CA1290504C - Ligament prosthesis - Google Patents
Ligament prosthesisInfo
- Publication number
- CA1290504C CA1290504C CA000558240A CA558240A CA1290504C CA 1290504 C CA1290504 C CA 1290504C CA 000558240 A CA000558240 A CA 000558240A CA 558240 A CA558240 A CA 558240A CA 1290504 C CA1290504 C CA 1290504C
- Authority
- CA
- Canada
- Prior art keywords
- elongate member
- cords
- cord
- bore
- ligament
- 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.)
- Expired - Fee Related
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
- 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
- A61F2002/0817—Structure of the anchor
- A61F2002/0823—Modular anchors comprising a plurality of separate parts
- A61F2002/0829—Modular anchors comprising a plurality of separate parts without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
-
- 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
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0864—Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
-
- 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
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/087—Anchor integrated into tendons, e.g. bone blocks, integrated rings
-
- 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
Abstract
P.C. 7173 LIGAMENT PROSTHESIS
Abstract A prosthesis for an anterior cruciate ligament is disclosed comprising first and second elongate members, first and second separately tensionable cords, a catch means on the bore surface of each elongate member, and a means for securing the elongate members to the femur and tibia respectively.
Abstract A prosthesis for an anterior cruciate ligament is disclosed comprising first and second elongate members, first and second separately tensionable cords, a catch means on the bore surface of each elongate member, and a means for securing the elongate members to the femur and tibia respectively.
Description
1~90':~0~
P.C. 7173 LIGAMENT PROST~ESIS
A variety of prostheses have been proposed for the repair or replacement of diseased or damaged ligaments, in particular the anterior cruciate ligament.
U.S. Patent No. 4,605,414 discloses a process for such a repair wherein the damagea ligament is removed and a strip of patellar tendon is combined with a sleeve of synthetic biocompatible material thereby creating the new anterior cruciate ligament.
U.S. Patent No . 4,597,766 discloses a ligament replacement which is comprised of a naturally occurring ligament or tendon isolated from an animal source tanned with a bifunctional reagent capable of cross-linking biological tissue. The ligament is fixed in place by attachment of a dicalcified chip of bone which is shaped to receive and retain the bioprosthesis.
U.S. Patent No. 3,953,896 discloses a prosthetic ligament used to replace a damaged cruciate ligament.
In this patent, the prosthetic ligament includes a cylindrical central portion of polyethylene and threaded outer portions provided with bushings to protect the central portion from abrasion caused b~
skeletal flexing. Fasteners, in the form of nut members, are also provided to fasten the prosthesis within the skeletal apertures.
U.S. Patent No. 3,545,008 discloses a tendon prosthesis which consists of a Dacron mesh sleeve sutured to the proximal ends of a ruptured tendon. The sleeve includes a mesh netting at its outer ends to encourage fibroblastic infiltration to occur between ~o~
the severed ends of the tenaon for anchoring the prosthesis to the tendon.
U.S. Patent No. 4,1~7,558 relates to a prosthetic ligament positioned within a surgically prepared passageway in the bone, and a Dacron or Dacron and silicone strand is disclosed as a replacement for a cruciate ligament with Dacron velour fabric used as collars at the outer ends of the central portion of the prosthesis to promote new tissue growth.
U.S. Patent No. 3,797,047 discloses an artificial tendon material which consists of a tubular sheath of silicone elastomer with an inner tensile element of knitted fabric.
U.S. Patent No. 3,805,300 discloses a tendon which is composed of a cord-like combination of silicone and Dacron strip with transverse openings for the natural tendon to be woven therethrough.
In these prior art procedures are well documented the various problems and possible solutions for the repair and/or replacement of the anterior cruciate ligament. A major problem that the prior art has not solved is how to make a replacement anterior cruciate ligament perfor~ in substantially the same manner as the natural anterior cruciate ligament.
The prosthesis of the present invention is placed in the appropriate position to reproduce the femoral and tibial anterior cruciate ligament origins, and then tensioned to approximate the anterior and posterior fibers of the normal anterior cruciate ligament. The result is a substantially smoother and more stable natural range of motion in a knee of a patient.
The prosthesis of the present invention overcomes the technical, surgical and practical shortcomings of the prior art. An important feature of the present l~90S(I~
invention is the ability to separately tension the first and second cords to more closely duplicate the function of the normal knee. A further important feature is that the cords, once tensioned, are fixed in the knee so that there is no backward movement of the tensioned cords.
The device of the present invention combines all of these features in one prosthetic device. These features, and other features discussed hereinafter, result in a prosthesis which is dynamically stable and therefore promotes smoother and more natural movement of the knee in the body of a patient.
The present invention relates to a prosthesis for an anterior cruciate ligament comprising first and second elongate members, first and second tensionable cords, a capture means, and means for securing the elongate members to the femur and tibia, respectively.
The first and second elongate members are inserted into a congruent channel in the femur and tibia, respectively, each member having a longitudinal bore.
The first tensionable cord is fixedly attached to the first elongate member and adapted to extend through the bore of the second elongate member, while the second cord is fixedly attached to the second elongate member and is adapted to extend through the bore of the first elongate member. Catch means of the prosthesis are positioned on the bore surface of each elongate member to releasably engage the respective cord which extends through the bore.
The catch means is preferably smooth, rounded projections on the bore to engage the first and second cords. The means for securing the elongate members to the femur and tibia is preferably a stepped cylirdrical housing, most preferably coated with a porous material capable of receiving bone tissue ingrowth.
The invention will be described in detail with reference to a preferred embodiment thereof, which is a anterior cruciate ligament prosthesis. Reference to this embodiment does not limit the scope of the invention, which is limited only by the scope of the claims.
In the drawings:
Fig. 1 is an exploded top view of a prosthesis of the invention.
Fig. 2 is a rear elevational view of the device of Fig. 1.
Fig. 3 is a cross sectional view taken along line 3-3 of the device of Fig. 2.
Fig. 4 is a cross sectional view taken along line 4-4 of the device of Fig. 3.
Figs. 5 and 6 illustrate the prosthesis in Fig. 1 implanted in a patient's knee.
Fig. 7 illustrates the stress-strain characteristics of a normal ligament and the prosthesis of the invention.
A prosthesis 4 for a ligamen~ of the invention is shown in Fig. 1. Device 4 comprises first and second elongate members 2 and 6 respectively. The elongate members, with a longitudinal bore 8, are inserted into congruent channels 10 in the femur and tibia. The device 4 further includes first and second tensionable cords 12, 13, respectively. The first cord 12 is fixedly attached to the first elongate member 2 and is adapted to extend through the longitudinal bore 8 of the second elongate member 6. The second cord 13 is fixedly attached to the second elongate member 6 and adapted to extend through the longitudinal bore 8 of the first elongate member 2. The cords are preferably 1~30'~ 4 ultrasonically welded to secure them to the elongate member to which they are fixedly attached.
A catch means, most preferably smooth rounded projections 20, is located in each of the elongate members 2 and 6 to hold securely thé second and first cords 13, 12, respectively. Additionally, a plug 16 with a V-shape is inserted into the bore 8 of each elongate member at the end opposed to the other elongate member. The plug 16 engages the respective cord member which extends through the bore 8 to its associated elongate member, with the plug holding the cord at a desired level of tension. The device further includes a means for securing each of the elongate members to the femur and tibia, respectively. The first and second elongate members 2 and 6, respectively, are preferably made of a surgical implant metal or metal alloy, such as cobalt chrome alloy. The metal or metal alloy parts can be readily manufactured by conventional casting, machining, etc., processes known to those skilled in the art.
The elongate members preferably have two diameters, a narrow diameter for placement in the bone at the intracondular notch and a wider diameter which acts to secure the member to the femoral and tibial end of the bone. The narrow diameter is preferably from about 9 mm. to 15 mm., while the wider diameter is preferably from about 14 mm to 20 mm. The elongate member is further provided with a porous coating 18 to further secure the device 4 by bone ingrowth in the tibial and femoral regions (see Figs. 5 and 6). The securing means is preferably a step cylinder with the larger diameter being positioned at the insertion end of the femur and tibia, respectively.
The first and second tensionable cords are pre-ferably made of woven implantable polyester material, most preferably Type 55 or Type 56 dacron. Pref~rably the tensionable cord has a strength of from about 300-900 lbs. with a diameter of from about .093 to .200 inches. The weave of the material will be preferably standard hollow or solid braid with strand size to range from 10-70 denier. Double weaving of the material is preferable, wherein each strand is braided and the individual braids make the cord weave.
The characteristics of the prosthetic ligament are chosen to match the natural ligament characteristics under low and moderate amounts of stress and strain. As shown in Fig. 7, higher degrees of strain and stress the prosthetic ligament will perform better than the natural ligament. The specific stress strain performance is achieved by a combination of weave type and heat setting.
The first cord 12 is fixedly attached to the first elongate member 2 as shown in Fig. 3, which also shows the device 4 with the catch means engaged. The second cord 13 is securely held in a fixed position, once the tensioning step is completed, by the rounded projections 20, and the plug 16 which is placed in the longitudinal bore 8 on the tibial side of the device. The same procedure is then performed on the femoral side wit~h the first cord 12. In this way the cords are loc~ed once the desired tension is achieved in each of the two cords.
As shown in Figs. 5 and 6 the first and second elongate members 2, 6 respectively are designed to be positioned so that they are in an oblique angle to one another. This step is important to the successful operation of the prosthetic ligament. The first and second cords are separately tensioned to independently act for flexion and extension. It is important also to the advantageous use of the prosthesis that the elongate member not be allowed to extend beyond the 1~9(~
aperture in the osteous tunnel which would cause abrasion of the tissue.
The use of device 4 will be described with reference to the implantation. It is to be understood that a fixation device of the present invention can be used with similar techniques to affix other types of prostheses for the anterior cruciate ligaments ~ACL) or other ligaments or tendons, or to affix the same type of prosthesis when used to repair or replace other ligaments or tendons than the ACL. The first step in the procedure is to create two substantially cylin-drical through drill holes (note broken lines in FIG. 5 and 6) in the femur and tibia, insert the second elongate member 6 through the rear end of the tibial drill hole (at the right of the hole in FIG. 5 and 6) and advance the member therein until the front of the elongate member 6 is flush with the tibial drill hole in the intracondular notch (at the left in FIG. 5 and 6), and then thread cord 13 sequentially through the femoral drill hole and first elongate member 2 in the direction shown by means of for example, a leader and thread.
The first elongate member 2 is then threaded through the femur in the same manner as on the tibial side. The next step is to pretension the two cords to the desired extent, for example with a conventional pretensioning tool or by hand with the use of an appropriate gauge. Each cord is held in the desired state of pretension wherein the plug 16 is then inserted through the rear end of the appropriate elongate member, in which position cord is firmly held and the tensioning tool is removed. The excess cord is then cut.
Further modifications will occur to those skilled in the art. The scope of the invention is defined by the appended claims and should not be understood as limited by the specific embodiments described herein.
P.C. 7173 LIGAMENT PROST~ESIS
A variety of prostheses have been proposed for the repair or replacement of diseased or damaged ligaments, in particular the anterior cruciate ligament.
U.S. Patent No. 4,605,414 discloses a process for such a repair wherein the damagea ligament is removed and a strip of patellar tendon is combined with a sleeve of synthetic biocompatible material thereby creating the new anterior cruciate ligament.
U.S. Patent No . 4,597,766 discloses a ligament replacement which is comprised of a naturally occurring ligament or tendon isolated from an animal source tanned with a bifunctional reagent capable of cross-linking biological tissue. The ligament is fixed in place by attachment of a dicalcified chip of bone which is shaped to receive and retain the bioprosthesis.
U.S. Patent No. 3,953,896 discloses a prosthetic ligament used to replace a damaged cruciate ligament.
In this patent, the prosthetic ligament includes a cylindrical central portion of polyethylene and threaded outer portions provided with bushings to protect the central portion from abrasion caused b~
skeletal flexing. Fasteners, in the form of nut members, are also provided to fasten the prosthesis within the skeletal apertures.
U.S. Patent No. 3,545,008 discloses a tendon prosthesis which consists of a Dacron mesh sleeve sutured to the proximal ends of a ruptured tendon. The sleeve includes a mesh netting at its outer ends to encourage fibroblastic infiltration to occur between ~o~
the severed ends of the tenaon for anchoring the prosthesis to the tendon.
U.S. Patent No. 4,1~7,558 relates to a prosthetic ligament positioned within a surgically prepared passageway in the bone, and a Dacron or Dacron and silicone strand is disclosed as a replacement for a cruciate ligament with Dacron velour fabric used as collars at the outer ends of the central portion of the prosthesis to promote new tissue growth.
U.S. Patent No. 3,797,047 discloses an artificial tendon material which consists of a tubular sheath of silicone elastomer with an inner tensile element of knitted fabric.
U.S. Patent No. 3,805,300 discloses a tendon which is composed of a cord-like combination of silicone and Dacron strip with transverse openings for the natural tendon to be woven therethrough.
In these prior art procedures are well documented the various problems and possible solutions for the repair and/or replacement of the anterior cruciate ligament. A major problem that the prior art has not solved is how to make a replacement anterior cruciate ligament perfor~ in substantially the same manner as the natural anterior cruciate ligament.
The prosthesis of the present invention is placed in the appropriate position to reproduce the femoral and tibial anterior cruciate ligament origins, and then tensioned to approximate the anterior and posterior fibers of the normal anterior cruciate ligament. The result is a substantially smoother and more stable natural range of motion in a knee of a patient.
The prosthesis of the present invention overcomes the technical, surgical and practical shortcomings of the prior art. An important feature of the present l~90S(I~
invention is the ability to separately tension the first and second cords to more closely duplicate the function of the normal knee. A further important feature is that the cords, once tensioned, are fixed in the knee so that there is no backward movement of the tensioned cords.
The device of the present invention combines all of these features in one prosthetic device. These features, and other features discussed hereinafter, result in a prosthesis which is dynamically stable and therefore promotes smoother and more natural movement of the knee in the body of a patient.
The present invention relates to a prosthesis for an anterior cruciate ligament comprising first and second elongate members, first and second tensionable cords, a capture means, and means for securing the elongate members to the femur and tibia, respectively.
The first and second elongate members are inserted into a congruent channel in the femur and tibia, respectively, each member having a longitudinal bore.
The first tensionable cord is fixedly attached to the first elongate member and adapted to extend through the bore of the second elongate member, while the second cord is fixedly attached to the second elongate member and is adapted to extend through the bore of the first elongate member. Catch means of the prosthesis are positioned on the bore surface of each elongate member to releasably engage the respective cord which extends through the bore.
The catch means is preferably smooth, rounded projections on the bore to engage the first and second cords. The means for securing the elongate members to the femur and tibia is preferably a stepped cylirdrical housing, most preferably coated with a porous material capable of receiving bone tissue ingrowth.
The invention will be described in detail with reference to a preferred embodiment thereof, which is a anterior cruciate ligament prosthesis. Reference to this embodiment does not limit the scope of the invention, which is limited only by the scope of the claims.
In the drawings:
Fig. 1 is an exploded top view of a prosthesis of the invention.
Fig. 2 is a rear elevational view of the device of Fig. 1.
Fig. 3 is a cross sectional view taken along line 3-3 of the device of Fig. 2.
Fig. 4 is a cross sectional view taken along line 4-4 of the device of Fig. 3.
Figs. 5 and 6 illustrate the prosthesis in Fig. 1 implanted in a patient's knee.
Fig. 7 illustrates the stress-strain characteristics of a normal ligament and the prosthesis of the invention.
A prosthesis 4 for a ligamen~ of the invention is shown in Fig. 1. Device 4 comprises first and second elongate members 2 and 6 respectively. The elongate members, with a longitudinal bore 8, are inserted into congruent channels 10 in the femur and tibia. The device 4 further includes first and second tensionable cords 12, 13, respectively. The first cord 12 is fixedly attached to the first elongate member 2 and is adapted to extend through the longitudinal bore 8 of the second elongate member 6. The second cord 13 is fixedly attached to the second elongate member 6 and adapted to extend through the longitudinal bore 8 of the first elongate member 2. The cords are preferably 1~30'~ 4 ultrasonically welded to secure them to the elongate member to which they are fixedly attached.
A catch means, most preferably smooth rounded projections 20, is located in each of the elongate members 2 and 6 to hold securely thé second and first cords 13, 12, respectively. Additionally, a plug 16 with a V-shape is inserted into the bore 8 of each elongate member at the end opposed to the other elongate member. The plug 16 engages the respective cord member which extends through the bore 8 to its associated elongate member, with the plug holding the cord at a desired level of tension. The device further includes a means for securing each of the elongate members to the femur and tibia, respectively. The first and second elongate members 2 and 6, respectively, are preferably made of a surgical implant metal or metal alloy, such as cobalt chrome alloy. The metal or metal alloy parts can be readily manufactured by conventional casting, machining, etc., processes known to those skilled in the art.
The elongate members preferably have two diameters, a narrow diameter for placement in the bone at the intracondular notch and a wider diameter which acts to secure the member to the femoral and tibial end of the bone. The narrow diameter is preferably from about 9 mm. to 15 mm., while the wider diameter is preferably from about 14 mm to 20 mm. The elongate member is further provided with a porous coating 18 to further secure the device 4 by bone ingrowth in the tibial and femoral regions (see Figs. 5 and 6). The securing means is preferably a step cylinder with the larger diameter being positioned at the insertion end of the femur and tibia, respectively.
The first and second tensionable cords are pre-ferably made of woven implantable polyester material, most preferably Type 55 or Type 56 dacron. Pref~rably the tensionable cord has a strength of from about 300-900 lbs. with a diameter of from about .093 to .200 inches. The weave of the material will be preferably standard hollow or solid braid with strand size to range from 10-70 denier. Double weaving of the material is preferable, wherein each strand is braided and the individual braids make the cord weave.
The characteristics of the prosthetic ligament are chosen to match the natural ligament characteristics under low and moderate amounts of stress and strain. As shown in Fig. 7, higher degrees of strain and stress the prosthetic ligament will perform better than the natural ligament. The specific stress strain performance is achieved by a combination of weave type and heat setting.
The first cord 12 is fixedly attached to the first elongate member 2 as shown in Fig. 3, which also shows the device 4 with the catch means engaged. The second cord 13 is securely held in a fixed position, once the tensioning step is completed, by the rounded projections 20, and the plug 16 which is placed in the longitudinal bore 8 on the tibial side of the device. The same procedure is then performed on the femoral side wit~h the first cord 12. In this way the cords are loc~ed once the desired tension is achieved in each of the two cords.
As shown in Figs. 5 and 6 the first and second elongate members 2, 6 respectively are designed to be positioned so that they are in an oblique angle to one another. This step is important to the successful operation of the prosthetic ligament. The first and second cords are separately tensioned to independently act for flexion and extension. It is important also to the advantageous use of the prosthesis that the elongate member not be allowed to extend beyond the 1~9(~
aperture in the osteous tunnel which would cause abrasion of the tissue.
The use of device 4 will be described with reference to the implantation. It is to be understood that a fixation device of the present invention can be used with similar techniques to affix other types of prostheses for the anterior cruciate ligaments ~ACL) or other ligaments or tendons, or to affix the same type of prosthesis when used to repair or replace other ligaments or tendons than the ACL. The first step in the procedure is to create two substantially cylin-drical through drill holes (note broken lines in FIG. 5 and 6) in the femur and tibia, insert the second elongate member 6 through the rear end of the tibial drill hole (at the right of the hole in FIG. 5 and 6) and advance the member therein until the front of the elongate member 6 is flush with the tibial drill hole in the intracondular notch (at the left in FIG. 5 and 6), and then thread cord 13 sequentially through the femoral drill hole and first elongate member 2 in the direction shown by means of for example, a leader and thread.
The first elongate member 2 is then threaded through the femur in the same manner as on the tibial side. The next step is to pretension the two cords to the desired extent, for example with a conventional pretensioning tool or by hand with the use of an appropriate gauge. Each cord is held in the desired state of pretension wherein the plug 16 is then inserted through the rear end of the appropriate elongate member, in which position cord is firmly held and the tensioning tool is removed. The excess cord is then cut.
Further modifications will occur to those skilled in the art. The scope of the invention is defined by the appended claims and should not be understood as limited by the specific embodiments described herein.
Claims (6)
1. A prosthesis for an ligament comprising:
(a) first and second elongate members for insertion into a congruent channel in the femur and tibia, respectively, each member having a longitudinal bore;
(b) first and second tensionable cords, the first cord being fixedly attached to the first elongate member and adapted to extend through the bore of the second elongate member, the second cord being fixedly attached to the second elongate member and adapted to extend through the bore of the first elongate member, (c) a capture means for engaging the respective cord member extending through the bore at a desired level of tension;
(d) means for securing each of the elongate members to the femur and tibia, respectively.
(a) first and second elongate members for insertion into a congruent channel in the femur and tibia, respectively, each member having a longitudinal bore;
(b) first and second tensionable cords, the first cord being fixedly attached to the first elongate member and adapted to extend through the bore of the second elongate member, the second cord being fixedly attached to the second elongate member and adapted to extend through the bore of the first elongate member, (c) a capture means for engaging the respective cord member extending through the bore at a desired level of tension;
(d) means for securing each of the elongate members to the femur and tibia, respectively.
2. The device of Claim 1 wherein the capture means comprise smoothly rounded projection to which engage the first and second cords on the bore.
3. The device of Claim 1 wherein the first and second cords are made of dacron.
4. The device of Claim 3 wherein the first and second cords are coated with silicone.
5. The device of Claim 1 wherein the means for securing the elongate members to the femur and tibia is a stepped cylindrical housing.
6. The device of Claim 5 wherein the housing is coated with a porous material.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/012,409 US4755183A (en) | 1987-02-09 | 1987-02-09 | Ligament prosthesis |
| US12,409 | 1987-02-09 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1290504C true CA1290504C (en) | 1991-10-15 |
Family
ID=21754827
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000558240A Expired - Fee Related CA1290504C (en) | 1987-02-09 | 1988-02-05 | Ligament prosthesis |
Country Status (9)
| Country | Link |
|---|---|
| US (1) | US4755183A (en) |
| EP (1) | EP0278713B1 (en) |
| JP (1) | JPS63200754A (en) |
| AT (1) | ATE61216T1 (en) |
| AU (1) | AU595679B2 (en) |
| CA (1) | CA1290504C (en) |
| DE (2) | DE8801427U1 (en) |
| ES (1) | ES2020599B3 (en) |
| ZA (1) | ZA88851B (en) |
Families Citing this family (38)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4828562A (en) * | 1988-02-04 | 1989-05-09 | Pfizer Hospital Products Group, Inc. | Anterior cruciate ligament prosthesis |
| US5197983A (en) * | 1988-04-19 | 1993-03-30 | W. L. Gore & Associates, Inc. | Ligament and tendon prosthesis |
| US4917700A (en) * | 1988-08-01 | 1990-04-17 | Zimmer, Inc. | Prosthetic ligament |
| GB8821229D0 (en) * | 1988-09-09 | 1988-10-12 | Imperial College | Improvements in & relating to ligaments |
| US4955910A (en) * | 1989-07-17 | 1990-09-11 | Boehringer Mannheim Corporation | Fixation system for an elongated prosthesis |
| US5151104A (en) * | 1989-10-26 | 1992-09-29 | Pfizer Hospital Products Group, Inc. | Self-locking joint connector |
| US5004474A (en) * | 1989-11-28 | 1991-04-02 | Baxter International Inc. | Prosthetic anterior cruciate ligament design |
| GB9011435D0 (en) * | 1990-05-22 | 1990-07-11 | Goodfellow John W | Artificial ligaments |
| FR2676356A1 (en) * | 1991-05-13 | 1992-11-20 | Cendis Medical | Fixation element for ligaments |
| FR2683715B1 (en) * | 1991-11-14 | 1995-07-07 | Bahuaud Jacques | TEXTILE PROSTHESIS OF LIGAMENT CROSS ANTERIOR KNEE. |
| US5507812A (en) * | 1992-12-28 | 1996-04-16 | Moore; David E. | Modular prosthetic ligament |
| WO1996016612A1 (en) * | 1994-12-02 | 1996-06-06 | Omeros Medical Systems, Inc. | Tendon and ligament repair system |
| US6106556A (en) * | 1994-12-02 | 2000-08-22 | Omeros Medical Systems, Inc. | Tendon and ligament repair system |
| US6554862B2 (en) | 1996-11-27 | 2003-04-29 | Ethicon, Inc. | Graft ligament anchor and method for attaching a graft ligament to a bone |
| US7083647B1 (en) * | 1996-11-27 | 2006-08-01 | Sklar Joseph H | Fixation screw, graft ligament anchor assembly, and method for securing a graft ligament in a bone tunnel |
| US5899938A (en) | 1996-11-27 | 1999-05-04 | Joseph H. Sklar | Graft ligament anchor and method for attaching a graft ligament to a bone |
| US6533816B2 (en) | 1999-02-09 | 2003-03-18 | Joseph H. Sklar | Graft ligament anchor and method for attaching a graft ligament to a bone |
| US6280472B1 (en) * | 1997-07-23 | 2001-08-28 | Arthrotek, Inc. | Apparatus and method for tibial fixation of soft tissue |
| US5931869A (en) * | 1997-07-23 | 1999-08-03 | Arthrotek, Inc. | Apparatus and method for tibial fixation of soft tissue |
| US6387129B2 (en) * | 1998-03-18 | 2002-05-14 | Arthrex, Inc. | Bicortical tibial fixation of ACL grafts |
| US6221107B1 (en) | 1998-08-03 | 2001-04-24 | Mark E. Steiner | Ligament fixation device and method |
| US6235058B1 (en) | 1998-10-19 | 2001-05-22 | Douglas B. Huene | Bone plug anchoring device and methods for anchoring one or more tendons or other grafts using the bone plug anchoring device |
| JP2001198147A (en) * | 2000-01-17 | 2001-07-24 | Matsuda Ika Kk | Ligament reinforcing material |
| US6827743B2 (en) * | 2001-02-28 | 2004-12-07 | Sdgi Holdings, Inc. | Woven orthopedic implants |
| US7229441B2 (en) * | 2001-02-28 | 2007-06-12 | Warsaw Orthopedic, Inc. | Flexible systems for spinal stabilization and fixation |
| US6652585B2 (en) * | 2001-02-28 | 2003-11-25 | Sdgi Holdings, Inc. | Flexible spine stabilization system |
| US7344539B2 (en) * | 2001-03-30 | 2008-03-18 | Depuy Acromed, Inc. | Intervertebral connection system |
| US6887271B2 (en) | 2001-09-28 | 2005-05-03 | Ethicon, Inc. | Expanding ligament graft fixation system and method |
| US6764513B1 (en) | 2001-11-07 | 2004-07-20 | Brian T. Dowling | Tibia tether |
| US7682392B2 (en) | 2002-10-30 | 2010-03-23 | Depuy Spine, Inc. | Regenerative implants for stabilizing the spine and devices for attachment of said implants |
| US7407511B2 (en) | 2004-05-13 | 2008-08-05 | Wright Medical Technology Inc | Methods and materials for connective tissue repair |
| US7648524B2 (en) * | 2005-12-23 | 2010-01-19 | Howmedica Osteonics Corp. | Porous tendon anchor |
| US8226714B2 (en) | 2006-09-29 | 2012-07-24 | Depuy Mitek, Inc. | Femoral fixation |
| CA2682701A1 (en) | 2007-03-20 | 2008-09-25 | Serica Technologies, Inc. | Prosthetic device and method of manufacturing the same |
| WO2009047767A1 (en) * | 2007-10-11 | 2009-04-16 | Tavor [I.T.N] Ltd. | Ligament and tendon prosthesis |
| US20110046734A1 (en) * | 2008-03-13 | 2011-02-24 | Tavor (I.T.N) Ltd. | Ligament And Tendon Prosthesis |
| US20100049258A1 (en) * | 2008-08-19 | 2010-02-25 | Dougherty Christopher P | Single tunnel double bundle posterior cruciate ligament reconstruction |
| US9333069B2 (en) | 2011-10-14 | 2016-05-10 | Biomet Sports Medicine, Llc | Method and apparatus for attaching soft tissue to bone |
Family Cites Families (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR2213761B1 (en) * | 1973-01-17 | 1976-05-14 | Rambert Andre | |
| US3953896A (en) * | 1974-09-06 | 1976-05-04 | Richards Manufacturing Company, Inc. | Prosthetic ligament |
| US4149277A (en) * | 1977-06-22 | 1979-04-17 | General Atomic Company | Artificial tendon prostheses |
| US4187558A (en) * | 1977-10-25 | 1980-02-12 | Cutter Laboratories, Inc. | Prosthetic ligament |
| US4187958A (en) * | 1978-09-12 | 1980-02-12 | Abex Corporation | Flow proportional conveyor drive system |
| DE3008270A1 (en) * | 1980-03-04 | 1981-09-17 | Meadox Medicals, Inc., Oakland, N.J. | Ligament or tendon prosthesis - is polyethylene terephthalate strip held lengthwise while treated with shrinking agent to reduce lengthwise extensibility |
| US4455690A (en) * | 1980-11-06 | 1984-06-26 | Homsy Charles A | Structure for in vivo implanation |
| US4464812A (en) * | 1983-10-24 | 1984-08-14 | The Crosby Group, Inc. | Socket for structural strand |
| US4597766A (en) * | 1984-10-26 | 1986-07-01 | American Hospital Supply Corporation | Implantable bioprosthetic tendons and ligaments |
| US4744793A (en) * | 1985-09-06 | 1988-05-17 | Zimmer, Inc. | Prosthetic ligament connection assembly |
| US4708132A (en) * | 1986-01-24 | 1987-11-24 | Pfizer-Hospital Products Group, Inc. | Fixation device for a ligament or tendon prosthesis |
-
1987
- 1987-02-09 US US07/012,409 patent/US4755183A/en not_active Expired - Fee Related
-
1988
- 1988-02-05 CA CA000558240A patent/CA1290504C/en not_active Expired - Fee Related
- 1988-02-05 DE DE8801427U patent/DE8801427U1/de not_active Expired
- 1988-02-08 EP EP88301026A patent/EP0278713B1/en not_active Expired - Lifetime
- 1988-02-08 AT AT88301026T patent/ATE61216T1/en not_active IP Right Cessation
- 1988-02-08 DE DE8888301026T patent/DE3861870D1/en not_active Expired - Fee Related
- 1988-02-08 ES ES88301026T patent/ES2020599B3/en not_active Expired - Lifetime
- 1988-02-08 ZA ZA88851A patent/ZA88851B/en unknown
- 1988-02-08 JP JP63027379A patent/JPS63200754A/en active Granted
- 1988-02-08 AU AU11394/88A patent/AU595679B2/en not_active Ceased
Also Published As
| Publication number | Publication date |
|---|---|
| DE8801427U1 (en) | 1988-07-14 |
| EP0278713B1 (en) | 1991-03-06 |
| ATE61216T1 (en) | 1991-03-15 |
| US4755183A (en) | 1988-07-05 |
| JPS63200754A (en) | 1988-08-19 |
| ES2020599B3 (en) | 1991-08-16 |
| AU1139488A (en) | 1988-08-11 |
| ZA88851B (en) | 1989-09-27 |
| JPH0448055B2 (en) | 1992-08-05 |
| AU595679B2 (en) | 1990-04-05 |
| DE3861870D1 (en) | 1991-04-11 |
| EP0278713A1 (en) | 1988-08-17 |
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| Date | Code | Title | Description |
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| MKLA | Lapsed |