CN106691525A - Fixing system for transplant in anterior cruciate ligament reconstruction - Google Patents
Fixing system for transplant in anterior cruciate ligament reconstruction Download PDFInfo
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- CN106691525A CN106691525A CN201710009324.5A CN201710009324A CN106691525A CN 106691525 A CN106691525 A CN 106691525A CN 201710009324 A CN201710009324 A CN 201710009324A CN 106691525 A CN106691525 A CN 106691525A
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- cruciate ligament
- expansion
- anterior cruciate
- hole
- healing
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- 230000035876 healing Effects 0.000 claims abstract description 23
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0642—Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/02—Inorganic materials
- A61L31/028—Other inorganic materials not covered by A61L31/022 - A61L31/026
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/04—Macromolecular materials
- A61L31/048—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/148—Materials at least partially resorbable by the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/16—Biologically active materials, e.g. therapeutic substances
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- A—HUMAN NECESSITIES
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/20—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
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- A—HUMAN NECESSITIES
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
- A61L2300/412—Tissue-regenerating or healing or proliferative agents
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/60—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
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- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/06—Materials or treatment for tissue regeneration for cartilage reconstruction, e.g. meniscus
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Abstract
The invention discloses a fixing system of a transplant in anterior cruciate ligament reconstruction. The fixing system comprises a positioner, a guide needle, a hollow drill bit and an expansion screw, the expansion screw is an absorbable expansion screw and comprises an inner nail and an expansion sleeve, protein factors and nano-hydroxyapatite are combined by an absorption method and then compounded with the polythene levo-propionate by a multiple emulsion method to prepare sustained release microspheres, the protein factors are BMP (bone morphogenetic protein)-2, the expansion sleeve is provided with a first through hole along axial direction, the inner nail is provided with a stepped through hole along the axial direction, the diameter of the first through hole is smaller than the minimum diameter of the stepped through hole, the guide needle is provide with a ladder pattern matched with the first through hole and the stepped through hole, and the positioner is provided with a sleeve for penetrating the guide needle. According to the fixing system of the transplant in anterior cruciate ligament reconstruction, tendon-bone healing is facilitated, high fixing strength can be generated, and the fixing system can overcomes the shortcomings of host immune response cause by ectogenic cells, low conversation efficiency and the like.
Description
Technical field
The present invention relates to be moved in the technical field of the medicine equipment in organism, more particularly to a kind of Healing in Anterior Cruciate Ligament Reconstruction
The fixed system of plant.
Background technology
Anterior cruciate ligament of knee joint (anterior cruciate ligament, ACL) be the important static(al) of knee joint and
One of dynamic property rock-steady structure, can prevent shin bone reach, hyperextension and excessively rotation, prevent the correlation after knee joint unstability concurrent
Disease.It is common disease, frequently-occurring disease that ACL is damaged, the numerous teenagers of major concern, is one of most common disease in population of adolescent.
There is instability of knee in ACL after damaging, increase joint other structures and damage probability, accelerate the regression of meniscus and articular cartilage,
Cause serious chronic ache and joint function disturbance, have a strong impact on daily routines and the quality of life of patient, suffer to teenager
Person brings huge pain and mental burden.ACL Reconstructions are fixed in bone road using transplanting tendon, substitute it is normal before hand over
The function of ligament is pitched, is that treatment ACL damages most efficient method.The fixation of graft is most important link during ACL rebuilds,
It is most weak link, domestic and foreign scholars did various researchs.It is good be fixed on can meet in the recent period early postoperation motion,
Muscular training and the requirement born a heavy burden, knee Stability is maintained before graft obtains biological healing, at a specified future date then contribute to rush
Enter graft and symphysis.The quality that graft is fixed depends on the selection of fixing means.
The selection of fixing means because graft selection and surgical technic selection it is different and different.But ultimate aim one
Do not changed directly, the fixation of tendon graft will as far as possible recover the mechanical characteristic of autologous tendon, also reach the biology of tendon bone
Healing.So the fixation of ACL need to meet following condition:Enough resisting pull out forces are first had to, secondly need to be recovered and be maintained knee to close
The stability of section, finally will also have enough strength to prevent ligament from being slided in joint.ACL after reconstruction is main
Biomechanics characteristic be intensity and stiffness.Intensity is the load for instigating graft to produce permanent displacement, and stiffness refers to graft
The tension force or displacement produced under certain load.
Extrusion screw fixed system is mainly fixes tendon by screw extruding tendon with the frictional force of osseous tunnel generation.
This fixed form makes graft contraction in length, there is bigger stiffness, the stability for rebuilding patella is improve, however, smaller
Interference screw enough mechanical forces can not be provided, and the screw being relatively large in diameter can cut suture and graft cause it is fixed not
Surely, tendon intensity is transplanted caused by interference screw cutting extruding to decline and rupture of tendon failure occur.
Indirect fixation refers to the method that fixture fixed position is located at outside tendon-bone has a common boundary, but due to graft and bone tunnel
There is certain space between road, therefore in knee joint flexion and extension, graft can occur perpendicular to tunnel axle as rain brush
Swing, i.e., " rain brush effect ";Or graft is occurring the expansion moving of direction of principal axis along osseous tunnel, i.e., " bungee jumping effect ".This two
Biological healing processes of the athletic meeting destruction graft in osseous tunnel are planted, while being also to cause osseous tunnel to expand most common original
Therefore one.
The healing of transplanting tendon and osseous tunnel inwall be between tendon-bone interface fibr tissue formed connection, new bone formation, bone to
Grown into tendon, partial mold transformation process.BMP-2 has makes undifferentiated mesenchymal cell directed differentiation be into cartilage
Cell and Gegenbaur's cell, and induced synthesis cartilage and bone tissue.Due to tendon-bone interface lack blood vessel, if without growth because
Son, even if the damage of very little can not well be healed.Studied be reported in internal in-situ rebuild damage ACL can not reach
To good effect.Repairing effect can be to a certain extent improved using extruding metal screw when ACL rebuilds, but due at this stage
The various defects existed after metallic screw implantation, still can not well be applied to clinic at present.
The content of the invention
The technical problem to be solved in the present invention is that:For the technical problem that prior art is present, the present invention provides one
The fixed system of graft, is more beneficial for tendon-bone healing in kind of Healing in Anterior Cruciate Ligament Reconstruction, can produce bigger fixing intensity, can be with
Exogenous cell is avoided to cause the low shortcoming of host immune response, transformation efficiency.
In order to solve the above technical problems, technical scheme proposed by the present invention is:
The fixed system of graft in a kind of Healing in Anterior Cruciate Ligament Reconstruction, including locator, guide pin, hollow boring bit and expansion
Screw, the swell fixture includes interior nail and expansion sleeve, and the interior nail and expansion sleeve are passed through absorption process and received by protein factor
The sustained-release micro-spheres that rice hydroxyapatite carrier is combined and is prepared into using multi-emulsion method composite polyethylene levorotatory lactide are combined and are made
Absorbable expansion screw, the protein factor be BMP-2;The expansion sleeve is provided with first through hole, the interior nail edge along axis
The direction of axis offers ladder hole, the minimum diameter of the diameter less than ladder hole of the first through hole;The guide pin
It is stepped with what first through hole and ladder hole were engaged;The locator is provided with for the sleeve pipe through guide pin.
As the further improvement of above-mentioned technical proposal:
The expansion sleeve includes fixed part and bulge, and the end of the fixed part is fixedly connected with the end of bulge,
Fixed part is coniform;The bulge is made up of at least three expanding petals, and fixed part is fixed in one end of the expanding petal
End, the expanding petal encloses the inner chamber for being set as cylinder, and the external diameter of the bulge is identical with the external diameter of interior nail.
The expanding petal is provided with four, and the radian of each expanding petal is 60 °.
Taper after the expansion sleeve expansion is a, a=60 °.
The expanding petal is provided with external screw thread, and internal thread is provided with the inside of the expanding petal.
The interior nail is provided with external screw thread, and the interior nail is divided into head and afterbody, and coning, the afterbody is the head
Cylinder, the maximum gauge of the head is identical with the overall diameter of bulge.
The interior externally threaded pitch of nail is 3.5mm, and minimum diameter of the head containing screw thread is 3mm, a length of 5mm, institute
A diameter of 7mm of the afterbody containing screw thread is stated, length is 20mm.
The locator is arch locator.
The fixed system of graft in Healing in Anterior Cruciate Ligament Reconstruction of the invention, when ACL rebuilds, is first positioned, really with locator
After recognizing position, tibial bone road is made, then pushes expansion sleeve expansion sleeve and transplanting tendon is temporarily fixed in bone road, be screwed into swollen during interior nail
The fixed transplanting tendon of expansion set expansion extruding.Interior nail is not contacted with tendon in expansion extrusion process, it is to avoid suture and graft
Cutting, also add the contact area of tendon and bone road wall in addition, is more beneficial for tendon-bone healing and produces bigger fixing intensity,
Direct fixed advantage is embodied, indirect fixed deficiency is turn avoid.When ACL rebuilds, there is marrow in knee joint cavity
Mescenchymal stem cell, Synovial Mesenchymal Stem Cells and chondroprogenitors etc. can migrate to tendon bone intersection and induce as bone group
The seed cell knitted, can be gone back to the nest to tendon bone intersection such cell using absorbable expansion screw and growth factor, be repaired
Damage ACL.The fixation kit rebuild for cruciate ligaments of knee joint of the invention, having can avoid exogenous cell from causing
The low shortcoming of host immune response, transformation efficiency.
Brief description of the drawings
Fig. 1 is the structural representation of expansion sleeve of the present invention.
Fig. 2 is the structural representation after expansion sleeve expansion of the present invention.
Fig. 3 is the structural representation of nail in the present invention.
Fig. 4 is the structural representation of guide pin.
Marginal data:
1st, interior nail;11st, through hole;2nd, expansion sleeve;21st, fixed part;22nd, bulge;23rd, expanding petal;24th, first through hole;3、
Guide pin.
Specific embodiment
Specific embodiment of the invention is described in detail below in conjunction with accompanying drawing.It should be appreciated that this place is retouched
The specific embodiment stated is merely to illustrate and explain the present invention, and is not intended to limit the invention.
For the ease of description, space relative terms can be used herein, such as " ... on ", " ... top ",
" in ... upper surface ", " above " etc., for describing such as a device shown in the figure or feature and other devices or spy
The spatial relation levied.It should be appreciated that space relative terms are intended to comprising the orientation except device described in figure
Outside different azimuth in use or operation.If for example, the device in accompanying drawing is squeezed, be described as " in other devices
To be positioned as " under other devices or construction after the device of part or construction top " or " on other devices or construction "
Side " or " under other devices or construction ".Thus, exemplary term " ... top " can include " ... top " and
" in ... lower section " two kinds of orientation.The device can also other different modes positioning (being rotated by 90 ° or in other orientation), and
And respective explanations are made to the relative description in space used herein above.
Fig. 1 to Fig. 4 shows a kind of implementation method of the fixed system of graft in Healing in Anterior Cruciate Ligament Reconstruction of the invention,
Including locator, guide pin 3, hollow boring bit and swell fixture, locator is arch locator, and locator is provided with for through leading
To the sleeve pipe of pin 3.Swell fixture includes interior nail 1 and expansion sleeve 2.Expansion sleeve 2 includes fixed part 21 and bulge 22, fixed part 21
For coniform.Bulge 22 is made up of four expanding petals 23, and the end of fixed part 21 is fixed in one end of expanding petal 23, and each is swollen
The radian of swollen valve 23 is 60 °, and expanding petal 23 is provided with external screw thread and the internal thread being engaged with interior nail 1, and expanding petal 23 encloses and is set as circle
The inner chamber of cylindricality, the external diameter of bulge 22 is identical with the external diameter of interior nail 1, and the taper after bulge 22 expands is 60 °.Interior nail 1 sets
There is external screw thread, 1 point of interior nail is head and afterbody, and coning, afterbody is cylinder, the maximum gauge and bulge of head to head
22 overall diameter is identical.Fixed part 21 is provided with first through hole 24 along axis, and interior nail 1 offers ladder hole along the direction of axis
11, the minimum diameter of the diameter less than ladder hole 11 of first through hole 24.Guide pin 3 is and first through hole 24 and ladder hole 11
What is be engaged is stepped.
In the present embodiment, by taking the build of Chinese as an example, 1 externally threaded pitch of interior nail is 3.5mm, and head contains screw thread most
Minor diameter is 3mm, a length of 5mm, a diameter of 7mm of the afterbody containing screw thread, and length is 20mm.Through hole 11 is by two hole structures in aperture
Into, it is 6mm positioned at the aperture of afterbody, head and afterbody are run through in a length of 17mm, another hole, and aperture is 3mm, 8mm long.Expanding petal
23 30mm long, the thickness 1mm of expanding petal 23, the inner side of expanding petal 23 has follows closely 1 supporting screw thread with interior, is easy to being screwed into for interior nail 1, expanding petal
23 diameter 7mm when closing up, fixed part 21 is converged to the gradually less cone of diameter, and fixed part 21 is provided with the first of diameter 2mm
Through hole 24.Expansion sleeve 2 expands when being screwed into interior nail 1, after interior nail 1 is inflated the parcel of set 2 completely, the effective length of the expansion of expansion sleeve 2
20mm (i.e. 1 body of interior nail is long), diameter is up to 9mm.
Interior nail 1 and expansion sleeve 2 are combined with nanometer hydroxyapatite carrier and used multiple by absorption process by protein factor
The sustained-release micro-spheres that newborn method composite polyethylene levorotatory lactide is prepared into combine the absorbable expansion screw being made.Protein factor is
BMP-2。
Polyethylene levorotatory lactide (Poly-L-lactide, PLLA) is a kind of new biodegradation material, Ke Yicong
It is made in the starch of plant resources (such as corn), is finally degraded into carbon dioxide and water in vivo, it is this kind of material non-toxic, nonantigenic
Property, with good degradability, absorbability, mechanical strength and biological safety, can be adjusted by controlling component content
The degradation speed of material is saved, the repeatability of product property and mechanical property is reached higher level.Nanometer hydroxyapatite
(nano-Hydroxyapatite, abbreviation nHA) is a kind of most common bioactive materials, and it has and body bone tissue phase
As inorganic constituents, be the bioactive materials with preferable biocompatibility and osteoconductive generally acknowledged at present.Nano-hydroxy
Apatite is the chief component of bone, because it implants with good biocompatibility, non-toxic, NIP reaction
Property, first in pharmaceutical carrier field by numerous studies, there are many researchs to show that the compound PLLA microballoons of nanometer hydroxyapatite delay
Release system and the encapsulating effect of medicine and protein is increased substantially, extend the release time of medicine, it was reported that wherein nanometer hydroxyl
Suction-operated of the base apatite to medicine serves the effect of key.Nano-HA is combined with PLLA, on the one hand can be made big
Width improves the encapsulating effect of sustained-release micro-spheres, the slow-release time of extension medicine, and the shakiness of explosive release and protein is reduced as far as possible
It is fixed, greatly improve the utilization rate of microglobulin matter, it is to avoid a large amount of protein dash forward release generation local acid concentration it is too high
Phenomenon, so as to avoid influence bone tissue generation.On the one hand the acid degradation products of PLA can be made can be buffered by HA, while
The osteoconductive of HA can provide good osteocyte adhesion growing environment, and the loose structure of compound is then cell growth, organizes
Regeneration and adhesion offer condition, meet the biological requirement of bone tissue engineer.BMP-2 is that the unique one kind having now been found that can be made
To induce the protein factor of the adequate condition of bon e formation, i.e., i.e. inducible cartilage and bone under the condition that only independent BMP-2 is present
The formation of tissue, and all played an important role in each stage of skeletonization.In addition, BMP-2 can be induced substantially dividing from marrow
From the pluripotent stem cell for obtaining to cartilage cell, bone cell differentiation, synthesize the protein such as BGP, entochondrostosis occur,
Osteocyte is formed, and bone mineralization forms new bone.But simple BMP-2 spreads too soon in vivo, is also easily decomposed by protein acid, Yi Fa
It is raw to be lost in, degrade and absorb, thus more target cells can not be acted within effective time, therefore in basis and clinical research
It is mainly used in other carrier material Application of composite in the reparation of tissue.Microballoon (microsphere) refer to medicine dissolving or
The microscopic, spherical entity formed in the matrix of macromolecular material is dispersed in, belongs to matrix type skeleton particulate.Because it is to certain organs
With the slow release of insoluble drug release in the targeting and particulate of tissue, the focus of controlled release agent type research in recent years is had become.Structure
The absorbable expansion bolted fastening system of BMP-2 sustained releases is built, not only with osteoconductive but also with osteoinductive, while can gradually inhale
Incorporate solution.
BMP-2 is combined with nanometer hydroxyapatite carrier by absorption process and is prepared into using the compound PLLA of multi-emulsion method slow
Release microballoon (BMP-2:HA:PLLA=15mg:15mg:200mg), sustained-release micro-spheres are be combined with each other by technique and are made bolt,
PLLA is nontoxic, inorganization reaction, and BMP-2/ nanometer hydroxyapatite microballoons are sustained during slow degraded, sustained release
BMP-2 can promote tendon bone intersection Derived from Mesenchymal Stem Cells, and can promote the cartilaginous tissue of new life to bone tissue knot
Structure is reinvented, so as to reappear original tendon-bone interface biological function.
BMP-2 is combined with nanometer hydroxyapatite carrier and be combined PLLA by absorption process and is prepared into sustained-release microparticle, so
After be fabricated to absorbable expansion bolted fastening system, it is slow in bolt degradation process, continue, stabilization release BMP-2/ hydroxy-apatites
Stone particulate, certain BMP-2 concentration is maintained in tendon-bone interface, to promote tendon-bone healing, ultimately forms natural fabric.
The fixed system of graft in Healing in Anterior Cruciate Ligament Reconstruction of the invention, in surgical procedure, first goes down on one's knees 90 degree, selection
Lateral meniscus anterior angle level, the position of posterior cruciate ligament of knee front 7mm, inserts ligament tibia locator, through set through inner side Xiyan otch
Pipe pierces guide pin 3, after confirming that position is good, with the hollow boring bit with artificial tendon same diameter, is made tibial bone road.To move
The one end for planting tendon is led into femoral bone tunnel, and first through hole 24 is inserted using guide pin 3, and tendon push-in expansion is close to along femur bone road
Set 2 to tail end enters road to the marrow, and being then screwed into interior nail 1 carries out expansion extruding fixation.The other end for transplanting tendon is led into shin bone tunnel
Road, carries out expansion bolt and fixes using same method.
Above-mentioned simply presently preferred embodiments of the present invention, not makees any formal limitation to the present invention.Although of the invention
It is disclosed above with preferred embodiment, but it is not limited to the present invention.Therefore, it is every without departing from technical solution of the present invention
Content, according to the technology of the present invention essence to any simple modification, equivalent variation and modification made for any of the above embodiments, all should fall
In the range of technical solution of the present invention protection.
Claims (8)
1. in a kind of Healing in Anterior Cruciate Ligament Reconstruction graft fixed system, it is characterised in that including locator, guide pin (3), empty
Heart drill bit and swell fixture, the swell fixture include interior nail (1) and expansion sleeve (2), and the interior nail (1) and expansion sleeve (2) are
Multi-emulsion method composite polyethylene levorotatory lactide is combined by absorption process by protein factor and used with nanometer hydroxyapatite carrier
The sustained-release micro-spheres being prepared into combine the absorbable expansion screw being made, and the protein factor is BMP-2;Expansion sleeve (2) edge
Axis is provided with first through hole (24), and the interior nail (1) offers ladder hole (11), the first through hole along the direction of axis
(24) minimum diameter of the diameter less than ladder hole (11);The guide pin (3) is and first through hole (24) and ladder hole
(11) what is be engaged is stepped;The locator is provided with for the sleeve pipe through guide pin (3).
2. in Healing in Anterior Cruciate Ligament Reconstruction according to claim 1 graft fixed system, it is characterised in that the expansion
Set (2) includes fixed part (21) and bulge (22), and the end of the fixed part (21) and the end of bulge (22) are fixed and connected
Connect, fixed part (21) is coniform;The bulge (22) is made up of at least three expanding petals (23), the expanding petal (23)
The end of fixed part (21) is fixed in one end, and the expanding petal (23) encloses the inner chamber for being set as cylinder, the bulge (22)
External diameter is identical with the external diameter of interior nail (1).
3. in Healing in Anterior Cruciate Ligament Reconstruction according to claim 2 graft fixed system, it is characterised in that the expansion
Valve (23) is provided with four, and the radian of each expanding petal (23) is 60 °.
4. in Healing in Anterior Cruciate Ligament Reconstruction according to claim 3 graft fixed system, it is characterised in that the expansion
Taper after set (2) expansion is a, a=60 °.
5. in Healing in Anterior Cruciate Ligament Reconstruction according to claim 2 graft fixed system, it is characterised in that the expansion
Valve (23) is provided with external screw thread, and internal thread is provided with the inside of the expanding petal (23).
6. in Healing in Anterior Cruciate Ligament Reconstruction according to claim 2 graft fixed system, it is characterised in that the interior nail
(1) external screw thread is provided with, the interior nail (1) is divided into head and afterbody, and coning, the afterbody is cylinder, institute to the head
The maximum gauge for stating head is identical with the overall diameter of bulge (22).
7. in Healing in Anterior Cruciate Ligament Reconstruction according to claim 6 graft fixed system, it is characterised in that the interior nail
(1) externally threaded pitch is 3.5mm, and minimum diameter of the head containing screw thread is 3mm, and a length of 5mm, the afterbody contains screw thread
A diameter of 7mm, length is 20mm.
8. in Healing in Anterior Cruciate Ligament Reconstruction according to claim 1 graft fixed system, it is characterised in that the positioning
Device is arch locator.
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CN201710009324.5A CN106691525A (en) | 2017-01-06 | 2017-01-06 | Fixing system for transplant in anterior cruciate ligament reconstruction |
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN107485434A (en) * | 2017-08-18 | 2017-12-19 | 南京市六合区人民医院 | A kind of spinal vertebral booster and its manufacture method |
WO2020029502A1 (en) * | 2018-08-07 | 2020-02-13 | 宁波宝亭生物科技有限公司 | Absorbable bone fixation device and preparation method thereof |
CN111329574A (en) * | 2020-03-13 | 2020-06-26 | 山东大学齐鲁医院(青岛) | Distal end plug |
Citations (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN2612353Y (en) * | 2003-01-28 | 2004-04-21 | 第一军医大学珠江医院 | Biodegradable cervical vertebra inosculation device |
CN2629660Y (en) * | 2003-07-31 | 2004-08-04 | 宋文超 | Expanding screw |
JP2005172211A (en) * | 2003-12-12 | 2005-06-30 | Mikio Takei | Anchor nut fixing tool |
CN101365499A (en) * | 2005-11-01 | 2009-02-11 | 骨骼技术股份有限公司 | Bone matrix compositions and methods |
CN101632601A (en) * | 2009-08-19 | 2010-01-27 | 雷伟 | Medical vertebral pedicle strengthening screw |
CN101912300A (en) * | 2009-09-29 | 2010-12-15 | 张强 | Multi-section device for fixing and imbedding vertebral pedicle screws used in minimally invasive thoracolumbar vertebrae fractures |
CN102470007A (en) * | 2009-07-06 | 2012-05-23 | 斯恩蒂斯有限公司 | Expandable fixation assemblies |
CN202263044U (en) * | 2011-08-12 | 2012-06-06 | 贺新宁 | Percutaneous minimally invasive pedicle screw-rod internal fixing system |
CN104434281A (en) * | 2014-12-27 | 2015-03-25 | 雷俊虎 | Bone tunnel cross pin positioning tool used in department of orthopaedics and application thereof |
CN104551504A (en) * | 2014-12-25 | 2015-04-29 | 上海友升铝业有限公司 | Coaxial positioning pin for stepped hole |
CN105358080A (en) * | 2013-05-13 | 2016-02-24 | 尼奥医疗公司 | Orthopedic implant kit |
CN205458998U (en) * | 2016-01-12 | 2016-08-17 | 徐敏鹏 | Inflation nail |
CN205493985U (en) * | 2016-02-06 | 2016-08-24 | 贺新宁 | Pedicle of vertebral arch screw general is put to bind and is put |
CN206792444U (en) * | 2017-01-06 | 2017-12-26 | 南京市六合区人民医院 | The fixed system of graft in Healing in Anterior Cruciate Ligament Reconstruction |
-
2017
- 2017-01-06 CN CN201710009324.5A patent/CN106691525A/en active Pending
Patent Citations (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN2612353Y (en) * | 2003-01-28 | 2004-04-21 | 第一军医大学珠江医院 | Biodegradable cervical vertebra inosculation device |
CN2629660Y (en) * | 2003-07-31 | 2004-08-04 | 宋文超 | Expanding screw |
JP2005172211A (en) * | 2003-12-12 | 2005-06-30 | Mikio Takei | Anchor nut fixing tool |
CN101365499A (en) * | 2005-11-01 | 2009-02-11 | 骨骼技术股份有限公司 | Bone matrix compositions and methods |
CN102470007A (en) * | 2009-07-06 | 2012-05-23 | 斯恩蒂斯有限公司 | Expandable fixation assemblies |
CN101632601A (en) * | 2009-08-19 | 2010-01-27 | 雷伟 | Medical vertebral pedicle strengthening screw |
CN101912300A (en) * | 2009-09-29 | 2010-12-15 | 张强 | Multi-section device for fixing and imbedding vertebral pedicle screws used in minimally invasive thoracolumbar vertebrae fractures |
CN202263044U (en) * | 2011-08-12 | 2012-06-06 | 贺新宁 | Percutaneous minimally invasive pedicle screw-rod internal fixing system |
CN105358080A (en) * | 2013-05-13 | 2016-02-24 | 尼奥医疗公司 | Orthopedic implant kit |
CN104551504A (en) * | 2014-12-25 | 2015-04-29 | 上海友升铝业有限公司 | Coaxial positioning pin for stepped hole |
CN104434281A (en) * | 2014-12-27 | 2015-03-25 | 雷俊虎 | Bone tunnel cross pin positioning tool used in department of orthopaedics and application thereof |
CN205458998U (en) * | 2016-01-12 | 2016-08-17 | 徐敏鹏 | Inflation nail |
CN205493985U (en) * | 2016-02-06 | 2016-08-24 | 贺新宁 | Pedicle of vertebral arch screw general is put to bind and is put |
CN206792444U (en) * | 2017-01-06 | 2017-12-26 | 南京市六合区人民医院 | The fixed system of graft in Healing in Anterior Cruciate Ligament Reconstruction |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN107485434A (en) * | 2017-08-18 | 2017-12-19 | 南京市六合区人民医院 | A kind of spinal vertebral booster and its manufacture method |
WO2020029502A1 (en) * | 2018-08-07 | 2020-02-13 | 宁波宝亭生物科技有限公司 | Absorbable bone fixation device and preparation method thereof |
CN111329574A (en) * | 2020-03-13 | 2020-06-26 | 山东大学齐鲁医院(青岛) | Distal end plug |
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