Implantation of micronized allograft tissue over a microfractured defect

Abstract

Techniques, mixtures, mixing and delivery kits, and improved delivery instruments for implantation of micronized allograft tissue over a microfractured defect. Allograft cartilage tissue is delivered over a cartilage defect that has been debrided and microfractured, without the need for a periosteal covering or separate type of patch sewn over the top. The allograft tissue may be any micronized cartilage particulates obtained by various methods, for example, cartilage delivered in its native form, dehydrated via lyophilization, “freeze-dried,” dehydrated via desiccation, or dehydrated by any other method.

What is claimed is: 
     
         1 . A method of surgery consisting essentially of the steps of:
 conducting microfracture surgery to obtain a microfracture site; and   providing a micronized allograft mixture at the microfracture site, the micronized allograft mixture comprising micronized allograft tissue particles and an autologous blood product.   
     
     
         2 . The method of  claim 1 , wherein the micronized allograft tissue particles have a size of about 0-300 microns. 
     
     
         3 . The method of  claim 1 , further comprising the step of applying a layer of fibrin over the micronized allograft mixture at the microfracture site. 
     
     
         4 . The method of  claim 1 , wherein the micronized allograft tissue particles are desiccated cartilage particles. 
     
     
         5 . The method of  claim 1 , wherein the micronized allograft mixture consists essentially of micronized allograft tissue particles and autologous blood product. 
     
     
         6 . The method of  claim 1 , wherein the autologous blood product is selected from the group consisting of whole blood, autologous conditioned plasma, platelet-rich plasma, bone marrow aspirate, bone marrow concentrate, and stem cells. 
     
     
         7 . The method of  claim 1 , wherein the micronized allograft mixture is formed by the steps of:
 providing a syringe comprising a tube and a plunger that fits tightly in the tube, the plunger being formed of a pushrod and a mixing element attached to the pushrod, the pushrod fitting into the mixing element and being designed to unsnap from the mixing element and snap back into the mixing element;   bringing together micronized allograft tissue particles and autologous blood product into the tube;   removing the pushrod from the mixing element; and   moving the mixing element in at least one direction to mix the micronized allograft tissue particles with the autologous blood product and to obtain the micronized allograft mixture.   
     
     
         8 . The method of  claim 1 , wherein the micronized allograft mixture further comprises growth factors, antiseptics, antibiotics, electrolytes and stem cells. 
     
     
         9 . The method of  claim 1 , wherein the microfracture site is part of a cartilage surface. 
     
     
         10 . The method of  claim 9 , wherein the microfracture site is part of a knee, an ankle, a foot, a shoulder, a hand, a wrist, an elbow, or a hip. 
     
     
         11 . A method of articular cartilage repair, comprising the steps of:
 preparing a cartilage defect by microfracture surgery;   preparing a micronized cartilage paste with particles size of about 0-300 microns, the micronized cartilage paste consisting essentially of micronized cartilage particulates and autologous blood product; and   applying the micronized cartilage paste over the cartilage defect without the need of applying a covering over the cartilage defect.   
     
     
         12 . The method of  claim 11 , wherein the micronized cartilage particulates are obtained by dehydration of cartilage via desiccation. 
     
     
         13 . The method of  claim 11 , wherein the micronized cartilage particulates are obtained by dehydration of cartilage via desiccation or lyophilization. 
     
     
         14 . The method of  claim 11 , further comprising the step of adding, to the micronized cartilage paste, a component selected from the group consisting of growth factors, antiseptics, antibiotics, electrolytes and stem cells. 
     
     
         15 . The method of  claim 11 , wherein the micronized cartilage paste is formed by:
 providing micronized cartilage particulates together with autologous blood product in a syringe comprising a tube and a plunger that fits tightly in the tube, the plunger being formed of a pushrod and a mixing element attached to the pushrod, the pushrod fitting into the mixing element and being designed to engage and disengage the mixing element; and   disengaging the pushrod from the mixing element to allow the mixing element to move in at least two different directions to allow mixing of the micronized cartilage particulates with the autologous blood product in the tube to form the micronized cartilage paste.   
     
     
         16 . A graft for treatment of a microfracture site, the graft comprising a biological allograft mixture consisting essentially of morselized, freeze-dried or desiccated cartilage and an autologous blood product. 
     
     
         17 . The graft of  claim 16 , wherein the autologous blood product is blood, platelet-rich plasma, autologous conditioned plasma, bone marrow aspirate, bone marrow concentrate, stem cells, or combinations thereof. 
     
     
         18 . The graft of  claim 16 , wherein the graft further includes growth factors, antiseptics, antibiotics and electrolytes. 
     
     
         19 . The graft of  claim 16 , wherein the microfracture site is part of a cartilage surface. 
     
     
         20 . The graft of  claim 19 , wherein the cartilage surface is part of a knee, an ankle, a foot, a shoulder, a hand, a wrist, an elbow, or a hip. 
     
     
         21 . A kit for mixing and delivering a micronized allograft paste to repair a microfracture site of a cartilage defect, comprising:
 a mixing syringe comprising a tube and a plunger consisting of a pushrod and a mixing element, wherein the pushrod is configured to engage and disengage the mixing element;   at least one straight needle;   at least one curved needle; and   an obturator.   
     
     
         22 . The kit of  claim 21 , wherein the kit comprises one straight needle and a 45 degree delivery needle. 
     
     
         23 . The kit of  claim 21 , further comprising a funnel for delivery of micronized allograft particles into the tube.