Bearing tray lock mechanism

Abstract

The adjustable implant includes a coupling device, a tray, and a bearing. The tray can be configured to be attached to the coupling device. The tray can include receptacles spaced circumferentially around the tray. The receptacles can be formed in or defined by the tray. The bearing can be configured to be coupled to the tray. The bearing can include attachment mechanisms spaced circumferentially around the bearing that engage with the receptacles to couple the bearing to the tray. Each attachment mechanism can be engageable with each receptacle, and alternatively, the rotational position of the bearing relative to the tray can be adjusted by engaging the attachment mechanisms with different receptacles in the tray.

Description

[Technical Field]

[0001] (Priority Claim) This application claims the benefit of priority to U.S. Provisional Patent Application No. 63 / 447,030, filed February 20, 2023, the contents of which are incorporated herein by reference in their entirety.

[0002] FIELD OF THE INVENTION The embodiments described herein relate generally to implants, and more particularly to implants with a bearing tray locking mechanism. [Background technology]

[0003] The shoulder joint is a complex interlocking of the scapula, clavicle, and humerus, allowing for a wide range of motion, at least when functioning normally. In a properly functioning shoulder joint, the head of the humerus fits into a shallow depression in the scapula, commonly called the glenoid cavity. Movement at the shoulder joint involves movement of the humeral head in the glenoid cavity of the scapula, and the articular structures and surrounding tissues provide a wide range of motion.

[0004] The shoulder joint can become degeneratively ill due to a variety of causes, including rheumatoid arthritis, osteoarthritis, rotator cuff arthroplasty, avascular necrosis, or fractures. When severe joint damage occurs and other treatments are ineffective, total, partial, or reverse shoulder replacement or reconstruction may be necessary. [Brief explanation of the drawings]

[0005] While various embodiments are shown in the accompanying drawings, these embodiments are illustrative and are not intended to be exhaustive or exclusive embodiments of the present invention.

[0006] [Figure 1] FIG. 1 shows a side view of an implant according to one embodiment of the present disclosure. [Figure 2] FIG. 2 shows a perspective view of a tray according to one embodiment of the present disclosure. [Figure 3]FIG. 3 shows a side view of a tray according to one embodiment of the present disclosure. [Figure 4] FIG. 4 shows a partial cross-sectional view of an implant according to one embodiment of the present disclosure. [Figure 5] FIG. 5 shows an enlarged view of a portion of a partial cross-sectional view of an implant according to one embodiment of the present disclosure. [Figure 6] FIG. 6 shows an enlarged view of a portion of an implant according to one embodiment of the present disclosure. [Figure 7] FIG. 7 shows a bottom view of a bearing according to one embodiment of the present disclosure. [Figure 8] FIG. 8 shows a partial view of a portion of a bearing according to one embodiment of the present disclosure. [Figure 9] FIG. 9 shows an enlarged view of a portion of an implant according to one embodiment of the present disclosure. [Figure 10] FIG. 10 illustrates a bottom view of an example bearing according to one embodiment of the present disclosure. [Figure 11] FIG. 11 illustrates a side view of an example bearing according to one embodiment of the present disclosure. [Figure 12] FIG. 12 illustrates a bottom view of an example bearing according to one embodiment of the present disclosure. [Figure 13] FIG. 13 illustrates a side view of an example bearing according to one embodiment of the present disclosure. [Figure 14] FIG. 14 illustrates a side view of another implant according to one embodiment of the present disclosure. [Figure 15] FIG. 15 illustrates a side view of another implant according to one embodiment of the present disclosure. [Figure 16] FIG. 16 shows a perspective view of a tray according to one embodiment of the present disclosure. [Figure 17] FIG. 17 shows a side view of a tray according to one embodiment of the present disclosure. [Figure 18] FIG. 18 shows a perspective view of a bearing according to one embodiment of the present disclosure. [Figure 19] FIG. 18 shows a perspective view of the back side of a bearing according to one embodiment of the present disclosure. [Figure 20]FIG. 20 shows a cross-sectional view of a portion of an implant according to one embodiment of the present disclosure. [Figure 21] FIG. 21 illustrates a side view of another implant according to one embodiment of the present disclosure. [Figure 22] FIG. 22 shows a perspective view of a tray according to one embodiment of the present disclosure. [Figure 23] FIG. 23 shows a perspective view of the back side of a bearing according to one embodiment of the present disclosure. [Figure 24] FIG. 24 shows a cross-sectional view of a portion of an implant according to one embodiment of the present disclosure. Summary of the Invention [Problem to be solved by the invention]

[0007] The inventors of the present disclosure recognized the need for a low-profile implant that can be adjusted to fit a patient pre- or intra-operatively. The present disclosure describes an adjustable implant. The implant can include a tray and a bearing component. The tray can be attached to a coupling device, such as a humeral stem or glenoid baseplate, and can be implanted into the patient's bone. The tray can include receptacles spaced apart around the tray's periphery. The receptacles can be formed within the tray so as to extend through the tray. A bearing can be configured to couple to the tray. The bearing includes an attachment mechanism disposed around the bearing, which can engage with the receptacle in the tray. The attachment mechanism can be spaced apart around the bearing's periphery and can engage with the receptacle in the tray. [Means for solving the problem]

[0008] Each attachment mechanism can be engaged with a respective receptacle, or alternatively, the rotational position of the bearing relative to the tray can be adjusted by engaging the attachment mechanism with one of the receptacles. Adjustable implants can include a variety of attachment mechanisms that help secure or support the bearing mounted in the tray. Adjustable implants that include bearing tray locking mechanisms are described below with reference to Figures 1 through 24. DETAILED DESCRIPTION OF THE INVENTION

[0009] 1 illustrates an adjustable implant 100 according to one example of the present disclosure. The adjustable implant 100 can be inserted into a patient's body. For example, the adjustable implant 100 can be implanted into a patient's shoulder during shoulder replacement or reconstruction surgery. The adjustable implant 100 can include a coupling device 110, a tray 120, and a bearing 130. The tray 120 can include a receptacle (receptacle 122). The bearing 130 can also include an attachment mechanism (attachment mechanism 132).

[0010] The connector 110 can be configured for insertion into the patient's bone. As shown in FIG. 1 , the connector 110 can be a stem that can be inserted into a reamed or broached portion of the patient's bone. In another embodiment, the connector 110 can be a stemless connector that can be inserted into a reamed or broached portion of the bone. An example of a stemless connector 110 is described below with reference to FIG. 14 . The connector 110 can help transfer force from the adjustable implant 100 to the patient's bone or other anatomical structure (e.g., tendons, ligaments, muscles, etc.). In embodiments, the connector 110 can include titanium, ceramic, stainless steel, other biocompatible materials, alloys, composites, or combinations thereof, etc.

[0011] The tray 120 can be configured to attach to the connector 110. For example, the tray can extend within the connector 110. The tray 120 can be attached to the connector 110 using common attachment strategies known in the implant art. For example, the tray 120 can be impacted onto the connector 110 to couple the tray 120 to the connector 110 via a press-fit connection, a friction connection, a taper lock connection, or the like. In one embodiment, the connector 110 can include a receptacle 112, and the tray 120 can include a tapered male portion 126. In this manner, the receptacle 112 is complementary to the tapered male portion 126, such that the tapered male portion 126 fits within the receptacle 112. In another embodiment, the connector 110 can include a tapered male portion, and the tray 120 can include a tapered receptacle complementary to the tapered male portion of the connector 110, such that the tapered receptacle of the tray 120 can receive the tapered male portion of the connector 110 therein. The tray 120 can include a peripheral region 124. In embodiments, the tray 120 can include titanium, cobalt chrome, stainless steel, any combination or alloy thereof, or the like.

[0012] The receptacles 122 can be formed in the tray 120 such that the receptacles 122 extend through the tray 120. Because the receptacles 122 extend through the tray 120, assembly of the tray 120 and the bearing 130 is possible while maintaining a thin overall thickness of the tray 120. As shown in FIG. 1 , the receptacles 122 can be spaced circumferentially around the outer periphery region 124 of the tray 120. The receptacles 122 can be located in the outer periphery region 124 because the outer periphery region 124 may be exposed to less stress than other regions of the tray 120. In other embodiments, the receptacles 122 can be formed in any portion of the tray 120. For example, the receptacles 122 can be formed near or around a central region of the tray 120. In yet another example, the receptacles 122 can be staggered such that the receptacles 122 alternate between being formed near the outer periphery region 124 and near the central region of the tray 120. The tray 120 and receptacle 122 are described in more detail with reference to Figures 2-24.

[0013] The bearing 130 can be configured to connect to the tray 120. The bearing 130 can also be configured to engage other components of the shoulder, such as the humeral head or glenoid ball. The bearing 130 can include a peripheral region 134 (first shown in FIG. 7 ) and a periphery 135. The bearing 130 can include polyethylene, ceramic, any combination or composite thereof, or the like. In embodiments, the tray 120 and bearing 130 can be manufactured in multiple sizes to allow the surgeon to select a tray and bearing to optimize the patient's outcome. Thus, the receptacle 122 and attachment mechanism 132 can be sized to fit all sizes of tray 120 and bearing 130.

[0014] The attachment mechanisms 132 may be circumferentially spaced apart on an outer circumferential region 134 of the bearing 130. The attachment mechanisms 132 are engageable with receptacles 122 on the tray 120 to couple the bearing 130 to the tray 120. Each attachment mechanism of the attachment mechanisms 132 may alternatively be engageable with each receptacle 122, and alternatively, the rotational position of the bearing 130 relative to the tray 120 may be adjusted by engaging the attachment mechanisms 132 with one of the different receptacles 122 in the tray 120. The tray 120 and the bearing 130 will now be described in more detail with reference to Figures 2-24.

[0015] Figure 2 shows a perspective view of tray 120 in one embodiment of the present invention. Figure 3 shows a side view of tray 120 in one embodiment of the present invention. Figures 2 and 3 are described together below. In one embodiment, tray 120 can include a first curved surface 202 (first shown in Figure 7), a flat surface 206, and a second curved surface 210.

[0016] The first curved surface 202 can be configured to face the coupling device 110 when the tray 120 is coupled to the coupling device 110. The first curved surface 202 can have a curvature that helps increase the clearance between the tray 120 and the coupling device 110, allowing the taper of the tray to fit comfortably inside the coupling device 110 when the tray 120 is coupled to the coupling device 110. The first curved surface 202 can also help minimize the amount of bone removal required from the patient to prepare the bone for implant placement. In one embodiment, the clearance between the coupling device 110 and the tray 120 can be approximately 0.4 mm. In another example, the clearance between the coupling device 110 and the tray 120 can be between 0.2 mm and 0.7 mm. In yet another example, the clearance between the coupling device 110 and the tray 120 can be between 0.1 mm and 0.9 mm.

[0017] The flat surface 206 can be configured to face away from the coupling device 110 when the tray 120 is connected to the coupling device 110. The flat surface 206 can extend along the outer periphery 204 of the tray 120. The flat surface 206 can be configured to support the bearing 130 around its outer periphery. Such support helps prevent the bearing 130 from falling out of the tray 120. Furthermore, the flat surface 206 helps to ensure that the bearing 130 is properly attached to the tray 120, because if the bearing 130 is not properly installed on the tray 120, a gap will form between the flat surface 206 and the bearing 130.

[0018] The second curved surface 210 can be configured to face away from the coupling device 110 when the tray 120 is connected to the coupling device 110. The second curved surface 210 can extend inward from the flat surface 206. For example, the second curved surface 210 can face the bearing 130 so that the second curved surface 210 can engage with the bearing 130 when the bearing 130 is attached to the tray 120. As shown in FIG. 2 , the second curved surface 210 can include a flat portion 214. The flat portion 214 can be aligned with the central axis CA of the second curved surface 210 (first shown in FIG. 3 ). In other embodiments, the flat portion 214 can be offset from the central axis CA of the tray 120. The flat portion 214 can provide additional support to the bearing 130 when the bearing 130 is attached to the tray 120. 6, 10, and 12, the bearing 130 may include complementary flats to aid in mounting the bearing to the tray 120. Additionally, the flats 214 and the flats of the bearing 130 help reduce the overall assembled height of the tray 120 and the bearing 130.

[0019] 2 and 3, the receptacles 122 may be spaced circumferentially around the inner portion 208 of the flat surface 206 and the outer periphery 212 of the second curved surface 210. In another embodiment, the receptacles 122 may be movable toward or away from the outer periphery 204 of the tray 120 such that the receptacles 122 do not originate at the inner portion 208 of the flat surface 206. The receptacles 122 may extend from the first curved surface 202 through the flat surface 206 and the second curved surface 210.

[0020] In an embodiment, the receptacles 122 may be spaced about the tray 120 with 30 degree spacing between each receptacle 122. For example, the receptacles 122 may be spaced about the tray 120 with 20 to 40 degree spacing between each receptacle 122. In an embodiment, the receptacles 122 may be spaced about the tray 120 with 2 to 40 degree spacing between each receptacle 122. In another embodiment, the receptacles 122 may be spaced about the tray 120 with 1 to 50 degree spacing between each receptacle 122. In another embodiment, the receptacles 122 may be spaced at any circumferential spacing around the tray 120, allowing for variations in the alignment of the bearing 130 and the tray 120 and providing sufficient support to prevent the bearing 130 from lifting, levering, rotating, or moving relative to the tray 120.

[0021] 4 shows a partial cross-sectional view of an adjustable implant 100 according to one embodiment of the present disclosure. In one embodiment, the bearing 130 can include a tray mating surface 216 and an articular surface 218.

[0022] The articular surface 218 can be configured to face outward from the tray 120. The articular surface 218 can be coupled to and manipulated by a second implantable component 402. For example, the glenosphere or second implantable component 402 and the articular surface 218 can mimic the humeral head and glenoid cavity of a patient's scapula, respectively. As previously described, the second implantable component 402 can be a glenoid ball component that is attached to replace the patient's humeral head. In some embodiments, the adjustable implant 100 is used in a reverse shoulder replacement procedure, where the head or ball of the humerus is moved from the humerus to the glenoid cavity side of the joint.

[0023] The tray mating surface 216 can be configured to face the second curved surface 210 of the tray 120 when the bearing is coupled to the tray 120. As described above and shown in FIGS. 6, 10, and 12, the tray mating surface 216 can include a flat portion that is complementary to the flat portion 214 of the second curved surface 210 (first shown in FIG. 2). The tray mating surface 216 can have a contour, curvature, or other shape that matches and complements the second curved surface 210 such that the tray mating surface 216 is adjacent to the second curved surface 210 of the tray 120 when the bearing 130 is attached to the tray 120. Such a contour of the tray mating surface 216 can promote smooth transfer of loads to the tray 120.

[0024] The tray mating surface 216 can include an attachment feature 132. For example, the attachment feature 132 can be formed on the tray mating surface 216 such that the attachment feature 132 extends from the tray mating surface 216 in a direction away from the articular surface 218.

[0025] 5 shows an enlarged view of a portion of a partial cross-section of an adjustable implant 100 according to one embodiment of the present disclosure. At least one receptacle 122 can include a first edge 502, a second edge 506, a third edge 508 (first shown in FIG. 6 ) and a locking tab 510. The locking tab 510 can include an angled surface 514 and a flat surface 516. At least one attachment mechanism 132 can include a body 518 and a mounting tab 524. The body 518 can include a base portion 520 and a distal portion 522. The mounting tab 524 can include a tapered surface 526 and a flat surface 528.

[0026] The first edge 502 may extend circumferentially and define an inner portion 504 of the receptacle 122. The second edge 506 may extend from the first edge 502 toward the outer periphery 204 of the tray 120. The third edge 508 may extend from the first edge 502 opposite the second edge 506 and toward the outer periphery 204 of the tray 120.

[0027] The locking tab 510 can extend between a second edge 506 and a third edge 508 opposite the first edge 502. The locking tab 510 can define a perimeter 512 of the receptacle 122. The locking tab 510 can be formed on the tray 120 to help retain the bearing 130 on the tray 120 after the bearing 130 is attached to the tray 120. For example, the locking tab 510 can help prevent the bearing 130 from lifting or prying off the tray 120. The locking tab 510 can also engage the second edge 506 or the third edge 508 to support the bearing 130 and prevent the bearing 130 from moving or rotating relative to the tray 120. In one embodiment, the locking tab 510 can include an angled surface 514 and a flat surface 516.

[0028] The angled surface 514 can extend from the flat surface 226 toward the first curved surface 202. The angled surface 514 can be angled at any angle relative to the flat surface 206 of the tray 120. For example, the flat surface 206 can be adjusted by increasing or decreasing the bend of the mounting tab 524 to change the attachment resistance between the tray 120 and the bearing 130. For example, the angle can be increased to approximately 90 degrees to minimize the attachment resistance created by the locking tab 510 between the tray 120 and the bearing 130. In another embodiment, the angle can be decreased to approximately 0 degrees to minimize the attachment resistance created by the locking tab 510 between the tray 120 and the bearing 130. The attachment resistance can be adjusted to provide feedback to the operator. For example, as the bearing 130 is attached to the tray 120, the attachment resistance can be higher than at any other point of attachment between the bearing 130 and the tray 120.

[0029] The flat surface 516 of the locking tab 510 can extend from the first curved surface 202 toward the first edge 502 of each receptacle 122. The flat surface 516 can engage with the mounting tab 524 when the mounting tab 524 is installed in the receptacle 122 to attach the bearing 130 to the tray 120. As shown in FIGS. 4 and 5 , the flat surface 516 can be approximately parallel to the flat surface 206. In another embodiment, the flat surface 516 can be angled such that the end of the flat surface 516 closest to the outer periphery 204 of the tray 120 is closer to the flat surface 206 than the end of the flat surface 516 farthest from the outer periphery 204 of the tray 120. In another embodiment, the flat surface 516 may be angled so that the edge of the flat surface 516 closest to the periphery 204 of the tray 120 is farther from the flat surface 206 than the edge of the flat surface 516 farthest from the periphery 204 of the tray 120. The flat surface 516 may engage the mounting tab 524 to help retain the mounting tab 524 within the receptacle 122.

[0030] The body 518 can extend radially from the tray mating surface 216 between a base portion 520 and a distal portion 522. The mounting tab 524 can extend from the distal portion 522 of the body 518 toward the outer periphery 135 of the bearing 130. A tapered surface 526 of the mounting tab 524 can be angled away from the bearing 130. The tapered surface 526 can taper as the mounting tab 524 extends from the body 518 toward the outer periphery 135 of the bearing 130. The tapered surface 526 helps reduce the clearance required between the first edge 502 and the locking tab 510, allowing sufficient space for the locking tab 510 to flex without contacting the first edge 502 when the bearing 130 is attached to the tray 120. Additionally, the tapered surfaces 526 may also help guide the locking tabs 510 into their respective receptacles 122 when the bearing 130 is installed in the tray 120 .

[0031] The flat surface 528 may be disposed toward the bearing 130 and extend from the body 518 toward the outer periphery 135 of the bearing 130. The flat surface 528 may engage the tray 120, and more specifically, the flat surface 516 of the tray 120, to hold the bearing 130 and tray 120 together once the bearing 130 is attached to the tray 120. The flat surface 528 of the mounting tab may be configured to abut the flat surface 528 of the locking tab 510 when coupling the bearing to the tray 120. In another embodiment, the flat surface 528 may be angled such that the edge of the flat surface 528 closest to the outer periphery 135 of the bearing 130 is closer to the tapered surface 526 than the edge of the flat surface 528 furthest from the outer periphery 135 of the bearing 130. In another embodiment, the flat surface 528 can be angled so that the edge of the flat surface 528 closest to the outer periphery 135 of the bearing 130 is farther from the tapered surface 526 than the edge of the flat surface 528 farthest from the outer periphery 135 of the bearing 130.

[0032] In one embodiment, the tapered surface 526 of the mounting tab 524 contacts the angled surface 514 of the locking tab 510, bending the body 518 away from the outer periphery 135 of the bearing 130 when the bearing 130 is attached to the tray 120. As discussed herein, the bending of the body 518 creates resistance when attaching the bearing 130 to the tray 120 and can provide feedback to the operator that the bearing 130 is ready to be attached to the tray 120.

[0033] 6 shows an enlarged view of a portion of adjustable implant 100 according to one embodiment of the present disclosure. Once mounting tabs 524 of bearing 130 pass locking tabs 510 of receptacle 122, attachment mechanism 132 can return to its original, unbent state.

[0034] Distance D is the distance between the first edge 502 of the receptacle 122 and the body 518 of the attachment mechanism 132 (see FIG. 5). Distance D can be varied by changing the thickness of the body 518 of the attachment mechanism 132 or by changing the distance between the first edge 502 of the receptacle 122 and the locking tab 510 (see FIG. 2). Distance D can be optimized. For example, the smaller the distance D, the less material is removed from the tray 120, making the tray 120 stronger and allowing the body 518 to be thicker, thus making the attachment mechanism 132 stronger. However, distance D must allow the attachment mechanism 132 to flex without contacting the first edge 502 of the receptacle 122 during installation of the bearing 130 to the tray 120. For example, distance D can have a minimum value of 1 mm. In another embodiment, distance D can have a minimum value between 0.5 mm and 2 mm. Additionally, the shorter the body 518 and the shallower the mounting tabs 524 , the less distance D the mounting mechanism 132 needs to flex when mounting the bearing 130 to the tray 120 .

[0035] FIG. 7 illustrates a bottom view of a bearing according to one embodiment of the present disclosure. As shown in FIG. 6, the attachment features 132 are the same. Furthermore, the attachment features 132 can be evenly circumferentially spaced around the outer periphery of the bearing 130. The attachment features 132 can be spaced apart at an angle A around the bearing 130. In an embodiment, the spacing of the attachment features 132 at angle A is complementary to the spacing of the receptacles 122 on the tray 120 (as shown in FIGS. 2 and 3 ). For example, if the receptacles 122 on the tray 120 are spaced 30 degrees apart from one another, the attachment features 132 can also be spaced 30 degrees apart from one another, making the attachment features 132 complementary to the receptacles 122. Similar to the receptacles 122 on the tray 120, the spacing of the attachment features 132 on the bearing 130 can be varied by changing the position of the bearing 130 relative to the tray 120.

[0036] 8 shows a partial view of a portion of a bearing 802 according to one embodiment of the present disclosure. The bearing 802 (e.g., bearing 130) can be attached to the tray 120 (see FIG. 2).

[0037] In one embodiment, at least one of the attachment features 132 can be a lug 220. The lug 220 can extend radially from the tray mating face 216. The lug 220 can have a shape complementary to at least one of the receptacles 122. The bearing 802 and lug 220 can be an integral, single piece. In another embodiment, the lug 220 can be coupled, attached, or secured to the bearing 802. Although the lug 220 does not engage the locking tab 510 ( FIG. 5 ) to prevent lifting or prying of the bearing 802 and tray 120, the lug 220 can provide support against torsional loads. For example, if the lug 220 is wider than the other attachment features 132, the lug 220 can withstand a greater torsional load before breaking. The interaction of the lug 220 with the receptacle 122 of the tray 120 is described in more detail below with reference to FIG. 9 .

[0038] 9 shows an enlarged view of a portion of an adjustable implant 100 in accordance with one embodiment of the present disclosure. As shown in FIG. 9, the bearing 802 can be attached to the tray 120 such that the lug 220 is within one of the receptacles 122 of the tray 120. For example, the lug 220 can fit within at least one of the receptacles 122, and when attached to the receptacle 122, the lug 220 can contact at least one of the first edge 502, the second edge 506, the third edge 508, or the locking tab 510 of the receptacle 122 to prevent movement of the bearing relative to the tray 120. In an embodiment, when the lug 220 is attached to the receptacle 122, the lug 220 can contact all of the first edge 502, the second edge 506, the third edge 508, and the locking tab 510. Because the lugs 220 can fill most of the attachment mechanism 132, the lugs 220 can engage with either the first edge 502, the second edge 506, the third edge 508, or the locking tabs 510 to provide support against torsional forces. As such, the lugs 220 can also help prevent unintentional movement of the bearing 802 relative to the tray 120 after the bearing 802 is attached to the tray 120.

[0039] 10 and 11 are discussed together below. Figure 10 shows a bottom view of a bearing 330 according to one embodiment of the present disclosure. Figure 11 shows a side view of a bearing 330 according to one embodiment of the present disclosure.

[0040] In one embodiment, at least one of the attachment mechanisms 132 may be a toe-in attachment mechanism 340. The toe-in attachment mechanism 1004 may be configured to engage with a mounting tab 524 (see FIG. 5) of the receptacle 122 (see FIG. 2) and fit inside the receptacle 122. For example, the toe-in attachment mechanism 340 may fit inside the receptacle 122 such that the mounting tab 524 contacts at least one of the first edge 502 (see FIG. 5), the second edge 506 (see FIG. 5), the third edge 508 (see FIG. 6), or the locking tab 510 (see FIG. 5). Contact between the toe-in attachment mechanism 340 and at least one of the first edge 502, the second edge 506, the third edge 508, and the locking tab 510 may help prevent movement of the bearing 330 relative to the tray 120.

[0041] For example, contact between the toe-in attachment mechanism 1004 and the locking tab 510 can help prevent lifting and prying of the bearing 1002 and tray 120. In some embodiments, the toe-in attachment mechanism 1004 can be mounted outboard to better resist prying forces applied in an inboard direction. Additionally, due to the larger size of the toe-in attachment mechanism 1004 compared to the attachment mechanism 132 of FIG. 5 , the toe-in attachment mechanism 1004 can engage either the second edge 506 or the third edge 508 to provide more support against torsional forces and prevent rotation or movement of the bearing 1002 relative to the tray 120. In one embodiment, the toe-in attachment mechanism 1004 can be configured to insert into the receptacle 122 before the other attachment mechanism 132.

[0042] 12 and 13 are described together. FIG. 12 shows a bottom view of a bearing 1202 according to one embodiment of the present disclosure. FIG. 13 shows a side view of a bearing 1202 according to one embodiment of the present disclosure. The bearing 1202 can be attached to the tray 120 (see FIG. 2). As shown in FIGS. 12 and 13, the attachment mechanism 132 of the bearing 1202 can include a lug portion 1204 and an attachment portion 1206.

[0043] The lug portion 1204 is located radially inward from the mounting portion 1206, and the lug portion 1204 can engage with either the first edge 502 (see FIG. 5 ), the second edge 506 (see FIG. 5 ), or the third edge 508 (see FIG. 6 ) of the receptacle 122. The lug portion 1204 can fill a portion of the space between the first edge 502 and the second edge 506 and provide support against torsional forces for the bearing 1202 and the tray 120. For example, the lug portion 1204 can engage with either the first edge 502, the second edge 506, or the third edge 508 to prevent movement or rotation of the bearing 1202 relative to the tray 120.

[0044] The attachment portion 1206 is located radially outward from the lug portion 1204, and the attachment portion 1206 can engage with either the second edge 506, the third edge 508, or the locking tab 510 (see FIG. 5 ). Similar to the attachment mechanism 132 described in FIG. 5 , the attachment portion 1206 can include a base 1208, a locking tab 1210, and a ramped surface 1212.

[0045] The base 1208 can extend from the tray mating surface 216 of the mounting portion 1206 and can extend between the base and the distal portion. The locking tab 1210 can extend from the base 1208 to the distal portion. The locking tab 1210 can be configured to engage with the mounting tab 524 (as described in FIG. 5 ) of the receptacle 122. The angled surface 1212 can help provide clearance between the mounting portion 1206 and the lug portion 1204 while the bearing 1202 is mounted to the tray 120.

[0046] The mounting portion 1206, and more specifically the locking tab 1210 of the mounting portion 1206, can help hold the bearing 1202 and the tray 120 together after the bearing 1202 is attached to the tray 120. For example, the locking tab 1210 can engage with the mounting tab 524 of the tray 120 to help prevent the bearing 1202 from being lifted off the tray 120. The mounting portion 1206 can engage with the second edge 506 and the third edge 508 to provide support for the bearing 1202 and the tray 120 against rotation or movement.

[0047] The lug portions 1204 are spaced apart from the mounting portions 1206 such that the mounting portions 1206 can bend radially inward toward the lug portions 1204 but do not contact the lug portions 1204 while the bearing 1202 is mounted to the tray 120. The spacing of the mounting portions 1206 can reduce the material required to make the bearing 1202 and can provide support for removal and movement or rotation of the bearing 1202 relative to the tray 120.

[0048] The bearings shown in Figures 1 and 4-12, such as bearing 130, bearing 802, bearing 1002, and bearing 1202, are examples of bearings that can be used in combination with tray 120 to create an adjustable implant with reduced clearance between the tray and connector 110 (see Figure 1). For example, any combination of the bearings shown in Figures 1 and 4-12, such as bearing 130, bearing 802, bearing 1002, and bearing 1202, can be used to adjust various parameters of adjustable implant 100. For example, more of attachment mechanisms 132 can include lugs 220 to prevent movement or rotation of the bearing relative to the tray, or all of attachment mechanisms 132 can include lug portions 1204 and lug portions 1204, improving resistance to lifting and prying while also improving resistance to movement and rotation of the bearing relative to the tray.

[0049] FIG. 14 shows a side view of an example of an adjustable implant 1400. As shown in FIG. 14, the coupling device 1410 (e.g., coupling device 110 of FIG. 1) may be a stemless coupling device. Thus, the implant 1400 may include a tray 120 and any of the bearings shown in FIGS. 1 and 4-12 (e.g., bearings 130, 802, 1002, 1202, etc.). In this manner, the adjustable implant 1400 may include a tray and bearing that are adjustable relative to one another, allowing for a small clearance between the bearing and coupling device 1410.

[0050] In the embodiment described herein, the tray 120 includes a receptacle and the bearing 130 includes an attachment mechanism. In another embodiment, the coupling relationship can be reversed. For example, the tray 120 can include an attachment mechanism configured to engage a receptacle in the bearing 130.

[0051] FIG. 15 illustrates a side view of another embodiment of an adjustable implant 1500 (e.g., adjustable implant 100 first shown in FIG. 1 or adjustable implant 1400 of FIG. 14 ) in accordance with one embodiment of the present disclosure. Adjustable implant 1500 differs from adjustable implants 100 and 1400 in that the connection interface between the tray and the bearing may be different. For example, implant 1500 may include an edge snap mechanism to secure the bearing to the tray. Despite this different connection, adjustable implant 1500 remains adjustable, similar to adjustable implants 100 and 1400, allowing a medical professional to adjust the rotational position of the bearing relative to the tray during surgery. In one example, implant 1500 may include a tray 1502, a bearing 1504, and a tapered male portion 1506.

[0052] The tray 1502 is configured to be attached to a connector, such as connector 110 first shown in FIG. 1 or connector 1410 in FIG. 14. For example, the tapered male portion 1506 of the tray 1502 is configured to be inserted into the connector, allowing the tray 1502 to be coupled to the connector and supported by the connector to distribute the loads experienced by the tray 1502 after implantation in the patient's shoulder. The tray 1502 can include a variety of materials, such as titanium, cobalt chromium alloy, stainless steel, combinations thereof, or alloys thereof.

[0053] The bearing 1504 can be configured to connect to the tray 1502. The bearing 1504 can also be configured to engage other components of the shoulder, such as the humeral head or glenoid ball. The bearing 1504 can include polyethylene, ceramic, any combination or composite thereof, and the like. The tray 1502 and bearing 1504 are manufactured in multiple sizes, allowing the surgeon to select the appropriate size tray and bearing to achieve the best outcome for the patient. The tray 1502, tapered portion 1506, and bearing 1504 are described in more detail below with reference to Figures 16-20.

[0054] Figures 16 and 17 are now described together. Figure 16 shows a perspective view of a tray 1502 (e.g., tray 120 (see Figure 1)) according to one example of the present disclosure. Figure 17 shows a side view of one embodiment of the tray 1502. The tray 1502 can include a flat surface 1602, a first curved surface 1604 (first shown in Figure 17), a second curved surface 1606, locking ridges 1608, locking barbs 1610, alignment bosses 1612, and receptacles 1614 extending from a radially outer surface 1616 and a radially inner surface 1618.

[0055] The flat surface 1602 can be configured to pivot away from the coupling device when the tray 1502 is coupled to the coupling device. The flat surface 1602 can extend along the outer periphery 1620 of the tray 1502. The flat surface 1602 can be configured to support the bearing 1504 around the outer periphery of the bearing 1504. Such support helps resist removal of the bearing 1504 from the tray 1502. Additionally, the flat surface 1602 helps ensure that the bearing 1504 is properly attached to the tray 1502, because a gap can form between the flat surface 1602 and the bearing 1504 if the bearing 1504 is not properly positioned on the tray 1502.

[0056] The first curved surface 1604 is configured to face the coupling device when the tray 1502 is coupled to the coupling device. The first curved surface 1604 has a curved shape designed to ensure clearance between the tray 1502 and the coupling device, thereby ensuring a proper fit without interference when the tray 1502 (e.g., tapered portion 1506) is coupled to the coupling device. The first curved surface 1604 also helps minimize the amount of bone tissue that needs to be removed to install the implant. In one embodiment, the clearance between the coupling device and the tray 1502 may be 0.4 mm. In other embodiments, the clearance between the coupling device and the tray 1502 may be between 0.2 mm and 0.7 mm. In yet another embodiment, the clearance between the coupling device and the tray 1502 may be between 0.1 mm and 0.9 mm.

[0057] The second curved surface 1606 can be configured to face away from the coupling device when the tray 1502 is connected to the coupling device. The second curved surface 1606 can extend inward from the flat surface 1602. For example, the second curved surface 1606 can face toward the bearing 1504 so that the second curved surface 1606 can engage the bearing 1504 when the bearing 1504 is attached to the tray 1502.

[0058] A locking ridge 1608, which may be part of the mounting receptacle, extends upward from the flat surface 1602 and may extend circumferentially around the outer periphery of the flat surface 1602. The locking ridge 1608 may extend the entire periphery of the flat surface 1602. In some embodiments, the locking ridge 1608 may extend only a portion of the periphery of the flat surface 1602. As shown in FIG. 16 , the locking ridge 1608 may be radially offset from the outer periphery 1620 of the tray 1502, such that the locking ridge 1608 is radially disposed inward of the outer periphery 1620 of the tray 1502. This offset of the locking ridge 1608 may vary around the periphery of the tray 1502, and the radially inward offset of the locking ridge 1608 may vary around the periphery 1620 of the tray 1502. The locking ridge 1608 may engage the bearing 1504 to couple the bearing 1504 to the tray 1502. The locking ridge 1608 can include a locking barb 1610 .

[0059] The locking barbs 1610 can be configured to engage the bearing 1504 to retain the bearing 1504 on the tray 1502 after the bearing 1504 is coupled to the tray 1502. The locking barbs 1610 can extend radially outward from a proximal portion of the locking ridge 1608. The locking barbs 1610 can also extend toward the outer periphery 1620 of the tray 1502.

[0060] The mounting receptacle (e.g., receptacle 1614) of the tray 1502 may also include an alignment boss 1612 extending upward (e.g., proximally) from the flat surface 1602. The alignment boss 1612 may also extend radially outward from the locking ridge 1608 to the outer periphery 1620 of the tray 1502. The alignment boss 1612 may be configured to engage a portion of the bearing 1504 to set the rotational position of the bearing 1504 relative to the tray 1502 in known increments.

[0061] 16 , the receptacle 1614 is defined by the locking ridge 1608 and the locking barbs 1610. For example, the locking barbs 1610 can form the receptacle 1614 around the locking ridge 1608, and the receptacle 1614 can extend from the radially outer surface 1616 to the radially inner surface 1618 of the locking ridge 1608. In other words, the receptacle 1614 configured to receive the bearing 1504 can extend around the entire circumference of the tray 1502 defined by the locking ridge 1608 and the locking barbs 1610.

[0062] 18 and 19 are described together below. FIG. 18 illustrates a perspective view of a bearing 1504 (e.g., bearing 130, bearing 802, bearing 1002, and bearing 1202) according to one embodiment of the present disclosure. FIG. 19 illustrates a perspective view of the underside of the bearing 1504 according to one embodiment of the present disclosure. The bearing 1504 can be configured to engage and couple to the tray 1502 and be rotationally adjustable relative to the tray 1502. The bearing 1504 can include an articular surface 1802, a first alignment relief notch 1804, a second alignment relief notch 1806, a third alignment relief notch 1808, a portion of the periphery 1810, and an edge protrusion 1812 (e.g., attachment feature 132).

[0063] The first alignment relief notch 1804 can be configured to receive the alignment boss 1612 of the tray 1502 to define the rotational position of the bearing 1504 relative to the tray 1502. In embodiments, the first alignment relief notch 1804 can be formed in an edge protrusion 1812. The first alignment relief notch 1804 can extend proximally toward the bearing 1504. In embodiments, the first alignment relief notch 1804 can also extend radially through at least a portion of the bearing 1504 toward the articular surface 1802. As shown in FIG. 18 , the first alignment relief notch 1804 can extend through the edge protrusion 1812 and to the tray mating surface 1902.

[0064] A second alignment relief notch 1806 and a third alignment relief notch 1808 may also be formed in the edge protrusion 1812. The second alignment relief notch 1806 and the third alignment relief notch 1808 may also be formed in the bearing 1504. In an embodiment, the second alignment relief notch 1806 may be circumferentially spaced in a first direction from the first alignment relief notch 1804, and the third alignment relief notch 1808 may be circumferentially spaced in a second direction from the first alignment relief notch 1804, which may be opposite the first direction.

[0065] The alignment boss 1612 can alternatively be inserted into either the first alignment relief notch 1804, the second alignment relief notch 1806, or the third alignment relief notch 1808 to define the rotational position of the bearing 1504 relative to the tray 1502 defined by the first alignment relief notch 1804, the second alignment relief notch 1806, and the third alignment relief notch 1808, respectively.

[0066] 19, the bearing 1504 can include a tray mating surface 1902 (e.g., tray mating surface 216 first shown in FIG. 7) and a center 1904. The tray mating surface 1902 can be configured to engage the second curved surface 1606 of the tray 1502 when the bearing 1504 is coupled to the tray 1502.

[0067] The edge protrusion 1812 can be configured to attach the bearing 1504 to the tray 1502. The edge protrusion 1812 can define at least a portion of the outer periphery 1810 of the bearing 1504. The edge protrusion 1812 can extend to the outer periphery of the bearing 1504 to engage the tray 1502. As shown in FIGS. 18 and 19 , the edge protrusion 1812 can extend from the outer periphery of the bearing 1504 toward the center 1904. The edge protrusion 1812 can be configured to engage the tray 1502 to couple the bearing 1504 to the tray 1502 and determine the rotational position of the bearing 1504 relative to the tray 1502.

[0068] In this way, the bearing 1504, more specifically the edge protrusion 1812, can include a body 1906 that extends from the bearing 1504 at the base 1908 towards the distal portion of the body 1912. The edge protrusion 1812 can also include a mounting tab 1910. The mounting tab 1910 can include a tapered surface 1914 (e.g., tapered surface 526) and a flat surface 1916 (e.g., flat surface 528). The tapered surface 526 can face away from the bearing 1504 and can taper as the mounting tab (e.g., mounting tab 1910 in FIG. 20) extends towards the center 1904 of the bearing 1504. The flat surface 1916 can face the bearing 1504 and can extend from the body (e.g., body 1906 in FIG. 20) towards the center 1904 of the bearing 1504. The adjustable implant 1500 is also described in FIG. 20.

[0069] FIG. 20 shows a cross-sectional view of a portion of an adjustable implant 1500 in accordance with one embodiment of the present disclosure. As best shown in FIG. 20 , the flat surface 1916 of the mounting tab 1910 can be configured to engage the distal surface of the locking barb 1610 when the bearing 1504 is coupled to the tray 1502. Thus, when attaching the bearing 1504 to the tray 1502, the mounting tab 1910 contacts the locking barb 1610, allowing the body 1906 to bend away from the center 1904 of the bearing 1504 when the bearing 1504 is attached to the tray 1502. Once the bearing 1504 is attached to the tray 1502, the body 1906 can bend toward the center 1904 and position the flat surface 1916 of the mounting tab 1910 adjacent the distal end of the locking barb 1610. Although the locking ridges 1608 and locking barbs 1610 of the tray 1502 and the mounting tabs 1910 of the bearing 1504 are shown only on the outer portions of the tray 1502 and bearing 1504, respectively, the locking ridges 1608 and locking barbs 1610 of the tray 1502 and the mounting tabs 1910 of the bearing 1504 can extend around the tray 1502 and bearing 1504, respectively, and can also be present on the inner portions of the tray 1502 and bearing 1504.

[0070] In summary, a medical professional can intraoperatively adjust the rotational position of the bearing 1504 relative to the tray 1502 by aligning the alignment boss 1612 of the tray 1502 with a preferred alignment notch (e.g., the first alignment relief notch 1804, the second alignment relief notch 1806, or the third alignment relief notch 1808) when connecting the bearing 1504 to the tray 1502.

[0071] FIG. 21 illustrates a side view of another embodiment of an adjustable implant 2100 (e.g., adjustable implant 100 first shown in FIG. 1 , adjustable implant 1400 of FIG. 14 , or adjustable implant 1500 first shown in FIG. 15 ) in accordance with an embodiment of the present disclosure. Adjustable implant 2100 may include a different attachment interface between the tray and the bearing compared to adjustable implant 100, adjustable implant 1400, or adjustable implant 1500. For example, adjustable implant 2100 may include a ledge snap that may couple the bearing to the tray. Despite the different attachment interface, the adjustability of adjustable implant 1500 is similar to adjustable implant 100, adjustable implant 1400, and adjustable implant 1500, in that the rotational position of the bearing relative to the tray may be adjusted intraoperatively by a medical professional completing the surgery.

[0072] The adjustable implant 2100 can include a tray 2102 (e.g., tray 120 first shown in FIG. 1 or tray 1502 first shown in FIG. 15) and a bearing 2104 (e.g., bearing 130 first shown in FIG. 1, bearing 802 first shown in FIG. 8, bearing 1002 first shown in FIG. 10, bearing 1202 first shown in FIG. 12, or bearing 1504 first shown in FIG. 15). The tray 2102 can include a locking ridge 2106 extending from a flat surface (e.g., flat surface 2202 first shown in FIG. 22). The locking ridge 2106 can include an outer portion 2108 and an inner portion 2110 (each of the outer portion 2108 and the inner portion 2110 extending around at least a portion of the periphery 2112). The locking ridge 2106 can include a receptacle 2114 formed in an outer portion 2108 of the locking ridge 2106 and a locking barb 2204 (first shown in FIG. 22 ) on an inner portion 2110 of the locking ridge 2106. The bearing 2104 can include a lug 2116 configured to insert into the receptacle 2114 on the outer portion 2108 of the locking ridge 2106 and an edge projection 2304 (first shown in FIG. 23 ) configured to attach to the locking ridge 2106 and the locking barb 2204 on the inner portion 2110 of the locking ridge 2106.

[0073] 22 illustrates a perspective view of a tray 2102 (e.g., tray 120 first shown in FIG. 1 or tray 1502 first shown in FIG. 15) according to one embodiment of the present disclosure. The tray 2102 may include a flat surface 2202 that extends around at least a portion of the periphery 2112 of the tray 2102. The tray 2102 may include a mounting receptacle that includes a locking ridge 2106 that extends upwardly from the flat surface 2202 and circumferentially surrounds the periphery of the flat surface 2202. As described above, the locking ridge 2106 may include an inner portion 2110 and an outer portion 2108. At the inner portion 2110 of the locking ridge 2106, the mounting receptacle can include a locking barb 2204, and at the outer portion 2108 of the locking ridge 2106, the mounting receptacle can include a receptacle 2114, which can extend from the radially outer surface 2206 through the locking ridge 2106 and through the radially inner surface 2208.

[0074] The inner portion 2110 of the locking ridge 2106 can be radially offset within the outer periphery 2112 of the tray 2102. The inner portion 2110 of the locking ridge 2106 can have a varying amount of radial offset as the locking ridge 2106 extends circumferentially around the tray 2102. For example, the offset from the outer periphery 2112 of the locking ridge 2106 can be minimized at the innermost portion of the inner portion 2110 and increase as the locking ridge 2106 extends away from the innermost portion of the inner portion 2110 of the tray 2102.

[0075] The locking barbs 2204 can extend from the distal end of the locking ridge 2106 toward the outer periphery 2112 of the inner portion 2110. The locking barbs 2204 can extend the entire length of the inner portion 2110 of the locking ridge 2106. The locking barbs 2204 can extend at least a portion of the length of the inner portion 2110 of the locking ridge 2106. As the locking barbs 2204 extend circumferentially along the locking ridge 2106, the extension of the locking barbs 2204 toward the outer periphery 2112 of the tray 2102 can vary. For example, the locking barbs 2204 can extend further from the locking ridge 2106 toward the inner end and can extend less from the locking ridge 2106 away from the inner end. In another embodiment, the locking barbs 2204 can have a maximum extension from the locking ridge 2106 within the inner portion 2110 of the tray 2102 .

[0076] At the outer portion 2108 of the locking ridge 2106, the locking ridge 2106 can define an outer periphery 2112 of the tray 2102. Receptacles 2114 formed in the outer portion 2108 of the locking ridge 2106 can extend from the radially outer surface 2206 through the radially inner surface 2208 of the outer portion 2108 of the tray 2102. The receptacles 2114 can be circumferentially spaced along the outer portion 2108 of the locking ridge 2106. As described herein, the locking ridge 2106 and the locking barbs 2204 can be configured to engage protrusions on the edge of the bearing 2104, and the receptacles 2114 can be configured to receive lugs 2116 of the bearing 2104.

[0077] 23 shows a perspective view of an example underside of a bearing 2104 in accordance with one embodiment of the present disclosure. The bearing 2104 may include a flat spot at the center 2310 of the tray-mating surface 2302. Formed on the tray-mating surface 2302 is an attachment feature (e.g., attachment feature 132 in FIG. 1 ). As shown in FIG. 23 , on an outer portion of the bearing 2104, the attachment feature may include at least one lug 2116, and on an inner portion of the bearing 2104, the attachment feature may include at least one edge protrusion 2304.

[0078] The lugs 2116 may extend radially outward from the center 2310 of the bearing 2104 and toward the outer periphery 2306 of the bearing 2104. The lugs 2116 have a shape complementary to at least one of the mounting receptacles (e.g., receptacle 2114 in FIG. 22 ) formed in the outer portion 2108 of the locking ridge 2106, such that the lugs 2116 fit inside the at least one receptacle 2114 to prevent movement of the bearing 2104 relative to the tray 2102. The lugs 2116 may engage with the receptacle 2114 to prevent rotational and axial movement of the bearing 2104 relative to the tray 2102.

[0079] An edge protrusion 2304 may be formed on the bearing 2104 radially outward from the tray mating surface 2302, the edge protrusion 2304 forming at least a portion of an inner periphery 2308 of the bearing 2104. The edge protrusion 2304 may be configured to engage with the locking ridge 2106 and the locking barbs 2204 of the tray 2102 to couple the tray 2102 to the bearing 2104. The edge protrusion 2304 may define at least a portion of the inner periphery 2308.

[0080] 24 illustrates a cross-sectional view of a portion of an adjustable implant 2100 (e.g., adjustable implant 100 of FIG. 1, adjustable implant 1400 of FIG. 14, or adjustable implant 1500 of FIG. 15) according to one embodiment of the present disclosure. As first shown in FIG. 24, bearing 2104 can include articular surface 2402 (e.g., articular surface 218 of FIG. 2).

[0081] On the exterior of the tray 2102 and bearing 2104, receptacles 2114 formed in locking ridges 2106 of the tray 2102 can receive lugs 2116 of the attachment mechanism of the bearing 2104. As described herein, engagement between the receptacles 2114 and the lugs 2116 can help maintain the rotational position of the bearing 2104 relative to the tray 2102 and movement (e.g., proximal movement) of the bearing 2104 relative to the tray 2102.

[0082] On the inside of the tray 2102 and the inside of the bearing 2104, the locking ridges 2106 and locking barbs 2204 of the tray 2102 can be configured to engage with protrusions 2304 on the edge of the bearing 2104. As described herein, the engagement between the locking ridges 2106 and locking barbs 2204 of the tray 2102 and the protrusions 2304 on the edge of the bearing 2104 can prevent the bearing 2104 from moving (e.g., moving proximally) relative to the tray 2102.

[0083] The edge projection 1812 can include a body 2404. The body 2404 can at least partially define the outer periphery 2406 of the bearing 2104. The body 2404 can include a base 2408 that extends adjacent the tray mating surface 2302. The body 2404 can also include a mounting tab 2410 (e.g., mounting tab 524 (see FIG. 5) or mounting tab 1910 (see FIG. 19)). The mounting tab 2410 can extend from a distal portion of the body 2404 toward the center 2310 (shown in FIG. 23) of the bearing 2104. The mounting tab 2410 can include a tapered surface 2412 and a flat surface 2414. The tapered surface 2412 can be configured to point away from the bearing 2104. The tapered surface 2412 can taper as the mounting tab 2410 extends from the body 2404 toward the center 2310 of the bearing 2104. The flat surface 2414 is configured to face the bearing 2104 and can extend from the body 2404 toward the center 2310 of the bearing 2104.

[0084] In embodiments, the tapered surface 2412 of the mounting tab 2410 can be configured to contact the locking barb 2204 and bend the body 2404 away from the center 2310 of the bearing 2104 when the bearing 2104 is attached to the tray 2102. The flat surface 2414 of the mounting tab 2410 can be configured to engage with the distal surface of the locking barb 2204 when the bearing 2104 is coupled to the tray 2102. As such, the flat surface 2414 of the mounting tab 2410 can engage with the locking ridge 2106 and locking barb 2204 of the tray 2102 to hold the bearing 2104 and tray 2102 together after the bearing 2104 is coupled to the tray 2102.

[0085] In summary, a medical professional can adjust the rotational position of the bearing 2104 relative to the tray 2102 during surgery by inserting the lug 2116 (or lug 2116) into the receptacle 2114 that corresponds to the preferred rotational position of the bearing 2104 relative to the tray 2102.

[0086] The following non-limiting examples detail specific aspects of the present subject matter to solve the problems and provide advantages discussed herein. Example 1 is an adjustable implant comprising: a coupling device implantable in a patient's bone; a tray configured to attach to the coupling device, the tray including receptacles circumferentially spaced about an outer periphery of the tray and formed therein to extend through the tray; and a bearing configured to couple to the tray, the bearing including attachment mechanisms circumferentially spaced about an outer periphery of the bearing and engageable with the receptacles in the tray to couple the bearing to the tray, each attachment mechanism engageable with a respective receptacle, and alternatively, the rotational position of the bearing relative to the tray can be adjusted by engaging the attachment mechanisms with different receptacles within the tray.

[0087] In Example 2, the subject matter of Example 1 optionally includes where the coupling device is a stem.

[0088] In Example 3, the subject matter of any or more of Examples 1 to 2 optionally includes the tray having a first curved surface configured to face the coupling device when the tray is coupled to the coupling device, a flat surface extending around the tray and configured to face away from the coupling device when the tray is coupled to the coupling device, and a second curved surface configured to face away from the coupling device when the tray is coupled to the coupling device, the second curved surface extending inward from the flat surface.

[0089] In Example 4, the subject matter of Example 3 optionally includes the mounting receptacle comprising a locking ridge extending upwardly from the flat surface and extending circumferentially around the flat surface, the locking ridge including a locking barb extending radially outward from a proximal portion of the locking ridge toward the outer periphery of the tray, and an alignment boss extending upwardly from the flat surface and from the locking ridge toward the outer periphery of the tray.

[0090] In Example 5, the subject matter of Example 4 optionally includes, wherein the locking barbs extend circumferentially around the locking ridge and extend radially inward from a radially outer surface of the locking ridge to a radially inner surface thereof.

[0091] In Example 6, the subject matter of Example 5 optionally includes, wherein the bearing comprises a tray mating surface configured to face the second curved surface of the tray when the bearing is coupled to the tray, and an articulation surface configured to face away from the tray.

[0092] In Example 7, the subject matter of Example 6 optionally includes the attachment mechanism comprising an edge protrusion formed on the interior of the bearing radially outward of the tray mating surface to form at least a portion of the outer periphery of the bearing.

[0093] In Example 8, the subject matter of Example 7 optionally includes wherein the edge projection comprises a body at least partially defining an outer periphery of the bearing, the body including a base extending adjacent the tray mating surface and a mounting tab extending from a distal portion of the body toward a center of the bearing.

[0094] In Example 9, the subject matter of Example 8 optionally includes the mounting tab having a tapered surface facing away from the bearing, the tapered surface tapering as the mounting tab extends from the body toward the center of the bearing, and a flat surface facing the bearing and extending from the body toward the center of the bearing.

[0095] In Example 10, the subject matter of Example 9 optionally includes: a tapered surface of the mounting tab configured to contact the locking barb and bend the body away from the center of the bearing when the bearing is attached to the tray; and a flat surface of the mounting tab configured to engage a distal surface of the locking barb when the bearing is coupled to the tray.

[0096] In Example 11, the subject matter of any one or more of Examples 6 to 10 optionally includes the bearing having a first alignment relief notch formed in the mounting mechanism and configured to receive an alignment boss of the tray to define a rotational position of the bearing relative to the tray.

[0097] In Example 12, the subject matter of Example 11 optionally includes the bearing including a second alignment relief notch formed in the mounting feature and circumferentially spaced apart from the first alignment relief notch in a first direction, and a third alignment relief notch formed in the mounting feature and circumferentially spaced apart from the first alignment relief notch in a second direction opposite the first direction.

[0098] In Example 13, the subject matter of Example 12 optionally includes an alignment boss insertable into either the first alignment relief notch, the second alignment relief notch, or the third alignment relief notch, and defining a rotational position of the bearing relative to the tray when defined by the first alignment relief notch, the second alignment relief notch, and the third alignment relief notch.

[0099] In Example 14, the subject matter of any or more of Examples 3 to 13 optionally includes the mounting receptacle comprising a locking ridge extending upwardly from the flat surface and extending circumferentially around the flat surface, the locking ridge including an outer portion extending circumferentially around at least a portion of the outer end of the tray, the outer portion defining at least a portion of the outer periphery of the tray, and an inner portion extending circumferentially around at least a portion of the inner end of the tray, the inner portion being offset radially inward from the outer periphery of the tray.

[0100] In Example 15, the subject matter of Example 14 optionally includes, at an outer portion of the locking ridge, the mounting receptacle extends through the locking ridge from a radially outer surface toward a radially inner surface of the locking ridge.

[0101] In Example 16, the subject matter of Example 15 optionally includes, at an inner portion of the locking ridge, the mounting receptacle comprises a locking barb extending radially outward from a distal portion of the locking ridge toward the outer periphery of the tray.

[0102] In Example 17, the subject matter of Example 16 optionally includes the bearing comprising a tray mating surface configured to face the second curved surface of the tray when the bearing is coupled to the tray, and an articular surface configured to face away from the tray, the articular surface being engageable with a second implantable component.

[0103] In Example 18, the subject matter of Example 17 optionally includes the attachment mechanism comprising: a lug extending radially outward from the tray mating surface toward an outer periphery of the bearing, the lug being complementarily shaped to at least one of the attachment receptacles formed on the outer portion of the locking ridge so that the lug fits inside the at least one receptacle to prevent movement of the bearing relative to the tray; and an edge protrusion formed radially outward from the tray mating surface on the bearing to form at least a portion of the inner periphery of the bearing.

[0104] In Example 19, the subject matter of Example 18 optionally includes wherein the edge projection comprises a body at least partially defining an outer periphery of the bearing, the body including a base extending adjacent the tray mating surface and a mounting tab extending from a distal portion of the body toward a center of the bearing.

[0105] In Example 20, the subject matter of Example 19 optionally includes the mounting tab having a tapered surface facing away from the bearing that tapers as the mounting tab extends from the body toward the center of the bearing, and a flat surface facing the bearing and extending from the body toward the center of the bearing.

[0106] In Example 21, the subject matter of Example 20 optionally includes: a tapered surface of the mounting tab configured to contact the locking barb and bend the body away from the center of the bearing when the bearing is attached to the tray; and a flat surface of the mounting tab configured to engage a distal surface of the locking barb when the bearing is coupled to the tray.

[0107] In Example 22, the subject matter of any or more of Examples 3 to 21 optionally includes the receptacles being circumferentially spaced about an inner portion of the flat surface and an outer circumferential portion of the second curved surface, the receptacles extending from the first curved surface through the flat surface and the second curved surface.

[0108] In Example 23, the subject matter of Example 22 can optionally include the bearing comprising a tray mating surface configured to face the second curved surface of the tray when the bearing is coupled to the tray, and an articular surface configured to face away from the tray, the articular surface being engageable with the second implantable component.

[0109] In Example 24, the subject matter of Example 23 optionally includes at least one receptacle having a first edge extending circumferentially and defining an inner portion of the receptacle, a second edge extending from the first edge toward an outer periphery of the tray, a third edge extending from the first edge opposite the second edge toward the outer periphery of the tray, and a locking tab extending between the second edge and the third edge opposite the first edge and defining an outer periphery of the receptacle.

[0110] In Example 25, the subject matter of Example 24 includes, optionally, the locking tab having a sloping surface tapering from the flat surface toward the first curved surface and a flat surface generally parallel to the flat surface, the flat surface of the locking tab extending from the first curved surface toward the first edge of each receptacle.

[0111] In Example 26, the subject matter of Example 25 optionally includes the at least one attachment mechanism comprising a body including a base portion attached to the tray mating surface and a distal portion, the body extending radially from the tray mating surface between the base portion and the distal portion, and an attachment tab extending from the distal portion of the body toward the outer periphery of the bearing.

[0112] In Example 27, the subject matter of Example 26 optionally includes the mounting tab having a tapered surface facing away from the bearing, the tapered surface narrowing as the mounting tab extends from the body toward the outer periphery of the bearing, and a flat surface facing the bearing, the flat surface extending from the body toward the outer periphery of the bearing.

[0113] In Example 28, the subject matter of Example 27 optionally includes, wherein the tapered surface of the mounting tab is configured to contact the inclined surface of the locking tab and bend the body away from the outer periphery of the bearing when the bearing is mounted to the tray, and the flat surface of the mounting tab is configured to abut against the flat surface of the locking tab when the bearing is coupled to the tray.

[0114] In Example 29, the subject matter of Example 28 optionally includes at least one mounting mechanism comprising a toe-in mounting mechanism configured to engage with a mounting tab of the receptacle, fit inside the receptacle, and contact at least one of the first edge, the second edge, the third edge, or the locking tab to prevent movement of the bearing relative to the tray.

[0115] In Example 30, the subject matter of Example 29 optionally includes, wherein the toe-in attachment feature is configured to insert into the receptacle before the other attachment features.

[0116] In Example 31, the subject matter of any one or more of Examples 24 to 30 optionally includes that the at least one attachment mechanism comprises a lug extending radially from the mating surface of the tray, the lug being complementarily shaped relative to at least one of the receptacles so that the lug fits inside at least one of the receptacles, and the lug contacting at least one of the first edge, the second edge, the third edge, or the locking tab to prevent movement of the bearing relative to the tray.

[0117] In Example 32, the subject matter of Example 31 optionally includes the lug and receptacle being complementary such that the lug fits inside the receptacle and contacts at least one of the first edge, the second edge, the third edge, or the locking tab to prevent movement of the bearing relative to the tray.

[0118] Example 33 is an adjustable implant comprising: a coupling device that can be implanted into a patient's bone; a tray configured to attach to the coupling device, the tray including receptacles spaced apart around the tray and formed in the tray to extend through the tray; and a bearing configured to couple to the tray, the bearing including attachment mechanisms spaced apart around the bearing and engageable with receptacles in the tray to couple the bearing to the tray, each attachment mechanism being engageable with a respective receptacle, alternatively allowing the rotational position of the bearing relative to the tray to be adjusted by engaging the attachment mechanisms with different receptacles within the tray.

[0119] In Example 34, the subject matter of Example 33 optionally includes, wherein the coupling device is a stem.

[0120] In Example 35, the subject matter of Example 34 optionally includes the tray having a first curved surface configured to face the coupling device when the tray is coupled to the coupling device, a flat surface configured to face away from the coupling device when the tray is coupled to the coupling device, the flat surface extending around the periphery of the tray, and a second curved surface configured to face away from the coupling device when the tray is coupled to the coupling device, the second curved surface extending inward from the flat surface.

[0121] In Example 36, the subject matter of Example 35 optionally includes the receptacles being circumferentially spaced apart around a central portion of the flat surface and an outer peripheral portion of the second curved surface, the receptacles extending from the first curved surface through the flat surface and the second curved surface.

[0122] In Example 37, the subject matter of Example 36 optionally includes the bearing comprising a tray mating surface configured to face the second curved surface of the tray when the bearing is coupled to the tray, and an articular surface configured to face away from the tray and engageable with the second implantable component.

[0123] In Example 38, the subject matter of Example 37 optionally includes at least one of the receptacles having a first edge extending circumferentially and defining an inner portion of the receptacle, a second edge extending from the first edge toward the outer periphery of the tray, a third edge extending from the first edge opposite the second edge toward the outer periphery of the tray, and a locking tab extending between the second edge and the third edge opposite the first edge and defining an outer peripheral end of the receptacle.

[0124] Example 39 is at least one machine-readable medium including instructions that, when executed by a processing circuit, cause the processing circuit to perform operations to implement any of the elements of Examples 1 to 38.

[0125] Example 40 is an apparatus including means for implementing any of the elements of examples 1 to 38.

[0126] Example 41 is a system for implementing any of the elements of Examples 1 to 38.

[0127] Example 42 is a method for implementing any of the elements of Examples 1 to 38.

[0128] The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments that may be practiced. These embodiments are referred to herein as "examples." Such examples may include elements in addition to those shown or described. However, the inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the inventors contemplate examples using any combination or permutation of the elements shown or described (or one or more aspects thereof), with respect to the particular example (or one or more aspects thereof), or with respect to any other example (or one or more aspects thereof) shown or described herein.

[0129] All publications, patents, and patent documents referenced in this document are incorporated herein by reference in their entirety, as if individually incorporated by reference. In the event of a conflict in usage between this specification and a document incorporated by reference, the usage of the incorporated reference should be considered complementary to the usage of this document. In the event of an irreconcilable conflict, the usage of this specification will take precedence.

[0130] In this document, the terms "a" or "an" are used, as commonly used in patent documents, to include one or more, regardless of other instances or uses of "at least one" or "one or more." In this document, the term "or" is used to refer to a non-exclusive "or," such that "A or B" can include "A but not B," "B but not A," and "A and B," unless otherwise noted. In the appended claims, the terms "including" and "in which" are used as the plain-English equivalents of the terms "comprising" and "wherein," respectively. Also, in the following claims, the terms "including" and "comprising" are open-ended, meaning that systems, apparatus, articles, or processes including elements in addition to those recited after such terms in a claim are still deemed to be within the scope of that claim. Furthermore, in the following claims, the terms "first," "second," "third," etc. are used merely as labels and are not intended to impose numerical requirements on their objects.

[0131] As used herein, the term "about" means "means approximately," "in the region of," "roughly," or "around." When the term "about" is used in conjunction with a numerical range, it modifies that range by extending the boundaries above and below the stated numerical values. Generally, the term "about" is used to modify a value stated herein by a variance of 10% above and below the numerical value with which it is used. Thus, about 50% means a range of 45% to 55%. Numerical ranges recited herein by endpoints include all numbers and fractions subsumed within that range by the endpoints (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.90, 4, 4.24, and 5). Similarly, numerical ranges recited herein by endpoints include subranges subsumed within that range (e.g., 1 to 5 includes 1 to 1.5, 1.5 to 2, 2 to 2.75, 2.75 to 3, 3 to 3.90, 3.90 to 4, 4 to 4.24, 4.24 to 5, 2 to 5, 3 to 5, 1 to 4, and 2 to 4). It is also to be understood that all numerical values ​​and fractions thereof are presumed to be modified by the term "about."

[0132] The above description is intended to be illustrative, not limiting. For example, the above examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments may be utilized by those skilled in the art upon reviewing the above description. The Abstract is provided to enable the reader to quickly grasp the nature of the technical disclosure, with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be construed as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in fewer than all features of a particular disclosed embodiment. Thus, the following claims are incorporated into the Detailed Description, with each claim standing on its own as an independent embodiment. The scope of the embodiments should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

Claims

1. a coupling device that can be implanted into the patient's bone; a tray configured to attach to the coupling device, the tray including receptacles formed therein that are circumferentially spaced about an outer periphery of the tray and extend therethrough; a bearing configured to couple to the tray, the bearing including attachment mechanisms circumferentially spaced apart around an outer periphery of the bearing and engageable with receptacles on the tray to couple the bearing to the tray, each attachment mechanism engageable with a respective receptacle, and alternatively, the rotational position of the bearing relative to the tray can be adjusted by engaging the attachment mechanisms with different receptacles within the tray; 1. An adjustable implant comprising:

2. The adjustable implant of claim 1 , wherein the coupling device is a stem.

3. The tray is a first curved surface configured to face the coupling device when the tray is coupled to the coupling device; a flat surface configured to face away from the coupling device when the tray is coupled to the coupling device, the flat surface extending around the periphery of the tray; a second curved surface configured to face away from the coupling device when the tray is coupled to the coupling device, the second curved surface extending inwardly from the flat surface; 10. The adjustable implant of claim 1, comprising:

4. The receptacle includes: a locking ridge extending upwardly from and circumferentially around said planar surface, a locking barb extending radially outward from a proximal portion of the locking ridge toward the outer periphery of the tray; an alignment boss extending upward from the planar surface and extending from the locking ridge toward the outer periphery of the tray; and a locking ridge comprising:

4. The adjustable implant of claim 3.

5. 5. The adjustable implant of claim 4, wherein the locking barbs extend circumferentially around the locking ridge and extend radially inward from a radially outer surface of the locking ridge to a radially inner surface of the locking ridge.

6. The bearing is a tray mating surface configured to face the second curved surface of the tray when the bearing is coupled to the tray; an articular surface configured to face away from the tray; 6. The adjustable implant of claim 5, comprising:

7. The attachment mechanism includes: a rim projection formed on the interior of the bearing radially outward of the tray mating surface so as to define at least a portion of the outer periphery of the bearing; 7. The adjustable implant of claim 6.

8. The edge protrusion is a body at least partially defining the outer periphery of the bearing, a base extending adjacent the tray mating surface; a mounting tab extending from a distal portion of the body toward the center of the bearing; a body including:

8. The adjustable implant of claim 7.

9. The mounting tab a tapered surface facing away from the bearing, the tapered surface tapering as the mounting tab extends from the body toward the center of the bearing; a flat surface facing the bearing, the flat surface extending from the body toward the center of the bearing; 9. The adjustable implant of claim 8, comprising:

10. the tapered surface of the mounting tab is configured to contact the locking barb and deflect the body away from the center of the bearing when the bearing is mounted to the tray; the flat surface of the mounting tab is configured to engage a distal surface of the locking barb when the bearing is coupled to the tray.

10. The adjustable implant of claim 9.

11. The bearing is a first alignment relief notch formed in the mounting mechanism, the first alignment relief notch configured to receive the alignment boss of the tray to define a rotational position of the bearing relative to the tray; 7. The adjustable implant of claim 6.

12. The bearing is a second alignment relief notch formed in the attachment mechanism, the second alignment relief notch being circumferentially spaced apart from the first alignment relief notch in a first direction; and a third alignment relief notch formed in the attachment mechanism, the third alignment relief notch being circumferentially spaced from the first alignment relief notch in a second direction opposite the first direction; and 12. The adjustable implant of claim 11, comprising:

13. 13. The adjustable implant of claim 12, wherein the alignment boss is insertable into either the first alignment relief notch, the second alignment relief notch, or the third alignment relief notch, and defines a rotational position of the bearing relative to the tray when defined by the first alignment relief notch, the second alignment relief notch, and the third alignment relief notch, respectively.

14. The receptacle includes: a locking ridge extending upwardly from and circumferentially around said planar surface, an outer portion extending circumferentially around at least a portion of an outer end of the tray, the outer portion defining at least a portion of the outer periphery of the tray; an inner portion extending circumferentially around at least a portion of an inner end of the tray, the inner portion being offset radially inward from the outer periphery of the tray; and and a locking ridge comprising:

4. The adjustable implant of claim 3.

15. 15. The adjustable implant of claim 14, wherein at the outer portion of the locking ridge, the receptacle extends through the locking ridge from a radially outer surface of the locking ridge toward a radially inner surface of the locking ridge.

16. At the inner portion of the locking ridge, the receptacle a locking barb extending radially outward from a distal portion of the locking ridge toward the outer periphery of the tray; 16. The adjustable implant of claim 15.

17. The bearing is a tray mating surface configured to face the second curved surface of the tray when the bearing is coupled to the tray; an articular surface configured to face away from the tray, the articular surface engageable with a second implantable component; 17. The adjustable implant of claim 16, comprising:

18. The attachment mechanism includes: a lug extending radially outward from the tray mating surface toward an outer periphery of the bearing, the lug being complementarily shaped relative to at least one of the receptacles formed on the outer portion of the locking ridge such that the lug fits inside at least one of the receptacles to prevent movement of the bearing relative to the tray; and an edge projection formed on the bearing radially outward of the tray mating surface so as to form at least a portion of an inner periphery of the bearing; 20. The adjustable implant of claim 17, comprising:

19. The edge protrusion is a body at least partially defining the outer periphery of the bearing, a base extending adjacent the tray mating surface; a mounting tab extending from a distal portion of the body toward the center of the bearing; Including, 20. The adjustable implant of claim 18 comprising the body.

20. The mounting tab a tapered surface facing away from the bearing, the tapered surface tapering as the mounting tab extends from the body toward the center of the bearing; a flat surface facing the bearing and extending from the body toward the center of the bearing; 20. The adjustable implant of claim 19, comprising:

21. 21. The adjustable implant of claim 20, wherein the tapered surface of the mounting tab is configured to contact the locking barb and bend the body away from the center of the bearing when the bearing is attached to the tray, and the flat surface of the mounting tab is configured to engage a distal surface of the locking barb when the bearing is coupled to the tray.

22. 4. The adjustable implant of claim 3, wherein the receptacles are circumferentially spaced about an inner portion of the flat surface and an outer circumferential portion of the second curved surface, and the receptacles extend from the first curved surface through the flat surface and the second curved surface.

23. The bearing is a tray mating surface configured to face the second curved surface of the tray when the bearing is coupled to the tray; an articular surface configured to face away from the tray, the articular surface engageable with a second implantable component; 23. The adjustable implant of claim 22, comprising:

24. At least one of the receptacles is a first edge extending circumferentially and defining an inner portion of the receptacle; a second edge extending from the first edge toward the outer periphery of the tray; a third edge extending from the first edge opposite the second edge toward the outer periphery of the tray; a locking tab extending between the second edge and the third edge opposite the first edge and defining a peripheral edge of the receptacle; 24. The adjustable implant of claim 23, comprising:

25. The locking tab an inclined surface tapering from the flat surface toward the first curved surface; a flat surface essentially parallel to the flat surface, the flat surface of the locking tab extending from the first curved surface toward the first edge of each of the receptacles; 25. The adjustable implant of claim 24, comprising:

26. At least one of the attachment mechanisms is The main body is a base attached to the tray mating surface; a distal portion, the body extending radially from the tray mating surface between the base and the distal portion; the body including: a mounting tab extending from the distal portion of the body toward the outer periphery of the bearing; 26. The adjustable implant of claim 25, comprising:

27. The mounting tab a tapered surface facing away from the bearing, the tapered surface tapering as the mounting tab extends from the body toward the outer periphery of the bearing; a flat surface facing the bearing, the flat surface extending from the body toward the outer periphery of the bearing; 27. The adjustable implant of claim 26, comprising:

28. 28. The adjustable implant of claim 27, wherein the tapered surface of the mounting tab is configured to contact the angled surface of the locking tab and bend the body away from the outer periphery of the bearing when the bearing is attached to the tray, and the flat surface of the mounting tab is configured to abut the flat surface of the locking tab when the bearing is coupled to the tray.

29. At least one of the attachment mechanisms is 29. The adjustable implant of claim 28, comprising a toe-in attachment mechanism configured to engage the mounting tab of the receptacle, fit inside the receptacle, and contact at least one of the first edge, the second edge, the third edge, or the locking tab to prevent movement of the bearing relative to the tray.

30. 30. The adjustable implant of claim 29, wherein the toe-in attachment features are configured to insert into the receptacle before the other attachment features.

31. At least one of the attachment mechanisms is a lug extending radially from the tray mating surface, the lug being complementarily shaped to at least one of the receptacles such that the lug fits inside at least one of the receptacles, and the lug contacting at least one of the first edge, the second edge, the third edge, or the locking tab to prevent movement of the bearing relative to the tray; 25. The adjustable implant of claim 24.

32. 32. The adjustable implant of claim 31, wherein the lug and the receptacle are complementary such that the lug fits inside the receptacle and contacts at least one of the first edge, the second edge, the third edge, or the locking tab to prevent movement of the bearing relative to the tray.

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