CA1071354A - Attached fibrous connective tissue to bone - Google Patents
Attached fibrous connective tissue to boneInfo
- Publication number
- CA1071354A CA1071354A CA252,800A CA252800A CA1071354A CA 1071354 A CA1071354 A CA 1071354A CA 252800 A CA252800 A CA 252800A CA 1071354 A CA1071354 A CA 1071354A
- Authority
- CA
- Canada
- Prior art keywords
- plug
- tissue
- bone
- prosthesis according
- connective tissue
- 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.)
- Expired
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- Prostheses (AREA)
Abstract
A bone implant for attaching fibrous connective tissue such as a tendon or ligament, either artificial or natural, to bone, which comprises a tapered porous plug, preferably of sintered metal; a tendon prosthesis having such a plug at its distal end is also disclosed.
Description
7~3~
This invention relates to improvements in attachi~g fibrous connective tissue to bone, and in particular to tendon and ligament prostheses.
It has been proposed to replace a tendon by either directly grafting in place a tendon ~rom a less important part of the body or by employing an artificial tendon such as a cord of an inert plastics material. To directly gra~t in place a tendon from another part of the body can cause adhesions between the grafted tendon and the surrounding tissue. This leads to a consequent loss of mobility. Problems have also arisen over securing tendon prostheses to the bone and the muscle (especially the former) with sufficient strength to withstand long term use. .
One major problem is providing a sufficiently strong securing means between the fibrous connective tissue and the bone.
Various methods have been devised for anchoring tendon prostheses: :~
~any of these methods have involved mesh-like materials which are emplo~ed to enable tissue infiltration into the mesh to occur so as to provide a strong bond These me~hods.arei~iscussed, for example, in the U.S. Patent ~o. 3,805,300. It is also known to 20 construct certain bone implants using porous material, the pores facilitating anchorage of the bone to the implant as a result o bone growth into the pores (see U.S. Patent No. 3,808,606). At present, however, there is still a need for improved means for connecting fibrous connective tissue to bone. :
According to the present invention there is provided a bone implant ~or attaching ~ibrous connective tissue (either artificial or natural), such as a tendon or ligament, to bone, : which implant comprises a tapered porous plug.
The reason for ta.pering the.plug is to provide intimate contact o~ plug and bone by action of the tension in the ~ibrous . :.
tissue. During the healing process, this intimate contact will ;~ ,.' ,:
This invention relates to improvements in attachi~g fibrous connective tissue to bone, and in particular to tendon and ligament prostheses.
It has been proposed to replace a tendon by either directly grafting in place a tendon ~rom a less important part of the body or by employing an artificial tendon such as a cord of an inert plastics material. To directly gra~t in place a tendon from another part of the body can cause adhesions between the grafted tendon and the surrounding tissue. This leads to a consequent loss of mobility. Problems have also arisen over securing tendon prostheses to the bone and the muscle (especially the former) with sufficient strength to withstand long term use. .
One major problem is providing a sufficiently strong securing means between the fibrous connective tissue and the bone.
Various methods have been devised for anchoring tendon prostheses: :~
~any of these methods have involved mesh-like materials which are emplo~ed to enable tissue infiltration into the mesh to occur so as to provide a strong bond These me~hods.arei~iscussed, for example, in the U.S. Patent ~o. 3,805,300. It is also known to 20 construct certain bone implants using porous material, the pores facilitating anchorage of the bone to the implant as a result o bone growth into the pores (see U.S. Patent No. 3,808,606). At present, however, there is still a need for improved means for connecting fibrous connective tissue to bone. :
According to the present invention there is provided a bone implant ~or attaching ~ibrous connective tissue (either artificial or natural), such as a tendon or ligament, to bone, : which implant comprises a tapered porous plug.
The reason for ta.pering the.plug is to provide intimate contact o~ plug and bone by action of the tension in the ~ibrous . :.
tissue. During the healing process, this intimate contact will ;~ ,.' ,:
2 ~ . :~
'^df135~
promote the ingrow~h of calcified bone rather than soft tissue by restricting or stopping movement of the plug relative to the surrounding bone.
In a preferred aspect of the invention there is provided a tendon prosthesis provided at its distal end thereof with a bone implant in accordance with the invention.
In use in a tendon prosthesis the plug is located in a correspondin~ recess in the bone at the distal end o~ the tendon prosthesis and the end o~ the prosthesis remote ~rom the plu~ is laced to the proximal tendon or muscle. Since the plug is -porous, in time, bone tissue grows into and through the voids in the plug and this provides a very secure attachment ~or the tendon prosthesis to the bone. The plug is tapered and attached to t~e remainder of the prosthesis so that, in use, the plug is held in tension in the direction of the taper. With this arrangement the tapered plug is held firmly in its bone resection.
The plug may be formed of any biocompatible material, for example ; a suitable ceramic, metal, or plastics material. Since it is ' , porous, a convenient method for its manufacture is by sintering ceramic, metal or plastics particles into a suitable tapered form.
Preferably the plug is of sintered metal, especially sintered titanium, niobium, or tantalum,or an alloy containing one or more thereof. In one preferred method of manufacture, titanium wlre of 20 to 200 microns diameter is wound around on a fine mandrel to provide a coil, pulled off the mandrel and extended so as to produce a series of helical regions. This wire is then pacXed into a suitably-shaped die, compacted, and heated in a vacu~m or inert gas so as to sinter the wire into a compact body. Prefer-- ably as many pores as possible in the sintered body should have a diameter or width of 100 to 400 microns. Winding the wire on the mandrel and extending it as described above avoids forming dense regions in the structure.
~- . ', ' ' : ' ::
- . .:
3S~
The fibrous connective tissue may be conn;ec~ed to the plug by any suitable means. A ligament can be looped around and tied to the plug, for example as described hereinafter. The replacement for the original fibrous connective tissue in a tendon prosthesis can be attached to the plug by adhesive or it can be formed integrally therewith. Preferably, however, specific means are provided for anchoring the fibrous connactive tissue to the plug, for example by providing a pin which extends transversely of the connective tissue and locates in a recess 10 the pl~g. For a tendon prosthesis, the plug is preferably frusto-conical. The plug may be provided with a passageway to receive an end of the fibrous connecti~e tissue.
The tendon prosthesis of the invention, in addition to the bone implant described above, is preferably provided with a cord member havin~ its central portion coated or sheathed with a material to promote sliding movement of the cord member within the bodyO
The cord member will generally be substantially non-résilient and may be, for example, of braided form, a mono-filament, or even strip-like. Preferably, it is an inert synthetic plastics material, such as a polyester or a poLyamide thread.
The sheath or coating for the cord member may be of any appropriate inert material (such as synthetic plastics material) and may be of any cross~section appropriate to the cross-section of the cord member, for example, annular. A
sheath member may be, for example, a right cylindrical silicone ; -~
polymer or polyurethane tube. The sheath or coating acts as a barrier against adhesions between the cord member and the surrounding tissue and hence promotes sliding movement of the cord member in the body~
. ~
., , , . .. : . . .
:
~37~354 According to a broad aspect of the present invention there is provided a prosthesis which comprises artificial fibrous connective tissue and, at a dis-tal end of the tissue, a bone implant comprising a tapered porous plug. The plug is connected to the artificial tissue with the plug tapering in the direction towards the artificial tissue.
Preferred features of the invention will now be described, by way of example, with xeference to the accompany-ing drawing in which:
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i ,i . :
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' ' '-'~ ..
. I - .
:, :
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' ~3 "'' 11:17~35~
Figure 1 is a schematic representation of a tendon prosthesis of the invention in place in the body between a muscle and the distal phalallx of a finger in a hand.
Figure 2 is a cross-section of the plug shown in - Figure 1 with the cord member and pin in place, and Figure 3 is a schematic perspective view of a bone implant according to the invention in use in securing a ligament to bone.
Referring to Figure 1, the tendon prosthesis comprises a polyurethane coating 1, a cord member 2 consisting of four strands of polyethylene terephthalate filament, and a plug 3.
The tendon extends between a muscle-tendinous junction 4 and the bone of the distal phalanx 5.
The plug 3 is formed by sintering together titanium wires and is porous to the extent that approximately 50% of its apparent volume is constituted by voids. The plug 3 is frusto-conical and is provided with an axial bore 6 through which the -cord member passes and a recess 7 in which is located a locking pin 8. The locking pin 8 is transverse to the cord member and the cord filaments double around the pin 8, so that the ends of ;~
the filaments are remote from the plug. This arrangement prevents the cord member from pulling through the axial bore 6 in the direction of muscle 4 and provides an attachment between the cord and the plug of great strength and small volume.
A resection 9 is provided in the distal phalanx 5 to provide a close fit with the plug 3. The strands of the cord member 2 remote from the plug are separated, are passed through the musculo-tendinous junction 4, and are then laced thereto. -Referring to Figure 2, it will:be seen that the axial ~-bore 6 is counter-bored from the surface adjacent recess 7 so as to accommodate the loop which is formed when the cord member 2 is doubled around the~pin 8.
.
- 5 - ;
3S~
Figure 3 shows a plug 10 which is generally wedge-shaped and whlch is inserted in the bone resection 11 with the thin edge 12 of the wedge lying axially within the resection.
A bore 13 is provided through the bone adjacent the thin edge 12 so as to take the end of a ligament 14 which is looped and tied around the plug 10. The bore is taken to the thin edge of plug in such a manner that in use the tension on khe plug is in the direction of the wedge-taper.
Since the bore implants and tendon prostheses of this invention are placed in the body surgically, it is desirable that they be supplied in sterile, sealed packages. It may be conve-nient to include in each package an appropriate reamer for resecting the bone to receive the plug.
~ .
- . . , ~ - , . . , -
'^df135~
promote the ingrow~h of calcified bone rather than soft tissue by restricting or stopping movement of the plug relative to the surrounding bone.
In a preferred aspect of the invention there is provided a tendon prosthesis provided at its distal end thereof with a bone implant in accordance with the invention.
In use in a tendon prosthesis the plug is located in a correspondin~ recess in the bone at the distal end o~ the tendon prosthesis and the end o~ the prosthesis remote ~rom the plu~ is laced to the proximal tendon or muscle. Since the plug is -porous, in time, bone tissue grows into and through the voids in the plug and this provides a very secure attachment ~or the tendon prosthesis to the bone. The plug is tapered and attached to t~e remainder of the prosthesis so that, in use, the plug is held in tension in the direction of the taper. With this arrangement the tapered plug is held firmly in its bone resection.
The plug may be formed of any biocompatible material, for example ; a suitable ceramic, metal, or plastics material. Since it is ' , porous, a convenient method for its manufacture is by sintering ceramic, metal or plastics particles into a suitable tapered form.
Preferably the plug is of sintered metal, especially sintered titanium, niobium, or tantalum,or an alloy containing one or more thereof. In one preferred method of manufacture, titanium wlre of 20 to 200 microns diameter is wound around on a fine mandrel to provide a coil, pulled off the mandrel and extended so as to produce a series of helical regions. This wire is then pacXed into a suitably-shaped die, compacted, and heated in a vacu~m or inert gas so as to sinter the wire into a compact body. Prefer-- ably as many pores as possible in the sintered body should have a diameter or width of 100 to 400 microns. Winding the wire on the mandrel and extending it as described above avoids forming dense regions in the structure.
~- . ', ' ' : ' ::
- . .:
3S~
The fibrous connective tissue may be conn;ec~ed to the plug by any suitable means. A ligament can be looped around and tied to the plug, for example as described hereinafter. The replacement for the original fibrous connective tissue in a tendon prosthesis can be attached to the plug by adhesive or it can be formed integrally therewith. Preferably, however, specific means are provided for anchoring the fibrous connactive tissue to the plug, for example by providing a pin which extends transversely of the connective tissue and locates in a recess 10 the pl~g. For a tendon prosthesis, the plug is preferably frusto-conical. The plug may be provided with a passageway to receive an end of the fibrous connecti~e tissue.
The tendon prosthesis of the invention, in addition to the bone implant described above, is preferably provided with a cord member havin~ its central portion coated or sheathed with a material to promote sliding movement of the cord member within the bodyO
The cord member will generally be substantially non-résilient and may be, for example, of braided form, a mono-filament, or even strip-like. Preferably, it is an inert synthetic plastics material, such as a polyester or a poLyamide thread.
The sheath or coating for the cord member may be of any appropriate inert material (such as synthetic plastics material) and may be of any cross~section appropriate to the cross-section of the cord member, for example, annular. A
sheath member may be, for example, a right cylindrical silicone ; -~
polymer or polyurethane tube. The sheath or coating acts as a barrier against adhesions between the cord member and the surrounding tissue and hence promotes sliding movement of the cord member in the body~
. ~
., , , . .. : . . .
:
~37~354 According to a broad aspect of the present invention there is provided a prosthesis which comprises artificial fibrous connective tissue and, at a dis-tal end of the tissue, a bone implant comprising a tapered porous plug. The plug is connected to the artificial tissue with the plug tapering in the direction towards the artificial tissue.
Preferred features of the invention will now be described, by way of example, with xeference to the accompany-ing drawing in which:
~ .
, ..
i ,i . :
.` ~
' ' '-'~ ..
. I - .
:, :
:: - 4a -. . .
' ~3 "'' 11:17~35~
Figure 1 is a schematic representation of a tendon prosthesis of the invention in place in the body between a muscle and the distal phalallx of a finger in a hand.
Figure 2 is a cross-section of the plug shown in - Figure 1 with the cord member and pin in place, and Figure 3 is a schematic perspective view of a bone implant according to the invention in use in securing a ligament to bone.
Referring to Figure 1, the tendon prosthesis comprises a polyurethane coating 1, a cord member 2 consisting of four strands of polyethylene terephthalate filament, and a plug 3.
The tendon extends between a muscle-tendinous junction 4 and the bone of the distal phalanx 5.
The plug 3 is formed by sintering together titanium wires and is porous to the extent that approximately 50% of its apparent volume is constituted by voids. The plug 3 is frusto-conical and is provided with an axial bore 6 through which the -cord member passes and a recess 7 in which is located a locking pin 8. The locking pin 8 is transverse to the cord member and the cord filaments double around the pin 8, so that the ends of ;~
the filaments are remote from the plug. This arrangement prevents the cord member from pulling through the axial bore 6 in the direction of muscle 4 and provides an attachment between the cord and the plug of great strength and small volume.
A resection 9 is provided in the distal phalanx 5 to provide a close fit with the plug 3. The strands of the cord member 2 remote from the plug are separated, are passed through the musculo-tendinous junction 4, and are then laced thereto. -Referring to Figure 2, it will:be seen that the axial ~-bore 6 is counter-bored from the surface adjacent recess 7 so as to accommodate the loop which is formed when the cord member 2 is doubled around the~pin 8.
.
- 5 - ;
3S~
Figure 3 shows a plug 10 which is generally wedge-shaped and whlch is inserted in the bone resection 11 with the thin edge 12 of the wedge lying axially within the resection.
A bore 13 is provided through the bone adjacent the thin edge 12 so as to take the end of a ligament 14 which is looped and tied around the plug 10. The bore is taken to the thin edge of plug in such a manner that in use the tension on khe plug is in the direction of the wedge-taper.
Since the bore implants and tendon prostheses of this invention are placed in the body surgically, it is desirable that they be supplied in sterile, sealed packages. It may be conve-nient to include in each package an appropriate reamer for resecting the bone to receive the plug.
~ .
- . . , ~ - , . . , -
Claims (10)
1. A prosthesis which comprises artificial fibrous connect-ive tissue and, at a distal end of said tissue, a bone implant comprising a tapered porous plug, said plug being connected to said artificial tissue with said plug tapering in the direction towards said artificial tissue.
2. A prosthesis according to claim 1 wherein the plug is provided with a passageway to receive an end of the fibrous connective tissue, means being provided to anchor the end of the fibrous connective tissue to the plug.
3. A prosthesis according to claim 2 wherein the anchor means comprises a pin.
4. A prosthesis according to claim 3 wherein the plug is provided with a recess extending across one face thereof, transversely of the passageway, for receiving the pin.
5. A prosthesis according to claim 1 wherein the plug is of frusto-conical shape.
6. A prosthesis according to claim 1 wherein the plug is of sintered metal.
7. A prosthesis according to claim 1 wherein said artificial tissue comprises a cord member, the central portion of the cord member being sheathed or coated with a material to promote sliding movement of the cord member within the body.
8. A prosthesis according to claim 1 wherein said plug is in the form of an elongated triangular cross-sectional member.
9. A bone implant for attaching artificial fibrous con-nective tissue to bone, which implant comprises a tapered porous plug having remote ends including a large end and being provided with a passageway disposed in the direction of said taper between said ends to receive an end of fibrous connective tissue, and pin means for extending transverse to said passage-way in bridging relation thereto at said enlarged end to anchor a fibrous connective tissue end to said plug.
10. A bone implant according to claim 9 wherein said plug is provided with a recess extending across said large end transversely of said passageway for receiving said pin.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA252,800A CA1071354A (en) | 1976-05-18 | 1976-05-18 | Attached fibrous connective tissue to bone |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA252,800A CA1071354A (en) | 1976-05-18 | 1976-05-18 | Attached fibrous connective tissue to bone |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1071354A true CA1071354A (en) | 1980-02-12 |
Family
ID=4105990
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA252,800A Expired CA1071354A (en) | 1976-05-18 | 1976-05-18 | Attached fibrous connective tissue to bone |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA1071354A (en) |
-
1976
- 1976-05-18 CA CA252,800A patent/CA1071354A/en not_active Expired
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| MKEX | Expiry |