Methods and compositions for articular resurfacing

Abstract

Disclosed herein are methods and compositions for producing articular repair materials and for repairing an articular surface. In particular, methods for providing articular replacement material, the method comprising the step of producing articular replacement material of selected size, curvature and/or thickness are provided. Also provided are articular surface repair systems designed to replace a selected area cartilage, for example, a system comprising at least one solid, non-pliable component and an external surface having near anatomic alignment to the surrounding structures.

What is claimed is:  
     
         1 . A method for providing articular replacement material, the method comprising the step of producing articular replacement material of selected dimensions.  
     
     
         2 . The method of  claim 1 , wherein the dimensions comprise thickness and curvature.  
     
     
         3 . The method of  claim 1 , wherein the dimensions comprise size and curvature.  
     
     
         4 . The method of  claim 1 , wherein the dimensions comprise size, thickness and curvature.  
     
     
         5 . The method of  claim 1 , wherein the articular replacement material replaces cartilage and wherein said material is non-pliable.  
     
     
         6 . The method of  claim 1 , wherein the dimensions of the articular replacement material are selected following intraoperative measurements.  
     
     
         7 . The method of  claim 6 , wherein said measurements are made using imaging techniques.  
     
     
         8 . The method of  claim 7 , wherein said imaging techniques are selected from the group consisting of ultrasound, MRI, CT scan, x-ray imaging obtained with x-ray dye and fluoroscopic imaging.  
     
     
         9 . The method of  claim 6 , wherein said measurements are made using a mechanical probe.  
     
     
         10 . The method of  claim 9 , wherein said measurements are made using an ultrasound probe, a laser, an optical probe and a deformable material.  
     
     
         11 . The method of  claim 1 , wherein said producing step comprises growing or hardening the articular replacement material.  
     
     
         12 . The method of  claim 1 , wherein said producing step comprises shaping the articular replacement material to the selected dimensions.  
     
     
         13 . The method of  claim 12 , wherein said shaping is selected from the group consisting of mechanical abrasion, laser ablation, radiofrequency ablation, cryoablation and enzymatic digestion.  
     
     
         14 . The method of  claim 12 , wherein said shaping is performed manually.  
     
     
         15 . The method of  claim 12 , wherein said shaping is performed by machine.  
     
     
         16 . The method of  claim 15 , wherein said shaping is automated.  
     
     
         17 . The method of  claim 1 , wherein said articular replacement material is produced postoperatively.  
     
     
         18 . The method of  claim 1 , wherein said articular replacement material is selected from a library of pre-existing repair systems.  
     
     
         19 . The method of  claim 1 , wherein said articular replacement material comprises synthetic materials.  
     
     
         20 . The method of  claim 19 , wherein the synthetic materials comprise metals, polymers or combinations thereof.  
     
     
         21 . The method of  claim 5 , wherein said cartilage replacement material comprises biological materials.  
     
     
         22 . The method of  claim 21 , wherein said biological materials comprise cells.  
     
     
         23 . The method of  claim 22 , wherein said cells are stem cells, fetal cells or chondrocyte cells.  
     
     
         24 . A method of making cartilage repair material, the method comprising the steps of 
 (a) measuring the dimensions of the intended implantation site or the dimensions of the area surrounding the intended implantation site; and    (b) providing cartilage replacement material that conforms to the measurements obtained in step (a).    
     
     
         25 . The method of  claim 24 , wherein the step (a) comprises measuring the thickness of the cartilage surrounding the intended implantation site and measuring the curvature of the cartilage surrounding the intended implantation site.  
     
     
         26 . The method of  claim 24 , wherein the step (a) comprises measuring the size of the intended implantation site and measuring the curvature of the cartilage surrounding the intended implantation site.  
     
     
         27 . The method of  claim 24 , wherein the step (a) comprises measuring the thickness of the cartilage surrounding the intended implantation site, measuring the size of the intended implantation site, and measuring the curvature of the cartilage surrounding the intended implantation site.  
     
     
         28 . The method of  claim 24 , wherein step (a) comprises obtaining and analyzing an image of the cartilage.  
     
     
         29 . The method of  claim 28 , wherein said image is obtained intraoperatively.  
     
     
         30 . The method of  claim 24 , wherein step (a) comprises using a mechanical probe intraoperatively to measure the dimensions.  
     
     
         31 . The method of  claim 30 , wherein the mechanical probe comprises a deformable material.  
     
     
         32 . The method of  claim 24 , wherein step (b) comprises selecting the cartilage replacement material from a library of pre-existing repair systems.  
     
     
         33 . The method of  claim 24 , wherein step (b) comprises growing the cartilage replacement material.  
     
     
         34 . The method of  claim 24 , further comprising shaping the cartilage material.  
     
     
         35 . The method of  claim 34 , wherein said shaping is by machine.  
     
     
         36 . The method of  claim 34 , wherein said shaping is automated.  
     
     
         37 . The method of  claim 34 , wherein said shaping is selected from the group consisting of mechanical abrasion, laser ablation, radiofrequency ablation, cryoablation and enzymatic digestion.  
     
     
         38 . The method of  claim 24 , wherein step (b) comprises growing cartilage replacement material comprising biological substances ex vivo.  
     
     
         39 . A method of repairing a cartilage in a subject, the method of comprising the step of implantating cartilage repair material prepared according to the method of  claim 1 , into the subject.  
     
     
         40 . A method of determining the curvature of an articular surface, the method comprising the step of (a) intraoperatively measuring the curvature of the articular surface using a mechanical probe.  
     
     
         41 . The method of  claim 40 , wherein the articular surface comprises cartilage.  
     
     
         42 . The method of  claim 40 , wherein the articular surface comprises subchondral bone.  
     
     
         43 . The method of  claim 40 , wherein the mechanical probe is selected from the group consisting of an ultrasound probe, a laser, an optical probe and a deformable material.  
     
     
         44 . A method of producing an articular replacement material comprising the step of providing an articular replacement material that conforms to the measurements obtained by the method of  claim 40 .  
     
     
         45 . A method of repairing an articular surface in a subject, the method of comprising the step of implanting articular repair material prepared according to the method of  claim 40  into the subject.  
     
     
         46 . A partial articular prosthesis comprising 
 a first component comprising a cartilage replacement material; and    a second component comprising one or more metals, wherein said second component has a curvature similar to subchondral bone, wherein said prosthesis comprises less than about 80% of the articular surface.    
     
     
         47 . The prosthesis of  claim 46 , wherein said first or second components comprise a non-pliable material.  
     
     
         48 . The prosthesis of  claim 46 , wherein said first or second components further comprises a polymeric material.  
     
     
         49 . The prosthesis of  claim 46 , wherein said first component comprises biological materials.  
     
     
         50 . The prosthesis of  claim 46 , wherein said first component exhibits biomechanical properties similar to articular cartilage.  
     
     
         51 . The prosthesis of  claim 50 , wherein said biomechanical properties are elasticity, resistance to axial loading or shear forces.  
     
     
         52 . The prosthesis of  claim 46 , wherein the first and second components comprise two or more metals.  
     
     
         53 . The prosthesis of  claim 46 , wherein the first or second components are bioresorbable.  
     
     
         54 . The prosthesis of  claim 46 , wherein the first or second components are porous or porous coated.  
     
     
         55 . The prosthesis of  claim 46 , wherein the first or second components are smooth.  
     
     
         56 . The prosthesis of  claim 46 , wherein the first or second components are adapted to receive injections.  
     
     
         57 . A partial articular prosthesis for use in a human with cartilage disease comprising 
 an external surface located in the load bearing area of an articular surface, wherein the dimensions of said external surface achieve a near anatomic fit with the adjacent cartilage.    
     
     
         58 . The prosthesis of  claim 57 , further comprising one or more metals or metal alloys.  
     
     
         59 . An articular surface repair system comprising 
 (a) cartilage replacement material, wherein said cartilage replacement material has a curvature similar to surrounding or adjacent cartilage; and    (b) at least one non-biologic material, wherein said articular surface repair system comprises a portion of the articular surface equal to or smaller than the weight-bearing surface.    
     
     
         60 . The articular surface repair system of  claim 59 , wherein said cartilage replacement material is non-pliable.  
     
     
         61 . The articular surface repair system of  claim 59 , wherein said cartilage replacement material has biomechanical properties similar to that of normal human cartilage.  
     
     
         62 . The articular surface repair system of  claim 59 , wherein said cartilage replacement material has a biochemical composition similar to that of normal human cartilage.  
     
     
         63 . An articular surface repair system comprising 
 a first component comprising a cartilage replacement material, wherein said first component has dimensions similar to that of adjacent or surrounding cartilage; and    a second component, wherein said second component has a curvature similar to subchondral bone, wherein said articular surface repair system comprises less than about 80% of the articular surface.    
     
     
         64 . The repair system of  claim 63 , wherein said first or said second component comprises a non-pliable material.  
     
     
         65 . The articular surface repair system of  claim 63 , wherein the first component has a curvature and thickness similar to that of adjacent or surrounding cartilage.  
     
     
         66 . The articular surface repair system of  claim 63 , wherein said thickness of said first component is not uniform.  
     
     
         67 . A partial articular prosthesis comprising 
 (a) a metal or metal alloy; and    (b) an external surface located in the load bearing area of an articular surface, wherein the external surface designed to achieve a near anatomic fit with the adjacent cartilage.    
     
     
         68 . The partial articular prosthesis of  claim 67 , wherein said external surface is comprises a polymeric material attached to said metal or metal alloy.  
     
     
         69 . An articular surface repair system comprising a cartilage replacement material, wherein said cartilage replacement material has a curvature similar to surrounding or adjacent cartilage, wherein said articular surface repair system is adapted to receive injections.  
     
     
         70 . The articular surface repair system of  claim 69 , wherein said injections are made through an opening in the external surface of said cartilage replacement material.  
     
     
         71 . The articular surface repair system of claims  69 , wherein said opening in the external surface terminates in a plurality of openings on the bone surface.  
     
     
         72 . The articular surface repair system of  claim 69 , wherein bone cement is injected through said opening.  
     
     
         73 . The articular surface repair system of  claim 72 , wherein said bone cement is injected under pressure in order to achieve permeation of portions of the marrow space with bone cement.  
     
     
         74 . The articular surface repair system of  claim 72 , wherein said bone cement is combined with a therapeutic drug.