US20140163689A1 - Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints - Google Patents

Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints Download PDF

Info

Publication number
US20140163689A1
US20140163689A1 US13/924,783 US201313924783A US2014163689A1 US 20140163689 A1 US20140163689 A1 US 20140163689A1 US 201313924783 A US201313924783 A US 201313924783A US 2014163689 A1 US2014163689 A1 US 2014163689A1
Authority
US
United States
Prior art keywords
canine
capsule
joint
methods
microparticles
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
Application number
US13/924,783
Inventor
Neville Alleyne
Stuart Young
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to US13/924,783 priority Critical patent/US20140163689A1/en
Publication of US20140163689A1 publication Critical patent/US20140163689A1/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/08Muscles; Tendons; Ligaments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30742Bellows or hose-like seals; Sealing membranes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30581Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid
    • A61F2002/30588Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid filled with solid particles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30677Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/307Prostheses for animals
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00365Proteins; Polypeptides; Degradation products thereof

Definitions

  • the present technology relates to the field of veterinary medicine.
  • methods and devices are provided for augmenting the capsule of the canine coxofemoral joint.
  • Hip dysplasia is a common problem in veterinary practice, accounting for up to 30% of canine orthopedic cases (Richardson D. C. “The role of nutrition in canine hip dysplasia.” Vet Clin North Am Small Anim. Pract. 1992; 22: 529-540). The frequency of the disease varies among breeds and can be as high as 70.5% in bulldogs and 48.2% in St. Bernards (Corley E. A, Keller G. G. “Hip Dysplasia: A Progress Report and Update.” Columbia, Mo.: Orthopedic Foundation of Animals 1993 (suppl)).
  • the canine coxofemoral joint is a ball and socket joint, where the femoral head meets the socket of the acetabulum.
  • chronic canine hip dysplasia the joint becomes deformed where the femoral head is subluxed out of the joint resulting in significant pain, restricted range of motion, and accelerated osteoarthritic changes of the joint.
  • Treatment for canine hip dysplasia can include total hip replacement.
  • Total hip replacement has become one of the most successful procedures utilized in the treatment of canine hip dysplasia, and associated disorders such as coxarthrosis; severe osteoarthritis, chronic subluxation, avascular necrosis, and fracture dislocation.
  • the typical minimum age for total hip replacement is approximately 10 months and/or a body weight of 35 pounds, and there appears to be no upper age limit for total hip replacement (Olmstead M L. “Total hip replacement.” Vet Clin North Am Small Anim Pract 1987, 17, 943-955; Tomlinson J, McLaughlin R Jr. “Total hip replacement: The best treatment for dysplastic dogs with osteoarthrosis.
  • the present technology relates to methods and devices for augmenting the capsule of a canine coxofemoral joint.
  • Some methods described herein can include the steps of identifying a subject in need of capsular augmentation, delivering an implantable device to the capsule, in which the implantable device includes a biodegradable matrix and a plurality of microparticles, and contacting the implantable device with at least a portion of the capsule.
  • the implantable device can include a sheet.
  • the sheet can include fenestrations.
  • More methods can also include anchoring the implantable device at the joint.
  • the anchoring can be at one or more sites of the joint selected from the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, ligamentum teres femoris, acetabulum, or femoral neck.
  • delivering can include injecting the implantable device into one or more sites of the capsule.
  • one or more sites can be selected from the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament. acetabular labrum, and ligamentum teres femoris.
  • the injecting can be into at least a portion of the stratum fibrosum of the capsule.
  • contacting the implantable device with at least a portion of the joint can include at least a portion of one or more sites selected from the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, and ligamentum teres femoris.
  • the joint has undergone capsulotomy or partial capsulectomy.
  • delivering includes percutaneous delivery. In some methods for augmenting the capsule of a canine coxofemoral joint, delivering includes an open surgical procedure.
  • the biodegradable matrix includes bovine collagen.
  • the biodegradable matrix includes one or more materials selected from albumin, gelatin, chitosan, hyaluronic acid, starch, cellulose, cellulose derivatives (e.g.
  • the plurality of microparticles include a material selected from the group consisting of poly methacrylate, polymethyl methacrylate, hydroxapatite, powdered bone, and glass.
  • the plurality of microparticles can be substantially spherical with a diameter less than 200 ⁇ m. In more embodiments, the plurality of microparticles can be substantially spherical with a diameter less than 100 ⁇ m.
  • the implantable device can also include a bioactive agent.
  • the bioactive agent can include an agent selected from the group consisting of a local anesthetic, non-steroidal anti-inflammatory drug, antibiotic, and antineoplastic agent.
  • the bioactive agent can include lidocaine.
  • the implantable device can also include a substrate.
  • the substrate can include a material selected from nylon, Dacron, and Teflon.
  • the substrate can be coated with the plurality of microparticles and the biodegradable matrix.
  • a canine coxofemoral joint including an implantable device, in which the implantable device comprises collagen and microparticles.
  • the collagen comprises bovine collagen.
  • the microparticles are substantially spherical with a diameter less than 200 ⁇ m. In more embodiments, the microparticles are substantially spherical with a diameter less than 100 ⁇ m.
  • the implantable device further comprises a bioactive agent.
  • the bioactive agent comprises an agent selected from the group consisting of a local anesthetic, non-steroidal anti-inflammatory drug, antibiotic, and antineoplastic agent.
  • the bioactive agent comprises lidocaine.
  • FIG. 1 shows a schematic of a canine coxofemoral joint ( 5 ).
  • the joint includes the femoral head ( 10 ), the acetabulum ( 20 ), pelvis ( 30 ), and capsule ( 40 ).
  • FIG. 2 shows a schematic of a canine coxofemoral joint imbricated with a collagen mesh containing microparticles.
  • FIG. 3 shows a schematic of a canine coxofemoral joint injected with a collagen matrix containing microparticles.
  • the present invention relates to methods and devices for augmenting the capsule of a canine coxofemoral joint.
  • methods include identifying a subject in need of capsular augmentation, delivering an implantable device to the capsule, in which the implantable device includes a biodegradable matrix and a plurality of microparticles, and contacting the implantable device with at least a portion of the capsule are described.
  • Such methods and devices can be useful to treat canine hip dysplasia and related disorders.
  • the implantable device can include a biodegradable matrix, such as collagen, and microparticles comprised of polymethyl methacrylate (PMMA).
  • the device can be inserted at the canine coxofemoral to augment the capsule.
  • PMMA polymethyl methacrylate
  • the biodegradable matrix provides a substrate for the host's fibroblasts to migrate into the device and invoke a fibrotic response at the insertion site.
  • the microparticles may further invoke the host to secrete components of the extracellular matrix, including the host's own collagen, at the site of insertion.
  • the response to inserting such an implantable device at the canine coxofemoral capsule can be that the host produces a fibrous matrix at the site of insertion, thickening and tightening the capsule, and strengthening the joint. Moreover, as the host continues to produce a fibrous matrix at the site of insertion, the tensile strength at the site of insertion can increase with time. This is in contrast to hip repairs such as arthroplasty, which tend to become weaker over a period of time through loosening of cement, stem migration or sublimation, and infection.
  • the canine coxofemoral joint ( 5 ) includes the femoral head ( 10 ) which is used for articulation of the joint.
  • the acetabulum ( 20 ) represents the concave portion of the coxofemoral joint and is part of the pelvis ( 30 ).
  • the deep acetabulum is further extended by a band of fibrocartilage surrounding its rim. This acetabular lip is continued as a transverse acetabular ligament in the ventral aspect of the femur and completes the circular restraint of the hip joint.
  • the ligament of the head of the femur also known as the teres ligament or round ligament, is a short, flat ligament that connects the center of the femoral head to the acetabular fossa. This ligament contributes to femoral stability by retaining the femoral head within the acetabulum and in the adult dog provides some vascularity to the femoral head.
  • the coxofemoral joint is surrounded by a fibrous joint capsule ( 40 ) that is connected to the femur at the base of the neck and at the acetabulum just around the acetabular lip. In chronic canine hip dysplasia, the joint becomes deformed where the femoral head is subluxed out of the joint. In such cases, the capsule of the coxofemoral joint can be one of the only restraining structures to maintain containment.
  • an implantable solid mesh described herein In some methods to augment a canine capsule ( 40 ), an implantable solid mesh described herein.
  • a collagen mesh ( 50 ) containing microparticles can be wrapped around the capsule of a canine coxofemoral joint.
  • the mesh can be imbricated to the capsule. Because the capsule may not be invaded, this method has the advantage of being minimally invasive. Thus the veterinary surgeon can minimize her incision on the capsule, reducing blood loss, and minimizing articular destruction, as compared to more invasive methods.
  • wrapping the capsule with the mesh strengthens the joint two-fold. First, the mesh provides tensile strength to the capsule, and second, the tensile strength increases as the biodegradable collagen is replaced by the host's collagen and secretions.
  • the implantable device can be in the form of a fluid gel or paste.
  • Such devices can be injected into a coxofemoral capsule.
  • the implantable devices described herein can be injected into the capsule using a syringe ( 60 ).
  • methods including injecting the implantable device are particularly advantageous because the treatment is minimally invasive.
  • “at least a portion” can refer to at least about 0.1%, 1%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80,%, 90%, 99% , and 100%.
  • fibrotic response can refer to the formation of fibrous tissue in response to medical intervention.
  • Implantable devices which induce a fibrotic response can do so through one or more mechanisms, for example, stimulating migration or proliferation of connective tissue cells, such as fibroblasts, smooth muscle cells, and vascular smooth muscle cells; inducing production of extracellular matrix components, such as collagen; promoting tissue remodeling; and inducing or promoting angiogenesis.
  • An implantable device can comprise one or more components that can include, for example, a plurality of microparticles, a biodegradable matrix, a bioactive agent, and/or a substrate.
  • the following description provides embodiments of implantable devices and methods of using such devices.
  • microparticles can promote a fibrotic response at the site of implantation and provide a scaffold to promote connective tissue deposition around the microparticles.
  • Microparticles can be microspheres, and/or nanoparticles. As will be understood, microparticles may be small enough to be delivered to a site, for example, by injection, but large enough to resist phagocytosis and the lymphatic and blood system from washing away any of the microparticles. As such, microparticles can have a diameter of greater than about 10 ⁇ m.
  • the microparticles can have a diameter between about 20 ⁇ m to about 200 ⁇ m, a diameter between about 25 ⁇ m to about 100 ⁇ m, or a diameter between about 30 ⁇ m to about 50 ⁇ m.
  • the microparticles can also be highly refined to limit any inflammation from smaller particles, and to increase the roundness and smoothness of the particles.
  • the microspheres can comprise an inert, histocompatible material, such as glass, hydroxapatite, powdered bone, or a polymer.
  • the polymer can be cured and polymerized prior to implantation to reduce toxic or carcinogenic potential of the monomers or cure agents.
  • the inert histocompatible polymer can be an acrylic polymer.
  • the acrylic polymer can be a polymer of methacrylate or one of its esters, such as methyl methacrylate, ethyl methacrylate, n-butyl methacrylate, isobutyl methacrylate, lauryl methacrylate, and 2-ethylhexyl methacrylate or any combination or copolymer thereof.
  • microparticles can comprise polymethylmethacrylate (PMMA).
  • Microparticles can be porous or non-porous. Porous microparticles containing an additional agent may be used to deliver agents to the site of implantation.
  • the microparticles can be suspended in a suspension agent.
  • the suspension agent can be an aqueous or non-aqueous solution.
  • the suspension agent can be of sufficient viscosity to promote the suspension of the microparticles.
  • the suspension agent can be, for example, up to about 0.1%, 0.2%, 0.5%, 1.0%, 2.0%, 5.0%, 10%, 15%, 20%, 30%, 40%, 50%, 60%, 70% and 80% by volume microparticles.
  • the amount of microparticles used is determined in part by other components of the suspension agent, such as the carrier concentration, and the method of implantation, such as injection.
  • the suspension agent can also contain a polymer, which can be histocompatible, as a carrier.
  • a carrier can be a biodegradable matrix.
  • a biodegradable matrix can comprise a biodegradable polymer. Examples of biodegradable polymers include collagen, albumin, gelatin, chitosan, hyaluronic acid, starch, cellulose, cellulose derivatives (e.g.
  • the biodegradable polymer can comprise collagen.
  • Collagen may allow for the separation of the microspheres to allow tissue ingrowth.
  • the collagen can be in many types and forms, or in combinations thereof.
  • collagen can be Type I, II or III.
  • Collagen can be native, denatured or cross linked. The various types and forms of collagen are described generally in Methods in Enzymol. (1982) 82:3-217, Pt. A, incorporated by reference in its entirety.
  • collagen can be produced from animal derived tissues such as bovine or porcine hides, avian combs, human tissues such as cadaver skin or human cell cultures or through recombinant methods.
  • an implantable device can contain a collagen fully dissolved or in suspension.
  • the solution can contain up to about 0.1%, 0.2%, 0.5%, 1.0%, 2.0%, 2.5%, 3.0%, 3.5%, 4.0%, 4.5%, 5%, 6%, 7%, 8%, 9%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, or 80% (v/v) collagen content.
  • the amount of collagen content in the solution is in part determined by the resultant viscosity, the percentage of other components such as microparticles and the method of implantation, such as injection.
  • an implantable device comprises a collagen matrix and microparticles.
  • An example of a commercially available material that may be used in some embodiments includes ARTEFILL (Artes Medical Inc.).
  • ARTEFILL comprises PMMA microparticles suspended in bovine collagen.
  • bovine collagen products such as ZYDERM I, ZYDERM II, and ZYPLAST (each produced by Allergan Inc.); bioengineered human collagen products such as COSMODERM I, COSMODERM II, and COSMOPLAST (Allegan Inc.); and porcine collagen products such as EVOLENCE (Ortho-McNeil-Janssen Pharmaceuticals, Inc.).
  • More examples of collagen products include collagen meshes such as INSTAT (Johnson & Johnson), and composite collagen meshes such as ALLODERM (Lifecell Corp.), as well as collagen sponges such as SURGIFOAM (Johnson & Johnson) and TERUDERMIS (Terumo Corp.).
  • Implantable devices described herein can include additional bioactive agents.
  • Bioactive agents can include any composition that is able to invoke a biological response in a subject.
  • a biological response can include, for example, responses to promote healing such as a fibrotic response.
  • bioactive agents that can induce a fibrotic response include silk, talc, chitosan, polylysine, fibronectin, bleomycin.
  • the microparticles can induce a fibrotic response.
  • More examples of bioactive agents include local anesthetics (e.g.
  • ketoprofen e.g. doxorubicin and mitoxantrone
  • fluoropyrimidines e.g.
  • the implantable device includes lidocaine.
  • concentration of lidocaine can be less than about 0.1%, 0.2%, 0.3%, 0.5%, 0.7%, 0.8%, 0.9%, 1%, and 5% by weight
  • Implantable devices described herein can include a substrate.
  • the microparticles and/or biodegradable matrix can be embedded in the substrate.
  • the microparticles and/or biodegradable matrix can coat or wrap at least a portion of the substrate.
  • the substrate can comprise a non-biodegradable material such as, nylon, Dacron and Teflon. More examples of non-biodegradable materials that can be used with the embodiments described herein include polyamides, polyolefins (e.g. polypropylene and polyethylene), polyurethanes, polyester/polyether block copolymers, polyesters (e.g. PET, polybutyleneterephthalate, and polyhexyleneterephthalate), polyester cloth (e.g.
  • DACRON polyester sheeting
  • nylon meshes DACRON meshes
  • MERSILENE acrylic cloth
  • IVALON polyvinyl sponge
  • VINYON-N polypropylene mesh
  • PROLENE polypropylene mesh
  • silicones fluoropolymers (e.g. fluorinated ethylene propylene), and polytetrafluoroethylene (PTFE; e.g. TEFLON mesh and cloth; DuPont).
  • an implantable device can be a fluid, suspension, emulsion, microspheres, paste, gel, spray, aerosol, or sheet.
  • sheets can be of varying sizes, thicknesses, geometries and densities.
  • the sheet can have a thickness of less than about 1 mm, 2 mm, 3 mm, 4 mm, 5 mm, and 10 mm.
  • a sheet can be trimmed to the geometries and size appropriate to the application.
  • a sheet can be rectangular with a length sufficient to circumvent the capsule of a canine coxofemoral joint.
  • a sheet can have a length and breadth sufficient to make contact with at least a portion of the capsule of a canine coxofemoral joint.
  • the implantable device may be fenestrated to promote infiltration by the host into the sheet. Such meshes can act as a scaffold.
  • the fenestrations may be formed in a variety of geometric shapes and sizes. Initially, a fenestrated implantable device may not be as strong as a solid sheet. However, because of the increased surface area and the potential for fibrovascular infiltration through the fenestrations, a fenestrated implantable device may ultimately be stronger than a solid sheet implant.
  • the fenestrations may also be used with sutures or other fixing devices to attach the implantable device to a site, for example, the capsule of a canine coxofemoral joint.
  • An implantable device including a mesh can provide many important advantages. Some mesh implants may be only as strong as the tissue in which the mesh is integrated. However, without wishing to be bound by any one theory, it is believed that when the implant includes microparticles a fibrotic response is induced in the host. In such a response, the host's response for healing occurs especially quickly along the scaffold of the implant. The microparticles make this process occur much faster than mesh implants without particles associated therewith.
  • the body's inflammatory response to the mesh implant is such that fibrous tissue forms a capsule around the biological mesh, and, thus, provides stability and security in the repair.
  • subject can refer to an animal that can benefit from the methods and devices described herein.
  • seed is not an absolute term and merely implies that the subject can benefit from the methods and devices described herein.
  • the subject is a dog.
  • Augmentation of a coxofemoral joint may prevent, reduce, or treat various joint disorders.
  • Disorders amenable to the methods and compositions described herein can include, for example, hip dysplasia, osteoarthritis, coxarthrosis, and chronic subluxation. More examples include chronic luxations, failed closed reductions, excessive postreduction instability, intra-articular fractures, concurrent pelvic fractures, or other fractures of the affected limb that prevent closed reduction (Martini F. M. et al., “Extra-articular absorbable suture stabilization of coxofemoral luxation in dogs.” Vet Surg 30: 468-475 (2001), incorporated by reference in its entirety).
  • the devices and methods described herein can also be utilized in association with other methods well known in the art to promote stabilization of hip luxation (see generally, Johnson A. L. and Dunning D. Atlas of orthopedic surgical procedures of the dog and cat. Chapters 15-18 (2005), incorporated by reference in its entirety).
  • a subject can be identified by various methods, including, for example, by x-ray or a test that requires manipulation of the hip joint into standard positions well known in the art (see generally, Slatter, D., Textbook of Small Animal Surgery, Chapter 144 (2002), incorporated by reference in its entirety).
  • the methods and compositions can be used prophylactically to prevent or reduce future damage or degeneration of a joint.
  • Subjects that may benefit from treatment can include particular types of dogs that may be more susceptible to hip dysplasia, for example, larger dogs and particular breeds such as Golden Retrievers, Labrador Retrievers, German Shepherds, Bulldogs, and St Bernards. Also, dogs with hip joint laxity may be susceptible to hip dysplasia and associated disorders. Such subjects may benefit from prophylactic treatment.
  • an implantable device can be during an open surgical procedure, microdisectomy, percutaneous procedure, and/or by injection.
  • an implantable device comprises a gel, paste, liquid or fluid
  • the device can be delivered to a site at the coxofemoral joint by injection.
  • the size of the needle used during such injections will vary according to the subject, viscosity of the implantable device, and application.
  • the needle can have a gauge in the range of about 22 to 25, and length in the range of about 1.5 to 3.0 inches.
  • the volume injected can be less than about 0.1 ml, 0.5 ml, 1.0 ml, 1.2 ml, 1.5 ml, 2.0 ml, 2.5 ml, 5 ml, 10 ml, 20 ml, and 50 ml.
  • Delivery can be to one of more sites at the coxofemoral joint so that the implantable device contacts at least a portion of the coxofemoral joint.
  • sites may be intra-articular or extra-articular, and can include the capsule, the stratum fibrosum of the capsule, the iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, and ligamentum teres femoris.
  • injections may be with the aid of a fluoroscope.
  • the implantable device can include a contrast dye to visualize delivery of the implantable device at the site of implantation.
  • an implantable device comprises a sheet
  • the sheet may be delivered to a site at the coxofemoral joint during an open surgical procedure, microdisectomy, and/or percutaneous procedure.
  • sheet can also refer to “mesh” in some instance.
  • the sheet can contact at least a portion of the coxofemeroal joint at one or more sites, for example, the capsule, the iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, and ligamentum teres femoris.
  • a sheet can circumvent the coxofemoral joint, and in particular, the capsule of the coxofemoral joint.
  • the sheet may be imbricated to the capsule and stimulate tissue growth. It is envisioned that new tissue growth tightens the capsule, thus promoting containment and minimizing subluxation at the joint.
  • Sheets can be attached at one or more sites at a coxofemoral joint. Such sites will be apparent to a skilled artisan, and may include, the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, ligamentum teres femoris, acetabulum, and femoral neck. Sheets can be anchored to the joint by various methods. Examples include the use of sutures, screws, anchors, hooks, staples, pins, and darts with methods well known in the art.
  • the coxofemoral joint may include a defect, for example, a partial capsulectomy, small capsulotomy, or large capsulotomy.
  • the sheet can span the defect and be attached to the joint to augment the compromised capsule, for example, at the capsule at the edges of the defect.
  • the sheet can be attached to the defect.
  • the devices described herein can be used where a coxofemoral joint has undergone complete capsulectomy. In such embodiments, a sheet can be utilized to replace the capsule and attached to the acetabulum and femoral neck of the joint.

Abstract

The present technology relates to methods and devices for augmenting the canine coxofemoral joint. In particular, methods for augmenting the capsule of the canine coxofemoral joint are provided. In some embodiments, augmentation can be performed by injecting an implantable device comprising a biodegradable matrix and microparticles into the capsule. In some embodiments, augmentation can be performed by imbricating an implantable device comprising a biodegradable matrix and microparticles at the capsule.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • This application is a divisional of U.S. application Ser. No. 12/398,124, filed Mar. 4, 2009, entitled “Methods and Compositions for Minimally Invasive Capsular Augmentation of Canine Coxofemoral Joints,” which claims priority to U.S. Provisional Application No. 61/034,118, filed Mar. 5, 2008, entitled “A Device and Method for Minimally Invasive Capsular and Augmentation for Canine Coxofemoral Joint.” The disclosures of all of the above-referenced prior applications, publication, and patents are considered part of the disclosure of this application, and are incorporated by reference herein in their entirety.
  • FIELD OF THE INVENTION
  • The present technology relates to the field of veterinary medicine. In particular, methods and devices are provided for augmenting the capsule of the canine coxofemoral joint.
  • BACKGROUND
  • Hip dysplasia is a common problem in veterinary practice, accounting for up to 30% of canine orthopedic cases (Richardson D. C. “The role of nutrition in canine hip dysplasia.” Vet Clin North Am Small Anim. Pract. 1992; 22: 529-540). The frequency of the disease varies among breeds and can be as high as 70.5% in bulldogs and 48.2% in St. Bernards (Corley E. A, Keller G. G. “Hip Dysplasia: A Progress Report and Update.” Columbia, Mo.: Orthopedic Foundation of Animals 1993 (suppl)). Male and female dogs are affected with equal frequency, in contrast to the disease in humans, where 80% of cases are female (Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip “Clinical Practice Guideline: Early Detection of Developmental Dysplasia of the Hip” Pediatrics (2000) 105: 896-905).
  • The canine coxofemoral joint is a ball and socket joint, where the femoral head meets the socket of the acetabulum. In chronic canine hip dysplasia, the joint becomes deformed where the femoral head is subluxed out of the joint resulting in significant pain, restricted range of motion, and accelerated osteoarthritic changes of the joint.
  • Treatment for canine hip dysplasia can include total hip replacement. Total hip replacement has become one of the most successful procedures utilized in the treatment of canine hip dysplasia, and associated disorders such as coxarthrosis; severe osteoarthritis, chronic subluxation, avascular necrosis, and fracture dislocation. The typical minimum age for total hip replacement is approximately 10 months and/or a body weight of 35 pounds, and there appears to be no upper age limit for total hip replacement (Olmstead M L. “Total hip replacement.” Vet Clin North Am Small Anim Pract 1987, 17, 943-955; Tomlinson J, McLaughlin R Jr. “Total hip replacement: The best treatment for dysplastic dogs with osteoarthrosis. Symposium on CHD: Surgical Management.” Vet Med 1996, 91, 118-124; and Olmstead M L. “Total hip replacement in the dog.” Semin Vet Med Surg (Small Anim) 1987, 2, 131-140). However, total hip replacement can lead to complications such as aseptic loosening, chronic subluxation, nerve injury, infection, fracture of the acetabulum, fracture of the femoral stem or shaft, patella luxation, pulmonary embolism and death (Konde L J, et al. “Radiographic evaluation of total hip replacement in the dog.” Vet Radiol 1982, 20, 98-106; Liska W D. “Femur fractures associated with canine total hip replacement.” Vet Surg 2004, 33, 164-172; and Montgomery R D et al. “Total hip arthroplasty for treatment of canine hip dysplasia.” Vet Clin North Am Small Anim Pract 1992, 22, 703-719).
  • Despite expensive screening and breeding programs, the disease continues to have a major economic and emotional impact on dog breeders and owners. Accordingly, there is a need for minimally invasive methods and devices to treat hip dysplasia and associated disorders.
  • SUMMARY
  • The present technology relates to methods and devices for augmenting the capsule of a canine coxofemoral joint. Some methods described herein can include the steps of identifying a subject in need of capsular augmentation, delivering an implantable device to the capsule, in which the implantable device includes a biodegradable matrix and a plurality of microparticles, and contacting the implantable device with at least a portion of the capsule.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the implantable device can include a sheet. In some such embodiments, the sheet can include fenestrations. More methods can also include anchoring the implantable device at the joint. In certain embodiments, the anchoring can be at one or more sites of the joint selected from the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, ligamentum teres femoris, acetabulum, or femoral neck.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, delivering can include injecting the implantable device into one or more sites of the capsule. In some such methods, one or more sites can be selected from the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament. acetabular labrum, and ligamentum teres femoris. In more embodiments, the injecting can be into at least a portion of the stratum fibrosum of the capsule.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, contacting the implantable device with at least a portion of the joint can include at least a portion of one or more sites selected from the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, and ligamentum teres femoris.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the joint has undergone capsulotomy or partial capsulectomy.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, delivering includes percutaneous delivery. In some methods for augmenting the capsule of a canine coxofemoral joint, delivering includes an open surgical procedure.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the biodegradable matrix includes bovine collagen.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the biodegradable matrix includes one or more materials selected from albumin, gelatin, chitosan, hyaluronic acid, starch, cellulose, cellulose derivatives (e.g. methylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, carboxymethylcellulose, cellulose acetate phthalate, cellulose acetate succinate, hydroxypropylmethylcellulose phthalate), casein, dextrans, polysaccharides, fibrinogen, poly(D,L lactide), poly(D,L-lactide-co-glycolide), poly(glycolide), poly(hydroxybutyrate), poly(alkylcarbonate), poly(orthoesters), polyesters, poly(hydroxyvaleric acid), polydioxanone, poly(ethylene terephthalate), poly(malic acid), poly(tartronic acid), polyanhydrides, polyphosphazenes, poly(amino acids), and copolymers thereof.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the plurality of microparticles include a material selected from the group consisting of poly methacrylate, polymethyl methacrylate, hydroxapatite, powdered bone, and glass.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the plurality of microparticles can be substantially spherical with a diameter less than 200 μm. In more embodiments, the plurality of microparticles can be substantially spherical with a diameter less than 100 μm.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the implantable device can also include a bioactive agent. In more embodiments, the bioactive agent can include an agent selected from the group consisting of a local anesthetic, non-steroidal anti-inflammatory drug, antibiotic, and antineoplastic agent. In more embodiments, the bioactive agent can include lidocaine.
  • In some methods for augmenting the capsule of a canine coxofemoral joint, the implantable device can also include a substrate. In more embodiments, the substrate can include a material selected from nylon, Dacron, and Teflon. In more embodiments, the substrate can be coated with the plurality of microparticles and the biodegradable matrix.
  • In addition to the methods described herein, also provided is a canine coxofemoral joint including an implantable device, in which the implantable device comprises collagen and microparticles.
  • In some embodiments, the collagen comprises bovine collagen.
  • In some embodiments, the microparticles are substantially spherical with a diameter less than 200 μm. In more embodiments, the microparticles are substantially spherical with a diameter less than 100 μm.
  • In some embodiments, the implantable device further comprises a bioactive agent. In more embodiments, the bioactive agent comprises an agent selected from the group consisting of a local anesthetic, non-steroidal anti-inflammatory drug, antibiotic, and antineoplastic agent. In more embodiments, the bioactive agent comprises lidocaine.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 shows a schematic of a canine coxofemoral joint (5). The joint includes the femoral head (10), the acetabulum (20), pelvis (30), and capsule (40).
  • FIG. 2 shows a schematic of a canine coxofemoral joint imbricated with a collagen mesh containing microparticles.
  • FIG. 3 shows a schematic of a canine coxofemoral joint injected with a collagen matrix containing microparticles.
  • DETAILED DESCRIPTION
  • The present invention relates to methods and devices for augmenting the capsule of a canine coxofemoral joint. In particular embodiments, methods are provided that include identifying a subject in need of capsular augmentation, delivering an implantable device to the capsule, in which the implantable device includes a biodegradable matrix and a plurality of microparticles, and contacting the implantable device with at least a portion of the capsule are described. Such methods and devices can be useful to treat canine hip dysplasia and related disorders.
  • In some embodiments, the implantable device can include a biodegradable matrix, such as collagen, and microparticles comprised of polymethyl methacrylate (PMMA). The device can be inserted at the canine coxofemoral to augment the capsule. Without wishing to be bound to any one theory, it is believed that the biodegradable matrix provides a substrate for the host's fibroblasts to migrate into the device and invoke a fibrotic response at the insertion site. In addition, the microparticles may further invoke the host to secrete components of the extracellular matrix, including the host's own collagen, at the site of insertion. Thus the response to inserting such an implantable device at the canine coxofemoral capsule can be that the host produces a fibrous matrix at the site of insertion, thickening and tightening the capsule, and strengthening the joint. Moreover, as the host continues to produce a fibrous matrix at the site of insertion, the tensile strength at the site of insertion can increase with time. This is in contrast to hip repairs such as arthroplasty, which tend to become weaker over a period of time through loosening of cement, stem migration or sublimation, and infection.
  • Referring to FIG. 1, the canine coxofemoral joint (5) includes the femoral head (10) which is used for articulation of the joint. The acetabulum (20) represents the concave portion of the coxofemoral joint and is part of the pelvis (30). The deep acetabulum is further extended by a band of fibrocartilage surrounding its rim. This acetabular lip is continued as a transverse acetabular ligament in the ventral aspect of the femur and completes the circular restraint of the hip joint. The ligament of the head of the femur, also known as the teres ligament or round ligament, is a short, flat ligament that connects the center of the femoral head to the acetabular fossa. This ligament contributes to femoral stability by retaining the femoral head within the acetabulum and in the adult dog provides some vascularity to the femoral head. The coxofemoral joint is surrounded by a fibrous joint capsule (40) that is connected to the femur at the base of the neck and at the acetabulum just around the acetabular lip. In chronic canine hip dysplasia, the joint becomes deformed where the femoral head is subluxed out of the joint. In such cases, the capsule of the coxofemoral joint can be one of the only restraining structures to maintain containment.
  • In some methods to augment a canine capsule (40), an implantable solid mesh described herein. Referring now to FIG. 2, for example, a collagen mesh (50) containing microparticles can be wrapped around the capsule of a canine coxofemoral joint. The mesh can be imbricated to the capsule. Because the capsule may not be invaded, this method has the advantage of being minimally invasive. Thus the veterinary surgeon can minimize her incision on the capsule, reducing blood loss, and minimizing articular destruction, as compared to more invasive methods. Moreover, wrapping the capsule with the mesh strengthens the joint two-fold. First, the mesh provides tensile strength to the capsule, and second, the tensile strength increases as the biodegradable collagen is replaced by the host's collagen and secretions.
  • In other embodiments, the implantable device can be in the form of a fluid gel or paste. Such devices can be injected into a coxofemoral capsule. Referring to FIG. 3, the implantable devices described herein can be injected into the capsule using a syringe (60). As will be apparent, methods including injecting the implantable device are particularly advantageous because the treatment is minimally invasive.
  • The following description is directed to certain specific embodiments. However, the invention can be embodied in a multitude of different ways. Reference in this specification to “one embodiment” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. The appearances of the phrase “in one embodiment,” “according to one embodiment,” or “in some embodiments” in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. Moreover, various features are described which may be exhibited by some embodiments and not by others. Similarly, one or more features may be described for one embodiment which can also be reasonably used in another embodiment.
  • As used herein, “at least a portion” can refer to at least about 0.1%, 1%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80,%, 90%, 99% , and 100%.
  • Some of the implantable devices described herein are adapted to promote a fibrotic response at a site of contact. As used herein, “fibrotic response” or “fibrosis” can refer to the formation of fibrous tissue in response to medical intervention. Implantable devices which induce a fibrotic response can do so through one or more mechanisms, for example, stimulating migration or proliferation of connective tissue cells, such as fibroblasts, smooth muscle cells, and vascular smooth muscle cells; inducing production of extracellular matrix components, such as collagen; promoting tissue remodeling; and inducing or promoting angiogenesis.
  • An implantable device can comprise one or more components that can include, for example, a plurality of microparticles, a biodegradable matrix, a bioactive agent, and/or a substrate. The following description provides embodiments of implantable devices and methods of using such devices.
  • In some embodiments, microparticles can promote a fibrotic response at the site of implantation and provide a scaffold to promote connective tissue deposition around the microparticles. Microparticles can be microspheres, and/or nanoparticles. As will be understood, microparticles may be small enough to be delivered to a site, for example, by injection, but large enough to resist phagocytosis and the lymphatic and blood system from washing away any of the microparticles. As such, microparticles can have a diameter of greater than about 10 μm. In some embodiments, the microparticles can have a diameter between about 20 μm to about 200 μm, a diameter between about 25 μm to about 100 μm, or a diameter between about 30 μm to about 50 μm. The microparticles can also be highly refined to limit any inflammation from smaller particles, and to increase the roundness and smoothness of the particles.
  • The microspheres can comprise an inert, histocompatible material, such as glass, hydroxapatite, powdered bone, or a polymer. The polymer can be cured and polymerized prior to implantation to reduce toxic or carcinogenic potential of the monomers or cure agents. The inert histocompatible polymer can be an acrylic polymer. The acrylic polymer can be a polymer of methacrylate or one of its esters, such as methyl methacrylate, ethyl methacrylate, n-butyl methacrylate, isobutyl methacrylate, lauryl methacrylate, and 2-ethylhexyl methacrylate or any combination or copolymer thereof. In preferred embodiments, microparticles can comprise polymethylmethacrylate (PMMA). Some embodiments in the form of a gel pr paste are described in U.S. Pat. No. 5,344,452, which is incorporated by reference in its entirety.
  • Microparticles can be porous or non-porous. Porous microparticles containing an additional agent may be used to deliver agents to the site of implantation.
  • In some embodiments, the microparticles can be suspended in a suspension agent. The suspension agent can be an aqueous or non-aqueous solution. The suspension agent can be of sufficient viscosity to promote the suspension of the microparticles. The suspension agent can be, for example, up to about 0.1%, 0.2%, 0.5%, 1.0%, 2.0%, 5.0%, 10%, 15%, 20%, 30%, 40%, 50%, 60%, 70% and 80% by volume microparticles. The amount of microparticles used is determined in part by other components of the suspension agent, such as the carrier concentration, and the method of implantation, such as injection.
  • The suspension agent can also contain a polymer, which can be histocompatible, as a carrier. Such a carrier can be a biodegradable matrix. A biodegradable matrix can comprise a biodegradable polymer. Examples of biodegradable polymers include collagen, albumin, gelatin, chitosan, hyaluronic acid, starch, cellulose, cellulose derivatives (e.g. methylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose, carboxymethylcellulose, cellulose acetate phthalate, cellulose acetate succinate, hydroxypropylmethylcellulose phthalate), casein, dextrans, polysaccharides, fibrinogen, poly(D,L lactide), poly(D,L-lactide-co-glycolide), poly(glycolide), poly(hydroxybutyrate), poly(alkylcarbonate), poly(orthoesters), polyesters, poly(hydroxyvaleric acid), polydioxanone, poly(ethylene terephthalate), poly(malic acid), poly(tartronic acid), polyanhydrides, polyphosphazenes, poly(amino acids), and copolymers thereof (see generally, Ilium, L., Davids, S. S. (eds.) “Polymers in Controlled Drug Delivery” Wright, Bristol, 1987; Arshady R., “Preparation of biodegradable microspheres and microcapsules.” J. Controlled Release 17:1-22, 1991; Pitt C. G., “The controlled parenteral delivery of polypeptides and proteins.” Int. J. Pharm. 59:173-196, 1990; Holland et al, “Polymers for Biodegradable Medical Devices. 1. The Potential of Polyesters as Controlled Macromolecular Release Systems.” J. Controlled Release 4:155-180, 1986).
  • In preferred embodiments, the biodegradable polymer can comprise collagen. Collagen may allow for the separation of the microspheres to allow tissue ingrowth. The collagen can be in many types and forms, or in combinations thereof. For example, collagen can be Type I, II or III. Collagen can be native, denatured or cross linked. The various types and forms of collagen are described generally in Methods in Enzymol. (1982) 82:3-217, Pt. A, incorporated by reference in its entirety. For example, collagen can be produced from animal derived tissues such as bovine or porcine hides, avian combs, human tissues such as cadaver skin or human cell cultures or through recombinant methods. In some embodiments, an implantable device can contain a collagen fully dissolved or in suspension. The solution can contain up to about 0.1%, 0.2%, 0.5%, 1.0%, 2.0%, 2.5%, 3.0%, 3.5%, 4.0%, 4.5%, 5%, 6%, 7%, 8%, 9%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, or 80% (v/v) collagen content. The amount of collagen content in the solution is in part determined by the resultant viscosity, the percentage of other components such as microparticles and the method of implantation, such as injection.
  • In particular embodiments, an implantable device comprises a collagen matrix and microparticles. An example of a commercially available material that may be used in some embodiments includes ARTEFILL (Artes Medical Inc.). ARTEFILL comprises PMMA microparticles suspended in bovine collagen.
  • Other examples of commercially available materials that have been used for tissue repair and cosmetic applications include bovine collagen products such as ZYDERM I, ZYDERM II, and ZYPLAST (each produced by Allergan Inc.); bioengineered human collagen products such as COSMODERM I, COSMODERM II, and COSMOPLAST (Allegan Inc.); and porcine collagen products such as EVOLENCE (Ortho-McNeil-Janssen Pharmaceuticals, Inc.). More examples of collagen products include collagen meshes such as INSTAT (Johnson & Johnson), and composite collagen meshes such as ALLODERM (Lifecell Corp.), as well as collagen sponges such as SURGIFOAM (Johnson & Johnson) and TERUDERMIS (Terumo Corp.).
  • Implantable devices described herein can include additional bioactive agents. Bioactive agents can include any composition that is able to invoke a biological response in a subject. A biological response can include, for example, responses to promote healing such as a fibrotic response. Examples of bioactive agents that can induce a fibrotic response include silk, talc, chitosan, polylysine, fibronectin, bleomycin. As will be understood, in some embodiments, the microparticles can induce a fibrotic response. More examples of bioactive agents include local anesthetics (e.g. lidocaine, bupivacaine, procaine, tetracaine, dibucaine, benzocaine, p-buthylaminobenzoic acid 2-(diethylamino)ethyl ester HCl, mepivacaine, piperocaine, dyclonine, and opioids such as morphine, diamorphine, pethidine, codeine, hydrocodone, and oxycodone), non-steroidal anti-inflammatory drugs (e.g. ketoprofen, auranofin, naproxen, acetaminophen, acetylsalicylic acid, ibuprofen, phenylbutazone, indomethacin, sulindac, diclofenac, paracetamol, and diflunisal, Celecoxib, and Rofecoxib), antibiotics (e.g. clindamycin, minocycline, erythromycin, probenecid, and moxifloxacin), and antineoplastic agents. Antineoplastic agents can have antimicrobial activity at extremely low doses; examples include anthracyclines (e.g. doxorubicin and mitoxantrone), fluoropyrimidines (e.g. 5-FU), folic acid antagonists (e.g. methotrexate), podophylotoxins (e.g. etoposide), camptothecins, hydroxyureas, and platinum complexes (e.g. cisplatin). In preferred embodiments, the implantable device includes lidocaine. The concentration of lidocaine can be less than about 0.1%, 0.2%, 0.3%, 0.5%, 0.7%, 0.8%, 0.9%, 1%, and 5% by weight
  • Implantable devices described herein can include a substrate. The microparticles and/or biodegradable matrix can be embedded in the substrate. In some embodiments, the microparticles and/or biodegradable matrix can coat or wrap at least a portion of the substrate. The substrate can comprise a non-biodegradable material such as, nylon, Dacron and Teflon. More examples of non-biodegradable materials that can be used with the embodiments described herein include polyamides, polyolefins (e.g. polypropylene and polyethylene), polyurethanes, polyester/polyether block copolymers, polyesters (e.g. PET, polybutyleneterephthalate, and polyhexyleneterephthalate), polyester cloth (e.g. DACRON), polyester sheeting (e.g. MYLAR; DuPont), nylon meshes, DACRON meshes (e.g. MERSILENE; Ethicon, Inc.), acrylic cloth (ORLON; DuPont), polyvinyl sponge (IVALON), polyvinyl cloth (VINYON-N), polypropylene mesh (MARLEX or BARD; CR Bard, Inc.; and PROLENE; Ethicon, Inc.), silicones, fluoropolymers (e.g. fluorinated ethylene propylene), and polytetrafluoroethylene (PTFE; e.g. TEFLON mesh and cloth; DuPont).
  • In some implementations, an implantable device can be a fluid, suspension, emulsion, microspheres, paste, gel, spray, aerosol, or sheet. With respect to sheets, the dimensions of a sheet can vary according to the application. Accordingly, sheets can be of varying sizes, thicknesses, geometries and densities. For applications such as capsular augmentation, the sheet can have a thickness of less than about 1 mm, 2 mm, 3 mm, 4 mm, 5 mm, and 10 mm. As will be appreciated, a sheet can be trimmed to the geometries and size appropriate to the application. In some embodiments, a sheet can be rectangular with a length sufficient to circumvent the capsule of a canine coxofemoral joint. In some embodiments, a sheet can have a length and breadth sufficient to make contact with at least a portion of the capsule of a canine coxofemoral joint.
  • For sheet material, woven structures are advantageous, as well as microporous materials. The implantable device may be fenestrated to promote infiltration by the host into the sheet. Such meshes can act as a scaffold. The fenestrations may be formed in a variety of geometric shapes and sizes. Initially, a fenestrated implantable device may not be as strong as a solid sheet. However, because of the increased surface area and the potential for fibrovascular infiltration through the fenestrations, a fenestrated implantable device may ultimately be stronger than a solid sheet implant. The fenestrations may also be used with sutures or other fixing devices to attach the implantable device to a site, for example, the capsule of a canine coxofemoral joint.
  • An implantable device including a mesh can provide many important advantages. Some mesh implants may be only as strong as the tissue in which the mesh is integrated. However, without wishing to be bound by any one theory, it is believed that when the implant includes microparticles a fibrotic response is induced in the host. In such a response, the host's response for healing occurs especially quickly along the scaffold of the implant. The microparticles make this process occur much faster than mesh implants without particles associated therewith. The body's inflammatory response to the mesh implant is such that fibrous tissue forms a capsule around the biological mesh, and, thus, provides stability and security in the repair.
  • As used herein “subject” can refer to an animal that can benefit from the methods and devices described herein. As will be understood by one of skill in the art, “need” is not an absolute term and merely implies that the subject can benefit from the methods and devices described herein. In preferred embodiments, the subject is a dog.
  • Augmentation of a coxofemoral joint may prevent, reduce, or treat various joint disorders. Disorders amenable to the methods and compositions described herein can include, for example, hip dysplasia, osteoarthritis, coxarthrosis, and chronic subluxation. More examples include chronic luxations, failed closed reductions, excessive postreduction instability, intra-articular fractures, concurrent pelvic fractures, or other fractures of the affected limb that prevent closed reduction (Martini F. M. et al., “Extra-articular absorbable suture stabilization of coxofemoral luxation in dogs.” Vet Surg 30: 468-475 (2001), incorporated by reference in its entirety). Moreover, the devices and methods described herein can also be utilized in association with other methods well known in the art to promote stabilization of hip luxation (see generally, Johnson A. L. and Dunning D. Atlas of orthopedic surgical procedures of the dog and cat. Chapters 15-18 (2005), incorporated by reference in its entirety).
  • A subject can be identified by various methods, including, for example, by x-ray or a test that requires manipulation of the hip joint into standard positions well known in the art (see generally, Slatter, D., Textbook of Small Animal Surgery, Chapter 144 (2002), incorporated by reference in its entirety).
  • In addition, the methods and compositions can be used prophylactically to prevent or reduce future damage or degeneration of a joint. Subjects that may benefit from treatment can include particular types of dogs that may be more susceptible to hip dysplasia, for example, larger dogs and particular breeds such as Golden Retrievers, Labrador Retrievers, German Shepherds, Bulldogs, and St Bernards. Also, dogs with hip joint laxity may be susceptible to hip dysplasia and associated disorders. Such subjects may benefit from prophylactic treatment.
  • Various methods can be used to deliver an implantable device to a subject. In some embodiments, the method of delivery can be during an open surgical procedure, microdisectomy, percutaneous procedure, and/or by injection. Where an implantable device comprises a gel, paste, liquid or fluid, the device can be delivered to a site at the coxofemoral joint by injection. As will be appreciated, the size of the needle used during such injections will vary according to the subject, viscosity of the implantable device, and application. For example, the needle can have a gauge in the range of about 22 to 25, and length in the range of about 1.5 to 3.0 inches. The volume injected can be less than about 0.1 ml, 0.5 ml, 1.0 ml, 1.2 ml, 1.5 ml, 2.0 ml, 2.5 ml, 5 ml, 10 ml, 20 ml, and 50 ml. Delivery can be to one of more sites at the coxofemoral joint so that the implantable device contacts at least a portion of the coxofemoral joint. Such sites may be intra-articular or extra-articular, and can include the capsule, the stratum fibrosum of the capsule, the iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, and ligamentum teres femoris.
  • Several techniques can be used to guide delivery during injection. Such techniques can include, for example, fluoroscopy, ultrasound, and/or the use of anatomical landmarks only. In preferred embodiments, injections may be with the aid of a fluoroscope. In such embodiments, the implantable device can include a contrast dye to visualize delivery of the implantable device at the site of implantation.
  • Where an implantable device comprises a sheet, the sheet may be delivered to a site at the coxofemoral joint during an open surgical procedure, microdisectomy, and/or percutaneous procedure. As used herein, “sheet” can also refer to “mesh” in some instance. The sheet can contact at least a portion of the coxofemeroal joint at one or more sites, for example, the capsule, the iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, and ligamentum teres femoris. In some embodiments, a sheet can circumvent the coxofemoral joint, and in particular, the capsule of the coxofemoral joint. In such embodiments, the sheet may be imbricated to the capsule and stimulate tissue growth. It is envisioned that new tissue growth tightens the capsule, thus promoting containment and minimizing subluxation at the joint.
  • Sheets can be attached at one or more sites at a coxofemoral joint. Such sites will be apparent to a skilled artisan, and may include, the capsule, iliofemoral ligament, ischiocapsular ligament, pubocapsular ligament, acetabular labrum, ligamentum teres femoris, acetabulum, and femoral neck. Sheets can be anchored to the joint by various methods. Examples include the use of sutures, screws, anchors, hooks, staples, pins, and darts with methods well known in the art.
  • In certain embodiments, the coxofemoral joint may include a defect, for example, a partial capsulectomy, small capsulotomy, or large capsulotomy. The sheet can span the defect and be attached to the joint to augment the compromised capsule, for example, at the capsule at the edges of the defect. In some embodiments, the sheet can be attached to the defect. In addition, it is also envisioned that the devices described herein can be used where a coxofemoral joint has undergone complete capsulectomy. In such embodiments, a sheet can be utilized to replace the capsule and attached to the acetabulum and femoral neck of the joint.
  • Various modifications to these examples may be readily apparent to those skilled in the art, and the principles defined herein may be applied to other examples without departing from the spirit or scope of the novel aspects described herein. Thus, the scope of the disclosure is not intended to be limited to the examples shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein. Accordingly, the novel aspects described herein is to be defined solely by the scope of the following claims.

Claims (7)

What is claimed is:
1. A canine coxofemoral joint augmented with an implantable device, wherein said implantable device comprises collagen and microparticles.
2. The canine coxofemoral joint of claim 1, wherein said collagen comprises bovine collagen.
3. The canine coxofemoral joint of claim 1, wherein said microparticles are substantially spherical with a diameter less than 200 μm.
4. The canine coxofemoral joint of claim 3, wherein said microparticles are substantially spherical with a diameter less than 100 μm.
5. The canine coxofemoral joint of claim 1, wherein said implantable device further comprises a bioactive agent.
6. The canine coxofemoral joint of claim 5, wherein said bioactive agent comprises an agent selected from the group consisting of a local anesthetic, non-steroidal anti-inflammatory drug, antibiotic, and antineoplastic agent.
7. The canine coxofemoral joint of claim 5, wherein said bioactive agent comprises lidocaine.
US13/924,783 2008-03-05 2013-06-24 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints Abandoned US20140163689A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US13/924,783 US20140163689A1 (en) 2008-03-05 2013-06-24 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US3411808P 2008-03-05 2008-03-05
US12/398,124 US8469961B2 (en) 2008-03-05 2009-03-04 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints
US13/924,783 US20140163689A1 (en) 2008-03-05 2013-06-24 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US12/398,124 Division US8469961B2 (en) 2008-03-05 2009-03-04 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints

Publications (1)

Publication Number Publication Date
US20140163689A1 true US20140163689A1 (en) 2014-06-12

Family

ID=41464961

Family Applications (2)

Application Number Title Priority Date Filing Date
US12/398,124 Expired - Fee Related US8469961B2 (en) 2008-03-05 2009-03-04 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints
US13/924,783 Abandoned US20140163689A1 (en) 2008-03-05 2013-06-24 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US12/398,124 Expired - Fee Related US8469961B2 (en) 2008-03-05 2009-03-04 Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints

Country Status (1)

Country Link
US (2) US8469961B2 (en)

Families Citing this family (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006026731A1 (en) 2004-08-30 2006-03-09 Spineovations, Inc. Method of treating spinal internal disk derangement
US8608749B2 (en) 2006-02-27 2013-12-17 Biomet Manufacturing, Llc Patient-specific acetabular guides and associated instruments
US9113971B2 (en) 2006-02-27 2015-08-25 Biomet Manufacturing, Llc Femoral acetabular impingement guide
US9907659B2 (en) 2007-04-17 2018-03-06 Biomet Manufacturing, Llc Method and apparatus for manufacturing an implant
US8603180B2 (en) 2006-02-27 2013-12-10 Biomet Manufacturing, Llc Patient-specific acetabular alignment guides
US9339278B2 (en) 2006-02-27 2016-05-17 Biomet Manufacturing, Llc Patient-specific acetabular guides and associated instruments
US9345548B2 (en) 2006-02-27 2016-05-24 Biomet Manufacturing, Llc Patient-specific pre-operative planning
US10278711B2 (en) 2006-02-27 2019-05-07 Biomet Manufacturing, Llc Patient-specific femoral guide
US8591516B2 (en) 2006-02-27 2013-11-26 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US8608748B2 (en) 2006-02-27 2013-12-17 Biomet Manufacturing, Llc Patient specific guides
US8092465B2 (en) 2006-06-09 2012-01-10 Biomet Manufacturing Corp. Patient specific knee alignment guide and associated method
US7967868B2 (en) 2007-04-17 2011-06-28 Biomet Manufacturing Corp. Patient-modified implant and associated method
US8241293B2 (en) 2006-02-27 2012-08-14 Biomet Manufacturing Corp. Patient specific high tibia osteotomy
US8407067B2 (en) 2007-04-17 2013-03-26 Biomet Manufacturing Corp. Method and apparatus for manufacturing an implant
US9918740B2 (en) 2006-02-27 2018-03-20 Biomet Manufacturing, Llc Backup surgical instrument system and method
US8377066B2 (en) 2006-02-27 2013-02-19 Biomet Manufacturing Corp. Patient-specific elbow guides and associated methods
US9173661B2 (en) 2006-02-27 2015-11-03 Biomet Manufacturing, Llc Patient specific alignment guide with cutting surface and laser indicator
US8568487B2 (en) 2006-02-27 2013-10-29 Biomet Manufacturing, Llc Patient-specific hip joint devices
US20150335438A1 (en) 2006-02-27 2015-11-26 Biomet Manufacturing, Llc. Patient-specific augments
US8858561B2 (en) * 2006-06-09 2014-10-14 Blomet Manufacturing, LLC Patient-specific alignment guide
US8535387B2 (en) 2006-02-27 2013-09-17 Biomet Manufacturing, Llc Patient-specific tools and implants
US9289253B2 (en) 2006-02-27 2016-03-22 Biomet Manufacturing, Llc Patient-specific shoulder guide
US9795399B2 (en) 2006-06-09 2017-10-24 Biomet Manufacturing, Llc Patient-specific knee alignment guide and associated method
GB2442441B (en) * 2006-10-03 2011-11-09 Biomet Uk Ltd Surgical instrument
KR101708622B1 (en) * 2009-03-10 2017-02-21 엘라스타겐 피티와이 리미티드 Injectable biomaterials
DE102009028503B4 (en) 2009-08-13 2013-11-14 Biomet Manufacturing Corp. Resection template for the resection of bones, method for producing such a resection template and operation set for performing knee joint surgery
US8632547B2 (en) 2010-02-26 2014-01-21 Biomet Sports Medicine, Llc Patient-specific osteotomy devices and methods
US9271744B2 (en) 2010-09-29 2016-03-01 Biomet Manufacturing, Llc Patient-specific guide for partial acetabular socket replacement
US9968376B2 (en) 2010-11-29 2018-05-15 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US9241745B2 (en) 2011-03-07 2016-01-26 Biomet Manufacturing, Llc Patient-specific femoral version guide
US8715289B2 (en) 2011-04-15 2014-05-06 Biomet Manufacturing, Llc Patient-specific numerically controlled instrument
US8668700B2 (en) 2011-04-29 2014-03-11 Biomet Manufacturing, Llc Patient-specific convertible guides
US8956364B2 (en) 2011-04-29 2015-02-17 Biomet Manufacturing, Llc Patient-specific partial knee guides and other instruments
US8532807B2 (en) 2011-06-06 2013-09-10 Biomet Manufacturing, Llc Pre-operative planning and manufacturing method for orthopedic procedure
US9084618B2 (en) 2011-06-13 2015-07-21 Biomet Manufacturing, Llc Drill guides for confirming alignment of patient-specific alignment guides
US20130001121A1 (en) 2011-07-01 2013-01-03 Biomet Manufacturing Corp. Backup kit for a patient-specific arthroplasty kit assembly
US8764760B2 (en) 2011-07-01 2014-07-01 Biomet Manufacturing, Llc Patient-specific bone-cutting guidance instruments and methods
US8597365B2 (en) 2011-08-04 2013-12-03 Biomet Manufacturing, Llc Patient-specific pelvic implants for acetabular reconstruction
US9066734B2 (en) 2011-08-31 2015-06-30 Biomet Manufacturing, Llc Patient-specific sacroiliac guides and associated methods
US9295497B2 (en) 2011-08-31 2016-03-29 Biomet Manufacturing, Llc Patient-specific sacroiliac and pedicle guides
US9386993B2 (en) 2011-09-29 2016-07-12 Biomet Manufacturing, Llc Patient-specific femoroacetabular impingement instruments and methods
US9301812B2 (en) 2011-10-27 2016-04-05 Biomet Manufacturing, Llc Methods for patient-specific shoulder arthroplasty
EP2770918B1 (en) 2011-10-27 2017-07-19 Biomet Manufacturing, LLC Patient-specific glenoid guides
KR20130046337A (en) 2011-10-27 2013-05-07 삼성전자주식회사 Multi-view device and contol method thereof, display apparatus and contol method thereof, and display system
US9554910B2 (en) 2011-10-27 2017-01-31 Biomet Manufacturing, Llc Patient-specific glenoid guide and implants
US9451973B2 (en) 2011-10-27 2016-09-27 Biomet Manufacturing, Llc Patient specific glenoid guide
US9237950B2 (en) 2012-02-02 2016-01-19 Biomet Manufacturing, Llc Implant with patient-specific porous structure
US9688741B2 (en) 2012-10-23 2017-06-27 Elastagen Pty Ltd Elastic hydrogel
AU2013360011B2 (en) 2012-12-10 2017-02-02 Allergan Pharmaceuticals International Limited Scalable three-dimensional elastic construct manufacturing
US9204977B2 (en) 2012-12-11 2015-12-08 Biomet Manufacturing, Llc Patient-specific acetabular guide for anterior approach
US9060788B2 (en) 2012-12-11 2015-06-23 Biomet Manufacturing, Llc Patient-specific acetabular guide for anterior approach
US9839438B2 (en) 2013-03-11 2017-12-12 Biomet Manufacturing, Llc Patient-specific glenoid guide with a reusable guide holder
US9579107B2 (en) 2013-03-12 2017-02-28 Biomet Manufacturing, Llc Multi-point fit for patient specific guide
US9826981B2 (en) 2013-03-13 2017-11-28 Biomet Manufacturing, Llc Tangential fit of patient-specific guides
US9498233B2 (en) 2013-03-13 2016-11-22 Biomet Manufacturing, Llc. Universal acetabular guide and associated hardware
US9517145B2 (en) 2013-03-15 2016-12-13 Biomet Manufacturing, Llc Guide alignment system and method
US20160194379A1 (en) 2013-08-13 2016-07-07 Elastagen Pty Ltd Regeneration of Damaged Tissue
US20150112349A1 (en) 2013-10-21 2015-04-23 Biomet Manufacturing, Llc Ligament Guide Registration
US20150290248A1 (en) * 2014-04-10 2015-10-15 Nanofiber Health, Inc. Fibrous component for health, performance, and aesthetic treatment
US10282488B2 (en) 2014-04-25 2019-05-07 Biomet Manufacturing, Llc HTO guide with optional guided ACL/PCL tunnels
US9408616B2 (en) 2014-05-12 2016-08-09 Biomet Manufacturing, Llc Humeral cut guide
US9561040B2 (en) 2014-06-03 2017-02-07 Biomet Manufacturing, Llc Patient-specific glenoid depth control
US9839436B2 (en) 2014-06-03 2017-12-12 Biomet Manufacturing, Llc Patient-specific glenoid depth control
US9833245B2 (en) 2014-09-29 2017-12-05 Biomet Sports Medicine, Llc Tibial tubercule osteotomy
US9826994B2 (en) 2014-09-29 2017-11-28 Biomet Manufacturing, Llc Adjustable glenoid pin insertion guide
ES2693579T3 (en) 2015-01-16 2018-12-12 Spineovations, Inc. Method of treatment of the intervertebral disc
US9820868B2 (en) 2015-03-30 2017-11-21 Biomet Manufacturing, Llc Method and apparatus for a pin apparatus
US10568647B2 (en) 2015-06-25 2020-02-25 Biomet Manufacturing, Llc Patient-specific humeral guide designs
US10226262B2 (en) 2015-06-25 2019-03-12 Biomet Manufacturing, Llc Patient-specific humeral guide designs
US10722310B2 (en) 2017-03-13 2020-07-28 Zimmer Biomet CMF and Thoracic, LLC Virtual surgery planning system and method

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5916565A (en) * 1996-03-08 1999-06-29 In Clover, Inc. Product and method for treating joint disorders in vertebrates
US20030236573A1 (en) * 2002-06-13 2003-12-25 Evans Douglas G. Devices and methods for treating defects in the tissue of a living being
US20060246033A1 (en) * 2005-03-02 2006-11-02 Cook Biotech Incorporated Injectable bulking agent compositions

Family Cites Families (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2474911A (en) 1944-03-11 1949-07-05 Standard Oil Dev Co Preparation of spherical gel particles
US5286763A (en) 1983-03-22 1994-02-15 Massachusetts Institute Of Technology Bioerodible polymers for drug delivery in bone
US4526909A (en) 1984-01-09 1985-07-02 Regents Of The University Of California Polymethylmethacrylate delivery system for bone morphogenetic protein
US4837285A (en) 1984-03-27 1989-06-06 Medimatrix Collagen matrix beads for soft tissue repair
DE3841401A1 (en) 1988-12-08 1990-06-13 Martin Lemperle ALLOPLASTIC IMPLANT
US5258028A (en) 1988-12-12 1993-11-02 Ersek Robert A Textured micro implants
CH679207A5 (en) 1989-07-28 1992-01-15 Debiopharm Sa
US5024659A (en) 1990-01-10 1991-06-18 Smith & Nephew Dyonics Inc. Breakable needle and hinged needle guide
US5290271A (en) 1990-05-14 1994-03-01 Jernberg Gary R Surgical implant and method for controlled release of chemotherapeutic agents
US5192326A (en) 1990-12-21 1993-03-09 Pfizer Hospital Products Group, Inc. Hydrogel bead intervertebral disc nucleus
US6537574B1 (en) 1992-02-11 2003-03-25 Bioform, Inc. Soft tissue augmentation material
DE69331096T2 (en) 1992-02-28 2002-08-14 Cohesion Tech Inc INJECTABLE, CERAMIC COMPOUNDS AND METHOD FOR THE PRODUCTION AND USE THEREOF
US5171279A (en) 1992-03-17 1992-12-15 Danek Medical Method for subcutaneous suprafascial pedicular internal fixation
JP3717930B2 (en) 1993-12-07 2005-11-16 ジェネティックス・インスチチュート・リミテッド・ライアビリティ・カンパニー BMP-12, BMP-13 and their tendon-derived compositions
KR0139235B1 (en) 1994-01-29 1998-04-28 조세현 Cement bead composition for orthopaedic surgery and its manufacturing process
US5599852A (en) 1994-10-18 1997-02-04 Ethicon, Inc. Injectable microdispersions for soft tissue repair and augmentation
US6372228B1 (en) 1994-11-15 2002-04-16 Kenton W. Gregory Method of producing elastin, elastin-based biomaterials and tropoelastin materials
US20020095218A1 (en) 1996-03-12 2002-07-18 Carr Robert M. Tissue repair fabric
US6129761A (en) 1995-06-07 2000-10-10 Reprogenesis, Inc. Injectable hydrogel compositions
DE19641775A1 (en) 1996-08-22 1998-02-26 Merck Patent Gmbh Process for the production of active ingredient-containing bone cements
US5913884A (en) 1996-09-19 1999-06-22 The General Hospital Corporation Inhibition of fibrosis by photodynamic therapy
US6355705B1 (en) 1997-02-07 2002-03-12 Queen's University At Kingston Anaesthetic bone cement
US6713527B2 (en) 1997-02-07 2004-03-30 Queen's University At Kingston Anaesthetic bone cement
US20020098222A1 (en) 1997-03-13 2002-07-25 John F. Wironen Bone paste
ATE220564T1 (en) 1997-08-14 2002-08-15 Sulzer Innotec Ag COMPOSITION AND DEVICE FOR REPAIRING CARTILAGE TISSUE IN VIVO CONSISTING OF NANOCAPSULES WITH OSTEOINDUCTIVE AND/OR CHONDROINDUCTIVE FACTORS
US6309420B1 (en) 1997-10-14 2001-10-30 Parallax Medical, Inc. Enhanced visibility materials for implantation in hard tissue
US6371992B1 (en) 1997-12-19 2002-04-16 The Regents Of The University Of California Acellular matrix grafts: preparation and use
CA2322954C (en) 1998-03-06 2011-06-07 Biosepra Inc. Implantable particles for tissue bulking and the treatment of gastroesophageal reflux disease, urinary incontinence, and skin wrinkles
DE69923167T2 (en) 1998-04-07 2006-01-12 Macropore, Inc., San Diego Membrane with corrugated surface for guiding the fabric
ATE514729T1 (en) 1999-02-01 2011-07-15 Eidgenoess Tech Hochschule BIOMATERIALS ADDED BY NUCLEOPHILIC REACTION ON CONJUGATE UNSATURATED GROUPS
US6264659B1 (en) 1999-02-22 2001-07-24 Anthony C. Ross Method of treating an intervertebral disk
US6183518B1 (en) 1999-02-22 2001-02-06 Anthony C. Ross Method of replacing nucleus pulposus and repairing the intervertebral disk
US20040010317A1 (en) 1999-08-18 2004-01-15 Gregory Lambrecht Devices and method for augmenting a vertebral disc
US6264695B1 (en) 1999-09-30 2001-07-24 Replication Medical, Inc. Spinal nucleus implant
AU1332101A (en) 1999-10-13 2001-04-23 Arthrocare Corporation Systems and methods for treating spinal pain
US7004977B2 (en) 1999-11-24 2006-02-28 A Enterprises, Inc. Soft tissue substitute and method of soft tissue reformation
US6383200B1 (en) 1999-12-21 2002-05-07 Securos, Inc. Tensioning device for cranial cruciate ligament stabilization
US6652883B2 (en) 2000-03-13 2003-11-25 Biocure, Inc. Tissue bulking and coating compositions
US7338657B2 (en) 2001-03-15 2008-03-04 Biosphere Medical, Inc. Injectable microspheres for tissue construction
DE60137230D1 (en) 2000-07-06 2009-02-12 Univ Georgetown STABLE (FIXED) FORMS OF VIRAL L1 CAPSID PROTEINS, THEIR FUSION PROTEINS, AND THEIR USES
US9387094B2 (en) 2000-07-19 2016-07-12 Warsaw Orthopedic, Inc. Osteoimplant and method of making same
US20020045942A1 (en) 2000-10-16 2002-04-18 Ham Michael J. Procedure for repairing damaged discs
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
US6827743B2 (en) 2001-02-28 2004-12-07 Sdgi Holdings, Inc. Woven orthopedic implants
FI20010540A0 (en) 2001-03-16 2001-03-16 Yli Urpo Antti Composite for the correction of defects in soft and hard tissue and the use of said composite
BR0210722A (en) 2001-06-29 2004-07-20 Medgraft Microtech Inc Biodegradable Injectable Implants and Related Methods of Production and Use
DE60232688D1 (en) 2001-11-20 2009-07-30 Univ Duke BOUNDARY-BIOMATERIALS
CA2482309A1 (en) 2001-12-10 2003-06-19 Colbar Lifescience Ltd. Methods, devices, and preparations for intervertebral disc treatment
US7131997B2 (en) 2002-03-29 2006-11-07 Scimed Life Systems, Inc. Tissue treatment
US20040054414A1 (en) 2002-09-18 2004-03-18 Trieu Hai H. Collagen-based materials and methods for augmenting intervertebral discs
US7824701B2 (en) 2002-10-18 2010-11-02 Ethicon, Inc. Biocompatible scaffold for ligament or tendon repair
US20060206116A1 (en) 2003-05-07 2006-09-14 Yeung Jeffrey E Injection device for the invertebral disc
CA2525369A1 (en) 2003-05-09 2004-11-25 Frank J. Falco Methods for using gadolinium as a contrast media
US7169405B2 (en) 2003-08-06 2007-01-30 Warsaw Orthopedic, Inc. Methods and devices for the treatment of intervertebral discs
US7905924B2 (en) 2003-09-03 2011-03-15 Ralph Richard White Extracapsular surgical procedure
WO2005065079A2 (en) 2003-11-10 2005-07-21 Angiotech International Ag Medical implants and fibrosis-inducing agents
US7534449B2 (en) 2004-07-01 2009-05-19 Yale University Targeted and high density drug loaded polymeric materials
MXPA06014403A (en) 2004-08-20 2007-05-08 Artes Medical Usa Inc Methods of administering microparticles combined with autologous body components.
US8127770B2 (en) 2004-08-30 2012-03-06 Spineovations, Inc. Method of using an implant for treament of ligaments and tendons
WO2006026731A1 (en) 2004-08-30 2006-03-09 Spineovations, Inc. Method of treating spinal internal disk derangement
EP3327116A1 (en) 2005-04-12 2018-05-30 Mesoblast, Inc. Isolation of adult multipotential cells by tissue non-specific alkaline phosphatase
US8399619B2 (en) 2006-06-30 2013-03-19 Warsaw Orthopedic, Inc. Injectable collagen material
US8093027B2 (en) 2006-09-13 2012-01-10 University Of South Florida Method for producing biocomposite comprising collagen and polymer
US20080096976A1 (en) 2006-10-24 2008-04-24 Neville Alleyne Method of treating spinal internal disk derangement
PT3345607T (en) * 2006-12-29 2022-11-21 Ossifi Mab Llc Methods of altering bone growth by administration of sost or wise antagonist or agonist
US20080299172A1 (en) 2007-06-04 2008-12-04 Stuart Young Tissue repair implant
AU2008320877B2 (en) 2007-10-30 2013-03-14 Viscogel Ab Chitosan composition
US20100010549A1 (en) 2008-03-05 2010-01-14 Neville Alleyne device and method of minimally invasive extracapsular ligamentous augmentation for canine stifle ligament injuries
US20100004700A1 (en) 2008-03-05 2010-01-07 Neville Alleyne Method of treating tissue with a suspenson of tricalcium hydroxyapatite microspheres
US8657859B2 (en) 2009-12-16 2014-02-25 Advanced Veterinary Solutions Implant for promoting stability of the canine stifle joint

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5916565A (en) * 1996-03-08 1999-06-29 In Clover, Inc. Product and method for treating joint disorders in vertebrates
US20030236573A1 (en) * 2002-06-13 2003-12-25 Evans Douglas G. Devices and methods for treating defects in the tissue of a living being
US20060246033A1 (en) * 2005-03-02 2006-11-02 Cook Biotech Incorporated Injectable bulking agent compositions

Also Published As

Publication number Publication date
US20100004699A1 (en) 2010-01-07
US8469961B2 (en) 2013-06-25

Similar Documents

Publication Publication Date Title
US8469961B2 (en) Methods and compositions for minimally invasive capsular augmentation of canine coxofemoral joints
US9585704B2 (en) Implant for promoting stability of the canine stifle joint
US20200196999A1 (en) Methods and procedures for ligament repair
US11116623B2 (en) Implantable tendon protection systems and related kits and methods
CN109259897B (en) Bone implant with mesh
ES2848562T3 (en) Indirect procedure for joint tissue repair
US20100010549A1 (en) device and method of minimally invasive extracapsular ligamentous augmentation for canine stifle ligament injuries
JP5484047B2 (en) PDGF-biomatrix composition and method for treating rotator cuff injury
JP2008518680A (en) Deformable graft device
CN103025250A (en) Method and apparatus for re-attaching the labrum to the acetabulum, including the provision and use of a novel suture anchor system
CN101420923A (en) Intravascular devices and fibrosis-inducing agents
Spinella et al. Surgical repair of Achilles tendon rupture in dogs: a review of the literature, a case report and new perspectives
Venturini et al. Combined intra-extra-articular technique for stabilisation of coxofemoral luxation
JP2021122744A (en) Soft glenoid awning and related repair procedures
US20120150093A1 (en) Synovial shunts
BR112020000506A2 (en) hyper-compressed pharmaceutical formulations
Rocha et al. Iliofemoral technique modification using an anchor screw as treatment of canine traumatic hip luxation-case report
Białecki et al. Hip joint replacement using monofilament polypropylene surgical mesh: an animal model
Hõim et al. Use of modified toggle pin technique for management of coxofemoral luxations in dogs: A review of literature and a report of two cases
Memarian et al. Surgical Repair of Cranioventral Hip Dislocation in a Cat: a Case Report

Legal Events

Date Code Title Description
STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION