Bone-tendon-bone assembly with allograft bone block and method for inserting same

• US 6,890,354 B2
• Filed: 03/08/2002
• Issued: 05/10/2005
• Est. Priority Date: 03/08/2002
• Status: Active Grant

• Current Assignee: Musculoskeletal Transplant Foundation
• Original Assignee: Musculoskeletal Transplant Foundation
• Inventors: Steiner, Anton J., Gertzman, Arthur A.
• Primary Examiner(s): McDermott, Corrine
• Assistant Examiner(s): Phan, Hieu
• Application Number:
  US10/092,537
• Publication Number:
  US 20030171811A1
• Time in Patent Office: 1,159 Days
• Field of Search: 623 1311- 132, 623/17.11, 623/17.16, 623 2014- 2017
• US Class Current: 623/13.14
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/087 Anchor integrated into tendons, e.g. bone blocks, integrated rings
• 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 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30228 Cylinders of elliptical or oval basis
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30785 parallel
• CPC Class Codes: A61F 2002/30787 inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30881 Circumferential ribs, flanges or fins
• CPC Class Codes: A61F 2002/30891 Plurality of protrusions
• CPC Class Codes: A61F 2002/30892 parallel
• CPC Class Codes: A61F 2002/30894 inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/4649 Bone graft or bone dowel harvest sites
• CPC Class Codes: A61F 2210/0004 bioabsorbable
• CPC Class Codes: A61F 2230/0069 cylindrical
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures
• CPC Class Codes: A61L 27/3604 : characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
• CPC Class Codes: A61L 27/3608 : Bone, e.g. demineralised bone matrix [DBM], bone powder
• CPC Class Codes: A61L 27/3662 : Ligaments, tendons
• CPC Class Codes: A61L 27/3695 : characterised by the function or physical properties of the final product, where no specific conditions are defined to achieve this A61L27/3687, A61L27/3691 take precedence
• CPC Class Codes: A61L 27/386 : Ligaments, tendons

Abstract

The invention is directed toward a bone block, a bone-tendon-bone assembly and method of tendon reconstruction in which at least one tendon replacement is extended between two bone blocks and fixed within each of two bone tunnels in the bones of a joint using interference screws. Each bone block has a central through going bore and at least one substantially parallel channel longitudinally cut in the exterior of the bone block body in which the ligament replacements are seated. One end of each bone block has a rounded recess leading from the central bore to the exterior parallel channel.

Claims

1. A sterile composite graft comprising:

first and second bone blocks, each bone block defining a central through going bore having a cross section which will allow a ligament replacement to be passed there through and at least one longitudinal channel cut substantially parallel to the axis of the central through going bore in the exterior surface of said bone block and a ligament replacement mounted to said bone blocks, said ligament replacement extending through said central bore of said bone blocks and around said first and second bone blocks seated in said longitudinal channel.

2. A sterile composite graft as claimed in claim 1 wherein said ligament replacement comprises at least one tendon taken from a group of tendons consisting of a semitendinous tendon, a patellar tendon, gracilis tendon, quadriceps tendon, adductor magnus tendon, peroneus tendons, tibialis tendons and hallucis achilles tendon.

3. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks further define a rounded notch in one end leading from said central bore to a parallel longitudinal channel to accommodate said ligament replacement extending around said bone block from said central bore to a parallel longitudinal channel.

4. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks further comprise a plurality of holes drilled radially through each of said bone blocks from an outer surface through to the central bore.

5. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks are constructed of allograft cortical bone.

6. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks are constructed of xenograft cortical bone.

7. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks are constructed of ceramic.

8. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks are constructed of bioabsorbable polymers.

9. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks define a plurality of radial ribs which extend outward from an outer surface of said bone block.

10. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks have a second fixation screw channel cut in their outer surface.

11. A sterile composite graft as claimed in claim 1 wherein said first and second bone blocks are oval in shape and define a plurality of holes leading from an outside surface of said bone block to said central through going bore.

12. A sterile composite graft as claimed in claim 11 wherein the angle for a bone block to be placed in a tibial tunnel ranges from about 5 degrees to about 15 degrees.

13. A sterile composite graft as claimed in claim 11 wherein the angle for a bone block to be placed in a femoral tunnel ranges from about 15 degrees to about 30 degrees.

14. A sterile composite graft as claimed claim 11 wherein each bone block includes an additive taken from a group of additives consisting of living cells such as chondrocytes, bone marrow cells, mesenchymal stem cells, natural extracts, tissue transplants, bioadhesives, transforming growth factor (TGF-beta), insulin-like growth factor (IGF-1), platelet derived growth factor, fibroblast GF, osteopontin VEGF, blood elements.

15. A sterile composite graft as claimed in claim 1 wherein said ligament replacement comprises a semitendinosus tendon.

16. A sterile composite graft as claimed in claim 1 wherein said ligament replacement comprises a patellar tendon.

17. A sterile composite graft as claimed in claim 1 wherein said ligament replacement comprises a gracilis tendon.

18. A sterile composite graft as claimed in claim 1 wherein an inner face of each bone block is cut on an angle to provide a flush alignment of the bone block.

19. A sterile bone block for use in implants comprising:

an arcuate bone block body having a central through going bore and at least one substantially parallel longitudinal channel cut in an exterior surface of said bone block body, said bone block body has an oval cross section and at least one suture hole is formed radially from an exterior surface of said bone block body through to the central bore, said bone block body defining a rounded recess formed in one end to accommodate a ligament replacement, said recess extending around a bone block end leading from said central bore to at least one substantially parallel longitudinal channel cut in the exterior surface of said bone block body.

20. A sterile bone block as claimed in claim 19 wherein said bone block body has a pathway notch formed in one end to accommodate a ligament replacement, said pathway notch extending around a bone block end leading from said central bore to the substantially parallel longitudinal channel cut in the exterior surface of said bone block body.

21. A sterile bone block as claimed in claim 19 wherein said bone block body has a plurality of radial ribs which extend outward from an outer surface of said bone block body.

22. A sterile bone block as claimed in claim 19 wherein said bone block body has a bone fixation screw channel cut in its outer surface within 90 degrees of said parallel longitudinal channel.

23. A sterile bone block for use in implants comprising:

an allograft bone block body with an oval cross section having a central through going bore and at least one substantially parallel longitudinal channel cut in an exterior surface of said bone block body, said bone block body has a rounded notch formed in one end to accommodate a ligament replacement, said notch extending around a bone block end leading from said central bore to the substantially parallel longitudinal channel cut in the exterior surface of said bone block body, said bone block body further defining a plurality of holes drilled radially through the body of said bone block from an outer surface through to the central bore.

24. A sterile composite graft as claimed claim 23 wherein each bone block includes an additive taken from a group of additives consisting of living cells such as chondrocytes, bone marrow cells, mesenchymal stem cells, natural extracts, tissue transplants, bioadhesives, transforming growth factor (TGF-beta), insulin-like growth factor (IGF-1), platelet derived growth factor, fibroblast GF, osteopontin VEGF, blood elements.