JP5122576B2 - 外科的修復方法および装置 - Google Patents
外科的修復方法および装置 Download PDFInfo
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- JP5122576B2 JP5122576B2 JP2009533340A JP2009533340A JP5122576B2 JP 5122576 B2 JP5122576 B2 JP 5122576B2 JP 2009533340 A JP2009533340 A JP 2009533340A JP 2009533340 A JP2009533340 A JP 2009533340A JP 5122576 B2 JP5122576 B2 JP 5122576B2
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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
- A61B17/04—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
- A61F2002/0817—Structure of the anchor
- A61F2002/0823—Modular anchors comprising a plurality of separate parts
- A61F2002/0829—Modular anchors comprising a plurality of separate parts without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
-
- 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
- A61F2002/0852—Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
-
- 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
- A61F2002/0858—Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
-
- 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
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Rehabilitation Therapy (AREA)
- Rheumatology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
本発明は、外科的修復方法および装置に関する。
1つの身体部分を、別の身体部分に対し、あるいは外科用インプラントまたは他の器具に対して固定しようとする場合等、外科的修復に対し、固定器具が使用されることが多い。たとえば、腱または靭帯の損傷では、たとえば断裂したかまたは分離した腱または靭帯を、それらが正常な場合に付着しているはずの骨に再度付着させるために、修復手術が必要であることが多い。膝靭帯損傷は、通常、1つまたは複数の靭帯に対する損傷を伴い、そのため、靭帯または少なくともその一部を脛骨および/または大腿骨に再度付着させることが必要である。図1は、膝1および靭帯2(たとえば、正常な場合、大腿骨11と脛骨12との間に付着している前十字靭帯、すなわちACL)の一部の概略図を示す。靭帯2への損傷の1つのタイプでは、図2に概略的に示すもののように、靭帯2が、大腿骨11および/または脛骨12から分離するかまたは部分的に断裂する場合がある。かかる損傷を、当該技術分野において既知であるように、靭帯2を移植片または他の修復材料と置き換えることによって修復することができる。靭帯2を置き換える1つの修復技法は、大腿骨11および脛骨12の両方にドリルにより孔13をあけることと、たとえば図3に示すような干渉ねじ14を使用して両孔に移植片14を固定することと、を含む。
本発明の一態様では、靭帯を骨に固定するために干渉ねじの使用を必ずしも必要としない靭帯修復技法を提供する。一実施形態では、骨自体の一部が、干渉ねじまたは他の固定器具を必要とすることなく靭帯を支持することができる。別の実施形態では、固定器具がある場合、それを、靭帯を適所に固定するために、内部骨表面、たとえば皮質骨表面と接触するように配置することができる。
本発明は、その適用が、以下の説明に示すかまたは図面に示す構成の詳細および構成要素の配置に限定されない。本発明は、他の実施形態が可能であり、さまざまな方法で実施されまたは実行されることが可能である。また、本明細書で使用する用語および術語は、説明の目的のためのものであり、限定するものとみなされるべきではない。
Claims (12)
- 関節修復材料を受け入れるように構成されかつ配置された穴を含む基部であって、接触面を有し、前記接触面において骨と接触し前記骨の面に対して前記関節修復材料を固定するように構成されかつ配置された、基部と、
前記関節修復材料を前記基部に固定するように構成されかつ配置された固定部であって、前記基部の前記接触面とは反対側において前記基部と係合するように配置され、かつ前記基部から離れる方向に延在し、前記穴を横切って延在する部分を有する、固定部と、
を備えた外科用固定器具であって、
当該外科用固定器具は、骨開口内で前記骨に対して前記関節修復材料を固定するために前記骨開口内に配置され、かつ前記固定部から前記接触面に向かう方向において前記固定部に固定される前記関節修復材料に加えられる張力に抵抗するように配置され、
前記基部および前記固定部が、前記関節修復材料を受け入れるために、前記関節修復材料の一部が前記穴を貫通し、前記固定部の第1側面に沿って前記固定部の遠位端に向かって延在し、前記固定部の前記遠位端をわたった後、前記固定部の第2側面に沿って前記遠位端から離れ、前記穴を貫通して戻るように配置され、
前記固定部が、前記関節修復材料を前記骨開口において骨と接触するように前記固定部の長さ方向の少なくとも一部に沿って位置決めするように配置される、外科用固定器具。 - 前記固定部の前記穴を横切って延在する部分が、前記穴近くの領域において薄くなるように、かつ前記穴から離れて配置された領域において厚くなるように、テーパ状になっている、請求項1に記載の器具。
- 前記固定部が、前記基部から離れる方向に延在する細長い形状を有する、請求項1または2に記載の器具。
- 前記基部が、環状の前記接触面を含む円形フランジを有する、請求項1〜3のいずれか一項に記載の器具。
- 前記基部が円形穴を有する、請求項4に記載の器具。
- 前記固定部が、前記関節修復材料を受け入れる対向する溝を有する、請求項1〜5のいずれか一項に記載の器具。
- 前記固定部が、前記関節修復材料を前記固定部に固定する縫合を受け入れるように構成された1つまたは複数の開口を有する、請求項1〜6のいずれか一項に記載の器具。
- 前記基部が、前記穴を画定する円柱状部分を有し、前記固定部が、前記円柱状部分に固定されかつ前記穴を横切って延在する楔型形状を有する、請求項1〜7のいずれか一項に記載の器具。
- 前記基部および前記固定部が吸収性材料から作製される、請求項1〜8のいずれか一項に記載の器具。
- 前記基部および前記固定部が、靭帯の皮質下骨固定を使用する膝靭帯修復処置で使用されるように構成される、請求項1〜9のいずれか一項に記載の器具。
- 前記基部が、環状形状を有する座金要素を有し、前記座金要素が、接触面を画定し、そのサイズを低減するのを可能にするように分割される、請求項1に記載の器具。
- 前記関節修復材料が、靭帯組織の自家移植片または同種移植片を含む、請求項1に記載の器具。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/582,185 | 2006-10-17 | ||
US11/582,185 US7942914B2 (en) | 2006-10-17 | 2006-10-17 | Method and apparatus for surgical repair |
US11/582,213 US7963983B2 (en) | 2006-10-17 | 2006-10-17 | Fixation device for surgical repair |
US11/582,213 | 2006-10-17 | ||
PCT/US2007/022041 WO2008048578A1 (en) | 2006-10-17 | 2007-10-16 | Method and apparatus for surgical repair |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2010506656A JP2010506656A (ja) | 2010-03-04 |
JP5122576B2 true JP5122576B2 (ja) | 2013-01-16 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2009533340A Expired - Fee Related JP5122576B2 (ja) | 2006-10-17 | 2007-10-16 | 外科的修復方法および装置 |
Country Status (5)
Country | Link |
---|---|
US (2) | US7942914B2 (ja) |
EP (1) | EP2117464A1 (ja) |
JP (1) | JP5122576B2 (ja) |
CA (1) | CA2702606C (ja) |
WO (1) | WO2008048578A1 (ja) |
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2006
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- 2006-10-17 US US11/582,213 patent/US7963983B2/en not_active Expired - Fee Related
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2007
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CA2702606C (en) | 2015-04-14 |
EP2117464A1 (en) | 2009-11-18 |
US20080177386A1 (en) | 2008-07-24 |
CA2702606A1 (en) | 2008-04-24 |
US20080177336A1 (en) | 2008-07-24 |
US7942914B2 (en) | 2011-05-17 |
JP2010506656A (ja) | 2010-03-04 |
US7963983B2 (en) | 2011-06-21 |
WO2008048578A1 (en) | 2008-04-24 |
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