CN1323228A - 用于软骨细胞移植的方法、器械和材料 - Google Patents
用于软骨细胞移植的方法、器械和材料 Download PDFInfo
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- CN1323228A CN1323228A CN99812041A CN99812041A CN1323228A CN 1323228 A CN1323228 A CN 1323228A CN 99812041 A CN99812041 A CN 99812041A CN 99812041 A CN99812041 A CN 99812041A CN 1323228 A CN1323228 A CN 1323228A
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- collagen protein
- cartilage
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Abstract
本发明提供通过移植一种可植入物在动物体内有效治疗关节表面软骨的方法,所述可植入物包括保留于可吸收支持基质上的软骨细胞。本发明还涉及用于在植入部位放置和操作可植入物的器械以及用于将可植入物固定于植入部位的固位装置。本发明还涉及用于动物体内软骨修复的可植入物及其制备方法,所述可植入物包括保留于可吸收支持基质上的软骨细胞。总的来讲,本发明还涵盖了一种包括可吸收的韧性支持基质的物品,所述支持基质用于活细胞在其上生长和粘附。
Description
发明领域
本发明涉及软骨细胞移植,骨和软骨移植、愈合、关节修复和关节炎病状的预防。本发明特别涉及软骨细胞移植和软骨再生的新方法和工具。
发明背景
在美国每年要进行50多万例关节成形术和全关节替换。在欧洲进行同样手术的数量大约相同。在欧洲的病例数中,包括大约9万例全膝关节替换和5万例修复膝关节缺陷的手术。在美国这些病例数基本相同(Praemer A.,Fumer S.,Rice,D.P.,美国肌与骨骼的状况,美国整形外科学会[AmericanAcademy of Orthopaedic Surgeons],Park Ridge,Ill.,1992,125)。
用于软骨再生治疗的方法将是最有效的,并且能在关节损伤的早期进行,因此减少需行人造关节替换术的患者数。应用这种预防性的治疗方法还将减少发展成骨关节炎的患者的数量。
用于复平关节中软骨结构的技术主要是试图诱导软骨的修复,这通过利用软骨下转孔、磨减以及切除病***骨和软骨下骨,暴露血管化的松质骨的其他方法来进行(Insall,J.,临床整形外科[Clin,Orthop.]1974,101,61;Ficat R.P.等,临床整形外科[Clin,Orthop.]1979,144,74;Johnson L.L.,关节镜手术[Operative Arthroscopy],McGinty J.B.编,Raven Press,New York,1991,341)。
Coon和Cahn(科学[Science]1966,153,1116)描述了一种技术,其用于培养从鸡胚体节获得的软骨合成细胞。后来,Cahn和Lasher(美国国家科学院报[PNAS USA]1967,58,1131)利用了一个***对DNA合成参与作为软骨分化的先决条件进行分析。EGF和FGF都可刺激软骨细胞生长(Gospodarowicz和Mescner,细胞生理学杂志[J.Cell Physiology]1977,93,117),但最终这些细胞丧失其分化功能(Benya等,细胞[Cell]1978,15,1313)。Brittberg,M.等描述了培养软骨细胞的方法并且在略微调整后应用(新英格兰医学杂志[new Engl.,J.Med.]1994,331,889)。将利用这种方法培养的细胞用做自体移植物,植入患者的膝关节。另外,Kolettas等检测了延长细胞培养时间后,软骨特异性分子如胶原和蛋白多糖的表达(细胞科学杂志[J.Cell Science]1995,108,1991)。他们发现当与由不同科学家所测试的在琼脂糖凝胶、藻酸盐珠上的悬浮培养或搅拌培养(保持圆形细胞形态)相比时,虽然在单层培养中细胞的形态发生改变(Aulthouse,A.等,体外细胞发育生物学[In vitro Cell Dev.Biol.],1989,25,659;Archer,C.等,细胞科学杂志1990,97,361;Hnselmann,H.等,细胞科学杂志1994,107,17;Bonaventure,J.等,实验细胞研究[Exp.Cell Res.]1994,212,97),但并不改***骨细胞表达的标记物,如Ⅱ型和Ⅸ型胶原蛋白而且大分子凝集蛋白多糖、凝集原、versican和连接蛋白并未发生改变(Kolettas,E.等,细胞科学杂志1995,108,1991)。
Wakitani等(组织工程[Tissue Engineering]4(4),429(1989))描述了在动物实验中利用Ⅰ型胶原蛋白凝胶来修复软骨缺损。在所有的实例中,主要问题是缺乏功能性组织修复所需的生物力学特性。
关节的软骨细胞是特化的间质来源的细胞,其只存在于软骨中。软骨是一种无血管组织,其物理特性依赖于软骨细胞产生的细胞外基质。在软骨内骨化过程中,软骨细胞发育成熟引起细胞过度生长,该过程以出现X型胶原蛋白的表达为特征(Upholt,W.B.和Olsen,R.R.,在《软骨的分子状况》[Cartilage Molecular Aspects]中,(Hall,B.和Newman,S.,编)CRC BocaRaton 1991,43;Reichenberger,E.等,发育生物学[Dev.Biol.]1991,148,562;Kirsch,T.等,分化[Differentiation],1992,52,89;Stephens,M.等,细胞科学杂志,1993,103,1111)。
关节的关节面外层Ⅱ型胶原蛋白的过度降解也是由骨关节炎引起的。因此胶原蛋白的网状结构被弱化随后发生纤维化,由此基质物质如蛋白多糖丢失,最终完全被取代。弱化的骨关节炎软骨的此类纤维化可以向下延伸到钙化的软骨并进入软骨下骨组织(Kempson,G.E.等,生物化学与生物物理学学报[Biochem.Biophys.Acta]1 976,428,741;Roth,V.和Mow,V.C.,骨关节外科杂志(J.Bone Joint Surgery,1980,62A,1102;Woo,S.L.-Y.等,在《生物工程手册》[Handbook of Bioengineering]中(R.Skalak and S.Chien编),McGraw-Hill,New York,1987,4.1-4.44页)。
例如在Wheater,Burkitt和Daniels编著的《功能组织学》[FunctionalHistology]第二版(Churchill Livingstone,London 1987,第4章)中,描述了骨、软骨和其他此类***的基础发育、组织学和显微解剖学。例如在Wheater,Burkitt,Stevens和Lowe编著的《基础组织病理学》[BasicHistopathology](Churchill Livingstone,London 1985,第21章)中,还描述了骨、软骨和其他***中缺损的基础组织解剖学。
虽然至少在以上提到的参考文献中详尽地描述了软骨细胞移植的需要,但仍需要一种通过移植或其他方法用于软骨修复的满意而有效的方法。
发明概述
本发明提供一种可植入物,其包括能支持细胞生长和向其附着的支持基质,本发明还提供一种将这种物体植入以便在植入部位再生细胞的方法。在一个实施方案中,本发明提供了在动物中通过移植一种包括软骨细胞的可植入物来有效治疗关节表面软骨的方法,其中所述软骨细胞保留于可吸收的支持基质上。在一个实施方案中,支持基质由胶原蛋白如Ⅰ型或Ⅱ型胶原蛋白制成,而软骨细胞为自体或同源的细胞。优选通过粘合剂或机械固位工具将可植入物固定于植入部位。本发明还涉及在植入部位放置和操作可植入物的一种工具,以及用于将可植入物固定于植入部位的固位装置。
本发明还涉及一种在动物中用于软骨修复的可植入物,所述可植入物包括保留于可吸收支持基质上的软骨细胞,而且本发明涉及制备它的方法。
附图简述
参照下面对说明本发明的附图进行的描述可以更好地理解本发明,其中:
图1A显示膝关节中骨的典型关节端,其具有带软骨帽的关节面。
图1B显示骨的关节端上软骨帽的软骨缺损或损伤。
图2显示根据本发明可移植物的一个实例。
图3显示可将图2的可植入物卷曲以便植入图4所示的关节镜导入器中。
图4显示根据本发明用于在植入部位植入可植入物的关节镜导入器。
图5图示说明利用能容纳关节镜的两个进入管道在软骨帽的缺损或损伤部位放置图3的可植入物。
图6为带有缺损或损伤的软骨以及根据本发明通过粘合剂固定于缺损或损伤部位的可植入物的横截面图,其中的缺损或损伤未扩展到软骨下层。
图7为带有缺损或损伤的软骨以及根据本发明通过机械固位器固定于缺损或损伤部位的可植入物的横截面图,其中的缺损或损伤未扩展到软骨下层。
图8图示说明用于将可植入物固定于缺损或损伤部位的机械固位器的一个实例。
图9为带有缺损或损伤的软骨以及根据本发明通过粘合剂固定于缺损或损伤部位的可植入物的横截面图,其中的缺损或损伤扩展到软骨下层。
图10为带有缺损或损伤的软骨以及根据本发明通过机械固位器固定于缺损或损伤部位的可植入物的横截面图,其中的缺损或损伤扩展到软骨下层。
图11A软骨细胞在固相支持基质上生长开始时固形支持基质组织学标本彩色显微照片的黑白拷贝。
图11AA是图11A的彩色显微照片。
图11B是彩色显微照片的黑白拷贝,其显示软骨细胞在图11A的支持基质上生长三周后负载有软骨细胞的支持基质。
图11BB是图11B的彩色显微照片。
图11C的照片显示由胶原蛋白形成且其上有软骨细胞生长的支持基质,其通过免疫组化染色显示。
图11D的照片显示在生物反应器***中,由胶原蛋白形成并且其上有软骨细胞生长的支持基质,其通过免疫组化染色显示。
发明详述
如上所述,人体关节中软骨损伤和缺损经常发生于膝关节。图1A显示在人膝关节10中骨的典型关节端。膝关节10由股骨12和胫骨14的接合以及覆盖股骨12关节端的健康软骨16组成。图1B显示在软骨16上的圆形缺损或损伤区18(此后有时称为缺损18)。
本发明包括软骨修复植入物以及用于此类植入物的植入方法和植入装置。植入物包括支持基质和维持在其上的自体或同源软骨细胞。
通常,支持基质为一种可以支持软骨细胞生长,而且随着时间的推移会被接受植入物的患者机体吸收的材料。移植方法可以是通过关节镜、最小侵袭或开放式外科技术。本发明的方法还考虑利用适当的同种异体和异源软骨细胞用于软骨缺损的修复。
图2显示这样一种植入物。具体而言,可植入物20包括支持基质22,其上维持着软骨细胞24。适宜的支持基质22应该为一种固体或凝胶样支架,其具有如下特征:在移植前后都能构保持一段时间稳定的形式以使软骨细胞能在其上生长,并且能够提供与软骨细胞天然环境类似的***以使软骨细胞的生长分化最佳化。
支持基质22应在一段时间内保持稳定,这段时间足以使软骨完全修复,然后随时间推移,例如在两到三个月内其被机体吸收而不遗留任何明显痕迹并且不形成毒性降解产物。术语“被吸收”意指包括如下过程,通过该过程支持基质被自然的生物学过程分解,并且例如通过***或血管处理被分解的支持基质和由此产生的降解产物。因此,支持基质22优选为一种生理上可吸收的,非抗原性膜样材料。而且,支持基质22优选为一种薄片样形式,其具有一个相对光滑的面21和一个相对粗糙的面23。例如粗糙面23为纤维状,通常面对软骨缺损18并刺激软骨细胞向内生长,而光滑面21通常背对软骨缺损18并阻止组织向内生长。
在一个实施方案中,支持基质22由多肽或蛋白制成。多肽或蛋白优选获自天然来源,如来自哺乳动物。然而,具有与来自天然来源的多肽或蛋白类似的物理和化学特性的人造材料,也可能用于制备支持基质22。在本发明的一个方面中,优选支持基质22可以发生可逆性变形,从而使用者可如下所述操作可植入物20,并随后使其回复原形。
可以构成支持基质22的优选材料为胶原蛋白,例如获自马,猪,牛,羊和鸡的胶原蛋白。可以构成支持基质22的适宜的材料包括Chondro-Cell(一种市售的Ⅱ型胶原蛋白基质垫,Ed.Geistlich Shne,瑞士)和Chondro-Gide(一种市售的Ⅰ型胶原蛋白基质垫,Ed.Geistlich Shne,瑞士)。虽然也可用Ⅱ型胶原蛋白基质,但Ⅰ型胶原蛋白构成的支持基质22比Ⅱ型胶原蛋白构成的支持基质略硬一些。
例如,如上所述可植入物可以通过如下所详述的在该支持基质上培养软骨细胞来制备。
对于自体植入物,首先通过关节镜技术在患者关节的非承重区获得软骨活组织,并在含20%胎牛血清的生长培养基中运送至实验室。然后,用一种酶处理软骨活组织来分离和提取软骨细胞,所述酶如胰蛋白酶乙二胺四乙酸(EDTA),其为一种蛋白分解酶和螯合剂。然后将提取的软骨细胞培养于生长培养基中,从最初细胞计数为大约5万个细胞到最终细胞计数为大约为2000万个软骨细胞或更多。
再次植入前三天将生长培养基替换为含10%自体血清(即,如下所述从患者血液中提取的血清)的移植物培养基。然后,将在移植物培养基中培养的软骨细胞浸入并穿透支持基质22,继续增殖形成可植入物20。然后,将可植入物20植入到患者软骨缺损部位18处。
当然为了容纳可植入物20,在植入前对缺损或损伤18可以直接进行处理,稍微扩大或者通过外科方法进行塑形。下面通过实例对培养方法以及生长培养基和移植物培养基进行详细描述,首先描述根据本发明用于处理获得的软骨活组织和培养软骨细胞的实验室方法。
用于在培养过程中处理软骨活组织和供软骨细胞生长的生长培养基(本文中后面为“生长培养基”)由如下成分组成:2.5ml硫酸庆大霉素(浓度为70μM/L),4.0ml两性霉素(浓度为2.2μM/L;商品名Fungizone,施贵宝公司生产的抗真菌药),15ml1-抗坏血酸(300μM/L),100ml胎牛血清(终浓度20%),以DMEM/F12培养基补足到400ml。(同样的培养基也用于将软骨活组织从医院运送到对软骨细胞进行抽提和扩增的实验室)。
将取自患者的血液在大约3,000rpm下离心以使血清与其他血液组分分离。保存分离到的血清并用于后期的培养和移植过程。
将预先取自患者用于自体移植的软骨活组织在上述的生长培养基中运送到将对其进行培养的实验室。在实验室中,轻轻倒出并弃去生长培养基,分离出软骨活组织。然后,将软骨活组织在单纯DMEM/F12中清洗至少三次以去除软骨活组织上的薄层胎牛血清。
然后,将软骨活组织在包括上述生长培养基并加入28ml胰蛋白酶EDTA(浓度0.055)的组合物中清洗。在该组合物中,将其在37℃和5%CO2下温育5到10分钟。温育后,将软骨活组织在生长培养基中洗2至3次以清除活组织上的任何胰蛋白酶。然后将软骨称重。通常,培养软骨细胞所需的最小软骨量为大约80-100mg。优选略微大的量,如200-300mg。称重后,将软骨置于在大约50ml单纯DMEM/F12培养基中含2ml胶原酶(浓度5,000酶活性单位;一种消化酶)的混合物中,并将其切碎以使酶可以部分消化软骨。切碎后,利用漏斗将切碎的软骨移入瓶中,并向该瓶中加入约50ml胶原酶和单纯DMEM/F12的混合物。然后将切碎的软骨在37℃和5%CO2下温育17到21小时。
在一个实施方案中,然后利用40μm筛孔将切碎并温育过的软骨过滤,离心(1054rpm或200倍地心引力)10分钟并用生长培养基清洗2次。然后,对软骨细胞计数以确定其存活力,之后在生长培养基中,于37℃和5%CO2下将软骨细胞温育至少两周,其间将生长培养基更换3到4次。
在重新植入患者的至少三天前,通过胰蛋白酶消化和离心将软骨细胞从生长培养基中分离,并转移到移植物培养基中,所述移植物培养基含有1.25ml硫酸庆大霉素(浓度为70μM/L),2.0ml两性霉素(浓度为2.2μM/L;商品名Fungizone,施贵宝公司生产的抗真菌药),7.5ml1-抗坏血酸(300μM/L),25ml自体血清(终浓度10%),以DMEM/F12培养基补足到大约300ml。
然后,将支持基质22切割成与NUNCLONTM细胞培养皿的孔底相称的适当大小,然后在无菌条件下放置到加有1-2ml移植物培养基的孔底上。然后将在大约5-10ml移植物培养基中足够数量的培养的软骨细胞(如300-1,000万)吸收到支持基质22中,并在37℃和5%CO2下温育大约72小时以使软骨细胞可以继续生长。在温育过程中,软骨细胞排列成簇并粘附于支持基质22。利用该方法发现支持基质22可以支持软骨细胞以足够形成可植入物20的数量在其上生长和维持,而支持基质22的生物力学特性无显著丧失。在可植入物植入软骨缺损部位后,支持基质22还提供了一个环境以支持软骨细胞的持续生长。
在另一个实施方案中,经过17-21小时的温育并如上所述判定细胞计数和存活力后,将软骨细胞转移到移植物培养基中,然后直接在支持基质22上生长至少两周。
已发现没有机械损伤或者粘附于支持基质22的软骨细胞的丢失也可以使可植入物20暂时变形。一旦如下所述将可植入物20引入到关节中或放置到待处理的表面上,这种变形是完全可逆的。
因而,与本发明的另一方面一致,可以使其上生长或负载有足够数量软骨细胞的支持基质22以能将其引入关节镜的工作装置中而不发生机械损伤或其负载的软骨细胞丢失的方式暂时发生变形。
同时,已发现通过粘附或机械固位工具可以将该基质固定于软骨缺损区,而不损害软骨细胞进一步的原位分化以及天然软骨基质材料的再生。
本发明的其他方面包括:将可植入物20放置于植入部位的工具,以及一种将可植入物20固定到植入部位的机械固位装置。
在本发明的一个实施方案中,植入操作是通过关节镜技术进行的。图3显示如何可以将可植入物20横跨其直径卷起以形成螺旋卷绕移植物圆柱体,以便通过关节镜导入器28的一个工作管道26可以将可植入物20传送到植入部位处。在图4中图示了一种适当的关节镜导入器。
在图4中,关节镜导入器30包括一个工作管道32,该管道的直径和长度适于进入目的关节并传送预期大小的可植入物20。例如,对于绝大多数操作,工作管道32的直径约为8-20mm,而长度约为30-60cm。在工作管道32内部而且纵向可移动的为一个注射管道34,其中容纳了一根可伸缩而且可拆卸的注射针36。注射管道34附着在手柄38上,所述手柄是可以伸缩性降低的,至少部分降低到工作管道32中。注射针36延伸了注射管道34的长度而且使液体可以通过其到达植入部位。通过伸缩性移动手柄38朝向或远离植入部位,将注射管道34在工作管道32内移动。
导入器30还包括由橡皮或其他适宜材料制成的帽40,其可在导入器30上滑动。在使用中,帽40包绕软骨缺损部位并阻止液体如血液和其他天然液体流入到该软骨缺损部位中。为了在植入部位抓紧、导入和放置可植入物20,导入器30还有两个或多个朝外偏斜的夹持元件42附着于手柄38。在使用中,当将手柄38伸缩性移近或远离使用者时,夹持元件42占据工作管道32的内部,并且以夹持的方式彼此相向移动(当手柄38朝向使用者移动时),或彼此离开来将夹持放松(当手柄38向远离使用者方向移动时)。此类伸缩性移动可以通过放置在手柄38内的一个偏斜的元件(未显示)来控制,所述手柄38使注射管道34和夹持元件42在工作管道32内可以滑动性地伸展和收缩。
图5-7显示用于在植入部位如膝关节10处植入可植入物22的一个典型的关节镜操作。将有缺损的软骨18从缺损部位去除,优选深度到软骨下层44以上,留下一个坑穴46(见图6-7)。在将软骨缺损18去除后,缺损部位准备接受可植入物22。如果软骨下层被干扰到在植入部位发生出血的程度,那么该部位可以首先用任何可吸收的材料覆盖,所述可吸收材料作为一个止血屏障。
另外,部位处理可以包括通过注射针36向坑穴46内注入生物相容性胶。在图6中为粘合剂48的此类生物相容性胶可以包含一种有机纤维蛋白胶(例如,Tisseel,基于纤维蛋白的粘合剂,Baxter,Austria或在外科手术室中使用自体血液样品制备的一种纤维蛋白胶)。
预先将可植入物20切割成预期的大小,并卷成如在图5中所示的螺旋圆柱体的形状,然后将其用夹持元件42抓紧并持于关节镜导入器30的末端内。然后将在其末端内持有可植入物20的关节镜导入器30通过进入管道33伸入到植入部位,将其从夹持元件42中释放,并用夹持元件42将其展开或当其在工作管道32内时令其展开。进入管道33包括一个或多个管道,这使得如导入器30和可视装置等器械可以接近移植部位。利用夹持元件42,对可植入物20进行操作以便可植入物20的粗糙面23面向坑穴46,并轻轻地将其放入坑穴46中以使粘合剂48可以在坑穴46内加固和结合可植入物20。
在另一实施方案中(图7),将机械固位工具用于将可植入物20固定于坑穴46中,所述工具如可吸收的大头针、锚钉、螺丝或缝线。适宜的大头针50包括Ortho-pinTM(一种市售的交酯共聚物大头针,Ed.Geistlich Shne,瑞士)。图8显示可吸收式大头针50的一个实例。在该实例中,大头针50包括头部52,在锚杆56内的髓内管道54,以及一个或多个固位环58。大头针50的尺寸依具体使用而改变,但通常大头针50长度约为10-15mm,头部52直径约为4mm,髓内管道54直径约为1.2mm,锚杆56直径约为2mm,而固位环58的直径约为2.5mm。固位环58用于将大头针50锚定在软骨缺损周围的健康软骨中。大头针50由任何不伤害机体并且在一段时间后可被机体吸收或降解的材料制成。例如大头针50可以由聚交酯制成。
联合利用粘合剂48和机械固位工具如大头针50在坑穴46中固定可植入物20也被认为是包括在本发明的范围内。
如在图6中所示,具有一个或多个管道的另一个进入管道可被用来使器械可以接近植入部位以帮助放置可植入物、粘合剂和/或机械固位工具,或者用来使可视装置可以接近植入部位。此类独立的进入管道也可用于执行一种或多种所描述的与关节镜导入器30或其他关节镜装置相关的功能。
如上所述,如在图9和10中所示,当关节缺损18延伸到软骨下层44中或其下,或者需要去除软骨下层44中或其下的软骨时,将上述的操作调整为包括在放置可植入物20前在坑穴46中放置止血屏障62。止血屏障62抑制血管组织、骨细胞、成纤维细胞等向发育中的软骨内生长和侵入。这被认为使透明软骨可以在移植部位生长。适当的止血屏障将抑制发育中软骨内的血管形成和细胞侵入,以优化软骨的形成并实现软骨在缺损部生长至完整厚度。止血屏障优选在较长时间内稳定,以允许软骨完全修复,然后随时间的推移止血屏障将被机体吸收或被降解。适宜的止血屏障为SurgicelW1912(Ethicon,Ltd.,英国),其为一种由氧化的再生无菌纤维素制成的可吸收性止血剂。
上述的外科器械由任何适于制造一次性或可多次重复使用的外科器械的材料制成,所述材料如金属和/或塑料或硅氧烷。
本发明的某些方面通过利用体外***研究了与不同支持基质接触时软骨细胞的行为。该体外检测可预测某些材料的机械抵抗关节镜操作的能力,而且还提供关于软骨细胞生长行为的信息。
从下面的实例可以对本发明的这些和其他方面进行更好地理解,这些实例意为阐明而非限定本发明。
实施例1
在CO2孵箱中于37℃将软骨细胞在上述生长培养基中培养三周,并在丹麦哥本哈根Verigen Transplantation Service ApS或者德国Lübeck的Lübeck大学的100级实验室中进行操作。[注:其他生长培养基的组合物也可用于培养软骨细胞。]将细胞用胰蛋白酶EDTA消化5到10分钟,并在Bürker-Türk小室内用台盼蓝存活力染色对细胞计数。将细胞数调整到每毫升7.5×105个软骨细胞。在所述100级实验室内将一块NUNCLONTM板打开盖子。
将一种支持基质材料,具体为Chondro-Gide胶原蛋白膜切割成与NUNCLONTM细胞培养盘中的一个孔底相适的适当大小。在该例中,在无菌条件下将大约4厘米大小的圆形膜放置于孔底。
三周后,将软骨细胞从生长培养基转移到上述的移植物培养基中,然后将5ml移植物培养基中的大约5×106个软骨细胞直接置于支持基质顶上,并将它们分散在支持基质表面上。将培养板在CO2孵箱于37℃温育三天。这段时间后,软骨细胞排列成簇并开始在支持基质上生长,而且通过用培养基对支持基质进行清洗或甚至通过给基质施加轻压都无法从支持基质上将软骨细胞清除。
在温育期结束时,将移植物培养基轻轻倒掉,并将其上保留有软骨细胞的支持基质在含0.1M二甲基次砷酸钠盐2.5%戊二醛(作为固定剂)中完全冷冻。对支持基质用番红O染色以进行组织学评价。其彩色显微照片的黑白拷贝示于图11A中。将显微照片的彩色版本也提交为图11AA以更好地显示显微照片的特征。
实施例2
在CO2孵箱中于37℃将软骨细胞在上述生长培养基中培养三周,并在丹麦哥本哈根Verigen Transplantation Service ApS或者德国Lübeck大学的100级实验室中操作。将细胞用胰蛋白酶EDTA消化5到10分钟,并在Bürker-Türk小室内用台盼蓝存活力染色对细胞计数。将细胞数调整到每毫升5×105个软骨细胞。在100级实验室内将一块NUNCLONTM板打开盖子。
如在实施例1中,将Chondro-Gide支持基质切割成与NUNCLONTM细胞培养盘中的一个孔底相适的适当大小。在该例中,在无菌条件下将大约4厘米大小的圆形膜放置于孔底。
三周后,将软骨细胞从生长培养基转移到上述的移植物培养基中,然后将5ml移植物培养基中的大约5×105个软骨细胞直接置于支持基质顶上,并使它们分散在支持基质表面上。将该培养板在CO2孵箱于37℃温育三周。
在温育期结束时,将移植物培养基轻轻倒掉,并将其上保留有软骨细胞的支持基质在含0.1M二甲基次砷酸钠盐的2.5%戊二醛(作为固定剂)中完全冷冻。对支持基质用番红O染色以进行组织学评价。免疫组织化研究中,将胶原蛋白膜在甲醇-丙酮中固定,并利用兔抗人Ⅱ型胶原蛋白和鼠抗人聚集蛋白聚糖(软骨)对Ⅱ型胶原蛋白和聚集蛋白聚糖(软骨)进行染色。利用荧光二抗使一抗显象。显示软骨细胞24的彩色显微照片的黑白拷贝示于图11B中。将显微照片的彩色版本也提交为图11B以更好地显示显微照片的特征。
在对支持基质Chondro-Gide的三周温育期过程中,观察到软骨细胞在支持基质上生长和增殖,在载体的中心形成簇,并沿表面排成行。
实施例3
在CO2孵箱中于37℃将软骨细胞在上述生长培养基中培养三周,并在丹麦哥本哈根Verigen Transplantation Service ApS或者德国Lübeck大学的100级实验室中操作。将软骨细胞用胰蛋白酶EDTA消化5到10分钟,并在Bürker-Türk小室内用台盼蓝存活力染色对细胞计数。将细胞数调整到每毫升5×105个软骨细胞。在100级实验室内将一块NUNCLONTM板打开盖子。
如在实施例1中,将Chondro-Gide支持基质切割成与NUNCLONTM细胞培养盘中的一个孔底相适的适当大小。在该例中,在无菌条件下将大约4厘米大小的圆形膜放置于孔底。
三周后,将软骨细胞从生长培养基转移到上述的移植物培养基中,然后将5ml移植物培养基中的大约5×105个软骨细胞直接置于支持基质顶上,并使它们分散在支持基质表面上。将所述培养板在CO2
孵箱中于37℃温育三周。
将持有生长的软骨细胞的支持基质与胶原蛋白酶一起温育16小时。然后对持有生长的软骨细胞的支持基质进行离心。将细胞接种到NUNCLONTM板上,并在Bürker-Türk小室内用台盼蓝存活力染色对一等份试样进行计数。其显微照片示于图11C中。合计的细胞数为6×106,而且存活率>95%。
实施例4
动物研究在德国Lübeck大学的研究机构内进行。
在两只绵羊膝关节的软骨中诱导四个直径7mm的圆形软骨缺损。所有的操作在静脉注射盐酸***/甲苯噻嗪全身麻醉下进行。通过在股骨骨顶部中间承重区的软骨上钻两个洞,以及在股骨髌骨和胫骨股骨关节区钻两个洞来诱导缺损。在两个缺损区中,每两个洞中有一个延伸穿透软骨和覆盖于骨上的软骨下层,而在每个区域中的另一个洞则没有穿透软骨和软骨下层。
同时,从该绵羊膝部的非承重区获取一片软骨。
根据实施例3,将由该软骨生成的软骨细胞在支持基质上培养6周。
然后,将负载于Chondro-Cell支持基质上的软骨细胞经关节镜外科技术植入。根据本发明如上所述,在一只绵羊中通过用纤维蛋白胶把所述基质粘到治疗区域进行固定,而在另一只绵羊中用聚交酯大头钉将所述基质固定。
将绵羊隔离,并将膝关节用敷料固定一周。
之后令绵羊可以自由活动。对关节的评价表明缺损愈合,细胞-支持基质植入物附着于软骨缺损部位,而且在软骨缺损部位有软骨再生。
虽然上述讨论部分涉及在玻璃制品如NUNCLONTM板中于支持基质上培养软骨细胞,以及按细胞培养所需更换生长或移植物培养基的方法,但本发明还包括在生物反应器如MinuCells GMBH Ltd.(D-93077 Bad Abbach,德国)生产的No.1302型生物反应器中,于支持基质上培养软骨细胞的方法。利用生物反应器,使恒速流动的生长或移植培养基流过所述支持基质,软骨细胞能够以较快的速度在支持基质上生长而不必如例如在使用NUNCLONTM板时所需的每24到96小时更换生长或移植物培养基。不言而喻,由于生长或移植物培养基流过生物反应器,利用此类生物反应器引起软骨细胞成角度生长。生长于所述生物反应器中所述支持基质上的软骨细胞的显微照片示于图11D中。
软骨细胞的培养,无论培养于玻璃器皿中还是在支持基质上,均可以在生长培养基中进行整个细胞培养过程,或者在移植物培养基中进行整个细胞培养过程。也就是说,无须把软骨细胞从生长培养基转移到移植物培养基中。在培养过程中的任何时间点可以将软骨细胞从生长培养基转移到移植物培养基,反之亦然,这取决于软骨细胞的特定条件、软骨细胞的生长阶段,和/或患者的状况。移植前,软骨细胞,无论是在生长培养基中还是在移植物培养基中,均仅需要在支持基质中浸泡大约2-3小时,以使足够数量的软骨细胞可以附于支持基质上。
在没有使用生物反应器的情况下,对用在培养过程特定阶段的生长培养基或移植物培养基都必须进行更换,例如,每24到96小时更换一次,这取决于例如细胞的数目和存活力。
虽然就其具体的实施方案而论已经对本发明进行了描述,但它并不仅限于此。从其最普遍的意义上说,本发明基本上包括任何包含支持基质的物质(及其用途),所述支持基质优选为柔韧的而且优选在活体中可吸收,其中支持基质作为活细胞的支持物,所述活细胞通常在其上短期生长并粘附于其上。这种粘附可能是凭借细胞的生长穿透基质表面。支持基质优选还为可植入物提供足够的物理完整性以便于其操作,例如将其植入活体所需的操作。
因此,追加的权利要求意思是将其解释为不仅涵盖本发明上述公开的实施方案,而且涵盖可以由本发明相关领域中的技术人员制备的本发明的所有此类实施方案、变体和等价体,其中所述实施方案、变体和等价体是在本发明实质和范围内。
Claims (49)
1.一种通过在软骨缺损部位移植可植入物用于治疗动物软骨缺损部位的方法,所述方法包括如下步骤:
(a)提供一种可植入物,所述可植入物包括维持在支持基质上的软骨细胞,所述支持基质可被所述动物吸收;
(b)将所述可植入物固定于软骨缺损部位。
2.根据权利要求1的方法,其进一步包括在所述步骤(b)之前,从软骨缺损部位去除缺损软骨但留下足够的软骨材料以防止从缺损处的软骨出血。
3.根据权利要求1的方法,其进一步包括在所述步骤(b)之前在临近缺损的部位放置一个止血屏障。
4.根据权利要求1的方法,其中支持基质是薄片样构件,其能够支持软骨细胞的生长并能够为可植入物提供物理完整性以便于其操作。
5.根据权利要求1的方法,其中支持基质包括多肽或蛋白。
6.根据权利要求1的方法,其中支持基质为胶原蛋白。
7.根据权利要求6的方法,其中胶原蛋白选自基本上包括马、猪、牛、羊和鸡的胶原蛋白的组合。
8.根据权利要求6的方法,其中胶原蛋白为猪的胶原蛋白。
9.根据权利要求6的方法,其中胶原蛋白为Ⅰ型胶原蛋白。
10.根据权利要求6的方法,其中胶原蛋白为Ⅱ型胶原蛋白。
11.根据权利要求1的方法,其中支持基质为固体构件。
12.根据权利要求1的方法,其中支持基质为凝胶样。
13.根据权利要求1的方法,其中在所述步骤(b)中用粘合剂将可植入物固定到缺损部位。
14.根据权利要求13的方法,其中粘合剂为纤维蛋白胶。
15.根据权利要求1的方法,其中在所述步骤(b)中用可吸收的机械固位工具将可植入物固定到缺损部位。
16.根据权利要求15的方法,其中所述机械固位工具为大头钉。
17.根据权利要求1的方法,其中所述动物为人类。
18.一种器械,其用于将在支持基质上包括软骨细胞的可植入物引入动物体内软骨缺损部位,其包括:
(a)一个管状外鞘,所述鞘具有适于安置在该器械用户端的近侧末端和适于安置在软骨缺损部位的远侧末端;
(b)一个手柄和可伸缩元件,其至少部分安置在所述鞘的所述近侧末端内;
(c)一个注射管道,其部分安置在所述手柄内,并从所述鞘的所述近侧末端延伸到所述鞘的所述远侧末端;以及
(d)夹持元件,其附着于可伸缩元件并适于在所述鞘内通过所述手柄的伸缩运动而夹持和释放可植入物。
19.根据权利要求18的器械,所述器械进一步包括一个帽,其可滑动地附于所述鞘的所述近侧末端并适于从软骨缺损部位排除液体。
20.通过植入动物用于软骨修复的可植入物,其包括支持基质和维持在该支持基质上的软骨细胞,其中所述支持基质可被该动物吸收。
21.根据权利要求20的可植入物,其中所述支持基质为薄片样构件,其能够支持软骨细胞的生长并能够为可植入物提供物理完整性以便于其操作。
22.根据权利要求20的可植入物,其中所述支持基质包括多肽或蛋白。
23.根据权利要求20的可植入物,其中所述支持基质是胶原蛋白。
24.根据权利要求23的可植入物,其中所述胶原蛋白选自基本上包括马、猪、牛、羊和鸡的胶原蛋白组合。
25.根据权利要求23的可植入物,其中所述胶原蛋白为猪的胶原蛋白。
26.根据权利要求20的可植入物,其中所述支持基质为固体。
27.根据权利要求20的可植入物,其中所述支持基质为凝胶样。
28.根据权利要求23的可植入物,其中所述胶原蛋白为Ⅰ型胶原蛋白。
29.根据权利要求23的可植入物,其中所述胶原蛋白为Ⅱ型胶原蛋白。
30.根据权利要求20的可植入物,其中所述可植入物可以发生可逆性变形。
31.根据权利要求20的可植入物,其中所述支持基质具有一个粗糙面。
32.根据权利要求31的可植入物,其中所述粗糙面是多孔的。
33.根据权利要求20的可植入物,其中所述支持基质具有一个光滑面。
34.根据权利要求20的可植入物,其中所述支持基质具有一个粗糙面和一个光滑面。
35.制备可植入物的方法,所述可植入物包括维持于支持基质上的软骨细胞,所述方法包括下述步骤:
(a)从宿主获取软骨细胞;
(b)在培养基中培养所述软骨细胞;
(c)提供一种包括固体或半固体构件的支持基质,其能够支持软骨细胞在其上的生长;
(d)将培养的软骨细胞加入到所述支持基质中,以允许在所述支持基质上进一步培养所述软骨细胞并将所述软骨细胞固位到所述支持基质上。
36.根据权利要求35的方法,其中支持基质为薄片样物品。
37.根据权利要求35的方法,其中支持基质包括多肽或蛋白。
38.根据权利要求35的方法,其中支持基质为胶原蛋白。
39.根据权利要求38的方法,其中胶原蛋白选自基本上包括马、猪、牛、羊和鸡的胶原蛋白的组合。
40.根据权利要求38的方法,其中胶原蛋白为猪的胶原蛋白。
41.根据权利要求38的方法,其中胶原蛋白为Ⅰ型胶原蛋白。
42.根据权利要求38的方法,其中胶原蛋白为Ⅱ型胶原蛋白。
43.根据权利要求35的方法,其中支持基质为固体。
44.根据权利要求35的方法,其中支持基质为凝胶样。
45.根据权利要求35的方法,其中支持基质是可吸收的。
46.一种制品,其包括安置并附于韧性支持基质上的活细胞,所述支持基质能够支持所述细胞的生长,所述生长在所述细胞附于所述基质处随所述生长穿透所述基质的表面。
47.根据权利要求46的物品,其中所述支持基质在置于动物体内时,适于经天然生物过程被吸收到该动物机体内。
48.一种可被动物吸收的元件,其用于在动物体内将可植入物机械固定于植入部位,所述元件包括:
(a)一个纵向的管状杆,其具有一个近侧末端和一个远侧末端;
(b)一个头部,其附于所述杆的所述近侧末端而且适于覆盖所述可植入物;以及
(c)至少一个固位环,其置于所述杆上的所述近侧末端和远侧末端之间,而且适于将所述可植入物和所述元件锚定于植入部位。
49.根据权利要求48的元件,其中所述元件由聚交酯制成。
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN101969882A (zh) * | 2007-12-21 | 2011-02-09 | 日本医疗器材有限公司 | 细胞移植用器械 |
CN101332314B (zh) * | 2008-07-22 | 2012-11-14 | 广东冠昊生物科技股份有限公司 | 生物型关节软骨修补件 |
CN104321021A (zh) * | 2012-03-28 | 2015-01-28 | 伊西康内外科公司 | 可扩展的组织厚度补偿件 |
CN108852477A (zh) * | 2018-09-12 | 2018-11-23 | 上海交通大学医学院附属第九人民医院 | 用于干细胞治疗人体关节软骨缺损的填充修复装置 |
Families Citing this family (457)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6569172B2 (en) * | 1996-08-30 | 2003-05-27 | Verigen Transplantation Service International (Vtsi) | Method, instruments, and kit for autologous transplantation |
US7618451B2 (en) * | 2001-05-25 | 2009-11-17 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools facilitating increased accuracy, speed and simplicity in performing total and partial joint arthroplasty |
US8545569B2 (en) | 2001-05-25 | 2013-10-01 | Conformis, Inc. | Patient selectable knee arthroplasty devices |
US7799077B2 (en) | 2002-10-07 | 2010-09-21 | Conformis, Inc. | Minimally invasive joint implant with 3-dimensional geometry matching the articular surfaces |
US8771365B2 (en) | 2009-02-25 | 2014-07-08 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs, and related tools |
US8556983B2 (en) | 2001-05-25 | 2013-10-15 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs and related tools |
US7534263B2 (en) | 2001-05-25 | 2009-05-19 | Conformis, Inc. | Surgical tools facilitating increased accuracy, speed and simplicity in performing joint arthroplasty |
US8617242B2 (en) | 2001-05-25 | 2013-12-31 | Conformis, Inc. | Implant device and method for manufacture |
US8083745B2 (en) | 2001-05-25 | 2011-12-27 | Conformis, Inc. | Surgical tools for arthroplasty |
US9603711B2 (en) | 2001-05-25 | 2017-03-28 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US8735773B2 (en) | 2007-02-14 | 2014-05-27 | Conformis, Inc. | Implant device and method for manufacture |
US8882847B2 (en) | 2001-05-25 | 2014-11-11 | Conformis, Inc. | Patient selectable knee joint arthroplasty devices |
US8480754B2 (en) | 2001-05-25 | 2013-07-09 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US7468075B2 (en) | 2001-05-25 | 2008-12-23 | Conformis, Inc. | Methods and compositions for articular repair |
ATE439806T1 (de) * | 1998-09-14 | 2009-09-15 | Univ Leland Stanford Junior | Zustandsbestimmung eines gelenks und schadenvorsorge |
US7239908B1 (en) * | 1998-09-14 | 2007-07-03 | The Board Of Trustees Of The Leland Stanford Junior University | Assessing the condition of a joint and devising treatment |
US9289153B2 (en) * | 1998-09-14 | 2016-03-22 | The Board Of Trustees Of The Leland Stanford Junior University | Joint and cartilage diagnosis, assessment and modeling |
US7184814B2 (en) | 1998-09-14 | 2007-02-27 | The Board Of Trustees Of The Leland Stanford Junior University | Assessing the condition of a joint and assessing cartilage loss |
CA2391819A1 (en) * | 1999-08-02 | 2001-02-08 | Verigen Transplantation Service International Ag | Kit for chondrocyte cell transplantation |
ATE426357T1 (de) | 2000-09-14 | 2009-04-15 | Univ Leland Stanford Junior | Beurteilung des zustandes eines gelenkes und planung einer behandlung |
JP2002233567A (ja) * | 2000-12-06 | 2002-08-20 | Mitsuo Ochi | 移植用組織等価物及びその製造方法 |
EP1355684B1 (en) * | 2000-12-28 | 2010-01-20 | Fidia Advanced Biopolymers S.R.L. | Use of a biological material containing three-dimensional scaffolds of hyaluronic acid derivatives for the preparation of implants in arthroscopy and kit for instruments for implanting said biological material by arthroscopy |
US8439926B2 (en) * | 2001-05-25 | 2013-05-14 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools |
DE60239674D1 (de) | 2001-05-25 | 2011-05-19 | Conformis Inc | Verfahren und zusammensetzungen zur reparatur der oberfläche von gelenken |
JP2005516972A (ja) * | 2002-01-22 | 2005-06-09 | ファイザー・インク | 血栓疾患の治療のためのtafi−a阻害剤として使用される3−(イミダゾリル)−2−アミノプロピオン酸 |
US20040136968A1 (en) * | 2002-09-27 | 2004-07-15 | Verigen Ag | Autologous cells on a support matrix for tissue repair |
EP1558181B1 (en) | 2002-11-07 | 2015-08-26 | ConforMIS, Inc. | Methods for determining meniscal size and shape and for devising treatment |
AU2003900620A0 (en) * | 2003-02-12 | 2003-02-27 | Australian Surgical Design And Manufacture Pty Limited | Arthroscopic chondrocyte implantation method and device |
US20050222687A1 (en) * | 2004-04-02 | 2005-10-06 | Gordana Vunjak-Novakovic | Cartilage implant assembly and method for implantation |
US7067123B2 (en) | 2003-04-29 | 2006-06-27 | Musculoskeletal Transplant Foundation | Glue for cartilage repair |
US7416546B2 (en) * | 2003-05-05 | 2008-08-26 | Boston Scientific Scimed, Inc. | Tissue patches and related delivery systems and methods |
US8034048B2 (en) * | 2003-05-05 | 2011-10-11 | Boston Scientific Scimed, Inc. | Tissue patches and related delivery systems and methods |
US7901457B2 (en) | 2003-05-16 | 2011-03-08 | Musculoskeletal Transplant Foundation | Cartilage allograft plug |
US7488348B2 (en) * | 2003-05-16 | 2009-02-10 | Musculoskeletal Transplant Foundation | Cartilage allograft plug |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
ES2403357T3 (es) | 2003-12-11 | 2013-05-17 | Isto Technologies Inc. | Sistema de cartílago particulado |
US7311674B2 (en) * | 2004-06-28 | 2007-12-25 | Scimed Life Systems, Inc. | End effector assembly cap and tissue removal device and related methods |
GB0415080D0 (en) * | 2004-07-05 | 2004-08-04 | Ucl Biomedica Plc | Methods for preparing tissue equivalent implants and products thereof |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US11998198B2 (en) | 2004-07-28 | 2024-06-04 | Cilag Gmbh International | Surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
US8697139B2 (en) | 2004-09-21 | 2014-04-15 | Frank M. Phillips | Method of intervertebral disc treatment using articular chondrocyte cells |
US8043315B2 (en) * | 2004-09-23 | 2011-10-25 | Arthrex, Inc. | Osteochondral repair using plug fashioned from partial distal allograft femur or condyle |
US20090319045A1 (en) | 2004-10-12 | 2009-12-24 | Truncale Katherine G | Cancellous constructs, cartilage particles and combinations of cancellous constructs and cartilage particles |
US7837740B2 (en) | 2007-01-24 | 2010-11-23 | Musculoskeletal Transplant Foundation | Two piece cancellous construct for cartilage repair |
DE102005010988A1 (de) | 2005-03-03 | 2006-09-14 | Karl Storz Gmbh & Co. Kg | Medizinisches Instrument zur autologen Chondrozytentransplantation |
JP2006314759A (ja) * | 2005-04-11 | 2006-11-24 | Hiroko Yanaga | 移植用軟骨組成物 |
WO2006121612A1 (en) * | 2005-05-05 | 2006-11-16 | Isto Technologies, Inc. | Treatment of joint disease, methods and apparatuses therefor |
US7815926B2 (en) | 2005-07-11 | 2010-10-19 | Musculoskeletal Transplant Foundation | Implant for articular cartilage repair |
KR100774089B1 (ko) * | 2005-07-20 | 2007-11-06 | 세원셀론텍(주) | 주입형 연골세포치료제의 이식방법 |
JP5292533B2 (ja) * | 2005-08-26 | 2013-09-18 | ジンマー・インコーポレイテッド | インプラントおよび関節疾患の治療、置換および治療方法 |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
AU2006287197B2 (en) * | 2005-09-02 | 2013-02-14 | Ed. Geistlich Soehne Ag Fuer Chemische Industrie | Method of repairing meniscal tears |
CN101291586A (zh) * | 2005-09-02 | 2008-10-22 | 英特菲思生物技术公司 | 用于细胞植入的方法 |
EP1926459B1 (en) | 2005-09-19 | 2015-01-07 | Histogenics Corporation | Cell-support matrix having narrowly defined uniformly vertically and non-randomly organized porosity and pore density and a method for preparation thereof |
WO2007035843A2 (en) * | 2005-09-21 | 2007-03-29 | Dask Technologies, Llc | Methods and compositions for organ and tissue functionality |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
CN100475276C (zh) * | 2005-12-19 | 2009-04-08 | 北京市创伤骨科研究所 | 一种复合结构的组织工程化软骨移植物及制备方法 |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
US8623026B2 (en) | 2006-02-06 | 2014-01-07 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools incorporating anatomical relief |
EP2671521A3 (en) | 2006-02-06 | 2013-12-25 | ConforMIS, Inc. | Patient selectable joint arthroplasty devices and surgical tools |
US8500740B2 (en) * | 2006-02-06 | 2013-08-06 | Conformis, Inc. | Patient-specific joint arthroplasty devices for ligament repair |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
US11980366B2 (en) | 2006-10-03 | 2024-05-14 | Cilag Gmbh International | Surgical instrument |
US20080154233A1 (en) * | 2006-12-20 | 2008-06-26 | Zimmer Orthobiologics, Inc. | Apparatus for delivering a biocompatible material to a surgical site and method of using same |
US9592125B2 (en) * | 2006-12-22 | 2017-03-14 | Laboratoire Medidom S.A. | In situ system for intra-articular chondral and osseous tissue repair |
US8632535B2 (en) | 2007-01-10 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Interlock and surgical instrument including same |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
US7434717B2 (en) | 2007-01-11 | 2008-10-14 | Ethicon Endo-Surgery, Inc. | Apparatus for closing a curved anvil of a surgical stapling device |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US8435551B2 (en) | 2007-03-06 | 2013-05-07 | Musculoskeletal Transplant Foundation | Cancellous construct with support ring for repair of osteochondral defects |
US7604151B2 (en) | 2007-03-15 | 2009-10-20 | Ethicon Endo-Surgery, Inc. | Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features |
CA2684040C (en) | 2007-04-12 | 2016-12-06 | Isto Technologies, Inc. | Method of forming an implant using a mold that mimics the shape of the tissue defect site and implant formed therefrom |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11857181B2 (en) | 2007-06-04 | 2024-01-02 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
WO2008157412A2 (en) | 2007-06-13 | 2008-12-24 | Conformis, Inc. | Surgical cutting guide |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
WO2009049199A2 (en) * | 2007-10-12 | 2009-04-16 | Seamless Technologies, Llc | Forming a tubular knit fabric for a paint roller cover |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
JP5410110B2 (ja) | 2008-02-14 | 2014-02-05 | エシコン・エンド−サージェリィ・インコーポレイテッド | Rf電極を有する外科用切断・固定器具 |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US11986183B2 (en) | 2008-02-14 | 2024-05-21 | Cilag Gmbh International | Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US9770245B2 (en) | 2008-02-15 | 2017-09-26 | Ethicon Llc | Layer arrangements for surgical staple cartridges |
US8682052B2 (en) | 2008-03-05 | 2014-03-25 | Conformis, Inc. | Implants for altering wear patterns of articular surfaces |
AU2009246474B2 (en) | 2008-05-12 | 2015-04-16 | Conformis, Inc. | Devices and methods for treatment of facet and other joints |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
EP2393430A1 (en) | 2009-02-06 | 2011-12-14 | Ethicon Endo-Surgery, Inc. | Driven surgical stapler improvements |
US9017334B2 (en) | 2009-02-24 | 2015-04-28 | Microport Orthopedics Holdings Inc. | Patient specific surgical guide locator and mount |
EP2405865B1 (en) | 2009-02-24 | 2019-04-17 | ConforMIS, Inc. | Automated systems for manufacturing patient-specific orthopedic implants and instrumentation |
US8808297B2 (en) | 2009-02-24 | 2014-08-19 | Microport Orthopedics Holdings Inc. | Orthopedic surgical guide |
US8808303B2 (en) | 2009-02-24 | 2014-08-19 | Microport Orthopedics Holdings Inc. | Orthopedic surgical guide |
US8109935B2 (en) * | 2009-05-15 | 2012-02-07 | Musculoskeletal Transplant Foundation | Implant inserter device |
US10016278B2 (en) | 2009-06-30 | 2018-07-10 | Dsm Ip Assets B.V. | Biphasic implant device providing joint fluid therapy |
EP2448523A1 (en) * | 2009-06-30 | 2012-05-09 | Kensey Nash Corporation | Multi-phasic implant device for the repair or replacement of cartilage tissue |
US9744123B2 (en) | 2009-06-30 | 2017-08-29 | Kensey Nash Corporation | Biphasic implant device providing gradient |
EP2509539B1 (en) | 2009-12-11 | 2020-07-01 | ConforMIS, Inc. | Patient-specific and patient-engineered orthopedic implants |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9320523B2 (en) | 2012-03-28 | 2016-04-26 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising tissue ingrowth features |
US9839420B2 (en) | 2010-09-30 | 2017-12-12 | Ethicon Llc | Tissue thickness compensator comprising at least one medicament |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US10213198B2 (en) | 2010-09-30 | 2019-02-26 | Ethicon Llc | Actuator for releasing a tissue thickness compensator from a fastener cartridge |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9168038B2 (en) | 2010-09-30 | 2015-10-27 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a tissue thickness compensator |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
WO2012112702A2 (en) | 2011-02-15 | 2012-08-23 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
JP6026509B2 (ja) | 2011-04-29 | 2016-11-16 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | ステープルカートリッジ自体の圧縮可能部分内に配置されたステープルを含むステープルカートリッジ |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
RU2644272C2 (ru) | 2012-03-28 | 2018-02-08 | Этикон Эндо-Серджери, Инк. | Узел ограничения, включающий компенсатор толщины ткани |
CN104334098B (zh) | 2012-03-28 | 2017-03-22 | 伊西康内外科公司 | 包括限定低压强环境的胶囊剂的组织厚度补偿件 |
MX358135B (es) | 2012-03-28 | 2018-08-06 | Ethicon Endo Surgery Inc | Compensador de grosor de tejido que comprende una pluralidad de capas. |
US9486226B2 (en) | 2012-04-18 | 2016-11-08 | Conformis, Inc. | Tibial guides, tools, and techniques for resecting the tibial plateau |
US9675471B2 (en) | 2012-06-11 | 2017-06-13 | Conformis, Inc. | Devices, techniques and methods for assessing joint spacing, balancing soft tissues and obtaining desired kinematics for joint implant components |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
BR112014032776B1 (pt) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico |
US11278284B2 (en) | 2012-06-28 | 2022-03-22 | Cilag Gmbh International | Rotary drive arrangements for surgical instruments |
US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
US9364230B2 (en) | 2012-06-28 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with rotary joint assemblies |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
RU2636861C2 (ru) | 2012-06-28 | 2017-11-28 | Этикон Эндо-Серджери, Инк. | Блокировка пустой кассеты с клипсами |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US10016527B2 (en) | 2012-10-23 | 2018-07-10 | Orthovita, Inc. | Materials and methods for repair of cartilage defects |
US20140178343A1 (en) | 2012-12-21 | 2014-06-26 | Jian Q. Yao | Supports and methods for promoting integration of cartilage tissue explants |
BR112015021082B1 (pt) | 2013-03-01 | 2022-05-10 | Ethicon Endo-Surgery, Inc | Instrumento cirúrgico |
JP6382235B2 (ja) | 2013-03-01 | 2018-08-29 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | 信号通信用の導電路を備えた関節運動可能な外科用器具 |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
US9629623B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Drive system lockout arrangements for modular surgical instruments |
US10136887B2 (en) | 2013-04-16 | 2018-11-27 | Ethicon Llc | Drive system decoupling arrangement for a surgical instrument |
BR112015026109B1 (pt) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | Instrumento cirúrgico |
RU2678363C2 (ru) | 2013-08-23 | 2019-01-28 | ЭТИКОН ЭНДО-СЕРДЖЕРИ, ЭлЭлСи | Устройства втягивания пускового элемента для хирургических инструментов с электропитанием |
US9808249B2 (en) | 2013-08-23 | 2017-11-07 | Ethicon Llc | Attachment portions for surgical instrument assemblies |
US9480516B2 (en) * | 2013-09-09 | 2016-11-01 | Globus Medical, Inc. | Percutaneous bone screw device and method |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
US20150272557A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Modular surgical instrument system |
BR112016021943B1 (pt) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico |
US9804618B2 (en) | 2014-03-26 | 2017-10-31 | Ethicon Llc | Systems and methods for controlling a segmented circuit |
BR112016023807B1 (pt) | 2014-04-16 | 2022-07-12 | Ethicon Endo-Surgery, Llc | Conjunto de cartucho de prendedores para uso com um instrumento cirúrgico |
BR112016023698B1 (pt) | 2014-04-16 | 2022-07-26 | Ethicon Endo-Surgery, Llc | Cartucho de prendedores para uso com um instrumento cirúrgico |
US10470768B2 (en) | 2014-04-16 | 2019-11-12 | Ethicon Llc | Fastener cartridge including a layer attached thereto |
CN106456158B (zh) | 2014-04-16 | 2019-02-05 | 伊西康内外科有限责任公司 | 包括非一致紧固件的紧固件仓 |
US10206677B2 (en) | 2014-09-26 | 2019-02-19 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
US20150297225A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
US9757128B2 (en) | 2014-09-05 | 2017-09-12 | Ethicon Llc | Multiple sensors with one sensor affecting a second sensor's output or interpretation |
BR112017004361B1 (pt) | 2014-09-05 | 2023-04-11 | Ethicon Llc | Sistema eletrônico para um instrumento cirúrgico |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
BR112017005981B1 (pt) | 2014-09-26 | 2022-09-06 | Ethicon, Llc | Material de escora para uso com um cartucho de grampos cirúrgicos e cartucho de grampos cirúrgicos para uso com um instrumento cirúrgico |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10077420B2 (en) | 2014-12-02 | 2018-09-18 | Histogenics Corporation | Cell and tissue culture container |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
US9968355B2 (en) | 2014-12-18 | 2018-05-15 | Ethicon Llc | Surgical instruments with articulatable end effectors and improved firing beam support arrangements |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
MX2017008108A (es) | 2014-12-18 | 2018-03-06 | Ethicon Llc | Instrumento quirurgico con un yunque que puede moverse de manera selectiva sobre un eje discreto no movil con relacion a un cartucho de grapas. |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US10052044B2 (en) | 2015-03-06 | 2018-08-21 | Ethicon Llc | Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
JP2020121162A (ja) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | 測定の安定性要素、クリープ要素、及び粘弾性要素を決定するためのセンサデータの時間依存性評価 |
US10213201B2 (en) | 2015-03-31 | 2019-02-26 | Ethicon Llc | Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw |
CN104826167A (zh) * | 2015-05-14 | 2015-08-12 | 杭州市第一人民医院 | 一种可注射型的自体骨修复材料及其制备方法 |
CN104906633A (zh) * | 2015-05-14 | 2015-09-16 | 杭州市第一人民医院 | 一种可注射型骨修复材料及其制备方法 |
US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
US10238386B2 (en) | 2015-09-23 | 2019-03-26 | Ethicon Llc | Surgical stapler having motor control based on an electrical parameter related to a motor current |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10736633B2 (en) | 2015-09-30 | 2020-08-11 | Ethicon Llc | Compressible adjunct with looping members |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US10524788B2 (en) | 2015-09-30 | 2020-01-07 | Ethicon Llc | Compressible adjunct with attachment regions |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US9943414B2 (en) * | 2015-12-30 | 2018-04-17 | Wasas, Llc. | System and method for non-binding allograft subtalar joint implant |
BR112018016098B1 (pt) | 2016-02-09 | 2023-02-23 | Ethicon Llc | Instrumento cirúrgico |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US10368867B2 (en) | 2016-04-18 | 2019-08-06 | Ethicon Llc | Surgical instrument comprising a lockout |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
BR112019011947A2 (pt) | 2016-12-21 | 2019-10-29 | Ethicon Llc | sistemas de grampeamento cirúrgico |
US10499914B2 (en) | 2016-12-21 | 2019-12-10 | Ethicon Llc | Staple forming pocket arrangements |
US10881401B2 (en) | 2016-12-21 | 2021-01-05 | Ethicon Llc | Staple firing member comprising a missing cartridge and/or spent cartridge lockout |
US10568624B2 (en) | 2016-12-21 | 2020-02-25 | Ethicon Llc | Surgical instruments with jaws that are pivotable about a fixed axis and include separate and distinct closure and firing systems |
US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
US10542982B2 (en) | 2016-12-21 | 2020-01-28 | Ethicon Llc | Shaft assembly comprising first and second articulation lockouts |
US20180168608A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical instrument system comprising an end effector lockout and a firing assembly lockout |
US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US10568625B2 (en) | 2016-12-21 | 2020-02-25 | Ethicon Llc | Staple cartridges and arrangements of staples and staple cavities therein |
MX2019007295A (es) | 2016-12-21 | 2019-10-15 | Ethicon Llc | Sistema de instrumento quirúrgico que comprende un bloqueo del efector de extremo y un bloqueo de la unidad de disparo. |
JP7010956B2 (ja) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | 組織をステープル留めする方法 |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
US10524789B2 (en) | 2016-12-21 | 2020-01-07 | Ethicon Llc | Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration |
US10624635B2 (en) | 2016-12-21 | 2020-04-21 | Ethicon Llc | Firing members with non-parallel jaw engagement features for surgical end effectors |
US10639035B2 (en) | 2016-12-21 | 2020-05-05 | Ethicon Llc | Surgical stapling instruments and replaceable tool assemblies thereof |
US11090048B2 (en) | 2016-12-21 | 2021-08-17 | Cilag Gmbh International | Method for resetting a fuse of a surgical instrument shaft |
CN110099619B (zh) | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | 用于外科端部执行器和可替换工具组件的闭锁装置 |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
US10307170B2 (en) | 2017-06-20 | 2019-06-04 | Ethicon Llc | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US11141154B2 (en) | 2017-06-27 | 2021-10-12 | Cilag Gmbh International | Surgical end effectors and anvils |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US20190000459A1 (en) | 2017-06-28 | 2019-01-03 | Ethicon Llc | Surgical instruments with jaws constrained to pivot about an axis upon contact with a closure member that is parked in close proximity to the pivot axis |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US11389161B2 (en) | 2017-06-28 | 2022-07-19 | Cilag Gmbh International | Surgical instrument comprising selectively actuatable rotatable couplers |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11974742B2 (en) | 2017-08-03 | 2024-05-07 | Cilag Gmbh International | Surgical system comprising an articulation bailout |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US11337691B2 (en) | 2017-12-21 | 2022-05-24 | Cilag Gmbh International | Surgical instrument configured to determine firing path |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
KR101976346B1 (ko) | 2018-06-07 | 2019-05-08 | 김찬우 | 연골 세절기 |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11350938B2 (en) | 2019-06-28 | 2022-06-07 | Cilag Gmbh International | Surgical instrument comprising an aligned rfid sensor |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US12004740B2 (en) | 2019-06-28 | 2024-06-11 | Cilag Gmbh International | Surgical stapling system having an information decryption protocol |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US12035913B2 (en) | 2019-12-19 | 2024-07-16 | Cilag Gmbh International | Staple cartridge comprising a deployable knife |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11223960B2 (en) | 2020-05-13 | 2022-01-11 | T-Mobile Usa, Inc. | Network planning tool for forecasting in telecommunications networks |
US10880754B1 (en) | 2020-05-13 | 2020-12-29 | T-Mobile Usa, Inc. | Network planning tool for retention analysis in telecommunications networks |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
US20220031320A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with flexible firing member actuator constraint arrangements |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
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US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
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US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
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US11950779B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Method of powering and communicating with a staple cartridge |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
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US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
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US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
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US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11723662B2 (en) | 2021-05-28 | 2023-08-15 | Cilag Gmbh International | Stapling instrument comprising an articulation control display |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11980363B2 (en) | 2021-10-18 | 2024-05-14 | Cilag Gmbh International | Row-to-row staple array variations |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
Family Cites Families (97)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US542A (en) * | 1837-12-29 | Machine for ti-ibeshing and cleaning g-rain | ||
US2670519A (en) * | 1951-10-24 | 1954-03-02 | Charles F Recklitis | Drainage tube with clot extractor |
US3989049A (en) * | 1973-07-30 | 1976-11-02 | In Bae Yoon | Method of applying an elastic ring to an anatomical tubular structure |
US4374523A (en) * | 1974-10-29 | 1983-02-22 | Yoon In B | Occlusion ring applicator |
US4174715A (en) * | 1977-03-28 | 1979-11-20 | Hasson Harrith M | Multi-pronged laparoscopy forceps |
CH632923A5 (en) * | 1978-10-06 | 1982-11-15 | Sulzer Ag | Implant for partial replacement of a sliding surface of a human joint |
EP0034912B1 (en) | 1980-02-21 | 1983-08-17 | J. & P. Coats, Limited | Device for use in the treatment of damaged articular surfaces of human joints |
US4393872A (en) * | 1980-05-27 | 1983-07-19 | Eder Instrument Co., Inc. | Aspirating surgical forceps |
US4649918A (en) | 1980-09-03 | 1987-03-17 | Custom Medical Devices, Inc. | Bone core removing tool |
US4553272A (en) | 1981-02-26 | 1985-11-19 | University Of Pittsburgh | Regeneration of living tissues by growth of isolated cells in porous implant and product thereof |
US4393874A (en) * | 1982-04-26 | 1983-07-19 | Telectronics Pty. Ltd. | Bradycardia event counting and reporting pacer |
IL68218A (en) | 1983-03-23 | 1985-12-31 | Univ Ramot | Compositions for cartilage repair comprising embryonal chondrocytes |
US4559936A (en) | 1983-09-29 | 1985-12-24 | Hill Edward B | Bone plugging apparatus |
EP0160025B1 (en) | 1983-10-20 | 1989-12-13 | KETHARANATHAN, Vettivetpillai | Biomaterial |
US4873976A (en) * | 1984-02-28 | 1989-10-17 | Schreiber Saul N | Surgical fasteners and method |
US4611594A (en) * | 1984-04-11 | 1986-09-16 | Northwestern University | Medical instrument for containment and removal of calculi |
US4620327A (en) | 1984-07-05 | 1986-11-04 | Caplan Arnold I | Process of adapting soluble bone protein for use in stimulating osteoinduction |
US4789663A (en) | 1984-07-06 | 1988-12-06 | Collagen Corporation | Methods of bone repair using collagen |
US4877020A (en) | 1984-11-30 | 1989-10-31 | Vich Jose M O | Apparatus for bone graft |
US4642117A (en) | 1985-03-22 | 1987-02-10 | Collagen Corporation | Mechanically sheared collagen implant material and method |
US4657020A (en) * | 1985-07-10 | 1987-04-14 | Jayco Pharmaceuticals | Method of using a foreign object protector hood |
US5902741A (en) | 1986-04-18 | 1999-05-11 | Advanced Tissue Sciences, Inc. | Three-dimensional cartilage cultures |
US5041138A (en) | 1986-11-20 | 1991-08-20 | Massachusetts Institute Of Technology | Neomorphogenesis of cartilage in vivo from cell culture |
US5736372A (en) * | 1986-11-20 | 1998-04-07 | Massachusetts Institute Of Technology | Biodegradable synthetic polymeric fibrous matrix containing chondrocyte for in vivo production of a cartilaginous structure |
GB8705985D0 (en) | 1987-03-13 | 1987-04-15 | Geistlich Soehne Ag | Dressings |
US4846835A (en) | 1987-06-15 | 1989-07-11 | Grande Daniel A | Technique for healing lesions in cartilage |
US5306311A (en) | 1987-07-20 | 1994-04-26 | Regen Corporation | Prosthetic articular cartilage |
US5258043A (en) | 1987-07-20 | 1993-11-02 | Regen Corporation | Method for making a prosthetic intervertebral disc |
US5158574A (en) | 1987-07-20 | 1992-10-27 | Regen Corporation | Prosthetic meniscus |
US5116374A (en) | 1989-03-02 | 1992-05-26 | Regen Corporation | Prosthetic meniscus |
CA1329089C (en) * | 1987-09-02 | 1994-05-03 | Russell Warren | Surgical fastener |
NZ226170A (en) | 1987-09-18 | 1990-07-26 | Ethicon Inc | Stable freeze-dried pharmaceutical composition containing epidermal growth factor |
CA1339083C (en) | 1987-11-13 | 1997-07-29 | Steven R. Jefferies | Bone repair material and delayed drug delivery system |
JP2820415B2 (ja) | 1988-03-14 | 1998-11-05 | ティーエイチエム・バイオメディカル・インコーポレイテッド | 生分解性および骨形成性を有する移植骨片代用組成体 |
US5201745A (en) | 1988-03-15 | 1993-04-13 | Imedex | Visceral surgery patch |
US4975526A (en) | 1989-02-23 | 1990-12-04 | Creative Biomolecules, Inc. | Bone collagen matrix for zenogenic implants |
US4904259A (en) | 1988-04-29 | 1990-02-27 | Samuel Itay | Compositions and methods for repair of cartilage and bone |
US5108436A (en) | 1988-09-29 | 1992-04-28 | Collagen Corporation | Implant fixation |
IE61346B1 (en) | 1988-11-02 | 1994-11-02 | Genentech Inc | A permeable material to fit around the teeth or gums of a mammal |
US5510418A (en) | 1988-11-21 | 1996-04-23 | Collagen Corporation | Glycosaminoglycan-synthetic polymer conjugates |
US5162430A (en) | 1988-11-21 | 1992-11-10 | Collagen Corporation | Collagen-polymer conjugates |
US5092883A (en) | 1988-12-28 | 1992-03-03 | Eppley Barry L | Method for promoting soft connective tissue growth and repair in mammals |
WO1990009783A1 (en) | 1989-02-22 | 1990-09-07 | Massachusetts Institute Of Technology | Delivery system for controlled release of bioactive factors |
AU5654990A (en) | 1989-04-28 | 1990-11-29 | Brigham And Women's Hospital | Novel materials and methods for guided tissue regeneration |
US5015255A (en) | 1989-05-10 | 1991-05-14 | Spine-Tech, Inc. | Spinal stabilization method |
US5129906A (en) * | 1989-09-08 | 1992-07-14 | Linvatec Corporation | Bioabsorbable tack for joining bodily tissue and in vivo method and apparatus for deploying same |
US5067964A (en) | 1989-12-13 | 1991-11-26 | Stryker Corporation | Articular surface repair |
US5019108A (en) | 1990-02-02 | 1991-05-28 | Bertin Kim C | Modular implant |
US6413511B1 (en) | 1990-12-20 | 2002-07-02 | University Of Pittsburgh Of The Commonwealth System Of Higher Education | Cartilage alterations by administering to joints chondrocytes comprising a heterologous polynucleotide |
US5190561A (en) * | 1991-01-23 | 1993-03-02 | Surgical Innovations, Inc. | Tissue and organ extractor |
US5206023A (en) | 1991-01-31 | 1993-04-27 | Robert F. Shaw | Method and compositions for the treatment and repair of defects or lesions in cartilage |
US5853746A (en) | 1991-01-31 | 1998-12-29 | Robert Francis Shaw | Methods and compositions for the treatment and repair of defects or lesions in cartilage or bone using functional barrier |
US5206028A (en) | 1991-02-11 | 1993-04-27 | Li Shu Tung | Dense collagen membrane matrices for medical uses |
US5147378A (en) * | 1991-03-05 | 1992-09-15 | Harold Markham | Grapsing forceps |
SE9101853D0 (sv) | 1991-06-17 | 1991-06-17 | Jonas Wadstroem | Improved tissue ashesive |
FR2679778B1 (fr) | 1991-08-02 | 1995-07-07 | Coletica | Utilisation de collagene reticule par un agent de reticulation pour la fabrication d'une membrane suturable, biocompatible, a resorption lente, ainsi qu'une telle membrane. |
US5259835A (en) | 1991-08-29 | 1993-11-09 | Tri-Point Medical L.P. | Wound closure means and method using flowable adhesive |
US5270300A (en) | 1991-09-06 | 1993-12-14 | Robert Francis Shaw | Methods and compositions for the treatment and repair of defects or lesions in cartilage or bone |
US5308327A (en) * | 1991-11-25 | 1994-05-03 | Advanced Surgical Inc. | Self-deployed inflatable retractor |
US5344459A (en) * | 1991-12-03 | 1994-09-06 | Swartz Stephen J | Arthroscopically implantable prosthesis |
IL100721A (en) | 1992-01-21 | 1996-12-05 | Milo Simcha | Punch for opening passages between two compartments |
US5326357A (en) | 1992-03-18 | 1994-07-05 | Mount Sinai Hospital Corporation | Reconstituted cartridge tissue |
AU4543193A (en) | 1992-06-22 | 1994-01-24 | Henry E. Young | Scar inhibitory factor and use thereof |
WO1994009118A1 (en) | 1992-10-13 | 1994-04-28 | The General Hospital Corporation | Immortalized human chondrocytes |
DE4300039C1 (de) * | 1993-01-04 | 1994-06-09 | Imz Fertigung Vertrieb | Befestigungsnagel und Setzwerkzeug hierfür |
AU5822094A (en) * | 1993-01-18 | 1994-08-15 | John Crowe | Endoscope forceps |
CA2130295A1 (en) | 1993-08-26 | 1995-02-27 | Richard A. Berg | Ionically crosslinked glycosaminoglycan gels for soft tissue augmentation and drug delivery |
US5423858A (en) * | 1993-09-30 | 1995-06-13 | United States Surgical Corporation | Septoplasty fasteners and device for applying same |
GB9400163D0 (en) | 1994-01-06 | 1994-03-02 | Geistlich Soehne Ag | Membrane |
US5354283A (en) * | 1994-01-07 | 1994-10-11 | Little Rapids Corporation | Trocar retention apparatus |
CA2142209A1 (en) | 1994-03-29 | 1995-09-30 | George H. Chu | Collagen implants having improved tensile properties |
WO1995030742A1 (en) | 1994-05-05 | 1995-11-16 | Genzyme Corporation | Methods and compositions for the repair of articular cartilage defects in mammals |
EP0692227A1 (de) | 1994-07-11 | 1996-01-17 | SULZER Medizinaltechnik AG | Flächiges Implantat |
EP0804127A1 (en) | 1994-07-28 | 1997-11-05 | Ivan Vesely | Bioprosthetic implants and method of making and using same |
US5769899A (en) | 1994-08-12 | 1998-06-23 | Matrix Biotechnologies, Inc. | Cartilage repair unit |
JPH0856951A (ja) * | 1994-08-25 | 1996-03-05 | Olympus Optical Co Ltd | 内視鏡用把持鉗子 |
DE4425456A1 (de) | 1994-09-07 | 1996-03-21 | Matthias Dr Med Honl | Radialparalleles Knochensägeblatt |
US5569252A (en) * | 1994-09-27 | 1996-10-29 | Justin; Daniel F. | Device for repairing a meniscal tear in a knee and method |
US6080194A (en) | 1995-02-10 | 2000-06-27 | The Hospital For Joint Disease Orthopaedic Institute | Multi-stage collagen-based template or implant for use in the repair of cartilage lesions |
US5713374A (en) | 1995-02-10 | 1998-02-03 | The Hospital For Joint Diseases Orthopaedic Institute | Fixation method for the attachment of wound repair materials to cartilage defects |
GB9721585D0 (en) | 1997-10-10 | 1997-12-10 | Geistlich Soehne Ag | Chemical product |
GB9503492D0 (en) | 1995-02-22 | 1995-04-12 | Ed Geistlich S Hne A G F R Che | Chemical product |
US6132463A (en) | 1995-05-19 | 2000-10-17 | Etex Corporation | Cell seeding of ceramic compositions |
EP0801676A2 (de) | 1995-10-20 | 1997-10-22 | Michael Sittinger | Neue künstliche gewebe, verfahren zu ihrer herstellung und ihre verwendung |
DE19601477C2 (de) * | 1996-01-17 | 1999-12-16 | Axel Kirsch | Befestigungsnagel |
US5842477A (en) * | 1996-02-21 | 1998-12-01 | Advanced Tissue Sciences, Inc. | Method for repairing cartilage |
DE19654884C2 (de) | 1996-03-04 | 1999-07-29 | Kirsch Axel | Formkörper |
DE59710789D1 (de) * | 1996-06-04 | 2003-10-30 | Sulzer Orthopedics Ltd | Verfahren zur herstellung von knorpelgewebe und von implantaten |
US6035268A (en) * | 1996-08-22 | 2000-03-07 | Lernout & Hauspie Speech Products N.V. | Method and apparatus for breaking words in a stream of text |
US5989269A (en) | 1996-08-30 | 1999-11-23 | Vts Holdings L.L.C. | Method, instruments and kit for autologous transplantation |
US5759190A (en) | 1996-08-30 | 1998-06-02 | Vts Holdings Limited | Method and kit for autologous transplantation |
EP0842670A1 (en) | 1996-11-13 | 1998-05-20 | Katsunari Nishihara | Biomedical materials |
US6187053B1 (en) | 1996-11-16 | 2001-02-13 | Will Minuth | Process for producing a natural implant |
DE19648876C2 (de) | 1996-11-16 | 1999-10-07 | Will Minuth | Verfahren zum Herstellen eines natürlichen Implantats |
AU6654598A (en) | 1997-02-13 | 1998-09-08 | Benedict, James A. | Implantable collagen-containing putty material |
US6383195B1 (en) * | 1998-04-13 | 2002-05-07 | Endoline, Inc. | Laparoscopic specimen removal apparatus |
JP2000037388A (ja) * | 1998-05-20 | 2000-02-08 | Osamu Yoshida | 臓器収納バッグと臓器収納バッグ挿入具 |
-
1999
- 1999-08-16 WO PCT/EP1999/005993 patent/WO2000009179A2/en not_active Application Discontinuation
- 1999-08-16 CN CN99812041A patent/CN1323228A/zh active Pending
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- 1999-08-16 NZ NZ509565A patent/NZ509565A/en not_active IP Right Cessation
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---|---|---|---|---|
CN101969882A (zh) * | 2007-12-21 | 2011-02-09 | 日本医疗器材有限公司 | 细胞移植用器械 |
CN101969882B (zh) * | 2007-12-21 | 2013-11-06 | 日本医疗器材有限公司 | 细胞移植用器械 |
CN101332314B (zh) * | 2008-07-22 | 2012-11-14 | 广东冠昊生物科技股份有限公司 | 生物型关节软骨修补件 |
CN104321021A (zh) * | 2012-03-28 | 2015-01-28 | 伊西康内外科公司 | 可扩展的组织厚度补偿件 |
CN108852477A (zh) * | 2018-09-12 | 2018-11-23 | 上海交通大学医学院附属第九人民医院 | 用于干细胞治疗人体关节软骨缺损的填充修复装置 |
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