WO2002017820A1 - Materiau de fixation poreux pour cellules - Google Patents
Materiau de fixation poreux pour cellules Download PDFInfo
- Publication number
- WO2002017820A1 WO2002017820A1 PCT/NL2001/000589 NL0100589W WO0217820A1 WO 2002017820 A1 WO2002017820 A1 WO 2002017820A1 NL 0100589 W NL0100589 W NL 0100589W WO 0217820 A1 WO0217820 A1 WO 0217820A1
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- WO
- WIPO (PCT)
- Prior art keywords
- attachment material
- foam
- metal
- cells
- layer
- Prior art date
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
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- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00035—Other metals or alloys
- A61F2310/00131—Tantalum or Ta-based alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00179—Ceramics or ceramic-like structures
- A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
- A61F2310/00203—Ceramics or ceramic-like structures based on metal oxides containing alumina or aluminium oxide
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00179—Ceramics or ceramic-like structures
- A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
- A61F2310/00239—Ceramics or ceramic-like structures based on metal oxides containing zirconia or zirconium oxide ZrO2
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00407—Coating made of titanium or of Ti-based alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
- A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
Definitions
- the present invention relates to a porous attachment material for cells, in particular bone (cells) , comprising a foam which is metallized with a biocompatible metal or metal alloy, the attachment material having interconnected pores .
- An attachment material of this type is known, for example from United States Patent US-A-5, 282, 861. This known attachment material is used as a replacement material for spongy (cancellous) bone and/or to receive cells and tissue, since it has a structure which resembles spongy bone of this type, which promotes bone (in) growth.
- This attachment material is produced by using a chemical vapour deposition method to deposit a biocompatible metal or metal- alloy, in particular tantalum or alloys thereof, on a substrate with a foam structure which is produced, for example, from carbon, graphite or ceramic material. Tantalum is used because it has long been known to have favourable properties for use as an implant material both for bone and tissue.
- This known attachment material is lightweight, strong, has a porous structure resembling the microstructure which is present in natural spongy bone and acts as a matrix for receiving bone, as well as providing permeability and a high specific surface area to promote the ingrowth of new bone.
- an insert e.g. from PE
- the required shape is applied to the implant by further machining operations of the product prior or after compression moulding. This further machining causes struts having an open end to be present, which can raise toxicity problems due to exposure of the bone to carbon.
- the X-ray permeability of tantalum is relatively weak, which causes diagnostic examination after surgery to be difficult.
- the foam is a non-carbonized polyurethane foam or polyether foam.
- foam have a network structure of interconnected pores which can be produced reproducibly.
- the use of these types of foam for the production of the porous attachment material according to the invention allows metallization techniques which are quicker than CVD to be used. Consequently, the total production costs of the attachment material according to the invention are lower than those of the attachment material according to the above prior art.
- the network structure of polyurethane foam and that of polyether foam allows the quantity of metal which is deposited to be controlled accurately, so that the porous attachment material according to the invention can also be produced in relatively flexible embodiments .
- This flexibility allows easy deformation of the attachment material according to the invention.
- the pore structure of polyurethane foam and that of polyether foam resemble the network structure of the pores in spongy bone, which promotes the growth of cells. It is also possible to control the pore structure of the foam.
- Polyurethane is preferred to polyether foam with a view to reproducibility.
- the dimensions of the interconnected pores of the attachment material preferably lie in the range from 50-1000 micrometers.
- the porosity is preferably in the range from 50-96%.
- the attachment material has a gradual change in porosity from low porosity, such as 50% or more, for example 70%, to high porosity, such as 96%, as seen in the thickness direction of the attachment material.
- a gradual change in porosity of this nature leads to a gradual transition between the natural bone and the implant in which the attachment material is used, the side of the attachment material with the highest porosity facing towards the bone and the side with the lowest porosity, which has a relatively dense attachment surface, adjoining, by way of example, a solid section of a prosthesis.
- the side with the high porosity can be deformed better and therefore adapted to the adjoining bone. At the moment of use during implantation, therefore, there is a large contact area between bone and attachment material and optimum conditions for bone (in) growth are created.
- the attachment material comprises a dense, non-porous surface layer of the biocompatible metal or metal alloy adjoining the side of low porosity.
- the attachment material comprises a dense, non-porous surface layer of the biocompatible metal or metal alloy adjoining the side of low porosity.
- there is a solid surface layer of biocompatible material on one side of the attachment material offering a good attachment surface for a solid part of a prosthesis, for example a prosthesis socket which is made from plastic.
- the biocompatible metal or metal alloy is preferably selected from the group consisting of Ti, TiNb, TiV, Ta, TaNb, CoCr, CoCrMo and stainless steel, alloys and combinations thereof. Titanium and titanium alloys, such as for example T16A14V are preferred, on account of their proven biocompatibility, as well as their commercial acceptance.
- the thickness of the porous attachment material is dependent on its use.
- the thickness of the attachment material is of the order of magnitude of up to 20 mm for cages used in the spinal column, while for other positions and functions the thickness is usually of the order of magnitude of 0.3-4 mm.
- the attachment material according to the invention may be provided in its pores with an additional upper layer of a calcium- containing and/or phosphate-containing material.
- HA hydroxyapatite
- fluoroapatite fluoroapatite
- TCP tricalcium phosphate
- OCP octocalcium phosphate
- brushite a precursor of HA
- calcium carbonate and the like, which further improve the biocompatibility properties of the attachment material according to the invention.
- Agents which stimulate bone growth, angiogenesis-stimulating agents, antibacterial agents and/or anti-inflammatories may also be provided in the pores in order to accelerate the growth process of the cells and to prevent infections .
- a second aspect of the invention provides a method for producing a porous attachment material for cells, in particular bone (cells) , in which a biocompatible metal or metal alloy is applied to the pore walls of a foam, the foam having interconnected pores, which method according to the invention is characterized in that a plastic foam which is selected from a non-carbonized polyurethane foam or polyether foam is used.
- the attachment material may be produced using a multistage process, in which case in a first step a thin, first starting layer of metal or metal alloy is deposited by means of a physical vapour deposition (PVD) process, and in a second step a thicker layer of the biocompatible metal or metal alloy is deposited by means of an accelerated deposition process, in particular physical vapour deposition processes, such as HS-PVD (high-speed PVD) or LPPS (low- pressure plasma spraying) or EB-PVD.
- PVD physical vapour deposition
- the layer thickness of the thin, first starting layer which is deposited using conventional PVD is preferably of the order of magnitude of a few ⁇ m to a few tens of ⁇ m, usually of the order of magnitude of at least 5 ⁇ m.
- the method according to the invention is preferably carried out as a single-step process, in which the full layer thickness is applied in one operation and in which the settings of a HS-PVD device used for this purpose are adjusted during the process in such a way that a lower energy level is used at the start, in order not to adversely affect the structure of the polyurethane foam, while after a sufficient thickness and strength has been reached the energy level is increased.
- the initial metal deposit is applied at a low temperature, while after a certain thickness of the metal deposit has been achieved the temperature may be raised and accordingly the deposition rate can be increased.
- the initial metal deposit protects the foam structure against deterioration.
- the manufacturing method advantageously comprises a finishing step, wherein a thin layer of a metal or metal alloy, preferably titanium of its alloys, is applied by electroplating.
- a thin layer of a metal or metal alloy preferably titanium of its alloys
- an ectroplated finishing layer has an improved smoothness compared to a surface layer deposited by PVD.
- a thin, first starting layer of metal or metal alloy is deposited by means of a physical vapour deposition process, and in a second step a thicker layer of metal or metal alloy, preferably titanium or its alloys, is electroplated.
- growth of the initial skeleton and application of a finishing layer is combined.
- a pyrolysis step may be carried out before or after the second step.
- the invention provides an implant which is characterized in that at least a section thereof comprises a porous attachment material according to the invention, as described above.
- implants include, inter alia, a total hip prosthesis, comprising both the femur and acetabulum components, a total knee prosthesis, comprising both the femur and tibia components, a shoulder prosthesis, a finger prosthesis, cages
- the attachment material according to the invention may be attached to a solid metal part, for example in the shape of a shell, in which a polyethylene insert is immovably positioned, for example by means of diffusion welding or electroplating. Unlike in the prior art, in which the insert is fixedly joined to the attachment material by means of compression moulding, in an implant according to the invention the insert may be exchangeable.
- the desired strength of the attachment material according to the invention is partly determined by its use. By way of example, the tensile and compressive strengths of trabecular bone are on average 10 MPa.
- the structure of the porous attachment material according to the invention which does not inherently have a self-regenerating capacity, will have to be stronger than the adjoining bone.
- the adhesion material according to the invention for load-bearing applications preferably has a tensile strength of more than 20 MPa, a compressive strength of more than 20 MPa, a shearing stress of more than 7 MPa and a Young's modulus of elasticity of 1 GPa.
- a further aspect of the invention relates to a method for the in-vitro culturing of cells, in particular bone cells, on a substrate in a culture medium, in which a substrate comprising biocompatible material has a foam structure of interconnected pores, and wherein a load is applied periodically or continuously to the substrate.
- the substrate may be produced from any biocompatible material, provided that it has a structure of interconnected pores.
- the substrate used is a porous attachment material according to the invention, as described above.
- cells for example bone marrow or cartilage cells, are cultured in a suitable liquid culture medium which contains the required growth substances, on the substrate.
- the substrate may be contacted with a reciprocating brush or roller which exerts a stress on the substrate.
- the cell material obtained can be processed further in various ways.
- the cell material formed can be removed from the substrate and be introduced immediately into the patient. In this variant, the reproducibility of the network structure of the pores is less important.
- the cell material formed may also be implanted together with the substrate, in which case the preferred embodiments of the attachment material according to the invention which have been discussed above are advantageously employed for the substrate.
- the invention provides a porous attachment material for cells, in particular bone (cells) , which attachment material comprises a foam of interconnected pores of a biocompatible material, which is characterized in that the attachment material has a gradual change from low porosity, for example of 50% or more, such as 70%, to a high porosity, such as 96%, as seen in the thickness direction.
- this gradual change offers a gradual transition between bone and implant, of which the attachment material forms part.
- the section of low porosity of 50% is provided with a dense, non-porous surface layer of the biocompatible material.
- Fig. 1 diagrammatically depicts an example of a prosthesis in cross section, in which an attachment material according to the invention is present at various locations; and Fig. 2 shows a detail from Fig. 1.
- Fig. 1 shows a diagrammatic cross section through a prosthesis, for example a hip or knee prosthesis, which is denoted overall by reference numeral 10, while natural bone is denoted by reference numeral 12.
- a head 14 of the prosthesis 10 is solid and consists of a biocompatible metal or ceramic, for example CoCrMo, A1 2 0 3 or yttrium- stabilized zirconia.
- a support part 16 for the head 14 is provided with a layer of attachment material 18 according to the invention.
- the support part 16 comprises an insert 20 of attachment material according to the invention, which functions as bone substitute, for example when removing a damaged joint surface.
- a socket 22 of the prosthesis has a layered structure and comprises, from the inside outwards, a polyethylene layer 24, which is in contact with the solid head 14, and a layer 26 of attachment material according to the invention.
- the layered structure is illustrated in more detail in Fig. 2, using the same reference numerals for the same components.
- the surface 28 of the attachment layer 26 is provided with a dense surface layer 29 (illustrated in black) and therefore provides a good attachment surface for the polyethylene or ceramic insert 24.
- the attachment layer 26 has a network structure of interconnected pores, in which the porosity is graduated, from 65% in the vicinity of the surface 28 to 95% on the surface 30 which comes into contact with the bone 12.
- the starting material used was a commercially available PU foam with an average of 63 pores per inch and with pore dimensions in the range from 400-500 micrometers.
- the thickness of the PU foam was on average 2 mm.
- the PU foam was provided in one step with a titanium layer with a layer thickness of 50 micrometers, using conventional PVD. Then, the plastic foam matrix was removed by pyrolysis. By means of a heat treatment under reducing conditions, the titanium foam obtained was brought to its primary ductility. The foam obtained in this way was a flexible attachment material for bone cells which was also eminently suitable as a substrate for the in-vitro culturing of cells.
- Another piece of the same PU foam was provided, by means of conventional PVD, with a thin layer of titanium with a thickness of 5 micrometers, after which a heat treatment was used to remove the PU matrix by means of pyrolysis, and the titanium foam obtained was brought to its primary ductility by means of a heat treatment. By means of a physical vapour deposition method using HS-PVD, the layer thickness was increased to 50 ⁇ m.
- the titanium foam thus produced had a porosity, which changed gradually from 65% to 95% on the side closest to the target.
- the separate pyrolysis step may be omitted.
- the temperature of the substrate is raised in such a way that pyrolysis occurs automatically.
- a finishing layer of titanium can be applied by electroplating in order to improve the surface properties of the foam thus produced.
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- Health & Medical Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Epidemiology (AREA)
- Medicinal Chemistry (AREA)
- Dermatology (AREA)
- Inorganic Chemistry (AREA)
- Engineering & Computer Science (AREA)
- Vascular Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dispersion Chemistry (AREA)
- Materials For Medical Uses (AREA)
Abstract
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2001294342A AU2001294342A1 (en) | 2000-08-29 | 2001-08-02 | Porous attachment material for cells |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
NL1016040 | 2000-08-29 | ||
NL1016040A NL1016040C2 (nl) | 2000-08-29 | 2000-08-29 | Poreus aanhechtingsmateriaal voor cellen, werkwijze voor de vervaardiging daarvan, alsmede toepassingen. |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2002017820A1 true WO2002017820A1 (fr) | 2002-03-07 |
Family
ID=19771971
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/NL2001/000589 WO2002017820A1 (fr) | 2000-08-29 | 2001-08-02 | Materiau de fixation poreux pour cellules |
Country Status (3)
Country | Link |
---|---|
AU (1) | AU2001294342A1 (fr) |
NL (1) | NL1016040C2 (fr) |
WO (1) | WO2002017820A1 (fr) |
Cited By (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1344537A1 (fr) * | 2002-02-08 | 2003-09-17 | Howmedica Osteonics Corp. | Echafaudage métallique poreux pour la colonisation tissulaire |
FR2883755A1 (fr) * | 2005-03-29 | 2006-10-06 | Urodelia Sa | Materiau implantable destine a etre colonise par un tissu, notamment un tissu osseux, et procede de fabrication de ce materiau |
WO2007016902A2 (fr) * | 2005-08-06 | 2007-02-15 | M.Pore Gmbh | Implant metallique-spongieux et son procede de production |
WO2008122596A2 (fr) * | 2007-04-05 | 2008-10-16 | Cinvention Ag | Composition d'implant thérapeutique durcissable |
WO2008122595A2 (fr) * | 2007-04-05 | 2008-10-16 | Cinvention Ag | Implant thérapeutique biodégradable pour réparation osseuse ou cartilagineuse |
EP1872745A3 (fr) * | 2006-06-30 | 2010-10-06 | Howmedica Osteonics Corp. | Resurfaçage de la tête fémorale |
WO2012065068A1 (fr) * | 2010-11-11 | 2012-05-18 | Zimmer, Inc. | Implant orthopédique présentant une surface polymérique poreuse de contact osseux |
EP2517663A1 (fr) * | 2006-08-22 | 2012-10-31 | Mitsubishi Electric Corporation | Appareil de traitement laser, procédé osséo-intégration, matériau d'implant et procédé de fabrication de matériau implant |
CN102861357A (zh) * | 2012-10-11 | 2013-01-09 | 四川大学 | 一种仿生牙种植体及其制备方法 |
FR2986961A1 (fr) * | 2012-02-20 | 2013-08-23 | Michel Brax | Implant orthopedique et procede pour fabriquer un tel implant orthopedique |
US8608801B2 (en) * | 2008-07-06 | 2013-12-17 | The Trustees Of Columbia University In The City Of New York | Osteochondral implants, arthroplasty methods, devices, and systems |
DE102014206151A1 (de) * | 2014-04-01 | 2015-10-01 | Waldemar Link Gmbh & Co. Kg | Implantatverbindung |
US9949837B2 (en) | 2013-03-07 | 2018-04-24 | Howmedica Osteonics Corp. | Partially porous bone implant keel |
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EP1344537A1 (fr) * | 2002-02-08 | 2003-09-17 | Howmedica Osteonics Corp. | Echafaudage métallique poreux pour la colonisation tissulaire |
US7458991B2 (en) | 2002-02-08 | 2008-12-02 | Howmedica Osteonics Corp. | Porous metallic scaffold for tissue ingrowth |
US7740795B2 (en) | 2002-02-08 | 2010-06-22 | Howmedica Osteonics Corp. | Porous metallic scaffold for tissue ingrowth |
FR2883755A1 (fr) * | 2005-03-29 | 2006-10-06 | Urodelia Sa | Materiau implantable destine a etre colonise par un tissu, notamment un tissu osseux, et procede de fabrication de ce materiau |
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EP2517663A1 (fr) * | 2006-08-22 | 2012-10-31 | Mitsubishi Electric Corporation | Appareil de traitement laser, procédé osséo-intégration, matériau d'implant et procédé de fabrication de matériau implant |
WO2008122595A2 (fr) * | 2007-04-05 | 2008-10-16 | Cinvention Ag | Implant thérapeutique biodégradable pour réparation osseuse ou cartilagineuse |
WO2008122595A3 (fr) * | 2007-04-05 | 2009-08-06 | Cinv Ag | Implant thérapeutique biodégradable pour réparation osseuse ou cartilagineuse |
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WO2008122596A2 (fr) * | 2007-04-05 | 2008-10-16 | Cinvention Ag | Composition d'implant thérapeutique durcissable |
US8608801B2 (en) * | 2008-07-06 | 2013-12-17 | The Trustees Of Columbia University In The City Of New York | Osteochondral implants, arthroplasty methods, devices, and systems |
WO2012065068A1 (fr) * | 2010-11-11 | 2012-05-18 | Zimmer, Inc. | Implant orthopédique présentant une surface polymérique poreuse de contact osseux |
US8998987B2 (en) | 2010-11-11 | 2015-04-07 | Zimmer, Inc. | Orthopedic implant with porous polymer bone contacting surface |
FR2986961A1 (fr) * | 2012-02-20 | 2013-08-23 | Michel Brax | Implant orthopedique et procede pour fabriquer un tel implant orthopedique |
WO2013124577A1 (fr) * | 2012-02-20 | 2013-08-29 | Brax Michel | Implant orthopedique et procede pour fabriquer un tel implant orthopedique |
US9724199B2 (en) | 2012-02-20 | 2017-08-08 | Michel Brax | Orthopaedic implant and method for manufacturing such an orthopaedic implant |
JP2015511842A (ja) * | 2012-02-20 | 2015-04-23 | ブラクス ミシェル | 整形外科用インプラント及び整形外科用インプラントの製造方法 |
AU2013223905B2 (en) * | 2012-02-20 | 2017-06-22 | Michel BRAX | Orthopaedic implant and method for producing such an orthopaedic implant |
CN102861357A (zh) * | 2012-10-11 | 2013-01-09 | 四川大学 | 一种仿生牙种植体及其制备方法 |
CN102861357B (zh) * | 2012-10-11 | 2014-06-11 | 四川大学 | 一种仿生牙种植体及其制备方法 |
US9949837B2 (en) | 2013-03-07 | 2018-04-24 | Howmedica Osteonics Corp. | Partially porous bone implant keel |
USD967960S1 (en) | 2013-03-07 | 2022-10-25 | Howmedica Osteonics Corp. | Porous tibial implant |
US11564801B2 (en) | 2013-03-07 | 2023-01-31 | Howmedica Osteonics Corp. | Partially porous tibial component |
DE102014206151A1 (de) * | 2014-04-01 | 2015-10-01 | Waldemar Link Gmbh & Co. Kg | Implantatverbindung |
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NL1016040C2 (nl) | 2002-03-01 |
AU2001294342A1 (en) | 2002-03-13 |
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