CN1988859B

CN1988859B - Apparatus and method for reconstructing a ligament

Info

Publication number: CN1988859B
Application number: CN2005800201993A
Authority: CN
Inventors: P·勒; M·A·约翰森; P·F·马沙尔
Original assignee: Scandius Biomedical Inc
Current assignee: Enterprise holding Co.; Covidien LP
Priority date: 2004-04-22
Filing date: 2005-04-22
Publication date: 2010-06-16
Anticipated expiration: 2025-04-22
Also published as: JP4879166B2; CA2564775A1; EP1746955A4; JP2007534380A; CN1988859A; CN101816584A; AU2005253927B2; CA2564775C; JP5325257B2; JP2011177524A; AU2005253927A1; EP1746955A2

Abstract

A method and apparatus for reconstructing a ligament. In one preferred form of the invention, provided is a graft ligament support block which comprises a body, and a graft hole and a transverse fixation pin hole extending through the body, with both the graft hole and the fixation pin hole preferably extending substantially perpendicular to the longitudinal axis of the body. In one preferred form of the invention, the invention also comprises an installation tool for inserting the graft ligament support block into the bone tunnel and, while supporting the graft ligament support block in the bone tunnel, forming a transverse tunnel in the host bone, with the transverse tunnel in the host bone being aligned with the transverse fixation pin hole in the graft ligament support block. In one preferred method of use, a graft ligament is looped through the graft hole in the graft ligament support block, and the graft ligament support block is mounted to the installation tool. Then the installation tool is used to advance the graft ligament support block through the tibial tunnel, across the interior of the knee joint, and up into the femoral tunnel, with the two free ends of the looped graft ligament extending back out through the tibial tunnel. Next, a transverse tunnel is formed in the host bone, with the transverse tunnel being aligned with the transverse fixation pin hole in the graft ligament support block. Then the graft ligament support block is secured in place by pinning the graft ligament support block within the femoral tunnel, i.e., by advancing a transverse fixation pin along the transverse tunnel in the host bone and into the transverse fixation pin hole in the graft ligament support block. Then the installation tool is detached from the graft ligament support block, and the installation tool is withdrawn from the surgical site.

Description

Be used to rebuild the apparatus and method of ligament

To quoting of unsettled existing patent application

This patent application is in the 03/04/04 unsettled existing U.S. Patent Application Serial Number No.10/793 by people such as Paul Re submission, the part continuation application of 532 " being used to rebuild the apparatus and method of ligament " (attorney docket No.SCAN-2CON), it is again in the 04/16/02 U.S. Patent Application Serial Number No.10/123 by people such as Paul Re submission, the continuation of 434 " being used for rebuilding the apparatus and method of ligament " (attorney docket No.SCAN-2) please, its requirement enjoys in the 10/01/01 U.S. Provisional Patent Application serial number No.60/326 by people such as Paul Re submission, the rights and interests of 351 " being used to rebuild the apparatus and method of ligament " (attorney docket No.SCAN-2PROV), these three patent applications are here by reference and incorporated herein.

Invention field

The present invention relates generally to operation device and program, relate more specifically to be used to rebuild the operation device and the program of ligament.

Background of invention

Ligament is that a bone is connected fibrous tissue on another bone.

Ligament usually can be damaged because of injured and/or accident (for example separate or tear or split, or the like).The ligament that damages can cause unstability, hinders the proper exercise in joint and causes pain.

Develop various operative procedure and repaired or changed the ligament of damage.Employed specific program depends on that needs recover and impaired to a certain extent specific ligament.

Because of a kind of ligament injured and/or that accident is usually damaged is anterior cruciate ligament (being ACL).At first see Fig. 1 and 2, can see that ACL extends between the bottom of the top of tibia 10 and femur 15.The ACL 5 that damages can cause kneed unstability and cause bigger pain and arthritis.

And develop many programs and more bring and recover the ACL that damages by transplanting ligament.Next see Fig. 3, generally speaking, these ACL replacing programs relate to, and get out osseous tunnel 20 and the osseous tunnel 25 that gets out in the femur 15 by tibia 10.In some cases, femur tunnel 25 can be the form of blind hole and ends at distal surface 30; Under other situation, the extension in femur tunnel 25 or femur tunnel 25 can fully pass femur 15.In case formed tibial tunnel 20 and femur tunnel 25, then just pass tibial tunnel 20 by the transplanting ligament of gathering or synthetical ligament or tendon constitute 35, through knee joint inside, and enter in the femur tunnel 25.Then, the distal portions of transplanting ligament 35 is fixed in the femur tunnel 25, and the proximal part of transplanting ligament 35 is fixed in the tibial tunnel 20.

Having many different modes will transplant ligament at present is fixed in the osseous tunnel.A kind of mode is to use interference screw (interference screw) 40 (Fig. 4) will transplant the ligament wedging and abuts against on the opposing sidewalls of osseous tunnel.Another way is to utilize button 45 and suture 50 (Fig. 5) or utilize lateral pin 55 (Fig. 6) that the transplanting ligament is hanged in osseous tunnel.Another way is to make the transplanting ligament fully pass osseous tunnel, and utilizes screw 60 and pad 65 (Fig. 7) or utilize the bail (not shown) will transplant the outside that ligament is fixed on bone.

It is fixing that " golden standard " that ACL repairs generally is regarded as so-called " bone-tendon-bone ".In this program, the graft of Patella tendon is used to change the ACL of nature.Bone grafting is connected two opposite ends of the tendon of being gathered, and one of them bone grafting is taken from patient's knee (being Patella), and bone grafting is taken from patient's tibia (promptly the Patella tendon is connected position on the tibia usually therein).Transplant ligament and launch in osseous tunnel then, wherein, a bone grafting utilizes interference screw to be fixed in the femur tunnel, and another bone grafting utilizes another interference screw to be fixed in the tibial tunnel.For many years, this program generally can form consistent, the good and reliable ligament repairing of intensity.Yet this program also generally is regarded as highly invasive, and is very painful under many situations, and generally can stay ugly cicatrix and stay bigger cavity in knee above-knee.

As a result, development in recent years goes out optional program, and it can use for example hamstring tendon of soft tissue graft thing.Yet soft tissue graft thing for example hamstring may be difficult in osseous tunnel stable.More particularly, use interference screw aggressive ground with the hamstring wedging and abut against on the opposing sidewalls of osseous tunnel, problem such as this for example may cause that graft slides, tendon twines, tissue necrosis and tendon cut off.In addition, use suture sling (for example as shown in Figure 5) and/or lateral pin (for example as shown in Figure 6) that hamstring is suspended in the osseous tunnel and may cause different problems, for example, have been found that, suture sling and/or lateral pin tend to allow to transplant ligament transverse movement in osseous tunnel by so-called " windscreen wiper " effect, thus overslaugh between transplanting ligament and host bone inside growth and/or cause wearing and tearing and/or other infringement to graft tissue.In addition, use lateral pin (for example as shown in Figure 6) that hamstring is fixed in the osseous tunnel and may cause other problem, for example, be difficult to the hamstring lopping on lateral pin, when perhaps if lateral pin passes the hamstring main body, hamstring can be torn along its length in its tensioning process, or the like.

Brief summary of the invention

The result, an object of the present invention is to provide a kind of modifying device that is used to rebuild ligament, wherein, this device is suitable for allowing to transplant ligament to be made by various soft tissue graft things, for example allograft, autograft, xenograft, bionic tissue grafts or synthetic graft, in addition, wherein, graft will use crosswise fixed pin fix in position.

Another object of the present invention provides a kind of improving one's methods of ligament that be used to rebuild, wherein, this method is suitable for allowing to transplant ligament and is made by various soft tissue graft things, allograft for example, autograft, xenograft, bionic tissue grafts or synthetic graft, in addition, wherein, graft will use crosswise fixed pin fix in position.

These and other objects solve by the present invention, in a kind of preferred form of the present invention, the present invention includes, provide and use transplanting ligament back-up block, this back-up block comprises main body, transplanting hole and extends through the crosswise fixed pin-and-hole of main body, wherein transplants the vertical axis extension that hole and crosswise fixed pin-and-hole preferably are substantially perpendicular to main body.In a kind of preferred form of the present invention, the present invention also comprises erecting tools, it will be used for transplanting the ligament back-up block and insert osseous tunnel, and when transplanting ligament back-up block is supported in the osseous tunnel, in host bone, form transverse tunnel, wherein, the transverse tunnel in the host bone is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block.

In a kind of preferred using method, make and transplant the ligament lopping and pass (looped through) and transplant transplanting hole in the ligament back-up block, and will transplant the ligament back-up block and be installed on the erecting tools.Two free ends transplanting ligament preferably are fixed under tensioning state on the proximal part of erecting tools then, thereby fasten two free ends transplanting ligament.Except two free ends of ligament are transplanted in control, this set also will help transplanting ligament back-up block is fixed on the erecting tools.Erecting tools is used for advance transplanting the ligament back-up block by tibial tunnel then, through knee joint inside, goes forward side by side and becomes a shareholder in the osseous tunnel, and wherein two free ends of the transplanting ligament of lopping leave tibial tunnel to returning to extend.Next, in host bone, form transverse tunnel, and transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block.Then, fix in the femur tunnel, that is, advance the crosswise fixed pin and enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block, make like this and transplant ligament back-up block fix in position by the transverse tunnel in host bone by transplanting ligament back-up block pin.Then, two free ends of the transplanting ligament of lopping discharge from erecting tools, erecting tools is separated from transplanting the ligament back-up block, and erecting tools are withdrawn from from operative site.At last, two free ends of the transplanting ligament of lopping are fixed on the tibia, therefore finish ACL and repair.If needs are arranged, can use second to transplant the connection of ligament back-up block execution tibia.

According to another characteristic of the invention, provide the device that is used to rebuild ligament, this device comprises:

Transplant the transplanting ligament that the ligament back-up block is used for supporting osseous tunnel, transplant the ligament back-up block and comprise:

Main body, it has far-end, near-end, and the longitudinal axis that extends between far-end and near-end, and near-end is a convergent shape, withdraws from graft ligament back-up block so that help by osseous tunnel;

Transplant the hole, it passes main body transverse to vertical axis extension, and is configured to accept therein to transplant ligament; With

The crosswise fixed pin-and-hole, it passes main body transverse to vertical axis extension, and is configured to accept therein the crosswise fixed pin.

According to another characteristic of the invention, provide the method that is used for the transplanting ligament is fixed on osseous tunnel, may further comprise the steps:

(1) make the lopping of transplanting ligament pass the transplanting hole of transplanting in the ligament back-up block, advance transplanting ligament back-up block to enter in the osseous tunnel, transplant the ligament back-up block along osseous tunnel to returning to withdraw from, advance transplanting ligament back-up block to enter in the osseous tunnel, wherein, transplant ligament and passed the transplanting hole of transplanting in the ligament back-up block by lopping, and form the transverse tunnel in the host bone, the crosswise fixed pin-and-hole of wherein transplanting in the ligament back-up block is aimed at the transverse tunnel in the host bone; With

(2) advance the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fix in the osseous tunnel thereby will transplant ligament back-up block pin.

According to another characteristic of the invention, provide the method for the transplanting ligament that is used for the correct bone tunnel, this method may further comprise the steps:

By the crosswise fixed pin-and-hole from transplant the ligament back-up block with withdraw from the crosswise fixed pin from the transverse tunnel of host bone, to transplant the pin of ligament back-up block in osseous tunnel fixed and remove; Transplant the ligament back-up block along osseous tunnel to returning to withdraw from; To transplant the ligament back-up block and push in the osseous tunnel, so that the crosswise fixed pin-and-hole in the back-up block is aimed at transverse tunnel; And advance the crosswise fixed pin to make it to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fix in the osseous tunnel thereby will transplant ligament back-up block pin.

Be used for supporting the transplanting ligament back-up block of the transplanting ligament of osseous tunnel, this transplanting ligament back-up block comprises:

Main body, it has far-end, near-end, and the longitudinal axis that extends between far-end and near-end;

Transplant the hole, it passes main body transverse to vertical axis extension, and is configured to accept therein to transplant ligament, and described transplanting hole has the given length along longitudinal axis, and described given length is substantially equal to the given cross sectional dimensions of described transplanting ligament; With

Zone of preference is transplanted the transplanting ligament back-up block in hole, and described transplanting hole is substantially equal to transplant the given cross sectional dimensions of ligament dimensionally;

Make the lopping of transplanting ligament pass the transplanting hole of transplanting in the ligament back-up block;

Advance transplanting ligament back-up block to enter in the osseous tunnel;

Form the transverse tunnel in the host bone, wherein said transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block; With

Advance the crosswise fixed pin that it is entered in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, decide in the osseous tunnel at pin thereby will transplant the ligament back-up block.

According to another characteristic of the invention, provide the method that is used for the transplanting ligament is fixed on osseous tunnel, this method may further comprise the steps:

Form the transverse tunnel in the host bone;

Zone of preference is transplanted the transplanting ligament back-up block in hole, and described transplanting hole is substantially equal to the given cross sectional dimensions of described transplanting ligament dimensionally;

Advance transplanting ligament back-up block to enter in the osseous tunnel, so that the crosswise fixed pin-and-hole of transplanting in the ligament back-up block is aimed at transverse tunnel; With

Advance the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fix in the osseous tunnel thereby will transplant ligament back-up block pin.

According to another characteristic of the invention, provide the device that is used to rebuild ligament, described device comprises:

Be used for supporting the transplanting ligament back-up block of the transplanting ligament of osseous tunnel, described transplanting ligament back-up block comprises:

The crosswise fixed pin-and-hole, it passes main body transverse to vertical axis extension and is configured to accept therein the crosswise fixed pin; With

Have the crosswise fixed pin of near-end and far-end, described near-end forms threaded interior hole therein, so that help to take out the crosswise fixed pin from osseous tunnel.

According to another characteristic of the invention, provide the method for the transplanting ligament that is used for the correct bone tunnel, may further comprise the steps:

Threaded interior hole in the crosswise fixed pin is engaged with extracting tool;

Utilize the extracting tool that engages with threaded interior hole from osseous tunnel, to withdraw from the crosswise fixed pin, and transplant the ligament back-up block to returning to withdraw from along osseous tunnel;

To transplant ligament back-up block location enters in the osseous tunnel;

According to another characteristic of the invention, provide the system that is used to rebuild ligament, described system comprises:

Transplant the hole, it passes main body transverse to vertical axis extension and is configured to accept therein to transplant ligament;

The staged steady pin, it has far-end, near-end, the longitudinal axis that extends between far-end and near-end is in the first of far-end, at the second portion of near-end, described first has the diameter littler than described second portion, and be arranged on annular shoulder between first and the second portion, wherein, described first, second portion and annular shoulder form given profile in perpendicular to the given planar cross section of longitudinal axis; With

The staged transverse tunnel drill, it has far-end, near-end, and the longitudinal axis that between far-end and near-end, extends, described staged is laterally bored the given profile corresponding to the staged steady pin, so that the staged transverse tunnel by a part of osseous tunnel is provided, it is configured to the via alignment with the crosswise fixed pin-and-hole, and wherein, described crosswise fixed pin-and-hole passes main body transverse to vertical axis extension and is configured to accept therein the crosswise fixed pin.

Advance transplanting ligament back-up block to enter in the osseous tunnel;

Utilize the staged transverse tunnel in the staged transverse tunnel drill formation host bone, wherein, described staged transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block; With

Advance staged crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fix in the osseous tunnel thereby will transplant ligament back-up block pin.

Utilize the staged transverse tunnel in the staged transverse tunnel drill formation host bone;

Advance transplanting ligament back-up block to enter in the osseous tunnel, so that the crosswise fixed pin-and-hole of transplanting in the ligament back-up block is aimed at the staged transverse tunnel; And

Advance staged crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the staged transverse tunnel in host bone, fix in the osseous tunnel thereby will transplant ligament back-up block pin.

Main body, it has far-end, near-end, the longitudinal axis that extends between far-end and near-end, and at least one element that is used for engaging with erecting tools;

Transplant the hole, it passes main body transverse to vertical axis extension and is configured to accept therein to transplant ligament; With

The crosswise fixed pin-and-hole, it passes main body transverse to vertical axis extension and is configured to accept therein the crosswise fixed pin;

Erecting tools, it comprises:

Keeper, described keeper comprises:

Axle, it has far-end, near-end, and the longitudinal axis that extends between far-end and near-end, and the near-end of described axle is configured to be bonded at least one element of described main body;

Be installed in the hands handle on the near-end of described axle;

Be suitable for being fixed on releasedly the brill conductor (drill guide) on the keeper, described brill conductor comprises:

Comprise the spider (outrigger) of far-end and near-end, the near-end of described spider is configured to be fixed on releasedly on the keeper; With

Drill holder, it movably is connected on the described far-end of described spider, described drill holder comprises the drilling pipe chamber that therefrom extends through, and described drill holder has position depth mark thereon, wherein, but the depth mark on the far-end of described spider and the described drill holder is arranged to the transverse tunnel degree of depth of indicating correct; With

Transverse tunnel drill with far-end and near-end, the far-end of described transverse tunnel drill is configured to can be positioned to pass drill holder, so that get out the horizontal osseous tunnel that passes osseous tunnel, transverse tunnel is drilled in has sign disposed thereon between its near-end and the far-end, wherein, the depth mark on described transverse tunnel drill and the drill holder is arranged to indicate the given depth of the far-end of described transverse tunnel drill.

Advance transplanting ligament back-up block to enter in the osseous tunnel;

To bore conductor and be positioned to connect on the graft back-up block, described brill conductor comprises spider and movably is connected drill holder on the spider, and described drill holder has position depth mark thereon;

By make drill holder in spider towards osseous tunnel motion and read depth mark on the described drill holder, thereby utilize drill holder and spider to determine the correct transverse tunnel degree of depth;

By according to the sign that is provided with thereon transverse tunnel drill being crept into to the given degree of depth, thereby form the transverse tunnel that reaches the correct transverse tunnel degree of depth in host bone, wherein transverse tunnel is aimed at the crosswise fixed pin-and-hole in the transplanting ligament back-up block; And

Advance the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, will transplant ligament back-up block pin and fix in the osseous tunnel.

Be positioned to connect on the reamer in inserting osseous tunnel boring conductor, described brill conductor comprises spider and movably is connected drill holder on the spider, and described drill holder has a depth mark thereon;

By make drill holder in spider towards osseous tunnel and read depth mark on the described drill holder, thereby utilize drill holder and spider to determine the correct transverse tunnel degree of depth;

By transverse tunnel drill being crept into to the given degree of depth, thereby in host bone, form the transverse tunnel that reaches the correct transverse tunnel degree of depth according to the sign that is provided with thereon;

From described osseous tunnel, take out reamer;

Erecting tools, it comprises:

Keeper, described keeper comprises:

Be installed in the hands handle of the described near-end of described axle;

Be suitable for being fixed on releasedly the brill conductor on the keeper, described brill conductor comprises:

The spider that comprises far-end and near-end, the near-end of described spider are configured to be fixed on releasedly on the keeper; With

Movably be connected the drill holder on the far-end of described spider, and described drill holder comprises the drilling pipe chamber that therefrom extends through; With

Transverse tunnel drill with far-end and near-end, the far-end of described transverse tunnel drill is configured to can be positioned to pass drill holder, so that get out horizontal osseous tunnel by osseous tunnel, described transverse tunnel drill has stop element, it is configured to and can be bonded on the drill holder, so that restriction is drilled into the predetermined degree of depth.

Main body, it has far-end, near-end, and the longitudinal axis that extends between far-end and near-end; With

Staged crosswise fixed pin, it has far-end, near-end, the longitudinal axis that extends between far-end and near-end is in the first of far-end, at the second portion of near-end, described first has the diameter littler than described second portion, and be arranged on annular shoulder between described first and the second portion, wherein, described first, second portion and annular shoulder form given profile in perpendicular to the given planar cross section of described longitudinal axis;

The staged transverse tunnel drill, the longitudinal axis that it has far-end, near-end and extends between described far-end and near-end, described staged is laterally bored the given profile corresponding to staged crosswise fixed pin, so that the staged of passing osseous tunnel transverse tunnel is provided, it is configured to accept the given profile of described staged crosswise fixed pin; With

Depth gauge with far-end and near-end, the far-end of described depth gauge is configured to can be positioned to pass drill holder, and engage with a part of staged transverse tunnel corresponding to the annular shoulder of staged steady pin, and described depth gauge have between far-end and the near-end position thereon labelling in case indication corresponding to the part of the annular shoulder of staged steady pin and the crosswise fixed pin-and-hole degree of depth between the bone surface.

Advance transplanting ligament back-up block to enter in the osseous tunnel;

By the position of first group of depth mark on the reading drill holder, determine the correct transverse tunnel degree of depth with respect to spider;

The use transverse tunnel drill forms the transverse tunnel in the host bone, described transverse tunnel drill has second group of position depth mark thereon, so that get out the transverse tunnel that reaches the correct transverse tunnel degree of depth, wherein transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block; With

By selecting the crosswise fixed pin based on the determined correct transverse tunnel degree of depth of first group of depth mark on the drill holder, and the transverse tunnel in the host bone advances selected crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block, fixes in the osseous tunnel thereby will transplant ligament back-up block pin.

Advance transplanting ligament back-up block to enter in the osseous tunnel;

By selecting the crosswise fixed pin based on the determined correct transverse tunnel degree of depth of first group of depth mark on the drill holder, and the transverse tunnel in the host bone advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block, fixes in the osseous tunnel thereby will transplant ligament back-up block pin.

Advance transplanting ligament back-up block to enter in the osseous tunnel;

Use transverse tunnel to be drilled in and form the transverse tunnel that reaches desired depth in the host bone, described transverse tunnel drill has at the stop element from described transverse tunnel drill far-end preset distance place, described stop element is configured to be bonded on the drill holder, so that restriction is drilled into the predetermined degree of depth, wherein said transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block; With

Use transverse tunnel to be drilled in and form the transverse tunnel that reaches desired depth in the host bone, described transverse tunnel drill has at the stop element from the far-end preset distance place of described transverse tunnel drill, described stop element is configured to and can be bonded on the drill holder, so that restriction is drilled into the predetermined degree of depth;

Advance transplanting ligament back-up block to enter in the osseous tunnel, so that the crosswise fixed pin-and-hole in the graft ligament back-up block is aimed at transverse tunnel; With

Main body, it has far-end, near-end, and the longitudinal axis that extends between far-end and near-end, and described near-end is a convergent shape, withdraws from transplanting ligament back-up block so that help by osseous tunnel;

The zone, it is configured for when getting out the transverse holes of passing osseous tunnel, is used for getting out crosswise fixed pin-and-hole by main body transverse to longitudinal axis.

Brief description

By following detailed description to the preferred embodiment of the present invention that will consider together with accompanying drawing, these and other objects of the present invention and feature will more fully be disclosed or be become apparent, in the accompanying drawings, similarly label is used for parts like the representation class, in the accompanying drawings:

Fig. 1 is the kneed sketch map of looking from the front side;

Fig. 2 is the kneed sketch map of looking from rear side;

Fig. 3 is the sketch map that general A CL rebuilds;

The sketch map that the ACL that Fig. 4 is to use interference screw to carry out rebuilds;

The sketch map that the ACL that Fig. 5 is to use the suture sling to carry out rebuilds;

The sketch map that the ACL that Fig. 6 is to use lateral pin to carry out rebuilds;

The sketch map that the ACL that Fig. 7 is to use screw and pad to carry out rebuilds;

Fig. 8 is the sketch map that forms according to transplanting ligament back-up block of the present invention;

Fig. 9 is the part exploded view, has shown transplanting ligament back-up block shown in Figure 8 and the erecting tools that is used to launch transplanting ligament back-up block shown in Figure 8;

Figure 10-the 12nd, various views have shown the transplanting ligament back-up block shown in Figure 8 that is installed in erecting tools far-end shown in Figure 9;

Figure 13 is a fragmentary, perspective view, has shown the details of the near-end of erecting tools shown in Figure 9;

Figure 14 is the side view of partly cut-away, has shown other details of the structure of erecting tools shown in Figure 9;

Figure 15 is the sectional view of the drill holder of erecting tools;

Figure 16 is the perspective view of crosswise fixed pin, and it can use together with transplanting ligament back-up block shown in Figure 8 and erecting tools shown in Figure 9;

Figure 17-the 33rd, a series of sketch maps have shown that the ACL that carries out according to the present invention rebuilds;

Figure 34 is a sketch map, has shown the transplanting ligament back-up block of another form formed according to the present invention;

Figure 35 is the side view that amplifies, and has shown the constructive alternative that is used for an erecting tools part;

Figure 36 is the cutaway view of the line 36-36 in Figure 35;

Figure 37 is a sketch map, has shown reamer conductor formed according to the present invention;

Figure 38 is a sketch map, has shown the reamer element of reamer conductor shown in Figure 37;

Figure 39-the 44th, a series of sketch maps have shown that the ACL that carries out according to the present invention rebuilds;

Figure 45,46A and 46B are the sketch maps of transplanting the ligament back-up block, and wherein each transplants the distal edge structure that the ligament back-up block has shown convergent shape;

Figure 47 is the sketch map that is formed with the crosswise fixed pin of threaded interior hole at its near-end;

Figure 48 is the sketch map with the instrument of recalling of screw thread protuberance, and described screw thread protuberance is configured to be bonded in the threaded interior hole of crosswise fixed pin shown in Figure 47;

Figure 49 is a sketch map, has shown the staged transverse tunnel drill with narrower cutting tip and broad cutting tip;

Figure 50 is to use the sketch map of the ACL reconstruction algorithm of staged transverse tunnel drill execution shown in Figure 49;

Figure 51 A, 51B and 52 are the sketch maps that are used to rebuild the system of ligament, and this system comprises staged transverse tunnel drill that has depth mark thereon and the drill holder that has depth mark thereon;

Figure 53 and 54 is the sketch maps with transverse tunnel drill of setting stop element thereon; With

Figure 55 and 56 is the sketch maps that are used to rebuild the system of ligament, and this system comprises transverse bolt insert depth gauge, and it is configured to can determine to insert the placement degree of depth of the transverse bolt in the transverse tunnel.

Detailed description of preferred embodiment

Next see Fig. 8, shown transplanting ligament back-up block 100, it comprises a kind of preferred form of the present invention.Transplant ligament back-up block 100 and comprise main body 105, transplant hole 110 and extend through the crosswise fixed pin-and-hole 115 of main body 105, wherein transplant hole 110 and crosswise fixed pin-and-hole 115 and preferably be substantially perpendicular to the longitudinal axis 120 of main body 105 and extend for these two.In a kind of preferred form of the present invention, transplant hole 110 and crosswise fixed pin-and-hole 115 along diametric(al) extend through main body 105, wherein transplant hole 110 and crosswise fixed pin-and-hole 115 extends parallel to each other basically.Transplant the near-end 125 that main body 105 preferably is arranged to more approach than crosswise fixed pin-and-hole 115 in hole 110, and crosswise fixed pin-and-hole 115 is arranged to than transplanting the far-end 130 that main body 105 is more approached in hole 110.In a kind of preferred form of the present invention, the far-end of main body 105 has circular cross section, and still, it also can have oval cross-section or polygon cross section (for example, square or rectangle or triangle, or the like).In a kind of preferable configuration, the cross sectional dimensions that far-end had of main body 105 only is slightly less than the diameter of osseous tunnel, so that interface closely is provided between the wall of main body 105 and osseous tunnel.In a kind of preferred form of the present invention, the far-end 130 of main body 105 is convergent shapes, passes osseous tunnel so that help to promote to transplant ligament back-up block 100.In a kind of preferred form of the present invention, the near-end of main body 105 is cut the type of being carved into (sculpted away), for example is shown as near-end 135, so as for transplant the ligament lopping pass transplant hole 110 and from here distad extension more space is provided.Main body 105 also comprises a pair of recess 140, is used for main body 105 is installed in suitable erecting tools, as hereinafter discussing in more detail.

If needs are arranged, transplant ligament back-up block 100 and also can comprise the suture hole 145 that is used to accept traction sutures, as hereinafter discussing in more detail.

In addition, if needs are arranged, the near-end in transplanting hole 110 can be convergent shape, as shown be 150, provide less abrasive bearing-surface so that pass transplanting hole 110 for the lopping of transplanting ligament, and/or the inlet of crosswise fixed pin-and-hole 115 can be (being shown as 155) of convergent shape, so that help the crosswise fixed pin to enter in the crosswise fixed pin-and-hole 115.

But main body 105 can be by material, allogeneic bone grafting, metal, pottery, Corallium Japonicum Kishinouye, fibrous composite the polymer bio-absorbable or that can biological reinvent, comprises composite at least a in aforementioned or the like and forms.By by intensity preferably material form main body 105, transplanting ligament just can remain under the tensioning state, even under main body 105 is smaller situation, perhaps in the hole 110,115 and/or 145 wherein one or more be positioned to be in close proximity under the situation of main body 105 peripheries, also be like this.

Next 9-15 with the aid of pictures has shown erecting tools 200, and it can use together with transplanting ligament back-up block 100.Erecting tools 200 generally comprises keeper 205 and relevant brill conductor 210.

Keeper 205 comprises axle 215, and it has at a pair of fingers 220 of its far-end and at the handle 225 of its near-end.Fingers 220 allows erecting tools 200 to match to merge with transplanting ligament back-up block 100 and maintains it releasedly, and this is to realize by optionally being assemblied in to transplant in the recess 140 (Fig. 8) that forms on ligament back-up block 100 near-ends.See Fig. 9-12 and 14.Substantially, fingers 220 and recess 140 comprise protruding formula/recessed formula connector; If needs are arranged, protruding formula and recessed formula position component be (that is, protruding formula part is on back-up block 100, and recessed formula part is on keeper 205) conversely; Perhaps can use the connector (for example grasper) of alternative types.One or more suture posts 227 are preferably formed on the near-end of axle 215 and near handle 225.Two free ends that suture post 227 allows to transplant ligament are fixed on the erecting tools, as hereinafter discussing in more detail.Handle 225 allows erecting tools 200 by habitually grasping of user.Handle 225 comprises post hole 230.Post hole 230 allows to bore conductor 210 and is fixed on releasedly on the keeper 205, as hereinafter discussing in more detail.

Bore conductor 210 and comprise spider 235, it has the screwed hole 240 (Figure 14) that is formed in its far-end 245, and at its notch 250 (Fig. 9) and the pillar 255 at near-end 260 places.The end of pillar 255 is threaded, for example is shown as 265.

Screwed hole 240 (Figure 14) in the spider far-end 245 is arranged to accept drill holder 270 therein dimensionally.Drill holder 270 has the screw thread 275 of proximal head of ending at 280 along its length.Head 280 can be used for the screwed hole 240 internal rotation drill holders 270 of artificially at spider, thereby moves drill holder 270 with respect to the far-end 245 of spider 235.Tube chamber 285 extends through drill holder 270.

Notch 250 and pillar 255 allow spider 235 to be installed in releasedly on the keeper 205.More particularly, spider 235 can be installed on the keeper 205, this is to be assemblied in the notch 250 of spider (Figure 13 and 14) by the axle 215 with keeper, the pillar 255 of spider is assemblied in the post hole 230 of keeper, then nut 290 is tightened and on the end of thread 265 of pillar 255, to realize.

As described below, transplanting ligament back-up block 100 and erecting tools 200 expections are used together with the crosswise fixed pin.In Figure 16, shown a kind of preferred crosswise fixed pin 300.Crosswise fixed pin 300 generally comprises the solid shafting 305 that ends at convergent shape far-end 310, and ribbed (perhaps have barb or threaded) segmentation 315.Non-circular socket 320 is formed in the near-end of crosswise fixed pin 300, thereby can come engage lateral steady pin 300 by screwdriver (driver).

To introduce the ACL that carries out according to the present invention now rebuilds.

At first, the position that makes arrangements for surgery to be to be used to transplant ligament, for example by removing ACL that damages or the like, uses seal wire 400 (Figure 17) to drill through tibia 10 then and enters kneed inside.Seal wire 400 preferably stops at and is not enough to the position (Figure 18) of closing with femur 15 bottom connections.Then, the tibia of dress intubate bores 500 (Figure 19) and is loaded on the seal wire 400 and drills through tibia 10 and enter kneed inside (Figure 20).Then, the tibia brill 500 of dress intubate is withdrawn from (Figure 21) along seal wire to returning, and leaves tibial tunnel 20.

Next, seal wire 400 inside that pierces femur 15 reaches suitable distance.If needs are arranged, seal wire 400 can drill femur 15 (Figure 22) always, and its reason is as described below.Then, the femur of dress intubate bores 600 (for example rubber shape is bored) and is loaded on the seal wire 400 (Figure 22), through tibial tunnel 20, through knee joint inside, pierces then in the femur 15, and stops (Figure 23) in the inside of femur 15.Then, the femur brill 600 of dress intubate is withdrawn to returning along seal wire, leaves femur tunnel 25 (Figure 24).

Next, by an end of transplanting ligament is screwed by transplanting hole 110, be installed on the transplanting ligament back-up block 100 and will transplant ligament 35, will transplant the far-end that ligament back-up block 100 is installed in axle 215 then, that is, by fingers 220 is undertaken in the recess 140.Two free ends transplanting ligament 35 preferably keep tightening, and this is for example by making suture 70 pass two free ends of transplanting ligament 35, then those sutures (for example by twining) are fixed on the suture post 227 and realize.This set will help to control two free ends transplanting ligament 35, and will help transplanting ligament back-up block 100 is remained on the keeper 205.Then, erecting tools 200 is used for promote transplanting ligament back-up block 100, and therefore promotes to transplant ligament 35 and pass tibial tunnel 20 (Figure 25), and through knee joint inside, become a shareholder (Figure 26) in the osseous tunnel 25 goes forward side by side.

If needs are arranged, can by the distally press against on the erecting tools 200, provide advance to transplant ligament back-up block 100 and transplant ligament 35 by tibial tunnel 20, through knee joint inside, the desired whole active forces in the osseous tunnel 25 of becoming a shareholder of going forward side by side.Perhaps, if seal wire 400 has fully drilled through femur 15 (for example as shown in figure 22), if and the near-end of seal wire 400 comprises suture eyelet (for example suture eyelet 405 shown in Figure 23 and 24), then suture can be used for helping traction to transplant ligament back-up block 100 and to transplant ligament 35 in place.More particularly, suture 700 (Figure 25) but the suture hole 145 of transplanting in the ligament back-up block 100 is passed in lopping, and by the suture eyelet 405 on the seal wire 400; Therefore, extend the top of deviating from femur 15 by ground, distally pull portion structure seal wire 400, suture 700 just can be used for helping traction to transplant ligament back-up block 100 and transplants ligament 35 (Figure 26) in place.This set will help to reduce to be promoted by erecting tools 200 size of the power of transplanting ligament back-up block 100 and the 35 required transmission in place of transplanting ligament.

Advanced (Figure 26) in place in case transplant ligament back-up block 100 and transplant ligament 35, drill holder 270 just is advanced with femur 15 and forms fluid-tight engagement (Figure 27).This move will help can stablize erecting tools 200 with respect to femur 15.Then, transverse tunnel drill 800 (Figure 28) is used to get out transverse tunnel 75, and the lateral parts that it passes femur 15 passes the crosswise fixed pin-and-hole of transplanting in the ligament back-up block 100 115, goes forward side by side into the mid portion of femur 15.Be appreciated that in this respect, transverse tunnel drill 800 will accurately and as one man be guided to pass the crosswise fixed pin-and-hole of transplanting in the ligament back-up block 100 115 (Figure 28), and this is to adjust by fingers 220 is bonded in the recess 140 because transplant the orientation of ligament back-up block 100 and erecting tools 200 (and drill holder 270).

In case transverse tunnel drill 800 has been used to get out after the transverse tunnel 75, transverse tunnel drill 800 is taken out (Figure 29).Unclamp drill holder 270 then and spider 210 is removed (Figure 30) from keeper 205.Then, be installed in crosswise fixed pin 300 on the screwdriver 325 and be pushed in the transverse tunnel 75 and pass the crosswise fixed pin-and-hole of transplanting in the ligament back-up block 100 115 (Figure 31), be fixed in the femur tunnel 25 thereby will transplant ligament back-up block 100 (and transplanting ligament 35).According to the segmentation 315 of crosswise fixed pin 300 be ribbed or barb arranged or threaded, near-end that can be by rapping screwdriver with hammer or by the rotation screwdriver and/or carry out the two simultaneously, thus advance the crosswise fixed pin by screwdriver 325.Screwdriver 325 is removed (Figure 32) then.Next, transplant of suture post 227 separation of two free ends of ligament 35, and keeper 205 is withdrawn from (Figure 33) from handle.Be appreciated that in this respect that when keeper 205 is withdrawn from transplant ligament back-up block 100 and will be held in place in the femur tunnel 25, this is because crosswise fixed pin 300 is present in transverse tunnel 75 and the crosswise fixed pin-and-hole 115.At last, two free ends transplanting ligament 35 are fixed on the tibia 10, thereby finish the ACL reconstruction algorithm.

In above disclosed embodiment, crosswise fixed pin-and-hole 115 (Fig. 8) is formed in the main body 105 in advance.This structure generally is favourable, and this is because after transplanting ligament back-up block 100 has been positioned in the femur tunnel and before crosswise fixed pin 300 has passed main body 105, need not to drill through main body 105.In addition, by the pre-crosswise fixed pin-and-hole 115 that forms in main body 105, crosswise fixed pin-and-hole 115 just can be endowed required geometry, for example, can allow to enter in the lateral pin hole 115 (for example in Fig. 8, being shown as 155) of convergent shape, thereby help crosswise fixed pin 300 is centered in the crosswise fixed pin-and-hole 115.Yet, it is also understood that if needs are arranged crosswise fixed pin-and-hole 115 can not form in advance in main body 105.But crosswise fixed pin-and-hole 115 can form at the scene when operation, for example forms by drilling main body 105 when forming transverse tunnels 75 with transverse tunnel drill 800.Under the situation that crosswise fixed pin-and-hole 115 forms the scene, certainly, main body 105 must be formed by the material that can bore.In addition, under the situation that crosswise fixed pin-and-hole 115 forms the scene, main body 105 preferably by intensity preferably material forms, this be since after any dislocation (being any eccentric placement) of crosswise fixed pin-and-hole 115 will tolerate well by main body 105.

In addition, in above disclosed embodiment, the outer surface of main body 105 is adjacent to transplanting 110 places, hole and is cut the type of being carved into, and for example is shown as 135 in Fig. 8, so that help to hold the transplanting ligament in femur tunnel 25.In Fig. 8, carry out the type of being carved into of cutting, so that produce smooth basically surface 135.Yet, if needs are arranged, can carry out the type of being carved into of cutting, so that alternative geometries is provided, surface groove for example, or the like.Therefore, for example, in Figure 34, main body 105 is shown as and has a pair of surface groove 165, and it is connected with transplanting hole 110, and extends from transplanting 11 beginning proximad ground, hole.Surface groove 165 is arranged to dimensionally and can be provided for accepting the recess of transplanting tough band portion when transplanting ligament from the extension of transplanting 110 proximad ground, hole.

In addition, in above disclosed embodiment, main body 105 is shown as (for example seeing Fig. 8) and has smoother outer surface.Yet if needs are arranged, main body 105 can have the spike that is formed on its sidewall or fin or the like, so that help to stablize main body 105 in osseous tunnel.

In addition, in above disclosed embodiment, drill holder 270 connects (that is, screw thread 275 on drill holder 270 outsides and the screwed hole in spider 235 240) via screw, and movably is connected on the spider 235.This set provides the mode that is used for drill holder 270 movably is fixed on the simple and cost-effective on the spider 235.Yet,, also can use the setting of other type if needs are arranged.For example, see Figure 35 and 36 now, drill holder 270 can have slick ribbed or coarse (for example annular knurl) outside 275A, the unthreaded hole 240A in the spider 235 is passed in its slip, wherein lock pin 235A can optionally be advanced (passing screwed hole 235B) and be engaged with drill holder 270 formation, thereby optionally drill holder is locked on the spider.Other the possible setting that is used for optionally drill holder 270 being locked on the spider 235 is conspicuous for the technical staff in boring and drill holder field.

In addition, in above disclosed embodiment, bore conductor 210 and be shown as (for example seeing Figure 14) and be fixed on releasedly on the keeper 205 by means of pillar 255 and last jack panel 290.Yet, should be appreciated that the connection (for example " quick-release " formula clamp mechanism) of other type also can be used for brill conductor 210 is fixed on the keeper 205 releasedly.

Also can before being positioned in the femur tunnel 25, transplanting ligament back-up block 100 and transplanting ligament 35 form transverse tunnel 75.More particularly, in a kind of possible setting, can use reamer conductor 200A (Figure 37).Reamer conductor 200A is equal to aforesaid erecting tools 200 basically, and difference is as described below.More particularly, reamer conductor 200A comprises reamer 205A and bores conductor 210.Reamer 205A is equal to aforesaid keeper 205 basically, difference is, it has the cylindrical elements 220A (Figure 37 and 38) at its far-end, this cylindrical elements 220A has the transverse holes 220B that therefrom extends through, and it has omitted the suture post 227 that preferably is arranged on the keeper 205.Reamer 205A be configured to so that: (i) diameter that had of its cylindrical elements 220A is approximately equal to the diameter in femur tunnel 25, (ii) when brill conductor 210 was connected on the reamer 205A, the tube chamber 285 in the drill holder 270 will be aimed at the transverse holes 220B among the reamer 205A.

Transplant ligament back-up block 100, keeper 205 and reamer conductor 200A and can be used for carrying out as described below the ACL reconstruction.

At first, the position that makes arrangements for surgery is to be used to transplant ligament, and for example by removing ACL that damages or the like, seal wire 400 (Figure 17) drills through tibia 10 and passes kneed inside then.Seal wire 400 preferably stops at and is not enough to the position (Figure 18) of closing with femur 15 bottom connections.Then, the tibia of dress intubate bores 500 (Figure 19) and is loaded on the seal wire 400 and drills through tibia 10 and enter kneed inside (Figure 20).Then, the tibia brill 500 of dress intubate is withdrawn from (Figure 21) along seal wire to returning, and leaves tibial tunnel 20.

Next, seal wire 400 inside that pierces femur 15 reaches suitable distance.Then, the femur of dress intubate bores 600 (rubber shape for example shown in Figure 22 is bored) and is loaded on the seal wire 400, through tibial tunnel 20, through knee joint inside, pierces then in the femur 15, and stops in the inside of femur 15.Then, the femur brill 600 of dress intubate is withdrawn to returning along seal wire, leaves femur tunnel 25, and seal wire 400 is withdrawn from (seeing Figure 39) then.

Next, advance reamer conductor 200A,, pass knee inside, and enter femur tunnel 25 so that its cylindrical elements 220A is pushed into by tibial tunnel 20.Should be appreciated that in this respect when reamer conductor 200A is pushed into by tibial tunnel 20 and femur tunnel 25, its cylindrical elements 220A will carry out reaming to these two osseous tunnels, thus clear any interference chip.

In case it is in place that reamer conductor 200A has advanced, then drill holder 270 just is advanced with femur 15 and forms fluid-tight engagement.This move will help to stablize reamer conductor 200A with respect to femur 15.Transverse tunnel drill 800 (Figure 40) is used to get out transverse tunnel 75 then, and it, is gone forward side by side into the mid portion of femur 15 by the transverse holes 220B among the cylindrical elements 220A by the lateral parts of femur 15.Be appreciated that in this respect, transverse tunnel drill 800 will be passed transverse holes 220B among the cylindrical elements 220A (Figure 40) by guiding accurately and as one man, and this is because the relative orientation of cylindrical elements 220A and drill holder 270 is adjusted by boring engaging that conductor 210 and reamer 205A predesignate.

In case transverse tunnel drill 800 has been used to get out transverse tunnel 75, then transverse tunnel drill 800 is removed.Unclamp drill holder 270 then, and reamer conductor 200A is withdrawn from (Figure 41) from operative site.

Next, screw to pass by the end that will transplant ligament and transplant hole 110, be installed in and transplant on the ligament back-up block 100, will transplant ligament back-up block 100 then and be installed in a far-end of spools 215 and will transplant ligament 35, that is, by fingers 220 is undertaken in the recess 140.Two free ends transplanting ligament 35 preferably keep tightening, for example, and by making suture 70 pass two free ends of transplanting ligament 35 and afterwards these sutures (for example by twining) being fixed on the suture post 227.This set will help to control two free ends transplanting ligament 35, and will help transplanting ligament back-up block 100 is remained on the keeper 205.Then, keeper 205 is used for promote transplanting ligament back-up block 100 and transplants ligament 35 by tibial tunnel 20, and through knee joint inside, become a shareholder (Figure 42) in the osseous tunnel 25 goes forward side by side.Be pushed in the femur tunnel 25 transplanting the ligament back-up block, perhaps it be pushed into reach in the femur tunnel 25 one section suitable apart from the time, it can be rotated by turning handle 225 when needed, so that crosswise fixed pin-and-hole 115 is aimed at transverse tunnel 75.By registration mark (for example registration mark 225A as shown in figure 43) is provided, can help this aligning on handle 225.

Then, being installed in crosswise fixed pin 300 on the screwdriver 325 is pushed and enters in the transverse tunnel 75, and pass the crosswise fixed pin-and-hole of transplanting in the ligament back-up block 100 115 (Figure 44), be fixed in the femur tunnel 25 thereby will transplant ligament back-up block 100 (and transplanting ligament 35).Then, screwdriver 325 is removed.Next, transplant of suture post 227 separation of two free ends of ligament 35, and keeper 205 is withdrawn from from handle.Be appreciated that in this respect that when keeper 205 is withdrawn from transplant ligament back-up block 100 and will be held in place in the femur tunnel 25, this is because have crosswise fixed pin 300 in transverse tunnel 75 and crosswise fixed pin-and-hole 115.At last, two free ends transplanting ligament 35 are fixed on the tibia 10 then, thereby finish the ACL reconstruction algorithm.

Next see Figure 45 and 46, shown improved transplanting ligament back-up block 1500, it comprises a kind of preferred form of the present invention.Transplant ligament back-up block 1500 and comprise main body 1505, transplant hole 1510 and extend through the crosswise fixed pin-and-hole 1515 of main body 1505, wherein transplant hole 1510 and crosswise fixed pin-and-hole 1515 and preferably be substantially perpendicular to the longitudinal axis 1520 of main body 1505 and extend for these two.In a kind of preferred form of the present invention, transplant hole 1510 and crosswise fixed pin-and-hole 1515 along diametric(al) extend through main body 1505, wherein transplant hole 1510 and crosswise fixed pin-and-hole 1515 extends parallel to each other basically.Transplant the near-end 1525 that main body 1505 preferably is arranged to more approach than crosswise fixed pin-and-hole 1515 in hole 1510, and crosswise fixed pin-and-hole 1515 is arranged to than transplanting the far-end 1530 that main body 1505 is more approached in hole 1510.In a kind of preferred form of the present invention, the far-end of main body 1505 has circular cross section, and still, it also can have oval cross-section or polygon cross section (for example, square or rectangle or triangle, or the like).In a kind of preferable configuration, the cross sectional dimensions that far-end had of main body 1505 only is slightly less than the diameter of osseous tunnel, so that provide interface closely between main body 1505 and osseous tunnel wall.In a kind of preferred form of the present invention, the far-end 1530 of main body 1505 is convergent shapes, so that help to advance transplanting ligament back-up block 100 to pass osseous tunnel.In a kind of preferred form of the present invention, the near-end of main body 1505 is cut the type of being carved into, and for example is shown as 1535, so that more space is provided, passes transplanting hole 1510 and distad extension from here to be used to the transplanting ligament lopping.Main body 1505 also comprises one or more recesses (not shown, but preferred class is similar to or is similar to the recess 140 that is arranged in the main body (105)), and it is used for main body 1505 is installed in suitable erecting tools.

If needs are arranged, transplant ligament back-up block 1500 and also can comprise the suture hole 1545 that is used to accept traction sutures, as hereinafter discussing in more detail.In addition, if needs are arranged, the near-end of transplanting hole 1510 can be (being shown as 1550 as figure) of convergent shape, so that be provided for the less damaging bearing-surface that the transplanting ligament of transplanting hole 1510 is passed in lopping, and/or the inlet of crosswise fixed pin-and-hole 1515 can be (being shown as 1555) of convergent shape, so that help the crosswise fixed pin to enter in the crosswise fixed pin-and-hole 1515.But main body 1505 can be by material, allogeneic bone grafting, metal, pottery, Corallium Japonicum Kishinouye, fibrous composite the polymer bio-absorbable or that can biological reinvent, comprise composite at least a in aforementioned or the like and form.By by intensity preferably material form main body 1505, then transplanting ligament can remain under the tensioning state, even under the smaller situation of main body 1505, perhaps in the

hole

1510,1515 and/or 1545 wherein one or more be positioned to be in close proximity under the situation of main body 1505 peripheries, also be like this.

Still see Figure 45,46A and 46B, shown convergent shape part 1560 at the near-end 1525 of main body 1505.If needs are arranged, for example when operating room was revised, convergent shape part 1560 helped graft piece 1505 to regain and the disengaging osseous tunnel.This benefits, because if main body is regained along nearside ground and broken away from osseous tunnel, other design with square corner can be tended to be stuck in the osseous tunnel.

Referring now to Figure 46 A and 46B,, shown main body 1505, it has the transplanting hole 1510 (Figure 46 A) of length X, and this length X is substantially equal to transplant the width of ligament.Transplant hole 1510 opening is provided, it is smaller than the length Y (Figure 46 B) in the transplanting hole 110 of main body 105, and this provides the contacting of increase of graft and tunnel wall again.

In a preferred embodiment of the invention, provide the method that is used for the transplanting ligament is fixed on osseous tunnel.This method comprises the first step of the transplanting ligament back-up block in zone of preference transplanting hole, and described transplanting hole is substantially equal to transplant the given width of ligament dimensionally.This method comprises making transplants the step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.This method comprises that propelling transplanting ligament back-up block enters another step in the osseous tunnel.This method comprises the step in the transverse tunnel that forms in the host bone, and wherein transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block.The final step of this method comprises, advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fixes in the osseous tunnel thereby will transplant ligament back-up block pin.

In another preferred embodiment of the present invention, provide the method that is used for the transplanting ligament is fixed on osseous tunnel.This method comprises the step that forms the transverse tunnel in the host bone.This method comprises the step of the transplanting ligament back-up block in zone of preference transplanting hole, and described transplanting hole is substantially equal to transplant the given width of ligament dimensionally.This method also comprises making transplants the step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.Transplant the ligament back-up block and be pushed and then enter in the osseous tunnel, so that the crosswise fixed pin-and-hole of transplanting in the ligament back-up block is aimed at transverse tunnel.Final step comprises, advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fixes in the osseous tunnel thereby will transplant ligament back-up block pin.

See Figure 47 and 48 now, in a preferred embodiment of the invention, shown removable crosswise fixed pin 1600 (Figure 47), it is configured in a similar fashion as aforesaid crosswise fixed pin 300 (Figure 16).Removable steady pin 1600 (Figure 47) generally comprises the solid shafting 1605 that ends at convergent shape far-end 1610, and ribbed (perhaps have barb or threaded) segmentation 1615.Socket 1620 is formed at the near-end of removable crosswise fixed pin 1600, thereby can come engage lateral steady pin 1600 by screwdriver.Socket 1620 can be suitable for accepting the screwdriver (for example hexagon screwdriver) of rotation type or the screwdriver of hammer type.Socket 1620 also is included in the threaded interior hole 1625 that wherein forms.Threaded interior hole 1625 is configured to be bonded on the instrument of recalling 1630 (Figure 48), so that help to take out removable steady pin 1600 from horizontal osseous tunnel.

Recall instrument 1630 and generally comprise axle 1635, it at one end has handle 1640 and has screw thread protuberance 1645 at the other end.Screw thread protuberance 1645 is configured to and can engages with threaded interior hole 1625 screw-types of formation in the removable steady pin 1600.When screw thread protuberance 1645 and threaded interior hole 1625 are complementary securely, can be by on handle 1640, applying suitable active force, and removable crosswise fixed pin 1600 is withdrawn from from osseous tunnel.

The method of the transplanting ligament that is used for the correct bone tunnel is provided in a preferred embodiment of the invention.This method comprises, the threaded interior hole in the crosswise fixed pin is engaged with extracting tool.This method also comprises the step of utilizing the extracting tool that engages with threaded interior hole to withdraw from the crosswise fixed pin from osseous tunnel.This method comprises and is repositioned at another step in the osseous tunnel with transplanting the ligament back-up block.This method comprises by the transverse tunnel in host bone and advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block, fixes on final step in the osseous tunnel thereby will transplant ligament back-up block pin.

Referring now to Figure 49,, in a preferred embodiment of the invention, shown staged transverse tunnel drill 1700 with axle 1705, it has along the narrower cutting tip 1710 of first length of its far-end, along broad cutting tip 1715 in second length of narrower cutting tip 1710 nearsides, and the discontinuous part 1720 that forms in narrower cutting tip 1710 and broad cutting tip 1715 intersections.

See Figure 50 now, used staged transverse tunnel drill 1700, so that get out staged transverse tunnel 1725 (Figure 50), it, by a part of osseous tunnel 25 and enters in the mid portion of femur 15 by the lateral parts of femur 15, and is as described herein.Transverse tunnel 1725 comprises narrower part 1730 and wider portion 1735, and it corresponds respectively to the narrower cutting tip 1710 and the broad cutting tip 1715 of staged transverse tunnel drill 1700.Staged part (not shown) in the transverse tunnel 1725 provides and has been used to stop the propulsive annular shoulder of transverse tunnel pin (not shown).

In a preferred embodiment of the present invention (not shown), the staged steady pin is provided, it has the profile of a part of staged transverse tunnel drill 1700.The staged steady pin is preferably configured as and has annular shoulder, and it is formed between the narrower part of its far-end and the wider portion at its near-end.Annular shoulder allows the staged steady pin to be accepted in the one section known distance that is contained in the transverse tunnel 1725 with locating, so that the narrower part of staged steady pin is positioned in the narrower part 1730 of transverse tunnel 1725, and the wider portion of staged steady pin is positioned in the wider portion 1735 of transverse tunnel 1725.

In a preferred embodiment of the invention, provide the method that is used for the transplanting ligament is fixed on osseous tunnel.This method comprises, makes the lopping of transplanting ligament pass the transplanting hole (not shown) of transplanting in the ligament back-up block.This method also comprises, advances transplanting ligament back-up block to enter in the osseous tunnel 25.This method also comprises the step of utilizing staged transverse tunnel drill 1700 (Figure 49) to form staged transverse tunnel 1725 (Figure 50) in host bone 15, and wherein staged transverse tunnel 1725 (Figure 50) is aimed at the crosswise fixed pin-and-hole (not shown) in transplanting the ligament back-up block.This method comprises, advance staged crosswise fixed pin (not shown) to enter in the crosswise fixed pin-and-hole (not shown) of transplanting in the ligament back-up block (not shown) by the transverse tunnel in host bone 15 1725, fix on final step in the osseous tunnel 25 thereby will transplant ligament back-up block pin.

In a preferred embodiment of the invention, the staged transverse tunnel 1725 (Figure 50) in forming host bone 15 before, erecting tools is used for advancing to be transplanted the ligament back-up block and enters osseous tunnel.Preferably, erecting tools uses with the staged transverse tunnel drill, so that form the staged transverse tunnel in the host bone.

In another preferred embodiment of the present invention, the staged transverse tunnel 1725 (Figure 50) in forming host bone 15 before, traction sutures is used for advancing transplants the ligament back-up block and enters osseous tunnel.

In a preferred embodiment of the invention, provide the other method that is used for the transplanting ligament is fixed on osseous tunnel.This method comprises, utilizes staged transverse tunnel drill 1700 (Figure 49) to form the first step of staged transverse tunnel 1725 (Figure 50) in host bone 15.This method comprises making transplants the subsequent step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.Be to advance transplanting ligament back-up block to enter in the osseous tunnel 25 subsequently, so that transplant crosswise fixed pin-and-hole (not shown) and staged transverse tunnel 1725 aligned steps in the ligament back-up block.This method comprises, advance staged crosswise fixed pin (not shown) to enter in the crosswise fixed pin-and-hole (not shown) of transplanting in the ligament back-up block (not shown) by the staged transverse tunnel in host bone 15 1725, fix on final step in the osseous tunnel 25 thereby will transplant ligament back-up block pin.

In a preferred embodiment of the present invention (not shown), to transplant after the ligament lopping passes the step of transplanting the hole forming the staged transverse tunnel and make, erecting tools is used for advancing to be transplanted the ligament back-up block and enters osseous tunnel.

Referring now to Figure 51 A, 51B and 52,, in a preferred embodiment of the invention, shown the transplanting ligament reconstructing system 1740 (Figure 52) of calibration, it generally comprises keeper 1745 and relevant brill conductor 1750.

Brill conductor 1750 has with above-mentioned brill conductor 210 similarly constructs.Preferably, bore conductor 1750 and comprise the spider 1755 with

smooth perforation

1760,1760 far-ends 1765 at it of boring a hole form and are arranged to dimensionally to accept drill holder 1770 therein.Be arranged on first group of depth mark 1775 on the drill holder 1770 and be arranged to indicate far away most advanced and sophisticated 1780 distances of preliminary election part to the femur 15 from drill holder 1770.Preferably, read depth mark 1775 with respect to the proximal openings 1785 of smooth perforation 1760.

Referring now to Figure 51 B and 52,, in a preferred embodiment of the invention, shown the horizontal brill 1700 of the staged that has second group of depth mark 1790 on it.Depth mark 1790 is configured to indicate the distance of the preliminary election part to the femur 15.Preferably, read depth mark 1790 with respect to the proximal openings 1795 (Figure 52) of drill holder 1770.

In a preferred embodiment of the invention, the method that is used for the transplanting ligament is fixed on osseous tunnel is disclosed.This method comprises making transplants the first step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.This method comprises, advances and transplants the subsequent step that the ligament back-up block enters osseous tunnel.After this step be, be located by connecting on the step of the brill conductor on the graft back-up block, described brill conductor comprises spider and movably is connected drill holder on the spider, and described drill holder has a depth mark thereon.This method also comprises, by make drill holder in spider towards the osseous tunnel motion and read depth mark on the described drill holder, thereby utilize drill holder and spider to determine the step of the correct transverse tunnel degree of depth.This method comprises by according to the sign that is provided with thereon transverse tunnel drill being crept into to the given degree of depth, and in host bone, form the step of the transverse tunnel reach the correct transverse tunnel degree of depth, wherein transverse tunnel is aimed at the crosswise fixed pin-and-hole in the transplanting ligament back-up block.This method comprises by the transverse tunnel in host bone and advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block, fixes on final step in the osseous tunnel thereby will transplant ligament back-up block pin.

In another preferred embodiment of the present invention, the method that is used for the transplanting ligament is fixed on osseous tunnel is disclosed.This method comprises and is positioned to connect first step on the osseous tunnel reamer in inserting osseous tunnel with boring conductor, described brill conductor comprises spider and movably is connected drill holder on the spider, and drill holder has position depth mark thereon.This method comprises, by make drill holder in spider towards the osseous tunnel motion and read depth mark on the described drill holder, thereby utilize drill holder and spider to determine the subsequent step of the correct transverse tunnel degree of depth.This method comprises, by according to sign disposed thereon transverse tunnel drill being crept into to the given degree of depth, and forms the step of the transverse tunnel that reaches the correct transverse tunnel degree of depth in host bone.This method requires to make the lopping of transplanting ligament to pass the step of transplanting the transplanting hole in the ligament back-up block.This method comprises that propelling transplanting ligament back-up block enters in the osseous tunnel, so that transplant crosswise fixed pin-and-hole and the aligned step of transverse tunnel in the ligament back-up block.This method comprises by the transverse tunnel in host bone and advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block, fixes on final step in the osseous tunnel thereby will transplant ligament back-up block pin.

Figure 53 and 54 in a preferred embodiment of the invention, has shown the transverse tunnel drill 1800 of controlling depth, and it has stop element disposed thereon 1805.Brill 1800 can have the tip of known any kind in the plastic operation, for example, and the trough of belt tip of standard, trocar tip, flat tip, or the like.Stop element 1805 is positioned at along a certain position of the length of the transverse tunnel drill 1800 of controlling depth, so that the limit lateral tunnel bores 1800 far away most advanced and sophisticated 1810 paracentesis depths (Figure 54) that enter in the femur 15.Stop element 1805 comes the far-end puncture of limit lateral tunnel brill 1800 by engaging with spider 1755 at the far-end 1765 near proximal openings 1785, and it only allows distal portions 1815 therefrom to pass through.

In a preferred embodiment of the invention, stop element 1805 is located along the part of the transverse tunnel drill 1800 of controlling depth adjustablely or regularly, and comprise locked plug-in unit, so that determine that optionally transverse tunnel drill 1800 enters the paracentesis depth in the femur 15.

Referring now to Figure 55 and 56,, in a preferred embodiment of the invention, shown depth gauge 1900, it has setting a series of depth gauge labellings 1905 thereon.Depth gauge 1900 is configured to and can be bonded on the crosswise fixed pin 1910 at its far-end 1915, is used for inserting and correctly navigating to femur 15 (Figure 56).The far-end 1915 of the depth gauge labelling 1905 indicated depth meters of depth gauge 1900 and the position of near-end in femur 15.Preferably, read depth gauge labelling 1905 with respect to the proximal openings 1795 of drill holder 1775, its insert 1900 passes from proximal openings 1795.

Referring to Figure 52, in a preferred embodiment of the invention, the method that is used for the transplanting ligament is fixed on osseous tunnel is disclosed.This method comprises making transplants the first step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.Be that propelling transplanting ligament back-up block enters the step in the osseous tunnel after this step.This method comprises, by reading depth mark 1775 with respect to the position of spider 1755 on drill holder 1770, determines another step of the correct transverse tunnel degree of depth.This method comprises, use the transverse tunnel drill 1770 that has depth mark 1790 on it to get out the transverse tunnel that reaches the correct transverse tunnel degree of depth, and the subsequent step of the transverse tunnel in the formation host bone, transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block.This method comprises, by select crosswise fixed pin and the transverse tunnel in host bone to advance selected crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block based on the 1775 determined correct transverse tunnel degree of depth of the depth mark on the drill holder 1770, fix on the interior final step of osseous tunnel thereby will transplant ligament back-up block pin.

Still referring to Figure 52, in a preferred embodiment of the invention, the method that is used for the transplanting ligament is fixed on osseous tunnel is disclosed.This method comprises, by reading depth mark 1775 with respect to the position of spider 1755 on drill holder 1770, determines the first step of the correct transverse tunnel degree of depth.This method comprises, uses the transverse tunnel drill 1700 that has depth mark 1790 on it so that get out the transverse tunnel that reaches the correct transverse tunnel degree of depth, thereby forms another step of the transverse tunnel in the host bone.This method comprises making transplants the subsequent step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.After this step be, advance transplanting ligament back-up block to enter in the osseous tunnel, so that transplant crosswise fixed pin-and-hole and the aligned step of transverse tunnel in the ligament back-up block.This method comprises, by selecting the crosswise fixed pin based on the 1775 determined correct transverse tunnel degree of depth of the depth mark on the drill holder 1770, and the transverse tunnel in the host bone advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block, fixes on final step in the osseous tunnel thereby will transplant ligament back-up block pin.

Referring now to Figure 53 and 54,, in a preferred embodiment of the invention, the method that is used for the transplanting ligament is fixed on osseous tunnel is disclosed.This method comprises making transplants the first step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.This method comprises that propelling transplanting ligament back-up block enters the subsequent step in the osseous tunnel.This method comprises another step of using transverse tunnel drill 1800 to form the transverse tunnel that reaches desired depth in host bone 15, transverse tunnel drill 1800 has at the stop element 1805 from its far-end preset distance place, and stop element 1805 is configured to be bonded on the far-end 1765 of drill holder 1265 or spider 1755, so that restriction is drilled into the predetermined degree of depth, wherein said transverse tunnel is aimed at the crosswise fixed pin-and-hole in transplanting the ligament back-up block.This method comprises, advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fixes on final step in the osseous tunnel thereby will transplant ligament back-up block pin.

Still referring to Figure 53 and 54, in a preferred embodiment of the invention, the method that is used for the transplanting ligament is fixed on osseous tunnel is disclosed.This method comprises, use transverse tunnel drill 1800 in host bone 15, to form the first step of the transverse tunnel that reaches desired depth, transverse tunnel drill 1800 has at the stop element 1805 from its far-end preset distance place, and stop element 1805 is configured to can be bonded on the far-end 1765 of drill holder or spider 1755, so that restriction is drilled into the predetermined degree of depth.This method comprises making transplants the subsequent step that the transplanting hole in the transplanting ligament back-up block is passed in the ligament lopping.This method comprises that propelling transplanting ligament back-up block enters in the osseous tunnel so that crosswise fixed pin-and-hole and aligned another step of transverse tunnel in the transplanting ligament back-up block.This method comprises, advances the crosswise fixed pin to enter in the crosswise fixed pin-and-hole of transplanting in the ligament back-up block by the transverse tunnel in host bone, fixes on final step in the osseous tunnel thereby will transplant ligament back-up block pin.

In a preferred embodiment of the present invention (not shown), provide the improved transplanting ligament back-up block that is similar to back-up block 1500 (Figure 45) and back-up block 100 (Fig. 8), to be used for supporting the transplanting ligament of osseous tunnel.This improved transplanting ligament back-up block comprises the zone that is arranged on wherein, and this zone is arranged for when getting out the lateral pin hole of passing osseous tunnel, gets out the crosswise fixed pin-and-hole that passes main body transverse to longitudinal axis.Preferably, improved transplanting ligament back-up block also comprises the near-end of convergent shape, withdraws from transplanting ligament back-up block so that help by osseous tunnel.

In the above, discussed the present invention at the ACL reconstruction.Yet, it is also understood that the present invention also can rebuild use with the ligament reconstruction of other type and/or the anatomical tissue of other type.

Claims

1. device that is used to rebuild ligament, described device comprises:

Main body, it has far-end, near-end, and the longitudinal axis that extends between described far-end and described near-end, and described near-end is radially inwardly to be convergent shape, withdraws from described graft ligament back-up block so that help by osseous tunnel;

Transplant the hole, it passes described main body transverse to described vertical axis extension, and is configured to accept therein to transplant ligament; With

The crosswise fixed pin-and-hole, it passes described main body transverse to described vertical axis extension, and is configured to accept therein the crosswise fixed pin.

2. device according to claim 1 is characterized in that, the described near-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described transplanting hole.

3. device according to claim 1 is characterized in that, at least a portion of the opening in described transplanting hole is a convergent shape, so that the transplanting ligament that passes described transplanting hole for lopping provides less abrasive bearing-surface.

4. device according to claim 1 is characterized in that the opening of described crosswise fixed pin-and-hole is a convergent shape, so that help to make the crosswise fixed pin to enter in the described crosswise fixed pin-and-hole.

5. device according to claim 1 is characterized in that, the cross section that described main body at least a portion between described transplanting hole and described crosswise fixed pin-and-hole has substantial cylindrical.

6. device according to claim 1 is characterized in that, the described far-end of described main body is a convergent shape, so that help to advance described transplanting ligament back-up block to pass through osseous tunnel.

7. device according to claim 1 is characterized in that, the described near-end of described main body is cut the type of being carved into, so that pass described transplanting hole and provide more space along the extension of nearside ground from here for transplanting the ligament lopping.

8. device according to claim 7 is characterized in that, the described near-end of described main body is cut the type of being carved into, so that form at least one smooth basically surface.

9. device according to claim 7 is characterized in that, the described near-end of described main body is cut the type of being carved into, so that be formed at least one surface groove that extends between the described near-end of described transplanting hole and described main body.

10. device according to claim 1, it is characterized in that, but described main body by the material that is selected from the polymer bio-absorbable, material, allogeneic bone grafting, metal, pottery, Corallium Japonicum Kishinouye, the fibrous composite that can biological reinvent, comprise the material of composite at least a in aforementioned and form.

11. device according to claim 1 is characterized in that, described main body also comprises at least one element that is used for engaging with erecting tools.

12. device according to claim 11 is characterized in that, described at least one element be included in form in the described near-end of described main body and be suitable for be formed at described erecting tools on the opening that engages of fingers.

13. device according to claim 11 is characterized in that, described at least one element comprises fingers, and its described near-end from described main body extends along nearside ground, and is suitable for being bonded in the opening that is formed on the described erecting tools.

14. device according to claim 1 is characterized in that, described main body also comprises the suture hole, and it passes described main body transverse to described vertical axis extension, and is configured to accept traction sutures therein.

15. device according to claim 14 is characterized in that, the described far-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described suture hole.

16. device according to claim 1 is characterized in that, also comprises erecting tools, described erecting tools comprises:

Keeper, described keeper comprises:

Axle, it has far-end, near-end, and the longitudinal axis that extends between described far-end and described near-end, and the near-end of described axle comprises at least one fingers that is used for being bonded on described opening;

Be installed in the handle on the described near-end of described axle.

17. device according to claim 16 is characterized in that, also comprises at least one the suture post on the described near-end that is formed at described axle.

18. device according to claim 16 is characterized in that, described erecting tools also comprises the brill conductor that is suitable for being fixed on releasedly on the described keeper.

19. device according to claim 18 is characterized in that, described brill conductor comprises:

The spider that comprises far-end and near-end, the described near-end of described spider is configured to be fixed on releasedly on the described keeper; With

Drill holder, it movably is connected on the described far-end of described spider, and described drill holder comprises the drilling pipe chamber that therefrom extends through.

20. device according to claim 19, it is characterized in that, described erecting tools is configured such that the described drilling pipe chamber in the described brill conductor is aimed at the described crosswise fixed pin-and-hole in the described main body when described transplanting ligament back-up block is connected on the described far-end of described axle.

21. device according to claim 16 is characterized in that, the described near-end of described keeper comprises orientation mark, and it is used for visually indicating the axial orientation of the described far-end of described axle.

22. device according to claim 1 is characterized in that, described transplanting hole comprises the given length along described longitudinal axis, and described given length is substantially equal to the given cross sectional dimensions of described transplanting ligament.

23. device according to claim 22, it is characterized in that, described transplanting hole is arranged between the described near-end and described crosswise fixed hole of described main body, and described transplanting hole is arranged near described crosswise fixed pin-and-hole, so that allow the given length of described transplanting ligament to fit in the osseous tunnel, wherein, when the described given length in described transplanting hole is substantially equal to the given cross sectional dimensions of described transplanting ligament and described transplanting hole and is positioned adjacent to described crosswise fixed pin-and-hole, be arranged on the described given length maximum of the described transplanting ligament in the described osseous tunnel.

24. device according to claim 22 is characterized in that, at least a portion of the opening in described transplanting hole is a convergent shape, so that the transplanting ligament that passes described transplanting hole for lopping provides less abrasive bearing-surface.

25. device according to claim 22 is characterized in that, the opening of described crosswise fixed pin-and-hole is a convergent shape, so that help to make the crosswise fixed pin to enter in the described crosswise fixed pin-and-hole.

26. device according to claim 22 is characterized in that, the cross section that described main body at least a portion between described transplanting hole and described crosswise fixed pin-and-hole has substantial cylindrical.

27. device according to claim 22 is characterized in that, the described far-end of described main body is a convergent shape, so that help to advance described transplanting ligament back-up block to pass through osseous tunnel.

28. device according to claim 22 is characterized in that, the described near-end of described main body is cut the type of being carved into, so that pass described transplanting hole and provide more space along the extension of nearside ground from here for transplanting the ligament lopping.

29. device according to claim 28 is characterized in that, the described near-end of described main body is cut the type of being carved into, so that form at least one smooth basically surface.

30. device according to claim 28 is characterized in that, the described near-end of described main body is cut the type of being carved into, so that be formed at least one surface groove that extends between the described near-end of described transplanting hole and described main body.

31. device according to claim 22, it is characterized in that, but described main body by the material that is selected from the polymer bio-absorbable, material, allogeneic bone grafting, metal, pottery, Corallium Japonicum Kishinouye, the fibrous composite that can biological reinvent, comprise the material of composite at least a in aforementioned and form.

32. device according to claim 22 is characterized in that, described main body also comprises at least one element that is used for engaging with erecting tools.

33. device according to claim 32 is characterized in that, described at least one element be included in form in the described near-end of described main body and be suitable for be formed at described erecting tools on the opening that engages of fingers.

34. device according to claim 32 is characterized in that, described at least one element comprises fingers, and its described near-end from described main body extends along nearside ground, and is suitable for being bonded in the opening that is formed on the described erecting tools.

35. device according to claim 22 is characterized in that, described main body also comprises the suture hole, and it passes described main body transverse to described vertical axis extension, and is configured to accept traction sutures therein.

36. device according to claim 35 is characterized in that, the described far-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described suture hole.

37. device according to claim 22 is characterized in that, also comprises erecting tools, described erecting tools comprises:

Keeper, described keeper comprises:

Axle, it has far-end, near-end, and the longitudinal axis that extends between described far-end and described near-end, and the near-end of described axle comprises at least one fingers that is used for being bonded on described opening; With

Be installed in the handle on the described near-end of described axle.

38. according to the described device of claim 37, it is characterized in that, also comprise at least one the suture post on the described near-end that is formed at described axle.

39., it is characterized in that described erecting tools also comprises the brill conductor that is suitable for being fixed on releasedly on the described keeper according to the described device of claim 37.

40., it is characterized in that described brill conductor comprises according to the described device of claim 37:

41. according to the described device of claim 40, it is characterized in that, described erecting tools is configured such that the described drilling pipe chamber in the described brill conductor is aimed at the described crosswise fixed pin-and-hole in the described main body when described transplanting ligament back-up block is connected on the described far-end of described axle.

42., it is characterized in that the described near-end of described keeper comprises orientation mark according to the described device of claim 37, it is used for visually indicating the axial orientation of the described far-end of described axle.

43. device according to claim 1 is characterized in that, described device also comprises

The crosswise fixed pin-and-hole, it passes described main body transverse to described vertical axis extension, and is configured to accept therein the crosswise fixed pin; With

Have the crosswise fixed pin of near-end and far-end, described near-end forms threaded interior hole therein, so that help to take out described crosswise fixed pin from described osseous tunnel.

44., it is characterized in that described threaded interior hole is arranged in the drive socket of described near-end of described steady pin according to the described device of claim 43.

45., it is characterized in that described drive socket is configured to accept the hexagon screwdriver according to the described device of claim 44.

46., it is characterized in that described drive socket is configured to accept the hammer screwdriver according to the described device of claim 44.

47., it is characterized in that the described near-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described transplanting hole according to the described device of claim 43.

48., it is characterized in that at least a portion of the opening in described transplanting hole is a convergent shape according to the described device of claim 43, so that the transplanting ligament that passes described transplanting hole for lopping provides less abrasive bearing-surface.

49., it is characterized in that the opening of described crosswise fixed pin-and-hole is a convergent shape according to the described device of claim 43, so that help to make the crosswise fixed pin to enter in the described crosswise fixed pin-and-hole.

50., it is characterized in that the cross section that described main body at least a portion between described transplanting hole and described crosswise fixed pin-and-hole has substantial cylindrical according to the described device of claim 43.

51., it is characterized in that the described far-end of described main body is a convergent shape according to the described device of claim 43, so that help to advance described transplanting ligament back-up block to pass through osseous tunnel.

52., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 43, so that pass described transplanting hole and provide more space along the extension of nearside ground from here for transplanting the ligament lopping.

53., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 52, so that form at least one smooth basically surface.

54., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 52, so that be formed at least one surface groove that extends between the described near-end of described transplanting hole and described main body.

55. according to the described device of claim 43, it is characterized in that, but described main body is by the material that is selected from the polymer bio-absorbable, material, allogeneic bone grafting, metal, pottery, Corallium Japonicum Kishinouye, the fibrous composite that can biological reinvent, comprises the material of composite at least a in aforementioned and forms.

56., it is characterized in that described main body also comprises at least one element that is used for engaging with erecting tools according to the described device of claim 43.

57. according to the described device of claim 56, it is characterized in that, described at least one element be included in form in the described near-end of described main body and be suitable for be formed at described erecting tools on the opening that engages of fingers.

58., it is characterized in that described at least one element comprises fingers according to the described device of claim 56, its described near-end from described main body extends along nearside ground, and is suitable for being bonded in the opening that is formed on the described erecting tools.

59., it is characterized in that described main body also comprises the suture hole according to the described device of claim 43, it passes described main body transverse to described vertical axis extension, and is configured to accept traction sutures therein.

60., it is characterized in that the described far-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described suture hole according to the described device of claim 59.

61., it is characterized in that also comprise erecting tools, described erecting tools comprises according to the described device of claim 43:

Keeper, described keeper comprises:

Be installed in the handle on the described near-end of described axle.

62. according to the described device of claim 61, it is characterized in that, also comprise at least one the suture post on the described near-end that is formed at described axle.

63., it is characterized in that described erecting tools also comprises the brill conductor that is suitable for being fixed on releasedly on the described keeper according to the described device of claim 61.

64., it is characterized in that described brill conductor comprises according to the described device of claim 63:

65. according to the described device of claim 64, it is characterized in that, described erecting tools is configured such that the described drilling pipe chamber in the described brill conductor is aimed at the described crosswise fixed pin-and-hole in the described main body when described transplanting ligament back-up block is connected on the described far-end of described axle.

66., it is characterized in that the described near-end of described keeper comprises orientation mark according to the described device of claim 61, it is used for visually indicating the axial orientation of the described far-end of described axle.

67. device according to claim 1 is characterized in that, described device also comprises:

The staged steady pin, it has far-end, near-end, the longitudinal axis that extends between described far-end and described near-end is in the first of described far-end, at the second portion of described near-end, described first has the diameter littler than described second portion, and be arranged on annular shoulder between described first and the described second portion, wherein, described first, second portion and described annular shoulder form given profile in perpendicular to the given planar cross section of described longitudinal axis; With

The staged transverse tunnel drill, it has far-end, near-end, and the longitudinal axis that between described far-end and described near-end, extends, described staged is laterally bored the given profile corresponding to described staged steady pin, so that the staged transverse tunnel by the described osseous tunnel of a part is provided, it is configured to the via alignment with described crosswise fixed pin-and-hole, wherein, described crosswise fixed pin-and-hole passes described main body transverse to described vertical axis extension, and is configured to accept therein the crosswise fixed pin.

68., it is characterized in that the described near-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described transplanting hole according to the described device of claim 67.

69., it is characterized in that at least a portion of the opening in described transplanting hole is a convergent shape according to the described device of claim 67, so that the transplanting ligament that passes described transplanting hole for lopping provides less abrasive bearing-surface.

70., it is characterized in that the opening of described crosswise fixed pin-and-hole is a convergent shape according to the described device of claim 67, so that help to make the crosswise fixed pin to enter in the described crosswise fixed pin-and-hole.

71., it is characterized in that the cross section that described main body at least a portion between described transplanting hole and described crosswise fixed pin-and-hole has substantial cylindrical according to the described device of claim 67.

72., it is characterized in that the described far-end of described main body is a convergent shape according to the described device of claim 67, so that help to advance described transplanting ligament back-up block to pass through osseous tunnel.

73., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 67, so that pass described transplanting hole and provide more space along the extension of nearside ground from here for transplanting the ligament lopping.

74., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 73, so that form at least one smooth basically surface.

75., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 73, so that be formed at least one surface groove that extends between the described near-end of described transplanting hole and described main body.

76. according to the described device of claim 67, it is characterized in that, but described main body is by the material that is selected from the polymer bio-absorbable, material, allogeneic bone grafting, metal, pottery, Corallium Japonicum Kishinouye, the fibrous composite that can biological reinvent, comprises the material of composite at least a in aforementioned and forms.

77., it is characterized in that described main body also comprises at least one element that is used for engaging with erecting tools according to the described device of claim 67.

78. according to the described device of claim 77, it is characterized in that, described at least one element be included in form in the described near-end of described main body and be suitable for be formed at described erecting tools on the opening that engages of fingers.

79., it is characterized in that described at least one element comprises fingers according to the described device of claim 77, its described near-end from described main body extends along nearside ground, and is suitable for being bonded in the opening that is formed on the described erecting tools.

80., it is characterized in that described main body also comprises the suture hole according to the described device of claim 67, it passes described main body transverse to described vertical axis extension, and is configured to accept traction sutures therein.

81. 0 described device is characterized in that according to Claim 8, the described far-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described suture hole.

82. the device according to claim 67 is characterized in that, also comprises erecting tools, described erecting tools comprises:

Keeper, described keeper comprises:

Be installed in the handle on the described near-end of described axle.

83. 2 described devices is characterized in that according to Claim 8, also comprise at least one the suture post on the described near-end that is formed at described axle.

84. 2 described devices is characterized in that according to Claim 8, described erecting tools also comprises the brill conductor that is suitable for being fixed on releasedly on the described keeper.

85. 4 described devices is characterized in that according to Claim 8, described brill conductor comprises:

86. 5 described devices according to Claim 8, it is characterized in that, described erecting tools is configured such that the described drilling pipe chamber in the described brill conductor is aimed at the described crosswise fixed pin-and-hole in the described main body when described transplanting ligament back-up block is connected on the described far-end of described axle.

87. 2 described devices is characterized in that according to Claim 8, the described near-end of described keeper comprises orientation mark, and it is used for visually indicating the axial orientation of the described far-end of described axle.

88. device according to claim 1 is characterized in that, described device also comprises erecting tools, and described erecting tools comprises:

Keeper, described keeper comprises:

Axle, it has far-end, near-end, and the longitudinal axis that extends between described far-end and described near-end, and the near-end of described axle is configured to be bonded on described at least one element of described main body;

Be installed in the hands handle on the near-end of described axle;

Be suitable for being fixed on releasedly the brill conductor on the described keeper, described brill conductor comprises:

The spider that comprises far-end and near-end, the near-end of described spider are configured to be fixed on releasedly on the described keeper; With

Drill holder, it movably is connected on the described far-end of described spider, described drill holder comprises the drilling pipe chamber that therefrom extends through, and described drill holder has position depth mark thereon, wherein, but the described far-end of described spider and the described depth mark on the described drill holder are arranged to the transverse tunnel degree of depth of indicating correct; With

Transverse tunnel drill with far-end and near-end, the far-end of described transverse tunnel drill is configured to pass described drill holder, so that get out the horizontal osseous tunnel that passes osseous tunnel, described transverse tunnel is drilled between its described near-end and the far-end has sign disposed thereon, wherein, the depth mark on described transverse tunnel drill and the described drill holder is arranged to indicate the given depth of the described far-end of described transverse tunnel drill.

89. 8 described devices is characterized in that according to Claim 8, the described near-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described transplanting hole.

90. 8 described devices is characterized in that according to Claim 8, at least a portion of the opening in described transplanting hole is a convergent shape, so that the transplanting ligament that passes described transplanting hole for lopping provides less abrasive bearing-surface.

91. 8 described devices is characterized in that according to Claim 8, the opening of described crosswise fixed pin-and-hole is a convergent shape, so that help to make the crosswise fixed pin to enter in the described crosswise fixed pin-and-hole.

92. 8 described devices is characterized in that according to Claim 8, the cross section that described main body at least a portion between described transplanting hole and described crosswise fixed pin-and-hole has substantial cylindrical.

93. 8 described devices is characterized in that according to Claim 8, the described far-end of described main body is a convergent shape, so that help to advance described transplanting ligament back-up block to pass through osseous tunnel.

94. 8 described devices is characterized in that according to Claim 8, the described near-end of described main body is cut the type of being carved into, so that pass described transplanting hole and provide more space along the extension of nearside ground from here for transplanting the ligament lopping.

95., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 94, so that form at least one smooth basically surface.

96., it is characterized in that the described near-end of described main body is cut the type of being carved into according to the described device of claim 94, so that be formed at least one surface groove that extends between the described near-end of described transplanting hole and described main body.

97. 8 described devices according to Claim 8, it is characterized in that, but described main body is by the material that is selected from the polymer bio-absorbable, material, allogeneic bone grafting, metal, pottery, Corallium Japonicum Kishinouye, the fibrous composite that can biological reinvent, comprises the material of composite at least a in aforementioned and forms.

98. 8 described devices is characterized in that according to Claim 8, described at least one element be included in form in the described near-end of described main body and be suitable for be formed at described erecting tools on the opening that engages of fingers.

99. 8 described devices is characterized in that according to Claim 8, described at least one element comprises fingers, and its described near-end from described main body extends along nearside ground, and is suitable for being bonded in the opening that is formed on the described erecting tools.

100. 8 described devices is characterized in that according to Claim 8, described main body also comprises the suture hole, and it passes described main body transverse to described vertical axis extension, and is configured to accept traction sutures therein.

101., it is characterized in that the described far-end of described main body is arranged to more approach than described crosswise fixed pin-and-hole in described suture hole according to the described device of claim 100.

102. 8 described devices according to Claim 8, it is characterized in that, described erecting tools is configured such that the described drilling pipe chamber in the described brill conductor is aimed at the described crosswise fixed pin-and-hole in the described main body when described transplanting ligament back-up block is connected on the described far-end of described axle.

103. 8 described devices is characterized in that according to Claim 8, the described near-end of described keeper comprises orientation mark, and it is used for visually indicating the axial orientation of the described far-end of described axle.

104. 8 described devices according to Claim 8, it is characterized in that, described depth mark proximal location from it to the remote location that is arranged on the described drill holder little by little becomes big, in addition, wherein, the described depth mark that is arranged on the described transverse tunnel drill little by little becomes big from primary importance to the second position near its described near-end near its described far-end.

105. 8 described devices is characterized in that according to Claim 8, the part of the described far-end of described spider provides first reference point, and it is corresponding to the described depth mark of described drill holder.

106. 8 described devices is characterized in that according to Claim 8, the part of described drill holder provides second reference point, and it is corresponding to the described depth mark of described horizontal brill.

107. 8 described devices is characterized in that according to Claim 8, described erecting tools also comprises:

Transverse tunnel drill with far-end and near-end, the far-end of described transverse tunnel drill is configured to pass described drill holder, so that get out the horizontal osseous tunnel that passes osseous tunnel, described transverse tunnel drill has stop element, it is configured to and can engages with described drill holder, so that restriction is drilled into the predetermined degree of depth.

108., it is characterized in that described stop element is arranged between the described far-end and described near-end of described transverse tunnel drill according to the described device of claim 107, adjustablely so that allow to regulate the described predetermined drilling depth that is used for described horizontal osseous tunnel.

109. according to the described device of claim 108, it is characterized in that, described stop element comprises the axle collar that is slidably disposed on the described transverse tunnel drill and the lock bolt that is carried by the described axle collar, it is used for optionally engaging with described transverse tunnel drill, so that allow to regulate the described predetermined drilling depth that is used for described horizontal osseous tunnel.

110. according to the described device of claim 107, it is characterized in that, described stop element is included in the given distance of described far-end from described transverse tunnel drill and is arranged on the axle collar on the described transverse tunnel drill regularly, and it is used to limit described transverse tunnel drill and creeps into to the described predetermined degree of depth.

111. device according to claim 1 is characterized in that, described device also comprises:

Staged crosswise fixed pin, it has far-end, near-end, the longitudinal axis that between described far-end and described near-end, extends, first at described far-end, second portion at described near-end, described first has the diameter littler than described second portion, and be arranged on annular shoulder between described first and the described second portion, wherein, described first, described second portion and described annular shoulder form given profile in perpendicular to the given planar cross section of described longitudinal axis;

The staged transverse tunnel drill, the longitudinal axis that it has far-end, near-end and extends between described far-end and described near-end, described staged is laterally bored the described given profile corresponding to described staged crosswise fixed pin, so that the staged of passing osseous tunnel transverse tunnel is provided, it is configured to accept the described given profile of described staged crosswise fixed pin; With

Depth gauge with far-end and near-end, the described far-end of described depth gauge is configured to pass described drill holder, so that engage with the described staged transverse tunnel of part corresponding to the described annular shoulder of described staged steady pin, and described depth gauge has thereon labelling of position between described far-end and described near-end, so as indication and the corresponding described part of described annular shoulder of described staged steady pin and the described crosswise fixed pin-and-hole degree of depth between the bone surface.

112., it is characterized in that the described near-end that is marked at described drill holder of described depth gauge is indicated the described crosswise fixed pin-and-hole degree of depth according to the described device of claim 111.

113. according to the described device of claim 111, it is characterized in that, also comprise crosswise fixed pin insertion member with near-end and far-end, sounding mark thereon is set between described near-end and described far-end, and is used for the composition surface of described crosswise fixed finger setting at described crosswise fixed pin-and-hole at described far-end.

114., it is characterized in that the described sounding mark of described crosswise fixed pin insertion member is indicated the degree of depth of described crosswise fixed pin at the near-end of described drill holder according to the described device of claim 113.