Stimulation Of Cartilage Formation Using Reduced Pressure Treatment

Abstract

System and methods for stimulating cartilage formation at a first tissue site through a second tissue site is presented. The system includes a fluid source for supplying a therapeutic solution, a reduced pressure source for supplying reduced pressure, a fluid delivery manifold for deploying adjacent the first tissue site, and a vacuum manifold for deploying within the second tissue site. The fluid delivery manifold extends between a proximal end fluidly coupled to the fluid supply and a distal end having at least one aperture for delivering the therapeutic solution to the defect adjacent the articulating surface of the first tissue site. The vacuum manifold extends between a proximal end fluidly coupled to the reduced pressure source and a distal end having at least one aperture for delivering the reduced pressure to the first tissue site adjacent the opposing surface of the first tissue site.

1 . A system for stimulating formation of cartilage at a defect in a first tissue site having an articulating surface within a joint and an opposing surface adjacent a second tissue site, the system comprising:
 a fluid source for supplying a therapeutic solution;   a fluid delivery manifold having a tubular body extending between a proximal end fluidly coupled to the fluid supply and a distal end dimensioned to be inserted within the joint adjacent the defect and having at least one aperture for delivering the therapeutic solution to the defect adjacent the articulating surface of the first tissue site;   a reduced pressure source for supplying reduced pressure; and   a vacuum manifold having a tubular body extending between a proximal end fluidly coupled to the reduced pressure source and a distal end dimensioned to be inserted into the second tissue site at a location of the second tissue site adjacent the opposing surface of the first tissue site and having at least one aperture for delivering the reduced pressure to the first tissue site adjacent the opposing surface of the first tissue site through the second tissue site to draw the therapeutic solution from the fluid delivery manifold through the first tissue site and the defect.   
     
     
         2 . The system of  claim 1 , wherein the defect extends through the articulating surface of the first tissue site. 
     
     
         3 . The system of  claim 1 , wherein the defect extends through both the articulating surface and the opposing surface of the first tissue site. 
     
     
         4 . The system of  claim 1 , wherein the first tissue site is cartilage and the second tissue site is bone tissue. 
     
     
         5 . The system of  claim 4 , wherein the joint is a knee joint. 
     
     
         6 . The system of  claim 4 , wherein the bone tissue is a head of a tibia. 
     
     
         7 . The system of  claim 4 , wherein the bone tissue is a head of a femur. 
     
     
         8 . The system of  claim 1 , wherein the proximal end of the tubular body of the fluid delivery manifold has a generally circular cross-section, and the distal end of the tubular body has a generally flattened cross-section to fit within the joint. 
     
     
         9 . The system of  claim 1 , wherein the proximal end of the tubular body of the fluid delivery manifold has a generally circular cross-section having a first diameter, and the distal end of the tubular body has a generally circular cross-section having a second diameter less than the first diameter. 
     
     
         10 . The system of  claim 1 , wherein the proximal end of the tubular body of the vacuum manifold has a generally circular cross-section having a first diameter, and the distal end of the tubular body has a generally circular cross-section having a second diameter less than the first diameter. 
     
     
         11 . The system of  claim 1 , wherein the therapeutic solution comprises a cell suspension. 
     
     
         12 . The system of  claim 1 , wherein the therapeutic solution includes protease inhibitors. 
     
     
         13 . The system of  claim 1 , wherein the distal end of the fluid delivery manifold includes a plurality of apertures for delivering the therapeutic solution to the first tissue site. 
     
     
         14 . The system of  claim 13 , wherein the plurality of apertures are configured to direct the therapeutic solution toward the defect in the first tissue site. 
     
     
         15 . The system of  claim 1 , wherein the distal end of the vacuum manifold includes a plurality of apertures for delivering the reduced pressure to the first tissue site through the second tissue site. 
     
     
         16 . The system of  claim 15 , wherein the plurality of apertures are configured to direct the reduced pressure toward the defect in the first tissue site. 
     
     
         17 . The system of  claim 1 , wherein the first tissue site is cartilage and the second tissue site is connective tissue. 
     
     
         18 . The system of  claim 1 , wherein the vacuum manifold is configured to be deployed into the head of a tibia. 
     
     
         19 . The system of  claim 1 , wherein the vacuum manifold is configured to be deployed into the head of a femur. 
     
     
         20 . A system for stimulating formation of new cartilage at a defect in cartilage having a first face and a second face opposing the first face adjacent skin tissue covering the cartilage, the system comprising:
 a fluid source for supplying a therapeutic solution;   a fluid delivery manifold having a tubular body extending between a proximal end fluidly coupled to the fluid supply and a distal end having at least one aperture for delivering the therapeutic solution to the defect adjacent the first face of the cartilage;   a reduced pressure source for supplying reduced pressure; and   a vacuum manifold having a tubular body extending between a proximal end fluidly coupled to the reduced pressure source and a distal end having at least one aperture for delivering the reduced pressure through the skin tissue to the defect adjacent the second face of the cartilage to draw the therapeutic solution from the fluid delivery manifold adjacent the first face through the cartilage and the defect.   
     
     
         21 . The system of  claim 20 , wherein the defect is a missing portion of the cartilage. 
     
     
         22 . The system of  claim 21 , further comprising a mold configured to provide a structure for the formation of the missing portion of the cartilage. 
     
     
         23 . The system of  claim 22 , wherein the mold includes a scaffold. 
     
     
         24 . The system of  claim 22 , wherein the mold is a three-dimensional porous structure. 
     
     
         25 . The system of  claim 22 , wherein the missing portion of the cartilage is a missing portion of an ear and the mold is shaped like the missing portion of the ear. 
     
     
         26 . The system of  claim 22 , wherein the distal end of the fluid delivery manifold is fluidly connected to a first face of the mold adjacent the first face of the cartilage and the distal end of the vacuum manifold is fluidly connected to a second face of the mold adjacent the skin tissue. 
     
     
         27 . The system of  claim 22 , wherein the missing portion of the cartilage is a missing portion of a nose and the mold is shaped like the missing portion of the nose. 
     
     
         28 . (canceled) 
     
     
         29 . (canceled) 
     
     
         30 . (canceled) 
     
     
         31 . (canceled) 
     
     
         32 . (canceled) 
     
     
         33 . (canceled) 
     
     
         34 . (canceled) 
     
     
         35 . A method for stimulating formation of new cartilage at a defect in cartilage having a first face and a second face opposing the first face adjacent skin tissue covering the cartilage, the method comprising:
 positioning a distal end of a fluid delivery manifold having at least one aperture adjacent the first face of the cartilage;   connecting a proximal end of the fluid delivery manifold to a fluid source containing a therapeutic solution;   positioning a distal end of a vacuum manifold having at least one aperture adjacent the second face of the cartilage;   connecting a proximal end of the vacuum manifold to a reduced pressure source for delivering reduced pressure to the first face of the cartilage;   delivering the therapeutic solution to the first face of the cartilage and the defect; and   delivering reduced pressure through the skin tissue to the second face of the cartilage to draw the therapeutic solution from the fluid delivery manifold through the cartilage and the defect.   
     
     
         36 . The method of  claim 35 , wherein the defect is a missing portion of the cartilage. 
     
     
         37 . The method of  claim 35 , further including the step of positioning a mold over the cartilage for providing a template for the new cartilage formation. 
     
     
         38 . The method of  claim 37 , wherein the mold includes a scaffold. 
     
     
         39 . The method of  claim 37 , wherein the defect is a missing portion of an ear and the mold is shaped like the missing portion of the ear. 
     
     
         40 . The method of  claim 37 , wherein the distal end of the fluid delivery manifold is fluidly connected to a first face of the mold and the distal end of the vacuum manifold is fluidly connected to a second face of the mold adjacent the skin tissue. 
     
     
         41 . The method of  claim 35 , wherein the therapeutic solution comprises a cell suspension. 
     
     
         42 . The method of  claim 35 , wherein the therapeutic solution includes protease inhibitors.