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Publication numberUS20070179607 A1
Publication typeApplication
Application numberUS 11/344,265
Publication date2 Aug 2007
Filing date31 Jan 2006
Priority date31 Jan 2006
Also published asCA2637888A1, EP1983937A2, EP1983937B1, US8999000, US20110224791, WO2007090107A2, WO2007090107A3
Publication number11344265, 344265, US 2007/0179607 A1, US 2007/179607 A1, US 20070179607 A1, US 20070179607A1, US 2007179607 A1, US 2007179607A1, US-A1-20070179607, US-A1-2007179607, US2007/0179607A1, US2007/179607A1, US20070179607 A1, US20070179607A1, US2007179607 A1, US2007179607A1
InventorsRobert Hodorek, Antony Lozier, Cheryl Blanchard
Original AssigneeZimmer Technology, Inc.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Cartilage resurfacing implant
US 20070179607 A1
Abstract
A cartilage resurfacing implant is provided for replacing cartilage of an articulating portion of a bone at a skeletal joint having opposed joint surfaces. The cartilage resurfacing implant includes a body having a bearing surface and a bone interface. The bearing surface is able to support articulation with an opposing joint surface.
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Claims(37)
1. A cartilage resurfacing implant for replacing articular cartilage of an articulating portion of a bone at a skeletal joint having articulating opposed joint surfaces, the cartilage resurfacing implant comprising:
a flexible body having a bearing surface and a bone interface, the bearing surface being able to support articulation with an opposing joint surface, the body being sufficiently flexible to conform to the shape of the bone in vivo.
2. The cartilage resurfacing implant of claim 1 wherein the body is flexibly deformable in response to normal joint articulation to conform to the opposed joint surfaces.
3. The cartilage resurfacing implant of claim 1 further comprising a plurality of reinforcing fibers embedded in the body, the reinforcing fibers extending from the bone interface to define a bone attachment.
4. The cartilage resurfacing implant of claim 3 wherein the body has a relatively higher stiffness near the bone interface and a relatively lower stiffness near the bearing surface.
5. The cartilage resurfacing implant of claim 4 wherein the body defines a stiffness gradient varying from relatively high near the bone interface to relatively low near the bearing surface.
6. The cartilage resurfacing implant of claim 5 wherein the body comprises a porous substrate defining a pore gradient varying from relatively small pores near the bone interface to relatively large pores near the bearing surface.
7. The cartilage resurfacing implant of claim 5 wherein the body comprises a porous substrate that varies from a relatively low pore density near the bone interface to a relatively high pore density near the bearing surface.
8. The cartilage resurfacing implant of claim 5 wherein the body comprises a crosslinked polymer structure that varies from more highly crosslinked near the bone interface to less highly crosslinked near the articular surface.
9. The cartilage resurfacing implant of claim 8 wherein the body comprises a crosslinked hydrogel.
10. The cartilage resurfacing implant of claim 3 wherein the body comprises a hydrogel.
11. The cartilage resurfacing implant of claim 5 wherein the reinforcing fibers comprise a percentage of the body composition that varies from a relatively high percentage of fiber reinforcement near the bone interface to a relatively low percentage of fiber reinforcement near the bearing surface.
12. The cartilage resurfacing implant of claim 5 wherein the reinforcing fibers comprise differing strengths of fibers that vary from relatively strong fibers near the bone interface to relatively less strong fibers near the articular surface.
13. The cartilage resurfacing implant of claim 12 wherein the body comprises metal fibers near the bone interface, high strength polymer fibers between the bone interface and bearing surface, and hydrogel fibers near the bearing surface.
14. The cartilage resurfacing implant of claim 3 wherein fibers extend from the bone interface to define flexible cables securable to the bone.
15. The cartilage resurfacing implant of claim 3 wherein fibers extend from the bone interface to define slender bristles distributed across the bone interface able to spread the fixation load evenly over the bone interface.
16. The cartilage resurfacing implant of claim 15 wherein the bristles comprise a main shaft and barbs extending outwardly from the main shaft to engage the bone.
17. The cartilage resurfacing implant of claim 3 wherein fibers extend from the bone interface to define one component of a hook-and-loop fastener arrangement.
18. The cartilage resurfacing implant of claim 17 wherein the fibers define hooks, the cartilage resurfacing implant further comprising a separate loop component able to be pre-installed on the bone and defining loops engageable with the hooks.
19. The cartilage resurfacing implant of claim 3 wherein the bone attachment comprises expandable pegs projecting from the bone interface.
20. The cartilage resurfacing implant of claim 19 wherein the pegs comprise an at least partially dehydrated hydrogel expandable by contact with body fluids.
21. The cartilage resurfacing implant of claim 19 wherein the pegs comprise heat expandable pegs.
22. The cartilage resurfacing implant of claim 3 further comprising an adhesive selected from the group consisting of fibrin glue, cyanoacrylate, epoxy, and bone cement.
23. The cartilage resurfacing implant of claim 3 further comprising a bone growth substance selected from the group consisting of bone paste, bone chips, bone growth proteins, bone growth peptides, bone marrow aspirate, stem cells, bone attachment proteins, and bone attachment peptides.
24. The cartilage resurfacing implant of claim 1 further comprising a set of similarly constructed bodies varying in size and shape selectable to repair differently sized and shaped cartilage defects.
25. The cartilage resurfacing implant of claim 1 wherein the body is intraoperatively shapable to a desired shape and size.
26. A cartilage resurfacing implant for replacing articular cartilage of an articulating portion of a bone at a skeletal joint having articulating opposed joint surfaces, the cartilage resurfacing implant comprising:
a body having a bearing surface and a bone interface, the bearing surface being able to support articulation with an opposing joint surface; and
a plurality of reinforcing fibers embedded in the body, the reinforcing fibers extending from the bone interface to define flexible cables securable to the bone.
27. A cartilage resurfacing implant for replacing articular cartilage of an articulating portion of a bone at a skeletal joint having articulating opposed joint surfaces, the cartilage resurfacing implant comprising:
a body having a bearing surface and a bone interface, the bearing surface being able to support articulation with an opposing joint surface; and
a plurality of reinforcing fibers embedded in the body, the reinforcing fibers extending from the bone interface to define slender bristles distributed across the bone interface able to spread the fixation load evenly over the bone interface.
28. The cartilage resurfacing implant of claim 27 wherein the bristles comprise a main shaft and barbs extending outwardly from the main shaft to engage the bone.
29. A cartilage resurfacing implant for replacing articular cartilage of an articulating portion of a bone at a skeletal joint having articulating opposed joint surfaces, the cartilage resurfacing implant comprising:
a body having a bearing surface and a bone interface, the bearing surface being able to support articulation with an opposing joint surface; and
a plurality of reinforcing fibers embedded in the body, the reinforcing fibers extending from the bone interface to define one component of a hook-and-loop fastener arrangement.
30. The cartilage resurfacing implant of claim 29 wherein the fibers define hooks, the cartilage resurfacing implant further defining a separate loop component able to be pre-installed on the bone and defining loops engageable with the hooks.
31. A cartilage resurfacing implant for replacing articular cartilage of an articulating portion of a bone at a skeletal joint having articulating opposed joint surfaces, the cartilage resurfacing implant comprising:
a body having a bearing surface and a bone interface, the bearing surface being able to support articulation with an opposing joint surface; and
a plurality of expandable pegs projecting from the bone interface, the pegs expandable in response to implantation adjacent to the bone.
32. The cartilage resurfacing implant of claim 31 wherein the pegs comprise fluid expandable pegs.
33. The cartilage resurfacing implant of claim 32 wherein the pegs comprise an at least partially dehydrated hydrogel expandable by contact with body fluids.
34. The cartilage resurfacing implant of claim 33 wherein reinforcing fibers from the body extend into the pegs.
35. The cartilage resurfacing implant of claim 31 wherein the pegs comprise expanding barbs.
36. The cartilage resurfacing implant of claim 31 wherein the pegs comprise heat expandable pegs.
37. The cartilage resurfacing implant of claim 31 wherein the pegs comprise a shape memory alloy.
Description
    FIELD OF THE INVENTION
  • [0001]
    The invention relates to implants for skeletal joints. In particular, the invention relates to implants for repairing cartilage defects in the articular surface of skeletal joints.
  • BACKGROUND
  • [0002]
    Degenerative and traumatic damage to the articular cartilage of skeletal joints can result in pain and restricted motion. Prosthetic joint replacement surgery is frequently utilized to alleviate the pain and restore joint function. During this surgery, one or more of the articulating surfaces of the joint are replaced with prosthetic bearing components. The replacement components typically include a portion for anchoring the implant adjacent to the joint and a portion for articulating with opposing joint surfaces. For example, during knee replacement surgery, an incision is made into the knee joint to expose the joint. Portions of the articular surfaces of the tibia and femur are removed and artificial joint components are positioned to replace the removed portions. In a total knee replacement, all of the articulating compartments of the joint are replaced with prosthetic components. However, often only one compartment of the knee joint, typically the medial compartment, is impaired. In a unicondylar knee replacement, only the damaged compartment is repaired with prosthetic bearing components. In an even less invasive approach, where the damage is limited to isolated defects in the articular cartilage, it has been proposed to replace just the articular cartilage in the immediate vicinity of the defect.
  • SUMMARY
  • [0003]
    The present invention provides a cartilage resurfacing implant for replacing cartilage of an articulating portion of a bone at a skeletal joint having opposed joint surfaces. The cartilage resurfacing implant includes a body having a bearing surface and a bone interface. The bearing surface is able to support articulation with an opposing joint surface.
  • [0004]
    In one aspect of the invention, the implant includes a flexible body.
  • [0005]
    In another aspect of the invention, the implant includes a plurality of reinforcing fibers embedded in the body and extending from the bone interface to define a bone attachment.
  • [0006]
    In another aspect of the invention, the implant includes a plurality of reinforcing fibers embedded in the body and extending from the bone interface to define flexible cables securable to the bone.
  • [0007]
    In another aspect of the invention, the implant includes a plurality of reinforcing fibers embedded in the body and extending from the bone interface to define slender bristles distributed across the bone interface able to spread the fixation load evenly over the bone interface.
  • [0008]
    In another aspect of the invention, the implant includes a plurality of reinforcing fibers embedded in the body and extending from the bone interface to define one component of a hook-and-loop fastener arrangement.
  • [0009]
    In another aspect of the invention, the implant includes a plurality of expandable pegs projecting from the bone interface.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0010]
    Various examples of the present invention will be discussed with reference to the appended drawings. These drawings depict only illustrative examples of the invention and are not to be considered limiting of its scope.
  • [0011]
    FIG. 1 is a side sectional view of an articulating bone end repaired with an illustrative cartilage resurfacing implant according to the present invention;
  • [0012]
    FIG. 2 is a detailed view of the cartilage resurfacing implant of FIG. 1;
  • [0013]
    FIG. 3 is a detailed view of the cartilage resurfacing implant of FIG. 1; and
  • [0014]
    FIG. 4 is a detailed view of the cartilage resurfacing implant of FIG. 1.
  • DESCRIPTION OF THE ILLUSTRATIVE EXAMPLES
  • [0015]
    Embodiments of a cartilage resurfacing implant include a body having a bearing surface and a bone interface. The implant may function as a replacement for damaged or diseased cartilage of a skeletal joint to sustain continued joint function. The implant may be used to replace a portion of any skeletal joint including, but not limited to, joints of the hip, knee, shoulder, spine, elbow, wrist, ankle, jaw, and digits. The implant may be configured to replace a relatively small defect within the joint, an entire compartment of the joint, or the total joint.
  • [0016]
    The bearing surface may be made of any material suitable for articulation with natural or prosthetic opposing bearing surfaces. Preferably the bearing material is resilient to facilitate intraoperative flexing, cutting, and/or otherwise shaping of the bearing surface to fit a surgical site. The bearing surface may include polyolefins, polyesters, polyimides, polyamides, polyacrylates, polyketones, and/or other suitable materials. For example the bearing surface may include ultrahigh molecular weight polyethylene. The bearing surface may include a hydrogel having a three dimensional network of polymer chains with water filling the void space between the macromolecules. The hydrogel may include a water soluble polymer that is crosslinked to prevent its dissolution in water. The water content of the hydrogel may range from 20-80%. The high water content of the hydrogel results in a low coefficient of friction for the bearing due to hydrodynamic lubrication. Advantageously, as loads increase on the bearing component, the friction coefficient decreases as water forced from the hydrogel forms a lubricating film. The hydrogel may include natural or synthetic polymers. Examples of natural polymers include polyhyaluronic acid, alginate, polypeptide, collagen, elastin, polylactic acid, polyglycolic acid, chitin, and/or other suitable natural polymers and combinations thereof. Examples of synthetic polymers include polyethylene oxide, polyethylene glycol, polyvinyl alcohol, polyacrylic acid, polyacrylamide, poly(N-vinyl-2-pyrrolidone, polyurethane, polyacrylonitrile, and/or other suitable synthetic polymers and combinations thereof.
  • [0017]
    The bone interface provides an anchor for the implant. The bone interface may be defined by a unitary body or by a substrate embedded in the body. A substrate may be solid or porous. The bearing surface may attach to the substrate by bonding, mechanical fasteners, porous interdigitation, and/or other suitable attachment methods. For example, the substrate may include an open porous structure in which a portion of the bearing surface is integrated to attach the bearing surface to the substrate. The substrate may be configured to be cemented in place, to be press-fit in place, to receive tissue ingrowth, and/or to be anchored to tissue in any other suitable tissue anchoring configuration. For example, the substrate may include an open porous structure for placement adjacent to body tissue to receive tissue ingrowth to anchor the implant adjacent the tissue. A porous structure may be configured to promote hard and/or soft tissue ingrowth. The porous structures may be in form of an open cell foam, a woven structure, a grid, agglomerated particles, and/or other suitable structures and combinations thereof.
  • [0018]
    The substrate may include any suitable material including, but not limited to, metals, polymers, ceramics, hydrogels and/or other suitable materials and combinations thereof. For example, a polymer substrate may include resorbable and/or non-resorbable polymers. Examples of resorbable polymers include polylactic acid polymers, polyglycolic acid polymers, and/or other suitable resorbable polymers. Examples of non-resorbable polymers include polyolefins, polyesters, polyimides, polyamides, polyacrylates, polyketones, and/or other suitable non-resorbable polymers. A metal substrate may include titanium, tantalum, stainless steel, and/or other suitable metals and alloys thereof. Preferably the substrate is relatively rigid to provide a suitable surface for hard tissue ingrowth. For example, the substrate may include a porous tantalum material having a structure similar to that of natural trabecular bone. Such a material is described in U.S. Pat. No. 5,282,861 entitled “Open Cell Tantalum Structures For Cancellous Bone Implants And Cell And Tissue Receptors”. The material is fabricated by vapor depositing tantalum into a porous matrix. The substrate may include protruding pegs or other bone engaging features to further enhance the connection of the substrate to tissue.
  • [0019]
    The cartilage resurfacing implant may have a relatively high stiffness near a bone interface to enhance fixation of the implant to the rigid bone surface and a relatively low stiffness near the bearing surface to provide a compliant surface able to move with surrounding natural cartilage tissue. The implant may include a stiffness gradient from relatively high near the bone interface to relatively low near the bearing surface to gradually distribute stresses from the articulating surface to the bone interface and improve its delamination resistance. The cartilage resurfacing implant may include a unitary porous body. The body may include a separate porous substrate joined to the bearing surface. The implant may include a graded porosity that varies from relatively low porosity and high stiffness near the bone interface to relatively high porosity and low stiffness near the bearing surface. For example, a substrate, or a unitary body, may include a porous metal having relatively small pores near the bone interface and relatively large pores toward the bearing surface. Alternatively the substrate, or unitary body, may have uniform or randomly sized pores that vary in the number of pores, or pore density, such that the there is a relatively low pore density and high stiffness near the bone interface and a relatively high pore density and low stiffness toward the bearing surface.
  • [0020]
    The cartilage resurfacing implant may include a crosslinked polymer structure that has higher crosslinking and stiffness near the bone interface and relatively low crosslinking and stiffness near the articular surface. For example, the implant may include a hydrogel that varies from highly crosslinked to lightly crosslinked to define a stiffness gradient.
  • [0021]
    The cartilage resurfacing implant may include fibrous reinforcement within the implant body that includes a relatively high percentage of fiber reinforcement near the bone interface to increase the strength and stiffness near the bone and a relatively low percentage of fiber reinforcement near the bearing surface. The fiber reinforcement may have a varying composition from relatively strong fibers near the bone interface to relatively less strong fibers near the articular surface. For example, metal fibers near the bone interface may transition to high strength polymer fibers away from the bone interface to hydrogel fibers at the bearing surface. A unitary porous metal layer may be included for immediate contact with the bone. The reinforcing fibers may project away from the bone interface toward the bone to form fibrous anchors. For example, fibers imbedded in the implant may extend from the back of the implant to form cables for securing the implant to a bone. The cables may be secured in tunnels in the bone or extend to an outer surface of the bone. The cables may be secured with screws, pins, clips, clamps, buttons and/or other fixation members.
  • [0022]
    In another example, fibers imbedded in the implant may extend from the back of the implant to form slender bristles distributed across the bone interface. For example, the bristles may be distributed to spread the fixation load evenly over the bone interface. This is especially helpful where the implant is flexible to conform to the shape of the bone at the bone interface as it provides many fixation points to stabilize the flexible implant. For example, the bristles may be distributed in any suitable number from 1-100 per square inch of bone interface. Preferably the bristles number 4-20 per square inch. Even more preferably the bristles number 9-16 per square inch. The bristles may have any cross-sectional shape and size but are preferably generally cylindrical and have diameters in the range of 0.010-0.125 inches. More preferably the bristles have diameters in the range of 0.020-0.070 inches and still more preferably the bristles have diameters in the range of 0.030-0.050 inches. The bristles may be pressed directly into the bone to attach the implant to the bone. Alternatively, the bristles may be pressed into predrilled holes. The bristles may have a roughened or projecting surface to enhance their grip on the bone. For example, the bristles may be abrasive grit blasted, plasma sprayed, barbed, and/or otherwise roughened. The bristles may be porous to enhance their grip on the bone by bone ingrowth into pores. For example, the bristles may include porous metals, ceramics, polymers, and/or other suitable porous materials. For example, the bristles may include porous tantalum having a structure similar to natural trabecular bone.
  • [0023]
    In another example, fibers imbedded in the implant may extend from the back of the implant to form one component of a hook and loop fastener arrangement. For example, the fibers may form hooks and/or loops on the back of the implant. A mating component may be pre-attached to the bone. For example, a mounting base including hooks and/or loops may be installed on the bone and the implant pressed against the mounting base to join the implant to the bone. The mounting base may be attached to the bone with adhesives, screws, staples, and/or other suitable fastening methods. For example, the mounting base may be in the form of a thin, flexible layer of loops attached to the bone with screws and hooks may project from the bone interface of the implant to engage the loops.
  • [0024]
    In another example, one or more pegs may extend from the back of the implant to engage one or more holes formed in the bone. The pegs may include expandable pegs. For example, expandable pegs may include heat expandable, fluid expandable, and/or otherwise expandable pegs that expand after insertion into the bone. The pegs may expand in width or diameter to grip the bone. The pegs may expand by deploying barbs to grip the bone. For example, partially or fully dehydrated hydrogel pegs may extend from the back of the implant. As the pegs absorb fluid from the surgical site and surrounding tissues, the pegs may expand to fill the holes and grip the bone. As the pegs press against the walls of the holes they form a strong frictional engagement. The pegs may also deform to positively engage the natural porosity of the bone in the walls of the holes. The positive engagement may be further enhanced by forming the holes with a larger diameter inside the bone than at the hole entrance. The hydrogel pegs may expand to at least partially take on the shape of the hole and thus form a positive engagement with the bone. For example, the bone holes may be undercut with a small entry diameter and a larger diameter deeper into the bone. The pegs may deploy barbs upon fluid expansion. In another example, the pegs may include a heat activated expansion mechanism. For example, the pegs may include a shape memory alloy that deploys barbs in the presence of heat from the patient's body. For example, the pegs and/or barbs may be made of shape memory alloy that transforms from a first shape prior to insertion to a second, deployed shape, after exposure to patient body temperature. The pegs may be fiber reinforced to enhance their tensile strength. For example, fibers from the implant may extend into the pegs.
  • [0025]
    The cables, bristles, hook and loop fasteners, and/or expanding pegs may be formed integrally with the implant or as separate elements subsequently attached to the implant.
  • [0026]
    The bearing surface may be formed by casting, injection molding, compression molding, machining, and/or other suitable forming processes and combinations thereof. For example, the bearing surface may be compression or injection molded into a porous substrate such that the bearing surface interdigitates with the substrate and is thereby joined to it.
  • [0027]
    The attachment of the cartilage resurfacing implant to the bone may be enhanced by the use of adhesives including fibrin glue, cyanoacrylate, epoxy, bone cement, and/or other suitable adhesives introduced at the bone interface. The attachment of the cartilage resurfacing implant to the bone may be enhanced by the use of bone growth inducing and/or conducting substances including bone paste, bone chips, bone growth proteins, bone growth peptides, bone marrow aspirate, stem cells, bone attachment proteins, bone attachment peptides, and/or other suitable bone growth promoting substances introduced at the bone interface.
  • [0028]
    The cartilage resurfacing implant may be provided in a variety of sizes and shapes to facilitate its use in repairing differently sized and shaped cartilage defects. Alternatively, the implant may be provided in a generic form that may be intraoperatively cut to the desired shape and size.
  • [0029]
    The drawing shows an illustrative cartilage resurfacing implant 10 according to the present invention. The illustrative implant 10 is shown in use to resurface a portion of a femoral articulating surface at a knee joint. However, it is within the scope of the invention for the cartilage resurfacing implant 10 to be configured to replace any amount of any bearing surface in any skeletal joint. The implant 10 includes a body 12 having a bearing surface 14 engageable with an opposing joint surface for joint articulation. The implant 10 includes a bone interface 16 engageable with the bone 18. The illustrative implant 10 includes a fiber reinforced hydrogel structure having a fiber free region 20 adjacent to the bearing surface 14 and a highly fiber reinforced region 22 adjacent to the bone interface 16. The fibers 24 are distributed in a gradient of increasing fiber density from relatively less dense near the bearing surface 14 to relatively more dense near the bone interface 16. The implant 10 is produced by embedding a fibrous preform into the hydrogel during formation of the hydrogel.
  • [0030]
    The implant 10 forms several attachments to the bone 18. A pair of cables 26, 28 extends from the bone interface 16 into the bone 18 to form localized connections to the bone. The cables 26, 28 preferably are formed from fibers that interdigitate into the implant body 12 and form a portion of the fibrous reinforcement of the body 12. One of the cables 26 is anchored to the bone 18 by a screw 30 threadably engaged with and embedded in the bone. The other cable 28 is anchored to the bone 18 by suspending an eyelet 32 formed in the end of the cable over a button 34 disposed against the cortical surface 36 of the bone 18. The bone interface 16 of the implant 10 includes distributed fixation to more uniformly distribute the dislocation forces over the bone interface 16. The distributed fixation includes a portion including bristles 100 embedded in the bone 18, another portion including a hook and loop fastener 150, and another portion including expanding pegs 200 embedded in the bone. The cables 26, 28, bristles 100, hook and loop fastener 150, and pegs 200 may each be used singly as the only form of fixation for the implant 10 to the bone 18 or in any combination of fasteners.
  • [0031]
    The bristles 100 are shown in more detail in FIG. 2. In the illustrative implant 10, the bristles 100 project form the bone interface 16. Each bristle 100 includes a main shaft 102 and barbs 104 extending outwardly from the main shaft 102. The bristles are pressed into holes 106 drilled in the bone 18 and the barbs 104 grip the sides of the holes 106. In the illustrative implant 10, the bristles 100 are extensions of stiff fibers embedded in the implant body 12.
  • [0032]
    The hook and loop fastener 150 is shown in more detail in FIG. 3. In the illustrative implant 10, hooks 152 project from the bone interface 16 and are formed as extensions of stiff fibers embedded in the implant body 12. A mounting base 154 includes loops 156 engageable with the hooks. Bone screws 158 extend through the mounting base 154 and into the bone 18 to secure the mounting base 154 to the bone 18.
  • [0033]
    The pegs 200 are shown in more detail in FIG. 4. In the illustrative implant 10, each peg 200 is formed as a fiber reinforced extension of the fiber reinforced hydrogel body 12 of the implant 10. The pegs 200 are molded as an integral part of the body 12. The pegs 200 are inserted into holes 202 formed in the bone 18. In the illustrative example, each hole 202 is undercut to have a larger diameter inside the bone 18 than at the surface of the bone 18. As the pegs 200 absorb fluid from the surgical site, the hydrogel swells causing the pegs 200 to fill at least a portion of the hole 202 and lock the implant 10 in place on the bone 18. One of the pegs 204 in FIG. 4 is shown expanded to partly fill a hole 202. This is illustrative of a peg 204 that is in the process of expanding or one that has limited expansion potential due to the nature of its hydrogel composition and/or expansion restraint introduced by fiber reinforcement of the peg 204. Another of the pegs 206 in FIG. 4 is shown fully expanded to fill the undercut hole 202.
  • [0034]
    In a cartilage resurfacing surgical procedure, a cartilage defect is identified on the articular surface of a bone. The defect may be relatively small and affect only a small area of the articular surface or the defect may be relatively large, or there may be a large number of defects, and affect the entire articular surface. The damaged portion of the articular surface is removed by abrading, cutting, scraping, drilling, and/or any other suitable process. A cartilage resurfacing implant 10 is selected to fit the prepared site. The implant 10 may be provided in a form that is cut or otherwise reformed intraoperatively to fit the prepared site. Fixation holes are formed in the bone, if necessary, and the implant 10 is applied to the prepared site.
  • [0035]
    Although examples of a cartilage resurfacing implant and its use have been described and illustrated in detail, it is to be understood that the same is intended by way of illustration and example only and is not to be taken by way of limitation. The invention has been illustrated in use to replace a portion of a damaged femoral articular surface at a knee joint. However, the cartilage resurfacing implant may be configured to replace any amount of any articular surface at any skeletal joint. Accordingly, variations in and modifications to the cartilage resurfacing implant and its use will be apparent to those of ordinary skill in the art, and the following claims are intended to cover all such modifications and equivalents.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US4502161 *19 Aug 19835 Mar 1985Wall W HProsthetic meniscus for the repair of joints
US4839215 *9 Jun 198613 Jun 1989Ceramed CorporationBiocompatible particles and cloth-like article made therefrom
US4996924 *20 Apr 19895 Mar 1991Mcclain Harry TAerodynamic air foil surfaces for in-flight control for projectiles
US5041138 *17 Apr 198920 Aug 1991Massachusetts Institute Of TechnologyNeomorphogenesis of cartilage in vivo from cell culture
US5067964 *13 Dec 198926 Nov 1991Stryker CorporationArticular surface repair
US5147904 *22 Aug 199015 Sep 1992Thera Patent Gmbh & Co. KgOpen-pored moldings, a process for their production and use thereof
US5282861 *11 Mar 19921 Feb 1994UltrametOpen cell tantalum structures for cancellous bone implants and cell and tissue receptors
US5314478 *26 Apr 199124 May 1994Kyocera CorporationArtificial bone connection prosthesis
US5358525 *28 Dec 199225 Oct 1994Fox John EBearing surface for prosthesis and replacement of meniscal cartilage
US5458643 *1 Feb 199417 Oct 1995Kyocera CorporationArtificial intervertebral disc
US5556429 *6 May 199417 Sep 1996Advanced Bio Surfaces, Inc.Joint resurfacing system
US5607474 *20 Sep 19934 Mar 1997Board Of Regents, University Of Texas SystemMulti-phase bioerodible implant/carrier and method of manufacturing and using same
US5645592 *21 May 19938 Jul 1997M.u.r.s.t. Italian Ministry for Universities and Scientific and Technological ResearchUse of hydrogels to fix bone replacements
US5658343 *6 Jun 199519 Aug 1997Sulzer Medizinaltechnik AgAreal implant
US5702397 *20 Feb 199630 Dec 1997Medicinelodge, Inc.Ligament bone anchor and method for its use
US5795353 *2 Nov 199618 Aug 1998Advanced Bio Surfaces, Inc.Joint resurfacing system
US6132468 *10 Sep 199817 Oct 2000Mansmann; Kevin A.Arthroscopic replacement of cartilage using flexible inflatable envelopes
US6140452 *18 Nov 199831 Oct 2000Advanced Bio Surfaces, Inc.Biomaterial for in situ tissue repair
US6179840 *23 Jul 199930 Jan 2001Ethicon, Inc.Graft fixation device and method
US6224630 *29 May 19981 May 2001Advanced Bio Surfaces, Inc.Implantable tissue repair device
US6231605 *17 Mar 199915 May 2001Restore TherapeuticsPoly(vinyl alcohol) hydrogel
US6306177 *18 Dec 199723 Oct 2001Advanced Bio Surfaces, Inc.Biomaterial system for in situ tissue repair
US6425923 *7 Mar 200030 Jul 2002Zimmer, Inc.Contourable polymer filled implant
US6443988 *18 Nov 19983 Sep 2002Disc Dynamics, Inc.Mold apparatus and kit for in situ tissue repair
US6447514 *7 Mar 200010 Sep 2002ZimmerPolymer filled hip fracture fixation device
US6494917 *6 Oct 200017 Dec 2002Orthopaedic HospitalWear resistant surface-gradient crosslinked polyethylene
US6530956 *10 Sep 199911 Mar 2003Kevin A. MansmannResorbable scaffolds to promote cartilage regeneration
US6533818 *26 Jul 200018 Mar 2003Pearl Technology Holdings, LlcArtificial spinal disc
US6547828 *23 Feb 200115 Apr 2003Smith & Nephew, Inc.Cross-linked ultra-high molecular weight polyethylene for medical implant use
US6620196 *30 Aug 200016 Sep 2003Sdgi Holdings, Inc.Intervertebral disc nucleus implants and methods
US6629997 *27 Mar 20017 Oct 2003Kevin A. MansmannMeniscus-type implant with hydrogel surface reinforced by three-dimensional mesh
US6679913 *13 Apr 199920 Jan 2004Tranquil Prospects Ltd.Implantable sheet material
US6719797 *14 Aug 200013 Apr 2004Bret A. FerreeNucleus augmentation with in situ formed hydrogels
US6827743 *25 Feb 20027 Dec 2004Sdgi Holdings, Inc.Woven orthopedic implants
US6994730 *31 Jan 20037 Feb 2006Howmedica Osteonics Corp.Meniscal and tibial implants
US7001731 *18 Mar 200221 Feb 2006Nuvelo, Inc.Chemokine receptor obtained from a cDNA library of fetal liver-spleen
US7077865 *13 Feb 200318 Jul 2006Disc Dynamics, Inc.Method of making an intervertebral disc prosthesis
US20010033857 *19 Dec 200025 Oct 2001Vyakarnam Murty N.Porous tissue scaffoldings for the repair or regeneration of tissue
US20020173855 *8 Feb 200221 Nov 2002Mansmann Kevin A.Cartilage repair implant with soft bearing surface and flexible anchoring device
US20030078617 *15 Jul 200224 Apr 2003Schwartz Herbert E.Unitary surgical device and method
US20040010312 *9 Jul 200215 Jan 2004Albert EnayatiIntervertebral prosthesis
US20040133275 *2 Oct 20038 Jul 2004Mansmann Kevin A.Implants for replacing cartilage, with negatively-charged hydrogel surfaces and flexible matrix reinforcement
US20050125077 *5 Dec 20039 Jun 2005Harmon Alexander M.Viable tissue repair implants and methods of use
US20050287187 *14 Apr 200529 Dec 2005Mansmann Kevin AHydrogel implants for replacing hyaline cartilage, with charged surfaces and improved anchoring
US20060009853 *28 Jul 200412 Jan 2006Medicinelodge, Inc.Tethered joint bearing implants and systems
US20070142916 *21 Dec 200521 Jun 2007Olson Stanley W JrBone graft composition, method and implant
US20080195205 *1 Mar 200514 Aug 2008Schwartz Bomedical LlcArticular Cartilage Fixation Device and Method
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US753100024 Sep 200712 May 2009Zimmer, Inc.Cartilage implant
US779908731 Aug 200621 Sep 2010Zimmer GmbhImplant
US781564514 Jan 200519 Oct 2010Hudson Surgical Design, Inc.Methods and apparatus for pinplasty bone resection
US78159267 Jul 200619 Oct 2010Musculoskeletal Transplant FoundationImplant for articular cartilage repair
US783774024 Jan 200723 Nov 2010Musculoskeletal Transplant FoundationTwo piece cancellous construct for cartilage repair
US78578148 Mar 200528 Dec 2010Hudson Surgical Design, Inc.Methods and apparatus for minimally invasive arthroplasty
US790145716 May 20038 Mar 2011Musculoskeletal Transplant FoundationCartilage allograft plug
US79351519 Apr 20103 May 2011Hudson Surgical Design, Inc.Femoral prosthetic implant
US80213688 Mar 200520 Sep 2011Hudson Surgical Design, Inc.Methods and apparatus for improved cutting tools for resection
US806237731 Oct 200722 Nov 2011Hudson Surgical Design, Inc.Methods and apparatus for knee arthroplasty
US808816715 Dec 20093 Jan 2012Hudson Surgical Design, Inc.Femoral prosthetic implant
US81140838 Mar 200514 Feb 2012Hudson Surgical Design, Inc.Methods and apparatus for improved drilling and milling tools for resection
US8114156 *12 Mar 200914 Feb 2012Edwin Burton HatchFlexibly compliant ceramic prosthetic meniscus for the replacement of damaged cartilage in orthopedic surgical repair or reconstruction of hip, knee, ankle, shoulder, elbow, wrist and other anatomical joints
US8152846 *6 Mar 200910 Apr 2012Musculoskeletal Transplant FoundationInstrumentation and method for repair of meniscus tissue
US822150024 Jul 200817 Jul 2012Musculoskeletal Transplant FoundationCartilage allograft plug
US82875458 Mar 200516 Oct 2012Hudson Surgical Design, Inc.Methods and apparatus for enhanced retention of prosthetic implants
US828759418 Nov 201016 Oct 2012Intersect Partners, LlcKnee joint prosthesis and hyaluronate compositions for treatment of osteoarthritis
US82929681 Feb 201123 Oct 2012Musculoskeletal Transplant FoundationCancellous constructs, cartilage particles and combinations of cancellous constructs and cartilage particles
US82982386 Aug 200830 Oct 2012Hudson Surgical Design, Inc.Methods and apparatus for pivotable guide surfaces for arthroplasty
US83088079 Nov 200613 Nov 2012Zimmer, GmbhImplant with differential anchoring
US83539149 Jul 200715 Jan 2013Hudson Surgical Design, Inc.Methods and apparatus for improved profile based resection
US839414918 Aug 201012 Mar 2013Zimmer, GmbhMethod for implantation of a femoral implant
US84039852 Nov 200526 Mar 2013Zimmer, Inc.Joint spacer implant
US84309326 Dec 201130 Apr 2013Puget Bio Ventures LLCFemoral prosthetic implant
US843555124 Jul 20097 May 2013Musculoskeletal Transplant FoundationCancellous construct with support ring for repair of osteochondral defects
US84970235 Aug 200930 Jul 2013Biomimedica, Inc.Polyurethane-grafted hydrogels
US863260124 Apr 200721 Jan 2014Zimmer, GmbhImplant
US867919012 Mar 201225 Mar 2014The Board Of Trustees Of The Leland Stanford Junior UniversityHydrogel arthroplasty device
US874090611 Jul 20083 Jun 2014Hudson Surgical Design, Inc.Method and apparatus for wireplasty bone resection
US8764829 *11 Jul 20111 Jul 2014James MarvelBuffer for a human joint and method of arthroscopically inserting
US8834568 *4 Feb 201116 Sep 2014Paul S. ShapiroSurgical technique using a contoured allograft cartilage as a spacer of the carpo-metacarpal joint of the thumb or tarso-metatarsal joint of the toe
US88522845 Feb 20087 Oct 2014Zimmer, Inc.Hydrogel proximal interphalangeal implant
US885329429 May 20137 Oct 2014Biomimedica, Inc.Polyurethane-grafted hydrogels
US888391526 Aug 201111 Nov 2014Biomimedica, Inc.Hydrophobic and hydrophilic interpenetrating polymer networks derived from hydrophobic polymers and methods of preparing the same
US890611014 Sep 20109 Dec 2014Musculoskeletal Transplant FoundationTwo piece cancellous construct for cartilage repair
US897993525 Jul 200817 Mar 2015Zimmer, Inc.Joint space interpositional prosthetic device with internal bearing surfaces
US906680427 Jun 201130 Jun 2015Puget Bioventures LlcMethod and apparatus for femoral and tibial resection
US9095641 *22 Dec 20104 Aug 2015Arthrex, Inc.Hybrid polymer/metal plug for treating chondral defects
US911402421 Nov 201225 Aug 2015Biomimedica, Inc.Systems, devices, and methods for anchoring orthopaedic implants to bone
US91196053 May 20111 Sep 2015Zimmer, Inc.Synthetic polymer adhesives and methods for making, using and delivering the same
US91737449 Sep 20113 Nov 2015Zimmer GmbhFemoral prosthesis with medialized patellar groove
US919239129 Jun 201524 Nov 2015Puget Bioventures LlcMethod for minimally invasive total knee arthroplasty
US91926954 Nov 200924 Nov 2015AllosourceAllografts combined with tissue derived stem cells for bone healing
US919876327 Aug 20141 Dec 2015Paul S. ShapiroSurgical technique using a contoured allograft cartilage as a spacer of the carpo-metacarpal joint of the thumb or tarso-metatarsal joint of the toe
US924180110 Mar 201426 Jan 2016Todd R. ParryJoint Arthroplasty
US9289299 *15 Mar 201322 Mar 2016Biomet Manufacturing, LlcMethod and apparatus for augumenting bone defects
US9289302 *20 Jul 200922 Mar 2016Zimmer, Inc.Mosaicplasty constructs
US930184515 Jun 20065 Apr 2016P Tech, LlcImplant for knee replacement
US930809527 Apr 201212 Apr 2016Zimmer, Inc.Femoral component for a knee prosthesis with improved articular characteristics
US938708224 Feb 201412 Jul 2016The Board Of Trustees Of The Leland Stanford Junior UniversityHydrogel arthroplasty device
US942102223 Nov 201523 Aug 2016Puget Bioventures LlcMethod and apparatus for total knee arthroplasty
US944590220 Oct 201020 Sep 2016Howmedica Osteonics Corp.Platform for soft tissue attachment
US9549820 *25 Jun 201024 Jan 2017Zimmer, Inc.Glenoid implant with synthetic labrum
US959212714 Dec 200614 Mar 2017Zimmer, Inc.Distal femoral knee prostheses
US960371018 Sep 201528 Mar 2017AllosourceMethods of manufacturing perforated osteochondral allograft compositions
US966221828 May 201430 May 2017R. Thomas GrotzResilient knee implant and methods
US96819064 Jan 201620 Jun 2017SMcd-TA/TD, LLCFixation of bone implants
US97004155 Oct 201511 Jul 2017AllosourceCartilage mosaic compositions and methods
US970194019 Dec 201411 Jul 2017Histogenics CorporationCell-support matrix having narrowly defined uniformly vertically and non-randomly organized porosity and pore density and a method for preparation thereof
US975061216 Mar 20165 Sep 2017P Tech, LlcMethods and systems for providing gender specific pharmaceuticals
US9757241 *30 Aug 201212 Sep 2017R. Thomas GrotzResilient interpositional arthroplasty device
US20060224244 *31 Mar 20055 Oct 2006Zimmer Technology, Inc.Hydrogel implant
US20060235542 *11 Apr 200619 Oct 2006Zimmer Technology, Inc.Flexible segmented bearing implant
US20070088444 *13 Oct 200519 Apr 2007Robert A HodorekMethod for repairing a bone defect using a formable implant which hardens in vivo
US20070100450 *2 Nov 20053 May 2007Zimmer Technology, Inc.Joint spacer implant
US20070260323 *14 Dec 20068 Nov 2007Zimmer, Inc.Distal femoral knee prostheses
US20080051889 *24 Sep 200728 Feb 2008Zimmer, Inc.Cartilage implant
US20080058947 *19 Jul 20076 Mar 2008Zimmer, Inc.Distal femoral knee prostheses
US20080097606 *15 Oct 200724 Apr 2008Cragg Andrew HKnee joint prosthesis and hyaluronate compositions for treatment of osteoarthritis
US20080195219 *5 Feb 200814 Aug 2008Zimmer, Inc.Hydrogel proximal interphalangeal implant
US20080221700 *31 Aug 200611 Sep 2008Zimmer, GmbhImplant
US20090036995 *25 Jul 20085 Feb 2009Zimmer, Inc.Joint space interpositional prosthetic device with internal bearing surfaces
US20090048679 *2 Feb 200719 Feb 2009Zimmer GmbhImplant
US20090088846 *17 Apr 20082 Apr 2009David MyungHydrogel arthroplasty device
US20090105772 *9 Nov 200623 Apr 2009Zimmer GmbhImplant
US20090187252 *24 Apr 200723 Jul 2009Zimmer GmbhImplant
US20100125341 *19 Nov 200820 May 2010Frauens John TDevice & method for restoring joints with artificial cartilage
US20100151114 *17 Dec 200917 Jun 2010Zimmer, Inc.In-line treatment of yarn prior to creating a fabric
US20100161073 *20 Jul 200924 Jun 2010Zimmer, Inc.Mosaicplasty constructs
US20100168857 *12 Mar 20091 Jul 2010Edwin Burton HatchFlexibly compliant ceramic prosthetic meniscus for the replacement of damaged cartilage in orthopedic surgical repair or reconstruction of hip, knee, ankle, shoulder, elbow. wrist and other anatomical joints
US20100331990 *25 Jun 201030 Dec 2010Zimmer, Inc.Glenoid implant with synthetic labrum
US20110059178 *3 Sep 201010 Mar 2011Musculoskeletal Transplant Foundation Inc.Tissue Engineered Meniscus Repair Composition
US20110060412 *3 Sep 201010 Mar 2011Musculoskeletal Transplant Foundation Inc.Tissue Engineered Meniscus Repair Composition
US20110093083 *21 Dec 201021 Apr 2011Zimmer, Inc.Distal femoral knee prostheses
US20110153028 *22 Dec 201023 Jun 2011Albertorio Ricardo EHybrid polymer/metal plug for treating chondral defects
US20110172768 *18 Nov 201014 Jul 2011Cragg Andrew HKnee joint prosthesis and hyaluronate compositions for treatment of osteoarthritis
US20110190887 *4 Feb 20114 Aug 2011Shapiro Paul SSurgical technique using a contoured allograft cartilage as a spacer of the carpo-metacarpal joint of the thumb or carpo-metatarsal joint of the toe
US20110270393 *11 Jul 20113 Nov 2011James MarvelBuffer for a human joint and method of arthroscopically inserting
US20120215311 *22 Feb 201123 Aug 2012Todd ParryArthroplasty shim
US20130211536 *15 Mar 201315 Aug 2013Biomet Manufacturing CorporationMethod And Apparatus For Augumenting Bone Defects
US20140277530 *11 Mar 201418 Sep 2014Smed-Ta/Td, LlcFixation of bone implants
US20140316526 *30 Aug 201223 Oct 2014R. Thomas GrotzResilient interpositional arthroplasty device
US20160058550 *9 Nov 20153 Mar 2016Smith & Nephew, Inc.Implantable biologic holder
USRE4325813 Dec 201020 Mar 2012Musculoskeletal Transplant FoundationGlue for cartilage repair
EP2338530A3 *16 Dec 20108 Jan 2014Arthrex, Inc.Hybrid polymer/metal plug for treating chondral defects
WO2009058780A2 *28 Oct 20087 May 2009Zimmer, Inc.Medical implants and methods for delivering biologically active agents
WO2009058780A3 *28 Oct 200811 Mar 2010Zimmer, Inc.Medical implants and methods for delivering biologically active agents
WO2010014446A1 *20 Jul 20094 Feb 2010Zimmer, Inc.Mosaicplasty constructs
WO2011056422A1 *20 Oct 201012 May 2011Howmedica Osteonics CorpPlatform for soft tissue attachment
WO2011146296A2 *11 May 201124 Nov 2011Drexel UniversityA fiber-hydrogel composite for tissue replacement
WO2011146296A3 *11 May 201119 Jan 2012Drexel UniversityA fiber-hydrogel composite for tissue replacement
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