U.S. patent application number 16/876847 was filed with the patent office on 2020-09-03 for joint arthroplasty systems, methods and components.
The applicant listed for this patent is FOOT INNOVATIONS, LLC. Invention is credited to Sergio Gutierrez, Roy W. Sanders.
Application Number | 20200276026 16/876847 |
Document ID | / |
Family ID | 1000004830366 |
Filed Date | 2020-09-03 |
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United States Patent
Application |
20200276026 |
Kind Code |
A1 |
Sanders; Roy W. ; et
al. |
September 3, 2020 |
JOINT ARTHROPLASTY SYSTEMS, METHODS AND COMPONENTS
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.
Inventors: |
Sanders; Roy W.; (Tampa,
FL) ; Gutierrez; Sergio; (Tampa, FL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
FOOT INNOVATIONS, LLC |
Tampa |
FL |
US |
|
|
Family ID: |
1000004830366 |
Appl. No.: |
16/876847 |
Filed: |
May 18, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15644131 |
Jul 7, 2017 |
10653529 |
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16876847 |
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14219676 |
Mar 19, 2014 |
9700424 |
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15644131 |
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13670664 |
Nov 7, 2012 |
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14219676 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61F 2002/30578
20130101; A61F 2002/30878 20130101; A61F 2002/4217 20130101; A61F
2/4202 20130101; A61F 2/4225 20130101; A61F 2002/30884 20130101;
A61F 2002/30387 20130101; A61F 2002/4207 20130101 |
International
Class: |
A61F 2/42 20060101
A61F002/42 |
Claims
21. A system for use in a joint arthroplasty for modifying a
subtalar joint, the system comprising: a first implant component
comprising a first convex surface and a third surface; a second
implant component comprising a second concave surface and a fourth
surface; and an insert configured to be inserted in the subtalar
joint and between the first implant component and the second
implant component, the insert comprising: a fifth surface, a
shoulder configured to releasably engage with a corresponding
recess of one of the first implant component or the second implant
component, the recess comprising a pair of sidewalls extending
along edges of one of the third surface of the first implant
component or the fourth surface of the second implant component,
the recess including a recess wall extending between the recess
sidewalls along a length of the insert, the length greater than a
width of the insert along which the pair of sidewalls extend, and a
sixth articulating surface configured to articulate with the other
of the third surface of the first implant component or the fourth
surface of the second implant component.
22. The system of claim 21, wherein the shoulder comprises a pair
of shoulder walls configured to be received by the pair of recess
sidewalls.
23. The system of claim 21, wherein the fifth surface is a concave
surface, and the third surface is configured to articulate with the
sixth articulating surface.
24. The system of claim 21, wherein the recess is configured to
attach the insert to the second implant component.
25. The system of claim 21, wherein the recess is sized to receive
the insert such that the insert does not extend beyond the recess
wall.
26. The system of claim 21, wherein the inferior surface of the
talus and the superior surface of the calcaneus form a posterior
facet of the subtalar joint, and the system is configured to modify
the posterior facet of the subtalar joint.
27. The system of claim 21, wherein at least one of the first
implant component or the second implant component includes a
biocompatible material.
28. The system of claim 21, wherein the first convex surface is
smooth or uninterrupted.
29. The system of claim 21, wherein the first convex surface is
porous.
30. The system of claim 21, wherein the fourth surface is
porous.
31. The system of claim 21, wherein the first implant component
includes a plurality of implant projections extending from the
first convex surface.
32. The system of claim 31, wherein the plurality of implant
projections include a first set of projections spaced from and
parallel to a second set of projections.
33. The system of claim 21, wherein the second implant component
defines a length greater than a width, and the shoulder is at an
end of the length.
34. The system of claim 21, wherein a radius of curvature of the
second concave surface equals a radius of curvature of the sixth
convex articulating surface.
35. The system of claim 21, wherein the insert is removably coupled
with the second implant component.
36. The system of claim 21, wherein the system is configured to be
implanted using a lateral and posterior approach.
37. The system of claim 21, further comprising a plurality of
fasteners configured to secure at least one of the first implant
component to the inferior surface of the talus or the second
implant component to the superior surface of the calcaneus.
38. The system of claim 38, wherein the plurality of fasteners are
configured to extend at an acute angle to at least one of the first
convex surface or the sixth articulating surface.
39. The system of claim 21, wherein the system is configured to
treat arthritis of the subtalar joint.
40. The system of claim 21, wherein the one of the first implant
component or the second implant component has a proximal end and a
distal end having a curvature matching the proximal end, the pair
of recess sidewalls extending along the edges of the one of the
third surface of the first implant component or the fourth surface
of the second implant component from the proximal end to the distal
end.
Description
FIELD
[0001] 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
[0002] 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.
[0003] 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.
[0004] 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.
[0005] Therefore, a need exists for improved surgical implant
systems, methods, and components for use in joint arthroplasty.
SUMMARY
[0006] Various exemplary implant systems, methods, and components
are described herein.
[0007] 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.
[0008] 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.
[0009] 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.
[0010] 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
[0011] FIG. 1 is a lateral view of an exemplary human foot
highlighting the subtalar joint.
[0012] FIG. 2 is a magnified view of the area indicated in FIG.
1.
[0013] FIG. 3 is a perspective view of a first exemplary implant
system disposed in the subtalar joint of a human foot.
[0014] FIG. 4 is a perspective view of the first exemplary implant
system illustrated in FIG. 3, free of the subtalar joint.
[0015] FIG. 5 is an exploded view of the exemplary implant system
illustrated in FIG. 4.
[0016] FIG. 6 is another exploded view of the exemplary implant
system illustrated in FIG. 4.
[0017] FIG. 7 is a perspective view of a second exemplary implant
system disposed in the subtalar joint of a human foot.
[0018] FIG. 8 is a perspective view of the second exemplary implant
system illustrated in FIG. 7, free of the subtalar joint.
[0019] FIG. 9 is an exploded view of the exemplary implant system
illustrated in FIG. 8.
[0020] FIG. 10 is another exploded view of the exemplary implant
system illustrated in FIG. 8.
[0021] FIG. 11 is a perspective view of a third exemplary implant
system disposed in the subtalar joint of a human foot.
[0022] FIG. 12 is a perspective view of the third exemplary implant
system illustrated in FIG. 11, free of the subtalar joint.
[0023] FIG. 13 is an exploded view of the exemplary implant system
illustrated in FIG. 12.
[0024] FIG. 14 is another exploded view of the exemplary implant
system illustrated in FIG. 12.
[0025] FIG. 15 is a perspective view of a fourth exemplary implant
system disposed in the subtalar joint of a human foot.
[0026] FIG. 16 is a perspective view of the fourth exemplary
implant system illustrated in FIG. 15, free of the subtalar
joint.
[0027] FIG. 17 is an exploded view of the exemplary implant system
illustrated in FIG. 16.
[0028] FIG. 18 is another exploded view of the exemplary implant
system illustrated in FIG. 16.
[0029] FIG. 19 is a perspective view of a fifth exemplary implant
system with the insert partially disposed in the second implant
component.
[0030] FIG. 20 is an exploded view of the exemplary implant system
illustrated in FIG. 19.
[0031] FIG. 21 is a magnified view of the area indicated in FIG.
20.
[0032] FIG. 22 is another exploded view of the exemplary implant
system illustrated in FIG. 19.
[0033] FIG. 23 is a perspective view of a sixth exemplary implant
system with the insert partially disposed in the second implant
component.
[0034] FIG. 24 is an exploded view of the exemplary implant system
illustrated in FIG. 23.
[0035] FIG. 25 is another exploded view of the exemplary implant
system illustrated in FIG. 23.
[0036] FIG. 26 is a perspective view of a seventh exemplary implant
system disposed in the subtalar joint of a human foot.
[0037] FIG. 27 is a perspective view of the seventh exemplary
implant system illustrated in FIG. 26, free of the subtalar
joint.
[0038] FIG. 28 is an exploded view of the exemplary implant system
illustrated in FIG. 27.
[0039] FIG. 29 is another exploded view of the exemplary implant
system illustrated in FIG. 27.
[0040] FIG. 30 is a perspective view of an eighth exemplary implant
system disposed in the subtalar joint of a human foot.
[0041] FIG. 31 is a perspective view of the eighth exemplary
implant system illustrated in FIG. 30, free of the subtalar
joint.
[0042] FIG. 32 is an exploded view of the exemplary implant system
illustrated in FIG. 31.
[0043] FIG. 33 is another exploded view of the exemplary implant
system illustrated in FIG. 31.
[0044] FIG. 34 is a perspective view of a ninth exemplary implant
system disposed in the subtalar joint of a human foot.
[0045] FIG. 35 is a perspective view of the ninth exemplary implant
system illustrated in FIG. 34, free of the subtalar joint.
[0046] FIG. 36 is an exploded view of the exemplary implant system
illustrated in FIG. 35.
[0047] FIG. 37 is another exploded view of the exemplary implant
system illustrated in FIG. 35.
[0048] FIG. 38 is a perspective view of a tenth exemplary implant
system disposed in the subtalar joint of a human foot.
[0049] FIG. 39 is a perspective view of the tenth exemplary implant
system illustrated in FIG. 38, free of the subtalar joint.
[0050] FIG. 40 is an exploded view of the exemplary implant system
illustrated in FIG. 39.
[0051] FIG. 41 is another exploded view of the exemplary implant
system illustrated in FIG. 39.
[0052] FIG. 42 is a perspective view of an eleventh exemplary
implant system disposed in the subtalar joint of a human foot.
[0053] FIG. 43 is a perspective view of the eleventh exemplary
implant system illustrated in FIG. 42, free of the subtalar
joint.
[0054] FIG. 44 is an exploded view of the exemplary implant system
illustrated in FIG. 43.
[0055] FIG. 45 is another exploded view of the exemplary implant
system illustrated in FIG. 43.
[0056] FIG. 46 is a flowchart representation of an exemplary method
of treatment.
[0057] FIG. 47 is a flowchart representation of a second exemplary
method of treatment.
[0058] FIG. 48 is a flowchart representation of a third exemplary
method of treatment.
[0059] FIG. 49 is a flowchart representation of a fourth exemplary
method of treatment.
[0060] FIG. 50 is a perspective view of a twelfth exemplary implant
system disposed in the subtalar joint of a human foot.
[0061] FIG. 51 is a perspective view of the exemplary implant
system illustrated in FIG. 50, free of the subtalar joint, with the
insert partially disposed in the second implant component.
[0062] FIG. 52 is an exploded view of the exemplary implant system
illustrated in FIG. 51.
[0063] FIG. 53 is another exploded view of the exemplary implant
system illustrated in FIG. 51.
[0064] FIG. 54 is a perspective view of a thirteenth exemplary
implant system disposed in the subtalar joint of a human foot.
[0065] FIG. 55 is a perspective view of the exemplary implant
system illustrated in FIG. 54, free of the subtalar joint.
[0066] FIG. 56 is an exploded view of the exemplary implant system
illustrated in FIG. 54.
[0067] FIG. 57 is another exploded view of the exemplary implant
system illustrated in FIG. 54.
DETAILED DESCRIPTION
[0068] 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.
[0069] 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.
[0070] FIGS. 1 and 2 illustrate an exemplary human foot 10
comprising a talus 12, calcaneus 14, and subtalar joint 16. The
posterior facet 18 of the subtalar joint 16 is formed by a concave,
or substantially concave, surface 20 on the talus 12 and a convex,
or substantially convex, surface 22 on the calcaneus 14, as shown
in FIG. 2.
[0071] 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.
[0072] FIGS. 3, 4, 5, and 6 illustrate an exemplary surgical
implant system 100 comprising a first implant component 102, a
second implant component 104, and an insert 106. First implant
component 102 is adapted to be attached to the talus 12 and second
implant component 104 is adapted to be attached to the calcaneus
14.
[0073] First implant component 102 and second implant component 104
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.
[0074] In the illustrated embodiment, first implant component 102
comprises a first implant proximal end 108, first implant distal
end 110, first implant body 112, and a plurality of first implant
projections 114.
[0075] First implant body 112 defines a convex, or substantially
convex, first implant surface 116 and an opposably facing, or
substantially opposably facing, concave, or substantially concave,
first articulating surface 118. Each of the first implant surface
116 and first articulating surface 118 has a radius of curvature
that extends from the first implant proximal end 108 to the first
implant distal end 110. First implant surface 116 is smooth,
substantially smooth, or uninterrupted and first articulating
surface 118 is smooth, substantially smooth, or uninterrupted, such
that articulation between articulating surface 118 and insert 106
can be accomplished, as described in more detail herein.
[0076] While first implant surface 116 has been described as
convex, or substantially convex, and first articulating surface 118
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.
[0077] First implant surface 116 and first articulating surface 118
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.
[0078] While each of the first implant surface 116 and first
articulating surface 118 has been described as having a radius of
curvature that extends from the first implant proximal end 108 to
the first implant distal end 110, 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.
[0079] While first implant surface 116 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.
[0080] In the illustrated embodiment, each projection of the
plurality of first implant projections 114 has a first implant
projection proximal end 120, first implant projection distal end
122, and extends outward and away, or radially outward, from first
implant surface 116 at a 90 degree, or substantially 90 degree,
angle from a first implant projection first end 124 to a first
implant projection second end 126. Each projection of the plurality
of first implant projections 114 is elongated, is disposed between
first implant proximal end 108 and first implant distal end 110,
and defines a serrated first implant projection second end 126. It
is considered advantageous for each projection of the plurality of
first implant projections 114 to define a serrated first implant
projection second end 126 at least because this structural
configuration provides a mechanism for increasing the amount of
attachment between first implant component 102 and the surface at
an implant site.
[0081] The serrated first implant projection second end 126 of each
projection of the plurality of first implant projections 114 is
configured such that it has a plurality of projection declining
surfaces 127. Each projection declining surface of the plurality of
projection declining surfaces 127 extends from a first end 127'
toward first implant distal end 110 to a second end 127''. The
first end 127' is disposed a first projection distance from first
implant surface 116 and the second end 127'' is disposed a second
projection distance from first implant surface 116. 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 implanting
first implant component 102 at an implant site while also
preventing, or substantially preventing, first implant component
102 from becoming loose after being implanted. For example, during
implantation, first implant component 102 can be introduced at in
implant site without the serrated first implant projection second
end 126 of each projection of the plurality of projections 114
increasing resistance, or substantially increasing resistance. In
addition, after implantation, the serrated first implant projection
second end 126 of each projection of the plurality of projections
114 will be forced into the treatment site upon the application of
force on first articulating surface 118 and/or toward first implant
proximal end 108.
[0082] While each projection of the plurality of first implant
projections 114 has been illustrated and described as disposed
between the first implant proximal end 108 and first implant distal
end 110, 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.
[0083] While a plurality of first implant projections 114 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.
[0084] While the first implant projection second end 126 of each
projection of the plurality of first implant projections 114 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 of
projection declining surfaces 127 and/or any other portion of a
first implant projection of the plurality of first implant
projections 114 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.
[0085] In the illustrated embodiment, second implant component 104
comprises a second implant proximal end 130, second implant distal
end 132, second implant body 134, and a plurality of second implant
projections 136.
[0086] Second implant body 134 defines a concave, or substantially
concave, second implant surface 138, recess 139, and a plurality of
recess projections 140. Second implant surface 138 is smooth,
substantially smooth, or uninterrupted and has a radius of
curvature that extends from the second implant proximal end 130 to
the second implant distal end 132.
[0087] Recess 139 is adapted to receive a portion, or the entirety,
of insert 106, as described in more detail herein. Recess 139 has a
recess length 141, recess base 142, recess distal end 143, recess
first portion 144, and a recess second portion 146. Recess 139
extends into second implant body 134 from a side opposably facing
second implant surface 138 to recess base 142 and from the second
implant proximal end 130 toward the second implant distal end 132
to recess distal end 143 disposed between second implant proximal
end 130 and second implant distal end 132. Recess length 141
extends from the second implant proximal end 130 toward the second
implant distal end 132 to recess distal end 143.
[0088] Each projection of the plurality of recess projections 140
extends into recess 139 along a portion, or the entirety, of recess
length 141 and has a tapered edge that is adapted to interact with
a portion of insert 106 to releasably attach insert 106 to second
implant component 104. Recess base 142 is opposably facing, or
substantially opposably facing, second implant surface 138, is
convex, or substantially convex, and is smooth, substantially
smooth, or uninterrupted. Recess base 142 has a radius of curvature
that extends from the second implant proximal end 130 to recess
distal end 143. Recess first portion 144 extends from recess base
142 and away from the second implant surface 138 to the plurality
of recess projections 140 and has a recess first portion width 145
along the second implant proximal end 130. Recess second portion
146 extends from the recess first portion 144 and away from the
second implant surface 138 and has a recess second portion width
147 along the second implant proximal end 130 that is measured from
a first recess projection of the plurality of recess projections
140 to a second recess projection of the plurality of recess
projections 140. The recess first portion width 145 is different
than the recess second portion width 147. In the illustrated
embodiment, recess first portion width 145 is greater than the
recess second portion width 147. However, recess first portion
width 145 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.
[0089] While second implant surface 138 has been described as
concave, or substantially concave, and recess base 142 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.
[0090] Second implant surface 138 and recess base 142 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.
[0091] While second implant surface 138 has been described as
having a radius of curvature that extends from the second implant
proximal end 130 to the second implant distal end 132 and recess
base 142 has been described as having a radius of curvature that
extends from the second implant proximal end 130 to recess distal
end 143, 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.
[0092] While second implant surface 138 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.
[0093] While second implant body 134 has been described as defining
a recess 139 with a recess length 141, recess first portion 144,
and a recess second portion 146 and defining a plurality of recess
projections 140, 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).
[0094] While each projection of the plurality of recess projections
140 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.
[0095] In the illustrated embodiment, each projection of the
plurality of second implant projections 136 has a second implant
projection proximal end 150, second implant projection distal end
152, and extends outward and away, or radially outward, from second
implant surface 138 at a 90 degree, or substantially 90 degree,
angle from a second implant projection first end 154 to a second
implant projection second end 156. Each projection of the plurality
of second implant projections 136 is elongated, is disposed between
second implant proximal end 130 and second implant distal end 132,
and defines a serrated second implant projection second end 156. It
is considered advantageous for each projection of the plurality of
second implant projections 136 to define a serrated second implant
projection second end 156 at least because this structural
configuration provides a mechanism for increasing the amount of
attachment between the second implant component 104 and the surface
at an implant site.
[0096] The serrated second implant projection second end 156 of
each projection of the plurality of second implant projections 136
is configured such that it has a plurality of projection declining
surfaces 157. Each projection declining surface of the plurality of
projection declining surfaces 157 extends from a first end 157'
toward second implant distal end 132 to a second end 157''. The
first end 157' is disposed a first projection distance from second
implant surface 138 and the second end 157'' is disposed a second
projection distance from second implant surface 138. 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 implanting
second implant component 104 at an implant site while also
preventing, or substantially preventing, second implant component
104 from becoming loose after being implanted. For example, during
implantation, second implant component 104 can be introduced at in
implant site without the serrated second implant projection second
end 156 of each projection of the plurality of projections 136
increasing resistance, or substantially increasing resistance. In
addition, after implantation, the serrated second implant
projection second end 156 of each projection of the plurality of
projections 136 will be forced into the treatment site upon the
application of force on second implant body 134 and/or toward
second implant proximal end 130.
[0097] While each projection of the plurality of second implant
projections 136 has been illustrated and described as disposed
between the second implant proximal end 130 and second implant
distal end 132, 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.
[0098] While a plurality of second implant projections 136 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.
[0099] While the second implant projection second end 156 of each
projection of the plurality of second implant projections 136 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 of
projection declining surfaces 157 and/or any other portion of a
second implant projection of the plurality of second implant
projections 136 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.
[0100] In the illustrated embodiment, a first projection of the
plurality of first implant projections 114 is disposed parallel, or
substantially parallel, to a second projection of the plurality of
first implant projections 114 and a first projection of the
plurality of second implant projections 136 is disposed parallel,
or substantially parallel, to a second projection of the plurality
of second implant projections 136. It is considered advantageous to
position a first projection of the plurality of first implant
projections 114 parallel, or substantially parallel, to a second
projection of the plurality of first implant projections 114 and a
first projection of the plurality of second implant projections 136
parallel, or substantially parallel, to a second projection of the
plurality of second implant projections 136 at least because this
configuration allows for the first implant component 102 and/or
second implant component 104 to be seated properly at the implant
site and provides a mechanism for reducing the complexity of the
implant procedure during the introduction of the first implant
component 102 and/or second implant component 104.
[0101] While first implant component 102 has been illustrated and
described as having a first projection of the plurality of first
implant projections 114 being disposed parallel, or substantially
parallel, to a second projection of the plurality of first implant
projections 114 and second implant component 104 has been
illustrated and described as having a first projection of the
plurality of second implant projections 136 being disposed
parallel, or substantially parallel, to a second projection of the
plurality of first implant projections 136, 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.
[0102] While each implant projection of the plurality of first
implant projections 114 has been illustrated and described as
extending outward and away from first implant surface 116 at a 90
degree, or substantially 90 degree, angle, and each projection of
the plurality of second implant projections 136 has been
illustrated and described as extending outward and away from second
implant surface 138 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.
[0103] Insert 106 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 form insert 106 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.
[0104] In the illustrated embodiment, insert 106 comprises an
insert proximal end 160, insert distal end 162, and an insert body
164. Insert 106 is adapted to be releasably attached to the second
implant component 104, as described in more detail herein.
[0105] Insert body 164 defines an insert base 166, insert
articulating portion 168, insert recess 170, and an insert shoulder
172. Insert base 166 has an insert base surface 174 and the insert
articulating portion 168 has an insert articulating surface 176.
Insert base surface 174 has a radius of curvature that extends from
insert proximal end 160 to shoulder 172 and insert articulating
surface 176 has a radius of curvature that extends from the insert
proximal end 160 to the insert distal end 162. Insert base surface
174 is concave, or substantially concave, and is opposably facing,
or substantially opposably facing, insert articulating surface 176
which is convex, or substantially convex. Insert base surface 174
is smooth, substantially smooth, or uninterrupted, and is
complementary to recess base 142 such that insert 106 is slidable
along recess base 142 and releasable attachment between insert 106
and second implant component 104 can be accomplished. Insert
articulating surface 176 is smooth, substantially smooth, or
uninterrupted, and is complementary to first articulating surface
118 such that insert 106 can articulate with first implant
component 102. Thus, insert articulating surface 176 is adapted to
articulate with first articulating surface 118.
[0106] Insert base 166 has an insert base width 167 along insert
proximal end 160 and insert articulating portion 168 has an insert
articulating width 169 along insert proximal end 160. Insert base
width 167 is equal to, substantially equal to, less than, or
greater than, recess first portion width 145. Insert articulating
width 169 is equal to, substantially equal to, less than, or
greater than, recess second portion width 147. It is considered
advantageous to include an insert 106 having an insert base width
167 that is equal to, substantially equal to, or greater than, the
recess first portion width 145 at least because this structural
arrangement provides a mechanism for introducing insert base 166
into recess first portion 144 and provides a mechanism for
achieving a friction fit between insert and second implant
component 104. It is considered advantageous to include an insert
106 having a insert articulating width 169 that is equal to,
substantially equal to, or greater than, the recess second portion
width 147 at least because this structural arrangement provides a
mechanism for achieving a friction fit between insert 106 and
second implant component 104. Thus, each of insert base 166 and
insert articulating portion 168 is adapted to interact with recess
139 (e.g., each projection of the plurality of recess projections
140) to create a friction fit between insert 106 and second implant
component 104.
[0107] Insert recess 170 extends into insert body 164 from insert
distal end 162 and toward insert proximal end 160 and from insert
base surface 174 toward insert articulating surface 176 to define
insert shoulder 172. Insert shoulder 172 is disposed between insert
proximal end 160 and insert distal end 162 and is disposed a
distance from insert proximal end 160 that is equal to, or
substantially equal to, recess length 141. Thus, insert base 166
extends from the insert proximal end 160 toward the insert distal
end 162 to insert shoulder 172 a distance that is equal to, or
substantially equal to, recess length 141. Insert articulating
surface 176 extends from insert proximal end 160 to insert distal
end 162. This structural arrangement is considered advantageous at
least because insert shoulder 172 provides a mechanical stop to
distal axial movement of insert 106 when it is being introduced
into recess 139. It is considered advantageous for insert
articulating surface 176 to extend from insert proximal end 160 to
insert distal end 162 at least because this structural arrangement
provides additional structure distal to insert shoulder 172 and
recess 139 when insert 106 is releasably attached to second implant
component 104, that can be utilized for articulation purposes.
[0108] Each of FIGS. 5 and 6 illustrates an exploded view of
implant system 100 and the relationship between the first implant
component 102, second implant component 104, and insert 106. In
use, each of the first implant component 102 and second implant
component 104 is adapted to be attached at a treatment site such
that first articulating surface 118 and recess 139 (e.g., recess
base 142) are facing, or substantially facing, each other. Insert
106 is releasably attached to the second implant component 104 by
sliding insert base 166 into recess first portion 144 and applying
a distally directed axial movement on insert 106 until insert
shoulder 172, which is adapted to interact with recess distal end
143, contacts recess distal end 143 and prevents additional distal
axial movement of insert 106. Insert articulating surface 176 is
adapted to articulate with first articulating surface 118 to
provide a range of movement between the insert 106 and first
implant component 102.
[0109] While insert 106 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.
[0110] While insert 106 has been described as being releasably
attached to second implant component 104 via friction fit between
second implant component 104 and insert 106, 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.
[0111] While insert 106 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.
[0112] Insert base surface 174 and insert articulating surface 176
can have any suitable radius of curvature and insert 106 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.
[0113] While the insert base surface 174 has been described as
having a radius of curvature that extends from insert proximal end
160 toward the insert distal end 162 to insert shoulder 172 and
insert articulating surface 176 has been described as having a
radius of curvature that extends from insert proximal end 160 to
insert distal end 162, 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.
[0114] Implant system 100 can be utilized in any suitable manner
and in any suitable location in a body. For example, implant system
100 can be utilized in subtalar joint arthroplasty, such as to
modify the posterior facet of the subtalar joint, as illustrated in
FIG. 3. Implant system 100 can be implanted using any suitable
method and/or approach. When modifying the posterior facet of the
subtalar joint, it is considered advantageous to introduce implant
system 100 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.
[0115] Alternative to first implant component 102 being adapted to
be attached to the talus 12 and second implant component 104 being
adapted to be attached to the calcaneus 14, 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.
[0116] Alternative to including an insert 106, 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., recess
139).
[0117] FIGS. 7, 8, 9, and 10 illustrate a second exemplary surgical
implant system 200. Implant system 200 is similar to implant system
100 illustrated in FIGS. 3, 4, 5, and 6, and described above,
except as detailed below. Reference numbers in FIGS. 7, 8, 9, and
10 refer to the same structural element or feature referenced by
the same number in FIGS. 3, 4, 5, and 6, offset by 100. Thus,
implant system 200 comprises a first implant component 202, a
second implant component 204, and an insert 206.
[0118] In the illustrated embodiment, first implant component 202
includes a plurality of first implant projections 214, a first
implant tab 277, and a plurality of fasteners 278. Each projection
of the plurality of first implant projections 214 extends outward
and away from the first implant surface 216 from a first implant
projection first end 224 to a first implant projection second end
226. Alternative to elongate projections 114 as illustrated in
FIGS. 3, 4, 5, and 6, each projection of the plurality of
projections 214 and has a circular, or substantially circular,
cross section along its length from the first implant projection
first end 224 to the first implant projection second end 226 and
extends from the first implant surface 216 at an angle. In
addition, each projection of the plurality of first implant
projections 214 defines a first implant projection second end 226
that is pointed.
[0119] First implant tab 277 comprises a first implant tab wall 279
that defines a plurality of first implant bores 280. First implant
tab 277 extends outward and away from first implant surface 216 at
an angle and along a portion of first implant proximal end 208.
Each bore of the plurality of first implant bores 280 extends
through the first implant tab wall 279 from the first implant
proximal end 208 toward the first implant distal end 210 at an
acute angle to first implant surface 216 and is adapted to receive
a portion of a fastener of the plurality of fasteners 278.
Optionally, each bore of the plurality of first implant bores 280,
or a portion thereof, can be countersunk or counterbored to allow a
fastener to sit flush with, or below, the outer surface of first
implant tab 277.
[0120] Each fastener of the plurality of fasteners 278 has a
fastener first end 281 that is adapted to receive a tool used to
install the fastener at an implant site and a fastener second end
282 that is threaded and adapted to be received by a pre-drilled
bore at the implant site. Each fastener of the plurality of
fasteners 278 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 first implant tab wall 279
and a second fastener is disposed through a second bore defined by
first implant tab wall 279. A fastener can be disposed through each
bore defined by a first implant tab wall.
[0121] While first implant tab 277 has been illustrated and
described as extending outward and away from first implant surface
216 and along a portion of first implant proximal end 208, 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.
[0122] While each bore of the plurality of first implant bores 280
has been illustrated and described as extending through the first
implant tab wall 279 from the first implant proximal end 208 toward
the first implant distal end 210 at an acute angle to first implant
surface 216, 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.
[0123] While a plurality of first implant bores 280 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.
[0124] In the illustrated embodiment, second implant component 204
includes a plurality of second implant projections 236, a second
implant tab 283, and a plurality of fasteners 278. Each projection
of the plurality of second implant projections 236 extends outward
and away from the second implant surface 238 from a second implant
projection first end 254 to a second implant projection second end
256. Alternative to elongate projections 136 as illustrated in
FIGS. 3, 4, 5, and 6, each projection of the plurality of second
implant projections 236 has a circular, or substantially circular,
cross section along its length from the second implant projection
first end 254 to the second implant projection second end 256 and
extends from the second implant surface 238 at an angle. In
addition, each projection of the plurality of second implant
projections 236 defines a second implant projection second end 256
that is pointed.
[0125] Second implant tab 283 comprises a second implant tab wall
284 that defines a plurality of second implant bores 285. Second
implant tab 283 extends outward and away from the second implant
surface 238 away from second implant distal end 232 at an obtuse,
or substantially obtuse, angle and along a portion of second
implant proximal end 230. Each bore of the plurality of second
implant bores 285 extends through the second implant tab wall 284
from the second implant proximal end 230 toward the second implant
distal end 232 at an acute angle to second implant surface 238 and
is adapted to receive a portion of a fastener of the plurality of
fasteners 278. Optionally, each bore of the plurality of second
implant bores 285, or a portion thereof, can be countersunk or
counterbored to allow a fastener to sit flush with, or below, the
outer surface of second implant tab 283. A first fastener is
disposed through a first bore defined by second implant tab wall
284 and a second fastener is disposed through a second bore defined
by second implant tab wall 284. A fastener can be disposed through
each bore defined by a second implant tab wall.
[0126] In the illustrated embodiment, each bore of the plurality of
first implant bores 280 and each bore of the plurality of second
implant bores 285 has a bore axis that extends through its center.
Each bore axis of the plurality of first implant bores 280 is
disposed on a first plane and each bore axis of the plurality of
second implant bores 285 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.
[0127] While second implant tab 283 has been illustrated and
described as extending outward and away from second implant surface
238 and along a portion of second implant proximal end 230, 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.
[0128] While each bore of the plurality of second implant bores 285
has been illustrated and described as extending through the second
implant tab wall 284 from the second implant proximal end 230
toward the second implant distal end 232 at an acute angle to
second implant surface 238, 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.
[0129] While a plurality of second implant bores 285 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.
[0130] While a plurality of fasteners 278 have been illustrated and
described as providing a secondary method of attachment between the
first implant component 202 and the surface at an implant site
and/or the second implant component 204 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.
[0131] Each projection of the plurality of first implant
projections 214 and each projection of the plurality of second
implant projections 236 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.
[0132] While first implant tab 277 has been illustrated and
described as extending outward and away from the first implant
surface 216 at an angle and second implant tab 283 has been
illustrated and described as extending outward and away from second
implant surface 238 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.
[0133] Each bore of the plurality of first implant bores 280 and/or
each bore of the plurality of second implant bores 285 can
optionally be adapted to receive a multi-angle screw that can
include a locking cap on fastener first end 281. 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.
[0134] FIGS. 11, 12, 13, and 14 illustrate a third exemplary
surgical implant system 300. Implant system 300 is similar to
implant system 200 illustrated in FIGS. 7, 8, 9, and 10, and
described above, except as detailed below. Reference numbers in
FIGS. 11, 12, 13, and 14 refer to the same structural element or
feature referenced by the same number in FIGS. 7, 8, 9, and 10,
offset by 100. Thus, implant system 300 comprises a first implant
component 302, a second implant component 304, and an insert
306.
[0135] In the illustrated embodiment, second implant component 304
omits the inclusion of a second implant tab, as illustrated and
described with respect to FIGS. 7, 8, 9, and 10, and includes a
plurality of second implant projections 336 and second implant body
334 defines a plurality of second implant protuberances 386.
[0136] Each projection of the plurality of second implant
projections 336 extends outward and away from the second implant
surface 338 from a second implant projection first end 354 toward
the second implant distal end 332 to a second implant projection
second end 356 at an acute angle with respect to implant surface
338. This configuration advantageously allows for placement and
implantation of second implant component 304 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 projections 336 (e.g., second implant
component 204). Thus, it is considered advantageous to include a
plurality of second implant projections 336 that extend at an angle
with respect to second implant surface 338 at least to allow second
implant component 304 to be implanted at an angle and to reduce the
distance required between the second implant component 304 and an
implant surface while second implant component 304 is being
introduced.
[0137] Second implant body 334 defines the plurality of second
implant protuberances 386 between the second implant proximal end
330 and the second implant distal end 332. Each protuberance of the
plurality of second implant protuberances 386 extends outward and
away from the second implant surface 338 toward the second implant
distal end 332 from a protuberance first end 387 to a protuberance
second end 388. Each protuberance of the plurality of second
implant protuberances 386 extends at an acute, or substantially
acute, angle with respect to second implant surface 338. The second
implant body 334 defines a passageway 389 through each protuberance
of the plurality of second implant protuberances 386 that extends
from a first opening defined on recess base 342 to second opening
defined on protuberance second end 388. Each passageway 389
provides access for passing a portion of a fastener of the
plurality of fasteners 378 through a protuberance of the plurality
of second implant protuberances 386 to attach, or assist with
attaching, second implant component 304 at an implant site.
Optionally, each passageway 389 defined by second implant body 334,
or a portion thereof, can be countersunk or counterbored to allow a
fastener to sit flush with, or below, the outer surface of recess
base 342. Thus, a first fastener is disposed through a first
passageway defined by second implant body 334 and a second fastener
is disposed through a second passageway defined by second implant
body 334. A fastener can be disposed through each passageway
defined by a second implant body.
[0138] In the illustrated embodiment, each bore of the plurality of
first implant bores 380 has a bore axis that extends through its
center and each passageway 389 defined by second implant body 334
has a passageway axis that extends through its center. Each bore
axis of the plurality of first implant bores 380 is disposed on a
first plane and each passageway axis of each passageway 389 defined
by second implant body 334 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.
[0139] While a plurality of second implant protuberances 386 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.
[0140] While each protuberance of the plurality of second implant
protuberances 386 has been illustrated and described as extending
at an acute angle with respect to second implant surface 338, 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.
[0141] FIGS. 15, 16, 17, and 18 illustrate a fourth exemplary
surgical implant system 400. The implant system 400 is similar to
implant system 300 illustrated in FIGS. 11, 12, 13, and 14, and
described above, except as detailed below. Reference numbers in
FIGS. 15, 16, 17, and 18 refer to the same structural element or
feature referenced by the same number in FIGS. 11, 12, 13, and 14,
offset by 100. Thus, implant system 400 comprises a first implant
component 402, a second implant component 404, and an insert
406.
[0142] In the illustrated embodiment, the first implant component
402 omits the inclusion of a first implant tab, as illustrated and
described with respect to FIGS. 11, 12, 13, and 14, and includes a
plurality of first implant projections 414 and a porous first
implant surface 416. It is considered advantageous for first
implant component 402 to have a porous, or substantially porous,
first implant surface 416 at least because this type of surface
increases the amount of bone ingrowth between first implant
component 402 and the bone at an implant site. The structural
configuration of first implant component 402 (e.g., omitting the
inclusion of a first implant tab) is considered advantageous at
least because it reduces the overall size of first implant
component 402 and reduces the complexity of implanting first
implant component 402 at a treatment site.
[0143] FIGS. 19, 20, 21, and 22 illustrate a fifth exemplary
surgical implant system 500. The implant system 500 is similar to
implant system 400 illustrated in FIGS. 15, 16, 17, and 18, and
described above, except as detailed below. Reference numbers in
FIGS. 19, 20, 21, and 22 refer to the same structural element or
feature referenced by the same number in FIGS. 15, 16, 17, and 18,
offset by 100. Thus, implant system 500 comprises a first implant
component 502, a second implant component 504, and an insert
506.
[0144] In the illustrated embodiment, first implant component 502
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 body 512 defines a flat, or
substantially flat, first implant surface 516 and an opposably
facing concave, or substantially concave, first articulating
surface 518. In addition, first implant body 512 defines a
plurality of first implant bores 590. Each bore of the plurality of
first implant bores 590 extends from a first opening defined on
first implant proximal end 508 to a second opening defined on first
implant surface 516. Each bore of the plurality of first implant
bores 590 provides access for a fastener of the plurality of
fasteners 578, such that attachment between first implant component
502 at an implant site can be accomplished. Optionally, each bore
of the plurality of first implant bores 590, or a portion thereof,
can be countersunk or counterbored to allow a fastener to sit flush
with, or below, the outer surface of first implant 502. Thus, a
first fastener is disposed through a first bore defined by first
implant body 512 and a second fastener is disposed through a second
bore defined by first implant body 512. A fastener can be disposed
through each bore defined by a first implant body.
[0145] 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 body 534 defines a flat, or substantially flat, second
implant surface 538, a recess 539 that has a flat, or substantially
flat, recess base 542, and a plurality of recess protuberances 591.
In addition, alternative to second implant body defining a
plurality of recess projections, second implant body 534 defines a
ridge 592 that extends into recess 539. Thus, second implant
component 504 comprises a second implant proximal end 530, second
implant distal end 532, and a second implant body 534. Second
implant body 534 defines recess 539 that extends into second
implant body 534 from the second implant proximal end 530 toward
the second implant distal end 532 and a ridge 592 that extends into
recess 539.
[0146] Each protuberance of the plurality of recess protuberances
591 is disposed along the recess length 541 of recess first portion
544 between the second implant proximal end 530 an recess distal
end 543 and extends into recess first portion 544. Each
protuberance of the plurality of protuberances 591 tapers from the
distal end of the protuberance to the proximal end of the
protuberance. A first protuberance of the plurality of
protuberances 591 is disposed on a first recess side 593 and a
second protuberance of the plurality of protuberances 591 is
disposed on a second recess side 594. The first recess side 593 is
opposite, or substantially opposite, the second recess side 594
across recess 539. Each of the first recess side 593 and second
recess side 594 extends from the second implant proximal end 530 to
the recess distal end 543.
[0147] Recess first portion 544 extends from recess base 542 to
ridge 592 and has a recess first portion width 545 along the second
implant proximal end 530. Recess second portion 546 has a recess
second portion width 547 along the second implant proximal end 530
that is different than recess first portion width 545. In the
illustrated embodiment, recess second portion width 547 is less
than recess first portion width 545 an amount that is equal to, or
substantially equal to, the distance ridge 592 extends into recess
539 on first recess side 593 and second recess side 594.
[0148] Ridge 592 extends into recess 539 about the entirety, or a
portion of, the perimeter of recess 539. Thus, ridge 592 extends
into recess 539 along the first recess side 593, second recess side
594, and recess distal end 543. The structural arrangement of
second implant body 534 and recess 539 is considered advantageous
at least because it provides a mechanism for releasably attaching
an insert, such as insert 506, to second implant component 504.
[0149] In the illustrated embodiment, each bore of the plurality of
first implant bores 590 has a bore axis that extends through its
center and each passageway 589 defined by second implant body 534
has a passageway axis that extends through its center. Each bore
axis of the plurality of first implant bores 590 is disposed on a
first plane and each passageway axis of each passageway 589 defined
by second implant body 534 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.
[0150] While each protuberance of the plurality of protuberances
591 has been described and illustrated as having a tapered
configuration and as being positioned in the recess first portion
544, 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.
[0151] In the illustrated embodiment, and alternative to having an
insert base surface that is concave, or substantially concave,
insert body 564 defines an insert base surface 574 that is flat, or
substantially flat, and that is complementary to recess base 542.
In addition, insert body 564 defines a plurality of first insert
recesses 595 and second insert recess 596. A first recess of the
plurality of first insert recesses 595 extends into insert base 566
on an insert first side 597 and a second recess of the plurality of
insert recesses 595 extends into insert base 566 on an insert
second side 598. Each recess of the plurality of insert recesses
595 is disposed between the insert proximal end 560 and insert
distal end 562 and tapers from the distal end of the recess to the
proximal end of the recess. Each recess of the plurality of insert
recesses 595 is complementary to a protuberance of the plurality of
recess protuberances 591. This configuration is considered
advantageous at least because it provides a mechanism for
releasably attaching insert 506 to second implant component
504.
[0152] In addition to defining shoulder 570, insert body 564
defines second insert recess 596 between insert base 566 and insert
articulating surface 576. Second insert recess 596 extends along
the entirety, or a portion of, insert distal end 562 and
complements ridge 592 along the recess distal end 543. Second
insert recess 596 extends into insert body 564 a distance that is
equal to, or substantially equal to, less than, or greater than,
the distance that ridge 592 extends into recess 539. Thus, second
insert recess 596 is adapted to interact with ridge 592 of recess
539.
[0153] In use, as shown in FIG. 19, as distally directed axial
movement is placed on insert 506, shown as arrow 599, insert base
566 is inserted into recess first portion 544. As distally directed
axial movement continues to be placed on insert 506, a first
protuberance of the plurality of protuberances 591 will engage with
a first recess of the plurality of first insert recesses 595 to
attach insert 506 to second implant component 504.
[0154] FIGS. 23, 24, and 25 illustrate a sixth exemplary surgical
implant system 600. The implant system 600 is similar to implant
system 500 illustrated in FIGS. 19, 20, 21, and 22, and described
above, except as detailed below. Reference numbers in FIGS. 23, 24,
and 25 refer to the same structural element or feature referenced
by the same number in FIGS. 19, 20, 21, and 22, offset by 100.
Thus, implant system 600 comprises a first implant component 602, a
second implant component 604, and an insert 606.
[0155] Alternative to introducing an implant system using a lateral
and posterior approach, as described above, the illustrated
embodiment provides an implant system 600 that can be introduced
into a body using a medial and posterior approach.
[0156] 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 body 612 defines a first articulating surface 618 that
extends from a first implant first side 700 to a first implant
second side 702. Each of the first implant first side 700 and first
implant second side 702 extends from first implant proximal end 608
to first implant distal end 610.
[0157] 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 body 612 defines a plurality of first implant protuberances
704. Each protuberance of the plurality of first implant
protuberances 704 extends outward and away from the first implant
surface 616 from a protuberance first end 706 toward first implant
distal end 610 to a protuberance second end 708 at an acute, or
substantially acute, angle with respect to first implant surface
616. The first implant body 612 defines a passageway 710 through
each protuberance of the plurality of first implant protuberances
704 and that extends from a first opening defined on the first
implant proximal end 608 to a second opening defined on the
protuberance second end 708. Each passageway 710 provides access
for passing a fastener of the plurality of fasteners 678 through a
protuberance of the plurality of protuberances 704 to attach, or
assist with attaching, first implant component 602 at an implant
site. Optionally, each passageway 710 defined by first implant body
612, or a portion thereof, can be countersunk or counterbored to
allow a fastener to sit flush with, or below, the outer surface of
first implant 602. Thus, a first fastener is disposed through a
first passageway defined by first implant body 612 and a second
fastener is disposed through a second passageway defined by first
implant body 612. A fastener can be disposed through each
passageway defined by a first implant body.
[0158] In the illustrated embodiment, second implant component 604
comprises a second implant proximal end 630, second implant distal
end 632, and a second implant body 634. Second implant body 634
defines recess 639 that extends into second implant body 634 from
the second implant proximal end 630 toward the second implant
distal end 632 and a ridge 692 that extends into recess 639.
[0159] In the illustrated embodiment, each passageway 710 defined
by first implant body 612 has a passageway axis that extends
through its center and each passageway 689 defined by second
implant body 634 has a passageway axis that extends through its
center. Each passageway axis of each passageway 710 defined by
first implant body 612 is disposed on a first plane and each
passageway axis of each passageway 689 defined by second implant
body 634 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.
[0160] In the illustrated embodiment, insert 606 comprises an
insert proximal end 660, insert distal end 662, and an insert body
664. 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),
insert body 664 defines an insert articulating surface 676 that has
a radius of curvature that extends from insert first side 697 to
insert second side 698.
[0161] In addition, insert body 664 defines second insert recess
696 between insert base 666 and insert articulating surface 676.
Second insert recess 696 extends along insert first side 697,
insert second side 698, and insert distal end 662. Second insert
recess 696 extends into insert body 664 a distance that is equal
to, or substantially equal to, less than, or greater than, the
distance that ridge 692 extends into recess 639. Insert base width
667 is equal to, substantially equal to, less than, or greater
than, recess first portion width 645. Insert articulating width 669
is greater than insert base width 667.
[0162] While insert articulating width 669 has been described and
illustrated as being greater than insert base width 667, 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.
[0163] FIGS. 26, 27, 28, and 29 illustrate a seventh exemplary
surgical implant system 800. The implant system 800 is similar to
implant system 500 illustrated in FIGS. 19, 20, 21, and 22, and
described above, except as detailed below. Reference numbers in
FIGS. 26, 27, 28, and 29 refer to the same structural element or
feature referenced by the same number in FIGS. 19, 20, 21, and 22,
offset by 300. Thus, implant system 800 comprises a first implant
component 802, a second implant component 804, and an insert
806.
[0164] In the illustrated embodiment, alternative to second implant
component being adapted to be attached to the calcaneus, as
described above, second implant component 804 is adapted to be
attached to the talus 12. Alternative to including a plurality of
second implant protuberances and a plurality of second implant
projections that extend from second implant surface, second implant
body 834 defines a plurality of bores 912 that extend through the
second implant proximal end 830 and through the second implant
surface 838. Alternative to second implant body defining a recess
base that is flat, or substantially flat, second implant body 834
defines a recess 839 having a recess base 842 that is concave, or
substantially concave. Optionally, each bore of the plurality of
second implant bores 912, or a portion thereof, can be countersunk
or counterbored to allow a fastener to sit flush with, or below,
the outer surface of second implant 804. Thus, a first fastener is
disposed through a first bore defined by second implant body 834
and a second fastener is disposed through a second bore defined by
second implant body 834. A fastener can be disposed through each
bore defined by a second implant body.
[0165] In the illustrated embodiment, alternative to first implant
component being adapted to be attached to the talus, as described
above, first implant component 802 is adapted to be attached to the
calcaneus 14. Alternative to first implant body defining a first
articulating surface that is concave, or substantially concave,
first implant body 812 defines a first articulating surface 818
that is convex, or substantially convex.
[0166] In the illustrated embodiment, each bore of the plurality of
first implant bores 890 and each bore of the plurality of second
implant bores 912 has a bore axis that extends through its center.
Each bore axis of the plurality of first implant bores 890 is
disposed on a first plane and each bore axis of the plurality of
second implant bores 912 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.
[0167] In the illustrated embodiment, alternative to insert body
defining an insert base surface having a flat, or substantially
flat, surface, insert body 864 defines an insert base surface 874
that is convex, or substantially convex, such that it compliments
recess base 842. In addition, alternative to insert body defining
an insert articulating surface that is convex, or substantially
convex, insert body 864 defines an insert articulating surface 876
that is concave, or substantially concave, such that it compliments
first articulating surface 818. Insert articulating surface 876 is
adapted to articulate with first articulating surface 818.
[0168] 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 recess 596), insert body 864
defines a plurality of second insert recesses 896. Each recess of
the plurality of second insert recesses 896 is disposed between the
insert base surface 874 and insert articulating surface 876 and
extends from the insert proximal end 860 toward the insert distal
end 862 to insert shoulder 870. Each recess of the plurality of
second insert recesses 896 extends into insert body 864 a distance
that is equal to, or substantially equal to, less than, or greater
than, the distance that ridge 892 extends into recess 839. Thus,
each recess of the plurality of insert second recesses 896 is
adapted to interact with ridge 892 of recess 839. In the
illustrated embodiment, ridge 892 and each recess of the plurality
of recesses 896 has a tapered configuration.
[0169] FIGS. 30, 31, 32, and 33 illustrate an eighth exemplary
surgical implant system 1000. The implant system 1000 is similar to
implant system 500 illustrated in FIGS. 19, 20, 21, and 22, and
described above, except as detailed below. Reference numbers in
FIGS. 30, 31, 32, and 33 refer to the same structural element or
feature referenced by the same number in FIGS. 19, 20, 21, and 22,
offset by 500. Thus, implant system 1000 comprises a first implant
component 1002, a second implant component 1004, and an insert
1006.
[0170] In the illustrated embodiment, second implant body 1034
defines a recess 1039 that omits the inclusion of a recess second
portion (e.g., recess second portion 546), a plurality of recess
protuberances (e.g., plurality of recess protuberances 591), and
ridge (e.g., ridge 592). Thus, recess 1039 extends from second
implant proximal end 1030 to second implant distal end 1032 and
from recess base 1042 away from second implant surface 1038. Recess
1039 has a recess length 1041 and a recess width 1045. Recess
length 1041 extends from the second implant proximal end 1030 to
the second implant distal end 1032 and recess width 1045 extends
along the second implant proximal end 1030. Thus, second implant
body 1034 defines a recess 1039 that extends the length of second
implant component 1004 and that omits the inclusion of a ridge
(e.g., ridge 592).
[0171] In the illustrated embodiment, insert 1006 comprises an
insert proximal end 1060, insert distal end 1062, and an insert
body 1064. Insert body 1064 defines an insert base surface 1074 and
an insert articulating surface 1076. Insert base surface 1074 is
flat, or substantially flat, and insert articulating surface 1076
has a radius of curvature that extends from the insert proximal end
1060 to the insert distal end 1062 and that is convex, or
substantially convex.
[0172] Insert 1006 has an insert length 1063 that extends from the
insert proximal end 1060 to the insert distal end 1062 and an
insert width 1069 that extends along the insert proximal end 1060.
Insert length 1063 is equal to, or substantially equal to, greater
than, or less than, recess length 1041 and recess width 1069 is
equal to, substantially equal to, less than, or greater than,
recess width 1045.
[0173] FIGS. 34, 35, 36, and 37 illustrate a ninth exemplary
surgical implant system 1100. The implant system 1100 is similar to
implant system 600 illustrated in FIGS. 23, 24, and 25, and
described above, except as detailed below. Reference numbers in
FIGS. 34, 35, 36, and 37 refer to the same structural element or
feature referenced by the same number in FIGS. 23, 24, and 25,
offset by 500. Thus, implant system 1100 comprises a first implant
component 1102, a second implant component 1104, and an insert
1106.
[0174] In the illustrated embodiment, second implant body 1134
defines a recess 1139 that omits the inclusion of a recess second
portion (e.g., recess second portion 646), a plurality of recess
protuberances (e.g., plurality of recess protuberances 691), and
ridge (e.g., ridge 692). Thus, recess 1139 extends from the second
implant proximal end 1130 to the second implant distal end 1132 and
from recess base 1142 away from second implant surface 1138. Recess
1139 has a recess length 1141 and a recess width 1145. Recess
length 1141 extends from the second implant proximal end 1130 to
the second implant distal end 1132 and recess width 1145 extends
along second implant proximal end 1130. Thus, second implant body
1134 defines a recess 1139 that extends the length of second
implant component 1104 and that omits the inclusion of a ridge
(e.g., ridge 692).
[0175] In the illustrated embodiment, insert 1106 omits the
inclusion of a plurality of first insert recesses (e.g., plurality
of first insert recesses 695) and second insert recess (e.g.,
second insert recess 696). Thus, insert 1006 comprises an insert
proximal end 1160, insert distal end 1162, and an insert body 1164.
Insert body 1164 defines an insert base 1166 and an insert
articulating portion 1168. Insert base 1166 has an insert base
surface 1174 and the insert articulating portion 1168 has an insert
articulating surface 1176. Insert base surface 1174 extends from
insert proximal end 1160 insert distal end 1162 and insert
articulating surface 176 has a radius of curvature that extends
from insert first side 1197 to insert second side 1198.
[0176] Insert base 1166 has an insert base width 1167 along the
insert proximal end 1160 and the insert articulating portion 1168
has an insert articulating width 1169 along the insert proximal end
1160. Insert base width 1167 is equal to, substantially equal to,
less than, or greater than, recess width 1145. Insert articulating
width 1169 is greater than insert base width 1167.
[0177] FIGS. 38, 39, 40, and 41 illustrate a tenth exemplary
surgical implant system 1200. The implant system 1200 is similar to
implant system 100 illustrated in FIGS. 3, 4, 5, and 6, and
described above, except as detailed below. Reference numbers in
FIGS. 38, 39, 40, and 41 refer to the same structural element or
feature referenced by the same number in FIGS. 3, 4, 5, and 6,
offset by 1100. Thus, implant system 1200 comprises a first implant
component 1202, a second implant component 1204, and an insert
1206.
[0178] In the illustrated embodiment, alternative to second implant
component defining a recess and a plurality of recess projections,
first implant body 1212 defines a convex, or substantially convex,
first implant surface 1216, recess 1239, and a plurality of recess
projections 1240. Recess 1239 is adapted to receive a portion, or
the entirety, of insert 1206. Recess 1239 has a recess length 1241,
recess base 1242, recess first portion 1244, and a recess second
portion 1246. Recess 1239 extends into first implant body 1212 to
recess base 1242 and from first implant proximal end 1208 to first
implant distal end 1210. Recess length 1241 extends from first
implant proximal end 1208 to first implant distal end 1210.
[0179] Each projection of the plurality of recess projections 1240
extends into recess 1239 along a portion, or the entirety, of
recess length 1241 and has a tapered edge that is adapted to
interact with a portion of insert 1206 to releasably attach insert
1206 to first implant component 1202. Recess base 1242 is opposably
facing, or substantially opposably facing, first implant surface
1216, is concave, or substantially concave, and is smooth,
substantially smooth, or uninterrupted.
[0180] Recess base 1242 has a radius of curvature that extends from
first implant proximal end 1208 to first implant distal end 1210.
Recess first portion 1244 extends from recess base 1242 to the
plurality of recess projections 1240 and has a recess first portion
width 1245 along first implant proximal end 1208. Recess second
portion 1246 has a recess second portion width 1247 along first
implant proximal end 1208 that is measured from a first recess
projection of the plurality of recess projections 1240 to a second
recess projection of the plurality of recess projections 1240. The
recess first portion width 1245 is greater than the recess second
portion width 1247.
[0181] In the illustrated embodiment, second implant body 1234
defines a concave, or substantially concave, second implant surface
1238 and an opposably facing, or substantially opposably facing,
convex, or substantially convex, second articulating surface 1243.
Each of the second implant surface 1238 and second articulating
surface 1243 has a radius of curvature that extends from second
implant proximal end 1230 to second implant distal end 1232. Second
implant surface 1238 is smooth, substantially smooth, or
uninterrupted and second articulating surface 1243 is smooth,
substantially smooth, or uninterrupted, such that articulation
between articulating surface 1243 and insert 1206 can be
accomplished, as described in more detail herein.
[0182] In the illustrated embodiment, insert 1206 comprises an
insert proximal end 1260, insert distal end 1262, and an insert
body 1264. Alternative to insert being attached to a second implant
component, insert 1206 is adapted to be attached to first implant
component 1202. In addition, alternative to insert body defining an
insert recess and a recess shoulder, insert body 1264 defines an
insert base 1266, insert articulating portion 1268, a first insert
recess 1296, and a second insert recess 1296'.
[0183] Insert base 1266 has an insert base surface 1274 and the
insert articulating portion 1268 has an insert articulating surface
1276. Each of insert base surface 1274 and insert articulating
portion 1268 has a radius of curvature that extends from insert
proximal end 1260 to insert distal end 1262. Insert base surface
1274 is convex, or substantially convex, and is opposably facing,
or substantially opposably facing, insert articulating surface
1276, which is concave, or substantially concave. Insert base
surface 1274 is smooth, substantially smooth, or uninterrupted, and
is complementary to recess base 1242 such that insert 1206 is
slidable along recess base 1242 and releasable attachment between
insert 1206 and first implant component 1202 can be accomplished.
Insert articulating surface 1276 is smooth, substantially smooth,
or uninterrupted, and is complementary to second articulating
surface 1243 such that insert 1206 can articulate with second
implant component 1204. Thus, insert articulating surface 1276 is
adapted to articulate with second articulating surface 1243.
[0184] Insert base 1266 has an insert base width 1267 along insert
proximal end 1260 and insert articulating portion 1268 has an
insert articulating width 1269 along insert proximal end 1260.
Insert base width 1267 is equal to, substantially equal to, less
than, or greater than, recess first portion width 1245. Insert
articulating width 1269 is greater than, recess second portion
width 1247.
[0185] Each of first insert recess 1296 and second insert recess
1296' extends into recess body 1264 between insert base 1266 and
insert articulating surface 1276. First insert recess 1296 extends
along insert first side 1297 and second insert recess 1296' extends
along insert second side 1298. Each of the first insert recess 1296
and second insert recess 1296' extends into insert body 1264 a
distance that is equal to, or substantially equal to, less than, or
greater than, the distance that a projection of the plurality of
projections 1270 extends into recess 1239. It is considered
advantageous to include an insert 1206 having a insert articulating
width 1269 that is greater than the recess second portion width
1247 and a first insert recess 1296 and second insert recess 1296'
at least because this structural arrangement provides a mechanism
for achieving a slideably engagement between a first implant
component 1202 and an insert.
[0186] FIGS. 42, 43, 44, and 45 illustrate an eleventh exemplary
surgical implant system 1300. The implant system 1300 is similar to
implant system 1200 illustrated in FIGS. 38, 39, 40, and 41, and
described above, except as detailed below. Reference numbers in
FIGS. 42, 43, 44, and 45 refer to the same structural element or
feature referenced by the same number in FIGS. 38, 39, 40, and 41,
offset by 100. Thus, implant system 1300 comprises a first implant
component 1302, a second implant component 1304, and an insert
1306.
[0187] In the illustrated embodiment, first implant component 1302
includes a plurality of first implant projections 1314, a first
implant tab 1377, and a plurality of fasteners 1378 and second
implant component 1304 includes a plurality of second implant
projections 1336, a second implant tab 1383, and a plurality of
fasteners 1378. The plurality of first implant projections 1314 is
similar to the plurality of first implant projections 214
illustrated in FIGS. 7, 8, 9, and 10. First implant tab 1377 is
similar to first implant tab 277 illustrated in FIGS. 7, 8, 9, and
10. The plurality of fasteners 1378 is similar to the plurality of
fasteners 278 illustrated in FIGS. 7, 8, 9, and 10. The plurality
of second implant projections 1336 is similar to the plurality of
second implant projections 236 illustrated in FIGS. 7, 8, 9, and
10. Second implant tab 1383 is similar to second implant tab 283
illustrated in FIGS. 7, 8, 9, and 10. Reference numbers relating to
the plurality of first implant projections 1314, first implant tab
1377, plurality of fasteners 1378, plurality of second implant
projections 1336, second implant tab 1383 in FIGS. 42, 43, 44, and
45 refer to the same structural element or feature referenced by
the same number in FIGS. 7, 8, 9, and 10, offset by 1100.
[0188] Thus, first implant tab 1377 comprises a first implant tab
wall 1379 that defines a plurality of first implant bores 1380,
each fastener of the plurality of fasteners 1378 has a fastener
first end 1381 and a fastener second end 1382, and second implant
tab comprises a second implant tab wall 1384 that defines a
plurality of second implant bores 1385. Optionally, each bore of
the plurality of first implant bores 1380, or a portion thereof,
can be countersunk or counterbored to allow a fastener to sit flush
with, or below, the outer surface of first implant 1302 and each
bore of the plurality of second implant bores 1385, or a portion
thereof, can be countersunk or counterbored to allow a fastener to
sit flush with, or below, the outer surface of second implant 1304.
Thus, a first fastener is disposed through a first bore defined by
first implant tab wall 1379 and a second fastener is disposed
through a second bore defined by first implant tab wall 1379 and a
first fastener is disposed through a first bore defined by second
implant tab wall 1384 and a second fastener is disposed through a
second bore defined by second implant tab wall 1384. A fastener can
be disposed through each bore defined by a first implant tab wall
and/or second implant tab wall.
[0189] In the illustrated embodiment, each bore of the plurality of
first implant bores 1380 and each bore of the plurality of second
implant bores 1385 has a bore axis that extends through its center.
Each bore axis of the plurality of first implant bores 1380 is
disposed on a first plane and each bore axis of the plurality of
second implant bores 1385 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.
[0190] 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.
[0191] 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).
[0192] FIG. 46 is a flowchart representation of an exemplary method
1400 of modifying a joint.
[0193] An initial step 1402 comprises creating an opening in a body
to provide access to a joint formed between a first bone and a
second bone. Another step 1404 comprises locating the first bone of
the joint. Another step 1406 comprises locating the second bone of
the joint. Another step 1408 comprises removing a first portion of
the first bone to configure the first bone to receive a first
implant component. Another step 1410 comprises removing a first
portion of the second bone to configure the second bone to receive
a second implant component. Another step 1412 comprises installing
the first implant component on the first bone. Another step 1414
comprises installing the second implant component on the second
bone. Another step 1416 comprises installing an insert on one of
the first implant component or second implant component. Another
step 1418 comprises closing the opening.
[0194] The step 1402 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.
[0195] While step 1402 has been illustrated and described as being
an initial step to methodology 1400, 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).
[0196] The step 1404 of locating the first bone of the joint, and
the step 1406 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.
[0197] The step 1408 of removing a first portion of the first bone
to configure the first bone to receive a first implant component,
and the step 1410 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.
[0198] 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.
[0199] 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.
[0200] 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.
[0201] The step 1412 of installing the first implant component on
the first bone, and the step 1414 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.
[0202] The step 1416 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.
[0203] 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.
[0204] The step 1418 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.
[0205] Methodology 1400 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.
[0206] While various steps, alternative steps, and/or optional
steps have been described above with respect to an exemplary method
of treatment 1400, 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 of treatment 1500, exemplary method of
treatment 1600, and/or exemplary method of treatment 1700.
[0207] FIG. 47 is a flowchart representation of an exemplary method
1500 of modifying the subtalar joint.
[0208] An initial step 1502 comprises creating an opening to
provide access to the subtalar joint formed between the talus and
calcaneus. Another step 1504 comprises locating the talus. Another
step 1506 comprises locating the calcaneus. Another step 1508
comprises removing a first portion of the talus to configure the
talus to receive a first implant component. Another step 1510
comprises removing a first portion of the calcaneus to configure
the calcaneus to receive a second implant component. Another step
1512 comprises installing the first implant component on the talus.
Another step 1514 comprises installing the second implant component
on the calcaneus. Another step 1516 comprises installing an insert
on one of the first implant component or second implant component.
Another step 1518 comprises closing the opening.
[0209] The step 1502 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).
[0210] An alternative step to the step 1512 of installing the first
implant component on the talus comprises installing a second
implant component on the talus. An alternative step to the step
1514 of installing the second implant component on the calcaneus
comprises installing a first implant component on the
calcaneus.
[0211] While various steps, alternative steps, and/or optional
steps have been described above with respect to an exemplary method
of treatment 1500, 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 of treatment 1400, exemplary method of
treatment 1600, and/or exemplary method of treatment 1700.
[0212] FIG. 48 is a flowchart representation of an exemplary method
1600 of modifying the calcaneocuboid joint.
[0213] An initial step 1602 comprises creating an opening to
provide access to the calcaneocuboid joint formed between the
calcaneus and cuboid. Another step 1604 comprises locating the
calcaneus. Another step 1606 comprises locating the cuboid. Another
step 1608 comprises removing a first portion of the calcaneus to
configure the calcaneus to receive a first implant component.
Another step 1610 comprises removing a first portion of the cuboid
to configure the cuboid to receive a second implant component.
Another step 1612 comprises installing the first implant component
on the calcaneus. Another step 1614 comprises installing the second
implant component on the cuboid. Another step 1616 comprises
installing an insert on one of the first implant component or
second implant component. Another step 1618 comprises closing the
opening.
[0214] The step 1602 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.
[0215] An alternative step to the step 1612 of installing the first
implant component on the calcaneus comprises installing a second
implant component on the calcaneus. An alternative step to the step
1614 of installing the second implant component on the cuboid
comprises installing a first implant component on the cuboid.
[0216] While various steps, alternative steps, and/or optional
steps have been described above with respect to an exemplary method
of treatment 1600, 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 of treatment 1400, exemplary method of
treatment 1500, and/or exemplary method of treatment 1700.
[0217] FIG. 49 is a flowchart representation of an exemplary method
1700 of modifying the talonavicular joint.
[0218] An initial step 1702 comprises creating an opening to
provide access to the talonavicular joint formed between the talus
and navicular. Another step 1704 comprises locating the talus.
Another step 1706 comprises locating the navicular. Another step
1708 comprises removing a first portion of the talus to configure
the talus to receive a first implant component. Another step 1710
comprises removing a first portion of the navicular to configure
the navicular to receive a second implant component. Another step
1712 comprises installing the first implant component on the talus.
Another step 1714 comprises installing the second implant component
on the navicular. Another step 1716 comprises installing an insert
on one of the first implant component or second implant component.
Another step 1718 comprises closing the opening.
[0219] The step 1702 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.
[0220] An alternative step to the step 1712 of installing the first
implant component on the talus comprises installing a second
implant component on the talus. An alternative step to the step
1714 of installing the second implant component on the navicular
comprises installing a first implant component on the
navicular.
[0221] While various steps, alternative steps, and/or optional
steps have been described above with respect to an exemplary method
of treatment 1700, 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 of treatment 1400, exemplary method of
treatment 1500, and/or exemplary method of treatment 1600.
[0222] FIGS. 50, 51, 52, and 53 illustrate a twelfth exemplary
surgical implant system 1800. The implant system 1800 is similar to
implant system 500 illustrated in FIGS. 19, 20, 21, and 22, and
described above, except as detailed below. Reference numbers in
FIGS. 50, 51, 52, and 53 refer to the same structural element or
feature referenced by the same number in FIGS. 19, 20, 21, and 22,
offset by 1500. Thus, implant system 1800 comprises a first implant
component 1802, a second implant component 1804, and an insert
1806.
[0223] 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 body 1812 defines a plurality of first implant
protuberances 1904. Each protuberance of the plurality of first
implant protuberances 1904 extends outward and away from the first
implant surface 1816 from a protuberance first end 1906 toward
first implant distal end 1810 to a protuberance second end 1908 at
an acute, or substantially acute, angle with respect to first
implant surface 1816. The first implant body 1812 defines a
passageway 1910 through each protuberance of the plurality of first
implant protuberances 1904 and that extends from a first opening
defined on the first implant proximal end 1808 to a second opening
defined on the protuberance second end 1908. Each passageway 1910
provides access for passing a fastener of the plurality of
fasteners 1878 through a protuberance of the plurality of
protuberances 1904 to attach, or assist with attaching, first
implant component 1802 at an implant site. Optionally, each
passageway 1910 defined by first implant body 1812, or a portion
thereof, can be countersunk or counterbored to allow a fastener to
sit flush with, or below, the outer surface of first implant 1802.
Thus, a first fastener is disposed through a first passageway
defined by first implant body 1812 and a second fastener is
disposed through a second passageway defined by first implant body
1812. A fastener can be disposed through each passageway defined by
a first implant body.
[0224] In the illustrated embodiment, each passageway 1910 defined
by first implant body 1812 has a passageway axis that extends
through its center and each passageway 1889 defined by second
implant body 1834 has a passageway axis that extends through its
center. Each passageway axis of each passageway 1910 defined by
first implant body 1812 is disposed on a first plane and each
passageway axis of each passageway 1889 defined by second implant
body 1834 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.
[0225] While a plurality of first implant protuberances 1904 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.
[0226] While second implant component 1804 is shown as including a
plurality of second implant projections 1836, a second implant
component can omit the inclusion of a plurality of second implant
projections. Alternatively, in addition to second implant 1804
including a plurality of second implant projections 1836, a first
implant can include a plurality of first implant projections.
[0227] FIGS. 54, 55, 56, and 57 illustrate a thirteenth exemplary
surgical implant system 2000. The implant system 2000 is similar to
implant system 800 illustrated in FIGS. 26, 27, 28, and 29, and
described above, except as detailed below. Reference numbers in
FIGS. 54, 55, 56, and 57 refer to the same structural element or
feature referenced by the same number in FIGS. 26, 27, 28, and 29,
offset by 1200. Thus, implant system 2000 comprises a first implant
component 2002, a second implant component 2004, and an insert
2006.
[0228] 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 body
2034 defines a plurality of second implant protuberances 2086. Each
protuberance of the plurality of second implant protuberances 2086
extends outward and away from the second implant surface 2038 from
a protuberance first end 2087 toward second implant distal end 2032
to a protuberance second end 2088 at an acute, or substantially
acute, angle with respect to second implant surface 2038. The
second implant body 2034 defines a passageway 2089 through each
protuberance of the plurality of second implant protuberances 2086
and that extends from a first opening defined on the second implant
proximal end 2030 to a second opening defined on the protuberance
second end 2088. Each passageway 2089 provides access for passing a
fastener of the plurality of fasteners 2078 through a protuberance
of the plurality of protuberances 2086 to attach, or assist with
attaching, second implant component 2004 at an implant site. Thus,
a first fastener is disposed through a first passageway defined by
second implant body 2034 and a second fastener is disposed through
a second passageway defined by second implant body 2034. A fastener
can be disposed through each passageway defined by a second implant
body.
[0229] 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 body 2012 defines a plurality of first implant
protuberances 2104. Each protuberance of the plurality of first
implant protuberances 2104 extends outward and away from the first
implant surface 2016 from a protuberance first end 2106 toward
first implant distal end 2010 to a protuberance second end 2108 at
an acute, or substantially acute, angle with respect to first
implant surface 2016. The first implant body 2012 defines a
passageway 2110 through each protuberance of the plurality of first
implant protuberances 2104 and that extends from a first opening
defined on the first implant proximal end 2008 to a second opening
defined on the protuberance second end 2108. Each passageway 2110
provides access for passing a fastener of the plurality of
fasteners 2078 through a protuberance of the plurality of
protuberances 2104 to attach, or assist with attaching, first
implant component 2002 at an implant site. Optionally, each
passageway 2089 defined by second implant body 2034, or a portion
thereof, can be countersunk or counterbored to allow a fastener to
sit flush with, or below, the outer surface of second implant 2004
and each passageway 2110 defined by first implant body 2012, or a
portion thereof, can be countersunk or counterbored to allow a
fastener to sit flush with, or below, the outer surface of first
implant 2002. Thus, a first fastener is disposed through a first
passageway defined by first implant body 2012 and a second fastener
is disposed through a second passageway defined by first implant
body 2012. A fastener can be disposed through each passageway
defined by a first implant body.
[0230] In the illustrated embodiment, each passageway 2110 defined
by first implant body 2012 has a passageway axis that extends
through its center and each passageway 2089 defined by second
implant body 2034 has a passageway axis that extends through its
center. Each passageway axis of each passageway 2110 defined by
first implant body 2012 is disposed on a first plane and each
passageway axis of each passageway 2089 defined by second implant
body 2034 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.
[0231] 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.
* * * * *