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Delete 		VIL-12 In certain embodiments, FIG. 9 illustrates the bones of a joint after preparatory steps in a system, and/or method of one embodiment of the present disclosure. At the phase illustrated the metatarsal bone 816 includes a bone tunnel 862 and bone pocket 864, each sized, positioned, and/or configured for deployment of members of the arthroplasty implant system 800, as one example. 109 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The bone tunnel 862 may extend from the bone pocket 864 at an angle. The length of the bone tunnel 862 and/or angle of the bone tunnel 862 within the bone pocket 864 may depend on a variety of factors including but not limited to, the size and location of the OCL 350, the desired exit point for the proximal end 866 of the bone tunnel 862, the size and depth of the bone pocket 864, characteristics of the patient, and the like. The angle for the bone tunnel 862 may be measured relative to a long axis 870 of the metatarsal bone 816. The angle may range from about negative 85 degrees and about positive 85 degrees. 108 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The body 510 may resemble a button or plug. In one embodiment, the body 510 has a circular cross section. The body 510 may include a joint-facing articular surface 512 and a posterior surface 514. The joint-facing articular surface 512 is a part of the implant 500 that generally faces the joint. The joint-facing articular surface 512 may be convex and meet the posterior surface 514 at the edge 520. The convex shape of the joint-facing articular surface 512 may be configured to simulate or emulate the shape and contour of a natural articular surface 260 of a joint. Furthermore, the convex shape may distribute loading during use of the joint from an apex 516 of the joint-facing articular surface 512 down and out towards the edge 520. 79 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 A bone pocket 864 is a type of opening or recess. A bone pocket 864 may be defined as a recess having a larger diameter than a bone tunnel 862. The bone pocket 864 may extend proximally from the natural articular surface 260 into the bone. 106 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The metatarsal bone 816 includes a bone tunnel 862 and a bone pocket 864. The bone tunnel 862 may be similar to the bone tunnel 340 described herein. In one embodiment, the bone tunnel 862 is cylindrical. The bone tunnel 862 may include a proximal end 866 (also referred to as a proximal opening) and a distal end 868. In one embodiment, the proximal end 866 exits between a distal end 190 and a proximal end 180 of a bone. In the illustrated embodiment, the proximal end 866 may exit near a dorsal surface 210 of a metatarsal bone 816. In certain embodiments, the distal end 868 may exit directly at, or onto, a distal articular surface 860 (e.g., a natural articular surface 260) of the metatarsal bone 816. In another embodiment, the distal end 868 may exit indirectly at, or onto, a distal articular surface 860 (e.g., a natural articular surface 260) by way of a bone pocket 864 formed in the distal articular surface 860 (e.g., a natural articular surface 260) of the metatarsal bone 816. The distal end 868 may exit within the bone pocket 864. The bone tunnel 862 may be formed using a surgical drill and drill bit. The length and diameter of the bone tunnel 862 can vary and may be similar to that of the bone tunnel 340. 105 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 FIG. 9 is a cross-section view of a distal end 190 of a metatarsal bone 816 according to one apparatus, system, and/or method of one embodiment of the present disclosure. FIG. 9 illustrates the metatarsal bone 816 and the first proximal phalanx 130 before components of the apparatus, system, or assembly of the present disclosure are deployed. 104 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The tether 840 includes a proximal end 842 and a distal end 844. In one embodiment, the proximal end 842 can be connected, coupled, joined, tied, or otherwise engaged with the bone anchor 820 and/or bone of a patient. The distal end 844 can be connected, coupled, joined, tied, or otherwise engaged with the arthroplasty implant 810. In one embodiment, the distal end 844 may be tied to the connector 530 by passing the distal end 844 through the opening 534 and tying a knot near the distal end 844. In another embodiment, the distal end 844 may be passed through the connector 530 (e.g., through the opening 534 and positioned near the proximal end 842 such that a loop engages the connector 530. In such an embodiment, the proximal end 842 and distal end 844 may both be connected, coupled, joined, tied, or otherwise engaged with the bone anchor 820. In certain embodiments, the tether 840 is flexible and can be stretched when tension is applied to tether 840, for example, to the proximal end 842 and distal end 844 of the tether 840. 103 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The tether 840 is configured to couple the arthroplasty implant 810 to the bone anchor 820. In certain embodiments, the tether 840 may couple the arthroplasty implant 810 to a bone. The term “tether” is used herein to mean any strand or flexible member, natural or synthetic, able to join or connect or couple two structures. In one embodiment, a tether can join tissue of a patient and/or to be anchored in a bone tunnel or to hard tissue and useful in a surgical procedure. A tether may join two structures either directly by connecting directly to one structure or directly to the other or indirectly by connecting indirectly (by way of one or more intermediary structures) to one structure, to the other structure, or to both structures. In certain embodiments, “tether” refers to a flexible line or flexible member of natural material, natural biological material, biomaterial, biomimetic materials, manmade material, or a combination of these either in a single tether, a composite tether, or a plurality of tissue tethers that extend in parallel and/or may be woven or bonded together. In certain embodiments, a tether may be long and thin. In certain embodiments, a tether may be planar and/or may be elastic or inelastic (rigid). Examples of a tether include, but are not limited to, a thread, a string, a polymer thread or line, a suture, suture tape, a woven tether, a fibrous material, a cord, and/or any of these in combination with each other, and the like. 102 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The opening 826 may be configured to receive the tether locking feature 832 within the opening 826 and retain the tether locking feature 832 within the opening 826. In one embodiment, the tether locking feature 832 and/or the opening 826 may be configured to engage with each other such that the tether locking feature 832 can sit within the opening 826 of a cylindrical body 822. For example, the tether locking feature 832 and opening 826 may each have a polygon cross section sized for a slip fit between the tether locking feature 832 and the opening 826. In certain embodiments, the tether locking feature 832 and opening 826 of the body 822 may cooperate to implement a line-lock device. Alternatively, or in addition, the tether locking feature 832 alone may implement the line-lock device. The tether locking feature 832 is configured to couple a proximal end of the tether 840 to the bone anchor 820. 101 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 In one embodiment, the tether locking feature 832 is configured to implement line-lock device, either independently, or together with the body 822. A line-lock device is a technology and/or apparatus that permits a suture, line, and/or tether to slide past the line-lock device in one direction, but the suture, line, and/or tether is impeded or restricted or locked from sliding past the line-lock device in another direction. To use the line-lock device, one end of a suture, line, and/or tether, such as tether 840 can be threaded through the line-lock device in one direction and as the tether 840 moves through the line-lock device the tether 840 is prevented from moving out of the line-lock device in the opposite direction. In this manner, a user can tighten the tether 840 using the tether locking feature 832 and/or body 822 and the tether 840 remains tight and/or taut. 100 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The bone anchor 820 may also include a tether locking feature 832. As used herein, a "lock" or "lock mechanism" refers to an object, member, structure, component, part, apparatus, system, or assembly that either alone or in combination with other parts or components prevents, limits, impedes, is in a fixed relationship to, stops, or restricts motion or movement and/or operation of the another object, member, structure, component, part, apparatus, system, or assembly. 99 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		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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Delete 		VIL-12 In one embodiment, the implant 310 includes a joint-facing articular surface 312. A joint-facing articular surface 312 is a surface that faces a joint, such as MTP joint 250. The joint-facing articular surface 312 can replace at least part of a natural articular surface of a bone adjacent to a joint. For example, in FIG. 1, the joint-facing articular surface 312 may replace at least part of the natural articular surface 260 of the first metatarsal 110 in an MTP joint 250. Of course, the implant 310 may be deployed on any articular surface of a joint of the patient. In certain embodiments, the joint-facing articular surface 312 is a smooth surface that minimizes friction between the joint-facing articular surface 312 and other articular surfaces of a joint. The size of the joint-facing articular surface 312 may vary according to the needs of the patient. In certain embodiments, the joint-facing articular surface 312 is sized to be just larger in diameter than a lesion or other area of the natural articular surface 260 being replaced. In other embodiments, the joint-facing articular surface 312 is as large in diameter or greater in diameter than the natural articular surface 260. 59 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The implant 310 serves to provide a structure that can be used to replace at least a portion of a natural articular surface of a bone (i.e., natural articular surface 260). The implant 310 can have a variety of shapes, come in different sizes, be made of different materials or combinations of materials (i.e., composites or alloys), and/or a variety of different designs. 58 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 FIG. 2 is a perspective view of a system 300 for use on a foot joint according to one embodiment. The system 300 includes an implant 310, a transosseous coupler 320, and a bone anchor 330. 57 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The MTP joint 250 includes an articular surface of the first metatarsal 110, an articular surface of the first proximal phalanx 130, and one or more layers of cartilage (not shown). In certain embodiments, the articular surface of the first metatarsal 110 is a natural articular surface 260 and the articular surface of the first proximal phalanx 130 is also a natural articular surface 270. Of course either surface (260, 270) or both surfaces (260, 270) can be artificial articular surfaces. "Articular surface" refers to a surface of a structure that is coupled to, and may cooperate with, other structures of a joint of a human or animal to enable movement of structures of the joint. A natural articular surface is an articular surface created as part of natural, or human facilitated, cellular growth and development of bones of a patient. 56 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 For sake of clarity, while embodiments can be used on other joints of a patient, this disclosure will describe embodiments with respect to the metatarsophalangeal (MTP) joint. Those of skill in the art will appreciate that embodiments within the scope of the present disclosure will not and are not limited to those use and implementation in the MTP joint alone and that embodiments of the disclosed solution can be used in one or more other joints of a patient. The metatarsophalangeal (MTP) joint is a joint between a metatarsal and a proximal phalangeal bone (phalanx) of a toe of the foot. More specifically, this disclosure will focus on exemplary embodiments that can be used on the MTP joint 250 between the first metatarsal 110 and the first proximal phalanx 130. 55 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 The first metatarsal 110 includes a proximal end 180 (also referred to as a base), a distal end 190 (also referred to as a head), and a body 200 that connects the proximal end 180 and the distal end 190. The body 200 includes a dorsal surface 210, a plantar surface 220, a medial surface 230, and a lateral surface 240. 54 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		VIL-12 FIG. 1 illustrates one exemplary embodiment of an implant system 100 that can be used with one or more joints of the foot. The foot includes a number of joints and a number of bones, not all of the bones and joints are described herein to provide clarity for the present disclosure. FIG. 1 illustrates a few of the bones and joints where an implant system 100 can be deployed. FIG. 1 illustrates a number of bones of a foot including a first metatarsal 110, other metatarsal bones 120, a first proximal phalanx 130, other proximal phalanges 140, intermediate phalanges 150, a first distal phalanx 160, and other distal phalanges 170. 53 Added by DJM 2 2022 2/5/22, 12:00 AM
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Delete 		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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