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VIL-12 Implementations may include one or more of the following features. The method may also include: reaming the articular implant out of the bone pocket to a size that supports a second articular implant having a greater diameter than the articular implant; restoring the bone tunnel; passing a second tether through the restored bone tunnel; securing a distal tether end of the second tether to the second articular implant; and securing a proximal tether end of the second tether within the restored bone tunnel as at least part of a revision procedure. 14 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 One general aspect of the present disclosure can include a method for deploying an articular implant in a metatarsophalangeal (MTP) joint of a patient. The method includes forming a bone pocket in an articular surface of a metatarsal bone, the bone pocket sized and positioned to resect at least one osteochondral lesion; forming a bone tunnel may include a distal tunnel end and a proximal tunnel end, the bone tunnel configured such that the distal tunnel end connects the bone pocket and the proximal tunnel end connects to an external surface of the metatarsal bone; passing a tether between the distal tunnel end and the proximal tunnel end of the bone tunnel, the tether having a distal tether end and a proximal tether end; securing the distal tether end to an articular implant; and securing the proximal tether end within the bone tunnel. 13 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 FIG. 5E is a perspective exploded view of an implant according to another embodiment. 23 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 One general aspect of the present disclosure can include an articular implant system for a metatarsophalangeal joint, the system having an implant configured to seat within a bone pocket of an articular surface of a metatarsal, the implant may include: a convex distal surface; a semispherical proximal surface that extends from the convex distal surface, the semispherical proximal surface having an implant radius that matches a bone radius of the bone pocket; and where the semispherical proximal surface engages a surface of the bone pocket to retain the implant within the bone pocket. 11 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 The tether couples the arthroplasty implant to the bone anchor through a bone tunnel that extends from the bone pocket such that when the tether couples the arthroplasty implant to the bone anchor at least a portion of the edge contacts a surface of the bone pocket below the distal articular surface. The bone tunnel may include a proximal opening near a dorsal surface of the metatarsal bone. The bone anchor sits within the bone tunnel and within the proximal opening and the bone anchor may include: a cylindrical body may include an opening that extends from one end of the cylindrical body to the other end and external threads on an outside surface of the cylindrical body, the external threads configured to engage an internal surface of the bone tunnel, and a tether locking feature configured to sit within the opening of the cylindrical body and couple a proximal end of the tether to the bone anchor. The arthroplasty implant may seat within the bone pocket such that a top of the joint-facing articular surface is congruent with or below a surface of surrounding cartilage of the distal articular surface and the edge is below the surface of surrounding cartilage when the tether couples the arthroplasty implant to the bone anchor. 10 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 Implementations may include one or more of the following features. The arthroplasty implant system may include an arthroplasty implant that may include: an articular implant where the articular implant is embedded within a bone pocket of the distal articular surface when the tether couples the articular implant to the bone anchor such that bone pocket retains the articular implant in place during osseointegration of the articular implant to the metatarsal bone. The arthroplasty implant may include a spacer configured to maintain separation between the distal articular surface and an articular surface of an adjacent phalanx bone. The arthroplasty implant may include: a body having a joint-facing articular surface and a convex posterior surface configured to engage the distal articular surface by way of a bone pocket formed within the distal articular surface; an edge between the joint-facing articular surface and the convex posterior surface; and a connector configured to engage with the tether and secure the arthroplasty implant to the tether. 9 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 One general aspect of the present disclosure can include an arthroplasty implant configured to engage a distal articular surface of a metatarsal bone; a bone anchor secured to the metatarsal bone away from the distal articular surface, and a tether configured to couple the arthroplasty implant and the bone anchor. 8 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 Implementations may include one or more of the following features. The system in which the transosseous coupler applies tension on the implant, where the tension holds the joint-facing articular surface in place on a distal end of the bone. A first diameter of the joint-facing articular surface is smaller than a second diameter of the natural articular surface of the bone. A first diameter of the joint-facing articular surface is greater than a width of an osteochondral lesion (OCL) of the natural articular surface and smaller than a second diameter of the natural articular surface of the bone. The system may include an implant that may include a body having a joint-facing articular surface, a convex posterior surface, and an edge between the joint-facing articular surface and the convex posterior surface. The bone tunnel may include a distal end and a proximal end and the proximal end exits between a distal end of the bone and a proximal end of the bone; and the distal end of the bone tunnel exits within a bone pocket that extends proximally from the natural articular surface into the bone. The implant may be coupled to the bone anchor by a transosseous coupler. A body of the implant may seat within the bone pocket with the edge extending above the natural articular surface of the bone. The joint-facing articular surface may be convex and a top of the joint-facing articular surface may be congruent with cartilage around the implant. The joint-facing articular surface may be convex with the edge being circular. The convex posterior surface may have an implant radius greater than a bone radius of the bone pocket. The transosseous coupler may include a tether configured to engage with a first connector coupled to the implant and configured to engage with a second connector coupled to the bone anchor. 7 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 The various apparatus, devices, systems, and/or methods of the present disclosure have been developed in response to the present state of the art, and in particular, in response to the problems and needs in the art that have not yet been fully solved by currently arthroplasty and/or implants. One general aspect of the present disclosure can include an implant having a joint-facing articular surface configured to replace at least part of a natural articular surface of a bone adjacent to a joint, and a transosseous coupler. The system may include a bone anchor configured to reside proximate another surface of the bone. The bone anchor can be separated from the natural articular surface by a bone tunnel. The system may include a transosseous coupler configured to couple the implant to the bone anchor and the bone anchor may be configured to couple the transosseous coupler to the bone such that the transosseous coupler retains the implant in place on the natural articular surface of the bone. 6 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 Accordingly, a need exists for an improved joint implant apparatus, system, and method that removes minimal bone material, mechanically secures the implant, secures the implant with an adjustable level of tension, enables natural movement of the joint, and provides adjunctive fixation. 5 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 However, these procedures, devices, and/or system have limitations. For example, certain procedures may remove a high percentage of bone of an articular surface of the joint. Other procedures may fuse the joint which may address pain but can limit mobility and activity of the patient. Other procedures and/or prosthesis may be prone to periprosthetic fractures and/or prosthetic dislocation. 4 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 The medical industry uses a variety of procedures to address these conditions, including: various osteotomy procedures, joint fusion procedures, fracture fixation procedures, joint resurfacing procedures, implants, joint spacers, and the like. Such procedures can be performed throughout the body and on various joints of the body. 3 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 FIG. 12 is a cross-section view of an implant according to one embodiment. 33 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 FIG. 1 is a perspective view of foot joint illustrating an implant system 100 according to one embodiment. The implant system 100 can be used on a variety of joints within the body of a patient. "Joint" or "Articulation" refers to the connection made between bones in a human or animal body which link the skeletal system to form a functional whole. Joints may be biomechanically classified as a simple joint, a compound joint, or a complex joint. Joints may be classified anatomically into groups such as joints of hand, elbow joints, wrist joints, axillary joints, sternoclavicular joints, vertebral articulations, temporomandibular joints, sacroiliac joints, hip joints, knee joints, articulations of foot, and the like. (Search "joint" on Wikipedia.com Dec. 19, 2021. CC-BY-SA 3.0 Modified. Accessed Jan 20, 2022.) 52 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 The present disclosure discloses an improved joint implant apparatus, system, and method that removes minimal bone material, mechanically secures the implant, secures the implant with an adjustable level of tension, enables or maintains more natural movement of the joint, and provides adjunctive fixation. 51 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 Various conditions may adversely affect skeletal joints such as the injury, disease, deterioration, elongation, shortening, or rupture of soft tissues, cartilage, and/or bone associated with the joint and consequent laxity, pain, loss of movement, and/or deformity. As mentioned, a variety of procedures can be used to address these conditions, including: various osteotomy procedures, joint fusion procedures, fracture fixation procedures, joint resurfacing procedures, implants, joint spacers, and the like. Such procedures can be performed throughout the body and on various joints of the body. 49 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 Orthopedic implants can be used to treat bone fractures, osteoarthritis, scoliosis, spinal stenosis, discomfort, and pain. Examples of orthopedic implants include, but are not limited to, a wide variety of pins, rods, screws, anchors, spacers, sutures, all-suture implants, ball all-suture implants, self-locking suture implants, cross-threaded suture implants, plates used to anchor fractured bones while the bones heal or fuse together, and the like. (Search "implant (medicine)" on Wikipedia.com May 26, 2021. CC-BY-SA 3.0 Modified. Accessed June 30, 2021.) 45 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 In some cases implants contain electronics, e.g. artificial pacemaker and cochlear implants. Some implants are bioactive, such as subcutaneous drug delivery devices in the form of implantable pills or drug-eluting stents. Orthopedic implants may be used to alleviate issues with bones and/or joints of a patient's body. 44 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 As used herein, "implant" refers to a medical device manufactured to replace a missing biological structure, support a damaged biological structure, or enhance an existing biological structure. Often medical implants are man-made devices, but implants can also be natural occurring structures. The surface of implants that contact the body may be made of, or include a biomedical material such as titanium, cobalt chrome, stainless steel, carbon fiber, another metallic alloy, silicone, polymer, Synthetic polyvinyl alcohol (PVA) hydrogels, biomaterials, biocompatible polymers such as PolyEther Ether Ketone (PEEK) or a polylactide polymer (e.g. PLLA) and/or others, or apatite, or any combination of these depending on what is functional and/or economical. Implants can have a variety of configurations and can be wholly, partially, and/or include a number of components that are flexible, semiflexible, pliable, elastic, supple, semi-rigid, or rigid. 43 Added by DJM 2 2022 2/5/22, 12:00 AM
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VIL-12 As used herein, "preoperative" or "PRE-OP" refers to any activity, method, feature, or aspect performed before a surgical procedure. As used herein, "intraoperative" or "INTRA-OP" refers to any activity, method, feature, or aspect performed during a surgical procedure. As used herein, a "fixation" or “fixation device” refers to an apparatus, instrument, structure, device, component, member, system, assembly, step, process, or module structured, organized, configured, designed, arranged, or engineered to connect two structures either permanently or temporarily. The two structures may be one or the other or both of man-made and/or biological tissues, hard tissues such as bones, teeth or the like, soft tissues such as ligament, cartilage, tendon, or the like. In certain embodiments, fixation is used as an adjective to describe a device or component or step in securing two structures such that the structures remain connected to each other in a desired position and/or orientation. Fixation devices can also serve to maintain a desired level of tension, compression, or redistribute load and stresses experienced by the two structures and can serve to reduce relative motion of one part relative to others. Examples of fixation devices are many and include both those for external fixation as well as those for internal fixation and include, but are not limited to pins, wires, Kirschner wires (K-wires), screws, anchors, bone anchors, plates, bone plates, intramedullary nails or rods or pins, implants, interbody cages, fusion cages, and the like. 40 Added by DJM 2 2022 2/5/22, 12:00 AM

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