CN107854194B - Absorbable composite patch for rotator cuff repair and manufacturing method - Google Patents

Absorbable composite patch for rotator cuff repair and manufacturing method Download PDF

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CN107854194B
CN107854194B CN201710995575.5A CN201710995575A CN107854194B CN 107854194 B CN107854194 B CN 107854194B CN 201710995575 A CN201710995575 A CN 201710995575A CN 107854194 B CN107854194 B CN 107854194B
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braiding
absorbable
rotator cuff
layer
traction
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CN107854194A (en
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陈晓
季杰
赖卫国
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Shanghai Ligetai Biotechnology Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063Implantable repair or support meshes, e.g. hernia meshes

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
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Abstract

The invention provides an absorbable composite patch for rotator cuff repair, which comprises a braiding body, wherein the braiding body comprises one or more braiding units, and the braiding units form a supporting base layer and an absorbable layer in a thickness extending direction by stacking; the absorbable layer is arranged on one or all of the two end surfaces of the supporting base layer along the thickness extending direction; the support base layer and the absorbable layer are both made of degradable materials. Correspondingly, the invention also provides a manufacturing method of the absorbable composite patch for rotator cuff repair. The invention has higher initial fixing strength, can simultaneously ensure that the rotator cuff and the humerus head are tightly combined, and reduces the gap; and along with the gradual degradation of collagen, the connective tissue of the human body gradually grows into micropores of the patch to form an integral structure, so that the healing of the rotator cuff is quickened.

Description

Absorbable composite patch for rotator cuff repair and manufacturing method
Technical Field
The invention relates to the field of medical instruments, in particular to an absorbable composite patch for rotator cuff repair and a manufacturing method thereof.
Background
The rotator cuff injury is common injury of the rotator joints, the patient often has shoulder pain after a certain trauma, the movement is limited, and the main symptoms of the rotator cuff injury are as follows: pain on the outside of the shoulder, and can radiate to the neck, upper arm; pain is aggravated when the shoulder abducts or performs whiplash movements in which the shoulder rotates from the outside to the inside rapidly; when the shoulder is outward-rotating, outward-expanding and anti-blocking, obvious pain also occurs to the shoulder; when the rotator cuff injury time is long, deltoid atrophy is also caused. In normal population, rotator cuff injury accounts for 5% -40% of shoulder joint diseases, and in population over 60 years old accounts for 17% -41%.
The current clinical rotator cuff injury repair technology comprises a single-row and double-row anchor with wires and an osteosynthesis technology. With the improvement of repair instruments and the improvement of repair technologies, a great deal of rotator cuff injuries can be sutured with tendons and bones, but partial rotator cuffs can not be repaired due to huge tearing and tissue contracture, so that some technologies for repairing rotator cuffs by tendon transfer technology are clinically presented, wherein the most common technologies are pectoral large muscle transfer technology and latissimus dorsi transfer technology. However, when the patient's shoulder joint has an unstable anterior superior or a large rotator cuff injury, the effect is not ideal in terms of pain or function. Although the rotator cuff repair technique has been significantly advanced, there is still a 38% -94% post-operative re-tear rate, particularly with a low degree of tendon-bone healing of degenerative rotator cuff injuries.
Ideal rotator cuff repair: the initial fixing strength is higher, and the initial strength of the rotator cuff is achieved; the gap between the rotator cuff and the humeral head is as small as possible; the mechanical stability can be maintained after repeated activities; the mechanical stability can be kept when cyclic load is loaded; the biological environment of the "healing site" is optimized.
Disclosure of Invention
In view of the shortcomings in the prior art, it is an object of the present invention to provide an absorbable composite patch for rotator cuff repair and method of manufacture.
The absorbable composite patch for rotator cuff repair provided by the invention comprises a braiding body, wherein the braiding body comprises one or more braiding units,
the woven unit forms a support base layer and an absorbable layer by stacking in a thickness extension direction; the absorbable layer is arranged on one or all of the two end surfaces of the supporting base layer along the thickness extending direction;
the support base layer and the absorbable layer are both made of degradable materials.
Preferably, a plurality of knitting units of the same layer in the thickness extending direction in the knitting body are sequentially connected to form a knitting layer;
the woven fabric comprises a plurality of woven layers, wherein the woven layers are sequentially stacked in the thickness extension direction of the woven body;
the two adjacent braiding layers can slide relatively and enable the braiding bodies to be switched between an initial state and an unfolding state:
in the initial state, a plurality of braiding layers are stacked in a flush way, a plurality of braiding units are arranged in a matrix on the cross section of a braiding body, and the width of the braiding body is minimum;
in the unfolded state, the plurality of braiding layers are staggered and stacked, and on the cross section of the braiding body, the plurality of braiding units are arranged in a parallelogram shape, so that the width of the braiding body is enlarged.
Preferably, the braid further comprises an elastic cord;
the elastic rope is connected with two adjacent braiding units of the braiding body in the thickness extending direction in the initial state;
in the unfolded state, the elastic cord is in a stretched state.
Preferably, two ends of the braiding body along the width extension direction are respectively provided with a first traction piece and a second traction piece;
in the thickness extending direction of the braiding parts, the first traction part and the second traction part are respectively connected to the two outermost braiding layers.
Preferably, the traction piece is integrally formed with or fixedly connected with the braiding part;
the traction piece comprises traction ropes, one or more traction ropes are arranged on any one of two sides in the width direction of the braiding, and the traction ropes on the same side are connected to the same braiding layer; the other ends of the two ends of the traction ropes in the axial direction, which are opposite to the end connected with the braiding bodies, form free ends, and the free ends of the traction ropes are mutually separated, partially connected or fully connected; or,
the traction piece is a braiding unit protruding out along the width extension direction of the braiding body.
Preferably, the cross-sectional shape of the knitting unit is arc-shaped; in the initial state, the cross section of the braiding part is in a folded shape.
Preferably, the adhesive further comprises an elastic coating; the whole or part of the braiding body is covered by the elastic covering film;
the elastic coating film generates elastic deformation along with the transition of the braiding body between an initial state and an unfolding state.
Preferably, the plurality of woven elements in a single woven layer are integrally formed, sequentially bonded or sequentially stitched.
Preferably, the absorbable layer is made of collagen;
the supporting base layer is made of polymer porous fabric and is made of any one or more of the following materials:
-collagen/polyvinyl alcohol composite mono-or multifilament;
polylactic acid based polymer monofilament or multifilament.
The invention also provides a manufacturing method of the absorbable composite patch for rotator cuff repair, which comprises the following steps:
step A: obtaining a polymer porous fabric by warp knitting yarns made of degradable materials;
and (B) step (B): cutting the polymer porous fabric by laser, ultrasonic waves or a hot knife to obtain a support base layer;
step C: preparing collagen film by electrostatic spinning;
step D: the collagen membrane is compounded on the support base layer to form an absorbable layer.
Compared with the prior art, the invention has the following beneficial effects:
1. the invention has higher initial fixing strength, can simultaneously ensure that the rotator cuff and the humerus head are tightly combined, and reduces the gap; and along with the gradual degradation of collagen, the connective tissue of the human body gradually grows into micropores of the patch to form an integral structure, so that the healing of the rotator cuff is quickened.
2. The support base layer has good biodegradability, excellent mechanical strength and good flexibility, and can well assist tissue remodeling.
3. The absorbable layer in the invention is natural active protein, has lower immunogenicity, good biocompatibility and histocompatibility, and is nontoxic to cells and organisms, and does not or less cause inflammation and immune rejection reaction.
4. The braiding bodies adopted by the invention have smaller diameter of the circumcircle in the initial state, and are convenient to pass through the incision; through stretching, the expansion can be performed step by step, and the requirements of different expansion areas are met.
5. The invention can solve the problem of higher re-tearing rate in the prior operation and the problem that the operation cannot be effectively repaired due to huge tearing, and has great clinical significance.
Drawings
Other features, objects and advantages of the present invention will become more apparent upon reading of the detailed description of non-limiting embodiments, given with reference to the accompanying drawings in which:
FIG. 1 is a schematic diagram of a braid structure;
FIG. 2 is a schematic diagram of a weave unit material construction;
FIG. 3 is a schematic view of the structure of the initial state of the braid;
FIG. 4 is a schematic view of a preliminary developed structure of a woven body subjected to stretching;
FIG. 5 is a schematic view of a further developed structure of the braid under tension;
fig. 6 is a schematic diagram of a woven structure coated with an elastic coating.
The figure shows:
Figure BDA0001442442320000041
Detailed Description
The present invention will be described in detail with reference to specific examples. The following examples will assist those skilled in the art in further understanding the present invention, but are not intended to limit the invention in any way. It should be noted that variations and modifications could be made by those skilled in the art without departing from the inventive concept. These are all within the scope of the present invention.
In the description of the present invention, it should be understood that the terms "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, are merely for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention.
As shown in fig. 1 and 2, in the embodiment, the absorbable composite patch for rotator cuff repair provided by the present invention comprises a woven body 1, wherein the woven body 1 further comprises a woven unit 100, the woven unit 100 is formed by stacking a support base layer 2 and an absorbable layer 3 in a thickness extension direction, and the absorbable layer 3 is disposed on two end surfaces of the support base layer 2 in the thickness extension direction. The supporting base layer 2 is a polymer porous fabric, plays a role in mechanical supporting, provides mechanical strength, and is made of any one or more of the following materials: collagen/polyvinyl alcohol composite mono-or multifilament, polylactic acid based polymer mono-or multifilament, such as PLLA, PLGA, PGLA, PGA, etc. The porous polymer fabric is woven by warp knitting, and then cut into a specific shape by laser, ultrasonic or a hot knife; the support base layer 2 has good biodegradability, excellent mechanical strength and good flexibility, and can well assist tissue remodeling. The upper and lower absorbable layers 3 are made of collagen, which is a natural active protein, has low immunogenicity, good biocompatibility and histocompatibility, and is nontoxic to cells and organisms, and does not or less cause inflammation and immune rejection. The absorbable layer 3 is formed by electrostatic spinning and is compounded on the supporting base layer 2 to form a multi-layer structure, so that the woven body 1 has excellent tissue compatibility and accelerates tissue growth. In the preferred embodiment, the braid 1 comprises only one braiding unit 100, that is, the braid 1 is integrally formed, and the surface area is adjusted by folding and unfolding during use to meet the use requirements under different conditions, but the structure is inconvenient to operate when passing through a small incision. Preferably, the absorbable layer 3 may be located on only one of the two end surfaces of the supporting base layer 2 in the thickness extending direction, so as to reduce the processing difficulty of the woven body 1, but correspondingly, the therapeutic effect is reduced.
In the embodiment, as shown in fig. 3 to 5, the braid 1 includes a plurality of braid units 100, and the plurality of braid units 100 of the same layer in the thickness extension direction in the braid 1 are sequentially connected to form the braid 10, and the plurality of braid units 100 in the braid 10 are integrally formed, sequentially bonded, or sequentially sewn. The two braiding layers 10 are stacked in turn in the thickness extension direction of the braiding body 1, and two adjacent braiding layers 10 can slide relatively and enable the braiding body 1 to be switched between an initial state and an unfolding state: as shown in fig. 3, in the initial state, the plurality of braid 10 are stacked in a flush manner, and the plurality of braid units 100 are arranged in a matrix shape in the cross section of the braid 1, so that the width of the braid 1 is minimum; as shown in fig. 4 and 5, in the developed state, the plurality of braid 10 are stacked in a staggered manner, and the plurality of braid elements 100 are arranged in a parallelogram shape in the cross section of the braid 1, so that the width of the braid 1 is increased. The braid 1 further comprises an elastic rope 4, wherein the elastic rope 4 is connected with two adjacent braiding units 100 of the braid 1 in the initial state along the thickness extending direction, and the two adjacent braiding layers 10 are pulled and bonded; when the braiding layers 10 are staggered from each other, the elasticity is also stretched, so that the braiding body 1 maintains the stability of the whole structure under the action of the partial force in the thickness extending direction. The two ends of the braiding part 1 along the width extension direction are respectively provided with a first traction piece 51 and a second traction piece 52, the first traction piece 51 and the second traction piece 52 are respectively connected to the two outermost braiding layers 10 along the thickness extension direction of the braiding part 1, the traction pieces can be traction ropes or braiding units 100 protruding in the width direction, one or more traction ropes are arranged on any one of two sides along the width direction of the braiding part 1, and the traction ropes on the same side are connected to the same braiding layer 10; the other end of the traction rope opposite to the end connected with the braiding 1 forms a free end in the axial direction, the free ends of the traction ropes are mutually separated, partially connected or fully connected, and the traction piece is arranged to help a doctor adjust the surface area of the braiding 1 in the use process. In addition, as shown in fig. 6, the periphery of the braiding unit 1 is further covered with an elastic covering film 6, the elastic covering film 6 covers the upper end face and the lower end face of the braiding unit 1, and two ends of the elastic covering film 6 are respectively and tightly connected with two ends of the braiding unit 1 along the width direction, preferably, the elastic covering film 6 covers the braiding unit 1 along the circumferential direction and is respectively and tightly connected with the braiding unit 100 at the leftmost upper corner and the braiding unit 100 at the rightmost lower corner, so that when the area of the braiding unit 1 changes, the elastic covering film 6 is also pulled and unfolded, thereby being beneficial to clamping the braiding unit 1 from the upper direction and the lower direction. Preferably, the cross-sectional shape of the knitting unit 100 is arc, in the initial state, the cross-sectional shape of the knitting body 1 is in a folded tile shape, the concave part of the arc-shaped knitting unit 100 forms a containing groove, and the knitting unit 100 of the previous layer is just contained, so that the function of fixing in the width extending direction can be achieved, and the stability of the knitting body 1 in the unfolded state is increased; further, the curved structure of the knitting unit 100 allows both ends to deform toward the middle when receiving a component force in the width direction, and thus the overall structure of the knitting unit 100 is more compact.
Working principle: before implantation, the braiding 1 is in a folded shape, as shown in fig. 3, and the largest circumcircle diameter of the braiding 1 is smaller due to the folded shape, so that the braiding can easily pass through a small incision. After the braid 1 passes through the small incision, the braid 10 can be spread step by pulling the pulling member as shown in fig. 4. As shown in fig. 5, pulling on the traction member can further expand the braid 10, meeting the needs of different areas of expansion of the practitioner. The two adjacent braiding layers 10 are kept in fit under the action of the elastic rope 4, the elastic coating film 6 on the periphery of the braiding body 1 is elastically deformed along with the expansion of the braiding body 1, the braiding body 1 is clamped in the up-down direction under the action of resilience force, and the smoothness of the upper surface and the lower surface of the braiding body 1 is ensured.
The invention also provides a manufacturing method of the absorbable composite patch for rotator cuff repair, which comprises the following steps: step A: obtaining a polymer porous fabric by warp knitting yarns made of degradable materials; and (B) step (B): cutting the polymer porous fabric by laser, ultrasonic waves or a hot knife to obtain a support base layer 2; step C: preparing collagen film by electrostatic spinning; step D: the absorbable layer 3 is formed by compositing a collagen film on the supporting base layer 2.
The foregoing describes specific embodiments of the present invention. It is to be understood that the invention is not limited to the particular embodiments described above, and that various changes and modifications may be made by one skilled in the art within the scope of the claims without affecting the spirit of the invention. The embodiments of the present application and features in the embodiments may be combined with each other arbitrarily without conflict.

Claims (9)

1. An absorbable composite patch for rotator cuff repair comprising a knitted body comprising one or more knitted elements,
the woven unit forms a support base layer and an absorbable layer by stacking in a thickness extension direction; the absorbable layer is arranged on one or all of the two end surfaces of the supporting base layer along the thickness extending direction;
the supporting base layer and the absorbable layer are both made of degradable materials;
a plurality of braiding units of the same layer in the braiding body along the thickness extending direction are sequentially connected to form a braiding layer;
the woven fabric comprises a plurality of woven layers, wherein the woven layers are sequentially stacked in the thickness extension direction of the woven body;
the two adjacent braiding layers can slide relatively and enable the braiding bodies to be switched between an initial state and an unfolding state:
in the initial state, a plurality of braiding layers are stacked in a flush way, a plurality of braiding units are arranged in a matrix on the cross section of a braiding body, and the width of the braiding body is minimum;
in the unfolded state, the plurality of braiding layers are staggered and stacked, and on the cross section of the braiding body, the plurality of braiding units are arranged in a parallelogram shape, so that the width of the braiding body is enlarged.
2. The absorbable composite patch for rotator cuff repair of claim 1, wherein the knit further comprises an elastic strand;
the elastic rope is connected with two adjacent braiding units of the braiding body in the thickness extending direction in the initial state;
in the unfolded state, the elastic cord is in a stretched state.
3. An absorbable composite patch for rotator cuff repair according to claim 2, wherein two ends of the woven body in the width extension direction are respectively provided with two traction members, namely a first traction member and a second traction member;
in the thickness extending direction of the braiding parts, the first traction part and the second traction part are respectively connected to the two outermost braiding layers.
4. An absorbable composite patch for rotator cuff repair according to claim 3, wherein the traction member is integrally formed with or fixedly attached to the woven body;
the traction piece comprises traction ropes, one or more traction ropes are arranged on any one of two sides in the width direction of the braiding, and the traction ropes on the same side are connected to the same braiding layer; the other ends of the two ends of the traction ropes in the axial direction, which are opposite to the end connected with the braiding bodies, form free ends, and the free ends of the traction ropes are mutually separated, partially connected or fully connected; or,
the traction piece is a braiding unit protruding out along the width extension direction of the braiding body.
5. An absorbable composite patch for rotator cuff repair according to claim 2, wherein said knit unit cross-sectional shape is arcuate; in the initial state, the cross section of the braiding part is in a folded shape.
6. An absorbable composite patch for rotator cuff repair according to claim 1, further comprising an elastic cover film; the whole or part of the braiding body is covered by the elastic covering film;
the elastic coating film generates elastic deformation along with the transition of the braiding body between an initial state and an unfolding state.
7. An absorbable composite patch for rotator cuff repair according to claim 1 wherein the plurality of knit elements in a single knit layer are integrally formed, sequentially bonded or sequentially stitched.
8. An absorbable composite patch for rotator cuff repair according to claim 1, wherein said absorbable layer material is collagen;
the supporting base layer is made of polymer porous fabric and is made of any one or more of the following materials:
-collagen/polyvinyl alcohol composite mono-or multifilament;
polylactic acid based polymer monofilament or multifilament.
9. A method of manufacturing an absorbable composite patch for rotator cuff repair, using the absorbable composite patch for rotator cuff repair of claim 1, comprising the steps of:
step A: obtaining a polymer porous fabric by warp knitting yarns made of degradable materials;
and (B) step (B): cutting the polymer porous fabric by laser, ultrasonic waves or a hot knife to obtain a support base layer;
step C: preparing collagen film by electrostatic spinning;
step D: the collagen membrane is compounded on the support base layer to form an absorbable layer.
CN201710995575.5A 2017-10-23 2017-10-23 Absorbable composite patch for rotator cuff repair and manufacturing method Active CN107854194B (en)

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CN109732806B (en) * 2019-02-14 2021-06-04 上海电气风电集团股份有限公司 Pultrusion piece for wind power blade, pouring method for wind power blade and wind power blade
CN111803713A (en) * 2020-05-29 2020-10-23 广州新诚生物科技有限公司 Woven film, woven bag and weaving method

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CN103418031A (en) * 2012-05-17 2013-12-04 天津市康尔医疗器械有限公司 Absorbable endocranium healing patch and preparation method thereof
CN105536071A (en) * 2016-01-21 2016-05-04 东华大学 Polylactic acid/polycaprolactone/polypropylene composite pelvic floor patch and preparation method thereof
CN106390204A (en) * 2016-11-16 2017-02-15 浙江省人民医院 Composite type artificial dura mater and preparation method
CN208864566U (en) * 2017-10-23 2019-05-17 上海利格泰生物科技有限公司 Absorbable composite patch for rotator cuff reparation

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CN103418031A (en) * 2012-05-17 2013-12-04 天津市康尔医疗器械有限公司 Absorbable endocranium healing patch and preparation method thereof
CN105536071A (en) * 2016-01-21 2016-05-04 东华大学 Polylactic acid/polycaprolactone/polypropylene composite pelvic floor patch and preparation method thereof
CN106390204A (en) * 2016-11-16 2017-02-15 浙江省人民医院 Composite type artificial dura mater and preparation method
CN208864566U (en) * 2017-10-23 2019-05-17 上海利格泰生物科技有限公司 Absorbable composite patch for rotator cuff reparation

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