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Drug delivery to a joint

a technology for delivering drugs and joints, applied in the direction of drugs, antibacterial agents, prostheses, etc., can solve the problems of irreversible damage to nerves or surrounding tissues, no linear, continuous delivery of anesthetics, and significant systemic side effects of anesthetics administered by these methods, etc., to achieve the effect of facilitating elution of drugs

Inactive Publication Date: 2007-03-08
HOSPITAL FOR SPECIAL SURGERY
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0005] In one aspect, this disclosure describes devices and methods for delivering drugs to the synovial fluid of a joint by locally implanting a drug delivery device. In certain embodiments, the device is positioned in such a way that agitation of synovial fluid facilitates elution of the drug from the device.
[0006] In one aspect, a method of intra-articular drug delivery includes selecting an attachment zone in a synovial joint and affixing a drug release device in the attachment zone. Exemplary suitable attachment zones include intra-articular regions of the synovial joint where there is no interfacing articular cartilage. In certain instances, an attachment zone may include intra-articular regions of bone that are non-load-bearing and optionally removed from the articulation surface. In certain embodiments, the drug release device includes a base affixable in the attachment zone, a sustained-release drug carrier, and a drug. The device may be positioned, in certain applications, so that the device releases the drug into the synovial fluid of the synovial joint, and further, so that agitation of the synovial fluid may facilitate elution of the drug from the drug release device.
[0010] In still another aspect, a drug delivery device may be delivered by a wide variety of methods, such as by placement into a drill site, or forceful injection by gun. In an embodiment, a method of intra-articular drug delivery may include selecting an attachment zone in a synovial joint, and affixing a drug release device in the attachment zone, the drug release device comprising a base affixable in the attachment zone, a sustained-release drug carrier, and a drug, the device positioned so that the device releases the drug into the synovial fluid of the synovial joint, and so that agitation of the synovial fluid facilitates elution of the drug from the drug release device.

Problems solved by technology

Unfortunately, these approaches have significant systemic side effects or are not effective for extended periods of time.
These methods have the disadvantage of potentially causing irreversible damage to nerves or surrounding tissues due to fluctuations in concentration and high levels of anesthetic.
In addition, anesthetic administered by these methods are generally neither confined to the target area, nor delivered in a linear, continuous manner.
In the case of a pump, the infusion lines are difficult to position and secure, the patient has limited, encumbered mobility and, when the patient is a small child or mentally impaired, they may accidentally disengage the pump.

Method used

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  • Drug delivery to a joint
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  • Drug delivery to a joint

Examples

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example 1

[0183] In one example, the drug carrier is provided as a cartridge. The drug may be loaded into the cartridge as a powder, compressed solid, or as granules without a polymer mixture. Alternative the drug may be combined with any suitable biocompatible, biodegradable polymer. Examples of such biocompatible biodegradable polymers useful include: hydroxyaliphatic carboxylic acids, either homo- or copolymers, such as polylactic acid, polyglycolic acid, polylactic glycolic acid; polysaccharides such as cellulose or cellulose derivatives such as ethyl cellulose, cross-linked or uncross-linked sodium carboxymethyl cellulose, sodium carboxymethylcellulose starch, cellulose ethers, cellulose esters such as cellulose acetate, cellulose acetate phthallate, hydroxypropylmethyl cellulose phthallate and calcium alginate, polypropylene, polybutyrates, polycarbonate, acrylate polymers such as polymethacrylates, polyanhydrides, polyvalerates, polycaprolactones such as poly-.epsilon.-caprolactone, po...

example 2

[0184] In one exemplary embodiment, a sustained release device includes a polymeric matrix or liposome from which drug is released by diffusion and / or degradation of the matrix. The release pattern is usually principally determined by the matrix material, as well as by the percent loading, method of manufacture, type of drug being administered and type of device, for example, microsphere. A major advantage of a biodegradable controlled release system over others is that it does not require the surgical removal of the drug depleted device, which is slowly degraded and absorbed by the patient's body, and ultimately cleared along with other soluble metabolic waste products.

[0185] Systemic anesthetics such as methoxyflurane, have been incorporated into liposomes and lecithin microdroplets, for example, as described by Haynes, et al., Anesthesiology 63:490-499 (1985). To date, the liposome and lecithin preparations have not been widely applied in clinical or laboratory practice, because...

example 3

[0186] A biocompatible intra-articular device size for implantation within a joint to continuously deliver a drug within the joint for a period of at least several weeks may include an outer bone anchor construct and an inner core consisting of a drug / polymer reservoir. The drug / polymer reservoir elutes a drug that dissolves in joint fluid through a semipermeable membrane at the synovial fluid interface. The device is implanted in a non-loaded but intra-articular portion of the joint where synovial fluid agitation across the semi-permeable membrane promotes drug elution.

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Abstract

A method of intra-articular drug delivery may include selecting an attachment zone in a synovial joint; affixing a drug release device in the attachment zone, the drug release device comprising a base affixable in the attachment zone, a sustained-release drug carrier, and a drug, the device positioned so that the device releases the drug into the synovial fluid of the synovial joint, and so that agitation of the synovial fluid facilitates elution of the drug from the drug release device.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims the benefit of U.S. Provisional Application Ser. No. 60 / 536,135, filed Jan. 13, 2004, and also claims the benefit of U.S. Provisional Application Ser. No. 60 / 566,737, filed Apr. 29, 2004. The aforementioned patent applications are hereby incorporated herein by this reference.INTRODUCTION [0002] Pain and disability from arthritis, joint degeneration, and surgery have been treated by a combination of oral medications or intra-articular injections of steroid compounds designed to reduce inflammation. In addition, other devices, such as hyaluronic acid products, have been injected to provide visco-supplementation. Unfortunately, these approaches have significant systemic side effects or are not effective for extended periods of time. [0003] In order to provide local or regional blockade for extended periods, clinicians currently use local anesthetics administered through a catheter or syringe to a site where the pain...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61F2/02A61K9/00A61K9/14A61K9/22A61L31/16
CPCA61K9/0024A61L31/16A61M37/0069A61L2300/402A61L2300/41A61L2300/222A61P29/00A61P31/04
Inventor HOTCHKISS, ROBERTKOSKI, JOHN
Owner HOSPITAL FOR SPECIAL SURGERY
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