JP2001514545A - 物体を骨に係留するための方法及び装置 - Google Patents
物体を骨に係留するための方法及び装置Info
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- JP2001514545A JP2001514545A JP53892698A JP53892698A JP2001514545A JP 2001514545 A JP2001514545 A JP 2001514545A JP 53892698 A JP53892698 A JP 53892698A JP 53892698 A JP53892698 A JP 53892698A JP 2001514545 A JP2001514545 A JP 2001514545A
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- bone
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- 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
- A61F2/0811—Fixation devices for tendons or ligaments
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
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- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0412—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from suture anchor body
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- A61B2017/042—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
- A61B2017/0422—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor
- A61B2017/0424—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor the separate member staying in the anchor after placement
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- A61B2017/0438—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors slotted, i.e. having a longitudinal slot for enhancing their elasticity
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- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
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- 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
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- A—HUMAN NECESSITIES
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- 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
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- A61F2002/0817—Structure of the anchor
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- A61F2002/0829—Modular anchors comprising a plurality of separate parts without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
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- 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
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- A—HUMAN NECESSITIES
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- 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
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0852—Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
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- A—HUMAN NECESSITIES
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- 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
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0888—Anchor in or on a blind hole or on the bone surface without formation of a tunnel
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Abstract
Description
Claims (1)
- 【特許請求の範囲】 1. 物体を骨に結合するためのアンカーであって、 骨に開けた骨穴に挿入するためのもので、近位端と遠位端の間に延長した軸方 向チャンネルを有する第1係留素子と、 前記軸方向チャンネルの内径より大きい外径を有する大径部分を含む挿入ステ ムと、 から成り、前記第1係留素子は、前記挿入ステムに摺動自在に取り付けられてお り、該挿入ステムは、前記軸方向チャンネル内で近位方向へ移動されることによ って該挿入ステムの前記大径部分の少なくとも一部分が該軸方向チャンネルを通 して移動され、それによって、該第1係留素子を拡張させて前記骨穴に締り嵌め させるように配設されていることを特徴とするアンカー。 2. 物体を骨に結合するためのアンカーであって、 骨に開けた骨穴に挿入するためのもので、近位端と遠位端の間に延長した軸方 向チャンネルを有する第1係留素子と、 前記軸方向チャンネルの内径より大きい外径を有する大径部分を含む挿入ステ ムと、 該挿入ステムの該大径部分の遠位側部分に設けられた第2係留素子と、 から成り、 前記第1係留素子は、前記挿入ステムに摺動自在に取り付けられており、該挿 入ステムは、前記軸方向チャンネル内で近位方向へ移動されることによって該挿 入ステムの前記大径部分の少なくとも一部分が該軸方向チャンネルを通して移動 され、それによって、該第1係留素子を拡張させて前記骨穴に締り嵌めさせるよ うに配設されており、該第1係留素子と第2係留素子とは、該挿入ステムの前記 近位方向への移動により該第2係留素子を第1係留素子を被ってカム移動させ、 それによって該第2係留素子の少なくとも一部分を前記骨穴の壁に食い込ませる ように配置されていることを特徴とするアンカー。 3. 前記第2係留素子は、前記第1係留素子を装着した前記挿入ステムを 挿通させるための貫通チャンネルを有していることを特徴とする請求の範囲第2 項に記載のアンカー。 4. 前記第2係留素子は、該第2係留素子の前記チャンネルの壁面と該第 2係留素子の外周面とによって画定される壁を有しており、該壁は、第2係留素 子の近位端から遠位端に向かって延長した複数の軸方向スロットを有し、該スロ ットとスロットの間に画定された可撓壁セクションを有していることを特徴とす る請求の範囲第2項に記載のアンカー。 5. 前記可撓壁セクションは、前記第2係留素子を近位方向へ移動させる 前の状態では該第2係留素子の前記チャンネルに実質的に整列していることを特 徴とする請求の範囲第4項に記載のアンカー。 6. 前記第2係留素子の近位方向への移動により前記可撓壁セクションを 前記第1係留素子を被ってカム移動させ、斜め外方に拡張させて前記骨穴の壁に 食い込ませるように配設されていることを特徴とする請求の範囲第5項に記載の アンカー。 7. 前記第2係留素子の前記チャンネルの少なくとも一部分は、前記第1 係留素子の少なくとも一部分の外径より小さい内径を有していることを特徴とす る請求の範囲第4項に記載のアンカー。 8. 前記第1係留素子は、前記骨穴の壁面に係合するための外周面を有す る実質的に細長い環状部材であることを特徴とする請求の範囲第1又は2項に記 載のアンカー。 9. 前記第1係留素子の外周面は、前記骨穴の壁面に係合するための構造 を有していることを特徴とする請求の範囲第8項に記載のアンカー。 10. 前記第1係留素子の外周面の前記構造は、突起、リッジ又は螺条から 成ることを特徴とする請求の範囲第9項に記載のアンカー。 11. 前記挿入ステムの近位端は、前記軸方向チャンネルの内径より小さい か、又は、該内径より実質的に大きくない外径を有し、該挿入ステムの遠位端が 前記大径部分を構成していることを特徴とする請求の範囲第1又は2項に記載の アンカー。 12. 前記挿入ステムは、その近位端に破壊可能部分を有していることを特 徴とする請求の範囲第11項に記載のアンカー。 13. 前記破壊可能部分は、所定の力を加えられると、破断するようになさ れていることを特徴とする請求の範囲第12項に記載のアンカー。 14. 前記破壊可能部分は、それが破断する前の状態では、該挿入ステムを 介して近位方向の力を伝達し、前記大径部分を前記軸方向チャンネル内で近位方 向へ移動させるようになされていることを特徴とする請求の範囲第13項に記載 のアンカー。 15. 前記挿入ステムは、前記大径部分より遠位側にヘッドを有しているこ とを特徴とする請求の範囲第14項に記載のアンカー。 16. 前記ヘッドは、該ヘッドが前記第1係留素子の遠位端に実質的に衝接 したとき前記軸方向チャンネル内での前記挿入ステムの移動を停止させるように なされていることを特徴とする請求の範囲第15項に記載のアンカー。 17. 縫合糸を該アンカーに結合するための縫合糸リテーナが前記挿入ステ ムに設けられていることを特徴とする請求の範囲第1又は2項に記載のアンカー 。 18. 前記縫合糸リテーナは、それによって保持われた縫合糸が該縫合糸リ テーナを圧縮するようになされていることを特徴とする請求の範囲第17項に記 載のアンカー。 19. 前記縫合糸リテーナは、前記挿入ステムの遠位端に設けられているこ とを特徴とする請求の範囲第18項に記載のアンカー。 20. 前記縫合糸リテーナは、スロット、溝又は孔から成ることを特徴とす る請求の範囲第19項に記載のアンカー。 21. 前記縫合糸リテーナは、前記ヘッドに設けられていることを特徴とす る請求の範囲第18項に記載のアンカー。 22. 前記縫合糸リテーナは、スロット、溝又は孔から成ることを特徴とす る請求の範囲第21項に記載のアンカー。 23. 前記挿入ステムは、縫合糸に係合するためのチャンネルを含むことを 特徴とする請求の範囲第1又は2項に記載のアンカー。 24. 前記挿入ステムの前記大径部分の外周面に、前記軸方向チャンネルに 係合するための複数の突起が形成されていることを特徴とする請求の範囲第1又 は2項に記載のアンカー。 25. 物体を骨に結合するための、アンカーを含むシステムであって、該ア ンカーは、 A. 挿入ステムと、 B. 該挿入ステムに被せられ、骨に開けた骨穴に挿入するためのもので、 近位端と遠位端の間に延長した軸方向チャンネルと、該骨穴の壁面に係合するた めの外周面を有する実質的に細長い第1係留素子と、 C. 前記挿入ステムの、前記第1係留素子より遠位側の部位に取り付けら れており、前記軸方向チャンネルの少くとも一部分の内径より大きい外径を有す るエキスパンダー素子とを含み、 D. 前記エキスパンダー素子と前記第1係留素子とは、前記挿入ステムを 前記軸方向チャンネル内で近位方向へ移動させると、該エキスパンダー素子の少 なくとも一部分が該軸方向チャンネルを通して移動され、それによって、該第1 係留素子を拡張させて前記骨穴に締り嵌めさせるように配置されていることを特 徴とするシステム。 26. 前記挿入ステムを前記軸方向チャンネル内で近位方向へ移動させるた めの展開機構が該挿入ステムに連結されており、該展開機構は、前記第1係留素 子の前記骨穴内での移動を制限するために該第1係留素子に少くとも接触するよ うになされていることを特徴とする請求の範囲第25項に記載のシステム。 27. 前記アンカーは、前記挿入ステムの、前記エキスパンダー素子より遠 位側の部位に設けられた第2係留素子を含む、該第1係留素子と第2係留素子と は、該挿入ステムの近位方向への移動により該第2係留素子を第1係留素子を被 ってカム移動させ、それによって該第2係留素子の少なくとも一部分を前記骨穴 の壁に食い込ませるように配置されていることを特徴とする請求の範囲第25又 は26項に記載のシステム。 28. 前記展開機構は、前記挿入ステムが前記軸方向チャンネル内を近位方 向へ移動している間、前記第1係留素子の少くとも近位端の移動を制限するよう に該第1係留素子の近位端に少くとも接触するようになされていることを特徴と する請求の範囲第25又は26項に記載のシステム。 29. 前記展開機構によって前記挿入ステムに及ぼされる引張力は、実質的 に前記第1係留素子を半径方向外方へ拡張させる力に変換されることを特徴とす る請求の範囲第28項に記載のシステム。 30. 前記展開機構は、前記挿入ステムが前記軸方向チャンネル内を近位方 向へ移動している間、前記第1係留素子に互いに反対向きの実質的に等しい力を 及ぼし、それによって該展開機構に及ぼされる正味力を実質的にゼロにするよう に、該第1係留素子に少くとも接触するようになされていることを特徴とする請 求の範囲第25又は26項に記載のシステム。 31. エキスパンダー素子の遠位端の外周面には、該遠位端の、前記軸方向 チャンネルを通しての移動を制止する逆テーパが付されていることを特徴とする 請求の範囲第25又は26項に記載のシステム。 32. 前記挿入ステムは、その近位端に破壊可能部分を有していることを特 徴とする請求の範囲第31項に記載のシステム。 33. 前記破壊可能部分は、前記展開機構によって前記挿入ステムに所定の 力が加えられると、切断されるようになされていることを特徴とする請求の範囲 第31項に記載のシステム。 34. 物体を骨に結合するためのアンカーであって、 骨に開けた骨穴に挿入するためのもので、近位端と遠位端の間に延長した軸方 向チャンネルを有する第1係留素子と、 前記軸方向チャンネルの内径より大きい外径を有する大径部分を含む挿入ステ ムと、 から成り、前記第1係留素子は、前記挿入ステムに摺動自在に取り付けられてお り、前記軸方向チャンネルの壁面と該第1係留素子の外周面とによって画定され る壁を有し、該壁は、少くともその一部分を貫通して延長した少くとも1つのス ロットを有しており、前記挿入ステムは、前記軸方向チャンネル内で近位方向へ 移動されることによって該挿入ステムの前記大径部分の少なくとも一部分が該軸 方向チャンネルを通して移動され、それによって、該第1係留素子を拡張させて 前記骨穴に締り嵌めさせるように配設されていることを特徴とするアンカー。 35. 前記挿入ステムの、前記大径部分より遠位側の部位に取り付けられた 第2係留素子を含み、該第1係留素子と第2係留素子とは、該挿入ステムの前記 近位方向への移動により該第2係留素子を第1係留素子を被ってカム移動させ、 それによって該第2係留素子の少なくとも一部分を前記骨穴の壁に食い込ませる ように配置されていることを特徴とする請求の範囲第34項に記載のアンカー。 36. 前記第1係留素子、第2係留素子及び挿入ステムのうちの少くとも1 つが、生吸収性材料で形成されていることを特徴とする請求の範囲第34又は3 5項に記載のアンカー。 37. 物体を骨に結合する方法であって、 請求の範囲第1項に記載のアンカーをその遠位端を先頭にして骨に開けた骨穴 に挿入する工程と、 前記挿入ステムを前記第1係留素子に対して近位方向へ移動させて、前記大径 部分の少くとも一部分を前記軸方向チャンネルを通して移動させ、それによって 該第1係留素子を拡張させて前記骨穴に締り嵌めさせる工程と、 から成る方法。 38. 物体を骨に結合する方法であって、 請求の範囲第2項に記載のアンカーをその遠位端を先頭にして骨に開けた骨穴 に挿入する工程と、 前記挿入ステムを前記第1係留素子に対して近位方向へ移動させて、(i)前 記大径部分の少くとも一部分を前記軸方向チャンネルを通して移動させ、それに よって該第1係留素子を拡張させて前記骨穴に締り嵌めさせるとともに、(ii) 該第2係留素子を該第1係留素子を被ってカム移動させ、それによって該第2係 留素子の少なくとも一部分を該骨穴の壁に食い込ませる移動工程と、 から成る方法。 39. 前記挿入ステム近位方向へ移動させる間、前記第1係留素子を実質的 に所定位置に保持する保持工程を含むことを特徴とする請求の範囲第37又は3 8項に記載の方法。 40. 前記保持工程は、前記第1係留素子の近位端を保持することによって 行われることを特徴とする請求の範囲第37又は38項に記載の方法。 41. 前記移動工程は、前記第1係留素子を前記骨穴内の実質的に所定位置 に保持したままで前記挿入ステムを該骨穴から引き抜くことによって行われるこ とを特徴とする請求の範囲第37又は38項に記載の方法。 42. 物体を骨に結合する方法であって、 請求の範囲第14項に記載のアンカーをその遠位端を先頭にして骨に開けた骨 穴に挿入する工程と、 前記挿入ステムの前記破壊可能部分に近位方向の力を加えて該挿入ステムを前 記第1係留素子に対して近位方向へ移動させて、前記大径部分の少くとも一部分 を前記軸方向チャンネルを通して移動させ、それによって該第1係留素子を拡張 させて前記骨穴に締り嵌めさせる工程と、 該大径部分の少くとも一部分を前記軸方向チャンネルを通して移動させた後引 き続き前記破壊可能部分に近位方向の力を加えて該破壊可能部分を切り離す工程 と、 から成る方法。 43. 前記近位方向の力は、前記大径部分の少くとも一部分が前記軸方向チ ャンネルを通して移動した後、前記破壊可能部分を前記骨の実質的に表面のとこ ろ又は表面下で切り離すように該破壊可能部分に加えられることを特徴とする請 求の範囲第42項に記載の方法。
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PCT/US1998/004838 WO1998038938A1 (en) | 1997-03-07 | 1998-03-06 | Methods and apparatus for anchoring objects to bone |
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JP2015126949A (ja) * | 2006-09-29 | 2015-07-09 | デピュイ・ミテック・エルエルシー | 大腿骨の固定 |
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US9386977B2 (en) | 2008-12-15 | 2016-07-12 | Smith & Nephew, Inc. | Composite anchor |
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Also Published As
Publication number | Publication date |
---|---|
EP0981299A1 (en) | 2000-03-01 |
JP4068159B2 (ja) | 2008-03-26 |
EP0981299A4 (en) | 2009-07-15 |
EP0981299B1 (en) | 2011-04-27 |
ES2362170T3 (es) | 2011-06-29 |
DE69842240D1 (de) | 2011-06-09 |
US5935129A (en) | 1999-08-10 |
AU6700098A (en) | 1998-09-22 |
WO1998038938A1 (en) | 1998-09-11 |
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