CROSS-REFERENCE TO RELATED APPLICATIONSThis application claims priority to and the benefit of U.S. Provisional Patent Application No. 62/838,792, filed on Apr. 25, 2019, which is hereby incorporated by reference herein in its entirety.
TECHNICAL FIELDThis disclosure relates generally to shoulder implants, and more particularly, to glenoid implants.
BACKGROUNDShoulder arthroplasty is used to treat acute osteoarthritis or a shoulder joint fracture. There are two common forms of shoulder arthroplasty: total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). TSA uses a metal ball component at the humeral head, which mates into a polyethylene cup on the glenoid. RSA switches the locations between the head and the cup, such that the humerus becomes the cup and the glenoid becomes the head. RSA can be performed as a revision to TSA, allowing greater functionality for patients with rotator cuff tears. RSA utilizes the patient's deltoid to control the movements of the shoulder.
Thus, a need exists for a shoulder implant that is bone conserving and also versatile for revision. The present disclosure is directed to solving these problems and addressing other needs.
SUMMARYAccording to some implementations of the present disclosure, a glenoid implant system includes an anchoring structure and a glenoid liner. The anchoring structure includes a base, a wall, and a ledge. The wall extends from a first surface of the base. The ledge extends generally along at least a portion of a first side of the wall, thereby forming an undercut. The wall has a slot formed in a second opposing side of the wall. The glenoid liner is configured to be removably coupled to the anchoring structure. The glenoid liner has a cap portion, a main body, and a deflectable finger. The cap portion has a first surface and a second opposing surface. The main body extends from the second opposing surface of the cap portion and includes a lip configured to engage the undercut of the anchoring structure. The deflectable finger extends from the second opposing surface of the cap portion. The deflectable finger has a protrusion configured to engage the slot of the anchoring structure to aid in securing the glenoid liner to the anchoring structure.
The foregoing and additional aspects and implementations of the present disclosure will be apparent to those of ordinary skill in the art in view of the detailed description of various embodiments and/or implementations, which is made with reference to the drawings, a brief description of which is provided next.
BRIEF DESCRIPTION OF THE DRAWINGSThe foregoing and other advantages of the present disclosure will become apparent upon reading the following detailed description and upon reference to the drawings.
FIG. 1 illustrates a first disassembled perspective view of a glenoid implant system, according to some implementations of the present disclosure;
FIG. 2 illustrates a second disassembled perspective view of the glenoid implant system ofFIG. 1, according to some implementations of the present disclosure;
FIG. 3 illustrates a perspective view of a glenoid liner of the glenoid implant system ofFIG. 1, according to some implementations of the present disclosure;
FIG. 4A illustrates a first step of assembling the glenoid implant system ofFIG. 1, according to some implementations of the present disclosure;
FIG. 4B illustrates a cross-sectional view of the first step of assembling the glenoid implant system ofFIG. 1, according to some implementations of the present disclosure;
FIG. 5A illustrates a second step of assembling the glenoid implant system ofFIG. 1, according to some implementations of the present disclosure;
FIG. 5B illustrates a cross-sectional view of the second step of assembling the glenoid implant system ofFIG. 5A, according to some implementations of the present disclosure;
FIG. 6A illustrates a third step of assembling the glenoid implant system ofFIG. 1, according to some implementations of the present disclosure;
FIG. 6B illustrates a cross-sectional view of the third step of assembling the glenoid implant system ofFIG. 6A, according to some implementations of the present disclosure;
FIG. 7A illustrates an assembled glenoid implant system ofFIG. 1, according to some implementations of the present disclosure;
FIG. 7B illustrates a cross-sectional view of the assembled glenoid implant system ofFIG. 7A, according to some implementations of the present disclosure;
FIG. 8A illustrates a disassembled perspective view of a first alternative glenoid implant system, according to some implementations of the present disclosure;
FIG. 8B illustrates an assembled perspective view of the first alternative glenoid implant system ofFIG. 8A, according to some implementations of the present disclosure;
FIG. 9A illustrates a disassembled perspective view of a second alternative glenoid implant system, according to some implementations of the present disclosure; and
FIG. 9B illustrates an assembled perspective view of the second alternative glenoid implant system ofFIG. 9A, according to some implementations of the present disclosure.
While the present disclosure is susceptible to various modifications and alternative forms, specific implementations have been shown by way of example in the drawings and will be described in further detail herein. It should be understood, however, that the present disclosure is not intended to be limited to the particular forms disclosed. Rather, the present disclosure is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure as defined by the appended claims.
DETAILED DESCRIPTIONThe present disclosure is described with reference to the attached figures, where like reference numerals are used throughout the figures to designate similar or equivalent elements. The figures are not drawn to scale, and are provided merely to illustrate the instant disclosure. Several aspects of the disclosure are described below with reference to example applications for illustration.
Referring generally toFIGS. 1-2, a disassembled view of aglenoid implant system100 is illustrated, according to some implementations of the present disclosure. Theglenoid implant system100 includes an anchoringstructure110 and a glenoid liner170 (e.g., an anatomic glenoid liner).
The anchoringstructure110 includes abase120, awall130, and aledge140. Thewall130 extends from afirst surface122 of thebase120. For example, in some implementations, thewall130 of the anchoringstructure110 extends generally perpendicularly from thefirst surface122 of thebase120. Theledge140 of the anchoringstructure110 extends from an inside surface of thewall130 as opposed to an outside surface of thewall130. Further, theledge140 extends generally along at least a portion of afirst side132 of thewall130, thereby forming an undercut136. In some implementations, the transition from theledge140 to the undercut136 includes a straight edge, a bevel, a chamfer, or any combination thereof. Thewall130 includes aslot138 formed in a secondopposing side134 of thewall130. Additionally, in some implementations, the anchoringstructure110 can include a porous coating, for example, around thewall130 of the anchoringstructure110. The porous coating can aid in osseointegration with the bone of a patient having the glenoid implant system installed and/or implanted.
Theglenoid liner170 includes acap portion172, amain body180, and a plurality ofdeflectable fingers190. Themain body180 extends from the second opposing surface of thecap portion172. Eachdeflectable finger190 also extends from the second opposingsurface176 of thecap portion172. In some implementations, theglenoid liner170 is one monolithic part. In some other implementations, one or more components of theglenoid liner170 is separate and distinct from the remaining components of theglenoid liner170. Thecap portion172 includes afirst surface174, and a second opposingsurface176. In some implementations, thefirst surface174 of thecap portion172 is generally concave. For example, in some implementations, thefirst surface174 of thecap portion172 is rounded and may resemble the shape of a healthy human glenoid bone. In some implementations, the second opposingsurface176 of thecap portion172 is generally planar.
Theglenoid liner170 is configured to be removably coupled to the anchoringstructure110. There are several components that aid in securing theglenoid liner170 to the anchoringstructure110. First, in some implementations, themain body180 includes alip186 configured to engage the undercut136 of the anchoringstructure110.
Second, in some implementations, eachdeflectable finger190 includes aprotrusion198, which is configured to engage theslot138 of the anchoringstructure110 to aid in securing theglenoid liner170 to the anchoringstructure110. For example, in some implementations, theprotrusion198 of thedeflectable finger190 includes an elongated rib, a ball, a hook, or any combination thereof. Further, in some implementations, eachdeflectable finger190 is snap-locked into thecorresponding slot138 of the anchoringstructure110 via theprotrusion198. Additionally, or alternatively, in some implementations, theglenoid liner170 includes a plurality of snap fasteners that are configured to engage one or more of theslots138 of the anchoringstructure110 to aid in securing theglenoid liner170 to the anchoringstructure110.
Third, in some implementations, theledge140 of the anchoringstructure110 includes afirst protrusion142. Thefirst protrusion142 is configured to engage a firstcorresponding notch182 formed in themain body180 of theglenoid liner170. As best shown inFIG. 3, the firstcorresponding notch182 is positioned generally between thecap portion172 of theglenoid liner170 and thelip186 of themain body180 of theglenoid liner170.
Fourth, in some implementations, the anchoringstructure110 further includes asecond protrusion144, which is positioned generally between thefirst protrusion142 of theledge140 and thebase120 of the anchoringstructure110. Thesecond protrusion144 is configured to engage a secondcorresponding notch184 formed in thelip186 of themain body180 of the glenoid liner170 (as best shown inFIG. 3).
In some implementations, thefirst protrusion142 extends a first distance from thewall130. Thesecond protrusion144 extends a second distance from thewall130 that is less than the first distance. Additionally, or alternatively, in some implementations, thefirst protrusion142 is stacked on thesecond protrusion144 in a stepped fashion.
While theglenoid implant system100 is shown inFIGS. 1-7B as including at least four sets of components that aid in securing theglenoid liner170 to the anchoring structure110 (e.g., thelip186 of themain body180 configured to engage the undercut136 of the anchoringstructure110; theprotrusion198 of eachdeflectable finger190 configured to engage thecorresponding slot138 of the anchoringstructure110; thefirst protrusion142 of theledge140 of the anchoringstructure110 configured to engage the firstcorresponding notch182 formed in themain body180 of theglenoid liner170; and thesecond protrusion144 of the anchoringstructure110 configured to engage the secondcorresponding notch184 formed in thelip186 of themain body180 of the glenoid liner170), a glenoid implant system of the present disclosure can include more or fewer sets of components that aid in securing theglenoid liner170 to the anchoringstructure110.
As an example, in some implementations, a first alternative glenoid implant system can include thelip186 of themain body180 configured to engage the undercut136 of the anchoringstructure110; and theprotrusion198 of eachdeflectable finger190 configured to engage thecorresponding slot138 of the anchoringstructure110.
As another example, in some implementations, a second alternative glenoid implant system can include theprotrusion198 of eachdeflectable finger190 configured to engage thecorresponding slot138 of the anchoringstructure110; thefirst protrusion142 of theledge140 of the anchoringstructure110 configured to engage the firstcorresponding notch182 formed in themain body180 of theglenoid liner170; and thesecond protrusion144 of the anchoringstructure110 configured to engage the secondcorresponding notch184 formed in thelip186 of themain body180 of theglenoid liner170.
As a further example, in some implementations, a third alternative glenoid implant system can include thelip186 of themain body180 configured to engage the undercut136 of the anchoringstructure110; theprotrusion198 of eachdeflectable finger190 configured to engage thecorresponding slot138 of the anchoringstructure110; and thesecond protrusion144 of the anchoringstructure110 configured to engage the secondcorresponding notch184 formed in thelip186 of themain body180 of theglenoid liner170.
As yet another example, in some implementations, a fourth alternative glenoid implant system can include thelip186 of themain body180 configured to engage the undercut136 of the anchoringstructure110; theprotrusion198 of eachdeflectable finger190 configured to engage thecorresponding slot138 of the anchoringstructure110; and thefirst protrusion142 of theledge140 of the anchoringstructure110 configured to engage the firstcorresponding notch182 formed in themain body180 of theglenoid liner170.
As an additional example, in some implementations, a fifth alternative glenoid implant system can include a dovetail locking mechanism on thefirst side132 of thewall130 that is configured to engage a mating dovetail locking mechanism on themain body180; and theprotrusion198 of eachdeflectable finger190 configured to engage thecorresponding slot138 of the anchoringstructure110.
While it is shown inFIG. 1 that thebase120 of the anchoringstructure110 is generally egg shaped, thebase120 of the anchoringstructure110 can have any suitable shapes. For example, in some implementations, thebase120 of the anchoringstructure110 is generally circular, generally oval, generally bean shaped, generally egg shaped, generally tear-drop shaped, generally football shaped, or any combination thereof.
Still referring toFIGS. 1-2, the anchoringstructure110 is configured to be anchored in a glenoid cavity of a patient. In some implementations, the anchoringstructure110 further includes afirst anchoring peg150 extending from a second opposingsurface124 of the base120 opposite thefirst surface122 of the base120 (e.g., across the base120). In some such implementations, the anchoringstructure110 can further include asecond anchoring peg152 extending from the second opposingsurface124 of thebase120, where thesecond anchoring peg152 is spaced from thefirst anchoring peg150. While in some implementations, only one anchoring peg is needed, having both thefirst anchoring peg150 and thesecond anchoring peg152 is advantageous to prevent any unwanted rotation of the anchoringstructure110 once it is installed into the patient.
In some implementations, thefirst anchoring peg150 and thesecond anchoring peg152 are the same, and have ridges that flex when press fit into the bone (e.g., the glenoid cavity) of the patient. In some implementations, the ridges aid in the osseointegration of the anchoringpeg150 to the bone of the patient. Alternatively, in some implementations, in place of thefirst anchoring peg150, the anchoringstructure110 includes a first screw hole for a center screw to attach the anchoringstructure110 to the bone (e.g., the glenoid cavity) of the patient. Additionally, or alternatively, in some implementations, in place of thesecond anchoring peg152, the anchoringstructure110 includes a second screw hole for a side screw to attach the anchoringstructure110 to the bone (e.g., the glenoid cavity) of the patient.
Furthermore, in some implementations, to aid in securing the anchoringstructure110 to a glenoid fossa of a patient, thebase120 of the anchoringstructure110 further includes a plurality of through-holes160 for receiving one or more respective fasteners therethrough. The plurality of through-holes160 can be straight, angled, or both.
In some implementations, the second opposingsurface124 of thebase120 is generally planar for coupling to a corresponding generally planar surface of the glenoid fossa of the patient. For example, in some implementations, the generally planar second opposingsurface124 of the base120 can be more bone-conserving, which sits on the reamed surface of the glenoid focca. In some other implementations, the second opposingsurface124 of thebase120 is generally convex for coupling to a corresponding generally concave surface of the glenoid fossa of the patient.
As disclosed herein, theglenoid liner170 is configured to be removably coupled to the anchoringstructure110. Some examples of the steps for coupling theglenoid liner170 to the anchoringstructure110 are illustrated inFIGS. 4A-7B, according to some implementations of the present disclosure.
Referring toFIGS. 4A-4B, a first step of assembling theglenoid implant system100 is illustrated in its perspective view (FIG. 4A) and its cross-sectional view (FIG. 4B), according to some implementations of the present disclosure. The same reference numbers inFIGS. 4A-4B are used for the same elements inFIGS. 1-3. Theglenoid liner170 is angled and/or tilted such that thelip186 of theglenoid liner170 is closer to the first side132 (FIG. 1) of thewall130, than the plurality ofdeflectable fingers190 is to the second opposing side132 (FIG. 1) of thewall130. In addition, in some implementations, the firstcorresponding notch182 formed in themain body180 of theglenoid liner170 is being aligned vertically with thefirst protrusion142 of theledge140 of the anchoringstructure110. Additionally, or alternatively, in some implementations, the secondcorresponding notch184 formed in thelip186 of themain body180 of theglenoid liner170 is being aligned vertically with thesecond protrusion144 of the anchoringstructure110.
Referring toFIGS. 5A-5B, a second step of assembling theglenoid implant system100 is illustrated in its perspective view (FIG. 5A) and its cross-sectional view (FIG. 5B), according to some implementations of the present disclosure. The same reference numbers inFIGS. 5A-5B are used for the same elements inFIGS. 1-3. Thelip186 of themain body180 is inserted to engage the undercut136 of the anchoringstructure110. In addition, in some implementations, thefirst protrusion142 of theledge140 of the anchoringstructure110 is inserted to engage the firstcorresponding notch182 formed in themain body180 of theglenoid liner170. Additionally, or alternatively, in some implementations, thesecond protrusion144 of the anchoringstructure110 is inserted to engage the secondcorresponding notch184 formed in thelip186 of themain body180 of theglenoid liner170.
Further, in some implementations, the plurality ofdeflectable fingers190 of theglenoid liner170 is pushed inward and downward relative to thewall130 of the anchoringstructure110, so that theprotrusion198 of eachdeflectable finger190 can move past a portion of thewall130 that is above thecorresponding slot138.
Referring toFIGS. 6A-6B, a third step of assembling theglenoid implant system100 is illustrated in its perspective view (FIG. 6A) and its cross-sectional view (FIG. 6B), according to some implementations of the present disclosure. The same reference numbers inFIGS. 6A-6B are used for the same elements inFIGS. 1-3. Thelip186 of themain body180 is almost fully engaged with the undercut136 of the anchoringstructure110. In addition, in some implementations, thefirst protrusion142 of theledge140 of the anchoringstructure110 is almost fully engaged with the firstcorresponding notch182 formed in themain body180 of theglenoid liner170. Additionally, or alternatively, in some implementations, thesecond protrusion144 of the anchoringstructure110 is almost fully engaged with the secondcorresponding notch184 formed in thelip186 of themain body180 of theglenoid liner170.
Further, theprotrusion198 of eachdeflectable finger190 has almost moved past the portion of thewall130 that is above thecorresponding slot138. In some implementations, the plurality ofdeflectable fingers190 of theglenoid liner170 is further pushed downward (e.g., toward thebase120 of the anchoring structure110), so that the plurality ofdeflectable fingers190 can spring back (e.g., deflect back to its original position) to allow theprotrusion198 of eachdeflectable finger190 to engage thecorresponding slot138 of the anchoringstructure110.
Referring toFIGS. 7A-7B, an assembledglenoid implant system100 is illustrated in its perspective view (FIG. 7A) and its cross-sectional view (FIG. 7B), according to some implementations of the present disclosure. The same reference numbers inFIGS. 7A-7B are used for the same elements inFIGS. 1-3. Thelip186 of themain body180 is engaged with the undercut136 of the anchoringstructure110. In addition, thefirst protrusion142 of theledge140 of the anchoringstructure110 is engaged with the firstcorresponding notch182 formed in themain body180 of theglenoid liner170. Thesecond protrusion144 of the anchoringstructure110 is also engaged with the secondcorresponding notch184 formed in thelip186 of themain body180ffof theglenoid liner170.
Further, the plurality ofdeflectable fingers190 of theglenoid liner170 has snapped down and into the correspondingslots138 of the anchoringstructure110, and theprotrusion198 of eachdeflectable finger190 is engaged with thecorresponding slot138 of the anchoringstructure110. In addition, thewall130 extends about an entire perimeter of the base120 (as best shown inFIG. 1). As such, when assembled, themain body180 of theglenoid liner170 is configured to be encapsulated within thewall130 of the anchoringstructure110.
Turning now toFIGS. 8A-8B, a first alternativeglenoid implant system200 is illustrated in its disassembled view of (FIG. 8A) and its assembled view (FIG. 8B), according to some implementations of the present disclosure. Theglenoid implant system200 is the same as, or similar to, theglenoid implant system100, where like reference numbers are used for like elements, except that the anchoringstructure210 of theglenoid implant system200 includes abaseplate216 and a glenoid liner adapter212 (e.g., an anatomic glenoid liner adapter).
In some implementations, the glenoid implant system200 (including, for example, thebaseplate216, theglenoid liner adapter212, and the glenoid liner270) can be used for TSA (e.g., an anatomic procedure). The anatomic procedure can involve the repair and/or replacement of the affected extremity's ball and socket joint after years of degeneration. This surgery involves replacing the ball portion of the shoulder, which is also referred to as the humeral head, with a metal sphere while a plastic or other synthetic apparatus is used for the socket replacement. This type of procedure is most helpful for patients with arthritis and other related conditions, which result in joint problems and missing cartilage.
As shown inFIG. 8A, theglenoid liner270 of theglenoid implant system200 is the same as, or similar to, theglenoid liner170 of theglenoid implant system100. Theglenoid liner270 is configured to be coupled to theglenoid liner adapter212, in the same or similar manner as what is disclosed and illustrated with reference toFIGS. 4A-7B.
Theglenoid liner adapter212 is configured to be coupled to thebaseplate216. Theglenoid liner adapter212 includes stackedprotuberances213 and214 extending from thebase220. The stackedprotuberances213 and214 are spaced from thesecond anchoring peg252. Thebaseplate216 includes a wall (e.g., a shell, a peripheral rim)215 configured to receive thefirst protuberance213. In some implementations, the coupling mechanism between thewall215 and thefirst protuberance213 includes an interference fit, a spring fit, a Morse Taper lock, or any combination thereof. Additionally, or alternatively, in some implementations, thebaseplate216 includes acavity217 configured to receive thesecond protuberance214. The coupling mechanism between thecavity217 and thesecond protuberance214 can include an interference fit, a spring fit, a Morse Taper lock, or any combination thereof. Additionally, or alternatively, in some implementations, theglenoid liner adapter212 is configured to be coupled to thebaseplate216 via a center screw.
In some implementations, thebaseplate216 includes peripheral screw holes260 located around thecavity217. The peripheral screw holes260 can be used for straight and/or angled screws. Further, in some implementations, thewall215 of thebaseplate216 provides added stability against edge loading. Additionally, in some implementations, thebaseplate216 can include a porous coating, for example, around thewall215 of thebaseplate216.
As disclosed herein, TSA uses a metal ball component at the humeral head, which mates into a polyethylene cup on the glenoid. RSA switches the locations between the head and the cup, such that the humerus becomes the cup and the glenoid becomes the head. RSA can be performed as a revision to TSA, allowing greater functionality for patients with rotator cuff tears. RSA utilizes the patient's deltoid to control the movements of the shoulder. The revision from TSA to RSA involves the replacement of both the glenoid component and the humeral component. On the glenoid side, the cemented glenoid component is replaced by a metal baseplate and screws. On the humeral side, the stem and the head are removed and replaced with new RSA components. The conversion shoulder arthroplasty corrects the failure of the TSA due to loosened implants, wear, infection, and/or shoulder dislocation or misalignment.
Thus, in some implementations, the present disclosure provides for a shoulder arthroplasty implant that allows easily accessible conversion from a TSA system to a RSA system. Referring toFIGS. 9A-9B, a second alternativeglenoid implant system300 is illustrated in its disassembled view of (FIG. 9A) and its assembled view (FIG. 9B), according to some implementations of the present disclosure. Theglenoid implant system300 includes an anchoringstructure310 that is the same as, or similar to, the anchoringstructure210 of the glenoid implant system200 (FIG. 8), where like reference numbers are used for like elements, except that the anchoringstructure310 of theglenoid implant system300 includes abaseplate316 and a glenosphere adapter312 (e.g., a reverse glenosphere adapter). Theglenoid implant system300 further includes a glenosphere370 (e.g., a reverse glenosphere) configured to be coupled to theglenosphere adapter312.
In some implementations, the glenoid implant system300 (including, for example, thebaseplate316, theglenosphere adapter312, and the glenosphere370) can be used for RSA (e.g., a reverse procedure). For patients with large rotator cuff tears, shoulder arthritis, and/or shoulder arthropathy, reverse total shoulder replacement is a better option because the rotator cuff muscles no longer function. The reverse total shoulder replacement relies on the deltoid muscle, instead of the rotator cuff, to position and power the arm.
In some implementations, thebaseplate316 of theglenoid implant system300 is the same as thebaseplate216 of theglenoid implant system200. As such, when RSA is performed as a revision to TSA, the baseplate can stay in the patient, where theglenoid liner adapter212 and theglenoid liner270 can be replaced by the to theglenosphere adapter312 and theglenosphere370.
Theglenosphere370 is configured to be coupled to theglenosphere adapter312. In turn, theglenosphere adapter312 is configured to be coupled to thebaseplate316. Theglenosphere adapter312 includes stackedprotuberances313 and314. Thebaseplate316 includes a wall (e.g., a shell, a peripheral rim) configured to receive thefirst protuberance313, similar to the coupling mechanism between thewall215 and thefirst protuberance213 of the glenoid implant system200 (FIGS. 8A-8B). Additionally, or alternatively, in some implementations, thebaseplate316 includes acavity317 configured to receive thesecond protuberance314, similar to the coupling mechanism between thecavity217 and thesecond protuberance214 of the glenoid implant system200 (FIGS. 8A-8B). Additionally, or alternatively, in some implementations, theglenosphere adapter312 is configured to be coupled to thebaseplate316 via a center screw.
In some implementations, the glenoid implant system of the present disclosure allows easily accessible conversion from a TSA system to a RSA system. For example, a glenoid implant assembly can include the following components: a baseplate (e.g., thebaseplate216 or the baseplate316), a glenoid liner adapter (e.g., the glenoid liner adapter212), a glenoid liner (e.g., theglenoid liner170 or the glenoid liner270), a glenosphere adapter (e.g., the glenosphere adapter312), and a glenosphere (e.g., the glenosphere370). Because RSA switches the locations between the head and the cup, RSA can be performed as a revision to TSA. As such, using the example glenoid implant assembly, the baseplate can remain in place during the revision to TSA, while the glenoid liner adapter and the glenoid liner can be replaed by the glenosphere adapter and the glenosphere.
One or more elements or aspects or steps, or any portion(s) thereof, from one or more of any of claims1-25 below can be combined with one or more elements or aspects or steps, or any portion(s) thereof, from one or more of any of the other claims1-25 or combinations thereof, to form one or more additional implementations and/or claims of the present disclosure.
While various examples of the present disclosure have been described above, it should be understood that they have been presented by way of example only, and not limitation. Numerous changes to the disclosed examples can be made in accordance with the disclosure herein without departing from the spirit or scope of the disclosure. Thus, the breadth and scope of the present disclosure should not be limited by any of the above described examples. Rather, the scope of the disclosure should be defined in accordance with the following claims and their equivalents.