阅读说明：本技术 患者特定的重建性关节盂系统和方法 (Patient-specific reconstructive glenoid system and method ) 是由 N·A·温斯洛 M·F·科瓦克斯 J·舒尔茨 于 2018-02-02 设计创作，主要内容包括：一种用于修复特定患者的关节盂缺损的系统可以包括患者特定的冲头(100)和患者特定的成形块(200)。该患者特定的冲头可以由骨盘形成患者特定的关节盂植入物(102)。该患者特定的成形块可以使该患者特定的关节盂植入物成形以匹配并填充特定患者的关节盂缺损。(A system for repairing a glenoid defect in a particular patient may include a patient-specific punch (100) and a patient-specific shaping block (200). The patient-specific punch may form a patient-specific glenoid implant (102) from the disc. The patient-specific shaped block can shape the patient-specific glenoid implant to match and fill a glenoid defect of a particular patient.)

1. A system for repairing a glenoid defect in a particular patient, the system comprising:

An impactor body; and

A patient-specific punch coupled to the impactor body, the patient-specific punch including a patient-specific void corresponding to the glenoid defect;

wherein the impactor body is configured to drive the patient specific punch into an implant material to form a patient specific glenoid implant.

2. the system of claim 1, wherein the patient-specific punch is removably coupled to the impactor body.

3. The system of claim 1 or 2, wherein the implant material comprises a bone disc formed from a resected portion of a humeral head.

4. The system of any one of claims 1-3, wherein the patient-specific glenoid implant is configured to couple to a baseplate configured to couple to the glenoid.

5. The system of claim 4, further comprising:

A patient-specific shaping block configured to receive the patient-specific glenoid implant in a shaping void; and

A spacer configured for placement in the patient-specific shaped mass, the spacer having a geometry corresponding to the base plate;

Wherein the shaped void is configured to match the glenoid defect;

wherein the patient-specific glenoid implant is configured to be impacted such that the shaped void and the spacer shape the patient-specific glenoid implant to repair the glenoid defect.

6. The system of claim 5, further comprising:

An impactor head configured to be removably coupled to the impactor body.

7. The system of claim 5 or 6, wherein the patient-specific shaped block further comprises a cover configured to receive an introducer needle.

8. The system of any one of claims 5-7, further comprising a baseplate reamer configured to ream the patient-specific glenoid implant to match a feature of the baseplate.

9. The system of any of claims 1-8, wherein the patient-specific punch includes a knife edge.

10. A system for repairing a glenoid defect in a particular patient, the system comprising:

A patient-specific punch including a patient-specific void corresponding to the glenoid defect, the patient-specific punch configured to form a patient-specific glenoid implant; and

a patient-specific shaping block configured to receive the patient-specific glenoid implant in a shaped void that matches the glenoid defect;

Wherein the patient-specific glenoid implant is configured to be impacted such that the shaped void shapes the patient-specific glenoid implant to fill the glenoid defect.

11. The system of claim 10, further comprising:

A base plate configured to be coupled to the patient-specific glenoid implant for implantation in a specific patient.

12. The system of claim 11, further comprising:

A spacer configured to be inserted into the patient-specific shaped mass, the spacer having a geometry corresponding to the base plate.

13. The system of any of claims 10-12, further comprising:

A bone cutter configured to form a bone disc, wherein the patient-specific punch is configured to impact the bone disc to form the patient-specific glenoid implant.

14. The system of claim 13, wherein the bone cutter comprises:

An extraction block configured to receive a humeral head resection;

a fastener configured to extend through the humeral head resection; and

A rotatable blade assembly configured to be received by and rotated about the fastener to cut the humeral head resection to form the bone disc.

15. The system of any of claims 10-14, further comprising:

an impactor body comprising an attachment portion configured to be removably coupled to one or more attachment members, wherein the patient-specific punch is configured to be removably coupled to the attachment portion of the impactor body.

16. the system of claim 15, further comprising:

An impactor head attachment configured to be removably coupled to the attachment portion of the impactor body.

17. A method for repairing a glenoid defect in a particular patient, the method comprising:

Driving a patient-specific punch into the implant material to create a patient-specific glenoid implant, wherein the patient-specific punch includes a patient-specific void corresponding to the glenoid defect;

Placing the patient-specific glenoid implant in a patient-specific shaped block that includes a shaped void that matches the glenoid defect; and

Impacting the patient-specific glenoid implant such that the patient-specific shaping block shapes the patient-specific implant to fill the glenoid defect.

18. the method of claim 17, further comprising:

The disc is formed by a cut-away portion of the humeral head.

19. The method of claim 17 or claim 18, further comprising:

Reaming the patient-specific implant to receive a substrate.

20. The method of claim 19, further comprising:

Coupling the patient-specific glenoid implant to the baseplate, the baseplate configured to be coupled to the glenoid.

Background

in some shoulder procedures, the glenoid bone is used to anchor one or more fasteners. Sometimes a patient's glenoid has one or more defects that may reduce the screw anchorage available on the glenoid. Some current practices of addressing a glenoid defect may involve lengthy procedures, difficult procedures, removal of excess glenoid, damage to the glenoid vault, and the like. In addition, some current practices are not effective in correcting defects, do not address defects inside the peripheral rim of the glenoid, may create irregular geometries within the shoulder joint, and the like.

Disclosure of Invention

To better illustrate the instruments disclosed herein, a series of non-limiting examples are provided herein:

In example 1, a system for repairing a glenoid defect of a particular patient can be provided that can include an impactor body and a patient-specific punch coupled to the impactor body, the patient-specific punch including a patient-specific void corresponding to the glenoid defect, the system optionally being configured such that the impactor body is configured to drive the patient-specific punch into an implant material to form a patient-specific glenoid implant.

in example 2, the system of example 1 is optionally configured such that the patient-specific punch may be removably coupled to the impactor body.

In example 3, the system of examples 1 or 2 is optionally configured such that the implant material may comprise a bone disc formed from a resected portion of a humeral head.

in example 4, the system of any of examples 1-3 is optionally configured such that the patient-specific glenoid implant can be configured to couple to a baseplate configured to couple to the glenoid.

In example 5, the system of example 4 may optionally include: a patient-specific shaping block configured to receive the patient-specific glenoid implant in a shaping void; and a spacer configured for placement in the patient-specific shaped block, the spacer having a geometry corresponding to the base plate, the system optionally configured such that the shaped void is configured to match the glenoid defect, the system optionally configured such that the patient-specific glenoid implant is configured to be impacted such that the shaped void and the spacer shape the patient-specific glenoid implant to repair the glenoid defect.

in example 6, the system of example 5 may optionally include an impactor head configured to be removably coupled to the impactor body.

in example 7, the system according to examples 5 or 6 may optionally be configured such that the patient-specific shaped mass may further comprise a cover configured to receive an introducer needle.

In example 8, the system of any of examples 5-7 may optionally include a baseplate reamer configured to ream the patient-specific glenoid implant to match a feature of the baseplate.

In example 9, the system of any of examples 1-8 is optionally configured such that the patient-specific punch may include a knife edge.

In example 10, a system for repairing a glenoid defect of a particular patient may be provided, the system may include: a patient-specific punch including a patient-specific void corresponding to the glenoid defect, the patient-specific punch configured to form a patient-specific glenoid implant; and a patient-specific shaped block configured to receive the patient-specific glenoid implant in a shaped void that matches the glenoid defect, the system optionally being configured such that the patient-specific glenoid implant is configured to be impacted such that the shaped void shapes the patient-specific glenoid implant to fill the glenoid defect.

In example 11, the system of example 10 may optionally include a base plate configured to be coupled to the patient-specific glenoid implant for implantation in a particular patient.

In example 12, the system of example 11 may optionally include a spacer configured to be inserted into the patient-specific shaped mass, the spacer having a geometry corresponding to the base plate.

In example 13, the system of any of examples 10-12 can optionally include a bone cutter configured to form a bone disc, the system optionally configured such that the patient-specific punch is configured to impact the bone disc to form the patient-specific glenoid implant.

in example 14, the system of example 13 is optionally configured such that the bone cutter may optionally comprise: an extraction block configured to receive a humeral head resection; a fastener configured to extend through the humeral head resection; and a rotatable blade assembly configured to be received by and rotated about the fastener to cut the humeral head resection to form the bone disc.

In example 15, the system of any of examples 10-14 may optionally include an impactor body that may include an attachment portion configured to be removably coupled to one or more attachment members, the system optionally being configured such that the patient-specific punch is configured to be removably coupled to the attachment portion of the impactor body.

In example 16, the system of example 15 may optionally include an impactor head attachment configured to be removably coupled to the attachment portion of the impactor body.

In example 17, a method for repairing a glenoid defect of a particular patient may be provided, the method may include: driving a patient-specific punch into the implant material to produce a patient-specific glenoid implant, the method optionally being configured such that the patient-specific punch may include a patient-specific void corresponding to the glenoid defect; placing the patient-specific glenoid implant in a patient-specific shaped block that includes a shaped void that matches the glenoid defect; and impacting the patient-specific glenoid implant such that the patient-specific shaping block shapes the patient-specific implant to fill the glenoid defect.

In example 18, the method of example 17 may optionally include forming a bone disc from the resected portion of the humeral head.

In example 19, the method of example 17 or example 18 may optionally include reaming the patient-specific implant to accommodate a substrate.

In example 20, the method of example 19 may optionally include coupling the patient-specific glenoid implant to the baseplate, the baseplate configured to be coupled to the glenoid.

In example 21, the system or method of any of examples 1-20 may optionally be combined.

These and other examples and features of the present devices, systems, and methods will be set forth in part in the detailed description which follows. This summary is intended to provide an overview of the subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive removal of the present invention. This detailed description is included to provide further information about the present patent application.

drawings

in the drawings, which are not necessarily drawn to scale, like reference numerals may describe similar components in different views. Like reference numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed herein.

Fig. 1 is a perspective view of a patient-specific punch for forming a patient-specific glenoid implant corresponding to a glenoid defect of a particular patient according to at least one example of the present disclosure.

fig. 2A is a perspective view of a patient-specific shaping block for shaping a patient-specific glenoid implant according to at least one example of the present disclosure.

fig. 2B is another perspective view of the patient-specific shaped block of fig. 2A, according to at least one example of the present disclosure.

Fig. 2C is a perspective view of a spacer and a spacer removal tool according to at least one example of the present disclosure.

Fig. 2D is a cross-sectional view of a spacer inserted into a patient-specific shaping block to shape a patient-specific glenoid implant according to at least one example of the present disclosure.

Fig. 3A is a perspective view of an impactor body and patient-specific punch attachment according to at least one example of the present disclosure.

Fig. 3B is a perspective view of an impactor head attachment for the impactor body of fig. 3A according to at least one example of the present disclosure.

Fig. 4 is a perspective view of a bone cutter according to at least one example of the present disclosure.

Fig. 5 is a perspective view of a patient-specific bone substitute injector according to at least one example of the present disclosure.

Fig. 6 is a perspective view of an injector and a patient-specific mold according to at least one example of the present disclosure.

fig. 7 is a perspective view of a patient-specific glenoid implant implanted into a corresponding glenoid defect of a specific patient according to at least one example of the present disclosure.

Detailed Description

In some shoulder procedures, defects in the patient's glenoid can affect repair of the shoulder, as the glenoid can be used to anchor fasteners. These glenoid defects reduce the amount of screw fixation available between the baseplate and the cortical or cancellous bone of the patient. Some current procedures attempt to counteract the effects of the glenoid defect with bone substitute and with cancellous bone fragments, but these procedures are time consuming, difficult to place, and the bone fragments are not always appropriate for the geometry of the glenoid defect void because they are not patient specific.

current surgical options are limited to addressing glenoid that experiences a large amount of retroversion at the posterior edge of the glenoid (e.g., B2Walch classification glenoid defects). Such defects predispose the shoulder to subluxation through the posterior wall and may result in impingement within the musculoskeletal system. These defects are of varying sizes, complex shapes, leave little to no bone along the posterior edge of the glenoid, and may spread anteriorly.

One current technique involves reaming the face of the glenoid down the side surface to eliminate the existing posterior slope that results from wear between the glenoid and humerus. Another current technique utilizes an augmented glenoid. Both of these current techniques involve removing a large amount of bone from the glenoid. The glenoid vault has only a certain amount of suitable bone before it is completely damaged. Some prior art addresses defects only at the peripheral edge of the glenoid. Many of these techniques produce irregular geometries within the shoulder joint.

The present disclosure provides various systems and methods related to a patient-specific glenoid implant for filling a void of a glenoid defect of a particular patient. In at least one example, the present disclosure provides systems and methods for naturally reconstructing a glenoid vault using autografts, allografts, bone substitutes, or combinations of these. In at least one example, the resulting glenoid implant will be matched to the patient and fixed on the existing bone as the new bone grows. In at least one example, the systems and methods of the present disclosure allow a surgeon to match a particular glenoid void while reconstructing the glenoid rim and producing the correct muscle tension. Further, in at least one example, the systems and methods of the present disclosure allow for preoperative planning and preparation to reduce surgical time. In at least one example, the systems and methods of the present disclosure allow a surgeon to mitigate the risk of biocompatibility rejection, as the patient's body will more readily accept implants made from the patient's anatomy. Although the present disclosure is described with reference to glenoid repair, the systems and methods of the present disclosure can also be used for any bone defect repair.

For the purposes of this disclosure, patient-specific may be defined to include a size that is specific to a certain patient, such that the size will vary from patient to patient. That is, the patient-specific glenoid implant can be customized to the anatomy of a particular patient. In at least one example, patient-specific may be defined to include a geometry that matches the anatomy of a particular patient. In at least one example, patient-specific may be defined to include a geometry that reflects the anatomy of a particular patient. In at least one example, patient-specific may be defined to include a geometry that exactly matches the geometry of the particular patient's anatomy. In at least one example, patient-specific may be defined as having a geometry that completely fills a void in a particular patient anatomy. Patient-specific glenoid implants may allow for more accurate and successful repair of glenoid defects.

Fig. 1 is a perspective view of a patient-specific punch 100 for forming a patient-specific glenoid implant 102 corresponding to a glenoid defect 104 of a specific patient 106 according to at least one example of the present disclosure. The glenoid defect 104 can have any geometry and can be located anywhere on the glenoid 108 of the patient 106. Further, in at least one example, the patient 106 can have multiple glenoid defects, and each glenoid defect can be repaired separately by multiple patient-specific punches, or a single patient-specific punch can be produced to address multiple glenoid defects.

The patient-specific punch 100 may include a patient-specific void 110 corresponding to the glenoid defect 104. In at least one example, the patient-specific gap 110 can be defined by a knife edge or cutting edge. In some examples, the patient-specific void 110 can include a measured geometry of the glenoid defect. In at least one example, the patient-specific gap 110 exactly matches the gap of the bone defect 104 of the particular patient 106. In at least one example, the geometry of the glenoid defect 104 can be determined in any of a variety of ways including patient imaging (e.g., X-ray, CT (computed tomography), MRI (magnetic resonance imaging)), pre-operative planning tools, and the like. In at least one example, the patient scan can be converted to a three-dimensional model to determine the three-dimensional size and shape of the glenoid defect. In at least one example, the segmentation of the CT scan is used to determine the size and shape of the glenoid defect. A patient-specific punch 100 is formed for a specific patient. In at least one example, the patient-specific punch 100 will only match the geometry of the particular patient for which it is produced.

In at least one example, the patient-specific punch 100 can include a patient-specific void 110 that matches a particular size of the glenoid defect 104, but does not exactly match the overall geometry of the glenoid defect 104. For example, the patient-specific void 110 can match the two-dimensional contour 112 of the glenoid defect 104 such that the patient-specific punch 100 can form the patient-specific glenoid implant 102 that includes the dimensions of the contour 112, but continues these dimensions over a fixed height 114. In other examples, the patient-specific punch 100 may include a patient-specific void 110 that matches a different selected portion of the geometry of the glenoid defect 104.

In some examples, the patient-specific punch 100 may be driven into the implant material to form the patient-specific glenoid implant 102. In some examples, the implant material may include bone. In at least one example, the implant can include an allograft. In some examples, the implant material may include autograft. In at least one example, the implant material can include a resected humeral head portion of a particular patient 106. In some examples, the implant material may include cancellous bone.

fig. 2A is a perspective view of a patient-specific shaping block 200 for shaping a patient-specific glenoid implant 102 in accordance with at least one example of the present disclosure. In some examples, the patient-specific shaped mass 200 may include a cover 202 configured to be placed over the patient-specific shaped mass 200. In at least one example, the cartridge can include one or more cover features 204 configured to interact with the cover 202 to seat, center, or secure the cover 202 on the block 200.

In some examples, the patient-specific shaped mass 200 may include a mass void 206. In at least one example, the block void 206 can include a patient-specific portion corresponding to the glenoid defect 104 of a particular patient 106. In at least one example, the patient-specific portion 208 can match the geometry of the glenoid defect 104. In some examples, the block void 206 may further include a substrate portion 210 corresponding to a substrate (e.g., a substrate used during shoulder surgery). In some examples, the block void 206 may include an impactor seat 212 configured to receive an impactor head during an impact. In some examples, the cover 202 may be configured to receive the impactor head and may include one or more features to deliver the impact force to the patient-specific glenoid implant 102.

In some examples, the patient-specific shaped block 200 may include one or more fastener holes 214 for receiving fasteners. In at least one example, the cover 202 may include one or more fastener holes 216 corresponding to the one or more fastener holes 214 of the patient-specific shaped mass 200. In some examples, the fastener may include a needle, a drill bit, a wire, and the like. In at least one example, the fastener can comprise a Steinman pin (Steinman pin) having a diameter of 3.2 mm. In at least one example, the cover 202 can receive a 3.2mm schanz pin to center it in the glenoid post, which can allow for accurate reaming andsimilarity between the Reverse Shuolder System and the glenoid reconstruction technique. In at least one example, cap 202 may provide alignment for a drill bit or other tool. At least one displayIn an example, the cover 202 may be a drill guide. In at least one example, one or more tools can be cannulated such that the one or more tools slide over the needle for controlled alignment. In at least one example, the patient-specific shaping block 200 can be used to shape the patient-specific glenoid implant 102 produced by the patient-specific punch 100.

Fig. 2B is another perspective view of a patient-specific shaped block 200 without a cover 202 according to at least one example of the present disclosure. In the example shown, the patient-specific shaped block 200 may include a cover attachment feature 218. In some examples, lid attachment feature 218 may be a needle about which lid 202 may pivot. In some examples, the cover attachment features 218 may include any of a variety of alignment features, such as pegs, holes, tabs, latches, slots, and the like. In at least one example, the cover attachment feature 218 may be a press-fit feature. In at least one example, the cover attachment feature 218 can include a hinge point. In some examples, lid 202 may include corresponding attachment features that correspond to lid attachment features 218. In at least one example, the patient-specific shaped mass 200 does not include a cover 202.

Fig. 2C is a perspective view of a spacer 220 and a spacer removal tool 222 according to at least one example of the present disclosure. In at least one example, spacer 220 can match the geometry of the base plate such that spacer 220 can shape patient-specific glenoid implant 102 to fit the base plate. In at least one example, the spacer 220 can ensure that the patient-specific glenoid implant 102 takes the shape required to fill the void of the glenoid defect 104. In some examples, spacer 220 may include defect feature 224 to make room for patient-specific glenoid implant 102 in patient-specific shaped block 200. In at least one example, defect feature 224 may be patient-specific.

In some examples, the spacer 220 may include a removal feature 226 such that a removal portion 228 of the removal tool 222 may interact with the removal feature 226 to remove the spacer 220 from the patient-specific shaped block 200. In at least one example, the removal feature 226 can allow the spacer 220 to be removed without the use of a particular spacer removal tool 222. Although in the example shown, the removal feature 226 includes a groove that receives the removal portion 228 of the removal tool 222, in other examples, the removal feature 226 and the removal portion 228 may include any features that interact to remove the spacer 220 from the patient-specific shaped block 200. In at least one example, the spacer removal tool 222 may form a lever arm when interacting with the spacer 220 to eject the spacer 220 from the patient-specific shaped block 200.

Fig. 2D is a cross-sectional view of spacer 220 inserted into patient-specific shaped block 200 to shape patient-specific glenoid implant 102 in accordance with at least one example of the present disclosure. In the example shown, the patient-specific glenoid implant 102 may extend into the impactor space 230 between the impactor seat 212 and the top surface 232 of the patient-specific shaped block 200. In at least one example, an impactor can be used to apply a force to the patient-specific glenoid implant 102 such that the patient-specific glenoid implant 102 fills the patient-specific portion 208 of the block void 206 to match the geometry of the glenoid defect 104 while accommodating the baseplate. After the patient-specific glenoid implant 102 is impacted to fill the patient-specific portion 208 of the block void 206, the spacer 220 can be removed with a spacer removal tool 222 or otherwise, and the patient-specific glenoid implant 102 can be prepared for implantation into the glenoid defect 104 of the particular patient 106. In at least one example, the spacer 220 can control critical features when impacting a patient-specific glenoid implant 102 made, for example, of cancellous bone. In at least one example, the spacer 220 can haveReverse Shoulder System baseplate geometry to simplify implantation with patient-specific glenoid implant 102Required for Reverse shelf System substrateAnd (5) reaming process. In at least one example, spacer 220 can have a Trabecular Metal^TMreverse Shoulder System baseplate geometry to simplify the implantation of a Trabecular Metal with a patient-specific glenoid implant 102^TMReverse Shoulder System substrate required reaming process.

Fig. 3A is a perspective view of an impactor 300 according to at least one example of the present disclosure. The impactor 300 may include an impactor body 302 and an impactor attachment 304. In the example shown, impactor attachment 304 may include patient-specific punch 100 of fig. 1, which patient-specific punch 100 includes patient-specific void 110. In at least one example, the impactor body 302 may include an attachment portion 306, the attachment portion 306 configured to interact with one or more attachment features 308 of the impactor attachment 304. In at least one example, the attachment portion 306 of the impactor body 302 may allow one or more impactor attachments 304 to be removably coupled to the impactor body 302. In at least one example, the impactor body 302 may be used for multiple procedures and multiple patients. In at least one example, some impactor attachments 304, such as patient-specific punches 100, are patient-specific and can only be used for the particular patient 106 to which they correspond. In this manner, when the patient-specific punch 100 is no longer needed, it may be removed from the impactor body 302 and discarded, but the impactor body 302 may still be used with other impactor attachments 304.

fig. 3B is a perspective view of another impactor attachment 304 in accordance with at least one example of the present disclosure. In at least one example, impactor attachment 304 may include impactor head attachment 310. In some examples, the impactor head attachment 310 may include one or more attachment features 308 such that the impactor head attachment 310 may be removably coupled to the impactor body 302. In at least one example, the impactor head attachment 310 may include a universal impactor face 312. In at least one example, the impactor head attachment 310 may be shaped and sized to fit within the impactor seat 212 of the patient-specific shaped block 200. In at least one example, impactor head attachment 310 may include one or more patient-specific features to facilitate shaping of patient-specific glenoid implant 102 to fill glenoid defect 104.

fig. 4 is a perspective view of a bone cutter 400 according to at least one example of the present disclosure. In some examples, the bone cutter 400 may include an extraction block 402 configured to receive an implant material 404. In some examples, implant material 404 may include allograft. In at least one example, implant material 404 may comprise autograft. In at least one example, the implant material 404 can include a resected humeral head. In some examples, the bone cutter 400 may include one or more fastener holes 406, each configured to receive a fastener, such as a needle 408, a screw 410, or the like. In at least one example, one or more of the fasteners 408, 410 can be configured to be driven into the implant material 404.

In some examples, the bone cutter 400 may include a rotatable blade assembly 412. In at least one example, the blade assembly 412 can be coupled to a fastener 410 driven through the extraction block 402 and the implant material 404. In at least one example, the blade assembly 412 can be coupled to the implant material 404. In at least one example, the blade assembly 412 can be coupled to the extraction block 402. In some examples, the blade assembly 412 may include one or more arcuate blades 414. In at least one example, blade 414 may comprise an explant knife. In some examples, a user may place the implant material 404 in the extraction block 402, insert the fasteners 408, 410, and attach the blade assembly 412. In at least one example, the implant material can include a resected humeral head that can be placed corticalically anteriorly into the extraction block 402. In at least one example, after attaching the blade assembly, the blade assembly 412 can be rotated to cut the implant material 404 to form the disc. In some examples, the blade 414 may pivot within a range 416 of, for example, 30 degrees to allow for a change in the angle of the blade 414. In at least one example, the pivot range 416 can facilitate entry of the blade 414 into the implant material 404. In at least one example, the pivot range 416 can allow the cutting of the blade 414 to compliment the natural anatomical shape of the humeral head, which can allow the surgeon to maximize the amount of bone available, which can give the surgeon greater opportunity to address the defect by providing them with more cancellous material to work with. In at least one example, the blade assembly 412 can be set to a predetermined depth such that the blade 414 will only cut to the predetermined depth to produce the desired trabecular shape for the surgeon. In at least one example, the bone cutter 400 can produce a conical disc.

In at least one example, a patient-specific punch 100 (fig. 1) can impact a disc to form a patient-specific glenoid implant 102. In at least one example, the patient-specific glenoid implant 102 can then be placed into the patient-specific shaping block 200 along with the spacer 220 and impacted to shape the patient-specific glenoid implant 102. In some examples, the patient-specific glenoid implant 102 will then perfectly match the glenoid defect 104 of the particular patient 106 and may be implanted into the glenoid defect 104 of the particular patient 106. In at least one example, the patient-specific glenoid implant 102 can be reamed to facilitate implantation. In at least one example, the patient-specific implant 102 can be coupled to the base plate prior to being implanted in the anatomy of the specific patient 106. In at least one example, the base plate can be coupled to the patient-specific implant 102 with peripheral screws.

fig. 5 is a perspective view of a patient-specific bone substitute injector 500 according to at least one example of the present disclosure. In at least one example, patient-specific bone substitute injector 500 can include an injector 502, a nozzle 504, and a patient-specific portion 506. In at least one example, the patient-specific portion 506 can include a patient-specific glenoid sleeve that can be placed over a face of the glenoid defect 104. In at least one example, the glenoid sleeve centers the bone substitute 508 to directly fill the glenoid defect 104 with the patient-specific feature 510. In at least one example, the glenoid sleeve restricts the locations in which bone substitute can be injected so that it fills only the glenoid defect 104. In at least one example, patient-specific portion 506 can include a vacuum seal adapter attached to the glenoid sleeve to form a sealing liner around glenoid 108. In at least one example, the patient-specific portion 506 can form a secure semi-sealing fit with the glenoid 108. In at least one example, the patient-specific portion 506 can prevent the bone substitute 508 from attaching where it is not needed. In at least one example, the patient-specific portion 506 can be a cap coupled to the nozzle 506, the cap having patient-specific features 510 to guide the bone substitute 508 into the glenoid defect 104. In at least one example, the patient-specific portion 506 can include one or more attachment features 512 to fit the patient-specific portion 506 over the glenoid 108 of a particular patient 106. In some examples, the patient-specific portion 506 can fit over the specific patient's glenoid 108, and the injector 502 can inject a bone substitute 508 to fill the glenoid defect 104, the bone substitute 508 can be configured to form the patient-specific implant 102 within the glenoid defect 104 of the specific patient 106. In at least one example, the patient-specific portion 506 can then be discarded, and the syringe 502 can be reused for a subsequent procedure or subsequent patient. For example, a new patient-specific part (corresponding to a glenoid defect of a new patient) can be coupled to the syringe 502, and the process can be repeated.

In at least one example, patient-specific bone substitute injector 500 may allow for the generation of patient-specific glenoid implant 102 with fewer devices. In some examples, the patient-specific glenoid implant 102 can be resurfaced as needed, e.g., to form a flat surface, before or after the bone substitute 508 has cured within the glenoid defect 104.

Fig. 6 is a perspective view of an injector 600 and a patient-specific mold 602 according to at least one example of the present disclosure. In at least one example, the patient-specific mold 602 can include a patient-specific void 604 corresponding to the glenoid defect 104 of a particular patient 106. In at least one example, the patient-specific void 604 can be matched to the glenoid defect 104. In some examples, the patient-specific mold 602 may include multiple portions 606, 608 coupled together via one or more locking features 610. In at least one example, the patient-specific mold 602 may be a single unitary piece. In some examples, the patient-specific mold may include an opening 612 for receiving a bone substitute 614 from the syringe 600 to fill the patient-specific void 604. In at least one example, after patient-specific void 604 is filled with bone substitute and the bone substitute has been cured, one or more locking features 610 of patient-specific mold 602 can be disengaged and patient-specific glenoid implant 102 can be removed from patient-specific mold 602. In at least one example, a patient-specific glenoid implant 102 can then be implanted into the glenoid defect 104 of a particular patient 106.

Fig. 7 is a perspective view of a patient-specific glenoid implant 102 implanted into the anatomy of a particular patient 106 to repair a glenoid defect 104 of the particular patient according to at least one example of the present disclosure. In some examples, any one or more of the devices, systems, and methods described with reference to fig. 1-6 may be used to form the patient-specific glenoid implant 102. In at least one example, the patient-specific glenoid implant 102 can be attached to a baseplate or other device prior to implantation into the glenoid defect 104. In some examples, the patient-specific glenoid implant may be formed of bone, for example, cancellous or other bone from a humeral head resection of the particular patient 106. In some examples, the patient-specific glenoid implant may be composed of bone substitutes (e.g., bone graftBamma-BSM、Beta-BSM, etc.). In at least one example, the patient-specific glenoid implant can be formed from an osteoconductive, osteoinductive, self-curing bone void filler. In at least one exampleIn some embodiments, the patient-specific glenoid implant 102 may be oversized (e.g., by enlarging the geometry of the patient-specific device) to facilitate the patient-specific glenoid implant 102 to interdigitate with the surrounding bone. In at least one example, the patient-specific glenoid implant can be provided with additional material to improve initial fixation. In at least one example, the implant material of the patient-specific glenoid implant 102 is both osteoconductive and osteoinductive.

in at least one example, the apparatus, systems, and methods of fig. 1-7 may allow a surgeon to precisely match the anatomy of a particular patient each time without cutting bone from the scapula or coracoid process. In at least one example, the devices, systems, and methods of fig. 1-7 can allow a surgeon to place a patient-specific glenoid implant without the need to face significant difficulty. In at least one example, the apparatus, systems, and methods of fig. 1-7 may be used as a VRS (domed reconstruction system), Trabecular Metal^TM Reverse Shoulder System、Reverse Shoulder System、(patient matched implant) or other two-stage procedure in the case of shoulder systems. For example, the system may first be used to partially fill the glenoid defect (which may be hardened or possibly have the bone heal) and then a subsequent patient-specific implant may be used to match the new shape of the glenoid (with the glenoid defect already filled). In at least one example, the allograft injection method can be performed subsequently by the anatomic glenoid system after bone healing. In at least one example, the devices, systems, and methods of fig. 1-7 can be such as to allow for reduced procedure time and better fixation, screw fixation, geometry, and overall form within a particular patient.

In the foregoing detailed description, it can be seen that various features are grouped together in a single example for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the claimed examples require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive subject matter lies in less than all features of a single disclosed example. Thus the following claims are hereby incorporated into the detailed description, with each claim standing on its own as a separate example.

Note that not all of the activities or elements described above in the general description are required, that a particular activity or portion of an apparatus may not be required, and that one or more other activities may be performed or included in addition to those elements described. Still further, the order in which activities are listed is not necessarily the order in which the activities are performed. In addition, the concepts have been described with reference to specific examples. However, one of ordinary skill in the art appreciates that various modifications and changes can be made without departing from the scope of the present disclosure as set forth in the claims below. Accordingly, the specification and figures are to be regarded in an illustrative rather than a restrictive sense, and all such modifications are intended to be included within the scope of the present disclosure.

Benefits, other advantages, and solutions to problems have been described above with regard to specific examples. However, the benefits, advantages, solutions to problems, and any feature(s) that may cause any benefit, advantage, or solution to occur or become more pronounced are not to be construed as a critical, required, or essential feature or feature of any or all the claims. Moreover, the particular examples disclosed above are illustrative only, as the disclosed subject matter may be modified and practiced in different but equivalent manners apparent to those skilled in the art having the benefit of the teachings herein. No limitations are intended to the details of construction or design herein shown, other than as described in the claims below. It is therefore evident that the particular examples disclosed above may be altered or modified and all such variations are considered within the scope of the disclosed subject matter. Accordingly, the protection sought herein is as set forth in the claims below.