Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/08—Muscles; Tendons; Ligaments

Definitions

• the present invention relates to an artificial ligament and its manufacturing process.
• a large number of types of artificial ligaments are known which are intended to replace articular ligaments.
• ligaments formed by folding or rolling textile bands of a biocompatible material, woven or knitted so as to leave free or, on the contrary, to bind together the longitudinal fibers of the ligament.
• it has been proposed to produce braided ligaments, with a greater or lesser twist, with the aim of improving the elasticity qualities of the artificial ligaments by reversible deformation of the turns thus formed along said ligaments.
• the present invention aims to further improve the response of current ligaments to the stresses to which they are subjected once implanted in the injured joints by proposing to approach as close as possible to the geometry and the configuration. fibers of a natural joint ligament.
• the present invention relates to an artificial ligament for the replacement of a natural articular ligament, comprising two end intraosseous parts and an intermediate intra articular part, characterized in that at least said intra articular part is formed.
• the length over which the width is slit is at most equal to that of the intra-articular part of the ligament, so that the two fiber cords of the ligament are independent of each other only in the middle of the intra-articular area of implantation of said ligament.
• the ligament may be made from two rolled half-widths which will then be sewn at the two ends over an adequate length to constitute the intraosseous parts.
• the structure in two twisted cords of the ligament according to the invention provides, for the replacement of the anterior cruciate ligament of the knee, a completely new and surprising biomechanical advantage compared to previously known ligaments.
• the anterior cruciate ligament undergoes a twist of about a quarter of a turn when the knee passes from its flexion position to its maximum extension position; by implanting an artificial ligament twisted in the same direction as this natural movement of torsion between the tibia and the internal femoral condyle on the knee in flexion, one can make so that, in position of extension of the knee, the two rolled cords forming the ligament untwist, then presenting a perfectly parallel structure. If, in this geometry, provision has been made to make the ligament from a knitted width preserving the parallelism of the longitudinal fibers, the latter will then be able to withstand the forces applied to the implanted ligament in their own longitudinal direction.
• This arrangement therefore allows the longitudinal fibers to be parallel to each other when the knee is close to the extension, that is to say in the position where it is usually traumatized during sprains; there is thus a progressive recruitment of the fibers during tensioning efforts, which is accompanied by a damping effect comparable to that of a natural ligament.
• a width is fixed flat, knitted over all or part of its length, in a longitudinal drive device, parallel to the edges of said width,
• the width is advanced towards a calibrated circular opening, through a converging nozzle, symmetrical in the longitudinal direction, while applying to said width a force intended to keep it flat, at least in the middle,
• either the ligament is gradually pivoted on itself at least a quarter of a turn before being sewn.
• the longitudinal fibers of the width used to form the ligament are stranded when knitting said width, so that after rolling, the ends of the ligament are twisted at least a quarter of a turn by compared to each other.
• the amount of rotation of the two cords can of course be perfectly determined by means of various tests carried out at the time of knitting.
• FIG. 1 is a partially exploded perspective view of the artificial ligament according to the invention
• FIG. 2 is a plan view of the knitted and slit width serving to obtain by convolute rolling the ligament represented in FIG. 1,
• FIGS 3 to 5 are views in sagittal section of the tibio-femoral joint showing the pivoting on itself of the anterior cruciate ligament of the knee between the position of extension and the position of maximum flexion.
• the articular ligament represented in the figures comprises two end intraosseous parts 1 and an intraarticular part 2, which are obtained from a knitted textile width 3 having, along a median longitudinal axis, a slot 3 intended to form, after convolute rolling of said width 4 parallel to its lateral edges, an opening 5 separating two cords 6 of the intra-articular part 2 of the ligament.
• the slot 3 has a length such that the intraosseous parts 1 comprising two contiguous cords, linked together by a transverse seam 1b.
• the two intra-articular cords 6 of the ligament are therefore of identical lengths, so that the distribution of the tensile forces is distributed uniformly between the two cords 6.
• the means for producing the ligament allow to print a final rotation of approximately 180 ° between the two intraosseous parts 1 of the ligament.
• the rotation will be dextrorotatory or levorotatory depending on the type of right or left ligament produced.
• the longitudinal, so-called technical, fibers of the width used for the production of the ligament are held together by a warp knitting, that is to say a knitted fabric knitted offering a high roughness and limiting the offset of said fibers. longitudinal with respect to their axis. Roughness is useful in the intraosseous areas to allow good bone re-stabilization of the implanted ligament.
• FIGS. 3 to 5 An example of implantation of the artificial articular ligament shown in FIGS. 1 and 2 has been shown in FIGS. 3 to 5 in place of the anterior cruciate ligament of the knee.
• the knee is shown in the position of maximum extension; in this position, the artificial ligament is stretched between the tibia 9 and the internal condyle of the femur 10 by presenting its two cords 8 parallel to each other. The longitudinal fibers making up the ligament are then recruited gradually with a damping effect already mentioned above.
• FIG. 4 the knee is slightly bent, which causes the ligament to begin to twist as the condyles of the femur 10 roll on the tibial plates.
• the knee is in maximum flexion; at this time, the end of the ligament implanted in the femoral tunnel has practically pivoted by an angle of 180 °. It is in this latter position that the anterior cruciate ligaments are generally implanted; we therefore understand that the pre-twisted ligament according to the invention is particularly suitable for this prosthetic operation and has, in the latter case, biomechanical qualities of stability and iso-stria almost ideal.
• the invention is of course not limited to the description which has just been given, but on the contrary extends to the production of any articular ligament commonly implanted prosthetics, such as lateral or crossed knee ligaments, spinal ligaments and shoulder ligaments.

Landscapes

• Health & Medical Sciences (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Rehabilitation Therapy (AREA)
• Rheumatology (AREA)
• Cardiology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Transplantation (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Prostheses (AREA)

Applications Claiming Priority (3)

Publications (1)

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ID=9434919

Family Applications (1)

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• 1992
  • 1992-10-28 FR FR9212840A patent/FR2697151B1/fr not_active Expired - Fee Related
• 1993
  • 1993-10-27 WO PCT/FR1993/001053 patent/WO1994009720A1/fr not_active Application Discontinuation
  • 1993-10-27 EP EP93924116A patent/EP0618787A1/de not_active Withdrawn
  • 1993-10-27 JP JP6510770A patent/JPH07506995A/ja active Pending
  • 1993-10-27 CA CA 2126459 patent/CA2126459A1/fr not_active Abandoned
  • 1993-10-27 AU AU53731/94A patent/AU5373194A/en not_active Abandoned

Non-Patent Citations (1)

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