FR3048357A1 - GLENOIDAL EMBASE FOR SHOULDER PROSTHESIS, AND IMPLANTATION ASSEMBLY COMPRISING SUCH A GLENOIDIAN EMBASE - Google Patents

Abstract

This glenoid base (2) comprises a support portion (5) intended to bear against the glenoid (3) of a scapula; a main anchoring element (8) having a general shape of revolution around a main axis of revolution (A) and intended to be anchored in a main bone bore (9) formed in the glenoid; and first and second secondary anchors (14, 15) adjacent to the main anchoring element (8) and located on either side of the main anchoring element (8), the first and second secondary anchors (14, 15) being intended to be anchored respectively in first and second secondary bores (16, 17) in the glenoid, the first secondary anchor (14) having a shape general revolution about a first axis of secondary revolution (B), the second secondary anchoring element (15) having a general shape of revolution about a second axis of secondary revolution (C).

Description

The present invention relates to a glenoid base for a shoulder prosthesis, and an implant assembly comprising such a glenoid base.

A glenoid base for a shoulder prosthesis and cementless fixation, comprises in known manner: a support part configured to be fixed, by means of bone anchoring screws, to a previously prepared glene of a scapula, the part support comprising a bearing face intended to bear against the glenoid, and a support face opposite to the bearing face and on which is intended to be fixed an insert adapted to cooperate with a humeral head or a humeral implant and an anchoring element, also called keel or anchor pad, extending from the bearing surface and intended to be anchored in a bone housing previously formed in the glenoid. The anchoring element advantageously has a trapezoidal shape to ensure a stable and robust anchoring of the glenoid base in the glenoid.

However, such a configuration of the anchor element involves a complex, long and tedious bone preparation of the glenoid. Indeed, the realization of the bone housing for receiving the anchoring element requires in particular the establishment of a cutting guide on the glenoid, the realization of preforations in the glenoid using a piercing tool guided by the cutting guide, making incisions in the glenoid using an osteotome guided by the cutting guide, and finalizing the bone cavity using the osteotome and compactors.

The present invention aims to remedy these disadvantages.

The technical problem underlying the invention therefore consists in providing a glenoid base for a shoulder prosthesis which is of simple structure and which simplifies and secures the surgical procedure, while ensuring optimal stability of the glenoid base in the bone. To this end, the present invention relates to a glenoid base for a shoulder prosthesis, the glenoid base being configured to be fixed, by means of at least one bone anchoring screw, to a previously prepared glene of a scapula, the glenoid base comprising: a support part comprising a bearing face intended to bear against the glenoid, and a support face opposite to the bearing face and on which is intended to be fixed a suitable insert to cooperate with a humeral head or a humeral implant. a main anchoring element extending from the bearing face and intended to be anchored in a main bone bore formed in the glenoid, the main anchoring element having a general shape of revolution around a main axis of revolution, - first and second secondary anchoring elements extending from the bearing face and located on either side of the main anchoring element, the first and second elements of secondary anchoring being adjacent, and advantageously contiguous, to the main anchoring element and being intended to be anchored respectively in a first and a second secondary bony bores formed in the glenoid, the first secondary anchoring element having a general shape of revolution about a first axis of secondary revolution, the second secondary anchoring element having a general shape of revolution around a second axis of revolution secondary education.

Such a configuration of the main anchoring element and the first and second secondary anchoring elements, and in particular the fact that they each have a general shape of revolution, makes it possible to achieve easily and rapidly in the glenoid, at the using suitable drill bits, the bone bores intended to receive these anchoring elements. The result is a simplified, secure and easily reproducible surgical procedure.

In addition, the fact that the main anchoring element and the first and second secondary anchoring elements are adjacent, and therefore contiguous, ensures a high stability of the glenoid base in the glenoid. The glenoid socket may further have one or more of the following features, taken alone or in combination.

According to one embodiment of the invention, each of the first and second secondary anchoring elements has a length less than the length of the main anchoring element. Advantageously, the first and second anchoring elements have substantially the same length. These arrangements make it possible to form an anchor "set" (formed by the main anchoring element and the first and second secondary anchoring elements) having a shape close to the trapezoidal anchoring elements of the prior art, and therefore to ensure bone stability substantially identical to that provided by them.

According to one embodiment of the invention, the main anchoring element and the first and second secondary anchoring elements are substantially aligned.

According to one embodiment of the invention, the main anchoring element is delimited externally at least partially by a portion of principal surface of revolution, the first secondary anchoring element is delimited externally at least partially by a first portion of secondary revolution surface, and the second secondary anchoring element is delimited externally at least partially by a second portion of secondary surface of revolution.

According to one embodiment of the invention, the first and second secondary anchoring elements are substantially symmetrical with respect to an anteroposterior median plane of the glenoid base.

According to one embodiment of the invention, the main anchoring element extends in a direction of principal extension coincides with the main axis of revolution and the first and second secondary anchoring elements extend according to first and second secondary extension directions respectively confounded with the first and second secondary axes of revolution, the main axis of revolution and the first and second secondary axes of revolution being substantially parallel.

According to one embodiment of the invention, the distance between the main axis of revolution and the first secondary axis of revolution is less than the sum of the maximum revolution radius of the portion of the main surface of revolution and the radius of revolution. maximum of the first portion of secondary revolution surface, and the distance between the main axis of revolution and the second secondary axis of revolution is less than the sum of the maximum revolution radius of the portion of the main surface of revolution and the radius of maximum revolution of the second portion of secondary revolution surface.

According to one embodiment of the invention, the support portion has two through-passage orifices disposed on either side of the first and second secondary anchoring elements, each through-hole being intended for the passage of a screw. bone anchor.

According to one embodiment of the invention, each through passage orifice is intended to receive the head of the respective bone anchoring screw.

According to one embodiment of the invention, the two throughflow orifices are inclined with respect to each other, and are for example inclined with respect to the main axis of revolution.

According to one embodiment of the invention, the main anchoring element comprises a through bore for the passage of a bone anchoring screw.

According to one embodiment of the invention, the through bore is inclined relative to the main axis of revolution.

According to one embodiment of the invention, the glenoid base comprises a fixing part extending from the bearing face and an edge of the support part, the fixing part comprising a through orifice. axis coincident with the axis of the through bore.

According to one embodiment of the invention, the bearing face is convex.

According to one embodiment of the invention, the glenoid base comprises first fixing means intended to cooperate with complementary fixing means provided on a first insert of a first type, and second fixing means intended to cooperate with complementary fixing means provided on a second insert of a second type.

According to one embodiment of the invention, the second fixing means comprise a detent housing opening into the support face and intended to cooperate with a detent portion provided on the second insert.

According to one embodiment of the invention, the first fixing means comprise a fixing housing internally delimited at least in part by a frustoconical surface flaring towards the support face, the fixing housing being intended to receive by complementary form a frustoconical fastening portion provided on the first insert.

According to one embodiment of the invention, the fixing housing opens into the latching housing.

According to one embodiment of the invention, the latching housing and the fixing housing are coaxial.

According to one embodiment of the invention, the fixing housing extends in the main extension direction, and advantageously along the main axis of revolution.

According to one embodiment of the invention, the fixing housing extends at least in part in the main anchoring element.

According to one embodiment of the invention, the detent housing defines at least one detent groove configured to receive a detent rib provided on the detent portion of the first insert.

The present invention further relates to a glenoid implant for a shoulder prosthesis, comprising: - a glenoid base according to the invention. a first insert of a first type configured to be fixed on the support part of the glenoid base, the first insert comprising a convex hinge part having a generally hemispherical shape and being able to cooperate with a humeral implant, and a second insert of a second type configured to be fixed on the support part of the glenoid base, the second insert comprising a hinge part comprising a concave articulation surface intended to cooperate with a humeral head or an implant humeral.

According to one embodiment of the invention, the first insert is metallic, and is for example made of stainless steel.

According to one embodiment of the invention, the first insert comprises a bearing portion intended to bear against the support portion.

According to one embodiment of the invention, the first insert comprises a fixing element comprising a fastening portion of frustoconical general shape intended to be fixed in the mounting housing of the glenoid base.

According to one embodiment of the invention, the first insert has a through bore opening into the pole of the convex hinge portion of the first insert, the through bore of the first insert being intended for the passage of a suitable fastening screw. to cooperate with a tapped bore provided on the glenoid base. The tapped bore is for example formed in the extension of the fixing housing, and advantageously extends substantially coaxially with the mounting housing

According to one embodiment of the invention, the through orifice comprises a first end opening into the pole of the convex hinge portion of the first insert, and a second end opposite the first end and opening into the free end of the fixing part.

According to one embodiment of the invention, the second insert is made of polyethylene.

According to one embodiment of the invention, the hinge portion of the second insert has a general shape of plate.

According to one embodiment of the invention, the second insert comprises a detent portion configured to cooperate with the latching slot provided on the glenoid base. Advantageously, the detent portion comprises at least one ratchet rib adapted to cooperate with the at least one detent groove defined by the detent housing.

According to one embodiment of the invention, the second insert comprises an angular indexing element configured to cooperate with the glenoid base so as to define a single position for fixing the second insert on the glenoid base.

According to one embodiment of the invention, the angular indexing element extends in the extension of the detent portion.

According to one embodiment of the invention, the angular indexing element is intended to be partly received in the fixing housing.

The present invention also relates to an implant assembly, comprising: a glenoid base according to the invention, a first piercing guide comprising a bearing surface intended to bear against the glenoid, and a stabilizing element extending from the bearing surface of the first piercing guide, the stabilizing element being adapted to be inserted into a bone piercing formed in a central portion of the glenoid, the first piercing guide further comprising a first and a second guide orifices opening into the bearing surface of the first drilling guide and each intended to guide at least one drill bit capable of producing the first and second secondary bores in the glenoid, and - a second drilling guide comprising a bearing surface for bearing against the glenoid, and a first and a second immobilization stud extending from the surface for supporting the second piercing guide, the first and second immobilization studs being intended to be inserted respectively into the first and second secondary bone bores formed in the glenoid, the second piercing guide further comprising a guide orifice opening into the bearing surface of the second drill guide and for guiding a drill bit capable of producing the main bone bore in the glenoid.

According to one embodiment of the invention, the implantation assembly further comprises: a main drill bit comprising a drilling portion configured to provide a bone bore delimited internally by a surface of revolution substantially corresponding to the portion of main surface of revolution, and - a secondary drill bit having a drilling portion configured to provide a bone bore delimited internally by a surface of revolution substantially corresponding to the first portion of secondary surface of revolution.

In any case the invention will be better understood with the aid of the description which follows with reference to the appended schematic drawing showing, by way of non-limiting example, an embodiment of this glenoid base.

Figure 1 is a perspective view of a glenoid base according to the invention.

Figures 2 and 3 are side views of the glenoid socket of Figure 1.

Figure 4 is a sectional view of the glenoid base of Figure 1.

Figure 5 is a side view of an alternative embodiment of the glenoid socket of Figure 1.

Figure 6 is a perspective view of the glenoid base of Figure 1 and a first insert adapted to be fixed on the glenoid base.

Figure 7 is a perspective view showing the first insert fixed on the glenoid base of Figure 1.

Figure 8 is a bottom perspective view of a second insert adapted to be fixed on the glenoid base of Figure 1.

Figure 9 is a perspective view showing the second insert attached to the glenoid socket of Figure 1.

Figure 10 is a perspective view of a total inverted shoulder prosthesis including the glenoid socket of Figure 1, the first insert of Figure 6 and a humeral implant.

Figures 11-12 are perspective views showing various steps of a method of implanting the glenoid socket of Figure 1 into a glenoidal scapula.

FIGS. 1 to 4 show a glenoid base 2 for a shoulder prosthesis, the glenoid base 2 being configured to be fixed, by means of bone anchoring screws, to a previously prepared glene 3 of a scapula 4 (see FIGS. Figures 16 and 17). The glenoid base 2 comprises a support portion 5 having a general shape of plate. The support portion 5 more particularly comprises a bearing face 6 intended to bear against the glenoid 3, and a support face 7 opposite the bearing face 6 and on which is intended to be fixed an insert adapted to cooperate with a humeral head or a humeral implant. According to the embodiment shown in the figures, the bearing face 6 is convex and the support face 7 is concave. The glenoid base 2 further comprises a main anchoring element 8, for example made in the form of an anchor pad, extending from the bearing face 6 and in a main extension direction . The main anchoring element 8 is intended to be anchored in a main bone bore 9 previously formed in the glenoid 3 (see FIG. 16). The main anchoring element 8 has a general shape of revolution around a principal axis of revolution A coincides with the main extension direction. The main anchoring element 8 is more particularly delimited externally by a portion of principal surface of revolution 11 generated by the rotation about the main axis of revolution A of a curve segment.

As shown more particularly in Figure 3, the main anchoring element 8 comprises a first substantially cylindrical anchoring portion 8a and extending from the bearing face 6, and a second anchoring portion 8b substantially frustoconical and extending in the extension of the first anchoring portion 8a. The main anchoring element 8 further comprises a through bore 12 inclined relative to the main extension direction and intended for the passage of a bone anchoring screw 13 (see in particular Figure 7). The glenoid base 2 also comprises a first secondary anchoring element 14 and a second secondary anchoring element 15, for example each made in the form of an anchor pad, each extending from the face of the support 6 and respectively according to first and second secondary extension directions substantially parallel to the main extension direction.

The first and second secondary anchoring elements 14, 15 are located on either side of the main anchoring element 8, and are contiguous, that is to say contiguous, to the latter. The first and second secondary anchoring elements 14, 15 are intended to be anchored respectively in a first secondary bone bore 16 and a second secondary bone bore 17 previously formed in the glenoid 3 (see in particular Figure 16).

The first secondary anchoring element 14 has a general shape of revolution around a first axis of secondary revolution B coincides with the first direction of secondary extension, while the second secondary anchoring element 15 has a general shape of revolution. around a second secondary revolution axis B coincides with the second secondary extension direction.

The first secondary anchoring element 14 is more particularly defined externally by a first portion of secondary revolution surface 18 generated by the rotation around the first secondary revolution axis B of a curve segment, and the second secondary anchoring element. 15 is delimited externally by a second portion of secondary revolution surface 19 generated by the rotation about the second secondary revolution axis C of a curve segment.

Advantageously, the spacing E1 between the main axis of revolution A and the first secondary axis of revolution B is less than the sum of the maximum revolution radius of the main surface area of revolution 11 and the maximum revolution radius of the first portion of secondary revolution surface 18, and the center distance E2 between the main axis of revolution A and the second secondary axis of revolution C is less than the sum of the maximum revolution radius of the portion of the main surface of revolution 11 and the maximum revolution radius of the second portion of secondary revolution surface 19.

According to the embodiment shown in the figures, the first and second secondary anchoring elements 14, 15 are symmetrical with respect to an anteroposterior median plane of the glenoid base 2, and the first and second portions of the surface of revolution. secondary 18, 19 have an identical geometry.

In addition, according to the embodiment shown in the figures, the main anchoring element 8 and the first and second secondary anchoring elements 14, 15 are substantially aligned.

As shown more particularly in FIG. 1, the support portion 5 comprises two through-passage orifices 21 arranged on either side of the first and second secondary anchoring elements 14, 15, and each intended for the passage of a screw. bone anchor 22 (see in particular Figure 6). The two through-passage orifices 21 are advantageously inclined with respect to each other, and also with respect to the main extension direction. Each through-passage orifice 21 is more particularly intended to receive and house the head of the respective bone anchoring screw 22. The glenoid base 2 further comprises a latching housing 23 centered with respect to the main axis of revolution and opening into the support face 7. The detent housing 23 is substantially cylindrical in shape and delimits a groove. According to the embodiment shown in the figures, the ratchet groove 24 is discontinuous taking into account the position of the throughthrough orifices 21. However, the ratchet groove 24 could be continuous, and therefore annular. The glenoid base 2 further comprises a fixing housing 25 opening into the detent housing 23, and delimited internally by a frustoconical surface 26 flaring towards the support face 7. The fixing housing 25 extends in the extension of the detent housing 23, and in the main extension direction so that the detent housing 23 and the fixing housing 25 are coaxial. As shown more particularly in FIG. 4, the fixing housing 25 extends partly in the main anchoring element 8. The glenoid base 2 further comprises a fastening portion 27, for example in the form of a fixing lug, extending from the bearing face 6 and an edge of the support portion 5. The fixing portion 27 comprises a passage orifice 28 of axis coinciding with the axis of the through bore 12 formed on the main anchoring element 8. The passage opening 28 is more particularly intended to serve as a stop for the head of the anchoring screw 13 for passing through the through bore 12 formed on the main anchoring element 8.

As can be seen in particular from FIGS. 2 and 5, the glenoid base 2 exists in a so-called standard version, in which the anchoring element 8 is short, and a so-called elongated version, in which the anchoring element 8 is long. .

FIGS. 6 and 7 more particularly represent a first insert 31, of a first type, intended to be fixed on the support portion 5 of the glenoid base 2. The first insert 31 is advantageously metallic, and may for example be realized Stainless steel.

The first insert 31 has a convex hinge portion 32 having a generally hemispherical shape, and being able to cooperate with a humeral implant. The hinge portion 32 comprises in particular a bearing portion 33 intended to bear against the support face 7 of the support portion 5.

The first insert 31 further comprises a fastening element 34 extending from the hinge portion 32. The fastening element 34 more particularly comprises a fastening portion 35 of frustoconical general shape intended to be fixed, by fitting conical, in the fixing housing 25 of the glenoid base 2.

The first insert 31 also comprises a through bore 36 having a first end opening into the pole of the hinge portion 32, and a second end opposite the first end and opening into the free end of the fixing portion 35. through bore 36 of the first insert 31 is intended for the passage of a fixing screw adapted to cooperate with a tapped bore 37 (see Figure 4) provided on the glenoid base 2 so as to secure the attachment of the first insert 31 on the glenoid base 2. The tapped bore 37 advantageously extends in the extension of the fixing housing 25, and coaxially with the fixing housing 25.

Figures 8 and 9 show more particularly a second insert 38, of a second type, intended to be fixed on the support portion 5 of the glenoid base 2. The second insert 38 is advantageously made of plastic, such as in polymer, and may for example be made of polyethylene.

The second insert 38 has a hinge portion 39 having a generally tray-like shape, and comprising a concave hinge surface 41 intended to cooperate with a humeral head or a humeral implant.

The second insert 38 further includes a detent portion 42 configured to cooperate with the detent housing 23 provided on the glenoid base 2. Advantageously, the detent portion 42 comprises a detent rib 43 adapted to cooperate with snap-fastening with the snap-in groove 24 delimited by the detent housing 23.

According to the embodiment shown in the figures, the second insert 38 comprises an angular indexing element 44 configured to cooperate with the glenoid base 2 so as to define a single fixing position of the second insert 38 on the glenoid base 2 Advantageously, the angular indexing element 38 extends in the extension of the detent portion 42, and is intended to be partially received in the fixing housing 25.

FIG. 10 represents a total inverted shoulder prosthesis 45 comprising a glenoid implant 46 formed by the assembly of the glenoid base 2 and the first insert 31, and a humeral implant 47 comprising in a known manner: a diaphyseal rod 48 intended to to be engaged in the medullary canal of a humerus. a metaphyseal plate 49 configured to be fixed, by a conical fitting, on an upper end portion of the diaphyseal rod 48, and a polyethylene humeral insert 50 configured to be received in a recess of the metaphyseal plate 49, humeral insert 50 having a cavity delimited by a spherical surface portion having a radius of curvature corresponding to that of the convex hinge portion 32 of the first insert 31.

FIGS. 11 to 13 show a first drilling guide 51 comprising a guide body 52 comprising a bearing surface 53 convex and intended to bear against the glenoid 3. The first piercing guide 51 also comprises a stabilizing element 54, such as a stabilization pad, extending from the bearing surface 53 and intended to be inserted into a bone piercing 55 formed in a central portion of the glenoid. The first drilling guide 52 further comprises a first guide orifice 56 and a second guide orifice 57 formed on the guide body 52 and opening into the bearing surface 53. The first and second guide orifices 56, 57 have parallel axes, and are arranged such that their spacing corresponds substantially to the spacing between the first and second secondary revolution axes B, C of the first and second secondary anchoring elements 14, 15. Each of the first and second orifices guide 56, 57 is intended to guide a drill bit 58 capable of producing the first and second secondary bores in the glenoid bone. The drill bit 58 more particularly comprises a drilling portion 59 configured so that the first and second secondary bores 16, 17 are each delimited internally by a surface of revolution corresponding substantially to the first and second secondary surface portions of revolution 18 , 19.

The first drilling guide 51 advantageously comprises a handle 61 to facilitate handling by a surgeon.

FIGS. 14 and 15 show a second piercing guide 62 comprising a guide body 63 comprising a bearing surface 64 intended to bear against the glenoid 3. The second piercing guide 62 also comprises a first immobilization element 65 and a second immobilizing element 66, for example made in the form of immobilization pads, parallel and extending from the bearing surface 64. The distance between the first and second immobilizing elements 65, 66 substantially corresponds to the spacing between the first and second guide holes 56, 57 provided on the first piercing guide 51. The first and second immobilization elements 65, 66 are intended to be inserted respectively in the first and second bores of bone secondary 16,17 formed in the glenoid 3.

The second drill guide 62 further comprises a guide orifice 67 opening into the bearing surface 64 between the first and second immobilizing elements 65, 66. The guide orifice 67 is intended to guide a drill bit 68 adapted to perform the main bone bore 9 in the glenoid 3. The drill bit 68 more particularly comprises a drilling portion 69 configured so that the main bone bore 9 is delimited internally by a surface of revolution substantially corresponding to the portion of main surface of revolution 11.

The second drilling guide 62 advantageously comprises a handle 70 to facilitate its handling by a surgeon.

It should be noted that each of the drill bits 58, 67 advantageously comprises a stop portion configured to abut against the guide bodies 52, 63 of the first and second drill guides 51, 62 so as to limit the depth inserting the drill bits 58, 67 into the glenoid 3 during the production of the main bone bores 9 and the first and second secondary bores 16,17.

A method of implantation of the glenoid base 2 according to the invention will now be described with particular reference to FIGS. 11 to 17.

Such an implantation method comprises the following steps: - performing the bone piercing 55 in a central portion of the glenoid 3 with the aid of a drill bit (see FIG. 11), - inserting the stabilizing element 54 of the first piercing guide 51 in the bone piercing 55, - positioning the bearing surface 53 of the first piercing guide 51 against the glenoid 3 (see FIG. 12), - introducing and guiding the guide drill 58 into the first orifice guide 56 provided on the first drill guide 51 so as to make the first secondary bone bore 16 in the glenoid, - extract the guide drill 58 from the first guide orifice 56, - introduce an immobilizing element, such as an immobilizing rod 71, in the first guide orifice 56 provided on the first drill guide 51 so as to immobilize in rotation the first drill guide 51 (see FIG. 13), - introduce and guide the guide bit 58 in the second th guide orifice 57 provided on the first drill guide 51 so as to make the second secondary bone bore 17 in the glenoid 3, - extract the guide drill 58 out of the second guide orifice 57, - insert the first and second elements immobilizing 65, 66 of the second drilling guide 62 respectively in the first and second secondary bores 16,17 (see Figure 14), - positioning the bearing surface 64 of the second piercing guide 62 against the glenoid 3 ( see Fig. 15), - insert and guide the guide bit 68 into the guide hole 67 provided on the second drill guide 62 so as to make the main bone bore 9 in the glenoid 3 (see Fig. 16) the main bone bore 9 being shaped so that the first and second secondary bores 16, 17 open laterally into the main bone bore 9, - anchor the main anchor 8 and the first and second secondary anchoring elements 14, 15 of the glenoid base 2 respectively in the main bone bore 9 and the first and second secondary bone bores 16,17 (see Figure 17), - fixing the glenoid base 2 by means of bone anchoring screws extending through the through bore 12 and the through-passage orifices 21.

The configuration of the glenoid base 2 and the first and second piercing guides makes it easy to produce the bone bores intended to receive the anchoring elements of the glenoid base 2, and thus to facilitate and secure the surgeon's gesture, while by making it reproducible.

As goes without saying, the invention is not limited to the sole embodiment of this glenoid base, described above as an example, it encompasses all the variants.

Claims (14)

A glenoid socket (2) for a shoulder prosthesis, the glenoid socket (2) being configured to be fixed, by means of at least one bone anchoring screw, to a glenoid (3) previously prepared with a scapula, the glenoid base (2) comprising: - a support part (5) comprising a bearing face (6) intended to bear against the glenoid (3), and a support face (7) opposite to the bearing face (6) and on which is intended to be fixed an insert adapted to cooperate with a humeral head or a humeral implant, - a main anchoring element (8) extending from the face of the support (6) and intended to be anchored in a main bone bore (9) formed in the glenoid, the main anchoring element (8) having a general shape of revolution around a main axis of revolution (A) a first and a second secondary anchoring element (14, 15) extending from the bearing face (6) and located by t and other of the main anchoring element (8), the first and second secondary anchoring elements (14, 15) being adjacent to the main anchoring element (8) and being intended to be anchored respectively in first and second secondary bone bores (16, 17) in the glenoid, the first secondary anchoring element (14) having a general shape of revolution about a first minor axis of revolution (B), the second secondary anchoring element (15) having a general shape of revolution around a second secondary axis of revolution (C). The glenoid base (2) according to claim 1, wherein the main anchoring element (8) is delimited externally at least partially by a portion of main surface of revolution (11), the first secondary anchoring element ( 14) is delimited externally at least partially by a first portion of secondary revolution surface (18), and the second secondary anchoring element (15) is delimited externally at least partially by a second portion of secondary revolving surface (19). . 3. glenoid socket (2) according to claim 1 or 2, wherein the main anchoring element (8) extends in a direction of principal extension coincides with the main axis of revolution (A), and the first and second secondary anchoring elements (14, 15) extend in first and second secondary extension directions, respectively, coinciding with the first and second secondary axes of revolution (B, C), the main axis of revolution ( A) and the first and second secondary axes of revolution (B, C) being substantially parallel. 4. glenoid base (2) according to claims 2 and 3, wherein the spacing (El) between the main axis of revolution (A) and the first axis of secondary revolution (B) is less than the sum of the radius of maximum revolution of the main surface area of revolution (11) and the maximum revolution radius of the first portion of the secondary revolution surface (18), and the center distance (E2) between the main axis of revolution (A) and the second secondary revolution axis (C) is less than the sum of the maximum revolution radius of the main surface area of revolution (11) and the maximum revolution radius of the second secondary surface area (19). The glenoid socket (2) according to any one of claims 1 to 4, wherein each of the first and second secondary anchoring elements (14, 15) has a length less than the length of the main anchoring element. (8). 6. Glenoid base (2) according to any one of claims 1 to 5, wherein the support portion (5) has two through-holes (21) arranged on either side of the first and second elements of secondary anchoring (14, 15), each through-passage orifice (21) being intended for the passage of a bone anchoring screw (22). The glenoid socket (2) according to any one of claims 1 to 6, wherein the main anchoring element (8) has a through bore (12) for the passage of a bone anchoring screw (13). ). The glenoid socket (2) according to claim 7, which has a fixing portion (27) extending from the bearing face (6) and an edge of the support portion (5), the fixing part (27) comprising a passage opening (28) of axis coinciding with the axis of the through bore (12). 9. Glenoid base (2) according to any one of claims 1 to 8, which comprises first fixing means for cooperating with complementary fixing means provided on a first insert (31) of a first type, and second fixing means intended to cooperate with complementary fastening means provided on a second insert (38) of a second type. 10. The glenoid socket according to claim 9, wherein the second fixing means comprise a latching housing (23) opening into the support face (7) and intended to cooperate with a detent portion (42) provided on the second insert (38). The glenoid socket according to claim 9 or 10, wherein the first fixing means comprise a fixing housing (25) internally delimited at least in part by a frustoconical surface (26) flaring in the direction of the support face ( 7), the fixing housing (25) being adapted to receive formally a frustoconical fastening portion (35) provided on the first insert (31). 12. Glenoid base (2) according to claims 10 and 11, wherein the fixing housing (25) opens into the latching housing (23). 13. A glenoid implant for shoulder prosthesis, comprising: a glenoid base (2) according to any one of claims 1 to 12, a first insert (31) of a first type configured to be fixed on the part of support (5) of the glenoid base (2), the first insert (31) having a hinge portion (32) having a generally hemispherical shape and being adapted to cooperate with a humeral implant, and - a second insert (38) ) of a second type configured to be fixed to the support portion (5) of the glenoid base (2), the second insert (38) having a hinge portion (39) comprising a concave hinge surface ( 41) for cooperating with a humeral head or a humeral implant. 14. implantation assembly, comprising: - a glenoid base (2) according to any one of claims 1 to 12, - a first piercing guide (51) comprising a bearing surface (53) intended to bear against the glenoid (3), and a stabilizing element (54) extending from the bearing surface (53) of the first piercing guide (51), the stabilizing element (54) being intended to be inserted in a bone piercing (55) in a central portion of the glenoid (3), the first piercing guide (51) further comprising a first and a second guide aperture (56, 57) opening into the bearing surface (53) of the first piercing guide (51) and each intended to guide at least one drill bit (58) adapted to produce the first and second secondary bores (16,17) in the glenoid, and - a second guide to piercing (62) comprising a bearing surface (64) intended to bear against the glenoid (3), and a premature and a second immobilization pad (65, 66) extending from the bearing surface (64) of the second piercing guide (62), the first and second immobilization pads (65, 66) being for insertion into the first and second secondary bone bores in the glenoid, respectively, the second piercing guide (62) further comprising a guide port (67) opening into the bearing surface (64) of the second guide drilling (62) and for guiding a drill bit (68) adapted to perform the main bone bore (9) in the glenoid.