Surgery – Instruments – Orthopedic instrumentation
Patent
1998-12-17
2000-08-29
Hirsch, Paul J.
Surgery
Instruments
Orthopedic instrumentation
A61B 1716
Patent
active
061101788
DESCRIPTION:
BRIEF SUMMARY
The invention lies in the field of medical technology and relates to an apparatus in accordance with the preamble of the first patent claim for the production of endochondral and of osteochondral bores.
The most diverse artificial implants and implants which are cultivated in vitro are known by means of which defects in joint cartilages or in joint cartilages and the bone tissue lying therebelow can be repaired. Implants of this kind are for example deformable masses or pastes which are spread into the defects and which substantially adapt to any shape of defect, but which however in most cases do not have sufficient mechanical stability in order that they can be stressed immediately after the operation.
Implants are also known which have mechanical properties which are at least similar to those of natural cartilage or bone respectively. Implants of this kind have the advantage that they can immediately take over the mechanical function of the tissue to be replaced (cartilage or cartilage and bone), which means that they are stressable to a limited extent immediately after the operation. Implants of this kind or also transplants, however, have the disadvantage that they must be matched in their shape to the shape of the defect, or that the defect must be cut out or bored out to a predetermined shape prior to the implantation.
It proves that a matching of the implant shape to the shape of the defect which is as exact as possible is advantageous for the healing process. For this reason it is customary in a corresponding surgical operation to cut out the defective location to a recess with a shape which is as definite as possible and to use an implant which has the same shape.
In transplantations of cartilage tissue or cartilage and bone tissue from healthy places to defective places it is, for example, customary to rotate a punch blade with a circular cutting edge into the cartilage tissue and the bone tissue lying below it, to break off the column which is punched out at its base through a wobbling of the blade and to remove it with the blade. This method is used both for the cutting out of defects and for the production of corresponding tissue columns for the transplantation.
A separation of tissue through the above named wobbling of a punch blade is possible only in bone tissue. In other words, this means that this method is restricted to osteochondral "bores" or that defects which affect only the cartilage layer must be deepened to osteochondral bores for the lack of a method for the production of endochondral bores. This disadvantage is not important in the use of tissue columns as transplants which are produced by the same method but is for example a disadvantage in the implantation of cartilage cultivated in vitro.
Furthermore, it proves that columns and openings which are produced in accordance with the named method through punching out and breaking have indefinite base surfaces and heights or depths respectively with relatively large fluctuations, through which the exactness of the fit in the region of this base surface both in transplants and in implants is largely left to chance or must be improved by a plastic mass. For the same reason it is also difficult to orient exactly the surfaces of the transplant or the implant respectively with respect to one another with the known method, which would be important for the success of the operation.
The object of the invention is now to provide an apparatus by means of which endochondral and osteochondral defects can with a minimum enlargement be bored open to endochondral or osteochondral bores with as precisely defined a depth as possible and with as precisely flat a base surface as possible in such a manner that they can be precisely filled with corresponding implants which are cultivated in vitro or which are artificial or else by transplants of a definite shape.
This object is satisfied by the apparatus as it is characterised in the patent claims.
The apparatus in accordance with the invention comprises a combination of a substantially hollow cylindri
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Mainil-Varlet Pierre
Muller-Glauser Werner
Saager Christoph
Zech Manfred
Hirsch Paul J.
Sulzer Orthopadie AG
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