METHODS AND DEVICES FOR DELIVERING AND AFFIXING TISSUE SCAFFOLDS

• US 20120271432A1
• Filed: 07/05/2012
• Published: 10/25/2012
• Est. Priority Date: 03/27/2009
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Inventors: Sengun, Mehmet Z., DiMatteo, Kristian
• Granted Patent: US 9,149,369 B2
• Time in Patent Office: Days
• US Class Current: 623/23.72
• CPC Class Codes: A61F 2/4618 of cartilage
• CPC Class Codes: A61F 2002/30766 Scaffolds for cartilage ingrowth and regeneration
• 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

Abstract

Methods and devices are provided for delivering and affixing tissue replacements. In one embodiment, a tissue scaffold can be delivered into a patient through a cannula to a cavity formed at a defect site in tissue, e.g., cartilage. A delivery shaft can be used to deliver the scaffold through the cannula, and a loading device can help load the scaffold onto the delivery shaft. A delivery guide device can position and temporarily hold the scaffold within the cavity. The delivery guide device can guide one or more surgical instruments to the scaffold to affix the scaffold within the cavity, e.g., to bone underlying the scaffold, using at least one securing mechanism.

Claims

1. A tissue scaffold delivery system, comprising:

a delivery guide having an inner lumen extending therethrough and at least one tooth extending from a perimeter of a distal end thereof, the at least one tooth being configured to penetrate a tissue scaffold and to engage bone to hold a tissue scaffold in a fixed position relative to the bone, the delivery guide further including at least one window adjacent to the distal end and configured to enable viewing of a component disposed within the inner lumen at the distal end.

2. The system of claim 1, wherein the at least one window comprises a plurality of cut-outs formed in the delivery guide.

3. The system of claim 1, wherein the at least one window comprises a transparent portion formed in the delivery guide.

4. The system of claim 1, further comprising a bone preparation tool configured to be advanced through the inner lumen of the delivery guide and to prepare bone for attachment of a tissue scaffold thereto.

5. The system of claim 14, wherein the bone preparation tool comprises a punch tool having at least one prong configured to punch at least one hole through a tissue scaffold held by the at least one prong and into bone underlying the tissue scaffold.

6. The system of claim 1, further comprising a scaffold seating tool configured to be advanced through the inner lumen of the delivery guide and to seat a tissue scaffold held in position by the at least one tooth.

8. The system of claim 1, further comprising a delivery shaft having at least one prong extending from a distal end thereof, the at least one prong being configured to extend through a tissue scaffold, and the delivery guide being disposable over the delivery shaft such that the at least one tooth is configured to engage a tissue scaffold disposed on the at least one prong of the delivery shaft.

9. The system of claim 8, further comprising a delivery cannula having a funnel coupled to a distal end thereof, the delivery shaft being slidably disposable through the delivery cannula.

10. The system of claim 1, wherein the delivery guide includes an alignment mechanism configured to position a tool inserted therethrough in a predetermined radial position relative to the delivery guide.

11. The system of claim 1, further comprising a loading block having a surface configured to seat a tissue scaffold thereon, the surface having at least one opening formed therein and configured to receive the at least one tooth on the delivery guide such that the at least one tooth can extend through a tissue scaffold seated on the surface, the loading block further including a guide member extending from the surface and having at least one channel formed therein, the at least one channel being positioned to guide the at least one prong into the at least one opening on the surface.

12. The system of claim 11, wherein the at least one tooth comprises two teeth, the at least one opening comprises two openings, and the at least one channel comprises two channels.

13. The system of claim 11, wherein the at least one opening formed in the surface of the loading block is in the form of an elongate slot configured to allow the at least one tooth on the delivery guide to slide therein.

14. The system of claim 11, wherein the at least one opening is located a predetermined distance from a terminal edge of the surface such that the at least one tooth will extend through a predetermined location on a tissue scaffold seated on the surface and having perimeter abutting the terminal edge.

15. A method for loading a tissue scaffold onto a delivery shaft, comprising:

positioning a tissue scaffold on a surface of a loading block such that the tissue scaffold is disposed over at least one opening formed in the surface; and

advancing at least one prong extending from a distal end of a delivery shaft along at least one channel formed in a guide member on the loading block, the at least one channel guiding the at least one prong through the tissue scaffold and into the at least one opening.

7. The system of claim 16, wherein the scaffold seating tool comprises a fastener-applying tool having a fastener-retaining member on a distal end thereof and configured to retain at least one fastener and to apply the fastener through a tissue scaffold held in position by the at least one tooth to fasten the tissue scaffold to a bone underlying the tissue scaffold.

16. The method of claim 15, wherein the guide member guides the at least one prong through the tissue scaffold at a predetermined location relative to a perimeter of the tissue scaffold.

17. The method of claim 15, wherein the at least one opening comprises at least one elongate slot, and wherein the method further comprises sliding the at least one prong through the at least one slot and removing the at least one prong from the at least one slot with the tissue scaffold attached thereto.

18. The method of claim 15, wherein positioning a tissue scaffold on a surface of a loading block comprises abutting a perimeter of the tissue scaffold against a surface of the guide member.

19. The method of claim 15, wherein positioning a tissue scaffold on a surface of a loading block comprises positioning at least a portion of the tissue scaffold underneath at least a portion of the guide member.

20. The method of claim 15, wherein a surface of the tissue scaffold having viable tissue cells disposed thereon is positioned in contact with the surface of the loading block.

21. A method for delivering a tissue scaffold, comprising:

positioning a distal end of a delivery guide on a tissue scaffold and against a surface of bone to hold a tissue scaffold at a fixed position relative to the surface of the bone; and

advancing a fastener-applying tool through the delivery guide to insert a fastener through the tissue scaffold and into the bone thereby fastening the tissue scaffold to the bone at the fixed position.

22. The method of claim 21, wherein positioning a distal end of the delivery guide comprises penetrating at least one tooth on the delivery guide through the tissue scaffold and into the bone.

23. The method of claim 21, further comprising, prior to advancing a fastener-applying tool through the delivery guide, advancing a punch tool through the delivery guide to form at least one hole through the tissue scaffold and into the bone for receiving the at least one fastener.

24. The method of claim 21, wherein an alignment feature on the delivery guide aligns the fastener-applying tool at a predetermined radial orientation relative to the delivery guide.

25. The method of claim 21, further comprising, prior to positioning a distal end of a delivery guide, positioning the tissue scaffold against the surface of bone using a delivery shaft, and wherein the delivery guide is advanced over the delivery shaft to position the distal end of the delivery guide on the tissue scaffold and against the surface of the bone.