Modular Knee Augmentation Cone

Abstract

A modular augment cone system and a method for implanting the modular augment cone system are provided. The system includes a body cone including a first notch in a cone wall, the body cone including a proximal end, a distal end, and a cone wall extending between the proximal and distal ends. A portion of the cone wall proximal to the first notch includes an attachment mechanism. The first augment cone is positionable within the first notch, and the first augment cone includes an attachment mechanism configured to mate with the attachment mechanism in the cone wall to attach the first augment cone within the first notch. The body cone may include a second notch in the cone wall. In such a system, the modular augment cone system may include a second augment cone configured to mate with the attachment mechanism in the cone wall to attach the second augment cone within the second notch.

Description

[Technical field]

[0001] [INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATION] This application claims priority to U.S. Provisional Patent Application No. 62 / 967,342, filed January 29, 2020, which is incorporated herein by reference.

[0002] This application relates to cones and augments for use in revision knee surgery. More particularly, this application describes a modular knee augment cone system having a body cone and an augment that can be mated to each other to form an asymmetric revision cone. [Background technology]

[0003] Revision knee replacement surgery is a procedure performed to replace knee implants that are not functioning properly. Various cone augments are implanted into the patient during a surgical procedure on the knee to accept, for example, a tibial implant. The cones required for such procedures may be symmetrical or asymmetrical cones. Asymmetrical cones may be left asymmetrical, right asymmetrical, or double asymmetrical based on the positioning of the augment on the body portion of the cone. Augmented cones are expensive. A variety of different types of augmented cones must be kept in stock to ensure that the correct augmented cone is on hand during surgery when needed. Summary of the Invention [Problem to be solved by the invention]

[0004] Therefore, to control costs and simplify the supply chain, it would be advantageous to have a single augmented cone system that can be used for many, if not all, procedures. [Means for solving the problem]

[0005] The invention is defined by the independent claims. The dependent claims relate to optional features of some embodiments of the invention. The systems, methods, and devices described herein each have several aspects, no single one of which is solely responsible for its desirable attributes. Without limiting the scope of this disclosure, some non-limiting features are briefly discussed below.

[0006] Details of one or more implementations of the subject matter described herein are set forth in the accompanying drawings and the description below. Other features, aspects, and advantages will become apparent from the description, drawings, and claims. Neither this summary nor the following detailed description is intended to define or limit the scope of the inventive subject matter.

[0007] One innovation includes, for example, a modular augmented cone system including a body cone including a proximal end, a distal end, and a cone wall extending between the proximal and distal ends and further including a first notch in the cone wall, a portion of the cone wall proximate the first notch including a cone wall mounting feature, and a first augmented cone positionable within the first notch, the first augmented cone including an augmented mounting feature configured to mate with the cone wall mounting feature to mount the first augmented cone within the first notch.

[0008] The modular augmented cone system can include several different embodiments having different aspects or features, some of which are discussed herein. However, the innovation is not limited to the different embodiments or features discussed herein. Additionally, features disclosed herein may be included in various embodiments of the modular augmented system, regardless of whether they are expressly described as being included in a particular embodiment, unless expressly stated otherwise or by the content of the feature. For example, in some embodiments, an exterior surface of the first augmented cone extends away from a central portion of the body cone when the first augmented cone is positioned within the first notch. In some embodiments, the body cone further comprises a second notch in the cone wall, and a portion of the cone wall proximate the second notch includes a cone wall mounting structure. In some embodiments, the modular augmented cone system further comprises a second augmented cone positionable within the second notch, the second augmented cone including an augmented mounting structure configured to mate with the cone wall mounting structure to mount the second augmented cone within the second notch.

[0009] In some embodiments of the modular augmented cone system, the cone wall of the body cone includes an exterior surface with a porous coating. In some embodiments, the cone wall of the body cone includes an exterior surface with a porous coating. In some embodiments, the porous coating extends to a distal end of the body cone. In some embodiments, the porous coating extends to a proximal end of the body cone. In some embodiments, the porous coating extends to both the proximal and distal ends of the body cone. In some embodiments, the body cone further includes a distal ring structure circumferentially positioned at the distal end of the body cone on the exterior surface of the cone wall, the porous coating extending to the distal ring structure. In some embodiments, the body cone further includes a proximal ring structure circumferentially positioned at the proximal end of the body cone on the exterior surface of the cone wall, the porous coating extending to the proximal ring structure. In some embodiments, the body cone further comprises a proximal ring structure circumferentially positioned on the exterior surface of the cone wall at a proximal portion of the body cone and a distal ring structure circumferentially positioned on the exterior surface of the cone wall at a distal end of the body cone, the porous coating extending between the proximal ring structure and the distal ring structure. In some embodiments, the first augment cone includes an exterior surface including the porous coating.

[0010] In some embodiments of the modular augment cone system, the body cone comprises one or more ribs circumferentially positioned on an interior wall surface of the body cone, the one or more ribs providing a surface to allow adhesive to lodge. In some embodiments, the cone wall mounting feature comprises a slot. In some embodiments, the mounting feature on the augment comprises an extension that fits into a slot in the cone wall mounting feature. In some embodiments, the mounting feature on the augment comprises a slot. In some embodiments, the cone wall mounting feature comprises a slot. In some embodiments, the cone wall mounting feature comprises an extension that fits into a slot in the mounting feature on the augment.

[0011] In some embodiments of the modular augmented cone system, the perimeter of the proximal end of the body cone is greater than the perimeter of the distal end of the body cone. In some embodiments, the first notch is positioned opposite the second notch in the cone wall. In some embodiments, the first notch and the second notch are positioned in the cone wall such that a portion of the cone wall between a first edge of the first notch and an adjacent first edge of the second notch is greater than a portion of the cone wall between a second edge of the first notch and an adjacent second edge of the second notch. In some embodiments, the body cone is a cross section of the body cone parallel to the longitudinal axis of the body cone that is substantially circular. In some embodiments, the first notch extends from the proximal end of the body cone toward the distal end of the body cone but does not reach the distal end of the body cone. In some embodiments, the first notch extends from the distal end of the body cone toward the proximal end of the body cone but does not reach the proximal end of the body cone. In some embodiments, the width w dimension of the first notch along the proximal end of the body cone is between about 16 mm and about 25 mm. In some embodiments, the length l dimension of the first notch along the extent of the first notch from the proximal end of the body cone toward the distal end of the body cone is between about 14 mm and 24 mm.

[0012] Another innovation includes a modular augmented cone system with a body cone including a proximal end, a distal end, and a cone wall extending between the proximal and distal ends, the body cone further including a first notch in the cone wall structured to receive the augmented cone, and a portion of the cone wall proximate the first notch includes a cone wall attachment feature.

[0013] Another innovation includes a modular augmented cone system including an augmented cone configured to be positioned within a notch in a wall of a body cone, the augmented cone including an augmented attachment mechanism configured to mate with an attachment mechanism on a wall of the body cone to attach the augmented cone to the wall and cover the notch in the wall of the body cone. In some embodiments, a body cone having a proximal end, a distal end, and a cone wall extending between the proximal and distal ends further includes a notch in the cone wall, and a portion of the cone wall proximate the first notch includes an attachment mechanism configured to mate with the attachment mechanism of the augmented cone.

[0014] Another innovation includes a method of using a modular augment cone system, the method including positioning a body cone in a patient as described herein and disposing a first augment cone in a first notch.

[0015] Another innovation includes a method of using a modular augment cone system, the method including positioning a body cone within a patient and disposing a first augment cone within a first notch.

[0016] Another innovation includes a method of using a modular augment cone system, the method including providing a modular augment cone system as described herein, positioning and connecting an augment cone within a first notch of a body cone, and embedding the body cone with the connected augment cone, e.g., embedding the body cone with the connected augment cone within a portion of a patient's knee.

[0017] Another innovation includes a method of embedding a modular augmented cone system, the method including assembling the modular augmented cone system of claim 1 by placing a first augmented cone in a first notch, and embedding the modular augmented cone system including a body cone and the first augmented cone in a prepared space.

[0018] Another innovation includes a method of embedding a modular augmented cone system, the method including providing a modular augmented cone system and positioning a first augmented cone within a first notch of a body cone.

[0019] In the drawings, which are not necessarily drawn to scale, like numbers may describe like components in different views. Like numbers with different letter suffixes may indicate different instances of like components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document. [Brief description of the drawings]

[0020] [Figure 1A] FIG. 1A shows a perspective side view of an example of an embodiment of a symmetric body cone of a modular augmented cone system, such as of a modular knee augmented cone system. FIG. 1A shows a body portion (or "body cone") of the modular symmetric cone having multiple notches in opposing walls of the body portion, each configured to receive an augmented cone ("augment"). The body portion of the modular symmetric cone may be referred to herein as the "body cone" or "body portion" for ease of reference. [Figure 1B] FIG. 1B is a side view illustrating the body cone of FIG. 1A showing the longitudinal axis of the body cone. [Figure 1C] 1B is a perspective bottom view of the body cone of FIG. 1A showing the circular planar undersurface on the distal end of the body cone. [Diagram 2]FIG. 1B is a perspective view of one example of an augment configured to be positioned within a notch in the body cone shown in FIG. 1A. The augment includes structure near its edge that fits within and / or against corresponding structure along the edge of the notch to allow the augment to be seated within the body cone and attached to the body cone within the notch. [Diagram 3] 1 is a perspective view of an example of an augment partially positioned within one of the notches in the body cone, with a second notch in the body cone having no augment positioned therein. When the augment is seated on the notch, the modular knee augment cone system is an asymmetric cone. When the augment is seated within the body cone, the side and lower ("distal") edges of the augment are structured to line up with corresponding structures on the edges of the notch, and the side and distal edges of the augment are positioned closely adjacent and / or in contact with said corresponding structures on the edges of the notch on the body cone. [Figure 4] FIG. 1 is a top view of an example of a modular knee augment cone system having an augment positioned in a first notch in the body cone. [Diagram 5] FIG. 1 illustrates a perspective view of an example of a body cone, according to some embodiments. [Figure 6] FIG. 13 is a top ("proximal") view showing another example of a modular knee augment cone system having an augment positioned within a first notch in the body cone. [Figure 7] FIG. 1 is a side cross-sectional view of an example of a body cone having a cement mantle step (sometimes referred to herein as a circumferential rib) and also having a bone growth coating (e.g., a porous lattice surface) on a portion of the exterior surface of the body cone contained between the upper (proximal) ring and the lower (distal) ring. [Figure 8]FIG. 13 is another cross-sectional side view showing an example of a body cone having a cement mantle step, a bone growth coating (e.g., a porous lattice surface) on a portion of the outer surface of the body cone contained between the upper (proximal) ring and the lower (distal) ring, and at least one axial rib for rotational fixation of the cement when implanted in a patient. [Figure 9] FIG. 13 is another cross-sectional side view of an example of a body cone having a cement mantle step, a bone growth coating (e.g., a porous lattice surface) on a portion of the exterior surface of the body cone, and at least one axial rib for rotational fixation of the cement when implanted in a patient. In this example, the porous lattice surface extends from the upper (proximal) surface of the body cone to the lower (distal) surface of the body cone. [Figure 10] 10 is a perspective view of an example of a body cone and a first augment positioned in a first notch of the body cone and a second augment positioned in a second notch of the body cone. FIG. 10 also shows that in this example, the body cone and the first and second augments include a porous lattice surface on the exterior surfaces of these components. [Figure 11] FIG. 13 is a side view of an example of a body cone having a tibial implant positioned therein, with a portion of the tibial implant extending through a first notch and a second notch in a wall of the body cone. [Figure 12] 12 is a side view of the body cone and tibial implant shown in FIG. 11, with the side view of FIG. 12 rotated axially approximately 70 degrees to show a different side view of these mated components. [Figure 13] FIG. 12 is a perspective top view of a body cone in the tibial implant shown in FIG. 11. [Figure 14] FIG. 12 is a bottom view of the body cone and tibial implant shown in FIG. 11. [Figure 15] 1 is a flowchart illustrating a process for using the modular knee augmentation cone system described herein. [Figure 16]13 is a flowchart illustrating another process for using the modular knee augmentation cone system described herein. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] Overview The present application relates to a modular augment cone system that can be used, for example, as an implant in a patient's knee. In one example, the application for the modular augment cone system described herein can be used in a replacement knee procedure to provide support and fill the void left by the primary implant. In some embodiments, a femoral cone can also be used. The modular augment cone system includes a body cone and an augment cone ("augment") that can mate with the body cone by positioning the augment in a notch in the wall of the body cone to create an asymmetric cone. The overall shape of the body cone is a truncated cone. In one example, the circular truncated cone-shaped body cone has a first diameter at a proximal end and a second diameter at a distal end, the first diameter being larger than the second diameter. In some embodiments, the first diameter is between 25 mm and 60 mm. In some embodiments, the first diameter is between 32 mm and 50 mm. In some embodiments, the second diameter is between 20 mm and 55 mm. In some embodiments, the second diameter is between 25 mm and 40 mm. The body cone may be symmetrical in its entire structure, e.g., portions of its structure do not include the notch and the augment cone. The edge of the body cone that engages with the augment at the notch includes an attachment mechanism that may include one or more structural features (e.g., one or more of a slot, groove, protrusion, dovetail, post, divot, tooth, ball, or post, etc.). In some embodiments, the body cone is medial symmetrical or transverse symmetrical. The inner diameter of the body cone may be wide enough to accommodate the implant and offset stem.

[0022] In some embodiments, the body cone described herein is a trial cone. The trial cone can be made of metal or plastic. However, some embodiments of the trial cone do not have a permanent locking mechanism (whereas embodiments of the implantable body cone have a permanent locking mechanism for locking the augment in the body cone). Instead, the trial cone may include a temporary locking mechanism, e.g., a screw, a ball detent / post and dovetail, or a snap tab. Once the distal force is deemed acceptable for trialing, the trial body cone and augment may not have a locking mechanism, e.g., a distal locking structure.

[0023] The augment has an open upper ("proximal") portion and a lower ("distal") generally hemispherical portion. The edge of the augment that mates with the body cone at the notch also includes an attachment mechanism (e.g., one or more of a slot, groove, protrusion, dovetail, post, divot, tooth, ball, or post, etc.) that corresponds to the attachment mechanism of the body cone so that the augment can be securely positioned within the notch and mated to the body cone. The attachment mechanisms of the body cone and augment may include one or more structures and may include a locking device (e.g., a pin, screw, or other fastener). In some embodiments, the fixation for the asymmetric augment for the cone may be a slot that does not provide distal / proximal fixation, or a variety of locking mechanisms. In other embodiments, the fixation for the augment in the body portion may be achieved by one of a variety of locking mechanisms including, but not limited to, a dovetail, a leaf spring, a locking tab, a screw-loaded ball / post and divot, a screw, a pin, or a ratchet tooth.

[0024] When an augment is positioned within a notch in a body cone, an asymmetric cone is formed. That is, an augment can be mated to a symmetric body cone to create an asymmetric cone. The body cone includes a cavity. The augment also includes a cavity that is partially surrounded by the augment interior surface / wall. When the augment is mated to the body cone, it covers the notch and extends from the body cone such that the augment cavity and the body cone cavity together form a larger cavity that is surrounded by the structure of the body cone and the augment cone (see, for example, FIG. 6 which shows body cone cavity 140 and augment cavity 240 combined to form a larger cavity).

[0025] The body cone may be described as having an "upper" or "proximal" end (positioned proximal to the patient's heart when implanted) and a "lower" or "distal" end (positioned distal to the patient's heart when implanted). The body cone includes at least one notch (or gap) in the wall of the body cone. A portion of the wall around each notch includes an attachment mechanism configured to receive and attach an augment. In some embodiments, the body cone has one notch. In some embodiments, the body cone has two notches. In some embodiments, the body cone has three or more notches. The notches may sometimes be referred to as "slots" in reference to the functionality they may enable. That is, the attachment mechanisms of the body cone and augments may be configured to allow the augment cone to be positioned in the notch by sliding the augment from the proximal end of the body portion into the wall of the body. The body portion has structure that allows grooves in opposing sides of the augment cone to fit over the walls of the body cone and allows the augment cone to slide into the notch, and the augment can be positioned in the notch such that the augment mates with the body portion. In one example, when the augment is positioned in the notch, a proximal end (e.g., surface) of the augment is aligned with a proximal edge (or surface) of the body portion. That is, the proximal end of the augment may be aligned with a plane that, when the augment is seated in the notch, is also aligned with the proximal end of the body cone.

[0026] In one embodiment, the body cone includes two notches, each capable of receiving an augmented cone positioned therein. In some embodiments, the two notches can be configured in the body portion wall directly opposite one another (e.g., on opposite sides of the body portion), for example, as illustrated in FIG. 6. In such examples, the centers of the two notches are aligned 180 degrees apart. In some embodiments, the two notches can be configured in the body portion wall opposite one another, but not directly opposite one another. For example, the first notch and the second notch can be positioned in the cone wall such that the portion of the cone wall between the first edge of the first notch and the adjacent first edge of the second notch is larger than the portion of the cone wall between the second edge of the first notch and the adjacent second edge of the second notch. In such examples, the centers of the two notches are not 180 degrees apart. That is, the notch center separation angle (as shown in FIG. 6) is not 180°.In various embodiments of a body cone having two notches, the notch center separation angles are 1°, 2°, 3°, 4°, 5°, 6°, 7°, 8°, 9°, 10°, 11°, 12°, 13°, 14°, 15°, 16°, 17°, 18°, 19°, 20°, 21°, 22°, 23°, 24°, 25°, 26°, 27°, 28°, 29°, 30°, 31°, 32°, 33°, 34°, 35°, 36°, 37°, 38°, 39°, 40°, 41°, 42°, 43°, 44°, 45° , 46°, 47°, 48°, 49°, 50°, 51°, 52°, 53°, 54°, 55°, 56°, 57°, 58°, 59°, 60°, 61°, 62°, 63°, 64°, 65°, 66°, 67°, 68°, 69°, 70°, 71°, 72°, 73°, 74°, 75°, 76°, 77°, 78°, 79°, 80°, 81°, 82°, 83°, 84°, 85°, 86°, 87°, 88°, 89°, 90°, 91°, 92°, 93°, 94°, 95°, 96°, 97°, 98°, 99°, 100°, 101°, 102°, 103°, 104°, 105°, 106°, 107°, 108°, 109°, 110°, 111°, 112°, 113°, 114°, 115°, 116°, 117°, 118°, 119°, 120°, 121°, 122°, 123°, 124°, 125°, 126°, 127°, 128°, 129°, 130°, 131°, 132°, 133°, 134°, 135°, 136°, 137°, 138°, 139°, 1 40°, 141°, 142°, 143°, 144°, 145°, 146°, 147°, 148°, 149°, 150°, 151°, 152°, 153°, 154°, 155°, 156°, 157°, 158°, 159°, 160°, 161°, 162°, 163°, 164°, 165°, 166°, 167°, 168°, 169°, 170°, 171°, 172°, 173°, 174°, 175°, 176°, 177°, 178°, or 179° ±0.5°.

[0027] In various embodiments of the body portion and / or the augment, the interior surface of the body cone can include one or more axially aligned ribs for rotational locking to the cement. The axially aligned ribs allow the cement to rest on a surface that is not curved about a central axis that provides resistance to rotational forces about the axis of the body cone. In some embodiments, preparation for use of the implant can include an offset jig with an overreamer on the stem reamer for the body, followed by an augmented reamer for the augmented cone.

[0028] In some embodiments, the exterior surfaces of the body cone and augment (i.e., facing away from the cavity) include a surface structure to facilitate bone ingrowth. 2 , including a proprietary titanium porous coating by DJI Surgical. 2 The advantage of P-Squared is that the non-spherical beads of the coating itself are also porous, hence the name P-Squared. 2 ) is given. The pore size, P 2 The variation in surface area helps bone apposition for superior growth outcomes. In some embodiments, the surface structure may be another type of porous rough coating. In some embodiments, the surface structure is 3D printed to generate a porous lattice surface. In some embodiments, the porous coating is a consistent depth on the outer surface (e.g., the outer surface of the body cone and / or the outer surface of the segment cone). Depending on the manufacturing method, there may or may not be upper (proximal) and lower (distal) rings on the outer surface of the body cone to capture or confine the porous coating. Depending on the ease of manufacturing, there may be an upper ring, a lower ring, both rings, or no rings. In some embodiments, the body cone does not include either one or more of the upper or lower rings, and the coating may be an all-around coating.

[0029] In some embodiments, the surface structures are produced using traditional subtractive manufacturing (eg, removing material from the exterior surface or surface coating of the body cone and / or augment cone).

[0030] term To facilitate understanding of the systems and methods discussed herein, several terms are defined below. The terms defined below, as well as other terms used herein, should be interpreted to include the definitions provided, the ordinary and customary meaning of the terms, and / or any other implied meaning for the respective terms. Thus, the definitions do not limit the meaning of these terms, but only provide exemplary definitions.

[0031] Augment Cone: A component of the modular augment cone system, an example of which is shown in FIG. 2. The augment cone is positionable within an opening (or cutout) in the body cone and can be attached to the body cone by corresponding attachment structures on the augmented cone and body cone. The augmented cone includes a cavity partially surrounded by the augmented cone structure. In use, the augment is attached to the body cone and may be locked into place before the body cone / augmented cone system is implanted in a patient.

[0032] Body Cone: A component of the modular augment cone system, an example of which is shown in FIG. 1A. The body cone is frustum cone shaped and structured to receive an implant (e.g., a tibial implant). The body cone includes an opening (or notch) configured to receive the augment cone. The body cone may have one or more notches, and the body cone also includes a cavity partially surrounded by the body cone structure. When the augment cone is attached to the body cone, the cavity of the augment cone is contiguous with the cavity of the body cone to form a cavity larger than the cavity of the body cone.

[0033] Modular Augmented Cone System: A system including a body cone and one or more augmented cones, an example of which is shown in Figure 10. The modular augmented cone system may include other components attached to the body cone.

[0034] P 2 is a new proprietary titanium porous coating by DJO Surgical, the first porous coating in the world where the non-spherical beads themselves are also porous, hence the name, P-Squared. 2 ) is given. The pore size, P 2 The changes in bone structure aid in bone apposition for superior growth outcomes. 2 The pore size range of the porosity is composed of two ranges of pore size, inter- and intra-bead. This change in pore size range may be responsible for the P 2 Example interbead pore sizes include pore sizes between each non-spherical bead of 200-525 microns (μm). Example intrabead pore sizes include pore sizes within each non-spherical bead of 25-65 microns (μm).

[0035] Exemplary Knee Augmentation Cone Systems and Methods 1A-1C show an example of one embodiment of a modular knee augmentation cone system. FIG. 1A is a perspective side view of an example of one embodiment of a symmetric body cone of the modular knee augmentation cone system. The body portion of the modular symmetric cone may be referred to herein as the "body cone" or "body portion" for ease of reference. FIG. 1B is a side view illustrating the body cone 101 of FIG. 1A showing the longitudinal axis 109 of the body cone 101. FIG. 1C is a perspective bottom view of the body cone 101 of FIG. 1A showing the circular planar lower surface 130 on the distal end 104 of the body cone 101. The view of FIG. 1C also shows the circular opening 121 in the distal end 104 of the body cone surrounded by the lower surface 130.

[0036] The body cone 101 includes cutouts 105, 110 in opposing portions of a wall 108 of the body cone 101. The portions of the wall 108 that form the openings may be referred to as "cutouts" 105, 110, although the term "cutout" as used herein does not imply that these gaps in the wall need to be formed by removing or cutting away material from the body cone wall, although they may be at least partially so formed. Rather, the term "cutout" is used herein to refer to a portion of the body cone wall that includes a gap configured to receive an augmented cone, for example, regardless of how it is formed. The body cone 101 partially surrounds a portion of the cavity 140. Each cutout 105, 110 is configured to receive an augmented cone (e.g., augmented cone 200 in FIG. 2).

[0037] In the example shown in FIG. 1A, the body portion 101 is frustum cone-shaped, and in this example is symmetrical. In some embodiments, the upper portion 115 of the body cone 101 can have a larger diameter than the lower portion 120 of the body cone 101. One or more notches 105, 110 extend from the upper surface 125 of the body portion 101 toward the lower surface 130 of the body 101. Each notch can have a width w and a length l. The dimensions of the notches can be based at least in part on the size of the body cone and / or the size of the implant to be used with the body cone 101. In some embodiments, the width w dimension of a first notch along the proximal end of the body cone is between about 16 mm and about 25 mm. In some embodiments, the width w dimension of the first notch along the proximal end of the body cone is 12 mm, 13 mm, 14 mm, 15 mm, 16 mm, 17 mm, 18 mm, 19 mm, 20 mm, 21 mm, 22 mm, 23 mm, 24 mm, 25 mm, 26 mm, 27 mm, 28 mm, or 29 mm, ±0.5 mm. In some embodiments, the length l dimension of the first notch along the extent of the first notch from the proximal end of the body cone towards the distal end of the body cone is between about 14 mm and 24 mm. In some embodiments, the length l dimension of the first cutout along the proximal end of the body cone is 9 mm, 10 mm, 11 mm, 12 mm, 13 mm, 14 mm, 15 mm, 16 mm, 17 mm, 18 mm, 19 mm, 20 mm, 21 mm, 22 mm, 23 mm, 24 mm, 25 mm, 26 mm, 27 mm, 28 mm, 29 mm, 30 mm, or 31 mm, ±0.5 mm. In this example, the cutouts 105, 110 do not extend the full length of the wall 108, but instead extend from the top surface 125 into the wall 108 to a length greater than about half the height of the body portion wall 108. Other examples may differ and the cutouts 105, 110 may extend further than the illustrated example, or may not extend as far as the illustrated example.

[0038] FIG. 1A also shows bone growth surface portion surface structures 135 on the outer surface of the body portion (shown as a darker surface) that are made to facilitate bone growth within the surface to hold the surface in place. In some examples, the surface structures 135 are2 In some examples, the surface is formed on the body cone in an additive manufacturing process, e.g., with a 3D printer. In some examples, the surface structure 135 is formed in a subtractive manufacturing process. In this example, the body cone 101 includes an upper ring 111 that extends circumferentially around the proximal end 103 of the body cone, and a lower ring 112 that extends circumferentially around the distal end 104 of the body cone. The surface structure 135 extends across the exterior surface of the body cone between the upper ring 111 and the lower ring 112. The notch lateral edge 106 and the notch lower edge 107 may not include the surface structure 135 because such edges 106, 107 allow the augment cone to slide within the notch and are not exposed when the augment is seated in the notch.

[0039] FIG. 2 is a perspective view showing an example of an augment cone (augment) 200 that can be used in the body cone of the modular knee augment cone system 100 shown in FIG. 1. In the example of FIG. 2, the augment cone 200 includes a curved, in this example approximately hemispherical, outer wall surface 205 that extends away from the cavity 140 to create an asymmetric cone-shaped structure in the body portion 101 when the augment 200 is positioned in one of the notches (or "slots") 105, 110. The cavities of the body cone and the augment cone form a larger combined cavity. Such an augment cone 200 can be positioned in each notch 105, 110. The augment includes edge portions 210 on opposing sides of the curved outer wall 205, each edge portion including a groove 215 configured to receive a portion of the body structure on the edge of the notch 105, 110 such that the augment 200 may be slid within a slot in the body and held in place by an interface between two grooves in corresponding structures on the body portion. FIG. 2 also shows a bone growth surface portion 235 on the outer surface of the augment cone 200 (shown with a darker surface) made to facilitate bone growth within the surface to hold the surface in place. In some examples, the surface structure 135 is P2 In some examples, the surface 235 is formed by a 3D printer.

[0040] 3 is a perspective view of an example of an augment 200 partially positioned in one of two cutouts in the body cone 101, with a second cutout in the body cone not shown having an augment cone positioned therein. As shown, the augment 200 can be positioned in the slot of the body cone by engaging a groove 215 in the augment 200 with a corresponding structure 117 on the side of the slot in the wall 108 of the body cone 101. When the augment 200 is fully positioned in the cutout, a portion 220 of the augment 200 is positioned adjacent to a corresponding surface 125 of the wall 108 near the cutout. The augment 200 can be held in place (in at least two directions) by interaction between the augment's groove 215 with a corresponding attachment structure (structure) 117 on the body cone 101. In this example, the attachment structure 117 is a dovetail that fits into a corresponding groove 215 on the augment 200. The attachment features 117 and corresponding grooves 215 are accordingly shaped for a close but movable fit to allow the augment 200 to be slid into place. That is, the augment 200 is slid into the notch from the proximal end of the body cone 101 and moved toward the distal end 104 until it is seated in the notch. When the augment 200 is seated in the notch, the modular knee augment cone system is an asymmetric cone. When the augment is seated in the body cone, the side and lower (distal) edges of the augment are structured to line up with corresponding structures at the edges of the notch, and the side and distal edges of the augment are positioned close to and / or in contact with said corresponding structures at the edges of the notch on the body cone. When the augment cone 200 is fully seated in the notch, it can be locked into place.

[0041] FIG. 4 is a top view of an example of a modular knee augment cone system having an augment 200 positioned in a first notch 110 in an asymmetric body cone 102. In this view, the body cone 102 is not shown to have one or more axially aligned ribs 119, although this embodiment may include such axially aligned ribs as shown in FIGS. 8, 9, and 10. The body cone generally preferably has axially aligned ribs to help prevent rotation of the body cone about its longitudinal axis 109 (FIG. 1B). In this example, the second notch in the body cone 102 does not have an augment positioned therein. In some examples, if the use of the modular knee augment cone system requires only a single augment in a particular application, in some embodiments the second notch in the body may be left open. In some embodiments the second notch may be filled by positioning an augment or cover plate in an unused notch 105 in the asymmetric body cone 102.

[0042] In this example, the second notch is not directly opposite the first notch; rather, the locations of the first and second notches within the body cone 102 are asymmetric. For example, the notch center separation angle, which is the angle formed from a line from the center of each first and second notch to the longitudinal axis 109 (FIG. 1B) of the body cone, is less than 180 degrees. For comparison, FIG. 6 shows an example of a body cone having two notches positioned directly opposite one another (i.e., the notch center separation angle is 180 degrees).

[0043] In one example, when the augment 200 is seated in the notch of the body cone, the top surface (or "proximal surface") of the augment coincides with the top surface ("proximal surface") of the body cone, and the edge of the augment is positioned closely and / or in contact with corresponding structure on the edge of the notch on the body cone that holds the augment in the body cone. In this example, the shape of the structure on the edge of the body cone may also be referred to as a "dovetail." Figure 4 shows an example of corresponding structure on the augment and body cone that interlock to hold the augment 200 on the body cone.

[0044] FIG. 5 is a perspective view of an example of an asymmetric body cone 102. As shown in FIG. 5, the notches 105, 110 are disposed in the wall 108 of the body cone 101 such that a first portion 151 of the wall 108 between the notches 105, 110 is a shorter distance (i.e., the circumferential distance of the wall between the vertical edges of the notches 105, 110) than a second portion 150 of the wall 108. The body cone 102 can include structures protruding from the interior wall 133 to which cement can adhere or another structure can contact, helping to prevent axial rotation of the body cone when placed in a patient. In this embodiment, the body cone 102 includes one or more ribs 119 (in this example, three) that extend from the proximal end 103 to the distal end 104 of the body cone 102. In some embodiments, the ribs 119 may be shorter in length. In some embodiments, the ribs 119 can be angled but still have a surface with longitudinal features. The body cone 102 also includes a plurality of cement mantle steps 114, e.g., three cement mantle steps 114, positioned circumferentially along an inner surface 113 of the body cone 102. In some embodiments, notches 105, 110 positioned on opposing sides of the body portion 102 can accommodate a baseplate keel therethrough (see, e.g., FIGS. 11 and 12).

[0045] FIG. 6 is a top view showing another example of a modular knee augment cone system having an augment 200 positioned in a first notch 105 of a symmetrical body cone 101. In this example, a second notch 110 in the body cone is positioned directly opposite the first notch 105 in the body cone. The second notch 110 does not have an augment positioned therein. When the augment is seated in the notch of the body cone, the top surface (or "proximal surface") 220 of the augment 200 coincides with the top surface ("proximal surface") 125 of the body cone 101, and an edge 210 of the augment 200 is positioned in close proximity and / or contact with a corresponding structure on the edge 106 of the first notch 105 on the body cone 101 that retains the augment 200 in the body cone 101. FIG. 6 also shows another example of an augment 200 and a corresponding structure on a body portion that interlock to retain the augment on the body portion. In this example, the augment includes an augment attachment feature 218 extending outwardly from the outer surface of the augment that fits into a groove 116 in the cone wall 108 over the edge of the notch.

[0046] 7 is a side cross-sectional view of an example of a body cone 102. As can be seen in this view, the interior surface 113 of the body cone 102 includes circumferential cement mantle steps 114, each step extending the interior surface 113 further inwardly toward the axial length of the body cone 102 as it progresses from the proximal end 103 to the distal end 104. This cross-sectional view also shows the bone growth coating 135 on the portion of the exterior surface of the body cone contained between the upper (proximal) ring 111 and the lower (distal) ring 112. FIG. 7 also shows that the exterior wall surface of the body cone 102 tapers inwardly from the proximal end 103 to the distal end 104 at an angle A. In some embodiments, angle A is between 0° and 30°, e.g., 1°, 2°, 3°, 4°, 5°, 6°, 7°, 8°, 9°, 10°, 11°, 12°, 13°, 14°, 15°, 16°, 17°, 18°, 19°, 20°, 21°, 22°, 23°, 24°, 25°, 26°, 27°, 28°, 29°, or 30°, ±0.5°. In some embodiments, angle A is between 5° and 15°. In some embodiments, angle A is between 8° and 12°. In some embodiments, angle A is between 9° and 11°.

[0047] FIG. 8 is another cross-sectional side view of an example of a body cone 102. This body cone 102 also includes a bone growth coating 135 (e.g., a porous lattice surface) on the portion of the outer surface of the body cone included between the cement mantle step 114, the upper ring 111, and the lower ring 112. In this example, the body cone 120 also includes at least one axial ("vertical") rib 119 extending a distance from the proximal end 103 toward the distal end 104 of the body cone 102 and extending from the inner wall surface 113 inward toward the longitudinal axis of the body cone. In various embodiments, the rib 119 can extend 0.5 mm, 1 mm, 2 mm, 3 mm, 4 mm, 5 mm, 6 mm, 7 mm, 8 mm, or 9 mm, ±0.5 mm. In some examples, the rib 119 extends between 1 mm and 4 mm from the inner wall surface 113. In various embodiments, the body cone can include two, three, or more axial ribs. The ribs 119 provide a surface with longitudinal features onto which the cement can rest, thereby providing resistance to forces to help prevent rotational movement of the body cone when implanted within a patient.

[0048] FIG. 9 also shows a cement mantle step 114, a bone growth coating 135 (P 2 1 is another cross-sectional side view of an example of a body cone 102 having a proximal end 103 of the body cone, a distal end 104 of the body cone 102, and at least one axial rib 119. In this example, the body cone does not include an upper or lower ring. Instead, the bone growth coating 135 extends on the exterior surface from the proximal end 103 of the body cone to the distal end 104 of the body cone 102.

[0049] FIG. 10 is a perspective view illustrating an example of an asymmetric body cone 102, a first augment 200a positioned in a first notch 105 of the body cone 102, and a second augment 200b positioned in a second notch 110 of the body cone 102. FIG. 10 also illustrates that in this example, the body cone 102 and the first and second augments 200a, 200b include bone growth surfaces 135 on the exterior portions of these components, i.e., the portions of these components that contact and / or are adjacent to bone when the modular augment cone system is implanted in a patient. Additionally, the embodiment of FIG. 10 further illustrates three ribs 119 extending inwardly from the interior wall surface 113 of the body cone 102.

[0050] 11-14 show an example of a body cone 102 with a tibial implant 260 positioned therein to illustrate the nature of these two components used together. FIG. 11 shows a side view of an example of a body cone 102 with a tibial implant 260 positioned therein. The tibial implant 260 includes an upper portion 264 positioned at the proximal end of the body cone 102 and a lower portion 266 extending from the bottom of the body cone 102 through an opening 121 in the distal end 104 of the body cone 102. In this example, the keel portion 262 of the tibial implant 260 extends through a first notch and a second notch in the wall of the body cone. FIG. 12 is a side view of the body cone 102 and tibial implant 260 illustrated in FIG. 11, with the side view of FIG. 12 being axially rotated approximately 70 degrees to illustrate a different side view of these mated components. Figure 13 is a perspective top view of the body cone 102 and tibial implant 260 shown in Figure 11. Figure 14 is a bottom view of the body cone 102 and tibial implant 260 shown in Figure 11. As shown in Figure 14, the tibial implant 260 includes a lower surface 268 positioned adjacent the proximal end 103 of the body cone 102. Figure 14 also shows that the body cone 102 is an asymmetric cone having a long wall 150 between an edge of the first notch and an edge of the second notch, and a short wall 151 between another edge of the first notch 105 and another edge of the second notch 110.

[0051] FIG. 15 is a flow chart illustrating a process 300 for using the modular knee augmentation cone system described herein. A knee replacement procedure requires the removal of a partial or total knee implant and replacement with a new implant. It can be a complex surgical procedure that may require extensive preoperative planning, specialized implants and tools, including various types of replacement cones based on the specific requirements of the surgical procedure. The modular knee augmentation cone system allows a smaller number of components to be kept on hand and assembled when required for the surgical procedure. In an example of preparing a knee to receive a modular knee augmentation cone system, a stem ream can be used to ream a hole in the center of the tibia to receive the tibial component. A cone ream can then be used to ream a hole in a portion of the proximal end of the tibia to create a cavity to receive the body cone. An augmentation ream can be used to create a small cavity contiguous with the cavity of the cone to receive the augmentation cone. In block 305 of the process 300, a modular augmentation cone system is provided. The modular augmented cone system includes a body (revision) cone and at least one augment, such as a body cone and augment as described herein (see, e.g., FIG. 10). In block 310, a first augment is positioned in a first notch of the body cone to form a portion of a wall of the body cone. The body cone and the augment each include a cavity, and by fixing the first augment in the first notch of the body cone, a combined cavity is formed defined by an inner surface of the body cone and an inner surface of the augment, the combined cavity being larger than the cavity of the body cone. In block 315, an optional second augment cone is positioned in a second notch of the body cone. Attaching the second augment to the body cone further increases the volume of the combined cone / augment cavity.The second augment may also be secured to the body cone using an attachment structure (e.g., a screw, pin, clip, or another fastener). The assembled cone / augment system may then be placed within the patient.

[0052] FIG. 16 is a flow chart illustrating another process 350 for using the modular knee augment cone system described herein. In block 355 of process 350, a modular augment cone system is provided. The modular augment cone system includes a body (revision) cone and at least one augment, such as a body cone and augment as described herein (see, e.g., FIG. 10). In block 360, the augment is positioned within a notch in the body cone to form a portion of a wall of the body cone. The body cone and augment each include a cavity, and by fixing a first augment into a first notch in the body cone, a combined cavity is formed defined by an inner surface of the body cone and an inner surface of the augment, the combined cavity being larger than the cavity of the body cone. In block 365, the body cone and attached augment are positioned within a patient, for example, during a knee revision surgery.

[0053] The foregoing description details certain embodiments of the systems, devices, and methods disclosed herein. However, no matter how detailed the foregoing appears in the text, it should be understood that the systems, devices, and methods can be implemented in many ways. Also, as noted above, it should be noted that the use of a particular term when describing a particular feature or aspect of the present invention should not be construed as implying that the term is redefined herein to be constrained to include every particular characteristic of the feature or aspect of the technology with which it is associated.

[0054] In particular, conditional terms such as "can," "could," "may," or "may" are understood in the context as being generally used to convey that certain embodiments include certain features, elements, and / or steps and other embodiments do not, unless specifically noted otherwise. Thus, such conditional terms are not generally intended to imply that features, elements, and / or steps are required in any way for one or more embodiments, or that one or more embodiments necessarily include logic for determining, with or without user input or instruction, whether those features, elements, and / or steps are included or performed in any particular embodiment.

[0055] Headings are included herein for reference and to aid in locating the various portions. These headings are not intended to limit the scope of the concepts described therein. Such concepts may have applicability throughout the entire specification.

[0056] Disjunctions such as the phrase "at least one of X, Y, or Z" are understood in the context to be generally used to present that an item, term, etc. may be either X, Y, or Z, or any combination thereof (e.g., X, Y, and / or Z), unless specifically noted otherwise. Thus, such disjunctions are not generally intended to, and do not imply, that a particular embodiment requires that at least one of X, at least one of Y, or at least one of Z, respectively, be present.

[0057] The phrase "based on" does not mean "based only on," unless expressly specified otherwise. That is, the phrase "based on" describes both "based only on" and "based at least on." Unless expressly noted otherwise, articles such as "a" or "an" should generally be construed to include one or more of the described items. Thus, phrases such as "a device configure to" are intended to include one or more of the referenced devices.

[0058] Those skilled in the art should understand that various modifications and changes can be made without departing from the scope of the described technology. Such modifications and changes are intended to be within the scope of the embodiments. Those skilled in the art should also understand that parts included in one embodiment can be interchanged with other embodiments, and one or more parts from a described embodiment can be included in other described embodiments in any combination. For example, any of the various components described herein and / or shown in the drawings can be combined, interchanged, or removed from other embodiments.

[0059] The above description discloses several methods and materials of the invention. The invention is susceptible to modifications of the methods and materials, as well as changes in the manufacturing methods and equipment. Such modifications will become apparent to those skilled in the art upon consideration of such disclosure or practice of the invention disclosed herein. Accordingly, the invention is not limited to the specific embodiments disclosed herein, but is intended to include all modifications and variations that are within the true scope and spirit of the invention as embodied in the appended claims. Applicants have the right to present claims directed to combinations and subcombinations of the disclosed inventions that are believed to be new and unobvious. Inventions embodied in other combinations or subcombinations of features, functions, elements and / or properties may be claimed by amending these claims or presenting new claims in this or a related application. Such amended or new claims, whether directed to the same or different inventions, and whether different, broader, narrower, or equivalent in scope to the original claims, are deemed to be within the subject matter of the invention described herein.

[0060] Exemplary embodiments Further examples of embodiments of the present invention are defined, without limitation, by the following enumerated exemplary embodiments (EEE).

[0061] EEE1. A modular augmented cone system comprising: a body cone including a proximal end, a distal end, and a cone wall extending between the proximal and distal ends, and further including a first notch in the cone wall, a portion of the cone wall proximate the first notch including a cone wall attachment feature; and a first augmented cone positionable in the first notch, the first augmented cone including an augmented attachment feature configured to mate with the cone wall attachment feature to attach the first augmented cone within the first notch.

[0062] EEE2. The modular augmented cone system as described in EEE1, wherein the circumference of the proximal end of the body cone is greater than the circumference of the distal end of the body cone.

[0063] EEE3. The modular augmented cone system of EEE1, wherein the body cone further comprises a second notch in the cone wall, and a portion of the cone wall adjacent the second notch includes a cone wall mounting structure.

[0064] EEE4. The modular augmented cone system as described in EEE3, wherein the first notch is positioned opposite the second notch in the cone wall.

[0065] EEE5. The modular augmented cone system as described in EEE3, wherein the first notch and the second notch are positioned in the cone wall such that a portion of the cone wall between a first edge of the first notch and an adjacent first edge of the second notch is larger than a portion of the cone wall between a second edge of the first notch and an adjacent second edge of the second notch.

[0066] EEE6. The modular augmented cone system as described in EEE1, wherein the body cone is a cross-section of the body cone parallel to the longitudinal axis of the body cone that is substantially circular.

[0067] EEE6. The modular augmented cone system as described in EEE1, wherein the first notch extends from the proximal end of the body cone toward the distal end of the body cone, but does not reach the distal end of the body cone.

[0068] EEE7. The modular augmented cone system as described in EEE1, wherein the first notch extends from the distal end of the body cone toward the proximal end of the body cone but does not reach the proximal end of the body cone.

[0069] EEE8. The modular augmented cone system as described in EEE1, wherein a width dimension of the first notch along the proximal end of the body cone is between 5 mm and 30 mm.

[0070] EEE9. The modular augmented cone system as described in EEE1, wherein a length dimension of the first notch along an extent of the first notch from the proximal end of the body cone to the distal end of the body cone is between 15 mm and 30 mm.

[0071] EEE10. A method for embedding a modular augmented cone system, comprising the steps of providing a modular augmented cone system as described in EEE1, positioning an augmented cone within a first notch in a body cone, and embedding the body cone.

[0072] EEE11. A method for embedding a modular augmented cone system, comprising the steps of assembling the modular augmented cone system described in EEE1 by placing a first augmented cone in a first notch, and embedding the modular augmented cone system comprising a body cone and the first augmented cone in a prepared space.

[0073] EEE12. A method for embedding a modular augmented cone system, comprising: providing a modular augmented cone system as described in EEE1; and positioning a first augmented cone within a first notch in a body cone.

[0074] A list of specific components The following is a list of specific components described and enumerated in this disclosure with reference to the above drawings: However, any aspect of the device illustrated in the drawings, whether or not otherwise noted herein, may form part of various embodiments of the invention and may provide a basis for claims limitations relating to such aspects, with or without further description. [Explanation of symbols]

[0075] A Angle of inward taper of wall l Length of cutout w Notch width dc Depth of bone growth coating 100 Modular Knee Augmentation Cone System 101 Symmetrical Body Cone 102 Asymmetrical Body Cone 103 Near end 104 Distal end 105 First notch 106 Notch side edge 107 Lower edge of cutout 108 Main body cone wall 109 Longitudinal axis of main body cone 110 Second notch 111 Upper Ring 112 Lower Ring 113 Inner wall body cone 114 Cement mantle step / peripheral rib on inner wall body cone 115 Upper part of the main cone 116 Groove in the wall of the edge of the notch 117 Cone wall mounting mechanism 118 Outer part of cone wall mounting mechanism 119 Axially aligned ribs 120 Lower part of the main body cone 121 Opening at the distal end of the main body cone 125 Upper surface 130 Lower surface 135 External Surface Body Cone / Bone Ingrowth Surface 140 Cavity 150 Large (long) wall of asymmetric body cone 151 Small (short) walls of asymmetric body cones 200 Augmented Cone 201 Inner edge of augmented cone 202 Outer edge 203 Near end 204 Distal end 205 External wall of augmented cone 210 Edge section 213 Inner wall augmented cone 215 Groove / Augment attachment mechanism 216 Attachment mechanism 217 Attachment mechanism 218 Augment attachment mechanism protrusion 220 Upper surface augmented cone 235 Bone growth surface of the augmented cone 240 Augmented Cone Cavity 260 Tibial Implant 262 Tibial Implant Carina 264 Upper Partial Tibial Implant 266 Lower Partial Tibial Implant 268 Bottom surface of tibial implant

Claims

1. a body cone including a proximal end, a distal end, and a cone wall extending between the proximal end and the distal end, the body cone further including a first notch in the cone wall, a portion of the cone wall proximate the first notch including a cone wall attachment feature; a first augment cone positionable within the first notch, the first augment cone including an augment attachment mechanism configured to mate with the cone wall attachment mechanism to mount the first augment cone within the first notch; and 1. A modular augmented cone system comprising:

2. 2. The modular augmented cone system of claim 1, wherein the body cone further comprises a second notch in the cone wall, a portion of the cone wall proximate the second notch including a cone wall mounting structure.

3. 3. The modular augmented cone system of claim 2, wherein the first notch and the second notch are positioned in the cone wall such that a portion of the cone wall between a first edge of the first notch and an adjacent first edge of the second notch is larger than a portion of the cone wall between a second edge of the first notch and an adjacent second edge of the second notch.

4. 3. The modular augmented cone system of claim 2, further comprising a second augmented cone positionable within the second notch, the second augmented cone including an augmented mounting structure configured to mate with the cone wall mounting structure to mount the second augmented cone within the second notch.

5. The modular augmented cone system of any one of claims 1 to 4, wherein the cone wall of the body cone includes an exterior surface provided with a porous coating.

6. The modular augmented cone system of claim 5 , wherein the porous coating extends to a distal end of the body cone.

7. The modular augmented cone system of claim 5 , wherein the porous coating extends to a proximal end of the body cone.

8. The modular augment cone system of claim 5 , wherein the porous coating extends to the proximal and distal ends of the body cone.

9. 6. The modular augmented cone system of claim 5, wherein the body cone further comprises a distal ring structure circumferentially positioned at a distal end of the body cone on an exterior surface of the cone wall, the porous coating extending to the distal ring structure.

10. 6. The modular augmented cone system of claim 5, wherein the body cone further comprises a proximal ring structure circumferentially positioned on an exterior surface of the cone wall at a proximal end of the body cone, the porous coating extending to the proximal ring structure.

11. 6. The modular augmented cone system of claim 5, wherein the body cone further comprises a proximal ring structure circumferentially positioned on an exterior surface of the cone wall at a proximal end of the body cone and a distal ring structure circumferentially positioned on the exterior surface of the cone wall at a distal end of the body cone, the porous coating extending between the proximal ring structure and the distal ring structure.

12. The modular augmented cone system of any one of claims 1 to 11, wherein the first augmented cone includes an exterior surface comprising a porous coating.

13. 13. The modular augmented cone system of claim 1, wherein the body cone comprises one or more ribs circumferentially positioned on an interior wall surface of the body cone, the one or more ribs providing a surface upon which an adhesive can rest.

14. The modular augmented cone system of any one of claims 1 to 13, wherein the cone wall attachment mechanism comprises a slot.

15. The modular augmented cone system of claim 14 , wherein the augment attachment feature on an augment comprises an extension that fits into a slot in the cone wall attachment feature.

16. The modular augmented cone system of any one of claims 1 to 15, wherein the augment attachment mechanism on the augment comprises a slot.

17. The modular augmented cone system of claim 14 , wherein the cone wall mounting mechanism comprises a locking mechanism.

18. The modular augmented cone system of claim 16 , wherein the cone wall attachment mechanism comprises an extension that fits into a slot of the augment attachment mechanism on the augment.

19. 1. A modular augmented cone system comprising: a body cone including a proximal end, a distal end, and a cone wall extending between the proximal end and the distal end, the body cone further including a first notch in the cone wall structured to receive an augmented cone, a portion of the cone wall proximate the first notch including an attachment mechanism for attaching the augmented cone to the body cone.

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