Implantable mesh for musculoskeletal trauma, orthopedic reconstruction and soft tissue repair

Abstract

Biocompatible mesh materials are employed to make implants for repairing or replacing a bone or for soft tissue repair. The mesh materials can be comprised of bioabsorbable materials, non-bioabsorbable materials or bioabsorbable and non-bioabsorbable materials. Pharmaceutical actives, bone growth enhancers and the like can be combined with the implants.

1 . An orthopedic implant comprised of a mesh material shaped in the form of a structure for repairing or replacing a bone or a joint, the structure having sufficient strength to repair or replace the bone or joint. 
   
   
       2 . The orthopedic implant of  claim 1  wherein the mesh material is comprised of at least two different strand structures having the same or different compositions. 
   
   
       3 . The orthopedic implant of  claim 2  wherein said at least two different strand structures are selected from the group consisting of monofilament, braided, yarns, threads, hollow tubes, flat strips, solid ovals, hollow ovals and solid rounds. 
   
   
       4 . The orthopedic implant of  claim 2  wherein said compositions are selected from the group consisting of resorbable materials, non-resorbable materials and resorbable and non-resorbable materials. 
   
   
       5 . The orthopedic implant of  claim 1  further comprising at least one additional mesh material overlaying and adjacent to at least a portion of the structure. 
   
   
       6 . The orthopedic implant of  claim 1  wherein the mesh materials are comprised of strands having interstices therebetween. 
   
   
       7 . The orthopedic implant of  claim 6  further comprising medication contained within at least some of the interstices. 
   
   
       8 . The orthopedic implant of  claim 6  wherein at least some of the interstices are filled with a biocompatible material. 
   
   
       9 . The orthopedic implant of  claim 8  further comprising medication contained within at least some of the interstices. 
   
   
       10 . The orthopedic implant of  claim 8  further comprising medication contained within at least some of the biocompatible material. 
   
   
       11 . The orthopedic implant of  claim 6  wherein at least some of the strands are tubular strands. 
   
   
       12 . The orthopedic implant of  claim 11  further comprising medication within the tubular strands. 
   
   
       13 . The orthopedic implant of  claim 1  wherein the mesh material is tubular and has a proximal end and a distal end. 
   
   
       14 . The orthopedic implant of  claim 13  wherein the mesh material is woven, braided or knitted. 
   
   
       15 . The orthopedic implant of  claim 13  comprising at least two tubular woven mesh materials, each having a proximal end and a distal end. 
   
   
       16 . The orthopedic implant  claim 15  wherein said at least two tubular woven mesh materials are coaxial. 
   
   
       17 . The orthopedic implant of  claim 16  wherein said at least two tubular woven mesh materials are coaxially movable relative to one another. 
   
   
       18 . The orthopedic implant of  claim 13  wherein one of the proximal end and/or the distal end is closed. 
   
   
       19 . The orthopedic implant of  claim 13  wherein the proximal end and the distal end are open and further comprising an elongate strap inserted in the proximal open end of the tubular mesh material and optionally extending through the distal open end, the strap and mesh material being moveable relative to one another. 
   
   
       20 . The orthopedic implant of  claim 19  wherein the strap is comprised of a mesh material. 
   
   
       21 . The orthopedic implant of  claim 13  wherein the proximal end and the distal end are open and further comprising an elongate strap having a first end and a second end, the first end of the elongate strap being inserted into the proximal open end of the tubular mesh material and extending through a first opening disposed along a side portion of the tubular mesh material and the second end of the elongate strap being inserted into the distal open end of the tubular mesh material and extending through said first opening or a second opening disposed along a side portion of the tubular mesh material. 
   
   
       22 . The orthopedic implant of  claim 21  wherein the strap is comprised of a mesh material. 
   
   
       23 . The orthopedic implant of  claim 21  further comprising a bracket disposed between the proximal end and the distal end for affixing the implant to a bone. 
   
   
       24 . The orthopedic implant of  claim 21  further comprising a fastener affixed to one end of the elongate strap. 
   
   
       25 . The orthopedic implant of  claim 13  wherein the tubular mesh material is flattened. 
   
   
       26 . The orthopedic implant of  claim 25  further comprising a bone plate wherein the flattened tubular mesh material is affixed as a covering over at least a portion of the bone plate. 
   
   
       27 . The orthopedic implant of  claim 26  wherein the flattened tubular mesh material is at least partially fused to the bone plate. 
   
   
       28 . The orthopedic implant of  claim 1  comprising a bone plate having a top surface and a bottom surface and a mesh material laminated to the top surface or the bottom surface or both the top surface and the bottom surface. 
   
   
       29 . The orthopedic implant of  claim 1  comprising a first flattened tubular mesh material, a second flattened tubular mesh material coaxially disposed within the first flattened tubular mesh material and a core strip coaxially disposed within the second flattened tubular mesh material, the core strip comprising a solid or a mesh material. 
   
   
       30 . The orthopedic implant of  claim 29  wherein a portion of the first flattened tubular mesh material is cut away to form a pocket. 
   
   
       31 . The orthopedic implant of  claim 1  wherein the mesh material is comprised of at least one mesh sheet wrapped around an optionally removable core. 
   
   
       32 . The orthopedic implant of  claim 31  wherein the core is solid, tubular or shaped. 
   
   
       33 . The orthopedic implant of  claim 1  wherein the mesh material is comprised of at least one rolled mesh sheet. 
   
   
       34 . The orthopedic implant of  claim 33  wherein the at least one rolled mesh sheet is pre-cut or pre-shaped. 
   
   
       35 . The orthopedic implant of  claim 33  wherein the at least one rolled mesh sheet has a proximal end and a distal end and is rolled in parallel with an axis. 
   
   
       36 . The orthopedic implant of  claim 35  which is rolled upon itself from the proximal end and/or the distal end in a direction along the axis and perpendicular thereto. 
   
   
       37 . The orthopedic implant of  claim 33  wherein the mesh material is diagonally rolled and optionally shaped. 
   
   
       38 . The orthopedic implant of  claim 33  wherein the mesh material is pre-cut or pre-shaped. 
   
   
       39 . The orthopedic implant of  claim 33  wherein the at least one rolled mesh sheet is shaped by heat, pressure or heat and pressure. 
   
   
       40 . The orthopedic implant of  claim 1  having the structure of a bone plate comprised of a solid material and a mesh material affixed to the solid material. 
   
   
       41 . The orthopedic implant of  claim 1  having the structure of a bone plate comprised of at least one mesh material. 
   
   
       42 . The orthopedic implant of  claim 1  further comprising at least one perforation in the mesh material. 
   
   
       43 . The orthopedic implant of  claim 1  comprising at least two sheets of the mesh material. 
   
   
       44 . The orthopedic implant of  claim 43  wherein said at least two sheets are the same or different. 
   
   
       45 . The orthopedic implant of  claim 44  wherein said at least two sheets are adhered to one another. 
   
   
       46 . The orthopedic implant of  claim 44  wherein said at least two sheets have a common perimeter and said at least two sheets are adhered to one another at the perimeter. 
   
   
       47 . The orthopedic implant of  claim 44  wherein said at least two sheets are adhered to one another at discreet points of contact. 
   
   
       48 . The orthopedic implant of  claim 44  wherein the mesh materials are comprised of strands having interstices therebetween and at least some of the interstices are filled with a biocompatible material or medication or a biocompatible material and medication. 
   
   
       49 . An implant device comprising a mesh material shaped in the form of a structure for orthopedic, musculoskeletal or soft tissue repair, the mesh material having multiple strands, the strands crossing each other at points of contact with one another wherein at least some of the strands are affixed to others at the points of contact. 
   
   
       50 . The implant device of  claim 49  wherein some of the strands are affixed to others by adhesive, fusion or knots. 
   
   
       51 . The implant device of  claim 49  wherein the mesh material is compacted. 
   
   
       52 . The implant device of  claim 49  comprised of more than one mesh material. 
   
   
       53 . The implant device of  claim 52  wherein at least one mesh material is compacted. 
   
   
       54 . The implant device of  claim 49  wherein the mesh material is comprised of one or more than one higher melting point strand and one or more than one lower melting point strand, at least the lower melting point strand or strands having at least one point of contact and said lower melting point strand or strands is fused at each point of contact. 
   
   
       55 . A method of making an implant device comprising a mesh material shaped in the form of a structure for orthopedic, musculoskeletal or soft tissue repair comprising affixing to one another at points of contact with one another strands of a mesh material having multiple strands, the strands crossing each other at points of contact with one another. 
   
   
       56 . The method of  claim 55  wherein the implant device is comprised of more than one mesh material. 
   
   
       57 . An implant device comprising a mesh material shaped in the form of a structure for orthopedic, musculoskeletal or soft tissue repair, the mesh having multiple strands and interstices between the strands, at least some of the interstices being filled with a biocompatible material or medication or a biocompatible material and medication. 
   
   
       58 . The implant device of  claim 57  comprised of more than one mesh material. 
   
   
       59 . A method of making an implant device comprising a mesh material shaped in the form of a structure for orthopedic, musculoskeletal or soft tissue repair comprising filling with a biocompatible material or medication or a biocompatible material and medication at least some interstices in a mesh having multiple strands and interstices between the strands. 
   
   
       60 . The method of  claim 59  wherein the implant device is comprised of more than one mesh material. 
   
   
       61 . An orthopedic implant device comprising a rolled up or compacted mesh material shaped in the form of a structure for repairing or replacing a bone or a joint. 
   
   
       62 . The orthopedic implant device of  claim 61  wherein the rolled up or compacted mesh material is overlayed with one or more layers of a mesh material which is the same as or different from the rolled up or compacted mesh material. 
   
   
       63 . The orthopedic implant device of  claim 61  wherein the mesh material is a filled mesh material. 
   
   
       64 . A method of contouring the orthopedic implant device of  claim 61  comprising heating the device and reshaping it to a new contour that fits a patient's anatomy wherein the device maintains the new contour upon cooling. 
   
   
       65 . An implant device comprising a mesh material for orthopedic, musculoskeletal or soft tissue repair, the mesh material having a flat central section with two opposing ends, the flat central section tapering at each opposing end to a cable, rope or strap comprised of the mesh material. 
   
   
       66 . A method of making an implant device comprising a rolled up or compacted mesh material shaped in the form of a structure for repairing or replacing a bone or a joint comprising rolling up a mesh material to make a rolled-up perform or compacting a mesh material to make a compacted preform and subjecting the rolled-up or compacted preform to heat and/or pressure in order to shape it into the implant device. 
   
   
       67 . The method of  claim 66  wherein the mesh material is a filled mesh material. 
   
   
       68 . An orthopedic implant device comprising a core wrapped with multiple layers of a mesh material and shaped in the form of a structure for repairing or replacing a bone or a joint. 
   
   
       69 . A method of making an implant device comprising a mesh material shaped in the form of a structure for repairing or replacing a bone or a joint comprising wrapping a core with multiple layers of a mesh material to make a wrapped core and subjecting the wrapped core to heat and/or pressure in order to shape it into the implant device. 
   
   
       70 . A method of contouring an orthopedic implant device having a contour that can be reshaped upon heating and being comprised of a mesh material or mesh materials, optionally in combination with non-mesh materials, comprising heating the device and shaping it to a new contour that fits a patient's anatomy wherein the device maintains the new contour upon cooling. 
   
   
       71 . The orthopedic implant of  claim 45  wherein the mesh materials are comprised of strands having interstices therebetween and at least some of the interstices are filled with a biocompatible material or medication or a biocompatible material and medication. 
   
   
       72 . The orthopedic implant of  claim 46  wherein the mesh materials are comprised of strands having interstices therebetween and at least some of the interstices are filled with a biocompatible material or medication or a biocompatible material and medication. 
   
   
       73 . The orthopedic implant of  claim 47  wherein the mesh materials are comprised of strands having interstices therebetween and at least some of the interstices are filled with a biocompatible material or medication or a biocompatible material and medication.