Joint resurfacing system

• US 5,556,429 A
• Filed: 05/06/1994
• Issued: 09/17/1996
• Est. Priority Date: 05/06/1994
• Status: Expired due to Term

• Current Assignee: Disc Dynamics, Inc.
• Original Assignee: Advanced Bio Surfaces, Inc.
• Inventors: Felt, Jeffrey C.
• Primary Examiner(s): Weiss, John G.
• Assistant Examiner(s): SNOW, BRUCE EDWARD
• Application Number:
  US08/239,248
• Time in Patent Office: 865 Days
• Field of Search: 623/66, 623/11, 623/16, 623/18, 606/72, 606/76, 606/77, 606/92, 606/93, 606/94, 606/213, 128/898, 433/223, 433/226
• US Class Current: 128/898
• CPC Class Codes: A61B 1/00165 with light-conductive means, e.g. fibre optics A61B1/07 takes precedence
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1682 for the foot or ankle
• CPC Class Codes: A61B 17/1686 for the hand or wrist
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• 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 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/3099 for temporo-mandibular [TM, TMJ] joints endoprostheses for mandibular reconstruction A61F2/2803
• CPC Class Codes: A61F 2/32 for the hip
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/4081 Glenoid components, e.g. cups
• CPC Class Codes: A61F 2/4202 for ankles
• CPC Class Codes: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• 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 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30024 differing in coefficient of friction
• CPC Class Codes: A61F 2002/30583 : filled with hardenable fluid, e.g. curable in-situ
• CPC Class Codes: A61F 2002/30957 : using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/4233 : for metatarso-phalangeal joints, i.e. MTP joints
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2210/0085 : hardenable in situ, e.g. epoxy resins
• CPC Class Codes: A61F 2250/0021 : differing in coefficient of friction
• CPC Class Codes: A61L 2430/38 : for reconstruction of the spine, vertebrae or intervertebral discs
• CPC Class Codes: A61L 27/18 : obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
• CPC Class Codes: A61L 29/041 : obtained by reactions only involving carbon-to-carbon unsaturated bonds
• CPC Class Codes: A61L 29/06 : obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
• CPC Class Codes: C08G 18/10 : Prepolymer processes involving reaction of isocyanates or isothiocyanates with compounds having active hydrogen in a first reaction step
• CPC Class Codes: C08G 18/3206 : aliphatic
• CPC Class Codes: C08G 18/4854 : Polyethers containing oxyalkylene groups having four carbon atoms in the alkylene group
• CPC Class Codes: C08G 18/69 : Polymers of conjugated dienes hydrogenated polymers of conjugated dienes C08G18/6208
• CPC Class Codes: C08L 23/00 : Compositions of homopolymers or copolymers of unsaturated aliphatic hydrocarbons having only one carbon-to-carbon double bond; Compositions of derivatives of such polymers
• CPC Class Codes: C08L 67/02 : Polyesters derived from dicarboxylic acids and dihydroxy compounds C08L67/06 takes precedence
• CPC Class Codes: C08L 75/04 : Polyurethanes
• CPC Class Codes: C08L 83/04 : Polysiloxanes
• CPC Class Codes: Y10S 623/919 : Bone
• CPC Class Codes: Y10S 623/923 : Bone

Abstract

A system for resurfacing orthopedic joints by arthroscopic means. The system involves a method that includes the delivery of a curable biomaterial, and the use of minimally invasive means to prepare an injury site, and then deliver, cure and shape a curable biomaterial at the site of injury.

Claims

1. A method for repairing or resurfacing the site of an injured articulating joint, the method comprising the steps of:

(a) providing a curable biomaterial; and

(b) performing the surreal steps of;

(i) accessing and preparing the joint site for receipt of the biomaterial;

ii) delivering a quantity of the curable biomaterial to the prepared joint site;

(iii) curing the delivered biomaterial in such a manner that the cured biomaterial is permanently retained in apposition to the prepared site; and

contouring the cured, retained biomaterial to achieve a desired conformation approximating that of the natural joint, wherein steps (i) through (iii) are each performed using minimally invasive surgical means.

2. A method according to claim 1 wherein the curable biomaterial comprises a polymeric matrix and hyrdrogel combination.

3. A method according to claim 2 wherein the polymeric matrix is selected from the group consisting of silicone polymers and polyurethane polymers.

4. A method according to claim 1 wherein the minimally invasive surgical means are arthroscopic means.

5. A method according to claim 4 wherein the delivery step is performed under arthroscopic visualization using a cannula suitably dimensioned to deliver the curable biomaterial.

6. A method according to claim 1 comprising the further step of coating or modifying the surface of the contoured material with a permanent interface material in order to improve the biocompatability or coefficient of friction of the cured biomaterial, wherein the coating or modifying step is also performed using minimally invasive surgical means.

7. A method according to claim 1 wherein the biomaterial comprises a curable polyurethane polymer.

8. A method according to claim 7 wherein the polyurethane comprises isocyanate, long-chain macrodiol, and short-chain diol extender components.

9. A method according to claim 8 wherein the isocyanate component comprises a diisocyanate.

10. A method according to claim 9 wherein the diisocyanate comprises diphenylmethane diisocyanate.

11. A method according to claim 8 wherein the long-chain macrodiol component comprises a glycol.

12. A method according to claim 11 wherein the glycol comprises polytetramethylene ether glycol.

13. A method according to claim 8 wherein the short-chain diol component comprises 1,4-butanediol.

14. A method according to claim 1 wherein the delivery step is performed using an arthroscopic cannula.

15. A method according to claim 1 wherein the minimally invasive surgical steps are each performed through access portals and under visualization with a fiberoptic scope.

16. A method for repairing or resurfacing the site of an injured articulating joint, the method comprising the steps of:

(a) providing a flowable, curable biomaterial;

hydrogel;

(b) preparing an access site by means of an arthroscopic system comprising a fiberoptic scope and a biomaterial delivery cannula and inserting and directing a delivery cannula through the tissue access site to the site of joint injury;

(c) delivering a quantity of the curable biomaterial through the cannula to the prepared joint site;

(d) curing the delivered biomaterial in such a manner that the cured biomaterial is retained in apposition to the prepared joint site; and

(e) contouring the cured biomaterial to achieve a desired conformation approximating that of the natural joint, wherein steps (b) through (e) are each performed using minimally invasive surgical means.

17. A method according to claim 16 comprising the further step of coating or modifying the surface of the contoured material with a permanent interface material in order to improve the biocompatibility or coefficient of friction of the cured biomaterial, wherein the coating or modifying step is also performed using minimally invasive surgical means.