JP2020198942A - anchor - Google Patents

Abstract

To provide an anchor capable of easily fixing a soft tissue of an organism to a bone with a simple configuration, and preventing detachment of the soft tissue from the bone.SOLUTION: There is provided an anchor which is inserted into an opening provided on a bone for fixing a soft tissue of an organism to a bone, the anchor comprises: a pair of flat anchor members 2a, 2b which are arranged to face each other; and a suture thread which is engaged to the pair of anchor members. The anchor members comprise a first hole part 3a provided on a center opening axis of the opening and a second hole part 4a extended obliquely from the center opening axis, in an inserted state into the opening, the suture thread is inserted into the first hole part and the second hole part and rotates the pair of anchor members in directions in which the anchor members separate from each other, by tension force of the suture thread.SELECTED DRAWING: Figure 3

Description

The present invention relates to anchors used for fixing soft tissues such as tendons, ligaments or muscles to bone in surgical operations and the like.

When soft tissues such as tendons, ligaments, and muscles are detached from the bone, for example, there is an anchor described in Patent Document 1 as being used for surgery to fix the soft tissue to the bone again. In Patent Document 1, the anchor is embedded in the bone by driving the anchor through the suture into the bone. At this time, since friction occurs between the embedded anchor and the bone interface, the anchor and the suture passed through the anchor stay on the bone, and the soft tissue and the bone are sutured using this suture. Fix the soft tissue to the bone.

However, since the soft tissue always moves in daily life, the anchor described in Patent Document 1 may be detached from the bone when a force greater than the frictional force for holding the anchor in the bone is applied. .. In this case, re-surgery or if re-surgery is not possible, the joint is replaced with an artificial joint, which increases the physical burden on the patient.

In order to prevent this, for example, Patent Document 2 and Patent Document 3 are disclosed as those for fastening the anchor in the bone. Patent Document 2 describes a configuration in which an anchor is inserted into an opening formed in a bone, and then an engaging member protruding from a side surface of the anchor pierces the bone and fixes the anchor to the opening. Patent Document 3 describes a configuration in which an anchor inserted into an opening rotates and pierces the bone to fix the anchor to the opening.

However, since the anchors described in Patent Documents 2 and 3 both use an actuator to project an engaging member or rotate the anchor, the anchor opens when the actuator fails due to a harsh internal environment. There is a problem that the anchor cannot be fixed to the bone and the anchor is detached from the bone. Further, by providing the actuator, the number of parts of the anchor increases and the cost increases. Since a plurality of anchors are used in one operation and the fee for the anchor is borne by the patient, there is also a problem that the financial burden on the patient increases.

Japanese Patent Publication No. 2014-517715 Japanese Patent No. 4433501 Special Table 2003-513695

The present invention has been made in view of the above-mentioned problems, and its main purpose is to provide an anchor that can be fixed to a bone with a simple structure and is prevented from detaching from the bone. Is.

The anchor of the present invention is an anchor inserted into an opening provided in the bone in order to fix the soft tissue of the living body to the bone, and is a pair of flat anchor members arranged facing each other and a pair. A suture thread that is locked to the anchor member is provided, and the anchor member extends obliquely from a first hole provided in the central opening shaft of the opening and the central opening shaft in a state of being inserted into the opening. The suture is inserted into the first hole and the second hole, and the pair of anchor members are separated from each other by the tension of the suture. It is characterized by being rotated.

With the above configuration, the tension of the suture causes the pair of anchor members to move in a direction away from each other and pierce the bone of the opening wall to fix the anchor. Therefore, the anchor can be fixed to the bone with a simple structure using only a pair of anchor members and sutures. Moreover, since a mechanism such as an actuator is not required, it is possible to reliably prevent the anchor from detaching from the bone due to a failure or the like.

The bones of the human body are composed of cortical bones forming the surface and cancellous bones forming the inside of the surface, and the cortical bones are harder than the cancellous bones. Here, in the present invention, the anchors separated from each other pierce the cancellous bone constituting the opening wall, but even if the anchor moves toward the opening by the patient moving the soft tissue after the operation, the anchor inserted into the cancellous bone It abuts and stays in the cortical bone. Therefore, the anchor can be securely fastened to the opening and fixed.

Further, in general, when suturing a bone and a tendon which is a soft tissue, an anchor is inserted into an opening provided in the bone with the tendon retracted to expose the bone, but the anchor of the present invention is used. Since it has a flat shape, an anchor can be inserted into the opening provided in the bone from above the tendon, and the operation can be easily performed without the trouble of retracting the tendon.

As a specific aspect of the anchor of the present invention, the suture is described in a state in which the first hole portion and a part of the second hole portion of the pair of anchor members are overlapped on the central opening axis. Examples thereof include those that penetrate the first hole and intersect at the second hole.

As a specific embodiment of the anchor of the present invention, the anchor member includes a base end portion arranged in the vicinity of the opening bottom portion and an extension portion extending from the base end portion toward the opening end portion. The first hole portion is provided at the base end portion, and the second hole portion is provided at the extension portion.

With the above configuration, if the positional relationship between the first hole portion provided at the base end portion and the second hole portion provided at the extension portion is adjusted, the distance for rotating the anchor members in the directions away from each other can be adjusted. And can provide anchors suitable for various surgical sites.

Further, as a specific embodiment of the anchor of the present invention, the stretched portion may be configured so that the cross section becomes smaller toward the opening end.

With the above configuration, the extended portion of the anchor member becomes sharper and can be more easily pierced and fixed to the bone of the opening wall.

Further, as a specific embodiment of the anchor of the present invention, the opening has a flat internal space, and the opening and the pair of anchor members are closely fitted to each other.

Since a general anchor has a cylindrical shape, an opening for fixing the anchor is constructed by using a drill or the like. As a result, bone shavings were generated and the invasion of the patient was large. However, since the anchor of the present invention has a flat shape and the opening provided in the bone is also a flat internal space, the opening can be formed by piercing the bone with, for example, a chisel, and the bone can be shaved. It is possible to suppress the generation of dregs and suppress the invasion of bones.

Further, since the opening having a flat internal space and the pair of anchor members are fitted to each other, a frictional force is generated between the anchor member and the bone interface forming the opening wall, and this frictional force also causes the anchor to be inside the opening. Can be fixed to.

According to the present invention, it is possible to provide an anchor that can be fixed to a bone with a simple structure and is prevented from detaching from the bone.

The perspective view of the anchor member 2a in this embodiment. The perspective view of the anchor member 2b in this embodiment. The plan view in the initial state of the anchor in this embodiment. The plan view after the rotation mechanism of the anchor in this embodiment operates. AA line sectional view of the anchor in this embodiment. BB line sectional view of the anchor in this embodiment. The plan view which shows the use state of the anchor in this embodiment. The plan view which shows the use state of the anchor in this embodiment.

The anchor of the present invention is used for surgery to fix the soft tissue to the bone again when the soft tissue such as a tendon, a ligament or a muscle is separated from the bone, and a suture is inserted into an opening provided in the bone. It is inserted with.

The anchor 1 of the present embodiment will be described in detail below with reference to the drawings.

As shown in FIGS. 1 to 6, the anchor 1 of the present embodiment is formed on a pair of flat anchor members 2 (2a, 2b) and a pair of anchor members 2 (2a, 2b) arranged to face each other. It includes a suture thread 10 to be locked.

The anchor member 2 is manufactured by using, for example, a metal, a bioabsorbable material, a medical polymer, or the like, and examples of the metal include stainless steel, alloys (Al, Co, Ni, Ta, W, V, and the like. ), Cobalt-based alloys, titanium and its alloys, magnesium alloys and the like are used. Further, as the bioabsorbable material and the medical polymer, hydroxyapatite, β-TCP (β-tricalcium phosphate), polyethylene (high density polyethylene, ultrahigh molecular weight polyethylene), PEEK and the like can be used.

The anchor member 2 has a flat plate-shaped magatama shape. In this embodiment, a pair of anchor members 2 (2a, 2b) are provided.

As shown in FIGS. 1 and 7, the anchor members 2 (2a, 2b) have a base end portion 5 (5a, 5b) arranged close to the opening bottom portion 20b, and a base end portion 5 to an opening end portion. It is provided with stretching portions 6 (6a, 6b) extending toward 20a. The base end portion 5 and the stretched portion 6 are integrally molded in the present embodiment. In the present embodiment, in the pair of anchor members 2a and 2b, the anchor member 2a includes a base end portion 5a and an extension portion 6a, and the anchor member 2b includes a base end portion 5b and an extension portion 6b, respectively.

As shown in FIGS. 1 to 8, the base end portion 5 (5a, 5b) has a substantially semi-disk shape and is arranged in the vicinity of the opening bottom portion 20b when inserted into the bone opening 20. ..

Further, a first hole portion 3 (3a, 3b) having a circular shape in a plan view is formed at a substantially central portion of the base end portion 5. The first hole portion 3 is arranged at the central opening shaft x1 of the opening 20 when the anchor member 2 is inserted into the opening 20. In the present embodiment, in the pair of anchor members 2a and 2b, the first hole portion 3a is provided at the base end portion 5a of the anchor member 2a, and the first hole portion 3b is provided at the base end portion 5b of the anchor member 2b. There is.

As shown in FIGS. 1 to 8, the extending portion 6 (6a, 6b) is provided integrally with the base end portion 5 and extends toward the opening end portion 20a when inserted into the bone opening 20. In the present embodiment, it extends diagonally in one direction, both ends form an arc, and the cross section becomes smaller toward the tip.

Further, in the stretched portion 6, a second hole portion 4 (4a, 4b) having an elliptical plan view is formed at a substantially central portion. When the anchor member 2 is inserted into the opening 20, the second hole 4 (4a, 4b) extends diagonally so as to be separated from the central opening shaft x1 of the opening 20, and is arranged at the central opening shaft x1. The end hole portion 7 (7a, 7b) and the end hole portion 7 (7a, 7b) are communicated with each other and extend obliquely from the central opening shaft x1 toward the opening end portion 20a (8a, 8b). ) And. In the present embodiment, in the pair of anchor members 2a and 2b, the extension portion 6a of the anchor member 2a is provided with the second hole portion 4a, the start end hole portion 7a, and the end hole portion 8a, respectively, and the extension portion 6b of the anchor member 2b is provided. A second hole portion 4b, a start end hole portion 7b, and an end hole portion 8b are provided.

As shown in FIG. 3, the pair of anchor members 2a and 2b configured as described above have surfaces of each other so that the stretching directions of the stretching portions 6a and 6b and the stretching directions of the second hole portions 4a and 4b are different. They are placed facing each other in close proximity. In this state, as shown in FIG. 7, the first hole portions 3a and 3b and the start end hole portions 7a and 7b of the second hole portions 4a and 4b arranged on the central opening shaft x1 overlap.

In this state, as shown in FIG. 5, the suture thread 10 is inserted into the opening end holes 7 (7a, 7b) of the first hole 3 (3a, 3b) and the second hole 4 (4a, 4b). .. More specifically, the suture thread 10 penetrates the first hole 3 (3a, 3b) and intersects at the start end hole portion 7 (7a, 7b) of the second hole portion 4 (4a, 4b) to form an anchor member. It is configured to extend from the opening end portion 20a along the extending portion 6 of 2.

As the suture 10, for example, an absorbent suture, a non-absorbable suture, or the like, which is appropriately suitable for the surgical procedure and the surgical site, can be used, and various materials such as natural materials and synthetic materials can be used. Can be used. In addition, the suture thread 10 also includes a suture tape.

As a result, the pair of anchor members 2 (2a, 2b) are sutured to the first hole portion 3 (3a, 3b) and the start end hole portion 7 (7a, 7b) of the second hole portion 4 (4a, 4b). The 10 is inserted and held in a state of being close to each other and facing each other. This state is the initial state.

A method of using the anchor 1 of the present embodiment configured as described above will be described.

First, as a preliminary preparation, the surgeon forms an opening 20 in a portion where soft tissues such as tendons, ligaments, and muscles are exfoliated from the bone. In the present embodiment, the opening 20 has a flat internal space having a rectangular cross-sectional view. The depth of this internal space is sufficiently deep that the anchor 1 in the initial state is inserted into the opening 20 and the anchor 2 is buried. Further, the length in the longitudinal direction in the cross section of the internal space is configured to have an opening width substantially equal to the width of the anchor 1 in the initial state. Further, the length of the cross section of the internal space in the lateral direction is substantially the same as the thickness of the anchor 1.

The opening 20 can be created by using a surgical tool, and in the present embodiment, the opening 20 is created by using, for example, a chisel or the like. Since a plurality of the openings 20 are formed depending on the surgical content, the surgeon forms the necessary openings 20 as appropriate according to the surgical content.

At this time, the surface of the human bone is formed of cortical bone, and the inside thereof is formed of cancellous bone, which has the property of being harder than cancellous bone. The opening 20 of this embodiment is cut from the cortical bone to the cancellous bone.

After forming the opening 20, the operator inserts the anchor 1 of the present embodiment into the opening 20, as shown in FIG. At this time, the opening wall forming the internal space of the opening 20 and the pair of anchor members 2a and 2b in the initial state are fitted close to each other according to the above configuration. Further, the base end portion 5 (5a, 5b) of the anchor member 2 (2a, 2b) is inserted so as to be arranged close to the opening bottom portion 20b, and the extension portion 6 (of the anchor member 2 (2a, 2b)) is inserted. 6a, 6b) extend toward the opening end 20a, and both ends of the suture 10 extend from the opening 20.

Hereinafter, for the sake of explanation, in the state where the anchor 1 is inserted into the opening 20, the opening bottom 20b where the base end 5 of the anchor 1 is arranged is defined as lower, and the opening end 20a where the extension 6 of the anchor 1 is arranged is defined as upper. To do.

Thus, the surgeon pulls both ends of the suture 10 upward to secure the pair of anchor members 2 (2a, 2b) to the opening 20. As a result, the tension of the suture causes the pair of anchor members 2 (2a, 2b) to rotate in directions separated from each other. This operation will be described in detail below.

First, in the initial state, as shown in FIGS. 3, 5 and 7, the central opening shaft x1 has the opening holes of the first hole 3 (3a, 3b) and the second hole 4 (4a, 4b). 7 (7a, 7b) are arranged, and the suture thread 10 is inserted into the first hole portion 3 (3a, 3b) and is arranged so as to intersect at the opening end hole portion 7 (7a, 7b). At this time, the anchor members 2 (2a, 2b) are fixed in the first hole 3 (3a, 3b) by the suture thread 10.

After that, when the operator pulls the suture 10 to fix the anchor 1, the suture 10 is tensioned upward, and as shown in FIGS. 4, 6 and 8, the suture 10 is the first 2 Move from the start hole portion 7 (7a, 7b) located below the hole portions 4a and 4b to the end hole portion 8 (8a, 8b) located above, and intersect at the end hole portion 8 (8a, 8b). To do. At this time, the pair of anchor members 2 are fixed at the first hole portion 3 (3a, 3b), and the end hole portion 7 (7a) is separated from the central opening shaft x1 so that the end hole portion 8 (8a, 8b) is separated from the central opening shaft x1. , 7b), so that the end hole 8 (8a, 8b) is arranged on the central opening axis x1 with the first hole 3a and 3b as the axis by the tension of the suture thread 10. By doing so, the anchor members 2a and 2b rotate in a direction in which they are separated from each other. Therefore, as shown in FIG. 8, the tip ends of the extended portions 6a and 6b of the anchor members 2a and 2b pierce the cancellous bone constituting the opening wall.

As a result, the anchor 1 of the present embodiment is fixed to the opening 20, and the suture thread 10 inserted through the anchor 1 is also fixed to the opening 20.

In the anchor 1 of the present embodiment configured as described above, the tension of the suture thread 10 causes the pair of anchor members 2a and 2b to move in a direction away from each other and pierce the bone of the opening wall to fix the anchor 1. Therefore, the anchor 1 can be fixed to the bone with a simple configuration using only a pair of anchor members 2a and 2b and a suture thread 10. Further, since the anchor members 2a and 2b are moved so as to be separated from each other by the tension of the suture thread 10, a mechanism such as an actuator is not required, and the anchor 1 can be reliably prevented from being detached from the bone due to a failure or the like.

In addition, the anchor members 2a and 2b may move toward the opening depending on the postoperative exercise motion, but the anchor members 2a and 2b are retained by the cortical bone arranged on the surface of the bone, so that the anchor 1 is surely opened. It can be fixed at 20.

Further, when the bone and the tendon, which is a soft tissue, are generally sutured, the anchor 1 is inserted into the opening 20 provided in the bone in a state where the tendon is retracted and the bone is exposed. Since the anchor 1 has a flat shape, the anchor 1 can be inserted into the opening 20 provided in the bone from above the tendon, and the operator can easily perform the operation without the trouble of retracting the tendon.

Further, since the stretched portion 6 is configured so that the cross section becomes smaller toward the opening end portion 20a arranged at the tip, the stretched portions 6a and 6b of the anchor members 2a and 2b become sharper and open more easily. It pierces the bone of the wall and can be securely fixed.

Further, conventionally, the shape of the anchor 1 is often cylindrical, and in order to form the opening 20 to be fitted to the anchor 1, it is necessary to form the opening 20 by using a drill or the like. The shavings of the eggplant were generated and the invasion to the patient was large. However, the opening 20 of the present embodiment has a flat interior space having a rectangular shape in a plan view, which can be created using fleas to reduce invasion to the patient.

In addition, since the opening 20 having a flat internal space and the pair of anchor members 2a and 2b are closely fitted to each other, a frictional force is generated between the anchor members 2a and 2b and the bone interface forming the opening wall. This frictional force also causes the anchor 1 to be fixed in the opening 20.

The anchor of the present invention is not limited to the above-described configuration.

For example, the anchor member is not limited to the magatama shape, and may have a rectangular shape, a polygonal shape, or a circular shape. Further, the stretched portion may not be configured so that the cross section becomes smaller toward the opening end, and for example, only the tip portion may be configured at an acute angle.

The shapes of the first hole and the second hole are not limited to this embodiment, and the shape, size, position, and the like can be appropriately changed. Further, by appropriately adjusting the positions of the first hole and the second hole, the distance for rotating the anchor members in the direction of separating from each other can be adjusted, and an anchor suitable for various surgical sites and surgical procedures can be obtained. Can be provided.

Further, the anchors in the above-described embodiment include only a pair of flat anchor members arranged to face each other, but after providing the above-mentioned pair of flat anchor members of the present invention, other anchors are provided. At least one member may be provided.

Further, in the above-described embodiment, in the initial state, the suture thread penetrates the first hole portion and intersects at the second hole portion, but it penetrates the first hole portion and the second hole portion. There may be.

In addition, since the anchor of the present invention has a simple structure using only the anchor member and the suture as described above, a plurality of anchor members can be inserted into one suture. With this configuration, the tension of the sutures applied to the plurality of anchor members can be made uniform to prevent the anchors from detaching due to the strength of the tension, and the cost can be reduced as compared with the case of using a plurality of sutures. can do.

More specifically, the suture penetrates the first hole of the anchor which is the starting point, intersects at the second hole, and extends from the open end. One end of the extended suture penetrates the first hole and the second hole of the anchor arranged in the vicinity of the anchor serving as the starting point, and extends from the open end. Further, a plurality of anchor members are inserted into one suture by repeatedly penetrating the first hole and the second hole of the anchor arranged in the vicinity of the anchor and extending from the opening end. .. As a result, since one suture is inserted into a plurality of anchors, a uniform tension can be applied to the anchors inserted through the suture, and the anchors fall out of the opening depending on the strength of the tension of the suture. Can be prevented. In addition, the cost can be reduced as compared with the case where a plurality of sutures are used.

The present invention can be modified in various ways without contrary to the gist thereof.

1 ... Anchor 2 ... Anchor member 3 ... 1st hole 4 ... 2nd hole 10 ... Suture thread 20 ... Opening

Claims (5)

An anchor that is inserted into an opening provided in the bone to fix the soft tissue of the living body to the bone.
A pair of flat anchor members arranged facing each other,
A suture thread that is locked to the pair of anchor members is provided.
The anchor member includes a first hole portion provided in the central opening shaft of the opening and a second hole portion provided obliquely extending from the central opening shaft in a state of being inserted into the opening.
The suture is inserted into the first hole and the second hole.
An anchor characterized in that the pair of anchor members are rotated in a direction away from each other by the tension of the suture. The suture thread is characterized in that it penetrates the first hole portion and intersects at the second hole portion in a state where the first hole portion and a part of the second hole portion of the pair of anchor members overlap each other. The anchor according to claim 1. The anchor member has a base end portion arranged close to the opening bottom portion and an extension portion extending from the base end portion toward the opening end portion.
The first hole portion is provided at the base end portion, and the first hole portion is provided.
The anchor according to claim 1 or 2, wherein the second hole portion is provided in the stretched portion. The anchor according to claim 3, wherein the stretched portion is configured so that the cross section becomes smaller toward the opening end. One of claims 1, claim 2, claim 3 or claim 4, wherein the opening has a flat internal space, and the opening and the pair of anchor members are closely fitted to each other. Anchor described in.

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