Combined Space Maintenance and Bone Regeneration System for the Reconstruction of Large Osseous Defects

Abstract

Systems, methods and compositions useful for treatment of traumatic bone injuries are provided. In one embodiment, a bone reconstruction system comprising a space maintaining composition comprising porous polymethylmethacrylate; and an osseous generating construct comprising a polymethylmethacrylate chamber that comprises one or more osseous generating materials is provided. Associated compositions and methods are also provided.

What is claimed is: 
     
         1 . A bone reconstruction system comprising:
 a space maintaining composition comprising porous polymethylmethacrylate; and   an osseous generating construct comprising a polymethylmethacrylate chamber that comprises one or more osseous generating materials.   
     
     
         2 . The system of  claim 1  wherein the osseous generating materials comprises one or more materials selected from the group consisting of morselized autologous bone, a demineralized bone matrix, a scaffold matrix comprising a bone generating compound, and a combination thereof. 
     
     
         3 . The system of  claim 2  wherein the scaffold matrix comprises one or more materials selected from the group consisting of a synthetic polymer, a ceramic material, a metal material, and a combination thereof. 
     
     
         4 . The system of  claim 1  wherein the osseous generating construct further comprises autologous cells. 
     
     
         5 . The system of  claim 1  wherein the osseous generating construct further comprises recombinant human bone morphogenetic proteins. 
     
     
         6 . The system of  claim 1  wherein the space maintaining composition further comprises an antibiotic. 
     
     
         7 . The system of  claim 6  wherein the antibiotic is present in a microparticle comprising poly(lactic-co-glycolic acid). 
     
     
         8 . The system of  claim 1  wherein the space maintaining composition further comprises a bioactive factor. 
     
     
         9 . The system of  claim 8  wherein the bioactive factor is present in a microparticle comprising poly(lactic-co-glycolic acid). 
     
     
         10 . A space maintaining composition comprising porous polymethylmethacrylate, wherein the porosity of the space maintaining composition is from about 10% to about 50%. 
     
     
         11 . The space maintaining composition of  claim 10  comprising pores having a diameter of from about 50 μm to about 150 μm. 
     
     
         12 . The space maintaining composition of  claim 10  comprising interconnectivities less than about 60% for connection sizes of 50 μm or larger. 
     
     
         13 . The space maintaining composition of  claim 10  further comprising an antibiotic. 
     
     
         14 . A method comprising:
 placing a space maintaining composition comprising porous polymethylmethacrylate within an osseous defect; and   placing an osseous generating construct comprising polymethylmethacrylate proximate to the osseous defect so as to generate an osseous construct.   
     
     
         15 . The method of  claim 14  further comprising removing the space maintaining composition from the osseous defect and placing the osseous construct within the osseous defect. 
     
     
         16 . The method of  claim 14  wherein the space maintaining composition further comprises an antibiotic. 
     
     
         17 . A method of making a space maintaining composition comprising:
 combining a methylmethacrylate monomer phase and an aqueous porogen phase comprising a hydrogel porogen; and   forming a porous polymethylmethacrylate.   
     
     
         18 . The method of  claim 17  wherein the aqueous porogen phase is present in an amount of about 10 weight percent to about 50 weight percent. 
     
     
         19 . The method of  claim 17  wherein the hydrogel porogen comprises one or more of carboxymethylcellulose, gelatin, collagen, pluronic, hyaluronic acid, alginate, chitosan, fibrin, agarose, poly(acrylic acid), poly(vinyl alcohol), poly(vinyl phosphonic acid), poly(glutamic acid), poly(ethylene glycol), poly(ethylene oxide), poly(phosphazene), oligo(poly(ethylene glycol) fumarate), poly(N-isopropyl acrylamide), or poly(hydroxyethyl methacrylate). 
     
     
         20 . The method of  claim 17  wherein the hydrogel porogen is present in the aqueous porogen phase in an amount of about 7 weight percent to about 9 weight percent.