Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00477—Coupling
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
  • A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
  • A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws

Definitions

• the present invention relates to a device for anchoring a tissue in a bone comprising an anchor elongate about an axis comprising a head pierced with a suture passage eyelet and a body for insertion and maintenance of the head inside the bone.
• It also relates to a method of fixing and maintaining a fabric on a block.
• the invention finds a particularly important, although not exclusive, application in the field of implants or anchors said second row for the repair of the rotator cuff.
• the rotator cuff is a set of tendons that essentially consists of four tendons that attach the sub-spinous, supraspinous, subscapular, and small round muscles to the humeral head.
• An implant is thus commonly known consisting of a small anchor to impact, free to slide about fifteen millimeters distal portion of the gripping instrument, and which is pre-assembled on said instrument and disposable.
• a small eyelet which serves among other things stop the anchor.
• This type of device is commonly implanted arthroscopically, that is to say by introducing the gripper instrument with a mini incision with or without video assistance.
• firstly anchors called first rank are set up in a known manner in itself, the strands from these anchors being passed through the fabric to be fixed, then the eye of a second-tier anchor implanted outside the fabric. To do this, it is lowered into a hole previously made to the needle, in a lateral position relative to the anchor first row.
• the device is provided with locking arms that deviate when drilling has been performed with said tip which is forced into the fabric, which has the disadvantage of being complicated and requires control means 1 'spacing .
• Also known (US 2006/0259076) is a suture chain blocked at the bottom of a screwed implant.
• the present invention aims to provide a second rank anchor better than those previously known to the requirements of practice, particularly in that it provides an implant of excellent strength, easy to implement, simple, which allows an excellent implementation tensioning suture threads, adjustable and adjustable during and after screwing, inexpensive and not requiring additional ancillary particular. To do this, it starts from the idea of constituting an implant also screwed as the first rank, but in two parts, namely one part constituting the body of the anchor and the other forming the eyelet in which will be passed the suture strands.
• the eyelet is designed with a diameter close to or equal to that of the core of the screwed portion, and thus itself serves as a guide foot.
• the invention essentially provides a device for anchoring a tissue in a bone comprising an anchor elongated about an axis, having a head forming a distal portion pierced with a suture passage and a body for inserting and holding the head inside the bone, characterized in that the body is provided with an external thread for screwing into the bone, and in that said anchor comprises means for fixing the the head on the body arranged to fix them to each other in the axial direction and allow the free rotation of one relative to the other about said axis, so that the head can remain stationary when screwing of the body in the bone.
• the body and the head are substantially cylindrical or cylindrical with the same diameter or substantially the same diameter;
• the fixing means between the head and the body are clipping means;
• the clipping means comprise a female part and a male part, the female part being formed of two opposite jaws in cylinder portions provided with a cylindrical central recess, separated by a transverse slot allowing their elastic spacing and comprising an end portion forming a retention chamber of a bead secured to the male part once it has been forced into said female part, said male part being cylindrical in shape complementary to that of the obvious and the male and female parts comprising at their ends contact surfaces arranged to co-act smoothly with each other once the clipping performed;
• the clipping means comprise a female part and a male part, the female part being formed of a doubly cylindrical axial recess forming an internal retaining recess of a bipartite bead end of said male part, the latter comprising two semi-cylindrical branches separated from each other by a central slot allowing them to be brought together for clipping said bead into the corresponding recess and the male and female parts comprising at their ends contact surfaces arranged to co-act with gentle friction with each other once the clipping is done;
• the male part is integral with the body and the female part secured to the head;
• the anchor is made of titanium and / or polyether ether ketone (PEEK) and / or of bioabsorbable material;
• PEEK polyether ether ketone
• the device comprises at least two anchors adapted to be fixed directly in the external part of the humeral head, at the level of the anatomical neck, then called second-rank anchors; -
• the device further comprises at least one set of anchors, said first row, adapted to be fixed in the bone to be placed later underneath the fabric and suture son integral said game clean to pierce the tissue, said threads passing through the eyelets of the second rank anchors to form a network of plating yarns of the fabric on the numeral head.
• the invention also proposes a method for fixing and maintaining a tissue on a block, for example for fixing a tendon or muscle type tissue to a humerus head, characterized in that it is fixed in the block.
• a set of anchors said first row provided with son of fixation we pass the strands of the son of fixation from this game through the fabric then through the eyelets of anchors said second row, then we insert the anchors of second row by screwing into respective holes previously obtained by needle in the outer part of the block, for example of the humeral head, at the level of the anatomical neck, the heads or ends provided with these eyelets being directed towards the block and held without turning when screwing the anchor, the strands being held in tension until complete screwing.
• FIG. 1 is a perspective view of a rotator cuff attached to the corresponding bone by by means of a first set of anchors of first rank and a second set of second anchors according to the invention.
• FIG. 2 is a perspective view of an embodiment according to the invention of the body for inserting and holding the head inside the bone.
• FIG. 3 is a perspective view of a movable rotating head pierced with a suture passage eyelet, belonging to an anchor according to the invention.
• Figure 4 shows the elements of Figures 2 and 3 assembled to form the anchoring device according to the embodiment of the invention more particularly described here.
• FIG. 5 shows in perspective another embodiment of the device according to the invention before clipping the head on the body.
• FIGS. 6A to 6F show diagrammatically in perspective the method of placing the anchoring devices of a fabric according to the embodiment of the invention more particularly described here.
• FIG. 1 shows an anchoring device 1 of a fabric 2 in a bone 3 comprising a set of two anchors
• the anchors 6 each comprise a pierced head 8 for the passage of the suture threads 5 and an insertion body 9 and holding the head 8 inside the bone 3.
• the anchor 6 said second row comprises means 10, 10 'for fixing the head 8 of the body 9 which will be detailed below and which are arranged to fix them. to one another in an axial direction and to allow rotation (arrow F) of the one relative to the other about the axis 7.
• the body 9 being provided with an external thread 11 screwing into the bone, the separation in rotation allows the head to remain stationary when screwing the body into the bone.
• the female part is formed of two opposing jaws 14 in a portion of a cylinder provided with a central cylindrical recess 15 separated by a transverse slot 16 allowing their elastic spacing (arrow 17) and comprising an end portion 18 forming a chamber recess. retention of a bead 19 integral with the male part 12 once it has been forced into said female part, said male part 12 being of cylindrical shape complementary to that of the recess 15, and the male and female parts comprising their end of the flat contact surfaces 20, 21 to co-act smoothly with each other once the clipping made (see Figure 4).
• the male part is integral with the threaded body and the female part integral with the head.
• the body and the head are substantially cylindrical, titanium, polyether ether ketone or PEEK, or plastic formed from poly lactide acid (bio-resorbable material).
• the body is for example a length of 2 cm, an internal diameter of 4 mm and has a screw pitch of 1.5 to 3 mm. It is provided at the upper outer portion 22 of the cylinder, a slot 23 of attack by a screwdriver.
• the head 8 is in turn provided with a central eyelet 24, for example of oval section, for passing right through the suture strands.
• Figure 5 shows a device 25 comprising a cylindrical body 26 provided with an external thread 27 known in itself and a portion 28 of actuation by a screwdriver (not shown).
• the body comprises at its end 29 a female portion 30 formed of an axial recess 31 comprising two portions of axial cylinders 32 and 33, the innermost form an internal recess.
• the two cylinder portions are for example slit by a transverse slot 34 over the entire height of the cylinders.
• the device 25 also comprises a head 35 provided with an eyelet 36 traversing the head from one side to the other, and at its end of connection with the body, a male portion 37 comprising two semicylindrical branches 38 separated from each other. the other by a central slot 39 allowing their approximation by clipping their end in the form of half-rolls 40 cylindrical or bevel.
• the male and female parts have at their respective ends surfaces 41, 42 of soft friction cooperation.
• FIG. 1 shows a complete device according to one embodiment of the invention with first-rank anchors of the known type, obtained by screwing into the bone previously prepared by impact.
• First set of anchors 4 of first rank is fixed with fixing son (not shown in Figure 6B as internal to the tool 43 screwing).
• the screws 4 of the first rank are screwed in a manner known per se.
• the strands 5 of the fixing threads coming from this set are then passed through the fabric 2 and then through the eyelets 24 of the second row anchors 6 (see FIG. 6E).
• the anchors 6 of second row are inserted by screwing (arrow 45) into respective holes 46 previously obtained by needle 47 in the bone 3.
• the heads 8 provided with these eyelets are directed towards the inside of the bone and held without turning when screwing, thanks to the existing rotation possibilities between head and body.
• the head provided with an eyelet is in fact held by friction hooking of the eyelet provided with the strand 5 in the lower part 48 of the implant sleeve.
• the tightening of the strands 5 to definitively fix and hold the fabric as shown in FIG. 1, is obtained during the screwing of the anchor and by action on the outer strands which slide through the cat or central eyelet 24.
• the present invention is not limited to the embodiments more particularly described. On the contrary, it embraces all the variants and in particular those where only one anchoring device of the second row is put in place and / or the male part is integral with the eyelet instead of being integral with the body.
• the fixation process is also applicable in other areas than surgery.

Applications Claiming Priority (2)

Publications (1)

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ID=39591703

Family Applications (1)

Country Status (7)

Families Citing this family (21)

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• 2007
  • 2007-12-21 FR FR0709090A patent/FR2925287B1/fr not_active Expired - Fee Related
• 2008
  • 2008-12-22 CA CA2710184A patent/CA2710184A1/en not_active Abandoned
  • 2008-12-22 EP EP08872893A patent/EP2229107A1/de not_active Withdrawn
  • 2008-12-22 US US12/809,520 patent/US20100331896A1/en not_active Abandoned
  • 2008-12-22 WO PCT/FR2008/001814 patent/WO2009106741A1/fr active Application Filing
  • 2008-12-22 JP JP2010538850A patent/JP2011506020A/ja not_active Withdrawn
  • 2008-12-22 KR KR1020107016056A patent/KR20100124709A/ko not_active Application Discontinuation

Non-Patent Citations (1)

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