Devices and methods for stabilizing tissue and implants

• US 9,226,828 B2
• Filed: 09/20/2013
• Issued: 01/05/2016
• Est. Priority Date: 10/26/2004
• Status: Expired due to Fees

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US14/032,969
• Publication Number:
  US 20140025166A1
• Time in Patent Office: 837 Days
• Field of Search: 623 1711- 1716, 606/279, 606 70- 71, 606280-299
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/56 Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/7022 Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables A61B17/702 takes precedence
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/8869 Tensioning devices
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws
• 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 2/30749 Fixation appliances for connecting prostheses to the body
• 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 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 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30677 Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/4435 Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2002/444 for replacing the nucleus pulposus
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00359 : Bone or bony tissue
• CPC Class Codes: A61L 2430/38 : for reconstruction of the spine, vertebrae or intervertebral discs
• CPC Class Codes: A61L 27/12 : Phosphorus-containing materials, e.g. apatite
• CPC Class Codes: A61L 27/225 : Fibrin; Fibrinogen
• CPC Class Codes: A61L 27/24 : Collagen
• CPC Class Codes: A61L 27/3834 : Cells able to produce different cell types, e.g. hematopoietic stem cells, mesenchymal stem cells, marrow stromal cells, embryonic stem cells
• CPC Class Codes: A61L 27/54 : Biologically active materials, e.g. therapeutic substances A61L27/227 takes precedence
• CPC Class Codes: A61L 27/58 : Materials at least partially resorbable by the body

Abstract

An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

Claims

1. An implant for repairing a joint between a first bone portion and a second bone portion, the implant comprising:

a first section constructed of a substantially rigid material, the first section having a first end surface configured for positioning against the first bone portion and a first external surface;

a graft constructed of soft tissue having a first end and a second end, the graft configured for stabilizing the first section relative to the first bone portion, the graft extending across an interface defined between the first end surface and the first bone portion, the first end surface configured for positioning in facing engagement with the first bone portion at the first interface;

a first fastener configured for mounting to the graft and the first section to anchor the graft to the first section, the graft and the first external surface of the first section lying on substantially parallel planes proximate the first fastener; and

a second fastener configured for mounting to the graft and the first bone to anchor the graft to the first bone, the graft being in facing engagement with the first bone adjacent the second fastener, such that the graft is positioned over the first external surface and the first bone in an implanted configuration.

2. The implant of claim 1, further comprising:

a second section constructed of a substantially rigid material, the second section having a second end surface configured for positioning against the second bone portion; and

a third section constructed of a substantially flexible material, the third section positioned between the first section and the second section.

3. The implant of claim 2, wherein the first and second sections are constructed of a biocompatible material selected from the group consisting of a polymer, a metal, a ceramic and a composite material.

4. The implant of claim 2, wherein the third section is constructed of a biocompatible material selected from the group consisting of a rubber, a gel, a foam, a polymer, a collagen and a composite material.

5. The implant of claim 2, wherein the first section is comprised of a lower implant, the second section is comprised of an upper implant and the third section is comprised of a middle section, the first section, the second section and the third section comprising a disc replacement implant.

6. The implant of claim 1, further comprising:

a third fastener configured for mounting to the second bone portion;

a fourth fastener configured for mounting to the second section; and

a suture secured to the third fastener and the fourth fastener and configured for tensioning to anchor the second section to the second bone portion.

7. The implant of claim 1, wherein the graft is comprised of a graft ligament consisting entirely of soft tissue.

8. The implant of claim 7, wherein the graft ligament is compacted through compression to reduce its cross-sectional area and increase a density of collagen material of the graft ligament.

9. The implant of claim 2, wherein the first bone is comprised of an inferior vertebra and the second bone portion is comprised of a superior vertebra, the first end surface configured for positioning in facing engagement with the inferior vertebra and

the second end surface configured for positioning in facing engagement with the superior vertebra in the implanted configuration.

10. The implant of claim 1, wherein the first section is comprised of a plate.

11. An implant assembly for augmenting a damaged area of an anterior longitudinal ligament at a joint between a first vertebra and a second vertebra, the implant assembly comprising:

a first ligament graft configured for positioning on the damaged ligament, the first ligament graft having a first end and a second end, the first end configured for positioning on an opposite side of the damaged area relative to the second end;

a first fastener configured to secure the first end to the damaged ligament, the first end positioned between the first fastener and the damaged ligament proximate the first fastener;

a second fastener configured to secure the second end to the damaged ligament, the second end positioned between the second fastener and the damaged ligament proximate the second fastener; and

a second ligament graft having a third end and a fourth end and being spaced from the damaged area at a lateral side of the first and second vertebrae in an implanted configuration, the third end configured for positioning proximate the first vertebra and the second end configured for positioning proximate the second vertebra in the implanted configuration, the third end configured for securing to the first vertebra by a third fastener and the fourth end configured for securing to the second vertebra by a fourth fastener.

12. The implant assembly of claim 11, further comprising:

a suture configured for placement through the first end, the damaged ligament, the first vertebra, the joint, the second vertebra and the second end, the suture configured for mounting to the first fastener and the second fastener and configured for tensioning to stabilize the damaged ligament.

13. The implant assembly of claim 12, wherein the suture extends in a substantially C-shape between the first fastener and the second fastener in the implanted configuration.

14. The implant assembly of claim 11, wherein the damaged ligament is an anterior longitudinal ligament, the first vertebra is a superior vertebra and the second vertebra is an inferior vertebra, the first ligament graft having the first end configured for positioning proximate a first vertebral body of the superior vertebra and the second end configured for positioning proximate a second vertebral body of the inferior vertebra.

15. The implant assembly of claim 11, wherein the first and second ligament grafts are constructed of a collagen material.

16. The implant assembly of claim 11, wherein the first and second ligament grafts are constructed of a material selected from the group consisting of autograft, allograft and xenograft materials.

17. The implant assembly of claim 11, wherein the first and second ligament grafts are constructed of a material selected from the group consisting of tendon graft, bone-tendon-bone graft, and meniscus graft.

18. The implant assembly of claim 11, wherein the first ligament graft includes a therapeutic substance.

19. The implant assembly of claim 18, wherein the therapeutic substance is selected from the group consisting of antibiotics, hydroxypatite, anti-inflammatory agents, steroids, analgesic agents, chemotherapeutic agents, bone morphogenic protein, demineralized bone matrix, collagen, growth factors, autogenetic bone marrow, calcium sulfate, immo suppressants, fibrin, osteoinductive materials, apatite compositions, enzymes, proteins, hormones and germicides.

20. The implant assembly of claim 11, further comprising:

a fifth fastener configured for securing to a first spinous process of the first vertebra;

a sixth fastener configured for securing to a second spinous process of the second vertebra; and

a spinous process suture configured for securing to the fifth fastener and the sixth fastener and configured for tensioning to provide stabilization to the joint in the implanted configuration.

21. An implant for repairing a joint between a first bone portion and a second bone portion, the implant comprising:

a first section constructed of a substantially rigid material, the first section having a first end surface configured for positioning against the first bone portion;

a graft constructed of soft tissue having a first end and a second end, the graft configured for stabilizing the first section relative to the first bone portion;

a first fastener configured for mounting to the graft and the first section to anchor the graft to the first section, the graft extending over and substantially parallel to a surface of the first section proximate the first fastener; and

a second fastener configured for mounting to the graft and the first bone to anchor the graft to the first bone, the graft being positioned between and in facing engagement with the second fastener and the first bone proximate the second fastener, the graft extending over an outside surface of the first section and an external surface of the first bone between the first fastener and the second fastener.