JP2006230874A - Tissue-lack prosthetic material fixing implement - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a tissue-lack prosthetic material fixing implement for fixing a tissue-lack prosthetic material firmly, accurately and easily to a lacking part of tissue. <P>SOLUTION: The tissue-lack prosthetic material fixing implement 1 for fixing the tissue-lack prosthetic material 6 to the lacking part of tissue comprises an anchor part 2 formed of a resilient material, a filament material 3 (a suture with a needle) connected to one end of the anchor part, and a filament material 4 (a suture) connected to the other end of the anchor part. The tissue-lack prosthetic material is preferably a bioabsorptive polymer. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

The present invention relates to a tissue defect prosthetic material fixing jig for firmly fixing a tissue defect prosthetic material to a defect part of tissue, accurately and simply.

A technique for reconstructing a deficient tissue by fixing a tissue deficient prosthetic material to the deficient portion of the tissue is known. For example, when a tissue defect prosthetic material made of collagen sponge or the like is fixed to the skin defect, cells around the defect invade into the tissue defect prosthesis material, and proliferate and differentiate to reconstruct the dermis-like tissue. It is known that Furthermore, recent progress in cell engineering technology has made it possible to cultivate a number of animal cells, including human cells, and try to reconstruct human tissues and organs by culturing these cells using a tissue-deficient prosthetic material as a scaffold. Research on so-called regenerative medicine is progressing rapidly.
Among these types of regenerative medicine, there is an increase in the number of patients with joint damage due to osteoarthritis and chronic rheumatism accompanying the aging of the current society, and sports trauma caused by the penetration of sports into daily life. From the increase, etc., it is expected that the deficient cartilage tissue is regenerated using artificial cartilage.
As artificial cartilage, for example, a tissue defect prosthetic material that serves as a scaffold for tissue regeneration such as collagen is seeded with the patient's own chondrocytes or mesenchymal stem cells, cultured, and differentiated. (For example, Patent Document 1).

In order to regenerate a tissue using the tissue defect prosthesis material, the tissue defect prosthesis material must be accurately fixed to the tissue defect. The fixed tissue defect prosthetic material is engrafted in the tissue when cells or connective tissue invade from the surrounding tissue, and finally is integrated with the surrounding tissue. As a method for fixing a tissue defect prosthetic material to a tissue defect, conventionally, a tissue defect prosthesis material is sutured to the defect. However, it has been extremely difficult to accurately fix the tissue defect prosthetic material to the cartilage defect by suturing. For example, a joint with a cartilage is easily moved by daily activities of a patient, and even if a tissue defect prosthetic material is used for cartilage regeneration, an external force is always applied to the fixed tissue defect prosthetic material. In order to prevent the tissue defect prosthetic material from shifting even when an external force is applied in this way, it is necessary to firmly fix the tissue defect prosthetic material. It is extremely difficult to firmly fix a tissue defect prosthetic material that is designed flexibly in order to enhance the properties only by suturing. If the tissue defect prosthetic material is displaced from the tissue defect, the tissue can no longer be regenerated without the tissue defect prosthetic material engrafting, or even if it is engrafted, the tissue functions sufficiently. I don't get it.

Tissue regeneration using conventional tissue defect prosthetic materials has a very low success rate, such as the fact that fixed tissue defect prosthetic materials do not engraft. Rather than this problem, it seems that there was a difficulty in fixing the tissue defect prosthetic material. Therefore, there has been a demand for a method capable of fixing a tissue defect prosthetic material firmly, accurately, and simply to a tissue defect.
JP 2002-291461 A

In view of the above situation, an object of the present invention is to provide a tissue defect prosthetic material fixing jig for firmly fixing a tissue defect prosthetic material to a defect part of tissue.

The present invention relates to a tissue defect prosthetic material fixing jig for fixing a tissue defect prosthetic material to a tissue defect part, and includes an anchor part made of a resilient material and a thread coupled to one end of the anchor part. It is a tissue defect prosthesis material fixing jig comprising a line and a thread connected to the other end of the anchor portion.
In the present specification, the tissue defect prosthetic material means a base material configured to fill a defective tissue and regenerate and repair the tissue. For example, a nonwoven fabric or sponge made of a bioabsorbable polymer or the like Examples thereof include a composite or a composite material thereof. Furthermore, tissue-deficient prosthetic materials include so-called cultured tissues that have been proposed so far, such as those obtained by seeding, culturing, and differentiating cells derived from humans or non-human organisms.
The present invention exemplified below will be described in detail.

The schematic diagram which shows an example of the jig | tool for tissue defect | deletion prosthetic material fixation of this invention in FIG. 1 was shown. Hereinafter, the tissue defect prosthetic material fixing jig of the present invention will be described in detail with reference to FIG.
A tissue defect prosthetic material fixing jig 1 shown in FIG. 1 includes an anchor portion 2, a thread coupled to one end of the anchor portion 2, in this example, a suture with needle 3, and an anchor portion 2. It consists of a thread connected to the other end, in this example, a suture 4. A needle 5 is attached to the end of the needle-attached suture thread 3.

The anchor portion 2 serves as an anchor for fixing the tissue defect prosthetic material to the tissue defect.
The anchor part 2 is made of an elastic material. The elastic material is not particularly limited as long as it has an appropriate restoring force against stress and can exhibit a sufficient fixing force by engagement with a living tissue (such as a bone hole described later). Any of those having elasticity in themselves and those capable of exerting structural elasticity such as sponge, braid, sliver, knitted fabric, woven fabric, non-woven fabric, and spiral mesh can be used. Among them, a composite material in which a sponge body is formed inside the braid is preferable because it can exhibit high elasticity and frictional force with living tissue.
The material constituting the elastic material is not particularly limited as long as it is not toxic and can be applied to the human body. However, in the case of a bioabsorbable polymer, the tissue defect prosthetic material is engrafted. It is preferable because it is not necessary to take it out by surgery or the like.

The bioabsorbable polymer is not particularly limited, and may be a bioabsorbable synthetic polymer or a bioabsorbable natural polymer.
The bioabsorbable synthetic polymer is not particularly limited, and examples thereof include polylactic acid, polyglycolic acid, poly-ε-caprolactone, lactic acid-glycolic acid copolymer, glycolic acid-ε-caprolactone copolymer, and lactic acid-ε. -Caprolactone copolymer, poly-p-dioxanone, polytrimethylene carbonate, polycitric acid, polymalic acid, poly-α-cyanoacrylate, poly-β-hydroxy acid, polytrimethylene oxalate, polytetramethylene oxalate, poly Examples include orthoester, polyorthocarbonate, polyethylene carbonate, poly-γ-benzyl-L-glutamate, poly-γ-methyl-L-glutamate, poly-L-alanine and the like.
The bioabsorbable natural polymer is not particularly limited, and examples thereof include polysaccharides such as starch, alginic acid, hyaluronic acid, chitin, pectic acid and derivatives thereof, and proteins such as gelatin, collagen, albumin and fibrin. .

The shape of the anchor portion 2 is not particularly limited, and may be any of a columnar shape, a square shape, a spherical shape, and the like, but a columnar shape is preferable because the operation is easy.
The size of the anchor portion 2 is not particularly limited. For example, in the case of a columnar shape, the preferable lower limit of the outer diameter is 0.5 mm, the preferable upper limit is 10 mm, and the preferable lower limit of the length is 1 mm. A preferable upper limit is 50 mm. When the outer diameter is less than 0.5 mm, sufficient fixation may not be obtained. When the outer diameter exceeds 10 mm, the tissue defect prosthetic material is fixed using the tissue defect prosthetic material fixing jig of the present invention described later. Therefore, the diameter of the bone hole or the like that must be formed becomes large, and the burden on the patient becomes excessive. When the length is less than 1 mm, a sufficient fixing force may not be obtained. When the length exceeds 50 mm, the tissue defect prosthetic material is fixed using the tissue defect prosthetic material fixing jig of the present invention described later. When the tissue defect prosthetic material is fixed, the anchor part may protrude beyond the bone hole or the like to the outer skin part.

A suture thread 3 with a needle is coupled to one end of the anchor portion 2 as a thread. The needle-attached suture thread 3 has a role of connecting the tissue defect prosthetic material fixing jig of the present invention to the tissue defect prosthetic material using the needle 5.
The yarns and needles constituting the needle-attached suture thread 3 are not particularly limited, and those usually used can be used. In addition, when the said bioabsorbable polymer is used as a suture thread, it is not necessary to take out by surgery etc. after tissue defect prosthetic material engraftment.
The mode of connection between the needle-attached suture thread 3 and the anchor part 2 is not particularly limited. For example, when the anchor part has sufficient tear strength, the suture part may be directly passed through the anchor part 2, On the contrary, when the tear strength is not sufficient, a reinforcing portion for passing a suture with a needle through the anchor portion may be provided and the suture thread may be passed through the reinforcing portion.
As the yarn, it is suitable to use a surgical suture with a needle that is generally used in the medical field. However, within the above-mentioned purpose range, the tip of the thread is processed hard or a linear needle is used. The specification is arbitrary, such as providing.

A suture thread 4 is coupled to the other end of the anchor portion 2. The suture thread 4 has a role of a traction thread for inserting the anchor portion 2 into a living tissue (bone) that has been previously perforated.
The suture that constitutes the suture 4 is not particularly limited, and a commonly used suture can be used.
There is no particular limitation on the manner in which the suture thread 4 and the anchor part 2 are joined. For example, when the anchor part has a sufficient tear strength, the suture thread may be passed directly through the anchor part 2, or conversely. If the tear strength is not sufficient, a reinforcing portion for passing a suture with a needle through the anchor portion may be provided, and the suture thread may be passed through the reinforcing portion.
In addition, it is preferable to tie the end portions of the suture thread 4 so that the suture thread 4 is not accidentally detached from the anchor portion 2 during operation.
The suture is not limited to this, and other yarns that can achieve the purpose may be used.

FIG. 2 shows an example of a procedure for fixing the tissue defect prosthetic material to the cartilage defect as an example of fixing the tissue defect prosthesis material to the tissue defect using the tissue defect prosthetic material fixing-like jig of the present invention. A schematic diagram is shown. A method for fixing the tissue defect prosthetic material to the cartilage defect will be described with reference to FIG.

First, the tissue defect prosthetic material fixing jig 1 is coupled to the tissue defect prosthetic material 6 (FIG. 2A). The coupling is performed using the needle 5 of the suture with needle 3. The needle 5 is removed after the coupling.
The bonding position and number of the tissue defect prosthetic material fixing jig 1 to be bonded to the tissue defect prosthetic material may be appropriately selected according to the size, shape, etc. of the tissue defect prosthetic material 6. It is preferable to couple a plurality of tissue defect prosthetic material fixing jigs.
When the tissue defect prosthetic material 6 is fixed to the cartilage defect part 7, the tissue defect prosthetic material 6 and the tissue defect prosthesis material fixing jig 1 are fixed so that the anchor part 2 stays in the bone hole 10. The distance with the anchor part 2 is adjusted.
A tissue defect prosthetic material with a fixing jig comprising such a tissue defect prosthetic material and the tissue defect prosthetic material fixing jig according to claim 1 bonded to the tissue defect prosthetic material is also one of the present invention. It is.

On the other hand, a bone hole 10 for fixing the tissue defect prosthetic material 6 is formed in advance in the cartilage defect 7 using an appropriate jig (FIG. 2B). The bone hole 10 extends from the cartilage defect portion through the bone to the outer skin.
The inner diameter of the bone hole 10 is smaller than the outer diameter of the anchor portion 2 of the tissue defect prosthetic material fixing jig 1 and a sufficient fixing force is expressed by the engagement between the inserted anchor portion 2 and the bone hole 10. Set the size to the extent you want.

Next, the tissue defect prosthetic material 6 (tissue defect prosthetic material with a fixing jig) combined with the tissue defect prosthesis material fixing jig 1 is fixed to the cartilage defect portion 7. Specifically, the suture thread 4 of the tissue defect prosthetic material fixing jig 1 is pulled to insert the anchor portion 2 into the bone hole 10 (FIG. 2C). At this time, a K wire or the like may be attached to the suture thread 4 and the K wire may be pulled.
When the suture thread connecting the anchor portion 2 and the tissue defect prosthetic material 6 is sufficiently stretched and the anchor portion 2 remains in the bone hole 10, the end portion of the suture thread 4 is cut to remove the suture thread 4. Pull it out of the skin and remove it.
By the above operation, the tissue defect prosthetic material 6 is fixed to the cartilage defect part 7 (FIG. 2D). Fixation of the tissue defect prosthetic material 6 to the cartilage defect 7 is achieved by the engagement between the anchor 2 and the bone hole 10.
By using the tissue defect prosthetic material fixing jig of the present invention, the tissue defect prosthetic material can be firmly and accurately fixed to the tissue defect without performing a difficult suturing operation. In particular, the tissue defect prosthetic material fixing jig of the present invention is suitable for easily and reliably fixing a tissue defect prosthetic material to a site such as cartilage where movement is intense and difficult to fix.

ADVANTAGE OF THE INVENTION According to this invention, the tissue defect prosthetic material fixing jig | tool for fixing a tissue defect prosthetic material to the defect | deletion part of a tissue firmly, correctly and simply can be provided.

Hereinafter, the present invention will be described in more detail with reference to examples. However, the present invention is not limited to these examples.

Example 1
A braid having an outer diameter of 2.0 mm was prepared using poly-L-lactic acid fiber (88 dtex, 32f), frozen in a state where the lactic acid-ε caprolactone copolymer solution was poured into the braid, and then freeze-dried. . The obtained freeze-dried product was cut into a length of 8 mm and used as an anchor portion.
A suture with a needle attached to one end of a 3.0 polyglycolic acid suture is bonded to one end of the obtained anchor portion, and a 3.0 nylon suture is further bonded to the other end. Thus, a jig for fixing a tissue defect prosthetic material was prepared.

A collagen sponge of 15 mm × 15 mm was used as a tissue defect prosthesis material, and the fixation to the cartilage defect part was simulated.
A tissue defect prosthesis material fixing jig was attached to each of the four corners of the collagen sponge using a suture with a needle.
On the other hand, a 15 mm × 15 mm defect was created in the joint of the porcine femur, and a bone hole penetrating a bone having an inner diameter of 1.0 mm was formed in each of the four corners of the defect.
The anchor part was inserted into the bone hole by pulling the suture of the tissue defect prosthetic material fixing jig. When the suture thread connecting the anchor portion and the collagen sponge was sufficiently stretched and the anchor portion remained in the bone hole, the end portion of the suture thread was cut and the suture thread was pulled out and removed.
The series of operations was extremely simple, and the collagen sponge was accurately and firmly fixed to the defect.

ADVANTAGE OF THE INVENTION According to this invention, the tissue defect prosthetic material fixing jig | tool for fixing a tissue defect prosthetic material to the defect | deletion part of a tissue firmly, correctly and simply can be provided.

It is a schematic diagram which shows an example of the jig | tool for tissue defect | deletion prosthetic material fixation of this invention. It is a schematic diagram explaining an example of the procedure which fixes a tissue defect prosthetic material to a cartilage defect part using the jig | tool for tissue defect prosthesis material fixation of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Jig for tissue defect prosthetic material fixation 2 Anchor part 3 Needle suture 4 Needle thread 5 Needle 6 Tissue defect prosthesis material 7 Cartilage defect part 8 Bone 9 Skin 10 Bone hole

Claims (3)

A tissue defect prosthetic material fixing jig for fixing a tissue defect prosthetic material to a tissue defect part, an anchor part made of a resilient material, and a yarn connected to one end of the anchor part, A jig for fixing a tissue defect prosthetic material, comprising a yarn connected to the other end of the anchor portion. 2. The tissue defect prosthetic material fixing jig according to claim 1, wherein the yarn is a surgical suture, and any one of the yarns is provided with a needle. A tissue defect prosthetic material with a fixing jig, comprising: a tissue defect prosthetic material; and the tissue defect prosthetic material fixing jig according to claim 1 or 2 bonded to the tissue defect prosthetic material.

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