The present invention generally relates to the field of orthopedics. In particular, the present invention is directed to an interventional technique and an implant for altering biomechanics of the spine to provide a therapeutic effect.
Spinal disorders are a major cause of disability, both in the younger and aged population. In the young population, there is association between strenuous work like lifting and lumbar disc problems. In the aging population, osteoporosis of the vertebral bodies can result in vertebral compression fractures.
The spinal column consists of individual bones called vertebrae. These vertebrae are connected with soft cartilaginous disks between each vertebrae called intervertebral discs. From a lateral view, the spine has several curves (
Current surgical treatments for spinal disorders range from removal of regions of the vertebral body (laminectomy) to fusion of adjacent vertebral bodies to replacement of the intervertebral disc with an artificial disc. Newer therapies for treating back pain include ablation of nerves within the vertebral body or thermal coagulation of tissue with the intervertebral disc. Other therapies include using mechanical constructs attached to the spinal processes to stabilize the spine during flexion/extension. Some of the interventions are major surgical procedures with significant morbidity, failure rates and complications; while others address the symptoms (pain) without altering the underlying the cause of the disorder—unstable spine biomechanics.
Selectively placed implants are used to address pathologies of the spine arising from improper force distribution. By using appropriately sized and positioned implants as described herein, displacement of targeted connective and muscle tissues surrounding the vertebrae is accomplished in order to realign force vectors and/or alter moment arms loading the spine to achieve therapeutic effects without cutting bone and with minimal cutting of the connective tissues.
In addition to the implants and related prosthesis and apparatus described, embodiments of the present invention include methods of treating spinal disorders and methods of installing implants and prostheses for less invasive spinal treatments. The embodiments of the present invention may be used in conjunction with other spinal therapies like fusion, laminectomy, vertebroblasty, kyphoplasty etc.
One of the exemplary methods disclosed herein comprises selecting at least one of the associated muscle and connective tissues surrounding the vertebrae as target tissue for treatment, and displacing the target tissue without severing the bones or target tissue, thereby redistributing loading within the intervertebral joint to achieve a therapeutic effect. The therapeutic effect could result from changes in the loading of the vertebral bodies or the nucleus pulposus of the intervertebral disc or the annulus of the intervertebral disc.
In another exemplary embodiment of the invention, an apparatus for treating spinal disorder by altering the force distribution in the joint is disclosed. The apparatus is configured and dimensioned for placement in a therapeutic location proximate to a target tissue surrounding the vertebrae and has a thickness sufficient to displace the target tissue from its natural path to a therapeutic path when placed in the therapeutic location. The change in the force distribution may be in the vertebral bodies or the nucleus pulposus of the intervertebral disc or the annulus of the intervertebral disc. Specific structures, configurations, dimensions and fixation modalities are described in more detail herein below.
In a further exemplary embodiment, an apparatus for treating disorders of the spine comprises a prosthesis configured to be mounted to at least one vertebral body in the spine in engagement with a target tissue. The target tissue may comprise at least one posteriorly positioned connective tissue of the spine, wherein the prosthesis is configured and dimensioned so as to displace the connective tissue sufficiently to alter the location, angle or magnitude of forces exerted thereby on a target vertebral body so as to achieve a therapeutic effect in the spine. Displacement of the connective tissue may shift an instantaneous axis of rotation of the target vertebral body dorsally. The shift may be at least about 3 mm. The prosthesis may be mounted to the target vertebral body or to a vertebral body different from the target vertebral body.
The target connective tissue may include the erector spinae muscle. In certain embodiments, the prosthesis is configured and dimensioned to displace the target tissue from a pre-treatment anatomical path by a displacement distance of more than about 10 mm. In other embodiments the prosthesis may comprise a fixation portion configured to be mounted to at least one vertebral body at a fixation site, a displacement portion configured to engage and displace the target tissue, and a spanning section between the fixation portion and the displacement portion. The spanning section may be configured and dimensioned to position the displacement portion with respect to the target tissue for displacement.
In yet another exemplary embodiment of the present invention, an apparatus for treating disorders of the spine may comprise a prosthesis configured to be located adjacent at least one vertebral body in the spine in engagement with a target tissue targeted for intervention. The target tissue may comprise at least one posteriorly positioned connective tissue of the spine, and the prosthesis may be configured and dimensioned so as to displace that connective tissue sufficiently to alter the location, angle or magnitude of forces exerted thereby on a target vertebral body so as to achieve a therapeutic effect in the spine. Such an exemplary embodiment may also include further features as summarized above and explained in more detail below.
Exemplary embodiments of the present invention may also include methods of treating the spine to reduce loading in a targeted region of the spine. In one such embodiment exemplary steps may comprise selecting at least one of the muscles or connective tissues extending posteriorly along the spine as target tissue for treatment, and implanting a device along the spine so as to displace said target tissue sufficiently to alter the location, angle or magnitude of forces exerted thereby such that loading in said targeted region is reduced.
In further exemplary embodiments of methods according to the present invention, the step of displacing may comprise securing a prosthesis to at least one vertebrae, wherein the prosthesis is configured and dimensioned to displace said target tissue by a distance of more than about 10 mm posteriorly from a pre-treatment anatomical path. Such methods may be directed at target tissues comprising the erector spinae muscles. The step of displacing the target tissue may further involve repositioning an instantaneous axis of rotation of a vertebral body dorsally by at least 3 mm
By using appropriately sized and positioned implants and methods as described herein, displacement of targeted connective and muscle tissues surrounding the vertebrae is accomplished in order to realign force vectors and/or alter moment arms loading the joint to achieve therapeutic effects without cutting bone and with minimal cutting of the connective tissues. Alternative and more specific methodologies are described in more detail herein below.
For the purpose of illustrating the invention, the drawings show aspects of one or more exemplary embodiments of the invention. However, it should be understood that the present invention is not limited to the precise arrangements and instrumentalities shown in the drawings, wherein:
Spinal conditions that result from or exacerbate unbalanced force distribution through the intervertebral joint or the vertebral body may be addressed in embodiments of the present invention by interventional techniques involving a redistribution of forces exerted on the joint without the need for highly invasive surgeries requiring significant trauma to the joint and associated muscle and connective tissues. In some embodiments of the invention, increased forces can be selectively applied to one side of a joint by forcing select muscle and/or connective tissues (target tissues) around a longer or more angled path, thus increasing the magnitude, altering the effective direction, and/or changing the moment arm of forces exerted by such muscles or tissues on the joint. This may be accomplished, for example, by appropriately shaped implants that may be placed under selected target tissues relatively non-invasively compared to current surgical techniques for addressing such conditions. Target tissue may include muscles, tendons or ligaments surrounding the spine.
Before addressing more details of exemplary embodiments of the present invention, it is helpful to have a basic understanding of the anatomy and biomechanics of the spine.
Anatomy of the Spine
The spinal column consists of seven cervical vertebrae (C1-C7) in the neck, twelve thoracic vertebrae (T1-T12) in the upper back, five lumbar vertebrae (L1-L5) in the lower back, five bones (that are “fused” together in adults) to form the bony sacrum and three to five bones fused together to form the coccyx or tailbone (
The intervertebral discs are fibrocartilaginous cushions serving as the spine's shock absorbing system. Intervertebral discs are composed of an annulus fibrosus and a nucleus pulposus (
The smallest physiological motion unit of the spine is the functional spinal unit (FSU). A FSU consists of two adjacent vertebrae, the intervertebral disc and all adjoining ligaments between them and excludes other connecting tissues such as muscles. The two adjacent vertebrae and intervertebral disc also cooperate to form a joint permitting articulation of the spine.
The spinal column consists of the cervical, thoracic and lumbar segments. Each vertebrae of the lumbar segment (
The spine has four major muscles—forward flexors (anterior), lateral flexors (lateral), rotators (lateral) and extensors (posterior). See, for example,
The deep back muscles (intrinsic back muscles) are grouped into superficial, intermediate, and deep layers depending on their proximity to the surface. The superficial layer includes the splenius capitis and cervicis muscles. The intermediate back muscles that act as the primary spinal extensors are the erector spinae muscles. The erector spinae muscles are on either side of the vertebral column within the posterior and anterior layers of the thoracolumbar fascia. The erector spinae muscles straighten a flexed column, and release during its flexion so that the motion is slow and controlled. The erector spinae muscles originate at the sacrum and extend through the lumbar, thoracic and cervical spine. In the lower spine the erector spinae appears as a single muscle. In the upper lumbar area the erector spinae split into three vertical columns (
In addition to the muscles described above, there is another group of back muscles that are referred to as the minor deep layer muscles. The interspinalis muscles pass between adjacent spinous processes and the intertransversii muscles pass between adjacent transverse processes.
Biomechanics of the Spine
Loads on the spine are primarily a result of body weight, muscle activity and externally applied loads. In general, the line of gravity of the trunk runs ventral to the axis of the spine, hence, the spine is subjected to a constant forward bending moment. This forward bending moment is counteracted by ligament forces and the posterior erector spinae muscles. During daily activities like lifting, the bending moment on the spine is influenced by the external loads as well as the body posture during lifting (
Exemplary methods disclosed in this invention comprise selecting at least one of the associated muscle and connective tissues surrounding the vertebrae as target tissue for treatment, and displacing the target tissue without severing the bones or target tissue, thereby redistributing loading within the intervertebral joint to achieve a therapeutic effect. In some embodiments, the target tissues are displaced posteriorly.
One of the benefits of the methods and devices in the present invention is that, compared to current treatments, the significantly lower surgical morbidity could be beneficial to patients showing early as well as advanced symptoms of spinal disorders. Additionally, the methods and devices of the present invention could be beneficial for patients with weak or osteoporotic bone. As used herein, “therapeutic effect” means an effect on a treated FSU that reduces or redistributes forces acting on the FSU or target bone structures, in particular the joint formed by the cooperation of the vertebrae and discs, decreases pain or provides another positive outcome for the patient whether across an FSU or in particular parts of an FSU. “Therapeutic effect,” however, does not imply, and should not be understood as requiring, any specific, quantified outcome other than as stated above. “Therapeutic location” as used herein refers to a location where a prosthesis or implant is placed in accordance with embodiments of the present invention to achieve a therapeutic effect. Similarly, “therapeutic path” refers to a path of target tissues over the implant or prostheses according to embodiments of the present invention that is displaced from the normal anatomical path of the tissue so as to achieve a therapeutic effect.
As used herein, in humans, dorsal refers to the back of an organism and ventral to the belly. Cranial refers to the head end and caudal to the tail end. In humans, anterior is used to indicate the ventral surface and posterior is used to indicate the dorsal surface. Superior means toward the head and inferior means toward the feet. Proximal refers to the end of a structure nearest a major point of reference and distal refers to the end of a structure furthest from a point of reference. The point of reference is usually the origin of a structure (such as a limb). Proximal and distal are relative terms. Medial means nearer the midline of the body and lateral means further from the midline of the body. Superficial refers to structures nearer the skin, and deep to structures further away from the skin. A sagittal plane divides the body into right and left (or medial and lateral) parts. A frontal (or coronal) plane passes from right to left and divides the body into dorsal and ventral (or posterior and anterior) parts. A transverse plane (or cross section) passes perpendicular to the long axis of the body and divides the body into cranial and caudal (head and tail) portions.
Exemplary embodiments of the invention described herein are particularly directed to treatment of the human spine. In general, it will be appreciated by persons of ordinary skill in the art that specific features described in connection with one exemplary embodiment may be incorporated in other exemplary embodiments unless otherwise noted. The exemplary embodiments described are thus included to illustrate features of the invention, not limit it.
In some embodiments, the implants of the present invention move the IAR measured during flexion by more than 3 mm dorsally, more preferably by more than 6 mm dorsally, most preferably by more than 9 mm dorsally. As will be evident to one skilled in the art, the relationship between the dorsal displacement of the IAR and the therapeutic effect will depend on the multiple factors including the size of the vertebral body (e.g.; VA, VB and VC), the location of the vertebral body (cervical, thoracic or lumbar), the state of the adjacent intervertebral discs, the state of the adjacent intervertebral bodies, the location of the IAR prior to treatment etc.
The location of the prosthesis may be at the same spinal level as the one being treated or could be located at a spinal level more cranial or caudal to the one being treated. The prosthesis may also span multiple spinal vertebrae.
It is proposed that by placing an implant under the deep back muscles to displace the muscles posteriorly, the moment arm of the force vectors can be increased to counter the anterior forces. In certain embodiments, an implant is placed on either side of the spinal process. The implant acts as a spacer to displace the tissue posterior to the spine. In some embodiments, the erector spinae muscles are displaced posteriorly. By increasing the moment arm of the erector spinae muscles, the force acting through the vertebral body/intervertebral disc could be redistributed to reduce the excessive loading on the anterior vertebral body (
In some embodiments, the implant may be attached to the vertebral body, the articular process, the transverse process, the spinous process, the lamina, the facet, the pedicle or any other bony structure of the vertebrae using screws, hooks, bands, sutures, wires, etc. The implants may be attached to the vertebral body at a single location or at multiple locations. The implants may be attached only in the cranial region or only in the caudal region. The implant may be attached to bone located medial to the implant or lateral to the implant. In other embodiments, the implant may be attached to bone ventral to the implant or dorsal to the implant. Implants may be attached to a vertebral body located away from the vertebral body/segment being treated. Implants may have sections or features for tissue displacement (displacement portion or segment), sections or features for fixation (fixation portion or segment), and a spanning portion that connects the displacement portion and the fixation portion. The displacement segment, the spanning segment and the fixation segment may be in alignment with each other or may be displaced from each other. The displacements or offset between the segments may be cranial, caudal, lateral, medial, ventral, dorsal, oblique etc. Implants may be rigid or substantially rigid or soft compliant prostheses secured to adjacent bone or the surrounding tissues.
In general, such implants may be rigid, semi-rigid or soft compliant prostheses secured to adjacent bone or the surrounding tissues. Rigid or substantially rigid prostheses according to embodiments of the invention described herein could be made of known bone-compatible implant materials such as titanium or stainless steel. Biocompatible polymers, ceramics, and other materials may also be used. The bearing surface of the prostheses should be designed to minimize negative effects of movement of the connective tissues across the implant surface, having a low coefficient of friction with no or minimal rough edges, corners, or discontinuities. Such prostheses could be implanted arthroscopically or using a mini-open or open surgical approach.
Implants also may be held in place by the surrounding tissues without using a fixation element. Soft compliant prostheses could be filled with water, saline, silicone, hydrogels, etc., sufficient to move the tissue laterally (relative to the direction of force exerted by such tissue) as described above. Such a soft compliant prosthesis could be placed in a deflated state and then inflated to the appropriate thickness. Alternatively, implants may be filled with other flowable materials including beads or other particles made of metal, polymer, or foam material, optionally in a liquid medium, which conform to the adjacent bone or tissue surfaces. The implant could be inflated with a curable material, such as a polymer, which is substantially liquid for a period of time during the implantation procedure, but then cures into a harder permanent state. Thixotropic materials, such as hydrogels derived from hyaluronic acid, change their mechanical properties as shear stress is applied to them. An implant filled with such materials could be made to change the amount of displacement that it provides based on the shear stress that it sees from overlying target tissues during flexion/extension. Implants may be coated with materials to reduce friction such as hydrophilic coatings or polytetrafluoroethylene (PTFE) coatings. Additionally or alternatively, the prosthesis may be adjustable to allow the dimensions such as thickness of the prosthesis to be adjusted during surgery or any time after surgery. Rigid or substantially rigid prostheses could be made of known bone-compatible implant materials such as titanium or stainless steel. Biocompatible polymers, ceramics, and other materials may also be used. Coatings like titanium nitride, titanium niobium nitride etc. may be used to increase wear resistance, lubricity etc. Whether rigid or compliant, the surface of the prosthesis should be designed to minimize negative effects of movement of the connective tissues across the implant surface. Such prosthesis could be implanted arthroscopically or using a mini-open or open surgical approach.
In various alternative embodiments, the displacement portion and the fixation portion of prostheses according to the invention may be of unibody construction, or may be formed of two or more parts depending on desired function. For example, the fixation portion may be stainless steel or titanium textured to enhance bony ingrowth and solid screw fixation, while the bearing/displacement portion could be made of a different material, for example, pyrolytic carbon to enhance the ability of overlying tissues to slide across the implant, or PTFE, silicone or other low-friction polymer with suitable wear characteristics to provide a softer bearing surface. In further alternatives, the displacement portion could be comprised of a substrate of one material with an overlying layer forming the bearing material. The substrate could be either attached to or contiguous with the fixation portion. In other embodiments, the fixation portion of the implant may have a relief feature to minimize contact with the underlying bone, thereby minimizing disruption of the periosteal layer.
The bearing surface may be hard and smooth, made from materials such as polished pyrolytic carbon, steel, or titanium, or coated or covered with a lubricious material, such as PTFE. It might alternatively be designed to encourage adhesion and ingrowth of the connective tissue onto this surface. For example the surface may be porous, roughened, or configured with openings into which bone or scar tissue may grow to enhance adhesion.
The implant could have a shape or feature adapted to guide the muscles and tendons and retain their position on the implant. For example, a groove or trough could be provided on the outer surface of the prosthesis through which the muscles and tendons would extend. These muscles and/or tendons are aligned with the groove when the implant is installed. Alternatively, the implant could include a ring or eyelet with a discontinuity to allow placement of the ring or eyelet around the muscles/tendons. Implants may have also varying thickness so as to provide varying displacement of the muscles and tendons.
In some embodiments, the implant could be anchored to the underlying bone with suitable fasteners such as screws. Depending on the location and surgical need, unicortical screws, bicortical screws, cancellous screws, cannulated screws, polyaxial screws, screws that lock into the implant etc. may be used. In some embodiments, the screw holes may be locking threads or other locking features. In other embodiments, the screw holes may be oriented in different directions to improve the stability of the anchored implant. In alternate embodiments, different types of screws may be used in different regions of the implant.
In some embodiments, implants may also be placed without securing it to surrounding tissues, for example without placement of bone-penetrating screws. In some embodiments, the device may be held in place solely by its position between the vertebral body and the vertebral muscles. For example, the device may be contoured to fit in between certain spinal processes, with certain features to prevent it from sliding superiorly or inferiorly. It could also be held in that location by the muscles on top of it.
Soft compliant prostheses could be filled with water, saline, silicone, hydrogels etc. sufficient to displace tissue as described above. Such a soft compliant prosthesis could be placed in a deflated state and then inflated to the appropriate thickness. Additionally or alternatively, the thickness of the prosthesis may be adjusted during surgery or at any time after surgery. Rigid or substantially rigid prostheses could be made of known bone compatible implant materials such as titanium or stainless steel.
Implants on either side of the spinous process may be identical or different. Implants on either side of the spinous process may be independent (without any connecting segment) or could be connected with a connecting section. The connecting segment may be rigid, substantially rigid or flexible. Such asymmetric implants may be useful in treating scoliosis or spines with mild lateral bending.
In some embodiments, extension, rotation, and lateral bending are not affected. In other embodiments, extension, rotation and lateral bending may be minimally affected.
The methods and devices of the present invention may be used to treat a variety of spinal disorders. For example, for treatment of spinal sagittal plane instability resulting from degenerative spondylolisthesis or surgical decompression or laminectomy. In some embodiments, the treatment could be directed towards instability due to ligament laxity. Alternatively, the methods and devices may be used to alleviate pain related to forward bending in patients with degenerative disc disease (DDD). In some embodiments, pain associated with extension, rotation and lateral bending may be alleviated.
The methods and devices of the present invention may result in reduced segmental motion during flexion and increased spinal stability during flexion. Alternatively, the methods and devices may increase flexion stiffness. In some embodiments, the methods and devices may increase facet engagement.
In some embodiments, the devices and methods of the present invention do not bear or transmit axial compressive loads on the spine.
The methods and devices of the present invention could be compatible with decompression for patients suffering from lumbar spinal stenosis, for example, laminotomy, facetectomy or foraminotomy. The devices could also be used in conjunction with spinous process sparing surgeries and in surgeries where the part or all of the spinous process is removed.
The implants of the present invention may be considered to be permanent implants that remain in the patient for many years or implants that are used temporarily for short duration of a few months for temporary pain reduction or to enable recovery from an adjunct spinal surgery. For example, the devices of the present invention may be used as a permanent or temporary implant in conjunction with vertebroplasty or kyphoplasty to stabilize the spinal segment that underwent vertebroplasty or kyphoplasty. Alternatively, the devices may be used to stabilize adjacent spinal segments to minimize the incidence of adjacent segment disease (e.g.; vertebral fracture, disc degeneration etc.) after vertebroplasty or kyphoplasty.
In some embodiments, the devices may be used to address sagittal or translation instability in spinal segments adjacent to segments that have undergone fusion surgery or segments that are stiff.
Implants of the present invention may take many forms as discussed in more detail below with respect to various exemplary embodiments of the present invention.
In some embodiments, devices of the present invention may be placed under the multifidus muscles, in contact with the posterior surface of the vertebral body structures. In other embodiments, devices of the present invention may be placed above the multifidus muscles, in contact with the erector spinae muscles.
In other exemplary embodiments, implant 201 (
In another embodiment, an implant 260 may have separate chambers 261, 262 and 263 (
In some embodiments, the implant may be anchored to a single vertebral body. The implant may be attached using screws, anchors, hooks, wires etc. The implant may have one or more features for coupling to an anchoring device, such as a loop, hole, or channel. For example, implant 270 (
In other embodiments multiple screws may be used to anchor the implant to a single vertebral body, such as through holes 281, 282 near opposing ends of implant 280 (
In some embodiments, multiple anchoring elements may be used to anchor the implant to multiple vertebrae (
The implants described herein in accordance with various embodiments of the invention may be used with cervical, thoracic or lumbar vertebrae. Implants may be placed at one level or at multiple levels of the spine. Implants may span a single level or multiple levels of the spine.
Other exemplary embodiments of the present invention, comprising implants 300, 310, 420, 410, 405, 430, 440, and 450 are shown, respectively, in
Implant fixation portions 312 (
Spanning sections 314 (
In other embodiments, the thickness of the displacement portion and the tissue displacement may be identical, whereby the displacement portion of the implant is in contact with the underlying bone, as, for example, shown in
In some embodiments, displacement distance across the displacement portion may vary. As further examples of how displacement distance and thickness may relate, the displacement portion may be in contact with the underlying tissue and the target soft tissue is displaced by a distance equivalent to the thickness of the displacement portion; thus displacement distance would equal thickness in such an embodiment. In other embodiments, the displacement portion may be elevated above the underlying tissue and the target soft tissue is displaced by a distance greater than the thickness of the displacement region; thus displacement distance is greater than thickness.
In some embodiments, the implant may have two or more spanning sections 433 and 435 (
In some embodiments of the present invention, the displacement of the connective tissue could be adjusted by adjusting the device pre-operatively, intra-operatively or post-operatively. The spanning sections may also comprise adjustable mechanisms (e.g. a pin, jack, screw, inflatable member, hydraulic piston, or hinge) to movably or pivotably alter the orientation or angle between the fixation section and the displacement section (for example, 453 in
Devices may include electric, pneumatic, or hydraulic motors or actuators to alter the displacement that may be remotely controlled, including by mechanisms that enable wireless communication to alter the displacement after implantation. Alternatively, the displacement may be adjusted by applying an energy field (e.g.; magnetic field, electric field, thermal field etc.) transdermally from an external location.
In some embodiments, the fixation portion may be cranial to the displacement portion (e.g.;
In some embodiments, implants of the present invention may be anchored to the target vertebral body. In some embodiments, the target intervertebral disc may be cranial to the vertebral body to which the implant is anchored. In other embodiments, the target intervertebral disc may be caudal to the vertebral body to which the implant is anchored. In some embodiments, the implants of the present invention may be anchored cranial or caudal to the target vertebral body. In some embodiments, the target vertebral body may be one spinal level caudal or one spinal level cranial to the vertebral body used to anchor or fix the implant. In some embodiments, the target vertebral body may be two or more spinal levels caudal or two or more spinal levels cranial to the vertebral body used to anchor or fix the implant.
In some embodiments, the fixation portion, the spanning portion and/or the displacement portion, or portions thereof, may be aligned, i.e. stacked on top of each other or overlapping in the ventral-dorsal direction (e.g. implant 300 in
In some embodiments, the implant may be anchored to a single vertebral body. The implant may be attached using screws, anchors, wires etc. For example, implant 300 (
In some embodiments, the anterior surface of the implant may also be contoured in the medial/lateral direction to conform to the contours of the posterior surface of the vertebral body.
In some embodiments, the implant may have features to enable it to be attached to the surrounding soft tissue, thereby preventing any dislocation of the implant. For example, the prosthesis may have an attached suture that can be wrapped around the target soft tissue.
The surface of the implant could be modified as needed for interaction with the soft/hard tissue. For example, the surface could be smooth to allow for easy movement of the soft tissue across the surface. Alternatively, the surface may have an adhesive surface to allow attachment to underlying bone or soft tissue. The surface could be coated with a hydrophilic or hydrophobic layer. The surface may have a polymeric coating for drug release. Drugs like anti-inflammatory drugs and antibiotics could be incorporated into the polymeric coating.
In those embodiments where the implant spans several vertebrae, it may have design features which accommodate the relative motion of the vertebrae. For example, since the posterior aspects of the vertebrae become closer and more distant as the spine is flexed and straightened, it may be advantageous to have an implant with vertebral sections which hold their position relative to each vertebra, either by fixation, adhesion, shape, or other means, such as having features which interact with the spinous processes on each vertebrae. This implant could further have intervertebral sections which flex, extend, and compress freely with the motion of the spine. This will prevent longitudinal motion of the implant surface relative to the vertebral bodies. These vertebral and intervertebral sections might not be dramatically different or segregated. For example, the implant might be cast from a relatively flexible, compressible material, with harder elements in the center of this flexible material corresponding to the locations of the vertebrae.
An implant which spans several vertebral bodies may be inserted from one end of the desired implanted location. It would be desirable for vertebral sections of the implant to naturally tend to lock into position relative to each vertebrae and hold that position, so that additional incisions to insert fixation elements are not necessary.
While the invention has been illustrated by examples in various contexts of treating spinal disease associated with force imbalances in the vertebral body/intervertebral in the lumbar spine, it will be understood that the invention may also have application to treatment of spinal disease in the thoracic and cervical spine.
The foregoing has been a detailed description of illustrative embodiments of the invention. It is noted that in the present specification and claims appended hereto, conjunctive language such as is used in the phrases “at least one of X, Y and Z” and “one or more of X, Y, and Z,” unless specifically stated or indicated otherwise, shall be taken to mean that each item in the conjunctive list can be present in any number exclusive of every other item in the list or in any number in combination with any or all other item(s) in the conjunctive list, each of which may also be present in any number. Applying this general rule, the conjunctive phrases in the foregoing examples in which the conjunctive list consists of X, Y, and Z shall each encompass: one or more of X; one or more of Y; one or more of Z; one or more of X and one or more of Y; one or more of Y and one or more of Z; one or more of X and one or more of Z; and one or more of X, one or more of Y and one or more of Z.
Various modifications and additions can be made without departing from the spirit and scope of this invention. Features of each of the various embodiments described above may be combined with features of other described embodiments as appropriate in order to provide a multiplicity of feature combinations in associated new embodiments. Furthermore, while the foregoing describes a number of separate embodiments, what has been described herein is merely illustrative of the application of the principles of the present invention. Additionally, although particular methods herein may be illustrated and/or described as being performed in a specific order, the ordering is highly variable within ordinary skill to achieve aspects of the present disclosure. Accordingly, this description is meant to be taken only by way of example, and not to otherwise limit the scope of this invention.
Exemplary embodiments have been disclosed above and illustrated in the accompanying drawings. It will be understood by those skilled in the art that various changes, omissions and additions may be made to that which is specifically disclosed herein without departing from the spirit and scope of the present invention.
This application is a continuation of U.S. patent application Ser. No. 13/974,930, filed on Aug. 23, 2013, and entitled “Method and Apparatus for Altering Biomechanics of the Spine”; which application claims the benefit of priority of U.S. Provisional Patent Application Ser. No. 61/792,720, filed Mar. 15, 2013, and U.S. Provisional Patent Application Ser. No. 61/693,140, filed Aug. 24, 2012. Each of these applications is incorporated by reference herein in its entirety.
Number | Name | Date | Kind |
---|---|---|---|
2632440 | Hauser | Mar 1953 | A |
2877033 | Koetke | Mar 1959 | A |
3242922 | Thomas | Mar 1966 | A |
3648294 | Shahrestani | Mar 1972 | A |
3681786 | Lynch | Aug 1972 | A |
3779654 | Horne | Dec 1973 | A |
3872519 | Giannestras et al. | Mar 1975 | A |
3875594 | Lynch | Apr 1975 | A |
3879767 | Stubstad | Apr 1975 | A |
3886599 | Schlien | Jun 1975 | A |
3889300 | Smith | Jun 1975 | A |
3902482 | Taylor | Sep 1975 | A |
3964106 | Hutter, Jr. et al. | Jun 1976 | A |
3985127 | Volkov et al. | Oct 1976 | A |
3988783 | Treace | Nov 1976 | A |
4007495 | Frazier | Feb 1977 | A |
4041550 | Frazier | Aug 1977 | A |
4052753 | Dedo | Oct 1977 | A |
4054955 | Seppo | Oct 1977 | A |
4069518 | Groth, Jr. et al. | Jan 1978 | A |
4156944 | Schreiber et al. | Jun 1979 | A |
4158894 | Worrell | Jun 1979 | A |
4164793 | Swanson | Aug 1979 | A |
4187841 | Knutson | Feb 1980 | A |
4246660 | Wevers | Jan 1981 | A |
4285070 | Averill | Aug 1981 | A |
4308863 | Fischer | Jan 1982 | A |
4353361 | Foster | Oct 1982 | A |
4367562 | Gauthier | Jan 1983 | A |
4470158 | Pappas et al. | Sep 1984 | A |
4501266 | McDaniel | Feb 1985 | A |
4570625 | Harris | Feb 1986 | A |
4576158 | Boland | Mar 1986 | A |
4621627 | DeBastiani et al. | Nov 1986 | A |
4637382 | Walker | Jan 1987 | A |
4642122 | Steffee | Feb 1987 | A |
4696293 | Ciullo | Sep 1987 | A |
4759765 | Van Kampen | Jul 1988 | A |
4759766 | Buettner-Janz et al. | Jul 1988 | A |
4776851 | Bruchman et al. | Oct 1988 | A |
4778472 | Homsy et al. | Oct 1988 | A |
4846842 | Connolly et al. | Jul 1989 | A |
4863471 | Mansat | Sep 1989 | A |
4871367 | Christensen et al. | Oct 1989 | A |
4873967 | Sutherland | Oct 1989 | A |
4883486 | Kapadia et al. | Nov 1989 | A |
4904261 | Dove et al. | Feb 1990 | A |
4919672 | Millar et al. | Apr 1990 | A |
4923471 | Morgan | May 1990 | A |
4942875 | Hlavacek et al. | Jul 1990 | A |
4955915 | Swanson | Sep 1990 | A |
4959065 | Arnett et al. | Sep 1990 | A |
4988349 | Pennig | Jan 1991 | A |
4988350 | Herzberg | Jan 1991 | A |
5002574 | May et al. | Mar 1991 | A |
5011497 | Persson et al. | Apr 1991 | A |
5019077 | DeBastiani et al. | May 1991 | A |
5019104 | Whiteside et al. | May 1991 | A |
5026372 | Sturtzkopf et al. | Jun 1991 | A |
5035700 | Kenna | Jul 1991 | A |
5041112 | Mingozzi et al. | Aug 1991 | A |
5100403 | Hotchkiss et al. | Mar 1992 | A |
5103811 | Crupi | Apr 1992 | A |
5121742 | Engen | Jun 1992 | A |
5152280 | Danieli | Oct 1992 | A |
5152790 | Rosenberg et al. | Oct 1992 | A |
5197966 | Sommerkamp | Mar 1993 | A |
5197986 | Mikhail | Mar 1993 | A |
5231977 | Graston | Aug 1993 | A |
5258032 | Bertin | Nov 1993 | A |
5304180 | Slocum | Apr 1994 | A |
5314481 | Bianco | May 1994 | A |
5318567 | Vichard | Jun 1994 | A |
5326364 | Clift, Jr. et al. | Jun 1994 | A |
5352190 | Fischer | Oct 1994 | A |
5375823 | Navas | Dec 1994 | A |
5383937 | Mikhail | Jan 1995 | A |
5405347 | Lee et al. | Apr 1995 | A |
5415661 | Holmes | May 1995 | A |
5425775 | Kovacevic et al. | Jun 1995 | A |
5456722 | McLeod et al. | Oct 1995 | A |
5480443 | Elias | Jan 1996 | A |
5540688 | Navas | Jul 1996 | A |
5545229 | Parsons et al. | Aug 1996 | A |
5571198 | Drucker et al. | Nov 1996 | A |
5575819 | Amis | Nov 1996 | A |
5578038 | Slocum | Nov 1996 | A |
5580353 | Mendes et al. | Dec 1996 | A |
5601553 | Trebling et al. | Feb 1997 | A |
5624440 | Huebner | Apr 1997 | A |
5662648 | Faccioli et al. | Sep 1997 | A |
5662650 | Bailey et al. | Sep 1997 | A |
5676667 | Hausman | Oct 1997 | A |
5681313 | Diez | Oct 1997 | A |
5695496 | Orsak et al. | Dec 1997 | A |
5702460 | Carls et al. | Dec 1997 | A |
5702465 | Burkinshaw | Dec 1997 | A |
5702467 | Gabriel et al. | Dec 1997 | A |
5716357 | Rogozinski | Feb 1998 | A |
5733287 | Tepic et al. | Mar 1998 | A |
5749872 | Kyle et al. | May 1998 | A |
5766251 | Koshino | Jun 1998 | A |
5803924 | Oni et al. | Sep 1998 | A |
5824106 | Fournol | Oct 1998 | A |
5871540 | Weissman et al. | Feb 1999 | A |
5873843 | Draper | Feb 1999 | A |
5879386 | Jore | Mar 1999 | A |
5888203 | Goldberg | Mar 1999 | A |
5928234 | Manspeizer | Jul 1999 | A |
5976125 | Graham | Nov 1999 | A |
5976136 | Bailey et al. | Nov 1999 | A |
5989292 | van Loon | Nov 1999 | A |
6036691 | Richardson | Mar 2000 | A |
6096040 | Esser | Aug 2000 | A |
6113637 | Gill et al. | Sep 2000 | A |
6132468 | Mansmann | Oct 2000 | A |
6139550 | Michelson | Oct 2000 | A |
6143032 | Schafer et al. | Nov 2000 | A |
6146423 | Cohen et al. | Nov 2000 | A |
6161080 | Aouni-Ateshian et al. | Dec 2000 | A |
6162223 | Orsak et al. | Dec 2000 | A |
6176860 | Howard | Jan 2001 | B1 |
6193225 | Watanabe | Feb 2001 | B1 |
6200347 | Anderson et al. | Mar 2001 | B1 |
D443060 | Benirschke et al. | May 2001 | S |
6245110 | Grundei et al. | Jun 2001 | B1 |
6264696 | Reigner et al. | Jul 2001 | B1 |
6277124 | Haag | Aug 2001 | B1 |
6280474 | Cassidy et al. | Aug 2001 | B1 |
6302915 | Cooney, III et al. | Oct 2001 | B1 |
6315798 | Ashby et al. | Nov 2001 | B1 |
6315852 | Magrini et al. | Nov 2001 | B1 |
6355037 | Crosslin et al. | Mar 2002 | B1 |
6364881 | Apgar et al. | Apr 2002 | B1 |
6368326 | Dakin et al. | Apr 2002 | B1 |
6371985 | Goldberg | Apr 2002 | B1 |
6409729 | Martinelli et al. | Jun 2002 | B1 |
6409767 | Perice et al. | Jun 2002 | B1 |
6468314 | Schwartz et al. | Oct 2002 | B2 |
6482232 | Boucher et al. | Nov 2002 | B1 |
6485503 | Jacobs et al. | Nov 2002 | B2 |
6494914 | Brown et al. | Dec 2002 | B2 |
6520964 | Tallarida et al. | Feb 2003 | B2 |
6527733 | Ceriani et al. | Mar 2003 | B1 |
6540708 | Manspeizer | Apr 2003 | B1 |
6572653 | Simonson | Jun 2003 | B1 |
6579318 | Varga et al. | Jun 2003 | B2 |
6589248 | Hughes | Jul 2003 | B1 |
6592622 | Ferguson | Jul 2003 | B1 |
6599321 | Hyde, Jr. | Jul 2003 | B2 |
6599322 | Amrich et al. | Jul 2003 | B1 |
6616696 | Merchant | Sep 2003 | B1 |
6620332 | Amrich | Sep 2003 | B2 |
6623486 | Weaver et al. | Sep 2003 | B1 |
6626945 | Simon et al. | Sep 2003 | B2 |
6632247 | Boyer, II et al. | Oct 2003 | B2 |
6652529 | Swanson | Nov 2003 | B2 |
6663631 | Kuntz | Dec 2003 | B2 |
6679914 | Gabbay | Jan 2004 | B1 |
6692497 | Tormala et al. | Feb 2004 | B1 |
6692498 | Niiranen et al. | Feb 2004 | B1 |
6702821 | Bonutti | Mar 2004 | B2 |
6709460 | Merchant | Mar 2004 | B2 |
6712856 | Carignan et al. | Mar 2004 | B1 |
6719794 | Gerber | Apr 2004 | B2 |
6752831 | Sybert et al. | Jun 2004 | B2 |
6770078 | Bonutti | Aug 2004 | B2 |
6800094 | Burkinshaw | Oct 2004 | B2 |
6814757 | Kopylov et al. | Nov 2004 | B2 |
6824567 | Tornier et al. | Nov 2004 | B2 |
6852125 | Simon et al. | Feb 2005 | B2 |
6852330 | Bowman et al. | Feb 2005 | B2 |
6854330 | Potter | Feb 2005 | B2 |
6855150 | Linchan | Feb 2005 | B1 |
6866684 | Fell et al. | Mar 2005 | B2 |
6884242 | LeHuec et al. | Apr 2005 | B2 |
6890358 | Ball et al. | May 2005 | B2 |
6893463 | Fell et al. | May 2005 | B2 |
6896702 | Collazo | May 2005 | B2 |
6905513 | Metzger | Jun 2005 | B1 |
6911044 | Fell et al. | Jun 2005 | B2 |
6916341 | Rolston | Jul 2005 | B2 |
6926739 | O'Connor et al. | Aug 2005 | B1 |
6966910 | Ritland | Nov 2005 | B2 |
6966928 | Fell et al. | Nov 2005 | B2 |
6972020 | Grayson et al. | Dec 2005 | B1 |
6974480 | Messerli et al. | Dec 2005 | B2 |
6994730 | Posner | Feb 2006 | B2 |
6997940 | Bonutti | Feb 2006 | B2 |
7004971 | Serhan et al. | Feb 2006 | B2 |
7008452 | Hawkins | Mar 2006 | B2 |
7011687 | Deffenbaugh et al. | Mar 2006 | B2 |
7018418 | Amrich et al. | Mar 2006 | B2 |
7025790 | Parks et al. | Apr 2006 | B2 |
7029475 | Pajabi | Apr 2006 | B2 |
7060073 | Frey et al. | Jun 2006 | B2 |
7105025 | Castro et al. | Sep 2006 | B2 |
7105027 | Lipman et al. | Sep 2006 | B2 |
7124762 | Carter et al. | Oct 2006 | B2 |
7128744 | Weaver et al. | Oct 2006 | B2 |
7141073 | May et al. | Nov 2006 | B2 |
7160333 | Plouhar et al. | Jan 2007 | B2 |
7163563 | Schwartz et al. | Jan 2007 | B2 |
7182787 | Hassler et al. | Feb 2007 | B2 |
7188626 | Foley et al. | Mar 2007 | B2 |
7201728 | Sterling | Apr 2007 | B2 |
7223292 | Messerli et al. | May 2007 | B2 |
7226482 | Messerli et al. | Jun 2007 | B2 |
7226483 | Gerber et al. | Jun 2007 | B2 |
7235077 | Wang et al. | Jun 2007 | B1 |
7235102 | Ferree et al. | Jun 2007 | B2 |
7238203 | Bagga et al. | Jul 2007 | B2 |
7241298 | Nemec et al. | Jul 2007 | B2 |
7247157 | Prager et al. | Jul 2007 | B2 |
7252670 | Morrison et al. | Aug 2007 | B2 |
7261739 | Ralph et al. | Aug 2007 | B2 |
7273481 | Lombardo et al. | Sep 2007 | B2 |
7276070 | Muckter | Oct 2007 | B2 |
7282065 | Kirschman | Oct 2007 | B2 |
7285134 | Berry et al. | Oct 2007 | B2 |
7288094 | Lindemann et al. | Oct 2007 | B2 |
7288095 | Baynham et al. | Oct 2007 | B2 |
7291150 | Graf | Nov 2007 | B2 |
7291169 | Hodorek | Nov 2007 | B2 |
7297161 | Fell | Nov 2007 | B2 |
7306605 | Ross | Dec 2007 | B2 |
7322983 | Harris | Jan 2008 | B2 |
7322984 | Doubler et al. | Jan 2008 | B2 |
7323012 | Stone et al. | Jan 2008 | B1 |
7341589 | Weaver et al. | Mar 2008 | B2 |
7341590 | Ferree | Mar 2008 | B2 |
7341602 | Fell et al. | Mar 2008 | B2 |
7361196 | Fallin et al. | Apr 2008 | B2 |
7476225 | Cole | Jan 2009 | B2 |
7479160 | Branch et al. | Jan 2009 | B2 |
7485147 | Pappas et al. | Feb 2009 | B2 |
7500991 | Bartish, Jr. et al. | Mar 2009 | B2 |
7534270 | Ball | May 2009 | B2 |
7544210 | Schaefer et al. | Jun 2009 | B2 |
7553331 | Manspeizer | Jun 2009 | B2 |
7572291 | Gil et al. | Aug 2009 | B2 |
7611540 | Clifford et al. | Nov 2009 | B2 |
7618454 | Bentley et al. | Nov 2009 | B2 |
7632310 | Clifford et al. | Dec 2009 | B2 |
7632311 | Seedhom et al. | Dec 2009 | B2 |
7637953 | Branch et al. | Dec 2009 | B2 |
7641689 | Fell et al. | Jan 2010 | B2 |
7655029 | Niederberger et al. | Feb 2010 | B2 |
7655041 | Clifford et al. | Feb 2010 | B2 |
7678147 | Clifford et al. | Mar 2010 | B2 |
7722676 | Hanson et al. | May 2010 | B2 |
7723395 | Ringeisen et al. | May 2010 | B2 |
7726319 | Boyce | Jun 2010 | B1 |
7744638 | Orbay | Jun 2010 | B2 |
7749276 | Fitz | Jul 2010 | B2 |
7758651 | Chauhan et al. | Jul 2010 | B2 |
7780670 | Bonutti | Aug 2010 | B2 |
7806898 | Justin et al. | Oct 2010 | B2 |
7819918 | Malaviya et al. | Oct 2010 | B2 |
7828852 | Bonutti | Nov 2010 | B2 |
7846211 | Clifford et al. | Dec 2010 | B2 |
7875082 | Naidu | Jan 2011 | B2 |
7879105 | Schmieding et al. | Feb 2011 | B2 |
7896921 | Smith et al. | Mar 2011 | B2 |
7896923 | Blackwell et al. | Mar 2011 | B2 |
7951176 | Grady et al. | May 2011 | B2 |
7959675 | Gately | Jun 2011 | B2 |
7967863 | Frey et al. | Jun 2011 | B2 |
7972383 | Goldstein et al. | Jul 2011 | B2 |
7993402 | Sidler | Aug 2011 | B2 |
8002833 | Fabris Monterumici et al. | Aug 2011 | B2 |
8002837 | Stream et al. | Aug 2011 | B2 |
8002841 | Hasselman | Aug 2011 | B2 |
8034117 | Matsuzaki et al. | Oct 2011 | B2 |
8043375 | Strzepa et al. | Oct 2011 | B2 |
8043380 | Park et al. | Oct 2011 | B1 |
8052753 | Melvin | Nov 2011 | B2 |
8052755 | Naidu | Nov 2011 | B2 |
8083746 | Novak | Dec 2011 | B2 |
8088166 | Makower et al. | Jan 2012 | B2 |
8088168 | Hassler et al. | Jan 2012 | B2 |
8092530 | Strzepa et al. | Jan 2012 | B2 |
8092544 | Wright et al. | Jan 2012 | B2 |
8100967 | Makower et al. | Jan 2012 | B2 |
8114156 | Hatch | Feb 2012 | B2 |
8123805 | Makower et al. | Feb 2012 | B2 |
8128697 | Fell et al. | Mar 2012 | B2 |
8128704 | Brown et al. | Mar 2012 | B2 |
8142503 | Malone | Mar 2012 | B2 |
8257444 | Linares | Sep 2012 | B2 |
8262707 | Huebner et al. | Sep 2012 | B2 |
8267972 | Gehlert | Sep 2012 | B1 |
8328805 | Cole | Dec 2012 | B2 |
8372078 | Collazo | Feb 2013 | B2 |
8382807 | Austin et al. | Feb 2013 | B2 |
8523921 | Horan et al. | Sep 2013 | B2 |
8523948 | Slone et al. | Sep 2013 | B2 |
8597362 | Shenoy et al. | Dec 2013 | B2 |
8845724 | Shenoy et al. | Sep 2014 | B2 |
20010020143 | Stark et al. | Sep 2001 | A1 |
20010023371 | Bonutti | Sep 2001 | A1 |
20010037155 | Merchant | Nov 2001 | A1 |
20020013587 | Winquist et al. | Jan 2002 | A1 |
20020029045 | Bonutti | Mar 2002 | A1 |
20020029084 | Paul et al. | Mar 2002 | A1 |
20020052606 | Bonutti | May 2002 | A1 |
20020065560 | Varga et al. | May 2002 | A1 |
20020091447 | Shimp et al. | Jul 2002 | A1 |
20020095154 | Atkinson et al. | Jul 2002 | A1 |
20020107574 | Boehm et al. | Aug 2002 | A1 |
20020133230 | Repicci | Sep 2002 | A1 |
20020151978 | Zacouto et al. | Oct 2002 | A1 |
20020165550 | Frey et al. | Nov 2002 | A1 |
20030055500 | Fell et al. | Mar 2003 | A1 |
20030083751 | Tornier | May 2003 | A1 |
20030088315 | Supinski | May 2003 | A1 |
20030100950 | Moret | May 2003 | A1 |
20030109928 | Pasquet et al. | Jun 2003 | A1 |
20030120344 | Michelson | Jun 2003 | A1 |
20030120346 | Mercinek et al. | Jun 2003 | A1 |
20030125807 | Lambrecht et al. | Jul 2003 | A1 |
20030139813 | Messerli et al. | Jul 2003 | A1 |
20030204265 | Short et al. | Oct 2003 | A1 |
20030216809 | Ferguson | Nov 2003 | A1 |
20040054409 | Harris | Mar 2004 | A1 |
20040117020 | Frey et al. | Jun 2004 | A1 |
20040127990 | Bartish, Jr. et al. | Jul 2004 | A1 |
20040133278 | Marino et al. | Jul 2004 | A1 |
20040143336 | Burkinshaw | Jul 2004 | A1 |
20040143338 | Burkinshaw | Jul 2004 | A1 |
20040148026 | Bonutti | Jul 2004 | A1 |
20040167630 | Rolston | Aug 2004 | A1 |
20040172133 | Gerber et al. | Sep 2004 | A1 |
20040186585 | Feiwell | Sep 2004 | A1 |
20040215195 | Shipp et al. | Oct 2004 | A1 |
20040230303 | Gomes et al. | Nov 2004 | A1 |
20040230315 | Ek | Nov 2004 | A1 |
20040236428 | Burkinshaw et al. | Nov 2004 | A1 |
20040243240 | Beaurain et al. | Dec 2004 | A1 |
20040260302 | Manspeizer | Dec 2004 | A1 |
20040267179 | Leman | Dec 2004 | A1 |
20050004671 | Ross et al. | Jan 2005 | A1 |
20050027360 | Webb et al. | Feb 2005 | A1 |
20050033424 | Fell | Feb 2005 | A1 |
20050033426 | Ogilvie et al. | Feb 2005 | A1 |
20050043808 | Felt et al. | Feb 2005 | A1 |
20050049708 | Atkinson et al. | Mar 2005 | A1 |
20050049711 | Ball | Mar 2005 | A1 |
20050085815 | Harms et al. | Apr 2005 | A1 |
20050119664 | Carignan et al. | Jun 2005 | A1 |
20050119744 | Buskirk et al. | Jun 2005 | A1 |
20050137708 | Clark | Jun 2005 | A1 |
20050143822 | Paul | Jun 2005 | A1 |
20050143830 | Marcinek et al. | Jun 2005 | A1 |
20050154390 | Biedermann et al. | Jul 2005 | A1 |
20050192674 | Ferree | Sep 2005 | A1 |
20050222685 | Hayden et al. | Oct 2005 | A1 |
20050251080 | Hyde, Jr. | Nov 2005 | A1 |
20050261680 | Draper | Nov 2005 | A1 |
20050261767 | Anderson et al. | Nov 2005 | A1 |
20050267584 | Burdulis, Jr. et al. | Dec 2005 | A1 |
20050273114 | Novak | Dec 2005 | A1 |
20050288788 | Dougherty-Shah | Dec 2005 | A1 |
20060036321 | Henninger et al. | Feb 2006 | A1 |
20060064169 | Ferree | Mar 2006 | A1 |
20060074492 | Frey | Apr 2006 | A1 |
20060085069 | Kim | Apr 2006 | A1 |
20060100715 | De Villiers | May 2006 | A1 |
20060106460 | Messerli et al. | May 2006 | A1 |
20060122620 | Kim | Jun 2006 | A1 |
20060129243 | Wong et al. | Jun 2006 | A1 |
20060142858 | Colleran et al. | Jun 2006 | A1 |
20060149274 | Justin et al. | Jul 2006 | A1 |
20060161260 | Thomas et al. | Jul 2006 | A1 |
20060074423 | Alleyne | Aug 2006 | A1 |
20060178744 | de Villiers et al. | Aug 2006 | A1 |
20060235387 | Peterman | Oct 2006 | A1 |
20060276907 | Boyer, II et al. | Dec 2006 | A1 |
20070027547 | Rydell et al. | Feb 2007 | A1 |
20070043356 | Timm et al. | Feb 2007 | A1 |
20070106299 | Manspeizer | May 2007 | A1 |
20070129804 | Bentley et al. | Jun 2007 | A1 |
20070129809 | Meridew et al. | Jun 2007 | A1 |
20070173946 | Bonutti | Jun 2007 | A1 |
20070161993 | Lowery et al. | Jul 2007 | A1 |
20070168033 | Kim et al. | Jul 2007 | A1 |
20070168036 | Ainsworth et al. | Jul 2007 | A1 |
20070198088 | Biedermann et al. | Aug 2007 | A1 |
20070198091 | Boyer et al. | Aug 2007 | A1 |
20070203581 | Vanaclocha | Aug 2007 | A1 |
20070208343 | Magerl et al. | Sep 2007 | A1 |
20070225820 | Thomas et al. | Sep 2007 | A1 |
20070233141 | Park et al. | Oct 2007 | A1 |
20070244483 | Winslow et al. | Oct 2007 | A9 |
20070244488 | Metzger et al. | Oct 2007 | A1 |
20070265708 | Brown et al. | Nov 2007 | A1 |
20070288014 | Shadduck et al. | Dec 2007 | A1 |
20070293947 | Mansmann | Dec 2007 | A1 |
20070299528 | Lotke | Dec 2007 | A9 |
20080015591 | Castaneda et al. | Jan 2008 | A1 |
20080015592 | Long et al. | Jan 2008 | A1 |
20080015593 | Pfefferie et al. | Jan 2008 | A1 |
20080015603 | Collazo | Jan 2008 | A1 |
20080015604 | Collazo | Jan 2008 | A1 |
20080021566 | Peters et al. | Jan 2008 | A1 |
20080033552 | Lee | Feb 2008 | A1 |
20080044449 | McKay | Feb 2008 | A1 |
20080071373 | Molz et al. | Mar 2008 | A1 |
20080071375 | Carver et al. | Mar 2008 | A1 |
20080091270 | Millet et al. | Apr 2008 | A1 |
20080097434 | Moumene et al. | Apr 2008 | A1 |
20080097441 | Hayes et al. | Apr 2008 | A1 |
20080097617 | Fellinger et al. | Apr 2008 | A1 |
20080132954 | Sekhon et al. | Jun 2008 | A1 |
20080140094 | Schwartz et al. | Jun 2008 | A1 |
20080140213 | Ammann et al. | Jun 2008 | A1 |
20080154311 | Staeubli | Jun 2008 | A1 |
20080154371 | Fell et al. | Jun 2008 | A1 |
20080154378 | Pelo | Jun 2008 | A1 |
20080161815 | Schoenefeld et al. | Jul 2008 | A1 |
20080161933 | Grotz et al. | Jul 2008 | A1 |
20080195099 | Minas | Aug 2008 | A1 |
20080200995 | Sidebotham | Aug 2008 | A1 |
20080208341 | McCormack | Aug 2008 | A1 |
20080234686 | Beaurain et al. | Sep 2008 | A1 |
20080262549 | Bennett | Oct 2008 | A1 |
20080262618 | Hermsen et al. | Oct 2008 | A1 |
20080275509 | Clifford et al. | Nov 2008 | A1 |
20080275552 | Makower et al. | Nov 2008 | A1 |
20080275555 | Makower et al. | Nov 2008 | A1 |
20080275556 | Makower et al. | Nov 2008 | A1 |
20080275557 | Makower et al. | Nov 2008 | A1 |
20080275558 | Clifford et al. | Nov 2008 | A1 |
20080275559 | Makower et al. | Nov 2008 | A1 |
20080275560 | Clifford et al. | Nov 2008 | A1 |
20080275561 | Clifford et al. | Nov 2008 | A1 |
20080275562 | Clifford et al. | Nov 2008 | A1 |
20080275563 | Makower et al. | Nov 2008 | A1 |
20080275564 | Makower et al. | Nov 2008 | A1 |
20080275565 | Makower et al. | Nov 2008 | A1 |
20080275567 | Makower et al. | Nov 2008 | A1 |
20080275571 | Clifford et al. | Nov 2008 | A1 |
20080281422 | Schmieding | Nov 2008 | A1 |
20080281425 | Thalgott et al. | Nov 2008 | A1 |
20090012615 | Fell | Jan 2009 | A1 |
20090014016 | Clifford et al. | Jan 2009 | A1 |
20090018656 | Clifford et al. | Jan 2009 | A1 |
20090018665 | Clifford et al. | Jan 2009 | A1 |
20090036893 | Kartalian et al. | Feb 2009 | A1 |
20090048683 | Morris et al. | Feb 2009 | A1 |
20090082808 | Butler | Mar 2009 | A1 |
20090088763 | Aram et al. | Apr 2009 | A1 |
20090088846 | Myung et al. | Apr 2009 | A1 |
20090112268 | Cole | Apr 2009 | A1 |
20090118830 | Fell | May 2009 | A1 |
20090164014 | Liljensten et al. | Jun 2009 | A1 |
20090182433 | Reiley et al. | Jul 2009 | A1 |
20090198341 | Choi et al. | Aug 2009 | A1 |
20090210063 | Barrett | Aug 2009 | A1 |
20090226068 | Fitz et al. | Sep 2009 | A1 |
20090248026 | Draper | Oct 2009 | A1 |
20090259311 | Shterling et al. | Oct 2009 | A1 |
20090259312 | Shterling et al. | Oct 2009 | A1 |
20090306783 | Blum | Dec 2009 | A1 |
20090312807 | Boudreault et al. | Dec 2009 | A1 |
20090318924 | Helenbolt et al. | Dec 2009 | A1 |
20090318976 | Gabriel et al. | Dec 2009 | A1 |
20100023126 | Grotz | Jan 2010 | A1 |
20100049322 | McKay | Feb 2010 | A1 |
20100049325 | Biedermann et al. | Feb 2010 | A1 |
20100057216 | Gannoe et al. | Mar 2010 | A1 |
20100076564 | Schilling et al. | Mar 2010 | A1 |
20100106247 | Makower et al. | Apr 2010 | A1 |
20100106248 | Makower et al. | Apr 2010 | A1 |
20100114322 | Clifford et al. | May 2010 | A1 |
20100121355 | Gittings et al. | May 2010 | A1 |
20100121457 | Clifford et al. | May 2010 | A1 |
20100125266 | Deem et al. | May 2010 | A1 |
20100131068 | Brown et al. | May 2010 | A1 |
20100131069 | Halbrecht | May 2010 | A1 |
20100137996 | Clifford et al. | Jun 2010 | A1 |
20100145449 | Makower et al. | Jun 2010 | A1 |
20100161057 | Berry et al. | Jun 2010 | A1 |
20100168857 | Hatch | Jul 2010 | A1 |
20100198354 | Halbrecht | Aug 2010 | A1 |
20100204798 | Gerbec et al. | Aug 2010 | A1 |
20100262246 | Attia | Oct 2010 | A1 |
20100292731 | Gittings et al. | Nov 2010 | A1 |
20100292733 | Hendricksen et al. | Nov 2010 | A1 |
20100305698 | Metzger et al. | Dec 2010 | A1 |
20100305708 | Lang et al. | Dec 2010 | A1 |
20110004305 | Jansson et al. | Jan 2011 | A1 |
20110054627 | Bear | Mar 2011 | A1 |
20110060422 | Makower et al. | Mar 2011 | A1 |
20110093073 | Gatt et al. | Apr 2011 | A1 |
20110093079 | Slone et al. | Apr 2011 | A1 |
20110093080 | Slone et al. | Apr 2011 | A1 |
20110121457 | Clevenger et al. | May 2011 | A1 |
20110137415 | Clifford et al. | Jun 2011 | A1 |
20110172768 | Cragg et al. | Jul 2011 | A1 |
20110202138 | Shenoy et al. | Aug 2011 | A1 |
20110213466 | Shenoy et al. | Sep 2011 | A1 |
20110224734 | Schelling | Sep 2011 | A1 |
20110230919 | Alleyne | Sep 2011 | A1 |
20110238180 | Fritz et al. | Sep 2011 | A1 |
20110245928 | Landry et al. | Oct 2011 | A1 |
20110264216 | Makower et al. | Oct 2011 | A1 |
20110270393 | Marvel | Nov 2011 | A1 |
20110288643 | Linder-Ganz et al. | Nov 2011 | A1 |
20120022649 | Robinson et al. | Jan 2012 | A1 |
20120022655 | Clifford | Jan 2012 | A1 |
20120046754 | Clifford et al. | Feb 2012 | A1 |
20120053644 | Landry et al. | Mar 2012 | A1 |
20120065640 | Metzger et al. | Mar 2012 | A1 |
20120116522 | Makower et al. | May 2012 | A1 |
20120136449 | Makower et al. | May 2012 | A1 |
20120179273 | Clifford et al. | Jul 2012 | A1 |
20120197410 | Horan et al. | Aug 2012 | A1 |
20120221106 | Makower et al. | Aug 2012 | A1 |
20120271366 | Katrana et al. | Oct 2012 | A1 |
20120290088 | Amirouche et al. | Nov 2012 | A1 |
20130013066 | Landry et al. | Jan 2013 | A1 |
20130013067 | Landry et al. | Jan 2013 | A1 |
20130041416 | Regala et al. | Feb 2013 | A1 |
20130096629 | Rollinghoff et al. | Apr 2013 | A1 |
20130150977 | Gabriel et al. | Jun 2013 | A1 |
20130166036 | De Cortanze et al. | Jun 2013 | A1 |
20130190886 | Tepic et al. | Jul 2013 | A1 |
20130204378 | Slone et al. | Aug 2013 | A1 |
20130211521 | Shenoy et al. | Aug 2013 | A1 |
20130289728 | Makower et al. | Oct 2013 | A1 |
20130304208 | Clifford et al. | Nov 2013 | A1 |
20130325123 | Clifford et al. | Dec 2013 | A1 |
20130338783 | Slone et al. | Dec 2013 | A1 |
20140052266 | Slone et al. | Feb 2014 | A1 |
20140156004 | Shenoy et al. | Jun 2014 | A1 |
20140156005 | Shenoy et al. | Jun 2014 | A1 |
20140257292 | Embleton et al. | Sep 2014 | A1 |
Number | Date | Country |
---|---|---|
1205602 | Jun 1986 | CA |
2788765 | Jun 2006 | CN |
19855254 | Jun 2000 | DE |
0383419 | Aug 1990 | EP |
0953317 | Apr 2004 | EP |
1410769 | Apr 2004 | EP |
1770302 | Apr 2007 | EP |
1429675 | Oct 2007 | EP |
1682020 | Oct 2007 | EP |
1847228 | Oct 2007 | EP |
1847229 | Oct 2007 | EP |
1005290 | Feb 2008 | EP |
1468655 | May 2008 | EP |
2452641 | May 2012 | EP |
2926456 | Jul 2009 | FR |
1507953 | Apr 1978 | GB |
2223406 | Apr 1990 | GB |
2250919 | Oct 1993 | GB |
59131348 | Jul 1984 | JP |
7100159 | Apr 1995 | JP |
2532346 | Nov 1996 | JP |
2000503865 | Apr 2000 | JP |
2001145647 | May 2001 | JP |
2003102744 | Apr 2003 | JP |
2006280951 | Oct 2006 | JP |
2007167318 | Jul 2007 | JP |
2007167319 | Jul 2007 | JP |
2007170969 | Jul 2007 | JP |
2011519303 | Jul 2011 | JP |
533300 | Feb 2005 | NZ |
2085148 | Jul 1997 | RU |
2217105 | Nov 2003 | RU |
2241400 | Dec 2004 | RU |
578063 | Oct 1977 | SU |
578957 | Nov 1977 | SU |
624613 | Sep 1978 | SU |
640740 | Jan 1979 | SU |
704605 | Dec 1979 | SU |
719612 | Mar 1980 | SU |
741872 | Jun 1980 | SU |
1186204 | Oct 1985 | SU |
1251889 | Aug 1986 | SU |
1316666 | Jun 1987 | SU |
1588404 | Aug 1990 | SU |
1699441 | Dec 1991 | SU |
1769868 | Oct 1992 | SU |
9107137 | May 1991 | WO |
9406364 | Mar 1994 | WO |
9619944 | Jul 1996 | WO |
2004019831 | Mar 2004 | WO |
2004024037 | Mar 2004 | WO |
2006045091 | Apr 2006 | WO |
2006049993 | May 2006 | WO |
2006110578 | Oct 2006 | WO |
2007056645 | May 2007 | WO |
2007090009 | Aug 2007 | WO |
2007090015 | Aug 2007 | WO |
2007090017 | Aug 2007 | WO |
2007106962 | Sep 2007 | WO |
2007109132 | Sep 2007 | WO |
2007109140 | Sep 2007 | WO |
2007109417 | Sep 2007 | WO |
2007109436 | Sep 2007 | WO |
2007114769 | Oct 2007 | WO |
2007117571 | Oct 2007 | WO |
2008006098 | Jan 2008 | WO |
2009009618 | Jan 2009 | WO |
2009018365 | Feb 2009 | WO |
2011025959 | Mar 2011 | WO |
2012062908 | May 2012 | WO |
Entry |
---|
Lapinskaya, Valentina Spiridonovna, “Treatment of Diseases and Injuries of Hip Joint Using a Method of Distraction”, Kuibyshev Medical Institute, 1990. |
Larionov D. Yu, et al., “Medical Devices,” Scientific and Technical Bimonthly Journal, May-Jun. 2008. |
Lapinskaya, V.S., et al., “An Endoapparatus for Restoration of the Hip Joint,” Writers Collective, 2008, UDK 615.472.03:616.728.2-089.28; pp. 8-12. |
Lentsner, A.A., et al., “Device for Functional Relief of Hip Joint in Cotyloid Cavity Fracture Cases”, Ortop Travmatol Protez. Apr. 1990 (4) 44-6. |
Andriacchi, Thomas P., Ph.D. et al.; “Methods for Evaluating the Progression of Osteoarthritis”; Journal of Rehabilitation Research and Development, vol. 37, No. 2., Mar./Apr. 2000, pp. 163-170. |
Arendt, Elizabeth, M.D.; “Anatomy and Malalignment of the Patellofemoral Joint—Its Relation to Patellofemoral Arthrosis”; Clinical Orthopaedics and Related Research; 2005, No. 436, pp. 71-75. |
Benzel, Edward; “Qualitative Attributes of Spinal Implants”; in: Biomechanics of Spine Stabilization, 1995, pp. 137-150. |
Buckwalter, Joseph A.; “Joint Distraction for Osteoarthritis”; The Lancet, Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, vol. 347, Feb. 3, 1996, pp. 279-280. |
Coathup, M.J. et al.; “Osseo-mechanical induction of extra-cortical plates with reference to their surface properties and gemoetric designs”, Elsevier, Biomaterials 20 (1999) pp. 793-800. |
Deie, Masataka, M.D. et al.; “A New Articulated Distraction Arthroplasty Device for Treatment of the Osteoarthritic Knee Joint: A Preliminary Report”; Arthroscopy: The Journal of Arthroscopic and Related Surgery; vol. 23, No. 8 Aug. 2007: pp. 833-838. |
Dienst, M. et al.; “Dynamic External Fixation for Distal Radius Fractures”; Clinical Orthopaedics and Related Research, 1997, vol. 338, pp. 160-171. |
Gunther, Klaus-Peter, M.D.; “Surgical Approaches for Osteoarthritis”; Best Practice & Research Clinical Rheumatology, vol. 15, No. 4, 2001, pp. 627-641. |
Hall, J. et al.; “Use of a Hinged External Fixator for Elbow instability after Severe Distal Humeral Fracture”; Journal of Orthopaedic Trauma, 2000, vol. 14, No. 6, pp. 442-448. |
Klein, D. et al.; “Percutaneous Treatment of Carpal, Metacarpal, and Phalangeal Injuries”; Clinical Orthopaedics and Related Research, 2000, vol. 375, pp. 116-125. |
Krakauer J. et al.; “Hinged Device for Fractures involving the Proximal Interphalangeal Joint”; Clinical Orthopaedics and Related Research, 1996, vol. 327, pp. 29-37. |
Leon, Heriberto Ojeda, M.D. et al.; “Minimally Invasive Selective Osteotomy of the Knee: A New Surgical Technique”; Arthroscopy: The Journal of Arthroscopic and Related Surgery, vol. 17, No. 5 May-Jun. 2001: pp. 510-516. |
Madey, S. et al.; “Hinged External Fixation of the elbow: optimal axis alignment to minimize motion resistance”; Journal of Orthopaedic Trauma, 2000, vol. 14, No. 1, pp. 41-47. |
Neel, Michael D., M.D. et al.; “Early Multicenter Experience With a Noninvasive Expandable Prosthesis”; Clinical Orthopaedics and Related Research, 2003, No. 415, pp. 72-81. |
Neel, Michael D., M.D.; “Repiphysis—Limb Salvage System for the Skeletally Immature”; Wright Medical Technology, Reipiphysis Limb Salvage System, 2004, pp. 1-8. |
Nockels, Russ P.; “Dynamic Stabilization in the Surgical Management of Painful Lumbar Spinal Disorders”; Spine, 2005, vol. 30, No. 16S, pp. S68-S72. |
Orthofix; “Xcaliber Articulated Ankle”; advertising brochure, May 2004. |
Orthofix; “Gentle Limb Deformity Correction”; website pages, http://www.eight-plate.com/, 2008. |
Perry, Clayton R. et al.; “Patellar Fixation Protected with a Load-Sharing Cable: A Mechanical and Clinical Study”; Journal of Orthopaedic Trauma, 1988, vol. 2, No. 3, pp. 234-240. |
Pilliar et al., “Bone Ingrowth and Stress Shielding with a Porous Surface Coated Fracture Fixation Plate,” Journal of Biomedical Materials Research, vol. 13, (1979), pp. 799-810. |
Repicci, John A., M.D. et al. “Minimally Invasive Unicondylar Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: an outpatient arthritic bypass procedure”; Orthopedic Clinics of North America, 35 (2004), pp. 201-216. |
Sharma, Leena et al. “The Mechanism of the Effect of Obesity in Knee Osteoarthritis—The Mediating Role of Malalignment”; Arthritis & Rheumatism, vol. 43, No. 3, Mar. 2000, pp. 568-575. |
Sommerkamp, G. et al.; “Dynamic External Fixation of Unstable Fractures of the Distal Part of the Radius”; The Journal of Bone and Joint Surgery; Aug. 1994, vol. 76-A, No. 8, pp. 1149-1161. |
Tencer, Allan F. et al. “Fixation of the Patella (Chap. 9.3)”; in: Biomechanics in Orthopedic Trauma Bone Fracture and Fixation, 1994. |
Thakur, A.J.; “Tension Band Wiring”; in; The Elements of Fracture Fixation, 1997, pp. 126-146. |
Uchikura, C. et al.; “Comparative Study of Nonbridging and Bridging External Fixators from Unstable Distal Radius fractures”; Journal of Orthopaedic Science, 2004, vol. 9, No. 6, pp. 560-565. |
Van Der Esch, M. et al.; “Structural Joint Changes, Malalignment, and Laxity in Osteoarthritis of the knee”; Scand J Rheumatol 2005; 34: pp. 298-301. |
Weisstein, Jason S., M.D. et al.; “Oncologic Approaches to Pediatric Limb Preservation”; Journal of the American Academy of Orthopaedic Surgeons; vol. 13, No. 8, Dec. 2005, pp. 544-554. |
Wilke, Hans-Joachim et al.; “Biomechanical Evaluation of a New Total Posterior-Element Replacement System”; Spine, 2006, vol. 31, No. 24, pp. 2790-2796. |
Yamamoto, Ei et al.; “Effects of Stress Shielding on the Transverse Mechanical Properties of Rabbit Patellar Tendons”; Journal of Biomechanical Engineering, 2000, vol. 122, pp. 608-614. |
European Search Report dated Aug. 7, 2014, issued in connection with related EP14164658. |
Extended Search Report dated Aug. 26, 2014, issued in connection with related EP14164658. |
Non-Final Rejection Office Action dated Aug. 27, 2014, in connection with related U.S. Appl. No. 14/175,813, filed Feb. 7, 2014. |
Notice of Allowance dated Aug. 4, 2014 in connection with related U.S. Appl. No. 14/175,829, filed Feb. 7, 2014, Vivek Shenoy. |
Office Action dated Dec. 19, 2014, in connection with U.S. Appl. No. 13/843,128, filed Mar. 15, 2013. |
Response to Final Office Action dated Apr. 1, 2013, in connection with related U.S. Appl. No. 13/002,829, filed Aug. 27, 2009. |
Response to First Non-Final Office Action dated May 5, 2014, in connection with related U.S. Appl. No. 14/175,829, filed Feb. 7, 2014. |
Response to Restriction Requirement dated Oct. 27, 2014, issued in connection with related U.S. Appl. No. 13/843,128, filed Mar. 15, 2013. |
Restriction Requirement dated Aug. 25, 2014, issued in connection with related U.S. Appl. No. 13/843,128, filed Mar. 15, 2013. |
Notice of Allowance dated Feb. 3, 2015, in connection with related U.S. Appl. No. 14/175,813, filed Feb. 7, 2014. |
Office Action dated Jul. 9, 2012, in connection with related European Application No. 10812664, entitled Method and Apparatus for Force Redistributon in Articular Joints, filed Aug. 27, 2010, Cotera, Inc. |
Maquet, P., Biomechanical Treatment of Patellofemoral Osteoarthritis. Advancement of the Patellar Tendon; Review of Rheumatism and Osteoarticular Diseases, National Library of Medicine, Dec. 1963, vol. 30, Issue 12, pp. 780-785. |
Maquet, Paul G.J., Biomechanics of the Knee With Application to the Pathogenesis and the Surgical Treatment of Osteoarthritis; Springer-Verlag Berlin Heidelberg New York, 1976, pp. 134-204. |
Sridhar et al., Obesity and symptomatic osteoarthritis of the knee, The Journal of Bone & Joint Surgery, Instructional Review, vol. 94-B, No. 4, Apr. 2012, pp. 433-441. |
Lasmar, et al., Importance of the Different Posterolateral Knee Static Stabilizers: Biomechanical Study; Clinics 2010; 65(4) pp. 433-440. |
Hunter, David et al., Alignment and Osteoarthritis of the Knee, Journal of Bone and Joint Surgery, 2009: 91 Suppl. 1:85-9, pp. 85-89. |
Halbrecht, Jeffrey L., Arthroscopic Patella Realignment: An All-Inside Technique, Arthroscopy: The Journal of Arthroscopic and Related Surgery, vol. 17, No. 9 Nov.-Dec. 2001; pp. 940-945. |
Arnold, Allison S., et al., Do the hamstrings operate at increased muscle-tendon lengths and velocities after surgical lengthening? Journal of Biomechanics, Mar. 2005; pp. 1-9. |
Unnanuntana, Aasis et al., Management of chronic lateral instability due to lateral collateral ligament deficiency after total knee arthroplasty: a case report; Journal of Medical Case Reports, 2010, 4:144; pp. 1-5. |
Maquet, P., Biomechanical Aspects of the Relationship between Femur and Patella, Z. Orthop. 112 (1974); pp. 620-623. |
Kwak, et al., Hamstrings and Iliotibial Band Forces Affect Knee Kinematics and Contact Pattern, Journal of Orthopaedic Research, 18: 101-108; The Journal of Bone and Joint Surgery, Inc. 1999. |
Maquet P., Reduction of the articular pressure of the hip by surgical lateralization of the greater trochanter, PMID: 1015273, Clin Orthop Relat Res. Mar.-Apr. 1977; (123): 138 (Abstract only). |
Maquet P., Importance of the position of the greater trochanter, PMID: 2382566, Acta Orthop Belg. 1990; 56 (1 Pt. B): 307 (Abstract only). |
Maquet, Paul, “Advancement of the Tibial Tubersosity,” Clinical Orthopaedics and Related Research, No. 15, 1976, pp. 225-230. |
Townsend et al., “The Biomechanics of the Human Patella and its Implications for Chodromalacia,” Journal of Biomechanics, 1977, vol. 10, pp. 403-407. |
Supplementary European Search Report dated May 23, 2012 for related application EP10812664 filed Aug. 27, 2010, entitled “Method and Apparatus for Force Redistribution in Articular,” Cotera, Inc. |
Arnoczky et al., Biomechanical Analysis of Forces Acting About the Canine Hip, American Journal Veterinary Research, vol. 42, Issue: 9, Sep. 1981, pp. 1581-1585. |
Becker et al., Surgical Treatment of Isolated Patellofemoral Osteoarthritis, Clinical Orthopaedics and Related Research vol. 466, No. 2, Feb. 2008, pp. 443-449. |
Cerejo et al., The Influence of Alignment on Risk of Knee Osteoarthritis Progression According to Baseline Stage of Disease, Arthritis & Rheumatism, vol. 46, No. 10, Oct. 2002, pp. 2632-2636. |
Clifford et al., The KineSpring load absorber implant: Rationale, Design and Biomechanical Characterization, Journal of Medical Engineering & Technology, vol. 35, No. 1, Jan. 2011, pp. 65-71. |
Delp et al., An Interactive Graphics-Based Model of the Lower Extremity to Study Orthopaedic Surgical Procedures, IEEE Transactions on Biomedical Engineering, vol. 37, No. 8, Aug. 1990, pp. 757-767. |
Delp et al., Biomechanical Analysis of the Chiari Pelvic Osteotomy Preserving Hip Abductor Strength, Reprinted from Clinical Orthopaedics, vol. 25, May 1990, pp. 189-198. |
Free et al, Trochanteric Transfer in Total Hip Replacement: Effects on the Moment Arms and Force-Generating Capacities of the Hip Abductors, Journal of Orthopaedic Research, vol. 14, No. 2, 1996, pp. 245-250. |
Jack Farr, M.D., Tibial Tubercle Osteotomy, Techniques in Knee Surgery, vol. 2, Issue 1, 2003, pp. 28-42. |
Goetz et al., Hip Joint Contact Force in the Emu (Dromaius novaehollandiae) during Normal Level Walking, Journal of Biomechanics, 41(4), 2008, pp. 770-778. |
Jacobsen et al., Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey, Rheumatology vol. 44 No. 2, 2005, pp. 211-218. |
Jingushi et al., Transtrochanteric Valgus Osteotomy for the Treatment of Osteoarthritis of the Hip Secondary to Acetabular Dysplasia, The Journal of Bone & Joint Surgery [Br], vol. 84-B, No. 4, May 2002, pp. 535-539. |
Kirkley et al., The Effect of Bracing on Varus Gonarthrosis, The Journal of Bone and Joint Surgery, vol. 81-A, No. 4, Apr. 1999, pp. 539-548. |
Lafeber et al., Unloading Joints to Treat Osteoarthritis, including Joint Distraction, Current Opinion in Rheumatology 2006, 18, pp. 519-525. |
Lloyd et al., An EMG-driven Musculoskeletal Model to Estimate Muscle Forces and Knee Joint Moments in Vivo, Journal of Biomechanics 36, 2003, pp. 765-776. |
Lloyd et al., Strategies of Muscular Support of Varus Andvalgus Isometric Loads at the Human Knee, Journal of Biomechanics 34, 2001, pp. 1257-1267. |
Maquet, P, Biomechanics of Hip Dysplasia, Acta Ortopaedica Belgica, vol. 65-3, 1999, pp. 302-314. |
McWilliams et al., Mild Acetabular Dysplasia and Risk of Osteoarthritis of the hip: a case-control study, Annals of the Rheumatic Diseases, 2010; 69, pp. 1774-1778. |
Merritt et al., Influence of Muscle-Tendon Wrapping on Calculations of Joint Reaction Forces in the Equine Distal Forelimb, Journal of Biomedicine and Biotechnology, vol. 2008, Article ID 165730, 9 pages. |
Pedersen et al., A Model to Predict Canine Pelvic Limb Musuloskeletal Geometry, Acta Anat 1991; 140, pp. 139-145. |
Pollo et al., Knee Bracing for Unicompartmental Osteoarthritis, Journal of the American Academy of Orthopaedic Surgeons, vol. 14, No. 1, Jan. 2006, pp. 5-11. |
Pollo et al., Reduction of Medial Compartment Loads with Valgus Bracing of the Osteoarthritic Knee, The American Journal of Sports Medicine, vol. 30, No. 3, 2002, pp. 414-421. |
Saleh et al., Operative Treatment of Patellofemoral Arthritis, The Journal of Bone & Joint Surgery, vol. 87-A, No. 3, Mar. 2005, pp. 659-671. |
Sharma et al., The Role of Knee Alignment in Disease Progression and Functional Decline in Knee Osteoarthritis, JAMA, vol. 286, No. 2, Jul. 11, 2001, pp. 188-195. |
Sims et al., Investigation of Hip Abductor Activation in Subjects with Clinical Unilateral Hip Osteoarthritis, Annals of the Rheumatic Diseases, 2002; 61: pp. 687-692. |
Thorp et al., The biomechanical effects of focused muscle training on medial knee loads in OA of the knee: a pilot, proof of concept study, Journal of Musculoskeletal and Neuronal Interactions, 10(2): 2010, pp. 166-173. |
Wenger et al., Early Surgical Correction of Residual Hip Dysplasia: The San Diego Children's Hospital Approach, Acta Orthopaedica Belgica, vol. 65, 1999, pp. 277-287. |
Winby et al., Muscle and External Load Contribution to Knee Joint Contact Loads during Normal Gait, Journal of Biomechanics 42, 2009, pp. 2294-2300. |
Response to Final Office Action dated Apr. 1, 2013, in connection with related U.S. Appl. No. 13/002,829 International filing date Aug. 27, 2010. |
Amendment and Response to Final Office Action dated May 20, 2013, in connection with related U.S. Appl. No. 12/870,462, filed Aug. 27, 2010. |
Advisory Action dated Apr. 23, 2013 in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
Advisory Action dated Jun. 20, 2013 in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
Tew, M et al.; Anteriorization of the quadriceps tendon. A biomechanical study on a new technique for unloading the patellofemoral joint. University of Tennessee College of Medicine; Poster No. 0848 ⋅ ORS 2012 Annual Meeting. |
Miller, R.K., Goodfellow, J.W., Murray, D.W. and O'Connor, J.J., In vitro measurement of patellofemoral force after three types of knee replacement; The Journal of Bone & Joint Surgery (Br), vol. 80-B, No. 5, Sep. 1998; pp. 900-906. |
Ganesh, V.K., et al., Biomechanics of bone-fracture fixation by stiffness-graded plates in comparison with stainless-steel plates, Biomedical Engineering Online, 2005, 4:46, 15 pgs. |
Benli, Semih et al., Evaluation of bone plate with low-stiffness material in terms of stress distribution, Journal of Biomechanics, 41 (2008) 3229-3235. |
Anatomic Locked Plating System Brochure, BIOMET® Orthopedics, Form BMET0002.0, Rev 053112, pp. 1-16, Copyright 2012. |
SPS Periarticular Plates Brochure, STRYKER® Trauma AG, Literature No. 982274, Lot B46404, pp. 1-8; Copyright 2004. |
Zimmer® Periarticular Distal Femoral Locking Plate Surgical Technique, the Science of the Landscape, Zimmer, 97-2347-044-00 Rev. 1 7.5 ML; pp. 1-20; Copyright 2005. |
Hessmann et al., Compression Plate With or Without Lag Screw; AO Surgery Reference—Online reference in clinical life; Distal Tibia—Reduction & Fixation—Compression Plate; https://www2.aofoundation.org/wps/portal; pp. 1-9; Dec. 3, 2008. |
LCP Locking Compression Plate—Ordering Information; Synthes®, 036.000.017, SE_042064 AD, 31080015; pp. 1-68; Copyright 2008. |
Plates for 4.5 mm and 6.5 mm Screws; Raj Surgical Works; http://www.orthoindustries.com/plates-for-4-5-mm-and-6-5-mm-screws.html; pp. 1-8; printed Nov. 19, 2012. |
Final (Rejection) Office Action dated Mar. 18, 2013, in connection with related U.S. Appl. No. 12/870,462, filed Aug. 27, 2010. |
Final Office Action dated Jan. 31, 2013, in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
PCT International Search Report and Written Opinion dated Jan. 9, 2014, for related application PCT/US2013/058877 filed Sep. 10, 2013 entitled “Method and Apparatus for Treating Canine Cruciate Ligament Disease,” Vivek Shenoy. |
Bruce et al., “Patellar Contact Pressure Changes with Anteromedialization of Tibial Tubercle, Lateral Release, and New Technique for Elevating Quadriceps Tendon: A Biomechanical Study,” Journal of Surgical Orthopaedic Advances 22(4), pp. 270-276, 2013. |
PCT International Search Report and Written Opinion dated Oct. 20, 2010, for related application PCT/US2010/046996 filed Aug. 27, 2010 entitled “Method and Apparatus for Force Redistribution in Articular Joints”; Vivek Shenoy, Mark Deem and Hanson Gifford. |
Office Action dated May 17, 2012, in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011, Shenoy. |
Office Action dated Jul. 24, 2012, in connection with related U.S. Appl. No. 12/870,462, filed Aug. 27, 2010, Shenoy. |
Final (Rejection) Office Action dated Jan. 31, 2013, in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
Synthes, Inc., LCP Proximal Tibial Plate 3.5; Technique Guide; pp. 1-20; Jun. 2011. |
Response to Election/Restriction dated Jul. 1, 2014 in connection with related U.S. Appl. No. 14/175,813, filed Feb. 7, 2014. |
Non-Final Office Action dated Apr. 11, 2014, in connection with related U.S. Appl. No. 14/175,829, filed Feb. 2, 2014, Vivek Shenoy. |
Final Office Action dated Feb. 26, 2015, in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
Response to Non-Final Office Action dated May 26, 2015, in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
Response to Non-Final Office Action dated Apr. 20, 2015, in connection with related U.S. Appl. No. 13/843,128, filed Mar. 15, 2013. |
Final Office Action dated Jun. 10, 2015, in connection with related U.S. Appl. No. 13/843,128, filed Mar. 15, 2013. |
Partial International Search dated May 11, 2015, in connection with related PCT/US2015/019938, filed Mar. 11, 2015. |
International Search Report and Written Opinion dated Jul. 3, 2015, in connection with related PCT/US2015/019938, filed Mar. 11, 2015. |
Office Action dated Jul. 1, 2015, in connection with related U.S. Appl. No. 13/974,930, filed Aug. 23, 2013. |
Restriction Requirement dated Jul. 23, 2015, in connection with related U.S. Appl. No. 14/642,121, filed Mar. 9, 2015. |
Response to Final Office Action dated Aug. 10, 2015, in connection with related U.S. Appl. No. 13/843,128, filed Mar. 15, 2013. |
Response to Restriction Requirement dated Sep. 23, 2015, in connection with related U.S. Appl. No. 14/642,121, filed Mar. 9, 2015. |
Supplemental Response to Final Office Action dated Sep. 3, 2015, in connection with related U.S. Appl. No. 13/843,128, filed Mar. 15, 2013. |
Final Office Action dated Sep. 15, 2015, in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
Chow, S. P. et al., Fracture of the Tibial Tubercle in the Adolescent; British Editorial Society of Bone and Joint Surgery, vol. 72-B. No. 2, Mar. 1990. |
Response to First Non-Final Office Action dated Nov. 2, 2015, in connection with U.S. Appl. No. 13/974,930, filed Aug. 23, 2013. |
Non-Final Office Action dated Oct. 7, 2015, in connection with U.S. Appl. No. 14/642,121, filed Mar. 9, 2015. |
Gumpel et al., An Objective Assessment of Synovitis of the Knee: Measurement of the Size of the Suprapatellar Pouch on Xeroradiography. Annals of the Rheumatic Diseases. 1980, (39): 359-366. |
Response to First Non-Final Office Action dated Jan. 25, 2016, in connection with related U.S. Appl. No. 14/642,121, filed Mar. 9, 2015. |
Office Action dated Feb. 26, 2016, in connection with related U.S. Appl. No. 13/974,930, filed Aug. 23, 2013. |
Appellant's Brief dated Mar. 15, 2016, in connection with related U.S. Appl. No. 13/002,829, filed Jan. 6, 2011. |
Lafaver, et al., “Tibial Tuberosity Advancement for Stabilization of the Canine Cranial Cruciate Ligament-Deficient Stifle Joint: Surgical Technique, Early Results, and Complications in 101 Dogs”, Veterinary Surgery, 36:573-586, 2007. |
Office Action dated May 5, 2016, in connection with U.S. Appl. No. 14/642,121, filed Mar. 9, 2015, Shenoy. |
Examination Search Report dated Sep. 6, 2016, in connection with Canadian Application No. 2,771,332. |
Response to Second Non-Final Office Action dated Oct. 5, 2016, in connection with U.S. Appl. No. 14/642,121, filed Mar. 9, 2015, Shenoy. |
Notice of Allowance dated Jun. 21, 2016, in connection with U.S. Appl. No. 13/974,930, filed Aug. 23, 2013, Shenoy. |
Restriction Requirement dated Jul. 22, 2015, in connection with related U.S. Appl. No. 14/644,792, filed Mar. 11, 2015. |
Response to Restriction Requirement dated Sep. 11, 2015, in connection with related U.S. Appl. No. 14/644,792, filed Mar. 11, 2015. |
Non-final Office Action dated Sep. 25, 2015, in connection with related U.S. Appl. No. 14/644,792, filed Mar. 11, 2015. |
Office Action dated May 18, 2016, in connection with U.S. Appl. No. 14/644,792, filed Mar. 11, 2015, Shenoy. |
Amendment and Response to Second Non-Final Office Action dated Sep. 19, 2016, in connection with U.S. Appl. No. 14/644,792, filed Mar. 11, 2015, Shenoy. |
Office Action dated Oct. 6, 2016, in connection with U.S. Appl. No. 13/002,829, filed Jan. 6, 2011, Shenoy. |
Response to Final Office Action dated Apr. 26, 2016, in connection with U.S. Appl. No. 13/974,930, filed Aug. 23, 2013. |
Amendment and Response to First Non-Final Office Action dated Feb. 3, 2016, in connection with U.S. Appl. No. 14/644,792, filed Mar. 11, 2015, Shenoy. |
Response to Final Office Action dated Apr. 26, 2016, in connection with U.S. Appl. No. 13/974,930, filed Aug. 23, 2013, Shenoy. |
Number | Date | Country | |
---|---|---|---|
20170027621 A1 | Feb 2017 | US |
Number | Date | Country | |
---|---|---|---|
61792720 | Mar 2013 | US | |
61693140 | Aug 2012 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 13974930 | Aug 2013 | US |
Child | 15295560 | US |