Cartilage repair apparatus and method

• US 20030036801A1
• Filed: 07/15/2002
• Published: 02/20/2003
• Est. Priority Date: 07/16/2001
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: Depuy Products Incorporated (Johnson & Johnson)
• Inventors: Schwartz, Herbert E., Malaviya, Prasanna, Plouhar, Pamela L., Pelo, Mark J.
• Granted Patent: US 7,361,195 B2
• Time in Patent Office: Days
• US Class Current: 623/23.63
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0646 for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2/30749 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/3872 Meniscus for implantation between the natural bone surfaces
• CPC Class Codes: A61F 2002/30294 Conical or frustoconical body made by spirally rolling up a sheet or a strip around itself
• CPC Class Codes: A61F 2002/30299 umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30579 with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30751 for attaching cartilage scaffolds to underlying bone
• CPC Class Codes: A61F 2002/30766 Scaffolds for cartilage ingrowth and regeneration
• CPC Class Codes: A61F 2230/0091 helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61F 2230/0093 Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61L 2430/06 for cartilage reconstruction, e.g. meniscus
• CPC Class Codes: A61L 27/3629 Intestinal tissue, e.g. small intestinal submucosa
• CPC Class Codes: A61L 27/3633 Extracellular matrix [ECM]
• CPC Class Codes: A61L 27/3654 Cartilage, e.g. meniscus
• CPC Class Codes: A61L 27/3683 subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment
• CPC Class Codes: A61L 27/3804 : characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
• CPC Class Codes: A61L 27/3852 : Cartilage, e.g. meniscus
• CPC Class Codes: A61L 27/3886 : comprising two or more cell types
• CPC Class Codes: A61P 19/00 : Drugs for skeletal disorders

Abstract

An orthopaedic device for repairing and regenerating cartilage includes a plug configured to be positioned in a hole formed in the cartilage and an anchor configured to support the plug. One or both of the plug and the anchor may be formed from naturally occurring extracellular matrix such as small intestine submucosa. A method for repairing and regenerating cartilage is also disclosed.

Claims

1. A device for repairing a diseased or damaged portion of articular cartilage on a bone of a joint, the cartilage having been prepared by forming an opening therein to remove the diseased or damaged portion, the device comprising:

a plug configured to be positioned in the opening formed in the cartilage, the plug comprising a shaped and dried naturally occurring extracellular matrix, and

an anchor configured to position and hold the plug in the opening.

2. The device of claim 1, wherein the plug is secured to the anchor.

3. The device of claim 1, wherein the naturally occurring extracellular matrix comprises comminuted naturally occurring extracellular matrix.

4. The device of claim 1, wherein the naturally occurring extracellular matrix comprises tissue selected from the group consisting of:

vertebrate small intestine submucosa;

vertebrate liver basement membrane;

vertebrate bladder submucosa;

vertebrate stomach submucosa;

vertebrate alimentary tissue;

vertebrate respiratory tissue; and

vertebrate genital tissue.

5. The device of claim 4, wherein the naturally occurring extracellular matrix comprises tissue selected from the group consisting of:

bovine tissue;

ovine tissue; and

porcine tissue.

6. The device of claim 3, wherein the comminuted naturally occurring extracellular matrix is lyophilized.

7. The device of claim 1, wherein the plug has an outer articular surface and one or more side surfaces extending therefrom.

8. The device of claim 7, further comprising a cover disposed over at least part of the articular surface of the plug.

9. The device of claim 8, wherein the cover extends over the majority of the surface area of the articular surface of the plug.

10. The device of claim 8, wherein the cover comprises one or more sheets of naturally occurring extracellular matrix laminated together.

11. The device of claim 8, wherein the cover comprises shaped naturally occurring extracellular matrix.

12. The device of claim 8, wherein the cover is perforated.

13. The device of claim 8, wherein the cover is chemically or physically crosslinked.

14. The device of claim 1, wherein the anchor comprises one or more tacks for securing the plug to the bone.

15. The device of claim 11, wherein the one or more tacks extend inwardly along the plug to secure the plug to the bone.

16. The device of claim 15, wherein each of the one or more tacks is barbed to secure to the native cartilage and bone.

17. The device of claim 1, wherein the plug is crosslinked by a process selected from the group consisting of:

chemical cross-linking and physical cross-linking.

18. The device of claim 13, wherein the plug has an articular surface, the device further comprising a cover disposed over at least part of the articular surface of the plug, wherein the cover is crosslinked by a process selected from the group consisting of:

chemical cross-linking and physical cross-linking.

19. The device of claim 1, wherein the plug is formed with a porosity sufficient to receive cells.

20. The device of claim 1, further comprising at least one of the following:

a bioactive agent, a biologically derived substance, cells, a biological lubricant, a biocompatible polymer and a biocompatible inorganic material.

21. The device of claim 20, wherein the cells are selected from the group consisting of:

fibrochondrocytes, chondrocytes, osteocytes, osteoblasts, osteoclasts and synoviocytes.

22. The device of claim 1, wherein the plug is adapted to receive at least one selected from the group consisting of:

a bioactive agent, a biologically derived agent, cells, a biocompatible inorganic material, and a biocompatible polymer.

23. The device of claim 1, wherein the plug is formed with a porosity sufficient to support a culture of chondrocytes.

24. The device of claim 1, wherein the anchor is formed of naturally occurring extracellular matrix cured and shaped to fasten into a subchondral portion of the bone.

25. The device of claim 24, wherein the anchor comprises (i) a head portion configured to support the plug, and (ii) a body portion extending from the head portion to fasten into the subchondral portion of the bone.

26. The device of claim 25, wherein the body portion has outwardly extending barbs to engage the subchondral portion of the bone.

27. The device of claim 24, wherein the naturally occurring extracellular matrix from which the anchor is formed comprises SIS.

28. The device of claim 24, wherein the naturally occurring extracellular matrix from which the anchor is formed comprises comminuted SIS.

29. The device of claim 24, wherein the naturally occurring extracellular matrix from which the anchor is formed comprises crosslinked SIS.

30. The device of claim 24, wherein the plug is lyophilized onto the anchor.

31. The device of claim 24, wherein the plug is adhesively attached to the anchor.

32. The device of claim 24, wherein the plug is sutured to the anchor.

33. The device of claim 24, wherein (i) the anchor is formed with a head portion to support the plug and a body portion extending from the head portion to fasten into the subchondral portion of the bone, and (ii) the plug is formed to be sufficiently porous to receive cells from adjacent tissue or from synovial fluid.

34. The device of claim 33, wherein the plug is lyophilized onto the head portion.

35. The device of claim 1, wherein:

the plug has an outer articular surface and a side surface extending therefrom,

the plug is circular in cross-section, and

the anchor comprises a circular-shaped cover portion with an annular-shaped sidewall extending therefrom,

the anchor is positioned relative to the plug such that (i) the cover portion covers at least part of the outer articular surface, and (ii) the sidewalls extend along the one or more side surfaces, and

a distal edge portion of the sidewalls is positionable in a concentric circular groove formed in the subchondral portion of the bone.

36. The device of claim 1, further comprising an outer cover and an inner cover, wherein:

the anchor comprises a head portion to support the plug and a body portion extending from the head portion to fasten into a subchondral portion of the bone,

the plug comprises a central body of comminuted naturally occurring extracellular matrix sandwiched between the outer cover and the inner cover, and

each of the outer cover and the inner cover comprises one or more layers of naturally occurring extracellular matrix.

37. The device of claim 1, wherein the anchor comprises a ring configured to secure the plug in the opening.

38. The device of claim 1, wherein:

the opening formed in the cartilage is circular in shape so as to define a generally cylindrically-shaped wall in the cartilage,

the anchor comprises a ring to surround the plug,

the ring is configured to engage the wall in the cartilage and secure the plug in the opening.

39. The device of claim 38, wherein:

the wall in the cartilage is formed with a circumferential groove, and the ring is resilient to fasten into the groove.

40. The device of claim 39, wherein the ring is split so as to have an open circumferential segment to accommodate the fastening of the ring into the groove in the wall in the cartilage.

41. The device of 39, wherein the ring is tapered to enhance retention in the opening.

42. A cartilage repair device for repairing damaged or diseased articular cartilage, the device comprising:

a plug;

cells seeded on the plug; and

an anchor configured to support and position the plug in a position which is proximate to healthy tissue;

wherein at least one of the plug and the anchor comprise naturally occurring extracellular matrix; and

wherein the cells are selected from the group consisting of;

chondrocytes;

fibrochondrocytes;

osteocytes;

ostoeblasts;

osteoclasts;

synoviocytes;

bone marrow cells;

mesenchymal cells;

stromal cells;

stem cells;

embryonic stem cells;

precursor cells derived from adipose tissue;

peripheral blood progenitor cells;

stem cells isolated from adult tissue;

genetically transformed cells;

a combination of chondrocytes and other cells;

a combination of osteocytes and other cells;

a combination of synoviocytes and other cells;

a combination of bone marrow cells and other cells;

a combination of mesenchymal cells and other cells;

a combination of stromal cells and other cells;

a combination of stem cells and other cells;

a combination of embryonic stem cells and other cells;

a combination of precursor cells isolated from adult tissue and other cells;

a combination of peripheral blood progenitor cells and other cells;

a combination of stem cells isolated from adult tissue and other cells; and

a combination of genetically transformed cells and other cells.

43. The device of claim 42, wherein the device comprises a unitary surgical device and wherein the plug and the anchor are combined to define the unitary surgical device prior to implantation.

44. The cartilage repair device of claim 42, wherein the anchor is further configured to support and position the plug in contact with the healthy articular cartilage.

45. The device of claim 42, wherein the extracellular matrix of the plug is cured by lyophilization to have a porosity sufficient to receive the cells.

46. The device of claim 42, wherein the plug has an articular surface with a surface area, and wherein the device further comprises a cover which covers a majority of the surface area of the articular surface of the plug.

47. The device of claim 46, wherein the cover is formed of one or more layers of naturally occurring extracellular matrix.

48. The device of claim 47, wherein both the extracellular matrix of the plug and the cover are lyophilized.

49. The device of claim 47, wherein the cover is perforated.

50. The device of claim 42, wherein the plug comprises naturally occurring extracellular matrix selected from the group consisting of:

lyophilized naturally occurring extracellular matrix material;

comminuted naturally occurring extracellular matrix material;

naturally occurring extracellular matrix fibers;

crosslinked naturally occurring extracellular matrix material;

naturally occurring extracellular matrix powder;

naturally occurring extracellular matrix foam;

woven naturally occurring extracellular matrix material;

a nonwoven mat of naturally occurring extracellular matrix material; and

naturally occurring extracellular matrix fragments.

51. The device of claim 50, wherein the naturally occurring extracellular matrix material comprises tissue selected from the group consisting of:

vertebrate small intesting submucosa;

vertebrate liver basement membrane;

vertebrate bladder submucosa;

vertebrate stomach submucosa;

vertebrate alimentary tissue;

vertebrate respiratory tissue; and

vertibrate genital tissue.

52. The device of claim 51, wherein the naturally occurring extracellular matrix comprises tissue selected from the group consisting of:

bovine tissue;

ovine tissue; and

porcine tissue.

53. The device of claim 42, wherein the naturally occurring extracellular matrix of the cover is formed with a porosity sufficient to receive cells.

54. The device of claim 42, further comprising at least one selected from the group consisting of:

a bioactive agent;

a biologically derived substance;

cells;

a biological lubricant;

a biocompatible inorganic material; and

a biocompatible polymer.

55. A cartilage repair device for repairing damaged or diseased articular cartilage, the device comprising:

a plug formed of naturally occurring extracellular matrix, the matrix being cured to have a strength sufficient to at least temporarily withstand the compression and shear stress to which the articular cartilage is subjected; and

an anchor configured to support and position the plug in a position which is proximate to healthy articular cartilage.

56. The device of claim 55, wherein the plug has a surface opposite the anchor, the device further comprising a cover extending over at least part of the surface of the plug, the cover comprising naturally occurring extracellular matrix.

57. The device of claim 55, wherein the anchor has (i) a head portion to which the plug is secured, and (ii) a body portion extending away from the head portion to fasten into subchondral bone.

58. The device of claim 57, wherein the plug comprises a plurality of layers of naturally occurring extracellular matrix attached to the head portion.

59. The device of claim 57, wherein the plug comprises a plurality of layers of naturally occurring extracellular matrix covering at least a portion of the head portion.

60. The device of claim 58, wherein at least some of the plurality of layers of naturally occurring extracellular matrix are wrapped about the head portion to attach the plug to the anchor.

61. The device of claim 58, wherein the anchor is formed of naturally occurring extracellular matrix cured to be hardened and rigid to fasten the plug to the bone.

62. The device of claim 55, wherein the naturally occurring extracellular matrix is lyophilized.

63. The device of claim 55, wherein the naturally occurring extracellular matrix comprises SIS.

64. The device of claim 55, wherein the naturally occurring extracellular matrix comprises lyophilized SIS.

65. The device of claim 55, wherein the naturally occurring extracellular matrix comprises comminuted SIS.

66. The device of claim 55, wherein the naturally occurring extracellular matrix is crosslinked by a process selected from the group consisting of:

physical cross-linking and chemical cross-linking.

67. The device of claim 55, wherein the naturally occurring extracellular matrix is formed with a porosity sufficient to receive cells.

68. The device of claim 55, wherein the naturally occurring extracellular matrix comprises comminuted lyophilized SIS.

69. A method for repairing a diseased or damaged portion of articular cartilage on a bone, the method comprising the steps of:

forming an opening in the articular cartilage so as to remove the diseased or damaged portion thereof, and

positioning a plug in the opening so as to be proximate to healthy articular cartilage, wherein the plug comprises a shaped and dried naturally occurring extracellular matrix.

70. The method of claim 69, wherein the plug has a structural rigidity sufficient to at least temporarily withstand design compression and shear stress at least as great as that expected to be placed on the proximate articular cartilage.

71. The method of claim 69, further comprising the step of seeding cells into the plug.

72. The method of claim 71, wherein the seeding step is performed before the positioning step.

73. The method of claim 71, wherein the seeding step is performed after the positioning step.

74. The method of claim 69, further comprising the step of administering into the plug a substance selected from the group consisting of:

a bioactive agent;

a biologically derived agent;

a biological lubricant;

a biocompatible polymer; and

a biocompatible inorganic material.

75. The method of claim 69, further comprising the steps of:

securing the plug to an anchor;

forming an opening in the subchondral portion of the bone; and

wherein the step of positioning the plug in the opening formed in the cartilage comprises positioning the anchor in the opening formed in the subchondral portion of the bone so as to position the plug in the opening formed in the cartilage.

76. The method of claim 75, wherein the anchor is formed of SIS.

77. The method of claim 69, wherein the naturally occurring extracellular matrix comprises SIS.

78. The method of claim 69, wherein the naturally occurring extracellular matrix comprises comminuted SIS.

79. The method of claim 69, wherein the naturally occurring extracellular matrix comprises lyophilized SIS.

80. A method of forming a device for repairing a diseased or damaged portion of articular cartilage on a bone, the method comprising the steps of:

providing a plug configured conformingly to fit into an opening formed in the cartilage to remove the diseased or damaged portion, the plug comprising a naturally occurring extracellular matrix having a porosity sufficient to promote cell migration from surrounding healthy tissue and synovial fluid, the plug being biodegradable over time in the cartilage opening and effective to synthesize new and healthy cartilage over such time to close and heal the opening, and

providing an anchor configured to position and hold the plug in the opening in contact with the healthy cartilage and subchondral portion of the bone adjacent the opening.

81. The method of claim 80, further comprising seeding chondrocytes onto the plug.

82. The method of claim 80, wherein the anchor providing step comprises forming a mass of naturally occurring extracellular matrix cured to have sufficient rigidity and strength to position and hold the plug in the opening.

83. The method of claim 80, wherein the anchor providing step comprises forming a mass of SIS cured to have sufficient rigidity and strength to position and hold the plug in the opening.

84. The method of claim 80, wherein the naturally occurring extracellular matrix comprises lyophilized SIS.

85. The method of claim 80 wherein the plug providing step comprises a process selected from the group consisting of:

combining a bioactive agent with the plug;

combining a biologically derived agent with the plug;

applying a biological lubricant to the plug;

seeding cells onto the plug;

combining a biocompatible polymer with the plug; and

applying a biocompatible inorganic material to the plug.

86. A cartilage repair device for repairing damaged or diseased articular cartilage, the device comprising:

a plug comprising a naturally occurring bioremodelable collageneous matrix;

an anchor configured to support and position the plug in a position which is proximate to healthy tissue;

the plug having a face juxtaposed with the anchor and an opposite articular face;

a cover extending over a majority of the surface area of the articular face of the plug; and

wherein the naturally occurring bioremodelable collageneous matrix of the plug has a porosity sufficient to receive cells.

87. The cartilage repair device of claim 86, wherein the cover has a structural strength sufficient to at least temporarily withstand the compression and shear stress to which articular cartilage is normally subjected.

88. The cartilage repair device of claim 86, wherein the anchor is further configured to support and position the plug in contact with the healthy articular cartilage.

89. The cartilage repair device of claim 86, further comprising at least one selected from the group consisting of:

a bioactive agent;

a biologically derived agent;

a biological lubricant;

cells;

a biocompatible polymer; and

a biocompatible inorganic material.

90. The cartilage repair device of claim 86, wherein the plug, cover and anchor each have a different density.

91. The cartilage repair device of claim 90, wherein the cover has the greatest density and the plug has the lowest density.

92. A cartilage repair device for repairing damaged or diseased articular cartilage, the cartilage having been prepared by forming an opening therein to remove the diseased or damaged portion, the device comprising:

an anchor configured to support and position the plug in a position which is proximate to healthy tissue;

a second element having a density different from the density of the anchor;

wherein at least one of the anchor and second element comprises naturally occurring bioremodelable collageneous matrix selected from the group consisting of;

vertebrate small intesting submucosa;

vertebrate liver basement membrane;

vertebrate bladder submucosa;

vertebrate stomach submucosa;

vertebrate alimentary tissue;

vertebrate respiratory tissue; and

vertibrate genital tissue.

93. The device of claim 92, wherein the second element comprises a porous plug having a lower density than the anchor.

94. The device of claim 92, wherein the second element has a higher density than the anchor.

95. The device of claim 93, further comprising a cover having a density greater than the anchor.

96. A method for repairing a diseased or damaged portion of cartilage, the method comprising the steps of:

providing a plug comprising naturally occurring extracellular matrix;

seeding cells onto the plug of naturally occurring extracellular matrix;

forming an opening in the cartilage so as to remove the diseased or damaged portion thereof,

positioning the plug in the opening so as to be proximate to healthy cartilage.

97. The method of claim 96, wherein the cartilage comprises articular cartilage.

98. The method of claim 96, wherein the cartilage comprises fibrocartilage.

99. The method of claim 96, wherein the naturally occurring extracellular matrix is selected from the group consisting of:

vertebrate small intestine submucosa;

vertebrate liver basement membrane;

vertebrate bladder submucosa;

vertebrate stomach submucosa;

vertebrate alimentary tissue;

vertebrate respiratory tissue; and

vertibrate genital tissue.

100. The method of claim 96, further comprising fixating the plug to healthy tissue.

101. A device for repairing a diseased or damaged portion of articular cartilage on a bone of a joint, the cartilage having been prepared by forming an opening therein to remove the diseased or damaged portion, the device comprising:

a plug configured to be positioned in the opening formed in the cartilage, the plug comprising a shaped naturally occurring extracellular matrix, and

an anchor configured to position and hold the plug in the opening.

102. The device of claim 101, wherein the plug is secured to the anchor.

103. The device of claim 101, wherein the naturally occurring extracellular matrix comprises comminuted naturally occurring extracellular matrix.

104. The device of claim 101, wherein the naturally occurring extracellular matrix comprises tissue selected from the group consisting of:

vertebrate small intestine submucosa;

vertebrate liver basement membrane;

vertebrate bladder submucosa;

vertebrate stomach submucosa;

vertebrate alimentary tissue;

vertebrate respiratory tissue; and

vertebrate genital tissue.

105. The device of claim 104, wherein the naturally occurring extracellular matrix comprises tissue selected from the group consisting of:

bovine tissue;

ovine tissue; and

porcine tissue.

106. The device of claim 103, wherein the comminuted naturally occurring extracellular matrix is lyophilized.

107. The device of claim 101, wherein the plug has an outer articular surface and one or more side surfaces extending therefrom.

108. The device of claim 107, further comprising a cover disposed over at least part of the articular surface of the plug.

109. The device of claim 108, wherein the cover extends over the majority of the surface area of the articular surface of the plug.

110. The device of claim 108, wherein the cover comprises one or more sheets of naturally occurring extracellular matrix laminated together.

111. The device of claim 108, wherein the cover comprises shaped naturally occurring extracellular matrix.

112. The device of claim 108, wherein the cover is perforated.

113. The device of claim 108, wherein the cover is chemically or physically crosslinked.

114. The device of claim 101, wherein the anchor comprises one or more tacks for securing the plug to the bone.

115. The device of claim 111, wherein the one or more tacks extend inwardly along the plug to secure the plug to the bone.

116. The device of claim 115, wherein each of the one or more tacks is barbed to secure to the native cartilage and bone.

117. The device of claim 101, wherein the plug is crosslinked by a process selected from the group consisting of:

chemical cross-linking and physical cross-linking.

118. The device of claim 113, wherein the plug has an articular surface, the device further comprising a cover disposed over at least part of the articular surface of the plug, wherein the cover is crosslinked by a process selected from the group consisting of:

chemical cross-linking and physical cross-linking.

119. The device of claim 101, wherein the plug is formed with a porosity sufficient to receive cells.

120. The device of claim 101, further comprising at least one selected from the group consisting of:

a bioactive agent, a biologically derived substance, cells, a biological lubricant, a biocompatible polymer, and a biocompatible inorganic material.

121. The device of claim 120, wherein the cells selected from the group consisting of:

fibrochondrocytes, chondrocytes, osteocytes, osteoblasts, osteoclasts and synoviocytes.

122. The device of claim 101, wherein the plug is adapted to receive at least one selected from the group consisting of:

a bioactive agent, a biologically derived agent, cells, a biocompatible inorganic material, and a biocompatible polymer.

123. The device of claim 101, wherein the plug is formed with a porosity sufficient to support a culture of chondrocytes.

124. The device of claim 101, wherein the anchor is formed of naturally occurring extracellular matrix cured and shaped to fasten into a subchondral portion of the bone.

125. The device of claim 124, wherein the anchor comprises (i) a head portion configured to support the plug, and (ii) a body portion extending from the head portion to fasten into the subchondral portion of the bone.

126. The device of claim 125, wherein the body portion has outwardly extending barbs to engage the subchondral portion of the bone.

127. The device of claim 124, wherein the naturally occurring extracellular matrix from which the anchor is formed comprises SIS.

128. The device of claim 124, wherein the naturally occurring extracellular matrix from which the anchor is formed comprises comminuted SIS.

129. The device of claim 124, wherein the naturally occurring extracellular matrix from which the anchor is formed comprises crosslinked SIS.

130. The device of claim 124, wherein the plug is lyophilized onto the anchor.

131. The device of claim 124, wherein the plug is adhesively attached to the anchor.

132. The device of claim 124, wherein the plug is sutured to the anchor.

133. The device of claim 124, wherein (i) the anchor is formed with a head portion to support the plug and a body portion extending from the head portion to fasten into the subchondral portion of the bone, and (ii) the plug is formed to be sufficiently porous to receive cells from adjacent tissue or from synovial fluid.

134. The device of claim 133, wherein the plug is lyophilized onto the head portion.

135. The device of claim 101, wherein:

the plug has an outer articular surface and a side surface extending therefrom,

the plug is circular in cross-section, and

the anchor comprises a circular-shaped cover portion with an annular-shaped sidewall extending therefrom,

the anchor is positioned relative to the plug such that (i) the cover portion covers at least part of the outer articular surface, and (ii) the sidewalls extend along the one or more side surfaces, and

a distal edge portion of the sidewalls is positionable in a concentric circular groove formed in the subchondral portion of the bone.

136. The device of claim 101, further comprising an outer cover and an inner cover, wherein:

the anchor comprises a head portion to support the plug and a body portion extending from the head portion to fasten into a subchondral portion of the bone,

the plug comprises a central body of comminuted naturally occurring extracellular matrix sandwiched between the outer cover and the inner cover, and

each of the outer cover and the inner cover comprises one or more layers of naturally occurring extracellular matrix.

137. The device of claim 101, wherein the anchor comprises a ring configured to secure the plug in the opening.

138. The device of claim 101, wherein:

the opening formed in the cartilage is circular in shape so as to define a generally cylindrically-shaped wall in the cartilage,

the anchor comprises a ring to surround the plug,

the ring is configured to engage the wall in the cartilage and secure the plug in the opening.

139. The device of claim 138, wherein:

the wall in the cartilage is formed with a circumferential groove, and

the ring is resilient to fasten into the groove.

140. The device of claim 139, wherein the ring is split so as to have an open circumferential segment to accommodate the fastening of the ring into the groove in the wall in the cartilage.

141. The device of 139, wherein the ring is tapered to enhance retention in the opening.

142. A method for repairing a diseased or damaged portion of articular cartilage on a bone, the method comprising the steps of:

forming an opening in the articular cartilage so as to remove the diseased or damaged portion thereof; and

positioning a plug in the opening so as to be proximate to healthy articular cartilage, wherein the plug comprises a naturally occurring extracellular matrix.

143. The method of claim 142, wherein the plug has a structural rigidity sufficient to at least temporarily withstand design compression and shear stress at least as great as that expected to be placed on the proximate articular cartilage.

144. The method of claim 142, further comprising the step of seeding cells into the plug.

145. The method of claim 144, wherein the seeding step is performed before the positioning step.

146. The method of claim 144, wherein the seeding step is performed after the positioning step.

147. The method of claim 142, further comprising the step of administering into the plug a substance selected from the group consisting of:

a bioactive agent;

a biologically derived agent;

a biological lubricant;

a biocompatible polymer; and

a biocompatible inorganic material.

148. The method of claim 142, further comprising the steps of:

securing the plug to an anchor;

forming an opening in the subchondral portion of the bone; and

wherein the step of positioning the plug in the opening formed in the cartilage comprises positioning the anchor in the opening formed in the subchondral portion of the bone so as to position the plug in the opening formed in the cartilage.

149. The method of claim 148, wherein the anchor is formed of SIS.

150. The method of claim 142, wherein the naturally occurring extracellular matrix comprises SIS.

151. The method of claim 142, wherein the naturally occurring extracellular matrix comprises comminuted SIS.

152. The method of claim 142, wherein the naturally occurring extracellular matrix comprises lyophilized SIS.

153. The method of claim 142, further comprising the step of securing the plug in the opening with a staple.

154. A cartilage repair device for repairing damaged or diseased articular cartilage, the device comprising a laminate of layers of a naturally occurring extracellular matrix, the laminate being seeded with cells.

155. The device of claim 154, wherein the naturally occurring extracellular matrix comprises SIS.

156. The device of claim 155, wherein the cells comprise chondrocyte cells.

157. An anchor for securing a cartilage repair plug in an opening, comprising:

a body, and

a barb movable relative to the body, the barb being positionable in (i) an extended position in which a tip thereof extends out of the body, and (ii) a retracted position in which the tip is retracted into the body.

158. The anchor of claim 157, wherein the body is ring shaped.

159. The anchor of claim 157, further comprising a tube, wherein the barb is positioned in the tube.

160. The anchor of claim 159, wherein:

the body is ring shaped,

an end portion of the tube is secured to the ring shaped body such that the tube extends radially inwardly toward the center of the ring shaped body.

161. The anchor of claim 157, wherein:

the barb has a cam surface defined in a first end thereof, and

the tip is defined in a second end of the barb.