Sacroiliac joint implant and sacroiliac joint instrument for fusing a sacroiliac joint

• US 9,381,045 B2
• Filed: 05/18/2012
• Issued: 07/05/2016
• Est. Priority Date: 01/13/2010
• Status: Active Grant

• Current Assignee: JCBD, LLC
• Original Assignee: JCBD, LLC
• Inventors: Donner, Edward Jeffrey, Donner, Christopher Thomas
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): Eckman, Michelle C
• Application Number:
  US13/475,695
• Publication Number:
  US 20120296428A1
• Time in Patent Office: 1,509 Days
• Field of Search: 623 1711- 1716, 606/99, 606/86.R
• US Class Current: 1/1
• 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
• CPC Class Codes: A61F 2/30988 Other joints not covered by any of the groups A61F2/32 - A61F2/4425
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• 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 2/46 Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
• 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

A system for fixating a dysfunctional sacroiliac joint for SI joint fusion, the system including a sacroiliac joint implant, a sacroiliac joint screw or rod and a delivery tool configured for approaching a sacroiliac joint. The system may include an implant having a porous 3D matrix structure and may be manufactured by laser or electron beam additive manufacturing. The delivery tool may include a radiolucent material. The SI fusion system may further include custom sacroiliac joint implants, anchors, alignment tools or targeting arms manufactured for a particular patient. Pre-surgical imaging studies, including 3D rendering, and their interpretation may assist in planning desired trajectories, anchor dimensions and implant dimensions and may provide details specific to the manufacture of particular sacroiliac joint tools or implants and their implantation into the sacroiliac joint. The system may be configured for use with surgical robots and may include an integrated nerve monitoring and stimulation system.

Claims

1. A sacroiliac joint fusion system for fusing a sacroiliac joint having a sacrum, an ilium, and a joint plane defined between the sacrum and the ilium, the system comprising:

a) a joint implant comprising a body having a hollow interior and an exterior surface having a plurality of openings defined therein that extend into the hollow interior, a first lateral side comprising a first surface, a second lateral side opposite the first lateral side comprising a second surface, a side extending between the first and second lateral sides, and a first bore extending through the joint implant, the first and second surfaces being generally parallel to each other, the hollow interior being adapted to have a biological material located therein prior to the implantation of the joint implant, the side extending a perimeter of the joint implant and including a closed inferior side so as to limit an amount of seepage of the biological material from the hollow interior 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 configured to deliver the joint implant into the sacroiliac joint such that the first and second surfaces are generally parallel with the joint plane of the sacroiliac joint; 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.

2. The system of claim 1, wherein in being coupled together, the implant arm and anchor arm form an angle relative to each other, and the angle is non-adjustable.

3. The system of claim 1, wherein the first bore extends non-parallel to the hollow interior.

4. The system of claim 3, wherein the joint implant further comprises a first pair of planar members extending from the body of the joint implant.

5. The system of claim 4, wherein the hollow interior extends within the confines of the first pair of planar members and the exterior surface in which the plurality of openings is defined includes exterior planar surfaces of the first pair of planar members.

6. The system of claim 5, wherein the implant further comprises a second pair of planar members extending from the body of the joint implant generally perpendicular to the first pair of planar members.

7. The system of claim 6, wherein the first pair of planar members extend over a wider radial extent than the second pair of planar members.

8. The system of claim 1, wherein the side further includes an open superior side opposite the closed inferior side and configured to allow and promote boney growth or expansion of biological material inserted within the joint implant toward certain areas within the sacroiliac joint and away or not toward certain other areas of the sacroiliac joint when the implant is implanted in the sacroiliac joint.

9. A system for fusing a sacroiliac joint having a sacrum, and ilium, and a joint plane defined between the sacrum and the ilium, the system comprising:

a) a joint implant comprising a longitudinal axis, a distal end, a proximal end opposite the distal end, a first lateral side extending between the distal and proximal ends, a second lateral side opposite the first lateral side and extending between the distal and proximal ends, and a side extending a perimeter of the joint implant between the first and second lateral sides and comprising a superior side including an access opening extending into an inner portion of the joint implant, the inner portion configured to receive biological material therein via the access opening, the first and second lateral sides comprising a plurality of interconnected members defining openings extending between groups of multiple interconnected members of the plurality of interconnected members, the openings extending into the inner portion of the joint implant; and

b) a delivery system comprising;

i) an implant arm configured to releasably couple to the joint implant and configured to deliver the joint implant into the sacroiliac joint such that first and second lateral sides are generally parallel with the joint plane of the sacroiliac joint; and

ii) an anchor arm in cooperation with the implant arm and configured to guide a delivery of an anchor element into a region of the sacroiliac joint relative to the joint implant, wherein a manufacturer supplied configuration of the fusion system is such that when the implant arm and the anchor arm are operably coupled and when the implant arm is releasably coupled to the joint implant, a delivery arrangement automatically exists such that the anchor arm is configured to guide the delivery of the anchor element to a predetermined location relative to the joint implant.

10. The system of claim 9, wherein the delivery system further comprises a driving tool configured to releasably couple with a proximal end region of the anchor element, wherein the driving tool is configured to be guided by the anchor arm.

11. The system of claim 9, wherein the predetermined location is adjacent the joint implant.

12. The system of claim 9, wherein the predetermined location is cranial or caudal of the joint implant.

13. The system of claim 9, wherein the joint implant further comprises a first bore extending at least partially through the joint implant, and wherein the predetermined location is within the bore of the joint implant.

14. The system of claim 9, wherein the delivery arrangement is fixed and nonadjustable.

15. The system of claim 9, wherein the delivery arrangement is adjustably fixed.

16. The system of claim 9, wherein the anchor arm comprises a collar that is configured to guide a surgical tool in delivering the anchor element to the predetermined location relative to the joint implant.

17. The system of claim 9, wherein the joint implant further comprises a first bore extending at least partially through the joint implant.

18. The system of claim 17, wherein the first bore extends non-parallel to the longitudinal axis of the joint implant.

19. The system of claim 17, wherein the first bore extends into at least one of the first or second lateral sides of the joint implant.

20. The system of claim 19, wherein the bore comprises an inner surface including a bore perimeter being closed and generally surrounded by and in close proximity to the openings.

21. The system of claim 17, wherein the first bore extends through the first and second lateral sides of the joint implant.

22. The system of claim 17, wherein the first bore extends substantially parallel to the longitudinal axis of the joint implant.

23. The system of claim 17, wherein the first bore extends distally from the proximal end of the joint implant and is configured to receive a feature of a distal end of the implant arm.

24. The system of claim 9, wherein the inner portion of the joint implant comprises a hollow interior, which is adapted to have the biological material located therein prior to the implantation of the joint implant.

25. The system of claim 9, wherein the inner portion of the joint implant comprises a lattice structure of material.

26. The system of claim 25, wherein the lattice structure of material is a certain biological material configured to promote bone growth.

27. The system of claim 9, wherein, in being coupled together, the implant arm and anchor arm form an angle relative to each other, and the angle is non-adjustable.

28. The system of claim 9, wherein the openings comprise multiple openings that are similarly shaped.

29. The system of claim 28, wherein the multiple openings are polygonal in shape.

30. The system of claim 28, wherein each of the multiple openings defines a shape that includes at least three vertices.

31. The system of claim 28, wherein the multiple openings comprise a repeating pattern of openings.

32. The system of claim 9, wherein a portion of the side of the joint implant opposite the access opening is closed so as to limit an amount of seepage of the biological material from the inner portion of the joint implant.

33. The system of claim 9, wherein the side of the joint implant further comprises an inferior side opposite of and substantially parallel to the superior side, the first and second lateral sides are substantially parallel to each other, the superior and inferior sides extend a thickness between the first and second lateral sides, the first and second lateral sides extend a height between the superior and inferior sides, the height is greater than the thickness.

34. The system of claim 33, wherein the height is between about 5 mm to about 30 mm.

35. The system of claim 33, wherein the height is about 20 mm.

36. The system of claim 33, wherein the thickness is between about 2 mm to about 20 mm.

37. The system of claim 33, wherein the thickness is about 4 mm.

38. The system of claim 33, wherein a ratio of the thickness to height is about 1/5.

39. The system of claim 33, wherein the joint implant further comprises a first keel extending generally perpendicularly off of the first lateral side and extending between the distal and proximal ends of the joint implant.

40. The system of claim 39, wherein the joint implant further comprises a second keel extending generally perpendicularly off of the second lateral side and extending between the distal and proximal ends of the joint implant.

41. The system of claim 40, wherein the first keel and the second keel are substantially parallel to each other.

42. The system of claim 40, wherein the first keel and the second keel are substantially coplanar with each other.

43. The system of claim 42, wherein the first keel is substantially centered on the first lateral side between a superior edge and an inferior edge of the joint implant along the extension between the distal and proximal ends of the joint implant, the second keel is substantially centered on the second lateral side between the superior edge and the inferior edge of the joint implant along the extension between the distal and proximal ends of the joint implant.

44. The system of claim 40, wherein the first and second keels define a first thickness that is less than a second thickness defined between the first and second lateral sides of the joint implant.

45. The system of claim 9, wherein at least one of the first and second lateral sides comprises an anti-migration element comprising surface undulations extending from the distal end to the proximal end.

46. The system of claim 45, wherein the first and second lateral sides comprises the surface undulations.

47. The system of claim 9, wherein the openings are defined by a perimeter comprising at least three curved sections each of which defines a region of concavity relative to an opening centroid.

48. A sacroiliac joint fusion system configured to fuse a sacroiliac joint of a patient, the sacroiliac joint having a sacrum, an ilium, and a joint plane defined between the sacrum and the ilium, the system comprising:

a) a joint implant comprising a longitudinal axis, a distal end, a proximal end opposite the distal end, a first lateral side extending between the distal and proximal ends, a second lateral side opposite the first lateral side and extending between the distal and proximal ends, and a side extending a perimeter of the joint implant between the first and second lateral sides and comprising a superior side including an access opening extending into an inner portion of the joint implant, the inner portion configured to receive biological material therein via the access opening, the first and second lateral sides comprising a plurality of interconnected members defining openings extending between groups of multiple interconnected members of the plurality of interconnected members, the openings extending into the inner portion of the joint implant; and

b) a delivery system comprising;

i) an implant arm configured to releasably couple to the joint implant and configured to deliver the joint implant into the sacroiliac joint such that first and second lateral sides are generally in apposition with the sacrum and the ilium, respectively, while the longitudinal axis is generally parallel and generally coincident with the joint plane of the sacroiliac joint; and

ii) an anchor arm in cooperation with the implant arm and configured to guide a delivery of an anchor element, wherein the joint implant, the implant arm and the anchor arm have an as-manufactured configuration that allows the anchor arm to properly align the anchor element to be received in a predetermined location relative to the joint implant and in at least one of the sacrum or the ilium when the joint implant is coupled to the implant arm.

49. The system of claim 48, wherein the delivery system further comprises a driving tool configured to releasably couple with a proximal end region of the anchor element, wherein the driving tool is configured to be guided by the anchor arm.

50. The system of claim 48, wherein the predetermined location is adjacent of the joint implant.

51. The system of claim 48, wherein the predetermined location is cranial or caudal of the joint implant.

52. The system of claim 48, wherein the joint implant further comprises a first bore extending at least partially through the joint implant, and wherein the predetermined location is within the bore of the joint implant.

53. The system of claim 48, wherein the delivery arrangement is fixed and nonadjustable.

54. The system of claim 48, wherein the delivery arrangement is adjustably fixed.

55. The system of claim 48, wherein the anchor arm comprises a collar that is configured to guide a surgical tool in delivering the anchor element to the predetermined location relative to the joint implant.

56. The system of claim 48, wherein the joint implant further comprises a first bore extending at least partially through the joint implant.

57. The system of claim 56, wherein the first bore extends non-parallel to the longitudinal axis of the joint implant.

58. The system of claim 56, wherein the first bore extends into at least one of the first or second lateral sides of the joint implant.

59. The system of claim 56, wherein the first bore extends through the first and second lateral sides of the joint implant.

60. The system of claim 56, wherein the first bore extends substantially parallel to the longitudinal axis of the joint implant.

61. The system of claim 56, wherein the first bore extends distally from the proximal end of the joint implant and is configured to receive a feature of a distal end of the implant arm.

62. The system of claim 48, wherein the inner portion of the joint implant comprises a hollow interior, which is adapted to have the biological material located therein prior to the implantation of the joint implant.

63. The system of claim 48, wherein the inner portion of the joint implant comprises a lattice structure of material.

64. The system of claim 63, wherein the lattice structure of material is a certain biological material configured to promote bone growth.

65. The system of claim 48, wherein, in being coupled together, the implant arm and anchor arm form an angle relative to each other, wherein the angle is non-adjustable.

66. The system of claim 48, wherein the openings comprise multiple openings that are similarly shaped.

67. The system of claim 66, wherein the multiple openings are polygonal in shape.

68. The system of claim 66, wherein each of the multiple openings defines a shape that includes at least three vertices.

69. The system of claim 66, wherein the multiple openings comprise a repeating pattern of openings.

70. The system of claim 48, wherein a portion of the side of the joint implant opposite the access opening is closed so as to limit an amount of seepage of the biological material from the inner portion of the joint implant.

71. The system of claim 48, wherein the side of the joint implant further comprises an inferior side opposite of and substantially parallel to the superior side, the first and second lateral sides are substantially parallel to each other, the superior and inferior sides extend a thickness between the first and second lateral sides, the first and second lateral sides extend a height between the superior and inferior sides, the height is greater than the thickness.

72. The system of claim 71, wherein the height is between about 5 mm to about 30 mm.

73. The system of claim 71, wherein the height is about 20 mm.

74. The system of claim 71, wherein the thickness is between about 2 mm to about 20 mm.

75. The system of claim 71, wherein the thickness is about 4 mm.

76. The system of claim 71, wherein a ratio of the thickness to height is about 1/5.

77. The system of claim 71, wherein the joint implant further comprises a first keel extending generally perpendicularly off of the first lateral side and extending between the distal and proximal ends of the joint implant.

78. The system of claim 77, wherein the joint implant further comprises a second keel extending generally perpendicularly off of the second lateral side and extending between the distal and proximal ends of the joint implant.

79. The system of claim 78, wherein the first and second keels define a first thickness that is less than a second thickness defined between the first and second lateral sides of the joint implant.

80. The system of claim 48, wherein at least one of the first and second lateral sides comprises an anti-migration element comprising surface undulations extending from the distal end to the proximal end.

81. The system of claim 80, wherein the first and second lateral sides comprises the surface undulations.

82. A sacroiliac joint fusion system for fusing a sacroiliac joint having a sacrum, and ilium, and a joint plane defined between the sacrum and the ilium, the system comprising:

a) a joint implant comprising a longitudinal axis, a distal end, a proximal end opposite the distal end, a first lateral side extending between the distal and proximal ends, a second lateral side opposite the first lateral side and extending between the distal and proximal ends, and a side extending a perimeter of the joint implant between the first and second lateral sides and comprising a superior side including an access opening extending into an inner portion of the joint implant, the inner portion configured to receive biological material therein via the access opening, the first and second lateral sides comprising a truss structure comprising a plurality of interlinked members extending between the distal and proximal ends and defining a plurality of geometric openings extending through the truss structure and into the inner portion of the joint implant;

b) a delivery system comprising;

i) an implant arm configured to releasably couple to the joint implant and configured to deliver the joint implant into the sacroiliac joint such that first and second lateral sides are generally parallel with the joint plane of the sacroiliac joint; and

ii) an anchor arm in cooperation with the implant arm and configured to guide a delivery of an anchor element, wherein a final manufactured configuration of the fusion system is such that, when assembled, a delivery arrangement automatically exists where the anchor arm is configured to guide the delivery of the anchor element relative to the joint implant.

83. The system of claim 82, wherein the joint implant further comprises a first bore extending at least partially through the joint implant, the first bore extending non-parallel to the longitudinal axis of the joint implant.

84. The system of claim 83, wherein the first bore extends into at least one of the first or second lateral sides of the joint implant.

85. The system of claim 83, wherein the first bore extends through the first and second lateral sides of the joint implant.

86. The system of claim 85, wherein the first bore comprises an inner surface including a bore perimeter being closed and generally surrounded by and in close proximity to the openings and wherein the anchor element is configured to be received in the first bore.

87. The system of claim 86, wherein a portion of the side of the joint implant opposite the access opening is closed so as to limit an amount of seepage of the biological material from the inner portion of the joint implant.

88. The system of claim 86, wherein the side comprises a distal side, a proximal side opposite the distal side, and an inferior side opposite the superior side, the distal side and the inferior side defining a closed surface with no openings into the inner portion.

89. The system of claim 83, wherein the anchor element is configured to be received in the first bore.

90. The system of claim 89, wherein the joint implant comprises a custom manufactured implant including predetermined dimensions selected for the patient, the predetermined dimensions being a result of an interpretation of imaging studies of the patient, and wherein the anchor arm comprises a predetermined configuration resulting from the interpretation from the imaging studies of the patient.

91. The system of claim 83, wherein the joint implant comprises a custom manufactured configuration including predetermined dimensions selected for a particular patient, the predetermined dimensions being a result of an interpretation of an imaging study of the patient.

92. The system of claim 82, wherein the joint implant further comprises a first bore extending at least partially through the joint implant, the first bore extending substantially parallel to the longitudinal axis of the joint implant.

93. The system of claim 92, wherein the first bore extends distally from the proximal end of the joint implant and is configured to receive a feature of a distal end of the implant arm.

94. The system of claim 82, wherein the inner portion of the joint implant comprises a hollow interior, which is adapted to have the biological material located therein prior to the implantation of the joint implant.

95. The system of claim 82, wherein the inner portion of the joint implant comprises a lattice structure of material.

96. The system of claim 95, wherein the lattice structure of material is a certain biological material configured to promote bone growth.

97. The system of claim 82, wherein in being coupled together, the implant arm and anchor arm form an angle relative to each other, wherein the angle is non-adjustable.

98. The system of claim 82, wherein the plurality of geometric openings comprises multiple openings that are similarly shaped.

99. The system of claim 98, wherein each of the multiple openings is polygonal in shape.

100. The system of claim 98, wherein the multiple openings comprise a repeating pattern of openings.

101. The system of claim 82, wherein a portion of the side of the joint implant opposite the access opening is closed so as to limit an amount of seepage of the biological material from the inner portion of the joint implant.

102. The system of claim 82, wherein the side comprises a distal side, a proximal side opposite the distal side, and an inferior side opposite the superior side, the distal side and the inferior side defining a closed surface with no openings into the inner portion.

103. The system of claim 82, wherein the side of the joint implant further comprises an inferior side opposite of and substantially parallel to the superior side, the first and second lateral sides are substantially parallel to each other, the superior and inferior sides extend a thickness between the first and second lateral sides, the first and second lateral sides extend a height between the superior and inferior sides, the height is greater than the thickness.

104. The system of claim 103, wherein the height is between about5 mm to about 30 mm.

105. The system of claim 103, wherein the height is about20 mm.

106. The system of claim 103, wherein the thickness is between about 2 mm to about 20 mm.

107. The system of claim 103, wherein the thickness is about4 mm.

108. The system of claim 103, wherein a ratio of the thickness to height is about 1/5.

109. The system of claim 103, wherein the joint implant further comprises a first keel extending generally perpendicularly off of the first lateral side and extending between the distal and proximal ends of the joint implant.

110. The system of claim 109, wherein the joint implant further comprises a second keel extending generally perpendicularly off of the second lateral side and extending between the distal and proximal ends of the joint implant.

111. The system of claim 110, wherein the first and second keels define a first thickness that is less than a second thickness defined between the first and second lateral sides of the joint implant.

112. The system of claim 82, wherein at least one of the first and second lateral sides comprises an anti-migration element comprising surface undulations extending from the distal end to the proximal end.

113. The system of claim 111, wherein the first and second lateral sides comprises the surface undulations.

114. The system of claim 82, wherein the joint implant further comprises a first keel extending generally perpendicularly off of the first lateral side and extending between the distal and proximal ends of the joint implant.

115. The system of claim 114, wherein the inner portion of the joint implant comprises a lattice structure of material.

116. The system of claim 114, wherein a portion of the side of the joint implant opposite the access opening is closed so as to limit an amount of seepage of the biological material from the inner portion of the joint implant.

117. The system of claim 114, wherein the side extending the perimeter of the joint implant further comprises an inferior side opposite the superior side, the distal end comprises a distal-inferior corner defining an intersection of the distal end and the inferior side, the distal-inferior corner substantially conforming to an anatomical curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

118. The system of claim 82, wherein the delivery of the anchor element is via a predetermined trajectory customized for a particular patient and is result of an interpretation of a pre-surgical imaging study of the patient.

119. The system of claim 82, wherein the side extending the perimeter of the joint implant further comprises an inferior side opposite the superior side, the distal end comprises a distal-inferior corner defining an intersection of the distal end and the inferior side, the distal-inferior corner generally anatomically mimicking a curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

120. The system of claim 82, wherein the delivery of the anchor element is via a trajectory which does not intersect the joint implant such that it allows the anchor element to be placed outside of the joint implant.

121. A sacroiliac joint fusion system configured to fuse a sacroiliac joint of a patient, the sacroiliac joint having a sacrum, an ilium, a joint plane, and an articular region including an anterior-inferior corner, the system comprising:

a) a joint implant comprising a longitudinal axis, a distal end, a proximal end opposite the distal end, a first lateral side extending between the distal and proximal ends, and a second lateral side opposite the first lateral side and extending between the distal and proximal ends, the first and second lateral sides comprising a plurality of polygonal openings extending into an inner portion of the joint implant, the joint implant further comprising a side extending between the first and second lateral sides and extending a perimeter of the joint implant, the side comprising an access opening extending into the inner portion and configured for receiving biological material therethrough; and

b) a delivery system comprising;

i) an implant arm configured to releasably couple to the joint implant and configured to deliver the joint implant into the sacroiliac joint such that first and second lateral sides are generally parallel with the joint plane of the sacroiliac joint; and

ii) an anchor arm in cooperation with the implant arm and configured to guide a delivery of an anchor element relative to the joint implant, wherein a final manufactured configuration of the delivery system and the joint implant are such that, when the implant arm is releasably coupled to the joint implant, a delivery arrangement automatically exists such that the anchor arm is correctly oriented to guide the delivery of the anchor element into the sacrum or the ilium along a trajectory relative to the joint implant.

122. The system of claim 121, wherein the joint implant further comprises a first bore extending at least partially through the joint implant.

123. The system of claim 122, wherein the first bore is configured to receive the anchor element therethrough.

124. The system of claim 122, wherein the first bore extends non-parallel to the longitudinal axis of the joint implant.

125. The system of claim 124, wherein the first bore extends into at least one of the first or second lateral sides of the joint implant.

126. The system of claim 124, wherein the first bore extends through the first and second lateral sides of the joint implant.

127. The system of claim 124, wherein the anchor element is configured to be received in the first bore.

128. The system of claim 122, wherein the first bore extends substantially parallel to the longitudinal axis of the joint implant.

129. The system of claim 128, wherein the first bore extends distally from the proximal end of the joint implant and is configured to receive a feature of a distal end of the implant arm.

130. The system of claim 121, wherein the side of the joint implant comprises an inferior side being substantially closed such that the biological material is prevented from seepage out the inferior side of the joint implant.

131. The system of claim 130, wherein the side of the joint implant further comprises a superior side opposite the inferior side, the superior side including the access opening.

132. The system of claim 130, wherein the side of the joint implant further comprises a proximal side adjacent the inferior side and at the proximal end of the joint implant, the proximal side including the access opening.

133. The system of claim 121, wherein the side comprises a superior side and an inferior side opposite the superior side, the distal end comprises a distal-superior corner defining an intersection of the distal end and the superior side, and a distal-inferior corner opposite the distal-superior corner and defining an intersection of the distal end and the inferior side, the distal-superior corner being differently shaped from the distal-inferior corner.

134. The system of claim 133, wherein the distal-inferior corner includes an inferior radius that is larger than a superior radius of the distal-superior corner.

135. The system of claim 121, wherein the side comprises an inferior side, the distal end comprises a distal-inferior corner defining an intersection of the distal end and the inferior side, the distal-inferior corner generally anatomically mimicking a curvature of the anterior-inferior corner of the articular region of the sacroiliac joint.

136. The system of claim 135, wherein the side of the joint implant further comprises a superior side opposite the inferior side, the superior side including the access opening.

137. The system of claim 135, wherein the side of the joint implant further comprises a proximal side adjacent the inferior side and at the proximal end of the joint implant, the proximal side including the access opening.

138. The system of claim 121, wherein the side comprises an inferior side, distal end comprises a distal-inferior corner defining an intersection of the distal end and the inferior side, the distal-inferior corner substantially conforming to an anatomical curvature of the anterior-inferior corner of the articular region of the sacroiliac joint.

139. The system of claim 121, wherein the side includes a radiopaque marker to assist in surgical navigation.

140. The system of claim 139, wherein the side includes an inferior side and the distal end comprises a distal-inferior corner defining an intersection of the distal end and the inferior side, wherein the radiopaque marker is positioned near the distal-inferior corner.

141. The system of claim 121, wherein the inner portion of the joint implant comprises a hollow interior, which is adapted to have a biological material located therein prior to the implantation of the joint implant.

142. The system of claim 121, wherein the inner portion of the joint implant comprises a lattice structure of material.

143. The system of claim 142, wherein the lattice structure of material is a biological material configured to promote bone growth.

144. The system of claim 121, wherein in being coupled together, the implant arm and anchor arm form an angle relative to each other, and the angle is non-adjustable.

145. The system of claim 121, wherein the side comprises an inferior side opposite of and substantially parallel to a superior side, the superior and inferior sides extending between the first and second lateral sides, the first and second lateral sides are substantially parallel to each other, the superior and inferior sides extend a thickness between the first and second lateral sides, the first and second lateral sides extend a height between the superior and inferior sides, the height is greater than the thickness.

146. The system of claim 145, wherein the height is between about5 mm to about 30 mm.

147. The system of claim 145, wherein the height is about20 mm.

148. The system of claim 145, wherein the thickness is between about 2 mm to about20 mm.

149. The system of claim 145, wherein the thickness is about4 mm.

150. The system of claim 145, wherein a ratio of the thickness to height is about 1/5.

151. The system of claim 145, wherein the joint implant further comprises a first keel extending generally perpendicularly off of the first lateral side and extending between the distal and proximal ends of the joint implant.

152. The system of claim 151, wherein the joint implant further comprises a second keel extending generally perpendicularly off of the second lateral side and extending between the distal and proximal ends of the joint implant.

153. The system of claim 152, wherein the first and second keels define a first thickness that is less than a second thickness defined between the first and second lateral sides of the joint implant.

154. The system of claim 121, wherein at least one of the first and second lateral sides comprises an anti-migration element comprising surface undulations extending from the distal end to the proximal end.

155. The system of claim 154, wherein the first and second lateral sides comprises the surface undulations.

156. The system of claim 121, wherein the joint implant comprises a custom manufactured implant including predetermined dimensions selected for the patient, the predetermined dimensions being a result of an interpretation of imaging studies of the patient, and wherein the anchor arm comprises a predetermined configuration resulting from the interpretation from the imaging studies of the patient.

157. The system of claim 121, wherein the joint implant further comprises a first keel extending in a generally outwardly direction from an inner portion of the joint implant and extending between the distal and proximal ends of the joint implant.

158. The system of claim 157, wherein the joint implant further comprises a second keel extending in a generally outwardly direction from an inner portion of the joint implant and extending between the distal and proximal ends of the joint implant.

159. The system of claim 158, wherein the delivery of the anchor element is via a trajectory which does not intersect the joint implant such that it allows the anchor element to be placed outside of the joint implant.

160. A system for fusing a sacroiliac joint comprising a sacrum and an ilium by an operator, the system comprising:

a) a first implantable body configured to be implanted non-transversely in the sacroiliac joint, the first implantable body comprising;

a longitudinal axis;

a distal end;

a proximal end opposite the distal end;

a first lateral side extending between the distal and proximal ends;

a second lateral side opposite the first lateral side and extending between the distal and proximal ends, the first and second lateral sides comprising a plurality of interconnected members defining openings extending between groups of multiple interconnected members of the plurality of interconnected members, the openings extending into an inner portion of the implantable body;

a side extending a perimeter of the first implantable body between the first and second lateral sides and comprising a superior side including an access opening extending into an inner portion of the first implantable body, the inner portion configured to receive biological material therein via the access opening;

a first keel extending substantially perpendicularly off of the first lateral side and extending between the distal and proximal ends; and

a second keel extending substantially perpendicularly off of the second lateral side and extending between the distal and proximal ends;

b) a second implantable body configured to be delivered transversely into the sacrum or the ilium;

c) a first arm configured to couple to the first implantable body;

d) a second arm configured to couple to the second implantable body; and

e) manufacturer provided instructions for using the system, wherein the first arm and the second arm are operable to enable the operator to provide an arrangement for delivery of the first implantable body relative to the second implantable body, the arrangement is such that one of a plurality of predetermined orientation between the first and second implantable bodies is automatically arrived at once the components of the system are coupled together, the one of the plurality of predetermined orientation being a cumulative result of an as-manufactured three-dimensional configurations of each component.

161. The system of claim 160, wherein the operator is a surgical robot.

162. The system of claim 160, wherein the arrangement includes limiting the position of the first implantable body relative to the second implantable body such that at least one of the following results may be automatically arrived at:

a) the avoidance of neurovascular structures;

b) the avoidance of a location of an anticipated implant;

c) the avoidance of an implant already present at the sacroiliac joint;

d) a second implantable body trajectory includes passing through a bore of the first implantable body;

or e) a second implantable body trajectory includes passing adjacent to the first implantable body.

163. The system of claim 160, wherein the system is operable to enable the operator to use the arrangement to adjust a trajectory of the second implantable body relative to anatomic structures.

164. The system of claim 160, wherein at least one of the first or second implantable bodies comprises a custom manufactured configuration including predetermined dimensions selected for a particular patient, the predetermined dimensions being a result of an interpretation of an imaging study of the patient.

165. The system of claim 160, wherein at least one of a plurality of predetermined orientation is customized for a particular patient and is result of an interpretation of an imaging study of the patient.

166. The system of claim 160, wherein the side extending the perimeter of the first implantable body further comprises an inferior side opposite the superior side, the distal end comprises a distal-inferior corner defining an intersection of the distal end and the inferior side, the distal-inferior corner generally anatomically mimicking a curvature of an anterior-inferior corner of an articular region of the sacroiliac joint.

167. The system of claim 160, wherein the side extending the perimeter of the first implantable body further comprises an inferior side opposite the superior side, the distal end comprises a distal-inferior corner defining an intersection of the distal end and the inferior side, the distal-inferior corner substantially conforming to an anatomical curvature of an anterior- inferior corner of an articular region of the sacroiliac joint.

168. The system of claim 160, wherein the side extending the perimeter of the first implantable body includes a radiopaque marker to assist in surgical navigation, and wherein the side includes a distal inferior-corner, and wherein the radiopaque marker is positioned near the distal-inferior corner.

169. The system of claim 160, wherein the first implantable body further comprises a first bore extending at least partially through the first implantable body, and wherein at least one of the plurality of predetermined orientation includes a trajectory passing through the bore.

170. The system of claim 169, wherein the first bore extends through the first and second lateral sides of the first implantable body.

171. The system of claim 170, wherein the bore comprises an inner surface including a bore perimeter being closed and generally surrounded by and in close proximity to the openings.

172. The system of claim 171, wherein the side of the first implantable body further comprises an inferior side opposite the superior side and being substantially closed such that the biological material is prevented from seepage out the inferior side of the joint implant.

173. The system of claim 171, wherein the first keel and the second keel are substantially parallel to each other.

174. The system of claim 173, wherein the first keel and the second keel are substantially coplanar with each other.

175. The system of claim 171, wherein the first and second keels define a first maximum thickness that is less than a second maximum thickness defined between the first and second lateral sides of the joint implant.

176. The system of claim 160, wherein at least one of the first or second arms includes a lumen extending a length of the first or second arm.

177. The system of claim 176, wherein at least one of the first or second arms further comprises a retainer rod in cooperation with the first or second arm, the retainer rod comprising a distal end configured to engage a complementary region located on the first or second implantable body, respectively, such that the body is releasably selectively retained by the arm.

178. The system of claim 177, wherein a biocompatible material can be fed through the lumen.

179. The system of claim 178, wherein the body includes an axial bore coaxially aligned with the lumen and into which the biocompatible material can be received.

180. The system of claim 160, wherein the inner portion of the first implantable body comprises a lattice structure of material.