Preparation for repairing cartilage defects or cartilage/bone defects in human or animal joints

Abstract

Repairs of cartilage defects or of cartilage/bone defects in human or animal joints with the help of devices including a bone part ( 1 ), a cartilage layer ( 2 ) and a subchondral bone plate ( 4 ) or an imitation of such a plate in the transition region between the cartilage layer ( 2 ) and the bone part ( 1 ). After implantation, the bone part ( 4 ) is resorbed and is replaced by reparative tissue only after being essentially totally resorbed. In a critical phase of the healing process, a mechanically inferior cyst is located in the place of the implanted bone part ( 1 ). In order to prevent the cartilage layer ( 2 ) from sinking into the cyst space during this critical phase of the healing process the device has a top part ( 11 ). and a bottom part ( 12 ), wherein the top part ( 11 ) consists essentially of the cartilage layer ( 2 ) and the subchondral bone plate ( 4 ) and the bottom part ( 12 ) corresponds essentially to the bone part ( 1 ) and wherein the top part ( 11 ) parallel to the subchondral bone plate ( 4 ) has a larger diameter than the bottom part ( 12 ). After implantation in a suitable opening or bore ( 20 ), the cartilage layer ( 2 ) and the subchondral bone plate ( 4 ) are supported not only on the bone part ( 1 ) but also on native bone tissue having a loading capacity not changing during the healing process. Therefore, the implanted cartilage layer cannot sink during the healing process.

1. A device ( 10 ) for repairing cartilage defects or cartilage/bone defects in human or animal joints, said device comprising a bone part ( 11 ), a cartilage layer ( 2 ) grown onto the bone part ( 1 ) and forming a cartilage surface ( 3 ), and a subchondral bone plate ( 4 ) or an imitation of a such a bone plate in a transition region between the bone part ( 1 ) and the cartilage layer ( 2 ), said device being implantable into an opening or a bore ( 20 ) set up in a defective ,region such that the bone part is adapted to be anchored in the healthy bone tissue and the cartilage surface ( 3 ) is flush with a native cartilage surface ( 3 ′), wherein for supporting the subchondral bone plate ( 4 ) and the cartilage layer ( 2 ) of the implanted device on at least two materials with differing resorbabilities, a cross-section of the bone part ( 1 ) is smaller than a cross section of the subchondral bone plate ( 4 ) and the cartilage layer ( 2 ) or the bone part has column regions ( 40 ,  41 ) that extend to the subchondral bone plate ( 4 ) and have a resorbability different from a resorbability of the regions between the column regions. 
     
     
       2. The device according to  claim 1 , further comprising a top part ( 11 ) and a bottom part ( 12 ), wherein the top part ( 11 ) substantially comprises the cartilage layer ( 2 ) and the subchondral bone plate ( 4 ), and the bottom part ( 12 ) substantially corresponds to the bone part and wherein the subchondral bone plate ( 4 ) is larger than a cross section parallel to the subchondral bone plate through the bottom part ( 12 ) such that the subchondral bone plate ( 4 ) of the implanted device ( 30 ) is supported on native bone tissue. 
     
     
       3. The device according to  claim 2 , wherein the top part ( 11 ) and the bottom part ( 12 ) are coaxial circular cylinders. 
     
     
       4. The device according to  claim 2 , wherein the bottom part ( 12 ) is a circular cylinder and the top part ( 11 ) has a square, rectangular, triangular or hexagonal cartilage surface ( 3 ). 
     
     
       5. The device according to  claim 1 , wherein the column regions ( 40 ,  41 ) extend perpendicular to the subchondral bone plate ( 4 ) through the bone part ( 1 ) up to the subchondral bone plate ( 4 ), and wherein the column regions ( 40 ,  41 ) and regions between the column regions have different resorbabilities. 
     
     
       6. The device according to  claim 5 , wherein the device is essentially cylindrical and the cartilage layer ( 3 ) is arranged on one of its end faces. 
     
     
       7. The device according to  claim 5 , wherein a resorption behavior of the column regions ( 40 ) is altered with respect to a resorption behavior of the regions between the column regions by way of chemical treatment. 
     
     
       8. The device according to  claim 7 , wherein the column regions ( 40 ) consist of bone issue treated with biphosphonate bisphosphonate. 
     
     
       9. The device according to  claim 1 , wherein the column regions ( 41 ) consist of a bone replacement material filled into corresponding axial bores. 
     
     
       10. The device according to  claim 1 , wherein said device is made of autologous tissue. 
     
     
       11. The device according to  claim 1 , wherein said device is made of homologous or heterologous, immunologically deactivated tissue. 
     
     
       12. The device according to  claim 11 , wherein said device is made of tissue that is immunologically deactivated by way of photo-oxidation. 
     
     
       13. The device according to  claim 11 , wherein said device consists of tissue removed from slaughtered animals. 
     
     
       14. The device according to  claim 13 , wherein the tissue is removed from cattle or pig's joints. 
     
     
       15. A method for repairing cartilage defects or cartilage/bone defects in human or animal joints using a device ( 10 ) according to  claim 2 , comprising the steps of producing in the defect region an opening or bore ( 20 ) extending into healthy bone material and implanting the device ( 10 ) in the opening or bore, wherein the opening ( 20 ) comprises an outer region ( 21 ) and an inner region ( 22 ), a cross section of the outer region ( 21 ) is larger than a cross section of the inner region ( 22 ) and wherein the opening ( 20 ) is adapted, relative to the device ( 10 ), such that the device is implantable with a press fit and the cartilage surface ( 3 ) of the implanted device ( 30 ) is flush with the native cartilage surface ( 3 ′). 
     
     
       16. The method according to  claim 15 , wherein a transition between the outer region ( 21 ) and the inner region ( 22 ) lies directly below the native subchondral bone plate ( 4 ′). 
     
     
       17. The method according to  claim 15 , wherein the opening ( 20 ) is produced by drilling. 
     
     
       18. The method according to  claim 15 , wherein, for repairing larger defects, a plurality of devices are implanted in a mosaic-like manner, wherein positions for openings or bores ( 2 ) and the shape and size of top parts ( 11 ) of the devices ( 10 ) are coordinated to one another such that a cartilage surface ( 3 ,  3 ′) essentially without interruption is achieved. 
     
     
       19. The method according to  claim 18 , wherein missing bone material between the openings is replaced with a bone replacement material having a resorbability that is different from the resorbability of the bone parts ( 1 ) of the devices ( 10 ). 
     
     
       20. A device for repairing cartilage defects or cartilage/bone defects in human or animal joints, said device comprising a bone part, a cartilage layer grown onto the bone part and forming a cartilage surface, and a subchondral bone plate or an imitation of a such a bone plate in a transition region between the bone part and the cartilage layer, wherein: (a) resorbability of the bone part is faster than resorbability of the subchondral bone plate or an imitation of a such a bone plate; (b) the bone part of the device comprises columns that have reduced resorbability relative to the rest of the bone part; and (c) the columns extend axially through the bone part up to the subchondral bone plate. 
     
     
       21. The device of claim 20, wherein the subchondral bone plate or an imitation of such a bone plate protrudes on all sides from the bone part. 
     
     
       22. The device of claim 21, wherein the subchondral bone plate or an imitation of such a bone plate has the form of a circular cylinder which is arranged coaxial to the bone part. 
     
     
       23. The device of claim 21, wherein the cartilage layer forms a square, rectangular, triangular, or hexagonal cartilage surface. 
     
     
       24. The device of claim 20, wherein the bone part and the subchondral bone plate or an imitation of a such a bone plate comprise a bone material or a bone substituted material and at least part of the material of the subchondral bone plate or an imitation of a such a bone plate is of a higher density than the material of the bone part. 
     
     
       25. The device of claim 20, wherein the device comprises autologous tissue. 
     
     
       26. The device of claim 20, wherein the device comprises homologous or heterologous, immunologically deactivated tissue. 
     
     
       27. The device of claim 26, wherein the device comprises tissue that is deactivated by photo-oxidation. 
     
     
       28. The device of claim 26, wherein the device comprises tissue removed from at least one slaughtered animal. 
     
     
       29. The device of claim 28, wherein the tissue is removed from a cattle or pig joint. 
     
     
       30. The device of claim 20, wherein the resorbability of the columns has been reduced by chemical treatment. 
     
     
       31. The device of claim 30, wherein the chemical treatment comprises treatment with bisphosphonate. 
     
     
       32. The device of claim 20, wherein the columns comprise axial bores in the bone part that have been filled with a material that is more resistant to resorption than the rest of the bone part. 
     
     
       33. A device for repairing cartilage defects or cartilage/bone defects in human or animal joints, said device comprising a bone part, a cartilage layer grown onto the bone part and forming a cartilage surface, and a subchondral bone plate or an imitation of a such a bone plate in a transition region between the bone part and the cartilage layer, wherein the device is adapted to be implanted into a bore formed in or near a defect region of a human or animal joint, and wherein the bone part comprises at least one column having a resorbability different from the resorbability of the rest of the bone part. 
     
     
       34. The device of claim 33, wherein the at least one column is adapted to bear the subchondral bone plate after the device has been implanted in the bore and the rest of the bone part has been resorbed.