Method and device for regenerating cartilage in articulating joints

• US 6,171,340 B1
• Filed: 02/23/1999
• Issued: 01/09/2001
• Est. Priority Date: 02/27/1998
• Status: Expired due to Fees

• Current Assignee: Charles L. Mcdowell
• Original Assignee: Charles L. Mcdowell
• Inventors: McDowell, Charles L.
• Primary Examiner(s): Millin, V
• Assistant Examiner(s): Koh, Choon P.
• Application Number:
  US09/256,006
• Time in Patent Office: 686 Days
• Field of Search: 623/18-23, 623/902, 623/18.11, 623/19.11
• US Class Current: 623/18.11
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61F 2/30724 Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
• CPC Class Codes: A61F 2/30728 Collars; Bone edge protectors A61F2/30734 takes precedence; sealing collars for use during cementing A61B17/8808
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/40 for shoulders
• CPC Class Codes: A61F 2/4081 Glenoid components, e.g. cups
• CPC Class Codes: A61F 2/4241 for hands, e.g. fingers
• 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 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30574 with an integral complete or partial collar or flange
• CPC Class Codes: A61F 2002/30672 temporary
• CPC Class Codes: A61F 2002/30731 Bone edge protectors
• CPC Class Codes: A61F 2002/30757 made of a sheet covering the natural articular surface, e.g. cap
• CPC Class Codes: A61F 2002/30841 Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30894 inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/3895 unicompartimental
• CPC Class Codes: A61F 2002/4007 implanted without ablation of the whole natural humeral head
• CPC Class Codes: A61F 2002/4251 : for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle joints
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: Y10S 623/902 : Method of implanting

Abstract

A method of repairing a damaged joint uses a prosthetic shield and/or spacers to protect regenerating cell growth on the articulating surface of the joint. The shield and spacers protect the articulating surfaces of the joint from compression and frictional stresses while guarding the bone from further damage. The shield and spacers also can deliver transplanted cells and cell enhancing growth factors to the site. The shield can be left in place or removed after the joint heals.

Claims

1. A method of repairing a joint having an articulating surface, the method comprising the steps of:

forming a gap between at least part of the articulating surfaces of two bones in the joint;

denuding to the bleeding subchondral bone at least a portion of the articulating surface of one bone of the joint;

maintaining the gap for a period of time;

allowing cells to grow into the gap on the articulating surface of at least one bone;

implanting a shield into a first bone of the joint at the articulating surface;

implanting a spacer into a second bone of the joint at the articulating surface opposite the first bone; and

protecting the cells growing on the articulating surface of at least one bone.

2. The method of claim 1, further comprising the step of:

denuding to the bleeding subchondral bone at least a portion of the articulating surfice of another bone in the joint.

3. The method of claim 1, further comprising the step of:

treating the denuded portion of the articulating surface to enhance cell growth.

4. The method of claim 3, wherein the denuded portion is treated by exposing the denuded portion to a factor selected from the group consisting of growth factors, attachment factors, recombinant growth factors, recombinant attachment factors, growth factor analogs, attachment factor analogs, and combinations thereof.

5. The method of claim 1, further comprising the step of:

transplanting cells to the denuded articulating surface.

6. The method of claim 1, further comprising the step of:

placing a substrate onto the denuded articulating surface.

9. A method of claim 1, further comprising the step of:

using the shield to deliver a factor to the denuded site, wherein the factor is selected from the group consisting of growth factors, attachment factors, recombinant growth factors, recombinant attachment factors, growth factor analogs, attachment factor analogs, and combinations thereof.

10. A method of claim 1, further comprising the step of:

using the spacer to deliver a factor to the denuded site, wherein the factor is selected from the group consisting of growth factors, attachment factors, recombinant growth factors, recombinant attachment factors, growth factor analogs, attachment factor analogs, and combinations thereof.

11. The method of claim 6, wherein the substrate is impregnated with a factor selected from the group consisting of growth factors, attachment factors, recombinant growth factors, recombinant attachment factors, growth factor analogs, attachment factor analogs, and combinations thereof.

7. A method of repairing a joint having an articulating surface, the method comprising the steps of:

forming a gap between at least part of the articulating surfaces of two bones in the joint;

denuding to the bleeding subchondral bone at least a portion of the articulating surface of one bone of the joint;

maintaining the gap for a period of time;

transplanting cells to the denuded articulating surface;

covering the transplanted cells with a membrane;

securing the membrane with a spacer;

allowing cells to grow into the gap on the articulating surface of at least one bone; and

protecting the cells growing on the articulating surface of at least one bone.

12. A method of claim 7, further comprising the step of:

using the spacer to deliver a factor to the denuded site, wherein the factor is selected from the group consisting of growth factors, attachment factors, recombinant growth factors, recombinant attachment factors, growth factor analogs, attachment factor analogs, and combinations thereof.

8. A method of repairing a joint having an articulating surface, the method comprising the steps of:

forming a gap between at least part of the articulating surfaces of two bones in the joint;

denuding to the bleeding subchondral bone at least a portion of the articulating surface of one bone of the joint;

maintaining the gap for a period of time;

transplanting cells to the denuded articulating surface;

covering the transplanted cells with a membrane;

securing the membrane with a shield;

allowing cells to grow into the gap on the articulating surface of at least one bone; and

protecting the cells growing on the articulating surface of at least one bone.

13. A method of claim 8, further comprising the step of:

using the shield to deliver a factor to the denuded site, wherein the factor is selected from the group consisting of growth factors, attachment factors, recombinant growth factors, recombinant attachment factors, growth factor analogs, attachment factor analogs, and combinations thereof.