Implants for bone fixation or fusion

Abstract

Implants for the fusion or fixation of two bone segments are described. For example, the implants can be used for the fusion or fixation of the sacroiliac joint. The implants can include fenestrations, have a rectilinear overall cross-sectional area, and have a curvature. Some implants can also be used to rescue failed implants.

What is claimed is: 
     
         1 . An implant for the fixation or fusion of the SI-Joint, the implant comprising:
 an elongate body have a longitudinal axis and a noncircular overall cross-sectional profile transverse to the longitudinal axis, the elongate body having a proximal end and a distal end, wherein the elongate body is curved along the longitudinal axis from the proximal end to the distal end of the elongate body.   
     
     
         2 . The implant of  claim 1 , wherein the noncircular overall cross-sectional profile has one or more apices. 
     
     
         3 . The implant of  claim 1 , wherein the noncircular overall cross-sectional profile is substantially rectilinear. 
     
     
         4 . The implant of  claim 1 , wherein the noncircular overall cross-sectional profile is triangular. 
     
     
         5 . The implant of  claim 1 , wherein the elongate body has a curvature between about 5 and 45 degrees. 
     
     
         6 . The implant of  claim 1 , wherein the elongate body has a curvature between about 15 and 30 degrees. 
     
     
         7 . The implant of  claim 1 , wherein the elongate body has a plurality of fenestrations. 
     
     
         8 . The implant of  claim 7 , wherein the fenestrations are located on a distal portion of the elongate body. 
     
     
         9 . An implant system comprising:
 the implant of  claim 1 ; and   a curved guidewire,   wherein the implant comprises a central lumen configured to receive the curved guidewire therethrough.   
     
     
         10 . The implant system of  claim 9 , further comprising a drill bit configured to receive the curved guidewire therethrough and drill a curved bore in bone along the guidewire. 
     
     
         11 . The implant system of  claim 9 , further comprising a broach configured to receive the curved guidewire therethrough and shape the curved bore to form an insertion path in the bone for the implant. 
     
     
         12 . An implant for the fixation or fusion of the SI-Joint, the implant comprising:
 an elongate body have a longitudinal axis and a noncircular overall cross-sectional profile transverse to the longitudinal axis, the elongate body having a proximal end and a distal end, wherein the elongate body comprises one or more faces that extend from the proximal end to the distal end of the elongate body, each face having a slot extending from the distal end of the elongate body towards the proximal end of the elongate body along the longitudinal axis; and   a rib slidably disposed in each slot.   
     
     
         13 . The implant of  claim 12 , wherein the slot is selected from the group consisting of a dovetail slot and a t-slot. 
     
     
         14 . The implant of  claim 12 , wherein the rib is made of a material selected from the group consisting of bone graft, metal, metal alloy, hydroxyapatite, ceramic, and polymer. 
     
     
         15 . The implant of  claim 12 , wherein the elongate body has three faces and a triangular overall cross-sectional profile transverse to the longitudinal axis. 
     
     
         16 . The implant of  claim 12 , wherein the rib is wedge shaped. 
     
     
         17 . The implant of  claim 12 , wherein the rib is positioned in a central portion of the implant and offset from both the proximal end and the distal end of the elongate body. 
     
     
         18 . An implant for the fixation or fusion of the SI-Joint, the implant comprising:
 an elongate body have a longitudinal axis and a noncircular overall cross-sectional profile transverse to the longitudinal axis having one or more apices, wherein a portion of the one or more apices is removed to form a face along the one or more apices, the face having a slot that extends along the longitudinal axis; and   a rib slidably disposed in the slot.   
     
     
         19 . The implant of  claim 18 , wherein the rib is made of a material selected from the group consisting of bone graft, metal, metal alloy, hydroxyapatite, ceramic, and polymer. 
     
     
         20 . The implant of  claim 18 , wherein the rib is sized and configured to restore the shape of the removed portion of the one or more apices. 
     
     
         21 . An implant for the fixation or fusion of the SI-Joint, the implant comprising:
 an elongate body have a longitudinal axis and a noncircular overall cross-sectional profile transverse to the longitudinal axis, the elongate body having a proximal end and a distal end, wherein the elongate body comprises one or more faces that extend from the proximal end to the distal end of the elongate body;   an elongate rib disposed along the one or more faces of the elongate body; and   a wire cage configured to secure the elongate rib to the elongate body.   
     
     
         22 . The implant of  claim 21 , wherein the wire cage comprises a first opening to receive the elongate body and a second opening to receive the elongate rib. 
     
     
         23 . An implant for the fixation or fusion of the SI-Joint, the implant comprising:
 an elongate body have a longitudinal axis and a noncircular overall cross-sectional profile transverse to the longitudinal axis, the elongate body having a proximal end and a distal end, wherein the elongate body comprises one or more faces that extend from the proximal end to the distal end of the elongate body; and   one or more fenestrations located on a distal portion of the elongate body.   
     
     
         24 . The implant of  claim 23 , wherein the one or more fenestrations are located along a central portion of the one or more faces of the elongate body. 
     
     
         25 . The implant of  claim 23 , wherein the elongate body comprises at least one apex and the one or more fenestrations are located at the distal end of the at least one apex. 
     
     
         26 . The implant of  claim 23 , wherein the one or more fenestrations are circular. 
     
     
         27 . The implant of  claim 23 , wherein the one or more fenestrations are oblong. 
     
     
         28 . The implant of  claim 23 , wherein the elongate body is tapered such that the distal end has a smaller diameter or width than the proximal end. 
     
     
         29 . The implant of  claim 23 , wherein the elongate body comprises a plurality of walls that form the one or more faces and define a lumen having a noncircular overall cross-sectional profile. 
     
     
         30 . The implant of  claim 29 , wherein the noncircular overall cross-sectional profile of both the elongate body and the lumen is triangular. 
     
     
         31 . The implant of  claim 29 , wherein the noncircular overall cross-sectional profile of both the elongate body and the lumen is rectangular. 
     
     
         32 . The implant of  claim 29 , wherein the elongate body is coated with hydroxyapatite.