Instrumentation and method for repair of meniscus tissue

• US 20090234452A1
• Filed: 03/06/2009
• Published: 09/17/2009
• Est. Priority Date: 03/06/2008
• Status: Active Grant

• Current Assignee: Musculoskeletal Transplant Foundation
• Original Assignee: Musculoskeletal Transplant Foundation
• Inventors: Fanelli, Gregory C., Barker, John E., Steiner, Anton J., Shock, James
• Granted Patent: US 8,152,846 B2
• Time in Patent Office: Days
• US Class Current: 623/14.120
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1611 the two jaw elements being integral with respective elongate shaft elements
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0805 Implements for inserting tendons or ligaments
• 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 2/3872 Meniscus for implantation between the natural bone surfaces
• CPC Class Codes: A61F 2/4618 of cartilage
• 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 2310/00359 Bone or bony tissue

Abstract

The invention is directed toward a method and instrumentation to replace a damaged human knee joint meniscus with an allograft meniscus. The implant has its bone base cut to a desired width in a workstation. The finished base is measured in the sizing groove of the sizing block for width and length. The tibia is then drilled with drill to the appropriate depth and length and groove is formed in the tibia with a tissue chisel so that the width is the same as the width of the bone base. The bone base is press fit into the tibia groove and may be secured with a bone screw.

Claims

1. A kit for placing an allograft meniscus implant on the surface of a human tibia comprising a meniscal implant of allograft material including a bone base and an instrumentation comprising (a) a drill apparatus, (b) a chisel, (c) a meniscus bone base measuring block and (d) a cutting work station.

2. A kit as claimed in claim 1 including a hand gauge provide with marking indicia along its length.

3. A kit as claimed in claim 1 wherein said bone base measuring block defines a plurality of parallel grooves, each of which has a different width and marking indicia placed along the length of said grooves.

4. A kit as claimed in claim 1 wherein said allograft meniscus implant includes an additive taken from a group of additives consisting of transforming growth factor (TGF-beta), insulin growth factor (IGF-1), platelet derived growth factor (PDGF), fibroblast growth factor (FGF)(Numbers 1-23), platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), osteopontin, and growth hormones such as somatotropin.

5. A kit as claimed in claim 1 wherein said allograft meniscus implant includes an additive taken from a group of additives consisting of living cells, cell elements such as chondrocytes, red blood cells, white blood cells, platelets, blood plasma, bone marrow cells, mesenchymal stem cells, pluripotential cells, osteoblasts, osteoclasts, fibroblasts, epithelial cells and entothial cells, natural extracts, and tissue transplants.

6. A kit as claimed in claim 1 wherein said allograft meniscus implant includes an additive taken from a group of additives consisting of living cells, cell elements such as chondrocytes, red blood cells, white blood cells, platelets, blood plasma, bone marrow cells, mesenchymal stem cells, pluripotential cells, osteoblasts, osteoclasts, fibroblasts, epithelial cells and entothial cells, natural extracts, tissue transplants, and growth factors such as transforming growth factor (TGF-beta), insulin growth factor (IGF-1), platelet derived growth factor (PDGF), fibroblast growth factor (FGF)(Numbers 1-23), platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), osteopontin;

growth hormones such as somatotropin;

cellular attractants and attachment agents;

fibronectin;

immuno-suppressants;

permeation enhancers, e.g. fatty acid esters such as laureate, myristate and stearate monoesters of polyethylene glycol, enamine derivatives, and alpha-keto aldehydes.

7. A kit as claimed in claim 1 wherein said cutting workstation has a C shaped body with the legs defining a plurality of aligned slits and a cross bar mounted to said legs, a thumb screw threadably mounted to said cross bar.

8. A kit as claimed in claim 1 wherein said drill apparatus comprises a housing with an integral handle extending from said handle, a drill rod assembly axially and rotatably mounted in said housing and a clamping rod mounted in said housing and extending past said housing, said clamping rod having a C shaped end curved back towards said housing.

9. A kit as claimed in claim 8 wherein said drill apparatus handle is a pistol type grip.

10. A kit as claimed in claim 1 wherein said chisel has a handle formed with linear throughgoing slots and a circular strike end and a cutting blade mounted to said handle, said cutting blade defining a linear cutout portion.

12. A kit as claimed in claim 1 including a circular core saw.

11. A kit as claimed in claimed 10 wherein said cutting blade has a distal beveled end.

13. A kit for placing an allograft meniscus implant on the surface of a human tibia comprising a meniscal implant of allograft material and an instrument comprising (a) a drill apparatus, (b) a chisel, (c) a meniscus bone base measuring block and (d) a cutting work station, said bone base measuring block defining a plurality of parallel grooves, each of which has a different width and marking indicia placed along the length of said grooves, said cutting workstation has a C shaped body with the legs defining a plurality of aligned slits and a cross bar mounted to said legs, and a thumb screw threadably mounted to said cross bar.

14. A kit as claimed in claim 13 wherein said drill apparatus comprises a housing with an integral handle extending from said handle, a drill rod assembly axially and rotatably mounted in said housing and a clamping rod mounted in said housing and extending past said housing, said clamping rod having a C shaped end curved back towards said housing.

15. A kit as claimed in claim 13 wherein said allograft meniscus implant has a bone base connecting the ends of said meniscus implant.

16. A kit as claimed in claim 13 wherein said allograft meniscus implant has cylindrical plugs at each end of said meniscus implant.

17. A kit as claimed in claim 13 including a hand gauge provided with marking indicia along its length.

18. A kit for placing an allograft meniscus implant on the surface of a human tibia comprising a meniscal implant of allograft material including a bone base and an instrument comprising (a) a drill apparatus, (b) a chisel, (c) a meniscus bone base measuring block and (d) a cutting work station, said bone base measuring block defines a plurality of parallel grooves, each of which has a different width and marking indicia placed along the length of said grooves, said cutting workstation has a C shaped body with the legs defining a plurality of aligned slits and a cross bar mounted to said legs, a thumb screw threadably mounted to said cross bar, said drill apparatus comprises a housing with an integral handle extending from said handle, a drill rod assembly axially and rotatably mounted in said housing and a clamping rod mounted in said housing and extending past said housing, said clamping rod having a C shaped end curved back towards said housing.

19. A method of preparing a meniscus implant having a bone base comprising the steps of:

(a) cutting the bone base into cylindrical posts of predetermined diameter;

(b) drilling a bore into a tibia having a predetermined diameter equal to or slightly larger than the diameter of each cylindrical post;

(c) placing each aid cylindrical post into a respective tibial bore; and

,

(d) fastening each said cylindrical post in said respective tibia bore.