Patent Description:
It may become necessary to conduct a second or subsequent surgery in order to replace a prosthetic joint with a (often larger) replacement joint. Such surgeries, known as "revision" surgeries, often occur due to further degeneration of bone or advancement of a degenerative disease, requiring removal of further bone and replacement of the removed, diseased bone with a larger or enhanced prosthetic joint, often referred to as a revision prosthesis. For example, bone is often lost around the rim of the acetabulum, and this may provide less rim coverage to securely place an acetabular cup.

In cases where the patient's bone around an implant is compromised, it may be necessary to utilize an augment to add additional support. For example, an acetabular augment may be placed to fill in a defect cavity around the acetabular shell to help support the loads transmitted to the shell. As part of the surgical technique, the surgeon may place both the shell and augment within the patient in order to ensure a proper fit before fastening the two components together to prevent motion between them. However, fastening the two components may be difficult, particularly when using bone cement, if the two components are congruent. Inadequate cementing between the components may cause them to separate after implantation, possibly causing particle generation and leading ultimately to revision.

In current augment designs no provision is typically given to assist with cement application. Therefore, surgeons apply the cement ad hoc (e.g., along the edges of the augment similar to a caulking bead) before fully assembling the components together or forgo the use of cement altogether. This leads to inconsistent and sometimes undesirable results with techniques that are not easily replicated. The closest prior art is document <CIT>, which defines the preamble of independent claims <NUM> and <NUM>.

Disclosed herein are systems, devices, and methods for orthopedic augments having retaining pockets, with the invention being defined in independent claims <NUM>, <NUM> and <NUM>. The systems, devices, and methods according to the invention include an orthopedic augment comprising an outer surface that interfaces with a patient's tissue or bone, and an inner surface that interfaces with an implant, the inner surface comprising a recessed pocket configured to receive a fixation material, a rim around at least a portion of the recessed pocket, and a port in the rim. The rim can mate with an implant. In certain embodiments, the recessed pocket extends along the inner surface in at least a direction laterally from the port. The port extends from the outer surface to the inner surface and thereby allows insertion of the fixation material into the recessed pocket.

In certain embodiments, the recessed pocket comprises a first compartment and a second compartment separated by a ridge. The ridge may be recessed relative to the rim. The fixation material rigidly affixes the augment to the implant. In certain embodiments, the fixation material is a cement or paste. In certain embodiments, the orthopedic augment further comprises a second port. The second port may be a fill gauge positioned inferiorly to the port, and the second port may have a geometry that is different than the geometry of the port. In certain embodiments, the port comprises a luer-lock fitting or a plug, and the port may be tapered. In certain embodiments, the orthopedic augment may further comprise an extension member configured to couple with an insertion device. The orthopedic augment may further comprise flanges, blades, hooks, or plates.

In certain embodiments, a surface of the augment is at least one of polished, matte, and porous. In certain embodiments, at least a portion of the outer surface comprises a polished finish. The outer surface may further comprise a matte finish or porous composition. In certain embodiments, the upper surface comprises a porous composition.

In certain embodiments, methods for implanting an orthopedic augment include placing an inner surface of the augment adjacent to an implant, wherein the inner surface comprises a recessed pocket and a port, and inserting a fixation material into the recessed pocket of the augment via the port, thereby affixing the augment to the implant. In certain embodiments, the inner surface of the augment further comprises a plurality of ports. The method may further include using at least one of the plurality of ports as a fill gauge, whereby the fixation material is injected into a first port until the fixation material is observed via a second port used as the fill gauge. The method may further include selecting a first port within which to inject the fixation material into the recessed pocket, and injecting the fixation material into the recessed pocket until the fixation element is observed passing a second port. In certain embodiments, the method includes determining a preferred orientation of the augment with respect to the implant and selecting, in response to the determining, one of the plurality of ports within which to inject the fixation material.

In certain embodiments, the recessed pocket comprises a first compartment and a second compartment. The port may be disposed proximate the first compartment. The method may further include injecting the fixation material into the first compartment via the port, wherein overfilling the first compartment causes the fixation material to flow into the second compartment. The fixation material may be a cement or paste and the implant may be an acetabular shell or cage.

A kit for use in orthopedic procedures may be provided that includes a plurality of augments, each comprising a surface having a recessed pocket configured to receive a fixation material, a rim around at least a portion of the recessed pocket, and a port in the rim, wherein at least one of the plurality of augments has more than one port in the rim.

In certain embodiments, an orthopedic augment is provided that includes an outer surface that interfaces with a patient's tissue or bone, and an inner surface that interfaces with an implant, the inner surface comprising recessed means for receiving a fixation material, a rim around at least a portion of the recessed means, and access means in the rim, wherein the recessed means extend along the inner surface in at least a direction laterally from the access means.

Variations and modifications of these embodiments will occur to those of skill in the art after reviewing this disclosure. The foregoing features and aspects may be implemented, in any combination and subcombinations (including multiple dependent combinations and subcombinations), with one or more other features described herein. The various features described or illustrated above, including any components thereof, may be combined or integrated in other systems. Moreover, certain features may be omitted or not implemented.

To provide an overall understanding of the systems, devices, and methods described herein, certain illustrative embodiments will be described. Although the embodiments and features described herein are specifically described for use in connection with acetabular systems, it will be understood that all the components, connection mechanisms, adjustable systems, manufacturing methods, coatings, and other features outlined below may be combined with one another in any suitable manner and may be adapted and applied to medical devices and implants to be used in other surgical procedures, including, but not limited to orthopedic knee replacement procedures, spine arthroplasty, cranio-maxillofacial surgical procedures, hip arthroplasty, shoulder arthroplasty, as well as foot, ankle, hand, and other extremity procedures.

The augments described herein provide a surgeon with unitization options to accommodate a wide variety of bone anatomies and implant structures. The augments preferably maintain a close interface with both an implant and a patient's surrounding bone or tissue while allowing the surgeon to place the augments in a variety of positions, either before or after implantation of the implant, in order to suit different bone anatomies and implant structures. In addition, the augments incorporate recessed pockets into which a fixation material, such as cement, may be deposited. The recessed pockets allow pressurized deposition of the fixation material into locations that provide improved bonding across a greater surface area between the augment and the implant to which the augment is coupled.

<FIG> shows a perspective view of an augment <NUM> having a recessed pocket <NUM> within an inner surface <NUM> of the augment <NUM>. The augment <NUM> has an outer surface <NUM> that interfaces with a patient's tissue or bone and an inner surface <NUM> that interfaces with an implant. The inner surface <NUM> has a recessed pocket <NUM> formed therein that, as shown in <FIG>, occupies a substantial area of the inner surface <NUM> and is configured to receive a fixation material such as a cement or paste. When injected into the recessed pocket <NUM>, the cement or paste affixes the augment <NUM> to an implant. Any suitable cement or paste may be used, including but not limited to polymethyl-methacrylate (PMMA), any other suitable biocompatible cement or paste, or other fixation material, or any combination thereof. In certain embodiments, the fixation material (e.g., PMMA) may be mixed with one or more pharmacological agents including, but not limited to, antibiotics, anti-inflammatory drugs, and growth factors.

The inner surface <NUM> also includes a rim <NUM> that mates with an implant and extends around at least a portion of the recessed pocket <NUM>. As shown in <FIG>, for example, the rim <NUM> encircles the perimeter of the recessed pocket <NUM> along the periphery of the inner surface <NUM>. When the augment <NUM> is positioned against an implant, the rim <NUM> substantially prevents a fixation material disposed in the recessed pocket <NUM> from leaving the recessed pocket <NUM>. For example, the rim <NUM> is configured to mate with an implant and may be shaped so that the rim <NUM> matches the geometry of the implant and abuts the implant, which prevents a fixation material from leaving the recessed pocket <NUM>. As shown in <FIG>, the rim <NUM> has a curvilinear or arced shape to complement the shape of an implant <NUM> such as an acetabular shell. In certain embodiments, the rim <NUM> may be optionally coated with a resorbable or non-resorbable material such as a polylactic plastic (PLA) or PGA plastic. In certain embodiments, a gasket or other sealing means may be optionally provided between the rim of the augment and the implant. The gasket may help to contain the fixation material with the recessed pocket.

In order to allow a surgeon to inject or otherwise insert a fixation material into the recessed pocket <NUM>, the inner surface <NUM> includes a port <NUM> within the rim <NUM> that extends from the outer surface <NUM> to the recessed pocket <NUM> of the inner surface <NUM>. As shown in <FIG>, for example, the port <NUM> is disposed in the top of the rim <NUM> and extends from the superior outer surface 110a to the recessed pocket <NUM>, thereby allowing a surgeon to inject a fixation material into the recessed pocket <NUM> when the augment <NUM> is mated with an implant. This can be done before or after the implant and augment have been implanted into a patient. The port <NUM> is shown as a half-circle or half-oval cutout made into the top of the rim <NUM> and having an open end 150a. In certain embodiments, a port may be provided as a through-hole made into the rim <NUM>. For example, port <NUM> is provided as a through-hole in the rim <NUM>. Alternatively, or additionally, in certain embodiments a port <NUM> may be provided as a through-hole in the outer surface <NUM> that accesses the recessed pocked <NUM> but is not disposed in the rim <NUM>.

The port <NUM> assists with the injection of a fixation material into desired areas of the augment regardless of where the augment is positioned relative to the implant or whether the augment is affixed to the implant before or after the two components are implanted. Unlike current augment designs, where if the surgeon desires to use cement, the surgeon must first cement the augment to the implant before implantation, the recessed pockets described herein (such as recessed pocket <NUM>) allow surgeons to place the augment adjacent to the implant in the desired location before or after implantation and then fill the recessed pocket with the fixation material via the port, thereby affixing the augment to the implant. Thus, the features of the augment <NUM> provide improved securement options for surgeons to implant augments before or after the acetabular shell or other implant has been implanted.

<FIG> shows a front elevation view of the inner surface <NUM> of the augment <NUM> of <FIG>, including the recessed pocket <NUM>, the rim <NUM> that substantially encircles the recessed pocket <NUM>, and the port <NUM> disposed on an upper portion of the rim <NUM>. As shown in <FIG>, the recessed pocket <NUM> has a shape that conforms to the shape of the augment <NUM> itself, although in certain embodiments the recessed pocket <NUM> may have any suitable shape including shapes that may not comport with the shape of the augment <NUM>, yet still fit within the inner surface <NUM> of the augment <NUM>. The rim <NUM> extends around at least a portion of the recessed pocket <NUM> and, as shown in <FIG>, extends around the entirety of the recessed pocket <NUM>. The rim <NUM> provides the surface with which the augment <NUM> mates with an implant and also prevents a fixation material within the recessed pocket <NUM> from leaving the pocket <NUM> when the augment is adjacent the implant. For example, in certain embodiments the rim <NUM> makes a fluid-tight seal with the surface of the implant. In certain embodiments, contact that does not create a fluid-tight seal may still be sufficient to prevent the fixation material from leaving the recessed pocket <NUM>. Disposed within the upper portion of the rim <NUM> is the port <NUM> that provides access to the recessed pocket <NUM>.

As discussed above, the rim <NUM> provides that portion of the inner surface <NUM> that contacts an orthopedic implant. <FIG> shows a side elevation view of the augment <NUM> of <FIG> adjacent to an implant <NUM>. The rim <NUM> of the augment <NUM> mates with the implant <NUM> and is shaped to complement the shape of the implant <NUM>. The rim <NUM> makes a substantially flush contact with the implant <NUM>, which substantially prevents a fixation material within the recessed pocket <NUM> from leaving the recessed pocket <NUM>. As discussed above, the recessed pocket <NUM> can have any suitable shape. The recessed pocket <NUM> can also be provided with any suitable depth, where the depth 130a depicted in <FIG> is the absolute depth of the pocket, as the depth varies with proximity to the rim <NUM>. The depth 130a of the recessed pocket <NUM> is proportional to the amount of fixation material that may be deposited within the recessed pocket <NUM> to affix the augment <NUM> to the implant <NUM>. In certain embodiments, it may be desirable to provide a recessed pocket <NUM> having a relatively large depth 130a. For example, the depth of the recessed pocket (e.g., depth 130a) may be designed as deep as possible without sacrificing the material strength of the augment or fixation material. Suitable depths include, for example, about <NUM>-<NUM> millimeters, about <NUM>-<NUM> millimeters, or about <NUM>-<NUM> millimeters.

Because the rim <NUM> mates substantially flush with the implant <NUM>, one or more ports <NUM> are provided to give a surgeon access to the recessed pocket <NUM> in order to inject or otherwise insert the fixation material into the recessed pocket <NUM>. <FIG> shows a top plan view of the augment <NUM> of <FIG> and depicts the port <NUM> disposed in the upper portion of the rim <NUM> and extending from the recessed pocket <NUM> to the superior outer surface 110a. Although only one port <NUM> is shown, it will be understood that any suitable number of ports may be provided and, moreover, that the ports may be provided on any suitable portion of the outer surface <NUM> of the augment <NUM>. For example, although the port <NUM> is shown on the superior outer surface 110a, alternatively or additionally, ports may be provided on the lateral outer surfaces 110b and the inferior outer surface 110c.

As shown in <FIG>, the recessed pocket <NUM> extends beyond the opening created by the port <NUM>. In particular, the recessed pocket <NUM> extends along the inner surface <NUM> in at least a direction laterally from the port <NUM>, as depicted by the direction of arrows <NUM> of <FIG>. The recessed pocket <NUM> therefore has a volume that does not depend upon the size of the port <NUM>. As shown in <FIG>, the recessed pocket <NUM> also has a depth 130a that extends beyond the opening created by the port <NUM>.

As discussed above, in certain configurations the augment may include more than one port. <FIG> shows a perspective view of an implant adjacent to an augment having multiple ports. In particular, <FIG> shows an implant <NUM>, in this case an acetabular shell, and an augment <NUM> mated thereto and having three ports <NUM>, <NUM>, <NUM>. The ports <NUM>, <NUM>, <NUM> are located on the superior outer surface 210a and extend through the top rim <NUM> of the augment <NUM>. The augment <NUM> includes a recessed pocket <NUM>, accessible from any of the ports <NUM>, <NUM>, <NUM>. Providing multiple ports gives the surgeon the option, for example, to use any or all of them to inject a fixation material into the recessed pocket <NUM>. For example, in certain embodiments, the operating window within which the surgeon works may be restricted so that one or more ports are not be accessible. However, because three ports <NUM>, <NUM>, <NUM> are provided, at least one of the ports may be accessible and the surgeon may fill the recessed pocket <NUM> by injecting a fixation material into that port. It will be understood that any suitable number of ports may be provided. For an augment having two or more ports, a surgeon would have similar options to use alternate ports if one or more ports are inaccessible for certain orientations of the augment with respect to an implant.

The above description applies to acetabular augments. However, similar recessed pockets could be applied to knee augments or other orthopedic implants where component are fixed together with a fixation material such as bone cement. An additional advantage of providing multiple ports is that a surgeon can inject the fixation material into one of the ports and use an unused port as a fill gauge to visually judge the amount of fixation material that has been injected into the augment. For example, as the recessed pocket is filled with fixation material, the surgeon can observe the fixation material through the unused port by looking into that port. This is helpful because the recessed pocket extends beyond the opening of the port. Numerous ports also give a surgeon the option to place the augment in any desired orientation, where at least one port is accessible from any orientation.

Although the ports <NUM>, <NUM>, <NUM> are shown as each having substantially the same geometry, it will be understood that any suitable geometry may be provided. For example, certain port geometries may be preferred for different types of syringes or other insertion devices used by the surgeon to inject a fixation material into the recessed pocket of an augment. As shown in <FIG>, a port <NUM> can have a straight-edge cut <NUM> through, for example, the outer surface of an augment. <FIG> shows that a port <NUM> can be tapered <NUM>, while <FIG> shows a port <NUM> having both a tapered portion <NUM> and a straight-edge portion <NUM> to create a funnel-shaped port <NUM>. In certain embodiments, any of ports <NUM>, <NUM>, <NUM> may be configured to include an integral lip at the upper surface for interfacing with an insertion device. In certain embodiments, the ports may include an insertion device fitting in order to assist with injection of the fixation material into the recessed pocket. A luer-lock type fitting, shown in <FIG> (female luer-lock <NUM>) and 3E (male luer-lock <NUM>), or tapered plug <NUM>, shown in <FIG>, may be incorporated into the port and outer surface so that a standard insertion device may be used, rather than requiring the surgeon to modify the insertion device. The insertion device fitting (e.g., the luer-lock or plug) allows for greater pressure to be generated, assisting with adequate flow of the fixation material into the gap between the augment and the implant and enhancing the fixation between the two components. In certain embodiments, both a plug and a luer-lock fitting are used. For example, as shown in <FIG>, in lieu of attaching the insertion device <NUM> directly to the plug <NUM> disposed within the port <NUM>, an extension tube <NUM> coupled to the insertion device <NUM> via a luer-lock <NUM> is used. The extension tube <NUM> prevents interference, for example, from soft tissues proximate the port <NUM>. In certain embodiments, the extension member such as extension tube <NUM> can have alternative fittings (e.g., other than the luer-lock <NUM>) for various syringe types or other insertion devices.

In addition to configurations of augments having multiple ports, in certain configurations, augments may include mounting members such as flanges, blades, hooks, plates, or any combination thereof, to assist with mounting the augment to the implant, the patient's tissue or bone, or both. Mounting members provide additional support and/or stability for the augment once positioned. Mounting members are often preferred due to bone degeneration, bone loss, or bone defects in the affected area (e.g., a hip joint). <FIG> shows a perspective view of an augment <NUM> having a mounting member <NUM>. The mounting member <NUM> is a flange with one or a plurality of screw holes <NUM> configured to receive a fixation member such as a bone screw. In some embodiments, mounting members such as mounting member <NUM> may include conventional screw holes, locking holes, combi-holes, or slots. The sites may be threaded, unthreaded, or partially threaded, and may be fixed or polyaxial. In some embodiments, attachment sites may include variable low-profile holes that allow for locking at a variety of angles. The flange mounting member <NUM> is coupled to, and extends from, the outer surface <NUM> of the augment <NUM>.

The inner surface <NUM> of the augment <NUM> has similar features as discussed above in connection with augment <NUM> of <FIG>, such as a recessed pocket <NUM> surrounded at least in part by a rim <NUM> and a port <NUM> therethrough that provides access to the recessed pocket <NUM>. The port <NUM> is provided in the bottom 340a of the rim <NUM> and extends to the inferior outer surface 310c of the augment <NUM>. It will be understood, however, that the port <NUM> (or additional ports, not depicted) could be provided on one or both lateral sides of the rim or on the top of the rim, similar to the location of the port <NUM> of <FIG> (e.g. along the top 340b of the rim, adjacent the mounting member <NUM> and the screw holes <NUM>). Furthermore, in certain embodiments, one or more ports could be provided on a part of the outer surface <NUM> that provides access to the recessed pocket <NUM> without going through the rim <NUM> (e.g. through a back side of the pocket). As shown, the rim (e.g., rim <NUM> and <NUM>) substantially encircles the perimeter of the recessed pocket and thereby provides a perimeter for the recessed pocket and a perimeter for the inner surface. In certain embodiments, however, the rim may not fully encircle the perimeter of the recessed pocket. For example, an augment may include multiple recessed pockets.

<FIG> show perspective views of an augment having multiple recessed pockets. Multiple pockets give a surgeon various options during the procedure. For example, not every pocket need be filled with a fixation element. Furthermore, the pockets can be designed with different respective volumes depending, for example, on patient-specific or implant-specific applications. As shown in <FIG>, for example, the augment <NUM> includes an inner surface <NUM> having recessed pockets <NUM>, <NUM>, <NUM>. The rim <NUM> of augment <NUM> is provided around at least a portion of each of the recessed pockets <NUM>, <NUM>, <NUM>, although the rim <NUM> does not fully encircle the perimeter of any one recessed pocket <NUM>, <NUM>, <NUM>. For example, the rim <NUM> provides an upper bound and a lower bound for the central recessed pocket <NUM>, and provides a lateral bound for the lateral recessed pocket <NUM> and a lateral bound for the lateral recessed pocket <NUM>. Disposed between the respective recessed pockets are ridges 442a and 442b. The ridges 442a and 442b do not extend as far as the rim <NUM>, and therefore do not contact an implant when the augment <NUM> is placed adjacent to an implant (although in certain embodiments at least a portion of the ridges 442a and 442b could be configured to contact an implant). It will be understood that the ridges 442a and 442b may have any suitable respective height. The augment <NUM> includes two ports <NUM> and <NUM>, where port <NUM> provides direct access to lateral recessed pocket <NUM> and port <NUM> provides direct access to lateral recessed pocket <NUM>. Although there is no port shown that provides direct access to the central recessed pocket <NUM>, overfilling either or both of the lateral recessed pockets <NUM>, <NUM> via ports <NUM>, <NUM> causes a fixation material to flow over the ridges 442a and 442b and thereby fill the central recessed pocket <NUM>. Therefore, access can be provided to a plurality of recessed pockets that are separated by ridges, even in the event where only one recessed pocket has direct access to a port. In certain embodiments, the multiple recessed pockets could be provided without ridges between the pockets. For example, the augment could be provided with continuous and/or smooth portions between the pockets or have other ridges or protrusions along the inner surface <NUM> that grasp or otherwise provide a non-smooth structure with which the fixation material couples.

<FIG> is a perspective view of the superior outer surface 410a and provides another view of the ports <NUM>, <NUM>. As can be seen in <FIG>, for example, the port <NUM> is shaped similarly to the recessed pocket <NUM> and provides, by use of the ridges 442a and 442b, indirect access to the central recessed pocket <NUM> and the lateral recessed pocket <NUM>, whereby overfilling the lateral recessed pocket <NUM> would cause the fixation material to flow to the other recessed pockets <NUM>, <NUM>. As can also be seen in <FIG>, the rim <NUM> provides the contact surface against which an implant is placed, whereas the ridges 442a and 442b are inset relative to the rim <NUM>. The ridges 442a and 442b do not extend as far the rim <NUM> and do not contact the implant in order to allow the fixation material to overfill from pocket to pocket. For example, as shown in <FIG>, which is a cross-sectional view taken along line C-C of <FIG>, the central recessed pocket <NUM> of the augment <NUM> has the greatest depth relative to the rim <NUM>, and the ridge 442b, located between the central recessed pocket <NUM> and the lateral recessed pocket <NUM>, is inset relative to the rim <NUM> by a distance, d. The distance, d, between the rim <NUM> and the ridge 442b is the area through which the fixation material is overfilled and flows from pocket to pocket. The ridge 442b can be provided at any suitable distance, d, that is inset relative to the rim <NUM>. <FIG> shows a top plan view of the augment <NUM> of <FIG>. As shown, the ports <NUM> and <NUM> are provided on the superior outer surface 410a and each of the recessed pockets <NUM>, <NUM>, <NUM> has a respective depth from the edge of the rim <NUM>, depicted by depths 430a, 432a, and 434a. Also shown are the ridges 442a and 442b that separate the respective pockets. <FIG> also shows that the rim <NUM> of the inner surface <NUM> abuts the implant <NUM>, but the ridges 442a and 442b are inset and do not contact the implant <NUM>.

As shown in <FIG>, the lateral recessed pockets <NUM>, <NUM> extend beyond the opening created by the ports <NUM>, <NUM>. In particular, the lateral recessed pockets <NUM>, <NUM> extend along the inner surface <NUM> in at least a direction laterally from the ports <NUM>, <NUM>, as depicted by the direction of arrows <NUM> of <FIG>. The central recessed pocket <NUM> does not have a port that provides direct access thereto. The recessed pockets <NUM>, <NUM>, <NUM> therefore have respective volumes that do not depend upon the size of the ports <NUM>, <NUM>. As shown in <FIG>, the recessed pockets also have depths 430a, 432a, 434a that extend beyond the opening created by the ports <NUM>, <NUM>.

<FIG> show perspective views of an augment <NUM> having various surface finishes. The augment <NUM> shown includes two recessed pockets <NUM> and <NUM> at least partially enclosed by a rim <NUM> and a mounting flange <NUM> extending from the augment <NUM>. In certain embodiments, at least one of the recessed pockets is configured to accept a screw. For example, recessed pocket <NUM> may be configured to accept a screw. The recessed pockets <NUM> and <NUM> are separated at least in part by a ridge <NUM> and are accessible through ports <NUM> and <NUM>, respectively. The ridge <NUM> has a height that does not extend as far as that of the rim <NUM>, and therefore the ridge <NUM> does not contact an implant when the augment <NUM> is placed adjacent to the implant, such as implant <NUM>. However, in certain embodiments, the ridge <NUM> can be extended to contact the implant <NUM>. For example, the ridge <NUM> may have a height equal to or greater than that of rim <NUM>. The ports <NUM> and <NUM> are shown as half circle or half oval cutouts made into the bottom 540b of the rim <NUM>. It is understood, however, that one or more ports could be provided on any of the lateral sides 540a of the rim <NUM> or on the bottom 540b or top 540c of the rim <NUM>, for example, as a through-hole or cut out made into the rim <NUM>, or in any other suitable shape. Furthermore, in certain embodiments, one or more ports could be included on the outer surface <NUM> that provide access to the recessed pockets <NUM> and <NUM> without passing through the rim <NUM>. The inner surface 530a of the recessed pocket <NUM> and surface 540d of the rim <NUM> are shown in <FIG> as having a porous composition, while the inner surface 532a of the recessed pocket <NUM> is shown as having a matte surface finish. The porous composition allows for better adhesion to fixation material such as cement or paste. The porous composition may interface with bone to promote ingrowth of the bone. In certain embodiments, the inner surfaces 530a and 532a in addition to the surface 540d of the rim <NUM> may include, at least in part, a variety of different surface treatments, compositions, or coatings. For example, the augment <NUM> shows a porous composition, a matte finish, and a polished finish on the back of the augment that extends to the mounting flange <NUM>.

The mounting flange <NUM> extends outward from the augment <NUM> and includes six screw holes <NUM> configured to receive a fixation member such as a bone screw. In certain embodiments, any number of screw holes <NUM> may be included. As shown in <FIG>, the mounting flange <NUM> has an upper surface <NUM> having a porous composition and a lower surface <NUM> having a polished finish. The porous upper surface <NUM> may receive a fixation material, and the polished lower surface <NUM> may be configured to interface with a patient's tissue, muscles, ligaments, or bone, or any combination thereof. The porous upper surface <NUM> is preferably configured to interface with bone and promote ingrowth of the bone. The polished lower surface <NUM> is preferably configured to interface with a patient's tissue, muscles, and/or ligaments to prevent interactions and attachments between the tissue, muscles, and/or ligaments and the polished lower surface <NUM>. In certain embodiments, the upper surface <NUM> and lower surface <NUM> may include, at least in part, a variety of different surface treatments, compositions, or coatings. For example, the augment <NUM> shows a mounting flange <NUM> with a porous composition and a polished finish. Any other suitable combination of surface treatments may be used on various surfaces of the augment <NUM>.

The augments described herein may be made of a number of materials, including Titanium, Cobalt-Chromium, Zirconium oxide, Stainless steel, monolithic ceramic or composite ceramic, such as Zirconia, Alumina, or other composites, or any other biocompatible materials or alloys that have the appropriate strength, resistance to wear, etc., or any combinations thereof. The augments may also be made fully porous or partially porous to allow for greater bone in-growth, for example, and the augments may be coated with hydroxyapatite or any other bone-promoting agents or combinations thereof. The augments may be manufactured according to any suitable technique or techniques, including, for example, using rapid manufacturing machines or standard manufacturing machines.

The foregoing is merely illustrative of the principles of the disclosure, and the systems, devices, and methods can be practiced by other than the described embodiments, which are presented for purposes of illustration and not of limitation. It is to be understood that the systems, devices, and methods disclosed herein, while shown for use in acetabular systems, may be applied to systems, devices, and methods to be used in other surgical procedures including, but not limited to, spine arthroplasty, cranio-maxillofacial surgical procedures, knee arthroplasty, shoulder arthroplasty, as well as foot, ankle, hand, and extremities procedures.

Variations and modifications will occur to those of skill in the art after reviewing this disclosure. The disclosed features may be implemented, in any combination and subcombination (including multiple dependent combinations and subcombinations), with one or more other features described herein. The various features described or illustrated above, including any components thereof, may be combined or integrated in other systems. Moreover, certain features may be omitted or not implemented.

Claim 1:
A method comprising:
placing an inner surface (<NUM>, <NUM>) of an orthopedic augment (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>) adjacent to an implant, wherein the inner surface comprises a recessed pocket (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>), a rim around at least a portion of the recessed pocket and a port (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>) in the rim; and
inserting a fixation material into the recessed pocket of the augment via the port, thereby affixing the augment to the implant.