Joint support and subchondral support system

Abstract

A joint support and subchondral support system for providing structural and dampening support to damaged subchondral bone in generalized or discrete arthritis includes a contoured, porous plate having a variable shaped inner surface, outer surface, and peripheral surface of variable thickness extending between the inner surface and the outer surface, suitable for insertion within the subchondral bone. The inner surface, outer surface and peripheral surface each have a concave portion and a convex portion. A guide pin hole or slot is located within the contoured, porous plate to aid in insertion and placement of the plate over at least one corresponding guide pin within the subchondral bone. The joint support and subchondral support system of the present invention is applicable to many parts of the joint as any area with cartilage disease has an adjoining subchondral component.

1 . A joint support and subchondral support system for providing structural and dampening support to damaged subchondral bone adjacent to a body joint, comprising:
 a contoured, porous plate having a variable shaped inner surface, outer surface, and peripheral surface of variable thickness extending between the inner surface and the outer surface, suitable for insertion within the subchondral bone;   the inner surface, outer surface and peripheral surface each having a concave portion and a convex portion;   wherein at least one guide pin hole or slot is located within the contoured, porous plate to aid insertion and placement of the plate over at least one corresponding guide pin within the subchondral bone.   
     
     
         2 . The joint support and subchondral support system of  claim 1 , wherein the porosity of the contoured plate is within a range of from about 50 microns to about 20 mm. 
     
     
         3 . The joint support and subchondral support system of  claim 2 , wherein the contoured, porous plate includes at least one of micropores, scaffold-like pores, and fibrous matrix material. 
     
     
         4 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate includes a plurality of surface dimpling thereon having a radius of from about 50 microns to about 3 mm. 
     
     
         5 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate includes a plurality of undersurface pimples thereon having a radius of from about 50 microns to about 3 mm. 
     
     
         6 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate may be configured to fit flush with at least one contour of the corresponding subchondral bone at a specific body joint locations. 
     
     
         7 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate may be inserted in at least two locations of the subchondral bone as a modular or monobloc insert. 
     
     
         8 . The joint support and subchondral support system of  claim 1 , wherein the inner surface, outer surface and peripheral surface each have a geometry, which varies according to the exact anatomic location being treated and specific geometry of lesion being treated. 
     
     
         9 . The joint support and subchondral support system of  claim 1 , wherein at least one guide pin may be configured to break away from the contoured, porous plate upon insertion of the plate within the subchondral bone. 
     
     
         10 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate has a cross-sectional area or from about 1 mm 2  no about 100 cm 2 . 
     
     
         11 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate has a vertical dimension of from about 1 mm to about 100 mm and a horizontal dimension of from about 1 mm about 100 mm. 
     
     
         12 . The joint support and subchondral support system or  claim 1 , wherein the peripheral surface has a variable thickness of from about 0.1 mm to about 5 cm. 
     
     
         13 . The joint support and subchondral support system of  claim 1 , wherein the insertion of the contoured, porous plate is peripheral or tangential to a body joint surfaces. 
     
     
         14 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate has at least one active or passive dampening element attached thereto. 
     
     
         15 . The joint support and subchondral support system of  claim 1 , wherein the contoured, porous plate is fabricated of a biocompatible material selected from the group consisting of metals, metal alloys, carbon fibers, foam metals, ceramics, ceramic composites, elastomer composites, elastomer-carbon fiber composites, chambered or fluid-filled materials, metal matrices, injectable gels, injectable composites with fluid and sold matrices, bone or bone-composite or allografts, crystal or hydroxyapatite materials, plastics, polymers, bioabsorbable composites, or composites/combinations of the above materials. 
     
     
         16 . A joint support and subchondral support system for providing structural and dampening support to damaged subchondral bone adjacent to a body joint, comprising:
 an elongated plate having a plurality of tapered strut elements of variable geometry and thickness oriented in a vertical configuration for insertion into the subchondral bone;   the strut elements comprising a plurality of superior struts formed on an upper portion of the plate and a plurality of inferior struts formed on a lower portion of the plate, wherein the plurality of inferior struts may bee configured to be out of plane with the plurality of superior struts.   
     
     
         17 . The joint support and subchondral support system of  claim 16 , wherein the elongated plate may be inserted separately from the plurality of strut elements within the subchondral bone as a modular insert. 
     
     
         18 . The joint support and subchondral support system of  claim 16 , wherein the plurality of strut elements has a porosity of at least one of micropores, scaffold-like pores, and fibrous matrix material. 
     
     
         19 . The joint support and subchondral support system of  claim 16 , wherein the elongated plate may be releasably attached to the plurality of strut elements with smoothly rounded joint elements at each intersection of the strut elements and the elongated plate. 
     
     
         20 . The joint support and subchondral support system of  claim 16 , wherein the plurality of strut elements may have a variable orientation or geometry of at least one of sinusoidal, parallel, radial, circular, curved, rectangular, trapezoidal, hexagonal, octagonal, cross-hatching, and cross-elements. 
     
     
         21 . The joint support and subchondral support system of  claim 16 , wherein the plurality of the superior and inferior struts have a width of from about 0.1 mm to about 10 mm and a height of from about 0.5 mm to about 35 mm. 
     
     
         22 . The Joint support and subchondral support system of  claim 16 , wherein the plurality of superior struts has a primary bearing element configured to be contoured such that the primary bearing element is generally the same as the corresponding subchondral none being treated. 
     
     
         23 . The joint support and subchondral support system of  claim 22 , wherein the primary bearing element includes a flared bearing surface that is substantially wider than each of the plurality of superior struts. 
     
     
         24 . The joint support and subchondral support system of  claim 23 , wherein the flared bearing surface has a width of from about 1.1 to about 4× a width of each of the plurality of superior struts. 
     
     
         25 . The joint support and subchondral support system of  claim 16 , wherein the plurality of superior struts may include at least one secondary bearing element that connects the plurality of superior struts to each other. 
     
     
         26 . The joint support and subchondral support system of  claim 25 , wherein the at least one secondary bearing element has a width of from about 0.5 to about 5× a width of the superior strut. 
     
     
         27 . The joint support and subchondral support system of  claim 16 , wherein at least one guide hole or slot is located within the elongated plate to aid insertion and placement of the plate and plurality of strut elements over at least one corresponding guide pin within the subchondral bone. 
     
     
         28 . The joint support and subchondral support system of  claim 16 , wherein the elongated plate and plurality of strut elements have at least one active or passive dampening element attached thereto. 
     
     
         29 . The joint support and subchondral support system of  claim 16 , wherein the elongated plate and plurality of strut elements are fabricated of a biocompatible material selected from the group consisting of metals, metal alloys, carbon fibers, foam metals, ceramics, ceramic composites, elastomer composites elastomer-carbon fiber composites, chambered or fluid-filled materials, metal matrices, injectable gels, injectable composites with fluid and sold matrices, bone or bone-composite or allografts, crystal or hydroxyapatite materials, plastics, polymers, bioabsorbable composites, or composites/combinations of the above materials. 
     
     
         30 . A joint support and subchondral support system for providing structural and dampening support to damaged subchondral bone adjacent to a body joint, comprising:
 a plurality of vertical struts of variable geometry and thickness having a first end and a second end, suitable for modular insertion within the subchondral bone;   the plurality of vertical struts further comprising a porous, bearing surface that is contoured to fit the subchondral bone being treated, wherein the porous, bearing surface includes a primary bearing flare.   
     
     
         31 . The joint support and subchondral support system of  claim 30 , wherein the vertical struts may have a porosity comprised of micropores, scaffold-like pores, or fibrous matrix material. 
     
     
         32 . The joint support and subchondral support system of  claim 30 , wherein the vertical struts may have a cross-sectional shape of at least one of a triangle, thermometer-shape, trapezoid, flared diamond-shape, oval, tapered with flared diamond-shape, and rectangle. 
     
     
         33 . The joint support and subchondral support system of  claim 30 , wherein at least one of the plurality of vertical struts first end and second end is tapered to assist in progressively dissipating stress within the subchondral bone. 
     
     
         34 . The joint support and subchondral support system of  claim 30 , wherein the porous, bearing surface includes a secondary bearing flare extending below the bearing surface. 
     
     
         35 . The joint support and subchondral support system of  claim 34 , wherein the secondary bearing flare is at least one of a horizontal wing strut and dimple. 
     
     
         36 . The joint support and subchondral support system of  claim 30 , wherein the plurality of vertical struts are inserted in at least one of a parallel and radial orientation within the subchondral bone. 
     
     
         37 . The joint support and subchondral support system of  claim 30 , wherein at least one active or passive dampening element is attached to the plurality of vertical struts. 
     
     
         38 . A joint support and subchondral support system for providing structural and dampening support to damaged subchondral bone adjacent to a body joint, comprising:
 a primary bearing strut element of variable geometry and thickness having a longitudinal body and an inner edge and an outer edge, suitable for insertion within the subchondral bone;   the longitudinal body having a porosity to allow vascularity, bridging bone, and other biological elements to pass through;   the inner edge having scalloping to penetrate the subchondral bone during insertion; and   the outer edge having at least two grooves formed therein an inner surface of the longitudinal body and contoured to fit the subchondral bone at the treatment site.   
     
     
         39 . The joint support and subchondral support system of  claim 38 , wherein an inserter holder may be slidably disposed through the at least two grooves at the outer edge on the inner surface of the longitudinal body and extended past the inner edge during insertion of the strut element within the subchondral bone. 
     
     
         40 . The joint support and subchondral support system of  claim 39 , wherein the inserter holder has a plurality of spikes at a distal end that may be slidably disposed within the at least two grooves at the outer edge on the inner surface of the longitudinal body. 
     
     
         41 . The joint support and subchondral support system of  claim 40 , wherein the plurality of spikes extend past the inner edge create channels in the subchondral bone whereby blood or marrow may access the outer edge through the grooves or vascular channels. 
     
     
         42 . The joint support and subchondral support system of  claim 38 , wherein the geometric shape of the primary bearing strut element is a circle. 
     
     
         43 . The joint support and subchondral support system of  claim 38 , wherein single or multiple geometric shapes of the primary bearing strut elements may be configured to be joined to each other in various patterns such that the geometric shapes may penetrate the subchondral bone to be treated. 
     
     
         44 . The joint support and subchondral support system of  claim 43 , wherein the single or multiple geometric shapes configured to be joined together include at least three connecting struts to form a multiple concentric circle in which each circle of the primary bearing strut element is connected to an adjacent circle by the connecting struts. 
     
     
         45 . The joint support and subchondral support system of  claim 38 , wherein the primary bearing strut element has a diameter of from about 1 mm to about 5 cm and a height/depth of from about 1 mm to about 3 cm. 
     
     
         46 . The joint support and subchondral support system of  claim 38 , wherein inner edge and outer edge of the primary bearing strut element is tapered. 
     
     
         47 . The joint support and subchondral support system of  claim 38 , wherein the longitudinal body includes a primary bearing flare. 
     
     
         48 . The joint support and subchondral support system of  claim 38 , wherein the longitudinal body includes a secondary flare extending below the longitudinal body. 
     
     
         49 . The Joint support and subchondral support system of  claim 38 , wherein the secondary flare is at least one of a vertical, double-tapered wing strut and obliquely extending arm. 
     
     
         50 . The joint support and subchondral support system of  claim 38 , wherein the porosity of the longitudinal body may be comprised of micropores, scaffold-like pores, or a fibrous matrix material. 
     
     
         51 . The joint support and subchondral support system of  claim 38 , wherein the primary bearing strut element includes a concentric taper from the outer edge to the inner edge. 
     
     
         52 . The joint support and subchondral support system of  claim 38 , wherein the primary bearing strut element may have a geometry in the form of a multiple concentric circle, joined circles, hexagon, octagon, or other non-euclidean shapes. 
     
     
         53 . The joint support and subchondral support system of  claim 38 , wherein a bearing surface cover may be attached to a periphery of the outer edge to contain marrow contents entering through vascular channels or exogenous substances injected through the cover. 
     
     
         54 . The joint support and subchondral support system of  claim 53 , wherein the bearing surface cover is fabricated from a thin, netted or woven material or biologic/synthetic membrane. 
     
     
         55 . The joint support and subchondral support system of  claim 38 , wherein at least one active or passive dampening element is attached to the primary bearing strut element. 
     
     
         56 . The joint support and subchondral support system or  claim 38 , wherein the primary bearing strut element is fabricated of a biocompatible material selected from the group consisting of metals, metal alloys, carbon fibers, foam metals, ceramics, ceramic composites, elastomer composites, elastomer-carbon fiber composites, chambered or fluid-filled materials, metal matrices, injectable gels, injectable composites with fluid and sold matrices, bone or bone-composite or allografts, crystal or hydroxyapatite materials, plastics, polymers, bioabsorbable composites, or composites/combinations of the above materials. 
     
     
         57 . A joint support and subchondral support system for providing structural and dampening support to damaged subchondral bone adjacent to a body joint, comprising:
 a primary bearing strut element of variable geometry and thickness having a longitudinal body and an inner edge and an outer edge;   the longitudinal body having a porosity to allow vascularity, bridging bone, and other biological elements to pass through;   the outer edge having at least two grooves formed therein an inner surface of the longitudinal body and contoured to fit the subchondral bone at the treatment site;   a contoured, porous plate having a variable shaped inner surface, outer surface, and peripheral surface of variable thickness extending between the Inner surface and the outer surface, suitable for insertion within the subchondral bone;   the inner surface, outer surface and peripheral surface each having a concave portion and a convex portion;   wherein the inner edge of the primary bearing strut element is in direct communication with the contoured porous plate within the subchondral bone being treated.   
     
     
         58 . The joint support and subchondral support system of  claim 57 , wherein the primary bearing strut element has at least one active or passive dampening element attached thereto. 
     
     
         59 . The joint support and subchondral support system of  claim 57 , wherein the contoured, porous plate has at least one active or passive dampening element attached thereto.