Implants and delivery system for treating defects in articulating surfaces

• US 20060178748A1
• Filed: 11/30/2005
• Published: 08/10/2006
• Est. Priority Date: 02/05/2004
• Status: Abandoned Application

• Current Assignee: OsteoBiologics Inc. (Smith & Nephew PLC)
• Original Assignee: OsteoBiologics Inc. (Smith & Nephew PLC)
• Inventors: Pak, John, Dinger, Fred B. III, Niederauer, Gabriele G., Wrana, Jeffrey S., Leatherbury, Neil C.
• Application Number:
  US11/290,142
• Publication Number:
  US 20060178748A1
• Time in Patent Office: Days
• US Class Current: 623/18.110
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1635 for grafts, harvesting or transplants
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1767 for the patella
• CPC Class Codes: A61B 2090/062 penetration depth
• 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 2/30965 Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
• CPC Class Codes: A61F 2/3877 Patellae or trochleae
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/461 of knees
• CPC Class Codes: A61F 2/4618 of cartilage
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• 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 2002/2839 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 2002/30011 differing in porosity
• CPC Class Codes: A61F 2002/30014 : differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2002/30057 : made from both cortical and cancellous adjacent parts
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30224 : cylindrical
• CPC Class Codes: A61F 2002/30301 : saddle-shaped
• CPC Class Codes: A61F 2002/30324 : differing in thickness
• CPC Class Codes: A61F 2002/30616 : Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30971 : Laminates, i.e. layered products
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4648 : Means for culturing bone graft
• CPC Class Codes: A61F 2002/4649 : Bone graft or bone dowel harvest sites
• CPC Class Codes: A61F 2002/4662 : for measuring penetration depth
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0095 : Saddle-shaped
• 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 2250/0018 : differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2250/0023 : differing in porosity
• CPC Class Codes: A61F 2250/0036 : differing in thickness
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite

Abstract

The invention provides implant plugs having a complex clinically acceptable proximal surface. The invention also provides multi-phase implant plugs which have a nonplanar proximal surface. Suitable implant proximal surface shapes include, but are not limited to, concave surfaces, convex surfaces, faceted domes and angled surfaces formed by the convergence of two facets. The implants of the invention are suitable for repair of tissue defects in articulating surfaces. The invention also provides delivery devices and methods for delivering the implants of the invention. The invention also provides methods for creating defects suitable for use with the implants of the invention.

Claims

1. An implant plug for insertion into a defect in a tissue, the implant plug comprising a complex, clinically acceptable proximal surface.

2. The implant of claim 1, wherein the proximal surface of the implant comprises two facets converging to form an angled surface.

3. The implant of claim 2, wherein the angle between the facets is between about 70 and about 130 degrees.

4. The implant of claim 3, wherein the angle between the facets is between about 90 and about 110 degrees.

5. The implant of claim 4, wherein the angle between the facets is about 100 degrees.

6. The implant of claim 1 wherein the proximal surface of the implant is concave.

7. The implant of claim 1 wherein the proximal surface of the implant is convex.

8. The implant of claim 1 wherein the proximal surface of the implant is a multifaceted dome.

9. The implant of claim 1 wherein the proximal surface of the implant is saddle-shaped.

10. The implant of claim 1 wherein the proximal surface of the implant is beveled so that part of the proximal surface meets the side of the implant at an angle less than 90 degrees.

11. The implant of claim 1 which is a single phase plug.

12. The implant of claim 1 which is a multi-phase plug.

13. The implant of claim 12 which is a dual phase plug.

14. The implant of claim 1 wherein the implant is loaded with a bioactive agent.

15. The implant of claim 1, wherein the implant comprises a composite material comprising an absorbable polymer and a ceramic or mineral.

16. The implant of claim 15, wherein the composite material further comprises fibers.

17. A kit for inserting an implant plug having a complex proximal surface into a defect in a tissue comprising at least one implant of claim 1 and at least one implant delivery device comprising:

a tubular outer shaft having a proximal and distal end, a longitudinal axis, and an internal bore along the longitudinal axis of said outer shaft;

an inner shaft having a distal end and a proximal end suitable for insertion into a defect, said inner shaft adapted to fit within said internal bore of the outer shaft so that the inner shaft and the outer shaft are slidably engaged;

wherein the proximal and distal ends of the outer shaft conform to the surface of the tissue at the perimeter of the defect, and the distal end of the inner shaft conforms to the proximal surface of the implant and the implant is sized for use with the delivery device.

18. The kit of claim 17, further comprising a cutting device.

19. The kit of claim 17, comprising a plurality of tissue implant delivery devices, each having different sizes of internal bores and inner shafts.

20. The kit of claim 19, further comprising a plurality of implants, each implant being sized for use with at least one delivery device.

21. A kit for preparing a defect at a specified location in a tissue having a nonplanar surface, the kit comprising:

a drill guide having a proximal end shaped to conform to the surface of the tissue at the perimeter of the defect;

a drill sleeve; and

a drill bit

22. The kit of claim 21 wherein the drill sleeve has a circular cross-section.

23. The kit of claim 21, further comprising a finishing drill bit having a flat end.

24. A method for creation of a defect having a selected location, diameter and depth in tissue having a complex surface, the method comprising the steps of:

a. placing a drill guide so that the proximal end of the guide is in contact with the tissue at the perimeter of the selected defect location, wherein the proximal end of the drill guide is shaped to conform to the shape of the tissue at the perimeter of the selected defect location;

b. inserting a drill sleeve into the interior of the drill guide;

c. seating the drill sleeve into the tissue to the selected defect depth;

d. inserting a drill bit into the drill sleeve; and

e. drilling the drill bit to the selected defect depth.

25. A method for creation of a defect having a selected location, diameter and depth in tissue having a complex surface, the method comprising the steps of:

a. placing a guide wire central to the selected defect location and at a selected angle to the tissue surface around the selected defect location;

b. placing a first cannulated drill bit over the guide wire and drilling to the selected defect depth;

c. removing the first cannulated drill;

d. placing a second cannulated drill bit over the guide wire and drilling to the selected defect depth, the second cannulated drill bit having a flat end; and

e. removing the second cannulated drill bit and the guide wire.