ORTHOPEDIC IMPLANT SYSTEMS INCLUDING INTERNAL NETWORKS AND REPAIR METHODS - Patent application

Abstract

The present disclosure relates to orthopedic implant systems and methods for repairing bone defects and restoring function to a joint. The implant systems and methods disclosed herein may include extensions (26) extending from respective base plates (24). The extensions may have an internal network (44) for conveying material within the respective implants.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This disclosure claims priority to U.S. patent application Ser. No. 17,221,049, filed April 2, 2021. [Background technology]

[0002] The present disclosure relates to orthopedic procedures and, more particularly, to orthopedic implant systems and methods for repairing bone defects and restoring function to joints.

[0003] Many bones of the human musculoskeletal system contain articular surfaces. Articular surfaces articulate against other bones to facilitate different types and degrees of joint movement. Articular surfaces can become damaged over time due to repeated use or wear, or can experience bone loss, or fracture as a result of traumatic impact. These types of bone defects can cause joint instability and pain.

[0004] Bone defects may occur along articular surfaces. Some techniques utilize bone grafts and / or implants to repair defects adjacent to the articular surfaces. The implants may be secured to the bone using one or more fasteners. Summary of the Invention

[0005] The present disclosure relates to orthopedic implant systems and methods, which may be used during methods for repairing bone defects. The implant systems described herein may be utilized to restore functionality to a joint and may include implants having an internal network for conveying various materials within each implant.

[0006] An orthopaedic implant system of the present disclosure may include an implant including a base plate and an extension. The base plate may include a plate body extending between an anterior surface and a posterior surface. The anterior surface may be configured to face an opposing articular surface associated with a bone. The extension may include an extension body extending from a posterior surface of the plate body. The extension body may include a network of internal passageways branching to respective ports along an exterior surface of the extension body.

[0007] An orthopaedic implant system of the present disclosure may include an implant including a base plate and an extension extending from the base plate. A front surface of the base plate may be configured to face an opposing articular surface associated with a bone. The extension may include an extension body including a network of internal passages coupled to respective ports along an exterior surface of the extension body. A pump may be configured to deliver a biological material at least partially into the network.

[0008] A method of installing an orthopedic implant of the present disclosure may include positioning the implant along a surgical site. The implant may include a base plate and an extension. The base plate may include a plate body extending between an anterior surface and a posterior surface. The extension may include an extension body extending from the plate body. The extension body may include a network of internal passages connected to respective ports along an exterior surface of the extension body. The positioning step may occur such that an anterior surface of the base plate faces toward an opposing articular surface associated with an adjacent bone.

[0009] The various features and advantages of the present disclosure will become apparent to those skilled in the art from the following detailed description. The drawings that accompany the detailed description can be briefly described as follows: [Brief description of the drawings]

[0010] [Figure 1]FIG. 1 is a perspective view of an exemplary orthopedic implant system, the implant system including a base plate and extensions. [Figure 2A] 2A is a cross-sectional view of the implant taken along line 2A-2A of FIG. 1. [Figure 2B] 2B is a cross-sectional view of the implant taken along line 2B-2B of FIG. 1. [Diagram 3] FIG. 1 illustrates an exemplary network of internal passageways. [Figure 3A] FIG. 1 illustrates an exemplary network of internal passageways. [Figure 4] FIG. 2 is a cross-sectional view of the implant of FIG. 1 coupled to an exemplary articulation member. [Diagram 5] FIG. 2 is a cross-sectional view of another implant of FIG. 1 coupled to an exemplary articulation member. [Figure 6] 1 is a cross-sectional view of another exemplary implant system. [Figure 7] 1A-1D are diagrams of an exemplary method for installing an orthopedic implant. [Figure 8] 1A-1D illustrate an exemplary implant system in various modes, positions, and conditions relative to a surgical site. [Figure 9] 1A-1D illustrate an exemplary implant system in various modes, positions, and conditions relative to a surgical site. [Figure 10] 1A-1D illustrate an exemplary implant system in various modes, positions, and conditions relative to a surgical site. [Figure 11] 1A-1D illustrate an exemplary implant system in various modes, positions, and conditions relative to a surgical site. [Figure 12] 1A-1D illustrate an exemplary implant system in various modes, positions, and conditions relative to a surgical site. [Figure 13] 1A-1D illustrate an exemplary implant system in various modes, positions, and conditions relative to a surgical site. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] Like reference numbers and designations in the various drawings indicate like elements.

[0012] The present disclosure relates to orthopedic implant systems and methods for repairing bone defects. The implant systems described herein may be utilized during arthroplasty procedures and may include implants incorporated into artificial joints to restore functionality to shoulders and other joints with progressive cartilage disease. The implants may include extensions extending from a respective base plate. The implants may be positioned along a surgical site, such as a glenoid surface, to at least partially fill a bone void. The extensions may include an internal network for conveying biomaterials and / or other materials within the respective implants, which may improve fixation and healing for the patient.

[0013] An orthopedic implant system according to an exemplary aspect of the present disclosure may include an implant including a base plate and an extension. The base plate may include a plate body extending between an anterior surface and a posterior surface. The anterior surface may be configured to face an opposing articular surface associated with a bone. The extension may include an extension body extending from a posterior surface of the plate body. The extension body may include a network of internal passages branching to respective ports along an exterior surface of the extension body.

[0014] In some embodiments, the network may be dimensioned to branch outwardly from the rear surface of the plate body to opposing side walls of the extension body.

[0015] In some embodiments, an internal passageway may interconnect each of the ports with a common interface opening defined along the exterior surface of the implant.

[0016] In some embodiments, each of the internal passages may split into branched paths at respective junctions, at least two of which may be established between the common interface opening and each of the respective ports.

[0017] In some embodiments, the network may be arranged according to a Fibonacci sequence, such that the cross-sectional area of ​​the internal passages may decrease progressively at each respective junction in a direction towards the respective port.

[0018] In some embodiments, the implant system may include a pump securable to the common interface opening. The pump may be configured to draw the biological material at least partially from the port into the internal passage.

[0019] In some embodiments, a common interface opening may be defined along the plate body. The network may include a main trunk extending outwardly from the common interface opening. The internal passages may split from the main trunk into branch paths coupled to respective ports.

[0020] In some embodiments, the implant system may include a pad including a concave articulating surface. The pad may be securable to a baseplate adjacent the anterior surface.

[0021] In some embodiments, the implant system may include an articulating head including a convex articulating surface. The articulating head may be securable relative to a baseplate adjacent an anterior surface.

[0022] In some embodiments, the articulation head may include a recess dimensioned to at least partially receive the plate body.

[0023] In some embodiments, the implant may include at least one fixation aperture extending at least partially through the plate body and the extension body, The at least one fixation aperture may be configured to receive a respective fastener for securing the implant to bone.

[0024] In some embodiments, the implant may include one or more bioactive layers that establish at least a majority of the surface of the expandable body that defines the network.

[0025] An orthopaedic implant system according to an exemplary aspect of the present disclosure may include an implant including a base plate and an extension extending from the base plate. A front surface of the base plate may be configured to face an opposing articular surface associated with a bone. The extension may include an extension body including a network of internal passages coupled to respective ports along an exterior surface of the extension body. A pump may be configured to deliver a biological material at least partially into the network.

[0026] In some embodiments, the implant may include an interface opening defined along an exterior surface of the implant. An internal passageway may interconnect the respective ports and the interface opening. The pump may be securable relative to the implant at the interface opening.

[0027] In some embodiments, the implant system may include an articulation member including an articulation surface that may be configured to cooperate with an opposing articular surface to establish a joint interface. The articulation member may be securable relative to the base plate.

[0028] In some embodiments, the implant system may include a plurality of fasteners, and the implant may include a plurality of fixation apertures, each of which may be configured to receive a respective one of the fasteners to secure the implant to bone.

[0029] A method of installing an orthopedic implant according to an exemplary aspect of the present disclosure may include positioning the implant along a surgical site. The implant may include a base plate and an extension. The base plate may include a plate body extending between an anterior surface and a posterior surface. The extension may include an extension body extending from the plate body. The extension body may include a network of internal passages coupled to respective ports along an exterior surface of the extension body. The positioning step may occur such that an anterior surface of the base plate faces toward an opposing articular surface associated with an adjacent bone.

[0030] In some embodiments, the method may include coupling a pump to the network and actuating the pump to transfer the biological material at least partially into the internal passageway.

[0031] In some embodiments, the method may include operating the pump in a first mode to draw at least a portion of the biological material from the surgical site, through the port, and then at least partially into the internal passage.

[0032] In some embodiments, the method may include operating the pump in a second mode to move at least a portion of the biological material in the network outwardly in a direction towards the port.

[0033] In some embodiments, the network may branch outwardly from the rear face of the plate body to the ports.

[0034] In some embodiments, the method may include forming a cavity in the bone along the surgical site, and the step of positioning the implant may include moving the extension at least partially into the cavity such that an exterior surface of the extension abuts a wall of the cavity adjacent the port.

[0035] In some embodiments, the implant may include fixation apertures. The method may include positioning fasteners at least partially through the fixation apertures and into the bone to secure the implant to the surgical site.

[0036] In some embodiments, the method may include securing an articulation member to the plate body adjacent the anterior surface. The articulation member may include an articulation surface that cooperates with an opposing articular surface to establish a joint interface.

[0037] In some embodiments, a surgical site may be established along the glenoid cavity.

[0038] 1 illustrates an exemplary orthopedic implant system 20 including an implant 22 that can be secured to a surgical site. The system 20 may be utilized for a variety of surgical procedures, such as joint arthroplasty, to repair a joint. For example, the implant 22 may be incorporated into a shoulder prosthesis. Although the implants disclosed herein primarily refer to the repair of defects within a glenoid cavity during shoulder reconstruction, such as anatomic or reverse shoulder prosthesis procedures, it will be appreciated that the disclosed implants may be utilized elsewhere in a patient's body and in other surgical procedures, including the repair of other joints, such as the humerus and wrist, wrist, hip, knee, ankle, or spinal joints, as well as the repair of fractures.

[0039] The implant 22 may include a base plate 24 and an extension 26. The base plate 24 may include a plate body 28 extending along a central axis A between an anterior surface 30 and a posterior surface 32 generally opposite the anterior surface 30. The anterior surface 30 may be configured to face an opposing articular surface AS associated with an adjacent bone B2, as shown in FIG. 4. The articular surface AS may be a portion of the bone B2 or an adjacent implant component secured to the bone B2.

[0040] The base plate 24 may have a variety of geometries. The perimeter of the base plate 24 may have a generally rectangular, elliptical, oval, oblong, or complex geometry. For example, the perimeter 28P of the plate body 28 may have a substantially circular or elliptical cross-sectional geometry, as illustrated in FIG. 1. For purposes of this disclosure, the terms "substantially" and "approximately" mean ±5% of the stated relationship or value, unless otherwise stated. A substantially circular geometry may reduce reaming width and complexity of preparing a surgical site to receive the implant 22.

[0041] The extensions 26 may include extension bodies 34 extending between a front surface 36 and a rear surface 38 generally opposite the front surface 36. The extension bodies 34 may be disposed on and extend from the rear surface 32 of the plate body 28 along the central axis A. For example, when implanted within a surgical site, the rear surfaces 32, 38 of the base plate 24 and extensions 26 may generally correspond to an inner side of the patient, and the front surfaces 30, 36 of the base plate 24 and extensions 26 may generally correspond to an outer side of the patient.

[0042] The implant 22 may include one or more fixation apertures 40. Each fixation aperture 40 may extend at least partially or completely through the plate body 28 and / or the extension body 34, as illustrated in FIG. 2B. Each fixation aperture 40 may be configured to receive a respective fastener F (for illustrative purposes, B1 and F are shown in dashed lines) to secure the implant 22 to tissue, such as bone B1, as illustrated in FIG. 2B. The system 20 may include multiple fasteners F received within the respective fixation apertures 40, as illustrated in FIG. 1. Exemplary fasteners may include pins, nails, bolts, and compression screws.

[0043] The implant 22 may include at least one interface opening 42 defined along an exterior surface of the implant 22. The interface opening 42 may extend along a central axis A between the anterior surface 30 and the posterior surface 32 of the plate body 28, as illustrated in FIGS. 2A-2B. The fixation openings 40 may be distributed around the interface openings 42 and / or the central axis A in an array, as illustrated in FIG. 1. The interface openings 42 may also serve as fixation openings. The interface openings 42 may be established along another portion of the implant 22. For example, the interface openings may be established along an exterior surface of the extension body, as illustrated by interface opening 242 in FIG. 6. The interface opening 242 may be established along a sidewall 239 of the extension body 234 at a location between the anterior surface 236 and the posterior surface 238 of the extension body 234. In this disclosure, like reference numerals designate like elements, where appropriate, and reference numerals supplemented by 100 or multiples thereof designate modified elements that are understood to incorporate the same features and advantages of the corresponding original elements.

[0044] With continued reference to FIG. 1 and with reference to FIG. 2A, the extension 26 may be sized to approximate various defective geometries and surface contours that may be encountered along the surgical site S. In some implementations, the geometry of the extension 26 may be patient-specific based on one or more measurements of the patient's anatomy. The posterior surface 38 of the extension 26 may be sized to contact tissue, such as bone B1, along the surgical site S. The posterior surface 38 may be sized to overlay the surface contour SC along the bone B1, as illustrated in FIGS. 2A-2B. In other implementations, as illustrated in FIG. 4, the extension 26 may be fitted into the bone B1 to at least partially or completely fill the volume of a cavity C in the bone B1, and the base plate 24 may be at least partially received within the cavity C.

[0045] The extender body 34 may include an internal network 44 for carrying blood, nutrients, bone marrow, and other biological materials to promote osseous integration of the implant 22 and healing of the patient. The biological materials may be provided by the patient or from another source. The internal network 44 may be utilized to communicate with other materials within the implant 22, including non-biological materials. Exemplary non-biological materials may include cement materials to improve fixation and antibiotics, such as gentamicin, to reduce the risk of infection at the bone-implant interface along the surgical site S.

[0046] The internal network 44 may be defined at least partially or completely within the thickness of the extension body 34 between the anterior surface 36 and the posterior surface 38. The internal network 44 may have a predetermined geometry dimensioned to establish a network of internal passageways 46 connected to respective ports 48 along the exterior surface of the extension body 34. For purposes of this disclosure, the term "predetermined" refers to an engineered construct that excludes random arrangements such as meshes and porous materials.

[0047] The internal passages 46 may be dimensioned to establish respective flow paths between the interface openings 42 and one or more of the respective ports 48. The internal passages 46 may be dimensioned to interconnect the interface openings 42 and the respective ports 48 along an exterior surface of the extension 26. One or more of the internal passages 46 may branch off into the respective ports 48.

[0048] The interface openings 42 may be common to each of the internal passages 46 and ports 48, as shown in Figures 2A-2B. In other embodiments, the implant 22 may include two or more interface openings 42, each connected to a respective set of internal passages 46. The network 44 may be dimensioned to branch outwardly from the posterior surface 32 of the plate body 28 and / or the anterior surface 36 of the extension body 34 along opposing side walls 39 and / or the posterior surface 38 of the extension body 34 to the ports 48, as shown in Figures 2A-2B. The side walls 39 may have a substantially smooth and continuous contour to facilitate positioning of the extensions 26 within the cavity C (Figure 4).

[0049] The interface openings 42 may be defined along the plate body 28. The network 44 may include a main trunk 52 extending outwardly from the interface openings 42. The network 44 may be established such that one or more (or each) of the internal passages 46 are sized to split from the main trunk 52 into branch passages 54 connected to the respective ports 48. The internal passages 46 may split into branch passages 54 at respective junctions 50. At least two junctions 50 may be established between the interface openings 42 and each of the respective ports 48 such that at least some of the internal passages 46 are branch passages 54 split from another internal passage 46. The arrangement of the internal passages 46 may reduce localized stress concentrations within the extensions 26.

[0050] In the illustrated embodiment of FIG. 3, the network 44' includes at least three junctions 50' established between the interface opening 42' and a respective one of the ports 48'. The internal passage 46' may split into at least two branch paths 54' at each junction 50', as illustrated in FIG. 3A. The cross-sectional area of ​​each internal passage 46' in the network 44' may be equal to or greater than the combined cross-sectional area of ​​the branch paths 54' that split off from the internal passage 46' at each junction 50'. For example, the internal passage 46' in FIG. 3A may have a cross-sectional area of ​​approximately 8 mm, and the two branch paths 54' may each have a cross-sectional area of ​​approximately 4 mm at the junction 50', yielding a total cross-sectional area of ​​approximately 8 mm. The cross-sectional area of ​​the main trunk 52' may be equal to or greater than the sum of all the cross-sectional areas of the downstream junctions 50' in the network 44'. The cross-sectional area of ​​the junctions 50' may decrease continuously from the main trunk 52' in the direction D1. For example, the network 44' may be predefined according to a Fibonacci sequence such that the cross-sectional area of ​​each internal passage 46' progressively decreases at each series of junctions 50' in a direction D1 from the interface opening 42' toward the respective port 48', although an inverse arrangement may be utilized.

[0051] The internal passages 46, including the branching pathways 54, may be established at various orientations to convey material throughout the internal network 44, including between the interface openings 42 and the ports 48. In implementations, the internal network 44 may be dimensioned to generally mimic the properties of a tree root system or the like. Portions of the internal passages 46 may branch outwardly from the interface openings 42 such that the portions of the internal passages 46 are radially offset from one another relative to the longitudinal axis A of the implant 22. Portions of the internal passages 46 may be established on opposing sides of adjacent portions of the internal passages 46, as illustrated by the branching pathways 54 of each internal passage 46. The projections of the branching pathways 54 may intersect one another on a common plane, as illustrated by FIG. 2A, but may be radially offset from one another by the thickness of the extension body 34, as illustrated by FIG. 2B, taken along line 2B-2B of FIG. 1. The branching pathways 54 may be coupled to the respective ports 48 at different circumferential locations relative to the longitudinal axis A (see, for example, FIG. 1).

[0052] 4, the implant system 20 may include an articulation member 56 securable to the base plate 24 adjacent the anterior surface 30. The articulation member 56 may have an articulation surface 58. The articulation surface 58 may be configured to cooperate with an opposing articulation surface AS to establish a joint interface JI.

[0053] The articulating member 56 may have a variety of geometries that complement the articulating surface AS. For example, the articulating member 56 may be an articulating head 60 having a generally convex articulating surface 58, as shown in Figure 4. The articulating head 60 may be, for example, a glenosphere secured to the glenoid cavity in a reverse shoulder repair procedure.

[0054] The articulation member may have other geometries. As illustrated by the implant 122 of FIG. 5, the articulation member 156 includes a pad 164 having an articulation surface 158. The articulation surface 158 may have a generally concave geometry. The articulation member 156 may be utilized, for example, in an anatomical shoulder repair procedure. The pad 164 may be fixable to the base plate 124 adjacent the anterior surface 130. At least one peg 166 may extend outwardly from the body of the pad 164. The peg 166 may be sized to be fixed within a hole H1 in the bone B1 to provide fixation along the surgical site S. The pad 164 may include at least one protrusion 167 sized to mate with the interface opening 142 to limit relative movement between the base plate 124 and the pad 164.

[0055] Various techniques may be utilized to secure the articulation members 56, 156 to the respective base plates 22, 122. The articulation members 56, 156 may be mechanically attached or removably secured to the respective base plates 24, 124. With reference to Figures 4 and 5, the articulation members 56, 156 may include respective recesses 62, 162 dimensioned to at least partially receive the respective plate bodies 28, 128. However, the opposite configuration may be utilized. The perimeter 62P / 162P of the recess 62 / 162 may be dimensioned to surround the perimeter 28P / 128P of the plate body 28 / 128 adjacent the anterior surface 30 / 130. The perimeter 28P / 128P of the plate body 28 / 128 may be dimensioned to cooperate with the perimeter 62P / 162P of the recess 62 / 162 to establish a Morse taper connection for securing the articulation member 56 / 156 to the base plate 24 / 124. The articulation member 56 / 156 may be impacted or pressed onto the base plate 24 / 124 to establish an interference fit or otherwise seat the articulation member 56 / 156. The articulation head 60 may include openings 61 dimensioned to receive respective fasteners FF. The fasteners FF may be at least partially received within the interface openings 42 and may cooperate with the screws to mechanically attach the articulation head 60 to the base plate 24 and aid in alignment of the articulation head 60.

[0056] The articulation members 56, 156 may be provided together to the surgeon in a kit that may include articulation members 56, 156 having different shapes and / or sizes for selection by the surgeon based on the patient's anatomy.

[0057] Referring back to FIG. 2A, the implant system 20 may include a pump 68 selectively coupled to the implant 22 (see also implant 222 in FIG. 6, shown in dashed lines for illustrative purposes). The pump 68 may be securable to the interface opening 42 via a threaded connection, for example. The pump 68 may be configured to transport material through at least a portion of the internal network 44 during operation (see, for example, pump 368 in FIG. 12). The pump 68 may be configured to draw or otherwise convey blood, bone marrow, and other tissue, nutrients, other biological material, and / or other material from the patient adjacent the surgical site S at least partially into the internal network 44 to promote endosteal integration of the implant 22 and healing of the patient, including any of the materials disclosed herein. In implementations, the pump 68 may be configured to transport or deliver biological material, such as biological material collected from a patient or donor prior to placement of the implant 22, from an external source to the network 44.

[0058] A variety of techniques may be utilized to form the implant 22. The implant 22 may be a monolithic arrangement in which the base plate 24 and the extensions 26 may be integrally formed, or the implant 22 may be a modular arrangement in which the base plate 24 and the extensions 26 may be included in a single piece. The extensions 26 may be printed or otherwise formed on the base plate 24 according to a predetermined geometric shape to establish a three-dimensional scaffold. The scaffold establishes an internal network 44 that extends at least partially through the volume of the extensions 26.

[0059] A variety of materials may be utilized to form the components of the implant system disclosed herein. The disclosed base plate, extensions, and articulation members may be made of surgical grade metallic materials. Examples of metallic materials include titanium alloys, such as Ti6Al4V, and cobalt-based materials, such as cobalt chromium (CoCr). Non-metallic materials, such as ultra-high molecular weight polyethylene (UHMWPE), may be utilized. The pad 164 (FIG. 5) may be made of non-metallic materials, including any of the non-metallic materials disclosed herein. Portions of the implant, such as the extensions, may be constructed from biological and other biomaterials, such as hydroxyapatite and allograft bone or other tissue.

[0060] The plate body of the base plate may include a first material and the extension of the extension may include a second material. The first material and the second material may be the same or may differ in composition and / or structure. For example, the densities of the first material and the second material may be the same or may differ. The plate body may be substantially solid.

[0061] One or more coatings or layers may be deposited along the surface of the implant, including the base plate and / or extensions. For example, at least one layer 55' may be disposed along the surface of the extension body 34' as illustrated in FIG. 3A or may otherwise establish the surface of the extension body 34'. The implant 22' may include one or more layers 55' that establish at least a majority or substantially all of the surface of the extension body 34' that defines the network 44'. The layer 55' may include any of the materials disclosed herein, including non-biological or bioactive materials or biologics that promote endosteal integration of the implant 22' at the surgical site. Exemplary layers may include calcium phosphate (CaP) and hydroxyapatite to promote bone growth. The layer 55' may be disposed on the surface of the implant 22' simultaneously with or after the formation of the implant 22'. For example, the layer 55' may be printed to establish the surface of the internal network 44' while printing adjacent portions of the implant 22'. In other implementations, layer 55' may be deposited on a surface of expander body 34 to establish the surface of network 44'. For example, layer 55' may be injected into network 44' as a slurry after formation of implant 22'.

[0062] FIG. 7 illustrates in a flow chart 380 an exemplary method of placing an orthopedic implant at a surgical site. The method may be utilized to perform arthroplasty to restore functionality of shoulders and other joints with progressive cartilage disease, such as, for example, repairing bone defects along the glenoid. Although the method 380 primarily refers to an implant for repairing defects in the glenoid during shoulder reconstruction, it should be understood that the method and the disclosed implant may be utilized in other locations on the patient and in other surgical procedures, such as the humerus or any other location disclosed herein. The method 380 may be utilized with any of the orthopedic implant systems disclosed herein. Fewer or additional steps are listed below and may be performed within the scope of the present disclosure, and the order of the listed steps is not intended to limit the present disclosure.

[0063] A kit for joint arthroplasty may be provided at step 380A. The kit may include any of the components of the implant system disclosed herein. The kit may include a set of implants of various sizes and geometries. At step 380B, the surgeon may select one or more components from the kit. For example, step 380B may include selecting an implant from the set of implants based on a planned surgical technique and / or a patient's anatomy including a surface contour SC associated with bone B1 along a surgical site S, as illustrated in FIG. 8. The surgical site S may be established, for example, along a glenoid fossa G. The kit may include fasteners of different sizes that may be received in respective openings in the implant to secure the implant to the surgical site S. The kit may include articulating members of various sizes and geometries for securing to the selected implant. The surgeon may select an articulating member from the kit based on a planned surgical technique and / or a patient's anatomy.

[0064] With continued reference to FIG. 7 and with reference to FIG. 8, the surgical site S may be prepared to receive an implant 322 at step 380C. The implant 322 may correspond to any of the implants disclosed herein. The implant 322 may include a base plate 324 and an extension 326. One or more operations may be performed to prepare the surgical site S, such as one or more reaming, milling and / or drilling operations to establish a particular geometry of the surgical site S. Step 380C may include forming one or more holes in the surgical site sized to receive the respective fasteners (see, e.g., FIG. 2B).

[0065] Step 380C may include forming a cavity C along the surgical site S, such as the articular surface of the glenoid cavity G, at step 380D. The cavity C may be formed by removing a portion of bone B1 or other tissue at the surgical site S, as shown in Figures 10 and 11. The tissue may include cartilage, cancellous bone, and / or cortical bone along the surgical site S.

[0066] Cavity C may be sized to at least partially or completely receive base plate 324 and / or extension 326. Cavity C may be formed to remove tissue from the defect in bone B1 and may be sized to approximate the contours of the defect. The defect in the glenoid may be characterized by the Walch classification. The surgeon may measure bone loss using imaging of the surgical site, such as radiographic or computed tomography techniques, or may approximate the contours of the defect using one or more dimensioners and / or measuring devices placed against the bone surface.

[0067] The selected implant 322 may be positioned along the surgical site S at step 380E. Step 380E may occur such that the anterior surface 330 of the base plate 324 faces toward the opposing articular surface AS associated with the adjacent bone B2, as shown in FIG.

[0068] With continued reference to FIG. 7 , and with reference to FIGS. 8 and 9 , step 380E may include moving implant 322 in direction D2 ( FIG. 8 ) such that posterior surface 338 abuts and is superimposed on surface contour SC of bone B1, as shown in FIG. 9 . In some implementations, implant 322 is positioned such that at least extension portion 326 abuts a surface and / or fills cavity C along surgical site S. For example, step 380E may include positioning extension portion 326 partially within cavity C, as illustrated in FIG. 10 , or positioning extension portion 326 completely within cavity C, as illustrated in FIG. 11 . Step 380E may include positioning at least a portion of a base plate within the cavity, as illustrated by base plate 24 in FIG. 4 .

[0069] Step 380E may include moving the extension 326 at least partially into cavity C such that an exterior surface of the extension body 334 abuts a wall of cavity C adjacent port 348, as illustrated in Figures 10-11. The exterior wall of the extension body 334 may have a substantially smooth or continuous contour, including a sidewall 339. One or more ports 348 may be defined in the sidewall 339 to facilitate delivery of biomaterial M following placement of the implant 322 and completion of the surgical procedure.

[0070] In some implementations, the extension body 334 may include one or more protrusions 370 extending outwardly from the posterior surface 338 or another portion of the extension body 334, as shown in FIG. 9A. The protrusions 370 may be dimensioned to resemble one or more roots extending outwardly from the posterior surface 338. Each protrusion 370 may define at least one of the internal passageway 346 and the port 348. Step 380E may include moving the implant 322 into abutment with a surface of the bone B1 such that the protrusions 370 are at least partially embedded within the bone B1, which may improve fixation of the implant 322 along the surgical site S.

[0071] At step 380F, one or more fasteners may be positioned in and at least partially through the respective fastener apertures and then into the bone to secure the selected implant to the surgical site, as illustrated by fastener F in FIG. 2B. Fastener F may be a compression screw that may function to apply and maintain compression between base plate 24 and the bone, which may reduce relative movement and tissue formation that may otherwise occur due to spacing between the contact surfaces of the implant and the bone.

[0072] The abutment of the extension 326 against the adjacent bone B1 may establish a suction or capillary action. The suction action may cause biomaterial M from the surgical site S to at least partially or completely fill the volume of the internal network 344, which may promote bone growth and fixation of the implant 322.

[0073] 12 with continued reference to FIG. 7, in some implementations, pump 368 may be coupled to internal network 344 of implant 322 at step 380G. Pump 368 may include one or more modes. For example, pump 368 may be a bidirectional pump, such as a syringe, movable in a third direction D3 during a first mode and movable in a fourth direction D4 during a second mode. The fourth direction D4 may be generally opposite to the third direction D3. In a first mode, pump 368 may function to draw biological material into internal network 344 and / or move biological material M toward interface opening 342. In a second mode, pump 368 may function to move biological material M away from interface opening 342 and through internal network 344.

[0074] In step 380H, pump 368 may be operated to transfer biological and / or other material M at least partially into interior passageway 346 of interior network 344. Step 380H may include operating pump 368 in one or more modes, such as a first mode and / or a second mode. In step 380H, pump 368 may be operated in a first mode to draw at least a portion of biological material M from surgical site S through port 348 and thereafter at least partially into interior passageway 346, such that the volume of interior network 344 is at least partially or substantially filled with biological material M. In step 380I, pump 368 may be operated in a second mode to push or otherwise move at least a portion of biological material M within network 344 in a direction toward port 348 and outwardly. In some implementations, step 380J may include delivering non-living and / or biological material M from pump 368 to internal network 344, which may be provided by the patient or from another source. Pump 368 may be operated in one or more cycles between the first mode and the second mode to at least partially or substantially fill the volume of internal network 344 with non-living and / or biological material M. Pump 368 may be decoupled from interface opening 342 of implant 322 in step 380J.

[0075] Interface opening 342 may be utilized to obtain a visual indication of the amount of biological material M contained within internal network 344. The surgeon may repeat steps 380G, 380H, 380I, and / or 380J until a determined portion of internal network 344 is filled with biological material M.

[0076] 13 with continuing reference to FIG. 7, a plug 372 may be positioned within the interface opening 342 (shown in dashed lines for illustrative purposes) to at least partially seal the internal network 344 at step 380K. The plug 372 may be made of any of the materials disclosed herein. In other implementations, the plug 372 is omitted. In some implementations, the fastener FF of FIG. 4 may function as the plug 72.

[0077] The articulation member 356 may be secured to the base plate 324 at step 380L. The articulation member 356 may include any of the articulation members disclosed herein. The articulation member 356 may be moved in a direction D5 and brought into abutment with the base plate 324. The articulation member 356 may be secured to the plate body 328 adjacent the anterior surface 330. The articulation surface 358 of the articulation member 356 may be disposed to mate with an opposing articular surface AS. The articulation surface AS may be established by the adjacent bone B2 or by another implant located along the adjacent bone B2. The adjacent bone B2 may be, for example, the humerus opposing the glenoid cavity G.

[0078] One or more subsequent and / or finishing operations may be performed in step 380M. Exemplary finishing operations may include closing an incision adjacent to the surgical site S.

[0079] The novel implants and methods of the present disclosure can provide improved fixation and healing for patients. The disclosed implants may include an internal network of extensions that receive biomaterials, which can improve the implant's endosteal integration and fixation through promotion of bone growth into the internal network. The disclosed internal network, which includes interconnected branches and nodes, mimics the structural, articulating, and / or physiological properties of natural bone and improves force distribution to promote structural compatibility with adjacent bone, which may improve fixation of the implant.

[0080] Although different non-limiting embodiments are illustrated as having particular components or steps, the embodiments of the present disclosure are not limited to those particular combinations. Some of the components or features from any of the non-limiting embodiments can be used in combination with features or components from any of the other non-limiting embodiments.

[0081] The foregoing description is illustrative and is not to be construed in any limiting sense. Those skilled in the art will appreciate that certain modifications may be made within the scope of the present disclosure. For these reasons, the following claims should be studied to determine the true scope and content of the present disclosure. [Explanation of symbols]

[0082] 20 Implant System 22 Base plate 22 Implants 24 Base plate 26 Extension 28 Plate body 30 front 32 Rear 34 Extension 36 Front 38 Rear 39 Side wall 40 fixed aperture 42 Interface opening 44 Internal Network 46 Internal passage 48 Ports 50 Joint 52 Main executives 54 Branching Routes 56 Joint connection members 58 Articular Surface 60 Articulating Head 61 Aperture 62 Depression 68 Pump 72 Plug

Claims

1. an implant including a base plate and an extension; the base plate includes a plate body extending between an anterior surface and a posterior surface, the anterior surface being configured to face an opposing articular surface associated with a bone; the extension includes an extension body extending from the rear surface of the plate body, the extension body including a network of internal passages branching to respective ports along an exterior surface of the extension body; the implant includes at least one fixation aperture extending at least partially through the plate body and the expander body; An orthopaedic implant system, wherein the at least one fixation aperture is configured to receive a respective fastener for securing the implant to bone.

2. The system of claim 1 , wherein the network is dimensioned to branch outwardly from the rear surface of the plate body to opposing side walls of the extension body.

3. The system of claim 1 , wherein the internal passages interconnect each port with a common interface opening defined along an exterior surface of the implant.

4. 4. The system of claim 3, wherein each of the internal passages divides into branching paths at respective junctions, and at least two of the junctions are established between the common interface opening and each of the respective ports.

5. 5. The system of claim 4, wherein the network is arranged so that the cross-sectional area of ​​the internal passages gradually decreases at each respective junction in a direction toward the respective port.

6. a pump securable to the common interface opening; The system of claim 3 , wherein the pump is configured to draw biological material from the port at least partially into the internal passageway.

7. the common interface opening is defined along the plate body; 7. The system of claim 6, wherein said network includes a main trunk extending outwardly from said common interface opening, and said internal passages are divided into branch paths coupled from said main trunk to said respective ports.

8. a pad including a concave articulating surface; The system of claim 1 , wherein the pad is securable to the base plate adjacent the front surface.

9. and further comprising an articulation head including a convex articulation surface; The system of claim 1 , wherein the articulating head is securable to the base plate adjacent the front surface.

10. The system of claim 9 , wherein the articulation head includes a recess dimensioned to at least partially receive the plate body.

11. The system of claim 1 , further comprising one or more bioactive layers establishing at least a majority of the surface of the expandable body that defines the network.

12. an implant including a base plate and an extension extending from the base plate, the anterior surface of the base plate being configured to face an opposing articular surface associated with a bone, the extension including a network of internal passageways coupled to respective ports along an exterior surface of the extension; a pump configured to transfer a biological material at least partially into the network; A plurality of fasteners; Equipped with An orthopaedic implant system, wherein the implant includes a plurality of fixation apertures, each of the fixation apertures configured to receive a respective one of the fasteners to secure the implant to bone.

13. the implant includes an interface opening defined along an exterior surface of the implant, and the internal passages interconnect the respective ports and the interface openings; and The system of claim 12 , wherein the pump is securable to the implant at the interface opening.

14. an articulation member including an articulation surface configured to cooperate with the opposing articulation surface to establish an articulation interface; The system of claim 12 , wherein the articulation member is securable to the base plate.

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