EP1119317A1 - Guide servant a fixer un ligament dans l'endosteum - Google Patents

Guide servant a fixer un ligament dans l'endosteum

Info

Publication number
EP1119317A1
EP1119317A1 EP99951670A EP99951670A EP1119317A1 EP 1119317 A1 EP1119317 A1 EP 1119317A1 EP 99951670 A EP99951670 A EP 99951670A EP 99951670 A EP99951670 A EP 99951670A EP 1119317 A1 EP1119317 A1 EP 1119317A1
Authority
EP
European Patent Office
Prior art keywords
chute
bone
ligament
bioabsorbable
hole
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP99951670A
Other languages
German (de)
English (en)
Inventor
Pertti Tormala
James P. Tasto
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Bionx Implants Oy
Original Assignee
Bionx Implants Oy
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Bionx Implants Oy filed Critical Bionx Implants Oy
Publication of EP1119317A1 publication Critical patent/EP1119317A1/fr
Withdrawn legal-status Critical Current

Links

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
    • 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
    • A61F2002/0876—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
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body

Definitions

  • This invention relates to the field of bioabsorbable implants and their methods of use. More particularly, this invention relates to a bioabsorbable implant for use in the endosteal fixation of a ligament, such as the cruciate ligaments, and the methods for its use.
  • cruciate ligaments serve the important purposes of maintaining the proper positioning of the femur with respect to the tibia and the tibia plateau and preventing potentially dangerous rotation, hyperextension, or hyperflexion of the knee joint.
  • the proper functioning of the cruciate ligaments is necessary to maintaining the proper stability and mobility of the knee joint.
  • Torn or damaged cruciate ligaments are commonly treated through the use of autografts - connective tissues, such as tendons or ligaments, which are transplanted from elsewhere in the patient and grafted onto the site of the originally damaged or torn cruciate ligament. Allograft tissue is also occasionally used in a variety of reconstructions. There are several important factors that determine the success of an autograft used to replace a torn or damaged cruciate ligament. The autograft must be affixed to a location as near as possible to the location of the original cruciate ligament.
  • the autograft will not function as the original cruciate ligament did and will not provide the necessary stability and movement control to the knee joint.
  • the autograft must not be damaged during the grafting process and must be able to quickly attach itself through the healing process to the bones to which it is grafted. Otherwise, during the post-operative rehabilitation period of the patient, the autograft may tear, stretch or separate from its fixation device and no longer serve as a proper replacement for the cruciate ligament. Further, the physical characteristics of the autograft should mirror those of the original cruciate ligament. These physical characteristics must be maintained over time and not degrade. Otherwise, the patient will eventually lose the stability and proper mobility of the knee joint and may require additional surgery to replace the autograft.
  • the hole is larger than the autograft segments in the hole.
  • the autograft is not pressed into solid contact with the bone, which slows the healing process. The autograft will most likely attach itself quickly and securely to the bone when as much of the autograft as possible is pressed securely against the bone surface.
  • the lack of good contact between the autograft and the bone causes the autograft to move around within the hole and at its entrance. This can damage the autograft, as well as cause a lack of stability in the knee joint. For optimal stability, the autograft must be tautly attached to the bone.
  • fixation apparatus that securely hold the autograft against the side of the hole drilled in the bone, at the entrance of the hole.
  • screws have been used to securely hold autografts against the sides of the drill hole.
  • the threads of the screw often damage and cause necrosis in the autograft, which can hinder proper healing. Screws also unnecessarily reduce the surface area of the autograft that is exposed to the bone. Additionally, the insertion of the screw may inadvertently advance the autograft during insertion.
  • other, bulkier, multi-part devices have been developed in which a screw does not directly press against the autograft.
  • fixation device that will aid rapid, secure, and sustained healing and attachment of connective tissue to bone or other hard tissue without damaging or causing necrosis in the connective tissue during the attachment procedure. It is further an object of the present invention to provide a fixation device that will aid rapid, secure, and sustained healing and attachment of connective tissue to bone or other hard tissue and that may be used simply, quickly, and arthroscopically or in an open procedure.
  • fixation device that will aid rapid, secure, and sustained healing and attachment of connective tissue to bone or other hard tissue and that is bioabsorbable. It is further an object of the present invention to provide a fixation device that will aid rapid, secure, and sustained healing and attachment of connective tissue to bone or other hard tissue and that has a high pullout strength of at least 50 MPa.
  • the present invention is designed to aid the attachment of connective tissue, such as ligaments, to hard tissue, such as bone.
  • connective tissue such as ligaments
  • the present invention is designed to aid the attachment of connective tissue, such as ligaments, to hard tissue, such as bone.
  • a hole is drilled in the bone and the ligament is fed into the hole.
  • the ligament may be folded upon itself in the hole so that a plurality of loops or segments of ligament are present in the hole.
  • the device of the present invention which will be referred to as a chute, is bioabsorbable and is inserted into the hole and pushes the ligament tightly against the side of the hole. This contact between the ligament and the bone promotes healing and strong attachment between the two.
  • the chute may be easily inserted into the hole, simply by pushing the chute into the hole by hand or with a simple arthroscopic or other surgical device. It is noted that the use of the present invention is useful in, but is not limited to, arthroscopic procedures.
  • the portion of the chute that abuts the bone contains barbs or spikes or other protrusions, which increase the pull out strength of the chute and prevents migration.
  • the portion of the chute that abuts the ligament does not contain barbs or spikes or other protrusions, so that the ligament is not damaged during the attachment process.
  • the present invention is useful for the attachment of any connective tissue or synthetic tissue (like bioabsorbable, fibrous polymeric ligaments) to hard tissue.
  • connective tissue or synthetic tissue like bioabsorbable, fibrous polymeric ligaments
  • the present invention could be easily used in allograft hamstring fixation, quadriceps tendon fixation, or even in a bone-tendon-bone method of fixation when the osseous component does not fit well into the canal.
  • FIG. 1 is a cross sectional side view of an embodiment of the chute of the present invention after having been inserted in a patient.
  • FIG. 2 is a cross sectional top view of an embodiment of the chute of the present invention after having been inserted in a patient.
  • FIG 3 is a cross sectional top view of another embodiment of the chute of the present invention after having been inserted in a patient.
  • FIG 4 is a cross sectional top view of another embodiment of the chute of the present invention after having been inserted in a patient.
  • FIG 5 is a cross sectional top view of another embodiment of the chute of the present invention after having been inserted in a patient.
  • FIG. 6 demonstrates the attachment of a ligament within a patient without using the chute of the present invention.
  • the chute of the present invention is designed to aid in the attachment of a ligament or other connective tissue to bone or other hard tissue.
  • the chute securely presses a ligament against the bone to which it is being attached, without harming the ligament, in order to promote healing.
  • a hole is drilled in the bone to which the ligament will be attached.
  • the hole is created using standard techniques, whether it is inside out or outside in. To the extent possible, the drill hole should approximate the size of the ligament or graft being used. However, this is not critical because the present invention will ensure strong connection between the ligament and the bone.
  • FIG. 6 demonstrates the ligament as it is attached in the prior art without using the chute of the present invention. It can be seen in FIG. 6 that a hole 3 has been drilled in the bone 6. The ligament 2 has been attached to an anchor 5 that is set in the base of the hole. It should be noted that the drill hole 3 is larger than the ligament 2. Thus, the ligament 2 can move around from one side of the hole 3 to the other, as it is pulled in various directions during the ordinary physical activities of the patient.
  • This movement of the ligament is shown in FIG. 6.
  • the position of the ligament 2 could occur, for instance, if the joint were in flexion. However, if the joint were in extension, the ligament 2 would be pulled to the other side of the entrance 7 to the hole 3. Thus, the ligament would be in the position of ligament 2a. drawn in dotted lines.
  • This motion of the ligament 2 within the hole 3 has several negative consequences.
  • this motion prevents the ligament 2 from maintaining good contact with any part of the bone 6. Such contact is important in promoting proper long-term attachment of ligament to bone. Without good contact between the bone and the ligament, the healing process takes longer, and the ligament is not as strongly attached to the bone.
  • the motion of the ligament 2 at the edge 7 of the hole 3 can cause damage or irritation to the ligament 2 as it rubs against the edge 7. This damage can be serious enough to cause a complete failure of the attachment, requiring additional ligament replacement surgery.
  • this motion of the ligament 2 exacerbates the problems associated with the stretching or "creep " of the ligament 2 over time.
  • ligaments are attached to a bone and are subject to the cyclical stresses that occur through the normal activities of the patient, they tend to stretch. This causes the ligaments to become less taut and therefore reduces the stability of the joint. It is important to maintain the long-term tautness of the ligament after it has been attached to the bone, so that stability in the joint is maintained.
  • the stresses that are placed on the ligament 2 are passed directly through to the portion of the ligament 2 attached to the anchor 5. Depending upon the manner in which the ligament 2 is attached to the anchor 5, this can result in the tearing of the ligament 2 at the point where it is attached to the anchor 5 or sutures tearing tlirough the ligament 2. Such a failure of the ligament 2 would require another replacement or reattachment operation.
  • the chute 1 an embodiment of the present invention, solves these problems.
  • the chute 1 presses against the ligament 2, forcing it into close, secure contact with the bone 6.
  • the length of the chute 1 used in a particular case may vary, so that there is strong contact along the length of the hole 3, including its aperture. As explained above, this contact promotes rapid healing and strong attachment of the ligament 2 to the bone 6.
  • the ligament 2 may not move around within the hole 3. Thus, there is no risk of damage to the ligament 2 caused by its rubbing against the edge of the hole 3. Further, the amount of stretch or creep in the ligament is reduced because the portion of the ligament 2 that is in contact with the chute 1 is held securely in place and is not allowed to stretch.
  • the pressure of the chute 1 against the ligament 2 prevents the stresses placed on the ligament 2 from being transferred to the point where the ligament 2 is attached to the anchor 5.
  • the chute 1 by preventing the movement of a long section of the ligament 2, at least partially shields from stresses the portion of the ligament 2 that is attached to the anchor 5. This prevents damage to the ligament 2 at the point of attachment.
  • the particular method of insertion will vary, depending upon the nature of the reconstruction being performed.
  • the chute of the present invention may be inserted by hand or with a surgical tool.
  • the portion 8 of the chute 1 that contacts the ligament 2 is relatively smooth and devoid of protuberances. Often, when pointed objects are placed in close contact with ligaments, they cause point necrosis in the ligament. The relative smoothness of the portion 8 of the chute 1 that contacts the ligament 2 helps to prevent such necrosis from occurring. The relative smoothness of the portion 8 of the chute 1 also facilitates easy insertion of the chute, with no damage to the ligament 2. It is always beneficial to reduce the amount of time needed to complete surgery. Thus, devices that may be easily used are always in demand. The ability of the chute 1 to be inserted simply by pushing it into the hole 3 makes it particularly useful.
  • the portion 9 of the chute 1 that contacts the bone 6 contains protrusions, such as barbs, ridges, scales, etc. that resist movement of the chute 1 towards the edge 7 of the hole 3. This tends to increase the pull out strength of the chute 1.
  • the protrusions are configured, however, so that they do not prevent the chute 1 from being easily inserted by merely pushing it into the hole 3.
  • the chute of the present invention can have a variety of different cross sections, depending upon the number and size of the ligament segments that are being pressed against the bone. Depending on the amount of ligament available, several segments of ligament may be looped through the hole in the bone. In all cases, the cross section of the chute 1 is designed to maximize the surface area contact between the ligaments 2 and the bone 6.
  • FIG. 2, FIG. 3 and FIG 4 show cross sections for additional embodiments of the present invention.
  • the ligament 2 takes up most of the space of the hole 3.
  • the chute 1 has a relatively small cross sectional area.
  • the chute 1 has a larger cross sectional area because the ligament 2 takes up less space in the hole 3.
  • FIG. 1 the chute 1 has a larger cross sectional area because the ligament 2 takes up less space in the hole 3.
  • the chute 1 has an even larger cross sectional area because the ligament 2 takes up even less space in the hole 3.
  • the cross section is designed so that a ridge 10 in the chute 1, does not contact the bone 6. Instead, the ridge 10 pushes a greater surface area of the ligament 2 against the bone 6, thereby promoting better healing and attachment between the bone 6 and the ligament 2.
  • FIG. 5 shows a cross section for an additional embodiment of the chute of the present invention to be used when there are four segments of ligament 2 looped in the hole 3.
  • the chute 1 has four ridges 1 1 , the ends of which contact the bone 6.
  • each of the ridges 1 1 may have barbs or other protrusions 12, which resist removal of the chute 1 once it is inserted into the hole 3.
  • the geometry of chute 1 is such that the majority of the surface area of the bone 6 is in secure contact with the ligament 2, not the chute 1. This feature promotes rapid and secure healing and attachment of the ligament 2 to the bone 6.
  • the chutes of the present invention are bioabsorbable and can be prepared from known bioabsorbable polymers, using techniques that are well known in the art for preparing such polymeric rods, plates, profiles, etc., such as injection molding and extrusion, and the chutes also can be prepared from oriented, fibrillated bioabsorbable polymers in accordance with the techniques described in U.S. Patent No. 4,968.317. the entire disclosure of which is incorporated herein by way of this reference. These and other known techniques for preparing the bioasorbable rods of the invention will be apparent to those of ordinary skill in the art. Since the chutes are bioabsorbable, as the ligaments become more strongly attached to the bone over time, the chutes degrade into harmless byproducts.
  • nonbioabsorbable implants can partially degrade into harmful products, thereby causing irritation or rejection by the tissue surrounding the implant. Also, at times nonbioabsorbable implants must be removed, requiring a second surgical procedure. Further, nonbioabsorbable implants can obscure the surrounding tissue, making it difficult to view, for instance with X- rays or MRI scanners. These problems are avoided by using a bioabsorbable chute.
  • the chutes which have a substantial contact surface with bone can contain open porosity or holes which penetrate the chute.
  • the diameter of the pores or holes can typically be between about 100 m-2000 ⁇ m. Such pores or holes help bone tissue and/or connective tissue to grow through the chute to create tissue-ligament contact through the chute even before the biosabsorption of the chute has occurred.
  • the chutes of the present invention can be manufactured of thermoplastic bioabsorbable (resorbable or biodegradable) polymers, copolymers, polymer alloys, or composites e.g. of poly- ⁇ -hydroxy acids and other aliphatic bioabsorbable polyesters, polyanhydrides, polyorthoesters, polyorganophosphatzenes, tyrosine polycarbonates and other known bioabsorbable polymers disclosed in numerous publications, e.g. in S. Vainiopaa et a Prog. Polym. Sci., 14 (1989) 679-716, FI Pat. No. 952884. FI Pat. No. 955547 and WO-90/04982, EP 0449867 Bl, US Pat. No.
  • Implants in accordance with the present invention may be manufactured of bioabsorbable polymers by using one polymer or a polymer alloy.
  • the implants can also be reinforced by reinforcing the material by fibers manufactured of a resorbable polymer or of a polymer alloy, or with biodegradable glass fibers, such as ⁇ -tricalciumphosphate fibres, bioactive glass fibers, CaM fibers, using techniques that are known to those of ordinary skill in the art, as described in EP 146398, the entire disclosure of which is incorporated herein by way of this reference.
  • Ceramic and bioactive glass powders may also be used as additives (fillers) in the implants of the present invention to promote new bone formation.
  • Bioactive glass or ceramic fillers and/or fiber reinforcement useful in making the polymeric chutes of the invention also are described e.g. in M. Brink "Bioactive Glasses with a Large Working
  • the materials and implants of the present invention may also contain various additives for facilitating the processability of the material (e.g. stabilizers, antioxidants or plasticizers) or for changing its properties (e.g. plasticizers or ceramic powder materials or biostable fibers, such as carbon) or for facilitating its treatment (e.g. colorants).
  • the implant of the present invention contains a bioactive agent or agents, such as antibiotics, chemotherapeutic agents, agents activating healing of wounds, growth factor(s), bone morphogenic protein(s), anticoagulants (such as heparin), etc.
  • bioactive implants are particularly advantageous in clinical use, because they have, in addition to their mechanical effect, also biochemical, medical and other effects to facilitate tissue healing and/or regeneration.

Abstract

L'invention concerne un implant bioabsorbable (1) conçu pour fixer un ligament (2), tel que les ligaments cruciformes, dans l'endostéum. Elle concerne un procédé servant à creuser un trou (3) dans l'os (6) et à placer un ligament (2) dans le trou (3) avec un guide (1). Ce ligament (2) est fixé au moyen d'un dispositif d'ancrage (5). Le guide (1) présente une structure constituée par un bord lisse (8) et un bord irrégulier (9), le bord lisse s'appuyant contre le ligament (2) et le bord irrégulier contre l'os (6).
EP99951670A 1998-09-30 1999-09-29 Guide servant a fixer un ligament dans l'endosteum Withdrawn EP1119317A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US16399898A 1998-09-30 1998-09-30
US163998 1998-09-30
PCT/US1999/022701 WO2000018332A1 (fr) 1998-09-30 1999-09-29 Guide servant a fixer un ligament dans l'endosteum

Publications (1)

Publication Number Publication Date
EP1119317A1 true EP1119317A1 (fr) 2001-08-01

Family

ID=22592536

Family Applications (1)

Application Number Title Priority Date Filing Date
EP99951670A Withdrawn EP1119317A1 (fr) 1998-09-30 1999-09-29 Guide servant a fixer un ligament dans l'endosteum

Country Status (3)

Country Link
EP (1) EP1119317A1 (fr)
AU (1) AU6406399A (fr)
WO (1) WO2000018332A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2781970A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Mécanisme de réglage de spiral d'horlogerie
EP2781965A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Cassette de mécanisme d'horlogerie
EP2781966A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Ancre de mécanisme d'échappement d'horlogerie
EP2781967A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Spiral d'horlogerie
EP2781971A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Structure de mécanisme d'horlogerie

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US7890158B2 (en) * 2001-06-05 2011-02-15 Lumidigm, Inc. Apparatus and method of biometric determination using specialized optical spectroscopy systems
US7235074B1 (en) 1999-07-09 2007-06-26 Sklar Joseph H Ligament shim
WO2002096323A1 (fr) * 2001-05-25 2002-12-05 Sklar Joseph H Rondelle de calage pour ligament
US20040068262A1 (en) * 2002-10-02 2004-04-08 Mark Lemos Soft tissue fixation implant
ES2853202T3 (es) * 2010-01-27 2021-09-15 Sportwelding Gmbh Elemento de sujeción adecuado para sujetar un tejido o un elemento protésico correspondiente en una abertura proporcionada en un hueso humano o animal

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US4255820A (en) * 1979-07-24 1981-03-17 Rothermel Joel E Artificial ligaments
US5632748A (en) * 1993-06-14 1997-05-27 Linvatec Corporation Endosteal anchoring device for urging a ligament against a bone surface
US5454811A (en) * 1993-11-08 1995-10-03 Smith & Nephew Dyonics, Inc. Cam lock orthopedic fixation screw and method
US5931869A (en) * 1997-07-23 1999-08-03 Arthrotek, Inc. Apparatus and method for tibial fixation of soft tissue

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See references of WO0018332A1 *

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2781970A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Mécanisme de réglage de spiral d'horlogerie
EP2781965A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Cassette de mécanisme d'horlogerie
EP2781966A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Ancre de mécanisme d'échappement d'horlogerie
EP2781967A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Spiral d'horlogerie
EP2781971A1 (fr) 2013-03-19 2014-09-24 Nivarox-FAR S.A. Structure de mécanisme d'horlogerie

Also Published As

Publication number Publication date
AU6406399A (en) 2000-04-17
WO2000018332A1 (fr) 2000-04-06

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Effective date: 20060401