Joint arthroplasty devices formed in situ

• US 7,717,956 B2
• Filed: 11/22/2005
• Issued: 05/18/2010
• Est. Priority Date: 05/25/2001
• Status: Expired due to Fees

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Lang, Philipp
• Primary Examiner(s): Philogene; Pedro
• Application Number:
  US11/326,705
• Publication Number:
  US 20070250169A1
• Time in Patent Office: 1,638 Days
• Field of Search: 623/14.12, 623 1711- 1716, 623/16.11, 623/18.11, 606/61, 606/90
• US Class Current: 623/14.12
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1662 for particular parts of the body
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/7098 wherein the implant is permeable or has openings, e.g. fenestrated screw hollow surgical screws A61B17/864
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/1075 for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer A61B8/0858 takes precedence
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/1077 Measuring of profiles
• CPC Class Codes: A61B 5/4504 : Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 : Cartilage
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• 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 2/30942 : for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• CPC Class Codes: A61F 2/36 : Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/4202 : for ankles
• CPC Class Codes: A61F 2/4261 : for wrists
• CPC Class Codes: A61F 2/4405 : for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• 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 2/46 : Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
• CPC Class Codes: A61F 2/4603 : for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30581 : having a pocket filled with fluid, e.g. liquid
• CPC Class Codes: A61F 2002/30583 : filled with hardenable fluid, e.g. curable in-situ
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30733 : Inserts placed into an endoprosthetic cavity, e.g. for modifying a material property
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30894 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30909 : Nets
• CPC Class Codes: A61F 2002/30948 : using computerized tomography, i.e. CT scans
• CPC Class Codes: A61F 2002/30957 : using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/30962 : using stereolithography
• CPC Class Codes: A61F 2210/0085 : hardenable in situ, e.g. epoxy resins
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• 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: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00047 : Aluminium or Al-based alloys
• CPC Class Codes: A61F 2310/00065 : Manganese or Mn-based alloys
• CPC Class Codes: A61F 2310/00071 : Nickel or Ni-based alloys
• CPC Class Codes: A61F 2310/00077 : Copper or Cu-based alloys
• CPC Class Codes: A61F 2310/00083 : Zinc or Zn-based alloys
• CPC Class Codes: A61F 2310/00107 : Palladium or Pd-based alloys
• CPC Class Codes: A61F 2310/00113 : Silver or Ag-based alloys
• CPC Class Codes: A61F 2310/00119 : Tin or Sn-based alloys
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00143 : Iridium or Ir-based alloys
• CPC Class Codes: A61F 2310/00149 : Platinum or Pt-based alloys
• CPC Class Codes: A61F 2310/00155 : Gold or Au-based alloys
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing

Abstract

Disclosed herein are methods and devices for repairing articular surfaces. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function.

Claims

1. A customizable implant configured for placement between joint surfaces of a joint, the implant comprising:

an expandable body;

a hollow cavity within said body;

a first exterior surface portion for opposing a first joint surface;

a second exterior surface portion for opposing a second joint surface;

the first exterior surface portion being substantially flat relative to the first joint surface;

the second exterior surface portion substantially matching a contour of the second joint surface; and

wherein the implant is configured for placement between the joint surfaces such that when expanded the second exterior surface portion engages the second joint surface and the first exterior surface portion provides the joint with a range of motion.

2. The implant of claim 1, wherein at least a portion of the implant is configured based on patient-specific data.

3. The implant of claim 1 having a first exterior surface portion configuration based on patient-specific data.

4. The implant of claim 1 having a second exterior surface portion configuration based on patient-specific data.

5. The implant of claim 1, wherein the second exterior surface portion is shaped and/or formed so that when expanded, the second exterior surface substantially conforms with the second joint surface.

6. The implant of claim 1, wherein the joint is selected from the group consisting of facet joints, uncovertebral joints and costovertebral joints.

7. The implant of claim 1, wherein the implant is fixable within the joint.

8. The implant of claim 1, wherein the body consists of different materials.

9. The implant of claim 1, wherein the body has a variable stiffness.

10. The implant of claim 1, wherein the first exterior portion is curved.

11. The implant of claim 1, wherein the implant is expandable to a size sufficient to surround a defect within the joint when implanted between the joint surfaces.

12. The implant of claim 1, wherein the implant is expandable to a size sufficient to extend beyond at least one perimeter of the joint when implanted between the joint surfaces.

13. The implant of claim 1, wherein the implant is expandable to a size sufficient to engage a joint surface along its perimeter when implanted between the joint surfaces.

14. The implant of claim 1, wherein the implant is expandable to a size sufficient to engage at least one joint surface when implanted between the joint surfaces, and wherein the joint surface is at least one of meniscal surface, cartilage and subchondral bone.

15. The implant of claim 1, wherein the implant is expandable to a size sufficient to engage at least one joint surface when implanted between the joint surfaces, and wherein the joint surface is prepared prior to injection by at least one of meniscal removal, aperture creation, and abrasion.

16. The implant of claim 1, wherein the implant is expandable by the injection of material selected from the group consisting of:

polymer, metal, gases, and crystal free metals.

17. The implant of claim 1, wherein the implant further incorporates an anchoring device.

18. The implant of claim 1, wherein the body further includes a wall that defines the cavity, the first exterior surface portion, and the second exterior surface portion of the body, wherein the wall has a variable thickness.

19. The implant of claim 1, wherein the body further includes a wall that defines the cavity and an exterior surface portion of the body, wherein the wall has a variable thickness.

20. The implant of claim 13 wherein the engaging of said perimeter assists in attaching or affixing the device to a surface.

21. A hollow device for forming an articular repair system in situ, the device having an aperture for injecting material into the device and a lumen coupled to the device to receive the material and form said articular repair system to treat a facet joint, uncovertebral joint or costovertebral joint in the spine, wherein the hollow device includes a first wall section and a second wall section formed from non-common materials so as to impart a varying expansion resulting in a desired shape of the device in an inflated state, and wherein the first wall section includes an exterior surface portion that substantially matches an articular surface portion.

22. An articular repair system formed in situ consisting of an injectable self-hardening material formed using a device as claimed in claim 21.

23. The device of claim 21, wherein said hollow device is bioresorbable.

24. A method of forming a customizable implant configured for placement between joint surfaces, the method comprising:

providing a first hollow device having walls with a variable wall thickness that imparts a varying expansion resulting in a desired shape of the device in an inflated state and having an exterior surface portion that substantially matches a corresponding surface portion of the joint;

inserting the first hollow device into a target joint; and

injecting material into the first hollow device to achieve the inflated state and the desired shape so as to form an implant to treat a facet joint, uncovertebral joint or costovertebral joint in the spine, wherein the exterior surface portion of the device engages the corresponding surface portion of the joint when the device is in the inflated state.

25. The method according to claim 24, further including the step of anchoring the implant to at least one of an articular surface, underlying bone, and adjacent bone.

26. The method according to claim 24, further including the step of removing surface irregularities in the target joint.

27. The method according to claim 26, wherein the surface irregularity is a bone spur.

28. The method according to claim 24, wherein the implant substantially conforms to a surface of the joint.

29. A method of forming a customizable implant configured for placement between joint surfaces, the method comprising:

providing a first hollow device having a first wall section and a second wall section formed from non-common materials so as to impart a varying expansion resulting in a desired shape of the device in an inflated state and having an exterior surface portion that substantially matches a corresponding surface portion of the joint;

inserting a first hollow device into a target joint; and

injecting material into the first hollow device to achieve the inflated state and the corresponding desired shape so as to form an implant to treat a facet joint, uncovertebral joint or costovertebral joint in the spine, wherein the exterior surface portion of the device engages the corresponding surface portion of the joint when the device is in the inflated state.

30. The method according to claim 29, further including the step of anchoring the implant to at least one of an articular surface, underlying bone, and adjacent bone.

31. The method according to claim 29, further including the step of removing surface irregularities in the target joint.

32. The method according to claim 31, wherein the surface irregularity is a bone spur.

33. The method according to claim 29, wherein the implant substantially conforms to a surface in the joint.

34. A method of forming a customizable implant configured for placement between joint surfaces, the method comprising:

providing a first hollow device having a varying expansion resulting in a desired shape of the device in an inflated state and having an exterior surface portion that substantially matches a corresponding surface portion of the joint;

inserting the first hollow device into a target joint;

injecting material into the first hollow devices to achieve the inflated state and the corresponding desired shape so as to form an implant to treat a facet joint, uncovertebral joint or costovertebral joint in the spine; and

anchoring the implant at least in part by engaging the exterior surface portion with the corresponding surface portion of the joint.

35. The method according to claim 34, further including the step of removing surface irregularities in the target joint.

36. The method according to claim 35, wherein the surface irregularity is a bone spur.

37. The method according to claim 34, wherein the implant substantially conforms to a surface in the joint.

38. The method of claim 34, wherein said anchoring is achieved by the implant substantially conforming in shape to at least one surface of a joint.

39. The method of claim 34, wherein said anchoring is achieved by the implant substantially conforming to the perimeter of a joint.

40. The method of claim 34, wherein said anchoring is achieved by the implant substantially conforming to a bone surface.

41. The method of claim 34, wherein said anchoring is achieved by the implant substantially conforming to a cartilage surface.