CN105125319B - The fixing device and using method of one volume reconstruction of ACL and front lateral ligament - Google Patents
The fixing device and using method of one volume reconstruction of ACL and front lateral ligament Download PDFInfo
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- CN105125319B CN105125319B CN201510627254.0A CN201510627254A CN105125319B CN 105125319 B CN105125319 B CN 105125319B CN 201510627254 A CN201510627254 A CN 201510627254A CN 105125319 B CN105125319 B CN 105125319B
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- acl
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Abstract
The invention provides the fixing device and using method of one volume reconstruction of a kind of ACL and front lateral ligament, the strip body of a flexibility, and the flexible annular body being connected with the strip body；The annular body is used for being connected with the ACL, and the strip body is used as front lateral ligament.Using method is first to be connected the annular body with ACL；Again the strip body is introduced from shin bone lower dead center bone road, through femur top dead centre station track；Finally the strip body is fixed with front lateral ligament lower dead center bone road.The fixing device of the present invention can occur elastic deformation, and with certain protective effect, make locomitivity remain able to return to initial level.Only need the i.e. achievable ACL of a strip device and one volume reconstruction of front lateral ligament to fix simultaneously, especially also reduce the bone road number for opening up, shorten the time, improve patient comfort.
Description
Technical field
The present invention relates to the technical field of the Design for Medical Device of ligament reconstructive, more particularly to a kind of ACL and front
The fixing device and using method of one volume reconstruction of lateral ligament.
Background technology
Knee joint is one of maximum most complicated joint of human body, is more than simple flexion movement, also in actual motion
There is a rotation of shin bone, and the three-dimensional motion of the series of complex such as rolling and slip of the femur ankle on shin bone.And this is a series of
Complicated motion be all by knee joint peripheral tendon and tough bring holding joint balance at the volley and stable state.
The restricted shin bone reach of ACL (Anterior cruciate ligament, abbreviation ACL) and regulation part rotational work
Energy.
But, make for many years numerous doctors and patient puzzlement, tears of anterior cruciate ligament through reconstruction Post operation,
The locomitivity of a lot of patients still cannot return to initial level.In these cases, patient is typically subject to rotation pine
The puzzlement of relaxation (rotational laxity).The mode that is even fixed using two-beam, can not still reduce lasting rotational slack
Effect.Meanwhile, newest medical advances find that tears of anterior cruciate ligament is frequently accompanied by front lateral ligament (Anterolateral
Ligament, abbreviation ALL) tear, and front lateral ligament has important biomechanical function in motion of knee joint.Front outer
The length of collateral ligament is probably 2 inches (5.08 centimetres), positioned at kneed front outside (Anterolateral) direction, connection
Femur and the front outside of shin bone.
And existing surgical technic takes ACL and front lateral ligament open independent fixed method, exist with
Lower defect：
1st, ACL and front lateral ligament are separately fixed, and need four Ge Gu roads, ALL femur bone roads and ACL femur bones
Because closer to the distance between road, it is understood that there may be interfere.ALL tibial bones road is almost parallel with articular surface, because ALL shin bones stop
Apart from articular surface only 1cm, bone road and articular surface hypotelorism have the possibility for injuring articular surface to point in operating process, postoperative also may be used
Bone mass under articular cartilage can be caused not good, easily cause cartilage degeneration, situations such as knee joint is easily caused fracture when injured again.
2nd, when ACL and ALL is rebuild simultaneously, (ALL is seldom individually damaged, and is in most cases damaged with ACL simultaneously) needs two
Graft, but every graft is not all fully used in fact, causes unnecessary waste.As external majority doctor exists
Heterogeneous tendon is selected when rebuilding ALL, surgery cost is considerably increased.
3rd, the operating time is longer because two grafts will be woven, while four Ge Gu roads need to be prepared to open up, operation technique compared with
For complexity, operating time extends, while more fixture and graft increase the incidence of postoperative complication.
In view of more than 80% cross ligament damage and the tear of front lateral ligament are simultaneous, accordingly, it is capable to no set
Meter can have simplified operation method, and reduce the occurrence probability of complication and reduce a kind of ACL of operation cost
The fixing device that rebuilds with front lateral ligament integral type and the using method of the device, are that those skilled in the art are badly in need of solving
Problem.
Content of the invention
It is an object of the invention to provide a kind of fixing device of one volume reconstruction of ACL and front lateral ligament, can solve
The problem that certainly ACL and front lateral ligament are torn simultaneously, improves the fastness of ligament and recovers stablizing for joint
Property, it is to avoid the postoperative various complication of conventional ACL are produced, and reduces medical treatment cost.
The technical scheme that the present invention is provided is as follows：
The strip body of one flexibility, and the flexible annular body being connected with the strip body；
The annular body is used for being connected with the ACL, and the strip body is used as front lateral ligament.
Flexible annular body is connected by the technical program with ACL, and the strip body of flexibility directly can be made
For front lateral ligament, and annular body is linked into an integrated entity with strip body, it is possible to achieve ACL and front lateral ligament
One volume reconstruction is fixed.It is not only simple in structure, easy to use, and cost is relatively low.
The improvement carried out in above-mentioned technology, the strip body by polyethylene yarn or terylene in a kind of braiding
Banding, its surface is formed with multiple mesh.
The function of ligament is safeguarded joint stablizing at the volley, and limits its work for surmounting physiological range for strengthening joint
Dynamic.When violence is subjected to, non-physiologic activity is produced, when ligament is pulled and exceedes its tolerance, i.e., can be damaged.Therefore,
The ligament of reconstruction need to keep original balance and stability, while also need to keep certain elasticity, so using yarn or washing
The banding strip body that synthetic fibre braiding is constituted, and fixed by the strip body and annular body Hou Yugu roads that are connected,
Reach the function of front lateral ligament.
Make the improvement of another way in above-mentioned technology, the annular body is by threads and around constituting.
By threads and around the annular body for constituting, the intensity of annular body can be improved.Meanwhile, using yarn and around
The annular body of composition, can deform upon on the basis of fixed ACL is ensured with certain flexibility, convenient from
Introduce in bone road.
On above-mentioned carrying out preferably, a diameter of 6mm of annular body.
Preferably, the strip body cross-section width is 4mm, and length is 7cm, and thickness is 0.5mm.
Preferably, the surface mesh mesh number of strip body is arranged between 100 mesh～120 mesh.
By above-mentioned structure can with understandable be that the annular body that arranges and strip body are needed to the greatest extent in use
Amount meets original ligament structure, not only can improve the comfort level of patient, and avoid redundance from causing unnecessary waste
With the probability for reducing pathology.So further limiting to the section of strip body, length and thickness.And surface
The difference of mesh number, it is therefore an objective to by change mesh number and the size of braided diameter during braiding so as to meet original ligament
Structure, improve comfort level.
It is a further object to provide a kind of using method of fixing device, before the fixing device is above-mentioned
The fixing device of one volume reconstruction of ligamentaum cruciatum and front lateral ligament, comprises the steps during use：
A), the annular body is connected with ACL；
B), the strip body is introduced from shin bone lower dead center bone road, through femur top dead centre station track；
C), the strip body is fixed with front lateral ligament lower dead center bone road.
The using method of the fixing device that the present invention is provided a, it is only necessary to graft, and a bone is opened up on femur
Road, while opening up one on shin bone to Liang Gegu roads, solves ACL and front lateral ligament tears problem simultaneously.Can be with
Simplify surgical procedure, shorten operating time, with the recovery knee Stability that minimum cost obtains firm stable, it is to avoid
Produce the postoperative various complication of conventional ACL.
Preferably, shin bone lower dead center bone road is drilled with shin bone in advance before the strip body is introduced and front outside is tough
Band lower dead center bone road, and femur top dead centre station track and front lateral ligament top dead centre bone road, femur top dead centre is drilled with femur
Station track is same bone road with front lateral ligament top dead centre bone road.
The bone road purpose for opening up in advance is to facilitate strip body therefrom to introduce and fixed, and outer before opening up on shin bone
Collateral ligament lower dead center bone road and the femur top dead centre station track that opens up on femur be same bone road, it is possible to reduce bone road is opened up
Quantity, simplifies procedures, while avoiding reducing patient comfort.
Preferably, the annular body is sutured with the ACL.
As ligament has certain elasticity, according to this, can be when there is elasticity in ligament, flexible strip body can be sent out
Raw elastic deformation, it is to avoid affect the elastic effect of ligament.
In sum, the fixing device and using method of one volume reconstruction of ACL of the present invention and front lateral ligament, can
To bring following at least one beneficial effect：
1st, fixing device of the invention can realize a volume reconstruction of ACL and front lateral ligament, be particularly suited for
In the case that ACL and front lateral ligament are torn simultaneously.
2nd, fixing device of the invention forms the ring-shaped sheet of front lateral ligament and flexibility by flexible strip body
The connection of body, the structure of suitable ligament realize inward turning stability of the control knee joint in 30 degree～90 degree of flexing, it is to avoid knee is closed
" pivot shift test " of section is positive.Cooperate with the fixed effect for strengthening ACL simultaneously, further recover kneed former normal
Function.
3rd, the banding of yarn or terylene woven of the fixing device of the invention by flexibility, and be formed with surface many
Individual mesh, does not interfere with ligament and elastic deformation occurs, and the mesh gas permeability for being formed is preferable.
4th, this body structure with ligament that fixing device overall structure of the invention is arranged relatively, not affects relaxing for patient
Appropriateness, and unnecessary waste is not resulted in, reduce the probability that complication occurs.
5th, during fixing device use of the invention, with good, suitable elasticity capacity, can closely paste with ligament
Close, form the protective layer outside ligament, prevent ligament in motion process from tearing again.
6th, the present invention can reduce the quantity for opening up bone road in operation, reduce operating time, it is to avoid bring discomfort to patient.
Reducing simultaneously has the possibility for injuring articular surface in operating process, reduction is postoperative may to cause bone mass under articular cartilage not good, easily
Cause cartilage degeneration, occur situations such as knee joint is easily caused fracture when injured again.
7th, present configuration is simple, and it is convenient to introduce, applied widely.
8th, utilization rate of the present invention is high, reduces operation cost, reduces and send out disease odds, and enable locomitivity extensive
Initial level is arrived again.
Description of the drawings
Below by the way of clearly understandable, preferred embodiment is described with reference to the drawings, to a kind of ACL and front
The above-mentioned characteristic of the fixing device that lateral ligament integral type is rebuild, technical characteristic, advantage and its implementation give furtherly
Bright.
Fig. 1 is the structural representation of the fixing device of one volume reconstruction of specific embodiment ACL and front lateral ligament；
Fig. 2 is the dimensional structure diagram in specific embodiment after the expansion of strip body；
Fig. 3 is that the application of the fixing device of one volume reconstruction of ACL and front lateral ligament in specific embodiment is illustrated
Figure；
Drawing reference numeral explanation：
Strip body 1；Mesh 11；Lateral plate 12
Annular body 2；
Shin bone 3；Shin bone 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.
Specific embodiment
In order to be illustrated more clearly that the embodiment of the present invention or technical scheme of the prior art, below by control description of the drawings
The specific embodiment of the present invention.It should be evident that drawings in the following description are only some embodiments of the present invention, for
For those of ordinary skill in the art, on the premise of not paying creative work, can be obtaining other according to these accompanying drawings
Accompanying drawing, and obtain other embodiments.
In embodiments of the invention one, referring to Fig. 1, it is consolidating for ACL of the present invention and one volume reconstruction of front lateral ligament
Determine the structural representation of device.The fixing device is the strip body 1 of a flexibility, and soft with what strip body 1 was connected
Property annular body 2, annular body 2 be used for be fixedly connected with ACL, and strip body 1 be directly used as before outside tough
Band.
Flexible strip body 1 by polyethylene yarn or terylene in a kind of braiding banding, according to concrete
Situation flexible material that remaining can be selected appropriate as braiding strip body 1 material, with meet treatment needs i.e.
Can.
1 one end of flexible strip shape body connects flexible annular body 2, and flexible annular body 2 is by threads and around structure
Into, and the 2 a diameter of 6mm of annular body after, concrete and around when by three, the yarn of a diameter of 2mm and can be coiled into, or directly
Connect by an one thread and around forming, yarn and around radical specifically determined according to actual diameter, only need to meet and around rear
Annular body 2 diameter in 6mm or so.
It should be noted that the fixing device in the present embodiment is before being not used, strip body 1 and annular body 2 can
Each prefabricated with difference.It is likely to be by different manufacturers according to the teaching of the present embodiment, makes strip body 1 and ring-type respectively
Body 2, then by another producer carry out supporting form one group of fixing device for completing, used for third party.
Strip body 1 in the present embodiment can be as shown in Figure 2 lateral plate 12 combine, certainly in other enforcements
Can be made up of a single lateral plate 12 in example, also the group that is connected can be mutually bonded after folding by a lateral plate 12
Into, specifically can width according to needed for strip body 1 do rational adjustment, it is also possible to direct sleeve of the braiding with certain length
Shape, directly cuts during use.Do not repeating one by one in the application.
Referring to Fig. 1,1 surface of strip body is formed with multiple mesh 11, and 11 concrete shape of mesh can be rectangle, just
Square or changeable, remaining tissue is not affected to grow after lateral ligament before need to only disclosure satisfy that composition.
1 one end of strip body can be passed through after annular body 2 during 2 practical combinations of strip body 1 and annular body,
One end through ring body 2 is fixed with other end suture.Or control one end length through ring body 2 in 2.5cm
Left and right is flushed with strip body 1 in itself and is sutured, and specifically can be selected according to the thickness of the strip body 1 for weaving in advance
Select and sutured in which way, the THICKNESS CONTROL of the strip body 1 after suture need to be only met in 0.5mm or so, can
To simplify manufacture craft, unnecessary waste is reduced.Wherein, it should be noted that superhigh molecular weight polyethylene can be adopted when suturing
Alkene suture is stitched together, and the fixing device avulsion power after suturing improves the pull resistance of whole device not less than 2500N.
Referring again to Fig. 1, for making the fixing device of design more life-like with the ligament structure of reality, comfort level, institute is improved
So that the design of strip body 1 in said structure to become band, 1 cross-sectional width of strip body of banding is arranged on 4mm left sides
Right (i.e. front lateral ligament diameter), and length is controlled in 7cm or so, and THICKNESS CONTROL in 0.5mm (due to being to be directly used as
Front lateral ligament, so relative thickness is thicker).
And annular body 2 is mainly used in for strip body 1 and ACL playing certain effect that is fixedly connected, so
By its diameter control in 6mm or so in the application, while convenient the introducing from bone road of the annular body 2 of flexibility deforms, because
This, prevents the long incidence for causing more fixture and graft to increase postoperative complication.
Wherein, it is the tensile strength that improves annular body 2, the tensile strength that need to meet 2 part of annular body is not less than
3000N, elongation at break are not less than 6%；And the tensile strength of 1 part of strip body of banding is not less than 2500N, fracture is stretched
Long rate is not not less than 15%；And then realize pull resistance when running so as to return to initial level.
During 2 concrete braiding of strip body 1 and annular body in above-described embodiment, can be with strip body 1 by changing
Become the mesh number on surface, realize the control to width.The banding strip sheet of certain length is woven during concrete braiding in advance can
Body 1, length can be controlled in 10cm or so, the annular body 2 that then one end of strip body 1 is passed through and turned to, this Shen
Please in preferably folded length be 2.5cm, the suture of folded portion ultra-high molecular weight polyethylene suture is fixed together, and sutures solid
Fixed length ensure that specifically certain OK a karaoke club intensity not less than 2cm.The length of whole device is controlled in certain numeral
In the range of, it is therefore an objective to avoid long can affect to fix, prevent from causing complication.Simultaneously for simplifying manufacture craft, can will be aforementioned
Weaving method be circulated braiding, make multiple strip bodies 1 continuously integral, directly carried out according to Len req during use
Cut.
Referring to Fig. 3, the fixing device of one volume reconstruction of the ACL of above-described embodiment and front lateral ligament is specifically used
When, different from conventional ligament reconstructive method, the fixing device in the present invention using method use a strip sheet
Body 1 and annular body 2 link into an integrated entity, and the bone road number for opening up also has been reduced, and specific using method is as follows：
A), the annular body is connected with ACL；
B), the strip body is introduced from shin bone lower dead center bone road, through femur top dead centre station track；
C), the strip body is fixed with front lateral ligament lower dead center bone road.
Strip body 1 in the present invention and ring-type sheet 2 are connected in Hou Xuconggu roads and introduce, therefore, in introducing
Front operative doctor is drilled with shin bone lower dead center bone road 31 and front lateral ligament lower dead center bone road 32 in advance on shin bone 3, and in stock
Femur top dead centre station track 41 and front lateral ligament top dead centre bone road 42 is drilled with bone 4.As in the application, fixing device is one
Strip body 1, therefore, the femur top dead centre station track 41 and the front lateral ligament top dead centre bone road 42 that open up on femur 4 can be
Same bone road, can reduce operation Zhong Gu roads and open up quantity, reduce operating time.
Wherein, before strip body 2 is introduced, also need to fix annular body 2 with ACL suture, suture
Ultra-high molecular weight polyethylene suture, or other sutures can be adopted, only medical, ACL during motion need to be reached
Elastic deformation can be realized by annular body 2 during pulling.Simultaneously for improving the stability of the fixing device that installs, can be in shin
Bone station track stop 31 can be fixed with peg button (endoubutton is not indicated in figure), it is also possible to which extrusion screw is fixed, femur
Fixed with extrusion screw at top dead centre station track 41, finally fixed i.e. with extrusion screw at front lateral ligament lower dead center bone road 32
Can.As strip body 1 that the fixing device is a flexibility and annular body 2 are constituted, even if so punishing in three Ge Gu roads
The elasticity for remaining to keep certain is not fixed, and reinforcement protective effect is played in the outside to ligament, prevent the weight that overexerts
The ligament that builds is torn again.
Fixing device in above-described embodiment, also can be used under special circumstances, for example can be in strip body 1 from shin
When bone lower dead center bone road is introduced, in advance annular body 2 is fixed with graft suture, then by strip body 1 under shin bone
Introduce in stop bone road, through femur top dead centre station track, finally fixing with front lateral ligament lower dead center bone road.Wherein, should say
Bright, graft can be autologous four for folding tendon Gracilis tendon or autologous two-fold rope tendon graft by half.
It should be noted that above-described embodiment can independent assortment as needed.The above is only the preferred of the present invention
Embodiment, it is noted that for those skilled in the art, in the premise without departing from the principle of the invention
Under, some improvements and modifications can also be made, these improvements and modifications also should be regarded as protection scope of the present invention.
Claims (6)
1. the fixing device of one volume reconstruction of a kind of ACL and front lateral ligament, it is characterised in that include：
The strip body of one flexibility, and the flexible annular body being connected with the strip body；
The annular body is used for being connected with the ACL, and the strip body is used as front lateral ligament.
2. the fixing device of one volume reconstruction of ACL according to claim 1 and front lateral ligament,
It is characterized in that：
The strip body by polyethylene yarn or terylene in a kind of braiding banding, its surface is formed with multiple
Mesh.
3. the fixing device of one volume reconstruction of ACL according to claim 1 and front lateral ligament,
It is characterized in that：
The annular body is by threads and around constituting.
4. the fixing device of one volume reconstruction of ACL according to claim 1 and front lateral ligament,
It is characterized in that：
The a diameter of 6mm of the annular body.
5. the fixing device of one volume reconstruction of ACL according to claim 1 and front lateral ligament,
It is characterized in that：
The strip body cross-section width is 4mm, and length is 7cm, and thickness is 0.5mm.
6. the fixing device of one volume reconstruction of ACL according to claim 1 and front lateral ligament,
It is characterized in that：
The surface mesh mesh number of the strip body is arranged between 100 mesh～120 mesh.
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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 |
Applications Claiming Priority (1)
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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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| CN105125319B true CN105125319B (en) | 2017-03-15 |
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| CN109662809B (en) * | 2019-01-23 | 2023-05-30 | 北京大学人民医院(北京大学第二临床医学院) | Bionic tumor type knee joint prosthesis |
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