CN106691525A - Fixing system for transplant in anterior cruciate ligament reconstruction - Google Patents

Fixing system for transplant in anterior cruciate ligament reconstruction Download PDF

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Publication number
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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China
Prior art keywords
cruciate ligament
expansion
anterior cruciate
hole
healing
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Pending
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CN201710009324.5A
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Chinese (zh)
Inventor
刘玉宝
林福庆
赵清华
郭玉祥
林禄攀
邹瑞
蔡小林
温传阳
施中平
张帆
胡桂花
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Liuhe Nanjing District People's Hospital
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Liuhe Nanjing District People's Hospital
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Priority to CN201710009324.5A priority Critical patent/CN106691525A/en
Publication of CN106691525A publication Critical patent/CN106691525A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • A61B17/0642Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L31/00Materials 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
    • A61L31/02Inorganic materials
    • A61L31/028Other inorganic materials not covered by A61L31/022 - A61L31/026
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L31/00Materials 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
    • A61L31/04Macromolecular materials
    • A61L31/048Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L31/00Materials 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
    • A61L31/14Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L31/148Materials at least partially resorbable by the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L31/00Materials 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
    • A61L31/14Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L31/16Biologically active materials, e.g. therapeutic substances
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/20Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
    • A61L2300/252Polypeptides, proteins, e.g. glycoproteins, lipoproteins, cytokines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/412Tissue-regenerating or healing or proliferative agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/60Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
    • A61L2300/602Type of release, e.g. controlled, sustained, slow
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L2430/00Materials or treatment for tissue regeneration
    • A61L2430/06Materials or treatment for tissue regeneration for cartilage reconstruction, e.g. meniscus

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
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  • Biomedical Technology (AREA)
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  • Chemical Kinetics & Catalysis (AREA)
  • Inorganic Chemistry (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Rheumatology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Prostheses (AREA)

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

The fixed system of graft in Healing in Anterior Cruciate Ligament Reconstruction
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.
CN201710009324.5A 2017-01-06 2017-01-06 Fixing system for transplant in anterior cruciate ligament reconstruction Pending CN106691525A (en)

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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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CN201710009324.5A CN106691525A (en) 2017-01-06 2017-01-06 Fixing system for transplant in anterior cruciate ligament reconstruction

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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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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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