Patent Description:
Metaphyseal and/or diaphyseal augments typically assist in preventing loosening and/or subsidence of an articular implant/component, such as, for example, an implanted tibia baseplate. Such augments can help distribute loads exerted on or by the articular implant through the bone, with the articular component maintaining fixation, which can result in a longer implant life.

One of the primary forces attributed to early failures of orthopedic implants, particularly in the tibia, is torsional stress. Moreover, torsional stresses can shear the articular implant-bone interface (cemented or un-cemented) apart, which can facilitate premature or early failure of the implant. Other forces, such as shear forces, can also contribute to similar premature or early failure of the articular implant-bone interface. Additionally, compressive loads, particularly unequal loads to a median plane (i.e. medial loading) of the articular implant-bone interface, can also cause subsidence and early failures of the articular implant.

Additionally, too much cortical contact with the augment can, as a consequence of carrying too much of the load, stress shield the host bone of the bone interface. Such situations can result in bone resorption, which can contribute to early failure of the implant. Additionally, unequal cortical contact due to lack of conformity or fit can load a particular region of the bone, and thereby relieve the articular implant-bone interface in a similar region. In at least certain situations, areas subjected to such unequal loads or contact can exhibit characteristics similar to a fulcrum, which can facilitate bone-interface failures for both the augment and the articular implant. <CIT> relates to a prosthetic knee system.

An aspect of the present application is an augment for implantation of an orthopedic implant device in a bone, the augment having an augment wall that includes an outer portion and an inner portion. The inner portion of the augment wall defines an inner region of the augment that is sized to receive placement of one or more components of the orthopedic implant device. A distal end of the outer portion has a first shape that is configured to generally conform to the shape of a metaphyseal-diaphyseal junction of a canal of the bone. Additionally, a proximal end of the outer portion has a second shape that is configured to generally conform to a shape of the metaphyseal region of the canal of the bone. Further, the first shape has a different shape and size than the second shape.

Another aspect of the present application is an augment for implantation of an orthopedic implant device in a bone, the augment having an augment wall that includes a posterior curvature portion and an anterior-medial portion. The posterior curvature portion at a first end of the augment is shaped to generally conform to a posterior curvature wall of a canal of the bone at a metaphyseal-diaphyseal junction of the canal, while the posterior curvature portion at a second end of the augment is shaped to generally conform to a posterior curvature wall of the canal at a metaphyseal region of the canal. Further, the anterior-medial portion at the first end of the augment is shaped to generally conform to an anterior-medial wall of the canal at the metaphyseal-diaphyseal junction, while the anterior-medial portion at the second end of the augment is shaped to generally conform to the anterior-medial wall at the metaphyseal region of the canal. Additionally, the shape of the posterior curvature portion at the metaphyseal region is different than the shape of the anterior-medial portion at the metaphyseal region.

The description herein makes reference to the accompanying figures wherein like reference numerals refer to like parts throughout the several views.

The foregoing summary, as well as the following detailed description of certain embodiments of the present application, will be better understood when read in conjunction with the appended drawings in which like reference numbers indicate like features, components and method steps. For the purpose of illustrating the invention, there is shown in the drawings, certain embodiments. It should be understood, however, that the present invention is not limited to the arrangements and instrumentalities shown in the attached drawings.

Certain terminology is used in the foregoing description for convenience and is not intended to be limiting. Words such as "upper," "lower," "top," "bottom," "first," and "second" designate directions in the drawings to which reference is made. This terminology includes the words specifically noted above, derivatives thereof, and words of similar import. Additionally, the words "a" and "one" are defined as including one or more of the referenced item unless specifically noted. The phrase "at least one of" followed by a list of two or more items, such as "A, B or C," means any individual one of A, B or C, as well as any combination thereof.

<FIG> illustrate anterior-posterior, medial-lateral, and isometric views, respectively, of an exemplary tibial implant device <NUM>. In the depicted embodiment, the tibial implant device <NUM> is a tibial articular assembly that includes a tibial (articular) baseplate <NUM>, a tibial augment <NUM>, and a stem <NUM>. The stem <NUM>, which can extend along a central stem axis <NUM>, can be directly or indirectly coupled to the tibial baseplate <NUM>, such as, for example, coupled to a tray stem <NUM>. As illustrated in <FIG>, according to certain embodiments, the tibial implant device <NUM> can include an offset/angled coupler <NUM>, which can offset at least the central stem axis <NUM> relative to a central tray stem axis <NUM> of the tray stem <NUM>. The tibial implant device <NUM> can also include other components, such as, for example, other intramedullary stems and other augments that can be assembled to the tibial implant device <NUM>.

The depicted tibial implant device <NUM> is structured to be cemented into and through the tibial augment <NUM> and onto a prepared proximal tibia of a patient. Further, while <FIG> illustrate the tibial augment <NUM> positioned on or about a tibial implant device <NUM> in a non-implanted state or condition, the tibial augment <NUM> can be implanted in a bone of the patient prior to implantation of the remainder of the tibial implant device <NUM>. Thus, an inner region <NUM> of the tibial augment <NUM> can be sized to receive passage and/or placement of at least a portion of the stem <NUM> and/or other components of the tibial implant device <NUM>, including, for example, the offset/angled coupler <NUM> and/or the tray stem <NUM>, during implantation of the tibial implant device <NUM> in a patient.

<FIG> illustrate anterior and medial-lateral views, respectively, of a proximal tibia bone <NUM>. <FIG> also includes transverse slice views of the proximal tibia bone <NUM>, as taken from identified lines 5C-5C through identified line 5J-5J (<FIG>). The proximal tibia bone <NUM> is oriented in <FIG> such that the bone <NUM> generally tapers inwardly for each sequential transverse slice view, thereby also reducing the size of the intramedullary canal <NUM>. Further, as depicted in each of slices 5E-5E through 5J-5J (<FIG>) of <FIG>, the cortical shape of the intramedullary canal <NUM> can be generally defined by an inner wall <NUM> of the proximal tibia bone <NUM> that comprises, at least in part, an anterior-medial wall <NUM>, a posterior curvature wall <NUM>, and an anterior-lateral wall <NUM>, the anterior-lateral wall <NUM> and the posterior curvature wall <NUM> being separated from each other, at least in part, by the anterior-medial wall <NUM>.

<FIG> illustrate an example of a symmetrical tibial augment <NUM> according to an illustrated embodiment of the present application. A variety of different augments can be used for the tibial augment <NUM>, including, for example, a cone or sleeve augment, among other augments. Further, the tibial augment <NUM>, and more specifically an augment wall <NUM>, can have a variety of shapes and sizes, and can have a symmetrical or asymmetrical configuration. For example, as illustrated by at least <FIG>, according to certain embodiments, the augment wall <NUM> of the tibial augment <NUM> can be generally symmetrical about a midline <NUM> that is generally perpendicular to a central longitudinal axis <NUM> of the tibial augment <NUM>. Thus, as shown in <FIG>, according to the illustrate embodiment, the midline <NUM> can generally divide the tibial augment <NUM> into generally symmetrical first and second sides 138a, 138b. The augment wall <NUM> can further include at least one opening 140a, 140b that is configured to accommodate placement of a component of the tibial implant device <NUM>. For example, according to the embodiment illustrated in <FIG>, the tibial augment <NUM> can include two opening 140a, 140b that are sized to accommodate at least the passage and/or placement of at least a portion of the keel(s) 142a, 142b of the tibial baseplate <NUM> about or through the opening(s) 140a, 140b. Further, while in the illustrated embodiment the augment wall <NUM> at the first and second sides 138a, 138b of the tibial augment <NUM> are depicted as having an opening 140a, 140b, other embodiments can be generally symmetrical with the exception that the augment wall <NUM> at one of the first and second sides 138a, 138b can contain an opening 140a, 140b, while such an opening 140a, 140b is not present at the other of the first and second sides 138a, 138b.

The augment wall <NUM> includes an inner portion <NUM> and an outer portion <NUM>. The inner portion <NUM> of the augment wall <NUM> can generally define an inner region <NUM> of the tibial augment <NUM>. At least a portion of the inner region <NUM> can extend between a distal end <NUM> and a proximal end <NUM> of the tibial augment <NUM>. Additionally, as discussed above, the inner region <NUM> can be sized to receive placement of at least one or more components of the tibial augment <NUM>, such as, for example, the stem <NUM>, offset/angled coupler <NUM>, and/or tray stem <NUM> of the tibial baseplate <NUM>, among other components. Additionally, while the surface of the outer portion <NUM> of the augment wall <NUM> in the illustrated embodiment has a step appearance or configuration, a variety of other surfaces or surface shapes can also be employed.

The outer portion <NUM> of the augment wall <NUM> is shaped to generally fit the cortical shape of a proximal tibia, and more specifically, a portion of the intramedullary canal of the tibia. According to certain embodiments, the outer portion <NUM> of the augment wall <NUM> of the tibial augment <NUM> can be configured such that at least the distal end <NUM>, or diaphyseal end, of the tibial augment <NUM> conforms to the general shape of the metaphyseal-diaphyseal junction of the tibia bone <NUM>, and at least the proximal end <NUM> of the tibial augment <NUM> conforms to the general shape or profile of the metaphyseal region of the tibial bone <NUM>. According to other embodiments, the distal end <NUM> and/or proximal end <NUM> can be shaped to provide other cross-sectional shapes that facilitate the ability of the tibial augment <NUM> to conform to the size and/or shape of at least a portion of the intramedullary canal <NUM> of the tibia bone <NUM>. Such conforming may not be limited to the physical shape(s) of each section of the outer portion <NUM> of the augment <NUM> mating or matching the shape of the adjacent portion of the inner wall <NUM> of the intramedullary canal <NUM>, but instead can include being shaped to operably contact an adjacent portion of the inner wall <NUM> of the intramedullary canal <NUM> while a central longitudinal axis <NUM> of the tibial augment <NUM> is aligned with, or at a selected position away from, a reference axis, including, for example, a longitudinal axis of the intramedullary canal <NUM>, the central stem axis <NUM>, and/or the central tray stem axis <NUM>, among other reference axes. Additionally, according to certain embodiments, the portion of the tibial augment <NUM> that is shaped to generally conform, or fit, to the shape or profile of the metaphyseal region can be located at distance away, in the metaphyseal direction, from the portion of the tibial augment <NUM> that conforms to the general shape or profile of the metaphyseal-diaphyseal junction that is about the same as the distance between the metaphyseal region and metaphyseal-diaphyseal junction of the tibia bone <NUM>.

Shaping the tibial augment <NUM> to generally conform to, or accommodate, changes and/or variances in the shape of the intramedullary canal <NUM> of the tibia bone <NUM>, can prevent or minimize the extent to which the tibial augment <NUM> is subjected to unequal loading conditions. Further, by shaping different portions or areas of the tibial augment <NUM>, as well as other augments herein, to generally conform to or otherwise accommodate the shape of at least an adjacent inner wall of the associated bone canal or cavity, the generally anatomically shaped augments discussed herein, including the tibial augment <NUM>, <NUM>', and the below-discussed femoral augment <NUM>, <NUM>', can reduce the impact forces on the corresponding articular implant-bone interface by distributing such forces or loads over a relatively larger surface area. More specifically, for example, such conforming configurations of the augments <NUM>, <NUM>', <NUM>, <NUM>' can improve resistance to torsional stress by equally distributing such forces circumferentially.

Further, such variations among and/or along at least the augment wall <NUM> of the tibial augment <NUM> can improve flexibility in the placement of the tibial augment <NUM>, and thus reduce or minimize the tibial augment <NUM> from hindering the ability to position an associated articular component relative to a joint line, while also not hindering joint balance (flexion-extension balance) and rotation of each component relative to the patella-femoral joint.

To generally accommodate the cortical shape(s) of the intramedullary canal <NUM> of the tibia bone <NUM>, including, for example, the shape at both the metaphyseal-diaphyseal junction and at metaphyseal region of the tibial bone <NUM>, as well as the shapes therebetween, different areas or sides of the outer portion <NUM> of the augment wall <NUM> can have different shapes. Additionally, the shapes along such different areas or sides of the outer portion <NUM> of the augment wall <NUM> can also vary between the distal and proximal ends <NUM>, <NUM> of the tibial augment <NUM>. Such variances or inconsistencies among and/or along the sides or areas of the tibial augment <NUM> can preclude the augment wall <NUM> of the tibial augment <NUM> from having a generally uniform cylindrical or conical shape.

Referencing <FIG>, according to certain embodiments, the augment wall <NUM> of the tibial augment <NUM> can include a first, or posterior curvature, portion <NUM> and a second, or anterior-medial, portion <NUM> that are separated from each other by at least a transversal axis <NUM> that is at least perpendicular to the midline <NUM>. Additionally, in the illustrated embodiment, at least a portion of posterior curvature portion <NUM> has a shape that is different than a corresponding portion of the anterior-medial portion <NUM>. For example, as shown by the top view of the proximal end <NUM> of the tibial augment <NUM> in <FIG>, the posterior curvature portion <NUM> can include a generally flat section 156a that transitions into rounded end sections 156b, 156c, while the anterior-medial portion <NUM> can include a rounded section 158a that transitions into generally flat sections 158b, 158c. Such differences in shapes, and the resulting dissimilar profiles, are depicted by at least <FIG> at least in the region around the proximal end <NUM> of the tibial augment <NUM>. As demonstrated by at least slices 11D-11D and 11E-11E from <FIG>, such differences in the shapes of the posterior curvature and anterior-medial portions <NUM>, <NUM> of the tibial augment <NUM> can facilitate the ability of the tibial augment <NUM> to generally conform to the shape of at least the adjacent posterior curvature wall <NUM> and the anterior-medial wall <NUM>, respectively, of the inner wall <NUM> of the intramedullary canal <NUM>. Additionally, as indicated by slice 11D-11D (<FIG>) from <FIG>, a portion of the anterior-medial portion <NUM> and/or the posterior curvature portion <NUM> can contact other portions of the inner wall <NUM> of the intramedullary canal <NUM>, including, for example, the lateral wall <NUM>.

The different shapes of the posterior curvature and anterior-medial portions <NUM>, <NUM> can alter or vary between the distal and proximal ends <NUM>, <NUM> along the augment wall <NUM> so that the outer position <NUM> of the augment <NUM> generally conforms to changes in shape along the inner wall <NUM> of the intramedullary canal <NUM> of the tibia bone <NUM>, as depicted each of slice views 5C-5C through 5J-5J from <FIG> and <FIG>-11B through <FIG>-11I (<FIG>) from <FIG>. According to the illustrated embodiment shown in at least <FIG>, such changes in shape in the inner wall <NUM> of the intramedullary canal <NUM>, and corresponding changes in shape along at least the posterior curvature and anterior-medial portions <NUM>, <NUM> of the augment wall <NUM>, can result in the posterior curvature and anterior-medial portions <NUM>, <NUM> generally having similar shapes at the distal end <NUM> of the tibial augment <NUM>, as shown, for example, by <FIG> and slice E-E in <FIG>. Such similarities in the shape of the posterior curvature and anterior-medial portions <NUM>, <NUM> can, for example, provide the augment wall <NUM> with a generally circular, semi-circular, or slightly oval shape at the distal end <NUM> of the tibial augment <NUM>. However, again, the particular shape(s) of the augment wall <NUM> at the distal end <NUM> of the tibial augment <NUM> can be configured or selected to generally conform to the metaphyseal-diaphyseal junction of the tibia bone <NUM>.

<FIG> further illustrate the symmetrical tibial augment <NUM> that is shaped to conform to the shape of the cortical shape of the bone <NUM>, and more specifically, in the illustrated embodiment, to the adjacent shape of the intramedullary canal <NUM>. For example, as shown in <FIG>, the proximal end <NUM> of the tibial augment <NUM> is shaped to generally conform to the general shape or profile of adjacent portions of the metaphyseal region of the tibial bone <NUM>. Further, as shown in <FIG>, the region around the anterior-lateral wall <NUM>, and moreover, in the region of the tibial tubercle <NUM>, can often be covered, at least in part, by the anterior aspect of a transversely resected portion of the proximal tibia bone <NUM>. Such coverage can prevent the tibial augment <NUM> from having direct access inferior-superior to the cancellous area <NUM> that can be present behind the tibial tubercle <NUM>. Yet, without direct access or special instrumentation, preparation, as well as placement of the tibial augments that lack the anatomical shapes disclosed herein, at such a location can be difficult.

Referencing <FIG>, in at least certain instances, patients can have an abnormality in the shape and/or size of the intramedullary canal <NUM> and/or can require enhanced support from a tibial augment <NUM>'. In such situations, the tibial augment <NUM>' can have an asymmetrical configuration about the midline <NUM>, as shown in at least <FIG>. Such an asymmetrical configuration can increase a thickness of the augment wall <NUM> between at least certain sections of the inner and outer portions <NUM>, <NUM> of the augment wall <NUM>. For example, compared to slices 11D-11D, 11E-11E, and 11F-11F (<FIG>) from <FIG>, the asymmetrical tibial augment <NUM>' shown in slice views from 17E-17E, 17F-17F, and <NUM>-<NUM> (<FIG>) from <FIG> has and increased thickness in the augment wall <NUM> at least in the vicinity of the lateral wall <NUM> portion of the inner wall <NUM> of the intramedullary canal <NUM>. However, according to certain embodiments, such increases in the thickness of the augment wall <NUM> and/or increases of the augment wall <NUM> in certain locations can be limited due to the previously discussed limitations associated with the cancellous area <NUM> behind the tibial tubercle <NUM>.

<FIG> illustrate posterior-anterior, medial-lateral, and isometric views, respectively, of a femoral implant device <NUM>. According to an illustrated embodiment of the present application, the femoral implant device <NUM> includes a femoral articular component <NUM>, an intramedullary stem <NUM>, and a femoral augment <NUM>. Additionally, as shown in <FIG>, according to certain embodiments, the femoral implant device <NUM> can also include a distal augment <NUM> and/or a posterior augment <NUM>. The stem <NUM>, which can extend along a central stem axis <NUM>, can be directly or indirectly coupled to the femoral articular component <NUM>, such as, for example, coupled to a component stem <NUM> of the femoral articular component <NUM>, as shown in <FIG>. As illustrated in <FIG>, according to certain embodiments, the femoral implant device <NUM> can include an offset/angled coupler <NUM>, which can offset at least the central stem axis <NUM> relative to a component stem axis <NUM> of the component stem <NUM>.

The depicted femoral implant device <NUM> is structured to be cemented into and through the femoral augment <NUM> and onto a prepared distal femur of a patient. Further, while <FIG> illustrate the femoral augment <NUM> positioned on or about a femoral implant device <NUM> in a non-implanted state or condition, the femoral augment <NUM> can be implanted in a bone of the patient prior to implantation of the remainder of the femoral implant device <NUM>. Thus, an inner region of the femoral augment <NUM> can be sized to receive passage and/or placement of at least a portion of the stem <NUM> and/or other components of the femoral implant device <NUM>, including, for example, the offset/angled coupler <NUM> and/or the component stem <NUM>, during implantation of the femoral implant device <NUM> in a patient.

<FIG> illustrate an example of a fully contained femoral augment <NUM> according to an illustrated embodiment of the present application. A variety of different augments can be used for the femoral augment <NUM>, including, for example, a cone or sleeve augment, among other augments. Further, the femoral augment <NUM> can have a variety of shapes and sizes. The femoral augment <NUM> can include an augment wall <NUM> that extends about a central axis <NUM> of the femoral augment <NUM>. The augment wall <NUM> has an inner portion <NUM> and an outer portion <NUM>. The inner portion <NUM> of the augment wall <NUM> can generally define an inner region <NUM> of the femoral augment <NUM>. At least a portion of the inner region <NUM> can extend between a distal end <NUM> and a proximal end <NUM> of the femoral augment <NUM>. The inner region <NUM> can be sized to receive placement of at least one or more components of the femoral augment <NUM>, such as, for example, the stem <NUM>, offset/angled coupler <NUM>, and/or component stem <NUM> of the femoral articular component <NUM>, among other components. For example, according to certain embodiments, the inner region <NUM> is sized to receive placement of at least the junction between the stem <NUM> and the component stem <NUM>.

The outer portion <NUM> of the augment wall <NUM> can be shaped to generally fit the cortical shape of a distal femur, and more specifically, of a portion of the intramedullary canal of the femur. Thus, according to certain embodiments, a diaphyseal, or distal end <NUM>, of the femoral augment <NUM> can be shaped to generally conform to the general shape of the metaphyseal-diaphyseal junction. The opposing proximal end <NUM> of the femoral augment <NUM> can be configured to conform to the general shape or profile of the metaphyseal region of the femoral bone. According to other embodiments, the distal end <NUM> and/or proximal end <NUM> can be shaped to provide other cross-sectional shapes that facilitate the ability of the femoral augment <NUM> to conform to the size and/or shape of at least a portion of the intramedullary canal of the femur. Such conforming may not be limited to the physical shape(s) of each section of the outer portion <NUM> of the augment mating or matching the shape of the adjacent portion of the inner wall of the intramedullary canal of the femoral bone, but instead can include being shaped to operably contact an adjacent portion of the inner wall of the intramedullary canal while a central axis <NUM> of the femoral augment <NUM> is aligned with, or at a selected position away from, a reference axis, including, for example, a longitudinal axis of the intramedullary canal of the femur, the central stem axis <NUM>, and/or the component stem axis <NUM>, among other reference axes. Additionally, the portion of the femoral augment <NUM> that is shaped to generally conform to the shape or profile of the metaphyseal region can be located at distance away, generally in the distal direction, from the portion of the femoral augment <NUM> that conforms to the general shape or profile of the metaphyseal-diaphyseal junction that is about the same as the distance between the metaphyseal region and metaphyseal-diaphyseal junction of the tibia.

Similar to the tibial augment <NUM>, <NUM>', shaping the femoral augment <NUM> to generally conform to, or accommodate, changes and/or variances in the shape of the intramedullary canal of the femur can prevent or minimize the extent to which the femoral augment <NUM> is subjected to unequal loading conditions. Further, again, by shaping different portions or areas of the femoral augment <NUM>, as well as other augments herein, to generally conform to or otherwise accommodate the shape of at least an adjacent inner wall of the associated bone canal or cavity, the generally anatomically shaped augments <NUM>, <NUM>', <NUM>, <NUM>', discussed herein can reduce the impact forces on the corresponding articular implant-bone interface by distributing such forces or loads over a relatively larger surface area. More specifically, for example, such conforming configurations of the augments <NUM>, <NUM>', <NUM>, <NUM>' can improve resistance to torsional stress by equally distributing such forces circumferentially.

To generally accommodate the cortical shape(s) of the medullary canal of the femur, including, for example, the shape at both the metaphyseal-diaphyseal junction and at metaphyseal region of the femur, as well as the shape therebetween, different areas or sides of the outer portion <NUM> of the augment wall <NUM> can have different shapes. Additionally, the shapes along such different areas or sides of the outer portion <NUM> of the augment wall <NUM> can also vary between the distal and proximal ends <NUM>, <NUM> of the femoral augment <NUM>. Such variances or inconsistencies among and/or along the sides or areas of the femoral augment <NUM> can preclude the augment wall <NUM> of the femoral augment <NUM> from having a generally uniform cylindrical or conical shape.

Referencing <FIG>, according to the invention, the outer portion <NUM> of the augment wall <NUM> includes a recess or relief <NUM>. As shown by at least <FIG>, according to the illustrated embodiment, the relief <NUM> can extend along a portion of the augment wall <NUM>, such as, for example, extending from the proximal end <NUM> to a region generally adjacent to the distal end <NUM> of the femoral augment <NUM>. However, according to other embodiments, the relief <NUM> can extend between, and through, the proximal end <NUM> and/or the distal end <NUM> of the femoral augment <NUM>. In the illustrated embodiment, the relief <NUM> has one or more sidewalls <NUM> and a base wall <NUM>. For example, as shown in <FIG>, the one or more sidewalls <NUM> can include a first sidewall 238a and a second sidewall 238b. The first and second sidewalls 238a, 238b can be angled such that the first and second sidewalls 238a, 238b converge toward each other from generally opposite directions and/or angles. For example, in the illustrated embodiment, the first and second sidewalls 238a, 238b can each extend from opposing first ends 242a, 242b, and converge toward each other so as to intersect or be generally in proximity to each other at second ends 244a, 244b of the first and second sidewalls 238a, 238b. Further, in the illustrated embodiment, the second ends 244a, 244b can be adjacent to, or generally form, an augment flange <NUM> that projects away from the first and second sidewalls 238a, 238b.

As indicated by <FIG>, according to certain embodiments, the first and second sidewalls 238a, 238b can also be angled or tapered, and thus non-parallel to a longitudinal central axis <NUM> of the femoral augment <NUM>. For example, as shown in the embodiment depicted in <FIG>, the portion of the first and second sidewalls 238a, 238b at the proximal end <NUM> of the augment wall <NUM> can be separated from the central axis <NUM> of the femoral augment <NUM> by a distance that is smaller than the distance between the central axis <NUM> and the vicinity of the intersection of the first and second sidewalls 238a, 238b and the base wall <NUM>.

As shown by at least <FIG> and <FIG>, according to the illustrated embodiment, the relief <NUM> can be shaped such that, when the femoral augment <NUM> is operably positioned on the femoral implant device <NUM>, the relief <NUM> is generally parallel to the bone facing side of the anterior flange <NUM> of the femoral implant device <NUM>. Such a shape can at least assist in adjustable rotational displacement of the femoral augment <NUM> relative to the femoral implant device <NUM>, and more particularly, of the anterior flange <NUM> (<FIG>) relative to the femoral augment <NUM>. Such rotational adjustment can also be facilitated by the angular orientation of the first and/or second sidewalls 238a, 238b of the augment wall <NUM>. For example, as indicated by the exemplary femoral augments <NUM>, <NUM>' shown in <FIG> and <FIG>, the first sidewall 238a can be oriented to facilitate that ability to adjust the angular position of the femoral augment <NUM> relative to other components of the femoral implant device <NUM>, such as, for example, relative to the anterior flange <NUM>, by about <NUM> degrees, among other degrees of rotational freedom. Thus, for example, such rotational displacement can, when the femoral implant device <NUM> is implanted in a patient, allow for selective adjustment in the distance between the first end 242a of the first sidewall 238a and the anterior flange <NUM>.

The rotational freedom provided by incorporation of the relief <NUM> and the associated adjustment in the position of the femoral augment <NUM> relative to the anterior flange <NUM> can assist in the femoral augment being adapted to accommodate rotational variation in the geometry of the intramedullary canal of the femur. Moreover, the relief <NUM> can assist in enhancing the flexibility as to the orientation at which the femoral augment <NUM> can be implanted in the intramedullary canal so as to further enhance the ability of the femoral augment <NUM> to conform or otherwise accommodate the particular shape of the intramedullary canal while also minimizing or preventing the position of the femoral augment <NUM> from impeding the positioning or operation of other components of the femoral implant device <NUM>. For example, the rotational freedom of the femoral augment <NUM> that is provided by, at least in part, the inclusion of the relief <NUM> can enhance the ability to position the femoral augment <NUM> to accommodate for rotational variation in the shape of the intramedullary canal while also not preventing the femoral implant device <NUM>, such a femoral articular component, from being positioned at a particular transverse rotational location.

<FIG> illustrate a femoral augment <NUM>' that is adapted to accommodate larger components, or collections of components, in the inner region <NUM>' of the augment <NUM>'. For example, the femoral augment <NUM>' depicted in <FIG> can be adapted to receive in the inner region one or more of the stem <NUM>, component stem <NUM>, and/or the offset/angled coupler <NUM>, among other components. According to such an embodiment, the relief <NUM> or augment flange <NUM>, if any, can include one or more tear lines or relief areas <NUM> that are adapted to open, break through, or tear the augment wall <NUM>, or otherwise relieve at least a portion of the augment <NUM>'. Thus, in certain situations, the formation of an opening along one or more of the tear lines or relief areas <NUM> can provide access to additional space so as to prevent the inner region <NUM>' from restricting or impeding positioning of components of the femoral implant device <NUM> relative to the femoral augment <NUM>. Thus, unlike the fully contained inner region <NUM> of the femoral augment <NUM> shown in <FIG>, the tear lines or relief areas <NUM> can allow for the femoral augment <NUM>' to transition from being fully contained to partially contained, which can occur, for example, upon the formation of openings or breakage along the tear line or relief areas <NUM>.

Additionally, in the illustrated embodiments of the femoral augments <NUM>, <NUM>' shown in at least <FIG>, at least some sides of the femoral augments <NUM>, <NUM>' can have different shapes and/or configurations. Further, similar to the tibial augments <NUM>, <NUM>' discussed above, the shape or configurations of those sides can alter, and can alter differently, between the proximal and distal ends <NUM>, <NUM> of the femoral augments <NUM>, <NUM>'. For example, referencing the top views of <FIG> and <FIG>, at the distal ends <NUM> of the femoral augments <NUM>, <NUM>', the femoral augments <NUM>, <NUM>' can generally egg-shape, which can assist in providing different shaped and sized profiles along the augment wall <NUM> of the femoral augments <NUM>, <NUM>', and shown by a comparison of <FIG> with <FIG>, and a similar comparison of <FIG> with <FIG>. Further, while the distal end <NUM> in the illustrated embodiments is shown as being generally egg-shaped, as shown in the <FIG> and <FIG>, the proximal ends <NUM> of the femoral augments <NUM>, <NUM>' can be generally circular. Thus, the transitions between, and the associated shapes, of the proximal and distal ends <NUM>, <NUM> can preclude the femoral augments <NUM>, <NUM>' from having a generally uniform cylindrical or conical shape. Instead, as previously mentioned, such variations in shapes along different portions of the femoral augment <NUM>, <NUM>' can be adapted to enhance the ability of the femoral augment <NUM>, <NUM>' to generally conform to the shape of adjacent portions of the intramedullary canal of the femur.

Claim 1:
An augment (<NUM>, <NUM>', <NUM>, <NUM>') for implantation of an orthopedic implant device in a bone,
the augment comprising:
an augment wall (<NUM>, <NUM>) having an outer portion (<NUM>, <NUM>) and an inner portion (<NUM>, <NUM>), the inner portion defining an inner region (<NUM>, <NUM>) of the augment, the inner region sized to receive placement of one or more components of the orthopedic implant device, a distal end (<NUM>,<NUM>) of the outer portion (<NUM>, <NUM>) having a first shape configured to generally conform to the shape of a metaphyseal-diaphyseal junction of a canal (<NUM>) of the bone, (<NUM>) a proximal end (<NUM>, <NUM>) of the outer portion (<NUM>, <NUM>) having a second shape configured to generally conform to a shape of the metaphyseal region of the canal of the bone, the first shape having a different shape and size than the second shape wherein a portion of the outer portion (<NUM>, <NUM>) includes a relief (<NUM>) that is configured to accommodate rotational displacement of the augment relative to a component of the orthopedic implant device, and characterised in that the relief (<NUM>) comprises at least one sidewall (<NUM>) that tapers outwardly as the at least one sidewall (<NUM>) extends from the proximal end (<NUM>, <NUM>) and toward the distal end (<NUM>, <NUM>).