CN102245112A - 复合材料锚定器 - Google Patents

复合材料锚定器 Download PDF

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CN102245112A
CN102245112A CN2009801506126A CN200980150612A CN102245112A CN 102245112 A CN102245112 A CN 102245112A CN 2009801506126 A CN2009801506126 A CN 2009801506126A CN 200980150612 A CN200980150612 A CN 200980150612A CN 102245112 A CN102245112 A CN 102245112A
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anchor
proximal part
distal portions
bone
hole
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CN102245112B (zh
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R·M·伦
D·A·保罗克
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Smith and Nephew Inc
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Smith and Nephew Richards Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/044Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0445Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors cannulated, e.g. with a longitudinal through-hole for passage of an instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0448Additional elements on or within the anchor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0448Additional elements on or within the anchor
    • A61B2017/0451Cams or wedges holding the suture by friction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0458Longitudinal through hole, e.g. suture blocked by a distal suture knot
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0464Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Rheumatology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
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Abstract

本发明涉及一种复合材料锚定器。该复合材料锚定器包括具有螺纹外表面的管状近端部分以及联接到该近端部分的远端部分,该远端部分包括顶部部分、底部部分以及通孔,其中顶部部分配置成布置在该近端部分的管道中。

Description

复合材料锚定器
相关申请的交叉引用
本申请是PCT国际专利申请,其要求于2008年12月15日提交的美国专利申请No.61/122512的权益,该文献以引用的方式全文结合到本文中。
技术领域
本公开涉及用于修复组织的装置和方法。
背景技术
关节镜手术通常需要将软组织再附连到骨上。为了实现该目的,锚定器被植入骨中,附连到锚定器的缝线穿过组织以将组织牢固地固定到位。该锚定器可以是单体式设计或者可以是多件式设计。这些锚定器可以由允许锚定器随时间被身体吸收的材料制成。然而,由这种可吸收材料制成的缝线锚定器可能不允许在锚定器降解期间将组织稳固地保持靠在骨上,从而不允许将组织再次附连到骨上。另外,这些锚定器不允许锚定器和用来将锚定器插入到骨中的装置之间的足够表面接触,从而降低了使用者将大量扭矩施加到该锚定器上的能力。结果,迫使使用者在插入该锚定器之前在骨中产生孔,从而给手术增加了程序步骤以及时间。
发明内容
在一个方面,本发明涉及复合材料锚定器。该锚定器包括具有螺纹外表面的管状近端部分以及联接到该近端部分的远端部分,该远端部分包括顶部部分、底部部分以及通孔,其中顶部部分配置成布置在该近端部分的管道中。
在一个实施例中,远端部分的顶部部分包括至少两个侧部以及定位在该至少两个侧部之间的中间部分。在另一个实施例中,底部部分大致是圆锥形的。在又一个实施例中,该至少两个侧部大致是梯形的并且该中间部分大致是圆形的。在另外的实施例中,该通孔定位在远端部分的底部部分中。在又一个实施例中,该锚定器进一步包括至少一条布置在通孔中并延伸穿过近端部分的管道的缝线。
在一个实施例中,近端部分和远端部分都包括可吸收材料。在另一个实施例中,近端部分包括可吸收材料而远端部分包括不可吸收材料。在又一个实施例中,该可吸收材料包括聚合物材料并且该不可吸收材料包括聚合物材料。在另一个实施例中,可吸收材料包括聚合物材料并且不可吸收材料包括金属材料。
在另一个方面,本公开涉及修复方法。该方法包括提供复合材料锚定器,该复合材料锚定器包括管状近端部分;联接到该近端部分的远端部分,该远端部分包括顶部部分、底部部分以及通孔,其中顶部部分配置成布置在该近端部分的管道中;以及至少一条布置在通孔中并延伸穿过近端部分的管道的缝线;将锚定器插入骨中;将软组织放置在孔上并将缝线插入穿过软组织;以及将缝线打结以将软组织固定到骨上。
在一个实施例中,通过旋进锚定器将锚定器插入到骨中。在另一个实施例中,该方法进一步包括在将锚定器插入骨中之前在骨中产生孔。在又一个实施例中,近端部分包括螺纹外表面。
本发明进一步的应用领域从下文提供的详细说明将变得显而易见。应当理解的是,详细说明和具体示例虽然示出了本发明的优选实施例,但是它们仅旨在描述目的且不旨在限制本发明的范围。
附图说明
被包括在说明书中并形成说明书一部分的附图描述了本发明的实施例,并且连同书面说明书一起用于解释本发明的原理、特性和特征,在附图中:
图1示出了本发明的复合材料锚定器的透视图。
图2示出了图1的复合材料锚定器的近端部分的透视图。
图3示出了图2的近端部分的横截面视图。
图4示出了图1的复合材料锚定器的远端部分的透视图。
图5示出了图1的复合材料锚定器的横截面视图。
图6A-6C示出了通过使用图1的复合材料锚定器的修复方法。
具体实施方式
优选实施例的下述描述本质上仅为示例性的,并且决不旨在限制本发明、其应用或使用。
图1-5示出了本公开的复合材料锚定器10。锚定器10包括近端部分11和联接到近端部分11的远端部分12。近端部分11包括管道11a、配置成安置远端部分12的内表面11b以及用来将锚定器10插入到骨中的递送装置(未示出),其将在下文作进一步描述,以及包括螺纹11d的外表面11c。远端部分12包括底部部分12a、顶部部分12b以及定位在底部部分12a中的通孔12c。为了允许更容易地将锚定器10插入到骨中,底部部分12a大致为圆锥形,其将在下文作进一步描述。顶部部分12b包括至少两个侧部12d以及定位在该至少两个侧部12d之间的中间部分12e。侧部12d是梯形的并且中间部分12e大致是圆形的。如图5所示,侧部12d的形状顺应内表面11b的形状以便允许侧部12d接合内表面11b并且从而当远端部分12放置在近端部分11的管道11a中时将远端部分12与近端部分11联接。
图6A-6C示出了通过使用本公开的复合材料锚定器来修复的方法。如图6A所示,锚定器10包括至少一条缝线20,其被安置在通孔12c中并且具有延伸通过近端部分11的管道11a的端部20a、20b,使得缝线20被安置在中间部分12e上。如图6B所示,通过使用递送装置40旋进,将锚定器10插入到骨30中。递送装置40延伸了大致近端部分11的长度,从而在锚定器10和递送装置40之间提供足够量的表面接触以允许使用者施加的扭矩比起递送装置40延伸小于大致近端部分11长度所将允许的量更大。在锚定器10上施加更大量的扭矩的能力允许用户将锚定器10插入到骨30中,特别是诸如皮层质骨的硬骨中,而无需在插入锚定器10之前首先在骨30中产生孔,从而在手术中节省了时间。
在将锚定器10放入到骨30中之后,移去递送装置40并且将软组织50放在骨30上邻近锚定器10布置。然后将缝线端部20a、20b插入穿过软组织50并且打结以将软组织50固定到骨30上,如图6C所示。
为了本公开的目的,近端部分11包括可吸收材料,诸如可吸收聚合物材料,并且远端部分12包括不可吸收材料,诸如不可吸收聚合物材料或金属材料。可以使用任何的可吸收聚合物材料。可以使用包括了填充物的可吸收材料,该填充物诸如硫酸钙、碳酸钙、磷酸钙、纤维或其它提供增强的强度、骨传导、减低的聚合物pH水平或其它益处的填充物材料。可以使用诸如聚醚醚酮(PEEK)的不可吸收聚合物材料或其它的不可吸收聚合物材料。类似地,金属材料可包括不锈钢、钛或本领域技术人员已知的另外的金属材料。
相信具有可吸收近端部分11和不可吸收远端部分12的锚定器10将充分减少在近端部分11降解期间软组织50变得松散的可能性。另外,具有复合布置的锚定器提供给外科医生在手术期间使用锚定器类型的更多选择。当前的两件式缝线锚定器整体由金属材料或非金属材料构成。
为了本公开的目的,锚定器10的近端部分11和锚定器10的远端部分12通过近端部分11和远端部分12之间的干涉配合来联接。然而,部件11、12可以通过超声焊接或本领域技术人员已知的另外的联接方法来联接。另外,对于内表面11b、侧部12d、中间部分12e以及底部部分12a来说可能具有不同的形状。此外,除螺纹以外的特征可以呈现在近端部分11的外表面11c上。相反,外表面11c可包括倒钩或允许锚定器10轴向推进到骨30中的其它表面特征。此外,可以布置多于一条缝线到通孔12c中并穿过管道11a。更多地,在将锚定器10插入骨30之前可以在骨30中形成孔。
由于在不偏离本发明的范围的前提下可对如上关于相应附图描述的示例性实施例进行各种修改,因此本发明旨在将包含在前述说明以及在附图中示出的所有内容应解释为描述性而不是限制性的。因而,本发明的广泛性和范围不应受任何上述示例性实施例限制,而是仅应当根据所附下述权利要求书及其等同物限定。

Claims (14)

1.一种复合材料锚定器,包括:
包括螺纹外表面的管状近端部分;以及
联接到所述近端部分的远端部分,所述远端部分包括顶部部分、底部部分以及通孔,其中所述顶部部分配置成布置在所述近端部分的管道中。
2.如权利要求1所述的锚定器,其中所述远端部分的顶部部分包括至少两个侧部以及定位在所述至少两个侧部之间的中间部分。
3.如权利要求1所述的锚定器,其中所述底部部分大致是圆锥形的。
4.如权利要求2所述的锚定器,其中所述至少两个侧部大致是梯形的并且所述中间部分大致是圆形的。
5.如权利要求1所述的锚定器,其中所述通孔定位在所述远端部分的底部部分中。
6.如权利要求1所述的锚定器,其中所述锚定器进一步包括至少一条布置在所述通孔中并延伸穿过所述近端部分的管道的缝线。
7.一种修复方法,包括:
提供复合材料锚定器,所述复合材料锚定器包括管状近端部分;联接到所述近端部分的远端部分,所述远端部分包括顶部部分、底部部分以及通孔,其中所述顶部部分配置成布置在所述近端部分的管道中;以及至少一条布置在所述通孔中并延伸穿过所述近端部分的管道的缝线;
将所述锚定器插入骨中;
将软组织放置在孔上并将所述缝线插入穿过所述软组织;以及
将所述缝线打结以将所述软组织固定到骨上。
8.如权利要求7所述的方法,其中通过旋进所述锚定器将所述锚定器插入到骨中。
9.如权利要求7所述的方法,进一步包括在将所述锚定器插入骨中之前在所述骨中产生孔。
10.如权利要求7所述的方法,其中所述近端部分包括螺纹外表面。
11.如权利要求1所述的锚定器,其中所述近端部分和所述远端部分都包括可吸收材料。
12.如权利要求1所述的锚定器,其中所述近端部分包括可吸收材料,所述远端部分包括不可吸收材料。
13.如权利要求12所述的锚定器,其中所述可吸收材料包括聚合物材料,所述不可吸收材料包括聚合物材料。
14.如权利要求12所述的锚定器,其中所述可吸收材料包括聚合物材料,所述不可吸收材料包括金属材料。
CN200980150612.6A 2008-12-15 2009-12-07 复合材料锚定器 Expired - Fee Related CN102245112B (zh)

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US12251208P 2008-12-15 2008-12-15
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PCT/US2009/066966 WO2010071742A1 (en) 2008-12-15 2009-12-07 Composite anchor

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EP (1) EP2375995A1 (zh)
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CN106456154A (zh) * 2014-03-06 2017-02-22 史密夫和内修有限公司 两部件式无结缝线锚
CN107809960A (zh) * 2015-06-30 2018-03-16 史密夫和内修有限公司 具有螺纹插塞的缝线锚定器系统

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CN102573662B (zh) * 2009-10-28 2015-08-05 史密夫和内修有限公司 带螺纹缝合线锚定器
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US9386977B2 (en) 2016-07-12
US20140343605A1 (en) 2014-11-20
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US8771315B2 (en) 2014-07-08

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