Orthopedic implants

Abstract

Apparatus and methods are described, including an orthopedic implant for implanting in an anatomical site. The implant comprises a front end, a rear end, a top, a bottom, a right side, and a left side. A distance between the top and the bottom is (a) greater at a first location at one of the sides than at a second location opposite the first location at the other one of the sides, and (b) greater at a third location at the front end than at a fourth location opposite the third location at the rear end. The implant is shaped to define one or more passageways passing through the implant. Other applications are also described.

1 . An apparatus for implanting in an anatomical site, the apparatus comprising:
 an orthopedic implant, comprising:
 a front end, 
 a rear end, 
 a top, 
 a bottom, 
 a right side, and 
 a left side, 
 a distance between the top and the bottom being (a) greater at a first location at one of the sides than at a second location opposite the first location at the other one of the sides, and (b) greater at a third location at the front end than at a fourth location opposite the third location at the rear end, 
 the implant being shaped to define one or more passageways passing through the implant. 
   
     
     
         2 . The apparatus according to  claim 1 , wherein at least one of the passageways passes from the top to the bottom. 
     
     
         3 . The apparatus according to  claim 1 , wherein the distance between the top and the bottom is at least 0.5% greater at the first location than at the second location. 
     
     
         4 . The apparatus according to  claim 1 , wherein the distance between the top and the bottom is at least 0.5% greater at the third location than at the fourth location. 
     
     
         5 . The apparatus according to  claim 1 , wherein the distance between the top and the bottom is greater at the first location than at the second location along at least 80% of one of the sides. 
     
     
         6 . The apparatus according to  claim 1 , wherein the distance between the top and the bottom is greater at the third location than at the fourth location along at least 80% of the front end. 
     
     
         7 . The apparatus according to  claim 1 , wherein a distance between the sides is greater at the front end than at the rear end. 
     
     
         8 . The apparatus according to  claim 1 , wherein at least one of the passageways has (a) an opening at the top, an edge of the opening that is on the top completely surrounding the opening at the top, and (b) an opening at the bottom, an edge of the opening that is on the bottom completely surrounding the opening at the bottom. 
     
     
         9 . The apparatus according to  claim 1 , wherein at least one of the passageways has (a) an opening at the top, an edge of the opening that is on the top not completely surrounding the opening at the top, and (b) an opening at the bottom, an edge of the opening that is on the bottom not completely surrounding the opening at the bottom. 
     
     
         10 . The apparatus according to  claim 1 , wherein at least 80% of a portion of the implant selected from the group consisting of: the front end, the rear end, the top, the bottom, the right side, and the left side is shaped to define openings to at least some of the passageways. 
     
     
         11 . The apparatus according to  claim 10 , wherein at least 90% of the selected portion is shaped to define openings to at least some of the passageways. 
     
     
         12 . The apparatus according to  claim 1 , wherein the implant is shaped to define at least 5 passageways. 
     
     
         13 . The apparatus according to  claim 1  wherein the implant is shaped to define at least 10 passageways. 
     
     
         14 . The apparatus according to  claim 1 , further comprising a connection interface that facilitates a connection of the implant to a tool. 
     
     
         15 . The apparatus according to  claim 14 , wherein the connection interface is shaped to define a threaded hole. 
     
     
         16 . The apparatus according to  claim 14 , wherein the connection interface is front-facing. 
     
     
         17 . The apparatus according to  claim 1 , wherein the distance between the top and the bottom is at least 0.5 mm greater at the first location than at the second location. 
     
     
         18 . The apparatus according to  claim 17 , wherein the distance between the top and the bottom is at least 2.5 mm greater at the first location than at the second location. 
     
     
         19 . The apparatus according to  claim 1 , further comprising a bone graft material. 
     
     
         20 . The apparatus according to  claim 19 , wherein the bone graft material is disposed within the passageways. 
     
     
         21 . The apparatus according to  claim 1 , wherein the implant consists of a metal. 
     
     
         22 . The apparatus according to  claim 1 , wherein the implant consists of a plastic. 
     
     
         23 . The apparatus according to  claim 1 , wherein the implant consists of bone graft material. 
     
     
         24 . An apparatus for implanting in an anatomical site, the apparatus comprising:
 an orthopedic implant, comprising:
 a front end, 
 a rear end, 
 a top, 
 a bottom, 
 a right side, and 
 a left side, 
 a distance between the top and the bottom being greater at a first location at one of the sides than at a second location opposite the first location at the other one of the sides, along at least 80% of one of the sides, 
 the implant being shaped to define one or more passageways passing through the implant; and 
 a front-facing connection interface that facilitates a connection of the implant to a tool. 
   
     
     
         25 . A method for operating on a subject, the method comprising:
 providing an orthopedic implant; and   by inserting, along an axis of insertion, the orthopedic implant into an anatomical site, changing an angular orientation of a first portion of bone with respect to a second portion of bone by rotating the first portion of bone about (a) the axis of insertion, and (b) an axis that is perpendicular to the axis of insertion.   
     
     
         26 . The method according to  claim 25 , further comprising, by inserting the implant into the site, increasing a distance of the first portion of bone from the second portion of bone. 
     
     
         27 . The method according to  claim 25 , wherein inserting the orthopedic implant into the anatomical site comprises inserting the orthopedic implant into an anatomical site that is surrounded at least in part by one or more bones. 
     
     
         28 . The method according to  claim 25 , further comprising creating an osteotomy at the anatomical site prior to inserting the orthopedic implant into the anatomical site. 
     
     
         29 . The method according to  claim 25 , wherein the anatomical site is a space between a first vertebra and a second vertebra of the subject,
 wherein the first portion of bone is the first vertebra,   wherein the second portion of bone is the second vertebra, and   wherein the method further comprises increasing a distance between the first and second vertebra, and changing an angular orientation of the first vertebra with respect to the second vertebra, by inserting the implant.   
     
     
         30 . The method according to  claim 29 , further comprising, before inserting the implant, enlarging the space. 
     
     
         31 . The method according to  claim 25 , further comprising inserting a bone graft material into the anatomical site. 
     
     
         32 . The method according to  claim 31 , wherein inserting the bone graft material comprises inserting bone graft material that is coupled to the implant. 
     
     
         33 . The method according to  claim 25 ,
 wherein the anatomical site is an osteotomy within a metatarsal bone of the subject,   wherein the first portion of bone is a first portion of the metatarsal bone,   wherein the second portion of bone is a second portion of the metatarsal bone, and   wherein the method comprises changing an angular orientation of the first portion of the metatarsal bone with respect to the second portion of the metatarsal bone by inserting the implant.   
     
     
         34 . The method according to  claim 25 ,
 wherein the anatomical site is an osteotomy within a tibia of the subject,   wherein the first portion of bone is a first portion of the tibia,   wherein the second portion of bone is a second portion of the tibia that is more distal than the first portion of the tibia, and   wherein the method further comprises changing an angular orientation of the first portion of the tibia with respect to the second portion of the tibia by inserting the implant.   
     
     
         35 . A method for operating on a subject, the method comprising:
 creating an osteotomy in a tibia of the subject; and   by inserting, along an axis of insertion, an orthopedic implant into the osteotomy:
 changing an angular orientation of a patella of the subject with respect to a trochlea of a femur of the subject by rotating the patella about the axis of insertion, by:
 changing an angular orientation of a tuberosity of the tibia of the subject with respect to another portion of the tibia by rotating the tuberosity of the tibia about the axis of insertion, and 
 increasing a distance of the patella from the trochlea by pivoting the tuberosity of the tibia with respect to a point of contact between the tuberosity of the tibia and another portion of the tibia. 
 
   
     
     
         36 . The method according to  claim 35 , further comprising inserting a bone graft material into the anatomical site. 
     
     
         37 . The method according to  claim 36 , wherein inserting the bone graft material comprises inserting bone graft material that is coupled to the implant. 
     
     
         38 . A method for operating on a subject, the method comprising:
 creating an osteotomy in a tibia of the subject; and   by inserting, along an axis of insertion, an orthopedic implant into the osteotomy, bone graft material being coupled to the implant:
 rotating a patella of the subject, via a patellar tendon of the subject, about the axis of insertion, by rotating a tuberosity of the tibia of the subject about the axis of insertion, and 
 increasing a distance of the patella from a trochlea of a femur of the subject, via the patellar tendon of the subject, by pivoting the tuberosity of the tibia with respect to a point of contact between the tuberosity of the tibia and another portion of the tibia.