US20060178752A1 - Compound bone structure of allograft tissue with threaded fasteners - Google Patents
Compound bone structure of allograft tissue with threaded fasteners Download PDFInfo
- Publication number
- US20060178752A1 US20060178752A1 US11/395,305 US39530506A US2006178752A1 US 20060178752 A1 US20060178752 A1 US 20060178752A1 US 39530506 A US39530506 A US 39530506A US 2006178752 A1 US2006178752 A1 US 2006178752A1
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- United States
- Prior art keywords
- bone
- mating face
- compound
- canceled
- mating
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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- A61L27/3604—Materials 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 characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
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Abstract
A composite allograft bone device comprising a first bone member body with a face that defines a plurality of spaced projections forming a pattern and a second bone member body defining a face that forms a plurality of spaced projections forming a second pattern. The projections in the first face allow the two bodies to be mated together. The mated bodies form a composite bone device which is provided with a throughgoing bore and a threaded rod member mounted in the throughgoing bore extending into and engaging the bone member bodies holding the same together. Alternatively a rod member with a demineralized or knurled outer surface can be press fit into the throughgoing bore engaging the bone member bodies in an interference fit holding the same together. In another embodiment an inner central cancellous bone block is surrounded by plates or a U shaped base constructed of cortical bone material.
Description
- This is a continuation-in-part of U.S. patent application Ser. No. 09/196,251 filed Nov. 20, 1998 and issued into U.S. Letters Patent No. 6,025,538 on Feb. 15, 2000.
- 1. Field of Invention
- The present invention generally relates to allograft bone devices for surgical implantation into bone tissue and particularly to a composite allograft bone device constructed from two or more separate bone pieces made from allograft, autograft and xenograft bone tissue that can be fastened together to have dimensions that are larger than the dimensions of naturally occurring bone suitable for implantation in a surgical site.
- 2. Description of the Prior Art
- Allograft bone tissue is widely used in orthopedic, neuro-, maxillofacial, podiatric and dental surgery. Allograft tissue is valuable in these fields of surgery because it is strong and it biointegrates well over time with the recipient patient's tissue. Allograft bone tissue can be shaped for specific surgical applications by the surgeon or by a bone product manufacturer in a manufacturing environment before the allograft bone tissue is transferred to the surgeon. Unfortunately because of the size limitation of the bone material only devices of a certain size could be constructed.
- Surgical implants constructed entirely from allograft bone tissue are generally superior to implants constructed from synthetic or nonabsorbable polymers or metals because allograft bone tissue is bioinert and integrates well with the surrounding tissues.
- Allograft bone occurs in two basic forms: 1) cancellous bone (also referred to as trabecular bone) and 2) cortical bone. Cortical bone is highly dense and has a compound structure comprised of calcium hydroxyapatite reinforced with collagen fiber. This cortical bone material is the predominant load bearing component of long bones in the human body. Many shapes and forms can be fabricated from allograft cortical bone tissue including rods, screws, plates, intervertebral discs and the like for use in human surgery. Cortical bone has one serious limitation that plastics and metal do not have. Bone parts and bone products made from allograft cortical tissue are limited in size, dimension and shape because of the anatomical limits on the thickness and length of the source bone.
- As an example, the largest long bone, the femur bone, has a thick cortical wall that varies in thickness from about two millimeters to about ten millimeters. The majority of the femoral cortical bone wall typically ranges from about three millimeter to about eight millimeters in thickness. The length of the cortical tissue is also naturally limited by the size and the weight of the allograft tissue donor. Accordingly, specific implants fabricated from cortical bone have previously not been larger than these natural anatomical dimensions. The other long bones of the human body, the humerous, the tibia, the fibula, the radius, the ulna, the ribs, etc., are similarly limited in dimension. Shaped implants made from these other long bones are also necessarily limited in dimension.
- The dimensional limit that has been achieved with single piece cortical bone is about 10 mm×about 13 mm cross-sections. The length of these sections can be much longer as they are taken from the long axis of the bone. The research that has been completed shows femoral sections ranging from 3 mm×4 mm to 10 mm×10 mm at the mid-shaft and
tibial sections 3 mm×6 mm to 10 mm×13 mm at the proximal end. - Many medical problems and surgical procedures require implants larger than have previously been made out of allograft cortical tissue. It is desirable to have a surgical implant made entirely out of allograft cortical tissue that is larger than can be made from a single piece of naturally occurring bone. Two requirements must be met by any implant fabricated entirely from cortical bone, however, to achieve a successful surgical result. First, the components must be held together in such a way that the mechanical structure of the implant is not compromised during the surgical implantation procedure. Many surgical implants are implanted in the recipient patient with a large applied force as they are actually hammered in as is the case for an intervertebral implant. Second, the compound structure of the implant must hold together during the post-operative period during which the allograft tissue is resorbed and remodeled.
- The prior art contains many references directed to fasteners, spinal cages and devices which are constructed of inert metals or plastics which are used in bone repair. There are relatively few devices used in bone repair constructed of allograft bone because of the difficulty in obtaining and shaping the material and the natural limits placed on the size of the device based on the constraints of the sizes of the natural bone which can be shaped to form devices of a larger required size.
- One example of an allograft device is disclosed in U.S. Pat. No. 4,877,020 which shows a dowel made of bone having a helicoidal thread. Other fasterner made of allograft bone such as screws, pins, anchors, plates and the like are disclosed in U.S. Pat. No. 5,968,047.
- Another device is shown in U.S. Pat. No. 4,932,973 where the use of a perforated bone matrix for use in insertion or implantation in a bone mass to promote bone growth is disclosed.
- Similarly U.S. Pat. No. 5,112,354 discloses the preparation of an allograft bone segment for use in skeletal reconstruction. The bone segment is demineralized and a multiplicity of bores (described as pores) are drilled into the bone mass in a pattern to maximize the surface area of the implant. Some of the bores are drilled through the bone mass at the center of the hexagon pattern.
- U.S. Pat. No. 5,439,684 is directed toward various swollen demineralized bone constructions such as sleeves, rectangular pledgets and wedges. The pledgets and wedges can be used as invertebrate support blocks. The bone can be machined into a desired shape for implantation such as a sheet, disc, ring, cube, cylinder or sliced and wrapped into a tubular shape. However, all of these bone structures are limited to the size and shape of the original material.
- Another patent of interest is U.S. Pat. No. 4,858,603 which shows a bone rod which is placed through an angular bore cut through two separate pieces of bone to hold the pieces together in a fixed secured relationship. The bone rod is made from a polymer which is absorbable in an animal body.
- Until now, the only way that separate bone pieces could be joined together to arrive at a larger device has been to tongue and groove the respective pieces which creates shearing areas and limits the use to which such constructed device could be used. This is a significant problem where a device is placed under stress and shearing forces as for example where it is hammered into place between vertebrae or into other bone areas. The first disclosure of joining together separate pieces of allograft bone is believed to be set forth in various articles by F. Albee. This disclosure also shows the machining of dowels, rods and screws from bone. F. Albee, Bone Graft Surgery in Disease. Injure and Deformity p. 22 (1940); and F. Albee, The Improved Albee Bone Mill, American Journal of Surgery p. 657 (March 1938).
- Accordingly, there is a need for implantable shaped structures made entirely out of cortical bone tissue that are larger than naturally occurring bone structures and are made out of cortical tissue. There is also a need for larger shaped bone structures made out of a combined cortical/cancellous structure.
- The present invention is directed toward a shaped structure made out of allograft bone tissue that is larger than the natural dimensions of a cortical bone layer made by combining two or more smaller pieces of bone to form a compound bone structure.
- The preferred compound bone structure is comprised of a first bone member having a first mating face constructed and arranged to support a load applied in a direction that is normal to the first mating face and to receive and engage a complimentary mating face of a second bone member. The second mating face is constructed and arranged to support a load applied in the direction normal to the second mating face and to engage the first mating face so that the first and second bone members cooperate to form the compound bone structure.
- The compound bone structure has an exterior surface that can be shaped to form an implant that can support the anatomical load and orient the implant in the surgical site so that the anatomical load is applied to the engaged first and second mating faces in the normal direction. Complimentary mating structures formed on the first and second mating faces prevent displacement of the first bone member with respect to the second bone member in both a longitudinal direction and a transverse direction when an anatomical load is applied.
- At least one fastener either threaded or of an interference fit is placed through the component bone members of compound bone structure extending through the compound bone structure and across the mating faces of the bone members.
- It is an object of the invention to make a compound bone structure from bone tissue of smaller bone segments for use in implantation into a surgical site and to support an anatomical load applied to the compound bone structure during a post-operative period while the implanted bone tissue is resorbed and remodeled.
- It is another object of the invention to fabricate shapes out of allograft cortical tissue that would enable larger parts to be made out of cortical tissue.
- It is still another object of the invention to fabricate shapes out of composite allograft cortical and cancellous tissue that would enable a larger structure to be made out of composite parts.
- It is still another object to use partially demineralized bone rods in an interference fit in a bore formed in the composite bone structure to hold the same together and promote bone growth.
- It is yet another object of the invention to form a compound bone structure which is implantable and is larger than bone pieces that are found in nature.
- These and other objects, advantages, and novel features of the present invention will become apparent when considered with the teachings contained in the detailed disclosure along with the accompanying drawings.
-
FIG. 1 shows an exploded flipped perspective elevational view of the inventive compound bone device without a mechanical fastener; -
FIG. 2 shows a top plan view of one of the bone members of the inventive compound bone device shown inFIG. 1 ; -
FIG. 3 shows an end elevational view of the bone member shown inFIG. 2 with the bore shown in phantom; -
FIG. 4 shows a top plan view of a second member of the inventive compound bone device shown inFIG. 1 ; -
FIG. 5 shows an end elevational view of the bone member shown inFIG. 4 with the bore shown in phantom; -
FIG. 6 shows an assembled perspective elevational view of the inventive compound bone device with the respective mating faces in phantom and a threaded rod being inserted; -
FIG. 7 shows an exploded flipped perspective view of the inventive compound bone device with rod removed and the rod bore in phantom; -
FIG. 8 shows an enlarged partial perspective view of a partially demineralized rod for insertion and interference fit in the bore of a compound bone device; -
FIG. 8 a shows an enlarged partial perspective view of a rod having a knurled outer surface for insertion and interference fit in the bore of a compound bone device; -
FIG. 8 b shows an enlarged perspective view of a wedged nail for insertion and interference fit in the bore of a compound bone device; -
FIG. 9 is an assembled side elevational view of the compound bone device showing the threaded rods removed and rod bores in phantom; -
FIG. 9 a is a slightly enlarged cross sectional view of a member of the compound bone device shown inFIG. 9 showing the end member; -
FIG. 10 is an assembled side elevational view of a compound bone structure with a countersunk bolt fastener member; -
FIG. 11 is an assembled side elevational view of a compound bone structure with a countersunk rivet fastener member;. -
FIG. 12 is an assembled side elevational view of a compound bone structure with a countersunk screw fastener member; -
FIG. 13 is a cross sectional view of the compound bone structure; -
FIG. 14 is a schematic view of the compound bone device in a surgical site formed between an upper and a lower vertebrae in lumbar portion of a spine; -
FIG. 15 is an exploded view of the composite cortical/cancellous compound bone embodiment; and -
FIG. 16 is an exploded view of another composite cortical/cancellous compound bond embodiment. - The preferred embodiment and the best mode of the invention is shown in
FIGS. 1-7 .FIG. 1 shows an exploded side view of acompound bone device 20 with afirst bone member 22 and asecond bone member 24 flipped for viewing. The first andsecond bone members bone member engagement surface FIGS. 2 and 4 respectively that has been shaped to form integral mating projections orteeth 30 on eachface members compound bone device 20 shown inFIG. 6 . -
Bone member 22 has amating face 26 constructed with three bar projections 31 separated bygrooves 32 formed on one end. The bar projections 31 run parallel to the longitudinal axis of the bar member and extend along the mating face less than ½ the length of the bar member. Thegrooves 32 are preferably around 2 to 2.12 mm in width and the side bars 31(a) have a width which is less than the width of the center bar 31(b). The other end of thebone member 22 has threebar projections 33 separated bygrooves 34 running transverse the longitudinal axis and extending across the width of thebone member 22. The midsection of the bone member has a plurality ofrectangular projections 35 formed by extendinggrooves 32 up to theside wall 36 of the innertransverse bar 33. Therectangular projections 35 are separated from the axially aligned bar members 31 by agroove 37 and theside wall 36 of innertransverse bar 33 by groove 37(a). The bars 31(b), 33 and center rectangular projection 35(a) have a width of approximately 2 mm. -
Bone member 24 is formed withgrooves 38 along each longitudinal side of the body and is also provided with acentral groove 39 extending longitudinally the length of thebone member 24.Grooves 40 run across the width and transversely intersectgrooves projections 30. Thegrooves 38 located on opposite sides of thebone member 24 receive the side bars 31(a) and the siderectangular projections 35. - The mating projections or teeth range from 0.5 to 2.0 mm in height, preferably 1.0 mm and are formed by cutting a plurality of slots, grooves or channels ranging from 1 to 4 mm in width with a generally rectangularly shaped cross sections in each
mating surface - The
mating projections 30 and the channels on thebone members members members compound bone device 20 during subsequent machining of the exterior surface of thedevice 20 and during or after implantation in a surgical site. - Two biased or
angled bores bone members bores FIGS. 6 and 7 . Thebores members bores first bore 47 through thecompound bone device 20. A cylindrical threadedrod 46 shown inFIG. 6 preferably made of cortical bone tissue is press fit into thecontinuous bore 47 to prevent the separation of themembers bone members rod 46 positioned at an angle to the plane of the engaged mating surfaces and extending substantially the full thickness of thecompound bone device 20. In the preferred embodiment shown inFIGS. 1-7 , thewall forming bore 47 is cylindrical and threaded and the threadedrod 46 is cylindrical. The threadedrod 46 has a diameter slightly less than the diameter of thebore 47 so that the rod is retained in the bore by the threads of the bore. If desired a suitable medical adhesive can be use to insure that the rod stays in the bore during insertion. The threadedrod 46 is preferably cut from cortical bone but resorbable synthetic rods or metal rods could be used. It is also appreciated that the rod could be threaded at each end 48 with a smooth center section or be in the form of abolt 330 threaded at one end and being held in position with an appropriatelysized nut 332. Thenut 332 can be constructed of cortical bone, synthetic (resorbable material) or metal. Thus the fasteners can be threaded into the bone or be held in place with cap means (not shown) or standard type nuts 332. The outer surfaces ofbone members bores 47 forming a stepped recess or well so that the outer shape of the graft is maintained as the head or nut is located in the well of the countersink. - An alternate embodiment is also formed with a stepped countersink at one end of the bore on the outer surface of the respective bone members to hold
rivets 340 made of resorbable synthetic material or metal. - It is also envisioned that the threaded rods could be replaced by
screws 342 made from bone material or a resorbable synthetic. - If desired the
cortical rod 346 can be unthreaded with an outer demineralized surface layer 348 (which increases toughness and malleability) leaving anallograft bone core 347 present in thecortical rod 346 as shown inFIG. 8 and the same is press fit into bores that are slightly undersized from the diameter of thecortical rod 346. - A
knurled rod 350 has a scored orknurled surface 352 as shown inFIG. 8 a can also be used and the same is press fit into bores that are slightly undersized. It is also envisioned that the knurled rods could be made from cortical bone material or a resorbable synthetic. - Likewise a wedge or
wedge nail 360 havingplanar sides 362 withangular edges 364 as shown inFIG. 8 b made from bone material or a resorbable synthetic and the same is press or interference fit into bores that are circular in cross section and are slightly undersized from length of the diagonals from the opposing edges of the square or rectangular cross section of the wedged nail. It will be appreciated that this greater size from the diameter of the bore must extend along a length of thewedge nail 360 so that both or multiple sections of the composite bone assembly are engaged. - It will be appreciated that three or more bone members can be fastened together by forming projections on both sides of the bone members. As an example,
bone member 24 could be provided with an identical mating face on its opposite side which would engage another bone member shaped identical tobone member 22. -
FIG. 9 shows an alternative embodiment of thecompound bone device 120 constructed with afirst bone member 122 and asecond bone member 124. The first andsecond bone members bone member surface teeth 130 on eachface members compound bone device 120. - Each
bone member groove 131 on each longitudinally extending side of each member so that when the members are engaged as shown inFIG. 9 , acomposite groove 133 extends longitudinally the length of thecompound bone device 120. Thegroove 133 is located on opposite sides of thecompound bone device 120 and serves as a holding slot for the instrument which holds thecompound bone device 120 while it is being machined. One end of eachbone member 124 has been machined to provide anextended end member 134 which covers the end portion ofbone member 122. The raised orextended end member 134 is flush with end surface 123 ofmember 122 and cooperate whenmembers impact surface 135 that can be struck with a hammer or other suitable instrument during a surgical procedure to implant thecompound bone device 120 into a surgical site. A cross section of thebone member 124 showingend member 134 is shown inFIG. 9a The mating projections orteeth 130 range from 0.5 to 2.0 mm in height, preferably 1.0 mm and are formed by cutting a plurality of slots, grooves orchannels 132 ranging from 1 to 4 mm in width with a generally rectangular shaped cross section in eachmating surface channels 132 are of equal dimensions and are preferably equally spaced about 2.0 mm to 2.12 mm apart. Thechannels 132 are preferably angled at +45 degrees and −45 degrees with respect to thelongitudinally extending grooves 131. - The mating projections or
teeth 130 formed by thechannels 132 are comprised of a plurality of identical longitudinally spaced rectangular projections in a central portion of eachmating surface - The
mating projections 130 and thechannels 132 on thebone members members members compound bone device 120 during subsequent machining of the exterior surface of thedevice 120 and during or after implantation in a surgical site. Thechannels 132 are machined in the cortical bone to preferably a 1 mm depth and are angled at +45 degrees and −45 degrees in relation to edge 131 of eachmember surface mating surfaces members compound bone device 20. In all of the described embodiments, the maximum tolerance between the engaged parts at the surface ranges from 0.025 mm to 0.1 mm. - Two bores 122 and 143 respectively, extend through each
bone member bores FIG. 9 . Thebores members bores first bore 147 and a continuoussecond bore 149 through thecompound bone device 120. Twocylindrical rods FIGS. 8 and 8 a are preferably made of cortical bone tissue and are press fit into each of thecontinuous bores members nail wedge 360 could be used to press or interference fit the two members together. - Thus, the mating surfaces 126, 128 of the
bone members FIGS. 1-7 and 9, 13 or normal to the plane of the engages mating surfaces as shown inFIGS. 10-12 and extending the full or partial thickness of thecompound bone device 120. The wall forming eachbore rods bores nail wedge 360. Alternativelybolts 350,screws 342 and threadedrods 146 as shown in FIGS. 9, 10-12 can be screwed into threaded bores of the compound bone device. When thebone members compound bone device 120 can be shaped to form a suitable implant device for implantation into a surgical site. If desired, theexterior surface rods 146 provide sufficient structural reinforcement for the compound bone device to allow thedevice 120 to be machined to form the desired shape. Anothercompound bone device 220 is shaped so that when thedevice 220 is implanted in a surgical site, the anatomical load of the patient is applied in a direction that is normal to the engaged mating faces 226, 228. The normal direction is shown inFIG. 14 by an arrow N. It can be appreciated from the cross-section that when the twomembers first member 222 are disposed between or adjacent channels on thesecond member 224 to prevent the relative movement between themembers compound bone device 220. -
FIGS. 13 and 14 show that theexterior surface 248 of thecompound bone device 220 can be shaped to form a intervertebral implant for the lumbar spine for insertion between vertebrae to fuse the vertebrae. Thecompound bone device 220 can be machined to provide a sloped and roundedproximal end 250 anddistal end 252 for easy intervertebral insertion. -
FIG. 13 shows a cross-section of acompound bone device 220 with thebores compound bone device 220. Eachmating face bone members - The
bores FIG. 13 that the oblique angles of thebores bore 247 is the inverse of or the negative of the angle ofbore 249. The preferred angle ofbore 247 with a line generally extending between the two faces is about 110 degrees and therefore the angle ofbore 249 is negative 110 degrees. It should be noted thatFIGS. 10-12 show transverse bores allowing the screw or bolt head or respective nut to lie planar in the countersink well. -
FIG. 14 shows a schematic representation of thecompound bone device 220 implanted in asurgical site 62 in the lumbar spine between anupper vertebra 64 and alower vertebra 66 to fuse the vertebra. In this surgical procedure, an intervertebral space is enlarged and shaped to receive the allograftcompound bone device 220 implant. Thecompound bone device 220 is inserted in thesurgical site 62 so that the applied anatomical load N is applied in a direction that is normal or perpendicular to the engaged mating faces 226, 228. - The
exterior surface 248 of thecompound bone device 220 is shaped to support the applied load in a direction that is normal to the engaged faces 226, 228 and to maintain the orientation of the implantedcompound bone device 220 in thesurgical site 62 throughout the post-operative period. - The engaged faces 26, 28, 126, 128, and 226, 228 support the major anatomical load of the patient during the post operative recovery period. The engagement between the
respective projections second bone members - It is desired that the
compound bone devices fastening rods 46, 146 (rods 246 not shown), 346 and 350 which are inserted inbores 47; 147, 149, and 247, 249 can be made of cortical, allograft tissue. The outer surface of each cortical rod is entirely within and surrounded by the bone mass of the compound bone device so that the rod is substantially protected from the biochemical attack that occurs from normal biological and biochemical processes as the implant is integrated into the bone of the patient. Only the end surfaces of therods - The biological and biochemical process cause a slow absorption of the implanted bone to occur over time. This absorption could structurally degrade the interlocking bone members of the compound bone device. Because the anatomical load is normal to the mating complimentary surfaces, the anatomical load can be sustained even during tissue degradation. Because the rods are substantially protected from the biochemical mechanism of absorption, the rods will continue to secure the bone members together long enough to allow full healing and integration to occur. The
cortical rods compound bone device - The normal absorption mechanisms that occur during the healing process also tend to structurally degrade the two engaged bone members of the
compound bone device device bone members compound bone device - The assembled
compound bone device 220 shown in the schematic view inFIG. 14 was tested in a cadaver lab in which it was inserted into the lumbar spine. The procedure requires that the assembly be hammered using considerable force into the intervertebral disc space. Four compound bone devices were successfully inserted into the spine with no signs of impact damage due to the insertion. - It can be understood by one skilled in the art that the preferred embodiment described above is intended as an example only to teach the broad principles of the invention and is not intended to be limiting. It can be understood, for example, that the mating projections or
teeth - It is appreciated that many geometric configurations of projections on each mating face can provide suitable structures to prevent relative movement between the bone members in the longitudinal and transverse directions.
- In another embodiment of the invention as shown in
FIG. 15 a composite bone assembly 400 is constructed of a centercancellous base block 402,side plates 404,end plates 406 and atop plate 408 andbottom plate 410. All of the plates are constructed of cortical bone and the six plate sides are fastened to thecentral block 402 by adhesives, rods, screws or other suitable fasteners. The plates are drilled withthroughgoing holes 420 to allow body fluids access to thebase block 402 to facilitate bone growth. While the center block is shown to be rectangular in shape, a wedge shape or other shape could be substituted. - In an alternate embodiment of the composite bone assembly invention as shown in
FIG. 15 a composite bone assembly 500 is constructed of a U shapedcortical base 502 which holds acancellous block 504 therein by interference fit, adhesives, threaded fasteners or press fit fasteners. The open surface of the cancellous material speeds up bone formation. - In general, a plurality of mating projections and channels forming mating spaces are provided on a first mating face and a plurality of mating projections and mating spaces are provided on a second mating face. When the faces are engaged or mated, the mating teeth on the first face are disposed within the mating spaces on the second mating face and the mating teeth on the second mating face are disposed within the mating spaces on the first mating face to prevent the relative movement between the bone members in the longitudinal and transverse directions when the bone members are inserted into a surgical site or are disposed in a surgical site during a post operative period. Each mating face is constructed and arranged to support an applied load applied in a normal direction and to engage a mating face with complimentary projection receiving construction.
- All of the compound bone devices described above allow for constructions 10 mm×25 mm or larger. This assembly technique considerably broadens the use of allograft tissues by allowing much larger implants to be formed than could have been attained from the normal human anatomy.
- It can also be understood that because the preferred embodiment is illustrative only, as it is contemplated to provide a compound bone device comprised of more than two bone members. In such a case, the compound bone device can be thought of as being comprised of an upper member, a middle member(s) and a lower member. The upper and lower members are provided with a single mating face and the middle member(s) is provided with two mating faces generally disposed on opposite sides thereof so that the three or more bone members or pieces can be engaged and fastened together with at least one embedded cortical bone rod, preferably located at an oblique angle to the longitudinal plane of the mating surfaces. In this regard the
composite block member 400 can be provided with stacked plates to form the respective walls. - Because bones are irregularly shaped and because not all applications of the invention require that the implant support an anatomical load that is applied in generally one direction, it can be understood that if more than one pair of engaged mating faces is present in a single compound bone device, the pairs need not necessarily be parallel nor do the individual members of each pair have to be generally planar to form a compound bone device.
- The compound bone device can be constructed and arranged to support a load applied in a direction that is generally normal to the two pairs of engaged faces so that the bone device can support an anatomical load and prevent the relative displacement of the three bone pieces in a longitudinal or tansverse direction.
- It can further be understood that because the illustrated embodiment is exemplary only, it is contemplated to provide compound bone devices which are shaped for many applications and that the compound bone device design is not restricted to use in the lumbar spine for spinal fusion. A compound bone device comprised of two or more bone members can be shaped during the manufacturing process to form compound bone rods, bone screws, plates, discs, wedges, blocks and other devices of various configurations.
- The compound bone device can be fabricated from xenograft, autograft or allograft bone tissue and it is contemplated to use any suitable bone tissue from any source to form a compound bone device.
- It is also understood that although it is preferred to fabricate the compound bone device without the use of adhesives or synthetic absorbable or nonabsorbable polymers or metals, it is within the scope of the invention to additionally secure together the bone members with any suitable surgical bone adhesive or with a synthetic absorbable or nonabsorbable polymer or in any combination with or without at least one component made of bone tissue.
- In the foregoing description, the invention has been described with reference to a particular preferred embodiment, although it is to be understood that specific details as shown are merely illustrative, and the invention may be carried out in other ways without departing from the true spirit and scope of the following claims.
Claims (37)
1. A compound bone device made from sterile bone tissue for implantation into a surgical site which supports an anatomical load applied to the compound bone device during a post-operative period while the implanted bone tissue is being resorbed and remodeled, comprising:
a first bone member defining a first mating face with a plurality of spaced projections constructed and arranged to support a load in a direction that is normal to the first mating face and to receive and engage a complimentary mating face of a second bone member;
a second bone member defining a second mating face that is complimentary to the first mating face of the first bone member constructed and arranged to support a load in the direction normal to the second mating face, said mating faces being mounted to each other so that the first and second bone members form a compound bone device which prevents displacement of the first bone member with respect to the second bone member in both a longitudinal direction and a transverse direction when an anatomical load is applied;
each bone member defining at least one bore within its body having an axis which intersects a plane across its mating face with said bore opening on said mating face, each bore being axially aligned with a bore defined in the body of an adjacent bone member and a threaded fastener member mounted in said axially aligned bores and extending across said mating face threadably engaging at least one of said bone members to hold the first and second bone members in engagement resisting separation of the first and second bone members.
2. A compound bone device made from bone tissue as claimed in claim 1 wherein each bone member has a body which defines at least two angularly positioned bores which are axially aligned with the angularly positioned bores of an adjacent bone member, said bores being orientated at an oblique angle to a plane of each engaged mating surface and intersecting the plane of the mating surface and a threaded fastener member is mounted in each of the aligned bores.
3. A compound bone device made from bone tissue as claimed in claim 1 wherein said threaded fastener member is a screw.
4. A compound bone device made from bone tissue as claimed in claim 1 wherein said threaded fastener member is a threaded bolt.
5. A compound bone device made from bone tissue as claimed in claim 1 wherein said threaded fastener member is a threaded rod.
6. A compound bone device made from bone tissue as claimed in claim 1 wherein said threaded fastener member is a threaded rod with at least one nut member.
7. A compound bone device made from bone tissue as claimed in claim 1 wherein said threaded fastener member is a threaded bolt with an associated nut member.
8. A compound bone device made from bone tissue as claimed in claim 1 wherein one of the mating faces defines a plurality of bar members substantially parallel to the longitudinal axis of bone members and a plurality of bar members oriented transverse to the axis of the parallel bar members.
9. A compound bone device made from sterile bone tissue for implantation into a surgical site which supports an anatomical load applied to the compound bone device during a post-operative period while the implanted bone tissue is being resorbed and remodeled, comprising:
a first bone member defining a first mating face constructed and arranged to support a load in a direction that is normal to the first mating face and to receive and engage a complimentary mating face of a second bone member;
a second bone member defining a second mating face that is complimentary to the first mating face of the first bone member constructed and arranged to support a load in the direction normal to the second mating face, said mating faces being mounted to each other so that the first and second bone members form a compound bone device which prevents displacement of the first bone member with respect to the second bone member in both a longitudinal direction and a transverse direction when an anatomical load is applied;
each bone member defining at least one throughgoing bore within its body which opens on said mating face and has a stepped countersink portion at its opposite end, each bore being axially aligned with an angularly oriented bore defined in the body of the other bone member and a threaded fastener member mounted in said axially aligned bores extending across said mating face to hold the first and second bone members in engagement resisting separation of the first and second bone members.
10. A compound bone device made from bone tissue as claimed in claim 9 wherein said threaded fastener member is a bolt and nut assembly.
11. A compound bone device made from bone tissue as claimed in claim 9 wherein said threaded fastener member is a threaded rod with at least one nut member.
12. A compound bone device made from bone tissue as claimed in claim 9 wherein each bone member has a body which defines at least two angularly positioned bores which are axially aligned with the angularly positioned bores of an adjacent bone member, said bores being orientated at an oblique angle to a plane of each engaged mating surface and intersecting the plane of the mating surface and a threaded fastener member is mounted in each of the aligned bores.
13. (canceled)
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29. A compound bone device made from sterile bone tissue for implantation into a surgical site which supports an anatomical load applied to the compound bone device during a post-operative period while the implanted bone tissue is being resorbed and remodeled, comprising:
a first bone member defining a first mating face constructed and arranged to support a load in a direction that is normal to the first mating face and to receive and engage a complimentary mating face of a second bone member;
a second bone member defining a second mating face that is complimentary to the first mating face of the first bone member constructed and arranged to support a load in the direction normal to the second mating face, said mating faces being mounted to each other so that the first and second bone members form a compound bone device which prevents displacement of the first bone member with respect to the second bone member in both a longitudinal direction and a transverse direction when an anatomical load is applied;
each bone member defining a bore within its body which is angularly oriented with respect to a plane across its mating face and opens on said mating face, each bore being axially aligned with an angularly oriented bore defined in the body of the other bone member and a cortical bone rod member having a partially demineralized outer surface mounted in said axially aligned bores extending across said mating face in an interference fit to hold the first and second bone members in engagement resisting separation of the first and second bone members.
30. A compound bone device made from sterile bone tissue for implantation into a surgical site which supports an anatomical load applied to the compound bone device during a post-operative period while the implanted bone tissue is being resorbed and remodeled, comprising:
a first bone member defining a first mating face constructed and arranged to support a load in a direction that is normal to the first mating face and to receive and engage a complimentary mating face of a second bone member;
a second bone member defining a second mating face that is complimentary to the first mating face of the first bone member constructed and arranged to support a load in the direction normal to the second mating face, said mating faces being mounted to each other so that the first and second bone members form a compound bone device which prevents displacement of the first bone member with respect to the second bone member in both a longitudinal direction and a transverse direction when an anatomical load is applied;
each bone member defining a bore within its body which opens on said mating face, each bore being axially aligned with a similarly oriented bore defined in the body of the other bone member and a cortical bone rod member having a partially demineralized outer surface mounted in said axially aligned bores extending across said mating face in an interference fit to hold the first and second bone members in engagement resisting separation of the first and second bone members.
31. A compound bone device made from sterile bone tissue for implantation into a surgical site which supports an anatomical load applied to the compound bone device during a post-operative period while the implanted bone tissue is being resorbed and remodeled, comprising:
a first bone member defining a first mating face constructed and arranged to support a load in a direction that is normal to the first mating face and to receive and engage a complimentary mating face of a second bone member;
a second bone member defining a second mating face that is complimentary to the first mating face of the first bone member constructed and arranged to support a load in the direction normal to the second mating face, said mating faces being mounted to each other so that the first and second bone members form a compound bone device which prevents displacement of the first bone member with respect to the second bone member in both a longitudinal direction and a transverse direction when an anatomical load is applied;
each bone member defining a bore within its body which is angularly oriented with respect to a plane across its mating face and opens on said mating face, each bore being axially aligned with an angularly oriented bore defined in the body of the other bone member and a cortical bone rod member with a knurled outer surface mounted in said axially aligned bores extending across said mating face in an interference fit to hold the first and second bone members in engagement resisting separation of the first and second bone members.
32. (canceled)
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US11/395,305 US20060178752A1 (en) | 1998-11-20 | 2006-04-03 | Compound bone structure of allograft tissue with threaded fasteners |
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US09/196,251 US6025538A (en) | 1998-11-20 | 1998-11-20 | Compound bone structure fabricated from allograft tissue |
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US11/395,305 US20060178752A1 (en) | 1998-11-20 | 2006-04-03 | Compound bone structure of allograft tissue with threaded fasteners |
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US11/395,305 Abandoned US20060178752A1 (en) | 1998-11-20 | 2006-04-03 | Compound bone structure of allograft tissue with threaded fasteners |
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US09/503,166 Expired - Lifetime US7044968B1 (en) | 1998-11-20 | 2000-02-14 | Compound bone structure of allograft tissue with threaded fasteners |
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Also Published As
Publication number | Publication date |
---|---|
AU1713000A (en) | 2000-06-13 |
US7044968B1 (en) | 2006-05-16 |
AU733499B2 (en) | 2001-05-17 |
WO2000030568A1 (en) | 2000-06-02 |
EP1049428A1 (en) | 2000-11-08 |
CA2289990A1 (en) | 2000-05-20 |
EP1049428A4 (en) | 2004-09-22 |
ES2338956T3 (en) | 2010-05-13 |
ATE454109T1 (en) | 2010-01-15 |
US6025538A (en) | 2000-02-15 |
DE69941892D1 (en) | 2010-02-25 |
EP1049428B1 (en) | 2010-01-06 |
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