Sacroiliac joint stabilization prostheses
Prostheses are described for stabilizing dysfunctional sacroiliac (SI) joints. The prostheses are sized and configured to be press-fit into surgically created pilot SI joint openings in dysfunctional SI joint structures. The prostheses include a fixation composition that is adapted to transition from a flowable state, wherein the fixation composition flows into spaces between the prostheses and the dysfunctional SI joint structures when the prostheses are implanted in a dysfunctional SI joint, to a solid elastomer state upon application of radiation energy, wherein the fixation composition forms a positive fit connection by and between the prostheses and the dysfunctional SI joint structures.
1. An implant for stabilizing a dysfunctional sacroiliac (SI) joint, said dysfunctional SI joint comprising a sacrum bone structure, an ilium bone structure and an intraarticular region between said sacrum and ilium bone structures, said implant comprising:
a hollow monolithic member configured and adapted to be advanced into said dysfunctional SI joint in a posterior trajectory,
said monolithic member comprising a first elongated section, a second elongated section, and a bridge section, said bridge section disposed between and not extending beyond said first elongated section and said second elongated section in any direction, whereby said monolithic member comprises a first bridge/elongated section interface proximate said first elongated section and a second bridge/elongated section interface proximate said second elongated section,
said monolithic member further comprising an outer surface and a first longitudinal axis,
said first elongated section configured to be advanced into said sacrum bone structure when said monolithic member is said advanced into said dysfunctional SI joint in said posterior trajectory,
said second elongated section configured to be advanced into said ilium bone structure when said monolithic member is said advanced into said dysfunctional SI joint in said posterior trajectory,
said bridge section configured to be advanced into said intraarticular region of said dysfunctional SI joint when said monolithic member is said advanced into said dysfunctional SI joint in said posterior trajectory,
said first elongated section comprising a first open proximal end, a first distal end, and a first plurality of slots,
said first elongated section further comprising a first elongate lumen, extending from said first open proximal end to said first distal end and a second plurality of slots disposed in said first bridge/elongated section interface of said monolithic member,
said first plurality of slots and said second plurality of slots in communication with said first elongate lumen of said first elongated section,
said first elongated section further comprising a first tapered region disposed on said first distal end,
said second elongated section comprising a second open proximal end, a second distal end, and a third plurality of slots,
said second elongated section further comprising a second elongate lumen extending from said second open proximal end to said second distal end and a fourth plurality of slots disposed in said second bridge/elongated section interface of said monolithic member, said third plurality of slots and said fourth plurality of slots in communication with said second elongate lumen of said second elongated section,
said second elongated section further comprising a second tapered region disposed on said second distal end,
said bridge section comprising a second longitudinal axis, a first proximal end and a third distal end,
said bridge section further comprising an elongate opening disposed between said first proximal end and said third distal end of said bridge section and extending through said bridge section, said elongate opening being in communication with said second plurality of slots and, thereby said first elongate lumen and said first plurality of slots of said first elongated section, and said fourth plurality of slots and, thereby said second elongate lumen and third plurality of slots of said second elongated section,
said bridge section further comprising a third tapered region disposed on said third distal end, said third tapered region comprising a gradually decreasing thickness along said second longitudinal axis of said bridge section, said second longitudinal axis of said bridge section being coincident with said first longitudinal axis of said monolithic member,
said monolithic member further comprising an osteogenic composition comprising poly(glycerol-co-sebacate) acrylate (PGSA), said osteogenic composition comprising a flowable state and a solid elastomer state,
said osteogenic composition disposed in at least one of said first elongate lumen of said first elongated section and said second elongate lumen of said second elongated section in said flowable state,
said monolithic member configured and adapted to allow said osteogenic composition to flow out of said at least one of said first elongate lumen of said first elongated section and said second elongate lumen of said second elongated section in said flowable state when said monolithic member is said advanced into said dysfunctional SI joint, whereby said osteogenic composition is in communication with said outer surface of said monolithic member and said at least one of said sacrum bone structure and said ilium bone structure of said dysfunctional SI joint,
said monolithic member further adapted to stabilize said dysfunctional SI joint and induce remodeling of damaged bone tissue of said at least one of said sacrum bone structure and said ilium bone structure of said dysfunctional SI joint when said monolithic member is said advanced into said dysfunctional SI joint.
2. The implant of claim 1 , wherein said osteogenic composition is adapted to transition from said flowable state to said solid elastomer state upon application of radiation energy.
3. The implant of claim 2 , wherein said radiation energy comprises ultraviolet (UV) light radiation in the range of 10-400 nm.
4. The implant of claim 2 , wherein, when said osteogenic composition is in communication with said outer surface of said monolithic member and said osteogenic composition is subjected to said application of radiation energy, whereby said osteogenic composition transitions to said solid elastomer state, said osteogenic composition configured to facilitate engagement of said monolithic member to said at least one of said sacrum bone structure and said ilium bone structure of said dysfunctional SI joint.
5. The implant of claim 1 , wherein said osteogenic composition further comprises a bone morphogenic protein (BMP) selected from the group consisting of BMP-1, BMP2a, BMP2b, BMP3, BMP4, BMP5, BMP6, BMP7 and BMP8a.
6. The implant of claim 1 , wherein said osteogenic composition further comprises an antibiotic selected from the group consisting of penicillin, gentamicin, vancomycin and rifampin.
7. The implant of claim 1 , wherein said osteogenic composition further comprises an anti-inflammatory selected from the group consisting of dexamethasone, betamethasone, prednisone and ibuprofen.