A prosthesis for replacing a natural articular surface on a bone may have a joint facing side with an articular surface, a bone anchoring side with a bone engagement surface, and a bone engagement pad secured to at least part of the bone engagement surface. The bone engagement pad may have a transverse portion extending transverse to a length of the bone, and one or more protruding portions extending generally perpendicular to the transverse portion. The transverse portion may have a pad bone-facing surface with a first porosity level, and a pad joint-facing surface on an opposite side of the transverse portion from the pad bone-facing surface, with a second, lower porosity level. The bone engagement surface may be formed via a first manufacturing process selected from the group consisting of forging, milling, and casting. The bone engagement pad may be formed via an additive manufacturing process.
