Implants for the comprehensive treatment of bone defects

Abstract

We provide implants that can perform 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 first support portion TA1 made of a first biocompatible material. Furthermore, in addition to the at least one first support portion TA1, the lattice structure GS has at least one second support portion TA2 having lower rigidity than the at least one first support portion TA1, and the at least one second support portion is made of a second biocompatible material having lower material rigidity than the first material.

Description

Technical Field

[0001] The present invention relates to an implant for the surface 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 the bone, the lattice structure having at least one support part made of a first biocompatible material.

Background Art

[0002] In the field of implants, embodiments for the surface treatment of bone defects are known. Such implants often have a lattice structure that is at least partially flexible and thus allows adaptation to different shapes. Implants designed in this way can be used in the rib cage region, particularly in the case of rib fractures, instead of rib plates, and by being placed over a wide area of the rib cage, the areas between different ribs are also covered. 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, and the at least partially flexible lattice structure allows the implant to conform to the curvature of the skull and further ensures sufficient elasticity. Implants for surface treatment often have a mesh-like support part that forms a lattice structure and is 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 a mesh of multiple closed and interconnected segments. 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 supports within the lattice structure, and the bone portion and bone defect can be stabilized through these supports. The lattice structure is manufactured by etching titanium. [Overview of the project]

[0005] Building upon the prior art described above, the problem addressed by the present invention is to provide an implant capable of treating bone defects in a planar manner, and when this implant is used, the risk of tissue irritation is also reduced.

[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 lattice structure having an upper surface and a lower surface opposite to the upper surface for fixing the implant to bone. The lattice structure has at least one first support made of a first biocompatible material.

[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 applied to a bone defect. 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 a bone defect. 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 present invention includes technical teachings that the lattice structure has at least one first support in addition to at least one second support having lower rigidity than the at least one first support, the at least one second support being made of a second biocompatible material having lower material rigidity than the first material.

[0011] In other words, the lattice structure of the implant according to the present invention is composed of support parts having offset rigidities from each other, in that, in addition to at least one first support part, at least one second support part having lower rigidity than at least one first support part is provided within the lattice structure. The at least one first support part is made of a first biocompatible material, and the at least one second support part is made of a second biocompatible material, and the lower rigidity of the at least one second support part compared to the at least one first support part is achieved in that the second material has lower material rigidity than the first material.

[0012] Such embodiments of implants have the advantage that the implant can be optimally adapted to treatment requirements by partially designing the lattice structure from support parts having different rigidities. Thus, localized high stability can be achieved in a targeted manner through at least one first, more rigid support part, while localized higher flexibility of the lattice structure can be achieved through at least one second support part, which is less rigid than the first support part, thereby allowing the lattice structure to conform more easily to a given placement area on the bone in terms of its shape. In the implant according to the present invention, different regions can be created by constructing the lattice structure from two types of support parts, namely, at least one region with high stability due to the higher rigidity of each first support part, and at least one region with high flexibility and elasticity due to the lower rigidity of each second support part. Different rigidities can be reliably achieved by forming the support parts from materials having different material rigidities. Furthermore, depending on the selected material, it is possible to provide the support parts with additional material-dependent properties.

[0013] The “rigidity” of each support should be understood, within the scope of the present invention, to mean, in particular, the resistance of each support to deformation caused by external loads. The “material rigidity” of each material is preferably understood to mean the material mechanical property defined by the ratio of the applied tension to the resulting expansion, and the relevant material property values ​​are, in particular, the modulus of elasticity and the shear modulus.

[0014] Due to its partial design, the lattice structure is flexible in the region of at least one second support, thereby giving the lattice structure particular three-dimensional moldability, allowing the shape of the implant to be easily adapted to a predetermined placement region on the bone. Thus, due to its flexible design, the implant lattice structure according to the present invention is particularly adaptable to curved bone defects and bone defects having an uneven shape. Preferably, the lattice structure is also moldable in the region of at least one first support, but the at least one first support is more rigid than the at least one second support and therefore more resistant to deformation. In general, the lattice structure can be designed within the framework of the present invention so that it can be adapted by the attending physician in terms of its size and shape by removing a portion of the lattice structure, and therefore a portion of the support, for example, by cutting the lattice structure to size.

[0015] The implant according to the present invention is provided for use in the treatment of bone defects, particularly for stabilizing bone. For this purpose, the lattice structure is preferably fixed to the bone in the area of ​​the bone defect to be treated, and this fixation to the bone can be in the form of fixation to multiple bone segments of the bone, or to multiple areas of the bone, or even to different bones. Preferably, for this purpose, the lattice structure comprises multiple fixation points, particularly in the form of screw connection points, to which the implant can be fixed via each bone screw. In particular, each of the support parts is provided with multiple such fixation points. Depending on the size of the specific treatment case and treatment area, the lattice structure may consist of one or more first support parts and one or more second support parts.

[0016] According to one embodiment of the present invention, at least one second support in the lattice structure is positioned between at least two first supports. The at least one second support connects at least two first supports to each other. Preferably, a more flexible intermediate region can be formed via at least one second support between a plurality of rigid supports, the shape of the implant provides better fit, and the level of tissue irritation induced in adjacent tissues is lower. This allows for the stabilization of bone regions in a targeted manner via the first support, and these stabilized bone regions can be connected to each other via the intermediate second support. Due to the lower rigidity of the second support, the risk of tissue irritation is locally reduced in a targeted manner, nevertheless resulting in a certain degree of mobility of the stabilized bone regions relative to each other. When the implant is used in the thoracic region, for example, a targeted local increase in the flexibility of the implant can be achieved to simplify the continuous movement of the thoracic cage due to the patient's breathing or other types of movement.

[0017] According to one possible embodiment of the present invention, the lattice structure is modular in that at least one first support and at least one second support are fixed to each other. Preferably, this fixing is achieved by integral bonding between the support parts. In an evolved form of this possible embodiment, at least one second support covers at least one first support in the region of each fixed part, in a direction that spans the upper and lower surfaces. Preferably, this covering can result in a higher load-bearing capacity of the connection between the support parts. Most preferably, at least one second support clamps at least one first support from both sides by projecting connecting segments in the region of each fixed part on both sides, thereby further increasing the load-bearing capacity of the connection.

[0018] According to a further embodiment of the present invention, at least one of the support members has a mesh structure formed by closed segments connected to one another via intermediate segments. Thus, a structure is achieved in each support member that creates mobility, and therefore flexibility, in the region of each support member. Preferably, the closed segments are ring-shaped, and within the framework of the present invention, the segments can also have shapes that are offset from there, such as polygonal shapes. The segments are connected to one another in the mesh structure via intermediate segments that may be linear or nonlinear. It is also conceivable that each intermediate segment defines a closed segment by being fixed to one another. In this case, at least one of the first support members or at least one of the second support members, or at least one of the first support members and at least one of the second support members, are provided with this type of mesh structure.

[0019] Alternatively or additionally, at least one of the support parts is plate-shaped. Most preferably, a plate-shaped structure is created in at least one first support part to achieve greater rigidity. However, in principle, at least one second support part may also be plate-shaped.

[0020] In an advanced form of the present invention, at least one of the support parts is manufactured by an additive manufacturing process. One possibility within the scope of the present invention is, in particular, manufacturing within the framework of a 3D printing process. Particularly preferably, at least one first support part is formed by additive manufacturing, in particular by 3D printing.

[0021] More preferably, the second biocompatible material has lower hardness than the first material. This has the advantage that at least one second support is softer than at least one first support, thereby reducing the risk of tissue irritation in the region of each second support.

[0022] According to one possible embodiment of the present invention, the first material is a metal or a metal alloy, particularly titanium or a titanium alloy. However, more preferably, the first material is a plastic, which is particularly a polymer, preferably a thermoplastic resin, and most preferably polyetheretherketone (PEEK). This is because polyetheretherketone is distinguished in particular by its very high biocompatibility and high material rigidity, and therefore high stability of the lattice structure can also be achieved through each of the first supports.

[0023] The second material is preferably a plastic, particularly a polymer, preferably a thermoplastic resin, and especially preferably polyethylene (PE), such as ultra-high molecular weight polyethylene (UHMWPE) or high-density polyethylene (HDPE). As a result, the rigidity of each second support can be reliably lower than that of each first support. In particular, polyethylene forms each second support as a non-porous layer, and as a result, sufficient stability can be achieved despite the lower rigidity, and furthermore, a smooth surface can be obtained for each second support.

[0024] Most preferably, the two aforementioned modifications are carried out together to produce an implant according to the present invention, in which first, at least one support made from polyetheretherketone (PEEK) is manufactured. This is particularly preferably carried out within an additive manufacturing framework. Next, for cleaning purposes, the at least one first support is plasma treated / plasma activated, preferably before the at least one support is placed layer by layer with polyethylene powder in a negative mold. In a subsequent pressing process, polyethylene (PE) is then heated together with polyetheretherketone (PEEK), thereby melting the polyethylene with the polyetheretherketone to form at least one second support. As a result, a load-bearing bond between the polyetheretherketone and polyethylene can be obtained.

[0025] According to a further possible embodiment of the invention, a cover layer is at least partially applied to at least one of the support parts, and the cover layer has a lower hardness than each of the support parts. By applying such a cover layer at least partially to each support part and having a lower hardness of this cover layer compared to this support part, the risk of skin or tissue irritation can be reduced. This is because at least partial covering of each support part by each cover layer results in a softer surface of the implant in each region due to the lower hardness of the cover layer.

[0026] In particular, the cover layer is applied onto at least one first support part. This is achieved particularly when at least one first support part is manufactured within the framework of an additive manufacturing process. As a result, the irregularities and edges of this support part can be covered by this cover layer, and thus a softer surface of the implant can be created in this region.

[0027] Within the scope of the meaning of the present invention, "hardness" should be understood as the mechanical resistance applied against mechanical penetration. Thus, the cover layer has a lower mechanical resistance against mechanical penetration than in the case of each support part. Thus, the cover layer can be described as being softer than each support part.

[0028] In the above-described possible embodiment, each support part is at least partially covered with a cover layer, that is, each support part can be provided with its respective cover layer at one or more of its parts or even over its entire circumference.

[0029] According to one embodiment of the present invention, each support portion is covered by a respective cover layer at at least a part of the upper surface of the lattice structure. Thus, in this case, the cover layer can be partially applied to the upper surface of each support portion, whereby each support portion is not partially covered on the upper surface. Alternatively, each support portion is covered by a cover layer over the entire upper surface of the lattice structure such that each support portion is covered by the cover layer over the entire upper surface. Thus, preferably, each support portion has a specific area covered or the upper surface completely covered in a standardized manner. Thus, in the latter case, tissue irritation is completely prevented on the upper surface, but in the case of partial covering, the contact area with the tissue and / or the unevenness of each support portion, such as the edge, etc., can be intentionally designed to be softened with the help of the cover layer.

[0030] Alternatively or additionally, each support portion can be covered by a respective cover layer at at least a part of the lower surface of the lattice structure. Thus, in this case, the cover layer is provided partially on the lower surface of the lattice structure for each support portion, and as a result, each support portion is not partially covered on the lower surface. Each support portion can also be covered by a cover layer over the entire lower surface of the lattice structure, whereby each support portion is completely covered by the cover layer on the lower surface. In either case, by partially or entirely covering each support portion on the lower surface of the implant, a softer surface on the lower surface of the implant can be obtained at least partially. As a result, tissue irritation on the lower surface of the implant can be reduced. In the case of partial covering of each support portion, this is intentionally done particularly at specific contact areas with the tissue and / or unevenness, such as the edge.

[0031] The above-described developments of the present invention can be achieved alternatively or additionally, and as a result, each support portion can be covered partially or entirely 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.

[0032] In combination, an implant design is also conceivable in which each support is completely enclosed within a cover layer. In this case, each support is completely surrounded, or entirely covered, by the associated cover layer.

[0033] Within the framework of the present invention, the cover layer may be porous. This has the advantage that particularly low hardness can be achieved in each cover layer due to this porous design. On the other hand, this creates the possibility that tissue can grow within the implant and angiogenesis is possible. In an advanced form of this embodiment, each support is at least partially embedded in the porous cover layer. Preferably, this makes it possible to obtain a uniform and soft surface in the corresponding area.

[0034] Alternatively, the cover layer can be non-porous. As a result, a very smooth and soft surface can be obtained in this area, thereby significantly avoiding tissue irritation. The non-porous design of the cover layer can prevent tissue growth on it. In particular, the structure of each part of the cover layer corresponds to the structure that each support part has in the area covered by the cover layer. This has the advantage that the structure of each support part is thus maintained.

[0035] Most preferably, a lower hardness of the applied cover layer is achieved by forming the applied cover layer from a biocompatible material having a lower hardness than the material of each support. In a particularly preferred possible embodiment of the present invention, in which at least one first support consists of polyetheretherketone and at least one second support consists of polyethylene, the applied cover layer is also made of polyethylene. The cover layer can then be formed only within the region of at least one first support, or additionally, on a second support made of polyethylene, for example, due to the porous structure of the cover layer, in order to create a softer surface for the implant.

[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 schematic diagram of an implant corresponding to the first embodiment. [Figure 2] This is a schematic diagram of an implant corresponding to the first embodiment. [Figure 3] This is a schematic diagram of an implant according to a second possible embodiment. [Figure 4] This is a schematic diagram of an implant according to the third embodiment. [Figure 5] This is a schematic diagram of an implant according to a fourth possible embodiment. [Figure 6] Figures 1 to 5 are schematic diagrams of possible modified implants. [Figure 7] Figures 1 to 5 are schematic diagrams of possible modified implants. [Figure 8] Figures 1 to 5 are schematic diagrams of possible modified implants. [Modes for carrying out the invention]

[0038] Figures 1 and 2 show schematic diagrams of implant I provided for the planar treatment of bone defects, particularly bone defects in the thoracic region. As is evident from Figure 1, implant I has a lattice structure GS formed by a plurality of support parts TA1, TA2. In the lattice structure GS, support part TA2 is positioned between two support parts TA1, and the two support parts TA1 are connected to each other via their respective intermediate support parts TA2. For this purpose, in the lattice structure GS, support part TA2 is connected to the support parts TA1 on both sides, forming a flat lattice structure GS.

[0039] As is evident from Figure 1, the support sections TA1 and TA2 each consist of a ring-shaped segment S and an intermediate segment ZS, respectively, with the intermediate segment ZS being designed as a linear intermediate piece and having a mesh structure in which it connects the ring-shaped segments S to each other. Each ring-shaped segment S within each support section TA1 or TA2 forms a through-hole DO, each capable of receiving one bone screw for fixing the implant I. Using the bone screw, the implant I can be fixed to the bone in the area of ​​the bone defect to be treated. Specifically, one rib or multiple ribs and / or bone segments or portions of multiple ribs can be connected to each other in the thoracic region, and the implant I provides corresponding stabilization via the lattice structure GS.

[0040] Supports TA1 located on either side of support TA2 are each made of a first biocompatible material in the form of polyetheretherketone (PEEK), and each support TA1 is manufactured within the framework of an additive manufacturing process, particularly within the framework of 3D printing. However, each intermediate support TA2 connecting the two supports TA1 in implant I is formed from a second biocompatible material, in this case polyethylene (PE).

[0041] As is clear from Figure 2, the region of connection between the intermediate support TA2 and each adjacent support TA1 is covered, and this covering extends across the upper surface OS and lower surface US of the lattice structure GS. The upper surface is opposite to the lower surface US, where implant I is positioned and fixed in the bone defect to be treated. To implement each covering, the intermediate support TA2 is provided with connecting segments VS1 and VS2, and VS3 and VS4, respectively, at the end where the connection to each adjacent support TA1 is established. These connecting segments VS1-VS4 protrude in pairs from the intermediate support TA2 like clamps, and the support TA2 clamps each support TA1 in the region of each connection by the corresponding connecting segments VS1 and VS2, and VS3 and VS4, respectively.

[0042] The connection between support TA2 and the support TA1 located on either side is formed by integral bonding, in this case, where the polyethylene forming support TA2 is melted together with the polyetheretherketone (PEEK) forming support TA1 within the framework of a hot press process. For this purpose, support TA1 is additively manufactured, then subjected to plasma treatment / plasma activation, and then placed in a negative mold of the lattice structure GS, with the opening regions located between support TA1 subsequently filled with polyethylene powder. Within the framework of the press process, the polyethylene forms the intermediate support TA2, and simultaneously integrally bonds it to the support TA1 located on either side. A non-porous layer is formed by the polyethylene.

[0043] The lattice structure GS of implant I is flexible, and this flexibility stems, on the one hand, from the fact that the intermediate segments ZS within each support TA1 or TA2 allow the ring-shaped segments S to move relative to each other. This flexibility of the lattice structure GS is further increased in the region of the intermediate support TA2, in that the intermediate support TA2 has lower rigidity than the support TA1 located on either side of it, because it is made of polyethylene. This is because polyethylene has lower material rigidity compared to polyetheretherketone of the support TA1 located on either side. This design of the lattice structure GS allows implant I to easily conform to the curvature of the bone in the region of the bone defect being treated. On the other hand, when implant I is fixed, this allows for a certain degree of mobility to facilitate the movement of the rib cage due to the patient's breathing or movement. Apart from the increased flexibility of the lattice structure GS, the intermediate support TA2 also ensures reduced tissue irritation due to the lower rigidity and hardness of polyethylene compared to polyetheretherketone.

[0044] Figure 3 shows a partial diagram of a further implant that substantially corresponds to the modified forms described above in Figures 1 and 2. This implant I' also includes a lattice structure GS' formed by multiple support sections TA1' and TA2'. In this lattice structure GS', the support sections TA1', which are additively fabricated from polyetheretherketone, are connected to each other via their respective intermediate support sections TA2'. However, in contrast to implant I from Figures 1 and 2, the intermediate support sections TA2' are fabricated in a plate-like manner. In this plate-like design, 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 support section TA2'. Furthermore, in the support sections TA1' located on either side of each support section TA2', a mesh structure offset from implant I in Figures 1 and 2 is selected, and the segments S are connected to each other via their respective non-linear S-shaped intermediate segments ZS'. For the remaining aspects, please refer to the explanation, as the embodiment shown in Figure 3 corresponds to the modified forms shown in Figures 1 and 2. In particular, the connection of the intermediate support portion TA2' to each adjacent support portion TA1' is also carried out by covering.

[0045] However, in the implant I'' according to the present invention shown in Figure 4, compared to the modified form shown in Figure 3, in the lattice structure GS'', the support part TA1'' manufactured by addition from polyetheretherketone has a plate-like design as described with reference to Figure 3, while the support parts TA2'' made from polyethylene are each provided with a mesh structure as described with reference to Figure 3, thus a mirror image design is selected. Each of TA2'' connects the support part TA1'' of the lattice structure GS'' to a further plate-like support part made from polyetheretherketone. For the remainder, the modified form shown in Figure 4 corresponds to the modified form shown in Figure 3, so please refer to its explanation.

[0046] Furthermore, Figure 5 shows an embodiment of implant I''' according to the present invention, which substantially corresponds to the modified form shown in Figure 3. The difference is that in implant I''', the support portion TA'' formed from polyetheretherketone (PEEK) of the lattice structure GS'''' is designed as an eight-shaped structure, and the ring-shaped segments S'' are connected to each other in pairs via their respective intermediate segments ZS''. The support portions TA2''' are connected to each other via intermediate support portions TA2''', and each of the intermediate support portions TA2''' has lower rigidity than the support portion TA1''' in that these support portions TA2''' are made of polyethylene (PE). The connection of each support portion TA2''' to the support portions TA1'''' located on both sides is performed in the same manner as the modified forms shown in Figures 1 and 2. For the remainder, the embodiment shown in Figure 5 corresponds to the modified form shown in Figure 3, so please refer to its description.

[0047] Finally, Figures 6 to 8 show possible variations of implants I, I', I”, and I''' from Figures 1 to 5, respectively. In the possible embodiment shown in Figure 6, the respective support parts TA1 and TA2, TA1' and TA2”, TA1”, and TA2”, TA1'''' and TA2''' are partially covered, in that a cover layer DS is provided on the upper surface OS of each implant I, I', I”, and I'''. This cover layer DS is made of polyethylene and may be porous or non-porous.

[0048] The rationale for applying the cover layer DS to the upper surface OS of each implant I, I', I'', and I'''' is that, as a result, a softer surface is obtained, particularly in the areas of each added-fabricated support TA1, TA1', TA1'', and TA1''''. This is because the added-fabrication of each support TA1, TA1', TA1'', and TA1'''' results in the creation of a raw surface and, in part, a hard edge on each support TA1, TA1', TA1'', and TA1'''', which could cause tissue irritation when each implant I, I', I'', and I'''' is placed in the patient's body. Furthermore, the structure of each support TA1, TA1', TA1'', and TA1'''' may, in some circumstances, be perceptible through the patient's tissue or skin, which could also cause corresponding irritation. This is mitigated by forming a polyethylene cover layer DS that has a lower hardness than each support TA1, TA1', TA1'', and TA1''''.

[0049] In the possible modifications shown in Figure 7, the cover layer DS' is applied in a similar manner to the possible modifications shown in Figure 6, but in this case, it is applied to the lower surface US of each implant I, I', I'', and I'''' to obtain a softer surface.

[0050] Finally, Figure 8 shows further possible modifications of implants I, I', I”, and I'''' from Figures 1–5, where each implant I, I', I”, and I'''' is covered with cover layer DS on the upper surface OS and with cover layer DS' on the lower surface US. Thus, each lattice structure GS, GS', GS”, or GS'''' of each implant I, I', I”, or I'''' is not sandwiched between cover layers DS and DS'.

[0051] According to embodiments of the present invention, in each case, an implant can be fabricated that enables reliable planar treatment of bone defects, and the use of this implant also reduces the risk of tissue irritation. [Explanation of symbols]

[0052] I, I', I'', I'''...implant, GS, GS', GS'', GS'''...lattice structure, TA1, TA2, TA1', TA2', TA1'', TA2'', TA1''', TA2'''...support section, S, S', S''...segment, ZS, ZS1, ZS2, ZS', ZS''...intermediate segment, DO...through hole, OS...top surface, US...bottom surface, VS1, VS2, VS3, VS4...connecting segment, DS, DS'...cover layer.

Claims

1. An implant (I, I', I'', I'''') for planar treatment of bone defects, particularly bone defects in the region of the rib cage or skull, comprising a flexible lattice structure (GS, GS', GS'', GS''') having an upper surface (OS) and a lower surface (US) opposite to the upper surface (OS) for fixing the implant (I, I', I'', I'''') to bone, wherein the lattice structure (GS, GS', GS'', GS''') has at least one first support portion (TA1, TA1', TA1'', TA1'''') made of a first biocompatible material, and the lattice structure (GS An implant characterized in that, in addition to the at least one first support portion (TA1, TA1', TA1'', TA1''), each GS', GS'', GS'''' has at least one second support portion (TA2, TA2', TA2'', TA2''') having lower rigidity than the at least one first support portion (TA1, TA1', TA1'', TA1''''), and the at least one second support portion (TA2, TA2', TA2'', TA2'''') is made of a second biocompatible material having lower material rigidity than the first material.

2. The implant (I, I', I'', I'') according to claim 1, characterized in that the at least one second support portion (TA2, TA2', TA2'', TA2''') is arranged within the lattice structure (GS, GS', GS'', GS''') between at least two first support portions (TA1, TA1', TA1'', TA1'''), and the at least two first support portions (TA1, TA1', TA1'', TA1''') are connected to one another.

3. The implant (I, I', I'', I'') according to claim 1 or 2, characterized in that the lattice structure (GS, GS', GS'', GS''') is modular, and the at least one first support portion (TA1, TA1', TA1'', TA1'''') and the at least one second support portion (TA2, TA2', TA2'', TA2''') are fixed to each other, particularly by an integral connection between the at least one first support portion (TA1, TA1', TA1'', TA1''') and the at least one second support portion (TA2, TA2', TA2'', TA2'''').

4. The implant (I, I', I'', I''') according to claim 3, characterized in that the at least one second support portion (TA2, TA2', TA2'', TA2''') covers the at least one first support portion (TA1, TA1', TA1'', TA1''') in a direction that spans the upper surface (OS) and the lower surface (US) in their respective fixed areas.

5. The implant (I, I', I'', I''') according to claim 4, characterized in that the at least one second support portion (TA2, TA2', TA2'', TA2''') clamps the at least one first support portion (TA1, TA1', TA1'', TA1''') from both sides by protruding connecting segments (VS1, VS2, VS3, VS4) in each of the fixed regions.

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

7. The implant (I', I'', I'''') according to any one of claims 1 to 6, characterized in that at least one of the support portions (TA', TA2', TA1'', TA2'', TA1'''', TA2'''') is plate-shaped.

8. The implant (I, I', I'', I''') according to any one of claims 1 to 7, characterized in that at least one of the support parts (TA1, TA2, TA1', TA2', TA1'', TA2'', TA1''''), in particular, the at least one first support part (TA1, TA1', TA1'', TA1'''), is manufactured by an additive manufacturing process.

9. The implant (I, I', I'', I'''') according to any one of claims 1 to 8, characterized in that the second material has a lower hardness than the first material.

10. The implant (I, I', I'', I''') according to any one of claims 1 to 9, 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).

11. The implant (I, I', I'', I'''') according to any one of claims 1 to 10, characterized in that the second material is a plastic, particularly a polymer, preferably a thermoplastic resin, and particularly preferably polyethylene (PE).

12. The implant (I, I', I'', I'') according to any one of claims 1 to 11, characterized in that a cover layer (DS, DS') is applied at least partially to at least one of the support parts (TA1, TA2, TA1', TA2', TA1'', TA2'', TA1'''', and the cover layer has a lower hardness than each of the support parts (TA1, TA1', TA1'', TA1'''').

13. The implant (I, I', I'', I''') according to claim 12, characterized in that each of the support portions (TA1, TA2, TA1', TA2', TA1'', TA2'', TA2''') is covered with the cover layer (DS) at least in part or in whole on the upper surface (OS) of the lattice structure (GS, GS', GS'', GS''').

14. The implant (I, I', I'', I''') according to claim 12 or 13, characterized in that each of the support portions (TA1, TA2, TA1', TA2', TA1'', TA2'', TA2''') is covered with the cover layer (DS') at least in part or in whole on the lower surface (US) of the lattice structure (GS, GS', GS'', GS''').

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