1. Field of the Invention
This invention relates to medical implants and more particularly to porous load-bearing implants for use with humans and animals.
2. Description of the Relayed Art
Metal and ceramic implants are widely used to replace missing or damaged biological structures, such as bone or tissue. One problem with current orthopedic implants, particularly with metal hip stem implants, is the large difference in the modulus of elasticity of the metal implant compared to that of the cortical bone into which it is implanted. The much stiffer metal tends to bear the majority of the stresses applied to the hip, producing a “stress shielding” effect. This leaves the bone comparatively unstressed, causing it to deteriorate and resorb into the body, a process known as “disuse atrophy.” This condition also weakens the interface between the implant and the bone, resulting in aseptic loosening. In addition to the significant pain this may produce, this condition may eventually create a need for painful and costly revision surgery.
To make the modulus of elasticity of an implant closer to that of bone, the use of foamed metal has been suggested as one possible solution. Foamed metals, compared to their solid counterparts, typically have a reduced modulus of elasticity as a result of their porous structure. This modulus of elasticity will typically continue to decrease as the metal's porosity increases. Nevertheless, one of the undesirable properties of foamed metals or other porous materials is the reduction in strength and increase in brittleness that may occur as porosity increases. This decreased strength makes porous materials a relatively poor candidate for use in load-bearing implants, such as hip stem implants.
In view of the foregoing, what are needed are porous metal and ceramic load-bearing implants that have a reduced modulus of elasticity while still retaining the strength necessary for load-bearing applications. Further needed are systems and methods for precisely designing the pore structure of such implants to achieve a desired strength and flexibility. Ideally, by properly designing the pore structure, an implant could be engineered to mimic the strength, stiffness, and modulus of natural bone. Such a pore structure may be further designed to promote bone ingrowth or deliver beneficial agents such as bone growth factors or other medicaments around the implant.
The present invention has been developed in response to the present state of the art, and in particular, in response to the problems and needs in the art that have not yet been fully solved by currently available apparatus and methods. Accordingly, an apparatus and method has been developed for processing an implant. In one embodiment, the process allows the adjusting of the modulus of elasticity of metal and ceramic implants to more closely mimic that of natural bone.
In one embodiment in accordance with the invention, a method for processing an implant and adjusting the modulus of elasticity, flexural strength, or porosity of metal and ceramic implants includes providing a green tape comprising metal or ceramic particles, or a combination thereof, for incorporation into a solid implant structure. Apertures are cut in selected regions of the green tape in order to create a desired pore or aperture structure in the solid implant structure. This pore structure may be designed to give the solid implant structure a desired modulus of elasticity. The green tape may then be layered in an orientation that will provide the desired pore structure and the metal and/or ceramic particles and layers may be fused together to create the solid implant structure.
In selected embodiments, the apertures may be cut in the green tape by laser cutting, etching, mechanical cutting, burning, or the like. In selected embodiments, the apertures may be elongated apertures. The elongated apertures may, in certain embodiments, be oriented to have a desired directional anisotropy. Similarly the pore structure created by the apertures may include a network of interconnected pores or closed pores. In certain embodiments, the pore structure may be characterized by a pore density that varies between an outer surface and a core of the solid implant structure.
To fuse the ceramic and/or metal particles together to create a solid implant structure, the method may also include pressing the layered green tape together to form a laminated structure, firing the laminated structure to burn off organic materials in the laminated structure, and sintering the laminated structure. If desired, the pore structure of the resulting solid implant structure may be infiltrated with beneficial agents to assist with bone ingrowth, healing, osteoconduction, osteointegration, drug delivery, or the like.
In another aspect of the invention, an implant in accordance with the invention may include a solid implant structure having multiple layers fused together. These layers include metal or ceramic particles, or a combination thereof, fused together. The layers are provided with apertures cut therein to provide a desired pore structure in the solid implant structure. This pore structure may be designed to provide a desired modulus of elasticity to the solid implant structure.
In certain embodiments, the apertures may be elongated apertures. These elongated apertures may or may not be oriented to have a desired directional anisotropy. Similarly, the pore structure created by the apertures may include a network of interconnected or closed pore. These pores may be characterized by a pore density that varies between an outer surface and a core of the solid implant structure. In selected embodiments, these pores may be infiltrated with beneficial agents for delivery to the body around the implant.
The present invention relates to apparatus and methods for adjusting the modulus of elasticity of metal and ceramic implants to more closely mimic that of natural bone. The features and advantages of the present invention will become more fully apparent from the following description and appended claims, or may be learned by the practice of the invention as set forth hereinafter.
In order that the advantages of the invention will be readily understood, a more particular description of the invention briefly described above will be rendered by reference to specific embodiments illustrated in the appended drawings. Understanding that these drawings depict only typical embodiments of the invention and are not therefore to be considered limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings, in which:
It will be readily understood that the components of the present invention, as generally described and illustrated in the Figures herein, could be arranged and designed in a wide variety of different configurations. Thus, the following more detailed description of the embodiments of apparatus in accordance with the present invention, as represented in the Figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of certain examples of presently contemplated embodiments in accordance with the invention. The presently described embodiments will be best understood by reference to the drawings, wherein like parts are designated by like numerals throughout.
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As shown, one embodiment of a hip implant 10 for performing hip replacement surgery may include a hip ball 12 connected to a stem 14. The hip ball 12 may fit into a liner 16 which may in turn be inserted into a metal shell 18 which is anchored to a recipient's pelvis. The stem 14, on the other hand, is inserted into the recipient's femur. The hip ball 12 is typically constructed of metal or ceramic while the liner 16 may be typically made of polyethylene, metal, or ceramic.
To provide sufficient strength, the stem 14 is typically constructed of metal. As previously mentioned, one problem with this metal construction is the large difference in modulus of elasticity of the metal compared to that of cortical bone. This creates a “stress shielding” effect that leaves the bone comparatively unstressed, causing it to deteriorate and resorb into the body. This condition may result in aseptic loosening by weakening the interface between the implant 10 and the bone. Another disadvantage of metal implants is their tendency to reflect x-rays or radio waves, which impairs postoperative radiographic evaluation of the implant 10.
To modify the stem's modulus of elasticity to more closely mimic that of natural bone, a pore structure 20 may be incorporated into the implant 10 to change the stem's modulus of elasticity. Unlike the random pore structure of foamed materials, this pore structure 20 may be carefully designed to retain much of the strength required by the implant while still improving the implant's modulus of elasticity. Ideally, this will reduce stress shielding and aseptic loosening that is characteristic of many current implants. Furthermore, by properly sizing the pores 20, the pore structure may also provide an improved bond between the stem 14 and the femur by promoting bone ingrowth into the pores 10. In certain embodiments, pores 20 having a size between about 0.1 μm and about 600 μm may be suitable for promoting bone ingrowth. In one embodiment, the average approximate diameter of the pores 20 is between about 0.1 μm and about 600 μm. In this specification, pore and aperture may be used interchangeably. In some instances, an aperture is an opening in the green tape and a pore or pore structure is the result of connecting apertures in adjacent layers of green tape.
In certain embodiments, the pores 20 may be formed to have different shapes, sizes, and orientations, to provide desired characteristics to the implant 10. For example, the pores 20 may, in certain embodiments, be elongated and oriented to have a substantially unidirectional anisotropy. This configuration may decrease the modulus of elasticity of the stem 14 in a lateral direction 24 while preserving much of the stem's load-bearing capacity in a longitudinal direction 22. In one embodiment, a width of the longitudinal pores is between about 0.1 μm and about 600 μm. In another embodiment, a length of the longitudinal pores is between about 0.1 μm and about 600 μm. The density and length of the pores 20 may also be varied along the length of the implant 10 to vary the modulus of elasticity or strength of the stem 14 at different locations. For example, a neck 26 of the implant 10 may have few if any pores to retain the material's stiffness in that region and because stress shielding in that area may be of little concern.
In other embodiments, elongated pores 20 may be designed to have a varying directional anisotropy. For example, as shown in
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An initial step of a method 50 in accordance with the invention may include providing 52 a ceramic or metal powder, or mixture thereof, such as one of the powders listed above. This powder may then be mixed 54 with an aqueous or non-aqueous solvent to form a mixture. In one embodiment, the mixture is a paste. Suitable solvents may include but are not limited to water, methanol, acetone, ethanol, isopropyl alcohol, butanol, toluene, xylene, hexanol, methyl ethyl ketone (MEK), hexane, or mixtures thereof. In certain embodiments, the solvent may comprise about two to ninety percent of the total volume. In other embodiments, water may comprise about ten to sixty percent of the total volume. In still other embodiments, water may comprise about twenty to twenty-five percent of the total volume.
In selected embodiments, a suitable dispersant may be added 56 to provide a lower viscosity suspension if desired. Suitable dispersants may include, for example, ammonium polymethacrylate (Darvan), polymethyl methacrylate (PMMA), glycerol, polyvinyl butyral (PVB), polyvinyl alcohol (PVA), or other suitable dispersants known to those of skill in the art. In some cases, the dispersant may comprise about 0.001 to about 10 percent of the total weight of the mixture. A suitable anti-foaming agent may also be added 58 to create a non-foaming suspension if desired. Such anti-foaming agents may include, for example, Triton® X-100. In some instances, the anti-foaming agent may comprise about 0.001 to about 10 percent of the total weight.
After a homogeneous mix is obtained, binders and plasticizers may be added 60 to the mixture. Suitable binders and plasticizers may include, for example, PVA, PVB, Santicizer® 160, dibutyl phthalate (DBP), glycerol, or the like. In selected embodiments, the binder may comprise about 0.01 to about 25 percent of the total weight. Similarly, a plasticizer may comprise about 0.01 to about 25 percent of the total weight.
If a random pore structure, such as that illustrated in
The foregoing steps may be used to prepare a final homogeneous suspension or slip. The slip may then be cast 64 into thin sheets by spreading the slip onto a substrate to create a film. Suitable substrates may include, for example, surfaces of glass, plastic, wood, metal, Mylar®, paper, or the like. The slip may then be spread manually, such as using a doctor blade, or in an automated process using a table-top, research, or production-type tape caster or by using other methods known to those of skill in the art. In selected embodiments, the thickness of the wet film may vary between about 0.001 mm and 100 mm. In other embodiments, the thickness may vary between about 0.01 mm and 0.1 mm. The wet film may then be dried 64 at a temperature ranging from about 0° C. to about 100° C. in an open lab (i.e., at room temperature), a temperature controlled oven, or in the heating zone of an automated tape caster.
After drying 64, the film may then be removed from the substrate and apertures 32 may be cut 66 into the dry green tape. These apertures 32 may be cut using a wide variety of techniques including but not limited to laser cutting, etching, mechanical cutting, and burning. For example, mechanical cutting may be performed by manual or automated operation of a blade, punch, drill bit, or other cutting device. A laser cutter may be used to provide additional accuracy. The apertures 32 may be cut in any shape or size, and may be produced as patterns of identical or mixed shapes. In certain embodiments, the aspect ratio of the apertures may range from about 0.001 to about 1000. In other embodiments, the aspect ratio of the apertures may range from about 20 to about 500.
Once the apertures 32 are formed, the green tape may be layered 68 (i.e., stacked and oriented) to create a desired pore structure. The layered tape may then be subjected to a process wherein they are fused together. The fusing step may include laminating the layers of green tape. The fusing step may also include firing or sintering the layers of green tape. In one embodiment, the fusing step includes sintering laminated layers of green tape. When fusing includes pressing 70 the layers together to form a laminated structure, the pressure applied may, in certain embodiments, range from about 1 PSI to about 150,000 PSI. The pressure applied may also be tailored to the specific materials used, the pore size, density, and shape within the laminated structure, the final shape of the laminated structure, or the like. In selected embodiments, pressing 70 may occur at a temperature between about 0° C. and 100° C.
After pressing, the laminated structure may then be subjected 72 to an organic bum-out cycle to remove all or a substantial part of the organic constituents in the tape, including but not limited to the pore-forming agents discussed above. In certain embodiments, the organic burn-out temperature may range from about 20° C. to about 1000° C. After this bum-out process 72 is complete, the structure may be fired 74 at higher temperatures to achieve a desired strength. In certain embodiments, these firing or sintering temperatures may range from about 100° C. to about 2300° C.
Once firing is complete, the user if left with a hardened load-bearing implant structure having the desired pore structure. As previous mentioned, this pore structure may, in certain embodiments, create channels or cavities in the implant structure. This pore structure or channel structure or cavity structure may be used to control or adjust the modulus of elasticity, the flexural strength, or the porosity of the implant structure.
If desired, these channels or cavities may be infiltrated 76 with one or more beneficial agents for delivery to the body upon implantation. Such beneficial agents may be used, for example, to prevent or reduce infection or inflammation, or to promote bone ingrowth, healing, osteoconduction, osteointegration, drug delivery, or the like. Beneficial agents may include but are not limited to bone growth factors, bone morphogenic proteins, hydroxyapatite, tricalcium phosphate, osteoconducting elements and compounds, collagen fibers, blood cells, bone cements, osteoblast cells, antibiotic agents, anti-bacterial agents, anti-inflammatory agents, cancer drugs, pain-relieving drugs, and the like.
The following are several non-limiting examples of implant structures created using a method 50 in accordance with the invention:
In a first example, ceramic alumina powder is mixed with water with the powder comprising about twenty to twenty-five percent of the total volume. A dispersant comprising less than one percent of the total weight is added to the mixture. PVA and glycerin are added to the mixture in a ratio of about 2:1 to obtain a final slip. This slip is then tape cast to a thickness of about 10 mils (0.01 inches) and dried to obtain a flexible tape. The tape is then laser cut to obtain channels like those illustrated in
In a second example, ceramic perovskite powder is mixed with toluene-ethanol mixtures with the ceramic powder comprising about forty to fifty percent of the total volume. A dispersant comprising less than one percent of the total weight is added to the mixture. PVB and Santicizer® 160 are added to the mixture in a ratio of about 2:1 to obtain a final slip. This slip is then tape cast to a thickness of about 10 mils (0.01 inches) and dried to obtain a flexible tape. The tape is then laser cut to obtain channels in the tape. The individual laser cut sheets are then stacked and laminated at a pressure of less than about 10,000 PSI at 60° C. The green laminated structure is then fired to between about 1200° C. to 1500° C. to obtain a fired component that has a tailored pore structure built into the device.
The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.
This application claims priority to U.S. Provisional Patent No. 60/738,202 filed on Nov. 18, 2005 and entitled POROUS METAL AND CERAMIC IMPLANTS FOR LOAD BEARING APPLICATIONS AND DRUG DELIVERY.
Number | Date | Country | |
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60738202 | Nov 2005 | US |