JP2016515005A - 組織捕捉骨アンカ - Google Patents
組織捕捉骨アンカ Download PDFInfo
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- JP2016515005A JP2016515005A JP2016500846A JP2016500846A JP2016515005A JP 2016515005 A JP2016515005 A JP 2016515005A JP 2016500846 A JP2016500846 A JP 2016500846A JP 2016500846 A JP2016500846 A JP 2016500846A JP 2016515005 A JP2016515005 A JP 2016515005A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0483—Hand-held instruments for holding sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0429—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being expanded by a mechanical mechanism which also locks them in the expanded state
- A61B2017/043—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being expanded by a mechanical mechanism which also locks them in the expanded state by insertion of a separate spreading member into the anchor
- A61B2017/0432—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being expanded by a mechanical mechanism which also locks them in the expanded state by insertion of a separate spreading member into the anchor the separate member staying in the anchor after placement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0438—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors slotted, i.e. having a longitudinal slot for enhancing their elasticity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0445—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors cannulated, e.g. with a longitudinal through-hole for passage of an instrument
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0456—Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0823—Modular anchors comprising a plurality of separate parts
- A61F2002/0835—Modular anchors comprising a plurality of separate parts with deformation of anchor parts, e.g. expansion of dowel by set screw
Abstract
Description
本願は、参照によりその全体を本明細書に組み込む、2013年3月14日出願の米国仮出願第61/786168号の利益および優先権を主張するものである。
いくつかの実施形態は、上述のアンカを使用して、アンカを骨に挿入する前に腱または靱帯などの軟組織を捕捉して固定することを含む。いくつかの実施形態では、軟組織は、軟組織または軟組織束の周りに通したループ状の縫合糸を用いてアンカに固定することができる。いくつかの実施形態では、固定構成を実現するための縫合糸の操作は、アンカと連動する縫合糸グラバを用いて実施することができる。いくつかの実施形態では、縫合糸グラバは、アンカの遠位端部から延びる。いくつかの実施形態では、縫合糸グラバは、縫合糸リムをアンカ内に引き込むようにアンカ内に引き込み可能である。適当な縫合糸グラバとしては、ワイヤループ、ワイヤフック、ピンチャ機構、または任意のその他の適当な構造などが挙げられるが、これらに限定されるわけではない。いくつかの実施形態では、縫合糸グラバは、ニチノールワイヤで構成される。本明細書に記載する特定の縫合糸グラバ(例えばワイヤループ)を利用する実施形態のいずれにおいても、任意のその他の適当な縫合糸グラバを利用することができることを理解されたい。
図7は、挿入器具の一実施形態の個々の構成要素を示す図である。挿入器具は、その挿入器具がアンカを挿入し、次いでそのアンカを配備するように相互作用することを可能にするように構成された様々な特徴を備える。挿入器具の一実施形態は、特定のアンカ構成または特定のスプレッダ構成で使用されるように構成することができる。図10は、シングルピースエキスパンダとともに使用されるように構成された挿入器の実施形態を示す図である。この挿入器具は、内側ロッドまたは内側管1100と、外側管1200と、ハンドル本体1300と、ねじ付きアクチュエータシャフト1400と、配備ノブ1500とを備える。いくつかの実施形態では、挿入器1000は、製造中にアンカに結合される。好ましい実施形態では、挿入器具は使い捨て式である。
様々な実施形態は、軟組織を骨に取り付ける方法を含む。いくつかの実施形態では、これらの方法は、上述の組織捕捉アンカを使用することを含む。1つの好ましい実施形態では、二頭筋腱固定手順が関節鏡検査法で実行される。
402 遠位端部
404 近位端部
410 アンカ本体
412 第1の端部
414 第2の端部
416 軸方向内腔
418 第1のタイン
420 第1の拡張スロット
422 第2のタイン
424 第2の拡張スロット
430 長手方向軸
432 第1の傾斜部分
434 第1の止め
436 第2の傾斜部分
438 平行部分
480 エキスパンダ
700 エキスパンダ
702 拡張部材
710 第1の端部
712 第2の端部
714 展開頭部
716 基部
718 シャフト
720 カム作用表面
750 エキスパンダ
757 縫合糸
788 ワイヤループ
800 シングルピースエキスパンダ
802 拡張部材
810 第1の端部
812 第2の端部
814 展開頭部
816 基部
818 第1のシャフト部分
820 展開ショルダ/カム作用表面
822 第2のシャフト部
850 アンカ
852 アンカ本体
854 第1の端部
856 第2の端部
858 軸方向内腔
860 第1のタイン
862 第1の拡張スロット
864 第2のタイン
868 第1の止め
870 カム作用当接部
900 ツーピースエキスパンダ
902 第1の拡張部材
904 第2の拡張部材
910 第1の端部
912 第2の端部
914 第1の展開頭部
916 基部
918 第1のシャフト部分
920 第1の端部
922 第2の端部
924 第2の展開頭部
926 基部
928 第2のシャフト部分
930 貫通孔
950 アンカ
952 アンカ本体
954 第1の端部
956 第2の端部
958 軸方向内腔
960 第1のタイン
962 第1の拡張スロット
964 第2のタイン
966 第2の拡張スロット
968 第1の止め
970 第2の止め
1000 挿入器具
1000a 挿入器具
1100 内側ロッド/内側管
1100a 内側ロッド/内側管
1105 遠位端部
1110 ねじ
1125 本体
1200 外側管
1200a 外側管
1210a 遠位端部
1212a 第1の当接部
1220 開口
1220a 開口
1225 ねじ
1225 ねじ
1250 近位端部
1250a 近位端部
1260a 第1の基部
1262a 第1の突出当接部
1270a 第2の基部
1272a 第2の突出当接部
1300 ハンドル本体
1300a ハンドル本体
1302 ハンドル部分
1304 蓋ピース
1312 ブレース受け開口
1315 平坦表面
1330 隆起部
1400 ねじ付きアクチュエータシャフト
1400a ねじ付きアクチュエータシャフト
1405 遠位端部
1420 近位端部
1425 第2のねじ部
1430 平坦領域
1450 クリート
1500 配備ノブ
1500a 配備ノブ
1505 ねじ
1510 中央穴
1530 溝
2500 アンカ
2502 第1の関節鏡検査口
2504 腱
2506 第2の関節鏡検査口
Claims (24)
- 拡張可能なアンカ本体と、
少なくとも1つの拡張部分、および
エキスパンダの遠位端部の第1の開口を備えるエキスパンダであり、
前記アンカ本体に対する第1の位置と前記アンカ本体に対する第2の位置との間で変位可能であり、前記拡張部分が、前記エキスパンダが前記第2の位置にあるときに前記アンカ本体を拡張させるように構成されるエキスパンダと、
前記第1の開口を通って延びる引き込み可能な縫合糸グラバと、
を備えることを特徴とする骨アンカ。 - 前記引き込み可能な縫合糸グラバが、ワイヤループを備える、請求項1に記載の骨アンカ。
- 前記ワイヤループの2つのリムが、前記エキスパンダを通って延び、前記エキスパンダの近位端部から出る、請求項2に記載の骨アンカ。
- 前記エキスパンダが、前記エキスパンダの前記遠位端部に第2の開口を備え、縫合糸が、前記第2の開口を通って延びる、請求項1に記載の骨アンカ。
- 前記縫合糸が、前記エキスパンダを通って延び、前記エキスパンダの近位端部から出る、請求項4に記載の骨アンカ。
- 前記第1の開口を通って延びる縫合糸をさらに備える、請求項1に記載の骨アンカ。
- 前記縫合糸が、前記エキスパンダを通って延び、前記エキスパンダの近位端部から出る、請求項6に記載の骨アンカ。
- 前記少なくとも1つの開口が、前記エキスパンダの軸に沿って位置合わせされる、請求項1に記載の骨アンカ。
- 前記少なくとも1つの開口が、前記エキスパンダの軸からずれている、請求項1に記載の骨アンカ。
- 請求項1に記載の骨アンカと、
前記骨アンカに結合された挿入器具とを備える、アンカ/挿入器アセンブリ。 - 前記引き込み可能な縫合糸グラバが、ワイヤループを備え、前記ワイヤループの2つのリムが、前記エキスパンダを通って延び、前記エキスパンダの近位端部から出、前記挿入器具中の軸方向通路を通る、請求項10に記載のアンカ/挿入器アセンブリ。
- 前記エキスパンダが、前記エキスパンダの前記遠位端部に第2の開口を備え、縫合糸が、前記第2の開口を通って延び、前記縫合糸の第1のリムが、前記エキスパンダを通って延び、前記エキスパンダの近位端部から出て、前記挿入器具中の軸方向通路を通る、請求項10に記載のアンカ/挿入器アセンブリ。
- 前記縫合糸の第2のリムが、前記挿入器具の側面に沿って延びる、請求項12に記載のアンカ/挿入器アセンブリ。
- 前記縫合糸の前記第2のリムが、挿入器のハンドルに固定される、請求項13に記載のアンカ/挿入器アセンブリ。
- 軟組織を骨アンカに固定する方法であって、
請求項1に記載の骨アンカを、第1の関節鏡検査口を通して患者に挿入するステップと、
前記縫合糸グラバを第2の関節鏡検査口を通して前記患者から引き出すステップと、
縫合糸を軟組織の周りに通すステップと、
前記縫合糸の少なくとも第1のリムを、前記第2の関節鏡検査口を通して前記患者から引き出すステップと、
前記縫合糸を前記縫合糸グラバと係合させるステップと、
前記縫合糸グラバを、前記エキスパンダの前記遠位端部の前記第1の開口を通して引き込むことにより、前記第1の開口を通して前記縫合糸の前記第1のリムを引っ張るステップと、
を含むことを特徴とする方法。 - 前記縫合糸グラバが、ワイヤループを備え、前記縫合糸を前記縫合糸グラバと係合させるステップが、前記縫合糸を前記ワイヤループに通すステップを含む、請求項15に記載の方法。
- 前記縫合糸の第2のリムが、前記骨アンカに挿入される前に、前記エキスパンダの前記遠位端部の前記第1の開口を通って延びる、請求項15に記載の方法。
- 前記縫合糸の第2のリムが、前記骨アンカに挿入される前に、前記エキスパンダの前記遠位端部の第2の開口を通って延びる、請求項15に記載の方法。
- 前記縫合糸の前記第1のリムを、前記軟組織の周りに通す前に、前記第2の関節鏡検査口を通して挿入するステップをさらに含む、請求項15に記載の方法。
- 前記縫合糸の前記第1のリムおよび第2のリムの両方が、前記縫合糸グラバと係合し、前記縫合糸グラバが引き込まれたときに、前記第1のリムおよび前記第2のリムの両方が、前記第1の開口を通して引っ張られる、請求項19に記載の方法。
- 骨に穴を形成するステップをさらに含む、請求項15に記載の方法。
- 前記穴がドリルで形成される、請求項21に記載の方法。
- 前記穴の領域で、前記穴から全ての前記骨の軟組織を除去するステップをさらに含む、請求項21に記載の方法。
- 前記縫合糸グラバを引き込んだ後で、前記アンカを前記骨に挿入するステップをさらに含む、請求項16に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201361786168P | 2013-03-14 | 2013-03-14 | |
US61/786,168 | 2013-03-14 | ||
PCT/US2014/021774 WO2014159058A1 (en) | 2013-03-14 | 2014-03-07 | Tissue capturing bone anchor |
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JP2018187747A Division JP6619493B2 (ja) | 2013-03-14 | 2018-10-02 | 組織捕捉骨アンカ |
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JP2016515005A true JP2016515005A (ja) | 2016-05-26 |
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JP2016500846A Pending JP2016515005A (ja) | 2013-03-14 | 2014-03-07 | 組織捕捉骨アンカ |
JP2018187747A Active JP6619493B2 (ja) | 2013-03-14 | 2018-10-02 | 組織捕捉骨アンカ |
JP2019206163A Active JP6874095B2 (ja) | 2013-03-14 | 2019-11-14 | 組織捕捉骨アンカ |
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JP2018187747A Active JP6619493B2 (ja) | 2013-03-14 | 2018-10-02 | 組織捕捉骨アンカ |
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MX366652B (es) | 2019-07-17 |
KR102391275B1 (ko) | 2022-04-27 |
JP2020039890A (ja) | 2020-03-19 |
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US20160030159A1 (en) | 2016-02-04 |
EP2967552B1 (en) | 2023-07-26 |
US10149751B2 (en) | 2018-12-11 |
AU2014241394B2 (en) | 2018-10-18 |
JP6874095B2 (ja) | 2021-05-19 |
JP2019022713A (ja) | 2019-02-14 |
EP2967552A1 (en) | 2016-01-20 |
AU2014241394A1 (en) | 2015-10-01 |
KR20150126680A (ko) | 2015-11-12 |
CA2904702A1 (en) | 2014-10-02 |
BR112015022457B1 (pt) | 2022-03-15 |
CA2904702C (en) | 2020-01-07 |
JP6619493B2 (ja) | 2019-12-11 |
ES2959496T3 (es) | 2024-02-26 |
KR102257312B1 (ko) | 2021-05-28 |
US11020218B2 (en) | 2021-06-01 |
BR112015022457A2 (pt) | 2017-07-18 |
US20210282918A1 (en) | 2021-09-16 |
KR20210063436A (ko) | 2021-06-01 |
US20190117377A1 (en) | 2019-04-25 |
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