CA2487042C - Viable tissue repair implants and methods of use - Google Patents

Viable tissue repair implants and methods of use Download PDF

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Publication number
CA2487042C
CA2487042C CA2487042A CA2487042A CA2487042C CA 2487042 C CA2487042 C CA 2487042C CA 2487042 A CA2487042 A CA 2487042A CA 2487042 A CA2487042 A CA 2487042A CA 2487042 C CA2487042 C CA 2487042C
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Prior art keywords
tissue
implant
slice
scaffold
cartilage
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Expired - Fee Related
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CA2487042A
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French (fr)
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CA2487042A1 (en
Inventor
Alexander M. Harmon
Stephanie M. Kladakis
Julia Hwang
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DePuy Mitek LLC
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DePuy Mitek LLC
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/3683Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/38Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • A61P17/02Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00Drugs for skeletal disorders
    • A61P19/02Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00Materials or treatment for tissue regeneration
    • A61L2430/06Materials or treatment for tissue regeneration for cartilage reconstruction, e.g. meniscus

Abstract

Biocompatible tissue implants are provided for repairing a tissue injury or defect. The tissue implants comprise a biological tissue slice that serves as a source of viable cells capable of tissue regeneration and/or repair. The biological tissue slice can be harvested from healthy tissue to have a geometry that is suitable for implantation at the site of the injury or defect. The harvested tissue slice is dimensioned to allow the viable cells contained within the tissue slice to migrate out and proliferate and integrate with tissue surrounding the injury or defect site. Methods for repairing a tissue injury or defect using the tissue implants are also provided.

Description

VIABLE TISSUE REPAIR IMPLANTS AND METHODS OF USE
CROSS REFERENCE TO RELATED APPLICATIONS
Not applicable.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH
Not applicable.

FIELD OF THE INVENTION
The present invention relates to methods and apparatus for the treatment of tissue injuries or defects. Specifically, the present invention relates to tissue repair and augmentation implants, and more particularly, to tissue implants having viable cells capable of tissue regeneration and integration with tissue surrounding the area to be repaired, as well as methods for using such tissue implants.
BACKGROUND OF THE INVENTION
Injuries to tissue, such as cartilage, skin, muscle, bone, tendon, and ligament where the tissue has been injured or traumatized frequently require surgical intervention to repair the damage and facilitate healing. Such surgical repairs can include suturing or otherwise repairing the damaged tissue with known medical devices, augmenting the damaged tissue with other tissue, using an implant, a graft or any combination of these techniques. Despite these conventional methods of tissue repair, there continues to be a need for surgical solutions that facilitate the regeneration of new, healthy tissue to provide more reliable repair and healing of the injured or damaged tissue over the long term.
The search for a reliable source of viable cells for tissue regeneration has been pursued for years. Recent tissue engineering techniques for repairing tissue have typically involved replacing or reconstructing damaged or injured tissue with cells that have been manipulated ex vivo to stimulate new tissue growth. The cells are usually incorporated into a delivery vehicle (e.g., a scaffold or surgical implant) for placement at the tissue site, whereupon new tissue can be grown. Various surgical implants are known and have been used in surgical procedures to help achieve these benefits. For example, it is known to use various devices and techniques for creating implants having isolated cells loaded onto a delivery vehicle. Such cell-seeded implants have been used in an in vitro method of making and/or repairing cartilage by growing cartilaginous structures that consist of chondrocytes seeded onto biodegradable, biocompatible fibrous polymeric matrices as well as matrices developed from collagenous materials.
Such methods require the initial isolation of chondrocytes from cartilaginous tissue prior to the chondrocytes being seeded onto the polymeric matrices. Other techniques for repairing damaged tissue employ implants having stem or progenitor cells that are used to produce the desired tissue. For example, it is known to use stem or progenitor cells, such as the cells within fatty tissue, muscle, bone marrow, or embryonic tissue to regenerate bone, cartilage, and other soft tissues in a patient. For example, stem cells from fat are removed from the patient and placed in an environment favorable to cartilage formation, thereby inducing the cells to proliferate and to create a different type of cell, such as cartilage cells.
While the trend towards using tissue engineering approaches to tissue repair continues to gain popularity, mainly because of the long-term benefits provided to the patient, these current techniques are not without drawbacks. One disadvantage with current tissue engineering techniques is that they can be time consuming. A
typical process involves the harvest of a tissue sample from the patient in a first surgical procedure, which is then transported to a laboratory for cell isolation, culture and amplification. The cell sample is grown for a period of 3 to 4 weeks using standard cell culture techniques to create a cell bank. Once the cell population has reached a target number, the cells are sent back to the surgeon for implantation during a second surgical procedure. This manual, labor-intensive process is extremely costly and time consuming. Although the clinical data suggest long-term benefits for the patient, the prohibitive cost of the procedure, combined with the traumatic impact of two surgical procedures, has hampered adoption of these techniques.
One method for tissue repair has been to place into a defect site an implant that is composed of cultured and amplified cells and a scaffold, which provides structural integrity and a surface area for cell adhesion and proliferation. In the past, such scaffolds have consisted mostly of two- or three-dimensional porous scaffolds that allow cell invasion and remodeling once the scaffold has been combined with living cells and has been delivered inside the patient. This model is limited in application because of the secondary surgery and high costs involved. And though allografts have been used for tissue repair in the past, this solution is also not ideal because of the limited availability.
of graft material and the potential for disease transmission.
For these reasons, there continues to exist a need in this art for novel devices and methods for regenerating tissue which are less time consuming and easier to implement.
It is also desirable to provide an implant which can serve as a reliable source of viable cells, and which can be made in a quick and efficient manner for immediate use during surgery. There is thus a need for a less costly solution to repairing tissue defects or injuries that also provides the advantages of tissue regeneration, without the encumbrances of the currently available devices and methods of tissue repair previously mentioned.

SUMMARY OF THE INVENTION
The present invention provides a biocompatible tissue implant for repairing a tissue defect or injury which comprises a biological tissue slice that serves as a source of viable cells capable of tissue regeneration and/or repair. The biological tissue slice can be harvested from healthy tissue during the tissue repair surgery to have a geometry that is suitable for implantation at the site of the injury or defect. The harvested tissue slice is dimensioned to allow the viable cells contained within the tissue slice to migrate out and proliferate and integrate with tissue surrounding the tissue repair site.
The implant can be delivered to the tissue site either alone or with a retaining element to secure the implant to the injury or defect site. In one embodiment, the harvested tissue slice can be combined with minced tissue fragments to further enhance tissue regrowth. The minced tissue fragments can be delivered in a hydrogel or adhesive, which can also function as the retaining element. Optionally, a biologically active agent can be added to the implant at the tissue repair site to further enhance tissue healing or regeneration.
In another embodiment of the present invention, the implant can comprise more than one tissue slice. The plurality of tissue slices can be joined together to form a layered tissue implant having a desired size and geometry suitable for implantation at the injury or defect site. In yet another embodiment, a tissue slice can be joined to a tissue scaffold to form a composite implant. The implant can comprise a plurality of both tissue slices and scaffold layers. The scaffold can further include a biologically active agent that enhances the effectiveness of the viable cells contained within the tissue slice to grow and integrate with the surrounding tissue area.
The present invention also provides a method of treating injured or diseased tissue using the biocompatible tissue implants of the present invention that involves delivering the tissue implant to the site of the tissue injury or defect. The tissue implant can optionally be secured to the tissue site with a retaining element. Once implanted, the viable cells contained within the implant can begin regenerating new tissue to be integrated into the tissue surrounding the repair site. The biocompatible tissue implants of the present invention can be used for the repair and/or regeneration of diseased or damaged tissue. Further, the tissue implants can be used for tissue bulking, cosmetic treatments, therapeutic treatments, tissue augmentation, and tissue remodeling. In embodiments in which the implant is used for tissue repair, the tissue repair implant can be used to treat a variety of injuries, such as for example, injuries occurring within the musculoskeletal system, such as rotator cuff injuries, anterior cruciate ligament (ACL) ruptures, or meniscal tears, as well as injuries occurring in other connective tissues, such as skin and cartilage. Furthermore, such implants can be used in other orthopaedic surgical procedures, such as hand and foot surgery, to repair tissues such as ligaments, nerves, and tendons.
By harvesting the tissue slice from viable, healthy tissue during the tissue repair surgery, the present invention provides a cell source for repairing the tissue injury or defect at minimal cost and without the need for additional surgeries. This method allows for the delivery of viable cells to an injury or defect site without the cost of cell isolation and amplification. Further, because the present invention does not require the tissue slice to be minced to fine particles, manipulation time is reduced and the viability of the cells within the tissue is improved. An additional advantage of using a tissue slice as a cell source for viable, healthy cells is that the tissue slice can provide a native tissue surface for the biocompatible tissue implant, which will then have similar mechanical properties to that of neighboring tissue. The tissue slice also provides a structure for better retention of the cells at the injury or defect site that can be easily fixed to the site using conventional methods such as sutures, staples, or glues. In addition, by using a thin tissue slice, the cells have the ability to migrate out from the tissue and provide good integration between the implanted tissue and the injury or defect site.
BRIEF DESCRIPTION OF THE DRAWINGS
The invention can be more fully understood from the following detailed description taken in conjunction with the accompanying exemplary drawing, in which:
FIG. 1A illustrates an exemplary embodiment of the tissue implant secured to a tissue defect with a retaining element of the present invention;
FIG. 113 illustrates the tissue implant of FIG. IA secured to a tissue defect with another retaining element of the present invention;

FIG. 1C illustrates the tissue implant of FIG. IA secured to a tissue defect with yet another retaining element of the present invention;

FIG. 2A illustrates another exemplary embodiment of the tissue implant secured to a tissue defect with a retaining element of the present invention;

FIG. 2B illustrates the tissue implant of FIG. 2A secured to a tissue defect with another retaining element of the present invention;

FIG. 2C illustrates the tissue implant of FIG. 2A secured to a tissue defect with yet another retaining element of the present invention;
FIG. 3A illustrates yet another exemplary embodiment of the tissue implant secured to a tissue defect with a retaining element of the present invention;

FIG. 3B illustrates the tissue implant of FIG. 3A secured to a tissue defect with another retaining element of the present invention;

FIG. 3C illustrates the tissue implant of FIG. 3A secured to a tissue defect with yet another retaining element of the present invention;
FIG. 4A illustrates the tissue implant of FIG. 3A secured to another tissue defect;
FIG. 4B illustrates the tissue implant of FIG. 4A with an additional retaining element;

FIG. 5 represents a bar chart comparing DNA content between shredded bovine ACL tissue and minced bovine ACL tissue fragments seeded onto a tissue scaffold in vitro, at 4 days and 21 days.
FIGS. 6A-6C are photomicrographs of histological sections of samples obtained after 3 weeks following the procedure of EXAMPLE 2, demonstrating cell migration from a meniscal tissue sample into a polymer scaffold;

FIG. 7A is a photograph of a cartilage sample obtained following the procedure of EXAMPLE 3, demonstrating that minced cartilage fragments combined with cartilage tissue plugs enhance cell migration in spaces between the fragments and the plugs;

FIG. 7B is a photograph of a cartilage sample obtained following the procedure of EXAMPLE 3, demonstrating that cartilage plugs cultured together as a bundle, without minced cartilage tissue fragments, did not bond together; and FIG. 7C is a photomicrograph of a histological section of the sample of FIG.
7A, demonstrating cell migration in the space between the minced cartilage fragments and the cartilage plugs.

DETAILED DESCRIPTION OF TIE INVENTION
The biocompatible tissue implants of the present invention are used in the treatment of various types of tissue for various purposes. For example, the implants can be used for the repair and/or regeneration of diseased or damaged tissue, or they can be used for tissue bulking, tissue augmentation, cosmetic treatments, therapeutic treatments, and for tissue sealing. The tissue implants include a tissue slice or strip harvested from healthy tissue that contains viable cells capable of tissue regeneration and/or remodeling.
The tissue slice is harvested to have a geometry that is suitable for implantation at the site of the injury or defect. The harvested tissue slice is dimensioned to allow the viable cells contained within the tissue slice to migrate out and proliferate and integrate with tissue surrounding the repair site.
Although the implants are sometimes referred to herein as "tissue repair implants" and the methods of using the implants are sometimes characterized as tissue repair techniques, it is understood that the implants can be used for a variety of tissue treatments, including but not limited to tissue repair, tissue bulking, cosmetic treatments, therapeutic treatments, tissue remodeling or augmentation, and tissue sealing.
The term "viable," as used herein, refers to a tissue sample having one or more viable cells. Virtually any type of tissue can be used to construct the tissue repair implants of the present invention. Preferably, the tissue used is selected from cartilage tissue, meniscal tissue, ligament tissue, tendon tissue, skin tissue, bone tissue, muscle tissue, periosteal tissue, pericardial tissue, synovial tissue, nerve tissue, fat tissue, kidney tissue, bone marrow, liver tissue, bladder tissue, pancreas tissue, spleen tissue, intervertebral disc tissue, embryonic tissue, periodontal tissue, vascular tissue, blood and combinations thereof. In one embodiment useful for cartilage repair, the tissue is free of bone tissue and is selected from the group consisting of cartilage tissue, meniscal tissue, periosteal tissue, fat tissue, bone marrow, blood, synovial tissue, ligament tissue and tendon tissue. The tissue used to construct the tissue implant can be autogeneic tissue, allogeneic tissue, or xenogeneic tissue.
The term "slice," as used herein, refers to.a thin section, strip or sliver derived from any of the tissue types described above and used to construct the tissue implant.
Preferably, the tissue slice has a thickness less than about 1 mm, and more preferably has a thickness in the range of about 200 m to about 500 m. A thin profile ensures proper migration of the cells out of the tissue slice. It is understood, however, that the tissue slice can have any length or width appropriate for implantation at the defect, since these parameters do not greatly affect cell migration out of the tissue slice.
In one aspect of the invention, the tissue slices can be combined with finely minced tissue fragments to enhance the effectiveness of the regrowth and healing response. In such an embodiment, the tissue slices can be as thick as about 3 mm.
However, the tissue slices are preferably between about 200 m to about 1 mm.

In another aspect of the invention, the sliced tissue may be contacted with a matrix-digesting enzyme to facilitate cell migration out of the extracellular matrix surrounding the cells. The enzymes can be used to increase the rate of cell migration out of the extracellular matrix and into the tissue defect or injury, or scaffold material.
Suitable matrix-digesting enzymes that can be used in the present invention include, but are not limited to, collagenase, chondroitinase, trypsin, elastase, hyaluronidase, peptidase, thermolysin, matrix metalloproteinase, gelatinise and protease.
In one embodiment useful for meniscal repair, the tissue used in the tissue repair implant can be selected from the group consisting of meniscal tissue, cartilage tissue, skin, synovial tissue, periosteal tissue, pericardial tissue, fat tissue, bone marrow, blood, tendon tissue, ligament tissue, or combinations thereof. In one embodiment useful for ligament repair, the tissue used in the tissue repair implant can be selected from the group consisting of tendon tissue, ligament tissue of the same type that is to be repaired, ligament tissue of a different type than the tissue that is to be repaired, synovial tissue, periosteal tissue, fascia, skin, and combinations thereof.
Turning now to the drawings and particularly to FIG. 1 A, an exemplary embodiment of the biocompatible tissue implant 20 of the present invention is shown.
In the illustrated example, the tissue implant 20 is used to repair a cartilage defect 10.
The tissue implant 20 comprises a tissue slice 22 that has been harvested from healthy, viable cartilage tissue to have a geometry that is suitable for implantation at the defect 10. The tissue slice 22 serves as a source of viable cartilage cells for repairing the cartilage defect, and is dimensioned to allow the viable cells contained within the tissue slice 22 to migrate out and proliferate and integrate with the cartilage tissue 12 surrounding the defect 10. To ensure proper migration of the cells out of the tissue implant 20, the tissue slice 22 has a thickness less than about 1 mm.
Preferably, the tissue slice 22 has a thickness in the range of about 200 m to about 500 m, and can have any length or width appropriate for implantation at the defect 10.
The tissue implant 20 can be delivered to the cartilage defect 10 and retained at the site of implantation by the force of compression against the tissue implant 20 by the surrounding cartilage tissue 12. For instance, the tissue implant 20 can be dimensioned to have a slightly larger overall size than the area of the defect so that, upon implantation, the tissue implant 20 can form a tight, interference fit within the defect 10.

Alternatively, as illustrated in FIGS. IA through 1C, the tissue implant 20 can be secured using any conventional method such as with a retaining element 30 to fix the tissue implant 20 to the defect 10. The retaining element 30 can comprise a fastener, staple, tissue tack, suture, adhesive, or any combination of these. One skilled in the art will appreciate that the retaining element 30 is not limited, however, to such examples, and can comprise other suitable tissue attachment devices known in the art.
Further, a number of factors can determine which retaining element 30 is selected, including the size of the defect, the type of tissue being repaired, and the availability and cost of the retaining element 30.
FIG. 1A illustrates the tissue implant 20 secured in place with a staple 32 which anchors to bone tissue 14 around the cartilage defect 10. The tissue implant 20 can also be secured in place with an adhesive 34 as shown in FIG. 1B. Suitable adhesives 34 include, but are not limited to, hyaluronic acid, fibrin glue, fibrin clot, collagen gel, collagen-based adhesive, alginate gel, crosslinked alginate, gelatin-resorcin-formalin-based adhesive, mussel-based adhesive, dihydroxyphenylalanine (DOPA)-based adhesive, chitosan, transglutaminase, poly(amino acid)-based adhesive, cellulose-based adhesive, polysaccharide-based adhesive, synthetic acrylate-based adhesives, platelet rich plasma (PRP), platelet poor plasma (PPP), PRP clot, PPP clot, blood, blood clot, blood component, blood component clot, polyethylene glycol-based adhesive, Matrigel,M
Monostearoyl Glycerol co-Succinate (MGSA), Monostearoyl Glycerol co-Succinate/polyethylene glycol (MGSA/PEG) copolymers, laminin, elastin, proteoglycans, and combinations thereof. As shown in FIG. 1C, the tissue implant 20 can also be fixed in place using sutures 36.
The tissue implant 20 can also be used in conjunction with minced tissue to enhance tissue repair. For example, minced tissue fragments can be added to the adhesive 34 to further improve the tissue regeneration and/or remodeling process.
Alternatively, the minced tissue fragments can be delivered in a gel-like carrier which is applied to the tissue implant 20 at the defect 10. The minced tissue fragments can fill in the spaces between the tissue slice 22 and the defect 10. In such an embodiment in which minced tissue fragments are combined with the tissue slice, the thickness of the tissue slice forming the tissue implant 20 can be about 3 mm, but preferably is between about 200 tm and about 1 mm. By way of non-limiting example, the gel-like carrier can be a biological or synthetic hydrogel such as hyaluronic acid, fibrin glue, fibrin clot, collagen gel, collagen-based adhesive, alginate gel, crosslinked alginate, chitosan, synthetic acrylate-based gels, platelet rich plasma (PRP), platelet poor plasma (PPP), TM
PRP clot, PPP clot, blood, blood clot, blood component, blood component clot, Matrigel, agarose, chitin, chitosan, polysaccharides, poly(oxyalkylene), a copolymer of poly(ethylene oxide)-poly(propylene oxide), poly(vinyl alcohol), laminin, elasti, proteoglycans, solubilized basement membrane, or combinations thereof.
The minced tissue fragments can be obtained using any of a variety of conventional techniques, such as for example, by biopsy or other surgical removal.
Preferably, the tissue sample is obtained during the repair surgery to minimize the total number of surgeries performed on the patient. Once a sample of living tissue has been obtained, the sample can then be processed under sterile conditions to create a suspension having at least one minced, or finely divided, tissue particle. It is also possible to harvest the tissue in minced form such that further processing is not necessary. The particle size of each tissue fragment can vary, for example, the tissue size can be in the range of about 0.1 and 3 mm3, in the range of about 0.5 and I mm', in the range of about 1 to 2 mm3, or in the range of about 2 to 3 mm3, but preferably the tissue particle is less than 1 mm3.
Preferably, the minced tissue has at least one viable cell that can migrate from the tissue fragment. More preferably, the tissue contains an effective amount of cells that can migrate from the tissue fragment and begin populating the tissue surrounding the defect 10. In an optional embodiment, the minced tissue fragments may be contacted with a matrix-digesting enzyme to facilitate cell migration out of the extracellular matrix surrounding the cells. The enzymes are used to increase the rate of cell migration out of the extracellular matrix and into the scaffold material.
Suitable matrix-digesting enzymes that can be used in the present invention include, but are not limited to, collagenase, chondroitinase, trypsin, elastase, hyaluronidase, peptidase, thermolysin, matrix metalloproteinase, gelatinase and protease. Preferably, the concentration of minced tissue particles in the gel-carrier is in the range of approximately 1 to 1000 mg/em3, and more preferably in the range of about 1 to mg/cm3.

While it is understood that a single tissue slice 22 is sufficient to form the tissue implant 20 of the present invention, the same principles of cell migration and integration also apply to a layered tissue implant 40 comprising a plurality of tissue slices 22. As illustrated in FIGS. 2A through 2C, a plurality of tissue slices 22 can be joined together to form a layered tissue implant 40 of the present invention. The term "joined," as used herein, broadly refers to the process of combining tissue slices together, such as by the placement of a layer of tissue onto another layer of tissue, either alone or with an additional retaining or adhesive element. Each of the tissue slices 22 can be uniformly sized, or they can be differently sized to form a layered implant 40 having an overall geometry and dimensions suitable for implantation at the site of injury 10.
Likewise, the number of tissue slices 22 to be joined together also depends upon the size of the defect, and the size of each of the slices 22. However, to ensure proper migration of the cells out of the tissue implant 40, each of the tissue slice 22 should have a thickness less than about 1 mm as previously described. Preferably, each of the tissue slices 22 has a thickness in the range of about 200 pm to about 500 m.
Similar to the tissue implant 20 described above, the layered implant 40 can be placed at the tissue defect 10 either alone, or with a retaining element 30 as previously mentioned. In FIG. 2A, the tissue implant 40 is secured to a cartilage defect 10 using a staple 32 that anchors the implant 40 to bone tissue 14 near the defect 10. In FIG. 2B, the tissue implant 40 is held in place with a adhesive 34 such as the ones listed above.
To further enhance tissue regeneration and/or remodeling, minced tissue fragments can be mixed in with the adhesive. In such an embodiment in which minced tissue fragments are combined with the tissue slices, the thickness of each tissue slice forming the layered implant 40 can be about 3 mm, but preferably is between about 200 m and about 1 mm. Finally, the tissue implant 40 can be secured to the cartilage tissue 12 surrounding the defect 10 with sutures 36. After the layered tissue implant 40 has been delivered to the defect 10, tissue regrowth can be further enhanced by applying minced tissue fragments in a gel-like carrier to the tissue implant 40 to fill in the spaces between the tissue slices 22.
In yet another embodiment of the present invention, the tissue slice 22 can be combined with a tissue scaffold 52 to form a composite tissue implant 50 as illustrated in FIGS. 3A through 3C. For example, the tissue slice 22 can be placed on the tissue scaffold 52 and delivered to the defect 10 as a composite implant 50. The composite tissue implant 50 can be secured to the cartilage defect 10 using a retaining element 30 such as a staple 32 as shown in FIG. 3A. Alternatively, as illustrated in FIG.
3B the composite tissue implant 50 can be fixed in place using an adhesive 34 such as the ones described above, or using sutures 36 as shown in FIG. 3C. To further enhance tissue regeneration and/or remodeling, minced tissue fragments can be mixed in with the adhesive. In addition, minced tissue fragments in a gel-like carrier can be applied to fill the spaces between the tissue slice 22, tissue scaffold 52, and the defect 10 to enhance tissue growth.
Although illustrated as having a single tissue slice 22 and a single tissue scaffold 52, it is envisioned that the composite tissue implant 50 of the present invention can include a plurality of layers of either tissue slices 22 or tissue scaffolds 52. For instance, in one embodiment a plurality of tissue slices 22 can be sandwiched between layers of the tissue scaffold 52 to form a multilayered, composite implant 50. In another embodiment, the tissue slices 22 and tissue scaffolds 52 can be alternately layered onto one another to form the multilayered, composite implant 50. One skilled in the art will recognize that the number and orientation of tissue slices 22 and scaffolds 52 in the composite implant 50 can vary depending on the size of the defect 10, the type of tissue to be repaired, and the availability of the materials.
With the present embodiment, the tissue scaffold 52 can offer several advantages to the composite implant 50. A tissue scaffold 52 provides additional structural integrity for cellular growth to occur. The tissue scaffold 52 also provides structural support for the tissue slice 22 itself, which can be necessary to help retain the implant 50 in place for certain tissue repairs. For example, in a partial meniscal replacement shown in FIG. 4A, the tissue scaffold 52 provides additional strength to the tissue slice 22 of the composite tissue implant 50 so that the implant 50 can be secured by sutures 36 to the meniscal tissue. If necessary or desired, a combination of retaining elements 30 can be used to secure the composite implant 50 to the meniscal tissue 60. As shown in FIG.
4B, the composite implant 50 can be secured using both sutures 36 and an adhesive or glue 34.
Another advantage provided by tissue scaffolds is that they can act as a delivery vehicle for bioactive agents or effectors which enhance the overall effectiveness of the viable cells to grow and integrate with the tissue surrounding the defect 10.

It is contemplated that the tissue scaffold 52 can be formed using virtually any material or delivery vehicle that is biocompatible and that has sufficient structural integrity and physical and/or mechanical properties to effectively provide for ease of handling in an operating room environment. Sufficient strength and physical properties are developed in the scaffold through the selection of materials used to form the scaffold, and the manufacturing process. In some embodiments, the scaffold is also pliable so as to allow the scaffold to adjust to the dimensions of the target site of implantation. For instance, the scaffold can comprise a gel-like material or an adhesive material, as well as a foam or mesh structure. Preferably, the scaffold can be a bioresorbable or bioabsorbable material.
In one embodiment of the present invention, the scaffold can be formed from a biocompatible polymer. A variety of biocompatible polymers can be used to make the biocompatible tissue implants or scaffold devices according to the present invention.
The biocompatible polymers can be synthetic polymers, natural polymers or combinations thereof. As used herein the term "synthetic polymer" refers to polymers that are not found in nature, even if the polymers are made from naturally occurring biomaterials. The term "natural polymer" refers to polymers that are naturally occurring. In embodiments where the scaffold includes at least one synthetic polymer, suitable biocompatible synthetic polymers can include polymers selected from the group consisting of aliphatic polyesters, poly(amino acids), copoly(ether-esters), polyalkylenes oxalates, polyamides, tyrosine derived polycarbonates, poly(iminocarbonates), polyorthoesters, polyoxaesters, polyamidoesters, polyoxaesters containing amine groups, poly(anhydrides), polyphosphazenes, poly(propylene fumarate), polyurethane, poly(ester urethane), poly(ether urethane), and blends and copolymers thereof. Suitable synthetic polymers for use in the present invention can also include biosynthetic polymers based on sequences found in collagen, laminin, glycosaminoglycans, elastin, thrombin, fibronectin, starches, poly(amino acid), gelatin, alginate, pectin, fibrin, oxidized cellulose, chitin, chitosan, tropoelastin, hyaluronic acid, silk, ribonucleic acids, deoxyribonucleic acids, polypeptides, proteins, polysaccharides, polynucleotides and combinations thereof.
For the purpose of this invention aliphatic polyesters include, but are not limited to, homopolymers and copolymers of lactide (which includes lactic acid, D-,L-and meso lactide); glycolide (including glycolic acid); c-caprolactone; p-dioxanone (1,4-dioxan-2-one); trimethylene carbonate (1,3-dioxan-2-one); alkyl derivatives of trimethylene carbonate; 8-valerolactone;13-butyrolactone; y-butyrolactone; e-decalactone;
hydroxybutyrate; hydroxyvalerate; 1,4-dioxepan-2-one (including its dimer 1,5,8,12-tetraoxacyclotetradecane-7,14-dione); 1,5-dioxepan-2-one; 6,6-dimethyl-1,4-dioxan-2-one; 2,5-diketomorpholine; pivalolactone; a, a diethylpropiolactone; ethylene carbonate;
ethylene oxalate; 3-methyl-1,4-dioxane-2,5-dione; 3,3-diethyl-1,4-dioxan-2,5-dione;
6,6-dimethyl-dioxepan-2-one; 6,8-dioxabicycloctane-7-one and polymer blends thereof.
Aliphatic polyesters used in the present invention can be homopolymers or copolymers (random, block, segmented, tapered blocks, graft, triblock, etc.) having a linear, branched or star structure. Other useful polymers include polyphosphazenes, co-, ter-and higher order mixed monomer based polymers made from L-lactide, DL-lactide, lactic acid, glycolide, glycolic acid, para-dioxanone, trimethylene carbonate and c-caprolactone.
As used herein, the term "glycolide" is understood to include polyglycolic acid.
Further, the term "lactide" is understood to include L-lactide, D-lactide, blends thereof, and lactic acid polymers and copolymers.
Elastomeric copolymers are also particularly useful in the present invention.
Suitable elastomeric polymers include those with an inherent viscosity in the range of about 1.2 dL/g to 4 dL/g, more preferably about 1.2 dL/g to 2 dL/g and most preferably about 1.4 dL/g to 2 dL/g as determined at 25 C in a 0.1 gram per deciliter (g/dL) solution of polymer in hexafluoroisopropanol (HFIP). Further, suitable elastomers exhibit a high percent elongation and a low modulus, while possessing good tensile strength and good recovery characteristics. In the preferred embodiments of this invention, the elastomer exhibits a percent elongation greater than about 200 percent and preferably greater than about 500 percent. In addition to these elongation and modulus properties, suitable elastomers should also have a tensile strength greater than about 500 psi, preferably greater than about 1,000 psi, and a tear strength of greater than about 50 lbs/inch, preferably greater than about 80 lbs/inch.
Exemplary biocompatible elastomers that can be. used in the present invention include, but are not limited to, elastomeric copolymers of a-caprolactone and glycolide with a mole ratio of c-caprolactone to glycolide of from about 35:65 to about 65:35, more preferably from 45:55 to 35:65; elastomeric copolymers of E-caprolactone and lactide (including L-lactide, D-lactide, blends thereof, and lactic acid polymers and copolymers) where the mole ratio of c-caprolactone to lactide is from about 95:5 to about 30:70 and more preferably from 45:55 to 30:70 or from about 95:5 to about 85:15;
elastomeric copolymers of p-dioxanone (1,4-dioxan-2-one) and lactide (including L-lactide, D-lactide, blends thereof, and lactic acid polymers and copolymers) where the mole ratio of p-dioxanone to lactide is from about 40:60 to about 60:40;
elastomeric copolymers of E-caprolactone and p-dioxanone where the mole ratio of s-caprolactone to p-dioxanone is from about from 30:70 to about 70:30; elastomeric copolymers of p-dioxanone and trimethylene carbonate where the mole ratio of p-dioxanone to trimethylene carbonate is from about 30:70 to about 70:30; elastomeric copolymers of trimethylene carbonate and glycolide (including polyglycolic acid) where the mole ratio of trimethylene carbonate to glycolide is from about 30:70 to about 70:30;
elastomeric copolymers of trimethylene carbonate and lactide (including L-lactide, D-lactide, blends thereof, and lactic acid polymers and copolymers) where the mole ratio of trimethylene carbonate to lactide is from about 30:70 to about 70:30; and blends thereof.
Examples of suitable biocompatible elastomers are described in U.S. Patent No.
5,468,253.
In one embodiment, the elastomer is a copolymer of 35:65 s-caprolactone and glycolide, formed in a dioxane solvent and including a polydioxanone mesh. In another embodiment, the elastomer is a copolymer of 40:60 c-caprolactone and lactide with a polydioxanone mesh. In yet another embodiment, the elastomer is a 50:50 blend of a 35:65 copolymer of E-caprolactone and glycolide and 40:60 copolymer of s-caprolactone and lactide. The polydioxanone mesh may be in the form of a one layer thick two-dimensional mesh or a multi-layer thick three-dimensional mesh.
The scaffold of the present invention can, optionally, be formed from a bioresorbable or bioabsorbable material that has the ability to resorb in a timely fashion in the body environment. The differences in the absorption time under in vivo conditions can also be the basis for combining two different copolymers when forming the scaffolds of the present invention. For example, a copolymer of 35:65 s-caprolactone and glycolide (a relatively fast absorbing polymer) can be blended with 40:60 c-caprolactone and L-lactide copolymer (a relatively slow absorbing polymer) to form a biocompatible scaffold. Depending upon the processing technique used, the two constituents can be either randomly inter-connected bicontinuous phases, or the constituents could have a gradient-like architecture in the form of a laminate type composite with a well integrated interface between the two constituent layers.
The microstructure of these scaffolds can be optimized to regenerate or repair the desired anatomical features of the tissue that is being regrown.
In one embodiment, it is desirable to use polymer blends to form scaffolds which transition from one composition to another composition in a gradient-like architecture.
Scaffolds having this gradient-like architecture are particularly advantageous in tissue engineering applications to repair or regenerate the structure of naturally occurring tissue such as cartilage (articular, meniscal, septal, tracheal, auricular, costal, etc.), tendon, ligament, nerve, esophagus, skin, bone, and vascular tissue. For example, by blending an elastomer of e-caprolactone-co-glycolide with c-caprolactone-co-lactide (e.g., with a mole ratio of about 5:95) a scaffold may be formed that transitions from a softer spongy material to a stiffer more rigid material, for example, in a manner similar to the transition from cartilage to bone. Clearly, one skilled in the art will appreciate that other polymer blends may be used for similar gradient effects, or to provide different gradients (e.g., different absorption profiles, stress response profiles, or different degrees of elasticity).
The biocompatible scaffold 52 of the tissue repair implant 50 of the present invention can also include a reinforcing material comprised of any absorbable or non-absorbable textile having, for example, woven, knitted, warped knitted (i.e., lace-like), non-woven, and braided structures. In one embodiment, the reinforcing material has a mesh-like structure. In any of the above structures, mechanical properties of the material can be altered by changing the density or texture of the material, the type of knit or weave of the material, the thickness of the material, or by embedding particles in the material. The mechanical properties of the material may also be altered by creating sites within the mesh where the fibers are physically bonded with each other or physically bonded with another agent, such as, for example, an adhesive or a polymer. The fibers used to make the reinforcing component can be monofilaments, yarns, threads, braids, or bundles of fibers. These fibers can be made of any biocompatible material including bioabsorbable materials such as polylactic acid (PLA), polyglycolic acid (PGA), + CA 02487042 2004-11-04 polycaprolactone (PCL), polydioxanone (PDO), trimethylene carbonate (TMC), copolymers or blends thereof. These fibers can also be made from any biocompatible materials based on natural polymers including silk and collagen-based materials. These fibers can also be made of any biocompatible fiber that is nonresorbable, such as, for example, polyethylene, polyethylene terephthalate, poly(tetrafluoroethylene), polycarbonate, polypropylene and poly(vinyl alcohol). In one embodiment, the fibers are formed from 95:5 copolymer of lactide and glycolide.
In another embodiment, the fibers that form the reinforcing material can be made of a bioabsorbable glass. Bioglass, a silicate containing calcium phosphate glass, or calcium phosphate glass with varying amounts of solid particles added to control resorption time are examples of materials that could be spun into glass fibers and used for the reinforcing material. Suitable solid particles that may be added include iron, magnesium, sodium, potassium, and combinations thereof.
The biocompatible scaffolds as well as the reinforcing material may also be formed from a thin, perforation-containing elastomeric sheet with pores or perforations to allow tissue ingrowth. Such a sheet could be made of blends or copolymers of polylactic acid (PLA), polyglycolic acid (PGA), polycaprolactone (PCL), and polydioxanone (PDO).
In one embodiment, filaments that form the biocompatible scaffolds 52 or the reinforcing material may be co-extruded to produce a filament with a sheath/core construction. Such filaments are comprised of a sheath of biodegradable polymer that surrounds one or more cores comprised of another biodegradable polymer.
Filaments with a fast-absorbing sheath surrounding a slower-absorbing core may be desirable in instances where extended support is necessary for tissue ingrowth.
One skilled in the art will appreciate that one or more layers of the reinforcing material may be used to reinforce the tissue implant of the invention. In addition, biodegradable textile scaffolds, such as, for example, meshes, of the same structure and chemistry or different structures and chemistries can be overlaid on top of one another to fabricate biocompatible tissue implants with superior mechanical strength.
In embodiments where the scaffold includes at least one natural polymer, suitable examples of natural polymers include, but are not limited to, fibrin-based materials, collagen-based materials, hyaluronic acid-based materials, glycoprotein-based materials, cellulose based materials, silks and combinations thereof. By way of nonlimiting example, the biocompatible scaffold can be constructed from a collagen-based small intestine submucosa.
By way of non-limiting example, the scaffolds 52 of the present invention can be highly porous to allow cell growth therein. Preferably, the median pore size is in the range of about 100 to 500 microns. In these embodiments, the scaffold should be sufficiently pliable to accommodate tissue growth within the interior region of the scaffold, so that the geometry of the scaffold can be remodeled as tissue ingrowth increases. Accordingly, in the present invention, tissue can be grown on the surface of the biocompatible scaffold, or alternatively, tissue can be grown into and on the surface of the biocompatible scaffold, such that the tissue becomes embedded in and integrated with the scaffold.
In another embodiment of the present invention, the biocompatible scaffold 52 can be formed from a biocompatible ceramic material. Suitable biocompatible ceramic materials include, for example, hydroxyapatite, a-tricalcium phosphate, P-tricalcium phosphate, bioactive glass, calcium phosphate, calcium sulfate, calcium carbonate, xenogeneic and allogeneic bone material and combinations thereof. Suitable bioactive glass materials for use in the present invention include silicates containing calcium phosphate glass, or calcium phosphate glass with varying amounts of solid particles added to control resorption time. Suitable compounds that may be incorporated into the calcium phosphate bioactive glass include, but are not limited to, magnesium oxide, sodium oxide, potassium oxide, and combinations thereof.
In yet another embodiment of the tissue implants of the present invention, the scaffold 52 can be formed using tissue grafts, such as may be obtained from autogeneic tissue, allogeneic tissue and xenogeneic tissue. By way of non-limiting example, tissues such as skin, cartilage, ligament, tendon, periosteum, perichondrium, synovium, fascia, mesenter and sinew can be used as tissue grafts to form the biocompatible scaffold 52.
In some embodiments where an allogeneic tissue is used, tissue from a fetus or newborns can be used to avoid the immunogenicity associated with some adult tissues.
In still yet another embodiment of the tissue implants, the scaffold can be formed from a polymeric foam component having pores with an open cell pore structure.
The pore size can vary, but preferably, the pores are sized to allow tissue ingrowth. More .19.
preferably, the pore size is in the range of about 50 to 1000 microns, and even more preferably, in the range of about 50 to 500 microns. The polymeric foam component can, optionally, contain a reinforcing component, such as for example, the textiles disclosed above. In some embodiments where the polymeric foam component contains a reinforcing component, the foam component can be integrated with the reinforcing component such that the pores of the foam component penetrate the mesh of the reinforcing component and interlock with the reinforcing component.
The foam component of the tissue implant may be formed as a foam by a variety of techniques well known to those having ordinary skill in the art. For example, the polymeric starting materials may be foamed by lyophilization, supercritical solvent foaming (i.e., as described in EP 464,163), gas injection extrusion, gas injection molding or casting with an extractable material (e.g., salts, sugar or similar suitable materials).
In one embodiment, the foam component of the tissue repair implants of the present invention may be made by a polymer-solvent phase separation technique, such as lyophilization. Generally, however, a polymer solution can be separated-into two phases by any one of the four techniques: (a) thermally induced gelation/crystallization;
(b) non-solvent induced separation of solvent and polymer phases; (c) chemically induced phase separation, and (d) thermally induced spinodal decomposition.
The polymer solution is separated in a controlled manner into either two distinct phases or two bicontinuous phases. Subsequent removal of the solvent phase usually leaves a porous structure with a density less than the bulk polymer and pores in the micrometer ranges resulting in a porous polymer structure or an interconnected open cell porous foam. See Microcellular Foams Via Phase Separation, J. Vac. Sci. Technol., A.
T.
Young, Vol. 4(3), May/Jun 1986.
The applicable polymer concentration or amount of solvent that may be utilized will vary with each system. Generally, the amount of polymer in the solution can vary from about 0.5% to about 90% and, preferably, will vary from about 0.5% to about 30%
by weight, depending on factors such as the solubility of the polymer in a given solvent and the final properties desired in the foam.
In one embodiment, solids may be added to the polymer-solvent system to modify the composition of the resulting foam surfaces. As the added particles settle out of solution to the bottom surface, regions will be created that will have the composition of the added solids, not the foamed polymeric material. Alternatively, the added solids may be more concentrated in desired regions (i.e., near the top, sides, or bottom) of the resulting tissue implant, thus causing compositional changes in all such regions. For example, concentration of solids in selected locations can be accomplished by adding metallic solids to a solution placed in a mold made of a magnetic material (or vice versa).
A variety of types of solids can be added to the polymer-solvent system.
Preferably, the solids are of a type that will not react with the polymer or the solvent.
Generally, the added solids have an average diameter of less than about 1.0 mm and preferably will have an average diameter of about 50 to about 500 microns.
Preferably, the solids are present in an amount such that they will constitute from about 1 to about 50 volume percent of the total volume of the particle and polymer-solvent mixture (wherein the total volume percent equals 100 volume percent).
Exemplary solids include, but are not limited to, particles of demineralized bone, calcium phosphate particles, bioglass particles, calcium sulfate, or calcium carbonate particles for bone repair, leachable solids for pore creation and particles of bioabsorbable polymers not soluble in the solvent system that are effective as reinforcing materials or to create pores as they are absorbed, and non-bioabsorbable materials.
Suitable leachable solids include nontoxic leachable materials such as salts (e.g., sodium chloride, potassium chloride, calcium chloride, sodium tartrate, sodium citrate, and the like), biocompatible mono and disaccharides (e.g., glucose, fructose, dextrose, maltose, lactose and sucrose), polysaccharides (e.g., starch, alginate, chitosan), water soluble proteins (e.g., gelatin and agarose). The leachable materials can be removed by immersing the foam with the leachable material in a solvent in which the particle is soluble for a sufficient amount of time to allow leaching of substantially all of the particles, but which does not dissolve or detrimentally alter the foam. The preferred extraction solvent is water, most preferably distilled-deionized water. Such a process is described in U.S. Patent No. 5,514,378. Preferably the foam will be dried after the leaching process is complete at low temperature and/or vacuum to minimize hydrolysis of the foam unless accelerated absorption of the foam is desired.
Suitable non-bioabsorbable materials include biocompatible metals such as stainless steel, cobalt chrome, titanium and titanium alloys, and bioinert ceramic particles (e.g., alumina, zirconia, and calcium sulfate particles). Further, the non-bioabsorbable materials may include polymers such as polyethylene, polyvinylacetate, polymethylmethacrylate, polypropylene, poly(ethylene terephthalate), silicone, polyethylene oxide, polyethylene glycol, polyurethanes, polyvinyl alcohol, natural polymers (e.g., cellulose particles, chitin, and keratin), and fluorinated polymers and copolymers (e.g., polyvinylidene fluoride, polytetrafluoroethylene, and hexafluoropropylene).
It is also possible to add solids (e.g., barium sulfate) that will render the tissue implants radio opaque. The solids that may be added also include those that will promote tissue regeneration or regrowth, as well as those that act as buffers, reinforcing materials or porosity modifiers.
As noted above, porous, reinforced tissue-repair implant devices of the present invention are made by injecting, pouring, or otherwise placing, the appropriate polymer solution into a mold set-up comprised of a mold and the reinforcing elements of the present invention. The mold set-up is cooled in an appropriate bath or on a refrigerated shelf and then lyophilized, thereby providing a reinforced scaffold. A
bioactive agent can be added either before or after the lyophilization step. In the course of forming the foam component, it is believed to be important to control the rate of freezing of the polymer-solvent system. The type of pore morphology that is developed during the freezing step is a function of factors such as the solution thermodynamics, freezing rate, temperature to which it is cooled, concentration of the solution, and whether homogeneous or heterogenous nucleation occurs. One of ordinary skill in the art can readily optimize the parameters without undue experimentation.
The required general processing steps include the selection of the appropriate materials from which the polymeric foam and the reinforcing components are made. If a mesh reinforcing material is used, the proper mesh density must be selected.
Further, the reinforcing material must be properly aligned in the mold, the polymer solution must be added at an appropriate rate and, preferably, into a mold that is tilted at an appropriate angle to avoid the formation of air bubbles, and the polymer solution must be lyophilized.
In embodiments that utilize a mesh reinforcing material, the reinforcing mesh has to be of a certain density. That is, the openings in the mesh material must be sufficiently small to render the construct sutureable or otherwise fastenable, but not so small as to impede proper bonding between the foam and the reinforcing mesh as the foam material and the open cells and cell walls thereof penetrate the mesh openings. Without proper bonding the integrity of the layered structure is compromised leaving the construct fragile and difficult to handle. Because the density of the mesh determines the mechanical strength of the construct, the density of the mesh can vary according to the desired use for tissue repair. In addition, the type of weave used in the mesh can determine the directionality of the mechanical strength of the construct, as well as the mechanical properties of the reinforcing material, such as for example, the elasticity, stiffness, burst strength, suture retention strength and ultimate tensile strength of the construct. By way of non-limiting example, the mesh reinforcing material in a foam-based biocompatible scaffold of the present invention can be designed to be stiff in one direction, yet elastic in another, or alternatively, the mesh reinforcing material can be made isotropic.
During the lyophilization of the reinforced foam, several parameters and procedures are important to produce implants with the desired integrity and mechanical properties. Preferably, the reinforcement material is substantially flat when placed in the mold. To ensure the proper degree of flatness, the reinforcement (e.g., mesh) is pressed flat using a heated press prior to its placement within the mold. Further, in the event that reinforcing structures are not isotropic it is desirable to indicate this anisotropy by marking the construct to indicate directionality. This can be accomplished by embedding one or more indicators, such as dyed markings or dyed threads, within the woven reinforcements. The direction or orientation of the indicator will indicate to a surgeon the dimension of the implant in which physical properties are superior.
As noted above, the manner in which the polymer solution is added to the mold prior to lyophilization helps contribute to the creation of a tissue implant with adequate mechanical integrity. Assuming that a mesh reinforcing material will be used, and that it will be positioned between two thin (e.g., 0.75 mm) shims it should be positioned in a substantially flat orientation at a desired depth in the mold. The polymer solution is poured in a way that allows air bubbles to escape from between the layers of the foam component. Preferably, the mold is tilted at a desired angle and pouring is effected at a controlled rate to best prevent bubble formation. One of ordinary skill in the art will appreciate that a number of variables will control the tilt angle and pour rate. Generally, the mold should be tilted at an angle of greater than about 1 degree to avoid bubble formation. In addition, the rate of pouring should be slow enough to enable any air bubbles to escape from the mold, rather than to be trapped in the mold.
If a mesh material is used as the reinforcing component, the density of the mesh openings is an important factor in the formation of a resulting tissue implant with the desired mechanical properties. A low density, or open knitted mesh material, is preferred. One preferred material is a 90:10 copolymer of glycolide and lactide, sold under the tradename VICRYL (Ethicon, Inc., Somerville, NJ). One exemplary low density, open knitted mesh is Knitted VICRYL VKM-M, available from Ethicon, Inc., Somerville, NJ. Other preferred materials are polydioxanone or 95:5 copolymer of lactide and glycolide.
The density or "openness" of a mesh material can be evaluated using a digital photocamera interfaced with a computer. In one evaluation, the density of the mesh was determined using a Nikon SMZ-U Zoom with a Sony digital photocamera DKC-5000 interfaced with an IBM 300PL computer. Digital images of sections of each mesh magnified to 20x were manipulated using linage-Pro Plus 4.0 software in order to determine the mesh density. Once a digital image was captured by the software, the image was thresholded such that the area accounting for the empty spaces in the mesh could be subtracted from the total area of the image. The mesh density was taken to be the percentage of the remaining digital image. Implants with the most desirable mechanical properties were found to be those with a mesh density in the range of about 12 to 80 % and more preferably about 45 to 80%.
In one embodiment, the preferred scaffold for cartilage repair is a mesh reinforced foam. More preferably, the foam is reinforced with a mesh that includes polydioxanone (PDO) and the foam composition is a copolymer of 35:65 e-caprolactone and glycolide. For articular cartilage, the preferred structure to allow cell and tissue ingrowth is one that has an open pore structure and is sized to sufficiently allow cell migration. A suitable pore size is one in which an average diameter is in the range of about 50 to 1000 microns, and more preferably, between about 50 to 500 microns. The mesh layer has a thickness in the range of about 1 micron to 1 000 microns.
Preferably, the foam has a thickness in the range of about 300 microns to 2 mm, and more preferably, between about 500 microns and 1.5 mm. Preferably, the mesh layer has a mesh density in the range of about 12 to 80 % and more preferably about 45 to 80%.
In another embodiment, the preferred scaffold for cartilage repair is a nonwoven structure. More preferably, the composition of the nonwoven structure are PANACRYL, a 95:5 copolymer of lactide and glycolide, VICRYL, a 90:10 copolymer of glycolide and lactide, or a blend of polydioxanone and VICRYL. For articular cartilage, the preferred structure to allow cell and tissue ingrowth is one that has an open pore structure and is sized to sufficiently allow cell migration. A suitable pore size for the nonwoven scaffold is one in which an average diameter is in the range of about 50 to 1000 microns and more preferably between about 100 to 500 microns. The nonwoven scaffold has a thickness between about 300 microns and 2 mm, and more preferably, between about 500 microns and 1.5 mm.
In yet another embodiment, the preferred scaffold for meniscus repair is a mesh reinforced foam. More preferably, the foam is reinforced foam with a mesh that includes polydioxanone (PDO) and the foam composition is a copolymer of 35:65 a-caprolactone and glycolide. The preferred structure to allow cell and tissue ingrowth is one that has an open pore structure and is sized to sufficiently allow cell migration. A
suitable pore size is one in which an average diameter is in the range of about 50 to 1000 microns, and more preferably, between about 50 to 500 microns. The mesh layer has a thickness in the range of about 1 micron to 1000 microns. Preferably, the foam has a thickness in the range of about 300 microns to 2 mm, and more preferably, between about 500 microns and 1.5 mm. In this embodiment, the preferred method of use is to surround the minced cartilage tissue with this scaffold material. Preferably, the mesh layer has a mesh density in the range of about 12 to 80 % and more preferably about 45 to 80%.
In still yet another embodiment, the preferred scaffold for tissue repair, including cartilage, meniscus, tendon, ligament, and skin repair, is constructed from a naturally occurring extracellular matrix material ("ECM"), such as that found in the stomach, bladder, alimentary, respiratory, urinary, integumentary, genital tracts, or liver basement membrane of animals. Preferably, the ECM is derived from the alimentary tract of mammals, such as cows, sheeps, dogs, cats, and most preferably from the intestinal tract of pigs. The ECM is preferably small intestine submucosa ("SIS"), which can include the tunica submucosa, along with basilar portions of the tunica mucosa, particularly the lamina muscularis mucosa and the stratum compactum.
For the purposes of this invention, it is within the definition of a naturally occurring ECM to clean and/or comminute the ECM, or even to cross-link the collagen fibers within the ECM. However, it is not within the definition of a naturally occurring ECM to extract and purify the natural fibers and reform a matrix material from purified natural fibers. Also, while reference is made to SIS, it is understood that other naturally occurring ECMs are within the scope of this invention. Thus, as used herein, the terms "naturally occurring extracellular matrix" or "naturally occurring ECM" are intended to refer to extracellular matrix material that has been cleaned, disinfected, sterilized, and optionally cross-linked.
Where SIS is used, a SIS graft can be harvested in a variety of ways, as will be understood by one skilled in the art. The resulting graft material can have a variety of geometries and consistencies including for example, coiled, helical, spring-like, randomized, branched, sheet-like, tubular, spherical, fragmented, fluidized, comminuted, liquefied, foamed, suspended, gel-like, injectable, powdered, ground, and, sheared.
One of ordinary skill in the art will appreciate that the selection of a suitable material for forming the biocompatible scaffold of the present invention depends on several factors. These factors include in vivo mechanical performance; cell response to the material in terms of cell attachment, proliferation, migration and differentiation;
biocompatibility; and optionally, bioabsorption (or bio-degradation) kinetics.
Other relevant factors include the chemical composition, spatial distribution of the constituents, the molecular weight of the polymer, and the degree of crystallinity.
A bioactive agent may, optionally, be incorporated within the tissue scaffolds of the present invention. Preferably, the bioactive agent is incorporated within, or coated on, the scaffolds 52 disclosed above. In embodiments where the bioactive agent is coated onto the scaffold 52, the bioactive agent is preferably associated with at least a portion of the scaffold 52. The bioactive agents used in the present invention can also be selected from among a variety of effectors that, when present at the site of injury, promote healing and/or regeneration of the affected tissue. In addition to being compounds or agents that actually promote or expedite healing, the effectors may also include compounds or agents that prevent infection (e.g., antimicrobial agents and antibiotics), compounds or agents that reduce inflammation (e.g., anti-inflammatory agents), compounds that prevent or minimize adhesion formation, such as oxidized regenerated cellulose (e.g., INTERCEED and Surgicel , available from Ethicon, Inc.), hyaluronic acid, and compounds or agents that suppress the immune system (e.g., immunosuppressants).
By way of example, other types of effectors present within the implant of the present invention can include heterologous or autologous growth factors, proteins (including matrix proteins), peptides, antibodies, enzymes, platelets, platelet rich plasma, glycoproteins, hormones, cytokines, glycosaminoglycans, nucleic acids, analgesics, viruses, virus particles, and cell types. It is understood that one or more effectors of the same or different functionality may be incorporated within the implant.
Examples of suitable effectors include the multitude of heterologous or autologous growth factors known to promote healing and/or regeneration of injured or damaged tissue. These growth factors can be incorporated directly into the scaffold, or alternatively, the scaffold can include a source of growth factors, such as for example, platelets. "Bioactive agents," as used herein, include one or more of the following:
chemotactic agents; therapeutic agents (e.g., antibiotics, steroidal and non-steroidal analgesics and anti-inflammatories, anti-rejection agents such as immunosuppressants and anti-cancer drugs); various proteins (e.g., short term peptides, bone morphogenic proteins, glycoprotein and lipoprotein); cell attachment mediators;
biologically active ligands; integrin binding sequence; ligands; various growth and/or differentiation agents and fragments thereof (e.g., epidermal growth factor (EGF), hepatocyte growth factor (HGF), vascular endothelial growth factors (VEGF), fibroblast growth factors (e.g., bFGF), platelet derived growth factors (PDGF), insulin derived growth factor (e.g., IGF-1, IGF-II) and transforming growth factors (e.g., TGF-13 I-III), parathyroid hormone, parathyroid hormone related peptide, bone morphogenetic proteins (e.g., BMP-2, BMP-4; BMP-6; BMP-12), sonic hedgehog, growth differentiation factors (e.g., GDF5, GDF6, GDF8), recombinant human growth factors (e.g., MP52), cartilage-derived morphogenetic proteins, (CDMPI)); small molecules that affect the upregulation of specific growth factors; tenascin-C; hyaluronic acid; chondroitin sulfate;
fibronectin;
decorin; thromboelastin; thrombin-derived peptides; heparin-binding domains;
heparin;
heparan sulfate; DNA fragments and DNA plasmids. Suitable effectors likewise include the agonists and antagonists of the agents described above. The growth factor can also include combinations of the growth factors described above. In addition, the growth factor can be autologous growth factor that is supplied by platelets in the blood. In this case, the growth factor from platelets will be an undefined cocktail of various growth factors. If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of "bioactive agent" and "bioactive agents" unless expressly limited otherwise.
Biologically derived agents, suitable for use as effectors, include one or more of the following: bone (autograft, allograft, and xenograft) and derivates of bone; cartilage (autograft, allograft and xenograft), including, for example, meniscal tissue, and derivatives; ligament (autograft, allograft and xenograft) and derivatives;
derivatives of intestinal tissue (autograft, allograft and xenograft), including for example submucosa;
derivatives of stomach tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of bladder tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of alimentary tissue (autograft, allograft and xenograft), including for example submucosa; derivatives of respiratory tissue (autograft, allograft and xenograft), including for example submucosa;
derivatives of genital tissue (autograft, allograft and xenograft), including for example submucosa;
derivatives of liver tissue (autograft, allograft and xenograft), including for example liver basement membrane; derivatives of skin tissue; platelet rich plasma (PRP), platelet poor plasma, bone marrow aspirate, demineralized bone matrix, insulin derived growth factor, whole blood, fibrin and blood clot. Purified ECM and other collagen sources are also appropriate biologically derived agents. If other such substances have therapeutic value in the orthopaedic field, it is anticipated that at least some of these substances will have use in the present invention, and such substances should be included in the meaning of "biologicallyderived agent" and "biologicallyderived agents" unless expressly limited otherwise.
Biologically derived agents also include bioremodelable collageneous tissue matrices. The terms "bioremodelable collagenous tissue matrix" and "naturally occurring bioremodelable collageneous tissue matrix" include matrices derived from native tissue selected from the group consisting of skin, artery, vein, pericardium, heart valve, dura mater, ligament, bone, cartilage, bladder, liver, stomach, fascia and intestine, whatever the source. Although the term "naturally occurring bioremodelable collagenous tissue matrix" is intended to refer to matrix material that has been cleaned, processed, sterilized, and optionally crosslinked, it is not within the definition of a naturally occurring bioremodelable collageneous tissue matrix to purify the natural fibers and reform a matrix material from purified natural fibers.
The proteins that may be present within the implant include proteins that are secreted from a cell or other biological source, such as for example, a platelet, which is housed within the implant, as well as those that are present within the implant in an isolated form. The isolated form of a protein typically is one that is about 55% or greater in purity, i.e., isolated from other cellular proteins, molecules, debris, etc. More preferably, the isolated protein is one that is at least 65% pure, and most preferably one that is at least about 75 to 95% pure. Notwithstanding the above, one of ordinary skill in the art will appreciate that proteins having a purity below about 55% are still considered to be within the scope of this invention. As used herein, the term "protein"
embraces glycoproteins, lipoproteins, proteoglycans, peptides, and fragments thereof.
Examples of proteins useful as effectors include, but are not limited to, pleiotrophin, endothelin, tenascin, fibronectin, fibrinogen, vitronectin, V-CAM, I-CAM, N-CAM, selectin, cadherin, integrin, laminin, actin, myosin, collagen, microfilament, intermediate filament, antibody, elastin, fibrillin, and fragments thereof.
Glycosaminoglycans, highly charged polysaccharides which play a role in cellular adhesion, may also serve as effectors according to the present invention.
Exemplary glycosaminoglycans useful as effectors include, but are not limited to, heparan sulfate, heparin, chondroitin sulfate, dermatan sulfate, keratan sulfate, hyaluronan (also known as hyaluronic acid), and combinations thereof.
The tissue scaffolds 52 of the present invention can also have cells incorporated therein. Suitable cell types that can serve as effectors according to this invention include, but are not limited to, osteocytes, osteoclasts, osteoclasts, fibroblasts, stem cells, pluripotent cells, chondrocyte progenitors, chondrocytes, endothelial cells, macrophages, leukocytes, adipocytes, monocytes, plasma cells, mast cells, umbilical cord cells, stromal cells, mesenchymal stem cells, epithelial cells, myoblasts,.tenocytes, ligament fibroblasts, neurons, bone marrow cells, synoviocytes, embryonic stem cells;

precursor cells derived from adipose tissue; peripheral blood progenitor cells; stem cells isolated from adult tissue; genetically transformed cells; a combination of chondrocytes and other cells; a combination of osteocytes and other cells; a combination of synoviocytes and other cells; a combination of bone marrow cells and other cells; a combination of mesenchymal cells and other cells; a combination of stromal cells and other cells; a combination of stem cells and other cells; a combination of embryonic stem cells and other cells; a combination of precursor cells isolated from adult tissue and other cells; a combination of peripheral blood progenitor cells and other cells; a combination of stem cells isolated from adult tissue and other cells; and a combination of genetically transformed cells and other cells. If other cells are found to have therapeutic value in the orthopaedic field, it is anticipated that at least some of these cells will have use in the present invention, and such cells should be included within the meaning of "cell" and "cells" unless expressly limited.
Cells typically have at their surface receptor molecules which are responsive to a cognate ligand (e.g., a stimulator). A stimulator is a ligand which when in contact with its cognate receptor induce the cell possessing the receptor to produce a specific biological action. For example, in response to a stimulator (or ligand) a cell may produce significant levels of secondary messengers, like Ca+2, which then will have subsequent effects upon cellular processes such as the phosphorylation of proteins, such as (keeping with our example) protein kinase C. In some instances, once a cell is stimulated with the proper stimulator, the cell secretes a cellular messenger usually in the form of a protein (including glycoproteins, proteoglycans, and lipoproteins). This cellular messenger can be an antibody (e.g., secreted from plasma cells), a hormone, (e.g., a paracrine,. autocrine, or exocrine hormone), a cytokine, or natural or synthetic fragments thereof.
The tissue implants 50 of the invention can also be used in gene therapy techniques in which nucleic acids, viruses, or virus particles deliver a gene of interest, which encodes at least one gene product of interest, to specific cells or cell types.
Accordingly, the biological effector can be a nucleic acid (e.g., DNA, RNA, or an oligonucleotide), a virus, a virus particle, or a non-viral vector. The viruses and virus particles may be, or may be derived from, DNA or RNA viruses. The gene product of interest is preferably selected from the group consisting of proteins, polypeptides, interference ribonucleic acids (iRNA) and combinations thereof.
Once the applicable nucleic acids and/or viral agents (i.e., viruses or viral particles) are incorporated into the biocompatible scaffold of the tissue repair implant, the implant can then be implanted into a particular site to elicit a type of biological response. The nucleic acid or viral agent can then be taken up by the cells and any proteins that they encode can be produced locally by the cells. In one embodiment, the nucleic acid or viral agent can be taken up by the cells within the tissue fragment of the minced tissue suspension, or, in an alternative embodiment, the nucleic acid or viral agent can be taken up by the cells in the tissue surrounding the site of the injured tissue.
One skilled in the art will recognize that the protein produced can be a protein of the type noted above, or a similar protein that facilitates an enhanced capacity of the tissue to heal an injury or a disease, combat an infection, or reduce an inflammatory response.
Nucleic acids can also be used to block the expression of unwanted gene product that may impact negatively on a tissue repair process or other normal biological processes.
DNA, RNA and viral agents are often used to accomplish such an expression blocking function, which is also known as gene expression knock out.
One of ordinary skill in the art will appreciate that the identity of the bioactive agent may be determined by a surgeon, based on principles of medical science and the applicable treatment objectives. It is understood that the bioactive agent or effector of the issue repair implant can be incorporated within the tissue scaffold 52 before or after manufacture of the tissue scaffold 52, or before or after the surgical placement of the implant 50.
Prior to surgical placement, the tissue scaffold 52 can be placed in a suitable container comprising the bioactive agent. After an appropriate time and under suitable conditions, the scaffold 52 will become impregnated with the bioactive agent.
Alternatively, the bioactive agent can be incorporated within the scaffold 52 by, for example, using an appropriately gauged syringe to inject the biological agent(s) into the scaffold. Other methods well known to those of skilled in the art can be applied in order to load a scaffold 52 with an appropriate bioactive agent, such as mixing, pressing, spreading, centrifuging and placing the bioactive agent into the scaffold 52.
Alternatively, the bioactive agent can be mixed with a gel-like carrier prior to injection into the scaffold 52.

Following surgical placement, an implant wherein the biocompatible scaffold 52 is devoid of any bioactive agent can be infused with biological agent(s), or an implant wherein the scaffold includes at least one bioactive agent can be augmented with a supplemental quantity of the bioactive agent. One method of incorporating a bioactive agent within a surgically installed implant is by injection using an appropriately gauged syringe.
The amount of the bioactive agent included with a biocompatible scaffold 52 will vary depending on a variety of factors, including the size of the scaffold, the material from which the scaffold is made, the porosity of the scaffold, the identity of the biologically component, and the intended purpose of the tissue repair implant.
One skilled in the art can readily determine the appropriate quantity of bioactive agent to include within a biocompatible scaffold for a given application in order to facilitate and/or expedite the healing of tissue. The amount of bioactive agent will, of course, vary depending upon the identity of the bioactive agent and the given application.
The tissue repair implants of the present invention can be used in a variety of surgical and non-surgical applications. In some surgical applications, such as for use in the repair of a variety of tissues including a tom ligament, tendon, rotator cuff, nerve, skin, cartilage, or meniscus, the tissue implants of the invention must be able to be handled in the operating room, and they must be able to be sutured or otherwise fastened without tearing. Additionally, the implants should have a structure suitable to encourage tissue ingrowth.
In one embodiment of the present invention, the tissue repair implant is used in the treatment of a tissue injury, such as injury to a ligament, tendon, nerve, skin, cartilage or meniscus. Repairing tissue injuries involves the steps of obtaining a slice of living tissue 22 by any of the variety of techniques known to those skilled in the art, and placing the tissue slice 22 in a desired position relative to the tissue injury. While a single tissue slice 22 can be used, more than one tissue slice 22 can be joined together to form a layered implant 40 for implantation. Repairing tissue injuries may also involve depositing the tissue slice 22 onto a biocompatible, bioabsorbable tissue scaffold 52 such that the tissue slice 22 becomes associated with the scaffold 52 to form a tissue repair implant 50. A retaining element 30 can optionally be applied to secure the implant to the injury or defect 10. In an additional step, finely minced, tissue fragments can be applied to the implant to enhance the effectiveness of the regrowth and healing process.
The cells in both the tissue slices and minced tissue fragments can migrate out and begin proliferating and integrating with surrounding tissue at the site of implantation, thereby repairing the tissue injury. This method for repairing tissue injuries can include an additional, optional step. Prior to the step of placing the tissue repair implant in a desired position relative to the tissue injury, the scaffold and associated tissue particles can be incubated for a duration and under conditions effective to allow cells within the tissue particles to migrate from the tissue and begin populating the scaffold.
The implants used to repair injured tissue can be of a size and shape such that they match the geometry and dimensions of a desired portion or lesion of the tissue to be treated. The implant can be sized and shaped to produce the necessary geometry by numerous techniques including cutting, folding, rolling, or otherwise manipulating the implant. As noted above, the bioactive agent may be added to the scaffold during or after manufacture of the scaffold or before or after the implant is installed in a patient.
An additional quantity of the bioactive agent may be added after the implant is installed.
Once access is made into the affected anatomical site (whether by minimally invasive, open or mini-open surgical technique), the implant can be affixed to a desired position relative to the tissue injury, such as within a tear or lesion. Once the implant is placed in the desired position or lesion, it can be affixed by using an appropriate retaining element or other suitable technique. In one aspect, the implant can be affixed by a chemical and/or mechanical fastening technique. Suitable chemical fasteners include glues and/or adhesive such as fibrin glue, fibrin clot, and other known biologically compatible adhesives. Suitable mechanical fasteners include sutures, staples, tissue tacks, suture 25 anchors, darts, screws, pins and arrows. It is understood that combinations of one or more chemical and/or mechanical fasteners can be used. Alternatively, one need not use any chemical and/or mechanical fasteners. Instead, placement of the implant can be accomplished through an interference fit of the implant with an appropriate site in the tissue to be treated.
30 In one use, the tissue repair implant can be for repair and to augment tissue loss during tendon or ligament repair surgery or it can be used as a stand alone device. In the case of repair, tendon or ligament ends are approximated through appropriate surgical techniques and the tissue repair implant is used around the joined end to give more mechanical support and to enhance the healing response. As a result of the healing process, the tendon or ligament tissue grows within the implant device, eventually maturing into a tissue with similar mechanical properties to that of native tissue. The implant provides the mechanical support that is initially necessary to ensure proper healing, and it also serves as a guide for tissue regeneration. In another use as a stand alone device, the ruptured tissue is removed, and the tissue repair implant with sliced tissue serves to replace the function of the damaged tissue. In one embodiment, the ruptured tissue can be the tissue source used for healing damaged tissue.
In embodiments where the tissue repair implant is used to repair ligament tissue, the tissue repair implant can be used for tissue augmentation, or alternatively, as a stand-alone device. In embodiments where the tissue repair implant is used for augmentation, the tissue repair implant can be used in conjunction with any of a variety of standard, established repair techniques known to those skilled in the art. In embodiments where the tissue repair implant is used for augmentation during ACL repair, surgeons currently use an autograft consisting of ligament tissue, bone-patellar tendons, tendon-bone tendons, hamstring tendons, or iliotibial band to repair tissue, and the tissue repair implant of the present invention can be placed either around the autograft, surrounded by the autograft, or alongside the autograft. In embodiments where the tissue repair element is used as a stand-alone device, the ruptured ligament can be removed and completely replaced by the tissue repair implant. In this case, the tissue repair implant can be affixed to bone at each end of the implant. In the case of ACL repair, one end of the implant can be stabilized at the original origin site of the femur, while the other end can be placed at the original insertion site on the tibia.
The tissue repair implant can be utilized in a variety of configurations. For example, the implant can be composed of long pieces of tissue, folded or stacked in multiple laminates, or it can be rolled into the shape or a tube-like structure. Tendon or ligament ends can be joined, for example, by suturing, stapling, clipping, adhering, or anchoring, the implant to ends of the implant. In some embodiments where the tissue repair implant is used to repair tendons, such as for example, rotator cuff repair, the surgeon can use the tissue repair implant to assist in the reapproximation of the torn rotator cuff to a bony trough through the cortical surface of the greater tuberosity. Often times, in older patients, the rotator cuff tissue is thin and degenerate and/or the quality of the humerus is osteoporotic. Therefore, in order to increase the strength of the attachment to the bony trough, the tissue repair implant can be placed on top of the tendon, such that the sutures would pass through both the scaffold and tendon, or alternatively, the tissue repair implant can be used on top of the bone bridge to prevent the sutures from pulling out of the bone. In either embodiment, the tissue repair implant provides suture retention strength. In situations where the quality of the rotator cuff is so degenerate that the tissue cannot be reapproximated to the humerus, the tissue repair implant can serve as a bridge, wherein one end of the implant can be joined to the remaining tendon while the other end can be attached to the bone.
In another variation, the implant can be used to repair or replace the sheath of a tendon. To do so, the implant is sutured or otherwise joined to the connective tissue, such as the periosteum, synovium, or muscle, or wrapped around the tendon.
This construction allows free gliding of the tendon within the sheath formed by the implant.
The implant provides the necessary structural support following surgery. Over time, however, the implant in this embodiment can be resorbed and replaced by new tissue.
The implants of the invention can also be used for organ repair replacement or regeneration strategies that may benefit from these unique tissue implants.
For example, these implants can be used for spinal disc, cranial tissue, dura, nerve tissue, liver, pancreas, kidney, bladder, uterus, esophagus, liver spleen, cardiac muscle, skeletal muscle, skin, fascia, pelvic floor, stomach, tendons, cartilage, ligaments, and breast tissues.
The implants of the present invention can also be used as a delivery device for a therapeutic, wherein the therapeutic is the minced tissue, which includes a combination of cells, extracellular matrix and inherent growth factors. The scaffold portion of the implant can allow for hormones and proteins to be released into the surrounding environment.
The methods of repairing tissue injuries using the tissue implants according to the present invention can be conducted during a surgical operation to repair the tissue injury. In an exemplary method, a patient is prepared for tissue repair surgery in a conventional manner using conventional surgical techniques. Tissue repair is performed at the site of the defective or injured tissue 10 using the composite tissue implant 50 of the present invention. The tissue slice 22 used to form the tissue implant 50 is obtained from the patient (or another donor) using appropriate tools and techniques.
The tissue slice 22 is either harvested with a specified geometry suitable for the defect or injury 10 or cut into the specified geometry after harvest. The method of harvesting or cutting into the specified geometry can be done with a conventional sterile surgical instruments or a specially designed device. The prepared tissue slice is then applied to a tissue scaffold 52. The scaffold and tissue can then be implanted at the site of tissue injury using a retaining element 30 such as sutures, staples, an adhesive agent, mechanical force or any other fixation device. Final wound closure is performed in a conventional manner using conventional surgical techniques.
The following examples are illustrative of the principles and practice of this invention. Numerous additional embodiments within the scope and spirit of the invention will become apparent to those skilled in the art.

In this in vitro study, cellular migration and new matrix formation from minced and shredded bovine anterior cruciate ligament (ACL) tissue into non-woven tissue scaffold (PANACRYL) was evaluated and compared. Pre-scored and sterilized PANACRYL non-woven sheets were trimmed to yield two (2) 2.5 x 2 cm sheets.
Next, bovine ACL tissue samples were obtained from two knees from the same animal.
To prepare the shredded tissue, an isolated section of the bovine ACL was trimmed under aseptic conditions to measure approximately 2 x 2 x 0.5 cm in overall dimensions.
Using a sterile scalpel, multiple full thick incisions were made parallel to the fibers of the ACL section, yielding tissue strands measuring approximately 2 cm in length and 0.1 cm in maximum diameter. The tissue strands were placed parallel to the long axis of a PANACRYL sheet to form a composite implant. To prepare the control, minced ACL
tissue fragments were also applied to a sheet of PANACRYL. The minced tissue fragments were obtained by mincing the bovine ACL tissue sample using scalpel blades to obtain small tissue fragments. Both the composite implant and the control were placed in Dulbecco's modified eagles medium (DMEM), supplemented with 20%
fetal bovine serum (FBS). After 4 days and 21 days, a DNA assay was performed and the histology of the samples were evaluated.

= CA 02487042 2004-11-04 Results After 4 days and 21 days, the samples were prepared for histological evaluation.
Five-micron sections were obtained and adhered to glue coated slides. These sections were then stained with hematoxylin and eosin. In addition, the DNA content of each sample was obtained by assay using a Molecular Probes CyQUANT Cell Proliferation Assay kit (cat. no. C-7026). 5 mm bunch biopsy samples of the composite implant were obtained at day 4 and day 21. The samples were washed once in lx PBS and frozen at -20 C for at least one hour. The samples were then thawed at room temperature and incubated in 40 l of 4M Guanidine-HCL. I 0 .d of the guanidine digested sample was added to 190 I of CyQUANT GR working solution. The mixture was vortexed and incubated for 5 minutes, and then loaded into a 96-well black walled plate and analyzed by spectrophotometry. The results of the DNA assay are shown in Table 1 below.
In the control sample with the minced tissue, the cells within the minced tissue appeared viable after 4 days, while no cells were noted within the tissue scaffold. After 21 days, an evenly distributed sparse cell population was noted within the scaffold. The foci of what appeared to be early new matrix formation was noted along the tissue-scaffold junction.
In the shredded tissue implant, the cells within the shredded tissue appeared viable after 4 days, while no cells were observed within the tissue scaffold.
After 21 days, an evenly distributed sparse cell population was noted within the scaffold. The foci of what appeared to be early new matrix formation was noted along the tissue-scaffold junction.

Table 1. Comparison of DNA content in minced v. shredded tissue DNA assay:

ample DNA (mg) y4 y4 avg. day day 21 av Minced 442 4294 525 4853.66667 Shredded 1793 2033.333 240 2680.6666 The data from Table 1 is also graphically presented in FIG. 5 as a bar chart for ease of comparison.

Discussion As indicated by the histological evaluation of the samples, the cells of the shredded ACL tissue were able to migrate into the tissue scaffold and show early signs of matrix formation at 21 days. Shredded ACL tissue also appeared to function similarly to minced ACL tissue fragments in that both tissue geometries exhibited the same cell population and distribution profile at 21 days.
As indicated by the DNA assays performed, the relative increase in DNA content noted in the shredded ACL tissue appears similar to the increase in DNA
content noted in the minced ACL tissue. These results are consistent with the histological data.
It was concluded that sparse and evenly distributed cell migration and focal new matrix formation can be observed in PANACRYL non-woven scaffolds seeded with shredded bovine ACL tissue at 21 days. These results are similar to minced bovine ACL
tissue fragments seeded onto the same scaffold at 21 days.

In this in vitro study, sliced meniscal tissue was tested as a source of viable cells for meniscal regeneration. First, an isolated bovine meniscus was obtained and trimmed to remove the surrounding synovium. Using a sterile dermatome, slices of meniscus were removed. The thickness of the slices were either 200 pm, 300 pm or 500 pm. The slices were approximately 1 to 2 cm in length. The meniscal slices were seeded onto scaffolds comprising sterilized, 65:35 polyglycolic acid/poly caprolactone acide foam reinforced with polydioxone mesh at a density of 20 mg/cm2. The scaffolds measured 4 x 2.5 cm. Platelet rich plasma (PRP) was added to the scaffolds at a concentration of 20 pl/cm2 and the scaffolds cultured for 3 and 5 weeks in Dulbecco's modified eagles medium (DMEM) supplemented with 0.5% fetal bovine serum (FBS). After 3 and 5 weeks, the samples were prepared for histological evaluation. Sections of the samples were obtained and stained with hematoxylin and eosin.
Results FIGS. 6A and 6B demonstrate migration of viable fibrochondrocytes from tissue slices of 200 pm (FIG. 6A) and 300 pm thickness (FIG. 6B), at 3 weeks. FIG. 6C
shows similar cell migration from 500 pm thick tissue at 3 weeks. At 5 weeks, similar cell migration patterns were observed for each of the varying tissue slices.
Discussion The study shows that cells in the sliced meniscal tissue were viable and able to migrate into and populate tissue scaffolds associated with the sliced tissue.
In addition, the variation in thickness of the slices did not appear to have a qualitative difference in the cell population in the scaffolds.

In this in vitro study, minced tissue fragments were used in conjunction with mosaicplasty techniques to demonstrate that better integration between cartilage plugs can be achieved and cartilage repair of damaged tissue can be enhanced by the addition of minced cartilage fragments.
Healthy articular cartilage was obtained from bovine stifle. A 3 mm biopsy punch was used to punch cylinders or plugs of cartilage tissue. The rest of the cartilage tissue, which was substantially free of bone, was minced using scalpel blades to obtain small tissue fragments. The size of the tissue fragments varied but was less than or equal to I x 1 mm in dimension. Four 3 mm cartilage cylinders were placed together in parallel to each other longitudinally in a glass cylinder with an inner diameter of 8 mm.
In one group, a blood clot was then formed inside the glass cylinder to keep the tissues together. In another group, the minced cartilage tissue was placed in the glass cylinder with four 3 mm cartilage cylinders and then a blood clot was formed inside to keep everything together. The glass cylinders were slipped off and the tissue-clot was placed in culture in 6 well plates containing chondrocyte growth medium. The chondrocyte growth medium consisted of Dulbecco's modified eagles medium (DMEM-high glucose) supplemented with 10% fetal calf serum (FCS), 10 mM HEPES, 0.1 mM
nonessential amino acids, 20 mg/ml of L-proline, 50 mg/ml ascorbic acid, 100 mg/ml penicillin, 100 mg/ml of streptomycin. The growth medium was changed every other day. The tissues were cultured at 37 C in a cell culture incubator for six weeks.
Samples were removed, macroscopic pictures were taken, and then the samples were placed in formalin for histology. Sections were stained with H&E and Safranin-O. FIG.
7A is a photograph of the group with minced tissue which shows that all the tissues are held together. Histology of this sample confirmed that cells from both the minced tissue and cylinders were migrating into the space between the tissue cylinders, keeping the whole entity together (FIG. 7C). FIG. 7B is a photograph of the group without the minced tissue, showing that after 3 weeks in culture the cartilage cylinders began pulling away from each other because there was nothing that was bonding them together.
Discussion This study shows that the addition of minced cartilage fragments to closely associated cartilage plugs or cylinders can produce better cellular integration between the plugs. While cartilage cylinders were used in the present example, it is contemplated that the same mosaicplasty principles can be applied to the present invention to provide a tissue repair implant comprising tissue slices and minced tissue fragments for enhanced cellular integration and tissue repair.
One of ordinary skill in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.

Claims (24)

1. A biocompatible tissue implant for repairing a tissue injury or defect, comprising:
(a) an isolated cartilage tissue slice harvested from healthy tissue, the tissue slice having a geometry suitable for implantation at a tissue site, the cartilage tissue slice dimensioned and capable of acting as a cell source that allows viable cells to migrate out of the tissue slice and to proliferate and integrate with tissue at the tissue injury or defect;
and (b) at least one minced cartilage tissue fragment containing a plurality of viable cells that can migrate from the cartilage tissue fragment, wherein the at least one minced tissue fragment is combined with the isolated biological tissue slice.
2. The implant of claim 1, wherein the tissue slice comprises autogeneic tissue, allogeneic tissue, xenogeneic tissue, and combinations thereof.
3. The implant of claim 1, wherein the tissue slice has a thickness less than about 3 mm.
4. The implant of claim 3, wherein the tissue slice has a thickness less than about 1 mm.
5. The implant of claim 4, wherein the tissue slice has a thickness in the range of about 200 µm to about 500 µm.
6. The implant of claim 1, further including a plurality of tissue slices joined together to form a layered implant of a desired size and geometry.
7. The implant of claim 1, further including a retaining element for securing the tissue slice to the tissue site.
8. The implant of claim 7, wherein the retaining element is selected from the group consisting of fasteners, staples, tissue tacks, sutures, adhesives, and combinations thereof.
9. The implant of claim 8, wherein the retaining element is an adhesive selected from the group consisting of hyaluronic acid, fibrin glue, fibrin clot, collagen gel, collagen-based adhesive, alginate gel, crosslinked alginate, gelatin-resorcin-formalin-based adhesive, mussel-based adhesive, dihydroxyphenylalanine (DOPA)-based adhesive, chitosan, transglutaminase, poly(amino acid)-based adhesive, cellulose-based adhesive, polysaccharide-based adhesive, synthetic acrylate-based adhesives, platelet rich plasma (PRP), platelet poor plasma (PPP), PRP clot, PPP clot, blood, blood clot, polyethylene glycol-based adhesive, Matrigel.TM., Monostearoyl Glycerol co-Succinate (MGSA), Monostearoyl Glycerol co-Succinate/polyethylene glycol (MGSA/PEG) copolymers, laminin, elastin, proteoglycans, and combinations thereof.
10. The implant of claim 1, wherein the at least one minced cartilage tissue fragment is delivered in a biological or synthetic hydrogel selected from the group consisting of hyaluronic acid, fibrin glue, fibrin clot, collagen gel, collagen-based adhesive, alginate gel, crosslinked alginate, chitosan, synthetic acrylate-based gels, platelet rich plasma (PRP), platelet poor plasma (PPP), PRP clot, PPP clot, blood, blood clot, Matrigel.TM., agarose, chitin, chitosan, polysaccharides, poly(oxyalkylene), a copolymer of poly(ethylene oxide)-poly(propylene oxide), poly(vinyl alcohol), laminin, elastin, proteoglycans, solubilized basement membrane, or combinations thereof.
11. The implant of claim 1, wherein the at least one minced cartilage tissue fragment has a particle size in the range of about 0.1 mm3 to about 2 mm3.
12. The implant of claim 1, further including a biocompatible tissue scaffold.
13. The implant of claim 12, wherein the tissue scaffold is bioresorbable.
14. The implant of claim 12, wherein the tissue scaffold is formed from a material selected from the group consisting of a synthetic polymer, a natural polymer, an injectable gel, a ceramic material, autogeneic tissue, allogeneic tissue, xenogeneic tissue, and combinations thereof.
15. The implant of claim 12, wherein the scaffold further comprises at least one bioactive agent applied thereto.
16. The implant of claim 15, wherein the at least one bioactive agent is selected from the group consisting of growth factors, matrix proteins, peptides, antibodies, enzymes, platelets, platelet rich plasma, glycoproteins, hormones, glycosaminoglycans, nucleic acids, analgesics, viruses, virus particles, cytokines and isolated cells and combinations thereof.
17. The implant of claim 12, further including a plurality of tissue slices and a plurality of tissue scaffolds joined together to form a layered implant of a desired size and geometry.
18. The use of (i) an isolated cartilage tissue slice harvested from healthy tissue, having a geometry suitable for implantation at an injury or defect site, and capable of acting as a source of viable cells; and (ii) at least one minced cartilage tissue fragment containing a plurality of viable cells that can migrate from the tissue fragment; for repairing a tissue injury or defect, wherein the at least one minced cartilage tissue fragment is applied to the isolated cartilage tissue slice to form a biocompatible tissue implant for delivery to the tissue site to be repaired; and the cartilage tissue slice is securable to the tissue site, such that viable cells are able to migrate out of the biocompatible tissue implant to proliferate and integrate with tissue at the tissue site.
19. The use of claim 18, wherein the biocompatible tissue implant is in the form of a plurality of tissue slices joined together to form a layered implant of a desired size and geometry.
20. The use of claim 18, wherein the tissue slice is applied to a biocompatible tissue scaffold to form a composite implant, and the composite implant is deliverable to the tissue site to be repaired.
21. The use of claim 18, wherein a bioactive agent is applied to the implant.
22. The use of claim 21, wherein the bioactive agent is selected from the group consisting of growth factors, matrix proteins, peptides, antibodies, enzymes, platelets, platelet rich plasma, glycoproteins, hormones, glycosaminoglycans, nucleic acids, analgesics, viruses, virus particles, cytokines and isolated cells and combinations thereof.
23. The use of claim 18, wherein the biocompatible tissue implant is securable to the tissue site using a retaining element selected from the group consisting of fasteners, staples, tissue tacks, sutures, adhesives, and combinations thereof.
24. The use of claim 18, wherein the at least one minced cartilage tissue fragment is applied in a biological or synthetic hydrogel selected from the group consisting of hyaluronic acid, fibrin glue, fibrin clot, collagen gel, collagen-based adhesive, alginate gel, crosslinked alginate, chitosan, synthetic acrylate-based gels, platelet rich plasma (PRP), platelet poor plasma (PPP), PRP clot, PPP clot, blood, blood clot, Matrigel.TM., agarose, chitin, chitosan, polysaccharides, poly(oxyalkylene), a copolymer of poly(ethylene oxide)-poly(propylene oxide), poly(vinyl alcohol), laminin, elastin, proteoglycans, solubilized basement membrane, or combinations thereof.
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Families Citing this family (168)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6964685B2 (en) 1999-06-22 2005-11-15 The Brigham And Women's Hospital, Inc. Biologic replacement for fibrin clot
US6179840B1 (en) 1999-07-23 2001-01-30 Ethicon, Inc. Graft fixation device and method
US20020095157A1 (en) 1999-07-23 2002-07-18 Bowman Steven M. Graft fixation device combination
CA2365376C (en) 2000-12-21 2006-03-28 Ethicon, Inc. Use of reinforced foam implants with enhanced integrity for soft tissue repair and regeneration
US20040078090A1 (en) * 2002-10-18 2004-04-22 Francois Binette Biocompatible scaffolds with tissue fragments
US7824701B2 (en) * 2002-10-18 2010-11-02 Ethicon, Inc. Biocompatible scaffold for ligament or tendon repair
US8197837B2 (en) 2003-03-07 2012-06-12 Depuy Mitek, Inc. Method of preparation of bioabsorbable porous reinforced tissue implants and implants thereof
US7794408B2 (en) 2003-03-28 2010-09-14 Ethicon, Inc. Tissue collection device and methods
US7067123B2 (en) 2003-04-29 2006-06-27 Musculoskeletal Transplant Foundation Glue for cartilage repair
US7901457B2 (en) 2003-05-16 2011-03-08 Musculoskeletal Transplant Foundation Cartilage allograft plug
US8226715B2 (en) 2003-06-30 2012-07-24 Depuy Mitek, Inc. Scaffold for connective tissue repair
US10583220B2 (en) 2003-08-11 2020-03-10 DePuy Synthes Products, Inc. Method and apparatus for resurfacing an articular surface
US7611473B2 (en) * 2003-09-11 2009-11-03 Ethicon, Inc. Tissue extraction and maceration device
US8034003B2 (en) 2003-09-11 2011-10-11 Depuy Mitek, Inc. Tissue extraction and collection device
US7316822B2 (en) 2003-11-26 2008-01-08 Ethicon, Inc. Conformable tissue repair implant capable of injection delivery
US7901461B2 (en) 2003-12-05 2011-03-08 Ethicon, Inc. Viable tissue repair implants and methods of use
WO2005058207A1 (en) 2003-12-11 2005-06-30 Isto Technologies, Inc. Particulate cartilage system
US11395865B2 (en) 2004-02-09 2022-07-26 DePuy Synthes Products, Inc. Scaffolds with viable tissue
US7767221B2 (en) * 2004-03-05 2010-08-03 The Trustees Of Columbia University In The City Of New York Multi-phased, biodegradable and osteointegrative composite scaffold for biological fixation of musculoskeletal soft tissue to bone
US8657881B2 (en) 2004-04-20 2014-02-25 Depuy Mitek, Llc Meniscal repair scaffold
US8137686B2 (en) 2004-04-20 2012-03-20 Depuy Mitek, Inc. Nonwoven tissue scaffold
US8221780B2 (en) 2004-04-20 2012-07-17 Depuy Mitek, Inc. Nonwoven tissue scaffold
US7837740B2 (en) * 2007-01-24 2010-11-23 Musculoskeletal Transplant Foundation Two piece cancellous construct for cartilage repair
ITPD20040312A1 (en) 2004-12-15 2005-03-15 Fidia Advanced Biopolymers Srl PROSTHESIS AND SUPPORT FOR REPLACEMENT, REPAIR, REGENERATION OF THE MENISCUS
JP2008529663A (en) * 2005-02-09 2008-08-07 チルドレンズ メディカル センター コーポレイション Devices that mix and deliver fluids for tissue recovery
US7686820B2 (en) 2005-04-14 2010-03-30 Ethicon Endo-Surgery, Inc. Surgical clip applier ratchet mechanism
US8523882B2 (en) 2005-04-14 2013-09-03 Ethicon Endo-Surgery, Inc. Clip advancer mechanism with alignment features
US7740641B2 (en) 2005-04-14 2010-06-22 Ethicon Endo-Surgery, Inc. Clip applier with migrational resistance features
US7297149B2 (en) 2005-04-14 2007-11-20 Ethicon Endo-Surgery, Inc. Surgical clip applier methods
US7261724B2 (en) 2005-04-14 2007-08-28 Ethicon Endo-Surgery, Inc. Surgical clip advancement mechanism
US8038686B2 (en) 2005-04-14 2011-10-18 Ethicon Endo-Surgery, Inc. Clip applier configured to prevent clip fallout
US7288098B2 (en) 2005-04-14 2007-10-30 Ethicon Endo-Surgery, Inc. Force limiting mechanism for medical instrument
US7879103B2 (en) 2005-04-15 2011-02-01 Musculoskeletal Transplant Foundation Vertebral disc repair
WO2007007062A2 (en) * 2005-07-08 2007-01-18 Depuy International Limited Cartilage repair implant
US7815926B2 (en) 2005-07-11 2010-10-19 Musculoskeletal Transplant Foundation Implant for articular cartilage repair
US20070020620A1 (en) * 2005-07-14 2007-01-25 Finn M G Compositions and methods for coupling a plurality of compounds to a scaffold
EP1916964A4 (en) 2005-08-26 2015-11-04 Zimmer Inc Implants and methods for repair, replacement and treatment of joint disease
US7799087B2 (en) * 2005-08-31 2010-09-21 Zimmer Gmbh Implant
US7797056B2 (en) * 2005-09-06 2010-09-14 Nmt Medical, Inc. Removable intracardiac RF device
US8202306B2 (en) * 2005-09-12 2012-06-19 Arthrex, Inc. Mesh reinforced tissue anchor
WO2007035778A2 (en) 2005-09-19 2007-03-29 Histogenics Corporation Cell-support matrix and a method for preparation thereof
US8308807B2 (en) * 2005-11-09 2012-11-13 Zimmer, Gmbh Implant with differential anchoring
US20070112360A1 (en) * 2005-11-15 2007-05-17 Patrick De Deyne Bioprosthetic device
US20090306776A1 (en) 2006-01-25 2009-12-10 Children's Medical Center Corporation Methods and procedures for ligament repair
US20070179607A1 (en) * 2006-01-31 2007-08-02 Zimmer Technology, Inc. Cartilage resurfacing implant
US20090048679A1 (en) * 2006-02-09 2009-02-19 Zimmer Gmbh Implant
US20080038236A1 (en) * 2006-03-06 2008-02-14 Artecel Sciences, Inc. Biocompatible scaffolds and adipose-derived stem cells
US20070250164A1 (en) * 2006-04-21 2007-10-25 Biomet Manufacturing Corp. Method for grafting whole superficial articular cartilage
WO2007125060A1 (en) * 2006-04-28 2007-11-08 Zimmer Gmbh Implant
EP2076220A2 (en) 2006-07-25 2009-07-08 Musculoskeletal Transplant Foundation Packed demineralized cancellous tissue forms for disc nucleus augmentation, restoration, or replacement and methods of implantation
CA2664866C (en) 2006-09-28 2018-08-14 Children's Medical Center Coporation Methods and collagen products for tissue repair
US8163549B2 (en) * 2006-12-20 2012-04-24 Zimmer Orthobiologics, Inc. Method of obtaining viable small tissue particles and use for tissue repair
US20100136082A1 (en) * 2006-12-22 2010-06-03 Laboratoire Medidom S.A. In situ system for intra-articular chondral and osseous tissue repair
US8764828B2 (en) 2007-02-02 2014-07-01 The Regents Of The University Of Michigan System and method for forming bone, ligament, and bone-ligament constructs
CA2618125A1 (en) * 2007-02-08 2008-08-08 Zimmer, Inc. Hydrogel proximal interphalangeal implant
US9056151B2 (en) * 2007-02-12 2015-06-16 Warsaw Orthopedic, Inc. Methods for collagen processing and products using processed collagen
US8753391B2 (en) * 2007-02-12 2014-06-17 The Trustees Of Columbia University In The City Of New York Fully synthetic implantable multi-phased scaffold
US8435551B2 (en) 2007-03-06 2013-05-07 Musculoskeletal Transplant Foundation Cancellous construct with support ring for repair of osteochondral defects
EP2139400B1 (en) * 2007-03-30 2011-01-12 Smith & Nephew, Inc. Tissue harvesting
AU2008240191B2 (en) 2007-04-12 2013-09-19 Zimmer, Inc. Compositions and methods for tissue repair
WO2009009620A2 (en) 2007-07-10 2009-01-15 Lifecell Corporation Acellular tissue matrix compositions for tissue repair
US8979935B2 (en) * 2007-07-31 2015-03-17 Zimmer, Inc. Joint space interpositional prosthetic device with internal bearing surfaces
US20090098092A1 (en) * 2007-08-11 2009-04-16 Meredith Thomas L Composite Bone Material and Method of Making and Using Same
WO2009042768A1 (en) * 2007-09-25 2009-04-02 University Of Pittsburgh-Of The Commonwealth System Of Higher Education Triggerably dissolvable hollow fibers for controlled delivery
WO2009111069A1 (en) 2008-03-05 2009-09-11 Musculoskeletal Transplant Foundation Cancellous constructs, cartilage particles and combinations of cancellous constructs and cartilage particles
US8152846B2 (en) * 2008-03-06 2012-04-10 Musculoskeletal Transplant Foundation Instrumentation and method for repair of meniscus tissue
TWI496566B (en) * 2008-12-30 2015-08-21 Ind Tech Res Inst Artificial dura biomedical device
US20100274362A1 (en) * 2009-01-15 2010-10-28 Avner Yayon Cartilage particle tissue mixtures optionally combined with a cancellous construct
WO2010096824A1 (en) * 2009-02-23 2010-08-26 Bartee Barry K Reinforced ptfe medical barrier
US8241298B2 (en) 2009-03-27 2012-08-14 Depuy Mitek, Inc. Methods and devices for delivering and affixing tissue scaffolds
US8308814B2 (en) 2009-03-27 2012-11-13 Depuy Mitek, Inc. Methods and devices for preparing and implanting tissue scaffolds
NL2002742C2 (en) * 2009-04-09 2010-10-12 Univ Delft Tech Mechanical device for tissue regeneration.
DE102009021003A1 (en) * 2009-05-12 2010-11-18 Centrotherm Sitec Gmbh Process and apparatus for providing liquid silicon
FR2949688B1 (en) * 2009-09-04 2012-08-24 Sofradim Production FABRIC WITH PICOTS COATED WITH A BIORESORBABLE MICROPOROUS LAYER
US8262679B2 (en) 2009-10-09 2012-09-11 Ethicon Endo-Surgery, Inc. Clip advancer
US8267945B2 (en) 2009-10-09 2012-09-18 Ethicon Endo-Surgery, Inc. Clip advancer with lockout mechanism
EP2501392B1 (en) * 2009-11-19 2018-09-19 Ortho Regenerative Technologies Inc. Soluble physiological chitosan formulations combined with platelet-rich plasma (prp) for tissue repair
US8597317B2 (en) 2009-12-11 2013-12-03 Taipei Medical University Method for repair of articular cartilage defect and a device used therein
TW201119659A (en) * 2009-12-11 2011-06-16 Univ Taipei Medical Composition for treating articular defect and method thereof
US9307980B2 (en) 2010-01-22 2016-04-12 4Tech Inc. Tricuspid valve repair using tension
US10058323B2 (en) 2010-01-22 2018-08-28 4 Tech Inc. Tricuspid valve repair using tension
US8475525B2 (en) 2010-01-22 2013-07-02 4Tech Inc. Tricuspid valve repair using tension
US8444699B2 (en) * 2010-02-18 2013-05-21 Biomet Manufacturing Corp. Method and apparatus for augmenting bone defects
US8337415B2 (en) * 2010-02-22 2012-12-25 Devicor Medical Products, Inc. Tissue harvesting, mincing, and transport device
JPWO2011105540A1 (en) * 2010-02-26 2013-06-20 三菱重工業株式会社 Composite repair method and composite material using the same
WO2011115612A1 (en) * 2010-03-15 2011-09-22 Peridyne Medical, Llc Thin collagen tissue for medical device applications
US9211361B2 (en) * 2010-03-15 2015-12-15 Kemal Schankereli Thin collagen tissue for medical device applications
EP3730163A1 (en) * 2010-03-25 2020-10-28 LifeCell Corporation Preparation of regenerative tissue scaffolds
US8646674B2 (en) * 2010-05-11 2014-02-11 Ethicon Endo-Surgery, Inc. Methods and apparatus for delivering tissue treatment compositions to stapled tissue
US8535239B2 (en) 2010-05-11 2013-09-17 Ethicon Endo-Surgery, Inc. Tissue harvesting device with manual dicing mechanism
US8974400B2 (en) 2010-05-11 2015-03-10 Ethicon Endo-Surgery, Inc. Instrument for applying therapeutic cells, with distal portion for processing therapeutic cells
US8286899B2 (en) 2010-05-11 2012-10-16 Ethicon Endo-Surgery, Inc. Tissue dicing and particle separation device
US8349255B2 (en) 2010-05-11 2013-01-08 Ethicon Endo-Surgery, Inc. Tissue processing system and method
US8641641B2 (en) 2010-05-11 2014-02-04 Ethicon Endo-Surgery, Inc. Instrument for applying therapeutic cells, with proximal portion for processing therapeutic cells
US9138210B2 (en) 2010-05-11 2015-09-22 Ethicon Endo-Surgery, Inc. Fistula cleaning and repair device and method
US8464925B2 (en) * 2010-05-11 2013-06-18 Ethicon Endo-Surgery, Inc. Methods and apparatus for delivering tissue treatment compositions to stapled tissue
US8986331B2 (en) 2010-05-12 2015-03-24 Ethicon Endo-Surgery, Inc. Instrument for debriding fistula and applying therapeutic cells
US8858546B2 (en) 2010-05-12 2014-10-14 Ethicon Endo-Surgery, Inc. Instrument for debriding fistula and applying therapeutic cells
US8714360B2 (en) 2010-05-12 2014-05-06 Ethicon Endo-Surgery, Inc. Tissue processing device with ultrasonic tissue particle separator
US8468891B2 (en) 2010-05-12 2013-06-25 Ethicon Endo-Surgery, Inc. Tissue processing device with ultrasonic measuring chamber
US20110282368A1 (en) 2010-05-12 2011-11-17 Swayze Jeffrey S Fistula Repair Device with Extendable Barbs and Therapeutic Cell Delivery
US8702644B2 (en) 2010-05-13 2014-04-22 Ethicon Endo-Surgery, Inc. Instrument for debriding tissue and applying therapeutic cells
US8568446B2 (en) 2010-05-13 2013-10-29 Ethicon Endo-Surgery, Inc. Multi-chamber therapeutic cell applicator instrument
US8491526B2 (en) 2010-05-13 2013-07-23 Ethicon Endo-Surgery, Inc. Therapeutic cell applicator instrument with modular tips
US8491497B2 (en) 2010-05-13 2013-07-23 Ethicon Endo-Surgery, Inc. Method and apparatus for morcellating tissue
US8486155B2 (en) 2010-05-13 2013-07-16 Ethicon Endo-Surgery, Inc. Fistula repair plug having multiple layers
US10130736B1 (en) 2010-05-14 2018-11-20 Musculoskeletal Transplant Foundation Tissue-derived tissuegenic implants, and methods of fabricating and using same
US8883210B1 (en) 2010-05-14 2014-11-11 Musculoskeletal Transplant Foundation Tissue-derived tissuegenic implants, and methods of fabricating and using same
US9352003B1 (en) 2010-05-14 2016-05-31 Musculoskeletal Transplant Foundation Tissue-derived tissuegenic implants, and methods of fabricating and using same
CA2807762C (en) 2010-08-13 2023-08-08 Wake Forest University Health Sciences Methods for making a tissue engineered muscle repair (temr) construct in vitro for implantation in vivo
US8668739B2 (en) 2010-08-20 2014-03-11 Zimmer, Inc. Unitary orthopedic implant
US8968725B2 (en) * 2010-12-02 2015-03-03 University Of Vermont And State Agricultural College Genipin cross-linked fibrin gels
DE102011002536A1 (en) * 2011-01-11 2012-07-12 Aesculap Ag Packaging containing a medical product for the treatment of human or animal cartilage damage
CA2832838C (en) 2011-04-14 2019-08-13 Lifecell Corporation Regenerative tissue matrix flakes
US8834928B1 (en) 2011-05-16 2014-09-16 Musculoskeletal Transplant Foundation Tissue-derived tissugenic implants, and methods of fabricating and using same
GB201113303D0 (en) 2011-08-02 2011-09-14 Xiros Ltd Connective tissue repair pad
EP2768418B1 (en) 2011-10-19 2017-07-19 Ethicon Endo-Surgery, Inc. Clip applier adapted for use with a surgical robot
US9162011B2 (en) 2011-12-19 2015-10-20 Allosource Flowable matrix compositions and methods
WO2013116744A1 (en) 2012-02-01 2013-08-08 Children's Medical Center Corporation Biomaterial for articular cartilage maintenance and treatment of arthritis
US9204959B2 (en) * 2012-02-02 2015-12-08 Smith & Nephew, Inc. Implantable biologic holder
US20130304209A1 (en) * 2012-05-11 2013-11-14 Arthrex, Inc. Biologic partial meniscus and method of preparation
US8961594B2 (en) * 2012-05-31 2015-02-24 4Tech Inc. Heart valve repair system
WO2014032748A1 (en) * 2012-08-31 2014-03-06 Eth Zurich Process of cartilage repair
US20140094830A1 (en) * 2012-09-28 2014-04-03 Covidien Lp Porous Substrate with Ferromagnetic Darts
EP2919794B1 (en) 2012-11-15 2021-01-20 AlloSource Minced cartilage systems and methods
US20140178343A1 (en) 2012-12-21 2014-06-26 Jian Q. Yao Supports and methods for promoting integration of cartilage tissue explants
US9788948B2 (en) 2013-01-09 2017-10-17 4 Tech Inc. Soft tissue anchors and implantation techniques
EP2951193A4 (en) 2013-02-01 2017-03-01 Children's Medical Center Corporation Collagen scaffolds
GB201301784D0 (en) 2013-02-01 2013-03-20 Xiros Ltd Connective tissue repair technology
GB201302114D0 (en) * 2013-02-06 2013-03-20 Xiros Ltd Connective tissue repair
KR102215401B1 (en) * 2013-02-22 2021-02-10 알로소스 Cartilage mosaic compositions and methods
CN105208978B (en) 2013-03-14 2016-12-07 4科技有限公司 There is the support of tether interface
CA2899713C (en) 2013-03-15 2022-07-19 Allosource Cell repopulated collagen matrix for soft tissue repair and regeneration
US9168140B2 (en) 2013-03-15 2015-10-27 Allosource Perforated osteochondral allograft compositions
WO2014169249A1 (en) 2013-04-12 2014-10-16 The Trustees Of Columbia University In The City Of New York Methods for host cell homing and dental pulp regeneration
AU2014296259B2 (en) 2013-07-30 2017-04-27 Musculoskeletal Transplant Foundation Acellular soft tissue-derived matrices and methods for preparing same
WO2015063580A2 (en) 2013-10-30 2015-05-07 4Tech Inc. Multiple anchoring-point tension system
US10052095B2 (en) 2013-10-30 2018-08-21 4Tech Inc. Multiple anchoring-point tension system
US9801720B2 (en) 2014-06-19 2017-10-31 4Tech Inc. Cardiac tissue cinching
WO2016027383A1 (en) * 2014-08-19 2016-02-25 National University Corporation Hokkaido University Composite comprising fabric and polyampholyte hydrogel and preparation method thereof
US10279081B2 (en) * 2014-10-24 2019-05-07 Allosource Composite grafts, systems, and methods
EP3217921A1 (en) * 2014-11-13 2017-09-20 Antonio Sambusseti Elastic device for reconstructing rotator cuffs
WO2016075652A1 (en) 2014-11-13 2016-05-19 Antonio Sambusseti Resorbable device for reconstructing rotator cuffs
TWI716365B (en) * 2014-11-13 2021-01-21 德商梅茲製藥有限兩合公司 Injectable dermal filler composition, a kit comprising the same, a method for preparing the same, and a use thereof
JP6717820B2 (en) 2014-12-02 2020-07-08 4テック インコーポレイテッド Eccentric tissue anchor
US10077420B2 (en) 2014-12-02 2018-09-18 Histogenics Corporation Cell and tissue culture container
US10524774B2 (en) 2015-04-02 2020-01-07 Arthrex, Inc. Method of repairing cartilage defects
US10531957B2 (en) 2015-05-21 2020-01-14 Musculoskeletal Transplant Foundation Modified demineralized cortical bone fibers
US10524775B2 (en) 2015-07-02 2020-01-07 Arthrex, Inc. Methods of repairing cartilage defects
US10912864B2 (en) 2015-07-24 2021-02-09 Musculoskeletal Transplant Foundation Acellular soft tissue-derived matrices and methods for preparing same
US11052175B2 (en) 2015-08-19 2021-07-06 Musculoskeletal Transplant Foundation Cartilage-derived implants and methods of making and using same
US11583613B2 (en) 2016-03-03 2023-02-21 University of Pittsburgh—of the Commonwealth System of Higher Education Hydrogel systems for skeletal interfacial tissue regeneration applied to epiphyseal growth plate repair
DE102016116387A1 (en) 2016-09-01 2018-03-01 Karl Leibinger Medizintechnik Gmbh & Co. Kg Fiber-reinforced bioresorbable implant and method for its production
CN111544652A (en) * 2017-01-30 2020-08-18 生命细胞公司 Transglutaminase-treated products
US10821205B2 (en) 2017-10-18 2020-11-03 Lifecell Corporation Adipose tissue products and methods of production
US11123375B2 (en) 2017-10-18 2021-09-21 Lifecell Corporation Methods of treating tissue voids following removal of implantable infusion ports using adipose tissue products
US11246994B2 (en) 2017-10-19 2022-02-15 Lifecell Corporation Methods for introduction of flowable acellular tissue matrix products into a hand
CA3075106A1 (en) 2017-10-19 2019-04-25 Lifecell Corporation Flowable acellular tissue matrix products and methods of production
US11458012B2 (en) * 2018-06-07 2022-10-04 The Regents Of The University Of Michigan Scaffold for nasal tissue engineering
US20210213170A1 (en) * 2018-06-13 2021-07-15 University Of Pittsburgh - Of The Commonwealth System Of Higher Education Bone regeneration in compromised wounds
KR20210073543A (en) * 2018-10-03 2021-06-18 이스타블리쉬먼트 렙스 에스.에이. Scaffolding for implantable medical devices and methods of use thereof
JP7323909B2 (en) 2019-02-25 2023-08-09 株式会社リメディオ medical sheet
WO2020243497A1 (en) 2019-05-30 2020-12-03 Lifecell Corporation Biologic breast implant
CN110772669A (en) * 2019-11-04 2020-02-11 中南大学湘雅三医院 Biological ink for 3D printing of artificial skin
US20210236693A1 (en) * 2020-01-30 2021-08-05 SDIP Innovations Pty Ltd Bioresorbable implant with inside-out resorption for enhanced bone ingrowth and tissue integration and method of manufacturing thereof
CN112989657B (en) * 2021-03-05 2022-05-03 海洋石油工程(青岛)有限公司 Bolt pretightening force calculation method based on flange joint assembly
CN113198045B (en) * 2021-04-29 2022-03-11 武汉纺织大学 Fitting type biological valve and preparation method thereof
FR3124067B1 (en) * 2021-06-17 2023-05-26 Palingen Implantable device comprising external mobilization means for the formation of articular cartilage

Family Cites Families (269)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US224226A (en) 1880-02-03 Frank rhind
US259260A (en) 1882-06-06 Adolf baeyer
US206200A (en) 1878-07-23 Improvement in fountain-pen holders
GB1008193A (en) 1961-03-01 1965-10-27 Ethicon Inc Improvements in or relating to surgical implants
US3272204A (en) * 1965-09-22 1966-09-13 Ethicon Inc Absorbable collagen prosthetic implant with non-absorbable reinforcing strands
US3857932A (en) 1970-09-09 1974-12-31 F Gould Dry hydrophilic acrylate or methacrylate polymer prolonged release drug implants
US3739402A (en) * 1970-10-15 1973-06-19 Cutter Lab Bicuspid fascia lata valve
US3812017A (en) 1972-07-26 1974-05-21 Kennecott Copper Corp Desulfurized char with phosphoric acid
US4057537A (en) 1975-01-28 1977-11-08 Gulf Oil Corporation Copolymers of L-(-)-lactide and epsilon caprolactone
US4045418A (en) 1975-01-28 1977-08-30 Gulf Oil Corporation Copolymers of D,L-lactide and epsilon caprolactone
US4130689A (en) 1976-06-11 1978-12-19 International Paper Company Production of high strength hollow rayon fibers
US4141087A (en) 1977-01-19 1979-02-27 Ethicon, Inc. Isomorphic copolyoxalates and sutures thereof
US4208511A (en) 1977-01-19 1980-06-17 Ethicon, Inc. Isomorphic copolyoxalates and sutures thereof
US4105034A (en) 1977-06-10 1978-08-08 Ethicon, Inc. Poly(alkylene oxalate) absorbable coating for sutures
US4205399A (en) 1977-06-13 1980-06-03 Ethicon, Inc. Synthetic absorbable surgical devices of poly(alkylene oxalates)
US4140678A (en) 1977-06-13 1979-02-20 Ethicon, Inc. Synthetic absorbable surgical devices of poly(alkylene oxalates)
US4130639A (en) * 1977-09-28 1978-12-19 Ethicon, Inc. Absorbable pharmaceutical compositions based on isomorphic copolyoxalates
US4344193A (en) * 1980-11-28 1982-08-17 Kenny Charles H Meniscus prosthesis
US4553272A (en) 1981-02-26 1985-11-19 University Of Pittsburgh Regeneration of living tissues by growth of isolated cells in porous implant and product thereof
US4585458A (en) 1981-06-10 1986-04-29 Kurland Kenneth Z Means and method of implanting bioprosthetics
US4520821A (en) 1982-04-30 1985-06-04 The Regents Of The University Of California Growing of long-term biological tissue correction structures in vivo
US4801299A (en) 1983-06-10 1989-01-31 University Patents, Inc. Body implants of extracellular matrix and means and methods of making and using such implants
EP0145492A3 (en) 1983-12-15 1987-01-21 A.W.Showell (Surgicraft) Limited Replacements for ligaments and tendons
US4609551A (en) 1984-03-20 1986-09-02 Arnold Caplan Process of and material for stimulating growth of cartilage and bony tissue at anatomical sites
US4837285A (en) 1984-03-27 1989-06-06 Medimatrix Collagen matrix beads for soft tissue repair
US4597766A (en) 1984-10-26 1986-07-01 American Hospital Supply Corporation Implantable bioprosthetic tendons and ligaments
CH665768A5 (en) 1985-05-03 1988-06-15 Sulzer Ag ARTIFICIAL TAPE MADE OF TEXTILE HOSE.
US5061281A (en) 1985-12-17 1991-10-29 Allied-Signal Inc. Bioresorbable polymers and implantation devices thereof
US5904717A (en) 1986-01-28 1999-05-18 Thm Biomedical, Inc. Method and device for reconstruction of articular cartilage
US6005161A (en) 1986-01-28 1999-12-21 Thm Biomedical, Inc. Method and device for reconstruction of articular cartilage
US5266480A (en) 1986-04-18 1993-11-30 Advanced Tissue Sciences, Inc. Three-dimensional skin culture system
US5902741A (en) 1986-04-18 1999-05-11 Advanced Tissue Sciences, Inc. Three-dimensional cartilage cultures
US5863531A (en) 1986-04-18 1999-01-26 Advanced Tissue Sciences, Inc. In vitro preparation of tubular tissue structures by stromal cell culture on a three-dimensional framework
US5736372A (en) 1986-11-20 1998-04-07 Massachusetts Institute Of Technology Biodegradable synthetic polymeric fibrous matrix containing chondrocyte for in vivo production of a cartilaginous structure
US5041138A (en) 1986-11-20 1991-08-20 Massachusetts Institute Of Technology Neomorphogenesis of cartilage in vivo from cell culture
DE3644588C1 (en) 1986-12-27 1988-03-10 Ethicon Gmbh Implant and process for its manufacture
NL8700113A (en) 1987-01-19 1988-08-16 Groningen Science Park INK, SUITABLE FOR TREATMENT BY RECONSTRUCTIVE SURGERY, WITH TISSUE-SPECIFIC POROSITY, AND METHOD FOR MANUFACTURING THE ENTAGMENT.
US5425766A (en) 1987-03-09 1995-06-20 Astra Tech Aktiebolag Resorbable prosthesis
US5681353A (en) 1987-07-20 1997-10-28 Regen Biologics, Inc. Meniscal augmentation device
US5007934A (en) * 1987-07-20 1991-04-16 Regen Corporation Prosthetic meniscus
US5306311A (en) 1987-07-20 1994-04-26 Regen Corporation Prosthetic articular cartilage
US5263984A (en) 1987-07-20 1993-11-23 Regen Biologics, Inc. Prosthetic ligaments
US5078744A (en) * 1987-09-04 1992-01-07 Bio-Products, Inc. Method of using tendon/ligament substitutes composed of long, parallel, non-antigenic tendon/ligament fibers
SU1535542A1 (en) 1987-11-18 1990-01-15 Всесоюзный Научно-Исследовательский Институт Глазных Болезней Method of treating secondary graucoma
GB8803697D0 (en) 1988-02-17 1988-03-16 Deltanine Research Ltd Clinical developments using amniotic membrane cells
US5053050A (en) 1988-04-29 1991-10-01 Samuel Itay Compositions for repair of cartilage and bone
US4902508A (en) 1988-07-11 1990-02-20 Purdue Research Foundation Tissue graft composition
US4917700A (en) 1988-08-01 1990-04-17 Zimmer, Inc. Prosthetic ligament
US4938763B1 (en) 1988-10-03 1995-07-04 Atrix Lab Inc Biodegradable in-situ forming implants and method of producing the same
US5258028A (en) * 1988-12-12 1993-11-02 Ersek Robert A Textured micro implants
US5147400A (en) 1989-05-10 1992-09-15 United States Surgical Corporation Connective tissue prosthesis
US5487897A (en) 1989-07-24 1996-01-30 Atrix Laboratories, Inc. Biodegradable implant precursor
US4946377A (en) 1989-11-06 1990-08-07 W. L. Gore & Associates, Inc. Tissue repair device
GB8928250D0 (en) 1989-12-14 1990-02-21 Erba Carlo Spa Use of supercritical fluids to obtain porous sponges of biodegradable polymers
EP0447355A1 (en) 1990-03-12 1991-09-18 Gebrüder Sulzer Aktiengesellschaft Implant for the human body
US5108989A (en) 1990-04-04 1992-04-28 Genentech, Inc. Method of predisposing mammals to accelerated tissue repair
US5269785A (en) 1990-06-28 1993-12-14 Bonutti Peter M Apparatus and method for tissue removal
FR2667246A1 (en) 1990-10-02 1992-04-03 Imedex BIOMATERIAL BASED ON COLLAGEN AND APPLICATIONS.
US5654135A (en) * 1990-10-02 1997-08-05 Imedex, Societe Anonyme Biomaterial based on collagen and its application
US6197325B1 (en) 1990-11-27 2001-03-06 The American National Red Cross Supplemented and unsupplemented tissue sealants, methods of their production and use
US6054122A (en) 1990-11-27 2000-04-25 The American National Red Cross Supplemented and unsupplemented tissue sealants, methods of their production and use
US5206023A (en) 1991-01-31 1993-04-27 Robert F. Shaw Method and compositions for the treatment and repair of defects or lesions in cartilage
FR2679250B1 (en) 1991-07-19 1995-07-13 Inoteb USE OF POROUS CALCIUM CARBONATE AS A SUPPORT MATERIAL FOR THE IN VITRO CULTURE OF EUKARYOTIC CELLS.
US6773458B1 (en) * 1991-07-24 2004-08-10 Baxter International Inc. Angiogenic tissue implant systems and methods
FR2679778B1 (en) 1991-08-02 1995-07-07 Coletica USE OF CROLAGEN CROSSLINKED BY A CROSSLINKING AGENT FOR THE MANUFACTURE OF A SLOW RESORPTIVE, BIOCOMPATIBLE, SUTURABLE MEMBRANE, AS WELL AS SUCH A MEMBRANE.
US5281422A (en) 1991-09-24 1994-01-25 Purdue Research Foundation Graft for promoting autogenous tissue growth
US5681572A (en) 1991-10-18 1997-10-28 Seare, Jr.; William J. Porous material product and process
IT1254170B (en) 1991-12-18 1995-09-11 Mini Ricerca Scient Tecnolog COMPOSITE MEMBRANES FOR GUIDED REGENERATION OF FABRICS
US6537574B1 (en) 1992-02-11 2003-03-25 Bioform, Inc. Soft tissue augmentation material
US5326357A (en) 1992-03-18 1994-07-05 Mount Sinai Hospital Corporation Reconstituted cartridge tissue
FR2688690B1 (en) 1992-03-19 1998-04-10 Laboureau Jacques ARTIFICIAL LIGAMENT.
GB9206509D0 (en) 1992-03-25 1992-05-06 Jevco Ltd Heteromorphic sponges containing active agents
US5366756A (en) 1992-06-15 1994-11-22 United States Surgical Corporation Method for treating bioabsorbable implant material
US5468253A (en) 1993-01-21 1995-11-21 Ethicon, Inc. Elastomeric medical device
US5514378A (en) 1993-02-01 1996-05-07 Massachusetts Institute Of Technology Biocompatible polymer membranes and methods of preparation of three dimensional membrane structures
US5656492A (en) 1993-02-12 1997-08-12 Brigham And Women's Hospital, Inc. Cell induction device
GB9306737D0 (en) 1993-03-31 1993-05-26 Surgicarft Ltd Ligament augmentation device
ATE190633T1 (en) 1993-04-27 2000-04-15 Cytotherapeutics Inc MEMBRANE MADE OF AN ACRYLNITRIL POLYMER
US5709854A (en) 1993-04-30 1998-01-20 Massachusetts Institute Of Technology Tissue formation by injecting a cell-polymeric solution that gels in vivo
AU678843B2 (en) 1993-08-10 1997-06-12 W.L. Gore & Associates, Inc. Cell encapsulating device
EP0713364A4 (en) 1993-08-13 1996-12-27 Shalaby W Shalaby Microporous polymeric foams and microtextured surfaces
US5455041A (en) 1993-09-13 1995-10-03 Research Foundation Of State University Of New York At Buffalo Method for inducing periodontal tissue regeneration
GB2281861B (en) 1993-09-21 1997-08-20 Johnson & Johnson Medical Bioabsorbable wound implant materials containing microspheres
WO1995008354A1 (en) 1993-09-24 1995-03-30 Takiron Co., Ltd. Implantation material
GB2282328B (en) 1993-09-29 1997-10-08 Johnson & Johnson Medical Absorbable structures for ligament and tendon repair
US5393594A (en) 1993-10-06 1995-02-28 United States Surgical Corporation Absorbable non-woven fabric
US5723331A (en) 1994-05-05 1998-03-03 Genzyme Corporation Methods and compositions for the repair of articular cartilage defects in mammals
US5855608A (en) * 1994-05-13 1999-01-05 Thm Biomedical, Inc. Device and methods for in vivo culturing of diverse tissue cells
US5571189A (en) 1994-05-20 1996-11-05 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
WO1996001641A1 (en) 1994-07-08 1996-01-25 Sulzer Medizinaltechnik Ag Method of manufacturing implant materials
US5632745A (en) 1995-02-07 1997-05-27 R&D Biologicals, Inc. Surgical implantation of cartilage repair unit
US5769899A (en) 1994-08-12 1998-06-23 Matrix Biotechnologies, Inc. Cartilage repair unit
FR2724563A1 (en) 1994-09-15 1996-03-22 Coletica USE OF COLLAGENIC MEMBRANES AS PERITONEAL REGENERATION PROSTHESES
TW369414B (en) 1994-09-30 1999-09-11 Yamanouchi Pharma Co Ltd Bone formation transplant
US5641501A (en) 1994-10-11 1997-06-24 Ethicon, Inc. Absorbable polymer blends
US6110212A (en) * 1994-11-15 2000-08-29 Kenton W. Gregory Elastin and elastin-based materials
US5891558A (en) 1994-11-22 1999-04-06 Tissue Engineering, Inc. Biopolymer foams for use in tissue repair and reconstruction
US6485723B1 (en) * 1995-02-10 2002-11-26 Purdue Research Foundation Enhanced submucosal tissue graft constructs
US6592588B1 (en) 1995-02-16 2003-07-15 Arthrex, Inc. Apparatus for osteochondral autograft transplantation
US7141072B2 (en) * 1998-10-05 2006-11-28 Ed. Geistlich Soehne Ag Fuer Chemische Industrie Method for promoting regeneration of surface cartilage in a damaged joint using multi-layer covering
GB9503492D0 (en) * 1995-02-22 1995-04-12 Ed Geistlich S Hne A G F R Che Chemical product
US5595751A (en) 1995-03-06 1997-01-21 Ethicon, Inc. Absorbable polyoxaesters containing amines and/or amido groups
US5648088A (en) 1995-03-06 1997-07-15 Ethicon, Inc. Blends of absorbable polyoxaesters containing amines and/or amide groups
US5464929A (en) 1995-03-06 1995-11-07 Ethicon, Inc. Absorbable polyoxaesters
US5698213A (en) 1995-03-06 1997-12-16 Ethicon, Inc. Hydrogels of absorbable polyoxaesters
US5618552A (en) 1995-03-06 1997-04-08 Ethicon, Inc. Absorbable polyoxaesters
US5607687A (en) 1995-03-06 1997-03-04 Ethicon, Inc. Polymer blends containing absorbable polyoxaesters
US5597579A (en) 1995-03-06 1997-01-28 Ethicon, Inc. Blends of absorbable polyoxaamides
US5700583A (en) 1995-03-06 1997-12-23 Ethicon, Inc. Hydrogels of absorbable polyoxaesters containing amines or amido groups
US5859150A (en) 1995-03-06 1999-01-12 Ethicon, Inc. Prepolymers of absorbable polyoxaesters
US5904716A (en) 1995-04-26 1999-05-18 Gendler; El Method for reconstituting cartilage tissue using demineralized bone and product thereof
US6121042A (en) 1995-04-27 2000-09-19 Advanced Tissue Sciences, Inc. Apparatus and method for simulating in vivo conditions while seeding and culturing three-dimensional tissue constructs
US6123727A (en) 1995-05-01 2000-09-26 Massachusetts Institute Of Technology Tissue engineered tendons and ligaments
US6132463A (en) 1995-05-19 2000-10-17 Etex Corporation Cell seeding of ceramic compositions
US6027742A (en) 1995-05-19 2000-02-22 Etex Corporation Bioresorbable ceramic composites
GB9510624D0 (en) 1995-05-25 1995-07-19 Ellis Dev Ltd Textile surgical implants
US6096532A (en) 1995-06-07 2000-08-01 Aastrom Biosciences, Inc. Processor apparatus for use in a system for maintaining and growing biological cells
FR2737663B1 (en) 1995-08-07 1997-10-03 Centre Nat Rech Scient COMPOSITION FOR BIO-MATERIAL, METHOD OF PREPARATION
US5716413A (en) * 1995-10-11 1998-02-10 Osteobiologics, Inc. Moldable, hand-shapable biodegradable implant material
AU7274696A (en) * 1995-11-06 1997-05-29 Mount Sinai Hospital Corporation Reconstituted mineralized cartilage tissue
US6200606B1 (en) 1996-01-16 2001-03-13 Depuy Orthopaedics, Inc. Isolation of precursor cells from hematopoietic and nonhematopoietic tissues and their use in vivo bone and cartilage regeneration
US5842477A (en) 1996-02-21 1998-12-01 Advanced Tissue Sciences, Inc. Method for repairing cartilage
US5755791A (en) 1996-04-05 1998-05-26 Purdue Research Foundation Perforated submucosal tissue graft constructs
US5788625A (en) 1996-04-05 1998-08-04 Depuy Orthopaedics, Inc. Method of making reconstructive SIS structure for cartilaginous elements in situ
ATE439849T1 (en) 1996-04-19 2009-09-15 Osiris Therapeutics Inc THE RESTORATION AND STRENGTHENING OF BONE USING MESENCHYMAL STEM CELLS
WO1997045147A1 (en) * 1996-05-28 1997-12-04 1218122 Ontario Inc. Resorbable implant biomaterial made of condensed calcium phosphate particles
ATE250666T1 (en) * 1996-06-04 2003-10-15 Sulzer Orthopedics Ltd METHOD FOR PRODUCING CARTILAGE TISSUE AND IMPLANTS
US6666892B2 (en) 1996-08-23 2003-12-23 Cook Biotech Incorporated Multi-formed collagenous biomaterial medical device
US5759190A (en) 1996-08-30 1998-06-02 Vts Holdings Limited Method and kit for autologous transplantation
US6569172B2 (en) 1996-08-30 2003-05-27 Verigen Transplantation Service International (Vtsi) Method, instruments, and kit for autologous transplantation
US5989269A (en) 1996-08-30 1999-11-23 Vts Holdings L.L.C. Method, instruments and kit for autologous transplantation
US6120514A (en) 1996-08-30 2000-09-19 Vts Holdings, Llc Method and kit for autologous transplantation
DE59706445D1 (en) 1996-09-10 2002-03-28 Mediphore Biotechnologie Ag Wi METHOD FOR PRODUCING AN IMPLANT, CONSTRUCTING A RESORBABLE SUPPORT MATERIAL, A MEDICAL ACTIVE SUBSTANCE, LIKE A PHARMACEUTICAL, ANTIBIOTIC, CYTOSTATIC OR HORMONE CONTAINING
US5964805A (en) 1997-02-12 1999-10-12 Stone; Kevin R. Method and paste for articular cartilage transplantation
EP0873145A2 (en) 1996-11-15 1998-10-28 Advanced Bio Surfaces, Inc. Biomaterial system for in situ tissue repair
US6187053B1 (en) 1996-11-16 2001-02-13 Will Minuth Process for producing a natural implant
FR2755846B1 (en) 1996-11-20 1998-12-31 Jacques Philippe Laboureau PRE-ORIENT PROSTHETIC LIGAMENT AND METHOD OF MAKING
US7618451B2 (en) * 2001-05-25 2009-11-17 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools facilitating increased accuracy, speed and simplicity in performing total and partial joint arthroplasty
US5914121A (en) 1997-02-12 1999-06-22 The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services Formation of human bone in vivo using ceramic powder and human marrow stromal fibroblasts
JPH10234844A (en) 1997-02-25 1998-09-08 Gunze Ltd Base material for regenerating cartilaginous tissue and regenerating method of cartilaginous tissue using the same
GB9704749D0 (en) * 1997-03-07 1997-04-23 Univ London Tissue Implant
US6001352A (en) 1997-03-31 1999-12-14 Osteobiologics, Inc. Resurfacing cartilage defects with chondrocytes proliferated without differentiation using platelet-derived growth factor
JP4132089B2 (en) 1997-05-30 2008-08-13 オステオバイオロジックス,インコーポレイテッド Fiber reinforced porous biodegradable implantation device
US6042592A (en) 1997-08-04 2000-03-28 Meadox Medicals, Inc. Thin soft tissue support mesh
US6110209A (en) 1997-08-07 2000-08-29 Stone; Kevin R. Method and paste for articular cartilage transplantation
US6241771B1 (en) 1997-08-13 2001-06-05 Cambridge Scientific, Inc. Resorbable interbody spinal fusion devices
US6511958B1 (en) 1997-08-14 2003-01-28 Sulzer Biologics, Inc. Compositions for regeneration and repair of cartilage lesions
US6165217A (en) 1997-10-02 2000-12-26 Gore Enterprise Holdings, Inc. Self-cohering, continuous filament non-woven webs
WO1999018886A1 (en) 1997-10-10 1999-04-22 Corbitt John D Jr Breast implant
US6117166A (en) * 1997-10-27 2000-09-12 Winston; Thomas R. Apparatus and methods for grafting blood vessel tissue
JP2001521786A (en) 1997-10-30 2001-11-13 ザ ジュネラル ホスピタル コーポレーション Adhesion of cartilage matrix using isolated chondrocytes
SE9704076D0 (en) * 1997-11-06 1997-11-06 Holdingbolaget Vid Goeteborgs Method for permeabilization of cell structures and use thereof
US7456012B2 (en) * 1997-11-06 2008-11-25 Cellectricon Ab Method and apparatus for spatially confined electroporation
WO1999025863A1 (en) * 1997-11-14 1999-05-27 Cedars-Sinai Medical Center Transfection and transfer of male germ cells for generation of transgenic species
US6080579A (en) 1997-11-26 2000-06-27 Charlotte-Mecklenburg Hospital Authority Method for producing human intervertebral disc cells
US6197586B1 (en) * 1997-12-12 2001-03-06 The Regents Of The University Of California Chondrocyte-like cells useful for tissue engineering and methods
US6187329B1 (en) 1997-12-23 2001-02-13 Board Of Regents Of The University Of Texas System Variable permeability bone implants, methods for their preparation and use
US6291240B1 (en) 1998-01-29 2001-09-18 Advanced Tissue Sciences, Inc. Cells or tissues with increased protein factors and methods of making and using same
DE19803673A1 (en) 1998-01-30 1999-08-05 Norbert M Dr Meenen Biohybrid joint replacement
CA2320136A1 (en) 1998-02-10 1999-08-12 Oregon Health Sciences University Treatment of bony defects with osteoblast precursor cells
US6179872B1 (en) 1998-03-17 2001-01-30 Tissue Engineering Biopolymer matt for use in tissue repair and reconstruction
DE19812195C2 (en) 1998-03-19 2000-03-30 Uwe Storch Process for producing a tissue-forming implant and its use
US6471958B2 (en) 1998-03-24 2002-10-29 University Of North Texas Health Science Center Non-contracting tissue equivalent
US6143293A (en) 1998-03-26 2000-11-07 Carnegie Mellon Assembled scaffolds for three dimensional cell culturing and tissue generation
US6378527B1 (en) 1998-04-08 2002-04-30 Chondros, Inc. Cell-culture and polymer constructs
US6886568B2 (en) * 1998-04-08 2005-05-03 The Johns Hopkins University Method for fabricating cell-containing implants
PL186960B1 (en) 1998-05-04 2004-04-30 Adamed Sp Z Oo Intravaginal set and therapeutic method employing that set
EP0998311B1 (en) 1998-05-19 2003-11-26 American National Red Cross Hemostatic sandwich bandage comprising a thrombin layer between two fibrinogen layers
US20030064917A1 (en) * 1998-07-23 2003-04-03 Crawford Susan E. Methods and compositions for inhibiting angiogenesis
EP1100558A1 (en) * 1998-07-24 2001-05-23 Pharmacal Biotechnologies, Inc. Osseous tissue reconstruction system and method
US6551355B1 (en) * 1998-08-14 2003-04-22 Cambridge Scientific, Inc. Tissue transplant coated with biocompatible biodegradable polymer
US6605294B2 (en) 1998-08-14 2003-08-12 Incept Llc Methods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
US6132468A (en) * 1998-09-10 2000-10-17 Mansmann; Kevin A. Arthroscopic replacement of cartilage using flexible inflatable envelopes
US6530956B1 (en) 1998-09-10 2003-03-11 Kevin A. Mansmann Resorbable scaffolds to promote cartilage regeneration
CA2346119C (en) 1998-10-14 2011-04-05 Orquest, Inc. A method of inducing or enhancing chondrogenesis with extracellular matrix containing gdf-5
US6214055B1 (en) * 1998-10-30 2001-04-10 Mures Cardiovascular Research, Inc. Method and kit for rapid preparation of autologous tissue medical devices
US6727224B1 (en) * 1999-02-01 2004-04-27 Genetics Institute, Llc. Methods and compositions for healing and repair of articular cartilage
WO2000044413A1 (en) 1999-02-01 2000-08-03 Genetics Institute, Inc. Methods and compositions for healing and repair of articular cartilage
US6656489B1 (en) * 1999-02-10 2003-12-02 Isotis N.V. Scaffold for tissue engineering cartilage having outer surface layers of copolymer and ceramic material
EP1027897B1 (en) 1999-02-10 2005-04-13 IsoTis N.V. Cartillage tissue engineering
US6197061B1 (en) 1999-03-01 2001-03-06 Koichi Masuda In vitro production of transplantable cartilage tissue cohesive cartilage produced thereby, and method for the surgical repair of cartilage damage
US6662805B2 (en) 1999-03-24 2003-12-16 The Johns Hopkins University Method for composite cell-based implants
ES2295021T3 (en) 1999-03-25 2008-04-16 Metabolix, Inc. USE AND MEDICAL APPLICATIONS OF POLYMER POLYMERS (HYDROXIALCANOATS).
US6103255A (en) 1999-04-16 2000-08-15 Rutgers, The State University Porous polymer scaffolds for tissue engineering
US6287340B1 (en) 1999-05-14 2001-09-11 Trustees Of Tufts College Bioengineered anterior cruciate ligament
WO2000073417A1 (en) 1999-05-27 2000-12-07 The Research Foundation Of State University Of New York In vitro cell culture device including cartilage and methods of using the same
GB9912240D0 (en) 1999-05-27 1999-07-28 Smith & Nephew Implantable medical devices
US6667049B2 (en) 1999-06-14 2003-12-23 Ethicon, Inc. Relic process for producing bioresorbable ceramic tissue scaffolds
US20040059416A1 (en) * 1999-06-22 2004-03-25 Murray Martha M. Biologic replacement for fibrin clot
US6333029B1 (en) 1999-06-30 2001-12-25 Ethicon, Inc. Porous tissue scaffoldings for the repair of regeneration of tissue
US6306424B1 (en) 1999-06-30 2001-10-23 Ethicon, Inc. Foam composite for the repair or regeneration of tissue
US6652872B2 (en) 1999-07-06 2003-11-25 Ramat At Tel Aviv University Ltd. Scaffold formed of tissue treated to eliminate cellular and cytosolic elements
US6179840B1 (en) * 1999-07-23 2001-01-30 Ethicon, Inc. Graft fixation device and method
US6499486B1 (en) * 1999-07-29 2002-12-31 Ethicon, Inc. Method for reconstructing a ligament
CA2378618C (en) 1999-08-06 2009-10-06 Cook Biotech Incorporated Tubular graft construct
JP2001129073A (en) 1999-11-02 2001-05-15 Olympus Optical Co Ltd Bone prosthesis material and tool for implanting bone prosthesis material
AU1598701A (en) 1999-11-12 2001-06-06 Kwan-Ho Chan Tissue-engineered ligament
CA2399224A1 (en) 2000-02-18 2001-08-23 Regeneration Technologies, Inc. Implantable tissues infused with growth factors and other additives
US20020133229A1 (en) 2000-03-24 2002-09-19 Laurencin Cato T. Ligament and tendon replacement constructs and methods for production and use thereof
US6629997B2 (en) * 2000-03-27 2003-10-07 Kevin A. Mansmann Meniscus-type implant with hydrogel surface reinforced by three-dimensional mesh
AU2001255767A1 (en) * 2000-04-28 2001-11-12 Curis, Inc. Methods and reagents for tissue engineering of cartilage in vitro
US8247333B2 (en) 2000-05-26 2012-08-21 University Of Virginia Patent Foundation Multifunctional periodic cellular solids and the method of making thereof
US6991652B2 (en) 2000-06-13 2006-01-31 Burg Karen J L Tissue engineering composite
US20010053839A1 (en) 2000-06-19 2001-12-20 Koken Co. Ltd. Biomedical material and process for making same
EP1167517A1 (en) 2000-06-22 2002-01-02 IsoTis N.V. Tissue engineering
DE60117984T8 (en) 2000-06-29 2007-06-14 Bio Syntech Canada Inc., Laval COMPOSITION AND METHOD FOR REPAIRING AND REGENERATING CARTIL AND OTHER WOVEN FABRICS
EP1301222B1 (en) 2000-07-19 2005-12-14 Osteotech, Inc. Osteoimplant and method of making same
US6638312B2 (en) 2000-08-04 2003-10-28 Depuy Orthopaedics, Inc. Reinforced small intestinal submucosa (SIS)
US8366787B2 (en) 2000-08-04 2013-02-05 Depuy Products, Inc. Hybrid biologic-synthetic bioabsorbable scaffolds
CA2777791A1 (en) * 2000-09-18 2002-03-21 Organogenesis Inc. Methods for treating a patient using a bioengineered flat sheet graft prostheses
US6752831B2 (en) 2000-12-08 2004-06-22 Osteotech, Inc. Biocompatible osteogenic band for repair of spinal disorders
AU2002245092A1 (en) * 2000-12-08 2002-07-30 Todd M. Boyce Implant for orthopedic applications
US6852330B2 (en) 2000-12-21 2005-02-08 Depuy Mitek, Inc. Reinforced foam implants with enhanced integrity for soft tissue repair and regeneration
US6599323B2 (en) 2000-12-21 2003-07-29 Ethicon, Inc. Reinforced tissue implants and methods of manufacture and use
US20020127265A1 (en) 2000-12-21 2002-09-12 Bowman Steven M. Use of reinforced foam implants with enhanced integrity for soft tissue repair and regeneration
CA2365376C (en) 2000-12-21 2006-03-28 Ethicon, Inc. Use of reinforced foam implants with enhanced integrity for soft tissue repair and regeneration
AU2002247044B2 (en) * 2001-01-30 2006-11-16 Orthogene, Inc. Compositions and methods for the treatment and repair of defects or lesions in articular cartilage using synovial-derived tissue or cells
US20020176893A1 (en) 2001-02-02 2002-11-28 Wironen John F. Compositions, implants, methods, and kits for closure of lumen openings, repair of ruptured tissue, and for bulking of tissue
AUPR289601A0 (en) 2001-02-05 2001-03-01 Commonwealth Scientific And Industrial Research Organisation Method of tissue repair
US20030050709A1 (en) * 2001-02-23 2003-03-13 Ulrich Noth Trabecular bone-derived human mesenchymal stem cells
US6827743B2 (en) 2001-02-28 2004-12-07 Sdgi Holdings, Inc. Woven orthopedic implants
US7252982B2 (en) * 2001-03-15 2007-08-07 Massachusetts Institute Of Technology Tissue engineering enhanced by the transfer of a growth factor gene
US6378572B1 (en) 2001-03-28 2002-04-30 Siemens Corporate Research, Inc. Image processing system for inspection of tablets in slab filler packaging machines
US6656488B2 (en) 2001-04-11 2003-12-02 Ethicon Endo-Surgery, Inc. Bioabsorbable bag containing bioabsorbable materials of different bioabsorption rates for tissue engineering
US6699252B2 (en) * 2001-04-17 2004-03-02 Regeneration Technologies, Inc. Methods and instruments for improved meniscus transplantation
US6444222B1 (en) * 2001-05-08 2002-09-03 Verigen Transplantation Services International Ag Reinforced matrices
RU2187261C1 (en) 2001-05-21 2002-08-20 Новокузнецкий государственный институт усовершенствования врачей Method for treating nasal septal deformation in sportsmen
ATE504264T1 (en) 2001-05-25 2011-04-15 Conformis Inc METHODS AND COMPOSITIONS FOR REPAIRING THE SURFACE OF JOINTS
US6626950B2 (en) * 2001-06-28 2003-09-30 Ethicon, Inc. Composite scaffold with post anchor for the repair and regeneration of tissue
JP3646162B2 (en) * 2001-07-04 2005-05-11 独立行政法人産業技術総合研究所 Transplant for cartilage tissue regeneration
AU2002316696B2 (en) * 2001-07-16 2007-08-30 Depuy Products, Inc. Cartilage repair and regeneration scaffold and method
EP1416880B1 (en) 2001-07-16 2011-03-02 DePuy Products, Inc. Cartilage repair apparatus
WO2003007839A2 (en) 2001-07-16 2003-01-30 Depuy Products, Inc. Devices form naturally occurring biologically derived
US20050027307A1 (en) 2001-07-16 2005-02-03 Schwartz Herbert Eugene Unitary surgical device and method
JP2005500101A (en) * 2001-07-16 2005-01-06 エドワーズ ライフサイエンシーズ コーポレイション Tissue engineering heart valve
JP4197159B2 (en) 2001-07-16 2008-12-17 デピュイ・プロダクツ・インコーポレイテッド Hybrid biosynthetic bioabsorbable scaffold material
WO2003007786A2 (en) 2001-07-16 2003-01-30 Depuy Products, Inc. Porous delivery scaffold and method
WO2003007790A2 (en) 2001-07-16 2003-01-30 Depuy Products, Inc. Hybrid biologic/synthetic porous extracellular matrix scaffolds
EP1416888A4 (en) 2001-07-16 2007-04-25 Depuy Products Inc Meniscus regeneration device and method
BR0214217A (en) 2001-11-16 2004-09-21 Childrens Medical Center Increased Organ Function
US7326426B2 (en) 2002-03-29 2008-02-05 Ethicon, Inc. Compositions and medical devices utilizing bioabsorbable liquid polymers
JP2003320008A (en) 2002-04-30 2003-11-11 Olympus Optical Co Ltd Living tissue filling body and method of manufacturing the same
JP2004008437A (en) 2002-06-06 2004-01-15 Olympus Corp Cultural bone
DE10234742A1 (en) 2002-07-30 2004-02-19 Bionethos Holding Method and device for growing cells
US20040062753A1 (en) 2002-09-27 2004-04-01 Alireza Rezania Composite scaffolds seeded with mammalian cells
US7824701B2 (en) * 2002-10-18 2010-11-02 Ethicon, Inc. Biocompatible scaffold for ligament or tendon repair
US20040078090A1 (en) 2002-10-18 2004-04-22 Francois Binette Biocompatible scaffolds with tissue fragments
JP2004195103A (en) * 2002-12-20 2004-07-15 Japan Tissue Engineering:Kk Oral cavity graft
US8940292B2 (en) * 2003-01-28 2015-01-27 Wake Forest University Health Sciences Enhancement of angiogenesis to grafts using cells engineered to produce growth factors
US8197837B2 (en) 2003-03-07 2012-06-12 Depuy Mitek, Inc. Method of preparation of bioabsorbable porous reinforced tissue implants and implants thereof
US7368124B2 (en) 2003-03-07 2008-05-06 Depuy Mitek, Inc. Method of preparation of bioabsorbable porous reinforced tissue implants and implants thereof
US7067123B2 (en) * 2003-04-29 2006-06-27 Musculoskeletal Transplant Foundation Glue for cartilage repair
US7413734B2 (en) * 2003-06-27 2008-08-19 Ethicon, Incorporated Treatment of retinitis pigmentosa with human umbilical cord cells
US8226715B2 (en) 2003-06-30 2012-07-24 Depuy Mitek, Inc. Scaffold for connective tissue repair
US7262020B2 (en) * 2003-07-03 2007-08-28 The Regents Of The University Of California Methods for comparing relative flux rates of two or more biological molecules in vivo through a single protocol
US10583220B2 (en) 2003-08-11 2020-03-10 DePuy Synthes Products, Inc. Method and apparatus for resurfacing an articular surface
US7316822B2 (en) 2003-11-26 2008-01-08 Ethicon, Inc. Conformable tissue repair implant capable of injection delivery
EP1537839A1 (en) 2003-12-02 2005-06-08 Dr. h. c. Robert Mathys Foundation Prosthetic device for cartilage repair
US7901461B2 (en) 2003-12-05 2011-03-08 Ethicon, Inc. Viable tissue repair implants and methods of use
US11395865B2 (en) 2004-02-09 2022-07-26 DePuy Synthes Products, Inc. Scaffolds with viable tissue
JP4292094B2 (en) 2004-02-24 2009-07-08 グンゼ株式会社 Nerve regeneration tube
US8657881B2 (en) * 2004-04-20 2014-02-25 Depuy Mitek, Llc Meniscal repair scaffold
US8137686B2 (en) 2004-04-20 2012-03-20 Depuy Mitek, Inc. Nonwoven tissue scaffold
US8221780B2 (en) 2004-04-20 2012-07-17 Depuy Mitek, Inc. Nonwoven tissue scaffold
CN101137402B (en) * 2004-10-20 2012-01-11 伊西康公司 Reinforced absorbable multilayered fabric for use in medical devices and its preparation thereof
CA2589041C (en) * 2004-12-23 2019-08-20 Ethicon, Incorporated Postpartum cells derived from umbilical cord tissue, and methods of making and using the same
US20060280768A1 (en) * 2005-06-13 2006-12-14 Julia Hwang Meniscal repair device and method
US20060293760A1 (en) * 2005-06-24 2006-12-28 Dedeyne Patrick G Soft tissue implants with improved interfaces
US20110110958A1 (en) * 2007-09-11 2011-05-12 University Of Florida Research Foundation Compositions and methods for the treatment of neoplasia

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US20050125077A1 (en) 2005-06-09
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