Articular cartilage fixation device and method
An articular cartilage fixation device and method for repairing and regenerating diseased or injured soft tissue such as articular cartilage of the knee, hip, shoulder, and the like. A cartilage flap or cartilage repair device is retained within the chondral or osteochondral defect for a sufficient amount of time such that the cartilage repair device can perform its function and facilitate an appropriate healing response. A plurality of biocompatible anchors are attached to a plurality of flexible members and are shaped to seat into the tissue beneath or near the defect such that the cartilage flap is retained within the defect.
1. A surgical device for repairing cartilage tissue at a defect site in a patient, said surgical device comprising:
a first biocompatible anchor shaped to sit within tissue at the defect site and retain a section of cartilage replacement material in the defect site;
a biocompatible flexible member traversing through said section of cartilage replacement material multiple times, a distal end of said flexible member mechanically locked to said section of cartilage replacement material at an attachment point and a proximal end of said flexible member threaded through said first biocompatible anchor at least twice to form at least two pulley mechanisms; and
a sliding device about said flexible member, the proximal end of the flexible member at least in part forming the sliding device, and the portion of the flexible member extending between the distal end and the sliding device traverses through the section of cartilage replacement material at least three times, wherein, when in use, the at least two pulley mechanisms are actuated to translate the sliding device distally along said flexible member to a position proximate said section of cartilage replacement material to locate and retain said section of cartilage replacement material in the defect site.
2. The device of claim 1 , wherein said sliding device comprises a slipknot fashioned about said flexible member which, when tensioned about said flexible member, retains said section of cartilage replacement material in the defect site.
3. The device of claim 1 , wherein said section of cartilage replacement material is formed at least in part of a material selected from the group consisting of non-woven materials and foam materials.
4. The device of claim 1 , wherein said section of cartilage replacement material is formed at least in part of a synthetic polymer selected from the group consisting of polyesters and co-polymers of polyesters.
5. The device of claim 1 , wherein said section of cartilage replacement material is a scaffold derived from at least one biological material selected from the group consisting of proteins, saccharides, and collagenous tissue.
6. The device of claim 1 , wherein said flexible member is a braided suture.
7. The device of claim 1 , wherein said sliding device comprises a stopping member, said stopping member being engageable with said section of cartilage replacement material.
8. The device of claim 1 , wherein said stopping device is engageable with a proximal surface of the section of cartilage replacement material.
9. The device of claim 4 , wherein the polyesters and co-polymers of polyesters are at least one of poly-L-lactic acid (PLLA), poly-D-lactic acid (D-PLA), polyglycolic acid (PGA), polydioxinone (PDO), polycaprolactone (PCL), polyvinyl alcohol (PVA), polyethylene oxide (PEO), and poly(etheylene terephthalate).
10. The device of claim 5 , wherein the proteins are at least one of tyrosine and polysaccharides, and the saccharides are at least one of chitosan and hyaluronic acid.
11. The device of claim 1 , wherein the at least two pulley mechanisms comprise a proximal looped end and two distal loops with the proximal looped end positioned through the sliding device, and wherein, upon tensioning of the proximal looped end, the two distal loops corresponding slide thorough the anchor to facilitate decreasing the distance between said attachment point and said anchor thereby positioning said section of cartilage replacement material in the defect site.
12. The device of claim 1 , wherein the section of cartilage replacement material comprises a scaffold, the scaffold being fabricated from a biocompatible material for facilitating at least one of chondral and osteochondral integration.
13. The device of claim 1 , wherein the device further comprises the section of cartilage replacement material.
14. The device of claim 1 , wherein the sliding device comprises a lockable sliding device.
15. The device of claim 1 , wherein mechanically locked comprises at least one of tied to the section of cartilage replacement material, integrally molded with the section of cartilage replacement material, glued to the section of cartilage replacement material, and attached to a base attached to the section of cartilage replacement material.
16. The device of claim 1 , wherein the biocompatible anchor is positioned proximate a first side of the section of cartilage replacement material, and the sliding device is positioned proximate a second side of the section of cartilage replacement material that substantially opposes the first side of the section.
17. The device of claim 1 , wherein each of the at least two pulley mechanisms include two member portions of the flexible member extending from the anchor, and wherein at least one member portion of one pulley mechanism traverses the cartilage replacement material, and both member portions of the other pulley mechanism traverse the cartilage replacement material.
18. The device of claim 1 , wherein the total length of the flexible member extending between the sliding device and the attachment point remains the same both before and after the section of cartilage replacement material is located and retained in the defect site.
19. The device of claim 1 , wherein the threading of the flexible member through the anchor at least twice to form at least two pulley mechanisms also forms at least, one loop between two adjacent pulley mechanisms, and wherein the sliding device is formed about the at least one loop.
20. The device of claim 1 , wherein the threading of the flexible member through the anchor at least twice to form at least two pulley mechanisms also forms at least one loop between two adjacent pulley mechanisms, and wherein the at least one loop is enlarged to locate and retain the section of cartilage replacement material in the defect site.
21. The device of claim 1 , wherein the sliding device is located at the proximal end of the flexible member both before and after the section of cartilage replacement material is located and retained in the defect site.
22. The device of claim 1 , wherein the attachment point is positioned proximate a first side of the section of cartilage replacement material, and the sliding device is positioned proximate a second side of the section of cartilage replacement material that substantially opposes the first side of the section.