Reverse shoulder system

Abstract

Improved shoulder prosthesis components and assemblies are provided. [Solution] This disclosure relates to an articular assembly configured to be coupled to a bone anchor. The articular assembly may include an articular body 280 having a first end 281 and a second end 282, with an articular surface 293 located at or adjacent to the first end. The articular body may include a bone anchor interface 288 located between the first end and the second end of the articular body. The bone anchor interface may include a groove 284 formed on the circumferential surface of the articular body, a locking member 253 located in the groove, and / or a deflectable portion 254 located between the locking member and the second end of the articular body.

Description

Technical Field

[0001] Incorporation by reference to any priority application This application claims the benefit of priority of U.S. Provisional Application No. 62 / 908,921, filed on October 1, 2019, which is hereby incorporated by reference in its entirety.

Background Art

[0002] This application relates to an apparatus and method for a reverse shoulder prosthesis. Arthroplasty is the standard treatment for the treatment of shoulder arthritis. A typical anatomical shoulder arthroplasty attempts to mimic the anatomical state. A metal humeral stem and a humeral head implant are attached to the humerus of the arm to replace the humeral side of the arthritic shoulder joint. Such replacement of the humeral head can form an articulation with the recess of the native glenoid fossa or the opposing glenoid resurfacing device.

[0003] In more severe cases, reverse reconstruction can be used. In reverse reconstruction, the kinematics of the shoulder joint are reversed by fixing a spherical device (sometimes called a glenoid ball) to the glenoid fossa and implanting a humeral implant with a cavity capable of receiving the glenoid ball.

[0004] A problem in reverse shoulder assemblies is that the articulating body is typically made from low friction polymers and metal humeral anchors. The metals and polymers used in reverse articulating bodies can wear at different rates. Also, in a typical assembly, there is a risk of unintentional separation between the articulating body and the anchor. Thus, there remains a continuing need for improvement in the components and assemblies of shoulder prostheses.

Summary of the Invention

Means for Solving the Problems

[0005] The connecting components used to link multiple parts of a shoulder joint assembly to each other require improvements, such as preventing relative movement between the components of the joint assembly.

[0006] Certain aspects of this disclosure relate to articular components configured to connect with a bone anchor. The articular component may include an articular body having a first end and a second end. An articular surface may be located at or adjacent to the first end. A bone anchor interface may be located between the first end and the second end of the articular body. The bone anchor interface may include a locking member configured to secure the articular component to the bone anchor and / or a deflectable portion located at the second end of the articular body. The deflectable portion may be configured to be deflected circumferentially by the surface of the humeral anchor to provide a load directed from the second end of the articular body towards the first end of the articular body when deflected.

[0007] The joint may include a cross-section configured to cover the edge of the bone anchor when the locking member is engaged with the bone anchor.

[0008] The bone anchor interface may include a groove formed on the circumferential surface of the articular body. The locking member may be positioned in the groove.

[0009] The deflectable portion may include at least two sections supported by a cantilever beam from the central part of the articulation body to the second end of the articulation body. It may include compression slots positioned between each of the rifling sections. The deflectable section may include a tapered surface positioned on its outer circumference. The deflectable section may be positioned between the locking member and the second end of the joint.

[0010] The joint component may include a rotational control zone positioned around the joint body between a first end and a second end. The rotational control zone may include a projection positioned in a first direction and a recess positioned in a second direction. The first direction may intersect the second direction. The projection may be a first projection, further including a second projection positioned on the opposite side of the first projection. The recess may be a first recess, further including a second recess positioned on the opposite side of the first recess.

[0011] Any of the joint components described herein may be included in a kit. A kit including a bone anchor in which a bone anchor recess is formed. The bone anchor recess may extend from a first end. The bone engagement outer surface may extend from the first end to a second end opposite the first end. The bone anchor recess may include a first peripheral portion adjacent to the first end configured to engage a locking member of the joint component, and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion may be configured to engage a deflectable portion. Optionally, the kit may include a tray or spacer having a first end and a second end configured to engage the bone anchor recess of the bone anchor at least by the second peripheral portion. The first end of the tray may include a tray recess formed therein. The tray recess may include a first peripheral portion adjacent to a first end configured to engage a locking member of the joint component, and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion is configured to engage a deflectable portion.

[0012] Certain aspects of this disclosure relate to humeral assemblies. A humeral assembly may include a humeral anchor (e.g., with or without a stem) and an articular assembly. A humeral anchor may be configured to be fixed to a bone. A humeral anchor may include a first end, a second end, and a recess extending between the first and second ends. The recess may be accessible from the first end of the humeral anchor and may include a first peripheral portion adjacent to the first end and a second peripheral portion between the first peripheral portion and the second end of the humeral anchor. An articular assembly may be configured to be inserted into the recess for fixation to the humeral anchor within the recess. An articular assembly may include an articular body having an articular surface located at or adjacent to its first end, and a humeral anchor interface located between the first and second ends of the articular body. The humeral anchor interface may include a groove formed on the circumferential surface of the articular body, a locking member positioned in the groove, and / or a deflectable projection positioned between the locking member (e.g., a locking ring or C-ring) and the second end of the articular body.

[0013] A deflectable projection may be positioned on the second peripheral portion of the recess and, when positioned therein, may be configured to be deflected circumferentially by the surface of the second peripheral portion and / or to provide a load between the locking member and the surface of the first peripheral portion. When the humeral anchor and the joint assembly are coupled together, the deflectable projection is configured to engage with the surface surrounding the second peripheral portion before the locking member engages with the first peripheral portion of the recess of the humeral anchor.

[0014] Certain aspects of this disclosure relate to articular assemblies configured to bond with bone anchors. The articular assembly may include an articular body having a first end and a second end, with an articular surface located at or adjacent to the first end. The articular body may include a bone anchor interface located between the first end and the second end of the articular body. The bone anchor interface may articulate with grooves formed on the circumferential surface of the articular body, locking members located in the grooves, and / or with the locking members. It may include a deflectable portion positioned between the second end of the body and the first end of the articular body. The deflectable portion may be configured to provide a load directed from the second end of the articular body to the first end of the articular body when deflected circumferentially by the surface of the humeral anchor and / or, for example, in a frustoconical shape.

[0015] The articular body may include a cross section positioned between the groove and the first end of the articular body. The cross section may be configured to cover the edge of the humeral anchor when the locking member is engaged with the humeral anchor.

[0016] The articulated joint may include a rotational control zone positioned around the joint between the first and second ends. The rotational control zone includes at least one projection positioned in a first direction and at least one recess positioned in a second direction. The first direction may traverse the second direction.

[0017] The deflectable portion may include a tapered surface positioned on its outer circumference. In some configurations, the deflectable projection includes a blind hole along the centerline of the articulation body. In some configurations, the deflectable portion may include at least two sections, for example, four sections supported by a cantilever beam from the central portion of the articulation body to a second end of the articulation body. The deflectable portion may also include a compression slot positioned between each of the at least two sections.

[0018] Any of the joint assemblies described herein may form part of a kit. The kit may include a bone anchor in which a bone anchor recess is formed. The bone anchor recess extends from a first end. The bone engagement outer surface extends from the first end to a second end opposite the first end. The bone anchor recess may have a first peripheral portion adjacent to the first end configured to engage a locking member of the joint assembly, and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion may be configured to engage a deflectable portion of the joint assembly.

[0019] In some embodiments, the kit may include a tray having a first end and a second end configured to engage with bone anchor recesses of bone anchors at least in a second peripheral portion. The first end of the tray may include a tray recess formed therein. The tray recess may include a first peripheral portion adjacent to the first end configured to engage with a locking member of a joint assembly, and a second peripheral portion between the first peripheral portion and the second end. The second peripheral portion may be configured to engage with a deflectable portion.

[0020] During use, the bone anchor may be positioned at the end of a patient's long bone. The joint assembly may rotationally align with the bone anchor by rotationally aligning a first rotationally aligning feature of the joint assembly (e.g., a projection or concave surface) with a second rotationally aligning feature (e.g., the negative of the first rotationally aligning feature) positioned in the recess. The recess may be formed in the bone anchor or in a tray coupled to the bone anchor positioned at the end of a long bone. The joint assembly may advance into the bone anchor until the reverse-loading projection is positioned within the tapered surface of the recess. For example, the joint assembly may advance until the tapered outer surface of the reverse-loading projection engages with the tapered surface of the recess, causing sections of the reverse-loading projection to move toward each other across its compression slot. The joint assembly may advance further until the locking member of the joint assembly is deflected within a groove formed in the central portion of the joint body. The joint assembly may advance further until the locking member of the joint assembly aligns with the groove positioned around the recess of the bone anchor, allowing the locking member to straddle the gap between the groove of the joint body and the groove positioned around the recess. When the reverse load projection is deflected by the tapered surface of the recess, after the locking member has straddled the gap between the groove of the joint body and the groove positioned around the recess, the reverse load projection reduces, minimizes, or eliminates the movement of the joint assembly relative to the bone anchor.

[0021] Certain aspects of this disclosure relate to a shoulder joint prosthesis assembly comprising a bone anchor and an articular assembly. The bone anchor may comprise a metallic body, and the articular assembly may comprise a polymer body. The bone anchor may comprise a body having a bone engagement side positioned relative to the bone and an assembly side opposite the bone engagement side. The assembly side may comprise a recess positioned around a mounting area. The mounting area may comprise a groove positioned around the mounting area. The groove provides a first retaining surface. The articular assembly comprises a body portion and a locking member. The body extends along a central insertion axis between a first portion configured to be inserted into the mounting area and a second portion opposite the first portion. The second portion comprises an articular surface.

[0022] In an assembly with a locking member, the locking member may include an arc-shaped member positioned around a first portion of the joint. The arc-shaped member has a second retaining surface. The second retaining surface may be positioned at an angle, for example, an acute angle, with respect to a plane perpendicular to the central insertion axis. The first portion of the second retaining surface may be positioned further from the articular surface in the direction of the central insertion axis than the first retaining surface when the joint assembly is engaged with a bone anchor. The second portion of the second retaining surface may be positioned closer to the articular surface in the direction of the central insertion axis than the first retaining surface when the joint assembly is engaged with a bone anchor. The first retaining surface may be positioned between the inner and outer ends of the second retaining surface when the locking member engages with a groove in the bone anchor.

[0023] The locking member may also include an elastic body. The first end of the elastic body may extend from the first end of the arched member. The second end of the elastic body may contact or engage with the polymer body. The first portion of the main body may include a recess configured to receive the elastic body in only one position. The elastic body may be configured to center the arched member with respect to the central insertion axis. For example, the elastic body stores strain energy when a deflection force is applied to deflect the first end of the locking member away from the central position, and releases strain energy when the deflection force is removed to return the locking member towards the central position.

[0024] Certain aspects of the present disclosure are directed to a shoulder joint prosthesis assembly including a bone anchor and an articular assembly. The bone anchor may include a metallic body, and the articular assembly may include a polymeric body. The bone anchor may include a bone engaging side disposed against bone and an assembly side opposite the bone engaging side. The assembly side may include a recess disposed around an attachment region. The attachment region may include a groove disposed around the attachment region. The groove includes a first retaining surface. The articular assembly may include a body portion and a locking member. The body portion extends along a central insertion axis between a first portion configured to be inserted into the attachment region and a second portion opposite the first portion. The second portion includes an articular surface.

[0025] Certain aspects of the present disclosure are directed to an articular portion including a body portion, e.g., a polymeric body portion, and a locking member. The body portion extends along a central insertion axis between a first portion configured to be inserted into the bone anchor and a second portion opposite the first portion. The second portion includes an articular surface. The locking member may include a locator body having an arcuate member disposed around the first portion and a first end coupled to the arcuate member and a second end coupled to the polymeric body. The locator body is configured to be received in the recess of the body portion in a predefined direction and / or position.

[0026] Any feature, structure, or step disclosed herein may be replaced with, combined with, or omitted from any other feature, structure, or step disclosed herein. Additionally, for purposes of summarizing the present disclosure, certain aspects, advantages, and features of the present invention are described herein. It is to be understood that not all such advantages necessarily are achieved in accordance with any particular embodiment of the present invention disclosed herein. Individual aspects of this disclosure are either essential or non-essential.

[0027] These and other features, aspects, and advantages are described below with reference to the drawings, which are intended for purposes of illustration only and should in no way be construed as limiting the scope of the embodiments. Further, various features of the different disclosed embodiments may be combined to form additional embodiments that are part of this disclosure. In the drawings, like reference characters consistently refer to corresponding features throughout the similar embodiments. The following is a brief description of each of the drawings.

Brief Description of the Drawings

[0028] [Figure 1] A reverse total shoulder arthroplasty system in the shoulder joint is shown, and the system includes an anchor with a humeral stem. [Figure 2] A schematic view of a shoulder arthroplasty system including an arthroplasty kit is shown, which can be used when converting from an anatomical arthroplasty to a reverse arthroplasty, or from a reverse arthroplasty to an anatomical arthroplasty, during the performance of an anatomical arthroplasty or a reverse arthroplasty. [Figure 3A] An example of an articular assembly is shown. [Figure 3B] A cross-sectional view of the articular assembly of FIG. 3A is shown, and the cross-section is taken along line 3B-3B. [Figure 3C] A bottom perspective view of the articular assembly of FIG. 3A is shown. [Figure 3D] An articular assembly with an asymmetric articular body configuration having an angled inner edge or side is shown. [Figure 3E] A cross-sectional view of the articular assembly of FIG. 3D is shown, and the cross-section is taken along line 3E-3E. [Figure 3F] An articular assembly with an alternative humeral anchor interface is shown. [Figure 3G] A cross-sectional view of the articular assembly of FIG. 3E is shown, and the cross-section extends in the medial-lateral direction through the center of the assembly. [Figure 4A]Figure 2 is a perspective view of the humeral anchor and joint assembly from the system before insertion of the joint assembly, illustrating the engagement features of these components. [Figure 4B] Figure 4A shows the humeral anchor and joint assembly after the joint assembly has been inserted. [Figure 4C] Figure 4B shows a cross-sectional view of the humerus assembly, where the cross-section is taken to traverse the insertion direction of the reverse joint assembly in the cross-sectional plane 4C to 4C. [Figure 4D] Figure 4B shows a top view of the assembled humerus assembly. [Figure 4E] Figure 4D shows cross-sectional views of the partial and joint assemblies of the humeral anchor, with the cross-sections taken along lines 4E, 4F to 4E, 4F. [Figure 4F] Figure 4D shows a cross-sectional view of the joint assembly, with the cross-section taken along lines 4E, 4F to 4E, and 4F. [Figure 5A] The image shows a humeral assembly including a stemmed humeral anchor, tray, and joint assembly. [Figure 5B] Figure 5A shows the tray for the humerus assembly. [Figure 6A] An example of a joint assembly is shown. [Figure 6B] Figure 6A shows a bottom view of the joint assembly. [Figure 6C] Figure 6A shows the locking member of the joint assembly. [Figure 6D] Figure 6A is a perspective view of the humeral anchor and joint assembly from the system before insertion of the joint assembly, illustrating the engagement features of these components. [Figure 6E] Figure 6D shows a partially enlarged cross-section of the connection between the humeral anchor and the joint assembly. [Figure 6F] Figure 6D shows a partially enlarged cross-section of the connection between the humeral anchor and the joint assembly. [Figure 6G] Figure 6D shows a partially enlarged cross-section of the connection between the humeral anchor and the joint assembly. [Figure 7]Here is another example of a joint assembly. [Figure 8A] Another example of a locking member is shown. [Figure 8B] A modified example of the locking member shown in Figure 8A is shown. [Figure 9A] Another example of a joint assembly and fracture stem is shown. [Figure 9B] Figure 9A shows a bottom perspective view of the joint assembly. [Figure 10A] Here is another example of a joint assembly. [Figure 10B] Figure 10A shows a partial cross-section of the joint assembly connected to the anchor. [Figure 11] Here is another example of a joint assembly. [Figure 12] Here is another example of a joint assembly. [Modes for carrying out the invention]

[0029] This application relates to a novel and inventive shoulder implant in various examples. The shoulder implant can be part of a partial shoulder arthroplasty system and a total shoulder arthroplasty system. Figure 1 shows a reverse configuration in which the humerus H is attached to an articular body 84 having a concave articular surface 85. A spherical articular body, commonly called a glenosphere 87 (sometimes called a glenofossal ball), is attached to the glenofossal region of the scapula. In this case, the concave articular surface 85 is located on the humeral articular surface of the glenosphere 87, which is fixed to the scapula. The reverse articular body 84 is attached to a tray 89 positioned between the reverse humeral articular body 84 and a stemmed anchor 83 surgically embedded in the humerus H. The humerus H is prepared by providing access to the medullary duct of the humerus H.

[0030] I. Systems and kits with shared implant components Figure 2 shows a schematic diagram of a total arthroplasty system including an arthroplasty kit 100 according to various embodiments, which can be used when performing anatomical arthroplasty or reverse arthroplasty, or when converting from anatomical arthroplasty to reverse arthroplasty, or from reverse arthroplasty to anatomical arthroplasty. The kit 100 may include one or more stemless humeral anchors 103, one or more stemmed humeral anchors 113, and one or more arthroplasty components 161. The stemless humeral anchor 103 may have a tapered shape at the distal portion 105 and proximal portion 107 of the anchor 104. The distal portion 105 of the anchor 103 shown in Figure 2 may have one or more fins 109 extending distally. The fins 109 may be configured to fix the anchor 103 to the humerus.

[0031] As shown in Figure 2, the stemless anchor 103 can be provided in multiple sizes to accommodate patients of different sizes, varying degrees of bone injury to the humerus, etc. In some embodiments, the lateral size of the stemless anchor 103 may vary to accommodate various sizes of humeral resections. For example, kit 100 may include multiple stemless anchors 103A, 103B, 103C, 103D...103n, where n is the number of different sizes. Although four sizes are shown in Figure 2 (e.g., n=4 with anchors 103A-103D), in other embodiments, the kit may include any appropriate number of anchors. In some embodiments, the length l1 of the stemless anchors 103A-103D may also vary to extend into the humerus by a depth selected by the clinician based on the specific patient being treated. Furthermore, anchors 103A-103D may have different fin lengths lf of the fin 109 to accommodate different sizes of humeruses.

[0032] In various embodiments, the length lf of the fins of anchors 103A to 103D may be substantially different to beneficially provide a wide range of anchoring strength to the humerus and to accommodate patients with different levels of bone injury. For example, in the arrangement of Figure 2, the first anchor 103A is The shortest overall length l1 and the shortest fin overall length lf can be the fourth anchor 103D, which can have the longest overall length l1 and the longest fin overall length lf. In various embodiments, the ratio of the overall length l1 of one anchor 103 of kit 100 (e.g., the largest anchor 103) to the overall length l1 of another anchor 103 (e.g., the smallest anchor 103) may be in the range of 1.15 to 2.5, 1.18 to 2.5, 1.2 to 2.5, 1.2 to 2, 1.2 to 1.8, 1.2 to 1.6, 1.3 to 1.6, or 1.25 to 1.4.

[0033] Kit 100 may also include one or more stemmed humeral anchors 113. Kit 100 may include one or more stemmed humeral anchors 112, each including a proximal metaphysical portion 120 and an elongated diaphysis portion 116 extending therefrom. The diaphysis portion 116 may be referred to herein as the stem or stem portion. In some embodiments, Kit 100 may also include a trauma or fracture stemmed anchor 140 that can be used in patients who have experienced a fracture of the humerus H. A stemmed humeral anchor 113 may be used, for example, in patients who have experienced severe bone loss and for whom a stemless anchor 103 cannot be properly fixed to the humerus. A trauma or fracture stem may be used when the humerus is fractured in one or more portions. Similar to the stemless anchor 103, Kit 100 may include several different sizes of stemmed humeral anchors 113 (sometimes referred to herein as stemmed anchors) having different lateral sizes and / or different lengths l2. For example, as shown in Figure 2, each stemmed humeral anchor 113 may have a length l2 that is longer than the length l1 of the stemless anchor 103. Beneficially, by including stemmed anchors 113 of different sizes in Kit 100, clinicians can select the appropriate size for a particular patient to ensure the secure implantation of the anchor 113 in the patient, taking into account the patient's bone size and health condition. In various embodiments, the length l2 of the stemmed humeral anchor may range from 55 mm to 175 mm. In contrast, the shorter length l1 of the stemless humeral anchor 103 may range from 16 mm to 28 mm. In various embodiments, stemmed humeral anchors 113, 140 may be configured to reach the intramedullary canal of the humerus H for additional fixation.

[0034] Beneficially, Kit 100 may include one or more shared humeral components to be used with either the stemless humeral implant 103 or the stemmed humeral implant 113, depending on which implant 103 or 113 would be more suitable for a particular patient's humeral biomimetic structure. For example, the shared humeral components of Kit 100 may include a plurality of articulation components or assemblies 161 that can be used in conjunction with either the stemless implant 103 or the stemmed implant 113. As described herein, both the stemless humeral anchor 103 and the stemmed humeral anchor 113 may include shared engagement features that can be used with the same set of tools and / or articulation components. For example, as described herein, the stemless anchor 103 and the stemmed anchor 113 may include convex and concave locking features configured to engage with the same set of articulation components.

[0035] For example, kit 100 may include an anatomical articular component 160 configured to mechanically connect to both a stemless humeral implant 103 and a stemmed humeral implant 113. A clinician may select the anatomical articular component 160 for a procedure where anatomical reconstruction is appropriate. The anatomical articular component 160 may include a coupler 168 and an articular body 164 (anatomical) configured to mechanically engage the coupler 168. As shown in Figure 2, the articular body 164 for the anatomical articular component 160 may include a rounded convex surface configured to engage with the surface of the patient's glenoid fossa. Depending on the patient's humeral structure, the coupler 168 may have a rounded convex surface on the anatomical articular body 164 (e.g., rounded The articular body 164 and coupler 168 may contain metals such as cobalt, chromium, or titanium. In some embodiments, the articular body includes a pyrocarbon layer at least on the articular surface. In various embodiments, the kit 100 may include anatomical articular components 160 having multiple sizes.

[0036] Kit 100 may include a reverse articular component 180 configured to mechanically connect to both a stemless humeral implant 103 and a stemmed humeral implant 113. A clinician may select the reverse articular component 180 for procedures where a reverse-type anatomical reconstruction is appropriate. The reverse articular component 180 may include a reverse articular body 184 and a locking device 188 configured to fix the reverse articular component 180 to either the stemless humeral implant 103 or the stemmed humeral implant 113, depending on the clinician's recommendation during the procedure. As shown, the reverse articular body 184 may include a rounded concave surface (e.g., essentially spherical) configured to engage with a glenoid sphere connected to the patient's glenoid fossa (not shown, but in some cases integrated into a larger surgical set with the kit). Furthermore, in some embodiments, kit 100 may include wear-resistant reverse joint components 180A, which may generally be similar to reverse joint components 180 but may be further formed to contain vitamin E to promote long-term compatibility with the patient's bone structure. Reverse joint components 180, 180A may include polymers, for example, ultra-high molecular weight polyethylene. In various embodiments, kit 100 may include reverse joint components 180, 180A having multiple sizes.

[0037] During a joint replacement procedure, the clinician may examine the bone structure of the humerus and / or scapula to determine whether the biostructure is suitable for a stemless humeral anchor or a stemmed humeral anchor, and whether the biostructure is suitable for an anatomical reconstruction or a reverse anatomical reconstruction. Beneficially, Kit 100, shown in Figure 2, can provide the clinician with a total joint replacement system containing components compatible with stemless or stemmed anchors and compatible with anatomical or reverse anatomical reconstructions. For example, during the procedure, the clinician may observe that the patient has a sufficient humeral structure, and therefore a stemless anchor 103 can be used to reduce damage to the patient's biostructure. The clinician may also choose whether to proceed with an anatomical reconstruction or a reverse reconstruction, and accordingly select either the anatomical joint component 160 or the reverse joint component 180, 180A.

[0038] Similarly, during the procedure of shoulder joint replacement, if the clinician determines that the patient's bone structure is damaged or otherwise more suitable for a stemmed anchor 113, the clinician can select a stemmed anchor 113 of the appropriate size. The clinician can further choose whether to proceed with anatomical reconstruction or reverse reconstruction, and accordingly select either the anatomical joint component 160 or the reverse joint component 180, 180A. Conveniently, Kit 100 in Figure 2 includes interchangeable or interoperable components that can be used with stemmed or stemless anchors and with anatomical or reverse anatomical reconstructions. The shared humeral joint component 161 (e.g., anatomical or reverse anatomical joint) can be used with either stemless or stemmed anchors 103, 113, so that the clinician can make or change reconstruction decisions during surgery. Thus, Kit 100 can enable the clinician to quickly determine the most appropriate reconstruction procedure for the patient and provide the clinician with the components to be used for that reconstruction procedure.

[0039] As described above, in the case of a humeral fracture, kit 100 may also include one or more trauma stems 140. Beneficially, the trauma stem(s) 140 may have engagement features that are generally similar to or identical to those of the stemless anchor(s) 103 and the humeral stem-stemmed anchor(s) 112, and as a result, the stemless anchor(s) 103, the humeral stem-stemmed anchor(s) 112, and the trauma stem(s) 140 can be used together with the shared joint components(s) 161 and a common set of tools. Beneficially, kit 100 can be used with either the stemless anchor(s) or the stemmed humeral anchor(s) 103, 113, and can provide a shared set of implantation tools and a shared set of joint components(s) 161 that can be used for anatomical reconstruction or reverse anatomical reconstruction.

[0040] In some embodiments, the coupler 168 may include a proximal extension 163A and a distal extension 163B configured to connect to the articular body 164. For anatomical reconstruction, the distal extension 163B of the fracture stem 140 can be received in a recess 217 of the fracture stem 140. A disc or intermediate portion 162 positioned between the proximal extension 163A and the distal extension 163B can be excluded because the recess 217 is raised toward the resection surface. In modified embodiments, the recess 217 is recessed from the distal end of a second recess (e.g., extending distally). In those embodiments, the disc or intermediate portion 162 provides a spacer function used in the trauma stem 140. Further details regarding the trauma stem can be found in the entirety of International Application No. PCT / US2015 / 065126, filed on 15 December 2015, the entirety of which is incorporated herein by reference for all purposes.

[0041] The final implant may take any appropriate configuration, such as any configuration described in PCT / US2019 / 054007, titled "SHOULDER PROSTHESIS COMPONENTS AND ASSEMBLIES," and PCT / US2019 / 054023, titled "MODULAR HUMERAL HEAD," both filed on the same day as this application and with attorney reference numbers TRNXSH.104WO2 and TRNXSH.105WO, respectively. The final implant may take any appropriate configuration, such as any configuration described in PCT / US2019 / 054023, titled "SHOULDER PROSTHESIS COMPONENTS AND ASSEMBLIES," filed on the same day as this application and with attorney reference number TRNXSH.104PR2. Any configuration disclosed in application number 62 / 908,725, titled “PROSTHESIS COMPONENTS AND ASSEMBLIES,” may be adopted. The overall content of each application listed in this section is incorporated herein by reference, both as a whole and for all purposes.

[0042] II. Examples of components of the humeral assembly As described above, this application discloses several kits and systems that provide shared components and may include multiple types of joint assemblies. For example, a humeral assembly may include joint portions and anchors.

[0043] Figures 3A–3C show exemplary articulated portions 261, sometimes referred to herein as articulated components. The articulated portion 261 includes an articulated body 280, such as a reverse component having a concave articulated surface; however, in some procedures, as described above, the clinician may select an anatomical articulated component, such as the anatomical articulated component 160 in Figure 2. In some embodiments, the articulated portion 261 may be an articulated assembly, such as a polymer articulated body 280 and a locking member 253, as will be described in more detail below. In other embodiments, the articulated portion 261 may be a single component, such as a polymer articulated body 280.

[0044] As shown in Figure 3A, the articular body 280 may include a first end or proximal end 281 and a second end or distal end 282. The articular body 280 may have an articular surface 293 located at the first end 281 and a humeral anchor interface 288 located at the second end 282. The humeral anchor interface 288 of the articular body 280 can be used to fix the articular body 280 to the anchor 203.

[0045] The articular body 280 includes a main body portion 287 proximal to the humeral anchor interface 288. The main body portion 287 may be defined by an outer wall 299 which may be curved or tapered. The maximum diameter of the main body portion 287 may be between 34 mm and 42 mm. The main body portion 287 may also include a marginal portion 291 between the articular surface 293 and the outer wall 299. The marginal portion 291 may have a first thickness T1 of 5.0 mm or less or 3.0 mm or less (see Figure 3B). The articular body 280 may include a marker 279 to provide an indication of the anatomical orientation for implantation. For example, the marker 279 may provide an indication of the side of the articular body 280 which should align with the side of the humerus. As shown in Figure 3B, the marker 279 may be a depression on the marginal portion 291 of the main body portion 287. However, the marker 279 may be printed on the edge portion 291 or elsewhere on the joint body 280, or otherwise visually indicated.

[0046] The articular body 280 may also include a cross section 286 positioned between the first end 281 and the second end 282 of the articular body 280. The cross section 286 may define the distal side of the main body portion 287. The cross section 286 may be configured to cover the edge or proximal surface 239 of the anchor 203 when assembled (see Figures 4A and 4F). When assembled with the humeral anchor 203, the main body portion 287 may overhang or underhang the anchor 203 by 2.0 mm or less or about 1.0 mm or less, depending on the size of the humeral assembly.

[0047] The main body portion 287 may have a second thickness T2 between the most distal point or apex of the articular surface 293 and the transverse surface 286 (see Figure 3B). The most distal point or apex of the articular surface 293 is proximal to or aligned with the transverse surface 286. In other configurations, the most distal point or apex of the articular surface 293 may be distal to the transverse surface 293. The thickness T2 may be about 25 mm or less, about 20 mm or less, about 15 mm or less, about 10 mm or less, about 5 mm or less, or about 1 mm or less. In some embodiments, the thickness T2 may be 0 mm. If the thickness T2 is insufficient during use, the clinician may use spacers to add thickness to achieve the desired thickness between the most distal point of the articular surface 293 and the proximal surface 239 of the anchor 203. For example, if the clinician has performed an underexcision or if the soft tissue is loose, the clinician may use spacers to construct the stem.

[0048] As shown in Figures 3A and 3B, the articular body 280 may be symmetrical about the central axis L. For example, the center of the radius of curvature or the center of rotation of the articular surface 293 may be aligned with the central axis L of the articular body 280. Symmetry of the articular body 280 may be desirable for stemless reverse configurations or stems with an inclination angle, e.g., about 135 degrees. Symmetry of the articular body 280 may be desirable if the morphology of the scapula is such that the movement of the arm toward the patient does not result in contact between the humeral implant assembly and the scapula. If contact is possible, notches in the scapula and / or wear of components may occur. Therefore, an angled proximal margin may be used, as will be further discussed below. An angled insert may be useful for other biomechanical adaptations, as will be discussed below.

[0049] In other configurations, the main body portion 287 may be bent to achieve a desired inclination angle. For example, Figures 3D to 3E show another joint portion 261A in which the proximal portion of the joint body 280 is bent relative to the cross section 286. The center of rotation of the joint surface 293 may be aligned with the central axis L of the joint body 280. In other embodiments, the center of rotation may be bent so that the center of the radius of curvature or the center of rotation does not align with the central axis L of the joint body 280. The angle between the cross section 286 and the proximal edge or edge portion 291 may be between 7.5 degrees and 17.5 degrees, for example, 10 degrees. The angled joint body 280 is a conversion from stemless anatomical to reverse type, or for example This can be desirable for stems with inclined sections, such as those with an inclination angle of approximately 145 degrees.

[0050] As shown in Figure 3C, the articulated joint 280 may include a rotational control zone 285 positioned around the articulated joint 280 between the first end 281 and the second end 282, for example, between the cross section 286 and the second end 282 of the articulated joint 280. The rotational control zone 285 may include at least one first alignment feature, such as a projection 252. For example, the projection 252 may be a convex tab. The rotational control zone 285 may include the first projection 252 and a second projection 252 circumferentially spaced from the first projection 252, for example, on the opposite side of the first projection 252. In addition to or instead of the first alignment feature, the rotational control zone 285 may include at least one second alignment feature different from the first alignment feature, such as a recess 251. For example, the recess 251 may be a concave elongated hole. The rotation control zone 285 may include a first recess 251 and a second recess 251 circumferentially spaced from the first recess 251, for example, on the opposite side of the first recess 251. As shown in the figure, the rotation control zone 285 includes different types of matching features, such as projections 252 and recesses 251. For example, projections 252 may extend in a first direction, and recesses 251 may extend in a second direction. The first direction may traverse the second direction.

[0051] As shown in Figures 3A and 3B, the humeral anchor interface 288 may include grooves 284 formed on its surface, such as on the circumferential surface of the humeral anchor interface 288. The grooves 284 may be located between the first end 281 and the second end 282 of the articular body 280, for example, between the rotational control zone 285 and the first end 281 of the articular body 280.

[0052] As described above, the joint portion 261 may be a joint assembly in which the articular body 280 and the locking member 253 are fitted into a groove 284 of the humeral anchor interface 288. The locking member 253 can reversibly fix the articular body 280 to the anchor 203. As shown in Figure 3A, the locking member 253 may be a locking ring with a discontinuity 258 (e.g., a C-ring) to facilitate radial compression of the locking member 253. The locking member 253 may include chamfered proximal and / or distal edges to facilitate insertion of the joint portion 261 into the anchor 203. For example, as shown in Figure 3B, the locking member 253 has a chamfered distal edge 259.

[0053] The humeral anchor interface 288 may include a reverse load-bearing or deflectable portion 254 projecting distal to the rotation control zone 285 and / or to the second end 282 of the articular body 280. At least the distal portion of the deflectable portion 254 may include a frustoconical or tapered surface 257 to facilitate insertion into the anchor 203.

[0054] The deflectable portion 254 may include at least two sections 255, for example, three or four sections supported by a cantilever beam from the central portion of the articulation body 280 to the second end 282 of the articulation body 280. The deflectable portion 254 may also include compression slots 256 positioned between each of the at least two sections 255. For example, as shown in Figure 3B, the deflectable portion 254 may include four sections 255 separated by intersecting compression slots 256. The compression slots 256 allow the deflectable portion 254 to be compressible in a direction transverse to the longitudinal axis L or in an annular direction.

[0055] Other humeral anchor interfaces 288 may also be provided for the articular body 280. For example, Figures 3F to 3G show a humeral portion 261B in which the humeral anchor interface 288 includes a deflectable portion 254. The deflectable portion 254 may be a compressible plug exhibiting annular compression. The deflectable portion 254 may include a projection 297 having a blind hole 298 that extends proximal from a second end 282 through a projection 297. The blind hole 298 is the center of the articular body 280. It may extend along axis L. The projection 297 may define a continuous perimeter without gaps, elongated holes, or other discontinuities. At least the distal portion of the deflectable portion 254 may include a frustoconical or tapered surface to facilitate insertion into the humeral anchor 203.

[0056] Figures 4A–4F show examples of humeral assemblies including an anchor 203 and an articulated portion 261. As shown, the anchor 203 is stemless, but the humeral anchor may also include a stem (see Figure 5A). Any of the features described herein with respect to the stemless anchor 203 may be applicable to humeral anchors including a stem or tray. In some embodiments, the anchor 203 may be monolithic or a single piece. In other embodiments, the anchor 203 may include a first portion or anchor portion and a second portion or tray portion adapted for connection to a stemless or stemmed anchor (see Figure 5B). A single articulated portion 261 may be compatible with a stemless anchor, a stemmed anchor, and / or a tray, respectively.

[0057] As shown in Figure 4A, the first recess 231 may extend distally from the proximal surface 239 of the anchor 203 to the proximal portion 207. The first recess 231 may be sized and shaped to receive the distal or lateral portion of the articular body 280. As shown in Figure 4A, the first recess 231 may be located in the proximal portion 207 of the anchor 203. The second recess 232 may extend distally from the first recess 231 to the first section 205A of the anchor 203. The first and second recesses 231, 232 may have different volumes. For example, the volume of the first recess 231 (and / or the diameter or lateral principal dimension of the first recess 231) may be larger than the volume of the second recess 232 (and / or the diameter or lateral principal dimension of the second recess 232). Therefore, the combined space formed by the depressions 231 and 232 may be larger towards the proximal surface 239 of the anchor 203 and smaller towards the distal end 205 of the anchor 203.

[0058] As shown in Figure 4A, the anchor 203 may include an inner surface 233 positioned around a first recess 231 adjacent to the proximal surface 239 of the anchor 203. The inner surface 233 may be a surface portion extending from the distal inner surface 235 to the proximal surface 239 of the anchor 203. The inner surface 233 may include one or more matching features configured to contact corresponding features of the rotation control zone 285 of the articulated portion 261. For example, the anchor 203 may include one or more concave locking features 243 and / or one or more convex locking features 241 positioned on the inner surface 233.

[0059] As shown in Figure 4A, the anchor 203 may include a plurality of, for example, two or a pair of, concave locking features 243 spaced apart from one another along the inner surface 233. The concave locking features 243 can be separated circumferentially, for example, by being positioned opposite each other across a recess 231 on the inner surface 233. As shown in Figure 4C, the first concave locking feature 243A may be located on the inner portion M of the anchor 203, and the second concave locking feature 243B may be located on the outer portion L of the anchor 203. In other examples, the first concave locking feature 243A may be located on the front portion of the anchor 203, and the second concave locking feature 243B may be located on the rear portion of the anchor 203. An angle can be defined between the concave locking features 243A, 243B, for example, 180 degrees, 120 degrees, 90 degrees, 60 degrees, or other angular separations between them. For example, two or more concave locking features 243A or 243B can be provided, such as three at 120-degree intervals, four at 90-degree intervals, or six at 60-degree intervals. In some embodiments, the spacing between locking features 243A and 243B may not be equal.

[0060] In addition to or instead of the concave locking feature 243, the inner circumferential surfaces 233 are, for example, opposite each other. It may include multiple, for example, two or a pair of concave locking features 241 that are circumferentially separated from each other, such as being positioned facing each other. As shown in Figure 4C, a first convex locking feature 241A may be located on the front portion A of the anchor 203, and a second convex locking feature 241B may be located on the rear portion P of the anchor 203. If both concave locking features 243 and convex locking features 241 are present, the concave locking features 243 may be circumferentially spaced apart from the convex locking features 241.

[0061] As shown in Figures 4A and 4C, the convex locking feature 241 may include projections 247 extending radially inward relative to the inner surface 233 toward the first recess 231. The projections 247 may be elongated and oriented proximal-distal in the first recess 231, for example, parallel to the direction of insertion of the joint portion 261. The projections 247 may extend from an adjacent portion of the inner surface 233 toward the central portion of the first recess 231. The portion of the inner surface 233 adjacent to the projection 247 may be concave in the structure facing the first recess 231 relative to the projection 247. For example, each convex locking feature 241 may be adjacent to a pair of concave recesses 242 formed in the inner surface 233. Similar to the concave locking feature 243, the convex locking feature 241 can be sized relative to the corresponding locking feature on the joint portion 261 that provides interference connection between the joint portion 261 and the anchor 203.

[0062] As shown in Figure 4A, the inner surface 233 may include a groove 244 extending circumferentially along the inner surface 233. The groove 244 may be distal to the proximal surface 239. The gap between the proximal surface 239 and the groove 244 may be 3.0 mm or less. The groove 244 may include a plurality of segments circumferentially arranged between a concave locking feature 243 and a convex locking feature 241 (see Figure 4A). The groove 244 may include any suitable number of segments, such as 4, 6, etc. As described below, the groove 244 may be sized relative to the locking member 253 of the articulated portion 261 to provide a snap-fit ​​or interlock-fit with the locking member 253. In various embodiments, the groove 244 may include a distally facing surface that can secure the locking member 253 of the articulated portion 261 to the anchor 203.

[0063] During use, when a clinician inserts the joint portion 261 into the anchor 203, the clinician can align the humeral anchor interface 288 of the joint body 280 with the first recess 231 of the anchor 203, for example, by using a rotational control zone 285. The joint portion 261 may include a first rotational alignment feature (e.g., a projection 252 or a recessed slot 251) along with a second rotational alignment feature (e.g., a negative of the first rotational alignment feature) positioned in the recess of the anchor 203. During assembly, the engagement between the rotational control zone and the corresponding feature of the anchor 203 can also function as an anti-rotation feature to suppress relative rotation between the anchor 203 and the joint portion 261.

[0064] When properly aligned, at least one projection 252A, 252B of the humeral anchor interface 288 contacts the corresponding concave locking feature 243A, 243B of the anchor 203, and / or at least one concave slot 251 of the humeral anchor interface 288 contacts the corresponding convex locking feature 241A, 241B of the anchor 203 (see Figure 4C). The rotational control zone 285 of the articular portion 261 and the inner circumferential surface 233 of the anchor 203 can be sized such that, when inserted into the first recess 231 of the articular portion 261, an interference fit or friction fit is formed between the articular portion 261 and the anchor 203. For example, the concave locking feature 243 can be sized relative to the corresponding projection 252 of the articular portion 261 to provide an interference connection between the articular portion 261 and the anchor 203. Such an interference fit may include an embodiment of a concave locking feature 243 that is smaller than the corresponding outer surface of the joint portion 261. As another example, the interference fit may include an embodiment of a convex locking feature 241 that is smaller than the corresponding outer surface of the joint component 261, for example, a projection 247 that extends to and engages with the corresponding outer surface of the joint component 261.

[0065] In embodiments where one or more matching or locking features have different shapes and / or sizes, the rotational positions can be more easily confirmed during surgery. For example, the projection 252 can be visually confirmed to be correctly rotated relative to the corresponding convex locking feature 243, and / or the concave slot 251 can be visually confirmed to be correctly rotated relative to the corresponding convex locking feature 241. By providing two opposing projections 252, only two rotational positions can result in the fixation of the joint portion 261 to the anchor 203. In some cases, these positions provide identical biomechanics for the shoulder joint at the time of assembly. The two positions are rotationally symmetric. In other embodiments, the two positions provide two biomechanical options so that the surgeon can choose from two positions of the joint component 280 relative to the anchor 203. In the first rotational position, the first projection 252A is positioned in the first concave recess 243A located above, and the second projection 252B is positioned in the second concave recess 243B located below. In the second rotational position, the first projection 252A is positioned in the second recessed recess 243B located below it, and the second projection 252B is positioned in the second recessed recess 243B located above it. Different numbers of alignment or locking features are also conceivable. For example, to provide the correct rotational position, there may be only a single alignment function in the rotational control zone 285.

[0066] As the articulated portion 261 advances into the anchor 203, the reverse load projection of the articulated portion 261 is positioned in the recess of the anchor 203 (see Figure 4E). The first contact point between the articulated portion 261 and the anchor 203 may be located between the distal portion of the deflectable portion 254 and the proximal portion of the second recess 232. Once the articulated portion 261 is coupled to the anchor 203, the deflectable portion 254 may be positioned in the second recess 232 of the anchor 203. The articulated portion 261 may advance until the deflectable portion 254 contacts the surface surrounding the second recess 232. The deflectable portion 254 may contact the surface surrounding the second recess 232 before the locking member 253 engages with the groove 284 of the anchor 203. For example, the articular portion 261 may advance until the tapered outer surface 257 of the deflectable portion 254 contacts the tapered surface of the second recess 232. Upon contact, the sections of the deflectable portion 254 move toward each other across their compression slot 256. When the deflectable portion 254 of the articular body 280 contacts the surface defining the second recess 232, the deflectable portion 254 may be deflected circumferentially by or from the surface defining the second recess 232. This deflection by the deflectable portion 254 reduces, minimizes, or eliminates the movement of the articular portion 261 relative to the anchor 203, even micro-movements. Once the humeral assembly is assembled, the deflectable portion 254 is deflected sufficiently so that a load is applied in the opposite direction to the direction of advancement. The deflectable portion 254 may also provide a load between the locking member 253 and the peripheral portion 233 of the first recess 231.

[0067] The joint assembly may advance further until the locking member 253 of the joint portion 261 is deflected within the groove 244 formed in the anchor 203 (see Figure 4F). The locking member 253 may serve to lock the joint portion 261 to the anchor 203 and to prevent the joint portion 261 from translating outward perpendicularly from the anchor 203. The locking member 253 may transition between a stationary configuration before the insertion of the joint portion 261 into the anchor 203 and a compressed configuration when the humeral assembly is assembled. In the compressed configuration, the locking member 253 may be radially compressed compared to the stationary configuration. In the stationary configuration, the inner surface of the locking member may be positioned in the groove 284, and the outer surface of the locking member 253 may be positioned outside the groove 284 (see Figure 4A). In the compression configuration, the inner surface of the locking member 253 may be positioned in the groove 284, and the outer surface of the locking member 253 may be positioned in the groove 244 of the humeral anchor 203 (see Figure 4F).

[0068] The above example describes a stemless anchor, but the anchor 203 is characterized by a stem, fracture stem, or tray or other structure configured to extend to the shaft of the humerus. The theory can also be applied to anchors having modular components such as pacers. For example, Figure 5A shows a humeral assembly with a stem. Similar to a stemless humeral assembly, the stemmed humeral assembly in Figure 5A may include an anchor 203 and an articular portion 261. As shown in Figure 5A, the anchor 203 may include a tray 289 attached to the metaphysical portion of the stem 283, for example, by matching tapers that form a Morse taper connection. The articular portion 261, which may include any of the features described above, may be attached to the tray 289, for example, using any of the features of the humeral anchor interface described above.

[0069] As shown in Figure 5B, the tray 289 includes internal features similar to those of the stemless anchor 203 shown in Figure 4A. For example, the tray 289 includes a first recess 231 and a second recess 232 extending distally from the first recess 231. The tray 289 also includes an inner circumferential surface 233 positioned around the first recess 231. The inner circumferential surface 233 may include one or more matching or locking features configured to contact the rotation control zone 285 of the articulated portion 261, as described above. The inner circumferential surface 233 may include a circumferential groove 244 extending circumferentially along the inner circumferential surface 233. The groove 244 may be sized relative to the locking member 253 of the articulated portion 261 to provide a snap-fit ​​or interlock-fit with the locking member 253.

[0070] As described above, the clinician may optionally provide tray 289 or other spacers to fill the soft tissue space. For example, if the clinician has performed a minimal resection or if the soft tissue is loose, the clinician may construct the stem using tray 289 or other spacers. Tray 289 or spacers increase the thickness between the most distal point of the articular surface and the proximal surface of the stem 283.

[0071] Figures 6A–6G show another articulated portion 352 configured to connect to anchor 304. The articulated portion 352 can be configured as an articulated component or articulated assembly containing functionally and physically distinct components. Anchor 304 may include any of the above features with respect to any of anchors 103, 203, 113, or 140. For example, anchor 203 may be a stemless anchor. A single articulated portion 352 may be compatible with stemless anchors, stemmed anchors, and / or trays, respectively. Anchor 304 has a body portion 308, for example, a metal body (see Figure 6D). The body portion 308 may include a bone-engaging side 312 configured to be positioned against bone, and an assembly side 316 opposite the bone-engaging side. The bone-engaging side 312 may form part of any of the anchors described herein, including stemless anchors or stemmed anchors. The assembly side 316 has a mounting area 324 which may include one or more recesses extending toward the bone engagement side, configured to receive at least a portion of the joint portion 352. The mounting area 324 may include a groove 385 positioned around the mounting area.

[0072] Figures 6A and 6B provide different diagrams of the joint portion 352. The joint portion 352 may include any of the features of the joint portion 261. As described above, the joint portion 352 includes an articular body 356, such as a reverse component having a concave articular surface, but in some procedures, as described above, the clinician may select an anatomical articular component, such as the anatomical articular component 160 in Figure 2. In some embodiments, the joint portion 352 may be a joint assembly, such as a polymer articular body 356 and a locking member 302, as will be described in more detail below. In other embodiments, the joint portion 352 may be a single component, such as a polymer articular body 356.

[0073] As shown in Figure 6A, the articular body 356 includes a first part or distal part 364 and a second part or proximal part 368. The articular body 356 has a joint located in the second part 368. It has a joint surface 372. The first portion 364 of the articular body 356 includes a distal surface 386 configured to be positioned in the mounting area 324 of the anchor 304. The first portion 364 of the articular body 356 may include one or more projections 353 from the distal surface 386 (see Figure 6B). One or more projections 353 may coincide with one or more corresponding recesses 321 in the proximal surface 320 of the bone anchor 304 (see Figure 6D). At least one projection 353 may be displaced from the center 360 of the articular body 356 and positioned off-center. In some cases, multiple projections 353 are provided, each off-center. Some variations may include, for example, a central recess located in the proximal surface 320 of the bone anchor 304 for mounting an anatomical articular component such as component 160. The projections 353 facilitate rotational alignment between the articular portion 352 and the anchor 304. In some embodiments, the articulated body 356 may include a central projection or other projection extending from the distal surface 386 of the articulated body 356. Any of the projections 353 may engage with the anchor 304, for example, by matching a taper that forms a Morse taper connection. The illustrated articulated body 356 includes projections 353, but in other embodiments, the articulated body 356 may include one or more recesses extending proximal from the distal surface 368. The recesses may match one or more projections extending proximal from the proximal surface 320 of the anchor 304. In another variation, each of the anchor 304 and the articulated body 356 has at least one projection and at least one recess to provide a favorable combination of connection features.

[0074] As shown in Figure 6A, the second portion 368 of the articular body 356 may include a groove 384 located between the articular surface 372 and the distal surface 386. The groove 384 may be formed on a surface such as the peripheral side or circumferential surface of the second portion 368. As shown in Figure 6B, the second portion 368 may include a recess 342 in the distal surface 386 of the articular body 356. The recess 342 may extend from the groove 384. For example, the recess 342 may extend proximal from the distal surface 386 of the articular body 356 to the depth of the groove 384.

[0075] As described above, the joint portion 352 may include a locking member 302 to ensure mechanical fixation between the joint body 356 and the anchor 304. The locking member 302 may be made of an elastic material such as titanium or another elastic metal. As shown in Figures 6A to 6B, the locking member 302 may be positioned around the joint body 356, for example, in the groove 384 of the second portion 368. The locking member 302 can reversibly fix the joint body 356 to the anchor 304 with a simple impact load from an impact member and hammer, without using any other tools to assemble the joint body 356 to the anchor 304. When the joint portion 352 is coupled to the anchor 304, the locking member 302 is deflected into the anchor groove 385 such that its outer circumferential surface 390 is positioned in the anchor groove 385 and its inner circumferential surface 388 is positioned in the joint groove 384 (see Figure 6E).

[0076] The locking member 302 may include an arched member 306 positioned at least partially around the first portion 364 of the articulated body 356, for example, at least partially within the articulated groove 384. As shown in Figures 6B to 6C, the arched member 306 may include a discontinuity 374 between the first end 366 of the arched member 306 and the second end 378 of the arched member in order to facilitate radial compression of the locking member 302.

[0077] The inner circumferential surface 388 and / or outer circumferential surface 390 of the locking member 302 may include one or more stress-reducing features 392. For example, as shown in Figure 6C, the arched member 306 includes a sector-shaped edge or a series of notches along at least part or all of the inner circumferential surface 388, although in other examples the sector-shaped edge may be along the outer circumferential surface 390. The figure shows a sector-shaped edge, but other stress-reducing features may include a reduction in thickness measured between the proximal and distal surfaces of the locking member 302. The stress-reducing features 392 facilitate bending and deflection of the arched member 306 to avoid plastic deformation during assembly. The stress-reducing features 392 also affect the humeral assembly. This helps maintain the integrity of the locking member 302 when a fitting force is applied.

[0078] As shown in Figure 6E, the outer circumferential surface 390 of the locking member 302 may have a first edge or distal edge 328 and a second edge or proximal edge 310 positioned obliquely to the first edge 328 to form a vertex. The second edge or proximal edge 310 may be positioned perpendicular to the central insertion axis 360 or at an angle α with respect to a plane PLN positioned along the anchor holding surface 322. The anchor holding surface 322 defines the upper end of the anchor groove 385. The angle α may be greater than 0 degrees and less than or equal to 20 degrees, for example, about 15 degrees. For locking member materials with a higher coefficient of friction, the angle α will be greater than 20 degrees. For example, the angle α may be less than or equal to about 45 degrees or less, or less than or equal to about 30 degrees.

[0079] As shown in Figure 6E, the second edge 310 of the locking member 302 may include a first portion 310A and a second portion 310B. To maintain fixation between the articulation body 356 and the anchor 304, at least a portion of the first portion 310A of the second edge 310 must extend into the groove 385 of the anchor 304. As the articulation body 352 is inserted into the anchor 304, the distal edge 328 of the locking member 302 advances toward the distal edge of the groove 385. After being fitted, the locking member 302 elastically recovers so that its proximal edge 310 contacts the retaining area 322. When the articulation body 356 is coupled with the anchor 304, the first portion 310A is positioned further away from the articulation surface 372 in the direction of the central insertion axis 360 than the retaining surface 322 of the anchor 304. The second portion 310B of the second edge 310 is aligned with at least the same plane as the retaining surface 332 of the anchor groove 385, or is positioned closer to the articulating surface 372 in the direction of the central insertion axis 360 than the retaining surface 332.

[0080] When the locking member 302 is deflected into the anchor groove 352, there is an interference fit between the anchor 304 and the locking member 302. The angle α between the second edge 310 of the locking member 302 and the plane PLN, which is about 45 degrees or less (or about 30 degrees or about 20 degrees or less, e.g., about 15 degrees or less), maintains contact between the locking member 302 and the anchor 304 despite the tensile force FT that pulls the articulation body 352 and the anchor 304 apart. As shown in Figure 6E, the frictional force FF between the locking member 302 and the anchor 304 prevents the locking member 302 from being released from the anchor groove 385, while the reaction force FR prevents the locking member 302 from sliding further into the anchor groove 385. The combination of the frictional force FF and the reaction force FR reduces or eliminates movement between the articulation body 356 and the anchor 304. For example, the locking member 302 allows for movement of 0.05 mm or less in the longitudinal and / or transverse directions between the anchor 304 and the articular body 356, or even no movement at all. The angled locking member 302 allows the humeral assembly to withstand high forces imposed on the shoulder joint without the risk of disassembly or removal of manufacturing clearance.

[0081] The shape of the outer surface 388 also allows the locking member 302 to withstand a range of gaps between the anchor groove 385 and the articular groove 384. For example, if there is a maximum gap (or other relatively large gap as shown in Figure 6F) between the anchor groove 385 and the articular groove 384, or a minimum gap (or other relatively small gap as shown in Figure 6G) between the anchor groove 385 and the articular groove 384, the locking member 302 will maintain fixation between the articular body 356 and the bone anchor 304 in either case.

[0082] The locking member 302 may also include an elastic body 314 extending from the arched member 306. The elastic body 314 may have a shape that substantially matches the shape of the recess 342 of the articulated body 356. The recess 342 may be configured to receive the elastic body 314 at a limited number of positions, or at only one position, such as the center position. The recess 342 may be shaped to accommodate the elastic body 314 while allowing some movement of the body 314 so that the articulated body 356 does not obstruct the loading and unloading of the body 314. This feature relates to the locking member 302 to the articulated body 356. This facilitates proper orientation. Since the locking member is always in the same position, proper orientation facilitates easy removal of the locking member 302.

[0083] As shown in Figure 6C, the elastic body 314 includes a first end 318 and a second end 322. The first end 318 of the elastic body 314 may extend from the first end 366 of the arched member 306. The second end 322 of the elastic body 314 is located radially inward of the arched member 306. In this configuration, the second end 378 of the arched member 306 forms one free end of the locking member 302, and the second end 322 of the elastic body 314 forms another free end of the locking member 302. The second end 322 of the elastic body 314 may overlap with the arched member 306, but is located radially inward.

[0084] As shown in Figure 6C, the elastic body 314 may include a radial portion 362 extending radially inward from the arched member 306. The elastic body 314 may also include an arched portion 370 extending from the radial portion 362. The arched portion 370 may be concentric with the arched member 306. For example, the arched portion 370 may be radially inward of the arched member 306 and may extend to at least the length of the gap 374 within the arched member 306.

[0085] The locking member 302 may be coupled to the main body portion 356 to hold the locking member 302 in a predefined position and orientation. For example, the second end 322 of the elastic body 314 may be coupled to the main body portion 356. As shown in Figure 6B, the second end 322 of the elastic body may include a first engaging feature 358 coupled to a second engaging feature 357 of the main body portion 356. The first engaging feature 358 may include an opening or a projection, and the engaging feature 357 of the main body portion 356 may include the negative of the first engaging feature 358. If the engaging feature 357 is a projection, the engaging feature 358 may be an opening formed in the second end 322.

[0086] The second end 322 of the elastic body 314 may be extended to form a locator body. The locator body may be positioned in the recess 342 in a predefined direction and / or position relative to the central insertion axis 360. The predefined direction and / or position may be a single direction and / or position, such as the central position within the recess 342. In some embodiments, the elastic body 314 may have an arched portion, and the wall of the recess 342 in that portion where the body is positioned may have an arched shape. The side ends of the elastic body 314 may be spaced, for example, equally spaced from the opposing walls of the recess 342. In some embodiments, the spacing of the elastic body 314 from the walls of the recess 342 may increase along the length of the body in the direction away from the engagement features 357, 358.

[0087] As described above, the locking member 302 may be shaped to correspond to a series of gaps between the anchor groove 385 and the articular groove 384. However, this may result in the locking member 302 not being centered with respect to the central axis 360 of the shoulder implant. The elastic body 314 may be configured to center the arcuate member 306 with respect to the central insertion axis 360. For example, the elastic body 314 stores strain energy when a deflection force is applied to deflect the locking member 302 away from its central position (e.g., around the center point 360), and releases strain energy when the deflection force is removed to return the locking member 302 toward its central position.

[0088] Other configurations of the locking member may achieve one or more of the advantages described above. For example, Figure 7 shows a joint portion 452 including a joint body 456 and a locking member 402. The locking member 402 may include any of the features described above with respect to the locking member 302.

[0089] As shown in Figure 7, the locking member 402 includes an arched member 406 positioned at least partially around the articulated body 456. The arched member 406 has a first end 466 and a second end 47 A discontinuity 474 may be included between 8 and 390. The inner circumferential surface 488 and / or outer circumferential surface 490 of the locking member 402 may include one or more stress-reducing features 492 to facilitate bending and deflection of the arched member 406 and avoid plastic deformation. For example, as shown, the arched member 406 includes a sector-shaped edge, a series of notches, along at least a portion of the outer circumferential surface 488. Figure 7 shows a sector-shaped edge, but other stress-reducing features such as a reduction in thickness are possible, or in some embodiments, material treatment techniques are provided along the edge or periphery, or between the proximal and distal edges of the locking member 402. The segment 493 between the stress-reducing features 492 may include any of the features of the outer circumferential surface 390 described above to facilitate engagement between the joint portion 452 and the anchor.

[0090] As shown in the figure, the arched member 406 includes a first arched portion 406A extending from a first end 466 and a second arched portion 406B extending from a second end 478. The locking member 402 may also include an elastic body 414 extending between the first arched portion 406A and the second arched portion 406B. The elastic body 414 includes a base 415 positioned radially inward of the arched member 406. In one embodiment, the base 415 extends to at least the length of the spacing 474 between the arched members 406. The elastic body 414 may also include a first radial member 462A extending from the base 402 to the first arched portion 406A, and a second radial member 462B extending from the base to the second arched portion 406B. In one embodiment, the base 415 includes an overhang portion 464 that extends away from one of the first radial members 462A, 462B to the wall of the recess 442. In one embodiment, the overhang portion 464 separates the first radial member 462A from the wall of the recess 442 so that the wall does not restrict the movement of member 462A. The base 415 may have overhang portions 464 at each end to provide this spacing function to both members 462A, 462B.

[0091] The elastic body 414 may have a shape that substantially matches the shape of the recess 442 of the articulated body 456. The recess 442 may be configured to receive the elastic body 414 at a limited number of positions, or at only one position, such as the center position. For example, a common shape of the recess 442 may be T-shaped. The portion of the recess 442 that receives the base 415 may be wider than the portion of the recess that extends from the periphery to the base-holding portion of the recess. Similarly, the base 415 of the elastic body 414 may be wider than the combined width of the radial members 462A, 462B. The elastic body 414 may form a C-shaped recess that is inverted, reversed, or posterior, capable of receiving a portion of the bottom, distal, or inner surface of the articulated body 456.

[0092] The elastic body 414 may be configured to position the arc-shaped member 406 at its center relative to the central insertion axis 460. For example, the elastic body 414 stores strain energy when a deflection force is applied to deflect the locking member 402 away from its central position (e.g., around the center point 460), and releases strain energy when the deflection force is removed to return the locking member 402 toward its central position.

[0093] Figure 8A shows another locking member 502 including a different configuration of the elastic body. The locking member 502 may include any of the features described above with respect to the locking members 302 and 402.

[0094] As shown in the figure, the locking member 502 includes an arched member 506 having a discontinuity 574 between the first end 566 of the arched member 506 and the second end 578 of the arched member 506 in order to facilitate radial compression of the locking member 502. The arched member 506 may also include one or more stress-reducing features 592 arranged along at least part or all of the inner circumferential surface 590 and / or outer circumferential surface 588 of the arched member 506. As shown in Figure 8B, the locking member 502A may include only stress-reducing features 592 along only the inner circumferential surface 590 of the arched member 506. In another modification, the stress-reducing features 592 may be arranged only on the outer circumferential surface 588 of the arched member 506. In either configuration, the outer circumferential surface 588 is as described above with respect to the locking member 302. It may have a slanted configuration.

[0095] The locking member 502 may also include one or more elastic bodies 514 (e.g., at least two elastic bodies, at least three elastic bodies, or, in some cases, only three elastic bodies) extending from the inner circumferential surface 590 of the arched member 506. Each elastic body 514 has a first end 518 extending from the arched member 506 and a second free end 522 positioned radially inward from the first end 518. The elastic bodies 514 may have an arched shape from the first end 518 to the second end 522. The elastic bodies 514 may be spaced circumferentially apart from each other. For example, the second end 522 of each elastic body 514 may be spaced circumferentially from the first end 518 of an adjacent elastic body 514 (e.g., equally spaced, or 120 degrees apart in the case of only three elastic bodies 514).

[0096] When coupled to an articulated joint, the elastic bodies 514 may be positioned in the articulated joint groove. Each elastic body 514 may be configured to center the arcuate member 506 with respect to the central insertion axis. For example, each elastic body 514 stores strain energy when a deflection force is applied to deflect the locking member 502 away from its central position, and releases strain energy when the deflection force is removed to return the locking member 502 toward its central position. If multiple elastic bodies 514 are provided, the elastic bodies may cooperate to move the locking member 502 toward its central position. For example, when the stored strain energy of one of the elastic bodies 514 (e.g., an elastic body extending at the 3 o'clock position in Figure 8A) is released, an adjacent span of the locking member 502 (also at the 3 o'clock position) may shift away from the elastic body 514 (e.g., the member 502 may move toward the right in Figure 8A, increasing the distance between the member 502 and the adjacent elastic body 514 at the 3 o'clock position). This may result in a corresponding shift of another span of the locking member 502 toward another elastic body 514 (for example, an elastic body 514 connected to member 502 at the 12 o'clock position, extending to a free end located between 9 and 10 o'clock), which may cause strain energy to accumulate in the other elastic body 514 (reducing the distance between the locking member 502 and the elastic body 514 at the 10 o'clock position). If strain energy is accumulated in the other elastic body 514, the movement of the locking member 502 (to the right in this example) may be restricted, and as a result, the elastic body 514 does not overcompensate by moving the locking member off-center (for example, too far to the right).

[0097] As described above, in the case of a humeral fracture, kit 100 may include one or more fracture stems 140. Figure 9A shows another joint portion 652 configured to connect to a fracture stem 140. Although Figure 9A shows a fracture stem, the fracture stem may be a stemless anchor or a stemmed anchor, including any of the features described above with respect to anchors 103, 203, 113, 140, or 304. Thus, the connection features of the fracture stem 140 are shared among these additional humeral anchor modifications, and the connection features of the stem 140 can provide a shared component in modifications of kit 100 where the connection features of the stem 140 are present in other anchors within the kit.

[0098] The proximal end of the fracture stem 140 includes a circumferential wall 621 that defines a cavity 619. The cavity 619 is radially spaced from and surrounding a hole 617 located at the proximal end of the stem 140. The hole 617 may be formed at least partially in a raised portion 623. The raised position 623 of the hole 617 allows the fracture stem 140 to be compatible with an anatomical articular component that is similar to an anatomical articular component 160 but can exclude a disc or central portion 162 provided in the coupler 168. A modified version of the coupler 160 can provide two adjacent pyramidal bodies without a spacer similar to a disc or central portion 162. The raised portion 623 extends proximal to the base 627 of the cavity 619. The proximal surface 624 of the raised portion 623 may be in the same plane or substantially the same plane as the proximal surface 622 of the circumferential wall 621. The fracture stem 140 is also the inner circumferential surface of the circumferential wall 621. It may include a surrounding groove 625.

[0099] The joint portion 652 may be configured as an articular component or articular assembly containing functionally and physically distinct components. A single joint portion 652 may be compatible with each of the stemless anchor, the stemmed anchor, and / or the tray. The joint portion 652 may include any of the features described above with respect to the joint portions 261, 352, and 452. As described above, the joint portion 652 includes an articular body 656, such as a reverse component having a concave articular surface 672, but in some procedures, as described above, the clinician may select an anatomical articular component, such as the anatomical articular component 160 in Figure 2. In some embodiments, the joint portion 652 may be an articular assembly, such as a polymer articular body 656 and a locking member 602, as will be described in more detail below. In other embodiments, the joint portion 652 may be a single component, such as a polymer articular body 656.

[0100] As shown in Figure 9B, the articular body 656 includes a first or distal portion 664 and a second or proximal portion 668. The articular body 656 has an articular surface 672 located on the second portion 668. The first portion 664 of the articular body 656 includes a distal surface 686 configured to be located in the cavity 619 of the fracture stem 140. For example, the first portion 664 of the articular body 656 may include a recess 690 extending proximal from the distal surface 686. The shape of the recess 690 may coincide with a raised portion 623 on the proximal surface of the fracture stem 140 (see, for example, Figure 9A). The recess 690 may be asymmetrical about at least one axis to facilitate proper rotational alignment with the raised portion 623, for example, to allow one, two, or another limited number of rotational positions in which the recess 690 can receive the raised portion 623. For example, as shown in Figure 9B, the recess 690 may have a straight portion 690a on its outside and a curved portion 690b on its inside. In other embodiments, the recess 690 may be symmetrical around all axes, such as being circular. When the articular portion 652 is joined to the fracture stem 140, the surface 688 of the recess 690 overlaps the raised portion 623 without filling the hole 617.

[0101] The articular body 656 may include a marker 679 to provide an indication of the anatomical orientation for implantation. For example, the marker 679 may provide an indication of the lateral aspect of the articular body 656 that should align with the lateral aspect of the humerus. As shown in Figure 9B, the marker 679 may be a depression on the distal surface 686 of the articular body 656. However, the marker 679 may be printed on the distal surface 686 or elsewhere on the articular body 656, or otherwise visually indicated.

[0102] The articular body 656 may include a groove 684 positioned between the articular surface 672 and the distal surface 686. The groove 684 may be formed on a surface such as a peripheral side or circumferential surface. As described above, the articular portion 652 may include a locking member 602 to ensure mechanical fixation between the articular body 656 and the fracture stem 140. The locking member 602 may be made of an elastic material such as a resilient metal. The locking member 602 may include any of the features of the locking members 253, 302, 502, and 502A described above.

[0103] As shown in Figures 9A and 9B, the locking member 602 can be positioned around the articular body 656, for example, within the groove 684. The locking member 602 can reversibly secure the articular body 656 to the fractured stem 140 with a simple impact load from an impact member and hammer, without using any other tools to assemble the articular body 656 to the fractured stem 140. When the articular portion 652 is coupled to the fractured stem 140, the locking member 602 is deflected such that its outer surface is positioned in the stem groove 625 and its inner surface is positioned in the articular groove 684.

[0104] Figure 10A shows a modified fracture stem 140 or one or more other upper parts of kit 100. Another joint portion 752 compatible with the arm bone anchor is shown. The joint portion 752 may include any of the features described above with respect to joint portions 261, 352, 452, and 652. In some embodiments, the joint portion 752 may be a joint assembly, such as a polymer joint body 756 and a locking member 702. In other embodiments, the joint portion 752 may be a single part, such as a polymer joint body 756.

[0105] As shown in Figure 10A, the articular body 756 includes a first or distal portion 764 and a second or proximal portion 768. The articular body 756 has an articular surface 772 located in the second portion 768. The first portion 764 of the articular body 756 includes a distal surface 786 configured to be located in the cavity 619 of the fracture stem 140 (see Figure 9A). For example, the first portion 764 of the articular body 756 may include a depression 790 extending proximal from the distal surface 786. The shape of the depression 790 may correspond to a raised portion 623 on the proximal surface of the fracture stem 140 (see, for example, Figure 9A). The depression 790 may include any of the features of the depression 690 described above. The articular body 756 may also include a marker 779 to provide an indication of anatomical orientation for implantation. The marker 779 may include any of the features of markers 679, 279.

[0106] The first portion 764 of the articular body 756 may also include a reverse load portion or deflectable portion 754 projecting distally from the distal surface of the articular body 756, for example from a distally facing surface 788 in a recess 790. As shown in the figure, the deflectable portion 754 has a cylindrical shape, but in other configurations, the deflectable portion 754 may have a frustoconical shape or other shapes. When inserted into the hole 617 of the fracture stem 140, the deflectable portion 754 may be compressible toward the central longitudinal axis L (see Figure 10B). The deflectable portion 754 may include any of the features of the deflectable portion 254. For example, the deflectable portion 754 may include at least two sections 755, e.g., three or four sections, supported by a cantilever from the central portion of the articular body 756. The deflectable portion 754 may also include compression slots 789 positioned between each of at least two sections 755. For example, as shown in Figure 10A, the deflectable portion 754 may include four sections 755 separated by intersecting compression slots 756. The compression slots 756 allow the deflectable portion 754 to become compressible in a direction across the longitudinal axis L or in an annular direction as the deflectable portion 754 is inserted into the hole 617.

[0107] The articular body 756 may include a groove 784 positioned between the articular surface 772 and the distal surface 786. The groove 784 may be formed on a surface such as a peripheral side or circumferential surface. The articular portion 752 may include a locking member 702 to ensure mechanical fixation between the articular body 756 and the fracture stem 140. The locking member 702 may be made of an elastic material such as a resilient metal. The locking member 702 may include any of the features of the locking members 253, 302, 502, 502A, and 602 described above.

[0108] As shown in Figure 10B, the locking member 702 can be positioned around the articular body 756, for example, within the groove 784. The locking member 702 can reversibly secure the articular body 756 to the fractured stem 140 with a simple impact load from an impact member and hammer, without using any other tools to assemble the articular body 756 to the fractured stem 140. When the articular body 752 is coupled to the fractured stem 140, the locking member 702 is deflected such that its outer surface is positioned in the stem groove 625 and its inner surface is positioned in the articular body groove 784.

[0109] The locking member 702 may include a proximal edge 702a and a distal edge 702b. The distal edge 702b may be positioned obliquely to the proximal edge 702a (see Figure 10B). As the joint portion 752 is inserted into the fracture stem 140, the distal edge 702b of the locking member 702 advances toward the distal edge 625b of the groove 625. After insertion, the locking member 702 is positioned toward the proximal edge 702a. The proximal edge 702a elastically returns to contact the proximal edge 625a of the groove 625.

[0110] Once the humeral implant is fully assembled, the locking member 702 may be positioned along the distal plane PLN of the proximal surface of the fracture stem 140. The PLN may extend transversely through the deflectable portion 752. The locking member 702 may be positioned between the distal surface 786 of the articular body 756 and the distal end 773 of the articular body 756. This provides a compact arrangement along axis L. This arrangement allows the coupler between the deflectable portion 752 and the anatomical articular component to connect near or to the proximal end of the fracture stem 140.

[0111] In a modified version of the deflectable portion 752, a continuous projection without the elongated hole 789 can be provided. For example, a blind hole can be formed in a projection having a tapered outer shape and an enclosed interior, similar to the blind hole 298 of the projection in the embodiment of Figure 3F.

[0112] Figures 11-12 show other engagement features that may be used in relation to any of the joint portions specified above to connect the joint portion to the fracture stem 140 or other bone anchor.

[0113] Figure 11 shows an articular body 856 having a distal surface 886. The articular body 856 may include a depression 890 extending proximal to the distal surface 886. The shape of the depression 890 may correspond to the proximal surface elevation 623 of the fracture stem 140 (see, for example, Figure 9A). The depression 890 may include any of the features of the depression 690 described above. The articular body 856 may also include a marker 879 that includes any of the features of markers 679 and 279.

[0114] The articular body 856 may include one or more deformable projections 894 extending from the distal surface 886. One or more deformable projections 894 may coincide with one or more corresponding recesses on the proximal surface of the bone anchor. One or more deformable projections 894 are compressed when inserted into one or more corresponding recesses. One or more deformable projections 894 may include a deformable material, such as a deformable polymer material such as UHMWPE. One or more deformable projections 894 may include a continuous periphery without gaps, slots, or other discontinuities. At least one deformable projection 894 may be displaced from the center of the articular body 856 and positioned off-center. For example, each of the one or more deformable projections 894 may be radially positioned between the recess 890 and the outer circumferential surface 896 of the distal surface 886. One or more deformable projections 894 may also facilitate rotational alignment between the articular portion 852 and the bone anchor. Any of the deformable projections 894 can engage with the bone stem 140, for example, by press fitting. The illustrated articular body 856 includes three deformable projections 894, but fewer or more deformable projections 894 may also be possible.

[0115] Figure 12 shows an articular body 956 having a distal surface 986. The articular body 956 includes a first or distal portion 964 and a second or proximal portion 968. The articular body 956 has an articular surface located in the second portion 968. The first portion 964 of the articular body 956 includes a distal surface 986 configured to be located in the cavity 619 of the fracture stem 140 (see Figure 9A).

[0116] The articular body 956 may include a depression 990 extending proximal from the distal surface 986. The shape of the depression 990 may correspond to the raised portion 623 on the proximal surface of the fracture stem 140 (see, for example, Figure 9A). The depression 990 may include any of the features of the depression 690 described above. For example, the depression 990 may have a straight portion 990a on its outer side and a curved portion 990b on its inner side. The articular body 956 may also include a marker 979 having any of the features of markers 679, 279.

[0117] The distal portion 964, when inserted into the cavity 619 of the fracture stem 140, may be compressed to form a press-fit connection. The distal portion 964 may be separated by compression slots 989 into at least two sections 987, such as three or four sections. For example, as shown in Figure 12, the distal portion 964 may include three sections 987 separated by compression slots 956 extending from the outer surface 996 to the recess 990. The distal portion 964 may include a first section 987 outside the recess 990 or along the straight portion 990a, and at least one section 987 inside the recess 990 or along the curved portion 990b, such as two sections 987. The distal portion 964 may include two compression slots 989 aligned along the transverse axis X. The distal portion may include at least one additional compression slot 989 on an axis perpendicular to the transverse axis X. As the distal portion 964 is inserted into the cavity 619 of the fractured stem 140, the compression slot 989 can compress the distal portion 964 in annular direction.

[0118] term While specific embodiments have been described herein, the implants and methods described herein may be used interchangeably with any joint components, as the context may indicate.

[0119] As used herein, the relative terms “proximal” and “distal” are defined in terms of the implant. Therefore, proximal refers to the direction of the joint components, such as the stem of the humeral anchor or the thread or porous surface or other anchor structure of a stemless anchor when the implant is assembled, while distal refers to the direction of the anchor components.

[0120] Unless otherwise specifically stated or understood in the context in which they are used, conditional language such as “can,” “could,” “might,” or “may” is generally intended to convey that a certain feature, element, and / or step is included in one embodiment but not in another. Therefore, such conditional language is generally not intended to imply that the feature, element, and / or step is required in any way in one or more embodiments.

[0121] The terms "comprising," "including," and "having" are synonymous and are used inclusively in open-ended form, without excluding additional elements, features, actions, or behaviors. The term "or" is used in an inclusive (not exclusive) sense, and when used to connect a list of elements, for example, "or" means one, some, or all of the elements in the list. Furthermore, the articles "a," "an," and "the" used in this application and the attached claims should be interpreted as meaning "one or more" or "at least one" unless otherwise specified.

[0122] The scope disclosed herein includes any and all overlaps, sub-scopes, and combinations thereof. Words such as "than" and "between" include the number stated. Numbers preceded by terms such as "about" or "approximately" include the number stated and should be interpreted on a case-by-case basis (e.g., ±5%, ±10%, ±15%, etc., as accurate as reasonably possible under the circumstances). For example, "about 1" includes "1". Phrases preceded by terms such as "substantially" and "generally" include the cited phrase and should be interpreted on a case-by-case basis (e.g. For example, it should be interpreted (to the extent reasonably possible under the circumstances). For instance, "substantially spherical" includes "spherical." Unless otherwise specified, all measurements are taken under standard conditions, including temperature and pressure.

[0123] Where used herein, the phrase “at least one” in a list of items refers to any combination of those items that contains a single element. For example, “at least one of A, B, or C” is intended to cover A, B, C, A and B, A and C, B and C, as well as A, B, and C. Conjunctions such as the phrase “at least one of X, Y, and Z” are understood in the context in which they are commonly used to convey that an item, term, etc., is at least one of X, Y, or Z, unless otherwise specifically stated. Thus, such conjunctions are not generally intended to imply that a particular embodiment requires the presence of at least one X, at least one Y, and at least one Z, respectively.

[0124] While specific embodiments and examples have been described herein, it should be emphasized that many variations and modifications may be made to the humeral head assemblies shown and described herein, and that their elements may be combined and / or modified in different ways to form further embodiments or acceptable examples. All such modifications and variations are intended to be included within the scope of this disclosure herein. A wide variety of designs and schemes are possible. Features, structures, or steps disclosed herein are not essential or indispensable.

[0125] Several embodiments have been described in reference to the accompanying drawings. However, it should be understood that the drawings are not drawn to actual size. Distances, angles, etc., are for illustrative purposes only and do not necessarily have an exact relationship to the actual dimensions and layout of the illustrated devices. Components can be added, removed, and / or rearranged. Furthermore, any particular features, aspects, methods, characteristics, qualities, attributes, elements, etc., associated with various embodiments can be used in all other embodiments described herein. Furthermore, it should be recognized that any method described herein can be carried out using any device suitable for performing the enumerated steps.

[0126] For the purposes of this disclosure, specific aspects, advantages, and novel features are described herein. It will be understood that not all such advantages may necessarily be achieved according to any particular embodiment. Thus, for example, a person skilled in the art will recognize that the disclosure may be embodied or implemented in a manner that achieves one advantage or group of advantages as taught herein, without necessarily achieving other advantages that may be taught or suggested herein.

[0127] Furthermore, although exemplary embodiments have been described herein, it will be understood by those skilled in the art that, as will be recognized based on this disclosure, the scope of the invention extends beyond the explicitly disclosed embodiments to any embodiment having equivalent elements, modifications, omissions, combinations, or subcombinations of specific features and aspects of the embodiments (e.g., aspects across various embodiments), adaptations, and / or modifications and uses of the invention. The limitations in the claims will be interpreted broadly based on the language adopted in the claims and will be interpreted as non-exclusive, and will not be limited to the embodiments described herein or those described during the examination of the application. Moreover, the actions of the disclosed processes and methods may be modified in any way, including rearranging actions and / or inserting additional actions and / or deleting actions. Accordingly, the specification and embodiments are interpreted as illustrative only, and the true scope and spirit are intended to be indicated by the claims and their equivalents in all their respective scopes.

[0128] None of the methods disclosed herein are required to be performed in the order described herein. The methods disclosed herein include specific actions taken by a practitioner, however they may include, explicitly or implicitly, instructions from a third party regarding these actions. For example, an action such as "joining the glenoid guide to the glenoid rim" may include "instructing the joining of the glenoid guide to the glenoid rim."

Claims

1. A joint component configured to connect with a bone anchor, A joint body having a first end and a second end, An articular surface located at or adjacent to the first end, A bone anchor interface surface disposed between the first end and the second end of the joint body, A locking member configured to fix the joint component to the bone anchor, A deflectable portion located at the second end of the joint body, configured to be deflected circumferentially by the surface of the humeral anchor in order to provide a load directed from the second end of the joint body toward the first end of the joint body when deflected, and The bone anchor interface and The joint component comprising:

2. The joint component according to claim 1, wherein the bone anchor interface is provided with a groove formed on the circumferential surface of the joint body.

3. The joint component according to claim 2, wherein the locking member is arranged in the groove.

4. The articulated component according to any one of the prior claims, wherein the deflectable portion comprises at least two sections supported by a cantilever beam from the central portion of the articulated body to the second end of the articulated body.

5. The joint component according to claim 4, further comprising a compression slot located between each of the at least two sections.

6. The articulated component according to any one of the prior claims, wherein the deflectable portion comprises a tapered surface arranged on its outer circumference.

7. The joint component according to any one of the prior claims, wherein the joint body has a cross-section configured to cover the edge of the bone anchor when the locking member is engaged with the bone anchor.

8. The joint component according to any one of the prior claims, further comprising a rotation control zone disposed around the joint body between the first end and the second end.

9. The joint component according to claim 8, wherein the rotation control zone comprises a projection arranged in a first direction and a recess arranged in a second direction.

10. The joint component according to claim 9, wherein the first direction intersects the second direction.

11. The joint component according to claim 9 or 10, wherein the projection is a first projection, and further comprises a second projection disposed on the opposite side of the first projection.

12. The joint component according to any one of claims 9 to 11, wherein the recess is a first recess, and further comprises a second recess located on the opposite side of the first recess.

13. The joint component according to any one of the prior claims, wherein the deflectable portion is disposed between the locking member and the second end of the joint body.

14. It's a kit, The joint component described in any one of the prior claims, A bone anchor having a bone anchor recess formed within the bone anchor, wherein the bone anchor recess extends from a first end, the bone engagement outer surface extends from the first end to a second end opposite to the first end, and the bone anchor recess has a first peripheral portion adjacent to the first end configured to engage the locking member of the joint component, and a second peripheral portion between the first peripheral portion and the second end configured to engage the deflectable portion, the bone anchor and The kit comprising the above.

15. The tray further comprises a first end and a second end configured to engage with the bone anchor recess of the bone anchor at least in the second peripheral portion, The kit according to claim 14, wherein the first end of the tray has a tray recess formed in the tray, the tray recess having a first peripheral portion adjacent to the first end configured to engage the locking member of the joint body, and a second peripheral portion between the first peripheral portion and the second end configured to engage the deflectable portion.

16. A humeral assembly, A humeral anchor configured to be fixed to a bone, wherein the humeral anchor comprises a first end, a second end, and a recess extending between the first end and the second end, the recess being accessible from the first end of the humeral anchor, and comprising a first peripheral portion adjacent to the first end and a second peripheral portion adjacent to the first peripheral portion, A joint assembly configured to be inserted into the recess and fixed therein to the humeral anchor, the joint assembly comprising a joint body having an articular surface located at or adjacent to the first end thereof, and a humeral anchor interface located between the first end and the second end of the joint body, the humeral anchor interface being, A groove formed on the circumferential surface of the joint body, A locking member arranged in the groove, A deflectable projection positioned at the second end of the joint body Equipped with, The aforementioned joint assembly and Equipped with, The deflectable projection is positioned in the second peripheral portion of the recess, and when positioned in this manner, it is deflected in the circumferential direction to provide a frictional load to the surface of the second peripheral portion and to provide a load between the locking member and the surface of the first peripheral portion. The aforementioned humeral assembly.

17. The humeral assembly according to claim 16, wherein the locking member comprises a C-ring.

18. The humeral assembly according to claim 16 or 17, wherein the deflectable projection comprises at least two sections supported by a cantilever from the central portion of the articular body to the second end of the articular body.

19. The humeral assembly according to claim 18, further comprising a compression slot positioned between each of the at least two sections.

20. The humeral assembly according to any one of claims 16 to 18, wherein the deflectable projection comprises a tapered surface arranged on its outer circumference.

21. The humeral assembly according to claim 18, wherein the deflectable projection comprises four sections, each of which comprises a cantilever beam supporting from the central portion of the articular body to the second end of the articular body.

22. The humeral assembly according to any one of claims 16 to 21, wherein the deflectable projection is provided with a blind hole along the centerline of the articular body.

23. The humeral assembly according to any one of claims 16 to 22, wherein the deflectable projection is configured to engage with the surface surrounding the second peripheral portion before the locking member engages with the first peripheral portion of the recess of the humeral anchor.

24. The humeral assembly according to any one of claims 16 to 23, wherein the humeral anchor comprises a stemless central part.

25. The humeral assembly according to any one of claims 16 to 23, wherein the humeral anchor comprises a stemmed anchor.

26. The humeral anchor comprises a first portion configured to be inserted into the excised humerus, and a second portion configured to connect with the first portion. The humeral assembly according to any one of claims 16 to 25, wherein the recess is formed in the second portion.

27. The humeral assembly according to claim 26, wherein the second portion comprises a tray configured to engage the joint assembly.

28. The humeral assembly according to any one of claims 16 to 27, wherein at least one of the projections and recesses disposed on the humeral anchor interface is configured to form an interlocking fit with a projection or recess formed on the first peripheral portion of the recess of the bone anchor.

29. The humeral assembly according to any one of claims 16 to 28, wherein the deflectable projection is disposed between the locking member and the second end of the joint body.

30. A joint assembly configured to connect with a bone anchor, A joint body having a first end and a second end, An articular surface located at or adjacent to the first end, A bone anchor interface surface disposed between the first end and the second end of the joint body, A groove formed on the circumferential surface of the joint body, A locking member arranged in the groove, A deflectable portion located at the second end of the joint body, configured to be deflected circumferentially by the surface of the bone anchor, and the load directed from the second end of the joint body to the first end of the joint body, and The bone anchor interface and The joint assembly comprising:

31. The deflectable portion extends from the central portion of the joint body to the second end of the joint body. The joint assembly according to claim 30, comprising at least two sections supported by a beam.

32. The humeral assembly according to claim 31, further comprising a compression slot positioned between each of the at least two sections.

33. The joint assembly according to any one of claims 30 to 32, wherein the deflectable portion comprises a tapered surface arranged on its outer circumference.

34. The joint body has a cross-section positioned between the groove and the first end of the joint body, The joint assembly according to any one of claims 30 to 33, wherein the cross-section is configured to cover the edge of the bone anchor when the locking member is engaged with the bone anchor.

35. The joint assembly according to any one of claims 30 to 34, further comprising a rotation control zone disposed around the joint between the first end and the second end.

36. The joint assembly according to claim 35, wherein the rotation control zone comprises a projection arranged in a first direction and a recess arranged in a second direction.

37. The joint assembly according to claim 36, wherein the first direction intersects the second direction.

38. The joint assembly according to any one of claims 35 to 37, wherein the projection is a first projection, and further comprises a second projection disposed on the opposite side of the first projection.

39. The joint assembly according to any one of claims 35 to 38, wherein the recess is a first recess, and further comprises a second recess located on the opposite side of the first recess.

40. The joint assembly according to any one of claims 35 to 39, wherein the deflectable projection is disposed between the locking member and the second end of the joint body.

41. It's a kit, The joint assembly according to any one of claims 30 to 40, A bone anchor having a bone anchor recess formed within the bone anchor, wherein the bone anchor recess extends from a first end, the bone engagement outer surface extends from the first end to a second end opposite to the first end, and the bone anchor recess has a first peripheral portion adjacent to the first end configured to engage the locking member of the joint assembly, and a second peripheral portion between the first peripheral portion and the second end configured to engage the deflectable portion, A tray having a first end and a second end configured to engage with the bone anchor recess of the bone anchor at least in the second peripheral portion, Equipped with, The first end of the tray is provided with a tray recess formed in the tray, the tray recess having a first peripheral portion adjacent to the first end configured to engage the locking member of the joint assembly, and a second peripheral portion between the first peripheral portion and the second end configured to engage the deflectable portion. The aforementioned kit.

42. It is a method, The bone anchor is placed at the end of the patient's long bone, Rotationally aligning a first rotationally alignable feature of a joint assembly with a second rotationally alignable feature located in a recess, wherein the recess is formed in a tray coupled to the bone anchor or to the bone anchor located at the end of the long bone, The joint assembly is advanced until the reverse load projection of the joint assembly is positioned within the tapered surface of the recess. The locking member of the joint assembly is deflected within a groove formed in the central portion of the joint body of the joint assembly, and the joint assembly is further advanced until the reverse load projection is deflected by the tapered surface of the recess. Further advancing the joint assembly until the locking member of the joint assembly aligns with the groove positioned around the recess of the bone anchor, and the locking member can straddle the gap between the groove of the joint body and the groove positioned around the recess. Includes, When the reverse load projection is deflected by the tapered surface of the recess, after the locking member has crossed the gap between the groove of the joint body and the grooves arranged around the recess, the reverse load projection reduces, minimizes, or eliminates the movement of the joint assembly relative to the bone anchor. The aforementioned method.

43. The method according to claim 42, comprising rotatably aligning the projection of the joint assembly with a concave surface formed on the circumference surrounding the recess.

44. The method according to claim 42 or 43, further comprising advancing the tapered outer surface of the reverse load projection to engage with the tapered surface of the recess, thereby moving the sections of the reverse load projection toward each other across the compression slot.

45. The method according to any one of claims 42 to 44, further comprising directly engaging the joint assembly with a recess formed in the bone anchor.

46. The further includes engaging the tray with the bone anchor recess, The method according to any one of claims 42 to 45, wherein the tray has a tray recess configured to directly engage the joint assembly.

47. A shoulder joint prosthesis assembly, A bone anchor comprising a metal body having a bone engagement side positioned relative to a bone and an assembly side opposite to the bone engagement side, wherein the assembly side comprises a recess positioned around a mounting area and a groove positioned around the mounting area, the groove including a first retaining surface, A joint assembly, A polymer body extending along a central insertion axis between a first portion configured to be inserted into the mounting region and a second portion opposite to the first portion, wherein the second portion includes an articulated surface of the polymer body, A locking member, An arc-shaped member, at least partially arranged around the first portion, comprising the arc-shaped member having a second retaining surface, An elastic body having a first end extending from the arch-shaped member and a second end positioned radially inward of the arch-shaped member. The locking member comprising The joint assembly comprising Equipped with, The second retaining surface is positioned at an angle (α) with respect to a plane perpendicular to the central insertion axis, and the first portion of the second retaining surface is positioned further from the articular surface in the direction of the central insertion axis than the first retaining surface when the joint assembly is engaged with the bone anchor, and the second portion of the second retaining surface is positioned closer to the articular surface in the direction of the central insertion axis than the first retaining surface when the joint assembly is engaged with the bone anchor. The aforementioned shoulder joint prosthesis.

48. The shoulder joint prosthesis assembly according to claim 47, wherein the angle (α) is greater than 0 degrees.

49. The shoulder joint prosthesis assembly according to claim 47 or 48, wherein the first portion of the polymer body comprises a groove configured to receive the elastic body at only one position.

50. The shoulder joint prosthesis assembly according to any one of claims 47 to 49, wherein the elastic body stores strain energy when a deflection force is applied in order to deflect the locking member away from the central position, and releases the strain energy when the deflection force is removed in order to return the locking member toward the central position.

51. The shoulder joint prosthesis assembly according to any one of claims 47 to 50, wherein the second end of the elastic body is bonded to the polymer body.

52. The shoulder joint prosthesis assembly according to any one of claims 47 to 51, wherein the inner or outer circumferential surface of the arch-shaped member has a rigidity reduction feature.

53. The shoulder joint prosthesis assembly according to any one of claims 47 to 52, wherein the elastic body comprises a radial portion extending radially inward from the first end of the arch-shaped member, and an arch-shaped portion extending from the radial portion.

54. The shoulder joint prosthesis assembly according to claim 53, wherein the arched portion is concentric with the arched member.

55. The shoulder joint prosthesis assembly according to claim 53 or 54, wherein the arch-shaped member defines a gap between the first end of the arch-shaped member and the second end of the arch-shaped member.

56. The shoulder joint prosthesis assembly according to claim 55, wherein the arch-shaped portion overlaps the aforementioned interval.

57. The shoulder joint prosthesis assembly according to any one of claims 47 to 56, wherein the locking member further comprises a second arc-shaped member at least partially positioned around the first portion.

58. The shoulder joint prosthesis assembly according to claim 57, wherein the elastic body extends between the arch-shaped member and the second arch-shaped member.

59. The elastic body has a base at the second end of the elastic body, The shoulder joint prosthesis assembly according to any one of claims 47 to 58, wherein the base is configured to be fixed in the recess of the first portion of the polymer body.

60. The elastic body extends from the base to the first end of the arc-shaped member at another end. The shoulder joint prosthesis assembly according to claim 59, comprising one deflectable member.

61. The shoulder joint prosthesis assembly according to claim 60, wherein the elastic body further comprises a second deflectable member extending from the base to the second arc-shaped member.

62. The locking member comprises at least one elastic body having a first end extending from the arch-shaped member and a second end positioned radially inward of the arch-shaped member. The shoulder joint prosthesis assembly according to any one of claims 47 to 61, wherein the at least one additional elastic body is spaced circumferentially away from the elastic body.

63. The shoulder joint prosthesis assembly according to claim 62, wherein the at least one additional elastic body comprises two elastic bodies.

64. A shoulder joint prosthesis assembly, A bone anchor comprising a metal body having a bone engagement side positioned relative to a bone and an assembly side opposite to the bone engagement side, wherein the assembly side comprises a recess positioned around a mounting area and a groove positioned around the mounting area, the groove including a first retaining surface, A joint assembly, A polymer body extending along a central insertion axis between a first portion configured to be inserted into the mounting region and a second portion opposite to the first portion, wherein the second portion includes an articulated surface of the polymer body, A locking member, An arc-shaped member arranged around the first part, An elastic body having a first end extending from the arch-shaped member and a second end positioned radially inward of the arch-shaped member, wherein the elastic body is configured such that the arch-shaped member is centered with respect to the central insertion axis. The locking member comprising The joint assembly comprising The shoulder joint prosthesis assembly comprising:

65. The shoulder joint prosthesis assembly according to claim 64, further comprising a locator body at the second end of the elastic body, wherein the locator body is configured to engage the polymer body at a predetermined position and / or direction.

66. The shoulder joint prosthesis assembly according to claim 65, wherein the polymer body is provided with a recess, and the locator body is further configured to be positioned in the recess at only one rotational position with respect to the central insertion axis.

67. The shoulder joint prosthesis assembly according to any one of claims 64 to 66, wherein the second end of the elastic body is bonded to the polymer body.

68. The arch-shaped member comprises a second retaining surface positioned along a plane that is positioned at an acute angle to a plane perpendicular to the central insertion axis, The shoulder joint prosthesis assembly according to any one of claims 64 to 67, wherein the first retaining surface is positioned between the inner and outer ends of the second retaining surface when the locking member is engaged with the groove of the bone anchor.

69. The elastic body stores strain energy when a deflection force is applied to deflect the locking member away from its central position, and when the deflection force is removed, it moves the locking member toward the central position. A shoulder joint prosthesis assembly according to any one of claims 64 to 68, which releases the strain energy in order to return to its original position.

70. The shoulder joint prosthesis assembly according to any one of claims 64 to 69, wherein the inner or outer circumferential surface of the arch-shaped member has a rigidity-reducing feature.

71. A shoulder joint prosthesis assembly, A polymer body extending along a central insertion axis between a first portion configured to be inserted into a bone anchor and a second portion opposite to the first portion, wherein the second portion includes an articular surface of the polymer body, A locking member comprising an arc-shaped member arranged around the first portion, and a locator body having a first end connected to the arc-shaped member and a second end connected to the polymer body, wherein the locator body is configured to be received in a recess of the polymer body in a predetermined direction and position, and The shoulder joint prosthesis assembly comprising:

72. The shoulder joint prosthesis assembly according to claim 71, wherein the predefined direction is one rotational position with respect to the central insertion axis.

73. The shoulder joint prosthesis assembly according to claim 71, wherein the predefined position is the central position.

74. The shoulder joint prosthesis assembly according to any one of claims 71 to 73, wherein the locator body is configured to store strain energy when a deflection force is applied in order to deflect the first end of the locking member away from the center position, and releases the strain energy in order to return the locking member toward the center position when the deflection force is removed.

75. A bone anchor comprising a metal body having a bone engagement side positioned relative to a bone and an assembly side opposite the bone engagement side, wherein the assembly side comprises a recess positioned around a mounting region configured to receive a first portion of the polymer body of the shoulder joint assembly, and a groove positioned around the mounting region configured to receive the arcuate member of the connecting component, The shoulder joint prosthesis assembly according to any one of claims 71 to 74, further comprising the above.

76. The shoulder joint prosthesis assembly according to any one of claims 71 to 75, wherein the locator body is bonded to the polymer body.

77. The shoulder joint prosthesis assembly according to any one of claims 71 to 76, wherein the inner or outer circumferential surface of the arch-shaped member has a rigidity-reducing feature.

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