Patent Description:
Many bones of the human musculoskeletal system include articular surfaces. The articular surfaces articulate relative to other bones to facilitate different types and degrees of joint movement. The articular surfaces can erode or experience bone loss over time due to repeated use or wear or can fracture as a result of a traumatic impact. These types of bone defects can cause joint instability and pain.

Bone deficiencies may occur along the articular surfaces of the glenoid bone. Some techniques utilize a bone graft and/or implant to fill a defect in the glenoid bone. The implant may be secured to the glenoid utilizing one or more fasteners.

<CIT> discloses a fusion cage with integrated fixation and insertion features. <CIT> discloses reverse shoulder systems and methods.

An orthopaedic implant according to the invention is defined in claim <NUM> and a method of forming an orthopaedic implant is defined in claim <NUM>. The implant may be used during methods for restoring functionality to a joint. The implant includes one or more fasteners coupled to a wall of the implant at a breakable connection.

An orthopaedic implant according to an exemplary aspect of this disclosure includes, inter alia, a main body including an inner wall establishing a passage. The passage extends inwardly from an external surface of the main body. A fastener is dimensioned to be partially received in bone. The fastener is coupled to the inner wall at a first breakable connection along the passage. A portion of the fastener is moveable outwardly from the passage in response to severing the first breakable connection.

A method of installing an orthopaedic implant at a surgical site may include, inter alia, positioning an implant along a bone at a surgical site. The implant may include a main body establishing a passage and a fastener coupled to an internal wall of the main body at a first breakable connection along the passage. The method may include engaging an interface of the implant with a driver. The method may include severing the first breakable connection in response to moving the driver at the interface, and then moving the driver to cause the fastener to move at least partially outwardly from the passage and into the bone to secure the implant at the surgical site.

A method of forming an orthopaedic implant according to an exemplary aspect of this disclosure includes, inter alia, printing a main body including an inner wall establishing a passage. The method includes printing a fastener at least partially in a volume of the passage. The fastener is dimensioned to be at least partially received in bone. The method includes printing a first breakable connection that interconnects the inner wall of the main body and the fastener. A portion of the fastener is moveable outwardly from the passage in response to severing the first breakable connection.

This disclosure relates to orthopaedic implants and methods of fabricating and installing implants. The implants described herein may be utilized during orthopaedic procedures and may be incorporated into a shoulder prosthesis for restoring functionality to shoulders having advanced cartilage disease. The disclosed implants may incorporate one or more fasteners that may be formed together with a main body of the respective implant. The fastener may be deployed during a surgical procedure according to a predetermined orientation and/or depth, which may reduce surgical duration and improve healing of the patient.

The fastener is a compression screw including a plurality of threads.

The compression screw includes a head portion and a shank portion extending from the head portion. The plurality of threads extend about a circumference of the shank portion. According to the invention, the fastener is cantilevered in the passage from the first breakable connection at the head portion.

In a further embodiment, the main body may include a baseplate and an augment. The baseplate may include a plate body extending along a longitudinal axis between a front face and a rear face. The augment may include an augment body dimensioned to contact bone. The augment body may extend outwardly from the rear face of the baseplate to establish at least a portion of the passage.

In a further embodiment, the augment body may include a porous scaffold extending between the external surface of the implant and the internal wall.

In a further embodiment, the augment may include an anchoring stem that establishes the passage. The anchoring stem may be dimensioned to extend outwardly from the augment body.

In a further embodiment, the anchoring stem may include one or more bone growth openings circumferentially distributed about a periphery of the anchoring stem that interconnect the passage and an external surface of the anchoring stem.

In a further embodiment, the plate body may establish a central aperture extending along the longitudinal axis between the front face and the passage.

In a further embodiment, the plate body may establish a plurality of peripheral apertures circumferentially distributed about the central aperture relative to the longitudinal axis. The augment may establish a plurality of peripheral passages at least partially aligned with respective ones of the peripheral apertures along a passage axis. The peripheral passages may extend between the rear face of the baseplate and the external surface of the implant. Each respective pair of the peripheral apertures and the peripheral passages may be dimensioned to at least partially receive a respective fastener along the passage axis. Each respective fastener may be dimensioned to be at least partially received in bone.

In a further embodiment, an articulation member may be secured to the baseplate adjacent the front face. The articulation member may include an articulating surface dimensioned to mate with an opposed articular surface associated with an adjacent bone.

In a further embodiment, a driving member may be coupled to the fastener at a second breakable connection. The driving member may include an interface dimensioned to engage a driver to cause the first breakable connection to sever in response to a first predetermined quantity of torque at the interface. The second breakable connection may be dimensioned to sever in response to a second predetermined quantity of torque at the interface. The second predetermined quantity of torque may be greater than the first predetermined quantity of torque.

In a further embodiment, the second breakable connection may at least partially extend along the passage.

In a further embodiment, the first breakable connection may include a plurality of connection points extending between the fastener and the internal wall.

In a further embodiment, the fastener may establish a passage dimensioned to at least partially receive a guide wire.

A method of installing an orthopaedic implant at a surgical site may include, inter alia. positioning an implant along a bone at a surgical site. The implant may include a main body establishing a passage and a fastener coupled to an internal wall of the main body at a first breakable connection along the passage. The method may include engaging an interface of the implant with a driver. The method may include severing the first breakable connection in response to moving the driver at the interface, and then moving the driver to cause the fastener to move at least partially outwardly from the passage and into the bone to secure the implant at the surgical site.

In a further example, the step of severing the first breakable connection may generate an audible click and/or tactile force.

In a further example the implant may include a driving member coupled to the fastener at a second breakable connection. The driving member may establish the interface. The step of severing the first breakable connection may include causing the driver to apply a first torque at the interface that exceeds a first predetermined quantity of torque.

In a further example, severing the second breakable connection may occur subsequent to the step of severing the first breakable connection in response to causing the driver to apply a second torque at the interface that may exceed a second predetermined quantity of torque.

In a further example, the main body may include an anchoring stem that establishes at least a portion of the passage. A portion of the anchoring stem may establish a plurality of bone growth openings circumferentially distributed about a periphery of the anchoring stem that interconnect the passage and an external surface of the anchoring stem. The method may include forming a recess in the bone. The method may include positioning the portion of the anchoring stem in the recess.

In a further example, the passage may extend along a longitudinal axis. The main body may establish a plurality of peripheral apertures circumferentially distributed about the longitudinal axis. The method may include positioning a plurality of fasteners at least partially in respective ones of the peripheral apertures and then at least partially into the bone to secure the implant at the surgical site.

In a further example, the method may include securing an articulation member to a front face of the main body. The articulation member may include an articulating surface dimensioned to mate with an opposed articular member associated with an adjacent bone at the surgical site.

A method of forming an orthopaedic implant according to an exemplary aspect of this disclosure includes, inter alia, printing a main body including an inner wall establishing a passage. The method includes printing a fastener at least partially in a volume of the passage. The fastener is dimensioned to be at least partially received in bone. The method includes printing a first breakable connection that interconnects the internal wall of the main body and the fastener. A portion of the fastener is moveable outwardly from the passage in response to severing the first breakable connection.

The step of printing the fastener includes printing a head portion, a shank portion extending from the head portion, and a plurality of threads about a circumference of the shank portion.

According to the invention, the step of printing the fastener occurs such that the fastener is cantilevered in the passage from the first breakable connection at the head portion.

In a further embodiment, the method may include printing a driving member including an interface. The method may include printing a second breakable connection interconnecting the driving member and the head portion of the fastener. The interface may be dimensioned to engage a driver to cause the first breakable connection to sever in response to a first predetermined quantity of torque at the interface. The second breakable connection may be dimensioned to sever in response to a second predetermined quantity of torque at the interface. The second predetermined quantity of torque may be greater than the first predetermined quantity of torque.

In a further embodiment, at least a portion of the second breakable connection may be established along the passage.

In a further embodiment, the step of printing the main body may include printing an augment including an augment body onto a rear face of a baseplate. The augment body may be dimensioned to contact bone. The baseplate may include a plate body extending between a front face and the rear face.

In a further embodiment, the plate body may establish a central aperture extending along a longitudinal axis between the front face and the passage. The plate body may establish a plurality of peripheral apertures circumferentially distributed about the longitudinal axis. The step of printing the augment may include establishing a plurality of peripheral passages at least partially aligned with respective ones of the peripheral apertures along a passage axis. Each of the peripheral passages may extend between the rear face of the baseplate and an external surface of the augment. Each respective pair of the peripheral apertures and the peripheral passages may be dimensioned to at least partially receive a respective fastener along the passage axis. Each respective fastener may be dimensioned to be partially received in bone.

In a further embodiment, the augment body may include a porous scaffold that establishes the external surface of the augment.

In a further embodiment, the step of printing the main body may include printing an anchoring stem to establish the inner wall. The scaffold may at least partially surround the anchoring stem.

In a further embodiment, the step of printing the anchoring stem may include establishing an array of bone growth openings circumferentially distributed about a periphery of the anchoring stem that interconnect the passage and an external surface of the anchoring stem. The anchoring stem may be dimensioned to extend outwardly from the augment body along the longitudinal axis.

<FIG> illustrate an exemplary orthopaedic implant <NUM>. The implant <NUM> may be utilized for various surgical procedures, such as an arthroplasty for restoring functionality to a joint. The implant <NUM> may be incorporated into a shoulder prothesis for implantation in a glenoid, for example. Although the implants disclosed herein primarily refer to repair of a defect in a glenoid during a shoulder reconstruction, such as an anatomical and/or reverse shoulder procedure, it should be understood that the disclosed implants may be utilized in other locations of the patient and other surgical procedures.

Referring to <FIG>, the implant <NUM> may include a main body <NUM> dimensioned to abut against bone at a surgical site. The main body <NUM> may be dimensioned to receive one or more fasteners <NUM>. Each of the fasteners <NUM> may be dimensioned to be at least partially received in bone to secure the implant <NUM> at the surgical site. One or more of the fasteners <NUM> may be removeable from the main body <NUM>. Various fasteners <NUM> may be utilized with the implant <NUM>, such as nails and compression screws. For example, each of the fasteners <NUM> may be a compression screw including a head portion <NUM> and a shank portion <NUM> extending outwardly from the head portion <NUM> to a respective tip portion <NUM>, as illustrated in <FIG> and <FIG>. A plurality of threads <NUM> may extend about a circumference <NUM> of the shank portion <NUM> to engage tissue such as bone, as illustrated by <FIG>.

The main body <NUM> may include a baseplate <NUM> and an augment <NUM>. The augment <NUM> is shown in dashed lines in <FIG> and <FIG> and is omitted in <FIG>, <FIG> and <FIG> for illustrative purposes. The baseplate <NUM> and augment <NUM> may be integrally formed to establish a monolithic or unitary component or may be separate and distinct components that are fixedly attached or otherwise secured to one another. The baseplate <NUM> may include a plate body <NUM> extending along a longitudinal axis X (<FIG>) between a first (e.g., front) face <NUM> and a second (e.g., rear) face <NUM> generally opposed to the first face <NUM>. A perimeter of the plate body <NUM> may have a substantially circular or elliptical geometry. A substantially circular geometry may reduce a reaming width and complexity of preparing a surgical site to accept the implant <NUM>.

The augment <NUM> may include an augment body <NUM> dimensioned to contact bone. The augment body <NUM> may be formed according to a geometry that substantially matches a geometry of the bone of the respective patient. The augment body <NUM> may extend along the longitudinal axis X (<FIG>) between a first (e.g., front) face <NUM> and a second (e.g., rear) face <NUM> generally opposed to the first face <NUM>. The front faces <NUM>, <NUM> may generally correspond to a lateral side of a patient, and the rear faces <NUM>, <NUM> may generally correspond to a medial side of the patient when implanted in a surgical site. The augment body <NUM> may extend outwardly from the rear face <NUM> of the baseplate <NUM> to establish an external surface <NUM> of the implant <NUM>.

The augment body <NUM> may be dimensioned to approximate various defect geometries and surface contours that may be encountered along a surgical site. The augment body <NUM> may be configured to at least partially or completely fill a recess or void V in a bone B such as a glenoid, as illustrated in dashed lines in <FIG>.

The augment body <NUM> may include a porous scaffold <NUM> extending between the rear face <NUM> of the baseplate <NUM> and the external surface <NUM> of the implant <NUM> established by the rear face <NUM> of the augment body <NUM>, as illustrated in <FIG> (see also <FIG>). The scaffold <NUM> may include an interconnected network of branches and nodes extending throughout a volume of the augment body <NUM>. The scaffold <NUM> may be infused with biological material or biologics to improve healing. The scaffold <NUM> is omitted from <FIG>, <FIG> and <FIG> for illustrative purposes. In other implementations, the augment body <NUM> may be substantially solid.

The plate body <NUM> of the baseplate <NUM> or another portion of the main body <NUM> may establish one or more apertures <NUM> dimensioned to receive a respective fastener, such as one of the fasteners <NUM>. Each aperture <NUM> may extend along a respective passage axis PA between the front face <NUM> and the rear face <NUM> of the baseplate <NUM>. The apertures <NUM> may include a central aperture 44C and one or more peripheral apertures 44P. The passage axis PA of the central aperture 44C may be substantially colinear with or otherwise parallel to the longitudinal axis X. The peripheral apertures 44P may be circumferentially distributed about the central aperture 44C relative to the longitudinal axis X, as illustrated by <FIG> and <FIG>.

Referring to <FIG>, with continuing reference to <FIG>, an inner wall <NUM> of the main body <NUM> such as the augment <NUM> may be dimensioned to establish one or more passages <NUM>. The augment body <NUM> may extend outwardly from the rear face <NUM> of the baseplate <NUM> to establish at least a portion of each of the passages <NUM>. Each passage <NUM> may extend inwardly from the external surface <NUM> of the main body <NUM>. Each of the passages <NUM> may be dimensioned to receive a respective one of the fasteners <NUM>. The passages <NUM> may extend between the front face <NUM> and rear face <NUM> of the augment <NUM>, as illustrated in <FIG>.

The passages <NUM> may include a central passage 46C and one or more of peripheral passages 46P extending at least partially through the augment <NUM>. The central passage 46C may be at least partially aligned with the central aperture 44C along the respective passage axis PA. The central passage 46C may extend along the longitudinal axis X. The peripheral passages 46P may be at least partially aligned with respective ones of the peripheral apertures 44P along the respective passage axes PA.

Each aperture <NUM> may extend along the respective passage axis PA between the front face <NUM> of the baseplate <NUM> and a respective one of the passages <NUM>. The central aperture 44C may extend along the longitudinal axis X between the front face <NUM> of the baseplate <NUM> and the central passage 46C, as illustrated in <FIG>.

The fasteners <NUM> may include a central fastener 24C and one or more peripheral fasteners 24P (see <FIG>). Each respective pair of the peripheral apertures 44P and peripheral passages 46P may be dimensioned to at least partially receive a respective peripheral fastener 24P along the passage axis PA (fasteners 24P indicated in dashed lines in <FIG> for illustrative purposes). The central passage 46C may be dimensioned to at least partially receive the central fastener 24C along the respective passage axis PA. The central fastener 24C may be spaced apart from the central aperture 44C.

The augment <NUM> may include one or more tubular members <NUM> extending between the rear face <NUM> of the baseplate <NUM> and the external surface <NUM> of the implant <NUM> established by the rear face <NUM> of the augment <NUM>. Each tubular member <NUM> may establish a respective one of the passages <NUM>. The scaffold <NUM> may extend between the external surface <NUM> of the implant <NUM> and the internal wall <NUM>, as illustrated in <FIG> and <FIG>. The scaffold <NUM> may substantially surround the passages <NUM> and tubular members <NUM> within the augment body <NUM>.

At least one of the tubular members <NUM> may serve as an anchoring stem <NUM> dimensioned to extend outwardly from the external surface <NUM> of the implant <NUM>. The anchoring stem <NUM> may be dimensioned to extend along the longitudinal axis X to establish the central passage 46C, as illustrated in <FIG>. In some implementations, one or more of the tubular members <NUM> extending from the peripheral apertures 44P may be dimensioned to extend outwardly from the external surface <NUM> to establish a respective anchoring stem. The anchoring stem <NUM> may be dimensioned to extend outwardly from the rear face <NUM> of the augment <NUM>, as illustrated by <FIG>, or another portion of the augment <NUM> that establishes the external surface <NUM> of the implant <NUM>.

A periphery <NUM> of the anchoring stem <NUM> may be substantially solid (see, e.g., <FIG>) or may be fenestrated to establish one or more openings for facilitating flow of blood, nutrients and other biological matter into and through the respective passage <NUM>. For example, the anchoring stem <NUM> may include a cage <NUM> establishing one or more bone growth openings <NUM>, as illustrated in <FIG>. The openings <NUM> may be dimensioned to promote bone ingrowth, which may improve fixation of the implant <NUM> to an adjacent bone. The bone growth openings <NUM> may be circumferentially distributed about the periphery <NUM> of the anchoring stem <NUM> such that the openings <NUM> interconnect the respective passage <NUM> and an external surface of the anchoring stem <NUM>.

The surgeon may deploy the central fastener 24C to secure the implant <NUM> at the surgical site. <FIG> illustrate the central fastener 24C in a deployed state. <FIG> illustrate the central fastener 24C in non-deployed (e.g., initial) state. The non-deployed state may correspond to a fabricated state of the implant <NUM> prior to a surgical procedure. The central fastener 24C may be movable between the non-deployed and deployed states such that deployment of the central fastener 24C causes a permanent change to the implant <NUM>.

Referring to <FIG>, with continuing reference to <FIG>, one or more of the fasteners <NUM>, such as the central fastener 24C, may be coupled to the internal wall <NUM> at a first breakable (e.g., breakaway) connection <NUM> along the respective passage <NUM>. The first breakable connection <NUM> may include one or more separate and discreet breakable connection points 58P distributed along surfaces of the inner wall <NUM> and head portion <NUM> of the fastener <NUM>. Each of the breakable connection points 58P may be a frangible connection having a reduced thickness, scoring, perforations, and/or different material compositions (e.g., different densities), etc., to facilitate severing the fastener <NUM> from the inner wall <NUM> of the implant <NUM>. In some implementations, the first breakable connection <NUM> is a single breakable connection point 58P. The first breakable connection <NUM> may interconnect the fastener <NUM> and inner wall <NUM> such that the fastener <NUM> is integrally formed with the main body <NUM>, as illustrated in <FIG>.

The fastener <NUM> may be cantilevered or suspended in the passage <NUM> from the first breakable connection <NUM> at the head portion <NUM>, as illustrated in <FIG>. The cantilevered arrangement of the fastener <NUM> may be established such that the shank portion <NUM> substantially floats within the passage <NUM> in the non-deployed state. The implant <NUM> may be formed such that the first breakable connection <NUM> serves as the only point of connection and contact between the fastener <NUM> and the inner wall <NUM> in the non-deployed state. In some implementations, other portions of the fastener <NUM> may be dimensioned to contact surfaces of the inner wall <NUM> in the non-deployed state. Portions of the fastener <NUM>, including the head portion <NUM> and/or threads <NUM>, may contact the inner wall <NUM> during deployment of the fastener <NUM>.

The first breakable connection <NUM> may be dimensioned to be severed in response to a predetermined amount of force applied to the head portion <NUM> or another portion of the fastener <NUM>. For example, the first breakable connection <NUM> may be severed by applying an axial force FA and/or rotational force FR relative to the passage axis PA, as illustrated by first breakable connection <NUM>' of <FIG>. The first breakable connection <NUM> may be dimensioned to sever in response to a first predetermined quantity of torque applied to the fastener <NUM>, such as applying the force FR about the passage axis PA.

Severing the first breakable connection <NUM> permanently causes the fastener <NUM> to move from the non-deployed state to the deployed state. A portion of the fastener <NUM> may be movable outwardly from the passage <NUM> in response or otherwise subsequent to severing the first breakable connection <NUM>, as illustrated in <FIG>. The head portion <NUM> of the fastener <NUM> may be dimensioned to contact an abutment <NUM> to limit movement of the fastener <NUM> along the passage axis PA, as illustrated by implant <NUM> of <FIG> (see also <FIG>).

<FIG> illustrates another exemplary orthopedic implant <NUM>. The implant <NUM> may include a main body <NUM> including a baseplate <NUM> and augment <NUM>. The augment <NUM> may include a scaffold <NUM> and one or tubular members <NUM> (scaffold <NUM> shown in dashed lines for illustrative purposes). Each tubular member <NUM> may be substantially solid along an inner wall <NUM> defining a periphery <NUM> of the tubular member <NUM> such that the tubular member <NUM> excludes any bone growth openings along the periphery <NUM>.

<FIG> illustrate another exemplary orthopedic implant <NUM>. <FIG> illustrates a non-deployed (e.g., initial) state of the implant <NUM>. The non-deployed state may correspond to a fabricated state of the implant <NUM> prior to a surgical procedure. <FIG> illustrates a first deployed (e.g., interim) state of the implant <NUM>. <FIG> illustrates a second deployed state of the implant <NUM> that differs from the first deployed state. The implant <NUM> includes a fastener <NUM> movable between the non-deployed and deployed states such that deployment of the fastener <NUM> causes a permanent change to the implant <NUM>.

Referring to <FIG>, the implant <NUM> may include a driving member <NUM> coupled to the fastener <NUM> at a second breakable (e.g., breakaway) connection <NUM>. The second breakable connection <NUM> may be a frangible connection having a reduced thickness, scoring, perforations, and/or different material compositions (e.g., different densities), etc., to facilitate severing the fastener <NUM> from the inner wall <NUM> of the main body <NUM>. The second breakable connection <NUM> may at least partially extend along a respective passage <NUM>, as illustrated by <FIG>. The driving member <NUM> may include an interface <NUM> dimensioned to engage a driver <NUM> (showing dashed lines for illustrative purposes). The driver <NUM> may apply an axial force FA and/or radial force FR to the interface <NUM> to cause a first breakable connection <NUM> to sever, as illustrated by connection <NUM>' of <FIG>. The driver <NUM> may engage the interface <NUM> to cause the first breakable connection <NUM> to sever in response to a first predetermined quantity of torque at the interface <NUM>.

The second breakable connection <NUM> may be dimensioned to sever in response to a second predetermined quantity of torque or force at the interface <NUM>. The second predetermined quantity of torque or force may be greater than the first predetermined quantity of torque or force. For example, the driver <NUM> may be moved to cause the first breakable connection <NUM> to sever and then to cause the fastener <NUM> to move along a respective passage axis PA, as illustrated by first breakable connection <NUM>' in <FIG>.

The driver <NUM> may continue to cause the fastener <NUM> to move along the passage axis PA until the fastener <NUM> is at a desired position, opposed by another portion of the implant <NUM>, and/or opposed by adjacent bone or other tissue. The driver <NUM> may continue to apply a force, such as the rotational force FR until the force FR exceeds the second predetermined quantity at the interface <NUM>, causing the second breakable connection <NUM> to sever, as illustrated by a second breakable connection <NUM>" of <FIG>. The first predetermined quantity of torque may be between <NUM> and <NUM> Newton-meters, such as between <NUM> and <NUM> Newton-meters, and the second predetermined quantity of torque may be between <NUM> and <NUM> Newton-meters, for example.

Various materials may be utilized to form the implants <NUM>, <NUM>, <NUM> and fasteners <NUM>, <NUM>, <NUM>, including metallic and/or non-metallic materials. The implants <NUM>, <NUM>, <NUM> and/or fasteners <NUM>, <NUM>, <NUM> may include one or more coatings or layers deposited along the respective surfaces. Example coatings may include calcium phosphate (CaP) having a porous construction for promoting bone ingrowth.

<FIG> illustrates an exemplary method of installing an orthopaedic implant at a surgical site in a flow chart <NUM>. The method may be utilized to perform an arthroplasty for restoring functionality to a joint such as a shoulder having advanced cartilage disease. Although the disclosure primarily refers a glenoid, it should be understood that the method may be utilized to restore functionality to a humerus and other joints of a patient. The method may be utilized with any of the implants disclosed herein. Fewer or additional steps than are recited below could be performed within the scope of this disclosure, and any recited order of the steps is not intended to limit this disclosure.

Referring to <FIG>, with continuing reference to <FIG>, a surgical site S may be prepared for receiving an implant <NUM> at step 370A. The implant <NUM> may incorporate the features of the implant <NUM>, for example. Step 370A may include performing one or more operations to prepare the surgical site S such as one or more reaming, milling and drilling operations to establish a desired geometry of the surgical site S. Step 370A may include forming at least one or more recesses R at the surgical site S. Step 370A may include forming each recess R in an articular surface AS of the bone B by removing tissue such as a portion of the bone B. The recess R may be dimensioned to at least partially receive a portion of a tubular member <NUM> of the implant <NUM>, such as the central tubular member 348C. The bone B may include an articular surface AS of a glenoid. The articular surface AS may have a relatively lesser concavity than an articular surface AS of <FIG>, for example.

Referring to <FIG>, with continuing reference to <FIG>, at step 370B the implant <NUM> may be positioned adjacent to and along the bone B at the surgical site S. The implant <NUM> may include a main body <NUM> establishing one or more passages <NUM> including a central passage 346C that extends along a longitudinal axis X of the implant <NUM>. The implant <NUM> may include an augment body <NUM> established by a scaffold <NUM> (shown in dashed lines in <FIG> and omitted from <FIG> for illustrative purposes). Step 370B may include positioning the implant <NUM> such that the scaffold <NUM> abuts against bone B and/or other tissue along the articular surface AS, as illustrated in <FIG>. The implant <NUM> may include at least one fastener <NUM> coupled to an internal wall <NUM> of the main body <NUM> at a first breakable connection <NUM> along the respective passage <NUM>. The first breakable connection <NUM> may include a plurality of breakable connection points 358P integrally formed with the main body <NUM> of the implant <NUM> along the passage <NUM>, as illustrated in <FIG>.

At least one of the tubular members <NUM> may be positioned in contact with the articular surface AS of the bone B, such as peripheral tubular members 348P. The central tubular member 348C may be positioned and at least partially received in the respective recess R (indicated in dashed lines in <FIG> for illustrative purposes) such that the tubular member 348C serves as an anchoring stem <NUM> for securing the implant <NUM> to the bone B. The recess R may include a first section dimensioned to substantially compliment a periphery <NUM> of the respective tubular member <NUM> and a second section that substantially compliments a geometry of a shank portion <NUM> of the fastener <NUM>, as illustrated in <FIG>. A portion of the anchoring stem <NUM> may include a cage <NUM> or another structure establishing one or more bone growth openings <NUM>. Positioning the implant <NUM> may include positioning at least the portion of the anchoring stem <NUM> defining the bone growth openings <NUM> in the recess R. The bone growth openings <NUM> may be positioned to face towards surfaces of the bone B bounding the recess R to promote bone ingrowth and additional fixation of the implant <NUM>. In some implementations, step 370B may include positioning a guide wire <NUM> in bone B, inserting the guide wire <NUM> in a passage <NUM> established by a cannulated fastener <NUM>, and then moving implant <NUM> in a direction D1 along the guide wire <NUM> to abut against an articular surface AS of the bone B, as illustrated in <FIG> (surface AS and recess R shown in dashed lines for illustrative purposes).

Referring to <FIG>, with continuing reference to <FIG>, at step 370C the surgeon may move a driver <NUM> into engagement with an interface <NUM> of the implant <NUM> to deploy the respective fastener <NUM>. The interface <NUM> may have various configurations for engagement with the driver <NUM>, such as a socket connection.

Referring to <FIG>, with continuing reference to <FIG>, at step 370D the surgeon may cause the driver <NUM> to apply a force at the interface <NUM> to deploy the fastener <NUM>. Step 370D may include severing the first breakable connection <NUM> at step 370E, as illustrated by first breakable connection <NUM>'. Step 370E may include applying an axial force FA and/or rotational force FR to the interface <NUM> relative to the respective passage axis PA and/or longitudinal axis X of the implant <NUM> to sever the breakable connection points 358P of the first breakable connection <NUM> and deploy the fastener <NUM>. Applying the axial force FA may include moving the driver <NUM> a distance along the passage axis PA. Applying the rotational force FR may include rotating the driver <NUM> circumferentially about the passage axis PA. Severing the first breakable connection <NUM> may include causing the driver <NUM> to apply a first torque at the interface <NUM> that exceeds a first predetermined quantity of torque. The first predetermined quantity of torque may include any of the quantities disclosed herein.

Severing the first breakable connection <NUM> may occur such that the severing action generates an indicator such as an audible click and/or tactile force which may be observable by the surgeon. The audible click may provide an indicator or feedback to the surgeon during installation of the implant <NUM> indicating that the implant <NUM> is no longer in the non-deployed state.

Step 370D may include moving the driver <NUM> axially along the passage axis PA at step 370F to cause the fastener <NUM> to move at least partially outwardly from the respective passage <NUM> and into the bone B to secure the implant <NUM> at the surgical site S. Step 370F may occur subsequent to step 370E.

In some implementations, the method <NUM> may include utilizing a driving member to establish the interface. Referring to <FIG>, with continuing reference to <FIG>, the method <NUM> may include severing the second breakable connection <NUM> at step <NUM>. Step <NUM> may occur subsequent to severing the first breakable connection <NUM> at step 370E. Severing the second breakable connection <NUM> may occur in response to causing the driver <NUM> to apply a second torque at the interface <NUM>. Severing the second breakable connection <NUM> may occur such that the severing generates an audible click. The audible click may provide an indicator or feedback to the surgeon during installation of the implant <NUM> indicating that the implant <NUM> is no longer in the non-deployed state.

Severing the second breakable connection <NUM> may occur in response to causing the driver <NUM> to apply a second torque at the interface <NUM> that exceeds a second predetermined quantity torque to sever the second breakable connection <NUM>, as illustrated by the second breakable connection <NUM>" of <FIG>. The second predetermined torque may be greater than the first predetermined quantity of torque such that the first breakable connection <NUM> severs prior to the severing of the second breakable connection <NUM>. The second breakable connection <NUM> may serve as a torque limiter to reduce a likelihood of applying excessive torque to the fastener <NUM>, which may otherwise cause the threads to lose fixation with the adjacent bone.

Referring to <FIG>, with continuing reference to <FIG>, the driver <NUM> may be removed from the interface <NUM> subsequent to step 370D. At step <NUM>, one or more other fasteners <NUM> may be positioned at least partially through the implant <NUM> and into the bone B to secure the implant <NUM> at the surgical site S. The fasteners <NUM> may include any of the fasteners disclosed herein including compression screws. In implementations, the fasteners <NUM> may include peripheral fasteners 324P positioned at least partially into the respective peripheral apertures 344P and peripheral passages 346P and then into the bone B to secure the implant <NUM>.

Referring to <FIG>, with continuing reference to <FIG>, the method may include securing an articulation member <NUM> to the main body <NUM> of the implant <NUM> at step 370I. The articulation member <NUM> is illustrated in dashed lines for illustrative purposes. Step 370I may include mechanically attaching or releasably securing the articulation member <NUM> to a first (e.g., front) face <NUM> of the baseplate <NUM>. The articulation member <NUM> may include a recess <NUM> dimensioned to receive a portion of the baseplate <NUM>. A perimeter of the baseplate <NUM> may be dimensioned to cooperate with a perimeter of the recess <NUM> to establish a Morse taper connection. The articulation member <NUM> may be impacted onto the baseplate <NUM> to establish the Morse taper connection and secure the articulation member <NUM>.

The articulation member <NUM> may include an articulation surface <NUM> dimensioned to mate with an opposed articular surface OA (shown in dashed lines for illustrative purposes). The articular surface OA may be associated with an adjacent bone OB at the surgical site S, such as a humerus or another bone forming the respective joint. The articular surface OA may be established by a bone surface and/or an opposed implant. The articulation surface <NUM> may have various geometries that complement a geometry of the opposed articular surface OA, such as a generally concave geometry or a generally convex geometry as illustrated in <FIG>.

Referring to <FIG>, with continuing reference to <FIG>, bone growth openings in tubular members <NUM>' may be omitted. Step 370B may include positioning the tubular members <NUM>' in abutment with an articular surface AS of the respective bone B. The implant <NUM>' may include an augment body <NUM>' established by a scaffold <NUM>' (shown in dashed lines in <FIG> and omitted from <FIG> for illustrative purposes). Step 370B may include positioning the implant <NUM>' such that the scaffold <NUM>' abuts against bone B and/or other tissue along the articular surface AS, as illustrated in <FIG>. Referring to <FIG>, a driver <NUM>' may apply an axial force FA and/or rotational force FR relative to the passage axis PA to at least partially drive the respective fastener <NUM> into the bone B.

<FIG> illustrates an exemplary method of forming an orthopaedic implant in a flow chart <NUM>. The method may be utilized to form any of the implants disclosed herein, including the implants <NUM>, <NUM>, <NUM> and/or <NUM>. Fewer or additional steps than are recited below could be performed within the scope of this disclosure, and any recited order of the steps is not intended to limit this disclosure.

Referring to <FIG>, with continuing reference to <FIG>, various techniques may be utilized to form an implant <NUM>. The method may utilize a printing assembly <NUM> to form the implant <NUM>. The printing assembly <NUM> may incorporate a three-dimensional (3D) printing head <NUM> coupled to a controller <NUM>. The controller <NUM> may be operable to obtain coordinate information corresponding to a predetermined geometry of the implant <NUM> and may be operable to command the printing head <NUM> to perform a series of passes to form successive layers of material on a substrate <NUM>. The printing assembly <NUM> may be operable to form the implant <NUM> utilizing any of the materials disclosed herein, including metallic and/or non-metallic materials. Three-dimensional printers are known, but utilization of three-dimensional printers to form the disclosed implants is not known.

At step 480A, the printing assembly <NUM> may print or otherwise form a portion of a main body <NUM> of the implant <NUM> on the substrate <NUM>. The main body <NUM> may include a baseplate <NUM> and an augment <NUM> extending from the baseplate <NUM>. The substrate <NUM> may be separate and distinct from the implant <NUM>. In some implementations, substrate <NUM>' is a prefabricated portion of the implant <NUM>, such as the baseplate <NUM>. The baseplate <NUM> may include a plate body <NUM> extending between a first (e.g., front) face <NUM> and a second (e.g., rear) face <NUM> along a longitudinal axis X of the implant <NUM>.

Step 480A may include printing the plate body <NUM> of the baseplate <NUM> to establish one or more apertures <NUM>. The apertures <NUM> may include a central aperture 444C and one or more peripheral apertures 444P extending between the front face <NUM> and the rear face <NUM> of the plate body <NUM>.

Step 480A may including printing the portion of the main body <NUM> to include an inner wall <NUM> establishing one or more passages <NUM>. The passages <NUM> may include a central passage 446C and one or more peripheral passages 446P. The central aperture 444C may extend along the longitudinal axis X between the front face <NUM> and the central passage 446C. The peripheral apertures 444P may be circumferentially distributed about the longitudinal axis X.

Step 480A may include printing an augment <NUM> including an augment body <NUM> onto the rear face <NUM> of the baseplate <NUM>. The augment body <NUM> may be dimensioned to contact bone. The peripheral passages 446P may be at least partially aligned with respective ones of the peripheral apertures 444P along the passage axes PA. Each of the peripheral passages 446P may extend between the rear face <NUM> of the baseplate <NUM> and an external surface <NUM> of the implant <NUM> along the a second (e.g., rear) face <NUM> of the augment <NUM>, as illustrated in <FIG>. Each respective pair of the peripheral apertures 444P and peripheral passages 446P may be dimensioned to at least partially receive a respective fastener along a passage axis PA, with each respective fastener dimensioned to be partially received in bone (see, e.g., <FIG>).

Step 480A may include printing one or more tubular members <NUM> that establish the respective passages <NUM>, as illustrated in <FIG>, <FIG> and <FIG>. The tubular members <NUM> may include a central tubular member 448C and one or more peripheral tubular members 448P circumferentially distributed about the central tubular member 448C relative to the longitudinal axis X. The augment body <NUM> may include a porous scaffold <NUM> that at least partially surrounds the tubular members <NUM>. The scaffold <NUM> may establish an external surface of the augment <NUM>. In some implementations, the augment body <NUM> is substantially solid.

The method may include printing or otherwise forming at least a portion of a driving member <NUM> at step 480B. The driving member <NUM> may include an interface <NUM> dimensioned to engage a driver (see, e.g., <FIG>). At least a portion of the driving member <NUM> may be formed along one of the apertures <NUM> and/or passages <NUM>, such as the central aperture 444C and/or central passage 446C. In some implementations, the driving member <NUM> is omitted.

Referring to <FIG>, with continuing reference to <FIG>, a portion of at least one fastener <NUM> is printed or otherwise formed at step 480C. Step 480C may be separately performed, or may be concurrently performed with steps 480A and/or 480B, for example. Step 480C may include printing the fastener <NUM> at least partially in a volume of the respective passage <NUM>. The fastener <NUM> may be dimensioned to be at least partially received in bone and may include any of the fasteners disclosed herein. The fastener <NUM> may include a central fastener 424C printed at least partially in the central passage 446C, for example. Each fastener <NUM> and respective passage axis PA may be dimensioned with respect to a predetermined geometry and/or predetermined orientation. The predetermined geometry and/or predetermined orientation may be patient-specific based on a preoperative surgical plan based on one or more measurements of the patient determined prior to formation of the implant <NUM>. The patient-specific geometry may provide a fastener <NUM> having a length and orientation that substantially complements a profile and quality of the bone of the patient and may facilitate positioning of the implant <NUM> during surgery.

At step 480D, a first breakable connection <NUM> is printed or otherwise formed. The first breakable connection <NUM> may be integrally formed with and interconnects the internal wall <NUM> of the main body <NUM> and the fastener <NUM>. The first breakable connection <NUM> can include a plurality of separate and distinct breakable connection points 458P circumferentially distributed about a longitudinal axis L of the fastener <NUM>, as illustrated in <FIG>. Although <FIG> illustrates the first breakable connection <NUM> established by a total of three breakable connection points 458P, it should be understood that the implant <NUM> may have fewer or more than three breakable connection points 458P to establish the first breakable connection <NUM>, such as only one or two breakable connection points 458P. Utilizing a plurality of breakable connection points 458P may provide improved control of placement and stability of the fastener <NUM> during formation of the implant <NUM> and prior to severing the first breakable connection <NUM>. The longitudinal axis L of the fastener <NUM> may be collinear with or otherwise parallel to the longitudinal axis X of the implant <NUM>. The interface <NUM> may be dimensioned to engage a driver to cause the first breakable connection <NUM> to sever in response to a first predetermined quantity of torque or force at the interface <NUM>. The fastener <NUM> may be formed such that a portion of the fastener <NUM> is moveable outwardly from the passage <NUM> in response to severing the first breakable connection <NUM>.

Referring to <FIG>, with continuing reference to <FIG>, the method may include printing or otherwise forming a remainder of the driving member <NUM> including a second breakable connection <NUM> at step 480E. The second breakable connection <NUM> is integrally formed with and interconnects the driving member <NUM> and the head portion <NUM> of the fastener <NUM>, as illustrated in <FIG>. At least a portion of the second breakable connection <NUM> may be established along the passage <NUM>. The second breakable connection <NUM> may be dimensioned to sever in response to a second predetermined quantity of torque or force at the interface <NUM> (<FIG>). The second predetermined quantity of torque or force may be greater than the first predetermined quantity of torque or force. The second predetermined quantity of torque or force may be based on a bone density or quality of the bone of the respective patient determined prior to formation of the implant <NUM>.

In implementations, the implant may be formed such that the fastener is cannulated. Referring to <FIG>, various steps of the method <NUM>, such as steps 480C and/or <NUM>, may be performed such that fastener <NUM> is cannulated. A passage <NUM> may be established along a longitudinal axis X of the implant <NUM>. The passage <NUM> may extend through the fastener <NUM> and/or driving member <NUM> and may be dimensioned to at least partially receive a guide wire <NUM>. The guide wire <NUM> may be at least partially received in bone B inwardly of a recess R (shown in dashed lines for illustrative purposes) to position and/or orient the fastener <NUM> relative to the surgical site S.

Various techniques may be utilized to establish each frangible connection point of the first breakable connection <NUM> and/or second breakable connection <NUM> at steps 480D-480E. Step 480D and/or step 480E may be performed such that each frangible connection point of the first breakable connection <NUM> and/or second breakable connection <NUM> is established by a reduced thickness, scoring, perforations, and/or different material compositions (e.g., different densities), etc., to facilitate severing the fastener <NUM> from the main body <NUM> and/or driving member <NUM>.

<FIG> illustrate exemplary techniques for establishing frangible connection points of any of the breakable connections disclosed herein, including the first and/or second breakable connections. Referring to <FIG>, breakable connection <NUM>/<NUM> may be established by a first width W1 along a portion of an inner wall <NUM> and/or driving member <NUM> and a second width W2 along a portion of a fastener <NUM>, such as an end portion or periphery of a head portion <NUM> or shank portion <NUM> of the fastener <NUM>. The first width W1 may be different from the second width W2 such that the breakable connection <NUM>/<NUM> has a reduced thickness along a portion of the breakable connection <NUM>/<NUM>. Referring to <FIG>, breakable connection <NUM>/<NUM> may have one or more perforations <NUM> extending at least partially or completely through a thickness of the breakable connection <NUM>/<NUM>. The breakable connection <NUM>/<NUM> may have one or more scores <NUM> extending at least partially or completely about a periphery of the breakable connection <NUM>/<NUM>. Referring to <FIG>, a portion of an inner wall <NUM> and/or driving member <NUM> directly coupled to breakable connection <NUM>/<NUM> may be made of a first material M1, the breakable connection <NUM>/<NUM> may be may be made of a second material M2, and a portion of fastener <NUM> directly coupled to the breakable connection <NUM>/<NUM> may be made of a third material M3. The second material M2 may differ from the first material M1 and/or the third material M3 to establish a frangible connection point. For example, the second material M2 may have a density that is less than or otherwise differs from the first material M1 and/or third material M3.

The first breakable connection and/or second breakable connection may be established along various positions of the respective fastener, including any of the positions disclosed herein, such as a top portion 425T of the shank portion <NUM> as illustrated by the first breakable connection <NUM> and second breakable connection <NUM> of <FIG>. Establishing the first breakable connection <NUM> and second breakable connection <NUM> along the top portion 425T may reduce a complexity of forming the implant <NUM>. The first breakable connection and/or second breakable connection may be established along other positions of the respective fastener, such as along a sidewall or circumference <NUM> of the head portion <NUM> as illustrated by the first breakable connection <NUM> in <FIG> and/or along a circumference <NUM> of the shank portion <NUM> as illustrated by the first breakable connection <NUM> in <FIG>.

Referring to <FIG>, with continuing reference to <FIG>, a remainder of the implant <NUM> may be printed or otherwise formed at step 480F. Step 480F may include printing or otherwise forming a remainder of the main body <NUM> including the baseplate <NUM> and/or augment <NUM> at step <NUM>.

Step <NUM> may include printing or otherwise forming an anchoring stem <NUM> to establish the inner wall <NUM>. The scaffold <NUM> may at least partially surround the anchoring stem <NUM>. The anchoring stem <NUM> may be dimensioned to extend outwardly from the augment body <NUM> along the longitudinal axis X. Step <NUM> may include establishing an array of bone growth openings <NUM> in the anchoring stem <NUM> at a position outwardly from the rear face <NUM> of the augment <NUM>. The bone growth openings <NUM> may be circumferentially distributed about a periphery <NUM> of a cage <NUM> or another portion of the anchoring stem <NUM>. The bone growth openings <NUM> may interconnect the passage <NUM> and an external surface of the anchoring stem <NUM>.

Step 480F may include printing or otherwise forming a remainder of the fastener <NUM> at step <NUM>. Step <NUM> may including printing or otherwise forming a reminder of the head portion <NUM> to a tip portion <NUM>, a shank portion <NUM> extending from the head portion <NUM>, and a plurality of threads <NUM> extending about a circumference <NUM> of the shank portion <NUM>. Printing or otherwise forming the fastener <NUM> may occur such that the fastener <NUM> is cantilevered in the passage <NUM> from the first breakable connection <NUM> at the head portion <NUM> of the fastener <NUM>, as illustrated in <FIG>. The fastener <NUM> may be substantially solid or may include one or more passages <NUM> extending from the circumference <NUM> of the shank portion <NUM> (passages <NUM> shown in dashed lines for illustrative purposes). The passages <NUM> may extend through the fastener <NUM> to facilitate communication of blood, nutrients and other biological matter in the passage <NUM>, which may improve healing.

The scaffold <NUM> may be printed or otherwise formed subsequent to, concurrently with, formation of the fastener <NUM> and tubular members <NUM>. For example, the scaffold <NUM> may be printed around a periphery of the tubular members <NUM>.

The method may include performing one or more finishing operations on the implant <NUM> at step 480I. Step 480I may include machining surfaces of the implant <NUM> according to a predetermined geometry. Step 480I may include applying one or more treatments to the implant <NUM>, including applying surface coatings and treatments. Step 480I may include placing the implant <NUM> in sterile packaging for conveyance to the surgeon.

In some implementations, the various steps of method <NUM> may be utilized such that the implant has a unitary construction, as illustrated by the implant <NUM> of <FIG>. Steps 480A-<NUM> may be performed such that substantially all portions of the implant <NUM> are printed or otherwise formed together to establish a monolithic or unitary component. For example, steps 480A-<NUM> may be performed such that at least a baseplate portion <NUM>, an augment portion <NUM> and at least one (or more) fastener <NUM> of the implant <NUM> are printed or integrally formed together to establish a monolithic or unitary component.

<FIG> illustrate another exemplary orthopaedic implant <NUM>. The implant <NUM> may incorporate any of the features of the implants disclosed herein, and may be formed utilizing any of the steps of method <NUM>. <FIG> and <FIG> illustrate the implant <NUM> in a non-deployed state. <FIG> and <FIG> illustrate the implant <NUM> in a first deployed state. <FIG> and <FIG> illustrate the implant <NUM> in a second deployed state. <FIG> and <FIG> illustrate the implant <NUM> in a third deployed state.

Referring to <FIG>, the implant <NUM> may include a main body <NUM> dimensioned to abut against bone B at a surgical site S (indicated in dashed lines for illustrative purposes). The bone B may be associated with a joint, including any of the joints disclosed herein. For example, the main body <NUM> may establish an acetabular cup having a generally hemispherical geometry for restoring functionality to a hip joint. The main body <NUM> of the implant <NUM> may be securable to an acetabulum and may be dimensioned to cooperate with a femoral head at least partially received in a cavity <NUM> (<FIG>).

The implant <NUM> may include one or more tubular members <NUM> coupled to the main body <NUM>. The tubular members <NUM> may have a generally tubular geometry or another geometry. The tubular members <NUM> may be integrally formed with the main body <NUM> or may be separate and distinct components mechanically attached or otherwise secured to the main body <NUM>. The tubular members <NUM> may be dimensioned to be at least partially received in a recess <NUM> established by the main body <NUM>.

Each tubular member <NUM> may be dimensioned to establish a respective passage <NUM>. Each passage <NUM> is dimensioned to at least partially or completely receive a respective fastener <NUM> such that the tubular member <NUM> serves as a carrier for the fastener <NUM>. The fastener <NUM> may include any of the fasteners disclosed herein. The fastener <NUM> may be a compression screw and may include a head portion <NUM> and a shank portion <NUM> extending from the head portion <NUM>. The shank portion <NUM> may include one or more threads <NUM>. Each fastener <NUM> may be dimensioned to extend along a respective passage axis PA.

Each fastener <NUM> may be coupled to the tubular member <NUM> at a first breakable connection <NUM>. The first breakable connection <NUM> may include one or more separate and discreet breakable connection points 1258P distributed along surfaces of an inner wall <NUM> of the implant <NUM> and the fastener <NUM>, as illustrated in <FIG>. The first breakable connection <NUM> may be established by any of the breakable connections disclosed herein, such as a frangible connection including one or more connection points having a reduced thickness, scoring, perforations, and/or different material compositions (e.g., different densities), etc..

Each tubular member <NUM> may include a first portion 1248A and a second portion 1248B extending from the first portion 1248A. The first portion 1248A and second portion 1248B may be integrally formed or may be separate and distinct components mechanically attached or otherwise secured to each other. In implementations, the first portion 1248A and second portion 1248B are coupled at a third breakable connection <NUM>. The third breakable connection <NUM> may be established by any of the breakable connections disclosed herein, such as a frangible connection including one or more connection points having a reduced thickness, scoring, perforations, and/or different material compositions (e.g., different densities), etc..

The head portion <NUM> of the fastener <NUM> may be dimensioned to contact an abutment <NUM> to limit axial movement of the fastener <NUM> along the passage axis PA, as illustrated in <FIG>. The second portion 1248B of the tubular member <NUM> may be dimensioned to establish the abutment <NUM>.

Referring to <FIG>, the first breakable connection <NUM> may be dimensioned to be severed in response to a predetermined amount of force applied to the head portion <NUM> or another portion of the fastener <NUM>. A driver <NUM> may be utilized to engage the fastener <NUM> and apply the predetermined amount of force, as illustrated in <FIG> (also shown in dashed lines in <FIG> for illustrative purposes). For example, the first breakable connection <NUM> may be severed in response to the driver <NUM> applying an axial force FA and/or rotational force FR to the head portion <NUM> of the fastener <NUM> relative to the passage axis PA, as illustrated by first breakable connection <NUM>' of <FIG>. The first breakable connection <NUM> may be dimensioned to sever in response to a first predetermined quantity of torque applied to the fastener <NUM>, such as applying the force FR about the passage axis PA. The shank portion <NUM> of each fastener <NUM> may be moved in a direction D2 outwardly of the respective passage <NUM> relative to the passage axis PA and into the bone B to secure the implant <NUM> at the surgical site S, as illustrated by <FIG> and <FIG>.

Referring to <FIG>, the third breakable connection <NUM> may be severed in response to a predetermined amount of force applied to the first portion 1248A or another portion of the tubular member <NUM> (first portion 1248A shown in dashed lines in <FIG> for illustrative purposes). Referring to <FIG>, with continuing reference to <FIG>, a driver <NUM> may be utilized to engage the first portion 1248A or another portion of the tubular member <NUM> and apply the predetermined amount of force. For example, the third breakable connection <NUM> may be severed in response to the driver <NUM> applying an axial force FA, rotational force FR and/or transverse (e.g., radial) force FT to the first portion 1248A or another portion of the tubular member <NUM> relative to the passage axis PA, as illustrated by the third breakable connection <NUM>'. The first portion 1248A may be moved in a direction D3 subsequent to being released from the second portion 1248B and removed from the recess <NUM> (shown in dashed lines in <FIG> for illustrative purposes).

Referring to <FIG>, the implant <NUM> may include an articulation member <NUM> mechanically attached or otherwise secured to the main body <NUM>. The articulation member <NUM> may be moved in a direction D4 at least partially or completely into the recess <NUM> to abut against the main body <NUM>, as illustrated in <FIG> and <FIG>. The articulation member <NUM> may serve as a liner in an installed position, and the main body <NUM> may serve as a shell. The articulation member <NUM> may extend at least partially along the main body <NUM>. The articulation member <NUM> may comprise a fourth material M4 that may be the same or may differ from a fifth material M5 of the main body <NUM>. The materials M4, M5 may include any of the materials disclosed herein, including metallic and/or non-metallic materials.

The articulation member <NUM> may include an articulation surface <NUM> dimensioned to mate with an opposed articular surface OA (shown in dashed lines for illustrative purposes). The articular surface OA may be associated with an adjacent bone at the surgical site S, such as a femoral head or another bone forming the respective joint. The articular surface OA may be established by a bone surface and/or an opposed implant. The articulation surface <NUM> may have various geometries that complement a geometry of the opposed articular surface OA, such as a generally convex geometry or a generally concave geometry as illustrated in <FIG>.

Various techniques may be utilized to secure the articulation member <NUM> to the main body <NUM>, such as bonding together surfaces of the articulation member <NUM> and main body <NUM> and/or securing the components together utilizing one or more fasteners. The removable aspect of the first portion 1248A of each tubular member <NUM> may serve to reduce a thickness of the articulation member <NUM>.

The novel implants and methods of this disclosure may provide versatility in securing the implants with fasteners to bone at a surgical site. The disclosed fasteners incorporated into the implants during formation may facilitate installation of the implant including more closely aligning the respective fastener to a pre-operative plan, which may reduce surgical duration and improve healing. Forming fasteners with the implants may also reduce separate sterile packaging and may reduce pre-operative planning and surgical duration. Reductions in surgical duration may be approximately <NUM>-<NUM> minutes or more. The disclosed driving members may serve as a torque limiter to reduce a likelihood that a surgeon over-torques the fastener and/or inserts the fastener too deeply, thereby increasing a likelihood of sufficient fixation.

Although the different non-limiting embodiments are illustrated as having specific components or steps, the embodiments of this disclosure are not limited to those particular combinations. It is possible to use some of the components or features from any of the non-limiting embodiments in combination with features or components from any of the other non-limiting embodiments.

It should further be understood that although a particular component arrangement is disclosed and illustrated in these exemplary embodiments, other arrangements could also benefit from the teachings of this disclosure.

Claim 1:
An orthopaedic implant (<NUM>) comprising:
a main body (<NUM>) including an inner wall (<NUM>) establishing a passage (<NUM>), the passage (<NUM>) extending inwardly from an external surface of the main body (<NUM>); and
a fastener (<NUM>) dimensioned to be partially received in bone, wherein the fastener (<NUM>) is coupled to the inner wall (<NUM>) at a first breakable connection (<NUM>) along the passage (<NUM>), and a portion of the fastener (<NUM>) is moveable outwardly from the passage (<NUM>) in response to severing the first breakable connection (<NUM>),
wherein the fastener (<NUM>) is a compression screw including a plurality of threads, and
the compression screw includes a head portion (<NUM>) and a shank portion (<NUM>) extending from the head portion (<NUM>), the plurality of threads extending about a circumference of the shank portion (<NUM>), characterised in that the fastener (<NUM>) is cantilevered in the passage (<NUM>) from the first breakable connection (<NUM>) at the head portion (<NUM>).