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
  • A61F2/0811—Fixation devices for tendons or ligaments
• • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
  • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
  • F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
  • F16B13/00—Dowels or other devices fastened in walls or the like by inserting them in holes made therein for that purpose
  • F16B13/12—Separate metal or non-separate or non-metal dowel sleeves fastened by inserting the screw, nail or the like
  • F16B13/124—Separate metal or non-separate or non-metal dowel sleeves fastened by inserting the screw, nail or the like fastened by inserting a threaded element, e.g. screw or bolt
• • 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
  • A61F2/0811—Fixation devices for tendons or ligaments
  • A61F2002/0817—Structure of the anchor
  • A61F2002/0823—Modular anchors comprising a plurality of separate parts
  • A61F2002/0835—Modular anchors comprising a plurality of separate parts with deformation of anchor parts, e.g. expansion of dowel by set screw
• • 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
  • A61F2/0811—Fixation devices for tendons or ligaments
  • A61F2002/0847—Mode of fixation of anchor to tendon or ligament
  • A61F2002/0858—Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• • 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
  • A61F2/0811—Fixation devices for tendons or ligaments
  • A61F2002/0847—Mode of fixation of anchor to tendon or ligament
  • A61F2002/087—Anchor integrated into tendons, e.g. bone blocks, integrated rings
• • 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
  • A61F2/0811—Fixation devices for tendons or ligaments
  • A61F2002/0876—Position of anchor in respect to the bone
  • A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone

Definitions

• the present invention relates to the means allowing the attachment of a ligament to a bone.
• the document FR-A-2 696 925 describes an anchoring technique in which a hole is made in the bone tissue of the bone to which the ligament is to be attached, we take a graft consisting of a central ligament part secured to two bone ends in the shape of a bar, we introduce one of the bone bars in the hole of the bone tissue, and we introduce in parallel in the same hole, side by side with the bone bar, an axial screw forcing laterally both on the bone bar and on the wall of the bone tissue hole
• the anchoring is effective, but, during its positioning, the practitioner cannot easily adjust the axial tension of the ligament, and above all, it risks weakening the ligament by the edges of the screw which come to cut it, in particular when one wishes to anchor the end of ligament in a blind hole from the int laughing joint
• EP-A-0596829 discloses a similar anchor with an inclined screw which also produces an effect of clamping the end of the ligament, pinch could weaken the ligament
• a device for anchoring the end of an artificial ligament prosthesis consisting of a lock or braid of physiologically compatible tissue.
• the anchoring is ensured by a piton, comprising an expandable cylindrical barrel partially engaged in a perforation of the bone and receiving a screw in an axial bore of the barrel to radially expand the barrel and block it in the perforation.
• the prosthesis end is fitted around the barrel part protruding outside the bone and is pressed against the external surface of the bone by the front face of a ferrule with a diameter greater than that of the barrel and forming a head of piton.
• the prosthesis is external to the bone, and extends radially with respect to the barrel and to the perforation of the bone.
• Such an anchoring is not suitable for holding a living ligament, which is weakened by the hole of relatively large diameter made in the ligament and necessary for the passage of the barrel.
• Document DE-U-92 10 031 relates to an expandable anchor for anchoring in concrete. This is a technical field far from that of the present invention.
• the dowel includes an expandable barrel whose outer surface has a square section, to define longitudinal edges opposing rotation in the concrete hole. The expansion takes place in a diagonal direction, by a central axial screw, thanks to four longitudinal slots perpendicular to the four lateral faces. The lateral faces are thus not planar, and are interrupted by the longitudinal slots.
• the object anchored by the peg remains outside the concrete.
• the problem proposed by the present invention is to design a new ligament anchoring device which ensures effective and reliable anchoring, without risk of shearing of the ligament, and which provides the practitioner with a great facility for adjusting the tension of the ligament during installation, without requiring additional preload of the ligament.
• a ligament anchoring device for fixing the end of a ligament to a bone, comprises:
• a body elongated along a longitudinal axis and limited by a peripheral lateral surface, by a proximal end and by a distal end,
• the axial hole comprises a rigid portion with internal thread, devoid of longitudinal slots,
• the axial core and the means for moving it axially consist of a screw, the rod of which has a threaded portion operatively engaged in the tapped portion of the axial hole, the screw comprising a portion adapted to bear, during screwing, against a conical narrowing of the axial hole and thus produce the expansion of the body.
• the enlarged diameter portion of the screw is formed by the distal end of the screw opposite the screw head.
• the screw head can have a polygonal cross section with rounded corners engaging in force, at the end of screwing, in a portion of the proximal end of the body with longitudinal through slots and with a diameter smaller than that of the screw head.
• the enlarged diameter portion of the screw is formed by the proximal screw head, engaged in a conical portion proximal to the axial body hole. According to a second embodiment:
• the axial core is mounted with free longitudinal sliding in the axial hole and is coupled to the body by means of blocking in axial rotation,
• the axial core has an axial threaded bore
• a screw with a threaded rod and a proximal head is engaged in the axial body hole, with its head in axial support against the proximal end of the body and with its rod engaged functionally in the threaded axial bore of the axial core, so that the rotation of the screw axially displaces the axial core and produces the expansion of the body.
• the screw head has a conical bearing face engaged against a second conical portion of axial hole associated with second longitudinal slots, constituting a second expandable portion of the body.
• the conical portions may have a circular cross section, then constituting a conical portion of revolution, or may have a polygonal cross section, then constituting a pyramidal portion.
• FIG. 1 is a schematic side view in partial section of a ligament prosthesis connecting two ends of bone and anchored by two ligament anchoring devices according to the present invention
• - Figure 2 is a side view in section on a larger scale of one of the two ligament anchoring devices of Figure 1
• - Figure 3 is a schematic cross-sectional view along the plane AA of Figure 2
• - Figure 4 is a side view in longitudinal section of a ligament anchoring device according to a first embodiment of the present invention
• FIG. 5 is a side view in longitudinal section of a ligament anchoring device according to a variant of the embodiment of FIG. 4,
• FIG. 6 is a side view in longitudinal section of a ligament anchoring device according to a second embodiment of the invention.
• FIG. 7 is a side view in longitudinal section of a ligament anchoring device according to a variant of the embodiment of FIG. 6,
• FIG. 8 is a side view in longitudinal section of a ligament anchoring device according to another variant of the embodiment of Figure 6
• - Figure 9 is a side view in longitudinal half-section of a anchor body according to another variant of the first embodiment of the present invention
• FIG. 10 is an end view of the anchoring body of FIG. 9,
• FIG. 11 is a side view in partial section of an expansion screw adaptable in the anchoring body of FIG. 9, and
• FIG. 12 is an end view of the screw head of Figure 11
• a ligament prosthesis 1 is adapted to connect a first bone 2 to a second bone 3
• the ligament prosthesis 1 comprises a central ligament 4 secured at its first end to a first bone bar 5 and secured at its second end of a second bone bar 6
• the ligament prosthesis 1 is engaged in two holes 7 and 8 made respectively in the first bone 2 and in the second bone 3.
• the respective hole 7 or 8 has an enlarged section, allowing the engagement, parallel to the axis of the hole 7 or 8 and side by side with the corresponding bone bar 5 or 6, of a device for anchoring 11 or 12 according to the invention.
• the bone bar 5 is of elongated shape
• the anchoring device 11 is also of elongated shape. Both are arranged side by side in the hole 7, parallel to the axis II-II of the hole.
• the anchoring device 11 is a selectively radially expandable element, as represented by the arrows 13 and 14, producing the jamming of the bone bar 5 in the bone 2.
• the expansion of the anchoring device 11 is preferably progressive, so as to allow the practitioner to easily and precisely adjust the position of the bone bar 5 in the hole 7, to adjust the tension of the ligament 4 during installation.
• the expansion of the anchoring device 11 is preferably reversible, allowing the practitioner to reduce the expansion to temporarily release the bone bar 5, when a new ligament tension adjustment is necessary.
• the anchoring device 11 comprises a body 15, elongated along a longitudinal axis II and limited by a peripheral lateral surface 16, by a proximal end 17 and by a distal end 18.
• Anti-rotation reliefs are provided on the external surface of the body 15, for example on the peripheral lateral surface 16 of the body 15, to oppose its rotation in the hole 7 of the bone tissue.
• the body 15 can have a substantially constant polygonal section over its entire length, for example a square section, thus comprising edges such as the edge 19 constituting an anti-rotation relief preventing rotation of the body 15 in hole 7 of the bone tissue.
• front reliefs 119 can be provided on the distal front face 18 of the body 15.
• a part of the peripheral lateral surface 16 of the body 15 is generally flat and continuous, to form a lateral bearing face
• This lateral support face 20 is adapted to bear against one side 21 of the bone strip 5 forming the end of the ligament 4.
• a longitudinal axial hole 22 is formed in the body 15, and opens at least at its proximal end 17.
• the axial hole 22 comprises at least one conical portion 23 of the axial hole.
• Longitudinal through slots, such as the slot 24, are distributed around the periphery of the peripheral surface 16 of the body 15, in the vicinity of the area occupied by the conical portion 23 of the axial hole 22.
• slots, such as the through slot 24 are distributed over a length F on either side of the conical portion 23.
• FIG. 3 illustrates an embodiment with four slots 24, seen in transverse section along the planes BB of FIGS. 4 to 8. It can be seen that the slots 24 are advantageously arranged in diagonal orientations connecting the tops of the square section, so that the lateral support face 20 is continuous, that is to say devoid of slots.
• an axial core is housed in the axial hole 22 of the body 15 and is movable longitudinally to bear against the conical portion 23 of the axial hole 22 and thus produce the expansion of the body 15.
• the axial hole 22 comprises a rigid portion 124 with internal thread, devoid of longitudinal slots.
• the axial core and the means for moving it axially are then constituted by a screw 25, the rod of which comprises a threaded portion 26 operatively engaged in the rigid proximal tapped portion 124 of the body 15 with axial hole 22, the distal end 27 of the screw 25, opposite the screw head 28, comprising a conical portion engaging in the conical portion 23 of the axial hole 22 to produce the expansion of the split intermediate part F of the body 15 when the screw 25 is screwed by its portion threaded 26 in the threaded portion 124 of the body 15.
• the screw 25 may include a head 28, provided with means for engaging a screwing tool, for example a blind axial hole of polygonal section.
• the screw head 28 has a conical bearing face 29 with radial grooves 30 engaging, in end of screwing, against a corresponding conical proximal face 31 striated from the body 15, opposing the unscrewing of the screw 25.
• proximal end 17 of the body 15 and the screw head 28 can be split to give them a flexibility capable of producing a reversible snap engagement opposing the involuntary unscrewing of the screw.
• the conical portion 23 of the axial hole 22 is constituted by the hole portion closest to the proximal end 17 of the body 15, and the rigid portion 124 of body 15 is close to the distal end 18.
• the screw 25 carries, by its proximal head 28 with a flared bearing face, against the conical portion 23 proximal of the axial hole 22 of the body 15.
• the slots extend along the proximal portion F of the body 15.
• an axial core 32 is mounted to slide freely in the axial hole 22 and is coupled to the body 15 by means of locking in axial rotation.
• the axial core 32 has, on its peripheral surface, a radial lug 33 for locking engaged in one of the slots 24 of the body 15 to prevent its rotation.
• the axial core 32 has a threaded axial bore 34.
• a screw 35, with a threaded rod 36 and a proximal head 37 is engaged in the axial hole 22 of the body 15. The head 37 comes to bear axially against the proximal end 17 of the body 15.
• the screw rod 36 is engaged functionally in the axial threaded bore 34 of the axial core 32.
• the difference lies in the fact that the screw head 37 has a conical or flared support face 38, engaged against a second conical portion 39 of the axial hole 22 associated with second longitudinal slots F2 constituting a second portion expandable from the body 15.
• the body 15 comprises a first expandable portion F close to the distal end 18, and a second expandable portion F2 close to the proximal end 17.
• FIG. 8 illustrates a variant of the embodiment of FIG. 6, in which the corresponding elements are identified by the same reference numbers.
• the modification resides in the particular shape of the axial core 32 which, in the embodiment of FIG. 6, is generally spherical, and, in the variant of FIG. 8, is generally frustoconical.
• the peripheral lateral surface 16 of the body 15 advantageously includes anti-slip reliefs opposing the axial sliding of the body 15 in the hole 7 of the bone tissue, and simultaneously opposing the relative axial sliding between the body 15 and the bone bar 5 to be blocked which forms the end of the ligament 4.
• FIGS. 9 to 11 is similar to the embodiment illustrated in FIGS. 3 and 4 To avoid repeating the description, the corresponding elements of the two embodiments will be identified by the same numerical references.
• the anchoring body 15 elongated along the longitudinal axis II, with its peripheral lateral surface 16 having a generally flat support side face 20, with an axial hole 22 with narrowing 23 between a narrower portion of the hole 122 and a larger proximal portion of hole 222, and with four slots 24
• the distal portion 122 of hole 22 is produced by crossing the four diagonal slots 24, as best seen in FIG. 10.
• the diagonal slots 24 extend over the length of anchor body 15 occupied by the distal portion 122 of hole 22, between the distal end 18 and the narrowing 23 On the proximal side, the narrowing 23 is bordered by an area 322 of axial hole 22 of enlarged diameter, promoting the radial elastic deformation of the body 15 in the region of the constriction 23
• the outer surface 16 of the anchoring body 15 is generally in the shape of a parallelepiped with a square section, with anti-slip reliefs 116 in the distal portion in the form of circular ribs with a triangular section.
• the anchoring body 15 comprises a proximal end portion 215 with longitudinal through slots such as the slots 216 and 217 and with an internal diameter D1 possibly variable to form a light cone with a distal apex.
• the axial core is also a screw 25 with generally cylindrical body, with a distal end 27 conical at a cone angle of about 60 ° intended to engage in the narrowing 23 of the anchoring body 15
• the proximal end of the screw 25 is a head 28 of polygonal cross section with rounded corners, for example a square section as illustrated in FIG.
• a ligament prosthesis comprises an anchoring device 11 engaged side by side, in a hole 7 in the bone tissue, with a bone bar 5 forming the end of a ligament 4
• the anchoring device according to the invention is carried out using biocompatible materials, possibly bioresorbable
• the anchor body 15 can be made of polyethylene
• the expansion screw 25 can be made of stainless steel, titanium or polyethylene
• present invention does not is not limited to the embodiments which have been explicitly described, but it includes the various variants and generalizations thereof contained in the field of claims below

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• Health & Medical Sciences (AREA)
• Engineering & Computer Science (AREA)
• General Engineering & Computer Science (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Biomedical Technology (AREA)
• Rehabilitation Therapy (AREA)
• Rheumatology (AREA)
• Cardiology (AREA)
• Mechanical Engineering (AREA)
• Transplantation (AREA)
• Orthopedic Medicine & Surgery (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=9484139

Family Applications (1)

Country Status (6)

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• 1995
  • 1995-10-27 FR FR9512910A patent/FR2740324B1/fr not_active Expired - Fee Related
• 1996
  • 1996-10-25 WO PCT/FR1996/001672 patent/WO1997015244A1/fr not_active Application Discontinuation
  • 1996-10-25 US US09/051,021 patent/US5989253A/en not_active Expired - Fee Related
  • 1996-10-25 AU AU73083/96A patent/AU7308396A/en not_active Abandoned
  • 1996-10-25 JP JP9516368A patent/JP2000500990A/ja active Pending
  • 1996-10-25 EP EP96934973A patent/EP0858300A1/fr not_active Withdrawn

Non-Patent Citations (1)

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