RU2013116764A - Устройство для восстановления сустава человека или животного - Google Patents

Устройство для восстановления сустава человека или животного Download PDF

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Publication number
RU2013116764A
RU2013116764A RU2013116764/14A RU2013116764A RU2013116764A RU 2013116764 A RU2013116764 A RU 2013116764A RU 2013116764/14 A RU2013116764/14 A RU 2013116764/14A RU 2013116764 A RU2013116764 A RU 2013116764A RU 2013116764 A RU2013116764 A RU 2013116764A
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Russia
Prior art keywords
articular
joint
elements
connecting element
stage
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RU2013116764/14A
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English (en)
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RU2585694C2 (ru
Inventor
Йерг МАЙЕР
Марсель ЭШЛИМАН
Марио ЛЕМАН
Андреас ВЕНГЕР
Штефани ГЕБЕЛЬ-МЕЛЬ
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Спайнуэлдинг Аг
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Abstract

1. Устройство для лечения сустава человека или животного, причем указанный сустав имеет две суставные поверхности, содержащее:два суставных элемента (1 и 2), проявляющие относительно друг друга по меньшей мере ограниченные суставные свойства и содержащие средства крепления к одной из указанных суставных поверхностей посредством материала, имеющего термопластические свойства, и энергии колебаний, причем материал, имеющий термопластические свойства, размещен на внешних сторонах каждого суставного элемента (1 и 2),и временно устанавливаемый соединительный элемент (4), размещаемый с возможностью отсоединения между двумя указанными элементами или вокруг двух указанных суставных элементов (1 и 2) и соединяющий указанные два суставных элемента (1 и 2) с образованием жесткого, не проявляющего суставные свойства единого элемента.2. Устройство по п.1, дополнительно содержащее промежуточный элемент (3), размещенный между внутренними сторонами суставных элементов (1 и 2).3. Устройство по п.2, в котором промежуточный элемент (3) является упругим и прикреплен к каждой из внутренних сторон двух суставных элементов (1 и 2), причем соединительный элемент (4) представляет собой распорку, зажимаемую или выполненную с возможностью зажатия между внутренними сторонами суставных элементов (1 и 2) и удерживаемую в зажатом положении посредством упругости промежуточного элемента.4. Устройство по любому из пп.1 или 2, в котором промежуточный элемент (3) является упругим или жестким или отсутствует, и в котором временно устанавливаемый соединительный элемент (4) представляет собой зажим, выполненный с возможностью сжатия двух суставных элементов (1

Claims (19)

1. Устройство для лечения сустава человека или животного, причем указанный сустав имеет две суставные поверхности, содержащее:
два суставных элемента (1 и 2), проявляющие относительно друг друга по меньшей мере ограниченные суставные свойства и содержащие средства крепления к одной из указанных суставных поверхностей посредством материала, имеющего термопластические свойства, и энергии колебаний, причем материал, имеющий термопластические свойства, размещен на внешних сторонах каждого суставного элемента (1 и 2),
и временно устанавливаемый соединительный элемент (4), размещаемый с возможностью отсоединения между двумя указанными элементами или вокруг двух указанных суставных элементов (1 и 2) и соединяющий указанные два суставных элемента (1 и 2) с образованием жесткого, не проявляющего суставные свойства единого элемента.
2. Устройство по п.1, дополнительно содержащее промежуточный элемент (3), размещенный между внутренними сторонами суставных элементов (1 и 2).
3. Устройство по п.2, в котором промежуточный элемент (3) является упругим и прикреплен к каждой из внутренних сторон двух суставных элементов (1 и 2), причем соединительный элемент (4) представляет собой распорку, зажимаемую или выполненную с возможностью зажатия между внутренними сторонами суставных элементов (1 и 2) и удерживаемую в зажатом положении посредством упругости промежуточного элемента.
4. Устройство по любому из пп.1 или 2, в котором промежуточный элемент (3) является упругим или жестким или отсутствует, и в котором временно устанавливаемый соединительный элемент (4) представляет собой зажим, выполненный с возможностью сжатия двух суставных элементов (1 и 2).
5. Устройство по п.4, в котором промежуточный элемент (3) не прикреплен к внутренним сторонам суставных элементов (1 и 2).
6. Устройство по п.1, в котором временно устанавливаемый соединительный элемент (4) является жестким и размещен между двумя суставными элементами (1 и 2) и жестко прикреплен к каждому из суставных элементов (1 и 2), причем временно устанавливаемый соединительный элемент (4) выполнен, по меньшей мере, частично из биорассасывающегося или биологически разлагаемого материала.
7. Устройство по п.2 или 3, в котором промежуточный элемент (3) выполнен из биорассасывающегося или биологически разлагаемого материала.
8. Устройство по любому из пп.1-3, в котором суставные элементы (1 и 2) содержат материал, имеющий термопластические свойства, по меньшей мере, в одной из следующих форм: ребра (10), выступающие с наружных поверхностей несущих пластин (11), покрытие указанной наружной поверхности несущей пластины (11), штыри, размещенные или выполненные с возможностью размещения в канавках на внешних сторонах несущих пластин, и штыри, размещенные или выполненные с возможностью размещения в перфорированных каналах или туннелях на или внутри несущих пластин.
9. Устройство по любому из пп.1-3, в котором суставные элементы выполнены полностью из материала, имеющего термопластические свойства.
10. Способ лечения сустава человека или животного, причем указанный сустав имеет две суставные поверхности, включающий этапы, на которых:
обеспечивают наличие устройства по п.1, в котором материал, имеющий термопластические свойства представляет единое целое с суставными элементами (1 и 2);
подготавливают суставные поверхности сустава, так, чтобы, по меньшей мере, частично обнажить субхондральную костную ткань;
проталкивают указанное устройство между подготовленными суставными поверхностями и одновременно вызывают вибрацию устройства в течение времени, достаточного для разжижения, по меньшей мере, части материала, имеющего термопластические свойства с обеспечением его проникновения в обнаженную субхондральную костную ткань;
обеспечивают отверждение сжиженного материала для образования соответствующего по форме соединения между указанным устройством и обнаженной субхондральной костной тканью; и
удаляют временно устанавливаемый соединительный элемент (4) для обеспечения, по меньшей мере, ограниченных суставных свойств.
11. Способ лечения сустава человека или животного, причем указанный сустав имеет две суставные поверхности, включающий в себя этапы, на которых:
обеспечивают наличие устройства по п.1, в котором материал, имеющий термопластические свойства, содержится в виде отдельных штырей (20);
подготавливают суставные поверхности сустава так, чтобы, по меньшей мере, частично обнажить субхондральную костную ткань;
размещают устройство между подготовленными суставными поверхностями;
проталкивают штыри (20) между наружной стороной суставных элементов (1 и 2) или в перфорированные каналы или туннели, имеющиеся в суставных элементах (1 и 2), и одновременно вызывают вибрацию штырей (20) в течение времени, достаточного для выполнения разжижения по меньшей мере части материала, имеющего термопластические свойства с обеспечением его протекания через перфорационные отверстия каналов или туннелей для проникновения в обнаженную субхондральную костную ткань;
обеспечивают отверждение сжиженного материала для образования соответствующего по форме соединения между устройством и обнаженной субхондральной костной тканью; и
удаляют временно устанавливаемый соединительный элемент (4) для обеспечения, по меньшей мере, ограниченных суставных свойств.
12. Способ по любому из пп.10 или 11, дополнительной включающий этап, на котором осуществляют фиксацию сустава, и этап, на котором освобождают сустав из зафиксированного состояния, причем этап фиксации выполняют до этапа проталкивания или этапа размещения, а этап освобождения из зафиксированного состояния выполняют после этапа отверждения или после этапа удаления.
13. Способ по п.12, в котором на этапе фиксации, острые выступы, предусмотренные на дистальной поверхности канюлированного направляющего инструмента, вдавливают в поверхность кости с любой стороны пары суставных поверхностей.
14. Способ по любому из пп.10, 11, 13, в котором этап подготовки суставных поверхностей сустава включает в себя подготовку по меньшей мере одной пары противолежащих канавок, причем на каждой из суставных поверхностей размещена одна канавка из пары.
15. Способ по любому из пп.10, 11, 13, в котором на этапе удаления соединительного элемента (4) вытягивают соединительный элемент (4) из сустава в направлении, противоположном направлению имплантации.
16. Способ по п.15, в котором на этапе обеспечения наличия устройства соединяют проксимальную поверхность устройства или соединительного элемента (4) с дистальным концом вибрационного инструмента (5), при этом на этапе удаления соединительного элемента (4) вытягивают вибрационный инструмент (5) и соединенный с ним соединительный элемент (4) в направлении от сустава.
17. Способ по любому из пп.10, 11, 13, в котором на этапе обеспечения наличия устройства обеспечивают наличие соединительного элемента (4) из биорассасывающегося или биологически разлагаемого материала, при этом на этапе удаления соединительного элемента (4) выполняют этап, на котором обеспечивают биорассасывание или биологическое разложение соединительного элемента в суставе.
18. Способ по любому из пп.10, 11, 13, который выполняют методом минимально инвазивной хирургии.
19. Способ по любому из пп.10, 11, 13, в котором сустав представляет собой блоковидный сустав, и способ выполняют посредством латерального доступа.
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