FR2774582A1 - Ligament anchor for orthopaedic surgery - Google Patents

Ligament anchor for orthopaedic surgery Download PDF

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Publication number
FR2774582A1
FR2774582A1 FR9801645A FR9801645A FR2774582A1 FR 2774582 A1 FR2774582 A1 FR 2774582A1 FR 9801645 A FR9801645 A FR 9801645A FR 9801645 A FR9801645 A FR 9801645A FR 2774582 A1 FR2774582 A1 FR 2774582A1
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ligament
anchoring
ring
branches
bone
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FR9801645A
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French (fr)
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FR2774582B1 (en
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Hugues Charles
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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
    • A61F2/0805—Implements for inserting 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
    • A61F2002/0852—Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
    • 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

Abstract

The ligament anchor (1) has a wire (4) with a hook (6) at one end, with two diverging feet (9). Each foot is carried by the end of a straight branch (12) attached to a loop (8). The branches are elastic (13) to allow the feet to be brought together for insertion into a bore in the bone.

Description

L'invention se rapporte à un dispositif d'ancrage d'un ligament sur une structure osseuse pour ligamento-plastie. The invention relates to a device for anchoring a ligament to a bone structure for ligamentoplasty.

Il se produit parfois une rupture de la liaison entre l'extrémité d'un ligament et l'os sur lequel il était fixé initialement. Sometimes there is a break in the connection between the end of a ligament and the bone to which it was originally attached.

Le ligament ne pouvant se raccrocher de manière naturelle, on fait appel à des dispositifs d'ancrage qui se fixent sur la structure osseuse et sur lesquels on accroche le ligament. The ligament can not hang naturally, we use anchoring devices that attach to the bone structure and on which we hang the ligament.

Un tel dispositif d'ancrage comprend classiquement un corps longiligne dont une extrémité présente un moyen d'accrochage sur une structure osseuse et dont l'autre extrémité présente un anneau pour y fixer au moins indirectement le ligament. Such an anchoring device conventionally comprises a slender body, one end of which has a means of attachment to a bone structure and the other end of which has a ring for fixing the ligament therein at least indirectly.

Est connu par exemple un dispositif d'ancrage FR-A2.731.610 formant harpon comprenant un corps cylindrique de révolution à la périphérie duquel sont découpées des ailettes dont les extrémités libres s'écartent progressivement du corps précité pour s'ancrer dans la structure osseuse. Is known for example an anchoring device FR-A2.731.610 forming a harpoon comprising a cylindrical body of revolution at the periphery of which fins are cut, the free ends of which gradually move away from the aforementioned body to anchor in the bone structure.

Au fur et à mesure de la traction sur la tête du dispositif d'ancrage, les extrémités libres de ces ailettes pénètrent dans la structure osseuse. As the head of the anchoring device is pulled, the free ends of these fins penetrate the bone structure.

La tête de ce dispositif est pourvue d'un évidement pour la fixation au moins indirecte du ligament. The head of this device is provided with a recess for at least indirect attachment of the ligament.

Ce dispositif est introduit en force dans un puits foré dans l'os, de sorte que les languettes, s'écartant de l'axe longitudinal, empêchent tout retrait du dispositif en pénétrant dans la paroi du puits. This device is forcefully inserted into a well drilled in the bone, so that the tabs, deviating from the longitudinal axis, prevent any withdrawal of the device by entering the wall of the well.

La résistance à la traction de ces dispositifs d'ancrage est toutefois relativement faible. The tensile strength of these anchoring devices is however relatively low.

Dans un domaine médical différent qui concerne la réduction de fractures, on connaît un dispositif (FR-A-2721818 ou FR-A-2737104) se présentant sous la forme d'un grappin, c'est à dire avec, pour moyens d'accrochage, deux branches recourbées à 1800 (cent quatre vingt degrés) par rapport à l'axe longitudinal du corps et dont les extrémités libres sont acérées pour pénétrer dans l'os et notamment dans la corticale.  In a different medical field which relates to the reduction of fractures, a device is known (FR-A-2721818 or FR-A-2737104) which is in the form of a grapple, that is to say with, for means of attachment, two branches curved at 1800 (one hundred and eighty degrees) from the longitudinal axis of the body and whose free ends are sharp to penetrate into the bone and in particular into the cortex.

Aprés mise en place, ces dispositifs sont coïncés de manière à exercer sur les deux parties de l'os une traction rapprochant les deux parties. After installation, these devices are coincident so as to exert on the two parts of the bone a traction bringing the two parts together.

Egalement, en raison de leur mode d'accrochage, les branches recourbées de ces dispositifs d'ancrage ne sont pas élastiques et ne peuvent être ramenées dans une position réduisant momentanément l'encombrement du dispositif, par exemple, pour faciliter une introduction percutanée. Also, because of their method of attachment, the curved branches of these anchoring devices are not elastic and cannot be brought back to a position temporarily reducing the size of the device, for example, to facilitate percutaneous introduction.

Ces dispositifs ne pourraient en aucune façon être utilisés dans la ligamento-plastie. These devices could in no way be used in ligamento-plasty.

Un des résultats que l'invention vise à obtenir est un dispositif pour ligamento-plastie qui remédie notamment aux inconvénients précités. One of the results that the invention aims to obtain is a device for ligament-plasty which remedies in particular the aforementioned drawbacks.

A cet effet, l'invention a pour objet un dispositif d'ancrage du type précité comprenant un corps longiligne dont une extrémité présente un moyen d'accrochage sur une structure osseuse et dont l'autre extrémité présente un anneau pour y fixer au moins indirectement le ligament, ce dispositif étant caractérisé en ce que le moyen d'accrochage comprend au moins deux pattes s'étendant selon des directions divergentes et sécantes à l'axe longitudinal du corps (4) du dispositif et
- d'une part, chaque patte est portée par l'extrémité d'une branche longiligne et les branches longilignes constituant le corps du dispositif s'écartent progressivement l'une de l'autre depuis l'anneau auquel elles sont associées et
- d'autre part, les branches comprennent un moyen élastique pour rapprocher momentanément les extrémités portant les pattes et loger le tout dans un volume cylindrique de section réduite pour introduire le dispositif au travers de la peau et/ou au travers d'un alésage réalisé dans la tête de l'os.To this end, the subject of the invention is an anchoring device of the aforementioned type comprising a slender body, one end of which has a means of attachment to a bone structure and the other end of which has a ring for fixing thereto at least indirectly. the ligament, this device being characterized in that the attachment means comprises at least two tabs extending in divergent and intersecting directions to the longitudinal axis of the body (4) of the device and
on the one hand, each leg is carried by the end of a slender branch and the slender branches constituting the body of the device progressively move away from one another from the ring with which they are associated and
- On the other hand, the branches comprise an elastic means for temporarily bringing the ends carrying the legs together and accommodating the whole in a cylindrical volume of reduced section to introduce the device through the skin and / or through a bore produced in the head of the bone.

L'invention sera bien comprise à l'aide de la description ci-après faite, à titre d'exemple non limitatif, en regard du dessin ci-annexé qui représente schématiquement
- figure 1 : un dispositif d'ancrage,
- figure 2 : le même dispositif en fonction,
- figure 3 : un ancillaire pour le montage. The invention will be better understood with the aid of the description below, given by way of nonlimiting example, with reference to the attached drawing which schematically represents
- Figure 1: an anchoring device,
- Figure 2: the same device in operation,
- Figure 3: an ancillary for mounting.

En se reportant au dessin, on voit que pour fixer un ligament 1 sur une structure osseuse 2 telle la fixation d'un ligament sur l'épaule ou le genou, le dispositif 3 d'ancrage utilisé comprend un corps 4 longiligne dont une extrémité 5 présente un moyen 6 d'accrochage sur la structure osseuse et dont l'autre extrémité 7 présente un anneau 8 pour y fixer au moins indirectement le ligament. Referring to the drawing, it can be seen that in order to fix a ligament 1 to a bone structure 2 such as the fixing of a ligament on the shoulder or the knee, the anchoring device 3 used comprises a slender body 4, one end of which 5 has a means 6 for attachment to the bone structure and the other end of which 7 has a ring 8 for fixing the ligament therein at least indirectly.

Le moyen 6 d'accrochage comprend au moins deux pattes 9 s'étendant selon des directions divergentes et sécantes à l'axe 10 longitudinal du corps 4 du dispositif. The attachment means 6 comprises at least two tabs 9 extending in divergent and intersecting directions to the longitudinal axis 10 of the body 4 of the device.

Chaque patte 9 est portée par l'extrémité d'une branche 12 longiligne et les branches 12 longilignes constituant le corps du dispositif s'écartent progressivement l'une de l'autre depuis l'anneau 8 auquel elles sont associées. Each tab 9 is carried by the end of an elongate branch 12 and the elongate branches 12 constituting the body of the device gradually move away from one another from the ring 8 with which they are associated.

Ces branches 12 comprennent un moyen 13 élastique pour rapprocher momentanément les extrémités portant les pattes et loger le tout dans un volume cylindrique de section réduite pour introduire le dispositif au travers de la peau et/ou au travers d'un alésage réalisé dans la tête de l'os. These branches 12 include an elastic means 13 for temporarily bringing the ends carrying the tabs together and accommodating the whole in a cylindrical volume of reduced section to introduce the device through the skin and / or through a bore made in the head. the bone.

On peut considérer qu'il s'agit d'un dispositif à mémoire de forme. We can consider that it is a shape memory device.

Les pattes 9 présentent chacune une face 11 d'appui tournée vers l'anneau 8 pour venir en appui sur la face externe de la structure osseuse appelée corticale. The legs 9 each have a support face 11 facing the ring 8 to come to bear on the external face of the bone structure called cortex.

Ces pattes sont faiblement courbées et leurs extrémités ne sont pas acérées, de sorte que l'extrémité libre des pattes ne pénètre quasiment pas dans la corticale. These legs are slightly curved and their ends are not sharp, so that the free end of the legs hardly penetrates into the cortex.

En venant en simple appui sur la corticale qui est la partie la plus résistante de l'os et avec une surface d'appui relativement grande par rapport aux dispositifs existants, on obtient une plus grande résistance à la traction. By coming into simple support on the cortex which is the most resistant part of the bone and with a relatively large bearing surface compared to the existing devices, one obtains a greater resistance to traction.

Ces faces d'appui sont présentées par des pattes 9 de section prismatique. These bearing faces are presented by lugs 9 of prismatic section.

En effet, le dispositif sera fourni aux chirurgiens dans une enveloppe en position rapprochée et se déploiera au moment de son utilisation.  Indeed, the device will be provided to surgeons in an envelope in a close position and will deploy when it is used.

Dans l'exemple représenté, le dispositif 3 le plus couramment utilisé se composera de deux branches 12 se croisant pour former l'anneau. In the example shown, the device 3 most commonly used will consist of two branches 12 intersecting to form the ring.

Pour fixer la coiffe des rotateurs, le chirurgien dispose d'un ancillaire 14 comportant un trocart 15 courbe à l'aide duquel il traverse la structure osseuse. To fix the rotator cuff, the surgeon has an ancillary device 14 comprising a curved trocar 15 with the aid of which it passes through the bone structure.

La pointe de ce trocart courbe présente une lumière 16 permettant d'y accrocher provisoirement des fils qui vont se fixer ultérieurement, d'une part, sur l'anneau du dispositif et, d'autre part, sur les ligaments à raccrocher. The tip of this curved trocar has a lumen 16 allowing it to temporarily hang wires which will subsequently be fixed, on the one hand, to the ring of the device and, on the other hand, to the ligaments to be hung up.

Le dispositif est introduit au travers de la peau après engagement dans une enveloppe le contraignant en position repliée pour être ensuite déployé et placé en position requise, le dispositif étant alors, par son corps logé dans le passage réalisé par l'ancillaire et les pattes disposées à l'extérieur, en appui sur la corticale. The device is introduced through the skin after engagement in an envelope constraining it in the folded position to then be deployed and placed in the required position, the device then being, by its body housed in the passage made by the ancillary and the legs arranged outside, resting on the cortex.

Dans le cas d'une ligamento-plastie du genou, après avoir foré au travers de la structure osseuse un puits dont le fond comprend un canal de plus faible section, le dispositif en position replié est poussé au fond du puits puis tiré à l'aide d'un fil au travers du canal pour être amené à l'extérieur. In the case of a knee ligament-plasty, after having drilled through the bone structure a well, the bottom of which comprises a channel of smaller section, the device in the folded position is pushed to the bottom of the well and then pulled out. using a wire through the channel to be brought outside.

Le fil sera préalablement introduit à l'aide d'une aiguille à chas. The thread will be introduced beforehand using an eye needle.

Les tendons demi-tendineux et droit interne forment des boucles passées au travers de l'anneau du dispositif d'ancrage. The semi-tendon and internal right tendons form loops passed through the ring of the anchoring device.

Le puits sera alors comblé par un greffon osseux.  The well will then be filled with a bone graft.

Claims (4)

REVENDICATIONS 1. Dispositif (3) d'ancrage d'un ligament (1) sur une structure osseuse (2) comprenant un corps (4) longiligne dont une extrémité (5) présente un moyen (6) d'accrochage sur la structure osseuse et dont l'autre extrémité (7) présente un anneau (8) pour y fixer au moins indirectement le ligament, 1. Device (3) for anchoring a ligament (1) on a bone structure (2) comprising a slender body (4), one end (5) of which has means (6) for hooking onto the bone structure and the other end (7) of which has a ring (8) for fixing the ligament therein at least indirectly, ce dispositif étant CARACTERISE en ce que le moyen (6) d'accrochage comprend au moins deux pattes (9) s'étendant selon des directions divergentes et sécantes à l'axe (10) longitudinal du corps (4) du dispositif et  this device being CHARACTERIZED in that the attachment means (6) comprises at least two tabs (9) extending in divergent and intersecting directions to the longitudinal axis (10) of the body (4) of the device and - d'une part, chaque patte (9) est portée par l'extrémité d'une branche (12) longiligne et les branches (12) longilignes constituant le corps du dispositif s'écartent progressivement l'une de l'autre depuis l'anneau (8) auquel elles sont associées et - On the one hand, each tab (9) is carried by the end of a long branch (12) and the long branches (12) constituting the body of the device gradually move away from each other from the 'ring (8) with which they are associated and - d'autre part, les branches (12) comprennent un moyen (13) élastique pour rapprocher momentanément les extrémités portant les pattes et loger le tout dans un volume cylindrique de section réduite pour introduire le dispositif au travers de la peau et/ou au travers d'un alésage réalisé dans la tête de l'os.  - on the other hand, the branches (12) comprise an elastic means (13) for temporarily bringing the ends carrying the tabs together and accommodating the whole in a cylindrical volume of reduced section to introduce the device through the skin and / or at the through a bore made in the head of the bone. 2. Dispositif d'ancrage d'un ligament selon la revendication 1 caractérisé en ce qu'il est composé de deux branches (12) se croisant pour former l'anneau. 2. Device for anchoring a ligament according to claim 1 characterized in that it is composed of two branches (12) crossing each other to form the ring. 3. Dispositif d'ancrage d'un ligament selon la revendication 1 caractérisé en ce que les pattes (9) présentent chacune une face (11) d'appui tournée vers l'anneau (8) pour venir en appui sur la face externe de la structure osseuse appelée corticale. 3. Anchoring device for a ligament according to claim 1 characterized in that the tabs (9) each have a face (11) of support facing the ring (8) to come to bear on the external face of the bone structure called cortex. 4. Dispositif d'ancrage d'un ligament selon la revendication 1 caractérisé en ce que les faces d'appui sont présentées par des pattes (9) de section prismatique.  4. Device for anchoring a ligament according to claim 1 characterized in that the bearing faces are presented by lugs (9) of prismatic section.
FR9801645A 1998-02-06 1998-02-06 DEVICE FOR ANCHORING A LIGAMENT ON A BONE STRUCTURE Expired - Fee Related FR2774582B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR9801645A FR2774582B1 (en) 1998-02-06 1998-02-06 DEVICE FOR ANCHORING A LIGAMENT ON A BONE STRUCTURE

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR9801645A FR2774582B1 (en) 1998-02-06 1998-02-06 DEVICE FOR ANCHORING A LIGAMENT ON A BONE STRUCTURE

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FR2774582A1 true FR2774582A1 (en) 1999-08-13
FR2774582B1 FR2774582B1 (en) 2000-08-11

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000064378A1 (en) * 1999-04-22 2000-11-02 Hugues Charles Device for anchoring a ligament on a bone structure
FR2893836A1 (en) * 2005-11-29 2007-06-01 Pierre Imbert Surgical implant for fixing e.g. aritfical ligament in knee joint, has hook comprising lugs disposed on either side of tunnel inlet so that hook rests on solid parts of femur and not on part with reduced thickness at tunnel position
EP2030593A1 (en) * 2007-08-29 2009-03-04 Phusis Surgical instrument assembly for reconstructing the posterior cruciate ligament of a knee

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992016167A1 (en) * 1991-03-21 1992-10-01 Bahaa Botros Seedhom Implantable fixing device for knee ligament prosthesis
GB2288739A (en) * 1994-04-27 1995-11-01 Corin Medical Ltd Surgical anchor
WO1997020522A1 (en) * 1995-12-05 1997-06-12 United Surgical Services Limited Surgical anchorage

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992016167A1 (en) * 1991-03-21 1992-10-01 Bahaa Botros Seedhom Implantable fixing device for knee ligament prosthesis
GB2288739A (en) * 1994-04-27 1995-11-01 Corin Medical Ltd Surgical anchor
WO1997020522A1 (en) * 1995-12-05 1997-06-12 United Surgical Services Limited Surgical anchorage

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000064378A1 (en) * 1999-04-22 2000-11-02 Hugues Charles Device for anchoring a ligament on a bone structure
FR2893836A1 (en) * 2005-11-29 2007-06-01 Pierre Imbert Surgical implant for fixing e.g. aritfical ligament in knee joint, has hook comprising lugs disposed on either side of tunnel inlet so that hook rests on solid parts of femur and not on part with reduced thickness at tunnel position
WO2007063213A3 (en) * 2005-11-29 2007-08-23 Pierre Imbert Surgical implant with extracortical support for a ligament transplant
EP2030593A1 (en) * 2007-08-29 2009-03-04 Phusis Surgical instrument assembly for reconstructing the posterior cruciate ligament of a knee
FR2920296A1 (en) * 2007-08-29 2009-03-06 Phusis Soc Par Actions Simplif SURGICAL INSTRUMENTATION ASSEMBLY FOR RECONSTRUCTING A CROSS LIGAMENT AFTER A KNEE

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