CN105125320A - Fixing device for ACL (anterior cruciate ligament) and ALL (anterolateral ligament) integrated reconstruction and usage method - Google Patents
Fixing device for ACL (anterior cruciate ligament) and ALL (anterolateral ligament) integrated reconstruction and usage method Download PDFInfo
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- CN105125320A CN105125320A CN201510628545.1A CN201510628545A CN105125320A CN 105125320 A CN105125320 A CN 105125320A CN 201510628545 A CN201510628545 A CN 201510628545A CN 105125320 A CN105125320 A CN 105125320A
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Abstract
The invention provides a fixing device for ACL (anterior cruciate ligament) and ALL (anterolateral ligament) integrated reconstruction and a usage method. The fixing device comprises a flexible long-strip-shaped body, wherein the long-strip-shaped body comprises a head and a tail, the head is arranged on an ACL in a sleeving manner, and the tail is used as an ALL. The usage method comprises steps as follows: firstly, the long-strip-shaped body is introduced from a tibia lower insertion bone tunnel; then the head covers the ACL, and the tail passes through a tibia upper insertion bone tunnel; finally, the tail is fixed with an ALL lower insertion bone tunnel. The fixing device can deform elastically and has a certain protecting effect to enable the motion capacity to be restored to the initial level. Meanwhile, only one fixing device is required for realizing fixing for ACL and ALL integrated reconstruction, particularly, the number of formed bone tunnels is reduced, the time is shortened, and the comfort of a patient is improved.
Description
Technical field
The present invention relates to the technical field of the Design for Medical Device of ligament reconstructive, particularly relate to fixture and the using method of a kind of anterior cruciate ligament and front lateral ligament one volume reconstruction.
Background technology
Knee joint is one of human body the most complicated maximum joint, and in actual motion, just simple flexion movement, also has the rotation of tibia, and the three-dimensional motion of the series of complex such as the rolling of femur ankle on tibia and slip.And the motion of this series of complex is all rely on the tendon of knee joint peripheral and tough bringing to keep joint balance at the volley and steady statue.Anterior cruciate ligament (Anteriorcruciateligament is called for short ACL) restricted tibia reach and adjustment portion spinfunction.
But make numerous doctor and patient's puzzlement for many years, tears of anterior cruciate ligament is through reconstruction Post operation, and the motor capacity of a lot of patient still cannot return to initial level.In these cases, patient generally can be subject to the puzzlement of rotational slack (rotationallaxity).Even if utilize the mode that two-beam is fixing, the effect of lasting rotational slack still can not be reduced.Meanwhile, up-to-date medical advances finds tears of anterior cruciate ligament tearing usually along with front lateral ligament (Anterolateralligament is called for short ALL), and front lateral ligament has important biomechanical function in motion of knee joint.The chances are 2 inches (5.08 centimetres) for the length of front lateral ligament, is positioned at (Anterolateral) direction, kneed front outside, connects the front outside of femur and tibia.
And existing surgical technic takes anterior cruciate ligament and front lateral ligament can open independent fixing method, all there is following defect:
1, anterior cruciate ligament and front lateral ligament are separately fixing, need four Ge Gu roads, because close together between ALL femur bone road and ACL femur bone road, may there is mutual interference.ALL tibial bone road and articular surface almost parallel, because ALL tibia stop distance articular surface only 1cm, bone road and articular surface hypotelorism, the possibility injuring articular surface is had in operating process, postoperative also may cause articular cartilage under bone mass not good, easy initiation cartilage degeneration, easily causes the situations such as fracture when knee joint is again injured.
2, when ACL and ALL rebuilds simultaneously, (ALL damages seldom separately, in most cases damages with ACL simultaneously) needs two grafts, but every bar graft is not all fully used in fact, causes unnecessary waste.Because external most doctor selects Heterogeneous tendon when rebuilding ALL, considerably increase surgery cost.
3, the operating time is longer, because will weave two grafts, need preparation to offer four Ge Gu roads, operation technique is comparatively complicated simultaneously, and operating time extends, and more fixture and graft increase the incidence rate of postoperative complication simultaneously.
It is simultaneous that cross ligament damage in view of more than 80% and front lateral ligament are torn, therefore, can design and can have simplification operation method, and the using method of the fixture that the occurrence probability reducing complication and a kind of anterior cruciate ligament and front lateral ligament integral type that reduce operation cost are rebuild and this device is those skilled in the art's urgent problems.
Summary of the invention
The object of this invention is to provide the fixture of a kind of anterior cruciate ligament and front lateral ligament one volume reconstruction, the problem that anterior cruciate ligament and front lateral ligament are torn simultaneously can be solved, improve the fastness of ligament and recover the stability in joint, avoid producing the postoperative various complication of conventional anterior cruciate ligament, and reduce medical treatment cost.
Technical scheme provided by the invention is as follows:
A fixture for anterior cruciate ligament and front lateral ligament one volume reconstruction, comprising:
Described fixture is the strip body of a flexibility, and described strip body comprises the head for being set on described anterior cruciate ligament and is used as the afterbody of front lateral ligament.
The technical program is set on anterior cruciate ligament by the head of flexible strip body, and afterbody be directly used as one before lateral ligament, anterior cruciate ligament and front lateral ligament one volume reconstruction can be met.Not only structure is simple, easy to use, and cost is lower.
In the above-mentioned improvement technically carried out, described strip body is by the sleeve-shaped of a kind of braiding in polyethylene yarn or terylene, and its surrounding sidewall is formed with multiple mesh.
The function of ligament, for strengthening joint, is safeguarded joint at the volley stable, and is limited its activity surmounting physiological range.When suffering violence, producing non-physiologic movable, when ligament is pulled and exceedes its tolerance, namely can damage.Therefore, the ligament rebuild need keep original balance and stability, also needs to keep certain elasticity simultaneously, so utilize the sleeve-shaped strip body that yarn or terylene woven are formed, by being fixed by socket the certain elasticity of rear maintenance, the basic function affecting ligament can be avoided.
In the improvement of the another kind of mode of above-mentioned technical work, described head is sleeve-shaped, and described afterbody is in banded, and banded described afterbody is flattened by sleeve-shaped and makes.
Arrange the head of strip body in sleeve-shaped, object facilitates head to be directly socketed on anterior cruciate ligament.And afterbody is arranged in banded, the structure due to front lateral ligament itself is flat, thus directly replaces impaired front lateral ligament by banded afterbody, more close with original structure, improves patient comfort degree.Afterbody is directly flattened by sleeve-shaped and forms simultaneously, not only facilitate the making of whole strip body construction, and the Flexible change of ligament can make the structure of afterbody change at the volley, namely switch between band shape and sleeve-shaped, improve the elasticity of total, do not affect original elastic level, can prevent the ligament rebuild from again rupturing.
On above-mentioned carrying out preferably, described head cross-sectional diameter is 8mm, and length is 8cm, and thickness is 0.2mm.
Preferably, described afterbody cross-sectional width is 4mm, and length is 7cm, and thickness is 0.5mm.
Preferably, the side mesh number of described head is between 60 order ~ 80 orders.
Preferably, the side mesh number of described afterbody is between 100 order ~ 120 orders.
The strip body that can understandablely be setting by above-mentioned structure in use needs to meet original ligament structure as far as possible, not only can improve the comfort level of patient, and avoids redundance cause unnecessary waste and reduce the probability that pathological changes occurs.So further limit the cross section of head and afterbody, length and thickness.And head is different with the side mesh number of afterbody, object is that realization changes the diameter of head and afterbody, makes it meet the requirement of different piece ligament by changing the size of mesh number and braided diameter in braiding process.
Another object of the present invention is to provide a kind of using method of fixture, and described fixture is the fixture of above-mentioned anterior cruciate ligament and front lateral ligament one volume reconstruction, comprises the steps: in use procedure
A), described strip body is introduced from tibia lower dead center bone road;
B), by described head be coated on anterior cruciate ligament outside, described afterbody is through femur top dead centre station track;
C), described afterbody and front lateral ligament lower dead center bone road are fixed.
The using method of fixture provided by the invention, only needs a graft, and on femur, offer a Ge Gu road, and on tibia, offers one to Liang Gegu road, and solution anterior cruciate ligament and front lateral ligament tear problem simultaneously.Can surgical procedure be simplified, shorten operating time, obtain the recovery knee Stability of firm stable with minimum cost, avoid producing the postoperative various complication of conventional anterior cruciate ligament.
Preferably, described strip body is drilled with tibia lower dead center bone road and front lateral ligament lower dead center bone road before introducing in advance on tibia, and on femur, being drilled with femur top dead centre station track and front lateral ligament top dead centre bone road, femur top dead centre station track and front lateral ligament top dead centre bone road are same bone road.
The bone road object offered in advance facilitates strip body therefrom introduce and fix, and lateral ligament lower dead center bone road and the femur top dead centre station track offered on femur are same bone road before offering on tibia, that can reduce bone road offers quantity, simplify procedures, avoid reducing patient comfort degree simultaneously.
Preferably, described head is reserved 2cm after being coated on front fork ligament, for being fixedly connected with tibia lower dead center bone road.
Because ligament has certain elasticity, according to this, leave the strip body of 2cm, object when ligament generation elasticity, elastic deformation can occur, avoid the elastic effect affecting ligament.
In sum, the fixture of anterior cruciate ligament of the present invention and front lateral ligament one volume reconstruction and using method, following at least one beneficial effect can be brought:
1, fixture of the present invention can realize a volume reconstruction of anterior cruciate ligament and front lateral ligament, is particularly useful for anterior cruciate ligament and front lateral ligament when tearing simultaneously.
2, fixture of the present invention forms an operator guards by flexible strip body; and the structure change of head and afterbody; the structure of suitable ligament, realizes controlling the inward turning stability of knee joint when flexing 30 degree ~ 90 degree, avoids kneed " pivot shift test " positive.The collaborative fixed effect strengthening anterior cruciate ligament, recovers kneed former normal function further simultaneously.
3, the yarn of fixture of the present invention by flexibility or the sleeve-shaped of terylene woven, and four sidewalls are formed with multiple mesh, can not affect ligament generation elastic deformation, and the mesh breathability formed is better, does not affect the recovery of ligament tissue.
What 4, fixture overall structure of the present invention was arranged is close with the structure comparison of ligament own, does not affect the comfort level of patient, and can not cause unnecessary waste, reduces the probability that complication occurs.
5, in fixture use procedure of the present invention, there is good, suitable elasticity capacity, can fit tightly with ligament, form the protective layer of ligament outside, prevent ligament in motor process from again tearing.
6, the present invention can reduce in operation the quantity offering bone road, reduces operating time, avoids bringing discomfort to patient.Reduce in operating process simultaneously and have possibility injuring articular surface, reduce postoperative may cause articular cartilage under bone mass not good, easily cause cartilage degeneration, when knee joint is again injured, easily cause the situation generations such as fracture.
7, structure of the present invention is simple, and it is convenient, applied widely to introduce.
8, utilization rate of the present invention is high, reduces operation cost, reduces and send out disease odds, and enable motor capacity return to initial level.
Accompanying drawing explanation
Below by clearly understandable mode, accompanying drawings preferred implementation, is further described the above-mentioned characteristic of the fixture that a kind of anterior cruciate ligament and front lateral ligament integral type are rebuild, technical characteristic, advantage and implementation thereof.
Fig. 1 is the structural representation of the fixture of specific embodiment anterior cruciate ligament and front lateral ligament one volume reconstruction;
Fig. 2 is the perspective view in specific embodiment after the expansion of strip body;
Fig. 3 is the another kind of structural representation of the fixture of specific embodiment anterior cruciate ligament and front lateral ligament one volume reconstruction;
Fig. 4 is the application schematic diagram of the fixture of anterior cruciate ligament and front lateral ligament one volume reconstruction in specific embodiment;
Drawing reference numeral illustrates:
Strip body 1; Head 11; Afterbody 12; Changeover portion 13;
Mesh 2;
Tibia 3; Tibia lower dead center bone road 31; Front lateral ligament lower dead center bone road 32;
Femur 4; Femur top dead centre station track 41; Front lateral ligament top dead centre bone road 42.
Detailed description of the invention
In order to be illustrated more clearly in the embodiment of the present invention or technical scheme of the prior art, contrast accompanying drawing is illustrated the specific embodiment of the present invention below.Apparently, accompanying drawing in the following describes is only some embodiments of the present invention, for those of ordinary skill in the art, under the prerequisite not paying creative work, other accompanying drawing can also be obtained according to these accompanying drawings, and obtain other embodiment.
In embodiments of the invention one, referring to Fig. 1, it is the structural representation of the fixture of anterior cruciate ligament of the present invention and front lateral ligament one volume reconstruction.This fixture is the strip body 1 of a flexibility, and strip body 1 comprises the head 11 for being set on anterior cruciate ligament and be used as the afterbody 12 of front lateral ligament.
Flexible strip body 1, by the sleeve-shaped of a kind of braiding in polyethylene yarn or terylene, can select all the other suitable flexible materials as the material of braiding strip body 1, with the needs of satisfied treatment according to specific circumstances.
Referring to Fig. 1, its surrounding sidewall is formed with multiple mesh 2, mesh 2 concrete shape can be rectangle, square or changeable, only need to meet to be coated on anterior cruciate ligament, or fold autologous four reduce by half tendon Gracilis tendon or autologous two folding Hams graft difficult drop-off.
It should be noted that, fixture in the present embodiment is not before using, head 11 and the afterbody 12 of strip body 1 can be unified to flatten into a band shape, the strip body 1 with certain length (longer than the length of actual needs) can be intertwined, conveniently deposit, during use, only need required cutting as the case may be.Can processing technology be simplified, reduce unnecessary waste.
In embodiments of the invention two, referring to Fig. 3, for making the fixture of design more close with actual ligament structure, improve comfort level, sleeve-shaped is designed to unlike by the head 11 of strip body 1 with said structure, and afterbody 12 designs in banded, and the afterbody 12 of band shape to be flattened by sleeve-shaped and makes.Concrete can be arranged on about 8mm by the cross-sectional diameter of head 11, and cut to lengthen is at about 8cm, and THICKNESS CONTROL is at 0.2mm.In addition, afterbody 12 is due to can directly as front lateral ligament, therefore, the cross-sectional width of afterbody 12 is arranged on about 4mm (i.e. the diameter of sleeve-shaped), and cut to lengthen is at about 7cm, and THICKNESS CONTROL is 0.5mm (owing to being that to flatten by sleeve-shaped the thus relative thickness made thicker).
Wherein, for improving the tensile strength of strip body 1, the tensile strength that need meet head 11 part of sleeve-shaped is not less than 2500N, and elongation at break is not less than 20%; And the tensile strength of afterbody 12 part of band shape is not less than 2500N, elongation at break is not less than 15%; And then the pull resistance realized when running, make it return to initial level.
It should be noted that, in other embodiments, the concrete form of strip body 1 also can be arranged according to practical situation, can be combined by two lateral plates or many lateral plates or one one-tenth belt body shape, be interconnected and fixed by the edge of lateral plate, formed for being socketed in head on anterior cruciate ligament 11 and being used as the afterbody 12 of front lateral ligament, do not repeating one by one in the application.
And strip body 1 is when actual fabrication in above-mentioned two embodiments, preferred strip body 1 is one of the forming.Concrete can weave the lamellar that has certain length and width in advance, but lateral plate edge as shown in Figure 2 mutually bonds and is connected and fixed.Also can directly weave the sleeve-shaped with certain length, directly cut during use.
Because head 11 is different with the diameter of afterbody 12, therefore, by changing mesh number or the diameter of side, the change of head 11 and afterbody 12 diameter can be realized during concrete braiding.Can weave the head 11 of certain length during concrete braiding in advance, length can be controlled in about 20cm, and then change braiding mesh and braided diameter gradually, take up one's knitting after reaching afterbody 12 width requirement afterbody 12, and the length of afterbody 12 also can be controlled in 20cm.Wherein, by changing the changeover portion 13 that obtains of braiding mesh gradually between head 11 and afterbody 12, controlled to be less than 1cm in length by changeover portion 13, object avoids longly affecting the fixing of strip body 1, prevents from causing complication.Simultaneously for simplifying processing technology, aforesaid weaving method can be carried out circulation braiding, making multiple strip body 1 integral continuously, directly carry out cutting according to Len req during use.
Referring to Fig. 4, when the anterior cruciate ligament of above-described embodiment and the fixture of front lateral ligament one volume reconstruction specifically use, be different from conventional ligament reconstructive method, what the method that the fixture in the present invention uses adopted is a strip body 1, and the bone number of channels offered also reduces, concrete using method is as follows:
A), described strip body is introduced from tibia lower dead center bone road;
B), by described head be coated on anterior cruciate ligament outside, described afterbody is through femur top dead centre station track;
C), described afterbody and front lateral ligament lower dead center bone road are fixed.
Introduce in strip body 1 Xu Conggu road in the present invention, therefore, operative doctor is drilled with tibia lower dead center bone road 31 and front lateral ligament lower dead center bone road 32 in advance on tibia 3 before being introduced, and on femur 4, be drilled with femur top dead centre station track 41 and front lateral ligament top dead centre bone road 42.Because fixture in the application is a strip body 1, therefore, the femur top dead centre station track 41 that femur 4 is offered can be same bone road with front lateral ligament top dead centre bone road 42, can reduce operation Zhong Gu road and offer quantity, reduce operating time.
When head 11 is coated on anterior cruciate ligament outside, 2cm can being reserved for being fixedly connected with tibia lower dead center bone road 31, when anterior cruciate ligament pulls during motion, elastic deformation can be realized by reserved section simultaneously.For improving the stability of the fixture of installing, peg button (endoubutton can be used at tibia station track stop 31, do not indicate in figure) fixing, also can fix with extrusion screw, femur top dead centre station track 41 place extrusion screw is fixed, and finally fixes at front lateral ligament lower dead center bone road 32 place extrusion screw.The strip body 1 being a flexibility due to this fixture is formed, even if so be fixed respectively at three Ge Gu road places and still can keep certain elasticity, and plays more protection effect to the outside of ligament, and the ligament rebuild that prevents from overexerting is torn again.
Fixture in above-described embodiment, also can use under special circumstances, such as, when needing to be nested with graft in advance in strip body 1, can when strip body 1 be introduced from tibia lower dead center bone road, in advance strip body 1 is socketed on graft, reserve about 2cm at the two ends of graft, then the two ends suture of strip body 1 and net cylinder are sewed up and be fixed together, finally carry out introducing again and fix.Wherein, it should be noted that graft can be autologous four reducing by half tendon Gracilis tendon or autologous two folding Hams graft of folding.
It should be noted that above-described embodiment all can independent assortment as required.The above is only the preferred embodiment of the present invention; it should be pointed out that for those skilled in the art, under the premise without departing from the principles of the invention; can also make some improvements and modifications, these improvements and modifications also should be considered as protection scope of the present invention.
Claims (10)
1. a fixture for anterior cruciate ligament and front lateral ligament one volume reconstruction, is characterized in that, comprising:
Described fixture is the strip body of a flexibility, and described strip body comprises the head for being set on described anterior cruciate ligament and is used as the afterbody of front lateral ligament.
2. the fixture of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction, is characterized in that:
Described strip body is by the sleeve-shaped of a kind of braiding in polyethylene yarn or terylene, and its surrounding sidewall is formed with multiple mesh.
3. the fixture of anterior cruciate ligament according to claim 1 and 2 and front lateral ligament one volume reconstruction, is characterized in that:
Described head is sleeve-shaped, and described afterbody is in banded, and banded described afterbody is flattened by sleeve-shaped and makes.
4. the fixture of anterior cruciate ligament according to claim 3 and front lateral ligament one volume reconstruction, is characterized in that:
Described head cross-sectional diameter is 8mm, and length is 8cm, and thickness is 0.2mm.
5. the fixture of anterior cruciate ligament according to claim 3 and front lateral ligament one volume reconstruction, is characterized in that:
Described afterbody cross-sectional width is 4mm, and length is 7cm, and thickness is 0.5mm.
6. the fixture of anterior cruciate ligament according to claim 2 and front lateral ligament one volume reconstruction, is characterized in that:
The side mesh number of described head is between 60 order ~ 80 orders.
7. the fixture of anterior cruciate ligament according to claim 2 and front lateral ligament one volume reconstruction, is characterized in that:
The side mesh number of described afterbody is between 100 order ~ 120 orders.
8. a using method for fixture, is characterized in that:
The anterior cruciate ligament of described fixture according to any one of claim 1-7 and the fixture of front lateral ligament one volume reconstruction, comprise the steps: in use procedure
A), described strip body is introduced from tibia lower dead center bone road;
B), by described head be coated on anterior cruciate ligament outside, described afterbody is through femur top dead centre station track;
C), described afterbody and front lateral ligament lower dead center bone road are fixed.
9. the using method of fixture according to claim 8, is characterized in that:
Described strip body is drilled with tibia lower dead center bone road and front lateral ligament lower dead center bone road before introducing in advance on tibia, and on femur, being drilled with femur top dead centre station track and front lateral ligament top dead centre bone road, femur top dead centre station track and front lateral ligament top dead centre bone road are same bone road.
10. the using method of fixture according to claim 8, is characterized in that:
Described head is reserved 2cm after being coated on front fork ligament, for being fixedly connected with tibia lower dead center bone road.
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| CN201510628545.1A CN105125320B (en) | 2015-09-28 | 2015-09-28 | Anterior cruciate ligament and the fixing device of front lateral ligament one volume reconstruction |
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| CN201510628545.1A CN105125320B (en) | 2015-09-28 | 2015-09-28 | Anterior cruciate ligament and the fixing device of front lateral ligament one volume reconstruction |
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Cited By (3)
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| CN106256332A (en) * | 2016-08-31 | 2016-12-28 | 桐庐洲济医疗器械有限公司 | Tendon braiding device is transplanted in Healing in Anterior Cruciate Ligament Reconstruction set |
| CN110292425A (en) * | 2019-06-20 | 2019-10-01 | 北京万洁天元医疗器械股份有限公司 | A kind of ligament fixation system containing filling bone block |
| CN117100340A (en) * | 2023-10-10 | 2023-11-24 | 上海声拓医疗科技有限公司 | Implant suitable for use in prosthetic devices |
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| CN110292425A (en) * | 2019-06-20 | 2019-10-01 | 北京万洁天元医疗器械股份有限公司 | A kind of ligament fixation system containing filling bone block |
| CN117100340A (en) * | 2023-10-10 | 2023-11-24 | 上海声拓医疗科技有限公司 | Implant suitable for use in prosthetic devices |
| CN117100340B (en) * | 2023-10-10 | 2024-07-23 | 上海声拓医疗科技有限公司 | Implant suitable for use in prosthetic devices |
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| Publication number | Publication date |
|---|---|
| CN105125320B (en) | 2017-03-01 |
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