WO2019224758A1 - Système de connecteur de tendon - Google Patents

Système de connecteur de tendon Download PDF

Info

Publication number
WO2019224758A1
WO2019224758A1 PCT/IB2019/054264 IB2019054264W WO2019224758A1 WO 2019224758 A1 WO2019224758 A1 WO 2019224758A1 IB 2019054264 W IB2019054264 W IB 2019054264W WO 2019224758 A1 WO2019224758 A1 WO 2019224758A1
Authority
WO
WIPO (PCT)
Prior art keywords
connector
tissue
attachment member
connection system
net
Prior art date
Application number
PCT/IB2019/054264
Other languages
English (en)
Inventor
Bashir KHOURY
Michael Menis
Shay Kahana
Original Assignee
Equindon Ltd.
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 Equindon Ltd. filed Critical Equindon Ltd.
Publication of WO2019224758A1 publication Critical patent/WO2019224758A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1146—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of tendons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0649—Coils or spirals

Definitions

  • the present invention relates to connectors for body tissues, in particular to connectors for tendons.
  • a tendon is a band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension.
  • a normal tendon is shown, for example, in FIG. 1A.
  • tendons tear either fully or partially (a full tear shown, for example in FIG. 1B), they need to be repaired surgically.
  • a tendon repair operation the surgeon makes at least one cut through the skin in the area above the injured tendon so they can see the tendon and look for injuries. The surgeon then removes any damaged tendon tissue. Next, the torn ends of the tendon are sewn back together. The connection of the tendon ends is made with conventional sutures by conventional suturing techniques. With the tendon reconnected, the surgeon sews the cut skin back together with medical stitches, and the wound is covered. Additionally, a splint or similar dressing may be applied to the body outside and proximate to the tendon repair site, in order to reduce tension on the tendon while it heals.
  • the present invention is directed to a coiled connector and system of these coiled connectors, for connecting tissues such as tom, severed, or mptured tendons.
  • tissue such as tom, severed, or mptured tendons.
  • two connectors are coupled, for example, by being joined together, to connect severed or torn ends of the tendon.
  • a net is placed over the connected tendon, e.g., the conjugated ends thereof, to provide additional securement of the tendon ends together and allow for reconnection, for example, by providing a compression force on the conjugated tendon ends.
  • Embodiments of the invention are directed to a tissue connection system.
  • the tissue connection system comprises: a first connector comprising a coiled body for receiving tissue, and terminating in an attachment member for attaching to a corresponding attachment member of a second connector; and, a second connector comprising a coiled body for receiving tissue and terminating in an attachment member for attaching to the attachment member of the first connector.
  • the tissue connection system is such that the attachment member of the first connector and the attachment member of the second connector are configured to attach in a connection such that the first connector and the second connector join in a substantially straight alignment.
  • the tissue connection system is such that the attachment member of the first connector and the attachment member of the second connector include correspondingly configured hook portions.
  • the tissue connection system is such that for each of the first connector and the second connector, the attachment member is at one end of the coiled body and a sharpened portion is at the other end of the body, oppositely disposed from the end including the attachment member.
  • the tissue connection system is such that the sharpened portion includes a barb.
  • the tissue connection system is such that the coiled body of the first connector and the second connector is in at least one of a helical or corkscrew shape.
  • the tissue connection system is such that it additionally comprises: a net for placement over the connection between the first connector and the second connector to secure the connection between the first connector and the second connector.
  • the tissue connection system is such that the net is movable from an open position, for placement over the connection, to a closed position for the reinforcement of the connection.
  • the tissue connection system is such that the net includes a flexible mesh.
  • the tissue connection system is such that the flexible mesh includes a shape memory retaining material, for example, Nitinol®.
  • the tissue connection system is such that the flexible mesh includes at least one of metal or plastic.
  • the tissue connection system is such that the first connector and the second connector include a shape memory material, for example, Nitinol®.
  • the tissue connection system is such that the first connector and the second connector include at least one of metal or plastic.
  • Embodiments of the invention are directed to a method for connecting tissue.
  • the method comprises: providing a tissue connector apparatus comprising: a first connector comprising a coiled body for receiving tissue, and terminating in an attachment member for attaching to a corresponding attachment member of a second connector; and, a second connector comprising a coiled body for receiving tissue and terminating in an attachment member for attaching to the attachment member of the first connector.
  • Tissue is then attached to the first connector and the second connector.
  • the first connector is joined or coupled to the second connector at the respective attachment members, the location of the joining or coupling of the first connector to the second connector defining a junction.
  • the method is such that it additionally comprises: placing a net over the junction such that the net provides a compression force to the tissue.
  • the method is such that the tissue includes a tendon.
  • Embodiments of the invention are directed to another method for connecting tissue.
  • the method comprises: providing a tissue connector apparatus comprising: a first connector comprising a coiled body for receiving tissue, and terminating in an attachment member for attaching to a corresponding attachment member of a second connector; and, a second connector comprising a coiled body for receiving tissue and terminating in an attachment member for attaching to the attachment member of the first connector.
  • the method includes joining the first connector to the second connector at the respective attachment members, the location of the joining of the first connector to the second connector defining a junction; and, attaching tissue to the first connector and the second connector.
  • this other method is such that it additionally comprises: placing a net over the junction such that the net provides a compression force to the tissue.
  • this other method is such that the tissue includes a tendon.
  • FIG. 1 A is a photograph of a healthy and normal tendon
  • FIG. 1B is a photograph of a completely torn or severed tendon
  • FIG. 2 A is a perspective view of a connector in accordance with embodiments of the invention
  • FIGs. 2B-1 and 2B-2 are side views of the connector of FIG. 2A;
  • FIG. 2C is a detailed view of the proximal end of Section AA of FIG. 2B-1 ;
  • FIG. 2D is a front view of the proximal end of the connector
  • FIG. 2E is a detailed view of the distal end of Section BB of FIG. 2B-2;
  • FIG. 3A is a perspective view of two connectors joined in accordance with embodiments of the invention.
  • FIGs. 3B-1 and 3B-2 are side views of the connectors of FIG. 3 A;
  • FIG. 3C is a detailed view of an a Section CC, a joined area or junction of the proximal portions of the joined connectors of FIG. 3B-2;
  • FIG. 4 is a perspective view of a net of the connection system
  • FIG. 5 A is a diagram of an initial portion of a process performed using the connection system in accordance with an example embodiment of the invention.
  • FIG. 5B is a diagram of a portion of a process connecting tissue in accordance with the embodiment of the invention.
  • FIG. 5C is a diagram of a portion of a process connecting tissue and securing the connection in accordance with the embodiment of the invention.
  • FIG. 2A shows a perspective view and side views (FIGs. 2B-1 and 2B-2) of a connector 100 in accordance with embodiments of the invention.
  • the connector 100 is, for example, a coil, such as a wire coil, with a body 104.
  • the body 104 terminates in a proximal end 110, and an oppositely disposed distal end 112.
  • a longitudinal axis (LA) extends through the connector 100.
  • the body 104 is, for example, coiled in a corkscrew or helical shape, in either a left or right (clockwise or counterclockwise) coil orientation.
  • the proximal end 110 is formed of a hook portion 114.
  • This hook portion 114 is, for example, in a“C” shape, and includes an area H4a, designed to receive a correspondingly shaped and dimensioned hook portion 114, on another connector 100, as shown, for example, in FIG. 3A.
  • the hook portion H4a may be a circular or other rounded or angled portion, provided it can receive a corresponding hook portion 114 or the like on another connector 100, to join (couple) the connectors 100 in an engaged manner, as shown, for example, in FIG. 3A.
  • the hook portions 114 are, for example, of a tolerance that there is a frictional engagement between the hook portions 114, such that the engagement results in the joined connectors 100 being at least in a straight or substantially straight alignment, with respect to each other.
  • the distal end 112 is formed of a barb or sharpened portion 116.
  • the barb 116 receives a tissue end, such as a tendon end and allows for the tendon portion to be moved proximally, (for receipt) along the coiled body 104, toward the hook portion 114 (where advancement typically terminates).
  • This proximal movement includes, for example, twisting the tendon portion on the connector 100 (while moving the tendon portion (e.g., tendon end) proximally).
  • the connector 100 is, for example, of a metal wire or plastic member, which is a surgical grade material.
  • Metals include shape memory retaining metals, such as Nitnol®, or stainless steel, or other inert metals, such as Titanium.
  • the material of the connector 100 may be flexible or rigid, but when two connectors 100 are joined or otherwise coupled to form a connector apparatus 120 (FIG. 3A), the joined connectors 100 maintain a straight or substantially straight alignment, which may also, but does not have to, be in a coaxial or substantially coaxial alignment.
  • FIGs. 3A-3C shows two connectors 100 joined together by an engagement of their respective hook portions 114 at the respective proximal ends 110.
  • the joined connectors 100 form a connector apparatus (or apparatus) 120 of a system (when alone or combined with the net 200 of FIG. 4).
  • the connectors 100 are for example, coiled in right or left handed coils.
  • the joinder is such that the connectors 100 are oriented and maintain a straight or substantially straight alignment, which may be, a coaxial or substantially coaxial alignment, with respect to each other.
  • FIG. 3C in Section CC of FIG.
  • FIG. 4 shows a net or sleeve 200, which secures the joined connectors 100.
  • the net 200 is shown in an open position, prior to its being closed around tissue, e.g., tendon, ends joined together by joined connectors 100.
  • the net 200 is, for example, a cylinder or tube, of a circular or rounded cross section, although other cross sectional shapes, such as rectangular, triangular, rounded, or combinations thereof are also permissible.
  • the net 200 is formed of a wire mesh frame 202, to be, for example, flexible.
  • the frame 202 of the net 200 is, for example, is formed of segments 204, connected at joints 206.
  • the ends of the segments 204 may be brought together, to close the net 200 or sleeve around the connected tissue ends held by the connectors 100, as a rod end 210 engages a recessed end 211 (formed by a C-shaped recess), to close the segments 204.
  • Other segment 204 ends are aperture ends 214. When the apertures 2l4a of the respective aperture ends 214 of a segment 204 are aligned, the ends 214 may be joined by pins or the like (not shown), which extend through the apertures 2l4a, to close the respective segments 204.
  • the net 200 may also include aperture protmsions 220, with apparatus 220a for accommodating pins and the like, to further secure the net 200 to the tissue it surrounds.
  • the net 200 is, for example, an integral member, but may be made of segments 204 joined together by welds at joints 206.
  • the net 200 is formed, for example, of a flexible and elastically deformable metal, such as Nitinol® or other medical grade metal or plastic.
  • the connectors 100 and/or the net 200 may be coated with dmgs, compounds, lubrication agents, and combinations thereof.
  • the connectors 100 and the net 200 define a system (apparatus) for connecting tissues, such as tendons, ligaments, vessels (blood, lymph and the like), nervous tissue, organs, and the like. In optional embodiments, only the connectors 100 need to be used.
  • the system of the connectors 100 and the net 200 may be applied for both human, veterinary, including equine, or other animal use.
  • FIGs. 5A-5C detail an exemplary operation for the system of the invention to join or conjugate ends of a severed or otherwise ruptured or torn tendon. In FIG. 5A two ends of a severed tendon
  • the tendon ends 300, 301 are attached to the respective connector 100 by being advanced from the distal end 112 to the proximal end 110 by twisting the tendon end 300, 301, along the coiled body 104 of the respective connector 100.
  • the advancement is such that each tendon end 300, 301 is received by the respective coiled body 104 (of each connector 100) and moved along the body 104 proximally, to at least to the hook portion 114 of the connector 100.
  • the hooked portions 114 are then engaged, such that the connectors 100 (with their tendon ends 300, 301) are joined to form a connector apparatus 120, as shown in FIG. 5B.
  • the hooked portions 114 engage at the junction 130 of the apparatus 120 (FIG. 3B-2).
  • the tendon ends 300, 301 may be attached to the respective connector 100, as detailed immediately above, after the connectors have been joined (engaged), to form the connector apparatus 120, as shown in FIG. 5B.
  • the connectors 100 are inside of the respective tendons 300, 301.
  • the tendon ends 300, 301 are, for example, in physical contact with each other so as to be joined or conjugated.
  • the net 200 may serve to provide a radially inward compression force or clamping force on the tendon ends 300, 301. This compression or clamping force augments contact of the tendon ends 300, 301 with each other, for joining and conjugating the tendon ends 300, 301.
  • the net 200 may be removed.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Rheumatology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un système et un procédé de connecteurs enroulés et 'un filet de fixation, pour connecter des tissus tels que des tendons déchirés, sectionnés ou rompus. Typiquement, deux connecteurs sont couplés, par exemple en étant joints l'un à l'autre, pour connecter des extrémités sectionnés ou déchirées du tendon. Avec les connecteurs ayant des extrémités de tendon jointes ou conjuguées ensemble, un filet est placé sur le tendon connecté, par exemple, leurs extrémités conjuguées, pour fournir une fixation supplémentaire des extrémités de tendon ensemble et permettre une reconnexion.
PCT/IB2019/054264 2018-05-23 2019-05-23 Système de connecteur de tendon WO2019224758A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201862675178P 2018-05-23 2018-05-23
US62/675,178 2018-05-23

Publications (1)

Publication Number Publication Date
WO2019224758A1 true WO2019224758A1 (fr) 2019-11-28

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ID=68615888

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2019/054264 WO2019224758A1 (fr) 2018-05-23 2019-05-23 Système de connecteur de tendon

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5662683A (en) * 1995-08-22 1997-09-02 Ortho Helix Limited Open helical organic tissue anchor and method of facilitating healing
US20090118776A1 (en) * 2004-09-24 2009-05-07 Biomec, Inc. Tissue anchors
US20140114351A1 (en) * 2012-10-15 2014-04-24 Guy Friedman Tendon repair apparatus
US20140257349A1 (en) * 2012-07-20 2014-09-11 Anthony E. Sudekum Terminal tissue attachment and repair device

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5662683A (en) * 1995-08-22 1997-09-02 Ortho Helix Limited Open helical organic tissue anchor and method of facilitating healing
US20090118776A1 (en) * 2004-09-24 2009-05-07 Biomec, Inc. Tissue anchors
US20140257349A1 (en) * 2012-07-20 2014-09-11 Anthony E. Sudekum Terminal tissue attachment and repair device
US20140114351A1 (en) * 2012-10-15 2014-04-24 Guy Friedman Tendon repair apparatus

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