Stimulation of cartilage formation using reduced pressure treatment
System and methods for stimulating cartilage formation at a first tissue site through a second tissue site is presented. The system includes a fluid source for supplying a therapeutic solution, a reduced pressure source for supplying reduced pressure, a fluid delivery manifold for deploying adjacent the first tissue site, and a vacuum manifold for deploying within the second tissue site. The fluid delivery manifold extends between a proximal end fluidly coupled to the fluid supply and a distal end having at least one aperture for delivering the therapeutic solution to the defect adjacent the articulating surface of the first tissue site. The vacuum manifold extends between a proximal end fluidly coupled to the reduced pressure source and a distal end having at least one aperture for delivering the reduced pressure to the first tissue site adjacent the opposing surface of the first tissue site.
1. A method for treating a defect in cartilage comprising:
positioning a vacuum manifold within a subchondral bone;
positioning a fluid delivery manifold within an intra-articular space adjacent a surface of the subchondral bone;
delivering a therapeutic solution to the defect through the fluid delivery manifold; and
applying reduced pressure to the vacuum manifold to draw the therapeutic solution from the fluid delivery manifold through the defect.
2. The method of claim 1 , further comprising a step of creating a hole in the subchondral bone for positioning the vacuum manifold within the subchondral bone.
3. The method of claim 1 , wherein the therapeutic solution comprises a cell suspension.
4. The method of claim 1 , wherein the therapeutic solution comprises protease inhibitors.
5. The method of claim 1 , wherein the therapeutic solution comprises hyaluronic acid.
6. The method of claim 1 , wherein the therapeutic solution comprises bioactive factors.
7. The method of claim 1 , wherein the therapeutic solution comprises chondrocytes.
8. The method of claim 1 , wherein the therapeutic solution comprises bone marrow stromal cells.
9. The method of claim 1 , wherein the therapeutic solution comprises stem cells.
10. The method of claim 1 , wherein the therapeutic solution comprises collagen.
11. The method of claim 1 , wherein the vacuum manifold comprises at least one aperture, wherein the at least one aperture is positioned within the subchondral bone.
12. The method of claim 11 , wherein the at least one aperture is configured to direct the therapeutic solution toward the defect.
13. The method of claim 12 , wherein the at least one aperture is arranged in a single row facing a single direction.
14. The method of claim 12 , wherein the at least one aperture is staggered around a circumference of the vacuum manifold.
15. The method of claim 1 , wherein the fluid delivery manifold comprises at least one aperture.
16. The method of claim 15 , wherein the at least one aperture comprises a row of fluid apertures facing a single direction.
17. The method of claim 15 , wherein the at least one aperture comprises a plurality of staggered apertures.
18. The method of claim 15 , wherein the at least one aperture comprises a plurality of fluid apertures aligned around a circumference of the fluid delivery manifold.
19. A method for treating a cartilage defect comprising:
positioning a fluid delivery manifold on a first face of a cartilage defect;
positioning a vacuum manifold on a second face of the cartilage defect and within a subchondral bone supporting the cartilage defect;
delivering a therapeutic solution to the cartilage defect through the fluid delivery manifold; and
applying reduced pressure to the vacuum manifold to draw the therapeutic solution from the fluid delivery manifold through the cartilage defect.
20. The method of claim 19 , wherein the first face of the cartilage defect is substantially opposite the second face of the cartilage defect.
21. The method of claim 19 , wherein the fluid delivery manifold is positioned substantially parallel to the vacuum manifold.
22. The method of claim 19 , wherein the fluid delivery manifold is positioned at an angle relative to the vacuum manifold.
23. The method of claim 19 , wherein applying reduced pressure causes the therapeutic solution to flow from the first face of the cartilage defect, through an interior of the cartilage defect and at least a portion of the subchondral bone, and out the second face of the cartilage defect to the vacuum manifold.