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Osteogenic devices and methods of use thereof for repair of endochondral bone and osteochondral defects

a technology of osteochondral bone and osteochondral defect, which is applied in the field of osteogenic protein-based materials and methods for repairing bone and cartilage defects, can solve problems that have been ignored or neglected, achieve the effects of restoring osteochondral or chondral defect, avoiding undesirable formation, and promoting and enhancing the rate and/or quality of new bone formation

Inactive Publication Date: 2009-07-02
RUEGER DAVID C +2
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0019]Because the instant invention provides practitioners with improved materials and methods for bone and cartilage repair, including repair of articular cartilage present in mammalian joints, it overcomes problems otherwise encountered using the methods and devices of the art. For example, the instant invention can induce formation of bona fide hyaline cartilage rather than fibrocartilage at a defect site. Functional hyaline cartilage forms on the articulating surface of bone at a defect site and does not degenerate over time to fibrocartilage. By contrast, prior art methods generally ultimately result in development of fibrocartilage at the defect site. Unlike hyaline cartilage, fibrocartilage lacks the physiological ability to restore articulating joints to their full capacity. Thus, when improved osteogenic devices are used in accordance with the instant methods, the practitioner can substantially restore an osteochondral or a chondral defect in a functionally articulating joint and avoid the undesirable formation of fibrocartilage typical of prior art methods. As contemplated herein, the invention further embodies allogenic replacement materials for repairing avascular tissue in a skeletal joint which results in formation of mechanically and functionally viable replacement tissues at a joint.
[0020]In summary, the methods, devices, and kits of the present invention can be used to induce endochondral or intramembraneous bone formation for repairing bone defects which do not heal spontaneously, as well as for promoting and enhancing the rate and / or quality of new bone formation, particularly in the repair of fractures and fusions, including spinal fusions. The methods, devices, and kits also can induce repair of osteochondral and / or subchondral defects, i.e., can induce formation of new bone and / or the overlying surface cartilage. The present invention is particularly suitable for use in repair of defects resulting from deteriorative or degenerative diseases such as, but not limited to, osteochondritis dessicans. It is also particularly suitable for use in patients requiring repetitive reconstructive surgeries, as well as cancer patients. Other applications include, but are not limited to, prosthetic repair, spinal fusion, scoliosis, cranial / facial repair, and massive allograft repair.

Problems solved by technology

In view of existing orthopedic and reconstructive technologies, these discoveries are unexpected and were heretofore unappreciated.

Method used

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  • Osteogenic devices and methods of use thereof for repair of endochondral bone and osteochondral defects
  • Osteogenic devices and methods of use thereof for repair of endochondral bone and osteochondral defects
  • Osteogenic devices and methods of use thereof for repair of endochondral bone and osteochondral defects

Examples

Experimental program
Comparison scheme
Effect test

experiment 1

[0142]1. Unitary Device Configuration (Dogs)

[0143]This study illustrates the efficacy of OP-1 combined with collagen matrix and carboxymethylcellulose for repairing critical-size ulna segmental defects in the art-recognized canine model.

[0144]Briefly, the data set forth below indicate at least comparable radiographic healing at sites that received a CMC / OP-1 device relative to segmental defects treated with the standard OP device. The final radiographic grade (maximum=6.0) for defects treated with CMC / OP-1 was 5.33±0.58 compared to 4.67±0.58 for defect receiving the standard OP-1 device. In general, new bone formation was evident as early as two weeks post-operative in all defects. The new bone continued to density, consolidate and remodel until sacrifice at twelve post-operative weeks. The mean load to failure of the defects treated with the CMC / OP-1 device was 59.33 N±26.77. This was 70% of the mean load to failure of the contralateral sides which received the standard OP-1 impla...

experiment 2

[0230]2. Accelerated Repair of a Closed Fracture Defect as Treated with a Unitary Device (Dogs)

[0231]The following is a comparative experimental study of the efficacy of injectable, CMC-containing rhOP-1 formulations for accelerating fracture healing in dogs.

Test System

[0232]Adult male mongrel dogs bred for purpose were utilized in this study. Special attention was paid in selecting animals of uniform size and weight to limit the variability in bone geometry and loading. The animals were screened clinically and radiographically to exclude acute and chronic medical conditions during a two-week quarantine period.

[0233]Using standard aseptic techniques, surgery was performed under isofluorane gas anesthesia and was monitored by electrocardiogram and heart rate monitors. Pre-surgical medication was administered approximately 20-30 minutes prior to anesthesia induction. The pre-surgical medication consisted of atropine (dosage 0.02 mg / lb body weight) and acepromizine (dosage 0.1 mg / lb b...

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Abstract

Disclosed herein are improved osteogenic devices and methods of use thereof for repair of bone and cartilage defects. The devices and methods promote accelerated formation of repair tissue with enhanced stability using less osteogenic protein than devices in the art. Defects susceptible to repair with the instant invention include, but are not limited to: critical size defects, non-critical size defects, non-union fractures, fractures, osteochondral defects, subchondral defects, and defects resulting from degenerative diseases such as osteochondritis dessicans.

Description

CONTINUING APPLICATION DATA[0001]The instant application is a continuing application of co-pending U.S. Ser. No. 08 / 822,186 filed on Mar. 20, 1997, the entire content of which is incorporated by reference herein.FIELD OF THE INVENTION[0002]The invention disclosed herein relates to materials and methods for repairing bone and cartilage defects using osteogenic proteins.BACKGROUND OF THE INVENTION[0003]A class of proteins now has been identified that is competent to act as true chondrogenic tissue morphogens. That is, these proteins are able, on their own, to induce the proliferation and differentiation of progenitor cells into functional bone, cartilage, tendon, and / or ligamentous tissue. This class of proteins, referred to herein as “osteogenic proteins” or “morphogenic proteins” or “morphogens,” includes members of the family of bone morphogenetic proteins (BMPs) which were initially identified by their ability to induce ectopic, endochondral bone morphogenesis. The osteogenic prot...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61K38/17A61K9/00A61P19/00A61K35/32A61K38/00C07K14/51
CPCA61F2/30756A61K38/00A61L27/54A61L27/425A61L27/44C07K14/51A61P19/00
Inventor RUEGER, DAVID C.TUCKER, MARJORIE M.CHANG, AN-CHENG
Owner RUEGER DAVID C
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