Design of orthopedic humerus trays and bearings, and related devices.

Abstract

A prosthesis assembly for reverse shoulder arthroplasty, comprising a bearing having a tab positioned along at least a first portion of the outer edge, and a toe projection positioned along a second portion of the outer edge. The prosthesis assembly further comprises a humeral implant having a wall portion with a barb, and an insertion slot passing through the wall portion located distal to the barb, the insertion slot being configured to receive a portion of an insertion tool, the portion of the barb engaging with the tab to connect the bearing to the humeral implant.

Description

Technical Field

[0001] (Priority Claim) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 522,316, filed Jun. 21, 2023, and U.S. Provisional Patent Application No. 63 / 529,044, filed Jul. 26, 2023, the entire disclosures of which are incorporated herein by reference.

[0002] The present disclosure relates to an orthopedic shoulder prosthesis that can be used during arthroplasty surgery, as well as instruments that support the attachment, sizing, and removal of such a prosthesis.

Background Art

[0003] In the human body, tissues may need repair or replacement. Such tissues include bone, muscle, tendon, ligament, and cartilage. For example, it may be necessary to replace one or more bones of a joint with artificial components due to disease. Such replacement may require the use of orthopedic guides and other instruments to facilitate the proper orientation and sizing of one or more artificial components.

[0004] The human shoulder joint may need repair or replacement. In cases where the bone is diseased and / or the rotator cuff is damaged or absent, normal or reverse total shoulder arthroplasty may be used. This can reduce pain and allow the shoulder joint to regain normal motor function (e.g., the patient can raise the arm above the head again).

Summary of the Invention

Problems to be Solved by the Invention

[0005] This disclosure provides orthopedic prostheses including humeral implants and bearings, and systems including such prostheses and support devices that can be used in shoulder arthroplasty. The components such as bearings are shown to be configured for reverse shoulder arthroplasty. However, the concepts discussed herein can also be applied to components such as bearings used in anatomical shoulder arthroplasty. Furthermore, the concepts discussed herein can be extended to other prostheses and devices and to other joints of the human body, and are therefore applicable to orthopedic prostheses and devices for hip, knee, ankle, etc.

[0006] The inventors have achieved a more compact humeral implant and bearing, reducing the likelihood of collision with soft tissue and / or bone. The more compact design facilitates implantation in patients, is better suited to the anatomy of smaller patients, and can reduce joint trauma compared to relatively larger designs. However, the inventors recognize that the more compact design of the humeral implant and bearing may present challenges with regard to joining these components, separating the components from each other, and maintaining a durable bond between the components. [Means for solving the problem]

[0007] The inventors describe herein a humeral bearing design utilizing outwardly flexed tabs to connect a humeral implant to a locking mechanism. These outwardly flexed tabs allow for the use of a more robust connecting locking mechanism with the humeral implant, resulting in a reduction in the size of the humeral implant. The inventors further recognize the benefits of a bearing that can be configured to rotate / clock to multiple desired positions precisely based on the patient's anatomy and relative to a neutral angle / position. The humeral implant may include a skirt, which can prevent soft tissue or bone fragments from becoming lodged between the humeral implant and the bearing. However, the skirt can accommodate the outwardly flexed tabs of the bearing. The inventors also describe instruments that facilitate the connection and disconnection of the bearing to the humeral implant in a more efficient, rapid, and easily reproducible manner. This reduces the complexity and time of the surgery. The inventors also describe trial components of a bearing that can be easily manipulated and installed by the surgeon during sizing / kinematics. This further reduces the time and complexity associated with these aspects of orthopedic surgery.

[0008] The above discussion is intended to provide an overview of the subject matter of this patent application. It is not intended to provide an exclusive or comprehensive description of the invention. The following description is included to provide further information regarding this patent application.

[0009] To better illustrate the orthopedic devices and orthopedic systems disclosed herein, a list of examples, not limited to these, is provided below.

[0010] Example 1 is a prosthesis assembly for reverse shoulder arthroplasty, optionally including a bearing and a humeral implant. The bearing may have a plurality of fingers positioned along at least a first portion of its outer edge. The humeral implant may have a wall portion having a plurality of receptacles configured to receive the plurality of fingers, and since the number of receptacles exceeds the number of fingers, the bearing can be clocked relative to the humeral implant at a plurality of desired angles.

[0011] In Example 2, the prosthesis assembly of Example 1 is used, and optionally the bearing includes a plurality of tabs forming a second portion of the outer edge of the bearing, a plurality of fingers arranged along the outside of the bearing, and a plurality of tabs arranged along the inside of the bearing.

[0012] In Example 3, the prosthesis assembly of Example 2 is provided, optionally, each of the plurality of tabs is separated by at least a first ridge, and the plurality of tabs are separated from the plurality of fingers by second and third ridges, each of the plurality of tabs has a barb extending inward toward the central axis of the bearing, the humeral implant has a barb proximal to the groove adjacent to the groove, the barb extends outward from the central axis of the humeral implant, and the plurality of tabs are configured to bend outward beyond the barb of the humeral implant so that the bearing is at least partially accepted into the groove when coupled to the humeral implant.

[0013] In Example 4, the prosthesis assembly of Example 3 is used, wherein optionally, either the second or third ridge is configured to receive a portion of the wall when the bearing is clocked to the humeral implant at a plurality of desired angles.

[0014] Example 5 is the prosthesis assembly of Example 3, and optionally the humeral implant includes a skirt located distal to the groove, with the skirt projecting outward from the groove away from the central axis of the humeral implant.

[0015] Example 6 is a prosthesis assembly from any of Examples 1 to 5, and further optionally includes a bearing and multiple indicators positioned on the humeral implant, indicating multiple desired angles of the bearing relative to the humeral implant.

[0016] Example 7 is the prosthesis assembly of Example 6, and optionally, a plurality of desired angles include at least a neutral angle relative to the scapular plane, a clockwise angle relative to the neutral angle in the range of 15 to 45 degrees, and a counterclockwise angle relative to the neutral angle in the range of 15 to 45 degrees.

[0017] Example 8 is a method for assembling a prosthesis for reverse shoulder arthroplasty, which optionally includes positioning a bearing at a desired angle / position relative to a humeral tray, aligning indicators corresponding to multiple fingers of the bearing so as to be accepted by at least some of multiple receptacles of the humeral tray, engaging one or more medial edges of the articular surface and / or outer edge of the bearing, and pushing the bearing down into the humeral tray by engaging one or more medial edges so that multiple tabs of the bearing bend outward and pass over corresponding mating mechanisms of the humeral tray.

[0018] In Example 9, the method of Example 8 is followed, and optionally, the corresponding fitting mechanism of the humeral tray includes a rail and a groove, with a plurality of tabs engaging with the rail from the distal side, and a portion of the plurality of tabs also receiving into the groove.

[0019] In Example 10, the method is one of those of Examples 8 to 9, and optionally the engagement may include fully inserting the multiple fingers into at least some of the multiple receptacles so that the multiple fingers engage with the wall portion of the humeral bearing and the bearing connects to the humeral bearing.

[0020] Example 11 is a prosthesis assembly for reverse shoulder arthroplasty, comprising a bearing having a plurality of tabs forming a portion of its outer edge, each of the plurality of tabs being separated by a ridge, and each of the plurality of tabs having a barb extending inward toward the central axis of the bearing, and a humeral implant having a groove configured to receive the plurality of tabs, the humeral implant having a barb proximal to the groove adjacent to the groove, the barb extending outward from the central axis of the humeral implant, and the plurality of tabs being configured to bend outward beyond the barb of the humeral implant so that the bearing is at least partially received in the groove when coupled to the humeral implant.

[0021] Example 12 is the subject of Example 11, and optionally includes an alignment boss located on the outer circumference of the humeral implant, wherein the alignment boss is configured to be received by a ridge, the ridge comprising a plurality of ridges at desired intervals, the plurality of ridges enabling the bearing to clock relative to the humeral implant at a plurality of desired angles.

[0022] Example 13 is the subject of Example 12 and optionally includes at least a neutral angle with respect to the scapular plane, a clockwise angle in the range of 15 to 45 degrees relative to the neutral angle, and a counterclockwise angle in the range of 15 to 45 degrees relative to the neutral angle.

[0023] In Example 14, it is the subject matter of Example 12 to Example 13, and optionally, a plurality of undulations include a plurality of windows that provide a larger opening for accessing the groove and a portion of the barb of the humeral implant, the humeral implant includes a plurality of detents inside the groove at a desired interval, and one or more of the plurality of detents are accessible through the plurality of windows.

[0024] In Example 15, it is the subject matter of Example 11 to Example 14, and optionally, the humeral implant includes a skirt located on the distal side of the groove, and the skirt projects outside the groove away from the central axis of the humeral implant.

[0025] In Example 16, it is the subject matter of Example 15, and optionally, when the bearing is coupled to the humeral implant, the outer surfaces of the plurality of tabs are located radially inside the outer edge of the skirt.

[0026] In Example 17, it is the subject matter of Example 11 to Example 16, and optionally, a plurality of undulations include a plurality of windows that provide a larger opening for accessing the groove and a portion of the barb of the humeral implant, the humeral implant includes a plurality of detents inside the groove at a desired interval, and one or more of the plurality of detents are accessible through the plurality of windows.

[0027] In Example 18, it is the subject matter of Example 17, and optionally, it includes a bearing press having a clamp configured to engage one or more of the plurality of detents of the humeral implant, and an actuator configured to engage the clamp and the bearing and press the bearing against the humeral implant.

[0028] In Example 19, it is the subject matter of Example 17 to Example 18, and optionally, it includes a bearing tong press including a single part having a clamp configured to engage one or more of the plurality of detents of the humeral implant, and an actuator configured to engage the clamp and the bearing and press the bearing against the humeral implant.

[0029] In Example 20, the subject matter of Examples 17 to 19 optionally includes a tool, and the plurality of windows are configured to provide access to the tool for inserting the tool between the bearing and the humeral implant to remove the bearing from the humeral implant.

[0030] In Example 21, the subject matter of Examples 11 to 20 optionally includes a bearing having a trial component, the trial component having one or more locking mechanisms separated from the body portion by a plurality of undulations including undulations, the bridge connecting each of the one or more locking mechanisms to the body portion, and the one or more locking mechanisms being configured to bend outwardly beyond the barbs of the humeral implant at at least some of the plurality of tabs and to bend outwardly via the bridge so as to be at least partially received in a groove when the trial component is coupled to the humeral implant.

[0031] In Example 22, the subject matter of Example 21 is optionally configured such that when the trial component is assembled to the humeral implant and engaged by a glenosphere, the one or more locking mechanisms are prevented from bending inwardly along the proximal articular portion, whereby the trial component is locked to the humeral implant during range of motion evaluation.

[0032] In Example 23, the subject matter of Examples 11 to 22 optionally includes a drill guide configured to attach to the bearing, the drill guide including at least one opening for guiding a drill through the bearing to the humeral implant. <000T07>

[0033] In Example 24, the subject matter of Examples 11 to 23 optionally includes either a tray or an integral prosthesis configured such that the humeral implant is coupled to the stem via a mechanical locking mechanism.

[0034] Example 25 is a prosthesis assembly for reverse shoulder arthroplasty, optionally comprising a trial component configured to simulate a bearing, the trial component having a plurality of tabs forming its outer edge, each tab separated by a ridge, the trial component having one or more locking mechanisms separated from the main body by a plurality of ridges including the ridge, and a bridge attaching each locking mechanism to the main body; and a humeral implant having a groove configured to receive the plurality of tabs, the humeral implant having a barb proximally adjacent to the groove, the barb extending laterally from the central axis of the humeral implant, and when the trial component is coupled to the humeral implant, one or more locking mechanisms are bent laterally via the bridge so that at least some of the plurality of tabs are bent laterally beyond the barb of the humeral implant and are at least partially received in the groove.

[0035] Example 26 is an orthopedic system for reverse shoulder arthroplasty, optionally comprising: a bearing having a plurality of tabs forming an outer edge; and a humeral implant having a groove configured to receive the plurality of tabs, wherein the humeral implant has a barb proximal to the groove adjacent to the groove, the barb extending laterally from the central axis of the humeral implant, and when the bearing is coupled to the humeral implant, the plurality of tabs are bent outward over the barb of the humeral implant and are at least partially received in the groove; and a trial part having one or more locking mechanisms separated from the main body by a plurality of ridges, the one or more locking mechanisms being bent outward via the bridge so that when the bearing is coupled to the humeral implant, at least some of the plurality of tabs are bent outward over the barb of the humeral implant and are at least partially received in the groove.

[0036] In Example 27, in the orthopedic system of Example 26, the trial component optionally includes a plurality of windows defined by at least some of a plurality of tabs, providing an opening for accessing a portion of the groove and barb of the humeral implant, the humeral implant including a plurality of detents inside the groove at desired intervals, one or more of the plurality of detents being accessible through the plurality of windows.

[0037] In Example 28, in any of the orthopedic systems of Examples 26 to 27, the trial component is optionally assembled to a humeral implant and engaged by a glenosphere, with one or more locking mechanisms configured to prevent inward bending at the proximal joint portion, thereby locking the trial component to the humeral implant during range of motion evaluation.

[0038] In Example 29, in any of the orthopedic systems of Examples 26 to 28, the trial component optionally includes a skirt located distal to the groove, the skirt protruding outward from the groove away from the midline axis of the humeral implant.

[0039] In Example 30, in the orthopedic system of Example 29, optionally, when the bearing is coupled to the humeral implant, the outer surfaces of the multiple tabs are positioned radially inside the outer edge of the skirt.

[0040] In Example 31, the trial component includes multiple bearings of different configurations in any of the orthopedic systems from Examples 26 to 30.

[0041] In Example 32, the trial component for reverse shoulder arthroplasty optionally includes a trial component configured to simulate a bearing. The trial component optionally has one or more locking mechanisms separated from the main body by a plurality of ridges. A bridge attaches one or more locking mechanisms to the main body, respectively. One or more locking mechanisms may be bent via the bridge and configured to connect one or more tabs to a humeral implant. The trial component may be configured to prevent one or more locking mechanisms from bending inward at the proximal articular portion when assembled to the humeral implant and engaged by a glenosphere.

[0042] In Example 33, the trial part of Example 32 optionally includes edge reliefs and internal reliefs, and the internal reliefs communicate with the joint surface of the trial part.

[0043] In Example 34, in any of the trial components of Examples 32 to 33, one or more locking mechanisms are optionally configured to be manually bent outward so that at least some of the one or more tabs are bent outward beyond a portion of the humeral implant.

[0044] Example 35 is a prosthesis assembly for reverse shoulder arthroplasty, comprising a humeral implant having a bearing having a tab positioned along at least a first portion of the outer edge and a toe projection positioned along a second portion of the outer edge, a wall having a barb, and an insertion slot passing through the wall located distal to the barb, wherein the insertion slot is configured to receive a portion of an insertion tool, and a portion of the barb engages with the tab to connect the bearing to the humeral implant.

[0045] In Example 36, the subject of Example 35 is optionally extended so that the bearing includes at least a first and a second ridge, the first ridge being configured to receive a toe projection adjacent to the tab, and the second ridge being located outside and proximal to the toe projection and configured to receive a portion of the barb.

[0046] In Example 37, the subject of Example 36 is optionally modified so that a bearing including tabs forms the inside of the bearing, and a toe projection is positioned along the outside of the bearing.

[0047] In Example 38, the subject of Example 36 optionally includes a groove along its inner side, with the insertion slot communicating with the groove.

[0048] In Example 39, the subject of Example 38 optionally includes a skirt in which the humeral implant is located distal to the groove, the skirt protrudes outward from the groove away from the central axis of the humeral implant, and the outer edge of the bearing substantially coincides with or is located inside the skirt along at least the first portion.

[0049] In Example 40, the subject of Example 39 optionally includes a ridge on the lateral side of the wall opposite to the humeral implant that forms an undercut configured to receive the toe process.

[0050] Example 41 is a prosthesis assembly for reverse shoulder arthroplasty, optionally comprising a humeral implant having a bearing with a tab positioned along at least a first portion of its outer edge, a wall portion having a barb, and a skirt located distal to the barb, wherein the skirt protrudes outward from the tab away from the central axis of the humeral implant, the tab is substantially coincide with or located internally to the skirt, and a portion of the barb engages with the tab to connect the bearing to the humeral implant.

[0051] In Example 42, the subject of Example 41 optionally includes an insertion slot that passes through the wall located distal to the barb, the insertion slot being configured to receive a portion of the insertion tool, the portion of the barb engaging with a tab to connect the bearing to the humeral implant.

[0052] In Example 43, the subject of Example 42 optionally includes a toe projection positioned along the second portion of the outer edge.

[0053] In Example 44, the subject of Example 43 is optionally extended so that the bearing includes at least a first and a second ridge, the first ridge being configured to receive a toe projection adjacent to the tab, and the second ridge being located outside and proximal to the toe projection and configured to receive a portion of the barb.

[0054] In Example 45, the subject matter of Examples 41 to 44 optionally includes a groove along its medial side, with the skirt located distal to the groove and projecting outward from the groove away from the central axis of the humeral implant.

[0055] Example 46 is a prosthesis assembly for reverse shoulder arthroplasty, optionally including a trial component configured to simulate a bearing, the trial component having two coupling mechanisms including two arms with at least one finger along the outer edge, each arm separated by a ridge, and the humeral implant is configured to receive and couple with the trial component.

[0056] In Example 47, the subject of Example 46 is optionally modified so that the humeral implant has a wall portion with a barb and an insertion slot passing through the wall portion located distal to the barb.

[0057] In Example 48, the subject of Example 47 is optionally modified so that the humeral implant includes a groove along the medial side adjacent to the wall and barb, and the insertion slot communicates with the groove.

[0058] In Example 49, the subject of Example 48 optionally includes a skirt in which the humeral implant is located distal to the groove, the skirt protrudes outside the groove away from the central axis of the humeral implant, and the outer edge of the trial part is substantially coincided with or located inside the skirt.

[0059] In Example 50, the subject of Example 49 optionally includes a ridge on the opposite wall of the humeral implant on the lateral side that forms an undercut configured to receive two bonding mechanisms.

[0060] Example 51 is at least one machine-readable medium that, when executed by a processing circuit, includes instructions for the processing circuit to perform an operation that carries out any of Examples 1 through 50.

[0061] Example 52 is an apparatus that includes means for carrying out any of Examples 1 to 50.

[0062] Example 53 is a method that implements any of Examples 1 to 50.

[0063] In some embodiments, the described examples may include any or a combination of the above examples of apparatus and systems, which include any or a combination of the individual features disclosed herein. [Brief explanation of the drawing]

[0064] The above and other features and advantages of this disclosure, as well as the methods for achieving them, will become clearer and the disclosure itself will be better understood by referring to the following description of embodiments together with the accompanying drawings.

[0065] [Figure 1] Figure 1 is an anatomical diagram of the patient's shoulder joint. [Figure 2] Figure 2 is a schematic diagram of a prosthesis assembly that is implanted in the patient's humerus and forms at least a portion of the shoulder joint. [Figure 3]Figure 3 is a perspective view of a bearing according to one embodiment of the present application. [Figure 3A-3C] Figures 3A to 3C are plan views of the bearing in Figure 3. [Figure 3D] Figure 3D is a cross-sectional view of a portion of the bearing in Figure 3 according to one embodiment of this application, showing one of several tabs and other mechanisms. [Figure 4] Figure 4 is a perspective view of another bearing according to one embodiment of this application. [Figure 5A-5B] Figures 5A and 5B are a plan view and a perspective view of a humerus tray according to one embodiment of this application. [Figure 6] Figure 6 shows an upper arm stem according to one embodiment of this application. [Figure 7] Figure 7 shows another example of the upper arm stem according to this application. [Figure 8] Figure 8 is a perspective view of an insertion device for assembling a humeral tray with an humeral stem according to one embodiment of this application. [Figure 8A] Figure 8A is a magnified view of the distal end of the insertion device that engages with the humerus tray in Figure 8. [Figures 9A-9C] Figures 9A to 9C show the bearings from Figures 3 to 3D, according to one embodiment of this application, coupled to the humerus trays of Figures 5A and 5B. [Figure 10] Figure 10 is a perspective view showing the process by which the bearings shown in Figures 3 to 3D, according to one embodiment of this application, are coupled to the humerus tray, with multiple tabs of the bearing bending outward beyond the barbs or other mechanisms of the humerus tray. [Figure 11] Figure 11 is a perspective view showing the bearing and humerus tray of Figure 10 connected together, according to one embodiment of this application. [Figure 11A] Figure 11A is an enlarged view showing one of the tabs of the bearing in Figure 11 according to one embodiment of the present application, which engages with the mechanism of the humerus tray including the barb and is partially fitted into the groove. [Figure 12] Figure 12 shows a method, bearing press, and tray clamp that can be used to assemble a bearing to a humerus tray according to one embodiment of the present application. [Figure 13] Figure 13 is a perspective view of a tong press that can be used to assemble a bearing according to one embodiment of the present application onto a humerus tray. [Figure 14] Figure 14 is a perspective view of an instrument, such as a bone knife, that can be used to disassemble a bearing from a humerus tray according to one embodiment of this application. [Figures 15A-15B] Figures 15A and 15B are perspective views of a drill guide that can be used to disassemble a bearing from a humerus tray according to one embodiment of the present application. [Figures 16A-16B] Figures 16A and 16B are perspective views of a trial component simulating a bearing according to one embodiment of this application. [Figures 17A-17B] Figures 17A and 17B show a humerus tray according to one embodiment of the present application and trial components assembled and clocked in relatively different positions. [Figures 18A-18B] Figures 18A and 18B are perspective views of a humerus tray relating to yet another example of this application. [Figure 18C] Figure 18C is a plan view of the humerus tray shown in Figures 18A and 18B. [Figures 19A-19C] Figures 19A to 19C are plan and perspective views of a bearing relating to yet another example of this application. [Figure 20] Figure 20 is an enlarged view of a portion of the outer side of the humerus tray shown in Figures 18A to 18C and the bearing assembly shown in Figures 19A to 19C, according to one embodiment of this application. [Figure 21] Figure 21 is an enlarged view of a portion of the inside of the humerus tray shown in Figures 18A to 18C and the bearing assembly shown in Figures 19A to 19C, according to one embodiment of this application. [Figures 22A-22B] Figures 22A and 22B are perspective views of the humerus tray shown in Figures 18A to 18C and the bearing assembly shown in Figures 19A to 19C, according to one embodiment of this application. [Figure 23] Figure 23 shows how to form the assembly shown in Figure 20 to Figure 22B. [Figures 24A-24E]Figures 24A to 24E show various diagrams of a second trial component that simulates the bearing shown in Figures 19A to 19C according to one embodiment of this application. [Figures 25A-25B] Figures 25A and 25B are perspective views of a bearing according to one embodiment of this application. [Figures 26A-26B] Figures 26A and 26B are perspective views of another example of a bearing according to one embodiment of this application. [Figure 27] Figure 27 is a perspective view of a humerus tray according to one embodiment of this application. [Figures 28A-28B] Figures 28A and 28B are perspective views of an orthopedic assembly relating to one embodiment of this application, in which the bearings of Figures 26A and 26B are coupled to the humerus tray of Figure 27. [Figure 28C] Figure 28C is a cross-sectional view of the orthopedic assembly shown in Figures 28A and 28B. [Figure 29] Figure 29 is a perspective view of an insertion device for assembling the humerus tray shown in Figure 27 with the bearings shown in Figures 26A and 26B, according to one embodiment of this application. [Figures 30A-30B] Figures 30A and 30B are perspective and plan views of a trial part simulating a bearing according to one embodiment of this application. [Figure 31A] Figure 31A shows how to assemble the trial parts shown in Figures 30A and 30B, according to one embodiment of this application, with the humerus tray shown in Figure 27. [Figure 31B] Figure 31B shows a method for disassembling the trial parts of Figures 30A and 30B, according to one embodiment of this application, from the humerus tray of Figure 27. [Figure 32] Figure 32 shows a tool configured to remove the bearings of Figures 26A and 26B, according to one embodiment of the present application, from the humerus tray of Figure 27. [Figure 32A] Figure 32A shows a portion of the tool in Figure 32 according to one embodiment of this application, and is an enlarged view of the bearings in Figures 26A and 26B from the humerus tray in Figure 27.

[0066] Corresponding reference letters indicate corresponding parts throughout several drawings. The examples provided herein illustrate embodiments of the disclosure and should not be construed as limiting the scope of the disclosure in any way. [Modes for carrying out the invention]

[0067] In describing embodiments of this disclosure as described with respect to the drawings, certain terms are used for clarity. However, this disclosure is not intended to be limited to the specific terms and figures used herein, and it should be understood that each specific term includes all technical equivalents.

[0068] This disclosure relates to orthopedic devices and systems that can be used in joint replacement surgeries such as reverse shoulder arthroplasty. Although these devices and systems are described in relation to reverse shoulder arthroplasty, they can be used in other procedures and other joints as described above.

[0069] Figure 1 shows a shoulder joint 100 with several ligaments removed. As shown, the shoulder joint 100 includes the humerus 102 and the scapula 104, which has a glenoid cavity 106 with a socket 108 for interacting with the humeral head 110 of the humerus 102. The humeral head 110 can perform articular movement within the socket 108, allowing for normal movement of the shoulder joint 100. Disease can cause degeneration of the bone or soft tissue of the humeral head 110 and / or the scapula 104. These can cause pain and / or adversely affect shoulder joint function. Typically, surgical intervention is required to replace the shoulder joint and restore shoulder joint function.

[0070] Figure 2 shows a schematic diagram of a prosthesis assembly 116 incorporated into a shoulder joint 100. For simplicity, the corresponding prosthesis assembly incorporated into the scapula is not shown. The prosthesis assembly 116 may include a humeral implant 118 and a bearing 120. The humeral implant 118 may include a humeral tray 122 and a stem and / or stemless anchor 124. In some embodiments, the humeral implant 118 may not include the humeral tray and humeral stem as separate components, and it is understood that these are integrated into a single component.

[0071] The humeral implant 118 can be fitted into a recess 119 formed in the proximal end 126 of the humerus 102. The embodiment in Figure 2 shows a fin design of a stem and / or stemless anchor 124 with shortened longitudinal length. However, more traditional stem designs have also been considered for the stem and / or stemless anchor 124. As shown in Figure 2, the humeral tray 122 can interact with and bond with the bearing 120 and the stem and / or stemless anchor 124. The bearing 120 can bond with the humeral tray 122 using a locking mechanism further described herein. The concepts of this application are not limited by the design examples of the bearing 120, humeral tray 122 and stem and / or stemless anchor 124 provided herein. Similarly, the humeral examples should not be interpreted restrictively, but are merely illustrative.

[0072] Reverse total shoulder arthroplasty is one of several types of shoulder joint replacement surgery. In reverse total shoulder arthroplasty, a portion of the patient's humerus and a portion of the patient's glenoid cavity are replaced and / or augmented by implantable components. In reverse shoulder arthroplasty, the artificial joint components include a glenoid implant (not specifically shown in Figure 2) that functions as a “ball” (a hemispherical or shaped replica of the humeral head) and a cup-shaped bearing 120 to receive the “ball”. In reverse shoulder arthroplasty, the bearing 120 functions as the glenoid cavity, with the “ball” on the glenoid side of the shoulder joint. In other words, the relationship of the artificial joint components in a surgically created shoulder joint is the reverse of that of an anatomically correct shoulder joint.

[0073] Figures 3 to 3C show an example of a bearing 120. The bearing 120 may include an articulated surface 128, an outer edge 130 or outer surface, a plurality of tabs 132, a plurality of ridges 134, and an index 136.

[0074] The bearing 120 can be formed from high-density polyethylene (HDPE) or other suitable implantable material. The bearing 120 is available in a range of standard sizes, including different thicknesses and diameters. The bearing 120 may have a central axis CL. The articular surface 128 forms the most proximal side of the bearing 120 and may be cup or bowl shaped to receive the ball component incorporated into the glenoid fossa. The articular surface 128 can be angled or inclined according to some embodiments. Thus, the bearing 120 may have a thickness that changes, for example, from the inside to the outside, or generally has a sloped thickness. The articular surface 128 may extend to adjacent to the outer edge 130. The outer edge 130 may form the outside of the bearing 120. The outer edge 130 may extend near or distal to the articular surface 128 to a plurality of tabs 132. The outside of the plurality of tabs 132 may form a portion of the outer edge 130.

[0075] The multiple tabs 132 may have lips, barbs, or other mechanisms configured to engage with a humeral implant (not shown), as further described and shown herein. The multiple tabs 132 may be circumferentially arranged along the distal portion of the bearing 120 and may form its distal edge. The multiple tabs 132 may be spaced apart from each other by each of the multiple ridges 134.

[0076] The multiple ridges 134 may include gaps between adjacent tabs 132. The multiple ridges 134 may include multiple windows 134A and alignment mechanisms 134B. The multiple windows 134A may be relatively larger in size than the alignment mechanisms 134B. Similar to the multiple ridges 134, the multiple windows 134A can be at least partially defined by portions of the multiple tabs 132. The alignment mechanisms 134B may have desired spacing from one another, as described later. The index 136 may be located adjacent to the alignment mechanisms 134B and positioned on the nearby outer edge 130. The index 136 may have different shapes, such as including a relatively large index 136A indicating a neutral position / angle with respect to the scapular plane.

[0077] Figure 3D shows a cross-section of a portion of the bearing 120, specifically one of the multiple tabs 132. As shown in Figure 3D, each of the multiple tabs 132 may include a barb 138 extending inward toward the centerline axis CL of the bearing 120 (Figures 3-3C). The multiple tabs 132, including the barbs 138, can be spaced apart from the interior of the bearing 120 by recesses 140 or grooves. A portion of the interior of the bearing 120 may include a chamfered surface 142 designed to mount and engage with the humerus tray. The chamfered surface 142 can improve assembly by preventing coupling when the bearing 120 and the humerus tray are not assembled directly axially.

[0078] Figure 4 shows a second embodiment of bearing 120A, which has a structure similar to bearing 120 in Figures 3-3D, but does not include an angled or inclined design. Thus, the articulated surface 128A is not angled or inclined, and bearing 120A can have similar or the same thickness on both the inner and outer sides, for example.

[0079] Figures 5A and 5B show the humerus tray 122. The humerus tray 122 may include a central axis CL, a main body 144, a stem 146, a rail 147, a barb 148, a groove 150, multiple detents 152, a skirt 154, and an alignment boss 156.

[0080] The main body 144 is generally dish-shaped or other curved and is configured to receive the distal portion of the bearing (not shown). The stem 146 extends distally to the main body 144 and is configured to have a taper or other mechanical feature for coupling with the humeral stem (not shown). A rail 147 or other mechanism extends from the main body 144 and can form the lateral proximal edge of the humeral tray 122. The rail 147 may include a chamfered surface 142A configured to engage with the chamfered surface 142 of the bearing 120 (see Figure 3D).

[0081] The barb 148 can project outward from the rail 147. The barb 148 can generally project outward from the central axis CL of the humerus tray 122. The barb 148 can extend over a smaller area than the entire circumference of the humerus tray 122. The barb 148 can include, for example, an overhang mechanism of the rail 147. The barb 148 can form part of the groove 150.

[0082] The groove 150 can extend over most of the periphery of the humerus tray 122 distal to the barb 148. Multiple detents 152 can be spaced apart from each other and positioned in the groove 150 at desired intervals. Multiple detents 152 may be recesses within the groove 150. A skirt 154 can be positioned distal to the groove 150 and form part of it. The skirt 154 can project radially outward from the groove 150 and actually project radially outward from the barb 148 and rail 147. An alignment boss 156 can be positioned on the outer circumference of the humerus tray 122. Although a single alignment boss (alignment boss 156) is illustrated, in further examples, two or more alignment bosses may be used at circumferential positions at different intervals. The alignment boss 156 can extend from the skirt 154 and project from the rail 147. The alignment boss 156 can be configured to be received by one of the multiple undulations 134 (e.g., the alignment mechanism 134B of the bearing 120 in Figures 3-3C), as will be further described and illustrated. The alignment boss 156 can include, for example, an index. The alignment boss 156 can be located, for example, on the innermost side of the humerus tray 122.

[0083] Figure 6 shows a stem and / or stemless anchor 124, which may include a finned design as an example. The stem and / or stemless anchor 124 may be configured to connect with a humeral tray 122 (Figures 5A and 5B), as further described and illustrated. As previously stated, the stem and / or stemless anchor 124 may be configured to be embedded in a prepared recess of the proximal humerus. The design of the stem and / or stemless anchor 124 may sometimes be described as a stemless or stem-free configuration. The stem and / or stemless anchor 124 may be configured as a Sidus® Stem-Free Shoulder prosthesis, a Comprehensive® Nano Stemless Shoulder, or other commercially available and manufactured by Zimmer Biomet Inc. in Warsaw, Indiana. The humeral implant designs shown in Figures 6 and 7 are purely illustrative and are provided only to facilitate practitioner understanding.

[0084] Figure 7 shows a stem and / or stemless anchor 124A that can be used with the humeral tray 122 (Figures 5A and 5B), which is another example having an elongated length designed to be inserted into a prepared recess in the humerus. Other humeral stem designs, not specifically shown, have also been considered.

[0085] Figure 8 shows an example of an insertion device 200. The insertion device 200 can be configured to engage and connect with the humerus tray 122. Figure 8A shows a locking mechanism 202, such as a movable jaw 204, which can be configured to engage with a groove 150 (Figure 8A) or a portion of a plurality of detents 152 (Figure 8A) to connect the humerus tray 122 to the insertion device 200. Using the insertion device 200, a surgeon can insert the humerus tray 122 into the humeral stem (e.g., a stem and / or stemless anchor 124, a stem and / or stemless anchor 124A, etc.) to connect the humerus tray 122 to the humeral stem. The insertion device 200 can be used, for example, to connect the humerus tray 122 to the humeral stem while the humeral stem is already implanted in the shoulder joint. However, such a procedure can also be performed on a back bench or in other locations.

[0086] Figures 9A-9C show the orthopedic assembly 300 of the humerus tray 122 and bearing 120. The bearing 120 is coupled to the humerus tray 122. Figure 9A shows that the alignment boss 156 is received by one of the alignment mechanisms 134B (one of a plurality of ridges 134). As shown in Figure 9A, the bearing 120 is positioned at a neutral angle or in a neutral position relative to the humerus tray 122 with index 136A aligned with the scapular plane. The alignment mechanisms 134BB and 134BBB (Figure 9A) can be positioned clockwise or counterclockwise (for example, by angle) relative to the alignment boss 156 at a desired circumferential position in the neutral position shown in Figure 9A. This angle may be, for example, between 15 and 45 degrees in the clockwise direction and between 15 and 45 degrees in the counterclockwise direction. The angle in the clockwise direction may be the same as the angle in the counterclockwise direction, or it may be a different angle.

[0087] Figure 9B shows one of the multiple undulations 134, in particular one of the multiple window portions 134A, which is located adjacent to one of the multiple detents 152, a portion of the rail 147, a portion of the barb 148, and a portion of the groove 150, allowing access. A tool (illustrated in Figure 14) can be inserted through one of the multiple window portions 134A, which are configured to provide access for inserting a tool between the bearing 120 and the humerus tray 122 in order to remove the bearing 120 from the humerus tray 122.

[0088] As shown in Figures 9B and 9C, when the bearing 120 is coupled to the humerus tray 122, the outer surfaces of the multiple tabs 132 are positioned radially inward or flush with the outer edge of the skirt 154. The skirt 154 may extend to protect the multiple tabs 132, barbs 148, and grooves 150 (which together form a locking mechanism as shown in Figure 9B) from contact with tissue.

[0089] Figure 10 shows the bearing 120 in the process of being coupled to the humerus tray 122. The alignment boss 156 can be aligned with one of the alignment mechanisms 134B. As shown in Figure 10, the multiple tabs 132 can be configured to bend outward from the centerline axis CL of the bearing 120 (as indicated by the arrows) by engagement of the multiple tabs 132 with a portion of the rail 147 and / or barb 148. Thus, the multiple tabs 132 are configured to bend outward beyond the barb 148 of the humerus tray 122, as shown in Figure 10. The assembly process in Figure 10 can be performed manually. However, assembly devices such as those in Figures 12 and 13 are intended to provide a method for on-site assembly when the patient has poor bone quality or when the patient has a fracture. The devices provide a method for pressing the bearing into the tray without applying a reaction force to the patient's bone.

[0090] Figures 11 and 11A show the bearing 120 coupled to the humerus tray 122. In such a relative coupling position, as shown in Figure 11A, when the bearing 120 is coupled to the humerus tray 122, the multiple tabs 132, including the barb 138, are at least partially received into the groove 150. The edge snap configuration of the bearing 120 and the humerus tray 122 can provide an audible sound when the multiple tabs 132 pass over the barb 148, engage with the barb 148 distally, and are partially received into the groove 150. Furthermore, the configuration of the bearing 120 with multiple ridges 134 and indicators 136, as shown in Figures 10 and 11, can facilitate confirmation of alignment / clocking before and after coupling. Visual confirmation that the bearing is installed is also provided by the near-zero gap between the bearing and the tray skirt.

[0091] Figure 12 shows a method 400 for joining a bearing 120 to a humerus tray 122 using a two-component instrument assembly including a bearing press 402. The bearing press 402 includes a clamp 404 and an actuator 406. The clamp 404 can be configured to engage with one or more grooves 150 and / or detents 152 of the humerus tray 122. This process can be performed by rotating a knob 408, as indicated by the arrow R on the left side of the viewer's hand. The actuator 406 can be configured to engage with the clamp 404 (when the clamp is engaged with the humerus tray 122) and the bearing 120, and to press the bearing 120 against the humerus tray 122 in the manner shown in Figures 10 to 11A and Figure 12.

[0092] Figure 13 shows an integrated instrument assembly including a bearing tong press 500 having a clamp 502 configured to engage with one or more grooves 150 and / or detents 152 of a humerus tray 122. The bearing tong press 500 may include an actuator 504 configured to engage the clamp 502 with a bearing 120 and to press the bearing 120 into the humerus tray 122, as shown in Figures 10 to 11A and Figure 13.

[0093] Figure 14 shows a tool such as a bone knife 600 that can be used to remove the bearing 120 from the humerus tray 122 (see Figure 9B). Referring to Figure 9B, the bone knife 600 (see Figure 14) is configured to be inserted through one or more of the multiple windows 134A. In other words, the multiple windows 134A are configured to provide access for the bone knife 600 to be inserted between the bearing 120 and the humerus tray 122, and for removing the bearing 120 from the humerus tray 122.

[0094] Figures 15A and 15B show a drill guide 700, which is another tool that can be used to remove the bearing 120 from the humerus tray 122. The drill guide 700 is configured to attach to the bearing 120 as shown in Figure 15B. The drill guide 700 includes at least one aperture 702 for guiding a drill through the bearing 120 into the humerus tray 122. Once a hole is formed in the bearing 120, a fastener or other component (not shown) is inserted into the drill hole and pressed against the humerus tray 122. By rotating the fastener, the bearing 120 can be pushed out of the humerus tray 122, separating the bearing 120 from the humerus tray 122.

[0095] Figures 16A and 16B show the trial part 800. The trial part 800 is configured to simulate the bearing configuration (shape, size, position, etc.) discussed previously. Therefore, the trial part 800 is available in, for example, several standard sizes and shapes. The trial part 800 is a temporary part that can be connected to the humerus tray 122 (see Figures 17A and 17B) or humerus tray trial discussed previously. The trial part 800 can be used to determine the size of the bearing 120 (shown previously) and / or to practice arthrokinematics such as range of motion. The trial part 800 has several locking mechanisms 802A and 802B separated from the main body 804. The several locking mechanisms 802A and 802B can be separated from the main body 804 by several ridges 806, including an internal ridge 806A and a lateral ridge 806B. The bridge 808 functions as a link that attaches each of the multiple locking mechanisms 802A and 802B to the main body 804 and extends between the internal relief 806A and the side relief 806B. The multiple locking mechanisms 802A and 802B are bent outward via the bridge 808, allowing at least some of the multiple tabs 132 to be bent outward.

[0096] Figures 17A and 17B show different examples of trial part 800A having a different shape from trial part 800 in Figures 16A and 16B. Furthermore, Figures 17A and 17B show that the multiple tabs 132 are bent outward by the multiple locking mechanisms 802A and 802B and extend beyond the barb 148 of the humeral tray 122. This allows the multiple tabs 132 to be at least partially received in the groove 150 when trial part 800A is connected to the humeral tray 122, as shown in Figures 17A and 17B. Trial part 800A (and in fact trial part 800 in Figures 16A and 16B) can include the previously described mechanism, namely, the articular surface 128, the outer edge 130 or lateral portion, the multiple tabs 132, the multiple ridges 806, and the indicator 136 in the manner discussed with respect to the bearing 120 (see Figures 3A to 3D). During range of motion evaluation, the trial part 800A (and actually the trial part 800) has an articulated surface 128 assembled to the glenosphere, and the configuration of multiple tabs 128, a bridge 808 (see Figures 16A and 16B), multiple locking mechanisms 802A and 802B (see Figures 16A and 16B), and the engagement and configuration by which the glenosphere is pressed along the articulated surface to the proximal portions of the multiple locking mechanisms 802A and 802B (see Figures 16A and 16B) prevents the multiple locking mechanisms 802A and 802B (see Figures 16A and 16B) from bending inward at the proximal articulation portion. This configuration of the trial part 800 (and trial part 800) will effectively lock the trial part 800A (and trial part 800) into the tray during range of motion evaluation, avoiding unexpected separation.

[0097] Figures 18A-18C show a humerus tray 922 relating to another example. The humerus tray 922 may include features different from and similar to the humerus tray 122 (Figures 5A and 5B). The humerus tray 922 may include a central axis CL (Figure 18A only), a main body 944, a stem 946, a rail 947, a barb 948, a groove 950, a skirt 954, indicators 970A, 970B, 970C and 970D, a wall 972, and a plurality of receptacles 974.

[0098] The main body 944 is generally dish-shaped or other curved and is configured to receive the distal portion of the bearing (not shown). The stem 946 extends distally from the main body 944 and is configured to connect to the humeral stem (not shown) with a taper or other mechanical mechanism. The rail 947 may include a chamfered surface 142A configured to engage with the corresponding chamfered surface of the bearing, as previously discussed. The rail 947 or other mechanism may extend proximal from the inner side 976 of the main body 144 and form the lateral-medial-proximal edge of the humeral tray 122.

[0099] The rail 947 can be connected to the first and second ends of the wall portion 972. The rail 947 may have a semicircular or other shape along its lateral proximal edge. The wall portion 972 may be positioned to project outward from the rail 947 relative to the central axis CL. This is because the wall portion 972 does not have an adjacent skirt 954. The wall portion 972 extends proximal from the outer side 978 of the main body portion 944 and can form the lateral proximal edge and lateral outer circumference of the humerus tray 122. The wall portion 972 may have a semicircular or other shape along its lateral proximal edge. The wall portion 972 may have a proximal rail 972A. Multiple receptacles 974 may be formed distal to the proximal rail 972A by the wall portion 972. Multiple receptacles 974 can be arranged around the wall portion 972 at predetermined intervals from one another (for example, one receptacle every 10 degrees, one every 15 degrees, etc.).

[0100] The barb 948 protrudes outward from the rail 947 and may have a structure similar to the previously discussed barb 148 (Figures 5A and 5B). Thus, the barb 948 can generally protrude outward from the central axis CL of the humerus tray 922. The barb 948 can extend over a smaller area than the rail 947 encircles the entire perimeter, and over a smaller area than the rail 922 encircles the entire perimeter. The barb 948 may include an overhanging mechanism, such as a projection on the rail 947. The barb 948 may form a portion of the groove 950.

[0101] The groove 950 may extend to surround half or less (and possibly more than half) of the humeral tray 922 distal to the barb 948. The skirt 954 may be positioned distal to the groove 950 on the medial 976 and may form a portion of the groove 950. The skirt 954 may project radially outward from the groove 950 and, in fact, radially outward from the barb 948 and rail 947.

[0102] Referring to Figures 18A and 18C, indices 970A, 970B, and 970C can be positioned at different locations on the humerus tray 922. Indicator 970A can be positioned, for example, on the skirt 954 and may be a notch, dimple, line, etc. Indicator 970A can indicate the neutral position relative to the neutral position and the clock (angle) position. Indicator 970B can be positioned on the proximal or lateral surface of the rail 947 and may indicate the innermost position and / or the neutral position. Indicator 970C can be positioned on the proximal surface of the main body 944 and may indicate the neutral position relative to the neutral position and the clock (angle) position. Moving to Figure 18B, indicator 970D can be positioned, for example, on the wall 972 along its outer circumference.

[0103] Figures 19A-19C show a bearing 920 relating to another example. The bearing 120 may include an articulated surface 928 (Figure 19B only), an outer edge 930 or outer side, a plurality of tabs 932, a plurality of ridges 934A, 934B and 934C, an index 936 (Figures 19B and 19C), and a plurality of fingers 980.

[0104] Figure 19A shows the distal side of a bearing 920 configured to connect to a humeral tray 922 (Figures 18A to 18C). The bearing 920 in Figure 19A includes a plurality of tabs 932, a plurality of ridges 934A, 934B and 934C, and a plurality of fingers 980.

[0105] The bearing 920 can be formed from high-density polyethylene (HDPE) or other suitable implant material. The bearing 920 is available in a range of standard sizes, including different thicknesses and diameters. The bearing 920 may have a central axis CL (Figure 19A only). The articular surface 928 forms the nearest side of the bearing 920 and may be cup or bowl shaped to receive a ball component attached to the articular fossa. The articular surface 928 may be angled or inclined according to several embodiments. Thus, the bearing 920 may have a thickness that changes from the inside to the outside, for example, or generally has a sloped thickness. The articular surface 928 may extend to adjacent to the outer edge 930. The outer edge 930 may form the side of the bearing 920. The outer edge 930 may extend distally from the articular surface 928 (Figure 19B) or from a position adjacent to the articular surface 928 to a plurality of tabs 932. The outside of the plurality of tabs 932 may form a portion of the outer edge 930.

[0106] The multiple tabs 932 may have lips, barbs, or other mechanisms configured to engage with a humeral implant (not shown), as further described herein. The multiple tabs 932 may be arranged around the medial distal portion of the bearing 920 and may form its distal edge. The multiple tabs 932 may be spaced apart from each other by one or more of the multiple ridges 934A. The multiple tabs 932 may be spaced apart from the multiple fingers 980 by the multiple ridges 934A.

[0107] Multiple ridges 934A may include gaps between adjacent multiple tabs 932, and multiple ridges 934B and 934C may be gaps between multiple tabs 932 and multiple fingers 980. Multiple fingers 980 may have desired spacing that matches / corresponds to at least some spacing of multiple receptacles 974 (Figures 18A-18C). Indicators 936 are positioned on the outer edge 930 and may be positioned, for example, adjacent and proximal to the outer multiple fingers 980 and / or adjacent to one or more of the inner multiple ridges 934A. Indicators 936 may have different shapes to include a relatively large indicator 936A that indicates a neutral position / angle with respect to the scapular plane.

[0108] The multiple fingers 980 may be projections extending outward from the central axis CL from the multiple undulations 934B and 934C. The multiple fingers 980 are individual projections and may be positioned along or near the outer edge 930 of the bearing 920.

[0109] Multiple tabs 932 can be constructed in the same manner as multiple tabs 132 shown in 3D from Figure 3A above. However, multiple tabs 932 can be arranged in a smaller area (e.g., half or less of the outer edge 930) and along the inside of the bearing 920. Multiple tabs 932 may include barbs as described above, which are spaced apart from the inside of the bearing 920 by recesses 940 or grooves (see Figure 19A).

[0110] Figure 20 shows the outer portion of assembly 1000 having a bearing 920 engaging with a humerus tray 922, where the multiple fingers 980 can be shaped to have tapered or other mechanisms, and a portion of the multiple fingers 980 engages with the wall portion 972 of the humerus tray 922 after being inserted into the multiple receptacles 974. The multiple fingers 980 can be configured to create press-fit or other type of engagement with the wall portion 972 when fully inserted into the multiple receptacles 974. The number of multiple receptacles 974 can exceed the number of multiple fingers 980. This allows the bearing 920 to be rotated / clocked to a desired angle relative to the humerus tray 922, as described above. For example, the multiple fingers 980 can be selectively positioned clockwise or counterclockwise (e.g., by angle) at a desired circumferential position relative to a neutral position, and different multiple fingers 980 can be inserted into different multiple receptacles 974. This angle may be, for example, between 15 and 45 degrees in the clockwise direction and between 15 and 45 degrees in the counterclockwise direction. The clockwise angle may be the same as or different from the counterclockwise angle. Figure 20 shows an index 936, including an index 936A (for the neutral position), a plurality of fingers 980, and at least several plurality of receptacles 974, positioned along the outer edge 930 of a bearing 920 adjacent to the wall 972. The index 936 aligns with the index 970D along the wall 972 and can correspond to one or more positions of the plurality of fingers 980.

[0111] Figure 21 shows the inside of the humerus tray 922 assembly 1000, which has a bearing 920 and one of several undulations 934A aligned with an index 970A located on the proximal and / or outer surface of the skirt 954. This alignment indicates that the bearing 920 is positioned neutrally relative to the humerus tray 922.

[0112] Figures 22A and 22B show assembly 1000 with bearing 920 and humerus tray 922 coupled. As shown in Figure 22B, the multiple fingers 980 are not accepted by all of the multiple receptacles 974. Furthermore, the ridges 934B and / or 934C provide a sufficiently large gap between the ends of the multiple fingers 980 and the multiple tabs 932, allowing bearing 920 to rotate relative to humerus tray 922 and clock to the desired angle as described above.

[0113] Figure 23 shows a method 1100 for coupling the bearing 920 to the humeral tray 922 to form the aforementioned assembly 1000. Method 1100 may include positioning the bearing 920 at a desired angle / position relative to the humeral tray 922 1102. This includes aligning an index or other mechanism, as described herein, such as aligning a plurality of fingers 980 to receive into at least a plurality of receptacles 974 1104. Method 1100 may include manually or instrumentally engaging one or more medial edges (indicated by ellipses) of the articular surface 928 and / or the outer edge 930 of the bearing 920 1106. The inner bearing 920 is pushed down (e.g., by engagement with one or more medial edges) such that a plurality of tabs 932 bend outward, pass over the rail 947, and engage with the rail 947 from the distal side with a portion of the tabs 932 received in the groove 950, as described and illustrated above. The engagement method 1100 involves fully inserting the multiple fingers 980 into at least some of the multiple receptacles 974, so that the multiple fingers 980 engage with the wall portion 972, thereby connecting the bearing 920 to the humeral tray 922 and preventing it from being easily separated except by using the aforementioned instrument.

[0114] Figures 24A to 24E show the trial component 1200. Figures 24A and 24B are perspective views of the trial component 1200. Figure 24C is a proximal plan view of the trial component 1200. Figure 24D is an inner plan view of the trial component 1200. Figure 24E is a distal plan view of the trial component 1200.

[0115] The trial component 1200 can be configured to simulate the configuration (shape, size, position, etc.) of the bearing 920 described above in relation to Figures 19A to 23. Therefore, the trial component 1200 is available in, for example, multiple standard sizes and shapes. The trial component 1200 may be a temporary component that can be coupled to either the humerus tray 922 described above (see Figures 18A to 18C and Figures 20 to 23) or a humerus tray trial. The trial component 1200 can be used to resize the bearing 920 (described above) or to practice arthrokinematics such as range of motion. Unlike the previous trials described herein, the trial component 1200 has one or more locking mechanisms 1202 rather than multiple locking mechanisms. One or more locking mechanisms 1202 can be separated from the main body 1204. One or more locking mechanisms 1202 can be separated from the main body 1204 by a plurality of ridges 1206, including an internal ridge 1206A and a lateral ridge 1206B. A bridge 1208 acts as a link attaching each of the one or more locking mechanisms 1202 to the main body 1204 and extends between the internal ridge 1206A and the lateral ridge 1206B. One or more locking mechanisms 1202 can be bent outward via the bridge 1208, allowing at least some of the plurality of tabs 932 to be bent outward. One or more locking mechanisms 1202 can be located inside, for example, a trial part 1200. The trial part 1200 may include other mechanisms having a bearing 920 (Figures 19A to 23), including a plurality of fingers 980, articulated surfaces 928, index 936, ridges 934A and 934B, and a plurality of tabs 932, as described above.

[0116] Figures 25A and 25B show an example of bearing 1320. Bearing 1320 may include an articulated surface 1328 (Figure 25A), an outer edge 1330 or outer side, a single continuous tab 1332, multiple ridges 1334A (Figure 25B), 1334B, 1334C (Figure 25B), 1334D, and a toe projection 1335.

[0117] The bearing 1320 can be formed from high-density polyethylene (HDPE) or other suitable embeddable material. The bearing 1320 is available in a range of standard sizes, including different thicknesses and diameters. The bearing 1320 may have a central axis CL (Figure 25A). The articular surface 1328 in Figure 25A forms the most proximal side of the bearing 1320 and may be cup or bowl shaped to receive the ball component mounted in the articular fossa. The articular surface 1328 may be a flat portion with edges of relatively equal height, according to some examples. Thus, the bearing 1320 may generally have the same thickness from the inside to the outside, for example. The articular surface 1328 may extend to adjacent to the outer edge 1330. The outer edge 1330 may form the side of the bearing 1320. The outer edge 1330 may extend distally from the articular surface 1328 or an adjacent position thereto to a single continuous tab 1332 on the inside, extending over 100 degrees or more on the inside of the outer edge 1330. The single continuous tab 1330 is formed by a ridge 1334A along its inner side and may be shaped as a snap or lip having an overhang mechanism such as a projection (e.g., a lip, barb, or other mechanism) extending to the ridge 1334A. The single continuous tab 1332 may be configured to engage with a humeral implant (not shown), as further described and shown herein. The single continuous tab 1332 may be circumferentially positioned along the distal portion of the bearing 1320 and may form its distal edge.

[0118] Multiple ridges 1334B and 1334C (Figure 25B) communicate with ridge 1334A and may include a gap along the outer edge 1330. Multiple ridges 1334B and 1334C can form a window in the manner described above. Multiple ridges 1334B and 1334C may extend inward while adjacent to the outer edge 1330, extending circumferentially to ridge 1334D. Ridge 1334D may extend circumferentially along the outside of the outer edge 1330. The toe projection 1335 is located distal to ridge 1334D and may form the distal portion of ridge 1334D. The toe projection 1335 may be an overhang mechanism such as a projection (e.g., lip, barb, or other mechanism) extending to ridge 1334D. The toe projection 1335 may be configured to engage with a humeral implant (not shown), as further described and shown herein. The toe projection 1335 may be circumferentially positioned along the distal portion of the bearing 1320 and may form its distal edge. The toe projection 1335 may be a single continuous locking mechanism extending over 100 degrees or more outside the outer edge 1330.

[0119] Figures 26A and 26B show bearing 1320A of another embodiment constructed in the same manner as bearing 1320 in Figures 25A and 25B, where the articulated surface 1328A (Figure 26A) can be angled or inclined according to several embodiments. Thus, bearing 1320A can have, for example, a thickness that changes from the inside to the outside, or generally has a sloped thickness.

[0120] Figure 27 shows the humerus tray 1322. The humerus tray 1322 may include a central axis CL, a main body 1344, a stem 1346, a rail 1347, a barb 1348, a raised section 1350, an insertion slot 1352, and a skirt 1354.

[0121] The main body 1344 is generally curved into a dish shape or other shape and can be configured to receive the distal portion of a bearing (not shown). The stem 1346 extends distally from the main body 1344 and can be configured to have a taper or other mechanical mechanism to connect with the humeral stem (not shown). The rail 1347 or other mechanism extends from the main body 1344 and can form the lateral proximal edge of the humeral tray 1322. The rail 1347 may include a chamfered surface 1347A configured to engage with the chamfered surface of the bearing 1320 or 1320A.

[0122] The barb 1348 can protrude outward from the rail 1347. The barb 1348 can generally protrude outward from the central axis CL of the humerus tray 1322. The barb 1348 can extend over a smaller area than the entire circumference of the humerus tray 1322. The barb 1348 can include, for example, an overhang mechanism of the rail 1347. The barb 1348 can form part of the groove 1349.

[0123] The groove 1349 may extend over a smaller area than the majority of the circumference of the humerus tray 1322 distal to the medial barb 1348 of the humerus tray 1322. The insertion slot 1352 may extend through the medial rail 1347 distal to the barb 1348. The slot 1352 may communicate with the interior of the humerus tray 1322 and the groove 1349. The ridge 1350 may be located on the outside of the humerus tray 1322 opposite to the groove 1349. The ridge 1350 is an undercut or similar mechanism in the rail 1347 and may be configured to receive the toe projection 1335 of the bearing (Figures 25A and 25B). The skirt 1354 may be located distal to the groove 1349 and may form part of it. The skirt 1354 protrudes radially outward from the groove 1349, and can actually protrude radially outward from the barb 1348 and the rail 1347 as well.

[0124] Figures 28A to 28C show the orthopedic assembly 1400 of the humerus tray 1322 and bearing 1320A. The bearing 1320A is coupled to the humerus tray 1322A. The coupling can be achieved in a manner similar to the techniques described, for example, in Figures 9A to 11A and 23, in which a single continuous tab 1332 (Figure 28C) bends outward beyond the barb 1348 and rail 1347. Figure 28C shows how the ridge 1334D receives a portion of the rail 1347 and a portion of the barb 1348. The groove 1349 receives the single continuous tab 1332. A tool (shown in Figure 29) can be inserted through the ridge 1334D and rail 1347 via an insertion slot 1352 (not shown in Figures 28A to 28C). An insertion slot 1352 (not shown in Figures 28A to 28C) is configured to provide access for inserting a tool between the bearing 1320A and the humerus tray 1322 for assembly of the bearing 1320A and the humerus tray 1322. As shown in Figure 28C, the toe projection 1335 and the ridge 1334A are configured to receive, or be received by, the rail 1347, the barb 1348 and the outer ridge 1350 of the assembly 1400.

[0125] As shown in Figures 28A to 28C, the outer edge 1330 along the single continuous tab 1332 is located inside or coplanar with the outer edge of the skirt 1354 when the bearing 1320A is coupled to the humeral tray 1322. The skirt 1354 may extend to protect the single continuous tab 1332, the barb 1348 and the groove 1349 (including the locking mechanism shown in Figure 28C) from contact with tissue.

[0126] Figure 29 shows a tool 1500 and insertion device 1501 for connecting a humerus tray to a bearing to form an assembly such as the orthopedic assembly 1400 in Figures 27A to 27C. The tool 1500 may include a projection tab 1502 configured for insertion into an insertion slot 1352 (Figure 27). The tool 1500 may include a handle 1504, a lever 1506, and a slide 1508. The slide 1508 can be actuated by the action of the lever 1506 and an internally loaded spring (not shown). The slide 1508 can push the bearing into the humerus tray via the spring and lever 1506.

[0127] Figures 30A and 30B show examples of trial parts 1600 that can be configured to simulate the configuration (shape, size, position, etc.) of bearings 1320 or 1320A previously described in relation to Figures 25A to 27B. Thus, trial parts 1600 are available in, for example, multiple standard sizes and shapes. Trial part 1600 is a temporary part that can be attached to either the humerus tray 1322 (see Figures 31A and 31B) or the humerus tray test. Trial part 1600 can be used to determine the size of bearings 1320 or 1320A (previously shown) or to practice arthrokinematics such as range of motion. Trial part 1600 differs from the previous tests described herein in that it has two separate locking mechanisms 1602A and 1602B. The two locking mechanisms 1602A and 1602B each include arms 1603A and 1603B having finger projections 1605A and 1605B (shown only in Figure 30A).

[0128] As best shown in Figure 30B, arms 1603A and 1603B can be separated from the main body 1604. Locking mechanisms 1602A and 1602B can be separated from the main body 1604 by a plurality of ridges 1606, including an internal ridge 1606A and a side ridge 1606B. Locking mechanisms 1602A and 1602B can be bent inward or outward via arms 1603A and 1603B, allowing at least several finger projections 1605A and 1605B (Figure 30A) to be bent as desired, including in the manner shown in Figures 31A and 31B. Locking mechanisms 1602A and 1602B can be positioned on the outside of, for example, the trial part 1600.

[0129] Figures 31A and 31B illustrate the steps of connecting the trial component 1600 to the humerus tray 1322 (Figure 31A) and separating the trial component 1600 from the humerus tray 1322 (Figure 31B). Figure 31A shows the locking mechanisms 1602A and 1602B being inserted into and engaged with the outer ridges 1350 and rails 1347. The trial component 1600 is then pressed against the humerus tray 1322, generally distally and downward, as indicated by the arrows in Figure 31A. During this step, the locking mechanisms 1602A and 1602B are biased to engage with the humerus tray 1322.

[0130] Figure 31B shows the process of removing the trial part 1600 from the humerus tray 1322. This involves pushing the inside of the trial part 1600 (indicated by arrows) to bend the locking mechanisms 1602A and 1602B further inward, thereby lifting the inside portion of the trial part 1600 upward (indicated by arrows) and removing the inside portion of the trial part from the humerus tray 1322.

[0131] Figures 32 and 32A show a tool 1700 configured to facilitate the removal of the bearing 1320A from the humerus tray 1322. As shown in Figure 32A, the tool 1700 may include a pliers-like component having a first jaw 1702 with a wedge-shaped tip 1704 and a second jaw 1706 with a blunt tip 1708. The wedge-shaped tip 1704 can be pressed between the bearing 1320A and the humerus tray 1322 by the action of the tool 1700, which includes the closure of the first jaw 1702 and the second jaw 1706.

[0132] The term “proximal” refers to the general orientation of the lateral and / or surface of the humeral implant when it is embedded in the bone. Thus, “proximal” generally refers to the direction or position toward the patient’s head, and “distal” refers to the opposite direction of proximal, i.e., away from the patient’s head. The terms “anterior” and “posterior” as used herein should be given their generally understood anatomical interpretations. Thus, “posterior” generally refers to a position or direction toward the posterior side of the patient. Similarly, “anterior” generally refers to a position or direction toward the anterior side of the patient. Thus, “posterior” refers to the opposite direction of “anterior.” Similarly, the terms “medial” and “lateral” should be given their generally understood anatomical interpretations. “Medial” refers to the more medially portion (medial part) of the prosthesis or guide (in the case of the embedded orientation), and “lateral” refers to the lateral part or lateral portion. “Medial” refers to the opposite direction of “lateral.” “Substantially,” “generally,” or “about” means within 10% of the discussed value.

[0133] Those skilled in the art will readily understand that various other modifications to the details of the components and methods described and illustrated in order to illustrate the essence of the present invention can be made without departing from the principles and scope of the invention as expressed in the appended claims. For example, the order of the steps or stages of the method can be changed from those described above, which will be understood by those skilled in the art.

[0134] Furthermore, it will be understood that various dependent claims, examples, and features described herein can be combined in ways different from those presented above and / or in the initial claims. For example, any feature from the above examples can be shared with other examples described herein, or features from a particular dependent claim can be shared with other dependent or independent claims, which will be understood by those skilled in the art.

[0135] The above detailed description includes references to accompanying drawings that form part of the detailed description. The drawings illustrate, for illustrative purposes, specific embodiments in which the present invention may be carried out. These embodiments are also referred to herein as “examples.” Such examples may include elements in addition to those shown or described. However, the inventors also consider examples in which only the shown or described elements are provided. Furthermore, the inventors also consider examples using any combination or permutation of the shown or described elements (or one or more embodiments thereof), with respect to a particular example (or one or more embodiments thereof) or with respect to other examples (or one or more embodiments thereof) shown or described herein.

[0136] In the event of any inconsistency in usage between this document and other documents incorporated by reference, the usage in this document shall prevail. In this document, the terms “including” and “in which” are used as plain English equivalents to the terms “equipped with” and “here,” respectively. Furthermore, in the following claims, the terms “including” and “equipped with” are open-ended, meaning that any system, apparatus, article, composition, formulation, or process that includes an element in addition to the element described after such terms in a claim is still considered to be within the scope of that claim.

[0137] In this document, the terms “a” or “an” are used to include one or more, regardless of other examples or uses of “at least one” or “one or more,” as is common in patent documents. In this document, the term “or” is used to refer to non-exclusive “or,” and “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise specified. In this document, the terms “including” and “among” are used as plain English equivalents of the terms “including” and “among.” Furthermore, in the following claims, the terms “including” and “equipped” are open-ended, meaning that a system, apparatus, article, composition, formulation, or process that includes an element in addition to the element described after such a term in a claim is still considered to be within the scope of that claim. In addition, in the following claims, terms such as “first,” “second,” “third,” etc., are used merely as labels and are not intended to impose numerical requirements on their subject matter.

[0138] The above description is illustrative and not restrictive. For example, the above examples (or one or more outside of them) can be used in combination with each other. Other embodiments can be used by those skilled in the art who have considered the above description. The abstract is provided in accordance with 37 C. FR § 1.72(b) to allow the reader to quickly grasp the nature of the technical disclosure. It is submitted with the understanding that it is not to 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 interpreted as meaning that any unclaimed disclosed feature is essential to any claim. Rather, the subject matter of the invention may reside in fewer features than all the features of a particular disclosed embodiment. Accordingly, the following claims are incorporated herein as examples or embodiments in the detailed description, and each claim exists independently as an independent embodiment, and it is assumed that these embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined by reference to the appended claims and the entire scope of equivalents to which these claims are entitled.

Claims

1. A prosthesis assembly for reverse shoulder arthroplasty, A bearing having a tab positioned along at least a first portion of its outer edge and a toe projection positioned along a second portion of its outer edge, A humeral implant having a wall portion with a barb and an insertion slot located distal to the barb and passing through the wall portion, wherein the insertion slot is configured to receive a portion of an insertion tool, and the portion of the barb engages with the tab to connect the bearing and the humeral implant, A prosthesis assembly equipped with [a specific feature / feature].

2. The prosthesis assembly according to claim 1, wherein the bearing comprises at least a first ridge and a second ridge, the first ridge configured to receive the toe projection adjacent to the tab, and the second ridge located outside and proximal to the toe projection and configured to receive a portion of the barb.

3. The prosthesis assembly according to claim 2, wherein the bearing including the tab forms the inside of the bearing, and the toe projection is positioned along the outside of the bearing.

4. The prosthesis assembly according to claim 3, wherein the humeral implant includes a groove along its inner side, and the insertion slot communicates with the groove.

5. The prosthesis assembly according to claim 4, wherein the humeral implant includes a skirt located distal to the groove, the skirt protrudes outward from the groove away from the central axis of the humeral implant, and the outer edge of the bearing substantially aligns with the skirt along at least the first portion, or is located inside the skirt.

6. The prosthesis assembly according to claim 5, wherein the wall opposite to the humeral implant on the lateral side includes a ridge that forms an undercut configured to receive the toe process.

7. A prosthesis assembly for reverse shoulder arthroplasty, A bearing having tabs positioned along at least a first portion of its outer edge, A humeral implant comprising a wall having a barb and a skirt located distal to the barb, wherein the skirt protrudes outward from the tab away from the central axis of the humeral implant, the tab is substantially aligned with the skirt or located inside the skirt, and a portion of the barb engages with the tab to connect the bearing to the humeral implant;

8. The prosthesis assembly according to claim 7, further comprising an insertion slot passing through the wall portion located distal to the barb, the insertion slot being configured to receive a portion of an insertion tool, and the portion of the barb engaging with the tab to connect the bearing with the humeral implant.

9. The prosthesis assembly according to claim 8, further comprising a toe projection positioned along a second portion of the outer edge.

10. The prosthesis assembly according to claim 9, wherein the bearing comprises at least a first ridge and a second ridge, the first ridge configured to receive the toe projection adjacent to the tab, and the second ridge located outside and proximal to the toe projection and configured to receive a portion of the barb.

11. The prosthesis assembly according to claim 7, wherein the humeral implant includes a groove along its medial side, the skirt is located distal to the groove, and the skirt protrudes outward from the groove away from the central axis of the humeral implant.

12. A prosthesis assembly for reverse shoulder arthroplasty, A trial component configured to simulate a bearing, wherein the trial component has two coupling mechanisms, each comprising two arms, each having at least one finger along its outer edge, and the two arms are separated by a ridge, A humeral implant configured to accept and connect the aforementioned trial component, A prosthesis assembly equipped with [a specific feature].

13. The prosthesis assembly according to claim 12, wherein the humeral implant has a wall portion having a barb and an insertion slot passing through the wall portion located distal to the barb.

14. The prosthesis assembly according to claim 13, wherein the humeral implant includes a groove along the medial side adjacent to the wall and the barb, and the insertion slot communicates with the groove.

15. The prosthesis assembly according to claim 14, wherein the humeral implant includes a skirt located distal to the groove, the skirt protrudes outward from the groove away from the central axis of the humeral implant, and the outer edge of the trial component is substantially aligned with or located inside the skirt.

16. The prosthesis assembly according to claim 15, wherein the wall opposite to the humeral implant on the lateral side includes a ridge that forms an undercut configured to receive two of the connecting mechanisms.

17. A prosthesis assembly for reverse shoulder arthroplasty, A bearing having a plurality of fingers arranged along at least a first portion of its outer edge, A humeral implant having a wall portion having a plurality of receptacles configured to receive a plurality of fingers, wherein the number of the plurality of receptacles exceeds the number of the plurality of fingers, and the bearing is able to clock relative to the humeral implant at a plurality of desired angles, A prosthesis assembly equipped with [a specific feature].

18. The prosthesis assembly according to claim 17, wherein the bearing includes a plurality of tabs forming a second portion of the outer edge of the bearing, the plurality of fingers arranged along the outside of the bearing, and the plurality of tabs arranged along the inside of the bearing.

19. The prosthesis assembly according to claim 18, wherein each of the plurality of tabs is separated by at least a first ridge, each of the plurality of tabs is separated from the plurality of fingers by a second ridge and a third ridge, each of the plurality of tabs has a barb extending inward toward the central axis of the bearing, the humeral implant has a barb on the proximal side of the groove adjacent to the groove, the barb extends outward away from the central axis of the humeral implant, and the plurality of tabs bend outward beyond the barb of the humeral implant so that they are at least partially received in the groove when the bearing is coupled to the humeral implant.

20. The prosthesis assembly according to claim 19, wherein one of the second and third undulations is configured to receive a portion of the wall when the bearing is clocked with respect to the humeral implant at a plurality of desired angles.

21. The prosthesis assembly according to claim 19, wherein the humeral implant includes a skirt located distal to the groove, the skirt protruding outward from the groove away from the central axis of the humeral implant.

22. The prosthesis assembly according to any one of claims 17 to 21, further comprising a plurality of indicators positioned on the bearing and the humeral implant, indicating a plurality of desired angles of the bearing relative to the humeral implant.

23. The prosthesis assembly according to claim 22, wherein the plurality of desired angles include at least a neutral angle with respect to the scapular plane, a clockwise angle with respect to the neutral angle in the range of 15 to 45 degrees, and a counterclockwise angle with respect to the neutral angle in the range of 15 to 45 degrees.

24. A method for assembling a prosthesis for reverse shoulder arthroplasty, Positioning the bearing at a desired angle / position relative to the humerus tray, including aligning indicators corresponding to multiple fingers of the bearing so that it can be accepted by at least some of the multiple receptacles of the humerus tray, Engaging one or more inner edges of the joint surface and / or the outer edge of the bearing, Multiple tabs bend outward, pushing the bearing down into the humerus tray via engagement with one or more of the medial edges, so as to overcome the corresponding fitting mechanism of the humerus tray. Methods that include...

25. The method according to claim 24, wherein the corresponding fitting mechanism of the humerus tray includes a rail and a groove, and a portion of the plurality of tabs is received in the groove, and the plurality of tabs engage with the rail from the distal side.

26. The method according to claim 24 or 25, wherein engaging includes fully inserting the plurality of fingers into at least some of the plurality of receptacles such that the bearing is coupled to the humeral bearing and the plurality of fingers engage with the wall portion of the humeral bearing.

27. A prosthesis assembly for reverse shoulder arthroplasty, A bearing having a plurality of tabs forming a portion of its outer edge, wherein each of the plurality of tabs is separated by a ridge, and each of the plurality of tabs has a barb extending inward toward the center axis of the bearing, A humeral implant having a groove configured to receive a plurality of the tabs, wherein the humeral implant has a barb adjacent to the groove proximal to the groove, the barb extending laterally away from the central axis of the humeral implant, and the plurality of tabs bend laterally beyond the barb of the humeral implant, and are configured to be at least partially received in the groove when the bearing is coupled to the humeral implant, A prosthesis assembly equipped with [a specific feature].

28. The prosthesis assembly according to claim 27, wherein the humeral implant includes an alignment boss located on the outer circumference of the humeral implant, the alignment boss is configured to be received by a ridge, the ridge includes a plurality of ridges at desired intervals, and the plurality of ridges allows the bearing to clock relative to the humeral implant at a plurality of desired angles.

29. The prosthesis assembly according to claim 28, wherein the plurality of desired angles include at least a neutral angle with respect to the scapular plane, a clockwise angle with respect to the neutral angle in the range of 15 to 45 degrees, and a counterclockwise angle with respect to the neutral angle in the range of 15 to 45 degrees.

30. The prosthesis assembly according to claim 27 or 28, wherein the plurality of ridges include a plurality of windows that provide a larger opening for accessing the groove and part of the barb of the humeral implant, the humeral implant includes a plurality of detents inside the groove at desired intervals, and one or more of the plurality of detents are accessible through the plurality of windows.

31. The prosthesis assembly according to any one of claims 27 to 30, wherein the humeral implant includes a skirt located distal to the groove, the skirt protruding outward from the groove away from the central axis of the humeral implant.

32. The prosthesis assembly according to claim 31, wherein when the bearing is coupled to the humeral implant, the outer surfaces of the plurality of tabs are located radially inward of the outer edge of the skirt.

33. The prosthesis assembly according to any one of claims 27, 31, and 32, wherein the undulation includes a plurality of windows providing a larger opening for accessing a portion of the groove and barb of the humeral implant, the humeral implant includes a plurality of detents inside the groove at desired intervals, and one or more of the plurality of detents are accessible through the plurality of windows.

34. The prosthesis assembly according to claim 33, further comprising a bearing press having a clamp configured to engage with one or more of the detents of the humeral implant, and an actuator configured to engage with the clamp and the bearing and to press the bearing against the humeral implant.

35. The prosthesis assembly according to claim 33, further comprising a bearing tongue press including a single component having a clamp configured to engage with one or more of the detents of the humeral implant, and an actuator configured to engage with the clamp and the bearing and to press the bearing against the humeral implant.

36. The prosthesis assembly according to claim 33, further comprising a tool, wherein a plurality of the windows are configured to provide access to the tool for inserting the tool between the bearing and the humeral implant in order to remove the bearing from the humeral implant.

37. The prosthesis assembly according to any one of claims 27 to 36, wherein the bearing comprises a trial part having a plurality of locking mechanisms separated from the main body by a plurality of the undulating parts including the undulating part, the bridge attaches each of the plurality of locking mechanisms to the main body, and when the trial part is coupled to the humeral implant, the plurality of locking mechanisms are bent outward through the bridge beyond the barb of the humeral implant so as to be at least partially received in the groove.

38. The prosthesis assembly according to claim 37, wherein the trial component is assembled on the humeral implant and, when engaged by the glenosphere, is configured to prevent the multiple locking mechanisms from bending inward at the proximal joint portion, thereby locking the trial component to the humeral implant during range of motion evaluation.

39. The prosthesis assembly according to any one of claims 27 to 38, further comprising a drill guide configured to be attached to the bearing, wherein the drill guide includes at least one opening for guiding a drill through the bearing to the humeral implant.

40. The prosthesis assembly according to any one of claims 27 to 39, wherein the humeral implant comprises either a tray configured to connect to a stem via a mechanical locking mechanism, or a single prosthesis.

41. A prosthesis assembly for reverse shoulder arthroplasty, A trial component configured to simulate a bearing, wherein the trial component has a plurality of tabs forming its outer edge, each of the plurality of tabs separated by a ridge, and the trial component has one or more locking mechanisms separated from the main body by the plurality of ridges including the ridge, and the bridge attaches one or more of the locking mechanisms to the main body, the trial component and A humeral implant having grooves configured to receive a plurality of the tabs, wherein the humeral implant has barbs adjacent to the grooves on the proximal side of the grooves, the barbs extending outward from the central axis of the humeral implant, and the humeral implant is bent outward via the bridge so that one or more of the locking mechanisms bend outward beyond the barbs of the humeral implant at least some of the plurality of tabs so that they are at least partially received in the grooves, A prosthesis assembly equipped with [a specific feature].

42. An orthopedic system for reverse shoulder arthroplasty, A bearing having multiple tabs forming an outer edge, A humeral implant having a groove configured to receive a plurality of tabs, wherein the groove has a barb adjacent to the proximal side of the groove, the barb extending outward from the central axis of the humeral implant, and the plurality of tabs are configured to bend outward beyond the barb of the humeral implant and at least partially receive into the groove when the bearing is coupled to the humeral implant, A trial component configured to simulate the bearing, wherein the trial component has one or more locking mechanisms separated from the main body by a plurality of undulations, a bridge attaching one or more of the locking mechanisms to the main body, and one or more of the locking mechanisms are bent outward via the bridge to bend at least some of the plurality of tabs outward beyond the barb of the humeral implant so that the bearing is at least partially received in the groove when coupled to the humeral implant, An orthopedic system equipped with [the necessary components].

43. The orthopedic system according to claim 42, wherein the trial component includes a plurality of window portions defined by at least some of the plurality of tabs, providing an opening for accessing the groove and portion of the barb of the humeral implant, the humeral implant includes a plurality of detents inside the groove at desired intervals, and one or more of the plurality of detents are accessible through the plurality of window portions.

44. The orthopedic system according to claim 42 or 43, wherein the trial component is assembled on the humeral implant and, when engaged by the glenosphere, is configured to prevent one or more of the locking mechanisms from bending inward at the proximal joint portion, thereby locking the trial component to the humeral implant during range of motion evaluation.

45. The orthopedic system according to any one of claims 42 to 44, wherein the trial component includes a skirt positioned distal to the groove, the skirt protruding outward from the groove away from the central axis of the humeral implant.

46. The orthopedic system according to claim 45, wherein when the bearing is coupled to the humeral implant, the outer surfaces of the plurality of tabs are positioned radially inward of the outer edge of the skirt.

47. The orthopedic system according to any one of claims 43 to 46, wherein the trial component comprises a plurality of bearings of different configurations.

48. A trial component for reverse shoulder arthroplasty, A trial component configured to simulate a bearing, wherein the trial component has one or more locking mechanisms separated from a main body by a plurality of undulations, a bridge attaches one or more of the locking mechanisms to the main body, one or more of the locking mechanisms are configured to bend through the bridge to connect one or more tabs to a humeral implant, and the trial component is assembled on the humeral implant and configured to prevent one or more of the locking mechanisms from bending inward when engaged by a glenosphere.

49. The trial part according to claim 48, wherein the plurality of undulations include edge undulations and internal undulations, and the internal undulations communicate with the articulated surface of the trial part.

50. The trial component according to claim 48 or 49, wherein one or more of the locking mechanisms are configured to be manually bent outward and bent outward beyond a portion of the humeral implant in at least some of the one or more of the tabs.

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