Surgery – Instruments – Orthopedic instrumentation
Patent
1998-03-30
1999-11-23
Buiz, Michael
Surgery
Instruments
Orthopedic instrumentation
A61B 1700
Patent
active
059892536
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD OF THE INVENTION
The present invention concerns means for attaching a ligament to a bone.
In orthopedic surgery it is frequently necessary to attach the end of a ligament to the bone of a patient, whether this is a ligament prosthesis comprising an artificial ligament or a living ligament taken from another part of the body of the patient.
Various anchoring techniques have been used until now. For example, document FR-A-2 696 925 describes an anchoring technique in which a hole is made in the bone tissue of the bone to which the ligament must be attached, a graft is taken consisting of a ligament central part attached to bone end parts in the form of a rod, one of the bone rods is inserted into the hole in the bone tissue and an axial screw is inserted in parallel into the same hole, beside the bone rod, applying force laterally both to the bone rod and to the wall of the bone tissue hole. The anchorage is effective but the surgeon cannot easily adjust the axial tension in the ligament during implantation and, more importantly, there is the risk of the ligament being weakened by the edges of the screw, which cut into it, in particular when the ligament end is to be anchored into a blind hole from the interior of the joint. Document EP-A-0 596 829 describes a similar anchorage with an oblique screw which additionally clamps the end of the ligament, which can also weaken the ligament.
In document FR-A-2 586 927 the end of the ligament is hollow and tubular and a conical plug is inserted into the hollow tube to press the wall of the tubular part of the ligament against a conical portion of a hole in the bone tissue. Clearly an anchorage of the above kind is not suitable for anchoring a living ligament, in which it is not easy to form a tubular end, and the surgeon will obviously find it very difficult to adjust the tension in the ligament during implantation.
In document EP-A-0 596 177 the end of the ligament is immobilized in a hole in the bone tissue by a transverse clamping screw. The screw can shear the end of the ligament and weaken the anchorage.
In document FR-A-2 671 717 a device is provided to anchor the end of the an artificial ligament prosthesis consisting of a wick or braid of a physiologically compatible woven material. The anchorage is provided by a pin having an expandable cylindrical shank partially inserted into a hole in the bone and receiving a screw in an axial bore in the shank to expand the shank radially and immobilize it in the hole. The prosthesis end fits around the part of the shank projecting out of the bone and is pressed against the external surface of the bone by the front face of a cylinder having a diameter greater than that of the shank and forming a head on the pin. The prosthesis is external to the bone and extends radially of the shank and of the hole in the bone. An anchorage of the above kind is not suitable for retaining a living ligament, which is weakened by the relatively large diameter hole needed in the ligament for the shank to pass through.
Document DE-U-92 10 031 concerns an expandable plug for anchorage in concrete. This is a technical field remote from that of the present invention. The plug has an expandable shank the outside surface of which has a square section to define longitudinal edges opposing rotation in the hole in the concrete. Expansion is effected in a diagonal direction by a central axial screw by virtue of four longitudinal slots perpendicular to the four side faces. Thus the side faces are not plane and are interrupted by the longitudinal slots. In the conventional manner, the object anchored by the plug remains outside the concrete.
SUMMARY OF THE INVENTION
The problem addressed by the present invention is that of designing a new ligament anchoring device that assures an effective and reliable anchorage without risk of shearing the ligament and which makes it very easy for the surgeon to adjust the tension in the ligament during implantation without requiring any additional prestressing of the ligament.
Another object of t
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patent: 4950270 (1990-08-01), Bowman et al.
patent: 5643266 (1997-07-01), Li
patent: 5643321 (1997-07-01), McDevitt
patent: 5702398 (1997-12-01), Thrabishy
Buiz Michael
Eilberg William H.
Trinh Vikki
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