Method and apparatus for resurfacing an articular surface

• US 20050038520A1
• Filed: 08/11/2003
• Published: 02/17/2005
• Est. Priority Date: 08/11/2003
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: Binette, Francois, Lu, Ed Yiling
• Granted Patent: US 10,583,220 B2
• Time in Patent Office: Days
• US Class Current: 623/18.110
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30225 Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/30677 Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30751 for attaching cartilage scaffolds to underlying bone
• CPC Class Codes: A61F 2002/30764 Cartilage harvest sites
• CPC Class Codes: A61F 2002/30766 Scaffolds for cartilage ingrowth and regeneration
• CPC Class Codes: A61F 2210/0004 bioabsorbable
• CPC Class Codes: A61F 2230/0069 cylindrical
• CPC Class Codes: A61L 2430/06 for cartilage reconstruction, e.g. meniscus
• CPC Class Codes: A61L 27/3654 Cartilage, e.g. meniscus
• CPC Class Codes: A61L 27/38 containing added animal cells organs or tissue containing native cells A61L27/36

Abstract

A biocompatible, bioresorbable tissue repair implant or scaffold device is provided for use in repairing a variety of cartilage tissue injuries, and particularly for resurfacing and/or repairing damaged or diseased cartilage. The repair procedures may be conducted with tissue repair implants that contain a biological component that assists in delaying or arresting the progression of degenerative joint diseases and in enhancing tissue healing or repair. The biocompatible, bioresorbable tissue repair implants include a scaffold and particles of viable tissue derived from cartilage tissue, such that the tissue and the scaffold become associated. The particles of living tissue contain one or more viable cells that can migrate from the tissue and populate the scaffold.

Claims

1. A method for resurfacing a diseased or damaged articular surface in a patient, comprising the steps of:

providing a tissue repair implant formed of a biocompatible, bioresorbable scaffold;

preparing the articular surface to receive the tissue repair implant;

implanting the tissue repair implant onto the prepared articular surface; and

securing the tissue repair implant in place.

2. The method of claim 1, wherein the step of preparing the articular surface includes debriding the diseased or injured articular surface to expose a subchondral bone surface.

3. The method of claim 2, wherein the step of preparing the articular surface includes forming one or more holes in the subchondral bone surface to induce bleeding and effect marrow cell infiltration.

4. The method of claim 1, wherein the scaffold is formed from a material selected from the group consisting of a synthetic polymer, a natural polymer, an injectable gel, a ceramic material, autogeneic tissue, allogeneic tissue, xenogeneic tissue, and combinations thereof.

5. The method of claim 1, wherein the scaffold is configured to cover substantially an entire surface area of the prepared articular surface.

6. The method of claim 1, wherein the tissue repair implant includes at least one biological component in association with the scaffold.

7. The method of claim 6, wherein the biological component comprises at least one tissue fragment having an effective amount of viable cells that can migrate out of the tissue fragment and populate the scaffold.

8. The method of claim 7, wherein the at least one tissue fragment includes a plurality of cells and, upon implantation at a surgical site, at least a portion of the plurality of cells is able to migrate out of the tissue fragment associated with the scaffold to proliferate and integrate with surrounding tissue at a site of implantation.

9. The method of claim 7, wherein the at least one tissue fragment includes a plurality of cells and, prior to implantation at a surgical site, at least a portion of the plurality of cells is able to migrate out of the tissue fragment associated with the scaffold to proliferate and populate the scaffold.

10. The method of claim 7, wherein the at least one tissue fragment comprises autogeneic tissue, allogeneic tissue, xenogeneic tissue, and combinations thereof.

11. The method of claim 7, where in the at least one tissue fragment comprises a bone-free tissue type selected from the group consisting of cartilage, meniscus, tendon, ligament and combinations thereof.

12. The method of claim 6, wherein the biological component is selected from the group consisting of antibiotics, antimicrobial agents, anti-inflammatory agents, growth factors, hormones, cytokines, proteins, glycosaminoglycans, immunosuppressants, nucleic acids, analgesics, cell types, viruses, virus particles, and combinations thereof.

13. The method of claim 12, wherein the cell type is selected from the group consisting of osteocytes, fibroblasts, stem cells, pluripotent cells, chondrocyte progenitors, chondrocytes, osteocytes, osteoclasts, osteoblasts, endothelial cells, macrophages, adipocytes, monocytes, plasma cells, mast cells, umbilical cord cells, leukocytes, stromal cells, mesenchymal stem cells, epithelial cells, myoblasts, tenocytes, ligament fibroblasts, and bone marrow cells.

14. The method of claim 6, wherein the biocompatible scaffold further comprises at least one additional biological component applied thereto.

15. The method of claim 14, wherein the at least one additional biological component comprises growth factors, matrix proteins, peptides, antibodies, enzymes, cytokines, viruses, nucleic acids, peptides, isolated cells, platelets or combinations thereof.

16. The method of claim 14, wherein the at least one additional biological component comprises platelets, and further wherein the platelets are delivered in a biological or synthetic hydrogel selected from the group consisting of alginate, cross-linked alginate, hyaluronic acid, collagen gel, fibrin glue, fibrin clot, poly(N-isopropylacrylamide), agarose, chitin, chitosan, cellulose, polysaccharides, poly(oxyalkylene), a copolymer of poly(ethylene oxide)-poly(propylene oxide), poly(vinyl alcohol), polyacrylate, platelet poor plasma (PPP) clot, laminin, solubilized basement membrane, and combinations thereof.

17. The method of claim 15, wherein the biological component further includes an activator of platelets.

18. The implant of claim 17, wherein the activator of platelets is selected from the group consisting of thrombin, adenosine di-phosphate (ADP), collagen, epinephrine, arachidonic acid, ristocetin, and combinations thereof.

19. The method of claim 6, wherein the biocompatible scaffold further comprises an adhesion agent for anchoring the suspension of tissue fragment to the biocompatible scaffold.

20. The method of claim 19, wherein the adhesion agent comprises an anchoring agent selected from the group consisting of hyaluronic acid, fibrin glue, fibrin clot, collagen gel, gelatin-resorcin-formalin adhesive, mussel-based adhesive, dihydroxyphenylalanine (DOPA) based adhesive, chitosan, transglutaminase, poly(amino acid)-based adhesive, cellulose-based adhesive, synthetic acrylate-based adhesives, platelet rich plasma (PRP), Matrigel, Monostearoyl Glycerol co-Succinate (MGSA), Monostearoyl Glycerol co-Succinate/polyethylene glycol (MGSA/PEG) copolymers, laminin, elastin, proteoglycans and combinations thereof.

21. The method of claim 19, wherein the adhesion agent comprises a chemical cross-linking agent selected from the group consisting of divinyl sulfone (DVS), polyethylene glycon divinyl sulfone (VS-PEG-VS), hydroxyethyl methacrylate divinyl sulfone (HEMA-DIS-HEMA), formaldehyde, glutaraldehyde, aldehydes, isocyanates, alkyl and aryl halides, imidoesters, N-substituted maleimides, acylating compounds, carbodiimide, hydroxychloride, N-hydroxysuccinimide, light, pH, temperature, and combinations thereof.

22. The method of claim 1, further comprising the step of harvesting cartilage tissue from the patient.

23. The method of claim 22, wherein the harvested cartilage tissue is minced to produce tissue fragments.

24. The method of claim 23, wherein the tissue fragments are incorporated into the tissue repair implant.

25. The method of claim 24, wherein the tissue repair implant is incubated with the tissue fragments prior to implantation.

26. The method of claim 24, wherein the cells of the tissue fragments are genetically modified prior to implantation.

27. The method of claim 1, wherein the step of securing the tissue repair implant is effected using one or more agents selected from the group consisting of fasteners, staples, tissue tacks, suture, adhesive, and combinations thereof.