as) United States
`a2) Patent Application Publication
`(10) Pub. No.: US 2015/0305877 A1
`
`(43) Pub. Date: Oct. 29, 2015
`Gargacetal.
`
`US 20150305877A1
`
`REVERSE SHOULDER SYSTEMS AND
`METHODS
`
`Publication Classification
`
`(51)
`
`Int. Cl.
`AGIF 2/40
`(52) US. Cl.
`CPC ..... AGLF 2/4081 (2013.01); ALF 2002/30013
`(2013.01)
`
`(2006.01)
`
`(57)
`
`ABSTRACT
`
`Reversed glenoid implants, and related kits and methods, are
`described that include an anchor member having a proximal
`head and a baseplate having a distal end with a first aperture
`sized to accept the proximal head of the anchor member. ‘The
`proximalheadis inserted along an un-threaded length thereof
`from the distal end into the first aperture, and the anchor
`memberisrestrained against axial translation with respect to
`the baseplate but is permitted to rotate with respect to the
`baseplate.
`
`(54)
`
`(71)
`
`(72)
`
`Applicant: Tornier, Inc., Bloomington, MN (US)
`
`Inventors: Shawn M. Gargae, Fort Wayne, IN
`(US); Brian C. Hodorek, Winona Lake,
`IN (US); William Matthew Kuester, St.
`Louis Park, MN (US); Austin Wyatt
`Mutchler, Warsaw, IN (US)
`
`(21)
`
`Appl. No.: 14/794,544
`
`(22)
`
`Filed:
`
`Jul. 8, 2015
`
`Related U.S. Application Data
`
`(63)
`
`(60)
`
`Continuation-in-part of application No. PCT/US2014/
`072442, filed on Dec. 26, 2014,
`
`Provisional application No. 61/923 ,382, filed on Jan.
`3, 2014.
`
`100
`
`>,
`
`
`
`CATALYST,EX-1020
`PAGE1
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`CATALYST, EX-1020
`PAGE 1
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`

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`Patent Application Publication
`
`Oct. 29,2015 Sheet 1 of 33
`
`US 2015/0305877 Al
`
`Glenohumeral
`Joint
`
`a
`
`Cavity Scapula
`
`Humerus
`
`Glenoid
`
`FIG. |
`
`CATALYST,EX-1020
`PAGE2
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`Patent Application Publication
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`Oct. 29,2015 Sheet 2 of 33
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`US 2015/0305877 Al
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`CATALYST,EX-1020
`PAGE3
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`PAGE 3
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`Patent Application Publication
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`Oct. 29, 2015 Sheet 3 of 33
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`US 2015/0305877 Al
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`Oct. 29, 2015
`
`REVERSE SHOULDER SYSTEMS AND
`METHODS
`
`INCORPORATION BY REFERENCE TO ANY
`PRIORITY APPLICATIONS
`
`[0001] Any and all applications for which a forcign or
`domestic priority claim is identified in the Application Data
`Sheet as filed with the present application are hereby incor-
`porated by reference under 37 C.F.R. §1.57.
`
`
`BACKGROUNDOFTHE INVENTION
`
`
`
`[0002]
`
`1. Field of the Invention
`
`[0003] The systems and methods described. herein are
`directed to orthopedic implants, for example to reverse shoul-
`der replacement systems and methodsfor implantation.
`[0004]
`2. Description of the Related Art
`[0005]
`Shoulder replacement surgery involves placing a
`motion providing device at the glenohumeraljoint, 1.e., the
`joint interface between the scapula and the proximal humerus
`of the arm. See FIG. 1. Reverse shoulder replacement
`reverses the curvature ofthe natural glenoid cavity and the
`proximal head of the humerus. Thatis, a convex surface of a
`glenoid componentis positioned on the scapula and a concave
`surface ofa humeral componentis positioned on the proximal
`humerus.
`
`Somereverse shoulder systems have limitations in
`[0006]
`connection with the fixation of the glenoid component. In
`some glenoid component designs, a one-piece construct is
`provided. in which a central threaded. post projects from a
`baseplate. The threaded post providesfixation to the bone of
`the scapula, but provides little to no flexibility of the final
`positioning, of peripheral features of the baseplate, such as
`screw or mountholes thereon. Also, the unitary nature ofthis
`approach requires more inventory to provide a proper mix of
`baseplate configurations and threaded post sizes.
`[0007] Other reverse shoulder systems provide a plate hav-
`ing an integral fixed central post and a plurality of screws that
`are placed througheither the postor the plate. These systems
`are limited in that the length, inner diameter, and configura-
`tion of the central post are fixed. As such, the size of a screw
`placed throughthe central post is predefined whichlimits the
`ability to perform revisions (subsequent surgeries on the
`patient to replace the system). In a revision surgery the old
`implant must be removed and replaced with a new implant.
`Commonly a substantial amount of bone is removed with the
`old implant and in this case larger screws are required to
`securely fix the new glenoid implant to the scapula.
`[0008]
`In currently available systems, specifically unitary
`systems having an integral fixed central threaded post, inde-
`pendent rotation is not provided between the post and the
`baseplate. For these unitary systems the post and the base-
`plate rotate together when the post is driven into the bone.
`With other glenoid implants wherein an anchor memberis
`driven through the baseplate and extends from a distal end of
`the baseplate,axial translationof the baseplaterelative to the
`anchor memberis not prevented. lor these systems, the base-
`plate is not secured against axial translation until the anchor
`memberis fully engaged in the scapula and pulls the baseplate
`against the surface of the bone thereby preventing rotation of
`the baseplate.
`
`SUMMARYOF THE INVENTION
`
`[0009] There is a need. for new shoulderprosthesis systems
`that can provide more flexibility and better adaptability to
`patient anatomies while maximizing revision options. When
`implanting reverse shoulder systemsit is desirable to inde-
`pendently attach a baseplate to the scapula and thereafter to
`independently rotate the baseplate with respectto the scapula
`suchthat fixation means in the peripheryof the baseplate can
`be driven into bone thereunder.
`
`[0010] A glenoid implant, according to some embodiments
`disclosed herein, includes an anchor memberand a baseplate.
`The anchor memberhasa longitudinal portion configured to
`be secured to a bone and a proximal head. The proximal head
`hasa first engaging surface. The baseplate has a proximal end
`and a distal end. The distal end of the baseplate comprises a
`first aperture sized to accept the proximal head of the anchor
`member and a second engaging surface. Whenthe proximal
`head is inserted from the distal end of the baseplate into the
`first aperture, the first engaging surface couples with the
`second engaging surface. In some embodiments, the anchor
`memberis restrained aguinst axial translation by this engage-
`ment with respect to the baseplate but is permitted to rotate
`with respect to the baseplate.
`[0011] Other embodiments of a glenoid implant mayfur-
`ther comprise a locking structure configured to applya force
`to the anchor member. A glenoid implant mayfurther com-
`prise a glonosphere configuredto be attached to the baseplate.
`A glenoid implant may also include one or more perimeter
`anchors for securing the baseplate to bone.
`[0012] A method for implanting a glenoid implant, accord-
`ing to some embodimentsdisclosed herein, includes provid-
`ing an anchor memberanda baseplate. The anchor member
`has a longitudinal portion configured to be secured to a bone
`and. a proximal! head. The proximal! head has a first engaging
`surface. The baseplate has a proximal end anda distal end.
`Thedistal end ofthe baseplate comprisesa first aperture sized
`to accept the proximal head of the anchor member and a
`second engaging surface. The method includes securing the
`anchor memberat least partially to bone. The method further
`includes, with the proximal head of the anchor member
`inserted into the first aperture such that the first engaging
`surface is coupled to the second engagingsurface,rotating the
`baseplaterelative to the anchor memberto adjust the position
`of the baseplate without adjusting the rotational position of
`the anchor member. The method mayfurther include securing
`the baseplate to the bone.
`[0013]
`In some embodiments, a method further comprises,
`prior to securing the anchor memberatleastpartially to bone,
`inserting the proximalheadintothefirst aperture to cause the
`first engaging surface to couple with the second engaging
`surface. A method may also comprise applying a force to the
`anchor member with a locking memberto prevent rotation
`between the anchor memberand the baseplate. A method may
`also comprise engaging a glenosphere to the baseplate. In
`some embodiments, securing the baseplate to bone comprises
`inserting one or more perimeter anchors through one or more
`openingsin the baseplate.
`[0014] Other embodiments of the invention include addi-
`tional implants or components of implants, as well as further
`methods, described herein. A system or kit mayalso be pro-
`vided according to some embodiments, wherein the system or
`kit comprisesa plurality of anchor members engageable with
`one or more baseplates and/or a plurality of baseplates
`
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`Oct. 29, 2015
`
`FIG. 8] is a side vicw of a latcralized baseplate
`[0031]
`engageable with one or more anchor members, examples of
`which are described furtherherein.
`formed by additive manufacturing.
`[0032]
`FIG. 8K is a half-wedge baseplate formed by addi-
`[0015]
`Inother embodiments, a glenoid implantfor a shoul-
`tive manufacturing.
`der prosthesis is formed. The glenoid implant comprises an
`[0033]
`FIG. 81, is a full-wedge baseplate formed by addi-
`anchor member and a baseplate. ‘he anchor member has a
`tive manufacturing.
`longitudinal portion configured to be secured to a bone and a
`[0034]
`FIG. 9A isa cross-sectional side view ofa baseplate
`proximal head. The proximal head has an external threaded
`with a dual
`threaded lumenand an anchor member.
`surface. The baseplate has a proximal end anda distal end.
`[0035]
`G. 9B is a cross-sectional side view of the base-
`Thedistal endhasa first aperture sized to accept the proximal
`plate of FIG. 9A.
`head ofthe anchor member. Thefirst aperture has an internal
`[0036]
`G. 9C is a cross-sectional side view of a glenoid
`threaded surface andaspace disposed proximal ofthe internal
`threaded surface. When the external threaded surface of the
`implant witha baseplate that has a dual threaded lumen and an
`anchor member.
`proximal head is disposed proximal of the internal threaded
`[0037]
`FIG. 9D is a cross-sectional side view of the base-
`surtace of the first aperture, the anchor memberis restrained
`plate of the glenoid implant of FIG. 9C.
`against axial translation with respect to the baseplate butis
`[0038]
`G. 9E showsa kit of anchor members, including
`rotatable with respect to the anchor member.
`the anchor member illustrated in FIG. 9C.
`[0016]
`In another embodiment, a glenoid implant for a
`[0039]
`T[IG. 9F is a side cross-sectional view of an assem-
`shoulder prosthesis is provided that includes a baseplate, an
`bly including the baseplate ofFIG. 9D and a peripheral screw.
`internal member, and a screw. The baseplate has a proximal
`[0040]
`G.9G is a perspective view of one embodimentof
`end, a distal end, an outer periphery, and an aperture that
`an internal memberofthe baseplate of FIG. 9D.
`extends therethrough adjacent to the outer periphery. The
`[0041]
`FIG. 9H isa perspective view of one embodiment of
`aperture extends from the proximal end to a bone engaging
`a peripheral screw of the glenoid assembly of FIG. 9C.
`surface. The internal memberdisposed in the baseplate has an
`[0042]
`FIG. 91 is a side cross-sectional viewof a proximal
`internal threaded surface surroundingthe aperture. ‘he screw
`portionofthe peripheral screw of FIG. 9H partially advanced
`is configuredto be placed through the aperture. The screw has
`an external threaded surface. A first number of threadstarts
`throughthe internal member of FIG. 9G.
`[0043]
`FIG. 9J is a side cross-sectional viewofthe proxi-
`disposed onthe internal threaded surface ofthe internal mem-
`malportion ofthe peripheral screw ofFIG. 9H fully advanced
`ber is greater than a second numberofthread starts disposed
`on the external threaded surface of the screw. The threads of
`through the internal memberof FIG. 9G.
`the external threaded surface of the anchor member have a
`[0044]
`FIG. 10 illustrates an implantation tool and a
`method ofusing such a tool to implant a portion of a glenoid
`constant thread form along the length thereof.
`implant.
`
`TdHieHho far
`
`1
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`BRIFF DESCRIPTION OF THE DRAWINGS
`
`[0017] These and other features, aspects and advantagesare
`described below with reference to the drawings, which are
`intended to illustrate bul not to limit the inventions. In the
`drawings,like reference characters denote corresponding fea-
`tures consistently throughout similar embodiments. The fol-
`lowing is a brief description of each of the drawings.
`[0018]
`FIG. 1 is a schematic view of the human shoulder.
`[0019]
`FIG. 2 is a perspective viewof a glenoid implant in
`an assembled configuration.
`[0020]
`FIG. 3 is an exploded viewof the glenoid implant
`shownin FIG. 2.
`
`FIG. 4 is a cross-sectional side view of the glenoid
`[0021]
`implant shown in FIG.2.
`[0022]
`FIG. 5 is a side view of a baseplate and an anchor
`memberof a glenoid implant.
`[0023]
`FIG.6 is a cross-sectional, exploded side view of a
`baseplate, an anchor memberand perimeter anchor members.
`[0024]
`FIG.
`6Aillustrates an embodiment of an anchor
`retention member.
`
`[0025]
`FIGS. 7A-7Eare side views of different embodi-
`ments ofanchor members, which may be assembledinto a kit.
`[0026]
`FIG. 8A is a top perspective view ofa baseplate.
`[0027]
`FIGS. 8B-8E are side views of different embodi-
`ments of baseplates.
`[0028]
`FIGS. 8F-8G are top views of different embodi-
`ments of baseplates.
`[0029]
`FIG. 8H is a top perspective view of another
`embodimentofa baseplate.
`[0030]
`FIG.81 is a side view of a baseplate with a distal
`portion formed by additive manufacturing.
`
`
`
`DETAILED DESCRIPTION OF THE PREFERRED
`EMBODIMENTS
`
`[0045] While the present description sets forth specific
`details ofvarious embodiments, it will be appreciatedthat the
`descriptionis illustrative only and should not be construed in
`any way as limiting. Furthermore, various applications of
`such embodiments and modifications thereto, which may
`occurto those whoare skilled in the art, are also encompassed
`by the general concepts described herein. Each and every
`feature described herein, and each and every combination of
`two or more ofsuch features, is included within the scope of
`the present invention provided that the features included in
`such a combination are not mutually inconsistent.
`[0046]
`FIG. 1 depicts the human shoulder. The glenoid
`cavity is a portion of the shoulder that is located on the
`scapula. The glenoid cavity articulates with the head of the
`humerus to permit motion of the glenohumeral joint. ‘lotal
`shoulder arthroplasty replaces the glenohumeral joint with
`prosthetic articular surfaces that replicate the naturally occur-
`ring concave and convex surfaces of the body. Typically, in
`total shoulder arthroplasty, an articular surface replaces the
`humeral head and anarticular surface replacescartilage in the
`glenoid cavity. In a typicalreverse total shoulder arthroplasty,
`a glenoid implant with a convex spherical headis inserted into
`the glenoid cavity and a complimentary socket is placed on
`the humerus. Reversetotal shoulder arthroplasty reverses the
`naturally occurring ball and sockct orientation related to the
`glenohumeral joint.
`[0047]
`FIGS. 2-4 depict a glenoid implant 100, more pref-
`erably a reverse glenoid implant, configured to be implanted
`in the glenoid cavityofa patient in the patient’s scapula. The
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`US 2015/0305877 Al
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`Oct. 29, 2015
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`movethe center ofrotation ofthe humeruslaterally compared
`to the positionofthe centerofrotation prior to intervention. In
`the context of an anatomic shoulderprosthesis, the lateralized
`baseplate may support an anatomic articular surface that is
`shifted laterally relative to the medial surface compared to the
`glenoid surface prior to intervention. The bone engaging sur-
`face 152 can be substantially parallel to the proximal surface
`144 and/or the distal surface 148. FIGS. 8K-8L illustrate
`modified embodiments in which the bone engaging surface
`varies, c.g., providing a partial or full wedge shape for reasons
`discussed below.
`
`[0050] The baseplate 108also has a lateral surface 156 that
`spans between the proximalsurface 144ofthe baseplate 108
`and the bone engaging surface 152 of the baseplate 108. The
`surface 156is disposedlateral with regard to the center ofthe
`implant 100 and also is disposed lateral of the mid-plane of
`the paticnt when the implant 100 is applicd to the patient. The
`lateral surface 156 can have a circular profile when viewed in
`a cross-section plane extending parallel to the proximal sur-
`face 144. The diameterofthe circular profile can be between
`about 20 mmand about 40 mm,e.g., between about 25 mm
`and about 35 mm,e.g. about 30 mm.In some embodiments,
`the lateral surface 156 of the baseplate 108 is configured to
`forma portionofafriction lock engagement, such as a Morse
`taper. In one embodiment, the lateral surtace 156 of the base-
`plate 108 is tronconical. The term tronconical, as used herein,
`refers to a shapeorsurface that is or is similar to a truncated
`cone. In some embodiments, the lateral surface 156 is con-
`figured with a gradually increasing perimeter in a direction
`from proximal surface 144 toward the bone engaging surface
`152.
`
`glenoid implant 100 includes an anchor member 104 for
`anchoring the implant 100 in the scapular glenoid, a baseplate
`108, a locking structure 112 configuredto deter rotation of the
`anchor memberrelative to the baseplate, and a gleno sphere
`116 having an articular surface (e.g., a convex, spherical
`surface). The glenosphere 116 is configured to couple to a
`complimentary prosthetic device anchored to the humerus
`(not shown, but sometimes referred to herein as the humeral
`component) in order for the joint replacement implants ta
`replicate the motion of the human shoulder. The humeral
`componentcan take any suitable form such asthose disclosed
`in connection with FIGS, 18-21 and elsewhere in U.S. provi-
`sional application No. 61/719,835, filed Oct. 29, 2012, which
`is incorporated by reference herein in its entirety. Suitable
`humeral components can be configured to couple with reverse
`shoulder joint components, including those described in con-
`nection with FIGS. 1-9, 27-38, and 39-41 of the ’?835 appli-
`cation. Suitable humeral components can be configured. ta
`adapt to anatomical and reverse shoulder configurations. The
`glenoid implant 100 and the humeral component provide a
`replacementfor the natural glenohumeral joint.
`[0048] As used herein, the terms “distal” and “proximal”
`are used to refer to the orientation of the glenoid implant as
`shown in FIGS. 2-4. As shown in FIG.3, a longitudinal axis
`120 of the glenoid implant 100 extends through a central
`longitudinal axis 124 of anchor member104 (shownin FIGS.
`4 and 6). The glenosphere 116 is towards the proximal end
`along the longitudinal axis 120 and the anchor member 104 is
`towardsthe distal end along the longitudinal axis 120. In other
`words, an elementis proximalto another elementifit is closer
`to acentral aperture 128 (shownin FIG. 4) ofthe glenosphere
`116 thanthe other element, and an elementis distal to another
`[0051] As illustrated in FIG. 5, in some embodiments, the
`baseplate 108 can include a central protrusion 160 that
`elementif it closer to a distal tip 132 (shown in FIG. 4) of the
`projects distally from the bone engaging surface 152 to the
`anchor member 104 than the other element. At some points
`distal end 140. The central protrusion 160 has an outer surface
`below, reference may be madeto the anatomicallocation. In
`164 that extends from the bone engaging surface 152 to the
`use whenthe implantis delivered into a patient’s scapula, the
`distal surface 148. Referring nowto FIG.6, the central pro-
`distal tip 132 ofthe anchor member 104 is more media! on the
`trusion 160 can include a first aperture 168 which may be
`patient, whereas the articular surface ofthe gleno sphere 116
`is more lateral on the patient.
`cylindrical. In some embodiments, the first aperture 168 may
`include a groove 172 along an inner wall ofthe first aperture.
`[0049] FIGS.3 and4show thatthe baseplate 108 is oriented
`‘The baseplate 108 can have a second aperture 176 that, in
`substantially perpendicular to the longitudinal axis 120 ofthe
`some embodiments, extends from thefirst aperture 168 to the
`glenoid. implant 100. The baseplate 108 is shown coupled. to
`proximal end 136 of the baseplate 108, such that a lumen 180
`he anchor member104 in FIGS. 4 and 5 and apart from the
`is formed throughthe baseplate 108. The second aperture 176
`anchor member104 in FIG. 6. Referring now to FIG.5, the
`can include an internally threaded surface 184 as shown.In
`baseplate 108 has a proximal end 136 and a distal end 140.
`some embodiments, the second aperture 176 is smaller in
`‘The proximal end 136 comprises a proximal surface 144 and
`diameter than the first aperture 168.
`he distal end 140 comprises a distal surface 148. The proxi-
`[0052]
`FIG. 6 showsthat the baseplate 108 includesa plu-
`mal surface 144 can be substantially parallel to the distal
`rality of holes, e.g., two holes 188, 192 positioned laterally
`surface 148. The baseplate 108 can also include a bone engag-
`outward of the lumen 180, that are configured to accept
`ing surface 152. A thickness of the baseplate 108 defined
`perimeter anchor members 196. The holes 188, 192 extend
`between the proximal surface 144 and the bone engaging
`fromthe proximal end 136 of the baseplate 108 to the bone
`surface 152 may correspondto the amountthat the baseplate
`engaging surface 152 of the baseplate 108. These holes 188,
`108 extends above a surface of the bone when implanted. The
`192 are also illustrated in FIG. 8A, which illustrates a per-
`hickness can be in a range between about 2 mm and about 12
`spective view ofthe proximal end 136 of the baseplate 108 of
`mm,e.g., between about 4 mm and about 9 mm,e.g., about 6
`FIGS. 2-6. Asillustrated, the baseplate 108 may havea cir-
`mm. Thicknesses of about 3 mm, 5mm, 7 mm, 8 mm, 10 mm
`cular shape, with a thickness between the proximal surface
`and 11 mm are also contemplated. As discussed further
`below, FIG.8Jillustrates a modified embodimentofa base-
`144 and the bone engaging surface 152 that is less than a
`plate 108] where the surface 144 is lateralizedrelative to the
`diameter of the proximal surface 136. It will be appreciated
`that the baseplate 108 need not be circular, and may have
`patient’s mid-plane. A lateralized baseplate is one in which
`other shapes as well.
`when combined with an articular component, the articulating
`surface is shifted laterally relative to the medical plane of the
`[0053] Referring to FIGS. 3 and 6, the holes 188, 192 can be
`palient compared to an anatomical position of the articular
`defined in part by internal members 200 that are disposed
`surface. In the context of a reverse shoulder, the shitting can
`within recesses 204 in baseplate 108. In some embodiments,
`
`
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`US 2015/0305877 Al
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`the internal member 200 is semi-spherical and the recess 204
`is semi-spherical, in order to permit movementof, e.g., rota-
`tion and/ortilting of the internal member 200 with respect to
`the baseplate 108. ‘lhe internal member 200 allows a longi-
`tudinal axis extending centrally through the holes 188, 192
`(for example longitudinal axis 208 extending through hole
`188 as shownin FIG.6) to be aimed to some extent toward a
`desired anatomical feature. The movement of the internal
`member200 allows the positioning and/or aiming of perim-
`eter anchor members 196 toward a desired location. The
`longitudinal axis 208 extending through the hole 188 can be
`substantially parallel to a longitudinal axis 212 extending
`through the second aperture 176 and/or lumen 180, as shown
`by the orientation ofthe internal member 200 in part defining
`the hole 188 or angled with respect to the longitudinal axis
`212 of the second aperture 176 and/or lumen 180, not shown.
`[0054] The number and position of the holes 188, 192
`depends on manyfactors including the anatomical structure
`of the patient, the diameter of the perimeter anchor members
`196, and size constraints dictated by dimensionsofthe base-
`plate 108. Thus, there may be fewer or greater holes and
`perimeter anchors membersthan illustrated. In some embodi-
`ments, perimeter anchor members 196 are inserted through
`the baseplate 108 from the proximal end 136 thereof. As
`shownin FIG. 6, the perimeter anchor member 196 can be
`inserted in the general direction of Arrow A.
`[0055]
`FIG. 6 showsthat the anchor member 104is config-
`ured to be attached to the bone of a patient. The anchor
`member104is generally formed of a cylindrical longitudinal
`portion 216 and a proximal head 220, both of which extend
`along a longitudinal axis 124 of the anchor member 104. The
`anchor member 104 has an externallateral surface 224 which
`mayinclude a self-tapping threaded surface. Other lateral
`surfaces of anchor members are discussed below in connec-
`
`tion with FIGS. 7A-7E, 8E, 9A, 9C and 9E.As used herein, a
`threaded surface is right-handed whenthe driving action is
`performed with clockwise rotation and. left-handed when the
`driving action is performed with counterclockwise rotation.
`Thethreading ofthe external lateral surface 224 ofthe anchor
`member 104 may be right-handed or left-handed. In some
`embodiments, the longitudinal portion 216 of the anchor
`member 104 comprises a distally tapered distal tip 132.
`[0056]
`FIG. 6 showsthat the proximal head 220 can have a
`cavity 228 disposed about the longitudinal axis 124. The
`cavity 228 cxtends distally from the proximal end of the
`proximal head 220. In some embodiments, the cavity 228
`comprises one or moreflat surfacesthat are capable ofmating
`with a driver configured to applyrotational force to drive the
`anchor member 104 into the bone. For example, the cavity
`228 can have a hexagonal cross-section, centered onthe lon-
`gitudinal axis 124, configured to mate with a hexagonalcross-
`section driver. The proximal head 220 can comprise a groove
`232. In some embodiments, the groove 232 is a circumferen-
`tial groove around an cxternal surface of the proximal head
`220. The proximal head 220 may include an inclined surface
`236,the function ofwhichis discussed in greaterdetail below.
`[0057] Referring to FIGS. 5 and6, the anchor member 104
`and the baseplate 108 are coupled in thefirst aperture 168,
`whichis sized to accept the proximal head 220 of the anchor
`member 104. In some embodiments, the glenoid implant 100
`comprises a member 240, as shown in FIGS. 3, 4 and6, that
`is sized to fit partly within the groove 232 in the proximal head
`220 andpartly within the groove 172 in the baseplate 108. The
`member240 can comprise a c-clip, O-ring or similar protrud-
`
`ing device that can span atleast a portion ofthe groove 232 in
`the proximal head 220 and atleast a portion ofthe groove 172
`in the baseplate 108. Alternatively member 240 may be com-
`prised ofelastically deformable barbs, fingers, or other pro-
`jections having one end attached to and angled away from
`either head 220 or baseplate 108 such that the projections are
`deformed between head and baseplate when headis inserted
`into baseplate and suchthat the unattached end ofthe projec-
`tions elastically expands into groove in head or baseplate. In
`this way, the anchor member 104 is held at a fixed position
`along the longitudinal axis 120 of the glenoid implant 100,
`shownin FIG.4, relative to the baseplate 108. Preferably the
`coupling provided by the member 240 does not prevent the
`relative rotation of the anchor