阅读说明：本技术 用于将肩关节假体的关节盂组件固定到解剖结构受损的肩胛骨的肩胛骨锚件以及用于制造该肩胛骨锚件的相关方法 (scapula anchor for securing a glenoid component of a shoulder prosthesis to an anatomically damaged scapula and related method for manufacturing the same ) 是由 福斯托·斯百思 米歇尔·普瑞赛科 于 2018-04-12 设计创作，主要内容包括：本发明提供了一种可定制的肩胛骨锚钉(1),用于将肩关节假体的关节盂组件固定到患者的解剖结构受损的肩胛骨,包括：关节盂支撑件,所述关节盂支撑件(2)由用于将所述关节盂组件固定至所述肩胛骨锚钉(1)的销元件(3)以及与所述销元件(3)成一体的凸缘(4)限定,所述凸缘(4)具有适于被置于至少部分地与所述肩胛骨的关节盂腔接触的远端表面(5)以及与所述远端表面(5)相对的近端表面(6)；其中至少一个定制部分(5,7,8)具体成形为与患者的解剖结构受损的肩胛骨的骨骼形态匹配；至少一个定制部分(5,7,8)包括布置为抵靠肩胛骨(50)的喙突(52)的至少一个喙状支撑件凸起(7)。(The invention provides a customizable scapula anchor (1) for securing a glenoid component of a shoulder prosthesis to an anatomically damaged scapula of a patient, comprising: a glenoid support, the glenoid support (2) being defined by a pin element (3) for securing the glenoid component to the scapula anchor (1) and a flange (4) integral with the pin element (3), the flange (4) having a distal surface (5) adapted to be placed in at least partial contact with a glenoid cavity of the scapula and a proximal surface (6) opposite the distal surface (5); wherein the at least one customized portion (5, 7, 8) is specifically shaped to match the bone morphology of the patient's anatomically damaged scapula; the at least one customized portion (5, 7, 8) includes at least one beak support projection (7) arranged to abut a coracoid process (52) of the scapula (50).)

1. A scapula anchor (1) for securing a glenoid component (100, 200) of a shoulder joint prosthesis to an anatomically damaged scapula (50) of a patient, comprising: a glenoid support (2), the glenoid support (2) being defined by a pin (3) for fixing a glenoid component (100, 200) to the scapula anchor (1) and a flange (4), the flange (4) being integral with the pin (3), the flange (4) having a distal surface (5) adapted to be at least partially in contact with a glenoid cavity (51) of the scapula (50) and a proximal surface (6) opposite to the distal surface;

The method is characterized in that:

The scapula anchor (1) comprises: at least one customized portion (5, 7, 8), the at least one customized portion (5, 7, 8) being shaped specifically with respect to a bone morphology of an anatomically damaged scapula (50) of an individual patient;

the at least one customized portion (5, 7, 8) comprises:

At least one beak support protuberance (7), said at least one beak support protuberance (7) being arranged to abut a coracoid process (52) of the scapula (50) and having a substantially tubular shape, said at least one beak support protuberance (7) having a proximal end (9) adjacent to the glenoid support (2) and a distal end (10) adapted to abut the coracoid process (52) of the scapula (50);

a through hole (11) extending between the proximal end (9) and the distal end (10) for inserting a stabilizing bone screw (12) into a coracoid process (52) of the scapula (50).

2. The scapula anchor (1) according to claim 1, wherein said at least one customized portion (5, 7, 8) comprises at least a distal surface (5) of said flange (4), said distal surface (5) having a shape complementary to the shape of the glenoid cavity of the scapula.

3. The scapula anchor (1) according to claim 1, wherein said at least one customized portion (5, 7, 8) comprises at least one acromion support projection (8), said at least one acromion support projection (8) being arranged to abut an acromion (53) of said scapula (50).

4. The scapula anchor (1) according to claim 3, wherein said at least one acromion support protrusion (8) is substantially tubular in shape, having a proximal end (9) adjacent to the glenoid support (2) and a distal end (10) adapted to abut against the acromion (53) of the scapula (50).

5. The scapula anchor (1) according to claim 4, wherein a through hole (11) extends between the proximal end (9) and the distal end (10) for inserting a stabilizing bone screw (12) into the shoulder peak (53) of the scapula (50).

6. The scapula anchor (1) according to claim 5, wherein the beak support protrusion (7) and/or the acromion support protrusion (8) are made integrally with the glenoid support (2).

7. The scapula anchor (1) according to claim 5, wherein the beak support protuberance (7) and/or the acromion support protuberance (8) are structurally different from the glenoid support (2) and are selected from a plurality of protuberances having different dimensional and/or morphological characteristics and are fitted to the glenoid support (2).

8. The scapula anchor (1) according to claim 5, wherein a distal end of the glenoid support (2) and/or the distal end (10) of the beak support protuberance (7) and/or the distal end (10) of the acromion support protuberance (8) has a partially irregular or trabecular structure to promote osteogenesis and osseointegration.

9. the scapula anchor (1) according to claim 1, wherein the glenoid support (2) comprises at least one hole (13), the at least one hole (13) being used for inserting a stabilizing bone screw (12) to secure the glenoid support (2) to the glenoid cavity (51).

10. a method for manufacturing a scapula anchor (1), the scapula anchor (1) being for securing a glenoid component (100, 200) of a shoulder joint prosthesis to an anatomically damaged scapula (50) of a patient, the method comprising the steps of:

Providing a glenoid support (2), the glenoid support (2) being defined by a pin (3) for fixing the glenoid component (100, 200) to the scapula anchor (1) and a flange (4), the flange (4) being integral with the pin (3), the flange (4) having a distal surface (5) adapted to be at least partially in contact with a glenoid cavity (51) of the scapula (50) and a proximal surface (6) opposite to the distal surface;

Characterized in that the method comprises the steps of:

In particular to provide at least one customized portion (5, 7, 8) of the scapula anchor (1), the shape of the at least one customized portion (5, 7, 8) matching the bone morphology of a scapula (50) damaged by the anatomy of a single patient,

The at least one customized portion (5, 7, 8) comprises at least one beak support protrusion (7), the at least one beak support protrusion (7) being arranged to abut a coracoid process (52) of the scapula (50).

11. Method of manufacturing a scapula anchor (1) according to claim 10, wherein the method comprises, before the step of shaping the at least one customizable portion (5, 7, 8) of the scapula anchor (1), a step of obtaining the bone morphology of the scapula of the patient, for example by computer tomography.

12. A scapula anchor (1) for securing a glenoid component (100, 200) of a shoulder joint prosthesis to an anatomically damaged scapula (50) of a patient, comprising:

A glenoid support (2), the glenoid support (2) including a flange (4) and a pin (3) integral with the flange (4), the pin (3) for securing the glenoid assembly (100, 200) to the scapula anchor (1);

Said flange (4) having a distal surface (5) structured to be at least partially in contact with the glenoid cavity (51) of the scapula (50) and an opposite proximal surface (6);

The scapula anchor (1) comprising at least one customized portion (5, 7, 8), the at least one customized portion (5, 7, 8) being specifically shaped to match the bone morphology of a single patient's anatomically damaged scapula (50);

The at least one customized portion (5, 7, 8) comprises at least one beak support tab (7), the at least one beak support tab (7) having a substantially tubular shape integrally formed with the glenoid support (2) and configured to abut a coracoid process (52) of the scapula (50);

The proximal end (9) of the at least one beak support protuberance (7) is adjacent to the glenoid support (2);

a distal end of the at least one beak support protuberance (7) is configured to abut against the coracoid process (52) to the scapula (50);

A through hole (11) extending between the proximal end (9) and the distal end (10) for inserting a stabilizing bone screw (12) into the coracoid process (52) of the scapula (50).

13. The scapula anchor (1) according to claim 12, wherein said at least one customized portion (5, 7, 8) comprises at least a distal surface (5) of said flange (4), said distal surface (5) being shaped complementary to a glenoid cavity (51) of the scapula (50).

14. The scapula anchor (1) according to claim 12, wherein said at least one customizable portion (5, 7, 8) comprises at least one acromion support tab (8), said at least one acromion support tab (8) being arranged to rest at an acromion (53) of the scapula (50).

15. The scapula anchor (1) according to claim 14, wherein said at least one acromion support protrusion (8) has a substantially tubular shape, said at least one acromion support protrusion having a proximal end (9) adjacent to the glenoid support (2) and a distal end (10) adapted to abut against the acromion (53) to the scapula (50).

16. The scapula anchor (1) according to claim 15, wherein a through hole (11) extends between the proximal end (9) and the distal end (10) for inserting a stabilizing bone screw (12) into the shoulder peak (53) of the scapula (50).

17. The scapula anchor (1) according to claim 16, wherein the acromion support protrusion (8) is made integral with the glenoid support (2).

18. The scapula anchor (1) according to claim 16, wherein the acromion support protuberance (8) is structurally different from the glenoid support (2), the acromion support protuberance (8) being selected from a plurality of protuberances having different dimensional and/or morphological features and fitting onto the glenoid support (2).

19. the scapula anchor (1) according to claim 16, wherein a distal end (5) of the glenoid support (2) and/or the distal end (10) of the beak support protuberance (7) and/or the distal end (10) of the acromion support protuberance (8) has a partially irregular or trabecular structure to promote osteogenesis and osseointegration.

20. The scapula anchor (1) according to claim 12, wherein the glenoid support (2) comprises at least one hole (13), the at least one hole (13) being used for inserting a stabilizing bone screw (12) to secure the glenoid support (2) to the glenoid cavity (51).

21. A method for manufacturing a scapula anchor (1), the scapula anchor (1) being for fixing a glenoid component (100, 200) of a shoulder joint prosthesis to an anatomically damaged scapula (50) of a patient; the method comprises the following steps:

-providing a glenoid support (2), the glenoid support (2) comprising a flange (4) and a pin (3) integral with the flange (4), the pin (3) being for fixing the glenoid assembly (100, 200) to the scapula anchor (1);

Said flange having a distal surface (5) structured to be at least partially in contact with the glenoid cavity (51) of the scapula (50) and an opposite proximal surface (6);

Providing at least one customizable portion (5, 7, 8) of the scapula anchor (1), the at least one customizable portion (5, 7, 8) being specifically shaped to match the bone morphology of a scapula (50) damaged by an anatomical structure of a single patient;

The at least one customized portion (5, 7, 8) includes at least one beak support tab (7), the at least one beak support tab (7) having a substantially tubular shape integrally formed with the glenoid support (2) and configured to abut a coracoid process (52) of the scapula (50).

22. The method for manufacturing a scapula anchor (1) according to claim 21, wherein a proximal end (9) of the at least one beak support tab (7) is shaped adjacent to the glenoid support (2) while a distal end (10) of the at least one beak support tab (7) is configured to abut against the coracoid process (52) to the scapula (50);

A through hole (11) extends between the proximal end (9) and the distal end (10) for inserting a stabilizing bone screw (12) into the coracoid process (52) of the scapula (50).

23. Method for manufacturing a scapula anchor (1) according to claim 22, wherein the method comprises a step of obtaining the bone morphology of the scapula of the patient, e.g. by computer tomography, before the step of shaping the at least one customized portion (5, 7, 8) of the scapula anchor (1).

Technical Field

The invention relates to a scapula anchor for securing a glenoid component of a shoulder joint prosthesis to a scapula of a patient, in particular to an anatomically damaged scapula.

The invention also relates to a method for producing the scapula anchor.

Background

as is widely known, a unitary shoulder prosthesis provides a glenoid prosthesis component and a humeral component, which are articulated to each other (articular).

Two types of whole shoulder prostheses are used in clinical practice.

The first type of prosthesis is defined as an anatomical prosthesis, the purpose of which is to reproduce the natural anatomy of the glenohumeral joint (glenohumeral joint), providing a humeral assembly with a convex end connected to the concave end of the glenoid assembly. In contrast, a second type of prosthesis, defined as an inverted (invert) prosthesis, provides a convex glenoid component that is connected to a concave humeral component. The latter prosthesis is used in critical situations where the rotator cuff is unstable.

the glenoid component (which is a prosthesis of natural anatomy or with a reverse prosthesis) is secured to an anchor member or scapular insert (scapular insert) which, in turn, is placed in contact with and anchored to the glenoid cavity (glenoid cavity) of the scapula. The humeral component is fixed to the top of the humerus by means of a fixation rod inserted into the humerus itself.

The anchor or scapula insert typically includes a pin for securing the glenoid component that is inserted into a hole formed at the glenoid cavity and a flange (flare) having a curved shape with a convex side that is inserted into a seat pre-formed in the glenoid cavity.

Despite its many advantages and generally satisfactory objectives, a general disadvantage of anchors is that: the anchor is not able to ensure correct and continuous fixation to the scapula with significant serious loosening and/or detachment problems in the event of damage to the skeletal anatomy.

in particular, known anchors have a standardized shape structure for use with any patient. During a preparatory step of implantation, the bone surface of the glenoid is treated by removing portions of the bone to create a seat that will subsequently receive the anchor. Once the anchor has been positioned in the seat, it is stabilized by the insertion of a stabilizing bone screw (stablilizionbone screw).

In this way, an optimal fixation of the anchor is ensured in case the patient has a substantially (intact) physiological scapular anatomy.

However, as the skilled person may well understand, the scapular anatomy of some patients may be damaged (compounded) due to, for example, resorption, deformation or low mass of bone tissue. In other words, the scapular tissue undergoes pathological changes in shape and/or tissue composition (pathological alteration) that are different for each patient. In the case of revision surgery of shoulder joint prostheses, the surgeon can also be faced with anatomically damaged scapulae.

in the case of important changes in the scapula anatomy, it can be quite difficult to obtain a seat for the anchor and to fix the anchor stably to the bone intraoperatively. As a result, the anchor does not adequately match the underlying bone surface, subsequently resulting in reduced implant stability.

A solution adapted to ensure the stabilization of the glenoid element in the case of anatomical damage is the use of stabilizing screws, which are long enough to reach the healthy bone deep in the glenoid.

Despite its advantages in many respects and generally corresponding to the purpose, this solution is not always possible due to the heterogeneity of the pathological scapular anatomy between patients. In fact, in the case of particularly compromised anatomical structures, the standard structure of the anchor does not allow the screw to reach healthy bone tissue.

An alternative solution described in U.S. patent No. 2007/01799624 discloses a modular anatomical shoulder joint prosthesis in which two tubular support members extend from the glenoid support beyond and are secured to a coracoid process and a shoulder acromion process by fasteners passing through the coracoid process and the shoulder acromion process, respectively. However, the two support members are of a support rod construction and do not allow for easier insertion of fasteners or screws.

Attempts to achieve proper fixation of the scapular anchors in the scapular anatomy of a particular patient are provided in U.S. patent No. 8532806. The patent document describes a method of manufacturing a glenoid support that matches the contour of a fractured glenoid.

Although advantageous in many ways for treating a fractured glenoid, this solution does not provide adequate fixation in the case of scapular anatomy where the morphology of the glenoid and/or the mass of the bone beneath the glenoid varies greatly.

It is an object of the present invention to provide a scapula anchor for fixing a glenoid component of a shoulder joint prosthesis to a patient's anatomically damaged scapula, the structural and functional features of which enable the above disadvantages with reference to the prior art to be overcome and which enable adaptation to anatomically damaged scapulae of different patients (even in cases where the morphology of the glenoid and/or the quality of the bone underlying the glenoid varies greatly), thereby ensuring a stable and durable fixing of the anchor to the bone.

disclosure of Invention

The underlying inventive concept of the present invention is to customize scapula anchors, in particular the beak support of said scapula anchors, according to the pathological scapula anatomy of a single patient.

This customization may be performed at the same time as the fabrication of the anchors based on a faithful reconstruction of the patient's anatomy or possibly during the implantation step.

based on such inventive concept, the previously identified technical problem is solved by a scapula anchor according to claim 1.

The customized portion of the implant is directly manufactured to match the bone surface in the implantation step and does not require a receiving seat. Obtaining a receiving base may be difficult to perform in the case of severely damaged scapular anatomy due to deformity, resorption or pathologically low bone tissue quality.

By making the anchor perfectly matched to the bone surface, the stability of the anchor to secure to the diseased scapular anatomy is improved.

The customized portion may advantageously be a flange of the glenoid support, i.e. the distal surface of the flange has a generally convex and wavy shape to shape match the bone morphology of the glenoid.

There are also other customized portions that may advantageously be represented by a beak support projection configured to shape match the bone morphology of the scapula's coracoid process and/or by a shoulder support projection configured to shape match the bone morphology of the scapula's scapula.

In cases where the morphology of the glenoid cavity and/or the quality of the underlying bone in the scapular anatomy varies greatly, the fixation of the scapular anchors to the glenoid cavity alone does not ensure stable and consistent fixation. The presence of the at least one beak support protrusion and/or the at least one acromion support protrusion allows the scapula anchor to be secured to other bone parts of the scapula for proper fixation.

the beak support protuberance may have a generally tubular shape, have a proximal end integral with the glenoid support and a second distal end adapted to abut the coracoid process to the scapula; a through hole may advantageously extend between the proximal and distal ends for stabilizing the insertion of a bone screw into the coracoid process of the scapula.

similarly, the acromion support projection may have a generally tubular profile, have a proximal end integral with the glenoid support, and a second distal end adapted to abut the acromion of the scapula; a through hole may advantageously extend between the proximal and distal ends for stabilizing the insertion of a bone screw into the shoulder crest of the scapula.

The glenoid support, beak and peak support raised distal end can thus be designed directly based on a faithful reconstruction of the damaged scapula anatomy of each patient.

In particular, the at least one beak and/or acromion support protuberance may advantageously be selected from a plurality of different modules which may have a length and/or a specific orientation, for example associated with the glenoid support, to adapt to the bone morphology and allow a fixation to the coracoid process and acromion process, respectively, of the scapula. In this case, the support tab is assembled to the glenoid support in the implantation step, thus also facilitating the implantation process and possible revision.

alternatively, the beak and/or acromion support nub may be integrally manufactured with the glenoid support, for example by EBM sintering (sintering) or SLM manufacturing.

Advantageously, the distal surface of the glenoid support and/or the distal end of the beak support protuberance and/or the distal end of the acromion support protuberance may have an at least partially irregular or trabecular structure to promote bone generation and osseointegration.

Furthermore, the glenoid support may comprise at least one hole for the insertion of a stable bone screw into the glenoid cavity and have a pin element made in one piece with the flange.

In summary, as mentioned above, it is not excluded that the glenoid support be made of a pin and a flange, which can be assembled during the step of implanting the anchor.

The technical problem identified above is also solved by a method for manufacturing a scapula anchor according to claim 11.

The method may advantageously comprise an initial step of obtaining the bone morphology of the scapula of the patient, for example by means of a computed tomography (computerized tomogry).

the features and advantages of the scapula anchor according to the invention will become clearer from the following description of a preferred embodiment, given by way of non-limiting example with reference to the accompanying drawings.

Drawings

FIG. 1 shows a proximal end view (proxiview) of a scapula anchor for a shoulder prosthesis (artificial prosthesis) made in accordance with the present invention;

FIG. 2 shows a first side view of the scapula anchor of FIG. 1;

FIG. 3 shows a distal end view (digital view) of the scapula anchor of FIG. 1;

FIG. 4 shows a second side view of the scapula anchor of FIG. 1;

FIG. 5 shows a proximal end view of the scapula anchor of FIG. 1 secured to an anatomically damaged scapula model;

FIG. 6 shows a perspective view of the scapula anchor of FIG. 1 secured to an anatomically damaged scapula model;

FIG. 7 shows, in perspective, a proximal end view of the scapula anchor of FIG. 1 secured to an anatomically damaged scapula model anchor;

FIG. 8 shows, in perspective, a first side view of the scapula anchor of FIG. 1 secured to an anatomically damaged scapula model;

FIG. 9 shows a second side view, in perspective, of the scapula anchor of FIG. 1 secured to an anatomically damaged scapula model;

FIG. 10 is a side view showing portions separated of a fully artificial shoulder prosthesis conforming to the natural anatomy including a scapula anchor according to the present invention;

FIG. 11 is a side view showing the disassembled parts of a fully artificial shoulder prosthesis as opposed to the natural anatomy including a scapula anchor according to the invention.

Detailed Description

with reference to these figures, the reference numeral 1 globally and schematically represents a preferred embodiment of an anchor made according to the present invention for firmly and safely fixing a prosthesis for a shoulder joint to an anatomically damaged scapula.

in the following description this anchor 1 will be referred to by the more abbreviated term "scapular anchor".

Advantageously, anchor 1 is a custom-made component to accommodate (adpat) the damaged anatomy of each patient.

The customization of the anchors may take place during the manufacturing step of the device or may be performed directly by the surgeon during the implantation step of the shoulder prosthesis.

In the first case, the anchor morphology was adapted to each patient based on a faithful reconstruction of the damaged scapular anatomy performed by modern computed tomography techniques. The method allows the shape of the anchor to be modified so that the anchor perfectly matches the articular bone surface to be fixed during the implantation step.

in contrast, in the second case the anchor has multiple portions that are standardized but at the same time modular, allowing the surgeon to select the anchor configuration that best fits the patient's anatomy during the implantation step.

the preferred embodiments described subsequently fall within the scope of the first customization described above, and in particular the anchors 1 are designed based on the model of the damaged scapula anatomy shown in fig. 5 to 9. This does not preclude other customization of the anchors based on the damaged anatomy of the individual patient.

The anchor 1 shown in the drawings comprises three parts for fixation to various skeletal sites (bone sites) of an anatomically damaged scapula 50: a glenoid support 2, a beak support tab 7 and a acromion support tab 8, which are provided as a glenoid cavity 51, a coracoid process 52 and a acromion process 53, respectively, for securing the anchor 1 to the scapula 50.

Other embodiments may provide glenoid support 2 with one or more beak support projections 7 and/or one or more acromion support projections 8.

the anchor 1 is made of a biocompatible metallic material (e.g. titanium or a titanium alloy) and has a macroscopically rough surface treatment (e.g. according to that described in us patent 12/601,510).

As can be noted in fig. 1 to 4, which show the anchor 1 itself, the glenoid support 2 comprises a pin element 3, the pin element 3 being hollow and extending along a longitudinal axis X-X, the pin element 3 having a longitudinal dimension greater than the diameter or its radial dimension.

The outer surface of the pin element 3 has longitudinal grooves to promote osteogenesis and osseointegration when the pin element 3 is inserted into a hole obtained by the surgeon in the glenoid cavity 51 of the scapula 50.

The pin 3 has a tapered distal end 3a, an opposite flared proximal end 3c and a securing hole 3b passes through the pin 3. The glenoid component 100, 200 of the shoulder prosthesis is fixed within the bore 3 b.

A flange 4 is formed adjacent the proximal end 3 c. The flange 4 as above is defined by a distal end surface 5 and by a proximal end surface 6, which two surfaces are connected to each other at a proximal edge 20. The proximal edge 20 is defined in turn by a first side edge 20a opposite a second side edge 20b, an upper edge 20c and a lower edge 20 d. The terms "lower" or "upper" are used herein with reference to a prosthesis implanted on an upright patient, wherein the upper portion will face the head. The preferred orientation of the anchor 1 thus corresponds to the orientation shown in fig. 1.

The proximal surface 6 is a uniform and concave face, in mirror image form with respect to an axis of symmetry Y-Y orthogonal to the axis X-X. The flared proximal end 3c of the pin 3 and the two stabilizing through holes 13 for the insertion of the respective stabilizing bone screws 12 into the glenoid cavity 51 open on the bottom of the proximal surface 6. The two stabilizing holes 13 terminate in the distal end surface 5.

In the preferred embodiment described, the two stabilizing holes 13 are placed below the proximal end 3c of the pin 3 and one of them is placed above the other.

other arrangements and numbers of stabilization holes 13 may be provided in other embodiments depending on the anatomy and quality of the patient's articular bone tissue.

Conversely, the distal end surface 5 has a non-uniform (tentatively) convex shape and has an irregular wave form that reconstructs the pathological morphology of the glenoid cavity 51 of the scapula 50. In other words, the distal surface 5 of the glenoid support 2 is designed to be complementary in shape to the surface of the glenoid cavity 51 so as to be able to perfectly match when implanted. In particular, in the embodiment described, the distal surface 5 of the glenoid support 2, customized to match the anatomical model of fig. 5 to 9, winds around a first portion of the pin 3 from the most proximal to the lateral edge 20a, and has a tapered form starting from the pin 3 towards the lower edge 20c and the lateral edge 20a up to the lateral wall 20e connected to the lateral edge 20 a. On the opposite side of the pin with respect to the axis Y-Y, i.e. the side closest to the side edge 20b, the distal surface 5 wraps around the proximal end 3c of the pin 3 and has a conical form going up towards the side edge 20b to a side wall 20f connected to the side edge 20 b. The side walls 20e, 20f lie in a plane parallel to the plane formed by the axis X-X and the axis Y-Y.

In an alternative embodiment, the distal surface 5 may or may not be customized to fit the anatomy of a single injured scapula, and has a standard shape, for example planar or hemispherical, coupled during the implantation step with a seat (couple) suitably obtained at the glenoid cavity 51.

As can be seen in fig. 2 to 4, the pin element 3 passes through the distal end surface 5 and projects therefrom. The pin element 3 may be supported integrally with the flange 4 or constrained to the flange 4 by interference.

At the upper edge 20c, the beak support ridge 7 and the acromion support ridge 8 are separated.

The beak support protrusion 7 and the acromion support protrusion 8 have a substantially tubular shape with a through hole 11 extending from the proximal end 9 to the distal end 10. The proximal ends 9 of the beak support 7 and acromion support 8 converge near the axis Y-Y, whereas subsequently the beak support 7 and acromion support 8 diverge away from the plane defined by the axis X-X and the axis Y-Y and by the distal surface 5.

the through holes 11 of the beak support projections 7 and the acromion support projections 8 allow the insertion of stabilizing screws 11 for fixing to the beak projection 52 and the acromion projection 53, respectively.

In alternative embodiments, the beak support projections 7 and the acromion support projections 8 may take different shapes, be not provided with through holes 11 and be fixed in other ways known in the art, for example by interference without using any fixing means.

In the described preferred embodiment, the beak support tab 7 and the acromion support tab 8 are made integrally with the glenoid support 2. For example, the beak support projections 7 and the shoulder support projections 8 may be manufactured by EBM sintering or SLM manufacturing processes. Alternative embodiments may also provide for the beak support tab 7 and acromion support tab 8 to be assembled with the glenoid support 2 during the implantation step of the anchor 1 to facilitate surgery and possible future revision.

In summary, the length and orientation of the beak support tab 7 and acromion support tab 8 are designed according to the damaged scapula anatomy 50 so that when the anchor 1 is implanted, the distal end 10 abuts against the corresponding surfaces of the beak 52 and acromion 53 to which the beak support tab 7 and acromion support tab 8 are secured by way of the stabilizing screw 12.

As can be seen in fig. 2 to 4, the distal end 10 of the beak support protuberance 7 and the distal surface 5 of the underlying glenoid support 2 have an irregular or trabecular structure 5a to promote osteogenesis and osseointegration and are chosen to increase the contact friction of the distal end 10 and the glenoid support 2 with respect to the surfaces of the articulating coracoid process 7 and the glenoid cavity 51, respectively. This does not preclude that other surfaces or all surfaces in contact with the bone could be made with a trabecular structure.

thus, by adjusting, for example, the length and/or orientation, the shapes of the beak support projections 7 and acromion support projections 8 may be customized to any patient during the implantation procedure to accommodate the particular anatomy of the patient's beak 52 and acromion 53 prior to the manufacturing procedure.

Fig. 5 to 9 show a preferred embodiment of a scapula anchor 1 fixed to an anatomically damaged scapula model according to which the scapula anchor 1 has been specifically designed.

As can be noted from figures 5 to 9, the glenoid support 2 is implanted by mating the distal surface 6 (excluding the side walls 20e, 20f) to the glenoid cavity 51, the distal surface 6 being in full apposition to the glenoid cavity 51. At the same time, the pin element 3 is inserted in a hole suitably made in the glenoid cavity 51 and the stabilizing screw 12 is inserted in the stabilizing hole 8 and screwed (threaded to) to the underlying bone.

The beak support protuberance 7 and the acromion support protuberance 8 ensure an additional support which is engaged against the distal end 10 of the respective beak 52 and acromion 53, the beak support protuberance 7 and the acromion support protuberance 8 being fixed to the beak 52 and acromion 53 by means of the stabilizing screw 12, the stabilizing screw 12 being inserted into the through hole 11 through the proximal end 9.

As described, once the scapula anchor 1 has been secured to the scapula 50 of the patient, the glenoid component 100, 200 of the shoulder total prosthesis is secured to the scapula anchor 1, which glenoid component 100, 200 will articulate with the humeral component 101, 201 previously secured at the top of the humerus by the humeral stem (humeralstem)102, 202.

fig. 10 and 11 are side views each showing a disassembled part of a fully artificial shoulder prosthesis corresponding to and opposite to the natural anatomy, including the scapula anchor 1 according to the invention.

From the above description it should be clear that the anchor according to the invention achieves the objects of the invention and achieves several advantages, the main ones of which are listed here below.

In essence, the solution of the present invention provides a scapular anchor that can be customized during the planning or implantation step to accommodate the specific damaged scapular anatomy of each patient (e.g., as detected by computed tomography).

advantageously, the scapula anchor provides a glenoid support that is complementary in shape relative to the glenoid cavity that will perfectly match the glenoid cavity once implanted, thereby promoting implant stability.

Advantageously, the scapula anchor provides a beak support projection and/or a acromion support projection, both projections also providing additional support for stabilization and fixation of the anchor to the scapula. These two projections can advantageously be customized in the design step or implantation step to suit the particular anatomy of the patient's coracoid and acromion processes.

advantageously, the distal surface of the glenoid support and/or the beak shape and/or the convex second distal end of the acromion support may have an irregular or trabecular structure to promote osteogenesis and osseointegration.