JP6279228B2 - スネアアセンブリ及びソフトアンカーを用いる組織を固定するためのシステム、デバイス、及び方法 - Google Patents
スネアアセンブリ及びソフトアンカーを用いる組織を固定するためのシステム、デバイス、及び方法 Download PDFInfo
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- JP6279228B2 JP6279228B2 JP2013097685A JP2013097685A JP6279228B2 JP 6279228 B2 JP6279228 B2 JP 6279228B2 JP 2013097685 A JP2013097685 A JP 2013097685A JP 2013097685 A JP2013097685 A JP 2013097685A JP 6279228 B2 JP6279228 B2 JP 6279228B2
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Description
(1) 外科用軟組織修復デバイスであって、
骨内に固定されるよう構成され、内部に形成された複数の開口部を備える可撓性作成物から形成されるソフトアンカーであり、第1の長さ及び第1の直径を備えるストレス無負荷形状を有するソフトアンカーと、
一端での折り畳み式スネア(collapsible snare)、及びそこから延在する少なくとも1本の細長いフィラメントを有するスネアアセンブリであり、前記細長いフィラメントが、前記折り畳み式スネアと反対側の終端部を有し、前記スネアアセンブリが、前記複数の開口部を通過する前記フィラメントによって、前記ソフトアンカーに連結されることで、前記ソフトアンカーが、前記折り畳み式スネアと前記終端部との間の前記細長いフィラメント上の中間位置に置かれる、スネアアセンブリと、
を含み、前記ソフトアンカー及びスネアが、前記フィラメントに張力を加えることによって、前記ストレス無負荷形状から係留形状にまで、前記ソフトアンカーが再構成可能であるように構成され、前記ソフトアンカーが、前記係留形状において、前記第1の長さ未満である第2の長さと、前記第1の直径を超える第2の直径と、を有する、デバイス。
(2) 前記ソフトアンカーが、中央ルーメンを有するカニューレ状の縫合糸である、実施態様1に記載のデバイス。
(3) 前記複数の開口部が、前記ソフトアンカーの遠位部分上の第1の開口部と、前記ソフトアンカーの近位部分上の第2の開口部とを有し、前記第1及び第2の開口部が、前記中央ルーメンと連通している、実施態様2に記載のデバイス。
(4) 前記フィラメントが、前記第2の開口部に入り込み、前記ルーメンを通って、前記第1の開口部から出る、実施態様3に記載のデバイス。
(5) 前記第1及び第2の開口部が、前記ソフトアンカーの同じ側にある、実施態様3に記載のデバイス。
(7) 前記ソフトアンカーが、少なくとも4つの横方向孔を含み、前記フィラメントが、前記対向する対をなす開口部を通って各横方向孔に入り込みそこから出る、実施態様6に記載のデバイス。
(8) 前記ソフトアンカーが、クロシェ編み縫合糸アンカーであり、前記フィラメントが、前記クロシェ編み縫合糸アンカーのフィラメントリム間でその前記長さに沿って画定された開口部を経て延在する、実施態様1に記載のデバイス。
(9) 係留形状にある前記ソフトアンカーが、前記ストレス無負荷形状における前記直径より少なくとも約20%大きい直径を有する、実施態様1に記載のデバイス。
(10) 前記スネアアセンブリが、前記フィラメントが第1及び第2のフィラメントリムを有するように二重フィラメントループから形成される、実施態様1に記載のデバイス。
(12) 外科的修復方法であって、
可撓性アンカーを脱離した軟組織に近位の場所で、骨内の孔に挿入することであり、前記アンカーが第1の長さと第1の直径とを有する第1の形状、及び前記第1の長さ未満である第2の長さと前記第1の直径より大きい第2の直径とを有する第2の形状を有し、前記アンカーが前記アンカーの少なくとも一部を通過するスネアアセンブリに連結され、前記スネアアセンブリがその一端での折り畳み式スネアと、そこから延在する少なくとも1本の細長いフィラメントとを有し、前記少なくとも1本の細長いフィラメントが前記折り畳み式スネアとは反対側の終端部を有する、挿入することと、
前記フィラメントに張力を加えることで、前記アンカーを前記第1の形状から前記第2の形状まで移動させて、前記骨に対して前記アンカーを固定することと、
前記スネア及び前記細長いフィラメントの前記終端部のうちの少なくとも1つが、前記脱離した軟組織の少なくとも一部を通過することと、
前記細長いフィラメントの前記終端部を、前記スネアを通して挿入することと、
前記スネアを前記細長いフィラメントの周りで折り畳むことと、
前記折り畳まれたスネアを前記軟組織に向かって摺動し、張力を前記アンカーと前記組織との間のフィラメントに加えることで、前記組織を前記骨に近接させることと、
を含む方法。
(13) 前記可撓性アンカーが、内部を通って延びるルーメンを有するカニューレ状のアンカーであり、前記可撓性アンカーが、近位端での第1の開口部と遠位端での第2の開口部とを有し、前記第1及び第2の開口部のそれぞれが、前記ルーメンと連通する、実施態様12に記載の方法。
(14) 前記可撓性アンカーが、前記可撓性アンカーの前記長さに沿って、そこを通って横方向に延在する複数の孔を有する、実施態様12に記載の方法。
(15) 前記第2の直径が、前記第1の直径より少なくとも約20%大きい、実施態様12に記載の方法。
(17)外科用軟組織修復デバイスであって、
骨内に固定されるよう構成され、内部に形成された複数の開口部を備える可撓性作成物から形成されるソフトアンカーであり、第1の長さ及び第1の直径を備えるストレス無負荷形状を有するソフトアンカーと、
一端での折り畳み式スネア、及びそこから延在する2本の細長いフィラメントを有するスネアアセンブリであり、前記2本の細長いフィラメントが、前記折り畳み式スネアと反対側の終端部を有し、前記スネアアセンブリが、前記複数の開口部を通過する前記2本の細長いフィラメントによって、前記ソフトアンカーに連結されることで、前記ソフトアンカーが、前記折り畳み式スネアと前記終端部との間の前記2本の細長いフィラメント上の中間位置に置かれる、スネアアセンブリと、
を含み、前記ソフトアンカー及びスネアが、前記2本の細長いフィラメントに張力を加えることによって、前記ストレス無負荷形状から係留形状にまで、前記ソフトアンカーが再構成可能であるように構成され、前記ソフトアンカーが、前記係留形状において、前記第1の長さ未満である第2の長さと、前記第1の直径を超える第2の直径と、を有し、
前記スネアアセンブリは、1本のフィラメント本体により形成されており、前記フィラメント本体の両端部は、前記2本の細長いフィラメントの前記終端部であり、中央開口部を有する引き結び部が、前記フィラメント本体における前記両端部間の中間部に形成されており、前記フィラメント本体における前記両端部が、前記フィラメント本体の前記引き結び部の前記中央開口部を通過することで、第1フィラメントリムおよび第2フィラメントリを有し、スネア開口部を備えた前記折り畳み式スネアが形成されており、前記フィラメント本体における前記両端部が前記スネア開口部を通過した状態で、前記フィラメント本体における前記両端部が引っ張られることにより、前記引き結び部の前記中央開口部への挿入部から前記スネア開口部への挿入部まで延び、前記2本の細長いフィラメントにより形成されるフィラメントループを縮小することができるようになっている、デバイス。
Claims (10)
- 外科用軟組織修復デバイスであって、
骨内に固定されるよう構成され、内部に形成された複数の開口部を備える可撓性作成物から形成されるソフトアンカーであり、第1の長さ及び第1の直径を備えるストレス無負荷形状を有するソフトアンカーと、
一端での折り畳み式スネア、及びそこから延在する2本の細長いフィラメントを有するスネアアセンブリであり、前記2本の細長いフィラメントが、前記折り畳み式スネアと反対側の終端部を有し、前記スネアアセンブリが、前記複数の開口部を通過する前記2本の細長いフィラメントによって、前記ソフトアンカーに連結されることで、前記ソフトアンカーが、前記折り畳み式スネアと前記終端部との間の前記2本の細長いフィラメント上の中間位置に置かれる、スネアアセンブリと、
を含み、前記ソフトアンカー及びスネアが、前記2本の細長いフィラメントに張力を加えることによって、前記ストレス無負荷形状から係留形状にまで、前記ソフトアンカーが再構成可能であるように構成され、前記ソフトアンカーが、前記係留形状において、前記第1の長さ未満である第2の長さと、前記第1の直径を超える第2の直径と、を有し、
前記スネアアセンブリは、1本のフィラメント本体により形成されており、前記フィラメント本体の両端部は、前記2本の細長いフィラメントの前記終端部であり、中央開口部を有する引き結び部が、前記フィラメント本体における前記両端部間の中間部に形成されており、前記フィラメント本体における前記両端部が、前記フィラメント本体の前記引き結び部の前記中央開口部を通過することで、第1フィラメントリムおよび第2フィラメントリを有し、スネア開口部を備えた前記折り畳み式スネアが形成されており、前記フィラメント本体における前記両端部が前記スネア開口部を通過した状態で、前記フィラメント本体における前記両端部が引っ張られることにより、前記引き結び部の前記中央開口部への挿入部から前記スネア開口部への挿入部まで延び、前記2本の細長いフィラメントにより形成されるフィラメントループを縮小することができるようになっている、デバイス。 - 前記ソフトアンカーが、中央ルーメンを有するカニューレ状の縫合糸である、請求項1に記載のデバイス。
- 前記複数の開口部が、前記ソフトアンカーの遠位部分上の第1の開口部と、前記ソフトアンカーの近位部分上の第2の開口部とを有し、前記第1及び第2の開口部が、前記中央ルーメンと連通している、請求項2に記載のデバイス。
- 前記2本の細長いフィラメントが、前記第2の開口部に入り込み、前記ルーメンを通って、前記第1の開口部から出る、請求項3に記載のデバイス。
- 前記第1及び第2の開口部が、前記ソフトアンカーの同じ側にある、請求項3に記載のデバイス。
- 前記ソフトアンカーが、前記ソフトアンカーの前記長さに沿って、そこを貫通して延在する複数の横方向孔を有し、前記複数の開口部が、対向する対をなす開口部を有し、それぞれの対向する対をなす開口部が前記横方向孔の1つと連通している、請求項1に記載のデバイス。
- 前記ソフトアンカーが、少なくとも4つの横方向孔を含み、前記2本の細長いフィラメントが、前記対向する対をなす開口部を通って各横方向孔に入り込みそこから出る、請求項6に記載のデバイス。
- 前記ソフトアンカーが、クロシェ編み縫合糸アンカーであり、前記2本の細長いフィラメントが、前記クロシェ編み縫合糸アンカーのフィラメントリム間でその前記長さに沿って画定された開口部を経て延在する、請求項1に記載のデバイス。
- 係留形状にある前記ソフトアンカーが、前記ストレス無負荷形状における前記直径より少なくとも約20%大きい直径を有する、請求項1に記載のデバイス。
- 前記2本の細長いフィラメントの少なくとも一部を取り外し可能に封入する可撓性スリーブを更に含む、請求項1に記載のアセンブリ。
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2012
- 2012-05-07 US US13/465,376 patent/US9345567B2/en active Active
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CA2815758A1 (en) | 2013-11-07 |
US9345567B2 (en) | 2016-05-24 |
AU2013205726B2 (en) | 2017-12-07 |
CN103385741A (zh) | 2013-11-13 |
BR102013011972A2 (pt) | 2015-10-13 |
BR102013011972B1 (pt) | 2021-02-02 |
CN103385741B (zh) | 2018-06-26 |
US20160296222A1 (en) | 2016-10-13 |
US20130296934A1 (en) | 2013-11-07 |
AU2013205726A1 (en) | 2013-11-21 |
US11272915B2 (en) | 2022-03-15 |
EP2662030A1 (en) | 2013-11-13 |
EP2662030B1 (en) | 2017-03-01 |
US20190223857A1 (en) | 2019-07-25 |
JP2013233435A (ja) | 2013-11-21 |
US10271833B2 (en) | 2019-04-30 |
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