Drug delivery to a joint

Abstract

A drug delivery device may include a base to be percutaneously affixable in an attachment zone of a synovial joint and a sustained-release drug carrier coupled to the base. The drug delivery device may also include an access device to provide access to the attachment zone. The attachment zone may comprise a non-articulating portion of a bone and/or cartilage with the synovial joint and the drug carrier may elute the drug into the synovial fluid sufficient to sustain a therapeutically effective concentration of the drug in the synovial fluid for at least 8 hours.

1 . A sustained-release intra-articular drug delivery device, comprising:
 a base, so sized and shaped as to be percutaneously affixable in an attachment zone of a synovial joint, the attachment zone comprising a non-articulating portion of bone and/or cartilage with the synovial joint; and   a sustained-release drug carrier coupled to the base, the carrier including a drug, the carrier so formed as to elute the drug into synovial fluid, upon implantation of the device in a joint, sufficient to sustain a therapeutically effective concentration of the drug in the synovial fluid for at least 8 hours.   
     
     
         2 . The drug delivery device of  claim 1 , wherein the base comprises at least one barb. 
     
     
         3 . The drug delivery device of  claim 2 , wherein the at least one barb is retractable. 
     
     
         4 . The drug delivery device of  claim 2 , wherein the at least one barb is expandable. 
     
     
         5 . The drug delivery device of  claim 1 , wherein the base has a variable diameter. 
     
     
         6 . The drug delivery device of  claim 5 , wherein a first diameter is selected to facilitate insertion and a second diameter is selected to facilitate affixation. 
     
     
         7 . The drug delivery device of  claim 1 , wherein the base is configured to be substantially flush with the bone surface after affixation. 
     
     
         8 . The drug delivery device of  claim 1 , wherein the drug carrier is replaceable. 
     
     
         9 . The drug delivery device of  claim 1 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to an articulating surface within the synovial joint. 
     
     
         10 . The drug delivery device of  claim 9 , wherein the band extends from about 0.5 millimeters to about 1 centimeter away from the articulating surface. 
     
     
         11 . The drug delivery device of  claim 1 , wherein the synovial joint is a hip joint, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the hip. 
     
     
         12 . The drug delivery device of  claim 11 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to at least one of a femoral head, and an acetabulum. 
     
     
         13 . The drug delivery device of  claim 1 , wherein the synovial joint is a knee joint, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the knee. 
     
     
         14 . The drug delivery device of  claim 13 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to at least one of a tibial plateau, a femoral condyle, a patellofemoral area, the medial rim of a femoral trochlea, the lateral rim of a femoral trochlea, and the periphery of an intercondylar notch. 
     
     
         15 . The drug delivery device of  claim 1 , wherein the synovial joint is a shoulder joint, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the shoulder. 
     
     
         16 . The drug delivery device of  claim 15 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to at least one of the anatomical neck of a humerus, a glenoid cavity, and a glenoid neck. 
     
     
         17 . The drug delivery device of  claim 1 , wherein the synovial joint is an arthroplastic joint comprising at least one prosthesis, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the joint. 
     
     
         18 . The drug delivery device of  claim 17 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to the at least one prosthesis. 
     
     
         19 . A sustained-release intra-articular drug delivery device, comprising:
 a base, so sized and shaped as to be percutaneously affixable in an attachment zone of a synovial joint, the attachment zone comprising a non-articulating portion of bone and/or cartilage with the synovial joint;   a sustained-release drug carrier coupled to the base, the carrier including a drug, the carrier so formed as to elute the drug into synovial fluid, upon implantation of the device in a joint, sufficient to sustain a therapeutically effective concentration of the drug in the synovial fluid for at least 8 hours; and   an access device, so sized and shaped as to provide access to the attachment zone.   
     
     
         20 . The drug delivery device of  claim 19 , wherein the base comprises at least one barb. 
     
     
         21 . The drug delivery device of  claim 20 , wherein the at least one barb is retractable. 
     
     
         22 . The drug delivery device of  claim 20 , wherein the at least one barb is expandable. 
     
     
         23 . The drug delivery device of  claim 19 , wherein the base has a variable diameter. 
     
     
         24 . The drug delivery device of  claim 23 , wherein a first diameter is selected to facilitate insertion and a second diameter is selected to facilitate affixation. 
     
     
         25 . The drug delivery device of  claim 19 , wherein the base is configured to be substantially flush with the bone surface after affixation. 
     
     
         26 . The drug delivery device of  claim 19 , wherein the drug carrier is replaceable. 
     
     
         27 . The drug delivery device of  claim 19 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to an articulating surface within the synovial joint. 
     
     
         28 . The drug delivery device of  claim 27 , wherein the band extends from about 0.5 millimeters to about 1 centimeter away from the articulating surface. 
     
     
         29 . The drug delivery device of  claim 19 , wherein the synovial joint is a hip joint, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the hip. 
     
     
         30 . The drug delivery device of  claim 29 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to at least one of a femoral head, and an acetabulum. 
     
     
         31 . The drug delivery device of  claim 19 , wherein the synovial joint is a knee joint, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the knee. 
     
     
         32 . The drug delivery device of  claim 31 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to at least one of a tibial plateau, a femoral condyle, a patellofemoral area, the medial rim of a femoral trochlea, the lateral rim of a femoral trochlea, and the periphery of an intercondylar notch. 
     
     
         33 . The drug delivery device of  claim 19 , wherein the synovial joint is a shoulder joint, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the shoulder. 
     
     
         34 . The drug delivery device of  claim 33 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to at least one of the anatomical neck of a humerus, a glenoid cavity, and a glenoid neck. 
     
     
         35 . The drug delivery device of  claim 19 , wherein the synovial joint is an arthroplastic joint comprising at least one prosthesis, and the attachment zone comprises a non-articulating portion of bone and/or cartilage within the joint. 
     
     
         36 . The drug delivery device of  claim 35 , wherein the attachment zone comprises a band of bone and/or cartilage adjacent to the at least one prosthesis.