KR19990065287A - LCI Screw for Reconstruction of the Cruciate Ligament of the Knee - Google Patents

Abstract

The present invention uses a hamstring tendon as an implant tendon at the anterior or posterior cruciate ligament reconstruction of a human knee joint, so that the graft can be easily fixed to the bone. Disclosed is a new type of Ligament Anchor (LA) screw that includes a through portion for screwing therethrough. The height and width of the penetrating portion were 5mm to 10mm and 6mm to 12mm, respectively, so that a suitable screw was always selected in consideration of the difference in the diameter of the knee tendon depending on the person. In addition, the Ligament Anchor (LA) screw according to the present invention can avoid the complications of patello femoral joint which may occur after reconstruction by using the knee tendon as a transplant tendon, and the operation time is easy and simple to reduce the operation time. It is possible to reconstruct the cruciate ligament using a tendon tendon without using specially designed aids. In addition, one-tunnel incision does not require a second incision of the skin of the thigh. Cruciate ligament reconstruction is possible at a lower surgical cost than conventional fixation methods.

Description

LCI Screw for Reconstruction of the Cruciate Ligament of the Knee

The present invention relates to the field of cruciate ligament reconstruction of a human knee. More specifically, the present invention relates to a new type of anchor anchor screw for easier and more robust fixation of the graft in arthroscopic cruciate ligament reconstruction.

Injuries of the anterior and posterior cruciate ligaments of a human knee not only cause severe dysfunction of the knee joint, but also cause degenerative arthritis. Therefore, when the cruciate ligaments are damaged, the anatomical stability and proper function of the cruciate ligaments are required.

The most important factors affecting success in anterior and posterior cruciate ligament reconstruction are the most important factors in the fixation of the femur and tibia in the early postoperative period. Research has been conducted on the towing tension and fixation method of the implant gun to withstand the load.

In the conventional cruciate ligament reconstruction, various graft materials and fixation methods are introduced and used, and reconstruction using an autograft is known as a universal and easy method. Currently, autologous tendons are widely used because of the advantages of bone-patellar tendon-bone and semitendinosus and placilis of the hamstring tendon. Biomechanical fixation methods include titanium and biodegradable interference screws, cross pin fixation SemiFix screws and bone mulch screws, screw and washer or staple, endobutton, mitek anchor, suture and post. It is becoming.

Looking at the advantages and disadvantages of autografts, bone-patellar tendon-bone grafts are strong and can be secured firmly with an interference screw. It is possible to exercise joints and has primary merits as bone to bone, but after pain-patellar tendon-bone transplantation, pain in the patello-femoral joint and weakened femoral renal power, There are problems such as patellar tendon rupture. The use of semitendinosus and gracilis among the hamstring tendons has been developed since Macey in 1989, and the strength of the semiconducting tendon is weaker than the patellar tendon but the stiffness is normal compared to the patellar tendon. It has the advantage of being more similar to ligaments, and several strands of smaller diameter have a larger surface area than one large diameter tendon, resulting in rapid remodeling of blood vessels after transplantation, no damage to the tendon tendon, and no patella-femoral pain. There are advantages such as no impairment of function by donor tissue, but it is difficult to fix.

The biomechanical strength of the graft tendon was 168% of the normal cruciate ligament strength at 14mm in the middle third of the bone-patella tendon-bone, 125% at 10mm and 70% in the semi-dry tendon. , Park Gun was experimentally proven to be 50%, and the biomechanical intensity reported by Noyes et al. (1984) showed that the normal cruciate ligament 1725 ± 269N, bone-patella tendon-bone (middle 1/3) 2900 ± 260N, Semi-dry tendon was 1216 ± 50N and park 838 ± 30N. The load on the cruciate ligament during normal activity was about 450N. In addition, Brown et al. (1993) proved that the strength of the two half-stranded tendon was almost doubled. According to the results of the experiment of Noyes et al., The two half-stranded tendon was 140% of the normal cruciate ligament strength. The semi-dry tendon of the strands can be seen that more than 250%. In light of these results, the strength of the graft tendon for initial stability is considered to be sufficient for the use of a four-third center graft-patellar tendon-bone or semi-pound tendon-bacconium.

Many researchers have reported the results of biomechanical experiments on the stability of the fixation method used for cruciate ligament reconstruction. Kurosaka et al. (1987) have the strongest influence on the stability of the implanted material immediately after surgery. Emphasis is placed on the selection of fixation methods, and in the experiments on bone-patella tendon-bone traction, the interfering screws are superior to the suture or staple method. Because of the weakness, most of the early failure causes after surgery are recorded due to the fixed part, and the good quality of the bone, the greater the compression force of the bone is reported to be a strong fixation.

Rupp et al. (1993) reported the ultimate failure loads of 768.6 N (544-1094 N) in the pull tension test in which the bone-patella tendon-bone of pigs was fixed by titanium and bioabsorbable interference screw and press-fit method. 805.2N (680-995N), 462.5N (80-825N), and Caborn et al. (1995) reported that failure of the human cadaver bone-patellar tendon-bone with titanium and bioabsorbable interference screws The failure strength was reported as 558.3 ± 67.9N, 552.5 ± 56.4N. As described above, the failure strengths of fixation methods differ not only among researchers, but also in terms of excellent fixation methods.

US Patent No. 4,927,421 discloses a titanium interference screw (Acufex Microsurgical, Mansfield, MA, USA) in relation to the method of fixation of the implant tendon during cruciate ligament reconstruction. -Fixation of bone graft shows excellent fixation, but can not be used to fix the tendon tendon, there is a disadvantage that will remain in vivo unless removed through secondary surgery. In addition, U.S. Patent No. 5,470,334 discloses a biodegradable interference screw (Linvatec Corp, Largo, FL, USA), which is similar to a titanium interference screw in fixing bone-patella tendon-bone. It shows high fixation force and has the advantage of bioabsorption, but it is considered to be inadequate as a method of fixing the tendon tendon due to the low fixation force to the tendon tendon. U.S. Pat.Nos. 5,306,301 and 5,645,588 disclose Endobutton (Acufex Microsurgical, Mansfield, Mass., USA), which was invented to fix the tendon, but reported to have a relatively low fixation force in biomechanical experiments. . SemiFix screws (Arthrex, Naples, FL, USA) are also designed to secure the tendon, which has good fixation but requires an expensive guide system for surgery and requires a second incision in the thigh. There is a problem.

It is an object of the present invention to provide a new type of screw structure for fixing the graft to a bone in cruciate ligament reconstruction of a human knee joint.

Another object of the present invention is to include a penetrating site in the screw and pass the patellar tendon as a graft to the penetrating site, and then fixate the screw directly to the femur without the aid of an assisting device under arthroscopy, thereby allowing patella-femoral formation that may occur after harvesting To minimize the complications of the joint, at the same time economical and easy to operate, and to provide an excellent fixing method.

In order to achieve the above objects, the present inventors have invented a LA screw of a novel structure. Using the present invention, the implant gun is fixed to the femur through the through portion of the screw, and another mechanism is required for fixing the screw of the present invention. Because it does not have a great economic contribution to both the surgeon and the patient, and can be easily fixed with a small skin incision under arthroscopy, it does not require another secondary skin incision at the surgical site, which is good for post-operative beauty. Have. In terms of fixation force, the biomechanical test using the pig knee joint shows excellent fixation force, which is almost similar to the existing interference screw.

In order to achieve the object of the present invention, the Ligament Anchor (LA) screw of the present invention includes a screw portion having a threaded portion for fixing the screw to the bone and a through portion for the passage of the implant gun, the screw is titanium It is preferably made of (titanium) or biodegradable material.

1 is a perspective view of a Ligament Anchor (LA) screw according to a preferred embodiment of the present invention.

2A is a side view of a Ligament Anchor (LA) screw in accordance with a preferred embodiment of the present invention.

2B is an illustration of the teeth of a Ligament Anchor (LA) screw in accordance with a preferred embodiment of the present invention.

2C and 2D are front views showing front and rear views of Ligament Anchor (LA) screws according to preferred embodiments of the present invention, respectively.

3A is a side view of another embodiment of a Ligament Anchor (LA) screw in accordance with the present invention.

3B is an illustration of a thread of another embodiment of a Ligament Anchor (LA) screw in accordance with the present invention.

3c and 3d are front and rear views, respectively, of another embodiment of a Ligament Anchor (LA) screw according to the present invention.

Figure 4a is another embodiment of the Ligament Anchor (LA) screw according to the present invention, showing the side, front, and back of the portion where the thread is formed.

Figure 4b is another embodiment of the Ligament Anchor (LA) screw according to the present invention, showing the side, front, back of the through portion.

Figure 4c is another embodiment of the Ligament Anchor (LA) screw according to the present invention, the side and front, showing a form in which the threaded portion is formed and the through portion combined form.

5A is a plan view of a driver for securing a Ligament Anchor (LA) screw in accordance with the present invention.

5B is a front view of a driver for fixing a Ligament Anchor (LA) screw according to the present invention.

Explanation of symbols for main parts of the drawings

1, 19: front of the screw

2, 20: rear of the screw

3, 15: thread

4: penetrating area for passage of the graft

6: screw part consisting of threads

7: Screw part with penetrating part for passage of graft

9: hole for guide pin

10, 21: self tapping screw part

25: coupling part of the detachable screw

30: coupling part of screw and driver

31: Pull device to tension the implant

The present invention uses a hamstring tendon as an implant tendon at the anterior or posterior cruciate ligament reconstruction of a human knee joint, so that the graft can be easily fixed to the bone. The present invention relates to a new type of Ligament Anchor (LA) screw that includes a penetrating portion for passing through the screw. Ligament Anchor (LA) screw according to the present invention is the height and width of the through portion of 5mm to 10mm, 6mm to 12mm, respectively, in consideration of the difference in the diameter of the knee tendon according to the person to always select a suitable screw. , The outer diameter of the Ligament Anchor (LA) screw according to the present invention is preferably 7mm to 15mm, the depth of the thread is preferably 1mm to 3mm. In addition, it is preferable that the total length of the part which consists of threads is 10 mm-18 mm. In addition, the Ligament Anchor (LA) screw according to the present invention can avoid the complications of patello femoral joint that can occur after reconstruction by using the knee tendon as a transplant tendon, and the operation time is easy and simple to reduce the operation time. It is possible to reconstruct the cruciate ligament using a tendon tendon without using specially designed aids. In addition, one-tunnel incision does not require a second incision of the skin of the thigh. Cruciate ligament reconstruction is possible at a lower surgical cost than conventional fixation methods.

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

When referring to the drawings of the present invention, like reference numerals designate like elements throughout the figures.

1 is a perspective view of a Ligament Anchor (LA) screw according to a preferred embodiment of the present invention. The self-tapping area 10 is for facilitating the advancement of the screw while securing the screw to the femur, and the through hole 9 is for the surgeon to secure the screw in the desired direction while securing the screw to the femur. It is for fixing the screw along the guide pin of 0.3mm to 1mm in diameter.

2a to 2d show a side view showing the structure of a Ligament Anchor (LA) screw according to a preferred embodiment of the present invention, an illustration of the thread, and a front view of the front (1) and rear (2) of the screw; have. The Ligament Anchor (LA) screw shown in FIGS. 2A-2D includes largely a threaded portion 6 for securing the screw to the femur and a threaded portion 7 for the passage of the implant gun. The threaded portion 6 in the first half of the screw has a self-tapping portion 10 for facilitating the screw advancement and a trapezoidal thread 3 for securing high traction tension while securing the screw to the femur. It is included.

The threaded portion 7 with holes for passage and fixation of the implant gun includes a perforated hole 4 and a hole 9 having a diameter of 0.5 mm to 1.5 mm is drilled in the center of the screw diameter throughout the screw. This is to fix the screw along a guide pin of 0.3 mm to 1 mm in diameter so that the surgeon can fix the screw in the desired direction while the screw is fixed to the femur.

3A-3D are side views of another embodiment of the Ligament Anchor (LA) screw of the present invention, illustrating a thread, and a front view of the front face 19 and rear face 20, shown in FIGS. 2A-2D. Unlike the thread is formed only in the first half of the screw, the thread 15 is formed in the whole screw is different. This is to further increase the traction tension of the screw in the initial stage after the operation.

4A to 4C are side views of another embodiment of the Ligament Anchor (LA) screw of the present invention, which is a separate screw that separates a threaded portion for securing the screw to the femur and a holed portion for passage of the implant gun. . In this case, first, the screwed part is fixed to the femur, and then the part passed through the graft is joined to the screwed part, which includes a coupling part 25, and this type is used to fix the graft during surgery. It is possible to prevent damage to the transplant tendon and have the advantage of very simple surgical procedures.

5a to 5b is a side view showing a driver for fixing the Ligament Anchor (LA) screw according to the present invention, so that the portion 30 and the implanted gun installed in the screw and the driver during the operation is not damaged And a pulling device 31 for tensioning the implant gun. By using this driver, the LA screw can be fixed more easily and the graft can be protected from damage during surgery.

Looking at the fixing method of the present invention Ligament Anchor (LA) screw with reference to Figures 1 and 5a, 5b as follows. First, a hamstring tendon is taken from the inner side of the upper tibia, and both ends are sewn with a nonabsorbable suture, and then passed through the threaded portion of the screw. Knee arthroscopy is performed to create a tunnel in the tibia and femur to fit the original attachment of the cruciate ligament and to insert a Ligament Anchor (LA) screw with a graft into the femur tunnel. Tibial fixation is firmly fixed in one of several ways.

As described above, the Ligament Anchor (LA) screw according to the present invention can be said to be an innovative one that is much more developed than the conventional fixing method by providing an easy and simple fixing method.

The present invention discloses a new type of Ligament Anchor (LA) screw for knee cruciate ligament reconstruction.

Among the fixation methods used for cruciate ligament reconstruction, bone-patella tendon-bone implantation tends to cause serious complications of patella-femoral joint after reconstruction. Is excellent, but requires expensive assistive devices, has the disadvantage of having to make a second incision in the thigh, while Endobutton has the disadvantage of weak fixation force.

LA screw according to the present invention can avoid the complications that may occur in the patella-femoral joint after reconstruction by using a patellar tendon, as described above easy and simple surgery, can reduce the operation time, specially manufactured auxiliary Reconstruction of the cruciate ligament using a tendon tendon is possible without the need for a back. One-tunnel incision eliminates the need for a second skin incision and can be reconstructed at a lower surgical cost than conventional fixation methods. While preferred embodiments of the invention have been described in detail, those skilled in the art will understand that various changes can be made from the invention without departing from the spirit, scope, and disclosure of the invention.

Claims (8)

In Ligament Anchor (LA) screws for cruciate ligament reconstruction, a) threaded threads for securing screws to bones; And b) threaded portion, including the penetration for the passage of the graft; Ligament Anchor (LA) screw comprising a. The Ligament Anchor (LA) screw of claim 1 wherein the material of the LA screw is titanium or a biodegradable material. The Ligament Anchor (LA) screw according to claim 1, wherein an outer diameter of the LA screw is 7 mm to 15 mm. The Ligament Anchor (LA) screw according to claim 1, wherein a height and a width of the penetrating portion of the LA screw are 5 mm to 10 mm and 6 mm to 12 mm, respectively. The Ligament Anchor (LA) screw of claim 1, wherein the thread depth is between 1 mm and 3 mm. The Ligament Anchor (LA) screw according to claim 1, wherein a total length of the portion consisting of the threads of a) is 10 mm to 18 mm. The detachable Ligament Anchor (LA) according to claim 1, wherein a screw portion including a threaded portion for securing the screw to the bone of a) and a threaded portion including a through portion for passage of the implant gun of b) are separated from each other. ) screw. The Ligament Anchor (LA) screw of claim 1, wherein the penetrating portion for passage of the implant gun comprises a circular or elliptical, or dome shaped.