Implants for the comprehensive treatment of bone defects

Abstract

We provide implants for the comprehensive treatment of bone defects. [Solution] The present invention relates to an implant I for the planar treatment of bone defects, particularly bone defects in the region of the rib cage or skull, comprising a lattice structure GS having an upper surface and a lower surface opposite to the upper surface for fixing the implant I to bone. The lattice structure GS has at least one support TA manufactured by an additive manufacturing process. Furthermore, at least one support TA has a cover layer DS having a lower hardness than the at least one support TA applied to each of at least several portions thereof.

Description

Technical Field

[0001] The present invention relates to an implant for the areal treatment of bone defects, particularly in the region of the rib cage or skull, comprising a flexible lattice structure having an upper surface and a lower surface opposite the upper surface for fixing the implant to bone, the lattice structure having at least one support portion.

Background Art

[0002] In the field of implants, deformed forms used for the areal treatment of bone defects are known. Such implants often have a lattice structure that is at least partially flexible and thus enables the implant to conform to different shapes. Implants designed in this way can be used in the rib cage region, particularly in the case of rib fractures, where they can be used instead of rib plates, and by being arranged over a wide area of the rib cage, they also cover the areas between different ribs. The lattice structure achieves sufficient flexibility to allow sufficient mobility of the rib cage while protecting the internal organs.

[0003] Furthermore, implants having a lattice structure in the region of the skull are provided for treating skull bone defects, the lattice structure enabling the implant to conform to the curvature of the skull and ensuring sufficient elasticity. Implants for the areal treatment of bone defects typically often have a mesh-like support portion, the mesh-like support portion forming a lattice structure and being fixed to the bone and used for stabilization.

[0004] German Patent Application Publication No. 19746396 describes an implant provided for the planar treatment of bone defects in the region of the skull. The implant has a lattice structure composed of multiple segments that are closed and interconnected. The lattice structure can be fixed to the underside of the corresponding region of the skull to fix a bone portion or to bridge a bone defect, and the fixation can be achieved by guiding a bone screw through each individual segment. The interconnected segments form a continuous support within the lattice structure, through which the bone portion and bone defect can be stabilized. The lattice structure is manufactured by etching titanium. [Overview of the Initiative]

[0005] Building upon the prior art described above, the problem addressed by the present invention is to provide an implant for the planar treatment of bone defects, and the complex geometric shape of the implant is achievable at a low manufacturing cost. Furthermore, the implant according to the present invention is intended to minimize irritation within the patient's body, particularly tissue irritation.

[0006] This problem is resolved based on the preamble of claim 1 in combination with its feature portion. Each subsequent dependent claim reflects a preferred evolution of the invention. Further preferred embodiments can be gathered from the specification and drawings.

[0007] According to the present invention, the implant includes a flexible lattice structure having an upper surface and a lower surface opposite to the upper surface for fixing the implant to the bone. The lattice structure has at least one support.

[0008] The implant according to the present invention is provided for the planar treatment of bone defects, which are particularly bone defects in the region of the rib cage or skull. For this planar treatment, the implant preferably comprises a flat lattice structure. The lattice structure has an upper and lower surface opposite to each other, the lower surface being the side on which the implant is positioned and fixed so as to face the bone defect.

[0009] "Planar" treatment should be understood, within the scope of the present invention, to mean, in particular, that the treatment area is covered by the implant when used for bone defects. Within the framework of the present invention, implants can be provided specifically for use in this planar treatment to connect bone segments of fractured bone and / or to establish connections between different bones and / or to cover bone defects. The treatment area covered by the implant according to the present invention may range from a few square millimeters to tens of square centimeters, depending on the specific use case, i.e., whether the application is intended in the area of ​​the rib cage or skull.

[0010] The lattice structure is flexible, thereby giving it three-dimensional deformability, allowing the shape of the implant to be easily adapted to a specific treatment area. Therefore, the implant lattice structure according to the present invention, due to its flexible design, can be adapted to curved bone defects and bone defects with uneven shapes. Furthermore, the lattice structure can be designed within the framework of the present invention to be adapted to the size and shape by the attending physician, for example, by removing a portion of the lattice structure or by cutting the lattice structure to size.

[0011] According to the present invention, the lattice structure preferably has at least one support portion used to stabilize bone. In particular, this at least one support portion is intended to be fixed to the bone in the area of ​​the bone defect to be treated, i.e., to be connected to multiple bone segments or one or more bone or bone portions. Stabilization via at least one support portion is achieved in particular in terms of establishing one or more connections to the bone in the applied state of the implant. Preferably, at least one support portion is provided with at least one fixing point for this purpose, and at at least one fixing point, fixation of the implant can be achieved, for example, using each bone screw. The implant according to the present invention may have one or more support portions.

[0012] The present invention includes the technical teaching that at least one support portion is manufactured by an additive manufacturing process. Furthermore, at least partially, a cover layer having a lower hardness than the at least one support portion is applied to the at least one support portion. In other words, in the implant according to the present invention, at least one support portion is formed within the framework of an additive manufacturing process. Furthermore, at least one support portion is at least partially covered with a cover layer having a lower hardness than the at least one support portion.

[0013] Such a design of the implant has the advantage that at least one support can be easily designed to have a complex geometric shape due to additive manufacturing, and this is possible at a low manufacturing cost. This makes it possible to obtain a complex and simultaneously flexible structure of at least one support, and therefore a lattice structure. Since a cover layer is applied at least partially on at least one support, and this cover layer has a lower hardness than the support, it is possible to avoid skin and / or tissue irritation caused by the high hardness of at least one support, particularly by manufacturing-related irregularities of at least one support. This is because at least partial covering of at least one support by the cover layer results in a softer surface of the implant in certain areas due to the lower hardness of the cover layer. Thus, as a whole, when at least one support of the lattice structure is designed in an appropriate manner at a low manufacturing cost and used, an implant can be obtained that can substantially reduce the occurrence of skin and / or tissue irritation.

[0014] Essential to the present invention is that at least one support portion of the implant according to the present invention is formed by an additive manufacturing process, which is particularly preferably carried out within the framework of a 3D printing method. Furthermore, at least one support portion is provided with a cover layer, at least on a portion thereof, the cover layer being less rigid than the at least one support portion and therefore softer. As a result, the implant according to the present invention is provided with a softer surface by the cover layer in the covering area of ​​at least one support portion.

[0015] Within the scope of this invention, "hardness" should be understood as the mechanical resistance applied to mechanical penetration. Therefore, each cover layer has lower mechanical resistance to mechanical penetration than the case of at least one support. Each cover layer can be described as being softer than at least one support.

[0016] According to the present invention, at least one support portion is at least partially covered with a cover layer; that is, at least one support portion may be provided with a cover layer on one or more of its portions, or even around its entire circumference.

[0017] According to one possible embodiment, at least a portion of at least one support on the upper surface of the lattice structure is covered with a cover layer. In this case, the cover layer is applied to several portions of at least one support on the upper surface, thereby leaving several portions of at least one support on the upper surface uncovered. Alternatively, at least one support is entirely covered with a cover layer on the upper surface of the lattice structure such that at least one support is entirely covered with the cover layer on the upper surface. Preferably, at least one support is covered in a targeted manner in a specific area, or the upper surface is completely covered. Thereafter, in the latter case, tissue irritation is completely prevented on the upper surface, but by covering several portions, it is possible to intentionally design the contact area with tissue and / or irregularities of the support, such as edges, to be softened with the help of the cover layer.

[0018] Alternatively or additionally, at least one support can be covered with a cover layer on at least a portion of the underside of the grid structure. In this case, some portions of the at least one support are covered with the cover layer on the underside of the grid structure, thereby leaving a portion of the underside of the at least one support uncovered. However, the at least one support may also be entirely covered with the cover layer on the underside of the grid structure, thereby completely covering the at least one support on its underside. In either case, partially or entirely covering the at least one support on its underside with its respective cover layer results in a softer surface on at least a portion of the underside of the implant. As a result, tissue irritation on the underside of the implant can be reduced. In the case of partial covering of the at least one support, this is done intentionally, particularly in specific contact areas and / or irregularities with the tissue, such as edges.

[0019] The aforementioned advanced forms of the present invention can be achieved alternatively or additionally, thereby allowing at least one support portion to be partially or entirely covered on the upper surface, partially or entirely on the lower surface, or partially or entirely on the upper surface and partially or entirely on the lower surface.

[0020] In combination, an implant design is also conceivable in which at least one support is completely enclosed within each cover layer. In this case, at least one support is completely surrounded and therefore completely covered by the cover layer.

[0021] According to one possible embodiment of the present invention, at least one support has a mesh structure formed by closed segments connected to one another via intermediate segments. As a result, a suitable design is achieved that can achieve high mobility, and therefore flexibility, in the region of at least one support. Preferably, the closed segments are ring-shaped, and the segments may also have offset shapes, such as polygonal shapes. The segments are connected to one another in the mesh structure via intermediate segments, which may be linear or nonlinear. Each intermediate segment may also define a closed segment by being fixed to one another.

[0022] Within the framework of the present invention, at least one support portion may be plate-shaped. In this case, at least one support portion has the shape of a plate, and at least one support portion can be designed as a rigid plate. In the implant according to the present invention, this makes it possible to intentionally define a rigid region in which particularly high stability of the implant is achieved. The plate-shaped design is obtained in particular when the implant according to the present invention is composed of multiple support portions, one or more of the support portions each having a mesh structure, and one or more of the support portions can be designed in the shape of a plate.

[0023] In a further possible embodiment of the present invention, the cover layer is porous. This has the advantage that, due to this porous design, particularly low hardness, and therefore even more, very soft surface can be obtained for each cover layer. On the other hand, this creates the possibility that tissue can grow within the implant and angiogenesis is possible. Furthermore, bodily fluids can pass through the cover layer thereby. In an advanced form of this embodiment, at least one support is at least partially embedded in the porous cover layer. Preferably, as a result, a uniform and soft surface can be obtained in the corresponding area.

[0024] Alternatively, the cover layer can be non-porous. Thus, a very smooth and at the same time soft surface can be achieved in this area, thereby significantly avoiding tissue irritation. The non-porous design of each cover layer can prevent tissue from growing thereon. In particular, the structure of the cover layer corresponds to the structure that at least one support part has in the covered area by each cover layer. This has the advantage that the structure of at least one support part is held outward.

[0025] Preferably, at least one support part is made of a first biocompatible material. The cover layer is preferably made of a second biocompatible material having a lower hardness than the first material. As a result, the hardness of the cover layer lower than that of at least one support part can be achieved in a simple way. Furthermore, by appropriate selection of the second material, further appropriate properties on the surface, such as the formation of a particularly smooth surface when machining the material, can be achieved.

[0026] In a development of the possible embodiments described above, the first material is a metal or a metal alloy, particularly titanium or a titanium alloy. However, most particularly preferably, the first material is a plastic, and this plastic is particularly a polymer, preferably a thermoplastic resin, particularly preferably polyetheretherketone (PEEK). This is because polyetheretherketone is distinguished by very good biocompatibility and high achievable strength.

[0027] The second material is preferably a plastic, particularly a polymer, preferably a thermoplastic resin, particularly preferably polyethylene (PE), such as ultra-high molecular weight polyethylene (UHMWPE) or high-density polyethylene (HDPE). As a result, a soft cover layer can be reliably manufactured compared to at least one support part. Furthermore, in this way, a porous cover layer can be obtained by using PE granules, and a non-porous cover layer can be obtained by using PE powder. In the latter case, a particularly smooth surface can be obtained.

[0028] Most particularly preferably, the two aforementioned deformation modes are implemented together, and for manufacturing the implant according to the invention, additive manufacturing of at least one support part made of polyetheretherketone (PEEK) is first carried out. Then, for cleaning purposes, plasma treatment / plasma activation of at least one support part is preferably carried out before at least one support part is arranged layer by layer or embedded together with PE powder or PE granules in a negative mold. In the subsequent pressing process, polyethylene (PE) is heated together with polyetheretherketone (PEEK), whereby the polyethylene is melted with the polyetheretherketone. As a result, a loadable bond between polyetheretherketone and polyethylene can be obtained.

[0029] Within the framework of the invention, at least one support part and each applied cover layer can also consist of one and the same material. Thus, at least one support part and the cover layer can each be made of, for example, polyethylene.

[0030] According to one embodiment of the invention, the lattice structure has a single continuous support part. Thus, in this case, the lattice structure is formed by a single support part.

[0031] Alternatively, the lattice structure has a plurality of support parts, and adjacent support parts are connected to each other via respective intermediate connecting parts having a lower rigidity than the adjacent support parts. This has the advantage that the flexibility of the lattice structure can thereby be intentionally increased in the region of each connecting part. Due to the low rigidity of each intermediate connecting part, the lattice structure, and thus the implant, can be deformed more easily in this region. Furthermore, as a result, the risk of skin and / or tissue irritation can also be intentionally locally reduced by at least one intermediate connecting part.

[0032] Particularly preferred is that the lower stiffness of each intermediate joint is achieved by fabricating each intermediate joint from a biocompatible material having lower material stiffness than the material of at least one support. If at least one support and cover layer are made from different materials, each intermediate joint is fabricated from the same material as the cover layer.

[0033] Within the framework of the present invention, each intermediate connecting portion may exist in the form of a linear or non-linear intermediate piece, or in the form of a mesh structure. Furthermore, each intermediate connecting portion may be plate-shaped.

[0034] Alternatively or additionally, each support and each connecting part are joined integrally with one another. This is achieved particularly when each connecting part and each support are made of plastic material, especially thermoplastic plastic.

[0035] To design a more robust connection between each support and each connecting part, within the framework of the present invention, each support and each connecting part may overlap in a direction traversing the upper and lower surfaces within their respective fixed areas. Thus, the load-bearing capacity of the connection between each support and each connecting part is increased. Most preferably, each connecting part clamps each support from both sides within its respective fixed area by a protruding connecting segment.

[0036] Preferred embodiments of the present invention, described below, are shown in the drawings. [Brief explanation of the drawing]

[0037] [Figure 1] This is a top view of the implant corresponding to the first embodiment. [Figure 2] Figure 1 is a schematic cross-sectional view of the implant. [Figure 3] A perspective view of an implant according to a second possible embodiment. [Figure 4]Figures 1 and 3 are schematic diagrams of possible modifications of the implant. [Figure 5] Figures 1 and 3 are schematic diagrams of possible modifications of the implant. [Figure 6] Figures 1 and 3 are schematic diagrams of possible modifications of the implant. [Figure 7] This is a schematic diagram of an implant according to the third embodiment. [Figure 8] Figure 7 is a schematic cross-sectional view of the implant. [Figure 9] This is a partial diagram of an implant corresponding to further possible embodiments. [Figure 10] This is a partial diagram of an implant corresponding to further possible embodiments. [Modes for carrying out the invention]

[0038] Figure 1 shows a top view of implant I, provided for the planar treatment of bone defects, particularly bone defects in the thoracic region. Implant I includes a lattice structure GS formed by a support TA in this case. As is clear from Figure 1, the support TA has a mesh structure in that it is composed of ring-shaped segments S and intermediate segments ZS connecting the ring-shaped segments S to each other. The intermediate segments ZS extend in a linear manner.

[0039] In the support portion TA, each ring-shaped segment S forms a through-hole DO, each capable of receiving a bone screw for fixing an implant I, which can then be fixed to the bone in the area of ​​the bone defect being treated by the bone screw guided through that area. Thus, with the help of the support portion TA, one or more bone segments or portions of ribs, and / or multiple ribs, can be connected to one another within the thoracic region, and the support portion TA stabilizes the bone segments or portions relative to one another, and / or the ribs relative to one another.

[0040] The intermediate segment ZS allows the ring-shaped segments S to move relative to each other, thereby making the entire mesh structure of the support TA flexible. This gives the lattice structure GS of the entire implant I a flexible property, on the one hand, allowing it to conform to the curvature of the bone in the area of ​​the bone defect being treated. On the other hand, when the implant I is fixed, a certain degree of mobility is thus allowed in the area of ​​the bone defect being treated to allow the rib cage to move due to the patient's breathing or movement.

[0041] In this case, the support TA is fabricated from polyether ether ketone (PEEK) within the framework of an additive manufacturing process, and the support TA is specifically molded in a 3D printing process. As a result, the complex mesh structure of the support TA can be manufactured at a low cost, and the high stability of the support TA can also be achieved through the biocompatible material polyether ether ketone (PEEK).

[0042] However, as a result of the additional manufacturing process of the support TA, a raw surface is produced on the support TA, and in some cases, a hard edge is also produced, which may cause corresponding tissue irritation when the implant is placed in the body of a particular patient. Furthermore, the mesh structure of the support TA may, in some situations, become perceptible through the patient's tissue or skin, which may also cause corresponding irritation. To reduce the risk of such irritation, the support TA is partially provided with a cover layer DS that is less hard and therefore softer than the support TA. As is evident when considering Figure 1 in combination with the schematic cross-sectional view in Figure 2, this cover layer DS is applied to the support TA on the upper surface OS, which is opposite to the lower surface US of implant I for fixing implant I to the bone.

[0043] In this case, the cover layer DS is made of ultra-high molecular weight polyethylene (UHMWPE), which has a lower hardness than the polyether ether ketone (PEEK) of the support TA, as a biocompatible material. The cover layer DS of implant I is plate-shaped and porous, and the support TA is embedded in the cover layer DS on the upper surface OS of implant I. The porous design of the cover layer DS creates a particularly soft surface on the upper surface OS of implant I, which allows for internal tissue growth and the passage of bodily fluids. This also allows for angiogenesis within the area of ​​implant I, resulting in better retention of soft tissue.

[0044] To manufacture implant I, the support TA of the lattice structure GS was additively fabricated and then subjected to plasma treatment / plasma activation for cleaning purposes, after which the support TA was layer-by-layer placed in a negative mold together with polyethylene granules. Implant I was then formed by heating the polyethylene with polyether ether ketone within the framework of a press process, in which case the polyethylene was melted with the polyether ether ketone.

[0045] Figure 3 is a perspective view of implant I' according to a second possible embodiment of the present invention. This implant I' substantially corresponds to the aforementioned modified forms shown in Figures 1 and 2. Implant I' also has a lattice structure GS, which is formed by a support TA made from polyetheretherketone (PEEK), has a mesh structure, and is additively manufactured. Furthermore, the support TA is also covered in portion within implant I', in that a cover layer DS' is applied to the support TA on the upper surface OS of implant I'. The cover layer DS' is made from polyethylene (PE) in accordance with the modified forms shown in Figures 1 and 2, and in contrast to implant I from Figures 1 and 2, the cover layer DS' in this case is not porous, and for that purpose, polyethylene powder was used instead of polyethylene granules to manufacture implant I'. This results in a smoother surface of implant I' on the upper surface OS than implant I from Figures 1 and 2. As is also evident in Figure 3, the cover layer DS' is designed with a structure corresponding to the mesh structure of the underlying support TA. As a result, even with the non-porous design of the cover layer DS', internal tissue growth and fluid passage are possible. For the remainder, please refer to the explanation of implant I', which corresponds to implant I in Figures 1 and 2.

[0046] Figures 4 to 6 show possible variations of the two implants I and I' according to Figures 1 to 3, respectively. In the possible variations according to Figure 2, the support TA of each implant I or I' is partially covered due to the fact that a cover layer DS'' is provided on the underside US of implants I and I'. This cover layer DS'' also has a lower hardness than the support TA, by being formed from polyethylene (PE). The cover layer DS'' can also be porous and plate-like, as described above, or it can be non-porous and have a structure corresponding to the mesh structure of the support TA.

[0047] In contrast to the possible modifications shown in Figure 5, implant I or I' is covered with cover layer DS or DS' on the upper surface OS and with cover layer DS'' on the lower surface US, thereby sandwiching support TA between cover layer DS or DS' and cover layer DS'', respectively.

[0048] Figure 6 shows possible variations of the two implants I and I' according to Figures 1 and 3, in which case the support TA is completely enclosed within the cover layer DS'''. In principle, this cover layer DS''' can also be porous or non-porous.

[0049] Figure 7 shows a schematic diagram of implant I'' according to a further embodiment of the present invention, which substantially corresponds to implant I' in Figure 3. In implant I'', in contrast to implant I', the lattice structure GS' is formed not by a single support, but by a plurality of support parts TA1 and TA2, each having a mesh structure. Each mesh structure of each support part TA1 or TA2 is also formed by ring-shaped segments S, which form through holes DO for bone screws and are connected to each other via intermediate segments ZS.

[0050] Support sections TA1 and TA2 are connected to each other via their respective intermediate connecting sections VA to form a lattice structure GS', and these connecting sections VA are designed to have lower rigidity than support sections TA1 and TA2. Therefore, higher flexibility is achieved in implant I'' compared to implant I' in Figure 3.

[0051] The connecting section VA, like the support sections TA1 and TA2, has a mesh structure composed of segment S and intermediate segment ZS. Here, the connecting section VA is made of polyethylene (PE) to reduce its rigidity. During the manufacturing process of implant I, an integral bond is established between each support section TA1 or TA2 and the intermediate connecting section VA in the pressing process. To further increase the load-bearing capacity of each connecting section, the intermediate connecting section VA covers each support section TA1 or TA2 in the region of each connecting section in each case, as is clear from the schematic diagram of implant I in Figure 8. For this purpose, the connecting section VA is equipped with connecting segments VS1 to VS4, which protrude from the connecting section VA in directions across the upper surface OS and lower surface US, so that the connecting section VA clamps each support section TA1 or TA2 from both sides in the respective connecting region.

[0052] Similar to the modified form shown in Figure 3, a cover layer DS' is also provided, so that in implant I'', the support parts TA1 and TA2, and further the connecting part VA, are covered on the upper surface OS in this case. The cover layer DS' is designed as a non-porous cover layer. For the remainder, implant I'' corresponds to the modified form shown in Figure 3, so please refer to that explanation. The modified forms shown in Figures 4 to 6 can also be implemented in implant I''.

[0053] Figure 9 shows some of further possible embodiments of implant I''' that substantially correspond to the modified forms described above in Figures 7 and 8. This implant I''' also includes multiple support sections TA', but only one of them can be seen in Figure 9. In contrast to implant I'' from Figures 7 and 8, the support section TA' is formed from polyetheretherketone (PEEK) to be plate-like and rigid. Ring-shaped segments S' are paired and connected to each other via intermediate segments ZS1, resulting in a figure-eight structure, which are then connected to each other via further web-like intermediate segments ZS2 to form the support section TA'.

[0054] Each support section TA' is also connected to an adjacent support section via an intermediate connecting section VA', each made of polyethylene (PE). The connection of each connecting section VA' to each support section TA' is achieved in a manner similar to the modified forms shown in Figures 7 and 8. Furthermore, the support sections TA' and connecting sections VA' are also provided with a cover layer DS' within the implant I''', and further modifications are possible within the scope of one of the modifications shown in Figures 4 to 6. For the remainder, please refer to the description of the embodiment shown in Figure 9, as it corresponds to the modified forms shown in Figures 7 and 8.

[0055] Finally, Figure 10 shows implant I IV One embodiment is shown, and this implant I IV This roughly corresponds to the aforementioned deformed form shown in Figure 9. The difference is that implant I IV The internal support section TA'' is formed from polyetheretherketone (PEEK) as an eight-shaped structure, and in each of the support sections TA'', ring-shaped segments S' are connected to each other in pairs via intermediate segments ZS1. The support sections TA'' are connected to each other via connecting sections VA'', and each of the connecting sections VA'' has lower rigidity than the support sections TA'' because these connecting sections VA'' are made of polyethylene (PE). The connection of each individual connecting section VA'' to each support section TA'' is performed in the same manner as the deformation forms shown in Figures 7 and 8, and both the support sections TA'' and the connecting sections VA'' are covered with a cover layer DS'. In this case as well, further deformation can be achieved within the range of one of the deformation forms shown in Figures 4 to 6.

[0056] Embodiments of the present invention make it possible to produce, in each case, an implant for the planar treatment of bone defects that is inexpensive to manufacture, and when this implant is used, only minor tissue stimulation is induced in the patient's body. [Explanation of symbols]

[0057] I, I', I”, I''', I IV...implant, GS, GS'...lattice structure, TA, TA1, TA2, TA', TA''...support section, S, S'...segment, ZS, ZS1, ZS2...intermediate segment, DO...through hole, DS, DS', DS'', DS''''...cover layer, OS...top surface, US...bottom surface, VA, VA', VA''...connecting section, VS1, VS2, VS3, VS4...connecting segment.

Claims

1. Implants for the planar treatment of bone defects, particularly bone defects in the thoracic or cranial region (I, I', I'', I'''', I ＩＶ ) and the upper surface (OS) and the opposite side of the upper surface (OS), the implant (I, I', I'', I'''', I ＩＶ The implant (I, I', I'', I'''', I'''') is characterized by comprising a flexible lattice structure (GS, GS') having a lower surface (US) for fixing the implant to bone, wherein the lattice structure (GS, GS') has at least one support portion (TA, TA1, TA2, TA', TA''), the at least one support portion (TA, TA1, TA2, TA', TA'') is manufactured by an additive manufacturing process, and the at least one support portion (TA, TA1, TA2, TA', TA'') is at least partially covered with a cover layer (DS, DS', DS'', DS'''') having a lower hardness than the at least one support portion (TA, TA1, TA2, TA', TA''), ＩＶ ).

2. The implant according to claim 1, characterized in that the at least one support portion (TA, TA1, TA2, TA', TA'') is covered at least a portion or the entirety of the upper surface (OS) of the lattice structure (GS, GS') with the cover layer (DS, DS', DS'''), i, I'', I''' ＩＶ ).

3. The implant (I, I', I'', I''', I''', I'''') according to claim 1 or 2, characterized in that the at least one support portion (TA, TA1, TA2, TA', TA'') is covered at least a portion or all of the lower surface (US) of the lattice structure (GS, GS') with the cover layer (DS'', DS''''). ＩＶ ).

4. The implant according to claims 2 and 3, characterized in that the at least one support portion (TA, TA1, TA2, TA', TA'') is completely sealed within the cover layer (DS''''), (I, I', I'', I'''', I ＩＶ ).

5. The implant (I, I', I'') according to any one of claims 1 to 4, characterized in that the at least one support portion (TA, TA1, TA2) has a mesh structure formed by closed segments (S), and the segments (S) are connected to each other by intermediate segments (ZS).

6. The implant according to any one of claims 1 to 5, characterized in that the at least one support portion (TA', TA'') is plate-shaped (I'', I'' ＩＶ ).

7. The implant according to any one of claims 1 to 6, characterized in that the cover layer (DS, DS'', DS'') is porous (I, I'', I'', I ＩＶ ).

8. The implant (I, I″, I′″, I) according to claim 7, characterized in that at least one of the support parts (TA, TA1, TA2, TA′, TA″) is at least partially embedded in the porous cover layer (DS, DS″, DS′″). ＩＶ )

9. The implant according to any one of claims 1 to 6, characterized in that the cover layer (DS', DS'', DS'''') is nonporous (I', I'', I'''', I ＩＶ ).

10. The implant (I', I'', I'''', I'''') according to claim 9, characterized in that the structure of the cover layer (DS', DS'', DS'''') corresponds to the structure that the at least one support portion (TA, TA1, TA2, TA', TA'') has in the area covered by each cover layer (DS', DS'', DS''''), ＩＶ ).

11. The implant according to any one of claims 1 to 10, characterized in that the at least one support portion (TA, TA1, TA2, TA', TA'') is made of a first biocompatible material, and the cover layer (DS, DS', DS'', DS'''') is made of a second biocompatible material having a lower hardness than the first material (I, I', I'', I'''', I ＩＶ ).

12. The implant according to claim 11, characterized in that the first material is a metal or a metal alloy, particularly titanium or a titanium alloy, or a plastic, particularly a polymer, preferably a thermoplastic resin, particularly preferably polyetheretherketone (PEEK).

13. The implant according to claim 11 or 12, characterized in that the second material is a plastic, particularly a polymer, preferably a thermoplastic resin, and particularly preferably polyethylene (PE).

14. The implant (I, I') according to any one of claims 1 to 13, characterized in that the lattice structure (GS) has a single continuous support portion (TA).

15. The implant (I'', I'''', I'''', I'''') according to any one of claims 1 to 13, characterized in that the lattice structure (GS') has a plurality of support parts (TA1, TA2, TA', TA''), and adjacent support parts (TA1, TA2, TA', TA'') are connected to each other via intermediate connecting parts (VA, VA', VA'') which have lower rigidity than the adjacent support parts (TA1, TA2, TA', TA''), ＩＶ ).

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