Insert for locking screw fitting

Abstract

A surgical implant opening insert for use in a surgical implant system, and a surgical implant system for use in arthroplasty, comprising an opening and the surgical implant opening insert, are provided. The insert can increase the surface area of ​​the surgical component available for bone regrowth and provide fitting means to allow the use of different fixation devices within the opening.

Description

Technical Field

[0001] (Cross - Reference to Related Applications) This application relates to the application number of a currently unknown co - pending application, entitled "Insert for Setting Cement Mantle Thickness", filed on the same day as this application by the same applicant with the same patent office. These applications and the patents arising therefrom, including their specifications and drawings, are incorporated herein by reference.

[0002] (Field of the Invention) This specification relates to an insert for positioning inside a screw hole of a surgical device. In particular, an insert for adapting a screw hole suitable for non - locking to a screw hole suitable for locking screws. The disclosure also relates to a kit comprising at least two implants of the disclosure. The disclosure also relates to a method of adapting a screw hole suitable for non - locking screws to a screw hole suitable for locking screws during surgery.

Background Art

[0003] Arthroplasty is a well - known surgical procedure in which a diseased and / or damaged biological joint is replaced by an artificial joint. For example, in hip arthroplasty surgery, the patient's natural hip joint is partially or entirely replaced with an artificial hip joint prosthesis.

[0004] In some cases, it may be necessary to perform a revision hip arthroplasty on a patient. In such revision surgery, a previously implanted hip joint prosthesis is surgically removed and a replacement hip joint prosthesis is implanted. In some revision surgeries, for example, all components of a previously implanted hip joint prosthesis, including the femoral stem, neck component, and acetabular cup, may be surgically removed. In other revision surgeries, only some of the components of a previously implanted hip joint prosthesis may be removed and replaced.

[0005] The placement of locking and non-locking screws in surgical implants is determined by the type and location of the implant, as well as whether the surgery is a corrective operation.

[0006] Typically, implants such as acetabular shells only provide threaded holes suitable for non-locking screws. This means that even if a surgeon prefers to use locking screws, the provided implant cannot be used. This is because locking and non-locking screws have different dimensions. Locking screw holes are typically smaller and have tighter tolerances than non-locking screw holes.

[0007] Other types of surgical implants used during acetabular shell and revision surgery typically contain several different screw holes, giving the surgeon the option to select the screw holes in the location with the most suitable bone. Surgeons typically do not place screws in all available screw holes. The overall area of ​​the surgical implant where internal bone growth is promoted is reduced by the number of screw holes present. [Overview of the Initiative] [Means for solving the problem]

[0008] According to a first aspect of this disclosure, a surgical implant system is provided, the system is A surgical implant comprising one or more surgical implants, wherein at least one of the surgical implants has a distal surface and a proximal surface, and the surgical implant opening extends between the distal surface and the proximal surface, One or more surgical fixation devices, A surgical implant comprising one or more opening inserts, At least one of the surgical implant opening inserts is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between a distal surface and a proximal surface, defined by the surface of the through hole, comprising: The intermediate surface includes the surgical implant opening contact portion. The surface of the through-hole includes the contact portion for the surgical fixation device.

[0009] A surgical implant opening insert may further include having an intermediate surface that defines a first cross-sectional profile in a plane, and a through-hole surface that defines a second cross-sectional profile in a plane, with the second profile located within the first profile.

[0010] Surgical implants may also be orthopedic implants. Surgical implants may be one or more of the following: acetabular shell, partial acetabular shell, acetabular cage, femoral implant. Surgical implants may also be trauma treatment implants, such as trauma plates.

[0011] Surgical implants may be provided with an opening surface having one or more insert-retaining elements.

[0012] A surgical implant may be provided with one or more insert retaining elements, for example, as male and / or female retaining elements, which are adapted to engage with complementary elements provided on the insert, for example, on the intermediate surface of the insert. A surgical implant may also be provided with a plurality of radially recessed female retaining elements, such as grooves or recesses.

[0013] A surgical implant, for example, may have a threaded insert retaining element at its surgical implant opening.

[0014] A surgical kit may comprise two or more surgical fixation devices, each including at least one fixation device of a first type and at least one fixation device of a second type. For example, one or more screw fixation devices may be provided, each including one or more non-locking fixation devices as the first type and / or one or more locking fixation devices as the second type.

[0015] A first type of fastener may differ from a second type of fastener with respect to one or more characteristics of the threaded portion of the fastener. One or more characteristics may be selected from handedness, shape, angle, lead, pitch, start, large diameter, small diameter, pitch diameter, thread depth, or tapered shape.

[0016] The first type of fastener may differ from the second type of fastener with respect to the head profile and / or length and / or length of the threaded portion and / or tip profile.

[0017] A first type of fastener may differ from a second type of fastener with respect to one or more dimensions of the fastener. One of these dimensions may include the diameter of the fastener, for example, the diameter of the portion that contacts the opening of the insert. Another dimension may include the cross-sectional profile of the fastener, for example, the portion that contacts the opening of the insert.

[0018] A surgical kit may comprise several different surgical implant opening inserts. The inserts may differ from one or more of the following: the main body, the distal face, the proximal face, the intermediate face extending between the distal and proximal faces, the through-hole extending between the distal and proximal faces, the through-hole surface, the surgical implant opening contact portion, and the surgical fixation device contact portion. These differences may relate to one or more of the following: material composition, porosity, dimensions, separation between feature portions, size of feature portions, extent of feature portions, shape or profile of feature portions.

[0019] This difference may be the inclination of the hole or may include the inclination of the hole. The insert may have an insert axis. The insert axis may extend from distal to proximal, for example, perpendicular to the proximal surface of the insert and / or perpendicular to the distal surface of the insert. The through hole may have a hole axis. The hole axis may be parallel to the insert axis, for example, may correspond to the insert axis. The hole axis may be inclined with respect to the insert axis or may have an inclination. The inclination may be from 0 degrees to 25 degrees with respect to the insert axis. The inclination may be from 0 degrees to 17 degrees with respect to the insert axis.

[0020] The first aspect of the present disclosure may include any of the features, options, and possibilities described elsewhere in this specification, including other aspects and descriptions of the embodiments. In particular, the surgical implant opening insert may include any of the features, options, or possibilities described in the second aspect.

[0021] According to a second aspect of the present disclosure, a surgical implant opening insert is provided, the insert comprising a body portion that provides a distal surface and a proximal surface and further provides an intermediate surface that extends between the distal surface and the proximal surface, a through hole that extends between the distal surface and the proximal surface and is defined by a through hole surface, the intermediate surface includes a surgical implant opening contact portion, the through hole surface includes a surgical fixture contact portion the intermediate surface defines a first cross-sectional profile in a plane, the through hole surface defines a second cross-sectional profile in a plane, and the second profile is within the first profile.

[0022] At least a portion of the insert may be formed of a porous material. The porous material may be selected and / or adapted to promote ingrowth of bone.

[0023] At least a portion of the insert may be formed of a deformable material. The deformable material may be selected and / or adapted to deform upon engagement by a surgical fixture. The deformable material may be selected and / or adapted to deform upon engagement with a surgical implant aperture.

[0024] The porous material and the deformable material may be the same material or different materials.

[0025] The insert may provide a first portion of a body portion formed of a first material, and a second portion of the body portion is formed of a second material. The first material and the second material may differ from each other in their porosity and / or deformability. The first portion of the body portion may define a through-hole surface. The second portion of the body portion may define an intermediate surface. The distal surface and / or the proximal surface may be partially defined by the first material and partially defined by the second material. The body portion may include a core of the first material. The body portion may include a core radially surrounded by the second material.

[0026] At least a portion of the insert may be formed of a deformable material, and the deformable material has a first pre-deformed state for the through-hole surface. The deformable material may have a first post-deformed state for the through-hole surface. The shape of the through-hole surface in the first post-deformed state may be different from the shape of the through-hole surface in the first pre-deformed state. For example, the shape of the through-hole surface may be deformed to engage a surgical fixture, such as one or more of its contact surfaces, such as a thread provided by the surgical fixture, such as the head portion of the surgical fixture. The insert may provide a through-hole surface adapted to engage one or more surfaces of a surgical fixture in the first post-deformed state.

[0027] The insert may provide that the through-hole surface includes a bone-engaging surgical fixture contact portion. The contact portion may be provided by deformation of the through-hole surface and / or by a thread provided by the through-hole surface and / or by a surgical fixture that threads the through-hole surface.

[0028] At least a portion of the insert may be formed of a deformable material, the deformable material having a second pre-deformation state for the intermediate surface. The deformable material may have a second post-deformation state for the intermediate surface. The shape of the intermediate surface in the second post-deformation state may differ from the shape of the intermediate surface in the second pre-deformation state. For example, the shape of the intermediate surface may be deformed to engage with a surgical implant opening, for example, one or more of its contact surfaces, for example, its through-hole. The insert may provide a through-intermediate surface adapted to engage with one or more surfaces of the surgical implant opening in the second post-deformation state. The one or more surfaces may include, or may be, a surface defining the surgical implant opening, a surface defining the through-hole within the surgical implant, the distal surface of the surgical implant, and the proximal surface of the surgical implant.

[0029] The distal and / or proximal faces of the insert, or both, are a continuation of the portion of the surgical implant and / or can be shaped to be complementary to the profile of, for example, the adjacent portion of the surgical implant in use. The portion of the surgical implant may be flat or curved, and may be, for example, partially hemispherical. The curvature of one or both of the distal and / or proximal faces of the insert may have the same radius as the portion of the surgical implant.

[0030] The distal and / or proximal surfaces of the insert, or both, may be shaped to match the profile of the adjacent portion of the surgical implant in use, for example, so as to be coplanar with the portion of the surgical implant. The portion of the surgical implant may be flat or curved, and may be, for example, partially hemispherical.

[0031] The distal and / or proximal surfaces of the insert, or both, may be molded to be recessed relative to the portion of the surgical implant, for example, relative to the profile of the adjacent portion of the surgical implant in use. The portion of the surgical implant may be flat or curved, for example, partially hemispherical. The curvature of one or both of the distal and / or proximal surfaces of the insert may have a radius greater than the radius of the portion of the surgical implant, for example.

[0032] The distal and / or proximal surfaces of the insert, or both, may be molded to protrude from a portion of the surgical implant, for example, from the profile of an adjacent portion of the surgical implant in use. The protruding element of the insert may be a head portion or a flange portion. The portion of the surgical implant may be flat, for example, a flange, or curved, for example, a plate configured to conform to the position of the bone.

[0033] The intermediate surface may define a first cross-sectional profile in a plane, which is a regular shape, for example, a circle. The through-hole surface may define a second cross-sectional profile in a plane, which is a regular shape, potentially of the same type, for example, a circle. The regular shape may be concentric, for example, concentric circles. The insert may provide that the first cross-sectional profile in the plane is a circular profile. The insert may provide that the second cross-sectional profile in that plane is also a circular profile. The insert may provide that the second cross-sectional profile has a smaller diameter than the diameter of the first cross-sectional profile.

[0034] The insert may provide a second cross-sectional profile in which the cross section decreases along the axis of the through hole and / or the axis of the body portion. The second cross-sectional profile may be tapered away from the distal end and / or towards the proximal end, for example, by tapering the hole from the distal end to the proximal end.

[0035] The insert may provide, for example, a tapered through-hole having threads.

[0036] The insert may provide a first cross-sectional profile in which the cross section decreases along the axis of the through hole and / or along the axis of the body portion. The profile may decrease by the intermediate surface being tapered over a portion of the transition from the distal end to the proximal end. The intermediate surface may have the largest first cross-sectional profile at the distal end. The intermediate surface may have the smallest first cross-sectional profile at the proximal end. The intermediate surface may have the smallest first cross-sectional profile from the intermediate position to the proximal end to provide, for example, a cylindrical portion. The intermediate surface may transition from the largest cross-sectional profile to the smallest cross-sectional profile to provide a curved intermediate surface, for example, a bowl-shaped portion.

[0037] The insert may have an insert axis. The insert axis may extend from distal to proximal, for example, perpendicular to the proximal surface of the insert and / or perpendicular to the distal surface of the insert. The through hole may have a hole axis. The hole axis may be parallel to the insert axis, for example, corresponding to the insert axis. The hole axis may be inclined with respect to the insert axis, or may have an inclination.

[0038] Multiple different orientations for inclination may be provided to the insert and / or the surgical implant, for example, by an insert having multiple rotational positions. The insert may have a first rotational position for a first orientation of inclination and a second rotational position for a second orientation of inclination. The inclination of the insert may be the same in one or more or all of the multiple rotational positions.

[0039] The inclination may be between 0 and 25 degrees relative to the insert axis. The inclination may also be between 0 and 17 degrees relative to the insert axis.

[0040] The insert may have an intermediate surface equipped with one or more surgical implant-retaining elements.

[0041] The insert may be provided with one or more surgical implant retaining elements, such as male and / or female retaining elements, adapted to engage with complementary elements provided on the surgical implant, for example, within a surface defining the surgical implant opening. The insert may also be provided with a plurality of radially extending male retaining elements, such as cylindrical projections.

[0042] The insert may be provided with a threaded surgical implant retaining element.

[0043] The insert may be a 3D printed insert. The insert may be 3D printed together with one or more other components, such as a surgical implant opening and / or the surgical implant.

[0044] A second aspect of this disclosure may include any of the features, options, and possibilities set out elsewhere in this specification, including other aspects and descriptions of embodiments.

[0045] A third aspect of this disclosure provides a method for constructing a surgical implant opening in a surgical implant, the method being: a) Select a surgical fixation device for insertion into the surgical implant opening, b) Inserting a surgical implant opening insert into the surgical implant opening, c) Inserting a surgical fixation device through the insert and opening, the insert is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between a distal surface and a proximal surface, defined by the surface of the through hole, comprising: The intermediate surface includes a surgical implant opening contact portion that contacts the surgical implant opening after the insert has been inserted into the opening. The through-hole surface includes a surgical fixation contact portion that comes into contact with the surgical fixation device after the device has been inserted into the hole.

[0046] The method may further provide that the insert has an intermediate surface that defines a first cross-sectional profile in a plane, and a through-hole surface that defines a second cross-sectional profile in a plane, with the second profile being within the first profile.

[0047] The method may include providing an insert that is at least a portion of an insert formed of a deformable material. The method may include deforming the deformable material by engagement with the deformable material by a surgical fixation device and / or by insertion of a surgical fixation device into a through-hole.

[0048] The method may further include providing an insert that is formed of a deformable material, the deformable material having a first pre-deformation state for the through-hole surface and a first post-deformation state for the through-hole surface. The method may further provide that the shape of the through-hole surface in the first post-deformation state is different from the shape of the through-hole surface in the first pre-deformation state. The difference in shape may be caused by the engagement of a surgical fixation device with the deformable material and / or by the insertion of the surgical fixation device into the through-hole.

[0049] The method may further include providing a through-hole surface that engages with one or more surfaces of a surgical fixation device in a first deformed state.

[0050] This method may provide that the surface of the through-hole includes a contact portion for a bone-engagement surgical fixation device.

[0051] The method may further provide that the insert provides at least a portion of an insert formed of a deformable material, the deformable material having a second pre-deformation state for the intermediate surface and a second post-deformation state for the intermediate surface. The method may further provide that the shape of the intermediate surface in the second post-deformation state is different from the shape of the intermediate surface in the second pre-deformation state. The difference in shape may be caused by the engagement of the surgical implant opening with the deformable material and / or by the insertion of the insert into the surgical implant opening.

[0052] The method may further provide that the insert provides a second post-deformed intermediate surface that engages with one or more surfaces of the surgical implant opening.

[0053] This method, a) For example, one or more surgical implant openings for receiving a first size or first type of fixation device for insertion into an insert within a surgical implant opening, b) One or more surgical implant openings that accept an insert but do not accept a surgical fixation device, c) For example, this may include selecting one or more surgical implant openings for receiving a second size or second type of fixation device for insertion into a surgical implant opening lacking an insert.

[0054] The method may include providing different types of inserts within two or more openings. The different types may differ from one or more of the following: the main body portion, the distal surface, the proximal surface, the intermediate surface extending between the distal and proximal surfaces, the through-hole extending between the distal and proximal surfaces, the through-hole surface, the surgical implant opening contact portion, and the surgical fixation device contact portion. With respect to such features, the differences may relate to one or more of the following: material composition, porosity, dimensions, separation between features, size of features, extent of features, shape or profile of features.

[0055] This difference may be the inclination of the hole, or may include the inclination of the hole. The insert may have an insert axis. The insert axis may extend from distal to proximal, for example perpendicular to the proximal surface of the insert and / or perpendicular to the distal surface of the insert. The through hole may have a hole axis. The hole axis may be parallel to the insert axis, for example corresponding to the insert axis. The hole axis may be inclined with respect to the insert axis, or may have an inclination. The inclination may be between 0 and 25 degrees with respect to the insert axis. The inclination may be between 0 and 17 degrees with respect to the insert axis.

[0056] This difference may also be the rotational position of the insert, especially when an inclined hole is provided.

[0057] A third aspect of this disclosure may include any of the features, options, and possibilities set out elsewhere in this specification, including other aspects and descriptions of embodiments.

[0058] A fourth aspect of this disclosure provides a method for implanting a surgical implant, the method being: a) Select a surgical implant having at least one surgical implant opening, b) Implanting a surgical implant in the patient's surgical site, c) Select a surgical fixation device for insertion into the surgical implant opening, d) Selecting a surgical implant opening insert for insertion into the opening of the surgical implant, e) Inserting a surgical implant opening insert into the opening of the surgical implant, f) Inserting a surgical fixation device into the patient's site through an insert and an opening, The insert is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between a distal surface and a proximal surface, defined by the surface of the through hole, comprising: The intermediate surface includes a surgical implant opening contact portion that contacts the surgical implant opening after the insert has been inserted into the opening. The through-hole surface includes a surgical fixation contact portion that comes into contact with the surgical fixation device after the device has been inserted into the hole.

[0059] The method may further provide that the insert has an intermediate surface that defines a first cross-sectional profile in a plane, and a through-hole surface that defines a second cross-sectional profile in a plane, with the second profile being within the first profile.

[0060] The method may include providing an insert that is at least a portion of an insert formed of a deformable material. The method may include deforming the deformable material by engagement with the deformable material by a surgical fixation device and / or by insertion of a surgical fixation device into a through-hole.

[0061] The method may further include providing an insert that is formed of a deformable material, the deformable material having a first pre-deformation state for the through-hole surface and a first post-deformation state for the through-hole surface. The method may further provide that the shape of the through-hole surface in the first post-deformation state is different from the shape of the through-hole surface in the first pre-deformation state. The difference in shape may be caused by the engagement of a surgical fixation device with the deformable material and / or by the insertion of the surgical fixation device into the through-hole.

[0062] The method may further include providing a through-hole surface that engages with one or more surfaces of a surgical fixation device in a first deformed state.

[0063] This method may provide that the surface of the through-hole includes a contact portion for a bone-engagement surgical fixation device.

[0064] The method may further provide that the insert provides at least a portion of an insert formed of a deformable material, the deformable material having a second pre-deformation state for the intermediate surface and a second post-deformation state for the intermediate surface. The method may further provide that the shape of the intermediate surface in the second post-deformation state is different from the shape of the intermediate surface in the second pre-deformation state. The difference in shape may be caused by the engagement of the surgical implant opening with the deformable material and / or by the insertion of the insert into the surgical implant opening.

[0065] The method may further provide that the insert provides a second post-deformed intermediate surface that engages with one or more surfaces of the surgical implant opening.

[0066] This method, d) For example, one or more surgical implant openings for receiving a first size or first type of fixation device for insertion into an insert within a surgical implant opening, e) One or more surgical implant openings that accept inserts but do not accept surgical fixation devices, f) For example, this may include selecting one or more surgical implant openings for receiving a second size or second type of fixation device for insertion into a surgical implant opening lacking an insert.

[0067] The method may include providing different types of inserts within two or more openings. The different types may differ from one or more of the following: the main body portion, the distal surface, the proximal surface, the intermediate surface extending between the distal and proximal surfaces, the through-hole extending between the distal and proximal surfaces, the through-hole surface, the surgical implant opening contact portion, and the surgical fixation device contact portion. With respect to such features, the differences may relate to one or more of the following: material composition, porosity, dimensions, separation between features, size of features, extent of features, shape or profile of features.

[0068] This difference may be the inclination of the hole, or may include the inclination of the hole. The insert may have an insert axis. The insert axis may extend from distal to proximal, for example perpendicular to the proximal surface of the insert and / or perpendicular to the distal surface of the insert. The through hole may have a hole axis. The hole axis may be parallel to the insert axis, for example corresponding to the insert axis. The hole axis may be inclined with respect to the insert axis, or may have an inclination. The inclination may be between 0 and 25 degrees with respect to the insert axis. The inclination may be between 0 and 17 degrees with respect to the insert axis.

[0069] This difference may also be the rotational position of the insert, especially when an inclined hole is provided.

[0070] A third aspect of this disclosure may include any of the features, options, and possibilities set out elsewhere in this specification, including other aspects and descriptions of embodiments. [Brief explanation of the drawing]

[0071] Embodiments of the present disclosure are described below, so to speak, by reference to the accompanying drawings, where similar reference numerals in the drawings relate to similar elements. [Figure 1] This disclosure shows various surgical implants that are useful. [Figure 2a] This is a side view of a pressure-fit insert according to the first embodiment. [Figure 2b] Figure 2a is a cross-sectional view of the interlocking insert. [Figure 2c] Figure 2b is a cross-sectional view showing the presence of the fasteners. [Figure 3] This diagram shows various sizes and types of fasteners that can be used in conjunction with this disclosure. [Figure 4] This is a cross-sectional elevation view of a further embodiment of the insert, shown inserted into a through-hole in the acetabular shell. [Figure 5a] This is a diagram of a further embodiment of the present disclosure, used in the context of an acetabular cage. [Figure 5b] This figure shows a further embodiment of the present disclosure, also used in the context of an acetabular shell, in which the insert incorporates a flange engagement head. [Figure 6a] This is a diagram of a further embodiment of the present disclosure, in which different parts of the insert are formed of different materials and / or in different ways. [Figure 6b] This is a diagram of a further embodiment of the present disclosure, in which different parts of the insert are formed of different materials and / or in different ways. [Figure 6c] This is a diagram of a further embodiment of the present disclosure, in which different parts of the insert are formed of different materials and / or in different ways. [Figure 6d] This is a diagram of a further embodiment of the present disclosure, in which different parts of the insert are formed of different materials and / or in different ways. [Figure 6e] This is a diagram of a further embodiment of the present disclosure, in which different parts of the insert are formed of different materials and / or in different ways. [Figure 7a] This is a side view of an insert having a mating feature. [Figure 7b] This is a perspective view of an acetabular cup with a threaded hole having a mating feature, and an insert with a mating feature that is inserted into the threaded hole of an acetabular shell. [Figure 8a] This is a cross-sectional side view of an embodiment of an insert having a first through-hole orientation. [Figure 8b] This is a cross-sectional side view of an embodiment of an insert having a second through-hole orientation. [Modes for carrying out the invention]

[0072] Referring to the drawings, Figure 1 shows a series of perspective views of examples of surgical implants, which are an acetabular correction cage 2, a partial acetabular cup 4, and an acetabular cup 6. Each of these surgical implants 2, 4, and 6 has a number of through-holes 8 for accommodating fixation devices (not shown) when in use. In most surgical cases, only a few of the through-holes 8 are used, and the others are left as open through-holes 8.

[0073] These are just a few examples of the wide variety of surgical implants to which this disclosure relates. For example, this disclosure can be used in trauma implants such as trauma plates, as well as in other orthopedic examples such as femoral implants including distal locking femoral stems.

[0074] Figure 2a provides a side perspective view of an embodiment of the insert 20, described in reference to the use of the acetabular joint. The insert 20 comprises a body portion 22 having a distal surface 24, the distal surface 24 having a distal opening 26 located at the distal end of a through hole 28, the through hole 28 extending through the body portion 22 to a proximal opening 30 provided on the proximal surface 32 of the body portion 22 (see Figure 2b).

[0075] Insert 20 is suitable for insertion into the through-hole 8 of various surgical implants, such as acetabular shells, cages, trauma plates, and / or distal locking femoral stems.

[0076] To retain the insert 20 within the surgical implants 2, 6, and 8, the outer diameter d1 of at least a portion S of the insert 20 is in an interlocking fit with a complementary portion of the surgical implants 2, 4, and 6. This portion may be a separate portion from the illustrated portion S, or it may be the entire profile of the outer surface 34. This retention provides a first level of retention of the insert 20 relative to the surgical implants 2, 6, and 8. Further, increased levels of retention are described below.

[0077] The insert 20 is formed from a porous material to promote internal bone growth. In this embodiment, the entire body portion 22 is formed from a porous material to promote internal bone growth. Therefore, providing the insert 20 in the through-holes 8 of the surgical components 2, 4, and 6 has the advantage of increasing the surface area of ​​the surgical components 2, 4, and 6 available for internal bone growth. The insert 20 can be used to fill the through-holes 8 even if no further use of the insert 20 is made.

[0078] The insert 20 can also function as an adapter that allows a different size and / or type of fixation device, which would normally work directly with the surgical implants 2, 4, and 6 by being inserted into the through-hole 8 in the absence of the insert 20, to work with the insert 20 and, therefore, with the surgical implants 2, 4, and 6. The through-hole 28 has a diameter d2 smaller than the diameter of the through-hole 8 of the surgical devices 2, 4, and 6, which is equal to the outer diameter d1 of the insert 20 plus tolerance. A typical diameter of d2 is, for example, 2 mm to 3.5 mm.

[0079] A through-hole 8 without insert 20 can reliably accept a fixation device with an outer diameter matching d1 in the presence of insert 20, while a through-hole 28 allows smaller diameter fixation devices, such as locking screws, to reliably engage with the through-hole 8 and therefore with the surgical implants 2, 4, and 6. This provides a second, enhanced level of retention. This means that a surgeon can select from a full set of such through-holes 8, which are best suited for accepting larger sizes or the first type of fixation device, and which are best suited for accepting smaller sizes or the second type of fixation device, and therefore should be provided with insert 20, and which should not be provided with a fixation device but should be provided with insert 20 to promote internal bone growth. The surgeon may still select some through-holes 8 that do not accept a fixation device or insert 20. This flexibility of selection allows for good implant stability, the optimal size and / or type of fixation device used, and the maximum internal bone growth promoted.

[0080] Figure 2b shows a thread 36 formed along the entire length of the side wall 38. In other examples not shown, the thread 36 may only extend partway along the length of the side wall 38. The thread 36 in Figures 2a and 2b has a constant diameter and is complementary to the male thread of a fastener such as a locking screw.

[0081] As shown in Figure 2c, when the fastener 40 is inserted into the insert 20 in this form, the threads 41 and 21 engage with each other, and there is no deformation of the material forming either the insert 20 or the fastener 40.

[0082] The insert 20 in any of the embodiments may be 3D printed. The insert 20 may be 3D printed so that it is already in place within the through-holes 8 of the surgical implants 2, 4, and 6, or so that it can be separately inserted into a particular through-hole 8.

[0083] Figure 3 shows a series of typical fixation devices 40a, 40b, 40c, 40d, and 40e for direct cooperation with surgical implants 2, 4, and 6, the fixation devices being able to cooperate with insert 20 as adapters and thus with surgical components 2, 4, and 6 in a reduced diameter form.

[0084] An exemplary fastener 40e is a locking screw. The diameter d2 of the through hole 28 corresponds to the diameter d3 of the locking screw head 30, but the diameter d3 is slightly increased to cause deformation of the insert 20 as the fastener is inserted. The level of deformation of the surface of the insert 20 relative to the implant substrate is, for example, in the range of 1-5%, which is purely sufficient to obtain an interlocking fit. The insert 20 is slightly oversized to allow for deformation. The deformation is controlled by the composition and structure of the insert 20. This can be, for example, through porosity, strut length and thickness if the insert is 3D printed, or, for example, through material properties if the material is solid.

[0085] As shown in Figure 4, the present disclosure provides further embodiments in which the insert 20 is positioned in a predetermined location within an opening, such as a through-hole 8, in a surgical implant in the form of an acetabular cup 6.

[0086] The shape of the insert 20 is formed such that its distal surface 24 is complementary to and represents a continuity with the distal surface 50 surrounding the acetabular cup 6 into which the insert is inserted. In this way, no interference occurs with the intended profile of the distal surface 50, and no interference occurs with opposing parts of the surgical implant system (not shown) during use. In the example shown in Figure 4, the distal surface 24 of the main body portion 22 is concave so that the curvature of the acetabular shell 6 is continuous across the surface of the distal surface 24 of the main body portion 22 when the insert 20 is positioned within the through-hole 8.

[0087] In this embodiment, as described above in the previous embodiment, the through-hole 28 of the insert 20 still extends through the through-hole 8 of the surgical implant 6, but in doing so narrows the diameter for receiving the fixation device to the diameter d2 of the through-hole 28. In this embodiment, the diameter is reduced to a minimum value d3 by tapering the through-hole 28 from distal to proximal. When the fixation device, in this case a locking screw, is screwed into the through-hole 28 of the insert 20, the locking screw deforms the porous material on which the insert 20 is formed, and as a result the head of the locking screw 22 is trapped in the deformed material, locking the insert 20 in place to both the locking screw and the surgical implant 6.

[0088] As shown in Figure 4, the through-hole 8 of the surgical implant 6 is tapered. Therefore, the main body portion 22 of the insert 20 may have a taper and complementary shape corresponding to the through-hole 8 so as to fill the through-hole 8 when the insert 20 is inserted.

[0089] As shown in Figure 5a, the insert 20 is located in one of the multiple through-holes 8 in the plate portion 54 of the acetabular cage 2. The insert 20 can be used in a wide variety of configurations to provide an adapter and promote bone growth.

[0090] In the relevant embodiment shown in Figure 5b, the insert 20 has a flange portion 52 on its proximal side. The flange portion 52 may be formed from a porous material to promote internal bone growth. The insert 20 is positioned in a through-hole 8 of the plate portion 54 of the acetabular cage 2. The diameter d4 of the proximal flange portion 52 is greater than the diameter d5 of the widest part of the through-hole 8 of the plate portion 54. When in use, this flange portion 52, particularly its distal surface 56, engages with the proximal side 58 of the plate portion 54. The flange portion 52 is particularly useful for inserts 20 used in cage or plate applications because it allows the insert 20 to be positioned so that the flange portion 52 is located between the surgical implant and the bone. This increases the bone contact area to promote internal bone growth. When the flange is positioned at the upper end 12 of the body portion 4, the flange portion 52 prevents the insert 2 from being pushed through the screw hole 10 of the surgical device 20. As shown in the diagram, a distal flange portion 59 is also provided, which has a larger diameter than the diameter d5 of the through hole 8. This helps to retain the insert 20 within the acetabular cage 2.

[0091] The flange portion 52 may be flat, as shown in Figure 5b, or it may be concave or convex, so as to be complementary to the surgical instrument intended to be inserted. For example, the flange portion 52 may be concave and / or convex so that when the insert 20 is positioned within the through hole 8, the curvature of the surgical instrument is continuous across the surface of the flange and the upper end 12 or lower end 14 of the main body portion 4.

[0092] In any embodiment of the insert 20, the material from which it is constructed may also be deformable in surgical use. This deformability may apply to the entire insert 20. Alternatively, in the embodiments shown in Figures 6a to 6e, the body portion 22 of the insert is formed from different materials in different regions. For example, the outer volume 60 of the body portion 22 may be formed from a first material to provide strength to the insert 20, while the inner volume 62 of the body portion 22, including the through-hole 28, may be formed from a different material, for example, porous and / or optimized for deformation, potentially also supporting internal bone growth. The different materials may be non-porous materials or porous materials having different properties from the non-porous material of the outer volume 60. The material of the outer volume may be a different porous material. The different materials may be varied from each other through control of lattice type, material type, lattice dimensions, pore size, etc.

[0093] Referring to Figures 6a and 6b, a first structure is used having a structural outer layer 60 and an internal surface grid 62. The surface grid 62 defines the proximal portion of the through hole 8, and the structural outer layer 60 defines the distal portion of the through hole 8. The fastener 40 engages with both and potentially with the deformation of the surface grid 62 and / or structural layer 60.

[0094] In Figure 6c, a second structure is used, which has a structural layer 60 and a finer, and therefore less porous, 3D grid 62 within it.

[0095] In the configurations shown in Figures 6d and 6e, the third structure is provided with a structural outer layer 60 and a 3D grid 62 inside the DPS Affixium™.

[0096] Further optional configurations of the present disclosure are shown in Figures 7a and 7b. As shown in Figure 7a, the insert 20 comprises a body portion 22 having a distal surface 24, the distal surface 24 having a distal opening 26 located at the distal end of a through hole 28, the through hole 28 extending through the body portion 22 to a proximal opening 30 provided on the proximal surface 32 of the body portion 22. The through hole 28 is the diameter d of the through hole 8 of the surgical implant 6. 11 A smaller diameter d 10 This allows for the engagement of different sizes or types of fasteners through the through-hole 28 and then with the bone.

[0097] In this embodiment, the insert 20 comprises a plurality of mating features 70 provided on the outer surface 34 of the main body portion 22 for locking the insert 20 into surgical implants 2, 4, and 6 of the type shown in Figure 7b, for example. The mating features 70 may be female or male, with the male form being shown. In the examples shown in Figures 7a and 7b, the mating features 70 are bayonet-type matings in the form of projections from the outer surface 34. In other examples not shown, the mating features may be threaded.

[0098] The insert 20 is provided with a through hole 28 having a first portion 72 and a narrower portion 74 closer to the proximal side. The first portion 72 functions to accommodate the larger diameter head of the fixture compared to the stem of the fixture when in use.

[0099] The insert 20 is configured to be insertable into the through-holes 8 of various surgical devices, such as the acetabular shell 4, cage 2, trauma plate, and / or distal locking femoral stem, using through-holes 8 of surgical implants 2, 4, and 6 that have been modified to accept the mating feature 70 of the insert 20. As shown in Figure 7b, the acetabular cup 6 in this case has multiple through-holes 8. Some of the through-holes, such as through-hole 8*, are unmodified and unsuitable for accepting the insert 20 having the projection 70. Through-hole 8' is provided in the modified design and therefore has multiple complementary female mating features 76 for engaging with the male mating feature 70 of the insert 20. Each female mating feature 76 in this case has a first groove portion 78 that allows axial movement of the male mating portion 70 relative to the insert 20, then a curved portion 80 that prompts the initiation of rotation of the insert 20 relative to the surgical implant 6, and finally a retaining portion 82. The retaining portion 82 resists any axial movement of the insert 20 and the surgical implant 6 relative to each other. The retaining groove portion 82, along with other retaining groove portions 82, is located in a common plane perpendicular to the axis of the through hole 8.

[0100] The insert 20 in the holding position has a through hole 8 having a male holding feature portion 70 in the holding portion of the female holding portion 76. + It is shown inside.

[0101] As shown in Figure 7a, the insert 20 provides a through-hole 28 with a smaller diameter than the through-holes 8' and 8* of the surgical implant 6, thereby narrowing the diameter of the through-hole 28, and thus narrowing the diameter of the through-hole 28 into which the fixation devices used to fasten the surgical devices 2, 4, 6 and bone are inserted.

[0102] As shown in Figure 7b, the through-hole 8 of the surgical implant 6 may be tapered. Therefore, the proximal body portion of the insert 20 has a corresponding taper and complementary shape so as to fill the through-hole 8 when the insert 20 is inserted.

[0103] In the configurations shown in Figures 7a and 7b, the through-hole 28 is not threaded. In this configuration, the threads of the fastener, such as a locking screw, may be self-tapping screws, or threads may be cut into the side wall 36 of the hole to secure the fastener to the insert 20.

[0104] In other configurations not shown, the through hole 28 may have threads formed in its side wall 36 along at least a portion of its length. In other configurations not shown, the threads may only extend partway along the length of the side wall 36. The threads are complementary to the threads of the fastener.

[0105] The mating features 70, 76 may be positioned to allow the surgeon to change the insertion angle of the surgical implants 2, 4, 6 and / or insert 20. Changing the insertion angle allows the surgeon to change the insertion angle of the through-hole 28 so as not to align with the through-holes 8, 10 of the surgical implants 2, 4, 6. Changing the insertion angle allows the surgeon to insert a fixation device, such as a locking or non-locking screw, at a different angle than the angle available in the original through-hole 8, for example, to access a higher quality area of ​​bone. By changing the insertion angle, it may be possible to allow the insert 20 to protrude from the surgical implants 2, 4, 6 as needed.

[0106] Referring to Figures 8a and 8b, different alignment options are provided for the through-hole 8 of the insert 20. In Figure 8a, the axis FF of the through-hole 8 extends distally and proximal only with respect to the insert 20. Therefore, when inserted, the fixture 40 also follows the alignment of axis FF. In Figure 8b, the axis PP of the through-hole 8 extends distally and proximal, but is still offset or inclined with respect to the insert 20. Therefore, when inserted, the fixture 40 follows the alignment of axis FF and is inclined with respect to axis II of the insert 20.

[0107] Potentially, if the insert is made of a solid material and is not deformable, the angle of the through-hole 8, including the corresponding locking feature and fixture 40, can be manufactured to be zero offset or with an angular offset within a certain range. Overall, various inserts 20 may be provided with different degrees of offset, typically, for example, 17 degrees in 5-degree steps (hence 5, 10, and 15-degree examples), up to a level of variation available for non-locking fixtures. The insert 20 can, of course, be rotated to different positions within the through-hole 8, and therefore the insert 8 can be rotated to allow the required angle in the required direction, so only one angular deformation is required at each offset.

[0108] If the insert is deformable, the locking mechanism is via a fastener 40 that bites into the material of the insert 20, and thus has a pre-formed offset similar to that described above, but without a fitting feature within the through-hole 8. In another option, the through-hole 8 of the insert 20 is made with a high level of porosity and is therefore very easy to deform. Thus, the user can position the fastener 40 at a desired angle within the through-hole 8 and screw the fastener 40 into the insert 20 at the desired angle. In this case, the maximum angle is limited by a larger opening that accepts the insert 20.

[0109] The disclosure also relates to a method for adapting a through-hole 8 suitable for a first size or type of fastener, such as a non-locking screw, to a second size or type of fastener, such as a locking screw. The method includes first providing a surgical implant including, for example, a through-hole 8 for a non-locking screw hole, and then providing an insert 20 according to one of the examples provided above. The insert 20 is then inserted into one of the through-holes 8 for a non-locking screw hole, and a second type of fastener, such as a locking screw, is inserted into the through-hole 28 of the insert 20.

[0110] Furthermore, a kit is also provided for adapting a through-hole 8 suitable for, for example, a non-locking screw to a through-hole 8 suitable for, for example, a locking screw. The kit comprises at least two inserts 20 with the aforementioned inserts and at least two different types of fasteners.

[0111] While specific embodiments of this disclosure have been described, it will be understood that many modifications, additions, and / or substitutions are possible within the claims. Various modifications and alternative forms are conceivable for the concepts of this disclosure, specific embodiments of which are illustrated in the drawings and described in detail herein. However, it should be understood that it is not the intention of this disclosure to limit the concepts to the specific forms disclosed, but rather to encompass all modifications, equivalents, and alternatives included in this disclosure and the attached "Claims."

[0112] [Implementation Method] (1) A surgical implant system, wherein the system is A surgical implant comprising one or more surgical implants, wherein at least one of the surgical implants has a distal surface and a proximal surface, and the surgical implant opening extends between the distal surface and the proximal surface, One or more surgical fixation devices, A surgical implant comprising one or more opening inserts, At least one of the surgical implant opening inserts is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and the main body portion further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between the distal surface and the proximal surface, defined by the surface of the through hole, comprises The aforementioned intermediate surface includes a surgical implant opening contact portion, The surface of the through-hole includes a surgical fixation device contact portion, forming a surgical implant system. (2) The surgical implant system according to Embodiment 1, wherein the intermediate surface of the surgical implant opening insert defines a first cross-sectional profile in a plane, and the through-hole surface defines a second cross-sectional profile in the plane, and the second profile is located within the first profile. (3) The surgical implant system according to Embodiment 1 or 2, further comprising two or more surgical fixation devices, each including at least one fixation device of the first type and at least one fixation device of the second type. (4) The surgical implant system according to Embodiment 3, comprising one or more screw fasteners, including one or more non-locking fasteners as the first type and / or one or more locking fasteners as the second type. (5) The surgical implant system according to Embodiment 3 or 4, wherein the first type of fastener differs from the second type of fastener with respect to one or more characteristics of the threaded portion of the fastener.

[0113] (6) A surgical implant system according to any of embodiments 3 to 5, wherein the first type of fixation device differs from the second type of fixation device with respect to one or more dimensions of the fixation device, for example, the diameter of the fixation device. (7) A surgical implant system according to any embodiment 1 to 6, further comprising a plurality of different surgical implant opening inserts, wherein the inserts differ from each other with respect to one or more or all of the following: the body portion, the distal surface, the proximal surface, the intermediate surface extending between the distal surface and the proximal surface, the through-hole extending between the distal surface and the proximal surface, the through-hole surface, the surgical implant opening contact portion, and the surgical fixation contact portion. (8) A surgical implant system according to any one of embodiments 1 to 7, further comprising a plurality of different surgical implant opening inserts, the inserts being different from each other in respect of one or more or all of the following: material composition, porosity, dimensions, separation between feature parts, size of feature parts, extent of feature parts, shape or profile of feature parts. (9) A surgical implant system according to any one of embodiments 1 to 8, further comprising a plurality of different surgical implant opening inserts, wherein the inserts differ from each other in terms of the inclination of the opening. (10) The surgical implant system according to Embodiment 9, wherein the insert has an insert axis, the insert axis extends distally to proximal, and the through hole has a hole axis, the hole axis is inclined with respect to the insert axis.

[0114] (11) The surgical implant system according to Embodiment 10, wherein the inclination is 0 to 25 degrees with respect to the insert axis. (12) The surgical implant system according to any one of embodiments 1 to 11, wherein the surgical implant is one or more of the following: an acetabular shell, a partial acetabular shell, an acetabular cage, a femoral implant, or a trauma treatment implant. (13) The surgical implant system according to any one of embodiments 1 to 12, wherein the surgical implant has an open surface provided with one or more insert retaining elements. (14) A surgical implant opening insert, wherein the insert is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and the main body portion further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between the distal surface and the proximal surface, defined by the surface of the through hole, comprises The aforementioned intermediate surface includes a surgical implant opening contact portion, The surface of the through-hole includes a surgical fixation device contact portion, A surgical implant opening insert wherein the intermediate surface defines a first cross-sectional profile within the plane, and the through-hole surface defines a second cross-sectional profile within the plane, the second profile being located within the first profile. (15) The surgical implant opening insert according to Embodiment 14, wherein at least a portion of the insert is formed of a porous material, and the porous material is adapted to promote internal bone growth.

[0115] (16) The surgical implant opening insert according to embodiment 14 or 15, wherein at least a portion of the insert is formed of a deformable material, and the deformable material is adapted to deform when engaged with a surgical fixation device. (17) A surgical implant opening insert according to any one of embodiments 14 to 16, wherein at least a portion of the insert is formed of a deformable material, the deformable material having a first pre-deformation state for the through-hole surface and a first post-deformation state for the through-hole surface, and the shape of the through-hole surface in the first post-deformation state is different from the shape of the through-hole surface in the first pre-deformation state. (18) The surgical implant opening insert according to Embodiment 17, wherein the through-hole surface in the first deformed state is adapted to engage with one or more surfaces of a surgical fixation device. (19) A surgical implant opening insert according to any one of embodiments 14 to 18, wherein the through-hole surface includes a bone engagement surgical fixation device contact portion. (20) A surgical implant opening insert according to any one of embodiments 14 to 19, wherein at least a portion of the insert is formed of a deformable material, the deformable material having a second pre-deformation state for the intermediate surface and a second post-deformation state for the intermediate surface, and the shape of the intermediate surface in the second post-deformation state is different from the shape of the intermediate surface in the second pre-deformation state.

[0116] (21) The surgical implant opening insert according to Embodiment 20, wherein the intermediate surface in the second deformed state is fitted to engage with one or more surfaces of a surgical implant opening. (22) The surgical implant opening insert according to any one of embodiments 14 to 21, wherein one or both of the distal surface and the proximal surface are molded to be a continuation of the profile of the adjacent portion of the surgical implant in use and / or complementary to the profile. (23) A surgical implant opening insert according to any one of embodiments 14 to 22, wherein the surface of the through hole is provided with screw threads. (24) A surgical implant opening insert according to any one of embodiments 14 to 23, wherein the first cross-sectional profile in a plane is a circular profile, and the second cross-sectional profile in the plane is also a circular profile having a diameter smaller than the diameter of the first cross-sectional profile. (25) A surgical implant opening insert according to any one of embodiments 14 to 24, wherein the cross section of the second cross-sectional profile decreases along the axis of the through hole by tapering the hole from the distal end to the proximal end, for example.

[0117] (26) A surgical implant opening insert according to any one of embodiments 14 to 25, wherein the cross section of the first cross-sectional profile is tapered along the axis of the through hole, for example, by tapering the intermediate surface over a portion of the transition from the distal end to the proximal end. (27) A surgical implant opening insert according to any one of embodiments 14 to 26, wherein one or more surgical implant retaining elements are provided on the intermediate surface. (28) A surgical implant opening insert according to any one of embodiments 14 to 27, wherein the one or more surgical implant retaining elements are, for example, male retaining elements and / or female retaining elements adapted to engage with complementary elements provided on the surgical implant within a surface defining a surgical implant opening. (29) A surgical implant opening insert according to any one of embodiments 14 to 28, wherein the insert is 3D printed. (30) A surgical implant opening insert according to any one of embodiments 14 to 29, wherein the first portion of the main body is formed of a first material, and the second portion of the main body is formed of a second material, and the first material and the second material differ from each other in their porosity and / or deformability.

[0118] (31) A surgical implant opening insert according to any one of embodiments 14 to 30, wherein the insert has an insert axis, the insert axis extends from distal to proximal, and the through hole has a hole axis, the hole axis is inclined with respect to the insert axis. (32) A method for constructing a surgical implant opening, the method being: a) Select a surgical fixation device for insertion into the surgical implant opening, b) Inserting the surgical implant opening into the surgical implant opening, c) inserting the surgical fixation device through the insert and the opening, wherein the insert is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and the main body portion further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between the distal surface and the proximal surface, defined by the surface of the through hole, comprises The intermediate surface includes a surgical implant opening contact portion that contacts the surgical implant opening after the insert is inserted into the opening, The through-hole surface includes a surgical fixation contact portion that contacts the surgical fixation after the surgical fixation is inserted into the hole, and optionally, the intermediate surface defines a first cross-sectional profile in a plane, and the through-hole surface defines a second cross-sectional profile in the plane, the second profile being within the first profile, in the method. (33) A method for implanting a surgical implant, the method being: a) Selecting a surgical implant having at least one surgical implant opening, b) Implanting the surgical implant into the patient's surgical site, c) Select a surgical fixation device for insertion into the surgical implant opening, d) Selecting a surgical implant opening insert for insertion into the opening of the surgical implant, e) Inserting the surgical implant opening insert into the opening of the surgical implant, f) inserting the surgical fixation device into the patient's site through the insert and the opening, The aforementioned insert is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and the main body portion further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between the distal surface and the proximal surface, defined by the surface of the through hole, comprises The intermediate surface includes a surgical implant opening contact portion that contacts the surgical implant opening after the insert is inserted into the opening, The method wherein the surface of the through-hole includes a surgical fixation contact portion that contacts the surgical fixation device after the surgical fixation device has been inserted into the hole.

Claims

1. A surgical implant system, wherein the system is A surgical implant comprising one or more surgical implants, wherein at least one of the surgical implants has a distal surface and a proximal surface, and the surgical implant opening extends between the distal surface and the proximal surface, One or more surgical fixation devices, A surgical implant comprising one or more surgical implant opening inserts, At least one of the surgical implant opening inserts is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and the main body portion further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between the distal surface and the proximal surface, defined by the surface of the through hole, comprises The aforementioned intermediate surface includes a surgical implant opening contact portion, The surface of the through-hole includes a surgical fixation device contact portion, forming a surgical implant system.

2. The surgical implant system according to claim 1, wherein the intermediate surface defines a first cross-sectional profile in a plane, and the through-hole surface defines a second cross-sectional profile in the plane, and the second profile is located within the first profile.

3. The surgical implant system according to claim 1 or 2, further comprising two or more surgical fixation devices, each including at least one fixation device of a first type and at least one fixation device of a second type.

4. A surgical implant system according to claim 3, comprising one or more screw fasteners, including one or more non-locking fasteners as the first type and / or one or more locking fasteners as the second type.

5. The surgical implant system according to claim 3, wherein the first type of fastener differs from the second type of fastener with respect to one or more characteristics of the threaded portion of the fastener.

6. The surgical implant system according to claim 3, wherein the first type of fixation device differs from the second type of fixation device with respect to one or more dimensions of the fixation device, for example, the diameter of the fixation device.

7. The surgical implant system according to claim 1, further comprising a plurality of different surgical implant opening inserts, wherein the inserts differ from each other with respect to one or more or all of the following: the body portion, the distal surface, the proximal surface, the intermediate surface extending between the distal surface and the proximal surface, the through-hole extending between the distal surface and the proximal surface, the surface of the through-hole, the surgical implant opening contact portion, and the surgical fixation device contact portion.

8. The surgical implant system according to claim 1, further comprising a plurality of different surgical implant opening inserts, wherein the inserts differ from each other in respect of one or more or all of the following: material composition, porosity, dimensions, separation between feature parts, size of feature parts, extent of feature parts, shape or profile of feature parts.

9. The surgical implant system according to claim 1, further comprising a plurality of different surgical implant opening inserts, wherein the inserts differ from each other in terms of the inclination of the opening.

10. The surgical implant system according to claim 9, wherein the insert has an insert axis, the insert axis extends from distal to proximal, and the through hole has a hole axis, the hole axis is inclined with respect to the insert axis.

11. The surgical implant system according to claim 10, wherein the inclination is 0 to 25 degrees with respect to the insert axis.

12. The surgical implant system according to claim 1, wherein the surgical implant is one or more of the following: an acetabular shell, a partial acetabular shell, an acetabular cage, a femoral implant, or a trauma treatment implant.

13. The surgical implant system according to claim 1, wherein the surgical implant has an open surface provided with one or more insert-holding elements.

14. A surgical implant opening insert, wherein the insert is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and the main body portion further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between the distal surface and the proximal surface, defined by the surface of the through hole, comprises The aforementioned intermediate surface includes a surgical implant opening contact portion, The surface of the through-hole includes a surgical fixation device contact portion, A surgical implant opening insert wherein the intermediate surface defines a first cross-sectional profile within the plane, and the through-hole surface defines a second cross-sectional profile within the plane, the second profile being located within the first profile.

15. The surgical implant opening insert according to claim 14, wherein at least a portion of the insert is formed of a porous material, and the porous material is adapted to promote internal bone growth.

16. The surgical implant opening insert according to claim 14 or 15, wherein at least a portion of the insert is formed of a deformable material, and the deformable material is adapted to deform when engaged with a surgical fixation device.

17. The surgical implant opening insert according to claim 14, wherein at least a portion of the insert is formed of a deformable material, the deformable material having a first pre-deformation state for the through-hole surface and a first post-deformation state for the through-hole surface, and the shape of the through-hole surface in the first post-deformation state is different from the shape of the through-hole surface in the first pre-deformation state.

18. The surgical implant opening insert according to claim 17, wherein the through-hole surface in the first deformed state is adapted to engage with one or more surfaces of a surgical fixation device.

19. The surgical implant opening insert according to claim 14, wherein the surface of the through-hole includes a bone engagement surgical fixation device contact portion.

20. The surgical implant opening insert according to claim 14, wherein at least a portion of the insert is formed of a deformable material, the deformable material having a second pre-deformation state for the intermediate surface and a second post-deformation state for the intermediate surface, and the shape of the intermediate surface in the second post-deformation state is different from the shape of the intermediate surface in the second pre-deformation state.

21. The surgical implant opening insert according to claim 20, wherein the intermediate surface in the second deformed state is adapted to engage with one or more surfaces of a surgical implant opening.

22. The surgical implant opening insert according to claim 14, wherein one or both of the distal and proximal surfaces are molded to be a continuation of the profile of the adjacent portion of the surgical implant in use and / or complementary to the profile.

23. The surgical implant opening insert according to claim 14, wherein a screw thread is provided on the surface of the through hole.

24. The surgical implant opening insert according to claim 14, wherein the first cross-sectional profile in a plane is a circular profile, and the second cross-sectional profile in the plane is also a circular profile having a diameter smaller than the diameter of the first cross-sectional profile.

25. The surgical implant opening insert according to claim 14, wherein the cross-section of the second cross-sectional profile decreases along the axis of the through hole by tapering the hole from the distal end to the proximal end, for example.

26. The surgical implant opening insert according to claim 14, wherein the cross-section of the first cross-sectional profile is reduced along the axis of the through hole by tapering the intermediate surface over a portion of the transition from the distal end to the proximal end, for example.

27. The surgical implant opening insert according to claim 14, wherein one or more surgical implant retaining elements are provided on the intermediate surface.

28. The surgical implant opening insert according to claim 14, wherein the one or more surgical implant retaining elements are, for example, male retaining elements and / or female retaining elements adapted to engage with complementary elements provided on the surgical implant within a surface defining a surgical implant opening.

29. The surgical implant opening insert according to claim 14, wherein the insert is 3D printed.

30. The surgical implant opening insert according to claim 14, wherein the first portion of the main body is formed of a first material, and the second portion of the main body is formed of a second material, and the first material and the second material differ from each other in their porosity and / or deformability.

31. The surgical implant opening insert according to claim 14, wherein the insert has an insert axis, the insert axis extends from distal to proximal, the through hole has a hole axis, and the hole axis is inclined with respect to the insert axis.

32. A method for constructing a surgical implant opening, wherein the method is a) Select a surgical fixation device for insertion into the surgical implant opening, b) Inserting the surgical implant opening into the surgical implant opening, c) Inserting the surgical fixation device through the insert and the opening, wherein the insert is A main body portion, wherein the main body portion provides a distal surface and a proximal surface, and the main body portion further provides an intermediate surface extending between the distal surface and the proximal surface, A through hole extending between the distal surface and the proximal surface, defined by the surface of the through hole, comprises The intermediate surface includes a surgical implant opening contact portion that contacts the surgical implant opening after the insert is inserted into the opening, The through-hole surface includes a surgical fixation contact portion that contacts the surgical fixation after the surgical fixation is inserted into the hole, and optionally, the intermediate surface defines a first cross-sectional profile in a plane, and the through-hole surface defines a second cross-sectional profile in the plane, the second profile being within the first profile, in the method.

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