Cartilage implant assembly and method for implantation

• US 20050222687A1
• Filed: 04/02/2004
• Published: 10/06/2005
• Est. Priority Date: 04/02/2004
• Status: Abandoned Application

• Current Assignee: Massachusetts Institute of Technology, Musculoskeletal Transplant Foundation
• Original Assignee: Massachusetts Institute of Technology
• Inventors: Tomford, William W., Sunwoo, Moon Hae, Gertzman, Arthur A., Vunjak-Novakovic, Gordana, Truncale, Katherine Ann Gomes
• Application Number:
  US10/815,778
• Publication Number:
  US 20050222687A1
• Time in Patent Office: Days
• US Class Current: 623/23.630
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/3094 Designing or manufacturing processes
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/4644 Preparation of bone graft, bone plugs or bone dowels, e.g. grinding or milling bone material bone material A61F2/28; disintegrating or milling devices B02C
• CPC Class Codes: A61F 2002/2817 Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/30004 the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30112 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30113 circular
• CPC Class Codes: A61F 2002/30121 with lobes
• CPC Class Codes: A61F 2002/30125 elliptical or oval
• CPC Class Codes: A61F 2002/30136 undulated or wavy, e.g. serpentine-shaped or zigzag-shaped
• CPC Class Codes: A61F 2002/30153 rectangular
• CPC Class Codes: A61F 2002/30179 X-shaped
• CPC Class Codes: A61F 2002/30224 cylindrical
• CPC Class Codes: A61F 2002/30225 Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/30228 : Cylinders of elliptical or oval basis
• CPC Class Codes: A61F 2002/3028 : polyhedral different from parallelepipedal and pyramidal
• CPC Class Codes: A61F 2002/30759 : Mosaicplasty, i.e. using a plurality of individual cartilage plugs for filling a substantial cartilage defect
• CPC Class Codes: A61F 2002/30764 : Cartilage harvest sites
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2230/0004 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0058 : X-shaped
• CPC Class Codes: A61F 2230/0063 : Three-dimensional shapes
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0014 : having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61F 2310/00383 : Gelatin
• CPC Class Codes: A61L 2430/06 : for cartilage reconstruction, e.g. meniscus
• CPC Class Codes: A61L 27/3608 : Bone, e.g. demineralised bone matrix [DBM], bone powder
• CPC Class Codes: A61L 27/3612 : Cartilage, synovial fluid
• 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 27/48 : with macromolecular fillers
• CPC Class Codes: A61L 27/52 : Hydrogels or hydrocolloids

Abstract

The invention is directed toward a cartilage repair assembly comprising a shaped structure of subchondral bone with an integral overlying cartilage cap which is treated to remove cellular debris and proteoglycans and milled cartilage in a bioabsorbable carrier. The shaped structure is dimensioned to fit in a drilled bore in a cartilage defect area so that said shaped bone and cartilage cap when centered in the bore does not engage the side wall of the bore in an interference fit and is surrounded by milled cartilage and carrier. A method for inserting the assembly into a cartilage defect area is disclosed.

Claims

1. A cartilage repair assembly for repair of a defect in an articular cartilage comprising an allograft bone plug having a subchondral bone and an overlying cartilage cap, said allograft bone plug having been treated to remove cellular debris and proteoglycans and an allograft milled cartilage mixture in a biocompatible carrier surrounding at least a portion of a side wall of said allograft bone plug.

2. A cartilage repair assembly as claimed in claim 1 wherein said allograft bone plug is cylindrically shaped.

3. A cartilage repair assembly as claimed in claim 1 wherein said allograft bone plug has an oval shaped cross section.

4. A cartilage repair assembly as claimed in claim 1 wherein said allograft bone plug has a cruciate shaped cross section.

5. A cartilage repair assembly as claimed in claim 1 wherein said allograft bone plug has a scalloped shaped cross section.

6. A cartilage repair assembly as claimed in claim 2 wherein said allograft bone plug has a diameter ranging from 1 mm to 30 mm.

7. A cartilage repair assembly as claimed in claim 2 wherein said allograft bone plug has a diameter ranging from about 4 mm to about 10 mm.

8. A cartilage repair assembly as claimed in claim 1 wherein said milled cartilage is hyaline cartilage.

9. A cartilage repair assembly as claimed in claim 1 wherein said milled cartilage is fibrocartilage.

10. A cartilage repair assembly as claimed in claim 1 wherein said milled cartilage is a mixture of fibrocartilage and hyaline cartilage.

11. A cartilage repair assembly as claimed in claim 1 including an additive consisting of one or more of a group consisting of growth factors, human allogenic cells, human autologous bone marrow cells, human allogenic bone marrow cells, stem cells, demineralized bone matrix, cartilage, and insulin.

12. A cartilage repair assembly as claimed in claim 11 wherein said demineralized bone matrix comprises bone powder having a size ranging from 200 to 850 microns and a weight ranging from 1% to 35% of the cartilage mixture.

13. A cartilage repair assembly comprising a sterile shaped structure of subchondral bone with an integral overlying cartilage cap, said shaped structure being dimensioned to fit in a drilled bore in a cartilage defect area so that said shaped bone and cartilage cap when centered in the bore does not engage the side wall of the bore in an interference fit, said shaped structure being treated to remove cellular debris and proteoglycans and sterile milled cartilage pieces mixed in a carrier surrounding said bone plug in said bore.

14. A cartilage repair assembly as claimed in claim 13 wherein said milled cartilage pieces are sized less than 1 mm.

15. A cartilage repair assembly as claimed in claim 13 wherein said cartilage is allograft cartilage.

16. A cartilage repair assembly as claimed in claim 13 wherein said cartilage is autologous cartilage.

17. A cartilage repair assembly as claimed in claim 13 wherein said shaped structure has a shape taken from a group consisting of a cylinder, an oval, a cruciate, and scallop.

18. A cartilage repair assembly as claimed in claim 13 wherein said milled cartilage pieces and carrier includes an additive taken from one or more of a group consisting of growth factors, human allogenic cells, human bone autologous marrow cells, human allogenic bone marrow cells, stem cells, demineralized bone matrix, cartilage, and insulin.

19. A cartilage repair assembly as claimed in claim 18 wherein said demineralized bone matrix comprises bone powder having a size ranging from 200 to 850 microns and a weight ranging from 1% to 35% of the cartilage mixture.

20. A cartilage repair assembly as claimed in claim 13 wherein said carrier includes a bioabsorbable carrier consisting of one or more of a group consisting of sodium hyaluronate, gelatin, collagen, chitosan, alginate, buffered PBS, Dextran or polymers.

21. A cartilage repair assembly as claimed in claim 13 wherein said milled cartilage is hyaline cartilage.

22. A cartilage repair assembly as claimed in claim 13 wherein said milled cartilage is fibrocartilage.

23. A cartilage repair assembly as claimed in claim 13 wherein said milled cartilage is a mixture of fibrocartilage and hyaline cartilage.

24. A cartilage repair assembly comprising a sterile shaped structure of subchondral bone and overlying integral cartilage cap, said shaped structure been dimensioned to fit in a drilled bore in a cartilage defect are so that said shaped bone and hyaline cartilage cap when centered in the bore can be rotated in said bore, said bone plug being treated to remove cellular debris and proteoglycans and sterile milled cartilage pieces mixed in a bioabsorbable carrier surrounding at least a portion of a side wall of shaped structure.

25. A cartilage repair assembly as claimed in claim 24 wherein said milled cartilage pieces are sized less than 1 mm.

26. A cartilage repair assembly as claimed in claim 24 wherein said cartilage is hyaline allograft cartilage.

27. A cartilage repair assembly as claimed in claim 24 wherein said milled cartilage is fibrocartilage.

28. A cartilage repair assembly as claimed in claim 24 wherein said milled cartilage is a mixture of fibrocartilage and hyaline cartilage.

29. A cartilage repair assembly as claimed in claim 24 wherein said cartilage is autologous cartilage.

30. A cartilage repair assembly as claimed in claim 24 wherein said shaped structure has a shape taken from a group consisting of a cylinder, an oval, a cruciate, and scallop.

32. A cartilage repair assembly as claimed in claim 24 wherein said milled cartilage pieces and carrier include an additive taken from one or more of a group consisting of growth factor, human allogenic cells, human bone marrow cells, human autologous bone marrow cells, demineralized bone matrix, cartilage, and insulin.

33. A cartilage repair assembly as claimed in claim 24 wherein said demineralized bone matrix comprises bone powder having a size ranging from 200 to 850 microns and a weight ranging from 1% to 35% of the cartilage mixture.

34. A cartilage repair assembly as claimed in claim 24 wherein said bioabsorbable carrier is one or more of a group consisting of sodium hyaluronate, gelatin, collagen, chitosan, alginate, buffered PBS, Dextran or polymers.

35. A cartilage repair assembly kit comprising a sterile shaped structure of allograft subchondral bone and an overlying cartilage cap, said structure being treated to remove cellular debris and proteoglycans and housed in a first sterile container and milled allograft cartilage pieces mixed in a carrier housed in a second sterile container, said first and second sterile containers being packaged together.

36. A cartilage repair assembly kit as claimed in claim 35 wherein said cartilage pieces are allograft hyaline cartilage.

37. A cartilage repair assembly kit as claimed in claim 35 wherein said carrier includes an additive taken from one or more of a group consisting of growth factors, human allogenic cells, human allogenic bone marrow cells, human autologous bone marrow cells, stem cells, demineralized bone matrix, cartilage, and insulin.

38. A cartilage repair assembly kit as claimed in claim 35 wherein said carrier is a bioabsorbable carrier taken from a group consisting of sodium hyaluronate, gelatin, collagen, chitosan, alginate, buffered PBS, Dextran or polymers.

39. A method of placing a preshaped allograft implant assembly in a cartilage defect, said assembly comprising a subchondral bone and an overlying cartilage cap plug which has been treated to remove cellular debris and proteoglycans and minced cartilage in a carrier comprising the steps of:

(a) drilling a hole in a patient at a site of a cartilage defect, a depth which equal to or less than the length of the bone and cartilage cap plug implant;

(b) placing a preshaped osteochondral plug having a cross section which is less than the cross sectional area of the hole with a length which equal to the depth of the hole allowing the structure to be moveable within said bore in the cylindrical hole; and

(c) placing a mixture of minced cartilage in a bioabsorbable carrier in the drilled cylindrical hole around the preshaped osteochondral plug.

40. A method as claimed in claim 39 wherein said hole is a cylindrical bore.

41. A method as claimed in claim 39 wherein said minced cartilage is allogenic.

42. A method as claimed in claim 39 wherein said minced cartilage is autologous.

43. A method as claimed in claim 39 wherein said assembly includes an additive consisting of one or more of a group consisting of growth factor, human allogenic cells, human bone marrow cells, demineralized bone matrix, cartilage, and insulin.

44. A method as claimed in claim 39 wherein said bioabsorbable carrier is taken from one or more of a group consisting of sodium hyaluronate, gelatin, collagen, chitosan, alginate, buffered PBS, Dextran or polymers.