+

WO2012028182A1 - Système d'implant orthopédique - Google Patents

Système d'implant orthopédique Download PDF

Info

Publication number
WO2012028182A1
WO2012028182A1 PCT/EP2010/062795 EP2010062795W WO2012028182A1 WO 2012028182 A1 WO2012028182 A1 WO 2012028182A1 EP 2010062795 W EP2010062795 W EP 2010062795W WO 2012028182 A1 WO2012028182 A1 WO 2012028182A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
therapeutic
fluent material
delivery
joint
Prior art date
Application number
PCT/EP2010/062795
Other languages
English (en)
Inventor
Stephanie Regula Margarethe Grassmann
Andreas Klockow
Original Assignee
Smith & Nephew Orthopaedics Ag
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Smith & Nephew Orthopaedics Ag filed Critical Smith & Nephew Orthopaedics Ag
Priority to PCT/EP2010/062795 priority Critical patent/WO2012028182A1/fr
Publication of WO2012028182A1 publication Critical patent/WO2012028182A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • 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
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • 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
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • 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
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
    • 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
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
    • 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
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30069—Properties of materials and coating materials elastomeric
    • 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
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • 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
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30677—Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
    • A61F2002/3068—Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body the pharmaceutical product being in a reservoir
    • 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
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • 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
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30838—Microstructures
    • 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
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3084—Nanostructures
    • 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
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
    • 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
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Definitions

  • the present invention relates to an orthopaedic implant system adapted for the delivery a therapeutic fluent material to an interface between an implant and a human or animal body and in particular, but not exclusively, for delivery of a therapeutic fluent material faciHtetbig one or more of the following, namely healing, fusing of adjoining bones, inciting osteointegration of implants, combating infections, preventing inflammatory response and treating areas with tumours.
  • BMP bone mineral proteins
  • HA coated implants Such surface coated implants have been shown to reduce the incident of loosening but not completely eliminate it.
  • Another therapeutic agent bone mineral proteins (BMP) have been shown to stimulate the osteogenic response to assist in the healing of fractured bones.
  • BMP are usually used in combination with bone grafts or as a putty which has limited load-bearing capabilities.
  • BMP with orthopaedic implants is not in widespread use which for several reasons including undesirable ectopic bone formation proximal to the implant.
  • the placement of therapeutic agents has been generally limited to the coating of orthopaedic implants, for example HA coated implants, but since the therapeutic agent is present as a coating only skeletal tissue immediate to the implant comes into contact with the therapeutic material.
  • Therapeutic agents are sometimes incorporated within temporary implants or bioabsorbable materials.
  • die surgeon removes an existing implant from an affected area and creates a temporary implant during surgery with antibiotic bone cement or uses a preformed antibiotic bone cement temporary implant.
  • temporary implants may restrict the range of motion of patients and only limited weight bearing is allowed.
  • Key to the healing and recovery of the patient is the early mobilization of the affected joint in order to limit the amount of scar tissue and joint stiffening.
  • Bioabsorbable materials are known to have inferior loading carrying characteristics in comparison to long-term permanent orthopaedic implants. Bioabsorbable materials have also been shown in some cases to weaken proximal areas of skeletal tissue.
  • Implants are also known that have a reservoir enabling sustained delivery of therapeutic materials using various mechanisms.
  • the quantity of therapeutic fluent material released and the time period of therapeutic fluent material delivery depends on the release mechanism of the implant.
  • the condition of the surgically affected area immediately following surgery is usually considered to be key to successful healing with an orthopaedic implant.
  • Such implants do not deliver therapeutic fluent materials instantaneously during surgery by the sturgeon.
  • an orthopaedic implant system comprising an orthopaedic implant for implantation within a body that is adapted for the delivery of a therapeutic fluent material to an interface between the implant and the body, the implant defining at least one channel that communicates with at least one aperture defined at the surface of the implant, and characterised in that said implant is adapted for delivery of said therapeutic fluent material intra-operatively to said interface via
  • such an orthopaedic implant system provides for the delivery of a therapeutic fluent material by virtue of its design and/or geometry and/or by virtue of its placement in vivo to deliver said therapeutic fluent material to said interface by means of hydraulic, capillary, gravitational or adhesive forces both during and possibly after surgery.
  • a deliver ⁇ ' is expected to optimize the postoperative healing process.
  • the present invention uses one or more of the following to deliver the therapeutic fluent material to the interface:-
  • the system enables the surgeon to deteoriine the correct quantity of therapeutic fluent material required for each particular case and either to select an implant pre-charged with that quantity of material for instantaneous delivery or to charge the implant with that quantity of therapeutic fluent material pre- or intra-operatively for immediate delivery. Hence, more or less fluent material can be used as required.
  • the invention therefore enables the surgeon to control fluent material delivery in terms of amount delivered and its delivery location.
  • the channels and apertures may be created during one or more manufacturing processes for the implant. These processes may include a rapid prototyping process (i.e. laser sintering) and a coating process.
  • the implant may be pre-charged with therapeutic fluent material by integrating it in one or more apertures or channels during one or more of these manufacturing processes.
  • the implant may be adapted for delivery of said therapeutic fluent material via vibratory forces applied extrinsically to the implant.
  • the implant preferably comprises one or more portions that are resiliently flexible or pliable whereby said therapeutic fluent material is delivered to said interface via squeezing or flexing said portion or portions or via the application of vibratory forces applied extrinsically to said portion or portions.
  • this portion or portions preferably comprise a sponge-like, open-cell structure defining a plurality of said channels therethrough.
  • the implant may incorporate an intrinsic piston mechanism for instantaneous, intra-operative delivery of said therapeutic fluent material to said interface.
  • the piston mechanism preferably comprises a piston located within an interior space of the implant and attached to one end of a piston rod to which said extrinsic force is applied to move the piston within the space and thereby deliver said therapeutic fluent material.
  • the piston rod is hollow and is in communication with the interior space whereby said interior space is chargeable with said therapeutic fluent material.
  • the piston mechanism is accommodated within the body of the implant after delivery of the therapeutic fluent material.
  • the piston mechanism is adapted for removal from the implant after deployment.
  • said piston rod protrudes through a port in the implant prior to delivery of said therapeutic fluent material through which said therapeutic fluent material is introduced into said interior space.
  • a pressure plate is secured to the other end of the piston rod to which plate said extrinsic force is applied to move the piston within the space.
  • the port is shaped to provide a countersink for the plate that thereby seals off the interior of the implant after deliver of the therapeutic fluent material.
  • the implant preferably comprises at least one port that is accessible mtra-operatively whereby said therapeutic fluent material is introduced into said channel or channels of said implant.
  • the port or ports each comprise a sealable means.
  • the implant is pre-charged with said therapeutic fluent material for deliver)' intra-operatively to said interface by virtue of its placement in vivo and/ or by virtue of forces applied extrinsically to the implant.
  • the implant is pre-charged with therapeutic fluent material adapted to undergo a phase change once located in vivo whereby said material is then delivered to said interface by forces created during said phase transformation.
  • the implant comprises a plurality of apertures that communicate with said at least one channel.
  • said at least one channel is a macro-, micro- or nano- channel.
  • said at least one channel is formed by a hollow interior space within the implant with which said apertures are in communication.
  • the aperture or apertures may each comprise a macro-, micro- or nano- aperture and be in the form of any of the following, namely holes, gaps, slits, fenestrations and open pores.
  • a means is provided to selectively close one or more of said apertures.
  • This means preferably comprises a sheath located in the interior space that selectively closes one or more of the apertures.
  • the sheath is removably located within the space.
  • the exterior surface of at least part of the implant is coated with a porous coating.
  • This coating preferably comprises a hydroxyapatite coating and/or titanium beads;
  • the implant comprises a natural or an artificial bone graft.
  • the implant is adapted to comprise or be at least partially comprised of a radiographic material or to comprise a radiographic marker.
  • the implant comprises one of a short-term implant, a long-term implant and a trauma implant.
  • the implant comprises an arthroplasty implant or a part thereof.
  • the implant may enable an arthrodesis (fixed joint).
  • the implant may comprises one of a screw, a nail, a plate and an internal/external fixation device.
  • the implant may also comprise or form a part of an implant adapted for implantation in one of a hip joint, a knee joint, an ankle joint, a toe joint, a shoulder joint, an elbow joint, a wrist joint, a hand joint, a finger joint, and the spine.
  • the implant may comprise any of the following: a femoral stem of a hip joint prosthesis; an acetabular shell;, a tibial tray; and an intervertebral disc prosthesis.
  • Fig. 1 is schematic plan view of first embodiment of the invention in the form of a tibial tray
  • Fig. 2 is a sectional view along the line II-II of Fig. 1;
  • Fig. 3 is schematic side view of a second embodiment of the invention in the form of femoral stem of a hip joint prosthesis
  • Fig. 4 is a is view similar to Fig. 3 but of another embodiment of a femoral stem of a hip joint prosthesis;
  • Fig. 5 is a side view of a piston mechanism for use in the embodiment of femoral stem as shown in Fig. 4 and that is also similar to that shown in the following Fig. 6;
  • Fig. 6 is a schematic side view of a fourth embodiment of the invention in the form of an intervertebral disc prosthesis
  • Fig. 7 is a schematic side view of a fifth embodiment of the invention also in the form of an intervertebral disc prosthesis
  • Fig. 8 is a schematic cross-sectional view of a sixth embodiment of the invention in the form of a hip acetabular shell pre-assembled with a liner to form an acetabular implant;
  • Fig. 9 is an exploded side view of the implant shown in Fig. 8.
  • a knee joint prosthesis comprises a tibial component in the form of a tibial tray 1, as shown in Figs. 1 and 2.
  • the tibial tray 1 comprises a platform-like tray 2 defining a superior surface 3 and an inferior surface 4 and an inferiorly extending tibial stem 5.
  • the tibial stem 5 is adapted to be implanted in a corresponding opening made by a surgeon in a proximal tibia.
  • the stem 5 is integrally formed with the tray 2.
  • a porous coating 6, for example a coating comprising a hydroxyapatite coating and/ or one including titanium beads may be disposed on the inferior surface 4 of the tray 2 and over the stem 5.
  • channels 7, 8 formed within the body of the tray 2 and the stem 5 are channels 7, 8.
  • one or more channels 7 each communicate with a plurality of capillary channels 8 that are small-bore micro- or nano- channels having , for example, a diameter of 600 ⁇ or less.
  • Each of these capillary channels 8 communicates with an aperture 9 defined at the inferior surface 4 of die tray 1 or at the surface of the stem 5.
  • These apertures 9 may be macro-, micro- and/or nano -apertures.
  • the channels 7 communicate with a port 10 located on the superior surface 3 of the tray 2 that permits the tray 1 to be charged with therapeutic fluent material and sealed by a plug, which may be a self-sealing plug, a resealable plug or cap.
  • the tray 1 can either be pre-charged with therapeutic fluent material prior to an operative procedure and retained in an orientation with the stem 5 uppermost so that the material cannot penetrate into the channels 8. Then, during and shordy after implantation capillary and gravitation forces will draw the therapeutic fluent material into the channels 8 from whence it will run out of the apertures 9 for dispersal via the porous coating 6 to treat the interface between the tray 1 and the tibial tissue into which it is implanted. Alternatively, the tray 1 is implanted and then charged with therapeutic fluent material intra-operatively. Again, capillary and gravitation forces will act to draw the therapeutic fluent material from the manifold channel 7 into the channels 8 and out through the apertures 9.
  • tibial trays could be adapted by traditional machining techniques to introduce the channels 7, 8, the apertures 9 and at least one port.
  • trays 1 will be especially manufactured and the channels 7, 8 srzed and orientated within the tray 2 and stem 5 to achieve maximal and even spread of the therapeutic fluent material to the interface between the bone and the implant.
  • Such trays 1 will also enable a port to be incorporated that comprises a micro- screwhole that sits flush with the superior surface 4 of the tray 2.
  • the port 9 can then be adapted to connect to a delivery means for the therapeutic fluent material.
  • the stem 11, 12 comprises a neck 13 and an anchoring blade 14 that tapers towards a distal end 15.
  • the blade 14 widens conically from the distal end 15 in the direction of the proximal end.
  • the neck 13 is terminated by a conically tapering pin 16 on which a spherical joint head (not shown) can be located.
  • the cone widens out and then defines a trochanter wing 17 before merging, via a shoulder 18, into the neck termination plane.
  • the cross-sectional profile of the blade 14 is preferably rectangular, but may also be circular, trapezoidal, rhombic or any other appropriate shape.
  • a manifold channel 19 is formed within the blade 14 of the stem 11 that communicates via small-bore channels 20 with apertures 21 defined in the surface of the blade 14.
  • a port providing access to the channel 19 is positioned in the shoulder 18 of stem 11 and is closeable by a plug 22.
  • the shape, size, position, distribution, uniformity and the number of apertures 21 is variable as appropriate.
  • the bore of the channels 20 may also be chosen as appropriate dependent on the viscosity of the therapeutic fluent material and is preferably optimized.
  • the channel 19 may be either pre ⁇ charged with therapeutic fluent material or such material may be introduced into the channel 19 intra-operatively.
  • the therapeutic fluent material may be delivered to the interface between the blade 14 and the femoral tissue by capillary and gravitational forces as described above.
  • this embodiment is particularly well suited to delivery of the therapeutic fluent material via vibratory forces applied extrinsically to the blade 14 in the direction of arrow F, for example by applying a vibrating apparatus to the shoulder 18 of the blade 14. Such forces will shake therapeutic fluent material from the manifold channel 19 into the channels 20 and thence out of the apertures 21.
  • the embodiment of stem 12 shown in Fig. 4 differs from that shown in Fig. 3.
  • the interior of the blade 14 defines a hollow interior space 23 with which a plurality of apertures 24 defined in the surface of the blade 14 is in communication.
  • a channel 25 communicates the space 23 with a port 26 located on the shoulder 18 of the stem 12.
  • a piston mechanism 27, as shown separately in Fig. 5, is fitted through the port 26 and comprises a piston 28 that is located within the space 23, a hollow piston rod 29 attached to the piston 28 that passes to the exterior of the implant through the channel 25, and an upper pressure plate 30 that is secured to the protruding end of the rod 29.
  • the open end of the rod 29 adjacent the plate 30 is sealable by a cap or plug 31.
  • the space 23 may be pre-charged with therapeutic fluent material or may be filled intra-operatively by the surgeon through the hollow rod 29, which communicates with an aperture in the piston 28 with the space 23.
  • the open end of the rod 29 is then sealed by the plug 31 and the piston mechanism is deployed when appropriate by pressing down on the pressure plate 30.
  • This moves the piston 29 in the space 23 and forces the therapeutic fluent material out of the stem 12 through the apertures 24.
  • the length of the rod 29 is chosen so that after operation of the piston mechanism 27 the pressure plate 30 locates into the port 26, which is shaped so as to provide a countersink for the plate 30 .
  • the plate 30 is therefore also used to seal off the interior of the stem 12 after delivery of the therapeutic fluent material..
  • the piston mechanism 27 is, therefore, accommodated within the implant 12 after delivery of the therapeutic fluent material.
  • the piston mechanism may be adapted such that as pressure is applied to the pressure plate 30, the fluent material flows around to the back side of the piston 29 between the wall of the piston 29 and the inner walls of the implant and out through the apertures 34 at the rear of the piston 29 as well as being forced out of the apertures below the piston 29, A plate or seal is provided in this case to prevent the fluent material from leaving the implant during pressure application.
  • the piston mechanism 27 can be removed from the stem 12 after deployment and the port 23 sealed off by a separate cap or plug .
  • the apertures 24 may be in the form of pores, as shown in Fig. 4, or of elongated fenestrations.
  • the apertures 24 are also only located in the distal part of the blade 14. This stem 12 has, therefore, been adapted only to treat areas of the skeletal structure that will be in the proximity of this part of the blade 14 after implantation.
  • the embodiment shown in Fig. 6 comprises an intervertebral disc prosthesis, a prosthetic disc 32 being shown between two vertebrae 33.
  • channels (not shown) are formed within the disc 32 that terminate in apertures 34 defined in the surface of the disc 32. At their other end the channels communicate with a hollow interior space 35 within the disc 32 in which is located a piston mechanism 36 that is similar in construction and operation to that described above with reference to Fig. 4 and as shown in Fig. 5.
  • the same reference numerals have therefore been used in Fig. 6 for similar parts of the mechanism 36 to those used above with reference to Figs. 4 and 5. It will be appreciated, however, that the size and shape of the mechanism 36 have been adapted for use in an intervertebral disc prosthesis.
  • the space 35 may be pre- charged with therapeutic fluent material or may be filled intra-operatively by the surgeon through the hollow rod 29, which communicates with the space 35.
  • the piston mechanism 36 is then deployed in exactly the same way as the mechanism 37 to deliver the therapeutic fluent material to the interface between the disc 32 and the body.
  • the piston mechanism may again be adapted such that as pressure is applied to the pressure plate 30, die fluent material flows between the walls of the piston 29 and the inner walls of the implant and out through the apertures 34, a plate or seal being provided to prevent the fluent material from leaving the implant during pressure application.
  • the piston mechanism 36 can be removed from the stem disc 32 after deployment and the space 35 sealed off by a separate cap or plug.
  • movement of the joint itself can be used to pump therapeutic fluent material through and out of the implant.
  • Such movement could activate an internal piston mechanism similar to that described above or squeeze a resiliendy flexible or pliable portion of the implant.
  • intervertebral disc prosthesis 37 in another embodiment of intervertebral disc prosthesis 37 as shown in Fig. 7, the intervertebral disc prosthesis 37 is again shown between two vertebrae 33. However, in this prosthesis 37, a port 38 is positioned at the posterior side of the disc through which the disc 37 is charged with therapeutic fluent material pre- or intra- operatively. Alternatively, the therapeutic fluent material may be integrated in one or more apertures and/or channels during one or more manufacturing processes.
  • the implants described above are all rigid implants, typically being comprised of any or a mixture of the metals, namely titanium, titanium alloy, stainless steel, stainless steel alloy, cobalt chrome alloy, polymer or polymer composite.
  • the implant system shown in Fig. 7 may be comprised, at least in part, of a sponge or sponge-like material with an open-cell structure that is porous so as to define a plurality of channels therethrough.
  • the shape, size, position, distribution, uniformity and the number of apertures 39 is variable as appropriate but in this particular embodiment the apertures may comprise holes, gaps, slits, fenestrations or open pores.
  • the sponge or sponge-like portion of this implant is preferably resiliently flexible or elastic so that when it is compressed either by pressure exerted by the vertebrae 33 or by the application of extrinsic force by a surgeon intra-operatively therapeutic fluent material is forced out through the apertures 39 to treat the interface between the disc 37 and the vertebrae 33, It will be appreciated that such an implant may continue to deliver therapeutic fluent material to the interface postoperatively when compressed by the adjacent vertebrae 33 when the spine is flexed and/ or straightened as the patient moves.
  • the embodiment of implant shown in Figs. 8 and 9 comprises an acetabular shell 40 forming part of an acetabular implant 41 adapted for implantation into the acetabulum of a hip such that it can receive a head of a femoral stem such as, for example, that shown in Figs. 3 and 4. It is possible, however, for the implant 41 to be adapted for interaction with a natural femoral head.
  • the implant 41 comprises two components, namely the acetabular shell 40 and a liner 42.
  • the acetabular shell 40 is metal and the liner 42 is a plastics material, such as an ultra high molecular weight polyethylene, but the shell 40 and the liner 42 may each be formed from any desirable material.
  • channels 43 are formed within the body of the shell 40. These channels 43 will typically be small-bore channels, for example micro- or nano-channels with a diameter less than 600 ⁇ .
  • the channels 43 communicate with apertures 44 defined on the exterior surface of the shell 43. These apertures 44 may also be micro- or nano- apertures.
  • therapeutic fluent material is integrated in one or more apertures 44 and/ or channels 43 during one or more manufacturing processes of the shell 40. It will be appreciated that in this case a port through which the therapeutic fluent material is poured into the shell 40 is not necessarily required as the therapeutic fluent material may be deposited in the shell 40 via the apertures 44 themselves. Such therapeutic fluent material may be deposited in a solid or gel form, for example, and adapted to undergo a phase change once implanted or located in vivo. The therapeutic fluent material is then delivered to the interface between the shell 40 and the acetabulum by forces created during said phase transformation. Adhesive forces between the acetabulum and therapeutic fluent material may also assist in delivery of the material.
  • the therapeutic fluent material may be delivered by press- fitting the shell 40 into the acetabulum and, prior to fitting of the liner 42, an impactor with a shape complementary to the interior of the shell 40 used to strike the shell 40 with blows intended to shake or vibrate the therapeutic fluent material out of the apertures 44 and/ or channels 43.
  • one or more ports 45 may be located on the rim of the shell 40 through which the shell 40 may be charged with therapeutic fluent material either pre- or intra- operatively. Delivery of this material may then take place by one or more of hydraulic, gravitational and capillary forces.
  • the port or ports 45 may be sealed by means of a sealing means such as a plug, cap or similar.
  • the acetabular shell 40 of the invention may be used with different types of liner 42, as appropriate.
  • the implant 41 is assembled by press fitting the liner 42 into an interior cavity of the shell 40 intra-operatively but it may be secured in any appropriate manner.
  • the shell 40 and the liner 42 will be pre-assembled to form the implant 41 by the manufacturer.
  • the shell 40 may also comprise a retaining ring 46 that can be used to secure additional components to the implant 41, as desired.
  • an implant system according to the invention may comprise a natural or artificial bone graft.
  • the methods described above for delivery of the therapeutic fluent material to an interface between the implant and tissues of the body may be employed with any of the other embodiments of implant systems described above. All of these implant systems enable, in accordance with the invention, a therapeutic fluent material to be delivered to a surgically affected area during surgery and sometimes for a period of time thereafter.
  • the delivery of therapeutic fluent materials direcdy during surgery is expected to optimize the healing process postoperative and it will be appreciated that a surgeon may detenriine during a surgical procedure the amount of therapeutic fluent material required.
  • the invention enables intraoperative control of therapeutic fluent material delivery in terms of amount delivered and its delivery location.
  • therapeutic fluent material to be used can be determined by the surgeon as appropriate. It is expected that such materials will be biological, biocompatible, bioactive material or therapeutically active agents. Such agents include bone slurry, bone morphogenic protein (BMP), bone growth factor, a pallet gel, antiinflammatory agents, analgesic agents, anti-microbial, anti-viral agents, oncological drug, chemotherapeutic agent, antibiotic agent, osteogenic agent, osteoinductive agent, osteoconduction agent, osteostimulative agent or a combination of these.
  • BMP bone morphogenic protein
  • osteoconduction agent osteostimulative agent or a combination of these.
  • the implant systems may be available in different lengths and geometries including thickness and cross-sectional shape, according to the characteristics of the patient, the patient bone or the requirements of the surgical procedure.
  • the surface of the implant system as a whole or its components may be surface treated or surface roughened to assist the osteointegration of the implant. This treatment may include, for example, adding surface layer(s) of titanium, hydroxyapatite, biocompatible phase-ttansforming material or other, pressure or grit blasting with zirconium oxide or other grit material(s).
  • the surface of the implant may also be produced with rapid prototype or manufacturing procedures, i.e. laser sintering.
  • the implant system may enable an arthrodesis (fixed joint).
  • the implant system may comprise or be at least partially comprised of a radiographic material or comprise a radiographic marker.
  • the implant system may comprise a short-term implant, a long-term implant or a trauma implant and it is primarily, but not exclusively, intended that the therapeutic fluent material will facilitate one or more of the following, namely healing, fusing of adjoining bones, inciting osteointegration of implants, combating infections, preventing inflammatory response and treating areas with tumours.
  • the system in accordance with the invention may be utilized intra-operatively or postoperatively when intervention is required to combat deep infections, to treat tumours or to improve a healing response.
  • the affected area may be treated with a therapeutic fluent material to assist its healing process prior to explantation of the trauma implant.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un système d'implant orthopédique comprenant un implant orthopédique (1; 11; 12; 29; 33, 34) destiné à être implanté dans un corps humain ou animal et qui est conçu pour administrer une matière fluide thérapeutique au niveau d'une interface entre l'implant et le corps. L'implant (1; 11; 12; 32; 37; 40) définit au moins un canal (7, 8; 19, 20; 23, 25; 43) communiquant avec au moins une ouverture (9; 21; 24; 34; 39; 44) définie à la surface de l'implant (1; 11; 12; 32; 37; 40). L'implant (1; 11; 12; 32; 37; 40) est conçu pour administrer la matière fluide thérapeutique de manière intra-fonctionnelle au niveau de ladite interface par le biais d'une ou de plusieurs forces intrinsèques à la construction de l'implant (1; 11; 12; 32; 37; 40) et/ou appliquées de manière extrinsèque à l'implant (1; 11; 12; 32; 37; 40). De préférence, l'implant (1; 11; 12; 29; 33, 34) est adapté de par sa conception et/ou sa géométrie et/ou de par son placement in vivo pour administrer ladite matière fluide thérapeutique au niveau de ladite interface par le biais de forces hydrauliques, capillaires, gravitationnelles ou adhésives. Le système d'implant peut comprendre un implant de courte durée, un implant de longue durée ou un implant de trauma.
PCT/EP2010/062795 2010-09-01 2010-09-01 Système d'implant orthopédique WO2012028182A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/062795 WO2012028182A1 (fr) 2010-09-01 2010-09-01 Système d'implant orthopédique

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/062795 WO2012028182A1 (fr) 2010-09-01 2010-09-01 Système d'implant orthopédique

Publications (1)

Publication Number Publication Date
WO2012028182A1 true WO2012028182A1 (fr) 2012-03-08

Family

ID=43587284

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2010/062795 WO2012028182A1 (fr) 2010-09-01 2010-09-01 Système d'implant orthopédique

Country Status (1)

Country Link
WO (1) WO2012028182A1 (fr)

Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015109353A1 (de) * 2015-06-12 2016-12-15 Aesculap Ag Gelenkteil und Kniegelenkendoprothese
US9724207B2 (en) 2003-02-14 2017-08-08 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9949769B2 (en) 2004-03-06 2018-04-24 DePuy Synthes Products, Inc. Dynamized interspinal implant
US10433974B2 (en) 2003-06-30 2019-10-08 DePuy Synthes Products, Inc. Intervertebral implant with conformable endplate
US10888433B2 (en) 2016-12-14 2021-01-12 DePuy Synthes Products, Inc. Intervertebral implant inserter and related methods
US10940016B2 (en) 2017-07-05 2021-03-09 Medos International Sarl Expandable intervertebral fusion cage
US10966840B2 (en) 2010-06-24 2021-04-06 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
US10973652B2 (en) 2007-06-26 2021-04-13 DePuy Synthes Products, Inc. Highly lordosed fusion cage
US11273050B2 (en) 2006-12-07 2022-03-15 DePuy Synthes Products, Inc. Intervertebral implant
US11344424B2 (en) 2017-06-14 2022-05-31 Medos International Sarl Expandable intervertebral implant and related methods
US20220168109A1 (en) * 2020-11-27 2022-06-02 Biorl S.R.L. Prosthetic implant
US11426290B2 (en) 2015-03-06 2022-08-30 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US11426286B2 (en) 2020-03-06 2022-08-30 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US11446156B2 (en) 2018-10-25 2022-09-20 Medos International Sarl Expandable intervertebral implant, inserter instrument, and related methods
US11446155B2 (en) 2017-05-08 2022-09-20 Medos International Sarl Expandable cage
US11452607B2 (en) 2010-10-11 2022-09-27 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
US11497619B2 (en) 2013-03-07 2022-11-15 DePuy Synthes Products, Inc. Intervertebral implant
US11510788B2 (en) 2016-06-28 2022-11-29 Eit Emerging Implant Technologies Gmbh Expandable, angularly adjustable intervertebral cages
US11596522B2 (en) 2016-06-28 2023-03-07 Eit Emerging Implant Technologies Gmbh Expandable and angularly adjustable intervertebral cages with articulating joint
US11602438B2 (en) 2008-04-05 2023-03-14 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11607321B2 (en) 2009-12-10 2023-03-21 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US11612491B2 (en) 2009-03-30 2023-03-28 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US11654033B2 (en) 2010-06-29 2023-05-23 DePuy Synthes Products, Inc. Distractible intervertebral implant
US11737881B2 (en) 2008-01-17 2023-08-29 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
US11752009B2 (en) 2021-04-06 2023-09-12 Medos International Sarl Expandable intervertebral fusion cage
US11850160B2 (en) 2021-03-26 2023-12-26 Medos International Sarl Expandable lordotic intervertebral fusion cage
WO2024008514A1 (fr) * 2022-07-07 2024-01-11 Limacorporate S.P.A. Élément partiellement trabéculaire à des fins d'augmentation ou agent de remplissage osseux
US11911287B2 (en) 2010-06-24 2024-02-27 DePuy Synthes Products, Inc. Lateral spondylolisthesis reduction cage
WO2024050502A3 (fr) * 2022-09-01 2024-04-25 MediCarbone, Inc. Procédés de création, d'insertion et de retrait d'un système de manchon intramédullaire pour le traitement et la stabilisation osseuse
USRE49973E1 (en) 2013-02-28 2024-05-21 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US12064356B2 (en) 2021-08-19 2024-08-20 Howmedica Osteonics Corp. Multi-size acetabular impactor
US12090064B2 (en) 2022-03-01 2024-09-17 Medos International Sarl Stabilization members for expandable intervertebral implants, and related systems and methods
WO2025088167A1 (fr) * 2023-10-26 2025-05-01 Charité - Universitätsmedizin Berlin Implant comprenant une pluralité de canaux

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5681289A (en) * 1995-08-14 1997-10-28 Medicinelodge Inc. Chemical dispensing system
US20070083265A1 (en) * 2000-12-14 2007-04-12 Malone David G Devices and methods for facilitating controlled bone growth or repair
WO2007053022A2 (fr) * 2005-11-07 2007-05-10 Ft Innovations (Fti) B.V. Implant et procede de fabrication d'un tel implant
WO2009149296A2 (fr) * 2008-06-04 2009-12-10 Ceramatec, Inc. Implant orthopédique d’exsudation de médicament
US20100042214A1 (en) * 2008-08-13 2010-02-18 Nebosky Paul S Drug delivery implants

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5681289A (en) * 1995-08-14 1997-10-28 Medicinelodge Inc. Chemical dispensing system
US20070083265A1 (en) * 2000-12-14 2007-04-12 Malone David G Devices and methods for facilitating controlled bone growth or repair
WO2007053022A2 (fr) * 2005-11-07 2007-05-10 Ft Innovations (Fti) B.V. Implant et procede de fabrication d'un tel implant
WO2009149296A2 (fr) * 2008-06-04 2009-12-10 Ceramatec, Inc. Implant orthopédique d’exsudation de médicament
US20100042214A1 (en) * 2008-08-13 2010-02-18 Nebosky Paul S Drug delivery implants

Cited By (74)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10376372B2 (en) 2003-02-14 2019-08-13 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US11432938B2 (en) 2003-02-14 2022-09-06 DePuy Synthes Products, Inc. In-situ intervertebral fusion device and method
US9788963B2 (en) 2003-02-14 2017-10-17 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9801729B2 (en) 2003-02-14 2017-10-31 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9808351B2 (en) 2003-02-14 2017-11-07 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9814590B2 (en) 2003-02-14 2017-11-14 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9814589B2 (en) 2003-02-14 2017-11-14 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10420651B2 (en) 2003-02-14 2019-09-24 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10405986B2 (en) 2003-02-14 2019-09-10 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10085843B2 (en) 2003-02-14 2018-10-02 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9724207B2 (en) 2003-02-14 2017-08-08 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US11096794B2 (en) 2003-02-14 2021-08-24 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US9925060B2 (en) 2003-02-14 2018-03-27 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10433971B2 (en) 2003-02-14 2019-10-08 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10786361B2 (en) 2003-02-14 2020-09-29 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10639164B2 (en) 2003-02-14 2020-05-05 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10492918B2 (en) 2003-02-14 2019-12-03 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US11207187B2 (en) 2003-02-14 2021-12-28 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10555817B2 (en) 2003-02-14 2020-02-11 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10575959B2 (en) 2003-02-14 2020-03-03 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US10583013B2 (en) 2003-02-14 2020-03-10 DePuy Synthes Products, Inc. In-situ formed intervertebral fusion device and method
US11612493B2 (en) 2003-06-30 2023-03-28 DePuy Synthes Products, Inc. Intervertebral implant with conformable endplate
US10433974B2 (en) 2003-06-30 2019-10-08 DePuy Synthes Products, Inc. Intervertebral implant with conformable endplate
US9949769B2 (en) 2004-03-06 2018-04-24 DePuy Synthes Products, Inc. Dynamized interspinal implant
US10512489B2 (en) 2004-03-06 2019-12-24 DePuy Synthes Products, Inc. Dynamized interspinal implant
US10433881B2 (en) 2004-03-06 2019-10-08 DePuy Synthes Products, Inc. Dynamized interspinal implant
US11712345B2 (en) 2006-12-07 2023-08-01 DePuy Synthes Products, Inc. Intervertebral implant
US11660206B2 (en) 2006-12-07 2023-05-30 DePuy Synthes Products, Inc. Intervertebral implant
US11273050B2 (en) 2006-12-07 2022-03-15 DePuy Synthes Products, Inc. Intervertebral implant
US11642229B2 (en) 2006-12-07 2023-05-09 DePuy Synthes Products, Inc. Intervertebral implant
US11497618B2 (en) 2006-12-07 2022-11-15 DePuy Synthes Products, Inc. Intervertebral implant
US11432942B2 (en) 2006-12-07 2022-09-06 DePuy Synthes Products, Inc. Intervertebral implant
US10973652B2 (en) 2007-06-26 2021-04-13 DePuy Synthes Products, Inc. Highly lordosed fusion cage
US11622868B2 (en) 2007-06-26 2023-04-11 DePuy Synthes Products, Inc. Highly lordosed fusion cage
US11737881B2 (en) 2008-01-17 2023-08-29 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
US11707359B2 (en) 2008-04-05 2023-07-25 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11617655B2 (en) 2008-04-05 2023-04-04 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11701234B2 (en) 2008-04-05 2023-07-18 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11712341B2 (en) 2008-04-05 2023-08-01 DePuy Synthes Products, Inc. Expandable intervertebral implant
US12023255B2 (en) 2008-04-05 2024-07-02 DePuy Synthes Products, Inc. Expandable inter vertebral implant
US11712342B2 (en) 2008-04-05 2023-08-01 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11602438B2 (en) 2008-04-05 2023-03-14 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11612491B2 (en) 2009-03-30 2023-03-28 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US12097124B2 (en) 2009-03-30 2024-09-24 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US11607321B2 (en) 2009-12-10 2023-03-21 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US11911287B2 (en) 2010-06-24 2024-02-27 DePuy Synthes Products, Inc. Lateral spondylolisthesis reduction cage
US11872139B2 (en) 2010-06-24 2024-01-16 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
US10966840B2 (en) 2010-06-24 2021-04-06 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
US11654033B2 (en) 2010-06-29 2023-05-23 DePuy Synthes Products, Inc. Distractible intervertebral implant
US11452607B2 (en) 2010-10-11 2022-09-27 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
USRE49973E1 (en) 2013-02-28 2024-05-21 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US11497619B2 (en) 2013-03-07 2022-11-15 DePuy Synthes Products, Inc. Intervertebral implant
US11850164B2 (en) 2013-03-07 2023-12-26 DePuy Synthes Products, Inc. Intervertebral implant
US11426290B2 (en) 2015-03-06 2022-08-30 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
DE102015109353A1 (de) * 2015-06-12 2016-12-15 Aesculap Ag Gelenkteil und Kniegelenkendoprothese
US11510788B2 (en) 2016-06-28 2022-11-29 Eit Emerging Implant Technologies Gmbh Expandable, angularly adjustable intervertebral cages
US11596523B2 (en) 2016-06-28 2023-03-07 Eit Emerging Implant Technologies Gmbh Expandable and angularly adjustable articulating intervertebral cages
US11596522B2 (en) 2016-06-28 2023-03-07 Eit Emerging Implant Technologies Gmbh Expandable and angularly adjustable intervertebral cages with articulating joint
US10888433B2 (en) 2016-12-14 2021-01-12 DePuy Synthes Products, Inc. Intervertebral implant inserter and related methods
US11446155B2 (en) 2017-05-08 2022-09-20 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
US11446156B2 (en) 2018-10-25 2022-09-20 Medos International Sarl Expandable intervertebral implant, inserter instrument, and related methods
US11806245B2 (en) 2020-03-06 2023-11-07 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US11426286B2 (en) 2020-03-06 2022-08-30 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US20220168109A1 (en) * 2020-11-27 2022-06-02 Biorl S.R.L. Prosthetic 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
US12023258B2 (en) 2021-04-06 2024-07-02 Medos International Sarl Expandable intervertebral fusion cage
US12064356B2 (en) 2021-08-19 2024-08-20 Howmedica Osteonics Corp. Multi-size acetabular impactor
US12090064B2 (en) 2022-03-01 2024-09-17 Medos International Sarl Stabilization members for expandable intervertebral implants, and related systems and methods
WO2024008514A1 (fr) * 2022-07-07 2024-01-11 Limacorporate S.P.A. Élément partiellement trabéculaire à des fins d'augmentation ou agent de remplissage osseux
WO2024050502A3 (fr) * 2022-09-01 2024-04-25 MediCarbone, Inc. Procédés de création, d'insertion et de retrait d'un système de manchon intramédullaire pour le traitement et la stabilisation osseuse
WO2025088167A1 (fr) * 2023-10-26 2025-05-01 Charité - Universitätsmedizin Berlin Implant comprenant une pluralité de canaux

Similar Documents

Publication Publication Date Title
WO2012028182A1 (fr) Système d'implant orthopédique
WO2012030331A1 (fr) Implant de distribution de matériau fluant
US11833052B2 (en) Tissue integration design for seamless implant fixation
JP6039024B2 (ja) プロテーゼを製造するプロセス
US6706071B1 (en) Prosthetic hip joint assembly
EP2637609B1 (fr) Implant orthopédique présentant une surface polymérique poreuse de contact osseux
US8858207B2 (en) Total knee joint mold and methods
US20100256758A1 (en) Monolithic orthopedic implant with an articular finished surface
CN111629695B (zh) 包含药物物质的髋臼间隔件装置
US20050143837A1 (en) Arthroplasty devices configured to reduce shear stress
US5201771A (en) Endoprosthesis of the hip joint
WO2012003036A2 (fr) Implant orthopédique monolithique présentant une surface articulaire finie
WO1999008626A1 (fr) Systeme de prothese modulaire manteau/implant pour fixation osseuse
KR102687742B1 (ko) 인체를 위한 보철 장치 및 보철 장치의 제조 방법
US10206783B2 (en) Prosthetic device for human body and production method therefor
JP7142000B2 (ja) インプラント及び関節インプラント
CN103705319A (zh) 生物固定型胫骨平台
CN100528104C (zh) 包括插入股骨的轴的髋关节假肢
RU2137442C1 (ru) Пористый протез тазобедренного сустава
TWI804623B (zh) 關節新組織形成之關節植入物
CN110368141B (zh) 股骨植入物
RU2268685C2 (ru) Головка эндопротеза тазобедренного сустава
Giannini et al. Bioceramics in orthopaedic surgery: know how status and preliminary results

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10747643

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205A DATED 03/06/2013)

122 Ep: pct application non-entry in european phase

Ref document number: 10747643

Country of ref document: EP

Kind code of ref document: A1

点击 这是indexloc提供的php浏览器服务，不要输入任何密码和下载