Method and apparatus for use of porous implants

Information

  • Patent Grant
  • 8266780
  • Patent Number
    8,266,780
  • Date Filed
    Wednesday, February 27, 2008
    16 years ago
  • Date Issued
    Tuesday, September 18, 2012
    12 years ago
Abstract
An orthopedic implant. The implant includes a metal portion having an internal three-dimensional cavity, the cavity having an opening to an outer surface of the metal portion, a ledge circumferentially surrounding at least a portion of the opening, and a porous metal insert formed in a three-dimensional shape conforming to the shape of the cavity and enclosed by the cavity without being bonded to the cavity. The insert is retained inside the cavity by the ledge.
Description
INTRODUCTION

Porous coated implants have been used to promote biologic fixation of surrounding bony tissue. In one example, porous material may be coated on an exterior surface of a prosthetic implant to encourage ingrowth of surrounding bone into the pore spaces of the porous material. Typically, the porous coating may comprise stainless steel, titanium, titanium alloys, tantalum, cobalt-chromium alloys, ceramics, polymers and other materials that are suited for use in a biocompatible environment. Various joining methods have been employed to attach the porous coating to a desired prosthetic implant. For example, soldering, brazing, adhesive joining, laser welding, diffusion bonding, metallurgic bonds and mechanical joining have been shown to suitably attach the porous material to a desired implant.


SUMMARY

The present teachings provide an orthopedic implant. The implant includes a metal portion having an internal three-dimensional cavity, the cavity having an opening to an outer surface of the metal portion, a ledge circumferentially surrounding at least a portion of the opening, and a porous metal insert formed in a three-dimensional shape conforming to the shape of the cavity and enclosed by the cavity without being bonded to the cavity. The insert is retained inside the cavity by the ledge.


The present teachings provide a method for attaching a porous metal insert to a substrate. The method includes forming a three-dimensional cavity in the substrate, the cavity having a first dimension along a first axis, the cavity defining an opening to an outer surface of the substrate, the opening having a second dimension along the first axis, the first dimension greater than the second dimension. The method further includes forming a porous metal insert having a three-dimensional shape mateable with the cavity and a third dimension along the first axis greater than the second dimension, cooling the insert below ambient temperature until the third dimension is equal or smaller than the second dimension, inserting the insert through the opening, and retaining the insert in the cavity by the ledge upon return to ambient temperature.


In another aspect, the method includes cooling a three-dimensional porous metal insert below ambient temperature, reducing at least a first dimension of the insert, and inserting the cooled metal insert through an opening into a three-dimensional cavity of a metal substrate, the opening having a second dimension parallel to the first dimension of the insert. The method further includes returning the metal insert to ambient temperature, returning the first dimension to a length greater than the second dimension, and retaining the metal insert in the cavity of the substrate.


Further areas of applicability of the present teachings will become apparent from the description provided hereinafter. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present teachings.





BRIEF DESCRIPTION OF THE DRAWINGS

The present teachings will become more fully understood from the detailed description and the accompanying drawings, wherein:



FIG. 1A is a perspective view of an exemplary porous insert according to the present teachings;



FIG. 1B is a perspective view of an exemplary porous insert according to the present teachings;



FIG. 1C is a perspective view of an exemplary porous insert according to the present teachings;



FIG. 1D is a perspective view of an exemplary porous insert incorporating a metal framework according to the present teachings;



FIG. 1E is a perspective view of a pair of exemplary porous inserts each having a metal framework and shown interconnected through a carrier in a manufacturing process according to the present teachings;



FIG. 2 is a perspective view of an exemplary substrate prepared for receiving a porous insert according to the present teachings;



FIG. 3 is a perspective view of an exemplary insert for attachment to the substrate of FIG. 2;



FIG. 4 is a perspective view of the insert of FIG. 3 shown attached to the substrate of FIG. 2;



FIG. 5 is a sectional view of FIG. 4 taken along axis 5-5;



FIG. 5A is a sectional view of a porous insert in a metal substrate according to the present teachings; and



FIG. 6 is a perspective view of a porous insert being implanted into a femoral implant according to the present teachings.





DESCRIPTION OF VARIOUS ASPECTS

The following description is merely exemplary in nature and is in no way intended to limit the present teachings, applications, or uses. For example, although the present teachings are illustrated for particular applications, the present teachings can be used for any orthopedic procedures in which porous inserts are used. Moreover, while variously metal inserts are illustrated, the inserts and theirs applications are merely exemplary.


Referring to FIGS. 1A-1E, various exemplary porous metal inserts or augments 100 according to the present teachings are illustrated. In general, the porous metal inserts illustrated in FIGS. 1A-1C comprise a uniform porous metal material or block 102. The porous metal insert 100 of FIG. 1A has a semi-circular shape. The porous metal insert 100 of FIG. 1B includes an integral retaining structure in the form of tapered sidewalls. The porous metal insert 100 of FIG. 1C includes apertures 104 formed therethrough. The apertures 104 may be used for attachment purposes for securing the insert 100 at a desired location, or for securing items to the insert 100.


The porous metal inserts illustrated in FIGS. 1D and 1E comprise a uniform porous metal block 102 captured within a solid metal framework 110. The framework 110 is adapted to provide additional strength to the insert 100. The framework 110 can be arranged exclusively on an outboard surface of the porous metal block 102, exclusively within the porous metal block 102 or as a combination. The insert 100 illustrated in FIG. 1E includes a series of interconnected frameworks 110, posts 112 and a carrier 114 constructed in a preliminary manufacturing step. The framework 110 may additionally or alternatively comprise wall surfaces.


The porous metal inserts 100 shown in FIGS. 1A-1E can be employed in cooperation with an implantable prosthesis and provide a suitable surface area for encouraging ingrowth of natural bone and/or soft tissue. In addition, the porous metal inserts 100 may be adapted to provide mechanical strength in a load-bearing application, or simply be employed as filler in cooperation with various prosthesis components. In this way, the porous metal inserts 100 can be load-bearing in applications having compression, tension, cantilever, static or dynamic loads. In other aspects, the porous metal inserts 100 can be used as an anchoring devices to facilitate bone fixation or healing in which the bone may be subjected to compression, tension or other loads. Additional porous metal inserts having various structures and features and various exemplary applications are described in co-pending and commonly assigned patent application Ser. No. 11/294,692, filed on Dec. 5, 2005, and Ser. No. 11/111,123 filed on Apr. 21, 2005, the disclosures of which are incorporated by reference herein.


According to the present teachings, the porous metal used in the inserts 100 can include stainless steel, titanium, titanium alloys, cobalt-chromium alloys and other materials that are suited for use in a biocompatible environment such as disposed on an implantable bone prosthesis, including Regenerex™, a porous titanium construct manufactured from Ti-6Al-4V alloy and commercially available from Biomet, Inc., of Warsaw, Ind. A method for making a porous metal implant is disclosed in co-pending and commonly assigned patent application Ser. No. 11/357,929, filed Feb. 17, 2006, the disclosure of which is incorporated by reference herein.


In one method of making the porous metal, a sponge material can be utilized as a template. The sponge material may be naturally occurring sponge, such as sponge found in the ocean, or alternatively, an artificial sponge, such as a synthetic polymer sponge. The sponge material can then be coated or saturated with fine metal particles. Next, the sponge material coated with the fine metal particles can be subjected to heat. Exposure to heat causes the sponge to melt away leaving the porous metal block 102. At this point, the porous metal block may be implanted as is, or placed within a solid metal framework (such as framework 110 shown in FIGS. 1D and 1E). It is appreciated that the framework 104 may be arranged around the sponge material prior to the melting away of the sponge. Likewise, the sponge material may provide a uniform or non-uniform pattern.


In another aspect, anti-infective agents (i.e. antibiotics), osteoconductive agents (i.e., hydroxyapatite), autologous blood products activated by thrombin to induce clots (i.e., blood, platelet rich plasma, autologous stem cells derived from any location within the body), hydrogels, either alone or containing autologous or allogenic cells, peptides, or other biologically active ingredients that induce or aide bone formation (i.e., bone morphogenic proteins) may be added and/or infiltrated to the porous metal of the implants, inserts, anchors and/or bone screws disclosed herein. Further, the porous metal structures described herein may also act as a carrier for bulk allograft or demineralized bone matrix products. Other growth promoters can be added and/or infiltered to the porous material of the implants, inserts, anchors and bone screws described herein to promote appropriate soft or hard tissue response, ingrowth or attachment.


According to another method of making the inserts 100, a laser can be utilized to contour a block of suitable material into a desired shape. As discussed above, a suitable material may comprise stainless steel, titanium, titanium alloys, cobalt-chromium alloys and other materials that are suited for use in a biocompatible environment such as disposed on an implantable bone prosthesis. In one implementation, a computer can be used to design the desired geometry and properties of the insert. In one method, a bone scan may be performed to create a mathematical model. Another method is by way of computer aided design software. Once the model has been created in the computer, the computer can communicate with the laser to remove or melt away portions of material in the block to reproduce the computer model. In one implementation, this process may be used to create the framework 110. A subsequent step requires the porous material 102 to be placed within the framework 110. In another implementation, this process may be used to create the framework 110 and the porous material 102 simultaneously. In such a method, the laser would be utilized to melt identified portions of material to a desired consistency which, when solidified would provide the porous material 102.


In another method of making the inserts 100, sections or layers of material are cut out of sheets of metal and stacked. The stacked layers can be subsequently joined by a joining process such as by welding, sintering or diffusion bonding. During a welding operation, the framework and the porous material 102 may be oppositely charged, by which a uniform melt may occur between touching surfaces. The material utilized is similar with those mentioned above. The sheets may be cut by any suitable method such as by laser, machined or other process. It is appreciated that this method may be used to create a framework, such as framework 110. A subsequent assembly step may require the porous material 102 to be placed within the framework 110. It is contemplated, however, that the framework 110 and the porous material 102 may be defined concurrently during the creation of each layer.


With reference now to FIG. 1E, the insert 100 can include a series of interconnected frameworks 110, posts 112, and a carrier 114 constructed in a preliminary step. The carrier 114 and posts 112 are used to create a casting. The porous material 102 is then located into the outer frameworks 110 through outer passages 116 defined by the frameworks 102. The intermediate framework 110 (without the porous material 102) along with the carrier 114 and posts 112 are subsequently removed leaving a pair of standalone frameworks 110 having porous material 102 contained therein. Alternatively, the intermediate framework 110 may comprise porous material therein. In another example, the collective series of frameworks 110 can be removed from the carrier 114 and posts 112 and subsequently left as a unitary component rather than being disconnected from each other.


In one exemplary method, the porous material 102 is located within the frameworks 110 as a secondary step. In this implementation, the temperature of the frameworks 110 is raised to a temperature that is below the melting point of the frameworks but enough to cause the frameworks 110 to expand. Additionally or alternatively, the temperature of the porous material 102 is reduced to cause the porous material 102 to contract. Once the desired geometries have been obtained, the porous material 102 is passed through the passages 116 on the frameworks 110. Once the frameworks 110 and the porous material 102 returns to ambient temperature, the porous material 102 has too large of an outer dimension to pass through the passage 116 of the frameworks 110. As a result, the porous material 102 is captured within the frameworks 110.


In another exemplary method, the porous material 102 and the frameworks 110 are initially at ambient temperature. The porous material 102 is then press-fit through the passages 116 of the frameworks 110. Next, the entire assembly of the insert 100 is heated to a temperature that causes the contact surfaces of the porous material 102 and frameworks 110 to weld together. Once the assembly of the insert 100 returns to ambient temperature, the porous material 102 remains secured to the frameworks 110.


Referring to FIGS. 2-5, of method of attaching a porous metal augment or insert 100 to a substrate 200 according to the present teachings is illustrated. In one exemplary application, the porous metal insert 100 can be made of porous titanium and the substrate 200 can be made of nonporous or solid metal such as CoCrMo, although the present teachings are not limited to these materials, as discussed above. For example, the substrate 200 can also be a porous metal of different material than the insert 100. In another aspect, a coralline or other porous ceramic material can be used for the substrate 200.


The method illustrated in FIGS. 2-5 uses a mechanical junction for attaching the insert 100 to the substrate 200 instead of the alternative methods that use adhesive fixation, interposition of a tertiary material, or direct bonding via heating. In this respect, the use of adhesives can clog the pores of the porous insert 100 and also create additional surface interactions. The use of a tertiary material layer can result in an increase of the thickness of the assembly, or a decrease in the thicknesses of the desired materials, and/or also create unnecessary additional surface interactions. The use of direct bonding of porous metal to a solid substrate requires sufficient heating of the substrate, resulting in a decrease in desired mechanical properties of the substrate 200.


The mechanical junction method traps the porous metal insert 100 in an internal cavity or pocket 202 of the solid substrate 200. Specifically, a three-dimensional cavity 202 can be machined or cast into the solid substrate 200, as shown in FIG. 2. The cavity 202 can be in the form of a blind bore or trough and can be bounded on all sides by the substrate 200, except for an area in the form of an opening 206 communicating with an outer surface 205 of the substrate. In other aspects, the cavity 202 may communicate with an outer surface of the substrate 200 by more than one openings, such as two opposite openings for a through bore, or other openings. The opening 206 can be circumferentially completely or partially surrounded by a retaining ledge 204 of the substrate 200. The opening 206 can have a dimension L1 bounded by the ledge 204 with L1 being smaller than a corresponding dimension L of the cavity 202 along a direction A, as shown in FIG. 5. The cavity 202 can have a three-dimensional shape complementary to the shape of the porous metal insert 100. The mating porous metal insert 100, however, can be slightly too oversized to be received through the opening 206 of the cavity 202 at ambient temperature.


For example, the porous metal insert 100 can have a dimension L2 greater than the corresponding dimension L1 of the opening 206 along the same direction A. The dimension L2 can be approximately equal to the dimension L of the cavity 202, such that the porous metal insert 100 can fit snugly into the cavity 202, although some play may be optionally provided for by making L2 slightly smaller than L. The porous metal insert 100 can be rapidly cooled below ambient temperature to induce the material of the porous metal insert 100 to shrink sufficiently for insertion into the cavity 202 through the opening 206. For example, the porous metal insert 100 can be cooled with liquid nitrogen. Once cooled, the porous metal insert 100 can be pressed into the cavity 202 through the opening 206 of the solid substrate 200. Upon return to ambient temperature, the porous metal material of the insert 100 expands to return to its original size, and the porous metal insert 100 is thereby trapped in the cavity 202 by the retaining ledge 204, as shown in FIGS. 4 and 5.


The ledge 204 can extend over and overlap with a portion of a surface 203 the porous metal insert 100 adjacent to the opening 206 preventing the porous metal insert 100 from sliding out of the opening 206. Further, the ledge 204 can extend only over portion of the perimeter of the porous metal insert 100. In the example illustrated in FIGS. 1-5, the ledge 204 can be formed only along two opposite sides or along all four sides, or over portions of those sides. It will be appreciated that the ledge 204 can have different shapes, sizes and extents, which can be selected according to manufacturing and other considerations, including the ability and ease in retaining the porous metal insert 100. The ledge 204 can be, for example, straight, as shown in FIG. 5, or L-shaped, or angled or curved toward the interior of the cavity 202, or other shapes. In another aspect, and referring to FIG. 5A, a portion 130 of the insert 100 can extend outside the opening 206 and outside the cavity 202, thereby providing a porous metal surface for tissue contact.


Optionally, the solid substrate 200 can also be heated below a critical temperature that does not alter the material properties of the substrate, to cause the substrate 200 to expand, thereby further facilitating insertion of the porous metal insert 100 into the cavity 202. Alternatively, other non thermal methods of changing the dimensions and shape of the substrate 20 and/or insert 100 can be used to allow for assembly of the insert in the substrate. For example, methods of changing kinetic energy can be used. Spinning the substrate 200 at a sufficiently high rate of revolution can cause expansion of the dimensions of the substrate 200 to allow the insert 100 to be received in the cavity 202. As the spinning is reduced and stopped, the substrate 200 shrinks in size, and can cold weld with the insert 100.


Referring to FIG. 6, a method of utilizing a porous metal insert 100 with a bone implant 300 as the substrate is illustrated. The exemplary bone implant 300 shown is a portion of a femoral hip stem. It is appreciated that while the exemplary bone implant 300 is shown as a femoral hip stem, other prosthesis components may similarly be employed. A cylindrical cavity 202 can be manufactured in the prosthesis 300, for example by machining or casting, or other methods. The cavity 202 has an opening 206 to the outer surface 305 of the implant 300. The opening 206 can be partially or fully circumferentially surrounded by a ledge 206. As described above, the porous metal insert 100, which is slightly oversized, is first rapidly cooled so that it can be inserted into the cavity 202 through the opening 206. After insertion, the porous metal insert 100 is allowed to reach ambient temperature. The ledge 204 can overlap a portion of the surface 203 of the porous metal insert 100 adjacent to the opening 206, thereby trapping the porous metal insert 100 into the cavity 202. As discussed above, the exemplary Regenerex™ material possesses an average porosity of about 67 percent, which can corresponds to a greater linear shrinkage of relative to a comparable solid metal material of the substrate 200. For example, immersing the porous metal insert 100 in liquid nitrogen can reduce a linear dimension L2 of about 0.5 inches by about 0.001-0.002 inches, or by about 4-8%.


It will be appreciated that the porous metal insert 100 and the cavity 202 formed in the substrate can have various three-dimensional shapes, including cylindrical, prismatic, parallelepiped, cubical, spherical, ovoid, or other shapes.


The foregoing discussion discloses and describes merely exemplary arrangements of the present teachings. One skilled in the art will readily recognize from such discussion, and from the accompanying drawings and claims, that various changes, modifications and variations can be made therein without departing from the spirit and scope of the present teachings as defined in the following claims.

Claims
  • 1. A method for attaching a metal insert to a substrate, the method comprising: providing a substrate that comprises an implantable orthopedic component of nonporous metal;forming a three-dimensional cavity defined by inner walls of the substrate, the cavity having a first dimension along a first axis, the cavity defining an opening to an outer surface of the substrate, the opening at least partially bounded by a ledge and having a second dimension along the first axis, the first dimension greater than the second dimension wherein the inner walls include side walls and a closed end wall, the closed end wall having a surface that faces the opening;forming a porous metal insert having a three-dimensional shape mateable with the cavity and a third dimension along the first axis greater than the second dimension, the porous metal insert having a porous metal outer surface configured to encourage ingrowth of soft tissue;cooling the insert below ambient temperature until the third dimension is equal or smaller than the second dimension;inserting the insert through the opening; andretaining the insert in the cavity by the ledge upon return to ambient temperature wherein the porous metal outer surface of the porous metal insert engages at least the closed end wall of the inner walls of the substrate.
  • 2. The method of claim 1, wherein the cavity and the insert are cylindrical.
  • 3. The method of claim 1, wherein the cavity and the insert are prismatic.
  • 4. The method of claim 1, wherein forming the cavity further comprises machining the cavity into the substrate.
  • 5. The method of claim 1, wherein forming the cavity further comprises casting the cavity into the substrate.
  • 6. The method of claim 1, wherein the ledge circumscribes the entire opening.
  • 7. The method of claim 1, wherein the cavity is a blind bore.
  • 8. The method of claim 1 wherein the porous metal insert is formed entirely of porous material.
  • 9. The method of claim 1 wherein the porous metal insert is uniformly porous.
  • 10. The method of claim 9 wherein an entirety of the porous metal insert is retained within the cavity.
  • 11. A method for attaching a porous metal insert to a metal substrate, the method comprising: providing a metal substrate that is a solid metal portion of an orthopedic implant;cooling a three-dimensional porous metal insert below ambient temperature, the porous metal insert having a porous metal outer surface configured to encourage ingrowth of soft tissue;reducing at least a first dimension of the insert;inserting the cooled metal insert through an opening into a three-dimensional cavity defined by inner walls of the metal substrate, the opening having a second dimension parallel to the first dimension of the insert wherein the inner walls include side walls and a closed end wall, the closed end wall having a surface that faces the opening;returning the metal insert to ambient temperature;returning the first dimension to a length greater than the second dimension; andretaining the metal insert in the cavity of the substrate wherein the porous metal outer surface of the porous metal insert engages at least the closed end wall of the inner walls of the metal substrate.
  • 12. The method of claim 11, further comprising machining the cavity into the substrate.
  • 13. The method of claim 11, further comprising casting the cavity into the substrate.
  • 14. The method of claim 11, wherein cooling the insert further comprises immersing the insert in liquid nitrogen.
  • 15. The method of claim 11, wherein cooling the insert comprises reducing a linear dimension of the insert by about 4-8%.
  • 16. The method of claim 11, further comprising heating the substrate.
  • 17. The method of claim 11 wherein the porous metal insert is uniformly porous.
  • 18. The method of claim 11 wherein the porous metal insert is formed entirely of porous material.
  • 19. The method of claim 18 wherein an entirety of the porous metal insert is retained within the cavity.
  • 20. A method for attaching a metal insert to a substrate, the method comprising: providing an orthopedic implant that comprises a substrate formed of nonporous metal;forming an opening in the substrate, the opening having a first outer dimension along a first axis;forming a cavity defined by inner walls of the substrate, the cavity having a second outer dimension along the first axis, the second outer dimension being greater than the first outer dimension, wherein a retaining ledge is formed on the substrate at a transition between the opening and the cavity wherein the inner walls include side walls and a closed end wall, the closed end wall having a surface that faces the opening;forming a porous metal insert made entirely of porous metal material configured to encourage ingrowth of soft tissue and having a three-dimensional shape mateable with the cavity and a third outer dimension along the first axis greater than the first outer dimension;cooling the insert below ambient temperature until the third outer dimension is equal or smaller than the first outer dimension;inserting the insert through the opening; andretaining the insert in the cavity by the retaining ledge upon return to ambient temperature wherein the porous metal insert engages at least the closed end wall of the inner walls of the substrate.
  • 21. The method of claim 20 wherein the cavity and the insert are cylindrical.
  • 22. The method of claim 20 wherein the cavity and the insert are prismatic.
  • 23. The method of claim 20 wherein forming the cavity further comprises machining the cavity into the substrate.
  • 24. The method of claim 20 wherein forming the opening and the cavity further comprises casting the opening and the cavity into the substrate.
  • 25. The method of claim 20 wherein the ledge circumscribes the entire opening.
  • 26. The method of claim 20 wherein the cavity is a blind bore.
  • 27. The method of claim 20 wherein providing the substrate comprises providing a femoral hip stem.
  • 28. The method of claim 20 wherein retaining the insert in the cavity comprises positioning a portion of the insert at a location that protrudes outside of the opening and beyond the retaining ledge.
  • 29. The method of claim 20, further comprising heating the substrate.
  • 30. The method of claim 20 wherein an entirety of the porous metal insert is retained within the cavity.
CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent application Ser. No. 11/294,692 filed Dec. 5, 2005, which is a continuation-in-part of U.S. patent application Ser. No. 11/111,123 filed on Apr. 21, 2005. This application is related to U.S. patent application Ser. No. 11/357,868 filed Feb. 17, 2006. This application is related to U.S. patent application Ser. No. 11/546,500 filed Oct. 11, 2006. This application is related to U.S. patent application Ser. No. 11/709,549 filed Feb. 22, 2007. The disclosures of the above applications are incorporated herein by reference.

US Referenced Citations (443)
Number Name Date Kind
3353259 Kirkpatrick Nov 1967 A
3579805 Kast May 1971 A
3605123 Hahn Sep 1971 A
3677795 Bokros et al. Jul 1972 A
3808606 Tronzo May 1974 A
3840904 Tronzo Oct 1974 A
3855638 Pilliar et al. Dec 1974 A
3896500 Rambert et al. Jul 1975 A
3905777 Lacroix et al. Sep 1975 A
3906550 Rostoker et al. Sep 1975 A
3938499 Bucalo Feb 1976 A
3986212 Sauer Oct 1976 A
4051559 Pifferi et al. Oct 1977 A
4164794 Spector et al. Aug 1979 A
4168326 Broemer et al. Sep 1979 A
4184213 Heimke et al. Jan 1980 A
4187559 Grell et al. Feb 1980 A
4205400 Shen et al. Jun 1980 A
4206271 Norling et al. Jun 1980 A
4217666 Averill Aug 1980 A
4224698 Hopson Sep 1980 A
4234972 Hench et al. Nov 1980 A
4285070 Averill Aug 1981 A
4285071 Nelson et al. Aug 1981 A
4307472 Morris Dec 1981 A
4309488 Heide et al. Jan 1982 A
4330891 Branemark et al. May 1982 A
4345339 Muller et al. Aug 1982 A
4351069 Ballintyn et al. Sep 1982 A
4355428 Deloison et al. Oct 1982 A
4362681 Spector et al. Dec 1982 A
4479271 Bolesky et al. Oct 1984 A
4542539 Rowe, Jr. et al. Sep 1985 A
4563778 Roche et al. Jan 1986 A
4566138 Lewis et al. Jan 1986 A
4570271 Sump Feb 1986 A
4612160 Donlevy et al. Sep 1986 A
4636219 Pratt et al. Jan 1987 A
4644942 Sump Feb 1987 A
4659331 Matthews et al. Apr 1987 A
4666450 Kenna May 1987 A
4685923 Mathys et al. Aug 1987 A
4693721 Ducheyne Sep 1987 A
4715859 Schelhas et al. Dec 1987 A
4715860 Amstutz et al. Dec 1987 A
4743256 Brantigan May 1988 A
4743262 Tronzo May 1988 A
4750905 Koeneman et al. Jun 1988 A
4756862 Spector et al. Jul 1988 A
4769041 Morscher et al. Sep 1988 A
4778473 Matthews et al. Oct 1988 A
4778474 Homsy Oct 1988 A
4795469 Oh Jan 1989 A
4801301 Noiles Jan 1989 A
4813959 Cremascoli et al. Mar 1989 A
4828565 Duthoit et al. May 1989 A
4840632 Kampner Jun 1989 A
4842606 Kranz et al. Jun 1989 A
4851006 Tuke et al. Jul 1989 A
4854496 Bugle Aug 1989 A
4863474 Brown et al. Sep 1989 A
4863475 Andersen et al. Sep 1989 A
4863538 Deckard Sep 1989 A
4871368 Wagner et al. Oct 1989 A
4883490 Oh Nov 1989 A
4883491 Mallory et al. Nov 1989 A
4892549 Figgie, III et al. Jan 1990 A
4904265 MacCollum et al. Feb 1990 A
4919666 Buchhorn et al. Apr 1990 A
4919675 Dietschi et al. Apr 1990 A
4923473 Griss et al. May 1990 A
4936847 Manginelli Jun 1990 A
4936856 Keller et al. Jun 1990 A
4936861 Muller et al. Jun 1990 A
4944759 Mallory et al. Jul 1990 A
4950270 Bowman et al. Aug 1990 A
4950299 Noiles Aug 1990 A
4955919 Pappas et al. Sep 1990 A
4957819 Kawahara et al. Sep 1990 A
4963154 Anapliotis et al. Oct 1990 A
4969907 Koch et al. Nov 1990 A
4969910 Frey et al. Nov 1990 A
4976738 Frey et al. Dec 1990 A
4978355 Frey et al. Dec 1990 A
4978356 Noiles Dec 1990 A
4978358 Bobyn Dec 1990 A
4997445 Hodorek Mar 1991 A
5004476 Cook Apr 1991 A
5009665 Serbousek et al. Apr 1991 A
5013324 Zolman et al. May 1991 A
5018285 Zolman et al. May 1991 A
5019105 Wiley May 1991 A
5021062 Adrey et al. Jun 1991 A
5021063 Tager et al. Jun 1991 A
5024670 Smith et al. Jun 1991 A
5027998 Bugle Jul 1991 A
5030233 Ducheyne Jul 1991 A
5047182 Sundback et al. Sep 1991 A
5080672 Bellis et al. Jan 1992 A
5080674 Jacobs et al. Jan 1992 A
5080685 Bolesky et al. Jan 1992 A
5084051 Tormala et al. Jan 1992 A
5092897 Forte Mar 1992 A
5096518 Fujikawa et al. Mar 1992 A
5098435 Stednitz et al. Mar 1992 A
5104410 Chowdhary Apr 1992 A
5108432 Gustavson Apr 1992 A
5120175 Arbegast et al. Jun 1992 A
5133764 Pappas et al. Jul 1992 A
5152796 Slamin Oct 1992 A
5152797 Luckman et al. Oct 1992 A
5156626 Broderick et al. Oct 1992 A
5163961 Harwin Nov 1992 A
5167502 Kawahara et al. Dec 1992 A
5176711 Grimes Jan 1993 A
5181928 Bolesky et al. Jan 1993 A
5192329 Christie et al. Mar 1993 A
5198308 Shetty et al. Mar 1993 A
5201766 Georgette Apr 1993 A
5203787 Noblitt et al. Apr 1993 A
5211665 Ku et al. May 1993 A
5226915 Bertin Jul 1993 A
5236457 Devanathan Aug 1993 A
5236462 Mikhail Aug 1993 A
5246530 Bugle et al. Sep 1993 A
5282861 Kaplan Feb 1994 A
5286260 Bolesky et al. Feb 1994 A
5290315 DeCarlo, Jr. Mar 1994 A
5310408 Schryver et al. May 1994 A
5314490 Wagner et al. May 1994 A
5323954 Shetty et al. Jun 1994 A
5326367 Robioneck et al. Jul 1994 A
5326368 Collazo Jul 1994 A
5343877 Park Sep 1994 A
5348788 White Sep 1994 A
5358532 Evans et al. Oct 1994 A
5360448 Thramann Nov 1994 A
5360452 Engelhardt et al. Nov 1994 A
5370692 Fink et al. Dec 1994 A
5370698 Heimke et al. Dec 1994 A
5370702 Jones Dec 1994 A
5370704 DeCarlo, Jr. Dec 1994 A
5370706 Bolesky et al. Dec 1994 A
5376122 Pappas et al. Dec 1994 A
5380325 Lahille et al. Jan 1995 A
5397359 Mittelmeier et al. Mar 1995 A
5405389 Conta et al. Apr 1995 A
5415704 Davidson May 1995 A
5443510 Shetty et al. Aug 1995 A
5443512 Parr et al. Aug 1995 A
5443519 Averill et al. Aug 1995 A
5484539 Tersi et al. Jan 1996 A
5486181 Cohen et al. Jan 1996 A
5496372 Hamamoto et al. Mar 1996 A
5504300 Devanathan et al. Apr 1996 A
5505984 England et al. Apr 1996 A
5507824 Lennox Apr 1996 A
5509933 Davidson et al. Apr 1996 A
5534027 Hodorek Jul 1996 A
5535810 Compton et al. Jul 1996 A
5540713 Schnepp-Pesch et al. Jul 1996 A
5545227 Davidson et al. Aug 1996 A
5549685 Hayes Aug 1996 A
5549691 Harwin Aug 1996 A
5549698 Averill et al. Aug 1996 A
5549701 Mikhail Aug 1996 A
5571187 Devanathan Nov 1996 A
5571194 Gabriel Nov 1996 A
5571198 Drucker et al. Nov 1996 A
5571200 Cohen et al. Nov 1996 A
5571201 Averill et al. Nov 1996 A
5573401 Davidson et al. Nov 1996 A
5591233 Kelman et al. Jan 1997 A
5593451 Averill et al. Jan 1997 A
5609641 Johnson et al. Mar 1997 A
5609645 Vinciguerra Mar 1997 A
5609646 Field et al. Mar 1997 A
5639280 Warner et al. Jun 1997 A
5658338 Tullos et al. Aug 1997 A
5658347 Sarkisian et al. Aug 1997 A
5658348 Rohr, Jr. Aug 1997 A
5665119 Koller et al. Sep 1997 A
5676700 Black et al. Oct 1997 A
5676704 Ries et al. Oct 1997 A
5688453 England et al. Nov 1997 A
5702473 Albrektsson et al. Dec 1997 A
5702477 Capello et al. Dec 1997 A
5702483 Kwong Dec 1997 A
5702487 Averill et al. Dec 1997 A
5723011 Devanathan et al. Mar 1998 A
5723014 Laurent et al. Mar 1998 A
5725587 Garber Mar 1998 A
5728510 White Mar 1998 A
5734959 Krebs et al. Mar 1998 A
5755743 Volz et al. May 1998 A
5755806 Stalcup et al. May 1998 A
5782928 Ries et al. Jul 1998 A
5782929 Sederholm Jul 1998 A
5798308 Chatterjee et al. Aug 1998 A
5824107 Tschirren et al. Oct 1998 A
5824108 Huebner Oct 1998 A
5863295 Averill et al. Jan 1999 A
5871548 Sanders et al. Feb 1999 A
5879398 Swarts et al. Mar 1999 A
5879399 Church et al. Mar 1999 A
5879401 Besemer et al. Mar 1999 A
5879404 Bateman et al. Mar 1999 A
5879405 Ries et al. Mar 1999 A
5888205 Pratt et al. Mar 1999 A
5904720 Farrar et al. May 1999 A
5916268 Schollner et al. Jun 1999 A
5925077 Williamson et al. Jul 1999 A
5926685 Krebs et al. Jul 1999 A
5931870 Cuckler et al. Aug 1999 A
5938702 Lopez et al. Aug 1999 A
5972032 Lopez et al. Oct 1999 A
5976148 Charpenet et al. Nov 1999 A
5981828 Nelson et al. Nov 1999 A
5989293 Cook et al. Nov 1999 A
6008432 Taylor Dec 1999 A
6013104 Kampner Jan 2000 A
6022509 Matthews et al. Feb 2000 A
6042611 Noiles Mar 2000 A
6042612 Voydeville et al. Mar 2000 A
6049054 Panchison et al. Apr 2000 A
6059833 Doets May 2000 A
6063442 Cohen et al. May 2000 A
6066176 Oshida May 2000 A
6087553 Cohen et al. Jul 2000 A
6099529 Gertzman et al. Aug 2000 A
6129765 Lopez et al. Oct 2000 A
6132469 Schroeder Oct 2000 A
6132674 Compton et al. Oct 2000 A
6136029 Johnson et al. Oct 2000 A
6139574 Vacanti et al. Oct 2000 A
6143036 Comfort Nov 2000 A
6143293 Weiss et al. Nov 2000 A
6149689 Grundei et al. Nov 2000 A
6152962 DeCarlo, Jr. Nov 2000 A
6162257 Gustilo et al. Dec 2000 A
6165222 Hoeppner et al. Dec 2000 A
6176879 Reischl et al. Jan 2001 B1
6187050 Khalili et al. Feb 2001 B1
6192272 Fiedler et al. Feb 2001 B1
6193761 Treacy Feb 2001 B1
6197065 Martin et al. Mar 2001 B1
6203844 Park Mar 2001 B1
6206924 Timm Mar 2001 B1
6217620 Park Apr 2001 B1
6228121 Khalili May 2001 B1
6231612 Balay et al. May 2001 B1
6240616 Yan Jun 2001 B1
6253443 Johnson Jul 2001 B1
6273891 Masini Aug 2001 B1
6290726 Pope et al. Sep 2001 B1
6293971 Nelson et al. Sep 2001 B1
6296667 Johnson et al. Oct 2001 B1
6302913 Ripamonti et al. Oct 2001 B1
6306173 Masini Oct 2001 B1
6309546 Herrmann et al. Oct 2001 B1
6312201 Nagaya et al. Nov 2001 B1
6322728 Brodkin et al. Nov 2001 B1
6340370 Willert et al. Jan 2002 B1
6352559 Church et al. Mar 2002 B1
6365092 Backa et al. Apr 2002 B1
6376573 White et al. Apr 2002 B1
6383224 Gie et al. May 2002 B1
6391251 Keicher et al. May 2002 B1
6416553 White et al. Jul 2002 B1
6432142 Kamiya et al. Aug 2002 B1
6443991 Running Sep 2002 B1
6447543 Studer et al. Sep 2002 B1
6447550 Hunter et al. Sep 2002 B1
6454811 Sherwood et al. Sep 2002 B1
6458161 Gibbs et al. Oct 2002 B1
6461385 Gayer et al. Oct 2002 B1
6475243 Sheldon et al. Nov 2002 B1
6488713 Hershberger Dec 2002 B1
6497727 Pope et al. Dec 2002 B1
6506192 Gertzman et al. Jan 2003 B1
6508841 Martin et al. Jan 2003 B2
6520995 Church et al. Feb 2003 B2
6527774 Lieberman Mar 2003 B2
6527807 O'Neil et al. Mar 2003 B1
6527809 Doursounian et al. Mar 2003 B1
6530958 Cima et al. Mar 2003 B1
6537321 Horber et al. Mar 2003 B1
6544472 Compton et al. Apr 2003 B1
6558428 Park May 2003 B2
6572655 Johnson Jun 2003 B1
6585772 Hunter et al. Jul 2003 B2
6592622 Ferguson Jul 2003 B1
6605293 Giordano et al. Aug 2003 B1
6605648 Johnson et al. Aug 2003 B1
6610097 Serbousek et al. Aug 2003 B2
6613093 DeCarlo, Jr. et al. Sep 2003 B2
6620200 Descamps et al. Sep 2003 B1
6621039 Wang et al. Sep 2003 B2
6626947 Lester et al. Sep 2003 B2
6626950 Brown et al. Sep 2003 B2
6641616 Grundei et al. Nov 2003 B1
6645206 Zdeblick et al. Nov 2003 B1
6652586 Hunter et al. Nov 2003 B2
6660040 Chan et al. Dec 2003 B2
6660224 Lefebvre et al. Dec 2003 B2
RE38409 Noiles Jan 2004 E
6676704 Pope et al. Jan 2004 B1
6676892 Das et al. Jan 2004 B2
6682566 Draenert et al. Jan 2004 B2
6682567 Schroeder Jan 2004 B1
6686437 Buchman et al. Feb 2004 B2
6695884 Townley Feb 2004 B1
6696073 Boyce et al. Feb 2004 B2
6709462 Hanssen Mar 2004 B2
6725901 Kramer et al. Apr 2004 B1
6726723 Running Apr 2004 B2
6726725 Hunter et al. Apr 2004 B2
6740186 Hawkins et al. May 2004 B2
6758864 Storer et al. Jul 2004 B2
6770099 Andriacchi et al. Aug 2004 B2
6783551 Metzger et al. Aug 2004 B1
6800094 Burkinshaw Oct 2004 B2
6811569 Afriat et al. Nov 2004 B1
6827742 Hayes, Jr. et al. Dec 2004 B2
6840960 Bubb Jan 2005 B2
6866685 Chan et al. Mar 2005 B2
6869447 Lee et al. Mar 2005 B2
6896703 Barbieri et al. May 2005 B2
6908486 Lewallen Jun 2005 B2
6916342 Frederick et al. Jul 2005 B2
6923833 Wasielewski Aug 2005 B2
6926740 Lewis et al. Aug 2005 B2
6945448 Medlin et al. Sep 2005 B2
6981991 Ferree Jan 2006 B2
7141073 May et al. Nov 2006 B2
7147819 Bram et al. Dec 2006 B2
7156880 Evans et al. Jan 2007 B2
7166133 Evans et al. Jan 2007 B2
7189263 Erbe et al. Mar 2007 B2
7192448 Ferree Mar 2007 B2
7351371 Nelles et al. Apr 2008 B2
20010011190 Park Aug 2001 A1
20010013166 Yan Aug 2001 A1
20010030035 Oda Oct 2001 A1
20020016635 Despres et al. Feb 2002 A1
20020040245 Lester et al. Apr 2002 A1
20020062154 Ayers May 2002 A1
20020068980 Serbousek et al. Jun 2002 A1
20020071827 Peterson et al. Jun 2002 A1
20020123750 Eisermann et al. Sep 2002 A1
20020139504 Klein Oct 2002 A1
20020143403 Vaidyanathan et al. Oct 2002 A1
20020151983 Shetty Oct 2002 A1
20020197178 Yan Dec 2002 A1
20030001282 Meynen et al. Jan 2003 A1
20030013989 Obermiller et al. Jan 2003 A1
20030033020 Hunter et al. Feb 2003 A1
20030049299 Malaviya et al. Mar 2003 A1
20030050703 Harris et al. Mar 2003 A1
20030050705 Cueille et al. Mar 2003 A1
20030069639 Sander et al. Apr 2003 A1
20030074079 McTighe et al. Apr 2003 A1
20030083741 Woo et al. May 2003 A1
20030105529 Synder et al. Jun 2003 A1
20030111752 Wood et al. Jun 2003 A1
20030114936 Sherwood et al. Jun 2003 A1
20030135281 Hanssen Jul 2003 A1
20030144741 King et al. Jul 2003 A1
20030144742 King et al. Jul 2003 A1
20030153981 Wang et al. Aug 2003 A1
20030153982 Pria Aug 2003 A1
20030155686 Hawkins et al. Aug 2003 A1
20030163202 Lakin Aug 2003 A1
20030171818 Lewallen Sep 2003 A1
20030200837 Matsuura et al. Oct 2003 A1
20030220696 Levine et al. Nov 2003 A1
20030232124 Medlin et al. Dec 2003 A1
20030236573 Evans et al. Dec 2003 A1
20040054418 McLean et al. Mar 2004 A1
20040054421 McLean Mar 2004 A1
20040064192 Bubb Apr 2004 A1
20040072010 Date et al. Apr 2004 A1
20040083004 Wasielewski Apr 2004 A1
20040088038 Dehnad et al. May 2004 A1
20040098127 Charlebois et al. May 2004 A1
20040102854 Zhu May 2004 A1
20040109853 McDaniel Jun 2004 A1
20040122521 Lee et al. Jun 2004 A1
20040126265 Takiguchi Jul 2004 A1
20040126583 Nakamura et al. Jul 2004 A1
20040137218 Liu et al. Jul 2004 A1
20040166340 Cairns et al. Aug 2004 A1
20040172137 Blaylock et al. Sep 2004 A1
20040186553 Yan Sep 2004 A1
20040199258 Macara Oct 2004 A1
20040199260 Pope et al. Oct 2004 A1
20040210316 King et al. Oct 2004 A1
20040225369 Lakin et al. Nov 2004 A1
20040225371 Roger Nov 2004 A1
20040229029 Bowles et al. Nov 2004 A1
20040238410 Inoue et al. Dec 2004 A1
20040243133 Materna Dec 2004 A1
20050004677 Johnson Jan 2005 A1
20050004678 Richards Jan 2005 A1
20050004680 Saladino et al. Jan 2005 A1
20050010303 Nogier Jan 2005 A1
20050025656 Bhaduri et al. Feb 2005 A1
20050031704 Ahn Feb 2005 A1
20050032025 Bhaduri et al. Feb 2005 A1
20050033298 Hawkes et al. Feb 2005 A1
20050035052 Kelly et al. Feb 2005 A1
20050048193 Li et al. Mar 2005 A1
20050049713 Garber et al. Mar 2005 A1
20050060040 Auxepaules et al. Mar 2005 A1
20050065307 King et al. Mar 2005 A1
20050065604 Stoll Mar 2005 A1
20050071015 Sekel Mar 2005 A1
20050085820 Collins et al. Apr 2005 A1
20050085915 Steinberg Apr 2005 A1
20050087915 Pope et al. Apr 2005 A1
20050090905 Hawkins et al. Apr 2005 A1
20050100470 Lefebvre et al. May 2005 A1
20050107883 Goodfried et al. May 2005 A1
20050149199 Steinberg Jul 2005 A1
20050171614 Bacon Aug 2005 A1
20050184134 Charlebois et al. Aug 2005 A1
20050234559 Fernandez et al. Oct 2005 A1
20050242162 Medlin et al. Nov 2005 A1
20050246032 Bokros et al. Nov 2005 A1
20060002810 Grohowski, Jr. Jan 2006 A1
20060003179 Wang et al. Jan 2006 A1
20060018942 Rowe et al. Jan 2006 A1
20060241776 Brown et al. Oct 2006 A1
20060241781 Brown et al. Oct 2006 A1
20070021838 Dugas et al. Jan 2007 A1
20070129809 Meridew et al. Jun 2007 A1
20070150068 Dong et al. Jun 2007 A1
20070173948 Meridew et al. Jul 2007 A1
20070196230 Hamman et al. Aug 2007 A1
20070243312 Bulko Oct 2007 A1
20070250175 Meridew et al. Oct 2007 A1
20070264152 Zhao Nov 2007 A1
20090084491 Uthgenannt et al. Apr 2009 A1
Foreign Referenced Citations (35)
Number Date Country
2404214 Aug 1974 DE
3130732 May 1983 DE
3205526 Sep 1983 DE
8612735 Mar 1989 DE
41 33 433 May 1993 DE
19726961 Nov 1998 DE
0214885 Mar 1987 EP
0378928 Jul 1990 EP
0538987 Apr 1993 EP
0551794 Jul 1993 EP
0577179 Jan 1994 EP
0612509 Aug 1994 EP
0648478 Apr 1995 EP
0 807 426 Nov 1997 EP
0806921 Nov 1997 EP
0985386 Mar 2000 EP
1082949 Mar 2001 EP
1 236 450 Sep 2002 EP
1312323 May 2003 EP
1 384 456 Jan 2004 EP
1421918 May 2004 EP
1430856 Jun 2004 EP
2 148 322 Mar 1973 FR
2775586 Sep 1999 FR
2803740 Jul 2001 FR
2001247 Jan 1979 GB
WO-9218069 Oct 1992 WO
WO-9613233 May 1996 WO
WO-9623459 Aug 1996 WO
WO-0038598 Jul 2000 WO
WO-0170141 Sep 2001 WO
WO-0207652 Jan 2002 WO
WO-2004069107 Aug 2004 WO
WO-2004080340 Sep 2004 WO
WO-2006007861 Jan 2006 WO
Related Publications (1)
Number Date Country
20080147187 A1 Jun 2008 US
Continuation in Parts (2)
Number Date Country
Parent 11294692 Dec 2005 US
Child 12038570 US
Parent 11111123 Apr 2005 US
Child 11294692 US