Assembled bone-tendon-bone grafts
View Patent ↗The present invention has multiple aspects. In its simplest aspect, the present invention is directed to an intermediate bone block comprising a machined segment of cortical bone, cancellous bone or both, the intermediate having a face comprising one to ten compression surfaces and one to ten cavities, the compression surfaces suitable for compressing soft tissue, the cavities for receiving and holding overflow soft tissue. The cavities are preferably channels, and more preferably channels having an omega cross-sectional profile. The invention is also directed to bone block assemblies suitable for binding to a soft tissue to form an implantable graft, and to such implantable grafts. A particularly preferred graft is a bone-tendon-bone graft.
1. An assembled implant comprising at least one bone block assembly for securing soft tissue, and a segment of soft tissue of sufficient length to extend beyond said bone block assembly, said bone block assembly comprising two to ten components of cortical bone, cancellous bone, artificial bone or a combination thereof, wherein said soft tissue is sandwiched between at least two of said components, and said components being connected by one to ten biocompatible connectors, at least two of said components having opposing faces that contact opposing sides of said soft tissue, said opposing faces being a first opposing face and a second opposing face, said first opposing face comprising compression surfaces and one to ten channels, said compression surfaces for compressing said soft tissue against the opposing face, and said channels for receiving overflow soft tissue from said compression surfaces and wherein said one to ten channels have an undercut cross-sectional profile and are laid out across said compression surfaces in a nested configuration along the direction of pull of said soft tissue; and wherein said second opposing face comprises a textured face.
2. The assembled implant of claim 1 , wherein said components comprise cortical bone, cancellous bone or both.
3. The assembled implant of claim 1 , wherein said soft tissue comprises allograft tissue, autograft tissue, xenograft tissue, an engineered construct of natural or synthetic origin or a combination thereof.
4. The assembled implant of claim 3 , wherein said soft tissue is selected from the group consisting of one to ten tendons, one to ten ligaments, an isolated segment or segments of pericardium, dermis, fascia, dura, skin, submucosal tissue, cartilage, or a combination thereof.
5. The assembled implant of claim 4 , wherein said soft tissue is one to ten tendons.
6. The assembled implant of claim 5 , wherein said one to ten tendons are treated with a crosslinking agent.
7. The assembled implant of claim 5 , wherein two to ten tendons are used, said tendons being of different lengths.
8. The assembled implant of claim 5 , wherein two to ten tendons are used, said tendons being of different cross-sectional area.
9. The assembled implant of claim 5 , wherein two to ten tendons are used, said tendons being of different anatomical origins.
10. The assembled implant of claim 1 , further comprising one to ten machined holes that traverse either said bone block assembly as a whole or a single component thereof.
11. The assembled implant of claim 1 , further comprising a depression on at least one of said components that aids in surgical placement.
12. The assembled implant of claim 1 , wherein said components have an outer surface that is shaped to aid in surgical placement.
13. The assembled implant of claim 12 , wherein the outer surface has a shape selected from the group consisting of polygonal, cylindrical, threaded, bulleted, chamfered, angled, ridged, capsule shaped, tapered and a combination thereof.
14. The assembled implant of claim 12 , wherein the outer surface contains spikes or indentations.
15. The assembled implant of claim 1 , at least one of said components comprise one to five grooves on an outer surface to accommodate one or more interference screws.
16. The assembled implant of claim 15 , wherein said grooves comprise threads or tapped threads.
17. The assembled implant of claim 15 , further comprising two equally placed grooves on an outer surface to accommodate one or more interference screws.
18. The assembled implant of claim 1 , further comprising a groove on an outer surface of said bone block assembly to accommodate said soft tissue.
19. The assembled implant of claim 1 , wherein any of said components comprise an internal leading edge configuration that reduces tissue stresses during assembly and use.
20. The assembled implant of claim 1 , wherein at least one of the opposing faces contains a lengthwise tapering profile.
21. The assembled implant of claim 1 , wherein said channels comprise a cross-sectional profile selected from the group consisting of triangular, dovetail, omega and a combination thereof.
22. The assembled implant of claim 1 , wherein said textured face comprises striations.
23. The assembled implant of claim 1 , wherein at least one of said channels comprises an omega profile.
24. The assembled implant of claim 1 , wherein said implant is perfused or coated with an osteoinductive substance.
25. The assembled implant of claim 1 , wherein said soft tissue is one to ten tendons having a first end and a second end.
26. The assembled implant of claim 25 , wherein only said first end of said one to ten tendons has a bone block assembly associated therewith.
27. The assembled implant of claim 1 , wherein said segment of soft tissue is sufficiently large so that excess tissue extends beyond the end or sides of said bone block assembly.
28. The assembled implant of claim 1 , wherein at least one of said components have an outer surface that is partially demineralized.
29. The assembled implant of claim 1 , wherein said implant is cleaned or perfused by treatment with a pressure cycling process.
30. The assembled implant of claim 1 , wherein at least one of said components are themselves assembled from smaller portions of cortical bone, cancellous bone, artificial bone or a combination thereof.
31. An assembled implant comprising a first and second bone portion, and a segment of soft tissue of sufficient length to extend between said first and second bone portions, wherein
said first bone portion is attached to said segment of soft tissue by a naturally occurring attachment, and
said second bone portion is an intermediate bone block for securing soft tissue comprising cortical bone, cancellous bone, artificial bone or a combination thereof, said intermediate bone block having a first face comprising compression surfaces and one to ten channels, said compression surfaces for compressing said soft tissue, and said channels for receiving overflow soft tissue from said compression surfaces and
wherein said channels comprise an undercut cross-sectional profile and are laid out across said compression surfaces in a nested configuration along the direction of pull of said soft tissue; and said intermediate bone block having a second face comprising a textured face.
32. The assembled implant of claim 31 , wherein said first bone portion attached to said segment of soft tissue by a naturally occurring attachment is reinforced by a machined portion of bone that is connected thereto by one to ten biocompatible connectors.
33. The assembled implant of claim 31 , wherein said undercut cross-sectional profile comprises an omega profile.