Orthopedic implants including peripheral aperture placement - Patents.com

Abstract

The present disclosure relates to orthopedic implants (20) and methods for repairing bone defects and restoring joint function. The implants disclosed herein include an expanded shape (40) that can approximate a surface contour or bone void along a surgical site and include a pattern of peripheral openings (44) that can be utilized for improved fixation of the implant at the surgical site.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Patent Application No. 16 / 837,201, filed April 1, 2020.

[0002] FIELD OF THE DISCLOSURE The present disclosure relates to orthopedic procedures, and more particularly to orthopedic implants and methods for repairing bone defects and restoring joint function. [Background technology]

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

[0004] Bone defects can occur along the articular surface of the glenoid bone. Some techniques utilize bone grafts and / or implants to fill defects in the glenoid bone. The implants may be secured to the glenoid cavity using one or more fasteners. Summary of the Invention

[0005] The present disclosure relates to orthopedic implants and methods that can be used during methods for repairing bone defects. The implants described herein may be utilized to restore joint function and include peripheral openings arranged in one or more patterns for receiving fasteners to secure the implant to the surgical site.

[0006] The orthopedic implant may include a base plate including a plate body extending along a longitudinal axis between an anterior surface and a posterior surface, and may include a fixation stem extending outward from the posterior surface. The plate body may include a body portion constituting the anterior surface, an extension portion extending outward from the body portion to constitute an extension surface portion of the posterior surface, and a plurality of peripheral openings distributed circumferentially about the longitudinal axis. The periphery of the plate body may be generally circular. The peripheral openings may be dimensioned to accommodate respective fasteners for securing the base plate to the surgical site. The extension surface portion may be disposed transversely to the longitudinal axis, and first and second reference planes disposed perpendicular to each other extend along the longitudinal axis such that the first reference plane bisects the extension surface portion. All peripheral openings of the base plate disposed about the longitudinal axis may be circumferentially offset from both the first and second reference planes.

[0007] A kit for arthroplasty may include a set of base plates and a plurality of fasteners. Each base plate of the set of base plates may include a plate body having a body portion with generally wedge-shaped extensions that cooperate to define anterior and posterior surfaces of the plate body, and a plurality of peripheral openings extending between the anterior and posterior surfaces. The peripheral openings may be dimensioned to receive respective fasteners for securing the plate body to the surgical site. A first reference plane may extend along a longitudinal axis of the plate body and bisect the extensions. The set of base plates may include a first base plate and a second base plate, wherein the peripheral openings of the first base plate may be distributed circumferentially about the longitudinal axis to form a first pattern, such that one or more of the peripheral openings extend along a first reference plane, and the peripheral openings of the second base plate may be distributed circumferentially about the longitudinal axis to form a second pattern, wherein the second pattern may be circumferentially offset from the first pattern relative to the longitudinal axis, and wherein the first pattern and the second pattern may have a common circumferential spacing between their respective peripheral openings.

[0008] A method for installing an orthopedic implant at a surgical site may include selecting a base plate from a set of base plates based on a surface contour of the surgical site. Each base plate of the set of base plates may include a plate body having a body portion and generally wedge-shaped extensions that cooperate to define an anterior and posterior surface of the plate body, and a plurality of peripheral openings may extend between the anterior and posterior surfaces. A first reference plane may extend along the longitudinal axis and bisect the extensions. The set of base plates may include a first base plate and a second base plate, and the peripheral openings of the first base plate may be arranged to define a first pattern such that one or more of the peripheral openings extend along the first reference plane, and the peripheral openings of the second base plate may be arranged to define a second pattern circumferentially offset from the first pattern relative to the longitudinal axis, and the first and second patterns may have a common circumferential spacing between their respective peripheral openings. The method may include positioning the selected base plate relative to the surface contour of the surgical site and may include positioning fasteners in each peripheral opening to secure the selected base plate to the surgical site. [Brief explanation of the drawings]

[0009] [Figure 1] FIG. 1 shows a side view of an exemplary orthopedic implant including a base plate and a glenoid ball. [Figure 2] FIG. 2 shows a perspective view of the implant of FIG. 1 with the glenoid ball in the removed position. [Figure 3] FIG. 3 shows a plan view of the base plate of FIG. 2, including an exemplary pattern or layout of peripheral openings. [Figure 4] FIG. 4 shows a perspective view of the base plate of FIG. [Figure 5] FIG. 5 shows a cross-sectional view of the implant of FIG. [Figure 6] FIG. 6 shows a cross-sectional view of the base plate of FIG. [Figure 7] FIG. 7 shows an exemplary pattern or layout of peripheral openings. [Figure 8] FIG. 8 shows a perspective view of the base plate. [Figure 9] FIG. 9 shows a plan view of the base plate of FIG. 8, including an exemplary pattern or layout of peripheral openings. [Figure 10] FIG. 10 shows a cross-sectional view of the base plate of FIG. [Figure 11] FIG. 11 shows a perspective cross-sectional view of the base plate of FIG. [Figure 12] FIG. 12 shows a perspective view of the base plate of FIG. [Figure 13] FIG. 13 shows a cross-sectional view of the base plate of FIG. [Figure 14] FIG. 14 shows an exemplary pattern or layout of peripheral openings. [Figure 15] FIG. 15 shows an exemplary pattern or layout of peripheral openings. [Figure 16] FIG. 16 shows a side view of an exemplary orthopedic implant including a baseplate and a glenoid ball. [Figure 17] FIG. 17 shows a perspective view of the implant of FIG. 14 with the glenoid ball in the removed position. [Figure 18] FIG. 18 shows a cross-sectional view of the base plate of FIG. [Figure 19] FIG. 19 shows a cross-sectional view of the base plate of FIG. [Figure 20] Figure 20 shows an exemplary pattern or layout of peripheral openings. Figures 20A-20B show an exemplary base plate profile. [Figure 21] FIG. 21 illustrates an exemplary method of placing an orthopedic implant at a surgical site. [Figure 22] FIG. 22 shows an exemplary implant positioned at a surgical site. [Figure 23] FIG. 23 shows an exemplary implant positioned at a surgical site. [Figure 24] 24A-24E show the base plate of FIG. 2 positioned relative to the surgical site at different viewing angles. [Figure 25] 25A-25E show the baseplate of FIG. 8 positioned relative to the surgical site at different viewing angles. [Figure 26] FIG. 26 illustrates a top view of an exemplary orthopedic implant including a base plate with an extension portion in a first position. [Figure 27] FIG. 27 shows the base plate of FIG. 26 including the extension portion in a second position. DETAILED DESCRIPTION OF THE INVENTION

[0010] The present disclosure relates to orthopedic implants and methods for repairing bone defects. The implants described herein may be utilized during arthroplasty procedures or incorporated into shoulder joint prostheses to restore function to shoulders with progressive cartilage disease. The disclosed implants may be utilized to address complex glenoid pathologies, which may have bone defects at many different orientations relative to the superior / inferior (S / I) plane of the glenoid surface. The implants may include expanding shapes configured to fill bone voids along the glenoid surface. The disclosed implants may include peripheral openings arranged in a pattern. The disclosed patterns may be utilized to improve fixation of the respective implant at the surgical site, which may result in improved healing.

[0011] An orthopedic implant according to exemplary aspects of the present disclosure may include a base plate including a plate body extending along a longitudinal axis between an anterior surface and a posterior surface, and may include a fixation stem extending outward from the posterior surface. The plate body may include a body portion constituting the anterior surface and an extension portion extending outward from the body portion to constitute an extension surface portion of the posterior surface. A plurality of peripheral openings may be distributed circumferentially about the longitudinal axis. The peripheral openings may be dimensioned to accommodate respective fasteners for securing the base plate to a surgical site. The extension surface portion may be disposed transversely to the longitudinal axis, and first and second reference planes may be disposed perpendicular to each other extending along the longitudinal axis such that the first reference plane bisects the extension surface portion, and all peripheral openings of the base plate disposed about the longitudinal axis may be circumferentially offset from both the first and second reference planes.

[0012] In some embodiments, the periphery of the plate body may be generally circular.

[0013] In some embodiments, the fixation stem may extend along the longitudinal axis.

[0014] In some embodiments, the plurality of peripheral openings may be substantially uniformly distributed around the longitudinal axis.

[0015] In some embodiments, the plurality of peripheral openings may include a total of four peripheral openings.

[0016] In some embodiments, the third reference plane may extend along the longitudinal axis such that the first and third reference planes form an acute angle, and the pair of peripheral openings may be circumferentially disposed along the third reference plane.

[0017] In some embodiments, the acute angle may be greater than 0 degrees, but less than 45 degrees.

[0018] In some embodiments, the acute angle may be between 30 and 60 degrees.

[0019] In some embodiments, the plurality of peripheral openings may include a total of four peripheral openings.

[0020] In some embodiments, the four peripheral openings may be substantially evenly distributed around the longitudinal axis.

[0021] In some embodiments, the posterior surface may include a second surface portion disposed generally perpendicular to the longitudinal axis, and the extended surface portion and the second surface portion may be joined at a joint surface to form an obtuse angle.

[0022] In some embodiments, the obtuse angle may be between 140 degrees and 170 degrees.

[0023] In some embodiments, the implant includes a glenoid ball including an articular surface that may have a generally convex shape, and the glenoid ball may be secured to a baseplate adjacent the anterior surface.

[0024] In some embodiments, the glenoid ball may include a recess sized to at least partially receive the body portion of the base plate.

[0025] In some embodiments, the perimeter of the body portion of the base plate may be sized to cooperate with the perimeter of the recess to form a molar taper connection.

[0026] A kit for joint arthroplasty according to an exemplary aspect of the present disclosure may include a set of base plates and a plurality of fasteners. Each base plate of the set of base plates may include a plate body having a body portion with generally wedge-shaped extensions that can cooperate to define an anterior and posterior surface of the plate body, and may also include a plurality of peripheral openings extending between the anterior and posterior surfaces. The peripheral openings may be dimensioned to receive respective fasteners for securing the plate body to the surgical site. A first reference plane may extend along the longitudinal axis of the plate body and bisect the extensions. The set of base plates may include a first base plate and a second base plate. The peripheral openings of the first base plate may be distributed circumferentially about the longitudinal axis to define a first pattern, such that one or more of the peripheral openings may extend along the first reference plane. The peripheral openings of the second base plate may be distributed circumferentially about the longitudinal axis to form a second pattern, the second pattern may be circumferentially offset from the first pattern relative to the longitudinal axis, and the first and second patterns may have a common circumferential spacing between their respective peripheral openings.

[0027] In some embodiments, the implant can include a fixation stem that can extend outward from the posterior surface along the longitudinal axis. The implant can include a glenoid ball including an articular surface that can have a generally convex shape, and the glenoid ball can be removably secured to a respective baseplate adjacent the anterior surface.

[0028] In some embodiments, the perimeter of the body portion may be generally circular, and the peripheral openings in both the first and second patterns may be generally uniformly distributed around the longitudinal axis.

[0029] In some embodiments, the second reference plane may extend along the longitudinal axis and may be perpendicular to the first reference plane, and the second pattern may be configured such that all peripheral openings of the second base plate disposed about the longitudinal axis may be circumferentially offset from both the first and second reference planes.

[0030] A method of installing an orthopedic implant at a surgical site according to exemplary aspects of the present disclosure may include selecting a base plate from a set of base plates based on a surface contour of the surgical site. Each base plate of the set of base plates may include a plate body having a body portion with generally wedge-shaped extensions that can cooperate to define an anterior and posterior surface of the plate body, and may include a plurality of peripheral openings extending between the anterior and posterior surfaces. A first reference plane may extend along the longitudinal axis and bisect the extensions. The set of base plates may include a first base plate and a second base plate. The peripheral openings of the first base plate may be arranged to define a first pattern, such that one or more of the peripheral openings may extend along the first reference plane. The peripheral openings of the second base plate may be arranged to define a second pattern that is circumferentially offset from the first pattern relative to the longitudinal axis, and the first and second patterns may have a common circumferential spacing between their respective peripheral openings. The method may include positioning the selected base plate relative to the surface contour of the surgical site and may include positioning fasteners in each peripheral opening to secure the selected base plate to the surgical site.

[0031] In some embodiments, the plurality of peripheral openings may include a total of four peripheral openings, the second reference plane may extend along the longitudinal axis and may be perpendicular to the first reference plane, two of the peripheral openings in the first pattern may be disposed along the first reference plane and another two of the peripheral openings in the first pattern may be disposed along the second reference plane, and the second pattern may be configured such that all peripheral openings in the second base plate may be circumferentially offset from both the first and second reference planes.

[0032] In some embodiments, the fixation stem can extend outward from the posterior surface along the longitudinal axis. The method can include positioning the fixation stem within a bone hole along the surgical site and securing the glenoid ball to a selected baseplate. The glenoid ball can include an articular surface having a generally convex shape.

[0033] 1-6 illustrate an exemplary orthopedic implant 20. The implant 20 can be utilized for various surgical procedures, such as arthroplasty procedures, to repair a joint. For example, the implant 20 can be incorporated into a shoulder prosthesis. While the implants disclosed herein primarily refer to repair of defects within the glenoid cavity during shoulder reconstruction, such as a reverse shoulder procedure, it should be understood that the disclosed implants can be utilized in other locations in a patient's body and in other surgical procedures.

[0034] 1-2, implant 20 includes a base plate 22 and a glenoid ball 24 removably secured to base plate 22. Base plate 22 includes a plate body 26 extending along a longitudinal axis A (FIG. 2) between an anterior (or first) surface 28 (FIG. 2) and a posterior (or second) surface 30 generally opposite anterior surface 28. Posterior surface 30 may generally correspond to a medial side of a patient, and anterior surface 28 may generally correspond to a lateral side of a patient, for example, when implanted at a surgical site.

[0035] The base plate 22 may include a post or fixation stem 32 extending outward from the posterior surface 30. The central axis of the fixation stem 32 may be offset from the longitudinal axis A. In FIG. 2, the fixation stem 32 extends along the longitudinal axis A and has a generally cylindrical shape. The fixation stem 32 may be sized, for example, for insertion into a glenoid cavity or bone hole that may be formed to secure the base plate 22.

[0036] The fixation stem 32 may include a first stem portion 34 and a second stem portion 36. The first stem portion 34 may be integrally formed with the plate body 26. The fixation stem 32 and the plate body 26 may be separate components. The first stem portion 34 may be mechanically attached or otherwise secured to the second stem portion 36 using various techniques, such as threading, bonding, and welding. In FIGS. 5-6, the first stem portion 34 and the second stem portion 36 are connected via a reverse taper connection. The fixation stem 32 may be a single component.

[0037] With continued reference to FIG. 1 and now referring to FIG. 2 , plate body 26 includes a body portion 38 and an extension portion 40 extending outward from body portion 38. Body portion 38 may define a perimeter 39 of plate body 26. Perimeter 39 of plate body 26 may have, for example, an oval shape. In FIGS. 3-4 , perimeter 39 of plate body 26 has a generally circular shape. The generally circular shape may reduce reaming width and the complexity of preparing a surgical site to receive implant 20. Body portion 38 defines an anterior surface 28 of plate body 26. Extension portion 40 defines at least a portion of posterior surface 30.

[0038] A variety of materials can be utilized to form the base plate 22 and glenoid ball 24. The base plate 22 and glenoid ball 24 may be made of a metallic material. The implant 20 may include one or more coatings or layers 41 deposited along the surface of the base plate 22. An exemplary coating 41 may include calcium phosphate (CaP) having a porous structure to promote bone growth.

[0039] The extension portion 40 may be sized to approximate various defect shapes and surface contours that may be encountered along a surgical site. The extension portion 40 may be configured to at least partially fill a bone void within the glenoid cavity. The extension portion 40 may be sized to accommodate a relatively smaller or larger overall volume of the base plate 22. For example, the cross-section of the extension portion 40 may have a generally wedge shape and may extend across the entire width of the body portion 38 (e.g., a "full wedge"), as shown in FIGS. 1 and 5-6. The extension portion 40 may have other shapes or contours, such as a generally step shape.

[0040] The extension portion 40 extends outward from the main body portion 38 to define an extension surface portion 42 of the posterior surface 30. The extension surface portion 42 may be generally planar. The extension surface portion 42 may be generally concave or convex. As shown in FIGS. 2 and 4 , the extension surface portion 42 is disposed transversely to the longitudinal axis A, and the extension surface portion 42 may be generally angled or extend across the entire width of the main body portion 38. The extension portion 40 may be dimensioned such that an innermost (e.g., lowermost) and outermost (e.g., uppermost) point of the extension surface portion 42 relative to the longitudinal axis A is defined along the periphery of the extension portion 40.

[0041] The extended surface portion 42 can be positioned at various angles relative to the body portion 38 to configure a relatively smaller or larger overall volume for the base plate 22. The extended surface portion 42 can form an acute angle α with respect to a reference plane perpendicular to the longitudinal axis A, as shown in FIG. 5 . The angle α can be greater than 0 degrees but less than 45 degrees. The angle α can be, for example, greater than or equal to about 5 degrees and less than or equal to about 45 degrees. The angle α can be approximately 10 degrees or 20 degrees. For purposes of this disclosure, unless otherwise disclosed, the term “approximately” means ±5% of the stated value.

[0042] The base plate 22 may include a plurality of peripheral openings (or holes) 44 along the anterior surface 28 of the plate body 26. The peripheral openings 44 may extend between the anterior surface 28 and the posterior surface 30 of the plate body 26, as shown in FIG. 5, with at least some or each of the peripheral openings 44 extending through the thickness of the extended portion 40 between the anterior surface 28 and the extended surface portion 42 of the posterior surface 30. Each peripheral opening 44 may be sized to receive a respective peripheral fastener PF (shown in dashed lines in FIG. 3) for securing the base plate 22 to the surgical site. Exemplary fasteners may include compression screws, as shown by the peripheral fasteners PF in FIGS. 24A-25E.

[0043] The base plate 22 may include one or more recesses 50 extending inwardly from the front surface 28 of the plate body 26. The recesses 50 may be dimensioned to accommodate an inserter or tool T (shown in dashed lines in FIG. 6 for illustrative purposes) for inserting or otherwise positioning the base plate 22 along the surgical site. The recesses 50 may also be omitted.

[0044] The glenoid ball 24 includes an articular surface 25 that may have a generally convex shape, as shown by Figures 2 and 5. The articular surface 25 may cooperate with a humeral component having a complementary generally concave shape. The anterior surface 28 may have a generally concave shape, as shown in Figures 5-6. The glenoid ball 24 may be omitted, and the anterior surface 28 may function as an articular surface that cooperates with a humeral component having a complementary generally convex shape.

[0045] The glenoid ball 24 may be mechanically attached or removably secured to the base plate 22 adjacent the anterior surface 28, as shown in FIGS. 1 and 5 . In FIG. 5 , the glenoid ball 24 may include a recess 27 sized to at least partially accommodate a body portion 38 of the base plate 22 adjacent the anterior surface 28. The recess 27 may be sized to surround an edge of the base plate 22 along the anterior surface 28. The periphery of the body portion 38 of the base plate 22 may be sized to cooperate with the periphery of the recess 27 to form a molar taper connection for securing the glenoid ball 24 to the base plate 22. The plate body 26 may include a central opening 43 extending along the longitudinal axis A. The glenoid ball 24 may include an opening 29 (shown in dashed lines in FIG. 5 for illustrative purposes) sized to accommodate a fastener F. The fastener F may include threads that cooperate with threads along the central opening 43. Fastener F may serve to align glenoid ball 24 with longitudinal axis A and / or secure glenoid ball 24 to base plate 24. Fastener F and / or apertures 29, 43 may be omitted. Fixation stem 32 may be omitted, and aperture 43 may be sized to accommodate a fastener such as a compression screw (shown in dashed lines by fastener F′ in FIG. 7 for illustrative purposes) to secure base plate 24 to the surgical site.

[0046] Continuing with reference to FIGS. 1-2 and with reference to FIG. 3 , the peripheral openings 44 can be distributed circumferentially around the longitudinal axis A to define respective patterns (or layouts) 48. Each pattern 48 can be predefined with respect to the shape of the base plate 22 and the extension portion 40. The perimeter of the extension portion 40 is shown with a dashed line for illustrative purposes. The patterns 48 can be defined relative to the front surface 28 of the plate body 26. The peripheral openings 44 can be positioned relative to first and second reference planes R1, R2 to define the patterns 48. The first and second reference planes R1, R2 can be positioned perpendicular to one another and can extend along the longitudinal axis A such that the first reference plane R1 bisects the extension surface portion 42 of the extension portion 40. The extension portion 40 can be dimensioned such that the innermost (e.g., lowermost) and outermost (e.g., uppermost) points of the extension surface portion 42 relative to the longitudinal axis A are defined along the first reference plane R1.

[0047] FIG. 4 shows a perspective view of the base plate 22 relative to a reference plane R1. FIG. 5 shows a cross-sectional view of the base plate 22 taken along the first reference plane R1 and through the maximum thickness of the extension portion 40. FIG. 6 shows a cross-sectional view of the base plate 22 taken along the second reference plane R2. The first and second reference planes R1 and R2 may divide the base plate 22 into four quadrants I-VI. The base plate 22 may be symmetrical on opposite sides of the first reference plane R1. The base plate 22 may be asymmetrical on opposite sides of the first reference plane R1.

[0048] The pattern 48 may be defined such that one or more of the peripheral openings 44 extend along a first reference plane R1. In FIG. 3 , the pattern 48 may be configured with a total of four peripheral openings 44. The four peripheral openings 44 may be spaced at approximately 90-degree increments around the longitudinal axis A, such that the openings 44 are generally uniformly distributed around the longitudinal axis A. Two of the peripheral openings 44 may extend along and align with the first reference plane R1 (designated 44-1, 44-3), and another two of the peripheral openings 44 may extend along and align with the second reference plane R2 (designated 44-2, 44-4). The pattern 48 may be defined such that the base plate 22 does not include any peripheral openings between adjacent pairs of peripheral openings 44.

[0049] Other exemplary patterns can be utilized with any base plate disclosed herein, including three or fewer or five or more peripheral openings. One or more of the peripheral openings 44-1 through 44-4 can be omitted. For example, openings 44-2 and 44-4 can be omitted so that pattern 48 is comprised of a pair of opposing openings 44-1 and 44-3, or vice versa, openings 44-1 and 44-3 can be omitted so that pattern 48 is comprised of openings 44-2 and 44-4. In FIG. 7, pattern 48' includes a total of three peripheral openings 44' (shown as 44-1' / 44-3', 44-5', and 44-6'). Openings 44-1' / 44-3' may extend along a first reference plane R1'. Openings 44-5' and 44-6' may be circumferentially offset or otherwise spaced apart from both the first reference plane R1' and the second reference plane R2'.

[0050] 2-4 and with reference to FIG. 5, each peripheral opening 44 may extend along a respective channel axis PA. The channel axis PA may be parallel to the longitudinal axis A. In FIG. 5, the channel axis PA is generally transverse to the longitudinal axis A, which may increase the spacing between the ends of adjacent fasteners inserted through the peripheral openings 44. At least a portion of the peripheral openings 44 may intersect with a respective notch 45 along the perimeter 39 of the plate body 26.

[0051] Various patterns or layouts of peripheral openings can be configured to approximate a variety of different surface contours and cavity shapes a surgeon may encounter in surgical preparation. A surgeon can be provided with a set of orthopedic implants in a kit for joint arthroplasty that includes any of the implants and patterns disclosed herein. The kit can include a set of base plates having any of the peripheral opening base plates, expansion shapes, and patterns disclosed herein. The kit can also include fasteners received in each peripheral opening to secure each base plate to the surgical site.

[0052] 8-13 illustrate an exemplary orthopedic implant 120. Referring to FIG. 8, the implant 120 may include a base plate 122 having a plate body 126 extending along a longitudinal axis A between an anterior (or first) surface 128 and a posterior (or second) surface 130 generally opposite the anterior surface 128. The base plate 122 may include a central post or fixation stem 132 that may extend outward from the posterior surface 130 along the longitudinal axis A. The plate body 126 may include a body portion 138, and an extension portion 140 may extend outward from the body portion 138. The body portion 138 may constitute the anterior surface 128 of the plate body 126. The extension portion 140 may constitute at least a portion of the posterior surface 130 and may have a generally wedge shape.

[0053] The base plate 122 may include a plurality of peripheral openings (or holes) 144 along the anterior surface 128 of the plate body 126 for securing the base plate 122 to a surgical site. The peripheral openings 144 may extend between the anterior surface 128 and the posterior surface 130, with at least some or each of the peripheral openings 144 extending through the thickness of the extended portion 140 between the anterior surface 128 and the extended surface portion 142 of the posterior surface 130, as shown in FIG. 13 . Each peripheral opening 144 may be sized to receive a respective fastener for securing the base plate 122 to a surgical site.

[0054] With continued reference to FIG. 8 and with reference to FIG. 9 , the peripheral openings 144 may be distributed circumferentially about the longitudinal axis A to form a respective pattern (or layout) 148. The peripheral openings 144 may be positioned relative to first and second reference planes R1, R2 such that the pattern 148 differs from the pattern 48 of the peripheral openings 44 ( FIG. 3 ). The first reference plane R1 may bisect the extension surface portion 142 of the extension portion 140 (shown with a dashed line for illustrative purposes). At least some of the peripheral openings 144 may be circumferentially offset (e.g., positioned “diagonally”) or otherwise spaced apart from both the first and second reference planes R1, R2 relative to the longitudinal axis A. In FIG. 9 , all of the peripheral openings 144 of the base plate 122 that are positioned about the longitudinal axis A may be circumferentially offset from both the first and second reference planes R1, R2 relative to the longitudinal axis A.

[0055] Varying amounts of peripheral openings 144 can be utilized to configure the pattern 148. In FIG. 9, the base plate 122 may include a total of four peripheral openings 144 (designated 144-1 through 144-4). However, it should be understood that fewer than three or more than four peripheral openings 144 may be utilized in accordance with the teachings disclosed herein. The peripheral openings 144 are generally uniformly distributed about the longitudinal axis A. The peripheral openings 144 may be non-uniformly distributed about the longitudinal axis A, such that some adjacent pairs of openings 144 are relatively closer or further apart than other adjacent pairs of openings 144.

[0056] The base plates 22, 122 may be provided as a pair of base plates (e.g., first and second base plates), each constituting a respective pattern 48, 148 (e.g., first and second patterns). The peripheral openings 44 of the pattern 48 and the peripheral openings 144 of the pattern 148 may have a common number of peripheral openings 44 / 144 and a common circumferential spacing between each adjacent opening 44 / 144 relative to the longitudinal axis A. The base plate 122 may have the same outline or shape as the base plate 22.

[0057] The peripheral openings 144 can be positioned such that the pattern 148 is circumferentially offset from the pattern 48 (FIG. 3) relative to the longitudinal axis A. For example, the base plate 122 can be free of any peripheral openings 144 along the first reference plane R1, as shown in FIGS. 9-11. FIGS. 10-11 show cross-sectional views of the base plate 122 taken along the first reference plane R1 and through the maximum thickness of the extension portion 140. The peripheral openings 44, 144 of both patterns 48, 148 can be substantially uniformly distributed around the longitudinal axis A.

[0058] In FIG. 9, the third reference plane R3 may extend along the longitudinal axis A such that the first and third reference planes R1, R3 form an acute angle β. The fourth reference plane R4 may extend along the longitudinal axis A such that the second and fourth reference planes R2, R4 form an acute angle φ. The third reference plane R3 may be perpendicular to the fourth reference plane R4. One or more of the openings 144 may be circumferentially disposed along the third reference plane R3, and one or more of the openings 144 may be circumferentially disposed along the fourth reference plane R4. A pair of opposing openings 144-1, 144-3 may be disposed along the third reference plane R3 (see also FIGS. 12-13), and another pair of opposing openings 144-2, 144-4 may be disposed along the fourth reference plane R4, as shown in FIG. 9. Angle β and / or angle φ may be greater than 0 degrees, such as from about 25 degrees to about 75 degrees, or may be narrower, such as from about 30 degrees to about 60 degrees, such as about 45 degrees. Angle β and / or angle φ may be greater than 0 degrees but less than 45 degrees. Angles β and φ may be the same or different. Angles β and φ may be the same, and the pattern 148 of apertures 144 may be circumferentially offset or shifted from the pattern 48 of apertures 44 by angle β relative to the longitudinal axis A.

[0059] In the embodiment of FIG. 14 , pattern 148′ may be circumferentially offset or shifted from pattern 48 ( FIG. 3 ) in a counterclockwise direction relative to longitudinal axis A′. Openings 144′ in pattern 148′ may be circumferentially offset a lower amount than openings 144 in pattern 148. Angle β′ and angle φ′ may be less than 45 degrees, such as about 30 degrees. In FIG. 15 , pattern 148″ may be circumferentially offset or shifted from pattern 48 in a clockwise direction relative to longitudinal axis A″. Angle β″ and angle φ″ may be less than 45 degrees, such as about 30 degrees. The disclosed values ​​of angle β and / or angle φ may be positive (e.g., clockwise) or negative (e.g., counterclockwise) relative to the respective reference planes R1, R2.

[0060] Fewer than three or more than five circumferentially offset peripheral openings may be used. One or more of the peripheral openings 144-1 through 144-4 may be omitted. For example, openings 144-2 and 144-4 may be omitted such that the pattern 148 is formed by a pair of opposing openings 144-1 and 144-3, or vice versa, openings 144-1 and 144-3 may be omitted such that the pattern 148 is formed by openings 144-2 and 144-4. As another example, openings 144-1 and 144-2 may be omitted such that the pattern 148 is formed by openings 144-3 and 144-4, or vice versa, openings 144-3 and 144-4 may be omitted such that the pattern 148 is formed by openings 144-1 and 144-2.

[0061] 16-19 illustrate an exemplary orthopedic implant 220. With reference to FIGS. 16-17, the implant 220 includes a base plate 222 having a plate body 226 extending along a longitudinal axis A between an anterior (or first) surface 228 and a posterior (or second) surface 230, which may be generally opposite the anterior surface 228. The base plate 222 may include a central post or fixation stem 232, which may extend outward from the posterior surface 230 along the longitudinal axis A. The plate body 226 includes a body portion 238 and an extension portion 240, which may extend outward from the body portion 238. The body portion 238 may constitute the anterior surface 228 of the plate body 226. The extension portion 240 may constitute at least a portion of the posterior surface 230 and may have a generally wedge shape.

[0062] The extension portion 240 may be dimensioned to extend less than the full width of the body portion 238 (e.g., a "partial wedge"). The rear surface 230 may include an extension surface portion 242 defined by the extension portion 240 and a second surface portion 247 joined at a joining surface 246. The second surface portion 247 may be disposed along a reference plane that may be generally perpendicular to the longitudinal axis A, as shown in FIG. 19 . FIG. 19 shows a cross-sectional view through the maximum thickness of the extension portion 240. The extension portion 240 may be dimensioned such that the joining surface 246 is configured along the longitudinal axis A (e.g., a "half wedge") and spans approximately one-half the width of the plate body 226, as shown in FIG. 16 . The extension portion 240 may be dimensioned to extend less than or more than one-half the width of the plate body 226, such as approximately three-quarters the width of the plate body 226 (e.g., three-quarters of a wedge).

[0063] The extension surface portion 142 may form an acute angle α with respect to a reference plane that may be perpendicular to the longitudinal axis A, as shown in FIG. 19. The angle α may be, for example, greater than or equal to about 5 degrees and less than or equal to about 45 degrees. The angle α may be about 15 degrees, 25 degrees, or 35 degrees. The shape of the extension portion 240 may be utilized with any of the base plates and / or patterns of peripheral openings disclosed herein.

[0064] The base plate 222 may include a plurality of peripheral openings (or holes) 244 along the anterior surface 228 of the plate body 226 for securing the base plate 222 to a surgical site, as shown in FIG. 17 . The peripheral openings 244 may extend between the anterior surface 228 and the posterior surface 230 of the plate body 226, with at least some, or each, of the peripheral openings 244 extending through the thickness of the extended portion 240 between the anterior surface 228 and the extended surface portion 242 of the posterior surface 230, as shown in FIG. 18 . In FIG. 18 , only a portion of the peripheral openings 244 may extend through the extended portion 240, and at least one of the openings 244 may extend between the anterior surface 228 and the second surface 247 of the posterior surface 230. Each peripheral opening 244 may be sized to receive a respective fastener for securing the base plate 222 to a surgical site.

[0065] 17-19, with continued reference to FIG. 16, peripheral openings 244 may be distributed circumferentially about longitudinal axis A to form respective patterns (or layouts) 248. Patterns 248 may be arranged according to any of the patterns disclosed herein. Patterns 248 may correspond to pattern 148 of FIG. 9, with FIG. 18 being a cross-sectional view taken along third or fourth reference planes R3, R4, and FIG. 19 being a cross-sectional view of base plate 222 taken along first reference plane R1.

[0066] FIG. 20 shows an exemplary pattern (or layout) 348. The base plate 322 includes an extension portion 340 (shown in dashed lines) that can extend less than the entire width of the plate body 326. Peripheral openings 344 (shown as 344-1 through 344-3) can be distributed circumferentially about the longitudinal axis A to form the pattern 348. Each opening 344 can be circumferentially offset from an adjacent reference plane R1, R2 to form a respective angle β (shown as β-1 through β-3). The angles β-1 through β-3 can be different such that the openings 344 are distributed non-uniformly about the longitudinal axis A.

[0067] Other base plate shapes or configurations can be utilized. In FIG. 20A , perimeter 339′ of base plate 322′ can have an elliptical, non-circular shape defined by points P1′, P2′ along the major axis of the ellipse and points P3′, P4′ along the minor axis. The major and minor axes can be aligned with, for example, first and second reference planes R1′, R2′. In FIG. 20A , perimeter 339″ of base plate 322″ can have an oval shape defined by points P1′, P2′ along the major axis of the oval and points P3′, P4′ along the minor axis. The major and minor axes can be aligned with, for example, first and second reference planes R1″, R2″.

[0068] 21 illustrates a flowchart 480 of an exemplary method for installing an orthopedic implant at a surgical site. The method may be utilized, for example, to perform arthroplasty to restore function to a shoulder with progressive cartilage disease, such as repairing bone defects along the glenoid cavity. Method 480 may be utilized with any of the orthopedic implants, expanded shapes, and peripheral opening patterns disclosed herein. Fewer or additional steps than those listed below 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.

[0069] A kit for joint arthroplasty may be provided at block 482. The kit may include any of the components disclosed herein, including a set of base plates, a plurality of peripheral fasteners, and one or more glenoid balls. At step 484, a base plate may be selected from the set of base plates based on the surface contour of the surgical site. An exemplary surface contour of surgical site S is shown in FIG. 22. Another exemplary surface contour of surgical site S' is illustrated by FIG. 23. Other exemplary surface contours of surgical site S are disclosed in FIGS. 24A-24E and 25A-25E. The set of base plates may include at least a first base plate (e.g., base plate 22) and a second base plate (e.g., base plate 122). Each of the base plates may include peripheral openings arranged to define a respective pattern, including any of the patterns disclosed herein. The peripheral openings of the second base plate may be arranged to define a second pattern (e.g., pattern 148) that may be circumferentially offset from the first pattern (e.g., pattern 48) of the first base plate relative to the longitudinal axis. The first and second patterns may have a common circumferential spacing between their respective peripheral openings.

[0070] 22 with continued reference to FIG. 21 , a surgical site S may be created to accommodate a prosthetic device 410 including an implant 420 in step 486. The implant 420 may include a base plate 422 and a glenoid ball 424. The implant 420, including the base plate 422, may correspond to any of the implants and base plates disclosed herein. The underside of the base plate 422 may include an extension portion 440 that may be dimensioned to abut the front surface and / or fill a bone void along the surgical site S. The extension portion 440 may have a generally wedge shape.

[0071] One or more procedures may be performed to create a surgical site S, such as one or more of reaming, milling, and drilling, to configure the desired shape of the surgical site. Step 486 may include forming a recess or bone hole BH at the surgical site S, such as the articular surface of a glenoid, by removing tissue, such as bone B, at the surgical site S. The bone hole BH′ may be formed to remove tissue from a defect in the bone B′, as shown in FIG. 23 . The bone hole BH′ may be sized to at least partially accommodate at least the extension portion 440′ of the base plate 422′. The defect in the glenoid may be characterized by the Walch classification. The surgeon may measure bone loss using imaging of the surgical site, e.g., radiography or computed tomography, or may approximate the contours of the defect using one or more sizers and / or measuring devices positioned against the bone surface. The bone hole BH′ may be sized to approximate the contours of the defect. The base plate 422'' may be sized such that the extension portion 440'' may extend less than the full width of the base plate 422'' (shown by dashed lines in FIG. 23 for illustrative purposes).

[0072] In step 488, the selected base plate 422 may be positioned relative to the surface contour and bone hole BH of the surgical site S. Step 488 may include positioning the fixation stem 432 of the selected base plate 422 within the bone hole BH to secure the base plate 422 to the surgical site S.

[0073] At step 490, one or more fasteners may be positioned in the respective peripheral openings along the respective path axis PA (shown by dashed lines in FIG. 22) to secure the selected base plate to the surgical site S, as shown by the peripheral fasteners PF and peripheral openings 44, 144 of the base plates 22, 122 in FIGs. 24A-24E and 25A-25E. In FIGs. 24A-24E and 25A-25E, the peripheral fasteners PF may be compression screws that may serve to create and maintain compression between the respective base plates 22, 122 and the glenoid surface, reducing relative movement and reducing tissue formation that may otherwise result from spacing between the base plates and the glenoid contact surface.

[0074] At step 492, the head portion or glenoid ball 424 may be secured to a selected base plate 422, which may provide an articulating surface for mating with an opposing articulating member M. The articulating member M may be, for example, an implant secured to the humerus. The base plate 422 may provide the articulating surface.

[0075] 24A-24E show implant 20 positioned relative to surgical site S at different viewing angles. FIGS. 25A-25E show implant 120 positioned relative to surgical site S at different viewing angles. FIGS. 25A-25E may correspond to the same viewing angles as FIGS. 24A-24E, respectively. The shapes of surgical sites S in FIGS. 24A-24E and 25A-25E may be the same or different. The implants 20, 120 in FIGS. 24A-24E and 25A-25E may be placed relative to their respective surgical sites S using, for example, method 480 of FIG. 21.

[0076] Each peripheral opening 44, 144 may be sized to receive a respective peripheral fastener PF for securing the plate body 26, 126 to the surgical site S. The peripheral fasteners PF may extend at least partially through the thickness of the bone tissue at the surgical site S.

[0077] 24A, the base plate 22 can be positioned so that the first and second reference planes R1, R2 are generally aligned with the patient's superior / inferior (S / I) and / or anterior / posterior (A / P) planes. One or more of the peripheral openings 44 and peripheral fasteners PF can be positioned along the S / I and / or A / P planes.

[0078] 25A, the first reference plane R1 of the base plate 122 may be positioned such that the first and second reference planes R1, R2 may be substantially aligned with the S / I and A / P planes. All of the peripheral openings 144 may be circumferentially offset from the first reference plane R1, the second reference plane R2, the S / I plane, and / or the A / P plane.

[0079] 26-27 show an exemplary orthopedic implant 520. The implant 520 includes a base plate 522, which may include a plate body 526 and an extension portion 540 positioned relative to a body portion 538. The body portion 538 and the extension portion 540 may be separate components. The base plate 522 may include a plurality of peripheral openings 544, which may form a pattern or layout 548. The openings 544 may be arranged according to any of the patterns disclosed herein.

[0080] The extension portion 540 may include one or more channels 550 extending along respective paths 552. The channels 550 may be elongated slots or may be generally arcuate, as shown in FIGS. 26-27 . The path axis PA of each opening 544 may be generally aligned with the path 522 of the respective channel 550. A first reference plane R1 may bisect the extension portion 540, and a second reference plane R2 may be perpendicular to the first reference plane R2. The base plate 522 may include a locking mechanism 554 movable between an unlocked mode and a locked mode. The locking mechanism 554 may include, for example, a retaining pin that may selectively engage one or more recesses along the body portion 538.

[0081] The extension portion 540 may be rotatable in a direction RD ( FIG. 27 ) about the longitudinal axis A of the base plate 522 in an unlocked mode. A locking mechanism 554 may be movable into a locked mode, which may limit movement of the extension portion 540 relative to the body portion 538. FIG. 26 shows the extension portion 540 and peripheral opening 544 in a first position relative to the longitudinal axis A. FIG. 27 shows the extension portion 540′ and peripheral opening 544′ in a second, different position relative to the longitudinal axis A′. As shown in FIG. 27 , the extension portion 540′ may be positioned such that the first and second reference planes R1′, R2′ defined by the extension portion 540′ may differ from the positions of the first and second reference planes R1, R2 defined by the extension portion 540 in FIG. 26 . The channels 550 may be dimensioned to accommodate respective fasteners inserted through adjacent peripheral openings 544 at different positions relative to the base plate 522, such as different circumferential positions relative to the longitudinal axis A. The extension portions 540 may be positioned relative to the peripheral openings 544, which may improve contact between the extension portions 540 and the surface contours along the surgical site and improve securement of fasteners received in the respective openings 544.

[0082] The novel implants and methods disclosed herein may provide versatility for securing implants with fasteners to bone at surgical sites. The disclosed implant and expansion shapes may be utilized to closely approximate the dimensions of bone surfaces, such as bone voids, which may result in improved healing at the surgical site. The disclosed patterns of peripheral openings may be utilized to improve fixation of each implant by selecting the pattern based on the shape of the surgical site and the bone thickness at each location of the peripheral opening. The disclosed base plates may have circular or non-circular shapes. The disclosed base plates having a generally circular shape may be utilized to orient the base plate's expansion portion in multiple directions to create a "best fit" for the expansion portion while ensuring optimal positioning of the peripheral screws. Furthermore, the multiple orientations of the expansion portion may help maintain the glenoid bone during base plate creation.

[0083] Although different non-limiting embodiments are illustrated as having particular components or steps, 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.

[0084] It should be understood that like reference numerals identify corresponding or similar elements throughout the several views. While particular component arrangements are disclosed and illustrated in these exemplary embodiments, it should be further understood that other arrangements can also benefit from the teachings of the present disclosure.

[0085] The foregoing description is illustrative and is not to be construed in any limiting sense. Those skilled in the art will recognize that certain modifications would be possible within the scope of the present disclosure. [Explanation of symbols]

[0086] 20 Implants 22 Base plate 24 Glenoid ball 25 Articular Surface 26 Plate body 27 Recess 28 Front 29 Aperture 30 Rear 32 Fixed stem 38 Main body part 39 Perimeter 40 Extension 42 Extended surface area 43 Aperture

Claims

1. 1. An orthopedic implant comprising: a base plate including a plate body extending along a longitudinal axis between an anterior surface and a posterior surface and a fixation stem extending outward from the posterior surface; the plate body includes a body portion defining the anterior surface, a wedge-shaped extension portion extending from the body portion to define the posterior extension surface portion, and a plurality of peripheral openings distributed circumferentially about the longitudinal axis, the peripheral openings being sized to receive respective fasteners for securing the base plate to a surgical site; the extended surface portion forms an angle greater than 0 degrees with respect to a reference plane perpendicular to the longitudinal axis, first and second reference planes disposed perpendicular to one another extend along the longitudinal axis, the first reference plane extending through a maximum thickness of the extended portion and bisecting the posterior surface along the extended portion; all peripheral openings of the base plate disposed about the longitudinal axis are circumferentially offset from both the first and second reference planes; The orthopedic implant includes a first base plate and a second base plate, wherein the peripheral openings of the first base plate are distributed circumferentially about the longitudinal axis to form a first pattern, one or more of the peripheral openings extending along the first reference plane, and the peripheral openings of the second base plate are distributed circumferentially about the longitudinal axis to form a second pattern, the second pattern being circumferentially offset from the first pattern relative to the longitudinal axis, and the first and second patterns having a common circumferential spacing between their respective peripheral openings.

2. The implant of claim 1 , wherein the periphery of the plate body is generally circular.

3. The implant of claim 1 , wherein the fixation stem extends along the longitudinal axis.

4. The implant of claim 1 , wherein the plurality of peripheral openings are substantially uniformly distributed about the longitudinal axis.

5. The implant of claim 4 , wherein the plurality of peripheral openings includes a total of four peripheral openings.

6. 2. The implant of claim 1, wherein a third reference plane extends along the longitudinal axis such that the first and third reference planes form an acute angle, and a pair of the peripheral openings are circumferentially disposed along the third reference plane.

7. 7. The implant of claim 6, wherein the acute angle is greater than 0 degrees but less than 45 degrees.

8. The implant of claim 6, wherein the acute angle is between 30 and 60 degrees.

9. The implant of claim 8 , wherein the plurality of peripheral openings includes a total of four peripheral openings.

10. The implant of claim 9 , wherein the four peripheral openings are substantially uniformly distributed around the longitudinal axis.

11. 2. The implant of claim 1, wherein the posterior surface includes a second surface portion disposed generally perpendicular to the longitudinal axis, the extended surface portion and the second surface portion joined at a joint surface, and the second surface portion extends less than the entire width of the body portion.

12. The implant of claim 1 , further comprising a glenoid ball including an articular surface having a generally convex shape, said glenoid ball secured to said baseplate adjacent said anterior surface.

13. The implant of claim 12 , wherein the glenoid ball includes a recess dimensioned to at least partially receive the body portion of the base plate.

14. 14. The implant of claim 13, wherein a periphery of the body portion of the base plate is dimensioned to cooperate with a periphery of the recess to form a molar taper connection.

15. 1. A kit for joint arthroplasty, comprising: A pair of base plates; a plurality of fasteners; Each base plate of the set of base plates includes a plate body having a body portion, the plate body having wedge-shaped extension portions that cooperate to define an anterior and posterior surface of the plate body, and a plurality of peripheral openings extending between the anterior and posterior surfaces, the extension portions defining an angle greater than 0 degrees with respect to a reference plane perpendicular to a longitudinal axis of the plate body, the peripheral openings being sized to receive respective fasteners for securing the plate body to a surgical site, a first reference plane extending along the longitudinal axis of the plate body and through a maximum thickness of the extension portion to bisect the posterior surface along the extension portion, the set of base plates includes a first base plate and a second base plate, the peripheral openings of the first base plate being distributed circumferentially about the longitudinal axis to form a first pattern such that one or more of the peripheral openings extend along the first reference plane, the peripheral openings of the second base plate being distributed circumferentially about the longitudinal axis to form a second pattern, the second pattern being circumferentially offset from the first pattern relative to the longitudinal axis, and the first and second patterns having a common circumferential spacing between their respective peripheral openings.

16. a fixation stem extending outwardly from the rear surface; 16. The kit of claim 15, further comprising a glenoid ball including an articular surface having a generally convex shape, the glenoid ball removably secured to each of the base plates adjacent the anterior surface.

17. 16. The kit of claim 15, wherein the periphery of the body portion is generally circular and the peripheral openings of both the first pattern and the second pattern are generally uniformly distributed around the longitudinal axis.

18. 18. The kit of claim 17, wherein a second reference plane extends along the longitudinal axis and is perpendicular to the first reference plane, and the second pattern is configured such that all peripheral openings of the second base plate disposed about the longitudinal axis are circumferentially offset from both the first and second reference planes.

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