WO1998042280A1 - Cement delivery system - Google Patents

Cement delivery system Download PDF

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Publication number
WO1998042280A1
WO1998042280A1 PCT/GB1998/000901 GB9800901W WO9842280A1 WO 1998042280 A1 WO1998042280 A1 WO 1998042280A1 GB 9800901 W GB9800901 W GB 9800901W WO 9842280 A1 WO9842280 A1 WO 9842280A1
Authority
WO
WIPO (PCT)
Prior art keywords
cement
delivery system
tube
tubular member
container
Prior art date
Application number
PCT/GB1998/000901
Other languages
French (fr)
Inventor
Alan James Dextradeur
Kevin Cheah
Original Assignee
Johnson & Johnson Professional, Inc.
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 Johnson & Johnson Professional, Inc. filed Critical Johnson & Johnson Professional, Inc.
Priority to AU67411/98A priority Critical patent/AU6741198A/en
Publication of WO1998042280A1 publication Critical patent/WO1998042280A1/en

Links

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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8811—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer tip, i.e. the part inserted into or onto the bone
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30723—Plugs or restrictors for sealing a cement-receiving space
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of shafts
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • A61F2002/30726—Centering or guiding rods, e.g. for insertion of femoral shafts
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface

Definitions

  • the present invention relates to a cement delivery system for delivering cement into a bone cavity in particular during a joint replacement operation.
  • the technique of using impacted cancellous allografr and cement is used in femor replacements to address serious loss of bone stock at a femoral revision.
  • the basic operative technique involves packing the bone canal within the femur with cancellous allograft bone chips to form a "neo- medullary canal".
  • a medullary plug is usually located in the bone to seal the bone canal and a guide rod extends from the plug. Specially designed instruments can be passed over the guide rod to pack the graft and the guide rod maintains centralization witnin the canal.
  • cement is introduced into the canal in a retrograde fashion. After filling the canal cavity with cement, the femoral component is inserted.
  • Known cement delivery systems are in the form of cement guns.
  • a known cement gun is described in EP-A-0106960 in which a tube is connectable to a cement holding cylinder and a plunger is provided which fits inside the tube and forces out a small quantity of cement at high pressure.
  • Cement delivery systems such as that shown in EP-A-0106960 have the disadvantage of requiring the tube to be inserted into the bone cavity risking the damage to the wall of the cavity of impacted allograf-.
  • a cement delivery system comprising a container suitable for holding cement, a tubular member communicating with and ex-ending from the container, and means for forcing cement from the container into the tubular member, wherein the tubular member has locating means to locate the tubular member centrally over a guide rod.
  • the locating means is in the form of a plurality of projections projecting from the internal surface of the tubular member.
  • the projections extend along the length of the tubular member. Spaces may be provided between the projections providing a passage for cement through the tubular member.
  • the projections are in the form of three radial lobes which together define a central passageway for a guide rod.
  • the means for forcing the cement from the container may be in the form of a syringe.
  • the tubular member may have a tapered distal end for ease of location of the tubular member over a guide rod.
  • Figure 1 is a cross section of a cement delivery system in accordance with the present invention located within a canal of a femur;
  • Figure 2a is a cross section of a first embodiment of a tubular member of the cement delivery system of Figure 1;
  • Figure 2b is a cross section of a second embodiment of a tubular member of the cement delivery system of Figure 1.
  • a cement delivery system 1 has a container 2 for holding bone cement for example PMMA bone cement.
  • a syringe 6 is provided in the container 2 to force the cement from the container 2 into an elongate tube .
  • the tube 4 or spout or obturator has a tapered end 8 which defines an opening 22 in the distal end 24 of the tube 4.
  • the tube 4 has at least three projections in the form of radial lobes 20 extending from the internal surface 26 of the tube 4.
  • the lobes 20 extend the full length of the tube 4.
  • the lobes 20 can be moulded with the tube 4.
  • the lobes 20 define passages 18 between the lobes 20 through which the cement 3 can pass.
  • the size of the passages 18 and the lobes 20 can be varied to obtain a greater or lesser cement flow through the tube 4.
  • Figure 2a shows a tube 4 in which the lobes 20 are fairly large providing three narrow passages 18 for the cement 3 resulting in a small amount of cement flow.
  • Figure 2b shows a tube 4 in which the passages 18 are larger allowing a greater cement flow.
  • the lobes 20 also define a central passage 28 along the length of the tube 4.
  • the central passage 28 is suitable for locating a guide rod 10 within the tube 4.
  • a guide rod 10 is shown in broken lines of Figures 2a and 2b.
  • a bone for example a femur 14, has a central canal 30 which during a replacement operation is sealed by an intra- edullary plug 12.
  • the plug 12 has a guide rod 10 extending along the canal 30 of the femur 14.
  • Femoral revision can be carried out by packing the canal 30 with cancellous allograft bone chips to form a neo- edullary canal 16.
  • the guide rod 10 is used to guide instruments for packing the graft and maintaining centralization within the canal 30 of the femur 14.
  • cement 3 is introduced into the bone canal 30 by a cement delivery system 1.
  • the tapered end 3 of the tube 4 of the cement delivery system 1 is located over the guide rod 10 and the tube 4 is guided within the bone canal 30.
  • the tube 4 maintains its central position over the guide rod 10 as the guide rod 10 enters the central passage 23 within the tube 4 defined by the lobes 20.
  • cement 3 is forced into the tube 4.
  • the cement 3 is then guided by the lobes 20 through the passages 13.
  • the cement 3 exits from the distal end 24 of the tube 4 and flows into the bone canal 30.
  • the tube 4 can be withdrawn slowly along the guide rod 10 during the cement delivery process. Once the bone canal 30 is full of cement 3, the tube 4 is removed from the guide rod 10. The internal arrangement of the tube 4 prevents the tube from contacting the neo-medullary canal 16 of the bone canal 30.
  • the cement delivery system 1 may allow more complete filling of the bone canal 30 and reduces voids in the cement and allograft matrix.
  • the described embodiments have curved radial lobes 20 to centre the guide rod 10 within the tube 4.
  • the lobes 20 could equally be replaced by radial strips which could be connected by a secondary internal tube into which the guide rod -10 is locatable thereby forming a double walled sheath.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

A cement delivery system (1) with a container (2) for holding cement (3). A syringe (6) is provided in the container (2) to force the cement (3) from the container (2) into a tube (4). The tube (4), which is locatable within a bone canal (30), has a central locating means for locating the tube (4) over a guide rod (10). The locating means of the tube (4) is in the form of a number of projections (20) from an internal surface (26) of the tube (4).

Description

CEMENT DELIVERY SYSTEM
The present invention relates to a cement delivery system for delivering cement into a bone cavity in particular during a joint replacement operation.
The technique of using impacted cancellous allografr and cement is used in femor replacements to address serious loss of bone stock at a femoral revision. The basic operative technique involves packing the bone canal within the femur with cancellous allograft bone chips to form a "neo- medullary canal". A medullary plug is usually located in the bone to seal the bone canal and a guide rod extends from the plug. Specially designed instruments can be passed over the guide rod to pack the graft and the guide rod maintains centralization witnin the canal. After a trial reduction, cement is introduced into the canal in a retrograde fashion. After filling the canal cavity with cement, the femoral component is inserted.
When inserting the cement into the canal cavity, the surgeon must take precautions to avoid hitting the -wall of the "neo- medullary canal" to prevent damage to the impacted bone graft. Damage to this graft could result in voids in the cement and/or cement extruding into lytic regions preventing any possibility of the replacement of graft by living bone.
It has been found that improved cementing techniques decrease the rate of aseptic loosening of femoral components of cemented total hip replacements of the non-allograft impaction type. Improved cementing techniques are also required when using allograft impaction.
Known cement delivery systems are in the form of cement guns. A known cement gun is described in EP-A-0106960 in which a tube is connectable to a cement holding cylinder and a plunger is provided which fits inside the tube and forces out a small quantity of cement at high pressure. Cement delivery systems such as that shown in EP-A-0106960 have the disadvantage of requiring the tube to be inserted into the bone cavity risking the damage to the wall of the cavity of impacted allograf-.
According to the present invention there is provided a cement delivery system comprising a container suitable for holding cement, a tubular member communicating with and ex-ending from the container, and means for forcing cement from the container into the tubular member, wherein the tubular member has locating means to locate the tubular member centrally over a guide rod.
' Preferably, the locating means is in the form of a plurality of projections projecting from the internal surface of the tubular member. Preferably, the projections extend along the length of the tubular member. Spaces may be provided between the projections providing a passage for cement through the tubular member.
Most preferably, the projections are in the form of three radial lobes which together define a central passageway for a guide rod.
The means for forcing the cement from the container may be in the form of a syringe.
The tubular member may have a tapered distal end for ease of location of the tubular member over a guide rod.
Embodiments of a cement delivery system in accordance with the present invention are now described with reference to the accompanying drawings, in which:
Figure 1 is a cross section of a cement delivery system in accordance with the present invention located within a canal of a femur; Figure 2a is a cross section of a first embodiment of a tubular member of the cement delivery system of Figure 1; and
Figure 2b is a cross section of a second embodiment of a tubular member of the cement delivery system of Figure 1.
Referring to the drawings, a cement delivery system 1 has a container 2 for holding bone cement for example PMMA bone cement. A syringe 6 is provided in the container 2 to force the cement from the container 2 into an elongate tube .
The tube 4 or spout or obturator has a tapered end 8 which defines an opening 22 in the distal end 24 of the tube 4.
The tube 4 has at least three projections in the form of radial lobes 20 extending from the internal surface 26 of the tube 4. The lobes 20 extend the full length of the tube 4. The lobes 20 can be moulded with the tube 4.
The lobes 20 define passages 18 between the lobes 20 through which the cement 3 can pass. The size of the passages 18 and the lobes 20 can be varied to obtain a greater or lesser cement flow through the tube 4. Figure 2a shows a tube 4 in which the lobes 20 are fairly large providing three narrow passages 18 for the cement 3 resulting in a small amount of cement flow. Figure 2b shows a tube 4 in which the passages 18 are larger allowing a greater cement flow.
The lobes 20 also define a central passage 28 along the length of the tube 4. The central passage 28 is suitable for locating a guide rod 10 within the tube 4. A guide rod 10 is shown in broken lines of Figures 2a and 2b.
A bone, for example a femur 14, has a central canal 30 which during a replacement operation is sealed by an intra- edullary plug 12. The plug 12 has a guide rod 10 extending along the canal 30 of the femur 14. Femoral revision can be carried out by packing the canal 30 with cancellous allograft bone chips to form a neo- edullary canal 16. The guide rod 10 is used to guide instruments for packing the graft and maintaining centralization within the canal 30 of the femur 14. After trial reduction, cement 3 is introduced into the bone canal 30 by a cement delivery system 1.
The tapered end 3 of the tube 4 of the cement delivery system 1 is located over the guide rod 10 and the tube 4 is guided within the bone canal 30. The tube 4 maintains its central position over the guide rod 10 as the guide rod 10 enters the central passage 23 within the tube 4 defined by the lobes 20.
As the cement delivery system 1 is activated by pushing the syringe 6 down within the container 2, cement 3 is forced into the tube 4.
There may be an initial portion of the tube 4 at its proximal end adjacent the container 2 without any lobes 20 into which the cement 3 first enters.
The cement 3 is then guided by the lobes 20 through the passages 13. The cement 3 exits from the distal end 24 of the tube 4 and flows into the bone canal 30.
The tube 4 can be withdrawn slowly along the guide rod 10 during the cement delivery process. Once the bone canal 30 is full of cement 3, the tube 4 is removed from the guide rod 10. The internal arrangement of the tube 4 prevents the tube from contacting the neo-medullary canal 16 of the bone canal 30.
The cement delivery system 1 may allow more complete filling of the bone canal 30 and reduces voids in the cement and allograft matrix. The described embodiments have curved radial lobes 20 to centre the guide rod 10 within the tube 4. However, it will be appreciated that the lobes 20 could equally be replaced by radial strips which could be connected by a secondary internal tube into which the guide rod -10 is locatable thereby forming a double walled sheath.
Modifications and improvements can be to the foregoing without departing from the scope of the present invention.

Claims

CLAIMS :
1. A cement delivery system (1) comprising a container (2) suitable for holding cement (3) , a tubular member (4) communicating with and extending from the container (2) , and means for forcing cement (3) from the container (2) into the tubular member (4) , wherein the tubular member (4) has locating means to locate the tubular member (4) centrally over a guide rod (10) .
2. A cement delivery system (1) as claimed in claim 1, wherein the locating means is in the form of a plurality of projections (20) projecting from the internal surface of the tubular member (4) .
3. A cement delivery system (1) as claimed in claim 2, wherein the projections (20) extend along the length of the tubular member (4) .
4. A cement delivery system (1) as claimed in claim 2 or claim 3 , wherein spaces are provided between the projections (20) providing a passage for cement (3) through the tubular member (4) .
5. A cement delivery system (1) as claimed in any of claims 2 to 4, wherein the projections (20) are in the form of three radial lobes which together define a central passageway for a guide rod (10) .
6. A cement delivery system (1) as claimed in any of the preceding claims, wherein the means for forcing cement (3) from the container (2) is in the form of a syringe (6) .
7. A cement delivery system (1) as claimed in any of the preceding claims, wherein the tubular member (4) has a tapered end for ease of location of the tubular member (4) over a guide rod (10) .
PCT/GB1998/000901 1997-03-26 1998-03-25 Cement delivery system WO1998042280A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU67411/98A AU6741198A (en) 1997-03-26 1998-03-25 Cement delivery system

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB9706236.8A GB9706236D0 (en) 1997-03-26 1997-03-26 Cement delivery system
GB9706236.8 1997-03-26

Publications (1)

Publication Number Publication Date
WO1998042280A1 true WO1998042280A1 (en) 1998-10-01

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Application Number Title Priority Date Filing Date
PCT/GB1998/000901 WO1998042280A1 (en) 1997-03-26 1998-03-25 Cement delivery system

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AU (1) AU6741198A (en)
GB (1) GB9706236D0 (en)
WO (1) WO1998042280A1 (en)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1095667A2 (en) * 1999-11-01 2001-05-02 Dunsch-Herzberg, Renate Apparatus for filling bone cement into a bone canal
WO2004071354A1 (en) * 2003-02-12 2004-08-26 Australian Surgical Design And Manufacture Pty Limited Arthroscopic chondrocyte implantation method and device
WO2009087421A2 (en) 2008-01-09 2009-07-16 Oswestry Tissue Bank Ltd Bone repair composition and a method of making the same
WO2017015371A1 (en) * 2015-07-21 2017-01-26 Smith & Nephew, Inc. Orthopedic instrumentation

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0093560A2 (en) * 1982-05-03 1983-11-09 Pfizer Hospital Products Group, Inc. Intramedullary canal seal for cement pressurization
US4919673A (en) * 1988-02-29 1990-04-24 Sulzer Brothers Limited Prosthesis for a femoral head
EP0379785A1 (en) * 1989-01-25 1990-08-01 SMITH & NEPHEW RICHARDS, INC. Femoral stem distal centralizer
FR2662931A1 (en) * 1990-06-11 1991-12-13 Setiey Louis Joint prosthesis element embedded in a bone
US5468245A (en) * 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0093560A2 (en) * 1982-05-03 1983-11-09 Pfizer Hospital Products Group, Inc. Intramedullary canal seal for cement pressurization
US4919673A (en) * 1988-02-29 1990-04-24 Sulzer Brothers Limited Prosthesis for a femoral head
EP0379785A1 (en) * 1989-01-25 1990-08-01 SMITH & NEPHEW RICHARDS, INC. Femoral stem distal centralizer
FR2662931A1 (en) * 1990-06-11 1991-12-13 Setiey Louis Joint prosthesis element embedded in a bone
US5468245A (en) * 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1095667A2 (en) * 1999-11-01 2001-05-02 Dunsch-Herzberg, Renate Apparatus for filling bone cement into a bone canal
EP1095667A3 (en) * 1999-11-01 2001-05-30 Dunsch-Herzberg, Renate Apparatus for filling bone cement into a bone canal
WO2004071354A1 (en) * 2003-02-12 2004-08-26 Australian Surgical Design And Manufacture Pty Limited Arthroscopic chondrocyte implantation method and device
WO2009087421A2 (en) 2008-01-09 2009-07-16 Oswestry Tissue Bank Ltd Bone repair composition and a method of making the same
WO2009087421A3 (en) * 2008-01-09 2010-03-25 Oswestry Tissue Bank Ltd Bone repair composition and a method of making the same
WO2017015371A1 (en) * 2015-07-21 2017-01-26 Smith & Nephew, Inc. Orthopedic instrumentation
CN107847234A (en) * 2015-07-21 2018-03-27 史密夫和内修有限公司 Orthopaedic instrumentation
US10188404B2 (en) 2015-07-21 2019-01-29 Smith & Nephew, Inc. Orthopedic instrumentation
US10799249B2 (en) 2015-07-21 2020-10-13 Smith & Nephew, Inc. Orthopedic instrumentation

Also Published As

Publication number Publication date
GB9706236D0 (en) 1997-05-14
AU6741198A (en) 1998-10-20

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