JP2002272756A - Instrument for anterior cruciate ligament based reconstructive surgery of knee joint and shank-side fixing instrument of repaired ligament shank - Google Patents

Instrument for anterior cruciate ligament based reconstructive surgery of knee joint and shank-side fixing instrument of repaired ligament shank

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Publication number
JP2002272756A
JP2002272756A JP2001076777A JP2001076777A JP2002272756A JP 2002272756 A JP2002272756 A JP 2002272756A JP 2001076777 A JP2001076777 A JP 2001076777A JP 2001076777 A JP2001076777 A JP 2001076777A JP 2002272756 A JP2002272756 A JP 2002272756A
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Japan
Prior art keywords
ligament
thread
knee joint
anterior cruciate
reconstruction
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Pending
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JP2001076777A
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Japanese (ja)
Inventor
Kiyohide Akutsu
Yoshio Koga
Takaaki Kurita
良生 古賀
昂明 栗田
清英 阿久津
Original Assignee
Yoshio Koga
Niigata Eng Co Ltd
良生 古賀
株式会社新潟鉄工所
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Application filed by Yoshio Koga, Niigata Eng Co Ltd, 良生 古賀, 株式会社新潟鉄工所 filed Critical Yoshio Koga
Priority to JP2001076777A priority Critical patent/JP2002272756A/en
Publication of JP2002272756A publication Critical patent/JP2002272756A/en
Application status is Pending legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/08Muscles; Tendons; Ligaments
    • A61F2/0805Implements for inserting tendons or ligaments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/08Muscles; Tendons; Ligaments
    • A61F2/0811Fixation devices for tendons or ligaments

Abstract

PROBLEM TO BE SOLVED: To improve and stabilize achievements in anterior cruciate ligament based reconstructive surgery under a proper tension to a repaired ligament for the easy fixing of knee joints. SOLUTION: The instrument G for anterior cruciate ligament based reconstructive surgery to be mounted on a thigh bone A and a shank B of the knee joint is provided with a repair ligament 1 inserted into a hole H1 of the thigh bone A and a hole H2 of the shank B, an end button 2 (stops) which is fixed on a front opening part h1 at the hole H1 of the thigh bone A to securely support a binding thread 3 linked to one end part of the repair ligament 1 and a staple (shank-side fixing instrument of the repair ligament) which is fixed on an opening part h2 in front of the knee at the hole H2 of the shank B with a spike 9 to securely support a fixing thread 5 linked being tensed to the other end part of the repair ligament 1. In the fixing of the fixing thread 5 on the staple 4, the free end part of a tension applying thread 6 linked to the other end part of the repair ligament 1 is pulled with a spring balance 11 to apply a fixed tension on the repair ligament 1 and the fixing thread 5 is tensed and bound on the staple 4 to match it.

Description

【発明の詳細な説明】 DETAILED DESCRIPTION OF THE INVENTION

【0001】 [0001]

【発明の属する技術分野】本発明は、膝関節の前十字靱帯を再建するために使用する再建靱帯の初期張力を調節して脛骨に固定する手術用器具およびその再建靱帯脛骨側固定器具に関するものである。 The present invention relates to the concerns surgical instruments and its reconstruction ligament tibial fixation device to adjust the initial tension of the reconstruction ligaments used to reconstruct the anterior cruciate ligament of the knee joint is fixed to the tibia it is.

【0002】 [0002]

【従来の技術】過激なスポーツ等によって損傷された膝関節における前十字靱帯を再建手術する症例が増加している。 BACKGROUND OF THE INVENTION cases for reconstructive surgery of the anterior cruciate ligament in the knee joint that has been damaged by extreme sports, etc. is increasing. この再建手術は、従来、一般的に、3ないし4重に束ねた長さ6cm程度の腱を用いた再建靱帯の両端部に糸を連結して、その一端部側に連結した糸を止め金に固定しておき、次に、膝関節を切開することなく関節鏡視下で脛骨の前面から大腿骨の前面に貫通する骨孔をあけ、前記止め金を大腿骨の前面の骨孔周縁における骨直上に固定すると共に、前記再建靱帯を大腿骨側の骨孔内を通して脛骨側の骨孔内に挿入し、再建靱帯に連結した他端側の糸を脛骨の前面に取り出して緊張させて脛骨に固定することによって、再建靱帯に張力を加えて膝関節部に固定する。 The reconstructive surgery, conventional staples generally 3 to be connected to the yarn at both ends of the reconstruction ligament with length 6cm approximately tendons bundled in quadruplicate, the yarn connected to the one end leave fixed, then drilled bone hole penetrating from the front surface of the tibia arthroscopically without incising the knee joint to the front of the femur, the catch on the front surface of the bone hole periphery of the femur is fixed to the bone immediately above, the reconstruction ligament was inserted into a bone bore in the tibia side through the bone hole in the femoral, the other end of the thread was ligated to the reconstructed ligament by tension removed to the front of the tibia tibia by fixing, in addition to tension the reconstruction ligaments fixed to the knee joint. その際、脛骨に固定したスクリューに糸を単純に巻き付けて固定したり、ステープルで糸を脛骨に押し付けて固定する方法が採用されている。 At that time, or fixed simply wound around the yarn screw fixed to the tibia, a method of fixing by pressing the thread tibia is employed with staples.

【0003】 [0003]

【発明が解決しようとする課題】しかしながら、前記のような脛骨の前面側における再建靱帯の固定方法では、 [0007] However, in the method for fixing the reconstruction ligament in the front side of the tibia, such as,
糸の緊張によって再建靱帯に適切な張力を加えることができない。 It can not be added to the appropriate tension to the reconstruction ligament by tension of the yarn. 膝関節における十字靱帯の再建手術において、術後の成績に関し再建靱帯の固定時の初期張力が影響することが指摘されており、この点から、従来の固定方法では、手術成績の向上と安定を図ることができない問題があった。 In reconstructive surgery cruciate at the knee joint, it has been pointed out that the initial tension during the fixed reconstruction ligament relates postoperative grades affect, from this point, in the conventional fixing method, the improvement of surgical results and stability there has been a problem that can not be achieved.

【0004】本発明は、上記事情に鑑みてなされたものであって、再建靱帯を適切な張力を加えて膝関節に容易に固定することができ、前十字靱帯再建手術の成績の向上と安定を図ることができる膝関節の前十字靱帯再建手術用器具およびその再建靱帯脛骨側固定器具を提供することを目的とする。 [0004] The present invention was made in view of the above circumstances, the reconstruction ligament added an appropriate tension can be easily fixed to the knee joint, improve the stability of the performance of the anterior cruciate ligament reconstructive surgery possible to the object to provide a anterior cruciate ligament reconstructive surgical instrument knee joint and its reconstruction ligament tibial fixation device that can.

【0005】 [0005]

【課題を解決するための手段】本発明は、前記課題を解決するために、以下の点を特徴としている。 The present invention SUMMARY OF], in order to solve the above problems, is characterized in the following points. すなわち、 That is,
請求項1に係る膝関節の前十字靱帯再建手術用器具は、 Anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 1,
膝関節の大腿骨と脛骨とにあけられた骨孔に挿入される再建靱帯と、該再建靱帯をその一端部に連結した結束糸を介して大腿骨に支持する止め器具と、再建靱帯の他端部に連結された固定糸と張力付加糸との組からなる複数組の締結糸と、前記張力付加糸によって再建靱帯に張力が付加された状態で緊張された前記固定糸の自由端側を結束支持し、前記再建靱帯の他端部を脛骨側に固定する再建靱帯脛骨側固定器具とを備えていることを特徴とする。 A reconstruction ligament to be inserted into the bone hole drilled in the femur and tibia of the knee joint, and stop device for supporting the femur through the binding yarn connecting the said reconstruction ligament at one end thereof, the other reconstructive ligament a plurality of sets of fastening yarns consisting of a set of the fixing thread and the tensioning thread which is connected to an end, the free end side of the fixed yarn tension is tensioned with additional state to rebuild ligament by the tensioning thread binding supporting the other end portion of the reconstruction ligament, characterized in that it comprises a reconstruction ligament tibial fixation device for fixing the tibial side.

【0006】前記膝関節の前十字靱帯再建手術用器具においては、再建靱帯は、その一端部に連結された結束糸に止め器具を取り付けた状態で、脛骨の膝前面の骨孔の開口部から脛骨と大腿骨の骨孔内に挿入され、大腿骨の前面の骨孔の開口部外に取り出されて大腿骨の骨皮質面上に支持された止め器具によって前記一端部が支持固定される。 [0006] In anterior cruciate ligament reconstructive surgical instrument of the knee joint, reconstruction ligament, a state of attaching the linked binding yarn stopping device at one end thereof, from the opening of the knee front of the bone tunnel in the tibia is inserted into the bone tunnel in the tibia and femur, the one end is supported and fixed by the front retrieved opening outer bone hole of stop device which is supported on the bone cortex surface of the femur of the femur. そして、脛骨の膝前面の骨孔の開口部に再建靱帯側固定器具が固定され、前記再建靱帯の他端部に連結された締結糸のうちの張力付加糸の組が用手的に牽引されて張力を加えられた状態にされ、これに合わせて締結糸のうちの固定糸の組が緊張され、固定糸の張力が張力付加糸の張力に一致されたところで、固定糸の自由端側が前記再建靱帯脛骨側固定器具に支持固定される。 Then, reconstruction ligament fixation device to the opening of the knee front of the bone tunnel in the tibia is fixed, the tensioning thread set of the fastening thread coupled is use hands to tow the other end of the reconstruction ligament Te is the state of being tensioned, this fixed yarn pairs of fastening yarn combined tension, where the tension of the fixing thread is matched to the tensile force of the tensioning thread, the free end side of the fixing thread is the It is supported by and fixed to reconstruct the ligament tibial fixation device. これにより、大腿骨と脛骨の骨孔内に挿入された再建靱帯が大腿骨側の止め器具と脛骨側の再建靱帯脛骨側固定器具とに所定張力を加えられた状態で確実に支持固定して装着される。 And thereby, securely supported and fixed in a state inserted rebuilt ligament in a bone hole in the femur and tibia were added a predetermined tension to the reconstruction ligament tibial fixation device of the stop device and the tibial side of the femoral It is mounted.

【0007】請求項2に係る膝関節の前十字靱帯再建手術用器具は、請求項1に記載の前十字靱帯再建手術器具において、締結糸の固定糸と張力付加糸はそれぞれの自由端部側が左右に2つに区分されると共に、前記再建靱帯脛骨側固定器具は平板状のプレートに一対の糸通し穴が相互に間隔をあけて設けられており、前記固定糸と張力付加糸のそれぞれの左右に分かれた自由端部が前記各糸通し穴に左右別々に挿通された後、少なくとも前記固定糸の各自由端部同士が相互に緊張状態で結び付けられて前記プレートに支持されていることを特徴とする。 [0007] anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 2 is the anterior cruciate ligament reconstructive surgical instrument of claim 1, the fixing thread and tensioning yarn fastening yarn respective free end while being divided into two right and left, the reconstruction ligament tibial fixation device has a pair of threading holes spaced from each other on a flat plate, each of said fixing thread and tensioning yarn after the free end portion which is divided into right and left is inserted horizontally separately to each threading holes that each free end portions of at least the fixing thread is supported by the plate tied under tension with one another and features.

【0008】この膝関節の前十字靱帯再建手術用器具においては、張力付加糸の左右の両自由端部を結んでループを作り、これを張力付加器具で牽引することができ、 [0008] In the anterior cruciate ligament reconstructive surgery for the instrument of the knee joint, make a loop by connecting the two free ends of the left and right of the tensioning thread, which can be towed by the tensioning device,
これにより再建靱帯に一定の張力を加えた状態にし、これに合わせて固定糸を、その自由端部の根元に結び目を作るようにして用手的に締め付けていって、張力付加糸と同一の緊張状態となったところでしっかり結び付けることにより前記プレートに支持固定することができるので、再建靱帯に対する一定張力の付加が一層確実に行えると共に、その維持が安定して行われ、医師による個人差が生じることなく、膝関節における初期張力を管理した前十字靱帯の再建手術が行え、手術成績の向上と安定を図ることができる。 Thus the state plus a constant tension to reconstruct the ligament, the fixing thread in accordance with the this, went tightened use hand manner so as to tie the knot at the base of its free end, tensioning yarn and same can be supported and fixed to the plate by tying firmly upon reaching a tense state, the addition of certain tension can be performed more reliably with respect to reconstruction ligament, its maintenance is stably performed, resulting individual differences by a physician it not, can do reconstructive surgery of the anterior cruciate ligament, which manages the initial tension in the knee joint, it is possible to achieve the stability and improvement of surgical results.

【0009】請求項3に係る膝関節の前十字靱帯再建手術用器具は、請求項1または2に記載の前十字靱帯再建手術用器具において、固定糸と張力付加糸は互いに異なる色に着色されていることを特徴とする。 [0009] anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 3 is the anterior cruciate ligament reconstructive surgical instrument according to claim 1 or 2, the fixing thread and tensioning yarn is colored in mutually different colors and wherein the are. この膝関節の前十字靱帯再建手術用器具においては、固定糸と張力付加糸は着色によって区別できるので、用手的に行う張力付加糸による再建靱帯の張力付加と、固定糸による再建靱帯脛骨側固定器具への固定とが間違いなく円滑に行え、前十字靱帯の再建手術が迅速に行える。 In anterior cruciate ligament reconstructive surgical instrument of this knee joint, since the fixing thread and tensioning yarn can be distinguished by coloration, and tensioning reconstruction ligament by tensioning thread performing use hands to reconstructive ligament tibial by fixing thread fixing of the fixture is definitely smoothly performed, reconstructive surgery of the anterior cruciate ligament can be performed quickly.

【0010】請求項4に係る膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具は、平板状のプレートの中央部に相互に間隔をあけて貫通した一対の糸通し穴を一方向に整列して設けた止め板と、前記糸通し穴の整列方向における各糸通し穴の外側位置において前記止め板のプレートに直交して固着されたスパイクとを備えていることを特徴とする。 [0010] Reconstruction ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 4, one pair of threading holes penetrating at a mutually distance in the central portion of a flat plate characterized in that it comprises a stop plate which is provided in alignment in the direction, and a spike which is fixed orthogonally to the plate of the stop plate at the outside positions of the threading holes in the alignment direction of the threading hole . この膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具においては、前記スパイクがプレートの両端部に前記糸通し穴の整列方向に整列して固着して設けられているので、 This in reconstructive ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument knee, the spikes are provided fixed in alignment with the aligned direction of the threading hole at both ends of the plate,
糸通し穴への固定糸と張力付加糸の挿通を妨げることがなく、固定糸と張力付加糸による再建靱帯の張力付加とプレートへの固定が円滑に行える。 Without interfering with the insertion of the fixing thread and tensioning yarn to the yarn threading hole, fixing it can be performed smoothly to tensioning and plate reconstruction ligament by fixing thread and tensioning yarn.

【0011】請求項5に係る膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具は、請求項4 [0011] Reconstruction ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 5, claim 4
に記載の再建靱帯脛骨側固定器具において、止め板の各糸通し穴は、それぞれ、それらの整列方向に直角な方向に平行に延長された長穴に形成されていることを特徴とする。 In reconstructive ligament tibial fixation device according to the hole through the yarn stop plate, respectively, characterized in that it is formed in a long hole which extends parallel to the direction perpendicular to their direction of alignment. この膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具においては、前記止め板の一対の糸通し穴が長穴に形成されているので、その糸通し穴の長手方向を骨孔の長手方向に合わせ、かつ、再建靱帯の端部に連結された固定糸と張力付加糸を、それらの自由端部を糸通し穴の長手方向に牽引して緊張させながら前記止め板に固定する場合、固定糸と張力付加糸が糸通し穴の周縁の角部で鋭角に折曲されることにより、損傷したり切断してしまうといった不具合が生じることがない。 This in reconstructive ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument knee, a pair of threading holes in the stop plate is formed on the elongated hole, the bone tunnel in the longitudinal direction of the threading hole longitudinally mating and the fixing thread and tensioning yarn connected to the end of the reconstruction ligament is fixed to the stopper plate while tensioned by pulling their free ends in the longitudinal direction of the hole threading If, by the fixing thread and tensioning yarn it is bent at an acute angle at the corners of the peripheral edge of the hole threading, causing no inconvenience may be damaged or cut.

【0012】請求項6に係る膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具は、請求項4 [0012] Reconstruction ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 6, claim 4
または5に記載の再建靱帯脛骨側固定器具において、スパイクはその横断面が多角形に形成されていることを特徴とする。 Or in reconstructive ligament tibial fixation device according to 5, spike characterized in that the cross section thereof is formed in a polygon. この膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具においては、前記止め板のスパイクの横断面が多角形に形成されているので、形状が簡単で製作がし易く、多角形に内接される円形状断面のスパイクよりも、打ち込まれた骨片と接触する周囲面積を大きく採ることができ、骨片に対する固定状態の維持が確実に行える。 In reconstructive ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of this knee joint, since the cross section of the spike of the stopper plate is formed in a polygonal, easily shape is simple manufacture, polygonal than spikes circular cross-section that is inscribed in the surrounding area in contact with the implanted bone pieces can be made large, it can be reliably performed to maintain the fixed state with respect to the bone pieces.

【0013】請求項7に係る膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具は、請求項4 [0013] Reconstruction ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 7, claim 4
〜6のいずれかに記載の再建靱帯脛骨側固定器具において、スパイクにはその外周に凹凸部が形成されていることを特徴とするこの膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具においては、スパイクは、脛骨の骨片に打ち込まれてからは、その外周の凹凸部によって骨片から容易に抜け出るのを防止されるので、長期間にわたり骨片に対する安定した固着状態が得られる。 In reconstructive ligament tibial fixation device as claimed in any 6 of the spike reconstruction ligament tibial side of the anterior cruciate ligament reconstructive surgical instrument of this knee joint, characterized in that the uneven portion is formed on the outer periphery in fixation device, spikes, since it was driven into the bone of the tibia, since is prevented from exiting easily from the bone pieces by uneven portions of its periphery, resulting stable fixed state for a long period of time for the bone fragments It is.

【0014】 [0014]

【発明の実施の形態】以下、本発明に係る膝関節の前十字靱帯再建手術用器具の一実施の形態を添付図面を参照して説明する。 BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, an embodiment of the anterior cruciate ligament reconstructive surgical instrument of the knee joint of the present invention with reference to the accompanying drawings. 図1、図2において、Aは前十字靱帯再建手術用器具Gを装着する膝関節における大腿骨、Bは脛骨であり、それらには、図1に示す脚を伸ばした状態の正面視で、脛骨Bの膝前面(図2で左側面)の中央よりやや一側寄り(図1で左側寄り)から大腿骨Aの骨端部中央を経て大腿骨Aの前部の他側寄り(図1で右側寄り)に向けて骨孔H1,H2があけられている。 1, 2, femur at the knee joint A is to pre-mount the cruciate ligament reconstructive surgical instrument G, B is the tibia, them is a front view of the extended state of the legs shown in FIG. 1, slightly one side closer to the center of the knee front of the tibia B (left side in FIG. 2) from (in FIG. 1 the left close) through the epiphysis center of the femoral a front portion of the other side near the femur a (Fig. 1 bone holes H1, H2 toward the right side near) in are opened. これらの骨孔H1,H2は、図2(B)に示す脚をほぼ90° These bone holes H1, H2 is approximately 90 ° leg shown in FIG. 2 (B)
曲げた状態の側面視では、ほぼ一直線状になっているが、図2(A)に示す脚を伸ばした状態では、大腿骨A The side view of the bent state, but are substantially straight, in the extended state the leg shown in FIG. 2 (A), the femur A
の骨端部で膝前面側へ折り曲がった状態となっている。 Has a bent state folded to the knee front side of the epiphysis.
前記骨孔H1,H2には、それらの全長の約1/3の長さの再建靱帯1が挿入されている。 Wherein the bone hole H1, H2 is about one third of the length of the reconstruction ligament 1 of their entire length are inserted.

【0015】大腿骨Aの骨孔H1は、前記再建靱帯1の直径に合わせてあけた直径8〜9mmの内側骨孔H1a [0015] Bone hole H1 of the femur A is inside bone hole H1a total of drilled diameter 8~9mm the diameter of the reconstruction ligament 1
とエンドボタン(止め器具)2の3mm幅に合わせた直径4〜5mmの外側骨孔H1bとからなり、外側骨孔H It consists of a an outer bone hole H1b of the end button (stop instrument) diameter 4~5mm tailored to 2 of 3mm wide, outer bone hole H
1bの骨皮質面側(前端側)の開口部h1には、矩形状の平板2aを有するエンドボタン(止め器具)2が、その長手方向を開口部h1の直径方向に向けて掛け渡されて大腿骨Aに支持されている。 The opening h1 of 1b cortical bone surface of the (front end), the end button (stop device) 2 having a rectangular flat plate 2a is passed over toward the longitudinal direction in a diameter direction of the opening h1 and it is supported by the femur a.

【0016】そして、エンドボタン2には、再建靱帯1 [0016] and, in the end button 2, reconstruction ligament 1
の大腿骨側Aの端部(一端部)に連結された結束糸3の2つに分かれた自由端部が、平板2aの中央にあけた一対の取付孔2b,2bに個別に通された後で相互に結び付けられて平板2aに連結されることにより、再建靱帯1の一端部が固定支持されている。 Free end divided into two femoral A end binding yarn 3 which is connected to (one end) of the pair of mounting holes 2b drilled in the center of the plate 2a, passed through separately 2b by being connected to the flat plate 2a later tied to each other, one end of the reconstruction ligament 1 is fixed and supported. 脛骨Bの骨孔H2における膝前面の開口部h2にはステープル(再建靱帯脛骨側固定器具)4が固定され、該ステープル4には、前記再建靱帯1の脛骨B側の端部(他端部)に連結された締結糸Lが2組に分離されてなる一方の固定糸5が、他方の張力付加糸6によって緊張された状態にされて連結されており、これにより、再建靱帯1が張力(初期張力)を加えられた状態でその他端部を脛骨Bに固定されている。 Knee front of the openings h2 of the bone hole H2 of the tibia B is fixed staple (rebuilt ligament tibial fixation device) 4, the said staple 4, the ends of the tibia B side of the reconstruction ligament 1 (the other end portion ) fastening yarn L which is connected to the the one of the fixing thread 5 formed is separated into two sets are connected are in a state of being tensioned by the other tensioning yarn 6, thereby, reconstructive ligament 1 is the tension and the other end portion in a state of being added (initial tension) is fixed to the tibia B.

【0017】前記ステープル4は、図3〜図5に示すように、矩形の平板状のプレート7と、該プレート7の中央にその長手方向(図3で左右方向)に整列しかつ長手方向に直角な方向に長く形成され両端部が円弧状にされた貫通穴からなる一対の糸通し穴8,8と、各糸通し穴8,8に整列された位置において前記プレート7の長手方向の外端部に該プレート7に直交して固着した一対のスパイク9,9とを備えている。 [0017] The staple 4, as shown in FIGS. 3 to 5, a rectangular flat plate 7, aligned in the longitudinal direction in the center of the plate 7 (the left-right direction in FIG. 3) and in the longitudinal direction both end portions is elongated in the perpendicular direction and a pair of threading holes 8, 8 a through hole defined in a circular arc shape, the longitudinal direction outside of the plate 7 in the aligned position in the threading holes 8,8 and a pair of spikes 9, 9 fixed perpendicular to the plate 7 to the end. 各スパイク9,9は、 Each spike 9, 9,
横断面が正三角形をしており、先端部が外側に凸の円弧状をした鋭角に形成されている。 And cross-section to an equilateral triangle, and is formed on the acute angle tip has a convex circular arc on the outside.

【0018】また、前記ステープル4は、各面の交叉部が円弧状の面取りが施されており、特に、前記糸通し穴8,8の周囲は平滑に仕上げられている。 Further, the staple 4 is cross section of each surface has been subjected to arc-shaped chamfer, in particular, around the threading holes 8, 8 are smoothly finished. 前記プレート7と糸通し穴8,8とで止め板10が構成されている。 Stop plate 10 is constituted by the said plate 7 and the threading hole 8,8.
前記各糸通し穴8,8は、図3(A)に示すように、その長手方向に沿う両内面を平行な直線状面8a,8aに形成してもよいが、図3(B)に示すように、プレート7の長手方向の中央側に位置する面を直線状面8aに、 Each threading holes 8, 8, as shown in FIG. 3 (A), both the inner surface parallel linear surfaces 8a along its longitudinal direction, may be formed on 8a, FIG. 3 (B) as shown, the surface located on the center side in the longitudinal direction of the plate 7 in a straight line surface 8a,
外側に位置する面を外側にやや凸の円弧状面8b,8b Slightly convex arcuate surface 8b of the surface located on the outside on the outer side, 8b
に形成することもできる。 It can also be formed.

【0019】前記スパイク9,9は、図4(A)、図5 [0019] The spike 9, 9, FIG. 4 (A), the 5
(A)に示すように、外周部が平滑に形成されているが、図4(B)、図5(B)に示すように、先端部側の円弧状の鋭角部を除いて、プレート7の長手方向の外側に向いた三角形の頂部に相当する部分に、スパイク9に直交する方向に向けられ横断面が円弧状の凹部9aを、 (A), the although the outer peripheral portion is smoothly formed, FIG. 4 (B), the as shown in FIG. 5 (B), with the exception of the arcuate acute angle portions of the front end portion, the plate 7 of the portion corresponding to the top of the longitudinal triangular outwardly directed, cross-section oriented in a direction perpendicular to the spike 9 is an arcuate recess 9a,
前記スパイク9の長さ方向に所定間隔をあけて複数個形成して、スパイク9の外周に凹部9aとそれらの間の凸部9bとを交互に配置した凹凸部9cを設けるようにしてもよい。 And a plurality formed at predetermined intervals in the longitudinal direction of the spike 9, may be provided a recess 9a and uneven portions 9c which are alternately arranged and the convex portion 9b therebetween on the outer periphery of the spike 9 . 該凹凸部9cは、上記のようにスパイク9の他の三角形の頂部に設けてもよく、スパイク9の外周の一部に限らず、全周部に設けてもよい。 Uneven portion 9c may be provided on top of the other triangular spikes 9 as described above, not only the part of the outer periphery of the spike 9 may be provided on the entire circumference. また、凹部9a The recess 9a
の横断面形状も円弧状に限らず、三角形、その他の形状にすることができる。 Is not limited to arcuate cross-sectional shape, a triangle, can be other shapes.

【0020】そして、前記ステープル4は、そのプレート7を前記脛骨Bの骨孔H2における膝前面の開口部h [0020] Then, the staple 4, the knee front of the opening h in the plate 7 bone hole H2 of the tibial B
2を跨るように配置して、そのスパイク9,9を脛骨にBに打ち込んで固定され、前記再建靱帯1に連結した固定糸5の2つ分けられた自由端部5a,5aを、前記糸通し穴8,8に個別に通した後に相互に結び付けることにより、前記固定糸5を糸通し穴8,8の間におけるプレート7の係止部7bに係止するようになっている。 Arranged so as to extend over the 2, the spike 9,9 secured dedicated to B in the tibia, two divided was the free end 5a of the fixing thread 5 which is coupled to the reconstruction ligament 1, the 5a, the yarn by linking each other after passing individually through the holes 8, 8, and the fixing thread 5 so as to engage the locking portion 7b of the plate 7 between the threading holes 8,8. その係止の際、前記張力付加糸6はその2つに分けられた自由端部6a,6aを、個別に前記糸通し穴8,8に通した後相互に結んで輪を作り、該輪に荷重を加えることによって前記固定糸5に緊張を与えられるようになっている。 During the engagement, the tensioning thread 6 free end 6a which is divided into two thereof, a 6a, looped tie mutually after passing the yarn through hole 8,8 individually, 該輪so that the given tension to the fixing thread 5 by applying a load to. 前記固定糸5と張力付加糸は、それらを誤って使用、操作されることがないように、互いに異なった色に着色されている。 The fixing thread 5 and the tensioning yarn, Misuse of them, so as not to be operated, it is colored different colors from each other.

【0021】前記のように、スパイク9の外周に凹凸部9cが設けられていると、スパイク9は、脛骨Bの骨片に打ち込まれてからは、その凹凸部9cによって骨片から容易に抜け出るのを防止されるので、長期間にわたり骨片に対する安定した固着状態が得られ、したがって、 [0021] As described above, the uneven portion 9c is provided on the outer periphery of the spike 9, spike 9 from being driven into the bone of the tibia B, escape easily from the bone pieces by the uneven portion 9c since is prevented from stable fixed state is obtained for the bone fragment over a long period of time, therefore,
前記固定糸5を係止する止め板10が長期間にわたり脛骨Bにしっかりと固定、維持される。 Firmly secured to the tibial B stop plate 10 for locking the fixing thread 5 over a long period of time, it is maintained. なお、前記結束糸3、締結糸Lにおける固定糸5と張力付加糸6の各自由端部は、1本に限らず、それぞれ、複数本としてもよく、複数本を束ねたもの、撚り合わせたものであってもよい。 Each free end of the binding yarn 3, the fixing thread 5 and the tensioning thread 6 in the fastening yarn L is not limited to one, respectively, may be a plurality of, a bundle of a plurality of, twisted together it may be the one.

【0022】次に、前記のように構成された膝関節の前十字靱帯再建手術器具Gを膝関節に装着する方法について図6を参照して説明する。 Next, it will be described with the anterior cruciate ligament reconstructive surgery instruments G of the constructed knee joint as with reference to FIG. 6 method of mounting the knee joint. 先ず、医師が関節鏡で患者の膝関節における損傷された前十字靱帯の大腿骨Aと脛骨Bに対する付着部を確認する。 First, to confirm the attachment relative to the femur A and the tibia B in cruciate ligament before the physician is damaged at the knee joints of patients with arthroscopic. そして、前十字靱帯の脛骨付着部に脛骨Bの前面から骨孔H2をあける。 Then, open the bone tunnel H2 from the front of the tibia B in the tibial attachment of the anterior cruciate ligament. さらに、前記骨孔H2を利用して、関節内から前十字靱帯の大腿骨付着部に骨孔H1をあける。 Further, by using the bone hole H2, open the bone hole H1 is the femoral attachment of the anterior cruciate ligament from the joint. そして、再建靱帯1 Then, reconstruction ligament 1
として膝屈筋腱を3重から4重に束ねたものを用いて、 The knee flexor tendon from triplicate using a bundle in quadruplicate as,
その両端に結束糸3と締結糸Lをそれぞれ複数本連結し、大腿骨A側ではエンドボタン2の中央部の2つの取付穴2b、2bに結束糸3をループ状に結んでおく。 The binding yarn 3 at both ends of the fastening yarn L and a plurality of connecting each of the two mounting holes 2b of the central portion of the end button 2 in femoral A side in advance by connecting the tie thread 3 in a loop 2b.

【0023】前記大腿骨Aの骨孔H1は、関節部から骨皮質面の開口部h1までの長さを測定して、関節部から約25mmの位置までは、再建靱帯挿入長と前記エンドボタン2の長さの1/2である3mmを加えた長さに相当する内側骨孔H1aとして、再建靱帯1の直径に合わせて直径8〜9mmのドリルで穿孔し、また、その内側骨孔H1aから外側の骨皮質面までは外側骨孔H1bとしてエンドボタン2の3mm幅に合わせた直径4〜5m [0023] Bone hole H1 of the femoral A measures the length from the joint portion to the opening h1 of the cortical bone surface, from the joint portion to a position of about 25 mm, said end button and reconstruction ligament insertion length as the inner bone hole H1a corresponding to the length plus two of 3mm which is half the length, and drilled with a diameter of 8~9mm in accordance with the diameter of the reconstruction ligament 1, also inside bone hole H1a diameter to the outside of the bone cortex surface tailored to 3mm width of the end button 2 as an outer bone hole H1b from 4~5m
mのドリルで穿孔する。 Drilling with a drill of m. 手術においては、個々の症例によって大腿骨Aの骨孔H1の長さが異なるので、その測定される長さに応じて大腿骨A側に固定される結束糸3 In surgery, the length of the bone hole H1 of the femur A by individual case is different, binding thread 3 to be fixed to the femur A side according to the length that is the measured
は、エンドボタン2上でその長さが決定される。 , The length on the end button 2 is determined.

【0024】次に、脛骨B骨孔H2のから関節内および大腿骨Aの骨孔H1を通して大腿の皮膚上にワイヤを通過させる。 Next, passing the wire on the skin of the thigh through bone holes H1 intraarticular and femur A from the tibia B bone hole H2. 再建靱帯1を連結したエンドボタン2の前後に設けられている孔2c,2cにそれぞれ通した誘導糸wを介してエンドボタン2を前記ワイヤに接続し、関節鏡で確認しながら前記ワイヤを引くことによって、エンドボタン2を先頭にしてその長手方向を骨孔H1,H2 Holes 2c provided around the end button 2 which is connected to rebuild ligament 1, via inductive yarn w through respective 2c connecting the end button 2 on the wire, pulls the wire while checking arthroscopy by, the longitudinally end button 2 to the head bone hole H1, H2
の軸方向に沿わせた状態で、脛骨Bにおける骨孔H2の膝前面の開口部h2から再建靱帯1を挿入し、関節内、 In a state that has along the axial direction, inserting the reconstructed ligament 1 from the opening h2 knee front of the bone hole H2 in the tibia B, intraarticular,
大腿骨Aの骨孔H1を通過させて(図6(A参照))、 Passed through a bone hole H1 of the femur A (FIG. 6 (see A)),
大腿骨Aの前面における骨孔H1の開口部h1から前記エンドボタン2を引き出す(図6(B)参照)。 From the opening h1 of the bone hole H1 in the front of the femur A draw the end button 2 (see FIG. 6 (B)).

【0025】再建靱帯1が骨孔H1内に再建靱帯挿入長とエンドボタン2の長さの1/2長を加えた長さ分を通過したことが、関節鏡で確認されたときに、後方誘導糸w1を先に持ち上げると、エンドボタン2は大腿骨Aの皮質面上で回転して開口部h1をその直径方向に跨るようにして該皮質面上に固定される(図6(C)参照)。 [0025] When rebuilding ligaments 1 that has passed through it by the length obtained by adding the half length of the length of the reconstruction ligament insertion length and the end button 2 within the bone hole H1, which is confirmed by arthroscopy, rear lifting the induction yarn w1 above, end button 2 is fixed to rotate on the cortical surface of the femur a so as to straddle an opening h1 to the diameter direction cortical plane (FIG. 6 (C) reference).
これにより、再建靱帯1はその一端部が大腿骨Aの骨皮質の前面にエンドボタン2と結束糸3とで固定支持され、他端側が脛骨Bにおける骨孔H2の前面の開口部h Thus, reconstruction ligament 1 is fixedly supported by an end button 2 one end thereof to the front surface of the cortical bone of the femur A and fascinated yarn 3, the front face of the opening h of the bone hole H2 and the other end side of the tibia B
2に複数組の締結糸Lが出ている状態となる。 A plurality of sets of the fastening thread L to 2 in a state that has come out.

【0026】次に、前記再建靱帯1の他端部の締結糸L Next, the fastening thread L of the other end of the reconstruction ligament 1
を固定糸5の組と張力付加糸6の組とに分離すると共に、固定糸5と張力付加糸6の各組毎にそれぞれ複数本ずつを左右2つに区分けした後、各区分けした固定糸5 Together with separated into a set of pairs and tensioning yarn 6 fixed yarn 5, for each set of fixing thread 5 and the tensioning thread 6 after divided into two right and left are provided in plurality each fixing thread which is the divided 5
の自由端部5a,5aと張力付加糸6の自由端部6a, Free ends 5a, 5a and the free end portion 6a of the tensioning thread 6,
6aを、前記ステープル4に設けた糸通し穴8,8に、 The 6a, the threading hole 8,8 provided in the staple 4,
それぞれ左、右別々に通過させる。 Left respectively, right to separately pass. そして、脛骨Bの骨孔H2における膝前面の開口部h2を跨るようにステープル4を配置し、その各スパイク9,9を脛骨Bに打ち込んでステープル4を固定する(図6(D)参照)。 Then, place the staple 4 to span the opening h2 knee front in bone hole H2 of the tibia B, and the respective spike 9,9 fixing the staple 4 are implanted to the tibia B (FIG. 6 (D) refer) .

【0027】しかる後に、左右に区分した前記張力付加糸6,6の糸通し穴8,8を通過した自由端部6a、6 [0027] Thereafter, the said tensioning yarns 6,6 was divided into right and left threading the free end 6a passing through the holes 8, 8, 6
aを相互に結び付けてループ6cを作り、該ループ6c Make a loop 6c in connection with a with each other, the loop 6c
にばね秤(張力付加器具)11のフック11aを引き掛ける。 Multiply pull the hook 11a of the spring scale (tensioning device) 11. そして、左右に区分して糸通し穴8,8を通過させた前記固定糸5,5の各1本ずつの自由端部5a,5 Then, the free end 5a of each respective one of said fixing thread 5 and 5 passed through the threading holes 8, 8 are divided into right and left, 5
aを前記ステープル4の係止部7bを渡すようにして結び目5cを作る。 Knotted 5c and a to pass the engaging portion 7b of the staple 4. 次に、ばね秤11で張力付加糸6に4 Then, the tensioning thread 6 in spring balance 11 4
0〜80Nに設定した張力(再建靱帯1の初期張力)を負荷する。 Load tension (initial tension of reconstruction ligament 1) set to 0~80N. その際、前記係止部7bの上の固定糸5,5 At that time, the fixing thread 5, 5 on the locking portion 7b
の自由端部5a,5aも前記張力の負荷に合わせて引き上げながら結び目を詰めていく。 The free end 5a of, 5a even go packed knot while pulling in accordance with the load of the tension.

【0028】前記係止部7bの上の固定糸5,5がばね秤11を引き掛けた張力付加糸6,6よりも緊張が掛かると、ばね秤11のばねが緩むため、係止部7bの上の固定糸5,5を、その張力がばね秤11の張力と一致するように調節した後結び目5cをしっかり結び付けて固定する(図6(E)参照)。 [0028] When the engaging fixing thread 5, 5 on the stopper portion 7b is applied tensions than tensioning yarns 6,6 hooked a spring balance 11, since the loosened spring spring balance 11, the locking portion 7b the fixing thread 5,5 over, the tension firmly tied to secure the knot 5c was adjusted to match the tension of the spring scale 11 (see FIG. 6 (E)). これを複数ずつの固定糸5 Fixing thread 5 of this by multiple
について繰り返し、最後に、ばね秤11を引き掛けていた張力付加糸6は、初期張力を与えたときの糸通し穴8,8の通過位置にマーク6eを付けておき、ばね秤1 For repeated, finally, tensioning yarn 6 which has hooked a spring balance 11, leave marks 6e to the passing position of the threading holes 8, 8 when the given initial tension spring balance 1
1を外してからそのマーク6eの位置で前記係止部7b The locking portion 7b and disconnect the 1 at the position of the mark 6e
上で結び付ける。 Link above.

【0029】前記実施の形態における膝関節の前十字靱帯再建手術用器具Gおよびそのステープル(脛骨側固定器具)によれば、エンドボタン2で一端部を大腿骨に固定された再建靱帯1の脛骨B側の端部に固定糸5と張力付加糸6とを連結して、それらの自由端部5a,5a、 [0029] The According to anterior cruciate ligament reconstructive surgical instruments G and its staple of the knee joint in the embodiment (tibial fixation devices), tibia reconstruction ligament 1 the end portion at the end button 2 fixed to the femur and connects the fixing thread 5 and the tensioning thread 6 on the end of the B-side, their free ends 5a, 5a,
6a,6aが2つに分けて延出されると共に、脛骨B側の骨孔H2の膝前面の開口部h2に跨ってスパイク9, 6a, with 6a is extended in two, spikes 9 across the opening h2 knee front of the bone hole H2 of the tibia B side,
9によりステープル4が脛骨Bに固定され、該ステープル4の中央に設けた一対の糸通し穴8,8に、前記固定糸5と張力付加糸6の2つに分かれた自由端部5a,5 9 staple 4 is fixed to the tibia B by, the pair of threading holes 8, 8 provided at the center of the staple 4, the fixing thread 5 and a free end portion 5a which is divided into two tensioning thread 6, 5
a、6a,6aがそれぞれ個別に通されて、張力付加糸6にばね秤11で所定の張力を加えた状態で固定糸5が緊張されて前記ステープル4に固定される構成としたので、再建靱帯1を常に一定の適切な張力(初期張力)を加えて膝関節に容易、確実に装着することができる。 a, 6a, 6a are respectively passed separately, since the fixing thread 5 in a state in which the tensioning thread 6 by adding a predetermined tension spring balance 11 is configured to be tensioned and fixed to the staple 4, rebuilding the ligament 1 is always easy to knee joint by adding a constant appropriate tension (initial tension), it can be reliably mounted. これにより、医師の個人差が生じることなく、初期張力を管理した十字靱帯の再建手術が行え、手術成績の向上と安定を図ることができる。 As a result, without the individual differences of the doctor occurs, can be done reconstructive surgery of the cruciate ligament, which was managing the initial tension, it is possible to achieve the stability and improvement of surgical results.

【0030】以上、膝前十字靱帯に対する再建靱帯1 [0030] As described above, reconstruction for knee anterior cruciate ligament ligament 1
を、脛骨Bの膝前の左方から大腿骨Aの前面の右方へ向けて脛骨Bと大腿骨Aにあけた骨孔H2,H1に装着して、張力を加えた状態で脛骨Bと大腿骨Aに支持固定する場合について説明したが、後十字靱帯についても、前記ステープル7を使用して再建靱帯を固定支持することができる。 A, and attached to the bone hole H2, H1, which towards the right side of the front of the femur A was drilled in the tibia B and femur A from the left side of the front knee tibia B, and the tibial B while applying a tension It has been described that supports fixed to the femur a, may be taken in relation to the posterior cruciate ligament, fixedly supporting the reconstruction ligaments using the staple 7.

【0031】なお、前記実施の形態においては、前記ステープル4の一対の糸通し穴8,8が長穴に形成されているので、その糸通し穴8,8の長手方向を骨孔H1, [0031] Note that in the above embodiment, the the pair of threading holes 8, 8 of the staple 4 is formed into a long hole, the bone hole H1 in the longitudinal direction of the threading holes 8,8,
H2の長手方向に合わせ、かつ、前記固定糸5と張力付加糸6を、それらの自由端部5a,5a、6a,6aの延出方向を糸通し穴8,8の長手方向に牽引して緊張させる場合、固定糸5と張力付加糸6が糸通し穴8,8の周縁の角部8cで鋭角に折曲されることにより、損傷したり切断してしまうといった不具合が生じることがなくて好ましいが、前記糸通し穴8,8の形状は長穴に限らず、円形等の形状であってもよい。 Adjusted to the longitudinal direction of the H2, and the fixed yarn 5 and tensioning yarn 6, their free ends 5a, 5a, 6a, the extending direction of 6a towing in the longitudinal direction of the threading holes 8,8 when tensioning, by the fixing thread 5 and the tensioning thread 6 it is bent at an acute angle at the corner 8c of the periphery of the threading holes 8, 8, and without inconvenience be damaged or cut occurs preferred, the shape of the threading holes 8, 8 is not limited to the long hole may be in the form of a circular or the like. 円形穴の場合は穴の周縁の面取りを大きな円弧に形成すれば、固定糸5と張力付加糸6が鋭角に折曲するのを避けることができる。 By forming the chamfered peripheral edge of the hole in the large arc in the case of circular hole, the fixing thread 5 and the tensioning thread 6 can be prevented from being bent at an acute angle.

【0032】また、前記実施の形態においては、前記ステープル4のスパイク9,9の横断面が正三角形に形成されているので、形状が簡単で製作がし易く、三角形に内包される円形断面のスパイクよりも、打ち込まれた骨片と接触する周囲面積を大きく採ることができ、骨片に対する固定状態の維持が確実に行えて好ましいが、スパイクの断面形状は、三角形に限らず、四角形や他の多角形、その他の形状であってもよい。 Further, in the above embodiment, since the cross section of the spike 9, 9 of the staple 4 is formed into an equilateral triangle, easily shape is simple manufacture, of circular cross-section that is included in the triangle than spikes, ambient area in contact with the implanted bone pieces can be made large, but is preferable to reliably perform the maintenance of the fixed state relative to the bone piece, spike sectional shape is not limited to a triangle, square or other polygonal, it may be other shapes. また、前記スパイク9,9は、プレート7の両端部に前記糸通し穴8,8の整列方向に整列して、糸通し穴8,8への固定糸5と張力付加糸6の挿通を妨げることがないようにして、それぞれ1個ずつ設けられているが、これに限らず、それぞれ、必要に応じて複数個ずつ設けてもよい。 Moreover, the spike 9, 9 aligned in the alignment direction of the threading holes 8, 8 at both ends of the plate 7, hinder the insertion of the fixing thread 5 and the tensioning thread 6 into the threading holes 8,8 as they never, but are provided one by one, respectively, is not limited thereto, respectively, may be provided by a plurality as needed.

【0033】 [0033]

【発明の効果】以上説明したように、本発明によれば以下の優れた効果を奏する。 As described above, according to the present invention exhibits the following excellent effect according to the present invention. 請求項1に係る膝関節の前十字靱帯再建手術用器具によれば、脛骨の膝前面の骨孔の開口部に固定器具が固定され、再建靱帯の他端部に連結された締結糸のうちの張力付加糸の組を用手的に牽引して張力を加えた状態にして、これに合わせて締結糸のうちの固定糸の組を緊張させて、その自由端側を前記固定器具に支持固定することができるので、大腿骨と脛骨の骨孔内に挿入された再建靱帯を、大腿骨側の止め器具と脛骨側の固定器具とに所定張力を加えた状態で確実に支持固定して装着することができる。 According to anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 1, retainer to the opening of the knee front of the bone tunnel in the tibia is fixed, among the fastening thread connected to the other end portion of the reconstruction ligament and of the state set tensioned by use hands to tow the tensioning threads, this by tensioning the set of fixing thread of the fastening yarn combined, supporting the free end side of the retainer can be fixed, the reconstruction ligament inserted into the bone hole in the femur and tibia, in the retainer of the locking device and the tibial side of the femoral and securely supported and fixed while applying a predetermined tension it can be mounted.

【0034】請求項2に係る膝関節の前十字靱帯再建手術用器具によれば、張力付加糸の左右の両自由端部を結んでループを作り、これを張力付加器具で牽引することができ、これにより再建靱帯に一定の張力を加えた状態にし、これに合わせて固定糸を、その自由端部の根元に結び目を作るようにして用手的に締め付けていって、張力付加糸と同一の緊張状態となったところでしっかり結び付けることにより固定器具のプレートに支持固定することができるので、再建靱帯に対する一定張力の付加を一層確実に行うことができると共に、その維持を安定して行わせることができ、医師による個人差が生じることなく、膝関節における初期張力を管理した前十字靱帯の再建手術を行うことができ、手術成績の向上と安定を図ることができる。 According to anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 2, looped by connecting the free ends of the left and right tensioning yarns, which can be towed by the tensioning device , thereby to while applying a constant tension to reconstruct the ligament, the fixing thread in accordance with the this, went tightening use hands to as knotted at the base of its free end, equal to the tensioning thread it is possible to by tying firmly upon reaching a tension state for supporting and fixing the plate mounting fixture, it is possible to perform the addition of certain tension on reconstruction ligaments more reliably, thereby accomplished the stably maintained that can be, without individual difference is caused by the doctor, reconstructive surgery of the anterior cruciate ligament, which manages the initial tension in the knee joint can be carried out, it is possible to achieve the stability and improvement of surgical results.

【0035】請求項3に係る膝関節の前十字靱帯再建手術用器具によれば、固定糸と張力付加糸が着色によって区別できるので、用手的に行う張力付加糸による再建靱帯の張力付加と、固定糸による固定器具への固定とを間違いなく円滑に行うことができ、前十字靱帯の再建手術を迅速に行うことができる。 [0035] According to anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 3, since the fixing thread and tensioning yarn can be distinguished by coloration, and tensioning reconstruction ligament by tensioning thread performing use hands to , it is possible to smoothly carry out definitely a fixed and to the fixture by fixing thread, before it is possible to perform reconstructive surgery of the cruciate ligament quickly. 請求項4に係る膝関節の前十字靱帯再建手術用器具における脛骨側固定器具によれば、スパイクがプレートの両端部に前記糸通し穴の整列方向に整列して固着して設けられているので、糸通し穴への固定糸と張力付加糸の挿通が妨げられることがなく、固定糸と張力付加糸による再建靱帯の張力付加とプレートへの固定を円滑に行うことができる。 According to tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 4, since the spike is provided by fixing in alignment with the aligned direction of the threading hole at both ends of the plate , without the insertion of the fixing thread and tensioning yarn to the yarn threading hole is prevented, it is possible to smoothly perform the fixing to the tensioning and plate reconstruction ligament by fixing thread and tensioning yarn.

【0036】請求項5に係る膝関節の前十字靱帯再建手術用器具における脛骨側固定器具によれば、止め板の一対の糸通し穴が長穴に形成されているので、その糸通し穴の長手方向を骨孔の長手方向に合わせ、かつ、再建靱帯の端部に連結された固定糸と張力付加糸を、それらの自由端部を糸通し穴の長手方向に牽引して緊張させながら前記止め板に固定する場合、固定糸と張力付加糸が糸通し穴の周縁の角部で鋭角に折曲されることにより、損傷したり切断してしまうといった不具合が生じることがないので、再建靱帯の膝関節への固定操作を円滑、迅速に行うことができる。 According to tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 5, since the pair of threading holes in the stop plate is formed in an elongated hole, the threading hole combined longitudinal to the longitudinal direction of the bone hole, and the fixing thread and tensioning yarn connected to the end of the reconstruction ligament, while their free ends tensed by pulling in the longitudinal direction of the hole threading the when fixing the stop plate, by the fixing thread and tensioning yarn is bent at an acute angle at the corners of the peripheral edge of the hole threading, because does not occur inconvenience may be damaged or cut, reconstruction ligament the fixing operation to the knee joint smoothly, can be performed quickly.

【0037】請求項6に係る膝関節の前十字靱帯再建手術用器具における脛骨側固定器具によれば、止め板のスパイクの横断面が多角形に形成されているので、形状が簡単で製作がし易く、打ち込まれた骨片と接触する周囲面積を大きく採ることができ、骨片に対する固定状態を確実に、安定的に維持することができる。 [0037] According to the tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 6, since the cross section of the spike of the stop plate is formed in a polygonal, shape is simple manufacture to facilitate, around the area in contact with the implanted bone can be made large, reliably fixed state with respect to the bone fragments, can be maintained stably.

【0038】請求項7に係る膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具によれば、脛骨の骨片に打ち込まれスパイクが、その外周の凹凸部によって骨片に対して安定した固着状態となるので、止め板を長期間にわたり脛骨部に固定、維持させることができる。 [0038] According to reconstruct the ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint according to claim 7, spike driven into bone fragments of the tibia, relative to the bone piece the uneven portion of the outer periphery since a stable fixed state, secured to the tibial portion to stop plate for a long period of time, can be maintained.

【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS

【図1】 本発明に係る膝関節の前十字靱帯再建手術用器具の一実施の形態を膝関節に装着された状態で示す正面図である。 An embodiment of the anterior cruciate ligament reconstructive surgical instrument of the knee joint according to the invention, FIG is a front view showing a state mounted on the knee joint.

【図2】 同じく側面図である。 [Figure 2] which is also a side view.

【図3】 本発明に係る膝関節の前十字靱帯再建手術用器具における脛骨側固定器具の一実施の形態を示す平面図である。 3 is a plan view showing an embodiment of a tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint of the present invention.

【図4】 同じく側面図である。 [Figure 4] which is also a side view.

【図5】 同じく正面図である。 [Figure 5] which is also a front view.

【図6】 前十字靱帯再建手術用器具を膝関節に装着する方法の説明図である。 [6] the anterior cruciate ligament reconstructive surgery for the instrument is an explanatory diagram of a method of attaching to the knee joint.

【符号の説明】 DESCRIPTION OF SYMBOLS

1 再建靱帯 2 エンドボタン(止め器具) 3 結束糸 4 ステープル(再建靱帯脛骨側固定器具) 5 固定糸 6 張力付加糸 7 プレート 8 糸通し穴 9 スパイク 10 止め板 11 ばね秤(張力付加器) A 大腿骨 B 脛骨 G 前十字靱帯再建手術用器具 H1,H2 骨孔 h1,h2 開口部 L 締結糸 1 rebuilt ligament 2 End button (stop device) 3 binding yarn 4 staples (rebuilt ligament tibial fixation device) 5 fixing thread 6 tension applying thread 7 plate 8 threading hole 9 spike 10 stop plate 11 spring balance (tensioning device) A femoral B tibia G anterior cruciate ligament reconstructive surgical instrument H1, H2 bone hole h1, h2 opening L fastening yarn

フロントページの続き (72)発明者 阿久津 清英 新潟県新潟市岡山1300番地 株式会社新潟 鉄工所機械カンパニー新潟精機工場内 Fターム(参考) 4C060 BB01 LL13 Front page of the continuation (72) inventor Kiyohide Akutsu Niigata, Niigata Prefecture Okayama 1300 address, Ltd. Niigata Iron Works Machinery Company Niigata Seiki factory in the F-term (reference) 4C060 BB01 LL13

Claims (7)

    【特許請求の範囲】 [The claims]
  1. 【請求項1】 膝関節の大腿骨と脛骨とにあけられた骨孔に挿入される再建靱帯と、該再建靱帯をその一端部に連結した結束糸を介して大腿骨に支持する止め器具と、 And 1. A reconstruction ligament to be inserted into the bone hole drilled in the femur and tibia of the knee joint, and stop device for supporting the femur through the binding yarn connecting the said reconstruction ligament at one end ,
    再建靱帯の他端部に連結された固定糸と張力付加糸との組からなる複数組の締結糸と、前記張力付加糸によって再建靱帯に張力が付加された状態で緊張された前記固定糸の自由端側を結束支持し、前記再建靱帯の他端部を脛骨側に固定する再建靱帯脛骨側固定器具とを備えていることを特徴とする膝関節の前十字靱帯再建手術用器具。 A plurality of sets of fastening yarns consisting of a set of the fixing thread and the tensioning thread which is connected to the other end of the reconstruction ligament, the fixing thread tension is tensioned with additional state to rebuild ligament by the tensioning thread the free end united support, anterior cruciate ligament reconstructive surgical instrument knee joint and the other end of the reconstruction ligament, characterized in that it comprises a reconstruction ligament tibial fixation device for fixing the tibial side.
  2. 【請求項2】 前記締結糸の固定糸と張力付加糸はそれぞれの自由端部側が左右に2つに区分されると共に、前記再建靱帯脛骨側固定器具は平板状のプレートに一対の糸通し穴が相互に間隔をあけて設けられており、前記固定糸と張力付加糸のそれぞれの左右に分かれた自由端部が前記各糸通し穴に左右別々に挿通された後、少なくとも前記固定糸の各自由端部同士が相互に緊張状態で結び付けられて前記プレートに支持されていることを特徴とする請求項1に記載の膝関節の前十字靱帯再建手術用器具。 Wherein with the fixing thread and tensioning yarn of the fastening yarn respective free end is divided into two right and left, the reconstruction ligament tibial fixation instrument through a pair of yarn on a flat plate hole There are spaced from one another, after the free end portion which is divided into each of the right and left of the fixing thread and tensioning yarn is inserted horizontally separately to each threading holes, each of at least the fixing thread anterior cruciate ligament reconstructive surgical instrument knee joint according to claim 1, the free end portions is characterized in that it is supported by the plate tied under tension with each other.
  3. 【請求項3】 前記固定糸と張力付加糸は互いに異なる色に着色されていることを特徴とする請求項1または2 3., wherein the fixing thread and tensioning yarn that is differently colored from each other according to claim 1 or 2
    に記載の膝関節の前十字靱帯再建手術用器具。 Anterior cruciate ligament reconstructive surgery for the instrument of the knee joint as claimed in.
  4. 【請求項4】 平板状のプレートの中央部に相互に間隔をあけて貫通した一対の糸通し穴を一方向に整列して設けた止め板と、前記糸通し穴の整列方向における各糸通し穴の外側位置において前記止め板のプレートに直交して固着されたスパイクとを備えていることを特徴とする膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具。 4. A stop plate which is provided by aligning the pair of threading holes in one direction passing through at a mutual distance in the central portion of a flat plate, through each yarn in the alignment direction of the threading hole reconstruction ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument of the knee joint, characterized in that it comprises a said stop plate plate orthogonally fixed spikes in the outside positions of the hole.
  5. 【請求項5】 前記止め板の各糸通し穴は、それぞれ、 Each threading holes of claim 5, wherein the stop plate, respectively,
    それらの整列方向に直角な方向に平行に延長された長穴に形成されていることを特徴とする請求項4に記載の膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具。 Reconstruction ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument knee joint according to claim 4, characterized in that it is formed them long hole extending parallel to the direction perpendicular to the direction of alignment.
  6. 【請求項6】 前記スパイクはその横断面が多角形に形成されていることを特徴とする請求項4または5に記載の膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具。 Wherein said spike reconstruction ligament tibial fixation device in anterior cruciate ligament reconstructive surgical instrument knee joint according to claim 4 or 5, characterized in that its cross-section is formed in a polygon.
  7. 【請求項7】 前記スパイクはその外周に凹凸部が形成されていることを特徴とする請求項4〜6のいずれかに記載の膝関節の前十字靱帯再建手術用器具における再建靱帯脛骨側固定器具。 Wherein said spike reconstruction ligament tibial fixation in anterior cruciate ligament reconstructive surgical instrument knee joint according to any one of claims 4-6, characterized in that the uneven portion is formed on the outer periphery instrument.
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US8764841B2 (en) 2007-03-30 2014-07-01 DePuy Synthes Products, LLC Mobile bearing assembly having a closed track
JP2016507318A (en) * 2013-02-22 2016-03-10 スポーツ メディシン イノベーションズ アーゲー Anatomically reasonable system for ligament reconstruction, the apparatus and method
JP2016508824A (en) * 2013-03-07 2016-03-24 デピュイ・シンセス・プロダクツ・インコーポレイテッド Implant and improvements on it
JP2017520289A (en) * 2014-05-15 2017-07-27 スミス アンド ネフュー インコーポレイテッド Tissue grafts fixed with tension adjustment

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KR100904929B1 (en) 2005-02-01 2009-06-29 이범구 Graft fixing apparatus for cruciate ligament reconstruction
CN101259047B (en) 2005-03-02 2010-06-16 王岩 Artificial full knee joint transposing prosthesis capable of reestablishing anterior cruciate ligament
CN100405992C (en) 2005-03-02 2008-07-30 岩 王 Artificial complete knee joint substitute prosthesis capable of reconstructing anterior cruciate ligament
US8216319B2 (en) 2005-10-27 2012-07-10 Depuy Products, Inc. Method of repairing a knee joint
US8764841B2 (en) 2007-03-30 2014-07-01 DePuy Synthes Products, LLC Mobile bearing assembly having a closed track
US8328874B2 (en) 2007-03-30 2012-12-11 Depuy Products, Inc. Mobile bearing assembly
US8142510B2 (en) 2007-03-30 2012-03-27 Depuy Products, Inc. Mobile bearing assembly having a non-planar interface
US8147557B2 (en) 2007-03-30 2012-04-03 Depuy Products, Inc. Mobile bearing insert having offset dwell point
US8147558B2 (en) 2007-03-30 2012-04-03 Depuy Products, Inc. Mobile bearing assembly having multiple articulation interfaces
US8128703B2 (en) 2007-09-28 2012-03-06 Depuy Products, Inc. Fixed-bearing knee prosthesis having interchangeable components
JP2011500181A (en) * 2007-10-30 2011-01-06 アエスキュラップ アーゲー Facet joint implant
KR101145651B1 (en) 2010-03-29 2012-05-24 김영환 Method for using the same and meniscus for cruciate ligament reconstruction of knee joint
US8652207B2 (en) 2011-04-20 2014-02-18 Mmt Co., Ltd. Plug components for bone tunnel
KR101253915B1 (en) 2011-06-29 2013-04-16 김진구 Connector for high tibia osteotomy
JP2016507318A (en) * 2013-02-22 2016-03-10 スポーツ メディシン イノベーションズ アーゲー Anatomically reasonable system for ligament reconstruction, the apparatus and method
JP2016508824A (en) * 2013-03-07 2016-03-24 デピュイ・シンセス・プロダクツ・インコーポレイテッド Implant and improvements on it
JP2017520289A (en) * 2014-05-15 2017-07-27 スミス アンド ネフュー インコーポレイテッド Tissue grafts fixed with tension adjustment

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