JPH10155820A - Plug for fixing reconstructive ligament into bone hole - Google Patents

Abstract

PROBLEM TO BE SOLVED: To improve the safety of ligament reconstruction by physically coupling the tendon, etc., used for reconstruction and plugs to form a composite and fixing the composite into bone holes by means of screw members, etc. SOLUTION: The reconstructive ligament composite is formed by tuning back the collected tendon double or triple and fixing the plugs 1 to both ends thereof. The reconstructive ligament composite is passed through the inside of the knee joint into the bone holes of the femur 5 and the tibia 6 and the plugs 1 are fixed by using the screw members 3 to the femur 5 and tibia 6 side. As a result, the need for collecting the bone chip for fixing the musculus gracilis and the semimembranous muscles from the other point is eliminated and the supply of the reconstructive ligament which is superior to a BHB method is made possible. The length of the reconstructive ligament is adjustable and an improvement in convenience is resulted.

Description

DETAILED DESCRIPTION OF THE INVENTION

The present invention is a plug for firmly and securely fixing the reconstructed ligament in the femoral bone 5 and the tibia 6 in the ligament reconstruction operation of a knee joint or the like. Tendons, ligaments, artificial ligaments, and other tissues used for reconstruction are collected and fixed using surgical thread or the like by means such as wrapping around the plug to produce a ligament composite for reconstruction.
The plug portions 1 at both ends are drawn into the bone hole, and are fixed to the bone by a fixing member 3 such as a screw.

It is preferable that a groove for protecting and anchoring the tendon is formed at the tip of the plug 1, but the shape is not particularly limited.

[0003] The plug 1 is made of a material which has a good biocompatibility, particularly a good affinity with bone, and which can obtain biological fixation relatively quickly after being fixed in a bone hole.

[Industrial applications]

The present invention is used in the medical field as a medical material for firmly fixing a bone and a reconstructed ligament at the time of ligament reconstruction of a knee joint or the like.

[Prior art]

In the knee joint, there are two large ligaments called anterior cruciate ligament and posterior cruciate ligament, which basically contribute to the stability of the knee joint in the longitudinal direction. If the ligament is torn for any reason, such as sports, unstable sway will occur in the knee joint, which often hinders sports activities and daily life.

[0006] In clinical practice, ligament reconstruction surgery is extremely necessary to eliminate such obstacles. Conventionally, the main substitute ligaments used for reconstruction of the anterior cruciate ligament and the posterior cruciate ligament are:
TB), 2) thin muscle and semi-membrane tendon (hereinafter abbreviated as STG), 3) artificial ligament, and the like. In recent years, 4) bone thin muscles and semi-membrane-like muscles (abbreviated as BHB) have also been found. The BHB is formed by simultaneously collecting thin muscles and semi-membrane muscles that run from the back of the knee joint to the back of the thigh, fixing bones collected from other parts at both ends, and reconstructing a ligament similar to BTB. This is a method for producing

[0007] The BTB reconstruction method of 1), which has been referred to as the golden standard for ligament reconstruction in the United States and other countries, has an extremely strong strength of the reconstructed ligament, has a good initial fixation property between the bone and the ligament, and is expected to have a patella ligament in the future. The bone fragments on both sides fuse with the femur and tibia matrix to form a more physiological and ideal reconstructed ligament.

[0008] In the reconstruction method using STG of 2),
The tendon used for reconstruction is collected from the same side as the affected side or from the contralateral side, but the decrease in muscle strength due to the effect of muscle collection is of little concern. Further, it is said that if the tendon is bent twice or three times, not only is the tensile strength excellent, but also histologically, it is closest to the original ligament material as a material for the reconstructed ligament.

[0009] The artificial ligament of 3) is sometimes used as a reinforcing material currently used together with the reconstructed ligament.

4) The BHB reconstruction method is a BTB reconstruction method and an ST method.
It can be said that this is a method that combines the advantages of the G reconstruction method. That is,
The bone fragments fixed on both sides of the BHB reconstruction ligament are firmly fixed in two tunnels of the femur and the tibia with a screw member at the time of the ligament reconstruction operation, and after a few weeks, the bone fragments and the mother bone are fused,
A more physiological ligament is reconstructed.

[Problems to be solved by the invention]

As described in the prior art, there are various ligament reconstruction methods, but each method has many problems that need to be solved.

[0012] In the BTB reconstruction method of 1), a part of the patella tendon is removed with the patella and tibia bone fragments attached thereto, which may cause patellofemoral joint disorders that cause pain around the patella after surgery.
There are many cases in which quadriceps muscle strength is reduced.
In addition, since the length of the collected reconstruction ligament cannot be adjusted, friction occurs between the ligament and the bone at the exit of the joint-side bone tunnel on the femur and tibia, and bone resorption occurs. In recent years, it has been pointed out that the ligament may be loosened later.

STG is the preferred reconstructed ligament material,
The method of fixing the ken and the bone used for the reconstruction has often been a problem. Since the tendon is fixed to the bone with staples and buttons, the initial fixation force remains anxious. Also, it is difficult to think that bones and tendons are firmly fixed under the influence of human beings physiologically, and there is hardly any evidence of this. Further, since the fixing property depends on the staples and the buttons, there is a concern that the fixing force is reduced when the staples and the buttons are removed. In addition, there is a risk that the bone tunnel will expand between the reconstructed ligament and the bone on the joint side and that the ligament will loosen in the future.

Since the artificial ligament is placed in a living body under an extremely poor environment for the artificial material, the material is significantly deteriorated and easily ruptured. In addition, at present, it is hardly used, except for a part, because it tends to cause arthritis due to rejection.

The reconstruction method combining the advantages of the reconstruction method using the patella tendon and the reconstruction method using the thin muscle / hemismoid tendon is called BH.
B. However, the problem with the BHB reconstruction method is where bone fragments used for fixation are obtained. In order to obtain a firm initial fixation, it is necessary to use relatively strong bone, and in this case, it is optimal to extract bone from the iliac bone. However, in this case, there is a problem that an extra surgical wound can be formed in another site for bone extraction. In addition, a bone tunnel for passing the reconstruction ligament through the tibia is prepared, and there is a method using a bone collected from the bone tunnel. However, since bones collected from bone tunnels are trabecular bones, the bones themselves have poor strength, and the initial fixation of tendons and bone fragments used for reconstruction and the fixation of bone fragments to the base bone are extremely poor. Problems are pointed out.

Therefore, the present invention solves the above-mentioned problems of the prior art, and provides a member capable of safer ligament reconstruction.

[Means for Solving the Problems]

The present invention was devised to take advantage of the BHB reconstruction method. That is, the tendon used for ligament reconstruction can be firmly fixed in the bone holes of the femur 5 and the tibia 6 through the plug 1. The plug 1 is firmly fixed in the bone hole by a screw member 3 or the like. The form of the plug 1 does not matter. The plug 1 is made of a material that is rich in biocompatibility and has excellent strength. The reconstructed ligament 4 and the plug 1 are used as a complex having a physical connection. If the plug 1 is fixed in the bone hole, biologically strong fixation to the bone can be obtained relatively early, and it is extremely useful for ligament reconstruction.

[Action]

A ligament is reconstructed using the reconstructed ligament produced by fixing the thin muscle / hemismoid tendon to the present plug 1 made of a material having a high biocompatibility. It is expected that the bone and the present plug 1 show good fixation in the bone hole, and that a stable ligament will be regenerated in the future.

【Example】

A state in which the collected tendon is folded back in two or three times, and the plug 1 is fixed to both ends thereof to form a reconstructed ligament complex.

FIG.

A state in which the prepared reconstruction ligament complex is passed through the inside of the knee joint and through the bone holes of the femur 5 and the tibia 6, and the main plugs of the femur and the tibia are fixed using the screw member 3.

FIG.

【The invention's effect】

By using this plug, a reconstructed ligament superior to the BHB method can be provided. That is, it is not necessary to newly collect a bone fragment for fixing the thin and semi-membrane-like muscle from another place, which is a problem in the BHB method, and the length of the reconstructed ligament can be adjusted. Along with this, the disadvantages associated with the conventional ligament reconstruction method are solved, and the convenience is extremely high.

The plug for fixing the reconstructed ligament in the bone hole according to claim 1 is excellent in biocompatibility and has strong fixation to bone, and if this method is used, the size according to each case can be improved. It is possible to create a reconstructed ligament, which is extremely effective for ligament reconstruction such as a knee joint.

As a result, one surgical method for obtaining a reconstructed ligament anatomically or physiologically similar to the original ligament is established.

[Brief description of the drawings]

FIG. 1 is a front and side view of a plug for fixing a reconstruction ligament in a bone tunnel.

FIG. 2

FIG. 1 is a front and side view of a plug for fixing a reconstructed ligament, which has been rotated 90 ° about a longitudinal axis, into a bone hole.

FIG. 3 shows a state of a reconstructed ligament complex prepared by fixing a tendon used for reconstruction to a plug for fixing in a bone hole.

FIG. 4 shows a state in which a plug portion of the reconstructed ligament complex is fixed in a knee joint using a screw member.

[Explanation of symbols]

REFERENCE SIGNS LIST 1 Plug for fixing reconstruction ligament in bone hole 2 Female screw part on plug surface for fixing reconstruction ligament in bone hole 3 Screw member 4 Reconstruction ligament 5 Femur 6 Tibia

Claims (1)

[Claims] 1. A plug 1 made of a material having excellent biocompatibility for effectively fixing a reconstructed ligament 4 to a bone, wherein a tissue such as a tendon used for reconstruction is wound around the plug. The plug is used in the form of a formed composite, and the plug is firmly fixed in the bone hole by a screw member 3 or the like. The form of the plug is not limited.