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RU2003126591A - Имплантаты для создания соединений с тканями, в частности, со скелетом, а также устройство и способ имплантации - Google Patents

Имплантаты для создания соединений с тканями, в частности, со скелетом, а также устройство и способ имплантации Download PDF

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Publication number
RU2003126591A
RU2003126591A RU2003126591/14A RU2003126591A RU2003126591A RU 2003126591 A RU2003126591 A RU 2003126591A RU 2003126591/14 A RU2003126591/14 A RU 2003126591/14A RU 2003126591 A RU2003126591 A RU 2003126591A RU 2003126591 A RU2003126591 A RU 2003126591A
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RU
Russia
Prior art keywords
implant
paragraphs
resonator
liquid state
tissue
Prior art date
Application number
RU2003126591/14A
Other languages
English (en)
Other versions
RU2314768C2 (ru
Inventor
Марсель АЭСШЛИМАНН (CH)
Марсель АЭСШЛИМАНН
Лоран ТОРРИАНИ (CH)
Лоран ТОРРИАНИ
Антонио ЛАНЧИ (CH)
Антонио Ланчи
Йорг МАЙЕР (CH)
Йорг МАЙЕР
Original Assignee
Вудвелдинг Аг (Ch)
Вудвелдинг Аг
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Filing date
Publication date
Application filed by Вудвелдинг Аг (Ch), Вудвелдинг Аг filed Critical Вудвелдинг Аг (Ch)
Publication of RU2003126591A publication Critical patent/RU2003126591A/ru
Application granted granted Critical
Publication of RU2314768C2 publication Critical patent/RU2314768C2/ru

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14—Macromolecular materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/866—Material or manufacture
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00491—Surgical glue applicators
    • A—HUMAN NECESSITIES
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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    • A—HUMAN NECESSITIES
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8872—Instruments for putting said fixation devices against or away from the bone
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    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
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    • A61C8/0012—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the material or composition, e.g. ceramics, surface layer, metal alloy
    • A61C8/0016—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the material or composition, e.g. ceramics, surface layer, metal alloy polymeric material
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    • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
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    • 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
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    • 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
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C65/00—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor
    • B29C65/02—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor by heating, with or without pressure
    • B29C65/08—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor by heating, with or without pressure using ultrasonic vibrations
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    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
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    • B29C65/00—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor
    • B29C65/48—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor using adhesives, i.e. using supplementary joining material; solvent bonding
    • B29C65/52—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor using adhesives, i.e. using supplementary joining material; solvent bonding characterised by the way of applying the adhesive
    • B29C65/54—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor using adhesives, i.e. using supplementary joining material; solvent bonding characterised by the way of applying the adhesive between pre-assembled parts
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    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
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    • B29C65/562—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor using mechanical means or mechanical connections, e.g. form-fits using extra joining elements, i.e. which are not integral with the parts to be joined
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
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    • B29C65/00—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor
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    • B29C65/60—Riveting or staking
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    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
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    • B29C66/30326—Particular design of joint configurations the joint involving an anchoring effect making use of protrusions or cavities belonging to at least one of the parts to be joined making use of cavities belonging to at least one of the parts to be joined in the form of porosity
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    • B29C66/50—General aspects of joining tubular articles; General aspects of joining long products, i.e. bars or profiled elements; General aspects of joining single elements to tubular articles, hollow articles or bars; General aspects of joining several hollow-preforms to form hollow or tubular articles
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    • B29C66/50—General aspects of joining tubular articles; General aspects of joining long products, i.e. bars or profiled elements; General aspects of joining single elements to tubular articles, hollow articles or bars; General aspects of joining several hollow-preforms to form hollow or tubular articles
    • B29C66/65—General aspects of joining tubular articles; General aspects of joining long products, i.e. bars or profiled elements; General aspects of joining single elements to tubular articles, hollow articles or bars; General aspects of joining several hollow-preforms to form hollow or tubular articles with a relative motion between the article and the welding tool
    • B29C66/652—General aspects of joining tubular articles; General aspects of joining long products, i.e. bars or profiled elements; General aspects of joining single elements to tubular articles, hollow articles or bars; General aspects of joining several hollow-preforms to form hollow or tubular articles with a relative motion between the article and the welding tool moving the welding tool around the fixed article
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    • B29C66/81427—General aspects of the pressing elements, i.e. the elements applying pressure on the parts to be joined in the area to be joined, e.g. the welding jaws or clamps characterised by the design of the pressing elements, e.g. of the welding jaws or clamps characterised by the surface geometry of the part of the pressing elements, e.g. welding jaws or clamps, coming into contact with the parts to be joined comprising a single ridge, e.g. for making a weakening line; comprising a single tooth
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    • B29C66/8141—General aspects of the pressing elements, i.e. the elements applying pressure on the parts to be joined in the area to be joined, e.g. the welding jaws or clamps characterised by the design of the pressing elements, e.g. of the welding jaws or clamps characterised by the surface geometry of the part of the pressing elements, e.g. welding jaws or clamps, coming into contact with the parts to be joined
    • B29C66/81431—General aspects of the pressing elements, i.e. the elements applying pressure on the parts to be joined in the area to be joined, e.g. the welding jaws or clamps characterised by the design of the pressing elements, e.g. of the welding jaws or clamps characterised by the surface geometry of the part of the pressing elements, e.g. welding jaws or clamps, coming into contact with the parts to be joined comprising a single cavity, e.g. a groove
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    • B29C65/56—Joining or sealing of preformed parts, e.g. welding of plastics materials; Apparatus therefor using mechanical means or mechanical connections, e.g. form-fits
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    • B29C65/603—Riveting or staking using extra riveting elements, i.e. the rivets being non-integral with the parts to be joined the rivets being pushed in blind holes
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    • B29C66/01—General aspects dealing with the joint area or with the area to be joined
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    • B29C66/50—General aspects of joining tubular articles; General aspects of joining long products, i.e. bars or profiled elements; General aspects of joining single elements to tubular articles, hollow articles or bars; General aspects of joining several hollow-preforms to form hollow or tubular articles
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    • B29C66/53—Joining single elements to tubular articles, hollow articles or bars
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Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Mechanical Engineering (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
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  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Neurology (AREA)
  • Epidemiology (AREA)
  • Transplantation (AREA)
  • Dentistry (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Ceramic Engineering (AREA)
  • Chemical & Material Sciences (AREA)
  • Dermatology (AREA)
  • Medicinal Chemistry (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
  • Materials For Medical Uses (AREA)
  • Lining Or Joining Of Plastics Or The Like (AREA)
  • Treatment Of Fiber Materials (AREA)

Claims (34)

1. Имплантат (7) для создания неподвижного соединения с тканью, для соединения ткани с другой тканью или с искусственным элементом, замещающим или поддерживающим другую ткань, или являющимся вспомогательным терапевтическим устройством, отличающийся тем, что хотя бы часть имплантата (7) состоит из материала, переходящего в жидкое состояние под действием механической энергии, при этом материал, переходящий в жидкое состояние, помещается на имплантате (7) таким образом, что он может вступать в контакт с тканью и может переходить в возбужденное состояние под действием механических колебаний и одновременно вдавливаться в ткань с целью ожижения хотя бы части материала, переходящего в жидкое состояние, и вдавливания его в отверстия ткани.
2. Имплантат по пункту 1, отличающийся тем, что в качестве материала, переходящего в жидкое состояние, применяется термопластический или тиксотропный материал.
3. Имплантат по одному из пунктов 1 или 2, отличающийся тем, что в состав материала, переходящего в жидкое состояние, входит хотя бы один ресорбируемый компонент.
4. Имплантат по одному из пунктов 1-3, отличающийся тем, что в состав материала, переходящего в жидкое состояние, входят также вещества, выполняющие другие функции.
5. Имплантат по одному из пунктов 1-4, отличающийся тем, что он выполняется в виде шпильки или штифта.
6. Имплантат по пункту 5, отличающийся тем, что материал, переходящий в жидкое состояние, располагается на поверхности дальнего конца имплантата и/или на цилиндрической поверхности имплантата и тем, что у имплантата есть сердечник (11), выполненный из материала, не переходящего в жидкое состояние.
7. Имплантат по пункту 5, отличающийся тем, что в его состав входит гильза (13), выполненная из материала, не переходящего в жидкое состояние, и тем, что материал, переходящий в жидкое состояние, располагается внутри гильзы, и тем, что в гильзе выполнены отверстия (58) для выхода материала, переходящего в жидкое состояние.
8. Имплантат по пункту 7, отличающийся тем, что материал, переходящий в жидкое состояние, является ресорбируемым, и тем, что у сердечника (11) или гильзы (13) имеется поверхность, хотя бы часть которой является биоактивной.
9. Имплантат по одному из пунктов 4-8, отличающийся тем, что в его состав входят средства фиксации (14, 15), располагаемые на переднем конце имплантата.
10. Имплантат по одному из пунктов 1-4, отличающийся тем, что он выполнен в форме пластины (35 и 36) или пленки (35).
11. Имплантат по пункту 10, отличающийся тем, что пластина или пленка (35) выполнена в один слой.
12. Имплантат по пункту 10, отличающийся тем, что пластина (35 или 36) или пленка состоит из слоя материала, переходящего в жидкое состояние, и слоя материала, не переходящего в жидкое состояние, при этом материал, переходящий в жидкое состояние, покрывает хотя бы часть одной поверхности материала, не переходящего в жидкое состояние, и эти два слоя соединены в один с помощью неподвижного соединения или неразъемного соединения материалов.
13. Имплантат по одному из пунктов 1-12, отличающийся тем, что он выполнен в виде средства анкеровки для искусственного опорного или фиксационного элемента, для искусственного сустава, для искусственного зуба, моста или зубного протеза, для шовной нити, для церкляжной проволоки, или для вспомогательного терапевтического устройства.
14. Устройство (1) для имплантации имплантатов (7) по одному из пунктов 1-13, при этом в состав данного устройства входит генератор (2), колебательный элемент и резонатор (6), при этом генератор (2) предназначен для возбуждения в колебательном элементе механических колебаний, а резонатор (6) и колебательный элемент образуют колебательный модуль (3), и резонатор (6) активно соединяется с имплантатом (7) для передачи механических колебаний и предназначен для вдавливания имплантата (7) в ткань, отличающееся тем, что в состав устройства также входит направляющая имплантата, опорой для которой служит кожух или передающий элемент.
15. Устройство для имплантации по пункту 14, отличающееся тем, что оно обеспечивает механические колебания резонатора (6) на частоте от 2 до 200 кГц.
16. Устройство для имплантации по одному из пунктов 14 или 15, отличающееся тем, что оно обеспечивает настройку на разные частоты механических колебаний, частоты разных форм и/или различные пульсации энергии.
17. Устройство для имплантации по одному из пунктов 14-16, отличающееся тем, что резонатор (6) или дальняя часть резонатора (6) заменяема и может стерилизоваться.
18. Устройство для имплантации по одному из пунктов 14-17, отличающееся тем, что резонатор (6) используется для фиксации имплантата (7) типа шпильки или штифта.
19. Набор для создания соединений с тканями, при этом в состав упомянутого набора входит устройство (1) для имплантации, в состав которого входит генератор (2), колебательный элемент и резонатор (6), при этом генератор (2) предназначен для возбуждения в колебательном элементе механических колебаний, а резонатор (6) и колебательный элемент образуют колебательный модуль (3), и резонатор (6) активно соединяется с имплантатом (7) для передачи механических колебаний и предназначен для вдавливания имплантата (7) в ткань, в состав упомянутого набора входит также множество имплантатов (7) по одному из пунктов 1-13.
20. Набор по пункту 19, отличающийся тем, что на дальнем конце резонатора (6) устройства (1) для имплантации устанавливается средство фиксации, и тем, что имплантаты (7) выполнены в виде шпильки или штифта и их ближние концы включают средства фиксации, переходящие в средства фиксации резонатора (6).
21. Набор по одному из пунктов 19 или 20, отличающийся тем, что в его состав входят разные имплантаты (7) типа шпильки или штифта, а также резонаторы (6) или дальние части резонаторов, чьи дальние поверхности сопрягаются с ближними сечениями имплантатов.
22. Набор по одному из пунктов 19-21, отличающийся тем, что хотя бы часть имплантатов (7) выполнена в виде шпильки и что в состав набора также входят дрели, диаметр которых соответствует наибольшему диаметру имплантатов (7) для обеспечения фрикционной посадки.
23. Набор по одному из пунктов 19-22, отличающийся тем, что хотя бы часть имплантатов (7) содержит материал, переходящий в жидкое состояние, находящийся в гильзе (13) с отверстиями (58), и тем, что в состав набора также входит хотя бы один резонатор (6) или дальняя часть резонатора, сечение которой сопрягается с ближним внутренним сечением гильзы (13).
24. Набор по одному из пунктов 19-23, отличающийся тем, что в состав набора также входят направляющие (82) с отверстиями и хотя бы один резонатор (6) или дальняя часть резонатора, сечение которого сопрягается с отверстием.
25. Набор по одному из пунктов 19-24, отличающийся тем, что в его состав также входит стерильное покрытие для устройства (1) для имплантации.
26. Набор по одному из пунктов 19-25, отличающийся тем, что устройство (1) для имплантации обеспечивает настройку на разные частоты механических колебаний, частоты разных форм и/или различные пульсации энергии, и тем, что в состав набора также входят инструкции по настройке для разных имплантатов.
27. Дополнительный набор с одним имплантатом или большим числом имплантатов (7) по одному из пунктов 1-13, при этом в состав упомянутого дополнительного набора входят также инструкции для имплантации имплантатов с помощью энергии механических колебаний.
28. Способ имплантации имплантатов (7) по одному из пунктов 1-13 с помощью устройства для имплантации, в состав которого входит генератор (2), колебательный элемент и резонатор (6), при этом генератор (2) предназначен для возбуждения в колебательном элементе механических колебаний, а резонатор (6) и колебательный элемент образуют колебательный модуль (3), и резонатор (6) активно соединяется с имплантатом (7) для передачи механических колебаний и предназначен для вдавливания имплантата (7) в ткань, при этом способ включат следующие этапы:
позиционирование имплантата (7) на ткани таким образом, что области имплантатов из материала, переходящего в жидкое состояние, входят в контакт или могут входить в контакт с тканью в том месте, где на поверхности ткани имеются неровности или отверстия, обеспечивающие неподвижное соединение, или в том месте, где такие неровности поверхности или отверстия могут быть образованы гидростатическим давлением;
воздействие на имплантат механическими колебаниями с одновременным вдавливанием имплантата в ткань до тех пор, пока хотя бы часть материала, переходящего в жидкое состояние, не будет ожижена и вдавлена в упомянутые поверхностные неровности или отверстия;
повторное отверждение материала, переходящего в жидкое состояние, при вдавливании имплантата в ткань.
29. Способ по пункту 28, отличающийся тем, что ткань является частью кости человека или животного, частью хряща, частью связки или частью сухожилия (10, 20, 50, 72, 73).
30. Способ по одному из пунктов 28 или 29, отличающийся тем, что создаваемое соединение является точечным соединением в глубину.
31. Способ по одному из пунктов 28-30, отличающийся тем, что отверстие выполняется в ткани перед имплантацией, при этом в данное отверстие помещается имплантат (7).
32. Способ по одному из пунктов 28-31, отличающийся тем, что тканью является кость с корковым слоем (22) и губчатой костью (23) и тем, что перед имплантацией вскрывается хотя бы корковый слой (22).
33. Способ по одному из пунктов 28 или 29, отличающийся тем, что создаваемое соединение является поверхностным соединением с большой площадью поверхности.
34. Способ по пункту 33, отличающийся тем, что перед позиционированием имплантата (7) соответствующим областям поверхности ткани придается шероховатость.
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CA2439533A1 (en) 2002-09-12
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EP1363543A1 (de) 2003-11-26
IL157169A0 (en) 2004-02-08
US8323323B2 (en) 2012-12-04
US9615872B2 (en) 2017-04-11
DE50208067D1 (de) 2006-10-19
US20150105862A1 (en) 2015-04-16
US8221477B2 (en) 2012-07-17
US8932337B2 (en) 2015-01-13
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US20130066384A1 (en) 2013-03-14
US8221475B2 (en) 2012-07-17
CA2439533C (en) 2009-11-03
US20170252082A1 (en) 2017-09-07
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RU2314768C2 (ru) 2008-01-20
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US20130060265A1 (en) 2013-03-07
US7335205B2 (en) 2008-02-26
US20070265622A1 (en) 2007-11-15
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US20160074083A1 (en) 2016-03-17
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US9924988B2 (en) 2018-03-27
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