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Methods and procedures for ligament repair

a technology of ligaments and methods, applied in the direction of ligaments, prostheses, peptides/protein ingredients, etc., can solve the problems of affecting the regeneration or healing process premature loss of fibrin clot scaffolds, and failure of meniscus and articular cartilage in human joints to heal after an injury, etc., to achieve the effect of facilitating the regeneration or healing of anterior cruciate ligaments

Inactive Publication Date: 2009-12-10
CHILDRENS MEDICAL CENT CORP
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0004]The invention relates in some aspects to methods and products that facilitate anterior cruciate ligament regeneration or healing. Thus, in some aspects the invention is a device for repairing a ruptured ligament having a scaffold configured for repair of a ruptured ligament and an anchor. The scaffold is attached to the anchor with a suture. The suture has at least one free end emerging from the scaffold. The suture and / or anchor may be bioabsorbable and / or synthetic, such as, for instance, polyglactin 910.

Problems solved by technology

In addition, the meniscus and the articular cartilage in human joints also often fail to heal after an injury.
This fibrinolytic process results in premature loss of the fibrin clot scaffold and disruption of the healing process for tissues within the joint or within intra-articular tissues.
While this procedure can initially restore gross stability in most patients, longer follow-up demonstrates many post-operative patients have abnormal structural laxity, suggesting the reconstruction may not withstand the physiologic forces applied overtime (Dye, 325 Clin. Orthop. 130-139 (1996)).
As anterior cruciate ligament rupture is most commonly an injury of a young athletes in their teens and twenties, early osteoarthritis in this group has difficult consequences.

Method used

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  • Methods and procedures for ligament repair
  • Methods and procedures for ligament repair
  • Methods and procedures for ligament repair

Examples

Experimental program
Comparison scheme
Effect test

example 1

[0076]Bilateral ACL transections were performed in six animals and repaired with a four stranded, absorbable suture repair using a variation of the Marshall technique. For each animal, one of the repairs was augmented with placement of a collagen-platelet rich hydrogel at the ACL transection site, while the contralateral knee had suture repair alone. No post-operative immobilization was used. The animals survived for four weeks and then underwent in vivo magnetic resonance imaging followed by euthanasia and immediate biomechanical testing. Six control knees with intact ACLs from three additional 30 kg pigs were also tested biomechanically as an intact ACL control group.

[0077]The supplementation of suture repair with a collagen-platelet rich hydrogel resulted in formation of a large scar mass in the region of the ACL which was perfused by the injection of IV gadolinium, suggesting the formation of a vascularized repair tissue in the ACL defect.

[0078]Despite suture resorption during t...

example 2

Experimental Design

[0081]Seven 30 kg Yorkshire pigs underwent bilateral ACL transection and suture repair.

[0082]Five of the animals were treated on one side with suture repair on one side and suture repair augmented with collagen-platelet rich plasma containing an average of 954K+ / −93K platelets / mm3 on the contralateral side (n=5). An additional two animals had suture repair on one side and suture repair augmented with collagen-platelet poor plasma (n=2) with a platelet counts less than 20 K / mm3 on the contralateral side (n=5). Sides were randomized to suture alone and augmented repair. All outcomes were measured after four weeks in vivo. Just prior to euthanasia, the animals had in vivo MRI of both knees with gadolinium contrast to assess perfusion of the ACL wound site. Immediately after euthanasia, the knees were harvested and ex vivo MRI performed, followed immediately by biomechanical testing of the ACL complex as previously described (Murray, M. M.; Spindler, K. P.; Devin, C.;...

example 3

[0105]In this example, we demonstrate biomechanical healing using a sponge, with anchor and suture in the absence of additional repair material / PRP. We conclude that biomechanical healing of the porcine ACL after complete transection and immediate suture repair using a collagen sponge is a novel treatment for this injury that is significantly better than the current standard of care (ACL reconstruction).

[0106]Complete ACL transections were performed in five 30 kg Yorkshire pigs and repaired with a four stranded, absorbable suture repair using a suture anchor in the femur. In each animal, the repair was augmented with threading a collagen sponge onto the suture anchor before tying the sutures. No post-operative immobilization was used. The animals were survived for three months and then underwent in vivo magnetic resonance imaging followed by euthanasia and immediate biomechanical testing. Six control knees with intact ACLs from three additional animals were used as an intact ACL con...

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Abstract

Methods and devices for the repair of a ruptured ligament using a scaffold device are provided. Aspects of the invention, may include a scaffold attached by a suture to an anchor. In aspects of the invention, the anchor may be secured to a bone near or at the repair site.

Description

FIELD OF THE INVENTION[0001]The invention relates generally to methods and devices for the repair of a ruptured ligament using a scaffold device.BACKGROUND OF THE INVENTION[0002]Intra-articular tissues, such as the anterior cruciate ligament (ACL), do not heal after rupture. In addition, the meniscus and the articular cartilage in human joints also often fail to heal after an injury. Tissues found outside of joints heal by forming a fibrin clot, which connects the ruptured tissue ends and is subsequently remodeled to form scar, which heals the tissue. Inside a synovial joint, a fibrin clot either fails to form or is quickly lysed after injury to the knee, thus preventing joint arthrosis and stiffness after minor injury. Joints contain synovial fluid which, as part of normal joint activity, naturally prevent clot formation in joints. This fibrinolytic process results in premature loss of the fibrin clot scaffold and disruption of the healing process for tissues within the joint or wi...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61F2/08A61K38/36
CPCA61B17/0401A61L2430/10A61B17/1146A61B2017/00004A61B2017/00893A61B2017/0414A61B2017/044A61B2017/0458A61F2/0811A61F2002/0888A61L17/12A61L27/22A61L27/24A61L27/52A61L27/56A61B17/0469
Inventor MURRAY, MARTHA M.
Owner CHILDRENS MEDICAL CENT CORP
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