Patent Publication Number: US-2023140714-A1

Title: Acetabular surgical implant for segmental pelvic defect and methods of use and manufacture

Description:
RELATED APPLICATION 
     This application is a continuation of U.S. patent application Ser. No. 17/306,272, filed May 3, 2021, which is a divisional of U.S. patent application Ser. No. 15/431,952, filed Feb. 14, 2017 (now U.S. Pat. No. 11,000,378), the disclosures of which are incorporated herein in their entireties. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present inventive concept relates generally to medical devices, and more particularly, to an acetabular surgical implant for a segmental pelvic defect and methods of use and manufacture. 
     2. Description of the Related Art 
     Loss of acetabular bone with distortion of anatomical pelvic landmarks pose a challenge to orthopedic surgeons. Conventional reconstructive medical devices designed to address such have a number of limitations and are inadequate. Among other deficiencies, such conventional reconstructive medical devices are modular and require a plurality of different devices and other materials, e.g., cement and/or cadaver bone, which is undesirable and suffer from high failure rates. Failure of an implant is often catastrophic given such results in unnecessary pain and costs to a patient, and may even result in death depending on various circumstances associated with the failure. 
     For instance,  FIGS.  12  and  13    illustrate a conventional reconstructive medical device assembly  120  used in two different procedures where varying degrees of bone  122  from a patient has been exposed and/or removed. The conventional reconstructive medical device assembly  120  includes a cage  124  having a body  126  with three flanges  128  that allow fixation of screws  130  to intact portion of the bone  122 . The conventional reconstructive medical device assembly  120  further includes an acetabular shell  132  adhered to the cage  124  via cement  134 . The design of the conventional reconstructive medical device assembly  120  does not allow growth of the bone  122  in and/or around the conventional reconstructive medical device assembly  120 . As such, the conventional reconstructive medical device assembly  120  is never incorporated into the bone  122 , which results in a high failure rate due to fatigue of the conventional reconstructive medical device assembly  120 . Also, in the procedure illustrated by  FIG.  13   , extensive stripping of the hip abductor muscles from the outer portion of the pelvis must be performed in order to place the flanged cage construct. Such extensive soft tissue exposure permanently weakens the hip abductor muscles resulting in a permanent limp and an increased risk of dislocation of the prosthetic hip. Further, one of the three flanges  128  must be cut off due to an absence of bone inferiorly, which results in unnecessary waste. 
       FIGS.  14  and  15    illustrate another conventional reconstructive medical device assembly  140  used in two different procedures where varying degrees of bone  142  from a patient has been exposed and/or removed. The conventional reconstructive medical device assembly  140  includes a wedge or augment  144  fixed to an intact portion of the bone  142  with screws  146 . The conventional reconstructive medical device assembly  140  also includes a body  148  that must be anchored to the augment  144  via cement  152 . The use of a plurality of implants secured together and to the bone  142  in such a manner causes the conventional reconstructive medical device assembly  140  to have a high failure rate due to micromotion between the augment  144  and the body of the acetabular shell  148 . Further, in the procedure illustrated by  FIG.  15   , the failure rate is particularly high due to an absence of bone available to grow around the conventional reconstructive medical device assembly  140 . 
     Accordingly, there is a need for a reconstructive medical device that does not suffer from the limitations of conventional reconstructive medical devices, does not allow forces to be transmitted between multiple implants, is readily accepted by surrounding bone, allows growth of bone in and around the device, has a simple design that is easy to use, has a reproducible technique for implantation, minimizes surgical exposure and stripping of the bone, and does not prolong recovery time or expenses of a patient, and does not increase the risk of repeat revision surgery. 
     SUMMARY OF THE INVENTION 
     The following brief description is provided to indicate the nature of the subject matter disclosed herein. While certain aspects of the present inventive concept are described below, the summary is not intended to limit the scope of the present inventive concept. Embodiments of the present inventive concept provide an inventive concept for a medical device, and a method of using such medical device for a segmental pelvic defect during a surgical procedure. The present inventive concept does not suffer from and remedies the deficiencies of conventional devices such as those previously set forth herein. 
     The present inventive concept provides, in its simplest form, an implantable medical device having a hemispherical cup with a plurality of equidistant apertures extending through the cup, and a ribbed, elongated stress-diffusion element, i.e., a stem, extending from the cup. The device may have one or more apertures. The apertures may be arranged in an array or a non-equidistant pattern, or a random pattern or a clustered pattern. An internal surface of one or more of the apertures may be variably angled so that the respective one or more of the apertures has a cone shape, allowing optimal screw placement into bone depending on the configuration of the acetabular defect. The cup and stem are operable to be mounted directly on and to a user&#39;s pelvis, thereby preventing any motion therebetween while allowing the medical device to directly transfer stress to bone of the user. The direct transfer of stress to the bone of the user causes the bone immediately adjacent to the medical device to grow stronger. Additionally, the direct placement of the medical device on the bone of the user enhances the ability of the bone of the user to incorporate or grow into and/or around the medical device. In this manner, the medical device of the present inventive concept provides increased functionality relative to conventional medical implants. 
     An object of the present inventive concept is to provide a one-piece, unitary medical device for surgical implantation to remedy a segmental pelvic defect that is installable and fully functional without any additional implants or other pieces other than a limited number of optional surgical placement screws, i.e., zero screws, one screw, two screws, three screws, or four screws, which may be installed to extend partially through the medical device and into one or more bones of the user. 
     Another object of the present inventive concept is to provide a medical device, e.g., an acetabular implant, for a pelvic defect that is installable and fully functional without any need for a surgical cage, a surgical shell, or any other intermediary implant, part, or material, e.g., an adhesive or cadaver bone which has a high-infection rate, positioned between the medical device and bone of the user. 
     Another object of the present inventive concept is to provide a medical device for pelvis reconstruction, e.g., in a revision hip replacement or a pelvic tumor resection, that receives stress from movement of the user, e.g., walking, and redistributes the stress along an extended portion of the user, e.g., one or more bones of the user. 
     Another object of the general inventive concept is to provide a surgical implant that is easy to use, comparatively simple to manufacture, and especially well adapted for the intended usage thereof. 
     The aforementioned objects and advantages of the present inventive concept may be achieved by providing a medical device or surgical implant. The implant may include a hemispherical cup having (i) a bone-abutment exterior surface, (ii) an interior surface defining a cavity, and/or (iii) a circumferential rim extending between the exterior surface and the interior surface. The implant may include at least one aperture extending between the exterior surface and the interior surface. The implant may include a stress-diffusion element extending from the cup. The cup and the stress-diffusion element are formed from a single block, e.g., a monoblock, thereby providing an implant consisting of a unitary piece. 
     The rim may extend entirely along only a single plane. The rim may define a circle with a first center point, i.e., an imaginary center point, at a center thereof. The exterior surface of the cup may define a second center point at a center thereof relative to a perimeter edge defined by the rim. A line, i.e., an imaginary line drawn, between the first center point and the second center point extends perpendicular to the plane. 
     The stress-diffusion element may be an elongated stem extending from the cup. The stem may include an intermediary base between the stem and the cup and may provide rotational stability by preventing rotation of the implant relative to a hole or bone tunnel in which the implant is installed. The base may be formed on the exterior surface of the cup and spaced from the second center point. The base may be centered between the second center point and a closest portion of the rim. The base may be centered between the at least one aperture and another aperture extending between the exterior surface and the interior surface. 
     The stress-diffusion element may include a plurality of longitudinal flutes. The stress-diffusion element may be smooth without any longitudinal flutes. Each of the plurality of longitudinal flutes may extend along an entirety of or a substantial portion of the stress-diffusion element. Each of the plurality of longitudinal flutes extend along an entirety of the stem. In this manner, the stem is a fluted stem. Distal ends of the plurality longitudinal flutes may adjoin at a common point. Individual proximal ends of the plurality longitudinal flutes may taper at individual, separate points. Adjacent ones of the plurality of longitudinal flutes may be spaced from each other by a trough with sidewalls and a bottom wall. One or more of the plurality of longitudinal flutes may not include a bottom wall, with the sidewalls adjoining each other. Each of the troughs may include an increasing depth along the stem. Each of the plurality of longitudinal flutes may include an increasing width along the stem. Ends of each of the plurality of longitudinal flutes may partially surround a portion of adjacent ones of the trough. Each of the plurality of longitudinal flutes may include a plateau along at least a portion thereof. Each of the plateaus may have an increasing width along the stem. The sidewalls of each of troughs may converge. A distance between sidewalls of each of the troughs may increase/decrease along a distance thereof. The at least one aperture may include a set of apertures or two sets of apertures, i.e., four apertures, arranged equidistant relative to each other along the cup. The rim may include a plurality of indentations arranged equidistant relative to each other along the rim. 
     In another embodiment of the invention, a surgical implant includes a hemispherical cup having (i) a bone-abutment exterior surface defining a convex side of the cup and (ii) an interior surface defining a concave side of the cup with a cavity; and a stress-diffusion element extending directly from the bone-abutment exterior surface of the hemispherical cup at an anteverted orientation to the hemispherical cup. 
     In yet another embodiment of the invention, a surgical implant includes a hemispherical cup having (i) a bone-abutment exterior surface defining a convex side of the hemispherical cup and (ii) an interior surface defining a concave side of the hemispherical cup with a cavity; and a stress-diffusion element extending directly from the bone-abutment exterior surface of the hemispherical cup at an anteverted orientation to the hemispherical cup, wherein the hemispherical cup and the stress-diffusion element are monolithic. 
     In still another of the invention, a surgical implant includes a hemispherical cup having (i) a bone-abutment exterior surface defining a convex side of the hemispherical cup and (ii) an interior surface defining a concave side of the hemispherical cup with a cavity; at least one aperture defined by a circumferential surface extending between the bone-abutment exterior surface and the interior surface, the at least one aperture operable to receive a screw therethrough; and a stress-diffusion element extending directly from the bone-abutment exterior surface of the hemispherical cup at an anteverted orientation to the hemispherical cup, wherein the hemispherical cup and the stress-diffusion element are monolithic. 
     The aforementioned objects and advantages of the present inventive concept may further be achieved by providing a surgical method of implanting a medical device. The method may include the step of exposing a portion of a bone of a patient. The method may include the step of forming a bone tunnel or hole at least partially through a bone of a patient. The method may include the step of placing a medical device on the bone so that a portion of the medical device extends at least partially into the bone tunnel, with the portion of the medical device in direct contact with the bone so that force can be efficiently transferred from the portion of the medical device to the bone or otherwise distributed or shared between the medical device and/or the bone of the patient. The medical device may be secured in the bone tunnel via a friction-fit engagement. The method may include hammering the medical device so that a portion of the medical device extends into a bone of the patient. A hole or bone tunnel may or may not be formed to receive the portion of the medical device. The medical device may include a hemispherical cup having a bone-abutment exterior surface, an interior surface defining a cavity, a circumferential rim extending between the exterior surface and the interior surface, and/or at least one aperture extending between the exterior surface and the interior surface. The medical device may include a stress-diffusion element extending from the cup. 
     The method may include the step of securing the medical device to the bone by installing a bone screw partially through the at least one aperture and into the bone. The placing of the medical device on the bone may include orienting the medical device so that (i) the cup is directly on the bone, and/or (ii) a substantial portion of the stress-diffusion element is directly on and extending along the bone so that stress received by the medical device is diffused through the medical device and distributed along the stress-diffusion element. The medical device may be secured to the bone without any other devices, adhesives, or other element. 
     The stress-diffusion element may include a plurality of longitudinal flutes. Each of the plurality of longitudinal flutes may extend along an entirety of the stem with (i) distal ends of the plurality longitudinal flutes adjoining at a common point, and/or (ii) proximal ends of the plurality longitudinal flutes tapering at separate points. 
     In another embodiment, the method includes the steps of implanting a medical device, the method comprising the steps of: exposing a portion of a bone of a patient; forming a tunnel at least partially through the bone; placing the medical device on the bone so that a stress-diffusion element extending from the medical device at least partially extends into the tunnel, the medical device including (i) a hemispherical cup having a bone-abutment exterior surface, (ii) an interior surface defining a cavity, (iii) a circumferential rim extending between the exterior surface and the interior surface, and (iv) at least one aperture extending between the exterior surface and the interior surface; and securing the medical device to the bone. 
     The aforementioned objects and advantages of the present inventive concept may further be achieved by providing a method of forming a medical device. The method may include the step of forming a hemispherical cup having (i) a bone-abutment exterior surface, (ii) an interior surface defining a cavity, (iii) a circumferential rim extending between the exterior surface and the interior surface, and/or (iv) a stress-diffusion element extending from the cup. The method may include the step of forming at least one aperture through the exterior surface and the interior surface. The cup and the stress-diffusion element may be co-formed from a single block or piece of material, i.e., a mono block. The cup and the stress-diffusion element may be formed as a unitary piece. The method may not include a step of attaching the stress-diffusion element to the cup. 
     The foregoing and other objects are intended to be illustrative of the present inventive concept and are not meant in a limiting sense. Many possible embodiments of the present inventive concept may be made and will be readily evident upon a study of the following specification and accompanying drawings comprising a part thereof. Various features and sub-combinations of the present inventive concept may be employed without reference to other features and sub-combinations. Other objects and advantages of this present inventive concept will become apparent from the following description taken in connection with the accompanying drawings, wherein is set forth by way of illustration and example, an embodiment of this present inventive concept and various features thereof. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       A preferred embodiment of the present inventive concept, illustrative of the best mode in which the applicant has contemplated applying the principles, is set forth in the following description and is shown in the drawings. 
         FIG.  1    is a top, left rear perspective view of a medical device, i.e., a surgical acetabular implant of the present inventive concept; 
         FIG.  2    is a front side elevation view of the surgical implant of  FIG.  1   ; 
         FIG.  3    is a rear side elevation view of the surgical implant of  FIG.  1   ; 
         FIG.  4    is a left side elevation view of the surgical implant of  FIG.  1   ; 
         FIG.  5    is a right side elevation view of the surgical implant of  FIG.  1   ; 
         FIG.  6    is a top plan view of the surgical implant of  FIG.  1   ; 
         FIG.  7    is a bottom plan view of the surgical implant of  FIG.  1   ; 
         FIG.  8    is a bottom, left, rear perspective view of the surgical implant of  FIG.  1   ; 
         FIG.  9    is a diagram illustrating the surgical implant of  FIG.  1    pre-installation into a tunnel formed in bone of a patient during use by an orthopedic surgeon during a surgical procedure; 
         FIG.  10    is a diagram illustrating the surgical implant of  FIG.  1    installed into the tunnel of  FIG.  9   ; 
         FIG.  11    is a diagram illustrating the surgical implant of  FIG.  1    installed into a tunnel formed in bone of a patient during another surgical procedure; 
         FIG.  12    is a diagram illustrating a plurality of conventional medical devices secured to bone of a patient; 
         FIG.  13    is a diagram illustrating a plurality of conventional medical devices secured to bone of a patient; 
         FIG.  14    is a diagram illustrating a plurality of conventional medical devices secured to bone of a patient; and 
         FIG.  15    is a diagram illustrating a plurality of conventional medical devices secured to bone of a patient. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The following detailed description of the present inventive concept references the accompanying drawings that illustrate specific embodiments in which the present inventive concept can be practiced. The embodiments are intended to describe aspects of the present inventive concept in sufficient detail to enable those skilled in the art to practice the present inventive concept. Other embodiments can be utilized and changes can be made without departing from the scope of the present inventive concept. The following detailed description is, therefore, not to be taken in a limiting sense. The scope of the present inventive concept is defined only by the appended claims, along with the full scope of equivalents to which such claims are entitled. 
     In this description, references to “one embodiment,” “an embodiment,” or “embodiments,” mean that the feature or features being referred to are included in at least one embodiment of the technology. Separate references to “one embodiment,” “an embodiment,” or “embodiments” in this description do not necessarily refer to the same embodiment and are also not mutually exclusive unless so stated and/or except as will be readily apparent to those skilled in the art from the description. For example, a feature, structure, act, or the like described in one embodiment may also be included in other embodiments, but is not necessarily included. Thus, the present technology can include a variety of combinations and/or integrations of the embodiments described herein. 
     Turning to the drawings and particularly  FIGS.  1 - 8   , a medical device, i.e., a surgical acetabular implant  20  is illustrated. The surgical implant  20  includes a hemispherical cup  22  with an exterior surface  24 , an interior surface  26 , and a circumferential rim  28  extending between the surfaces  24 ,  26  and defining an outermost edge of the cup  22 . 
     The exterior surface  24  is convex and provides a surface operable to abuttingly engage one or more bones of a patient when the surgical implant  20  is installed and in use. The interior surface  26  is concave and defines a cavity  30  provides a surface operable to abuttingly engage one or more other medical devices. The circumferential rim  28  defines a planar circle with a center point. The circumferential rim  28  has a plurality of indentations, which cause the circumferential rim  28  to have plurality of extensions  32  and a plurality of notches  34  alternately and evenly spaced about the circumferential rim  28 . The plurality of extensions  32  and the plurality of notches  34  cause the circumferential rim  28  to have a variable, non-uniform surface, which advantageously provides a plurality of contact points to facilitate handling of the surgical implant  20  by an orthopedic surgeon during a surgical procedure. Additionally, the plurality of contact points facilitates mating of the surgical implant  20  with one or more other medical devices. It is foreseen, however, that the circumferential rim  28  could have a uniform surface with no notches or extensions without deviating from the scope of the present inventive concept. 
     The surgical implant  20  includes at least one aperture  40  extending through the cup  22  with an interior, circumferential surface  42  formed between the surfaces  24 ,  26  of the cup  22 . In the exemplary embodiment, the surgical implant  20  includes four of the apertures  40 , i.e., a first aperture  40 - 1 , a second aperture  40 - 2 , a third aperture  40 - 3 , and a fourth aperture  40 - 4 , evenly spaced around a perimeter of the cup  22 . The perimeter is of a set distance between the outermost edge of the cup  22  defined by the circumferential rim  28 , which is on one side of the cup  22 , and an outermost center point  50  of the cup  22 , which is on an opposite side of the cup  22 . An imaginary line extending between the center point  50  and the center point defined by the rim  28  is perpendicular to the plane defined by the rim  28 . As best illustrated by  FIG.  5   , each of the apertures  40  is spaced equidistant from each other around the perimeter of the cup, and are equally spaced from the center point  50 . It is foreseen that the surgical implant  20  may include only one, two, or three of the apertures  40  without deviating from the scope of the present inventive concept. For instance, it is foreseen that the surgical implant  20  may only include the aperture  40 - 1  and/or the aperture  40 - 4  without deviating from the scope of the present inventive concept. 
     The surgical implant  20  includes an elongated stress-diffusion element or stem  60  extending from the exterior surface  24  of the cup  22 . In the exemplary embodiment, the stem  60  is cylindrical and tapered, but it is foreseen that the stem  60  may be of one or more other shapes, e.g., rectangular and/or cylindrical, and/or be non-tapered with a uniform width without deviating from the scope of the present inventive concept. 
     The stem  60  includes a base  62  formed on the exterior surface  24  of the cup  22  and is spaced from the center point  50 . The base  62  is centered between the center point  50  and a closest portion of the circumferential rim  28 . The base  62  is centered between the apertures  40 - 1 ,  40 - 4 . The stem  60  includes a plurality of longitudinal flutes  64 . In the exemplary embodiment, the stem  60  includes six longitudinal flutes evenly spaced around the stem  60 , but it is foreseen that the stem  60  may include (i) fewer longitudinal flutes, e.g., one rib, two, three, four, or five longitudinal flutes, (ii) additional longitudinal flutes, e.g., seven, eight, nine, or ten longitudinal flutes, or (iii) no longitudinal flutes without deviating from the scope of the present inventive concept. Each of the plurality of longitudinal flutes  64  extend along at least a substantial portion of the stem  60  and preferably along an entirety of the stem  60 . Distal ends of each of the plurality of longitudinal flutes  64  meet at a common point  66 , which defines an outermost point of the stem  60 . Proximal ends of the plurality of longitudinal flutes  64  are tapered to separate points  68 , which are adjacent to the base  62 . 
     Adjacent ones of the plurality of longitudinal flutes  64  are spaced from each other by a trough  70  with sidewalls  72 ,  74  and a bottom wall  76 . Each of the troughs  70  has an increasing depth in a direction from the point  66  toward its respective one of the points  68  along the stem  60 . Each of the sidewalls  72 ,  74  of the troughs  70  converge in a direction from the point  66  toward its respective one of the points  68  along the stem  60 . Each of the troughs  70  has an increasing width in a direction from the point  66  toward its respective one of the points  68  along the stem  60 . Each of the plurality of longitudinal flutes  64  includes a plateau  80  along a portion thereof. Each of the plateaus  80  includes a width that increases in a direction from the point  66  toward its respective one of the points  68  along the stem  60 . Each of the plurality of longitudinal flutes  64  includes an end portion that partially surrounds adjacent troughs  70  on each side of a respective one of the plurality of longitudinal flutes  64 . End portions of adjacent ones of the plurality of longitudinal flutes  64  cooperatively surround an entire end of each of the troughs  70  formed therebetween. 
     The surgical implant  20  is operable to be surgically implanted into a patient to correct a pelvic defect. For instance, after a portion of a pelvic bone  90  of a patient has been exposed by the surgeon during a surgical procedure, a bone tunnel  92  is formed at least partially through the bone  90 . In the exemplary embodiment, the bone tunnel  92  is formed by reaming via a reaming tool to have a depth that is equal to a length of the stem  60 , and a tapered width that is equal to a width defined by the bottom wall  76  of the troughs  70  of the stem  60 . Alternatively, it is also foreseen that the width of the bone tunnel  92  may be greater or less than the width defined by the bottom wall  76  of the troughs  70  of the stem  60  and/or not tapered without deviating from the scope of the present inventive concept. For instance, the bone tunnel  92  may be ¾ mm smaller than an outermost circumference of the stem  60 . Alternatively, it is foreseen that the width of the bone tunnel  92  may be greater than, less than, or equal to the width of an outermost portion of the plurality of longitudinal flutes  64  of the stem  60  and/or tapered to correspond to the plurality of longitudinal flutes  64  of the stem  60  without deviating from the scope of the present inventive concept. It is foreseen that the depth of the bone tunnel  92  may be greater or less than the length of the stem  60  without deviating from the scope of the present inventive concept. 
     After formation of the bone tunnel  92 , the surgical implant  20  is positioned so that the stem  60  is aligned with the bone tunnel  92  as illustrated by  FIG.  9   . Next, the stem  60  is inserted into the bone tunnel  92  so that the surgical implant  20  is secured to the bone  90 . It is foreseen that, depending on specific surgical applications, which may vary from patient to patient, the surgeon will likely be required to utilize a tool, e.g., a hammer, to force the stem  60  of the surgical implant  20  into the bone tunnel  92 . For instance, if the bone tunnel  92  is formed to have a width equal to the width defined by the bottom wall  76  of the troughs  70  of the stem  60 , then it will be necessary for the surgeon to force the surgical implant  20  into the bone tunnel  92  so that the plurality of longitudinal flutes  64  form grooves in the bone tunnel  92 . In this manner, the plurality of longitudinal flutes  64  prevent the surgical implant  20  from rotating relative to the bone tunnel  92  after the surgical implant  20  has been installed in the bone  90 . 
     To further secure the surgical implant  20  to the bone  90 , one or more surgical screws  94  may be secured through one or more of the apertures  40 . In each of the surgical procedures illustrated by  FIGS.  10  and  11   , the surgeon has elected to utilize only one of the surgical screws  94  via posterior placement of the surgical screw  94  through the aperture  40 - 4  to further secure the surgical implant  20  to the bone  90 . The surgical implant  20  advantageously allows the surgeon to access a more solid portion of the bone  90  relative to other portions of the bone  90  adjacent to the surgical implant  20 . 
     As illustrated, the surgical implant  20  is securely mounted to the bone  90  without any intermediate device, adhesive, or other element. In other words, there is no intermediate device, adhesive, or other element between the surgical implant  20  and the bone  90 . Thus, the surgical implant  20  is operable to transmit and/or distribute any force received thereon, e.g., via another implant secured to the interior surface  26  of the cavity  30 , directly to the bone  90  via at least the stem  60  of the surgical implant  20 . For instance, the surgical implant  20  is operable to distribute force received from intact iliac bone when the patient ambulates such that the surgical implant  20  shares the load with the bone  90 . 
     It has been discovered that the efficient transfer and/or distribution of force to the bone  90 , as advantageously provided by the surgical implant  20 , causes the human body to more readily receive the surgical implant  20 , which facilitates growth of the bone  90  around the stem  60  and around and into the cup  22 . Indeed, when the body receives forces transferred and/or distributed by the surgical implant  20 , such is interpreted by the body as a potent biological signal, which causes the body to make the bone  90  denser. In this manner, growth of the bone  90  around the surgical implant  20  is facilitated. Once the cup  22  has been incorporated into the bone  90 , the surgical screw  94  becomes an inert piece of metal, with a majority of the load shared between the surgical implant  20  and the bone  90 . 
     The surgical implant  20  is formed from a mono block, i.e., a unitary piece of material, such as stainless steel, a resin material, or the like. In this manner, the cup  22  and the stem  60  are made of the same material. The stem  60  is formed to have one of a plurality of lengths, i.e., 40 mm, 45 mm, or 50 mm. The stem  60  is formed to be tapered in a direction from the point  66  toward the points  68  such that a width at the points 68 is X mm and a width at a point 40 to 100 mm from the point  66  is X-2 mm. 
     In the exemplary embodiment the width at the points  68  is 8 mm or 10 mm and the width at the point 40 to 100 mm from the point  66  is 6 mm or 8 mm. The troughs  70  are formed to have a maximum depth of 4 mm and a minimum depth of 0 mm at the points  68 . After formation of the surgical implant  20 , an entirety of the surgical implant  20  is coated via hydroxyapatite (HA) or other like coating, e.g., via a spray-coating process or a dipping process. It is foreseen that only the stem  60  may be coated with HA without deviating from the scope of the present inventive concept. 
     The stem  60  is formed to extend from the cup  22  at a forty-five degree angle thereto, as illustrated by  FIGS.  4  and  5   . The stem  60  is formed to have a twenty degree anteverted orientation, i.e., an anterior angulation or “tipping forward,” relative to the plane defined by the rim  28 . As illustrated by  FIG.  2   , instead of extending straight from the cup, i.e., at zero degrees, the stem  60  extends from the cup  22  at a twenty degree angle thereto. As illustrated by  FIG.  6   , the stem  60  and the apertures  40  are equally spaced at a distance between the center point  50  and the rim  28 . 
     The stem  60  is formed to extend from and be oriented with respect to the cup  22  based on whether the surgical implant  20  is to be used on a left side of the patient, i.e., a left acetabulum, or a right side of the patient, i.e., a right acetabulum, for reconstruction of a segmental acetabular defect with pelvic discontinuity. Thus, the surgical implant  20  may be formed to have a mirror image of the surgical implant  20 , as illustrated by  FIGS.  1 - 8   , which is formed for use with a left acetabulum. 
     Accordingly, the present inventive concept maximizes transmission of force received from the medical device  20  to the bone  90 , simplifies the surgical procedure required to use the medical device, does not allow forces to be transmitted between multiple implants, is readily accepted by surrounding bone, allows growth of bone in and around the device, has a simple design that is easy to use, has a reproducible technique for implantation, minimizes surgical exposure and stripping of the bone, and does not prolong recovery time or expenses of a patient, and does not increase the risk of repeat revision surgery 
     Having now described the features, discoveries and principles of the general inventive concept, the manner in which the general inventive concept is constructed and used, the characteristics of the construction, and advantageous, new and useful results obtained; the new and useful structures, devices, tools, elements, arrangements, parts and combinations, are set forth in the appended claims. 
     It is also to be understood that the following claims are intended to cover all of the generic and specific features of the general inventive concept herein described, and all statements of the scope of the general inventive concept which, as a matter of language, might be said to fall there between.