Knee arthroplasty implants, instruments, systems, and methods of implanting the same. The knee arthroplasty implants may include a femoral implant and a tibial tray implant, each with trabecular surfaces configured to contact bone to provide a scaffold for bone healing and interdigitation. The implants may also include fixation pegs with bulleted profiles to increase the surface area for bone ingrowth. An inserter instrument may include a sliding rack, which is incrementally extended with a rotatable shaft, thereby allowing for quick lock and release of various tibia trays.

An improved modular rotational device includes a first and second threaded coupler for affixation along the stem of an endoprosthetic device, for example, a humeral prosthesis or a femoral prosthesis. The rotational device axis of rotation is coaxial with the stem, and its axis of rotation is located in close proximity to the intramedullary stem of the prosthesis or in close proximity to the distal articulation of the prosthesis. A housing has a proximal and distal end with an axial bore therethrough for receiving an elongated stem of the device. A lobe ring may be utilized to limit the axis of rotation of the device. Additional endoprosthetic devices may be attached to male or female threaded couplers, or to Morse tapers. A plurality of suture attachments facilitates attachment of soft tissue thereto.

The improved endoprosthetic device surface treatment encourages soft tissue attachment thereto. A porous mesh surface treatment creates on an outer surface of the endoprosthetic device a three-dimensional surface structure similar to cancellous bone. Suture attachment features are provided at various locations around the treated surface structure to initially affix a vascularized soft tissue to the treated surface. As the patient heals the soft tissue grows and infiltrates the porous mesh surface to achieve an attachment strength substantially equal to the surrounding tissue.

Systems, methods and apparatuses including an insert having a body with a plurality of bladders therein, a proximal surface and a distal surface. Two or more of the plurality of bladders are in fluid communication with one another. The plurality of bladders are expandable and contractible in volume. The proximal surface shapable by a change in the volume of one or more of the plurality of bladders. The proximal surface is configured to interface with a first arthroplasty implant of the patient. The distal surface is spaced from the proximal surface by the body and is configured to interface with a second arthroplasty implant of the patient.