KR101606542B1

KR101606542B1 - Cruciate Ligament reconstruction system

Info

Publication number: KR101606542B1
Application number: KR1020150146495A
Authority: KR
Inventors: 김일환; 이영국; 안병철; 송근수; 정인태
Original assignee: (주)올소테크
Priority date: 2015-10-21
Filing date: 2015-10-21
Publication date: 2016-03-25

Abstract

The present invention relates to a system for reconstructing a new ligament in a tunnel penetrating to conform to a cruciate ligament removed by tearing on a tibia and a femur, and is characterized in that a bar type ligament inserted in the tunnel and imparting a stretching force And a wire to which a wire for imparting a predetermined tension to both ends of the ligament is connected; A connecting member to which a button and a washer, which are tied to the surfaces of the tibia and the femur, are woven with the wires passing through the tunnel, respectively, to maintain the tensions; And a fixation member to which a tongue screw engaged with the ligament on the tunnel and a fixation screw for restraining the washer on the tibia are respectively fastened.
Accordingly, the present invention has the effect of maximizing the completeness of the overall operation by composing a connecting member stably attaching to the bone surface while preventing the wire from loosening, and a fixing member pressing and restraining the bone by the binding force.

Description

Cruciate Ligament reconstruction system [0001]

The present invention relates to a system for reconstructing a torn or torn cruciate ligament due to trauma or severe exercise. More specifically, the present invention relates to a system for reconstructing a torn or torn cruciate ligament, Or an artificial ligament so as to have a predetermined tension so as to properly align an unstable knee joint.

In general, the ACL ligament (anterior, ACL, PCL) is a ligament supporting the tibia and femur, which is located at the knee joint, and acts as a central axis of rotational movement of the knee and plays an important role for normal knee motion . Such a cruciate ligament may be injured when the knee is strongly pushed backward or when the knee part strikes against a bodily object from the forward or backward direction and the cruciate ligament is strongly pushed in the impact direction. These ACLs can be treated by physical therapy if the degree of rupture is mild, but should be treated with cruciate ligament reconstruction to reconstruct the ruptured cruciate ligament if the degree of rupture is significant.

The cruciate ligament reconstruction was performed by removing the injured cruciate ligament in the tibia and femur, puncturing the tibia and femur in accord with the removed cruciate ligament, and then placing an autogenous graft or an allogenous graft in the perforated tunnel The wire connected to the ligament is pulled and fixed to have a predetermined tension. A treatment instrument (implant) required for such reconstruction is a toothbrush which has a large number of wires attached to both ends of a ligament which can be stretched and expanded and a planting material which is attached to the surface of the tibia and femur and inserted into the tunnel, And fixing them in place. Here, the connecting material is an important instrument that has a considerable effect on the operation result and the rehabilitation as well as the operation process depending on the degree of adhesion to the bone surface and the degree of connection (knot) to the wire. Therefore, there is a need for the development of ligaments that fix the ligaments to the tunnels.

For example, Korean Patent Laid-Open Publication No. 10-2015-0058776 entitled "Implantable Gun Fixing Device for Reconstructing the Posterior Cruciate Ligament" The disclosed document proposes a ring connected to both ends of the ligament, a suture washer attached to the surface of the tibia and femur, and a wire connected to the ring and suture washer to securely tie the ligament. That is, an existing sealing washer in which a hole through which a wire passes is formed on both sides of a bridge on which a wire is wound, and the bridge is formed to be convex downward, and sharp spikes are formed around the bridge.

Therefore, since the bridge is inserted into the tunnel at the time of attachment, the position is automatically aligned and the fixing force due to the spikes is improved, and the rounding wire can prevent the wire from flowing due to the centering of the wire automatically at the time of tension by the bridge . However, since the wire is simply wrapped around the bridge, there is a considerable difficulty in tightening the knot due to the loosening of the knot during tensioning of the ligament. In addition, since the hole through which the wire passes has a relatively large diameter, there is a serious problem that the wire after the operation is relaxed and flows along the bridge during the stretching process.

As another example, Korean Patent Laid-Open No. 10-2014-0022905 entitled "Tissue graft fixation device" is disclosed. The disclosed document defines a plurality of holes through which a wire passes at predetermined intervals while forming a fixing member to which the wires are connected in a bar shape having a width narrower than the length. That is, the wires can be looped into a plurality of holes formed in a row, thereby preventing loosening in the process of forming a knot. Further, since the diameter of the hole is relatively narrow, it is possible to prevent the cutting due to the flow. However, since the fixing member is formed in the shape of a bar, the contact surface with the bone surface is so small that it can not be stably fixed, resulting in a problem that the ligature is caused to flow from the bone surface due to elongation and contraction of the ligament.

Especially, the former and the latter have a problem that side effects or complications arise after the surgery because the mechanism that fixes each plant with tension is composed of simple connecting materials. Thus, there is an urgent need to improve the degree of completion of the surgery, as well as the improvement of the connecting material, which severely affects the operation or the operation after the operation.

Korean Patent Laid-Open Publication No. 10-2015-0058776 entitled "Implantable Gun Fixing Device for Posterior Cruciate Ligament Reconstruction & Korean Patent Laid-Open Publication No. 10-2014-0022905 entitled "Tissue graft fixation device"

SUMMARY OF THE INVENTION Accordingly, the present invention has been made to solve the above-mentioned conventional problems, and it is an object of the present invention to improve a structure for preventing wire loosening while stably attaching a connection material to a bone surface, The present invention provides a system for reconstructing cruciate ligaments that maximizes the completeness of an overall operation by adding a fixing member for constraining and restraining the ligament.

In order to achieve this object, the present invention provides a system for reconstructing a new ligament in a tunnel penetrating the tibia and the femoral bone in accordance with a ruptured cruciate ligament, the system comprising: a bar type ligament inserted in the tunnel, And a wire to which a wire for imparting a predetermined tension to both ends of the ligament is connected; A plurality of connection holes having a diameter through which wire passes through the center so as to maintain a tension by being woven with a wire passing through the tunnel to the surface of the tibia and the femur, and a plurality of spikes A plurality of spikes for preventing a flow on one surface of the tibia which is in close contact with the tibia; a plurality of spikes Wherein the button and the washer have a connection surface formed on one surface thereof with a pressing surface inclined at a predetermined angle or radius along an outer diameter of the connection hole and the insertion hole; And a screw which engages with and engages with the tunnel and the ligament is formed on an outer surface of a shaft inclined to be narrowed in a fastening direction so as to engage with the ligament on the tunnel, wherein the screw has semicircular corrugations having the same radius, A shaft which is fastened to the tibia through a washer so as to restrain the washer on the tibia by pressing the washer; and a head Wherein the washer includes a fixing member to which a fixing screw formed to be inclined at a predetermined angle or a radius is fastened to one surface of the head which is in close contact with the washer, And a fixture is formed.

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It should be understood, however, that the terminology or words of the present specification and claims should not be construed in an ordinary sense or in a dictionary, and that the inventors shall not be limited to the concept of a term It should be construed in accordance with the meaning and concept consistent with the technical idea of the present invention based on the principle that it can be properly defined. Therefore, the embodiments described in the present specification and the configurations shown in the drawings are merely the most preferred embodiments of the present invention, and not all of the technical ideas of the present invention are described. Therefore, It is to be understood that equivalents and modifications are possible.

As described in the above construction and operation, the present invention prevents the wire from being loosened while stably attaching a connecting material for tackling the plant material to the bone surface stably, and at the same time, The addition of a restraining fixture provides the effect of maximizing the completeness of the overall operation.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a block diagram generally showing a system according to the present invention; FIG.
Fig. 2 and Fig. 3 are diagrams showing a button according to the present invention; Fig.
Fig. 4 and Fig. 5 are structural views showing a washer according to the present invention. Fig.
Fig. 6 is a schematic view showing a tundish screw according to the present invention; Fig.
7 and 8 are views showing a fixing screw according to the present invention.
FIGS. 9 to 16 are views illustrating a procedure for reconstructing the cruciate ligament using the system according to the present invention. FIG.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.

The present invention relates to a system for reconstructing a new ligament in a tunnel (BH) penetrating through the tibia (B1) and the femur (B2) so as to coincide with the cruciate ligament removed by rupture, It is a system for the reconstruction of the cruciate ligaments mainly composed of fixtures.

First, the embedding material according to the present invention is connected to a bar type ligament 11 which is inserted on a tunnel BH to give an expanding force and a wire 15 which gives a predetermined tension to both ends of the ligament 11 . Ligament (11) is also called transplant, and is largely divided into self and artificial. The autogenous ligament (11) uses part of the patient's Achilles tendon or hamstring tendon, and the artificial ligament (11) uses the fibrous material to which the aramid is woven. Here, it is preferable that the self ligament 11 is formed into a plurality of strands in order to have a sufficient strength and a stretching force. Preferably, one strand is wound in a loop in accordance with the length of the tunnel BH, do.

One or more wires 15 are connected to the button 21 of the connecting member and the other wire 15 is connected to the washer 25, respectively. The wire 15 is a medium for guiding the ligament 11 inserted in the tunnel BH to have a predetermined tension force and fixing the ligament 11 in a tense state together with the connection of the wire 15 The completeness of surgery varies greatly.

The connecting member according to the present invention is woven with the wire 15 passing through the tunnel BH to the surfaces of the tibia B1 and the femur B2 as shown in Fig. 1, and is attached so as to maintain the tensions. These connecting members are distinguished by a button 21 and a washer 25. The button 21 is attached to the femur B2 alone and the washer 25 is attached to the fixing screw 35 to be described later.

The button 21 is attached to and fixed to the femur B2 which is woven with the wire 15 at one side of the ligament 11 and coincides with the tunnel BH so that the diameter of the wire 15 passing through the center as shown in Fig. And a plurality of spikes 21b for preventing the flow from being formed on one surface of the connection hole 21a and the femur B2. Here, the upper surface of the button 21 is formed with a pressing surface 21c inclined at a predetermined angle or radius along the outer diameter of the connection hole 21a. The pressing surface 21c prevents damage to the wire 15 knitted into the connection holes 21a.

At this time, it is preferable that the connection hole 21a is formed at four or more places so that the wires 15 are connected by a plurality of strands. That is, as shown in FIG. 3A, the two wires 15 can be connected to the connection hole 21a in a loop, and the two wires 15 can be connected in a loop so as to cross the wires 15 as shown in FIG. 3B. When the wires 15 are crossed, the wires 15 are pressed against each other, so that the fixing force can be improved. As shown in FIGS. 3C and 3D, four or more wires 15 can be connected to the connection holes 21a in a balanced manner. Therefore, the moment applied to the button 21 can be uniformly applied without being concentrated so that the durability can be improved.

The washer 25 is attached to and fixed to the lower tibia B1 of the tunnel BH by being woven with the other side wire 15 of the ligament 11. The wire 15 is passed through the center as shown in Fig. 35 and a plurality of spikes 25b for preventing flow on one surface of the tibia B1 which is in close contact with the tibia B1 are formed. Here, the upper surface of the washer 25 is formed with a pressing surface 25c inclined at a predetermined angle or radius along the outer diameter of the insertion hole 25a. The pressing surface 25c is engaged with the head 35b of the fixing screw 35 and serves to vary the fastening posture of the fixing screw 35 according to the shape. The pressing surface 25c will be described later with a fixing screw 35 described later.

At this time, the washer 25 may further include a connection groove 25d, which is opened to the inner surface of the insertion hole 25a so that one or more wires 15 pass therethrough as shown in FIG. 5a. That is, the wire 15 passed through the insertion hole 25a is fixed by the pressing of the fixing screw 25 as shown in FIG. 14. In the process of pressing the wire 15 by the fixing screw 25 as shown in FIG. 15, (15) is rotated along the head (25b). When the wire 15 is rotated along the head 25b, the wire 15 is pulled and the tension of the ligament 11 is changed. Therefore, it is preferable to form the connection groove 25d that can restrain the rotation of the wire 15.

5B, the washer 25 may further include at least one fixture 25e for preventing rotation according to the fastening of the fastening screw 35. As shown in FIG. The fixture 25e is formed in a groove or a hole shape, and a fixing guide (not shown) is inserted. 14, the washer 25 is attached to the tibia B1 by the fastening of the fastening screw 35. When the fastening washer 25 presses the fastening washer 25 as shown in FIG. 15, Is rotated along the head 25b. When the washer 25 is rotated along the head 25b, the wire 15 wound on the washer 25 is rotated together with the wire 15 so that the tension of the ligament 11 is changed. Therefore, it is preferable to form the fastener 25e for restricting the rotation of the washer 25 like the connection groove 25d.

Finally, the fixture according to the present invention comprises a tongue screw 31 which is engaged with the ligament 11 on the tunnel BH as shown in Fig. 1, a fixing screw (not shown) for restricting the washer 25 on the tibia B1 35 are respectively fastened. The tongue screw 31 is fastened between the tunnel BH and the ligament 11 to completely fix the ligament 11 on the tunnel BH and the fastening screw 35 is inserted into the insertion hole 25a of the washer 25, And is fastened in the tibia B1 to fix the washer 25 completely.

The tundish screw 31 is formed with a screw 31a engaging with the tunnel BH and the ligament 11 on the outer surface of the shaft inclined to be narrowed in the fastening direction as shown in Fig. And is formed of semicircular corrugations and rectangular peaks perpendicular to the fastening direction between the corrugations. That is, due to the semicircular corrugation, the area of engagement with the ligament 11 is increased to improve the binding force, and prevents horizontal advancement or retraction on the tunnel BH due to the horizontal peaks. Although the tongue screw 31 is shown as being fastened to the tunnel BH on the femur B2 side, it may be fastened to the tunnel BH on the tibia B1 side as the case may be, and may be fastened to the tibia B1 and the femur B2 ) Side tunnel BH, respectively.

The fixing screw 35 has a shaft 35a which is fastened in the tibia B1 in a state of passing through the washer 25 as shown in Fig. 7 and a head 35a which presses the wire 15 and the washer 25 in a fixed manner And the head 35b is formed such that one side of the head 35b which is in close contact with the washer 25 is inclined at a predetermined angle or a predetermined radius. That is, when the head 35b is inclined linearly together with the pressing surface 25c as shown in FIG. 7A, the shaft 35a is locked in the tibia B1 in a concentric manner with the insertion hole 25a, , And the shaft 35a can be fastened to the tibia B1 in multiple directions as shown in Fig.

Since the contact area between the head 35b and the pressing surface 25c is large and coincided with the former, the fixing force of the washer 25 is excellent. On the other hand, since the angle of the washer 25 attached to the surface of the tibia B 1 depends on the attachment position Is limited. On the other hand, the latter is not restricted by the angle, so that the attachment position is free, while the fixing force is somewhat weak because the area where the head 35b and the pressing surface 25c are engaged is small.

Hereinafter, a method for reconstructing an ACL will be described using the system according to the present invention.

First, a self or an artificial ligament 11 is prepared, and the wire 15 is connected to both ends of the prepared ligament 11 as shown in Fig. Here, the wire 15 at one end (upper side) is preferably connected to the button 21 in advance. Then, the ruptured cruciate ligament is removed on the tibia B1 and the femur B2, and it passes through a tunnel BH corresponding to the cruciate ligament removed by rupture as shown in Fig. Then, the prepared ligament 11 is inserted into the tunnel BH as shown in Fig. Here, when the button 21 is connected to the ligament 11, the other side of the ligament 11 to which the button 21 is connected is inserted into the tunnel BH on the femur B2 side and then the tunnel BH on the side of the tibia B1, In the order of pulling. When the button 21 is brought into close contact with the surface of the femur B1, the tongue screw 31 is fastened to the tunnel BH of the femur B2 to fix the ligament 11 to the femur B2. Here, the wire 15 exposed on the tibia B1 is pulled, and the tongue screw 31 is fastened with the ligament 11 being given a predetermined tension.

Next, the position of the washer 25 to be attached to the tibia B1 is selected, and drilled with a drill at a predetermined position. Then, the wire 15 connected to the other side of the ligament 11 is passed through the insertion hole 25a of the washer 25 as shown in FIG. 12, and the fixing screw 35 is inserted into the insertion hole 25a, To the tibia B1. Here, the head 35b of the fixing screw 35 is fastened to a depth apart from the wire 15 located on the pressing surface 25c of the washer 25 as shown in Fig. Then, after pulling the wire 15 so that the ligament 11 has a predetermined tension, the fixing screw 35 is fully fastened as shown in Fig. 15 to fix the wire 15. The wire 15 remaining from the washer 25 is cut and closed and the reconstruction of the cruciate ligament is completed when the tuna screw 31 is fastened to the tunnel BH of the tibia B1 as shown in Fig. . On the other hand, since the reconstructing method of the cruciate ligament is only a reference example for helping understanding of the present invention, it can be applied differently according to the most suitable method according to the patient or the physician.

It will be apparent to those skilled in the art that various modifications and variations can be made in the present invention without departing from the spirit and scope of the invention as defined by the appended claims. It is therefore intended that such variations and modifications fall within the scope of the appended claims.

B1: tibia B2: femur
BH: Tunnel 11: Ligament
15: Wire 21: Button
21a: Connection hole 21b, 25b: Spike
21c, 25c: compression face 25: washer
25a: insertion hole 25d: connection groove
25e: fixture 31: tongue screw
31a: screw 35: set screw
35a: shaft 35b: head

Claims

A system for reconstructing a new ligament in a tunnel penetrating through the tibia and femur to conform to a ruptured cruciate ligament, comprising:
A bar type ligament which is inserted into the tunnel and imparts an expansion and contraction force, and a wire to which a predetermined tension force is applied to both ends of the ligament;
A plurality of connection holes having a diameter through which wire passes through the center so as to maintain a tension by being woven with a wire passing through the tunnel to the surface of the tibia and the femur, and a plurality of spikes A plurality of spikes for preventing a flow on one surface of the tibia which is in close contact with the tibia; a plurality of spikes Wherein the button and the washer have a connection surface formed on one surface thereof with a pressing surface inclined at a predetermined angle or a radius along an outer diameter of the connection hole and the insertion hole; And
Wherein a screw is formed on an outer surface of a shaft inclined to narrow in a fastening direction so as to engage with the ligament on the tunnel, the engaging screw being engaged with the tunnel and the ligament, wherein the screw has semicircular corrugations having the same radius, A shaft which is fastened to the tibia through a washer so as to restrain the washer on the tibia by pressing, and a head which fixes the wire and the washer according to the fastening, Wherein the washer includes a fixing member to which a fixing screw formed to be inclined at a predetermined angle or a radius is fastened to one surface of the head which is in close contact with the washer, Is formed on the surface of the cruciate ligament.

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