CN105125320B - Anterior cruciate ligament and the fixing device of front lateral ligament one volume reconstruction - Google Patents
Anterior cruciate ligament and the fixing device of front lateral ligament one volume reconstruction Download PDFInfo
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- CN105125320B CN105125320B CN201510628545.1A CN201510628545A CN105125320B CN 105125320 B CN105125320 B CN 105125320B CN 201510628545 A CN201510628545 A CN 201510628545A CN 105125320 B CN105125320 B CN 105125320B
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Abstract
The invention provides the fixing device of a kind of anterior cruciate ligament and front lateral ligament one volume reconstruction and using method, described fixing device is the strip body of a flexibility, and described strip body includes the head for being set on described anterior cruciate ligament and the afterbody being used as front lateral ligament.Using method is first to introduce described strip body from tibia lower dead center bone road；Again described head is coated on outside anterior cruciate ligament, described afterbody is through femur top dead centre station track；Finally described afterbody is fixed with front lateral ligament lower dead center bone road.The fixing device of the present invention can occur elastic deformation, and has certain protective effect, enables motor capacity to return to initial level.Only need a bar fixing device to can achieve that anterior cruciate ligament and front lateral ligament one volume reconstruction are fixed, and especially also reduce the bone road number opening up simultaneously, shorten the time, improve patient comfort.
Description
Technical field
The present invention relates to the technical field of the Design for Medical Device of ligament reconstructive, more particularly, to a kind of anterior cruciate ligament and front
The fixing device of lateral ligament one volume reconstruction and using method.
Background technology
Knee joint is one of maximum joint the most complicated of human body, is more than simple flexion movement, also in actual motion
There is a rotation of tibia, and the three-dimensional motion of the series of complex such as rolling on tibia for the femur ankle and slip.And this is a series of
Complicated motion is all to rely on the tendon of knee joint peripheral and tough bringing to keep joint balance at the volley and steady statue.
The reach of anterior cruciate ligament (Anterior cruciate ligament, abbreviation ACL) restricted tibia and regulation part rotational work
Energy.
But, make for many years numerous doctors and patient puzzlement, tears of anterior cruciate ligament through reconstruction Post operation,
The motor capacity of a lot of patients still cannot return to initial level.In these cases, patient is typically subject to rotation pine
The puzzlement of relaxation (rotational laxity).Even utilize the fixing mode of two-beam, still can not reduce lasting rotational slack
Effect.Meanwhile, up-to-date medical advances find that tears of anterior cruciate ligament is frequently accompanied by front lateral ligament (Anterolateral
Ligament, abbreviation ALL) tear, and front lateral ligament has important biomechanical function in motion of knee joint.Front outer
The length of collateral ligament is probably 2 inches (5.08 centimetres), positioned at kneed front outside (Anterolateral) direction, connects
Femur and the front outside of tibia.
And existing surgical technic takes anterior cruciate ligament and front lateral ligament can open independent fixing method, all exist with
Lower defect：
1st, anterior cruciate ligament and front lateral ligament are separately fixed, and need four Ge Gu roads, ALL femur bone road and ACL femur bone
Because close together between road, it is understood that there may be interfere.ALL tibial bone road is almost parallel with articular surface, because ALL tibia stops
Point apart from articular surface only 1cm, bone road and articular surface hypotelorism, have the possibility injuring articular surface in operating process, postoperative also may be used
Bone mass under articular cartilage can be led to not good, easily cause cartilage degeneration, situations such as be easily caused fracture when knee joint is injured again.
2nd, when ACL and ALL rebuilds simultaneously, (ALL seldom individually damages, and in most cases damages with ACL simultaneously) needs two
Graft, but every graft is not all fully used in fact, causes unnecessary waste.Because abroad most doctors exist
Select Heterogeneous tendon when rebuilding ALL, considerably increase surgery cost.
3rd, the operating time is longer, because two grafts will be woven, needs preparation to open up four Ge Gu roads, operation technique is relatively simultaneously
For complexity, operating time prolongation, the incidence rate of simultaneously more fixture and graft increase postoperative complication.
In view of more than 80% cross ligament damage and the tear of front lateral ligament are simultaneous, accordingly, it is capable to no set
Meter can have simplification operation method, and reduces the occurrence probability of complication and a kind of anterior cruciate ligament reducing operation cost
The fixing device rebuild with front lateral ligament integral type and the using method of this device, are that those skilled in the art are badly in need of solving
Problem.
Content of the invention
It is an object of the invention to provide the fixing device of a kind of anterior cruciate ligament and front lateral ligament one volume reconstruction, can solve
The problem that certainly anterior cruciate ligament and front lateral ligament tear simultaneously, improves the fastness of ligament and recovers stablizing of joint
Property, it is to avoid produce the conventional postoperative various complication of anterior cruciate ligament, and reduce medical treatment cost.
The technical scheme that the present invention provides is as follows：
A kind of anterior cruciate ligament and the fixing device of front lateral ligament one volume reconstruction, including：
Described fixing device is the strip body of a flexibility, and described strip body is included for being set in described front friendship
Head on fork ligament and the afterbody being used as front lateral ligament.
The technical program is set on anterior cruciate ligament by the head of flexible strip body, and afterbody is directly used as
For lateral ligament before, disclosure satisfy that anterior cruciate ligament and front lateral ligament one volume reconstruction.It is not only simple in structure, easy to use,
And cost is relatively low.
The improvement carrying out in above-mentioned technology, described strip body is woven by one of polyethylene yarn or terylene
Sleeve-shaped, its four the week side of boss wall is formed with multiple mesh.
The function of ligament is to strengthen joint, safeguards joint stablizing at the volley, and limits it and surmounts the work of physiological range
Dynamic.When suffering from violence, produce non-physiologic activity, when ligament is pulled and exceedes its tolerance, can damage.Therefore,
The ligament rebuild need to keep original balance and stability, also need to keep certain elasticity, so using yarn or washing simultaneously
The sleeve-shaped strip body that synthetic fibre braiding is constituted, can be by keeping certain elasticity after being fixed by socket, it is to avoid impact ligament
Basic function.
The improvement of another way is made on above-mentioned technology, described head is in sleeve-shaped, described afterbody is in banding, banding
Described afterbody is flattened by sleeve-shaped and makes.
By the head setting of strip body in sleeve-shaped it is therefore an objective to facilitate head to be directly socketed on anterior cruciate ligament.
And be in banding by afterbody setting, because the front lateral ligament structure of itself is flat, thus directly being replaced by the afterbody of banding
Impaired front lateral ligament, is more nearly with original structure, improves patient comfort.Afterbody is directly flattened by sleeve-shaped simultaneously
Form, not only facilitate the making of whole strip body construction, and the Flexible change of ligament at the volley can make the knot of afterbody
Structure changes, and switches between banding and sleeve-shaped, improve total elasticity, do not affect former resilient
Level, can prevent the ligament rebuild from rupturing again.
On above-mentioned carrying out preferably, a diameter of 8mm of described head cross-sectional, 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 mesh～80 mesh.
Preferably, the side mesh number of described afterbody is between 100 mesh～120 mesh.
Need to meet original in use by the strip body that above-mentioned structure can understandable be setting as far as possible
Ligament structure, the comfort level of patient not only can be improved, and avoid redundance cause unnecessary waste and reduce occur
The probability of pathological changes.So further limiting to the section of head and afterbody, length and thickness.And the side of head and afterbody
Veil mesh number is different it is therefore an objective to by changing the size of mesh number and braided diameter during braiding, realization changes head and tail
The diameter in portion is so as to meet the requirement of different piece ligament.
It is a further object to provide a kind of using method of fixing device, before described fixing device is above-mentioned
Ligamentaum cruciatum and the fixing device of front lateral ligament one volume reconstruction, comprise the steps during use：
A), described strip body is introduced from tibia lower dead center bone road；
B), described head is coated on outside anterior cruciate ligament, described afterbody is through femur top dead centre station track；
C), described afterbody is fixed with front lateral ligament lower dead center bone road.
The using method of the fixing device that the present invention provides is it is only necessary to a graft, and opens up a bone on femur
Road, and open up one on tibia to Liang Gegu road, solve anterior cruciate ligament and front lateral ligament tears problem simultaneously.Can letter
Change surgical procedure, shorten operating time, obtain the recovery knee Stability of firm stable with minimum cost, it is to avoid produce
The raw routine postoperative various complication of anterior cruciate ligament.
Preferably, described strip body is drilled with tibia lower dead center bone road before introducing in advance on tibia and front outside is tough
Band lower dead center bone road, and femur top dead centre station track and front lateral ligament top dead centre bone road, femur top dead centre are drilled with femur
Station track and front lateral ligament top dead centre bone road are same bone road.
The bone road purpose opening up in advance is to facilitate strip body therefrom to introduce and fixing, and outer before opening up on tibia
Collateral ligament lower dead center bone road and the femur top dead centre station track that opens up on femur are same bone road, it is possible to reduce the opening up of bone road
Quantity, simplifies procedures, and avoids reducing patient comfort simultaneously.
Preferably, described head is coated on reserved 2cm after 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 it is therefore an objective to can occur in ligament
When elastic, there is elastic deformation, it is to avoid the elastic effect of impact ligament.
In sum, the fixing device of anterior cruciate ligament of the present invention and front lateral ligament one volume reconstruction and using method, can
To bring following at least one beneficial effect：
1st, the fixing device of the present invention is capable of a volume reconstruction of anterior cruciate ligament and front lateral ligament, is particularly suited for
In the case that anterior cruciate ligament and front lateral ligament tear simultaneously.
2nd, the fixing device of the present invention is passed through flexible strip body and is formed a protection structure, and head and afterbody
Structure change, the structure of suitable ligament, realize controlling the inward turning stability in 30 degree～90 degree of flexing for the knee joint, it is to avoid knee joint closes
" pivot shift test " of section is positive.Work in coordination with the fixed effect strengthening anterior cruciate ligament simultaneously, recover kneed former normal further
Function.
3rd, the fixing device of the present invention is by the sleeve-shaped of flexible yarn or terylene woven, and four side walls are formed with
Multiple mesh, do not interfere with ligament and elastic deformation occur, and the mesh breathability being formed is preferably, does not affect the extensive of ligament tissue
Multiple.
4th, the present invention fixing device overall structure setting with this body structure of ligament relatively, do not affect patient relax
Appropriateness, and do not result in unnecessary waste, reduce the probability that complication occurs.
5th, during the fixing device of the present invention uses, there is good, suitable elasticity capacity, closely can paste with ligament
Close, form the protective layer outside ligament, prevent ligament in motor process from tearing again.
6th, the present invention can reduce the quantity opening up bone road in operation, reduces operating time, it is to avoid bring discomfort to patient.
Reduce in operating process simultaneously and have the possibility injuring articular surface, reduction is postoperative may to lead to bone mass under articular cartilage not good, easily
Cause cartilage degeneration, occur situations such as be easily caused fracture when knee joint is injured again.
7th, present configuration is simple, and it is convenient to introduce, applied widely.
8th, utilization rate of the present invention is high, reduces operation cost, reduces and send out disease odds, and enable motor capacity extensive
Arrive initial level again.
Brief description
Below by the way of clearly understandable, preferred implementation is described with reference to the drawings, to a kind of anterior cruciate ligament and front
The above-mentioned characteristic of fixing device, technical characteristic, advantage and its implementation that lateral ligament integral type is rebuild give furtherly
Bright.
Fig. 1 is the structural representation of the fixing device of specific embodiment anterior cruciate ligament and front lateral ligament one volume reconstruction；
Fig. 2 is the perspective view after strip body expansion in specific embodiment；
Fig. 3 is that another kind of structure of the fixing device of specific embodiment anterior cruciate ligament and front lateral ligament one volume reconstruction is shown
It is intended to；
Fig. 4 is that the application of the fixing device of anterior cruciate ligament and front lateral ligament one volume reconstruction in specific embodiment is illustrated
Figure；
Drawing reference numeral explanation：
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.
Specific embodiment
In order to be illustrated more clearly that the embodiment of the present invention or technical scheme of the prior art, brief description will be compareed below
The specific embodiment of the present invention.It should be evident that drawings in the following description are only some embodiments of the present invention, for
For those of ordinary skill in the art, on the premise of not paying creative work, other can also be obtained according to these accompanying drawings
Accompanying drawing, and obtain other embodiments.
In embodiments of the invention one, referring to Fig. 1, it is consolidating of anterior cruciate ligament of the present invention and front lateral ligament one volume reconstruction
Determine the structural representation of device.This fixing device is the strip body 1 of a flexibility, and strip body 1 is included for sheathed
Head 11 on anterior cruciate ligament and the afterbody 12 as front lateral ligament.
The sleeve-shaped that flexible strip body 1 is woven by one of polyethylene yarn or terylene, according to tool
The situation of body can select remaining suitable flexible material as the material of braiding strip body 1, to meet the needs for the treatment of
?.
Referring to Fig. 1, its four the week side of boss wall is formed with multiple mesh 2, mesh 2 concrete shape can be rectangle, square or
Changeable, only need to disclosure satisfy that and be coated on anterior cruciate ligament, or autologous four folding reduce by half tendon Gracilis tendon or
Autologous two-fold rope tendon graft is difficult for drop-off.
It should be noted that the fixing device in the present embodiment is not before using, the head 11 of strip body 1 and tail
Portion 12 can unify to flatten into a banding, and the strip body 1 with certain length (longer than the length being actually needed) can twine
Around together, conveniently deposit, during use, only need required cutting as the case may be.Processing technology can be simplified, reduce not
Necessary waste.
In embodiments of the invention two, referring to Fig. 3, for making the fixing device of design and actual ligament structure more adjunction
Closely, improve comfort level, from unlike said structure, the head 11 of strip body 1 is designed to sleeve-shaped, and afterbody 12 sets
Meter is in banding, and the afterbody 12 of banding is flattened by sleeve-shaped and makes.Specifically the cross-sectional diameter of head 11 can be arranged
In 8mm, and length controls in 8cm, and THICKNESS CONTROL is in 0.2mm.In addition, afterbody 12 is due to can be directly as
Front lateral ligament, therefore, the cross-sectional width of afterbody 12 be arranged on 4mm about (i.e. the diameter of sleeve-shaped), and length controls
7cm, and THICKNESS CONTROL is 0.5mm (flattening making thus relative thickness is thicker by then passing through sleeve-shaped).
Wherein, for improving the tensile strength of strip body 1, the tensile strength of head 11 part of sleeve-shaped need to be met not
Less than 2500N, elongation at break is not less than 20%；And the tensile strength of afterbody 12 part of banding is not less than 2500N, fracture is stretched
Long rate is not not less than 15%；And then pull resistance during realization operation is so as to return to initial level.
It should be noted that in other embodiments, the concrete form of strip body 1 is also can be entered according to practical situation
Row setting, can be combined by two lateral plates or many lateral plates or one becomes belt body shape, by the edge phase interconnection of lateral plate
Connect fixation, form the head 11 for being socketed on anterior cruciate ligament and the afterbody 12 being used as front lateral ligament, this Shen
Please in do not repeating one by one.
And in above-mentioned two embodiment strip body 1 in actual fabrication, preferably strip body 1 is one of the forming.
A lamellar with certain length and width specifically can be woven in advance, but lateral plate edge phase as shown in Figure 2
Mutually bonding is connected.The sleeve-shaped with certain length can also directly be woven, directly cut during use.
Because head 11 is different with the diameter of afterbody 12, therefore, can be by changing the net of side during concrete braiding
Mesh number or diameter, realize head 11 and the change of afterbody 12 diameter.Certain length can be woven in advance during concrete braiding
Head 11, length can be controlled in 20cm, then gradually changes braiding mesh and braided diameter, reaches afterbody 12 width requirement
After take up one's knitting afterbody 12, and the length of afterbody 12 also can be controlled in 20cm.Wherein, pass through gradually between head 11 and afterbody 12
Change the braiding changeover portion 13 that obtains of mesh, changeover portion 13 is controlled and is less than 1cm it is therefore an objective to avoid long affecting to grow in length
The fixation of strip body 1, prevents from causing complication.It is to simplify processing technology simultaneously, aforesaid weaving method can be followed
Ring weaves, and makes multiple strip bodies 1 continuously integral, directly carries out cutting according to Len req during use.
Referring to Fig. 4, the fixing device of the anterior cruciate ligament of above-described embodiment and front lateral ligament one volume reconstruction is specifically used
When, different from conventional ligament reconstructive method, the method that the fixing device in the present invention uses uses a strip originally
Body 1, and the bone road number opening up also reduces, specific using method is as follows：
A), described strip body is introduced from tibia lower dead center bone road；
B), described head is coated on outside anterior cruciate ligament, described afterbody is through femur top dead centre station track；
C), described afterbody is fixed with front lateral ligament lower dead center bone road.
Strip body 1 in the present invention need to introduce from bone road, and therefore, operative doctor is in advance in tibia before being introduced
It is drilled with tibia lower dead center bone road 31 and front lateral ligament lower dead center bone road 32 on 3, and femur top dead centre is drilled with femur 4
Station track 41 and front lateral ligament top dead centre bone road 42.Because in the application, fixing device is a strip body 1, therefore, stock
The femur top dead centre station track 41 and the front lateral ligament top dead centre bone road 42 that open up on bone 4 can be same bone road, can reduce
Operation Zhong Gu road opens up quantity, reduces operating time.
When head 11 is coated on anterior cruciate ligament outside, 2cm can be reserved for fixing with tibia lower dead center bone road 31
Connect, when anterior cruciate ligament pulls when moving, elastic deformation can be realized by reserved section simultaneously.For improving the fixing dress installed
The stability put, can be fixed with peg button (endoubutton, in figure does not indicate) in tibia station track stop 31, also may be used
Fixed with extrusion screw, fixed with extrusion screw at femur top dead centre station track 41, finally in front lateral ligament lower dead center bone road 32
Place's extrusion screw is fixed.Because the strip body 1 that this fixing device is a flexibility is constituted, even if so in three bones
It is fixed the elasticity remaining to keep certain at road respectively, and reinforcement protective effect is played to the outside of ligament, prevent from exerting oneself
The ligament of too quickly reconstruction tears again.
Fixing device in above-described embodiment, also can use under special circumstances, for example, need in advance in strip body 1
In the case of being nested with graft, can be when strip body 1 introduces from tibia lower dead center bone road, in advance by strip body 1
It is socketed on graft, in the reserved 2cm in the two ends of graft about, then by the two ends suture of strip body 1 and net cylinder
Suture is fixed together, and finally carries out introducing fixing again.Wherein, it should be noted that graft can be autologous four folding
Tendon Gracilis tendon or autologous two-fold rope tendon graft by half.
It should be noted that above-described embodiment all can independent assortment as needed.The above is only the preferred of the present invention
Embodiment it is noted that for those skilled in the art, in the premise without departing from the principle of the invention
Under, some improvements and modifications can also be made, these improvements and modifications also should be regarded as protection scope of the present invention.
Claims (7)
1. the fixing device of a kind of anterior cruciate ligament and front lateral ligament one volume reconstruction is it is characterised in that include：
Described fixing device is the strip body of a flexibility, and described strip body includes tough for being set in described front intersection
Head on band and the afterbody being used as front lateral ligament.
2. the fixing device of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction,
It is characterized in that：
The sleeve-shaped that described strip body is woven by one of polyethylene yarn or terylene, its four the week side of boss wall is formed
There are multiple mesh.
3. the fixing device of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction,
It is characterized in that：
Described head is in sleeve-shaped, and described afterbody is in banding, and the described afterbody of banding is flattened by sleeve-shaped to be made.
4. the fixing device of anterior cruciate ligament according to claim 3 and front lateral ligament one volume reconstruction,
It is characterized in that：
The a diameter of 8mm of described head cross-sectional, length is 8cm, and thickness is 0.2mm.
5. the fixing device of anterior cruciate ligament according to claim 3 and front lateral ligament one volume reconstruction,
It is characterized in that：
Described afterbody cross-sectional width is 4mm, and length is 7cm, and thickness is 0.5mm.
6. the fixing device of anterior cruciate ligament according to claim 2 and front lateral ligament one volume reconstruction,
It is characterized in that：
The side mesh number of described head is between 60 mesh～80 mesh.
7. the fixing device of anterior cruciate ligament according to claim 2 and front lateral ligament one volume reconstruction,
It is characterized in that：
The side mesh number of described afterbody is between 100 mesh～120 mesh.
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| CN106256332B (en) * | 2016-08-31 | 2017-10-31 | 桐庐洲济医疗器械有限公司 | Healing in Anterior Cruciate Ligament Reconstruction set transplanting tendon braiding device |
| 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 |
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