CN111867489A - 用于修复软组织并将软组织附接到骨的装置、系统和/或方法 - Google Patents
用于修复软组织并将软组织附接到骨的装置、系统和/或方法 Download PDFInfo
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Abstract
提供用于将软组织固定到骨的装置、系统和/或方法。在一个实施例中,用于利用骨锚固件将软组织固定到骨的修复装置包括软组织锚固件和一个或多个柔性构件。所述软组织锚固件包括基座,所述基座具有从所述基座延伸的多个支腿。所述一个或多个柔性构件联接到所述基座并且被构造成以固定长度从所述基座延伸到所述骨锚固件。利用此布置,所述一个或多个柔性构件的所述固定长度被构造成在所述软组织锚固件与所述骨锚固件之间维持基本上固定的预定距离,使得当所述骨锚固件被置于骨中时,所述一个或多个柔性构件抵靠所述软组织向下拉动所述软组织锚固件,以将所述软组织固定到所述骨。
Description
技术领域
本发明总体上涉及软组织修复部位。更具体地,本发明涉及用于修复软组织并将软组织附接到骨的装置、系统和/或方法。
背景技术
骨科手术中最常见的需求之一是将软组织(诸如韧带或肌腱)固定到骨上。通常,利用骨锚固件和缝合线材料将软组织固定到骨上,缝合线材料联接在软组织与骨锚固件之间,使得软组织抵靠骨收紧。然而,将缝合线联接到软组织是费时的,并且通常需要复杂的缝合线模式才能有效固定,通常需要专门的外科医生。虽然这可以提供良好的初始修复,但是修复的强度和质量可能随后续的负荷和活动而迅速降低,这通常取决于患者的活动水平而进行后续程序。如此,消除这种类型的手术的复杂性和耗时性,同时还增加了手术的长期有效性将是有利的。
发明内容
本发明的实施例涉及用于在软组织修复部位处修复软组织并将软组织附接到骨的各种装置、系统和/或方法。例如,在一个实施例中,提供一种用于将软组织固定到骨的修复装置系统。所述修复装置系统包括骨锚固件、软组织锚固件和一个或多个柔性构件。所述骨锚固件包括在近侧端与远侧端之间延伸的细长结构,所述骨锚固件限定沿着所述细长结构延伸的骨锚固件轴线。所述软组织锚固件包括基座,所述基座具有从所述基座延伸的多个支腿,以便朝向所述骨锚固件延伸。所述一个或多个柔性构件延伸以将所述软组织锚固件联接到所述骨锚固件。另外,所述一个或多个柔性构件被尺寸设定成并且被构造成基本上维持所述软组织锚固件相对于所述骨锚固件以预定的距离间隔开。
在另一实施例中,当将所述骨锚固件置于骨中时,所述一个或多个柔性构件促使所述软组织锚固件同时抵靠所述骨固定所述软组织。在另一实施例中,所述基座限定居中延伸通过所述基座的中心开口,所述软组织锚固件限定相对于所述基座的所述中心开口轴向延伸的组织锚固件轴线,所述组织锚固件轴线被构造成与所述骨锚固件轴线基本上同轴地延伸。在另一实施例中,所述锚固件的所述基座与上表面和下侧表面一起延伸,以在其间限定外周边,所述支腿直接从所述外周边延伸并且弯曲地延伸,以使得所述支腿被构造成朝向所述骨锚固件延伸。在另一实施例中,所述一个或多个柔性构件以连续环延伸。在又一实施例中,所述一个或多个柔性构件包括两个环部分,所述两个环部分从所述骨锚固件向上延伸,以缠绕在所述软组织锚固件的部分周围。
在另一实施例中,所述一个或多个柔性构件包括以编织构型延伸的一个或多个柔性细丝。在另一实施例中,所述一个或多个柔性构件被构造成联接到在骨锚固件的细长结构中限定的凹口、凹槽和通孔中的至少一个。
根据本发明的另一实施例,提供一种用于将软组织固定到骨的医疗装置系统。所述医疗装置系统包括输送器械和修复装置系统。所述输送器械包括限定输送器械轴线的细长部分,并且包括远侧冲击表面。所述修复装置系统被构造成可拆卸地联接到所述输送器械。所述修复装置系统包括骨锚固件、软组织锚固件和一个或多个柔性构件。所述骨锚固件包括在近侧端与远侧端之间延伸的细长结构,所述骨锚固件限定沿着所述细长结构延伸的骨锚固件轴线。所述软组织锚固件包括基座,所述基座具有从所述基座延伸的多个支腿,所述基座限定中心开口,所述中心开口限定组织锚固件轴线。所述一个或多个柔性构件延伸以将所述软组织锚固件联接到所述骨锚固件。利用此布置,所述修复装置系统可拆卸地联接到所述输送器械,其中所述细长部分延伸通过所述软组织锚固件的所述中心开口并且所述远侧冲击表面紧靠所述骨锚固件的所述近侧端,使得当所述骨锚固件被植入骨中时,所述一个或多个柔性构件在所述骨锚固件与所述软组织锚固件之间拉紧地延伸,以同时将所述软组织锚固件拉入所述软组织。
在另一实施例中,所述修复装置系统被构造成与所述输送器械一起被输送,使得所述输送器械轴线与所述骨锚固件轴线和所述组织锚固件轴线基本上共轴或基本上平行。在另一实施例中,当利用所述输送器械将所述骨锚固件置于骨中时,所述一个或多个柔性构件在所述骨锚固件与所述软组织锚固件之间维持基本上固定的距离。在另一实施例中,当利用所述输送器械将所述骨锚固件置于骨中时,所述软组织锚固件利用联接到所述软组织锚固件的所述一个或多个柔性构件抵靠所述骨压缩软组织。在又一实施例中,所述一个或多个柔性构件具有固定长度,使得当所述一个或多个柔性构件处于拉紧位置时,所述一个或多个柔性构件在预输送状态下和已输送状态下在所述骨锚固件与所述软组织锚固件之间维持基本上固定的距离。在另一实施例中,所述骨锚固件在所述骨锚固件的所述远侧端中限定孔,所述孔被尺寸设定成并且被构造成接纳对准部分,所述对准部分从邻近所述输送器械的所述远侧冲击表面处延伸。
在另一实施例中,所述医疗装置系统还包括保持器元件,所述保持器元件具有线和保持部分,所述线沿着所述软组织锚固件的下侧并且朝向所述保持部分延伸,所述保持部分可拆卸地联接到所述输送器械并且被构造成将所述线保持到其上。在另一实施例中,所述医疗装置系统还包括保持器元件,所述保持器元件被尺寸设定成并且被构造成将所述输送器械可拆卸地联接到所述修复装置系统,所述保持器元件具有线,所述线被构造成沿着所述软组织锚固件的下侧定位到所述一个或多个柔性构件处于拉紧位置的位置。
根据本发明的另一实施例,提供一种将软组织固定到骨的方法。所述方法包括以下步骤:提供利用一个或多个柔性构件联接到软组织锚固件的骨锚固件,使得所述骨锚固件与输送器械的远侧冲击表面接合,其中所述软组织锚固件沿着所述输送器械在近侧定位,且所述一个或多个柔性构件沿着所述输送器械在所述骨锚固件与软组织锚固件之间延伸;将所述骨锚固件的远侧端定位在所述软组织的附近且定位在限定在所述骨中的预形成的孔附近,其中所述软组织位于所述骨的上方;以及利用所述输送器械向所述骨锚固件施加力,以驱动所述骨锚固件通过所述软组织并进入所述预形成的孔中,使得当所述骨锚固件被驱动到所述预形成的孔中时,所述一个或多个柔性构件将从所述软组织锚固件的基座延伸的支腿拉入所述软组织中,使得所述基座的下侧抵靠所述软组织的外表面定位,以基本上抵靠所述骨固定所述软组织。
在另一实施例中,所述施加步骤包括将所述骨锚固件驱动到所述预形成的孔中,以基本上同时将所述软组织锚固件联接到所述软组织。在另一实施例中,所述施加步骤包括利用联接到所述骨锚固件的所述一个或多个柔性构件将所述软组织锚固件的所述支腿拉入所述软组织中,以使得当所述骨锚固件被置于所述预形成的孔内时所述软组织锚固件夹紧所述软组织。在另一实施例中,所述施加步骤包括利用所述一个或多个柔性构件在所述骨锚固件与所述软组织锚固件之间维持基本上固定的距离。在又一实施例中,所述施加步骤包括击打所述输送器械的远侧端,以使得所述输送器械的所述远侧冲击表面将所述骨锚固件击打到所述骨的所述预形成的孔中。在再一实施例中,所述提供步骤包括提供用于将所述骨锚固件可拆卸地联接到所述输送器械的保持器元件,所述保持器元件具有线,所述线沿着所述软组织锚固件的下侧延伸,以使得所述一个或多个柔性构件维持拉紧位置。
根据本发明的另一实施例,提供一种用于利用骨锚固件将软组织固定到骨的修复装置。所述修复装置包括软组织锚固件和一个或多个柔性构件。所述软组织锚固件包括基座,所述基座具有从所述基座延伸的多个支腿。所述一个或多个柔性构件联接到所述基座并且被构造成以固定长度从所述基座延伸到所述骨锚固件。
在另一实施例中,所述基座包括联接结构,所述联接结构被构造成将所述一个或多个柔性构件联接到其上,所述联接结构包括突出部、开口和凹口中的至少一个。在另一实施例中,所述一个或多个柔性构件包括以编织构型延伸的一个或多个柔性细丝。在又一实施例中,所述一个或多个柔性构件包括连续环。在再一实施例中,所述一个或多个柔性构件包括一个或多个缝合线。在另一实施例中,所述一个或多个柔性构件沿着所述基座以所述一个或多个柔性构件的下降环部分延伸并通过所述软组织锚固件的所述中心开口。
附图说明
通过阅读以下详细说明并参考附图,本发明的前述和其他优点将变得显而易见,在附图中:
图1是根据本发明的一个实施例的医疗装置系统的分解立体图,描绘了修复装置系统和输送器械;
图2是根据本发明的另一实施例的软组织锚固件的立体图;
图2A是根据本发明的另一实施例的图2的软组织锚固件的俯视图,描绘了从片状材料切下的软组织锚固件;
图2B是根据本发明的软组织锚固件的俯视图,描绘了从片状材料切下的软组织锚固件的另一实施例;
图3是根据本发明的另一实施例的图1的修复装置系统的立体图,描绘了利用一个或多个柔性构件联接到软组织锚固件的骨锚固件;
图3A是根据本发明的软组织锚固件的立体图,描绘了联接到软组织锚固件的一个或多个柔性构件的另一实施例;
图4是根据本发明的另一实施例的图1的医疗装置系统的部分立体图,描绘了在输送修复装置系统之间呈组装形式的医疗装置系统;
图5是根据本发明的另一实施例的医疗装置系统的侧视图,描绘了在输送到骨中预形成的孔以及将软组织固定到骨之前的系统;
图6是根据本发明的另一实施例的修复装置系统的侧视图,描绘了植入骨中的骨锚固件和以固定方式抵靠骨保持软组织的软组织锚固件;
图7是根据本发明的修复装置系统的另一实施例的立体图,描绘了一个柔性构件,其中软组织锚固件和柔性构件联接到骨锚固件的中间部分;
图8是根据本发明的修复装置系统的另一实施例的立体图;
图9是根据本发明的另一实施例的图8的修复装置系统的软组织锚固件的立体图;
图10是根据本发明的另一实施例的图8的修复装置系统的骨锚固件的立体图;
图11是根据本发明的另一实施例的图10的骨锚固件的俯视图;
图11A是根据本发明的另一实施例的沿着图11的截面线A-A截取的骨锚固件的横截面视图;
图11B是根据本发明的另一实施例的沿着图11的截面线B-B截取的骨锚固件的横截面视图;
图12是根据本发明的医疗装置系统的另一实施例的立体图,描绘了图8的输送器械和修复装置系统;
图13是根据本发明的另一实施例的图12的医疗装置系统的放大视图;并且
图13A是根据本发明的另一实施例的沿着图13的截面线A-A截取的医疗装置系统的横截面图,描绘了用于将修复装置系统保持到输送器械的保持器元件。
具体实施方式
本文公开了软组织修复装置和系统的各种实施例。这种修复装置和系统可以被尺寸设定成并被构造成使例如软组织接近并融合到骨。各种实施例可以提供使软组织以邻接关系保持抵靠骨而没有间隙的结构。以这种方式,本发明的修复装置和系统可以提供用于将软组织融合到骨所需的适当的愈合。
参考图1,提供了以分解状态示出的医疗装置系统10的一个实施例。这种医疗装置系统10可以用于将诸如肌腱和韧带的软组织固定到骨。医疗装置系统10可以包括输送器械12和修复装置系统14,输送器械12被设计为促使将修复装置或修复装置系统14锚固到软组织和骨。修复装置系统14可以包括软组织锚固件16,所述软组织锚固件被构造成与骨锚固件18相关联或与其联接。在一个实施例中,软组织锚固件16可以利用一个或多个柔性构件20联接到骨锚固件18。在组装医疗装置系统10后,修复装置系统14可以被尺寸设定成且被构造成将软组织固定到骨,使得当骨锚固件18被置于且被锚固在骨中时,软组织锚固件16可以同时就位并锚固到软组织(参见图5至图6)。
现在参考图2和图2A,现在将描述软组织锚固件16。如所阐述的,软组织锚固件16可以被尺寸设定成且被构造成沉入软组织中并联接到软组织。软组织锚固件16可以包括基座22和从基座22延伸的多个支腿24。软组织锚固件16可以由片状材料形成,以使得包括基座22和多个支腿24的锚固件16可以形成为无缝的、整体的和一件式的结构,如图2A所描绘。软组织锚固件16可以由金属材料形成,诸如不锈钢、钛或镍钛诺,或任何其他合适的医学级材料或材料的组合。可以从片状材料激光切割这种金属材料,或者使用本领域中已知的任何合适的技术来切割这种金属材料。在另一实施例中,软组织锚固件16可以由聚合物材料或生物可吸收材料形成。在从片状材料上切下后,可以弯曲支腿以使支腿向下定位,或者可以移动支腿以使其定向成远离锚固件16的单侧或下侧延伸,如图2所描绘。在支腿30已经适当地定向并弯曲就位后,然后可以视需要对锚固件进行电抛光或化学抛光。在另一实施例中,如本领域普通技术人员已知的,软组织锚固件16可以由医学级聚合物材料形成。在另一实施例中,如本领域普通技术人员已知的,软组织锚固件16可以由生物可吸收材料形成。在另一实施例中,如图2B所描绘,软组织锚固件26可以包括基座28,所述基座具有从其延伸的支腿30,使得支腿30可形成有倒钩32或从其延伸的多个倒钩。这种软组织锚固件26可以以与相对于本文中的图2和图2A描述和描绘的软组织锚固件类似的方式形成,并且可以与本文中描述和描绘的医疗装置系统10(图1)一起使用。
参考图2,软组织锚固件16的基座22可以是平坦的,并且通常包括前面讨论的片状材料的厚度34。基座22可以以大体上圆形构型延伸,其中限定有中心开口36,以便限定平坦的环状结构等。利用这种中心开口36,基座22可以限定上表面38和下侧表面40,每个上表面和下侧表面延伸到基座22的内周边42和外周边44。中心开口36可以轴向居中,以便限定相对于基座22的上表面38和下侧表面40垂直延伸的组织锚固件轴线46(也参见图2A)。另外,上表面38和下侧表面40可以在大多数情况下以平面方式延伸,使得基座22作为平坦结构延伸。在另一实施例中,上表面38和/或下侧表面40可以形成有圆顶构型。
在一个实施例中,锚固件16可以包括联接结构48,所述联接构件被尺寸设定成且被构造成将一个或多个柔性构件20联接到其上。这种联接结构48可以形成在基座22上或中,以便与外周边44或内周边42或两者相关联。例如,基座22可以包括联接结构48,所述联接结构可以呈从基座22向外延伸的多个延伸部或突出部50的形式,以便扩大基座22的上表面38和下侧表面40的表面积。另外,例如,外周边44可以包括三个突出部50,使得每个突出部可以沿着外周边44在分开的多个支腿24对之间延伸。在另一实施例中,联接结构48可以呈形成在外周边中的凹口或凹槽的形式,或者可以是在基座22的上表面38和下侧表面40之间延伸的通孔的形式。在另一实施例中,类似于所描述的,联接结构48可以从基座22的内周边42延伸或限定在其中。在另一实施例中,上面描述的联接结构48可以从基座22的内周边42和外周边44两者延伸或限定在其中等。在又一实施例中,支腿24中的一个或多个可以至少部分地用作用于联接一个或多个柔性构件20的联接结构48。
如先前所述,软组织锚固件16可以包括可从基座22延伸的多个支腿24。例如,软组织锚固件16可以包括六个支腿或更多或更少个支腿。在一些应用中,软组织锚固件16可能仅需要包括三个、四个或五个支腿。在保持强度需要更大的其他应用中,软组织锚固件16可以包括七个或八个支腿。在另一实施例中,多个支腿24可以从外周边44延伸,以便向下弯曲。在一个实施例中,多个支腿24可以在共同方向上延伸。在另一实施例中,支腿24可以向下延伸,以便定向成大体上从基座22的下侧表面40延伸。在另一实施例中,支腿24可以相对于下侧表面40基本上垂直地延伸并且相对于组织锚固件轴线46基本上平行地延伸。在另一实施例中,支腿24中的每一个可以从基座22以曲率52或半径从外周边44延伸,然后大体上线性地延伸到自由端54。利用这种曲率52或半径,支腿24可以相对于基座22向下延伸,使得支腿24的自由端54可以相对于组织锚固件轴线46以径向距离56定位,所述径向距离可以大于外周边44相对于组织锚固件轴线46的径向距离58。外周边44的一些部分,诸如突出部50的端部,可以进一步径向延伸或包括相对于组织锚固件轴线46的径向距离,所述径向距离与支腿24或支腿的自由端54的径向距离56类似。另外,每个支腿24的自由端54可以以自由边缘60延伸,使得每个支腿的端部部分可以以锥形部分62延伸,所述锥形部分被尺寸设定成且被构造成向自由端54渐缩。这种自由边缘60可以由片状材料的厚度34限定并且可以是尖的,以便促使锚固件16的支腿24容易地穿透软组织。
现在参考图3,现在将描述处于组装状态的修复装置系统14及其部件。如先前所述,修复装置系统14可以包括与骨锚固件18相关联或与其联接的软组织锚固件16。骨锚固件18可以被尺寸设定成且被构造成永久地置于预形成的孔(未示出)内。骨锚固件18可以由诸如PEEK(聚醚醚酮)的聚合材料或任何其他合适的聚合材料形成。在另一实施例中,骨锚固件18可以由诸如钛的金属材料或任何其他合适的金属材料或诸如不锈钢的金属材料的组合形成。在又一个实施例中,骨锚固件18可以由诸如PLGA(聚乳酸-共-乙醇酸)的生物可吸收材料或任何其他合适的生物可吸收材料形成。另外,如本领域普通技术人员已知的,可以使用典型的制造工艺来形成这种骨锚固件18。
在一个实施例中,骨锚固件18可以是细长结构70,以限定骨锚固件轴线72,骨锚固件轴线72相对于细长结构70轴向且居中延伸。骨锚固件18的细长结构70可以在近侧端74与远侧端76之间延伸。在一个实施例中,骨锚固件18可以被尺寸设定成且被构造成联接到前面描述的软组织锚固件16。在另一实施例中,骨锚固件18可以包括骨联接结构78,所述骨联接结构被尺寸设定成且被构造成联接到骨。例如,骨联接结构78可以包括沿着骨锚固件18的外表面82的多个肋80。多个肋80可以相对于骨锚固件18的细长结构70横向延伸。多个肋80中的每一个可以在骨锚固件18的外表面82周围连续地延伸,使得肋80可以各自展现出横向延伸的弓形结构。另外,多个肋80中的每一个可以相对于彼此均匀地间隔开。另外,每个肋80可以各自延伸以限定近侧肋架84和下降的渐缩的侧壁86,从而从近侧肋架84向下渐缩,使得侧壁86可以向下延伸到远侧肋的近侧肋架84。在另一实施例中,骨联接结构78可以包括绕线,所述绕线沿着骨锚固件18的外表面82延伸。
骨锚固件18的近侧端74可以包括近侧端表面88,所述近侧端表面可以限定大体上圆形的轮廓。另外,近侧端表面88可以限定近侧端孔90或凹槽,所述孔或凹槽可以接纳输送器械12的接合结构142(图1),在本文中进一步讨论。这种近侧端孔90可以沿着骨锚固件轴线72且在近侧端表面88内居中对准。另外,近侧端孔90可以限定有向下或向远侧延伸的侧壁92或多个侧壁。在一个实施例中,远侧端延伸的侧壁92可以朝向骨锚固件轴线72稍微向内渐缩,以便促使被尺寸设定成且被构造成插入近侧端孔90中的输送器械12的接合结构142(图1)的过盈配合。在另一实施例中,接合结构142可以朝向输送器械12的远侧端122稍微渐缩(见图1)。
骨锚固件18的远侧端76或远侧端部分可以在其中限定凹口94或凹槽。这种凹口94可以被尺寸设定成且被构造成接纳一个或多个柔性构件20中的一个的一部分。凹口94可以是作为在骨锚固件18的远侧端76中的通道延伸的开口,使得凹口94可以在骨锚固件18的远侧端部分内延伸,以使得凹口94的一部分延伸通过骨锚固件18的远侧端部分的相对侧96。以这种方式,邻近骨锚固件18的远侧端76的凹口94可以接纳一个或多个柔性构件20中的一个,然后在凹口94内被拉得更深,以使得柔性构件20可以延伸通过凹口94的邻近骨锚固件18的远侧端部分的相对侧96并从其延伸。
如先前所述,软组织锚固件16可以利用一个或多个柔性构件20联接到骨锚固件18。一个或多个柔性构件20可以由一个或多个聚合物细丝或纤维形成。聚合物细丝或纤维可以是聚乙烯材料,诸如超高分子量聚乙烯(“UHMWPE”)、聚酯材料、聚丙烯材料等。在另一实施例中,一个或多个柔性构件20可以由缝合线材料形成。在另一实施例中,聚合物细丝或纤维可以是生物可吸收材料,诸如聚丙交酯(“PLA”)、聚己内酯(“PCL”)、聚二恶烷酮(“PDX”)等,或如本领域普通技术人员已知的任何一种合适的生物可吸收材料。在另一实施例中,细丝或纤维可以以纺织或编织构型形成,或者可以与以并排构型卷绕的股线一起延伸,或者可以与并排卷绕的股线一起并且以扭绞构型或任何其他合适的构型延伸以形成柔性构件。
在一个实施例中,一个或多个柔性构件20可以包括第一柔性构件98和第二柔性构件100。第一柔性构件98可以以连续环延伸。第一柔性构件的连续环可以被尺寸设定成且被构造成在基座22的联接结构48(诸如突出部50)周围延伸,以使得连续环缠绕在软组织锚固件16的基座22周围。第一柔性构件98的连续环可以以具有编织或纺织构型的细丝延伸。在另一实施例中,第一柔性构件可以是由一个或多个柔性细丝制成的柔性缠绕物,所述柔性缠绕物可以卷绕在基座22的联接结构48(诸如突出部50)周围,使得一个或多个柔性细丝可以以多个绕组卷绕。
第二柔性构件100可以以连续环延伸。在另一实施例中,第二柔性构件100可以以具有两个自由端的环延伸。在另一实施例中,第二柔性构件100可以是缝合线等。第二柔性构件100可以延伸以缠绕在邻近软组织锚固件16的基座22的第一柔性构件98周围并与其联接。另外,第二柔性构件100可以在多个位置,诸如沿着第一柔性构件98的三个位置处联接到第一柔性构件98。例如,第二柔性构件100可以缠绕在介于第一柔性构件98的连接点104与基座22的突出部50之间的中间部分102上方并与其联接,使得第二柔性构件100可以相对于基座22向内拉动中间部分102并且在邻近基座22的内周边42的中心开口36上方拉动所述中间部分。从第一柔性构件98的中间部分102,第二柔性构件100可以以可以呈下降环部分106形式的下降柔性构件部分向下延伸通过软组织锚固件16的中心开口36。下降环部分106可以包括下环部分108,所述下环部分可以联接到骨锚固件18。在一个实施例中,下降环部分106的下环部分108可以插入到骨锚固件18中限定的凹口94中,以将软组织锚固件16联接到骨锚固件18,如先前所描述。从第一柔性构件98下降的下降环部分106可以以预定长度110向下延伸,以使得骨锚固件18可以定位成距软组织锚固件16预定距离。以这种方式,修复装置系统14可以与一个或多个柔性构件20,诸如第一柔性构件98和第二柔性构件100组装在一起,从而将软组织锚固件16联接到骨锚固件18。另外,以这种方式,在将一个或多个柔性构件20拉紧后,软组织锚固件16可以与骨锚固件18保持基本上固定的距离。另外,软组织锚固件16可以利用一个或多个柔性构件20联接到骨锚固件18,使得组织锚固件轴线46和骨锚固件轴线72可以相对于彼此基本上同轴或基本上平行。
关于图3A,提供了以连续环形式延伸的第二柔性构件112的另一实施例。在此实施例中,第二柔性构件112可以以先前描述的类似方式联接到第一柔性构件98和软组织锚固件16。在此实施例中,第二柔性构件112可以围绕第一柔性构件98的中间部分102成环,使得连续的环可以在一个环端部分114处穿过其自身,然后以下降环部分116向下延伸,所述下降环部分被尺寸设定成且被构造成联接到骨锚固件18(图3),类似于先前描述的下降环部分。
如图3所描绘,通过组装修复装置系统14,组装的修复装置系统可以与输送器械12组装在一起,如图4所描绘。现在参考图1、图3、图4和图5,现在将描述输送器械12以及与修复装置系统14的组装。
输送器械12可以是在具有纵向长度124的在近侧端120与远侧端122之间延伸的细长结构。输送器械12可以限定沿着输送器械12的长度124居中延伸的输送器械轴线126。近侧端120可以限在手柄130近侧定位的近侧冲击表面128。输送器械12还可以包括冲击轴132,所述冲击轴联接到手柄130并且沿着输送器械轴线126从手柄130纵向地向远侧延伸。另外,输送器械12可以包括远侧端部分134,所述远侧端部分134包括夹持部分136、对准部分138、远侧冲击表面140和接合结构142。夹持部分136可以联接到冲击轴132的远侧部分,并且可以包括一个或多个夹具144,用于将软组织锚固件16悬挂在夹持部分136的远侧下侧附近。对准部分138可以在夹持部分136的远侧以圆柱形结构延伸,并且可以是冲击轴132的连续延伸部。接合结构142可以在对准部分138的远侧延伸,并且更具体地,可以从远侧冲击表面140延伸并在其远侧延伸。远侧冲击表面140可以被定义为从接合结构142横向延伸的架146,并且可以相对于输送器械轴线126基本上垂直地延伸。接合结构142可以是圆柱形等,并且可以被尺寸设定成且被构造成与骨锚固件18的近侧端孔90配合并对应,以使得远侧冲击表面140紧靠骨锚固件18的近侧端表面88。利用此布置,输送器械12的远侧端部分134可以可拆卸地联接到修复装置系统14,如下所述。
通过组装修复装置系统14,可以将输送器械12的对准部分138插入通过软组织锚固件16的中心开口36,然后将接合结构142定位到骨锚固件18的近侧端孔90中。一个或多个夹具144可以沿着软组织锚固件16的基座22的下侧表面定位,以将软组织锚固件16悬挂在夹持部分136的下侧下方。在此位置中,可以将包括下降环部分106的一个或多个柔性构件20放置在稍微拉紧的定向或位置中。通过将修复装置系统14联接到输送器械12的远侧端部分134,组织锚固件轴线46、骨锚固件轴线72和输送器械轴线126中的每一个可以相对于彼此同轴或基本上同轴。另外,利用此布置,修复装置系统14可以可拆卸地联接到输送器械12的远侧端部分134,并且可以用于将软组织5固定到骨7。
现在参考图5和图6,现在将描述用于与输送器械12一起输送修复装置系统14的实施例。在准备输送修复装置系统14时,医师可以在骨7中邻近固定软组织5所需的位置处形成孔9。如本领域普通技术人员已知的,可以利用适当尺寸的锥子(未示出)等来在骨7中制备这种孔9。孔9的深度可以比骨锚固件18的高度或伸长长度更深,并且其应被尺寸设定成且被构造成以过盈配合接纳骨锚固件18,使得骨锚固件18的肋80稳定并适当地将骨锚固件18置于骨7中。当在骨7中预形成了适当的孔9后,医师可以将期望用于固定到骨7的软组织5的一部分定位到骨7中的预形成的孔9上方的位置。然后,医师可以在骨7中预形成的孔9正上方的软组织5内,诸如用解剖刀形成细缝(未示出)。然后,与输送器械12组装在一起的骨锚固件18的远侧端76可以被定位并插入通过软组织5中的狭缝,以使得远侧端76位于骨7中预形成的孔9的顶部13内。然后,医师可以使输送器械12定向,以使得输送器械12可以与预形成的孔9的中心轴线11基本上对准并且同轴。在此接合处,医师可以使用诸如锤子(未示出)的冲击器械来冲击输送器械12的近侧冲击表面128。锤子的冲击力直接转化为施加在与输送器械12的远侧冲击表面140邻接的骨锚固件18的近侧端表面88上的冲击力(见图1和图3)。随着医师继续锤击输送器械12的近侧冲击表面128,可以将骨锚固件18驱动到预形成的孔9中,达到医师希望的深度。另外,随着将骨锚固件18更深地驱动到预形成的孔9中,可以同时将软组织锚固件16的支腿24驱动到软组织5中。
在骨锚固件18就位时或在完全就位之前,可以移除抵靠夹持部分136保持软组织锚固件16的一个或多个夹具144(图4)。随着医师继续将骨锚固件18置于预形成的孔9中达到骨7的外表面15下方的深度,当由于导致骨锚固件18与软组织锚固件16之间具有固定距离的一个或多个柔性构件20的固定长度(以及下降环部分106的预定长度110(图3))而使骨锚固件18向下冲击时,软组织5被夹持力150抵靠骨7的外表面15夹持,而软组织锚固件16被向下施加力。由于可能遇到的软组织5的厚度的可变性,医师可以通过继续将骨锚固件18驱动到骨中直到用适当的夹持力抵靠骨7夹持软组织5为止来测量抵靠骨7的夹持力150或软组织5的厚度。以这种方式,修复装置系统14可以用于各种厚度的软组织5。
另外,修复设备系统14通过消除用于抵靠骨和植入的骨锚固件穿引和系紧软组织所必需的复杂缝合线样式来为医师提供优势,而本发明的修复装置系统14在将骨锚固件18适当地置于骨7中之后,软组织5同时被软组织锚固件16固定到骨。另外,修复装置系统14通过以集中方式可植入而无需将切向部件和缝合线联接在非集中位置来使潜在问题最小化,从而消除了由于多个非集中部件而造成的复杂性和潜在的刺激。
另外,参考图3和图6,第二柔性构件100联接到第一柔性构件98促成了邻近软组织锚固件16的基座22的内周边42的多个附接点,从而更有效地跨软组织锚固件16的基座22的下侧表面40抵靠软组织5分布夹持力150。甚至进一步,通过一个或多个柔性构件20沿着围绕基座22的突出部50的多个附接点以及在第一柔性构件98与第二柔性构件100之间在中间部分102处的联接所产生的夹持力150的这种分布最小化了第一柔性构件98和第二柔性构件100发生故障的可能性。此外,在软组织5相对于软组织锚固件16和骨锚固件18的轴线46、72变得受到横向负载时,一个或多个柔性构件20在其邻近软组织锚固件16的内周边42的多个附接点处可以基本上最小化由于沿着中间部分102在第一柔性构件98与第二柔性构件100之间的附接点处的弹簧效应而导致的潜在过载,从而最小化修复部位的潜在故障,并最小化支腿24通过软组织5的潜在横向撕裂。而且,在愈合过程中以及此后,在软组织5因患者的活动而变得受到负载时,软组织锚固件16的夹持力150和置于软组织5内的多个支腿24之间的配合可以基本上防止软组织5相对于骨7的横向移动,从而维持软组织5正确地固定到骨7,并最小化故障和进行后续手术的可能性。而且,在完全愈合后,暴露在软组织上方的唯一部件可以是软组织锚固件16的上表面以及一个或多个柔性构件20的部分,以为植入物提供非常低的暴露轮廓,从而最小化对患者的任何潜在长期刺激,并最小化在愈合过程期间的潜在刺激。
现在参考图7,提供了修复装置系统160的另一实施例。修复装置系统160的此实施例可以包括类似的结构特征,并且可以以与图3的修复装置系统14类似的方式采用并且在先前的实施例中进行了描述。修复装置系统160的此实施例可以包括利用一个或多个柔性构件166联接到骨锚固件164的软组织锚固件162。软组织锚固件162可以类似于图2的软组织锚固件,并且可以包括基座168,所述基座具有在内周边174与外周边176之间延伸的上表面170和下侧面172。在此实施例中,基座168还可以包括多个支腿180,诸如八个支腿,每个支腿以曲率182或半径从外周边176延伸并且相对于基座168的下侧表面172向下延伸。另外,在此实施例中,外周边176可以不限定图2中描绘的突出部50,使得联接结构可以是基座168和支腿180的部分。骨锚固件164可以包括与图3中描述和描绘的骨锚固件18的类似结构,但是在此实施例中,骨锚固件164可以限定延伸通过骨锚固件164的中间部分186的孔口184,使得孔口184可以延伸到骨锚固件164的相对侧188。
另外,在此实施例中,一个或多个柔性构件166可以以单个柔性构件190延伸。这种单个柔性构件190可以作为连续环或封闭环延伸,或者延伸有两个自由端。单个柔性构件190可以是可以被纺织在一起以形成单个柔性构件190的一个或多个柔性细丝。单个柔性构件190可以联接到基座168并且抵靠软组织锚固件162的支腿180的部分联接。另外,单个柔性构件190可以从基座168延伸并通过由软组织锚固件162的内周边174限定的中心开口192,以便以向下下降部分194延伸,以延伸通过在骨锚固件164中限定的孔184。以这种方式,单个柔性构件190可以联接到骨锚固件164和软组织锚固件162。利用此布置,类似于图5和图6中描述和描绘的修复装置系统14,修复装置系统160可以联接到骨和软组织,以将软组织固定到骨。
现在参考图8,可以用于将软组织固定到骨的修复装置系统200的另一实施例。修复装置系统200的此实施例可以类似地起作用并且包括与在先前实施例中描绘的修复装置系统类似的结构。例如,修复装置系统200可以包括利用一个或多个柔性构件206互连到骨锚固件204的软组织锚固件202。如在先前的实施例中,修复装置系统200可以例如与图5的输送器械12一起使用,并且可以以与本文中图5和图6所描绘和描述的类似的方式和类似的功能性用于将软组织联接到骨。另外,对于本领域普通技术人员将显而易见的是,此实施例的修复装置系统200可以与输送器械250一起使用,如图12所描绘,使得修复装置200和输送器械250可以以与将软组织固定到骨的类似功能性采用,如在图5和图6中描述和描绘的那样。
参考图8和图9,软组织锚固件202可以包括基座208和多个支腿210,每个支腿可以从基座208向下或在基本上类似或共同的方向上延伸。如在先前的实施例中,基座208可以展现出大体上圆形的轮廓。基座208可以展现出具有支腿210的垫圈结构或从其延伸的锚固结构。基座208可以包括上表面212和下侧表面214,每个上表面和下侧面延伸并限定外周边216和内周边218。内周边218可以限定中心开口220或圆形开口,所述开口可以对称地限定在基座208中。支腿210可以直接从外周边216延伸,使得支腿210可以展现出弯曲或曲线,然后远离下侧表面214延伸。在一个实施例中,支腿210可以是细长的,并且沿着支腿的伸长长度的大部分相对于基座208的下侧表面214大体上垂直地延伸。支腿210可以延伸到远侧端或自由端222,并且可以被尺寸设定成且被构造成沉入软组织并与软组织接合。在一个实施例中,如果没有支腿210的邻近基座208的外周边216的上述弯曲或曲线部分,则支腿210可以维持可以大体上线性地延伸的固定构型(在软组织中的输送前和输送后)。在一个实施例中,类似于先前的实施例,支腿210的自由端222或自由端部分可以展现出笔直的边缘轮廓(侧视图)并且还可以展现出点轮廓(前视图)。在另一实施例中,支腿210中的每一个可以延伸类似的长度。软组织锚固件202的支腿210可以具有长度224,所述长度被尺寸设定成且被构造成以部分深度延伸到软组织中,并且不完全通过软组织。在一个实施例中,软组织锚固件202可以包括六个支腿210或更多个,诸如八个支腿。在另一实施例中,软组织锚固件202可以包括四个支腿,或至少四个支腿210。在另一实施例中,软组织锚固件202可以包括至少三个支腿210。
另外,在另一实施例中,软组织锚固件202的基座208和支腿210可以充当用于柔性构件206的联接结构。例如,柔性构件206可以联接到两个相邻的支腿210以及基座208的部分,类似于在图7的实施例中描述和描绘的并且在本文中进一步详细讨论的。如此,在此实施例中,如果没有支腿210,则软组织锚固件202的基座208的外周边216可以以圆形轮廓延伸,以便不展现出如先前实施例中所描述的突出部。利用此布置,柔性构件206可以有效地将软组织锚固件202联接到骨锚固件204。
参考图8、图10和图11,现在将描述修复装置系统200的骨锚固件204。类似于先前的实施例,骨锚固件204可以是在近侧端226与远侧端228之间延伸并且沿着骨锚固件204的纵向长度232限定骨锚固件轴线230的细长结构。另外,骨锚固件204可以以圆形轮廓横向延伸(见图11),并且可以限定沿着骨锚固件204的外表面236径向延伸的肋234。另外,类似于先前的实施例,骨锚固件204可以在骨锚固件204内限定第一孔238和第二孔240。第一孔238可以沿着骨锚固件轴线230纵向延伸,并且沿着骨锚固件204的近侧端226限定在表面中。第二孔240可以相对于骨锚固件轴线230横向延伸,并且可以在邻近骨锚固件204的远侧端228或者在更靠近骨锚固件204的远侧端228而非近侧端226的位置处在骨锚固件204的相对侧之间延伸。
关于图10、图11A和图11B,骨锚固件204可以包括平坦部分242或平坦侧表面(见图11)。这种平坦部分242可以沿着骨锚固件的相对侧延伸,以便沿着骨锚固件204的外表面236至少部分地限定在肋234中。这种平坦部分242可以从横向第二孔240延伸到骨锚固件204的近侧端226。通过这种平坦部分242,柔性构件206(图8)可以延伸通过横向第二孔240,并且沿着相对的平坦部分242朝向软组织锚固件202向上延伸(见图8)。利用此布置,肋234可以以不连续的方式在骨锚固件204的外表面236上径向地延伸,以便相对于其他肋234是分开和分立的。另外,骨锚固件204的外表面236可以展现出沿骨锚固件204的远侧部分244的结构,以在骨锚固件204被植入骨中时辅助骨锚固件204保持适当的定向和对准。例如,骨锚固件204的远侧部分244可以从第二孔240以圆柱形表面246向远侧端延伸,所述圆柱形表面可以向远侧过渡到圆锥形表面248,以便朝向骨锚固件204的远侧端228渐缩。
另外,如先前所述,骨锚固件204可以限定第一孔238和第二孔240。第一孔238可以被尺寸设定成且被构造成在骨锚固件204的近侧端226处接纳输送器械250的接合部分252(见图13A)。第一孔238可以以比先前实施例中所描绘的更深的方式在骨锚固件204内延伸,以使得第一孔238延伸超过骨锚固件204的伸长长度232的大部分。如此,第一孔238可以被尺寸设定成确保适当的接合并维持与输送器械250的接合部分252对准。第二孔240可以横向地延伸通过邻近骨锚固件204的相对平坦部分242的下端的骨锚固件204的相对侧并且在其间横向延伸。另外,第二孔240可以延伸通过骨锚固件204,以便对称地延伸通过骨锚固件轴线230。如图11B所示,第二孔240可以展现出椭圆形轮廓,所述椭圆形轮廓被尺寸设定成且被构造成接纳并保持柔性构件206(图8)。以这种方式,柔性构件206的部分可以以并排布置的方式延伸通过第二孔。
现在参考图8、图12、图13和图13A,类似于先前的实施例,修复装置系统200可以可拆卸地联接到输送器械250。如在先前的实施例中,软组织锚固件202可以利用一个或多个柔性构件206以及如在此实施例中所描绘的单个柔性构件206来维持与骨锚固件204的联接布置。例如,柔性构件206可以延伸通过在骨锚固件204中限定的横向延伸的第二孔240,以使得柔性构件206的两个相对的端环256可以沿着骨锚固件204的相对的平坦部分242向近侧延伸。然后,可以将端环256定位成通过软组织锚固件202的中心开口220,以使得两个端环256的每个端部分可以缠绕在例如组织锚固件202的两个相邻的支腿210和基座208的部分周围。以这种方式,软组织锚固件202可以联接到骨锚固件204以形成修复装置系统200。
另外,类似于先前的实施例,修复装置系统200可以用于利用输送器械250将软组织固定到骨。例如,在此实施例中,输送器械250可以包括手柄258和轴260,所述输送器械250限定了在其中纵向延伸的输送器械轴线262。类似于先前的实施例,手柄258可以限定近侧端表面,所述近侧端表面可以用作近侧冲击表面264(用于用锤子冲击)。轴260可以固定地联接到手柄258,并且可以在向远侧纵向延伸到远侧端部分266。远侧端部分266可以包括对准部分268、接合部分252和远侧冲击表面272。对准部分268可以被尺寸设定成且被构造成通过软组织锚固件202的中心开口220而定位。接合部分252可以被尺寸设定成且被构造成插入通过限定在骨锚固件204的近侧端226中的第一孔238,以使得输送器械250的远侧冲击表面272与骨锚固件204的近侧端226或近侧表面邻接。利用此布置,输送器械轴线262可以与骨锚固件轴线230同轴。
在此实施例中,修复装置系统200可以利用保持器元件274可拆卸地联接到输送器械250。如先前所述,通过输送器械250的远侧端部分266与骨锚固件204接合,保持器元件274可以被尺寸设定成且被构造成沿着轴260的远侧端部分266保持和悬挂软组织锚固件202,以使得柔性构件206拉紧或处于拉紧位置。在此拉紧位置中,软组织锚固件202可以被保持在骨锚固件204处并且与所述骨锚固件间隔预定距离,以便被悬挂在骨锚固件204上方。保持器元件274可以包括线276和突片278。如图13A中所描绘,线276可以沿着软组织锚固件202的基座208的下侧表面214延伸,并且在基座208的两侧上向上延伸到突片278。突片278可以在其中限定通道280或用于保持线276的部分的联接结构。突片278也可以被尺寸设定成例如通过过盈配合等联接到输送器械250的轴260,使得线可以缠绕在轴260周围,以便有助于过盈配合。以这种方式,保持器元件274可以将柔性构件206维持在拉紧位置,以便临时地和可拆卸地将修复装置系统200保持或联接到输送器械250,并且在利用修复装置系统200将软组织固定到骨时,可以通过例如将线276剪断然后从软组织锚固件202下方拉出来将线移除。在另一实施例中,保持器元件274的突片278可以从轴260移除,以促进释放保持在突片278与轴260之间的缠绕线276,从而从修复装置系统200释放输送器械250。
本文公开的各种修复装置和系统实施例或其他实施例可以应用于各种软组织到骨的修复中的任一种。例如,各种修复装置实施例可以用于屈肌腱修复、髌骨肌腱修复、跟腱修复、股四头肌腱修复和/或二头肌腱修复,或任何其他肌腱/韧带到骨的修复,诸如Kidner手术或插入式跟腱修复,或其他任何肌腱/韧带到骨的修复。如此,可以适当地设定修复装置的尺寸以正确地固定到不同尺寸或类型的软组织和骨。
虽然本发明可能容易受到各种修改和替代形式的影响,但是在附图中借助于实例示出了具体的实施例,并且在本文中对其进行了详细描述。另外,本文所公开的任何一个实施例的结构特征可以被本文中所阐述的另一实施例的结构特征中的任何一个组合或替换。如此,应理解,本发明不旨在限于所公开的特定形式。而是,本发明包括将一个实施例的任何部分与落入由所附权利要求书限定的本发明的精神和范围内的另一实施例、所有修改、等同物和替代物一起使用。
Claims (20)
1.一种用于将软组织固定到骨的修复装置系统,所述修复装置系统包括:
骨锚固件,其具有在近侧端与远侧端之间延伸的细长结构,所述骨锚固件限定沿着所述细长结构延伸的骨锚固件轴线;
软组织锚固件,其具有基座,所述基座具有从所述基座延伸的多个支腿,以便朝向所述骨锚固件延伸;以及
一个或多个柔性构件,其延伸以将所述软组织锚固件联接到所述骨锚固件,所述一个或多个柔性构件被尺寸设定成并且被构造成基本上维持所述软组织锚固件相对于所述骨锚固件以预定的距离间隔开。
2.根据权利要求1所述的修复装置系统,其中,当将所述骨锚固件置于骨中时,所述一个或多个柔性构件促使所述软组织锚固件同时抵靠所述骨固定所述软组织。
3.根据权利要求1所述的修复装置系统,其中,所述基座限定居中延伸通过所述基座的中心开口,所述软组织锚固件限定相对于所述基座的所述中心开口轴向延伸的组织锚固件轴线,所述组织锚固件轴线被构造成与所述骨锚固件轴线基本上同轴地延伸。
4.根据权利要求1所述的修复装置系统,其中,所述锚固件的所述基座与上表面和下侧表面一起延伸,以在其间限定外周边,所述支腿直接从所述外周边延伸并且弯曲地延伸,以使得所述支腿被构造成朝向所述骨锚固件延伸。
5.根据权利要求1所述的修复装置系统,其中,所述一个或多个柔性构件以连续环延伸。
6.根据权利要求1所述的修复装置系统,其中,所述一个或多个柔性构件包括两个环部分,所述两个环部分从所述骨锚固件向上延伸,以缠绕在所述软组织锚固件的部分周围。
7.一种用于将软组织固定到骨的医疗装置系统,所述医疗装置系统包括:
输送器械,其具有细长部分,所述细长部分限定输送器械轴线,所述输送器械包括远侧冲击表面;以及
修复装置系统,其被构造成可拆卸地联接到所述输送器械,所述修复装置系统包括:
骨锚固件,其具有在近侧端与远侧端之间延伸的细长结构,所述骨锚固件限定沿着所述细长结构延伸的骨锚固件轴线;
软组织锚固件,其具有基座,所述基座具有从所述基座延伸的多个支腿,所述基座限定中心开口,所述中心开口限定组织锚固件轴线;以及
一个或多个柔性构件,其延伸以将所述软组织锚固件联接到所述骨锚固件;
其中,所述修复装置系统可拆卸地联接到所述输送器械,其中所述细长部分延伸通过所述软组织锚固件的所述中心开口并且所述远侧冲击表面紧靠所述骨锚固件的所述近侧端,使得当所述骨锚固件被植入骨中时,所述一个或多个柔性构件在所述骨锚固件与所述软组织锚固件之间拉紧地延伸,以同时将所述软组织锚固件拉入所述软组织。
8.根据权利要求7所述的医疗装置系统,其中,所述修复装置系统被构造成与所述输送器械一起被输送,使得所述输送器械轴线与所述骨锚固件轴线和所述组织锚固件轴线基本上共轴或基本上平行。
9.根据权利要求7所述的医疗装置系统,其中,当利用所述输送器械将所述骨锚固件置于骨中时,所述一个或多个柔性构件在所述骨锚固件与所述软组织锚固件之间维持基本上固定的距离。
10.根据权利要求7所述的医疗装置系统,其中,当利用所述输送器械将所述骨锚固件置于骨中时,所述软组织锚固件利用联接到所述软组织锚固件的所述一个或多个柔性构件抵靠所述骨压缩软组织。
11.根据权利要求7所述的医疗装置系统,其中,所述一个或多个柔性构件具有固定长度,使得当所述一个或多个柔性构件处于拉紧位置时,所述一个或多个柔性构件在预输送状态下和已输送状态下在所述骨锚固件与所述软组织锚固件之间维持基本上固定的距离。
12.根据权利要求7所述的医疗装置系统,还包括保持器元件,所述保持器元件具有线和保持部分,所述线沿着所述软组织锚固件的下侧并且朝向所述保持部分延伸,所述保持部分可拆卸地联接到所述输送器械并且被构造成将所述线保持到其上。
13.根据权利要求7所述的医疗装置系统,还包括保持器元件,所述保持器元件被尺寸设定成并且被构造成将所述输送器械可拆卸地联接到所述修复装置系统,所述保持器元件具有线,所述线被构造成沿着所述软组织锚固件的下侧定位到所述一个或多个柔性构件处于拉紧位置的位置。
14.根据权利要求7所述的医疗装置系统,其中,所述骨锚固件在所述骨锚固件的所述远侧端中限定孔,所述孔被尺寸设定成并且被构造成接纳对准部分,所述对准部分从邻近所述输送器械的所述远侧冲击表面处延伸。
15.一种将软组织固定到骨的方法,所述方法包括:
提供利用一个或多个柔性构件联接到软组织锚固件的骨锚固件,使得所述骨锚固件与输送器械的远侧冲击表面接合,其中所述软组织锚固件沿着所述输送器械在近侧定位,且所述一个或多个柔性构件沿着所述输送器械在所述骨锚固件与软组织锚固件之间延伸;
将所述骨锚固件的远侧端定位在所述软组织的附近且定位在限定在所述骨中的预形成的孔附近,其中所述软组织位于所述骨的上方;以及
利用所述输送器械向所述骨锚固件施加力,以驱动所述骨锚固件通过所述软组织并进入所述预形成的孔中,使得当所述骨锚固件被驱动到所述预形成的孔中时,所述一个或多个柔性构件将从所述软组织锚固件的基座延伸的支腿拉入所述软组织中,使得所述基座的下侧抵靠所述软组织的外表面定位,以基本上抵靠所述骨固定所述软组织。
16.根据权利要求15所述的方法,其中,所述施加包括将所述骨锚固件驱动到所述预形成的孔中,以基本上同时将所述软组织锚固件联接到所述软组织。
17.根据权利要求15所述的方法,其中,所述施加包括利用联接到所述骨锚固件的所述一个或多个柔性构件将所述软组织锚固件的所述支腿拉入所述软组织中,以使得当所述骨锚固件被置于所述预形成的孔内时所述软组织锚固件夹紧所述软组织。
18.根据权利要求15所述的方法,其中,所述施加包括利用所述一个或多个柔性构件在所述骨锚固件与所述软组织锚固件之间维持基本上固定的距离。
19.根据权利要求15所述的方法,其中,所述施加包括击打所述输送器械的远侧端,以使得所述输送器械的所述远侧冲击表面将所述骨锚固件击打到所述骨的所述预形成的孔中。
20.根据权利要求15所述的方法,其中,所述提供包括提供用于将所述骨锚固件可拆卸地联接到所述输送器械的保持器元件,所述保持器元件具有线,所述线沿着所述软组织锚固件的下侧延伸,以使得所述一个或多个柔性构件维持拉紧位置。
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CN111867489B (zh) | 2024-04-16 |
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AU2019223962A1 (en) | 2020-09-10 |
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WO2019164853A1 (en) | 2019-08-29 |
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CN118303936A (zh) | 2024-07-09 |
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