Joint spacer with compartment for orthobiologic material

• US 7,001,385 B2
• Filed: 01/13/2004
• Issued: 02/21/2006
• Est. Priority Date: 08/20/1998
• Status: Expired due to Fees

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: Bonutti IP LLC
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): REIP, DAVID OWEN
• Application Number:
  US10/755,995
• Publication Number:
  US 20040148026A1
• Time in Patent Office: 770 Days
• Field of Search: 606/61, 606/60, 606/86, 623/16.11, 623/17.11, 623/17.16
• US Class Current: 606/60
• CPC Class Codes: A61B 17/562 Implants for placement in joint gaps without restricting joint motion, e.g. to reduce arthritic pain
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 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 2/30734 Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
• CPC Class Codes: A61F 2/38 for elbows or knees
• 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 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2002/0086 for preferentially controlling or promoting the growth of specific types of cells or tissues of bone tissue onto implantable joints A61F2002/3093
• CPC Class Codes: A61F 2002/30128 concentric ellipses
• CPC Class Codes: A61F 2002/30187 D-shaped or half-disc-shaped
• CPC Class Codes: A61F 2002/3023 wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30232 Half-cylinders
• CPC Class Codes: A61F 2002/30518 with possibility of relative movement between the prosthetic parts
• CPC Class Codes: A61F 2002/30556 for adjusting thickness
• CPC Class Codes: A61F 2002/30578 having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30622 Implant for fusing a joint or bone material
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• CPC Class Codes: A61F 2002/30754 Implants for interposition between two natural articular surfaces
• CPC Class Codes: A61F 2002/30787 inclined obliquely with respect to each other
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0034 : D-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0009 : for adjusting thickness
• CPC Class Codes: A61F 2310/00976 : Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated
• CPC Class Codes: Y10S 606/909 : Bone

Abstract

To change a spatial relationship between two or more bones in a patient'"'"'s body, a wedge member is moved into a joint between the bones. As the wedge member enters the joint, pivotal movement occurs between the bones to change the orientation of the bones relative to each other. The wedge member may have a circular cross sectional configuration and be moved into the joint by rotating the wedge member about an axis which extends between a thin leading edge portion and a thick trailing edge portion of the wedge member. Alternatively, the wedge member may have a cam-shaped configuration and be rotated through less than a revolution to apply force against the bones. The wedge member may have a porous construction which enables bone to grow through the wedge member and immobilize the joint. The wedge member may be coated with and/or contain bone growth promoting material. The wedge member may be connected to only one of the bones or may be connected to two adjacent bones. If the wedge member is connected to only one bone, the joint may be capable of being flexed after the wedge member is inserted into the joint.

Claims

1. An implantable device for changing the spatial relationship between first and second bones, the device comprising a wedge body configured and dimensioned for insertion into a joint located between the first and second bones, the wedge body having a thin end portion, a thick end portion, a first major side surface which extends from the thin end portion to the thick end portion, a second major side surface which intersects the first major side surface to form an edge at the thin end portion and extends from the thin end portion to the thick end portion, and a minor side surface which extends between the first and second major side surfaces and tapers from the thick end portion to the thin end portion, the wedge body having a compartment containing a bone growth inducing material.

2. The device of claim 1 wherein the bone growth inducing material includes demineralized bone.

3. The device of claim 2 wherein the demineralized bone is a powder.

4. The device of claim 1 wherein the bone growth inducing material includes collagen.

5. The device of claim 4 wherein the collagen is in the form of apatite compositions with collagen.

6. The device of claim 4 wherein the bone growth inducing material includes demineralized bone.

7. The device of claim 6 wherein the demineralized bone is a powder.

8. The device of claim 4 wherein the wedge body is made of a porous material.

9. The device of claim 8 wherein the porous material includes cavities with at least some of the cavities containing a bone growth promoting material.

10. The device of claim 1 further including fastener means for fixedly connecting the wedge body to at least one of the first and second bones.

11. The device of claim 10 wherein the fastener means includes at least one screw.

12. The device of claim 10 wherein the fastener means includes a first connector configured and dimensioned to connect the wedge body to the first bone and a second connector configured and dimensioned to connect the wedge body to the second bone.

13. The device of claim 1 wherein the bone growth inducing material includes a bone morphogenic protein.

14. A spinal implant for insertion in a joint located between first and second vertebrae, the implant comprising a wedge member configured and dimensioned for insertion into the joint, the wedge member having a thin end portion, a thick end portion, a first major side surface which extends from the thin end portion to the thick end portion, a second major side surface which intersects the first major side surface to form an edge at the thin end portion and extends from the thin end portion to the thick end portion, and a minor side surface which extends between the first and second major side surfaces and tapers from the thick end portion to the thin end portion, the wedge member having a compartment containing a bone growth inducing material.

15. The implant of claim 14 wherein the bone growth inducing material includes demineralized bone.

16. The implant of claim 15 wherein the demineralized bone is a powder.

17. The implant of claim 14 wherein the bone growth inducing material includes collagen.

18. The implant of claim 17 wherein the collagen is in the form of apatite compositions with collagen.

19. The implant of claim 17 wherein the bone growth inducing material includes demineralized bone.

20. The implant of claim 19 wherein the demineralized bone is a powder.

21. The implant of claim 17 wherein the wedge member is made of a porous material.

22. The implant of claim 21 wherein the porous material includes cavities with at least some of the cavities containing a bone growth promoting material.

23. The implant of claim 14 further including fastener means for fixedly connecting the wedge member to at least one of the first and second vertebrae.

24. The implant of claim 23 wherein the fastener means includes at least one screw.

25. The implant of claim 23 wherein the fastener means includes a first connector configured and dimensioned to connect the wedge member to the first vertebra and a second connector configured and dimensioned to connect the wedge member to the second vertebra.

26. The implant of claim 14 wherein the wedge member tapers from the thick end portion to the thin end portion.

27. The implant of claim 26 wherein the wedge member is made of a biocompatible metallic material.

28. The implant of claim 14 wherein a bone growth promoting material is disposed on the wedge member.

29. The implant of claim 14 wherein the bone growth inducing material includes a bone morphogenic protein.

30. A method of changing the spatial relationship between first and second bones, the method comprising:

providing an implantable device including an internal compartment, the implantable device having a thin end portion, a tick end portion, a first major side surface which extends from the thin end portion to the thick end portion, a second major side surface which intersects the first major side surface to form an edge at the thin end portion and extends from the thin end portion to the thick end portion, and a minor side surface which extends between the first and second major side surfaces and tapers from the thick end portion to the thin end portion;

placing a bone growth inducing material into the internal compartment, the bone growth inducing material including a bone morphogenic protein; and

inserting the implantable device into a joint located between the first and second bones.

31. The method of claim 30 further comprising connecting the implantable device to at least one of the first and second bones.

32. The method of claim 30 wherein inserting the implantable device into the joint located between the first and second bones comprises:

positioning the thin end portion of the implantable device in the joint located between the first and second bones; and

expanding at least a portion of the joint by moving the implantable device into the joint to apply a force against the first and second bones with the implantable device such that the spatial relationship between a first central longitudinal axis of the first bone and a second central longitudinal axis of the second bone changes as the implantable device is moved into the joint.

33. The method of claim 30 wherein the bone growth inducing material includes demineralized bone.

34. The method of claim 33 wherein the demineralized bone is a powder.

35. The method of claim 33 wherein the bone growth inducing material includes collagen.

36. The method of claim 35 wherein the collagen is in the form of apatite compositions with collagen.

37. The method of claim 35 wherein the implantable device is made of a porous material.

38. The method of claim 37 wherein the porous material includes cavities with at least some of the cavities containing a bone growth promoting material.

39. The method of claim 30 wherein the thick end portion has a first thickness and the thin end portion has a second thickness less than the first thickness.

40. The method of claim 39 wherein inserting the implantable device into the joint located between the first and second bones comprises:

positioning the thin end portion of the implantable device in the joint located between the first and second bones; and

expanding at least a portion of the joint located between the first and second bones by moving the implantable device into the joint to apply a force against the first and second bones with the implantable device, such that the spatial relationship between a first central longitudinal axis of the first bone and a second central longitudinal axis of the second bone changes as the implantable device is moved into the joint.

41. The method of claim 30 wherein the first and second bones are first and second vertebrae.