Methods for less invasive glenoid replacement
The invention features a glenoid (shoulder socket) implant prosthesis, a humeral implant prosthesis, devices for implanting glenoid and humeral implant prostheses, and less invasive methods of their use for the treatment of an injured or damaged shoulder.
1. A method of treating a patient, comprising:
providing a glenoid implant having a body, the body comprising a bearing surface, a medial surface opposite the bearing surface, a circumferential peripheral portion defined between the bearing surface and the medial surface, and a radially symmetric central peg extending from said medial surface and oriented along a central axis of the implant, the circumferential peripheral portion defining a cortical-bone-contacting surface;
identifying a patient having a glenoid surface;
reaming a cavity into the glenoid surface wholly within a boundary of a native glenoid cavity of the patient without interrupting a peripheral margin of the glenoid surface, wherein reaming the cavity comprises:
forming a first cavity at a first depth with respect to the glenoid surface and a second cavity at a second depth with respect to the glenoid surface,
wherein a diameter of a reamer used to form the first cavity is smaller than a diameter of a reamer used to form the second cavity,
wherein the first depth is deeper than the second depth, and
wherein the first and second cavities are concentric; and
inserting the glenoid implant into the cavity, such that at least a portion of the circumferential peripheral portion of the body resides below the adjacent glenoid surface and the portion residing below the adjacent glenoid surface lies directly adjacent to and is at least partially circumferentially surrounded by cortical bone of the glenoid,
wherein the diameter of the reamer used to form the first cavity corresponds to diameter of the central peg,
wherein the diameter of the reamer used to form the second cavity corresponds to diameter of the circumferential peripheral portion of the body.
2. The method of treating a patient as in claim 1 , wherein reaming the cavity comprises reaming a circular cavity.
3. The method of treating a patient as in claim 1 , wherein reaming the cavity comprises reaming an oblong cavity.
4. The method of treating a patient as in claim 1 , further comprising securing the implant within the cavity using bone cement.
5. The method of treating a patient as in claim 1 , further comprising securing the implant within the cavity by press fit.
6. The method of treating a patient as in claim 1 , further comprising securing the implant within the cavity using a bone screw.
7. The method of treating a patient as in claim 1 , further comprising stabilizing the implant within the cavity using the peg extending from the medial surface of the implant.
8. The method of treating a patient as in claim 1 , further comprising accessing the glenoid via a deltopectoral approach.
9. The method of treating a patient as in claim 1 , further comprising accessing the glenoid via an anterolateral approach.
10. The method of treating a patient as in claim 1 , further comprising accessing the glenoid via an incision no more than about 9 cm in length.
11. The method of treating a patient as in claim 1 , wherein reaming the cavity is accomplished while leaving the majority of the inferior capsule intact.
12. The method of treating a patient as in claim 1 , wherein reaming the cavity is accomplished while leaving the peripheral cortex intact.
13. The method of treating a patient as in claim 1 , wherein reaming the cavity step is accomplished using a power drill having a 90 degree bend.