US20140128985A1 - Joint Arthroplasty Systems, Methods, and Components - Google Patents

Abstract

Surgical implant systems, methods, and components are described herein. More particularly, the disclosure relates to joint arthroplasty systems, methods, and components. Particular embodiments described herein can be used to modify the subtalar joint (e.g., posterior facet of the subtalar joint), calcaneocuboid, talonavicular, and any other suitable joint. An exemplary implant system comprises a first implant component, a second implant component, and an insert.

Description

FIELD
• The disclosure relates generally to surgical implant systems, methods, and components. More particularly, the disclosure relates to joint arthroplasty systems, methods, and components. Particular embodiments described herein can be used to modify the subtalar joint (e.g., posterior facet of the subtalar joint), calcaneocuboid, talonavicular, and any other suitable joint.
BACKGROUND
• The subtalar joint is a joint in the foot formed between the talus and calcaneus and it serves several important roles in human gait. For example, the subtalar joint allows for inversion and eversion of the rear portion of the foot about the lengthwise axis of the foot and abduction and adduction relative to the vertical axis of the tibia. In addition, the subtalar joint allows both pronation and supination to occur and serves to translate rotation of the foot to the tibia and vice versa. The subtalar joint is composed of three articulating facets between the talus and the calcaneus: the anterior, middle, and posterior facets. The anterior and middle facets produce a gliding motion whereas the posterior facet produces a complex triaxial movement due to its saddle shape.
• Commonly, inflammatory arthritis, such as rheumatoid arthritis, affects the subtalar joint and requires treatment. Rheumatoid arthritis is known to destroy the subtalar joint through synovitis and, in some cases, directly damages the cartilage in the joint or the tendons around the ankle. In addition to inflammatory arthritis, other afflictions can also affect the subtalar joint, such as eccentric forces that act on the subtalar joint and erode the joint causing pain and discomfort.
• Various forms of treatment can be used to treat the afflictions that affect the subtalar joint. For example, various non-operative treatments, such as activity modification, weight-loss, prescription shoes, and/or medication can be used. Alternatively, when non-operative treatments are not successful at providing adequate treatment, operative treatments can be used, such as arthrodesis—the fusing of the talus to the calcaneus. Arthrodesis is generally accomplished by removing any remnants of cartilage from the subtalar joint and placing screws and/or bone grafts across the subtalar joint. This treatment, however, presents several disadvantages. For example, it permanently fixes the talus to the calcaneus, eliminating movement between these bones, and sometimes results in pain and discomfort requiring the performance of subsequent procedures to address these issues.
• Therefore, a need exists for improved surgical implant systems, methods, and components for use in joint arthroplasty.
SUMMARY
• Various exemplary implant systems, methods, and components are described herein.
• A first exemplary implant system for use in a joint arthroplasty comprises a first implant component, a second implant component, and an insert. The first implant component has a first implant proximal end, a first implant distal end, and a first implant body. The first implant body defines a substantially flat first implant surface, a substantially concave first articulating surface opposably facing the first implant surface, a first implant protuberance, and a passageway. The first implant protuberance extends outward and away from the first implant surface and toward the first implant distal end from a first implant protuberance first end to a first implant protuberance second end. The passageway extends from a first opening defined on the first implant proximal end to a second opening defined on the first implant protuberance second end. The second implant component has a second implant proximal end, a second implant distal end, and a second implant body. The second implant body defines a substantially flat second implant surface, a recess that extends into the second implant body from a side opposably facing the second implant surface to a recess base, a second implant protuberance, and a passageway. The second implant protuberance extends outward and away from the second implant surface and toward the second implant distal end from a second implant protuberance first end to a second implant protuberance second end. The passageway extends from a first opening defined on the recess base to a second opening defined on the second implant protuberance second end. The insert is adapted to be releasably attached to the second implant component and has an insert articulating surface that is substantially convex and adapted to articulate with the first articulating surface.
• A second exemplary implant system for use in a joint arthroplasty comprises a first implant component, a second implant component, and an insert. The first implant component has a first implant proximal end, a first implant distal end, and a first implant body. The first implant body defines a substantially flat first implant surface, a substantially concave first articulating surface opposably facing the first implant surface, a first implant protuberance, and a passageway. The first implant protuberance extends outward and away from the first implant surface and toward the first implant distal end from a first implant protuberance first end to a first implant protuberance second end. The passageway extends from a first opening defined on the first implant proximal end to a second opening defined on the first implant protuberance second end. The second implant component has a second implant proximal end, a second implant distal end, and a second implant body. The second implant body defines a substantially flat second implant surface, a recess, a second implant protuberance, and a passageway. The recess extends into the second implant body from a side opposably facing the second implant surface to a recess base and from the second implant proximal end toward the second implant distal end. The second implant protuberance extends outward and away from the second implant surface and toward the second implant distal end from a second implant protuberance first end to a second implant protuberance second end. The passageway extends from a first opening defined on the recess base to a second opening defined on the second implant protuberance second end. The recess has a recess first portion that extends from the recess base and away from the second implant surface and a recess second portion that extends from the recess first portion and away from the second implant surface. The insert is adapted to be releasably attached to the second implant component and has an insert articulating surface that is substantially convex and adapted to articulate with the first articulating surface.
• A third exemplary implant system for use in a joint arthroplasty comprises a first implant component, a second implant component, and an insert. The first implant component has a first implant proximal end, a first implant distal end, and a first implant body. The first implant body defines a substantially flat first implant surface, a substantially concave first articulating surface opposably facing the first implant surface, a first implant protuberance, and a passageway. The first implant protuberance extends outward and away from the first implant surface and toward the first implant distal end from a first implant protuberance first end to a first implant protuberance second end. The passageway extends from a first opening defined on the first implant proximal end to a second opening defined on the first implant protuberance second end. The second implant component has a second implant proximal end, a second implant distal end, and a second implant body. The second implant body defines a substantially flat second implant surface, a recess, a second implant protuberance, and a passageway. The recess extends into the second implant body from a side opposably facing the second implant surface to a recess base and from the second implant proximal end toward the second implant distal end. The second implant protuberance extends outward and away from the second implant surface and toward the second implant distal end from a second implant protuberance first end to a second implant protuberance second end. The passageway extends from a first opening defined on the recess base to a second opening defined on the second implant protuberance second end. The recess has a recess first portion that extends from the recess base and away from the second implant surface and a recess second portion that extends from the recess first portion and away from the second implant surface. The insert is adapted to be releasably attached to the second implant component and has an insert articulating surface that is substantially convex and adapted to articulate with the first articulating surface. The recess first portion has a recess first portion width along the second implant proximal end and the recess second portion has a recess second portion width along the second implant proximal end. The recess first portion width is different than the recess second portion width.
• Additional understanding of the exemplary surgical implant systems, methods, and components can be obtained by review of the detailed description, below, and the appended drawings.
BRIEF DESCRIPTION OF THE FIGURES
• FIG. 1 is a lateral view of an exemplary human foot highlighting the subtalar joint.
• FIG. 2 is a magnified view of the area indicated inFIG. 1.
• FIG. 3 is a perspective view of a first exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 4 is a perspective view of the first exemplary implant system illustrated inFIG. 3, free of the subtalar joint.
• FIG. 5 is an exploded view of the exemplary implant system illustrated inFIG. 4.
• FIG. 6 is another exploded view of the exemplary implant system illustrated inFIG. 4.
• FIG. 7 is a perspective view of a second exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 8 is a perspective view of the second exemplary implant system illustrated inFIG. 7, free of the subtalar joint.
• FIG. 9 is an exploded view of the exemplary implant system illustrated inFIG. 8.
• FIG. 10 is another exploded view of the exemplary implant system illustrated inFIG. 8.
• FIG. 11 is a perspective view of a third exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 12 is a perspective view of the third exemplary implant system illustrated inFIG. 11, free of the subtalar joint.
• FIG. 13 is an exploded view of the exemplary implant system illustrated inFIG. 12.
• FIG. 14 is another exploded view of the exemplary implant system illustrated inFIG. 12.
• FIG. 15 is a perspective view of a fourth exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 16 is a perspective view of the fourth exemplary implant system illustrated inFIG. 15, free of the subtalar joint.
• FIG. 17 is an exploded view of the exemplary implant system illustrated inFIG. 16.
• FIG. 18 is another exploded view of the exemplary implant system illustrated inFIG. 16.
• FIG. 19 is a perspective view of a fifth exemplary implant system with the insert partially disposed in the second implant component.
• FIG. 20 is an exploded view of the exemplary implant system illustrated inFIG. 19.
• FIG. 21 is a magnified view of the area indicated inFIG. 20.
• FIG. 22 is another exploded view of the exemplary implant system illustrated inFIG. 19.
• FIG. 23 is a perspective view of a sixth exemplary implant system with the insert partially disposed in the second implant component.
• FIG. 24 is an exploded view of the exemplary implant system illustrated inFIG. 23.
• FIG. 25 is another exploded view of the exemplary implant system illustrated inFIG. 23.
• FIG. 26 is a perspective view of a seventh exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 27 is a perspective view of the seventh exemplary implant system illustrated inFIG. 26, free of the subtalar joint.
• FIG. 28 is an exploded view of the exemplary implant system illustrated inFIG. 27.
• FIG. 29 is another exploded view of the exemplary implant system illustrated inFIG. 27.
• FIG. 30 is a perspective view of an eighth exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 31 is a perspective view of the eighth exemplary implant system illustrated inFIG. 30, free of the subtalar joint.
• FIG. 32 is an exploded view of the exemplary implant system illustrated inFIG. 31.
• FIG. 33 is another exploded view of the exemplary implant system illustrated inFIG. 31.
• FIG. 34 is a perspective view of a ninth exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 35 is a perspective view of the ninth exemplary implant system illustrated inFIG. 34, free of the subtalar joint.
• FIG. 36 is an exploded view of the exemplary implant system illustrated inFIG. 35.
• FIG. 37 is another exploded view of the exemplary implant system illustrated inFIG. 35.
• FIG. 38 is a perspective view of a tenth exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 39 is a perspective view of the tenth exemplary implant system illustrated inFIG. 38, free of the subtalar joint.
• FIG. 40 is an exploded view of the exemplary implant system illustrated inFIG. 39.
• FIG. 41 is another exploded view of the exemplary implant system illustrated inFIG. 39.
• FIG. 42 is a perspective view of an eleventh exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 43 is a perspective view of the eleventh exemplary implant system illustrated inFIG. 42, free of the subtalar joint.
• FIG. 44 is an exploded view of the exemplary implant system illustrated inFIG. 43.
• FIG. 45 is another exploded view of the exemplary implant system illustrated inFIG. 43.
• FIG. 46 is a flowchart representation of an exemplary method of treatment.
• FIG. 47 is a flowchart representation of a second exemplary method of treatment.
• FIG. 48 is a flowchart representation of a third exemplary method of treatment.
• FIG. 49 is a flowchart representation of a fourth exemplary method of treatment.
• FIG. 50 is a perspective view of a twelfth exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 51 is a perspective view of the exemplary implant system illustrated inFIG. 50, free of the subtalar joint, with the insert partially disposed in the second implant component.
• FIG. 52 is an exploded view of the exemplary implant system illustrated inFIG. 51.
• FIG. 53 is another exploded view of the exemplary implant system illustrated inFIG. 51.
• FIG. 54 is a perspective view of a thirteenth exemplary implant system disposed in the subtalar joint of a human foot.
• FIG. 55 is a perspective view of the exemplary implant system illustrated inFIG. 54, free of the subtalar joint.
• FIG. 56 is an exploded view of the exemplary implant system illustrated inFIG. 54.
• FIG. 57 is another exploded view of the exemplary implant system illustrated inFIG. 54.
DETAILED DESCRIPTION
• The following detailed description and the appended drawings describe and illustrate various exemplary surgical implant systems, methods, and components. The description and drawings are exemplary in nature and are provided to enable one skilled in the art to make and use one or more exemplary surgical implant systems and/or components, and/or practice one or more exemplary methods. They are not intended to limit the scope of the claims in any manner.
• The use of “e.g.,” “etc.,” “for instance,” “in example,” and “or” and grammatically related terms indicates non-exclusive alternatives without limitation, unless otherwise noted. The use of “optionally” and grammatically related terms means that the subsequently described element, event, feature, or circumstance may or may not be present/occur, and that the description includes instances where said element, event, feature, or circumstance occurs and instances where it does not. The use of “exemplary” refers to “an example of” and is not intended to convey a meaning of an ideal or preferred embodiment. The use of “attached” and grammatically related terms refers to the fixed, releasable, or integrated association of two or more elements and/or devices. Thus, the term “attached” and grammatically related terms includes releasably attaching or fixedly attaching two or more elements and/or devices. As used herein, the terms “proximal” and “distal” are used to describe opposing axial ends of the particular elements or features being described.
• FIGS. 1 and 2 illustrate an exemplaryhuman foot10 comprising atalus12,calcaneus14, and subtalar joint16. Theposterior facet18 of the subtalar joint16 is formed by a concave, or substantially concave,surface20 on thetalus12 and a convex, or substantially convex,surface22 on thecalcaneus14, as shown inFIG. 2.
• While the systems, methods, and components described herein are exemplified by systems and methods for modifying the posterior facet of the subtalar joint in a human foot, the systems, methods, and components described and illustrated herein can by used to treat any suitable ailment or joint within the body of an animal, including, but not limited to, humans. Skilled artisans will be able to select a suitable ailment and/or joint within the body of an animal to utilize a system and/or method described herein according to a particular embodiment based on various considerations, including the type of ailment and/or the structural arrangement at a treatment site. Example joints considered suitable to utilize a system, method, and/or component described herein include, but are not limited to, the subtalar joint, the talonavicular joint, and the calcaneocuboid joint.
• FIGS. 3,4,5, and6 illustrate an exemplarysurgical implant system100 comprising afirst implant component102, asecond implant component104, and aninsert106.First implant component102 is adapted to be attached to thetalus12 andsecond implant component104 is adapted to be attached to thecalcaneus14.
• First implant component102 andsecond implant component104 can be formed of any suitable material, and skilled artisans will be able to select a suitable material to form a first implant component and/or second implant component according to a particular embodiment based on various considerations, including the structural arrangement at an implant site and/or the material forming the insert of an implant system. Example materials considered suitable to form a first implant component and/or second implant component include, but are not limited to, biocompatible materials, materials that can be made biocompatible, ceramics, polymers, polyethylene, ultra-high-molecular-weight polyethylene (UHMWPE), metals, tantalum, titanium (Ti), and cobalt alloys (e.g., cobalt-chromium (CoCr), cobalt-chromium-molybdenum (CoCrMo)). It is considered advantageous to form a first implant component and/or second implant component of titanium or ultra-high-molecular-weight polyethylene (UHMWPE) at least because these materials have properties that limit adverse reactions after being implanted and have high wearability.
• In the illustrated embodiment,first implant component102 comprises a first implantproximal end108, first implantdistal end110,first implant body112, and a plurality offirst implant projections114.
• First implant body112 defines a convex, or substantially convex,first implant surface116 and an opposably facing, or substantially opposably facing, concave, or substantially concave, first articulatingsurface118. Each of thefirst implant surface116 and first articulatingsurface118 has a radius of curvature that extends from the first implantproximal end108 to the first implantdistal end110.First implant surface116 is smooth, substantially smooth, or uninterrupted and first articulatingsurface118 is smooth, substantially smooth, or uninterrupted, such that articulation between articulatingsurface118 and insert106 can be accomplished, as described in more detail herein.
• Whilefirst implant surface116 has been described as convex, or substantially convex, and first articulatingsurface118 has been described as concave, or substantially concave, the first implant surface and/or first articulating surface of a first implant component can have any suitable structural arrangement. Skilled artisans will be able to select a suitable structural arrangement for the first implant surface and/or first articulating surface of a first implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. Example structural arrangements considered suitable for the first implant surface and/or first articulating surface of a first implant component include, but are not limited to, curved, nonuniform, uniform, flat, substantially flat, concave, substantially concave, convex, substantially convex, and any other structural arrangement considered suitable for a particular application.
• First implant surface116 and first articulatingsurface118 can have any suitable radius of curvature and first implant component can have any suitable dimensions, and skilled artisans will be able to select a suitable radius of curvature for an implant surface and first articulating surface of a first implant component and/or suitable dimensions for a first implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. For example, one or more first implant components can be provided in a kit such that one, two, at least two, or a plurality of the implant components has/have a different radius of curvature on an implant surface and/or first articulating surface and/or different dimensions. It is considered advantageous to provide a variety of differently sized first implant components at least because this provides a mechanism for matching a first implant component with the anatomy at an implant site. It is considered advantageous for a first implant component to have a thickness that is able to withstand the forces placed on the first implant component and/or an implant site (e.g., subtalar joint) during use (e.g., walking, running) and prevent, or substantially prevent, fracture of and/or damage to the first implant component.
• While each of thefirst implant surface116 and first articulatingsurface118 has been described as having a radius of curvature that extends from the first implantproximal end108 to the first implantdistal end110, the first implant body of a first implant component can define a radius of curvature along any suitable length of a surface. Skilled artisans will be able to select a suitable length to define a radius of curvature on a surface according to a particular embodiment based on various considerations, including the structural configuration at an implant site. Example lengths considered suitable to define a radius of curvature on the surface of a first implant component include, but are not limited to, from the first implant proximal end to the first implant distal end of a first implant component, from a location distal to the first implant proximal end to the first implant distal end of a first implant component, between the first implant proximal end and the first implant distal end of a first implant component, and from the first implant proximal end to a location proximal to the first implant distal end of a first implant component.
• Whilefirst implant surface116 has been described as smooth, substantially smooth, or uninterrupted, the first implant surface of a first implant component can comprise any suitable texture, roughness, and/or porosity and skilled artisans will be able to select a suitable texture, roughness, and/or porosity for the first implant surface of a first implant component according to a particular embodiment based on various considerations, including the desired amount of bone ingrowth desired between a first implant component and the bone at an implant site. For example, alternative to first implant surface comprising a smooth, substantially smooth, or uninterrupted surface, the first implant surface of a first implant component can comprise a porous, or substantially porous, surface. It is considered advantageous for the first implant surface of a first implant component to have a porous, or substantially porous, surface to increase the amount of bone ingrowth between a first implant component and the bone at an implant site.
• In the illustrated embodiment, each projection of the plurality offirst implant projections114 has a first implant projectionproximal end120, first implant projectiondistal end122, and extends outward and away, or radially outward, fromfirst implant surface116 at a 90 degree, or substantially 90 degree, angle from a first implant projectionfirst end124 to a first implant projectionsecond end126. Each projection of the plurality offirst implant projections114 is elongated, is disposed between first implantproximal end108 and first implantdistal end110, and defines a serrated first implant projectionsecond end126. It is considered advantageous for each projection of the plurality offirst implant projections114 to define a serrated first implant projectionsecond end126 at least because this structural configuration provides a mechanism for increasing the amount of attachment betweenfirst implant component102 and the surface at an implant site.
• The serrated first implant projectionsecond end126 of each projection of the plurality offirst implant projections114 is configured such that it has a plurality of projection declining surfaces127. Each projection declining surface of the plurality ofprojection declining surfaces127 extends from afirst end127′ toward first implantdistal end110 to asecond end127″. Thefirst end127′ is disposed a first projection distance fromfirst implant surface116 and thesecond end127″ is disposed a second projection distance fromfirst implant surface116. The first projection distance is greater than the second projection distance. This configuration is considered advantageous at least because it provides a mechanism for reducing the complexity of implantingfirst implant component102 at an implant site while also preventing, or substantially preventing,first implant component102 from becoming loose after being implanted. For example, during implantation,first implant component102 can be introduced at in implant site without the serrated first implant projectionsecond end126 of each projection of the plurality ofprojections114 increasing resistance, or substantially increasing resistance. In addition, after implantation, the serrated first implant projectionsecond end126 of each projection of the plurality ofprojections114 will be forced into the treatment site upon the application of force on first articulatingsurface118 and/or toward first implantproximal end108.
• While each projection of the plurality offirst implant projections114 has been illustrated and described as disposed between the first implantproximal end108 and first implantdistal end110, a projection can be positioned at any suitable location on the implant component and can extend any suitable length along the implant component. Skilled artisans will be able to select a suitable location to position a projection on an implant component and a suitable length for a projection according to a particular embodiment based on various considerations, including the structural arrangement of the desired implant site. Example positions and lengths considered suitable for a projection of an implant component include, but are not limited to, a projection that is disposed on the implant surface of an implant component and extends from the first implant proximal end to the first implant distal end, a projection that is disposed on the implant surface of an implant component and extends from the first implant proximal end to a location proximal to the first implant distal end, a projection that is disposed on the implant surface of an implant component and extends between the first implant proximal end and the first implant distal end, and a projection that is disposed on the implant surface of an implant component and extends from a location between the first implant proximal end and the first implant distal end to the first implant distal end.
• While a plurality offirst implant projections114 has been described and illustrated, any suitable number of projections can be included on a first implant component, and skilled artisans will be able to select a suitable number of projections for inclusion on a first implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. Example number of projections considered suitable to include on a first implant component include, but are not limited to, one, at least one, two, three, four, five, a plurality, and any other number considered suitable for a particular application. If more than one implant projection is included on a first implant component, the implant projections can be disposed on a first implant surface in any suitable structural configuration. For example, the implant projections can be disposed linearly between a first implant proximal end and a first implant distal end and/or staggered between a first implant proximal end and a first implant distal end.
• While the first implant projectionsecond end126 of each projection of the plurality offirst implant projections114 has been described and illustrated as serrated, the first implant projection second end of a projection can have any suitable structural configuration. Skilled artisans will be able to select a suitable structural configuration for the first implant projection second end of a projection according to a particular embodiment based on various considerations, including the structural arrangement of a desired implant site. Example structural configurations considered suitable for the first implant projection second end of a projection include, but are not limited to, tapered, pointed, smooth, substantially smooth, porous, substantially porous, serrated, serrated having one or more identical teeth, serrated having a first tooth and a second tooth with a different structural configuration, serrated having at least two teeth with different structural configurations, serrated having a first set of teeth with a first configuration and a second set of teeth with a second structural configuration different than the first structural configuration, and any other structural configuration considered suitable for a particular application. For example, a projection declining surface of the plurality ofprojection declining surfaces127 and/or any other portion of a first implant projection of the plurality offirst implant projections114 can include one or more cavities or comprise a porous, or substantially porous, surface to allow for bone ingrowth. Example structural configurations for a tooth of a serrated first implant projection second end include, but are not limited to, triangular, square, circular, curved, and any other structural configuration considered suitable for a particular application.
• In the illustrated embodiment,second implant component104 comprises a second implantproximal end130, second implantdistal end132,second implant body134, and a plurality ofsecond implant projections136.
• Second implant body134 defines a concave, or substantially concave,second implant surface138,recess139, and a plurality ofrecess projections140.Second implant surface138 is smooth, substantially smooth, or uninterrupted and has a radius of curvature that extends from the second implantproximal end130 to the second implantdistal end132.
• Recess139 is adapted to receive a portion, or the entirety, ofinsert106, as described in more detail herein.Recess139 has arecess length141,recess base142, recessdistal end143, recessfirst portion144, and a recesssecond portion146.Recess139 extends intosecond implant body134 from a side opposably facingsecond implant surface138 to recess base142 and from the second implantproximal end130 toward the second implantdistal end132 to recessdistal end143 disposed between second implantproximal end130 and second implantdistal end132.Recess length141 extends from the second implantproximal end130 toward the second implantdistal end132 to recessdistal end143.
• Each projection of the plurality ofrecess projections140 extends intorecess139 along a portion, or the entirety, ofrecess length141 and has a tapered edge that is adapted to interact with a portion ofinsert106 to releasably attachinsert106 tosecond implant component104.Recess base142 is opposably facing, or substantially opposably facing,second implant surface138, is convex, or substantially convex, and is smooth, substantially smooth, or uninterrupted.Recess base142 has a radius of curvature that extends from the second implantproximal end130 to recessdistal end143. Recessfirst portion144 extends fromrecess base142 and away from thesecond implant surface138 to the plurality ofrecess projections140 and has a recess first portion width145 along the second implantproximal end130. Recesssecond portion146 extends from the recessfirst portion144 and away from thesecond implant surface138 and has a recesssecond portion width147 along the second implantproximal end130 that is measured from a first recess projection of the plurality ofrecess projections140 to a second recess projection of the plurality ofrecess projections140. The recess first portion width145 is different than the recesssecond portion width147. In the illustrated embodiment, recess first portion width145 is greater than the recesssecond portion width147. However, recess first portion width145 can have any suitable width. Example widths considered suitable for a recess first portion width include, but are not limited to, equal to, substantially equal to, greater than, or less than, a recess second portion width.
• Whilesecond implant surface138 has been described as concave, or substantially concave, andrecess base142 has been described as convex, or substantially convex, the second implant surface and recess base of a second implant component can have any suitable structural arrangement. Skilled artisans will be able to select a suitable structural arrangement for the second implant surface and/or recess base of a second implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site and/or the structural arrangement of the insert of an implant system. Example structural arrangements considered suitable for the second implant surface and/or recess base of a second implant component include, but are not limited to, curved, nonuniform, uniform, flat, substantially flat, convex, substantially convex, concave, substantially concave, and any other structural arrangement considered suitable for a particular application.
• Second implant surface138 andrecess base142 can have any suitable radius of curvature and second implant component can have any suitable dimensions, and skilled artisans will be able to select a suitable radius of curvature for an implant surface and recess base of a second implant component and/or suitable dimensions for a second implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. For example, one or more second implant components can be provided in a kit such that one, two, at least two, or a plurality of the implant components has/have a different radius of curvature on an implant surface and/or recess base and/or different dimensions. It is considered advantageous to provide a variety of differently sized second implant components at least because this provides a mechanism for matching a second implant component with the anatomy at an implant site. It is considered advantageous for a second implant component to have a thickness that is able to withstand the forces placed on the second implant component and/or an implant site (e.g., subtalar joint) during use (e.g., walking, running) and prevent, or substantially prevent, fracture of and/or damage to the second implant component.
• Whilesecond implant surface138 has been described as having a radius of curvature that extends from the second implantproximal end130 to the second implantdistal end132 andrecess base142 has been described as having a radius of curvature that extends from the second implantproximal end130 to recessdistal end143, the second implant body can define a radius of curvature along any suitable length of a surface. Skilled artisans will be able to select a suitable length to define a radius of curvature on the surface of a second implant component according to a particular embodiment based on various considerations, including the structural configuration at an implant site. Example lengths considered suitable to define a radius of curvature on the surface of a an implant component include, but are not limited to, from the second implant proximal end to the second implant distal end of a second implant component, from a location distal to the second implant proximal end to the second implant distal end of a second implant component, between the second implant proximal end and the second implant distal end of a second implant component, from the second implant proximal end to a location proximal to the second implant distal end of a second implant component, from the second implant proximal end to the recess distal end of a second implant component, from a location distal to the second implant proximal end to the recess distal end of a second implant component, between the second implant proximal end and the recess distal end of a second implant component, and from the second implant proximal end to a location proximal to the recess distal end of a second implant component.
• Whilesecond implant surface138 has been described as smooth, substantially smooth, or uninterrupted, the second implant surface of a second implant component can comprise any suitable texture, roughness, and/or porosity and skilled artisans will be able to select a suitable texture, roughness, and/or porosity for the second implant surface of a second implant component according to a particular embodiment based on various considerations, including the desired amount of bone ingrowth desired between a second implant component and the bone at an implant site. For example, alternative to second implant surface comprising a smooth, substantially smooth, or uninterrupted surface, the second implant surface of a second implant component can comprise a porous, or substantially porous, surface. It is considered advantageous for the implant surface of a second implant component to have a porous, or substantially porous, surface to increase the amount of bone ingrowth between a second implant component and the bone at an implant site.
• Whilesecond implant body134 has been described as defining arecess139 with arecess length141, recessfirst portion144, and a recesssecond portion146 and defining a plurality ofrecess projections140, the body of an implant component can define a recess having any suitable structural arrangement to provide a mechanism for attaching an insert to an implant component. Skilled artisans will be able to select a suitable structural arrangement for an implant component and/or recess of an implant component according to a particular embodiment based on various considerations, including the structural arrangement at an implant site and/or the structural arrangement of the insert of an implant system. For example, the body of an implant component can define a recess having only a single portion extending along a recess length that is equal to, or substantially equal to, a portion, or the entirety, of the length of the implant component (e.g., recess can extend the entire axial length of an implant component from the implant proximal end to the implant distal end).
• While each projection of the plurality ofrecess projections140 has been described and illustrated as having a tapered configuration, a recess projection can have any suitable structural configuration, and skilled artisans will be able to select a suitable structural configuration for a recess projection according to a particular embodiment based on various considerations, including the material forming the insert of an implant system. Example structural arrangements considered suitable for a projection include, but are not limited to, flat, or substantially flat, tapered, curved, serrated, and any other structural arrangement considered suitable for a particular application.
• In the illustrated embodiment, each projection of the plurality ofsecond implant projections136 has a second implant projectionproximal end150, second implant projectiondistal end152, and extends outward and away, or radially outward, fromsecond implant surface138 at a 90 degree, or substantially 90 degree, angle from a second implant projectionfirst end154 to a second implant projectionsecond end156. Each projection of the plurality ofsecond implant projections136 is elongated, is disposed between second implantproximal end130 and second implantdistal end132, and defines a serrated second implant projectionsecond end156. It is considered advantageous for each projection of the plurality ofsecond implant projections136 to define a serrated second implant projectionsecond end156 at least because this structural configuration provides a mechanism for increasing the amount of attachment between thesecond implant component104 and the surface at an implant site.
• The serrated second implant projectionsecond end156 of each projection of the plurality ofsecond implant projections136 is configured such that it has a plurality of projection declining surfaces157. Each projection declining surface of the plurality ofprojection declining surfaces157 extends from afirst end157′ toward second implantdistal end132 to asecond end157″. Thefirst end157′ is disposed a first projection distance fromsecond implant surface138 and thesecond end157″ is disposed a second projection distance fromsecond implant surface138. The first projection distance is greater than the second projection distance. This configuration is considered advantageous at least because it provides a mechanism for reducing the complexity of implantingsecond implant component104 at an implant site while also preventing, or substantially preventing,second implant component104 from becoming loose after being implanted. For example, during implantation,second implant component104 can be introduced at in implant site without the serrated second implant projectionsecond end156 of each projection of the plurality ofprojections136 increasing resistance, or substantially increasing resistance. In addition, after implantation, the serrated second implant projectionsecond end156 of each projection of the plurality ofprojections136 will be forced into the treatment site upon the application of force onsecond implant body134 and/or toward second implantproximal end130.
• While each projection of the plurality ofsecond implant projections136 has been illustrated and described as disposed between the second implantproximal end130 and second implantdistal end132, a projection can be positioned at any suitable location on an implant component and can extend any suitable length along the implant surface of the implant component. Skilled artisans will be able to select a suitable location to position a projection and a suitable length for a projection according to a particular embodiment based on various considerations, including the structural arrangement of the desired implant site. Example positions and lengths considered suitable for a projection include, but are not limited to, a projection that is disposed on the implant surface of an implant component and extends from the second implant proximal end to the second implant distal end, a projection that is disposed on the implant surface of an implant component and extends from the second implant proximal end to a location proximal to the second implant distal end, a projection that is disposed on the implant surface of an implant component and extends between the second implant proximal end and the second implant distal end, and a projection that is disposed on the implant surface of an implant component and extends from a location between the second implant proximal end and the second implant distal end to the second implant distal end.
• While a plurality ofsecond implant projections136 has been described and illustrated, any suitable number of projections can be included on a second implant component, and skilled artisans will be able to select a suitable number of projections for inclusion on a second implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. Example number of projections considered suitable to include on a second implant component include, but are not limited to, one, at least one, two, three, four, five, a plurality, and any other number considered suitable for a particular application. If more than one implant projection is included on a second implant component, the implant projections can be disposed on a second implant surface in any suitable structural configuration. For example, the implant projections can be disposed linearly between a second implant proximal end and a second implant distal end and/or staggered between a second implant proximal end and a second implant distal end.
• While the second implant projectionsecond end156 of each projection of the plurality ofsecond implant projections136 has been described and illustrated as serrated, the second implant projection second end of a projection can have any suitable structural configuration. Skilled artisans will be able to select a suitable structural configuration for the second implant projection second end of a projection according to a particular embodiment based on various considerations, including the structural arrangement of the desired implant site. Example structural configurations considered suitable for the second implant projection second end of a projection include, but are not limited to, tapered, pointed, smooth, substantially smooth, porous, substantially porous, serrated, serrated having one or more identical teeth, serrated having a first tooth and a second tooth with a different structural configuration, serrated having at least two teeth with different structural configurations, serrated having a first set of teeth with a first configuration and a second set of teeth with a second structural configuration different than the first structural configuration, and any other structural configuration considered suitable for a particular application. For example, a projection declining surface of the plurality ofprojection declining surfaces157 and/or any other portion of a second implant projection of the plurality ofsecond implant projections136 can include one or more cavities or comprise a porous, or substantially porous, surface to allow for bone ingrowth. Example structural configurations for a tooth of a serrated second implant projection second end include, but are not limited to, triangular, square, circular, curved, and any other structural configuration considered suitable for a particular application.
• In the illustrated embodiment, a first projection of the plurality offirst implant projections114 is disposed parallel, or substantially parallel, to a second projection of the plurality offirst implant projections114 and a first projection of the plurality ofsecond implant projections136 is disposed parallel, or substantially parallel, to a second projection of the plurality ofsecond implant projections136. It is considered advantageous to position a first projection of the plurality offirst implant projections114 parallel, or substantially parallel, to a second projection of the plurality offirst implant projections114 and a first projection of the plurality ofsecond implant projections136 parallel, or substantially parallel, to a second projection of the plurality ofsecond implant projections136 at least because this configuration allows for thefirst implant component102 and/orsecond implant component104 to be seated properly at the implant site and provides a mechanism for reducing the complexity of the implant procedure during the introduction of thefirst implant component102 and/orsecond implant component104.
• Whilefirst implant component102 has been illustrated and described as having a first projection of the plurality offirst implant projections114 being disposed parallel, or substantially parallel, to a second projection of the plurality offirst implant projections114 andsecond implant component104 has been illustrated and described as having a first projection of the plurality ofsecond implant projections136 being disposed parallel, or substantially parallel, to a second projection of the plurality offirst implant projections136, a first projection of a plurality of implant projections can be disposed at any suitable angle to a second projection of the plurality of implant projections. Skilled artisans will be able to select a suitable angle to position a first projection of a plurality of implant projections with respect to a second projection of the plurality of implant projections, according to a particular embodiment based on various considerations, including the number of projections disposed on a first implant component and/or the structural arrangement at a desired implant site.
• While each implant projection of the plurality offirst implant projections114 has been illustrated and described as extending outward and away fromfirst implant surface116 at a 90 degree, or substantially 90 degree, angle, and each projection of the plurality ofsecond implant projections136 has been illustrated and described as extending outward and away fromsecond implant surface138 at a 90 degree, or substantially 90 degree, angle, a projection can extend outward and away from an implant surface at any suitable angle and comprise any suitable length. Skilled artisans will be able to select a suitable angle and length for a projection to extend outward and away from an implant surface of an implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. Example angles considered suitable for a projection to extend outward and away from an implant surface of an implant component include, but are not limited to, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, an angle such that the projection is normal to the implant surface, an angle such that the projection is substantially normal to the implant surface, and any other angle considered suitable for a particular application. It is considered advantageous for a projection to extend outward and away from a first implant surface and/or second implant surface at least a length that will provide resistance to sliding after implantation and reduces interference during implantation of the component.
• Insert106 can be formed of any suitable material, and skilled artisans will be able to select a suitable material to form an insert of an implant system according to a particular embodiment based on various considerations, including the material forming a first implant component and/or second implant component of an implant system. Example materials considered suitable to form an insert include, but are not limited to, biocompatible materials, materials that can be made biocompatible, ceramics, polymers, polyethylene, and ultra-high-molecular-weight polyethylene (UHMWPE), metals, tantalum, titanium (Ti), and cobalt alloys (e.g., cobalt-chromium (CoCr), cobalt-chromium-molybdenum (CoCrMo)). It is considered advantageous to forminsert106 of ultra-high-molecular-weight polyethylene at least because ultra-high-molecular-weight polyethylene can be easily machined or molded into a desired structural arrangement and has increased wearability and biocompatibility as compared to other materials. In addition, ultra-high-molecular-weight polyethylene has decreased frictional properties (e.g., lower coefficient of friction) as compared to other materials and wear particulates are easily phagocytized when compared to particulates formed from other materials.
• In the illustrated embodiment, insert106 comprises an insertproximal end160, insertdistal end162, and aninsert body164.Insert106 is adapted to be releasably attached to thesecond implant component104, as described in more detail herein.
• Insert body164 defines aninsert base166, insert articulatingportion168,insert recess170, and aninsert shoulder172.Insert base166 has aninsert base surface174 and theinsert articulating portion168 has aninsert articulating surface176.Insert base surface174 has a radius of curvature that extends from insertproximal end160 toshoulder172 and insert articulatingsurface176 has a radius of curvature that extends from the insertproximal end160 to the insertdistal end162.Insert base surface174 is concave, or substantially concave, and is opposably facing, or substantially opposably facing, insert articulatingsurface176 which is convex, or substantially convex.Insert base surface174 is smooth, substantially smooth, or uninterrupted, and is complementary to recess base142 such thatinsert106 is slidable alongrecess base142 and releasable attachment betweeninsert106 andsecond implant component104 can be accomplished. Insert articulatingsurface176 is smooth, substantially smooth, or uninterrupted, and is complementary to first articulatingsurface118 such thatinsert106 can articulate withfirst implant component102. Thus, insert articulatingsurface176 is adapted to articulate with first articulatingsurface118.
• Insert base166 has an insert base width167 along insertproximal end160 and insert articulatingportion168 has aninsert articulating width169 along insertproximal end160. Insert base width167 is equal to, substantially equal to, less than, or greater than, recess first portion width145. Insert articulatingwidth169 is equal to, substantially equal to, less than, or greater than, recesssecond portion width147. It is considered advantageous to include aninsert106 having an insert base width167 that is equal to, substantially equal to, or greater than, the recess first portion width145 at least because this structural arrangement provides a mechanism for introducinginsert base166 into recessfirst portion144 and provides a mechanism for achieving a friction fit between insert andsecond implant component104. It is considered advantageous to include aninsert106 having ainsert articulating width169 that is equal to, substantially equal to, or greater than, the recesssecond portion width147 at least because this structural arrangement provides a mechanism for achieving a friction fit betweeninsert106 andsecond implant component104. Thus, each ofinsert base166 and insert articulatingportion168 is adapted to interact with recess139 (e.g., each projection of the plurality of recess projections140) to create a friction fit betweeninsert106 andsecond implant component104.
• Insert recess170 extends intoinsert body164 from insertdistal end162 and toward insertproximal end160 and frominsert base surface174 towardinsert articulating surface176 to defineinsert shoulder172.Insert shoulder172 is disposed between insertproximal end160 and insertdistal end162 and is disposed a distance from insertproximal end160 that is equal to, or substantially equal to,recess length141. Thus, insertbase166 extends from the insertproximal end160 toward the insertdistal end162 to insert shoulder172 a distance that is equal to, or substantially equal to,recess length141. Insert articulatingsurface176 extends from insertproximal end160 to insertdistal end162. This structural arrangement is considered advantageous at least becauseinsert shoulder172 provides a mechanical stop to distal axial movement ofinsert106 when it is being introduced intorecess139. It is considered advantageous forinsert articulating surface176 to extend from insertproximal end160 to insertdistal end162 at least because this structural arrangement provides additional structure distal to insertshoulder172 andrecess139 wheninsert106 is releasably attached tosecond implant component104, that can be utilized for articulation purposes.
• Each ofFIGS. 5 and 6 illustrates an exploded view ofimplant system100 and the relationship between thefirst implant component102,second implant component104, and insert106. In use, each of thefirst implant component102 andsecond implant component104 is adapted to be attached at a treatment site such that first articulatingsurface118 and recess139 (e.g., recess base142) are facing, or substantially facing, each other.Insert106 is releasably attached to thesecond implant component104 by slidinginsert base166 into recessfirst portion144 and applying a distally directed axial movement oninsert106 untilinsert shoulder172, which is adapted to interact with recessdistal end143, contacts recessdistal end143 and prevents additional distal axial movement ofinsert106. Insert articulatingsurface176 is adapted to articulate with first articulatingsurface118 to provide a range of movement between theinsert106 andfirst implant component102.
• Whileinsert106 has been illustrated and described as being releasably attached to an implant component that is attached to the calcaneus, the insert of an implant system can alternatively be attached to an implant component that is attached to the talus such that articulation between the insert and an implant component attached to the calcaneus can be accomplished, as described in more detail herein.
• Whileinsert106 has been described as being releasably attached tosecond implant component104 via friction fit betweensecond implant component104 and insert106, any suitable method of attachment between an insert and an implant component can be used. Skilled artisans will be able to select a suitable method of attachment between an insert and an implant component according to a particular embodiment based on various considerations, including the materials forming the insert and/or implant component. Example methods of attachment considered suitable between an insert and an implant component include, but are not limited to, using an adhesive, welding, providing a permanent attachment, releasable attachment, fixed attachment, and any other method of attachment considered suitable for a particular application. For example, an insert can be deformed to form to the structural arrangement of an implant component and permanently attached to the implant component. In an additional example, a metal tab can be provided over the insert articulating surface and a fastener (e.g., screw) can be introduced through the tab and the insert to prevent, or substantially prevent, the insert from becoming free of an implant component after implantation. In yet another example, an insert can be attached to an implant component using a fastener (e.g., screw) that passes through a portion, or the entirety, of the insert and the implant component, and optionally to the implant site. Subsequent to implantation, a first insert is adapted to be exchanged with a second insert by removing the first insert and introducing the second insert, as described herein.
• Whileinsert106 has been described as having a particular structural arrangement, the insert of an implant system can have any suitable structural arrangement that accomplishes attachment between the insert and a first implant component and provides articulation between the insert and a second implant component. Skilled artisans will be able to select a suitable structural arrangement for the insert of an implant system according to a particular embodiment based on various considerations, including the structural arrangement of a first implant component and/or second implant component. For example, an insert can be adapted to extend the entire length of an implant component from the implant component proximal end to the implant component distal end.
• Insert base surface174 and insert articulatingsurface176 can have any suitable radius of curvature and insert106 can have any suitable dimensions, and skilled artisans will be able to select a suitable radius of curvature for a base surface and insert articulating surface of an insert and/or suitable dimensions for an insert according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. For example, one or more inserts can be provided in a kit such that one, two, at least two, or a plurality of the inserts has/have a different radius of curvature on a base surface and/or an insert articulating surface and/or different dimensions. It is considered advantageous to provide a variety of differently sized inserts at least because this provides a mechanism for matching an insert with the anatomy of an implant site, a first implant component, and/or second implant component.
• While theinsert base surface174 has been described as having a radius of curvature that extends from insertproximal end160 toward the insertdistal end162 to insertshoulder172 and insert articulatingsurface176 has been described as having a radius of curvature that extends from insertproximal end160 to insertdistal end162, an insert body can define a radius of curvature along any suitable length of the surface of an insert. Skilled artisans will be able to select a suitable length to define a radius of curvature on the surface of an insert according to a particular embodiment based on various considerations, including the structural configuration of an implant component. Example lengths considered suitable to define a radius of curvature on the surface of an insert include, but are not limited to, from the insert proximal end to the insert distal end, from a location distal to the insert proximal end to the insert distal end, between the insert proximal end and the insert distal end, and from the insert proximal end to a location proximal to the insert distal end.
• Implant system100 can be utilized in any suitable manner and in any suitable location in a body. For example,implant system100 can be utilized in subtalar joint arthroplasty, such as to modify the posterior facet of the subtalar joint, as illustrated inFIG. 3.Implant system100 can be implanted using any suitable method and/or approach. When modifying the posterior facet of the subtalar joint, it is considered advantageous to introduceimplant system100 using a lateral and posterior approach at least because this approach provides access to the joint and has limited, or reduced, exposure to vital structures as compared to a medial approach.
• Alternative tofirst implant component102 being adapted to be attached to thetalus12 andsecond implant component104 being adapted to be attached to thecalcaneus14, a first implant component and/or second implant component of an implant system, such as those described herein, can be attached to a talus, navicular, and/or cuboid. Skilled artisans will be able to select a suitable implant component to attach to a talus, navicular, and/or cuboid according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example joints considered suitable to utilize an implant system and/or implant method described herein include, but are not limited to, the subtalar joint, the talonavicular joint, and the calcaneocuboid joint.
• Alternative to including aninsert106, an implant system can omit the inclusion of an insert and a first implant component can articulate with a second implant component. For example, when a first implant component and a second implant component are each formed of a metal or ceramic, the first implant component can articulate with the second implant component. This can be accomplished by omitting the structure on the first implant component and/or second implant component that is configured to receive a portion, or the entirety, of an insert (e.g., recess139).
• FIGS. 7,8,9, and10 illustrate a second exemplarysurgical implant system200.Implant system200 is similar toimplant system100 illustrated inFIGS. 3,4,5, and6, and described above, except as detailed below. Reference numbers inFIGS. 7,8,9, and10 refer to the same structural element or feature referenced by the same number inFIGS. 3,4,5, and6, offset by 100. Thus,implant system200 comprises afirst implant component202, asecond implant component204, and aninsert206.
• In the illustrated embodiment,first implant component202 includes a plurality offirst implant projections214, afirst implant tab277, and a plurality offasteners278. Each projection of the plurality offirst implant projections214 extends outward and away from thefirst implant surface216 from a first implant projectionfirst end224 to a first implant projectionsecond end226. Alternative to elongateprojections114 as illustrated inFIGS. 3,4,5, and6, each projection of the plurality ofprojections214 and has a circular, or substantially circular, cross section along its length from the first implant projectionfirst end224 to the first implant projectionsecond end226 and extends from thefirst implant surface216 at an angle. In addition, each projection of the plurality offirst implant projections214 defines a first implant projectionsecond end226 that is pointed.
• First implant tab277 comprises a firstimplant tab wall279 that defines a plurality of first implant bores280.First implant tab277 extends outward and away fromfirst implant surface216 at an angle and along a portion of first implantproximal end208. Each bore of the plurality of first implant bores280 extends through the firstimplant tab wall279 from the first implantproximal end208 toward the first implantdistal end210 at an acute angle tofirst implant surface216 and is adapted to receive a portion of a fastener of the plurality offasteners278. Optionally, each bore of the plurality of first implant bores280, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface offirst implant tab277.
• Each fastener of the plurality offasteners278 has a fastenerfirst end281 that is adapted to receive a tool used to install the fastener at an implant site and a fastenersecond end282 that is threaded and adapted to be received by a pre-drilled bore at the implant site. Each fastener of the plurality offasteners278 is adapted to attach, or assist with attaching, an implant component at an implant site. Thus, a first fastener is disposed through a first bore defined by firstimplant tab wall279 and a second fastener is disposed through a second bore defined by firstimplant tab wall279. A fastener can be disposed through each bore defined by a first implant tab wall.
• Whilefirst implant tab277 has been illustrated and described as extending outward and away fromfirst implant surface216 and along a portion of first implantproximal end208, the tab of an implant component can extend from any suitable portion of an implant component and along any suitable length of an implant component. Skilled artisans will be able to select a suitable location to position a tab and a suitable length for a tab according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant component. Example locations considered suitable to position a tab include, but are not limited to, along the first implant proximal end of a first implant component, and on the first implant surface of a first implant component. Example lengths considered suitable for a tab include, but are not limited to, a length equal to, or substantially equal to, the length of the first implant proximal end of a first implant component, a length that is less than the length of the first implant proximal end of a first implant component, and a length that is greater than the length of the first implant proximal end of a first implant component.
• While each bore of the plurality of first implant bores280 has been illustrated and described as extending through the firstimplant tab wall279 from the first implantproximal end208 toward the first implantdistal end210 at an acute angle tofirst implant surface216, a bore of a first implant component can extend at any suitable angle to the first implant surface of a first implant component. Skilled artisans will be able to select a suitable angle to define a bore according to a particular embodiment based on various considerations, including the structural arrangement of an implant site. Example angles considered suitable to define a bore on the tab of a first implant component include, but are not limited to, at an angle that is acute to the first implant surface of a first implant component, at an angle that is obtuse to the first implant surface of a first implant component, and defining a bore such that it extends parallel, or substantially parallel, to the first implant surface of the a implant component.
• While a plurality of first implant bores280 has been illustrated and described, the wall of a tab can define any suitable number of bores having any suitable diameter, and skilled artisans will be able to select a suitable number of bores for inclusion in a tab and a suitable diameter for each bore according to a particular embodiment based on various considerations, including the structural configuration at an implant site. Example number of bores considered suitable include, but are not limited to, one, at least one, two, three, four, a plurality, and any other number considered suitable for a particular application. An example diameter considered suitable for a bore includes, but is not limited to, a diameter that is capable of receiving a fastener.
• In the illustrated embodiment,second implant component204 includes a plurality ofsecond implant projections236, asecond implant tab283, and a plurality offasteners278. Each projection of the plurality ofsecond implant projections236 extends outward and away from thesecond implant surface238 from a second implant projectionfirst end254 to a second implant projectionsecond end256. Alternative to elongateprojections136 as illustrated inFIGS. 3,4,5, and6, each projection of the plurality ofsecond implant projections236 has a circular, or substantially circular, cross section along its length from the second implant projectionfirst end254 to the second implant projectionsecond end256 and extends from thesecond implant surface238 at an angle. In addition, each projection of the plurality ofsecond implant projections236 defines a second implant projectionsecond end256 that is pointed.
• Second implant tab283 comprises a secondimplant tab wall284 that defines a plurality of second implant bores285.Second implant tab283 extends outward and away from thesecond implant surface238 away from second implantdistal end232 at an obtuse, or substantially obtuse, angle and along a portion of second implantproximal end230. Each bore of the plurality of second implant bores285 extends through the secondimplant tab wall284 from the second implantproximal end230 toward the second implantdistal end232 at an acute angle tosecond implant surface238 and is adapted to receive a portion of a fastener of the plurality offasteners278. Optionally, each bore of the plurality of second implant bores285, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface ofsecond implant tab283. A first fastener is disposed through a first bore defined by secondimplant tab wall284 and a second fastener is disposed through a second bore defined by secondimplant tab wall284. A fastener can be disposed through each bore defined by a second implant tab wall.
• In the illustrated embodiment, each bore of the plurality of first implant bores280 and each bore of the plurality of second implant bores285 has a bore axis that extends through its center. Each bore axis of the plurality of first implant bores280 is disposed on a first plane and each bore axis of the plurality of second implant bores285 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each bore axis of a plurality of first implant bores can extend parallel, or substantially parallel, to a second plane that contains each bore axis of a plurality of second implant bores.
• Whilesecond implant tab283 has been illustrated and described as extending outward and away fromsecond implant surface238 and along a portion of second implantproximal end230, the tab of an implant component can extend from any suitable portion of an implant component and along any suitable length of an implant component. Skilled artisans will be able to select a suitable location to position a tab and a suitable length for a tab according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. Example locations considered suitable to position a tab include, but are not limited to, along the second implant proximal end of a second implant component, and on the second implant surface of a second implant component. Example lengths considered suitable for a tab include, but are not limited to, a length equal to, or substantially equal to, the length of the second implant proximal end of a second implant component, a length that is less than the length of the second implant proximal end of a second implant component, and a length that is greater than the length of the second implant proximal end of a second implant component.
• While each bore of the plurality of second implant bores285 has been illustrated and described as extending through the secondimplant tab wall284 from the second implantproximal end230 toward the second implantdistal end232 at an acute angle tosecond implant surface238, a bore of a second implant component can extend at any suitable angle to an implant surface of the second implant component. Skilled artisans will be able to select a suitable angle to define a bore according to a particular embodiment based on various considerations, including the structural arrangement at an implant site. Example angles considered suitable to define a bore on a second implant component include, but are not limited to, at an angle that is acute to the second implant surface of a second implant component, at an angle that is obtuse to the second implant surface of a second implant component, and defining a bore such that it extends parallel, or substantially parallel, to the second implant surface of a second implant component.
• While a plurality of second implant bores285 have been illustrated and described, the wall of a tab can define any suitable number of bores having any suitable diameter, and skilled artisans will be able to select a suitable number of bores for inclusion in a tab and a suitable diameter for each bore according to a particular embodiment based on various considerations, including the structural configuration at an implant site. Example number of bores considered suitable include, but are not limited to, one, at least one, two, three, four, a plurality, and any other number considered suitable for a particular application. An example diameter considered suitable for a bore includes, but is not limited to, a diameter that is capable of receiving a fastener.
• While a plurality offasteners278 have been illustrated and described as providing a secondary method of attachment between thefirst implant component202 and the surface at an implant site and/or thesecond implant component204 and the surface at an implant site, any suitable number of fasteners and/or any suitable method of attachment can be used to attach an implant component at a desired treatment site. Skilled artisans will be able to select a suitable number of fasteners and/or a suitable method of attachment according to a particular embodiment based on various considerations, including the structural configuration at a desired implant site. Example number of fasteners considered suitable include, but are not limited to, one, at least one, two, three, four, five, six, a plurality, and any other number considered suitable for a particular application. The number of fasteners included can be based on the number of bores defined by a first implant component and/or a second implant component. Example methods of attachment considered suitable between a first implant component and/or a second implant component and the surface at a desired treatment site include, but are not limited to, using an adhesive, plugs, screws, compression screws, locking screws, multi-angle screw, cortical screw, cancellous screw, and any other method of attachment considered suitable for a particular application.
• Each projection of the plurality offirst implant projections214 and each projection of the plurality ofsecond implant projections236 can extend outward and away from an implant surface of an implant component at any suitable angle and have any suitable length. Skilled artisans will be able to select a suitable angle and length for a projection to extend outward and away from an implant surface of an implant component according to a particular embodiment based on various considerations, including the structural arrangement at a desired implant site. Example angles considered suitable for a projection to extend outward and away from an implant surface of an implant component include, but are not limited to, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an angle less than 45 degrees, an acute angle, an obtuse angle, an angle such that the projection is normal to the implant surface, an angle such that the projection is substantially normal to the implant surface, and any other angle considered suitable for a particular application. It is considered advantageous for a projection to extend outward and away from a first implant surface and/or second implant surface at least a length that will provide resistance to sliding after implantation and reduces interference during implantation of the component.
• Whilefirst implant tab277 has been illustrated and described as extending outward and away from thefirst implant surface216 at an angle andsecond implant tab283 has been illustrated and described as extending outward and away fromsecond implant surface238 at an obtuse, or substantially obtuse, angle, an implant tab can extend outward and away from an implant surface of an implant component at any suitable angle and have any suitable length. Skilled artisans will be able to select a suitable angle and length for an implant tab to extend from an implant surface of an implant component according to a particular embodiment based on various considerations, including the structural arrangement of a desired implant site. Example angles considered suitable for a tab to extend outward and away from an implant surface of an implant component include, but are not limited to, a 90 degree angle, a substantially 90 degree angle, an acute angle, an obtuse angle, an angle such that the tab is normal to the first implant surface, an angle such that the tab is substantially normal to the first implant surface, and any other angle considered suitable for a particular application. It is considered advantageous to for first implant tab and/or second implant tab to be dimensioned such that it is adapted to accept the fastener first end of a fastener, or a plurality of fasteners, and provide material around the fastener first end of each fastener at least to prevent fatigue and/or failure.
• Each bore of the plurality of first implant bores280 and/or each bore of the plurality of second implant bores285 can optionally be adapted to receive a multi-angle screw that can include a locking cap on fastenerfirst end281. Using a multi-angle screw is considered advantageous at least because it provides a mechanism directing the fastener to a desired location at the treatment site. For example, such that distal cortical fixation can be achieved.
• FIGS. 11,12,13, and14 illustrate a third exemplarysurgical implant system300.Implant system300 is similar toimplant system200 illustrated inFIGS. 7,8,9, and10, and described above, except as detailed below. Reference numbers inFIGS. 11,12,13, and14 refer to the same structural element or feature referenced by the same number inFIGS. 7,8,9, and10, offset by 100. Thus,implant system300 comprises afirst implant component302, asecond implant component304, and aninsert306.
• In the illustrated embodiment,second implant component304 omits the inclusion of a second implant tab, as illustrated and described with respect toFIGS. 7,8,9, and10, and includes a plurality of second implant projections336 andsecond implant body334 defines a plurality of second implant protuberances386.
• Each projection of the plurality of second implant projections336 extends outward and away from the second implant surface338 from a second implant projection first end354 toward the second implantdistal end332 to a second implant projection second end356 at an acute angle with respect to implant surface338. This configuration advantageously allows for placement and implantation ofsecond implant component304 at a distance from an implant surface that is less than that required when a second implant component includes projections that extend at a 90 degree, or substantially 90 degree, angle and have the same length as the plurality of second implant projections336 (e.g., second implant component204). Thus, it is considered advantageous to include a plurality of second implant projections336 that extend at an angle with respect to second implant surface338 at least to allowsecond implant component304 to be implanted at an angle and to reduce the distance required between thesecond implant component304 and an implant surface whilesecond implant component304 is being introduced.
• Second implant body334 defines the plurality of second implant protuberances386 between the second implantproximal end330 and the second implantdistal end332. Each protuberance of the plurality of second implant protuberances386 extends outward and away from the second implant surface338 toward the second implantdistal end332 from a protuberance first end387 to a protuberance second end388. Each protuberance of the plurality of second implant protuberances386 extends at an acute, or substantially acute, angle with respect to second implant surface338. Thesecond implant body334 defines apassageway389 through each protuberance of the plurality of second implant protuberances386 that extends from a first opening defined onrecess base342 to second opening defined on protuberance second end388. Eachpassageway389 provides access for passing a portion of a fastener of the plurality offasteners378 through a protuberance of the plurality of second implant protuberances386 to attach, or assist with attaching,second implant component304 at an implant site. Optionally, eachpassageway389 defined bysecond implant body334, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface ofrecess base342. Thus, a first fastener is disposed through a first passageway defined bysecond implant body334 and a second fastener is disposed through a second passageway defined bysecond implant body334. A fastener can be disposed through each passageway defined by a second implant body.
• In the illustrated embodiment, each bore of the plurality of first implant bores380 has a bore axis that extends through its center and eachpassageway389 defined bysecond implant body334 has a passageway axis that extends through its center. Each bore axis of the plurality of first implant bores380 is disposed on a first plane and each passageway axis of eachpassageway389 defined bysecond implant body334 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each bore axis of a plurality of first implant bores can extend parallel, or substantially parallel, to a second plane that contains each passageway axis of each passageway defined by a second implant body.
• While a plurality of second implant protuberances386 have been illustrated and described, the body of an implant component can define any suitable number of protuberances, and skilled artisans will be able to select a suitable number of protuberances for inclusion in an implant component according to a particular embodiment based on various considerations, including the structural configuration at an implant site. Example number of protuberances considered suitable include to include in an implant component include, but are not limited to, one, at least one, two, three, four, a plurality, and any other number considered suitable for a particular application.
• While each protuberance of the plurality of second implant protuberances386 has been illustrated and described as extending at an acute angle with respect to second implant surface338, a protuberance of an implant component can extend at any suitable angle to the implant surface of the implant component. Skilled artisans will be able to select a suitable angle to define a protuberance according to a particular embodiment based on various considerations, including the structural arrangement at an implant site. Example angles considered suitable to define a protuberance on an implant component include, but are not limited to, an angle that is acute to the implant surface of an implant component, an angle that is obtuse to the implant surface of an implant component, and defining a protuberance such that it extends at a 90 degree, or substantially 90 degree, angle to the implant surface of an implant component.
• FIGS. 15,16,17, and18 illustrate a fourth exemplarysurgical implant system400. Theimplant system400 is similar toimplant system300 illustrated inFIGS. 11,12,13, and14, and described above, except as detailed below. Reference numbers inFIGS. 15,16,17, and18 refer to the same structural element or feature referenced by the same number inFIGS. 11,12,13, and14, offset by 100. Thus,implant system400 comprises afirst implant component402, asecond implant component404, and aninsert406.
• In the illustrated embodiment, thefirst implant component402 omits the inclusion of a first implant tab, as illustrated and described with respect toFIGS. 11,12,13, and14, and includes a plurality offirst implant projections414 and a porousfirst implant surface416. It is considered advantageous forfirst implant component402 to have a porous, or substantially porous,first implant surface416 at least because this type of surface increases the amount of bone ingrowth betweenfirst implant component402 and the bone at an implant site. The structural configuration of first implant component402 (e.g., omitting the inclusion of a first implant tab) is considered advantageous at least because it reduces the overall size offirst implant component402 and reduces the complexity of implantingfirst implant component402 at a treatment site.
• FIGS. 19,20,21, and22 illustrate a fifth exemplarysurgical implant system500. Theimplant system500 is similar toimplant system400 illustrated inFIGS. 15,16,17, and18, and described above, except as detailed below. Reference numbers inFIGS. 19,20,21, and22 refer to the same structural element or feature referenced by the same number inFIGS. 15,16,17, and18, offset by 100. Thus,implant system500 comprises afirst implant component502, asecond implant component504, and aninsert506.
• In the illustrated embodiment,first implant component502 omits the inclusion of the plurality of first implant projections and alternative to having a first implant surface that is convex, or substantially convex,first implant body512 defines a flat, or substantially flat,first implant surface516 and an opposably facing concave, or substantially concave, first articulatingsurface518. In addition,first implant body512 defines a plurality of first implant bores590. Each bore of the plurality of first implant bores590 extends from a first opening defined on first implantproximal end508 to a second opening defined onfirst implant surface516. Each bore of the plurality of first implant bores590 provides access for a fastener of the plurality offasteners578, such that attachment betweenfirst implant component502 at an implant site can be accomplished. Optionally, each bore of the plurality of first implant bores590, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface offirst implant502. Thus, a first fastener is disposed through a first bore defined byfirst implant body512 and a second fastener is disposed through a second bore defined byfirst implant body512. A fastener can be disposed through each bore defined by a first implant body.
• In the illustrated embodiment, and alternative to having a second implant surface that is concave, or substantially concave, and a recess base that is convex, or substantially convex,second implant body534 defines a flat, or substantially flat,second implant surface538, arecess539 that has a flat, or substantially flat,recess base542, and a plurality ofrecess protuberances591. In addition, alternative to second implant body defining a plurality of recess projections,second implant body534 defines aridge592 that extends intorecess539. Thus,second implant component504 comprises a second implantproximal end530, second implantdistal end532, and asecond implant body534.Second implant body534 definesrecess539 that extends intosecond implant body534 from the second implantproximal end530 toward the second implantdistal end532 and aridge592 that extends intorecess539.
• Each protuberance of the plurality ofrecess protuberances591 is disposed along therecess length541 of recessfirst portion544 between the second implantproximal end530 an recessdistal end543 and extends into recessfirst portion544. Each protuberance of the plurality ofprotuberances591 tapers from the distal end of the protuberance to the proximal end of the protuberance. A first protuberance of the plurality ofprotuberances591 is disposed on afirst recess side593 and a second protuberance of the plurality ofprotuberances591 is disposed on asecond recess side594. Thefirst recess side593 is opposite, or substantially opposite, thesecond recess side594 acrossrecess539. Each of thefirst recess side593 andsecond recess side594 extends from the second implantproximal end530 to the recessdistal end543.
• Recessfirst portion544 extends fromrecess base542 toridge592 and has a recessfirst portion width545 along the second implantproximal end530. Recesssecond portion546 has a recesssecond portion width547 along the second implantproximal end530 that is different than recessfirst portion width545. In the illustrated embodiment, recesssecond portion width547 is less than recessfirst portion width545 an amount that is equal to, or substantially equal to, thedistance ridge592 extends intorecess539 onfirst recess side593 andsecond recess side594.
• Ridge592 extends intorecess539 about the entirety, or a portion of, the perimeter ofrecess539. Thus,ridge592 extends intorecess539 along thefirst recess side593,second recess side594, and recessdistal end543. The structural arrangement ofsecond implant body534 andrecess539 is considered advantageous at least because it provides a mechanism for releasably attaching an insert, such asinsert506, tosecond implant component504.
• In the illustrated embodiment, each bore of the plurality of first implant bores590 has a bore axis that extends through its center and eachpassageway589 defined bysecond implant body534 has a passageway axis that extends through its center. Each bore axis of the plurality of first implant bores590 is disposed on a first plane and each passageway axis of eachpassageway589 defined bysecond implant body534 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each bore axis of a plurality of first implant bores can extend parallel, or substantially parallel, to a second plane that contains each passageway axis of each passageway defined by a second implant body.
• While each protuberance of the plurality ofprotuberances591 has been described and illustrated as having a tapered configuration and as being positioned in the recessfirst portion544, a protuberance can have any suitable structural configuration and be positioned at any suitable location on an implant component. Skilled artisans will be able to select a suitable structural configuration for a protuberance and a suitable location to position a protuberance on an implant component according to a particular embodiment based on various considerations, including the material forming an insert and/or implant component. Example locations considered suitable to position a protuberance on an implant component include, but are not limited to, along a portion, or the entirety, of the recess first portion of an implant component, along a portion, or the entirety, of the recess second portion of an implant component, and along a portion, or the entirety, of the recess base of an implant component.
• In the illustrated embodiment, and alternative to having an insert base surface that is concave, or substantially concave,insert body564 defines aninsert base surface574 that is flat, or substantially flat, and that is complementary to recessbase542. In addition,insert body564 defines a plurality of first insert recesses595 andsecond insert recess596. A first recess of the plurality of first insert recesses595 extends intoinsert base566 on an insertfirst side597 and a second recess of the plurality of insert recesses595 extends intoinsert base566 on an insertsecond side598. Each recess of the plurality of insert recesses595 is disposed between the insertproximal end560 and insertdistal end562 and tapers from the distal end of the recess to the proximal end of the recess. Each recess of the plurality of insert recesses595 is complementary to a protuberance of the plurality ofrecess protuberances591. This configuration is considered advantageous at least because it provides a mechanism for releasably attachinginsert506 tosecond implant component504.
• In addition to definingshoulder570, insertbody564 definessecond insert recess596 betweeninsert base566 and insert articulatingsurface576.Second insert recess596 extends along the entirety, or a portion of, insertdistal end562 and complementsridge592 along the recessdistal end543.Second insert recess596 extends into insert body564 a distance that is equal to, or substantially equal to, less than, or greater than, the distance thatridge592 extends intorecess539. Thus,second insert recess596 is adapted to interact withridge592 ofrecess539.
• In use, as shown inFIG. 19, as distally directed axial movement is placed oninsert506, shown asarrow599,insert base566 is inserted into recessfirst portion544. As distally directed axial movement continues to be placed oninsert506, a first protuberance of the plurality ofprotuberances591 will engage with a first recess of the plurality of first insert recesses595 to attachinsert506 tosecond implant component504.
• FIGS. 23,24, and25 illustrate a sixth exemplarysurgical implant system600. Theimplant system600 is similar toimplant system500 illustrated inFIGS. 19,20,21, and22, and described above, except as detailed below. Reference numbers inFIGS. 23,24, and25 refer to the same structural element or feature referenced by the same number inFIGS. 19,20,21, and22, offset by 100. Thus,implant system600 comprises afirst implant component602, asecond implant component604, and aninsert606.
• Alternative to introducing an implant system using a lateral and posterior approach, as described above, the illustrated embodiment provides animplant system600 that can be introduced into a body using a medial and posterior approach.
• In the illustrated embodiment, alternative to first implant body defining a first articulating surface that extends from the first implant proximal end to the first implant distal end,first implant body612 defines a first articulatingsurface618 that extends from a first implantfirst side700 to a first implantsecond side702. Each of the first implantfirst side700 and first implantsecond side702 extends from first implantproximal end608 to first implantdistal end610.
• In the illustrated embodiment, alternative to first implant body defining a plurality of bores that extend through the first implant proximal end and through the first implant surface,first implant body612 defines a plurality offirst implant protuberances704. Each protuberance of the plurality offirst implant protuberances704 extends outward and away from thefirst implant surface616 from a protuberancefirst end706 toward first implantdistal end610 to a protuberancesecond end708 at an acute, or substantially acute, angle with respect tofirst implant surface616. Thefirst implant body612 defines apassageway710 through each protuberance of the plurality offirst implant protuberances704 and that extends from a first opening defined on the first implantproximal end608 to a second opening defined on the protuberancesecond end708. Eachpassageway710 provides access for passing a fastener of the plurality offasteners678 through a protuberance of the plurality ofprotuberances704 to attach, or assist with attaching,first implant component602 at an implant site. Optionally, eachpassageway710 defined byfirst implant body612, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface offirst implant602. Thus, a first fastener is disposed through a first passageway defined byfirst implant body612 and a second fastener is disposed through a second passageway defined byfirst implant body612. A fastener can be disposed through each passageway defined by a first implant body.
• In the illustrated embodiment,second implant component604 comprises a second implantproximal end630, second implantdistal end632, and asecond implant body634.Second implant body634 definesrecess639 that extends intosecond implant body634 from the second implantproximal end630 toward the second implantdistal end632 and aridge692 that extends intorecess639.
• In the illustrated embodiment, eachpassageway710 defined byfirst implant body612 has a passageway axis that extends through its center and eachpassageway689 defined bysecond implant body634 has a passageway axis that extends through its center. Each passageway axis of eachpassageway710 defined byfirst implant body612 is disposed on a first plane and each passageway axis of eachpassageway689 defined bysecond implant body634 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each passageway axis of each passageway defined by a first implant component can extend parallel, or substantially parallel, to a second plane that contains each passageway axis of each passageway defined by a second implant component.
• In the illustrated embodiment, insert606 comprises an insert proximal end660, insertdistal end662, and aninsert body664. Alternative to insert body defining an insert articulating surface that has radius of curvature that extends from the insert proximal end to the insert distal end (e.g.,FIG. 19,FIG. 20), insertbody664 defines aninsert articulating surface676 that has a radius of curvature that extends from insertfirst side697 to insertsecond side698.
• In addition,insert body664 definessecond insert recess696 betweeninsert base666 and insert articulatingsurface676.Second insert recess696 extends along insertfirst side697, insertsecond side698, and insertdistal end662.Second insert recess696 extends into insert body664 a distance that is equal to, or substantially equal to, less than, or greater than, the distance thatridge692 extends intorecess639.Insert base width667 is equal to, substantially equal to, less than, or greater than, recessfirst portion width645. Insert articulatingwidth669 is greater thaninsert base width667.
• Whileinsert articulating width669 has been described and illustrated as being greater thaninsert base width667, the insert articulating portion of an insert can have any suitable width. Skilled artisans will be able to select a suitable width for the articulating portion of an insert according to a particular embodiment based on various considerations, including the structural arrangement at an implant site. Example widths considered suitable include, but are not limited to, an articulating portion that has a width greater than the width of a base portion of an insert, an articulating portion that has a width less than the width of a base portion of an insert, and an articulating portion that has a width equal to, or substantially equal to, than the width of a base portion of an insert.
• FIGS. 26,27,28, and29 illustrate a seventh exemplarysurgical implant system800. Theimplant system800 is similar toimplant system500 illustrated inFIGS. 19,20,21, and22, and described above, except as detailed below. Reference numbers inFIGS. 26,27,28, and29 refer to the same structural element or feature referenced by the same number inFIGS. 19,20,21, and22, offset by 300. Thus,implant system800 comprises afirst implant component802, asecond implant component804, and aninsert806.
• In the illustrated embodiment, alternative to second implant component being adapted to be attached to the calcaneus, as described above,second implant component804 is adapted to be attached to thetalus12. Alternative to including a plurality of second implant protuberances and a plurality of second implant projections that extend from second implant surface,second implant body834 defines a plurality ofbores912 that extend through the second implantproximal end830 and through thesecond implant surface838. Alternative to second implant body defining a recess base that is flat, or substantially flat,second implant body834 defines arecess839 having arecess base842 that is concave, or substantially concave. Optionally, each bore of the plurality of second implant bores912, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface ofsecond implant804. Thus, a first fastener is disposed through a first bore defined bysecond implant body834 and a second fastener is disposed through a second bore defined bysecond implant body834. A fastener can be disposed through each bore defined by a second implant body.
• In the illustrated embodiment, alternative to first implant component being adapted to be attached to the talus, as described above,first implant component802 is adapted to be attached to thecalcaneus14. Alternative to first implant body defining a first articulating surface that is concave, or substantially concave,first implant body812 defines a first articulatingsurface818 that is convex, or substantially convex.
• In the illustrated embodiment, each bore of the plurality of first implant bores890 and each bore of the plurality of second implant bores912 has a bore axis that extends through its center. Each bore axis of the plurality of first implant bores890 is disposed on a first plane and each bore axis of the plurality of second implant bores912 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each bore axis of a plurality of first implant bores can extend parallel, or substantially parallel, to a second plane that contains each bore axis of a plurality of second implant bores.
• In the illustrated embodiment, alternative to insert body defining an insert base surface having a flat, or substantially flat, surface, insertbody864 defines aninsert base surface874 that is convex, or substantially convex, such that it complimentsrecess base842. In addition, alternative to insert body defining an insert articulating surface that is convex, or substantially convex,insert body864 defines aninsert articulating surface876 that is concave, or substantially concave, such that it compliments first articulatingsurface818. Insert articulatingsurface876 is adapted to articulate with first articulatingsurface818.
• In addition, alternative to insert body defining an insert second recess that extends along the entirety, or a portion of, the insert distal end (e.g., second insert recess596), insertbody864 defines a plurality of second insert recesses896. Each recess of the plurality of second insert recesses896 is disposed between theinsert base surface874 and insert articulatingsurface876 and extends from the insertproximal end860 toward the insertdistal end862 to insertshoulder870. Each recess of the plurality of second insert recesses896 extends into insert body864 a distance that is equal to, or substantially equal to, less than, or greater than, the distance thatridge892 extends intorecess839. Thus, each recess of the plurality of insert second recesses896 is adapted to interact withridge892 ofrecess839. In the illustrated embodiment,ridge892 and each recess of the plurality ofrecesses896 has a tapered configuration.
• FIGS. 30,31,32, and33 illustrate an eighth exemplarysurgical implant system1000. Theimplant system1000 is similar toimplant system500 illustrated inFIGS. 19,20,21, and22, and described above, except as detailed below. Reference numbers inFIGS. 30,31,32, and33 refer to the same structural element or feature referenced by the same number inFIGS. 19,20,21, and22, offset by 500. Thus,implant system1000 comprises afirst implant component1002, asecond implant component1004, and aninsert1006.
• In the illustrated embodiment,second implant body1034 defines arecess1039 that omits the inclusion of a recess second portion (e.g., recess second portion546), a plurality of recess protuberances (e.g., plurality of recess protuberances591), and ridge (e.g., ridge592). Thus,recess1039 extends from second implantproximal end1030 to second implantdistal end1032 and fromrecess base1042 away fromsecond implant surface1038.Recess1039 has arecess length1041 and arecess width1045.Recess length1041 extends from the second implantproximal end1030 to the second implantdistal end1032 andrecess width1045 extends along the second implantproximal end1030. Thus,second implant body1034 defines arecess1039 that extends the length ofsecond implant component1004 and that omits the inclusion of a ridge (e.g., ridge592).
• In the illustrated embodiment,insert1006 comprises an insertproximal end1060, insertdistal end1062, and aninsert body1064.Insert body1064 defines aninsert base surface1074 and aninsert articulating surface1076.Insert base surface1074 is flat, or substantially flat, and insert articulatingsurface1076 has a radius of curvature that extends from the insertproximal end1060 to the insertdistal end1062 and that is convex, or substantially convex.
• Insert1006 has aninsert length1063 that extends from the insertproximal end1060 to the insertdistal end1062 and aninsert width1069 that extends along the insertproximal end1060.Insert length1063 is equal to, or substantially equal to, greater than, or less than,recess length1041 andrecess width1069 is equal to, substantially equal to, less than, or greater than,recess width1045.
• FIGS. 34,35,36, and37 illustrate a ninth exemplarysurgical implant system1100. Theimplant system1100 is similar toimplant system600 illustrated inFIGS. 23,24, and25, and described above, except as detailed below. Reference numbers inFIGS. 34,35,36, and37 refer to the same structural element or feature referenced by the same number inFIGS. 23,24, and25, offset by 500. Thus,implant system1100 comprises afirst implant component1102, asecond implant component1104, and aninsert1106.
• In the illustrated embodiment,second implant body1134 defines arecess1139 that omits the inclusion of a recess second portion (e.g., recess second portion646), a plurality of recess protuberances (e.g., plurality of recess protuberances691), and ridge (e.g., ridge692). Thus,recess1139 extends from the second implantproximal end1130 to the second implantdistal end1132 and fromrecess base1142 away fromsecond implant surface1138.Recess1139 has arecess length1141 and arecess width1145.Recess length1141 extends from the second implantproximal end1130 to the second implantdistal end1132 andrecess width1145 extends along second implantproximal end1130. Thus,second implant body1134 defines arecess1139 that extends the length ofsecond implant component1104 and that omits the inclusion of a ridge (e.g., ridge692).
• In the illustrated embodiment,insert1106 omits the inclusion of a plurality of first insert recesses (e.g., plurality of first insert recesses695) and second insert recess (e.g., second insert recess696). Thus,insert1006 comprises an insertproximal end1160, insertdistal end1162, and aninsert body1164.Insert body1164 defines aninsert base1166 and aninsert articulating portion1168.Insert base1166 has aninsert base surface1174 and theinsert articulating portion1168 has aninsert articulating surface1176.Insert base surface1174 extends from insertproximal end1160 insertdistal end1162 and insert articulatingsurface176 has a radius of curvature that extends from insertfirst side1197 to insertsecond side1198.
• Insert base1166 has aninsert base width1167 along the insertproximal end1160 and theinsert articulating portion1168 has aninsert articulating width1169 along the insertproximal end1160.Insert base width1167 is equal to, substantially equal to, less than, or greater than,recess width1145. Insert articulatingwidth1169 is greater thaninsert base width1167.
• FIGS. 38,39,40, and41 illustrate a tenth exemplarysurgical implant system1200. Theimplant system1200 is similar toimplant system100 illustrated inFIGS. 3,4,5, and6, and described above, except as detailed below. Reference numbers inFIGS. 38,39,40, and41 refer to the same structural element or feature referenced by the same number inFIGS. 3,4,5, and6, offset by 1100. Thus,implant system1200 comprises afirst implant component1202, asecond implant component1204, and aninsert1206.
• In the illustrated embodiment, alternative to second implant component defining a recess and a plurality of recess projections,first implant body1212 defines a convex, or substantially convex,first implant surface1216,recess1239, and a plurality ofrecess projections1240.Recess1239 is adapted to receive a portion, or the entirety, ofinsert1206.Recess1239 has arecess length1241,recess base1242, recessfirst portion1244, and a recesssecond portion1246.Recess1239 extends intofirst implant body1212 to recess base1242 and from first implantproximal end1208 to first implantdistal end1210.Recess length1241 extends from first implantproximal end1208 to first implantdistal end1210.
• Each projection of the plurality ofrecess projections1240 extends intorecess1239 along a portion, or the entirety, ofrecess length1241 and has a tapered edge that is adapted to interact with a portion ofinsert1206 to releasably attachinsert1206 tofirst implant component1202.Recess base1242 is opposably facing, or substantially opposably facing,first implant surface1216, is concave, or substantially concave, and is smooth, substantially smooth, or uninterrupted.Recess base1242 has a radius of curvature that extends from first implantproximal end1208 to first implantdistal end1210. Recessfirst portion1244 extends fromrecess base1242 to the plurality ofrecess projections1240 and has a recessfirst portion width1245 along first implantproximal end1208. Recesssecond portion1246 has a recess second portion width1247 along first implantproximal end1208 that is measured from a first recess projection of the plurality ofrecess projections1240 to a second recess projection of the plurality ofrecess projections1240. The recessfirst portion width1245 is greater than the recess second portion width1247.
• In the illustrated embodiment,second implant body1234 defines a concave, or substantially concave,second implant surface1238 and an opposably facing, or substantially opposably facing, convex, or substantially convex, second articulatingsurface1243. Each of thesecond implant surface1238 and second articulatingsurface1243 has a radius of curvature that extends from second implantproximal end1230 to second implantdistal end1232.Second implant surface1238 is smooth, substantially smooth, or uninterrupted and second articulatingsurface1243 is smooth, substantially smooth, or uninterrupted, such that articulation between articulatingsurface1243 and insert1206 can be accomplished, as described in more detail herein.
• In the illustrated embodiment,insert1206 comprises an insertproximal end1260, insertdistal end1262, and aninsert body1264. Alternative to insert being attached to a second implant component,insert1206 is adapted to be attached tofirst implant component1202. In addition, alternative to insert body defining an insert recess and a recess shoulder, insertbody1264 defines aninsert base1266, insert articulatingportion1268, afirst insert recess1296, and asecond insert recess1296′.
• Insert base1266 has aninsert base surface1274 and theinsert articulating portion1268 has aninsert articulating surface1276. Each ofinsert base surface1274 and insert articulatingportion1268 has a radius of curvature that extends from insertproximal end1260 to insertdistal end1262.Insert base surface1274 is convex, or substantially convex, and is opposably facing, or substantially opposably facing, insert articulatingsurface1276, which is concave, or substantially concave.Insert base surface1274 is smooth, substantially smooth, or uninterrupted, and is complementary to recess base1242 such thatinsert1206 is slidable alongrecess base1242 and releasable attachment betweeninsert1206 andfirst implant component1202 can be accomplished. Insert articulatingsurface1276 is smooth, substantially smooth, or uninterrupted, and is complementary to second articulatingsurface1243 such thatinsert1206 can articulate withsecond implant component1204. Thus, insert articulatingsurface1276 is adapted to articulate with second articulatingsurface1243.
• Insert base1266 has aninsert base width1267 along insertproximal end1260 and insert articulatingportion1268 has an insert articulating width1269 along insertproximal end1260.Insert base width1267 is equal to, substantially equal to, less than, or greater than, recessfirst portion width1245. Insert articulating width1269 is greater than, recess second portion width1247.
• Each offirst insert recess1296 andsecond insert recess1296′ extends intorecess body1264 betweeninsert base1266 and insert articulatingsurface1276.First insert recess1296 extends along insertfirst side1297 andsecond insert recess1296′ extends along insertsecond side1298. Each of thefirst insert recess1296 andsecond insert recess1296′ extends into insert body1264 a distance that is equal to, or substantially equal to, less than, or greater than, the distance that a projection of the plurality of projections1270 extends intorecess1239. It is considered advantageous to include aninsert1206 having a insert articulating width1269 that is greater than the recess second portion width1247 and afirst insert recess1296 andsecond insert recess1296′ at least because this structural arrangement provides a mechanism for achieving a slideably engagement between afirst implant component1202 and an insert.
• FIGS. 42,43,44, and45 illustrate an eleventh exemplarysurgical implant system1300. Theimplant system1300 is similar toimplant system1200 illustrated inFIGS. 38,39,40, and41, and described above, except as detailed below. Reference numbers inFIGS. 42,43,44, and45 refer to the same structural element or feature referenced by the same number inFIGS. 38,39,40, and41, offset by 100. Thus,implant system1300 comprises afirst implant component1302, asecond implant component1304, and aninsert1306.
• In the illustrated embodiment,first implant component1302 includes a plurality offirst implant projections1314, afirst implant tab1377, and a plurality offasteners1378 andsecond implant component1304 includes a plurality ofsecond implant projections1336, asecond implant tab1383, and a plurality offasteners1378. The plurality offirst implant projections1314 is similar to the plurality offirst implant projections214 illustrated inFIGS. 7,8,9, and10.First implant tab1377 is similar tofirst implant tab277 illustrated inFIGS. 7,8,9, and10. The plurality offasteners1378 is similar to the plurality offasteners278 illustrated inFIGS. 7,8,9, and10. The plurality ofsecond implant projections1336 is similar to the plurality ofsecond implant projections236 illustrated inFIGS. 7,8,9, and10.Second implant tab1383 is similar tosecond implant tab283 illustrated inFIGS. 7,8,9, and10. Reference numbers relating to the plurality offirst implant projections1314,first implant tab1377, plurality offasteners1378, plurality ofsecond implant projections1336,second implant tab1383 inFIGS. 42,43,44, and45 refer to the same structural element or feature referenced by the same number inFIGS. 7,8,9, and10, offset by 1100.
• Thus,first implant tab1377 comprises a firstimplant tab wall1379 that defines a plurality of first implant bores1380, each fastener of the plurality offasteners1378 has a fastenerfirst end1381 and a fastenersecond end1382, and second implant tab comprises a secondimplant tab wall1384 that defines a plurality of second implant bores1385. Optionally, each bore of the plurality of first implant bores1380, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface offirst implant1302 and each bore of the plurality of second implant bores1385, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface ofsecond implant1304. Thus, a first fastener is disposed through a first bore defined by firstimplant tab wall1379 and a second fastener is disposed through a second bore defined by firstimplant tab wall1379 and a first fastener is disposed through a first bore defined by secondimplant tab wall1384 and a second fastener is disposed through a second bore defined by secondimplant tab wall1384. A fastener can be disposed through each bore defined by a first implant tab wall and/or second implant tab wall.
• In the illustrated embodiment, each bore of the plurality of first implant bores1380 and each bore of the plurality of second implant bores1385 has a bore axis that extends through its center. Each bore axis of the plurality of first implant bores1380 is disposed on a first plane and each bore axis of the plurality of second implant bores1385 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each bore axis of a plurality of first implant bores can extend parallel, or substantially parallel, to a second plane that contains each bore axis of a plurality of second implant bores.
• While particular combinations of implant components, inserts, and features thereof have been described and illustrated herein, an implant system can combine any suitable implant component, insert, and/or feature thereof in any suitable manner to form an implant system. Skilled artisans will be able to select a suitable implant component, insert, and/or feature thereof to form an implant system according to a particular embodiment based on various considerations, including the structural arrangement at an implant site.
• Various methods of treatment are described and illustrated. While the methods described herein are shown and described as a series of acts, it is to be understood and appreciated that the methods are not limited by the order of acts, as one or more acts may, in accordance with these methods, occur in different orders with one or more other acts described herein, or any other suitable act(s), concurrently with one or more other acts described herein, or any other suitable act(s), and/or in the alternative to one or more other acts described herein, or any other suitable act(s).
• FIG. 46 is a flowchart representation of anexemplary method1400 of modifying a joint.
• Aninitial step1402 comprises creating an opening in a body to provide access to a joint formed between a first bone and a second bone. Anotherstep1404 comprises locating the first bone of the joint. Anotherstep1406 comprises locating the second bone of the joint. Anotherstep1408 comprises removing a first portion of the first bone to configure the first bone to receive a first implant component. Anotherstep1410 comprises removing a first portion of the second bone to configure the second bone to receive a second implant component. Anotherstep1412 comprises installing the first implant component on the first bone. Anotherstep1414 comprises installing the second implant component on the second bone. Anotherstep1416 comprises installing an insert on one of the first implant component or second implant component. Anotherstep1418 comprises closing the opening.
• Thestep1402 of creating an opening can be accomplished using any suitable tool and/or method of creating an opening (e.g., in a body) and can be created at any suitable location on a body, and skilled artisans will be able to select a suitable tool and/or method to create an opening and a suitable location on a body to create an opening according to a particular embodiment based on various considerations, including the size and location of the opening. Example methods and/or tools considered suitable for creating an opening include, but are not limited to, scalpels, lasers, and any other tool and/or method considered suitable for a particular application. Example locations considered suitable to create an opening on a body include, but are not limited to, on the foot, on the ankle, lateral portion of the foot, posterior and lateral portion of the foot, medial portion of the foot, posterior and medial portion of the foot, and any other location considered suitable for a particular application.
• Whilestep1402 has been illustrated and described as being an initial step tomethodology1400, any other suitable step can be completed prior to the step of creating on opening to provide access to a joint, and skilled artisans will be able to select a suitable step to complete prior to creating an opening to provide access to a joint according to a particular embodiment based on various considerations, including the location of the joint intended to be treated. An example step that can be completed prior to the step of creating an opening includes, but is not limited to, preparing the location of a desired opening for an incision (e.g., cleaning the area).
• Thestep1404 of locating the first bone of the joint, and thestep1406 of locating the second bone of the joint, can each be accomplished using any suitable method of visualization, and skilled artisans will be able to select a suitable method of visualization to locate a first bone and/or a second bone according to a particular embodiment based on various considerations, including the location of the first bone and/or second bone. Example methods of visualization considered suitable include, but are not limited to, direct visualization, using a scope, and any other method of visualization considered suitable for a particular application.
• Thestep1408 of removing a first portion of the first bone to configure the first bone to receive a first implant component, and thestep1410 of removing a first portion of the second bone to configure the second bone to receive a second implant component, can each be accomplished using any suitable technique and/or tool for removing a portion of a bone (e.g., to prepare a bone to receive an implant component). Skilled artisans will be able to select a suitable technique and/or tool for removing a portion of a bone to configure the bone to receive an implant component according to a particular embodiment based on various considerations, including the size and location of the implant site.
• Example methods of removing a portion of a bone to configure the bone to receive an implant component include, but are not limited to, conventional techniques, drilling, sanding, cutting, and any other method considered suitable for a particular application. Example tools considered suitable for removing a portion of a bone to configure the bone to receive an implant component include, but are not limited to, conventional tools, drills, sanders, saws (e.g., bone saws), and any other tool considered suitable for a particular application.
• An optional step comprises testing the fit between the first implant component and the first bone. Another optional step comprises testing the fit between the second implant component and the second bone. Each of the steps of testing the fit between the first implant component and the first bone, and testing the fit between the second implant component and the second bone, can be accomplished by advancing the implant component toward the implant site, contacting the implant component on the bone, and determining if a desired fit between the bone and the implant component has been achieved. If a desired fit between the bone and the implant component has not been achieved, another optional step comprises removing a second portion of the first bone, and/or removing a second portion of the second bone, to configure the first bone and/or the second bone to receive an implant component. Alternative to, or in combination with, the step of removing a second portion of the first bone and/or removing a second portion of the second bone, a step comprising fitting another implant component different than the first implant component and/or second implant component between the first bone and/or second bone can be completed.
• Another optional step comprises preparing the surface of the bone (e.g., first bone, second bone) to receive an implant component. This step can be accomplished using any suitable method, material, and/or tool, and skilled artisans will be able to select a suitable method, material, and/or tool to prepare the surface of a bone to receive an implant component according to a particular embodiment based on various considerations, including the type of attachment desired between an implant component and the bone. Examples methods, materials, and/or tools considered suitable to prepare the surface of the bone to receive an implant component include, but are not limited to, using an abrasive, using an air-powered abrasive unit, etching the bone, cleaning the bone, and any other method, material, and/or tool considered suitable for a particular application.
• Thestep1412 of installing the first implant component on the first bone, and thestep1414 of installing the second implant component on the second bone, can each be accomplished using any suitable method of attachment and/or any suitable tool. Example methods of attachment and/or tools considered suitable include, but are not limited to, using a peg, tab, keel, fastener, screw, bolt, adhesive, cement, and any other method of attachment and/or tool considered suitable for a particular application.
• Thestep1416 of installing an insert on one of the first implant component or second implant component can be accomplished by advancing the insert toward the implant site, and/or by inserting the insert into one of the first implant component or second implant component. For example, this step can be accomplished by placing an insert in a recess defined by an implant component.
• An optional step comprises attaching the insert to one of the first implant component or second implant component. This step can be accomplished using any suitable method of attachment and/or any suitable tool. Example methods of attachment and/or tools considered suitable include, but are not limited to, using a fastener, screw, bolt, adhesive, cement, and any other method of attachment and/or tool considered suitable for a particular application.
• Thestep1418 of closing the opening can be accomplished using any suitable method of closing an opening, and/or by using any suitable device, and skilled artisans will be able to select a suitable method and/or device for closing an opening according to a particular embodiment based on various considerations, including the location and size of the opening. Example methods and/or devices considered suitable for closing an opening include, but are not limited to, using sutures, staples, strips, glues (e.g., liquid tissue glues), and any other method and/or device considered suitable for a particular application.
• Methodology1400 can accomplished on any suitable joint (e.g., in a body), and skilled artisans will be able to select a suitable joint to perform a method described herein according to a particular embodiment based on various considerations, including the desired treatment intended to be performed. Example joints considered suitable to perform a methodology described herein include, but are not limited to, the subtalar joint, talonavicular joint, calcaneocuboid joint, and any other joint considered suitable for a particular application.
• While various steps, alternative steps, and/or optional steps have been described above with respect to an exemplary method oftreatment1400, these steps, alternative steps, and/or optional steps can be included in, accomplished concurrently with, and/or accomplished in the alternative to, the methodologies, steps, alternative steps, and/or optional steps described herein with respect to exemplary method oftreatment1500, exemplary method oftreatment1600, and/or exemplary method oftreatment1700.
• FIG. 47 is a flowchart representation of anexemplary method1500 of modifying the subtalar joint.
• Aninitial step1502 comprises creating an opening to provide access to the subtalar joint formed between the talus and calcaneus. Anotherstep1504 comprises locating the talus. Anotherstep1506 comprises locating the calcaneus. Anotherstep1508 comprises removing a first portion of the talus to configure the talus to receive a first implant component. Anotherstep1510 comprises removing a first portion of the calcaneus to configure the calcaneus to receive a second implant component. Anotherstep1512 comprises installing the first implant component on the talus. Anotherstep1514 comprises installing the second implant component on the calcaneus. Anotherstep1516 comprises installing an insert on one of the first implant component or second implant component. Anotherstep1518 comprises closing the opening.
• Thestep1502 of creating an opening to provide access to the subtalar joint formed between the talus and calcaneus can be accomplished by creating an opening at any suitable location, and skilled artisans will be able to select a suitable location to create an opening according to a particular embodiment based on various considerations, including the size of the implant components intended to be used. Example locations considered suitable to create an opening include, but are not limited to, creating an opening such that a lateral approach of the subtalar joint can be accomplished, creating an opening such that a medial approach of the subtalar joint can be accomplished, creating an opening such that a posterior and lateral approach of the subtalar joint can be accomplished, creating an opening such that a posterior and medial approach of the subtalar joint can be accomplished, and any other location considered suitable for a particular application. For example, an opening can be created at, near, behind, and/or around the peroneal tendons (e.g., between the peroneal tendons and the Achilles tendon).
• An alternative step to thestep1512 of installing the first implant component on the talus comprises installing a second implant component on the talus. An alternative step to thestep1514 of installing the second implant component on the calcaneus comprises installing a first implant component on the calcaneus.
• While various steps, alternative steps, and/or optional steps have been described above with respect to an exemplary method oftreatment1500, these steps, alternative steps, and/or optional steps can be included in, accomplished concurrently with, and/or accomplished in the alternative to, the methodologies, steps, alternative steps, and/or optional steps described herein with respect to exemplary method oftreatment1400, exemplary method oftreatment1600, and/or exemplary method oftreatment1700.
• FIG. 48 is a flowchart representation of anexemplary method1600 of modifying the calcaneocuboid joint.
• Aninitial step1602 comprises creating an opening to provide access to the calcaneocuboid joint formed between the calcaneus and cuboid. Anotherstep1604 comprises locating the calcaneus. Anotherstep1606 comprises locating the cuboid. Anotherstep1608 comprises removing a first portion of the calcaneus to configure the calcaneus to receive a first implant component. Anotherstep1610 comprises removing a first portion of the cuboid to configure the cuboid to receive a second implant component. Anotherstep1612 comprises installing the first implant component on the calcaneus. Anotherstep1614 comprises installing the second implant component on the cuboid. Anotherstep1616 comprises installing an insert on one of the first implant component or second implant component. Anotherstep1618 comprises closing the opening.
• Thestep1602 of creating an opening to provide access to the calcaneocuboid joint formed between the calcaneus and cuboid can be accomplished by creating an opening at any suitable location, and skilled artisans will be able to select a suitable location to create an opening according to a particular embodiment based on various considerations, including the size of the implant components intended to be used. Example locations considered suitable to create an opening include, but are not limited to, creating an opening such that a lateral approach of the calcaneocuboid joint can be accomplished, creating an opening such that a medial approach of the calcaneocuboid joint can be accomplished, and any other location considered suitable for a particular application. For example, an opening can be created at, near, behind, and/or around the extensor brevis.
• An alternative step to thestep1612 of installing the first implant component on the calcaneus comprises installing a second implant component on the calcaneus. An alternative step to thestep1614 of installing the second implant component on the cuboid comprises installing a first implant component on the cuboid.
• While various steps, alternative steps, and/or optional steps have been described above with respect to an exemplary method oftreatment1600, these steps, alternative steps, and/or optional steps can be included in, accomplished concurrently with, and/or accomplished in the alternative to, the methodologies, steps, alternative steps, and/or optional steps described herein with respect to exemplary method oftreatment1400, exemplary method oftreatment1500, and/or exemplary method oftreatment1700.
• FIG. 49 is a flowchart representation of anexemplary method1700 of modifying the talonavicular joint.
• Aninitial step1702 comprises creating an opening to provide access to the talonavicular joint formed between the talus and navicular. Anotherstep1704 comprises locating the talus. Anotherstep1706 comprises locating the navicular. Anotherstep1708 comprises removing a first portion of the talus to configure the talus to receive a first implant component. Anotherstep1710 comprises removing a first portion of the navicular to configure the navicular to receive a second implant component. Anotherstep1712 comprises installing the first implant component on the talus. Anotherstep1714 comprises installing the second implant component on the navicular. Anotherstep1716 comprises installing an insert on one of the first implant component or second implant component. Anotherstep1718 comprises closing the opening.
• Thestep1702 of creating an opening to provide access to the talonavicular joint formed between the talus and navicular can be accomplished by creating an opening at any suitable location, and skilled artisans will be able to select a suitable location to create an opening according to a particular embodiment based on various considerations, including the size of the implant components intended to be used. Example locations considered suitable to create an opening include, but are not limited to, creating an opening such that a lateral approach of the talonavicular joint can be accomplished, creating an opening such that a medial approach of the talonavicular joint can be accomplished, and any other location considered suitable for a particular application.
• An alternative step to thestep1712 of installing the first implant component on the talus comprises installing a second implant component on the talus. An alternative step to thestep1714 of installing the second implant component on the navicular comprises installing a first implant component on the navicular.
• While various steps, alternative steps, and/or optional steps have been described above with respect to an exemplary method oftreatment1700, these steps, alternative steps, and/or optional steps can be included in, accomplished concurrently with, and/or accomplished in the alternative to, the methodologies, steps, alternative steps, and/or optional steps described herein with respect to exemplary method oftreatment1400, exemplary method oftreatment1500, and/or exemplary method oftreatment1600.
• FIGS. 50,51,52, and53 illustrate a twelfth exemplarysurgical implant system1800. Theimplant system1800 is similar toimplant system500 illustrated inFIGS. 19,20,21, and22, and described above, except as detailed below. Reference numbers inFIGS. 50,51,52, and53 refer to the same structural element or feature referenced by the same number inFIGS. 19,20,21, and22, offset by 1500. Thus,implant system1800 comprises afirst implant component1802, asecond implant component1804, and aninsert1806.
• In the illustrated embodiment, alternative to first implant body defining a plurality of bores that extend through the first implant proximal end and through the first implant surface,first implant body1812 defines a plurality offirst implant protuberances1904. Each protuberance of the plurality offirst implant protuberances1904 extends outward and away from thefirst implant surface1816 from a protuberancefirst end1906 toward first implantdistal end1810 to a protuberancesecond end1908 at an acute, or substantially acute, angle with respect tofirst implant surface1816. Thefirst implant body1812 defines apassageway1910 through each protuberance of the plurality offirst implant protuberances1904 and that extends from a first opening defined on the first implantproximal end1808 to a second opening defined on the protuberancesecond end1908. Eachpassageway1910 provides access for passing a fastener of the plurality offasteners1878 through a protuberance of the plurality ofprotuberances1904 to attach, or assist with attaching,first implant component1802 at an implant site. Optionally, eachpassageway1910 defined byfirst implant body1812, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface offirst implant1802. Thus, a first fastener is disposed through a first passageway defined byfirst implant body1812 and a second fastener is disposed through a second passageway defined byfirst implant body1812. A fastener can be disposed through each passageway defined by a first implant body.
• In the illustrated embodiment, eachpassageway1910 defined byfirst implant body1812 has a passageway axis that extends through its center and eachpassageway1889 defined bysecond implant body1834 has a passageway axis that extends through its center. Each passageway axis of eachpassageway1910 defined byfirst implant body1812 is disposed on a first plane and each passageway axis of eachpassageway1889 defined bysecond implant body1834 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each passageway axis of each passageway defined by a first implant component can extend parallel, or substantially parallel, to a second plane that contains each passageway axis of each passageway defined by a second implant component.
• While a plurality offirst implant protuberances1904 have been illustrated and described, the body of an implant component can define any suitable number of protuberances, and skilled artisans will be able to select a suitable number of protuberances for inclusion in an implant component according to a particular embodiment based on various considerations, including the structural configuration at an implant site. Example number of protuberances considered suitable include to include in an implant component include, but are not limited to, one, at least one, two, three, four, a plurality, and any other number considered suitable for a particular application.
• Whilesecond implant component1804 is shown as including a plurality of second implant projections1836, a second implant component can omit the inclusion of a plurality of second implant projections. Alternatively, in addition tosecond implant1804 including a plurality of second implant projections1836, a first implant can include a plurality of first implant projections.
• FIGS. 54,55,56, and57 illustrate a thirteenth exemplarysurgical implant system2000. Theimplant system2000 is similar toimplant system800 illustrated inFIGS. 26,27,28, and29, and described above, except as detailed below. Reference numbers inFIGS. 54,55,56, and57 refer to the same structural element or feature referenced by the same number inFIGS. 26,27,28, and29, offset by 1200. Thus,implant system2000 comprises afirst implant component2002, asecond implant component2004, and aninsert2006.
• In the illustrated embodiment, alternative to including a plurality of bores that extend through the second implant proximal end and through the second implant surface,second implant body2034 defines a plurality ofsecond implant protuberances2086. Each protuberance of the plurality ofsecond implant protuberances2086 extends outward and away from thesecond implant surface2038 from a protuberancefirst end2087 toward second implantdistal end2032 to a protuberancesecond end2088 at an acute, or substantially acute, angle with respect tosecond implant surface2038. Thesecond implant body2034 defines apassageway2089 through each protuberance of the plurality ofsecond implant protuberances2086 and that extends from a first opening defined on the second implantproximal end2030 to a second opening defined on the protuberancesecond end2088. Eachpassageway2089 provides access for passing a fastener of the plurality offasteners2078 through a protuberance of the plurality ofprotuberances2086 to attach, or assist with attaching,second implant component2004 at an implant site. Thus, a first fastener is disposed through a first passageway defined bysecond implant body2034 and a second fastener is disposed through a second passageway defined bysecond implant body2034. A fastener can be disposed through each passageway defined by a second implant body.
• In the illustrated embodiment, alternative to first implant body defining a plurality of bores that extend through the first implant proximal end and through the first implant surface,first implant body2012 defines a plurality offirst implant protuberances2104. Each protuberance of the plurality offirst implant protuberances2104 extends outward and away from thefirst implant surface2016 from a protuberancefirst end2106 toward first implantdistal end2010 to a protuberancesecond end2108 at an acute, or substantially acute, angle with respect tofirst implant surface2016. Thefirst implant body2012 defines apassageway2110 through each protuberance of the plurality offirst implant protuberances2104 and that extends from a first opening defined on the first implantproximal end2008 to a second opening defined on the protuberancesecond end2108. Eachpassageway2110 provides access for passing a fastener of the plurality offasteners2078 through a protuberance of the plurality ofprotuberances2104 to attach, or assist with attaching,first implant component2002 at an implant site. Optionally, eachpassageway2089 defined bysecond implant body2034, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface ofsecond implant2004 and eachpassageway2110 defined byfirst implant body2012, or a portion thereof, can be countersunk or counterbored to allow a fastener to sit flush with, or below, the outer surface offirst implant2002. Thus, a first fastener is disposed through a first passageway defined byfirst implant body2012 and a second fastener is disposed through a second passageway defined byfirst implant body2012. A fastener can be disposed through each passageway defined by a first implant body.
• In the illustrated embodiment, eachpassageway2110 defined byfirst implant body2012 has a passageway axis that extends through its center and eachpassageway2089 defined bysecond implant body2034 has a passageway axis that extends through its center. Each passageway axis of eachpassageway2110 defined byfirst implant body2012 is disposed on a first plane and each passageway axis of eachpassageway2089 defined bysecond implant body2034 is disposed on a second plane that intersects the first plane at an angle. The first plane and second plane can intersect at any suitable angle, and skilled artisans will be able to select a suitable angle for a first plane and a second plane to intersect according to a particular embodiment based on various considerations, including the structural arrangement at a treatment site. Example angles considered suitable for a first plane and a second plane to intersect include, but are not limited to, an angle between about 1 degree and 90 degrees, an angle between about 90 degrees and about 180 degrees, a 90 degree angle, a substantially 90 degree angle, a 45 degree angle, a substantially 45 degree angle, an acute angle, an obtuse angle, and any other angle considered suitable for a particular application. Alternatively, a first plane that contains each passageway axis of each passageway defined by a first implant component can extend parallel, or substantially parallel, to a second plane that contains each passageway axis of each passageway defined by a second implant component.
• The foregoing detailed description provides exemplary embodiments of the invention and includes the best mode for practicing the invention. The description and illustration of embodiments is intended only to provide examples of the invention, and not to limit the scope of the invention, or its protection, in any manner.

Claims (25)

1. A system for use in a joint arthroplasty, the system comprising:

a first implant component having a first implant proximal end, a first implant distal end, and a first implant body defining a porous first implant surface, a concave first articulating surface opposably facing the porous first implant surface, and a plurality of first implant projections extending outward and away from the first implant surface from a first implant projection first end to a first implant projection second end for each of said plurality of projections;

a second implant component having a second implant proximal end, a second implant distal end, and a second implant body defining a second implant surface, a recess extending into the second implant body from a side opposably facing the second implant surface to a recess base, at least one second implant protuberance extending outward and away from the second implant surface from a second implant protuberance first end to a second implant protuberance second end, and a passageway extending from a first opening defined on the recess base to a second opening defined on the second implant protuberance second end; and

an insert adapted to be releasably attached to the second implant component and having an insert articulating surface that is convex and adapted to articulate with the first articulating surface,

wherein said joint is selected from the group consisting of a subtalar joint, a calcaneocuboid joint, and a talonavicular joint and said porous first implant surface and said second implant surface are configured for implanting within said joint.

2. The system ofclaim 1, wherein the recess extends from the second implant proximal end toward the second implant distal end and has a recess first portion extending from the recess base and away from the second implant surface and a recess second portion extending from the recess first portion and configured to provide a slideable engagement between said second implant component and said insert.

3. The system ofclaim 2, wherein the recess first portion has a recess first portion width along the second implant proximal end; wherein the recess second portion has a recess second portion width along the second implant proximal end; and wherein the recess first portion width is different than the recess second portion width.

4. (canceled)

5. The system ofclaim 1, wherein the first implant body further comprises a plurality of first implant protuberances and a plurality of passageways, each protuberance of the plurality of first implant protuberances extending outward and away from the first implant surface from a first implant protuberance first end to a first implant protuberance second end, each passageway extending from a first opening defined on the first implant proximal end to a second opening defined on a first implant protuberance second end; and

wherein the second implant body comprises a plurality of second implant protuberances and a plurality of passageways, each protuberance of the plurality of second implant protuberances extending outward and away from the second implant surface from a second implant protuberance first end to a second implant protuberance second end, each passageway extending from a first opening defined on the second implant proximal end to a second opening defined on a second implant protuberance second end.

6. (canceled)

7. (canceled)

8. The system ofclaim 1, the system further comprising a second fastener disposed through the passageway.

9. The system ofclaim 1, wherein the insert is formed of ultra-high-molecular-weight polyethylene.

10. The system ofclaim 1, wherein the first implant component is adapted to be attached to the talus; and wherein the second implant component is adapted to be attached to the calcaneus.

11. A system for use in a joint arthroplasty in a foot, the system comprising:

a first implant component having a first implant proximal end, a first implant distal end, and a first implant body defining a first implant surface, a concave first articulating surface opposably facing the first implant surface, and a plurality of first implant projections extending outward and away from the first implant surface from a first implant projection first end to a first implant projection second end for each of said plurality of projections;

a second implant component having a second implant proximal end, a second implant distal end, and a second implant body defining a second implant surface, a recess extending into the second implant body from a side opposably facing the second implant surface to a recess base and from the second implant proximal end toward the second implant distal end, and a plurality of second implant projections extending outward and away from the second implant surface from a first implant projection first end to a first implant projection second end for each of said plurality of projections, the recess having a recess first portion extending from the recess base and away from the second implant surface and a recess second portion extending from the recess first portion; and

an insert adapted to be releasably attached to the second implant component and having an insert articulating surface that is convex and adapted to articulate with the first articulating surface,

wherein said joint is selected from the group consisting of a subtalar joint, a calcaneocuboid joint, and a talonavicular joint and said porous first implant surface and said second implant surface are configured for implanting within said joint.

12. The system ofclaim 11, wherein the recess first portion has a recess first portion width along the second implant proximal end; wherein the recess second portion has a recess second portion width along the second implant proximal end; and wherein the recess first portion width is different than the recess second portion width.

13. (canceled)

14. The system ofclaim 11, wherein the first implant body further comprises a plurality of first implant protuberances and a plurality of passageways, each protuberance of the plurality of first implant protuberances extending outward and away from the first implant surface from a first implant protuberance first end to a first implant protuberance second end, each passageway extending from a first opening defined on the first implant proximal end to a second opening defined on a first implant protuberance second end; and

wherein the second implant body further comprises a plurality of second implant protuberances and a plurality of passageways, each protuberance of the plurality of second implant protuberances extending outward and away from the second implant surface from a second implant protuberance first end to a second implant protuberance second end, each passageway extending from a first opening defined on the second implant proximal end to a second opening defined on a second implant protuberance second end.

15. The system ofclaim 14, wherein each passageway defined by the first implant body has a passageway axis; wherein each passageway defined by the second implant body has a passageway axis; wherein each passageway axis of each passageway defined by the first implant body is disposed on a first plane; and wherein each passageway axis of each passageway defined by the second implant body is disposed on a second plane.

16. (canceled)

17. The system ofclaim 14, the system further comprising a first fastener disposed through the passageway defined by the first implant component; and a second fastener disposed through the passageway defined by the second implant component.

18. The system ofclaim 11, wherein the insert is formed of ultra-high-molecular-weight polyethylene.

19. The system ofclaim 11, wherein the first implant component is adapted to be attached to the talus; and wherein the second implant component is adapted to be attached to the calcaneus.

20. A system for use in a joint arthroplasty, the system comprising:

a first implant component having a first implant proximal end, a first implant distal end, and a first implant body defining a first implant surface, a concave first articulating surface opposably facing the first implant surface, and a plurality of first implant bores, each bore having a bore axis that extends through each bore center;

a second implant component having a second implant proximal end, a second implant distal end, and a second implant body defining a second implant surface, a recess extending into the second implant body from a side opposably facing the second implant surface to a recess base and from the second implant proximal end toward the second implant distal end, and a plurality of second implant bores, each bore having a bore axis that extends through each bore center, the recess having a recess first portion extending from the recess base and away from the second implant surface and a recess second portion extending from the recess first portion; and

an insert adapted to be releasably attached to the second implant component and having an insert articulating surface that is concave and adapted to articulate with the first articulating surface,

wherein said joint is selected from the group consisting of a subtalar joint, a calcaneocuboid joint, and a talonavicular joint and said first implant surface and said second implant surface are configured for implanting within said joint.

21. The system ofclaim 1, wherein said first implant component further comprises at least one first implant protuberance extending outward and away from the first implant surface and a passageway extending from a first opening defined on a first end of said at least one first implant protuberance to a second opening defined on a second end of said at least one first implant protuberance.

22. The system ofclaim 11, wherein said first implant component further comprises at least one first implant protuberance extending outward and away from the first implant surface and a passageway extending from a first opening defined on a first end of said at least one first implant protuberance to a second opening defined on a second end of said at least one first implant protuberance.

23. The system ofclaim 22, wherein said second implant component further comprises at least one second implant protuberance extending outward and away from the second implant surface and a passageway extending from a first opening defined on a first end of said at least one second implant protuberance to a second opening defined on a second end of said at least one second implant protuberance.

24. The system ofclaim 23, the system further comprising a first fastener disposed through the passageway defined by the first implant component and a second fastener disposed through the passageway defined by the second implant component.

25. A method of using the system ofclaim 1, comprising installing said first implant component onto a first bone of said joint and installing said second implant component to a second bone of said joint.

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