Antibiotic delivery system and method for treating an infected synovial joint during re-implantation of an orthopedic prosthesis

Abstract

An antibiotic delivery system including an intramedullary stem that is adapted to be removably mounted into a medullary canal of a bone. The stem includes a body having an inlet adapted to be in fluid communication with a source of liquid-borne antibiotic and a plurality of outlets disposed along the stem. A channel extends between the inlet and the plurality of outlets for delivering a fluid-borne antibiotic from the inlet to the plurality of outlets so as to distribute the antibiotic along the medullary canal in a controlled fashion. A method of treating an infected joint during a two-stage re-implantation of an orthopedic implant is also disclosed.

What is claimed is: 
     
       1. An antibiotic delivery system comprising:
 a femoral intramedullary stem adapted to be removably mounted into a medullary canal of a femur bone, said femoral intramedullary stem including a body having a proximate end and a distal end disposed remote from said proximate end, said body including a plurality of fins extending therealong and disposed in spaced angular relationship with respect to each other so as to define valleys that provide fluid flow spaces disposed between adjacent fins, said fins adapted to engage said medullary canal in a removably stable fashion, a femoral head and a neck extending from said proximal end of said body and between said body and said femoral head, said femoral intramedullary stem including at least one inlet, and a plurality of outlets disposed along said stem and between an outer surface of one of said plurality of adjacent fins in said valleys and in fluid communication with said fluid flow spaces and a channel extending between said inlet and said plurality of outlets, said femoral head having a plurality of outlets and a channel extending between said at least one inlet and said plurality of outlets for delivering fluid-borne antibiotics from said at least one inlet to said plurality of outlets so as to distribute said antibiotic along said intramedullary canal and the socket of a hip joint in a controlled fashion.   
     
     
       2. An antibiotic delivery system as set forth in  claim 1 , wherein said body includes an inlet and said femoral head includes an inlet, both inlets being in fluid communication with a source of fluid-borne antibiotic. 
     
     
       3. An antibiotic delivery system as set forth in  claim 1 , wherein said femoral head has a hemispherical shape so as to be complimentarily received in the socket of a hip joint. 
     
     
       4. A method of treating an infected joint during a two-stage re-implantation of an orthopedic implant, said method comprising the steps of:
 removing the infected implants mounted to the medullary canal of a bone; 
 debriding the medullary canal; and  
 installing an intramedullary stem into the medullary canal where the stem includes an inlet, a plurality of outlets and a channel extending between the inlet and the plurality of outlets, wherein installing the intramedullary stem includes installing a tibial intramedullary stem into the medullary canal of the tibia bone and installing a femoral intramedullary stem into the medullary canal of a femur bone; 
 said intramedullary stem including a plurality of fins extending along a longitudinal axis of the intramedullary stem and disposed in spaced angular relationship with respect to each other so as to define valleys that provide fluid flow spaces disposed between adjacent fins and a plurality of outlets disposed along said intramedullary stem and between an outer surface of one of said plurality of adjacent fins in said valleys and in fluid communication with said fluid flow spaces providing a source of fluid-borne antibiotic to the inlet of the intramedullary stem so as to distribute the antibiotic into the medullary canal in a controlled fashion. 
 
     
     
       5. A method of treating an infected orthopedic implant as set forth in  claim 4 , wherein said step of installing an intramedullary stem includes installing a tibial intramedullary stem into the medullary canal of the tibia bone and installing a femoral intramedullary stem into the medullary canal of a femur bone. 
     
     
       6. A method of treating an infected orthopedic implant joint as set forth in claim  5  4, wherein the method further inludes the step of positioning a coupler between the tibial intramedullary stem and the femoral intramedullary stem so as to provide axial stability between the tibial and femoral intramedullary stems. 
     
     
       7. A method of treating an infected orthopedic implant joint as set forth in  claim 6 , wherein the method further includes the step of establishing fluid communication between the coupler and the inlet of the tibial and femoral intramedullary stems and providing fluid communication between the coupler and a the source of fluid-borne antibiotic so as to distribute the antibiotic through the tibial and femoral intramedullary stems and along the medullary canals in a controlled fashion. 
     
     
       8. A method of treating an infected area of bone comprising a first bone and a second bone, said method comprising:
 removing an infected intramedullary implant from the first bone;   disposing a first intramedullary implant in a medullary canal of the first bone, wherein the implant comprises an outer surface, an inlet, a plurality of outlets in fluid communication with the inlet, and a channel in fluid communication with the inlet and the plurality of outlets;   delivering a fluid from the plurality of outlets to the medullary canal of the first bone in a controlled fashion, wherein the plurality of outlets are disposed in one or more valley regions in the outer surface of the first intramedullary implant;   removing a second infected intramedullary implant from the second bone in the infected area;   disposing a second intramedullary implant in a second medullary canal of the second bone, wherein the second implant comprises an outer surface, an inlet, a plurality of outlets in fluid communication with the inlet, and a channel in fluid communication with the inlet and the plurality of outlets; and   delivering the fluid from the plurality of outlets to the second medullary canal of the second bone in a controlled fashion, wherein the plurality of outlets are disposed in one or more valley regions in the outer surface of the second intramedullary implant.   
     
     
       9. The method of claim 8, wherein the first bone comprises a femur or a tibia. 
     
     
       10. The method of claim 8, wherein disposing the first intramedullary implant in the medullary canal of the first bone comprises engaging a plurality of fins disposed on the first intramedullary implant with bone lining the intramedullary canal of the first bone. 
     
     
       11. The method of claim 8, wherein the first implant comprises a head coupled thereto, the head having a plurality of outlets fluidly coupled to the channel, the method further comprising:
 disposing the head in a bone socket; and   delivering the fluid from the plurality of outlets in the head to the bone socket in a controlled fashion.   
     
     
       12. The method of claim 8, wherein the head comprises a hemispherically shaped head. 
     
     
       13. The method of claim 8, wherein the fluid comprises an antibiotic, an antibacterial, or an irrigation fluid. 
     
     
       14. The method of claim 8, further comprising applying negative pressure wound therapy to the infected area. 
     
     
       15. The method of claim 8, wherein removing the infected intramedullary implant from the first or the second bone comprises removing a prosthetic joint from the first bone. 
     
     
       16. The method of claim 15, wherein the prosthetic joint comprises a prosthetic hip joint or a prosthetic knee joint. 
     
     
       17. The method of claim 8, further comprising coupling the first intramedullary implant to the second intramedullary implant with a coupler. 
     
     
       18. A system for delivering fluid to an infected area of bone having a first bone, said system comprising:
 a first intramedullary implant configured to be disposed in a medullary canal of the first bone, wherein the first implant comprises an outer surface, an inlet, a plurality of outlets in fluid communication with the inlet, and a channel in fluid communication with the inlet and the plurality of outlets,   wherein the plurality of outlets are disposed in one or more valley regions of the outer surface;   a source of fluid in fluid communication with the channel, wherein the fluid is delivered to the medullary canal via the plurality of outlets; and   a second intramedullary implant configured to be disposed in a medullary canal of a second bone, wherein the second implant comprises an outer surface, an inlet, a plurality of outlets in fluid communication with the inlet, and a channel in fluid communication with the inlet and the plurality of outlets,   wherein the plurality of outlets are disposed in one or more valley regions of the outer surface of the second intramedullary implant, and   wherein the source of fluid is in fluid communication with the channel of the second intramedullary implant, and   wherein the fluid is delivered to the medullary canal of the second bone via the plurality of outlets of the second intramedullary implant.   
     
     
       19. The system of claim 18, wherein the first intramedullary implant comprises a femoral implant configured to be disposed in the medullary canal of a femur, or wherein the first intramedullary implant comprises a tibial implant configured to be disposed in the medullary canal of a tibia. 
     
     
       20. The system of claim 18, further comprising a coupler for coupling the first intramedullary implant to the second intramedullary implant. 
     
     
       21. The system of claim 18, wherein the first implant comprises a head coupled thereto, the head having a plurality of outlets fluidly coupled to the channel, wherein the head is configured to be disposed in a socket of a joint, and
 wherein the fluid is delivered to the socket in a controlled fashion via the plurality of outlets in the head.   
     
     
       22. The system of claim 21, wherein the head comprises a hemispherically shaped head. 
     
     
       23. The system of claim 18, wherein the fluid comprises an antibiotic, antibacterial, or an irrigation fluid. 
     
     
       24. The system of claim 18, further comprising a pump, wherein the pump pumps the fluid from the source of the fluid to the plurality of outlets. 
     
     
       25. The system of claim 18, further comprising a pump for applying negative pressure wound therapy to the infected area. 
     
     
       26. The system of claim 18, wherein the first intramedullary implant comprises a plurality of fins disposed thereon.