CN105125319A - Fixing device for ACL (anterior cruciate ligament) and ALL (anterolateral ligament) integrated reconstruction and usage method - Google Patents
Fixing device for ACL (anterior cruciate ligament) and ALL (anterolateral ligament) integrated reconstruction and usage method Download PDFInfo
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- CN105125319A CN105125319A CN201510627254.0A CN201510627254A CN105125319A CN 105125319 A CN105125319 A CN 105125319A CN 201510627254 A CN201510627254 A CN 201510627254A CN 105125319 A CN105125319 A CN 105125319A
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Abstract
The invention provides a fixing device for ACL (anterior cruciate ligament) and ALL (anterolateral ligament) integrated reconstruction and a usage method. The fixing device comprises a flexible long-strip-shaped body and a flexible annular body connected with the flexible long-strip-shaped body, wherein the annular body is connected with an ACL, and the long-strip-shaped body is used as an ALL. The usage method comprises steps as follows: firstly, the annular body is connected with the ACL; then the long-strip-shaped body is introduced from a thighbone lower insertion bone tunnel and passes through a thighbone upper insertion bone tunnel; finally, the long-strip-shaped body is fixed with an ALL lower insertion bone tunnel. The fixing device can deform elastically and has a certain protecting effect to enable the motion capacity to be restored to the initial level. Meanwhile, only one device is required for realizing fixing for ACL and ALL integrated reconstruction, particularly, the number of formed bone tunnels is reduced, the time is shortened, and the comfort of a patient is improved.
Description
Technical field
The present invention relates to the technical field of the Design for Medical Device of ligament reconstructive, particularly relate to fixture and the using method of a kind of anterior cruciate ligament and front lateral ligament one volume reconstruction.
Background technology
Knee joint is one of human body the most complicated maximum joint, and in actual motion, just simple flexion movement, also has the rotation of tibia, and the three-dimensional motion of the series of complex such as the rolling of femur ankle on tibia and slip.And the motion of this series of complex is all rely on the tendon of knee joint peripheral and tough bringing to keep joint balance at the volley and steady statue.Anterior cruciate ligament (Anteriorcruciateligament is called for short ACL) restricted tibia reach and adjustment portion spinfunction.
But make numerous doctor and patient's puzzlement for many years, tears of anterior cruciate ligament is through reconstruction Post operation, and the motor capacity of a lot of patient still cannot return to initial level.In these cases, patient generally can be subject to the puzzlement of rotational slack (rotationallaxity).Even if utilize the mode that two-beam is fixing, the effect of lasting rotational slack still can not be reduced.Meanwhile, up-to-date medical advances finds tears of anterior cruciate ligament tearing usually along with front lateral ligament (Anterolateralligament is called for short ALL), and front lateral ligament has important biomechanical function in motion of knee joint.The chances are 2 inches (5.08 centimetres) for the length of front lateral ligament, is positioned at (Anterolateral) direction, kneed front outside, connects the front outside of femur and tibia.
And existing surgical technic takes anterior cruciate ligament and front lateral ligament can open independent fixing method, all there is following defect:
1, anterior cruciate ligament and front lateral ligament are separately fixing, need four Ge Gu roads, because close together between ALL femur bone road and ACL femur bone road, may there is mutual interference.ALL tibial bone road and articular surface almost parallel, because ALL tibia stop distance articular surface only 1cm, bone road and articular surface hypotelorism, the possibility injuring articular surface is had in operating process, postoperative also may cause articular cartilage under bone mass not good, easy initiation cartilage degeneration, easily causes the situations such as fracture when knee joint is again injured.
2, when ACL and ALL rebuilds simultaneously, (ALL damages seldom separately, in most cases damages with ACL simultaneously) needs two grafts, but every bar graft is not all fully used in fact, causes unnecessary waste.Because external most doctor selects Heterogeneous tendon when rebuilding ALL, considerably increase surgery cost.
3, the operating time is longer, because will weave two grafts, need preparation to offer four Ge Gu roads, operation technique is comparatively complicated simultaneously, and operating time extends, and more fixture and graft increase the incidence rate of postoperative complication simultaneously.
It is simultaneous that cross ligament damage in view of more than 80% and front lateral ligament are torn, therefore, can design and can have simplification operation method, and the using method of the fixture that the occurrence probability reducing complication and a kind of anterior cruciate ligament and front lateral ligament integral type that reduce operation cost are rebuild and this device is those skilled in the art's urgent problems.
Summary of the invention
The object of this invention is to provide the fixture of a kind of anterior cruciate ligament and front lateral ligament one volume reconstruction, the problem that anterior cruciate ligament and front lateral ligament are torn simultaneously can be solved, improve the fastness of ligament and recover the stability in joint, avoid producing the postoperative various complication of conventional anterior cruciate ligament, and reduce medical treatment cost.
Technical scheme provided by the invention is as follows:
The strip body of one flexibility, and the flexible annular body be connected with described strip body;
Described annular body is used for being connected with described anterior cruciate ligament, and described strip body is used as front lateral ligament.
The annular body of flexibility is connected with anterior cruciate ligament by the technical program, and the strip body of flexibility can directly as front lateral ligament, and annular body and strip body link into an integrated entity, and can realize anterior cruciate ligament and front lateral ligament one volume reconstruction is fixed.Not only structure is simple, easy to use, and cost is lower.
In the above-mentioned improvement technically carried out, described strip body is by the band shape of a kind of braiding in polyethylene yarn or terylene, and its surface is formed with multiple mesh.
The function of ligament, for strengthening joint, is safeguarded joint at the volley stable, and is limited its activity surmounting physiological range.When suffering violence, producing non-physiologic movable, when ligament is pulled and exceedes its tolerance, namely can damage.Therefore, the ligament rebuild need keep original balance and stability, also need to keep certain elasticity simultaneously, so utilize the banded strip body that yarn or terylene woven are formed, and be connected and fixed Hou Yugu road by strip body and annular body and fix, make it reach the function of front lateral ligament.
In the improvement of the another kind of mode of above-mentioned technical work, described annular body is by threads and around forming.
By threads and around form annular body, the intensity of annular body can be improved.Meanwhile, adopt yarn and around the annular body formed, there is certain flexibility deformation can occur on the basis ensureing fixing anterior cruciate ligament, conveniently introduce from bone road.
On above-mentioned carrying out preferably, annular body diameter is 6mm.
Preferably, described strip body cross-section width is 4mm, and length is 7cm, and thickness is 0.5mm.
Preferably, the surperficial mesh number of strip body is arranged between 100 order ~ 120 orders.
By above-mentioned structure can understandablely be arrange annular body and strip body in use need to meet original ligament structure as far as possible, not only can improve the comfort level of patient, and avoid redundance cause unnecessary waste and reduce the probability that pathological changes occurs.So the further cross section to strip body, length and thickness limit.And the difference of surperficial mesh number, object is the size by change mesh number and braided diameter in braiding process, makes it meet the structure of original ligament, improves comfort level.
Another object of the present invention is to provide a kind of using method of fixture, and described fixture is the fixture of above-mentioned anterior cruciate ligament and front lateral ligament one volume reconstruction, comprises the steps: in use procedure
A), described annular body is connected with anterior cruciate ligament;
B), by described strip body introduce from tibia lower dead center bone road, through femur top dead centre station track;
C), described strip body and front lateral ligament lower dead center bone road are fixed.
The using method of fixture provided by the invention, only needs a graft, and on femur, offer a Ge Gu road, offers one to Liang Gegu road on tibia simultaneously, and solution anterior cruciate ligament and front lateral ligament tear problem simultaneously.Can surgical procedure be simplified, shorten operating time, obtain the recovery knee Stability of firm stable with minimum cost, avoid producing the postoperative various complication of conventional anterior cruciate ligament.
Preferably, described strip body is drilled with tibia lower dead center bone road and front lateral ligament lower dead center bone road before introducing in advance on tibia, and on femur, being drilled with femur top dead centre station track and front lateral ligament top dead centre bone road, femur top dead centre station track and front lateral ligament top dead centre bone road are same bone road.
The bone road object offered in advance facilitates strip body therefrom introduce and fix, and lateral ligament lower dead center bone road and the femur top dead centre station track offered on femur are same bone road before offering on tibia, that can reduce bone road offers quantity, simplify procedures, avoid reducing patient comfort degree simultaneously.
Preferably, described annular body and described anterior cruciate ligament are sewed up.
Because ligament has certain elasticity, according to this, can when ligament generation elasticity, can there is elastic deformation in flexible strip body, avoid the elastic effect affecting ligament.
In sum, the fixture of anterior cruciate ligament of the present invention and front lateral ligament one volume reconstruction and using method, following at least one beneficial effect can be brought:
1, fixture of the present invention can realize a volume reconstruction of anterior cruciate ligament and front lateral ligament, is particularly useful for anterior cruciate ligament and front lateral ligament when tearing simultaneously.
2, fixture of the present invention forms the connection of the ring-shaped body of front lateral ligament and flexibility by flexible strip body, the structure of suitable ligament, realize controlling the inward turning stability of knee joint when flexing 30 degree ~ 90 degree, avoid kneed " pivot shift test " positive.The collaborative fixed effect strengthening anterior cruciate ligament, recovers kneed former normal function further simultaneously.
3, the yarn of fixture of the present invention by flexibility or the band shape of terylene woven, and be formed with multiple mesh on the surface, ligament generation elastic deformation can not be affected, and the mesh breathability formed is better.
What 4, fixture overall structure of the present invention was arranged is close with the structure comparison of ligament own, does not affect the comfort level of patient, and can not cause unnecessary waste, reduces the probability that complication occurs.
5, in fixture use procedure of the present invention, there is good, suitable elasticity capacity, can fit tightly with ligament, form the protective layer of ligament outside, prevent ligament in motor process from again tearing.
6, the present invention can reduce in operation the quantity offering bone road, reduces operating time, avoids bringing discomfort to patient.Reduce in operating process simultaneously and have possibility injuring articular surface, reduce postoperative may cause articular cartilage under bone mass not good, easily cause cartilage degeneration, when knee joint is again injured, easily cause the situation generations such as fracture.
7, structure of the present invention is simple, and it is convenient, applied widely to introduce.
8, utilization rate of the present invention is high, reduces operation cost, reduces and send out disease odds, and enable motor capacity return to initial level.
Accompanying drawing explanation
Below by clearly understandable mode, accompanying drawings preferred implementation, is further described the above-mentioned characteristic of the fixture that a kind of anterior cruciate ligament and front lateral ligament integral type are rebuild, technical characteristic, advantage and implementation thereof.
Fig. 1 is the structural representation of the fixture of specific embodiment anterior cruciate ligament and front lateral ligament one volume reconstruction;
Fig. 2 is the perspective view in specific embodiment after the expansion of strip body;
Fig. 3 is the application schematic diagram of the fixture of anterior cruciate ligament and front lateral ligament one volume reconstruction in specific embodiment;
Drawing reference numeral illustrates:
Strip body 1; Mesh 11; Lateral plate 12
Annular body 2;
Tibia 3; Tibia lower dead center bone road 31; Front lateral ligament lower dead center bone road 32;
Femur 4; Femur top dead centre station track 41; Front lateral ligament top dead centre bone road 42.
Detailed description of the invention
In order to be illustrated more clearly in the embodiment of the present invention or technical scheme of the prior art, contrast accompanying drawing is illustrated the specific embodiment of the present invention below.Apparently, accompanying drawing in the following describes is only some embodiments of the present invention, for those of ordinary skill in the art, under the prerequisite not paying creative work, other accompanying drawing can also be obtained according to these accompanying drawings, and obtain other embodiment.
In embodiments of the invention one, referring to Fig. 1, it is the structural representation of the fixture of anterior cruciate ligament of the present invention and front lateral ligament one volume reconstruction.This fixture is the strip body 1 of a flexibility, and the flexible annular body 2 be connected with strip body 1, and annular body 2 is for being fixedly connected with anterior cruciate ligament, and strip body 1 is directly used as front lateral ligament.
Flexible strip body 1, by the band shape of a kind of braiding in polyethylene yarn or terylene, can select all the other suitable flexible materials as the material of braiding strip body 1, with the needs of satisfied treatment according to specific circumstances.
Flexible strip shape body 1 one end connects flexible annular body 2, and flexible annular body 2 is by threads and around forming, and around after annular body 2 diameter be 6mm, concrete and around time can be three, the yarn of 2mm by diameter and be coiled into, or directly by an one thread and around forming, yarn and around concrete the determining according to actual diameter of radical, only need meet and around after the diameter of annular body 2 at about 6mm.
It should be noted that fixture in the present embodiment is not before using, strip body 1 and annular body 2 can be distinguished prefabricated separately.Be likely by the instruction of different manufacturers according to the present embodiment, make strip body 1 and annular body 2 respectively, then undertaken supportingly forming one group of fixture completed by another producer, carry out for third party.
Strip body 1 in the present embodiment can combine by lateral plate 12 as shown in Figure 2, certainly can be made up of independent lateral plate 12 in other examples, also mutually can be bonded to be connected and fixed after folding by a lateral plate 12 and form, specifically can do rational adjustment according to width needed for strip body 1, also can directly weave the sleeve-shaped with certain length, directly cut during use.Do not repeating one by one in the application.
Referring to Fig. 1, strip body 1 surface is formed with multiple mesh 11, and mesh 11 concrete shape can be rectangle, square or changeable, does not affect growth promoter before only needing to meet formation after lateral ligament on remaining tissue.
Can, by strip body 1 one end through after annular body 2, one end and the other end of passing ring body 2 be sewed up fixing when strip body 1 and annular body 2 practical combinations.Maybe one end cut to lengthen through ring body 2 itself to be flushed with strip body 1 at about 2.5cm and sew up, specifically can select to sew up in which way according to the thickness of the strip body 1 woven in advance, only need meet the THICKNESS CONTROL of the strip body 1 after stitching at about 0.5mm, can processing technology be simplified, reduce unnecessary waste.Wherein, when it should be noted that stitching, ultra-high molecular weight polyethylene suture can be adopted together, and the fixture avulsion power after sewing up is not less than 2500N, improves the pull resistance of whole device.
Again referring to Fig. 1, for making the fixture of design more true to nature with actual ligament structure, improve comfort level, so the strip body 1 in said structure is designed to band shape, banded strip body 1 cross-sectional width is arranged on about 4mm (namely lateral ligament diameter), and cut to lengthen is at about 7cm, and THICKNESS CONTROL is at 0.5mm (owing to being directly be used as front lateral ligament, so relative thickness is thicker).
And annular body 2 is mainly used in strip body 1 and anterior cruciate ligament to play certain effect that is fixedly connected with, so in the application by its diameter control at about 6mm, the convenient introducing from bone road of simultaneously flexible annular body 2 deforms, therefore, the long incidence rate causing more fixture and graft to increase postoperative complication is prevented.
Wherein, for improving the tensile strength of annular body 2, the tensile strength that need meet annular body 2 part is not less than 3000N, and elongation at break is not less than 6%; And the tensile strength of strip body 1 part of band shape is not less than 2500N, elongation at break is not less than 15%; And then the pull resistance realized when running, make it return to initial level.
When strip body 1 in above-described embodiment and annular body 2 specifically weave, the mesh number changing surface can be passed through by strip body 1, realize the control to width.The banded strip body 1 of certain length can be woven in advance during concrete braiding, length can be controlled in about 10cm, then one end of strip body 1 is passed and the annular body 2 turned to, in the application, preferred folded length is 2.5cm, folded part ultra-high molecular weight polyethylene suture is fixed together, and the length that stitching is fixed is not less than 2cm, specifically certain OK a karaoke club intensity can be ensured.The length of whole device all controls in certain digital scope, and object avoids longly affecting fixing, prevents from causing complication.Simultaneously for simplifying processing technology, aforesaid weaving method can be carried out circulation braiding, making multiple strip body 1 integral continuously, directly carry out cutting according to Len req during use.
Referring to Fig. 3, when the anterior cruciate ligament of above-described embodiment and the fixture of front lateral ligament one volume reconstruction specifically use, be different from conventional ligament reconstructive method, what the method that the fixture in the present invention uses adopted is that a strip body 1 and annular body 2 link into an integrated entity, and the bone number of channels offered also reduces to some extent, concrete using method is as follows:
A), described annular body is connected with anterior cruciate ligament;
B), by described strip body introduce from tibia lower dead center bone road, through femur top dead centre station track;
C), described strip body and front lateral ligament lower dead center bone road are fixed.
Strip body 1 in the present invention is connected and fixed in Hou Xuconggu road with ring-type 2 and introduces, therefore, operative doctor is drilled with tibia lower dead center bone road 31 and front lateral ligament lower dead center bone road 32 in advance on tibia 3 before being introduced, and on femur 4, be drilled with femur top dead centre station track 41 and front lateral ligament top dead centre bone road 42.Because fixture in the application is a strip body 1, therefore, the femur top dead centre station track 41 that femur 4 is offered can be same bone road with front lateral ligament top dead centre bone road 42, can reduce operation Zhong Gu road and offer quantity, reduce operating time.
Wherein, before strip body 2 is introduced, also need annular body 2 and anterior cruciate ligament to sew up to fix, stitching thread also can adopt ultra-high molecular weight polyethylene suture, or other sutures, only need reach medical, when anterior cruciate ligament pulls during motion, elastic deformation can be realized by annular body 2.Simultaneously for improving the stability of the fixture of installing, peg button (endoubutton can be used at tibia station track stop 31, do not indicate in figure) fixing, also can fix with extrusion screw, femur top dead centre station track 41 place extrusion screw is fixed, and finally fixes at front lateral ligament lower dead center bone road 32 place extrusion screw.Because this fixture is that the strip body 1 of a flexibility and annular body 2 are formed; even if still certain elasticity can be kept so be fixed respectively at three Ge Gu road places; and play more protection effect to the outside of ligament, the ligament rebuild that prevents from overexerting is torn again.
Fixture in above-described embodiment, also can use under special circumstances, such as can when strip body 1 be introduced from tibia lower dead center bone road, in advance annular body 2 and graft are sewed up fixing, then strip body 1 is introduced from tibia lower dead center bone road, through femur top dead centre station track, finally fixing with front lateral ligament lower dead center bone road.Wherein, it should be noted that graft can be autologous four reducing by half tendon Gracilis tendon or autologous two folding Hams graft of folding.
It should be noted that above-described embodiment all can independent assortment as required.The above is only the preferred embodiment of the present invention; it should be pointed out that for those skilled in the art, under the premise without departing from the principles of the invention; can also make some improvements and modifications, these improvements and modifications also should be considered as protection scope of the present invention.
Claims (9)
1. a fixture for anterior cruciate ligament and front lateral ligament one volume reconstruction, is characterized in that, comprising:
The strip body of one flexibility, and the flexible annular body be connected with described strip body;
Described annular body is used for being connected with described anterior cruciate ligament, and described strip body is used as front lateral ligament.
2. the fixture of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction, is characterized in that:
Described strip body is by the band shape of a kind of braiding in polyethylene yarn or terylene, and its surface is formed with multiple mesh.
3. the fixture of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction, is characterized in that:
Described annular body is by threads and around forming.
4. the fixture of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction, is characterized in that:
Described annular body diameter is 6mm.
5. the fixture of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction, is characterized in that:
Described strip body cross-section width is 4mm, and length is 7cm, and thickness is 0.5mm.
6. the fixture of anterior cruciate ligament according to claim 1 and front lateral ligament one volume reconstruction, is characterized in that:
The surperficial mesh number of described strip body is arranged between 100 order ~ 120 orders.
7. a using method for fixture, is characterized in that:
The anterior cruciate ligament of described fixture according to any one of claim 1-6 and the fixture of front lateral ligament one volume reconstruction, comprise the steps: in use procedure
A), described annular body is connected with anterior cruciate ligament;
B), by described strip body introduce from tibia lower dead center bone road, through femur top dead centre station track;
C), described strip body and front lateral ligament lower dead center bone road are fixed.
8. the using method of fixture according to claim 7, is characterized in that:
Described strip body is drilled with tibia lower dead center bone road and front lateral ligament lower dead center bone road before introducing in advance on tibia, and on femur, being drilled with femur top dead centre station track and front lateral ligament top dead centre bone road, femur top dead centre station track and front lateral ligament top dead centre bone road are same bone road.
9. the using method of fixture according to claim 7, is characterized in that:
Described annular body and described anterior cruciate ligament are sewed up.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201510627254.0A CN105125319B (en) | 2015-09-28 | 2015-09-28 | The fixing device and using method of one volume reconstruction of ACL and front lateral ligament |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201510627254.0A CN105125319B (en) | 2015-09-28 | 2015-09-28 | The fixing device and using method of one volume reconstruction of ACL and front lateral ligament |
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| CN105125319A true CN105125319A (en) | 2015-12-09 |
| CN105125319B CN105125319B (en) | 2017-03-15 |
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Cited By (1)
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| CN109662809A (en) * | 2019-01-23 | 2019-04-23 | 北京大学人民医院(北京大学第二临床医学院) | A kind of bionical tumorous type knee-joint prosthesis |
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| CN105125319B (en) | 2017-03-15 |
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