination or permutation of the elements shown or described (or one or more aspects thereof) with respect to a particular example (or one or more aspects thereof), or with respect to other example (or aspects) shown or described herein.

[0079] In the event of inconsistent usage between this specification and any document so incorporated by reference, the usage in this specification controls. The terms "including" and "in which" are used herein as the plain English equivalents of the terms "comprising" and "wherein." Also, in the following claims, the terms "including" and "comprising" are open-ended, i.e., they are deemed to fall within the scope of a claim even if they include systems, devices, articles, compositions, formulations, or processes in addition to the elements recited after such terms in the claim.

[0080] As used herein, the terms "a" or "an" are used, as is common in patent documents, to include one or more, regardless of other instances or uses of "at least one" or "one or more." The term "or" is used herein to refer to a non-exclusive "or," such that "A or B" includes "A but not B," "B but not A," and "A and B," unless otherwise specified. The terms "comprises" and "in which" are used herein as the plain-English equivalents of the terms "comprises" and "wherein," respectively. Also, in the following claims, the terms "comprises" and "comprises" are open-ended; that is, systems, devices, articles, compositions, formulations, or processes that include elements in addition to those recited after such terms in a claim are still considered to be within the scope of that claim. Furthermore, in the following claims, terms such as "first," "second," and "third" are used merely as labels and are not intended to impose numerical requirements on their objects.

[0081] The above description is intended to be illustrative, not limiting. For example, the above examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments will be apparent to those of ordinary skill in the art upon reviewing the above description. The Abstract is provided in accordance with Code of Federal Regulations § 1.72(b) to enable the reader to quickly grasp the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Additionally, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be construed as meaning that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in fewer than all features of a particular disclosed embodiment. Accordingly, the following claims are herein incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as an independent embodiment, and it is contemplated that these embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full range of equivalents to which such claims are entitled.

Claims

1. 1. An implant configured to be implanted into a reamed or broached portion of a patient's bone, the implant extending between a first end and a second end; a central body extending from the first end to the second end; one or more fins attached to the periphery of the central body such that the central body and one or more fins form a major plane at the first end of the implant, the one or more fins extending radially outward from the central body and extending from the first end of the implant towards the second end of the implant, the central body and one or more fins being oriented at a major angle relative to the major plane so that the implant can be inserted into a reamed or broached portion of bone from a direction generally parallel to a longitudinal axis of the patient's bone; An implant comprising:

2. The implant of claim 1 , wherein the central body further comprises an attachment mechanism configured to attach the implant to a second implant component.

3. The implant of claim 2 , wherein the attachment mechanism is a male tapered trunnion extending at an elongated angle from the first end of the implant.

4. The implant of claim 3 , wherein the extension angle and the primary angle are adjacent pairs.

5. The implant of claim 3 , wherein the extension angle is perpendicular to the major plane.

6. 3. The implant of claim 2, wherein the attachment mechanism is a female tapered trunnion that extends inside the central body from the first end of the implant toward the second end of the implant.

7. The implant of claim 6 , wherein the female tapered trunnion extends inside the central body at an angle approximately equal to the major angle.

8. The implant of claim 6 , wherein the female tapered trunnion extends inside the central body generally perpendicular to the major plane.

9. 1. A system configured to be implanted in a patient, the system comprising: a first implantable component configured to be inserted into a reamed or broached portion of the patient's bone, the first implantable component extending between a first end and a second end, the first implantable component comprising: a central body extending from the first end of the first implantable component toward the second end of the first implantable component; one or more fins attached to the periphery of the central body, the one or more fins extending radially outward from the central body and extending from the first end of the first implantable component to the second end of the first implantable component, the central body and the one or more fins being oriented at a major angle relative to the first end of the first implantable component, the major angle allowing insertion of the first implantable component into a reamed or broached portion of the patient's bone from a superior approach; A system comprising:

10. The system of claim 9 , further comprising an attachment mechanism configured to attach the first implantable component to a second implantable component.

11. The system of claim 10 , wherein the attachment mechanism is a male tapered trunnion extending from the first end of the first implantable component.

12. The system of claim 11 , wherein the second implantable component is a prosthetic humeral head configured to be attached to the first implantable component via the male tapered trunnion.

13. 13. The system of claim 12, wherein the male tapered trunnion extends from the first end of the first implantable component at an angle approximately parallel to the major angle so that the prosthetic humeral head can be impacted onto the first implantable component from the superior approach.

14. The system of claim 11 , wherein the second implantable component is a cup member configured to be attached to the first implantable component via the male tapered trunnion.

15. 15. The system of claim 14, wherein the male tapered trunnion extends from the first end of the first implantable component such that the cup member can be impacted onto the first implantable component from the superior approach.

16. The system of claim 10 , wherein the attachment mechanism is a female tapered trunnion extending from the first end of the first implantable component inside the central body.

17. 17. The system of claim 16, wherein the second implantable component is a prosthetic humeral head configured to be attached to the first implantable component via the female tapered trunnion, the female tapered trunnion extending inside a central body of the first implantable component so that the prosthetic humeral head can be impacted onto the first implantable component from the superior approach.

18. 17. The system of claim 16, wherein the second implantable component is a cup member configured to be attached to the first implantable component via the female tapered trunnion, the female tapered trunnion extending inside a central body of the first implantable component so that the cup member can be impacted onto the first implantable component from the superior approach.

19. 1. A method of performing arthroplasty on at least one of a glenoid cavity or a humerus of a glenohumeral joint, comprising: making an entry incision in the soft tissues above and lateral to the glenohumeral joint; creating a pathway from the entry incision to the glenohumeral joint; inserting a cutting instrument through the passageway to cut the natural humeral head of the humerus along the articular margin of the natural humeral head while the natural humeral head remains in its anatomical position relative to the glenoid cavity without any dislocation; inserting an implant through the passage and securing the implant to the humerus such that a longitudinal axis of a central body of the implant extends substantially parallel to a longitudinal axis of the humerus; Maintaining both the subscapularis and supraspinatus muscles associated with the glenohumeral joint intact and connected to the surrounding bone during the entire arthroplasty; A method comprising:

20. inserting a reamer through the entry incision; reaming the glenoid cavity with the reamer; inserting a glenoid implant through the passage; Fixing the glenoid implant to the glenoid cavity; 20. The method of claim 19, further comprising:

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