WO2002098307A1 - Dispositif permettant l'apport d'un medicament a un os fracture - Google Patents

Dispositif permettant l'apport d'un medicament a un os fracture Download PDF

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Publication number
WO2002098307A1
WO2002098307A1 PCT/AU2002/000482 AU0200482W WO02098307A1 WO 2002098307 A1 WO2002098307 A1 WO 2002098307A1 AU 0200482 W AU0200482 W AU 0200482W WO 02098307 A1 WO02098307 A1 WO 02098307A1
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WO
WIPO (PCT)
Prior art keywords
fixation device
bone
bone fixation
bisphosphonate
bisphosphonic acid
Prior art date
Application number
PCT/AU2002/000482
Other languages
English (en)
Inventor
David Graham Little
Original Assignee
The Royal Alexandra Hospital For Children
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The Royal Alexandra Hospital For Children filed Critical The Royal Alexandra Hospital For Children
Publication of WO2002098307A1 publication Critical patent/WO2002098307A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/866—Material or manufacture
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/66—Phosphorus compounds
    • A61K31/662—Phosphorus acids or esters thereof having P—C bonds, e.g. foscarnet, trichlorfon
    • A61K31/663—Compounds having two or more phosphorus acid groups or esters thereof, e.g. clodronic acid, pamidronic acid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7291—Intramedullary pins, nails or other devices for small bones, e.g. in the foot, ankle, hand or wrist
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
    • 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
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
    • 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
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
    • A61F2002/0086—Special surfaces of prostheses, e.g. for improving ingrowth for preferentially controlling or promoting the growth of specific types of cells or tissues
    • 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
    • A61F2310/0097—Coating or prosthesis-covering structure made of pharmaceutical products, e.g. antibiotics

Definitions

  • the present invention relates to a drug for use in bone healing. More specifically, the present invention relates to the use of bisphosphonates to increase the amount of healing bone around a fracture when delivered to the region of a fracture by a fixation device.
  • bisphosphonates While most commonly used for the prevention of bone resorption, bisphosphonates have recently been noted to promote bone growth and fracture repair. Research has shown that intravenous bisphosphonates increase the rate of bone formation in distraction osteogenesis. Administration of oral bisphosphonates may also be effective.
  • intravenous and oral administration of the drug may be effective, it may also be useful in certain circumstances to provide a local or regional dose of bisphosphonate at and around the fracture site rather than administering the drug systemically.
  • the present invention aims to provide a delivery system for bisphosphonates which enables a therapeutically effective amount of a bisphosphonate to be delivered to a desired regional site of bone.
  • the present invention consists in a bone fixation device, the device including a body containing or coated with a drug selected from the group consisting of at least one bisphosphonate.
  • the drug is free to move from within or on the body of the device to a position outside the body of the device.
  • the bone fixation device may be a screw or a number of screws with or without a plate member.
  • the bone fixation device is made from a material including, but not limited to, stainless steel, a titanium alloy or any other biocompatible metal.
  • the fixation device maybe made from a bioresorbable material such as polyglycolide (PGA), poly-(L-lactide), poly (D,L-lactide) (PLA) or another biocompatible polymer.
  • PGA polyglycolide
  • PLA poly-(L-lactide)
  • the bisphosphonate may be admixed with the material of the fixation device and delivered to the bone as the fixation device is resorbed thereby releasing the bisphosphonate.
  • a metal device is coated with a layer of bioresorbable material containing a bisphosphonate.
  • the screw or screws may contain a therapeutically effective amount of a bisphosphonate.
  • the external surface of the screws may be coated with the at least one bisphosphonate or, alternatively, each screw may include a receptacle member such as a hollow interior, compartment or groove or grooves to house the at least one bisphosphonate.
  • the screw(s) may further include an opening or other such structure such as a series of apertures which extend from the receptacle member to an outer surface of the screw(s) such that the at least one bisphosphonate may be released from within the screw to the surrounding bone.
  • the opening may be sealed with a resorbable material that breaks down upon placement of the device in a patient's body.
  • the entire body of the device may be sealed with a resorbable material that breaks down upon placement of the device in a patient's body.
  • the plate of the fixation device contains the at least one bisphosphonate.
  • the plate may also be coated with the bisphosphonate or include some other structure to hold the bisphosphonate prior to its release into the fractured bone.
  • the bone fixation device of the invention comprises an intramedullary device.
  • An example of such a device includes, but is not limited to, an intramedullary nail.
  • the fixation device may further comprise an external fixation pin or wire, useful in fractures, osteotomies or arthrodeses managed with external fixation devices.
  • the external fixation pin or wire may also promote bone formation in distraction osteogenesis by providing regional delivery of a bisphosphonate to the bone undergoing distraction.
  • the fixation device includes threaded or smooth Kirshner wires wherein the bisphosphonate is deposited on the surface of the wire, or in grooves or hollows of the wires.
  • the at least one bisphosphonate is zoledronic acid ⁇ 1-hydroxy-2-[(1 H-imidazol-1-yl)ethylidine] bisphosphonic acid ⁇ .
  • the at least one bisphosphonate may include, but is not limited to, any one of the following: pamidronate ⁇ 3-amino-1-hydroxypropylidene bisphosphonic acid ⁇ ; alendronate ⁇ 4-amino-1- hydroxybutylidene bisphosphonic acid ⁇ ; etidronate ⁇ 1-hydroxyethylidene bisphosphonic acid ⁇ ; clodronate ⁇ dichloromethylene bisphosphonic acid ⁇ ; risedronate ⁇ 2-(3-pyridinyl)-1-hydroxyethylidene bisphosphonic acid ⁇ ; tiludronate ⁇ chloro-4-phenylthiomethylidene bisphosphonic acid ⁇ ; ibandronate ⁇ 1-hydroxy-3(methylpentylamino)-propylidene bisphosphonic acid ⁇ ;
  • EB-1053 1 -hydroxy-3-(1-pyrrolidinyl)-propylidene-1 ,1 -bisphosphonic acid; or any other therapeutically effective bisphosphonate or pharmaceutically acceptable salts or esters thereof.
  • the at least one bisphosphonate is administered in the following doses: zoledronate at 0.0001 to 0.5 mg/kg body weight per dose; pamidronate at 0.0001 to 5.0 mg/kg body weight per dose; ibandronate (ibandronic acid) at 0.0001 to 0.5 mg/kg body weight per dose; risedronate at 0.0001 to 0.5 mg/kg body weight per dose; alendronate at 0.0001 to 5.0 mg/kg body weight per dose; clodronate at 0.0001 to 20 mg/kg body weight per dose; etidronate at 0.0001 to 20 mg/kg body weight per dose; tiludronate at 0.0001 to 5.0 mg/kg body weight per dose; incadronate at 0.0001 to 5.0 mg/kg body weight per dose; minodronate at 0.0001 to 0.5 mg/kg body weight per dose; olpadronate at 0.0001 to 0.5 mg/kg body weight per dose; neridronate at 0.01 to 5.0 mg/
  • EB-153 at from 0.0001 to 5.0 mg/kg body weight per dose.
  • the at least one bisphosphonate may be admixed with other substances or carriers such as gelatin, glycerol, collagen, hyaluonan-based sponges, pads, pastes and gels, chitosan, fibrin, synthetic polymers, calcium sulphate, tricalcium phosphate, hydroxyapatite or other ceramics, and or their combinations to alter the rate at which the bisphosphonate dose is administered to the fractured bone.
  • substances or carriers such as gelatin, glycerol, collagen, hyaluonan-based sponges, pads, pastes and gels, chitosan, fibrin, synthetic polymers, calcium sulphate, tricalcium phosphate, hydroxyapatite or other ceramics, and or their combinations to alter the rate at which the bisphosphonate dose is administered to the fractured bone.
  • the bone fixation device of the present invention may be used to promote union of a fractured bone.
  • the bone fixation device may also be used to promote the fusion of a joint during an arthrodesis procedure, including spinal arthrodesis (spinal fusion).
  • the bone fixation device may be used to promote the union of a bone following an osteotomy procedure.
  • the device may also be used to promote union in a fracture healing slowly (delayed union) or where healing has appreciably ceased (non-union).
  • the bone fixation device may be used to treat a patient suffering from osteonecrosis or osteochondritis dissecans. Furthermore, the device may be used to treat a patient in need of internal fixation because of osteoporosis and the resultant risk of fracture. Alternatively, the patient may be at risk of pathological fracture.
  • the bone fixation device may be used to treat a patient having a pathological fracture secondary to malignant disease.
  • the at least one bisphosphonate contained within or coated on the device would have the advantage of stimulating fracture repair in addition to preventing further resorption due to the malignant process.
  • the bone fixation device may further be used to treat a patient suffering from Paget's disease, fibrous dysplasia, osteofibrous dysplasia, congenital pseudarthrosis, osteogenesis imperfecta or other conditions requiring fixation of a fracture.
  • the bone fixation device may be used prophylactically in a patient who is receiving or has received systemic corticosteroid or other therapy, is an active smoker, intakes large quantities of alcohol or any other substance known to cause osteoporosis and resultant fracture and to interfere with fracture union.
  • the bone fixation device comprises a plate member and a plurality of screws
  • said device may be particularly useful in the promotion of union of fractures of the femur, tibia, fibula, calcaneus, metatarsals, humerus, radius, ulna, metacarpals, maxilla, mandible and cranium, but could be used in any bone where plate fixation is feasible.
  • the screws When used alone, the screws may be used to treat a patient suffering from a fracture of a small bone such as the scaphoid, talus and femoral neck.
  • This embodiment may also be useful for the treatment of fractures of the spine, fractures involving articular surfaces and fractures around the foot and ankle or hand and wrist.
  • the bone fixation device of this embodiment may also be used in the treatment of osteochondritis dissecans.
  • the bone fixation device may be used in the treatment of a patient requiring a spinal or other joint arthrodesis.
  • the bone fixation device may be used to secure the arthrodesis in such a manner as to potentiate the bony healing necessary to accomplish an effective arthrodesis.
  • the bone fixation device may be used in the treatment of a patient requiring an osteotomy.
  • the fixation device may be used to secure the osteotomy in such a manner as to potentiate bony healing of the osteotomy.
  • the bone fixation device of the present invention may be used in humans or alternately in the field of veterinary medicine.
  • the invention consists in a method of promoting union of a fracture in a patient in need of such treatment using the device according to the first aspect of the invention, the method including the steps of:
  • the bone fixation device may be positioned substantially adjacent or across the fracture site or substantially spaced from the fracture site. Furthermore, the bone fixation device may be positioned external the fractured bone or internal the bone.
  • the at least one bisphosphonate is delivered to a sufficient region of bone around the fracture site by diffusion of the drug such that total osteoblastic production of bone is increased in addition to preventing against osteoporosis in the region around the fracture which may result from disuse or from stress shielding by the bone fixation device.
  • the entire dose of bisphosphonate may be delivered early in the course of healing of the fracture, that is, in approximately the first two weeks following the surgical procedure.
  • the entire dose may, however, be delivered in a more prolonged manner in the course of healing of the fracture for example over approximately the first two months.
  • the entire dose may be delivered over approximately one or more years following the fracture.
  • the invention consists in a method of promoting union of an arthrodesis, including a spinal arthrodesis in a patient in need of such treatment using the device according to the first aspect of the invention, the method including the steps of:
  • the invention consists in a method of promoting union of an osteotomy in a patient in need of such treatment using the device according to the first aspect of the invention, the method including the steps of:
  • the invention consists in a method of promoting healing of osteochondritis dissecans in a patient in need of such treatment using the device according to the first aspect of the invention, the method including the steps of: (a) carrying out reduction of the osteochondritic fragment;
  • the invention consists in a method of promoting healing of osteonecrosis in a patient in need of such treatment using the device according to the first aspect of the invention, the method including the steps of:
  • the bisphosphonate As bisphosphonates have a strong affinity for bone mineral, when the at least one bisphosphonate is delivered to a region of bone surrounding a fracture, arthrodesis site, osteotomy site, site of osteochondritis dissecans or site of osteonecrosis, the bisphosphonate should be taken up locally in that region of bone thus minimising the distribution of the bisphosphonate to other regions of the body (ie systemic distribution).
  • the fixation device of the present invention does not include an orthopaedic prosthesis such as a prosthetic joint or dental replacement device wherein the provision of bisphosphonates would enhance securement of the prosthetic device in the surrounding bone.
  • Fig. 1 is a generic formula for one class of bisphosphonates.
  • Fig. 2 is a schematic view of one embodiment of the present invention.
  • Fig. 3 is a schematic view of a further embodiment of the present invention.
  • Fig. 4 is a schematic view of another embodiment of the present invention.
  • the invention relates to the use of a bisphosphonate with the general formula depicted in Figure 1 wherein Ri is varied to give binding and solubility properties to the bisphosphonate and R 2 is varied to give various potencies and other properties to the bisphosphonate.
  • An orthopaedic fixation device according to the present invention is generally depicted in the accompanying drawings as 10.
  • the fixation device 10 includes a central canal 11 which receives a therapeutic dose of bisphosphonate.
  • the side vent holes 12 allow the bisphosphonate to diffuse out of the fixation device 10 and be taken up by the bone in the region of the fixation device 10.
  • the fixation device is preferably positioned sufficiently close to a fracture site to allow for diffusion of the bisphosphonate to said fracture site. Such local or regional administration and binding of the bisphosphonate leads to the prevention of the unwanted bisphosphonate dosing of other areas of the body.
  • the device depicted in Figure 3 is positioned within a fractured scaphoid bone 13.
  • the fixation device 10 comprises a screw 20 which may be countersunk under the articular surface 14.
  • the screw 20 provides compression of the fractured bone.
  • the screw 20 further includes a groove 15 which is adapted to receive and hold a therapeutically effective dose of bisphosphonate.
  • an external surface of screw 20 may be coated with the therapeutically effective amount of bisphosphonate.
  • Scaphoid fractures are known to have a high incidence of delayed union and osteonecrosis. Both these conditions may be ameliorated by the local administration of a bisphosphonate.
  • the fixation device 10 may include a plate 30 having a series of screws 20 dependent therefrom. The screws 20 are drilled into the bone such that both the plate 30 and the screws 20 fix the bone in place.
  • either the plate 30 or the screws 20 may be contain a therapeutic amount of bisphosphonate.
  • both the plate 30 and the screws 20 may contain a therapeutic amount of bisphosphonate.
  • the present experiment uses 20 to 24 -week-old NZW rabbit model.
  • 16 animals were allocated into one of four groups (4 per group) i) Saline (Control) ii) 1 mg pamidronate, delivered via plate (1 mg plate) iii) 8mg pamidronate, delivered via plate (8mg plate) iv) 5mg pamidronate, delivered via cannulated screw (5mg screw)
  • All plates were identical in design, % tubular plates with 7 holes and 55 mm in length, made to fit 2.7mm screws, but also compatible with 3.5 mm screws. Plates were prepared by autoclave sterilisation. For 1 mg plates, a solution of pamidronate 10 mg/ml was prepared and 0.1 ml (1 mg) was distributed on the concave side of the plate. This is the side in direct contact with bone. For 8 mg plate, a solution of pamidronate 25 mg/ml was prepared and 0.3 ml (approx 8mg) was applied to the concave side of the plate. Plates were placed in sterile Petrie dishes and incubated for 12 hrs at 37° C until dry, prior to implantation.
  • Delivery screws were of a special design.
  • a 3.5 mm cortical bone screw had been cannulated with a 1.1 mm hole and a 0.7 mm side vent hole (Fig 1 ). 5mg of pamidronate was placed in the sterile screw immediately prior to surgery.
  • the operative field was prepared by shaving with clippers, disinfected with povidone iodine 4% w/v in 70% alcohol.
  • the tibia was exposed sub-periosteally along its length and a spare plate used as a template to allow pre-drilling and tapping of fixation holes.
  • Drill sites were placed in holes 1 , 2, 4, 6 and 7 (proximal to distal) - holes 3 and 5 were not used as they were close to the planned osteotomies.
  • Two osteotomies were created with a saw and a 10 mm piece of mid-diaphyseal tibia removed and replaced.
  • the designated 7-hole % tubular plate was then attached to the tibia, 2 screws in each large segment and one screw in the de-vascularised central segment. All screws were 2.7mm cortical screws apart from the screw in the second hole, which was 3.5mm.
  • the cannulated screw contained disodium pamidronate powder. Wounds were closed with dissolvable suture and Buprenorphine 0.05 mg/kg was given at the end of surgery and 12 hours post-operatively. Animals were allowed to freely weight bear.
  • the scanner generated data for BMD, BMC, cross sectional area and polar moment of inertia.
  • This experiment looks at the effect of regional bisphosphonate dosing via a delivery device for fracture care.
  • the inventor has previously documented that systemic bisphosphonate delivery can increase the amount, mineral content and strength of callus during bone healing.
  • increases in BMC were noted on the operative side, but also increases in BMC of 1 O%-12% were seen on the non-operative side.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Medicinal Chemistry (AREA)
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  • Bioinformatics & Cheminformatics (AREA)
  • General Chemical & Material Sciences (AREA)
  • Neurology (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Organic Chemistry (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Materials For Medical Uses (AREA)

Abstract

La présente invention se rapporte à un dispositif de fixation d'os, tel qu'une vis, une broche de fixation ou un fil métallique, ledit dispositif comportant un corps contenant ou recouvert d'un médicament sélectionné parmi des biphosphonates. Ce dispositif peut être mis en oeuvre dans une pluralité de procédures visant à accélérer la réparation d'un os, notamment à accélérer la consolidation d'une fracture, à assurer une fixation interne suite à une ostéoporose et à traiter une ostéonécrose ou une ostéochondrite disséquante.
PCT/AU2002/000482 2001-06-07 2002-04-18 Dispositif permettant l'apport d'un medicament a un os fracture WO2002098307A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AUPR5537 2001-06-07
AUPR5537A AUPR553701A0 (en) 2001-06-07 2001-06-07 A device for the delivery of a drug to a fractured bone

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WO2002098307A1 true WO2002098307A1 (fr) 2002-12-12

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Cited By (26)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1365769A1 (fr) * 2001-02-06 2003-12-03 The Royal Alexandra Hospital for Children Medicament destine au traitement de l'osteonecrose et a la gestion de patients etant predisposes a l'osteonecrose
WO2005009496A1 (fr) * 2003-07-31 2005-02-03 Bioretec Oy Dispositif d'implant multifonctionnel
EP1508343A1 (fr) * 2003-08-21 2005-02-23 ASPENBERG, Per Vilhelm implant revêtu de bisphosphonate et son procédé de fabrication
WO2005074944A1 (fr) * 2004-02-10 2005-08-18 Abiogen Pharma S.P.A. Utilisation de neridronate de sodium pour favoriser une nouvelle formation osseuse
WO2007048263A2 (fr) 2005-10-27 2007-05-03 Nexilis Ag Implant et procede de fabrication
US7255713B2 (en) 2003-12-18 2007-08-14 Malek Michel H Systems and methods for agent delivery
US7527611B2 (en) 2003-07-15 2009-05-05 Spinal Generations, Llc Method and device for delivering medicine to bone
US7575572B2 (en) 2003-07-15 2009-08-18 Spinal Generations, Llc Method and device for delivering medicine to bone
WO2009121935A2 (fr) * 2008-04-04 2009-10-08 Novartis Ag Composition pharmaceutique avec du bisphosphonate
US7608062B2 (en) 2003-07-15 2009-10-27 Spinal Generations, Llc Method and device for delivering medicine to bone
US8062270B2 (en) 2003-07-15 2011-11-22 Spinal Generations, Llc Method and device for delivering medicine to bone
CN101549177B (zh) * 2009-05-22 2012-10-10 熊焱昊 一种用于脊柱内固定术螺钉的药物涂层及制备和应用
US8870836B2 (en) 2003-07-15 2014-10-28 Spinal Generations, Llc Method and device for delivering medicine to bone
US8882740B2 (en) 2009-12-23 2014-11-11 Stryker Trauma Gmbh Method of delivering a biphosphonate and/or strontium ranelate below the surface of a bone
US8940320B2 (en) * 2005-10-27 2015-01-27 Thommen Medical Ag Dental implant and production method for said implant
US9005184B2 (en) 2009-09-10 2015-04-14 Woodwelding Ag Device to be implanted in a human or animal body for material or signal delivery or acquisition within the body, and method of implanting the device
CN106086842A (zh) * 2016-08-25 2016-11-09 济南御麟化工科技有限公司 一种金属表面高度生物兼容性涂层及制备方法
KR20160149441A (ko) 2015-06-18 2016-12-28 (주)다림티센 비스포스포네이트를 포함하는 콜라겐 기반의 서방형 ｂｍｐ 전달체 및 이의 제조방법
US9603644B2 (en) 2012-08-07 2017-03-28 Spinal Generations, Llc Methods and devices for delivery of medicine to bone
US9615863B2 (en) 2014-10-22 2017-04-11 Spinal Generations, Llc Multichannel cannula for kyphoplasty and method of use
US9642658B2 (en) 2008-10-15 2017-05-09 Orthoclip Llc Device and method for delivery of therapeutic agents via internal implants
CN108404222A (zh) * 2018-05-25 2018-08-17 湖南早晨纳米机器人有限公司 一种用于硬组织材料的多孔钛基纳米复合材料及其制备方法、应用
US10653470B2 (en) 2014-02-19 2020-05-19 Spinal Generation, LLC Compressible mixing and delivery system for medical substances
CN111658820A (zh) * 2020-05-07 2020-09-15 广州创赛生物医用材料有限公司 一种促进骨再生的可注射水凝胶及其制备方法
US20210205459A1 (en) * 2018-06-01 2021-07-08 The University Of North Carolina At Chapel Hill Injectable thermoresponsive hydrogels as a combinatory modality for controlled drug delivery, biomaterial implant and 3d printing bioink
US11832860B2 (en) 2018-06-22 2023-12-05 University Of Virginia Patent Foundation Bone fixation system for promoting the union of a bone fracture and fusion of bones across a joint space and related methods thereof

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EP1365769A1 (fr) * 2001-02-06 2003-12-03 The Royal Alexandra Hospital for Children Medicament destine au traitement de l'osteonecrose et a la gestion de patients etant predisposes a l'osteonecrose
US7425549B2 (en) 2001-02-06 2008-09-16 The Royal Alexandra Hospital For Children Drug for the treatment of osteonecrosis and for the management of patients at risk of developing osteonecrosis
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US7608062B2 (en) 2003-07-15 2009-10-27 Spinal Generations, Llc Method and device for delivering medicine to bone
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US7527611B2 (en) 2003-07-15 2009-05-05 Spinal Generations, Llc Method and device for delivering medicine to bone
WO2005009496A1 (fr) * 2003-07-31 2005-02-03 Bioretec Oy Dispositif d'implant multifonctionnel
WO2005018699A1 (fr) * 2003-08-21 2005-03-03 Optovent Ab Dispositif de type implant recouvert de bisphosphonate et procede associe
EP1508343A1 (fr) * 2003-08-21 2005-02-23 ASPENBERG, Per Vilhelm implant revêtu de bisphosphonate et son procédé de fabrication
CN1871038B (zh) * 2003-08-21 2010-10-06 艾德拜奥股份有限公司 涂覆双膦酸盐的植入装置和其所用的方法
US7255713B2 (en) 2003-12-18 2007-08-14 Malek Michel H Systems and methods for agent delivery
WO2005074944A1 (fr) * 2004-02-10 2005-08-18 Abiogen Pharma S.P.A. Utilisation de neridronate de sodium pour favoriser une nouvelle formation osseuse
JP2009513196A (ja) * 2005-10-27 2009-04-02 ニクリス アーゲー インプラント及びその製造方法
WO2007048263A2 (fr) 2005-10-27 2007-05-03 Nexilis Ag Implant et procede de fabrication
WO2007048263A3 (fr) * 2005-10-27 2007-06-28 Nexilis Ag Implant et procede de fabrication
US9050391B2 (en) 2005-10-27 2015-06-09 Nexilis Ag Implant and production method for said implant
US8940320B2 (en) * 2005-10-27 2015-01-27 Thommen Medical Ag Dental implant and production method for said implant
WO2009121935A2 (fr) * 2008-04-04 2009-10-08 Novartis Ag Composition pharmaceutique avec du bisphosphonate
WO2009121935A3 (fr) * 2008-04-04 2010-06-03 Novartis Ag Composition pharmaceutique avec du bisphosphonate
US9642658B2 (en) 2008-10-15 2017-05-09 Orthoclip Llc Device and method for delivery of therapeutic agents via internal implants
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US8882740B2 (en) 2009-12-23 2014-11-11 Stryker Trauma Gmbh Method of delivering a biphosphonate and/or strontium ranelate below the surface of a bone
US9603644B2 (en) 2012-08-07 2017-03-28 Spinal Generations, Llc Methods and devices for delivery of medicine to bone
US11712278B2 (en) 2014-02-19 2023-08-01 Spinal Generations, Llc Compressible mixing and delivery system for medical substances
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US20210205459A1 (en) * 2018-06-01 2021-07-08 The University Of North Carolina At Chapel Hill Injectable thermoresponsive hydrogels as a combinatory modality for controlled drug delivery, biomaterial implant and 3d printing bioink
US11832860B2 (en) 2018-06-22 2023-12-05 University Of Virginia Patent Foundation Bone fixation system for promoting the union of a bone fracture and fusion of bones across a joint space and related methods thereof
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