WO2023027138A1 - Dispositif de freinage de ménisque - Google Patents

Dispositif de freinage de ménisque Download PDF

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Publication number
WO2023027138A1
WO2023027138A1 PCT/JP2022/031983 JP2022031983W WO2023027138A1 WO 2023027138 A1 WO2023027138 A1 WO 2023027138A1 JP 2022031983 W JP2022031983 W JP 2022031983W WO 2023027138 A1 WO2023027138 A1 WO 2023027138A1
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WO
WIPO (PCT)
Prior art keywords
meniscus
contact
tibia
base portion
base
Prior art date
Application number
PCT/JP2022/031983
Other languages
English (en)
Japanese (ja)
Inventor
武徳 秋山
Original Assignee
武徳 秋山
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
Priority claimed from JP2021139024A external-priority patent/JP2024149928A/ja
Application filed by 武徳 秋山 filed Critical 武徳 秋山
Publication of WO2023027138A1 publication Critical patent/WO2023027138A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor

Definitions

  • the present invention relates to a meniscus braking device that is used to prevent the meniscus from deviating from the tibial margin, reduce the meniscus that has deviated from the tibial margin, and brake the meniscus in the repositioned state.
  • Knee injuries include deviation of the meniscus from the tibial margin. Meniscal prolapse is caused by rupture and degeneration of the meniscus, as well as dysfunction of the meniscal tibial ligament (hereinafter coronary ligament). Meniscal prolapse results in less cushioning by the meniscus in the knee joint and increased instability. As a result, cartilage damage occurs due to contact between the femur and tibia in the knee joint, and osteoarthritis, osteonecrosis, and the like may develop, making it difficult to walk.
  • coronary ligament meniscal tibial ligament
  • the meniscus damping device of the present invention comprises a base portion attached to the tibia, and the outer edge of the meniscus and the coronary ligament supported by the base portion and deviated from the tibia margin. an abutting portion that abuts on one or both sides, and the base portion includes a contact actuating portion that moves the abutting portion in a repositioning direction of the meniscus and brakes the meniscus at a predetermined position. characterized by
  • the base portion may be provided on a plate fixed to the tibia. In this case, it is attached to the tibia via the plate, and is included in the above configuration of the present invention.
  • the abutting portion is preferably made of a hard material such as metal, or an absorbent material for fixation in the body. Furthermore, the abutting portion may be in a state in which it cannot advance or retreat when it abuts against the meniscus, but may abut against the meniscus with a predetermined elastic force.
  • the base portion is formed in a bar shape
  • the contact action portion includes a screw thread formed on the outer peripheral surface of the base portion and an end portion provided at one end of the base portion. and a locking portion that locks the abutting portion in a retaining state, and the abutting portion is locked to the locking portion of the base portion so that the base portion is screwed into the tibia. It is characterized by pressing the meniscus accordingly.
  • the base portion is formed in a tubular shape having a hollow portion along the axial direction thereof, and a guide member is inserted through the hollow portion of the base portion to define and guide the direction of insertion into the tibia. preferably.
  • the base portion is attached to the tibia, then the contact portion is brought into contact with the meniscus or the coronary ligament, and further, the contact portion is moved in the meniscus reduction direction by the operation of the contact action portion. By moving it, the meniscus can be braked while being returned to a predetermined position.
  • the meniscus deviating from the tibial margin can be reduced in a short period of time, and the reduced state can be maintained.
  • the structure can be simplified by the base portion, the contact portion, and the contact operating portion.
  • the contact part is brought into contact only with the coronary ligament, and the meniscus is moved in the reduction direction or braked via the coronary ligament. is preferred.
  • FIG. 4 is an explanatory view schematically showing a meniscus reduction method using a meniscus braking device;
  • FIG. 4 is an explanatory view schematically showing another meniscus reduction method using a meniscus braking device;
  • FIG. 11 is an explanatory view showing another modified example of the meniscus braking device;
  • the meniscus braking device of this embodiment includes a rod-shaped base member 1 (corresponding to the base portion in the present invention) and a plate-like contact member 2 (corresponding to the contact portion in the present invention). It is composed of
  • the base member 1 includes a body portion 10 , a tapered portion 11 provided at one end (distal end) of the body portion 10 , and a tapered portion 11 provided at the other end (base end) of the body portion 10 and having a diameter larger than that of the body portion 10 . and a diameter portion 12 .
  • a screw thread 13 is formed on the outer peripheral surface of the body portion 10, and a connecting portion 14 for connecting a rotary tool or the like is formed on the large diameter portion 12, as partially shown in FIG. there is As a result, the base member 1 can be screwed into the tibia by its rotation as will be described later.
  • the base member 1 is provided with a hollow portion 15 penetrating over the entire length along the axis thereof, thereby forming a tubular shape.
  • the contact member 2 has a hole 20. As shown in FIG. The inner diameter of the hole portion 20 of the contact member 2 is larger than the outer diameter of the body portion 10 of the base member 1 and smaller than the large diameter portion 12 of the base member 1 . As a result, the abutting member 2 can be freely moved along the longitudinal direction by inserting the main body portion 10 of the base member 1, and is engaged with the large-diameter portion 12 of the base member 1 to prevent it from coming off.
  • the base member 1 has a so-called screw shape
  • the contact member 2 has an annular shape and has a so-called washer shape.
  • the thread 13 and the large-diameter portion 12 of the body portion 10 of the base member 1 function as a contact operating portion of the present invention for moving and braking the contact member 2 .
  • the large diameter portion 12 corresponds to the locking portion in the present invention.
  • the base member 1 is guided along the guide wire 3 as shown in FIG.
  • a rotating tool or the like (not shown) is connected to the large-diameter portion 12 of the member 1 to rotate the base member 1 .
  • the base member 1 is screwed into the tibia 41, and along with this, the abutment member 2 locked to the large-diameter portion 12 of the base member 1 contacts the outer edge of the deviated meniscus 40 and the coronary ligament 42. touch.
  • the base member 1 is further rotated, and the contact member 2 pushes the meniscus 40 in the repositioning direction. Then, when the meniscus 40 returns to the predetermined position (normal position) of the knee joint, the rotation of the base member 1 is stopped. As a result, as shown in FIG. 3C, the threaded state of the base member 1 to the tibia 41 is maintained, and the meniscus 40 is braked at the normal position.
  • the movement of the meniscus 40 in the deviating direction is restricted by the contact of the base member 1, which is screwed to the tibia 41 and fixed, and the contact member 2. Therefore, the meniscus 40 can be reliably reduced in a short period of time, and the reduced state can be maintained.
  • the contact member 2 is brought into contact with the outer edge of the meniscus 40 to reduce the meniscus 40.
  • the present invention is not limited to this, and the meniscus 40 can be reduced.
  • the contact member 2 may contact only the coronary ligament 42 .
  • the guide wire 3 as a guide member is inserted into the tibia 41, and then the base member 1 is guided along the guide wire 3 as shown in FIG. 4B. At this time, the contact member 25 is brought into contact with the coronary ligament 42 outside the deviated meniscus 40 .
  • a contact member 25 smaller than the contact member 25 that contacts the meniscus 40 can be used.
  • the base member 1 is further rotated, and the contact member 25 presses the coronary ligament 42, thereby pushing the meniscus 40 in the reduction direction.
  • FIG. 4C the screwed state of the base member 1 to the tibia 41 is maintained, the coronary ligament 42 is pressed by the contact member 25, and the meniscus 40 is braked.
  • the abutment member 25 abuts against the coronary ligament 42 instead of the meniscus 40 to brake the meniscus 40, which is advantageous in that damage to the meniscus 40 can be prevented.
  • the base member 1 has a screw shape and the contact member 2 has an annular washer shape, but the base portion and the contact portion in the present invention are limited to the shapes shown in the present embodiment. isn't it.
  • a plate fixed to the tibia may be used as the base portion, and this plate may be provided with the contact portion.
  • the contact member 2 has a washer shape.
  • the contact member 2 may be formed in a C shape by providing an opening in a part of the contact member 2 . According to this, the abutment member 2 can be removed from the base member 1 without removing the body portion 10 fixed to the tibia 41 from the tibia 41, which is advantageous when the abutment member 2 is replaced. .
  • the shape of the abutting part in the present invention can be selected from a flat shape or a lightly curved shape that matches the shape of the tibia.
  • a curved plate-shaped contact member 26 can be employed.
  • reduction and braking of the meniscus 40 may be performed using a plurality of base members 1 (two in FIG. 5).
  • the size of the abutment member can be selected from a small shape that abuts only on a part of the meniscus or the coronary ligament, or a shape with a wide front-rear width that abuts widely from the front to the back of the meniscus.
  • the abutment part which has a shape that matches the shape of the tibia and has a wide front-to-rear width, is advantageous for reduction and fixation of the meniscus, which is more prone to prolapse.
  • the main body portion 10 may be provided with the large diameter portion 12 detachably. Accordingly, by removing the large diameter portion 12 from the body portion 10 fixed to the tibia 41, even if the contact member 2 has an annular washer shape, the body portion 10 can be brought into contact without being pulled out from the tibia 41. The member 2 can be removed from the base member 1, which is advantageous when the contact member 2 is replaced.
  • an urging means may be provided to apply tension to the contact portion so that the contact portion contacts the meniscus 40 or the coronary ligament 42 with a predetermined elastic force.
  • the abutment member 26 can be adjusted according to the screwing posture of the base member 1 so that the amount and position of the abutment member 26 pressed against the meniscus 40 and the coronary ligament 42 can be adjusted.
  • 26 may be configured to have a predetermined movable range.
  • the meniscus 40 may be reduced by bringing the abutting part into contact with the .

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

Abstract

L'invention concerne un dispositif de freinage de ménisque avec lequel un ménisque dévié d'une marge de tibia peut être repositionné facilement et de manière fiable, et qui a une structure simple. Le dispositif de freinage de ménisque comprend : une partie de base 1 fixée au tibia ; et une partie de butée 2 supportée par un élément de base 1 et venant en butée sur l'un des bords externes ou sur les deux d'un ménisque 40 s'écartant de la marge de tibia et d'un ligament coronaire 42. L'élément de base 1 comprend une partie d'opération de butée 13 qui déplace un élément de butée 2 dans une direction de repositionnement du ménisque 40 et freine le ménisque 40 à une position prédéterminée.
PCT/JP2022/031983 2021-08-27 2022-08-25 Dispositif de freinage de ménisque WO2023027138A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
JP2021139024A JP2024149928A (ja) 2021-08-27 半月板制動装置
JP2021-139024 2021-08-27
US202163287596P 2021-12-09 2021-12-09
US63/287,596 2021-12-09

Publications (1)

Publication Number Publication Date
WO2023027138A1 true WO2023027138A1 (fr) 2023-03-02

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Family Applications (1)

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PCT/JP2022/031983 WO2023027138A1 (fr) 2021-08-27 2022-08-25 Dispositif de freinage de ménisque

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WO (1) WO2023027138A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08206128A (ja) * 1994-11-16 1996-08-13 David A Mcguire 可橈性手術用ねじ回しおよび関節腔鏡による靭帯再構成術におけるその使用法
JP2015513979A (ja) * 2012-04-04 2015-05-18 スミス アンド ネフュー インコーポレーテッドＳｍｉｔｈ ＆ Ｎｅｐｈｅｗ，Ｉｎｃ． 骨ねじおよび自己保持型ドライバ
US20160074070A1 (en) * 2014-09-12 2016-03-17 Empire Technology Development Llc Meniscal repositioning device

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08206128A (ja) * 1994-11-16 1996-08-13 David A Mcguire 可橈性手術用ねじ回しおよび関節腔鏡による靭帯再構成術におけるその使用法
JP2015513979A (ja) * 2012-04-04 2015-05-18 スミス アンド ネフュー インコーポレーテッドＳｍｉｔｈ ＆ Ｎｅｐｈｅｗ，Ｉｎｃ． 骨ねじおよび自己保持型ドライバ
US20160074070A1 (en) * 2014-09-12 2016-03-17 Empire Technology Development Llc Meniscal repositioning device

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