FR2687911A1 - Ligament prosthesis with protective sheet - Google Patents

Ligament prosthesis with protective sheet Download PDF

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Publication number
FR2687911A1
FR2687911A1 FR9202571A FR9202571A FR2687911A1 FR 2687911 A1 FR2687911 A1 FR 2687911A1 FR 9202571 A FR9202571 A FR 9202571A FR 9202571 A FR9202571 A FR 9202571A FR 2687911 A1 FR2687911 A1 FR 2687911A1
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France
Prior art keywords
core
prosthesis according
braiding
sheath
protective sheath
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Granted
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FR9202571A
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French (fr)
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FR2687911B1 (en
Inventor
Frismand Jean
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PERIODE SA
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PERIODE SA
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Classifications

    • 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
    • A61F2/08—Muscles; Tendons; Ligaments
    • D—TEXTILES; PAPER
    • D04—BRAIDING; LACE-MAKING; KNITTING; TRIMMINGS; NON-WOVEN FABRICS
    • D04C—BRAIDING OR MANUFACTURE OF LACE, INCLUDING BOBBIN-NET OR CARBONISED LACE; BRAIDING MACHINES; BRAID; LACE
    • D04C1/00—Braid or lace, e.g. pillow-lace; Processes for the manufacture thereof
    • D04C1/06—Braid or lace serving particular purposes
    • D04C1/12—Cords, lines, or tows
    • D—TEXTILES; PAPER
    • D07—ROPES; CABLES OTHER THAN ELECTRIC
    • D07B—ROPES OR CABLES IN GENERAL
    • D07B1/00—Constructional features of ropes or cables
    • D07B1/02—Ropes built-up from fibrous or filamentary material, e.g. of vegetable origin, of animal origin, regenerated cellulose, plastics
    • D—TEXTILES; PAPER
    • D07—ROPES; CABLES OTHER THAN ELECTRIC
    • D07B—ROPES OR CABLES IN GENERAL
    • D07B2201/00—Ropes or cables
    • D07B2201/10—Rope or cable structures
    • D07B2201/1096—Rope or cable structures braided
    • D—TEXTILES; PAPER
    • D07—ROPES; CABLES OTHER THAN ELECTRIC
    • D07B—ROPES OR CABLES IN GENERAL
    • D07B2201/00—Ropes or cables
    • D07B2201/20—Rope or cable components
    • D07B2201/2083—Jackets or coverings
    • D07B2201/209—Jackets or coverings comprising braided structures
    • D—TEXTILES; PAPER
    • D07—ROPES; CABLES OTHER THAN ELECTRIC
    • D07B—ROPES OR CABLES IN GENERAL
    • D07B2201/00—Ropes or cables
    • D07B2201/20—Rope or cable components
    • D07B2201/2083—Jackets or coverings
    • D07B2201/20907—Jackets or coverings comprising knitted structures
    • D—TEXTILES; PAPER
    • D10—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
    • D10B—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
    • D10B2403/00—Details of fabric structure established in the fabric forming process
    • D10B2403/03—Shape features
    • D10B2403/031—Narrow fabric of constant width
    • D10B2403/0311—Small thickness fabric, e.g. ribbons, tapes or straps
    • D—TEXTILES; PAPER
    • D10—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
    • D10B—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
    • D10B2509/00—Medical; Hygiene

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Rehabilitation Therapy (AREA)
  • Rheumatology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Manufacturing & Machinery (AREA)
  • Textile Engineering (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Materials For Medical Uses (AREA)

Abstract

The invention relates to the field of replacing and reinforcing human and animal ligaments and tendons with artificial materials. This invention combines: 1. A material having good elasticity characteristics, for the core of the ligamentary prosthesis. 2. And protection of this core by a flexible outer sheath made by a textile process with an abrasion-resistant material which has low elasticity.

Description

Prothèse de ligament à vaine de protection
La présente invention concerne le domaine du remplacement et du renfort des ligaments et tendons humains et animaux par des matériaux artificiels.Protective vain ligament prosthesis
The present invention relates to the field of replacement and reinforcement of human and animal ligaments and tendons with artificial materials.

Les chirurgiens orthopédistes connaissent depuis plusieurs années la possibilité de renforcer ou de remplacer un ligament ou un tendon naturel défaillant, généralement du fait de leur rupture, par un matériau prothétique, le plus souvent de type textile. Orthopedic surgeons have known for several years the possibility of strengthening or replacing a failed natural ligament or tendon, generally due to their rupture, by a prosthetic material, most often of textile type.

Dans la suite du texte, le mot ligament sera seul employé, mais l'invention concerne également les tendons. Le ligament croisé antérieur du genou est particulièrement concerné par l'invention, et servira de base à la description mais l'ensemble des ligaments de l'organisme sont concernés (autres ligaments du genou, cheville, main, épaule, rachis ...), ainsi que les tendons (membres supérieur et inférieur essentiellement). In the remainder of the text, the word ligament will be used alone, but the invention also relates to the tendons. The anterior cruciate ligament of the knee is particularly concerned by the invention, and will serve as a basis for the description but all of the ligaments of the body are concerned (other ligaments of the knee, ankle, hand, shoulder, spine ...) , as well as the tendons (upper and lower limbs essentially).

Différents matériaux, qui doivent être biocompatibles, ont été utilisés. Aucun n'a donné des résultats satisfaisants. Les raisons en sont multiples. A titre d'exemple, nous donnons certaines caractéristiques et défauts les plus notables de différents matériaux:
- Les fibres de carbone ne sont pas assez élastiques (1 % d'allongement à la rupture) et sont trop fragiles vis-à-vis des sollicitations de flexion.Different materials, which must be biocompatible, have been used. None have given satisfactory results. There are multiple reasons. As an example, we give some of the most notable characteristics and defects of different materials:
- The carbon fibers are not elastic enough (1% elongation at break) and are too fragile with respect to bending stresses.

- Les fibres de polyester (polyéthylène téréphtalate) et certains polyamides ont une élasticité acceptable (15 à 20 % d'allongement à la rupture), mais résistent mal aux sollicitations d'abrasion (usure par frottement). Les particules d'usure déclenchent une réaction inflammatoire locale qui peut nécessiter l'ablation de la prothèse. La prothèse peut également se rompre très rapidement et nécessiter une nouvelle intervention. - Polyester fibers (polyethylene terephthalate) and certain polyamides have an acceptable elasticity (15 to 20% elongation at break), but have poor resistance to abrasion stresses (wear by friction). The wear particles trigger a local inflammatory reaction which may require removal of the prosthesis. The prosthesis can also rupture very quickly and require a new intervention.

- Les fibres de polyéthylène haute ténacité (type spectra, dynema) ont d'excellentes propriétés de résistance à l'abrasion (10 à 100 fois supérieures au polyester) mais une élasticité très insuffisante (3 % à la rupture) par rapport aux ligaments naturels (30 à 40 % d'allongement à la rupture). - High tenacity polyethylene fibers (spectra, dynema type) have excellent abrasion resistance properties (10 to 100 times superior to polyester) but very insufficient elasticity (3% at break) compared to natural ligaments (30 to 40% elongation at break).

- D'autres produits sont dégradés par l'organisme avec le temps et ne peuvent servir que de prothèses ou de renforts transitoires (certains polyamides, polyarylamides, polypropylène). - Other products are degraded by the body over time and can only be used as prostheses or transient reinforcements (certain polyamides, polyarylamides, polypropylene).

Les orifices de passage osseux intra-articulaires et les massifs osseux sont les endroits d'usure privilégiés du ligament du fait des frottements lors des mouvements articulaires. Certains ont tenté de protéger le ligament artificiel par des embouts rigides en métal ou en matière plastique (polyéthylène, téflon...), embouts éventuellement vissés dans
I'os.The intra-articular bone passage openings and the bone mass are the preferred places of wear of the ligament due to friction during joint movements. Some have tried to protect the artificial ligament with rigid metal or plastic end caps (polyethylene, teflon ...), end caps possibly screwed into
I'os.

L'absence de souplesse de ces matériaux provoque un frottement du ligament dans l'embout et donc une usure. Ces embouts sont difficiles à mettre en place par le chirurgien et présentent un risque de descellement et de déplacement important, entraînant alors la rupture rapide de la prothèse.  The lack of flexibility of these materials causes friction of the ligament in the tip and therefore wear. These tips are difficult to install by the surgeon and present a risk of loosening and significant displacement, thus causing rapid rupture of the prosthesis.

L'utilisation de polymères souples (silicone, téflon, polyéthylène ...) permet de réaliser des gaines souples de protection, mais ces matériaux ne sont pas assez résistants à l'usure et on aboutit à la création de particules d'usure de la gaine, puis à la rupture du ligament. Ces particules sont très mal tolérées par l'organisme. The use of flexible polymers (silicone, teflon, polyethylene ...) makes it possible to produce flexible protective sheaths, but these materials are not sufficiently resistant to wear and this leads to the creation of wear particles of the sheath, then rupture of the ligament. These particles are very poorly tolerated by the body.

L'invention consiste:
- à associer un matériau présentant de bonne caractéristiques d'élasticité, de type polyester par exemple, pour l'âme de la prothèse ligamentaire et,
- à protéger cette âme par une gaine extérieure souple réalisée par procédé textile avec un matériau résistant à l'abrasion et dont l'élasticité n'a pas d'importance, de type polyéthylène haute ténacité par exemple.The invention consists of:
to associate a material having good elasticity characteristics, of the polyester type for example, for the core of the ligament prosthesis and,
- To protect this core by a flexible outer sheath produced by textile process with a material resistant to abrasion and whose elasticity does not matter, of high tenacity polyethylene type for example.

Brève description des dessins:
la figure 1 montre une articulation de genou vue de face avec un ligament selon l'invention;
la figure 2 montre une articulation de genou vue de face avec un ligament passant au niveau des orifices osseux intra-articulaires dans des embouts;
la figure 3 montre une articulation de genou vue de face avec un ligament selon un autre mode de réalisation de l'invention;
la figure 4 montre un mode de réalisation de l'âme du ligament selon l'invention;
la figure 5 montre un autre mode de réalisation de l'âme du ligament selon l'invention;
la figure 6 montre un mode de réalisation de la gaine du ligament selon l'invention
la figure 7 montre un autre mode de réalisation du ligament selon l'invention.Brief description of the drawings:
Figure 1 shows a knee joint viewed from the front with a ligament according to the invention;
FIG. 2 shows a knee joint seen from the front with a ligament passing at the level of the intra-articular bone orifices in end pieces;
Figure 3 shows a front knee joint with a ligament according to another embodiment of the invention;
FIG. 4 shows an embodiment of the core of the ligament according to the invention;
FIG. 5 shows another embodiment of the core of the ligament according to the invention;
Figure 6 shows an embodiment of the ligament sheath according to the invention
Figure 7 shows another embodiment of the ligament according to the invention.

Description détaillée de l'invention:
L'âme 2 du ligament selon l'invention a des caractéristiques d'élasticité suffisante, pour remplir la fonction mécanique de ligament ou de tendon. Cette élasticité doit être comprise entre 10 et 40 % et notamment entre 10 et 25 %.Detailed description of the invention:
The core 2 of the ligament according to the invention has characteristics of sufficient elasticity, to fulfill the mechanical function of ligament or tendon. This elasticity must be between 10 and 40% and in particular between 10 and 25%.

Selon l'invention, lors des sollicitations de traction sur la prothèse ligamentaire, l'âme élastique 2 est la partie essentiellement sollicitée en traction, la gaine extérieure 1 de protection bien que moins élastique n'est pas complètement tendue. According to the invention, during tensile stresses on the ligament prosthesis, the elastic core 2 is the part essentially stressed in tension, the outer sheath 1 of protection although less elastic is not completely stretched.

Ceci peut être réalisé de deux façons:
Selon la figure 3 la gaine de protection 1 est interrompue sur une partie de la longueur de la prothèse. Pour une prothèse de ligament croisé de genou, par exemple, la gaine se trouve au niveau des passages et contacts osseux 10 et laisse l'âme 2 nue dans l'articulation. This can be done in two ways:
According to Figure 3 the protective sheath 1 is interrupted over part of the length of the prosthesis. For a knee cruciate ligament prosthesis, for example, the sheath is at the level of the bone passages and contacts 10 and leaves the core 2 bare in the joint.

Une autre façon consiste à réaliser un ligament selon la figure 1 tel que la gaine extérieure 1 soit constituée de fibres bien moins tendues que l'âme 2. Ce procédé peut d'ailleurs avantageusement être associé au premier mode de réalisation. Another way is to make a ligament according to Figure 1 such that the outer sheath 1 is made of fibers much less stretched than the core 2. This process can also advantageously be associated with the first embodiment.

Le résultat de l'invention est d'obtenir:
- une prothèse ligamentaire dont l'élasticité est optimale, ce qui autorise une fonction correcte de l'articulation;
- une prothèse ligamentaire qui ne présente pas d'usure importante, comme c'est le cas avec les prothèses actuelles. L'absence de particules d'usure entraîne une bonne tolérance de la prothèse par l'organisme.The result of the invention is to obtain:
- a ligament prosthesis whose elasticity is optimal, which allows a correct function of the joint;
- a ligament prosthesis that does not show significant wear, as is the case with current prostheses. The absence of wear particles leads to good tolerance of the prosthesis by the body.

L' âme 2 est avantageusement réalisée avec des structures textiles dimensionnellement stables longitudinalement qui en sollicitation de traction présentent une déformation permanente minimale et donc un comportement essentiellement élastique réversible dû au matériau. A titre d'exemple:
- tresse à angle de tressage petit (entre 0 et 300) tel que schématisé par la figure 4;
- ruban tel que schématisé par la figure 5;
- tricot technique à maille bloquée éventuellement renforcé par des fils de chaîne.The core 2 is advantageously made with dimensionally stable textile structures longitudinally which in tensile stress have minimal permanent deformation and therefore an essentially elastic reversible behavior due to the material. For exemple:
- braid with a small braiding angle (between 0 and 300) as shown diagrammatically in Figure 4;
- ribbon as shown diagrammatically in FIG. 5;
- technical knit with blocked mesh possibly reinforced with warp threads.

L'âme peut avoir une structure plate selon la figure 5 ou tubulaire selon la figure 4. The core can have a flat structure according to FIG. 5 or a tubular structure according to FIG. 4.

La gaine extérieure peut avantageusement être réalisée avec des structures textiles qui en sollicitation de traction autorisent une déformation importante largement supérieure aux propriétés d'élasticité du matériau utilisé:
- tresse tubulaire à angle de tressage important, de 18 à 50 notamment supérieur à 300 tel que schématisé par la figure 6;
- tricot tubulaire technique à maille bloquée, tresse hélicoïdale...The outer sheath can advantageously be made with textile structures which in tensile stress allow a significant deformation much greater than the elasticity properties of the material used:
- tubular braid with a large braiding angle, from 18 to 50 in particular greater than 300 as shown diagrammatically in FIG. 6;
- technical tubular knit with blocked mesh, helical braid ...

La structure de la gaine comporte de préférence des tissus à fils serrés résistant bien à l'abrasion et au passage d'aspérités osseuses, la gaine est de préférence placée non tendue sur l'âme afin d'augmenter sa valeur d'allongement possible. Il est très facile de comprimer à la manière d'un accordéon une gaine en tresse tubulaire en l'enfilant sur une âme. The structure of the sheath preferably comprises fabrics with tight threads resistant well to abrasion and to the passage of bony asperities, the sheath is preferably placed untensioned on the core in order to increase its possible elongation value. It is very easy to compress, like an accordion, a tubular braid sheath by threading it over a core.

Le retour élastique de la prothèse est réalisé par l'âme en polyester. The elastic return of the prosthesis is achieved by the polyester core.

La structure extérieure réalisée par un procédé textile cité (tricot, tresse ...) présente l'avantage de sa souplesse et de sa tolérance dans les modifications de forme par rapport à une protection rigide, de type tube métallique ou plastique par exemple. The external structure produced by a cited textile process (knitting, braiding, etc.) has the advantage of its flexibility and of its tolerance in shape modifications compared to a rigid protection, of the metal or plastic tube type for example.

La gaine extérieure peut également prolonger seule, à ses extrémités la prothèse ligamentaire et servir de structure d'ancrage osseux selon la description de la figure 7. La prothèse est alors constituée de trois parties : une partie centrale intra-articulaire nue ou gainée, qui a fonction de matériau élastique, une partie de transition de chaque côté de cette partie centrale, nécessairement gainée et qui correspond à la partie intermédiaire de protection contre les phe iomènes d'usure par frottement, et uTlP p.ni. externe 'onSIitu$c de la gaine seule servant à la fixation à l'os. The outer sheath can also extend alone, at its ends, the ligament prosthesis and serve as a bone anchoring structure as described in FIG. 7. The prosthesis then consists of three parts: a bare or sheathed intra-articular central part, which a function of elastic material, a transition part on each side of this central part, necessarily sheathed and which corresponds to the intermediate part of protection against phe iomenes of wear by friction, and uTlP p.ni. external 'onSIitu $ c of the only sheath used for fixation to the bone.

L'utilisation de cette gaine protège l'âme contre la rupture, et donc également contre l'apparition d'une quantité importante de particules d'usures par frottement. Ceci entraîne une bien meilleure tolérance de la prothèse par l'organisme. The use of this sheath protects the core against rupture, and therefore also against the appearance of a large amount of particles of wear by friction. This results in a much better tolerance of the prosthesis by the body.

Bien que la prothèse qui vient d'être décrite paraisse le mode de réalisation préférable, on comprendra que diverses modifications peuvent lui être apportées sans sortir du cadre de l'invention, certains de ses éléments pouvant être remplacés par d'autres qui joueraient un rôle technique identique ou analogue. Although the prosthesis which has just been described seems to be the preferable embodiment, it will be understood that various modifications can be made to it without departing from the scope of the invention, some of its elements being able to be replaced by others which would play a role. identical or analogous technique.

En particulier, le polyester peut être remplacé par un autre matériau suffisamment élastique (polyéthylène téréphtalate, polyamide, polyarylamide, polypropylène), sa réalisation textile peut être un ruban, une tresse, de simples fils longitudinaux partiellement ou totalement libres ou toute autre structure. La gaine extérieure peut également être réalisée avec un autre matériau résistant à l'abrasion, son mode de réalisation textile peut être une tresse, un tricot, du crochet, du tissu ou tout autre mode de réalisation qui permette un allongement important de la gaine, allongement supérieur à ce qui est possible par la simple élasticité du matériau. In particular, the polyester can be replaced by another sufficiently elastic material (polyethylene terephthalate, polyamide, polyarylamide, polypropylene), its textile production can be a ribbon, a braid, simple longitudinal threads partially or completely free or any other structure. The outer sheath can also be made with another abrasion-resistant material, its textile embodiment can be a braid, knitting, crochet, fabric or any other embodiment which allows a significant elongation of the sheath, greater elongation than is possible by the simple elasticity of the material.

La gaine ou l'âme élastique peuvent être composées de plusieurs couches de tissus, notamment 4 à 6 bandelettes de rubans pour l'âme ou 2 à 3 tissus tubulaires concentriques pour la gaine ou l'âme. The sheath or the elastic core may be composed of several layers of tissue, in particular 4 to 6 strips of ribbons for the core or 2 to 3 concentric tubular fabrics for the sheath or the core.

La gaine est liée à l'âme sur toute sa longueur ou, au moins, aux extrémités du ligament. Cette liaison est réalisée:
- soit par assemblage mécanique (épissure 5 de type marine, par exemple),
- soit par couture 4 (point élastique ou zig-zag),
- soit par liaison intime par la machine à tisser lors du tissage ou tricotage.The sheath is linked to the core over its entire length or, at least, to the ends of the ligament. This connection is made:
- either by mechanical assembly (splice 5 of marine type, for example),
- either by stitching 4 (elastic stitch or zig-zag),
- either by intimate connection by the weaving machine during weaving or knitting.

Les extrémités de la gaine et de l'âme peuvent également être réunies par un autre moyen mécanique, par exemple un sertissage dans un embout métallique. The ends of the sheath and of the core can also be joined by another mechanical means, for example crimping in a metal end-piece.

En cas de ligament formé en anneaux, tels les anneaux connus du Dr. GRAF (Société SAFIR) les deux éIéments âme et gaine ne sont pas obligatoirement liés, car ils ne peuvent s'échapper l'un de l'autre.  In the event of a ligament formed into rings, such as the rings known to Dr. GRAF (SAFIR Company), the two elements of soul and sheath are not necessarily linked, because they cannot escape from each other.

Claims (9)

REVENDICATIONS 1. Prothèse de remplacement total ou de renfort de ligament ou de tendon humain ou animal caractérisée en ce qu'elle comporte une âme élastique entourée d'une gaine de protection contre les frottements et aspérités osseuses qui est à la fois souple, peu élastique, résistante à l'usure et fabriquée par technique textile. 1. Total replacement prosthesis or human or animal ligament or tendon reinforcement characterized in that it comprises an elastic core surrounded by a sheath for protection against friction and asperities of bone which is both flexible, not very elastic, wear resistant and made by textile technique. 2. Prothèse selon la revendication 1 caractérisée en ce que la gaine de protection a une longueur égale ou supérieure à l'âme. 2. Prosthesis according to claim 1 characterized in that the protective sheath has a length equal to or greater than the core. 3. Prothèse selon la revendication 1 caractérisée en ce que la gaine de protection n'est présente qu'aux endroits de l'âme exposés à l'usure. 3. Prosthesis according to claim 1 characterized in that the protective sheath is present only at the locations of the core exposed to wear. 4. Prothèse selon l'une des revendications 1 à 3 caractérisée en ce que l'âme est réalisée par technique de mise en oeuvre textile donnant un produit dimensionnellement stable longitudinalement choisi notamment parmi les procédés connus suivants : tissage, tressage à angle de tressage compris entre 0 et 30 ou tricotage technique à maille bloquée. 4. Prosthesis according to one of claims 1 to 3 characterized in that the core is produced by textile implementation technique giving a dimensionally stable product longitudinally chosen in particular from the following known methods: weaving, braiding at an angle of braiding included between 0 and 30 or technical knitting with blocked mesh. 5. Prothèse selon l'une des revendications 1 à 4 caractérisée en ce que l'âme est réalisée en un polymère biocompatible d'élasticité réversible compris entre 10 et 40 % choisi notamment parmi les matériaux connus suivants : polyéthylène téréphtalate, polyamide, polyarylamide ou polypropylène. 5. Prosthesis according to one of claims 1 to 4 characterized in that the core is made of a biocompatible polymer of reversible elasticity of between 10 and 40% chosen in particular from the following known materials: polyethylene terephthalate, polyamide, polyarylamide or polypropylene. 6. Prothèse selon l'une des renvendications 1 à 5 caractérisée en ce que la gaine de protection est réalisée par technique de mise en oeuvre textile donnant un produit à structure serrée autorisant un allongement de 10 à 40 % choisi notamment parmi les procédés connus suivants : tressage à angle de tressage compris entre 18 et 50 , tressage hélicoïdal ou tricotage technique à maille bloquée. 6. Prosthesis according to one of claims 1 to 5 characterized in that the protective sheath is produced by textile processing technique giving a product with a tight structure allowing an elongation of 10 to 40% chosen in particular from the following known methods : braiding with a braiding angle between 18 and 50, helical braiding or technical knitting with a blocked mesh. 7. Prothèse selon l'une des revendications 1 à 6 caractérisée en ce que la gaine de protection est réalisée en polymère biocompatible souple, peu élastique mais résistant à l'usure et notamment en polyéthylène haute ténacité. 7. Prosthesis according to one of claims 1 to 6 characterized in that the protective sheath is made of flexible biocompatible polymer, not very elastic but resistant to wear and in particular of high tenacity polyethylene. 8. Prothèse selon l'une des revendications 1 à 7 caractérisée en ce que la gaine de protection est liée à l'âme par couture, assemblage mécanique ou réalisation intime lors du tressage ou tricotage, et est peu tendue par rapport à l'âme. 8. Prosthesis according to one of claims 1 to 7 characterized in that the protective sheath is linked to the core by sewing, mechanical assembly or intimate production during braiding or knitting, and is slightly stretched relative to the core . 9. Prothèse selon l'une des revendications 1 à 8 caractérisée en ce que l'âme ou la gaine de protection sont composées de plusieurs couches de tissu, notamment 4 à 6 bandelettes de rubans pour l'âme ou 2 à 3 tissus tubulaires concentriques pour l'âme ou la gaine.  9. Prosthesis according to one of claims 1 to 8 characterized in that the core or the protective sheath are composed of several layers of fabric, in particular 4 to 6 strips of ribbons for the core or 2 to 3 concentric tubular fabrics for the soul or the sheath.
FR9202571A 1992-03-02 1992-03-02 PROSTHESIS OF PROTECTIVE SHEATH LIGAMENTS. Expired - Fee Related FR2687911B1 (en)

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