CN1151859A - 用于辫状缝线的单向缝线定位器 - Google Patents

用于辫状缝线的单向缝线定位器 Download PDF

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Publication number
CN1151859A
CN1151859A CN96112181A CN96112181A CN1151859A CN 1151859 A CN1151859 A CN 1151859A CN 96112181 A CN96112181 A CN 96112181A CN 96112181 A CN96112181 A CN 96112181A CN 1151859 A CN1151859 A CN 1151859A
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Prior art keywords
suture
localizer
substrate
passage
copolymer
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Pending
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CN96112181A
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D·C·罗森曼
D·G·希尔
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Johnson and Johnson Medical SAS
Ethicon Inc
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Ethicon SAS
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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
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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
    • A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0448—Additional elements on or within the anchor
    • A61B2017/0451—Cams or wedges holding the suture by friction
    • 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
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • A61F2002/3052—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts unrestrained in only one direction, e.g. moving unidirectionally
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Abstract

一种适用于关节镜外科手术，用于固定辫状缝线之一端的单向可调节缝线定位器，它包括具有一顶端和一基底部分的截头锥体，其中有一通道从顶端延展至基底部，且顶端具有多个从顶端延至基底部的裂隙，并含有至少两个柔韧的指状物；以及用该定位器固定缝线至少一端的方法。

Description

用于辫状缝线的单向缝线定位器
本发明涉及对辫状缝线进行定位的外科用装置。特别地，本发明涉及适用于关节镜手术的单向可调节缝线定位器。
外科医生常常必须在关节镜手术中将韧带与骨连接，将软组织与骨连接或修复韧带的撕裂伤。他们喜好用缝线来完成，因为缝线体积小且强度大。通过将多股缝线打结来固定缝线。然而，在关节镜下打结是相当困难的，因为术者的手指不能接近关节内且术者的视野受限。许多这些步骤是依赖于体外打结来克服这些困难。即使是利用线结推进器和缝线攫取器，对外科医生来讲很快系关节镜下线结仍然困难。因此提供一种对关节镜下外科手术中取代缝线线结的装置对本领域来讲是一显著的贡献。
我们已发现了一种适用于关节镜手术的单向可调节缝线定位器，它能固定辫状缝线的一端，其中该装置包括有一顶端和一基底部份的截头锥体，其中有一通道从顶端延展至基底，而且其顶端具有多个从顶端延至基底的裂隙，从而产生了至少一个柔韧的指状物。
图1为包含一辫状缝线的缝线定位器的透视图。
图2为缝线定位器的前视图。
参考图一，单向可调节缝线定位器为一具有顶端4和基底6的截头锥体。将顶端4和基底连接的是基本上与中心线10呈同心圆状的通道8，中心线10是从基底6的中心延伸到顶端4的中心的一条线。顶端4具有至少两条裂隙12和14，它们一般从顶端延至基底。优选地顶端4具有4条裂隙12、14、16和18，这样分别就形成了指状物20、22、24和26(如图2所示)。指状物20、22、24和26优选具有顶点20a、22a、24a和26a，它们适于包容辫状缝线29，从而使缝线不能从顶端4向基底6移动，而能从基底6向顶端4移动，这是因为指状物20、22、24和26的柔韧性造成的。缝线定位器应具有有足够直径的通道8以允许辫状缝线容易穿过通道8，但该直径也应小至能使指状物20、22、24和26在辫状缝线于通道8内向基座6移动时能抓住该辫状缝线。
在固定缝线之一端的过程中，应将缝线穿过部分组织以进行固定，然后将缝线穿过缝线定位器的通道8。将缝线定位器依缝线的方向进行定位，从而使基底部在缝线上朝组织移动时可与组织接触。定位器将缝线滑动直至其接触到组织。下一步医生将拉紧缝线使组织互相靠近。随着进展，医生可用另一缝线定位器固定缝线的另一端，从而将缝线两端固定。优选地，准备置放缝线线结定位器的缝线之两端应系有单结以防止缝线散开以至释出缝线线结定位器。
本发明之定位器可用任何生物可容性材料用常规制造方法制作。该装置可由多种生物可容性金属组成，例如钛、不锈钢和钽以及聚合材料。优选的生物可吸收结聚合材料包括但不限于包括下列物质的单聚物及其两种以上之其聚物的脂肪族聚酯物，这些物质是∈-己内酯、乙交酯、丙交酯(包括d、1、d1和meso)以及对-二恶烷酮(dioxanone)。优选的非吸收性聚合物包括但不限于由尼龙、聚酯和聚丙烯组成的材料。所有这些材料已被证明在用于缝线或其它可植入医用装置时均在生物学上可接受。
用聚合材料制作定位器的优选方法是将融化的聚合物于常规用于聚合物系统注入成形的处理条件下注入适当设计的模具中。当融化的聚合物冷却后，可从模具中容易地取出已成形的定位器，并检查、包装及灭菌。
可用任何已知的消毒方法将定位器灭菌。所选方法很大程度上取决于所采用制作定位器的材料。适宜的消毒方法包括热或蒸汽消毒、放射消毒(如钴放射或电子束)、环氧乙烷和其它本领域内已知的方法。
在描述了本发明及其某些具体实施方案后，对于本领域的专业人员来说很明显可以对本发明进行许多变化和修改而不脱离本发明的精神和范围。

Claims (5)

1.一种适用于关节镜外科手术，用于固定辫状缝线的单向可调节缝线定位器，它包括具有一顶端和一基底部份的截头锥体，其中有一通道从顶端延展至基底，而且其顶端具有有多个从顶端延至基底的裂隙，并含至少一个柔韧的指状物。
2.权利要求1的已消毒定位器，其中定位器具有四个柔韧的指状物。
3.权利要求1的已消毒定位器，其中通道中有一已消毒的辫状缝线。
4.权利要求1的已消毒定位器，其中缝线定位器由来自下列材料的生物可容性材料制成：钛、钽、ε-已内酯的单聚体、乙交酯的单聚体、丙交酯的单聚体、对-二噁烷酮的单聚体、ε-己内酯的共聚体、乙交酯的共聚体、丙交酯的共聚体和对-二噁烷酮的共聚体。
5.一种将已穿过组织之缝线的一端相对于该组织进行固定的方法，它包括将一个含有一顶端和一基底部分的截头锥体之已消毒单向可调节缝线定位器置于缝线上，使其基底朝向组织并通过在通道中从基底至顶端穿过缝线来相对于缝线移动缝线定位器，直至基底部触及组织的过程；其中定位器中有一通道自顶端向基底延展，而且顶端含有多个从第一顶端延至基底的裂隙，从而具有至少两个柔韧的指状物。
CN96112181A 1995-07-28 1996-07-27 用于辫状缝线的单向缝线定位器 Pending CN1151859A (zh)

Applications Claiming Priority (2)

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US508,600 1983-06-28
US08/508,600 US5669935A (en) 1995-07-28 1995-07-28 One-way suture retaining device for braided sutures

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CN1151859A true CN1151859A (zh) 1997-06-18

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US (1) US5669935A (zh)
EP (1) EP0755656B1 (zh)
JP (1) JPH0938094A (zh)
CN (1) CN1151859A (zh)
AU (1) AU6058796A (zh)
CA (1) CA2182077A1 (zh)
DE (1) DE69631096T2 (zh)
MX (1) MX9603057A (zh)
ZA (1) ZA966405B (zh)

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CA2182077A1 (en) 1997-01-29
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