Two piece cancellous construct for cartilage repair
The invention is directed toward a cartilage repair assembly comprising a shaped allograft two piece construct with a demineralized cancellous cap and a mineralized cylindrical base member defining a blind bore with a through-going transverse bore intersecting the blind bore. The demineralized cancellous cap has a cylindrical top portion and a smaller diameter cylindrical stem extending away from the top portion which fits into the blind bore of the mineralized base member. The cap stem defines a transverse through-going bore which is aligned with the through-going bore of the base member to receive a cylindrical cortical pin holding the cap within the base member. The shaped structure is dimensioned to fit in a drilled bore in a cartilage defect area so that the assembly engages the side wall of the drilled bore in an interference fit.
1. In a multi-component construct for cartilage and bone repair, said construct having an outer periphery whose size and shape are selected such that said construct is positionable in a defect site to be repaired, said construct including a cap member shaped to form a stem having a longitudinal axis, which defines an axial direction, and a top section attached to one end of said stem and extending radially outward therefrom, said top section having first and second opposed surfaces, said first surface being sized and shaped so as to be adjacent an original cartilage layer at the defect site when said construct is positioned therein, and a base member sized and shaped so as to be adjacent a subchondral bone layer at the defect site when said construct is positioned therein, said base member including a proximal end proximate said second surface of said top section when said multi-component construct is assembled, a distal end remote from said cap member when said multi-component construct is assembled, and a blind bore extending in said axial direction from said proximal end toward said distal end, said blind bore being sized and shaped so as to receive said stem of said cap member, the improvement wherein:
said cap member is formed from a first piece of cancellous bone which is demineralized to thereby provide said top section and said stem of said cap member with an elastic quality, said top section including a first sidewall having a first diameter;
said base member is formed from a second, separate piece of cancellous bone that is mineralized, whereby said base member does not have an elastic quality, said base member including a second sidewall having a second diameter which is substantially equal to, but not greater than, said first diameter, whereby said proximal end of said base member is substantially coextensive with said top section of said cap member and wherein said first and second diameters are selected such that said outer periphery of said construct is delimited by said first sidewall of said top section of said cap member, and by said second sidewall of said base member; and
said second surface of said top section of said cap member is in direct contact with said proximal end of said base member upon assembly of said multi-component construct, whereby said base member supports said top section such that said first surface of said top section is substantially flush with an outer surface of the original cartilage layer at the defect site.
2. The construct of claim 1 , wherein said blind bore of said base member includes a bottom surface intermediate said proximal end of said base member and said distal end of said base member.
3. The construct of claim 2 , wherein an opposite end of said stem, remote from said top section of said cap member, is in direct contact with said bottom surface of said blind bore of said base member upon assembly of said multi-component construct.
4. The construct of claim 1 , wherein said first surface of said top section is a planar top surface.
5. The construct of claim 1 , wherein said first piece of cancellous bone has a calcium content of less than 0.2%.
6. The construct of claim 1 , wherein said cap member is treated to be non-osteoinductive.