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

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

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical instrument for adjusting the initial tension of a reconstructed ligament used for reconstructing an anterior cruciate ligament of a knee joint and fixing the reconstructed ligament to the tibia, and a reconstructed ligament tibia-side fixing instrument. It is.

[0002]

2. Description of the Related Art The number of cases of reconstructing anterior cruciate ligament in a knee joint damaged by extreme sports or the like is increasing. Conventionally, in this reconstructive operation, a thread is generally connected to both ends of a reconstruction ligament using tendons of about 6 cm in length, which are bundled in three to four layers, and the thread connected to one end of the ligament is stopped. Then, a bone hole penetrating from the anterior surface of the tibia to the anterior surface of the femur under an arthroscopic view without incising the knee joint is formed, and the stopper is applied to the periphery of the anterior surface of the femoral bone. While fixing directly above the bone, inserting the reconstruction ligament through the femur-side bone hole and into the tibia-side bone hole, taking out the other end of the thread connected to the reconstruction ligament to the front surface of the tibia, and tightening the tibia. The tension is applied to the reconstructed ligament to secure it to the knee joint. At that time, a method is employed in which the thread is simply wound around a screw fixed to the tibia and fixed, or the thread is pressed against the tibia with a staple and fixed.

[0003]

However, in the above-mentioned method of fixing the reconstructed ligament on the front side of the tibia,
The tension in the thread does not allow proper tensioning of the reconstructed ligament. It has been pointed out that the initial tension at the time of fixation of the reconstructed ligament affects the postoperative results in the operation of reconstructing the cruciate ligament in the knee joint. There was a problem that could not be solved.

The present invention has been made in view of the above circumstances, and it is possible to easily fix a reconstructed ligament to a knee joint by applying an appropriate tension, thereby improving the results of anterior cruciate ligament reconstruction surgery and stabilizing the results. It is an object of the present invention to provide a surgical instrument for anterior cruciate ligament reconstruction of a knee joint and a tibial fixation instrument for the reconstruction ligament.

[0005]

The present invention has the following features in order to solve the above-mentioned problems. That is,
The surgical instrument for anterior cruciate ligament reconstruction of the knee joint according to claim 1,
A reconstruction ligament to be inserted into a bone hole opened in the femur and tibia of the knee joint; a stop device for supporting the reconstruction ligament to the femur via a binding thread connected to one end thereof; A plurality of sets of fastening yarns composed of a set of a fixing yarn and a tension applying yarn connected to an end, and a free end side of the fixing yarn tensioned in a state where tension is applied to the reconstructed ligament by the tension applying yarn. And a device for fixing and supporting the other end of the reconstruction ligament on the tibia side.

[0006] In the surgical instrument for anterior cruciate ligament reconstruction of the knee joint, the reconstruction ligament is attached to a binding thread connected to one end of the knee ligament through an opening in a bone hole in front of the knee of the tibia. It is inserted into the bone hole of the tibia and femur, taken out of the opening of the bone hole in front of the femur, and the above-mentioned one end is supported and fixed by a stop device supported on the bone cortical surface of the femur. Then, a reconstruction ligament-side fixing device is fixed to the opening of the bone hole in front of the knee of the tibia, and a set of tensioning yarns of the fastening yarns connected to the other end of the reconstruction ligament is manually pulled. When the tension of the fixing yarn is adjusted to match the tension of the tension applying yarn, the free end side of the fixing yarn is It is supported and fixed by the reconstruction ligament tibial fixation device. Thereby, the reconstructed ligament inserted into the femoral and tibia bone holes reliably supports and fixes the femur-side stop device and the tibia-side reconstruction ligament tibia-side fixing device under a predetermined tension. Be attached.

The surgical instrument for anterior cruciate ligament reconstruction of the knee joint according to a second aspect of the present invention is the surgical instrument for anterior cruciate ligament reconstruction according to the first aspect, wherein the fixing thread of the fastening thread and the tension applying thread have their respective free ends. In addition to being divided into two right and left, the reconstruction ligament tibia-side fixing device is provided with a pair of threading holes spaced apart from each other in a flat plate, and each of the fixing yarn and the tension applying yarn is provided. After the left and right free ends are separately inserted into the respective threading holes on the left and right, at least the respective free ends of the fixed yarns are tied together in tension and supported by the plate. Features.

In the surgical instrument for reconstructing the anterior cruciate ligament of the knee joint, a loop is formed by connecting the left and right free ends of the tension applying thread, and this can be pulled by the tension applying instrument.
In this way, a certain tension was applied to the reconstructed ligament, and in accordance with this, the fixing thread was manually tightened so as to tie a knot at the root of its free end, and the same as the tension-applied thread. Since it can be supported and fixed to the plate by firmly tying it when it is in a tensioned state, it is possible to more reliably apply constant tension to the reconstructed ligament, maintain it stably, and cause individual differences among doctors Without performing the operation, the anterior cruciate ligament can be reconstructed while controlling the initial tension in the knee joint, and the operation results can be improved and stabilized.

According to a third aspect of the present invention, there is provided the surgical instrument for anterior cruciate ligament reconstruction according to the first or second aspect, wherein the fixing thread and the tension applying thread are colored in different colors. It is characterized by having. In the surgical instrument for reconstruction of the anterior cruciate ligament of the knee joint, the fixation thread and the tensioning thread can be distinguished by coloring, so that the tension of the reconstruction ligament is manually applied by the tensioning thread, and the reconstruction ligament tibia by the fixation thread. The fixation to the fixation device can be performed smoothly without fail, and the reconstruction operation of the anterior cruciate ligament can be performed quickly.

According to a fourth aspect of the present invention, there is provided a surgical instrument for reconstructing an anterior cruciate ligament of a knee joint, comprising a pair of threaded holes penetrating through a central portion of a flat plate at a distance from each other. And a spike fixed orthogonally to the plate of the stop plate at a position outside each threading hole in the alignment direction of the threading hole. . In the reconstruction ligament tibia-side fixation device in the anterior cruciate ligament reconstruction surgical instrument of the knee joint, the spikes are provided at both ends of the plate so as to be aligned and fixed in the alignment direction of the threading holes.
It is possible to smoothly apply tension to the reconstructed ligament and fix the plate to the plate using the fixing yarn and the tension applying yarn without hindering the insertion of the fixing yarn and the tension applying yarn into the threading hole.

[0011] In the instrument for reconstructing an anterior cruciate ligament of a knee joint according to claim 5, the tibial fixation device for reconstruction ligament is provided in claim 4.
In the reconstructed ligament tibial fixation device according to the above, each threading hole of the stopper plate is formed as an elongated hole extending in parallel to a direction perpendicular to the alignment direction. In the reconstruction ligament tibial fixation device in the anterior cruciate ligament reconstruction surgical instrument of the knee joint, since the pair of threading holes of the stopper plate is formed in an elongated hole, the longitudinal direction of the threading hole is defined as a bone hole. The fixed yarn and the tension applying yarn are aligned with the longitudinal direction of the ligament and connected to the end of the reconstructed ligament, and their free ends are secured to the stopper plate while being pulled and stretched in the longitudinal direction of the threading hole. In this case, the fixing yarn and the tension applying yarn are bent at an acute angle at the peripheral edge of the threading hole, so that there is no problem that the yarn is damaged or cut.

[0012] In the instrument for reconstructing the anterior cruciate ligament of the knee joint according to claim 6, the tibial fixation device for reconstruction ligament is provided.
Or the spiking device according to item 5, wherein the spike has a polygonal cross section. In the reconstruction ligament tibial fixation device in the anterior cruciate ligament reconstruction surgical instrument of the knee joint, since the cross section of the spike of the stopper plate is formed in a polygonal shape, the shape is simple, easy to manufacture, and a polygonal shape. The peripheral area in contact with the implanted bone fragment can be larger than that of a spike having a circular cross section inscribed in the bone fragment, and the fixed state of the bone fragment can be reliably maintained.

[0013] In the surgical instrument for anterior cruciate ligament reconstruction of the knee joint according to claim 7, the tibial fixation instrument for reconstruction ligament is provided.
7. The reconstruction ligament tibial side fixation device according to any one of claims 6 to 6, wherein the spike is formed with an uneven portion on the outer periphery thereof, wherein the knee joint has an anterior cruciate ligament reconstruction surgical instrument. In the fixation device, after the spikes are driven into the bone fragments of the tibia, the spikes are prevented from easily coming out of the bone fragments by the irregularities on the outer periphery thereof, so that a stable fixation state to the bone fragments can be obtained for a long period of time. Can be

[0014]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an exploded perspective view of a knee joint reconstruction instrument for anterior cruciate ligament according to the present invention. 1 and 2, A is a femur in a knee joint to which an anterior cruciate ligament reconstruction instrument G is attached, B is a tibia, and they are front views in a state where legs shown in FIG. From the center of the anterior surface of the tibia B (left side in FIG. 2), a little closer to one side (left side in FIG. 1), through the center of the epiphysis of the femur A, to the other side in front of the femur A (FIG. Bone holes H1 and H2 are opened toward the right side. These bone holes H1 and H2 extend the legs shown in FIG.
In a side view of the bent state, it is almost straight, but in a state where the leg shown in FIG.
Is bent toward the front of the knee at the epiphysis.
The reconstruction ligament 1 having a length of about 1/3 of the entire length is inserted into the bone holes H1 and H2.

The bone hole H1 of the femur A is formed with an inner bone hole H1a having a diameter of 8 to 9 mm and drilled in accordance with the diameter of the reconstruction ligament 1.
And an outer bone hole H1b having a diameter of 4 to 5 mm corresponding to a width of 3 mm of the end button (stopping device) 2.
An end button (stopping device) 2 having a rectangular flat plate 2a is laid over the opening h1 on the side of the cortical surface (front end side) of the opening 1b so that the longitudinal direction thereof extends in the diameter direction of the opening h1. It is supported by the femur A.

The end button 2 includes a reconstruction ligament 1
The free ends divided into two of the binding yarn 3 connected to the end (one end) of the femoral side A are individually passed through a pair of mounting holes 2b, 2b opened in the center of the flat plate 2a. One end of the reconstructed ligament 1 is fixedly supported by being later connected to the flat plate 2a. A staple (reconstruction ligament tibial-side fixing device) 4 is fixed to an opening h2 on the anterior surface of the knee in the bone hole H2 of the tibia B, and the staple 4 has an end (the other end) of the reconstruction ligament 1 on the tibia B side. ) Are connected to each other in a state where one fixed yarn 5 formed by separating the fastening yarn L into two sets is tensioned by the other tension applying yarn 6, whereby the reconstructed ligament 1 is tensioned. The other end is fixed to the tibia B with (initial tension) applied.

As shown in FIGS. 3 to 5, the staple 4 has a rectangular flat plate 7 and a central portion of the plate 7 which is aligned in the longitudinal direction (the left-right direction in FIG. 3) and longitudinally aligned. A pair of threading holes 8, 8 each formed of a through hole formed in a direction perpendicular to each other and having both ends formed in an arc shape, and the outside of the plate 7 in the longitudinal direction at a position aligned with each threading hole 8, 8. At the end, a pair of spikes 9, 9 fixed perpendicular to the plate 7 are provided. Each spike 9, 9
The cross section is an equilateral triangle, and the tip is formed at an acute angle in the shape of a circular arc convex outward.

The staple 4 has an arc-shaped chamfer at the intersection of each surface, and the periphery of the threading holes 8, 8 is particularly smoothed. The plate 7 and the threading holes 8 constitute a stopper plate 10.
As shown in FIG. 3 (A), each of the threading holes 8, 8 may be formed such that both inner surfaces along its longitudinal direction are parallel linear surfaces 8a, 8a. As shown, the surface located on the center side in the longitudinal direction of the plate 7 is a straight surface 8a,
The surfaces located on the outside are arcuate surfaces 8b, 8b slightly convex outward.
Can also be formed.

The spikes 9 and 9 are shown in FIGS.
As shown in (A), the outer peripheral portion is formed smoothly, but as shown in FIGS. 4 (B) and 5 (B), the plate 7 except for the arc-shaped acute angle portion on the tip end side is formed. In a portion corresponding to the top of a triangle facing outward in the longitudinal direction, a concave portion 9a having a circular cross section oriented in a direction perpendicular to the spike 9 is provided.
A plurality of the spikes 9 may be formed at predetermined intervals in the longitudinal direction, and the outer periphery of the spike 9 may be provided with concave and convex portions 9c in which concave portions 9a and convex portions 9b therebetween are alternately arranged. . The uneven portion 9c may be provided at the top of another triangle of the spike 9 as described above, and may be provided not only at a part of the outer periphery of the spike 9 but also at the entire periphery. Also, the recess 9a
Is not limited to an arc shape but may be a triangle or other shapes.

The staple 4 has its plate 7 connected to the opening h on the front surface of the knee in the bone hole H2 of the tibia B.
2 and the spikes 9, 9 are fixed to the tibia by driving the spikes 9, 9 into the tibia, and the two divided free ends 5a, 5a of the fixing thread 5 connected to the reconstruction ligament 1 are connected to the thread. The fixing thread 5 is locked to the locking portion 7b of the plate 7 between the threading holes 8, 8 by being tied to each other after individually passing through the through holes 8, 8. At the time of the locking, the tension applying yarn 6 passes the free end portions 6a, 6a divided into two separately through the threading holes 8, 8, and then ties each other to form a loop. The tension is applied to the fixing thread 5 by applying a load to the fixing thread 5. The fixing yarn 5 and the tension applying yarn are colored differently from each other so that they are not used or operated by mistake.

As described above, if the uneven portion 9c is provided on the outer periphery of the spike 9, the spike 9 is easily driven out of the bone piece by the uneven portion 9c after being driven into the bone piece of the tibia B. A stable fixation to the bone fragments over a long period of time,
The stop plate 10 for locking the fixing thread 5 is firmly fixed and maintained on the tibia B for a long period of time. In addition, the free ends of the fixing yarn 5 and the tension applying yarn 6 in the binding yarn 3 and the fastening yarn L are not limited to one, and may be plural, respectively, and may be bundled and twisted. It may be something.

Next, a method of attaching the surgical instrument G for reconstruction of the anterior cruciate ligament of the knee joint configured as described above to the knee joint will be described with reference to FIG. First, a physician uses an arthroscope to check the attachment of the damaged anterior cruciate ligament to the femur A and tibia B in the patient's knee joint. Then, a bone hole H2 is made in the anterior cruciate ligament from the front surface of the tibia B at the tibial attachment part. Further, using the bone hole H2, a bone hole H1 is opened from the inside of the joint to the thigh bone attachment portion of the anterior cruciate ligament. And reconstruction ligament 1
Using a bundle of three to four folds of knee flexor tendon,
A plurality of binding yarns 3 and a plurality of fastening yarns L are connected to both ends thereof, and the binding yarn 3 is tied in a loop shape to two mounting holes 2b, 2b at the center of the end button 2 on the femur A side.

The length of the bone hole H1 of the femur A is measured from the joint to the opening h1 of the cortical surface. Up to a position about 25 mm from the joint, the length of the reconstructed ligament and the end button are measured. An inner bone hole H1a corresponding to a length obtained by adding 3 mm which is １ ／ of the length of 2 with a drill having a diameter of 8 to 9 mm in accordance with the diameter of the reconstructed ligament 1 is formed. From the outer cortical surface to the outer bone cortical surface as a lateral bone hole H1b, 4-5 m in diameter according to the 3 mm width of the end button 2
Drill with a m drill. In the operation, since the length of the bone hole H1 of the femur A differs depending on the individual case, the binding thread 3 fixed to the femur A side in accordance with the measured length.
Is determined on the end button 2.

Next, a wire is passed from the tibia B bone hole H2 into the joint and through the bone hole H1 of the femur A onto the skin of the thigh. The end button 2 is connected to the wire via guide threads w passing through holes 2c, 2c provided before and after the end button 2 to which the reconstruction ligament 1 is connected, and the wire is pulled while confirming with an arthroscope. Thus, the longitudinal direction of the end button 2 with the end button 2 at the top is the bone hole H1, H2.
The reconstruction ligament 1 is inserted into the tibia B from the opening h2 on the anterior surface of the knee in the bone hole H2 in the axial direction,
After passing through the bone hole H1 of the femur A (see FIG. 6 (A)),
The end button 2 is pulled out from the opening h1 of the bone hole H1 on the front surface of the femur A (see FIG. 6B).

When it is confirmed by an arthroscopy that the reconstruction ligament 1 has passed through the bone hole H1 by a length obtained by adding the length of the insertion of the reconstruction ligament and half the length of the end button 2, the posterior ligament is used. When the guide thread w1 is lifted first, the end button 2 rotates on the cortical surface of the femur A and is fixed on the cortical surface so as to straddle the opening h1 in the diameter direction (FIG. 6C). reference).
As a result, the reconstructed ligament 1 has one end fixedly supported on the front surface of the bone cortex of the femur A by the end button 2 and the binding thread 3, and the other end side formed with the opening h on the front surface of the bone hole H2 in the tibia B.
In this state, a plurality of sets of the fastening yarns L are exposed.

Next, the fastening yarn L at the other end of the reconstructed ligament 1
Is divided into a set of fixed yarns 5 and a set of tension applying yarns 6, and a plurality of fixed yarns 5 and tension applying yarns 6 are respectively divided into two sets of right and left, and then each of the fixed yarns is divided. 5
Free ends 5a, 5a and free ends 6a,
6a into the threading holes 8, 8 provided in the staple 4,
Pass through left and right respectively. Then, the staple 4 is arranged so as to straddle the opening h2 on the front surface of the knee in the bone hole H2 of the tibia B, and the spikes 9, 9 are driven into the tibia B to fix the staple 4 (see FIG. 6D). .

After that, the free ends 6a, 6a passing through the threading holes 8, 8 of the tension applying yarns 6, 6 divided into right and left.
a to each other to form a loop 6c.
The hook 11a of the spring balance (tension applying device) 11 is hooked. Then, the free ends 5a, 5 of the fixing yarns 5, 5 each passing through the threading holes 8, 8 are divided into right and left.
The knot 5c is made by passing the a through the engaging portion 7b of the staple 4. Next, 4 is applied to the tension applying yarn 6 by the spring balance 11.
A tension (initial tension of the reconstructed ligament 1) set at 0 to 80N is applied. At this time, the fixing yarns 5, 5 on the locking portion 7b
The free ends 5a, 5a are also packed with the knot while being pulled up in accordance with the tension load.

When the fixing yarns 5, 5 on the locking portion 7b are tensioned more than the tension applying yarns 6, 6 hooked on the spring balance 11, the spring of the spring balance 11 is loosened. After adjusting the tension of the fixing threads 5 and 5 so that the tension thereof matches the tension of the spring balance 11, the knot 5c is tightly tied and fixed (see FIG. 6 (E)). A plurality of fixing yarns 5
Finally, the tension-applying thread 6 hooked on the spring balance 11 is marked with a mark 6e at the passing position of the threading holes 8, 8 when the initial tension is applied.
1 and remove the locking portion 7b at the position of the mark 6e.
Tie on.

According to the surgical instrument G for anterior cruciate ligament reconstruction of the knee joint and the staple thereof (tibial fixation instrument) in the above embodiment, the tibia of the reconstruction ligament 1 having one end fixed to the femur with the end button 2 The fixed yarn 5 and the tension applying yarn 6 are connected to the end on the B side, and their free ends 5a, 5a,
6a, 6a are extended in two parts, and spikes 9, 9a are straddled over the opening h2 on the front of the knee of the bone hole H2 on the tibia B side.
9, the staple 4 is fixed to the tibia B, and the free ends 5a, 5 divided into two of the fixing thread 5 and the tension applying thread 6 are inserted into a pair of threading holes 8, 8 provided in the center of the staple 4.
Since a, 6a, and 6a are individually passed through and the fixed thread 5 is tensioned and fixed to the staple 4 in a state where a predetermined tension is applied to the tension applying thread 6 by the spring scale 11, the rebuilding is performed. The ligament 1 can be easily and reliably attached to the knee joint by always applying a constant appropriate tension (initial tension). Thereby, the reconstruction operation of the cruciate ligament with the initial tension managed can be performed without causing individual differences among doctors, and the operation results can be improved and stabilized.

As described above, the reconstruction ligament 1 for the anterior cruciate ligament
Are attached to the bone holes H2 and H1 opened in the tibia B and the femur A from the left in front of the knee of the tibia B to the right in front of the femur A, and the tibia B is tensioned. The case where the ligament is supported and fixed to the femur A has been described. However, also for the posterior cruciate ligament, the staple 7 can be used to fix and support the reconstructed ligament.

In the above embodiment, since the pair of threading holes 8, 8 of the staple 4 are formed as long holes, the longitudinal direction of the threading holes 8, 8 is defined as the bone hole H1,
The fixed yarn 5 and the tension-applying yarn 6 are pulled in the longitudinal direction of the threading holes 8, 8 by adjusting the free ends 5a, 5a, 6a, 6a of the fixed yarn 5 and the tension applying yarn 6 in the longitudinal direction of H2. When the tension is applied, the fixing yarn 5 and the tension applying yarn 6 are bent at an acute angle at the corner 8c of the peripheral edge of the threading holes 8, 8, so that a trouble such as damage or cutting does not occur. Preferably, the shape of the threading holes 8, 8 is not limited to a long hole, but may be a circular shape or the like. In the case of a circular hole, if the chamfer of the periphery of the hole is formed into a large arc, the fixing yarn 5 and the tension applying yarn 6 can be prevented from being bent at an acute angle.

In the above embodiment, the spikes 9, 9 of the staple 4 are formed in an equilateral triangle in cross section, so that the shape is simple and easy to manufacture, and the circular cross section included in the triangle is easy. A larger area can be taken in contact with the implanted bone fragment than a spike, and it is preferable because the fixed state with respect to the bone fragment can be reliably maintained.However, the cross-sectional shape of the spike is not limited to a triangle, but may be a square or other shape. Polygon, or other shapes. Further, the spikes 9, 9 are aligned at both ends of the plate 7 in the alignment direction of the threading holes 8, 8 to prevent the fixing thread 5 and the tension applying thread 6 from being inserted into the threading holes 8, 8. Each of them is provided so as not to cause a problem, but the present invention is not limited to this, and a plurality of each may be provided as necessary.

[0033]

As described above, according to the present invention, the following excellent effects can be obtained. According to the surgical instrument for anterior cruciate ligament reconstruction of the knee joint according to claim 1, the fixing instrument is fixed to the opening of the bone hole on the front surface of the knee of the tibia, and of the fastening thread connected to the other end of the reconstruction ligament. The tensioned thread set is manually pulled to make a tensioned state, and the fixing thread set of the fastening threads is tensioned in accordance with the tension, and the free end side is supported by the fixing device. Since it can be fixed, the reconstruction ligament inserted into the femoral and tibia bone holes is securely supported and fixed with a predetermined tension applied to the femoral side fixing device and the tibia side fixing device. Can be installed.

According to the surgical instrument for anterior cruciate ligament reconstruction of the knee joint according to the second aspect, a loop is formed by connecting the left and right free ends of the tension applying thread, and this can be pulled by the tension applying instrument. In this way, a certain tension is applied to the reconstructed ligament, and in accordance with this, the fixing yarn is manually tightened so as to tie a knot at the root of its free end, and the same as the tension applying yarn It can be supported and fixed to the plate of the fixation device by firmly tying it when it becomes tensioned, so that a constant tension can be applied to the reconstructed ligament more reliably and its maintenance can be performed stably This makes it possible to perform an anterior cruciate ligament reconstruction operation in which the initial tension in the knee joint is managed without causing individual differences among doctors, thereby improving and stabilizing the operation results.

According to the surgical instrument for anterior cruciate ligament reconstruction of the knee joint according to the third aspect, since the fixing thread and the tension applying thread can be distinguished by coloring, it is possible to manually apply the tension to the reconstruction ligament by the tension applying thread. The fixation to the fixation device with the fixation thread can be performed smoothly without fail, and the anterior cruciate ligament reconstruction operation can be performed quickly. According to the tibial fixation device in the anterior cruciate ligament reconstruction surgical device of the knee joint according to claim 4, since the spikes are provided in both ends of the plate in alignment with the alignment direction of the threading holes, the spikes are provided. Thus, the insertion of the fixing yarn and the tension applying yarn into the threading hole is not hindered, and the tension of the reconstruction ligament by the fixing yarn and the tension applying yarn and the fixation to the plate can be performed smoothly.

According to the tibial fixation device of the anterior cruciate ligament reconstruction device for a knee joint according to the fifth aspect, the pair of threading holes of the stopper plate are formed as long holes. The longitudinal direction is aligned with the longitudinal direction of the bone hole, and the fixing yarn and the tension applying yarn connected to the end of the reconstructed ligament are tensioned by pulling their free ends in the longitudinal direction of the threading hole. When fixed to the stopper plate, the fixing thread and the tension-applying thread are bent at an acute angle at the periphery of the threading hole, so that there is no problem such as damage or cutting, so the reconstruction ligament. Can be smoothly and quickly fixed to the knee joint.

According to the tibial fixation device of the anterior cruciate ligament reconstruction device for a knee joint according to the sixth aspect, since the cross section of the spike of the stopper plate is formed in a polygonal shape, the shape is simple and the manufacture is simple. Therefore, a large area can be taken in contact with the implanted bone fragment, and the fixed state to the bone fragment can be reliably and stably maintained.

According to the device for reconstructing the anterior cruciate ligament of the knee joint according to the seventh aspect of the present invention, the spikes which are driven into the bone fragment of the tibia are deformed with respect to the bone fragment by the uneven portion on the outer periphery. Since the anchoring state is stable, the stopper plate can be fixed and maintained on the tibia for a long period of time.

[Brief description of the drawings]

FIG. 1 is a front view showing an embodiment of a surgical instrument for anterior cruciate ligament reconstruction of a knee joint according to the present invention in a state of being attached to a knee joint.

FIG. 2 is a side view of the same.

FIG. 3 is a plan view showing one embodiment of a tibial fixation device in the anterior cruciate ligament reconstruction device for a knee joint according to the present invention.

FIG. 4 is a side view of the same.

FIG. 5 is a front view of the same.

FIG. 6 is an explanatory view of a method of mounting an anterior cruciate ligament reconstruction surgical instrument on a knee joint.

[Explanation of symbols]

Reference Signs List 1 reconstruction ligament 2 end button (stopping device) 3 binding thread 4 staple (reconstruction ligament tibia-side fixing device) 5 fixing thread 6 tensioning thread 7 plate 8 threading hole 9 spike 10 stop plate 11 spring balance (tensifier) A Femur B Tibia G Instrument for anterior cruciate ligament reconstruction surgery H1, H2 Bone hole h1, h2 Opening L Fastening thread

Continued on the front page (72) Inventor Kiyohide Akutsu 1300 Okayama, Niigata City, Niigata Prefecture Niigata Iron Works Machinery Company Niigata Precision Machinery Factory F-term (reference) 4C060 BB01 LL13

Claims (7)

[Claims] 1. A reconstructing ligament to be inserted into a bone hole opened in a femur and a tibia of a knee joint, and a stop device for supporting the reconstructing ligament to the femur via a binding thread connected to one end thereof. ,
A plurality of sets of fastening yarns each comprising a set of a fixing yarn and a tension applying yarn connected to the other end of the reconstruction ligament; and a fixing yarn tensioned in a state where tension is applied to the reconstruction ligament by the tension applying yarn. An instrument for reconstructing the anterior cruciate ligament of a knee joint, comprising: a reconstructive ligament tibial-side fixing device for binding and supporting the free end side and fixing the other end of the reconstructive ligament to the tibia side. 2. The fixing yarn and the tension applying yarn of the fastening yarn are respectively divided into two at the free end side on the left and right sides, and the reconstructing ligament tibial side fixing device has a pair of threading holes in a flat plate. Are provided at an interval from each other, and after the left and right free ends of the fixing yarn and the tension applying yarn are separately inserted into the respective threading holes separately on the left and right, at least each of the fixing yarns The surgical instrument for reconstructing an anterior cruciate ligament of a knee joint according to claim 1, wherein the free ends are connected to each other under tension and supported by the plate. 3. The fixing yarn and the tension applying yarn are colored in different colors from each other.
The instrument for reconstructing anterior cruciate ligament of a knee joint according to 1. 4. A stopper plate provided with a pair of threading holes penetrating at a distance from each other in a central portion of a flat plate and arranged in one direction, and each threading thread in an alignment direction of the threading holes. And a spike fixed orthogonally to the plate of the stop plate at a position outside the hole, the reconstruction ligament tibial fixation device in a knee joint anterior cruciate ligament reconstruction surgical instrument. 5. Each of the threading holes of the stop plate,
The device for reconstructing the anterior cruciate ligament of a knee joint according to claim 4, wherein the device is formed in a long hole extending parallel to a direction perpendicular to the alignment direction. 6. The device for reconstructing an anterior cruciate ligament for a knee joint according to claim 4, wherein the spike has a polygonal cross section. 7. The tibial fixation of a reconstruction ligament in a surgical instrument for anterior cruciate ligament reconstruction according to any one of claims 4 to 6, wherein the spike has an uneven portion formed on an outer periphery thereof. Appliances.