WO2017040569A1 - Meniscal repair adhesive - Google Patents

Meniscal repair adhesive Download PDF

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Publication number
WO2017040569A1
WO2017040569A1 PCT/US2016/049561 US2016049561W WO2017040569A1 WO 2017040569 A1 WO2017040569 A1 WO 2017040569A1 US 2016049561 W US2016049561 W US 2016049561W WO 2017040569 A1 WO2017040569 A1 WO 2017040569A1
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WO
WIPO (PCT)
Prior art keywords
group
composition according
combinations
prepolymer
composition
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/US2016/049561
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French (fr)
Inventor
Dottie M. CLOWER
Eric J. Beckman
Bradd N. PICONE
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cohera Medical Inc
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Cohera Medical Inc
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Filing date
Publication date
Priority to CN201680050493.7A priority Critical patent/CN108136069A/en
Priority to RU2018111319A priority patent/RU2018111319A/en
Priority to BR112018003908A priority patent/BR112018003908A2/en
Priority to EP16842847.2A priority patent/EP3344303B1/en
Priority to CA2996949A priority patent/CA2996949C/en
Priority to AU2016315735A priority patent/AU2016315735B2/en
Priority to JP2018510954A priority patent/JP2018527080A/en
Priority to KR1020187009037A priority patent/KR20180054649A/en
Application filed by Cohera Medical Inc filed Critical Cohera Medical Inc
Priority to MX2018002476A priority patent/MX2018002476A/en
Publication of WO2017040569A1 publication Critical patent/WO2017040569A1/en
Priority to IL257781A priority patent/IL257781A/en
Priority to ZA2018/01421A priority patent/ZA201801421B/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14—Macromolecular materials
    • A61L27/18—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
    • A61L24/04—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials
    • A61L24/046—Surgical adhesives or cements; Adhesives for colostomy devices containing macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C265/00—Derivatives of isocyanic acid
    • C07C265/14—Derivatives of isocyanic acid containing at least two isocyanate groups bound to the same carbon skeleton
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07F—ACYCLIC, CARBOCYCLIC OR HETEROCYCLIC COMPOUNDS CONTAINING ELEMENTS OTHER THAN CARBON, HYDROGEN, HALOGEN, OXYGEN, NITROGEN, SULFUR, SELENIUM OR TELLURIUM
    • C07F7/00—Compounds containing elements of Groups 4 or 14 of the Periodic Table
    • C07F7/02—Silicon compounds
    • C07F7/08—Compounds having one or more C—Si linkages
    • C07F7/0834—Compounds having one or more O-Si linkage
    • C07F7/0838—Compounds with one or more Si-O-Si sequences
    • C—CHEMISTRY; METALLURGY
    • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
    • C08L83/00—Compositions of macromolecular compounds obtained by reactions forming in the main chain of the macromolecule a linkage containing silicon with or without sulfur, nitrogen, oxygen or carbon only; Compositions of derivatives of such polymers
    • C08L83/04—Polysiloxanes
    • C08L83/08—Polysiloxanes containing silicon bound to organic groups containing atoms other than carbon, hydrogen and oxygen
    • C—CHEMISTRY; METALLURGY
    • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
    • C08L91/00—Compositions of oils, fats or waxes; Compositions of derivatives thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2400/00—Materials characterised by their function or physical properties
    • A61L2400/06—Flowable or injectable implant compositions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/06—Materials or treatment for tissue regeneration for cartilage reconstruction, e.g. meniscus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/10—Materials or treatment for tissue regeneration for reconstruction of tendons or ligaments

Definitions

  • This invention relates to repairing tissue defects and injuries such as meniscal tears.
  • a meniscus is a C-shaped piece of cartilage located at the edge of the knee between the femur and tibia. Each knee has two menisci: one on the outer edge of the knee (lateral meniscus) and one on the inner edge of the knee (medial meniscus).
  • a meniscal tear is a common injury that often occurs when the knee is twisted. As people age, the meniscus can also become worn and susceptible to tearing. Meniscal tears are typically treated through either open or arthroscopic surgery. In either case, the area typically is flooded with saline during the surgery.
  • a composition that includes (a) a prepolymer having at least one free isocyanate group that is capable of bonding to tissue and that cures in vivo upon exposure to water to form a polymer having a compressive modulus between 1.9 and 14.4 MPa and a tensile modulus between 5.0 and 30, and (b) an oil that is miscible in the prepolymer, the oil being selected from the group consisting of silicone oils, mineral oil, vegetable oils, and combinations thereof.
  • the composition retains its integrity when delivered in an aqueous medium.
  • the prepolymer may include urethane linkages, urea linkages, or a combination thereof.
  • suitable oils include silicone oils such as polydimethylsiloxane, simethicone, and combinations thereof.
  • the prepolymer is a siloxane prepolymer.
  • An example of a suitable siloxane prepolymer has the formula:
  • n is 1 to 10; x and y, independently, are 2 to 10; R 1 , R 2 , R 3 , R 5 , and R 6 , independently, are selected from the group consisting of hydroxyl groups; straight chain, branched, or cyclic Ci-C 6 alkyl groups that may be substituted with one or more isocyanate groups; straight chain, branched, or cyclic Ci-C 6 fluorinated alkyl groups that may be substituted with one or more isocyanate groups; and combinations thereof; R 4 is selected from the group consisting of -NCO, -SH, -OH, R 7 N + X-; R 7 is a straight chain, branched, or cyclic Ci-C 6 alkyl group; and X is selected from the group consisting of F, CI, Br, and I, with the proviso that at least one of R 1 , R 2 , R 3 , R 4 , R 5 , and R 6 includes an isocyanate group.
  • R 1 and R 2 are selected from the group consisting of hydroxyl groups; straight chain, branched, or cyclic Ci-C 6 alkyl groups that may be substituted with one or more isocyanate groups; straight chain, branched, or cyclic Ci-Ce fluonnated alkyl groups that may be substituted with one or more isocyanate groups; and combinations thereof.
  • the prepolymer can include the reaction product of a polyisocyanate, an active hydrogen component selected from the group consisting of polyols, polyamines, polythiols, polycarboxylic acids, and combinations thereof, and, optionally, an ionic salt or amino acid component having an average hydroxyl or amino functionality, or combination thereof, of at least 1.
  • suitable ionic salts components include ammoniates, halides, sulfonates, phosphonates, carboxylates, and combinations thereof.
  • the composition may include at least two different prepolymers.
  • component refers to single compounds, and to blends of different compounds.
  • the composition may be used to repair a variety of tissues, including meniscal tissue, tendons, cartilage, and the like.
  • the composition may be used to repair a meniscal defect such as a tear by delivering the composition to a knee joint in an aqueous environment in the area of a meniscal defect, and allowing the composition to cure in the presence of water present in the knee joint. Because the composition retains its integrity even when immersed in an aqueous environment such as the saline environment typically encountered during surgery, it remains intact and in place following delivery to the desired area of the knee joint as it cures and bonds to the meniscal tissue.
  • compositions include (a) a prepolymer having at least one free isocyanate group that is capable of bonding to tissue and that cures in vivo upon exposure to water to form a polymer having a compressive modulus between 1.9 and 14.4 MPa and a tensile modulus between 5.0 and 30, and (b) an oil that is miscible in the prepolymer, the oil being selected from the group consisting of silicone oils, mineral oil, vegetable oils, and combinations thereof.
  • the composition retains its integrity when delivered in an aqueous medium.
  • compositions retain their integrity even when delivered in an aqueous environment, e.g., a saline solution, they remain intact and in place following delivery to the desired area of the tissue during surgery as the prepolymer cures and bonds to the tissue.
  • the cured compositions are capable of withstanding the tensile, shear, and compressive forces to which they are exposed, e.g., within the knee joint.
  • the specific cure times, viscosities, and mechanical properties can be tailored as necessary for individual applications.
  • the prepolymer includes at least one isocyanate group, it can bond to tissue, e.g., meniscal tissue, by reacting with surface groups on the tissue.
  • tissue e.g., meniscal tissue
  • the release of controlled amounts of gas can create a scaffold-like structure and/or a textured surface that facilitates potential cell attachment and tissue regrowth through the cured polymer.
  • the oil in the composition contributes to the ability of the composition to retain its integrity when delivered in an aqueous environment.
  • the oil may also perform the function of a defoaming agent.
  • compositions include siloxane prepolymers having the formula recited in the Summary of the Invention.
  • prepolymers may be prepared e.g., by reacting alkoxy silanes and isocyanate-functional organosilanes.
  • Suitable alkoxy silane reactants have the formula: (R 1 R 2 R 3 )-Si-CH2-Z where (i) Z is an -OH, -SH, -NCO, or - HR 4 group.
  • R 4 is a hydrogen, an alkyl group (e.g., a Ci- C 6 alkyl group), or an aryl group (e.g., having at least one ring such as a phenyl group).
  • Each R 1 , R 2 , and R 3 is H, an alkoxy group (e.g., a Ci-Ce alkoxy group), an alkyl group (e.g., a Ci-Ce alkyl group), a heteroalkyl group other than an alkoxy group (e.g., an alkyl amido or amido group), an aryl group (e.g., a phenyl group), or a heteroaryl group (e.g., a pyrrolyl, furyl, or pyridinyl group), with the proviso that at least two of R 1 , R 2 , and R 3 are alkoxy groups.
  • the alkyl groups may be straight chain, branched, or cyclic alkyl groups.
  • Suitable isocyanate-functional organosilane reactants have at least one free isocyanate group and at least one terminal silane group having the formula: (R 5 R 6 R 7 )-Si- where each R 5 , R 6 , and R 7 , independently, is H, an alkoxy group (e.g., a Ci-Ce alkoxy group), an alkyl group (e.g., a Ci-Ce alkyl group), a heteroalkyl group other than an alkoxy group (e.g., an alkyl amido or amido group), an aryl group (e.g., a phenyl group), or a heteroaryl group (e.g., a pyrrolyl, furyl, or pyridinyl group).
  • an alkoxy group e.g., a Ci-Ce alkoxy group
  • an alkyl group e.g., a Ci-Ce alkyl group
  • the compositions include prepolymers prepared by reacting a polyisocyanate and an active hydrogen component.
  • suitable active hydrogen components include hydroxyl-functional components, amine-functional components, thiol -functional components, carboxylic acid-functional components, and combinations thereof.
  • some or all of the functional groups may be primary groups.
  • One class of suitable active hydrogen components includes multi-functional alcohols selected from glycerol, di-glycerol, erythritol, pentaerythritol, xylitol, arabitol, fucitol, ribitol, sorbitol, mannitol, and combinations thereof.
  • hydroxyalkyl derivatives and esters of any of these alcohols such as ethoxylated pentaerythritol.
  • Suitable active hydrogen components includes hydroxyalkyl derivatives of C3-C10 carboxylic or dicarboxylic acids (e.g., dimethylol propionic acid, dimethylol butyric acid, and combinations thereof), and hydroxyalkyl derivatives of C3- C10 hydrocarbons (e.g., trimethylol propane).
  • C3-C10 carboxylic or dicarboxylic acids e.g., dimethylol propionic acid, dimethylol butyric acid, and combinations thereof
  • hydroxyalkyl derivatives of C3- C10 hydrocarbons e.g., trimethylol propane
  • the active hydrogen component can also be a hydroxalkyl amine (e.g., triethanolamine), a di-, tri-, or tetralkylene glycol, or combination thereof.
  • hydroxyl-functional compounds selected from saccharides (e.g., glucose, fructose, sucrose, or lactose), oligosaccharides, polysaccharides, esters thereof, and combinations thereof.
  • the active hydrogen component can also be a polyamine or polyetheramine, e.g.,
  • An ionic salt or amino acid may also be included as a reactant in preparing the prepolymer.
  • Suitable ionic salt reactants include one or more hydroxyl and/or amino functional groups. Consequently, they are able to react with isocyanate-functional components in the reaction mixture, and thereby become covalently incorporated in the prepolymer.
  • suitable salts include ammoniates, halides, sulfonates, phosphonates, carboxylates, and combinations thereof. Specific examples include ammonium halides (e.g., ethyl triethanol ammonium chloride), choline halides (e.g., choline chloride), and combinations thereof.
  • suitable amino acids include lysine, 1-arginine, and combinations thereof.
  • the composition may further include a catalyst.
  • suitable catalysts include tertiary amines (e.g., aliphatic tertiary amines), organometallic compounds (e.g., bismuth salts and zirconium chelates), platinum, and palladium.
  • tertiary amines e.g., aliphatic tertiary amines
  • organometallic compounds e.g., bismuth salts and zirconium chelates
  • platinum e.g., platinum, and palladium.
  • Specific examples include l,4-diazabicyclo[2.2.2]octane (“DABCO”), 2,2'dimorpholine diethyl ether (“DMDEE”), dibutyltin dilaurate (“DBTDL”), bismuth 2-ethylhexanoate, bismuth neodecanoate, and combinations thereof.
  • DABCO 2,2'dimorpho
  • the composition may also include rheology-modifying agents such as a solvent and/or a non-volatile diluent.
  • suitable solvents include dimethylsulfoxide (DMSO), dimethylformamide (DMF), tetrahydrofuran (THF), glyme, and combinations thereof.
  • suitable non-volatile diluents include dimethylsulfoxide (DMSO), propylene carbonate, diglyme, polyethylene glycol diacetates, polyethylene glycol dicarbonates, dimethylisosorbide, ethyl pyruvate, triacetin, triethylene glycol and combinations thereof.
  • a single reagent can perform multiple roles.
  • DMSO can function as both a solvent and a non-volatile diluent.
  • the amount of the rheology modifying agent is selected based upon the constituents of the composition and the particular application for which it is being used.
  • the composition may also include antioxidants (e.g., BHT and BHA), water scavengers (e.g., acyl and aryl halides, and anhydrides), Bronsted acids, protonic acids (e.g., sulfuric or hydrochloric acid), and the like.
  • antioxidants e.g., BHT and BHA
  • water scavengers e.g., acyl and aryl halides, and anhydrides
  • Bronsted acids e.g., acyl and aryl halides, and anhydrides
  • protonic acids e.g., sulfuric or hydrochloric acid
  • the composition may also include a colorant to help a surgeon visualize the composition during application to the meniscal tissue.
  • a colorant is beta-carotene.

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  • Chemical & Material Sciences (AREA)
  • Health & Medical Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Medicinal Chemistry (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Polymers & Plastics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Dermatology (AREA)
  • Oil, Petroleum & Natural Gas (AREA)
  • Surgery (AREA)
  • Polyurethanes Or Polyureas (AREA)
  • Materials For Medical Uses (AREA)
  • Adhesives Or Adhesive Processes (AREA)
  • Compositions Of Macromolecular Compounds (AREA)
  • Prostheses (AREA)

Abstract

A composition that includes (a) a prepolymer having at least one free isocyanate group that is capable of bonding to tissue and that cures in vivo upon exposure to water to form a polymer having a compressive modulus between 1.9 and 14.4 MPa and a tensile modulus between 5.0 and 30, and (b) an oil that is miscible in the prepolymer, the oil being selected from the group consisting of silicone oils, mineral oil, vegetable oils, and combinations thereof. The composition retains its integrity when delivered in an aqueous medium.

Description

Meniscal Repair Adhesive
CLAIM OF PRIORITY
This application claims priority to U.S. Provisional Application Serial No.
62/211,953, filed on August 31, 2015, the entire contents of which are hereby
incorporated by reference.
TECHNICAL FIELD
This invention relates to repairing tissue defects and injuries such as meniscal tears.
BACKGROUND
A meniscus is a C-shaped piece of cartilage located at the edge of the knee between the femur and tibia. Each knee has two menisci: one on the outer edge of the knee (lateral meniscus) and one on the inner edge of the knee (medial meniscus). A meniscal tear is a common injury that often occurs when the knee is twisted. As people age, the meniscus can also become worn and susceptible to tearing. Meniscal tears are typically treated through either open or arthroscopic surgery. In either case, the area typically is flooded with saline during the surgery.
SUMMARY
In one aspect, there is described a composition that includes (a) a prepolymer having at least one free isocyanate group that is capable of bonding to tissue and that cures in vivo upon exposure to water to form a polymer having a compressive modulus between 1.9 and 14.4 MPa and a tensile modulus between 5.0 and 30, and (b) an oil that is miscible in the prepolymer, the oil being selected from the group consisting of silicone oils, mineral oil, vegetable oils, and combinations thereof. The composition retains its integrity when delivered in an aqueous medium.
In certain embodiments, the prepolymer may include urethane linkages, urea linkages, or a combination thereof. Examples of suitable oils include silicone oils such as polydimethylsiloxane, simethicone, and combinations thereof. In certain embodiments, the prepolymer is a siloxane prepolymer. An example of a suitable siloxane prepolymer has the formula:
Figure imgf000003_0001
In this formula, n is 1 to 10; x and y, independently, are 2 to 10; R1, R2, R3, R5, and R6, independently, are selected from the group consisting of hydroxyl groups; straight chain, branched, or cyclic Ci-C6 alkyl groups that may be substituted with one or more isocyanate groups; straight chain, branched, or cyclic Ci-C6 fluorinated alkyl groups that may be substituted with one or more isocyanate groups; and combinations thereof; R4 is selected from the group consisting of -NCO, -SH, -OH, R7N+X-; R7 is a straight chain, branched, or cyclic Ci-C6 alkyl group; and X is selected from the group consisting of F, CI, Br, and I, with the proviso that at least one of R1, R2, R3, R4, R5, and R6 includes an isocyanate group. Another example of a suitable siloxane prepolymer has the following formula:
Figure imgf000004_0001
In this formula, R1 and R2, independently, are selected from the group consisting of hydroxyl groups; straight chain, branched, or cyclic Ci-C6 alkyl groups that may be substituted with one or more isocyanate groups; straight chain, branched, or cyclic Ci-Ce fluonnated alkyl groups that may be substituted with one or more isocyanate groups; and combinations thereof.
In certain embodiments, the prepolymer can include the reaction product of a polyisocyanate, an active hydrogen component selected from the group consisting of polyols, polyamines, polythiols, polycarboxylic acids, and combinations thereof, and, optionally, an ionic salt or amino acid component having an average hydroxyl or amino functionality, or combination thereof, of at least 1. Examples of suitable ionic salts components include ammoniates, halides, sulfonates, phosphonates, carboxylates, and combinations thereof. The composition may include at least two different prepolymers.
As used herein, the term "component" refers to single compounds, and to blends of different compounds.
Representative examples of suitable prepolymers having the following structures:
Figure imgf000005_0001
The composition may be used to repair a variety of tissues, including meniscal tissue, tendons, cartilage, and the like. For example, the composition may be used to repair a meniscal defect such as a tear by delivering the composition to a knee joint in an aqueous environment in the area of a meniscal defect, and allowing the composition to cure in the presence of water present in the knee joint. Because the composition retains its integrity even when immersed in an aqueous environment such as the saline environment typically encountered during surgery, it remains intact and in place following delivery to the desired area of the knee joint as it cures and bonds to the meniscal tissue.
The details of one or more embodiments of the invention are set forth in the description below. Other features, objects, and advantages of the invention will be apparent from the description and from the claims.
DETAILED DESCRIPTION
The compositions include (a) a prepolymer having at least one free isocyanate group that is capable of bonding to tissue and that cures in vivo upon exposure to water to form a polymer having a compressive modulus between 1.9 and 14.4 MPa and a tensile modulus between 5.0 and 30, and (b) an oil that is miscible in the prepolymer, the oil being selected from the group consisting of silicone oils, mineral oil, vegetable oils, and combinations thereof. The composition retains its integrity when delivered in an aqueous medium.
Because the compositions retain their integrity even when delivered in an aqueous environment, e.g., a saline solution, they remain intact and in place following delivery to the desired area of the tissue during surgery as the prepolymer cures and bonds to the tissue. In addition, the cured compositions are capable of withstanding the tensile, shear, and compressive forces to which they are exposed, e.g., within the knee joint. The specific cure times, viscosities, and mechanical properties can be tailored as necessary for individual applications.
Because the prepolymer includes at least one isocyanate group, it can bond to tissue, e.g., meniscal tissue, by reacting with surface groups on the tissue. In some cases, the release of controlled amounts of gas can create a scaffold-like structure and/or a textured surface that facilitates potential cell attachment and tissue regrowth through the cured polymer.
The oil in the composition contributes to the ability of the composition to retain its integrity when delivered in an aqueous environment. The oil may also perform the function of a defoaming agent.
In some embodiments, the compositions include siloxane prepolymers having the formula recited in the Summary of the Invention. Such prepolymers may be prepared e.g., by reacting alkoxy silanes and isocyanate-functional organosilanes.
Suitable alkoxy silane reactants have the formula: (R1R2R3)-Si-CH2-Z where (i) Z is an -OH, -SH, -NCO, or - HR4 group. R4 is a hydrogen, an alkyl group (e.g., a Ci- C6 alkyl group), or an aryl group (e.g., having at least one ring such as a phenyl group). Each R1, R2, and R3, independently, is H, an alkoxy group (e.g., a Ci-Ce alkoxy group), an alkyl group (e.g., a Ci-Ce alkyl group), a heteroalkyl group other than an alkoxy group (e.g., an alkyl amido or amido group), an aryl group (e.g., a phenyl group), or a heteroaryl group (e.g., a pyrrolyl, furyl, or pyridinyl group), with the proviso that at least two of R1, R2, and R3 are alkoxy groups. The alkyl groups may be straight chain, branched, or cyclic alkyl groups.
Suitable isocyanate-functional organosilane reactants have at least one free isocyanate group and at least one terminal silane group having the formula: (R5R6R7)-Si- where each R5, R6, and R7, independently, is H, an alkoxy group (e.g., a Ci-Ce alkoxy group), an alkyl group (e.g., a Ci-Ce alkyl group), a heteroalkyl group other than an alkoxy group (e.g., an alkyl amido or amido group), an aryl group (e.g., a phenyl group), or a heteroaryl group (e.g., a pyrrolyl, furyl, or pyridinyl group).
In some embodiments, the compositions include prepolymers prepared by reacting a polyisocyanate and an active hydrogen component. Examples of suitable active hydrogen components include hydroxyl-functional components, amine-functional components, thiol -functional components, carboxylic acid-functional components, and combinations thereof. In some embodiments, some or all of the functional groups may be primary groups. One class of suitable active hydrogen components includes multi-functional alcohols selected from glycerol, di-glycerol, erythritol, pentaerythritol, xylitol, arabitol, fucitol, ribitol, sorbitol, mannitol, and combinations thereof. Also suitable are hydroxyalkyl derivatives and esters of any of these alcohols such as ethoxylated pentaerythritol.
Another class of suitable active hydrogen components includes hydroxyalkyl derivatives of C3-C10 carboxylic or dicarboxylic acids (e.g., dimethylol propionic acid, dimethylol butyric acid, and combinations thereof), and hydroxyalkyl derivatives of C3- C10 hydrocarbons (e.g., trimethylol propane).
The active hydrogen component can also be a hydroxalkyl amine (e.g., triethanolamine), a di-, tri-, or tetralkylene glycol, or combination thereof. Also suitable are hydroxyl-functional compounds selected from saccharides (e.g., glucose, fructose, sucrose, or lactose), oligosaccharides, polysaccharides, esters thereof, and combinations thereof.
The active hydrogen component can also be a polyamine or polyetheramine, e.g.,
Jeff amine.
An ionic salt or amino acid may also be included as a reactant in preparing the prepolymer. Suitable ionic salt reactants include one or more hydroxyl and/or amino functional groups. Consequently, they are able to react with isocyanate-functional components in the reaction mixture, and thereby become covalently incorporated in the prepolymer. Examples of suitable salts include ammoniates, halides, sulfonates, phosphonates, carboxylates, and combinations thereof. Specific examples include ammonium halides (e.g., ethyl triethanol ammonium chloride), choline halides (e.g., choline chloride), and combinations thereof. Examples of suitable amino acids include lysine, 1-arginine, and combinations thereof.
The composition may further include a catalyst. Examples of suitable catalysts include tertiary amines (e.g., aliphatic tertiary amines), organometallic compounds (e.g., bismuth salts and zirconium chelates), platinum, and palladium. Specific examples include l,4-diazabicyclo[2.2.2]octane ("DABCO"), 2,2'dimorpholine diethyl ether ("DMDEE"), dibutyltin dilaurate ("DBTDL"), bismuth 2-ethylhexanoate, bismuth neodecanoate, and combinations thereof. The amount of catalyst is selected based upon the particular reactants.
The composition may also include rheology-modifying agents such as a solvent and/or a non-volatile diluent. Examples of suitable solvents include dimethylsulfoxide (DMSO), dimethylformamide (DMF), tetrahydrofuran (THF), glyme, and combinations thereof. Examples of suitable non-volatile diluents include dimethylsulfoxide (DMSO), propylene carbonate, diglyme, polyethylene glycol diacetates, polyethylene glycol dicarbonates, dimethylisosorbide, ethyl pyruvate, triacetin, triethylene glycol and combinations thereof. A single reagent can perform multiple roles. Thus, for example, DMSO can function as both a solvent and a non-volatile diluent. The amount of the rheology modifying agent is selected based upon the constituents of the composition and the particular application for which it is being used.
The composition may also include antioxidants (e.g., BHT and BHA), water scavengers (e.g., acyl and aryl halides, and anhydrides), Bronsted acids, protonic acids (e.g., sulfuric or hydrochloric acid), and the like. The acids may also function as catalysts.
The composition may also include a colorant to help a surgeon visualize the composition during application to the meniscal tissue. An example of a suitable colorant is beta-carotene.
A number of embodiments of the invention have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the invention. Accordingly, other embodiments are within the scope of the following claims.

Claims

WHAT IS CLAIMED IS: 1. A composition comprising:
(a) a prepolymer having at least one free isocyanate group that is capable of bonding to tissue and that cures in vivo upon exposure to water to form a polymer having a compressive modulus between 1.9 and 14.4 MPa and a tensile modulus between 5.0 and 30, and
(b) an oil that is miscible in the prepolymer, the oil being selected from the group consisting of silicone oils, mineral oil, vegetable oils, and combinations thereof, wherein the composition retains its integrity when delivered in an aqueous medium.
2. A composition according to claim 1 wherein the prepolymer comprises linkages
selected from the group consisting of urea linkages, urethane linkages, and combinations thereof.
3. A composition according to claim 1 wherein the prepolymer is a siloxane prepolymer.
4. A composition according to claim 3 wherein the siloxane prepolymer has the formula:
Figure imgf000011_0001
where n is 1 to 10; x and y, independently, are 2 to 10; R1, R2, R3, R5, and R6,
independently, are selected from the group consisting of hydroxyl groups; straight chain, branched, or cyclic Ci-C6 alkyl groups that may be substituted with one or more isocyanate groups; straight chain, branched, or cyclic Ci-C6 fluorinated alkyl groups that may be substituted with one or more isocyanate groups; and combinations thereof; R4 is selected from the group consisting of -NCO, -SH, -OH, R7N+X-; R7 is a straight chain, branched, or cyclic Ci-C6 alkyl group; and X is selected from the group consisting of F, CI, Br, and I, with the proviso that at least one of R1, R2, R3, R4, R5, and R6 includes an isocyanate group.
5. A composition according to claim 3 wherein the siloxane prepolymer has the formula:
Figure imgf000012_0001
where R1 and R2, independently, are selected from the group consisting of hydroxyl
groups; straight chain, branched, or cyclic Ci-C6 alkyl groups that may be substituted with one or more isocyanate groups; straight chain, branched, or cyclic Ci-C6 fluorinated alkyl groups that may be substituted with one or more isocyanate groups; and combinations thereof.
6. A composition according to claim 1 wherein the prepolymer comprises the reaction product of a polyisocyanate and an active hydrogen component selected from the group consisting of polyols, polyamines, polythiols, polycarboxylic acids, and combinations thereof.
7. A composition according to claim 1 wherein the prepolymer comprises the reaction product of (a) a polyisocyanate, (b) an active hydrogen component selected from the group consisting of polyols, polyamines, polythiols, polycarboxylic acids, and combinations thereof, and (c) an ionic salt or amino acid component having an average hydroxyl or amino functionality, or combination thereof, of at least 1.
8. A composition according to claim 7 wherein the ionic salt component is selected from the group consisting of ammoniates, halides, sulfonates, phosphonates, carboxylates, and combinations thereof.
9. A composition according to claim 1 wherein the composition comprises at least two different prepolymers.
10. A composition according to claim 8 wherein the prepolymers are selected from the group of compounds having the formulae:
Figure imgf000013_0001
Figure imgf000014_0001
and combinations thereof.
11. A composition according to claim 1 wherein the oil comprises a silicone oil.
12. A composition according to claim 11 wherein the silicone oil is selected from the group consisting of poly dimethyl siloxane, simethicone, and combinations thereof.
13. A composition according to claim 1 wherein the tissue is selected from the group consisting of meniscal tissue, cartilage, tendons, and combinations thereof.
14. A method of repairing a defect in meniscal tissue comprising delivering a
composition according to claim 1 to the knee joint in an aqueous environment in the area of the meniscal defect, and allowing the composition to cure and bond to the meniscal tissue.
PCT/US2016/049561 2015-08-31 2016-08-31 Meniscal repair adhesive Ceased WO2017040569A1 (en)

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JP2018510954A JP2018527080A (en) 2015-08-31 2016-08-31 Meniscus repair adhesive
BR112018003908A BR112018003908A2 (en) 2015-08-31 2016-08-31 meniscal repair sticker
EP16842847.2A EP3344303B1 (en) 2015-08-31 2016-08-31 Meniscal repair adhesive
CA2996949A CA2996949C (en) 2015-08-31 2016-08-31 Meniscal repair adhesive
AU2016315735A AU2016315735B2 (en) 2015-08-31 2016-08-31 Meniscal repair adhesive
CN201680050493.7A CN108136069A (en) 2015-08-31 2016-08-31 Meniscal repairs adhesive
RU2018111319A RU2018111319A (en) 2015-08-31 2016-08-31 MENISK RECOVERY ADHESIVE
KR1020187009037A KR20180054649A (en) 2015-08-31 2016-08-31 Restoration adhesive for meniscus
MX2018002476A MX2018002476A (en) 2015-08-31 2016-08-31 Meniscal repair adhesive.
IL257781A IL257781A (en) 2015-08-31 2018-02-27 Meniscal repair adhesive compositions and uses thereof
ZA2018/01421A ZA201801421B (en) 2015-08-31 2018-02-28 Meniscal repair adhesive

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EP3344303B1 (en) * 2015-08-31 2021-08-04 Arthrex, Inc. Meniscal repair adhesive
CN109260505B (en) * 2018-11-12 2021-02-09 上海交通大学 A kind of multi-component bone cementing material and using method
CN114984298A (en) * 2022-07-18 2022-09-02 重庆大学 A kind of cartilage tissue adhesive and its preparation method and use

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ZA201801421B (en) 2019-07-31
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CA2996949C (en) 2020-10-27
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BR112018003908A2 (en) 2018-09-25
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AU2016315735A1 (en) 2018-03-15
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EP3344303A4 (en) 2019-04-24
CN108136069A (en) 2018-06-08

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