JP6764966B2 - 骨インプラントの固定法 - Google Patents
骨インプラントの固定法 Download PDFInfo
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- JP6764966B2 JP6764966B2 JP2019037289A JP2019037289A JP6764966B2 JP 6764966 B2 JP6764966 B2 JP 6764966B2 JP 2019037289 A JP2019037289 A JP 2019037289A JP 2019037289 A JP2019037289 A JP 2019037289A JP 6764966 B2 JP6764966 B2 JP 6764966B2
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
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- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
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- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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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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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Cardiology (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Neurology (AREA)
- Physical Education & Sports Medicine (AREA)
- Dentistry (AREA)
- Prostheses (AREA)
Description
[0001]本願は、参照により本明細書に組み込まれる、2013年3月15日に出願され「FIXATION OF BONE IMPLANTS」と題された米国仮特許出願第61/789、158号に基づく通常出願である。
6は、インプラント30の一体部分として、またはインプラント30の付属品として形成されうる。突出部54は、突出部54に加えられる張力に耐えうる任意の材料で形成することができ、この材料は、支持層34を作るのに使用される材料に類似することになる。
めに、脛骨122に形成された穴にぴったり収まる。図9に示されるように、インプラント110が完全に設置されると、インプラント110を脛骨122に対して緊張状態に保持するスクリュー118の対が存在することになる。1つの突出部114およびスクリュー118のみを使用して脛骨122にインプラントを固定させられることも企図されている。
第1の長さL1を経て進むにつれて、外側縁部260は、杭256にD1未満の全径を与えるように互いに向かって押され、杭256が穴266を経て前進するのを可能にする。縁部260の最大直径d2が第2の長さL2に達するように杭256が進むと、縁部260は互いに離れる方向に広がって、杭256に最大直径d2に近い全径を与える。このことが起こると、縁部260が、穴266内の第1の長さL1と第2の長さL2との交差部において大腿骨268に当接することになるので、杭256は、容易には大腿骨268から引き抜かれえない。杭256は、PEEK、チタン、コバルトクロム、吸収性材料、または他のポリマー材料を含む、そのような用途に適した強度をもたらす任意の材料から作られうる。
以上説明したように、本発明は以下の形態を有する。
[形態1]
関節面、および前記関節面に対向する整合面を有する、関節トレイと、
前記整合面に接続され、かつ、第1の接続面および前記第1の接続面に対向する第2の接続面を有し、前記第1の接続面が前記整合面に接続される、支持トレイと、
前記第2の接続面に接続される骨内部成長層とを含む、整形外科用インプラント。
[形態2]
前記骨内部成長層が、前記骨内部成長層内への骨の内部成長を促すように構成された、全体に形成された複数の細孔を含む、形態1に記載の整形外科用インプラント。
[形態3]
前記骨内部成長層が、前記複数の細孔のうちの少なくとも1つの細孔内に少なくとも1つの生物学的に活性のある物質を有する、形態2に記載の整形外科用インプラント。
[形態4]
前記支持層が、少なくとも1つの治療剤を保持するように構成され内設された貯槽と、前記第2の接続面を貫通して形成された複数の開口部とを有し、前記複数の開口部が、前記貯槽を骨内部成長層に流体的に接続する、形態3に記載の整形外科用インプラント。
[形態5]
前記支持層が露出面を有し、前記貯槽へのポートが前記露出面を貫通して形成される、形態4に記載の整形外科用インプラント。
[形態6]
前記整形外科用インプラントが、大腿骨インプラントおよび脛骨インプラントのうちの1つとして構成される、形態2に記載の整形外科用インプラント。
[形態7]
前記支持層が、前記整合面および前記骨内部成長層のうちの少なくとも1つに分離可能に接続される、形態5に記載の整形外科用インプラント。
[形態8]
前記整合面を前記第1の接続面に接続するポリマー保持層をさらに含む、形態5に記載の整形外科用インプラント。
[形態9]
関節面、および前記関節面に対向する整合面を有する、関節構成要素と、
前記整合面に接続され、かつ、第1の面、前記第1の面に対向する第2の面、および少なくとも1つの突出部を有する本体構成要素であって、前記第1の面が、前記整合面に接続され、また、前記少なくとも1つの突出部が、前記第2の面から離れる方向に延在し、かつ、張力により組織構造の方へ付勢されるように構成されている、本体構成要素とを含む、整形外科用インプラント。
[形態10]
前記本体構成要素が、前記関節構成要素に接続される支持構成要素と、前記支持構成要素に接続される骨固定構成要素とを含む、形態9に記載の整形外科用インプラント。
[形態11]
前記少なくとも1つの突出部が、前記第2の面に対して角度を付けられる、形態10に記載の整形外科用インプラント。
[形態12]
前記少なくとも1つの突出部が、前記支持構成要素および前記骨固定構成要素のうちの少なくとも一方の一体部分である、形態10に記載の整形外科用インプラント。
[形態13]
前記少なくとも1つの突出部に接続された張力部材をさらに含む、形態10に記載の整形外科用インプラント。
[形態14]
前記張力部材が、アンカー、および前記アンカーを前記少なくとも1つの突出部に接続する張力伝達手段を含む、形態13に記載の整形外科用インプラント。
[形態15]
前記少なくとも1つの突出部が穴を有し、前記穴は、前記穴用に形成された入口を有する、形態10に記載の整形外科用インプラント。
[形態16]
前記少なくとも1つの突出部が、前記入口に隣接して前記穴の内側および外側のうちの一方に形成されたロッキング特徴を有する、形態15に記載の整形外科用インプラント。
[形態17]
前記ロッキング特徴に接続される張力部材をさらに含む、形態16に記載の整形外科用インプラント。
[形態18]
前記第2の面に結合される骨接着剤をさらに含む、形態13に記載の整形外科用インプラント。
[形態19]
整形外科用インプラントの埋め込み方法であって、
関節面、および前記関節面に対向する整合面を有する、関節構成要素と、第1の面、前記第1の面に対向する第2の面、および少なくとも1つの突出部を有し、前記第1の面が前記整合面に接続されており、また、前記少なくとも1つの突出部が前記第2の面から離れる方向に延在している、前記整合面に接続される本体構成要素とを含む、整形外科用インプラントを用意するステップと、
埋め込みのための組織部位を準備するステップと、
前記準備された組織部位に前記整形外科用インプラントを設置するステップと、
前記準備された組織部位に前記整形外科用インプラントを押し込むために、前記少なくとも1つの突出部に張力を加えるステップとを含む、方法。
[形態20]
前記準備するステップが、前記組織部位を切除して、前記整形外科用インプラントが前記準備された組織部位内に配置されたときに前記突出部へのアクセスをもたらす少なくとも1つの穴を前記組織部位に作ることを含む、形態19に記載の方法。
Claims (14)
- トルキング端部と、その内部に形成された内側チャンバと、分離間隙によって分離された少なくとも二つの嵌合特徴とを有し、前記分離間隙が前記内側チャンバの中に延在し、前記少なくとも二つの嵌合特徴のうち少なくとも一つが、前記少なくとも二つの嵌合特徴の幅が大きくなる第一テーパ付け部分と前記少なくとも二つの嵌合特徴の前記幅が小さくなる第二テーパ付け部分とを有し、前記少なくとも二つの嵌合特徴は、整形外科用インプラントと嵌合可能である、本体と、
前記本体の前記内側チャンバの中に取り外し可能に設置された支持部材であって、前記少なくとも二つの嵌合特徴の間の前記分離間隙を少なくとも部分的に充填する支持部分を有する、支持部材とを含む、整形外科用スクリューであって、
前記少なくとも二つの嵌合特徴は、前記トルキング端部の反対側の端部に配置され、前記整形外科用スクリューは、ねじの直径を画定する複数のねじ山を有し、前記少なくとも二つの嵌合特徴の前記幅は前記ねじの直径より小さい、整形外科用スクリュー。 - 前記分離間隙が、前記本体に形成された割れ目である、請求項1に記載の整形外科用スクリュー。
- 前記支持部分が、前記少なくとも二つの嵌合特徴が互いに向かって前進することを干渉する、請求項1に記載の整形外科用スクリュー。
- 前記支持部分が前記分離間隙を充填する、請求項1に記載の整形外科用スクリュー。
- 前記内側チャンバがその中にねじ山を有し、前記支持部材が、本体ねじ山が形成されたスクリュー本体を有する内部スクリューであり、前記スクリュー本体の前記本体ねじ山が前記内部スクリューの前記ねじ山と係合し、前記支持部材を前記本体に取り外し可能に接続する、請求項1に記載の整形外科用スクリュー。
- 前記内側チャンバが内側幅を画定し、前記支持部分が前記内側幅より小さい支持幅を画定する、請求項1に記載の整形外科用スクリュー。
- 前記少なくとも二つの嵌合特徴にはねじ山が形成されていない、請求項1に記載の整形外科用スクリュー。
- 前記本体が、複数のねじ山を有するねじ山部分と、前記ねじ山部分と前記少なくとも二つの嵌合特徴との間のテーパなし部分とを含む、請求項7に記載の整形外科用スクリュー。
- 前記少なくとも二つの嵌合特徴のうちの前記少なくとも一つの嵌合特徴が前記第一テーパ付け部分と前記第二テーパ付け部分との間のテーパなし部分を含む、請求項1に記載の整形外科用スクリュー。
- 本体を含む整形外科用スクリューであって、
前記本体がトルキング端部と、その内部に形成された内側チャンバと、分離間隙によって分離された少なくとも二つの嵌合特徴とを有し、
前記分離間隙が前記内側チャンバの中に延在し、前記少なくとも二つの嵌合特徴のうち少なくとも一つが、前記少なくとも二つの嵌合特徴の幅が大きくなる第一テーパ付け部分と前記少なくとも二つの嵌合特徴の前記幅が小さくなる第二テーパ部分とを有し、前記少なくとも二つの嵌合特徴は、前記整形外科用インプラントと嵌合可能であり、
前記少なくとも二つの嵌合特徴は、前記トルキング端部の反対側の端部に配置され、前記整形外科用スクリューは、ねじの直径を画定する複数のねじ山を有し、前記少なくとも二つの嵌合特徴の前記幅は前記ねじの直径より小さい、整形外科用スクリュー。 - 前記分離間隙が、前記本体に形成された割れ目である、請求項10に記載の整形外科用スクリュー。
- 前記少なくとも二つの嵌合特徴にはねじ山が形成されていない、請求項10に記載の整形外科用スクリュー。
- 前記本体が、複数のねじ山を有するねじ山部分と、前記ねじ山部分と前記少なくとも二つの嵌合特徴との間のテーパなし部分とを含む、請求項12に記載の整形外科用スクリュー。
- 前記少なくとも二つの嵌合特徴のうちの前記少なくとも一つの嵌合特徴が、前記第一テーパ付け部分と前記第二テーパ付け部分との間のテーパなし部分を含む、請求項10に記載の整形外科用スクリュー。
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- 2014-03-12 CA CA2900697A patent/CA2900697C/en active Active
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EP2967888B1 (en) | 2018-09-26 |
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CA2900697A1 (en) | 2014-09-25 |
JP2016512091A (ja) | 2016-04-25 |
WO2014150920A3 (en) | 2015-02-19 |
JP2019103844A (ja) | 2019-06-27 |
US20190151002A1 (en) | 2019-05-23 |
US9681906B2 (en) | 2017-06-20 |
EP3228267A1 (en) | 2017-10-11 |
US11051865B2 (en) | 2021-07-06 |
WO2014150920A2 (en) | 2014-09-25 |
EP2967888A2 (en) | 2016-01-20 |
US20170156870A1 (en) | 2017-06-08 |
EP2967888A4 (en) | 2016-11-16 |
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