WO2014098779A2 - Système de réparation de ligament et de tendon artificiels - Google Patents

Système de réparation de ligament et de tendon artificiels Download PDF

Info

Publication number
WO2014098779A2
WO2014098779A2 PCT/TR2013/000371 TR2013000371W WO2014098779A2 WO 2014098779 A2 WO2014098779 A2 WO 2014098779A2 TR 2013000371 W TR2013000371 W TR 2013000371W WO 2014098779 A2 WO2014098779 A2 WO 2014098779A2
Authority
WO
WIPO (PCT)
Prior art keywords
ligament
femoral
tube
repair system
prosthesis
Prior art date
Application number
PCT/TR2013/000371
Other languages
English (en)
Other versions
WO2014098779A3 (fr
WO2014098779A4 (fr
Inventor
Mustafa Cemil ALLAHVERDI
İrfan ISIK
Mehmet Hakan AKPINAR
Sevki Serkan HEZAR
Mahir MAHIROGULLARI
Original Assignee
DEMIRBOGA, Muhittin
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by DEMIRBOGA, Muhittin filed Critical DEMIRBOGA, Muhittin
Publication of WO2014098779A2 publication Critical patent/WO2014098779A2/fr
Publication of WO2014098779A3 publication Critical patent/WO2014098779A3/fr
Publication of WO2014098779A4 publication Critical patent/WO2014098779A4/fr

Links

Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/04—Metals or alloys
    • A61L27/06—Titanium or titanium alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/10—Materials or treatment for tissue regeneration for reconstruction of tendons or ligaments

Definitions

  • the present invention relates to a prosthetic ligament and tendon repair system made of nitinol and titanium materials and developed for use in all kinds of joints.
  • the knee is a joint in the form of a hinge disposed between the thigh bone (femur) and the shin bone (tibia) .
  • the joint comprises two parts, i.e. the inner and the outer parts. Said joint is protected by the knee cap in the front part thereof. All the bone surfaces within the joint are covered with the joint cartilage.
  • Ligaments are structures securing the knee joint.
  • the ligaments which are completely different structures, should not be confused with the tendons.
  • Ligaments are fixed structures, both ends of which are attached to the bones and they are provided with limited flexibility.
  • tendons are structures with one end thereof being attached to the bones, while the other end thereof continues with the muscles and transmits the motion of said muscles to the bones.
  • Lateral ligaments are provided on the inner and outer sides of the knee and prevent the knee from opening to both sides. Apart from the outer lateral ligaments, ligaments preventing the knee from opening to outside are provided on the rear outer corner of the knee.
  • Anterior cruciate ligament (ACL) connects the tibia and femur to each other exactly through the middle point. The function thereof is to limit the rotational motion of the knee and to prevent the forward movement of the tibia.
  • Posterior cruciate ligament (PCL) prevents the backward movement of the tibia.
  • the anterior cruciate ligaments consist of rigid and inflexible fibers and aid in stabilizing the knee by preventing excessive forward movement and rotation of the tibia on the femur. Said ligament restrict the forward, inward and outward rotation of the tibia bone. It extends inside the knee from back to front, and from outside to inside in the midline thereof. ACL tears mostly occur during sudden change of direction (football, tennis, skiing) and sudden deceleration while descending to the ground during jumping or running .
  • the anterior cruciate ligament can be damaged by various mechanisms; however, said damage often occurs during rotation or falling on the knee. Turning of the leg onto itself and falling to the ground upon sticking the foot to the artificial turf in the astro pitch, likewise, falling during skiing and turning of the body on the fixed leg due to the ski remaining in place lead to ACL tears. Unfortunately, this important anatomic structure does not heal by itself and operation is needed to confer the functions thereof again. In the operation, own parts of the ligament cannot be used.
  • anterior cruciate ligament tears rather occur as a result of the sport injuries, there is quite a large group of patients and anterior cruciate ligament reconstruction is widely carried out all over the world. There are several different methods widely used for reconstruction of the anterior cruciate ligament:
  • the best known involve connecting the tendon or the ligament to the bone by means of metal or dissolvable materials.
  • the firm ligaments and tendons present in various parts of the patient are taken and can be connected to the damaged regions by means of metal or dissolvable materials.
  • carrying out the reconstruction by placing a new ligament instead of the tendon, repair chance of which is almost zero is the most widely used treatment method.
  • a tissue having similar rigidity, structure, and length to that of the ACL taken around the knee is transferred to the original position of the ACL.
  • 5 types of tissue grafts are used;
  • Patellar tendon The middle 1/3 of the patellar tendon extending between the knee cap bone and the tibia are taken together with the bone fragments having a size of 1 x 2 x 1 cm (length of 2 cm, width and height of 1 cm) on the upper and lower part.
  • Rear knee tendons The hamstring tendons located on inner rear part of the knee are taken and folded to the appropriate length and thickness. These two tissues are used 90% of the time .
  • Quadriceps tendon The tendon located on the knee cap is taken therefrom along with a bone fragment having a size of 2 x 1 x 1 cm.
  • Allograft Tissues taken from cadavers are used. 5. Synthetic ligaments: They are rarely preferred due to the complications thereof. In the future, fostering synthetic ligaments can be developed.
  • the allografts of human origin used in the arthroscopic repair of the anterior cruciate ligament comprise two types as fresh frozen and dried.
  • the allografts of human origin stored as dried are softened in a saline solution for a certain period of time prior to surgery, while the fresh frozen allografts are made ready for use by being kept at room temperature.
  • the product made ready for use can be connected to the patient by means of repair materials available in the market.
  • the reliability of allografts of human origin is controversial. Although tests are performed against the known diseases, allografts of human origin can carry diseases being present in the person from whom said allografts are taken. In addition, the ages of the people . from whom said allografts are taken are not known. Therefore, placement of grafts belonging to elderly people to the younger patients can be the case especially in the ligament and tendon repairs.
  • the allografts of elderly people give rise to quick dissolution and ruptures in younger patients and the performed surgical operation fails.
  • the second method of reconstruction of the anterior cruciate ligament is the placement, during treatment, of a relatively small number of autograft products made of synthetic (polyester) materials into the body of the patient by means of using fasteners such as screws, buttons or pins comprised of metal or dissolvable materials.
  • the U.S. patent application numbered US2009054982 and titled 'Elastic metallic replacement ligament' states the following: '
  • the present invention relates to the orthopedic implants for reconstruction of severed, ruptured, or damaged ligaments. More particularly, this invention relates to an improved elastic replacement ligament made from metallic wires in a braided construction for replacement of a natural ligament of the body such as the anterior cruciate ligament of the knee.'
  • ⁇ prosthetic ligament includes a cord of thermotropic liquid crystal filaments.
  • the cord preferably comprises multi-filament thermotropic liquid crystal filaments.
  • the cord has an eye spliced at each of its ends.
  • the attachment methods may include difficulties regarding the implementation techniques, as well as side effects.
  • a so called button connection method a metal button and a polyester conveying band are used. This system can lead to tunnel expansion by providing a suspension effect.
  • the suspension system referred to as cross pinning requires an additional surgical procedure and causes frequent difficulty in practice with respect to the other systems.
  • problems such as bone tunnel wall fracture inside the joint due to the screws and falling of the screws into the joint can occur.
  • the recovery time of the treatment increases due to the formation of a plurality of scars and stitches in the event that the allografts performed by taking pieces from other tendons and ligaments are used.
  • the duration of the surgery can last 1.5 hours or more.
  • the patient is taken away from his/her normal life for a longer period of time, and healing duration of the wound also increases.
  • the patients are allowed to run smoothly or to ride a bike approximately after 3 months. Sportive activity is resumed within 4-6 months.
  • the metallic materials used are sometimes unable to biologically adapt to human tissues; thus, various infections can be seen.
  • rejection reactions can take place in the body against the synthetic product, problems such as swelling, persistent pain in the knee can occur, and the antibodies formed in the body partially weaken the synthetic material.
  • the synthetic materials wear the edges of the bone over time by acting as a sharp line inside the knee and can cause expansion in the bone tunnels. Thus, the usage area thereof is limited.
  • the present invention is developed for the purpose of aiding the surgical interventions performed as a result of the physical injuries and ruptures occurring in the anterior cruciate ligament and all the other tendons and ligaments.
  • Another object of the present invention is to put an end to the inconveniences of the person caused by the treatment procedures performed by taking pieces from the patient's other ligaments, tendons or muscles.
  • Another object of the present invention is to reduce the long treatment and surgical operation durations.
  • the surgical operation duration is at most 30 minutes.
  • Another object of the present invention is to prevent the friction arising from the metallic structure of the prosthetic materials placed from outside and thus, the bone wears resulting therefrom.
  • Still another object of the present invention is to construct tendon and ligament prostheses that are fully compatible biologically. They can be used even in patients who are allergic to nickel.
  • Another object of the. present invention is to enable enough elongation and . shape change of the placed prosthesis in accordance with the original biological sample.
  • Another object of the present . invention is to provide a secured and durable placement of the prosthesis inside the bone.
  • Another object of the present invention is to provide solutions for the tunnel expansion and wear problems that will occur after the treatment, as well as to prevent the suspension movement of the tendon.
  • Another object of the present invention is to obtain a prosthesis that is more durable and stronger than the normal anterior cruciate ligament.
  • FIG. 1 Top view of the ligament and tendon repair system Figure 2. Side view of the ligament and tendon repair system Figure 3. Peg structure of the ligament and tendon system
  • the present invention relates to a braided type prosthetic ligament and tendon repair system made of a titanium-nitinol material and comprising the following: a special femoral button ring (3) provided at one end thereof for placement of the femoral peg (3.1) positioned parallel to the extension direction of the tube; a tibial screw hole (4) provided at the other end thereof and positioned again parallel to the extension direction of the tube; a flattened double cylinder tube (1) made of flexible metal wire (2) material, formed in special molds by joining at least two ceramic coated tube segments (1.1) with same length and different ' radius by an articulation line (1.2); and teflon coated strips (5) positioned on both ends of said cylinder tube so as to be perforated and provided with special teflon holes (5.1) perforated thereon with a certain spacing.
  • a special femoral button ring (3) provided at one end thereof for placement of the femoral peg (3.1) positioned parallel to the extension direction of the tube
  • the system in order to achieve maximum efficiency and maximum strength, is especially provided in the form of an articulated two segment double cylinder tube (1) .
  • the number of segments can also be more than two.
  • the structure is obtained by braiding of the ceramic coated metal wires (2) so as to form a helix in the special molds.
  • the femoral button ring (3), tibial screw hole (4) are not post formed on the prosthetic cylinder and they are integrally obtained inside the special molds that are suitable for this form.
  • the prosthesis is made of ceramic coated materials in order to achieve better bone compatibility.
  • Ceramic is known to be a material with relatively high bone compatibility, and thus undesirable complications and reactions are not observed in the joints. Indeed, ceramic can be used in the hip prostheses.
  • the coefficient of friction increases in the event that the placed prosthetic materials are made of metallic materials and bone wear takes place. Over time, said wears can lead to movement problems and pain resulting from wear. For this reason, the coefficient of friction is reduced by coating the system with ceramic, and wear caused thereby is prevented.
  • the teflon coating of the perforatable strips minimizes the amount of damage to the femoral and tibial tunnels and can easily be used for all patients without causing any allergic reaction.
  • Another reason for choosing teflon coated material in this system is that the teflon coated materials are already being used in making synthetic veins and they are fully compatible with the human body.
  • Teflon holes (5.1) are perforated on .
  • the bone marrow flows onto the prosthesis and the fusion of the prosthesis with the body is provided in a shorter period of time by entry of the bone marrow through said holes.
  • the used metallic braided cylindrical tubes are made of nitinol material for being in full compliance with the human body and for being used safely in patients who are allergic to nickel material.
  • the stents made of nitinol material are now widely used and known to be in full compliance with the human body.
  • the ligament and tendon prosthesis according to the present invention is comprised of 2 to 500 flexible metal wires (2) having a thickness of 0 to 1 mm and it is implemented by means of minimally invasive surgical procedure thanks to the provision thereof with a thinner but stronger structure than the original tendon. Thus, tunnel expansion and the tunnel mouth opening problems are not experienced. On the other hand, since the prosthesis can be directly attached to the bone through both ends thereof, it also provides a solution to the suspension movement problem.
  • the prosthetic material is attached at an angle by being rotated around its own axis and serves as the anterior cruciate ligament. Accordingly, it is made of a flexible and shapeable material. However, it is provided with strength sufficient for preventing the elongation thereof against the force, it stretches just until the actual anterior cruciate ligament and the length thereof does not increase. In spite of this, it is much stronger than the actual anterior cruciate ligament and it can withstand up to 1160 Nm of force.
  • the femoral peg (3.1) attached to the femoral button ring (3) takes direction so as to be parallel with the movement direction and facilitates the advancement of the prosthesis inside the bored narrow tunnel.
  • the prosthesis exits out the bone it is released as a result of the applied force, takes a vertical position relative to the tunnel and prevents displacement of the prosthesis by being secured.
  • the physician implementing the prosthesis is not required to perform pulling and suspension movements for placement and reinforcement of the prosthesis, and the system provides convenience for both the physician and the patient.
  • Said femoral peg (3.1) is connected by means of flexible metal wires (2), which are the continuation of the body, to the femoral button ring (3) .
  • the present invention can be used not only for the reconstruction of the anterior cruciate ligament, but also for all the other tendons and ligaments and it can provide so many options in terms of usage extensiveness .

Landscapes

  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Transplantation (AREA)
  • Chemical & Material Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Epidemiology (AREA)
  • Inorganic Chemistry (AREA)
  • Dermatology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medicinal Chemistry (AREA)
  • Rehabilitation Therapy (AREA)
  • Rheumatology (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un système de réparation de ligament et de tendon prothétiques, qui est fait de nitinol et de titane et développé pour être utilisé dans tous les types d'articulations.
PCT/TR2013/000371 2012-12-21 2013-12-20 Système de réparation de ligament et de tendon artificiels WO2014098779A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
TR201215093 2012-12-21
TR2012/15093 2012-12-21

Publications (3)

Publication Number Publication Date
WO2014098779A2 true WO2014098779A2 (fr) 2014-06-26
WO2014098779A3 WO2014098779A3 (fr) 2014-08-14
WO2014098779A4 WO2014098779A4 (fr) 2014-10-16

Family

ID=50424687

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/TR2013/000371 WO2014098779A2 (fr) 2012-12-21 2013-12-20 Système de réparation de ligament et de tendon artificiels

Country Status (1)

Country Link
WO (1) WO2014098779A2 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111000665A (zh) * 2019-12-26 2020-04-14 赵滨 一种用于人工髋关节置换术后增加假体稳定的结构及方法

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030114929A1 (en) 2001-12-14 2003-06-19 Celanese Advanced Materials, Inc. Prosthetic ligament
US20090054982A1 (en) 2007-08-23 2009-02-26 William Wayne Cimino Elastic metallic replacement ligament

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5197983A (en) * 1988-04-19 1993-03-30 W. L. Gore & Associates, Inc. Ligament and tendon prosthesis
GB0024898D0 (en) * 2000-10-11 2000-11-22 Ellis Dev Ltd A connector

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030114929A1 (en) 2001-12-14 2003-06-19 Celanese Advanced Materials, Inc. Prosthetic ligament
US20090054982A1 (en) 2007-08-23 2009-02-26 William Wayne Cimino Elastic metallic replacement ligament

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111000665A (zh) * 2019-12-26 2020-04-14 赵滨 一种用于人工髋关节置换术后增加假体稳定的结构及方法

Also Published As

Publication number Publication date
WO2014098779A3 (fr) 2014-08-14
WO2014098779A4 (fr) 2014-10-16

Similar Documents

Publication Publication Date Title
Bonnin et al. Extensor tendon ruptures after total knee arthroplasty
Mayr et al. Revision anterior cruciate ligament reconstruction: an update
US20100023126A1 (en) Resilient arthroplasty device
Satora et al. Synthetic grafts in the treatment of ruptured anterior cruciate ligament of the knee joint.
JP2013537451A (ja) 人工半月と、ヒト膝関節における移植の方法
JAMES et al. Cruciate Ligament Stents in Reconstruction of the Unstable Knee: A Preliminary Report.
US11839546B2 (en) Mechanical fuse for surgical implants and related methods
Aboalata et al. The crossing internal suture augmentation technique to protect the all-inside anterior cruciate ligament reconstruction graft
Sanada et al. Gravity equinus position to control the tendon length of reversed free tendon flap reconstruction for chronic Achilles tendon rupture
CN106691628A (zh) 一种一体化人工骨韧带骨移植物及其制备方法
Weninger et al. Anterior cruciate ligament reconstruction using a fascia lata graft with fibertape augmentation
WO2014098779A2 (fr) Système de réparation de ligament et de tendon artificiels
RU2445015C1 (ru) Способ восстановления поврежденных связок голеностопного сустава
DO LE et al. A novel distal biceps rupture repair technique utilizing a biocomposite scaffold
Silfverskiöld et al. Early active mobilization of tendon grafts using mesh reinforced suture techniques
CN107898534B (zh) 具有固化带的可吸收韧带
US8870868B2 (en) External ankle distraction and load bypassing system and method
Moran Materials for ligament replacement
McCarty et al. Reconstruction of a chronic distal biceps tendon rupture 4 years after initial injury
Radford et al. Immediate strength after suture of a torn anterior cruciate ligament
Seedhom Reconstruction of the anterior cruciate ligament
RU2325864C1 (ru) Способ лечения передней нестабильности коленного сустава
Trasolini et al. Internal bracing in multiple-ligament knee reconstruction
AZIZ et al. EXTENSOR TENDON INJURY MANAGEMENT IN POST-TOTAL KNEE REPLACEMENT PATIENTS
RU2398539C1 (ru) Способ профилактики вывиха эндопротеза тазобедренного сустава

Legal Events

Date Code Title Description
NENP Non-entry into the national phase in:

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205 DATED 27/08/2015)

122 Ep: pct application non-entry in european phase

Ref document number: 13843065

Country of ref document: EP

Kind code of ref document: A2