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WO2001091670A1 - Plaque en forme de bouton pour chirurgie reparatrice des lesions tendon-os - Google Patents

Plaque en forme de bouton pour chirurgie reparatrice des lesions tendon-os Download PDF

Info

Publication number
WO2001091670A1
WO2001091670A1 PCT/EP2001/006033 EP0106033W WO0191670A1 WO 2001091670 A1 WO2001091670 A1 WO 2001091670A1 EP 0106033 W EP0106033 W EP 0106033W WO 0191670 A1 WO0191670 A1 WO 0191670A1
Authority
WO
WIPO (PCT)
Prior art keywords
holes
tendon
threads
bone
button
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2001/006033
Other languages
English (en)
Inventor
Roberto Rotini
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Istituto Ortopedico Rizzoli
Original Assignee
Istituto Ortopedico Rizzoli
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Istituto Ortopedico Rizzoli filed Critical Istituto Ortopedico Rizzoli
Priority to AU81789/01A priority Critical patent/AU8178901A/en
Publication of WO2001091670A1 publication Critical patent/WO2001091670A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • 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
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0404—Buttons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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
    • A61B2017/0417—T-fasteners
    • 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
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0876—Position of anchor in respect to the bone
    • A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
    • 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
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0876—Position of anchor in respect to the bone
    • A61F2002/0888—Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Definitions

  • the present invention relates to a button-shaped plate, or miniplate, for tying suturing threads in reconstructive surgery of tendon-bone lesions, particularly for massive lesions of the shoulder rotator cuff.
  • the surgical procedure for this problem essentially consists in passing suturing threads through the end of the tendon, inserting into the humerus, at the tendon reinsertion region (where the tendon must anchor to the bone), by means of a large needle, the pairs of ends of each thread, making the pairs of ends exit from the outer surface of the bone (after perforating, with the needle, the external cortex of the proximal end of the humerus) and tying together the pairs of ends of all the threads.
  • the tension of the threads can cause, during the operation or thereafter, the breakage of the cortical surface, due to the fact that bone often has, in the anchoring seat, osteoporosis deriving from lack of movement.
  • Miniplates are known which have been devised in order to obviate this drawback and are adapted to rest against the surface of the humerus, in the region where the pairs of threads are made to exit, and are crossed by a plurality of small holes through which the pairs of threads are made to exit and then tied together.
  • Such known miniplates have shortcomings due to the fact that, also because of the imperfect alignment between the exit points of the pairs of threads and the holes of the plate, said plate does not adhere perfectly to the surface of the bone while the knots are being tied; on one hand, this causes less tension of the suturing threads and therefore less tendon-bone contact; and on the other hand, it entails the possibility of friction and wear of the threads between the bone edge and the edge of the holes of the plate.
  • the aim of the present invention is to obviate the above cited shortcomings and to meet the mentioned requirements, by providing a button-shaped plate for reconstructive surgery of tendon-bone lesions, particularly for massive lesions of the shoulder rotator cuff, which remains perfectly in contact with the surface of the humerus during tying of the knots and has no surfaces which can cut the suturing threads.
  • an object of the present invention is to provide a structure which is simple, relatively easy to provide in practice, safe in use, effective in operation, and relatively low in cost.
  • the present button-shaped plate for reconstructive surgery of tendon-bone lesions, particularly for massive lesions of the shoulder rotator cuff, characterized in that it has two holes which are adapted to be crossed by pairs of suturing threads, said holes being extended, on the face designed to rest against the humerus, by respective short portions of cannulas adapted to engage in corresponding holes formed beforehand in the surface of bone.
  • Figure 1 is a front view of a button-shaped plate for reconstructive surgery of tendon-bone lesions, particularly for massive lesions of the shoulder rotator cuff;
  • Figure 2 is a sectional side view, taken along the line II-II of Figure 1, of said button-shaped plate;
  • Figure 3 is a sectional bottom view of the plate;
  • Figure 4 is a sectional top view, taken along the line IV-IV of Figure 1;
  • Figures 5a, 5b and 5c are views of the successive steps of the application of the plate according to the invention. Ways to carrying out the Invention
  • 1 generally designates a button-shaped plate for reconstructive surgery of tendon-bone lesions, particularly for massive lesions of the shoulder rotator cuff, according to the invention.
  • the plate 1 is rectangular, with rounded corners 2, and has two holes 3 and 4 which are designed to be crossed by pairs of suturing threads F.
  • the holes 3, 4 on the face designed to rest against the humerus are extended by respective short portions of cannulas 5 and 6 which are designed to engage in corresponding holes P formed beforehand in the surface of the bone O.
  • the holes of the cannulas are slightly inclined with respect to the axis of said cannulas; for the same reason, at the ends of the cannulas 5 and 6 the edges 3a, 4a of the holes 3 and 4 are conveniently rounded; the outer surface of the plate has, between the holes 3 and 4, a channel 9 having a rounded profile in order to keep the threads and the knot of the threads in a protected position.
  • the button-shaped plate is crossed by two small holes 7 and 8 which allow to grip it with a gripping tool.
  • the operation of the invention and the application method are as follows: by using a template which reproduces the relative distance of the holes, the surface of the outer cortex of the proximal end of the humerus (P of Figure 5a) is perforated beforehand; the button-shaped plate is rested against the humerus so that the cannulas are inserted in the holes P formed earlier; by using a tough curved needle, the pairs of ends of the threads F coupled to the end of the tendon are inserted in the humerus (Figure 5b) in the tendon reinsertion area, which has been freshened in order to accelerate the process for bonding the tendon to the bone; the threads are made to exit through each one of the holes of the button-shaped plate; once at least one pair of threads for each hole has passed through, the pairs of threads are subjected to traction and are tied together (Figure 5c):

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Rheumatology (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Rehabilitation Therapy (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne une plaque en forme de bouton (1) destinée à la chirurgie réparatrice des lésions tendon-os, en particulier, des lésions importantes de la coiffe du rotateur de l'épaule. Cette plaque est pourvue de deux orifices (3, 4) qui sont conçus pour être traversés par des paires de fils de suture (F) et ils sont allongés, sur la face configurée pour reposer contre l'humerus, au moyen de portions courtes respectives de canules (5, 6) conçues pour s'engrener dans les orifices correspondants (P) ménagés préalablement dans la surface de l'os.
PCT/EP2001/006033 2000-05-30 2001-05-25 Plaque en forme de bouton pour chirurgie reparatrice des lesions tendon-os Ceased WO2001091670A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU81789/01A AU8178901A (en) 2000-05-30 2001-05-25 Button-shaped plate for reconstructive surgery of tendon-bone lesions

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITBO20000322 IT1321281B1 (it) 2000-05-30 2000-05-30 Placca a bottone per chirurgia ricostruttiva delle lesionitendine-osso, particolarmente per lesioni massive della cuffia dei
ITBO2000A000322 2000-05-30

Publications (1)

Publication Number Publication Date
WO2001091670A1 true WO2001091670A1 (fr) 2001-12-06

Family

ID=11438514

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2001/006033 Ceased WO2001091670A1 (fr) 2000-05-30 2001-05-25 Plaque en forme de bouton pour chirurgie reparatrice des lesions tendon-os

Country Status (3)

Country Link
AU (1) AU8178901A (fr)
IT (1) IT1321281B1 (fr)
WO (1) WO2001091670A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7530990B2 (en) 2001-05-16 2009-05-12 Smith & Nephew, Inc. Endobutton continuous loop for bone tendon with double loop knot
JP2014213093A (ja) * 2013-04-26 2014-11-17 国立大学法人愛媛大学 移植用靱帯の固定具および移植用靱帯の固定方法
US9101461B2 (en) 2006-08-16 2015-08-11 Arthrex, Inc. Button and continuous loop for fixation of ligaments

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2269958C2 (ru) * 2004-05-12 2006-02-20 Федеральное государственное учреждение "Нижегородский научно-исследовательский институт травматологии и ортопедии Федерального агенства по здравоохранению и социальному развитию" Способ одномоментной дерматотенопластики при кожно-сухожильных дефектах тыльной поверхности кисти

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2288737A (en) * 1994-04-18 1995-11-01 Corin Medical Ltd Suture anchor
WO1996039083A1 (fr) * 1995-06-06 1996-12-12 Li Medical Technologies, Inc. Fixation et procede de fixation servant notamment a fixer des elements de suture dans les os
US5645588A (en) * 1993-02-11 1997-07-08 Acufex Microsurgical, Inc. Graft attachment device
WO2001030252A1 (fr) * 1999-10-29 2001-05-03 Akthea (S.A.S.) Plaque orthopedique de suture et ancillaire pour la mise en place d'une telle plaque

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5645588A (en) * 1993-02-11 1997-07-08 Acufex Microsurgical, Inc. Graft attachment device
GB2288737A (en) * 1994-04-18 1995-11-01 Corin Medical Ltd Suture anchor
WO1996039083A1 (fr) * 1995-06-06 1996-12-12 Li Medical Technologies, Inc. Fixation et procede de fixation servant notamment a fixer des elements de suture dans les os
WO2001030252A1 (fr) * 1999-10-29 2001-05-03 Akthea (S.A.S.) Plaque orthopedique de suture et ancillaire pour la mise en place d'une telle plaque

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7530990B2 (en) 2001-05-16 2009-05-12 Smith & Nephew, Inc. Endobutton continuous loop for bone tendon with double loop knot
US9101461B2 (en) 2006-08-16 2015-08-11 Arthrex, Inc. Button and continuous loop for fixation of ligaments
JP2014213093A (ja) * 2013-04-26 2014-11-17 国立大学法人愛媛大学 移植用靱帯の固定具および移植用靱帯の固定方法

Also Published As

Publication number Publication date
ITBO20000322A1 (it) 2001-11-30
IT1321281B1 (it) 2004-01-08
AU8178901A (en) 2001-12-11

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