Patent Description:
With its complexity, range of motion and extensive use, a common soft tissue injury is damage to the rotator cuff or rotator cuff tendons. Damage to the rotator cuff is a potentially serious medical condition that may occur during hyperextension, from an acute traumatic tear or from overuse of the joint. Current procedures attempt to alleviate impingement or make room for movement of the tendon to prevent further damage and relieve discomfort but do not repair or strengthen the tendon. Use of the still damaged tendon can lead to further damage or injury. In some instances, biological tissue scaffolds are used to reinforce degenerated rotator cuff tendons. However, clinical outcomes are variable due to the chronicity and degree of degeneration of the tendon. An alternative technique may include superior capsule reconstruction (SCR), which utilizes biological tissue scaffolds to stabilize the joint by direct attachment of the glenoid to the humeral head. Accordingly, there is an ongoing need to design medical implants to treat injuries to the rotator cuff, rotator cuff tendons, or other soft tissue or tendon injuries throughout a body. An exemplary implant for a rotator cuff is disclosed in <CIT>.

The invention provides a medical implant for treating a shoulder joint according to claim <NUM>. For better understanding of the invention, the present disclosure further provides design, material, manufacturing method, and use alternatives for medical devices. An example medical implant for treating a shoulder joint includes a humeral head attachment region configured to be attached to a humeral head of the shoulder joint, a glenoid attachment region configured to be attached to a glenoid of the shoulder joint and a rotator cuff tendon attachment region configured to be attached to a rotator cuff tendon of the shoulder joint.

Alternatively or additionally to any of the embodiments above, wherein the humeral head attachment region is positioned between the glenoid attachment region and the rotator cuff tendon attachment region.

Alternatively or additionally to any of the embodiments above, wherein the glenoid attachment region is bifurcated into a first attachment arm and a second attachment arm, with a gap located between the first attachment arm and the second attachment arm.

Alternatively or additionally to any of the embodiments above, wherein the humeral head attachment region and the glenoid attachment region extend along a base of the implant with a bifurcation location therebetween.

Alternatively or additionally to any of the embodiments above, wherein the rotator cuff tendon attachment region extends from the bifurcation location at an acute angle to the base.

Alternatively or additionally to any of the embodiments above, wherein the humeral head attachment region, the glenoid attachment region and the rotator cuff tendon attachment region together define a monolithic structure.

Alternatively or additionally to any of the embodiments above, wherein the humeral head attachment region includes a reinforcement member.

Alternatively or additionally to any of the embodiments above, further comprising one or more attachment supports extending from the reinforcement member, the one or more attachment supports configured to be anchored to the humeral head.

Alternatively or additionally to any of the embodiments above, wherein attachment of the humeral head attachment region to the humeral head and attachment of the glenoid attachment region to the glenoid is designed to pull the glenoid closer to the humeral head.

Another rotator cuff tendon repair implant includes a humeral head attachment member, a glenoid attachment member and a rotator cuff tendon attachment member each having a first end coupled to one another at a bifurcation region, and wherein each of the humeral head attachment member, the glenoid attachment member and the rotator cuff tendon attachment member have a second end which extends away from the bifurcation region.

Alternatively or additionally to any of the embodiments above, wherein the humeral head attachment member and the glenoid attachment member define a planar base having a first end, a second end and a first length extending therebetween, the bifurcation region located intermediate the first end of the base and the second end of the base, and wherein the rotator cuff tendon attachment member bifurcates from the base at the bifurcation region.

Alternatively or additionally to any of the embodiments above, wherein the glenoid attachment member is bifurcated into a first attachment arm and a second attachment arm.

Alternatively or additionally to any of the embodiments above, wherein the base and the rotator cuff tendon attachment member define a monolithic structure.

Alternatively or additionally to any of the embodiments above, wherein the base includes a first top surface adjacent to the glenoid attachment region and the rotator cuff tendon attachment member includes a bottom surface, and wherein the bottom surface is offset from the first top surface.

Alternatively or additionally to any of the embodiments above, wherein the bottom surface is offset from the first top surface at a first angle between <NUM> degrees and <NUM> degrees.

Alternatively or additionally to any of the embodiments above, wherein the base is configured to attach to a humeral head along the humeral head attachment region, the base is configured to attach to the glenoid along the glenoid attachment region and the rotator cuff tendon attachment member is configured to attach to a rotator cuff tendon along the rotator cuff tendon attachment region.

Alternatively or additionally to any of the embodiments above, wherein the rotator cuff attachment member is configured to attach to a bursal side of a rotator cuff.

Alternatively or additionally to any of the embodiments above, wherein the rotator cuff attachment member is configured to attach to the articular side of a rotator cuff.

A non-claimed method for delivering an implant to repair a shoulder includes advancing an implant to a target site, the implant including a humeral head attachment region, a glenoid attachment region and a rotator cuff tendon attachment region. The method further includes attaching the humeral head attachment region to a humeral head, attaching the glenoid attachment region to a glenoid and attaching the rotator cuff tendon attachment region to a rotator cuff tendon.

Additionally, when particular features, structures, and/or characteristics are described in connection with one embodiment, it should be understood that such features, structures, and/or characteristics may also be used connection with other embodiments whether or not explicitly described unless clearly stated to the contrary,.

The drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the disclosure.

<FIG> illustrates an example tendon repair implant <NUM>. As discussed above, the tendon repair implant <NUM> may be designed to repair damaged rotator cuff tendons of the shoulder. In some instances, the rotator cuff tendon repair implant <NUM> may be described as a scaffold structure having a base <NUM> and a rotator cuff attachment member <NUM> projecting away from the base <NUM> at a bifurcation location <NUM>. As illustrated in <FIG>, the base <NUM> may include a first end region <NUM> and a second end region <NUM> positioned opposite the first end region <NUM>. The bifurcation location <NUM> may be positioned at an intermediate location between the first end region <NUM> and the second end region <NUM>. Additionally, the rotator cuff attachment member <NUM> may include a third end region <NUM>, which may be positioned at the free end of the rotator cuff attachment member <NUM> opposite the bifurcation location <NUM>.

As illustrated in <FIG>, the base <NUM> may include a humeral head attachment region <NUM> (located adjacent to or proximate the first end region <NUM>) and a glenoid attachment region <NUM> (located adjacent to or proximate the first end region <NUM>). It can be appreciated that the humeral head attachment region <NUM> may include that region of the tendon repair implant <NUM> which is designed to be attached to the humeral head of a patient. Similarly, it can be appreciated that the glenoid attachment region <NUM> may include that region of the tendon repair implant <NUM> which is designed to be attached to the glenoid of a patient. Further, the rotator cuff attachment member <NUM> of the tendon repair implant <NUM> may be designed to attach to a region of a rotator cuff tendon. The positioning and attachment of the tendon repair implant <NUM> will be shown in greater detail in <FIG>.

<FIG> further illustrates that the rotator cuff attachment member <NUM> may extend away from the base <NUM> at an angle θ. In some examples, the angle θ may be about <NUM> to about <NUM> degrees. Additionally, <FIG> illustrates that the glenoid attachment region <NUM> may have a length Y, which may be about <NUM> to about <NUM>. Further, <FIG> illustrates that the humeral head attachment region <NUM> may have a length W, which may be about <NUM> to about <NUM>. Further yet, <FIG> illustrates that the rotator cuff attachment member <NUM> may have a length Z, which may be about <NUM> to about <NUM>. Further yet, <FIG> illustrates that the base <NUM> (including the humeral head attachment region <NUM> and/or the glenoid attachment region <NUM>) of the tendon repair device <NUM> may have a thickness X, which may be about <NUM> to about <NUM>.

Additionally, <FIG> illustrates that each of the glenoid attachment region <NUM>, the rotator cuff attachment member <NUM> and the humeral head attachment region <NUM> may include one or more apertures designed to permit an anchor to extend therethrough and attach to a target site (e.g., glenoid, humeral head, tendons, etc.). For example, <FIG> illustrates that the glenoid attachment region <NUM> may include one or more apertures <NUM> located along the second end region <NUM> of the base <NUM>, the humeral head attachment region <NUM> may include one or more apertures <NUM> located along the first end region <NUM> of the base <NUM> and the rotator cuff attachment member <NUM> may include one or more apertures <NUM> located along the third end region <NUM>. While <FIG> illustrates that each of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment member <NUM> may include two apertures, respectively, it is contemplated that, in some examples, each of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment member <NUM> may include <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> or more apertures positioned therein. In other instances, one or more of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment member <NUM> may be otherwise configured for attachment to its respective anatomical structure with fasteners or anchors without the need or inclusion of apertures.

As described above, <FIG> illustrates that the rotator cuff attachment member <NUM> may be described as a flap, arm, branch, etc. which lies in a plane offset from a plane defined by the base <NUM>. In other words, the configuration of the rotator cuff attachment member <NUM> may be defined as "non-planar" relative to the base <NUM>. As will be described in greater detail below, the non-planar arrangement of the rotator cuff attachment member <NUM> and the base <NUM> may permit the rotator cuff attachment member <NUM> to attach to target treatment sites (e.g., bones, tendons, etc.) which are offset from the plane defining the base <NUM>. However, it can be appreciated that, in some examples, the rotator cuff attachment member <NUM> may be formed from a flexible fabric material, and therefore, may be able to lay flat along the base <NUM> prior to implantation. It can further be appreciated that, after implantation, the rotator cuff attachment member <NUM> may assume a non-planar arrangement relative to the base <NUM>.

<FIG> illustrates a side view of the tendon repair device <NUM> described above with respect to <FIG>. For example, <FIG> illustrates the humeral head attachment region <NUM> and the glenoid attachment region <NUM> of the base <NUM>. <FIG> also illustrates the rotator cuff attachment member <NUM> attached to the base <NUM> at the bifurcation location <NUM> and extending away from the base <NUM> at an angle θ. <FIG> clearly illustrates that the plane in which the rotator cuff attachment member <NUM> lies is offset from and intersects the plane in which the base <NUM> lies (e.g., the rotator cuff attachment member <NUM> is non-parallel, and thus non-coplanar with respect to the base <NUM>, as described above).

Additionally, as described above, <FIG> illustrates the apertures <NUM> extending through an end region of the glenoid attachment region <NUM> from an upper surface to a lower surface of the glenoid attachment region <NUM>, the apertures <NUM> extending through an end region of the humeral head attachment region <NUM> from an upper surface to a lower surface of the humeral head attachment region, and the apertures <NUM> extending through an end region of the rotator cuff attachment member <NUM> from an upper surface to a lower surface of the rotator cuff attachment member <NUM>.

<FIG> illustrates a cross-sectional view of a shoulder <NUM> including the example tendon implant device <NUM> described above implanted therein. The shoulder <NUM> further shows a head <NUM> of a humerus <NUM> mating with a glenoid <NUM> of the scapula <NUM>. A rotator cuff tendon <NUM> is also shown. It can be appreciated from <FIG> that the end <NUM> of the rotator cuff tendon <NUM> has been retracted (e.g., torn away) from the humeral head <NUM>. The muscles of the rotator cuff (along with others) control the movement of the humerus <NUM> relative to the scapula <NUM>, and therefore, the separation of the rotator cuff tendon <NUM> from the humeral head <NUM> may create potential instability in the shoulder. As discussed above, to stabilize the shoulder, it may be desirable to not only reinforce the stability of the humeral head <NUM> relative to the glenoid <NUM>, but also reinforce the stability of the rotator cuff tendon <NUM> to both the humeral head <NUM> and the glenoid <NUM> via the implant device <NUM>.

<FIG> illustrates that the tendon repair device <NUM> may be positioned such that the humeral head attachment region <NUM> is adjacent to the humeral head <NUM>, the glenoid attachment region <NUM> extends inferior to or underneath a portion of the rotator cuff <NUM> whereby it is positioned adjacent to the glenoid <NUM>, and the rotator cuff attachment member <NUM> has been positioned such that it lies superior to or overtop (e.g., along the bursal side) of a portion of the rotator cuff tendon <NUM>. Additionally, <FIG> illustrates that the humeral head attachment region <NUM> of the base <NUM> has been fixedly attached to the humeral head <NUM> via one or more anchors <NUM>, the glenoid attachment region <NUM> of the base <NUM> has been fixedly attached to the glenoid <NUM> via one or more anchors <NUM> and the rotator cuff attachment member <NUM> has been attached to the rotator cuff <NUM> via one or more anchors <NUM>.

It can be appreciated that while <FIG> illustrates the tendon repair device <NUM> attached to the humeral head <NUM>, the glenoid <NUM> and/or the rotator cuff <NUM> utilizing anchors <NUM>/<NUM>/<NUM>, it is contemplated that the device <NUM> may be attached to the humeral head <NUM>, the glenoid <NUM> and/or the rotator cuff <NUM> using a variety of attachment mechanisms. For example, portions of the implant device <NUM> may be attached to the humeral head <NUM>, the glenoid <NUM> and/or the rotator cuff <NUM> using staples, sutures, adhesive or the like.

<FIG> illustrates an alternative attachment technique utilizing the tendon repair device <NUM> described above. <FIG> illustrates the tendon repair device <NUM> positioned substantially similar to that described above with respect to <FIG>. For example, <FIG> illustrates that the humeral head attachment region <NUM> may be attached to the humeral head <NUM>, the glenoid attachment region <NUM> may extend inferior to or underneath a portion of the rotator cuff <NUM> whereby it may be attached to the glenoid <NUM>. However, in contrast to <FIG>, <FIG> illustrates that, in some examples, the rotator cuff attachment member <NUM> may be attached to the articular side of the rotator cuff tendon <NUM>. This attachment technique may be desirable if the surgeon wishes to work from inside the joint toward the exterior of the joint. <FIG> illustrates the anchoring mechanism (e.g., screws, staples, sutures, etc.) extending through a portion of the rotator cuff attachment member <NUM> and into the articular side of the rotator cuff tendon <NUM>.

<FIG> illustrates another example tendon repair device <NUM>. The tendon repair device <NUM> may be similar in form and function to the tendon repair device <NUM> described above. For example, the tendon repair device <NUM> may include a base <NUM> having a humeral head attachment region <NUM> designed to attach to a humeral head (as described above), a glenoid attachment region <NUM> designed to attach to a glenoid (as described above) and a rotator cuff attachment member <NUM> designed to attach to a rotator cuff tendon (as described above).

However, <FIG> illustrates that, in some examples, the implant <NUM> may include a multitude of apertures <NUM> distributed throughout the entire tendon repair device <NUM>, or portions thereof. In some examples, the apertures <NUM> may be distributed uniformly throughout the implant <NUM>. In other examples, the apertures <NUM> may be distributed unevenly throughout the implant <NUM>. Designing the implant <NUM> to include a multitude of apertures distributed throughout the implant <NUM> may permit a clinician to attach the implant to a body structure (e.g., bone, tendon, etc.) through any one of the apertures <NUM>, thereby lessoning the precision required for a clinician to attach the implant (and potentially decreasing the overall procedure time to implant the tendon repair device <NUM>).

Further, it can be appreciated that any of the tendon repair devices disclosed herein may be constructed from a variety of materials. For example, the tendon repair devices disclosed herein may be constructed from a synthetic mesh. Other repair devices may be constructed from a synthetic mesh embedded in collagen. In yet other embodiments, the tendon repair devices may be constructed from a biodegradable material. Additionally, in some examples, the tendon repair devices disclosed herein may be constructed in a layered configuration, whereby a biological material is sequentially layered with a synthetic material.

<FIG> illustrates another example tendon repair device <NUM>. As discussed above, the tendon repair device <NUM> may be designed to repair damaged rotator cuff tendons of the shoulder. In some instances, the tendon repair device <NUM> may be a continuous member having a rotator cuff attachment region <NUM> and a glenoid attachment region <NUM>. In some examples (such as that shown in <FIG>), the tendon repair device <NUM> may "fold back" on itself to form a configuration in which it will be positioned in a patient's shoulder. The positioning and attachment of the tendon repair device <NUM> will be shown in greater detail in <FIG>.

Additionally, it can be appreciated that the tendon repair device <NUM> may further include a humeral head attachment region <NUM> positioned between the rotator cuff attachment region <NUM> and the glenoid attachment region <NUM>. It can be appreciated that the humeral head attachment region <NUM> may include that portion of the tendon repair device <NUM> which is designed to be attached to the humeral head of a patient. Similarly, it can be appreciated that the glenoid attachment region <NUM> may include that portion of the tendon repair device <NUM> which is designed to be attached to the glenoid of a patient. Further, the rotator cuff attachment region <NUM> of the tendon repair device <NUM> may be designed to be attached to a portion of the rotator cuff tendons.

Additionally, <FIG> illustrates that each of the glenoid attachment region <NUM>, the rotator cuff attachment region <NUM> and the humeral head attachment region <NUM> may include one or more apertures designed to permit an anchor to extend therethrough and attach to a target site (e.g., glenoid, humeral head, tendons, etc.). For example, <FIG> illustrates one or more apertures <NUM> positioned within the glenoid attachment region <NUM>, one or more apertures <NUM> positioned within the humeral head attachment region <NUM> and one or more apertures <NUM> positioned within the rotator cuff attachment region <NUM>. While <FIG> illustrates that each of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment region <NUM> may include two apertures, respectively, it is contemplated that, in some examples, each of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment region <NUM> may include <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> or more apertures positioned therein. In other instances, one or more of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment member <NUM> may be otherwise configured for attachment to its respective anatomical structure with fasteners or anchors without the need or inclusion of apertures.

Like <FIG>, <FIG> illustrates a cross-sectional view of a shoulder <NUM> including the example tendon implant device <NUM> described above. The shoulder <NUM> further shows a head <NUM> of a humerus <NUM> mating with a glenoid <NUM> of the scapula <NUM>. A rotator cuff tendon <NUM> is also shown. It can be appreciated from <FIG> that the end <NUM> of the rotator cuff tendon <NUM> has been retracted (e.g., torn away) from the humeral head <NUM>. The muscles of the rotator cuff (along with others) control the movement of humerus <NUM> relative to scapula <NUM>, and therefore, the separation of the rotator cuff tendon <NUM> from the humeral head <NUM> may create potential instability in the shoulder. As discussed above, to stabilize the shoulder, it may be desirable to not only reinforce the stability of the humeral head <NUM> relative to the glenoid <NUM>, but also reinforce the stability of the rotator cuff tendon <NUM> to both the humeral head <NUM> and the glenoid <NUM> via the implant device <NUM>.

<FIG> illustrates that the tendon repair device <NUM> may be positioned such that the humeral head attachment region <NUM> is adjacent to the humeral head <NUM>, the glenoid attachment region <NUM> extends inferior to or underneath a portion of the rotator cuff <NUM> whereby it is positioned adjacent to the glenoid <NUM>, and the rotator cuff attachment region <NUM> has been positioned such that it lies superior to or overtop (e.g., along the bursal side) of a portion of the rotator cuff tendon <NUM>. Additionally, <FIG> illustrates that the humeral head attachment region <NUM> has been fixedly attached to the humeral head <NUM> via one or more anchors <NUM>, the glenoid attachment region <NUM> has been fixedly attached to the glenoid <NUM> via one or more anchors <NUM> and the rotator cuff attachment region <NUM> has been attached to the rotator cuff <NUM> via one or more anchors <NUM>. For example, portions of the implant device <NUM> may be attached to the humeral head <NUM>, the glenoid <NUM> and/or the rotator cuff <NUM> using staples, sutures, adhesive or the like.

<FIG> further illustrates that, according to the invention, the tendon repair device <NUM> is configured within the body such that tendon repair device <NUM> folds over on itself at the location where it is attached to the humeral head <NUM>, with both the glenoid attachment region <NUM> and the rotator cuff attachment region <NUM> extending toward the sagittal plane of the patient from the humeral head attachment region <NUM>. Further, it can be appreciated that the point at which the tendon repair device <NUM> folds over on itself may double the thickness of the device <NUM> at a location in which an anchor may attach the device <NUM> to the humeral head <NUM>, in some instances. For example, <FIG> illustrates that the anchor <NUM> may extend through the folded over portion of the device <NUM> to anchor the humeral head attachment region <NUM> of the device <NUM> to the humeral head <NUM> with the anchor <NUM> passing through two thicknesses of the tendon repair device <NUM>, if desired.

As discussed above, it can be appreciated that while <FIG> illustrates the tendon repair device <NUM> attached to the humeral head <NUM>, the glenoid <NUM> and/or the rotator cuff <NUM> utilizing anchors <NUM>/<NUM>/<NUM>, it is contemplated that the device <NUM> may be attached to the humeral head <NUM>, the glenoid <NUM> and/or the rotator cuff <NUM> using a variety of attachment mechanisms. For example, portions of the implant device <NUM> may be attached to the humeral head <NUM>, the glenoid <NUM> and/or the rotator cuff <NUM> using staples, sutures, or the like.

<FIG> illustrates an alternative attachment technique utilizing the tendon repair device <NUM> described above. <FIG> illustrates the tendon repair device <NUM> positioned substantially similar to that described above with respect to <FIG>. For example, <FIG> illustrates that the glenoid attachment region <NUM> may extend inferior to or underneath a portion of the rotator cuff <NUM> whereby it may be attached to the glenoid <NUM> and the rotator cuff attachment region <NUM> may be positioned such that it lies superior to or overtop (e.g., along the bursal side) of a portion of the rotator cuff tendon <NUM>. However, in contrast to <FIG>, <FIG> illustrates that, in some examples, the anchor <NUM> may be positioned "inside" the folded over portion of the humeral head attachment region <NUM>. In other words, <FIG> illustrates that the anchor <NUM> may be positioned along an inner surface <NUM> of the tendon repair device <NUM>, whereby the anchor <NUM> extends through only a single thickness of the device <NUM> to attach to the humeral head <NUM>.

<FIG> illustrates another example tendon repair device <NUM>. The tendon repair device <NUM><NUM> may be similar in form and function as the tendon repair device <NUM> described above. Like the device <NUM>, the tendon repair device <NUM> may be a continuous member having a rotator cuff attachment region <NUM>, a glenoid attachment region <NUM>, and a humeral head attachment region <NUM> positioned between the rotator cuff attachment region <NUM> and the glenoid attachment region <NUM>. However, as shown in <FIG>, the glenoid attachment region <NUM> of the device <NUM> may be split or bifurcated into a first attachment arm <NUM> and a second attachment arm <NUM>, with a gap or opening located therebetween.

Like other tendon repair devices described above, it can be appreciated that the humeral head attachment region <NUM> may include that portion of the tendon repair device <NUM> which is designed to attach to the humeral head of a patient. Similarly, it can be appreciated that the glenoid attachment region <NUM> may include that portion of the tendon repair device <NUM> which is designed to attach to the glenoid of a patient. Further, the rotator cuff attachment region <NUM> of the tendon repair device <NUM> may be designed to attach to a portion of the rotator cuff tendons.

Additionally, <FIG> illustrates that the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM>, the rotator cuff attachment region <NUM> and the humeral head attachment region <NUM> may include one or more apertures designed to permit an anchor to extend therethrough and attach to a target site (e.g., glenoid, humeral head, tendons, etc.). For example, <FIG> illustrates one or more apertures <NUM> positioned within the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM>, one or more apertures <NUM> positioned within the humeral head attachment region <NUM> and one or more apertures <NUM> positioned within the rotator cuff attachment region <NUM>. In other instances, one or more of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment region <NUM> may be otherwise configured for attachment to its respective anatomical structure with fasteners or anchors without the need or inclusion of apertures.

<FIG> illustrates a perspective view of the example tendon repair device <NUM> implanted within a shoulder. It can be appreciated that the placement and anchoring techniques utilized for the rotator cuff attachment region <NUM> and the humeral head attachment region <NUM> of the repair device <NUM> may be similar in form and function to the tendon repair device <NUM> described with respect to <FIG>. For example, <FIG> shows the rotator cuff attachment region <NUM> attached to the rotator cuff <NUM> via one or more anchors <NUM>. Additionally, <FIG> shows the humeral head attachment region <NUM> anchored to the humeral head <NUM> via one or more anchors <NUM>.

However, <FIG> further illustrates that attachment of the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM> may "wrap around" or extend around the sides of the humeral head <NUM> at a position inferior to a superiormost extent of the humeral head <NUM> and attach themselves along anterior and posterior sides of the glenoid <NUM> (depicted as the dashed line <NUM>) via one or more anchors <NUM>. The anchor points <NUM> can be more inferior than anchor points described in previous embodiments and may provide a downward restraint vector between the humeral head <NUM> and the glenoid <NUM>. Further, if the glenoid <NUM> is interpreted to represent the face of a clock when viewed laterally, it can be appreciated that the first arm <NUM> and the second arm <NUM> may be attached at locations represented by approximately <NUM>:<NUM> and <NUM>:<NUM>, for example.

<FIG> illustrates a cross-sectional view of a shoulder <NUM> including the example tendon implant device <NUM> described above. The shoulder <NUM> further shows a head <NUM> of a humerus <NUM> mating with a glenoid <NUM> of the scapula <NUM>. A rotator cuff tendon <NUM> is also shown. <FIG> further illustrates that the tendon repair device <NUM> may be positioned such that the humeral head attachment region <NUM> is attached to the humeral head <NUM> via one or more anchors <NUM> and the rotator cuff attachment member <NUM> has been positioned such that it is attached to the rotator cuff tendon <NUM>, such as the bursal side the rotator cuff tendon <NUM>, via one or more anchors <NUM>. Further, <FIG> illustrates the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM> "wrapping around" or extending around the humeral head <NUM> at a position inferior to the humeral head anchors <NUM>, whereby each of the first attachment arm <NUM> and the second attachment arm <NUM> are attached to the glenoid via anchors <NUM>.

It can be appreciated from <FIG> that the design and corresponding attachment technique utilized with the tendon repair device <NUM> may be permit the distal end <NUM> of the rotator cuff tendon <NUM> to be pulled directly onto the humeral head <NUM>. For example, the bifurcated design of the glenoid attachment region <NUM> (e.g., the ability of the first attachment arm <NUM> to separate from the second attachment arm <NUM>) may permit the distal end <NUM> of the rotator cuff tendon <NUM> to be positioned directly against the humeral head <NUM> in the gap of opening between the first and second attachment arms <NUM>, <NUM>. Allowing the rotator cuff tendon <NUM> to be positioned directly against the humeral head <NUM> may facilitate the direct re-attachment of the rotator cuff tendon <NUM> to the humeral head <NUM>.

Furthermore, as shown in <FIG> and <FIG>, it can be seen that the attachment point of the humeral head region <NUM> to the humeral head <NUM> (i.e., via anchors <NUM>) is located superior to the attachment points of the first and second arms <NUM>, <NUM> of the glenoid attachment region <NUM> (i.e., via anchors <NUM>), thus generating a force vector that pulls the humeral head <NUM> in an inferior direction toward the sagittal plane of the patient.

Like the tendon repair device <NUM> described with respect to <FIG>, <FIG> further illustrates that, in some examples, the tendon repair device <NUM> may be configured within the body such that tendon repair device <NUM> folds over on itself at the location where it is attached to the humeral head <NUM>. Further, it can be appreciated that the point at which the tendon repair device <NUM> folds over on itself may double the thickness of the device <NUM> at a location in which an anchor may attach the device <NUM> to the humeral head <NUM>. For example, <FIG> illustrates that the anchor <NUM> may extend through the folded over portion of the device <NUM>, and thus through two thicknesses of the device <NUM>, to anchor the humeral head attachment region <NUM> of the device <NUM> to the humeral head <NUM>.

Like the tendon repair device <NUM> described with respect to <FIG>, <FIG> illustrates an alternative attachment technique utilizing the tendon repair device <NUM> described above. <FIG> illustrates the tendon repair device <NUM> positioned substantially similar to that described above with respect to <FIG>. For example, <FIG> illustrates that the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM> "wrapping around" the humeral head <NUM> and attaching to the glenoid <NUM>. <FIG> also illustrates that the rotator cuff attachment member <NUM> may be positioned such that it lies overtop (e.g., along the bursal side) of a portion of the rotator cuff tendon <NUM>. However, in contrast to <FIG>, <FIG> illustrates that, in some examples, the anchor <NUM> may be positioned "inside" the folded over portion of the humeral head attachment portion <NUM>. In other words, <FIG> illustrates that the anchor <NUM> may be positioned along an inner surface <NUM> of the tendon repair device <NUM>, whereby the anchor <NUM> extends through only a single thickness of the device <NUM> to attach to the humeral head <NUM>.

<FIG> illustrates another example tendon repair device <NUM>. The tendon repair device <NUM> may be similar in form and function as the tendon repair device <NUM> described above. Like the device <NUM>, the tendon repair device <NUM> may be a continuous member having a rotator cuff attachment member <NUM>, a humeral head attachment region <NUM> and a glenoid attachment region <NUM> split or bifurcated into a first attachment arm <NUM> and a second attachment arm <NUM>, with a gap or opening located therebetween.

Additionally, <FIG> illustrates that the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM>, the rotator cuff attachment member <NUM> and the humeral head attachment region <NUM> may include one or more apertures designed to permit an anchor to extend therethrough and attach to a target site (e.g., glenoid, humeral head, tendons, etc.). For example, <FIG> illustrates one or more apertures <NUM> positioned within the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM>, one or more apertures <NUM> positioned within the humeral head attachment region <NUM> and one or more apertures <NUM> positioned within the rotator cuff attachment region <NUM>. In other instances, one or more of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment region <NUM> may be otherwise configured for attachment to its respective anatomical structure with fasteners or anchors without the need or inclusion of apertures.

Additionally, <FIG> illustrates that the tendon repair device <NUM> may further include a reinforcement member <NUM> positioned within or along the humeral head attachment region <NUM>. In some examples, the reinforcement member <NUM> may be embedded within the region of the tendon repair device defined by the humeral head attachment region <NUM>. As shown in <FIG>, the reinforcement member <NUM> may extend across the width of the tendon repair device <NUM>. Further, in some examples, the reinforcement member <NUM> may be shaped similar to a rectangular beam. However, it is contemplated that the reinforcement member <NUM> may include different shapes. For example, it is contemplated that the reinforcement member <NUM> may be circular, square, ovular, etc. Additionally, it is contemplated that the repair device <NUM> may include multiple, smaller reinforcement members. For example, it can be appreciated that the reinforcement member <NUM> may be divided into multiple, smaller reinforcement members.

<FIG> illustrates a perspective view of the example tendon repair device <NUM> implanted within a shoulder. It can be appreciated that the placement and anchoring techniques utilized for the rotator cuff attachment region <NUM> and the humeral head attachment region <NUM> of the repair device <NUM> may be similar in form and function to the tendon repair device <NUM> described with respect to <FIG>. For example, <FIG> shows the rotator cuff attachment region <NUM> attached to the rotator cuff <NUM> via one or more anchors <NUM>. <FIG> further illustrates that attachment of the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM> may "wrap around" or extend around the sides of the humeral head <NUM> at a position inferior to a superiormost extent of the humeral head <NUM> and attach themselves along anterior and posterior sides of the glenoid <NUM> (depicted as the dashed line <NUM>) via one or more anchors <NUM>.

Additionally, <FIG> illustrates that the tendon repair device <NUM> may further include one or more attachment supports <NUM> which may be designed to extend from the reinforcement member <NUM> (positioned along the humeral head attachment region <NUM>) to the humeral head <NUM> (<FIG> and <FIG> will illustrate the positioning of the attachment supports <NUM> in greater detail). It can be appreciated from <FIG> that each of the attachment supports <NUM> may have a first end which is attached to the reinforcement member <NUM> and a second end (opposite the first end) which is attached to the humeral head <NUM> via anchors <NUM>.

Like the tendon repair device <NUM> described with respect to <FIG>, <FIG> illustrates a cross-sectional view of a shoulder <NUM> including the example tendon implant device <NUM> described above. The shoulder <NUM> further shows a head <NUM> of a humerus <NUM> mating with a glenoid <NUM> of the scapula <NUM>. A rotator cuff tendon <NUM> is also shown. <FIG> illustrates that the rotator cuff attachment region <NUM> has been positioned such that it is attached to the rotator cuff tendon <NUM>, such as the bursal side the rotator cuff tendon <NUM>, via one or more anchors <NUM>. Further, <FIG> illustrates the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM> "wrapping around" or extending around the humeral head <NUM> at a position inferior to a superiormost extent of the humeral head <NUM>, whereby each of the first attachment arm <NUM> and the second attachment arm <NUM> are attached to the glenoid via anchors <NUM>.

Additionally, <FIG> further illustrates that the tendon repair device <NUM> may be positioned such that the humeral head attachment region <NUM> is attached to the humeral head <NUM> via one or more anchors <NUM>. Further, <FIG> illustrates that the anchor <NUM> may extend through the reinforcement member <NUM> positioned within the humeral head attachment region (as described above). Alternatively, the anchor <NUM> may lay adjacent (e.g., medial) to the reinforcement member <NUM>. Additionally, <FIG> illustrates the attachment supports <NUM> extending between the reinforcement member <NUM> and the humeral head <NUM>. It can be appreciated from <FIG> that the attachment supports <NUM> may be attached to the humeral head <NUM> via the anchors <NUM>. It can be appreciated that the attachment supports <NUM> may distribute the load transmitted into the humeral head <NUM> over a larger surface area.

<FIG> illustrates the same cross-sectional view of a shoulder <NUM> including the example tendon implant device <NUM> described above with respect to <FIG>. For example, the shoulder <NUM> shows a head <NUM> of a humerus <NUM> mating with a glenoid <NUM> of the scapula <NUM>. A rotator cuff tendon <NUM> is also shown. <FIG> illustrates that the rotator cuff attachment member <NUM> has been positioned such that it is attached to the bursal side the rotator cuff tendon <NUM> via one or more anchors <NUM>. Further, <FIG> illustrates the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM> "wrapping around" or extending around the humeral head <NUM> at a position inferior to a superiormost extent of the humeral head <NUM>, whereby each of the first attachment arm <NUM> and the second attachment arm <NUM> are attached to the glenoid via anchors <NUM>. The anchors <NUM> being located inferior to the anchors <NUM> to generate a force vector pulling the humeral head <NUM> toward the glenoid <NUM> in an inferior direction toward the sagittal plane of the patient.

Additionally, <FIG> further illustrates that the tendon repair device <NUM> may be positioned such that the humeral head attachment region <NUM> is attached to the humeral head <NUM> via one or more anchors <NUM>. However, in contrast to <FIG> above, <FIG> illustrates that the anchor <NUM> may positioned along the inner surface <NUM> of the tendon repair device <NUM>. Like <FIG>, however, <FIG> illustrates the attachment supports <NUM> extending between the reinforcement member <NUM> and the humeral head <NUM>. It can be appreciated from <FIG> that the attachment supports <NUM> may be attached to the humeral head <NUM> via the anchors <NUM>.

<FIG> illustrates another example tendon repair implant <NUM>. The example tendon repair implant <NUM> may be similar in form and function to the tendon repair implant <NUM> discussed with respect to <FIG> and may also include features which are similar to the tendon repair implants discussed with respect to <FIG>.

As discussed above, the tendon repair implant <NUM> may be designed to repair damaged rotator cuff tendons of the shoulder. In some instances, the rotator cuff tendon repair implant <NUM> may be described as a scaffold structure having a base <NUM> and a rotator cuff attachment member <NUM> projecting away from the base <NUM> at a bifurcation location <NUM>. As illustrated in <FIG>, the base <NUM> may include a first end region <NUM> and a second end region <NUM> positioned opposite the first end region <NUM>. The bifurcation location <NUM> may be positioned at an intermediate location between the first end region <NUM> and the second end region <NUM>. Additionally, the rotator cuff attachment member <NUM> may include a third end region <NUM>, which may be positioned at the free end of the rotator cuff attachment member <NUM> opposite the bifurcation location <NUM>.

As illustrated in <FIG>, the base <NUM> may include a humeral head attachment region <NUM> (located adjacent to or proximate the first end region <NUM>) and a glenoid attachment region <NUM> (located adjacent to or proximate the first end region <NUM>). It can be appreciated that the humeral head attachment region <NUM> may include that region of the tendon repair implant <NUM> which is designed to be attached to the humeral head of a patient. Similarly, it can be appreciated that the glenoid attachment region <NUM> may include that region of the tendon repair implant <NUM> which is designed to be attached to the glenoid of a patient. Further, the rotator cuff attachment member <NUM> of the tendon repair implant <NUM> may be designed to attach to a region of a rotator cuff tendon.

Further, as shown in <FIG>, the glenoid attachment region <NUM> of the device <NUM> may be split or bifurcated into a first attachment arm <NUM> and a second attachment arm <NUM>, with a gap or opening located therebetween. As discussed above with respect to <FIG>, the first attachment arm <NUM> and the second attachment arm <NUM><NUM> of the glenoid attachment region <NUM> may "wrap around" or extend around the sides of the humeral head at a position inferior to a superiormost extent of the humeral head and attach themselves along anterior and posterior sides of the glenoid.

Additionally, the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM>, the rotator cuff attachment region <NUM> and the humeral head attachment region <NUM> may include one or more apertures designed to permit an anchor to extend therethrough and attach to a target site (e.g., glenoid, humeral head, tendons, etc.). For example, <FIG> illustrates one or more apertures <NUM> positioned within the first attachment arm <NUM> and the second attachment arm <NUM> of the glenoid attachment region <NUM>, one or more apertures <NUM> positioned within the humeral head attachment region <NUM> and one or more apertures <NUM> positioned within the rotator cuff attachment region <NUM>. In other instances, one or more of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment region <NUM> may be otherwise configured for attachment to its respective anatomical structure with fasteners or anchors without the need or inclusion of apertures.

While <FIG> illustrates that the humeral head attachment region <NUM> and the rotator cuff attachment member <NUM> may include two apertures, and that each attachment arm <NUM>/<NUM> of the glenoid attachment region <NUM> may include one aperture, respectively, it is contemplated that, in some examples, each of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment member <NUM> may include <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> or more apertures positioned therein. In other instances, one or more of the glenoid attachment region <NUM>, the humeral head attachment region <NUM> and the rotator cuff attachment member <NUM> may be otherwise configured for attachment to its respective anatomical structure with fasteners or anchors without the need or inclusion of apertures.

Like the tendon implant <NUM> described above this respect to <FIG>, <FIG> illustrates that the rotator cuff attachment member <NUM> may be described as a flap, arm, branch, etc. which lies in a plane offset from a plane defined by the base <NUM>. In other words, the configuration of the rotator cuff attachment member <NUM> may be defined as "non-planar" relative to the base <NUM>. As has been previously described, the non-planar arrangement of the rotator cuff attachment member <NUM> and the base <NUM> may permit the rotator cuff attachment member <NUM> to attach to target treatment sites (e.g., bones, tendons, etc.) which are offset from the plane defining the base <NUM>.

Claim 1:
A medical implant (<NUM>, <NUM>, <NUM>) for treating a shoulder joint, comprising:
a humeral head attachment region (<NUM>, <NUM>, <NUM>) configured to be attached to a humeral head of the shoulder joint;
a glenoid attachment region (<NUM>, <NUM>, <NUM>) configured to be attached to a glenoid of the shoulder joint; and
a rotator cuff tendon attachment region (<NUM>, <NUM>, <NUM>) configured to be attached to a rotator cuff tendon of the shoulder joint,
wherein the medical implant (<NUM>, <NUM>, <NUM>) is a continuous member, wherein the humeral head attachment region (<NUM>, <NUM>, <NUM>) is positioned between the glenoid attachment region (<NUM>, <NUM>, <NUM>) and the rotator cuff tendon attachment region (<NUM>, <NUM>, <NUM>);
wherein the medical implant is configured to fold over on itself in within the body at a position along the humeral head attachment region (<NUM>, <NUM>, <NUM>) with both the glenoid attachment region (<NUM>, <NUM>, <NUM>) and the rotator cuff tendon attachment region (<NUM>, <NUM>, <NUM>) extending toward the sagittal plane from the humeral head attachment region (<NUM>, <NUM>, <NUM>).