ITMO20120217A1 - DEVICE FOR FIXING MUSCLE TENDONS TO A BONE. - Google Patents

Description

DESCRIPTION

â € œDevice for fixing muscle tendons to a

BONEâ €

The present invention relates to a device for fixing muscle tendons to a bone.

Specifically, but not exclusively, it finds useful application as a tool for carrying out surgical interventions aimed at treating injuries that require the repositioning and fixing of tendons to the respective portions of bone for the restoration of the original foot print or the repair of tendon damage.

An emblematic case of use is that of the repair of the rotator cuff using an arthroscopic approach with the creation of transosseous canals for the passage of the sutures.

Disadvantageously, the operations of the aforementioned type are often long and invasive, since they require the execution of multiple sutures for tendon fixation. Furthermore, it is also possible that the sutures fail as a result of normal movement of the joint after surgery.

In this context, the technical task underlying the present invention is to propose a device for fixing muscle tendons to a bone which overcomes the aforementioned drawbacks of the known art.

In particular, it is an object of the present invention to provide a device capable of allowing fast and easy fixing of the muscle tendons to a bone.

This problem is solved, according to the invention, by a device for fixing muscle tendons to a bone, consisting of a ligating organ having a first and a second extremity, and characterized by the fact that it comprises a locking device associated with the first and second extremities of the binding organ having the function of joining them together giving rise to a closed loop.

The presence of the locking device, in fact, allows the surgeon to fix the ends of the ligating organ together without resorting to knots between sutures, therefore in a simpler, faster and less invasive way. A further object of the present invention is to propose a device for fixing muscle tendons to a bone and capable of ensuring its tightness.

According to the invention, the locking device (3) is conceived in such a way as to have two openings, the first designed for connecting the same component to the first end (2a) of the binding organ (2) and the second in correspondence with the portion of the locking device (3) that is not inserted into the bone, inside which the second end (2b) of the ligator organ is fixed by the interaction between the opening obtained on the locking device (3) and a component (5) grafted at the second end (2b) to compose the closed ring with the transosseous passage mentioned above.

The locking system of the second end of the ligator organ (2b) by means of the terminal (5) allows the surgeon to adjust it in different positions, thus fixing the tendon to the bone in a stable manner.

Further objects and advantages are substantially achieved by a device for fixing muscle tendons to a bone comprising the technical characteristics set out in one or more of the appended claims.

These characteristics and advantages of the present invention will become clearer from the indicative, and therefore non-limiting, description of some preferred but not exclusive embodiments of the invention for fixing muscle tendons to a bone, as illustrated in the accompanying drawings in which:

- figure 1 is a perspective view of a device for fixing muscle tendons to a bone according to the present invention in a first embodiment; Figure 2 is a perspective view of a device for fixing muscle tendons to a bone according to the present invention in a second embodiment;

- figure 3 is a sectional side view of a detail of the device of figure 2; And

- figure 4 is a perspective view of the device of figure 1 inserted in a bone;

Figure 5 shows a perspective view relating to a third embodiment;

figure 6 shows a perspective view relating to a fourth embodiment;

Figure 7 shows an exploded perspective view relating to the embodiment of Figure 6.

figure 8 shows a perspective view relating to a fifth embodiment;

- figure 9 is a perspective view of the embodiment of figure 8 inserted in a bone.

With reference to the attached figures, 1 indicates a device for fixing muscle tendons to a â € œOâ € bone;

The device 1 comprises a ligating organ 2, which can be inserted in a transosseous canal, represented in figure 4. In particular, this transosseous canal is substantially practiced at one end of a long bone of a patient, particularly of a humerus. More particularly, this transosseous “C” canal is practiced in correspondence with the humeral trochite and is passing through. In other words, the transosseous “C” canal crosses the trochite, which proximally therefore presents an opening close to the tendon area to be repaired.

The ligator organ 2, after being passed inside the transosseous canal and coming out proximally from the bone, is passed through the tendon to be fixed. In further detail, the ligating organ 2 passes from the transosseous canal â € œCâ € to the hole â € œAâ € obtained in the tendon and, once the ring is closed, fixing the second end (2b) of the ligating organ through the terminal ( 5) inside the first portion (4) of the locking device (3), it keeps the tendon in a fixed position with respect to the joint. In this way it is possible to regenerate the connection between an â € œMâ € muscle and the â € œOâ € bone.

In detail, the binding organ 2 has a first 2a and a second end 2b, which can be fixed together according to the invention so as to define a ring 1 which, being partially inserted in the transosseous canal and by crossing the hole â € œAâ € obtained in the tendon, it is able to promote the repair of the rotator cuff ensuring the restoration of an anatomical foot print.

In further detail, the binding organ 2 has an elongated shape. Furthermore, the ligating organ 2 is flexible, so that it can be folded back on itself during the implantation operation in such a way as to ring the first 2a and the second extremity 2b together by means of the link constituted by the locking device (3).

With particular reference to the embodiment shown in Figure 1, the binding member 2 comprises a band 13 made of polymeric and radiolucent material. In an alternative embodiment, illustrated in Figure 2, the binding member 2 comprises at least one suture thread 14. In particular, in this embodiment the tying organ 2 comprises a pair of suture threads 14.

The embodiment shown in figure 1 allows to have, by means of the band 13, a lower tension at the interface with the tendon, consequently improving the cyclic seal.

To obtain the same result in the embodyment of figure 2 it is necessary to use more sutures.

According to the invention, the device 1 comprises a locking device 3 associated with the ends 2a, 2b of the binding member 2. In particular, this locking device 3 allows mechanical fixing and does not comprise, for example, means chemicals such as resins or adhesives. By locking device 3 we also mean a device which is inserted between the first 2a and the second end 2b of the tying organ 2 to join them. In particular, the presence of the locking device 3 prevents the possibility of directly connecting the ends 2a, 2b of the binding member 2 to each other. In other words, a knot on the binding member 2 (where actually possible) does not define a locking device 3 as specified in the present description.

In detail, the locking device 3 comprises a first portion 4 fixed to the first end 2a of the tying organ 2, and a second portion 5 fixed to the second end of the tying organ 2.

Note that the first portion 4 can be inserted into an opening of the transosseous canal â € œCâ €, at the distal opening. In particular, the first portion 4 anchors itself in this opening in a way that will be better illustrated hereinafter. It should be noted that, with reference to the embodiment of figure 2, when the ligating organ 2 comprises sutures 14, the second portion 5 can be fixed to these sutures 14 after their insertion into the transosseous canal. and in the hole â € œAâ € obtained in the tendon. Advantageously, in this way it is possible to associate the device 1 with a transosseous “C” canal of smaller dimensions than those of the second portion 5, reducing the invasiveness of the operation.

It should be noted that the aforementioned first 4 and second portions 5 can be fixed to each other in a permanent way (unless broken), in such a way as to lock the two ends 2a, 2b of the tying organ 2 in a stable reciprocal position.

In detail, the first portion 4 includes a stop 6 which has the function of stabilizing it on the cortical surface of the bone â € œOâ €, in particular in correspondence with the distal opening of the aforementioned â € œCâ € transosseous canal. This element 6 has a lower face 6a, able to abut against the external cortex of the bone â € œOâ €, and an upper face 6b opposite the lower face.

According to the preferred embodiment of the present invention, the stop 6 is a plate of constant thickness and substantially circular shape, which has the function of the cortical stop member of the device 1. Other embodiments, not illustrated, are obviously possible in which the stop 6 has other forms.

The first portion 4 also comprises an anchoring zone 7. This anchoring zone 7 has a substantially tubular shape extending away from said abutment 6, in particular from the lower face 6a. In greater detail, in the preferred embodiment the anchoring zone 7 extends along an inclined direction, in particular perpendicular, with respect to the stop 6. This anchoring zone 7 is implanted in the transosseous canal â € œCâ € through the distal entrance, in in order to cling to the walls of this â € œCâ € transosseum canal. To this end, the anchoring zone 7 is defined by a plurality of discs 21 which have a common central axis. By interfering with the walls of the transosseous canal, the discs 21 ensure a stable seal of the first portion 4 of the blocking device.

Other embodiments are obviously possible, not illustrated, in which the anchoring zone 7 has other forms.

It should be noted that, in the embodiment described, the first end 2a of the binding member 2 is fixed to the first portion 4 of the locking device 3 in correspondence with the anchoring zone 7.

The first portion 4 of the locking device 3 further comprises a receiving area 8 for the second portion 5. In particular, the receiving area 8 is adapted to stably receive and subsequently lock the second portion 5 of the locking device 3. In detail, the first portion 4 comprises at least one rigid band 9, connected to the stop 6 and preferably made in a single component therewith.

This band 9 defines, in cooperation with the aforementioned stop 6, a cavity 10 suitable for receiving the second portion 5 of the locking device 3. The first portion 4 of the locking device 3 also comprises at least one tooth 11, located in particular in the area reception 8 and even more particularly on the band 9, which has the function of engaging and retaining the second portion 5 of the locking device 3 in a way that will be better described hereinafter.

With further detail, the second portion 5 has a prevalent longitudinal development direction.

It can also be inserted into the cavity 10 parallel to the prevailing longitudinal development direction.

When inserting the second portion 5 into the cavity 10, the upper surface 5a faces the aforementioned band 9. In particular, the upper surface 5a comes into contact with the band 9, and in particular with the tooth 11 fixed to it .

The second portion 5 also has a serrated area 12, placed in particular on the upper surface 5a. The serrated area 12 interacts with the tooth 11 during the sliding of the second portion 5 with respect to the first portion 4, allowing this sliding in a single direction. In other words, the tooth 11, cooperating with the serrated area 12, allows the insertion of the second portion 5 into the cavity 10 but at the same time prevents its extraction.

The tying member 2 can, according to an embodiment shown in figure 1, comprise at least one further seat 16 for fixing a further suture thread (not shown). This further seat is placed between the first 2a and the second extremity 2b, that is to say in an intermediate area, of the binding organ 2.

According to the present invention, the further seat 16 comprises a plate 19, which has a pair of slots 20 to allow the passage of the aforementioned further suture thread.

It should be noted that, according to the embodiment of Figure 2, and with particular reference to the detail of Figure 3, the first 4 and the second portion 5 of the locking device 3 each comprise at least one respective seat 15 to accommodate a respective end 14a of the wire 14 of suture. Each seat 15 comprises in particular respective clamping means (not shown), which have the function of clamping the end 14a of each wire 14 inside the respective seat 15. Purely by way of example, the clamping means they can be a plastically deformable portion of the locking device 3.

Also in the further embodiment, illustrated in Figures 6 and 7, two suture threads 14 are used. In this case, however, they are each fixed to its own fixing terminal 35. Each terminal is in turn predisposed to be fixed and locked individually to the locking device 3.

Appropriate clamping means (not shown) have the function of clamping the end 14a of each wire 14 inside the respective seat provided in the terminal 35.

The adoption of an independent locking of the suture threads 14 allows to further improve the operative capacity of the fastening device with respect to the realization of figure 2 because it makes it possible to load each thread individually inside two independent trans osseous channels , previously created, guaranteeing the surgeon greater freedom in the reconstruction of the original foot print and more uniforming the pressure with which the affected part of tendon tissue is pressed against the surface of the bone with which it is placed in contact.

According to a further embodiment, a locking device 3 can comprise a first portion 40 which can be inserted and anchored at least in part in an opening of a trans-osseous channel C and anchored thereto. For this purpose, similarly to the previously illustrated embodiments, the first portion 40 is provided with an anchoring zone and a support plate to the external surface of the cortical zone of the bone.

A second portion 41 of the locking device is fixed to the first end 2a of a binding member 2, which, in this case, consists of a suture thread.

The second portion 41 is lockable to the first portion 40 in a stable reciprocal position.

The second portion 41 is equipped with a cavity 42 which is adapted to house the binding organ 2 near its second end 2b.

In particular, the second portion 41 has an elongated body which is designed to be coupled stably inside a hollow seat 43 obtained in the first portion 40.

The cavity 42 is obtained with a transversal arrangement in the elongated body of the second portion 41 and is sized to accommodate the section of the tying organ 2.

The elongated body of the second portion 41 can be stably coupled in the hollow seat 43 obtained in the first portion 40, by means of a snap connection able to define at least a predetermined relative locking position of the second portion 41 with respect to the first portion 40.

In this predetermined locking position, the cavity 42 is located at least partially inside the said hollow seat 43.

This allows, once the tying organ 2 has been inserted or slipped into the hollow seat 43 of the first portion 40 and its tensioning, operating on the second end 2b, to insert the elongated body of the second portion 41 until the snap connection and the consequent locking of the binding member 2 tightened between the elongated body of the second portion 41 and the hollow seat 43 of the first portion 40.

In the embodiment illustrated in figures 8 and 9, a binding member 2 is integral with the locking device 3 with one end corresponding to the end 2a of the previous embodiments illustrated. through hollow seat 45, which is arranged coaxially to the locking device 3 and to its first portion 4, and is specifically designed and sized to accommodate the end 2b of the tying element 2.

The end 2b of the tying element 2 is in fact shaped and sized to be inserted inside the through hollow seat 45 until it protrudes from it, as shown in figure 9, at least with its terminal part in correspondence with the which is a through loop 47.

The insertion of the end 2b of the ligator element 2 in the through hollow seat 45 allows to make a ring closure and to realize the desired tension to make the tendon M adhere to the bone.

By means of a suitable device, of the type used in the embodiments shown in figures 1, 2, 6 and 7, the end 2b of the tying element 2, once introduced into the through hollow seat 45, can be positioned up to to achieve the desired tensioning for the tying element 2 in a stable manner.

The through slot 47 is used to fix a drag wire used to guide the ligator element 2 in the trans-osseous hole in order to allow a successful closure of the ring.

The invention achieves the proposed aims, and also achieves important advantages. Among the latter, we highlight the possibility of creating an implant that does not give inflammatory reactions from reabsorption, a high seal of the system through the construction of a cortical seal implant and a general simplification of the implementation of the implant with the reduction of operating times and consequently of the costs of the intervention.

Also not negligible are other characteristics such as radio transparency and the absence of nodes in the system.

Claims (16)

CLAIMS 1. Device (1) for fixing muscle tendons to a bone (O), comprising a ligator organ (2) which can be inserted into a transosseous canal (C) and subsequently passes through a hole (A) obtained in the muscle tendon, called organ binder (2) presenting a first (2a) and a second end (2b); characterized in that it comprises a locking device (3) associated with said first (2a) and second ends (2b) to join said ends (2a, 2b) together forming a closed loop without the need to create nodes to stabilize the tendon. 2. Device (1) according to the preceding claim, characterized in that said locking device (3) comprises a first portion (4) fixed to said first end (2a) and which can be inserted at least partially into an opening of a channel (C) transosseous; a second portion (5) fixed to said second end (2b) and fixable to said first portion (4) to lock said first (2a) end to said second end (2b) in a stable reciprocal position. Device (1) according to the preceding claim, characterized in that said first portion (4) comprises a stop (6) for stabilizing said first portion (4) on the surface of a bone (O). Device (1) according to the preceding claim, characterized in that said first portion (4) comprises an anchoring zone (7) extending away from said abutment (6) and insertable in a transosseous channel (C). 5. Device (1) according to any one of claims 2 to 4, characterized in that said first portion (4) comprises a receiving area (8) for said second portion (5), said first portion (4) further comprising at least one locking or anti-slipping tooth or system (11) placed in correspondence with said receiving area (8); said second portion (5) presenting a serrated area (12) adapted to interact with said tooth or locking or anti-slipping system (11) to allow the unidirectional sliding of said second portion (5) with respect to said first portion (4). 6. Device (1) according to any one of the preceding claims, characterized in that said binding member (2) comprises a band (13) made of polymeric material. Device (1) according to any one of claims 1 to 5, characterized in that the binding member (2) comprises at least one suture thread (14). 8. Device (1) according to the preceding claim when it depends on 2, characterized in that said first (4) and second portion (5) of said locking device (3) each comprise at least one respective seat (15) to accommodate a respective end of said suture thread (14), each seat (15) comprising respective clamping means for locking said end of said thread (14) inside said seat (15). 9. Fixing device (1) according to any one of the preceding claims, characterized in that the tying member (2) comprises at least one further seat (16) for fixing a further suture thread, said further seat (16 ) being placed between said first (2a) and second ends (2b). 10. Fixing device (1) according to the preceding claim, characterized in that said further seat (16) comprises a plate (19) having a pair of slots (20) for the passage of a suture thread (14). 11. Device (1) according to claim 1 characterized in that said blocking device (3) comprises a first portion (40) which can be inserted at least partially into an opening of a transosseous canal (C); a second portion (41) of said locking device (3) being fixed to said first end (2a) and being lockable to said first portion (40) in a mutual stable position; said second portion (41) being provided with a cavity (42) which is adapted to house said binding member (2) in proximity to its second end (2b). 12. Device according to claim 11 characterized by the fact that said second portion (41) has an elongated body which is designed to be coupled stably inside a hollow seat (43) obtained in the first portion (40 ). 13. Device according to claim 12 characterized in that said cavity (42) is obtained with a transversal arrangement in the elongated body of the second portion (41). 14. Device according to claim 13 characterized in that the elongated body of said second portion (41) can be stably coupled in the hollow seat (43) obtained in the first portion (40) by means of a snap connection able to define at least one predetermined relative locking position of the second portion (41) with respect to the first portion (40); it being provided that in the said predetermined locking position the cavity (42) is located at least partially inside the said hollow seat (43). 15. Device according to claim 1 characterized in that said locking device (3) is adapted to individually receive and lock fixing terminals (35) each of which is adapted to be fixed to a suture thread (14). 16. Device according to claim 1 characterized by the fact that said binding member (2) is integral, with its own end, first end (2a) to the locking device 3 which is provided with a through hollow seat (45), which It is arranged coaxially to the locking device 3 and to its first portion (4), and is specifically designed and sized to accommodate the end (2b) of the tying element (2); the end (2b) of the tying element 2 being shaped and sized to be inserted inside the through hollow seat (45) until it protrudes from it at least with its terminal part in correspondence with which a Through slot (47) for the insertion of a dragging wire necessary for the successful closing of the ring.