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Publication numberUS3176316 A
Publication typeGrant
Publication dateApr 6, 1965
Filing dateJan 7, 1963
Priority dateJan 7, 1963
Publication numberUS 3176316 A, US 3176316A, US-A-3176316, US3176316 A, US3176316A
InventorsBruce R Bodell
Original AssigneeBruce R Bodell
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Plastic prosthetic tendon
US 3176316 A
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Description  (OCR text may contain errors)

April 6, 1965 B. R. BODELL PLASTIC PROSTHETIC TENDON Filed Jan. 7, 1963 Inventor BRUCE R. BODELL 35/ MM, 611mm zMflaeaw United States Patent 0 3,176,316 PLASTIC PROSTEETIC TENDON Bruce R. Bodeil, 808 PM Ava, River Forest, Ell. Filed Jan. 7, 1963, Ser. No. 249,818 2 Qlaims. (Cl. 3-1) This invention relates to improvements in plastic tendon prostheses and to methods for effecting improved plastic prosthetic tendon grafts. More particularly, the invention is directed to a tendon substitute which by reason of improved structure, especially end structure, and which, by reason of improved suture methods, obviates, in use, many of the undesirable and objectionable features and the shortcomings of prior art devices and techniques.

, Up to the present there have been no completely satisfactory techniques and no uniformly successful procedures by which transected tendons of the fingers could be reapproximated or replaced by autogenous tendon grafts to give normal finger function, particularly when the transection occurs in the area of the middle and proximal phal-anges of the fingers. The principal cause for this I failure has been adherence of scar tissue (at the site of tendon suture) to the sheath which surrounds the tendon. In many instances, the overall result has been immobiliza tion of the tendon. Attempts to prevent adhesion have met with only limited success, and because of these frequent adhesions, neither primary repeir nor delayed autogenous tendon grafting has yielded consistently good funcare also suitable.

Teflon grafts have been used in the prior art, to replace the extensor communis or anterial tibial tendons of dogs. These particular tendons were selected for research, experimentation, investigative work, and testing because,

being covered by sheaths where they pass beneath an extensor retinaculum, they present problems which approximate very closely similar problems which must be considered in dealing with other fiexor tendons, such as tendons of the fingers in the human.

In prior art plastic prosthetic tendon research and investigations, grafts of closely woven or braided Teflon, coated with liquid Teflon to prevent tissue ingrowth, have been used. A bifurcation V was provided at each end of the prosthetic tendon. The arms of the bifurcation were flat bars of limited flexibility. These Y bars were sutured to the tendon ends, either with Teflon or with mattress sutures of 4-0 silk. While these plastic prosthetic tendons and the suturing techniques used have produced encouraging results in initial investigations, they have not been completely successful in several important applications, particularly when directed to transections in the area of the middle and proximal phalanges of the fingers. Frequently, the failures were due to scar tissue which formed at the site of tenton suture, where the bars of the plastic tendons were sutured to the living tendon. This scar tissues adhered to the sheath which surrounds the tendon and the tendon was immobilized.

The principal object of the present invention is to provide an improved prosthetic tendon which is acceptable to and compatible with human tissues and which will glide freely in the tissues to ensure adequate motion of the part controlled.

Another important object is to provide an improved 3,l76,3l6 Patented Apr. 6, 1955 end structure for joining prosthetic tendons to natural living tendons or other tissues.

Still another object of the invention is to provide a prosthetic tendon in which the junction of the prosthetic with the living tendon is at a site away from the tendon sheath.

Related important objects of the present invention are to provide improved overall structures for prosthetic tendons; to provide improved methods of joining prosthetic tendons to living tendons and to muscles and other tissues; to provide an improved prosthetic tendon which can be joined with living tendon in a manner to avoid disruption when usual and ordinary stresses are imposed after healing has occurred; to provide a prosthetic tendon which can be used to replace a transected tendon or a fixed tendon; to provide a prosthetic tendon which may be used to replace not only transected tendons, but which may also be used as a replacement in the case of destruction of tendons anywhere in the body where destruction of the natural tendon, as for example through crushing, burns, or missile injuries, has been so extensive as to preclude reapproximation of the severed ends; and to provide a prosthetic tendon which can be connected to a living tendon in a manner to minimize the formation of motion-impairing scar tissue.

Through a technique of tendon transfer to a nonparalyzed muscle, the prosthesis may be used to restore the function of a body part immobilized by muscle paralysis. It may also be used for manipulating parts of limb prosthesis by connection with body muscles through the artificial tendon.

Other objects, advantages, and utilities of the present invention will become apparent as the detailed description continues and upon consideration of the accompanying drawings forming a part of this specification and in which like numerals are employed to designate like parts throughout the same.

FIGURE 1 is a schematic representation of the prosthetic tendon of the invention;

FIGURE 2 is an end view of the prosthesis of the invention taken along the line 22 of FIGURE 1;

FIGURE 3 is an enlarged view of an end detail of the prosthesis of the invention; and

FIGURE 4 is a schematic idealized representation of the manner of suture of the prosthesis to a tendon.

Referring now to FIGURE 1, there is shown, for the purpose of illustrative disclosure, a preferred embodiment of the tendon prosthesis of the invention. The prosthesis, indicated generally at 11, consists of a body in the form of a strong solid or semi-solid flexible shaft 12 having an outer shell or sheath 13 of finely braided, woven, or intertwined inelastic synthetic plastic material such as Teflon, Kel-F, or Silastic, some of the fibers or threads 14 of which continue to and beyond the ends of the principal structure forming an expanding, conically shaped loosely woven casing or sleeve 15 near the ends and terminating, finally, in a plurality of well defined individual or composite strands, threads, or distinct thread-like fibers 16 extending longitudinally beyond the ends of the main portion of the device. Instead of constituting a direct extension of the hollow sleeve or casing 15, the threads may be anchored at a position within the sleeve 15 or even to the shaft portion of the prosthesis. As illustrated in FIG- URE 1, the terminating threads extending outwardly of the ends of the body of the prosthesis proper are four in number. While more than four end threads may be used, if desired, it has been found that four threads are adequate for efiecting a good and a balanced suture bond between the prosthesis of the invention and the natural tendon to which it is connected. Three end threads have provided satisfactory suture bonds, and prosthetic tendons having cial problems in establishing a balanced mechanical stresssupporting bond between the prosthesis and the tendon The flexible shaft portion'12' of the prosthetic tendon maybe of any desired length, depending .upon the particular use and function intended. In cross-section, as depictedin thepreferred embodiment of FIGURE 2, the prosthesis is circular. It may be oval or'elliptical, and in certain cases a shaft having a double-bowed or a fairly flat cross-sectional configuration may be a satisfactory form. In most instances, the shape of the original natural tendon itself will be adapted for the prosthesis. The shaft 'l2 of the prosthetic tendon isof a braided or of a finely woven mesh of a synthetic m aterial such. as Teflon, Kel-F, Silastic, etc; This structural form imparts both flexibility and strength to the tendon. Elasticity is should be longenough to, permit their use as sutures for connecting the prosthetic tendon to the natural tendon.

' A thread length of 3" to 4" is preferred for many applications. Shorter lengths may be used and special uses may require longer terminal-threads.

' While preferred embodiments of the invention'have to be avoided. The shaft maybe essentially solid throughf out the major portion of its length, :but as described and depicted in the drawings, the shaft is formed to provide a loosely woven hollow cylindrical casing or sleeve at either end (see FIGURE 3). It is into this hollow po'r tion 17 or open cylindrical sleeve-that the end 18 of the of livingtendon fibers 20 to form an integral firm and v 1 strong union between the-prosthetic'tendon and the living been provided;-it will be apparent-that numerous modifications and variations thereof maybe without de'parting from underlying principles of'the invention. It is therefore desired by the following claims to include within the scope of the inventionall' such variations and modifications by which substantially the results of thisEinvention may be-obtained through the use of substantially, the same or equivalent means. a Y a What is claimed is: 1 i a l. A tendon prosthesis comprisinga solid central section longitudinally aligned between and integrally joined to hollow end sleeve sections, said central section having an elongatedv substantially inelastic, flexible shaft including a tight mesh .lubric plastic outer sheath portion impenetrable to livingfibers and scar tissue, each said hollow end sleeve section extending longitudinally from" said cenliving tendon 19 is inserted at the time theprosthetic tendon is sutured or otherwise fastened to the natural tral section and having anopen end to'receive therewithin the end of a living tendon, each said hollow end sleeve section being a loose mesh to facilitate ingrowth of living tissue, and each said hollow end sleeve section having a plurality of endwise projecting connection threads for suture into the corresponding tendon for fixingsuchtentendon 19. The bond developed through ingrowth of the a living tendon into the sleeve 15:0f the prosthesis is important in supplementing themechanical bond provided by suturing the plastic end-threads" 16-or fibers of'thei prosthetic tendon to the end 18 of the living tendon 19.

' WhileQas is apparent from the above discussion, it is, important to encourage ingrowth of natural tendon fibers" atthe ends of the prosthetic tendon,]that is, withinthe sleeve 15, :it is essential that ingrowth of tissues into the shaft portion 12 of the prosthesis be avoided and that the shaft be smooth and fiber-impervious. The outer sheath shaft by natural fibers and tissuesh Inorder to provide a still'smoother and more impervious outer surface a coat- 13'is tightly woven or braided to preclude invasion of, the

don to the prosthesis while living tissue ingrows in the loose mesh to form a secure bond,

. 2.;A-tendon prosthesis comprising a: solid central-section longitudinally aligned between and i'nte grally joined to hollow end sleeve sections, saidcentral section 'provid ing an elongated substantially inelastic,fflexible shaft and 1 comprising "a large number of interwoven 'lubi'ic plastic threads defining a 't'ight mesh outer sheath portion impenetrable to living fibers and scartissue, with only some of said threads continuing endwisein each direction from said central section to-constitute each end section as a loose mesh sleeve having'a main length region to facilitate ingrowth of living tissue and having an ,open end to receive therewithin the endof a living tendon, and

Y several of the threads comprising each said hollow end The overall diameter of the shaft 12 will be dictated by the dimensions of the particular natural tendoni with which it is to be associated 'or which it is to replace in whole or in part. Ordinarily. the thickness or the diameter willbe" in the order of to /1 inch; The length ofjithe 7 loosely woven sleeve or hollowed end portion 15 of the prosthesisshould be sufficient to receive the natural tendon segment 22' which isrto be inserted; Ordinarily, a; length of about A to about of an inch .is sufiicient'.

For larger tendons, longer. sleeves are to be preferred.

The terminal threads or strands 16 of the prosthesis sleeve section continuing therebeyond fonsuture into the,

corresponding tendon for fixingsuch'tendon to the prosform a secure bond;

'thesis whileliving tissue ingrows in the loose mesh to References Cited by the Examiner 7 UNITEDSTATES PATENTS V 8/38 1 Bowen 3-1 OTHER REFERENCES Williams: Teflon as a Tendon Substitute, from Surgical Forum,'vol. XI, October 1960, pp...'39-40.

RICHARD A. GAUDET, Primary Examiner,

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US2127903 *May 5, 1936Aug 23, 1938Davis & Geck IncTube for surgical purposes and method of preparing and using the same
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US3513484 *Oct 27, 1967May 26, 1970Extracorporeal Med SpecArtificial tendon
US3545008 *May 27, 1968Dec 8, 1970Karl F Bader JrTendon prosthesis
US3577837 *Apr 30, 1968May 11, 1971Karl F Bader JrSubdermal tendon implant
US3596292 *Feb 20, 1969Aug 3, 1971Franklin InstituteHair implant structure
US3646615 *Jan 26, 1970Mar 7, 1972Richard A NessReinforcing element for muscles
US3683422 *Aug 10, 1970Aug 15, 1972Cutter LabBone prosthesis
US3745590 *Jun 25, 1971Jul 17, 1973Cutter LabArticulating prosthesis with ligamentous attachment
US3797047 *Apr 28, 1972Mar 19, 1974Rhone Poulenc SaArtificial tendon
US3805300 *Jul 28, 1972Apr 23, 1974Cutter LabTendon prosthesis
US3823705 *Dec 26, 1972Jul 16, 1974Dow CorningBlood vessel bridging device
US3858245 *May 18, 1972Jan 7, 1975Hair Again LtdMethod of applying hair with individual sutures
US3896500 *Jan 8, 1974Jul 29, 1975Gilles BousquetMethod of and prosthesis for restoring ligaments of a joint
US3971670 *Jul 17, 1974Jul 27, 1976Homsy Charles AImplantable structure and method of making same
US3987497 *Mar 20, 1975Oct 26, 1976Ceskoslovenska Akademie VedTendon prosthesis
US4052754 *Jul 14, 1976Oct 11, 1977Homsy Charles AImplantable structure
US4127902 *Mar 17, 1978Dec 5, 1978Homsy Charles AStructure suitable for in vivo implantation
US4149277 *Jun 22, 1977Apr 17, 1979General Atomic CompanyArtificial tendon prostheses
US4246660 *Dec 26, 1978Jan 27, 1981Queen's University At KingstonArtificial ligament
US4255820 *Jul 24, 1979Mar 17, 1981Rothermel Joel EArtificial ligaments
US4301551 *Jul 9, 1979Nov 24, 1981Ecole PolythechniqueDeformable high energy storage tension spring
US4345339 *May 19, 1981Aug 24, 1982Sulzer Brothers LimitedBiologically implantable member for a tendon and/or ligament
US4400833 *Jun 10, 1981Aug 30, 1983Kurland Kenneth ZMeans and method of implanting bioprosthetics
US4469101 *Jun 7, 1982Sep 4, 1984Battelle Memorial InstituteSuture device
US4483331 *Sep 16, 1982Nov 20, 1984Medical Engineering CorporationRod-type penile implant
US4548201 *Apr 20, 1982Oct 22, 1985Inbae YoonElastic ligating ring clip
US4610688 *Apr 4, 1983Sep 9, 1986Pfizer Hospital Products Group, Inc.Triaxially-braided fabric prosthesis
US4792336 *Mar 3, 1986Dec 20, 1988American Cyanamid CompanyGlycolic acid ester and trimethylene carbonate copolymer
US4915893 *Jul 15, 1983Apr 10, 1990Medtronic, Inc.Method of preparing polyester filament material
US4979956 *Jul 10, 1989Dec 25, 1990Pfizer Hospital Products Group, Inc.Device and method for tendon and ligament repair
US5049155 *Aug 16, 1990Sep 17, 1991W. L. Gore & Associates, Inc.Elongated concentric loops
US5061283 *Nov 15, 1990Oct 29, 1991Pfizer Hospital Products Group, Inc.Method for tendon and ligament repair
US5110852 *Oct 27, 1988May 5, 1992Rijksuniversiteit Te GroningenFilament material polylactide mixtures
US5171274 *Aug 28, 1991Dec 15, 1992Sulzer Brothers LimitedImplant for replacing a ligament or tendon
US5197983 *Aug 20, 1991Mar 30, 1993W. L. Gore & Associates, Inc.Ligament and tendon prosthesis
US5258040 *Feb 28, 1991Nov 2, 1993W. L. Gore & AssociatesProsthesis for tensile load-carrying tissue and method of manufacture
US5456722 *Jul 30, 1993Oct 10, 1995Smith & Nephew Richards Inc.Load bearing polymeric cable
US5540703 *Nov 30, 1994Jul 30, 1996Smith & Nephew Richards Inc.Knotted cable attachment apparatus formed of braided polymeric fibers
US5549676 *Sep 16, 1994Aug 27, 1996Johnson; Lanny L.Biological replacement ligament
US5800544 *Dec 4, 1995Sep 1, 1998Omeros Medical Systems, Inc.Tendon and ligament repair system
US6080192 *May 28, 1998Jun 27, 2000Omeros Medical Systems, Inc.Tendon and ligament repair system
US6106556 *Oct 29, 1998Aug 22, 2000Omeros Medical Systems, Inc.Tendon and ligament repair system
US6106558 *Sep 15, 1997Aug 22, 2000Applied Medical Research, Inc.Neuro decompression device
US6203572Feb 9, 1999Mar 20, 2001Linvatec CorporationDevice and method for ligament reconstruction
US6214047 *Mar 10, 1998Apr 10, 2001University Of CincinnatiArticle and method for coupling muscle to a prosthetic device
US6322571Apr 5, 1999Nov 27, 2001Brian D. AdamsApparatus and method for placing sutures in the lacerated end of a tendon and similar body tissues
US6342060 *Aug 20, 1999Jan 29, 2002Brian D. AdamsTendon passing device and method
US6592622 *Oct 24, 2000Jul 15, 2003Depuy Orthopaedics, Inc.Apparatus and method for securing soft tissue to an artificial prosthesis
US6733510Jan 12, 2000May 11, 2004University Of CincinnatiArticle and method for coupling muscle to a prosthetic device
US6740100Mar 28, 2002May 25, 2004Omeros CorporationTendon repair using adhesive
US6986751Oct 31, 2003Jan 17, 2006Cabg Medical, Inc.Grafted network incorporating a multiple channel fluid flow connector
US6991615Aug 2, 2004Jan 31, 2006Cabg Medical, Inc.Grafted network incorporating a multiple channel fluid flow connector
US7001429Jun 17, 2003Feb 21, 2006Depuy Orthopaedics, Inc.suturing connective tissues to resorbable and biologically inert materials of the retaining member of the prosthesis; enhanced mechanical anchoring; stimulating tissue ingrowth; joint (knee) replacement surgery
US7011643Aug 5, 2003Mar 14, 2006Cabg Medical, Inc.Grafted network incorporating a multiple channel fluid flow connector
US7041140Sep 24, 2002May 9, 2006Applied Medical Research, Inc.Neuro decompression device
US7494506 *Jan 21, 2005Feb 24, 2009Lars-Laboratoire D'application Et De Recherche ScientifiqueMethod for fixing traction threads to ends of a prosthetic ligament
US7658705Dec 8, 2005Feb 9, 2010Cardioenergetics, Inc.Actuation mechanisms for a heart actuation device
US7715918Oct 18, 2006May 11, 2010University Of CincinnatiMuscle energy converter with smooth continuous tissue interface
US7753837Dec 8, 2005Jul 13, 2010The University Of CincinnatiPower system for a heart actuation device
US7850729Dec 8, 2005Dec 14, 2010The University Of CincinnatiDeforming jacket for a heart actuation device
US8006700Apr 2, 2002Aug 30, 2011Demopulos Gregory ASoft tissue repair system
US8142501Apr 21, 2009Mar 27, 2012The Board Of Regents Of The University Of Texas SystemArtificial ligaments and tendons comprising multifilaments and nanofibers and methods for making
US8226716 *Jan 14, 2010Jul 24, 2012Depuy Mitek, Inc.Method and apparatus for fixing a graft in a bone tunnel
US8333803 *Nov 19, 2009Dec 18, 2012Lifecell CorporationReinforced biologic material
US8439976 *Mar 31, 2010May 14, 2013Arthrex, Inc.Integrated adjustable button-suture-graft construct with two fixation devices
US8460379Mar 31, 2010Jun 11, 2013Arthrex, Inc.Adjustable suture button construct and methods of tissue reconstruction
US8579975 *Feb 14, 2011Nov 12, 2013Imds CorporationDouble bundle ACL repair
US8591578Nov 17, 2011Nov 26, 2013Arthrex, Inc.Adjustable suture-button constructs for ligament reconstruction
US8591580Jun 5, 2012Nov 26, 2013Depuy Mitek, LlcFolded ligament graft
US8617241 *Mar 31, 2010Dec 31, 2013Imds CorporationDouble bundle ACL repair
US8628573Nov 17, 2011Jan 14, 2014Arthrex, Inc.Adjustable suture-button construct for knotless stabilization of cranial cruciate deficient ligament stifle
US8642735Apr 18, 2012Feb 4, 2014Children's Medical Center CorporationBiologic replacement for fibrin clot
US20090254104 *Mar 27, 2009Oct 8, 2009Children's Medical Center CorporationMethods and collagen products for tissue repair
US20100121448 *Jan 14, 2010May 13, 2010Depuy Mitek, Inc.Method and apparatus for fixing a graft in a bone tunnel
US20100161054 *Nov 19, 2009Jun 24, 2010Jason ParkReinforced Biologic Material
US20100249930 *Mar 31, 2010Sep 30, 2010Medicinelodge, Inc. Dba Imds Co-InnovationDouble bundle acl repair
US20100256677 *Mar 31, 2010Oct 7, 2010Arthrex, Inc.Integrated adjustable button-suture-graft construct with two fixation devices
US20110054524 *Mar 4, 2009Mar 3, 2011Xiros LimitedImplantable prosthetic cord
US20110137416 *Feb 14, 2011Jun 9, 2011Thomas H. MyersDouble bundle acl repair
US20130013065 *Jul 3, 2012Jan 10, 2013Matthew BillsTendon repair device and method
US20130204367 *Feb 2, 2012Aug 8, 2013Smith & Nephew, Inc.Implantable biologic holder
USRE43143Dec 2, 2005Jan 24, 2012Hayhurst John OTissue manipulation
EP0106501A1 *Sep 8, 1983Apr 25, 1984W.L. GORE & ASSOCIATES, INC.A synthetic prosthesis for replacement or repair of ligaments or tendons
EP0169045A2 *Jul 15, 1985Jan 22, 1986JOHNSON & JOHNSONConnective tissue prosthesis
EP0170358A1 *May 28, 1985Feb 5, 1986Surgicraft LimitedSurgical element
EP0192949A1 *Sep 8, 1983Sep 3, 1986W.L. GORE & ASSOCIATES, INC.A method of making a synthetic prosthesis for replacing or repair of ligaments or tendons
EP0201667A1 *Feb 8, 1986Nov 20, 1986Gebrüder Sulzer AktiengesellschaftArtificial tendon made of a tubular textile structure
EP0314412A1 *Oct 24, 1988May 3, 1989Howmedica Inc.Device for tendon and ligament repair
EP0475889A1 *Aug 6, 1991Mar 18, 1992SULZER Medizinaltechnik AGImplant serving as ligament or tendon
EP0498690A1 *Jan 24, 1992Aug 12, 1992Patrick SurerImplant for ligament surgery
WO1982004390A1 *Jun 8, 1982Dec 23, 1982Kenneth Z KurlandMeans and method of implanting bioprosthetics
Classifications
U.S. Classification623/13.19, 128/DIG.210, 128/DIG.140
International ClassificationA61F2/08
Cooperative ClassificationY10S128/21, A61F2/08, Y10S128/14
European ClassificationA61F2/08