DE20303205U1 - Device for insertion and fixing of cartilage substituting implant, comprising holding and anchoring element - Google Patents

Abstract

The device (1) is assembled of a piece of fleece (12) serving as the carrier matrix and provided with the prepared substance required for the body to grow its own cartilage replacement and several screws (14) as fixing elements. The fleece (12) can be inserted and positioned by using arthroscopy or mini-arthromy and is fixed with the appropriate number of screws (14), depending on the size of the gap (30). For an easier insertion of the shafts (16) the fleece (12) can be prepared with the required amount of openings (36).

Description

Implant and implant system

The invention relates to an implant for holding a cartilage replacement implant replacing a damaged cartilage area of a joint of a human body on the human body and to a cartilage replacement implant for replacing a damaged cartilage area of a human body.

Furthermore, the invention relates to an implant system for replacing a damaged cartilage region of a joint of a human body, comprising at least one cartilage replacement implant for replacing the damaged cartilage region and at least one implant for holding the cartilage replacement implant on the human body.

It is known that traumatic or degenerative defects in cartilage in the human body can be treated using autologous chondrocyte transplantation (ACT). In this method, the body's own cartilage cells are removed, multiplied in the laboratory and an autologous chondrocyte suspension is produced. When the cartilage defect is actually repaired, for example in the case of a defect in a knee joint, an arthrotomy is carried out, i.e. the knee joint is completely opened. The cartilage defect is then prepared. The defect is then covered with a sewn-on autologous periosteal flap. This forms an implant of the type described above. The autologous chondrocyte suspension, the actual cartilage replacement implant, is injected under the periosteal flap. This is then fixed to the human cartilage by the periosteal flap, the implant.

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body. After the injection, the chondrocytes colonize the defect area and begin producing cartilage matrix.

The treatment method described above using a periosteal flap and an autologous chondrocyte suspension cannot be performed arthroscopically because a complex suture technique is required to attach the periosteal flap to the defective cartilage area.

It is therefore an object of the present invention to improve an implant, a cartilage replacement implant and an implant system of the type described above in such a way that a defective cartilage area can be treated arthroscopically or via a miniarthrotomy.

This object is achieved according to the invention in an implant of the type described above in that the implant has an anchoring section for anchoring the implant to the human body and a holding section for holding the cartilage replacement implant to the implant and/or to the damaged cartilage area.

Such an implant can be introduced to the defective cartilage area through a small opening in the human body. A complete opening of the joint is not necessary. The laborious sewing of a periosteal flap to the remaining cartilage is also not necessary. For example, the implant can be used to hold a carrier vaccinated with an autologous chondrocyte suspension to the human body using the holding section of the implant.

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A particularly good hold of the implant on the human body is achieved if the anchoring section has anchoring means for introduction into body tissue, in particular into a bone or a cartilage area.
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Preferably, the anchoring means comprise at least one threaded section. This allows the implant to be securely fixed in human body tissue, in particular in bone or cartilage.

The anchoring section can be inserted into human body tissue particularly easily if the anchoring section is tapered.

In order to increase the holding forces between the anchoring section and body tissue, the anchoring section comprises a contact surface for connection to a tissue surface. The larger the contact surface, the greater the holding forces that can be achieved between the anchoring section and the tissue surface.

A particularly simple structure of the implant results when the contact surface is essentially flat.

The anchoring section can have a recess so that the implant can grow in particularly well and also so that as little material as possible is required to manufacture the implant. This recess also enables the anchoring section to be additionally fixed to the body tissue.

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The implant can also be fixed to the body tissue particularly easily if the recess is arranged transversely to a longitudinal axis of the anchoring section. For example, it could be provided in the form of a hole through which a wire or thread is guided and fixed to the body tissue.

In order to enable particularly simple fixation of the implant to the human body, the anchoring section has at least one retaining projection for insertion into a bone or cartilage gap. The retaining projection can, for example, be inserted between a bone and the cartilage tissue arranged on it. This makes it possible to dispense with additional anchoring means, such as a threaded section.

It is advantageous if part of the retaining projection is formed as an extension of the contact surface. This results in a particularly simple structure of the implant.

In order to ensure that the contact surface can be held to the body tissue over a large area, it is advantageous if connecting means are provided to connect the contact surface to the tissue surface.

It would be conceivable to provide connecting means in the form of pointed projections. However, it is particularly advantageous if the connecting means include means for adhesively connecting the contact surface to the fabric surface. In this way, the contact surface can be fixed to the fabric surface over a large area, for example with fabric adhesive.

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A connection between the contact surface and the fabric surface is particularly easy if the contact surface is at least partially provided with the connecting means. This means that a connection between the two surfaces can be created simply by applying the contact surface to the fabric surface.

A particularly simple structure of the implant is achieved if it is symmetrically shaped.

The implant can be designed and manufactured even more easily if it is essentially flat in shape.

According to a particularly preferred form of the invention, the implant can be designed in the form of a Velcro strip that adheres to the tissue surface. The underside of the strip adheres to the tissue surface, and the cartilage replacement implant can be held on the Velcro strip on the other side if it is designed in the form of a carrier, for example.

It is advantageous if the anchoring section is essentially rotationally symmetrical. An implant constructed in this way is particularly easy to design and manufacture.

Furthermore, a particularly simple structure of the implant results if the holding section is essentially rotationally symmetrical.

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A particularly secure hold of the cartilage replacement implant on the human body is achieved if the holding section has at least one holding surface for the cartilage replacement implant and if the holding surface points in the direction of the anchoring section. Such a design is obtained, for example, with an implant in the form of a pin, a nail or a screw with a corresponding head on which the contact surface is arranged.

Such a contact surface can be formed in a simple manner if a cross-section of the implant is larger in the area of the holding section than in the area of the anchoring section. This also means that the anchoring section can be easily introduced into body tissue, whereas the holding section with a larger cross-section can comprise a sufficiently large holding surface for holding the cartilage replacement implant.
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In order to improve the ingrowth of the cartilage replacement implant in the defect area, it can be provided that the holding section is covered at least in sections with a cartilage replacement implant element. This allows an arrangement of implant and cartilage replacement implant to be formed, according to which the implant is completely covered by cartilage replacement implant material.

Preferably, the cartilage replacement implant element is arranged pointing away from the anchoring section. For example, on a pin or a screw, the cartilage replacement implant element could be arranged on a head of the pin or the screw.

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In order to optimally treat defect areas that have a complicated shape, it is advantageous if the holding section is flexible. This allows the cartilage replacement implant to be securely fixed to the body tissue even in the case of severe curvatures or similar.
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A particularly simple construction of the holding section results if it comprises at least one thread, a ribbon or a cord.

In order to remove protruding parts of the implant after the cartilage replacement implant has been fixed to the body tissue, the holding section can have at least one predetermined breaking point.

In order to prevent the cartilage replacement implant from becoming accidentally detached from the implant, the holding section can be provided with at least one retaining section. This can, for example, penetrate into the cartilage replacement implant and be shaped in such a way that it prevents the cartilage replacement implant from moving away from the anchoring section.

A particularly preferred embodiment of the invention provides that the at least one retaining element is hook-shaped.

A particularly secure hold of the cartilage replacement implant on the anchoring element and/or on the body tissue can be achieved if a free end of the at least one retaining element points in the direction of the anchoring section.

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To prevent rejection of the implant, the implant is preferably made of a biocompatible material.

To ensure that the implant grows together completely and the defective cartilage area can be reconstructed in an almost natural manner, the biocompatible material can be resorbable.

The object set out at the outset is achieved according to the invention in a cartilage replacement implant of the type described at the outset in that the cartilage replacement implant comprises a carrier inoculated with cartilage cells.

For such a cartilage replacement implant, no covering of the defect area is required, so no periosteal flap needs to be sewn on. The cartilage cells contained in the carrier are settled in the defect area simply by holding the carrier to the body tissue.

The carrier is particularly simple in its construction because it is made of fleece. This has the advantage that the fleece can be completely penetrated by cartilage cells due to its essentially permeable structure. It can also be fixed to human body tissue in a simple and varied way using implants of the type described above.

It is advantageous if the cartilage replacement implant is made of a biocompatible material. For example, the carrier could be made of a resorbable material so that autologous chondrocytes can

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continue to multiply next to the carrier, grow together and completely fill the defect area when the carrier is resorbed after some time.

In order to simplify the fixation of the cartilage replacement implant to the body tissue, it is advantageous if the cartilage replacement implant has at least one opening for the insertion of an implant of the type described above. In this way, the cartilage replacement implant can be easily attached to the body tissue.

The object posed at the outset is further achieved according to the invention in an implant system of the type described at the outset in that the implant is one of the implants described above and that the cartilage replacement implant is one of the cartilage replacement implants described above.

The following description of preferred embodiments of the invention serves to explain in more detail in conjunction with the drawing. They show:

Figure 1: a sectional view through a first embodiment of an implant system;

Figure 2: a sectional view through a second embodiment of an implant system;

Figure 3: a sectional view through a third embodiment of an implant system;

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Figure 4: a sectional view through a fourth embodiment of an implant system;

Figure 5: a sectional view through a fifth embodiment of an implant system;

Figure 6: a view of the implant system from Figure 5 in the direction of arrow A;

Figure 7: a sectional view through a sixth embodiment of an implant system;

Figure 8: a view of the implant system from Figure 7 in the direction of the arrow

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Figure 9: a sectional view through a seventh embodiment of an implant system;

Figure 10: a sectional view through an eighth embodiment of an implant system;

Figure 11: a sectional view through a ninth embodiment of an implant system;

Figure 12: a side view of an implant in the form of a fastening element;

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Figure 13: a side view of another embodiment of a fastening element;

Figure 14: a side view of another embodiment of a fastening element; and

Figure 15: a side view of another embodiment of a fastening element.

Figure 1 shows an implant system, designated overall by the reference numeral 10. It comprises a cartilage replacement implant in the form of a fleece 12 inoculated with an autologous chondrocyte suspension and several implants in the form of screws 14.

The fleece 12 is made of collagen, for example, and forms a carrier matrix for the patient's own bone cells. The screw 14 has a screw thread 16, a head 18 and a tapered tip 20. The head 18 has a larger cross-section than a screw core 22, so that an annular surface 24 is formed pointing towards the tip 20, which serves as a holding surface.

Figure 1 shows a schematic section through an articular surface of a bone 28 covered with cartilage 26. Due to damage, the cartilage 26 has a recess in the form of a gap 30.
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To insert the fleece 12, the gap 30 is prepared accordingly, in particular a bone surface 32 of the bone 28 and a cartilage edge 34 of the cartilage 26 delimiting the gap 30.

To reconstruct the defective cartilage area, the fleece 12 is brought to the gap 30 arthroscopically or via a miniarthrotomy and inserted into it. Depending on the size of the gap 30, the fleece 12 is fixed in the gap 30 with several screws 14 inserted perpendicular to the bone surface 32. The fleece 12 is held on the ring surfaces 24 of the head 18 of the screw 14 and thus fixed between the head 18 and the bone surface 32. To make it easier to insert the screw 14, the fleece 12 can have an opening 36 transverse to the bone surface 32.

Figure 2 shows a second embodiment of an implant system, which is provided with the reference numeral 40. Elements of the second embodiment described in connection with Figure 1 are provided with identical reference numerals, and the same applies to all of the following embodiments.

The implant system 40 differs from the implant system 10 only in the design of a screw 42 serving as an implant. Unlike the screw 14, a fleece pad 46 is arranged on its head pointing away from its tip 44.

The fleece 12 introduced into the gap 30 is fixed with the screw 42 by screwing the screw 42 with its thread 46 into the bone 28. In contrast to the screw 14, the screw 42 is inserted so deeply into the fleece 12 that

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that the fleece pad 46 completely closes a recess 52 formed by a head 52 of the screw. The screw 42 is thus invisibly countersunk in the fleece 12.

Figure 3 shows a third embodiment of an implant system, which is provided with the reference number 60. To secure the fleece 12 in the gap 30 of the cartilage 26 to the bone 28, several thread anchors 62 are provided, two of which are shown as examples in Figure 3. The thread anchor 62 is essentially constructed in the form of a headless threaded screw, which has a tapered end 64. A thread 66 is attached to the other end.

To fix the fleece 12 in the gap 30, one or more suture anchors 62 are first screwed at least partially, preferably completely, into the bone 28. The sutures 66 are passed through the fleece and free suture ends 68 of various suture anchors 62 are knotted together on a side of the fleece 12 facing away from the bone surface 32.

Figure 4 shows a fourth implant system, which is provided with the reference number 70 overall and which essentially corresponds to the implant systems 40 and 70. Instead of the screws 14 or 42, however, a barbed mandrel 72 is used, with an anchoring section 76 provided with a thread 74 and tapering at its end and with a holding section 80 provided with barbs 78. Overall, the barbed mandrel 72 is designed to be rotationally symmetrical. The barbs are formed by rotationally symmetrical depressions. The holding section 80 has a

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also has a tapered end 82, wherein it can be provided that the tapered end can be broken off, preferably by providing a corresponding predetermined breaking point, which is not shown in more detail in Figure 4.

To fix the fleece 12 in the gap 30, the barb mandrel 72 is first screwed into the bone 28 until only the holding section 80 protrudes from the bone 28. The fleece 12 is then pushed over the holding section 80, whereby it is held on the holding section 80 by the barbs 78. If necessary, the tapered end 82 of the barb 72 is removed.

A fifth embodiment of an implant system, provided with the reference number 90 overall, is shown in Figures 5 and 6. The implant is designed in the form of a Velcro strip 92, which has a bottom 94 serving as an anchoring section and a top 96 serving as a holding section. The bottom 94 is fixed to the bone surface 32 with an adhesive, for example gelatin, or by means of self-adhesion. The fleece 12 adheres to the top 96 of the Velcro strip 92 due to its roughened structure. In this way, the cartilage replacement implant can be fixed particularly gently in the gap 30 of the cartilage 26, since no foreign bodies have to be introduced into the bone 28. Furthermore, a large-area fixation of the fleece 12 to the surface 32 is possible.

A sixth variant of an implant system, which is provided with the reference number 100 as a whole, is shown in Figures 7 and 8. The implant is designed in the form of a flat cross 102 made of plastic, the underside 104 of which forms a contact surface on the bone surface 32. An upper side 106 of the

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Cross 102 is provided with a plurality of hooks 108, the free ends 110 of which point in the direction of the cross 102.

To fix the fleece 12 in the gap 30 of the cartilage 26, the cross 102 is first inserted into the gap 30 and its underside 104 is brought into contact with the bone surface 32. The size of the cross 102 is selected such that free ends of the cross 102 form holding tabs 112 which can be inserted into a gap 114 between the cartilage 26 and the bone 28. The cross 102 is thereby held at all four of its free ends in gaps 114 by means of the holding tabs 112 which act as holding projections. After the cross 102 has been inserted, the fleece 12 is inserted into the gap 30. It is held by the hooks 108 which easily penetrate the tissue structure of the fleece 12.

A ninth embodiment of an implant system shown in Figure 9 is provided with the reference number 120. It corresponds essentially to the implant system 100. A flat cross 122 made of plastic has a bottom 124 serving as a contact surface on the bone surface 32 and an upper side 126 provided with hooks 128. A vertically projecting threaded pin 130 with a tapered end is arranged centrally on the bottom 124.

To fix the fleece 12 in the gap 30 of the cartilage 26, the cross 122 is first fixed to the bone 28 by means of the threaded pin 130. The size of the cross 128 is selected so that free ends of the cross 122 do not touch the cartilage edge 34. The cross 122 is therefore only fixed to the bone by the threaded pin 128. However, it would be conceivable to fix the cross

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122 larger so that it can be additionally fixed in gaps 114 between the cartilage 26 and the bone 28, like the cross 102. After fixing the cross 122, the fleece 12 is inserted into the gap 30 and hooks onto the hooks 128.
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An eighth embodiment of an implant system provided with the reference number 140 is shown in Figure 10. The fleece 12 simultaneously forms both the cartilage replacement implant and the implant for fastening it. For this purpose, it is trapezoidal in cross-section, so that a lower side 142 is larger than a top side 144 of the fleece 12. The gap 30 in the cartilage 26 is prepared in such a way that the fleece 12 can be inserted into the gap 30 in a form-fitting manner. It is held on the cartilage edge 34 by means of a multi-sided or all-sided undercut. A threaded pin 146 shown in dashed lines in Figure 10 can be provided as additional fixation, which can, for example, be completely sunk into the bone 28 and can have hooks or a thread in the direction of the fleece 12.

Figure 11 shows a ninth embodiment of an implant system, designated overall by the reference numeral 150. A single thread anchor 152 is provided as an implant for holding the fleece 12 on the bone 28 in the gap 30 of the cartilage 26, which is designed in the form of a headless threaded pin with a tapered end. At its other end, it has one or more transverse bores 154 through which one or more threads 156 are passed.

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To fix the fleece 12, the thread anchor 152 is first sunk into the bone 28. Then one or more threads 156 are passed centrally through the fleece 12 so that they can rest on the fleece 12 on an upper side 158 of the fleece, running essentially parallel to the bone surface 32. The threads 156 are passed through the cartilage edge 34 on different sides of the gap 30 and thus fixed to the cartilage 26. Free thread ends 160 are knotted together for final fixation. The fleece 12 is held in this way between the threads 156 and the bone surface 32.
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Figures 12 to 15 show different variants of implants for fixing the fleece 12 in the gap 30.

Figure 12 shows a dowel, which is provided with the reference number 170 in its entirety and which is provided with retaining projections 172 and two intersecting slots 174 running in the longitudinal direction of the dowel 170. The dowel 170 has an anchoring section 176 which is provided with the retaining projections 172. The dowel 170 also has a holding section 178 which is provided with barbs 180. The retaining projections 172 and the barbs 180 each act in opposite directions, so that the dowel 170 can be fixed in the bone 28 with its anchoring section 176 and at the same time the fleece 12 is held on the barbs 180 of the holding section 178.

Figure 13 shows an impaction pin 190 suitable as an implant, which comprises a smooth shaft which has a head 194 at one end and whose other end 196 tapers to a point.

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Figure 14 shows a further embodiment of an implant in the form of a suture anchor 200. The suture anchor 200 essentially corresponds to the impact pin 190, but does not have a head. It comprises a tapered end 204 and a transverse bore 202 arranged at the other end of a threadless shaft 206. Furthermore, a suture 208 is fixed in the shaft 206 at the end adjacent to the transverse bore 204 so that it points away from the shaft 206 in the longitudinal direction of the shaft.

Finally, Figure 15 shows a further impact pin, provided overall with the reference number 210, with a shaft 212 which has a tapered end 214 and at its other end carries a barb mandrel 216 with a plurality of barbs 218, which is also tapered and smaller in diameter than the shaft 212.

The screws 14 and 22, the suture anchor 62, the barb mandrel 72, the Velcro fastener 92, the cross 102, the cross 122, the threaded pin 146, the suture anchor 152 as well as the dowel 170, the impact pin 190, the suture anchor 200 and the impact pin 210 can be made of resorbable material; alternatively, it would also be conceivable to use a biocompatible, non-resorbable material, for example titanium.

The threads and hooks described can also be made of absorbable materials or of biocompatible materials.
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Claims (35)

1. Implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) for holding a cartilage replacement implant ( 12 ) replacing a damaged cartilage region ( 26 ) of a joint of a human body on the human body, characterized in that the implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) has an anchoring section ( 22 ; 48 ; 62 ; 76 ; 94 ; 104 ; 112 ; 130 ; 146 ; 152 ; 176 ; 192 ; 206 ; 212 ) for anchoring the implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) to the human body and a holding section ( 18 ; 52 ; 66 ; 80 ; 96 ; 106 ; 126 ; 156 ; 178 ; 194 ; 208 ; 216 ) for holding the cartilage replacement implant ( 12 ) on the implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) and/or on the damaged cartilage area ( 26 ). 2. Device according to claim 1, characterized in that the anchoring section has anchoring means ( 16 ; 48 ; 74 ; 112 ; 172 ) for introduction into body tissue, in particular into a bone ( 28 ). 3. Implant according to claim 2, characterized in that the anchoring means comprise at least one threaded portion ( 16 ; 48 ; 74 ). 4. Implant according to one of the preceding claims, characterized in that the anchoring section ( 22 ; 48 ; 62 ; 76 ; 130 , 146 ; 152 ; 176 ; 190 ; 206 ; 212 ) tapers. 5. Implant according to one of the preceding claims, characterized in that the anchoring section ( 94 ; 104 ; 124 ) comprises a contact surface for connection to a tissue surface ( 32 ). 6. Implant according to claim 5, characterized in that the contact surface ( 94 , 104 ; 124 ) is substantially flat. 7. Implant according to one of the preceding claims, characterized in that the anchoring section ( 62 , 152 ; 176 ; 206 ) has a recess ( 154 ; 174 ; 202 ). 8. Implant according to claim 7, characterized in that the recess ( 154 ; 174 ; 202 ) is arranged to extend transversely to a longitudinal axis of the anchoring section ( 62 ; 152 ; 176 ; 206 ). 9. Implant according to one of the preceding claims, characterized in that the anchoring section ( 104 ) has at least one holding projection ( 112 ) for insertion into a bone or cartilage gap ( 114 ). 10. Implant according to claim 9, characterized in that a part of the retaining projection ( 112 ) is formed as an extension of the contact surface ( 104 ) thereon. 11. Implant according to one of claims 5 to 10, characterized in that connecting means are provided for connecting the contact surface ( 94 ; 104 ; 124 ) to the tissue surface ( 32 ). 12. Implant according to claim 11, characterized in that the connecting means comprise means for adhesively connecting the contact surface ( 94 ; 104 ; 124 ) to the tissue surface ( 32 ). 13. Implant according to one of claims 11 or 12, characterized in that the contact surface ( 94 ; 104 ; 124 ) is at least partially provided with the connecting means. 14. Implant according to one of the preceding claims, characterized in that the implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) is symmetrically shaped. 15. Implant according to one of the preceding claims, characterized in that the implant ( 92 ; 102 ; 122 ) is essentially flat. 16. Implant according to claim 15, characterized in that the implant is designed in the form of a Velcro strip ( 92 ) adhering to the tissue surface ( 32 ). 17. Implant according to one of the preceding claims, characterized in that the anchoring section ( 22 ; 48 ; 62 ; 76 ; 130 ; 146 ; 152 ; 176 ; 192 ; 206 ; 212 ) is essentially rotationally symmetrical. 18. Implant according to one of the preceding claims, characterized in that the holding section ( 18 ; 52 ; 66 ; 80 ; 156 ; 180 ; 194 ; 208 ; 216 ) is essentially rotationally symmetrical. 19. Implant according to one of the preceding claims, characterized in that the holding section ( 18 ; 52 ; 80 ; 180 ; 194 ; 216 ) has at least one holding surface ( 24 ) for the cartilage replacement implant ( 12 ) and that the holding surface points in the direction of the anchoring section ( 22 ; 62 ; 76 ; 176 ; 192 ; 212 ). 20. Implant according to one of the preceding claims, characterized in that a cross section of the implant ( 14 ; 42 ; 190 ) in the region of the holding section ( 18 ; 52 ; 194 ) is larger than in the region of the anchoring section ( 22 ; 48 ; 190 ). 21. Implant according to one of the preceding claims, characterized in that the holding section ( 52 ) is at least partially covered with a cartilage replacement implant element ( 46 ). 22. Implant according to claim 21, characterized in that the cartilage replacement implant element ( 46 ) is arranged pointing away from the anchoring section ( 48 ). 23. Implant according to one of the preceding claims, characterized in that the holding section ( 66 ; 96 ; 156 ; 208 ) is flexible. 24. Implant according to claim 23, characterized in that the holding portion ( 66 ; 96 ; 156 ; 208 ) comprises at least one thread, a band or a cord. 25. Implant according to one of the preceding claims, characterized in that the holding section ( 80 ) has at least one predetermined breaking point. 26. Implant according to one of the preceding claims, characterized in that the holding section ( 18 ; 80 ; 106 ; 126 ; 178 ; 216 ) is provided with at least one retaining element ( 24 ; 78 ; 108 ; 128 ; 180 ; 218 ). 27. Implant according to claim 26, characterized in that the at least one retaining element ( 106 ; 126 ) is hook-shaped. 28. Implant according to one of claims 25 or 26, characterized in that a free end ( 110 ) of the at least one retaining element ( 106 ; 126 ) points in the direction of the anchoring section. 29. Implant according to one of the preceding claims, characterized in that the implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) is made of a biocompatible material. 30. Implant according to claim 29, characterized in that the biocompatible material is resorbable. 31. Cartilage replacement implant ( 12 ) for replacing a damaged cartilage region ( 26 ) of a human body, characterized in that the cartilage replacement implant ( 12 ) comprises a carrier ( 12 ) inoculated with cartilage cells. 32. Cartilage replacement implant according to claim 31, characterized in that the carrier ( 12 ) is a fleece ( 12 ). 33. Cartilage replacement implant according to one of claims 31 or 32, characterized in that the cartilage replacement implant ( 12 ) is made of a biocompatible material. 34. Cartilage replacement implant according to one of claims 31 to 33, characterized in that the cartilage replacement implant ( 12 ) has at least one opening ( 36 ) for introducing an implant ( 14 ) according to one of claims 1 to 30. 35. Implant system ( 10 ; 40 ; 60 ; 70 ; 90 ; 100 ; 120 ; 140 ; 150 ) for replacing a damaged cartilage region ( 12 ) of a joint of a human body, comprising at least one cartilage replacement implant ( 12 ) for replacing the damaged cartilage region ( 26 ) and at least one implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) for holding the cartilage replacement implant ( 12 ) on the human body, characterized in that the at least one implant is an implant ( 14 ; 42 ; 62 , 66 ; 72 ; 92 ; 102 ; 122 ; 146 ; 152 , 156 ; 170 ; 190 ; 200 ; 210 ) according to one of claims 1 to 30 and that the at least one cartilage replacement implant ( 12 ) is a cartilage replacement implant ( 12 ) according to one of claims 31 to 34.