CN103826544B - 锚定器系统以及与其一起使用的输送装置 - Google Patents

锚定器系统以及与其一起使用的输送装置 Download PDF

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CN103826544B
CN103826544B CN201280014306.1A CN201280014306A CN103826544B CN 103826544 B CN103826544 B CN 103826544B CN 201280014306 A CN201280014306 A CN 201280014306A CN 103826544 B CN103826544 B CN 103826544B
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embolism
anchor
threaded
hole
suture
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CN103826544A (zh
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理查德·伦恩
D·保尔克
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Smith and Nephew 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • 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
    • A61B2017/0409Instruments for applying 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
    • A61B2017/0414Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
    • 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
    • A61B2017/042Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
    • A61B2017/0422Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor
    • A61B2017/0425Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor the anchor or the separate member comprising threads, e.g. a set screw in the anchor
    • AHUMAN NECESSITIES
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    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
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    • 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
    • A61B2017/044Suture 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
    • A61B2017/0441Suture 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 the shaft being a rigid coil or spiral
    • 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
    • A61B2017/0453Additional elements on or within the anchor threaded elements, e.g. set 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
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0454Means for attaching and blocking the suture in the suture anchor the anchor being crimped or clamped on the suture

Abstract

本公开涉及一种锚定器系统。锚定器系统包括锚定器以及布置在锚定器内的栓塞,锚定器包括螺纹外部和无螺纹外部,栓塞包括远侧部、近侧部以及通孔,近侧部包括螺纹部和连接部,其中螺纹外部的内表面被成形以与输送装置的部分对接,并且无螺纹外部的内表面包括用于与栓塞的螺纹部上的螺纹啮合的螺纹。还公开了与锚定器系统一起使用的输送装置。

Description

锚定器系统以及与其一起使用的输送装置
相关中请的交叉引用
本申请是PCT国际专利申请,其要求于2011年3月22日提交的美国专利申请No.61/466069的优先权,其公开内容通过引入以其全文并入本文。
背景技术
技术领域
本发明涉及一种用于修复组织的装置和方法。
现有技术
关节镜手术过程通常需要将软组织重新连接到骨上。最初,为了实现该目的,锚定器被置于骨中,并且连接到锚定器的缝合线穿过组织以将组织牢固地保持就位。近年来发展的重新连接组织的方法包括将缝合线附接至组织,将缝合线末端置于制备好的骨孔中,以及将锚定器插入骨孔内以提供缝合线与骨的固定并进而提供组织与骨的固定。通过植入物与骨孔之间过盈的缝合线固定取决于患者骨质量。因此,如果患者的骨具有较差质量,那么锚定器和骨孔之间具有较少的过盈,并因此缝合线及组织较差地固定至骨。需要一种减少对患者骨质量依赖的将组织固定至骨的锚定器和方法。
发明内容
在一个方面,本公开涉及一种锚定器系统。该锚定器系统包括锚定器以及设置在锚定器内的栓塞,锚定器包括螺纹外部和无螺纹外部,该栓塞包括远侧部、近侧部以及通孔,近侧部包括螺纹部和连接部,其中螺纹外部的内表面被成形以与输送装置的部分对接,并且无螺纹外部的内表面包括用于与栓塞的螺纹部上的螺纹啮合的螺纹。
在一个实施例中,锚定器的螺纹外部包括纵向沟槽。在另一实施例中,无螺纹外部具有比螺纹外部小的直径。在又一实施例中,无螺纹外部与栓塞远侧部接合。
在另一方面,本公开涉及一种输送装置。输送装置包括外轴杆,外轴杆包括远端、近端以及连接至近端的手柄,至少部分远端具有比近端小的直径;以及内轴杆,内轴杆设置在外轴杆内,内轴杆包括远端、近端以及连接至近端的于柄,远端包括叉股、定位于叉股之间的开口以及标记。在一个实施例中,输送装置还包括位于外轴杆远端上的锚定器和位于内轴杆远端上的栓塞,锚定器包括螺纹外部和无螺纹外部,栓塞包括远侧部、近侧部以及通孔,近侧部包括螺纹部和连接部,连接部位于内轴杆的开口内。
附图简述
结合在说明书中并构成说明书一部分的附图示出了本公开的各实施例,并且连同书面描述一起用于解释本公开的原理、特性和特征。在附图中:
图1示出了本公开的锚定器系统和输送装置的等距视图;
图2示出了图1的锚定器系统以及输送装置一端的等距视图;
图3示出了图1的锚定器系统和输送装置的另一等距视图;
图4示出了图3的锚定器系统和输送装置的等距视图;
图5和6示出了通过使用图1的锚定器系统和输送装置进行组织修复的方法。
具体实施方式
下面对优选实施例的描述本质上仅为示例性的,并且决不旨在限制本公开、其应用或使用。
图1-4示出了本公开的锚定器系统10和输送装置20。锚定器系统10包括锚定器11和栓塞12。锚定器11包括套管11a、螺纹外部11b以及无螺纹外部11e。为本公开的目的,外部11e具有比螺纹外部11b小的直径。虽然螺纹11g位于外部11b上,但是不同于螺纹的其他特征也可以用于允许锚定器11插入骨中并将锚定器11固定至骨。螺纹外部11b包括延伸螺纹外部11b的部分长度的纵向沟槽11d。然而,沟槽11d可延伸螺纹外部11b的整个长度。沟槽11d的作用是随着锚定器11插入骨中而允许螺纹11g具有更多切割动作。外部11b的内表面11e被成形以与输送装置20的部分紧密配合,如将在下文说明的,并且外部11e的内表面11f被成形以与栓塞12的部分紧密配合,如将在下文说明的。栓塞12包括远侧部12a和近侧部12b。远侧部12a是尖状的,然而具有不是尖状的其他形状的远侧部也在本发明的范围内。近侧部12b包括螺纹部12c和连接部12d。近侧部12b具有不同于螺纹12f的其他特征也在本发明的范围内。栓塞12还包括通孔12e。
输送装置20包括外轴杆20a,外轴杆20a具有远端20b和近端20c。手柄20d连接至外轴杆20a的近端20c。输送装置20还包括设置在外轴杆20a内的内轴杆20e,内轴杆20e包括远端20f和近端20g。手柄20h连接至内轴杆20e的近端20g。外轴杆20a的远端20b容纳在锚定器11内并被成形以与内表面11e紧密配合。内轴杆20e的远端20f包括叉股20i以及位于叉股20i之间的开口20j。连接部12d位于开口20j内。可以使用不同于叉股20i和连接部12d的其他连接装置。内轴杆20e的远端20f还包括以环绕末端20f的环的形式的标记20k,用于稍后描述的目的。可以使用不同于环20k的标记。
图5和图6示出了通过使用锚定器系统10和输送装置20进行组织修复的方法30。缝合锚定器40插入骨50中,缝合线41穿过组织60设置,以及然后缝合线41穿过栓塞12的通孔12e设置。栓塞12通过使用输送装置20随后插入骨50中先前形成的孔51中。具体而言,使用者敲击手柄20h以轴向地驱动栓塞12进入孔51中。栓塞12被驱动进入孔51中直至标记20k位于骨50中为止,如图5所示。可选地,拉紧缝合线41以牵拉组织60更加靠近骨50。
外轴杆20a则通过使用手柄20d轴向移动以使得外部11e与螺纹部12c形成接触,以及位于外部11c的内表面11f上的螺纹(未示出)与部分12c的螺纹12f形成啮合。内表面11f可包括不同于螺纹的其他特征以允许锚定器11和栓塞12之间的连接。外轴杆20a的手柄20d可旋转以转动外轴杆20a并轴向地移动锚定器11,或手柄20d可用于没有旋转地轴向移动外轴杆20a和锚定器11。手柄20d然后旋转以转动轴杆20a和锚定器11。旋转锚定器11引起锚定器11在栓塞12上轴向移动直至外部11e接触远侧部12a和缝合线41为止。输送装置20随后从孔12e移除。虽然部分缝合线41仍位于锚定器11和骨孔51之间,但是锚定器11和栓塞12之间的缝合线41的夹紧提供了主要的缝合线固定力,这终止了缝合线固定以及由此组织固定对患者骨质量的单一依靠。
为了本公开的目的,锚定器11和栓塞12均包括非金属材料,诸如聚合物材料。然而,可以使用金属材料。聚合物材料是不可吸收聚合材料,也可以是可吸收聚合物材料。可以使用任何可吸收聚合物材料。可使用的可吸收材料包括诸如硫酸钙、碳酸钙、磷酸钙、纤维的填料,或能够提供增强强度、骨传导性、降低的聚合物PH水平或其他益处的其他填充材料。不可吸收聚合物材料可包括但不限于聚醚醚酮(PEEK)或其他不可吸收聚合物材料。类似地,金属材料可包括不锈钢、钛或对于本领域技术人员公知的其他金属材料。
输送装置20的轴杆20a、20e是生物相容的金属材料,其包括但不限于不锈钢或钛。然而,可以使用允许输送装置20能经受住手术期间在其上施加的力的其他材料。手柄20d、20h是非金属材料,包括但不限于聚合物材料。然而,可使用其他材料。手柄20d、20h通过机械方法或非机械方法连接至轴杆20a、20e。标记20k通过使用激光置于轴杆20e上。然而,可以使用将标记20k置于轴杆20e上的其他方法。叉股20i以及轴杆远端20b的缩减直径部分可通过使用本领域技术人员公知的工艺来制作。
由于在不偏离本公开范围的情况下可对如上参照对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的以及附图中示出的所有内容解释为例证性的而非限制性的。因此,本公开的宽度和范围不应受上述任何示例性实施例限制,而是仅应当根据附于本文的下述权利要求及其等效物来限定。

Claims (5)

1.一种用于缝合线固定的锚定器系统,其包括:
锚定器,其包括螺纹外部和无螺纹外部;以及
栓塞,其设置在所述锚定器内,所述栓塞包括远侧部、近侧部以及通孔,所述近侧部包括螺纹部和连接部,
其中,所述螺纹外部的内表面被成形以与输送装置的一部分对接,并且所述无螺纹外部的内表面包括用于与所述栓塞的所述螺纹部上的螺纹啮合的螺纹;
其中,所述锚定器在所述栓塞之上的轴向前进使得能够在缝合线穿过所述栓塞的所述通孔时夹紧所述缝合线;并且
其中,所述栓塞的所述远侧部被构造成:一旦所述锚定器部分地而非完全地覆盖所述栓塞的所述通孔,就限制所述锚定器在所述栓塞之上的轴向前进。
2.如权利要求1所述的锚定器系统,其中所述锚定器的所述螺纹外部包括纵向沟槽。
3.如权利要求1所述的锚定器系统,其中所述无螺纹外部具有比所述螺纹外部小的直径。
4.如权利要求1所述的锚定器系统,其中所述无螺纹外部与所述栓塞的所述远侧部接合。
5.一种输送装置,其包括:
外轴杆,其包括远端、近端以及连接至所述近端的手柄,所述远端的至少一部分具有比所述近端小的直径;
内轴杆,其设置在所述外轴杆内,所述内轴杆包括远端、近端以及连接至近端的手柄,远端包括叉股、定位于所述叉股之间的开口以及标记;
锚定器,其位于所述外轴杆的所述远端上并且包括螺纹外部和无螺纹外部;以及
栓塞,其位于所述内轴杆的所述远端上并且包括远侧部、近侧部以及通孔,所述近侧部包括螺纹部和连接部,所述连接部位于所述内轴杆的所述开口内;
其中,所述锚定器在所述栓塞之上的轴向前进使得能够在缝合线穿过所述栓塞的所述通孔时夹紧所述缝合线;并且
其中,所述栓塞的所述远侧部被构造成:一旦所述锚定器部分地而非完全地覆盖所述栓塞的所述通孔,就限制所述锚定器在所述栓塞之上的轴向前进。
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