Source: https://patents.google.com/patent/NL1026738C2/en
Timestamp: 2020-01-18 23:15:27
Document Index: 80270515

Matched Legal Cases: ['art 2', 'art 2', 'art 19', 'art 21', 'art 38', 'art 38', 'art 38', 'art 20', 'art 38', 'arts 25', 'art. 1026738']

NL1026738C2 - Orthopedic mounting assembly. - Google Patents
Orthopedic mounting assembly. Download PDF
NL1026738C2
NL1026738C2 NL1026738A NL1026738A NL1026738C2 NL 1026738 C2 NL1026738 C2 NL 1026738C2 NL 1026738 A NL1026738 A NL 1026738A NL 1026738 A NL1026738 A NL 1026738A NL 1026738 C2 NL1026738 C2 NL 1026738C2
NL1026738A
2004-07-28 Application filed by Hendrik Glastra filed Critical Hendrik Glastra
2004-07-28 Priority to NL1026738 priority Critical
2004-07-28 Priority to NL1026738A priority patent/NL1026738C2/en
2006-01-31 Publication of NL1026738C2 publication Critical patent/NL1026738C2/en
τ »·
Short indication: Orthopedic mounting assembly.
The invention relates to an assembly for connecting a (natural or artificial) ligament or tendon to a bone part, comprising a housing to be fixed in the bone part with a first end facing the joint band, with a controlled displaceable therein, carrier to be coupled with the ligament, cooperating with an actuator.
Devices and systems for securing a natural or artificial weight belt or tendon to a bone part and all associated problems have been extensively described in the prior art. For example, German Offenlegungsschrift 37 10 587 describes an elongated fastening element to be placed in a bore formed at least as long as the bore, with a non-rotatably guided driver therein which can be displaced longitudinally by means of a screw element so that its axial position, and thus also the tension generated in the ligament or tendon can be adjusted as desired. International Patent Application WO97 / 36557 describes a similar fastening element with elongated parts provided with inner and outer threads and cooperating with each other, the inner of which is connected to the ligament can be moved longitudinally by its longitudinal axis. Furthermore, reference can be made to French patent application 2,663,837 and German Gebrauchsmuster G8701123.
It is clear that such an assembly, which after all forms a "foreign element" in the bone, must have minimal dimensions so that the surgical procedure required for its placement is minimally stressful for the bone, while, despite these small dimensions, the adjustment range - in other words, the distance over which the end of the ligament or tendon connected to the assembly can be moved should be -30 maximum. It is desired that only a force acting in the longitudinal direction and no reaction torque is exerted on this tire or tendon end.
This object is achieved according to the invention in that the assembly comprises a flexible, tension-resistant element, the first end of which is to be attached to the free joint band end and the second end to be introduced into the second housing end, in a U -shaped loop around the driver and finally fix it to the house.
The flexible, tension-resistant element attached to the free joint band end with the first end can be easily manipulated into a small space and guided and secured in the manner described above while the fact that it is arranged in a U-shaped loop around the actuator. displacement of the displacement guide results in a displacement of this displacement over a certain distance a causing the end of the tension-resistant element attached to the ligament or tendon 10 to be displaced by double the distance 2a. In this way a maximum setting range is achieved with minimum dimensions. The whole can be manufactured with simple and inexpensive elements.
A favorable embodiment is characterized by a second deflecting member arranged close to the second housing end for the tension-resistant element, the free end of which, after being guided around this deflecting member, can be fixed to or near the second housing end. Manipulating and securing the tension-resistant element is thereby considerably facilitated.
A particularly favorable embodiment is characterized in that the housing has a cylindrical bore in which the carrier is guided in a non-rotatable and longitudinal direction, the carrier has an axial bore and a recess for guiding the tension-resistant element around the carrier and between the and the second housing end, the second deflecting member is arranged, such that after the introduction of the second end of the tension-resistant element into the first housing end it can be guided around the engaging member, can then be guided around the second deflecting member and or can be fixed near the second housing end.
The actuator is preferably formed by a threaded axial bore guided into the driver and screwed with the upper end supported on the first housing end.
The screw element herein preferably has a central bore for guiding the tension-resistant element which can be fixed at the upper end thereof.
The actuator can also be formed by a compression spring arranged between the second housing end and the driver, so that a certain, substantially constant pre-tension is exerted on the joint band or tendon.
1026738 l r - 3 -
In a favorable embodiment, the housing is not itself fixed in the bone, but is accommodated in an outer housing to be fixed in the bone part, which is preferably provided with external screw thread.
The invention is elucidated with reference to the drawing, in which a favorable embodiment of the invention is shown. In this drawing: Fig. 1 is a partial section through a bone part with the outer housing of the assembly according to the invention accommodated therein in partially exploded form; Fig. 2Ά shows an end view of the carrier used therein; Fig. 2B is a side view of this carrier; Fig. 3 is a partial sectional view similar to Fig. 3 of the complete assembly.
FIG. 1 and 3 show a bone part 2, for example a part of the upper leg, in which the treating surgeon has drilled a channel 4 in order to be able to attach the end 5 of a ligament 6 to this bone part 2 with the aid of the assembly proposed by the invention. The skin covering the bone 2 is indicated by 3. The ligament band 6 can thereby be a torn or torn natural ligament band, but can also be an artificial ligament band, while the device according to the invention can also be used for reattaching to a bone part from a torn-off tendon end. Reference is made to the above-mentioned prior art, the content of which is considered herein incorporated.
The embodiment of the assembly shown in the figures comprises a cylindrical outer housing or sleeve 10 provided with (whether or not self-tapping) orthopedic outer thread 8 with the right end 11 and with an incision 14 at the left end 13 on which a tool used for screwing in can engage .
This outer housing 10 is intended for receiving a cylindrical housing 12 with a first end 14 and a second end 16 in a tightly fitting and non-rotatable manner (for example through mutual cooperation of a not-shown-cam and recess). 35, the cylindrical carrier 18 slidably arranged longitudinally, shown in front view in Fig. 2A and shown in side view in Fig. 2B. This carrier 18 is, as shown in Fig. 2A, partially flattened along its length, as indicated by 20 and provided with two guide pins 22a, 22b which fit into suitable (not shown) elongated recesses in the wall of the housing 12, so that the carrier 20, although displaced in the longitudinal direction, cannot rotate, which carrier has a first cylindrical part 19 and a second, shorter, cylindrical part 21 with the groove 23 between them.
Furthermore, the driver has a central bore 24 provided with an internal thread 25.
This inner screw thread corresponds to the outer screw thread 26 of a screw element 27 to be screwed into it, with a central bore 28 and the beveled head 29 of which rests on the second housing end 16. This head 29 has a hexagonal opening 30 on which a suitable tool 50 can act (see fig. 3).
A diametrical guide pin 31 is arranged between the carrier 18 and the first housing end 14.
The end 6 of the ligament or tendon 15 to be fixed is secured via a suitable fastening element 32 to the first end 34 of an elongated flexible tension-resistant element 36, hereinafter referred to as "tension element", the free second end of which is 38 inserted into the first end 14 of the housing 12, then with the part 38a being guided over the flattened portion 20 of the carrier 18, with the part 38b passing through the groove 23, then with the part 38c being guided again over the flattened part 20 of the carrier 18, then passes around the deflection pin 31 and is subsequently carried out with the part 38d through the central bore 27 in the screw element 26.
FIG. 3 shows how, while the housing 12 is in the outer housing 10, after this tensioning element has been tensioned, a knot 39 is laid in this end 38 which is larger than the diameter of the bore, so that the tensioning element remains tensioned. Thereafter, with the aid of a suitable tool 50 which fits into the hexagonal opening 30, the tension in the joint band 6 can be adjusted to the desired value by displacing the carrier 18 via the screw element 26.
The figures show with dashed lines in the housing 12 between a ring-shaped stop 40 and the carrier 18 a coil spring 42.
Of course, this only works when the carrier 18 is no longer coupled to the screw element 27. For this purpose, the screw element 27 can only bear a thread over a part of its length - for example on the left-hand part in the figure - so that when the driver is over the remaining part bearing no thread, only the spring bias. When the thread parts 25, 26 are completely omitted, there is no possibility of any adjustment. The spring 42 is of course not essential.
Manipulating the device proposed by the invention is very simple. Through the components located in the housing 12, a "guide wire" already follows the path described above. One end thereof is fixed by the surgeon to the tensile member 36 attached to the ligament or tendon 6 and then pulled to the other end leaving from the left. The housing 12 is thereby located at such a distance from the bone 2 that manipulation thereof presents no problem whatsoever. By tightening the guide wire and the tension element 36 connected thereto, the housing 12 will eventually slide into the outer housing 10 screwed into the bone, the tension element 36 exiting at the left-hand housing end. When the housing 12 then abuts completely therein, the tension element 36 is tightened until the desired tension in the joint band 6 is reached and the knot 39 is laid as short as possible, with which the fitting is completed. Re-tensioning is very easily possible. When this post-tensioning occurs after a longer period of time, only a small incision need be made in the skin 3, the size of the outer diameter d of the tool 5.
The assembly can be manufactured with minimal dimensions: in a practical embodiment, the length of the outer housing was 90:18 mm, with an outer diameter of 9.5 mm. The operating tool 50 has a diameter d = 3 mm so that the incision required for post-tensioning is minimal.
Naturally, modifications are possible within the scope of the invention, in particular in the form of the carrier 18 and the manner in which the pulling element 36 is guided around it. The screw element may also be eccentric and the second end of the tension element 38 may be attached to the housing in a manner other than that indicated. For example, it is possible that a bar is arranged transversely through the hexagonal opening 30 to which the tension element 38, for example consisting of two wires, is tied. Instead of a hexagonal opening, a slot can also be used for cooperation with a screwdriver.
1. Assembly for connecting a (natural or artificial) ligament or tendon to a bone part, comprising a housing to be secured in the bone part with a first end facing the joint band, containing a controlled movable part of the joint band with the joint band a coupling carrier, cooperating with an actuator, characterized by a flexible, tension-resistant element, with its first end to be attached to the free joint band end and with the second end to be introduced into the second housing end, to be guided in a U-shaped loop around the carrier and finally to fix it to the house.
An assembly according to claim 1, characterized by a second deflecting member arranged near the second housing end for the tension-resistant element, the free end of which, after being guided around said deflecting member, can be fixed to or near the second housing end.
3. Assembly as claimed in claim 2, characterized in that the housing has a cylindrical bore in which the carrier is guided rotatably and displaceably in longitudinal direction, the carrier has an axial bore and a recess for guiding the tension-resistant element around the carrier and between the carrier and the second housing end are provided with the second deflecting member, such that after the introduction of the second end of the tension-resistant element into the first housing end it can be guided around the driver, then can be guided around the second deflecting member and can be fixed at or near the second housing end.
4. Assembly as claimed in claim 3, characterized in that the actuator is formed by a screw element guided in an axial bore provided with a thread and guided by the upper end on the first end of the housing.
5. Assembly as claimed in claim 4, characterized in that the screw element has a central bore for guiding the tension-resistant element that can be fixed at the upper end thereof.
6. Assembly as claimed in claims 1-3, characterized in that the actuator is formed by a compression spring arranged between the second housing end and the carrier.
An assembly according to claims 1-6, characterized in that the housing is accommodated in an outer housing to be fixed in the bone part. 1026738 - 7 - * ->
An assembly according to claim 7, characterized in that the outer housing carries external threads. 1026738
NL1026738A 2004-07-28 2004-07-28 Orthopedic mounting assembly. NL1026738C2 (en)
NL1026738 2004-07-28
NL1026738A NL1026738C2 (en) 2004-07-28 2004-07-28 Orthopedic mounting assembly.
PCT/NL2005/000522 WO2006011786A1 (en) 2004-07-28 2005-07-19 Orthopaedic securing assembly
NL1026738C2 true NL1026738C2 (en) 2006-01-31
ID=34974117
NL (1) NL1026738C2 (en)
WO (1) WO2006011786A1 (en)
JP5425797B2 (en) 2007-11-02 2014-02-26 バイオメット ユーケイ リミテッド Replacement joint prosthesis
DE8701123U1 (en) 1986-01-24 1987-04-02 Pfizer Hospital Products Group, Inc., New York, N.Y., Us
DE3710587A1 (en) 1987-03-31 1988-10-20 Witzel Ulrich Substitute for the patellar ligament
FR2663867A1 (en) 1990-06-29 1992-01-03 Rhone Poulenc Nutrition Animal Method for smoothing pellets of active ingredients
WO1997036557A1 (en) 1996-04-01 1997-10-09 Kokbing Lo Fixing element and ligament fixed with fixing element
FR2847456A1 (en) * 2002-11-21 2004-05-28 Michel Collette Anchoring screw insertable in a bone canal of a ligament graft e.g. for anterior cruciate ligament repair, includes conical intermediate threaded part and smooth rounded end having a diameter at least equal to diameter of bone canal
2004-07-28 NL NL1026738A patent/NL1026738C2/en not_active IP Right Cessation
2005-07-19 WO PCT/NL2005/000522 patent/WO2006011786A1/en active Application Filing
WO2006011786A1 (en) 2006-02-02
US20090312795A1 (en) 2009-12-17 Suture anchors
US5957924A (en) 1999-09-28 Installation tool for suture anchor
2009-04-01 VD1 Lapsed due to non-payment of the annual fee