CA2322485A1 - Improved bioabsorbable bone block fixation implant - Google Patents
Improved bioabsorbable bone block fixation implant Download PDFInfo
- Publication number
- CA2322485A1 CA2322485A1 CA002322485A CA2322485A CA2322485A1 CA 2322485 A1 CA2322485 A1 CA 2322485A1 CA 002322485 A CA002322485 A CA 002322485A CA 2322485 A CA2322485 A CA 2322485A CA 2322485 A1 CA2322485 A1 CA 2322485A1
- Authority
- CA
- Canada
- Prior art keywords
- implant
- bone
- drillhole
- bone block
- elongated body
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0858—Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/087—Anchor integrated into tendons, e.g. bone blocks, integrated rings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body
Abstract
The invention relates to pliable surgical implants (1) manufactured of bioabsorbable (or biodegradable) polymer, copolymer, polymer alloy or composite and used for fixation of a bone block (9) (graft) into a drill hole (3) in a bone.
Description
IMPROVED BIOABSORBABLE BONE BLOCK FIXATION IMPLANT
BACKGROUND OF THE INVENTION
The invention relates to surgical implants manufactured of bioabsorbable (or biodegradable) polymer, copolymer, polymer alloy or composite and used for fixation of a bone block (graft) into a drillhole in a bone.
DESCRIPTION OF THE PRIOR ART
In surgery it is generally known to use a bone-patellar tendon-bone (BPTB) graft, taken from the knee of the patient, to replace the severely damaged anterior cruciate ligament (ACL). In a surgical procedure one bone graft is fixed into a drillhole made from the knee joint into the distal femur and another bone graft is fixed into a drilIhole made into the proximal tibia. The bone plugs are fixed into drillholes with bone fixation screws and in most cases with so-called interference screws. A screw is installed into the space between the drillhole and the bone graft to lock the bone graft into the drillhole. The patellar tendon part between the bone blocks acts as a new ACL. The surgical technique of such bone-tendon-bone procedures is described, e.g., in Bach, B.R., Potential Pitfalls of Kurosaka Screw Interference Fixation for ACL Surgery, The American Journal of Knee Surgery, Vol. 2, No, 2 (1989), at 76-82, the entire disclosure of which is incorporated herein by way of this reference.
The fixation screws, like interference screws, are normally made of metal, like stainless steel or titanium or of a bioabsorbable polymer, like polylactide.
Metallic and/or 2S bioabsorbable polymeric materials and composites, suitable for manufacturing of bone-tendon-bone graft fixation screws, are described in literature, like in Barber, A.F., Burton, E.F., McGuire, D.A. and Paulos L.E., Preliminary Results of an Absorbable Interference Screw, The Journal of Arthroscopic and Related Surgery, Vol.l l, No. 5 (1995), at 537-548;
Sequin, F. and Texhammer, R., ASIF/AO Instrumentation, Springer-Verlag, Berlin Heidelberg New York 1981; Bach, B. R., Arthroscopy-Assisted Patellar Tendon Substitution for Anterior Cruciate Ligament Insufficiency, America Journal of Knee Surgery, Vol. 2, No.
I (1989), at 3-20, the entire disclosures of which are incorporated herein by way of this reference.
Rigid fixation of the ACL graft has been recognized as one of the most important factors that determine the long term success of an ACL replacement. See, e.g., Daniel DM:
Principles of knee ligament surgery, in Daniel DM, Akeson W, O'Connor (eds):
Knee Ligaments Structure, Function, Injury, and Repair. New York, Raven Press, 1990, pp 11-30;
and Kurosoka M, Yoshiya S, Andrish JT: A Biomechanical comparison of different surgical techniques of graft fixation in anterior cruciate ligaments reconstruction, Am. J. Sports Med.
15:225-229, 1987, the entire disclosures of which are incorporated herein by way of this reference. Moreover, S. Rupp et al. made biomechanical studies of the fixation strength and the failure modes of a biodegradable screw and the press-fit fixation technique compared with a titanium interference screw in the porcine knee using a BPTB-graft. See Rupp, S., Krauss, P. W. and Fritsch, E. W., Fixation Strength of a Biodegradable Interference Screw and a Press-Fit Technique in Anterior Cruciate Ligament Reconstruction With a BPTB Graft, The Journal of Arthroscopic and Related Surgery, Vol. 13, No 1 (1997), 61 -65, the entire disclosure of which is incorporated herein by way of this reference. In the study of Rupp et al., the following ultimate failure mean loads were obtained:
- biodegradable screw 805.2 N
- titanium screw 768.6 N
BACKGROUND OF THE INVENTION
The invention relates to surgical implants manufactured of bioabsorbable (or biodegradable) polymer, copolymer, polymer alloy or composite and used for fixation of a bone block (graft) into a drillhole in a bone.
DESCRIPTION OF THE PRIOR ART
In surgery it is generally known to use a bone-patellar tendon-bone (BPTB) graft, taken from the knee of the patient, to replace the severely damaged anterior cruciate ligament (ACL). In a surgical procedure one bone graft is fixed into a drillhole made from the knee joint into the distal femur and another bone graft is fixed into a drilIhole made into the proximal tibia. The bone plugs are fixed into drillholes with bone fixation screws and in most cases with so-called interference screws. A screw is installed into the space between the drillhole and the bone graft to lock the bone graft into the drillhole. The patellar tendon part between the bone blocks acts as a new ACL. The surgical technique of such bone-tendon-bone procedures is described, e.g., in Bach, B.R., Potential Pitfalls of Kurosaka Screw Interference Fixation for ACL Surgery, The American Journal of Knee Surgery, Vol. 2, No, 2 (1989), at 76-82, the entire disclosure of which is incorporated herein by way of this reference.
The fixation screws, like interference screws, are normally made of metal, like stainless steel or titanium or of a bioabsorbable polymer, like polylactide.
Metallic and/or 2S bioabsorbable polymeric materials and composites, suitable for manufacturing of bone-tendon-bone graft fixation screws, are described in literature, like in Barber, A.F., Burton, E.F., McGuire, D.A. and Paulos L.E., Preliminary Results of an Absorbable Interference Screw, The Journal of Arthroscopic and Related Surgery, Vol.l l, No. 5 (1995), at 537-548;
Sequin, F. and Texhammer, R., ASIF/AO Instrumentation, Springer-Verlag, Berlin Heidelberg New York 1981; Bach, B. R., Arthroscopy-Assisted Patellar Tendon Substitution for Anterior Cruciate Ligament Insufficiency, America Journal of Knee Surgery, Vol. 2, No.
I (1989), at 3-20, the entire disclosures of which are incorporated herein by way of this reference.
Rigid fixation of the ACL graft has been recognized as one of the most important factors that determine the long term success of an ACL replacement. See, e.g., Daniel DM:
Principles of knee ligament surgery, in Daniel DM, Akeson W, O'Connor (eds):
Knee Ligaments Structure, Function, Injury, and Repair. New York, Raven Press, 1990, pp 11-30;
and Kurosoka M, Yoshiya S, Andrish JT: A Biomechanical comparison of different surgical techniques of graft fixation in anterior cruciate ligaments reconstruction, Am. J. Sports Med.
15:225-229, 1987, the entire disclosures of which are incorporated herein by way of this reference. Moreover, S. Rupp et al. made biomechanical studies of the fixation strength and the failure modes of a biodegradable screw and the press-fit fixation technique compared with a titanium interference screw in the porcine knee using a BPTB-graft. See Rupp, S., Krauss, P. W. and Fritsch, E. W., Fixation Strength of a Biodegradable Interference Screw and a Press-Fit Technique in Anterior Cruciate Ligament Reconstruction With a BPTB Graft, The Journal of Arthroscopic and Related Surgery, Vol. 13, No 1 (1997), 61 -65, the entire disclosure of which is incorporated herein by way of this reference. In the study of Rupp et al., the following ultimate failure mean loads were obtained:
- biodegradable screw 805.2 N
- titanium screw 768.6 N
WO 99144544 PCI'/US99104613 - press-fit 462.5 N
Using screws as fixation implants of bone grafts in a bone-tendon-bone procedure is complicated by several facts:
- if the threads are not cut into the drillhole, substantial compacta ossium (cortex) has to be cut offbefore the insertion of the absorbable screw, which (cutting of cortex) delays the surgical operation, increases trauma and can reduce the grip of the screw into the bone wall of the drillhole because, in such a case, the screw is fixed only into the mechanically weaker substantial spongiosa ossium;
- when using bioabsorbable screws with the drillhole threading technique, the threading of the drillhole delays surgical operation;
- the threads of the screw can cut the bone block to pieces during screw installation if the screw is too big in relation to the bone block and/or if the space between the drillhole and bone block is too small;
- the threads of the screw can damage the tendon during screw installation;
- the bone block (and the tendon) can rotate with the screw during screw installation so that the optimal position of the bone graft is lost andlor the bone graft is damaged;
- divergence of the graft andlor screw can occur;
- the bioabsorbable screw can break during insertion;
- if subsequent surgery is necessary, a metal screw can potentially complicate subsequent surgery and a hardware removal may be necessary, see Rupp et al., supra; and - a metal screw can disturb postoperative MRl scans, see Rupp et al., supra.
Complications, like those recited above and others, are illustrated in, e.g.
in Bach et al., Barber et al. and Rupp et al., all supra. In addition, when using the prior art implants described above, the bone block must be located into the drill hole before the installation of the screw and the bone block must be kept in a proper place in the drill hole during the screw insertion. These procedures lengthen and complicate the surgical procedure.
Thus, it would be advantageous to have a bone-tendon-bone fixation implant which must not be turned into the drillhole as the prior art screws need. It would be especially S advantageous to have an implant which is manufactured of bioabsorbable polymer, copolymer, polymer alloy or fiber-reinforced or particle-filled bioabsorbable polymer composite, which implant can be pushed into a hole or drill canal made into a bone, to fixate a bone graft into the drillhole.
U.S. Pat. Appl. Serial No. 08/914,137, entitled "Bone Block Fixation Implant,"
describes a bioabsorbable implant (bolt or wedge). This implant, which is aimed for fixation of a BPTB-graft, can be pushed into a drillhole in a bone, and comprises: ( 1 ) at least an elongated body, (2) at least one gripping element to lock the implant into the drillhole and (3) a platform surface for location of a bone block between the implant and the wall of the drillhole. The implant may be equipped with (4) an additional arresting means to prevent the 1 S slipping of the bone block out of the drillhole. However, this implant has certain limitations that are overcome by the present invention, namely:
- the tendon of the bone block is not protected or the space reserved for the tendon is very limited, so that during insertion or after it, the tendon may rub against the rim of the drillhole in the bone and be damaged;
- the limited space available for the tendon may result in a relatively thin and weak tendon graft;
- the size of the drillhole in relation to the size of the implant must be exact because the implant is rigid and, as a result, an implant that is too large may break the bone graft, while an implant that is too small may yield a weak fixation; and - the size of the bone block is small, because the wedge-like implant needs a lot of space inside of a drillhole.
Therefore, it would be advantageous to have a bone-tendon-bone fixation implant which is simple to insert and which could be used without the cutting of cortex and/or the threading of a drillhole, and which need not be turned into the drillhole as the prior art screws are. It also would be advantageous to have a bone-tendon-bone fixation implant that has a geometric configuration such that the implant slips easily into the drillhole, but exhibits strong resistance to be pulled out of the drill hole. It would also be desirable to provide an implant for fixing a bone-tendon-bone graft into a bone, which implant does not interfere with noninvasive examinations such as radiographs, MRI (magnetic resonance imaging) or CT (computer topography) and which is biocompatible, and which makes a strong and rigid fixation of a bone block in a BPTB-fixation operation.
By utilizing the present invention, it is possible, when inserting a fixation implant into a patient, to eliminate the above-mentioned difficulties and functional restrictions present in connection with prior art screws, bolts or wedges for bone-tendon-bone fixation.
BRIEF DESCRIPTION OF THE INVENTION
The present invention surprisingly discloses that the problems of the prior art can be eliminated to a great extent with a surgical fixation implant of the present invention. Thus, there is described an implant manufactured of a bioabsorbable polymer, copolymer, polymer alloy or fiber-reinforced or particle-filled bioabsorbable polymer composite, which implant is pushed into a hole or drill canal made into a bone, to fix a bone graft into the drillhole, the implant comprising: ( 1 ) at least a pliable (expandable and compressible) body, wherein the implant body comprises at least one groove formed on the surface of the implant body in the longitudinal direction of the implant body, which groove opens into (2) a fish-tail like slot inside of which part of the tendon of the BPTB-graft will be located, (3) two ailerons, formed by the walls of the implant on both sides of the slot, (4) at least one gripping element to lock the implant into the drillhole, and (5) a curved and/or slanting threshold surface to prevent the slipping of the bone block out of the drillhole. The implant may be equipped optionally with a (6) finger sleeve for fixing a bone block tightly to the implant.
BRIEF DESCRIPTION OF THE FIGURES
The invention is illustrated through the following specification, with reference made to the accompanying drawings. In the drawings:
FIG. 1 shows as figures (A-E) one embodiment in accordance with the invention.
FIG. 1 A shows, as a longitudinal figure, the groove edge of the implant.
FIG. 1 B shows, as a transverse figure, the non-leaning edge of the implant.
FIG. 1 C shows, as a transverse figure, the leaning edge of the implant.
FIG. 1 D shows, as a side view, the implant with a bone block.
FIG. 1 E shows the implant with a bone block, as a longitudinal cross-sectional figure in plane a-a of FIG. 1 A.
FIG. 2 shows as figures (A-E) another embodiment of the implant.
FIG. 2A shows, as a longitudinal figure, the groove edge of the implant.
FIG. 2B shows, as a transverse figure, the non-leaning edge of the implant.
FIG. 2C shows, as a transverse figure, the leaning edge of the implant.
FIG. 2D shows, as a side view, the implant with a bone block.
FIG. 2E shows the implant with a bone block, as a longitudinal cross-sectional figure in plane a-a of FIG. 2A.
FIG. 3 shows, as an enlarged perspective figure, two implants equipped with ridge-like gripping elements.
FIG. 4 shows, as an enlarged perspective figure, an implant with a hole for the tip of an installation instrument.
DETAILED DESCRIPTION OF THE INVENTION
FIGS. lA through lE illustrate a fixation implant in accordance with the invention.
Specifically, the fixation implant of the present invention comprises: (a} a cylindrical and/or conical body 1, which is pliable and which may be elongated (the length of the body can be bigger that its maximum diameter); (b) at least one gripping element 2, which locks the implant into the drillhole 3 in the bone 4 so that the gripping elements) sink at least partially inside of the bone 4 during the insertion of the implant; (c) at least one groove 5 formed on the surface of the implant body in the longitudinal direction of the implant body; (d) a slot 6 into which the groove 5 expands and into which slot 6 a part of the tendon 7 of the BPTB-graft is located between the implant and the surface of the drillhole; (e) walls of the implant, which form ailerons (10, 11 ) on both sides of the slot 6, which ailerons press against the walls of the drill hole during the insertion procedure; and (fj a threshold surface 8, which typically is curved and/or slanting, which threshold surface 8 prevents the slipping of the bone block 9 out of the drillhole after insertion, but which also serves to guide the bone block 9 to partly protrude into the slot 6 during the insertion procedure to expand the implant by pressing the ailerons or wings ( 10, 11 ) against the walls of the drillhole.
According to one advantageous embodiment of the present invention, the cross-sectional form of the slot 6 is fish-tail like, so that the tendon is protected securely inside of the slot against damage, bath during the insertion procedure and after it.
Additionally, according to FIG. 2, the implant 1 can include a finger-sleeve 16 on which the bone graft 9 (from which the tendon 7 emerges) is located between the implant 1 and the surface of the drillhole 3. The finger-sleeve 16 of the implant 1 can include at least one hole 12. The bone graft may be fixed on the implant by means of tied sutures) 13, which go through the finger-sleeve hole 12 and through a hole 14 made into the bone block. The sutures 13 can also he tied around the bone block and/or around the finger-sleeve 16. A tight press fit of implant 1 and bone graft (block) 9 into the drillhole 3 is achieved when the maximum thickness of the implant 1 combined with the maximum thickness of the bone graft 9 is larger than the diameter of the drillhole 3.
Refernng still to FIGS. 1 and 2, it is seen that the implant of the invention comprises a groove 5 and a slot 6 for the tendon. The groove 5 and the slot 6 protect the tendon 7 and provide the implant body 1 with expansion capacity after its insertion. That expandability and compressibility (pliability) of the implant of the present invention makes inserting of the implant simpler and easier than if the implant were stiff. Moreover, under the present 1 S invention, after the pliable implant is inserted into the drillhole, it expands to the walls of the drillhole and resists being removed from the drillhole.
FIGS. 1 E and 2E show typical longitudinal cross-sections of the implants with a bone block 9, located into the drillhole 3 in the bone. Accordingly, most advantageously, the outer surface of the implant 1 is cylindrical of its form and the gripping elements 2 are formed on the cylindrical surface of the implant.
The gripping elements 2 illustrated in FIGS. 1 and 2 are typically protuberances emerging from the surface of the implant. Such protuberances are, e.g,.
threads, barbs or transverse ridges. The geometry of gripping elements is such that the implant 1 slips easily into the drillhole 3, but does not slip back again after its insertion.
According to the advantageous embodiments of the invention depicted in FIGS. 1-3, the gripping elements are transverse ridges 2 emerging from the surface of the implant 1. The ridges 2 according to FIG. 3 cause only a little resistance when the implant 1 with the bone graft is pushed into the drillhole, but the ridges effectively prevent the slippage of the implant 1 back from the drillhole 3 after its insertion. Because the bone graft is locked into the drillhole in relation to the implant, any potential slippage of the bone graft back from the drillhole is also effectively prevented. Many additional geometries for the gripping elements (like barbs or threads) of the implant of the invention can be used to achieve the same results, as would be apparent to persons of ordinary skill in the art.
FIG. 3 shows as perspective figures two typical implants of the invention, each having circular ridges as gripping elements 2 around the cylindrical body of the implant, with a threshold surface 8 and with a finger sleeve 16.
The implant of the invention can be pushed arthroscopically into a drillhole in a bone, with the bone block fixed on the finger-sleeve 16, using, e.g., one or a combination of the following techniques:
- the implant of the invention (with the fixed bone block) is pushed to its place through a tube-like cannula;
- a longitudinal hole is made through the implant for receipt of a guide wire, and the implant (and fixed bone block) is pushed into its place in the drillhole along the guide wire;
and - a small, (optionally threaded) hole or notch 15 (see FIGS. 1 B, 2B and 4) is made in the proximal part of the implant, so that the tip of a (e.g" bayonet-like) installation instrument is fixed (pushed) into the hole (15), and the instrument is used to push the attached implant (and fixed bone block) into position in the drillhole; and - a small, transverse hole 12 (see FIG. 2A) is made through the finger-sleeve of the implant for a suture 13 and the implant (and fixed bone block) is pushed into place using the suture to control the positioning of the bone block.
Alternatively, the bone block can be inserted into the drillhole prior to the implant. In that case (where the bone block is first inserted into the drillhole, followed by the implant), the bone block can be pushed arthroscopically into the drillhole in the same manner as described above for the implant.
By inserting implants according to the invention, it is possible to efficiently attach and immobilize bone grafts into drillholes in bone, against forces tending to loosen the bone I 0 grafts, without having to carry out a time-consuming and risky fixations with a screw or other prior art implant, which fixations may damage the bone block and/or the tendon graft fixed to the bone graft. Fixation implants in accordance with the invention can be manufactured of bioabsorbable (biodegradable or resorbable) polymers, copolymers, polymer alloys or composites, e.g., of poly-a-hydroxide acids and other aliphatic biodegradable polyesters, 15 polyanhydrides, polyorthoesters, polyorganophosphatsenes and other bioabsorbable polymers known in the art and disclosed in numerous publications, e.g., in Vainionpaa, S., Rokkanen, P. and Tormala, P. Surgical Applications of Biodegradable Polymers in Human Tissues, Progr. Polym. Sci., Vol. 14, (1989), at 679-716, as well as in Finnish Patent Applications FI-9528$4, FI-955547 and the publication WO-90/04982, the entire disclosures of which are 20 incorporated herein by way of this reference.
Implants in accordance with the invention can be manufactured of biodegradable polymers by using one polymer or polymer alloy. The implants can also be reinforced by reinforcing the material by fibres manufactured of resorbable polymer or polymer alloy, or biodegradable glass fibers, such as ~i-tricalsiumphosphate fibres, bio-glass fibers or CaM
fibres (see, e.g. , publication EP146398, the entire disclosure of which is incorporated herein by way of this reference}. Ceramic powders can also be used as additives (fillers) in implants to promote new bone formation.
Implants according to the invention can also comprise a flexible outer layer, which is S a surface layer improving the toughness of the implant and/or operating as a hydrolysis barner, and a stiffer inner layer or core of the implant. To prepare such an embodiment, the implant can be coated with an outer layer having different chemical and mechanical properties (e.g., hydrolysis and strength retention) than the core of the implant. In such a case, an outer layer having greater resistance to hydrolysis than the implant's core can be used, enabling the implant (after insertion in a patient) to retain its strength and biodegrade in less time than it would have without such an outer coating.
Surgical implants in accordance with the invention can be manufactured of biodegradable polymers, which may or may not contain suitable biodegradable reinforcement fibres andlor particle fillers, by means of various methods used in plastic technology, such as injection molding, extrusion and fibrillation and molding related thereto (see, e.g., U.S.
Patent No. 4,968,317, the entire disclosure of which is hereby incorporated by reference) or by means of compression molding, wherein the implants are shaped from the raw material by employing heat andlor compression. Also mechanical machining (e.g., cutting, drilling, lathing, grinding etc. ) can be used to prepare the implants of the present invention.
According to one advantageous embodiment of the invention, the implant contains holes or open porosity to facilitate tissue (such as bone) growth inside of the implant. Such holes or pores typically have a diameter from 100 ,um to 2000 pm. The holes or pores may be filled at least partially with cancellous bone of the patient or with ceramic bone substitute powder or granules (like bioactive glass), to accelerate their filling with new bone. The growth of such new bone inside of the holes or pores of the implant facilitates the final healing of the drillhole and the fixation of bone block inside of the drillhole, when the implant biodegrades and disappears from the drilihole.
It also is possible to manufacture implants of the invention using the aforementioned polymeric raw materials in dissolving techniques, which are known in the art.
Under such techniques, at least part of the polymer is either dissolved in a suitable solvent or softened by means of that solvent; the polymer is then compressed into an implant piece by means of pressure and/or by means of slight heat, wherein the dissolved or softened polymer is glued to form a macroscopic implant piece, wherefrom the solvent is removed by evaporation.
I 0 It is natural that the implants of the invention can also contain various additives for facilitating the processability of the material (e.g., stabilizers, antioxidants or plasticisers) or for changing its properties (e.g., plasticisers or ceramic powder materials or biostable fibres, such as carbon fibres) or for facilitating its treatment (e.g. colorants).
According to one advantageous embodiment, the implant of the invention contains 15 some bioactive agent or agents, such as antibiotics. chemotherapeutic agents, agents activating healing of wounds, growth factor(s), bone morphogenic protein(s), anticoagulant (such as heparin) etc. Such bioactive implants are particularly advantageous in clinical use, because they have, in addition to their mechanical effect, also biochemical, medical and other effects to facilitate tissue healing and/or regeneration.
The invention and its function is further illustrated by way of the following examples.
EXAMPLE 1.
The aim of this example was to demonstrate how the diameter of the implant body in relation to the diameter of the drillhole in the bone affects the fixation strength of the implant.
Implants in accordance with FIG. 2. were manufactured with a length of 22 mm (including a 12 mm long finger-sleeve) and having variable diameters from 10.3 mm to 10.8 mm.
In this example, each implant with one end of a trimmed BPTB-graft was inserted into a drill hole of 10 mm in diameter, which was made through the femoral metaphyseal bone of pig using a cannulated drill. The bone was fixed into the lower jaw of a tensile testing machine (Lloyd LRSK, available from J J Lloyd Instruments, Southampton, UK).
After fixing the other end of the BPTB-graft into the upper (moving) jaw of the tensile testing machine, the BPTB-graft, which was fixed with the implant into the drillhole, was subjected to a vertical tensile loading at a strain rate of 50 mm/min, until failure.
Two samples were I S tested in each case. Table 1 gives the measured forces for failure for each of the tested implants.
Table 1.
Max. Diameter of Implant i,mm) Force to failure (N) Force to failure (N) Sample 1 Sample 2 10.3 607 358 10.4 201 142 10.5 370 287 10.6 1312 686 10.7 777 1298 10.8 1427 1228 i3 WO 99/44544 PC'T/US99/04613 This test showed that through the selection of the proper diameter of the implant of the invention, the force to failure values of the implant of the invention are superior to those reported in literature for prior art interference screws ( 768.6 N; and a range of 544 to 1094 N, reported in Daniel DM: Principles of knee ligament surgery, in Daniel DM, Akeson W, O'Connor (eds): Knee Ligaments Structure, Function, Injury, and Repair. New York, Raven Press, 1990, pp. 11-30).
EXAMPLE 2.
I 0 The aim of this example was to demonstrate how rapid and simple the implant is to operate and how secure the fixation of the implant is. The fixation capacity of a biodegradable implant in accordance with the invention (diam. of 10.8 mm) was compared with the performance of a titanium interference screw (Acufex; available from Acufex Microsurgical Inc, Mansfield, Massachusetts; diam. 7 mm, length 25 mm ) and fixation implants made in accordance with U.S. Patent Application Serial No. 081914,137 (wedges with the following dimensions: length 25 mm, width 10 mm and height of the ridged implant body 7 mm) in an anterior cruciate ligament (ACL) reconstruction, using a bone-patellar-tendon-bone (BPTB) graft in the porcine knee. The same test methods were used as in Example 1. Again, two parallel tests were carried out in each case. Table 2 gives the measured forces for failure.
Table 2.
Implant Force to failure !N) Force to failure (N) Sample 1 Sample 2 Present Invention 1228 1427 Interference screw 349 975 Wedge of US Pat. Appl.. No. 081914,137 770 921 The results indicate that the biodegradable implant of the present invention provides a more stable graft fixation than the prior art implants. This test also showed that, in accordance with the disclosure above, inserting of the implant of the present invention is easier and swifter, and it protects the BPTB graft better during operation than the prior art fixation implants.
Using screws as fixation implants of bone grafts in a bone-tendon-bone procedure is complicated by several facts:
- if the threads are not cut into the drillhole, substantial compacta ossium (cortex) has to be cut offbefore the insertion of the absorbable screw, which (cutting of cortex) delays the surgical operation, increases trauma and can reduce the grip of the screw into the bone wall of the drillhole because, in such a case, the screw is fixed only into the mechanically weaker substantial spongiosa ossium;
- when using bioabsorbable screws with the drillhole threading technique, the threading of the drillhole delays surgical operation;
- the threads of the screw can cut the bone block to pieces during screw installation if the screw is too big in relation to the bone block and/or if the space between the drillhole and bone block is too small;
- the threads of the screw can damage the tendon during screw installation;
- the bone block (and the tendon) can rotate with the screw during screw installation so that the optimal position of the bone graft is lost andlor the bone graft is damaged;
- divergence of the graft andlor screw can occur;
- the bioabsorbable screw can break during insertion;
- if subsequent surgery is necessary, a metal screw can potentially complicate subsequent surgery and a hardware removal may be necessary, see Rupp et al., supra; and - a metal screw can disturb postoperative MRl scans, see Rupp et al., supra.
Complications, like those recited above and others, are illustrated in, e.g.
in Bach et al., Barber et al. and Rupp et al., all supra. In addition, when using the prior art implants described above, the bone block must be located into the drill hole before the installation of the screw and the bone block must be kept in a proper place in the drill hole during the screw insertion. These procedures lengthen and complicate the surgical procedure.
Thus, it would be advantageous to have a bone-tendon-bone fixation implant which must not be turned into the drillhole as the prior art screws need. It would be especially S advantageous to have an implant which is manufactured of bioabsorbable polymer, copolymer, polymer alloy or fiber-reinforced or particle-filled bioabsorbable polymer composite, which implant can be pushed into a hole or drill canal made into a bone, to fixate a bone graft into the drillhole.
U.S. Pat. Appl. Serial No. 08/914,137, entitled "Bone Block Fixation Implant,"
describes a bioabsorbable implant (bolt or wedge). This implant, which is aimed for fixation of a BPTB-graft, can be pushed into a drillhole in a bone, and comprises: ( 1 ) at least an elongated body, (2) at least one gripping element to lock the implant into the drillhole and (3) a platform surface for location of a bone block between the implant and the wall of the drillhole. The implant may be equipped with (4) an additional arresting means to prevent the 1 S slipping of the bone block out of the drillhole. However, this implant has certain limitations that are overcome by the present invention, namely:
- the tendon of the bone block is not protected or the space reserved for the tendon is very limited, so that during insertion or after it, the tendon may rub against the rim of the drillhole in the bone and be damaged;
- the limited space available for the tendon may result in a relatively thin and weak tendon graft;
- the size of the drillhole in relation to the size of the implant must be exact because the implant is rigid and, as a result, an implant that is too large may break the bone graft, while an implant that is too small may yield a weak fixation; and - the size of the bone block is small, because the wedge-like implant needs a lot of space inside of a drillhole.
Therefore, it would be advantageous to have a bone-tendon-bone fixation implant which is simple to insert and which could be used without the cutting of cortex and/or the threading of a drillhole, and which need not be turned into the drillhole as the prior art screws are. It also would be advantageous to have a bone-tendon-bone fixation implant that has a geometric configuration such that the implant slips easily into the drillhole, but exhibits strong resistance to be pulled out of the drill hole. It would also be desirable to provide an implant for fixing a bone-tendon-bone graft into a bone, which implant does not interfere with noninvasive examinations such as radiographs, MRI (magnetic resonance imaging) or CT (computer topography) and which is biocompatible, and which makes a strong and rigid fixation of a bone block in a BPTB-fixation operation.
By utilizing the present invention, it is possible, when inserting a fixation implant into a patient, to eliminate the above-mentioned difficulties and functional restrictions present in connection with prior art screws, bolts or wedges for bone-tendon-bone fixation.
BRIEF DESCRIPTION OF THE INVENTION
The present invention surprisingly discloses that the problems of the prior art can be eliminated to a great extent with a surgical fixation implant of the present invention. Thus, there is described an implant manufactured of a bioabsorbable polymer, copolymer, polymer alloy or fiber-reinforced or particle-filled bioabsorbable polymer composite, which implant is pushed into a hole or drill canal made into a bone, to fix a bone graft into the drillhole, the implant comprising: ( 1 ) at least a pliable (expandable and compressible) body, wherein the implant body comprises at least one groove formed on the surface of the implant body in the longitudinal direction of the implant body, which groove opens into (2) a fish-tail like slot inside of which part of the tendon of the BPTB-graft will be located, (3) two ailerons, formed by the walls of the implant on both sides of the slot, (4) at least one gripping element to lock the implant into the drillhole, and (5) a curved and/or slanting threshold surface to prevent the slipping of the bone block out of the drillhole. The implant may be equipped optionally with a (6) finger sleeve for fixing a bone block tightly to the implant.
BRIEF DESCRIPTION OF THE FIGURES
The invention is illustrated through the following specification, with reference made to the accompanying drawings. In the drawings:
FIG. 1 shows as figures (A-E) one embodiment in accordance with the invention.
FIG. 1 A shows, as a longitudinal figure, the groove edge of the implant.
FIG. 1 B shows, as a transverse figure, the non-leaning edge of the implant.
FIG. 1 C shows, as a transverse figure, the leaning edge of the implant.
FIG. 1 D shows, as a side view, the implant with a bone block.
FIG. 1 E shows the implant with a bone block, as a longitudinal cross-sectional figure in plane a-a of FIG. 1 A.
FIG. 2 shows as figures (A-E) another embodiment of the implant.
FIG. 2A shows, as a longitudinal figure, the groove edge of the implant.
FIG. 2B shows, as a transverse figure, the non-leaning edge of the implant.
FIG. 2C shows, as a transverse figure, the leaning edge of the implant.
FIG. 2D shows, as a side view, the implant with a bone block.
FIG. 2E shows the implant with a bone block, as a longitudinal cross-sectional figure in plane a-a of FIG. 2A.
FIG. 3 shows, as an enlarged perspective figure, two implants equipped with ridge-like gripping elements.
FIG. 4 shows, as an enlarged perspective figure, an implant with a hole for the tip of an installation instrument.
DETAILED DESCRIPTION OF THE INVENTION
FIGS. lA through lE illustrate a fixation implant in accordance with the invention.
Specifically, the fixation implant of the present invention comprises: (a} a cylindrical and/or conical body 1, which is pliable and which may be elongated (the length of the body can be bigger that its maximum diameter); (b) at least one gripping element 2, which locks the implant into the drillhole 3 in the bone 4 so that the gripping elements) sink at least partially inside of the bone 4 during the insertion of the implant; (c) at least one groove 5 formed on the surface of the implant body in the longitudinal direction of the implant body; (d) a slot 6 into which the groove 5 expands and into which slot 6 a part of the tendon 7 of the BPTB-graft is located between the implant and the surface of the drillhole; (e) walls of the implant, which form ailerons (10, 11 ) on both sides of the slot 6, which ailerons press against the walls of the drill hole during the insertion procedure; and (fj a threshold surface 8, which typically is curved and/or slanting, which threshold surface 8 prevents the slipping of the bone block 9 out of the drillhole after insertion, but which also serves to guide the bone block 9 to partly protrude into the slot 6 during the insertion procedure to expand the implant by pressing the ailerons or wings ( 10, 11 ) against the walls of the drillhole.
According to one advantageous embodiment of the present invention, the cross-sectional form of the slot 6 is fish-tail like, so that the tendon is protected securely inside of the slot against damage, bath during the insertion procedure and after it.
Additionally, according to FIG. 2, the implant 1 can include a finger-sleeve 16 on which the bone graft 9 (from which the tendon 7 emerges) is located between the implant 1 and the surface of the drillhole 3. The finger-sleeve 16 of the implant 1 can include at least one hole 12. The bone graft may be fixed on the implant by means of tied sutures) 13, which go through the finger-sleeve hole 12 and through a hole 14 made into the bone block. The sutures 13 can also he tied around the bone block and/or around the finger-sleeve 16. A tight press fit of implant 1 and bone graft (block) 9 into the drillhole 3 is achieved when the maximum thickness of the implant 1 combined with the maximum thickness of the bone graft 9 is larger than the diameter of the drillhole 3.
Refernng still to FIGS. 1 and 2, it is seen that the implant of the invention comprises a groove 5 and a slot 6 for the tendon. The groove 5 and the slot 6 protect the tendon 7 and provide the implant body 1 with expansion capacity after its insertion. That expandability and compressibility (pliability) of the implant of the present invention makes inserting of the implant simpler and easier than if the implant were stiff. Moreover, under the present 1 S invention, after the pliable implant is inserted into the drillhole, it expands to the walls of the drillhole and resists being removed from the drillhole.
FIGS. 1 E and 2E show typical longitudinal cross-sections of the implants with a bone block 9, located into the drillhole 3 in the bone. Accordingly, most advantageously, the outer surface of the implant 1 is cylindrical of its form and the gripping elements 2 are formed on the cylindrical surface of the implant.
The gripping elements 2 illustrated in FIGS. 1 and 2 are typically protuberances emerging from the surface of the implant. Such protuberances are, e.g,.
threads, barbs or transverse ridges. The geometry of gripping elements is such that the implant 1 slips easily into the drillhole 3, but does not slip back again after its insertion.
According to the advantageous embodiments of the invention depicted in FIGS. 1-3, the gripping elements are transverse ridges 2 emerging from the surface of the implant 1. The ridges 2 according to FIG. 3 cause only a little resistance when the implant 1 with the bone graft is pushed into the drillhole, but the ridges effectively prevent the slippage of the implant 1 back from the drillhole 3 after its insertion. Because the bone graft is locked into the drillhole in relation to the implant, any potential slippage of the bone graft back from the drillhole is also effectively prevented. Many additional geometries for the gripping elements (like barbs or threads) of the implant of the invention can be used to achieve the same results, as would be apparent to persons of ordinary skill in the art.
FIG. 3 shows as perspective figures two typical implants of the invention, each having circular ridges as gripping elements 2 around the cylindrical body of the implant, with a threshold surface 8 and with a finger sleeve 16.
The implant of the invention can be pushed arthroscopically into a drillhole in a bone, with the bone block fixed on the finger-sleeve 16, using, e.g., one or a combination of the following techniques:
- the implant of the invention (with the fixed bone block) is pushed to its place through a tube-like cannula;
- a longitudinal hole is made through the implant for receipt of a guide wire, and the implant (and fixed bone block) is pushed into its place in the drillhole along the guide wire;
and - a small, (optionally threaded) hole or notch 15 (see FIGS. 1 B, 2B and 4) is made in the proximal part of the implant, so that the tip of a (e.g" bayonet-like) installation instrument is fixed (pushed) into the hole (15), and the instrument is used to push the attached implant (and fixed bone block) into position in the drillhole; and - a small, transverse hole 12 (see FIG. 2A) is made through the finger-sleeve of the implant for a suture 13 and the implant (and fixed bone block) is pushed into place using the suture to control the positioning of the bone block.
Alternatively, the bone block can be inserted into the drillhole prior to the implant. In that case (where the bone block is first inserted into the drillhole, followed by the implant), the bone block can be pushed arthroscopically into the drillhole in the same manner as described above for the implant.
By inserting implants according to the invention, it is possible to efficiently attach and immobilize bone grafts into drillholes in bone, against forces tending to loosen the bone I 0 grafts, without having to carry out a time-consuming and risky fixations with a screw or other prior art implant, which fixations may damage the bone block and/or the tendon graft fixed to the bone graft. Fixation implants in accordance with the invention can be manufactured of bioabsorbable (biodegradable or resorbable) polymers, copolymers, polymer alloys or composites, e.g., of poly-a-hydroxide acids and other aliphatic biodegradable polyesters, 15 polyanhydrides, polyorthoesters, polyorganophosphatsenes and other bioabsorbable polymers known in the art and disclosed in numerous publications, e.g., in Vainionpaa, S., Rokkanen, P. and Tormala, P. Surgical Applications of Biodegradable Polymers in Human Tissues, Progr. Polym. Sci., Vol. 14, (1989), at 679-716, as well as in Finnish Patent Applications FI-9528$4, FI-955547 and the publication WO-90/04982, the entire disclosures of which are 20 incorporated herein by way of this reference.
Implants in accordance with the invention can be manufactured of biodegradable polymers by using one polymer or polymer alloy. The implants can also be reinforced by reinforcing the material by fibres manufactured of resorbable polymer or polymer alloy, or biodegradable glass fibers, such as ~i-tricalsiumphosphate fibres, bio-glass fibers or CaM
fibres (see, e.g. , publication EP146398, the entire disclosure of which is incorporated herein by way of this reference}. Ceramic powders can also be used as additives (fillers) in implants to promote new bone formation.
Implants according to the invention can also comprise a flexible outer layer, which is S a surface layer improving the toughness of the implant and/or operating as a hydrolysis barner, and a stiffer inner layer or core of the implant. To prepare such an embodiment, the implant can be coated with an outer layer having different chemical and mechanical properties (e.g., hydrolysis and strength retention) than the core of the implant. In such a case, an outer layer having greater resistance to hydrolysis than the implant's core can be used, enabling the implant (after insertion in a patient) to retain its strength and biodegrade in less time than it would have without such an outer coating.
Surgical implants in accordance with the invention can be manufactured of biodegradable polymers, which may or may not contain suitable biodegradable reinforcement fibres andlor particle fillers, by means of various methods used in plastic technology, such as injection molding, extrusion and fibrillation and molding related thereto (see, e.g., U.S.
Patent No. 4,968,317, the entire disclosure of which is hereby incorporated by reference) or by means of compression molding, wherein the implants are shaped from the raw material by employing heat andlor compression. Also mechanical machining (e.g., cutting, drilling, lathing, grinding etc. ) can be used to prepare the implants of the present invention.
According to one advantageous embodiment of the invention, the implant contains holes or open porosity to facilitate tissue (such as bone) growth inside of the implant. Such holes or pores typically have a diameter from 100 ,um to 2000 pm. The holes or pores may be filled at least partially with cancellous bone of the patient or with ceramic bone substitute powder or granules (like bioactive glass), to accelerate their filling with new bone. The growth of such new bone inside of the holes or pores of the implant facilitates the final healing of the drillhole and the fixation of bone block inside of the drillhole, when the implant biodegrades and disappears from the drilihole.
It also is possible to manufacture implants of the invention using the aforementioned polymeric raw materials in dissolving techniques, which are known in the art.
Under such techniques, at least part of the polymer is either dissolved in a suitable solvent or softened by means of that solvent; the polymer is then compressed into an implant piece by means of pressure and/or by means of slight heat, wherein the dissolved or softened polymer is glued to form a macroscopic implant piece, wherefrom the solvent is removed by evaporation.
I 0 It is natural that the implants of the invention can also contain various additives for facilitating the processability of the material (e.g., stabilizers, antioxidants or plasticisers) or for changing its properties (e.g., plasticisers or ceramic powder materials or biostable fibres, such as carbon fibres) or for facilitating its treatment (e.g. colorants).
According to one advantageous embodiment, the implant of the invention contains 15 some bioactive agent or agents, such as antibiotics. chemotherapeutic agents, agents activating healing of wounds, growth factor(s), bone morphogenic protein(s), anticoagulant (such as heparin) etc. Such bioactive implants are particularly advantageous in clinical use, because they have, in addition to their mechanical effect, also biochemical, medical and other effects to facilitate tissue healing and/or regeneration.
The invention and its function is further illustrated by way of the following examples.
EXAMPLE 1.
The aim of this example was to demonstrate how the diameter of the implant body in relation to the diameter of the drillhole in the bone affects the fixation strength of the implant.
Implants in accordance with FIG. 2. were manufactured with a length of 22 mm (including a 12 mm long finger-sleeve) and having variable diameters from 10.3 mm to 10.8 mm.
In this example, each implant with one end of a trimmed BPTB-graft was inserted into a drill hole of 10 mm in diameter, which was made through the femoral metaphyseal bone of pig using a cannulated drill. The bone was fixed into the lower jaw of a tensile testing machine (Lloyd LRSK, available from J J Lloyd Instruments, Southampton, UK).
After fixing the other end of the BPTB-graft into the upper (moving) jaw of the tensile testing machine, the BPTB-graft, which was fixed with the implant into the drillhole, was subjected to a vertical tensile loading at a strain rate of 50 mm/min, until failure.
Two samples were I S tested in each case. Table 1 gives the measured forces for failure for each of the tested implants.
Table 1.
Max. Diameter of Implant i,mm) Force to failure (N) Force to failure (N) Sample 1 Sample 2 10.3 607 358 10.4 201 142 10.5 370 287 10.6 1312 686 10.7 777 1298 10.8 1427 1228 i3 WO 99/44544 PC'T/US99/04613 This test showed that through the selection of the proper diameter of the implant of the invention, the force to failure values of the implant of the invention are superior to those reported in literature for prior art interference screws ( 768.6 N; and a range of 544 to 1094 N, reported in Daniel DM: Principles of knee ligament surgery, in Daniel DM, Akeson W, O'Connor (eds): Knee Ligaments Structure, Function, Injury, and Repair. New York, Raven Press, 1990, pp. 11-30).
EXAMPLE 2.
I 0 The aim of this example was to demonstrate how rapid and simple the implant is to operate and how secure the fixation of the implant is. The fixation capacity of a biodegradable implant in accordance with the invention (diam. of 10.8 mm) was compared with the performance of a titanium interference screw (Acufex; available from Acufex Microsurgical Inc, Mansfield, Massachusetts; diam. 7 mm, length 25 mm ) and fixation implants made in accordance with U.S. Patent Application Serial No. 081914,137 (wedges with the following dimensions: length 25 mm, width 10 mm and height of the ridged implant body 7 mm) in an anterior cruciate ligament (ACL) reconstruction, using a bone-patellar-tendon-bone (BPTB) graft in the porcine knee. The same test methods were used as in Example 1. Again, two parallel tests were carried out in each case. Table 2 gives the measured forces for failure.
Table 2.
Implant Force to failure !N) Force to failure (N) Sample 1 Sample 2 Present Invention 1228 1427 Interference screw 349 975 Wedge of US Pat. Appl.. No. 081914,137 770 921 The results indicate that the biodegradable implant of the present invention provides a more stable graft fixation than the prior art implants. This test also showed that, in accordance with the disclosure above, inserting of the implant of the present invention is easier and swifter, and it protects the BPTB graft better during operation than the prior art fixation implants.
Claims (12)
1. A surgical implant for fixing a bone block into a drillhole in a bone, said implant comprising: at least one elongated body having walls and manufactured from bioabsorbable polymer, copolymer, polymer alloy or composite; at least one gripping element on the elongated body, for locking the implant into the drillhole; at least one slot on the elongated body; two ailerons formed by the walls of the elongated body; and a curved or slanting threshold surface on the elongated body, to prevent the bone block from slipping out of the drillhole.
2. A surgical implant according to claim 1, further comprising a finger-sleeve on the elongated body, for locating the bone block rigidly on the implant.
3. A surgical implant according to claims 1, wherein said slot has a fish-tail like cross-section.
4. A surgical implant according to claim 1, wherein said at least one gripping element comprises at least one protuberance.
5. A surgical implant according to claim 1, wherein said at least one gripping element comprises at least one thread.
6. A surgical implant according to claim 1, wherein said at least one gripping element comprises at least one transverse ridge.
7. A surgical implant according to claim l, wherein said at least one gripping element comprises at least one barb.
8. A surgical implant according to claim 1, wherein said elongated body is cylindrical in form.
9. A surgical implant according to claim 1, wherein said elongated body is porous.
10. A surgical implant according to claim 1, wherein said implant is capable of releasing a drug or other bioactive substance.
11. A method of inserting the surgical implant of claim 1 and a bone block into a drillhole in a bone, comprising the steps of:
a. attaching the bone block to the elongated body;
b. inserting the bone block and elongated body into the drillhole; and c. locking the implant into the drillhole by means of the gripping means on the implant.
a. attaching the bone block to the elongated body;
b. inserting the bone block and elongated body into the drillhole; and c. locking the implant into the drillhole by means of the gripping means on the implant.
12. A method of inserting the surgical implant of claim 1 and a bone block into a drillhole in a bone, comprising the steps of:
a. inserting the bone block into the drillhole;
b. inserting the elongated body into the drillhole;
c. locking the implant into the drillhole by means of the gripping means on the implant.
a. inserting the bone block into the drillhole;
b. inserting the elongated body into the drillhole;
c. locking the implant into the drillhole by means of the gripping means on the implant.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/033,475 | 1998-03-02 | ||
US09/033,475 US5984966A (en) | 1998-03-02 | 1998-03-02 | Bioabsorbable bone block fixation implant |
PCT/US1999/004613 WO1999044544A1 (en) | 1998-03-02 | 1999-03-02 | Improved bioabsorbable bone block fixation implant |
Publications (1)
Publication Number | Publication Date |
---|---|
CA2322485A1 true CA2322485A1 (en) | 1999-09-10 |
Family
ID=21870621
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002322485A Abandoned CA2322485A1 (en) | 1998-03-02 | 1999-03-02 | Improved bioabsorbable bone block fixation implant |
Country Status (7)
Country | Link |
---|---|
US (1) | US5984966A (en) |
EP (1) | EP1069871A4 (en) |
JP (1) | JP2002505153A (en) |
CN (1) | CN1299252A (en) |
AU (1) | AU736616B2 (en) |
CA (1) | CA2322485A1 (en) |
WO (1) | WO1999044544A1 (en) |
Families Citing this family (135)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6648890B2 (en) | 1996-11-12 | 2003-11-18 | Triage Medical, Inc. | Bone fixation system with radially extendable anchor |
US6632224B2 (en) | 1996-11-12 | 2003-10-14 | Triage Medical, Inc. | Bone fixation system |
US5893850A (en) | 1996-11-12 | 1999-04-13 | Cachia; Victor V. | Bone fixation device |
WO1999059488A1 (en) * | 1998-05-21 | 1999-11-25 | Chan Kwan Ho | Apparatus and method for ligament fixation |
US6572655B1 (en) | 1998-08-26 | 2003-06-03 | Lanny L. Johnson | Method for securing a prosthesis component to bone |
US6497726B1 (en) | 2000-01-11 | 2002-12-24 | Regeneration Technologies, Inc. | Materials and methods for improved bone tendon bone transplantation |
US6264694B1 (en) * | 1999-02-11 | 2001-07-24 | Linvatec Corporation | Soft tissue graft fixation device and method |
DE59900298D1 (en) * | 1999-10-21 | 2001-11-08 | Storz Karl Gmbh & Co Kg | Biodegradable fixation body |
US20030023304A1 (en) * | 2000-01-11 | 2003-01-30 | Carter Kevin C. | Materials and methods for improved bone tendon bone transplantation |
US6878166B2 (en) | 2000-08-28 | 2005-04-12 | Ron Clark | Method and implant for securing ligament replacement into the knee |
US7005135B2 (en) * | 2001-01-30 | 2006-02-28 | Ethicon Inc. | Glass scaffolds with controlled resorption rates and methods for making same |
US6511481B2 (en) | 2001-03-30 | 2003-01-28 | Triage Medical, Inc. | Method and apparatus for fixation of proximal femoral fractures |
US6887243B2 (en) | 2001-03-30 | 2005-05-03 | Triage Medical, Inc. | Method and apparatus for bone fixation with secondary compression |
GB0116605D0 (en) * | 2001-07-07 | 2001-08-29 | Atlantech Medical Devices Ltd | Expandable bone anchor |
US6685706B2 (en) * | 2001-11-19 | 2004-02-03 | Triage Medical, Inc. | Proximal anchors for bone fixation system |
EP1334702B1 (en) * | 2002-02-08 | 2004-07-07 | Karl Storz GmbH & Co. KG | Anchor element to anchor a ligament transplant |
US6890354B2 (en) | 2002-03-08 | 2005-05-10 | Musculoskeletal Transplant Foundation | Bone-tendon-bone assembly with allograft bone block and method for inserting same |
US6730124B2 (en) | 2002-03-08 | 2004-05-04 | Musculoskeletal Transplant Foundation | Bone-tendon-bone assembly with cancellous allograft bone block |
DE20205016U1 (en) * | 2002-03-30 | 2003-08-14 | Mathys Medizinaltechnik Ag Bet | Surgical implant |
GB0208667D0 (en) | 2002-04-16 | 2002-05-29 | Atlantech Medical Devices Ltd | A transverse suspension device |
US6793678B2 (en) | 2002-06-27 | 2004-09-21 | Depuy Acromed, Inc. | Prosthetic intervertebral motion disc having dampening |
WO2004008949A2 (en) | 2002-07-19 | 2004-01-29 | Triage Medical, Inc. | Method and apparatus for spinal fixation |
US20040068262A1 (en) * | 2002-10-02 | 2004-04-08 | Mark Lemos | Soft tissue fixation implant |
US7235078B2 (en) * | 2002-11-26 | 2007-06-26 | Hs West Investments Llc | Protective devices for use with angled interference screws |
US7070601B2 (en) | 2003-01-16 | 2006-07-04 | Triage Medical, Inc. | Locking plate for bone anchors |
WO2004098453A2 (en) | 2003-05-06 | 2004-11-18 | Triage Medical, Inc. | Proximal anchors for bone fixation system |
US8016865B2 (en) * | 2003-09-29 | 2011-09-13 | Depuy Mitek, Inc. | Method of performing anterior cruciate ligament reconstruction using biodegradable interference screw |
US7896917B2 (en) | 2003-10-15 | 2011-03-01 | Biomet Sports Medicine, Llc | Method and apparatus for graft fixation |
WO2005069924A2 (en) | 2004-01-16 | 2005-08-04 | Arthrocare Corporation | Bone harvesting device and method |
AU2005215772B2 (en) | 2004-02-13 | 2011-11-17 | Frantz Medical Development, Ltd | Soft tissue repair apparatus and method |
US8002778B1 (en) * | 2004-06-28 | 2011-08-23 | Biomet Sports Medicine, Llc | Crosspin and method for inserting the same during soft ligament repair |
US7476253B1 (en) * | 2004-08-11 | 2009-01-13 | Biomet Manufacturing Corporation | Humeral head preserving implant |
US20060045902A1 (en) * | 2004-09-01 | 2006-03-02 | Serbousek Jon C | Polymeric wrap for in vivo delivery of osteoinductive formulations |
US20060057184A1 (en) * | 2004-09-16 | 2006-03-16 | Nycz Jeffrey H | Process to treat avascular necrosis (AVN) with osteoinductive materials |
US7282630B2 (en) * | 2004-09-23 | 2007-10-16 | Timothy Peter Van Vliet | Soundboard for a musical instrument comprising nanostructured aluminum materials and aluminum materials with nanostructured composites |
US8137382B2 (en) | 2004-11-05 | 2012-03-20 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US8303604B2 (en) | 2004-11-05 | 2012-11-06 | Biomet Sports Medicine, Llc | Soft tissue repair device and method |
US8118836B2 (en) | 2004-11-05 | 2012-02-21 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9801708B2 (en) | 2004-11-05 | 2017-10-31 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8128658B2 (en) | 2004-11-05 | 2012-03-06 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to bone |
US7905904B2 (en) | 2006-02-03 | 2011-03-15 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US7749250B2 (en) | 2006-02-03 | 2010-07-06 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US8840645B2 (en) | 2004-11-05 | 2014-09-23 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9017381B2 (en) | 2007-04-10 | 2015-04-28 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US8298262B2 (en) | 2006-02-03 | 2012-10-30 | Biomet Sports Medicine, Llc | Method for tissue fixation |
US8088130B2 (en) | 2006-02-03 | 2012-01-03 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US7601165B2 (en) | 2006-09-29 | 2009-10-13 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable suture loop |
US7909851B2 (en) | 2006-02-03 | 2011-03-22 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US8361113B2 (en) | 2006-02-03 | 2013-01-29 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8998949B2 (en) | 2004-11-09 | 2015-04-07 | Biomet Sports Medicine, Llc | Soft tissue conduit device |
WO2006062518A2 (en) | 2004-12-08 | 2006-06-15 | Interpore Spine Ltd. | Continuous phase composite for musculoskeletal repair |
US8535357B2 (en) * | 2004-12-09 | 2013-09-17 | Biomet Sports Medicine, Llc | Continuous phase compositions for ACL repair |
KR100653875B1 (en) * | 2005-05-13 | 2006-12-05 | 주식회사 엠아이텍 | Ligament supporting device |
US7842042B2 (en) | 2005-05-16 | 2010-11-30 | Arthrocare Corporation | Convergent tunnel guide apparatus and method |
KR101420988B1 (en) * | 2005-10-13 | 2014-07-17 | 신세스 게엠바하 | Drug-impregnated encasement |
US8801783B2 (en) | 2006-09-29 | 2014-08-12 | Biomet Sports Medicine, Llc | Prosthetic ligament system for knee joint |
US8968364B2 (en) | 2006-02-03 | 2015-03-03 | Biomet Sports Medicine, Llc | Method and apparatus for fixation of an ACL graft |
US11311287B2 (en) | 2006-02-03 | 2022-04-26 | Biomet Sports Medicine, Llc | Method for tissue fixation |
US10517587B2 (en) | 2006-02-03 | 2019-12-31 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US8506597B2 (en) | 2011-10-25 | 2013-08-13 | Biomet Sports Medicine, Llc | Method and apparatus for interosseous membrane reconstruction |
US9538998B2 (en) | 2006-02-03 | 2017-01-10 | Biomet Sports Medicine, Llc | Method and apparatus for fracture fixation |
US8771352B2 (en) | 2011-05-17 | 2014-07-08 | Biomet Sports Medicine, Llc | Method and apparatus for tibial fixation of an ACL graft |
US8574235B2 (en) | 2006-02-03 | 2013-11-05 | Biomet Sports Medicine, Llc | Method for trochanteric reattachment |
US8597327B2 (en) | 2006-02-03 | 2013-12-03 | Biomet Manufacturing, Llc | Method and apparatus for sternal closure |
US9468433B2 (en) | 2006-02-03 | 2016-10-18 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US8652172B2 (en) | 2006-02-03 | 2014-02-18 | Biomet Sports Medicine, Llc | Flexible anchors for tissue fixation |
US11259792B2 (en) | 2006-02-03 | 2022-03-01 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US8562647B2 (en) | 2006-09-29 | 2013-10-22 | Biomet Sports Medicine, Llc | Method and apparatus for securing soft tissue to bone |
US8562645B2 (en) | 2006-09-29 | 2013-10-22 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US8652171B2 (en) | 2006-02-03 | 2014-02-18 | Biomet Sports Medicine, Llc | Method and apparatus for soft tissue fixation |
US9149267B2 (en) | 2006-02-03 | 2015-10-06 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9271713B2 (en) | 2006-02-03 | 2016-03-01 | Biomet Sports Medicine, Llc | Method and apparatus for tensioning a suture |
US9078644B2 (en) | 2006-09-29 | 2015-07-14 | Biomet Sports Medicine, Llc | Fracture fixation device |
GB0615750D0 (en) * | 2006-08-08 | 2006-09-20 | Royal Berkshire Nhs Foundation | Aglet |
US9918826B2 (en) | 2006-09-29 | 2018-03-20 | Biomet Sports Medicine, Llc | Scaffold for spring ligament repair |
US8500818B2 (en) | 2006-09-29 | 2013-08-06 | Biomet Manufacturing, Llc | Knee prosthesis assembly with ligament link |
US8672969B2 (en) | 2006-09-29 | 2014-03-18 | Biomet Sports Medicine, Llc | Fracture fixation device |
US11259794B2 (en) | 2006-09-29 | 2022-03-01 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US7686838B2 (en) | 2006-11-09 | 2010-03-30 | Arthrocare Corporation | External bullet anchor apparatus and method for use in surgical repair of ligament or tendon |
US8105382B2 (en) | 2006-12-07 | 2012-01-31 | Interventional Spine, Inc. | Intervertebral implant |
US8007533B2 (en) * | 2007-02-12 | 2011-08-30 | Rti Biologics, Inc. | Progressive grip assembled bone-tendon-bone grafts, methods of making, and methods of use |
US8147546B2 (en) | 2007-03-13 | 2012-04-03 | Biomet Sports Medicine, Llc | Method and apparatus for graft fixation |
US7998176B2 (en) | 2007-06-08 | 2011-08-16 | Interventional Spine, Inc. | Method and apparatus for spinal stabilization |
US20100172953A1 (en) * | 2007-06-13 | 2010-07-08 | Fmc Corporation | Biopolymer Based Implantable Degradable Devices |
US8900307B2 (en) | 2007-06-26 | 2014-12-02 | DePuy Synthes Products, LLC | Highly lordosed fusion cage |
EP2471493A1 (en) | 2008-01-17 | 2012-07-04 | Synthes GmbH | An expandable intervertebral implant and associated method of manufacturing the same |
KR20110003475A (en) | 2008-04-05 | 2011-01-12 | 신세스 게엠바하 | Expandable intervertebral implant |
US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
CA2757296C (en) | 2009-03-31 | 2016-01-19 | Medicinelodge, Inc. | Double bundle acl repair |
TW201041612A (en) * | 2009-04-21 | 2010-12-01 | Sensors For Med & Science Inc | Protective shell for an in vivo sensor made from resorbable polymer |
US8343227B2 (en) | 2009-05-28 | 2013-01-01 | Biomet Manufacturing Corp. | Knee prosthesis assembly with ligament link |
US8449612B2 (en) | 2009-11-16 | 2013-05-28 | Arthrocare Corporation | Graft pulley and methods of use |
US20110118838A1 (en) * | 2009-11-16 | 2011-05-19 | George Delli-Santi | Graft pulley and methods of use |
US9393129B2 (en) | 2009-12-10 | 2016-07-19 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
PL2536446T3 (en) * | 2010-02-19 | 2014-09-30 | Reoss Gmbh | Device for covering and/or reconstructing a bone defect site, and method for production thereof |
US8979860B2 (en) | 2010-06-24 | 2015-03-17 | DePuy Synthes Products. LLC | Enhanced cage insertion device |
US9592063B2 (en) | 2010-06-24 | 2017-03-14 | DePuy Synthes Products, Inc. | Universal trial for lateral cages |
TW201215379A (en) | 2010-06-29 | 2012-04-16 | Synthes Gmbh | Distractible intervertebral implant |
US9402732B2 (en) | 2010-10-11 | 2016-08-02 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
TWI475985B (en) * | 2011-02-14 | 2015-03-11 | Marcus Seiler | Device for covering and/or reconstructing a bone defect site; method of manufacturing an attachment for a covering device for a bone defect site |
US8968402B2 (en) | 2011-10-18 | 2015-03-03 | Arthrocare Corporation | ACL implants, instruments, and methods |
US9357991B2 (en) | 2011-11-03 | 2016-06-07 | Biomet Sports Medicine, Llc | Method and apparatus for stitching tendons |
US9370350B2 (en) | 2011-11-10 | 2016-06-21 | Biomet Sports Medicine, Llc | Apparatus for coupling soft tissue to a bone |
US9357992B2 (en) | 2011-11-10 | 2016-06-07 | Biomet Sports Medicine, Llc | Method for coupling soft tissue to a bone |
US9381013B2 (en) | 2011-11-10 | 2016-07-05 | Biomet Sports Medicine, Llc | Method for coupling soft tissue to a bone |
US9259217B2 (en) | 2012-01-03 | 2016-02-16 | Biomet Manufacturing, Llc | Suture Button |
WO2014018098A1 (en) | 2012-07-26 | 2014-01-30 | DePuy Synthes Products, LLC | Expandable implant |
US20140067069A1 (en) | 2012-08-30 | 2014-03-06 | Interventional Spine, Inc. | Artificial disc |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
US9757119B2 (en) | 2013-03-08 | 2017-09-12 | Biomet Sports Medicine, Llc | Visual aid for identifying suture limbs arthroscopically |
US9918827B2 (en) | 2013-03-14 | 2018-03-20 | Biomet Sports Medicine, Llc | Scaffold for spring ligament repair |
US9522028B2 (en) | 2013-07-03 | 2016-12-20 | Interventional Spine, Inc. | Method and apparatus for sacroiliac joint fixation |
US10136886B2 (en) | 2013-12-20 | 2018-11-27 | Biomet Sports Medicine, Llc | Knotless soft tissue devices and techniques |
US9615822B2 (en) | 2014-05-30 | 2017-04-11 | Biomet Sports Medicine, Llc | Insertion tools and method for soft anchor |
US9700291B2 (en) | 2014-06-03 | 2017-07-11 | Biomet Sports Medicine, Llc | Capsule retractor |
US10039543B2 (en) | 2014-08-22 | 2018-08-07 | Biomet Sports Medicine, Llc | Non-sliding soft anchor |
US9955980B2 (en) | 2015-02-24 | 2018-05-01 | Biomet Sports Medicine, Llc | Anatomic soft tissue repair |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US9974534B2 (en) | 2015-03-31 | 2018-05-22 | Biomet Sports Medicine, Llc | Suture anchor with soft anchor of electrospun fibers |
CA2985398C (en) | 2015-05-08 | 2021-08-03 | Reoss Gmbh | Device for covering and/or reconstructing a bone defect site; method for producing a cap of a covering device for a bone defect site |
US9913727B2 (en) | 2015-07-02 | 2018-03-13 | Medos International Sarl | Expandable implant |
CN109688980B (en) | 2016-06-28 | 2022-06-10 | Eit 新兴移植技术股份有限公司 | Expandable and angularly adjustable intervertebral cage with articulation joint |
EP4233801A3 (en) | 2016-06-28 | 2023-09-06 | Eit Emerging Implant Technologies GmbH | Expandable, angularly adjustable intervertebral cages |
US10537436B2 (en) | 2016-11-01 | 2020-01-21 | DePuy Synthes Products, Inc. | Curved expandable cage |
US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
CN108095861B (en) * | 2018-02-08 | 2023-10-20 | 中国人民解放军陆军军医大学第一附属医院 | Locking device convenient for measuring stability and taking out of orthopedic implant |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
US11903813B2 (en) * | 2019-04-15 | 2024-02-20 | Kevin L. Harreld | Intraosseous screw with cortical window and system and method for associating soft tissue with bone |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
CN113367854B (en) * | 2021-05-24 | 2023-08-01 | 北京纳通医疗科技控股有限公司 | Tibial tray prosthesis and knee joint prosthesis |
Family Cites Families (24)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4655777A (en) * | 1983-12-19 | 1987-04-07 | Southern Research Institute | Method of producing biodegradable prosthesis and products therefrom |
US4744793A (en) * | 1985-09-06 | 1988-05-17 | Zimmer, Inc. | Prosthetic ligament connection assembly |
FI81498C (en) * | 1987-01-13 | 1990-11-12 | Biocon Oy | SURGICAL MATERIAL OCH INSTRUMENT. |
FI85223C (en) * | 1988-11-10 | 1992-03-25 | Biocon Oy | BIODEGRADERANDE SURGICAL IMPLANT OCH MEDEL. |
US4997433A (en) * | 1990-01-16 | 1991-03-05 | Marlowe Goble E | Endosteal fixation stud and system |
US5062843A (en) * | 1990-02-07 | 1991-11-05 | Mahony Iii Thomas H | Interference fixation screw with integral instrumentation |
US5224946A (en) * | 1990-07-02 | 1993-07-06 | American Cyanamid Company | Bone anchor and method of anchoring a suture to a bone |
DE59102908D1 (en) * | 1990-07-06 | 1994-10-20 | Sulzer Ag | Band anchoring. |
DE69127977T2 (en) * | 1990-09-04 | 1998-09-17 | Smith & Nephew Inc N D Ges D S | SURGICAL SCREW |
US5080663A (en) * | 1990-09-26 | 1992-01-14 | Univerity College London | Sewing device |
CA2062012C (en) * | 1991-03-05 | 2003-04-29 | Randall D. Ross | Bioabsorbable interference bone fixation screw |
FR2676356A1 (en) * | 1991-05-13 | 1992-11-20 | Cendis Medical | Fixation element for ligaments |
US5360448A (en) * | 1991-10-07 | 1994-11-01 | Thramann Jeffrey J | Porous-coated bone screw for securing prosthesis |
US5234430A (en) * | 1991-12-18 | 1993-08-10 | Huebner Randall J | Orthopedic fixation screw and method |
EP0596829B1 (en) * | 1992-11-02 | 2000-11-22 | Sulzer Orthopädie AG | Anchor for synthetic ligament |
US5380334A (en) * | 1993-02-17 | 1995-01-10 | Smith & Nephew Dyonics, Inc. | Soft tissue anchors and systems for implantation |
US5632748A (en) * | 1993-06-14 | 1997-05-27 | Linvatec Corporation | Endosteal anchoring device for urging a ligament against a bone surface |
US5405359A (en) * | 1994-04-29 | 1995-04-11 | Pierce; Javi | Toggle wedge |
US5454811A (en) * | 1993-11-08 | 1995-10-03 | Smith & Nephew Dyonics, Inc. | Cam lock orthopedic fixation screw and method |
FI101933B1 (en) * | 1995-06-13 | 1998-09-30 | Biocon Oy | A joint prosthesis |
FI955547A (en) * | 1995-11-17 | 1997-05-18 | Biocon Oy | Surgical fixation device |
US5702397A (en) * | 1996-02-20 | 1997-12-30 | Medicinelodge, Inc. | Ligament bone anchor and method for its use |
US5766250A (en) * | 1996-10-28 | 1998-06-16 | Medicinelodge, Inc. | Ligament fixator for a ligament anchor system |
US6001100A (en) * | 1997-08-19 | 1999-12-14 | Bionx Implants Oy | Bone block fixation implant |
-
1998
- 1998-03-02 US US09/033,475 patent/US5984966A/en not_active Expired - Fee Related
-
1999
- 1999-03-02 CA CA002322485A patent/CA2322485A1/en not_active Abandoned
- 1999-03-02 CN CN99805711.8A patent/CN1299252A/en active Pending
- 1999-03-02 JP JP2000534152A patent/JP2002505153A/en active Pending
- 1999-03-02 EP EP99909762A patent/EP1069871A4/en not_active Withdrawn
- 1999-03-02 WO PCT/US1999/004613 patent/WO1999044544A1/en not_active Application Discontinuation
- 1999-03-02 AU AU28896/99A patent/AU736616B2/en not_active Ceased
Also Published As
Publication number | Publication date |
---|---|
CN1299252A (en) | 2001-06-13 |
WO1999044544A1 (en) | 1999-09-10 |
JP2002505153A (en) | 2002-02-19 |
EP1069871A4 (en) | 2002-02-06 |
AU2889699A (en) | 1999-09-20 |
AU736616B2 (en) | 2001-08-02 |
EP1069871A1 (en) | 2001-01-24 |
US5984966A (en) | 1999-11-16 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US5984966A (en) | Bioabsorbable bone block fixation implant | |
EP1332730B1 (en) | Bone block fixation implant | |
US20040068262A1 (en) | Soft tissue fixation implant | |
EP1294313B1 (en) | Fixation anchor | |
JP4931317B2 (en) | Sheath for implantable fixation device | |
EP2150288B1 (en) | Graft fixation | |
EP1169979B1 (en) | Use of an adhesive substance for the manufacture of a bone adhesive for fixing a bone plug in a bone tunnel | |
US7001390B2 (en) | Anchoring element for anchoring a ligament transplant | |
CA2179026C (en) | Suture anchor device | |
JP2001505107A (en) | Apparatus and method for securing a self or artificial tendon graft to bone | |
WO2012106763A1 (en) | Prosthetic menisci and method of implanting in the human knee joint | |
US20040153076A1 (en) | Ligament graft cage fixation device | |
WO2000018332A1 (en) | Chute for endosteal ligament fixation | |
AU2005202598A1 (en) | Sheaths for implantable fixation devices |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
EEER | Examination request | ||
FZDE | Discontinued |