CN110584832A

CN110584832A - Device for treating tearing of huge rotator cuff

Info

Publication number: CN110584832A
Application number: CN201810604796.XA
Authority: CN
Inventors: 张正文
Original assignee: Nanchang Renren Medical Technology Co Ltd
Current assignee: Nanchang Renren Medical Technology Co Ltd
Priority date: 2018-06-13
Filing date: 2018-06-13
Publication date: 2019-12-20

Abstract

The invention discloses a device for treating giant rotator cuff tear, which comprises a pressurizing device, a high-pressure tee joint device, a handle device and a balloon device which are sequentially connected; the upper articular bursa reconstruction principle is utilized, and a saccule structure is adopted to replace an autologous tendon or a variant tendon for treating huge rotator cuff tear, particularly supraspinatus and tendon tear thereof; the balloon is filled between the humerus head and the acromion to replace the torn tendon, so as to avoid severe pain caused by impact of the humerus head on the acromion and repair the spherical reticular structure of the rotator cuff. The balloon can be produced in batch, and the problem of insufficient source of autologous tendons or allogeneic tendons is solved; the invention can be used for open type operation and minimally invasive arthroscopy operation; when the device is used for minimally invasive arthroscopic surgery, the surgical trauma of a patient can be greatly reduced, and the surgical recovery time of the patient is shortened; the invention has simple operation and is easy to be used in clinic.

Description

Device for treating tearing of huge rotator cuff

Technical Field

The invention belongs to the field of medical instruments, and particularly relates to a device for treating tearing of huge rotator cuff.

Background

The shoulder joint is a ball-socket joint composed of a humeral head and a shallow scapula. The four muscles, supraspinatus, infraspinatus, teres minor and scapula, converge together in the form of tendons and cover the head of the humerus to form a spherical reticular structure called rotator cuff. The role of the rotator cuff is to retain the humeral head within the scapular pelvis. The humerus is pasted on the scapula by the rotator cuff, which plays an important role in the normal movement of the shoulder joint. When one or more of the rotator cuff tendons tear, the tendons are no longer fully attached to the humeral head. Most of the tears occur in the supraspinatus muscle and its tendon, and other parts of the rotator cuff may also tear. In many cases, tendon tears begin with wear and, with damage progression, complete tears may occur, progressing from small to large tears.

Since most rotator cuff tears are mostly normal frayed tears, which occur with aging, there is a significant risk of rotator cuff tear in people over the age of 40. Those who do repetitive weight lifting or over-head activities are also at risk of rotator cuff tear. Players are particularly prone to overuse tears, such as tennis players and baseball pitchers. The risk of rotator cuff tear is also high for painters, carpenters and other workers doing work over. Although overuse tears from physical activity or work-over occur in younger patients, most tears in younger patients are caused by trauma such as falls.

Giant rotator cuff tears most commonly occur in the supraspinatus muscle and its tendon, with a significant portion being irreparable. The main purpose of surgical treatment of the irreparable giant rotator cuff tear is to eliminate and relieve pain. After this type of tear occurs, the humeral head moves upward, away from the normal anatomical position, and the humeral head impacts the shoulder peak causing severe pain. In the operation for treating the tearing, a method for reconstructing the joint capsule is called, namely autologous tendon (such as fascia lata) and allogeneic tendon are used for replacing a huge rotator cuff tear, the humeral head is pressed downwards to return to a normal anatomical position, severe pain caused by impacting a shoulder peak by the humeral head is avoided, so that the stability above the glenohumeral joint is restored again, and the rotation center of the humeral joint returns to the original position. However, this treatment has two major drawbacks:

(1) if the autologous tendon is adopted, the tendon at other parts of the patient needs to be cut, the operation is very complicated, the operation wound is large, and the recovery time of the patient is long.

(2) If a foreign tendon is used, great care is needed to eliminate the risk of infection, rejection, and the source of the foreign tendon is very limited.

Disclosure of Invention

Aiming at the defects of the prior art, the invention provides a device for treating giant rotator cuff tear, which utilizes the reconstruction principle of an upper joint capsule, adopts a balloon structure to replace an autologous tendon or a heterologous tendon, and is used for treating giant rotator cuff tear, in particular to supraspinatus and tendon tear thereof; the balloon is filled between the humerus head and the acromion to replace the torn tendon, so as to avoid severe pain caused by impact of the humerus head on the acromion and repair the spherical reticular structure of the rotator cuff.

In order to achieve the purpose, the invention is realized by the following technical scheme:

a device for treating giant rotator cuff tear comprises a pressurizing device, a high-pressure tee joint device, a handle device and a balloon device which are connected in sequence;

the pressurizing device comprises a sleeve, a wrench and a pressure gauge, wherein a piston and a piston sleeve are arranged in the sleeve, a nut is arranged at one end of the sleeve, a connecting pipe is arranged at the other end of the sleeve, the pressure gauge is arranged on the side wall of the sleeve, a rack is arranged on the wrench, the rack extends into the sleeve and forms threaded fit with the thread of the nut, a pushing rod is further arranged on the wrench, a spring is arranged between the wrench and the pushing rod, pre-compression is formed after the spring is assembled, the spring has elasticity, the rack of the wrench is pushed to be meshed with the thread of the nut, and the pushing rod rotates clockwise, pushes forwards, rotates anticlockwise and retreats; when the wrench is held tightly and the spring is compressed, the rack on the wrench is separated from the screw thread of the nut, the injection rod can be quickly pulled, and the medium can be quickly absorbed or the spherical bag can be quickly vacuumized; one end of the connecting pipe is connected with the high-pressure three-way device through a connecting pipe joint;

the handle device comprises an injection pipe joint, an injection pipe and a handle, wherein the handle is sleeved on the injection pipe, one end of the handle is connected with the injection pipe joint in a threaded mode, one end of the injection pipe is connected with the injection pipe joint in an injection molding mode, the other end of the injection pipe penetrates through the handle, a sleeve head and a sleeve are sleeved on one end of the handle, and one end of the handle device is connected with the high-pressure three-way device through the injection pipe joint;

the balloon device comprises a one-way valve and a balloon, wherein a pipe orifice structure is arranged on the balloon and is communicated with the inside and the outside of the balloon, the one-way valve is arranged in the pipe orifice structure of the balloon, one end of the sleeve is sleeved on the pipe orifice structure, and the injection tube penetrates through the one-way valve and enters the inside of the balloon.

As the optimization of the technical scheme, the sleeve head is of a conical bell mouth structure, so that the balloon can conveniently penetrate through the sleeve after being folded, and the tail end of the sleeve is provided with the inner cylindrical surface chamfering structure, so that the balloon can not be scratched by using the structure, and the balloon can be favorably separated.

As the optimization of the technical scheme, the outer side wall of the tail end of the injection tube is provided with the concave circular ring structure, the inner side wall of the one-way valve is provided with the convex circular ring structure, and when the injection tube is connected with the one-way valve, the concave circular ring structure and the convex circular ring structure form concave-convex matching.

Preferably, one end of the one-way valve is provided with a blade structure, and when the injection tube is separated from the one-way valve, the blade is closed under the self elasticity. If the inside of the saccule is filled with a medium with certain pressure, the pressure acts on the periphery of the blade to further seal the inlet of the one-way valve, so that the inside of the saccule is completely sealed.

Preferably, in the above technical solution, the balloon is made of absorbable or non-absorbable medical polymer material.

Preferably, the sleeve is provided with a volume scale.

The working principle of the invention is as follows: the spanner is gripped to compress the spring to the bottom, the spanner is pulled to vacuumize, air in the balloon is sucked out and folded to form a cylindrical shape, and the balloon is completely sleeved by the sleeve. When the vacuum is pumped, the one-way valve has certain elasticity, is in concave-convex fit with the injection pipe and has a sealing function, so that the vacuum can be pumped well; when arthroscopic surgery is performed, firstly, the sleeve is placed in a balloon filling position through an arthroscopic surgery working channel, the position of the sleeve is well positioned by utilizing the good visual field of the arthroscope, the sleeve is slowly drawn out to expose the folded balloon, a certain amount of medium is pre-drawn by a pressurizing device, a high-pressure three-way device is connected, the injection rod starts to rotate slowly clockwise, and the medium is injected into the balloon; the balloon is expanded and unfolded under the action of the medium, and is restored to a thin cushion shape from the folded cylindrical shape. The pressure gauge can display the pressure inside the sacculus, and the scales on the sleeve can display the volume of the medium injected into the sacculus. When the pressure and volume inside the balloon have been adapted, the continued injection of the medium is stopped. The far end of the handle device props against the one-way valve, the connector of the injection tube is rotated anticlockwise, the injection tube is separated from the one-way valve, and the balloon device is left at the part to be stuffed; the one-way valve is closed under the action of medium pressure in the balloon.

On the basis of researching the structure of the rotator cuff, aiming at the main occurrence part of huge tearing of the rotator cuff, namely, the supraspinatus and the tendon thereof are torn, a balloon device is adopted to replace the torn tendon, the balloon device is made of high polymer medical plastic materials, has good biocompatibility, can be non-absorption materials or absorption materials, has good softness and elasticity, smooth surface and small friction, can bear pressure in the rotator cuff without breaking, is in a thin cushion shape, can be attached to a physiological structure in the rotator cuff, is provided with a one-way valve structure, has certain elasticity, and has a self-sealing function when a medium can flow into the inside of the rotator cuff from a rotator cuff or not; in addition, the pressurizing device is arranged, so that the device can be simultaneously used for open surgery and arthroscopic surgery; the saccule can be pre-vacuumized by a pressurizing device before being implanted into the rotator cuff, folded and curled, has the smallest volume and is suitable for minimally invasive working channels under arthroscopic surgery; when the device is placed at a proper position of the rotator cuff, a certain medium, such as normal saline, is injected into the balloon through a pressurizing device to expand and unfold the balloon; the pressurizing device is provided with capacity scales, and simultaneously, the pressurizing device is provided with a pressure gauge and can control the capacity and the pressure of the injected medium. The invention is also provided with a handle device, one end of the handle device is connected with the saccule, and the other end of the handle device is connected with the pressurizing device through a high-pressure three-way device.

The invention has the beneficial effects that:

(1) the saccule of the invention can be produced in batch, and solves the problem of insufficient source of autologous tendon or allogeneic tendon.

(2) The invention can be used for both open surgery and minimally invasive arthroscopic surgery. When the device is used for minimally invasive arthroscopic surgery, the trauma of the surgery of a patient can be greatly reduced, and the surgery recovery time of the patient is shortened.

(3) The invention has simple operation and is easy to be used in clinic.

Drawings

A more complete understanding of the present invention, and the attendant advantages and features thereof, will be more readily understood by reference to the following detailed description when considered in conjunction with the accompanying drawings wherein:

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a cross-sectional view of the pressurizing means in the present invention;

FIG. 3 is a schematic view of the structure of the handle device of the present invention;

FIG. 4 is a schematic view of a balloon apparatus of the present invention;

FIG. 5 is a partial cross-sectional view of a balloon apparatus of the present invention;

1-pressurizing device, 101-sleeve, 102-wrench, 103-pressure gauge, 104-piston, 105-piston sleeve, 106-nut, 107-connecting pipe, 108-rack, 109-pushing injection rod, 110-spring, 111-connecting pipe joint, 2-high pressure tee joint device, 3-handle device, 301-injection pipe joint, 302-injection pipe, 303-handle, 304-casing head, 305-casing pipe, 306-concave circular ring structure, 4-balloon device, 401-one-way valve, 402-balloon, 403-pipe orifice structure, 404-convex circular ring structure, 405-blade.

Detailed Description

In order to make the contents of the present invention more comprehensible, the present invention is further described below with reference to the accompanying drawings. The invention is of course not limited to this particular embodiment, and general alternatives known to those skilled in the art are also covered by the scope of the invention. The present invention is described in detail with reference to the drawings, and the drawings are not to be considered as limiting the invention, but are enlarged partially in accordance with the general scale for convenience of explanation.

In the following examples, a device for treating a large rotator cuff tear according to the present invention is illustrated in detail with reference to the schematic drawings of fig. 1 to 5. In describing the embodiments of the present invention in detail, the schematic drawings are not drawn to a general scale and are partially enlarged and omitted for convenience of explanation, so that the present invention should not be limited thereto.

As shown in figures 1-5, the invention provides a device for treating giant rotator cuff tear, which comprises a pressurizing device 1, a high-pressure tee joint device 2, a handle device 3 and a balloon device 4 which are connected in sequence;

the pressurizing device 1 comprises a sleeve 101, a wrench 102 and a pressure gauge 103, wherein a piston 104 and a piston sleeve 105 are arranged in the sleeve 101, one end of the sleeve 101 is provided with a screw cap 106, and the other end of the sleeve 101 is provided with a connecting pipe 107; be equipped with the capacity scale on the sleeve 101, the manometer 103 is established on the lateral wall of sleeve 101, be equipped with rack 108 on the spanner 102, and rack 108 stretches into in the sleeve 101, form screw-thread fit with the screw thread of nut 106, still be equipped with injection pole 109 on the spanner 102, be equipped with spring 110 between spanner 102 and the injection pole 109, there is the precompression when spring 110 after the assembly, elasticity, the rack 108 that promotes spanner 102 and the screw-thread engagement of nut 106, injection pole 109 clockwise rotation, push forward and inject, counter-clockwise turning, go back. When the wrench 102 is tightened and the spring is compressed, the rack 108 on the wrench 102 disengages from the threads of the nut 106, and the plunger rod 109 can be pulled rapidly to suck the medium or vacuum the capsule 402 rapidly; one end of the connecting pipe 107 is connected with the high-pressure three-way device 2 through a connecting pipe joint 111;

the handle device 3 comprises an injection pipe connector 301, an injection pipe 302 and a handle 303, the handle 303 is sleeved on the injection pipe 302, one end of the handle 303 is connected with the injection pipe connector 301 in a threaded mode, one end of the injection pipe 302 is connected with the injection pipe connector 301 in an injection molding mode, the other end of the injection pipe 302 penetrates through the handle 303, one end of the handle 303 is sleeved with a sleeve head 304 and a sleeve 305, the sleeve head 304 is of a conical bell mouth structure and can conveniently penetrate through a sleeve after being folded, and the tail end of the sleeve 305 is provided with an inner cylindrical surface chamfer structure which can not scratch the balloon 402 and is beneficial to the removal of the balloon; one end of the handle device 3 is connected with the high-pressure three-way device 2 through an injection pipe joint 301;

the balloon device 4 comprises a one-way valve 401 and a balloon 402, a nozzle structure 403 is arranged on the balloon 402, the nozzle structure 403 is communicated with the inside and the outside of the balloon 402, the one-way valve 401 is arranged in the nozzle structure 403 of the balloon 402, one end of a sleeve 305 is sleeved on the nozzle structure 403, and the injection tube 302 passes through the one-way valve 401 and enters the inside of the balloon 402; an inner concave ring structure 306 is arranged on the outer side wall of the tail end of the injection pipe 302, an outer convex ring structure 404 is arranged on the inner side wall of the one-way valve 401, a blade structure is arranged at one end of the one-way valve 401, when the injection pipe 302 is connected with the one-way valve 401, the inner concave ring structure 306 and the outer convex ring structure 404 are in concave-convex fit, a blade 405 of the one-way valve 401 is propped open by the injection pipe 302, it is shown that the one-way valve 401 is in an open state, and a medium can be injected into; when the syringe 302 is disengaged from the one-way valve 401, the blade 405 closes under its own resilience. If the inside of the balloon 402 is filled with a medium with certain pressure, the pressure acts on the periphery of the blades 404 to further close the inlet of the one-way valve 401, and the inside of the balloon 402 is completely sealed.

The outer cylindrical surface of the one-way valve 401 and the inner cylindrical surface of the pipe orifice structure 403 are assembled by means of bonding, thermal welding, ultrasonic welding or laser welding;

syringe 301 adopts medical polymer material, and syringe 302 adopts medical stainless steel material, and casing head 304 adopts medical plastics material, and sleeve 305 adopts medical stainless steel material, and sacculus 402 and check valve 401 adopt absorbable or non-absorbable medical polymer material.

The working principle is as follows: wrench 102 is squeezed to compress spring 110 to its bottom, and wrench 102 is pulled to draw a vacuum, which draws air from balloon 402 and folds it into a cylindrical shape, and completely encases balloon 402 with sleeve 305. When the vacuum is pumped, the check valve 401 has certain elasticity, forms concave-convex fit with the injection tube 302 and has a sealing function, so that the vacuum can be pumped well; during arthroscopic surgery, firstly, the sleeve 305 is placed in a balloon 402 stuffing position through an arthroscopic surgery working channel, the position of the sleeve 305 is well positioned by utilizing good visual field of an arthroscope, the sleeve 305 is slowly drawn out to expose the folded balloon 402, a certain amount of medium is extracted in advance by the pressurizing device 1, the high-pressure three-way device 2 is connected, the injection rod 109 starts to rotate clockwise slowly, and the medium is injected into the balloon 402; the balloon 402 is inflated and expanded by the medium, and returns to a thin cushion shape from the folded cylindrical shape. Pressure gauge 103 may display the pressure inside balloon 402, and a scale on sleeve 305 may display the volume of medium injected inside balloon 402. When the pressure and volume inside balloon 402 has been adequate, continued injection of media is stopped. The tail end of the handle device 3 is propped against the one-way valve 401, the syringe connector 301 is rotated anticlockwise, the syringe 302 is separated from the one-way valve 401, and the balloon device 4 is left at the position to be stuffed; one-way valve 401 closes under the pressure of the medium inside balloon 402.

On the basis of researching the structure of the rotator cuff, aiming at the main occurrence part of huge tear of the rotator cuff, namely, the supraspinatus and the tendon thereof are torn, the balloon device 4 is adopted to replace the torn tendon, the balloon device 4 is made of high polymer medical plastic materials, has good biocompatibility, can be non-absorption materials or absorbable materials, has good softness and elasticity, smooth surface and small friction, can bear pressure in the rotator cuff without breaking, is in a thin cushion shape, can be attached to a physiological structure in the rotator cuff, and is provided with a one-way valve 401 structure on the balloon device 4, wherein the one-way valve 401 has certain elasticity, and a medium can flow into the inside of the rotator cuff from a nozzle 402 of the rotator cuff, otherwise, has a self-sealing function; in addition, the pressurizing device 1 is arranged, so that the pressurizing device can be used for open surgery and arthroscopic surgery at the same time; the sacculus 402 can be pre-vacuumized, folded and curled by the pressurizing device 1 before being implanted into the rotator cuff, has the smallest volume and is suitable for minimally invasive working channels under arthroscopic surgery; when the device is placed at a proper position of the rotator cuff, a medium, such as physiological saline, is injected into the balloon 402 through the pressurizing device 1, so that the balloon 402 is inflated and unfolded; the pressurizing device 1 is provided with capacity scales and a pressure gauge 103, so that the capacity and the pressure of the injected medium can be controlled.

It is to be understood that while the present invention has been described in conjunction with the preferred embodiments thereof, it is not intended to limit the invention to those embodiments. It will be apparent to those skilled in the art from this disclosure that many changes and modifications can be made, or equivalents modified, in the embodiments of the invention without departing from the scope of the invention. Therefore, any simple modification, equivalent change and modification made to the above embodiments according to the technical essence of the present invention are still within the scope of the protection of the technical solution of the present invention, unless the contents of the technical solution of the present invention are departed.

Claims

1. A device for treating giant rotator cuff tear is characterized by comprising a pressurizing device, a high-pressure tee joint device, a handle device and a balloon device which are connected in sequence; the pressurizing device comprises a sleeve, a wrench and a pressure gauge, a piston and a piston sleeve are arranged in the sleeve, a nut is arranged at one end of the sleeve, a connecting pipe is arranged at the other end of the sleeve, the pressure gauge is arranged on the side wall of the sleeve, a rack is arranged on the wrench, the rack extends into the sleeve and forms threaded fit with threads of the nut, a pushing rod is further arranged on the wrench, a spring is arranged between the wrench and the pushing rod, and one end of the connecting pipe is connected with the high-pressure three-way device through a connecting pipe joint; the handle device comprises an injection pipe joint, an injection pipe and a handle, wherein the handle is sleeved on the injection pipe, one end of the handle is connected with the injection pipe joint in a threaded mode, one end of the injection pipe is connected with the injection pipe joint in an injection molding mode, the other end of the injection pipe penetrates through the handle, a sleeve head and a sleeve are sleeved on one end of the handle, and one end of the handle device is connected with the high-pressure three-way device through the injection pipe joint; the balloon device comprises a one-way valve and a balloon, wherein a pipe orifice structure is arranged on the balloon and is communicated with the inside and the outside of the balloon, the one-way valve is arranged in the pipe orifice structure of the balloon, one end of the sleeve is sleeved on the pipe orifice structure, and the injection tube penetrates through the one-way valve and enters the inside of the balloon.

2. The device for treating giant rotator cuff tear according to claim 1, wherein said cannula head has a conical flare configuration and said cannula has an end with an internal cylindrical chamfer configuration.

3. The device for treating giant rotator cuff tear according to claim 1, wherein said syringe has a concave circular ring structure on the outer side wall of the distal end thereof, and said one-way valve has a convex circular ring structure on the inner side wall thereof, said concave circular ring structure and said convex circular ring structure forming a concave-convex fit when said syringe is connected to said one-way valve.

4. The device for treating giant rotator cuff tear of claim 1, wherein said one-way valve has a blade structure at one end.

5. The device for treating giant rotator cuff tear according to claim 1, wherein said balloon is made of absorbable or non-absorbable medical polymer material.

6. The device for treating giant rotator cuff tear according to claim 1, wherein said sleeve is provided with a volume scale.