JP2016083366A - 二頭筋腱固定術送達ツール - Google Patents
二頭筋腱固定術送達ツール Download PDFInfo
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- 230000007246 mechanism Effects 0.000 claims abstract description 79
- 210000002435 tendon Anatomy 0.000 claims abstract description 78
- 238000013519 translation Methods 0.000 claims description 6
- 210000000988 bone and bone Anatomy 0.000 abstract description 59
- 238000000034 method Methods 0.000 abstract description 28
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- 238000004873 anchoring Methods 0.000 abstract 1
- 210000003811 finger Anatomy 0.000 description 40
- 230000001012 protector Effects 0.000 description 30
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- 238000003780 insertion Methods 0.000 description 13
- 230000037431 insertion Effects 0.000 description 13
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- 208000021245 head disease Diseases 0.000 description 1
- 210000002758 humerus Anatomy 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
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- 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
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- A—HUMAN NECESSITIES
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- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0642—Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
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- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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- A—HUMAN NECESSITIES
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- A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
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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
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- A61F2/0805—Implements for inserting tendons or ligaments
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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
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
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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
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
- A61B2017/0648—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks threaded, e.g. tacks with a screw thread
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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
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0823—Modular anchors comprising a plurality of separate parts
- A61F2002/0835—Modular anchors comprising a plurality of separate parts with deformation of anchor parts, e.g. expansion of dowel by set screw
-
- 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
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0841—Longitudinal channel for insertion tool running through the whole tendon anchor, e.g. for accommodating bone drill, guidewire
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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
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0858—Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
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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
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
-
- 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
- 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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- Orthopedic Medicine & Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Surgery (AREA)
- Rheumatology (AREA)
- Cardiology (AREA)
- Rehabilitation Therapy (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Surgical Instruments (AREA)
Abstract
Description
本願は、2014年10月23日出願の米国特許仮出願第62/067,701号、表題「Biceps Tenodesis Implants and Delivery Devices」に対する優先権を主張し、これは本明細書においてその全体を組み込まれる。
組織を骨に固定するための、外科用装置及び方法、より具体的には、二頭筋腱を上腕骨に固定するための、外科用インプラント、供給ツール、及び方法が提示される。
(1) 固定具インサータツールであって、
第1の細長い本体であって、その遠位端から遠位方向に延び、固定具アセンブリのシース内に形成される相対するスロットに沿って延びるように構成された、第1及び第2の突起を有する、第1の細長い本体と、
前記第1の細長い本体に対して摺動自在に配置される第2の細長い本体と、
前記第1及び第2の細長い本体の近位端に連結されたハンドルアセンブリであって、前記ハンドルアセンブリが固定機構を含み、前記固定機構は、前記固定機構が前記第1及び第2の細長い本体の互いに対する移動を防止する固定位置と、前記第1及び第2の細長い本体が互いに対して軸方向に摺動自在である非固定位置との間で可動である、ハンドルアセンブリとを含む、固定具インサータツール。
(2) 前記第1の細長い本体は、内側シャフトを含み、前記第2の細長い本体は、前記内側シャフトの周囲に配置された外側シャフトを含む、実施態様1に記載の固定具インサータツール。
(3) 前記第2の細長い本体は、内側シャフトを含み、前記第1の細長い本体は、前記内側シャフトの周囲に配置された外側シャフトを含む、実施態様1に記載の固定具インサータツール。
(4) 前記第1の細長い本体は、固定具アセンブリのシースに連結されたガイドワイヤの近位端を受容するように構成されたルーメンを含む、実施態様1に記載の固定具インサータツール。
(5) 前記ハンドルアセンブリは、前記ハンドル内に配置されるガイドワイヤと選択的に係合し、その移動を防ぐように構成された、ガイドワイヤロックを含む、実施態様4に記載の固定具インサータツール。
(7) 前記作動装置の回転が前記内側シャフト及び外側シャフトの互いに対する軸方向の並進運動を生じるのに有効であるように、前記作動装置は前記ハンドルアセンブリに対して回転可能である、実施態様6に記載の固定具インサータツール。
(8) 前記作動装置の枢動が前記内側シャフト及び外側シャフトの互いに対する軸方向の並進運動を生じるのに有効であるように、前記作動装置は、前記ハンドルアセンブリに対して枢動可能である、実施態様6に記載の固定具インサータツール。
(9) 前記作動装置は、前記第1の細長い本体から垂直方向に延びる少なくとも1つのハンドルを含む、実施態様6に記載の固定具インサータツール。
(10) 前記作動装置は、前記第1の細長い本体の前記近位端から近位方向に延びている、実施態様6に記載の固定具インサータツール。
(12) 前記ハンドルアセンブリは、静止ハウジング、及び枢動可能なトリガを備えるピストルグリップ構成体を有する、実施態様1に記載の固定具インサータツール。
(13) 前記第1の細長い本体は、内側シャフトを含み、前記第2の細長い本体は、前記内側シャフトの周囲に配置される外側シャフトを含み、前記ハンドルアセンブリは、前記内側シャフトの前記第1及び第2の突起を前記外側シャフト内へと後退させるために、前記内側シャフトを前記外側シャフトに対して近位方向に移動させるように構成された、作動装置を含む、実施態様1に記載の固定具インサータツール。
(14) 腱固定システムであって、
外側シャフトであって、その内部を通じて延びる内側ルーメン、及び前記外側シャフトの遠位端上に形成されるシース位置合わせ突起部を有する、外側シャフトと、
前記外側シャフト内に配置される内側シャフトであって、その遠位端上に形成された第1及び第2の突起を有し、前記突起は、前記突起が前記外側シャフトの前記遠位端を超えて遠位方向に延びる伸長位置と、前記突起が前記外側シャフトの前記遠位端内へと後退する後退位置との間で可動であり、前記突起は、前記外側シャフト上の前記シース位置合わせ突起部の両側に沿って延びている、内側シャフトと、
前記第1及び第2のシャフトそれぞれの近位端に連結されたハンドルアセンブリとを含む、腱固定システム。
(15) 前記シース位置合わせ機構は、ほぼ円錐形の形状を有する、実施態様14に記載の腱固定システム。
(17) 前記外側シャフトの前記遠位端は、閉じており、細長いスロットが、その内部を通じて前記第1及び第2の突起を受容するために、前記外側シャフトの前記遠位端に形成されている、実施態様14に記載の腱固定システム。
(18) 腱を骨に固定するための方法であって、
インサータツールを操作して、前記インサータツールの遠位端に連結されたシースを組織を通じて挿入することであって、前記シースは、これに係合し、前記インサータツールを通じて延びるガイドワイヤを有する、ことと、
前記インサータツールの遠位端上の一対の突起の間に腱を位置付け、前記インサータツールを操作して、前記突起の間にある前記腱と共に、前記シースを、骨孔内へと前進させることであって、前記インサータツールのハンドルアセンブリ上の固定機構は、前記ガイドワイヤ及び前記突起を互いに対して固定位置に維持する、ことと、
前記ハンドルアセンブリ上の前記固定機構を、非固定位置へと移動させ、前記ハンドルアセンブリを操作して、前記突起を前記ガイドワイヤに対して後退させることと、
前記ガイドワイヤが係合した前記シースが前記骨孔内に残るようにして前記インサータツールを取り除くこととを含む、方法。
(19) 前記インサータツールは、第1及び第2のシャフトを含み、前記突起は、前記第1のシャフト上に形成され、前記ハンドルアセンブリを操作して前記突起を前記ガイドワイヤに対して後退させることは、前記第1のシャフトを前記第2のシャフトに対して移動させることを含む、実施態様18に記載の方法。
(20) 前記固定機構は、前記第1のシャフト上のハンドルと、前記第2のシャフト上のハンドルとの間に延びて、前記固定機構が固定位置にあるときに、前記第1及び第2のシャフトの互いに対する移動をブロックする、実施態様19に記載の方法。
Claims (17)
- 固定具インサータツールであって、
第1の細長い本体であって、その遠位端から遠位方向に延び、固定具アセンブリのシース内に形成される相対するスロットに沿って延びるように構成された、第1及び第2の突起を有する、第1の細長い本体と、
前記第1の細長い本体に対して摺動自在に配置される第2の細長い本体と、
前記第1及び第2の細長い本体の近位端に連結されたハンドルアセンブリであって、前記ハンドルアセンブリが固定機構を含み、前記固定機構は、前記固定機構が前記第1及び第2の細長い本体の互いに対する移動を防止する固定位置と、前記第1及び第2の細長い本体が互いに対して軸方向に摺動自在である非固定位置との間で可動である、ハンドルアセンブリとを含む、固定具インサータツール。 - 前記第1の細長い本体は、内側シャフトを含み、前記第2の細長い本体は、前記内側シャフトの周囲に配置された外側シャフトを含む、請求項1に記載の固定具インサータツール。
- 前記第2の細長い本体は、内側シャフトを含み、前記第1の細長い本体は、前記内側シャフトの周囲に配置された外側シャフトを含む、請求項1に記載の固定具インサータツール。
- 前記第1の細長い本体は、固定具アセンブリのシースに連結されたガイドワイヤの近位端を受容するように構成されたルーメンを含む、請求項1に記載の固定具インサータツール。
- 前記ハンドルアセンブリは、前記ハンドル内に配置されるガイドワイヤと選択的に係合し、その移動を防ぐように構成された、ガイドワイヤロックを含む、請求項4に記載の固定具インサータツール。
- 前記ハンドルアセンブリは、前記第1の細長い本体に連結され、前記第1の細長い本体を前記第2の細長い本体に対して軸方向に移動させるように構成されている、作動装置を含む、請求項1に記載の固定具インサータツール。
- 前記作動装置の回転が前記内側シャフト及び外側シャフトの互いに対する軸方向の並進運動を生じるのに有効であるように、前記作動装置は前記ハンドルアセンブリに対して回転可能である、請求項6に記載の固定具インサータツール。
- 前記作動装置の枢動が前記内側シャフト及び外側シャフトの互いに対する軸方向の並進運動を生じるのに有効であるように、前記作動装置は、前記ハンドルアセンブリに対して枢動可能である、請求項6に記載の固定具インサータツール。
- 前記作動装置は、前記第1の細長い本体から垂直方向に延びる少なくとも1つのハンドルを含む、請求項6に記載の固定具インサータツール。
- 前記作動装置は、前記第1の細長い本体の前記近位端から近位方向に延びている、請求項6に記載の固定具インサータツール。
- 前記作動装置は、少なくとも1つのフィンガーループを含む、請求項6に記載の固定具インサータツール。
- 前記ハンドルアセンブリは、静止ハウジング、及び枢動可能なトリガを備えるピストルグリップ構成体を有する、請求項1に記載の固定具インサータツール。
- 前記第1の細長い本体は、内側シャフトを含み、前記第2の細長い本体は、前記内側シャフトの周囲に配置される外側シャフトを含み、前記ハンドルアセンブリは、前記内側シャフトの前記第1及び第2の突起を前記外側シャフト内へと後退させるために、前記内側シャフトを前記外側シャフトに対して近位方向に移動させるように構成された、作動装置を含む、請求項1に記載の固定具インサータツール。
- 腱固定システムであって、
外側シャフトであって、その内部を通じて延びる内側ルーメン、及び前記外側シャフトの遠位端上に形成されるシース位置合わせ突起部を有する、外側シャフトと、
前記外側シャフト内に配置される内側シャフトであって、その遠位端上に形成された第1及び第2の突起を有し、前記突起は、前記突起が前記外側シャフトの前記遠位端を超えて遠位方向に延びる伸長位置と、前記突起が前記外側シャフトの前記遠位端内へと後退する後退位置との間で可動であり、前記突起は、前記外側シャフト上の前記シース位置合わせ突起部の両側に沿って延びている、内側シャフトと、
前記第1及び第2のシャフトそれぞれの近位端に連結されたハンドルアセンブリとを含む、腱固定システム。 - 前記シース位置合わせ機構は、ほぼ円錐形の形状を有する、請求項14に記載の腱固定システム。
- 前記シース位置合わせ機構は、その内部に形成され、前記内側シャフトの前記第1及び第2の突起を受容するように構成された、第1及び第2の相対する切り込みを含む、請求項15に記載の腱固定システム。
- 前記外側シャフトの前記遠位端は、閉じており、細長いスロットが、その内部を通じて前記第1及び第2の突起を受容するために、前記外側シャフトの前記遠位端に形成されている、請求項14に記載の腱固定システム。
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CN105769272A (zh) | 2016-07-20 |
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AU2020201041B2 (en) | 2020-10-29 |
CN105769272B (zh) | 2020-08-18 |
BR102015026750B1 (pt) | 2022-07-05 |
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BR102015026750A2 (pt) | 2016-04-26 |
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AU2015243097B2 (en) | 2019-11-21 |
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EP3020372B1 (en) | 2021-05-19 |
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