JP4740537B2 - 骨トンネルに移植片を固定するための方法及び装置 - Google Patents
骨トンネルに移植片を固定するための方法及び装置 Download PDFInfo
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- 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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1714—Guides or aligning means for drills, mills, pins or wires for applying 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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
-
- 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
-
- 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
- A61F2/0805—Implements for inserting 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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1637—Hollow drills or saws producing a curved cut, e.g. cylindrical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1675—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the knee
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
-
- 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
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/087—Anchor integrated into tendons, e.g. bone blocks, integrated rings
-
- 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
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
Description
図1−10を参照すると、膝関節の脛骨トンネル等の骨トンネルに少なくとも1本のクロスピン(図1−10では示されていない)を配置するためのクロスピンガイド組立体5が示されている。クロスピンガイド組立体5は台部分15及びアーム部分20を有するL形の部材10からなる。アーム部分20は台部分15に対して横方向に、好ましくはこれに垂直に延びる。
それからトロカール210(あるいは2つ以上のトロカールが用いられる場合複数のトロカール210)スリーブ200,230(図28)から外されよう。それから第1の吸収可能なロッド255(図29)がトロカールスリーブ200を通して靱帯250を通り抜ける位置に滑り込むことにより用いられよう。それからスリーブ200が靱帯250及び大腿骨120から取り外され、第1の吸収可能なロッド255が大腿骨120内の位置にあって靱帯250を通り抜けるようにする。同様に第2の吸収可能なロッド260がスリーブ230を通る位置に滑り込むようにされよう。それから図29に示されるように、スリーブ230が取り外されて、靱帯250を大腿骨トンネル130内に係止するように、第2の吸収可能なロッド260が第1の吸収可能なロッド255とともに靱帯を通り抜けるようにする。
Claims (25)
- 第1の縦方向の軸をなす第1の端部及び第2の端部を有し、上記第1の縦方向の軸方向に沿って上記第1端部と第2の端部との間が一様な断面の太さを有する二重に折り畳まれた靱帯移植片であって、
第2の縦方向の軸をなす第3の端部及び第4の端部を有し、上記第2の縦方向の軸に沿って上記第3の端部と第4の端部との間に一様でない断面の太さを有し、上記第2の縦方向の軸に沿って上記第3の端部と第4の端部との間に第1の部分、第2の部分及び第3の部分を有する腱と、
上記腱の上記第2の部分が所定の中間部の断面の太さを有するとともに、上記腱の上記第1の部分及び上記第3の部分がそれぞれ上記所定の中間部の断面の太さよりも小さな中間部の断面の太さを有することと、
上記第3の端部及び第4の端部をそれぞれ形成し上記第1の縦方向の軸に沿って上記第1の端部と第2の端部との間が一様な断面の太さを有する二重に折り畳まれた上記靱帯移植片を形成するように上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付ける取付け材料と、
からなることを特徴とする靱帯移植片。 - 上記取付け材料が縫合材料であることを特徴とする請求項1に記載の靱帯移植片。
- 上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分がそれぞれ上記第3の端部及び第4の端部において上記第1の部分、第2の部分及び第3の部分の少なくとも他の少なくとも1つの部分に縫合されるようにしたことを特徴とする請求項2に記載の靱帯移植片。
- 上記腱が人体から採取されることを特徴とする請求項1に記載の靱帯移植片。
- 上記腱の上記第1の部分及び上記第3の部分がそれぞれ上記腱の上記第2の部分に対して折り畳まれ、これに縫合されるようにしたことを特徴とする請求項1に記載の靱帯移植片。
- 上記腱の上記第1の部分が第1の所定の長さにわたって上記腱の上記第2の部分に対して折り畳まれるとともに該腱の上記第2の部分に縫合され、上記腱の上記第3の部分が第2の所定の長さにわたって上記第2の部分に対して折り畳まれこれに縫合されるようにしたことを特徴とする請求項5に記載の靱帯移植片。
- 上記第1の所定の長さが上記第2の所定の長さより短いことを特徴とする請求項6に記載の靱帯移植片。
- 上記第1の所定の長さと上記所定の第2の所定の長さとが相互に等しいことを特徴とする請求項6に記載の靱帯移植片。
- 上記第1の所定の長さと上記第2の所定の長さとの全体の長さが上記靱帯移植片の上記第1の端部から上記第2の端部までの長さに等しいことを特徴とする請求項6に記載の靱帯移植片。
- 上記第1の所定の長さと上記第2の所定の長さとの全体の長さが上記靱帯移植片の上記第1の端部から上記第2の端部までの長さより小さいことを特徴とする請求項6に記載の靱帯移植片。
- 上記第1の部分及び第3の部分がそれぞれ第3の所定の長さ及び第4の所定の長さにわたってそれ自体に折り畳まれて縫合され、上記第2の部分がその間でそれ自体に折り畳まれて縫合され、上記第1の部分及び第3の部分が相互に縫合されることを特徴とする請求項1に記載の靱帯移植片。
- 上記第3の所定の長さと第4の所定の長さとが相互に等しいことを特徴とする請求項11に記載の靱帯移植片。
- 上記第1の所定の長さが上記第3の所定の長さより長いことを特徴とする請求項11に記載の靱帯移植片。
- 上記第2の部分がそれ自体に折り畳まれ、上記第1の部分と第3の部分との間に骨心が配置され、上記第1の部分及び第3の部分が間に配置された上記骨心に一体的に取付けられることを特徴とする請求項1に記載の靱帯移植片。
- 上記折り畳まれた第2の部分が第1の片及び第2の片をなし、その間で縫合されることを特徴とする請求項14に記載の靱帯移植片。
- 上記靱帯移植片を形成するように一体的に取付けられた少なくとも2つの上記腱をさらに含むことを特徴とする請求項1に記載の靱帯移植片。
- 第1の縦方向の軸をなす第1の端部及び第2の端部を有し、上記第1の縦方向の軸に沿って上記第1の端部と上記第2の端部との間に一様な断面の太さを有する二重に折り畳まれた靱帯移植片を形成する方法であって、
間に第2の縦方向の軸をなす第3の端部及び第4の端部を有し、上記第2の縦方向の軸
に沿って上記第3の端部と第4の端部との間に一様でない断面の太さを有し、上記第2の軸方向に沿って上記第3の端部と第4の端部との間に一列に第1の部分、第2の部分及び第3の部分を有するように形成された腱を用い、
上記腱の上記第2の部分が所定の中間部の断面の太さを有するとともに、上記腱の上記第1の部分及び上記第3の部分のそれぞれが上記所定の中間部の断面の太さよりも小さな中間部の断面の太さを有し、
上記第3の端部及び第4の端部をそれぞれ形成し上記第1の縦方向の軸に沿って上記第1の端部と第2の端部との間の一様な断面の太さを有する二重に折り畳まれた上記靱帯移植片を形成するように上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付けるステップからなることを特徴とする靱帯移植片を形成する方法。 - 上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付けるステップが縫合材料を用いることを含むことを特徴とする請求項17に記載の靱帯移植片を形成する方法。
- 上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付けるステップが上記第1の部分を第1の所定の長さにわたって上記第2の部分に折り畳み、上記第3の部分を第2の所定の長さにわたって上記第2の部分に折り畳み、上記折り畳まれた第1の部分を上記第2の部分に縫合し、上記折り畳まれた第3の部分を上記第2の部分に縫合するステップを含むことを特徴とする請求項18に記載の靱帯移植片を形成する方法。
- 上記折り畳まれた第1の部分の上記第1の所定の長さが上記折り畳まれた第3の部分の上記第2の所定の長さより短いことを特徴とする請求項19に記載の靱帯移植片を形成する方法。
- 上記折り畳まれた第1の部分の上記第1の所定の長さが上記折り畳まれた第3の部分の上記第2の所定の長さより短いことを特徴とする請求項19に記載の靱帯移植片を形成する方法。
- 上記第1の部分、第2の部分及び第3の部分が上記第3の端部から上記第4の端部にわたっており、さらに上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付けるステップが上記第1の部分をそれ自体に折り畳み、上記第3の部分をそれ自体に折り畳み、上記折り畳まれた第1の部分を縫合し、上記折り畳まれた第3の部分を縫合し、上記第2の部分をそれ自体に折り畳み、上記折り畳まれた第2の部分を縫合するステップを含むことを特徴とする請求項17に記載の靱帯移植片を形成する方法。
- 上記第1の部分、第2の部分及び第3の部分が上記第3の端部から上記第4の端部にわたっており、さらに上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付けるステップが上記第2の部分をそれ自体に折り畳み、上記第1の端部と上記第3の端部との間に骨心を配置し、上記第1の端部及び第3の端部を間に配置された上記骨心に一体的に取付けるステップを含むことを特徴とする請求項17に記載の靱帯移植片を形成する方法。
- 上記折り畳まれた第2の部分をそれ自体に取付けるステップをさらに含むことを特徴とする請求項23に記載の靱帯移植片を形成する方法。
- 第1の縦方向の軸をなす第1の端部及び第2の端部を有し、上記第1の縦方向の軸に沿っ
て上記第1の端部と上記第2の端部との間に一様な断面の太さを有する二重に折り畳まれた靱帯移植片を形成する方法であって、
間に第2の縦方向の軸をなす第3の端部及び第4の端部を有し、上記第2の縦方向の軸に沿って上記第3の端部と第4の端部との間に一様でない断面の太さを有し、上記第2の軸方向に沿って上記第3の端部と第4の端部との間に第1の部分、第2の部分及び第3の部分を有するように形成された腱を用い、
上記第3の端部及び第4の端部をそれぞれ形成し上記第1の縦方向の軸に沿って上記第1の端部と第2の端部との間の一様な断面の太さを有する二重に折り畳まれた上記靱帯移植片を形成するように上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付けることと、
上記第1の部分、第2の部分及び第3の部分が上記第3の端部から上記第4の端部にわたっており、上記第1の部分、第2の部分及び第3の部分の少なくとも1つの部分を上記第1の部分、第2の部分及び第3の部分の他の少なくとも1つの部分に取付けるステップが上記第1の部分を第1の所定の長さにわたって上記第2の部分に折り畳み、上記第3の部分を第2の所定の長さにわたって上記第2の部分に折り畳み、上記折り畳まれた第1の部分を上記第2の部分に縫合し、上記第3の部分を上記第2の部分に縫合するステップを含むことと、
上記折り畳まれた第1の部分の上記第1の所定の長さが上記折り畳まれた第3の部分の上記第2の所定の長さより短いことと、
を特徴とする靱帯移植片を形成する方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/039,857 US7195642B2 (en) | 2001-03-13 | 2001-10-26 | Method and apparatus for fixing a graft in a bone tunnel |
US10/039,857 | 2001-10-26 | ||
PCT/US2002/034223 WO2003037163A2 (en) | 2001-10-26 | 2002-10-26 | Method and apparatus for fixing a graft in a bone tunnel |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2005507697A JP2005507697A (ja) | 2005-03-24 |
JP4740537B2 true JP4740537B2 (ja) | 2011-08-03 |
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JP2003539513A Expired - Lifetime JP4740537B2 (ja) | 2001-10-26 | 2002-10-26 | 骨トンネルに移植片を固定するための方法及び装置 |
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EP (1) | EP1443850B1 (ja) |
JP (1) | JP4740537B2 (ja) |
AU (1) | AU2002359297B2 (ja) |
CA (1) | CA2463874C (ja) |
WO (1) | WO2003037163A2 (ja) |
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US9314332B2 (en) | 2016-04-19 |
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WO2003037163A3 (en) | 2004-03-25 |
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US7195642B2 (en) | 2007-03-27 |
US8591580B2 (en) | 2013-11-26 |
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US20120253462A1 (en) | 2012-10-04 |
EP1443850A2 (en) | 2004-08-11 |
US8226716B2 (en) | 2012-07-24 |
JP2005507697A (ja) | 2005-03-24 |
WO2003037163A2 (en) | 2003-05-08 |
US20020173849A1 (en) | 2002-11-21 |
EP1443850B1 (en) | 2013-09-18 |
CA2463874C (en) | 2008-10-07 |
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