Systems for and methods of fusing a sacroiliac joint

• US 9,017,407 B2
• Filed: 09/19/2011
• Issued: 04/28/2015
• Est. Priority Date: 01/13/2010
• Status: Active Grant

• Current Assignee: JCBD, LLC
• Original Assignee: JCBD, LLC
• Inventors: Donner, Edward Jeffrey
• Primary Examiner(s): HOFFMAN, MARY C
• Application Number:
  US13/236,411
• Publication Number:
  US 20120095560A1
• Time in Patent Office: 1,317 Days
• Field of Search: 606 96- 98
• US Class Current: 623/17.11
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1626 Control means; Display units
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7043 with a longitudinal element fixed to one or more transverse elements which connect multiple screws or hooks
• CPC Class Codes: A61B 17/7055 connected to sacrum, pelvis or skull
• CPC Class Codes: A61B 17/7074 Tools specially adapted for spinal fixation operations other than for bone removal or filler handling A61B17/7062, A61B17/808, A61B17/8858 take precedence; for spinal image producing devices A61B90/36, A61B34/20; markers A61B90/39
• CPC Class Codes: A61B 17/8645 Headless screws, e.g. ligament interference screws
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61F 2/30988 Other joints not covered by any of the groups A61F2/32 - A61F2/4425
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30179 X-shaped
• CPC Class Codes: A61F 2002/30622 Implant for fusing a joint or bone material
• CPC Class Codes: A61F 2002/30995 for sacro-iliac joints
• CPC Class Codes: A61F 2002/4687 Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2310/00017 Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00179 Ceramics or ceramic-like structures
• CPC Class Codes: A61F 2310/00359 Bone or bony tissue

Abstract

One implementation of the present disclosure may take the form of a sacroiliac joint fusion system including a joint implant, an anchor element and a delivery tool. The join implant includes a distal end, a proximal end, a body extending between the proximal and distal ends, and a first bore extending non-parallel to a longitudinal axis of the body. The anchor element includes a distal end and a proximal end and is configured to be received in the first bore. The delivery tool includes an implant arm and an anchor arm. The implant arm includes a proximal end and a distal end. The distal end of the implant arm is configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant. The anchor arm includes a proximal end and a distal end. The distal end of the anchor arm is configured to engage the proximal end of the anchor element. The anchor arm is operably coupled to the implant arm in an arrangement such that the longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element. The arrangement is fixed and nonadjustable.

Claims

1. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, a first bore extending non-parallel to a longitudinal axis of the body, and a second bore generally coaxial with a center longitudinal axis of the joint implant, the second bore receiving a feature of the distal end of an implant arm when the distal end of the implant arm is releasably coupled to the proximal end of the joint implant;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

c) a delivery tool comprising;

i) the implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant;

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable, and

iii) an implant retainer that extends through the implant arm, a distal end of the implant retainer defining at least a portion of the feature of the distal end of the implant arm that is received in the second bore.

2. The system of claim 1, wherein at least a portion of the implant retainer is in the form of an elongated body that is at least one of longitudinally displaceable or rotationally displaceable within the implant arm in the course of the at least a portion of the feature of the distal end of the implant arm being received in the second bore so as to releasably couple with the proximal end of the joint implant.

3. The system of claim 1, wherein the anchor arm comprises a plurality of specific sized anchor arms, each specific sized anchor arm being configured to couple with the implant arm at a respective specific location, wherein when a specific sized anchor arm is coupled to the implant arm at the respective specific location on the implant arm, the specific sized anchor arm is operably coupled to the implant arm in a manner that results in the arrangement.

4. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, and a first bore extending non-parallel to a longitudinal axis of the body;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

c) a delivery tool comprising;

i) an implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant; and

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable;

iii) a handle coupled to a proximal end of the implant arm, a center longitudinal axis of the handle is substantially at least one of coaxial or parallel with a longitudinal axis of the implant arm; and

iv) an implant retainer that extends through the implant arm, a distal end of the implant retainer defining at least a portion of a feature of the distal end of the implant arm that is received in the second bore, wherein the handle is coupled to the implant retainer such that the handle and implant retainer can rotate relative to the implant arm.

5. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, and a first bore extending non-parallel to a longitudinal axis of the body;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

c) a delivery tool comprising;

i) an implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the Point implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant; and

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable; and

iii) a handle coupled to a proximal end of the implant arm via a spring-biased retaining ball and groove interlocking arrangement, a center longitudinal axis of the handle is substantially at least one of coaxial or parallel with a longitudinal axis of the implant arm.

6. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, a first bore extending non-parallel to a longitudinal axis of the body, at least one pair of planar members radially extending from the body of the joint implant, and a guide member cantilevered off of the body of the joint implant and including a guide hole coaxially aligned with the first bore of the joint implant;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

c) a delivery tool comprising;

i) an implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant; and

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable.

7. The system of claim 6, wherein the guide member includes an anchor element retaining feature.

8. The system of claim 7, wherein the anchor element retaining feature includes a series of arcuate members that are configured to bias against the anchor element when the anchor element is extended through the guide hole and first bore.

9. The system of claim 7, wherein the anchor element retaining feature includes an arm defined in the guide member and configured to bias against the anchor element when the anchor element is extended through the guide hole and first bore.

10. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, a first bore extending non-parallel to a longitudinal axis of the body, and first, second, third and fourth radially extending members, wherein each of the radially extending members extends lengthwise along the joint implant, the first and second radially extending members are substantially coplanar with each other, and the third and fourth radially extending members are substantially coplanar with each other and generally perpendicular to the first and second radially extending members;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

c) a delivery tool comprising;

i) an implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant; and

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable.

11. The system of claim 10, wherein the first and second radially extending members extend over a wider radial extent than the third and fourth radially extending members.

12. A system for fusing a sacroiliac joint including a sacrum and an ilium, the system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, and a first bore extending non-parallel to a longitudinal axis of the body of the joint implant;

b) an anchor element configured to be received in the first bore; and

c) a delivery tool comprising;

i) an implant arm configured to releasably couple to the joint implant; and

ii) an anchor arm coupled to the implant arm and configured to deliver the anchor element to the first bore,

wherein a final manufactured configuration of the tool and a final manufactured configuration of the joint implant are such that, when the system is assembled such that the implant arm is releasably coupled to the joint implant, a delivery arrangement automatically exists such that the anchor arm is correctly oriented to deliver the anchor element to the first bore.

13. The system of claim 12, wherein the delivery tool further includes a handle coupled to a proximal end of the implant arm, and a center longitudinal axis of the handle is substantially at least one of coaxial or parallel with a longitudinal axis of the implant arm.

14. The system of claim 12, wherein the joint implant further comprises at least one pair of planar members radially extending from the body of the joint implant.

15. The system of claim 12, wherein the first bore extends substantially transverse to the longitudinal axis of the body of the implant.

16. The system of claim 12, wherein in being coupled together, the implant arm and anchor arm form an angle relative to each other, and the angle is non-adjustable.

17. The system of claim 16, wherein the anchor arm is specific sized anchor arms, each specific sized anchor arm being configured to couple with the implant arm at a respective specific location, wherein when a specific sized anchor arm is coupled to the implant arm at the respective specific location on the implant arm, the angle is the same regardless of which specific sized anchor arm is coupled to the implant arm.

18. The system of claim 12, wherein in being coupled together, the implant arm and anchor arm intersect at an angle, and the angle is non-adjustable.

19. The system of claim 12, wherein the joint implant further comprises a second bore generally extending distally from the proximal end of the joint implant, the second bore receiving a feature of a distal end of the implant arm when the distal end of the implant arm is releasably coupled to the proximal end of the joint implant, wherein the feature of the distal end of the implant arm actively retains the joint implant when releasably coupled and is configured to actively release the joint implant when actuated by the delivery tool.

20. The system of claim 19, wherein the delivery tool further includes an implant retainer including a distal end defining at least a portion of the feature of the distal end of the implant arm that is received in the second bore, wherein the implant retainer is configured to decouple with the second bore via movement of the implant retainer relative to a shaft of the implant arm.

21. The system of claim 20, wherein the movement of the implant retainer is rotational movement.

22. The system of claim 20, wherein the movement of the implant retainer is longitudinal displacement.

23. The system of claim 19, wherein the delivery tool further includes an implant retainer including a distal end defining at least a portion of the feature of the distal end of the implant arm that is received in the second bore, wherein the implant retainer is configured to decouple from the second bore via a separating force applied only to the implant retainer.

24. The system of claim 23, wherein the separating force is rotational movement of the implant retainer relative to a shaft of the implant arm.

25. The system of claim 23, wherein the separating force is longitudinal displacement of the implant retainer relative to a shaft of the implant arm.

26. The system as in any of claim 12 or 19, in which the body of the joint implant further comprises a top planar surface, a bottom planar surface opposite the top planar surface, a distal end member extending between the top and bottom planar surfaces and positioned distal of the first bore, a proximal end member extending between the top and bottom planar surfaces and positioned proximal of the first bore, and at least one planar member extending generally perpendicularly off of the distal and proximal end members.

27. The system of claim 26, wherein the body of the joint implant extends a length between the distal and proximal ends, and wherein the at least one planar member extends the length.

28. The system of claim 27, wherein the at least one planar member comprises a first planar member and a second planar member, wherein the first and the second planar members are generally parallel to each other.

29. The system of claim 28, wherein the first bore extends between the first and the second planar members.

30. The system of claim 28, wherein the first planar member and the second planar member are generally coplanar.

31. The system of claim 26, wherein the top planar surface includes a width that is greater than a thickness between opposite side surfaces of the distal and proximal end members, wherein the width and the thickness are defined generally perpendicular to the longitudinal axis of the body of the joint implant.

32. The system of claim 31, wherein a junction of the top planar surface and the opposite side surfaces includes a sloped transition.

33. The system of claim 32, wherein the sloped transition includes an outward flaring of the opposite side surfaces.

34. The system of claim 26, wherein the distal and proximal end members include opposite side surfaces, and wherein the top planar surface includes a pair of top side edges that extend lengthwise along the body of the joint implant and define a juncture of the top planar surface and the opposite side surfaces, wherein a width between the pair of top side edges is greater than a thickness between the opposite side surfaces.

35. The system of claim 34, wherein the juncture includes a sloped transition.

36. The system of claim 35, wherein the sloped transition includes an outward flaring of the opposite side surfaces.

37. The system as in any of claim 12 or 19, in which the body of the joint implant further comprises a first surface, a second surface generally opposite the first surface, the first and second surfaces extending a length between the distal and proximal ends, and a first outwardly projecting member extending outwardly from the first surface, the first outwardly projecting member extending a portion of the length of the body of the joint implant and including a third surface, a fourth surface generally opposite the third surface, and a first thickness defined between the third and fourth surfaces, the third and the fourth surfaces outwardly extending a first height from the first surface.

38. The system of claim 37, wherein the first thickness is variable along the first height.

39. The system of claim 38, wherein the first thickness is least at an outward edge of the first outwardly projecting member.

40. The system of claim 38, wherein the first thickness is greatest at an outward edge of the first outwardly projecting member.

41. The system of claim 37, wherein the first thickness is different than a second thickness defined between the first and second surfaces.

42. The system of claim 41, wherein the first thickness is less than the second thickness.

43. The system of claim 41, wherein the first thickness is greater than the second thickness.

44. The system of claim 37, wherein the first height is variable along the portion of the length of the body of the joint implant.

45. The system of claim 44, wherein the first height tapers towards a distal tip of the body of the joint implant.

46. The system of claim 37, wherein the first outwardly projecting member extends the length of the body of the implant.

47. The system of claim 37, wherein:

the first and second surfaces are generally parallel;

the third and fourth surfaces are generally parallel; and

the first and second surfaces are generally perpendicular to the third and fourth surfaces.

48. The system of claim 37, further comprising a second outwardly projecting member extending outwardly from the second surface, the second outwardly projecting member extending a portion of the length of the body of the joint implant and including a fifth surface and a sixth surface generally opposite the fifth surface.

49. The system of claim 48, wherein the first and second outwardly projecting members are generally parallel to each other.

50. The system of claim 48, wherein the first and second outwardly projecting members are generally coplanar to each other.

51. The system of claim 37, further comprising a second outwardly projecting member extending outwardly from the second surface, the second outwardly projecting member extending a portion of the length of the body of the joint implant and including a fifth surface and a sixth surface generally opposite the fifth surface, the fifth and surfaces outwardly extending a second height from the second surface;

wherein, when implant in the sacoliac jiont, each of the first and second outwardly projecting members are oriented non-parallel to the joint plane of the sacroiliac joint so as to extend into one of the sacrum or the ilium.

52. The medical kit of claim 51, wherein a disposition of the second outwardly projecting member is a substantial a mirror of a disposition of the first outwardly projecting member when mirrored over a plane which extends along and is coincident with a longitudinal axis of the joint implant.

53. The system of claim 12, wherein the anchor arm comprises a first anchor arm guide configured to deliver the anchor element to the first bore according to the delivery arrangement, and wherein the anchor arm comprises a second anchor arm guide configured to deliver another anchor element adjacent the joint implant and not in the bore of the joint implant in another delivery arrangement that automatically exists such that the second anchor arm guide is correctly oriented to deliver the another anchor element adjacent the joint implant and not in the bore of the joint implant when the system is assembled such that the implant arm is releasably coupled to the joint implant.

54. The system of claim 12, wherein the joint implant further comprises a guide member cantilevered off of the body of the joint implant, the guide member including a guide hole aligned with the bore of the joint implant such that the delivery arrangement includes correctly orienting the anchor element with both the implant bore and the guide hole such that the anchor is to be delivered to both the bore of the joint implant and the guide hole.

55. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, a first bore extending non-parallel to a longitudinal axis of the body, and a second bore generally coaxial with a center longitudinal axis of the joint implant, the second bore receiving a feature of the distal end of an implant arm when the distal end of the implant arm is releasably coupled to the proximal end of the joint implant;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

c) a delivery tool comprising;

i) the implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant, wherein the feature of the distal end of the implant arm actively retains the joint implant when releasably coupled and is configured to actively release the joint implant when actuated by the delivery tool; and

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable.

56. The system of claim 55, wherein the delivery tool further includes an implant retainer including a distal end defining at least a portion of the feature of the distal end of the implant arm that is received in the second bore, wherein the implant retainer is configured to decouple with the second bore via movement of the implant retainer relative to a shaft of the implant arm.

57. The system of claim 56, wherein the movement of the implant retainer is rotational movement.

58. The system of claim 56, wherein the movement of the implant retainer is longitudinal displacement.

59. The system of claim 55, wherein the delivery tool further includes an implant retainer including a distal end defining at least a portion of the feature of the distal end of the implant arm that is received in the second bore, wherein the implant retainer is configured to decouple from the second bore via a separating force applied only to the implant retainer.

60. The system of claim 59, wherein the separating force is rotational movement of the implant retainer relative to a shaft of the implant arm.

61. The system of claim 59, wherein the separating force is longitudinal displacement of the implant retainer relative to a shaft of the implant arm.

62. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, and a first bore extending non-parallel to a longitudinal axis of the body, the body of the joint implant further comprises a first surface, a second surface generally opposite the first surface, the first and second surfaces extending a length between the distal and proximal ends, and a first outwardly projecting member extending outwardly from the first surface, the first outwardly projecting member extending a portion of the length of the body of the joint implant and including a third surface, a fourth surface generally opposite the third surface, and a first thickness defined between the third and fourth surfaces, the third and the fourth surfaces outwardly extending a first height from the first surface;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

)

a delivery tool comprising;

i) an implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant; and

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable.

63. The system of claim 62, wherein the first thickness is variable along the first height.

64. The system of claim 63, wherein the first thickness is least at an outward edge of the first outwardly projecting member.

65. The system of claim 63, wherein the first thickness is greatest at an outward edge of the first outwardly projecting member.

66. The system of claim 65, wherein the first thickness is less than the second thickness.

67. The system of claim 65, wherein the first thickness is greater than the second thickness.

68. The system of claim 62, wherein the first thickness is different than a second thickness defined between the first and second surfaces.

69. The system of claim 62, wherein the first height is variable along the portion of the length of the body of the joint implant.

70. The system of claim 69, wherein the first height tapers towards a distal tip of the body of the joint implant.

71. The system of claim 62, wherein the first outwardly projecting member extends the length of the body of the implant.

72. The system of claim 62, wherein:

the first and second surfaces are generally parallel;

the third and fourth surfaces are generally parallel; and

the first and second surfaces are generally perpendicular to the third and fourth surfaces.

73. The system of claim 62, further comprising a second outwardly projecting member extending outwardly from the second surface, the second outwardly projecting member extending a portion of the length of the body of the joint implant and including a fifth surface and a sixth surface generally opposite the fifth surface.

74. The system of claim 73, wherein the first and second outwardly projecting members are generally parallel to each other.

75. The system of claim 73, wherein the first and second outwardly projecting members are generally coplanar to each other.

76. A medical kit for the fusion of a sacroiliac joint including a sacrum, an ilium, a caudal access region and a joint plane, the kit comprising:

a) a delivery tool comprising an anchor arm coupled to an implant arm, the anchor arm comprising a first anchor arm guide;

b) a joint implant comprising a bore defined therein that extends generally transverse to a longitudinal length of the joint implant; and

c) an anchor element configured to be received in the bore of the joint implant,

wherein the bore of the implant, the implant, the implant arm and the anchor arm have an as-manufactured configuration that limits the first anchor arm guide to properly align the anchor element in only a single orientation relative to the bore of the implant such that the anchor element is to be received in the bore of the implant when the implant is coupled to the implant arm.

77. The medical kit of claim 76, wherein the anchor element comprises a plurality of multiple anchor elements of different sizes.

78. The medical kit of claim 76, wherein the joint implant is multiple joint implants of different sizes, each of the multiple joint implants having the as-manufactured configuration.

79. The medical kit of claim 76, further comprising sterile packaging.

80. The medical kit of claim 79, further comprising instructions directing:

1) the implant to be delivered into the sacroiliac joint via the caudal access region of the sacroiliac joint; and

     2) the anchor element to be driven generally transverse to the joint plane of the sacroiliac joint when the anchor element is caused to be received in the bore.

81. The medical kit of claim 80, wherein the instructions are at least one of provided with the sterile packaging, via an internet source, or via physician seminar.

82. The medical kit of claim 76, wherein the joint implant further comprises a second bore extending distally from a proximal end of the joint implant, the second bore receiving a feature of a distal end of the implant arm when the distal end of the implant arm is releasably coupled to the proximal end of the joint implant.

83. The medical kit of claim 82, wherein the delivery tool further includes an implant retainer that extends through the implant arm, a distal end of the implant retainer defining at least a portion of the feature of the distal end of the implant arm that is received in the second bore.

84. The medical kit of claim 83 wherein the feature of the distal end of the implant arm actively retains the joint implant when releasably coupled and is configured to actively release the joint implant when actuated by the delivery tool.

85. The medical kit of claim 84, wherein the implant retainer is configured to decouple with the second bore via movement of the implant retainer relative to a shaft of the implant arm.

86. The medical kit of claim 85, wherein the movement of the implant retainer is rotational movement.

87. The medical kit of claim 85, wherein the movement of the implant retainer is longitudinal displacement.

88. The medical kit of claim 76, wherein a body of the joint implant comprises a top planar surface, a bottom planar surface opposite the top planar surface, a distal end member extending between the top and bottom planar surfaces and positioned distal of the bore, a proximal end member extending between the top and bottom planar surfaces and positioned proximal of the bore, and at least one planar member extending generally perpendicularly off of the distal and proximal end members.

89. The medical kit of claim 88, wherein the body of the joint implant extends the longitudinal length of the joint implant between a distal end and a proximal end, and wherein the at least one planar member extends the longitudinal length.

90. The medical kit of claim 89, wherein the at least one planar member comprises a first planar member and a second planar member, wherein the second planar member is generally a mirrored copy of the first planar member and mirrored over a plane which extends along and is coincident with an implant longitudinal length.

91. The medical kit of claim 89, wherein the at least one planar member comprises a first planar member and a second planar member, wherein the first and the second planar members are generally parallel to each other.

92. The medical kit of claim 91, wherein the bore extends between the first and the second planar members.

93. The medical kit of claim 88, wherein the top planar surface includes a width that is greater than a thickness between opposite side surfaces of the distal and proximal end members, wherein the width and the thickness are defined generally perpendicular to the longitudinal length of the body of the joint implant.

94. The medical kit of claim 93, wherein a junction of the top planar surface and the opposite side surfaces includes a sloped transition.

95. The medical kit of claim 94, wherein the sloped transition includes an outward flaring of the opposite side surfaces.

96. The medical kit of claim 88, wherein the distal and proximal end members include opposite side surfaces, and wherein the top planar surface includes a pair of top side edges that extend lengthwise along the body of the joint implant and define a juncture of the top planar surface and the opposite side surfaces, wherein a width between the pair of top side edges is greater than a thickness between the opposite side surfaces.

97. The medical kit of claim 96, wherein the juncture includes a sloped transition.

98. The medical kit of claim 97, wherein the sloped transition includes an outward flaring of the opposite side surfaces.

99. The medical kit as in any of claim 76 or 88, in which the anchor arm comprises a plurality of specific sized anchor arms, each specific sized anchor arm being configured to couple with the implant arm at a respective specific location, wherein when a specific sized anchor arm is coupled to the implant arm at the respective specific location on the implant arm, the specific sized anchor arm is operably coupled to the implant arm in a manner that results in an arrangement such that the anchor is aligned to be received in the bore of the joint implant when the joint implant is coupled to the implant arm.

100. The medical kit of claim 99, wherein the joint implant is multiple joint implants of different sizes, each of the multiple joint implants having the as-manufactured configuration and result in the arrangement.

101. The medical kit of claim 99, wherein the joint implant is multiple joint implants of different configurations, each of the multiple joint implants having the as-manufactured configuration and result in the arrangement.

102. The medical kit of claim 101, wherein the different configurations include different angles of the bore relative to a longitudinal axis of the joint implant.

103. The medical kit as in any of claim 76 or 88, in which an interface arrangement between the joint implant and a distal end of the implant arm comprises a complementary configuration including a projection and a recess configured to receive the projection such that the joint implant is prevented from pivoting relative to the implant arm when the joint implant is coupled to the implant arm and an extreme distal face of the implant arm distal end abuts the implant.

104. The medical kit of claim 103, wherein a proximal end of the joint implant comprises an opening defining a passageway which extends distally and communicates with the bore of the joint implant, the opening and passageway configured to receive at least one of a) an injection of biocompatible material or b) a fastener, wherein the receipt of the fastener allows, interference with the anchor extending through the bore such that after implantation the fastener interfering with the anchor resists migration of the anchor.

105. The medical kit of claim 103, wherein the distal end of the implant arm corresponds with respect to both a size and shape of a portion of the joint implant which comprises a respective portion of the interface arrangement such that when the joint implant is supported off the implant arm respective outer surfaces of the joint implant and implant arm distal end transition smoothly moving from the joint implant to the implant arm distal end.

106. The medical kit of claim 103, wherein the joint implant further comprises a guide member cantilevered off of the joint implant and including a guide hole aligned with'"'"'the bore of the joint implant such that the as-manufactured configuration includes allowing the anchor element to align with both the implant bore and the guide hole such that the anchor is to be received in both the bore of the joint implant and the guide hole.

107. The medical kit of claim 103, wherein the anchor arm further comprises a second guide configured to deliver the anchor adjacent the joint implant and not through the bore.

108. The medical kit of claim 76, wherein the joint implant is multiple joint implants having different dispositions of the bore of the joint implant, each of the multiple joint implants having the as-manufactured configuration and wherein the medical kit further comprises a corresponding anchor arm guide which properly aligns the anchor relative to the bore such that the anchor is to be received in the bore of the joint implant when the implant is coupled to the implant arm,

109. The medical kit of claim 108, wherein the different dispositions of the bore comprise different angles defined between a longitudinal axis of the bore of the joint implant relative to a longitudinal axis of the joint implant extending along the longitudinal length of the joint implant.

110. The medical kit of claim 109, wherein the different angles of the bore of the joint implant comprise an angular difference defined in a reference plane that is coincident with and extending along the longitudinal axis of the joint implant.

111. The medical kit of claim 109, wherein the different angles of the implant bore comprise an angular difference defined in a reference plane that is normal to the longitudinal axis of the joint implant.

112. The medical kit of claim 109, wherein the different angles of the implant bore comprise an angular difference defined in a first reference plane that is normal to the longitudinal axis of the joint implant and in a second reference plane that is coincident with and extending along the longitudinal axis of the joint implant.

113. The medical kit of claim 108, wherein the different dispositions of the bore comprise different positions of the bore relative to a proximal most surface of the joint implant.

114. The medical kit as in any of claim 76 or 108, in which the joint implant further comprises a first surface, a second surface generally opposite the first surface, the first and second surfaces extending the longitudinal length between an implant distal end and an implant proximal end, and a first outwardly projecting member extending outwardly from the first surface, the first outwardly projecting member extending a portion of the longitudinal length and including a third surface, a fourth surface generally opposite the third surface, and a first thickness defined between the third and fourth surfaces, the third and the fourth surfaces outwardly extending a first height from the first surface.

115. The medical kit of claim 114, further comprising a second outwardly projecting member extending outwardly from the second surface, the second outwardly projecting member extending a portion of the longitudinal length of the joint implant and including a fifth surface and a sixth surface generally opposite the fifth surface, the fifth and the sixth surfaces outwardly extending a second height from the second surface.

116. The medical kit of claim 115, wherein a disposition of the second outwardly projecting member is a substantial mirror of a disposition of the first outwardly projecting member when mirrored over a plane which extends along and is coincident with the longitudinal length of the joint implant.

117. The medical kit of claim 115, wherein, when implanted in the sacroiliac joint, the first outwardly projecting member is oriented non-parallel to the joint plane of the sacroiliac joint so as to extend into one of the sacrum or the ilium.

118. The medical kit of claim 76, wherein the joint implant further comprises a guide member cantilevered off of the joint implant and including a guide hole aligned with the bore of the joint implant such that the as-manufactured configuration includes allowing the anchor element to align with both the implant bore and the guide hole such that the anchor is to be received in both the implant bore and the guide hole. and a sixth surface generally opposite the fifth surface, the fifth and the sixth surfaces outwardly extending a second height from the second surface;

wherein, when implanted in the sacroiliac joint, each of the first and second outwardly projecting members are oriented non-parallel to the joint plane of the sacroiliac joint so as to extend into one of the sacrum or the ilium.

119. The medical kit of claim 76, wherein the first anchor arm guide is a collar that is configured to guide a surgical tool in delivering the anchor element in the bore of the joint implant.

120. The medical kit of claim 91, wherein the first planar member and the second planar member are generally coplanar.

121. A sacroiliac joint fusion system comprising:

a) a joint implant comprising a distal end, a proximal end, a body extending between the proximal and distal ends, and a first bore extending non-parallel to a longitudinal axis of the body, the body of the joint implant further comprises a top planar surface, a bottom planar surface opposite the top planar surface, a distal end member extending between the top and bottom planar surfaces and positioned distal of the first bore, a proximal end member extending between the top and bottom planar surfaces and positioned proximal of the first bore, and at least one planar member extending generally perpendicularly off of the distal and proximal end members;

b) an anchor element comprising a distal end and a proximal end and being configured to be received in the first bore; and

c) delivery tool comprising;

i) an implant arm comprising a proximal end and a distal end, the distal end of the implant arm configured to releasably couple to the proximal end of the joint implant such that a longitudinal axis of the implant arm is substantially at least one of coaxial or parallel with the longitudinal axis of the body of the joint implant; and

ii) an anchor arm comprising a proximal end and a distal end, the distal end of the anchor arm configured to engage the proximal end of the anchor element, the anchor arm operably coupled to the implant arm in an arrangement such that a longitudinal axis of the anchor element is generally coaxially aligned with a longitudinal axis of the first bore when the distal end of the implant arm is releasably coupled with the proximal end of the joint implant and the distal end of the anchor arm is engaged with the proximal end of the anchor element, wherein the arrangement is fixed and nonadjustable.

122. The system of claim 121, wherein the body of the joint implant extends a length between the distal and proximal ends, and wherein the at least one planar member extends the length.

123. The system of claim 122, wherein the at least one planar member comprises a first planar member and a second planar member, wherein the first and the second planar members are generally parallel to each other.

124. The system of claim 123, wherein the first bore extends between the first and the second planar members.

125. The system of claim 123, wherein the first planar member and the second planar member are generally coplanar.

126. The system of claim 121, wherein the top planar surface includes a width that is greater than a thickness between opposite side surfaces of the distal and proximal end members, wherein the width and the thickness are defined generally perpendicular to the longitudinal axis of the body of the joint implant.

127. The system of claim 126, wherein a junction of the top planar surface and the opposite side surfaces includes a sloped transition.

128. The system of claim 127, wherein the sloped transition includes an outward flaring of the opposite side surfaces.

129. The system of claim 121, wherein the distal and proximal end members include opposite side surfaces, and wherein the top planar surface includes a pair of top side edges that extend lengthwise along the body of the joint implant and define a juncture of the top planar surface and the opposite side surfaces, wherein a width between the pair of top side edges is greater than a thickness between the opposite side surfaces.

130. The system of claim 129, wherein the juncture includes a sloped transition.

131. The system of claim 130, wherein the sloped transition includes an outward flaring of the opposite side surfaces.