Fixation method for the attachment of wound repair materials to cartilage defects

• US 5,713,374 A
• Filed: 02/10/1995
• Issued: 02/03/1998
• Est. Priority Date: 02/10/1995
• Status: Expired due to Fees

• Current Assignee: Hospital For Joint Diseases Orthopaedic Institute (Sinai Health System)
• Original Assignee: Hospital For Joint Diseases Orthopaedic Institute (Sinai Health System)
• Inventors: Frenkel, Sally, Menche, David, Pachence, James M.
• Primary Examiner(s): Lacyk, John P.
• Application Number:
  US08/386,799
• Time in Patent Office: 1,089 Days
• Field of Search: 128/897-98, 623/11, 623/13, 623/16, 602/42, 602/43, 602/53, 602/79, 606/151, 606/213, 606/215, 606/233
• US Class Current: 128/898
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61F 2/0059 Cosmetic or alloplastic implants A61F2/10 - A61F2/16, A61F2/28 take precedence
• CPC Class Codes: A61F 2/0077 Special surfaces of prostheses, e.g. for improving ingrowth A61F2/30767 takes precedence
• CPC Class Codes: A61F 2/2846 Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects nets or sleeves applied to surface of endoprostheses A61F2/30907; bone plates A61B17/80; bone regeneration in dental surgery A61C8/0006
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• 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 2002/30011 differing in porosity
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30461 sutured, ligatured or stitched
• CPC Class Codes: A61F 2002/30751 for attaching cartilage scaffolds to underlying bone
• CPC Class Codes: A61F 2002/30761 Support means for artificial cartilage, e.g. cartilage defect covering membranes
• CPC Class Codes: A61F 2002/30929 having at least two superposed coatings
• CPC Class Codes: A61F 2013/00357 implanted wound fillings or covers membranes for covering bone defects A61F2/2846
• CPC Class Codes: A61F 2210/0004 bioabsorbable
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2250/0024 made from both porous and non-porous parts, e.g. adjacent parts
• CPC Class Codes: A61F 2310/00365 Proteins; Polypeptides; Degradation products thereof

Abstract

An attachment method to hold a biomaterial in place until healing occurs. The method consists of anchoring sutures through the subchondral plate into bony tissue with at least two lines emerging from the surface. The anchored suture lines are then pulled through the implant at its four quadrants, and is thus used to secure the cartilage repair material into the wound site.

Claims

1. An attachment method used to hold a cartilage repair template into a cartilage defect site, the method comprising the steps of:

(a) anchoring sutures through the subchondral plate into bony tissue, in said defect site, with at least two lines emerging from a surface thereof; and

(b) using the anchored suture lines to secure the cartilage repair template to the site and wherein the template includes a dense collagen membrance which is positioned closely adjacent to or against said subchondral plate.

2. The method of claim 1 additionally comprising the further step of selecting the cartilage repair template to be a bilayer material for the repair of cartilage defects leading to the regeneration of hyaline-like cartilage, comprising:

a) a first layer comprising a dense collagen membrane having a pore size of less than 1 micrometer which is cross-linked with a non-cytotoxic agent to increase strength and lengthen resorption time, to provide a barrier against movement of cells from the subchondral plate, the membrane being sufficiently permeable to allow the passage therethrough of fluids, nutrients, cytokines, and other endogenous factors necessary for healing; and

b) a second layer secured to the first layer and comprising a porous collagen matrix having a pore size of 50 to 200 micrometers, which permits the ingrowth of cells; and

c) positioning said cartilage repair template in said defect site, such that said dense collagen membrane is located closely adjacent to or in contact with said subshondral plate.

3. The method of claim 2 additionally comprising the step of selecting the template to comprise autologous periosteum placed on top of the collagen matrix and the matrix is initially devoid of cells.

4. The method of claim 2 additionally comprising the step of selecting the template to comprise a collagen film placed on top of the collagen matrix and the matrix is initially devoid of cells.

5. The method of claim 2 additionally comprising the step of selecting the template to comprise chondrocyte cells cultured ex vivo with the porous collagen matrix so that the chondrocytes permeate the collagen matrix.

6. The method of claim 2 additionally comprising the step of selecting the template to comprise a piece of autologous periosteum placed on top of the collagen matrix containing the chondrocyte cells.

7. The method of claim 2 additionally comprising the step of selecting the template to comprise a collagen film placed on top of the collagen matrix containing the chondrocyte cells.

8. The method of claim 2 additionally comprising the step of attaching the dense collagen membrane to the collagen matrix using a resorbable suture.

9. The method of claim 2 additionally comprising the step of applying the dense collagen membrane to the collagen matrix during formation of the bilayer material.

10. The method of claim 2 additionally comprising the step of selecting the dense collagen membrane to have a thickness in the range of 50 to 200 micrometers.

11. The method of claim 2 additionally comprising the step of selecting the porous collagen matrix to have a thickness in the range of 0.5 to 8 millimeters.