CN104203162B - There is the reverse shoulder orthopaedic implants of the glenoid cavity installing plate parts of band screw locking top cover - Google Patents

Abstract

The invention discloses a kind of reverse shoulder orthopaedic implants, including glenoid cavity convex supporting head parts, these glenoid cavity convex supporting head parts have the lateral bearing surface being configured to carry out joint motions together with the humerus cup of artificial body of the humerus.Glenoid cavity installing plate parts, it includes the platform being configured to receive glenoid cavity convex supporting head parts.

Description

Reversed Shoulder Orthopedic Implant with Glenoid Mounting Plate Component with Screw-Locking Cap

Cross reference Kyle Lappin's serial number 13/431,416 titled "REVERSE SHOULDER ORTHOPAEDIC IMPLANT HAVING AN ELLIPTICAL GLENOSPHERE COMPONENT" (Attorney Docket No. 265280-220507), assigned to the same assignee as, and filed concurrently with, the present invention.

technical field

The present disclosure relates generally to orthopedic implants, and more particularly to inverted shoulder orthopedic implants.

Background technique

During the patient's lifetime, total shoulder replacement surgery may be required on the patient due to, for example, disease or trauma. In total shoulder replacement surgery, a humeral prosthesis is used to replace the natural head of the patient's humerus. A humeral prosthesis typically includes an elongated stem member implanted in the intramedullary canal of the patient's humerus and a hemispherical prosthetic head member secured to the stem member. In such total shoulder replacement surgery, the natural glenoid surface of the scapula is reconstructed or otherwise replaced with a glenoid component that provides a bearing surface on which the prosthetic head component of the humeral prosthesis rests. Perform joint movements.

However, in some cases, the patient's natural shoulder (including its soft tissues) has deteriorated to a severe degree of joint instability and pain. In many of these cases, it may be necessary to alter the mechanics of the shoulder. A reverse shoulder implant is used for this purpose. As the name suggests, a reverse shoulder implant reverses the anatomy or structure of a healthy shoulder. Specifically, inverted shoulder implants are designed so that the prosthetic head (ie, the "ball" in a ball-and-socket joint) known as the glenosphere component is secured to the patient's scapula, A corresponding concave bearing called the humeral cup (ie the "socket" in the ball and socket joint) is secured to the patient's humerus at the same time. This inverted configuration allows the patient's deltoid, one of the larger and stronger shoulder muscles, to lift the arm.

Contents of the invention

According to one aspect, a reverse shoulder orthopedic implant includes a glenoid bearing head component having a curved lateral bearing surface configured to articulate with a humeral cup of a humeral prosthesis, and having a shape forming inside surface of the tapered bore therein. The glenoid bearing component has an anterior/posterior width defined by the distance between the most anterior point of the lateral bearing surface and the rearmost point of the lateral bearing surface, and defined by the highest point of the lateral bearing surface and the lateral bearing surface The distance between the lowest points defines the top/bottom width. The anterior/posterior width of the glenosphere component is greater than its superior/inferior width.

The lateral bearing surface of the glenoid bearing component may be semi-ellipsoidal in shape. The glenoid bearing head component may be metallic.

An imaginary line segment extends from the highest point of the inner surface to the lowest point of the inner surface. The center of the tapered bore may be located between the midpoint of the imaginary line segment and the highest point of the inside surface. Alternatively, the center of the tapered bore may be located at the midpoint of the imaginary line segment.

The inverted shoulder orthopedic implant may also include a glenoid plate component having an annular platform with an elongated stem extending outwardly from a medial surface thereof. The tapered outer surface of the annular platform is tapered and lockable in the tapered bore of the glenoid bearing component.

According to another aspect, a reverse shoulder orthopedic implant includes a glenoid bearing component having a curved lateral bearing surface configured to articulate with a humeral cup of a humeral prosthesis, and having A medial surface of a bore formed therein to receive a glenoid plate component. The glenosphere component has an anterior/posterior width defined by the distance between the most anterior point of the glenosphere component and the posterior point of the glenosphere component, and The superior/inferior width is defined by the distance between the highest point of the glenoid bearing component and the lowest point of the glenoid bearing component. The anterior/posterior width of the glenosphere component is greater than the superior/inferior width of the glenosphere component.

The lateral bearing surface of the glenoid bearing component may be semi-ellipsoidal in shape. The glenoid bearing head component may be metallic.

An imaginary line segment extends from the highest point of the inner surface to the lowest point of the inner surface. The center of the bore may be located between the midpoint of the imaginary line segment and the highest point of the inside surface. Alternatively, the center of the bore may be located at the midpoint of the imaginary line segment.

The inverted shoulder orthopedic implant may also include a glenoid plate component having an annular platform with an elongated stem extending downwardly from a lower surface thereof. The bore formed in the glenoid bearing component may comprise a tapered bore into which the tapered outer surface of the annular shaped platform tapers to lock.

According to another aspect, a reverse shoulder orthopedic implant includes a glenoid bearing component having a lateral bearing surface configured to articulate with a humeral cup of a humeral prosthesis. The lateral bearing surface is semi-ellipsoidal with its longitudinal axis extending in the anterior/posterior direction. The inverted shoulder orthopedic implant also includes a glenoid mounting plate component secured to the glenoid bearing head component.

The anterior/posterior width of the glenoid bearing component can be defined by the distance between the most anterior point of the lateral bearing surface and the rearmost point of the lateral bearing surface, and its superior/inferior width can be defined by the highest point of the lateral bearing surface and The distance between the lowest points of the lateral support surfaces is defined. The anterior/posterior width of the glenosphere component is greater than the superior/inferior width of the glenosphere component.

A tapered bore may be formed in the medial surface of the glenoid bearing head component into which the tapered outer surface of the glenoid mounting plate component tapers and locks.

An imaginary line segment extends from the highest point of the inner surface to the lowest point of the inner surface. The center of the tapered bore may be located between the midpoint of the imaginary line segment and the highest point of the inside surface. Alternatively, the center of the tapered bore may be located at the midpoint of the imaginary line segment.

Both the glenoid bearing head component and the glenoid mounting plate component may be metal.

The platform of the glenoid plate component may include a plurality of screw holes extending therethrough.

According to another aspect, a reverse shoulder orthopedic implant includes a glenoid plate component having a platform with a plurality of screw holes extending therethrough, and an elongated shaft extending downwardly from a medial surface thereof. pole. The elongated rod is configured to be implanted in the patient's scapula. The elongated rod has a bore formed therein. The reverse shoulder orthopedic implant also includes a nut having a shaft positioned in the bore of the glenoid mounting plate component, and a locking flange extending outwardly from the shaft for Each of the plurality of screw holes of the glenoid mount component is at least partially covered.

Each of the plurality of screw holes defines a circumference. An outer edge of the locking flange of the nut overlaps at least a portion of a circumference of each of the plurality of screw holes of the glenoid plate component.

The bore formed in the elongate shaft of the glenoid plate component may be embodied as a threaded bore, and the shaft of the nut may be embodied as a threaded shaft threaded into the threaded bore of the glenoid plate component.

The locking flange may be annular in shape, the shaft extending outwardly from a lower surface of the locking flange. A drive socket may be formed in the upper surface of the locking flange.

The reverse shoulder orthopedic implant may also include a glenosphere component having a bore formed therein, the nut being captured in the bore of the glenosphere component .

The reverse shoulder orthopedic implant may also include a retaining ring secured within the bore of the glenosphere component to retain the nut therein.

The reverse shoulder orthopedic implant may also include a plurality of compression screws positioned in the plurality of screw holes of the glenoid plate component. Each of these compression screws has a screw head with a rounded outer edge, the outer edge of the locking flange of the nut is at least 100 degrees from the outer edge of the rounded edge of each of the plurality of screw holes of the glenoid mounting plate component. partially overlapped.

According to another aspect, a reverse shoulder orthopedic implant includes a glenoid plate component having a platform with a plurality of screw holes extending therethrough, and an elongated shaft extending downwardly from a medial surface thereof. pole. The elongated rod has a bore formed therein. The reverse shoulder orthopedic implant also includes a glenosphere component having a bore formed therein and a nut captured in the bore of the glenosphere component. The nut is rotatable relative to the glenosphere component. The nut has a shaft positioned in the bore of the glenoid plate component, and a locking flange extending outwardly from the shaft to at least partially cover the plurality of screw holes of the glenoid plate component each of the .

The locking flange of the nut may comprise an annular shaped bevel.

The nut may also include a cylindrically shaped surface extending upwardly from the ramp of the annular shape, and a retaining flange extending outwardly from the cylindrically shaped surface. A retaining ring may be positioned about the cylindrically shaped surface of the nut and secured to a sidewall of the glenosphere defining the bore. The diameter of the retaining flange of the nut is larger than the inner diameter of the retaining ring and smaller than the outer diameter of the retaining ring.

A drive socket is formed in the upper surface of the retaining flange of the nut.

A retaining ring may be press fit within the bore of the glenosphere component to retain the nut therein.

Each of the plurality of screw holes defines a circumference. An outer edge of the locking flange of the nut overlaps at least a portion of a circumference of each of the plurality of screw holes of the glenoid plate component.

The bore formed in the elongate shaft of the glenoid plate component may be embodied as a threaded bore, and the shaft of the nut may be embodied as a threaded shaft threaded into the threaded bore of the glenoid plate component.

The reverse shoulder orthopedic implant may also include a plurality of compression screws positioned in the plurality of screw holes of the glenoid plate component. The locking flange of the nut may include an annular shaped ramp, each of the plurality of compression screws having a screw head with a rounded outer edge. The bevel of the locking flange of the nut contacts the circular outer edge of each of the plurality of screw holes of the glenoid plate component.

According to another aspect, a reverse shoulder orthopedic implant includes a glenoid plate component configured to be implanted within a scapula of a patient. The glenoid plate component has a platform with a plurality of screw holes extending therethrough. A plurality of compression screws are positioned in the plurality of screw holes of the glenoid mounting plate component. Each of the plurality of compression screws has a screw head with a rounded outer edge. A nut is secured to the glenoid plate component. The nut has a locking flange including an outer edge that overlaps at least a portion of the circular outer edge of each of the plurality of screw holes of the glenoid plate component.

Each of the plurality of screw holes defines a circumference, and an outer edge of the locking flange of the nut overlaps at least a portion of the circumference of each of the plurality of screw holes of the glenoid plate component.

The platform of the glenoid plate component may include an elongated stem having a threaded bore formed therein, and the nut has a threaded shaft extending downwardly from the lower surface of the locking flange. The threaded shaft of the nut is threaded into the threaded bore of the glenoid plate component.

A drive socket may be formed in the upper surface of the nut.

Description of drawings

In particular, it is described in detail with reference to the following drawings, in which:

1 is a front elevational view showing a reverse shoulder orthopedic implant implanted in a patient's shoulder;

2 is a side elevational view showing the elliptical glenoid bearing head component of the inverted shoulder orthopedic implant of FIG. 1 implanted in a patient's scapula;

3 is an elevational view of the lateral bearing surface of the elliptical glenoid bearing head component of FIG. 2;

Figure 4 is a cross-sectional view of the elliptical glenoid bearing head component viewed in the direction of the arrow taken along line 4-4 of Figure 3;

5 is a medial elevational view of the elliptical glenoid bearing component of FIG. 3 showing the tapered bore centrally positioned;

Figure 6 is a view similar to Figure 5 but showing the tapered bore positioned in an offset position;

7 is a cross-sectional view showing the elliptical glenoid bearing component of FIG. 3 implanted in a patient's scapula;

8 is an exploded perspective view showing a nut for locking the compression screw within the glenoid mounting plate component;

9 is a cross-sectional view showing a compression screw and nut installed on a glenoid mounting plate component;

Fig. 10 is a plan view showing a compression screw and nut mounted on a glenoid mounting plate component;

11 is an exploded perspective view showing a nut captured in the glenoid bearing component and used to lock the compression screw within the glenoid mounting plate component;

12 is an assembled cross-sectional view showing the nut captured in the glenosphere component by the retaining ring; and

Figure 13 is a view similar to Figure 12, but showing the glenoid bearing head component secured to the glenoid mounting plate component.

detailed description

While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments of the present invention have been shown by way of example in the drawings and will be described in detail herein. It should be understood, however, that there is no intent to limit inventive concepts to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention.

Terms denoting anatomical references, such as anterior, posterior, medial, lateral, superior, inferior, etc., are used in this disclosure with respect to the orthopedic implants described herein and the patient's natural anatomy. These terms have well-known meanings in the fields of anatomy and plastic surgery. Such anatomical reference terms used in the specification and claims are intended to be accorded their commonly understood meanings unless otherwise indicated.

Referring now to FIGS. 1-6, a reverse shoulder orthopedic implant 10 for replacing a patient's natural shoulder is shown. The inverted shoulder orthopedic implant 10 includes an elliptical glenoid bearing head component 12 secured to the scapula 22 by a glenoid mounting plate component 14 implanted in the bony tissue of the patient's scapula 22. Glenoid surface20. The elliptical glenoid bearing head component 12 articulates on a bearing surface 24 of a humeral cup 26 of the humeral prosthesis. As seen in FIG. 1 , humeral cup 26 is secured to humeral stem component 28 that has been implanted in the intramedullary canal (not shown) of the patient's humerus.

The elliptical glenosphere component 12 includes a body 32 having a curved lateral surface 34 . The curved lateral surface 34 of the body 32 provides a smooth bearing surface on which the bearing surface 24 of the humeral cup 26 articulates. As can be seen in Figures 2-4, the lateral bearing surface 34 is semi-ellipsoidal in shape. That is, the lateral bearing surfaces 34 define the general shape of an ellipsoid bisected along its longitudinal plane.

The elliptical glenosphere component 12 also includes a substantially planar medial surface 36 opposite its lateral bearing surface 34 . The inner side surface 36 has a tapered bore 38 formed therein. A tapered sidewall 40 defining the bore 38 extends laterally away from the inner side surface 36 to a bottom wall 42 . As will be discussed in greater detail below, the annularly shaped tapered surface of the glenoid plate component 14 can be inserted into the tapered bore to engage the sidewall 40, thereby gradually turning the elliptical glenoid bearing component 12 into the tapered bore. The retraction locks to the glenoid mounting plate component 14.

As can be seen in FIG. 4 , one end of the mounting hole 44 opens into the bottom wall 42 of the tapered bore 38 and the other end of the mounting hole 44 opens into the lateral bearing surface 34 . As will be discussed in more detail below, a surgical instrument such as a hex driver may be passed through the mounting hole 44 during the surgical procedure in which the elliptical glenosphere component 12 is implanted.

As mentioned above, the glenosphere component 12 described herein is semi-ellipsoidal in shape, unlike conventional hemispherical components. As can be seen in Figures 2 and 3, the glenosphere component 12 is wider in the anterior/posterior direction than it is in the superior/inferior direction. Specifically, as best seen in FIG. 2 , the longitudinal axis 46 of the glenosphere component 12 extends in an anterior/posterior direction and its shorter lateral axis 48 extends in a superior/inferior direction. extend. This is geometrically demonstrated in the front view of the lateral bearing surface 34 of the glenosphere component 12 shown in FIG. A pair of phantom line segments extending through the glenosphere component 12 in their respective directions are shown. Specifically, the imaginary line segment 52 is between the most anterior point 54 of the glenosphere component 12 (i.e., the most anterior point on the lateral bearing surface 34 of the glenosphere component) and the glenosphere component 12. Extends between the most posterior point 56 of the component 12 (ie, the most posterior point on the lateral bearing surface 34 of the glenosphere component). The length of imaginary line segment 52 defines the anterior/posterior width of glenosphere component 12 . As can be seen in FIG. 3 , in the exemplary embodiment described herein, line segment 52 is at an imaginary tangent 58 passing through the most anterior point 54 of the glenosphere component 12 and passing through the glenosphere. An imaginary tangent 60 to the rearmost point 56 of the member 12 extends orthogonally therebetween. Similarly, the imaginary line segment 62 is between the highest point 64 of the glenosphere component 12 (i.e., the highest point on the lateral bearing surface 34 of the glenosphere component) and the 12 (ie, the lowest point on the lateral bearing surface 34 of the glenosphere component). As can be seen in FIG. 3 , in the exemplary embodiment described herein, line segment 62 is at an imaginary tangent 68 through the highest point 64 of the glenosphere component 12 and through the glenosphere. An imaginary tangent 70 to the lowest point 66 of the member 12 extends orthogonally therebetween. The length of imaginary line segment 62 defines the superior/inferior width of glenosphere component 12 . The imaginary line segment 52 is longer than the imaginary line segment 62 because the glenoid bearing head component 12 is wider in the anterior/posterior direction than it is in the superior/inferior direction.

It will be appreciated that such an arrangement in which the glenoid bearing head component 12 is wider in the anterior/posterior direction than it is in the superior/inferior direction may reduce the incidence of notching in some patients. Specifically, depending on the specific patient's anatomy, a glenosphere that is wider in the anterior/posterior direction than it is in the superior/inferior direction may reduce joint loss relative to a hemispherical glenosphere. Opportunity for the medial side of the glenoid bearing head component to make contact with the scapula.

As can be seen in the front view of the medial surface 36 of the glenosphere component shown in FIGS. See Figure 6), or bias upward in the up/down direction (see Figure 7). Specifically, the central axis 72 of the tapered bore 38 may be positioned at the center of the superior/inferior width of the elliptical glenosphere component 12, or it may be positioned at the center of the elliptical glenosphere component 12. The upper/lower width of the center upper position. This is demonstrated in the frontal views of the medial surface 36 of the glenoid bearing component shown in FIGS. The midpoint 74 bisects the imaginary line segment 62 defining the superior/inferior width of the glenosphere component 12 . As can be seen in FIG. 5 , for a central glenoid bearing component 10 , the central axis 72 of the tapered bore 38 is positioned at an imaginary position defining the superior/inferior width of the glenosphere component 12 . At the midpoint 74 of line segment 62 . However, as can be seen in FIG. 6 , with the offset glenosphere component 10 , the central axis 72 of the tapered bore 38 is still positioned on/on the surface defining the glenosphere component 12 . On the imaginary line segment 62 of the lower width, but spaced in the upward direction from the midpoint 74 of this line segment. In other words, with respect to the offset glenoid bearing component 10, the central axis 72 of the tapered bore 38 is positioned on the imaginary line segment 62 between its midpoint 74 and highest point 64. location.

This offset of the tapered bore 38 in an upward direction will reduce the glenoid bearing component 12 when securing the glenoid bearing component 12 to the glenoid mounting plate component 14 implanted in the patient's glenoid surface. The shaped support head member 12 is biased in a downward direction. Such an implanted offset glenosphere component 12 is shown in FIG. 2 . It should be appreciated that such a downward bias of the glenoid bearing head component 12 may reduce the incidence of notching in some patients. Specifically, depending on a particular patient's anatomy, a downward bias of the glenosphere relative to a central glenosphere component reduces the medial glenosphere contact with the glenosphere. Chances of scapula contact.

It should be understood that the tapered bore 38 of the elliptical glenosphere component 12 may also be offset in other directions. For example, the tapered bore 38 of the elliptical glenosphere component 12 may be offset anteriorly or posteriorly relative to the center of the medial surface 36 of the glenosphere component (i.e., it may be offset relative to the bisected The midpoint 74 of the imaginary line segment 62 is offset forward or upward). Additionally, the tapered bore 38 of the elliptical glenosphere component 12 may be offset downward relative to the center of the medial surface 36 of the glenosphere component. In addition, however, the tapered bore 38 of the elliptical glenosphere component 12 may be offset in the combined direction relative to the center of the medial surface 36 of the glenosphere component. For example, the tapered bore 38 of the elliptical glenosphere component 12 may be offset both upwardly and anteriorly (or upwardly and posteriorly) relative to the center of the medial surface 36 of the glenosphere component.

Glenoid bearing component 12 may be constructed from implant-grade biocompatible metal, although other materials may also be used. Examples of such metals include cobalt, including cobalt alloys such as cobalt chromium alloys; titanium, including titanium alloys such as Ti6Al4V alloys, and stainless steel. The lateral bearing surface 34 of such metal glenosphere component 12 may be polished or otherwise treated to enhance the smoothness of the bearing surface thereof.

Glenoid bearing head component 12 may be provided in a variety of different configurations to provide the flexibility required to conform to anatomy that varies from patient to patient. For example, the glenosphere component 12 may be provided in various superior/inferior diameters to meet the needs of a given patient. For example, in one exemplary embodiment, the glenosphere component 12 may be provided with two different superior/inferior diameters (38mm and 42mm).

As shown in FIG. 7 , the glenoid bearing component 12 is mounted on a glenoid mounting plate component 14 that has been implanted in the bone tissue of the glenoid surface 20 of the patient's scapula 22 . To accomplish this, the surgeon first aligns the glenoid bearing component 12 with respect to the implanted glenoid component 14 such that its tapered bore 38 matches the circular shape of the glenoid component 14. The tapered outer surfaces 108 are aligned. The surgeon then advances the glenoid bearing component 12 such that the tapered outer surface 108 of the glenoid mounting plate component 14 is inserted into the tapered bore 38 of the glenoid bearing component 12 . The surgeon then strikes the glenosphere component 12 (or a head impact tool positioned thereon) with a surgical hammer, sledgehammer, or other impact tool to drive the glenosphere component 12 from the inside , so as to force the sidewall 40 defining the tapered bore 38 of the glenoid bearing component into contact with the tapered outer surface 108 of the glenoid mounting plate component 14, thereby placing the glenoid bearing component 12 is tapered and locked to the implanted glenoid plate component 14 . The final assembly of such glenoid bearing head component 12 to the implanted glenoid mounting plate component 14 is shown in FIGS. 2 and 7 .

Referring now to FIGS. 8-10 , the glenoid plate component 14 is shown in greater detail. Glenoid plate component 14 includes a platform 102 having a stem 104 extending outwardly from a medial surface 106 of the platform. The stem 104 of the glenoid plate component is configured to be implanted into the surgically prepared bone tissue of the glenoid surface 20 of the patient's scapula 22 . As noted above, the glenoid bearing component 12 is securable to the glenoid mounting plate component 14 . In particular, the outer annular surface 108 of the platform of the glenoid plate component is tapered. As detailed above, the glenoid bearing component 12 may be mounted on the glenoid plate component 14 such that the tapered outer surface 108 of the glenoid plate component 14 is inserted into the glenoid bearing component. 12 in the tapered bore 38. So positioned, the glenoid bearing component 12 may be driven or otherwise advanced toward the glenoid mounting plate component 14 such that the portion of the tapered bore 38 defining said glenoscopic bearing component The sidewall 40 is forced into contact with the tapered outer surface 108 of the glenoid component 14 , thereby tapering and locking the glenoid bearing component 12 to the glenoid component 14 .

As best seen in FIGS. 8 and 90, the stem 104 of the glenoid plate component has a threaded bore 110 formed therein. The threaded bore 110 extends through the entire length of the rod 104, although it could be realized as a blind hole. A plurality of threads 112 are formed in the sidewall defining the threaded bore 110 . Threads 112 are sized to mate with, and thus threadably receive, the threads of nut 140 and a retraction tool (not shown).

As can be seen in FIGS. 8-10 , the platform 102 of the glenoid plate component has a plurality of screw holes 114 extending therethrough. One end of each of the screw holes 114 opens to the inner side surface 106 of the platform 102 and the other end opens to the opposite outer side surface 116 of the platform. As best seen in FIG. 9 , each of the screw holes 114 is reamed to accommodate the screw head of a compression screw used to secure the glenoid mounting plate component 12 to the bone of the patient's scapula 22 . organize. Therefore, the upper end of the screw hole 114 has a larger diameter than the lower end of the screw hole 114 . Each of the screw holes 114 is located in one of the four quadrants of the platform 102 of the glenoid plate component. Accordingly, each of the screw holes 114 is positioned approximately 90 degrees from each other.

In the exemplary embodiment described herein, each of the threaded holes 114 is spaced radially outward from the center of the platform 102 of the glenoid mounting plate component and is located between the threaded bore 110 and the outer annular edge 118. The location in between where the outer side surface 116 of the platform meets the outer tapered surface 108 at the outer annular edge 118 . As can be seen in FIGS. 8 and 9 , the lateral surface 116 of the platform 102 of the glenoid plate component has a counterbore surface 120 formed therein. As can be seen in FIG. 8 , each of the screw holes 114 opens partially into a counterbore surface 120 of the platform 102 of the glenoid plate component. In particular, as seen from the front view of the lateral surface 116 of the glenoid plate component shown in FIG. 10 , the outer boundary or perimeter of each of the screw holes 114 defines a circumference 122 . An inner segment 124 of circumference 122 (ie, a segment positioned near the center of platform 102 of the glenoid plate component) of each of screw holes 114 is positioned within countersink surface 120 .

Glenoid plate component 14 may be constructed from implant-grade biocompatible metal, although other materials may also be used. Examples of such metals include cobalt, including cobalt alloys such as cobalt chromium alloys; titanium, including titanium alloys such as Ti6Al4V alloys, and stainless steel. Such metal glenoid plate components 14 may also be coated with a surface treatment, such as hyaluronic acid (HA), to enhance biocompatibility. Additionally, the surfaces of the glenoid plate component 14 that engage natural bone (eg, the medial surface 106 of the platform 102 and the exterior surface of the stem 104 ) may be textured to facilitate securing the component to the bone. Such surfaces may also be porous coated to promote bone ingrowth for durable fixation.

In the exemplary embodiment described herein, unlike the glenoid bearing head component 12 (which can be sized in various sizes to provide the flexibility required to conform to anatomy that varies from patient to patient), the joint Glenoid mounting plate component 14 may be configured as a single "universal" size that accommodates various sizes of glenoid bearing components. For example, in one exemplary embodiment, the glenoid mounting plate component 14 may be provided in a single size to accommodate a 38 mm glenosphere component 12 and a 42 mm glenosphere component 12 .

As seen in FIGS. 8-10 , compression screws 130 may be positioned in some or all of screw holes 114 to secure glenoid plate component 12 to the bony tissue of the patient's scapula 22 . Each of the compression screws 130 includes a threaded shank 132 with a circular screw head 134 on its distal end. The diameter of the threaded shank 132 is smaller than the diameter of the lower end of the reaming screw hole 114 of the glenoid mounting plate component 12 , so that the threaded shank 132 can pass through the entire length of the screw hole 114 . On the other hand, the diameter of the screw head 134 is smaller than the diameter of the upper end of the reaming screw hole 114 but larger than the diameter of the lower end of the reaming screw hole 114 . Thus, the screw head 134 of the compression screw 130 is received in the upper end of the reamer screw hole 114 when installed in the glenoid plate component 12 .

Like the glenoid plate component 14, the compression screw 130 may be constructed of implant-grade biocompatible metal, although other materials may also be used. Examples of such metals include cobalt, including cobalt alloys such as cobalt chromium alloys; titanium, including titanium alloys such as Ti6Al4V alloys, and stainless steel.

As can be seen in FIGS. 8-10 , a nut 140 is secured to the glenoid plate component 14 . The nut 140 includes a locking flange 142 having a threaded shaft 144 extending away from a lower surface 146 thereof. The threaded shaft 144 of the nut may be threaded into the threaded bore 110 of the stem 104 of the glenoid plate component to secure the nut 140 to the glenoid plate component. A drive socket 148 , such as a hex drive socket, is formed in an upper surface 150 of the locking flange 142 of the nut. A driving tool, such as a hex driver (not shown), may be inserted into drive socket 148 to drive (ie, rotate) nut 140 relative to glenoid plate component 14 . Rotation in one direction (eg, clockwise) can be used to tighten the nut 140 and thereby secure it to the glenoid mounting plate component 14, while rotation in the opposite direction (eg, counterclockwise) can be used to loosen the nut 140 and thus removed from the glenoid plate component 14 .

As can be seen in FIG. 9 , the lower surface 146 of the locking flange 142 of the nut defines a generally conical annular shaped ramp 152 . The annular shaped bevel 152 is sized and shaped to be received into and closely complement the counterbore surface 120 of the platform 102 of the glenoid plate component. In this manner, the locking flange 142 partially covers the screw hole 114 of the glenoid plate component so that the head 134 of the compression screw 130 is positioned therein. "Cover" as used herein with respect to the position of the locking flange 142 relative to the screw hole 114 of the glenoid plate component 14 and/or the head 134 of the compression screw 130 means the circumference of the outer annular edge 154 and the screw hole 114 122 and/or the rounded outer edge 136 of the compression screw 130 or at least a section thereof overlaps. This is best demonstrated in side elevation or plan view in FIG. 10 . Specifically, when viewed sideways (such as the situation of FIG. 10 ), the outer annular edge 154 of the locking flange 142 of the nut is in contact with the circumference 122 of each of the screw holes 114 and each of the compression screws 130. The circular outer edge 136 intersects and thus overlaps the circumference 122 and the circular outer edge 136 . In this way, the locking flange 142 prevents the compression screw 130 from backing out of the threaded hole 114 .

As can be seen in FIG. 9, when the nut 140 is mounted to the glenoid plate component 14, the annular shaped ramp 152 of the locking flange 142 of the nut contacts or otherwise engages the mount in the glenoid plate component 14. The rounded outer edge 136 of each screw head 134 of any one of the compression screws 130. This contact creates a clamping force to resist retraction of the compression screw 130 from the bony tissue of the patient's scapula 22 .

Like the glenoid plate component 14 and compression screw 130, the nut 140 may be constructed from implant-grade biocompatible metal, although other materials may also be used. Examples of such metals include cobalt, including cobalt alloys such as cobalt chromium alloys; titanium, including titanium alloys such as Ti6Al4V alloys, and stainless steel.

As shown in FIG. 7 , the glenoid mounting plate component 14 can be positioned in the desired position and orientation, and then by inserting one or more compression screws 130 through the screw holes 114 and driving them into the bone tissue. The glenoid plate component 14 is secured in place to first implant the glenoid plate component 14 into the surgically prepared glenoid surface 20 of the patient's scapula 22 . Once the compression screw 114 is seated, the surgeon can insert the threaded shaft 144 of the nut 140 into the threaded bore 110 of the stem 104 of the glenoid mounting plate component, and then use a hex driver (not shown) to turn the screw The cap 140 is rotationally inserted into a drive socket 148 formed in the upper surface 150 of the locking flange 142 of the nut to install the nut 140 . Tightening the nut 140 in this manner causes the annular shaped bevel 152 of the locking flange 142 of the nut to engage with the rounded outer edge 136 of each screw head 134 of the compression screw 130 mounted in the glenoid mounting plate component 14. contact, thereby maintaining a clamping force against the screw head 134 for resisting retraction of the compression screw 130 from the bony tissue of the patient's scapula 22 . Once the screw cap 140 is installed, the surgeon may then taper lock the glenoid bearing component 12 to the implanted glenoid mounting plate component 14 in the manner described above.

If the glenoid plate component 14 subsequently needs to be removed, for example, during a revision surgery, the surgeon can do so by breaking the tapered lock between the glenoid bearing head component 12 and the implanted glenoid plate component 14 . Attaching and lifting the glenoscopic bearing component 12 away, the glenoscopic bearing component 12 is first removed from the implanted glenoid mounting plate component 14 . The surgeon can then insert a hexagonal driver (not shown) into the drive socket 148 formed in the upper surface 150 of the locking flange 142 of the nut, and rim the nut 140 with the mounting nut 140. Rotate in the opposite direction. Loosening the nut in this manner causes the annular shaped ramp 152 of the locking flange 142 of the nut to move into contact with the rounded outer edge of each screw head 134 of the compression screw 130 mounted in the glenoid mounting plate component 14. 136 disengages, thereby releasing the clamping force from screw head 134. Continued loosening of the nut 140 allows its threaded shaft 144 to come out of the threaded bore 110 of the shaft 104 of the glenoid plate component, allowing the nut 140 to be lifted off. The surgeon may then use a driving tool (not shown) to remove the compression screw 130 . An extraction tool (not shown) may be threaded into the threaded bore 110 of the glenoid component stem 104 and then used to extract the glenoid component 14 from the bone tissue of the patient's scapula 22 .

Referring now to FIGS. 11-13 , an embodiment is shown in which a nut 140 is captured in the glenosphere component 14 . In such an embodiment, slight modifications have been made to the glenosphere component 14 and nut 140 as shown in FIGS. 11-13. Like reference numerals are used in FIGS. 11-13 to designate components similar to those discussed above in connection with FIGS. 1-10 . As can be seen in FIG. 11 , nut 140 is captured and retained in tapered bore 38 of glenosphere component 12 by retaining ring 160 . To accomplish this, the nut 140 of the design in FIGS. Matches with the annular retaining flange 164. The retaining ring 160 is captured on the cylindrically shaped surface 162 of the nut 140 . That is, the cylindrically shaped surface 162 of the nut 140 is positioned in the opening 166 of the retaining ring. As can be seen in FIGS. 11 and 12 , the inner diameter of the retaining ring 160 (ie, the diameter of its opening 166 ) is larger than the diameter of the cylindrically shaped surface 162 of the nut 140 but smaller than the diameter of the retaining flange 164 of the nut. The outer diameter of the retaining ring 160 (i.e., the diameter of its outer surface 168) is larger than the diameter of the retaining flange 16 of the nut, and is sized and configured to be press fit, welded (or press fit and welded), or The taper locks to the tapered sidewall 40 defining the tapered bore 38 of the glenosphere component. Thus, when assembled, the retaining ring 160 captures the nut 140 in the tapered bore 38 of the glenoid bearing component. So captured, nut 140 is allowed free rotation and limited linear movement relative to glenosphere component 12, but is prevented from dislodging from tapered bore 38 of the glenosphere component.

The design of Figures 11-13 can be installed in a similar manner as described above in connection with the design of Figures 8-10. Specifically, the glenoid can be mounted by positioning the glenoid mounting plate component 14 in the desired position and orientation, and then by inserting one or more compression screws 130 through the screw holes 114 and driving them into the bone tissue. With the plate component 14 secured in place, the glenoid mounting plate component 14 is first implanted into the surgically prepared glenoid surface 20 of the patient's scapula 22 . Once the compression screw 114 is seated, the surgeon can then install the glenoid bearing head component 12 by inserting the threaded shaft 144 of the nut into the threaded bore 110 of the stem 104 of the glenoid mounting plate component, And thereby install the nut 140 captured therein. The drive tip of a hex driver (not shown) may then be advanced through the glenosphere component mounting hole 44 and into the nut drive socket 148 . The surgeon then turns the nut 140 using the hex driver. Tightening the nut 140 in this way causes the annular shaped ramp 152 of the locking flange 142 of the nut to come into contact with the circular outer edge 136 of each screw head 134 of the compression screw 130 mounted in the glenoid mounting plate component 14, thereby A clamping force is maintained against the screw head 134 to resist retraction of the compression screw 130 from the bony tissue of the patient's scapula 22 . Once the screw cap 140 is installed, the surgeon may then taper lock the glenoid bearing component 12 to the implanted glenoid mounting plate component 14 in the manner described above.

If the glenoid mounting plate component 14 subsequently needs to be removed, for example, during a revision surgery, the surgeon can do so by inserting the drive end of the hex driver through the mounting hole 44 of the glenoid bearing head component and into the mounting hole 44 of the nut. The socket 148 is driven in to first remove the glenoid bearing head component 12 and thus the captive nut 140 from the implanted glenoid mounting plate component 14 . The surgeon then uses the hex driver to rotate nut 140 in the opposite direction to that used to install nut 140 . Loosening the nut in this manner causes the annular shaped ramp 152 of the locking flange 142 of the nut to move into contact with the rounded outer edge of each screw head 134 of the compression screw 130 mounted in the glenoid mounting plate component 14. 136 disengages, thereby releasing the clamping force from screw head 134. The surgeon can then break the tapered locking connection between the glenoid bearing head component 12 and the glenoid plate component 14 and continue to loosen the nut 140 until its threaded shaft 144 clears the glenoid component stem 104 The threaded bore 110 of the shaft allows the glenoid bearing head component 12 and thus the nut 140 captured therein to be lifted off the glenoid mounting plate component 14 . The surgeon may then use a driving tool (not shown) to remove the compression screw 130 . An extraction tool (not shown) may be threaded into the threaded bore 110 of the glenoid component stem 104 and then used to extract the glenoid component 14 from the bone tissue of the patient's scapula 22 .

It should be appreciated that the nut 140 as described above in connection with FIGS. 8-13 provides for the efficiency of implanting the glenoid plate component 14 during a surgical procedure. For example, nut 140 allows glenoid plate component 14 to be implanted without the use of self-locking surgical screws. Surgical installation of self-locking surgical screws requires the use of a guide wire and has other surgical considerations. By providing a locking function, the nut 140 allows the use of compression screws, which are much easier to install surgically, in place of self-locking surgical screws.

It should be understood that the concepts and features disclosed herein can be used in various combinations with each other, or independently of each other. For example, the elliptical glenoid bearing head component 12 of FIGS. 1-6 may be used in combination with the glenoid plate component 14 of FIGS. 8-10, or with the glenoid plate component 14 of FIGS. 11-13. In addition, the elliptical glenoid bearing head component 12 of FIGS. 1-6 may be used in combination with other glenoid plate components, including the glenoid plate components described herein without the nut 140 . Similarly, the glenoid mounting plate component 14 of FIGS. 8-10 may be used in combination with the elliptical glenoid bearing component 12 of FIGS. 1-6, or, alternatively, with a conventional hemispherical or other Type of glenoid bearing head components are used. In the same vein, the glenoid mounting plate component 14 of FIGS. 11-13 may be used in combination with the elliptical glenoid bearing component 12 of FIGS. 1-6, or, alternatively, with a conventional hemispherical or other types of glenoid bearing components.

While the disclosure has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative and not restrictive, it being understood that only examples have been shown and described embodiment, and all changes and modifications within the essential scope of the present invention should be protected.

The present invention has several advantages arising from the various features of the devices, systems and methods described herein. It should be noted that alternative embodiments of the apparatus, systems and methods of the present invention may not include all of the features described, but still benefit from at least some of the advantages of such features. Those of ordinary skill in the art can easily devise their own specific implementations of devices, systems, and methods that may incorporate one or more of the features of the invention and fall within the spirit and spirit of the invention as defined by the claims. within range.

Claims (18)

1. A reverse shoulder orthopedic implant comprising: a glenoid mounting plate component having a platform having (i) a plurality of screw holes extending therethrough, and (ii) an elongated stem extending outwardly from a medial surface thereof, the the elongated rod is configured to be implanted in the patient's scapula and has a bore formed therein, and a nut having (i) a shaft positioned in the bore of the glenoid mounting plate component, and (ii) a locking flange extending outwardly from the shaft for at least partially covering each of the plurality of screw holes of the glenoid mounting plate component, A glenosphere component having a bore formed therein, wherein the nut is captured in the bore of the glenosphere component middle, wherein the upper surface of the nut opposite the axis of the nut and opposite the elongated stem of the glenoid mount component when the nut is seated in the bore of the glenoid plate component The upper surface of the platform is flush. 2. The reverse shoulder orthopedic implant of claim 1, wherein: each of the plurality of screw holes defines a circumference, and An outer edge of the locking flange of the nut overlaps at least a portion of the circumference of each of the plurality of screw holes of the glenoid plate component. 3. The reverse shoulder orthopedic implant of claim 1, wherein: said bore formed in said elongated shaft of said glenoid plate component comprises a threaded bore, said shaft of said nut comprises a threaded shaft, and The threaded shaft of the nut is threaded into the threaded bore of the glenoid plate component. 4. The reverse shoulder orthopedic implant of claim 1, wherein: said locking flange is annular in shape, the shaft extends outwardly from a lower surface of the locking flange, and A drive socket is formed in the upper surface of the locking flange. 5. The reverse shoulder orthopedic implant of claim 1 , further comprising a plurality of compression screws positioned in the plurality of screw holes of the glenoid mounting plate component, wherein: each of the plurality of compression screws has a screw head with an outer edge, and An outer edge of the locking flange of the nut overlaps at least a portion of the outer edge of each of the plurality of screw holes of the glenoid plate component. 6. A reverse shoulder orthopedic implant comprising: a glenoid mounting plate component having a platform having (i) a plurality of screw holes extending therethrough, and (ii) an elongated stem extending outwardly from a medial surface thereof, the said elongated rod has a bore formed therein, a glenoid bearing component having a bore formed therein, and a nut captured in the bore of the glenosphere component, the nut being rotatable relative to the glenosphere component and having (i) a shaft positioned in the bore of the glenoid plate component, and (ii) a locking flange extending outwardly from the shaft to at least partially cover the glenoid plate each of the plurality of screw holes of the component, Wherein, when the glenoid bearing component is attached to the glenoid mounting plate component, the outermost periphery of the platform is in contact with the sidewall defining the bore of the glenoid bearing component engaged such that the nut and a portion of the platform are disposed in the bore, wherein the locking flange comprises a cylindrically shaped body having an outer surface and a retaining flange extending outwardly from the outer surface, wherein a retaining ring is positioned around the body adjacent the outer surface of the body and fastened to The sidewall of the glenosphere component defines the bore. 7. The reverse shoulder orthopedic implant of claim 6, wherein the locking flange of the nut includes a ring-shaped bevel formed at the first end of the body. 8. The reverse shoulder orthopedic implant of claim 7, wherein the retention flange is formed at a second end of the body opposite the first end. 9. The reverse shoulder orthopedic implant of claim 8, wherein the retaining flange of the nut has a diameter greater than the inner diameter of the retaining ring and smaller than the outer diameter of the retaining ring. 10. The reverse shoulder orthopedic implant of claim 8, wherein a drive socket is formed in an upper surface of the retaining flange of the nut. 11. The reverse shoulder orthopedic implant of claim 8, wherein said retaining ring is press fit within said bore of said glenosphere component so that said screw The cap remains therein. 12. The reverse shoulder orthopedic implant of claim 6, wherein: each of the plurality of screw holes defines a circumference, and An outer edge of the locking flange of the nut overlaps at least a portion of the circumference of each of the plurality of screw holes of the glenoid plate component. 13. The reverse shoulder orthopedic implant of claim 6, wherein: said bore formed in said elongated shaft of said glenoid plate component comprises a threaded bore, said shaft of said nut comprises a threaded shaft, and The threaded shaft of the nut is threaded into the threaded bore of the glenoid plate component. 14. The reverse shoulder orthopedic implant of claim 6, further comprising a plurality of compression screws positioned in the plurality of screw holes of the glenoid mounting plate component, wherein: said locking flange of said nut comprises an annular shaped bevel, each of the plurality of compression screws has a screw head with a rounded outer edge, and The bevel of the locking flange of the nut contacts the rounded outer edge of each of the plurality of screw holes of the glenoid plate component. 15. A reverse shoulder orthopedic implant comprising: A glenoid plate component configured to be implanted in a patient's scapula, the glenoid plate component having a platform with (i) a plurality of screw holes extending therethrough, and (ii) an elongated rod extending outwardly from the inside surface of the platform, the elongated rod having a bore formed therein, a plurality of compression screws positioned in the plurality of screw holes of the glenoid mounting plate component, each of the plurality of compression screws having a screw head with an outer edge, a glenoid bearing component having a bore formed therein, and a nut secured to the glenoid plate component, the nut comprising (i) a shaft positioned in a bore of the glenoid plate component, and (ii) a locking flange having an outer edge, the The outer edge overlaps at least a portion of the outer edge of each of the plurality of compression screws positioned in the plurality of screw holes of the glenoid plate component, wherein when the screw cap When seated in the bore of the glenoid plate component, the upper surface of the nut opposite the axis of the nut and the upper surface of the platform opposite the elongated stem of the glenoid plate component flush with the surface, Wherein, when the glenoid bearing component is attached to the glenoid mounting plate component, the outermost periphery of the platform is in contact with the sidewall defining the bore of the glenoid bearing component engaged such that the nut and a portion of the platform are disposed in the bore. 16. The reverse shoulder orthopedic implant of claim 15, wherein: each of the plurality of screw holes defines a circumference, and The outer edge of the locking flange of the nut overlaps at least a portion of the circumference of each of the plurality of screw holes of the glenoid plate component. 17. The reverse shoulder orthopedic implant of claim 15, wherein: the bore of the elongated rod is threaded, the shaft of the nut is threaded and extends downwardly from the lower surface of the locking flange, and The threaded shaft of the nut is threaded into the threaded bore of the glenoid plate component. 18. The reverse shoulder orthopedic implant of claim 15, wherein a drive socket is formed in the upper surface of the nut.